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PubMed1990

Severe postaxial acrofacial dysostosis: an anatomic and angiographic study.

We describe a severe case of postaxial acrofacial dysostosis syndrome [POADS] or Genée-Wiedemann syndrome in a stillborn female. The report includes an arteriographic and anatomic study of the limbs. Previously unreported findings such as hypoplasia of the femora, ossification defect of the ischium and pubis, bilobed tongue, and lung hypoplasia were noted. This case documents further variability in the POADS or Genée-Wiedemann syndrome.

Angiography↗
PubMed1985

The skeleton of early Eocene Cantius, oldest lemuriform primate.

A recently discovered partial skeleton of the adapid Cantius trigonodus from the early Eocene Willwood Formation of the Bighorn Basin, Wyoming, documents substantial new information about the anatomy of the oldest lemuriform primates. It is very similar in all features to its descendant, middle Eocene Notharctus, and both exhibit numerous resemblances to certain extant Malagasy lemurs, particularly Lepilemur, Propithecus, Lemur, and Hapalemur griseus. Like these forms, Cantius had relatively long hind limbs and short forelimbs. Forelimb traits (prominent brachialis flange of the humerus, well-developed olecranon process of the ulna, and strong shafts of the ulna and radius) suggest active use of the forelimbs in progression. Specializations in the hind limb (e.g., expanded articular surface of the femoral head, narrow and elevated patellar trochlea and prominent lateral trochlear ridge, posteriorly oriented femoral and tibial condyles, narrow and elongate talus, and hallucal metatarsal with prominent peroneal tubercle) indicate capabilities for leaping and for powerful grasping with an opposable hallux. Cantius was presumably primitive in having a relatively long ischium and much more distal inferior tibial tuberosity than most extant lemurs--traits suggesting that powerful extension of the thigh and flexion at the knee were important in its locomotion and posture. We interpret Cantius as an active arboreal quadruped with a propensity for leaping. The existence of this skeletal structure in one of the oldest primates of modern aspect suggests that it represents the primitive lemuriform morphology.

Animals↗
PubMed1991

Ontogeny and evolution of pelvic diameters in anthropoid primates and in Australopithecus afarensis (AL 288-1).

Pelvic diameters (both anteroposterior [AP] and transverse [TR]) were investigated in a series of anthropoid primates. The ratio of diameters (AP/TR) in each of three pelvic planes (inlet, midpelvis, and outlet) was calculated. In addition to the above, the length of the iliac, pubic, and ischial axes and the angles between these axes were determined. The AP/TR ratio at the pelvic inlet is (reported in millimeters, +/- SD, unless otherwise specified) 1.81 +/- 0.27 in New World monkeys (Cebidae) and Macaca mulatta; 1.53 +/- 0.17 in hylobatids and pongids; 0.87 +/- 0.08 in Homo sapiens; and 0.58 in Australopithecus afarensis (AL 288-1). The AP/TR ratio in the midpelvis is 1.61 +/- 0.23 in nonhominid primates (Cebidae, M. mulatta, hylobatids, and pongids), 1.12 +/- 0.11 in humans, and 0.59 in AL 288-1. In monkeys (Cebidae and M. mulatta), hylobatids, pongids, H. sapiens, and AL 288-1, the ratios of the length of the pubic axis over the ischial axis were 0.84 +/- 0.06, 0.95 +/- 0.07, 1.10 +/- 0.15, and 1.46, respectively; the pubis-ilium angles were 96 +/- 11, 120 +/- 10, 131 +/- 11, and 147 degrees, respectively; and the ischium-pubis angles were 106 +/- 11, 86 +/- 8, 96 +/- 7, and 68 degrees, respectively. In none of these pelvic features was AL 288-1 "intermediate" between pongids and H. sapiens. The anatomical peculiarities of the pelvis in AL 288-1 are explained primarily as the result of early adaptation to erect posture, which resulted in the reduction of the distance between the sacroiliac joint and the hip joint. As a consequence, the sacral promontory moved toward the pubic symphysis, and this resulted in shortening of the AP diameter and widening of the TR diameter at the pelvic inlet.

Animals↗
PubMed1992

Comparative study of sexual dimorphism of the innominate bone in rodents and amphibians.

