Reactive microglia in aging and dementia: an immunohistochemical study of postmortem human brain tissue

Significantly increased up-regulation of HLA DR (major histocompatibility complex class II antigen) was seen using immunohistochemistry in postmortem brain tissue from demented patients with Alzheimer’s disease (AD) (73 cases, 61 females/12 males, mean age 84 ± 9 years) compared to controls (22 cases, 10 females/12 males, mean age 78 ± 9 years). The counts of HLA DR-expressing activated microglia were significantly higher in female AD patients compared to males, significantly higher in AD patients with the age at death greater than 75 years compared to those dying younger and higher, although not statistically significantly, in AD patients with the apolipoprotein E (ApoE) ɛ4 allele compared to those patients not carrying this allele. In contrast to the situation in AD patients, in the control cases the HLA DR expression was higher in males compared to females. Furthermore, in the very old non-demented patients (age at death > 80 years), a decrease in the up-regulation of HLA DR expression was observed. A significant correlation between activated microglia and neurofibrillary tangles was seen in female AD patients compared to males, in AD cases without ApoE ɛ4 allele compared to those with this allele, in sporadic cases compared to familial and in cases with senile rather than presenile onset of the disease. Our results indicate that there is an age- and/or sex-related variability in up-regulation of HLA DR expression of microglia and that the linkage between this up-regulation and AD lesions is significantly influenced by the ApoE ɛ4 allele, gender of subjects, age at onset and familiality of the disease. Received: 20 May 1998 / Revised: 5 August 1998, 4 October 1998 / Accepted: 21 October 1998     

CO2 gas perfusion: improved efficiency and safety with sapphire-probe laser ablation of human artery.

CO2 gas has been proposed as a new perfusion medium for laser angioplasty. To compare CO2 gas with conventional saline perfusion, 146 fresh specimens of normal and atheromatous human artery were irradiated with a neodymium: yttrium-aluminum-garnet laser with a sapphire probe in flowing whole blood in an experimental circulation-occlusion model. The dimensions of the ablation crater and the extent of the surrounding tissue damage were measured microscopically. Significantly better ablation of atheromatous plaque was achieved with CO2 perfusion than with saline perfusion: mean ablation areas were 5.0 mm2 versus 2.8 mm2, respectively (P = .001, Student t test). In contrast, the ablation areas on normal vessel wall were identical (mean, 3.4 mm2) with the two perfusion media. Moreover, CO2 gas functioned as a negative contrast agent and facilitated direct monitoring of the laser recanalization procedure. On an experimental basis, CO2 gas perfusion seems to improve the efficiency and safety of laser ablation in human arteries.     

Percutaneous transluminal laser angioplasty. Progress over the past two years

The progress in percutaneous transluminal laser angioplasty (PTLA) over the past two years is presented. The technical development includes the application of new equipments to laser sources, delivery systems and monitors. We review new experimental research in rapidly establishing animal models and human postmortem specimens, as well as efforts to select adequate wave length and irradiation time for laser energy with suitable infusion media. A summary of clinical trials is given on expanding usage, complication rates and long-term patency of PTLA. The current trends in PTLA respecting guide wire assisted balloon angioplasty and other recanalization methods are described.     

Internal fixation of forearm fractures in children

Fourteen children with severely displaced diaphyseal fractures of both bones of the forearm treated with open reduction and internal fixation were reviewed; these operations represented 9 per cent of all the diaphyseal forearm fractures in children during a 9-year period. The mean age of the patients at the time of the injury was 12 (7-14) years; they were reexamined 8 (5-11) years later, all after cessation of growth.

At follow-up, limited prosupination, observed in 8 patients, was associated with a fracture of the proximal third of the forearm; limited motion of the radiocarpal joint, in 2 patients, was associated with shortening of the ulna. Only 4 patients complained of pain or were aware of restricted motion, and the average function was good.

Open reduction and internal fixation is indicated in displaced fractures of the forearm even in children.     

Diurnal variation of melatonin and cortisol is maintained in non-septic intensive care patients

Objective  

To study the diurnal variation of melatonin and cortisol in critically ill patients and to assess whether the severity of organ dysfunction, sedation and sympathetic activity correlate with the production of these hormones.     

Disc degeneration and lumbar instability: Magnetic resonance examination of 16 patients

Flexion and extension radiographs of 75 young males with low back pain disclosed abnormal segmental motion of the lumbar spine in 16 patients with translational movements in 20 intervertebral segments. These 16 patients were further investigated by magnetic resonance imaging to assess disc degeneration in the unstable segments. On T2-weighted images of the 20 segments, the disc was normal in 13 and degenerated in only 7 patients. Thus, the initial factor in lumbar instability in young patients with low back pain is not always degeneration of the disc.     

Effect of lateral release on patellar motion in chondromalacia: An MRI study of 11 knees

Preoperatively and postoperatively, patellar motion in 11 knees with chondromalacia was analyzed by MRI at 0°, 10°, 20°, and 30° of knee flexion. The preoperative patellar position clearly deviated from normal at 0°-10° of knee flexion. The lateral release operation corrected this deviation.     

Gln27Glu variant of Beta2-adrenoceptor gene affects male type fat accumulation in women

Background  

The β₂-adrenergic receptor (BAR2) is the main lipolytic receptor in white human adipose tissue. There is a functional glutamine 27 glutamic acid (Gln27Glu, rs 1042714) polymorphism in its gene, which has been variably associated with body mass index. This gene variant may be associated with male-type adiposity in women and thus increased cardiovascular risk. We investigated whether the BAR2 Gln27Glu polymorphism is associated with visceral fat and coronary intima thickness in women.     

Cyclodextrins and chitosan derivatives in sublingual delivery of low solubility peptides: A study using cyclosporin A, α-cyclodextrin and quaternary chitosan N-betainate

Systemic drug delivery through intraoral membranes may offer a promising administration route for lipophilic peptide drugs. The aim of the present study was to investigate the effect of α-cyclodextrin (α-CD) and a novel chitosan derivative, chitosan N-betainate (CH), on sublingual absorption of a hydrophobic model peptide cyclosporin A (CsA), and the effect of temperature on the complexation of CsA with α-CD.     

Hip arthroplasty infection: Current concepts

Due to systemic or local antibiotic treatment and other preventive procedures, the incidence of deep hip-prosthetic infections in Scandinavia is less than 1 percent, with the majority hematogenous. Coagulasenegative staphylococci and anaerobes are involved in more than half of the cases. The diagnosis is sometimes difficult; preoperative aspiration often gives misleading results; and granulocyte scanning usually adds valuable information. In deep infection the current strategy is to revise with a two-stage procedure. Revisions should be carried out at specialized centers with bacteriologic competence and sufficient experience with implants.