The uncertainty of predicting intact anterior cruciate ligament degeneration in terms of structural properties using T(2)(*) relaxometry in a human cadaveric model.

The combination of healing anterior cruciate ligament (ACL) volume and the distributions of T2(*) relaxation times within it have been shown to predict the biomechanical failure properties in a porcine model. This MR-based prediction model has not yet been used to assess ligament degeneration in the aging human knee. Using a set of 15 human cadaveric knees of varying ages, we obtained in situ MR measures of volume and T2(*) of the intact ACL and then related these MR variables to biomechanical outcomes (maximum and yield loads, linear stiffness) obtained via ex vivo failure testing. Using volume in conjunction with the median T2(*) value, the multiple linear regression model did not predict maximum failure load for the intact human ACL; R(2)=0.23, p=0.200. Similar insignificant results were found for yield load and linear stiffness. Naturally restricted distributions of the intact ligament volume and T2(*) (demonstrated by the respective Z-scores) in an older cadaveric population were the likely reason for the insignificant results. These restricted distributions may negatively affect the ability to detect a correlation when one exists. Further research is necessary to understand the relationship of MRI variables and ligament degeneration. While this study failed to find a significant prediction of human biomechanical outcome using these MR variables, with further research, an MR-based approach may offer a tool to longitudinally assess changes in cruciate ligament degradation.

Coupling of the type A endothelin receptor to multiple responses in adult rat cardiac myocytes.

In adult rat cardiac myocytes, endothelin (ET) receptors couple to multiple signaling pathways, including stimulation of phosphoinositide hydrolysis (pertussis toxin insensitive) and inhibition of adenylyl cyclase via Gi. We have used ET-1 and congeners to characterize the subtypes of ET receptors on isolated rat myocytes. The rank orders of potency for stimulating phosphoinositide hydrolysis, inhibiting hormone-sensitive adenylyl cyclase, and competing with 125I-ET-1 for binding to myocytes are the same and show the pattern characteristic of an ETA receptor interaction, i.e., ET-1 approximately ET-2 > sarafotoxin 6b > ET-3; the corresponding EC50 values for the effects of ET on signal transduction are approximately 0.5 nM (ET-1), 0.7 nM (ET-2), 7 nM (sarafotoxin 6b), and 60 nM (ET-3). The ETA receptor antagonist BQ-123 abolishes the cellular responses to ET-1 and competes fully for 125I-ET-1 binding in a concentration-dependent manner. Sarafotoxin 6c, an ETB-specific agonist, does not diminish the responses to ET-1 or compete for 125I-ET-1 binding; no specific binding of the ETB-specific ligand 125I-IRL-1620 is detectable on myocytes. Myocytes express approximately 4 x 10(5) ET-1 binding sites/cell. The association of 125I-ET-1 with myocytes is largely irreversible, as are the biochemical responses to ET-1; thus, constants derived from analyses that assume reversible equilibria are in error. We conclude that the effects of ET on transmembrane signaling in rat ventricular myocytes result from occupation of ETA receptors and that the responses are likely to be long lived, compared with those of the readily dissociable neurotransmitters released by the autonomic nervous system.

Spontaneous rupture of the spleen. An unusual complication of anticoagulant therapy.

A 44-year-old man, who had been taking warfarin sodium because of a previous myocardial infarct, suddenly developed abdominal pain and signs of peritoneal irritation, requiring exploratory laparotomy. The spleen was ruptured. There were not any systemic diseases nor antecedents of trauma that could be considered predisposing factors for the apparently spontaneous rupture of the spleen. The only abnormality recorded was an elevated prothrombin time. Thus, a coagulopathy produced by the anticoagulants appeared to be the only possible predisposing factor for his splenic rupture.