Sexual dimorphism in the shape of the innominate bone was demonstrated in the rat, mouse, Chinese hamster (Cricetulus griseus), frog (Ranna nigromaculata), and newt (Cynops pyrrhogaster) with a computer-assisted morphometric technique. In the rat, mouse, and hamster, ratios of ischium and pubis widths to the innominate bone length (INL) were larger in the males than in the females; however, the ratio of pubis length to INL was larger in the females than in the males. In the frog, the ratio of distance between the upper edge of the acetabulum and the lower edge of the pubis to INL was larger in males than in females. In the newt, ratios of width of ischiopubis and the longitudinal length of the ischiopubis to INL were larger in females than in males.

Animals↗
PubMed2004

Effect in rats of simultaneous prenatal exposure to ochratoxin A and aflatoxin B1. I. Maternal toxicity and fetal malformations.

Ochratoxin A (OA) and Aflatoxin B1 (AFB1), the food borne mycotoxins are produced by several fungal species of the genera Aspergillus and Penicillium. To determine the teratogenic effects, these mycotoxins were administered orally either individually or in combination to the pregnant Wistar rats on days 6-15 of gestation. OA and AFB1 were dissolved in corn oil and different doses of OA (0.125, 0.25, 0.50, and 0.75 mg/kg), AFB1 (0.125, 0.25, 0.50, and 1.00 mg/kg), and a combination of OA+AFB1 (0.125+0.125; 0.25+0.50; 0.50+0.25 mg/kg) were given by gastric intubation to rats. During dosing period, the body weight and body weight gains significantly decreased at a higher dosage, in both individual and combined treatments. In all the combination treatments, the percent implants resorbed, fetal body weights, and crown-rump lengths were comparable to those of controls and with the individual mycotoxin treatment. The number of dead fetuses was significantly increased in the high OA combination (OA+AFB1 0.50+0.25) group as compared with the other two combinations. OA and AFB1 alone and in combination caused various gross, skeletal, and visceral anomalies. The occurrence was considerably less pronounced in fetuses of AFB1 and combination groups as compared with those of OA group fetuses. The exencephaly, incomplete closure of skull, wavy and fused ribs, agenesis of the ischium bone, and enlarged renal pelvis, recorded in OA treatment and ear abnormality and incomplete ossification of skull bones observed in AFB1 when given individually, were not seen in combination groups. However, new manifestations, such as gastroschisis and syndactyly were observed and the incidence of cardiac defects was increased in fetuses due to the combined treatment. The results of the present study indicated that there is some interaction between these mycotoxins that resulted in reduced teratogenic activity of OA in the presence of AFB1. Apparently, new manifestations observed in combination treatment points to the potential threat of teratogenicity in terms of public health hazards.

Abnormalities, Drug-Induced↗
PubMed2006

Skeletal development of the Mexican spadefoot, Spea multiplicata (Anura: Pelobatidae).

The larval chondrocranium of Spea multiplicata is described, as is the development and adult morphology of the skeleton. There are major modifications to the larval chondrocranium throughout development, including the presence of embryonic trabeculae in young tadpoles and significant reorganization of cartilaginous structures at metamorphosis. The first bone to ossify is the parasphenoid (Stage 35), followed by the presacral neural arches, ilium, and femur (Stage 36). By Stage 39, most of the postcranial elements have begun to ossify. Metamorphic climax is accomplished over three Gosner stages (39-41) and involves major modifications to the chondrocranium, as well as the appearance of three cranial elements (septomaxilla, nasal, and premaxilla). After metamorphosis, the exoccipital, vomer, dentary, angulosplenial, squamosal, pterygoid, sphenethmoid, ischium, and hyoid begin to ossify. The stapes, mentomeckelian, operculum, carpals, and tarsals do not appear until juvenile and adult stages. The development of the hyoid and cartilaginous condensations of the carpals and tarsals are described. In addition, phenotypic plasticity within the genus and the absence of a palatine (= neopalatine) bone are discussed.

Animals↗
PubMed2000

New skeletal remains of Omomys (Primates, Omomyidae): functional morphology of the hindlimb and locomotor behavior of a Middle Eocene primate.

