ABSTRACT
The purpose of this study was to assess the effect of basic-fibroblast growth factor (bFGF) on the xenograft for radial bone defect in adult rats. Twenty adult Wistar rats weighing between 200 and 250g were divided into two groups; bFGF group (10 rats, 20 radiuses) and non-bFGF group (10 rats, 20 radiuses). A segmental bone defect measuring 5mm in length was made at both radiuses 10mm proximal to the wrist joint. The defect was filled with xenograft (Lubboc) measuring 3x3x5 mm in size. The xenograft was treated with 400 ng/ml bFGF (recombinant human basic-fibroblast growth factor ) mixed with liquid collagen (Vitrogen 100) in the bFGF group, but with collagen alone in the non- bFGF group. At 6 and 12 weeks after the treatment, the radiuses were harvested and examined histologically and the area of the remained xenograft not replaced by host bone was measured by image analysis system (VIDAS) on mid-sagittal section. The new bone formation and maturation from the differentiation of osteoblast was more remarkable in the bFGF group than in the non-bFGF group. At the time of 6 and 12 weeks after the treatment, the mean of the remained xenograft area was significantly smaller in the bFGF (9.16+/-0.49mm2, 6.20+/-0.30mm2) than in the non-bFGF group (12.16+/-0.59mm2, 10.07+/-0.48mm2) (P<0.001). In comparison with the areas of new bone replacemet area between 6 week and 12 week groups, sigificant and remarkable new bone replacement area could be achieved in the bFGF group than in the non-bFGF group (P<0.05). From these results, it is suggested that bFGF might increase the replacement of xenograft by new host bone and accelerate the healing process for the segmental bone defect of the radius in adult rats.
Subject(s)
Adult , Animals , Humans , Rats , Collagen , Fibroblast Growth Factor 2 , Heterografts , Osteoblasts , Osteogenesis , Radius , Rats, Wistar , Wrist JointABSTRACT
Acetabular bone deficiencies encountered during the revision hip arthroplasties should be recon- structed to provide the implant stability and to restore the normal center of rotation of hip and the leg length. We revised the loosened acetabular cup by grafting fresh-frozen bulk femoral head and inserting uncemented cup in 17 hips of 15 patients. The average follow-up period was 2 years and 3 months. The acetabular bone deficiencies were type 2A in 6 hips, type 2B in 8, type 3A in 1 and type 3B in 2 by Paprosky's classification. Three blocks of femoral head were grafted in 3 type 3 deficiencies, but only one in type 2 deficiencies. The cup-host bone contact was 41% on the average. However, the cup-host bone contact in the zone I was present only in 12 out of 17 hips and its average was 14%. Incorporation of the allograft into the host bone occurred between 5 months and 1 year and 7 months (average, 8,6 months) after revision surgery. Significant radiographic loosening sign was noted only in 2 hips which had not only type 3B bone deficiencies reconstructed with 3 blocks of femoral head allograft but also no cup-host bone contact in zone I . The bulk allograft of fresh-frozen femoral head demonstrated acceptable results in type 2 acetabular bone deficiencies, although the follow-up period was relatively short. Reconstruction of type 3B acetabular bone deficiencies by using multiple blocks of femoral head allograft had been failed. We presumed that the lack of the graft stability and the intimate contact between the grafts and host bone was the cause of failure.
Subject(s)
Humans , Acetabulum , Allografts , Arthroplasty , Classification , Follow-Up Studies , Head , Hip , Leg , TransplantsABSTRACT
In the orthopaedic field, some elective surgery such such as joint replacement, spinal surgery and limb sparing procedures for musculoskeletal tumors frequently need various amounts of blood trans- fusion. But homologous transfusion occasionally result in various side effect including allergic reaction, febrile reaction, coagulopathies due to reduced platelets and coagulating factors, graft versus host disease(GVHD) and transmission of infectious diseases such as malaria, syphilis, hepatitis and AIDS. Recently these complications especially in elective surgery might result in medicolegal and social problem. Risks of transfusion could be minimized with autologous blood. So many authors are interested in prebanked autologous transfusion in elective orthopaedic surgery to prevent these problems. But there might be need of additional homologous blood transfusion because of the time limited and low yield of autologous blood. Recombinant human erythropoietin(4-HuEPO) has been shown to increase erythropoiesis. The authors could yield 5 units during 14 days using r-HuEPO without any adverse reactions. Therefore we could performed decompression, posterolateral fusion with pedicular screw fixation in spondylolisthesis without additional homologous transfusion.
