The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions

The management of patients with combined medial collateral (MCL) and anterior cruciate (ACL) rupture remains controversial. We studied 25 such patients who elected to have the ACL lesion treated conservatively; 14 underwent MCL repair with early mobilization and 11 were treated with immobilization for two weeks. The mean follow up was 5.9 years (2 to 11). There was no difference in the clinical assessment of ligamentous laxity, KT-1000 measurements or Tegner activity scores between the two groups but there were significantly higher Lysholm function scores in the operated group.

Synthesis and biological activities of 4-chloroindole-3-acetic acid and its esters

4-Chloroindole-3-acetic acid (4-Cl-IAA) and its esters were synthesized from 2-chloro-6-nitrotoluene as the starting material. The biological activities of 4-CI-IAA and its esters were determined by four bioassays. Except for the tert-butyl ester, 4-Cl-IAA and its esters had stronger elongation activity toward Avena coleoptiles than had indole-3-acetic acid. The biological activities of the methyl, ethyl and allyl esters were as strong as the activity of the free acid. All the esters, except for the tert-butyl, inhibited Chinese cabbage hypocotyl growth more than the free acid did, and all the esters induced severe swelling and formation of numerous lateral roots in black gram seedlings even at a low concentration. Furthermore, adventitious root formation was strongly promoted in Serissa japonica cuttings by all the esters. The root formation-promoting activities of the ethyl and allyl esters were about three times the value for indole-3-butyric acid which is used to promote and accelerate root formation in plant cuttings.

Neural substrates for depth perception of the Necker cube; a functional magnetic resonance imaging study in human subjects

We have studied the cerebral activity for the depth perception of the Necker cube by functional magnetic resonance imaging. Three types of line drawing figures were used as stimuli, the Necker cube, hidden line elimination cube and overlapping squares. Subjects were instructed to perceive both orientations of the depth of the Necker cube. They were instructed to shift their attention voluntarily during viewing overlapping squares to obtain a control for the attentional shift in perceiving the Necker cube. A hidden line elimination cube was used as a control for monocular stereopsis. The results showed a clear symmetrical activation in premotor and parietal areas during the Necker cube perception compared with other conditions. The present result suggests that a neural process similar to mental image manipulation occurs during depth perception of the Necker cube.

Early and delayed Tc-99m ECD brain SPECT in SLE patients with CNS involvement

We compared early and delayed Tc-99m ECD SPECT scans in 32 SLE patients (Group 1, definite neuropsychiatric disorders; Group 2, minor neurologic symptoms or normal) with those of normal controls by visual inspection and semi-quantitative evaluation. With visual interpretation, 13 out of 14 patients in Group 1 (93%) and 7 out of 18 patients in Group 2 (39%) had diffuse uneven decrease in early scans. Seven patients in Group 2 (39%) who had normal early scans demonstrated focal decrease in the medial frontal lobe in delayed scans. With cerebral region to cerebellar ratios, in early scans, the medial frontal lobe in Group 1 and Group 2 was significantly lower than in normal controls, and lateral frontal lobe and occipital lobes in Group 1 were significantly lower than in normal controls. Nevertheless, in delayed scans, every cortical region except for the parietal lobe in Groups 1 and 2 was significantly lower than in normal controls. The retention rates in all regions in SLE patients were significantly lower than in normal controls. No case showed SPECT improvement on follow-up studies in either group in spite of clinical improvement. Delayed Tc-99m ECD brain SPECT of high sensitivity might be useful in detecting CNS involvement. Although the SPECT findings did not correlate with the neuropsychiatric symptoms, early and delayed Tc-99m ECD SPECT seems to provide useful objective diagnostic information in SLE patients.

