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Purification and heterogeneity of inorganic pyrophosphatase of pig scapula cartilage.

Inorganic pyrophosphatase (pyrophosphate phosphohydrolase; EC 3.6.1.1) was purified from pig scapula cartilage by fractionation with N-cetylpyridinium chloride and (NH4)2SO4, followed by ion-exchange and gel-filtration chromatography. Enzyme preparations of high purity were obtained, with specific activities (100-400 units/mg) higher than those previously described for mammalian pyrophosphatases. The enzyme activity could be separated into several subfractions on ion-exchange columns.

Alkaline Phosphatase↗

Properties of inorganic pyrophosphatase of pig scapula cartilage.

The properties of a highly purified inorganic pyrophosphatase (pyrophosphate phosphohydrolase; EC 3.6.1.1) from pig scapula cartilage were studied. The enzyme had a molecular weight of 66 000 and a pH optimum of 7-8. It was markedly activated by magnesium, but not, or only to a much smaller degree, by other metal ions. PP1 was the only substrate found and had a Km value of 11 muM. The enzyme was not inhibited by phosphate and other inhibitors of alkaline phosphatase such as CN- minus, amino acids and theophylline; it was slightly inhibited by tartrate, formaldehyde and ammonium molybdate and strongly inhibited by F- minus, Ca2+ and other metal ions. The properties of the enzyme in the presence of concentrations of PP1 present in plasma (3.5 muM) were similar to those found at higher (2 mM) concentrations of PP1. The diphosphonates ethane-1-hydroxy-1,1-diphosphonate and dichloromethylenediphosphonate inhibited the enzyme in the presence of low PP1 concentrations. The characteristics of this enzyme are therefore similar to pyrophosphatases from other sources, such as from yeast and erythrocytes, and do not support a specific role of this enzyme in the calcification process.

Amino Acids↗

Post-traumatic fibro-osseous lesion of the ribs and scapula (sclerosing xanthofibroma).

Fibrous lesions of bone may be difficult to classify. Their etiology is controversial, most being considered to be developmental lesions rather than true neoplasms. We describe a patient with post-traumatic fibro-osseous lesion of the ribs, also known as sclerosing xanthofibroma; a lesion believed to be a reactive response to intramedullary hemorrhage following chest wall trauma. Clinically, the lesions in our patient were thought to be metastatic disease because of their multifocal appearance. An extensive clinical and laboratory metastatic evaluation with surgical resection of one of the lesions using intraoperative gamma probe was undertaken. In addition to the multiple rib involvement, our case also showed a lesion in the scapula. The pathologic and radiologic features of this entity are reviewed along with the summary of the differential diagnosis.

Antigens, CD↗

Osteosarcoma of the scapula arising in osteogenesis imperfecta.

A case of osteosarcoma arising in the scapula of a 37 year old woman with severe congenital sporadic white sclera type osteogenesis imperfecta (OI) is presented. Osteosarcoma occurs as a sporadic rather than a related occurrence in patients with OI. A delay in the diagnosis of osteosarcoma may occur due to the similarity in symptomatology between the two conditions and because of the difficulty in differentiating between hyperplastic callus and tumor using conventional radiographic imaging techniques.

Adult↗

Unusual stress fracture of the scapula in a jogger.

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.

Adult↗

Fractures of the scapula: a review of 53 fractures.

A series of 53 fractures of the scapula has been reviewed. Almost three fourths of our patients were injuried in automobile or motorcycle accidents in which severe force was applied to the shoulder region. There is rarely a problem in diagnosis, but one may need to take special roentgenographic views to delineate the extent of the fracture clearly. A geographic classification of these fractures was used, and it was found that 66% occur in the region of the scapular neck. It was emphasized that 81% of these patients had other associated injuries, many of which were life threatening. Symptomatic immobilization of the scapular fracture seems to be adequate for the vast majority, if not all, patients.

Adolescent↗

Bilateral avulsion fractures of the cranial margin of the scapula.

Avulsion of the cranial margin of the scapula is a rare injury. A case of bilateral avulsion fractures is reported. The postulated mechanism of injury is a powerful contraction of the omohyoid muscle avulsing its insertion. Conservative management was successful.

Accidents, Traffic↗

Increasing use of the scapula osteocutaneous free flap.

