Effect of ethane-1-hydroxy-1,1-diphosphonate (EHDP) and dichloromethylene diphosphonate (Cl2MDP) on the calcification and resorption of cartilage and bone in the tibial epiphysis and metaphysis of rats

Young male rats (70–90 g) were treated for various periods with several doses of disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) or disodium dichloromethylene diphosphonate (Cl₂MDP). Effects of treatment on the changes in the thickness, growth and mineralization of proximal growth plate and metaphysis of the tibia were assessed histologically and by micro-radiography. High doses (10 or 30 mg P/kg/day) of EHDP impaired mineralization of the growth cartilage, which became increased in thickness, and of the osteoid in the metaphysis and diaphysis. Matrix formation continued, although at a diminished rate. High doses (10 or 30 mg P/kg/day) of Cl₂MDP produced a different effect. There was no inhibition of mineralization, but there was a marked impairment of normal metaphyseal remodelling, with persistence of columns of calcified cartilage. Resorption at the periosteal surface in the metaphysis was also inhibited, so that the metaphysis became club-shaped. Osteoclasts were present in large numbers in the metaphysis, but their appearance was abnormal and similar to that seen in human osteopetrosis.     

Effects of high sucrose cariogenic diets with varied protein-calorie levels on the bones and teeth of the rat

The systemic effects of high sucrose cariogenic diets and dental changes other than caries induction were studied in rats. Diets were evaluated for protein quantity and quality in terms of NDpCal %. The molar teeth were smaller and weighed less than normal. Incisor teeth lost the usual orange pigmentation, and the mandible and femur were smaller in size than normal. These changes were present to a less marked degree when the cariogenic diet was of a nutritional standard liekly to be accepted as adequate unless special investigations were made. It is suggested that in order to exclude borderline protein-calorie deficiency and side effects influencing mineralisation processes, precautions are necessary in the use of high sucrose diets.

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Zusammenfassung Die Ganzkörperwirkung von sucrosereichen, karieserzeugenden Nahrungen sowie die nicht durch Karies hervorgerufenen Zahnveränderungen wurden an Ratten untersucht. Die Nahrungen wurden auf ihren quantitativen und qualitativen Proteingehalt geprüft, ausgedrückt als Nettoprozent der Kalorien entsprechend den Nahrungsproteinen (Net Dietary Protein Calories Per Cent). Die Molare waren kleiner und leichter als normal. Die Schneidezähne verloren ihre übliche orangefarbene Pigmentation. Mandibula und Femur waren kleiner als normal. Diese Veränderungen fanden sich weniger ausgeprägt, wenn man die kariogene Nahrung so zusammensetzte, daß sie als adaequat gelten konnte, außer wenn ganz spezielle Prüfungen vorgenommen wurden.Es wird vorgeschlagen, daß bei Anwendung hochdosierter Sucrose-Nahrungen Vorsichtsmaßnahmen nötig sind, um einen möglichen Mangel an Proteinkalorien sowie Nebenwirkungen, die den Mineralisationsprozeß beeinflussen, ausschließen zu können.

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Résumé Les effets généraux de régimes cariogènes, riches en saccharose, ainsi que les altérations dentaires, autres que la carie, ont été étudiés chez le rat. Les régimes sont testés pour leur contenu protéique et leur qualité en terme de NDpCal %. Les molaires sont plus petites et pèsent moins que les témoins. Les incisives perdent leur pigmentation orange et le fémur et la mandibule sont diminués de taille. Ces changements s'observent moins nettement, lorsque le régime cariogène présente des qualités nutritives «acceptables» à moins d'effectuer des recherches particulières. Pour éviter des déficiences en protéines et calories, ainsi que des effets secondaires, altérant le processus de minéralisation, il semble nécessaire d'être prudent en utilisant des régimes riches en saccharose.

     

原发性骨淋巴瘤误诊1例

患者,男,16岁,左髋部疼痛、活动受限半年加重1个月,于2010年4月21日入院。半年前出现低热盗汗症状,随后感左髋部疼痛、活动受限,休息后不能缓解。就治于甘肃徽县中医医院,诊断：左髋化脓性关节炎,抗炎治疗效果不佳。     

Ultrasound imaging in musculoskeletal injuries-What the Orthopaedic surgeon needs to know

Patients with musculoskeletal complaints have either been ignored or advised investigations far beyond their means or comfort. Focusing attention only on spine and head restricted the evaluation in cases of trauma and were followed up only if the injuries were life threatening. In the same vein, the extremities often got overlooked or at best were evaluated only by plain radiographs. Soft tissue injuries were therefore often missed and not only raised the morbidity in the patient but also dissatisfaction towards the treating physician. Recent exponential improvement in medical ultrasound technology has revolutionised the field of musculoskeletal imaging. Cutting-edge technology using state-of-the-art machines and high-frequency transducers have placed it in a stronger position as compared to in the past in many aspects of musculoskeletal imaging. Also, with better techniques and understanding of the modality, under given set of circumstances MSK ultrasound has far reaching results allowing for detailed evaluation of soft tissues including nerves, ligaments and tendons.     

