Arthroscopy of the elbow: Diagnosis and extraction of loose bodies

Arthroscopy of the elbow was performed in 35 cases of suspected loose bodies. Loose bodies were found in 13 cases. Preoperative radiographs were falsely negative in two cases and falsely positive in 12. In ten cases arthroscopic removal was attempted; it succeeded in six cases. When no loose bodies were found, the most common diagnosis was degenerative joint disease.

Arthroscopy is recommended for diagnosis and treatment of loose bodies in the elbow joint.     

Influence of Zona Pellucida Thickness of Human Embryos on Clinical Pregnancy Outcome Following In Vitro Fertilization Treatment

Purpose: To evaluate the correlation between the degree ofzona pellucida thickness variation (ZPTV) of transferredembryos with identical morphologies and subsequent clinicalpregnancy rates during 141 intracytoplasmic sperminjection (ICSI) treatment cycles. Methods: A total of 141 women participating in the studygroup comprising mostly male factor infertilities and somerepeat in vitro fertilization (IVF) failures were transferred,2 days after ovum pickup, with two to three embryos withidentical grades created by fertilization with ICSI. Allselected embryos were subjected to zona pellucida thicknessmeasurements immediately prior to transfer using a computerizedembryo measurement program from videocinematographyrecordings. Results: A total of 326 identical-grade transferredpre-embryos resulted in 70 clinical pregnancies with live-bornimplantation rate of 27.6%. A highly significant correlationwas observed between ZPTV of transferred embryos andthe IVF outcome with 77.1% and 83.64% of the clinicalpregnancies resulting from transferred embryos with ZPTVvalues greater than 20 and 25, respectively. The mean ZPTVvalues for 70 conceptual cycles and 62 nonconceptual cycleswere 28 ± 6.43 and 17.85 ± 8.11, respectively. No significantcorrelation between ZP thickness and number of blastomeresin the transferred embryos was evident, though embryoswith better scores had significantly thinner zonae and higherZPTV values. Though average zona thickness of embryosdeclined with age, the mean ZPTV value for women lessthan 30 years old was significantly higher (25.84 ± 8.57)as compared with those from women older than 35 years(20.72 ± 8.45). Conclusions: The degree of ZPTV of the transferred embryosexhibits a strong correlation with clinical pregnancy outcome following IVF treatment. This potentially reliable indicatorof IVF success rate could be used as a criteria forembryo selection during clinical transfers.     

Nonfunctioning pituitary adenoma: incidence,causes of death and quality of life in relation to pituitary function

The incidence of clinically significant, nonfunctioning pituitary adenoma, requiring surgical treatment, has not been established. According to previous studies, both surgery type and subsequent radiotherapy may have an impact on quality of life (QOL), and some studies have shown increased cardiovascular mortality in patients with pituitary disease. We studied all patients with functionless, suprasellar pituitary adenoma who were operated on during the period 1985–1996 (N = 192; transsphenoidal surgery = 160, craniotomy = 32). QOL was evaluated from Short Form 36 and Major Depression Inventory questionnaires. Causes of death were obtained from the Danish Register of Causes of Death. Incidence was 5.6/mill/year. Postoperatively, 27% of the patients had normal pituitary function and 27% were panhypopituitary. Fifty three patients had died. Death from cardiovascular, cerebrovascular and malignant diseases was not increased. Overall, QOL was not different from QOL of an age- and sex matched background population. QOL was, however, impaired in patients who had undergone craniotomy as compared to patients undergoing transsphenoidal surgery. QOL was not reduced in hypopituitary patients or in patients receiving radiotherapy. The study was supported by grants from The Aarhus University Hospital Research Initiative and The Obel Family Foundation, Aalborg, Denmark     

The role of SAP in murine CD150 (SLAM)-mediated T-cell proliferation and interferon gamma production

