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ID PMID Title PublicationDate abstract
19951249 Recent developments in patent anti-cancer agents targeting the matrix metalloproteinases ( 2010 Jun Matrix metalloproteinases (MMPs) belong to a family of closely related calcium- and zinc-dependent endopeptidases involved in the degradation and remodeling of extracellular matrix (ECM) proteins that are associated with the tumorigenic processes. MMPs promote tumor invasion and metastasis, regulating host defense mechanisms and normal cell function. Thus, MMP inhibitors (MMPIs) are expected to be useful chemotherapeutic agents for the treatment of malignant cancer, osteoarthritis, and rheumatoid arthritis. A vast number of small molecular MMPIs have been developed in recent years. Although there have been considerable preclinical and clinical studies on these inhibitors, most of the effective candidates in clinical trials, however, have yielded unsatisfactory results, thus they are as yet unavailable for use as therapeutic drugs. Currently, more efforts have been directed to the design of specific inhibitors towards certain MMP family members for selective usage. This review will focus primarily on an analysis of recent developed MMPIs that have entered preclinical or clinical trials, and recently registered patents with regard to new highly selective MMPIs in USA or patent applications related to the specific inhibitors of MMPs. We also analyze the clinical failure and discuss the possible strategies to best optimize the development of these novel agents.
19924720 Analysis of multiple phenotypes. 2009 The complex etiology of common diseases like cardiovascular disease, diabetes, hypertension, and rheumatoid arthritis has led investigators to focus on the genetics of correlated phenotypes and risk factors. Joint analysis of multiple disease-related phenotypes may reveal genes of pleiotropic effect and increase analytical power, but at the cost of increased analytical and computational complexity. All three data sets provided for analysis at the Genetic Analysis Workshop 16 offered multiple quantitative measures of phenotypes related to underlying disease processes as well as discrete measures of affection status. Participants in Group 6 addressed the challenges and possibilities of association analysis of these data sets on multiple levels, including phenotype definition and data reduction, multivariate approaches to gene discovery, analysis of causality and data structure, and development of predictive models. These approaches included combinations of continuous and discrete phenotypes, use of repeated measures in longitudinal data, and models that included multiple phenotypic measures and multiple single-nucleotide polymorphism variants. Most research teams regarded the use of multiple related phenotypes as a tool for increasing analytical power, as well as for clarifying the underlying biology of complex diseases.
19728295 IL-17 induces osteoclastogenesis from human monocytes alone in the absence of osteoblasts, 2009 Nov 1 IL-17 is a proinflammatory cytokine crucial for osteoclastic bone resorption in the presence of osteoblasts or synoviocytes in rheumatoid arthritis. However, the role of IL-17 in osteoclastogenesis from human monocytes alone remains unclear. Here, we investigated the role of IL-17 in osteoclastogenesis from human monocytes alone and the direct effect of infliximab on the osteoclastogenesis induced by IL-17. Human peripheral blood mononuclear cells (PBMC) were cultured for 3 days with M-CSF. After non-adherent cells were removed, IL-17 was added with either infliximab or osteoprotegerin (OPG). Seven days later, adherent cells were stained for vitronectin receptor. On the other hand, CD11b-positive monocytes purified from PBMC were also cultured and stained as described above. CD11b-positive cells were cultured with TNF-alpha and receptor activator of NF-kappaB ligand (RANKL). In the cultures of both adherent cells and CD11b-positive cells, IL-17 dose-dependently induced osteoclastogenesis in the absence of soluble-RANKL. OPG or infliximab inhibited IL-17-induced osteoclastogenesis. Interestingly, in the culture of CD11b-positive cells, the osteoclastogenesis was more potently inhibited by infliximab than by OPG. TNF-alpha and RANKL synergistically induced osteoclastogenesis. The present study clearly demonstrated the novel mechanism by which IL-17 directly induces osteoclastogenesis from human monocytes alone. In addition, infliximab potently inhibits the osteoclastogenesis directly induced by IL-17.
