Synthetic hydroxyapatite (HA) and tricalcium phosphate (TCP) are promising bone-substitute materials in the orthopaedic and dental fields, as their chemical composition is similar to that of bone. This study investigated the osseointegration performance of carbonated biphasic calcium phosphate (CBCP) ceramics containing carbonated hydroxyapatite and tricalcium phosphate prepared by microwave irradiation, in femoral defects of dogs. The defects were created as 3-mm holes on the lateral aspect of femur and filled with the implant material. The serum was collected postoperatively and biochemical assays for alkaline phosphatase activity levels were carried out. The animals' defective sites were radiographed at 4, 8, and 12 weeks. The radiographic results showed that the process of ossification started after 4 weeks and the defect was completely filled with new bone after 8 weeks. Histological examination of the tissue showed the osteoblastic activity inducing the osteogenesis in the defect. The complete haversian system with osteoblastic and osteoclastic activity and bone remodelling process were observed after 12 weeks. The alkaline phosphatase activity levels also correlated with the formation of osteoblast cells. This calcium phosphate ceramic has proved to work well as a biocompatible implant and as an osteoconductive and osteoinductive material for the filling of bone defects.

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A 3 week old infant presented with persistent hypoxaemia and was diagnosed with pulmonary arteriovenous malformations. Her family history was positive for hereditary haemorrhagic telangiectasia. She was treated successfully with coil embolotherapy at the age of 4 months. Transcatheter embolisation may be considered the primary treatment for pulmonary arteriovenous malformations in infancy.H ereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is an autosomal dominant mucocutaneous and visceral vascular dysplasia, characterised by the occurrence of telangiectasia and arteriovenous malformations (AVMs). Patients are usually recognised by the presence of telangiectasia, recurrent epistaxis, and a positive family history. Clinical symptoms usually appear after puberty.First reports appear to be from around 1864 when Sutton and Babington described patients with recurrent epistaxis and vascular abnormalities. Rendu, Osler, and Weber later recognised the combination of epistaxis in a familial pattern with telangiectasia. Pulmonary AVM is the most dangerous localisation of HHT because of the risk of paradoxical septic embolism.1 In 1897, the first pulmonary AVM was found at the postmortem examination of a 12 year old boy.2 Reported series of patients with pulmonary AVM, however, indicate that such findings are uncommon in children.3-6 To our knowledge, only 12 cases of pulmonary AVM diagnosed during the first year of life have been described from 1975 onwards, the last one being reported in 2000.6 Most of the previously described cases were treated primarily with surgery. We report on a 3 week old infant who presented with persistent hypoxaemia as a result of pulmonary AVM. CASE REPORTA 3 week old Dutch Antillean girl was admitted after an apparently life threatening event. The pregnancy was uncomplicated, and the patient was born term with a birth weight of 2420 g (p13). Apgar scores were 8 and 9 after one and five minutes respectively. There had been no remarkable events until the day of admission, when she had an apnoeic episode after several coughs. The pregnancy had been the mother's seventh. Two older children originate from another relationship; four pregnancies were terminated by legal abortion. The history later revealed the occurrence of HHT in the family, with a confirmed mutation in the gene coding for endoglin on chromosome 9. This family, 3655, and the mutation have been described previously.7 The patient's mother has been diagnosed recently with HHT, and the presence of the same mutation is under investigation.Physical examination at admission showed a healthy and alert black neonate without fever. Besides mild tachypnoea and a persistent percutaneous oxygen saturation of 87%, vital signs were stable. Auscultation of the chest showed normal heart sounds with a slight early systolic murmur, maximal at the upper left sternal border, attributed to a persistent ductus arteriosus as evidenced by cardiac ultrasonography. On revision three weeks later, it was no longer audible o...

If only obese children with reported apnoea, restless sleep or TH have a sleep study, 95% of all obese children with significant OSA will be identified using this method.

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