Anterior cruciate ligament

Anterior cruciate ligament surgery is currently widely practiced. Nevertheless it is a surgery which is performed electively, mostly in young healthy adults who chose to continue in their sporting endeavours. We present a short account of the various aspects of this surgery as well as our preferred technique and results.     

Projected needs of health manpower in Saudi Arabia, 1974-90

Although our projections are not completely accurate, due to inadequate data and crude methods of approximation, three conclusions are inescapable: 1. The nation should give priority to planning new schools for health administrators and rural health workers, and to generally expanding present schools for paramedicals. 2. Plans should proceed rapidly for the two new medical schools. 3. A Health Manpower plan based on census information and special studies should be developed over the next 2 years. This plan should have input from all concerned ministries. (The Ministry of Health has regarded a proposal from University Associate "a group of Harvard, Johns Hopkins and A.U.B. professors" for technical cooperation in health services planning.)     

Non-visualization of lung markings below hemidiaphragm in subtle subpulmonic effusion: an old sign resuscitated

To assess the lack of visibility of vascular markings under the hemidiaphragm on a frontal chest radiograph as a sign of pleural effusion, fifteen patients were collected showing this sign. Pleural effusion was diagnosed by ultrasound, comparison with previous or subsequent chest x-ray or computed tomography. Patients in the study group exhibited this sign in the absence of the classical signs of pleural effusion. In the control group, lack of visibility of blood vessels was observed in only 4.2% cases. Non-visualization of vascular markings below the hemidiaphragm should alert the interpreter to the possible presence of pleural effusion and a lateral or decubitus view or ultrasound examination may be carried out to rule out effusion.     

The importance of the Holter ECG monitoring of patients in the acute period of an ischemic stroke

10 guinea pigs of group 1 were injected subcutaneously kanamycin (400 mg/kg). The other 10 guinea pigs of group 2 received human ceruloplasmin as an intraperitoneal injection of 10% solution (0.25 ml of the protein preparation per 100 g body weight) 30 min before kanamycin administration. 7 days after the treatment the cochlease were isolated and examined electron microscopically. The Corti's organ was stained with alcyan blue and lanthanum hydroxide. In animals of group 1 there was mitochondrial vacuolization, enlargement of the cisterns of the endoplasmic network, Golgi apparatus, sub-superficial network; glycocalix layer on the surface of the receptor epithelium was unbroken but uneven, in the sensor cells of the Corti's organ of the group 2 animals only few mitochondria were vacuolized. A great number of ribosomes and mitochondrial contacts with membraneous cell structures were indicative of active protein synthesis and energetic processes. Glycocalix was less damaged. This was indicative of an otoprotective effect of ceruloplasmin which diminished kanamycin ototoxicity.     

Human papilloma virus in neoplastic and non-neoplastic conditions of the external eye

Cervical lymphadenitis produced by non-tuberculous mycobacteria (NTM) is gaining in importance and should be included in the differential diagnosis of cervical masses, particularly in immunodepressed children and patients. The treatment of choice and diagnostic test are discussed. A case of primary cervical adenitis by NTM is reported and the management is discussed in the light of recent bibliography.     

The potent mGlu receptor antagonist LY341495 identifies roles for both cloned and novel mGlu receptors in hippocampal synaptic plasticity

Understanding the roles of metabotropic glutamate (mGlu) receptors has been severely hampered by the lack of potent antagonists. LY341495 (2S-2-amino-2-(1S,2S-2-carboxycyclopropyl-1-yl)-3-(xanth-9-y l)propanoic acid) has been shown to block group II mGlu receptors in low nanomolar concentrations (Kingston, A.E., Ornstein, P.L., Wright, R.A., Johnson, B.G., Mayne, N.G., Burnett, J.P., Belagaje, R., Wu, S., Schoepp, D.D., 1998. LY341495 is a nanomolar potent and selective antagonist at group II metabotropic glutamate receptors. Neuropharmacology 37, 1-12) but can be used in higher concentrations to block all hippocampal mGlu receptors, identified so far by molecular cloning (mGlu1-5,7,8). Here we have further characterised the mGlu receptor antagonist activity of LY341495 and have used this compound to investigate roles of mGlu receptors in hippocampal long-term potentiation (LTP) and long-term depression (LTD). LY341495 competitively antagonised DHPG-stimulated PI hydrolysis in AV12-664 cells expressing either human mGlu1 or mGlu5 receptors with Ki-values of 7.0 and 7.6 microM, respectively. When tested against 10 microM L-glutamate-stimulated Ca2+ mobilisation in rat mGlu5 expressing CHO cells, it produced substantial or complete block at a concentration of 100 microM. In rat hippocampal slices, LY341495 eliminated 30 microM DHPG-stimulated PI hydrolysis and 100 microM (1S,3R)-ACPD-inhibition of forskolin-stimulated cAMP formation at concentrations of 100 and 0.03 microM, respectively. In area CA1, it antagonised DHPG-mediated potentiation of NMDA-induced depolarisations and DHPG-induced long-lasting depression of AMPA receptor-mediated synaptic transmission. LY341495 also blocked NMDA receptor-independent depotentiation and setting of a molecular switch involved in the induction of LTP; effects which have previously been shown to be blocked by the mGlu receptor antagonist (S)-MCPG. These effects may therefore be due to activation of cloned mGlu receptors. In contrast, LY341495 did not affect NMDA receptor-dependent homosynaptic LTD; an effect which may therefore be independent of cloned mGlu receptors. Finally, LY341495 failed to antagonise NMDA receptor-dependent LTP and, in area CA3, NMDA receptor-independent, mossy fibre LTP. Since in the same inputs these forms of LTP were blocked by (S)-MCPG, a novel type of mGlu receptor may be involved in their induction.     

Administration of 9-[2-(phosphonomethoxy)propyl]adenine (PMPA) for prevention of perinatal simian immunodeficiency virus infection in rhesus macaques

Simian immunodeficiency virus (SIV) infection of newborn macaques is a useful animal model to explore novel strategies to reduce perinatal human immunodeficiency virus (HIV) infection. The availability of two easily distinguishable virus isolates, SIVmac251 and the simian/human immunodeficiency virus chimera SHIV-SF33, allows tracing the source of infection following inoculation with both viruses by different routes. In the present study, we evaluated the efficacy of pre- and postinoculation treatment regimens with 9-[2-(phosphonomethoxy)propyl]adenine (PMPA) to protect newborn macaques against simultaneous oral SIVmac251 and intravenous SHIV-SF33 inoculation. Untreated newborns became persistently infected following virus inoculation. When three pregnant macaques were given a single subcutaneous dose of PMPA 2 hr before cesarean section, their newborns became SIV-infected following SIV and SHIV inoculation shortly after birth. In contrast, when four newborn macaques were inoculated simultaneously with SIV and SHIV, and started immediately on PMPA treatment for 2 weeks, only one animal became persistently SIV-infected; the remaining three PMPA-treated newborns, however, had some evidence of an initial transient virus infection but were seronegative and healthy at 8 months of age. Our data demonstrate that PMPA treatment can reduce perinatal SIV infection and suggest that similar strategies may also be effective against HIV.