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Effects of diacerhein in an accelerated canine model of osteoarthritis.

OBJECT: To determine whether diacerhein has a disease-modifying effect in an accelerated canine model of osteoarthritis. DESIGN: Fourteen adult mongrel dogs underwent unilateral L4-S1 dorsal root ganglionectomy (DRG), followed 3 weeks later by ipsilateral anterior cruciate ligament transection. Seven dogs received diacerhein (15-20 mg/kg) daily throughout the interval between DRG and sacrifice, eight weeks after ligament transection. The other seven dogs served as OA controls. RESULTS: The mean volume of synovial fluid obtained from the OA knee of the diacerhein-treated dogs was approximately 40% less than that from the OA knee of the controls. In addition, diacerhein appeared to reduce the severity of fibrillation (femoral condyle) and full-thickness ulceration (trochlear ridge) of the articular cartilage and the level of collagenase activity in extracts of the OA cartilage, and to increase net PG synthesis in the OA cartilage, although none of the above changes were statistically significant. CONCLUSION: The differences between the diacerhein group and untreated OA controls, even though not statistically significant, suggest that diacerhein was active in this rapidly progressive model of OA. Because changes associated with initiation of OA may be different than those associated with progression, whether diacerhein has a disease-modifying effect should be examined in a less rapidly progressive model.

Animals↗

Effects of ankle joint effusion on lower leg function.

BACKGROUND: Inversion ankle sprains are among the most frequently encountered injuries in and outside of sport. Altered feedback from joint damage and/or edema may negatively affect dynamic stabilization, thereby increasing the patients' susceptibility to further injury. In order to understand better how the sensorimotor system responds to the presence of ankle edema during a functional task, further examination is warranted. OBJECTIVE: To quantify muscle activation in the peroneal, tibialis anterior, and soleus musculature as well as to determine ankle joint peak torque, peak power, and root mean square (RMS) power during a closed kinetic chain activity following artificial ankle effusion. DESIGN: Dependent variables were compared within subjects across time intervals and between groups. SETTING: All data were collected in the biomechanics laboratory. PARTICIPANTS: Subjects were 20 healthy, neurologically sound volunteers (age 21.9 +/- 2.1 y, height 174.5 +/- 9.3 cm, mass 79.3 +/- 15.9 kg) with no lower extremity injuries. INTERVENTIONS: Subjects were prepared for surface electrodes on the peroneus longus (PL), tibialis anterior (TA), soleus (Sol), and medial malleolus (ground). Anthropometric measures for the lower extremity were recorded for use by the Omnikinetic closed chain dynamometer. Measurements were taken prior to ankle effusion (baseline), immediately following effusion (post), and again at 30 minutes. MAIN OUTCOME MEASUREMENTS: Testing consisted of 6 repetitions at 35% of 1-repetition max and a constant speed of 1.5 Hz. Separate two-way MANOVAs with repeated measures on time intervals were used to detect differences between groups (effusion and control) over time for torque, power, and RMS power and for peak and average EMG. RESULTS: An overall time x group interaction was detected for EMG (F4,72=3.878; P=0.007) and kinetic variables (F6,70=5.55; P=0.0001). Average and peak PL EMG decreased immediately following effusion (Sidak's; P=0.048), and average EMG remained depressed 30 minutes following effusion (Sidak's; P=0.02). Immediately posteffusion, a decrease in ankle torque was detected (Sidak's; P=0.007). No differences in TA or Sol EMG, power, or RMS power were detected (P>0.05). CONCLUSIONS: Decreases in ankle plantarflexion torque and PL EMG indicate that a neuromuscular deficit exists in the presence of edema that could increase the susceptibility for further ankle injury.

Adult↗

Gamma knife radiosurgery as a primary treatment for prolactinomas.

OBJECT: The purpose of this study was to estimate the efficacy of gamma knife radiosurgery (GKS) in controlling tumor growth and endocrinopathy associated with prolactinomas. METHODS: Between 1993 and 1997, 164 of 469 patients with pituitary adenomas treated by GKS harbored prolactinomas. The dose to the tumor margin ranged from 9 to 35 Gy (mean 31.2 Gy), and the visual pathways were exposed to a dose of less than 10 Gy. The mean tumor diameter was 13.4 mm. The mean follow-up time for 128 cases was 33.2 months (range 6-72 months). Tumor control was observed in all but two patients who underwent surgery 18 and 36 months, respectively, after GKS. Clinical cure was achieved in 67 cases. Clinical improvement was noted with a decrease in the hyperprolactinemia after GKS. Nonetheless, in 31 (29%) of 108 patients who were followed for more than 2 years no improvement in serum prolactin levels was demonstrated, although this could be normalized by bromocriptine administration after treatment. Nine infertile women became pregnant 2 to 13 months after GKS and all gave birth to normal children. There was no visual deterioration related to GKS. Five women experienced premature menopause. In these patients there was subtotal disappearance of the tumor and an empty sella developed. CONCLUSIONS: Gamma knife radiosurgery as a primary treatment for prolactinomas can be safe and effective both for controlling tumor growth and for normalization of prolactin hypersecretion. A higher margin dose (> or = 30 Gy) seemed to be associated with a better clinical outcome. Gamma knife radiosurgery may make prolactinomas more sensitive to the bromocriptine.

Humans↗