OBJECTIVE: Our aim was to evaluate the cartilage cap of osteochondromas using T2 maps and to compare these values to those of normal patellar cartilage, from age and gender matched controls. MATERIALS AND METHODS: This study was approved by the Institutional Review Board and request for informed consent was waived. Eleven children (ages 5-17 years) with osteochondromas underwent MR imaging, which included T2-weighted fat suppressed and T2 relaxation time mapping (echo time = 9-99/repetition time = 1500 msec) sequences. Lesion origins were femur (n = 5), tibia (n = 3), fibula (n = 2), and scapula (n = 1). Signal intensity of the cartilage cap, thickness, mean T2 relaxation times, and T2 spatial variation (mean T2 relaxation times as a function of distance) were evaluated. Findings were compared to those of patellar cartilage from a group of age and gender matched subjects. RESULTS: The cartilage caps showed a fluid-like high T2 signal, with mean thickness of 4.8 mm. The mean value of mean T2 relaxation times of the osteochondromas was 264.0 +/- 80.4 msec (range, 151.0-366.0 msec). Mean T2 relaxation times were significantly longer than the values from patellar cartilage (39.0 msec) (p < 0.0001). These findings were observed with T2 spatial variation plots across the entire distance of the cartilage cap, with the most pronounced difference in the middle section of the cartilage. CONCLUSION: Longer T2 relaxation times of the cartilage caps of osteochondromas should be considered as normal, and likely to reflect an increased water content, different microstructure and component.
Adolescent ; Bone Neoplasms/*pathology ; Cartilage, Articular/*pathology ; Child ; Child, Preschool ; Female ; Femur ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Osteochondroma/*pathology ; Patella/*pathology ; Retrospective Studies ; Tibia

OBJECTIVES: The spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Patients typically present with sudden onset back pain followed by neurological deficits. METHODS: Diagnosis of SSEH is usually made with MRI and standard treatment is surgical evacuation. In 1996, Groen published the most comprehensive review on the SSEH in which he analyzed 333 cases. We review 104 cases of SSEH presented in the English literature since the last major review and add three of our own cases, for a total of 107 cases. RESULTS: Our patients presented with back pain and neurologic deficits. Two made excellent functional recovery with prompt surgical decompression while one continued to have significant deficits despite evacuation. Better postoperative outcome was associated with less initial neurological dysfunction, shorter time to operation from symptom onset and male patients. CONCLUSION: We discuss the etiology of SSEH and report current trends in diagnosis, treatment, and outcome.
Back Pain ; Decompression, Surgical ; Hematoma, Epidural, Spinal ; Humans ; Male ; Neurologic Manifestations ; Retrospective Studies

Although heparin is better known as an anticoagulant, it also has several anti-inflammatory effects. Heparin is known to inhibit neutrophil adhesion, chemotaxis and oxygen free radical production. In addition, heparin is also known to act as an oxygen radical scavenger. Our hypothesis was that heparin would attenuate renal ischemia reperfusion injury. In this study, we investigated whether heparin had a protective effect on renal ischemia reperfusion injury. Sheep (n = 12) were prepared for the chronic study with venous, arterial and urinary catheters inserted. In addition, pneumatic occluders and ultrasonic flow probes were placed on renal arteries. After a 5-day recovery period, the sheep were randomized to either a heparin treatment group (400 IU/kg i.v. bolus 10 minutes before renal artery occlusion, followed by a continuous effusion 25,000 IU in 250 ml of 0.9% NaCl at 10 ml/hr, n = 6) or a control group (n = 6), which received an equivalent volume of 0.9% NaCl. All the sheep then underwent 90 minutes of bilateral renal ischemia followed by 24 hours of reperfusion. Blood urea nitrogen (BUN), serum creatinine (Scr), and creatinine clearance (CrCl) were determined at various intervals during both the ischemic and reperfusion periods. Kidney tissue samples were obtained at autopsy for histologic examination. As a result, there were significant differences in the degree of inflammation (1.50 +/- 1.24 Vs 0.50 +/- 0.79, P < 0.05) between the control and heparin treatment groups, but not in the degree of injury (2.83 +/- 0.44 Vs 2.33 +/- 0.28). In this study, heparin significantly attenuated polymorphonuclear leukocytes (PMNs) infiltration within the interstitium, but it did not affect the degree of renal damage as measured by urinary chemistries or renal tubular damage as assessed by histopathologic evaluation.
Animal ; Anticoagulants/pharmacology* ; Cell Movement/drug effects ; Female ; Heparin/pharmacology* ; Ischemia/pathology* ; Kidney/pathology ; Kidney/drug effects* ; Neutrophils/physiology ; Neutrophils/drug effects* ; Renal Circulation* ; Reperfusion Injury/pathology* ; Sheep

Objectives　To observe the gene expression of rat osteoblasts treated with titanium particles and to identify the novel genes which may be related to the periprosthetic osteolysis.　Methods　Neonatal rat osteoblasts were grown in DME medium with 10% bovine serum, and 0.1% titanium particles were added to the medium when the cells reached 80% confluency.After 24 hours，the total RNA was isolated.Messenger RNA differential display techniques were used to compare the differences between the treated and the control group. Furthermore，the differentially displayed gene fragments were isolated，reamplified，and cloned for reverse northern hybridization，northern hybridization and sequencing. The sequences were compared with GenBank database using the BLAST network service at the National Center for Biotechnology Information（NCBI）.　Results　35 fragments were differentially displayed between tho two groups. Of the 35 fragments that were analyzed by reverse northern hybridization，the 5 positive genes were sequenced and compared with NCBI.One of the five positive genes, named G46T, showed 92% homology with mouse macrophage-derived monocyte chemotactic protein-3. The other 4 positives were unknown genes.　Conclusions　Titanium particles may alter the gene expression of rat osteoblasts.G46T gene may be related with periprosthetic osteolysis.

