Alfonso Rodriguez-Baeza

Morphological Characteristics and Distribution Pattern of the Arterial Vessels in Human Cerebral Cortex: A Scanning Electron Microscope Study

The human cerebral cortex is supplied by vessels that arise from the pial arteries. These vessels give rise to a dense vascular network that is highly interconnected. Cortical arteries have been classified in different categories. Both their angioarchitectonic pattern and anatomical structures involved in their regulation are not fully understood.

PERIVASCULAR STRUCTURES IN CORROSION CASTS OF THE HUMAN CENTRAL NERVOUS SYSTEM : A CONFOCAL LASER AND SCANNING ELECTRON MICROSCOPE STUDY

Scanning electron microscopy (SEM) of microvascular corrosion casts revealed perivascular structures that resembled smooth muscle and pericyte cells. Although these structures have been studied in widely different experimental contexts, their origin, function, and distribution pattern in different tissues are not understood.

Effects of forearm muscles on carpal stability

Thirty cadaveric forearms were tested using a wrist testing apparatus specifically designed to investigate the mechanisms of muscle stabilization of the wrist. The specimens were set in a jig allowing the distal row to migrate proximally and to rotate around the pronosupination forearm axis. Five wrist motor tendons (FCR, FCU, ECU, ECRL and APL) were loaded with specific weights. Reactive rotations of the scaphoid, triquetrum and capitate were measured by an electromagnetic motion tracking device. When all five tendons were loaded simultaneously, the capitate supinated and the proximal row predominantly supinated and flexed. By contrast, when the ECU was loaded in isolation, it caused pronation to both proximal and distal rows. The FCR exhibited a mixed effect pronating the capitate and triquetrum, whilst supinating the scaphoid. Based on this, a hypothesis is proposed linking wrist stability to the balance of wrist pronators (ECU and FCR) and supinators (FCU, ECRL and APL).

The Role of the Flexor Carpi Radialis Muscle in Scapholunate Instability

PURPOSE The flexor carpi radialis (FCR) muscle has been suggested to act as a dynamic scaphoid stabilizer. Because the FCR tendon uses the scaphoid tuberosity as a pulley to reach its distal insertion onto the second metacarpal, it has been hypothesized that FCR muscle contraction generates a dorsally directed vector that resists the scaphoid from rotating into flexion. The purpose of the present study was to validate that hypothesis and clarify the role of the FCR as a dynamic scaphoid stabilizer. METHODS Ten fresh cadaver wrist specimens were tested. A custom-designed testing apparatus was used to hold the forearm and wrist vertically, in neutral forearm rotation. A 6-degree-of-freedom, electromagnetic motion-tracking device, with sensors attached to the scaphoid, triquetrum, capitate, and radius, was used to monitor spatial changes in carpal alignment as a result of isometrically loading the FCR in 5 different wrist positions. RESULTS In all specimens and all wrist positions, the scaphoid consistently rotated into flexion when the FCR was loaded. It also exhibited variable degrees of pronation or supination, depending on whether the wrist was in flexion or extension. When the wrist was loaded in neutral position, the scaphoid consistently supinated and the triquetrum pronated, these differences being statistically significant (p < .05). CONCLUSIONS The scaphoid consistently rotated into flexion and supination when the FCR was loaded, while the triquetrum rotated in flexion and pronation. The positive effects of FCR muscle re-education in dynamic scapholunate instabilities can be explained not by this muscles capability of extending the scaphoid, as has often been hypothesized, but by its ability to induce supination to the scaphoid and pronation to the triquetrum. Such opposite rotations are likely to result in a dorsal coaptation of the scapholunate joint with relaxation of the dorsal scapholunate ligament.

Scavenger function of resident autofluorescent perivascular macrophages and their contribution to the maintenance of the blood-retinal barrier.

PURPOSE The retina contains two distinct populations of monocyte-derived cells: perivascular macrophages, and microglia. The present study was undertaken to evaluate the presence and function in mouse and human retinas of a subtype of resident perivascular macrophages with scavenger function, different from microglia, in physiological conditions and during retinopathy. METHODS Perivascular macrophages were characterized by means of confocal microscopy, electron microscopy, and flow cytometry analyses. Two murine models of blood-retinal barrier breakdown and photoreceptor degeneration were used to analyze the role of these macrophages during retinopathy. RESULTS The macrophages analyzed constituted a small population of resident perivascular cells different from microglia, since they were Iba-1 negative. Although these cells expressed F4/80 and CD11b antigens in common with microglia, they also expressed BM8 and MOMA-2 epitopes, which are macrophagic markers not expressed by microglia. Perivascular macrophages emitted autofluorescence due to cytoplasmic inclusions containing protein-bound oxidized lipids. They constitutively expressed the scavenger receptor class A and moved along blood vessels, providing an additional coating to thinner areas of the basement membrane. Moreover, they accumulated blood-borne horseradish peroxidase and acetylated low-density lipoprotein in healthy retinas. In addition, during blood-retinal barrier breakdown and photoreceptor degeneration, these cells migrated to the lesion site. CONCLUSIONS All these morphologic and functional features are consistent with those described for brain Mato cells. Thus, this study showed the presence of autofluorescent perivascular macrophages, different from microglia, with a scavenger function that may contribute to the maintenance of the blood-retinal barrier in healthy conditions and that are also involved in retinopathy.

