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61.
Summary It is generally accepted that osteoclasts are responsible for the breakdown and removal of bone matrix constituents. However,
very little is known about the fate of osteocytes during bone resorption. In the present study we have examined sites of bone
destruction in calvaria of young rats aged 4–9 days in the hope of obtaining information on the fate of osteocytes. Decalcified
glutaraldehyde-formaldehyde-fixed specimens were prepared for ultrathin section electron microscopy. When sequentially arranged,
the images obtained suggest that osteoclasts engulf and destroy osteocytes during bone degradation. We propose that the following
sequence of events takes place when a lacuna is opened up by an osteoclast: (1) When the osteoclast comes in contact with
an osteocyte, the villi of the ruffled border become flat and broad. (2) Long osteoclastic extensions surround the osteocyte.
(3) The osteocyte is subsequently internalized with apparent degradation. 相似文献
62.
E. I. Barengolts M. Berman S. C. Kukreja T. Kouznetsova C. Lin E. V. Chomka 《Calcified tissue international》1998,62(3):209-213
Estrogen deficiency is a risk factor for osteoporosis and coronary artery disease. Osteoporosis can be evaluated by measuring
bone mineral density (BMD). Coronary atherosclerotic burden can be evaluated by measuring coronary calcium using electron
beam computed tomography (EBT) of the heart. We compared coronary calcium scores in 45 asymptomatic postmenopausal women with
normal and low BMD. BMD of the lumbar spine and proximal femur was measured by dual X-ray absorptiometry (DXA), and coronary
calcium was measured quantitatively by EBT. Women were divided into control, osteopenia, and osteoporosis groups based on
the T score of the lumbar spine. Women were similar in age, years since menopause, height, weight, and body mass index (BMI).
BMD ± SD (g/cm2) of L1–L4 was 0.96 ± 0.11, 0.83 ± 0.03, and 0.73 ± 0.05, in control, osteopenia, and osteoporosis group, respectively. The
total coronary calcium score ± SD (relative units) was 41.9 ± 83.1, 115.1 ± 181.9, and 221.7 ± 355.4 for control, osteopenia,
and osteoporosis group, respectively; the score was significantly higher in the osteoporosis than in the control group. This
study provides initial data suggesting that women with osteoporosis may have a higher risk of developing coronary atherosclerosis. 相似文献
63.
小儿先天性髋关节脱位近年来应用术式的演变及其评估 总被引:5,自引:2,他引:3
本文介绍本院近4年来小儿先天性髋脱位治疗应用术式的演变。由20多年来一直喜欢用骨盆截骨术演变为近1年来用得最多的是造盖术。近4年共手术463例,565髋。实践证明:比起骨盆截骨术,造盖术显得更简便,侵袭小,不需二次手术拔除内固定针。因在我国大龄髋脱位偏多,造盖术更适合我国国情。经过一些改进,可以克服造盖折断和吸收问题。 相似文献
64.
P. Rokkanen O. Böstman E. Hirvensalo E. A. Mäkelä E. Partio H. Pätiälä S. Vainionpää K. Vihtonen P. Törmälä 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》1992,2(2):107-110
Résumé L'utilisation de matériaux d'ostéosynthèse biodégradables a l'avantage d'éviter la réintervention pour extraire le matériel. Les biomatériaux de polymères polyglycolides ont été expérimentés sur plus de 3 600 animaux de laboratoire avant leur introduction en pratique clinique. Depuis 1984 nous les avons utilisés comme matériau d'ostéosynthèse dans près de 1 700 cas parmi lesquels 880 cas de fracture malléolaire, 226 cas d'ostéotomie en chevron pour hallux valgus, 65 cas de fracture de la tête radiale et 54 cas de fracture de l'olécrane. Parmi les 800 premiers cas traités par broches biodégradables nous avons obtenu des résultats favorables et sans incidents dans 91 pour cent des cas. Il y eut 7 cas de fixation défaillante nécessitant une réintervention. Il y a eu 7 cas d'infection superficielle et 3 cas d'infection profonde. Nous avons observé la formation d'une collection séreuse sous-cutanée sans influence sur le résultat radiologique ou clinique dans 52 cas (6,5 %). Au vue de ces résultats et compte tenu des avantages économiques et psychologiques des matériaux biodégradables (pas de réintervention), on peut penser que l'usage de biomatériaux rivalise favorablement avec l'usage de matériaux conventionnels dans certains types d'ostéosynthèse.