CD150 (signaling lymphocyte activation molecule [SLAM]) is a self-ligand cell surface glycoprotein expressed on T cells, B cells, macrophages, and dendritic cells. To further explore the role of CD150 signaling in costimulation and T(H)1 priming we have generated a panel of rat antimouse CD150 monoclonal antibodies. CD150 cell surface expression is up-regulated with rapid kinetics in activated T cells and lipopolysaccharide/interferon gamma (IFN-gamma)-activated macrophages. Anti-CD150 triggering induces strong costimulation of T cells triggered through CD3. DNA synthesis of murine T cells induced by anti-CD150 is not dependent on SLAM-associated protein (SAP, SH2D1A), because anti-CD150 induces similar levels of DNA synthesis in SAP(-/-) T cells. Antibodies to CD150 also enhance IFN-gamma production both in wild-type and SAP(-/-) T cells during primary stimulation. The level of IFN-gamma production is higher in SAP(-/-) T cells than in wild-type T cells. Anti-CD150 antibodies also synergize with interleukin 12 (IL-12) treatment in up-regulation of IL-12 receptor beta(2) mRNA during T(H)1 priming, and inhibit primary T(H)2 polarization in an IFN-gamma-dependent fashion. Cross-linking CD150 on CD4 T cells induces rapid serine phosphorylation of Akt/PKB. We speculate that this is an important pathway contributing to CD150-mediated T-cell proliferation.     

Hypothesis of Improved Visualization of Microstructures in the Interventricular Septum with Ultrasound and Adaptive Beamforming

In this work, in vivo ultrasound cardiac images created with Capon's minimum variance adaptive beamformer are compared with images acquired with the conventional delay-and-sum beamformer. Specifically, we provide three views of a human heart imaged through the parasternal short-axis, the parasternal long-axis and the apical four-chamber views. The minimum variance beamformer produced images with improved lateral resolution, resulting in better resolved speckle structure and improved edges, especially on close investigation of the interventricular septum. These improvements in image quality might possibly improve the visualization of microstructures in the human heart.     

Mapping the amphetamine-evoked changes in [11C]raclopride binding in living rat using small animal PET: modulation by MAO-inhibition

The performance of small animal PET for neuroreceptor studies in a psychopharmacological challenge paradigm is not yet well-described. Therefore, we used microPET and [(11)C]raclopride to map the availability of dopamine D(2/3) receptors in brain of anesthetized rats, first in a baseline condition, and again after challenge with saline or d-amphetamine. Parametric maps of the specific binding (binding potential, pB) were calculated using a reference tissue input from cerebellum, and spatially normalized to a digitized stereotaxic coordinate system for rat brain. In volumes of interest (VOIs), the mean baseline pB (n=6) was 2.05 in dorsal striatum (caudate-putamen), and 1.34 in ventral striatum (nucleus accumbens), and did not significantly differ upon retest 2 h later. The availability of [(11)C]raclopride binding sites at baseline was 8% higher in the right striatum. Challenge with amphetamine sulfate (1 mg/kg, i.v., n=4) decreased pB by 19% in both ventral and dorsal striatum. We have earlier predicted that blockade of monoamine oxidase (MAO) should potentiate the amphetamine-evoked dopamine release, thus enhancing the displacement of [(11)C]raclopride binding in vivo. However, pretreatment of rats with pargyline hydrochloride (4 mg/kg, n=4; 20 mg/kg, n=4) 1 day prior to PET did not potentiate the amphetamine-evoked reduction in dopamine receptor availability within the extended striatum. We conclude that small animal PET can be used to investigate stimulant-induced dopamine release, but that the spatial resolution is insufficient to detect differences between relative changes in dorsal vs. ventral divisions of the rat striatum. Furthermore, the present results do not reveal potentiation of the amphetamine-evoked release of dopamine in rats with MAO inhibition.     

The Cerebral Circulation in the Elderly: The Influence of Age, Vascular Disease, and Antihypertensive Treatment

Cerebral blood flow (CBF) and cerebral metabolic activity tend to decrease in old age. The effect of age per se on the regulation of CBF is not readily separated from the effect of age-associated diseases such as atherosclerosis, multi-infarct dementia, and diabetes mellitus, which may lead to an impairment of CBF autoregulation. Stroke may be prevented effectively by antihypertensive treatment in otherwise healthy elderly patients, but care should be taken to prevent overtreatment with consequent cerebral ischemia. The risk of this may be especially great in elderly patients with hypertension who have postural hypotension.