The innervation of the enthesis organ of the rat achilles tendon

PURPOSE: The enthesis (bony insertion of a tendon or ligament) is a common site of overuse injuries in sport. Because enthesopathies can be painful, it is often assumed that the enthesis is highly innervated-but with little evidence to support the assumption. The Achilles tendon has one of the most complex of attachment sites, for together with adjacent tissues, the enthesis itself forms part of an 'enthesis organ' which reduces stress concentration at the bony interface. These adjacent structures include a 'sesamoid fibrocartilage' in the tendon, a 'periosteal fibrocartilage' on the superior tuberosity of the calcaneus, and a fat pad which extends into the retrocalcaneal bursa during plantarflexion. The purpose of the present study is to investigate the innervation of the whole enthesis organ complex. METHODS: The tendon attachment site was removed from one leg of 3 male Wistar rats at each of the following ages-neonates, 4 weeks, 12 weeks, and 24 months. The tissue was fixed in 4% paraformaldehyde, prepared for routine indirect immunohistochemistry and cryosectioned in the sagittal plane. Serial sections were immunolabelled with polyclonal antibodies to protein gene product 9.5, substance P, calcitonin gene related peptide and neurofilament 200. Histology reference sections were stained with toluidine blue. RESULTS: No nerve fibers were detected at the enthesis itself or in the sesamoid and periosteal fib ro cartilages in rats of any age. However, the fat pad was richly supplied by nerve fibers which immunolabelled with all of the antibodies used. It also contained abundant mast cells. The innervation of the fat pad was confirmed in 10 human Achilles tendons obtained from the Department of Forensic Medicine at the Ludwig-Maximilians-Universität, in accordance with the ethical regulations of Munich University. The nerve fibers again immunolabelled with all antibodies and formed an intricate network in which the fibers lay between individual fat cells. CONCLUSION: We suggest that healthy entheses are not innervated because of the high levels of mechanical loading experienced at insertion sites. However, the striking innervation of the adjacent fat pad suggests that it may have an unheralded proprioceptive role monitoring changes in insertional angle between tendon and bone that occur as a result of foot movements

An immunohistochemical study of the tissue bridging adult spondylolytic defects—the presence and significance of fibrocartilaginous entheses

Introduction Spondylolytic spondylolisthesis is an osseous discontinuity of the vertebral arch that predominantly affects the fifth lumbar vertebra. Biomechanical factors are closely related to the condition. An immunohistochemical investigation of lysis-zone tissue obtained from patients with isthmic spondylolisthesis was performed to determine the molecular composition of the lysis-zone tissue and enable interpretation of the mechanical demands to which the tissue is subject. Methods: During surgery, the tissue filling the spondylytic defects was removed from 13 patients. Twelve spondylolistheses were at the L5/S1 level with slippage being less than Meyerding grade II. Samples were methanol fixed, decalcified and cryosectioned. Sections were labelled with a panel of monoclonal antibodies directed against collagens, glycosaminoglycans and proteoglycans. Results: The lysis-zone tissue had an ordered collagenous structure with distinct fibrocartilaginous entheses at both ends. Typically, these had zones of calcified and uncalcified fibrocartilage labelling strongly for type II collagen and aggrecan. Labelling was also detected around bony spurs that extended from the enthesis into the lysis-zone. The entheses also labelled for types I, III and VI collagens, chondroitin four and six sulfate, keratan and dermatan sulfate, link protein, versican and tenascin. Conclusions: Although the gap filled by the lysis tissue is a pathological feature, the tissue itself has hallmarks of a normal ligament—i.e. fibrocartilaginous entheses at either end of an ordered collagenous fibre structure. The fibrocartilage is believed to dissipate stress concentration at the hard/soft tissue boundary. The widespread occurrence of molecules typical of cartilage in the attachment of the lysis tissue, suggests that compressive and shear forces are present to which the enthesis is adapted, in addition to the expected tensile forces across the spondylolysis. Such a combination of tensile, shear and compressive forces must operate whenever there is any opening or closing of the spondylolytic ga

COVID-19 and anatomy: Stimulus and initial response.

