The Relationship between the Shoulder Functional Score and the Change in Labral Morphology after Arthroscopic Bankart Repair.

PURPOSE OF THE STUDY: The aim of arthroscopic Bankart repair is restoration of the anterior block mechanism and regaining stability. There are few studies that have tested the adequacy of the angle made with the glenoid and the height from the glenoid level of the repaired labral tissue, but the correlation with the clinical results is not clear. The aim of this study was to defi ne the correlation of the height and slope of the repaired labral tissue in the glenoid anterior with the clinical results. MATERIAL AND METHODS This prospective study included 20 patients who underwent an arthroscopic Bankart repair. To evaluate the labrum anatomy of the affected shoulder, 4 measurement parameters were defi ned as axial height (Ah), axial slope (As), oblique coronal height (Ch), and oblique coronal slope (Cs) on non-contrast T2 MRI. The measurements were taken preoperatively of the affected shoulder and at 1 year postoperatively of both the affected shoulder and the contralateral asymptomatic shoulder. The measured values were compared with each other and with the contralateral shoulder. Correlations of the anatomic values with the Constant-Murley scores recorded at 1, 3, 6, and 12 months postoperatively were examined with the Wilcoxon test. RESULTS The mean preoperative Constant score of the patients was 57.7 (32-77) and postoperative scores at 1, 3, 6, and 12 months were 63.6 (44-79), 77.8 (61-90), 89.6 (77-100), and 95.2 (79-100), respectively (p=0.001). There was a statistically signifi cant difference in the preoperative MRI measurements of the axial and oblique coronal plane labral height and slope values compared to the postoperative values and those of the asymptomatic contralateral shoulder (p< 0.05 for all). There was no statistically signifi cant difference between the labral height and slope values of both planes postoperatively compared to the asymptomatic contralateral shoulder (p= 0.776, p= 0.910, p= 0.132, p= 0.589, respectively). These increases in the radiological data were not found to be statistically signifi cant in the correlation analysis with the increases in the Constant-Murley scores (Ah p=0.935, As p=0.587, Ch p=0.078, Cs p=0.105). CONCLUSIONS This prospective study was conducted using conventional T2 magnetic resonance imaging, which was suffi cient for the measurement of labral height and slope. This study results showed no signifi cant correlation between the radiological and clinical outcomes. KEY WORDS: Bankart repair, labrum height, labrum slope, functional result.

Clinical importance of eosinophil count in nasal fluid in patients with allergic and non-allergic rhinitis.

Eosinophil count in nasal fluid (ECNF) was used to differentiate nasal pathologies. Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) were performed to evaluate the ECNF's accuracy in distinguishing allergic rhinitis (AR) from non-allergic rhinitis (NAR). We also evaluated the accuracy of ECNF in recognizing patients with mild and severe symptoms of rhinitis and patients with ineffective and effective clinical responses to antihistamines. 1,170 consecutive adult patients with a clinical history of rhinitis were studied. ECNF's median in AR was 6.0 and 2.0 in NAR and the best cut-off value was > 3.0, AUC = 0.75. ECNF's median in AR with mild nasal symptoms was 3.0 and 7.0 with severe symptoms, and the best cut-off value was 4.0, AUC = 0.90. ECNF's median in NAR with mild nasal symptoms was 2.0 and 8.5 with severe symptoms, and the best cut-off value was > 4.0, AUC = 0.86. ECNF's median in AR with effective clinical response to antihistamines was 4.0 and 8.0 with ineffective response, the best cut-off value was < or = 5.0, AUC = 0.94. ECNF's median in NAR with an effective clinical response to antihistamines was 1.0 and 2.0 with ineffective response, and the best cut-off value was < or = 3.0, AUC = 0.64. Our results suggest an interesting practical use of ECNF data as evaluator of the clinical severity both AR and NAR. As predictor of the clinical response to antihistamines, ECNF is accurate only in patients with AR. The ECNF's performance was moderately accurate in distinguish patients with AR and NAR.

Atherogenic forms of dyslipidaemia in women with polycystic ovary syndrome.

