A case of germinal center formation by CD45RO T and CD20 B lymphocytes in rheumatoid arthritic subchondral bone: proposal for a two-compartment model of immune-mediated disease with implications for immunotherapeutic strategies.

In rheumatoid arthritis (RA) disease activity occurring as joint destruction of cartilage and bone is thought to be driven by inflammatory reactions which are initiated by exogenous microbial mechanisms and perpetuated by endogenous autoimmune mechanisms. According to the synovial model of RA, these reactions originate in the adjacent synovial tissues. The following set of observations is presented herein to suggest an alternate model involving subchondral bone.

Effect of fetal thyroid hormone (RT3) on sarcoma cells in culture.

Fetal thyroid hormone (RT3) is considered metabolically inactive and is present in high concentration in fetuses and in some patients with end-stage malignant disease. In a virus-induced erythroleukemia cell model, RT3 was found to stimulate the growth of the erythroleukemia cells in culture. The focus of this research was to test the effect of RT3, at several concentrations, on the growth of naturally occurring human sarcomas in cell culture.

Aspiration biopsy of primary neoplasms of bone.

Aspiration biopsy of bone is a simple and relatively safe diagnostic tool that had a diagnostic accuracy of 72 per cent in thirty-one patients who had a primary bone tumor that was suspected of being malignant and of 83 per cent in twelve patients who had a suspected giant-cell tumor. However, twenty-six primary lesions of bone that were thought likely to be benign were not as easily and definitively diagnosed (an accuracy rate of 23 per cent), and for these lesions, multiple needle-aspiration samples or open biopsy provides greater diagnostic accuracy.

Limb salvage procedures for children with osteosarcoma: an alternative to amputation.

Amputation remains the standard surgical management for patients with osteosarcoma. However, in carefully selected patients, eradication of the primary tumor can be achieved by En-Bloc resection of the affected bone preserving both anatomical and functional status. Our criteria for limb salvage procedures are that patients must: (1) be age 12 years or older, (2) have no angiographic or clinical evidence of neurovascular involvement, (3) have low-grade osteosarcoma and/or good response to preoperative chemotherapy, and (4) be compliant.

Comparison of fixation in the treatment of femoral neck fractures.

Two hundred ninety patients with femoral neck fractures of the Garden Type III or IV were treated during the years 1965 through 1978 using one of four types of internal fixation devices. The results divided the devices into two distinct groups. Those allowing highly stable fixation (Calandruccio compression and Deyerle devices) had a higher rate of union and a higher rate of early complications.

Acetabular disruption and central fracture-dislocation of the hip. A long-term study.

Displaced acetabular fractures are serious injuries often resulting in permanent disability. Fifty-five patients with fifty-six such injuries seen at the Campbell Clinic between 1927 and 1970 had either central dislocation with or without fracture of the weightbearing dome, or acetabular disruption usually associated with posterior displacement of the hip. After an average follow-up of 8.

Primary prosthetic replacement for femoral neck fractures.

Treatment of displaced femoral neck fractures remains a problem. Routine prosthetic replacement is controversial. Review of 100 patients treated at the Campbell Clinic from 1957 to 1966 suggests that 60% long-term good results can be anticipated at a cost of 5% mortality and 25% morbidity.