骨组织工程中的间质干细胞：成骨活性、免疫特性、促血管化及成骨效应

BACKGROUND: It is still a challenge to repair bone defects caused by trauma, infection, tumor and congenital diseases. Bone tissue engineering is a promising method for bone defect repair showing important guiding significance in the clinic. OBJECTIVE: To review the progress of proliferation, osteogenic activity, immunogenicity, proangiogensis and in vivo osteogenic effect of mesenchymal stem cells in bone tissue engineering. METHODS: The first author retrieved Wanfang and PubMed datebase for literatures published from 2008 to 2016, using the keywords of “mesenchymal stem cell, tissue engineering, osteogenesis, immune property, angiogenesis” in Chinese and English, respectively. Articles regarding mesenchymal stem cells, tissue engineering, osteogenesis, immune property and angiogenesis were included, and repetitive and dated studies were excluded. Totally 1 772 articles were retrieved initially, and in accordance with inclusion and exclusion criteria, 41 eligible articles were included for review analysis. RESULTS AND CONCLUSION: Bone marrow mesenchymal stem cells and adipose-derived mesenchymal stem cells are extensively applied in bone tissue engineering. Studies have shown that the osteogenic activity of bone marrow mesenchymal stem cells is higher than that of adipose-derived mesenchymal stem cells, but its immune regulation effect is weaker than that of adipose-derived mesenchymal stem cells. Mesenchymal stem cells hold remarkable immune regulation (immunosuppression and immune enhancement) and tissue repair capacity, which can eliminate inflammatory reactions at injured sites, promoting tissue repair. Adipose-derived mesenchymal stem cells cultured under hypoxia environment can secret more angiogenic cytokines generating more vascular structures. Furthermore, increasing proof have confirmed that porous nano-polylactic acid combined with nano-carbon biological material can significantly promote the proliferation and osteogenesis of bone marrow mesenchymal stem cells. Taking its tumorigenesis into consideration, mesenchymal stem cells should be prudently used in the clinic. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

手术治疗骨转移癌

目的报道手术治疗骨转移癌的临床经验。方法１９８８年２月－１９９７年３月共手术治疗骨转移癌８９例。其中男５８例,女３１例。年龄１０－７４岁,其中４１－７０岁７２例,占８０．９％。其最好发部位分别是脊柱２３例,股骨２２例和骨盆１３例,而最常见的原发肿瘤分别是肺癌２２例,肝癌１１例。手术可分止痛、稳定瘤骨和肿瘤切除三大类。结果８９例中,７７例（８６．５２％）疼痛缓解或消失。７３例获随访（１－９年）,１例术后３天死亡,术后３个月内死亡６例,４－６个月死亡７例,７－９个月死亡１２例,１０－１２个月死亡１８例,１－２年死亡１５例,５例２年以后死亡,至今存活９例,其中１例甲状腺癌脊柱转移者已存活６年。结论　骨转移癌手术的目的是缓解疼痛、改善生存质量和在可能情况下延长生命,而骨转移癌患者的生存时间主要与原发癌的组织学特征有关而与手术本身关系不大。     

应用Ilizarov技术治疗长管状骨缺损性骨不连

目的探讨和总结应用Ilizarov技术治疗长管状骨复杂缺损性骨不连的重建方式及疗效。方法1996年1月至2005年1月,收治长管状骨缺损性骨不连患者61例,男46例,女15例;年龄6～55岁,平均28.2岁。胫骨29例,股骨9例,肱骨11例,桡骨7例,尺骨5例。骨缺损长度4～14cm,平均6.4cm。选择骨缺损4￣6cm的30例患者行Ilizarov截骨肢体延长术,骨缺损6￣9cm的21例患者行Ilizarov骨节段截骨后传送延长术,骨缺损超过9cm的10例患者行同侧腓骨转移结合Ilizarov架固定术。平均骨延长4.8cm;随访时间10～84个月,平均47个月。结果61例骨缺损最终均达到骨性愈合,平均带架时间9个月,平均骨愈合时间7.1个月。21例78个针道低度感染和积液,原因为针道骨吸收和针道局部清洁护理差。1例腓骨转移患者带架期间摔伤后再骨折。股骨轴向偏移<3mm、向前外侧成角<10°者5例,其中股骨3例,肱骨2例,经调架后逐步矫正。结论应用Ilizarov技术修复长管状骨复杂缺损性骨不连的原则是彻底切除病灶,其次是考虑功能重建。Ilizarov技术是治疗长管状骨复杂缺损性骨不连、成功重建肢体长度的有效方法。     

