Giant cell tumor of the temporal bone (osteoclastoma)

A 49-year-old white female patient was referred to the ENT Department, Zentralkrankenhaus, Bremen, because of conductive hearing loss. Widespread tumor formation was found in the left temporal bone and was identified by biopsy to be an osteoclastoma. The tumor was extirpated surgically and reconstruction was performed. Periodic clinical follow-ups during a 36-month period after surgery have included control computed tomographic scans and have shown no evidence for recurrent disease. The specific pathology of the osteoclastoma is presented and different ways for treatment are discussed.     

尼尔雌醇作用下去势雌兔骨组织形态计量学改变

目的：评估尼尔雌醇对绝经后骨质疏松症的疗效，并探讨其机理。方法：将３０只雌性新西兰兔随机分成３组（每组１０只）：治疗组［摘除卵巢＋尼尔雌醇（每月２ｍｇ）］、模型组（摘除卵巢）和正常对照组（假手术），６个月后处死取材，并在处死前行四环素标记，ＶＩＤＡＳ图象分析系统下作骨组织形态计量学测定。结果：治疗组的单位体积骨小梁骨量（ＢＶ／ＴＶ）、相对类骨质量（ＯＶ／ＢＶ）、成骨细胞指数（ＯＢＩ）和组织水平的骨形成速率［ＢＦＲ（Ｔ）］明显高于模型组和（或）正常对照组。结论：尼尔雌醇能增加成骨细胞数量，可能是一种成骨细胞募集和（或）增殖的刺激剂。     

Genetic analysis of hypophosphatasia

A review is presented of the recent advances in: (i) clinical features, (ii) biochemistry and molecular biology of alkaline phosphatase, (iii) genetic defect in hypophosphatasia, and (iv) prenatal diagnosis. Despite the recent progress, the pathogenesis of hypophosphatasia is far from being elucidated. More clinical cases and further characterization of the alkaline phosphatase gene mutations are needed for better understanding of the clinical spectrum of the entity.     

骨髓基质细胞与玻璃陶瓷复合培养体内成骨的实验研究

目的 观察骨髓基质细胞（BMSC）与钙磷陶瓷（BGC）复合后形成骨组织的生物学机制,为形成组织工程化新生骨组织提供理论依据。方法 将BMSC与BGC复合植入动物体内后进行大体观察、组织学染色,观察其成骨过程。结果 一定浓度的BMSC与BGC复合植入动物体内可产生成熟新生骨组织,其成骨过程与局部血运、材料孔隙、孔径有关。结论 利用组织工程学方法可以形成新生骨组织,为进一步研究组织工程化新生组织的体内移植手段和方法提供了新的思路和可能。     

滋阴泻火中药为主对改善性早熟儿童骨骼发育作用及机理的探讨

对女性特发性性早熟患儿50例采用滋阴泻火中药与甲地孕酮联合治疗,32例单纯使用甲地孕酮治疗,对照组25例不用药物治疗。对照组于1年后骨龄差/年龄差值从1.39±0.24上升为1.54±0.20(P<0.01),最终身高预测值从154.2±5.3cm下降至149.4±4.8cm(P<0.01)。单纯使用甲地孕酮治疗,对患儿骨龄提前及最终身高预测值下降趋势无明显影响。而联合治疗的患儿生长速率减慢,△BA/△CA值从1.36±0.19下降为0.65±0.16(P<0.001),最终身高的预测值从153.6±3.8cm增加至158.8±4.4cm(P<0.01)。研究结果表明,滋阴泻火中药可明显减慢性早熟儿童的骨骼生长,延缓其骨骼成熟,从而防止骨骺过早融合并改善最终身高。     

骨巨细胞瘤的生物学行为研究

本文对骨巨细胞瘤（ＧＣＴ）的传统组织学分级与其生物学行为不甚相符的原因进行了研究。采用５１例ＧＣＴ为研究对象，以１３例骨囊肿（良性）和１５例骨肉瘤（恶性）为对照组，采用图像分析仪（ＩＡＴ）对细胞核（ＧＣＴ取基质细胞核），进行了形态计量研究（８项参量），ＤＮＡ含量，ＤＮＡ倍体类型研究，及术后复发病例的ＤＮＡ倍性与其传统分级的比较研究。结果经统计学处理发现ＧＣＴⅠ级和Ⅱ级之间无显著差别，且它们的生物学属性在潜在恶性和低度恶性范畴。研究还揭示ＧＣＴ的ＤＮＡ≥５ｃ细胞数超过７％者系术后复发、转移的高危病例。     