Utilization of biodegradable implants in the surgical treatment of fractures and osteotomies
Summary The utilization of biodegradable implants instead of metals in orthopaedic surgery abolishes the need to remove the fixation material. For this study biodegradable rods and screws of self-reinforced polyglycolide, polylactide and lactide-glycolide copolymer were developed and manufactured. The clinical introduction of these implants was preceded by thorough experimental studies with 3 600 animals. From November 1984 the developed biodegradable method of osteofixation was used in 1 700 operations. These included 880 displaced malleolar fractures, 226 chevron-osteotomy for hallux valgus, 65 displaced fracture of the radial head, 54 displaced frature of the olecranon and other fresh fractures or orthopaedic operations. In the first 800 cases operated on using self-reinforced polyglycolide rods the postoperative course was uneventful (91%). Because of failure in the fixation reoperation was needed in 7 cases. A superficial wound infection was observed in 7 cases, deep infection in 3 and transient fluid accumulation in 52 cases (6,5%). Fluid accumulation did not influence the radiological or clinical end-result. The advantages of biodegradable fixation are many-sided. There is a costbenefit and clinical capacity is free for other use, and psychological advantages must be emphasised because removal of implants is not needed. The over all results of this study were considered favourable.相似文献
65.
Clanton C. Shipp Paul S. Berger Manya S. Deehr Bess Dawson-Hughes M.D. 《Calcified tissue international》1988,42(5):287-292
Summary Precision of dual-photon absorptiometry (DPA) measurements was determined in a lumbar spine phantom and in humans. Approximately
half of the measurements were made before and half after a153gadolinium source change. The phantom was measured with different amounts of acrylic, which simulates human soft tissue, in
order to evaluate the influence of body thickness on bone mineral density (BMD). Results of scans analyzed with two software
versions from Lunar Radiation Corp., the widely used 08B and a prototype 08C, are compared. DPA with a cold source significantly
overestimated BMD in the phantom in the presence of large amounts (more than 25 cm) of soft tissue equivalent with version
08B but not with the newer version 08C. Similiarly, in nine subjects, there was a significant decrease in spine BMD after
a source change when scans were analyzed with version 08B (mean difference 0.026 g/cm2,P=0.002) but not with 08C (0.01 g/cm2,P=0.234). No systematic effect of source change on femoral BMD measurements was observed. The SD of the mean difference of
two measurements of the nine subjects was 0.019 g/cm2 (1.6% of the mean value) for the spine with software version 08B and 0.024 g/cm2 (2.0%) with version 08C, 0.03 g/cm2 (3.3%) for the femur neck, 0.03 g/cm2 (4.0%) for the greater trochanter, and 0.04 g/cm2 (4.9%) for Ward's triangle region of the proximal femur. The spine phanton was scanned on two other commercial bone densitometers
in order to assess inter-instrument variation. Phantom measurements of L2-4 BMD made on two Lunar Radiation Corp model DP3
scanners which differed by 2% were 10 and 12% higher than those with a Norland Corp. model 2600 scanner. 相似文献
66.
作者自1988年1月至1993年12月收治Pilon骨折31例,根据Riled的分类祛:Ⅰ型5例,Ⅱ型10例,Ⅲ型16例.手术治疗22例,保守治疗9例.随访l-4年,疗效按Bourne的标准评定,Ⅰ型骨折手术或保守治疗优良率100%,Ⅱ、Ⅲ型骨折手术治疗优良率85%,保守治疗优良率33.3%.作者认为Pilon骨折Ⅱ、Ⅲ型应手术治疗.保守治疗仅用于Ⅰ型骨折.手术控AO的四步重建法进行.但严重的粉碎骨折或开放骨折伴软组织缺损,内固定确定难干实施者,则改用踝部超关节外固定支架固定. 相似文献
67.
