Steroids have been implicated as an etiology in delayed wound healing. Although there is much documentation in the literature that steroids delay wound healing, most studies are in vitro or use high systemic doses. No studies have used a one-time, postoperative, intralesional steroid injection and evaluated wound healing. This study retrospectively reviewed 73 patients with 115 foot and ankle surgeries over 12 years. Seventy-two patients had steroid injections and 43 did not. The average healing time for the steroid group was 17.1 +/- 10.5 days, and for the non-steroid group 17.3 +/- 8.75 days. There were two infections in the non-steroid group, and one infection in the steroid group. There were five dehiscences in each group. The patients were further subdivided into groups based on age, gender, number of procedures, type of surgery, health status, steroid type, and steroid dose. The healing time increased in patients > 60 years old, and in immunocompromised patients. The patients who had more complex surgery had increased healing time. The males had a longer healing time than the females. Overall, there was not a statistically significant difference between the steroid groups and the non-steroid group. Therefore, one-time postoperative intralesional steroid injections were not found to delay wound healing.

Adult↗

PubMedDate not supplied

Retrovirus transfer of a bacterial gene into mouse haematopoietic progenitor cells.

The haematopoietic system is made up of a hierarchy of cells with different developmental, functional and proliferative capacities. Although cellular diversity appears to arise from the commitment and maturation of stem cells, the molecular basis for this differentiation process is unknown. The introduction of cloned DNA sequences into haematopoietic progenitor cells would provide a novel approach for studying this differentiating in vivo system. One laboratory has reported DNA-mediated transfer of genes into mouse bone marrow cells. However, retroviruses offer a number of advantages over DNA-mediated gene transfer procedures, including high efficiency infection of a wide range of cell types in vitro and in vivo, stable and low copy integration into the host chromosome, and a defined integrated provirus structure. For these reasons recombinant DNA techniques have been utilized to construct high efficiency retrovirus vectors expressing foreign genes. We demonstrate here, using such a retrovirus vector, the transfer of a dominant selectable drug-resistance gene into defined classes of mouse haematopoietic progenitor cells. These observations should facilitate the development of molecular genetic approaches to fundamental and clinical problems in haematopoiesis.

Animals↗

PubMedDate not supplied

Molecular identification of a human DNA repair gene following DNA-mediated gene transfer.

Although it has long been evident that the response of eukaryotes to DNA damaging agents is determined by the effectiveness of a variety of DNA repair systems, there is little detailed knowledge of the nature of these systems or the genes which control them. In humans, a number of hereditary conditions, including xeroderma pigmentosum, ataxia telangiectasia and Fanconi's anaemia, exhibit increased sensitivity to a variety of DNA damaging agents and a predisposition to cancer, suggesting a defect in some aspect of DNA repair. This report describes the identification of a human DNA repair gene following DNA-mediated gene transfer into Chinese hamster ovary (CHO) mutant cells, that like xeroderma pigmentosum cells, are sensitive to a variety of DNA damaging agents and are defective in the initial incision step of DNA repair. The resulting transformants exhibit normal resistance to DNA damaging agents and independent transformants demonstrate a common set of human DNA sequences associated with a human DNA repair gene. These observations provide the basis for the isolation and characterization of the human genes responsible for DNA repair.

Animals↗

PubMedDate not supplied

Rearrangements of the cellular p53 gene in erythroleukaemic cells transformed by Friend virus.

There is now good evidence that the cellular protein, p53, is involved in the transformation process, although its precise role is unknown. It was reported recently that expression of the p53 gene can immortalize cells and that the p53 gene can replace the myc oncogene in a myc-ras immortalization/transformation assay. We have investigated whether p53 is involved in the progression towards the neoplastic state in vivo and report here that erythroleukaemic cell lines transformed by different isolates of Friend leukaemia virus show altered expression of the cellular p53 gene. High levels of p53 protein are found in certain lines, but the protein is undetectable in others. This heterogeneity in p53 gene expression is associated with heterogeneity in tumorigenicity. We demonstrate that genomic rearrangements are responsible for p53 gene inactivation in these cell lines and that they occur in vivo during the natural progression of Friend virus-induced erythroleukaemia.

Animals↗

PubMedDate not supplied

Expression of human adenosine deaminase in murine haematopoietic progenitor cells following retroviral transfer.

