Clinical relevance of altered bone immunopathology pathways around the elbow.

Normal healing of fractures is a complex process that relies heavily on a cascade of consecutive activations of immune cells and mediators. This mechanism somewhat overlaps with all processes related to bone metabolism, from the absence of unions to heterotopic ossifications and osteoporosis. We aimed to review and describe this intricate process of bone metabolism with particular focus on abnormal function and to exemplify it with a series of clinical cases which could justify their practical importance. The elbow has great potential for fracture healing but it is very sensitive to prolonged immobilization which can easily lead to intra-articular adherences and stiffness. In addition, the interosseus membrane facilitates communication between the regenerative environments when both radius and ulna are fractured. Such extensive injuries, around the proximal forearm, can lead to heterotopic ossifications and synostosis, which decrease sagittal range of motion through impingement and even block rotational movement through bone bridges. Increased knowledge and awareness of the biological mechanism of fracture healing, will have great improvement in the pharmacological adjuvant treatment of elbow injuries.

Neurobehavioral studies, in transgenic F3/CONTACTIN (C57BL/6J × CBA) mice, on cognitive and anxiety aspects during late-adolescential period.

OBJECTIVE: Besides than in the control of developmental events, axonal adhesive glycoproteins may be also involved in functions requiring fine organization and connectivity of the nervous tissue. We previously demonstrated morphological alterations and functional cerebellar deficits in transgenic mice (TAG/F3 mice) ectopically expressing the F3/Contactin axonal glycoprotein under the control of a selected regulatory region from the Transient Axonal Glycoprotein (TAG-1) gene. In the present study, the hippocampal function was explored by evaluating the ability of TAG/F3 mice to encode spatial and non-spatial relationships between discrete stimuli and to analyze an anxiety-related behavior. MATERIALS AND METHODS: To the first end, mice were placed in an "open-Field" containing five objects and, after three sessions of habituation (S2-S4), their reactivity to objects displacement (S5-S4) and object substitution (S7-S6) was examined.To the second end, mice were placed in the "elevated zero maze", a standard test to explore the anxiety-related behavior, in order to study, in transgenic mice, the effects of F3 misexpression on emotional reactivity by measuring the avoidance of the unsheltered open sectors. RESULTS: Statistical evaluations of reactivity to object novelty, TAG-F3 mice showed a lower DO exploration with respect to wild-type mice and, regarding DOs, TAG/F3 mice interacted less than wild-type mice, showing an impaired spatial change response. Furthermore, the number of HDIPS in transgenic TAG/F3 mice resulted significantly lower with respect to the controls (wild type). CONCLUSIONS: These results indicate that the coordinated expression of axonal adhesive glycoproteins may be relevant for the functional maturation of the hippocampus.

Musculo-skeletal tumors incidence and surgical treatment - A single center 5-year retrospective.

OBJECTIVE: Muscle-skeletal tumors represent a challenging pathology for orthopedic surgeons worldwide. The extremely invasive character, the local destruction, the high recurrence rate, the high incidence in young patients and the unfavorable prognosis are all very well known. For these patients it is very important to produce an accelerated functional, social and psychological postoperative rehabilitation. We studied 121 cases of muscle-skeletal tumors which were treated in our hospital over a 5 years period. PATIENTS AND METHODS: We noticed a high prevalence in males and mainly between the 2nd-3rd and 5th-7th decades of their life. At our observation, most patients were suffering in advanced stages of malignant lesions. RESULTS: We try to manage amputations below 5%, with a significant reduction in introducing reconstructive surgical methods as a choice of treatment (10 prostheses and 12 cases of filling with acrylic cement or bone substituent increased with internal fixation). In this way we could observe an unusual ratio between benign and malignant tumors, probably caused by the patient's lack of concern for minimal symptoms. The rural citizen's addressability towards the medical system is alarmingly low, due to the big gap existing from diagnosis to treatment. CONCLUSIONS: There is still an hard effort to develop better reconstructive techniques for the treatment of muscle-skeletal tumors and more studies must be made in order to achieve this goal.

Application of acrylic spacers for long bone defects after tumoral resections.

INTRODUCTIONS: Tumoral resections pose serious challenges because sufficient removal has to be balanced against function preservation. A particular type of resection is encountered when the tumor is located in the diaphysis. It can lead to an important gap which cannot always amend to bone grafting in the same procedure. PATIENTS AND METHODS: The aim of the paper is to evaluate the long term outcome of segmental bone loss in patients with malignant tumors removed from diaphyseal regions and treated by intramedullary nailing and polymethylmethacrylate spacer. The limb function was then evaluated using a range of motion by the Musculoskeletal Tumor Score (MSTS) and the perceived quality of life measured by the EORTC QLQ-C30. RESULTS: There were no immediate postoperative local or systemic complications and no failures of the nail/cement construct. All cases were allowed immediate weight bearing (lower limb) and none were immobilized (upper limb). The average length of the bone defect was 9 (6-14) centimeters. The average follow-up was 2.5 (1-4) years. CONCLUSIONS: Polymethylmethacrylate cement spacers, over intramedullary nailing, have statistically proved a feasible and inexpensive procedure with limited complications, low surgical stress and favorable functional outcomes. It can be a definitive therapy for advanced cases, as well as temporary solution which can be successfully converted to secondary bone grafting.

Bite force in subjects with complete dentition.

Bite force is the condition, expression and measure of the masticatory function. The purpose of this study was to examine, by means of a newly constructed electronic gnathodynamometer, the values of maximal bite forces in subjects with complete dentition, the time in which they express 50% and 75% respectively of the total forces value, and the shape of the bite curve during testing. The obtained data was statistically analyzed with respect to gender and age. Analysis of the variance confirmed the finding that there was no statistically significant correlation between the values of forces and subjects' age, but there was a statistically significant difference between males and females in the values of the bite forces in the front segment, as well as between the values of the force on anterior and posterior teeth. The correlation between the time T1 posterior right and T1 posterior left, and between T1 and T2 for anterior teeth are statistically significant. Analysis of the bite curves suggests that males "bite" shorter than females with a sharper peak of the curve. Numerical values and bite curves should be a diagnostic factor in the further follow-up of subjects or in the choice of prosthodontic therapy.