Preoperative ankle arthroscopy revealed an essential amount of information that would otherwise have been undetected. For instance, the ligaments showed typical abnormalities corresponding to different entities of ankle instability and different intraarticular pathologic conditions.

In 42 elderly patients, 33 women and nine men with a mean age of 72 years, we treated displaced fractures of the proximal humerus (34 three-part, 8 four-part) using a blade plate and a standard deltopectoral approach. Functional treatment was started immediately after surgery. We reviewed 41 patients at one year and 38 at final follow-up at 3.4 years (2.4 to 4.5). At the final review, all the fractures had healed. The clinical results were graded as excellent in 13 patients, good in 17, fair in seven, and poor in one. The median Constant score was 73 +/- 18. Avascular necrosis of the humeral head occurred in two patients (5%). We conclude that rigid fixation of displaced fractures of the proximal humerus with a blade plate in the elderly patient provides sufficient primary stability to allow early functional treatment. The incidence of avascular necrosis and nonunion was low. Restoration of the anatomy and biomechanics may contribute to a good functional outcome when compared with alternative methods of fixation or conservative treatment. Regardless of the age of the patients, we advocate primary open reduction and rigid internal fixation of three- and four-part fractures of the proximal humerus.

For the treatment of full-thickness articular cartilage lesions of the knee joint, as a result of trauma or osteochondritis dissecans, a variety of biological reconstruction techniques have been developed. Different studies, some of which were performed as randomised, prospective clinical studies, showed that the autologous chondrocyte transplantation (ACT) provides the most satisfying and reliable method of cartilage reconstruction in the adult when applied to defects exceeding 4 cm (2). Based on these results, ACT seems to be of economic benefit, as the risk of developing osteoarthritis correlates significantly with the size of the cartilage defect, when not treated properly and in time. Surveying the studies on basic scientific aspects of ACT, cartilage defect animal models and clinical studies, it can be concluded that clinical results of ACT depend on a variety of factors. In this review, published by the joined advisory board of the German Societies of Traumatology (DGU) and Orthopaedic Surgery (DGOOC), we summarize the current knowledge available and the state of the art concerning ACT. Especially we discuss the advantages of different procedures, methods for treating knee cartilage defects and factors that influence the outcome of the different treatment regimens, with the aim to develop guidelines for the correct indication and application of the ACT.

Proliferating cells and tumour cells maintain a high glycolytic rate even under aerobic conditions. FT02B cells, a rat hepatoma cell line, show high activities of glycolytic enzymes. Within a culture period of 48 h the cell number increases 5-fold. Replacement of glucose by pyruvate in the culture medium lowers glycolytic enzyme activity and prevents proliferation. Transfection assays revealed that glucose deprivation dramatically decreases the transcriptional activities of the Spl-dependent aldolase and pyruvate kinase promoters leading to reduced reporter gene expression. Spl binding activity is also inhibited by ocadaic acid, an inhibitor of protein phosphatase 1. Western blot analyses with nuclear extracts from FT02B cells cultured in the presence or absence of glucose revealed differences in the phosphorylation state of Spl. From these results we conclude that glucose increases the amount of the dephosphorylated form of Spl which has a higher DNA binding activity. As a consequence gene expression of the glycolytic enzymes is increased which is a prerequisite for cell proliferation.

Protein S6 could be isolated in five forms of different length and acidity from the mixture of all 70-S ribosomal proteins by column chromatography on DEAE-cellulose followed by purification on Sephadex G-100. Amino acid sequence studies on the intact protein and a fragment obtained using 2-(2-nitrophenyl-sulfenyl)-3-methyl-3'-bromoindolenine skatole were done by automatic Edman degradation using an improved liquid-phase Beckman sequenator. The protein was digested with trypsin and all 19 peptides were isolated. Their amino acid compositions were analysed and the sequence of the amino acids within the peptides was determined either by means of a solid-phase peptide sequenator or by using the dansyl-Edman technique. Further, protein S6 was digested with chymotrypsin, thermolysin, staphylococcal protease, trypsin after modification of lysyl &-amino groups by exo-cis-3,6-endoxo-S74-tetrahydrophthalic acid anhydride and with 2-(2-nitrophenyl-sulfenyl)-3-methyl-3'-bromoindolenine skatole, a reagent which specifically cleaves tryptophanyl bonds. Amino acid analyses and partial sequencing of these fragments established the alignment of the tryptic peptides.The longest form of S6 (S6-6) consists of 135 amino acids and has an isoelectric point of pH 4.8. The shorter forms S6-5, S6-4, S6-3 and S6-2 show no difference in their amino acid composition and sequence with the exception that they have one, two, three and four glutamic acid residues less, respectively, at their C-termini. A comparison of the amino acid sequence of S6 with that of the most acidic protein L12 from the 5 0 4 subunit and other ribosomal proteins of known primary structure is made. Further a prediction for regions with a-helices and with fl-sheets in protein S6 is performed.The amino acid sequence of a mutationally altered S6 protein was shown to be identical with the primary structure of S6-2, the shortest form of wild-type protein S6.The protein S6 is the most acidic protein of the 30-S ribosomal subunit [I]. The protein protects part of the 16-S RNA from nuclease attack by interacting with the proteins S18, S8 and S15 and this interaction occurs approximately in the middle of the 16-S RNA sequence [2]. Evidence that S6 protein may be involved in the initiation step of protein synthesis in vitvo [3] could not be confirmed [4]. This paper describes the characterization of five different forms of S6 and the experimental data which Further, a new and simple method to isolate and purify the protein directly from the 70-S subunit without using zonal centrifugation was developed.Chemical cleavage of the protein by 2-(2-nitrophenyl-sulfenyl)-3-methyl-3'-bromoindoleine skatole [6] at its single tryptophanyl bond led to two big fragments suitable for Edman degradation [7] in an improved liquid-phase Beckman sequenator [8,9]. Peptides obtained by cleavage with various enzymes were sequenced either by solid-phase Edman degradation [lo-121 or by the dansyl-Edman technique [13,14]. The alignment of the isolated and sequenced led to the primary structure of pr...

