Clinical parkinsonism in dementia patients with substantia nigra Lewy bodies

In a retrospective clinicopathological study, we examined the substantia nigra (SN) of 48 dementia patients with SN Lewy bodies (LBs) to determine if the severity of degeneration correlated with either the occurrence of signs of parkinsonism at dementia presentation or with the frequency of treatment for parkinsonism during the disease course. The SN specimens were graded for microscopic degeneration using a semi-quantitative five-tiered scale. Whereas no correlation was found between the grade of degeneration and occurrence of signs at presentation (r = -0.16, p = 0.18), with 16 of 38 patients having had signs reported, a more severe grade was statistically correlated with an increased frequency of treatment during the course (r = 0.41, p = 0.004), with ten of 41 patients having been treated for parkinsonism. Contrary to our expectations, we found that fewer than half of the patients with the two most severe grades of degeneration presented with signs of parkinsonism or were ever treated for parkinsonism.

Association study of apolipoprotein E epsilon4 with clinical phenotype and clozapine response in schizophrenia

Schizophrenic patients with the apolipoprotein E (APOE = gene; apoE = protein) epsilon4 allele exhibited lower psychosis scores than patients without the epsilon4 allele in previous reports. The present study tested the hypothesis that the APOE epsilon4 allele confers association with the clinical manifestations of schizophrenia or clozapine response. A total of 95 schizophrenic patients who were treatment resistant were included in the study. The results demonstrated that the presence of the APOE epsilon4 allele did not influence the response to clozapine in schizophrenic patients, neither was the baseline psychopathology related to the APOE epsilon4 allele. Given the multiple functions of the apoE protein in the brain, further study of the influence of APOE on CNS medication response is needed.

Biomechanics of neurotrauma

This paper reviews the traditional areas of impact biomechanics as they relate to brain injury caused by blunt impact. These areas are injury mechanisms, human response to impact, human tolerance to impact and the use of human surrogates. With the advent of high-speed computers, it is now possible to add computer models to the list of human surrogates that used to be limited to animals and human cadavers. The advantages and shortcomings of current computer models are discussed. One of the computer models was used to predict the pressures and shear stresses developed in the brain and the extent of stretch of the bridging veins in the brains of American football players who sustained severe helmet-to-helmet head impact during the game. It was found that increases in intracranial pressure were more dependent on translational acceleration while the primary determinant for the development of shear stresses in the brain is rotational acceleration. Although the current head injury criterion is based almost entirely on translational acceleration, it is recommended that any new criterion should reflect the contribution of both translational and rotational acceleration.

Protective effects of (-)-epigallocatechin-3-gallate on UVA- and UVB-induced skin damage

It has been known that green tea and its components possess significant chemopreventive effects against chemical carcinogens and photo-caused skin tumor formation. In this study, the protective effects of (-)-epigallocatechin-3-gallate (EGCG), a major green tea catechin, on the ultraviolet (UV)-induced skin damage (photoaging) were studied in guinea pigs, hairless mice and human dermal fibroblast cultures. The lipid peroxidation was significantly reduced in the EGCG-treated group. The amount of lipid peroxides produced in the control and EGCG treated group were 838 +/- 144 and 286 +/- 57 nmol/mg at 18 h after UV irradiation, respectively. UVB-induced erythema was also significantly reduced in the EGCG treated group. The erythema relative index of the control and the EGCG treated group were 311 +/- 45 and 191 +/- 49 at 16 h after UV irradiation, respectively. EGCG treatment reduced UVA-induced skin damage (roughness and sagginess) and protected from the decrease of dermal collagen in hairless mouse skin. EGCG treatment blocked the UV-induced increase of collagen secretion and collagenase mRNA level in fibroblast culture. The nuclear transcription factors NF-kappaB and AP-1 binding activities were also inhibited by EGCG treatment.

Comparison of brain responses between frontal and lateral impacts by finite element modeling

This study was conducted to investigate differences in brain response due to frontal and lateral impacts based on a partially validated three-dimensional finite element model with all essential anatomical features of a human head. Identical impact and boundary conditions were used for both the frontal and lateral impact simulations. Intracranial pressure and localized shear stress distributions predicted from these impacts were analyzed. The model predicted higher positive pressures accompanied by a relatively large localized skull deformation at the impact site from a lateral impact when compared to a frontal impact. Lateral impact also induced higher localized shear stress in the core regions of the brain. Preliminary results of the simulation suggest that skull deformation and internal partitions may be responsible for the directional sensitivity of the head in terms of intracranial pressure and shear stress response. In previous experimental studies using subhuman primates, it was found that a lateral impact was more injurious than a frontal impact. In this study, shear stress in the brain predicted by the model was much higher in a lateral impact in comparison with a frontal impact of the same severity. If shear deformation is considered as an injury indicator for diffuse brain injuries, a higher shear stress due to a lateral impact indicate that the head would tend to have a decreased tolerance to shear deformation in lateral impact. More research is needed to further quantify the effect of the skull deformation and dural partitions on brain injury due to impacts from a variety of directions and at different locations.

Development of a finite element model of the human shoulder

Previous studies have hypothesized that the shoulder may be used to absorb some impact energy and reduce chest injury due to side impacts. Before this hypothesis can be tested, a good understanding of the injury mechanisms and the kinematics of the shoulder is critical for occupant protection in side impact. However, existing crash dummies and numerical models are not designed to reproduce the kinematics and kinetics of the human shoulder. The purpose of this study was to develop a finite element model of the human shoulder in order to achieve a deeper understanding of the injury mechanisms and the kinematics of the shoulder in side impact. Basic anthropometric data of the human shoulder used to develop the skeletal and muscular portions of this model were taken from commercial data packages. The shoulder model included three bones (the humerus, scapula and clavicle) and major ligaments and muscles around the shoulder. This model was then integrated into a human thorax model developed at Wayne State University (WSU) along with pre-existing models of other body parts such as the pelvis and the lower extremities. Material properties used for the model were taken from the literature. The model was first used to simulate lateral shoulder impact study by the Association Peugeot- Renault (APR) followed by simulations of several of the 17 rigid and padded cadaveric impacts conducted on a side impact sled at WSU. Contact forces measured at the levels of shoulder, thorax, abdomen and pelvis were used as response variables to validate the model. Additionally, a cadaveric test involving the deployment of a generic side airbag was also used to check the validity of the model. Model prediction of accelerations of the shoulder matched well against those measured experimentally. The role of the shoulder in side impact protection and the reduction of injury to the ribcage are discussed, based on model results.

Analogue pattern matching in a dendritic spine model based on phosphorylation of potassium channels

Modification of potassium channels by protein phosphorylation has been shown to play a role in learning and memory. If such memory storage machinery were part of dendritic spines, then a set of spines could act as an 'analogue pattern matching' device by learning a repeatedly presented pattern of synaptic activation. In this study, the plausibility of such analogue pattern matching is investigated in a detailed circuit model of a set of spines attached to a dendritic branch. Each spine head contains an AMPA synaptic channel in parallel with a calcium-dependent potassium channel whose sensitivity depends on its phosphorylation state. Repeated presentation of synaptic activity results in calcium activation of protein kinases and subsequent channel phosphorylation. Simulations demonstrate that signal strength is greatest when the synaptic input pattern is equal to the previously learned pattern, and smaller when components of the synaptic input pattern are either smaller or larger than corresponding components of the previously learned pattern. Therefore, our results indicate that dendritic spines may act as an analogue pattern matching device, and suggest that modulation of potassium channels by protein kinases may mediate neuronal pattern recognition.

