Medial and lateral laxity in knees with advanced medial osteoarthritis.

OBJECTIVE: An increase in coronal laxity is recognized as a risk factor for progression of knee osteoarthritis (OA). The purpose of this study was to evaluate coronal laxity, which was defined as the angular motion from the neutral, unloaded (baseline) position to the loaded position, in patients with advanced medial knee OA. METHOD: Preoperative coronal laxity was assessed using radiographs in patients with medial knee OA undergoing total knee arthroplasty by applying a force of 150 N with an arthrometer. A consecutive series of 211 knees with OA and 40 normal control knees were examined. A knee with OA was defined as clinically "balanced" when the difference between medial and lateral laxity was 3° or less. Values are expressed as median [25th, 75th percentile]. RESULTS: The laxity was 4° [3, 5] from the baseline on the medial side and 3° [2, 4] on the lateral side. The distribution of medial and lateral laxity indicated that 90% (189/211) of patients fell within 3°. The equivalence test showed that the medial and lateral laxity was similar, with an equivalence margin of 3° (P < 0.001). In the control knees, the laxity was 3° [2, 4] from the baseline on the medial side and 2° [2, 4] on the lateral side. The differences between the knees with advanced OA and the controls were significant (P = 0.005, medial; P = 0.006, lateral). CONCLUSION: This study showed that a clinically balanced knee was maintained even in patients with advanced medial knee OA.

Spectroscopy of Pionic Atoms in

We observed the atomic 1s and 2p states of π^{-} bound to ^{121}Sn nuclei as distinct peak structures in the missing mass spectra of the ^{122}Sn(d,^{3}He) nuclear reaction. A very intense deuteron beam and a spectrometer with a large angular acceptance let us achieve a potential of discovery, which includes the capability of determining the angle-dependent cross sections with high statistics. The 2p state in a Sn nucleus was observed for the first time. The binding energies and widths of the pionic states are determined and found to be consistent with previous experimental results of other Sn isotopes. The spectrum is measured at finite reaction angles for the first time. The formation cross sections at the reaction angles between 0° and 2° are determined. The observed reaction-angle dependence of each state is reproduced by theoretical calculations. However, the quantitative comparison with our high-precision data reveals a significant discrepancy between the measured and calculated formation cross sections of the pionic 1s state.

Determination of histamine in microdialysis samples from Guinea pig skin by high-performance liquid chromatography with fluorescence detection.

AIM: To develop a sensitive and selective liquid-chromatographic method for the determination of histamine in microdialysis samples from guinea pig skin following allergenic provocation. METHODS: The novel fluorescence derivatization method is based on an intramolecular excimer-forming reaction between 2 amino moieties of histamine and 2 molecules of 4-(1-pyrene)butanoyl chloride (PBC) yielding the corresponding dipyrene-labeled derivative. RESULTS: The PBC derivative of histamine was separated within 20 min, and the detection limit (signal-to-noise ratio = 3) of histamine was 0.6 fmol/20 µl volume injected. The basal extracellular levels of histamine in guinea pig skin microdialysates were 20.6 ± 1.7 fmol/10 µl. Subcutaneous administration of histamine liberator compound 48/80 (3 mg/kg) increased the extracellular histamine levels in the skin dialysates by about 860%, whereas ovalbumin challenge (2 mg/kg i.v.) in the sensitized guinea pigs increased the extracellular histamine levels by about 3,030%. CONCLUSION: The novel technique for histamine determination in microdialysis samples from the guinea pig skin may be utilized in preclinical research of antihistaminergic drugs and evaluation of allergenic properties of various dermal preparations such as transdermal drug delivery systems.

First observation of two hyperfine transitions in antiprotonic He.

