Local control of long bone giant cell tumour using curettage, burring and bone grafting without adjuvant therapy

Giant cell tumour (GCT) is a benign, but aggressive, primary tumour of the bone. The recurrence rate after surgical treatment has been reported to be as high as 50%. Many surgical techniques have been employed in the treatment of this tumour. More aggressive interventions, such as en bloc resection and bulk allograft or prosthetic reconstruction, are generally understood to be associated with lower rates of local recurrence. However, because of lessened morbidity, intralesional techniques have come to be favoured for this condition. In addition to curettage, various adjuvant procedures and packing materials have been advocated in order to control and reconstruct long bone defects secondary to this neoplasm. We report our experience with 40 long bone GCT patients treated with curettage, burring, bone grafting and no adjuvants between 1997 and 2002. There was a local recurrence rate of 32.5%, with most recurrences noted within the first 30 months after surgery. Minor complications were found in 18% of patients. The risk of local recurrence in this study is acceptable (within the range that has been historically reported for curettage and bone grafting). In cases where more resources are available, the addition of adjuvant therapies, as noted in the recent literature, may be beneficial. The results of this study should be considered when designing multicenteric studies in the future.

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Résumé Les tumeurs à cellules géantes sont bénignes et agressives localement. Le taux de récidive après traitement chirurgical est important (50%). Beaucoup de techniques chirurgicales ont été utilisées dans le traitement de ces tumeurs. Des techniques très agressives comme la résection en bloc et une allogreffe massive ou une reconstruction prothétique ont pu être proposées avec un taux de récidive faible. Cependant du fait d’une morbidité moindre des techniques de traitement local de la tumeur ont pu être utilisées dans des conditions favorables. Après curetage, différentes procédures de reconstruction ont été réalisées. Nous rapportons notre expérience de 40 tumeurs à cellules géantes traitées par curetage, bourrage, greffes sans adjuvant particulier entre 1997 et 2002. Le taux de récidive a été de 32,5%, surtout dans les 30 premiers mois. Après l’intervention chirurgicale des complications mineures ont été retrouvées dans 18% des cas. Le risque de récidive locale, dans cette étude est acceptable.

     

Prevention of thrombosis and vascular inflammation: importance of combined cyclooxygenase and 5-lipoxygenase inhibitors

Aspirin, a standard non-steroidal anti-inflammatory drug (NSAID) is currently used in antithrombotic treatment. However, its use is limited by largely recognized gastrotoxicity and recommended doses are low. The major side effect of aspirin is related to its ability to suppress prostaglandin (PG) synthesis by constitutive cyclooxygenase-1 (COX-1). Specific inhibitors of COX-2, the inducible isoform of COX which was more recently described, have potent antiinflammatory effects. They are associated with minor risk of gastric tractus toxicity and reduced inflammatory leukocyte components known for their proatherothrombotic properties. Nevertheless, recent findings attributed a significant cardiovascular risk to some of them. 5-lipoxygenase (5-LOX), an enzyme mainly expressed by leukocytes, is responsible for the generation of leukotrienes, the major lipidic proinflammatory mediators. Development of combined inhibitors of 5-LOX and COX isoforms 1 and 2 inaugurate an interesting new therapeutic pathway. Indeed, such inhibitors suppress not only the activation of platelets, leukocytes and endothelial cells but also prevent their metabolic and functional interactions. In addition to their broad spectrum inhibition, they may be associated with the minor gastrotoxic effect. Thus, platelet-leukocyte interactions which dominate the underlying inflammatory process particularly in atherosclerosis, might reinforce the benefits of such inhibitors.     

Signal transduction in the platelet activation induced by IgG anti-streptokinase and anisoylated plasminogen-streptokinase activator complex

Streptokinase (SK) is one of the plasminogen activators currently used in therapeutics. SK antibodies may appear in the blood after thrombolytic therapy with SK or after ß-hemolytic streptococci infection. Such antibodies may both activate platelets and neutralize the ability of SK to convert plasminogen into plasmin. We previously demonstrated that platelet activation induced by the combination of IgG anti-SK and anisoylated plasminogen-SK activator complex (APSAC) is mediated by Fγ7RIIal receptor. However, the mechanism by which IgG anti-SK and APSAC (or SK) transduce an activating signal across the platelet plasma membrane remains unknown. We have demonstrated in the present study that the platelet aggregation induced by the combination of IgG anti-SK and APSAC is accompanied by an increase in inositol phosphate, Ca²⁺ mobilization and thromboxane (Tx) A2 generation. Neomycin, erbstatin and GF 109203X, which inhibit phospholipase C (PLC), protein tyrosine kinase (PTK) and protein kinase C (PKC) activities, respectively, abolished platelet aggregation induced by IgG anti-SK plus APSAC, indicating the pivotal roles of the PLC, PTK and PKC pathways in this immunological activation. In addition, TxA2 generation is also important since aspirin, a cyclo-oxygenase inhibitor and SQ 29548, a TxA2 receptor antagonist, showed significant inhibition of the platelet response. The contribution of released ADP was confirmed using apyrase, which significantly inhibited IgG anti-SK plus APSAC-induced platelet aggregation. Finally, WEB 2086, a platelet-activating factor (PAF) receptor antagonist, was not effective, indicating that PAF is not involved in this process. APSAC- or SK-induced platelet activation may limit the therapeutic effectiveness of the drug and may contribute to the pathogenesis of early reocclusion. The study of the mechanism leading to APSAC-induced platelet activation could be relevant for a better understanding of the physiopathology of immune complex disorder diseases and thrombolytic treatment failure.     