Qualitative analysis of neck kinematics during low-speed rear-end impact

OBJECTIVE

To analyze neck kinematics and loading patterns during rear-end impacts.

DESIGN

The motion of each cervical vertebra was captured using a 250 frame/s X-ray system during a whole body rear-end impact. These data were analyzed in order to understand different phases of neck loading during rear-end impact.

BACKGROUND

The mechanism of whiplash injury remains largely unknown. An understanding of the underlying kinematics of whiplash is crucial to the identification of possible injury mechanisms before countermeasures can be designed.

METHODS

Metallic markers were inserted into the vertebral bodies and spinous processes of each of the seven cervical vertebrae. Relative displacement-time traces between each pair of adjacent cervical vertebrae were calculated from X-ray data. Qualitative analyses of the kinematics of the neck at different phase of impact were performed.

RESULTS

The neck experiences compression, tension, shear, flexion and extension at different cervical levels and/or during different stages of the whiplash event.

CONCLUSIONS

Neck kinematics during whiplash is rather complicated and greatly influenced by the rotation of the thoracic spine, which occurs as a result of the straightening of the kyphotic thoracic curvature.

RELEVANCE

Understanding the complicated kinematics of a rear-end impact may help clinicians and researchers shed some light on potential mechanisms of whiplash neck injury.

Kinematics of human cadaver cervical spine during low speed rear-end impacts

The purposes of this study were to measure the relative linear and angular displacements of each pair of adjacent cervical vertebrae and to compute changes in distance between two adjacent facet joint landmarks during low posterior-anterior (+Gx) acceleration without significant hyperextension of the head. A total of twentysix low speed rear-end impacts were conducted using six postmortem human specimens. Each cadaver was instrumented with two to three neck targets embedded in each cervical vertebra and nine accelerometers on the head. Sequential x-ray images were collected and analyzed. Two seatback orientations were studied. In the global coordinate system, the head, the cervical vertebrae, and the first or second thoracic vertebra (T1 or T2) were in extension during rear-end impacts. The head showed less extension in comparison with the cervical spine. Relative motion for each cervical motion segment went from flexion at the upper cervical levels to extension at the lower cervical levels, with a transition region at the mid-cervical levels. This rotational pattern formed an "S" shape in the cervical spine during the initial phase of low-speed rear impacts. A pair of facet joint landmarks on each cervical motion segment was used to measure the distance across the joint space. Uni-axial facet capsular strains were calculated by dividing changes in this distance over the original distance in seven tests using three specimens. In 20-degree seatback tests, the average strain was 32+/-11% for the C2/C3 facet joint (17%-43% range), and 59+/-26% for the C3/C4 facet joint (41%-97% range). The C4/C5 and C5/C6 facet joints exhibited peak tensile or compressive strains in different specimens. In 0-degree seatback tests, the average strain was 28+/-11% for the C2/C3 facet joint (21%-41% range), 30+/-9% for the C3/C4 facet joint (21%-39% range), 22+/-4% for the C4/C5 facet joint (19%-25% range), and 60+/-13% for the C5/C6 facet joint (51%-69% range). In 20-degree seatback tests, there was less initial cervical lordosis, more upward ramping of the thoracic spine, and more relative rotation of each cervical motion segment in comparison with the 0-degree seatback tests. Relative to T1, the head went from flexion to extension for 20-degree seatback tests while stayed in extension for 0-degree seatback tests.

Immunotactoid glomerulopathy associated with idiopathic hypereosinophilic syndrome

A case of immunotactoid glomerulopathy in an 18-year-old man with an idiopathic hypereosinophilic syndrome is presented. The patient showed cervical lymphadenopathy, asymptomatic proteinuria of nephrotic range, and hematuria without any defined immunologic disease. Marked and prolonged hypereosinophilia was found in peripheral blood (eosinophil count; 6,248/mm3) and bone marrow (eosinophil series; 32%). Diffuse and/or nodular eosinophilic infiltration was identified in multiple organs such as kidney, stomach, liver, lymph node, and skin. Renal biopsy revealed endocapillary proliferative features of typical immunotactoid glomerulopathy with IgG and C3 deposition and microtubular structures of variable size, 20-80 nm in diameter, mainly in the subendothelium. This study suggests that immunotactoid glomerulopathy may be a secondary immunologic manifestation of the tissue damage by eosinophils in the idiopathic hypereosinophilic syndrome.

Association study of a functional serotonin transporter gene polymorphism with schizophrenia, psychopathology and clozapine response

Serotonin is implicated in the pathogenesis of schizophrenia. Following serotonin release, the serotonin transporter (5-HTT) is the major determinant of serotonin inactivation. The present study tested the hypothesis that a biallelic polymorphism in the 5' regulatory region of the 5-HTT gene (5-HTTLPR) confers susceptibility to schizophrenia, association with the clinical manifestations of schizophrenia or clozapine response. 90 treatment-resistant schizophrenic patients were assessed using the Brief Psychiatric Rating Scale before and after clozapine treatment. The results demonstrated that the 5-HTTLPR variants did not play a major role in the susceptibility, clinical manifestations or clozapine response in schizophrenia.

[Bibliometric analysis on tissue engineering research literatures]

OBJECTIVE

To comprehend the progress of tissue engineering research and speculate its developmental trends.

METHODS

MEDLINE search was conducted to retrieve the papers published between 1987 to 1999 under the main headings of tissue engineering. Years, nationalities, languages, journals, authors and heading frequencies of 314 papers were analyzed by bibliometrics.

RESULTS

Since 1990, the number of tissue engineering research literatures had doubled, and papers between 1998 and 1999 made up 57.96% of the total papers. All papers came from 15 nations, in 6 languages and 140 journals; 64.97% came from United States and 25.79% from England, Netherlands and Germany; 93.95% was in English; 42.04% was published on 15 journals. Vacanti JP and 19 other authors presented 5 to 24 papers. Heading frequencies were cytology 22.89%, transplantation 13.30%, scaffolds and extracellular matrixes 11.72%, implanting 10.60%, polymers 8.91%, potential applications 8.91%, artificial substitutes 6.88%, tissue culture 6.70% and biogenetics 4.96%.

CONCLUSION

Tissue engineering literatures mainly come from United States, England, Netherlands and Germany. English is the major language. J Biomed Mater Res and 14 other journals are important journals about tissue engineering research. Vacanti JP and 19 other authors are prolific authors. Cytology, transplantation, scaffolds and extracellular matrixes and implanting are hot topics and key points on tissue engineering research.