We report on the first experimental results for microwave spectroscopy of the hyperfine structure of p¯3He+. Due to the helium nuclear spin, p¯3He+ has a more complex hyperfine structure than p¯4He+, which has already been studied before. Thus a comparison between theoretical calculations and the experimental results will provide a more stringent test of the three-body quantum electrodynamics (QED) theory. Two out of four super-super-hyperfine (SSHF) transition lines of the (n,L)=(36,34) state were observed. The measured frequencies of the individual transitions are 11.12559(14) GHz and 11.15839(18) GHz, less than 1 MHz higher than the current theoretical values, but still within their estimated errors. Although the experimental uncertainty for the difference of these frequencies is still very large as compared to that of theory, its measured value agrees with theoretical calculations. This difference is crucial to be determined because it is proportional to the magnetic moment of the antiproton.

Traumatic internal carotid artery occlusion--case report.

A 20-year-old male was admitted comatose immediately after a motorcycle accident. Initial computed tomography demonstrated traumatic subarachnoid hemorrhage, and the diagnosis of traumatic internal carotid artery occlusion was established by angiography. Conservative management improved his symptoms, but eventually he died from delayed traumatic apoplexy. Traumatic internal carotid artery occlusion is relatively rare, but is serious and requires early diagnosis and treatment. For patients with severe head trauma and vascular occlusion, anticoagulants are contraindicated, and frequent follow-up angiography is recommended.

Coexistence of extracranial internal carotid artery aneurysm and multiple intracranial aneurysms--case report.

A rare case of extracranial internal carotid artery (ICA) aneurysm coexisting with intracranial multiple aneurysms in a 64-year-old female is reported. The three intracranial aneurysms were clipped uneventfully by two-stage craniotomies. The extracranial ICA aneurysm at the infratemporal region was excised through a high cervical route and ICA was reconstructed by an end-to-end direct anastomosis. Ours is the first case reported of extra- and intracranial aneurysms surgically treated successfully.

[Arachnoid cyst of the fourth ventricle. Case report].

A 65-year-old female was admitted because of progressive vertigo, truncal ataxia, and unsteadiness of gait for the past 6 years. Computed tomography (CT) and magnetic resonance imaging revealed a non-enhanced, large midline cyst in the posterior fossa and slightly dilated lateral and third ventricles. Metrizamide CT cisternography showed no communication between the cyst and the subarachnoid space. Suboccipital craniectomy, laminectomy of the atlas, and membranectomy of the cyst were performed. On light microscopic examination, the cyst wall was composed of arachnoid cells and connective tissues. Thus, this lesion was not an epithelial cyst but an arachnoid cyst occupying the fourth ventricle. An arachnoid cyst of the fourth ventricle is extremely rare, and only two cases were previously reported.

[A case of cerebellar arteriovenous malformation with hemifacial spasm at onset].

A case of cerebellar AVM onset with hemifacial spasm was reported. The patient, a 47 year old woman, had been suffering from lt. hemifacial spasm for 10 years, and she visited our hospital for operation. Preoperative angiography revealed that there was an AVM in the lt. cerebellar hemisphere fed by the lt. SCA and the lt. PICA. In addition, a non-ruptured saccular aneurysm was observed on the feeding SCA. The microvascular decompression was performed and the AVM was removed, since the lt. facial nerve had been compressed by this elongated and redundant PICA. After the operation, lt. hemifacial spasm disappeared. Two months after the operation, the aneurysm disappeared angiographically. These findings indicated that the hemodynamic stress due to the presence of AVM seemed to have resulted in ectasia or redundancy of the PICA and in the development of the aneurysm. Such a case was quite rare and it may be the first time to be reported in literatures.

[Direct surgical management of aneurysms in the cavernous sinus: a report of 5 cases].

