Presenting randomised trial reports.
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Croatia↗
Biomedical subjects
A Marusić
Publications and source records attributed to A Marusić.
Sensitivity to metals in 40 patients with failed hip endoprosthesis.
Hypersensitivity to metals and tissue reaction around a failed implant were investigated in 40 patients undergoing revision hip arthroplasty. Metal sensitivity was tested using a standard cutaneous patch test. Nine patients were positive for chromium, nickel, cobalt, metal rust or endoprosthesis scrapings, or combinations of these allergens. Patients with positive or negative patch test did not differ in terms of their age, sex, primary diagnosis, number of endoprosthesis revisions, length of implant function, presence of other metal parts around the implant, circulating immunocomplexes, and histological appearance of the tissue around the implant. We conclude that stainless steel endoprostheses may be safely used for repeated revision hip arthroplasty, and that hypersensitivity to metals probably does not play a significant role in the loosening of the endoprosthesis.
Adult↗
Peer review in the Croatian Medical Journal from 1992 to 1996.
We analyzed the peer review process in the Croatian Medical Journal (CMJ) from 1992 to 1996 by a retrospective analysis of review forms for 319 manuscripts. The forms asked about manuscript's structure (7 questions), its scientific value (7-item scale), clarity and length, and final recommendation (5-item scale). An international manuscript had at least one author affiliated with a non-Croatian institution. The overall rejection rate of manuscripts was 23.5%. National and international manuscripts had similar rejection rates except for original research manuscripts in clinical sciences (34.7% vs. 18.9%, p=0.046). Out-door peer review was asked for 77.4% of the manuscripts; other manuscripts were commissioned and passed an in-house review. Over the years, the number of international reviewers increased, and that of national reviewers decreased. National reviewers more often did not fill in the review form, and international reviewers more often asked for a major revision. The agreement between reviewers ranged from 34.1% (scientific value) to 90.7% (reference citations). Kappa for inter-rater agreement was poor to fair, without difference between national and international manuscripts. International manuscripts had shorter median review time (from receipt to decision) and publishing time (from acceptance to publication) than national manuscripts: 58 vs. 112 days (p<0.001), and 116 vs. 140 days (p<0.009), respectively. Our analysis shows that peer review can be introduced and sustained in a small journal from the scientific periphery. It can be fair both to national and international manuscripts, although work with the authors of national manuscripts may be needed to improve the quality of data presentation.
Croatia↗
Bone turnover in homozygous beta 2-microglobulin knock-out mice does not differ from that of their heterozygous littermates.
beta 2-Microglobulin is a constituent of the class I major histocompatibility complex (MHC) molecule and crucial for its normal function in cell recognition. It has also been isolated from bone and shown to regulate bone metabolism and to be altered in various bone diseases. In order to further investigate the role of the immune system in bone metabolism, we studied basic properties of bone physiology in beta 2-microglobulin-deficient mice created by the technique of gene knock-out. Ten week-old male offspring homozygous (non-functional class I MHC molecule) or heterozygous (functional class I MHC molecule) for beta 2-microglobulin knock-out gene did not differ in the following measures of bone turnover: femur length, dry and ash weight and calcium content, serum calcium concentration and alkaline phosphatase activity, total vertebral tissue area, trabecular bone volume, osteid surface, osteoclast surface and mineral apposition rate. These data indicate that the bone turnover in beta 2-microglobulin-deficient mice is appropriate for the stage of their skeletal maturation.
Animals↗
The role of tumor necrosis factor-alpha in the generation of acute phase response and bone loss in rats and talc granulomatosis.
BACKGROUND: Trabecular bone loss is the part of acute-phase response (APR) in rats with subcutaneous granulomatous inflammation induced by talc. EXPERIMENTAL DESIGN: We investigated the possible involvement of inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha) in the pathogenesis of bone loss and other aspects of APR. Intraperitoneal administration of specific neutralizing antibodies to TNF-alpha or of recombinant cytokine indicated that TNF-alpha was the primary mediator of bone changes, evidence as slower bone elongation rate, bone marrow hyperplasia, and decreased trabecular bone volume and osteoblast number in tibial metaphysis. RESULTS: Moreover, direct intraosseal administration of anti-TNF-alpha antibody neutralized the effect of inflammation on bone. On the other hand, the serum indices of the APR (decreased zinc and iron concentrations, ACTH and C-reactive protein concentration) were not greatly affected after the administration of anti-TNF antibody, except for the normalization of the hypercupremia and weight loss. CONCLUSIONS: The data presented in this report demonstrated direct involvement of TNF-alpha in the generation of bone alterations during the development of APR in rats with talc granulomatosis.
Acute-Phase Reaction↗
Role of 1,25-dihydroxyvitamin D3 in the generation of the acute-phase response in rats with talc-induced granulomatosis.