19700149 Cardiovascular risk in menopausal women and prevalent related co-morbid conditions: facing 2009 Oct OBJECTIVE: To review scientific publications regarding cardiovascular risk during the menopausal years and that related to currently recognized highly prevalent co-morbid factors within this period. METHODS: Citations were selected from a PubMed search and the authors' files according to their clinical and experimental relevance. RESULTS AND DISCUSSION: Although experimental and some observational data have supported the fact that estrogens are beneficial for the female vascular system, these positive actions have been challenged by the results of the Women's Health Initiative trial and the Million Women Study, which demonstrated an increase in cardiovascular risk and related adverse events. The role of hormone therapy for the menopause has shifted from a preventive use to a limited role in symptom management, for which it remains the most effective intervention. Baseline evaluation of menopausal women should include individual cardiovascular risk assessment, including hypertension, dyslipidemia, elevated body weight, and the metabolic syndrome. Concomitantly, new factors influencing cardiovascular risk have been delineated among postmenopausal women, namely sleeping disorders, depression, vitamin D insufficiency, rheumatoid arthritis, sexual dysfunction, stress, and psychosocial factors. Therefore, a new landscape may be recognized for menopausal women management. Precise evaluation and treatment of each factor should be separately assessed to improve quality of life and reduce cardiovascular disease prevalence. At present, cardiovascular risk reduction strategies are a requisite (albeit underused) for menopausal women. These include education in terms of health, healthy lifestyle, and pharmacologic preventive interventions to reduce co-morbid conditions.
19688024 Human coagulated plasma as a natural and low cost matrix for in vitro angiogenesis. 2009 Jul BACKGROUND: Angiogenesis, the development of new blood vessels, is an important process in tissue development and wound healing, but becomes pathologic when associated with solid tumor growth, proliferative retinopathies, and rheumatoid arthritis. Accurate and reliable qualification of neovascular (angiogenic) response, both in vitro and in vivo, is an essential requirement for the study of new blood vessel growth. The complexity of currently used three-dimensional in vitro angiogenesis systems makes it difficult to approve material in its models. Capillary-like structure occurs on basement membrane components such as collagen and/or laminin, while in other models, CLS formation occurs on transitional matrices such as fibrin. To solve this problem, we were interested in developing an angiogenesis system which allows rapid and reliable quantification of three-dimensional neovessel formation in vitro. METHODS: Human bone marrow endothelial cells were seeded on gelatin-coated microcarriers and suspended in a solution of platelet-poor plasma which was induced to polymerize by addition of calcium chloride. In this way, microcarriers were entrapped in three-dimensional coagulated plasma. RESULTS: Within a few hours, endothelial cells begin to leave these supporting microcarries and migrate into the coagulated-plasma matrix and formed CLS within 48-72 hours. CONCLUSION: We developed a convenient angiogenesis in vitro system which allows reliable quantification of capillary formation in a three-dimensional environment.
19629618 The prevalence of musculoskeletal complaints in a rural area in Iran: a WHO-ILAR COPCORD s 2009 Nov The objective of this study is to study the prevalence of musculoskeletal complaints and disorders in a rural area in Iran. Interviews were conducted in randomly selected subjects from five villages in Tuyserkan County, northwestern part of Iran. The three phases of stage 1 Community Oriented Program for Control of Rheumatic Diseases were done during the same day. A total of 614 houses was visited, 1,565 persons interviewed, and 1,192 persons examined. Musculoskeletal complaints during the past 7 days were detected in 66.6% (shoulder 22.7%, wrist 17.4%, hands and fingers 14.9%, hip 13.9%, knee 39.2%, ankle 19.6%, toes 12.7%, cervical spine 17.9%, and dorsolumbar spine 41.9%). Degenerative joint diseases were detected in 20.5% (cervical spondylosis 2.2%, knee osteoarthritis [OA] 19.3%, hand OA 2.7%, and hip OA 0.13). Low back pain was detected in 23.4%, soft tissue rheumatism in 2.2%, rheumatoid arthritis in 0.19%, ankylosing spondylitis in 1.1%, systemic lupus erythematosus in 0.06%, and fibromyalgia in 0.06%. The prevalence of rheumatic complaints in rural Iran is very high and needs attention in the curricula of medical schools and in the planning of rural health care by the government.