New associated craniodental and postcranial remains of Omomys carteri from Bridger C beds in Uinta County, Wyoming represent the largest and most nearly complete single taxon sample of omomyid postcranial fossils presently known. They allow, for the first time, a description and detailed analysis of the functional morphology of the hindlimb of this middle Eocene omomyine primate. Comparisons of pelvic, femoral, tibial, and pedal morphology and metrics with a large sample of prosimian primates of known locomotor behavior suggest that Omomys possessed a highly distinctive mosaic of functional adaptations related to active quadrupedalism and leaping. Traits suggestive of quadrupedalism include the lengths of the ischium and ilium, position of the femoral trochanters, and lengths and features of the tarsal bones. Morphological traits that suggest leaping include a semi-cylindrical femoral head with moderate posterior expansion of the articular surface, greater trochanter projecting anterior to the femoral shaft, deeper than wide femoral condyles, narrow and deep patellar groove with prominent lateral border, elongated calcaneus, and close aposition of distal tibia and fibula. While Omomys most closely resembles active quadrupedal cheirogaleids like Cheirogaleus and Mirza, leaping must have been an important component of its locomotor repertoire. In this respect, Omomys closely resembles other North American omomyines (notably Hemiacodon), and is significantly more generalized postcranially than European microchoerines (e.g., Microchoerus, Nannopithex, and Necrolemur).

Animals↗
PubMed1994

Ultrasonic signs of pelvic osteomyelitis in children.

The ultrasonic findings were reviewed in 13 children in whom pelvic osteomyelitis was diagnosed by a positive 99mtechnetium methylene diphosphonate (MDP) bone scan in conjunction with clinical and laboratory features of osteomyelitis. All patients presented with pain in the region of the hip joint. In six patients the ultrasound study was confined to the hip joint, and all six had normal findings. In seven patients the ultrasound study was extended to include the pelvis. Deep soft tissue swelling was demonstrated in six of these, including a periosseous abscess in one case. Ultrasonography was negative in one patient with a 5-week history, whose pelvic osteomyelitis was resolving at the time of the ultrasound study. Oedema of the obturator internus and externus muscles was observed in osteomyelitis affecting the pubis and ischium, and of the iliacus and/or the gluteus medius muscle in osteomyelitis of the ilium. In children presenting with hip pain who have a normal hip ultrasound study, extension of the ultrasound examination to include these four pelvic muscles may help to identify and document the progression of acute pelvic osteomyelitis.

Adolescent↗
PubMed2000

Neuroanatomy of the pelvis: implications for colonic and rectal resection.

PURPOSE: Urinary dysfunction remains a common complication of radical pelvic surgery, particularly after abdominoperineal resection. In treating rectal carcinoma, the extent of primary resection and lymphadenectomy are major determinants in the degree of postoperative urologic morbidity. METHODS: Twelve male and eight female hemipelves from fresh cadavers were dissected with reference to the neuroanatomy of the lower genitourinary tract. These cadavers were dissected within twelve hours of thaw from frozen state. The cadavers were hemisected at the level of the sacral promontory for better exposure of neural trunks and vascular structures leading into the pelvis. These structures were followed down sequentially into the true pelvis, using magnified dissection under operating microscope or loupe dissection or both. RESULTS: Coordinated lower urinary tract function relies on both autonomic and somatic nerve activity. Emanating from the inferior hypogastric plexus, the pelvic nerve supplies sympathetic and parasympathetic innervation to the pelvic viscera. The course of the pelvic nerve is as follows: 1) from the inferior hypogastric plexus, it has multiple branches forming a web-like complex within the endopelvic fascial sleeve, some of which innervate the bladder detrusor; 2) a main branch traveling inferolateral to the rectum remains deep to the fascia of the levator ani muscle and courses to the external urinary sphincter; 3) at the level of the prostatic apex (or bladder neck in females), this pelvic nerve branch sends direct branches to the urinary sphincter. The pudendal nerve traverses the pelvis in the pudendal canal, and before leaving the pelvis to enter the perineum, it gives an intrapelvic branch that courses alongside the ischium to enter the external urinary sphincter. In the ischiorectal fossa, terminal branches of the pudendal nerve (i. e., perineal nerve) can be seen inserting into the urinary sphincter. CONCLUSIONS: Urinary retention and urinary incontinence represent two distinct urologic complications after abdominoperineal resection. Injury to detrusor branches of the pelvic nerve can cause detrusor denervation and urinary retention. In addition, injury to intrapelvic branches of the pelvic and pudendal nerves to the urinary sphincter can result in intrinsic sphincter deficiency and urinary incontinence. A better understanding of the neuroanatomy of the lower genitourinary tract can give a physiologic basis for clinical findings of postoperative voiding dysfunction and may help the surgeon refine surgical technique by more precisely determining resection limits to minimize urologic complications.