2-Amino-3-methylimidazo[4,5-f]quinoline inhibits nitric oxide production in lipopolysaccharide-stimulated RAW 264.7 cells by blocking p38 kinase activation

We show that 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), a heterocyclic amine, significantly inhibits nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated macrophages. The decrease in NO production was found to correlate well with a decrease in inducible NO synthase (iNOS) mRNA expression as demonstrated by Northern blot analysis. Treatment of RAW 264.7 cells with IQ selectively inhibited the activation of NF-kappaB/Rel, an important transcription factor of iNOS gene expression, while neither AP-1 nor Oct was affected by IQ. Since iNOS transcription has been shown recently to be under the control of the p38 kinase signaling cascade, we assessed the effect of IQ on p38 kinase activation. Treatment of RAW 264.7 with IQ inhibited LPS-stimulated p38 kinase phosphorylation in a dose-related manner. IQ also inhibited the p38 kinase activity. Collectively, this series of experiments indicates that IQ inhibits LPS-induced expression of iNOS gene in RAW 264.7 cells. Based on our findings, the most likely mechanism that can account for this biological effect involves the negative regulation of NF-kappaB/Rel and p38 kinase pathway.

Dexamethasone inhibits IL-1 beta gene expression in LPS-stimulated RAW 264.7 cells by blocking NF-kappa B/Rel and AP-1 activation

In the present study, the mechanism by which dexamethasone (DEX) inhibited IL-1beta gene expression in bacterial lipopolysaccharide (LPS)-activated RAW 264.7 cells was investigated. The decrease in LPS-induced IL-1beta mRNA expression was demonstrated by quantitative reverse transcription polymerase chain reaction (RT-PCR). Since the promoter in IL-1beta gene contains binding motifs for NF-kappaB/Rel, AP-1, NF-IL6, and CREB/ATF, which appear to be important in LPS-mediated IL-1beta induction, the effects of DEX on the activation of these transcription factors were examined. Treatment of DEX to RAW 264.7 cells induced a dose-related inhibition of NF-kappaB/Rel and AP-1 in chloramphenicol acetyltransferase activity, while neither NF-IL6 nor CREB/ATF activation was affected by DEX. Treatment of RAW 264.7 cells with DEX inhibited DNA binding of NF-kappaB/Rel and AP-1 proteins to their cognate DNA sites as measured by electrophoretic mobility shift assay (EMSA). DEX treatment caused a significant reduction in nuclear c-rel, p65, and p50 protein contents, and these decreases were paralleled by the accumulation of cytoplasmic c-rel, p65, and p50. DEX treatment of RAW 264.7 cells did not inhibit the nuclear translocation of c-jun and c-fos. We found that the inhibition of IL-1beta production by DEX is not related to p38, which is important in the IL-1beta induction. These results suggest that DEX may inhibit IL-1beta gene expression by a mechanism involving the blocking of LPS-induced NF-kappaB/Rel and AP-1 activation.

Chlorophyllin suppression of lipopolysaccharide-induced nitric oxide production in RAW 264.7 cells

Chlorophyllin (CHL), a water-soluble derivative of chlorophyll, functions as an anticarcinogen and antioxidant. In the present study, we investigated the effect of CHL on nitric oxide production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Treatment with CHL inhibited nitric oxide production in the LPS-stimulated RAW 264. 7 cells in a dose-related manner. Competitive RT-PCR analysis, using a DNA competitor as an internal standard, demonstrated that the treatment with 1, 10, and 50 microM CHL decreased LPS-induced iNOS mRNA expression in a concentration-dependent manner. Since the expression of the iNOS gene is mainly regulated by NF-kappaB, we then examined the effects of CHL on the NF-kappaB DNA binding activity, using an electrophoretic mobility shift assay. CHL down-regulated the NF-kappaB DNA binding on its cognate recognition site at the concentrations just noted. Employing a transfection and reporter gene expression system with p(NF-kappaB)(3)-chloramphenicol acetyl transferase (CAT), the treatment of CHL produced a dose-dependent inhibition of CAT activity in RAW 264.7 cells. Furthermore, CHL partially restored LPS-decreased IkappaBalpha, an inhibitory protein against NF-kappaB activation, in the cytosolic extract from the LPS-treated cells determined by immunoblot analysis. CHL also protected the hydroxyl radical-induced cytotoxicity in RAW 264.7 cells, indicating its antioxidant effect. These results suggest that CHL suppresses the nitric oxide production and iNOS mRNA expression mediated by the inhibition of NF-kappaB activation, and its action mechanism may be based on its antioxidant effect.

Limiting donor site morbidity by suprafascial dissection of the radial forearm flap

A technique of suprafascial flap elevation to prevent donor site problems is described, based on careful intraoperative observation of the anatomical relations of all involved structures in a series of over 400 free forearm flaps used in various reconstructive procedures.

Inconsistency between severe substantia nigra degeneration with Lewy bodies and clinical parkinsonism in dementia patients: a cliniconeuropathological study

In a retrospective cliniconeuropathological study, we reviewed all the cases received in our dementia brain bank during a 4-year period to determine if all patients with severe substantia nigra (SN) degeneration and SN Lewy bodies (LBs) exhibited prominent signs of parkinsonism and were treated for parkinsonism during the disease course. The SN of 426 cases were graded for microscopic degeneration using a semiquantitative five-tiered scale, with grade 0 indicating normal and grade 4 the most severe degeneration. Twenty-nine cases with grade 3 (16) or grade 4 (13) SN degeneration with SN LBs and clinical records were identified. Ten had been treated for parkinsonism (6 grade 3, 4 grade 4) and 19 had not. Whereas most of the patients had exhibited signs of end-stage parkinsonism during their last year, 1 grade 3 and 2 grade 4 patients apparently never exhibited prominent signs of parkinsonism during the course of their dementia. No clear neuropathological differences were noted between these patients that did not have prominent signs and a control group of six patients with clinical Parkinson's disease with dementia (parkinsonism onset at least 1 year before dementia onset). We conclude that in patients with dementia there is an inconsistent relationship between the expression of clinical parkinsonism during life and severe SN degeneration with LBs identified at necropsy.

Suppression of IL-2 and IL-4 gene expression by nodularin through the reduced NF-AT binding activity

Nodularin is a cyclic peptide produced by cyanobacteria. In the present study, the inhibitory effect of nodularin on T lymphocyte functions was demonstrated. Direct addition of nodularin to B6C3F1 mouse splenocyte cultures produced a concentration-dependent inhibition of the lymphoproliferative response to concanavalin A stimulation. Nodularin inhibited PMA plus ionomycin (Io)-induced IL-2 mRNA expression in murine splenocytes and thymocytes as determined by quantitative/competitive RT-PCR. To further characterize the mechanism for the transcriptional regulation of IL-2, the binding activity of transcription factors, NF-AT, AP-1, NF-kappaB, and Oct, was evaluated by electrophoretic mobility shift assays in mouse splenocytes. Nodularin reduced the NF-AT binding activity in PMA/Io-induced splenocytes, but no significant effect was observed on AP-1, NF-kappaB, or Oct binding activity. Nodularin also inhibited IL-4 mRNA expression in PMA/Io-stimulated murine splenocytes. These results suggest that T lymphocyte is a possible cellular target of nodularin, and the inhibitory effect of nodularin on T-cell specific transcription factor NF-AT induces T-cell dysfunction, which leads to a diminution in IL-2 and IL-4 gene transcription.

