For successful pregnancy, progesterone production by the corpus luteum and decidualization of the endometrium are necessary. In contrast, regression of the corpus luteum and endometrial shedding should be induced promptly for the next conception when pregnancy does not occur. Superoxide radical and its scavenger, superoxide dismutase (SOD), play important roles in the regulation of cellular function. The present review focuses on the roles of superoxide radicals and SOD in the regulation of corpus luteum function and endometrial function.

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It is often difficult for clinicians to diagnose osteoporotic fresh compression vertebral fracture on X-ray of patients with spondylosis deformans and multiple old compression fractures. To prevent neurological compromise due to delayed vertebral collapse after fracture, the initial diagnosis and therapy are very important. Magnetic resonance imaging (MRI) is very sensitive for detecting these fractures. T1 weighted images with low signal intensity are more sensitive than T2 weighted images with high signal intensity.
We retrospectively studied the T1 weighted images of 48 fresh fractures in 45 patients. Fractures were classified into two types from biomechanical studies. In type A, the range of low intensity was in the anterior column on para-sagittal images, and these images showed little collapse and patients had good outcome. In type M, the range of low intensity reached to the middle column, and images often showed collapsed vertebrae. Type M patients should be carefully treated.
Initial MRI diagnosis of osteoporotic vertebral compression fracture is very useful for deciding therapeutic strategy.

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Matrix γ-carboxyglutamic acid (Gla) Protein (MGP), a mineral binding vitamin K-dependant protein exists in the matrix of cartilage and in the media of the aortic wall and is considered as a regulator of physiological or pathological calcification. Calcification or ossification of the spinal ligaments have received attention in a number of reports, as in some cases the spinal cord is compressed and myelopathy occurs. In the present study, to investigate the role of MGP in the calcification or the ossification of the spinal ligaments, we examined expression of MGP in the lumber spinal yellow ligaments of human. In immunohistochemical study we found the diffuse staining of MGP in the matrix of yellow ligaments and MGP was accumulated at the enthesis of the ligament and the circumference of the site of pathological calcification. There was a tendency in staining of MGP that they were better stained in young patients than old ones. Semiquantitative RT-PCR to amplify MGPm-RNA was performed to measure the quantity of MGP mRNA in the yellow ligaments, showing that the quantity of MGP mRNA was decreased in proportion to aging. These results suggest that expression of MGP in spinal ligament could be a potential clue for elucidating how heterotoropic calcification or ossification develops in ligament tissue.

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At many institutions, sagittal and coronal slice magnetic resonance imaging (MRI) is routinely used for knee examinations. Recently, MRI diagnosis for knee meniscal injuries has spread remarkably, and the diagnostic value of the procedure is almost established. We made panoramic images by reconstructing 3D data images along the form of the meniscus using curved cuts and multiplanar reconstruction (MPR). We assessed the usefulness of the panoramic images for evaluating meniscal injuries in 34 patients who had arthroscopic surgery after the MRI. MRI data were acquired in the axial plane using a double echo steady state (DESS). The presence of 30 meniscal tears, 5 anterior cruciate ligament tears, 2 posterior cruciate ligament tears, and 1 medial collateral ligament tear were confirmed by the arthroscopic surgery. Sensitivity, specificity and accuracy for medial meniscus was 100, 95 and 97% respectively, and for lateral meniscus was 93, 95 and 97% respectively. The meniscal tears were visible on the panoramic images, which showed the entire meniscus from the anterior to the posterior segment, so that the anatomical locations of the tear were indicated distinctly. Furthermore, the posterior segment was shown in detail on the panoramic images better than on the conventional plane images.

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There is no consensus on whether the patella should be resurfaced in total knee arthroplasty (TKA) at present. Therefore, the indications for patellar resurfacing in TKA were evaluated in this study.
Sixty-seven knees that were received TKA between 1996 and 1998 were studied. The patella were resurfaced in 26 knees, but were not resurfaced in 41 knees. The mean age of the patients was 71 years, and the follow-up period ranged between 24 months and 60 months, with a mean period of 41 months.
The Japanese Orthopaedic Association (JOA) scores, patella scores, and plain radiographs were evaluated. In the non-resurfacing group, the deformation of the patellofemoral joint was investigated, and the patella scores and femoral rotational alignment were evaluated by the degree of congruity between the patellofemoral joint.
Although there were no significant differences between two groups in JOA scores, in those cases with rheumatoid arthritis, the resurfacing group was significantly higher than the non-resurfacing group in patella scores. Anterior knee pain tended to appear more often in the non-resurfacing group. In the resurfacing group, we observed more progressive deformation of the patellofemoral joint and lower patella scores when the congruity between the patellofemoral joints were not good. This trend was more pronounced in those cases with rheumatoid arthritis. In the cases with low femoral rotational alignment scores, the joints were incongruity.
In those cases with osteoarthritis, resurfacing of patella is not necessary in the long term if the femoral rotation is adjusted adequately and the patellofemoral joint is congruent. However, in those cases with rheumatoid arthritis, patellar resurfacing is recommended because the deformation of the joint progresses, and the frequency of pain increases with time even when the patellofemoral joints are congruent.

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Bone is the most frequently transplanted tissue in humans. Bone grafting is a common procedure to fill bone defects, such as when a fracture dose not heal properly, or to replace bone lost to tumor surgery or trauma. The grafted bone is resorbed and replaced by new tissue moving from host bone, however, the incorporation through slow remodeling may initially weakens the graft., The purpose of this study was to investigate the effect of basic fibroblast growth factor (bFGF) on the incorporation of a bone graft. bFGF (0, 10, 100, 500, or 1,000ng) was mixed with a collagen gel and implanted into bone grafts taken from rabbit iliums. The bone grafts were put back in the iliums as they were and harvested at 1, 2, and 4 weeks after surgery. X-ray radiographs of the bone grafts were taken using SOFTEX. Histological examination and histomorphometric analysis were performed on bone samples. Treatment with bFGF had greatly stimulated osteogenesis in the bone grafts both radiologically and histologically in comparison with untreated grafts (those filled with plain collagen gel). Of a total of 4 dose-groups, the 100ng group exhibited the best result, but the osteogenesis was poorer in the higherdose groups. These effects were evident as long as 4 weeks postoperatively. These findings suggest that bFGF may be a practical and important candidate for use in bone grafting procedures.

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A 66-year-old man was admitted to our hospital in August 2003 after an episode of postprandial abdominal pain. He had undergone pylorus-preserving pancreatoduodenectomy for chronic pancreatitis and pancreatic head pseudocyst in February 1993. Upon admission, his serum amylase and pancreatic amylase levels were elevated at 1169 IU/L and 1111 IU/L, respectively. Abdominal echo and computed tomography studies revealed pancreatic stones and dilatation of the main pancreatic duct. These findings led to a diagnosis of acute exacerbation of chronic pancreatitis. Although the patient improved with conservative medical treatment, surgical intervention was required to prevent future recurrence. Opening of the main pancreatic duct revealed an incarcerated pancreatic stone in the pancreatojejunostomy. After removal of the stone, side-to-side pancreaticojejunostomy and Roux-en-Y reconstruction were performed. The patient was discharged on postoperative day 15 and had no recurrent pain during the 4-month follow-up period. We conclude that even in cases in which pancreatoduodenectomy has been performed, chronic pancreatitis can persist despite conservative medical therapy, and surgery is indicated.

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