Infection-provoked reversible posterior leukoencephalopathy syndrome in an adult with nephrotic syndrome: a case report

Background

Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare and heterogeneous clinico-neuroradiological syndrome characterized by headache, altered mental status, seizures, and visual disturbances. Hypertension and immunosuppression are two of the main factors that predispose an individual to RPLS. However, RPLS can develop when no major risk factors are present. RPLS has been reported in pediatric nephrotic patients, but rarely in adults.

Case presentation

A 42-year-old Asian woman with nephrotic syndrome presented with seizures, headaches, and nausea. Her blood pressure was controlled, and no immunosuppressants had been prescribed. All symptoms and tests indicated RPLS following infection with pneumonia, which was successfully treated by immediate administration antibiotic and anti-epileptic medications. Seizures did not recur during a 2-year follow-up period.

Conclusions

When patients with nephrotic syndrome have an infection, RPLS symptoms should be investigated thoroughly. With early diagnosis and appropriate treatment of RPLS, morbidity and mortality can be prevented.

Entropy-Based Quantitative Electroencephalogram Analysis for Diagnosing Attention-Deficit Hyperactivity Disorder in Girls

Diagnosis of attention-deficit hyperactivity disorder (ADHD) is currently based on core symptoms or checklists; however, the inevitability of practitioner subjectivity leads to over- and underdiagnosis. Although the Federal Drug Administration has approved an elevated theta/beta ratio (TBR) of the electroencephalogram (EEG) band as a tool for assisting ADHD diagnosis, several studies have reported no significant differences of the TBR between ADHD and control subjects. This study detailed the development of a method based on approximate entropy (ApEn) analysis of EEG to compare ADHD and control groups. Differences between ADHD presentation in boys and girls indicate the necessity of separate investigations. This study enrolled 30 girls with ADHD and 30 age-matched controls. The results revealed significantly higher ApEn values in most brain areas in the control group than in the ADHD group. Compared with TBR-related feature descriptors, ApEn-related feature descriptors can produce the higher average true positive rate (0.846), average true negative rate (0.814), average accuracy (0.817), and average area under the receiver operating characteristic curve value (0.862). Therefore, compared with TBR, ApEn possessed the better potential for differentiating between girls with ADHD and controls.

Variations in cognitive demand affect heart rate in typically developing children and children at risk for developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) is a diagnosis for children who present with movement difficulties, but are of normal intelligence without neurological deficits. Previous studies have demonstrated that children with DCD exhibit perceptual deficits and lower cognition performance. To date, their autonomic nervous system (ANS) responses during tasks requiring cognitive and perceptual effort have not been compared to typically developing children (TDC).

OBJECTIVE

The present study investigated heart rate variability (HRV) as a marker for ANS response differences between DCD and TDC, and the impact of different levels of task difficulty.

METHODS

Participants were 60 individuals (9-10 years); 30 children at risk for DCD, and 30 TDC. Each participant performed two tasks each of which demanded enhanced cognitive effort: a visual signal detection task and a digit memory task-each task had two levels of difficulty, low (LD) and high (HD). Heart rate responses were continuously recorded during performance of each task. Frequency domain analysis and heart rate sample entropy (SampEn) were computed to determine ANS responses in each of the tasks.

RESULTS

HRV differences were detected between the two levels of task difficulty, LD and HD, for the visual signal detection task, but not for the digit memory task. HRV differences between LD and HD conditions were greater for TDC children than DCD when engaged in visual signal detection task, compare to the memory task.

INTERPRETATION

The results suggest that children at risk for DCD may show decreased HRV as a marker for altered ANS responses and potential deficits in the linkage between their perceptions and actions.

Newly diagnosed gastroesophageal reflux disease increased the risk of acute exacerbation of chronic obstructive pulmonary disease during the first year following diagnosis--a nationwide population-based cohort study

BACKGROUND

While prior studies have demonstrated that chronic obstructive pulmonary disease (COPD) is associated with gastroesophageal reflux disease (GERD), and that GERD is associated with acute exacerbations of COPD (AECOPD), no study to date has been able to establish temporality in this relationship. The purpose of this cohort study was to explore the impact of a new diagnosis of GERD on the risk of subsequent AECOPD.

METHODS

We used a retrospective population-based cohort design to analyse the data of 1976 COPD subjects with GERD as an exposure cohort and 3936 COPD subjects without GERD as a comparison group. We individually tracked each subject in this study for 12 months and identified those subjects who experienced an episode of AECOPD. Hazard ratios (HR) were calculated using Cox proportional hazards regression analysis.

RESULTS

The incidence of AECOPD was 4.08 and 2.79 per 100 person-year in individuals with and without GERD, respectively (p = 0.012). Following adjustment for sex, age, ischaemic heart disease, heart failure, atrial fibrillation, hypertension, osteoporosis, anxiety, diabetes mellitus, angina, stroke, anaemia, dementia, occupational category, monthly insurance premium, number of OPD visits and COPD severity. The stepwise Cox regression analysis revealed that GERD was independently associated with an increased risk of AECOPD (HR = 1.48, 95% CI = 1.10-1.99).

CONCLUSION

This study demonstrated that GERD is an independent risk factor for AECOPD. Caution should be exercised when assessing GERD symptoms in patients with COPD.

Periodic Lateralized Epileptiform Discharges Associated With Irreversible Hyperglycemic Hemichorea-Hemiballism

Periodic lateralized epileptiform discharges (PLEDs) on electroencephlography (EEG) usually indicate an acute, diffuse, and severe cerebral insult. Although hyperglycemic hemichorea-hemiballisum (HCHB) and striatal hyperintensity on T1-weighted magnetic resonance (MR) images is an accepted clinical entity, PLEDs have not previously been reported. Herein, we report a 74-year-old man with hyperglycemic HCHB, hyperintense putamen on T1-MR images and PLEDs on EEG. Aggressive sugar control with neuroleptic treatment only slightly improved the severity of HCHB. We also tried titrated oral and intravenous haloperidol, clonazepam, and propranolol sequentially and in combination; however, the effects were poor. Unlike the generally reversibility of hyperglycemic HCHB, the condition was still present 6 months later. Hyperglycemia can cause HCHB and produce subcortical type-PLEDs, which may explain the findings in our patient. In conclusion, PLEDs can be found in patients with hyperglycemic HCHB and striatal hyperintensity on T1-weighted MR images, and the appearance of PLEDs may indicate an irreversible outcome. EEG should be considered in such circumstances.