Five patients with aneurysms in the cavernous sinus were treated by direct surgical approach. Two small aneurysms were located in the C3 segment, one small aneurysm was on the primitive trigeminal artery (PTA), and the last two aneurysms were giant ones. The three small aneurysms were discovered incidentally by angiography and the two giant aneurysms presented oculomotor palsy. After ordinary fronto-temporal craniotomy, the two C3 aneurysms were treated through an intradural approach, and the PTA aneurysm and the two giant aneurysms were treated through combined epi- and subdural approach. The three small aneurysms were clipped and the two giant aneurysms were trapped with the reconstruction of ICA by saphenous veins. In all cases the aneurysms were excluded postoperatively, but in one giant-aneurysm case (Case 5) the bypass was occluded postoperatively, but the patient had no permanent neurological deficit. The four patients developed third nerve palsy and one developed fourth nerve palsy which resolved within 3 to 6 months. In one C3-aneurysm case (case i) the patient had loss of vision due to much packing in the medial side of the ICA. All patients were discharged and returned to their usual life. Three cases (case 2, 4, 6) are presented here and the problems of direct surgical management of aneurysms in the cavernous sinus are discussed with the related literature.

[Trigeminal neuralgia associated with primitive trigeminal artery: report of two cases].

Two cases of trigeminal neuralgia associated with the primitive trigeminal artery are reported. From 1981, the authors have treated 131 trigeminal neuralgia patients with microvascular decompression. Among them, we encountered two rare cases of trigeminal neuralgia associated with the primitive trigeminal artery (PTA) and its variant (PTAV). Case 1 is a 74-year-old woman who was admitted to our hospital due to pain of maxilla and mandible. We diagnosed her pain as trigeminal neuralgia. Preoperative angiogram showed the primitive trigeminal artery arising from the cavernous portion of the right internal carotid artery (ICA). She underwent a microvascular decompression operation. We found that her right trigeminal nerve was compressed by the right superior cerebellar artery (SCA) and the right anterior inferior cerebellar artery (AICA). We transferred the offending arteries, and her pain disappeared. Case 2 is a 48-year-old man who was admitted to our hospital due to severe mandibular pain. We diagnosed his pain as trigeminal neuralgia, and he underwent a microvascular decompression operation. His left trigeminal nerve was found compressed by the left SCA and the AICA, and the AICA was arising from the direction of Meckel's cave. His severe pain disappeared completely after operation. Postoperative angiogram of his left ICA showed an aberrant artery arising from the cavernous portion of the ICA, to the region of the left AICA. This aberrant artery is a variant of PTA (PTAV). PTA and PTAV, the so called persistent congenital arteries, are said to accompany aneurysms and other vascular lesions, and affect hemodynamic stress.(ABSTRACT TRUNCATED AT 250 WORDS)

Segmented scintillation detectors with silicon photomultiplier readout for measuring antiproton annihilations.

The Atomic Spectroscopy and Collisions Using Slow Antiprotons experiment at the Antiproton Decelerator (AD) facility of CERN constructed segmented scintillators to detect and track the charged pions which emerge from antiproton annihilations in a future superconducting radiofrequency Paul trap for antiprotons. A system of 541 cast and extruded scintillator bars were arranged in 11 detector modules which provided a spatial resolution of 17 mm. Green wavelength-shifting fibers were embedded in the scintillators, and read out by silicon photomultipliers which had a sensitive area of 1 × 1 mm(2). The photoelectron yields of various scintillator configurations were measured using a negative pion beam of momentum p ≈ 1 GeV/c. Various fibers and silicon photomultipliers, fiber end terminations, and couplings between the fibers and scintillators were compared. The detectors were also tested using the antiproton beam of the AD. Nonlinear effects due to the saturation of the silicon photomultiplier were seen at high annihilation rates of the antiprotons.

Derivatization chemistries for determination of serotonin, norepinephrine and dopamine in brain microdialysis samples by liquid chromatography with fluorescence detection.