Objectives　To observe the gene expression of rat osteoblasts treated with titanium particles and to identify the novel genes which may be related to the periprosthetic osteolysis.　Methods　Neonatal rat osteoblasts were grown in DME medium with 10% bovine serum, and 0.1% titanium particles were added to the medium when the cells reached 80% confluency.After 24 hours，the total RNA was isolated.Messenger RNA differential display techniques were used to compare the differences between the treated and the control group. Furthermore，the differentially displayed gene fragments were isolated，reamplified，and cloned for reverse northern hybridization，northern hybridization and sequencing. The sequences were compared with GenBank database using the BLAST network service at the National Center for Biotechnology Information（NCBI）.　Results　35 fragments were differentially displayed between tho two groups. Of the 35 fragments that were analyzed by reverse northern hybridization，the 5 positive genes were sequenced and compared with NCBI.One of the five positive genes, named G46T, showed 92% homology with mouse macrophage-derived monocyte chemotactic protein-3. The other 4 positives were unknown genes.　Conclusions　Titanium particles may alter the gene expression of rat osteoblasts.G46T gene may be related with periprosthetic osteolysis.

PURPOSE: This study evaluated the expression level of Receptor Activator of NF-kappaB Ligand (RANKL), Osteoprotegerin (OPG)and other pro-inflammatory cytokines in the osteoarthritic and periprosthetic joint fluid in order to characterize the role of these regulatory proteins in periprosthetic osteolysis. MATERIALS AND METHODS: Joint fluid specimens taken from 47 patients undergoing hip or knee reconstructive surgery were analyzed by enzyme-linked immunoassay (ELISA)in order to determine the relative protein expression level of RANKL, OPG, IL-1beta, IL-6 and TNF-alpha. The fluid from joints with osteoarthritis (15 cases, Group I), implants revised without associated osteolysis (15 cases, Group II)and failed implants with radiographically moderate to severe osteolysis (17 cases, Group III) were compared. The fluids from all cases with implants (Group II and III) was combined (Group IV)and compared with the osteoarthritic joint fluids. RESULTS: RANKL was present in all the fluids at similar concentrations. The OPG levels were significantly lower (2.2-3.9 fold)in Groups II and III than in Group I (p<0.0001). The IL-1beta concentration was significantly higher in Groups II, III and IV and with Group III being the highest (12.1 fold)(p<0.0001). The IL-6 expression level was significantly higher in Group III (2.0 fold)than in Groups I and II (p<0.0001). The TNF-alpha levels were 2.0 times higher in Group III and significantly higher in all implant cases (Group IV)are analyzed (p=0.03). CONCLUSION: Permissive RANKL protein expression coupled with suppressed OPG levels and enhanced osteoclastogenic cytokine expression results in periprosthetic osteolysis.
Cytokines ; Hip ; Humans ; Immunoassay ; Interleukin-6 ; Joints* ; Knee ; Osteoarthritis ; Osteolysis* ; Osteoprotegerin ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; Tumor Necrosis Factor-alpha

BACKGROUND: Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. METHODS: This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. RESULTS: The mean age of patients was 61.0±8.3 years old, with a mean body mass index of 28.4±4.8 kg/m², 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of 28.7±22.8 months. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. CONCLUSIONS: This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.
Abdominal Wall ; Abscess ; Body Mass Index ; Comorbidity ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Abdominal ; Herniorrhaphy ; Humans ; Hypertension ; Immunosuppression ; Incisional Hernia ; Kidney Transplantation ; Kidney ; Liver Transplantation ; Liver ; Male ; Organ Transplantation ; Recurrence ; Retrospective Studies ; Seroma ; Surgical Mesh ; Tobacco Use ; Transplants

No abstract available.
Exosomes* ; Lymphatic System* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Oligodontia is the congenital absence of six or more teeth and comprises the more severe forms of tooth agenesis. Many genes have been implicated in the etiology of tooth agenesis, which is highly variable in its clinical presentation. The purpose of this study was to identify associations between genetic mutations and clinical features of oligodontia patients. An online systematic search of papers published from January 1992 to June 2021 identified 381 oligodontia cases meeting the eligibility criteria of causative gene mutation, phenotype description, and radiographic records. Additionally, ten families with oligodontia were recruited and their genetic etiologies were determined by whole-exome sequence analyses. We identified a novel mutation in WNT10A (c.99_105dup) and eight previously reported mutations in WNT10A (c.433 G > A; c.682 T > A; c.318 C > G; c.511.C > T; c.321 C > A), EDAR (c.581 C > T), and LRP6 (c.1003 C > T, c.2747 G > T). Collectively, 20 different causative genes were implicated among those 393 cases with oligodontia. For each causative gene, the mean number of missing teeth per case and the frequency of teeth missing at each position were calculated. Genotype-phenotype correlation analysis indicated that molars agenesis is more likely linked to PAX9 mutations, mandibular first premolar agenesis is least associated with PAX9 mutations. Mandibular incisors and maxillary lateral incisor agenesis are most closely linked to EDA mutations.
Humans ; Phenotype ; Wnt Proteins