The common garden ant, Lasius niger, marks its paths with isocoumarin (R)‐1. The structures of other isocoumarins from related ant species were elucidated by synthesis and mass spectrometric studies. The substances were tested for biological activity by means of trail‐following tests and electroantennograms.

The purpose of this study was to evaluate prospectively the findings during arthroscopy in patients with chronic instability of the ankle joint. One hundred and ten consecutive patients who had suffered at least two ankle sprains and were symptomatic for at least 6 months were included in this study. A complete rupture of the anterior talofibular ligament was found in 64%, of the calcaneofibular ligament in 41% and of the deltoid ligament in 6%. Cartilage lesions of the talus were seen in 54% of the joints, more of them medial (56%) than lateral (15%) or ventral (20%). Other frequently observed findings were synovialitis (38%), rupture of the syndesmosis (7%), and ventral scarring (6%). While cartilage damage was found independently of the lateral ligament injuries, all complete tears of the deltoid ligament were associated with cartilage injury of the talus. Medial instability was assessed in five ankles clinically and found arthroscopically in 23 ankle joints. Our arthroscopic findings show that chronic instability of the ankle joint is associated with various pathological conditions of ligaments, capsule and cartilage. It can therefore give essential information about the status of the chronic unstable joint with regard to the choice of operative or conservative treatment.

In 42 elderly patients, 33 women and nine men with a mean age of 72 years, we treated displaced fractures of the proximal humerus (34 three-part, 8 four-part) using a blade plate and a standard deltopectoral approach. Functional treatment was started immediately after surgery. We reviewed 41 patients at one year and 38 at final follow-up at 3.4 years (2.4 to 4.5).At the final review, all the fractures had healed. The clinical results were graded as excellent in 13 patients, good in 17, fair in seven, and poor in one. The median Constant score was 73 ± 18. Avascular necrosis of the humeral head occurred in two patients (5%).We conclude that rigid fixation of displaced fractures of the proximal humerus with a blade plate in the elderly patient provides sufficient primary stability to allow early functional treatment. The incidence of avascular necrosis and nonunion was low. Several studies have shown an increase in the incidence of fractures of the proximal humerus, especially in older age groups. In the last 25 years open reduction and internal fixation (ORIF) of displaced fractures has become widely advocated. The deformity cannot, in many cases, be corrected and the reduction maintained by closed reduction and immobilisation. The blood supply of the head of the humerus is at risk however, not only from the injury, but also from dissection of the soft tissues at open reduction and fixation. 9 The incidence of malunion, nonunion, and avascular necrosis (AVN) after ORIF has been reported to be between 12% and 34% for three-part fractures [10][11][12] and between 41% and 59% for four-part fractures. 5,13,14 In elderly patients, osteoporotic bone, often in combination with a thin or ruptured rotator cuff, can lead to unpredictable clinical results. Extensive exposure and the insertion of implants increase the risk of the development of AVN 9,15 and limited exposure and dissection of the soft tissues at the fracture site with minimal internal fixation have been recommended. 9,12 Stable reduction is essential for healing of the fracture and allows early movement of the shoulder. In 1995, we started to use a rigid angular blade plate for fixation of displaced fractures of the proximal humerus. Our technique of reduction involves minimal exposure of the fracture. We describe our results in elderly patients after a minimum follow-up of 2.4 years. Patients and MethodsBetween 1995 and 1996, all patients with fractures of the proximal humerus treated at the Orthopaedic University Clinic in Basel were included in the study if they fulfilled the following criteria: over 50 years of age, a displaced three-or four-part fracture of the proximal humerus not caused by high-energy trauma and not pathological, at least 30% contact between the head and shaft of the humerus, no other fractures or deformities in the upper limbs, and no