Replacement of the distal femur and proximal tibia with frozen allografts.

Eighty-eight osteoarticular distal femoral allografts and 68 proximal tibial allografts have been transplanted at the authors' institution from 1958 to 1970. These allografts were used in limb-sparing operations performed after the diagnosis of benign or malignant tumors. All allografts were preserved by freezing to -70 degrees or -30 degrees. Allograft fixation technique depended either on press fitting of the allograft host junction or on quadrangular titanium intramedullary rods. The most prevalent long-term complication was the time-dependent development of destructive arthrosis. After excluding patients with tumor failures (8.3%) and those with failures caused by infections, amputations, or allograft removal without subsequent replacement (5%), 135 patients remained. In this group of patients, after treatment of complications, good or excellent results were obtained in 31% of patients, and fair results in 45% of patients. In the latter group, significant limitation of knee motion existed. The remainder (24%) had either complete limitation of knee motion or had to rely on orthopaedic bracing.

[Systemic osteoporosis in women]. / O sistemnom osteoporoze u zhenshchin.

This paper is based on investigation of biopsies from the upper flaring portion of the ilium of 53 women, sick of systemic osteoporosis. The results of quantitative evaluation of the osseous tissue parameters by means of histomorphometric method allowed to reveal systemic osteoporosis of 4 types, note distinctions between osseous tissue loss mechanisms in case of systemic osteoporosis and age atrophy of bones. Comparison of osseous tissue quantitative parameters with the peculiarities of microanatomy of trabeculae allowed to verify the degree of disturbance of such remodelling mechanisms as resorption and osteogenesis for each of 4 types. The possibility of fractures of axial skeleton and limb bones at normal value of spongy bone in biopsies from the upper flaring portion of the ilium has been demonstrated.

The state of human bone tissue during space flight.

The results of studying the bone tissue of cosmonauts after the flights (4-8 month) have been compared to the data of investigating the healthy individuals during head-down tilt (HDT, 370 days). Noninvasive methods (computer tomography, gammaphoton absorptiometry) revealed a decrease in the vertebral spongy mineral density or a increase of this parameter by a similar magnitude versus the individual preflight values in some cosmonauts. During studies of clinical cases of osteoporosis it was shown that the vertebral mineral density ratios and presence or absence of vertebral compression fractures in different age groups are nonequal.

[Pathogenetic aspects of studying clonal properties of bone marrow stromal cells in diseases of the osteoarticular system]. / Patogeneticheskie aspekty izucheniia klonal'nykh svoistv stromal'nykh kletok kostnogo mozga pri zabolevaniiakh kostno-sustavnogo apparata.

Properties of clonogenic stromal fibroblasts of bone marrow which are precursors of osteo- and chondrogenesis, of patients with different diseases of osteoarticular apparatus have been studied. Peculiarities of their reaction on growth-stimulating influence of nonstromal auto- and xenogeneic cells have been demonstrated. The possibilities of data application for studying of pathogenesis of hereditary osteochondrodysplasias as well as other groups of the skeleton affections are considered.

[Differential diagnosis of secondary chondrosarcoma of the bones]. / Differentsial'naia diagnostika vtorichnoi khondrosarkomy kosti.

A procedure based on multifactorial evaluation of the most important clinical and X-ray signs was suggested to differentiate between secondary bone chondrosarcoma and such benign lesions as chondroma and osteochondrous exostosis. The analysis included 100 patients with secondary bone chondrosarcoma and 36 of those with benign lesions. The study used complex parameters derived from two, three or four simple ones. The method described assured a 95% credibility of differential diagnosis.

[Effect of 1-alpha oxyvitamin D3 on bone tissue in systemic osteoporosis]. / Vliianie 1-al'fa oksivitamina D3 na kostnuiu tkan' pri sistemnom osteoporoze.

Prolonged administration of oxydevit (I alpha OH D3), a synthetic analogue of the active metabolite of vitamin D (I alpha 25, (OH)2D3) in patients with systemic osteoporosis inhibited the progress of the process. Abatement of the pain syndrome and increase in physical activity were accompanied by stabilization of the roentgenologic picture and of such parameters of the bone tissue as volume density of the spongy bone and thickness of the trabeculae. The mechanism of action of the drug is not quite clear, but importance is attached to the influence of the drug on the absorption of calcium from the intestines and to persistent normalization of the level of calcium in the blood. Taking into consideration the course of such disease as systemic osteoporosis, the inhibitory impact should be regarded as achievement of therapeutic effect.

[Osteoid osteoma of the hands and feet]. / Osteoid-osteoma kostei kistei i stop.

Having studied 38 patients with osteoid osteoma of the bones of hands and feet the authors have revealed a number of peculiarities in clinical and roentgenological picture of the tumour of this localization. The process involves neighbouring and even rather remote tissues (muscular atrophy, vegetative disturbances), quite often there are destruction of the bones adjacent to the affected one, articular changes looking like inflammation and pronounced sclerotic reaction. Osteoid osteoma of the bones of hands anf feet is characterized by subperiosteal form when the "nest" of the tumour is situated outside the bone, thus causing atrophy due to pressure of the tissues lying below. Since the only effective method of treatment of osteoid osteoma consists in surgical removal of the "nest", it is of utmost importance to take into consideration atypical course of the tumour of this localization when maring the diagnosis. Angiographic investigation may be of considerable help in diagnostics.

[Prognosis in fibrosarcoma of bone]. / Prognoz pri fibrosarkome kosti.

A retrospective study of 42 patients with bone fibrosarcoma was carried out. A new highly informative index--tumor growth rate--is suggested. It is a ratio of tumor maximum diameter to case history length (Rtg = L, CM/t, month). Three histologically-identified grades of fibrosarcoma malignity are discussed. They are based on the variation in metastasis development and survival rates. As a result of mathematical treatment of the findings, 8 characteristics of bone fibrosarcoma were identified which influenced prognosis. A multi-factorial analysis of the data was undertaken using said characteristics. Indexes were calculated for each characteristic and tabulated to prognosticate 3-year survival of patients with fibrosarcoma of the bone.

[Comparative analysis of immunoreactive indices in malignant and benign bone tumors]. / Sravnitel'nyi analiz pokazatelei immunologicheskoi reaktivnosti pri zlokachestvennykh i dobrokachestvennykh opukholiakh kostei.

The paper discusses the results of a study of immunologic surveillance in patients with bone tumors. T-lymphocyte deficiency was found in 21-32% of cases only, while all patients showed changes in the level of some T-cell subpopulations and their ratio. Patients with malignant tumors (mostly osteosarcoma) revealed a lowered response to PHA and a high frequency of sensitization to tumor antigens. In those cases, serum, blood--circulating T-cells and tumor--infiltrating lymphocytes showed a suppressor activity. A moderately decreased response to PHA, a low frequency of sensitization to tumor antigens and a stimulating activity in serum, blood--circulating T-cells and lymphocytes were registered in cases of benign tumors (mainly giant cell tumors). Suppressor activity of blood T-lymphocytes was matched by a high level of TG cells, while stimulating effect--by a low one.