תוצאת חיפוש

Biological Test for Menopausal Osteoporosis

Benjamin Klein, Nathan Rojansky

Depts. of Experimental Surgery and of Obstetrics and Gynecology, Hadassah- Hebrew University Medical Center, Ein Kerem, Jerusalem

Osteoporosis has become a major public health problem in many western countries in which about 25% of women by the age of 65 will have had osteopenic fractures. The most important contributing factor to this condition is loss of gonadal function. This progressive disease, characterized by reduction in bone mass, may be prevented by estrogen replacement therapy. While there are several methods of diagnosing the disease when already established, there is no method that can identify women at high risk of developing osteoporosis. We have developed a biological test in which the serum of postmenopausal women is added to rat osteoprogenitor cell culture and its influence on proliferation, differentiation and mineralization of bone cells is determined. The serum of 20 menopausal women was examined by the biological test and the results compared to the findings of dual photon absorptiometry. This showed that rapid bone-losers had a significantly lower mineralization index as compared to nonosteopenic women (p<0.0001). The proliferation index (cell count) and alkaline phosphatase activity did not show significant differences between osteopenic and nonosteopenic groups. This preliminary study showed that a test based on serum reacting with a culture of bone cells to induce mineralization may be of value in the diagnosis of osteoporosis.

Patterns of Injuries and Preventive Measures for Motorcycle Accidents

D. Soffer, Y. Galili, N. Nasralla, D. Aladgem, O. Ablai, Y. Kluger

Depts. of Surgery B and C, Trauma Services, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University

Retrospective analysis of a series of 32 motorcyclists admitted after road accidents was performed. 62% were injured on scooters with 50 cc engine capacity and most of the combined injuries occurred in this group. Most crashes occurred at road junctions.Riders of scooters with larger engine capacities tended to wear protective garments as opposed to riders with smaller engines. There was no correlation between engine capacity and severity of injury. We conclude that motorcyclists should receive special education, especially as to behavior on entering road junctions. We recommend that taxes on protective garments should be lowered in order to encourage motorcyclists to use them.

Leg-Lengthening For Length Inequality

Zvia Burgansky, Abraham Ganel, Uri Givon

Pediatric Orthopedics Unit, Chaim Sheba Medical Center, Tel Hashomer (Affiliated with the Sackler Faculty of Medicine, Tel Aviv University)

32 patients (age range 1.5-22 years) were treated for leg-length discrepancy. 39 lengthening procedures were performed of which 36 involved gradual distraction, in 2 cases chondrodiasthesis was used, and 1 had 1-step elongation. Gradual distraction was done according to Ilizarov, including corticotomy and a 1-week delay before the initiation of distraction. In 33 cases Wagner's external fixator was used, in 2 an Ilizarov frame and in 1 an orthofix fixator. There was complete clinical and radiological union in all but 1 case. Significant correction of leg-length discrepancy and equalization of leg-length was achieved in most patients. In some growing patients over-correction was successfully achieved. The most prevalent complications were pin-site problems, axis deviation, joint subluxation and joint contractures. At latest follow-up most of these complications had disappeared. 91% of the patients either functioned normal or were only mildly limited.

Maggot Therapy for Gangrene and Osteomyelitis

K.Y. Mumcuoglu, M. Lipo, I. Ioffe-Uspensky, J. Miller, R. Galun

Dept. of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem

5 patients with diabetic-foot were treated by maggot therapy. The most serious case was in a 75-year-old man who had gangrene and osteomyelitis of the right foot. Proteus mirabilis, Enterococcus sp., Providencia stuartii and Staphylococcus spec. (coagulase positive) were isolated from lesions which did not respond to antibiotic therapy. The patient had twice refused amputation but agreed to maggot therapy. Larvae of the sheep blowfly Phoenicia (Lucilia) sericata were used for twice-weekly treatment over a period of 7 months. Sterile larvae were applied to the wound and replaced every 3-4 days. After 4 months of treatment, the necrotic tissue around the toes and on the sole of the foot detached from the healthy tissue. During the last 3 months of treatment the larvae removed the remaining infected tissue. As therapy progressed, new layers of healthy tissue covered the wound. The offensive odor associated with the necrotic tissue and the intense pain in the foot decreased significantly. At the end of therapy, during which there were no complaints of discomfort, he was able to walk. In the 4 other patients who had relatively superficial gangrene, the maggots debrided the wounds within 2-4 weeks. Thereafter treatment was continued with antibiotics. Maggot therapy can be recommended in cases of intractable gangrene and osteomyelitis, when treatment with antibiotics and surgical debridement have failed.

Radiation-Induced Meningioma: The Changing Pattern of the Disease

G. Sviri, A. Sahar, M. Feinsod

Depts of Neurosurgery, Rambam and Sheba Medical Centers, Haifa and Tel Hashomer; and The B. Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, and the Sackler Faculty of Medicine, Tel Aviv University

In this country radiation-induced meningiomas were usually associated with low-dose irradiation of the scalp of immigrants from North Africa, given as part of the treatment of tinea capitis. An Ashkenazi patient developed meningiomas 15 years after high-dose irradiation for a benign lesion in the parasellar region. The accumulating literature about high-dose radiation-induced meningiomas is reviewed and attention is drawn to the ever increasing number of meningiomas observed in immigrants from the former Soviet Union.

Temporal Hemianopia And Diabetes Insipidus Following Head Injury

M. Zaaroor, D. Goldsher, M. Feinsod

Center for Treatment and Applied Research in Head Injuries, Dept. of Neurosurgery and Diagnostic Radiology Dept., Rambam Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa

Bitemporal hemianopia and diabetes insipidus following head injury are caused by a lesion in the center of the optic chiasm, together with injury to the adjacent pituitary stalk or the hypothalamus. This combination was thought to be a rare complication of severe head injury. The case of a 16-year-old male is presented, which together with recent reports suggests that this relatively under-recognized syndrome is not infrequent, that it may follow even minor head injury, and that magnetic resonance imaging can demonstrate the chiasmal lesion.