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PubMed1993

[Bone demineralization and elevation of serum osteocalcin concentrations in young children with hyperthyroidism].

Bone mineralization and serum osteocalcin level were evaluated in 15 children with Grave's disease. Two groups were constituted according to the presence (group I: n = 9) or absence (group II: n = 6) of a severe bone demineralization. A spontaneous fracture and a collapsed vertebra were found in one group I patient. Patients in group I were younger than in group II (8.3 +/- 4.9 vs 11.5 +/- 4.3 yrs). One patient in group II and six in group I were prepubertal with advanced bone age and increased growth velocity. Osteocalcin measurement (Oc) was performed in 10 patients (group I: n = 6; group II: n = 4) at the time of biological hyperthyroidism. The six patients with bone demineralization had elevated Oc levels. In group II, two patients had normal Oc levels and two had elevated Oc levels. In treated patients with good control of hyperthyroidism, all group II patients except one, had normal serum Oc levels and bone mineralization remain normal (n = 5) after 0.6 to 4.6 yrs of follow-up. In group I patients, although height velocity was normal, elevated (n = 4) or slightly elevated (n = 1) serum Oc levels and severe bone demineralization (n = 7 cases) persisted after 0.5 to 3 yrs of good control of the hyperthyroidism. Although the method used for measuring bone mineralization is potentially less precise than bone densitometry and not all the patients had serum osteocalcin measurements at the same time of the illness, our results emphasize that skeletal demineralization may be particularly marked in young children with Grave's disease and should be carefully evaluated.

Absorptiometry, Photon↗
PubMed1977

Physical and psychological complications after intestinal bypass for obesity.

Cognitive changes, depression, arthralgia and dermatitis developed in a 33-year-old woman 5 years after a jejunoileal shunt for massive obesity, The dermatitis and low serum carotene and vitamin C values suggested vitamin deficiencies, The serum magnesium concentration also was low. Vitamin and mineral replacement led to amelioration of the physical and psychological symptoms; the improvement has been maintained at 18-month follow-up. The favourable changes were documented with the Wechsler Adult Intelligence Scale, the Minnesota Multiphasic Personality Inventory and test performance ratings. It is concluded that the surgical procedure caused vitamin and magnesium deficiencies and that these resulted in the patient's symptoms.

Adult↗
PubMed1976

[Isolated decalcifying algodystrophy of the hip].

Transitory demineralization of the hip, a special form of reflex sympathetic dystrophy, is a rare condition. It should however be distinguished from more severe conditions such as tuberculosis or neoplastic bone disease. The typical symptoms are illustrated from 3 personally observed cases. The patients, usually men between the ages of 30 and 50 years or women in the last months of pregnancy, suffer severe mechanical pain in the hip, with limping and weakness. They usually need crutches for walking. Clinical examination of the hip reveals only slight restriction of passive movements. The erythrocyte sedimentation rate may be slightly elevated. Bone scan discloses hypercaptation, while other laboratory tests are negative. A few weeks after onset of symptoms, pelvic X-rays show extreme demineralization of the femoral head. On the other hand, the joint space and bony contours remain intact. The prognosis is excellent and the symptoms disappear after a few months or after delivery.

Accidents, Traffic↗
PubMed1989

Histochemical detection of osteocalcin in normal and pathological human bone.

We investigated the immunohistochemical localization of osteocalcin in demineralized, paraffin-embedded normal and pathological human bone. Acid decalcification protocols appeared to be more suitable for osteocalcin detection than mild chelating agents. In normal lamellar bone, osteocalcin was detected in osteocytes and along the lamellar bone matrix in fine granular deposits. Under pathological conditions (osteomyelitis, neoplasia), appositional bone showed immunoreactivity in osteoblasts and osteocytes but not in the provisory woven bone matrix. Intense immunoreactivity could be seen at the cell borders of osteoclasts and the bone margins of Howship lacunae. In primary bone-forming tumors, osteocalcin immunoreactivity was detected in osteoblasts and their malignant counterparts. On the basis of these results, we conclude that optimal preservation of osteocalcin is obtained through mild acid decalcifiers. Osteocalcin is deposited in bone matrix, especially that of metabolically inactive bone. In neoplasms, osteocalcin could be a marker of osteoblastic differentiation.

Bone Neoplasms↗
PubMedDate not supplied

Update on intraoperative analysis of mandibular margins.

PURPOSE: Assessing the adequacy of the surgical resection during composite resection of carcinoma is limited by the ability to evaluate the bone margins. The standard pathologic evaluation of bone is by decalcification. PATIENTS AND METHODS: A method of analysis was devised based on histologically proven methods of cortical invasion and subsequent spread. Frozen-section analysis of cancellous bone was investigated as a rapid method of evaluating adequacy of the mandibular resection. This report is an update of previously published results and includes an increase in the sample size as well as the analysis of additional pathology. Subjects consisted of 66 patients undergoing full thickness mandibular resection with 30 cases of histologically proven mandibular invasion qualifying for evaluation. Results on frozen section were then compared to the permanent section analysis on the cancellous bone and to the decalcified specimen. RESULTS: Complete correlation was found between frozen and permanent section results. Frozen section analysis was able to correctly predict adequacy of resection in 60 of 61 margins. CONCLUSION: Based on these results, the oncologic surgeon can evaluate bone margins at the time of the resection and adjust the amount of excision required to eradicate the disease.

Adult↗
PubMed1995

Rapid analysis of mandibular margins.

