chondroitin-sulfates and Fractures--Bone

Collagen has been extensively described as a beneficial material in bone tissue engineering due to its biocompatibility, biodegradability, low antigenicity, and high tensile strength. However, collagen scaffolds in their pure form have some drawbacks and improvements in the physical, chemical, and biologic properties of collagen are necessary to overcome those inadequacies. Recently, the selective hydrolysis of carboxyamides of asparagine and glutamine residues of collagen has been employed to increase the number of negative sites and enhance the piezoelectric properties of collagen. Anionic collagen scaffolds were prepared by use of a hydrolysis treatment for either 24 h [bovine pericardium (BP 24)] or 48 h (BP 48). Bovine osteoblasts were cultured on them and on native matrices to understand the cellular interactions responsible for the good osteoconductivity and biocompatibility reported with in vivo tests. Based on the data obtained on cell adhesion, alkaline phosphatase (ALP) and extracellular matrix macromolecule production, and cellular proliferation through histological analysis, we may conclude that the materials tested reveal sufficient biocompatibility level for bone repair. Further, the evidence of some connection between ALP activity and the mineralization process should be emphasized. BP 48 presented the most promising results stimulating in vitro mineralization, ALP production, and possible osteoblast differentiation.

Topics: Alkalies; Alkaline Phosphatase; Animals; Bone and Bones; Cattle; Cell Adhesion; Cell Line; Chondroitin Sulfates; Collagen; Coloring Agents; Fractures, Bone; Hydrolysis; In Vitro Techniques; Osteoblasts

Thrombosis prophylaxis using heparins is mandatory in most trauma patients. However, heparins can induce heparin-induced thrombocytopenia (HIT), the most common and clinically important immune-mediated drug-dependent thrombocytopenia. Affected patients are at risk of developing new thromboembolic complications. HIT has to be considered if platelet counts decrease >50% between day 5-10 of heparin therapy that cannot be explained alternatively or if new thromboses occur in a sufficiently heparinised patient. Immediately changing the anticoagulant to danaparoid or lepirudin is most important. Proof of anti-platelet-factor-4/heparin antibodies secures the diagnosis, usually retrospectively. Diagnosis and therapy are demonstrated in a typical HIT patient. HIT usually occurs in the second week of heparin administration. Heparin-reexposure within 100 days can lead to HIT before day 5. For early recognition of HIT, platelet counts should be monitored regularly. Because of earlier discharge of patients to rehabilitation or outpatient care, the problem of HIT-diagnosis and therapy gains increasing relevance in these sectors.

Topics: Adult; Anticoagulants; Autoantibodies; Chondroitin Sulfates; Dermatan Sulfate; Drug Combinations; Fractures, Bone; Heparin; Heparitin Sulfate; Hirudins; Humans; Male; Multiple Trauma; Platelet Count; Platelet Factor 4; Postoperative Complications; Recombinant Proteins; Thrombocytopenia; Thromboembolism

To determine whether serum or synovial fluid concentrations of chondroitin sulfate epitope 846 and carboxy propeptides of type II collagen (CPII) can be used to diagnose osteochondral fragmentation (OC) in horses.. 38 horses with unilateral OC of the radiocarpal (n = 31) or intercarpal (33) joints and 8 clinically and radiographically normal horses. Procedures-For horses with OC, serum and synovial fluid concentrations of epitope 846, CPII, and keratan sulfate (KS) were determined, along with synovial fluid WBC counts and total protein concentrations. Serum epitope 846, CPII, and KS concentrations were measured in control horses.. Synovial fluid epitope 846 and total protein concentrations were significantly higher in the joints with OC than in unaffected joints, but CPII and KS concentrations and WBC counts were not. Synovial fluid total protein and 846 epitope concentrations were linearly related to grade of OC. Serum epitope 846 and CPII concentrations were significantly higher in horses with OC than in control horses. Discriminant analysis allowed 27 of 34 (79%) horses to be correctly classified as having or not having OC on the basis of serum epitope 846 and CPII concentrations.. Results suggest that serum and synovial fluid concentrations of epitope 846 and CPII are associated with OC. Increases in concentrations of epitope 846 and CPII suggest that increased synthesis of cartilage aggrecan and type II procollagen may be associated with OC.. Measurement of serum epitope 846 and CPII concentrations may be useful in the diagnosis of OC in horses.

Topics: Animals; Biomarkers; Chondroitin Sulfates; Epitopes; Fractures, Bone; Horse Diseases; Horses; Lameness, Animal; Procollagen; Synovial Fluid

Heparin-induced thrombocytopenia (HIT) with thrombosis is a rare, but important complication of heparin therapy. We describe the case of a 53-year-old patient hospitalized with complicated pelvic fracture. Intravenous infusion of unfractionated heparin (15'000 IU/24 h) was given for thrombosis prevention. After 11 days' treatment the patient developed deep venous thrombosis of the left calf, complicated 2 days later by massive bilateral pulmonary embolism. Simultaneous with these thromboembolic events, thrombocytopenia, signs of activated coagulation, and antibodies to heparin occurred. In the context of this case the diagnostic and therapeutic possibilities of HIT, and in particular treatment with the heparinoid danaproid (Orgaran), are discussed.

Topics: Chondroitin Sulfates; Dermatan Sulfate; Drug Combinations; Fractures, Bone; Heparin; Heparinoids; Heparitin Sulfate; Humans; Male; Middle Aged; Pelvic Bones; Pulmonary Embolism; Thrombocytopenia; Thrombosis

Topics: Animals; Biomechanical Phenomena; Bony Callus; Chondroitin; Chondroitin Sulfates; Evaluation Studies as Topic; Female; Fractures, Bone; Rats