The use of bisphosphonate for the palliative treatment of painful bone metastasis due to hormone refractory prostate cancer

PURPOSE: Hormone refractory prostate cancer is dominated by osseous metastases leading to bone pain and pathological fractures. We assessed the clinical efficacy of bisphosphonate in the management of symptomatic skeletal metastases due to prostate cancer. MATERIALS AND METHODS: A total of 85 patients with painful osseous metastases due to hormone refractory prostate cancer were treated with clodronate in an open prospective nonrandomized clinical study. Clodronate was started as an intravenous phase for 8 days at a dose of 300 mg. daily followed by an oral maintenance phase of 1,600 mg. daily. The primary study end point was decreased pain without an increase in analgesic medication for at least 2 consecutive measurements. Secondary end points were decreased analgesics, an improved Karnofsky index and mobility as well as the duration of bisphosphonate action. Decreased pain was documented by a 10-point visual analog scale and consumption of analgesics was documented in a diary. RESULTS: A palliative response with a significant decrease in mean pain score from 7.9 (range 6 to 10) to 2.5 (range 0 to 4) (p <0.001) was achieved in 64 of the 85 patients (75%), 19 (22%) were completely pain-free without further need of analgesics and 45 significantly decreased the daily consumption of analgesics. The mean duration of bisphosphonate action was 9 weeks (range 4 to 22) and mean survival was 12 weeks (range 6 to 22). Improvement in bone pain was paralleled by an improvement in the mean Karnofsky index of 45% (range 30% to 60%) to 70% (range 50% to 80%) at the end of the treatment period. CONCLUSIONS: Bisphosphonate treatment of painful osseous metastases due to hormone refractory prostate cancer results in a significant pain decrease and a significant decrease in the daily consumption of analgesics in 75% of patients. Each characteristic is paralleled by an increase in the Karnofsky index, mainly due to better mobility. Bisphosphonate should have a definite role in the palliative management of symptomatic hormone refractory prostate cancer.     

"定骨舒筋"用于髌骨骨折早期康复的临床研究

目的观察"定骨舒筋"手法用于髌骨闭合性骨折早期康复的疗效。方法60例伤后半个月的病例,对照组30例在夹板固定下行股四头肌收缩活动;治疗组30例去除夹板,用手法对骨折端进行有效的固定而进行主动和被动的关节活动。结果治疗组平均愈合时间4.33周,比对照组明显缩短(P<0.01),膝关节活动度比对照组明显提高(1个月P<0.01;2个月P<0.05),3个月膝关节功能积分优级率比对照组高(P<0.05)。结论"定骨舒筋"对骨折的提前愈合和关节的尽早恢复具有良好的临床疗效。     

羊骨胶原肽对实验性高血压大鼠血压和血脂的影响

目的观察羊骨胶原肽(SBCP)对实验性高血压大鼠血压和血脂的影响;方法经口给予正常SD大鼠一氧化氮合酶抑制剂(L-NAME)建立一氧化氮缺乏性高血压模型。40只SD大鼠随机分为空白组(给予蒸馏水)、对照组(单纯给予L-NAME,15mg/kg bw·d)、样品1组和样品2组(给予L-NAME15mg/kg bw·d,同时分别给予1000mg/kg bw d SBCP 1及SBCP 2),观察大鼠一般状况及血压、心率和血脂的变化。结果给予L-NAME1w后对照组及样品1组、样品2组大鼠血压即明显高于实验前和空白组。随后样品1组和样品2组大鼠的血压开始持续回落,从第3周开始至实验结束,两组血压均低于对照组,并有显著性差别;在实验期间各组大鼠心率变化、体重增长量、食物利用率的差异均无显著性,各组大鼠血脂均在正常范围。结论在不影响心率的条件下,经口给予SBCP在体内具有一定的降血压作用,但对大鼠的血脂没有明显影响。     

Dislocation of the Trapezium (Multangulum Majus): A Case Report A Case Report

A case of complete, closed dislocation of the trapezium is reported. The treatment was open reposition and fixation with two Kirschner wires. No avascular necrosis occurred. Two and a half years after the injury there were no subjective complaints, the mobility and strength of the thumb were normal and there were no radiological signs of arthrosis.     

