Poly-L-lactide acid-modified scaffolds for osteoinduction and osteoconduction.

Poly-L-lactide acid (PLLA) scaffold has been modified to enhance its osteoconductive and osteoinductive properties in view of a bone tissue engineering application. Two approaches have been followed: (i) coating with laminin or fibronectin and (ii) grafting with arginine-glycine-aspatic acid (RGD) or SIKVAV peptides. Moreover we have added a bioactive molecule 1,25-(OH)2 D3 into the scaffold that shows better cellular interaction to implement osteoinduction and osteogenesis. The two coatings promoted only cell adhesion in the very short term while even if grafted scaffolds had cell seeding efficiency similar to ungrafted PLLA, the grafted ones supported better the proliferation of seeded human osteoblast (hOB) and human mesenchymal stem cells (hMSCs) over 1 week of culture. Our data showed that in view of bone integration and bone regeneration, PLLA grafting with RGD can be considered a good substrate to induce hOB adhesion and proliferation but having no significant effect on the osteogenic induction, the scaffold has to be reinforced with osteoinductive molecules. It can be concluded from reverse transcriptase polymerase chain reaction results, alkaline phosphatase activity and mineralization assays that 1,25(OH)2 D3 reinforced RGD-PLLA keeps increased cell proliferation supported by an upregulation of the studied osteogenic markers and induced hMSCs differentiation into osteoblasts demonstrating osteoinductivity and osteoconductivity of the new formulated scaffold. These results can lead to a future application of RGD-D3-PLLA as an osteogenic material for bone replacement..

Fractures of the radial head associated with dislocation of the elbow.

Fractures of the radial head associated with dislocation of the elbow constitute a pathology for which it is difficult to choose treatment, and that has a high failure rate. A retrospective study of the literature and of a series of cases was conducted: 31 patients came to our observation between 1990 amd 2001 and were analyzed by clinical (Broberg and Morrey Score and SECEC Score) and radiographic testing. Based on the Broberg and Morrey Score the results were excellent in 4 patients (13%), good in 8 (26%), fair in 12 (39%), and poor in 7 (22%) with a success rate of 39% and a failure rate of 61% principally due to secondary stiffness and instability. In an attempt to reduce the number of failures, a treatment protocol aimed at restoring a stable, mobile and painless elbow was devised.

Hard metal lung disorders: analysis of a group of exposed workers.

The experience gained during the last 5 years in the study of 36 male workers exposed to hard metal dusts (10 engaged in mixing, 12 in presintering, three in sintering and 11 in grinding) is presented. The mean age was 33.2 years (S.D., 11.8) and the mean number of years of exposure was 9.4 (S.D., 7.6). All subjects received a physical examination, chest X-rays, pulmonary function test (VC, FEV1, expiratory flows, RV, DLCO, and metacholine bronchial provocation test), skin tests, bronchoalveolar lavage (BAL) and determination of trace metals in BAL, blood, urine, pubic hair and toe nails. Two cases of bronchial asthma, six cases of interstitial lung disease and one case with both disorders were identified; eight of these cases presented at BAL signs of alveolitis with different cytologic features. Among the other 27 asymptomatic subjects, two showed an aspecific bronchial hyperreactivity, four showed a reduced DLCO, 12 showed an inverted ratio of CD4/CD8 lymphocytes in BAL without signs of alveolitis while one subject presented both an aspecific bronchial reactivity and a reduced DLCO. The presence of aspecific bronchial hyperreactivity in asymptomatic subjects might represent a preclinical indicator of a possible evolution towards bronchial asthma. An altered DLCO, alone or associated with an inverted CD4/CD8 ratio of BAL lymphocytes, might constitute an early sign of a possible evolution towards interstitial lung disease. The association of aspecific bronchial reactivity and reduced DLCO might indicate the possible evolution towards a mixed form.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pleural fibrosis in asbestosis and ventilatory function: a study of 50 cases]. / Fibrosi pleuriche asbestosiche e funzione ventilatoria: studio di 50 casi.

The importance of non-malignant pleural fibrosis in asbestosis in relation to respiratory function is still open to debate because of the differing results obtained in studies of different population groups. In the present study we selected 50 subjects with occupational exposure to asbestos presenting mono- or bilateral pleural fibrosis at X-ray but without lung impairment. Each subject underwent bronchial lavage and ventilatory function tests. The subjects were divided into 4 groups on the basis of the degree of pleural alterations according to the ILO Classification of Pneumoconioses. The results revealed that the mean values of CV and FEV1 in each group were within physiological limits. Moreover, analysis of the type of lung function showed a normal situation in 64% and restricted function in 28% of the cases. The prevalence of the latter finding was not correlated to the severity of pleural fibrosis in the various groups. Also, comparison between severity of pleural fibrosis and number of asbestos bodies/ml of BAL liquid on the one hand and frequency of alveolitis on the other did not reveal any relationship. Therefore, the onset of pleural fibrosis appears to be independent of the quantity of inhaled asbestos fibres and due to different mechanisms from those leading to lung fibrosis. In practice, a correct interpretation of the presence of pleural fibrosis from a clinical and prognostic viewpoint also requires other investigations such as BAL and a complete respiratory function study.

Chronic bronchitis in the iron and steel industry: prevalence study.

The paper reports the results of a prevalence study on functional impairment and chronic bronchitis in 733 foundry workers and in a control group of 1041 workers not exposed to the specific risks of the iron and steel industry. This study is the first part of a longitudinal study lasting 5 years within the framework of the Fourth Research Programme of the European Coal and Steel Community. Data on microclimate and particulate pollution for the various departments showed uniformly cold and damp conditions. Concentrations of pollutants were generally below the current T.L.V.'s. The subjects were subdivided into groups according to age, smoking and length of exposure. All the subjects were administered the "E.C.S.C. Questionnaire for the study of chronic bronchitis and pulmonary emphysema" and underwent a chest X-ray and spirometry to measure FVC, FEV1 and Vmax 50. The prevalence of functional impairment and chronic bronchitis was higher in the foundry workers than in the group of non-exposed workers. A statistical standardization was made of the effect of age and smoking thus accentuating the effect of exposure. The results are compared with the data obtained by other epidemiologic studies on working populations exposed to a similar risk.