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At least 127 records · Page 7Linked to original sources

Endemic non-venereal syphilis (bejel) in Saudi Arabia.

A total of 2515 people attending a large military hospital in Saudi Arabia was studied clinically, serologically, and (when appropriate) radiologically for evidence of treponematosis. The indications are that non-venereal endemic syphilis (bejel) is prevalent among the nomadic communities living in rural areas. In contrast, venereal syphilis is much less common, and is found almost exclusively in urban populations. Some of the high risk regions for bejel have been identified, and many people from these locations complained of persistent pain in the legs, which was often associated with radiological evidence of osteoperiostitis of the long bones. Bejel also seems to have become clinically "attenuated" within the last 30 years, with the majority of seroreactors having latent disease. A hypothesis suggesting a reason for this change is put forward, and ways of controlling the infection are outlined.

Adolescent↗

Comparison between polyurethanes containing castor oil (soft segment) and cancellous bone autograft in the treatment of segmental bone defect induced in rabbits.

The aim of this study is to compare polyurethanes containing castor oil (soft segment) in granular form compared to cancellous bone autograft applied to a segmental bone defect. Norfolk adult female rabbits - approximately 13 months of age with a mean body weight of 4.5 kg - are used. In both radial diaphyses, 1 cm osteoperiosteal segmental defects are created. The defect in the left radius is filled with the castor-oil-based polyurethane, and the right one, filled with cancellous bone autograft, collected from the left proximal humerus. The rabbits are euthanazed at 15, 30, 60, and 120 days postsurgery (5 animals/ period), for histological analyses. By radiographic analyses, at these time points, the bone regeneration is more evident and accelerated in the bone defects treated with the cancellous bone autograft. At 120 days postsurgery, the segmental bone defects treated with the cancellous bone autograft are totally reconstituted and remodeled, while the bone defects treated with polyurethane polymer have bone formation of 79%. Histological study shows that the polyurethane acts as a space filler, minimizing the local production of fibrous tissue. No granule degradation, resorption or any inflammatory reaction is detected. Thus, it is possible to conclude that the castor-oil-plant-based polyurethane - in the granule presentation - is biocompatible and osteointegrated, but does not show the same bone regeneration capacity as the cancellous bone autograft.

Animals↗

The osteoninductive property of decalcified bone matrix. An experimental study,.

Demineralised homologous bone-matrix implant was used to bridge a large circumferential osteoperiosteal gap in the diaphysis of the ulna of rabbits. Periodic observations of the graft were made clinically, radiologically, histologically and by tetracycline fluorescence up to forty-two weeks. By the twelfth week after operation 81 per cent of the animals revealed bone formation in the implant and complete bridging of the gap. The new bone was laid on the surface and in the substance of the matrix, suggesting that the inductive principle was acting locally. The bone, once formed, remodelled to the texture of a mature tubular bone and did not undergo absorption during a long follow-up period. Demineralise bone-matrix proved to be a highly osteoinductive and readily osteoconductive material. The graft did not evoke any appreciable local foreign-body or immunogenic reaction. The high degree of success in bridging massive bone defects justifies further serious studies and hopes for a useful substitute for massive autologous bone grafts.

Animals↗

The effect of recombinant human osteogenic protein-1 on healing of large segmental bone defects.

A rabbit ulnar non-union model was used to evaluate the effect of recombinant human osteogenic protein-1 on the healing of a large segmental osteoperiosteal defect. A 1.5-centimeter segmental defect was created in the mid-part of the ulnar shaft of adult rabbits. The defect was filled with an implant containing either recombinant human osteogenic protein-1 or naturally occurring bovine osteogenic protein. The recombinant human osteogenic protein-1 implants consisted of a carrier of 125 milligrams of demineralized, guanidine-extracted, insoluble rabbit bone matrix (the collagen carrier), reconstituted with 3.13, 6.25, 12.5, twenty-five, fifty, 100, 200, 300, or 400 micrograms of recombinant human osteogenic protein-1. Animals that received recombinant human osteogenic protein-1 were compared with animals that received an implant of 250 micrograms of a preparation of naturally occurring bovine osteogenic protein mixed with the collagen carrier. Limbs that served as controls received either the collagen carrier alone or no implant at all. The treated and the untreated defects were examined radiographically and histologically at eight or twelve weeks after implantation. Mechanical testing was performed on six animals. All implants of recombinant human osteogenic protein-1, except for those containing 3.13 micrograms of the substance, induced complete radiographic osseous union within eight weeks. The defects that were treated with an implant of bovine osteogenic protein also healed within this time-period. The bone induced by both types of implants had new cortices with advanced remodeling and marrow elements. Histological evaluation of this new bone at eight weeks postoperatively revealed primarily lamellar bone, with the formation of new cortices and normal-appearing marrow elements. The average torsional strength and energy-absorption capacity of the union induced by recombinant human osteogenic protein-1 was comparable with that of intact bone. The control defects that had been implanted with collagen carrier alone and those with no implant showed no bridging of the defect.

