PubMed · 11022701
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K Endo. 2000. [Bone scintigraphy].. https://pubmed.ncbi.nlm.nih.gov/11022701/
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LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the indications for the use of free-tissue transfer in lower extremity reconstruction. 2. Understand modalities to enhance the healing and care of soft tissue and bone before free-tissue transfer. 3. Understand the lower extremity reconstructive ladder and the place of free-tissue transfer on the ladder. 4. Understand the specific principles of leg, foot, and ankle reconstruction. 5. Understand the factors that influence the decision to perform an immediate versus a delayed reconstruction. Free-tissue transfer using microsurgical techniques is now routine for the salvage of traumatized lower extremities. Indications for microvascular tissue transplantation for lower extremity reconstruction include high-energy injuries, most middle and distal-third tibial wounds, radiation wounds, osteomyelitis, nonunions, and tumor reconstruction. The authors discuss the techniques and indications for lower extremity reconstruction.
Patients with cancer that has metastasized to bone will frequently develop functional problems that may respond to rehabilitative treatment. Many rehabilitation professionals, however, are concerned about the possibility of producing pathologic fracture with their treatment. Several methods have been proposed for identifying which malignant lesions in bone are at risk of fracture. In this article, these methods are reviewed and statistical analyses of them are presented. The risk of rehabilitating patients with bony metastases is also reviewed, as are the reported outcomes of these rehabilitation efforts. Standard approaches to the rehabilitation of these patients have evolved, although most of them have not been rigorously validated, and these are discussed. None of the methods for identifying lesions at risk of pathologic fracture are useful in other than long bones, and they are limited even there. The risk of producing pathologic fractures in cancer patients by increasing mobility and function, however, is low. Satisfactory outcomes have been demonstrated in attempting to rehabilitate patients who have had recent surgical repair of pathologic or impending fractures. Rehabilitation of cancer patients with bony metastases can be safely and effectively accomplished using standard approaches to the treatment of these patients.
Mitochondrial permeability transition (MPT) and cytochrome c redistribution from mitochondria are two events associated with apoptosis. We investigated whether an MPT event obligatorily leads to cytochrome c release in vivo. We have previously shown that treatment of human osteosarcoma cells with the protonophore m-chlorophenylhydrazone (CCCP) for 6 h induces MPT and mitochondrial swelling without significant cell death. Here we demonstrate that release of cytochrome c does not occur and the cells remain viable even after 72 h of treatment with CCCP. Bax is not mobilized to mitochondria under these conditions. However, subsequent exposure of CCCP-treated cells to etoposide or staurosporine for 48 h results in rapid cell death and cytochrome c release that is accompanied by Bax association with mitochondria, demonstrating competency of these mitochondria to release cytochrome c with additional triggers. Our findings suggest that MPT is not a sufficient condition, in itself, to effect cytochrome c release.