Subcutaneous injection of nonspecific irritants such as magnesium silicate (talc) provokes granulomatous inflammation in the rat. Part of the acute phase response (APR) in these animals is the loss of trabecular bone at sites distant from the site of inflammation. To assess the possible involvement of vitamin D in the bone loss, we studied the development of the acute phase response in vitamin D-deprived rats. The serum APR provoked by subcutaneous inflammation in rachitic rats consisted of hypozincemia, hypercupremia, increased alkaline phosphatase activity and adrenocorticotropic hormone (ACTH) concentration, and was similar to that in control animals except for the absence of hypoferremia. Control rats with talc-induced subcutaneous inflammation also had splenomegaly and decreased total and mononuclear peripheral blood cell counts, while subcutaneous inflammation did not induce spleen changes in rachitic rats. Subcutaneous inflammation induced the loss of trabecular bone and decreased the osteoblastic cell count in tibial metaphyses in control animals. Rachitic rats had abundant osteoid on trabecular surfaces, and the number of osteoblasts and osteoclasts was comparable to that of the controls. Subcutaneous inflammation did not affect any of the bone parameters in rachitic rats. These results indicate that vitamin D plays an important role in the generation of the acute phase response during inflammation, particularly in the induction of spleen and bone cell changes. The discrepancy of the blood on one hand and bone and spleen indices of the APR on the other, indicate that they may be divergent pathways in the generation of the inflammatory response, some of which may be dependent on vitamin D.
Acute-Phase Reaction↗
Psychological disturbances among 47 Croatian prisoners of war tortured in detention camps.
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Concentration Camps↗
Protecting the population in occupied areas of Croatia.
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Croatia↗
Production of leukemia inhibitory factor mRNA and protein by malignant and immortalized bone cells.
Leukemia inhibitory factor (LIF) is a recently characterized glycoprotein with complex biologic activities on bone cells. We tested various rodent and human immortalized and malignant bone cell lines and primary osteoblast-enriched cell cultures from fetal rat calvarial digests for expression of LIF mRNA and LIF protein. Both human and rodent immortalized and malignant cells expressed a single 4.4 kb mRNA transcript that hybridized to a human LIF cDNA probe in Northern blots. LIF mRNA was undetectable in unstimulated rodent osteoblast-like cells lines MC3T3-E1 and Py1a. However, treatment with LPS (10 micrograms/ml), TGF-beta (1 ng/ml), TNF-alpha (100 ng/ml) or inhibitors of protein synthesis (cycloheximide, emetine, puromycin, and anisomycin) induced the expression of LIF message in these cells. In contrast, primary osteoblast-enriched cells did not express LIF mRNA in Northern blot assays either constitutively or after treatment with TNF-alpha or cycloheximide. The human osteosarcoma cells lines U-2 OS and Saos-2 constitutively expressed LIF mRNA and did not respond to LPS treatment. However, phorbol myristate acetate (PMA), an activator of protein kinase C, was a potent stimulator of LIF message in Saos-2 but not U-2 OS cells. The effects of PMA (0.5 ng/ml) on LIF mRNA in Saos-2 cells were detectable at 1 h and maximal at 6 h. TNF-alpha (100 ng/ml) and inhibitors of protein synthesis also increased LIF mRNA in both Saos-2 and U-2 OS cells. LIF protein was also detected constitutively in the conditioned medium from both Saos and U-2 OS cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
New bone induction by demineralized bone matrix in immunosuppressed rats.
Subcutaneous implantation of demineralized bone matrix (DBM) initiates a sequence of developmental events which culminate in endochondral bone formation. To test the effects of T-cell deficiency on new bone formation, the morphology of DBM-induced bone was examined in rats thymectomized at three weeks of age and in thymectomized or nonthymectomized rats lethally irradiated and reconstituted with syngeneic bone marrow. At 24 days after implantation, bone induction in control rats was appropriate for their age, while thymectomized-irradiated-reconstituted rats and thymectomized rats had significantly more new bone and larger bone marrow space than the controls. In non-thymectomized, irradiated and reconstituted rats, bone induction occurred in only 25% of the animals, compared to 95% in other groups.
Age Factors↗
Effects of transforming growth factor-beta and IL-1 alpha on prostaglandin synthesis in serum-deprived osteoblastic cells.
