Results following spongiosa transplantation in giant cell tumor of bone

Between 1952-1988 47 giant cell tumors of the bone were treated at the Orthopedic University Clinic of Vienna with different surgical margins: In 9 cases a radical or wide, in 3 cases a marginal and in 35 cases an intralesional resection was performed. In the cases with intralesional resections the tumors were diligently curatted and the resulting bone cavity was shaved with a rase. In addition in eleven cases a chemical cauterization was done with phenol. Afterwards the lesion was filled up with autogenous or homogeneous bone chips with or without fibrin tissucol. In the cases where phenol was used no local recurrence was observed over a mean period of 39 months (max. 91, min. 6) of follow up. Because of the subchondral joint location of the giant cell tumors of the extremities a radical or wide resection usually causes the loss of a part of the joint which is followed by poor functional results. Intralesional resections in combination with phenol cauterization not only achieved good functional results, but also succeeded in reducing the rate of local recurrencies from 25-44% in 0 as described by other authors.     

Characterization of a human endocrine tissue and tumor-associated Ewing's sarcoma antigen

The histogenesis of Ewing's sarcoma (ES), the second most frequent primary bone tumor in humans, remains controversial. A new cell line (SIM-1) was derived from a peripheral neuroectodermal tumor (PNET) and used for the production of a monoclonal antibody (HBA-71), which recognizes a novel cell surface antigen of ES- and PNET-derived cells and paraffin-embedded tumor sections. The HBA-71 antigen expression is restricted to PNET/ES and the antigen was not detected on cell lines or tissue sections of any other tumor tested, with the exception of ependymoma. Three proteins with molecular weights of 300,000, 185,000, and 90,000 were isolated from SIM-1 membrane extracts by HBA-71 affinity chromatography. Trypsin treatment of intact SIM-1 cells destroys the HBA-71 epitope and cleaves off two proteins with molecular weights of 210,000 and 95,000. HBA-71 antigen expression is not influenced by treatment of ES cell lines with differentiation inducers. Within normal tissues reactivity was observed with the adenohypophysis, ependymal cells, endocrine pancreas, Sertoli, and ovary granulosa cells. The reagent links ES with PNET and provides a highly valuable probe for (a) the immunohistological differential diagnosis of ES/PNET using fresh tissue or paraffin sections from other small round cell tumors, (b) the histogenetic studies of ES/PNET, and (c) the in vivo diagnostic and therapeutic procedures in patients with ES and PNET.     

Early onset of family centred intervention predicts language outcomes in children with hearing loss

Objective

To investigate the impact of age at diagnosis and age at onset of intervention on language outcomes in children with hearing impairments.

Methods

Receptive and expressive language outcomes of a sample of 63 children (mean age 5;1 years) with hearing loss (mean 78 dB, SD 25.3) enrolled in the only specific early intervention program in Upper Austria were assessed. The sample can be regarded as representative for children with significant hearing loss. For 89% the hearing loss was congenital. Language results were related to age at diagnosis, age at first fitting of hearing aids and age at enrolment in the intervention program. Confounding variables such as IQ, degree of hearing loss and family parameters were controlled for in regression analyses.

Results

Early commencement of family centred intervention had a significant impact on language outcomes as opposed to age at diagnosis and age at fitting of hearing aids.

Conclusion

In managing intervention in children with hearing loss, time between diagnosis and onset of early intervention should be kept as short as possible. However, age of entry to early intervention explained only about 4% of the variance in language outcomes.     

Evidence for epistasis between the 5-HTTLPR and the dopamine D4 receptor polymorphisms in externalizing behavior among 15-year-olds

The present study aimed to clarify the functional role of genes in the dopamine and serotonin systems by examining whether polymorphisms in these genes are related to adolescent externalizing behavior either alone or in interaction with each other. Participants were selected from an ongoing prospective study of the outcome of early risk factors. At age 15 years, 298 adolescents (144 males, 154 females) completed the Youth Self Report, 296 primary caregivers the Child Behavior Checklist and 253 teachers the Teacher Report Form. DNA was genotyped for the DRD4 exon III VNTR and the 5-HTTLPR polymorphisms. Results revealed that individuals with the DRD4 7r allele reported significantly more externalizing behavior than carriers of other variants. In addition, a significant interaction emerged, indicating that adolescents carrying two copies of the 5-HTTLPR short allele and the DRD4 7r variant scored highest on aggressive and/or delinquent behavior compared to other genotypes. This result suggests an effect of 5-HTTLPR on externalizing behavior in the presence of DRD4 7r but no effect in its absence.     

The effect of early confirmation of hearing loss on the behaviour in middle childhood of children with bilateral hearing impairment

Aim To determine if the benefit of early confirmation of permanent childhood hearing impairment (PCHI) on children’s receptive language development is associated with fewer behavioural problems. Method Follow‐up of a total population cohort of 120 children with PCHI of moderate or greater severity (≥40 decibels relative to hearing threshold level) (67 males, 53 females; mean age 7y 11mo, range 5y 5mo–11y 8mo) and 63 hearing children (37 males, 26 females; mean age 8y 1mo, range 6y 4mo–9y 10mo). The main outcome measures were the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents and the Vineland Adaptive Behaviour Scales (VABS) which are completed on the basis of a parental interview. Results Children with PCHI had lower standard scores than hearing children on the Daily Living Skills (p=0.001) and the Socialisation (p=0.001) scales of the VABS. They had significantly higher Total Behaviour Problem scores on the parent‐rated (p=0.002) and teacher‐rated SDQ (p=0.03). Children for whom PCHI was confirmed by 9 months did not have significantly fewer problems on the behavioural measures than those confirmed after that age (p=0.635 and p=0.196). Interpretation Early confirmation has a beneficial effect on receptive language development but no significant impact in reducing behavioural problems in children with PCHI.     

Scope and limitations of ultrasonography in the documentation of fractures – an experimental study

Sonographic studies were performed on cadaveric bones placed in a water bath, using 7.5-MHz linear-array transducers and 3.5-MHz sector transducers. Depending on its size, the defect was revealed as an interruption of the cortical reflection of echo or a dorsal band of echoes confined to the region of the fracture. It was interesting to note that fractures and bony defects are not visualized when the transducer is placed parallel to the fracture line or the zone of bony impaction. A further remarkable aspect was the numerous artefacts adjacent to each other at several fracture margins. It may be concluded that in an experimental setting and under standardized conditions, high-resolution transducers permit the examiner to detect cortical discontinuities of 1 mm or more.