Structure of the interendothelial cell cleft

Since the work of Bundgaard it is known that the interendothelial cell cleft is a narrow, but open, sometimes highly convoluted gap linking the blood vessel lumen with the subendothelial space. A remarkable feature of this cleft is its constant width. It is here suggested that electrostatic repulsions, and the presence of a system of posts between the walls act to maintain cleft width. Contrary to intuition the presence of posts would not constitute an intolerable increase in hydrodynamic resistance, since no massive posts are necessary. Links between the walls involving only a single macromolecular chain each, which would be very difficult to detect ultrastructurally, would, nevertheless, particularly when charged, act as extremely stiff springs of essentially fixed length. A detailed calculation is presented to show how this idea could work and it is proposed that similar such posts support the subendothelial layers. Recent ultrastructural evidence in support of single chain links is quoted.     

Brain circuitry outside the synaptic cleft

A growing body of experimental evidence suggests that astroglia, and possibly microglia, play an important part in regulating synaptic networking of the brain. It has also emerged that extracellular matrix (ECM) structures that enwrap synaptic connections can generate molecular signals affecting both neuronal and glial activity. Thus it appears that the mechanism of information processing in the brain, which has hitherto been associated almost exclusively with neural circuits, could also involve informative signal exchange outside the synaptic cleft. In this Theme Issue, research teams including leading experts on astroglia–neuron communication and on ECM signalling report their recent findings, share their views and discuss future conceptual advances in the field. Potential implications for drug development and new therapeutic targets with regard to some common neurological conditions are discussed throughout the issue.     

Surgical treatment of the cleft foot

Between 1970 and 1997, we treated a total of 32 cleft feet in 21 patients (11 male and 10 female). We classified cases of cleft foot on the basis of the number of central ray deficiencies. Fourteen patients with 22 cleft feet were followed up for more than 1 year postoperatively (9 feet had no or one central ray deficiency, and 13 feet had two or three central ray deficiencies). The mean follow-up period was 8.8 years. The objective of this study was to evaluate the results of operative treatment of cleft foot. We evaluated the results of three methods: simple closure of the cleft, application of a double-pedicled flap, and insertion of a silicone block. Cosmetic complications, including widening of the foot, hypertrophic scarring, pigmentation of the grafted skin, and overlapping of the toes, were observed in patients with two or three central ray deficiencies. Few functional complications were observed: None of the patients experienced gait disturbances, although one patient complained of pain following walking. Roentgenography showed that the distance between the first and fifth metatarsals was 86 percent of that of the contralateral foot. When treating patients with no or one central ray deficiency, satisfactory results can be expected with simple closure of the cleft. However, in patients with two or three central ray deficiencies, it is difficult to obtain satisfactory results with simple closure of the cleft or application of a double-pedicled flap. Therefore, silicone block insertion to correct the defect is recommended when there is more than one central ray deficiency.     

Genetics of cleft lip and cleft palate in China.

During the past 10 years, 60 cases of cleft lip with or without cleft palate [CL(P)] were recorded among 45,072 newborns at Shanghai International Peace Maternity and Infant Hospital, China. The incidence was 1.33 per 1,000 births. The family histories of 163 CL(P) patients were analyzed. The incidences of CL(P) in the first-, second-, and third-degree relatives of CL(P) patients were 11/246 (4.47%), 10/1,032 (0.97%), and 6/1,727 (0.35%), respectively. Of the 163 probands, three had a history of consanguinity of the parents (1.8%), in contrast to 0.77% in the general population. These data are suggestive of multifactorial inheritance. The heritability of CL(P) in our study calculated by Falconer's formula was 77.6%.