Aged↗
PubMed2004

Composite pelvic exenteration: is it worthwhile?

BACKGROUND: In locally advanced pelvic cancer, tumor fixation to the bony pelvis is regarded as unresectable and often inoperable. Few data exist regarding the futility or utility of pelvic exenteration with en bloc resection of involved portions of the bony pelvis. METHODS: Thirty-four of 625 patients undergoing radical pelvic procedures had an en bloc resection of pelvic organs with portions of the bony pelvis. There were 19 female and 15 male patients, and the median age was 59 years. Primary neoplasms included 19 rectal, 6 cervicouterine, 4 anal, 3 vaginal, 1 sarcoma, and 1 penile. All but three patients underwent preoperative pelvic irradiation. Pelvic exenterations were posterior in 7 patients, anterior in 3, supralevator in 3, and total in 21 patients. Pelvic bony resections included portions of the sacrum-coccyx in 18 patients, ischium in 5, pubic symphysis in 4, and ischial pubic rami in 4, and hemipelvectomy was performed in 3. RESULTS: Surgical morbidity occurred in 67.6% (23) of 24 patients. Median follow-up was 37 months. Pelvic or perineal tumor recurrence was concurrent with distant metastases in 9 patients (26.4%); 6 (17.6%) had only distant relapse, and 2 (5.8%) died with local recurrence alone. Overall cancer-related mortality rate was 50%. Five-year overall and cancer-specific survival rates were 44% and 52%, respectively. CONCLUSIONS: Substantial survival can be accomplished for patients whose tumors are fixed to limited portions of the bony pelvis. These procedures are still associated with substantial morbidity, but operative mortality is infrequent.

Anus Neoplasms↗
PubMed2006

Hip joint remodeling in an adult following excision of a giant cell tumor involving the acetabulum: a case report and literature review.

We describe a 47-year-old man with a giant cell tumor of bone involving the acetabulum treated with curettage and bone grafting which resulted in good remodeling of the hip joint. The patient had a 15 x 18-cm(2) mass lesion extending from the right ischium to the acetabulum. Treatment included curettage, phenol, and ethanol application as an adjuvant, and cancellous bone allografting was performed on the subchondral area of the acetabulum. The posterior column of the acetabulum was disappeared by tumor invasion. Despite central migration of the femoral head, adequate hip joint repair was achieved without surgery 5.5 years postoperatively and with no tumor recurrence. The patient could walk without pain or ambulation aids; hip range of motion was 100 degrees for flexion, 0 degrees for extension, 30 degrees for abduction, 45 degrees for external rotation, and 10 degrees for internal rotation, and the functional result was 93.3% in the Enneking scoring system. We performed intralesional curettage with phenol and ethanol adjuvant therapy for pelvic giant cell tumor without tumor recurrence, and good repair of a hip joint adaptation can be achieved even in an adult patient.

Acetabulum↗
PubMed2005

Differential regulation of avian pelvic girdle development by the limb field ectoderm.

Although limb development has been a subject of intense research over the last decades, development of the girdles has been poorly investigated. Particularly, a detailed analysis of pelvic girdle development including functional data is not available to date. Here, we describe the early steps of the formation of mesenchymal and cartilaginous anlagen of the pelvic elements using alcian blue staining in whole mount embryos and serial histological sections, and the expression pattern of several marker genes to provide an operative basis for further research in pelvis development. Moreover, we describe pelvis development after unilateral hindlimb bud amputation and somatopleural ectoderm extirpation. We show for the first time, that ectodermal signals at pre-limb bud stages are required for pelvis formation. We present evidence suggesting that the regulation of ilium development is different from the development of ischium and pubis.

Animals↗
PubMed2003

Multiple insufficiency fractures with severe osteoporosis.

Multiple insufficiency fracture is a rare injury. We report a 63-year-old woman who spontaneously developed insufficiency fractures at multiple sites including ribs, sacrum, pubis, ischium, acetabulum, metatarsal bone, and femoral neck. The patient had severe osteoporosis with a bone mineral density of 0.267 g/cm(2), although there was no evidence of bone metabolic disease or metastatic bone tumor. Risk factors for osteoporosis in this case were her postmenopausal state and a history of gastrectomy. Interestingly, the serum level of insulin-like growth factor I, recognized as a growth factor that stimulates bone formation, was markedly decreased, and the patient had had viral hepatitis C. It was speculated that the synergistic effects of these disorders might have produced the osteoporosis, leading ultimately to the multiple insufficiency fractures.

