We employ an arthroscopic surgical technique for anterior cruciate ligament (ACL) reconstruction of the knee. This technique makes possible an early return to sports after operation for ACL injured athletes. We report arthroscopic and MRI findings before and after arthroscopic ACL reconstruction.

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Striated muscles in the perineum, which include the ischiocavernosus (IC), bulbocavernosus (BC), and levator ani (LA), were identified in an attempt to understand motor regulation of penile erection in the male rabbit. The IC surrounded the corpus spongiosum of the penis whereas the BC attached to the dorsum of the penis at the midline. The LA encircled the rectum and attached to the base of the penis. This anatomy suggested that the IC plays the primary role in the erection in the rabbit, whereas the BC may cause flips of the erected penis. Spinal motoneurons that innervate the IC were identified by retrograde labeling by horseradish peroxidase (HRP). As in other mammals, spinal labels from the IC appeared ipsilaterally in the ventral horn that encompassed the sixth lumbar (L6) and the first sacral segments. HRP injections into the BC labeled a small number of cells bilaterally at the same spinal levels. Rabbits are peculiar in having the IC motoneurons scattered among other motoneurons, unlike the rat and other rodents that have their IC motoneurons aggregated to form a spinal nucleus. Castration caused significant decreases in both the wet weight of IC muscles and the size of IC motoneurons within 2 weeks. Testosterone supplement following castration maintained the IC muscle weight and the neuronal size. Neither castration nor testosterone supplement induced changes in the number of IC motoneurons.

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We investigated knee functions and a return to sports in 50 competitive athlete patients treated with arthroscopic anterior cruciate ligament reconstruction using double-looped STG augmented by woven polyester at a 1-year follow-up. There were 25 males and 25 females with a mean age of 24.3 years (range: 19-39 years). The majority of preinjury sports were basketball, volleyball and soccer. Athletic rehabilitation including agility training and sports-specific training was started at 12 weeks. Fourty patients (80%) was rated as normal or nearly normal on the assessment of International Knee Documentation Commitee postoperatively. Fourty-eight patients (96%) obtained full range of motion, and the mean quadriceps muscle strength of the injured side was 91.3%of that of the uninjured side. As for a return to sports, 46 patients (92%) were able to do fully competitive sports at a mean of 8.1 postoperative months. These results suggest that arthroscopic reconstruction using augmented double-looped STG allows early athletic rehabilitation, and lead satisfactory outcome as well as a reliable and early return to preinjury level of sport activity for the majority of the competitive athlete patients.

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In the present study we examined the localization and overexpression of heat shock proteins (hsps), mainly hsp90, in pancreatic carcinoma tissue compared with control tissue (including chronic pancreatitis and normal pancreas tissue), with the aid of immunohistochemical staining, in situ hybridization and reverse transcriptase polymerase chain reaction. Hsp90 α mRNA was overexpressed more highly in pancreatic carcinoma than in the control tissue. The proliferating-cell-nuclear-antigen labeling index was also high in pancreatic carcinoma tissue compared with the other tissue. These findings suggest that the overexpression of hsp90 α mRNA in carcinomas may be correlated with cell proliferation. However, hsp90 β was constitutively overexpressed almost equally in all groups of pancreatic tissue including pancreatic carcinoma, chronic pancreatitis and normal pancreas tissue. Immunohistochemical staining demonstrated a differentiation in the expression of hsp90 between histological types of pancreatic carcinoma. These findings suggest that hsp90 α is involved in carcinogenesis and that hsp90 β is correlated to structural conformation. Hsp90 α and hsp90 β seem to perform different functions in tissue containing malignant cells. P53, MDM2 and WAF1, that were cell-cycle-related oncogene product were more strongly expressed in the nuclei of the cancer cells of the cancer tissue. Especially, MDM2 was more strongly expressed in mucinous carcinoma and the mucin secreting tissues surrounding pancreatic carcinoma tissue. The expression of MDM2 protein might also be correlated to secretion systems during structural conformation and be correlated to hsp90 β.

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The factors in volved in occupational low back pain occurring in professional drivers were investigated epidemiologically with questionnaires (92 items) including low back symptoms, personal factors and occupational factors. The responses of one hundred fifty-three of one hundred eighty-one truck drivers who work in a large chemical industry corporation were analyzed after they had completely filled in questionnaires. As analysis of the results shows, the prevalence of LBP in one month of the survey was 50.3%. Correlating among data of personal factors and LBP, the prevalence of LBP was significantly higher in the drivers (Odd' s ratio of 2.7) who answered "yes" to the item"shortage of spending time with family"than in the drivers who didnt answer "yes" . The occupational factors, working load and working environment showed no correlation with the prevalence of LBP. In contrast, 3 items of the working format related significantly to the prevalence of LBP: "irregular duty time" (Odd' s ratio of 3.0), "short resting time" (2.4), and "long driving time in a day" (2.0). Eighty-one of the 153 drivers (52.9%) pointed out the relationship between LBP and work, especially work which muolves vibration or road shock. Our results and the results from previous published studies suggested that vibration is an obvious risk factor for LBP. From the viewpoint of prophylaxis, an improvement in working conditions reduces the incidence of drivers' LBP to some extent.

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SAPHO syndrome stands for synovitis, acne, pustulosis, hyperostosis and osteitis. The common site of skeletal lesions in this syndrome is the sternocostoclavicular area. Spondylodiscitis is rarely described in published studies. In general, skin lesions develop before the onset of skeletal lesions. We report a case of SAPHO syndrome in which spondylodiscitis developed more than 1 year before the onset of pustulosis.

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Congenital pseudarthrosis of the tibia presents surgeons with one of the most challenging of all orthopedic problems. Various surgical treatments have succeeded only rarely. We report long-term follow-up of a patient with congenital pseudarthrosis of the tibia treated with pulsed electromagnetic fields (PEMF) and bone grafting. In this severe case, Bassett type III and Boyd type II, encouraging results were achieved with Boyd's dual onlay grafts and PEMF. Seven years after surgery, skeletal maturity was complete and an unacceptable degree of leg shortening had been avoided.

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