Aneurysmal bone cyst treated with percutaneous doxycycline: is a single treatment sufficient?

OBJECTIVE: The purpose of this case series is to report on the effectiveness of a single percutaneous injection of doxycycline as a primary treatment for aneurysmal bone cyst (ABC). MATERIALS AND METHODS: A retrospective cohort study was conducted on seven patients diagnosed with ABC at various anatomical sites, with the intention to treat by a single percutaneous injection of doxycycline. Mean patient age was 14 years. RESULTS: Signs of treatment response were seen in six of seven patients after one injection. Three of the seven received a second treatment, despite signs of response. Another had expansion of the lesion after treatment, requiring excision. In total, three patients had a single injection of doxycycline as their sole treatment and another three showed signs of response after a single injection. CONCLUSIONS: A single percutaneous injection of doxycycline should be considered a viable primary treatment option for ABC.

Recurrent aneurysmal bone cyst of the cervical spine in childhood treated with doxycycline injection.

A 12-year-old female was treated surgically for an aneurysmal bone cyst of the cervical spine involving the C2 and C3 vertebrae. The patient underwent surgery twice and further surgery was assessed as unfeasible. Treatment by intraosseous injection of doxycycline was uncomplicated and has resulted in resolution of the multifocal recurrent disease.

Brachial artery aneurysm and bilateral posterior circulation strokes in a young child with tuberous sclerosis complex.

Although tuberous sclerosis (TS) may affect many organs, vascular manifestations involving medium- and large-size vessels are rare. We present a young child with known TS who presented with bilateral posterior circulation infarcts and subsequently was found to have right-hand ischaemia secondary to a thrombosed brachial artery aneurysm. A wound on his right middle finger failed to heal with conservative management, and digital subtraction angiography and MR angiogram demonstrated a lack of bypass target with microcollateral supply of the forearm only. The right middle digit ischaemia was initially managed with right middle finger disarticulation at the metacarpophalangeal joint, but the wound failed to heal and the patient proceeded to a thumb-sparing carpo-metacarpal amputation. Aneurysms, stenotic-occlusive disease and embolic stroke are rare but important complications of TS.

Radiofrequency ablation of osteoid osteoma: Aiming for excellent outcomes in an Australasian context.

INTRODUCTION: To report a series of patients with osteoid osteoma treated by radiofrequency ablation in whom no complications or recurrences occurred. METHODS: Over a 13-year period, 32 consecutive patients with osteoid osteoma were treated by radiofrequency ablation in an Australasian teaching centre. RESULTS: All patients had resolution of symptoms with no complication or recurrence. CONCLUSIONS: This series is further evidence for the use of radiofrequency ablation as the primary treatment for osteoid osteoma.

Computed tomography assisted osteodensitometry in total hip arthroplasty.

BACKGROUND: Periprosthetic bone remodelling is an important issue in total hip arthroplasty, which can compromise long-term outcomes. The aim of this study was to evaluate bone remodelling of the proximal femur with an uncemented hydroxyapatite-coated taper stem. METHODS: Twenty-three patients (27 hips) were included in this study. The mean age of the patients at the index operation was 57.2 years. There were 15 men and 8 women. Bone remodelling was assessed with quantitative computed tomography and the clinical outcome determined using the Harris Hip Scores. The mean preoperative Harris Hip Score was 38 points and at the 1-year follow up, it was rated 96 points. All hips were radiologically stable. RESULTS: At the 1-year follow up, we found a greater bone-density loss of the cancellous bone (ranging from 16.7 to 28.2%) compared with the cortical bone (ranging from 5.3 to 7.8%). A strong correlation was found between the low density of the cortical bone at the index operation and a higher loss of bone density at the follow up. CONCLUSION: The newly designed tapered stem showed good clinical and radiological outcomes with a proximal femoral bone loss that compares favourably with other studies.

Neutral Ferrocenoyl Receptors for the Selective Recognition and Sensing of Anionic Guests.

A range of neutral, hydrogen-bonding ferrocenoyl anion receptors and redox sensors operable in nonaqueous solvents are reported and a series of anion-binding and -sensing experiments presented. Thioamide-based receptor L2 binds halide anions more effectively than its carboxamide analogue L1, with the thioamide (N-H) group proving to be a better NMR antenna for detecting the recognition event. The binding of this class of neutral hydrogen-bonding receptor has favorable DeltaH degrees and unfavorable DeltaS degrees. Multidentate amide receptor L5 binds halide guests more strongly, with the effect of solvent on this binding process being studied. The introduction of a primary amine functionality (L4) causes remarkably strong HSO(4)(-) binding, the first reasoned report of selectivity for this acidic anionic guest. Analogously to many biological anion recognition processes, different binding modes operate dependent on guest acidity. In this way, the chemical properties of the substrate are addressed, yielding novel anion selectivities. All the receptors investigated exhibit electrochemical anion recognition. Typically, an EC mechanistic response is observed as ferrocene oxidation "switches-on" electrostatic interactions with the bound guest. Remarkable cathodic shifts of the ferrocene oxidation wave are also induced (up to 220 mV with HSO(4)(-) and 240 mV with H(2)PO(4)(-)) as the proximate bound negative charge stabilizes positively charged ferrocenium. Difunctional receptor L8 shows a large, novel UV-visible spectroscopic enhancement with H(2)PO(4)(-).