The present paper provides an overview on currently developed derivatization chemistries and techniques for determination of monoamine neurotransmitters serotonin (5-HT), norepinephrine (NE) and dopamine (DA) in microdialysis samples by microbore liquid chromatography with fluorescence detection. In mild alkaline conditions, 5-hydroxyindoles and catecholamines react with benzylamine (BA), forming highly fluorescent 2-phenyl-4,5-pyrrolobenzoxazoles and 2-phenyl(4,5-dihydropyrrolo) [2,3-f]benzoxazoles, respectively. However, for derivatization of DA a higher fluorescence intensity was achieved for reaction with 1,2-diphenylethylenediamine (DPE) rather than with BA, therefore for simultaneous determination of 5-HT, NE and DA in brain microdialysates, a two-step derivatization with BA followed by DPE was developed. The detection limits for 5-HT, NE and DA were 0.2, 0.08 and 0.13 fmol, respectively, in an injection volume of 20 microL, which corresponds to concentrations of 30, 12 and 19.5 pm, respectively in standard solution prior to derivatization. The experimental data presented demonstrate the ability of the technique to simultaneously monitor neuronally releasable pools of monoamine neurotransmitters in the rat and mouse brains at basal conditions and following pharmacological treatments or physiological stimuli. These techniques play an important role in drug discovery and clinical investigation of psychiatric and neurological diseases such as depression, schizophrenia and Parkinson's disease.

Chemiluminescence characteristics of N-(4-substituted benzyl)isoluminol.

We synthesized N-(4-substituted benzyl)isoluminol which has 4-bromo-, 4-methyl-, 4-methoxy-, 4-nitrogroups. These compounds produced chemiluminescence by the reaction with the oxidizing agent, potassium hexacyanoferrate and hydrogen peroxide, in an alkaline medium. The chemiluminescence intensities of these compounds were 0.03-4.7 times that of isoluminol. We used Hamett substituent constants as a parameter for the electronic substituent effects. The relationship between the amino-H chemical shift value and the Hamett substituent constants showed a good linear correlation. The relationship between the chemiluminescence intensities and the Hamett substituent constants showed a good linear correlation. The relationship between the fluorescence intensities and the Hamett substituent constants also showed a good linear correlation. These results suggest that the change in the electron density around the amino group strongly influences the fluorescence intensities and corresponding chemiluminescence intensities of these derivatives.

Depletion of arylhydrocarbon receptor during adipose differentiation in 3T3-L1 cells.

Arylhydrocarbon receptor (AhR) is the receptor for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds. Although a physiological ligand for AhR has yet to be identified, several lines of evidence suggest that AhR may play an important role not only in the regulation of xenobiotic metabolism but also in the maintenance of homeostatic functions. When TCDD is administrated in vivo, this compound is primarily deposited in adipose tissue. Therefore, it is critical to know the states of AhR in adipose cells for assessing the expression of toxicities of TCDD and related compounds in vivo. In this report, we examined the levels of AhR protein and its associated protein (Arnt) during the adipose differentiation in 3T3-L1 cells. The level of AhR protein was found to decrease with ongoing adipose differentiation in 3T3-L1 cells. The binding activity to the xenobiotic response element and the cellular response to TCDD were also lowered as a result of adipose differentiation. These results indicate that the depletion of AhR is a novel event associated with adipose differentiation in 3T3-L1 cells and that the magnitude of the depletion of AhR is sufficient for 3T3-L1 cells to lose the functional response to xenobiotics. We also found a population of 3T3-L1 cells which have an adipose differentiation capability in the presence of high doses of TCDD. These cells lack nuclear AhR but not cytoplasmic AhR, suggesting a possible negative role of liganded nuclear AhR in adipose differentiation. The level of the Arnt protein also decreased as a result of the differentiation. However, the pattern of the depletion of the Arnt protein was distinct from that of the AhR protein. The data presented in this study will provide opportunities to carry out studies to better understand the roles of AhR in adipose cells which are the primary targets of TCDD.

Purification and characterization of extracellular and cell wall bound beta-glucosidases from Aspergillus kawachii.