N. Glajchen S. Thomas P. Jowell S. Epstein M.D. F. Ismail M. Fallon 《Calcified tissue international》1990,46(1):28-32
Summary The paucity of information on the effect of long-term high-dose salmon calcitonin administration on normal bone mineral metabolism
and histology prompted an investigation of the influence of high-dose synthetic calcitonin in the rat. Serum ionized calcium,
osteocalcin or BGP (bone gla protein), and immunoreactive PTH were measured serially during calcitonin administration and
bone histomorphometry analyzed at 6 weeks (after sacrifice). Daily injections of salmon calcitonin, 0.4 IU/100 g (group B)
and 2 IU/100 g (group C), resulted in significant hypocalcemia at 4 hours for both experimental groups (P<0.004). Serium iPTH was significantly higher over the study period for both groups administered calcitonin. Serum BGP levels
were significantly lower than controls during the study in group C (P<0.002) and to a lesser extent in group B (P<0.05). In group C, bone histomorphometry revealed increased resorption (onteoclast count), decreased trabecular bone volume,
and decreased double-labeled tetracycline surface (bone formation). In group B an increase in osteoclast count but no alteration
in bone formation was observed. To assess the role of PTH in the above findings, high-dose calcitonin was administered to
parathyroidectomized rats. All of the above changes in bone histomorphometry were not observed in this group of animals. In
conclusion, high doses of calcitonin promote hypocalcemia, secondary hyperparathyroidism, and osteoclastosis in the normal
rat in a dose-dependent manner with very high-dose calcitonin impairing bone formation. 相似文献
68.
69.
Tadeusz F. Wisniewski 《European Journal of Trauma》2004,30(2):120-123
AbstractBackground: Posterior acromioclavicular dislocation is rare.
Dislocation associated with fracture of the clavicle and
simultaneous entrapment of the lateral end of the clavicle by
trapezius muscle has not been reported. Posterior dislocation
occurs frequently owing to forceful move of the scapula
anteriorly and superiorly or from direct force applied to the
lateral end of the clavicle and this may be associated with
clavicular fracture. In acute dislocations, open reduction,
internal joint stabilization and soft tissues reconstruction
have been recommended.Case Study: Acute posterior dislocation occurred in a 32-year-old man.
The lateral end of the clavicle was displaced posteriorly and
inferiorly, and firmly entrapped in trapezius muscle. The
clavicular fracture was undisplaced. The coracoclavicular
ligaments were stretched but intact. Open reduction was secured
with two smooth Kirschner wires. The disrupted soft tissues were
repaired. The clavicular fracture was not explored. Shoulder
movement started at 6 weeks. Wires were removed. 10 years later
he had pain-free, unrestricted shoulder movement, and the
radiographs showed wellreduced, essentially normal
acromioclavicular joint.Conclusion: Open reduction, internal joint stabilization and soft
tissue reconstruction will result in return and long lasting
unrestricted pain-free function of the shoulder. 相似文献
70.
Abstract Kyphoplasty and vertebroplasty have become recognized procedures for the treatment of vertebral fractures, especially in patients
with osteoporosis. In most cases of osteoporotic spinal vertebral fracture in elderly patients, polymethylmethacrylate (PMMA)
cement is used to fill the defect and stabilize the vertebral body. The techniques of vertebroplasty and kyphoplasty differ
in the possibility of realignment and reconstruction of the vertebral body and spinal column. Long-term results in terms of
integration of the cement and bioreactivity of the vertebral body are still lacking; so, these procedures are still no options
in the treatment of younger patients. Vertebroplasty and kyphoplasty show different success in the management of fresh traumatic
spine fractures. The acute traumatic vertebral fracture has to be classified sensitively, to find the right indication for
cement augmentation. Mild acute compression fractures can be treated by vertebroplasty or kyphoplasty, severe compression
and burst fractures by combination of internal fixation and kyphoplasty. The indications for use of biological or osteoinductive
cement in spinal fracture management must still be regarded as restricted owing to the lack of basic biomechanical research
data. Such cement should not be used except in clinical studies. 相似文献