Animals↗

The effect of osteogenin (a bone morphogenetic protein) on the formation of bone in orthotopic segmental defects in rats.

We studied the effects of partially purified, natural osteogenin, a bone morphogenetic protein, on the formation of bone in rats. An osteoperiosteal segmental defect, eight millimeters wide, in the middle of the femoral diaphysis was created bilaterally in thirty-six adult male Fischer rats and stabilized with a polyacetyl plate and threaded Kirschner wires. One defect was filled with a cylinder of 60 per cent hydroxyapatite and 40 per cent tricalcium phosphate ceramic (pore diameter, 250 to 400 micrometers) containing 100 micrograms of partially purified bovine osteogenin, and the contralateral defect was filled with a hydroxyapatite-tricalcium ceramic cylinder without osteogenin. Eighteen animals (six animals each at one, two, and four months after the operation) were studied histologically and histomorphometrically. The implants from eighteen additional animals (six animals each at one, two, and four months after the operation) were subjected to biomechanical testing. Histomorphometry revealed that the total area of bone, the area of bone outside of the implant, and the amount of bone within the pores of the implant were all significantly (p < or = 0.05) greater in the femora that had an implant with osteogenin than in those that had an implant without osteogenin at most time-periods. The presence of osteogenin had no significant effect on the biomechanical parameters measured in this study.

Animals↗

Effect of recombinant human osteogenic protein-1 on healing of segmental defects in non-human primates.

The effect of recombinant human osteogenic protein-1 on the healing of segmental bone defects was studied in twenty-eight African green monkeys (Cercopithecus aethiops). A 2.0-centimeter osteoperiosteal defect was created in the middle of the ulnar shaft in fourteen animals and in the diaphysis of the tibia in the other fourteen. The ulnar defect was filled with an implant consisting of 1000 micrograms of recombinant human osteogenic protein-1 in 400 milligrams of bovine bone-collagen carrier in six animals, with collagen carrier alone in two animals, and with autogenous cancellous bone graft from the contralateral tibia and femur in six animals. The tibial defect was filled with 250, 500 (two tibiae), 1000, or 2000 micrograms of recombinant human osteogenic protein-1 in 400 milligrams of collagen carrier in five animals, with collagen carrier alone in one animal, and with autogenous cancellous bone graft in six animals; in the two remaining animals (controls), the tibial defect was left unfilled. The tibial defects were stabilized with an intramedullary Steinmann pin. All animals were killed at twenty weeks postoperatively. Healing of the defects was evaluated with biweekly radiographs, with histological examination, and with mechanical testing. Radiographically, all of the defects that had been treated with recombinant human osteogenic protein-1 exhibited new-bone formation, but they differed in the degree of healing and remodeling. Five of the six ulnae treated with recombinant human osteogenic protein-1 and four of the five tibiae treated with this substance exhibited complete healing at six to eight weeks, with bridging of the defect by new bone first observed at four weeks. The two unhealed defects both exhibited new-bone formation but incomplete union, which precluded mechanical testing. No defect that had been filled with collagen carrier or that had been left unfilled exhibited any signs of healing or major new-bone formation. None of the six ulnae that had been filled with autogenous bone graft exhibited complete healing, compared with five of the six tibiae that had been so treated. Histological evaluation of the defects treated with recombinant human osteogenic protein-1 revealed the formation of new cortices with areas of woven and lamellar bone and normal-appearing marrow elements at twenty weeks postoperatively. The tibial defects that had been treated with autogenous bone graft had a similar appearance. All control ulnar and tibial defects and all ulnar defects that had been treated with autogenous bone graft had fibrous union with little new-bone formation.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Fibular segment bone bridging in trans-tibial amputation.

The purpose of this paper is to present an alternative method of achieving a synostosis between tibia and fibula in trans-tibial amputations by means of a fibular segment in place of tibial osteoperiosteal flaps as described by Ertl, in 1949. From May 1997 through to February 2003, 15 patients were submitted to the proposed procedure. As a result, all patients produced a solid synostosis between tibia and fibula and were rehabilitated with the use of prostheses. The capacity of these patients for distal weight-bearing on the stump was remarkable when compared to patients submitted to the conventional trans-tibial amputation technique.

Adult↗

Biodegradable guide for bone regeneration. Polyurethane membranes tested in rabbit radius defects.

