Triple pelvic osteotomy for the treatment of symptomatic acetabular dysplasia in adolescents and adults : A review of 42 hips.

We treated 42 hips with symptomatic acetabular dysplasia using triple pelvic osteotomy. The mean age of the patients was 20.7 years (12-47). The median follow-up was 50.3 months. The average Harris hip score improved from 74 to 92 points. Significant improvement from the preoperative to the latest follow-up evaluation was seen radiologically with reference to the center-edge angle, the anterior center-edge angle, the acetabular index and the femoral head extrusion index. Shenton's line was intact in 9 hips before the operation and it was intact in 40 hips at the latest follow-up. The cross-over sign was present in 15 hips before the operation and it was present in one hip after the operation. The results of this study demonstrated that triple pelvic osteotomy provides improved radiographic results and good symptomatic relief in acetabular dysplasia.

Clinical Significance of Peripheral Blood CEA mRNA Expression in Gastric Cancer Patients Underwent Curative Resection.

PURPOSE: Recent advances in molecular technology have made it possible to detect small numbers of circulating tumor cells in the peripheral blood or bone marrow. Carcinoembryonic antigen (CEA) is an oncofetal antigen that is expressed in epithelial tumor cells. CEA mRNA may be a reliable marker for the detection of tumor cells in the peripheral blood of patients with epithelial cancer. MATERIALS AND METHODS: We analyzed the peripheral blood of 46 patients with gastric cancer who had undergone curative resection. The presence of CEA mRNA was serially monitored using RT-PCR (Preop, Post op 15 day, 2 months (m), 4 m, 6 m, 8 m, 10 m, 12 m). The clinical characteristics, serum CEA level and immunohistochemical staining of tumor tissue were also evaluated. Patients were followed up for 6 to 12 months. RESULTS: There was no significant relationship seen between CEA mRNA RT-PCR positivity in the peripheral blood and sex, stage, serum CEA level or immunohistochemical staining for CEA antigen, During follow up,eight patients experienced recurrence; were positve for CEA mRNA RT-PCR recurrence was seen in 66.7% (6/9) of the patients who before clinical recurrence as compared to 5.4% (2/37) of patients who were negative (p=0.0002). Serial changes of CEA mRNA RT-PCR correlated with clinical recurrence; 100% in the positively converted group (3/3), 0% in the negatively converted group(0/18), 50% in all positive group (3/6) and 10.5% in all negative group (2/19) experienced recurrence, respectively. CONCLUSION: RT-PCR analysis of CEA mRNA in the peripheral blood seems to be a promising tool for the early detection of micrometastatic circulating tumor cells in gastric cancer patients and may be useful in determining patients at high risk for recurrence. However, definitive correlation with recurrence certainly requires a longer follow up duration in further studies.

Noncompetitive, Ca(2+)-independent inhibition of pyruvate dehydrogenase phosphatase by fluphenazine.

The effects of two different classes of calmodulin antagonists on the catalytic activities of purified pyruvate dehydrogenase (PDH) phosphatase and PDH complex (PDC) were studied. In general, PDH phosphatase was more strongly inhibited than PDC by the calmodulin antagonists with the following potency order: fluphenazine > chlorpromazine > thioridazine > triflupromazine. Promazine and two sulfonamides (W-5 and W-7) did not suppress PDH phosphatase activity at 1 mM concentrations, while about 20% of PDC activity was inhibited by these antagonists. Fluphenazine-mediated inhibition of PDH phosphatase was observed with the purified PDC as well as intact mitochondria. Although Ca2+ stimulates PDH phosphatase activity, the addition of exogenous Ca2+ did not overcome the inhibition by calmodulin antagonists. These results suggest that the suppression of PDH phosphatase activity is dependent upon the structure of the individual calmodulin antagonist and appears to be Ca(2+)-independent. Kinetic analysis showed a noncompetitive inhibition of PDH phosphatase by fluphenazine, indicating that it binds to different site(s) from the catalytic site of the enzyme.

Origin of human motor readiness field linked to left middle frontal gyrus by MEG and PET.

