Re-implantation of autoclaved bone segments in musculoskeletal tumor surgery. Clinical experience in 9 patients followed for 1.1-8.4 years and review of the literature.

Nine patients who had malignant bone tumors of the lower extremity were managed with wide en bloc resection and re-implantation of the extracorporeally autoclaved specimens. The segments were fixed by plate osteosynthesis, knee arthrodesis rod, or intramedullary nails. In one patient the complete femur was re-implanted. After a mean follow-up of 66 months (range 13-101 months), 8 out of 9 patients were still free of disease. One patient with Ewing's sarcoma and re-implantation of the complete femur died of systemic recurrence. No local recurrence was seen. One patient with Ewing's sarcoma of the tibia who had undergone postoperative irradiation developed a local infection 18 months postoperatively which finally had to be treated by knee disarticulation. After an average duration of 13 months, all graft-host junctions had healed. The functional result of the patient with the knee disarticulation was poor. In all other patients, the functional outcome was good or excellent. The evaluation of 115 patients (106 from the literature, 9 from our study) with a mean follow-up of 63 months showed 8 local recurrences. There were 4 secondary infections and only 1 primary infection. In tumors of the extremities and the pelvis, the functional outcome was excellent or good in about 80%. Limb salvage using re-implantation of autoclaved tumor-bearing bone segments for reconstruction has a low complication rate and good functional results in appropriately selected patients compared with other options of management.

[The effect of barbiturates and diphenylhydantoin on the mitotic activity of thymocytes and bone marrow cells in mice and rats]. / Uber die Wirkungen von Barbituraten und Diphenylhydantoin auf die mitotische Aktivität von Thymozyten und Knochenmarkszellen von Mäusen und Ratten.

Phenobarbitone (PB) and diphenylhydantoin (DPH) inhibited the mitotic rate of thymocytes and bone marrow cells (colchicine blocked metaphases) dose- and time-dependent (20-80 mg/kg i.p., 12-48 hours) in mice and rats in vivo. The inhibition of proliferation was evident also after repeated administration of the drugs and other barbiturates. Other substances with a depressive effect on the central nervous system (etomidate, ketamine, chlorpromazine and ethanol) did not influence the mitotic rate of the thymocytes. Inhibition of the mitotic rate by PB was also observed in adrenalectomised rats. In vitro PB and DPH inhibited the mitotic rate of thymocytes in therapeutic and toxicologically relevant concentrations (10(-5)-10(-3) mol/l). The investigations indicate a direct effect of PB and DPH on rats. Possible immunosuppressive effects are discussed.

[Seasonal variations of the mitotic activity of thymocytes in CBA mice]. / Jahreszeitlichen Schwankungen der mitotischen Aktivität von Thymozyten bei CBA-Mäusen.

Considerable seasonal variations were exhibited by mitotic activities of thymocytes in CBA mice. In April and May they were about twice as high as in October and November. Biorhythmic changes in mitotic activity of thymocytes should be taken into consideration for any study of drug effects on the thymus.