Regular, moderate consumption of red wine is linked to a reduced risk of coronary heart disease and to lower overall mortality, but the relative contribution of wine's alcohol and polyphenol components to these effects is unclear. Here we identify procyanidins as the principal vasoactive polyphenols in red wine and show that they are present at higher concentrations in wines from areas of southwestern France and Sardinia, where traditional production methods ensure that these compounds are efficiently extracted during vinification. These regions also happen to be associated with increased longevity in the population.

PURPOSE:To explore the mode of spread of disease between the perirenal space and the perivascular central retroperitoneum and to determine the anatomy along the medial border of the perirenal space.MATERIALS AND METHODS:Anatomic dissection, injection of latex, and observation of cross sections of the abdomen were performed in nine cadavers. Attention was paid to the juncture of the central prevertebral, perivascular, and extraperitoneal regions, and the perirenal space. Anatomic findings were correlated with observations made at computed tomography (CT) in 82 patients with retroperitoneal hemorrhage (n = 24), inflammation (n = 37), and neoplasia (n = 21) involving the perirenal spaces or the central retroperitoneum.RESULTS:Along most of the length of each kidney, no apparent fascia separates the perirenal space from the central retroperitoneum. At this location, septa between fat lobules form a fenestrated multitier barrier. These septa were imperceptible on CT scans obtained in healthy individuals. After injection of latex in cadavers, this potential barrier was seen. In the clinical study, spread of disease was allowed in only 38 (30%) of 128 instances of potential spread. Spread was facilitated along the renal vessels and the interlobular septa.CONCLUSION:Beyond the kidneys, the renal fascia is closed, forming a cone superiorly and an inverted cone inferiorly. A network of interlobular septa acted as a barrier or pathway to the free spread of disease from the perirenal space to the central retroperitoneum or from the central retroperitoneum to the perirenal space.

OBJECTIVE, The prevailing concept is that lack of fusion of the anterior and posterior renal fasciae caudally (an open cone) allows free communication between the perirenal space and the extraperitoneal portion of the pelvis, However, perirenal disease rarely extends into the pelvis and an open cone has not been observed on CT scans, Accordingly, we determined the anatomy of the caudal extent of the cone of the renal fasciae in cadavers and on CT scans,MATERIALS AND METHODS. Anatomic dissections of the lower portion of the retroperitoneum and the extraperitoneal portion of the pelvis were made in eight cadavers, Two cadavers were intact, two had colored latex injected into the perirenal space before dissections, and the abdomens and pelves of four were sectioned transversely in 3- to 5-cm-thick slices, The renal fasciae were traced on transparent films placed on the cross sections, and computer-generated three-dimensional representations of the tracings were made, These anatomic findings were correlated with observations made on CT scans of 59 consecutive patients with diseases involving the lower part of the retroperitoneum and the extraperitoneal portion of the pelvis (32 patients with hemorrhage, 16 with inflammatory processes, and 11 with neoplastic conditions).RESULTS, The anatomic study showed that the anterior and posterior renal fasciae merge to form a single multilaminar fascia in the iliac fossa, Anteriorly, this common fascia is loosely connected to the parietal peritoneum. Posteriorly lies the caudal continuation of the posterior pararenal compartment. This joins with the laterocaudal continuation of the central part of the retroperitoneum, which contains the iliac vessels, The distal part of the ureter lies within the caudal continuation of the single multilayered renal fascia, The CT studies done in patients showed that extension of the perirenal processes to the pelvis and vice versa was both restrained and uncommon: no direct extension of any abnormalities was observed in either direction, and laminar thickening of the fasciae was seen in one fifth of the patients. Similarly, no inferior communication of the perirenal space with the anterior or posterior pararenal spaces was seen,CONCLUSION, There is an anatomic barrier between the inferior perirenal space and the extraperitoneal pelvis formed by the fusion of the leaves of the renal fasciae into a single multilaminar fascia that acts as a barrier of disease extension, The multilaminar nature of this fascia, however, may also act as a filter, allowing some permeability between its layers, This potential interlaminar pathway is rare and is manifested as fascial thickening on CT scans, This laminar filter-barrier observation explains the lack of extension of perirenal diseases into the pelvis.