OBJECTIVE: Dyslipidaemia is very common in patients with polycystic ovary syndrome (PCOS) but, beyond plasma lipids, atherogenic lipoprotein (Lp) and apolipoprotein (apo) alterations are still ill defined. DESIGN: We measured concentrations of apoB, Lp(a) and small, dense low-density lipoprotein (LDL) in 42 patients with PCOS [age: 28 +/- 7 years, body mass index (BMI): 27 +/- 5 kg/m(2)] vs. 37 age- and BMI-matched healthy controls. METHODS: Elevated Lp(a) levels considered were those > 30 mg/dl while elevated apoB concentrations were those > 100 g/l. RESULTS: Polycystic ovary syndrome showed increased triglycerides levels (p = 0.0011) and lower high-density lipoprotein (HDL)-cholesterol concentrations (p = 0.0131) while total- and LDL cholesterol were similar. PCOS also showed smaller LDL size (p = 0.0005), higher levels of total small, dense LDL (p < 0.0001), higher concentrations of Lp(a), as considered as absolute values (p = 0.0143) and log-transformed (p = 0.0014), while no differences were found in apoB levels. Elevated Lp(a) concentrations were found in 24% of PCOS, while elevated apoB levels were relatively uncommon (14%). Spearman correlation analysis revealed that Lp(a) concentrations were weakly correlated only with HDL-cholesterol levels (r = -0.378, p = 0.0431). In addition, 36% of patients with PCOS with normal plasma lipid profile showed elevated levels of Lp(a), apoB or small, dense LDL. CONCLUSIONS: Atherogenic Lp abnormalities may be found in one-third of women with PCOS who have a normal lipid pattern. Future prospective studies are needed to test to which extent such atherogenic forms of dyslipidaemia may contribute to the increased cardiovascular risk in young women with PCOS.

Transglutaminase-catalyzed reactions responsible for the pathogenesis of celiac disease and neurodegenerative diseases: from basic biochemistry to clinic.

Transglutaminases (TGases) are enzymes which catalyze the cross linking of a glutaminyl residue of a protein/peptide substrate to a lysyl residue of a protein/peptide co-substrate with the formation of an N-gamma-(epsilon-L-glutamyl)-L-lysine [GGEL] cross link (isopeptidic bond) and the concomitant release of ammonia. Such cross-linked proteins are often highly insoluble. The TGases are closely related enzymes and can also catalyze other important reactions for cell life. Recently, several findings concerning the relationships between the biochemical activities of the TGases and the basic molecular mechanisms responsible for some human diseases, have been reported. For example, some neurodegenerative diseases, such as Alzheimer's disease (AD), Huntington's disease (HD), Parkinson's disease (PD), supranuclear palsy, etc., are characterized in part by aberrant cerebral TGase activity and by increased cross-linked proteins in affected brains. Our article describes the biochemistry and the physio-pathological roles of the TGase enzymes, with particular reference to human pathologies in which the molecular mechanism of disease can be due to biochemical activities of the tissue TGase enzyme (tTGase, type 2), such as in a very common human disease, Celiac Disease (CD), and also in certain neuropsychiatric disorders.

Optical analysis of the light emission from porous silicon: a hybrid polyatom surface-coupled fluorophor.

The most extensive data set yet generated correlating photoluminescence excitation (PLE) and photoluminescence (PL) spectra is presented for aged (equilibrated) porous silicon (PS) samples. The observed features, which are temperature independent over the range 10-300 K, show a detailed correlation with the results of photoacoustic spectroscopy (PAS) and with molecular electronic structure calculations. The observed energy level patterns are reproduced in the photoabsorption (PA) of PS films released after the etching of a silicon wafer. It is concluded that the energy level pattern found for the photoluminescing surface of PS results from a structure which is neither uniquely molecule- or bulk-like but represents a hybrid form for which the density of states associated with a polyatomic vibrationally excited surface-bound fluorophor dominates the nature of the observed features which are not those of a semiconductor. These fluorophor features are broadened and shifted to lower excitation energy as a result of the intimate presence of the silicon surface to which the fluorophor is bound. The dominance of the surface-bound fluorophor accounts for the temperature-independent PLE and PL features. The observed spectral features are thus suggested to be the result of a strong synergistic interaction in which the silicon surface influences the location of surface-bound fluorophor excited states whereas the nature of the vibrationally excited surface-bound fluorophor coupling to the silicon surface provides the mechanism for an enhanced vibronic structure dominated interaction and energy transfer. The observed PLE, PL, PAS, and PA measurements are found to be consistent with previous photovoltaic and photoconductivity measurements, correlating well with a surface-bound oxyhydride-like emitter. This study suggests the important role that the overtone structure of a molecule bound to a surface can play as one forms a hybrid system.