Inhibitors on an elastase-like enzyme activity catalyzing Suc-Ala-Ala-Pro-Leu-pNA amidolysis in human seminal plasma

The behavior of some proteinase inhibitors toward the Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme activity in human seminal plasma (HSP) was tested. [(2S, 3R)-3-Amino-2-hydroxy-5-methyl-hexanoyl]L-valyl-L-valyl-L-aspartic acid (Amastatin) and 3-[1-[(2-(hydroxymethyl)- -pyrolidinyl)-2-methylpropyl]-carbamoyl] octanohydroxamic acid (Actinonin) showed strong inhibitory effects. No inhibition of this present enzyme activity was seen with anti-human serum (whole), anti-human leukocyte elastase, phenyl-methyl sulfonyl fluoride, Elastatinal, ethyeneglycol bis(beta-aminoethyl ethyl)N,N,N:N'-tetra acetic acid, and [L-3-trans-ethoxycarbonyl-oxirane-2-carbonyl]1-L-leucine(3-methylbutyl)a mido (E-64). No relation was observed between human pancreatic elastase antigen and the Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme enzyme activity in HSP. Two peaks of Suc-Ala-Ala-Leu-Pro-pNA amidolytic enzyme activity were separated by Cellulofine GCL-2000 gel filtration and these activities were completely abolished by addition of Amastatin. Suc-Ala-Ala-Pro-Leu-pNA amidolytic enzyme activity in HSP is not an elastase-like metalloproteinase but is rather an acyl amidase-like leucine aminopeptidase.

Preoperative tumor embolization

We performed an embolization of tumors which we considered to need preoperative embolization, such as deep-seated tumors, or hypervascular tumors. We experienced 12 such cases in the two-year period from September 1996. Eight cases were meningiomas, one case was a hemangiopericytoma, one case was an angiofibroma and two cases were glomus tumors. As embolic material, we usually use estrogen-alcohol and polyvinyl acetate which soften the tumor. When a provacative test is either impossible or positive, the distal induction of a microcatheter is impossible or a dangerous anastomosis is present, we select polyvinyl alchol particles (120 approximately 250mum) and liquid coils. We performed an embolization of a very hypervascular tumor, juvenile angiofibroma, by a direct tumor puncture, using a mixure of N-butylcyanoacrylate, lipiodol and tantalum powder. Angiography in all cases showed a reduction of the tumor stain. The embolic method should be selected based on a combination of such factors as the purpose of embolization, the identification of the feeding artery and the histological findings.

Late hemorrhage from persistent pseudoaneurysm in vertebral artery dissection presenting with ischemia: case report

BACKGROUND

Vertebral artery dissection lesions tend to resolve spontaneously, but abnormal findings such as aneurysmal-dilatation occasionally persist. However, the clinical features and pathological findings in such cases have never been verified.

CASE DESCRIPTION

A 62-year-old man presented with left cerebellar infarction. Angiography showed the "pearl and string sign" in the left vertebral artery, and he was diagnosed as having left vertebral artery dissection. Repeated angiography showed persistent aneurysmal dilatation with irregular stenosis. Eleven years after the cerebellar infarction, the patient presented with a subarachnoid hemorrhage from an aneurysm of the left vertebral artery, and the lesion was explored via the left suboccipital approach. The vertebral artery was firm, making the placement of a clip impossible, so the lesion was treated by coating of the bleeding point. The patient died of pneumonia and hyperglycemia on postoperative day 15. Postmortem examination revealed an organized intramural hematoma, thickening of the intima, and fibrous degeneration of the media of the vertebral artery, a fusiform, distended thin arterial wall with intimal disruption at the aneurysmal dilatation, and arteriosclerosis of all cerebral arteries.

CONCLUSION

This case indicates that persistent aneurysmal dilatation of a dissection is a pseudoaneurysm prone to rupture, and that healing of the affected vessels might be severely compromised in the presence of pathological conditions such as arteriosclerosis and disturbed intraluminal blood flow in the dissected lesions.

Effect of dextran derivatives on arginine amidase activities released from isolated rabbit arteries

In the present research we examined the levels and types of arginine amidase activities that were released from isolated rabbit arteries treated with heparin or chondroitin sulfate. Heparin accelerated the release of arginine amidase activity from the isolated rabbit ear artery, the induction was not significant; a slight increase in activity was observed in the level of arginine amidase released from isolated rabbit aorta, but no significant difference was observed. On the other hand, it was revealed that the addition of chondroitin sulfate, accelerated this release from isolated rabbit ear artery with 5% significant differences. After the addition of chondroitin sulfate, the arginine amidase activity released from isolated rabbit arteries was analyzed using various affinity adsorption methods. This analysis confirmed the presence of two types of fibrinolytic enzymes: plasminogen/plasmin activity and plasminogen activators, but no thrombin was detected.

