An association between the natural course of shoulder joint destruction in rheumatoid arthritis and HLA-DRB1*0405 in Japanese patients.

To assess the association between HLA-DRB1 alleles and shoulder destruction due to rheumatoid arthritis (RA) in Japanese, we typed for HLA-DRB1 alleles in 100 Japanese RA patients who could be classified into 5 groups: non-progressive (N) with normal radiographs; erosive (E) showing marginal erosion but no collapse; collapse (C) showing subchondral cysts followed by collapse; arthrosis-like (A) showing osteoarthrotic features; and the mutilating (M) showing mutilating bone destruction. The HLA-DRB1*0405 antigen frequency in N, E, C, A, and M types was 55%, 61%, 33%, 71%, 100%, respectively. That in the M type (100%) was significantly higher than that in the others (the N, E, C, and A types; 57%).

[Recovery process from myocardial stunning after transient ischemia: assessment with pulsed wave Doppler transmitral flow pattern].

Sustained left ventricular systolic dysfunction after transient myocardial ischemia is well known as "myocardial stunning", but little is known about the recovery in left ventricular diastolic function. Changes in left ventricular systolic and diastolic performance following dobutamine-induced ischemia were investigated in 13 patients with chest pain syndrome and normal coronary arteries (control) and 34 patients with coronary artery disease. Two-dimensional echocardiography and pulsed wave Doppler transmitral flow velocity curves were recorded at baseline, after infusion of a peak dose of dobutamine and at 20 min and 2 hours after dobutamine infusion.

Occurrence of sustained increase in QT dispersion following exercise in patients with residual myocardial ischemia after healing of anterior wall myocardial infarction.

Our objective was to evaluate the effect of exercise on QT dispersion over the next 3 hours, as seen on a standard 12-lead electrocardiogram in patients with healed myocardial infarction with or without residual ischemia. We measured QT and QTc dispersion before, immediately after, and 1 and 2 hours after symptom-limited, dynamic treadmill exercise tests in 28 patients with healed anterior wall myocardial infarction with (group I, n = 18) and without (group II, n = 10) residual ischemia. The same protocol was followed in 5 group I patients after successful performance of coronary angioplasty.

Hepatocyte growth factor facilitates cartilage repair. Full thickness articular cartilage defect studied in rabbit knees.

Hepatocyte growth factor (HGF) is a multifunctional factor which promotes proliferation, motility and morphogenesis in epithelial cells. In addition, it has been found to play an important role in cartilage metabolism. To investigate articular cartilage repair using HGF in vivo, we injected HGF into rabbit knee joints, where 4 mm diameter osteochondral defects had been made, and observed the animals for 6 months.

The relationship between HLA-DRB1 alleles and disease subsets of rheumatoid arthritis in Japanese.

To assess the association between HLA-DRB1 and the pathogenesis of rheumatoid arthritis (RA) in the Japanese population, we typed for HLA-DRB1 alleles in 852 Japanese patients. An analysis of HLA-DRB1 allele associations was performed on the overall group and in three disease subsets of adult-onset RA, classified according to the extent of joint destruction evident on plain radiograms, i.e.

In vivo but not in vitro stimulations rescue of the defective class switching to IgG or IgA in B-cells of immunodeficiency with hyper IgM.

In an X-linked immunodeficiency with hyper IgM (X-HIM), several mutations of genes coding for CD40 ligand are responsible for B-cell defects. However, it is controversial whether the defective class switching from IgM to IgG or IgA but not IgE is rescued by in vitro stimulations or not. In six X-HIM patients, signaling through CD40 induced IgE but not IgG or IgA secretion in vitro.

The optimum dose of gamma radiation-heavy doses to low wear polyethylene in total hip prostheses.

Wear volume, surface area and coefficient of friction of UHMWPE cup crosslinked with gamma radiation of 0, 50, 75, 100, 125, 150 and 200 Mrad sliding against an alumina ball were measured using a sphere-on-flat reciprocating type tribology testing machine. The effects of gamma radiation were scarcely observed in coefficient of friction. The coefficient of friction under lubricated (distilled water) and non-lubricated testing conditions was 0.

The reproducibility of color Doppler duplex sonography in the measurement of renal arterial blood velocity.

In this study, the reproducibility of color Doppler duplex sonography for repeated measurements of renal blood flow was evaluated in 14 healthy subjects. We examined the reproducibility for different examiners and different time intervals between the examinations. Doppler frequency sonograms were analyzed with several parameters, and statistical evaluation was performed by calculating both the correlation coefficient (r) and coefficient of variation (CV).

Hydroxyapatite in revision of total hip replacements with massive acetabular defects: 4- to 10-year clinical results.

Hydroxyapatite (HA) granules of 100 to 300 microm, 0.9 to 1.2 mm and 3.

Particulate bioglass compared with hydroxyapatite as a bone graft substitute.

Bioactive ceramics, notably hydroxyapatite, have been used clinically in various situations in which bone augmentation and restoration are required. Particulate material has been used either alone or in conjunction with freeze dried or autologous bone, with variable clinical success. In this study a bioactive glass, 45S5 Bioglass, has been compared with hydroxyapatite in an animal model to discover whether the 2 major disadvantages of hydroxyapatite may be overcome.

Eosinophilic granuloma associated with intratumoral hemorrhage--case report.