Combined magnetoencephalography and positron emission tomography identified a prior source of activity in the left middle frontal gyrus during uncued movements of the right index finger. Voluntary movements gave rise to a change in the cortical electrical potential known as the Bereitschaftspotential or Readiness Potential, recorded as early as 1500 ms before the onset of movement. The Readiness Field is the magnetic field counterpart to the Bereitschaftspotential. In the present study, magnetoencephalography identified four successively active sources of fluctuation in the Readiness Field in the period from 900 ms before, to 100 ms after, the onset of the movement. The first source to be active was registered between 900 and 200 ms prior to the onset of the movement. This source of initial activity was mapped by positron emission tomography to the middle frontal gyrus, Brodmann area 9. The three sources subsequently to be active were mapped to the supplementary motor area, premotor cortex, and motor cortex (M1), all in the left hemisphere.

Auditory event-related magnetic fields in a tone-duration discrimination task. Source localization for the mismatch field and for a new component M2".

Auditory event related magnetic fields were measured using an odd-ball paradigm in which the rare event was a tone of short duration, D2, and the frequent one a tone of longer duration, D1. The subjects were required to attend to and count the number of rare stimuli. In the average across target stimuli a mismatch field (MMF) occurs and the dependence of the MMF, especially its latency, on the tone duration D2 is examined in detail. The location of an equivalent current dipole for the MMF-source is found and turns out to be at variance with earlier results. In addition to the MMF we propose a new component, here called M2", which in time overlaps the magnetic equivalent of the P200 signal and which has a source location (equivalent current dipole) lying rather close to the MMF-source. The two sources are, however, active at latencies differing by a time equal to D2. We speculate that M2" indicates the onset of the process: "evaluation of tone-duration" while the MMF indicates the end of this process.

Eicosanoid production and phospholipase A2 secretion by peritoneal macrophages from rats with adjuvant-induced arthritis.

The effect of adjuvant-induced arthritis on rat peritoneal macrophage (RPM) function with respect to [14C]arachidonic acid (AA) release, leukotriene B4 (LTB4) and prostaglandin E2 (PGE2) production, and secreted phospholipase A2 (PLA2) activity was investigated. Twice as many cells were lavaged from the peritoneal cavity of arthritic rats 21 days post-adjuvant injection than were lavaged from normal rats. PGE2 production was increased two-fold in Ca++ ionophore-stimulated RPM from the adjuvant animals as compared with RPM from control animals. However, PLA2 secretion, LTB4 production and [14C]AA release were unchanged. These results suggest that PGE2 production, rather than LTB4 production or PLA2 secretion, is preferentially enhanced in Ca++ ionophore-stimulated RPM from arthritic rats and may, therefore, reflect a major role for PGE2 in adjuvant-induced arthritis. However, the presence of increase numbers of macrophages and their associated products, including PLA2 and LTB4, may also contribute to the inflammatory process in this disease.

[Preoperative and postoperative magnetoencephalography in a patient with partial epilepsy]. / Prae-og postoperativ magnetoencefalografisk undersøgelse af en patient med partiel epilepsi.

Magnetoencephalography (MEG) is a non-invasive method with a potential of clinical diagnostic use to localize epileptogenic foci in the brain. The aim of this study was to investigate whether the pathological focus localized by MEG was concurrent with the conventional preoperative examinations in a patient with medically intractable epilepsy who underwent surgery (left side uncohippocampectomy). A conventional preoperative test battery had already documented a left-hemisphere fronto-temporal epileptogenic focus. Postoperatively the patient was seizure free. MEG was performed three months before and ten months after the operation. The analysis of the MEG data indicated a left hemisphere fronto-temporal focus in agreement with results obtained by means of the conventional methods used for locating epileptic foci. Postoperatively the focus had disappeared.

Dependence of the auditory evoked magnetic field (100 msec signal) of the human brain on the intensity of the stimulus.

The intensity dependence of the 100 msec magnetic field signal evoked by contralateral application of a tone burst stimulus has been examined for both hemispheres and for a number of frequencies. In all cases the component of the magnetic field normal to the skull was measured; in some cases this component was oriented in the outward direction (group 1 and some group 2 subjects), in the other cases in the inward direction (group 2). The experimental results were analysed in terms of an equivalent current dipole model. The analysis gave rise to the introduction of a transit time (tau 0 approximately 60 msec) from the onset of the stimulus to the activation of the current dipole and to the introduction of a functional relationship between the dipole moment and a 'reduced' intensity, and between the latency and the 'reduced' intensity. Further, the reproducibility of the signal was verified.