Adenosine deaminase (ADA) deficiency, an autosomal recessive inborn error of metabolism, leads to severe combined immune deficiency in man. This enzyme, although constitutively expressed in most tissues, is expressed at high level in immature T cells, and study of the pathophysiology of the disorder indicates that increased deoxyadenosine or altered methylation capacity have toxic effects on T-cell maturation. Although bone marrow transplantation can correct the immune deficiency, this therapy is associated with graft-versus-host disease and incomplete immune restoration, and so our laboratory and others have sought to develop a method of gene replacement as a possible treatment for the disease. Moreover, characterization of the complementary DNA of the human ADA gene and some of its mutants makes it possible to design gene transfer strategies. We have now subcloned a human adenosine deaminase cDNA into the retrovirus shuttle vector pZIP-SV(B), and in this way have isolated a cell line, 4.2T, which produces high titres of replication-defective retrovirus which have been used to transfer the gene for human ADA to mouse bone marrow cells. Transfer and expression of the neomycin-resistance gene (neo) and the ADA gene in murine bone marrow colony-forming units (CFU) was demonstrated by in vitro colony formation in the presence of the antibiotic G418 or 9-xylofuranosyladenine plus deoxycoformycin, respectively. Isoenzyme analysis also showed human ADA expression in the cultured mouse bone marrow.

Adenosine Deaminase↗

PubMedDate not supplied

[ROBODOC--a path into the future of hip endoprosthetics or an investment error?].

GOAL: The Orthopaedic Department of Martin-Luther-University has been using computer-guided, robot-assisted surgery in cementless total hip arthroplasty since June 1997. The goal of the present paper is to critically evaluate the advantages and disadvantages of the ROBODOC system when using two different femoral components and the employment of the system in orthopaedics in general. METHOD: Between June 1997 and August 1999 87 procedures have been performed using the ROBODOC system. 48 ABG stems and 39 OSTEOLOC stems manufactured by HOWMEDICA were used. The results are based on a prospective study. RESULTS: The main advantage of the system is the excellent three-dimensional preoperative planning and the precise execution of the preoperative plan during surgery. Problematic situations of the proximal femur can be evaluated and the optimal position of the femoral component can be guaranteed. Investigations on cadaver femurs showed significant differences in the bone-implant contact. The first results let us expect some advantage in congenital and acquired femoral deformities. CONCLUSION: The ROBODOC system has to be critically considered as an alternative to hand implantation. In our opinion, it should be used only under certain circumstances considering the current technical progress. Only in these cases the potential of the system can be used beneficially.

Arthroplasty, Replacement, Hip↗

PubMedDate not supplied

[Axial load in case of press-fit fixation of the ACL graft--a fundamental study].

AIM: The aim of this study was the determination of the axial fixation load resting on smooth press-fit dowels needed for fixation of the patellar tendon graft (BTB) in order to reach the same fixation properties compared to the interference screw on anterior cruciate ligament (ACL) plasty. METHOD: Bovine test specimens with 27 BTB grafts fixed in tibial drill holes were used and divided in 3 groups: interference screw, and press-fit cylinder (Ø 7 mm) with 150 N and 100 N axial loads. Prior to fixation, impactation of the transplant into bone was carried out. Failure testing was done in a tensiometer at a cross-head speed of 50 mm/min. Determinations of peak load and stiffness were also made. RESULTS: Similar peak loads and stiffness were reached on introducing a press-fit dowel (slashed circle 7 mm) with 100 N and 150 N axial load compared to interference screw fixation of the BTB graft. Peak load: 988.1 N +/- 365.1 (screw) versus 1 210.4 N +/- 292.4 (dowel 150 N) and 1 109.8 N +/- 505.4 (dowel 100 N). Stiffness: 86.4 N/mm +/- 20.5 (screw) versus 102.4 N/mm +/- 15.2 (dowel 150 N) and 77.1 N/mm +/- 11.0 (dowel 100 N). There was no significant difference. CONCLUSION: When introducing a press-fit dowel (slashed circle 7 mm) with 100 N axial load into a preformed bone bed, the same fixation properties are reached as in the case of an interference screw on BTB-ACL plasty.

Animals↗

PubMedDate not supplied

[Cage failure following replacement of the third lumbar vertebral body in Hodgkin's disease].

AIM: We present a case report and the histological analysis of cage failure following vertebral body replacement in Hodgkin's disease. METHOD: In a 35-year-old patient with a single metastasis of Hodgkin's disease replacement of the third lumbar vertebral body (Harms-titanium-mesh-cage, DePuy Acromed, completely filled with autogenous spongiosa from the iliac crest) was performed. 51 months postoperatively, the patient presented with acute back pain without trauma. The X-ray showed a collapse of the Harms-titanium-mesh-cage. The cage fragments had caused ventral dislocation of the main blood vessels and dura compression without neurological deficits. After the replacement of the failed Harms-cage (Synex, Synthes) histological analysis (light microscope, non-decalcified horizontal cuts, thickness of 150-200 microm, Giemsa und van Gieson staining) was done. RESULT: The histology showed a remodelling of new bone in the area of the endplates without contact to the cage wall. In the region of the cage corpus, bony necrosis and connective tissue rich in cells was found. CONCLUSION: Bridging fusion in vertebral body replacement cages is not proven. As a result cage failure may occur. Therefore, in tumour patients with high live expectancy, Palacos filling of the cages should be discussed.

Adult↗