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Evaluation of bone remodeling in regard to the age of scaphoid non-unions

World Journal of Orthopedics 2016年第7期7卷 418-425页

作者： susanne rein Uwe Hanisch Hans-Eberhard Schaller Hans Zwipp Stefan Rammelt Stefan Weindel Department of Plastic and Hand Surgery Burn UnitTrauma Center Bergmannstrost Center of Orthopaedics and Traumatology University Medicine "Carl Gustav Carus" DresdenTechnicalUniversity Dresden Institute of Pathology "Carl Thiem" Hospital Deptartment of Plastic Hand Reconstructive and Burn SurgeryTrauma Center Tuebingen University Deptartment of Hand Aesthetic and Plastic SurgeryHospital of Linth

AIM: To analyse bone remodeling in regard to the age of scaphoid non-unions(SNU) with ***: Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin(HE), tartrate resistant acid phosphatase(TRAP), CD 68, osteocalcin(OC) and osteopontin(OP). Histological examination was performed in a blinded ***: The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU(P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts(P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts(P = 0.008; r = 0.43). SNU older than 6 mo showed a signifi-cant decrease of the number of fibroblasts(P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in ***: Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.

关键词： Bone remodeling Histology Immunohistological staining Scaphoid non-union Scaphoid Wrist joint

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Anemia and long-term outcome in adjuvant and neoadjuvant radiochemotherapy of stage Ⅱ and Ⅲ rectal adenocarcinoma:The Freiburg experience(1989-2002)

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World Journal of Gastroenterology 2006年第12期12卷 1849-1858页

作者： Christian Weissenberger Geissler Michael Otto Florian Barke Annette Henne Karl von Plehn Georg rein Alex Müller Christine Bartelt susanne Henke Michael Department of Radiotherapy University Hospital of Freiburg79106 FreiburgGermany Department Oncology Gastroenterology and Internal MedicineStidtische Kliniken Esslingen73730 Esslingen a.N.Germany Department of Internal Medicine I Division of OncologyUniversity Hospital of Freiburg79106 FreiburgGermany

AIM： To evaluate the long-term outcome of standard 5-FU based adjuvant or neoadjuvant radiochemotherapy and to identify the predictive factors, especially anemia before and after radiotherapy as well as hemoglobin increase or decrease during radiotherapy. METHODS： Two hundred and eighty-six patients with Union International Contre Cancer （UICC） stage Ⅱ and Ⅲ rectal adenocarcinomas, who underwent resection by conventional surgical techniques （low anterior or abdominoperineal resection）, received either postoperative （n = 233） or preoperative （n = 53） radiochemotherapy from January 1989 until July 2002. Overall survival （OAS）, cancer-specific survival （CSS）, disease-free survival （DFS）, local-relapse-free （LRS） and distant-relapse-free survival （DRS） were evaluated using Kaplan-Meier, Log-rank test and Cox＇s proportional hazards as statistical methods. Multivariate analysis was used to identify prognostic factors. Median follow-up time was 8 years. RESULTS： Anemia before radiochemotherapy was an independent prognostic factor for improved DFS （risk ratio 0.76, P= 0.04） as well as stage, grading, R status （free radial margins）, type of surgery, carcinoembryonic antigen （CEA） levels, and gender. The univariate analysis revealed that anemia was associated with impaired LRS（better local control） but with improved DFS. In contrast, hemoglobin decrease during radiotherapy was an independent risk factor for DFS （risk ratio 1.97, P= 0.04）. During radiotherapy, only 30.8% of R0-resected patients suffered from hemoglobin decrease compared to 55.6% if R1/2 resection was performed （P= 0.04）. The 5-year OAS, CSS, DFS, LRS and DRS were 47.0%, 60.0%, 41.4%, 67.2%, and 84.3%, respectively. Significant differences between preoperative and postoperative radiochemotherapy were not found. CONCLUSION ： Anemia before radiochemotherapy and hemoglobin decrease during radiotherapy have no predictive value for the outcome of rectal cancer. Stage, grading, R status （free radial margins）, t

关键词： Rectal cancer Adjuvant radiotherapy Adjuvant radiochemotherapy Anemia Procjnostic factor

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