Amidolytic activities and prostate-specific antigen in human seminal plasma

The amounts of protein measured by absorbance at 280 nm, succinyl-L-alanyl-L-alanyl-L-prolyl-L-leucine-p-nitroanilide (Suc-Ala-Ala-Pro-Leu-pNA), D-valyl-cyclohexyl-alanyl-L-arginine-p-nitroanilide (Val-CHA-Arg-pNA), and glutamyl-L-phenylalanine-p-nitroanilide (Glu-Phe-pNA) amidolytic activities, and prostate-specific antigen (PSA) were measured in human seminal plasma (HSP) samples separated from the semen of 46 cases, including 13 cases of azoospermia and 33 cases of normozoospermia showing either good or poor quality of liquefaction. There was a highly significant correlation between the concentrations of all amidolytic enzyme activities studied and the concentration of PSA in HSP samples (p<.01). The HSP sample volume showed a relatively good negative coefficient of correlation to all items measured (p<.01) with the exception of protein concentration. The Suc-Ala-Ala-Pro-Leu-pNA, Val-CHA-Arg-pNA, and Glu-Phe-pNA amidolytic activities in azoospermia HSP samples were 2.33. 1.68, and 1.43 times higher, respectively, than those of normozoospermia samples showing good quality liquefaction. After the addition of morphologically purified human sperm to HSP sample of azoospermia cases, the Suc-Ala-Ala-Pro-Leu-pNA amidolytic activity in the HSP sample of azoospermia was not decreased for up to 18 h incubation, while the number of motile human sperm gradually declined, and no motile human sperm were detected after 18 h of incubation. The high Suc-Ala-AlaPro-Leu-pNA amidolytic activity in HSP samples of azoospermia cases did not result from a lack of motility.

[Usefulness of DIC-CT in choledocholithiasis]

In order to assess the efficacy of helical CT in drip-infusion cholangiography (DIC-CT) for diagnosis of choledocholithiasis, 82 patients with biliary diseases, including 25 patients with a definite diagnosis of choledocholithiasis obtained by direct cholangiography, were investigated by DIC-CT and EUS. Comparative investigation showed that, of the 25 cases, 94.7% could be imaged by DIC-CT and 87.5% by EUS, with respective sensitivities of 94.7% and 87.5%. The specificities in both cases were 100% and accuracies were 97.8% with DIC-CT and 96% with EUS respectively. Therefore, in diagnosis the choledocholithiasis, DIC-CT displays similar diagnostic efficiency as EUS or ERC, and can be recognized as the non-invasive and useful procedure for pre-operative diagnosis of cholecystolithiasis.

Regulation of growth hormone-releasing hormone receptor messenger ribonucleic acid expression by glucocorticoids in MtT-S cells and in the pituitary gland of fetal rats

Regulation of GH-releasing hormone receptor (GHRH-R) messenger RNA (mRNA) expression was studied, with the ribonuclease protection assay, in the fetal rat pituitary gland and in MtT-S clonal cells. GHRH-R mRNA was first detected on embryonic day (E)19 and increased rapidly thereafter, to reach a maximum at E21. Incubation of E17 or E18 pituitaries with 50 nM dexamethasone (DEX), a synthetic glucocorticoid, induced GHRH-R mRNA expression, suggesting that glucocorticoids play a pivotal role in the developmental expression of this mRNA. In E19 pituitaries, 24 h treatment with DEX increased GHRH-R mRNA by 60%, and GH mRNA by 76%, but did not affect pit-1 mRNA level, suggesting that the effect of DEX is specific for expressions of GH mRNA and GHRH-R mRNA. The accumulation of GHRH-R mRNA by DEX was time dependent, and it was slightly enhanced by the protein synthesis inhibitor, puromycin (100 microM). In MtT-S cells (a pituitary cell line established from an estrogen-induced tumor), DEX induced GHRH-R mRNA expression within 2 h in a dose-dependent manner. This induction was augmented by puromycin (100 microM) or cycloheximide (3.5 microM). However, the RNA synthesis inhibitor Actinomycin D (1 microM) completely inhibited GHRH-R mRNA accumulation in response to either DEX or DEX plus puromycin, suggesting that glucocorticoids induce GHRH-R mRNA mainly through stimulation of mRNA transcription. These results suggest: that GHRH-R mRNA accumulation in the fetal pituitary gland of rats normally occurs at E19, probably because of the direct action of glucocorticoids on the pituitary gland, to stimulate GHRH-R mRNA transcription; and that the expression of glucocorticoid receptors is an important event in GH cell development in rats. Accordingly, immunocytochemical results suggest an increase in glucocorticoid receptors in immature GH cells between E17 and E18. The present results also imply that MtT-S cells may be a good model in which to further study the molecular mechanisms of the regulation of GHRH-R gene expression.