Effect of light and calcium on cyclic GMP synthesis in rod outer segments of toad retina.

The rod outer segments of toad retina contain a guanylate cyclase activity of about 3 +/- 1 nmol of cGMP formed/min per mg protein. In darkness this value is largely independent of the Ca2+ concentration, although it is enhanced by light upon lowering the Ca2+ concentration from 10(-5) to 10(-8) M. The activating effect of light on cyclase at low Ca2+ concentrations is enlarged upon increasing the light intensity. With a flash of light bleaching 7 X 10(-2) percent of rhodopsin, cyclase activity increased by a factor of 30 when Ca2+ levels dropped from 10(-5) to 10(-8) M. In view of recent observations that shortly after a flash of light the calcium activity inside the photoreceptor cell decreases, it seems likely that Ca2+ plays a regulatory role on cGMP metabolism in visual excitation.

Incorporation into lipid bilayer membranes of a photo--sensitive pigment from the honeybee compound eye.

An increase of electrical conductance up to a factor 10(2)--5-10(2) was obtained by adding, in the dark, the honeybee photopigment to a positively charged lipid bilayer. The increase in conductance was made slower by illuminating the system during the incorporation of the protein into the membrane and it was negligible when the photopigment was bleached before the incorporation. The interaction of the photopigment with the membrane is tentatively interpreted in terms of formation of channels.

The histone H1 globular region. A possible supersecondary structure from spectroscopic and statistical studies.

The central region of the basic nuclear protein, histone H1, has a highly conserved amino acid sequence and a globular structure which is still not known at atomic resolution. A possible secondary and supersecondary structure was predicted by combining experimental measurements of circular dichroism and NMR spectroscopy with a statistical method based on the amino acid sequence. Our results showed the protein fragment as being highly structured and having a total alpha-helix content of about 40%.

Adenylate kinase activity in rod outer segments of bovine retina.

The rod outer segments of bovine retina contain two different adenylate kinases: a soluble activity, which is not sensitive to calcium ion, and an activity bound to disk membranes, which is dependent on the calcium levels. In fact, the maximal activity associated to the disks is reached at Ca(2+) concentrations between 10(-6) and 10(-7) M, which is the range of calcium level actually present in the rod cell. The Michaelis-Menten kinetics of the enzyme activity on disk membranes was determined and the actual concentrations of ATP, AMP and ADP were measured in the photoreceptor outer segment. Therefore, the physiological relevance of the adenylate kinase activity was discussed considering the above results. The formation of ATP catalyzed by the enzyme seems appropriate to supply at least some of the reactions necessary for phototransduction, indicating that ATP could be regenerated from ADP directly on the disk membranes where the photoreception events take place.

Recent advances in our understanding of rhodopsin and phototransduction.

The present models of phototransduction for vertebrates and invertebrates have been reviewed and the relative literature updated. The emerging picture for vertebrate phototransduction is a result of a better knowledge of its general outlines, although some important details such as the role of calcium ions are still lacking. The molecular events involved in the rising phase of the electrical response have basically been understood, whilst those involved in response inactivation and recovery remain to be elucidated. In an overall strategy, the phototransduction in invertebrates shares a great deal of similarity with that in vertebrates but differs in the underlying molecular events. However, a complete picture of phototransduction in invertebrate photoreceptors has not yet emerged. The available data on the structure of the visual pigment rhodopsin reveal further details on the present model of the retinal-binding pocket of the protein and consequently of the "red shift" of the absorbance of retinal. The problem of the energy supplied during photoreception, in particular, the availability of ATP in the rod outer segment and the presence in the disk membranes of a Ca-ATPase are discussed. Finally, recent progress in understanding the molecular mechanisms of inherited retinal diseases and relative gene identification are summarized.

