Pulmonary veno-occlusive disease following hematopoietic stem cell transplantation: a rare model of endothelial dysfunction.

Veno-occlusive disease is among the most serious complications following hematopoietic stem cell transplantation. While hepatic veno-occlusive disease occurs more commonly, the pulmonary variant remains quite rare and often goes unrecognized antemortem. Endothelial damage may represent the pathophysiologic foundation of these clinical syndromes. Recent advances in the treatment of hepatic veno-occlusive disease may have application to its pulmonary counterpart.

[Coating of metal implants with the bioactive glass ceramics Ceravital]. / Beschichtung von Metallimplantaten mit bioaktiver Glaskeramik Ceravital.

The bioactive glass ceramic Ceravital forms a physicochemical bonding with bone which is capable of withstanding stress caused by tension. This glass ceramic may already be put to clinical use as replacement for minor osseous parts. However, physical data are limited for maximum stress withstanding or gracile whole ceramic implants. In this study, metal cylinders from an alloy of CoCrMo are initially coated with a bio-compatible adhesive layer of enamel, approximately 0,2 to 0,3 mm thick. The adhesive strength of this kind of enamel amounts to about 120 to 140 kp/cm2. After the enamelling process, the glass ceramic is pressed into the enamel in granules at a particle size of 100 to 200 micrometer. As the first results show, this new process is suitable for the combination of metal implant stability and tissue compatibility of glass ceramic.

[Osteo-keramo-keratoprosthesis (author's transl)]. / Osteo-Keramo-Keratoprothese, Eine Modifikation der Osteo-Odonto-Keratoprothese nach Strampelli.

A high percentage of plastic keratoprosthesis is rejected again or intraocular infections occur because there is a cleft-like open junction between anterior chamber and lacrimal film. Only the ketratoprosthesis by Strampelli (1970) settles firmly in the cornea without the above risks, because the autogenous transplanted bone unites well with the grafted labial mucosa. 5 years of investigation have confirmed that glass ceramic Ceravital unites firmly with bones (Blencke et al. 1973, Strunz et al. 1977c, Bunte et al. 1977). For the osteo-keramo-keratoprosthesis Ceravital is used the same location as Dentin for the osteo-odonto-keratoprosthesis. The new surgical method has the advantage that 1. toothless patients can be operated, 2. the anterior chamber cannot flatten because the ceramic disk has the same shape as the corneal surface, and 3. broader optical cylinders can be used, by which a widening of the visual field is achieved.

Ceramic augmentation of the lower jaw.

Atrophy of the lower jaw is essentially a manifestation of vertical bone resorption and must be treated in a compensatory manner. Animal experiments have shown the value of the bioactive glass ceramic Ceravital as a bone replacement material. After box-shaped or step-shaped osteotomies, we perform interpositional plastic operations with glass ceramic in order to augment the atrophied human lower jaw. Results, advantages and dangers of the method are shown in 12 patients.

[Comparative studies on the adhesiveness to the bone of various implantation materials]. / Vergleichende Untersuchungen über die Haftung verschiedener Implantatmaterialien im Knochen.

After earlier experiments showed that bone became adherent to glass ceramic, the maximum mechanical stress on the bone-ceramic interface, as compared with polymethylmethacrylate (PMMA) and aluminium oxide ceramic, was investigated for shearing force and tension. Whereas the PMMA and aluminium oxide ceramic test objects which had been inclosed in the connective tissue were very easily pushed out without measurable pressure, the average fracture load for 15 smooth glass ceramic objects was 466 p/mm2 in the pushed out test and 167 p/mm2 in the tension test.

Angiography in vascular malformations of the face.

While angiography has been established as a useful procedure in evaluating vascular malformations of the face, the role of selective catheterization has not been stressed. Five patients with either capillary-cavernous hemangiomas or arteriovenous racemose hemangiomas were selected to illustrate the angiographic features of vascular malformations of the face as well as problems in angiographic evaluation and therapeutic techniques. Angiographic studies were valuable in establishing the extent and type of hemangioma, its blood supply and drainage, and associated intraorbital or intracranial extensions. We believe that selective catheterization is essential in preoperative evaluation of facial hemoangiomas, particularly in detecting unsuspected intracranial involvement.

[Dentomaxillary destructions in oxalosis]. / Dentomaxilläre Destruktionen bei Oxalose.

Oxalosis, a rare metabolic disorder, leads to excessive formation of oxalate and deposition of calcium oxalate crystals in the tissue. This leads to renal insufficiency with resulting secondary hyperparathyroidism and myelofibrosis. In a 27 year old female patient, extensive destruction of the maxilla, mandible and teeth was observed which has not yet been described and which led to the loss of all teeth.

[Jaw-enlargement with glass ceramics in the animal experiment]. / Kiefer-Augmentation mit Glaskeramik im Tierversuch

The use of alloplastic material in the reconstruction of the defective or atrophic mandible appears obvious as the difficulties and risks of bone or cartilage transplants are well known. It appears that all the materials used up to now were demarcated by the bone as foreign bodies so that one could only observe strong union without a connective tissue line of separation with glass ceramics. In experimental operations in the pig, box shaped osteotomies were cut into the lower jaw and glass ceramic bodies were fixed into the clefts. Clinical and histological examinations proved the bone acceptance. It appears that these bio-active glass ceramics are particularly suited as bone replacement.

A integração de um Sistema de Gestão Acadêmica com o Moodle na UFMG - Márcio Bunte

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