Comorbidity↗
PubMed2002

Intraosseous lipoma: a clinical study of 12 patients.

We studied 12 patients (13 bones) with intraosseous lipoma to elucidate the clinical features of this disease. The patients ranged in age from 14 to 54 years. Eleven patients were men and 1 was a woman. The involved bones were the calcaneus in 6 patients (7 bones), humerus in 3, ischium in 2, and sacrum in 1. Three bones were in Milgram's stage I, 8 were in stage II, and 2 were in stage III. On plain radiographs, all bones showed a well-circumscribed radiolucent area. Nine bones showed calcification or ossification. Computed tomography or magnetic resonance imaging showed low density or high signal intensity, respectively, identical to the findings in normal adipose tissue. The tumor was curetted in 3 patients (3 bones), in whom local recurrence was not seen thereafter. In the remaining 9 patients (10 bones), we observed the natural course; in 1 of these patients, incisional biopsy was performed. During the follow-up period, only 1 patient showed slight enlargement of the lesion, while the findings in the others remained unchanged. Three patients had pain, which disappeared after the surgery or during the course of the observation. Partly because intraosseous lipoma tends to undergo spontaneous involution, and partly because diagnosis is easy from the radiological findings, surgery does not seem to be necessary in most patients.

Adolescent↗
PubMed1994

Pressure ulcers: a review.

This article reviews the etiology, pathology, description, risk factors, prevention, medical and surgical management, and complications of pressure ulcers. Pressure ulcers, which develop primarily from pressure and shear, are also known as decubitus ulcers, bed sores, and pressure sores. They continue to occur in hospitals, nursing homes, and among disabled persons in the community. Estimates of the prevalence of pressure ulcers in hospitalized patients range from 3% to 14% and up to 25% in nursing homes. Persons with spinal cord injury and the elderly are two groups at high risk. The most common sites of development are the sacrum, ischium, trochanters, and about the ankles and heels. Areas of ongoing research such as electrical stimulation and growth factors are discussed.

Aged↗
PubMedDate not supplied

Carbon fibre pad insertion as a method of achieving soft tissue augmentation in order to reduce the liability to pressure sore development in the spinal injury patient.

Twenty patients at the Northern Regional Spinal Injury Unit received carbon fibre implants inserted into the sites of previously closed pressure sores or threatened pressure sores. The most common site was over the ischium, but some have also been inserted at the trochanteric area, the sacral area and also over bony protuberances of the leg. Seven implants from four patients had to be removed because of damage or infection. Sixteen patients with 18 implants have proceeded with no recurrence for a period of 4-8 years.

Adult↗
PubMed1982

Model experiments to study the stress distributions in a seated buttock.

Mechanical stress states that develop in the buttock during sitting may exceed tissue tolerance and lead to decubitus ulcer formation in susceptible patients, such as those with spinal cord injury. The danger of this complication can be reduced by using suitable cushions to minimize stress magnitudes and gradients within soft tissues. In this investigation, a two-dimensional physical model of the buttock-cushion system was developed to aid in cushion design. The model consists of PVC gel simulating flesh, cast around a wooden core simulating the ischium bone. A grid etched on the gel permits measurement of strains via photographs of the undeformed and deformed model buttock supported by various cushion materials. The displacement field is analyzed, using a finite strain theory and a strain energy function, to obtain the "tissue stresses'. In this manner, the performances of five clinically used cushion materials were compared with respect to the high stress regimes developed in the model buttock.

Buttocks↗
PubMed1984

Immediate vaginal reconstruction following resection for malignancy using the gluteal thigh flap.

Immediate flap closure of perineal defects following extirpative procedures for gynecologic malignancies is highly desirable. Advantages include more rapid healing, reduced infection rate, decreased nutritional demands, early rehabilitation, greater safety in radiated fields, and more functional results. The posterior thigh flap, deriving its blood supply from the inferior gluteal artery, was used in 7 patients (9 flaps) with excellent results. The flap has proven reliable and quite feasible at the time of resection. While most partial pelvic or vaginal defects can be reconstructed with a single flap, bilateral flaps are recommended for more extensive defects. The major postoperative problem has been discomfort while sitting and paresthesias along the distribution of the posterior cutaneous nerve. To avoid these problems, the flap should be rotated distal to the ischium and, in subtotal reconstruction, the nerve excluded.

Adult↗