Anatomy and pathology of the sesamoid bones

Summary The sesamoid bones were studied in 100 hands and feet in 50 cadavers and in 1000 radiographs of the hands of South Sinai Bedouin children. The sesamoids of the metacarpophalangeal joint of the thumb and metatarsophalangeal joints of the hallux were always present in the dissections and radiographs. Other sesamoids were observed in the radiographs of the metacarpophalangeal joints of the index finger in 50% of the cases, the middle finger in 3%, the ring finger in 1% and the little finger in 70%. Sesamoids were also seen in 62% of the interphalangeal joints of the thumb. There are differences between the hand and the foot in relation to the occurrence of degenerative changes in the joints. In the thumb, the metacarpophalangeal joint is involved macroscopically in 75% of the cases, and only in 13% of the radiographs, with the pathological changes located in one or the other part of the joint. In the hallux, 40% of the cases are involved both macroscopically and in radiographs, but all the parts of the joint are affected.

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Résumé Pour étudier les os sésamoïdes (OS), 100 mains et 50 pieds ont été disséqués sur le cadavre et les radiographies des mains de 1000 enfants bédouins du sud Sinaï ont été examinées.Les os des articulations métacarpo-phalangienne du pouce et métatarso-phalangienne du gros orteil, ont toujours été retrouvés, aussi bien dans les dissections que sur les radiographies. Les autres OS observés dans l'articulation MP se répartissent ainsi: index: 50% des cas; médius: 3%; annulaire: 1%; petit doigt: 70%. Ils ont été mis en évidence dans 62% des cas au niveau de l'articulations interphalangienne du pouce.Il y a des différences entre la main et le pied dans la fréquence des changements dégénératifs de ces articulations. Au niveau du pouce l'articulation n'a été trouvée affectée que dans 75% des cas à l'examen macroscopique et dans 13% seulement à l'examen radiographique. Les modifications pathologiques atteignaient l'une des deux extrémités articulaires. Pour le gros orteil, 40% des cas pathologiques ont été décelés tant à l'examen macroscopique que radiologique, mais dans cette localisation tous les composants de l'articulation étaient affectés.

     

Determination of Background Gradients with Diffusion MR Imaging

A new magnetic resonance (MR) imaging technique, opposite-polarity pulsed-field-gradient technique, with which the effects of background magnetic field gradients can be separated from the effects of diffusion, is described. It is based on the processing of two sets of diffusion-weighted images, the acquisition parameters of which differ only in the polarity of the applied diffusion pulses. The two effects can be separated because the cross term (b_c) of the gradient factor function is antisymmetric with respect to reversal of the sign of the applied diffusion pulses. The technique permits simultaneous measurement of the spatial distribution of both the diffusion constants and background magnetic field gradients, with the same spatial resolution as the parent images from which they were derived. The technique has been validated with a phantom in which the spatial distribution of susceptibility-induced background gradients is known, the results showing excellent agreement with theory. The technique was applied to two systems in which the spatial distribution of the background gradient is unknown. Sources of error in the measurement of background gradients and (unrestricted) diffusion constants are analyzed, including the effects of voxel size, partial volumes, and interactions between background and imaging gradients.     

Dynamic contrast-enhanced MR imaging of musculoskeletal tumors: Basic principles and clinical applications

The purpose of this article is to review the basic principles and clinical applications of dynamic contrast-enhanced MRI in the musculoskeletal system. This method of physiologic imaging provides clinically useful information by depicting tissue vascularization and perfusion, capillary permeability, and composition of the interstitial space. Different imaging, evaluation, and postprocessing techniques are described. The most important applications in the musculoskeletal system are identification of areas of viable tumor for biopsy, tissue characterization, and monitoring of preoperative chemotherapy. Practical guidelines for performing a dynamic contrast-enhanced MR examination are proposed.