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PubMed2003

Bispyridinium cyclophanes: novel templates for human choline kinase inhibitors.

The synthesis and biological activities of four novel bispyridinium cyclophanes as choline kinase (ChoK) inhibitors are presented. Their synthetic methodology has been optimized according to dilution, temperature, and reaction time and provides pure bispyridinium cyclophanes in high yields very easily. One of these cyclophanes (6, 4,8-diaza-3(1,4),9(4,1)-dipyridina-1(1,4),6(1,3)-dibenzenacyclodecaphan-3(1),9(1)-bis(ilium) dibromide) has an IC(50(ChoK)) of 0.3 microM and is the most potent human ChoK inhibitor described to date.

Antineoplastic Agents↗
PubMed2003

Conformational dynamics of a bispyridinium cyclophane.

A complete study of the conformational behavior of 4,8-diaza-3(1,4),9(4,1)-dipyridina-1,6(1,4)-dibenzenacyclodecaphan-3(1),9(1)-bis(ilium) bishexafluorophosphate is described. This study allows us to conclude that the process observed by which the different chemical shifts of the pyridinium protons show coalescence at a high-temperature 1H NMR is the rotation around the C-N bond, whereas the conformational equilibrium between the four conformers is produced at low temperature.

Journal Article↗
PubMed1996

Alternative donor site for alveolar bone grafting in adults with cleft lip and palate.

Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting restores continuity of the dental arch, closes oronasal fistulae, supports the alar base, and facilitates spontaneous eruption of permanent teeth adjacent to the cleft. However, timing of the graft and the selection of materials have been topics of much debate in the literature. This article discusses an alternative donor site in cases where rehabilitation has passed the recommended time. Harvesting bone from the third molar regions allows not only the removal of impacted third molars during the same surgical procedure, but also eliminates the morbidity associated with additional surgical sites such as the ilium or mandibular symphysis. This report should not be interpreted as a recommendation for the use of this alternative site in cases where grafting is carried out within the optimal time period, which is usually in the mixed dentition stage. However, when grafting is necessary in young adults suffering from complete cleft lip and palate, the third molar region may provide another acceptable donor site.

Adolescent↗
PubMed1999

Primary alveolar soft part sarcoma of bone.

AIMS: Alveolar soft part sarcoma is a distinct, rare soft tissue tumour occurring primarily within the skeletal muscles or musculofascial planes in young adults. Primary involvement of bone is extremely rare. We report on six patients with alveolar soft part sarcoma occurring primarily in bone. METHODS AND RESULTS: Thorough clinical and radiographic examinations were done to rule out any other primary site. The patients were four women and two men aged 17-35 years (mean, 24.5 years). The primary site of the tumour was the femur in three patients, the ilium in one and the fibula in two. In one of the patients with fibular involvement, the tibia was also involved by direct extension. Of the long bone lesions, three were centred in the metaphysis and one in the diaphysis. Radiographically, all of the lesions demonstrated an osteolytic pattern of bone destruction with ill-defined margins and a wide zone of transition between the lesion and adjacent normal bone. Microscopically, all tumours showed the typical histological pattern of alveolar soft part sarcoma. Diastase-resistant, periodic acid-Schiff-positive crystalline structures were identified within the cytoplasm and confirmed ultrastructurally. Immunohistochemically, a keratin stain was negative in all cases; there was positive staining for MyoD1 in the cytoplasm but not the nuclei. Distant metastasis developed in four patients; one died. CONCLUSION: Alveolar soft part sarcoma arising in bone is extraordinarily rare but should be considered in the differential diagnosis of metastatic hypernephroma in a young patient.

Adolescent↗
PubMed2003

Management of massive acetabular defects in revision total hip arthroplasty.

Twenty-four cases of massive periacetabular bone loss (Paprosky Type 3B) were reconstructed using custom triflanged acetabular components (CTAC). Fixation is obtained by the creation of a triflanged component that is anchored to the ilium, ishium, and pubis with multiple fixation screws. Acetabular defects are grafted with large amounts of cancellous allograft. Modular polyethylene liners are then locked into the CTAC. Twenty-one of 24 cases (87.5%) were considered clinically successful at short-term follow-up (average, 48 months; maximum, 78 months), with stable fixation and reconstruction of periacetabular bone. Three failures occurred from loss of fixation in patients with a preoperative dissociation of the hemipelvis and severe osteopenia. Presently, these devices should be used with caution in cases with a preoperative dissociation of the hemipelvis, unless additional column plating is performed.