Tissue factor over-expression by human pancreatic cancer cells BXPC3 is related to higher prothrombotic potential as compared to breast cancer cells MCF7

Cancer histology influences the risk of venous thromboembolism and tissue factor (TF) is the key molecule in cancer-induced hypercoagulability. We investigated the relation between TF expression by pancreatic and breast cancer cells (BXPC3 and MCF7 respectively) and their capacity to trigger in vitro thrombin generation in normal human plasma. Flow cytometry and Western blot analysis for TF expression were performed using murine IgG1 monoclonal antibody against human TF. Real-time PCR for TFmRNA was also performed. Activity of TF expressed by cancer cells was measured with a specific chromogenic assay. Thrombin generation in PPP was assessed using calibrated automated thrombogram. Cancer cells were added to platelet poor plasma from healthy volunteers. In separate experiments cells were incubated with the anti-TF antibody at concentration that completely neutralized the activity of recombinant human TF on thrombin generation. BXPC3 cells expressed significantly higher amounts of functional TF as compared to MCF7 cells. Incubation of BXPC3 and MCF7 cells with PPP resulted in acceleration of the initiation phase of thrombin generation. BXPC3 cells manifested higher procoagulant potential than MCF7 cells. The incubation of BXPC3 or MCF7 cells with the anti-TF monoclonal antibody which resulted in reversal of their effect on thrombin generation.The present study establishes a link between the amount of TF expressed by cancer cells with their procoagulant activity. Both studied types of cancer cells trigger thrombin generation but they have different procoagulant potential. The procoagulant activity of BXPC3 and MCF7 cells is related to the amount of TF expressed. Kinetic parameters of thrombogram are the most relevant for the detection of the TF-dependent procoagulant activity of cancer cells. TF expression is one of the mechanisms by which cancer cells manifest their procoagulant potential but it is not the unique one. The present experimental model will allow the characterization the procoagulant fingerprint of cell lines from the same or different histological types of cancer.     

4-芳杂环单/双氨甲基酚衍生物的合成和量化计算

本文在前报的基础上,设计和合成了4-芳杂环取代的氨甲基酚衍生物28个。初步药理试验表明,多数显示不同程度的抗炎活性。用CNDO/2法计算所得数据提示,该类化合物分子中的氨甲基氮和酚羟基氧与受体正电荷中心的结合,可能对抗炎活性起着重要作用。     

Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets

Objective: The aim of this study was to evaluate the alterations on plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and gingival crevicular fluid (GCF) volume after use of three different brackets types for 60 days. Setting Participants: The sample comprised 20 patients of both sexes aged 11–15 years (mean age: 13.3 years), with permanent dentition, adequate oral hygiene, and mild tooth crowding, overjet, and overbite. Methods: A conventional metallic bracket Gemini?, and two different brands of self-ligating brackets — In-Ovation^®R and SmartClip? — were bonded to the maxillary incisors and canines. PI, GI, GBI scores, and GCF volume were measured before and 30 and 60 days after bonding of the brackets. Data were analysed statistically using non-parametric tests coefficient at a 5% significance level. Results: There was no statistically significant correlation (P?>?0.05) between tooth crowding, overjet, and overbite and the PI, GI, GBI scores, and GCF volume before bonding, indicating no influence of malocclusion on the clinical parameters. Regardless of the bracket design, no statistically significant difference (P?>?0.05) was found for GI, GBI scores. PI and GCF volume showed a significant difference among the brackets in different periods. In pairwise comparisons a significant difference was observed when compared before with 60 days after bonding, for the teeth bonded with SmartClip? self-ligating bracket, (PI P?=?0.009; GCF volume P?=?0.001). Conclusion: There was an increase in PI score and GCF volume 60 days after bonding of SmartClip? self-ligating brackets, indicating the influence of bracket design on these clinical parameters.     

缬昔洛韦的合成

目的;对缬昔洛韦的合成进行了研究。方法：以阿昔洛韦和Ｎ－苄氧羰基－Ｌ－缬氨酸为原料,经酰化,催化氢解反应得到了新型抗疱疹毒药物缬昔洛韦。结果;本品的元素分析,红外,质谱及核磁共振图谱数据与文献报道一致,总收率为４５．２％,结论;采用此法合成缬昔洛韦是可行的,适合于工业生产。     

β射线诱导人肝癌细胞凋亡

0　引言　凋亡或细胞程序性死亡是一种不同于细胞坏死的死亡方式 ,是在基因控制下的有序死亡 ,是一个主动性自杀过程 ,常伴有特征性形态学和生化变化 .临床上放射线治疗肿瘤主要应用射线诱导细胞凋亡这一机制 .1 88Re发射 2 110Ke V的 β射线 ,15 5 Ke Vγ射线 ,半衰期 17h,具有良好的核物理性质 .国外 1 88Re的研究主要在 1 88Re标记单克隆抗体对肿瘤的放射免疫治疗 ,并显示具有一定的疗效 ,而国内关于 1 88Re的研究较少 ,经文献检索未见有关于 1 88Re诱导细胞凋亡的报道 .本实验旨在研究 1 88Re-β射线诱导人肝癌细胞系 h HCC(human…