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Biomedical subjects

S Gitelis

Publications and source records attributed to S Gitelis.

At least 37 records · Page 2Linked to original sources
PubMed1991

The effects of long term monolayer culture on the proteoglycan phenotype of a clonal population of mature human malignant chondrocytes.

Articular cartilage chondrocytes maintain biosynthetic heterogeneity in cell culture, but undergo irreversible dedifferentiation of their proteoglycan phenotype, as defined by keratan sulfate content. A recently described cell line of malignant human chondrocytes, 105KC, was the first to maintain a differentiated keratan sulfate-proteoglycan phenotype in long-term culture. A clone of 105KC, labeled KC2H3, is currently described and represents a distinct and metabolically more homogeneous population of mature chondrocytes than 105KC. KC2H3 cells universally express keratan sulfate biosynthesis, as defined by indirect immunofluorescence. In addition, KC2H3 expresses a more mature proteoglycan phenotype than 105KC, as demonstrated by the keratan sulfate content: 24% of glycosaminoglycan content of the aggregating proteoglycans of KC2H3 versus 13% for 105KC. Further reported are the effects of long term monolayer culture on the proteoglycan phenotype expressed by KC2H3. After more than 16 months in continuous monolayer, KC2H3 cells remained morphologically indistinguishable from those maintained in suspension alternating with monolayer. In addition, the proteoglycan phenotype remained mature, without a tendency towards dedifferentiation. The flattened morphology adopted by chondrocytes while in monolayer has been considered a stimulus of dedifferentiation; the present study is the first to examine the direct effects of physical state on a homogeneous and stable population of chondrocytes.

Chondroitin Sulfates↗
PubMed1991

Allograft prosthetic composite arthroplasty for osteosarcoma and other aggressive bone tumors.

Allograft prosthetic composite arthroplasty is a reconstruction alternative after limb salvage for aggressive bone tumors. It combines an off-the-shelf implant with a fresh-frozen allograft and has several potential advantages over conventional techniques. Good clinical results can be achieved with acceptable morbidity. The procedure can be performed successfully even in patients receiving chemotherapy. Nonunion was the most common complication encountered but was amenable to autogenous iliac bone graft. The procedure can be customized to meet the needs of the patient, making custom implant manufacturing delay and expense unnecessary.

Adolescent↗
PubMed1991

Synthesis of chondrocytic keratan sulphate-containing proteoglycans by human chondrosarcoma cells in long-term cell culture.

Keratan sulphate is an integral component of the large aggregating proteoglycans of mature human articular cartilage. The keratan sulphate content of chondrocytic proteoglycans increases during maturation, and it is a useful marker of mature-type chondrocytic proteoglycans. Ordinarily, in cell culture, chondrocytes from non-neoplastic tissues dedifferentiate, diminish or cease to synthesize aggregating proteoglycans with the same amount of keratan sulphate as those formed in vivo, and do not maintain their in vivo phenotype. In tissue culture, this down-regulation of synthesis of keratan sulphate is irreversible. The study of the metabolism of mature human chondrocytes has been hampered by the absence of stable models. We report a cell-line, 105KC, derived from a human chondrosarcoma, that has maintained a stable proteoglycan phenotype during more than three years of culture. Analysis with immunofluorescence suggested that 105KC cells continued to synthesize keratan sulphate in long-term culture. Biochemical analysis demonstrated that 105KC cells maintained the production of chondrocytic large-aggregating proteoglycans and that keratan sulphate composed 13 per cent of their glycosaminoglycan content. To our knowledge, 105KC represents the first model to have maintained the post-fetal chondrocytic proteoglycan phenotype in stable culture. This study documents the feasibility of the development of mature chondrocytic cell-lines and sheds light on the biological characteristics of chondrosarcomas.

Cartilage↗
PubMed1990

Complications associated with limb salvage for extremity sarcomas and their management.

A retrospective clinical review of 100 consecutive patients with extremity sarcomas managed by limb salvage operations was performed to evaluate local tumor control and morbidity. The mean follow-up period was 45.1 months. Overall survival was 86%. There were local recurrences in 3% of patients, and 26 complications in 22 patients. Wound necrosis was the most frequent complication. Failure of allogeneic bone graft operations occurred in 25 patients. Most of the complications were salvageable without loss of limb. Limb salvage is an acceptable surgical treatment of extremity sarcomas based on adequate local control and minimal morbidity.

