Treatment of non-unions and delayed unions often requires osteogenic material. Recently, a biomimetic bone matrix that simulates the cellular environment of hard tissue, identified as P-15, was introduced to the orthopaedic community. A total of 22 patients with mal-union or delayed union fractures was treated from June 2000 to October 2003 with P15- bone graft substitute (P15-BGS) in the site of fracture and mostly with internal fixation. Patients were examined by independent radiographic analysis. Assessment criteria included time elapsed until bone bridging and time to full consolidation. In addition, histological assessment of the callus was done at the time of recovery of metal implants in five patients. Full consolidation was achieved in 90% (20 out of 22) of the patients treated with P15-BGS. The average time for full consolidation was 4.2 months. Histological assessment of the fracture callus in five of the patients confirmed the positive clinical and radiographic results. P15-BGS appears to offer a safe, economical and clinically useful alternative to autograft in the repair of ununited fractures. These results compare favourably with those in the published literature as an alternative to autograft.

Tamarix is one of the taxonomically most complex genera among the angiosperms, and there is little consensus regarding its infrageneric classification. Here we present the most complete phylogenetic reconstruction of the genus to date. This includes a DNA phylogenetic tree based on nuclear ribosomal ITS, and a plastid DNA phylogeny based on three intergenic spacers (trnS-trnG, ndhF-rpl32, and trnQ-rps16). In total, both nuclear and plastid phylogenetic analyses include more than 70 samples of 39 species from 27 countries, which represent close to 60% of the diversity of the genus. Two complementary trees, based only on one plastid marker, are also included. The first, based on trnS-trnG, is used to increase the number of species related to T. amplexicaulis. The second, based on ndhF-rpl32, is used to investigate the separation between T. tetrandra and T. parviflora. The incongruence between the available infrageneric classifications and the molecular results is confirmed. A reticulate evolution is inferred from the trees, showing characters such as vaginate leaves appearing at different stages along the evolutionary history of the genus. The presence of T. canariensis outside the Canary Islands is cast into doubt, and all such records from NW Africa and Europe are here considered to belong to T. gallica. The results also suggest independence of T. karelinii from T. hispida, and T. parviflora from T. tetrandra. Relationships between a number of species are still not resolved, and additional studies will be needed to further refine the complex taxonomy of Tamarix.

Granulomatous slack skin is an uncommon cutaneous T-helper cell lymphoma closely related to mycosis fungoides. To the best of our knowledge this disease has not been previously described in children. We report on an 11-year-old boy who presented with painless slack skin masses in the neck, right axilla and arm, anterior wall of the abdomen, both inguinal regions, and the malleolar and dorsal aspects of the feet. The disease started 3 years earlier with erythematous lesions on the neck and wrists. Histologic examination of a specimen from the abdominal mass revealed an extensive lymphoid infiltrate with scattered multinucleated giant cells extending from the papillary dermis to the subcutis. The lymphoid cells showed the following immunophenotype: CD43+ (MT1), CD45+, CD45RO+, CD20-. The phenotype of the giant cells was lysozyme positive, CD68+ and Mac387-. The tumoral lymphoid cells had clonal rearrangement for the gene of the beta chain of the T-cell receptor (C beta TCR). The disease could be controlled with systemic glucocorticoids. Due to the presence of many histiocytes arranged in aggregates in the papillary and mid-dermis, this case was initially considered to be a cutaneous form of histiocytosis. We recommend deep and extensive biopsies in patients with slack skin disease.

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