cpmA, a gene involved in an output pathway of the cyanobacterial circadian system

We generated random mutations in Synechococcus sp. strain PCC 7942 to look for genes of output pathways in the cyanobacterial circadian system. A derivative of transposon Tn5 was introduced into the chromosomes of reporter strains in which cyanobacterial promoters drive the Vibrio harveyi luxAB genes and produce an oscillation of bioluminescence as a function of circadian gene expression. Among low-amplitude mutants, one mutant, tnp6, had an insertion in a 780-bp open reading frame. The tnp6 mutation produced an altered circadian phasing phenotype in the expression rhythms of psbAI::luxAB, psbAII::luxAB, and kaiA::luxAB but had no or little effect on those of psbAIII::luxAB, purF::luxAB, kaiB::luxAB, rpoD2::luxAB, ndhD::luxAB, and conII::luxAB. This suggests that the interrupted gene in tnp6, named cpmA (circadian phase modifier), is part of a circadian output pathway that regulates the expression rhythms of psbAI, psbAII, and kaiA.

Bone morphogenetic protein-2 promotes survival and differentiation of striatal GABAergic neurons in the absence of glial cell proliferation

We examined the potential neurotrophic effects of bone morphogenetic protein (BMP)-2 on the survival and differentiation of neurons cultured from the rat developing striatum at embryonic day 16, a period during which the mRNAs for BMP-2 and its receptor subunits (types IA, IB, and II) were detected. BMP-2 exerted potent activity to promote the survival of striatal neurons and increased the number of surviving microtubule-associated protein-2-positive cells by 2.4-fold as compared with the control cultures after 4 days in vitro. Although basic fibroblast growth factor (bFGF) also showed relatively high activity to promote the survival of striatal neurons, transforming growth factor-beta1, -beta2, and -beta3, glial cell line-derived neurotrophic factor, or brain-derived neurotrophic factor promoted their survival weakly. Striatal neurons cultured in the presence of BMP-2 or bFGF possessed extensive neurite outgrowths, the majority of which were GABA-immunoreactive. Inhibition of glial cell proliferation by 5-fluorodeoxyuridine did not affect the capacity of BMP-2 to promote the survival of striatal GABAergic neurons. In contrast, the ability of bFGF to promote the survival of striatal neurons was inhibited significantly by the treatment of cells with 5-fluorodeoxyuridine. All these results suggest that BMP-2 exerts potent neurotrophic effects on the striatal GABAergic neurons in a glial cell-independent manner.

An HIV autopsy--characterization of zidovudine-resistant subtype E HIV-1 from autopsy tissue suggests the route of infection and an alternative protocol of therapy

This CPC concerns a 47-year-old male patient with acquired immunodeficiency syndrome (AIDS). The patient became symptomatic when he developed Pneumocystis carinii pneumonia, but recovered sufficiently to be treated as an outpatient. Two years after falling ill, he developed septic shock and died within a short time. During this period, he failed to respond to HIV drugs, and there was no improvement in his immunodeficient status. The HIV retrieved from the patient's organs at autopsy was found to be type E and to have acquired resistance to Zidovudine. It was also possible to determine the route of infection. HIV treatment guidelines are continuously being revised on the basis of HIV research and the development of new treatment plans, and at the present time, when no definitive method of treatment has yet been established, it is essential for the clinician to keep abreast of the latest information. Since HIV patients are compromised hosts, it is important to diagnose and treat other infectious complications, not only complications unique to AIDS, and we have briefly described the latest HIV therapy.