Segmental, 1-cm osteoperiosteal defects were produced in both radii of 10 rabbits. One defect was covered with a biodegradable polyurethane membrane formed as a tube. The contralateral defect served as an untreated control. Healing was analyzed by radiographic and histologic studies after 5 weeks. Nine out of 10 control defects displayed nonunion, whereas membrane-treated defects consistently healed by forming callus external to the membrane fusing the bone fragments. Loose connective tissue was predominant in the bone gap underneath the membrane. Presumably, the membrane has served as a scaffold for regenerating periosteum.

Animals↗

A new concept in Dorello's canal microanatomy: the petroclival venous confluence.

The so-called Dorello's canal was studied in 32 specimens (16 human cadaver heads) injected with colored latex and fixed in formalin (28 specimens) or studied with microscopic and ultrastructural methods (four specimens). To avoid the differences usually encountered in the description of this area, the authors preferred to consider a larger space that they have named the petroclival venous confluence (PVC). It was located between two dural layers: inner (or cerebral) and outer (or osteoperiosteal). The PVC was quadrangular on transverse section. The posterior petroclinoid fold and the axial plane below the dural foramen of the abducent nerve (sixth cranial nerve) limited the PVC at the top and bottom, respectively. Its anteroinferior limit was the posterosuperior aspect of the upper clivus and outer layer of the dura mater. Its anterior limit was the vertical plane containing the posterior petroclinoid fold, and its posterior limit was the inner layer of the dura. The PVC was limited laterally by the medial aspect of the petrous bone apex and medially by the virtual sagittal plane extending the medial limit of the inferior petrosal sinus upward. The PVC was a venous space bordered by endothelium and continuous with the cavernous sinus, the basal sinus of the clivus, and the inferior petrosal sinus. There were trabeculations between the two dural layers. The petrosphenoidal ligament of Gruber may be regarded as a larger trabeculation, and it divided the PVC into a superior and an inferior compartment. The abducent nerve generally ran through the inferior compartment, where it was fixed to the surrounding dura mater. This nerve was only separated from venous blood by a meningeal sheath of varying thinness lined with endothelium. The clinical implications of these findings are discussed.

Abducens Nerve↗

Autolysed antigen-extracted allogeneic bone for repair of diaphyseal bone defects in rabbits.

Autolysed antigen-extracted allogeneic bone (AAA bone) was used to bridge a large osteoperiosteal gap in the diaphysis of the radius of 50 rabbits. Periodic observations of the graft were made clinically, radiologically and histologically every week up to fourteen weeks. The continuity of the radius was evaluated macroscopically and histologically. The AAA bones were progressively resorbed and replaced by the new bone. The bone remodelled to the mature tubular bone and did not undergo absorption during the experimental period. The AAA bone proceeded to be an osteoinductive and osteoconductive material. There were no appreciable histologic signs of immune or foreign body reaction.

Animals↗

[The experimental study of membrane-guided tissue regeneration of bone].

OBJECTIVE: To confirm membrane-guided tissue regeneration in the healing course of segmental bone defects and study the mechanism. METHODS: Segmental, 1 cm osteoperiosteal defects were produced in both radii of 12 rabbits. One side was covered with hydroxyapatite/polylactic acid(HA/PLA) membrane encapsulated as a tube. The contralateral side served as an untreated control. Healing courses were detected by radiographic and histologic examinations. RESULTS: All control sides showed nonunion, whereas there were consistent healing pattern in test sides. CONCLUSION: Membrane technique can promote bone regeneration.

Animals↗

[Meatomyosynangiosis (Ugo Fisch operation) in progressive perceptive deafness. Principles, results and indications].

Meatomyosynangiosis is the operation suggested by Ugo Fisch. It consists of positioning a flap of superficial temporal muscle in contact with the osteoperiosteal and vasculo-neural elements of the internal auditory meatus. In about one third of the cases this operation results in tonal and vocal improvement for patients suffering from progressive perceptive deafness. According to Ugo Fisch, these results are due to retrograde revascularisation of the internal ear starting from the implanted muscular flap. Our own surgical experience confirms these clinical findings. The greatest chance of securing such an improvement is with young patients under fifty and results from this operation in other cases of perceptive deafness are definitely less conclusive and more uncertain. The main indication then for this meatomyosynangiosis is, at present, for progressive perceptive deafness in young patients with no more than 50 Db at lower frequencies. Furthermore, the arteriolar anastomosis pictures we have obtained after this operation was carried out on animals would appear to confirm the physiopathogenetic explanation suggested by Ugo Fisch.

Adolescent↗

The effect of a composite of polyorthoester and demineralized bone on the healing of large segmental defects of the radius in rats.