Calcium fluoride containing granules produced in vitro in rat bones

Abstract – Femurs and tibias of normal rats were fixed in 4% unbuffered solutions of glutaraldehyde or formaldehyde containing 1 % NaF. Following washing, radiographically controlled demineralization was performed in 3.25% HNO₃. Light microscopy and transmission electron microscopy revealed the presence of so-called fluoride granules in bone trabeculae, cartilage, cartilage remnants, bone cells, chondrocytes and in the bone marrow. Selected area diffraction indicated that the fluoride granules contained CaF₂. X-ray diffraction analysis of non-demineralized NaF-fixed bones were negative for CaF₂. The results are discussed and related to precipitation artifacts reported in demineralized hard tissues and to similar CaF₂-containing granules observed in demineralized bones and incisors of rats given high doses of NaF in diet or drinking water.     

带股方肌蒂骨瓣移植术治疗股骨头缺血性坏死一例

报道用带股方肌蒂骨瓣移植术成功地治疗一例11岁儿童左股骨头缺血性坏死,复习了手术方法;对本术式的适应症和并发症及有关血供进行了讨论。     

Monostotic fibrous dysplasia of the cranial bones

Summary Polyostotic fibrous dysplasia affects many bones of the skeleton and usually on one side only. In monostotic variety only one bone is affected. The condition which usually starts in early childhood is at first active, gradually becomes quiescent and finally with termination of skeletal growth becomes inactive and ceases to grow. These stages can be seen histologically as well as radiologically. The main feature is increasing calcification of the mass. In half of our cases there was an intracranial mass with signs of raised intracranial or intra-orbital pressure. In all of these cases the mass originated from the base of skull. Those growing from the vault of the skull grew outward.Pathogenesis, diagnosis and treatment are discussed.Our thanks are due to Professor Armin and Professor Kamalian for pathological reports of our cases, and to Dr. Yaghamai and Dr. Tafazzoli for x-ray studies of these cases.     

Effects of Oxytetracycline on the Mechanical Properties of Bone and Skin in Young Rats

The influence of the tetracycline antibiotics on growing bones has been disputed. In the present study 58 young male rats were given intraperitoneal injections twice a day for 2 weeks; half of the rats received oxytetracycline and the other half placebo. The concentration of oxytetracycline in plasma was comparable with therapeutic levels in man. Compared with the control animals the oxytetracycline rats had, at the end of the medication period, a significantly lower weight (7 per cent), shorter bones (1-2 per cent), lower bending strength of both the tibia diaphysis (9 per cent) and the distal femur metaphysis (22 per cent) and even lower tensile strength of intact (17 per cent) and sutured (27 per cent) skin. The effect of oxytetracycline seems to be reversible as no differences between the two groups could be detected 1-3 weeks after the end of medication.     

Cleidocranial dysostosis in infancy

The progress of ossification of the skeletal system especially of the skull in an infant with cleidocranial dysostosis is documented. The parietal bones, absent at birth, were formed by wormian bones by four years of age.     

Bone mineralization in newborns whose mothers received magnesium sulphate for tocolysis of premature labour

Prolonged maternal magnesium sulphate infusion therapy for tocolysis of premature labour may result in secondary fetal hypermagnesaemia, which has been associated with bony abnormalities in the newborn. We report on four infants, members of two twin pregnancies, who were exposed to prolonged fetal hypermagnesaemia. Three of the infants, all appropriate for gestational age, showed abnormal radiological findings consisting of abnormal mineralisation of long-bone metaphyses owing to fetal hypermagnesaemia. The fourth infant, who was growth retarded, had normal bones. Intrauterine growth restriction appears to be protective against magnesium sulphate-induced abnormal bone mineralisation in the newborn.