Subject(s)
Humans , Blood Transfusion , Communicable Diseases , Decompression , Erythropoiesis , Erythropoietin , Extremities , Hepatitis , Hypersensitivity , Joints , Malaria , Social Problems , Spondylolisthesis , Syphilis , TransplantsABSTRACT
Hypercalcemia is a relatively common complication of cancer that is clinically important because, left unattended, it is associated with symptomatic deterioration and even death. So hypercalcemia can afflict the quality of life and complicate management of the cancer patients with anorexia, lethargic, stuporous mentality, and severely dehydrated. Nonetheless, most cancers are at an advanced stage by the time hyperclacemia develops, many clinicians share doubts about the role of antihypercalcemic therapy in this situation. Furthermore, because the symptoms of hypercalcemia may mimic that of progressive malignant disease or the toxic effects of chemotherapy and radiation therapy, this may not always be recognized. So concerns are needed for active management of patients with malignant hypercalcemia. The authors reviewed the morbidity and mortality in 20 patients with malignant hypercalcemia out of 219 patients with bone metastasis, who were treated at the department of orthopaedic surgery, Catholic University Medical College from January 1989 through December 1992. The results were as follows. 1. The overall incidence of malignant hypercalcemia was 8.6% of bone metastases (20 out of 219 cases).: lung cancer 11.2% (10 out of 89 cases), breast cancer 22.5% (7 out of 31 cases), stomach cancer 6.3% (3 out of 47 cases). 2. The underlying diseases associated with hyprecalcemia were 10 cases of lung cancer(50%), 7 cases of breast cancer(35%) and 3 cases of stomach cancer(15%). Out of lung cancers, 8 cases were squamous cell cancers, the other 2 cases were oat cell cancers. 3. Only 7 out of 20 patients were treated with hydration, diuretics, steroid, calcitonin and mithramycin. And the mean survival duration after recognition of hypercalcemia was 11.3 weeks independent of treatment. In conclusion, the authors emphasize that inspite of grave prognosis, when treated actively, calcium lowering therapy may allow patients to be discharged during terminal period of their illness.
Subject(s)
Humans , Anorexia , Avena , Breast , Breast Neoplasms , Calcitonin , Calcium , Diuretics , Drug Therapy , Hypercalcemia , Incidence , Lung , Lung Neoplasms , Mortality , Neoplasm Metastasis , Neoplasms, Squamous Cell , Plicamycin , Prognosis , Quality of Life , Stomach , Stomach Neoplasms , StuporABSTRACT
Fracture of the tibial shaft is one of the most common fracture of the long bones and, due to its frequency and easy accessibility to traumatic insults, it is frequently complicated with malunion, delayed union and nonunion, and osteomyelitis. Recently, closed flexible intramedullary nailing of the fracture of the long bones has gained popularity. And its application to the tibial shaft fracture is reported to meet the object of fracture treatment by providing maintenance of reduction and by allowing early mobilization of the injured leg. There are other advantages such as stimulation of forming external callus by allowing some motion at fracture site, adequate fixation without exposure of the fracture site. Authors carried out retrospective study of the 56 tibial shaft fractures in 54 patients which were fixed with Rush nails (31 tibial fracture in 30 patients) or Ender nails (25 tibial fractures in 24patients). The results were analyzed to compare the effectiveness of these two methods. The results were as follows: 1. Tibial fracture treated with rush nailing united clinically at 15.7 weeks and united radiologically at 21.8 week on an average postoperatively. 2. There was a tendency of earlier healing of fracture of tibial shaft treated with Ender nailing:clinical union and radiological union were obtained at 12.8 weeks and 18.8 weeks on an average, respectively. 3. Ender nailing has advantage such fracture fragment during insertion. 4. Additional insertion of Ender nail as ease of nailing, low incidence of displacement of undisplaced provided greater stability at the fracture and it was attributable to earlier healing of tibial fracture treated with Ender nailing. 5. Rush and Ender nailings failed to maintain reduction of the fracture of proximal tibia shaft. As the advantages of Ender nailing surpass those of Rush nailing, authors have preference of Ender nailing in the treatment of the tibial shaft fracture.
Subject(s)
Humans , Bony Callus , Early Ambulation , Fracture Fixation, Intramedullary , Incidence , Leg , Osteomyelitis , Retrospective Studies , Tibia , Tibial FracturesABSTRACT
Aneurysmal bone cyst is a rare, non-neoplastic condition, which was first coined by Jaffe and Lichtenstein in 1942. Clavicle is an unusual site for aneurysmal bone cyst. Authors present a case of aneurysmal bone cyst which was found in the right clavicle of a 5 years old boy, because of its rarity of site of predilection.