[A case of enlarged infundibular dilatation diagnosed by vertebral angiograms with carotid compression and neuroendoscope]

A case of enlarged infundibular dilatation diagnosed by vertebral angiograms with carotid compression was reported. A 57-year-old woman suffered from headache. She underwent MRA which revealed left internal carotid artery aneurysm. Left common carotid angiograms suggested a left saccular internal carotid artery aneurysm (4 mm x 6 mm) without a posterior communicating artery. However, it was confirmed to be an enlarged infundibular dilatation on left vertebral angiograms with carotid compression. It was confirmed at operation microscopically and neuroendoscopically, and the dilatation was treated by coating. When carotid angiograms reveal no posterior communicating artery, it is difficult to differentiate the origin of posterior communicating artery from internal carotid artery-posterior communicating artery junction aneurysms. Vertebral angiograms with carotid compression is useful for the differentiation for the exact diagnosis.

Abnormal contingent negative variation in writer's cramp

OBJECTIVE

To investigate the physiological abnormality in writer's cramp, a focal dystonia which specifically affects writing.

METHODS

We recorded brain potentials that precede hand and neck movements (contingent negative variation or CNV) in 11 patients and 11 age-matched normal subjects. A 1000 Hz tone burst (S1) was delivered to the right or left ear in random sequence, and 2 s after, a 2000 Hz tone burst (S2) was delivered to both ears simultaneously. For the response task to S2, the subjects were instructed to extend their fingers ipsilateral to the ear to which S1 was given in one experiment or to rotate the head to the side of the S1 presentation in another. All the patients had symptoms in the right hand only, and performed both tasks normally. CNV amplitudes were compared between normals and patients using unpaired t test.

RESULTS

They showed normal CNV for neck movement but significantly decreased CNV amplitudes for movements both in the affected and unaffected hands.

CONCLUSIONS

Our findings suggest that motor programming is specifically abnormal for the affected body part, including the asymptomatic contralateral limb, and that the clinical symptom may result from a deficient compensatory mechanism for abnormal motor programs or subroutines.

Origin of the "N10" stationary-field potential after median nerve stimulation

The scalp far-field potentials after median nerve stimulation at the wrist consist of P9, P11, P13, and P14 positive components. Earlier, Emerson et al. (1984) identified the "N10" negative potential in-between the P9 and P11 and claimed that this was not merely a passive return to the baseline after the P9 positive deflection but a distinct component reflecting a proximal brachial plexus volley. They thought N10 was a far-field potential having widespread distribution with a fixed latency. In this study we found that N10 was of higher amplitude after median nerve stimulation at the elbow than after stimulation at the wrist. Indeed the N10 latency was fixed from the lower anterior neck to the scalp, and its amplitude was maximum at the anterior lower neck. The latency of N10 was about 0.3 milliseconds longer than the Erb's potential and 0.15 milliseconds longer than the potential recorded from the lateral neck on the side of stimulation. The N10 amplitude increased in parallel with increased stimulus intensity. In order to explore the origin of the N10 stationary field potential, we designed a paired stimuli paradigm applied to the wrist (S1) and to the elbow (S2). The interstimulus interval between S and S2 was adjusted so that the timing of S2 was immediately after the traveling impulse produced by the S1 stimulus as it passed through the S2 stimulus site. This technique allowed stimulation of the anterior interosseous nerve selectively at the elbow while the median nerve originating from the wrist was undergoing refractory period. The response of (S1 + S2) - S1 showed only the N10 with absence of cervical and cortical responses, implying that N10 was activated, predominantly by the interosseous nerve, i.e., an antidromic motor volley, when the median nerve was stimulated at the elbow.

