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Abstract To our knowledge, this is the first case of synovial osteochondromatosis in a patient presenting with a double patella-like condition. The true duplication of the patella, which is called double patella, is extremely rare. In our case, the operative and histopathological findings showed that the double patella-like condition was secondarily induced by synovial osteochondromatosis. Synovial osteochondromatosis should be considered as a differential diagnosis for congenital double patella.

Takamata, Akira, Tomoyuki Ito, Kazuhiro Yaegashi, Hisatake Takamiya, Yasuyo Maegawa, Toshiyuki Itoh, John E. Greenleaf, and Taketoshi Morimoto. Effect of an exercise-heat acclimation program on body fluid regulatory responses to dehydration in older men. Am. J. Physiol. 277 (Regulatory Integrative Comp. Physiol. 46): R1041-R1050, 1999.--We examined if an exercise-heat acclimation program improves body fluid regulatory function in older subjects, as has been reported in younger subjects. Nine older (Old; 70 [+ or -] 3 yr) and six younger (Young; 25 [+ or -] 3 yr) male subjects participated in the study. Body fluid regulatory responses to an acute thermal dehydration challenge were examined before and after the 6-day acclimation session. Acute dehydration was produced by intermittent light exercise [4 bouts of 20-min exercise at 40% peak rate of oxygen consumption ([Vo.sub.2peak]) separated by 10 min rest] in the heat (36 [degrees] C; 40% relative humidity) followed by 30 min of recovery without fluid intake at 25 [degrees] C. During the 2-h rehydration period the subjects drank a carbohydrate-electrolyte solution ad libitum. In the preacclimation test, the Old lost ~0.8 kg during dehydration and recovered 31 [+ or -] 4% of that loss during rehydration, whereas the Young lost ~1.2 kg and recovered 56 [+ or -] 8% (P [is less than] 0.05, Young vs. Old). During the 6-day heat acclimation period all subjects performed the same exercise-heat exposure as in the dehydration period. Exercise-heat acclimation increased plasma volume by ~5% (P [is less than] 0.05) in Young subjects but not in Old. The body fluid loss during dehydration in the postacclimation test was similar to that in the preacclimation in Young and Old. The fractional recovery of lost fluid volume during rehydration increased in Young (by 80 [+ or -] 9%; P [is less than] 0.05) but not in Old (by only 34 [+ or -] 5%; NS). The improved recovery from dehydration in Young was mainly due to increased fluid intake with a small increase in the fluid retention fraction. The greater involuntary dehydration (greater fluid deficit) in Old was accompanied by reduced plasma vasopressin and aldosterone concentrations, renin activity, and subjective thirst rating (P [is less than] 0.05, Young vs. Old). Thus older people have reduced ability to facilitate body fluid regulatory function by exercise-heat acclimation, which might be involved in attenuation of the acclimation-induced increase in body fluid volume. aging; thirst; fluid balance; renal function; vasopressin; aldosterone; plasma renin activity