Acetabulum↗
PubMed1992

Serum parathyroid hormone and calcitonin levels following ovariectomy in the adult rat.

The ovariectomized rat is a reasonably good and often utilized model of human post-menopausal osteoporosis (Devlin and Ferguson, 1989). Mature rats were either ovariectomized or underwent a sham operation, killed at intervals following operation and the serum concentration of parathyroid hormone and calcitonin at death related to the histomorphometry of the cancellous bone of the proximal ilium. The mean serum calcitonin concentration for all ovariectomized rats was 66.4 pg/ml (SD = 18) and for the control rats was 76.42 pg/ml (SD = 20). The serum calcitonin concentration in the ovariectomized rats was significantly negatively correlated with the extent of erosion cavities of the cancellous bone (r = -0.598, t = -2.36, p = 0.039). No significant correlation was observed for the control rats (r = -0.107, t = -0.357, p = 0.727). The mean extent of erosion cavities in the ovariectomized group was 6.81% (SD = 1.94) and in the control group was 6.47% (SD = 2.21), with no significant differences between the two groups (t = 0.41, p = 0.69). No significant correlations were observed in serum parathyroid hormone (PTH) concentration with the bone resorption parameters. From this study it was concluded that calcitonin may be of aetiological importance in bone loss in the ovariectomized rat.

Animals↗
PubMed1995

[Ultrasound anatomy of the fetal hip joint with special reference to the blood supply].

AIM: Study of the anatomy of the fetal hip joint in 115 pregnancies between 13. to 40.th weeks of gestation by ultrasound. METHOD: Sonoanatomy was studied by high resolution ultrasound (Acuson 128). For investigation of vascular supply of the fetal hip, colour-coded Doppler sonography was performed. In-vivo studies on vascular supply were correlated with histological sections of 34 fetal hip specimens, according to the conceptional age of 13-35 weeks. RESULTS: Vascular studies of the proximal end of the human femur showed a supply by the lateral and medial femoral circumflex arteries branched from the femoral artery or the deep femoral artery. After 22 weeks of gestation the acetabular artery supplied by the obturator artery was visible by means of Doppler sonography. At the end of pregnancy, large numbers of intraosseous blood vessels are demonstrable within the femoral head and neck. CONCLUSION: The basic arterial pattern of the hip joint is established at birth. Proximal end of the growing femur, acetabulum, os ilium and labrum acetabulare are clearly visible by ultrasound.

Acetabulum↗
PubMed1992

Treatment of infected segmental defect of long bone with vascularized bone transfer.

Experience with infected pseudarthrosis with segmental osseous defect, treated by debridement and microvascular bone transfer, is reported. Fourteen patients form the basis for the study, including 12 males and two females. Patient age at the time of operation averaged 35.1 years. Follow-up averaged 52 months. The affected site included tibia (10), femur (2), and ulna (2). A total of 15 vascularized bone graft transfers were carried out for the 14 patients, with the donor bone fibula (8) and ilium (7). Bony union was ultimately obtained in all patients. In 11 patients, primary union was obtained at both ends of the transferred bone segment. In the remaining three patients, a secondary procedure, consisting of onlay nonvascularized bone autografting at one end of the vascularized transferred bone segment, was required to obtain union. Recurrent infection following union occurred in one patient. One of the two patients with active osteomyelitis at the time of vascularized bone transfer had complications from recurrent sepsis, leading to the authors' caveat that vascularized bone transfer should be deferred until such time as sepsis is inactive. Criteria used in this series for determining inactive sepsis (absence of sinus tracts, negative bacterial cultures, negative c-reactive protein, and a sedimentation rate of less than 15 mm per hour) seem appropriate. The study suggests that vascularized bone transfer is a useful procedure for the treatment of infected segmental osseous defects of long bones, of more than 3 cm extent and one month or more after inactive sepsis.

Adult↗
PubMed1995

[Tumorous space-occupying lesions of the pelvic skeleton. A radiological analysis of 234 cases].