Guanylate cyclase in rod outer segments of the toad retina. Effect of light and Ca2+.

Guanylate cyclase activity was measured in disrupted rod outer segments of the toad retina. The experiments showed that cGMP is synthesized from GTP at a rate of 3 +/- 1 nmol/min per mg protein. In darkness this value is largely independent of the Ca2+ concentration, while it is enhanced by flashes of light of increasing intensity upon lowering Ca from 10-5 to 10-8 M. In view of recent observations that shortly after a flash of light calcium activity inside the photoreceptor cell decreases, it seems likely that calcium plays a regulatory role in cGMP metabolism in visual excitation.

Rhodopsin reconstitution in bleached rod outer segment membranes in the presence of a retinal-binding protein from the honeybee.

The physiological role of a retinal-binding protein from honeybee is investigated. This protein, upon previous loading with all-trans retinal and subsequent irradiation with monochromatic light of wavelength 490 nm, is able to promote the reconstitution of rhodopsin when added to a suspension of opsin membranes from bleached bovine rod outer segments. In this respect this retinal-binding protein could have a role very similar to that postulated for the well-known cephalopod retinochrome, that serves to catalyze the formation in the presence of light of 11-cis retinal in photo-receptor cells and to provide it for the reconstitution of rhodopsin during the visual cycle.

Transglutaminase-dependent formation of protein aggregates as possible biochemical mechanism for polyglutamine diseases.

Transglutaminases (Enzyme Commission 2.3.2.13) are a large family of enzymes that show the common capacity to catalyze cross-linking of protein substrates. Some members of this family of enzymes are also capable of catalyzing other reactions important for the cell life. The distribution and the role of these enzymes have been widely studied in numerous cell types and tissues, but only recently their expression and functions started to be investigated in the central nervous system. One of the main biochemical properties of the transglutaminase enzymes is to form large protein aggregates that are insoluble in all known protein detergents, such as urea, guanidinium, and sodium dodecyl sulfate. Recently, the transglutaminase activity has been hypothesized to be involved in the pathogenetic mechanisms responsible for the formation of cellular inclusions present in Huntington disease and in all the other polyglutamine (polyQ) diseases hitherto identified, such as spinobulbar muscular atrophy or Kennedy disease, spinocerebellar ataxias (SCA-1, SCA-2, SCA-3 or Machado-Joseph disease, SCA-6 and SCA-7) and dentatorubropallidoluysian atrophy. In this review we describe the biochemical properties of the transglutaminase enzymes and some recent findings about the physiopathological roles played by these enzymes in the central nervous system.

Characteristics of retinal-binding proteins from the honeybee retina.

Spectrophotometric studies were performed on two water soluble retinal-binding proteins isolated from honeybee retina. Both pigments, B and C, absorb maximally at about 440 nm. Pigment B is bleached by light to a photoproduct with lambda max at about 370 nm. This pigment reacts with hydroxylamine in the dark to form a product with an absorbance maximum at 360 nm, whereas with cyanoborohydride it reacts only in the light forming a product with lambda max at about 330 nm. Irradiation of pigment C also leads to the formation of a photoproduct with lambda max at about 370 nm but, in contrast to that of pigment B, it reconverts to its 440 nm-form during the following dark period. The results obtained by changing the pH of the extracts support the hypothesis that all-trans retinal binds to each protein via a Schiff base linkage (pK of 8.4). The data are discussed with relation to the physiological role pigment B could play in the visual cycle of honeybees.

Electromagnetic field of extremely low frequency decreased adenylate kinase activity in retinal rod outer segment membranes.

Adenylate kinase activity in rod outer segment membranes of bovine retina decreased of about 55% when exposed to an extremely low frequency electromagnetic field of 75 Hz and 250 microT. The effect was independent of the time of permanence in the field. Negligible effects of the field were found on the enzymatic activity of a soluble isoform of adenylate kinase or of rod outer segment membranes solubilized with Triton, suggesting the importance of the membrane in determining the conditions of the enzyme inactivation.