Role of the extensor carpi ulnaris and its sheath on dynamic carpal stability

Ten cadaveric forearms were tested using a wrist testing apparatus specifically designed to investigate the mechanisms of muscle stabilization of the wrist. The specimens were set in a jig allowing the distal row to migrate proximally and rotate around the axis of pronosupination. The extensor carpi ulnaris (ECU) was loaded with specific weights. Reactive rotations of the scaphoid, triquetrum, and capitate were measured by an electromagnetic motion tracking device. Loading the ECU caused pronation of both proximal and distal rows. After sectioning its sheath, the overall direction of the movement remained unchanged, but there was a 40% and 50% decrease of the pronation power over the distal and proximal carpal row, respectively. In addition to stabilizing the distal radiolunar joint, the ECU is an important structure that contributes to the dynamic stability of the wrist. Furthermore, its sheath plays a crucial role in maintaining the effect of the ECU muscle on the carpus.

Effectiveness of a Footprint Guide to Establish an Anatomic Femoral Tunnel in Anterior Cruciate Ligament Reconstruction: Computed Tomography Evaluation in a Cadaveric Model

PURPOSE To compare drilling the femoral tunnel with an offset aimer and BullsEye guide (ConMed Linvatec, Largo, FL) to perform an anatomic single-bundle reconstruction of the anterior cruciate ligament (ACL) through the anteromedial portal. METHODS Seven matched pairs of cadaveric knees were studied. The intent was to drill the femoral tunnel anatomically in all cases. In group A the femoral tunnel was drilled arthroscopically with an offset aimer. In group B the femoral tunnel was drilled arthroscopically with the BullsEye guide. Two tunnels were drilled through the same entry point in each knee. One was done at 110° of knee flexion and the other at 130°. They were scanned by computed tomography and reconstructed 3-dimensionally. Volume-rendering software was used to document relations of the drilled tunnel to the bony anatomy and tunnel length. RESULTS In group B the femoral tunnel was placed at the center of the femoral insertion site. The center of the tunnel was 9.4 mm from the high cartilage margin and 8.6 mm from the low cartilage margin. In group A the tunnels were placed deeper (5.4 mm and 12.6 mm, respectively) (P = .018). There were no differences in tunnel length for either knee flexion degree. Three of the tunnels drilled at 110° in group A compromised the posterior tunnel wall and measured less than 25 mm in length. CONCLUSIONS Accurate placement in the center of the femoral footprint of the ACL is better accomplished with the BullsEye guide rather than 5-mm offset aimers. Five-millimeter offset aimers might cause posterior tunnel blowout and present the risk of obtaining short tunnels when performing oblique femoral tunnel placement through the anteromedial portal at 110° of knee flexion. CLINICAL RELEVANCE The BullsEye guide might be better than standard offset aimers in the performance of anatomic single-bundle ACL reconstruction.

Morphological characterization of pecteneal hyalocytes in the developing quail retina

The periphery of the vitreous body contains a population of cells termed hyalocytes. Despite the existence for more than one century of publications devoted to the pecten oculi, a convoluted coil of blood vessels that seems to be the primary source of nutrients for the avian avascular retina, little information can be found concerning the pecteneal hyalocytes. These cells are situated on the inner limiting membrane in close relationship with the convolute blood vessels. To characterize the origin and macrophagic activity of pecteneal hyalocytes, we have analysed two different stages of quail eye development using histochemistry and immunohistochemistry. Pecteneal hyalocytes express the QH1 epitope and cKit, confirming that these cells belong to the haematopoietic system. They also express vimentin, an intermediate filament protein present in cells of mesenchymal origin and very important for differentiation of fully active macrophages. However, similarly as described in porcine hyalocytes, pecteneal hyalocytes express the glial fibrillary acidic protein, a recognized neuroglial marker. Pecteneal hyalocytes did not express other neuroglial markers, such as glutamine synthetase or S100. Acidic phosphatase was activated and Lep100 was found in secondary lysosomes, confirming phagocytic activity of pecteneal hyalocytes during ocular development. Pecteneal hyalocytes strongly react with RCA‐I, WFA, WGA, PNA, SNA, LEA and SBA lectins, whereas other avian macrophages from thymus and the bursa of Fabricius did not bind PNA, SNA and LEA lectins. Interestingly, WGA lectin reacts with all kinds of avian macrophages, including pecteneal hyalocytes, probably reflecting the specific binding of WGA to components of the phagocytic and endocytic pathways. In conclusion, pecteneal hyalocytes are a special subtype of blood‐borne macrophages that express markers not specifically associated with the haematopoietic system.

L-Ferritin Binding to Scara5: A New Iron Traffic Pathway Potentially Implicated in Retinopathy

Iron is essential in the retina because the heme-containing enzyme guanylate cyclase modulates phototransduction in rods and cones. Transferrin endocytosis is the classical pathway for obtaining iron from the blood circulation in the retina. However, the iron storage protein ferritin has been also recently proposed as an iron carrier. In this study, the presence of Scara5 and its binding to L-ferritin was investigated in the retina. Our results showed that Scara5, the specific receptor for L-ferritin, was expressed in mouse and human retinas in many cell types, including endothelial cells. Furthermore, we showed that intravenously injected ferritin crossed the blood retinal barrier through L-ferritin binding to Scara5 in endothelial cells. Thus, suggesting the existence of a new pathway for iron delivery and trafficking in the retina. In a murine model of photoreceptor degeneration, Scara5 was downregulated, pointing out this receptor as a potential player implicated in retinopathy and also as a possible therapeutic target.

Imaging of cellular aging in human retinal blood vessels.

To date two main aging vascular lesions have been reported in elderly human retinas: acellular capillaries and microaneurysms. However, their exact mechanism of formation remains unclear. Using high resolution microscopy techniques we revise cellular alterations observed in aged human retinal vessels, such as lipofuscin accumulation, caveolae malfunction, blood basement membrane disruption and enhanced apoptosis that could trigger the development of these aging vascular lesions. Moreover, we have generated a set of original images comparing retinal vasculature between middle and old aged healthy humans to show in a comprehensive manner the main structural and ultrastructural alterations occurred during age in retinal blood vessels.