Biomedical subjects
Publications and source records attributed to J T Watson.
Prepatellar bursitis secondary to infection with an atypical mycobacterium developed in an 88-year-old man. A review of all previously reported cases in the English literature indicates tuberculosis is important in the differential diagnosis of prepatellar bursitis.
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Fractures of the forearm in the athletic population can often result in significant dysfunction if they are not treated correctly. Conservative management of these injuries is often fraught with difficulty. We review current techniques of internal fixation with the goal of allowing the athlete to begin early functional rehabilitation and eventual return to participation. With these goals in mind, functional orthoptic management is also reviewed. In addition, recommendations for allowing full participation are given, as well as eventual hardware removal.
Fast atom bombardment mass spectrometry (FAB-MS) studies of the nonapeptide bradykinin sampled from aqueous glycerol illustrate the importance of the matrix to analyte ratio in the FAB experiment. Enhanced mass spectral results (in conventional direct probe FAB analyses) are characterized by increased ionization efficiency of the analyte together with a substantial reduction in the glycerol background signal. Replicate analyses of different bradykinin/glycerol/water mixtures show this improvement to depend upon the glycerol/bradykinin relationship and not the water/bradykinin relationship in sampling 4 nmol of bradykinin from 1% to 56% aqueous glycerol (2 microL initial sample volumes). The optimum desorption ionization occurs when the molar ratio of glycerol to bradykinin is approximately 300:1. A model emphasizing the importance of the analyte surface concentration in the matrix (with water being simply a convenient vehicle for the deposition of minute portions of glycerol) is proposed to account for the spectral enhancement. The FAB-MS enhancement behavior of four other peptides, selected for their differences in hydrophobicity (and hence, surface activity in glycerol), is compared to that of bradykinin.
Intracranial implantation of minute pellets of gonadal steroids was combined with aromatase inhibitor treatment to determine if aromatization within the preoptic area (POA) is necessary for androgens to activate sexual behavior in the Japanese quail (Coturnix japonica). In this species, implantation of pellets of testosterone propionate (TP) or estradiol benzoate (EB) in the POA of castrated males restores male-typical copulatory behavior. In Experiment 1, adult male castrated quail were implanted intracranially with 200-micrograms pellets of equimolar mixtures of crystalline TP + cholesterol (CHOL), TP + 1,4,6-androstatriene-3,17-dione (ATD, an aromatase inhibitor), EB + ATD, or CHOL and behavior-tested with intact males and females. Copulation was stimulated by POA implants containing TP or EB (three of six CHOL + TP males and two of seven ATD + EB males copulated vs zero of four CHOL males), but copulation was not inhibited by combining ATD with TP (three of four ATD + TP males copulated). In Experiment 2, adult male castrated quail were injected systemically with ATD or oil for 6 days prior to and 14 days after intracranial implantation of 200-micrograms pellets containing the same amounts of TP or EB as in Experiment 1. The ATD injections completely blocked copulatory behavior in males with TP implants in the POA such that ATD/TP and Oil/TP mount frequencies differed significantly, but failed to block copulation in males with EB implants in the POA (proportions of males copulating were ATD/EB, 6/8; ATD/TP, 0/6; Oil/TP, 4/7). The cloacal foam gland, an androgen-sensitive secondary sex character, was unaffected by the dose of ATD used. We conclude that activation of copulatory behavior by TP implants in the POA is not due to nonspecific effects of high local testosterone concentrations but rather to aromatization. These results support the hypothesis that cells within the POA aromatize testosterone to estrogens, which directly stimulate the cellular processes leading to activation of male-typical copulatory behavior.
Intracranial implantation of minute pellets of gonadal steroids was performed to determine neuroanatomical loci at which steroids activate sexual behavior in the Japanese quail (Coturnix japonica). In this species, systemic treatment of castrated males with either testosterone propionate (TP) or estradiol benzoate (EB) restores male-typical copulatory behavior (head grabbing, mounting, and cloacal contact movements). In addition, EB activates female-typical receptive behavior (crouching). Adult male castrated quail were implanted intracranially with 300-micrograms pellets containing TP, EB, or cholesterol (CHOL) and behavior was tested with intact males and females. Either TP or EB pellets in the preoptic area (POA) activated male-typical copulatory behavior. Mounting was specifically activated without concomitant activation of other steroid-sensitive sexual and courtship behaviors. TP and EB implants in adjacent nuclei containing receptors for these steroids and CHOL implants in POA had no effect on male-typical copulatory behavior. Eighteen percent of all males tested for female-typical receptivity crouched, but no specific effect of EB was seen at any site. The similarity of the POA sites for activation of mounting by TP and EB is consistent with the hypothesis that cells within the POA aromatize testosterone to estrogens, which directly stimulate the cellular processes leading to behavioral activation.