OBJECTIVES: To determine the appropriate use of the scapula osteocutaneous free flap (SOFF) and to document donor site morbidity. STUDY DESIGN: Retrospective review and prospective physical therapy evaluation. METHODS: A computer database of all free flap procedures performed at a single institution was created. Specific clinical and operative details from cases involving a bone flap were extracted from the database. Rates of usage of the various osteocutaneous flaps were compared over four successive 2-year intervals (1992-1999). A single physical therapist performed a structured evaluation of the donor site. RESULTS: Overall, 64 bone flap procedures were performed, of which 24 (37.5%) were SOFF procedures. The SOFF utilization has increased from 6.6% to 63.6%, while fibula and iliac crest utilization has fallen significantly. This is in part because of the greater versatility of the SOFF, with the possibility of separate skin paddles and adequate bone length. The mean cutaneous area harvested with the SOFF was 110 cm2 (range, 48-200 cm2) compared with 55.4 cm2 (range, 25-102 cm2) and 77.6 cm2 (range, 50-120 cm2) for the fibula and iliac crest, respectively. Mean bone flap lengths were 8.37, 7.65, and 10.1 cm, respectively, for the SOFF, fibula, and iliac crest. Dual skin paddles were used in 50% of the SOFF procedures versus 2.8% for the fibula flap procedures. There were no significant complications of the donor site in any patient, and there was only one flap failure (4.1%). Related to the SOFF, donor site morbidity was subjectively judged as "mild," for pain, mobility, and strength. There were no complaints of poor appearance of the donor site. Activities of daily living were judged as "not limited" or 'limited a little" in the majority of patients. Objective measurements of range of motion revealed an average reduction of 1 degree to 12 degrees in five different shoulder functions. Elbow and arm ranges of motion were not limited. Strength was minimally reduced in the shoulder, while the arm and forearm showed no reduction in strength. CONCLUSIONS: The SOFF is a versatile osteocutaneous free flap that can be used for a multitude of reconstructive problems. This and its relative lack of significant donor site morbidity have caused its use to increase significantly.

Activities of Daily Living↗

Malignant chondromyxoid fibroma of the scapula.

A rare case of malignant chondromyxoid fibroma developed in the scapula of a woman who was treated with interscapulothoracic resection. When a biopsy specimen was submitted for study, difficulty was encountered in establishing the histologic diagnosis. A large dose of radiation was given before surgery, based on an original biopsy diagnosis of osteosarcoma; in retrospect, preoperative irradiation probably was contraindicated. Two years and four months after surgery, the patient was working with no evidence of recurrence or metastasis.

Adult↗

Scapulectomy for the treatment of malignant tumors of the scapula.

Two cases of Tikhor-Linberg resection for rhabdomyosarcoma and malignant chondromyxoid fibroma and two cases of scapulectomy for metastatic disease of the shoulder girdle are reviewed. After resection of the scapula, active motion of the shoulder will be severely restricted, but normal function of elbow, wrist, and hand permit use of the extremity in many activities of daily living. Surgical treatment for metastatic bone disease in the upper extremity and the role of radiation therapy for metastatic bone disease are discussed.

Activities of Daily Living↗

Fanconi anemia patient with bilaterally hypoplastic scapula and unilateral winging associated with scoliosis and rib abnormality.

Fanconi anemia is an autosomal recessive disease characterized by bone marrow failure, variable congenital physical abnormalities, and predisposition to hematologic malignancy and several solid tumors. The most frequently associated congenital malformations are those of the skeletal system, mainly radius and thumb. Herein, we report bilaterally hypoplastic scapula with unilateral winging associated with scoliosis and rib abnormality, a previously unreported skeletal abnormality in Fanconi anemia patients.

Child↗

Pseudowinging of the scapula due to osteochondromata.

We report two patients, each with pseudowinging of the scapula caused by an osteochondroma. Local excision of the tumour cured the deformity. Clinical examination will help differentiate winging from pseudowinging, especially if the patient has scoliosis.

Child↗

Stress distribution in the scapula studied by neutron diffraction.

High intensity neutron beams provide a method of measuring the preferred orientation of apatite crystals in bulk samples of bone. Measurements at seven different sites on the scapula show that the c axes of the crystals lie preferentially along the directions of pull of the attached muscles. The highest orientation is found at positions under the influence of only a single group of muscles, such as M. teres major or M. infraspinatus. In intermediate regions a multiple distribution of crystals is found, able to withstand stresses in more than one direction. The technique provides a method of assessing the distribution of stress in bones.

Animals↗

A case of cutaneous bronchogenic cyst over the left scapula.

Bronchogenic cyst is noted shortly after birth or in early childhood and usually presents as a swelling or draining sinus in the presternal area. Its origin and pathogenesis can be explained as a developmental anomaly of the tracheobronchial buds from the primitive foregut. The patient was a 4-year-old boy with a child-fist-sized soft mass over his left scapula, which had been detected at birth and had been gradually growing. Grossly, it appeared to be a simple cyst with clear mucoid fluid. Histopathological study demonstrated a unilocular cyst composed of ciliated pseudostratified columnar epithelia, interspersed goblet cells, smooth muscles, and mucous glands on the cyst wall, which are features compatible with cutaneous bronchogenic cyst.

Bronchogenic Cyst↗

Haemangiosarcoma of the scapula in three dogs.

Three cases of haemanglosarcoma in the scapula of the dog are reported. Two cases were euthanased soon after diagnosis, due to the presence of metastases, while the third was treated surgically and recovered well. However, seven months after surgery, this dog was re-presented with a cervical spinal problem which was presumed to be a metastatic lesion.

Animals↗