Isolated aphasic status epilepticus as initial presentation of nonketotic hyperglycemia

Diagnosis of aphasic status epilepticus is sometimes not easy because of its rarity and electroclinical dissociation. Although most cases are associated with organic brain lesions, nonketotic hyperglycemia (NKH)-related aphasic status epilepticus is rare, especially if it is isolated (without other clinical seizure activity). On the other hand, unlike other metabolic disorders, or hypoglycemia-related generalized seizures, focal motor seizure and epilepsia partialis continua can occur in 25% of NKH, with seizures being the initial manifestation in up to 50% of patients. However, the presentation of epileptic aphasia is rare in NKH patients. We report a rare case of NKH presenting initially as persistent and isolated aphasic status epilepticus. Brain magnetic resonance imaging did not reveal any focal lesion, but ictal electroencephalography (EEG) disclosed left frontotemporal continuous theta to delta waves, intermingled with epileptiform discharges. Correcting the hyperglycemia failed to improve the language disorder, and the seizure was controlled only by the addition of carbamazepine. Patients with NKH may initially present with isolated aphasic status epilepticus. Unlike stroke-related aphasia, accurate diagnosis is difficult if based solely on neurologic examination and brain neuroimaging. Use of EEG and blood sugar determination should be helpful in this special condition.

Postural responses to a suprapostural visual task among children with and without developmental coordination disorder

We sought to determine the effects of varying the perceptual demands of a suprapostural visual task on the postural activity of children with developmental coordination disorder (DCD), and typically developing children (TDC). Sixty-four (32 per group) children aged between 9 and 10 years participated. In a within-participants design, each child performed a signal detection task at two levels of difficulty, low (LD) and high difficulty (HD). During performance of the signal detection tasks we recorded positional variability of the head and torso using a magnetic tracking system. We found that task difficulty had a greater effect on task performance among the TDC group than among children with DCD. Overall positional variability was greater the DCD group than in the TDC group. In the TDC group, positional variability was reduced during performance of the HD task, relative to sway during performance of the LD task. In the DCD group, positional variability was greater during performance of the HD task than during performance of the LD task. In children, DCD may reduce the strength of functional integration of postural activity with the demands of suprapostural visual tasks.

Polymorphisms in the apoptosis-associated genes FAS and FASL and risk of oral cancer and malignant potential of oral premalignant lesions in a Taiwanese population

BACKGROUND

Our aim was to measure the relationship of FAS (-1377G>A and -670A>G), FASL (-844C>T) gene variants and risk of oral cancer.

METHODS

Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis was used to determine the FAS and FASL polymorphisms in 294 oral squamous cell carcinoma (OSCC), 53 oral submucous fibrosis (OSF), and 84 oral leukoplakia (OL) patients, as well as in 333 healthy controls. A standardized questionnaire was applied to collect demographic data, and potential confounding factors. JMP statistical software was used to analyze the association.

RESULTS

FAS and FASL polymorphisms were not correlated with OSCC development or the malignant potential of OL by simple and multivariate logistic regression. However, a two- to fourfold difference in the risks of betel quid chewing, alcohol consumption, and smoking on OSCC development were observed between participants with different FAS polymorphisms. FAS polymorphisms were significantly correlated with the malignant potential of OSF. Multivariate logistic regression analysis indicated that FAS A(-1377)-G(-670) vs. G(-1377)-A(-670) haplotype (OR = 2.26, 95% CI = 1.16-4.41) was correlated with the malignant potential of OSF.

CONCLUSIONS

We suggest that FAS and FASL polymorphisms are not significantly correlated with OSCC development or malignant potential of OL. The impact of substance usage on OSCC development could be differentiated by FAS polymorphisms. FAS A(-1377)-G(-670) haplotype may play a role in the malignant potential of OSF.

Handling leachate from glass cullet stockpiles

Mixed glass cullet (crushed recycled glass containers) is stockpiled uncovered before use as roadway construction aggregate or daily cover in landfills. Rainwater that leaches through the stockpiles dissolves and suspends contaminants such as those from food residuals and paper labels. The objective of this study was to determine leachate quantity and quality from cullet stockpiles as a basis for development of Best Management Practices (BMPs). Four 35-tonne field stockpiles were set up for leachate analysis and to determine the effects of mechanical turning treatment on the leachate. Field-collected leachate and laboratory-generated washwater of cullet (water:cullet=3:1 by weight) were both analyzed for basic wastewater parameters, which showed pollutant levels comparable to or higher than those of untreated domestic wastewater or urban stormwater. While organic contamination decreased substantially (e.g., washwater BOD>95% reduction), TKN and total-phosphorus levels in leachate ranged between 11.6-154mgL(-1) and 1.6-12.0mgL(-1), respectively, and remained comparable to levels found in untreated domestic wastewater after four months. Turning enhanced the degradation of the organic constituents inside the stockpiles, which was confirmed by elevated temperatures. Based on this study, leachate from glass cullet stockpiles should not be released to surface water. For leachate from long-term cullet stockpiles, release to groundwater should be only done after treatment to reduce nitrogen levels.

Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Breastfeeding is undisputedly preferable to formula feeding for infant nutrition because of its nutritional, immunological and psychological benefits. However, studies on the association between breastfeeding and development of atopic dermatitis (AD) have shown inconsistent results.

OBJECTIVES

To examine the association between exclusive breastfeeding for at least 3 months after birth and the development of AD in childhood.

METHODS

An electronic literature search of MEDLINE (January 1966-May 2008) and EMBASE (1980-May 2008) was conducted. Prospective cohort studies that met the predetermined criteria were independently assessed by three reviewers. The pooled effect estimate was calculated by random effects model. Heterogeneity across the studies was investigated by meta-regression analysis.

RESULTS

Twenty-one studies with 27 study populations were included for meta-analysis. The summary odds ratio (OR) for the effect of exclusive breastfeeding on the risk of AD was 0.89 (95% confidence interval, CI 0.76-1.04). Heterogeneity was found across the studies (chi(2) = 83.6, d.f. = 26; P < 0.001). Breastfeeding was associated with a decreased risk of AD (OR 0.70; 95% CI 0.50-0.99) when analysis was restricted to the studies comparing breastfeeding with conventional formula feeding. The pooled OR for study populations with atopic heredity was 0.78 (95% CI 0.58-1.05).

CONCLUSIONS

There is no strong evidence of a protective effect of exclusive breastfeeding for at least 3 months against AD, even among children with a positive family history.