PURPOSE: From the material of a bone tumour record file, an attempt was made to determine criteria enabling radiographic prediction of malignancy and tumour entity of lesions of the pelvis. METHODS: Patients' age, location and radiographic morphology of 234 space-occupying lesions of the pelvis were analysed retrospectively. RESULTS: 62.8% of all lesions were malignant, and the portion of malignant tumours increased with increasing age. While 68.0% of the lesions were found in the ilium, 18.8% in the pubis and 13.2% in ischium, the proportion of benign and malignant lesions did not vary in the different bones. Lesions showing a growth rate according to Lodwick grade IA and to IB were benign in 100% and in 82.0%, respectively. In contrast, tumours of grade II or III were malignant in 89.1% and 88.0% of cases, respectively. CONCLUSIONS: By the construction of subgroups by combining the patients' age and growth rate, the prediction of the malignant potential of a lesion increased significantly. The younger the patient, the more aggressively a benign lesion may grow, while the older the patient the slower a malignant tumour may grow. Prediction of the tumour entity is rarely possible.

Adolescent↗
PubMed1999

[Parotid swelling with night sweat, fever and weight loss symptoms. A rare differential diagnosis].

HISTORY AND CLINICAL FINDINGS: A 29-year-old patient complained of recurrent swelling of the eyelids and cheeks, fever, diffuse headaches, night sweat and weight loss (8 kg during 8 weeks). Both parotid glands showed swelling which were solid, plain and non-painful to pressure. Palpation did not reveal enlarged lymph nodes. There were no other pathological findings except for anisocoria and disturbed motoric function of the right eye's pupil. INVESTIGATIONS: Laboratory findings, chest X-ray, abdominal sonography and ilium crest biopsy showed no signs of lymphoma or other tumour. MRT showed enlarged parotid glands and hypointensity of a few small (up to 2 cm) areas. Because of these findings Heerfordt syndrome with involvement of the third cranial nerve and the lacrimal glands was suspected and verified by parotid biopsy. TREATMENT AND COURSE: Under corticosteroid therapy started with 80 mg/d symptoms rapidly ceased. Therapy was continued for one year. 8 months after therapy had been stopped the patient had no complaints and investigations showed no signs of recurrence nor pulmonary or any other organ manifestation. CONCLUSION: If swelling of the parotid glands with night sweat, fever and weight loss occur, parotid biopsy should be performed early to exclude malignancy. With parotid gland biopsy also diagnosis of other diseases which have similar signs, such as Sjögren syndrome and parotid gland sarcoidosis, can be established early.

Adult↗
PubMedDate not supplied

[Preliminary results of treatment with vascular pedicled iliac bone chip in femur head necrosis].

For revascularisation of femoral head with osteonecrosis and pseudarthrosis of the femoral neck 68 femoral head were treated with a pedicled bonegraft. Therefore were taken the medial bonegraft (A. circumflexa ilium profunda) and the lateral bonegraft, based on the deep branches of the superior gluteal vessels. On the basis of postexamination it is reported about the first 35 patients, who were treated with a medial autological pedicled bonegraft. Prae- and postoperative each of them was clinical, radiological and angiological examinated. Because of this operation in 78.8% the clinical picture, existing about pain and the ability to walk and move, could be improved.

Adult↗
PubMedDate not supplied

[Vascular pedicled iliac bone graft in therapy of femur head necrosis in the adult. Clinical and angiographic results].

23 hip joints with hip head necrosis in 22 patients were provided with a pedicle bone-graft perfused by the art. circumflexa ilium profunda. I two cases it was necessary to remove the bone-graft contralaterally because bone had already been removed from the side with the necrosis at an earlier date. In these cases the arterio-venous bundle of vessels of the autologous heterotope transplant was connected through microanastomosis with the arteria and vena circumflexa femoris lateralis. In addition to the usual clinical follow-up the method of superselective angiography was also applied to make possible direct perfusion control of the implanted bone-graft in the operated patients. In 18 of the 23 pedicle autologous heterotope transplants unimpeded perfusion could be shown. By introducing regional stress angiography in 7 cases it became possible to make further well-founded statements about the physiotherapeutical follow-up treatment. Electronic subtraction provides a more accurate assessment of even the minutest arteries possible.

Adult↗
PubMedDate not supplied

[Tuberculosis of the pelvic girdle].