Adolescent↗
PubMed1990

Function after amputation, arthrodesis, or arthroplasty for tumors about the knee.

We studied the function of twenty-two patients who had had a malignant skeletal tumor adjacent to the knee. An above-the-knee amputation was done in seven; a resection arthrodesis, in nine; and a replacement arthroplasty, in six. The patients all walked at a similar speed (sixty-one to sixty-six meters per minute), which is slower than normal (eighty meters per minute). They all walked with comparable efficiency at three velocities: the mean consumption of oxygen was 0.210 milliliter per kilogram of body weight per meter at free velocity, 0.215 milliliter per kilogram of body weight per meter when they walked 25 per cent faster, and 0.211 to 0.240 milliliter per kilogram of body weight per meter when they walked 50 per cent faster. The three groups of patients and a normal control group consumed oxygen at similar rates. The patients who had had an amputation were very active, and they were the least worried about damaging the affected limb, but they had difficulty walking on steep, rough, or slippery surfaces. The patients who had had an arthrodesis had a more stable limb and performed the most demanding physical work and recreational activities, but they had difficulty sitting. The patients who had had an arthroplasty led sedentary lives and were the most protective of the limb, but they were the least self-conscious about the limb.

Adolescent↗
PubMed1989

Characterization of the pseudocapsule of soft-tissue sarcomas. An experimental study in rats.

The effect of preoperative radiation therapy on the pseudocapsule of experimental rat soft-tissue sarcomas has not been histologically evaluated in a controlled study. The irradiated animal showed marked thickening of the capsular structure surrounding the sarcoma. Everywhere morphologically distinct from the tumor, there was no evidence of tumor invasion into or through this capsular structure. The membrane was consistently thicker and more hyalinized than in the control animals. The nonirradiated animals showed a minimal pseudocapsular structure with a characteristic tumor penetration. Irradiation produced distinct histologic changes in the pseudocapsule. Although assumed on the basis of clinical observations alone, irradiation-induced pseudocapsule has not previously been demonstrated in an experimental model of soft-tissue sarcoma.

Animals↗
PubMed1989

Osteoid osteoma and osteoblastoma.

In conclusion, while similar histologically, osteoid osteoma and osteoblastoma have the potential of being significantly different clinically. Osteoid osteoma tends to be a problem of pain and not of great oncologic significance. Osteoblastoma, on the other hand, has the potential for local bone destruction and aggressiveness as well as the rare occurrence of metastases. For this reason, the latter tumor needs to be respected from an oncologic standpoint and appropriate surgical excision performed.

Bone Neoplasms↗
PubMed1989

The treatment of pigmented villonodular synovitis of the hip. A case report and literature review.

Pigmented villonodular synovitis (PVS) is a rare occurrence in the hip joint. A 33-year-old female with PVS of the right hip was successfully treated by synovectomy and total hip arthroplasty. The literature includes 64 cases of PVS involving the hip, with an average patient age of 34.8 years. Multiple methods of initial treatment were encountered including synovectomy alone, synovectomy and total hip arthroplasty, radiation therapy, and arthrodesis. Synovectomy is only effective when articular cartilage is preserved. Total hip arthroplasty, although of concern in such a young population, appears to be the procedure of choice for either advanced cases of PVS or those that have failed joint-sparing procedures.

Adult↗
PubMed1988

Osteosarcomas arising on the surfaces of long bones.

Malignant bone-forming tumors that arise from the surfaces of long bones are far less common than those that arise from within bone. These surface osteosarcomas are clinically and radiographically similar, yet histologically they are quite distinct. In reviewing the literature, we classified the tumors according to three subgroups: parosteal (juxtacortical) osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. We also studied the clinical, radiographic, and histological findings in eighty patients who had been treated for an osteosarcoma over a forty-four-year period. Adequate follow-up data existed for forty-eight of the eighty patients. The duration of follow-up ranged from two to fifteen years after the initial operation (amputation or resection). Patients who had a parosteal osteosarcoma had the best prognosis; those who had a periosteal osteosarcoma, the next best; and those who had a high-grade surface osteosarcoma, the poorest. Because of these widely varying prognoses, the lesions require different treatment.

Adolescent↗
PubMed1988

The use of large allografts for tumor reconstruction and salvage of the failed total hip arthroplasty.