Influence of temperature on the ontogenetic expression of neural development-related genes from developing tilapia brain expressed sequence tags

The developing central neural circuits in teleosts are genetically controlled and temperature-initiated. We compiled a list of transcripts expressed in the developing tilapia (Oreochromis mossambicus) brain using expressed sequence tags derived from the developing brain, and investigated genes with thermosensitive ontogenetic expression. Of 1084 clones, 893 were unique genes, 445 of which were known. Fourteen of the latter were neural development-related, and the ontogenetic expression of nine was temperature-influenced. Discs large homolog 5, myelin expression factor 2, plasticity-related protein-2, tsc2 gene product-related genes, and an inhibitor of differentiation protein 2 (Id2) were differentially temperature-influenced according to their developmental stages. Endothelial differentiation-related factor 1, midkine-related growth factor b, and mitogen-activated protein kinase 14b were specifically influenced by elevated temperature, and beta-catenin-like isoform 1 by lower temperature. Neural development-related genes, particularly those with thermosensitive ontogenetic expression, might be important for developing central neural circuits in teleosts.

Estradiol and para-chlorophenylalanine downregulate the expression of brain aromatase and estrogen receptor-alpha mRNA during the critical period of feminization in tilapia (Oreochromis mossambicus)

The period of maximal feminizing action of 17beta-estradiol (E(2)) upon sex ratio is before 10 days posthatching in tilapia (Oreochromis mossambicus). The effect of E(2) at this time is mimicked by para-chlorophenylalanine (p-CPA), a serotonin (5-hydroxytryptamine; 5-HT) synthesis inhibitor. The effect of E(2) on sexual differentiation may be mediated by the 5-HT system, which is consistent with the suggestion in mammals. The masculinizing actions of 17alpha-methyltestosterone (MT) are most potent later at up to day 20 of age, and may depend on MT induction of aromatase activity. In the present study, the effects of gonadal steroids and p-CPA on brain aromatase and estrogen receptor (ER) mRNA expression during the critical period of sexual differentiation were investigated. Treatment of tilapia with E(2) resulted in a significant decrease in the expression of brain aromatase and ERalpha between days 0 and 10, but not subsequently. The effect of E(2) at this time can be mimicked by p-CPA. Treatment of tilapia with MT, by contrast, resulted in a significant increase in brain aromatase, ERalpha and ERbeta mRNA expression when given between days 10 and 20. The downregulation of brain aromatase and ERalpha mRNA expression by E(2) before 10 days of age and, in turn, the upregulation of brain aromatase and ERalpha and ERbeta mRNA expression by MT at up to day 20 of age coincide with the period in which E(2) and MT have the maximal effect on gonadal feminization and masculinization, respectively.

Measurement and simulation of light distribution in biological tissues

Lateral light-distribution images of biologic tissues were used to study the tissues' optical characteristics. Monte Carlo simulation with the same conditions was performed to simulate the light distribution for comparison. Simulation results showed that the lateral light distribution was similar to the internal light distribution in biologic tissue. The direction of muscle fibers and the temperature both affect the near-field light distribution in tissue. The lateral view distribution can be both measured and simulated to study photon migration in tissue. It can also be used to estimate or verify the optical coefficients of tissue.

Comparative anti-caries effects of tablet and liquid fluorides in cleft children

Children with cleft lip and/or palate are at a higher risk for developing caries of the primary incisors compared with non-cleft children. To determine whether fluoride in tablet or liquid form would be more efficacious with children with cleft lip and/or palate, a two-year clinical investigation was conducted to test the anti-caries effects. One-hundred and fifteen cleft children (59 boys and 56 girls) between 22 and 26 months old were randomly selected into control, tablet and liquid fluoride groups. The amount of administered fluoride was 0.25 mg F daily in non-fluoridated Taiwan. Dental examinations were conducted using mirrors and #23 explorers. Caries were assessed using the DMF index in the baseline, first year and second year. The results showed that children in the tablet and liquid groups had a significantly lower DMFT increment than in the control group (p < 0.05). In the DMFS index, children in the liquid group showed a significantly lower caries increment than in the control group (p < 0.01), and children in the tablet group presented a borderline, but non-significant statistical difference when compared with the control group (p = 0.065). No significant statistical difference was found in either DMFT or DMFS between tablet and liquid fluoride administrations (p = 0.521 and p = 0.383, respectively). It is concluded that dietary fluoride supplements in liquid form show efficacy in reducing early childhood caries in the cleft children. Liquid fluoride showed slightly better numerical anti-caries effect than tablet fluoride, which is possibly due to its ease of administration with small children.

Lateral approach without ligament release in total knee arthroplasty: new concepts in the surgical technique

A lateral approach without ligament release was performed in 475 primary total knee arthroplasties (TKAs) in 344 patients and 50 revision TKAs in 39 patients. Deformities of the genu varum or valgum were corrected by accurate bone cut; no ligament releases were required other than to achieve adequate exposure. A lateral approach allowed both self-centering of the extensor mechanism and knee closure in complete flexion. Better range of motion was achieved. More than 90 degree active flexion usually occurred 3 days postoperatively. Postoperative roentgenograms showed all knees had good varus and valgus stability, which was sustained with time, except 1 with late genu recurvatum due to inadequate polyethylene thickness and the other with a broken tibial base plate. Complications such as disruption of patellar blood supply and knee instability, more frequently observed in the medial approach with ligament release, did not occur. The results suggest that this new technique is safe and may give better outcomes.

Effects of estrogen and neurotransmitters on the primary cultures of tilapia brain from different ages

The effects of estrogen and neurotransmitters on the proliferation of brain cells were investigated in the primary cultures of tilapia brain from different ages. Treatment of brain cells that were cultured on day 1, 3, 5, 7, 10, 30, and 180 posthatching with serotonin (5-HT), resulted in a significant increase of the Brdu(+)-cell number. By contrast, norepinephrine (NE) resulted in a significant decrease and gamma-aminobutyric acid (GABA) had no effect. 17 beta-Estradiol (E(2)) significantly increased the Brdu(+)-cell number when the brain cells were cultured after 5 days of age, but had no effect when cultured on day 1 or 3 of age. These results indicate that the proliferation of brain cell is enhanced by 5-HT at each stage. This effect is mimicked by E(2) when given after 5 days of age. Conversely, NE has an effect to depress the proliferation of brain cells. Whereas, GABA has no effect.