We investigated the effects that the combination of IL-1 alpha and transforming growth factor-beta (TGF-beta) had on PGE2 production in a murine clonal osteoblastic cell line MC3T3-E1 and primary rat calvarial osteoblast-like cells. In serum-supplemented medium, IL-1 alpha was a potent stimulator of PGE2 production in MC3T3-E1 cells (50-fold increase with 0.1 ng/ml). TGF-beta (10 ng/ml) had only a small effect alone and no additional effect on IL-1 alpha-induced responses. In serum-deprived MC3T3-E1 cells, PGE2 responses to IL-1 alpha were either absent or markedly reduced. TGF-beta alone had small effects. However, simultaneous addition of TGF-beta with IL-1 alpha to MC3T3-E1 cells partially restored the ability of IL-1 alpha to generate a PGE2 response (10-fold increase in PGE2 with 0.1 ng/ml of both IL-1 alpha and TGF-beta). As with MC3T3-E1 cells, serum-deprived primary fetal rat calvarial osteoblastic cells also did not respond to IL-1 alpha, unless TGF-beta was present in the medium (sixfold increase in PGE2 with 0.1 ng/ml IL-1 alpha and 10 ng/ml TGF-beta). The synergistic effect of TGF-beta and IL-1 alpha was specific for PGE2 responses, because these factors did not synergistically affect cell proliferation, collagen and noncollagen protein synthesis, or alkaline phosphatase activity. The observed synergy was not associated with changes in the steady state cyclooxygenase (PGH synthase) mRNA levels. However, it did correlate with increased release of [3H]arachidonic acid from prelabeled serum-depleted MC3T3-E1 cells. Hence, the synergistic interactions of IL-1 alpha and TGF-beta on PGE2 appear to occur through an increase in the release of arachidonic acid substrate from phospholipid pools. These effects may be important for both normal bone turnover and the responses of bone to inflammatory and immune stimuli.
Alkaline Phosphatase↗
Acute zinc deficiency and trabecular bone loss in rats with talc granulomatosis.
Subcutaneous inflammation induced by magnesium silicate (talc) leads to the suppression of bone elongation, osteoblast insufficiency, and subsequent bone loss in rats. Since bone and immunological changes in talc granulomatosis are similar to those observed in zinc deficiency, we investigated the kinetics of zinc tissue distribution and the effects of zinc supplementation on the development of bone loss in rats with talc-induced inflammation. Decrease in serum zinc concentration was observed between 5 and 15 h in rats with talc granulomatosis. It was paralleled by the accumulation of zinc in the liver and rapid disappearance of osteoblasts from the trabecular bone surfaces. However, talc-injected rats supplemented parenterally and orally with zinc sulfate exhibited a decrease in osteoblast trabecular surface comparable to that of unsupplemented rats bearing granulomas despite normalized serum zinc concentrations. Zinc supplementation slightly increased osteoblast trabecular surface in all supplemented groups, but this effect was not significant. We conclude that zinc is the earliest indicator of the acute-phase response in rats with talc granulomatosis. Although zinc appears to be important for the normal function of bone cells, there is no causative relationship between acute zinc deficiency and decreased osteoblast number and activity in rats with talc granulomatosis.
Acute-Phase Reaction↗
Cortisol modulates the actions of interleukin-1 alpha on bone formation, resorption, and prostaglandin production in cultured mouse parietal bones.
Previous studies have shown that both interleukin-1 (IL-1) and glucocorticoids inhibit collagen synthesis in bone organ and cell cultures. In this study we examined their interactions in cultured neonatal mouse parietal bones. IL-1 alpha stimulated [3H]thymidine incorporation. Cortisol decreased thymidine incorporation, but did not block the effect of IL-1. Both cortisol and IL-1 alpha decreased the incorporation of [3H]proline into collagenase-digestible protein (CDP) and reduced alpha 1(I)procollagen mRNA levels at 72 h. Noncollagen protein (NCP) labeling was increased by IL-1 and decreased by cortisol. In the presence of cortisol, IL-1 alpha (6 pM) increased CDP as well as NCP labeling. The increase in CDP labeling was paralleled by an increase in alpha 1(I)procollagen mRNA, suggesting a pretranslational site for the cortisol-IL-1 alpha interaction. In the same bones, cortisol consistently blocked IL-1 alpha-stimulated 45Ca release and prostaglandin E2 (PGE2) production. The ability of IL-1 alpha to increase CDP in the presence of cortisol was the same in the presence or absence of indomethacin, an inhibitor of PGE2 synthesis, or aphidicholin (30 microM), an inhibitor of DNA synthesis, indicating that the reversal was neither PG mediated nor dependent on cell proliferation. In conclusion, our results demonstrate that IL-1 inhibits collagen, but not NCP or DNA, synthesis and that cortisol inhibits IL-1 alpha-induced bone resorption and PGE2 production and reverses its inhibitory effect on collagen synthesis in cultured neonatal mouse calvariae.
Animals↗
Holographic analysis of the human pelvis.