2-Acetylaminofluorene suppresses immune response through the inhibition of nuclear factor-kappaB activation during the early stage of B cell development

2-Acetylaminofluorene (AAF), an arylamide carcinogen, has been known to inhibit humoral and cell-mediated immune response by lipopolysaccharide (LPS). In the current study we demonstrate that AAF induced the down-regulation of protein kinase C (PKC) that is a key enzyme in the pathways leading to LPS-induced B-cell proliferation, while having no inhibitory effect on intracellular cAMP in spleen cells. Additionally, to identify the mechanism of action of AAF during B-cell development, we determined the effects of AAF on LPS-induced nuclear factor-kappaB (NF-kappaB) activation in 70Z/3 murine pre-B cells, CH12 murine mature B cells and S194 murine plasmacytoma cells. LPS-induced NF-kappaB activation, which is dependent on PKC, was inhibited by pretreatment with AAF for 2 h in the nuclei of 70Z/3 murine pre-B cells by detection of NF-kappaB specific DNA-protein binding. Conversely, AAF barely inhibited the constitutive NF-kappaB binding activity in mature B-cells, S194 and CH12. To confirm the effect of AAF on NF-kappaB activation, a chloramphenicol acetyl transferase (CAT) expression vector containing multiple copies of the NF-kappaB element (pCAT(kappaB)(3)) was transiently transfected into 70Z/3 or S194 cells, and assessed for inducible CAT activity. AAF treatment of 70Z/3 cells resulted in a significant inhibition of CAT activity induced by LPS. However, AAF exhibited no inhibitory effect on constitutive CAT activity in mature B cells, S194, indicating that AAF no longer has suppressive effects on the immune response in differentiated B cells. Taken together, these results suggest that AAF may act to suppress immune response by blocking the activation of PKC and nuclear expression of NF-kappaB at the early stage of B cell development.

Role of nuclear factor of activated T-cells and activator protein-1 in the inhibition of interleukin-2 gene transcription by cannabinol in EL4 T-cells

We previously reported that immunosuppressive cannabinoids inhibited interleukin (IL)-2 steady-state mRNA expression and secretion by phorbol-12-myristate-13-acetate plus ionomycin-activated mouse splenocytes and EL4 murine T-cells. Here we show that inhibition of IL-2 production by cannabinol, a modest central nervous system-active cannabinoid, is mediated through the inhibition of IL-2 gene transcription. Moreover, electrophoretic mobility shift assays demonstrated that cannabinol markedly inhibited the DNA binding activity of nuclear factor of activated T-cells (NF-AT) and activator protein-1 (AP-1) in a time- and concentration-dependent manner in activated EL4 cells. The inhibitory effects produced by cannabinol on AP-1 DNA binding were quite transient, showing partial recovery by 240 min after cell activation and no effect on the activity of a reporter gene under the control of AP-1. Conversely, cannabinol-mediated inhibition of NF-AT was robust and sustained as demonstrated by an NF-AT-regulated reporter gene. Collectively, these results suggest that decreased IL-2 production by cannabinol in EL4 cells is due to the inhibition of transcriptional activation of the IL-2 gene and is mediated, at least in part, through a transient inhibition of AP-1 and a sustained inhibition of NF-AT.

Endoscopic bone graft for delayed union and nonunion

We performed endoscopic bone grafting for eight patients of delayed union and nonunion which developed after femoral and humeral shaft fractures. The mean interval from initial intervention to endoscopic bone grafting was 7.3 months. Six patients of delayed union and nonunion healed at 4.1 months on average. Two patients had unsatisfactory healing and eventually underwent non-endoscopic revisional surgery. There was no intraoperative on postoperative complication. Endoscopic bone grafting can be a less invasive alternative, obtaining rapid bone union in cases of compromised healing of the diaphyseal fracture.

Removal of the deeply inserted proximal interlocking screw in the greater trochanter after femoral nailing

Removal of the proximal interlocking screw (PIS), especially one that is deeply inserted in the greater trochanter or covered by heterotopic ossification, is troublesome and requires considerable effort because the search for its head usually requires removing bone from around the insertion site. We introduce a simple tip to remove this complicated PIS with the aid of a proximal drill guide, drill bit, and AO countersink.

Suppression of the interleukin-2 gene expression by aflatoxin B1 is mediated through the down-regulation of the NF-AT and AP-1 transcription factors

The effect of aflatoxin B1 (AFB1) on the interleukin-2 (IL-2) gene expression was investigated in thymocytes of B6C3F1 mice, Jurkat E6-1 human T-cell leukemia, and EL4.IL-2 murine thymoma. AFB1 inhibited the phorbol-12myristate-13-acetate/i6nomycin (PMA/Io)-induced IL-2 mRNA expression in the murine thymocytes and Jurkat E6-1 cells as determined by qualitative RT-PCR, while no effect was observed in the EL4.IL-2 cells. Electrophoretic mobility shift assay indicated that AFB1 treatment showed an inhibition of the NF-AT and AP-1 DNA binding in PMA/Io-stimulated thymocytes and Jurkat E6-1 cells. No effect was observed on the Oct and NF-kappaB DNA binding. Employing a reporter gene expression system with p(NF-AT)3-CAT and p(AP-1)3-CAT, treatment with AFB1 to the transfected Jurkat E6-1 cells also showed an inhibition of the PMA/Io-induced NF-AT/CAT and AP-1/CAT activities. These results suggest that suppression of the IL-2 gene expression by AFB1 is mediated through the down-regulation of the NF-AT and AP-1 activation.

Performance, serum characteristics, carcase traits and lipid metabolism of broilers as affected by supplement of chromium picolinate

1. This study investigated the effects of dietary supplementation with chromium picolinate on the performance, serum and carcase traits and lipid metabolism of broilers. In trial 1, 120 1-day-old broilers with an equal number of males and females were assigned at random to 4 groups with 3 replicates. Four treatments with dietary supplements of 0 (control), 800, 1600 and 3200 microg/kg of chromium picolinate were used. In trial 2, 6-week-old broilers (20) were used to determine how supplements of 0, 200, 400 and 800 microg/kg chromium in an incubation medium influence their hepatocyte lipogenic capacity and adipocyte lipolysis, in vitro. 2. Dietary supplements of 1600 and 3200 microg/kg chromium in broiler diets significantly increased food consumption (P<0.05); 1600 microg/kg markedly improved weight gain (P<0.05); 1600 and 3200 microg/kg groups showed increased liver lipid content (P<0.05). However, the abdominal fat content tended to decrease in these 2 groups. 3. Dietary supplements of 1600 and 3200 microg/kg of chromium decreased serum glucose and nonesterified fatty acids (NEFA) concentrations while increasing serum phospholipid content (P<0.05). Insulin concentration decreased only in birds receiving 3200 ppb chromium (P<0.05). Serum triacylglycerol (TG) clearance rate in chromium-supplemented groups was markedly enhanced (P<0.05). 4. In addition, chromium supplemented groups had increased serum HDL contents and also reduced serum VLDL and LDL contents (P<0.05). 5. Trial 2 indicated that lipogenesis from [U-14C]glucose by isolated hepatocytes was significantly enhanced by 400 ppb chromium (P<0.05). 6. The results from this study demonstrate that a supplement of 1600 microg/kg of chromium picolinate in the ration influences the growth, carcase, serum traits and lipid metabolism of broilers.