Simplified rat intubation using a new oropharyngeal intubation wedge

Our new oropharyngeal intubation wedge made from a plastic 3-ml syringe has been used successfully for the expansion of the oropharyngeal cavity and visualization of vocal cords for endotracheal intubation in the rat. All the animals we used tolerated the intubation and ventilation procedures in a series of experiments. After the proper setting of the respirator, vital signs were maintained within normal range. The postmortem examination and measurements in the upper airway confirmed that the endotracheal tube was properly sited and also demonstrated the precise size of the device that should be used. The main advantages of this method include low cost, simplicity, and reliability. Furthermore, because no expensive, elaborate, difficult-to-operate, or hard-to-get special equipment is needed, this technique can be used in every laboratory.

Effects of gonadal steroids on brain serotonergic and aromatase activity during the critical period of sexual differentiation in tilapia, Oreochromis mossambicus

The effects of gonadal steroids on brain serotonin (5-HT) and aromatase activity during the critical period of sexual differentiation were investigated in tilapia, Oreochromis mossambicus. Treatment of tilapia with 17beta-oestradiol (E2) between days 7 and 10 posthatching resulted in a significant increase in the female : male ratio as determined at day 90, and a significant reduction in brain 5-HT content. Treatment between days 10 and 20, or between days 20 and 30, had no significant effect. Since the 5-HT system may influence sexual differentiation, we examined the effects of para-chlorophenylalanine (p-CPA), a 5-HT synthesis inhibitor. As with E2, treatment of tilapia with p-CPA between days 7 and 10 posthatching resulted in a significant increase in the female : male ratio. Again, treatment between days 10 and 20, or between days 20 and 30, had no significant effect. Both p-CPA and E2 significantly depressed brain aromatase activity when administrated between days 7 and 10, but not subsequently. In tilapia treated between days 7 and 10, the brain 5-HT content was lowered by E2 to an extent similar to that seen with p-CPA, which is consistent with the suggestion that the effect of E2 on sexual differentiation may be mediated by the 5-HT system. Treatment of tilapia with 17alpha-methyltestosterone (MT), by contrast, resulted in a reduction in the female : male ratio, and treatment was most effective when given between days 10 and 20. The period of maximal effect of MT upon sex ratio appears to coincide with the ability of MT to induce an increase in brain aromatase activity.

Effect of CO2 laser on healing of cultured meniscus

BACKGROUND AND OBJECTIVE

A new method to improve cartilage repair is clinically important. The enhancement of meniscal healing by low power CO2 laser was investigated in an organ culture system.

STUDY DESIGN/MATERIALS AND METHODS

A longitudinal or a radial defect was made in the avascular zone of rabbit menisci. Irradiation by CO2 laser with 1 W (energy density 50 J/cm2) and 2 W (energy density 100 J/cm2) was used.

RESULTS

Histologic and scanning electron microscopic evaluations revealed that both energy densities of laser irradiation and the type of and the site of meniscal defect can influence the course and the outcome of meniscal healing. A marked increase in fibrochondrocytic proliferation and regeneration of collagen fibers were demonstrated in the meniscal defects irradiated by 100 J of CO2 laser energy.

CONCLUSIONS

The healing of meniscal defects could be promoted by low power CO2 laser irradiation.

Temperature affects the development of central neurotransmitter systems of tilapia, Oreochromis mossambicus

The effects of temperature on the development of central neurotransmitter systems were investigated with tilapia, Oreochromis mossambicus. Zero-day-old (the hatching day) tilapia were kept at four different temperatures: 20 (lower), 24 (control), and 28 and 32 degrees C (elevated), respectively. On the 5th day, brain serotonin (5-HT), norepinephrine (NE), gamma-aminobutyric acid (GABA), and glutamate (Glu) contents were quantified by a high-performance liquid chromatograph with electrochemical detection. Similar experiments were performed on the 5-, 10-, 15-, 20-, and 25-day-olds. The results showed that aquatic temperature influenced brain 5-HT, NE, Glu, and GABA contents during its respective restricted period. The influence of both lower and elevated temperatures on the neurotransmitter content, either increasing or suppressing, is dependent on its developing stage. The facts provide an evidence that the development of central neurotransmitter systems is influenced by aquatic temperature during its specific effective period.

Effects of temperature on the deformity and sex differentiation of tilapia, Oreochromis mossambicus

The effects of temperature on the deformity and sex differentiation of tilapia, Oreochromis mossambicus, were investigated. Zero- (the hatching day), 5-, and 10-day-old tilapia were respectively divided into 4 groups that were reared at 20, 24, 28, and 32 degrees C for 5 days. Percentages of deformity were significantly increased when tilapia were kept in the elevated temperatures (28 and 32 degrees C) before 5 days old during this experiment, whereas the lower temperature (20 degrees C) had no effect on the development of morphology. On the other hand, exposure to the lower temperature before 10 days old induced a high proportion of females whereas a high proportion of males was induced by the elevated temperature after 10 days old during this experiment. These results indicate that morphological development is influenced by temperature, particularly by the elevated temperature during a restricted developmental period. Both lower and elevated temperatures induce the gonadal feminization and masculinization, respectively, during its restricted developmental period. J. Exp. Zool. 286:534-537, 2000.

Acoustic inspection of bond strength of steel-reinforced mortar after exposure to elevated temperatures

In order to evaluate the bond strength between the reinforcement and concrete after fire damage, a combination of acoustic through-transmission and pull-out tests were used. Previous studies have shown a 25% decrease in the ultrasonic pulse velocity at 90% of the maximum load at room temperature. The specimens were kept in the oven at an elevated temperature for 1, 2, or 3 h. They were then removed and cooled to room temperature. Inspection was conducted using a high-power ultrasonic pulse velocity system while a pull-out load was applied. The correlation between preheated temperature, acoustic wave velocity, and the applied load was analyzed. Initial results show that bond strength and pulse velocity decreased substantially as the temperature or the heating time increased.

Age-related differences in the secretion of calcitonin in male rats

The mechanism of hypercalcitoninemia associated with aging was investigated in male rats. To mimic some of the hormonal changes with aging, orchidectomized (Orch) and hyperprolactinemic rats were used to mimic the physiological status of aging. Orch and haloperidol-induced hyperprolactinemic rats aged 3, 8, and 17 months were infused with CaCl2 and then bled from a jugular catheter following the CaCl2 challenge. Rat thyroid gland was incubated with Locke's medium at 37 degrees C for 30 minutes. Compared with 8- and 3-month-old rats, 17-month-old rats exhibited the lowest levels of plasma testosterone and the highest levels of plasma prolactin (PRL) and calcitonin (CT). The release of CT in the thyroid glands in vitro was highest in 17-month-old rats. Orchidectomy decreased rat plasma CT and thyroid CT release in vitro. Hyperprolactinemic rats had higher levels of plasma PRL and CT compared with control animals. The release of thyroid CT in vitro was greater in hyperprolactinemic rats. These results suggest that the hypersecretion of CT in 17-month-old rats may be due in part to hyperprolactinemia.

Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan

OBJECTIVE

The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan.

DESIGN

Randomized and prospective study.

SETTING

Institutional setting.

PATIENTS AND METHODS

One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD.

RESULTS

Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001).

CONCLUSIONS

Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents.

Oxidative injury induced by synthetic humic acid polymer and monomer in cultured rabbit articular chondrocytes

Humic substance has been proposed as one of the causative factors of Kashin-Beck disease (KBD), an endemic osteoarthritic disorder with necrosis of chondrocytes widely prevalent in some regions of China. In order to exclude the complications of natural humic substance, here we prepared phenolic polymers of synthetic humic acid (SHA) by oxidation of phenolic monomer, the protocatechuic acid (PCA). The biological effects of SHA and PCA on primary culture of rabbit articular chondrocytes were investigated. We found that not only SHA but also PCA caused chondrocyte injury, as evidenced by the loss of cell viability measured with methylthiazol tetrazolium (MTT) assay and the increased release of intracellular lactate dehydrogenase (LDH). Both SHA and PCA could result in lipid peroxidation and glutathione (GSH) depletion in chondrocytes, indicating that oxidative stress may be involved in chondrocyte injury. Furthermore, a marked increase in intracellular calcium level ([Ca2+]i) occurred after chondrocytes treated with SHA or PCA. These results suggest that chondrocyte injury elicited by SHA or PCA may be mediated through the occurrence of oxidative stress and the disruption of intracellular Ca2+ homeostasis. Data also suggest that the monomeric phenolic acid may be considered one of the causative factors of KBD in addition to humic substance.

Arecoline cytotoxicity on human oral mucosal fibroblasts related to cellular thiol and esterase activities

Betel quid (BQ) chewing is associated with an increased risk of oral submucous fibrosis (OSF) and oral cancer in India and many south-east Asian countries. Recently, we have shown that arecoline is cytotoxic to cultured human oral mucosal fibroblasts. This study investigated protective effects of various agents against the cytotoxicity of arecoline and its mechanisms. Arecoline, at concentrations of 0.2 and 0.4 mM, decreased the cell numbers by 38% and 63%, respectively. At a concentration of 2 mM, N-acetyl-L-cysteine [a glutathione (GSH) synthesis precursor] could prevent arecoline-induced cytotoxicity. The decrease in cell numbers was reduced to 17% relative to control. Extracellular addition of esterase at a concentration of 0.1 U/ml could almost completely protect the oral mucosal fibroblast (OMF) from arecoline-induced cytotoxicity. Arecoline is a muscarinic receptor agonist. However, atropine, a muscarinic receptor antagonist was unable to protect the cells from arecoline cytotoxicity at a concentration of 10 microM. Pretreatment of OMF with 50 microM buthionine sulfoximine (a cellular GSH synthesis inhibitor) or 0.5 mM diethylmaleate (a cellular GSH depleting agent) potentiated the cytotoxic effects of arecoline. These results indicate that cytotoxicity of arecoline on OMF is associated with cellular GSH levels and esterase activities. Factors that induce the GSH synthesis or esterase activity of oral mucosal cells can be used for future chemoprevention of BQ chewing-related lesions.

Effects of gonadal steroids on the GABA and glutamate contents of the early developing tilapia brain

The effects of gonadal steroids on the gamma-aminobutyric acid (GABA) and glutamate (Glu) contents of the early developing brain were investigated. Seven-day-old (7 days post-hatch) tilapia were divided into three groups which were continuously treated with 100 mg/kg diet 17beta-estradiol (E2), 100 mg/kg diet methyltestosterone (MT), and a normal diet, respectively. Until 10, 20, and 30 days old, the GABA and Glu contents of the brains were detected by HPLC-ECD. The brain GABA and Glu contents, before 30 days old, significantly increased with age. These results demonstrate that before 30 days old is a developing period of both GABA and Glu systems in the tilapia brain. During this period, both E2 and MT have a facilitative effect on the GABAergic and Gluergic system during a restricted effective period.

Effects of gonadal steroids on the serotonin synthesis and metabolism in the early developing tilapia brain

The effects of gonadal steroids on serotonin (5-HT) synthesis and metabolism in the early developing brain were investigated. Seven-day-old (7 days post-hatch) tilapia, Oreochromis mossambicus were continuously treated with 17beta-estradiol (E2), methyltestosterone (MT) and para-chlorophenylalanine (p-PCA) up to the age of 30 days. The brain 5-HT content, before 30 days, increased with age. The result indicates that this is a developing period of the central 5-HTergic system. During this developing period, the activity of tryptophan hydroxylase (TPH) and monoamine oxidase (MAO) was not altered by age. Both E2 and MT influence the central 5-HT content during its restricted developmental period. E2 has an initial inhibitory effect and then a facilitative effect while MT only has a facilitative effect. The initial inhibitory effect of E2 is mediated by decreasing TPH activity and increasing MAO activity to decrease the 5-HT content. The facilitative effect of both E2 and MT is suppressed by p-CPA.

Effects of hyperprolactinemia on calcitonin secretion in male rats

The role of prolactin (PRL) in calcitonin (CT) release by the thyroid C cell in male rats was studied. Anterior pituitary (AP)-grafted male rats were characterized by hyperprolactinemia. Brain cortex (CX)-grafted male rats were used as control animals. AP- and CX-grafted rats were infused intravenously with CaCl2 and bled from the jugular catheter at 0, 30, 60, and 120 minutes following the CaCl2 challenge. Rat thyroid gland was incubated with or without 3-isobutyl-1-methylxanthine (IBMX) at 37 degrees C for 30 minutes. Thyroid C cells were incubated in culture medium at 37 degrees C for 60 minutes. Cyclic adenosine 3',5'-monophosphate (cAMP) in rat thyroid tissues following incubation with IBMX was extracted by 65% ethanol. AP-grafted rats had higher plasma levels of PRL and CT compared with CX-grafted rats. Both the release of CT and accumulation of cAMP in thyroid glands were higher in AP-grafted versus CX-grafted rats. Direct administration of ovine PRL (oPRL) on the thyroid glands did not increase CT secretion in vitro. Thyroid C cells of AP-grafted rats secreted more CT compared with CX-grafted rat cells. These results suggest that hyperprolactinemia increases the release of CT by thyroid C cells in rats through a cAMP-dependent pathway caused by an indirect effect of PRL.

