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Biomedical subjects

C Lidor

Publications and source records attributed to C Lidor.

At least 19 recordsLinked to original sources

Stress fracture of the tibia after arthrodesis of the ankle or the hindfoot.

We studied twelve patients who had a stress fracture of the tibia and one patient who had a stress fracture of the fibula after arthrodesis of the ankle or the foot. A second stress fracture subsequently developed in two patients. All but two patients were managed non-operatively, and the fractures healed uneventfully. One patient who was managed operatively had a below-the-knee amputation to treat a painful non-union of a tibial fracture, and the other had interlocking intramedullary nailing for a displaced fracture. All but one of the arthrodesis sites had fused before the stress fracture occurred. All of the stress fractures that occurred after arthrodesis of the ankle were in the middle and distal aspects or the distal aspect of the tibia, while those that occurred after triple arthrodesis were in the distal aspect of the fibula or the medial malleolus. Although six of the thirteen patients still had uncorrected alignment and deformity after the arthrodesis, optimum alignment after the arthrodesis did not preclude the occurrence of a stress fracture. We conclude that stress fracture must be considered in the differential diagnosis of pain months or even years after solid fusion at the site of an ankle or triple arthrodesis.

Adult↗

Centrocentral anastomosis with autologous nerve graft treatment of foot and ankle neuromas.

Painful neuromatas in the foot and around the ankle can be difficult to treat. Five patients of clinically and histologically proven neuromas underwent centrocentral union with autologous transplantation. Three patients had previous toe amputations involving multiple operations. One patient had failed multiple operative treatments for Morton's neuroma in his 3rd web space. One patient had a neuroma in his superficial peroneal nerve caused by a gun shot wound. All patients but one showed definitive subjective and objective improvement after centrocentral union with the interposed autologous nerve graft. The patient with "recurrent" Morton's neuroma had the least improvement. This technique can be recommended as an alternative for the prevention of painful stump neuromata.

Adult↗

Decrease in bone levels of 1,25-dihydroxyvitamin D in women with subcapital fracture of the femur.

In a previous study we were able to show that in women over the age of 45 the level of 1,25-dihydroxyvitamin D (1,25(OH)2D) in bone, but not in serum, is significantly reduced when compared with younger women. In the present study we measured the concentration of 1,25(OH)2D in sera and bones of 19 female patients with subcapital fractures of the femur, mean age 78 +/- 2 years. We were able to show that serum levels of 1,25(OH)2D were within the normal range, while bone levels were markedly reduced compared to levels in femoral bone obtained from young female cadavers or to the previously reported levels in non-osteoporotic elderly women. Thus, reduced levels of 1,25(OH)2D in bones of elderly women may lead, together with other factors, to subcapital fractures.

Adult↗

Decrease in bone level of 1,25-dihydroxyvitamin D in women over 45 years old.

The most active metabolite of vitamin D is 1,25-dihydroxyvitamin D [1,25(OH)2D]. Its level in the bone may play a role in the pathogenesis of metabolic bone diseases such as osteoporosis. To assess this, and to see whether there is correlation between serum and bone levels, we studied serum and bone samples taken from 43 patients (18 men and 25 women) undergoing different orthopedic procedures. Patients were studied according to sex and age groups (less than 45 years, 46-60 years, greater than 61 years). Serum level of 1,25(OH)2D was found to be 29.7 +/- 2.61 pg/ml (mean +/- SEM) for women, 32.2 +/- 3.86 pg/ml for men, and 30.7 +/- 2.18 pg/ml for the group as a whole. No significant statistical differences were found among age subgroups in either sex or between sexes. Bone level of 1,25(OH)2D was found to be 31.5 +/- 4.46 pg/g for women, 26.5 +/- 3.06 pg/g for men, and 29.4 +/- 2.81 pg/g for the entire group. No significant statistical difference was found between the age subgroups for men. However, the level of 1,25(OH)2D was found to be higher in the group of younger women (less than 45 years) compared with the older women (46-60 years and greater than 61 years) (P less than 0.005).

Adolescent↗

Parosteal lipoma of the proximal radius: a report of five cases.

Parosteal lipoma of the proximal radius is a benign, slow-growing tumor. It may cause compression of either the posterior interosseous or the superficial branch of the radial nerve. Surgical excision usually leads to complete recovery. Five cases of parosteal lipoma of the proximal radius are presented. X-ray films demonstrated a radiolucent mass in contact with the radius. Two patients had signs of posterior interosseous nerve compression, and two showed signs of superficial radial nerve compression. In one case the lipoma surrounded an exostosis arising from the proximal radius. The tumors were excised in four patients. The three patients with neurologic involvement recovered fully. One patient refused surgery, and posterior interosseous nerve paralysis developed.

