Visualization of femorotibial contact in total knee arthroplasty using X-ray fluoroscopy

The purpose of this study was to build a visualization technique of the femorotibial contact in fixed-bearing total knee arthroplasty (TKA) using X-ray fluoroscopy, and to apply this technique to a TKA patient during dynamic motion. In vivo kinametcis of the metallic knee implant was determined using a 2D/3D registration technique, which uses computer assisted design (CAD) model of the implant to estimate the 3D pose of radiopaque metallic femoral and tibial components from a single-plane fluoroscopic image. In fixed-bearing TKA, a 3D pose of radiolucent tibial polyethylene insert can be determined from the estimated pose of the tibial component. To visualize femorotibial contact, the proximity between surfaces of femoral component and tibial insert was calculated, and mapped onto the insert surface model. For the clinical application, dynamic states of contact on the tibial insert were observed including axial rotation and unilateral loading during knee flexion, and post-cam contact of posterior stabilized TKA. The present technique provided us new information and enabled us to better understand the relationship between in vivo knee kinematics and articular shape of the implant.     

Impact of health education and screening over all-cause mortality in Japan: evidence from a cohort study during 1984-2002

BACKGROUND: Health education and screening are two components of preventive health services in Japan since 1983. This study investigated their relationships with all-cause mortality as they are studied insufficiently in Hokkaido, Japan. METHODS: This study enrolled 1,532 men and 1,653 women aged 40-97 years from 1,702 randomly selected households of 60 areas during 1984-1985 and followed them until 2002. At baseline survey, staffs of 45 health centers collected sociodemographic, medical, behavioral, and dietary information including health education and screening from study subjects with informed consent. RESULTS: For men, age-adjusted Cox proportional hazard model indicated lower mortality for those who received health education (RR = 0.76, P < 0.01) and screening (RR = 0.83, P < 0.05) than those who did not. Health education showed lower mortality even after adjusting for many variables. Similarly for women, health education (RR = 0.66, P < 0.01) and screening (RR = 0.64, P < 0.001) revealed lower age-adjusted mortality. Almost similar results were found for both services when models were adjusted for many variables and when the deaths including lost to follow-up cases of the first 4 years of baseline survey are excluded. CONCLUSIONS: This study shows protective effects of health education and screening over all-cause mortality for both sexes. However, further studies are needed to confirm the results.     

Evaluation of hypoglycemic and antihyperglycemic effects of Datura metel (Linn.) seeds in normal and alloxan-induced diabetic rats

The seed powder of Datura metel was tested for its hypoglycemic activity in normal and alloxan-induced diabetic rats. Graded doses (25, 50 and 75 mg/kg, p.o.) of the seed powder when given to both normal and diabetic rats produced significant reduction in blood glucose at the 8 h. The effect was found to be dose dependent with all treatments at the doses administered.     

Ulcerative colitis occurring in the course of rheumatoid arthritis: a case successfully treated with mesalamine enema

We report a case of ulcerative colitis (UC) that occurred during the course of rheumatoid arthritis (RA). A 29-year-old woman with a 25-year history of RA was hospitalized for high fever, abdominal pain and hematochezia. Colonoscopy revealed erosive and reddish mucosa from the distal transverse colon to rectum. Histology revealed cryptitis (mainly caused by neutrophils), mild crypt abscess and goblet cell depletion. She was diagnosed with left-sided UC and treated with mesalamine enema. The abdominal symptoms and colonoscopic findings were greatly ameliorated. We conclude that the mesalamine enema was effective in this case of UC occurring during the course of RA.     

Switch to Latanoprost Monotherapy from Combined Treatment with β-Antagonist and Other Antiglaucoma Agents in Patients with Glaucoma or Ocular Hypertension

Purpose To investigate the effects on intraocular pressure (IOP) and the occurrence of adverse events upon switching directly to latanoprost monotherapy from multiple drug therapy, including a -antagonist, for glaucomatous eyes.Methods Patients with primary open-angle glaucoma or ocular hypertension and receiving long-term therapy with two or three topical ocular hypotensive drugs (including one topical -antagonist) were switched to latanoprost monotherapy for 12 weeks without any intervening washout period. Observations were performed before switching (baseline) and at weeks 4, 8, and 12 after switching to latanoprost monotherapy.Results Of the 29 enrolled patients, 26 (90%) completed this protocol. Three patients had excessive IOP elevation, and these patients were withdrawn. The switch to latanoprost monotherapy was followed by a significant (P < 0.0001) mean reduction of 3.9mmHg at week 12 in per-protocol cases (n = 26) and a significant (P = 0.0016) mean reduction of 2.8mmHg at last postswitch visit in patients in the intent-to-treat analysis group (n = 29). Adverse ocular events other than IOP elevation were mild.Conclusions The switch to latanoprost monotherapy in glaucoma patients receiving multiple drug therapy resulted in an additional, significant IOP reduction. Jpn J Ophthalmol 2004;48:276–280 © Japanese Ophthalmological Society 2004     