Assessment of model adequacy for Markov regression time series models

In Markov regression models with time series data, we apply asymptomatic results to obtain the quasi-score, quasi-Wald, and quasi-likelihood ratio tests for assessing model adequacy. Based on limited simulation studies, we show that these three test statistics, particularly the quasi-score test, perform reasonably well in small samples. In addition, we apply these tests to the mean-shift outlier model to examine outliers. The usefulness of these tests is demonstrated via the analysis of three practical examples.

Oxidative stress induced by humic acid solvent extraction fraction in cultured rabbit articular chondrocytes

Kashin-Beck disease (KBD), an endemic, chronic osteoarthritic disorder with necrosis of chondrocytes, commonly occurs in China. The humic substance present in the drinking water of endemic areas has been proposed as one of the causative factors. In this study an in vitro cell culture system was used to investigate the damaging effects of humic acid (HA), a constituent of humic substance, on cultured rabbit articular chondrocytes. The commercial Aldrich humic acid (AHA) was fractionated with a series of organic solvents including n-hexane, benzene, ethyl acetate, and methanol. Among the several fractions of AHA, the ethyl acetate fraction (AHA-[EA]) displayed the most potent inhibitory effect on the survival of chondrocytes in clonogenic assays. Cellular injury induced by AHA-[EA] was evaluated by measuring cell viability with methylthiazol tetrazolium (MTT) and by determining the release of intracellular lactate dehydrogenase (LDH). Incubation of chondrocytes with AHA-[EA] (100-500 microg/ml) for 12 h produced a concentration-dependent decrease in cell viability and increase in LDH release. In addition, AHA-[EA] triggered lipid peroxidation manifested by elevated malondialdehyde (MDA) formation. In chemiluminescence assay, AHA-[EA] at the concentrations of 150-600 microg/ml caused 6- to 15-fold increases of luminol-amplified chemiluminescence responses, which are considered to reflect the production of hydrogen peroxide (H2O2). Moreover, pretreating the cells with 500-750 U/ml of catalase significantly prevented the loss of cell viability, while superoxide dismutase (SOD) enhanced the adverse effect of 300 microg/ml AHA-[EA]. Data suggest that the injury to chondrocytes induced by AHA-[EA] may be first through O2.- production, which is then converted into H2O2, thus initiating lipid peroxidation and leading to chondronecrosis observed in KBD.

Catalase prevents estradiol-induced chondrocyte cytotoxicity

Osteoarthritis is a common geriatric disease and estrogen may play an important role in this disease. Estradiol may cause chondrocyte damage as suggested by in vitro and in vivo data. One of the possible mechanisms of estradiol-induced chondrocyte damage was thought to be related to free radicals. Whether catalase, a known free radical scavenger, can prevent estradiol-induced chondrocyte damage was tested using a chondrocyte culture system. The results of this study suggest that catalase can significantly reduce the estradiol-induced damage to chondrocytes. Apparently, catalase alters the molecular structure of estradiol as indicated by the absorption spectrum of estradiol with time. The modified estradiol may decrease its toxicity to the chondrocytes. However, the contents of free radicals in the treated chondrocytes have no significant difference from the untreated control cells. Studies to further investigate the mechanism or prevention of estradiol-induced chondrocyte damage in osteoarthritis are warranted.

Effects of ovarian steroid hormones and thyroxine on calcitonin secretion in pregnant rats

In the present study, the roles of ovarian steroid hormones and thyroxine (T4) in regulating the secretion of calcitonin (CT) in pregnant rats were examined. The levels of plasma progesterone, pre- and post-CaCl2 plasma CT, and recovery time of plasma CT and calcium after calcium challenge were greatest in midterm pregnant rats. The levels of basal plasma progesterone, CT, calcium, and recovery time of plasma CT after calcium challenge were less in late pregnant rats, but basal plasma estradiol was highest in late pregnancy. The concentrations of plasma T4 were gradually decreased in rats during pregnancy. Regardless of the presence of estradiol, administration of progesterone in ovariectomized (Ovx) rats resulted in an increase of plasma T4 as well as the basal and calcium-induced secretion of CT. Administration of estradiol alone did not alter the CaCl2-induced levels but decreased the post-CaCl2 levels of plasma calcium in Ovx rats. The basal levels of plasma CT were decreased in Ovx rats treated with T4. These results suggest that the hypercalcitoninemia in midterm pregnant rats is due to an increased secretion of progesterone. Hypocalcitoninemia in late pregnant rats, however, is due in part to lower plasma calcium.

Cytotoxic and cytostatic effects of arecoline on oral mucosal fibroblasts

Betel quid (BQ) chewing shows strong correlation to the incidence of oral submucous fibrosis and oral cancer in Taiwan. Arecoline, the main areca alkaloid, is considered to be one of the etiologic factors in BQ. To elucidate the role(s) of arecoline in the pathogenesis of BQ chewing related oral mucosal lesions, we used oral mucosal fibroblasts to study the effects of serum concentration, cell density, and incubation time on the cytotoxic response to arecoline. At a concentration less than 0.2 mM, arecoline was not cytotoxic to oral mucosal cells after 1, 3, and 6 days of incubation. After 3 days of incubation, the cytotoxic and cytostatic effects of arecoline became evident when the cells were exposed to higher concentrations of arecoline (0.2 mM) and serum (10% FCS). Exposure of cells (1 x 10(4) cells/well) to 0.2 mM of arecoline in 0.5% FCS for 3 and 6 days led to a 20% and 23% decrease, respectively, in the cell number, whereas exposure of cells (1 x 10(4) cells/well) to 0.2 mM arecoline in 10% FCS led to a 38% and 53% decrease, respectively, in cell number. At a higher cell density (5 x 10(4) and 1 x 10(5) cells/well), 0.2 mM arecoline led to less cytotoxicity (38% and 21% of decreasing in cell number, respectively) after 6 days of incubation. Our results indicated that arecoline was not mitogenic to oral mucosal fibroblasts, and that the cytotoxic and cytostatic effects of arecoline on oral mucosal fibroblasts could be modulated by the changes in the cell density, serum concentrations, and incubation time.