The authors report four cases of fat embolism syndrome following total hip arthroplasty using cementless acetabular press-fit components and cemented press-fit femoral components. Factors implicated in the production of this syndrome following "hybrid" total hip arthroplasty include increased canal pressure during femoral reaming and prosthetic insertion, retained marrow elements and reaming debris, and the use of lumbar epidural anesthesia. This potentially fatal syndrome must be a recognized complication following the use of cemented press-fit femoral stems. Specific recommendations for decreasing the incidence of this complication are reviewed.
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Steroid autoradiography was undertaken to determine the neuroanatomical loci which might be involved in the activation of steroid-sensitive behaviors in the Japanese quail (Coturnix japonica). Male and female quail were either surgically gonadectomized or photically regressed and implanted with androgen or estrogen to restore normal sexual and courtship behavior. After gonadectomy or implant removal, each quail was injected with 250 microCi of [3H]-testosterone (3H-T), [3H]-estradiol (3H-E2), or [3H]-dihydrotestosterone (3H-DHT), sacrificed, processed for autoradiography, and the telencephalon, diencephalon, mesencephalon, and rhombencephalon were examined for labelled cells. Following 3H-T or 3H-E2 injection and autoradiography, labelled cells were found in nucleus septalis lateralis (SL), nucleus preopticus medialis (POM), nucleus paraventricularis (PVN), regio lateralis hypothalami (LHy), nucleus inferior hypothalami (IH), nucleus infundibuli (IN), nucleus intercollicularis (ICo), substantia grisea centralis (GCt), nucleus taeniae (Tn), and in the reticular formation near nucleus motorius nervi trigemini (MV). In addition, following 3H-E2 autoradiography, labelled cells were found around nucleus accumbens (Ac). Following 3H-DHT autoradiography, labelled cells were found only in SL, PVN, Tn, LHy, ICo, and CGt. No labelled cells were found in Ac, POM, IH, IN, or MV even after long exposure times. These results suggest that the nuclei labelled following 3H-E2 but not 3H-DHT administration bind exclusively the aromatized metabolites of T. Since quail show a sex difference in male-typical copulatory behavior in response to E2, labelled cells were counted in POM, LHy, IH, and Tn of male and female quail following 3H-E2 injection and autoradiography. No sex differences in the number of labelled cells were found in POM, LHy, or IH. Males were found to have more labelled cells than females in Tn. These results show that sex differences in male-typical copulatory behavior are not due to sex differences in the number of cells binding estrogens in POM. The results reported here constitute the most neuroanatomically extensive report of steroid binding cells to date for a galliform brain, the first comparison in a galliform bird of the distributions of cells labelled following injection of 3H-T, 3H-E2, and 3H-DHT and the first analysis of sex differences in numbers of estrogen-binding cells in four nuclei in the avian brain.
Orthopedic manifestations of metabolic bone disease are usually related to structural compromise of the skeleton. Fractures due to osteoporosis are the most often encountered problem. In this overview, the authors focus on the commonly encountered fractures related to osteoporosis and discuss concerns and complications related to their management. In addition, they point out the subtle ways in which less commonly encountered metabolic bone diseases, such as osteomalacia, hyperparathyroidism, and Paget's disease, might come to the attention of the orthopedist. Appropriate criteria for medical and surgical management are suggested.
Bone quality is an accepted criterion for determining fixation options for total hip arthroplasty (THA). Eighty patients with 95 uncemented THAs were evaluated by comparing preoperative roentgenographic assessment with histologic evaluation of bone biopsy specimens obtained from the ipsilateral iliac crest. Roentgenographic analysis of bone quality was performed using the Singh and Engh indices. Histologic evaluation employed a quantitative analysis of static and dynamic parameters of bone turnover on undecalcified sections. Extensive statistical analysis comparing roentgenographic with histologic parameters of bone quality showed: (1) no relationship of the two roentgenographic indices to trabecular bone volume and most other histologic parameters and (2) a high incidence of bone abnormalities. Bone quality is an imprecise term and is inadequately measured by these roentgenographic indices. Histologic measurement offers a more precise means of analyzing the relationship of the bone environment to the performance of the THA.
The records of fifty-one patients who were treated by intramedullary nailing with reaming for non-union of the tibia were retrospectively reviewed. The fractures had been treated initially by closed reduction and immobilization in a cast, external fixation followed by immobilization in a cast, fixation by pins incorporated in a plaster cast, minimum internal fixation and immobilization in a cast, dynamic compression plating, or intramedullary nailing with or without reaming. After the initial treatment had failed, intramedullary nailing with reaming was done to gain union. Although closed nailing of the tibia was preferred, in thirty-three patients, the site of the non-union was opened to improve alignment by performing an osteotomy or to remove failed hardware. Bone grafts from the iliac crest were used in ten patients, and a fibular ostectomy or osteotomy was done in thirty-three. Of thirty-four open fractures (fourteen grade I, seven grade II, and thirteen grade III), eight were infected at the time of intramedullary nailing. The average time of the diagnosis of a non-union was 9.6 months; the average length of follow-up after nailing was twenty months. In forty-nine (96 per cent) of the fifty-one patients, tibial union occurred at an average of seven months postoperatively. Complications included persistent infection (three patients), acquired infection after intramedullary nailing with reaming (three patients), fracture of the nail that necessitated an additional operation (two patients), shortening of more than one centimeter (two patients), malrotation of more than 15 degrees (one patient), peroneal palsy (one patient), and amputation (one patient). When used to treat non-union of the tibia, intramedullary nailing with reaming can produce union as effectively as other alternatives, while enabling the patient to function more normally without external immobilization or walking aids.