19570124 The therapeutic effect of balneotherapy: evaluation of the evidence from randomised contro 2009 Jul STUDY DESIGN: Systematic review. SUMMARY OF BACKGROUND DATA: There is widespread popular belief that balneotherapy is effective in the treatment of various ailments. METHODS: We searched PubMed (1950-2006), Scopus and Cochrane library for randomised controlled trials (RCTs), examining the clinical effect of balneotherapy (both as a solitary approach and in the context of spa) on various diseases. RESULTS: A total of 203 potentially relevant articles were identified. In all, 29 RCTs were further evaluated; 22 of them (75.8%) investigated the use of balneotherapy in rheumatological diseases and eight osteoarthritis, six fibromyalgia, four ankylosing spondylitis, four rheumatoid arthritis and three RCTs (10.3%) in other musculoskeletal system diseases (chronic low back pain). In addition, three relevant studies focused on psoriasis and one on Parkinson's disease. A total of 1720 patients with rheumatological and other musculoskeletal diseases were evaluated in these studies. Balneotherapy did result in more pain improvement (statistically different) in patients with rheumatological diseases and chronic low back pain in comparison to the control group in 17 (68%) of the 25 RCTs examined. In the remaining eight studies, pain was improved in the balneotherapy treatment arm, but this improvement was statistically not different than that of the comparator treatment arm(s). This beneficial effect lasted for different periods of time: 10 days in one study, 2 weeks in one study, 3 weeks in one study, 12 weeks in 2 studies, 3 months in 11 studies, 16-20 weeks in one study, 24 weeks in three studies, 6 months in three studies, 40 weeks in one study and 1 year in one study. CONCLUSION: The available data suggest that balneotherapy may be truly associated with improvement in several rheumatological diseases. However, existing research is not sufficiently strong to draw firm conclusions.
19565360 Immunogenicity of Anti-TNF-alpha agents in autoimmune diseases. 2010 Apr Prognosis of several autoimmune diseases, especially rheumatoid arthritis (RA), ankylosing spondylitis, Crohn's disease (CD), and psoriasis, usually refractory to conventional treatment improved considerably with the introduction of tumor necrosis factor alpha (TNF-alpha) antagonistic agents, which is now available (infliximab, etanercept, and adalimumab). However, a portion of patients persists with active disease, infusion reactions, and relapses even during current biological therapy. One of the reasons for this is the associated immunogenicity to these drugs. The incentive for induction of antibodies against anti-TNF-alpha agent depends mainly on its constitution. Chimerical drugs have a higher capacity of inducing immunogenicity compared to completely human drugs. Among the three anti-TNF-alpha agents, this phenomenon has been studied mainly in patients using infliximab, especially in RA and CD. The prevalence of anti-infliximab antibodies in RA varies from 12% to 44% and seems to be inversely proportional to the level of seric infliximab and therapeutic response. The use of etanercept was associated to the development of anti-etanercept antibodies in 0% to 18% of patients, without apparent effect on effectiveness or adverse events. Studies with RA and CD patients show prevalence of anti-adalimumab antibodies from 1% to 87%. Immunosuppressive drug addiction can reduce the induction of anti-TNF-alpha antibodies.
19273309 Dysregulation of CD8+ lymphocyte apoptosis, chronic disease, and immune regulation. 2009 Jan 1 Expansion of CD8+ lymphocyte subsets are found in many states with chronic antigenic exposure including HIV, multiple myeloma, rheumatoid arthritis, CMV infection, transplantation and even normal aging. These expansions are characterized by the expression of CD57 antigen and the loss of CD28-. These lymphocytes are thought to represent clonally expanded cytotoxic T lymphocytes (CTL) that have become senescent and lack proliferative ability. These cells also demonstrate suppressive properties and have been linked with immunodeficiency raising the question of the function of these cells in relationship to immunoregulation. Alterations in the CD95/Fas apoptotic pathway and changes in pro-survival factors such as Hsp27 likely contribute to this lymphocyte subset expansion. Further understanding of the normal CD8+ lymphocyte response to antigen and the factors that lead to abnormal continued expansion in certain disease states will be crucial to understanding the pathogenesis of chronic antigenic stimulation.