Twelve fresh human pelves with preserved lumbar spines, hip joints, and ligaments, were tested by double-exposure and sandwich-hologram interferometry. During physiologic loadings (50-300 N), the pelvis moved as a whole downward and backward. Iliac wings exhibited marked undulation, except for the central part, which showed minor deformations. The sacrum moved downward and rotated forward over an axis 5-9 cm below the promontorium. Removal of the sacroiliac interosseous ligaments eliminated all joint movements and caused a tighter contact between articular surfaces. Removal of the sacrotuberous and sacrospinous ligaments had no influence on the pelvic behavior. The magnitudes of deformations as well as their underlying mineral contents were unequally distributed between the two pelvic sides. These results indicate that the sacroiliac interosseous ligaments are the main determinant of sacral movement. Asymmetric load transmittance to the hip joints might be responsible for the mineral content differences between the pelvic sides.
Adult↗
Talc granulomatosis in the rat. Involvement of bone in the acute-phase response.
We investigated the dynamics of the acute-phase response (APR) and osteoblast trabecular surface in rats with subcutaneous inflammation provoked by magnesium silicate (talc). The first visible indicator of the APR was a rapid and profound hypozincemia, paralleled by a decrease in metaphyseal trabecular surfaces covered with osteoblasts in long bones. Both the intensity of serum APR and the decrease in osteoblast trabecular surface were directly proportional to the number of granulomas. Alterations in bone metabolism were specific for the inflammation, whereas mild hypozincemia and decrease in mononuclear and increase in polymorphonuclear peripheral white blood cell fractions developed in animals pair-fed with rats bearing two or four granulomas. Rats with talc granulomatosis had high serum ACTH and corticosterone levels, but neither adrenalectomy nor high doses of hydrocortisone could revert bone alterations in talc-injected animals. Glucocorticoids were necessary for the development of hypozincemia and hypercupremia seen in talc granulomatosis, as well as for normal bone metabolism. Inhibition of prostaglandin synthesis had no effect on bone alterations and serum APR in rats bearing talc-induced granulomas. We conclude that the decrease in bone formation constitutes an important aspect of the host acute-phase response in a rat model of talc granulomatosis.
Acute-Phase Reaction↗
Cellular and morphological changes in lymphoid organs after a single injection of interleukin 1 alpha in the mouse.
We investigated the effects of a single i.v. injection of recombinant human interleukin 1 alpha (IL-1 alpha) on the morphology and the cellularity of several lymphoid organs in normal mice. The injection of 100 U of IL-1 alpha resulted in maximal neutrophilia and leukocytosis at 1 h. By 72 h, the numbers of mononuclears, but not that of polymorphonuclears, returned to baseline levels. Absolute increase in mononuclears was paralleled by relative lymphopenia. Changes in the peripheral blood coincided with rapid decrease in the spleen cellularity and white pulp volume (especially the marginal zone), and an increase in the red pulp volume. Bone marrow cellularity was increased at 1 h, but returned to control levels by 6 h after IL-1 injection. Thymus cell depletion and cortex atrophy were maximal at 6 h and could be observed throughout the experiment. These findings indicate that leukocytosis induced by a single i.v. injection of IL-1 alpha in normal mice is concomitant with a rapid cell depletion of the spleen and thymus. Morphological and cellular changes in lymphoid organs may represent the mobilization of immunocompetent cells during the development of the inflammatory response.
Animals↗
New bone formation in autologous membranous bone transplanted into the anterior abdominal wall.
During a gross anatomy dissection, a piece of the calvarial bone was found between aponeuroses of the anterior abdominal wall in an 82-year-old male cadaver. It corresponded closely in size to the calvarial defect after the neurosurgery performed 5 years before death, showing that very little resorption had occurred over the years. Moreover, 13 percent of the transplant was new bone, indicating that membranous bone can, in the long term, induce new bone formation in humans.
Abdominal Muscles↗
Immunosuppression induced by talc granulomatosis in the rat.
Granulomatosis caused by four subcutaneous talc powder-suspension injections induced strong immunosuppression in rats. The disturbance included reduction of mononuclear white blood cell count in the peripheral blood, atrophy of the thymic cortex, spleen enlargement with predominance of red over the white pulp, increase in the number of lymph node germinal centres and a significant delay of the first-set and second-set allograft rejection. Neither phagocytic function of reticuloendothelial system nor erythrocyte count and humoral immune response were found to be altered. Indomethacin suppression of prostaglandin production did not normalize the allograft rejection dynamics. In contrast, splenectomy completely abolished the immunosuppressive effects of granulomatosis. In splenectomized, talc-treated animals WBC counts were not altered and the rejection of allografts was not delayed. Suppression of immune response to alloantigens was transferred to normal and splenectomized recipients by both serum and spleen cells of talc-injected animals. Also, in a cell mixture-transfer experiment, spleen cells from talc-granulomatosis-bearing donors suppressed the immune response induced by lymph node cells from immune donors in T cell-deficient rats. The inability of serum from splenectomized talc-injected rats to transfer the suppression suggested the crucial role of the spleen in the mechanisms leading to suppression in rats bearing talc-granulomatosis.
Animals↗