Kimiaki Nishida

Clinical results of trochanteric fractures treated with the TARGON® proximal femur intramedullary nailing fixation system

The aim of this study was to investigate the outcome of 352 (71 males) patients with trochanteric fractures that were treated with the TARGON® PF nail. The mean age was 83 years. According to the Jensen classification, there were 35 cases in type 1,94 cases in type 2,75 in type 3,63 in type 4 and 85 in type 5. Postoperative all patients were allowed to fully weight bear from the first postoperative day. Clinical and radiological data were collected at regular time intervals. The average waiting time to surgical reconstruction for the 352 cases was 3.5 days (1-7). The mean length of hospital stay was 14 days (5-22). The operative times ranged from 11 to 125 minutes with an average time of 32 minutes. Fifty percent of the patients regained their mobility to their pre-injury level at the final follow up. Out of 310 patients (88%) who were available for radiographie assessment, all fractures united except one case. 300 (85%) of the lag screws were placed in the inferior area in the anteroposterior view and in the central area in the lateral view (IM), which is regarded as the optimal position. The lag screws back-slided between 0 and 19 mms with an average of 6 mm. Sliding distance of the lag screw for over 10 mm was seen in 42 cases (13%). Varus collapse of the femoral head-and-neck greater than 10° was observed in 6 cases. Postoperative complications developed in 6 cases (1.7%), including wound infection in two cases, and secondary fracture at the subtrochanteric region, nonunion, back-out of the guiding sleeve and medial perforation of the lag screw, each in one case. The presented case series indicates that the TARGON® PF system is an effective and safe internal fixation device for trochanteric proximal femoral fractures. Further, prospective comparative evidence regarding the use of this system is needed to analyse and validate the presented clinical impression of our centre.

Antitumor effects of adriamycin encapsulated in liposomes on chemically induced malignant fibrous histiocytoma in rats: Histological aspects*

We previously reported that, in an experimental animal model (rat), the in vivo growth of chemically induced malignant fibrous histiocytoma (MFH) was inhibited more effectively by adriamycin encapsulated in liposomes (LADM) than by free adriamycin (ADM). To elucidate the histological changes caused by LADM administration, we compared LADM-treated tumor tissues with free ADM-treated tissues. A suspension of chemically induced rat MFH cells was injected subcutaneously into syngeneic rats. After a tumor had developed, free ADM or LADM was administered intravenously. The tumor tissues were then examined histologically. Microscopic examination showed that the number of small round infiltrated cells was greater in the LADM group than in the ADM group. Additionally, an immunohistochemical study with anti-rat lymphocyte or anti-rat macrophage monoclonal antibodies demonstrated that the significant decrease in W3/25+ cells observed in the control and ADM groups was not apparent in the LADM group, and that the percent-ages of cells positive for OX-8, ED2, and ED3 were significantly higher than in the ADM group. These histological changes seem to correlate closely with the inhibition of tumor growth. Our results suggest that LADM possesses the drug-carrying characteristic of liposomes and may also augment certain host defenses against rat MFH, just as biological response modifers do.