Preparation of optically active trifluoromethylated (3′-indolyl) thiacarboxylic acids, novel plant growth regulators, through lipase-catalyzed enantioselective hydrolysis

Among a variety of lipases tested, that obtained from Candida antarctica (SP 435) induced enantioselective hydrolysis of trifluoroethyl 5,5,5-trifluoro-4-(3'-indolyl)-3-thiapentanoate (1c). The selectivity could be increased by optimizing the reaction conditions. Thus, good selectivity was achieved (E = 37) in a buffer containing 10% dichloroethane. In order to improve the optical yields, a sequential kinetic resolution was utilized for the preparative-scale enantioselective hydrolysis of 1c using SP 435. Hydrolysis of trifluoroethyl 6,6,6-trifluoro-5-(3'-indolyl)-4-thiahexanoate (2c) with the lipase of Pseudomonas aeruginosa (LIP) in a buffer containing 20% tert-amyl alcohol at 25 degrees C gave excellent selectivity (E=357).

Determination of progesterone and 17-hydroxyprogesterone by high performance liquid chromatography after pre-column derivatization with 4,4-difluoro-5,7-dimethyl-4-bora-3a,4a-diaza-s-indacene-3-propionohydra zide

Progesterone, 17-hydroxyprogesterone and four other 3-keto steroids were determined by high performance liquid chromatography with fluorescence detection. Each steroid was derivatized with 4,4-difluoro-5,7-dimethyl-4-bora-3a,4a-diaza-s-indacene++ +-3- propionohydrazide (BODIPY FL hydrazide) and separated on a Wakosil 5C4 column with acetonitrile-water (7 + 3) as mobile phase. The limits of detection of progesterone, 17-hydroxyprogesterone, dehydroepiandrosterone, androstenedione, testosterone and 17-methyltestosterone were 550-3700 fmol per 10 microliters injection (signal-to-noise ratio = 5) serum. The calibration curves were linear up to 1000 ng/ml serum. The proposed method was most sensitive among the available high performance liquid chromatographic methods after fluorescence and chemiluminescence pre-labeling with dansylhydrazine.

Reversibility of the curdlan feeding effects on the morphological structure of intestinal mucosa in rats

We reported in the previous paper that rats fed a curdlan diet showed significant increases in the weight of the cecum and its contents, a decrease in fecal wet weight, a retardation in the transit time of the gastrointestinal tract and morphological changes of the ileal and cecal mucosal surface when compared with the rats fed a cellulose diet. In the present study, we intended to learn if the curdlan effects on the morphological structure of intestinal mucosa were reversible. When rats were fed on the curdlan diet for 2 weeks followed by a cellulose diet for another 2 weeks, the cecum and cecal contents were not different from those of the cellulose group. The transit time of the gastrointestinal tract of the curdlan-followed-by-cellulose group was shorter than that of the curdlan group, whereas it was longer than that of the cellulose group. In scanning electron micrographs, the ileal villi of the curdlan-followed-by-cellulose group were normal, as in the cellulose group. However, their ileal and cecal microvilli were similar to those of the curdlan group, that is, the microvilli were crowded and more tightly packed, and some appeared to have been squeezed out. From these results, it was concluded that the effects of the curdlan feeding were only partially reversible, but the effects on the surface structure of intestinal mucosa were still sustained even after curdlan feeding of 2 weeks was discontinued. This might result from response to the high viscosity of the intestinal contents remaining after discontinuation of the curdlan.

Age-dependent decline in cortisol levels and clinical manifestations in patients with ACTH-independent Cushing's syndrome

OBJECTIVE

Adrenocortical cells change with age in both subcellular morphology and level of steroidogenesis. This study evaluates the influence of aging on hypercortisolism and clinical manifestations in patients with ACTH-independent Cushing's syndrome due to a cortisol-secreting adrenal adenoma (CS).

DESIGN

Restrospective study.

PATIENTS

Thirty-six (33 females and 3 males) with CS. 31 healthy controls were age- and sex-matched to CS patients.

MEASUREMENT

Patient age at diagnosis was compared to the degree of hypercortisolism and clinical manifestations. The degree of hypercortisolism was estimated using serum cortisol levels and urinary free cortisol excretion. Positive clinical manifestations were quantified using 12 symptoms and signs which resulted in a clinical score for each patient. Endogenous creatinine clearance, estimated disease duration and gender were analysed as possible factors affecting adenoma-secreated cortisol.

