Bone metastasis ultimately occurs due to a complex multistep process, during which the interactions between cancer cells and bone microenvironment play important roles. Prior to colonization of the bone, cancer cells must succeed through a series of steps that will allow them to gain migratory and invasive properties; epithelial-to-mesenchymal transition (EMT) is known to be integral here. The aim of this study was to determine the effects of G protein subunit alpha Q (GNAQ) on the mechanisms underlying bone metastasis through EMT pathway. A total of 80 tissue samples from patients who were surgically treated during January 2012 to December 2014 were used in the present study. Comparative gene analysis revealed that the GNAQ was more frequently altered in metastatic bone lesions than in primary tumour sites in lung cancer patients. We investigated the effects of GNAQ on cell proliferation, migration, EMT, and stem cell transformation using lung cancer cells with GNAQ-knockdown. A xenograft mouse model tested the effect of GNAQ using micro-CT analyses and histological analyses.Aims
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Osteonecrosis of the femoral head occurs in young patients. The preservation of the hip joint is vitally important, because hip arthroplasty does not guarantee satisfactory long-term results in young and active patients. Curved intertrochanteric varus osteotomy is one of several joint preserving procedures used for this disease. Between June 2004 and June 2007, 52 patients (55 hips) who had osteonecrosis of the femoral head were treated with curved intertrochanteric varus osteotomy. There were 29 men and 23 women who had a mean age at the time of osteotomy of 33 years (range, 18 to 52 years). The osteotomy was fixed with a 120 degree compression hip screw in the first 34 hips and with a 95 degree dynamic condylar screw in the remaining 21 hips. Clinical evaluation was performed using the scoring system of Merle d'Aubigne et al.Introduction
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Ceramic-on-ceramic couplings are an attractive alternative bearing surface to eliminate or reduce problems related to polyethylene wear debris. Past disappointing experiences with alumina-ceramic bearings have led to many improvements in the manufacture and the design of ceramic implants. The purpose of this study was to report the results of contemporary alumina-on-alumina total hip arthroplasties (THAs) with regard to wear, osteolysis, and fracture of the ceramic in patients with osteonecrosis of the femoral head. Between February 1998 and October 2003, 365 patients (432 hips) with osteonecrosis of the femoral head underwent cementless total hip arthroplasty using contemporary alumina bearings. There were 243 men and 122 women who had a mean age at the time of index operation of 43 years (range, 18 to 65 years). They were evaluated clinically and radiographically at 5 to 10 years (average, 7 years). During the follow-up, special regards were addressed to wear, periprosthetic osteolysis and ceramic failure.Introduction
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Advanced stage and a large area of necrotic bone are known risk factors for failure after transtrochanteric rotational osteotomy of the hip in patients with osteonecrosis. The purpose of this study was to determine whether there were other risk factors for failure of this osteotomy. One hundred and five patients (113 hips) underwent transtrochanteric anterior rotational osteotomy for femoral head osteonecrosis and were followed for a mean period of 51 months post-operatively. Radiographic failure was defined as secondary collapse or osteoarthritic change. Multivariate analysis with the use of a Cox proportional-hazards frailty model was performed to assess factors that influenced the secondary collapse and osteophyte formation. A Kaplan-Meier product-limit method was performed to estimate survival.Introduction
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