Serotonin-6 receptor variant (C267T) and clinical response to clozapine

Clozapine is an effective atypical antipsychotic that has high affinity for serotonin type 6 receptors (5HT6). We tested the hypothesis that clinical response to clozapine in patients refractory to typical antipsychotic treatment is related to the genetic variant (C267T) of the 5HT6 receptors. Ninety-nine schizophrenic patients with a history of non-response to typical antipsychotics were included in the study. The results demonstrated a modest but significant relationship between presence of the variant of the 5HT6 receptors and the response to clozapine in these patients. Patients with homogenous 267T/T genotype had a better response than other patients. Although replication is required, these results suggest that the 5HT6 receptor C267T polymorphism may be involved in clozapine response, especially in patients with anxious or depressed symptoms.

Endoscopic bone graft for delayed union and nonunion

Nonunion and delayed union are serious consequences in the treatment of fractures. Bone graft has been a mainstay of treatment for nonunion and delayed union. But with rapid development of the endoscopic procedure, bone grafting can be performed after curettage of fibrous tissue around the fracture gap and sclerotic fracture end under direct visual control of the endoscope. This technical note provides procedures for this technique.

Acetylaminofluorene inhibits nitric oxide production in LPS-stimulated RAW 264.7 cells by blocking NF-kappa B/Rel activation

The mechanism by which 2-acetylaminofluorene (AAF) inhibited nitric oxide (NO) formation, in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells was investigated. The decrease in NO, as demonstrated by measurement of nitrite was found to correlate well with a decrease in inducible nitric oxide synthase (iNOS) mRNA. Since the promoter in iNOS gene contains binding motifs for NF-kappa B/Rel, AP-1, and NF-IL6 which appear to be important for LPS-mediated iNOS induction, the effect of AAF on the activation of these transcription factors was determined. Treatment of AAF to RAW 264.7 cells induced a dose-related inhibition of NF-kappa B/Rel in chloramphenicol acetyltransferase activity, while either AP-1 or NF-IL6 activation was not affected by AAF. Treatment of RAW 264.7 cells with AAF inhibited protein/DNA binding of NF-kappa B/Rel to its cognate site as measured by electrophoretic mobility shift assay. In addition, AAF treatment caused a significant reduction of nuclear c-rel, p65, and p50 protein levels, and this decrease was paralleled by the accumulation of cytoplasmic c-rel, p65, and p50. These data suggest that AAF inhibits iNOS gene expression by a mechanism involving a blockade of LPS-induced nuclear translocation of NF-kappa B/Rel.

The inhibitory effect of polysaccharides isolated from Phellinus linteus on tumor growth and metastasis

It was previously reported that polysaccharides (PL) isolated from Phellinus linteus strongly stimulated cell-mediated and humoral immunity. This study was undertaken to investigate the immunochemotherapeutic activity of PL against tumor growth and metastasis. PL alone significantly prolonged the survival rate of B16F10-implanted mice, inhibited tumor growth in NCI-H23-implanted nude mice, and reduced the frequency of pulmonary metastasis of B16F10 melanoma. Adriamycin significantly inhibited tumor growth, but only slightly inhibited metastasis. The combination therapy with PL and adriamycin was more effective in inhibiting tumor growth, but not metastasis. PL did not induce direct toxicity in cancer cells, which is characteristic of immunotherapeutics. In conclusion, PL might be of use in immunochemotherapy of cancer because of its effective activities on tumor growth and metastasis through the immunopotentiation of the patients without toxicity.

Subcutaneous sacrococcygeal myxopapillary ependymoma

We report a case of myxopapillary ependymoma presenting as a primary tumor of the subcutaneous tissue in the sacrococcygeal region. The mass was large, well-encapsulated, lobulated, and multiseptated, with varying signal intensity on T1- and T2-weighted MR images caused by hemorrhagic necrosis, blood degradation products, and calcification. Only a small viable portion enhanced after administration of contrast material. Multiple lobules formed from fibrous septa and dystrophic calcification also characterize this tumor.

No evidence for association of serotonin-2A receptor variant (102T/C) with schizophrenia or clozapine response in a Chinese population

The serotonin hypothesis in schizophrenia had regained interest with the superior efficacy of clozapine in the refractory schizophrenic patients. Among the serotonin receptors, the serotonin 2A (5HT2A) receptor subtype is the most widely studied. Previous studies on the association between a silent mutation polymorphism of the 5HT2A gene (102T/C) and schizophrenia or clozapine response have yielded conflicting findings. Therefore, we investigated whether these genetic variants of the 5HT2A receptor are associated with schizophrenia or with response to clozapine treatment in a Chinese population. Ninety-seven schizophrenic patients and 101 control subjects were included in the study. The receptor variants were found at similar frequencies in schizophrenic patients and healthy control subjects. Also, we did not find the variants to influence the response to clozapine in schizophrenic patients. We suggest that the assessment method of clozapine response and the ethnicity may influence the result.

Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases

From March of 1995 to November of 1997, 95 free radial forearm flaps for orofacial reconstructions were performed and included in this prospective study of donor site morbidity. All flaps were elevated using the suprafascial dissection technique. Donor site closure was performed with either split-thickness skin grafts (64 cases) or full-thickness skin grafts (31 cases). Among the 95 flaps, there were two complete flap losses and one partial flap loss because of arterial thrombosis. One orocutaneus fistula was successfully treated with a pedicled pectoralis major flap. At the donor site, the rate of complete take of skin graft was 94 percent in 95 patients. Functional and aesthetic results evaluated at least 6 months postoperatively in 50 patients revealed no significant change in grip power, pulp-to-pulp pinch power, or wrist movement in the complete skin graft take group (45 cases), whereas in the partial skin graft failure group (5 cases), both grip power and movement were significantly decreased. There was no remarkable cold intolerance in any of the 50 patients. Critical evaluations of sensory change revealed numbness distal to the donor site in 54 percent of the patients. However, dysesthesia was usually mild and improved spontaneously as time passed. Aesthetic outcome was rated as good or fair in 98 percent of the cases. The results of this prospective study show that suprafascial elevation of the radial forearm flap is superior to the classic elevation technique, particularly with regard to a higher rate of immediate complete take of skin grafts, thus avoiding impairment of range of motion and strength of the donor hand.