Cortical magnetic fields evoked by frequency glides of a continuous tone.

Frequency glides from a continuous tone have been shown to produce activity from the human cortex that can be recorded as time-varying magnetic fields outside the scalp in the same way as simpler auditory stimuli such as clicks and tone bursts. Data analysis has been based on a model assuming an equivalent current dipole localized close to the skull surface. Recorded data have shown good agreement with such a model. Interhemispheric differences have been shown in the location of this dipole, as well as with regard to dipole moment and latencies of responses to contralateral stimulation. The location of the equivalent dipole for frequency glide stimulation is close to that previously reported for tone pulse stimulation. However, the results indicate that differences in location of the order of 10 mm may exist. Comparing previously reported electric responses to frequency glides indicates essentially qualitative agreement although some significant differences have also been found. This is interpreted as evidence that at least the major contributions to the two types of response are produced by the same generator in the temporal lobe of the human cortex.

Auditory magnetic fields from the human cerebral cortex: location and strength of an equivalent current dipole.

Auditory evoked cortical magnetic fields are recorded from human subjects by means of a SQUID gradiometer. The spatial and temporal distributions of the averaged evoked fields normal to the surface of the skull are measured from both hemispheres in response to contra- and ipsilateral 1 kHz stimulation. The evoked magnetic response can be separated into a dominant and a 'residual' signal and the former is analysed with a particular source model consisting of a single equivalent current dipole in each hemisphere. We find that the equivalent current dipoles are located near the superior surface of the temporal lobes approximately 20 mm below the surface of the skull. The dipoles are oriented in the superior-inferior direction. In the left hemisphere the dipole is located approximately 14 mm posterior to that in the right hemisphere, but otherwise no hemisphere/ear difference in dipole location or orientation is found. The strength of the dipole in the left hemisphere is found to be twice as great as that in the right hemisphere when stimulating the right ear, whereas no difference is found when stimulating the left ear. The strength of the dipole is greater in response to contralateral than ipsilateral stimulation. By means of a statistical experiment and using estimates of the variance of the recorded evoked fields we show that the model suggested is adequate to describe the experimental data and that the overall confidence of the extracted dipole parameters can be estimated.

Auditory magnetic fields: source location and 'tonotopical organization' in the right hemisphere of the human brain.

The late, acoustically evoked, averaged magnetic field from the right hemisphere of the human brain is composed of two signals. One is dominant, appears generated by an equivalent current dipole within or near the primary auditory cortex and shows a frequency dependent location and/or orientation (tonotopical organization). The other, denoted the 'residual' signal, resembles the electric T-complex and is possibly generated more diffusely in the auditory and adjacent cortical areas.

Auditory magnetic fields from the human cortex. Influence of stimulus intensity.

The late averaged magnetic field evoked by contra- and ipsilateral auditory stimulation is recorded by means of a SQUID magnetometer from both hemispheres in four normally hearing, right-handed male adults. The stimuli consist of 1 kHz, 500 ms tone pulses with intensities from 5 to 85 dB HL and averaging is based on 60 sweeps. Stimulating the right ear the averaged magnetic field from the left hemisphere is approx. twice as great as that from the right hemisphere, whereas stimulating the left ear no difference in magnitude is found. The amplitude input-output functions are steeply rising near threshold and more shallow at high intensities. The responses from contralateral stimulation are approx. 9 ms earlier than those from ipsilateral stimulation with no interhemispheric difference.

Magnetic auditory responses from the human brain. A preliminary report.

By means of a magnetic sensor, SQUID (Superconducting Quantum-Interference Device) the late acoustically evoked magnetic field was recorded from the right and left side of the skull in 5 humans in response to ipsi- and contralateral 1 kHz tone bursts at 80 dB SPL. The '100 ms' component of the magnetic field has opposite polarity on the two sides of the head and when crossing the primary auditory cortex at the Sylvian fissure in a posterior--anterior track, polarity inversion of this component takes place within a highly localized region. The evoked magnetic field is widely distributed across the scalp and seems to be produced by an equivalent magnetic dipole located in or near the primary auditory cortex. In the present experiment neither right--left hemisphere nor ipsi--contralateral differences could be demonstrated.