Identification of L-dopa immunoreactivity in some neurons in the human mesencephalic region: a novel dopa neuron group?

The presence of L-3,4-dihydroxyphenylalanine (L-DOPA) immunoreactivity is reported for the first time in some neurons in the human mesencephalic region, using an immunohistochemical method with a newly raised, highly specific anti-L-DOPA antiserum. We have found many L-DOPA-positive/dopamine (DA)-positive and a few L-DOPA-positive/DA-negative cell bodies in dopaminergic regions in the midbrain. The present results suggest the existence of more than one neuronal group of L-DOPA in the human mesencephalon. L-DOPA in one group is an intermediate metabolite for decarboxylation to DA and in another group may exist as an end-product. L-DOPA in the latter neurons could be a neuromodulator and/or neurotransmitter. Thus, we suggest that L-DOPA plays an important role besides being an intermediate of DA in the human mesencephalon.

A case report of insufficiency fracture of the Fossa acetabuli in a patient with rheumatoid arthritis.

Aside from vertebral compression fractures, the most common site of insufficiency fractures is the pelvis and lower extremities. In the pelvis, the fractures usually occur in the ilium, the pubis and the ischium, but rarely in the fossa acetabuli. We report a severe insufficiency fracture of the fossa acetabuli in a 78-year-old woman with rheumatoid arthritis (RA). She had associated insufficiency fractures of the rib, the thoracic spine and the sacrum. In our case, senile osteoporosis was present before the onset of the fracture was recognized on radiographs, and RA and corticosteroid therapy might have further aggravated the porosis, resulting in the destruction of the fossa acetabuli. Regarding treatment for the fracture, a cemented total hip replacement without bone graft was attempted for several reasons such as the patient's activities, postoperative rehabilitation and the bone mass of the acetabulum. The postoperative course was satisfactory during study period. However, further follow-up is needed to monitor carefully how the patient will be in the future.

Evaluation of glycosaminoglycans levels in normal joint fluid of the knee.

Glycosaminoglycans (GAGs) level in joint fluid have been investigated in various joint diseases as a joint maker. However, there are very few studies of normal joint fluid providing a baseline for a better understanding of altered GAGs level in pathological joint fluid. We investigated GAGs level in knee joint fluid for 25 healthy young volunteers with a mean age of 27.5 years (range: 18 to 36 years). Biochemical evaluations included the concentration of hyaluronic acid (HA), chondroitin 4-sulfate (C4S) and chondroitin 6-sulfate (C6S), and the C6S/C4S ratio. The unsaturated disaccharides derived from HA by Morgan-Elson methods, and those from CS were measured with high performance liquid chromatography. The mean HA concentration was 3.4+/-0.6 mg/ml. The mean concentration of C4S and C6S, and C6S/C4S ratio were 19.0+/-4.9 nmol/ml, 125.5+/-44.4 nmol/ml and 6.5+/-1.1 respectively.

Serum and synovial fluid levels of chondroitin sulfate in patients with osteoarthritis of the knee joint.

We measured serum and synovial fluid levels of chondroitin sulfate (CS) in patients with osteoarthritis (OA) of the knee joint to clarify whether CS levels differ in various stages of OA, and whether measurement of CS levels is useful in evaluating the pathology of OA. The study population was 117 OA patients and 23 healthy young volunteers. Synovial fluid was obtained from 69 of 117 OA patients. The mean serum level of C4S in all of the OA patients was significantly higher than that in the controls (p< 0.05). However, there was little difference between respective OA stages. A small amount of serum C6S (0.2 to 0.6 nmol/ml) was detected in 31.6% of the OA patients and in 26.1%of the control subjects. The mean serum C0S level in all OA patients was significantly higher than that in the controls (p< 0.01). However no significant difference was found between respective OA stages. As for synovial fluid CS, the C4S level in the early stage of OA tended to be higher than that in the advanced stage. C6S levels showed a markedly decreasing trend with advancing OA stage. C0S was not detected in synovial fluid. The present study demonstrated that serum levels of C4S and C0S in OA patients are elevated compared with normal subjects, and that synovial fluid levels of C4S and C6S may provide useful in assessing the pathology of OA.