Biomedical subjects
Publications and source records attributed to J Gil-Albarova.
Synovial chondromatosis is an uncommon lesion, characterised by cartilaginous and osseous metaplasia of the joint synovium. It usually involves a large joint and rarely occurs in the hand. A case of tenosynovial chondromatosis of the third finger is reported.
We present the case of a 40-year-old man that presented a fast growing tumour on the external side of the left elbow. The tumour was extirpated by means of marginal exerectomy. The microscopic study corresponded to epithelioid malignant schwannoma, and the patient received radiotherapy and adjuvant chemotherapy. During the following years two local recidives and two new malignant schwannomas, one in the left sciatic common trunk and another paraspinal one, appeared and were extirpated. Radiotherapy and chemotherapy were again administered. In the last year, four new tumours have appeared: in the supraclavicular space, right posterior costofrenic, left costovertebral, and in the inferior abdominal wall, none of them has been extirpated or has hystologic diagnosis at the moment, however radiologic findings suggest malignant schwannomas. In this moment there is no neurologic deficiency except for the secondary ones to surgical procedures, and no neurofibromatosis types I to VII signs have been observed. So, the possibility of a new neurofibromatosis type is appointed.
We studied the effect of implantation of self-reinforced polyglycolic acid (SR-PGA) screws through the greater trochanter in rabbits. 15 rabbits aged 10 weeks had an SR-PGA screw inserted through the left trochanter physis. A similar drilling was made through the right greater trochanter without screw implantation. The animals were assigned to 3 groups of 5, and were killed after 1, 2 or 3 months. Radiographs of both femurs were obtained monthly and the articulo-trochanteric distance and the neck-shaft angle were measured. After killing the animals, a histological study was performed. The drilling on the right trochanter generated a bony bridge in all the animals. The SR-PGA screws did not give rise to an epiphysiodesis. The progressive peripheral degradation of the implants gave rise to the formation of only modest bridges, which were smaller in size than those observed in the control trochanter. Our findings suggest that absorbable PGA screws implanted through a growth plate cause only minor bone formation and no epiphyseodesis.
The effect of femoral elongation on skeletal muscle, nerves, and vessels was studied. Three groups of five lambs were used. After the intervention, the animals were killed at 2, 3, and 4 months. A left femoral elongation of 6 cm was practiced on all of them by means of callotasis, with a distraction rate of 0.5 mm every 12 hours. The femoral elongation process was evaluated by monthly x-ray films. The nucleic acid and protein levels in the muscular tissue were quantified at the level of the elongation focus and in the control extremity. The motor conduction velocity of the sciatic nerve was measured in both posterior limbs before the intervention and immediately before the lambs were killed. The arterial blood flow of both subsequent extremities was measured at the moment of death. A histological study of quadriceps muscle, sciatic nerves, artery, and subsequent femoral vein were examined histologically at the level of the elongation focus of both extremities. After elongation, no significant differences were observed in the muscle protein and nucleic acid levels with respect to the control extremity. No significant changes of the nerve conduction velocity were observed in any animal among the different groups. The arterial blood flow of the elongated extremity showed a progressive increase, reaching its maximum value 1 month after the distraction had terminated, with subsequent normalization. This increase of the blood flow was also observed in the control extremity, suggesting a possible systemic effect. The histological study revealed a comparative thickening of the endomysium and perimysium in the elongated muscle tissue, present at the end of the distraction and which was later normalized. No histological changes of the nerve stems undergoing distraction were observed either. During elongation, the arteries showed minimal histological changes. On the other hand, the veins showed areas of endothelial damage accompanied by thrombosis phenomena, especially at the end of the distraction period. The vascular morphology presented progressive normalization after the distraction phase.
We compared delayed distraction (DD) with immediate distraction (ID) in bone-lengthening. Open femoral diaphyseal osteotomy was performed on 24 three-month-old lambs, and external distractor fixators were applied. In the ID group (n 12), distraction commenced on the first postoperative day; in the DD group (n 12), distraction was delayed until the tenth day after surgery. In all the animals, the femur was lengthened by 2 cm at the rate of 1 mm/day. The animals were killed 1, 2, and 3 months postoperatively. Radiography and densitometry of the lengthened callus showed that DD, compared with ID, improved the quality of the callus with quicker, denser, and more homogeneous bone formation.
We investigated the lymphocyte-mediated immune response to polymethylmethacrylate bone cement in 26 patients who had revision surgery for aseptic loosening of cemented total hip arthroplasties, at a mean time of seven years after the first replacement. We studied eight patients with cemented total hip arthroplasties which were not loose as controls. Patch tests to polymethylmethacrylate bone cement were positive in 13 patients with loosening, and these patients had higher lymphoblast transformation values against polymethylmethacrylate bone cement patients with a negative skin reaction (p < 0.01) or those in the control group (p < 0.001). Specific monoclonal antibodies were used to assess the percentage of certain cells of the immune system according to their cluster of differentiation (CD). There was a higher number of total T and B lymphocytes (CD2 and CD22) and interleukin-2 receptor-positive lymphocytes (activated cells, CD25) in patients with loose prostheses. More CD25 lymphocytes were found in patients with positive patch tests. The activation of the lymphocyte-mediated immune response was not related to the presence or absence of aggressive granulomatous lesions at the cement-bone interface.
A 14-year-old boy had a congenital shortening of the first right metatarsal bone, with overloading of the central metatarsals and medial deviation of the second toe. A percutaneous osteotomy and slow distraction by an external fixator for 10 weeks lengthened the bone from 32 mm to 60 mm. After the distraction, a bone graft was performed, and tenotomies and a capsulotomy corrected a threatening subluxation. Consolidation of the lengthening focus required 16 weeks.
A 21-year-old man complained of pain and rigidity of the elbow with a flexion contracture of 100 degrees. A radiographic examination revealed an 1.5-cm osteolytic injury in the center of a sclerotic lesion in the distal humerus. The diagnosis of an osteoblastoma was later confirmed histologically. Once the tumor had been excised, the pain disappeared and functional mobility was reestablished.
The aim of the present article is to ascertain the differences between two surgical treatments commonly used in displaced radial neck fractures in children. We report the retrospective results of 20 displaced radial neck fractures with > 30 degrees of tilt (Judet grades 3-4) in children aged between 7 and 14 years treated with closed intramedullary pinning according to the Metaizeau technique (6 cases) or with arthrotomy and pinning (14 cases). Sex distribution was 14 girls and 6 boy. The average follow-up was 43 months. We found no relationship between delay in the surgical treatment and functional results. On the other hand, a relationship between residual final tilt and poorer functional results appears. The Metaizeau technique produced better results and fewer complications than arthrotomy and pinning, and, in our opinion, is the treatment of choice in this type of fracture.