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An evaluation of total hip replacement patients requires objective criteria that allow for the measurement of any changes in the biomechanics of the prosthesis and the effects of these changes on clinical findings. An evaluation of loading and joint movement during walking in these patients has been dealt with by many authors. In this study 15 patients who had undergone total hip replacement for coxarthrosis primary or secondary to congenital dysplasia were examined by kinematic and kinetic gait analysis, clinical evaluation, and radiographic evaluation of the position of the neocenter of prosthetic joint rotation. The patients with prostheses in congenital dysplasia presented with a pattern of walking that was significantly modified. In agreement with what is reported in the literature proximal positioning had less influence on gait parameters as compared to lateral dislocation. Furthermore, changes in positioning observed did not seem to have negative effects on joint loading, measured indirectly by the calculation of joint moments.

A retrospective analysis was performed to assess the efficacy of various treatments of non-Hodgkin's primary bone lymphomas (PBL).Fifty-two consecutive, previously untreated PBL patients were seen between the years 1982 and 1998. Information was obtained regarding each patient's presentation and clinical course. Histology was reviewed in all cases. Modern immunohistochemical stains were performed on each case.Regarding therapeutic approach, we observed a complete response (CR) in 35/41 (85%) patients treated with chemotherapy with/without radiation therapy and in 7/11 (64%) patients who received radiation therapy alone. Relapses were observed in only 2/35 (6%) patients after chemotherapy (with/without radiation therapy), as compared with 4/7 (57%) patients after radiation therapy alone (p = 0.004); the relapse-free survival curves of these two subsets were significantly different. At both univariate and multivariate analysis only type of front-line therapeutic approach (chemotherapy with/without radiation therapy vs. radiation therapy alone) turned out to have a significant prognostic influence.Our data indicate that in PBL use of chemotherapy or combined-modality therapy seems to provide more durable CRs than radiation therapy alone.

Fitek cementless cups have been adopted in our department in 1989. The first 100 consecutive Fitek implants were analyzed clinically (Harris hip score) and radiographically (anteroposterior and lateral x-rays) with a mean follow-up of 9.7 years. We did not have any case of cup loosening or any other problem requiring cup revision. In this series, we had 86 excellent, 10 good, 2 fair, and 2 poor results. The 2 poor results were because of 2 cases of aseptic loosening of the stem (1 cemented and 1 cementless). The x-rays showed an average angle of cup inclination of 36.5 degrees (range 16 degrees -54 degrees ) after surgery and no variations at the last follow-up. Bidimensional linear wear of the acetabular component showed 6 cases of measurable wear with an average wear rate per year of 0.265 mm. The overall wear rate per year was 0.02 mm. At the time of the last follow-up examination, we had 3 femoral osteolysis and no case of acetabular osteolysis. In our series, we observed "lack of contact" zones above the polar depression in 71 cases immediately after surgery. The average thickness of these lines was 1 (range 0.5-3.5) mm. Of these, at the last follow-up, 61 cases (86%) showed a complete "filling" of the "lack of contact," whereas in 10 (24%), the "filling" was incomplete (4 cases still showing a radiolucent line [

Although TNF-related apoptosis-inducing ligand (TRAIL) usually induces cell death in tumor cells, there are some tumor cell types that are resistant to its apoptogenic effects. Some chemotherapeutic drugs, however, can sensitize resistant cancer cells to TRAIL by either upregulating surface TRAIL death receptor expression or by modulating intracellular signalling pathways emanating from TRAIL receptors. U2OS human osteosarcoma cells express TRAIL-R2 but are resistant to TRAIL-induced apoptosis. however, the genotoxic drugs, Doxorubicin and Cisplatin, are able to sensitize U2OS cells to TRAIL, without affecting their surface expression of either death or decoy TRAIL receptors. We demonstrate that Doxorubicin and Cisplatin downmodulate X-IAP, while not affecting FLIP levels in U2OS cells. Selective downmodulation of X-IAP protein synthesis by specific small interference RNA transfection induced a sensitization of U2OS cells to TRAIL comparable to that induced by pharmacological treatment with genotoxic drugs. TRAIL-R2 downmodulation by siRNAs completely abolished the TRAIL-induced apoptosis of genotoxin-treated U2OS cells. Our findings demonstrate that Doxorubicin and Cisplatin do not sensitize U2OS osteosarcoma cells to TRAIL by surface receptor modulation but rather by the removal of the intracellular signalling inhibition generated by X-IAP, suggesting a foreseeable relevant advantage to the therapy of these tumors by the combined regimen of genotoxin-based chemotherapy and TRAIL.

The B203.13 monoclonal antibody was developed by immunizing mice with the B/monocyte biphenotypic cell line B1b. During normal hematopoiesis B203.13 is expressed on a fraction of CD34+ cells, while on mature cells it is only present on B-lymphocytes. We tested this antibody as a marker of childhood B-acute lymphoblastic leukemia (B-ALL). Bone marrow aspirates from 139 cases of early B-ALL and 25 controls were studied. About 40% of the B-ALL patients expressed B203.13. In these patients, B203.13 was constantly co-expressed with CD10, but never co-expressed with CD20, contrary to the controls. The CD10(+)/B203.13(+) phenotype was specific to B-ALL, since CD10(+)/CD20(+) cells from common acute lymphoblastic leukemia (c-ALL) did not express B203.13. We concluded that the use of B203.13 in association with CD10 and CD20 provides meaningful information for distinguishing normal residual B-cells from leukemic B-lymphoblasts and that recurrence of a CD10(+)/B203.13(+) phenotype after transplantation may be a very early relapse indicator of early B-acute lymphoblastic leukemia.