Large bone defects have become a more common orthopedic problem in recent year. This is due to the increased enthusiasm for limb salvage surgery as a technique to manage patients with primary bone tumors and for patients who have had multiple joint arthroplasties with subsequent bone loss. One technique that has proven successful for this difficult problem is the use of fresh frozen allografts to reconstruct these skeletal defects. From January 1981 until January 1987, 60 large fragment fresh frozen allografts were used for skeletal reconstruction. These grafts were divided into three basic groups: intercalary, 15; osteoarticular, 16; and allograft-prosthetic composite, 29. The diagnoses included 43 bone tumors, 16 failed total hip arthroplasties, and one traumatic bone loss. The average patient age was 39.7 years and had an average follow-up period of 24 months. The average length of allograft was 12.4 cm. Using the Enneking Functional Evaluation System, the final functional analysis revealed excellent or good results in 86% of the patients and fair or poor results in 14% of the patients. Roentgenological union at the allograft-host bone junction was achieved in 90% of the patients in a mean time of 5.8 months after surgery. An additional three patients obtained union after autogeneic bone grafting. At the time of follow-up evaluation, 92.3% of the patients were free of tumor; they had no local recurrences. The use of fresh frozen allografts represents an acceptable alternative for the reconstruction of large skeletal defects. One can expect good or excellent function for the majority of patients. The best functional results were obtained with the intercalary allografts and the allograft-prosthetic composites.

Adolescent↗
PubMed1986

Studies in a patient with tumor-induced hypophosphatemic osteomalacia.

A 7-year study of a patient with tumor (hemangiopericytoma)-induced hypophosphatemic osteomalacia (TIO) is presented, and the findings are in keeping with the depressed tubular reabsorption of phosphate and low 1,25(OH)2 vitamin D levels seen in other studies. Despite normalization of 1,25(OH)2 vitamin D levels with pharmacologic doses of vitamin D2, there was no discernible effect on serum phosphorus levels. Also, despite hypercalcemia induced by pharmacologic doses of vitamin D2, serum parathyroid hormone levels were persistently elevated, and gradually returned to subnormal levels after removal of the tumor. Following removal of the tumor, there was a rapid increase of the 1,25(OH)2 vitamin D levels to supraphysiologic levels, prompt appropriate increase in tubular reabsorption of phosphate levels, and symptomatic improvement in the osteomalacia. Speculations on the physiologic and pathophysiologic role of the putative hormone(s) produced by the tumors associated with this syndrome are presented.

Calcitriol↗
PubMed1986

Soft-tissue masses of the locomotor system: comparison of MR imaging with CT.

Magnetic resonance (MR) images and computed tomographic (CT) scans of histologically characterized soft-tissue masses of the locomotor system in 35 patients were compared for image contrast, demonstration of bone destruction, and display of extent and anatomic relationships of the masses. Subjective criteria for predicting malignancy were tested. T1 measurements were made in a few cases. Intensities of masses relative to those of fat and muscle in spin-echo T1-weighted and highly T2-weighted images were evaluated for correlation with tissue type. Subjective value of using coronal and sagittal images was assessed. Because of its superior inherent image contrast and its ability to provide direct sagittal and coronal images, MR was better than CT in demonstrating size and extent of most tumors and their relationships to vascular and nonvascular structures. However, bone destruction was more difficult to see with MR. Except for fatty tumors, MR was not helpful in identifying tissue type. Subjective criteria were of limited value in distinguishing benign from malignant lesions. Moreover, there is currently no credible evidence that T1 or T2 measurements are helpful in this regard. Study results suggest that MR is superior to CT in evaluating soft-tissue masses of the locomotor system. If an MR examination is performed, CT may not be necessary in certain cases unless bone involvement is suspected.

Extremities↗
PubMed1983

Segmental replacement of long bones using titanium fiber metal composite following tumor resection.

A series of 17 long bone defects following tumor resections were reconstructed using titanium fiber metal implants with adequate bone grafts. There were nine diaphyseal segmental arthroplasties and eight arthrodeses of the knee. The results were excellent in 11 and satisfactory in five, and there was one failure. Sixteen patients became fully weight-bearing. Adequate bone grafts, especially from both posterior iliac crests, and good skin coverage are essential to adequate bony reconstruction.

Adult↗