A 2-year-old boy presented with a rapidly growing soft scalp mass in the left parietal region. Surgical exploration and histological examination demonstrated an eosinophilic granuloma associated with intratumoral hemorrhage. Eosinophilic granuloma should also be considered when a scalp mass lesion exhibits rapid growth.

Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns.

Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre- and postoperatively.

[Complex partial status epilepticus in a patient with a frontal cavernous angiomas].

We described a 34-year-old woman with a right frontal cavernous angioma who presented with complex partial status epilepticus (CPSE). In the first CPSE, complex partial seizure with complete unresponsiveness and tonic motor manifestation on her left arm occurred repeatedly at short intervals. Her consciousness was mildly disturbed between the seizures.

Vasospastic angina pectoris associated with apical hypertrophic cardiomyopathy.

As the chest symptoms and electrocardiographic changes of hypertrophic cardiomyopathy are occasionally very similar to those of angina pectoris, there are some difficulties in the diagnosis and treatment of cases of ischemic heart disease associated with hypertrophic cardiomyopathy. Here we report a case of vasospastic angina pectoris associated with hypertrophic cardiomyopathy diagnosed by coronary spasm provocation test performed by intracoronary administration of acetylcholine. In the treatment of such cases, beta blockers, which have the effect of decreasing the oxygen demand of the heart and the potential to induce coronary spasm, must be administered carefully.

Trigeminal neuralgia associated with venous angioma--case report.

A 35-year-old male presented with trigeminal neuralgia associated with venous angioma at the root entry zone. Magnetic resonance imaging and angiography demonstrated a venous angioma with a dilated petrosal draining vein, and displacement of the anterior inferior cerebellar artery (AICA). The AICA and dilated petrosal vein were both decompressed, resulting in complete relief from symptoms of trigeminal neuralgia for 30 months.

Lipoma in the quadrigeminal cistern--case report.

A 65-year-old male presented with a rare lipoma in the quadrigeminal cistern manifesting as left abducens nerve paresis which was effectively treated by total extirpation. The usual neurological symptoms of lipoma in the quadrigeminal cistern are intracranial hypertension and hydrocephalus which can be successfully treated by shunt operation. Direct surgery is indicated when the symptoms are ascribed to localized symptoms, but tumor removal should be partial if the superior cerebellar arteries are involved.

Signaling through CD40 rescues IgE but not IgG or IgA secretion in X-linked immunodeficiency with hyper-IgM.

The ligand for CD40 (CD40L) is a membrane protein on activated T cells that induces B cell proliferation and differentiation. Several mutations of the CD40L gene were reported responsible for defective class switching of B cells in an X-linked immunodeficiency with hyper IgM (X-HIM). We studied four affected males from three families and found three independent mutations including new mutations of CD40L gene.

Recurrent Cushing's disease associated with nephrotic syndrome.

A case of recurrent Cushing's disease with nephrotic syndrome due to membranoproliferative glomerulonephritis (MPGN) is presented. Functional pituitary adenoma recurred 6 years after transsphenoidal pituitary adenomectomy. Due to infiltration into the surrounding tissues, transcranial surgery was performed.

Experimental studies on a new bioactive bone cement: hydroxyapatite composite resin.

We developed hydroxyapatite composite resin (CAP) as a new type of bioactive bone cement. CAP is composed of 80% w/w hydroxyapatite granules (mean particle size: 2 microns) and bis-phenol-A glycidyl methacrylate-based resin. The setting time is 5 min and the peak curing temperature during polymerization is 46 degrees C.

Meningioangiomatosis not associated with von Recklinghausen's disease--case report.

A 7-year-old girl with meningioangiomatosis not associated with von Recklinghausen's disease is described. The radiological findings were similar to meningioma, but intraoperatively, a thin septum was found between the mass and the dura mater. Microscopically, there was significant proliferation of fibroblastic spindle-shaped cells and collagenous fibers in the subarachnoid space.

Pubic-type dislocation of the hip combined with fracture of the ipsilateral greater trochanter. A case report.

Traumatic anterior dislocation of the hip is a relatively uncommon injury, and when it does occur it is frequently combined with osteochondral fracture of the femoral head or the acetabulum. Anterior dislocation of the hip with an associated fracture of the ipsilateral greater trochanter is extremely rare. This paper presents a case of this rare type of injury and clarifies the mechanism of the injury using a cadaver specimen.

Alumina versus polyethylene in total knee arthroplasty.

The cementless alumina total knee prosthesis, which uses alumina in the portions coming in contact with the bone and a combination of alumina and ultra-high molecular-weight polyethylene (UHMWPE) in the sliding portions, is referred to as a total condylar. Alumina total knee arthroplasty was performed on 137 patients, including 103 rheumatoid arthritis (RA) and 34 osteoarthrosis (OA) patients, from January 1982 to February 1985. The follow-up period was seven years 11 months and four years ten months, respectively.

[Platelet accumulation in abdominal aortic aneurysms and the effect of antiplatelet drugs: assessment by indium platelet scintigraphy].

A dual tracer technique using 111In labeled platelets and 99mTc labeled human serum albumin was applied to evaluate the in vivo thrombogenicity in 12 cases with abdominal aortic aneurysm (AAA) and the effect of antiplatelet drug on the thrombogenicity. The magnitude of platelet accumulation at AAA was expressed as the ratio of radioactivity of 111In platelets on the vascular wall to those in the blood pool (PAI; platelet accumulation index). Of the 12 patients with AAA, 11 had positive studies on baseline imaging and 1 had equivocally positive image.