Thymidine phosphorylase and dihydropyrimidine dehydrogenase expression in hepatocellular carcinoma and metastatic liver cancer

Thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) are considered to be key enzymes affecting the prognosis for patients with various cancers. We tried to prove the correlation of TP and DPD expression in hepatocellular carcinoma (HCC) and liver metastasis. We quantified TP and DPD levels by an enzyme-linked immunosorbent assay (ELISA) in the tumor (T) and adjacent normal tissue (N) obtained from 8 HCC patients, and 11 liver metastasis patients together with 9 of their primary cancers. TP levels were higher in the primary cancer, liver metastasis, and HCC compared with each adjacent tissue. TP levels were higher in HCC than in liver metastasis, and TP levels in the adjacent tissues of HCC were also higher than those in adjacent tissues of liver metastasis. TP levels were higher in liver metastasis than in primary cancer, and TP levels in adjacent tissues of liver metastasis were also higher than those in adjacent tissues of primary cancer. However, there were no differences in TP T/N ratio between HCC and liver metastasis, and between primary cancer and liver metastasis. DPD levels were lower in the liver metastasis compared with the adjacent liver tissues, and DPD levels in liver metastasis or its adjacent liver tissues were higher than those in primary cancer or its adjacent tissues. There were no differences in DPD T/N ratio between HCC and liver metastasis, and between primary cancer and liver metastasis. Thus, we demonstrated that TP was highly expressed in liver malignancy. We may be able to increase the success of anticancer chemotherapy for liver malignancy while decreasing the side effects by analysis of T/N ratios in TP, DPD, and TP/DPD in addition to TP expression.     

Phenylarsine oxide (PAO) more intensely induces apoptosis in acute promyelocytic leukemia and As2O3-resistant APL cell lines than As2O3 by activating the mitochondrial pathway

We studied the cytotoxic effect of an organic arsenical compound, phenylarsine oxide (PAO) on an acute promyelocytic leukemia (APL) cell line (NB4) and an As₂O₃-resistant NB4 subline (NB4/As). Cell growth was inhibited by 50% (IC₅₀) upon 2-day treatment with As₂O₃ or PAO at 0.54 and 0.06 μM, respectively in NB4 cells (P = 0.025), and 2.80 and 0.08 μM, respectively in NB4/As (P = 0.030). 0.1 μM PAO increased the proportion of hypodiploid cells (50.3%) by a greater degree than the same dose of As₂O₃ (3.8%) in NB4 cells. In NB4 cells, 0.1 μM PAO reduced the mitochondrial transmembrane potential (20.5% in a PI^negative-Rhodamine123^low fraction) by a greater degree than 1 μM As₂O₃ (7.1%). Western blotting showed that 0.1 μM PAO downregulated the expression of both Bcl-2 and Bcl-X_L proteins, whereas I μM As₂O₃ downregulated only Bcl-2 expression. These results suggest that the cytotoxic effect of PAO on an APL cell line and As₂O₃-resistant subline is significantly higher than that of As₂O₃. PAO-induced apoptosis seems to be related to the activation of the mitochondrial pathway and downregulation of both Bcl-2 and Bcl-X_L. PAO is a considerable agent for relapsed/refractory APL and for purging APL cells following stem cell transplantation.     

Prognostic significance of surface markers expressed in multiple myeloma: CD56 and other antigens

Multiple myeloma (MM) is characterized by increased numbers of malignant plasma cells. Plasma cells, that represent the terminal differentiation of B lymphocytes, have considerable heterogeneity of surface markers expressed on them. Some studies showed the prognostic significance of several immunophenotypic molecules on MM cells. Here, we review several surface markers related to their prognostic significance in MM patients. We also report that CD56-negative MM is the unique entity characterized by poor prognosis with high incidence of extramedullary disease, Bence Jones protein, renal insufficiency, thrombocytopenia and plasmablastic morphology.