The characteristics of spontaneous calcium (Ca(2+)) oscillation and mechanically induced Ca(2+) waves in articular chondrocytes were studied. In some, but not all, chondrocytes in sliced cartilage and primary cultures, we observed spontaneous oscillation of intracellular Ca(2+) that never spread to adjacent cells. In contrast, a mechanical stimulus to a single cell by touching with a glass rod induced an increase of intracellular Ca(2+) that spread to neighboring cells in a wave-like manner, even though there was no physical contact between the cells. This indicated the release of some paracrine factor from the mechanically stimulated cells. Application of ultrasonic vibration also induced an oscillation of intracellular Ca(2+). The application of a uridine 5'-triphosphate (UTP), UTP, induced a transient increase in intracellular Ca(2+) and the release of adenosine 5'-triphosphate (ATP) in cultured chondrocytes. A P2 receptor antagonist (suramin) and blockers of Cl(-) channels, niflumic acid and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), reduced the UTP-induced ATP release. The results indicated that Cl(-) channels were involved in the extracellular release of ATP following mechanical or P2Y receptor stimulation. Thus, ATP stimulation of P2Y receptors elicits an increase in intracellular Ca(2+), triggering further release of ATP from adjacent cells, thereby expanding the Ca(2+) wave in chondrocytes.

The effects of low-intensity pulsed ultrasound (US) on the proliferation and chondroitin sulfate synthesis of cultured chondrocytes embedded in Atelocollagen gel in vitro were examined. Articular cartilage was harvested from the hip, knee, and shoulder joints of 10-week-old Japanese white rabbits. Chondrocytes isolated by collagenase digestion were embedded in type I collagen gel, Atelocollagen gel, and were cultured in Dulbecco's modified eagle's medium for 3 weeks. The US apparatus, SAFHS, was used to deliver an ultrasound signal with spatial and temporal average intensities of 30 mW/cm(2) (US group). The frequency was 1.5 MHz with a 200-microsecond tone burst repeated at 1.0 kHz. US treatments were administered for 20 min per day under culture dishes, with the medium replaced twice a week. Another group of cells was exposed to sham ultrasound as a control. Cell number, histological findings, synthesis of isomers of chondroitin sulfate, and stiffness of the chondrocyte-collagen gel composites were analyzed. US exposure promoted synthesis of chondroitin sulfate, especially chondroitin 6-sulfate, although it did not significantly enhance cell number and stiffness. In this three-dimensional culture model, these results suggest that US exposure may be clinically useful in improving the quality of chondrocyte-Atelocollagen implants for transplantation into articular cartilage defects.

Apoptosis in the developing inner ear tissue of human (Carnegie stage 14 to 21, approximately 5 to 8 weeks of gestation) and mouse (10.5 to 14 days of gestation) embryos was systematically analyzed by a computer-assisted three-dimensional reconstruction of the serial histological sections and by the TUNEL method. Morphogenetic events such as folding between the utricular portion and endolymphatic duct, constriction of the junction of the saccule with the cochlea and folding of the vestibular portion to form the semicircular ducts were accompanied by a localized distribution of apoptosis. The apoptosis was also related to the innervation of the cochlear and vestibular epithelia from the sensory ganglion of the eighth cranial nerve and the differentiation of the otic epithelia into the sensory epithelia. These results suggest that apoptosis plays an important role in the development of the inner ear.

No abstract

Twenty-six hips (19 patients) with osteonecrosis of the femoral head with stage I or II of the disease, according to the Ficat and Arlet classification, underwent core decompression. Osteonecrosis was confirmed histologically in all 26 hips. Of 19 patients, 7 had prognostic factors traditionally associated with poor outcome including collagen vascular disease and continued use of steroids. The follow-up period averaged 7 years 10 months (range: 2 years 5 months-13 years 8 months) for 17 patients with 24 hips. Two patients died secondary to systemic illness. Seventeen hips (65.4%) had very good or good results using the Ficat criteria. Eight hips (30.8%) needed further operation [total hip arthroplasty (THA) for 7 hips, osteotomy for 1 hip]. Of the 12 hips in patients who had used steroids, 6 hips (50%) were converted to THA. Four hips in patients with systemic lupus erythematosus (SLE) needed THA (100%). We conclude that core decompression provides an effective treatment for steroid-associated osteonecrosis other than in cases with SLE, as well as providing effective treatment for non-steroid-associated osteonecrosis in the early stages of the disease.