Rhodopsin and phototransduction.

Recent studies on rhodopsin structure and function are reviewed and the properties of vertebrate as well as invertebrate rhodopsin described. Open issues such as the 'red shift' of the absorbance spectra are emphasized in the light of the present model of the retinal-binding pocket. The processes that restore the rhodopsin content in photoreceptors are also presented with a comparison between vertebrate and invertebrate visual systems. The central role of rhodopsin in the phototransduction cascade becomes evident by examining the main reports on light-activated conformational changes of rhodopsin and its interaction with transducin. Shut-off mechanisms are considered by reporting the studies on the sites of rhodopsin phosphorylation and arrestin binding. Furthermore, recent findings on the energetics of phototransduction point out that the ATP needed for photoreception in vertebrates is synthesized in the outer segments where phototransduction events take place.

Langmuir-Blodgett films of photosensitive proteins.

The striking properties of monolayers and multilayers of photosensitive proteins obtained by using the Langmuir-Blodgett technique are described. The close packing of the protein molecules, which preserve most of the properties found in solution, seems to be the main cause for their thermal stability, which in some cases reached a temperature of 200 degrees C without the loss of the protein secondary structure. The review is focused on three of the most intensively studied photosensitive proteins, namely photosynthetic reaction centres, bacteriorhodopsin and bovine rhodopsin, and on their possible applications as molecular optical devices.

Retinal photoisomerase: role in invertebrate visual cells.

In invertebrate visual cells, the rhodopsin content is maintained at a high level by the fast process of photoregeneration during daylight. Rhodopsin is converted by photoabsorption to metarhodopsin, which is reconverted to rhodopsin by light. In addition, rhodopsin is regenerated by a slow process of renewal which takes days to complete and involves the biosynthesis of opsin. It is well known that rhodopsin can be formed from opsin only when 11-cis-retinal is present; this requires the existence of an isomerizing enzyme which is capable of transforming all-trans-retinal, released from the degradation of metarhodopsin, into the 11-cis-retinal isomer. In some invertebrate visual systems, experiments on rhodopsin regeneration have been interpreted by assuming that the isomerization reaction is a light-dependent process involving a retinal-protein complex. Two retinal photoisomerases which have been well characterized, i.e. bee photoisomerase and cephalopod retinochrome, are reviewed here. Their properties are compared in order to determine their physiological role, which is likely to be in the renewal of visual pigment rhodopsin. To conclude, a visual pigment cycle is proposed in which rhodopsin regeneration follows two light-dependent pathways. This greatly simplifies the rhodopsin regeneration scheme for invertebrate visual systems.

Calcium pump in the disk membranes isolated from bovine retinal rod outer segments.

The existence of a Ca2+ pump in rod outer segment disks of bovine retina is strongly suggested by the isolation on sodium dodecyl sulfate polyacrylamide gel electrophoresis of a hydroxylamine-sensitive phosphorylated intermediate (E-P) of molecular mass of about 100 kDa as well as by measurements of active calcium transport and adenosine 5'-triphosphate (ATP) hydrolysis. Active Ca2+ uptake by disks was dependent on the presence of Mg(2+)-ATP, was inhibited by vanadate or lanthanum and appeared poorly sensitive to calmodulin. ATP hydrolysis by disk membranes was a function of free Ca2+ concentration in the absence of exogenous Mg2+. The presence of a Ca2+ pump on disk membranes is discussed in terms of its possible role in Ca2+ ion buffering during photoreceptor cell functioning.

ATP synthesis in the disk membranes of rod outer segments of bovine retina.

ATP is synthesized on the disk membrane isolated from rod outer segments of the bovine retina. Together with a slow component which accounted for a constant rate of about 22 nmol ATP/min/mg of protein and which was due to the adenylate kinase activity, a fast component with a maximal activity of about 58 nmol ATP/min/mg of protein was measured at physiological calcium concentrations. This fast activity disappeared in the presence of the Ca(2+) ionophore A23187, was inhibited by vanadate or thapsigargin but not by oligomycin, suggesting that this ATP synthesis is due to the reversal functioning of the Ca(2+)-ATPase previously found on the disk membranes.