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world

Intercomparison of ILAS-II version 1.4 and version 2 target parameters with MIPAS-Envisat measurements

This paper assesses the mean differences between the two ILAS-II data versions (1.4 and 2) by comparing them with MIPAS measurements made between May and October 2003. For comparison with ILAS-II results, MIPAS data processed at the Institut für Meteorologie und Klimaforschung, Karlsruhe, Germany (IMK) in cooperation with the Instituto de Astrofísica de Andalucía (IAA) in Granada, Spain, were used. The coincidence criteria of ±300 km in space and ±12 h in time for H<sub>2</sub>O, N<sub>2</sub>O, and CH<sub>4</sub> and the coincidence criteria of ±300 km in space and ±6 h in time for ClONO<sub>2</sub>, O<sub>3</sub>, and HNO<sub>3</sub> were used. The ILAS-II data were separated into sunrise (= Northern Hemisphere) and sunset (= Southern Hemisphere). For the sunrise data, a clear improvement from version 1.4 to version 2 was observed for H<sub>2</sub>O, CH<sub>4</sub>, ClONO<sub>2</sub>, and O<sub>3</sub>. In particular, the ILAS-II version 1.4 mixing ratios of H<sub>2</sub>O and CH<sub>4</sub> were unrealistically small, and those of ClONO<sub>2</sub> above altitudes of 30 km unrealistically large. For N<sub>2</sub>O and HNO<sub>3</sub>, there were no large differences between the two versions. Contrary to the Northern Hemisphere, where some exceptional profiles deviated significantly from known climatology, no such outlying profiles were found in the Southern Hemisphere for both versions. Generally, the ILAS-II version 2 data were in better agreement with the MIPAS data than the version 1.4, and are recommended for quantitative analysis in the stratosphere. For H<sub>2</sub>O data in the Southern Hemisphere, further data quality evaluation is necessary

Biomechanical comparison of menisci from different species and artificial constructs

Background: Loss of meniscal tissue is correlated with early osteoarthritis but few data exist regarding detailed biomechanical properties (e. g. viscoelastic behavior) of menisci in different species commonly used as animal models. The purpose of the current study was to biomechanically characterize bovine, ovine, and porcine menisci (each n = 6, midpart of the medial meniscus) and compare their properties to that of normal and degenerated human menisci (n = 6) and two commercially available artificial scaffolds (each n = 3). Methods: Samples were tested in a cyclic, minimally constraint compression-relaxation test with a universal testing machine allowing the characterization of the viscoelastic properties including stiffness, residual force and relative sample compression. T-tests were used to compare the biomechanical parameters of all samples. Significance level was set at p < 0.05. Results: Throughout cyclic testing stiffness, residual force and relative sample compression increased significantly (p < 0.05) in all tested meniscus samples. From the tested animal meniscus samples the ovine menisci showed the highest biomechanical similarity to human menisci in terms of stiffness (human: 8.54 N/mm +/- 1.87, cycle 1; ovine: 11.24 N/mm +/- 2.36, cycle 1, p = 0.0528), residual force (human: 2.99 N +/- 0.63, cycle 1 vs. ovine 3.24 N +/- 0.13, cycle 1, p = 0.364) and relative sample compression (human 19.92\% +/- 0.63, cycle 1 vs. 18.72\% +/- 1.84 in ovine samples at cycle 1, p = 0.162). The artificial constructs - as hypothesized- revealed statistically significant inferior biomechanical properties. Conclusions: For future research the use of ovine meniscus would be desirable showing the highest biomechanical similarities to human meniscus tissue. The significantly different biomechanical properties of the artificial scaffolds highlight the necessity of cellular ingrowth and formation of extracellular matrix to gain viscoelastic properties. As a consequence, a period of unloading (at least partial weight bearing) is necessary, until the remodeling process in the scaffold is sufficient to withstand forces during weight bearing

Stratospheric dryness

International audienceThe mechanisms responsible for the extreme dryness of the stratosphere have been debated for decades. A key difficulty has been the lack of models which are able to reproduce the observations. Here we examine results from a new atmospheric chemistry general circulation model (ECHAM5/MESSy1) together with satellite observations. Our model results match observed temperatures in the tropical lower stratosphere and realistically represent recurrent features such as the semi-annual oscillation (SAO) and the quasi-biennual oscillation (QBO), indicating that dynamical and radiation processes are simulated accurately. The model reproduces the very low water vapor mixing ratios (1?2 ppmv) periodically observed at the tropical tropopause near 100 hPa, as well as the characteristic tape recorder signal up to about 10 hPa, providing evidence that the dehydration mechanism is well-captured, albeit that the model underestimates convective overshooting and consequent moistening events. Our results show that the entry of tropospheric air into the stratosphere at low latitudes is forced by large-scale wave dynamics; however, radiative cooling can regionally limit the upwelling or even cause downwelling. In the cold air above cumulonimbus anvils thin cirrus desiccates the air through the sedimentation of ice particles, similar to polar stratospheric clouds. Transport deeper into the stratosphere occurs in regions where radiative heating becomes dominant, to a large extent in the subtropics. During summer the stratosphere is moistened by the monsoon, most strongly over Southeast Asia