Between 1955 and 1980 a total of 67 patients (42 female, 25 male) with advanced tuberculosis of the pelvic girdle underwent surgery at the authors' clinic. In 43 patients the sacroiliac joint was affected (in 2 cases bilaterally), in 11 the ischium, in 9 the pubic bone, and in 2 each the ilium and the sacrum. The average of the patients (who included 4 migrant workers) was 44. The youngest patient was 8, the oldest 67 years old. The average interval between the onset of complaints and diagnosis was 4.6 years (minimum 1 month, maximum 20 years). Thirty-eight of the patients had already had treatment for an organic or osteoarticular tuberculosis. Although 24 (35.8%) of the patients were simultaneously suffering from a florid, specific infection localized elsewhere, and abscesses, fistulas, or a combination of these were identified in 40 patients (59.7%), only 17 (25.4%) were in slightly impaired general condition, and in over one-half of the patients, the hourly blood sedimentation rate was normal or only slightly elevated (up to 20 mm n.W.). In 9 cases (13.4%) the only pointers to tuberculosis were the patient's history, clinical and radiological findings, and the subsequent evolution of the disease. In these cases the diagnosis could not be confirmed either by histologic or by bacteriologic study of focal tissue. In 67 patients, 66 osseous foci were removed and in 2 cases merely an abscess (after an average of 2-3 weeks' tuberculostatic therapy), the bone cavities were filled with a mixture of heterogeneous or autogenous spongiosa and tuberculostatics or merely with chemotherapeutic drugs, and primary closure of the wound was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed1989

[Diagnosis of pelvic fractures: synoptic views of the pelvis versus CT].

An attempt has been made, using 21 patients with pelvic fractures, to determine the circumstances in which plain films provide adequate information and when additional information can be obtained by CT. It was found that in all cases of acetabular fractures the diagnosis could be suspected on plain films, but that it proved impossible to demonstrate accurately the position of fragments, the degree of dislocation or the presence of intra-articular bone fragments. These problems could be solved by using CT. In patients with injury to the sacro-iliac joints or of the sacrum, the extent of the injury and the degree of pelvic instability was better shown by CT. All other bony lesions, such as fractures of the ilium, pubis, ischium or the symphysis could be diagnosed adequately by simple radiographs.

Fractures, Bone↗
PubMed1987

[Angiographic control of treatment of femur head necrosis with a pedicled pelvic bone graft].

A new operative method is introduced in the therapy of the idiopathic necrosis of the femoral head. This operation is based on the idea, that ischaemic processes play an important role in the origin of the idiopathic necrosis of the femoral head. The transplantation of a pedicle bone graft should provide a good arterial supply. 28 Preoperative superselective angiographies of the A. circumflexa femoris medialis showed pathological findings in 17 cases. A good supply of the bone graft was found in 4 from a total of 7 postoperative angiographies of the reset A. circumflexa ilium profunda.

Angiography↗
PubMed1981

[A new technique of triple osteotomy for turning dysplastic acetabula in adolescents and adults (author's transl)].

A new form of triple-osteotomy of the pelvis is described. The ischium is osteotomized from a dorsal approach, immediately behind the hip joint. The ischium is left in place, the ligaments giving stability to the sacrum remain in tension. After turning the patient a small medial incision is done for the osteotomy of the pubis. The The ilium is cut through with a Gigli saw from a small incision laterally. It should descend medially in a distance of 2-2,5 cm apart from the joint. The possibilities to turn the acetabulum are very good and correspond to the amount of abduction before operation. Injuries to the sciatic nerve are avoided by the dorsal approach. The evaluations of 32 patients with different degrees of dislocations are reported. The osteotomy may be done even in flat-shaped femoral heads, where the acetabulum is still congruent as long as it is possible to abduct the leg and turn the femoral head into the acetabulum. It has been done in high dislocations with secondary acetabulae as well. The operation may be used in children above 8 years, where the osteotomy of Salter and acetabuloplasties are not efficient any more. In contrary to Chiari's osteotomy the acetabulum is covered by cartilage and the angle of inclination usually normal. It can be used in adults and beginning arthrosis as long as the abduction is not limited.

Acetabulum↗
PubMed1980

[Follow-up results of Dega's acetabuloplasty (author's transl)].

From 1966 to 1974 231 acetabuloplasties were performed in 193 children. Dega's technique was not consequently observed in these operations. The follow-up was made in 166 children with 202 acetabuloplasties. 65 per cent of the operated hips were found within the normal range. The clinical examination revealed excellent and good results in 82 per cent. There was a relatively great number of failures due to technical problems, mainly in the first time. The results obtained allow the conclusion that Dega's acetabuloplasty is a valuable method in the operative treatment of the congenital hip in early childhood provided that it is performed with a good operative technique. Because of the possible failures we prefer now Pemberton's pericapsular osteotomy of the ilium.

Acetabulum↗