We isolated two extracellular beta-glucosidases (EX-1: 145 kDa, EX-2: 130 kDa) and one cell wall bound beta-glucosidase (CB-1: 120 kDa) from Aspergillus kawachii and characterized their physical and kinetic properties. From the results of N-terminal amino acid sequence, enzymatic parameters and deglycosylation of the three purified enzymes, we strongly suggest that these three enzymes were products of the same gene, modified by different degree of glycosylation. All three purified beta-glucosidases adsorbed to the purified cell wall fraction of this strain. This association could dramatically improve the stability of purified enzymes. These three purified beta-glucosidases were readily inactivated even in moderate conditions but became very stable upon the addition of the purified cell wall fraction. The all purified beta-glucosidases were stable in the range of pH 2.0-9.0 and stable below 30 degrees C with 2 mg/ml of the purified cell wall fraction.

A case of sigmoid sinus dural arteriovenous fistula after treated cavernous dural arteriovenous fistula.

SUMMARY: Transvenous embolization has been recommended recently as the primary treatment for symptomatic cavernous dural arteriovenous fistula (dural AVF). We present a case of sigmoid sinus dural AVF which developed after transvenous embolization of cavernous dural AVF. A 43-year-old man was admitted to our hospital because of left conjunctivill chemosis, exophthalmus and abducens nerve palsy. Cerebral angiograms showed left cavernous dural AVF fed by the bilateral internal and external carqtid arteries and draining into the enlarged left superior ophthalmic vein. Transfemoral approach in the cqvernous sinus via inferior petrosal sinus (IPS) was difficult because of the occlusive change of IPS. Then, direct canulation of the left superior ophthalmic vein and transvenous embolization using interlocking detachable coils (IDC) were performed. Dural AVF and clinical symptoms were disappeard rapidly after embolization. Six months later, follow-up cerebral angiograms showed development of a dural AVF in the left sigmoid sinus. The pathogenesis of dural AVF remains unclear. We suggest that injury to the sinus wall during endovascular procedures may have provoked the development of dural AVF in our case. Clinical and angiographical follow-up are important.

Long-term results of donor-specific blood transfusion with cyclosporine in living related kidney transplantation.

Donor-specific blood transfusion (DST) was introduced to achieve better graft survival. However, its benefits are controversial considering the immunosuppression of cyclosporine (CYA) or tacrolimus (Tac), and its long-term effects have not been well discussed. Of the 40 patients who received DST with CYA, 3 (7.5%) became cross-match positive. Of the 37 patients with negative cross-match, 34 patients received a one-haplotype-matched kidney and were compared to patients with one-haplotype-matched kidney transplant without preoperative DST (n = 13). Acute rejection within 3 months after transplant was 29.4% in the DST group, and 15.4% in the non-DST group. All rejection episodes were steroid resistant in the non-DST group. If the graft survival rates were calculated excluding non-immunological graft loss, graft survival rate was 91.0 and 72.8% at 5 and 10 years in the DST group, and 83.3% at 5 and 10 years in the non-DST group, respectively. The two graft survival lines converged 7 years and 7 months after transplantation. No beneficial effect of DST was statistically evident under CYA immunosuppression. In terms of the severity of acute rejection or the onset of chronic rejection, DST induced a small benefit, however, which seemed to disappear within 8 years after transplantation.

[A case of superficial esophageal cancer with an intramural metastasis to the gastric wall].

Reported is a case of 61-year-old man with a superficial esophageal cancer that was associated with an intramural metastasis to the stomach. Examination of the upper G.I. tract revealed a slightly elevated lesion with an irregular surface at the left wall of the lower esophagus, and a large submucosal tumor with an ulcerous formation that had developed and had increased rapidly within a month. Thus a resection of the lower esophagus and a total gastrectomy were performed. Histopathologically, the tumor of the lower esophagus was determined as being a moderately differentiated squamous cell carcinoma with a deep invasion to the submucosal tissue. The submucosal tumor of the stomach also was found to be a moderately differentiated squamous carcinoma. Neither provided evidence, however, of a direct involvement of the gastric serosa may have metastasized from the neighboring lymph nodes or from other organs, nor of any continuous mucosal metastasis between the primary lesion of the esophagus and the submucosal tumor of the stomach. Judging from these findings, the case was diagnosed as an esophageal cancer with an intramural metastasis to the stomach.