19190236 Nonpeptidergic allosteric antagonists differentially bind to the CXCR2 chemokine receptor. 2009 May The chemokine receptor CXCR2 is involved in different inflammatory diseases, like chronic obstructive pulmonary disease, psoriasis, rheumatoid arthritis, and ulcerative colitis; therefore, it is considered an attractive drug target. Different classes of small CXCR2 antagonists have been developed. In this study, we selected seven CXCR2 antagonists from the diarylurea, imidazolylpyrimide, and thiazolopyrimidine class and studied their mechanisms of action at human CXCR2. All compounds are able to displace (125)I-CXCL8 and inhibit CXCL8-induced beta-arrestin2 recruitment. Detailed studies with representatives of each class showed that these compounds displace and antagonize CXCL8, most probably via a noncompetitive, allosteric mechanism. In addition, we radiolabeled the high-affinity CXCR2 antagonist SB265610 [1-(2-bromophenyl)-3-(4-cyano-1H-benzo[d] [1,2,3]-triazol-7-yl)urea] and subjected [(3)H]SB265610 to a detailed analysis. The binding of this radioligand was saturable and reversible. Using [(3)H]SB265610, we found that compounds of the different chemical classes bind to distinct binding sites. Hence, the use of a radiolabeled low-molecular weight CXCR2 antagonist serves as a tool to investigate the different binding sites of CXCR2 antagonists in more detail.
19021011 Association studies of the IL-23R gene in autoimmune thyroid disease in the Japanese popul 2009 Feb Autoimmune thyroid diseases (AITDs), including Graves' disease (GD) and Hashimoto's thyroiditis (HT), are caused by interplays of genetic factors and environmental triggers. Interleukin-23 and its receptor (IL-23R) guide T cells towards the Th17 phenotype. IL-23R single nucleotide polymorphisms (SNPs) have been shown to be associated with several autoimmune diseases, including Crohn's disease and rheumatoid arthritis, and Graves' ophthalmopathy (GO) in Caucasians. To determine whether variants in the IL-23R gene are associated with AITDs in Japanese, 464 Japanese AITD patients (290 with GD, 174 with HT) and 179 matched Japanese control subjects were genotyped for four SNPs spanning the IL-23R gene. SNPs rs11209026 and rs7530511 were genotyped using TaqMan allelic discrimination assays and SNPs rs2201841 and rs10889677 were genotyped using a fluorescent-based restriction fragment length polymorphism method. Case-control association studies were performed using the chi(2) and Fisher's exact tests with Yates correction. Of the four SNPs rs11209026 was non-polymorphic in our dataset. The other three SNPs were not associated with GD or GO or HT in our Japanese population. These results suggest that the IL-23R gene is associated with AITDs only in a specific ethnic group.
21375196 Association of visfatin with chronic kidney disease in a cohort of patients with and witho 2010 Nov OBJECTIVE: To evaluate association of serum visfatin with CKD secondary to diabetic nephropathy and to compare it with patients of CKD secondary to other risk factors. METHODS: Seventy eight individuals including 28 healthy controls and 50 patients of CKD were included in this study. Patients with CKD were further grouped based on etiology of CKD into diabetics and non-diabetics. Patients with type 1 diabetes mellitus, urinary tract infection, urolithiasis, liver cirrhosis, stroke, ischaemic heart disease, and rheumatoid arthritis were excluded. Measurement of Serum visfatin was done through EIA Kit (Phoenix pharmaceuticals Burlingame CA). RESULTS: Visfatin concentration was significantly high in patients with CKD compared to controls (8.7 +/- 4.7 vs. 5.2 +/- 3.3 p = 0.001). No significant difference in Visfatin concentrations between patients of CKD with and without diabetes was detected (9.2 +/- 5.5 vs. 8.3 +/- 3.2 p = 0.694). A significant negative correlation of visfatin with estimated GFR (r2= -0.383, p = 0.01) and a positive correlation with degree of proteinuria (p = 0.01) was observed. CONCLUSION: The present study confirms the association of visfatin with CKD, however further studies at molecular level to check its expression within renal tissue may clarify its definitive role in CKD
21183282 Rituximab in Hodgkin lymphoma: is the target always a hit? 2011 Aug In 1997, the anti-CD20 monoclonal antibody (MAb) rituximab became the first MAb approved for clinical use in oncology, and ushered in a new era of rationally designed targeted agents in cancer therapeutics. It is currently approved for use in non-Hodgkin lymphoma (NHL), chronic lymphoid leukemia (CLL), and rheumatoid arthritis (RA). Rituximab is non-mutagenic, associated with low treatment-related toxicity, and few, if any, long term adverse events, making it an attractive agent to be tried in off-label settings like Hodgkin lymphoma (HL). HL consists of two distinct subtypes - classic HL (cHL) and lymphocyte predominant HL (LPHL). CD20 is present in virtually all patients with LPHL, and in a significant minority of patients with cHL. In this CD20 positive sub-population, the use of rituximab is a rational intervention strategy. Rituximab has been used in patients with cHL as well as LPHL with good efficacy. In this article, we provide a clinically-oriented overview of the use of rituximab in the different sub-types of HL, and report updated results of our series of 8 LPHL patients treated with rituximab. A systematic review of the literature is also presented.