Osteocalcin, one of the vitamin K-dependent bone proteins, has recently been implicated in bone resorption. To explore this hypothesis, bone and serum osteocalcin were measured in three different osteopetrotic rat mutations characterized by reduced bone resorption. These three mutations (ia/ia, tl/tl, and op/op) exhibit heterogeneity with respect to osteoclast number and activity and response to being cured by bone marrow transplantation. Calvarial bone osteocalcin was present in normal amounts, but difficult to extract, in ia/ia rats that have increased numbers of inactive osteoclasts. Bone osteocalcin was greatly decreased in op/op (53-60% of control) and tl/tl (64-73% of control) osteopetrotic rats, in which osteoclasts are both reduced in number and inactive. These decreases in osteocalcin levels in bone coexist with elevated serum levels of osteocalcin in all three mutations. Since osteocalcin synthesis is known to be stimulated by 1,25(OH)2D3, the increase in serum osteocalcin may be a reflection of the elevated blood levels of 1,25(OH)2D3 known to occur in each of these mutations. These findings indicate that the composition of osteopetrotic bone is abnormal with respect to osteocalcin in the two rat osteopetrotic mutations showing decreased osteoclast numbers. Considered together with the emerging evidence that the extracellular matrix in many developing tissues plays a role in cell recruitment and differentiation, these data suggest that osteocalcin abnormalities may be a contributing factor to the spectrum of osteoclast aberrations in osteopetrosis.

Osteopetrosis is a metabolic bone disease inherited in a number of species including human beings and characterized by a generalized increase in skeletal density detected radiographically. This condition results primarily from reduced osteoclast function which produces partial or complete absence of marrow spaces, a variable compensatory hepatosplenomegaly, interferences with tooth eruption and certain neurological complications. Experimental investigations of some mutations have shown that restoration of bone resorption and recovery from the disease follow bone marrow transplantation. These data indicate that in these mutations, including some children, the defect is intrinsic to osteoclasts or their stem cells. In other mutations in animals and children, bone marrow transplants do not restore bone resorption and the defect is believed to be one of local environmental products or signals whose importance in cell differentiation and regulation is becoming increasingly appreciated. These data, reviewed with respect to the emerging cell biology of the osteoclast, indicate that osteopetrotic mutations have much to teach us about the regulation of bone metabolism.

Previous reports have described an accelerated induction of new attachment and repair of furcations in dogs after treatment of roots surfaces with citric acid, but few controlled clinical studies have examined its usefulness in surgical treatments for periodontitis. This study compared the effects of a comprehensive surgical plaque control procedure with or without citric acid treatment for generalized and localized effects on gingival height, probing pocket depth and attachment level in 72 teeth in 3 patients who were treated surgically for moderate periodontitis and examined every 3 months for 1 year. No statistically significant differences in the effects of the 2 treatments were observed. These observations suggest that there is no clinical advantage of citric acid conditioning of the root surface during surgical treatment of periodontitis.

The staining intensity and inhibitor sensitivity of acid phosphatase activity was determined histochemically in various tissues of normal and ia rat pups by the use of freeze-dried whole body sections. Activity was determined using alpha-naphthylphosphate as substrate and hexazonium pararosaniline as coupler. Sections from ia rats (6 and 24 days old) showed markedly higher enzyme activity in bone than sections from normal littermates. However, there were no differences between ia and normal pups in acid phosphatase activity in soft tissues and developing teeth. Preincubation of sections with 1-100 mM sodium dithionite (an iron-binding agent) caused a dose-related inhibition of enzyme activity in bone of ia and normal pups, but only slight inhibition of activity in soft tissues. Partial restoration of the dithionite-inhibited activity in bone was achieved by subsequent preincubation in 1 mM FeCl2. Addition of 100 mM sodium tartrate to the staining solution of non-preincubated sections caused almost complete inhibition of activity in soft tissues and the developing teeth but no inhibition of the activity in bone that was sensitive to sodium dithionite. These data indicate a) that sodium dithionite can be used as a specific histochemical inhibitor of the tartrate-resistant acid phosphatase and b) that the source of increased acid phosphatase activity in bone from ia rats is mostly from the tartrate-resistant acid phosphatase.