KNEE LAXITY IN PATIENTS WITH OSTEOARTHRTTIS AND RHEUMATOID ARTHRITIS

Thirty-four patients with osteoarthritis (OA) and 32 patientswith rheumatoid arthritis (RA) were studied to determine theeffects of OA and RA on the laxity of the knee joints. Laxitywas measured with the Genucom Knee Analysis System. The antero-posteriorlaxity of the OA and RA knees was greater than the control,normal knees in the early stage, and decreased with the severityof disease in OA, but not in RA. Severe OA and RA were associatedwith a restricted internal-external rotation at the knee jointcompared with the control. Internal-external rotation decreasedwith worsening of both diseases. Varus-valgus laxity tendedto increase slightly with the severity of disease. While themorphological changes of the cruciate ligaments in advancedOA and RA were not statistically different, the laxity of OA-afflictedknees was affected slightly by the severity of the damage tothe cruciate ligaments. KEY WORDS: Osteoarthritis, Rheumatoid arthritis, Knee joint, Laxity, Cruciate ligament     

Analysis of nucleotide sequences of hepatitis C virus isolates from husband–wife pairs

Abstract To identify the route of hepatitis C virus (HCV) transmission, we investigated the sexual transmission of HCV by examining HCV markers among spouses of patients with chronic liver disease (CLD) due to HCV. Of 83 spouses, 14 (16.9%) had elevated serum aspartate aminotransferase or alanine aminotransferase, 20 (24.1%) had detectable anti-HCV antibodies, and 17 (20.5%) had measurable HCV-RNA in serum. However, the seropositivity rate of anti-HCV antibodies (24.1%) of patients' spouses was not significantly higher than that (15.4–27.5%) of an unselected population in the same district. Ten patient-spouse pairs underwent nucleotide sequence analysis of the HCV core and envelope genes. Overall the sequence homology of 10 couples (91.1%) was not significantly higher than that of 10 randomly chosen unrelated pairs (88.2%). As reported earlier, in an age and sex matched case-control study of HCV transmission, a history of surgery is a prominent HCV risk factor. These results suggest that sexual transmission of HCV is rare.     

Myelodysplastic syndrome with myelofibrosis: myelodysplastic syndrome as a major primary disorder for acute myelofibrosis

Summary Seven cases of myelodysplastic syndrome with myelofibrosis, which is defined using the following criteria: (1) pancytopenia with < 5% blasts in the peripheral blood; (2) minimal or no splenomegaly; (3) myelofibrosis with cellular marrow; (4) absence of diffuse proliferation of blasts in the bone marrow; and (5) presence of myelodysplastic features of bone marrow or peripheral blood cells, are presented. They were in the range of 52–82 years old and consisted of 3 males and 4 females. Six out of 7 cases developed into acute leukaemia after 5 to 8 months from the onset and died from between 2 weeks to 8 months from the evolution to leukaemia. The type of leukaemia was acute myeloblastic in 3 patients, and acute myelo-megakaryoblastic in 3 patients. Another patient died of severe hepatic injury after 5 months from the onset of the disease. These findings revealed that the complication of myelofibrosis in the patients with myelodysplastic syndrome was an indicative sign of rapid progression to overt leukaemia or otherwise poor prognosis for survival. In addition myelodysplastic syndrome is thought to be major primary disorder for acute myelofibrosis. Myelodysplastic syndrome with myelofibrosis is closely associated with the neoplastic proliferation of megakaryoblasts in a considerable number of patients.     

CASE REPORT: A long-term survivor of jejunal leiomyosarcoma with liver metastasis: Effective transcathetel arterial embolization for hepatic metastatic foci

We report a case of jejunal leiomyosarcoma with liver metastases in a 52-year-old Japanese male. An echogram demonstrated multiple cystic liver masses in April 1991. The diagnosis of metastatic leiomyosarcoma was made on the basis of characteristic hepatic angiography images and liver biopsy findings. The jejunal leiomyosarcoma was resected and unresectable liver metastatic foci were treated repeatedly with transcathetel arterial embolization. Transcathetel arterial embolization was considered to be effective in this case as the patient survived 4 years and 9 months after the first treatment.