Adult↗

Management of pyogenic vertebral osteomyelitis with spinal cord compression in the elderly.

Five elderly and debilitated patients presented with compressive myelopathy due to pyogenic spondylitis. All had undergone surgery which consisted of eradication of the infected tissue via an anterior approach followed by primary bone graft. Supplementary antibiotic treatment was determined by intraoperative bacteriological culture. This aggressive approach, disregarding the patients' advanced age and poor general medical state, resulted in total resolution of the neurological deficit and the patients' return to their preoperative everyday activity.

Aged↗

Osteoporosis as the sole presentation of bone marrow mastocytosis.

Three (young) adults with severe generalized osteopenia and vertebral compression fractures were studied. Extensive clinical and laboratory investigations were not contributory. Undecalcified bone biopsies demonstrated multiple mast cell granulomas in the marrow in two patients and numerous mast cells diffusely distributed throughout the bone marrow in the third patient. Mast cells may serve as a pathogenic agent in osteoporosis. Therefore, we conclude that isolated skeletal mastocytosis without clinical evidence of mast cell mediator release should be sought in the evaluation of a patient with unexplained severe bone loss.

Adult↗

Migratory multiple bone involvement in a patient with systemic mastocytosis.

A young patient with severe generalized osteopenia and multiple compressed vertebral fractures caused by systemic mastocytosis is presented. Extensive clinical, laboratory, and pathologic examination showed the involvement of the skeleton alone. Follow-up bone scintigraphy with Tc-99m MDP during a period of 6 years demonstrated migratory multiple axial lesions. These results suggest that Tc-99m MDP imaging is an accurate detection of the activity of the disease.

Adult↗

Biochemical and biomechanical properties of avian callus after local administration of dihydroxylated vitamin D metabolites.

In vitamin D-fed chicks 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3 were implanted into experimentally-produced fractures of the mid-tibia. The mechanical and biochemical properties of the tibia were evaluated for two weeks, including torsion tests, measurement of alkaline phosphatase activity, 45Ca incorporation, and Ca2+ content. Both dihydroxylated metabolites of vitamin D3 had a direct effect on endochondral bone formation. 24,25(OH)2D3 strengthened the callus, and raised alkaline phosphate activity in the first seven days after fracture. 1,25(OH)2D3 decreased the strength of the callus concomitant with a reduction in 45Ca incorporation. It is suggested that local application of 24,25(OH)2D3 into fractures may accelerate healing and prevent non-union.

24,25-Dihydroxyvitamin D 3↗

Proteoglycan synthesis in vitamin D-deficient cartilage: recovery from vitamin D deficiency.

Vitamin D appears to be required for mineralization of skeletal elements. There is also evidence that cartilage proteoglycans may be involved in the regulation of mineralization. Previous studies have shown an alteration in the structure of the proteoglycans of the epiphyseal growth cartilage as a result of the decrease in serum calcium related to deficiency of dietary vitamin D. Vitamin D deficiency also induces a thickening of the epiphyseal growth plate presumably because of the inhibition of maturation of the growth plate chondrocytes. In order to compare the effect on proteoglycan structure with that on growth plate morphology, the proteoglycans of healing epiphyseal cartilage were characterized. The results indicate that, consistent with previous data, in vitamin D-deficient hatching chicks, the proteoglycans of the growth cartilage, but not of the articular cartilage, are smaller in monomer size with slightly smaller chondroitin sulfate chains whose sulfation pattern is unaltered. Sternal cartilage proteoglycans are unaffected. During recovery from vitamin D deficiency, the proteoglycans isolated from the growth cartilage are still not completely normal one day after supplementation with vitamin D, but are indistinguishable from normal by four days. In addition, the results conflict with those of a previous study in which only growth cartilage of hatchling chicks, not sternal or articular cartilage, was reported to synthesize large proteoglycans. Instead, all of these cartilages in the normal chicken have been found in this study to produce large proteoglycans of a size typical for mammalian cartilage and embryonic chick cartilage.

24,25-Dihydroxyvitamin D 3↗

Calcitriol increases Ca2+-ATPase activity.

Treatment with calcitriol of isolated cartilage cells derived from epiphyseal growth plates of rachitic chicks results in reduced intracellular calcium concentrations. The reduction in calcium was found to correlate with increased activity of Ca2+-ATPase. The activities of Na+-K+-ATPase and of Mg2+-ATPase did not change in response to the treatment with calcitriol. It is suggested that calcitriol regulates intracellular calcium by modulating the activity of the Ca2+-pumping ATPase.

Alkaline Phosphatase↗