21082862 Benzimidazol-2-ylidene gold(I) complexes are thioredoxin reductase inhibitors with multipl 2010 Dec 23 Gold(I) complexes such as auranofin have been used for decades to treat symptoms of rheumatoid arthritis and have also demonstrated a considerable potential as new anticancer drugs. The enzyme thioredoxin reductase (TrxR) is considered as the most relevant molecular target for these species. The here investigated gold(I) complexes with benzimidazole derived N-heterocyclic carbene (NHC) ligands represent a promising class of gold coordination compounds with a good stability against the thiol glutathione. TrxR was selectively inhibited by in comparison to the closely related enzyme glutathione reductase, and all complexes triggered significant antiproliferative effects in cultured tumor cells. More detailed studies on a selected complex revealed a distinct pharmacodynamic profile including the high increase of reactive oxygen species formation, apoptosis induction, strong effects on cellular metabolism (related to cell surface properties, respiration, and glycolysis), inhibition of mitochondrial respiration and activity against resistant cell lines.
20681077 Polyethylene glycol–coated (PEG5000) gold nanoparticles. 2004 Gold nanoparticles belong to a small class of nanomaterials, while have been intensively investigated for biomedical use because of their excellent biocompatibility with human tissues and high affinity for functional groups such as thiols, phosphines, and amines (1-5). Gold nanoparticles have been approved by the United States Food and Drug Administration to treat human rheumatoid arthritis. They also have been used to enhance tumor sensitivity to radiation therapy. Surface-enhanced Raman scattering of gold nanoparticles has been tested for optical imaging of tumors (1, 6). Gold and gold-speckled silica nanoparticles have recently been developed as contrast agents for photoacoustic imaging (PAI) and multimodality imaging (3, 5, 7). Gold nanoparticles for PAI are based on either surface plasmon resonance (SPR) or fluorescent dyes attached to or encapsulated within nanoparticles. Nanoshells and nanorods are two representatives of SPR-based contrast agents (1, 7, 8). Peak absorption can be tuned throughout the visible and near-infrared (NIR) regions by controlling the physical dimensions of the metallic layer of nanoshells and the cylindrical symmetry of nanorods. Both nanoshells and nanorods exhibit good resistance to chemical/thermal denaturation and photobleaching. Dye-doped NIR nanoparticles function on the basis of strong optical absorption in the NIR region (3). Furthermore, dye encapsulation in nanoparticles significantly increases the circulation time of dyes in blood, allowing for extended imaging periods. On the other hand, proper comparison among nanoparticles appears difficult because shapes, sizes, materials, and mechanisms of different nanoparticles vary. Cai et al. reported the feasibility of gold nanoparticles modified with a methoxy-polyethylene glycol (PEG) sulhydryl moiety (molecular weight: 2.0 kDa) as a contrast agent for X-ray and computed tomography (MICAD chapter on PEG-AuNPs) (9). Recently, Zhang et al. modified gold nanoparticles with a PEG5000-thiol moiety and tested the PEGylated nanoparticles as a PAI contrast agent in vivo (5). Zhang et al. demonstrated the ability of PEGylated gold nanoparticles to detect tumors in vivo with photoacoustic tomography (PAT) (5). Their findings also suggest an opportunity for image-guided cancer therapy, with non-targeted gold nanoparticles serving as tumor-imaging contrast agents and mediators of cancer therapy.