We have localized nicotinic acetylcholine receptors in the zebra finch brain by using three 125I-labelled ligands: alpha bungarotoxin and two monoclonal antibodies to neuronal nicotinic receptors (MAb 35 of Tzardos et al., J. Biol. Chem., 250: 8635-8645, '81; and MAb 270 of Whiting and Lindstrom: J. Neurosci. 6: 3061-3069, '86). Unfixed brains from intact adult male and female zebra finches were prepared for in vitro autoradiography. Low-resolution film autoradiograms and high-resolution emulsion autoradiograms were prepared for each of the three ligands. The major brain structures that bind all three of the ligands are hippocampus; hyperstriatum dorsalis; hyperstriatum ventralis; nucleus lentiformis mesencephali; nucleus pretectalis, some layers of the optic tectum; nucleus mesencephalicus lateralis; pars dorsalis; locus ceruleus; and all cranial motor nuclei except nucleus nervi hypoglossi. The major structures labelled only by [125I]-alpha bungarotoxin binding included hyperstriatum accessorium and the nuclei: preopticus medialis, medialis hypothalami posterioris, semilunaris, olivarius inferior, and the periventricular organ. Of the song control nuclei, nucleus magnocellularis of the anterior neostriatum; hyperstriatum ventralis, pars caudalis; nucleus intercollicularis; and nucleus hypoglossus were labelled. The binding patterns of the two antibodies were similar to one another but not identical. Both labelled nucleus spiriformis lateralis and nucleus geniculatus lateralis, pars ventralis especially heavily and also labelled the nucleus habenula medialis; nucleus subpretectalis; nucleus isthmi, pars magnocellularis; nucleus reticularis gigantocellularis; nucleus reticularis lateralis; nucleus tractus solitarii; nucleus vestibularis dorsolateralis; nucleus vestibularis lateralis; nucleus descendens nervi trigemini; and the deep cerebellar nuclei. Lobus parolfactorius and nucleus vestibularis medialis were labelled by only MAb 270, whereas only MAb 35 labelled nucleus laminaris and the medial and lateral pontine nuclei. These data extend previous reports of cholinergic participation in the song system (Ryan and Arnold: J. Comp. Neurol. 202: 211-219, '81) to suggest that the zebra finch song system may contain several closely related nicotinic receptors. In several brain nuclei it appeared that certain anatomical portions of a nucleus or a certain class of neurons were specifically labelled. Furthermore, in certain cases, the labelling appeared to be clustered around Nissl-stained cell nuclei, thus suggesting that the receptors are concentrated on or in somata.
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The formation of polyhydrogen adducts of peptide molecules during fast atom bombardment (FAB) mass spectrometry (MS) is shown to be matrix dependent. FAB/MS analyses completed in glycerol solvent produced higher than expected peak intensities at m/z corresponding to (M + 2)+, (M + 3)+, and (M + 4)+ when the contributions of all stable isotopes present in the sample are included. Analysis of the same peptides in thioglycerol by positive or negative ion FAB yielded peak intensity distributions for the protonated molecule which matched those predicted from the natural abundance of stable isotopes. These findings suggest that thioglycerol should be the FAB matrix in analyses of peptides when determination of elemental or isotopic composition is desired.
A new technique known as thermally-assisted fast atom bombardment (TA-FAB) has been applied to the analysis of a series of cyclic tetrapeptide mycotoxins in order to demonstrate the usefulness of the method for structural elucidation. TA-FAB uses saturated aqueous solutions of highly hydroxylated compounds, such as fructose, as alternatives to the usual viscous liquid matrices employed in conventional FAB. During the TA-FAB analysis, the probe tip is resistively heated causing differences to occur in the desorption profiles for the analyte and the matrix ions enabling an optimization for analyte desorption as a function of temperature. In this study, direct comparisons are made between TA-FAB, conventional FAB, and electron impact ionization for the analysis of the Helminthosporium carbonum mycotoxins at the 1.5 micrograms level. The results demonstrate the superior capacity of TA-FAB to provide both molecular weight confirmation and significant fragmentation to aid in the structural elucidation of these important biomolecules.
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