RESULTS

Patient age correlated negatively with serum cortisol level (r = -0.417, P = 0.0107, n = 36) and urinary excretion of free cortisol (r = -0.613, P = 0.0002, n = 31). Analysis of Spearman's rank correlation showed that the clinical score decreased with age (rho = -0.631, P = 0.0004, n = 33). Oedema, weakness/myopathy, hirsutism, striae and psychological changes were infrequent symptoms in the elderly. Using stepwise multiple regression analysis, we estimated the clinical score (Y) by factors of serum cortisol levels (X1:nmol/l), age (X2: years of age) and gender (X3: gender; female = 1, male = 0), i.e. Y = 4.771 + 0.004 X1 - 0.064 X2 + 2.548 X3 (r = 0.743, P < 0.0001, n = 33). Results suggested that aging both suppressed cortisol secretion and repressed manifestations directly as an independent factor, although its direct effect may be weak.

CONCLUSIONS

Our findings indicated the importance of age as a factor modulating hormonal levels and possible clinical manifestations in patients with cortisol-secreting adenomas.

Developmental expression of NMDA receptor subunits and the emergence of glutamate neurotoxicity in primary cultures of murine cerebral cortical neurons

Using primary cultures of murine cerebral cortices, we investigated the developmental expression of N-methyl-D-aspartate (NMDA) receptor subunits in relation to the appearance of NMDA receptor-mediated glutamate neurotoxicity. The cultures were not affected by glutamate exposure on culture days 7-9, but became sensitive to glutamate neurotoxicity on day 11. The expression of NMDA receptor subunit messenger RNAs (mRNAs) was investigated by means of reverse transcription polymerase chain reaction (RT-PCR). The epsilon 3-NR2C and epsilon 4-NR2D transcripts could not be detected in the culture. The epsilon 2-NR2B and zeta 1-NR1 subunit mRNAs, on the other hand, could be detected clearly and continuously from the culture initiation, and the epsilon 1-NR2A subunit mRNA became clearly detectable on culture day 4. The expression of these three subunits' proteins in the glutamate-insensitive stage (culture day 8) and the sensitive stage (day 11) were studied by means of Western blotting. The epsilon 2-NR2B and zeta 1-NR1 subunit proteins were clearly expressed on culture days 8 and 11, but the epsilon 1-NR2A subunit protein could hardly be detected on either day 8 or day 11. These results suggest that the glutamate neurotoxicity in the primary culture was mediated mainly by epsilon 2/zeta 1 NMDA receptors. The time lag between the protein expression of the epsilon 2-NR2B and zeta 1-NR1 subunits and the emergence of glutamate neurotoxicity may be necessary for the maturation of functional NMDA receptor systems, including heteromeric receptor formation, increase in receptor density and maturation of the postreceptor signal transduction system.

The influence of osteoporosis on varus osteoarthritis of the knee

We studied 37 patients with varus osteoarthritis of the knee to determine the influence of the bone mineral density (BMD) on the varus deformity. There were 15 men (21 knees) and 22 women (38 knees). The mean age of the men was 69 years and of the women 68 years. BMD was measured in the L1-L4 spinal region using dual X-ray absorptiometry. In the women a low level of BMD was associated with varus deformity originating at the proximal tibia, but a high level was predominantly linked with deformity originating in the joint space. Similar findings were obtained in the men. Our results suggest that a low BMD predisposes to trabecular microfractures and consequently increased stress on the articular cartilage. A low BMD does not preclude osteoarthritic change in the knee.

The influence of osteoporosis on varus osteoarthritis of the knee

We studied 37 patients with varus osteoarthritis of the knee to determine the influence of the bone mineral density (BMD) on the varus deformity. There were 15 men (21 knees) and 22 women (38 knees). The mean age of the men was 69 years and of the women 68 years. BMD was measured in the L1–L4 spinal region using dual X-ray absorptiometry.

In the women a low level of BMD was associated with varus deformity originating at the proximal tibia, but a high level was predominantly linked with deformity originating in the joint space. Similar findings were obtained in the men.

Our results suggest that a low BMD predisposes to trabecular microfractures and consequently increased stress on the articular cartilage. A low BMD does not preclude osteoarthritic change in the knee.