Use of a Distal Radius Endoprosthesis Following Resection of a Bone Tumour: A Case Report

Limited literature is available on the reconstruction of the distal radius using prosthetic replacement following resection of a bone tumour. We present the first reported case, in the English literature, of the use of an entirely metal endoprosthesis for the reconstruction of the distal radius. This case involves a 66-year-old male who was treated for giant cell tumour of the distal radius with surgical excision of the lesion and replacement of the defect using a predominantly titanium endoprosthesis. He was followed-up for 56 months following surgery and had a good functional outcome with no associated pain or complications. We propose that the use of a primarily titanium endoprosthesis for the reconstruction of a bone defect of the distal radius is a suitable alternative, providing good function of the forearm with satisfactory range of movement at the wrist and adequate pain relief

Myocardial response to acute injury

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Effects of the xanthine oxidase system on cardiac function in anaesthetised rats

This investigation aimed to determine whether contractile dysfunction of the myocardium could be produced upon generation of free radicals in the anaesthetised rat. The enzyme xanthine oxidase, combined with its substrate purine and an iron source, was used to generate free radicals in the venous circulation. The suspended form of xanthine oxidase, with substrate, produced a transient, significant depression in the contractile indices dP dt−1 max and dP dt−1 P−1 and arterial blood pressure, 1146 ± 87 mm Hg s−1, 9 ± 1 s−1, and 18 ± 1 mm Hg, respectively. This could not be attenuated by the enzymatic free radical scavengers superoxide dismutase and catalase. Furthermore, the suspended xanthine oxidase alone or its vehicle were able to produce a similar effect to that of the complete free-radical-generating system. The maximum soluble dose of the crystalline form of the enzyme when employed in the generating system had no effect upon administration despite its production of superoxide radicals in vitro. These results suggest that the haemodynamic effects of the free-radical-generating system containing the suspended form of xanthine oxidase were due to the effects of its vehicle and that the free-radical-generating system containing the crystalline form of the enzyme did not produce sufficient free radicals in vivo to modify myocardial contractility

Effects of chronic norepinephrine administration on cardiac function in rats

We assessed the changes in the contractile response of rat hearts in vivo after chronic exposure to a range of doses of norepinephrine (NE) and determined whether free radical production played a role in these changes. Osmotic minipumps were implanted subcutane-ously (s.c.) in male rats and delivered either NE (0.15-0.35 mg/kg/h) or acid saline for 10-28 days. The animals were then anaesthetised and prepared for haemodynamic measurement, and dose-response curves to acutely administered NE and calcium chloride were constructed. We analysed plasma for evidence of free radical activity by measuring the levels of thiobarbituric acid-reactive substances (TBARS). All doses of NE studied produced left, but not right, ventricular hypertrophy. Treatment with 0.25 mg/kg/h NE for 28 days produced signs of distress and, by 10 days, treatment with 0.35 mg/kg/h resulted in 33% mortality. Treatment with the two lower doses, but not the highest dose, of NE resulted in increases in basal left ventricular (LV) maximum rate of pressure generation and a marked increase in systolic, but not diastolic, arterial blood pressure (SBP, DBP). All doses of NE caused reduced responses to acutely administered NE but no marked change in the response to calcium chloride. Levels of plasma free radicals were increased only with the highest dose of NE. Over the concentration range studied, chronic administration of NE to rats causes (3-adrenoceptor downregulation and free radical production was associated only with the administration of a dose of NE that resulted in high mortality