Vertebral rim lesions in dorsolumbar spine.
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Biomedical subjects
Publications and source records attributed to J Ball.
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The distribution of aluminium has been investigated using a new histochemical technique in transiliac bone biopsy specimens from 20 patients with aluminium related bone disease and 17 with other metabolic bone diseases. The method, which employs solochrome azurine at acid pH (acid solochrome azurine), showed a wider distribution of aluminium within cortical and trabecular bone than other histochemical techniques. The results compared well with atomic absorption spectrophotometric analysis of these biopsy specimens. Wavelength dispersive electron probe analysis of serial sections validated the procedure. The method has certain advantages over both these analytical techniques.
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Osteogenesis imperfecta (OI) is an inherited disorder of connective tissue metabolism characterized by fragility of the bones, resulting in multiple fractures. In this study electron microscopic examination of the osteoid region of iliac crest bone biopsy specimens from a 55-year-old man and his three sons (18, 21, and 25 years of age) affected with the common Type I (autosomal dominant) form of OI revealed collagen fibrils consistently smaller in diameter than those from normal age-matched control subjects, with the majority of OI fibrils measuring 0.04-0.06 micron, as opposed to 0.06-0.08 micron in the control subjects. This defect may be due to the biosynthesis of Type III collagen, not normally found in adult lamellar bone or, more likely, to a failure of maturation of Type I fibrils to their normal diameters, possibly owing to the increased levels of hydroxylysine previously reported in OI collagen, a factor known to be inversely related to fibril diameter.
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The enthesopathic lesion of ankylosing spondylitis consists of a nonspecific, nongranulomatous inflammatory lesion which leads to destruction of the attachment of ligament to bone. Resulting erosion leads to reactive bone formation which may form a new enthesis and around the outer fibres of the annulus may lead to syndesmophyte formation. What determines the distribution of the enthesopathy and ankylosis is not known.
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Aluminium removal by desferrioxamine chelation has been demonstrated in three long-term haemodialysis patients with dialysis encephalopathy and fracturing renal osteodystrophy. Aluminium concentrations in serum and in both bone marrow and bone trabeculae, determined separately in transiliac biopsy specimens, fell significantly over the treatment period. Bone aluminium removal was confirmed by specific histochemical staining. In two patients osteomalacia disappeared, and in two patients osteitis fibrosa emerged but improved in one following vitamin D therapy. We conclude that desferrioxamine is capable of mobilising aluminium from bone and that the calcification defect in fracturing renal osteodystrophy may be overcome.
Of the three related survey studies that were conducted, two are summarized and one, which characterizes all three, is reported in detail. The studies attempted to determine how aviators compared with the general population on the personality dimension--locus of control (internal vs. external) and how this was related to aviators' attendance at FAA Safety Clinics. In addition, aviators were surveyed regarding their attitudes towards safety, their flying skill, and the likelihood that they would have an accident during the remainder of their careers. Results showed aviators to be significantly more internal in locus of control than the general U.S. population and to have strong self-serving biases regarding their skill and safety levels. Pilots who attended FAA Safety Clinics tended to have a more internal locus of control than those who did not.
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Four cases of pulmonary leiomyosarcoma are presented. The characteristic histological features are described with specific reference to the criteria of malignancy. It is suggested that diagnosis by bronchoscopy provides insufficient material for histological grading and open lung biopsy is the diagnostic tool of choice. The available methods of treatment are discussed.
As part of a systemic study of the spine between D11 and S1 the distribution and severity of anterior and posterior annular tears has been assessed by charting the tears in sagittal slabs of 117 fresh specimens. No significant sex difference was seen. The number of cases with tears in multiple discs increases with age, but exceptions to this trend occurred in both young and elderly spines. Age adjusted correlation coefficients indicate that anterior and posterior tears at L4 and L5 do not predict tears at other levels. At L3 and above, significant positive correlations occur between multiple disc levels, particularly posteriorly. In patients 50o year old or more the mean anterior tear score rises sharply from L5 to peak at L2 and L1, but, in contrast, the mean posterior tear score falls from L4 to L1 in this age group. The increase in severity of anterior tears corresponds with increased mobility in the L4-L1 disc from 50-70 years. The data are compatible with 2 factors causing tears. One affects L4 and L5 in young adults and is possibly mechanical in nature; the second operates at a later age, promotes widespread disc involvement, and is primarily degenerative in nature. The increased prevalence and severity of anterior tears (and the associated increase in mobility) in the upper lumbar region in the middle aged and elderly may be a pathogenic factor in back pain for this age group.
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