Down-regulation of protein kinase C: a potential mechanism for 2-amino-3-methylimidazo[4,5-f]quinoline-mediated immunosuppression

Immunosuppressive mechanism of food-born mutagenic and carcinogenic heterocyclic amine, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), was studied in murine spleen cells. IQ suppressed the IL-2 secretion and its mRNA expression. Treatment of IQ also decreased PKC activity in both the membrane fraction and the cytosol fraction. Treatment of PMA resulted in the recovery of IQ-induced suppression of IL-2 production, but the addition of ionomycin (Io) had no effect. Subsequently, we examined the effect of IQ on the activation of NF-kappaB, AP-1, and NF-AT, which are key transcription factors for IL-2 transcription. The activation of NF-kappaB and AP-1 was markedly inhibited by IQ in PMA/PHA-stimulated cells. Meanwhile, NF-AT was not affected by IQ in PMA/Io-stimulated cells. These results suggest that the immunosuppression induced by IQ might be associated with the down-regulation of PKC and subsequent blockade of the activation of NF-kappaB and AP-1 in the IL-2 gene expression.

Transforming growth factor-beta 1 (TGF-beta1) promotes IL-2 mRNA expression through the up-regulation of NF-kappaB, AP-1 and NF-AT in EL4 cells

Transforming growth factor beta1 (TGF-beta1) has been previously shown to modulate interleukin 2 (IL-2) secretion by activated T-cells. In the present studies, we determined that TGF-beta1 induced IL-2 mRNA expression in the murine T-cell line EL4, in the absence of other stimuli. IL-2 mRNA expression was significantly induced by TGF-beta1 (0.1-1 ng/ml) over a relatively narrow concentration range, which led to the induction of IL-2 secretion. Under identical condition, we examined the effect of TGF-beta1 on the activity of nuclear factor AT (NF-AT), nuclear factor kappaB (NF-kappaB), activator protein-1 (AP-1) and octamer, all of which contribute to the regulation of IL-2 gene expression. Electrophoretic mobility shift assays showed that TGF-beta1 markedly increased NF-AT, NF-kappaB and AP-1 binding to their respective cognate DNA binding sites, whereas octamer binding remained constant, as compared with untreated cells. Employing a reporter gene expression system with p(NF-kappaB)3-CAT, p(NF-AT)3-CAT and p(AP-1)3-CAT, TGF-beta1 treatment of transfected EL4 cells induced a dose-related increase in chloramphenicol acetyltransferase activity that correlated well with the DNA binding profile found in the electrophoretic mobility shift assay studies. These results show that TGF-beta1, in the absence of any additional stimuli, up-regulates the activity of key transcription factors involved in IL-2 gene expression, including NF-AT, NF-kappaB and AP-1, to help promote IL-2 mRNA expression by EL4 cells.

Prevention of malrotation deformity in femoral shaft fracture

OBJECTIVE

To confirm the need to check anteversion (AV) of the intact femur to prevent malrotation deformity following intramedullary nailing in femoral shaft fracture.

DESIGN

Prospective.

RESULTS

Four patients out of forty-two (forty-three nailings) developed malrotation deformity of more than 15 degrees after femoral nailing. In the second part of the study, distal fragments of the fractured femurs were rotated 13.8 degrees on average to match with the rotational alignment of the intact femur. The malrotation deformity was controlled to less than 5 degrees in all cases. Closed reduction along the longitudinal axis of the femur was performed and was acceptable in forty-two cases (thirty-four cases in Part 1 of the study and eight cases in Part 2) prior to nailing. The coefficient of correlation between preoperative and postoperative AVs was 0.73 in these cases.

CONCLUSION

Because true neutral rotation of the distal fragment alone is not accurate in preventing malrotation deformity of the femur following intramedullary nailing, we recommend measuring AV in both intact and fractured femurs and correcting rotational malalignment if it exists at the time of femoral nailing. Rotational alignment did not change significantly unless we failed to externally reduce the fracture due to a flexion deformity of the proximal fragment.

Inhibition of NF-kappa B/Rel nuclear translocation by dexamethasone: mechanism for the inhibition of iNOS gene expression

The decrease in NO production was found to correlate well with a decrease in inducible nitric oxide synthase (iNOS) mRNA expression as demonstrated by Northern blot analysis and quantitative RT-PCR. Since the promoter in iNOS gene contains binding motifs for NF-kappa B/Rel, NF-IL6, and Oct which appear to be important for LPS-mediated iNOS induction, the effects of DEX on the activation of these transcription factors were examined. Treatment of DEX to RAW 264.7 cells induced a dose-related inhibition of NF-kappa B/Rel in chloramphenicol acetyltransferase activity, while NF-IL6 or Oct activation was not affected by DEX. Treatment of RAW 264.7 cells with DEX inhibited DNA binding of NF-kappa B/Rel proteins to their cognate DNA site as measured by electrophoretic mobility shift assay. In addition, DEX treatment caused a significant reduction in nuclear c-rel, p65, and p50 protein contents, and these decreases were paralleled by the accumulation of cytoplasmic c-rel, p65, and p50. These results suggest that DEX may inhibit iNOS gene expression by a mechanism involving the blockade of LPS-induced nuclear translocation of NF-kappa B/Rel.

Fracture of the ipsilateral neck of the femur in shaft nailing. The role of CT in diagnosis

We report retrospective and prospective studies to identify the causes of fracture of the femoral neck associated with femoral shaft nailing on the same side. Of a total of 14 neck fractures in a series of 152 shaft nailings, eight were not visible on the initial pelvic radiographs. We used CT scans before and after operation, and fluoroscopy during the procedure in our prospective series, and reviewed abdominal CT scans retrospectively with the window set to bone level. Six of the eight undisplaced fractures were shown to have been present before operation, but two were iatrogenic. We recommend the preoperative use of CT scans of the femoral neck in high-risk patients such as those with associated fractures of the acetabulum, the distal femur or the patella. Early diagnosis will allow better general management and early fixation of the neck fracture.

Effects of estradiol and progesterone on cytochrome P4501A1 expression in Hepa 1c1c7 cells

The effects of estradiol and progesterone on the expression of cytochrome P4501A1 were investigated in Hepa 1c1c7 cells. Both steroids, at 10 microM concentration, increased P4501A1-mediated 7-ethoxyresorufin O-deethyalase activity and amounts of its immunoreactive protein and CYP1A1 mRNA. Gel shift assay revealed that the steroids could induce both AhR transformation and binding of the ligand-AhR complex to its specific DNA recognition site. Transient transfection demonstrated that 5'flanking region of CYP1A1 could respond to the steroid action. The competitive binding assay showed that the steroids bound to AhR with moderate affinity. These results suggested that steroidal structure can be AhR ligands and induce CYP1A1 expression in AhR-dependent manner.

