Allogeneic platelet gel with autologous cancellous bone graft for the treatment of a large bone defect

BACKGROUND/AIMS: A 50-year-old type 2 diabetic male with a comminuted fracture of the tibia and delayed union after insufficient initial osteosynthesis with a resulting pseudoarthrosis was treated operatively by using a graft composed of platelet gel mixed with autologous cancellous bone. The essential idea of this therapy was to combine the healing capacities of platelet-derived growth factors and osteogenic stem cells and the modeling capacity of the gel. Due to a history of diabetes, allogeneic instead of autologous platelets were used. METHODS: The allogeneic platelet concentrate was ABO- and RhD-matched, leukocyte-depleted, irradiated and activated by human thrombin. The defect of 45 ml was filled with the graft mixture and fixed with an external fixator. RESULTS: Postoperative care was uneventful. After 6 months the graft was incorporated, the bone defect was fully bridged and full weight-bearing capacity was achieved. No side effects were observed and no platelet or HLA class I antibodies were detected. CONCLUSION: This case report shows that the clinical use of allogeneic platelet-derived growth factors is feasible and that a prospective study is necessary to prove the effectiveness and reproducibility of this therapeutic approach.     

Osteolytic lesions marker in multiple myeloma

The degradation product of collagen type I carboxy terminal telopeptide (ICTP) represents a new biochemical parameter that reflects the changes in the resorption properties of skeletal system. Affection of the skeleton is one of the most important characteristics of multiple myeloma (MM). We estimated significance of ICTP as osteolysis predictor and overall survival in comparison with standard prognostic parameters β₂-microglobulin and C-reactive protein (CRP), in patients with MM. With our results, we have shown significant difference in serum level of ICTP (P = 0.009) between patients with and without osteolysis on conventional radiography. It was proved that ICTP is the most significant predictor of osteolysis (P = 0.09), while CRP is the most significant risk factor for overall survival (P < 0.01). Being highly significant predictor of osteolysis, ICTP can be used for identification of patients with MM who had increased risk for developing osteolytic lesions.     

Different clinical severity of first episodes and recurrences of thrombotic thrombocytopenic purpura

The clinical course of thrombotic thrombocytopenic purpura (TTP) is characterized by recurrent disease episodes in up to 50% of cases. The clinical presentation and severity of different TTP episodes have not been systematically compared. Laboratory and clinical information from 51 patients with recurrent disease, derived from 136 patients with TTP included in the Milan TTP registry (URL: http://www.ttpdatabase.org), were used to compare mortality, symptoms and disease-related laboratory measurements in different disease episodes. The prevalence of severe neurological symptoms (coma, seizures, and focal neurological defects) was significantly lower in recurrences than in the first episode. Platelet counts and haemoglobin levels at presentation were higher in recurrences than in the first disease episode, and lactate dehydrogenase levels were lower. Also, mortality tended to be lower in the second and third disease episodes than in the first. Recurrences of TTP are generally milder than first episodes. These differences in severity should be taken into account in clinical research on TTP and in patient management.     

Influence of calcium on the action of Vipera ammodytes ammodytes snake venom on the myocardium

V. ammodytes ammodytes snake venom produced irreversible block of the isolated, artificially stimulated rat right ventricle or isolated rat heart. This was the result of degenerative changes of the myocardium caused by the direct effect of toxic components of the venom. An excess of Ca²⁺ could temporarily restart the contractions.     

Vasculitis in rheumatoid arthritis--case report

The presence of positive rheumatoid factor (RF) titer in a patient with rheumatoid arthritis (RA) is of clinical value because its presence tends to correlate with the development of extraarticular manifestations. There is a loose correlation with severity of disease and titer. Extraarticular manifestations includes vasculitis, pericarditis, subcutaneous nodules, pulmonary nodules or interstitial fibrosis, episcleritis and mononeuritis multiplex. The vasculitis is most frequently evidenced as skin infarctions/ulcerations and mononeuritis multiplex. We report a case of rheumatoid vasculitis in a 48 years old women with long history of RA, who developed vasculitis of distal arteries with gangrene of digits of upper and lower extremities.     

The biological lavelling and 75Se of protein antigens of Fasciola hepatica

Adult liver flukes were incubated for several hours at 37° in a culture medium containing ⁷⁵Se-L-selenomethionine. Analysis of homogenates of the parasite showed that significant amounts of isotope had become incorporated into parasite proteins. Separation of the fluke proteins on Sephadex G-100 demonstrated the highest specific activity in the most serologically active protein fractions.