Effects of thermal acclimation on the neurotransmitters, serotonin and norepinephrine in the discrete brain of male and female tilapia, Oreochromis mossambicus

Effects of thermal acclimation on the serotonin (5-HT) and norepinephrine (NE) contents in the discrete brain of male and female tilapia, Oreochromis mossambicus were investigated. Sexually mature males and females were exposed to 26 degrees C, 29 degrees C, or 32 degrees C of water temperature for 3 weeks. The hypothalamic 5-HT content in the 29 degrees C and 32 degrees C acclimated male was lower than that in the 26 degrees C group. In females, the hypothalamic 5-HT content in the 32 degrees C acclimated group was less than those in the 26 degrees C and 29 degrees C groups. Similar results were found in the hypothalamic NE contents of males and females. In the optic lobe, the elevated temperature acclimation (29 degrees C and 32 degrees C) resulted in a higher 5-HT content in both males and females; whereas, the NE content was increased by the elevated temperature acclimation in females but not altered in that of males. In the telencephalon, the elevated temperature acclimation had no influence on the 5-HT content of males and females, but resulted in a lower NE content in both males and females. These results demonstrate that the neurotransmitter activity of teleost is influenced by the thermal acclimation in a sex- and regional-dependent pattern. The alterations of 5-HT and NE in the central nervous system might be involved in the physiological and biochemical responses that occur during thermal acclimation in fish.

Effects of estradiol on the serotonin secretion and turnover in the hypothalamus of male tilapia, Oreochromis mossambicus, in vitro

The effects of estradiol on the secretion and turnover of serotonin in the hypothalamic fragments of male tilapia, Oreochromis mossambicus, were studied using a static incubation system. The quantitative analysis of serotonin and its related metabolite, 5-hydroxyindoleacetic acid, were performed by high-performance liquid chromatography with electrochemical detection. The hypothalamic fragments were incubated with 17 beta-estradiol at a concentration of 2 x 10(-8), 8 x 10(-8), 2 x 10(-7), 4 x 10(-7), or 4 x 10(-6) g/ml. The low dose of estradiol, 2 x 10(-8) g/ml, had no effect on the concentration of serotonin and 5-hydroxyindoleacetic acid or serotonin turnover in the hypothalamic incubation media. The moderate doses of estradiol 8 x 10(-8) and 2 x 10(-7) g/ml, increased the concentrations of serotonin and 5-hydroxyindoleacetic acid in the hypothalamic incubation media, but had no effect on the serotonin turnover. The high doses of estradiol, 4 x 10(-7) and 4 x 10(-6) g/ml, did not alter the serotonin concentration in the hypothalamic incubation media, but increased the 5-hydroxyindoleacetic acid concentration and serotonin turnover. These results demonstrate that the moderate dose of estradiol increases the serotonin activity by increasing the serotonin concentration, whereas the high dose of estradiol increases the serotonin activity by increasing the ratio of 5-hydroxyindoleacetic acid and serotonin. However, the serotonin concentration is homeostatically maintained in the extracellular fluid of hypothalamus under the high dose of E2 treatment.

Phrenic nerve transfer in the repair of brachial plexus injuries: an animal model

Ten young mongrel dogs underwent unilateral denervation of the brachial plexus. In six dogs, a 2-cm segment of phrenic nerve autograft was sutured to either the resected musculocutaneous nerve or the radial nerve. A hemoclip was applied to either musculocutaneous or radial nerve in the control groups. Five months postoperatively, the grafted musculocutaneous nerve demonstrated less fibrous tissue and less muscle atrophy of the biceps when compared to the control group with clipped nerve. In the group with the grafted radial nerve, the electromyographic findings of multiphasic action potential and muscle contraction from electric stimulation suggested reinnervation of the radial nerve.

IN CONCLUSION

phrenic nerve transfer may be used to repair specific damages to nerve trunk with histological, electromyographic and clinical recovery.

Effect of forms of collagen linked to polyurethane on endothelial cell growth

Collagen has been widely coated or grafted onto polymer surfaces to improve the biocompatibility of materials. To better support the growth of endothelial cells on polyurethane (PU), collagen was grafted to the carboxyl group enriched PU through 1,2-bis(2,3-epoxypropoxy)ethane linking. Our results demonstrated that collagen in various conditions may result in different forms being grafted to the PU substrate, which subsequently affected the growth of endothelial cells. Collagen predialyzed against physiological phosphate buffered saline (PBS) could be reconstituted into native type fibrils with a bigger diameter at 37 degrees C than could collagen neutralized by titration with NaOH. At low temperature, titrated collagen formed floss-like fibrils packed in a ball with cobblestone-like morphology. The amount of collagen grafted was related to the condition of the collagen used, which in consequence affected the diameter of the collagen fibril formed and the growth of endothelial cells. In conclusion, reconstituted collagen fibrils formed from collagen in PBS at 37 degrees C grafted in the highest amounts to an epoxy-PU substrate and that optimally supported the growth of endothelial cells. Such prepared materials may be potentially good vascular bioprosthetic materials and may provide a wide range of biological applications.

Model selection for extended quasi-likelihood models in small samples

We develop a small sample criterion (AICc) for the selection of extended quasi-likelihood models. In contrast to the Akaike information criterion (AIC). AICc provides a more nearly unbiased estimator for the expected Kullback-Leibler information. Consequently, it often selects better models than AIC in small samples. For the logistic regression model, Monte Carlo results show that AICc outperforms AIC, Pregibon's (1979, Data Analytic Methods for Generalized Linear Models. Ph.D. thesis. University of Toronto) Cp*, and the Cp selection criteria of Hosmer et al. (1989, Biometrics 45, 1265-1270). Two examples are presented.

Effects of mercury on serotonin concentration in the brain of tilapia, Oreochromis mossambicus

In order to know the effect of mercury pollution on the serotonergic system of fish, serotonin concentrations in a discrete brain region of tilapia, Oreochromis mossambicus, were examined. Serotonin concentration was measured using a high performance liquid chromatography system with electrochemical detector. In male fish, the concentrations of serotonin were 1.468 +/- 0.350, 0.811 +/- 0.190 and 0.330 +/- 0.061 micrograms/g wet tissue in hypothalamus, telencephalon and optic lobe, respectively. The serotonin content was significantly different between each region; the hypothalamus had a higher content than that of the telencephalon and optic lobe. The serotonin concentration in female hypothalamus was 1.102 +/- 0.112 micrograms/g wet tissue which was significantly lower than that in males. However, serotonin concentration in the telencephalon and optic lobe showed no difference between male and female. After exposure to 0.015 and 0.03 ppm HgCl2 for 6 months beginning 7 days posthatching, male sample fish showed a significantly dose-dependent decrease in serotonin concentration in the hypothalamus. But a similar phenomenon was not found in other regions of the brain. These results suggest that exposure to HgCl2 results in an attenuated development of the serotonergic system in the hypothalamus of fish.

