The ultimate one-stop for cancer patients with bone metastases: new combined bone metastases clinic.
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Biomedical subjects
Publications and source records attributed to T Axelrod.
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Clinical and radiographic assessment of the results of 40 Swanson silicone ulnar head prosthesis implants in three different patient groups is presented. Twenty-eight were done for treatment of rheumatoid arthritis, eight for ulnoradial impingement after the Darrach procedure, and four for ulnocarpal impingement resulting from malunited Colles' fractures. Patients were reviewed 12 to 48 months after operation (mean, 29 months). Seventy-eight percent of patients reported relief of pain and improved function. Radiologic examination showed that all patients exhibited resorption of the distal ulna (mean 4.4 mm) and that resorption was worst in the group with rheumatoid arthritis. Bone resorption about the implant predisposed the cap to both side-to-side tilt and pistoning of the prosthesis on supination and pronation. There was a 10% revision rate because of silicone synovitis. Although clinical results remain satisfactory for patients with rheumatoid arthritis and ulnocarpal impingement, the radiologic results suggest that Swanson ulnar head replacement should be restricted to elderly patients with rheumatoid arthritis.
Malunions of distal radius fractures are commonplace. Patients are decreasingly willing to accept the disability that may be associated with them. While the first line of treatment is initial good fracture care, corrective osteotomies offer later opportunity for pain relief and improved function.
Intra-articular incongruity of the distal radius at the radiocarpal joint is a bad prognostic feature; reduction by closed or open operative techniques is important. However, both techniques have limitations. We describe a new technique of reduction of the lunate facet under radiographic control, with very limited operative exposure and tissue trauma. In two cases anatomic restoration of the radiocarpal joint was obtained by this technique and maintained with external and limited internal fixation. Follow-up results are very encouraging. Currently we suggest use of this simple technique when faced with an incongruous radiocarpal joint after unsatisfactory attempts at closed reduction.
Male rats were injected with 5, 10, and 20 mg diphenylhydantoin daily for two months and then caged for five days with cyclic females. Thereafter the males underwent necropsy, the organs of the genital tract were examined, and found to be unaffected. Blood testosterone and Leydig cell counts were normal. A significant reduction of fertility was observed which appears to be loss of libido on behavioural grounds. Except for similar behavioural changes described in human epileptics no further reports are available concerning anticonvulsants and fertility. Our findings indicate that there is no reason to suspect that diphenylhydantoin had endocrine-mediated effects on male fertility in the rat.
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Antigen presenting cells may have a direct bearing on the results of allotransplantation of bone. There is no doubt that these cells are neither T nor B lymphocytes and that they do reside in the bone marrow. Evidence suggests that these bone marrow cells are of the granulocyte lineage and that they initiate immunologic reactions in vitro. The removal of bone marrow that contains these cells from bone allografts would decrease the immunologic response to the implantation of such transplants.