Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population

We carried out an anthropometric analysis using three dimensional computer tomographic measurements of the cut surface of the proximal tibia in 200 knees that were obtained from 50 male and 50 female Korean cadavers. We measured the mediolateral (ML), middle anteroposterior (AP), medial and lateral anteroposterior dimensions and the aspect ratio (ML/AP) of the resected proximal tibial surface; we then compared this data with the five conventionally used symmetric total knee components. We found that the ML (73.5+/-5.6 mm) and AP (47.3+/-3.8 mm) average dimensions of our study population were smaller than the dimensions of the symmetric commercially available TKA implants. We found a progressive decrease in the aspect ratio with the increasing anteroposterior dimension of the proximal tibia, as compared to the constant aspect ratio shown by the conventional tibial prostheses. The smaller sized prostheses were found to show mediolateral undersizing and the larger sized prostheses were found to show mediolateral overhang. This study may provide guidelines for designing a suitable tibial component of total knee prostheses for the Korean population, the aspect ratio of which decreases with increasing anteroposterior dimension.     

Actualités thérapeutiques dans le cancer du rein métastatique

Introduction

For some years, therapeutic management of metastatic renal cancers benefits from considerable progress.

Point

Define the efficiency of antiangiogenic molecules and the new recommendations of the treatment of metastatic renal cancer.

Material and methods

An English bibliographical search was realized from the data bank Medline (PubMed) using the following keywords: renal cell carcinoma, immunotherapy, antiangiogenic drugs, and tyrosine kinase inhibitors, and about 20 published articles were consulted including phases II and III randomized trials.

Results

Since 2004, the treatment ofmetastatic renal cancer is constantly changing. Before, the treatment was based essentially on the use of cytokines determining the era of the immunotherapy. At present, the studies of the tumoral biology as well as the genetic aspects of the pathology showed the utility of new molecules with the antiangiogenic properties, which were able to define new therapeutic standards. The results of these targeted therapies concern especially the improvement of the progression-free survival with the sunitinib or the bevacizumab used in the first line of treatment, or with the sorafenib used in second line. The inhibitors of m-TOR (temsirolimus) can be usedwith a benefit on the overall survival in the cases of metastatic renal cancers with bad prognosis.

Conclusion

In spite of the current therapeutic progress, the prognosis of metastatic renal cancer is still bad. Consequently, it is important to intensify the researches and to follow any therapeutic development.     

Chimiothérapie néo-adjuvante par doxorubicine et vinorelbine dans le traitement d’un cancer du sein pendant la grossesse: cas clinique et revue de la littérature

Introduction

Little published data is available about chemotherapy in pregnant women, particularly concerning the use of vinorelbine, or the association of vinorelbine and anthracyclines in a neoadjuvant context. The focus of this paper is a case study of a woman in the second trimester of pregnancy who presented with locally advanced breast cancer.

Case

A 42-year-old pregnant woman with a T4bN1M0 breast cancer who received neoadjuvant chemotherapy including doxorubicin (60 mg/m²) and vinorelbine (30 mg/m² day 1 and 8) every three weeks for four cycles, from the 26^th to the 38^th week of gestation. During the 38^th week of pregnancy the patient spontaneously delivered a male infant whose birthweight and Apgar score were normal. The newborn did not have any anomalies. The patient experienced a clinical improvement with a response rate of 50%. The child showed normal development and growth at 26 months.

Discussion

Combined chemotherapy including doxorubicin and vinorelbine should be taken into consideration as neoadjuvant treatment for pregnant women with locally advanced breast cancer.

     

Nipple adenoma in a man: An unusual case report

Adenomatosis (adenoma, papillary adenoma, florid papillomatosis) of the nipple is a rare benign disorder involving the nipple witch can be mistaken clinically for Paget's disease and pathologically can be misinterpreted as an adenocarcinoma. It occurs mostly in middle-aged women and is extremely rare in adolescents and children. We report a 55-year-old man with an adenomatosis of the nipple evolving positively after surgery.     

Neutrophil proteinase 3 and dipeptidyl peptidase I (cathepsin C) as pharmacological targets in granulomatosis with polyangiitis (Wegener granulomatosis)

Neutrophils are among the first cells implicated in acute inflammation. Leaving the blood circulation, they quickly migrate through the interstitial space of tissues and liberate oxidants and other antimicrobial proteins together with serine proteinases. Neutrophil elastase, cathepsin G, proteinase 3 (PR3), and neutrophil serine protease 4 are four hematopoietic serine proteases activated by dipeptidyl peptidase I during neutrophil maturation and are mainly stored in cytoplasmic azurophilic granules. They regulate inflammatory and immune responses after their release from activated neutrophils at inflammatory sites. Membrane-bound PR3 (mbPR3) at the neutrophil surface is the prime antigenic target of antineutrophil cytoplasmic autoantibodies (ANCA) in granulomatosis with polyangiitis (GPA), a vasculitis of small blood vessels and granulomatous inflammation of the upper and/or lower respiratory tracts. The interaction of ANCA with mbPR3 results in excessive activation of neutrophils to produce reactive oxygen species and liberation of granular proteinases to the pericellular environment. In this review, we focus on PR3 and dipeptidyl peptidase I as attractive pharmacological targets whose inhibition is expected to attenuate autoimmune activation of neutrophils in GPA.