Inhibitory effect of neuropeptide Y (NPY) on the in vitro activity of tyrosine hydroxylase

Neuropeptide Y (NPY) is found to be costored with norepinephrine (NE) in vesicles of the nerve terminals. Tyrosine hydroxylase (TH), the synthetic enzyme of NE, has been mentioned to be a rate-limiting step. In an attempt to understand the effect of NPY on TH activities, an in vitro assay is carried out using chromatographic analysis of 3,4-dihydroxyphenylalanine (DOPA) formation from tyrosine. NPY (40-120 pmol/ml) produced a dose-dependent depression of DOPA formation catalysed by the adrenal TH of rats. Lineweaver-Burk plot (Km = 156 microM, Vmax = 1.05 nmol/h/mg protein) showed a non-competitive inhibition in NPY (80 pmol/ml, IC50)-treated samples. Moreover, failure of denatured NPY even at maximum concentration to influence the TH activities suggested the essential of nature form for NPY. Participation of pterine cofactor seems also negligible, because increase of 2-amino-4-hydroxy-6,7-dimethyltetrahydropteridine did not overcome the effect of NPY. These results indicate that NPY has the ability to inhibit the catalytic action of TH in the adrenal gland of rats.

Estradiol-induced knee osteoarthrosis in ovariectomized rabbits

Experiments in animals have shown that estrogen is chondrodestructive. The existence of 17 beta-estradiol receptor in rabbit chondrocyte and canine cartilage suggests that estrogen is associated with the development of osteoarthrosis (OA). The increased frequency of knee OA in obese postmenopausal women, who are often associated with hyperestrogenism, suggests a link between estradiol and OA. The pathologic changes induced by nine and 12 weeks of intraarticular injection of high doses of estradiol (0.3 mg/kg body weight/day) and low doses of estradiol (0.06 mg/kg body weight/day) into knee joints of ovariectomized rabbits have been examined. In the high-dose group, loss of condyle surface congruity, thinning, fissuring, and fibrillation of the remaining cartilage surface were observed at Week 9. At Week 12, cartilage erosion extended to the calcified layer, exposing the subchondral bone. Scanning electron microscopy (SEM) further revealed numerous pits, which indicated formation of cysts on the cartilage surface. Injection of low dose estradiol, conversely, did not induce significant pathologic changes. The results demonstrated that the direct interaction of estradiol and rabbit cartilage was dose- and duration-dependent. Pathologic changes from the current animal model of knee OA closely resembled those of knee OA in humans. Thus, this model constitutes a potential tool for further studies of the early pathologic changes of OA and the possible prevention of cartilage degeneration by estrogen receptor inhibitors.

[Preliminary study of cartilage repair with autologous periosteum and fibrin adhesive system]

The potential surgical transplantation with autogenous periosteal grafts and Fibrin Adhesive System (FAS) was attempted in a rabbit model. The grafts were taken from the tibia, transplanted and fixed with FAS to artificial full-thickness (0.4 x 0.3 cm) defect on the femoral condyle. Histologic and ultrastructural findings revealed chondrocyte regeneration in the control, grafted, and graft/FAS treated group at week 6; however, chondrogenesis of the reparative tissue was best demonstrated in the graft/FAS group. At week 12, the interface between the reparative tissue and the surrounding tissue was invisible in the FAS/graft group, as compared with the well-defined interface in the grafted group and the control. The results strongly suggest that FAS-treated periosteal transplant is a potential model for the repair of articular cartilage defects. Although the results are preliminary, all seem promising in the clinical aspects.

Evidence for eicosanoids within the reparative front in avascular necrosis of human femoral head

Eicosanoids, including prostaglandins and leukotrienes, are important mediators of inflammation. To observe inflammation after necrosis, the histology and the changes of eicosanoid levels were compared in the subchondral cortex and spongy bone of femoral head of sixteen patients with Ficat III or IV idiopathic avascular necrosis (AVN). Neither inflammatory cells nor elevation of eicosanoid levels were observed in the necrotic subchondral cortex or osteochondral junction, whereas infiltration of lymphocytes and plasma cells, fibrosis, and fat emboli were present in the reparative front of necrotic spongy bone. Biochemical analysis in this region revealed significant increases of prostaglandin E2 (PGE2), 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), thromboxane B2 (TXB2), leukotriene B4 (LTB4), and LTC4. The increased eicosanoids due to initial necrosis become aggravating factors by increasing vascular permeability, which leads to marrow edema and intraosseous hypertension; it ultimately develops into a cycle of inflammation and AVN.

Age-related differences in basal and calcium-stimulated plasma calcitonin levels in female rats

The effects of aging on calcitonin (CT) secretion in female rats were investigated. Old (24 mo) at constant diestrus status and young (2 mo) at diestrus status rats were either ovariectomized (Ovx) or left intact as controls. Ovx rats were injected subcutaneously with estradiol benzoate (25 micrograms/kg body wt) or sesame oil one time per day for 3 days. All rats were infused with CaCl2 (10 mg/ml) at a rate of 2 ml/h for 30 min via a jugular catheter connected to a peristaltic pump. Blood samples (0.5 ml each) were collected at 0, 30, 60, and 120 min. The basal and post-CaCl2 levels of plasma Ca measured with radioimmunoassay were significantly higher (P less than 0.05-0.01) in old than in young female rats. The pre- and post-CaCl2 levels of plasma Ca and CT in young rats were not altered by Ovx or estradiol replacement. In old rats, Ovx caused a higher (P less than 0.01) level in plasma CT at 0 and 30 min after CaCl2 infusion. Both basal and stimulated levels of plasma CT were higher (P less than 0.01) in old Ovx than in young Ovx rats. These results demonstrated that 1) the increase of plasma CT in response to Ca challenge was greater in old than in young female rats, 2) the influence of estradiol and ovarian function on plasma CT concentration increases as a function of age, and 3) estradiol reduced the plasma CT in response to hypercalcemia in old Ovx rats. The sensitivity of the target tissue of young rats may be lower in response to the modulation of estrogen during hypercalcemia without compromising the secretion and hypocalcemic effect of CT in young rats. All suggested an age-related relationship between estrogen and CT secretion in minute-to-minute regulation during Ca infusion in rats.