18819035 Gliadin IgG antibodies and circulating immune complexes. 2009 OBJECTIVE: Circulating immune complexes (CICs) in blood are associated with autoimmune-diseases such as systemic lupus erythematosus, immune complex glomerulonephritis, rheumatoid arthritis and vasculitis. However, slightly increased serum concentrations of such CICs are sometimes also found in healthy individuals. The objective of the current study was to assess whether food antigens could play a role in the formation of CICs. MATERIAL AND METHODS: A total of 352 (265 F, 87 M), so far, healthy individuals were tested for CICs containing C1q and immunoglobulin G (IgG) as well as for gliadin IgG antibodies using the ELISA technique. Additionally, fructose and lactose malabsorption was assessed using hydrogen breath tests. RESULTS: In our study, 15.3% (54/352) of the patients presented with elevated CIC concentrations (above 50 microg/ml) and 6.5% (23/352) of the study population were positive for gliadin IgG antibodies (above 20 U/ml). CIC concentration levels were significantly higher in the group with elevated gliadin IgG antibodies (CIC median: 49.0 microg/ml) compared with the group with normal levels of gliadin IgG antibodies (CIC median: 30.0 microg/ml; Mann-Whitney U-test, U=1992; p <0.001). As expected, there was no difference in CIC concentrations (Mann-Whitney U-test, U=6106; p=0.783) and gliadin IgG (Mann-Whitney U-test, U=3761; p=0.411) between patients in the fructose or lactose malabsorber groups and the subjects without malabsorption. CONCLUSIONS: The results of this study indicate that certain food antigens (e.g. gluten) could play a role in the formation of CICs. An association between CICs and fructose or lactose malabsorption seems to be improbable.
18465156 Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity: a review 2009 Feb Multifocal ERG ring ratios provide a sensitive and objective method to detect ocular toxicity in patients taking hydroxychloroquine (Plaquenil). In order to measure ring ratios, the average mfERG amplitude was calculated for each of five concentric rings of a 61-hexagon mfERG. The age-corrected amplitude of the central hexagon (R(1)) and the ratios of R(1) to each of the successive rings (R(1)/R(2), R(1)/R(3), etc.) were then computed. Normative values for ring ratios were established from a population of 67 normal controls. In the study population, a ring was considered abnormal if it was above the 99% confidence limits for the normal population. The technique was evaluated on 131 eyes of 62 patients taking Plaquenil for a variety of conditions including rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome. Patients who had taken Plaquenil for an extended period showed a higher incidence of retinal toxicity, regardless of the condition for which they were taking the drug. Among patients who had taken a cumulative dose of less than 1,250 g, 7 of 67 eyes (10%) showed a characteristic mfERG defect, while in patients with a cumulative dosage of 1,250 g or more, 26 of 64 eyes (41%) showed one of these defects. In at least one patient, the technique was able to detect the early onset of Plaquenil toxicity followed by reversal of the toxic effects after the medication was discontinued. It appears appropriate to recommend that mfERG testing be done on all patients on Plaquenil therapy.
18461290 Spontaneous remission of "methotrexate-associated lymphoproliferative disorders" after dis 2009 There are a number of intriguing reports of lymphoproliferative disorders (LPDs) diagnosed during immunosuppressive treatment for underlying autoimmune disease, and spontaneously abated shortly after treatment discontinuation. Such LPDs, completely or partially regressing, occur in the clinical setting of "Methotrexate (MTX)-associated LPDs", recognized by the World Health Organization (WHO) among the "Immunodeficiency-associated LPDs". We identified 26 literature patients achieving spontaneous complete remission (CR) of their LPD, and eight others showing partial remission (PR). Most of them were affected by rheumatoid arthritis, received low-dose and long-term pulsed MTX alone or combined with other immunosuppressants, and developed a lymphoma. By reviewing the patients achieving CR, the following can be drawn: the absence of a unique type of LPD, the occurrence of an increased incidence of diffuse large B cell lymphoma as well as of frequent extranodal involvement, and EBV-infection. Further, CR mostly occurred within 4 weeks after discontinuation of immunosuppressant, and appeared to be persistent overtime. Conversely in the patients experiencing PR, the interval between discontinuation of immunosuppressive treatment and clinical response was mostly reported as longer than 4 weeks; moreover, in many cases the persistence of LPD or its progression induced to start cytotoxic therapy. Increased awareness is needed on the possible occurrence of LPD spontaneous remission following immunosuppressant discontinuation, after that it is therefore advisable to have a careful monitoring of the patient for some weeks, before starting cytotoxic therapy.