Treatment of Class III malocclusion with the horseshoe appliance: case reports in growing patients

The horseshoe appliance was developed by Dr. Schwarz, and is used to correct sagittal relationships by elastic force in patients with Class III malocclusion. The horseshoe appliances minimize the increment of lower anterior facial height and allow the mandible to be repositioned harmoniously with the soft tissue and muscle matrix of the jaw. It has the advantages of good patient cooperation, ease of construction, and effective modification. In patients who were treated with the horseshoe appliance, the following results were observed: 1. Forward growth of the maxilla was enhanced, overgrowth of the mandible was restricted, and a normal arch relationship was established. 2. Minimum downward and backward rotation of the mandible was accepted with the free sliding of the appliance, and elastic force and increment of lower anterior facial height were minimized. 3. Both labioversion of maxillary incisors and linguoversion of mandibular incisors were observed and facial profile was improved.

Cloning and characterization of the upstream region of Clostridium botulinum type B neurotoxin gene

The upstream region of the gene coding for Clostridium botulinum type B (BoNT/B) neurotoxin was cloned and sequenced. There were two open reading frames, which were identified as a nontoxic-nonhemagglutinin component (ntnh/B) and a 22 kDa adjacent open reading frame (orf22/B). Deduced primary structure of ntnh/B showed that it was composed of 1,197 amino acid residues. Pairwise comparisons of the ntnh/B component with other botulinum toxin types showed high degree of homology to ntnh/A (82% identity). Northern blot analysis revealed that toxin gene could be transcribed alone or co-transcribed with the ntnh gene. The orf22/B gene encoding for 178 amino acids (M.W. 21.6 kDa) was located between the 33 kDa hemagglutinin gene and the ntnh gene. Orf22/B also showed high degree of homology to orf22/A (98.9% identity). These results suggested that the upstream region of the BoNT/B gene (containing the ntnh/B and orf22/B genes) might be evolutionarily closely related to the counterparts of the BoNT/A.

Ultrastructural characteristics of central neurocytoma in cell culture

The study was performed to determine the ultrastructural characteristics of central neurocytoma and its features in primary cell culture. Fresh tissue from three tumors was mechanically and enzymatically dissociated into individual cells, which were cultured onto poly-L-lysine precoated Aclar coverslips in the media. The tumor cells attached to the surface of the coverslips within 12 to 24 h and delicate cytoplasmic processes developed within 2 to 3 days. Electron microscopic examination of the cultured tumor cells and the tumor tissue supported neuronal origin. Combined tissue culture and electron microscopic study provides a rapid, reliable, and reproducible means for the diagnosis of central neurocytoma.

Cleavage of the synaptobrevin/vesicle-associated membrane protein (VAMP) of the mouse brain by the recombinant light chain of Clostridium botulinum type B toxin

The light chain of Clostridium botulinum type B toxin was expressed in Escherichia coli using the expression vector pEt-3a containing phage T7 promoter. The expressed protein was then purified by DEAE-cellulose and phosphocellulose chromatography and the proteolytic activity of the purified light chain was studied. The purified recombinant light chain cleaved synaptobrevin when mixed with the mouse brain microsome and the proteolytic activity of the light chain was inhibited if a metal chelating agent such as EDTA or 2,2'-dipyridyl was added. The recombinant light chain cleaved synaptobrevin more effectively than the native type B toxin. When the native toxin was trypinized and was reduced with DTT, its proteolytic activity was similar to that of the recombinant light chain.

Induction of liver-associated transforming growth factor beta 1 (TGF-beta 1) mRNA expression by carbon tetrachloride leads to the inhibition of T helper 2 cell-associated lymphokines

Acute treatment of B6C3F1 mice with a hepatotoxic dose (500 mg/kg) of carbon tetrachloride (CCl4) produced a marked but transient increase in transforming growth factor beta 1 (TGF-beta 1) mRNA expression in the liver within 24 hr. We have previously shown that an identical dose of CCl4 also produces a marked increase in serum TGF-beta 1 concentrations which peak at 48 hr and produce a marked inhibition of the anti-sRBC IgM antibody forming cell (AFC) response. Similar increases in TGF-beta 1 transcripts scripts in the liver were also induced by an acute hepatotoxic dose (600 mg/kg) of acetaminophen. No increase in TGF-beta 1 mRNA expression was detected in the spleen following treatment with either agent. Direct addition of TGF-beta 1 (0.05-1.0 ng/ml) to naive splenocyte cultures produced a marked and dose-related inhibition of the anti-sRBC IgM AFC response. Under the same conditions, TGF-beta 1 induced a marked decrease in IL-4 and IL-5 mRNA expression in sRBC-sensitized splenocytes. Concomitantly, TGF-beta 1 induced a rapid increase in NF-kappa B/Rel trans-acting factor binding within the first 24 hr post-sRBC sensitization of splenocytes. Conversely, NF-kappa B/Rel binding activity was inhibited on Days 2 through 4 in sRBC-sensitized splenocytes in the presence of TGF-beta 1. The increase in NF-kappa B/Rel binding within 24 hr following sRBC sensitization is consistent with the positive influence TGF-beta 1 exerts on Th1 cytokines such as IL-2 and IFN-gamma. Conversely the decrease in NF-kappa B/Rel binding at the later time period during the AFC response (Days 2-4) coincides with the inhibitory effects TGF-beta 1 exerted on IgM production by B cells.

Murine Cyp1a-1 induction in mouse hepatoma Hepa-1C1C7 cells by myristicin

Mouse hepatoma Hepa-1c1c7 (Hepa-1) cells were treated with myristicin to assess the role of myristicin in the process of Cyp1a-1 induction. Treatment of Hepa-1 cells with myristicin increased Cyp1a-1 transcription in a dose-dependent manner as shown by analysis of 7-ethoxyresorufin O-deethylase activity, Cyp1a-1 protein level, and Cyp1a-1 mRNA. Myristicin, however, did not competitively displace [3H]2,3,7,8-tetrachlorodibenzo-p-dioxin from the Hepa-1 cytosolic aryl hydrocarbon (Ah) receptor in a competitive Ah receptor binding analysis using sucrose density gradient sedimentation and did not affect formation of DNA-protein complexes between the Ah receptor and its DRE target in a gel mobility shift assay using oligonucleotides corresponding to DRE 3 of the Cyp1a-1. These results suggest that the induction of Cyp1a-1 gene expression by myristicin in Hepa-1 cells might occur through an Ah receptor-independent pathway.

Intramedullary entrapment of the radial nerve associated with humeral shaft fracture

We present an unusual case of a humeral shaft fracture with intramedullary entrapment of the radial nerve by an undisplaced posterior triangular fragment tightly fixed to the lateral intermuscular septum. Initial examination showed a complete high radial nerve palsy and an angulated mid-shaft humeral fracture associated with an undisplaced posterior triangular fragment. After failure of several closed reductions, we decided to attempt an open reduction and internal fixation with simultaneous exploration of the radial nerve. During surgery, the radial nerve was found emerging from the medullary canal of the proximal fragment. The nerve was freed by briefly displacing the undisplaced posterior triangular fragment. The fracture was then reduced and fixed by plate and screws. Six months after the operation, there was full recovery of the radial nerve and complete union of the fracture. Clearly, closed intramedullary nailing would be contraindicated in this particular type of associated radial nerve injury. We therefore suggest that in cases of mid-shaft fractures of the humerus with associated radial nerve palsy, and an undisplaced posterior triangular fragment, consideration should be given to the possible entrapment of the radial nerve in the medullary canal.