髁上型内锁髓内钉在恶性骨肿瘤切除后骨重建术中的应用

目的介绍一种新设计的髁上型内锁髓内钉，适用于股骨下端和胫骨上端同种异体关节移植或瘤段灭活再植术。方法应用髁上型内锁髓内钉于同种异体骨关节移植６例。６例均为恶性骨肿瘤，其中股骨下端４例，胫骨上端２例。该钉为中空，闭合断面呈三叶草形，外径为１０ｍｍ～１２ｍｍ，远端前屈角为８°，近、远端设冠状方向直径５ｍｍ锁孔，逆行插钉法安装。结果６例骨关节移植均未出现近、晚期并发症，４例术后随访６个月以上，均在３个月左右骨接合端有初步愈合，术后功能好。结论髁上型内锁髓内钉使用方便，固定可靠，有较好的临床应用价值。     

Bone marrow micrometastases in 109 breast cancer patients: Correlations with clinical and pathological features and prognosis

Background: The presence in bone marrow of cells which react with monoclonal antibodies against tumor-associated antigens has been proposed over the last few years as a new prognostic factor in breast cancer patients. Patients and methods: Bone marrow aspirates were obtained from 109 stage I and II breast cancer patients during or 2–4 weeks after primary surgery. The samples were processed for leukocyte separation on a Ficoll-Hypaque gradient and then used to prepare cytospin slides for immunocytochemical analysis. The slides were stained with a pool of monoclonal antibodies (MoAbs) which recognize tumor associated antigens, using the alkaline phosphatase anti-alkaline phosphatase method. The median follow-up was 36 months (range 15–62); 22 patients relapsed and 7 died. Results: Thirty-four of the 109 patients (31.1%) had MoAb positive bone marrow cells. The bone marrow was positive in 28/74 (37.9%) patients who had the aspirate taken during surgery and in 6/35 (17.1%) who had it taken after surgery (p = 0.055). No association was found between bone marrow positivity and tumour size, nodal status, menopausal status, estrogen receptor positivity or the proliferative index. No association was found between bone marrow and prognosis: the log-rank test was 0.291 (p > 0.5) for OS and 0.023 for DFS; the hazard ratio (positive vs negative) was 1.51 for OS (95% CI: 0.33–6.86) and 0.93 for DFS (95% CI: 0.35–2.45). Conclusions: In our series, bone marrow positivity did not correlate with prognostic parameters or prognosis. Of interest is the relative excess of positivity when the bone marrow was obtained during surgery.     

Neoadjuvant chemotherapy in malignant fibrous histiocytoma of bone and in osteosarcoma located in the extremities: Analogies and differences between the two tumors

Background: Malignant fibrous histiocytoma (MFH) is a rare bone tumor usually treated like osteosarcoma. Studies on analogies and differences between the two tumors have seldom been reported.Patients and methods: Between March 1982 and December 1994, 51 patients with high-grade MFH of bone and 390 with high-grade osteosarcoma were treated with the same regimen of neoadjuvant chemotherapy. All of the tumors in both groups were located in the limbs. Preoperative chemotherapy was performed according to three different, successively activated, regimens consisting of MTX/CDP intraarterially, MTX/CDP/ADM, and MTX/CDP/ADM//IFO.Results: The rate of limb salvage was the same in both the MFH (92%) and osteosarcoma (85%) patients. MFH showed a statistically significantly lower rate of good histologic response, 90% or more tumor necrosis (27% vs. 67%, P = 0.00001) for all three regimens. Despite this low chemosensitivity, the disease-free survivals of the two neoplasms were similar (67% vs. 65%).Conclusions: In terms of histologic response to primary chemotherapy, MFH has a lower chemosensitivity than osteosarcoma. Nevertheless, the two tumors have similar prognoses when treated with chemotherapy regimens based on MTX, CDP, ADM and IFO.     

Experiment study on combined free periosteum grafting and new reconstituted bone xenograft in repairing segmental defects

Segmental bone defects in long bones often pose achallenge tO their sMcal ~nt, and the vasculallzedperiosted po used either alone or in combination withother ~ materials has been Preferred as a uSeals solution to this Problems"'l. HOwever, the use Of vascularized graft has to resort to ndcrosuopcal tecboqUes, Whichmakes it difficult tO populallze this OPe~ in the graSsests level intitutions. We Pimeeded with combined useOf free Periosteum and new reconshtuted bine xenograft(NRBX) in re…