The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large segmental defects in the rat radius was studied. Sixty male Wistar rats were divided into four groups, A through D, and an osteoperiosteal diaphyseal defect of 50 per cent of the length of the bone was made in the right radius of each rat. In Group A, the defect was filled with polyorthoester and demineralized bone; in Group B, demineralized bone; and in Group C, polyorthoester. No material was implanted in the defects in the Group-D rats. The rats were killed fifty days postoperatively. The formation of bone in the defects was quantified with computer-assisted measurements of the area on radiographs. The host-tissue response was evaluated with light microscopy. Defects that had been filled with the composite of polyorthoester and demineralized bone or with demineralized bone alone showed regeneration of bone corresponding to 93.6 and 77.6 per cent of the area of the defect, respectively. Defects that had no implant or that had been filled with polyorthoester alone showed significantly less formation of bone. No inflammation was seen with light microscopy, and only traces of the polyorthoester could be detected in the defects that had been filled with the composite or with polyorthoester alone.

Animals↗

Morphometric and physical investigations of segmental cortical bone autografts and allografts in canine ulnar defects.

Cortical bone grafts were implanted for six months in mature dogs using an osteoperiosteal 3-cm defect in the ulna to evaluate their respective morphometric and physical values compared with autografts. The bone-grafting material included fresh auto- and allografts, frozen and thimerosal preserved allografts, and partially demineralized bone allografts. The grafts were evaluated by roentgenograms, microradiograms, photon absorptiometry, porosity, fluorescence labeling measurements, and torsional loading at failure. Autografts achieved a better union score than the allografts, but intracortical bone porosity, percentage of cumulative new bone, and mineral apposition rate were not variables with statistical significance. Lamellar bone was found earlier and in greater quantity in autografts. Within the graft, new bone was deposited at a slower rate than in the recipient bone. Autografts showed less peripheral resorption and a greater torsional resistance than allografts. Photon absorptiometry demonstrated that nondemineralized allografts underwent a substantial loss of peripheral bone. This marked reduction in the outer diameter of the graft had more influence on torsional resistance than did the intracortical porosity of the graft. Demineralized allografts were osteoinductive in only 28% of the cases and appeared to respond in an all-or-nothing pattern. Frozen and thimerosal preserved allografts were the most acceptable substitutes to autografts.

Absorptiometry, Photon↗

Implant-prosthetic rehabilitation after excision of hard palate gland carcinoma.

In Summer 2002, a patient with frequent epistaxis was admitted to the San Gerardo Hospital. Local examination showed a big mass in the nasal fossa. TC and RMN revealed a diffuse erosion of the palatal bone and infiltration of the maxilla. The tumor was removed and histological examination showed a gland carcinoma. The young age of the patient and the need of an adequate bone reconstruction led to use osteoperiosteal calf bone graft. Subsequently, using local anesthesia, 6 implants were positioned. After normal healing and the period of osteointegration, a Toronto bridge was made on implants that the patient wears with no problem.

Adenocarcinoma, Clear Cell↗

[Impact of angiodysplasia on bones].

Vascular malformations usually have an impact on bones because of hemodynamic disturbances in the muscular and osteoperiosteal systems. In fact, even when these structures are not involved by arterial or venous malformations, the blood flow is altered in them. The consequences for bones affect the longitudinal growth of the skeleton of the malformed limb. Growth rarely becomes slower. On the contrary, the condition usually results in an acceleration of bone growth, which results in an excess in the length of the limb presenting with the vascular malformation. This overlengthening may be variably great, and the therapeutic indications must be adapted to its extent. When it is slight, compensation is sufficient to balance the pelvis. Conversely, when it is greater, its correction must be surgical. This surgery is aimed at equalizing the lower limbs, either by slowing down epiphyseal growth and shortening the longer side, or by progressively lengthening the other side, as the case may be. The respective indications of these methods must be carefully considered and adapted to each case, in order to obtain the best possible result with the smallest surgical risk.

Arteriovenous Malformations↗

In vivo study on critical defects using the sheep model.

Bone grafting procedures are widely used to repair large defects successfully in humans, but new surgical therapies can be designed to improve allograft integration. The objective of this study was to investigate the best surgical procedure to study bone graft integration in a large animal model. An osteoperiosteal defect of 3 cm in the tibia or in the metatarsal was made in 15 adult crossbreed sheep to investigate osteo-integration of a homologous bone graft in an intercalary critical defect. DCP plates, alone or in association with Scotchcast or external fixator were used as fixation devices. The Scotchcast as was applied after surgery and left for 2 months to avoid torsion stress of the limb during the stand up movement. Metatarsal defect fixed with 7-hole DCP plate and protected with Scotchcast was the best surgical approach to avoid early or late implant failures, and provided good radiographic results after 4 months.

Animals↗