19838387 The INDUS knee prosthesis - Prospective multicentric trial of a posteriorly stabilized hig 2009 Oct BACKGROUND: The anatomical and morphological differences and high-flexion daily activities in the Asian population have since ever prompted for development of customized knee replacement systems. INDUS knee system has advantages both of high-flex designs and is developed by keeping the anatomical variations of the native population in mind. The purpose of this study is to analyze the 2-year follow-up results using the INDUS prosthesis. MATERIALS AND METHODS: Two hundred and ninety-seven knees in 276 patients were prospectively analyzed. There were 65 men (72 knees) and 211 (225 knees) women with a mean age of 64.56 years. Two hundred and forty-five knees had primary osteoarthritis, 48 knees had rheumatoid arthritis, and four knees had post-traumatic arthritis. Clinical parameters, including the Knee Society scores (knee score and function score), range of motion, post-operative anterior knee pain, and complications were recorded. Pre- and post-operative serial radiographs were analyzed for limb alignment, component positioning, and evidence of loosening. RESULTS: The patients were followed-up for an average of 2.59 years (range, 2-3.3 years). The mean knee score and the mean function score were significantly improved from a pre-operative value of 39.4 points and 46.7 points to a post-operative value of 87 points and 86 points, respectively (P value <0.05). Two hundred and thirty four knees had no anterior knee pain while 63 knees had mild to moderate pain, but none of the patients requested any intervention for the same. Of the 276 patients (297 knees), 79 knees had flexion above 140 degrees , 167 had a flexion range of 130-140 degrees , 27 had a flexion range of 100-130 degrees , and 24 knees had a flexion < 100 degrees , with the mean range of movement being 132.9 degrees . Improvements in the range of movement were retained over time and a total of 205 patients (224 knees, 75.7%) could squat or sit cross-legged at the final follow-up. The mean tibiofemoral angle was 8.5 degrees +/-6.9 degrees of varus pre-operatively and 5.4 degrees +/-2.2 degrees of valgus (3-7 degrees of valgus) at the final follow-up, with no loss of alignment noted in any case. One knee underwent revision for late infection while another knee had periprosthetic supracondylar fracture treated with plate fixation. CONCLUSIONS: Use of the INDUS knee prosthesis has a favorable short-term outcome, with a mean range of 135 degrees flexion and excellent knee scores.
19817281 [Early clinical results of total knee arthroplasty with journey prosthesis]. 2009 Sep OBJECTIVE: To evaluate the early clinical results of total knee arthroplasty (TKA) with JOURNEY prosthesis. METHODS: From September 2006 to May 2007, TKA with JOURNEY prosthesis was used to treat 32 patients in ATOS Clinic, Germany. There were 21 males and 11 females, aged 40-84 years old (average 65.6 years old). The locations were left knee in 13 cases and right knee in 19 cases, including 5 cases of traumatic arthritis, 19 cases of osteoarthritis and 8 cases of rheumatoid arthritis. All patients had pain and limited range of motion (ROM) of knee. MRI scanning showed that cartilage and meniscus damaged in all cases. The disease course was 1 to 4 years (average 2.2 years). The CPM practice started 2 days after operation. RESULTS: The operative time was (75.0 +/- 21.7) minutes. The blood loss was (280 +/- 130) mL. All incision healed by first intention. Thirty-two patients were followed up 12 to 18 months (average 14.2 months). Hydrarthrosis occurred in 8 cases at 3-6 months postoperatively. Femur paraprosthetic fracture and implant dislocation occurred at 1 week and at 6 months in 2 cases, respectively. There were statistically significant differences in KSS score between preoperation and 3, 6, 12 months after operation (P < 0.05), between 3 months and 6, 12 months after operation (P < 0.05); there was no statistically significant difference in KSS score between 6 months and 12 months after operation (P > 0.05). There were statistically significant differences in pain score between preoperation and 3, 6, 12 months after operation (P < 0.05), and in ROM between 3 months and 6, 12 months after operation (P < 0.05). There was no statistically significant difference in ROM between preoperation and 3 months after operation (P > 0.05). CONCLUSION: It is a simple way to TKA with JOURNEY prosthesis, which has a good results in early follow-up period.