Viscoelastic testing reveals normalization of the coagulation profile 12 weeks after severe COVID-19

COVID 19 is associated with a hypercoagulable state and frequent thromboembolic complications. For how long this acquired abnormality lasts potentially requiring preventive measures, such as anticoagulation remains to be delineated. We used viscoelastic rotational thrombelastometry (ROTEM) in a single center cohort of 13 critical ill patients and performed follow up examinations three months after discharge from ICU. We found clear signs of a hypercoagulable state due to severe hypofibrinolysis and a high rate of thromboembolic complications during the phase of acute illness. Three month follow up revealed normalization of the initial coagulation abnormality and no evidence of venous thrombosis in all thirteen patients. In our cohort the coagulation profile was completely normalized three months after COVID-19. Based on these findings, discontinuation of anticoagulation can be discussed in patients with complete venous reperfusion

MIPAS reduced spectral resolution UTLS-1 mode measurements of temperature, O₃, HNO₃, N₂O, H₂O and relative humidity over ice: retrievals and comparison to MLS

During several periods since 2005 the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) on Envisat has performed observations dedicated to the region of the upper troposphere/lower stratosphere (UTLS). For the duration of November/December 2005 global distributions of temperature and several trace gases from MIPAS UTLS-1 mode measurements have been retrieved using the IMK/IAA (Institut für Meteorologie und Klimaforschung/ Instituto de Astrof´ısica de Andalucía) scientific processor. In the UTLS region a vertical resolution of 3 km for temperaure, 3 to 4 km for H2O, 2.5 to 3 km for O3, 3.5 km for HNO3 and 3.5 to 2.5 km for N2O has been achieved. The retrieved temperature, H2O, O3, HNO3, N2O, and relative humidity over ice are intercompared with the Microwave Limb Sounder (MLS/Aura) v2.2 data in the pressure range 316 to 0.68 hPa, 316 to 0.68 hPa, 215 to 0.68 hPa, 215 to 3.16 hPa, 100 to 1 hPa and 316 to 10 hPa, respectively. In general, MIPAS and MLS temperatures are biased within ±4K over the whole pressure and latitude range. Systematic, latitude-independent differences of −2 to −4K (MIPASMLS) at 121 hPa are explained by previously observed biases in the MLS v2.2 temperature retrievals. Temperature differences of −4K up to 12K above 10.0 hPa are present both in MIPAS and MLS with respect to ECMWF (European Centre for Medium-Range Weather Forecasts) and are likely due to deficiencies of the ECMWF analysis data. MIPAS and MLS stratospheric volume mixing ratios (vmr) of H2O are biased within ±1 ppmv, with indication of oscillations between 146 and 26 hPa in the MLS dataset. Tropical upper tropospheric values of relative humidity over ice measured by the two instruments differ by ±20% in the pressure range ~146 to 68 hPa. These differences are mainly caused by the MLS temperature biases. Ozone mixing ratios agree within 0.5 ppmv (10 to 20%) between 68 and 14 hPa. At pressures smaller than 10 hPa, MIPAS O3 vmr are higher than MLS by an average of 0.5 ppmv (10%). General agreement between MIPAS and MLS HNO3 is within the range of −1.0 (−10%) to 1.0 ppbv (20%). MIPAS HNO3 is 1.0 ppbv (10%) higher compared to MLS between 46 hPa and 10 hPa over the Northern Hemisphere. Over the tropics at 31.6 hPaMLS shows a low bias of more than 1 ppbv (>50%). In general, MIPAS and MLS N2Ovmr agree within 20 to 40 ppbv (20 to 40%). Differences in the range between 100 to 21 hPa are attributed to a known 20% positive bias in MIPAS N2O data