Medial and lateral osteoarthritis of the knee is related to variations of hip and pelvic anatomy.

OBJECTIVE: We evaluated if increased risk of combined hip and lateral knee osteoarthritis (OA) could be attributed to anatomical reasons in the hip region resulting in increased abductor moment over the knee. METHODS: We measured pelvic width, femoral offset, femoral neck length and angle in 29 women with lateral knee OA (13 unilateral, 16 bilateral) and 27 women with bilateral medial OA. Twenty-one of these patients with normal hips (lateral/medial OA of the knee=12/9) and 35 with associated hip OA (lateral/medial OA of the knee=17/18) were evaluated separately. Radiographic examinations in 14 women planned for hip prosthesis because of failures after hip fracture acted as controls. RESULTS: Patients with lateral OA of the knee had wider pelvis than controls (13.7 mm increased distance between the medial borders of the acetabulum, P=0.001). Patients with medial OA had 11.4mm longer distance from the centre of the femoral head to the centre of the proximal part of the femoral shaft (P=0.005), corresponding to a higher offset. The pelvic and hip anatomy also differed between patients with medial and lateral OA of the knee. In the groups without hip OA, presence of lateral knee OA was associated with a wider pelvis (P=0.009), shorter femoral neck (P=0.02) and Head-Shaft distance (P=0.04). In the groups with OA of the hip associated lateral OA of the knee also implied increased Neck Shaft angle (coxa valga, P=0.008), but there was no difference in pelvic width (P=0.15). We found a shorter lever arm over the hip in lateral knee OA compared to medial knee OA (P=0.02), but not when compared to controls. CONCLUSION: Our findings suggest that occurrence of medial or lateral OA has a biomechanical background originating from pelvis and hip anatomy.

An aminopeptidase P from Lactococcus lactis with original specificity.

An aminopeptidase P (E.C. 3.4.11.9) that cleaves the Arg-1-Pro-2 bond of bradykinin has been isolated for the first time from Lactococcus lactis. The peptidase was purified to homogeneity in a 3-step procedure and characterized. It is a monomeric metalloenzyme with a 43 kDa molecular mass, activated by Mn2+ and inhibited by DTT. It differs from the majority of aminopeptidases P already described by displaying a specificity for X-Pro-Pro N-terminal and probably an extended binding site that could accommodate amino acid residues beyond the P'2 position of the substrate.

Ulcerative colitis and indeterminate colitis in the city of Malmö, Sweden. A 25-year incidence study.

BACKGROUND: This study was designed to assess time trends in the incidence of ulcerative colitis and indeterminate colitis in an urban population. METHODS: Medical records of in- and out-patients with inflammatory bowel disease were reviewed by a panel to establish the diagnosis. All histopathologic specimens and almost all radiographs were re-examined. RESULTS: During the time period 1958 to 1982 there were 354 new cases of definite ulcerative colitis, 117 of probable ulcerative colitis, and 100 of indeterminate colitis. This corresponds to an average annual incidence per 100,000 of 5.5, 1.8, and 1.6, respectively. The incidence was higher in men than in women. Peak incidence was between 20 and 29 years, but indeterminate colitis was most common in 10- to 19-year-old males. The incidence was stable from 1958 to 1972 but then increased in almost all age groups in both sexes. The increase in annual incidence of definite ulcerative colitis from 4.2 to 9.4/10(5) corresponds to an average annual increase of about 5% (p < 0.001). The increase in the incidence of definite ulcerative colitis was due to an increased proportion of patients with proctitis. CONCLUSIONS: This study has shown an increased incidence of ulcerative colitis and indeterminate colitis, and we have found no reason to believe that this is a spurious finding.