Hallucinations and signs of parkinsonism help distinguish patients with dementia and cortical Lewy bodies from patients with Alzheimer's disease at presentation: a clinicopathological study

OBJECTIVES

To compare, in a retrospective clinicopathological study, the presentation features of patients with dementia and cortical Lewy bodies (Lewy body dementia) with those of patients with Alzheimer's disease.

METHODS

From a population of 426 cases from the dementia brain bank, 39 cases of Lewy body dementia and 61 cases of Alzheimer's disease with presentation details were identified.

RESULTS

The Lewy body dementia group had significantly more frequent hallucinations (23% v 3%, P = 0.006) and signs of parkinsonism (41% v 5%, P < 0.0001) than the Alzheimer's disease group. The Lewy body dementia group also had a greater proportion of men (62% v 34%, P = 0.013).

CONCLUSION

Hallucinations and signs of parkinsonism help distinguish Lewy body dementia from Alzheimer's disease at presentation. These indicators may not be very sensitive, because they were reported for less than half of the patients with Lewy body dementia.

The relationship between loading conditions and fracture patterns of the proximal femur

In an attempt to test the hypothesis of spontaneous hip fracture, seven pairs of femurs, with ages ranging from 59 to 90, were tested under two loading conditions designed to simulate muscular contraction. Simulated iliopsoas contraction produced femoral neck fractures at an average normalized ultimate load of 5.2 +/- 0.8 times body weight. Simulated gluteus medius contraction produced sub-/inter-trochanteric fractures at an average normalized ultimate load of 4.1 +/- 0.6 times body weight. The average ultimate load for all specimens was 3040 +/- 720 N. Fracture patterns produced by both loading conditions were clinically relevant. The results from this study suggest that abnormal contraction produced by major rotator muscles could induce hip fracture.

2-amino-3-methylimidazo[4,5-f]quinoline-mediated immunosuppression involves inhibition of protein kinase C in murine splenocytes

The effects of the food-borne mutagenic and carcinogenic heterocyclic amine, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), on the proliferation of murine spleen cells was examined. A significant and dose-related suppression of the proliferative response to concanavalin A (Con A) was observed by the treatment of IQ. IQ also decreased markedly the level of proliferative response induced by PMA and ionomycin and the IL-2 secretion by T cells. Treatment of PMA resulted in the recovery of IQ-induced suppression of IL-2 production, but the addition of ionomycin (Io) had no effect. IQ decreased PKC activity in both the membrane fraction and the cytosol fraction and inhibited the phosphorylation of MARCKS protein. These results suggest that the suppression of spleen cell proliferation induced by IQ might be associated with the inhibition of PKC activity and the subsequent IL-2 secretion of T cells.

Exposure to low-intensity ultrasound increases aggrecan gene expression in a rat femur fracture model

The effects of ultrasound stimulation on various parameters of bone repair after diaphyseal injury were assessed in a standard rat femur fracture model. Bilateral closed femoral fractures were made in 79 skeletally mature male Long-Evans rats. An ultrasound signal consisting of a 200 microsecond burst sine wave of 0.5 MHz repeating at 1 kHz, with an intensity of 50 or 100 mW/cm2 spatial and temporal average, was applied to one fracture in each animal. The contralateral fracture was not exposed to ultrasound and served as a control. Mechanical testing of the healing fracture was performed 3 weeks after injury. In fractures treated with a 50 mW/cm2 ultrasound signal, the average maximum torque (223.5 +/- 50.5 Nmm compared with 172.6 +/- 54.9 Nmm, p = 0.022, paired t test) and average torsional stiffness (13.0 +/- 3.4 Nmm/degree compared with 9.5 +/- 2.9 Nmm/degree, p = 0.017) were significantly greater in treated than in control fractures. In animals treated with a 100 mW/cm2 ultrasound signal, the average maximum torque and torsional stiffness were greater in treated than in control fractures, but this trend did not reach statistical significance. Biochemical analysis of callus in ultrasound-treated and control fractures failed to demonstrate significant differences in cell number, collagen content, or calcium content. Evaluation of gene expression in fractures treated with 50 mW/cm2 ultrasound demonstrated a shift in the expression of genes associated with cartilage formation; aggrecan gene expression was significantly higher on day 7 after fracture and significantly lower on day 21 (p = 0.033 and 0.035, respectively). alpha 1(II) procollagen gene expression was similarly modified, but this trend did not reach statistical significance. Expression of genes coding for bone-related proteins, including alpha 1(I) procollagen, bone gamma-carboxyglutamic acid protein, alkaline phosphatase, and transforming growth factor-beta 1, did not differ between ultrasound-treated and control fractures. These data suggest that ultrasound stimulation increased the mechanical properties of the healing fracture callus by stimulating earlier synthesis of extracellular matrix proteins in cartilage, possibly altering chondrocyte maturation and endochondral bone formation.

Attenuation of inducible nitric oxide synthase gene expression by delta 9-tetrahydrocannabinol is mediated through the inhibition of nuclear factor- kappa B/Rel activation

delta 9-Tetrahydrocannabinol (delta 9-THC) a prototypic compound belonging to the family of agents known as cannabinoids, produces a wide variety of biological effects, including inhibition of immune function. The putative mechanism for cannabinoid biological action involves binding to cannabinoid receptor types 1 and 2 (CB1 and CB2) to negatively regulate adenylate cyclase and inhibit intracellular signaling via the cAMP cascade. In the current study, we show that delta 9-THC produces a marked inhibition of inducible nitric oxide synthase (iNOS) transcription and nitric oxide production by the macrophage line RAW 264.7 in response to lipopolysaccharide (LPS). Analysis of RAW 264.7 cell RNA demonstrated transcripts for CB2 but not CB1. Treatment of RAW 264.7 with delta 9-THC inhibited forskolin-stimulated cAMP production in a dose-related manner, verifying the expression of functional cannabinoid receptors by this cell line. iNOS transcription, which is regulated in part by the nuclear factor-kappa B/Rel (NF-kappa B/Rel) family of transcription factors, has been shown to be under the control of the cAMP signaling cascade. We demonstrate that delta 9-THC inhibits the activation and binding of NF-kappa B/Rel proteins to their cognate DNA site, kappa B, in response to LPS stimulation. LPS treatment of RAW 264.7 cells also induced the activation of the cAMP cascade, as indicated by an increase in binding of nuclear factors to the cAMP response element. Activation of CRE binding proteins was inhibited by delta 9-THC. Forskolin treatment of RAW 264.7 cells induced both kappa B and cAMP response element binding activity and was likewise inhibited by delta 9-THC. Collectively, this series of experiments indicates that NF-kappa B/Rel is positively regulated by the cAMP cascade to help initiate iNOS gene expression in response to LPS stimulation of macrophages. This activation of iNOS is attenuated by delta 9-THC through the inhibition of cAMP signaling.