Evaluating surgical margins during composite resection of carcinoma is limited by analysis of the bone margins. The standard pathologic evaluation of bone is by decalcification. A method of analysis was devised based on histologically proven methods of cortical invasion and subsequent spread. Frozen section analysis (FSA) of the cancellous bone was investigated as a rapid method of evaluating adequacy of the mandibular resection. Subjects consisted of 29 patients undergoing full-thickness mandibular resection, with 16 cases of histologically proven mandibular invasion qualifying for evaluation. Results of FSA were then compared to the permanent section analysis of the cancellous bone and to the decalcified specimen. Complete correlation was found between frozen and permanent section results. Frozen section analysis was able to correctly predict adequacy of resection in 32 (97%) of 33 margins.

Carcinoma, Squamous Cell↗
PubMed1986

Effects of decalcification on immunoperoxidase staining.

One of the limitations of immunoperoxidase methods applied in surgical pathology is the loss of immunoreactivity during fixation and processing. In this study, the effects of decalcification on the immunoreactivity of various antigens in formalin fixed tissues were examined. The pieces of fixed tissue were placed in four different decalcifying solutions (EDTA, formic acid, nitric acid, and Plank-Rychlo solution) for various time periods and then processed routinely and embedded in paraffin. The paraffin sections of the tissues were stained with immunoperoxidase methods for immunoglobulins, hormones, or tissue/tumor-specific markers. Sections of nondecalcified tissues were used as a control. The immunohistochemical staining intensity and the number of positive cells were not reduced significantly in decalcified tissues within the usual time period of routine decalcification procedures. Many antigens survived even prolonged decalcification. The results of this study indicate that routinely decalcified tissues can be used for immunoperoxidase staining without significant loss of immunoreactivity.

Decalcification Technique↗
PubMed1987

Effect of decalcification agents on immunoreactivity of cellular antigens.

The effects of several strong acids, weak acids, a proprietary decalcifier, and edetic acid on the immunohistochemical staining of cryostat and fixed paraffin embedded sections of tissue from a variety of normal and pathological calcified and uncalcified specimens were studied. Even decalcification in strong acids (HCl, HN03, 5% trichloracetic acid, HCl-edetic acid did not diminish the reactivity of many useful antigens (including leucocyte common antigen, intermediate filaments, S100 protein and epithelial membrane antigen). Weaker acids (formic acid, acetic acid) and edetic acid decalcified more slowly and generally showed greater preservation of antigenic reactivity with better morphology and staining quality. Trichloracetic acid was also useful as a quick one step fixation and decalcifying agent for both cryostat and routinely processed sections. Knowledge of the preservation of antigenic reactivity in decalcified tissue will be useful in the diagnosis of tumours of uncertain histogenesis and origin which affect calcified tissues.

Acids↗
PubMed1995

Bone tissue in rheumatoid arthritis (2). Pathophysiologic data, pathologic findings, and therapeutic implications.

The occurrence of bone decalcification during rheumatoid arthritis is well documented, despite discrepancies among published data. The most recent studies support a decrease in bone mass, especially at the proximal femur, although estimations of the extent of bone loss ascribable to rheumatoid arthritis vary. The fracture risk is increased by approximately 100% in rheumatoid arthritis patients. Bone mass is negatively correlated with functional impairment, joint motion restriction and disease activity as assessed by laboratory tests for inflammation. Increased physical activity can reduce bone loss. Markers for bone formation (osteocalcin, procollagen type I carboxy-terminal propeptide) are normal or decreased, whereas markers for bone resorption (hydroxyproline, pyridinoline, and deoxypyridinoline) are elevated. This decoupling of bone formation and resorption may be responsible for bone loss. Although estrogen therapy can keep in check menopause-related bone loss, earlier findings suggesting that estrogens may have beneficial effects on the joint disease itself have been disproven. The value of preventive bisphosphonate therapy is currently under debate.

Arthritis, Rheumatoid↗
PubMed1997

Plastination of the larynx for whole-organ sectioning.

Whole-organ sectioning is an important technique for the assessment of laryngeal pathology. Since currently established methods require prior decalcification which causes morphological changes, the critical border area between cartilage and surrounding soft tissue cannot be investigated in the same specimen and morphometric studies are not possible. Plastination is a laboratory technique that has previously demonstrated its capacity to overcome these shortcomings. In so doing water and lipids are replaced by curable polymer within the laryngeal cells making decalcification unnecessary. In the present study, more than 50 human larynges were processed using block plastination (BP) and sheet plastination (SP). For BP the complete organ was plastinated as a whole and then cut into thin serial sections. For SP the fresh organ was sliced first and plastinated in a second step. Findings demonstrated that SP allowed for the production of whole-organ sections within a period of 1 week only. Section thicknesses were as thin as 15 mm using a diamond wire saw and an ultramilling device. Sectioning was possible in both coronary and horizontal planes. Following BP, specimens were cut in an industrial cutting machine to thicknesses of about 0.6 mm. Shrinkage of tissue was less than 10% for both methods. In all, SP was technically superior to routine paraffin histology, although cutting equipment is very expensive and delicate in handling. At present the technique of BP is the method of choice for macromorphometrical investigations on serial sections of the human larynx.

Acetone↗
PubMed1988

Sialolithiasis of a Blandin's gland duct.

A case of sialolithiasis in a Blandin's gland duct is reported. Although minor salivary glands calculi are not uncommon, Blandin's glands are rare sites of occurrence. In this case, a calculus without decalcification is reported. Not only clinico-pathological features but also electron probe micro analyzer plus energy dispersive X-ray spectroscopy studies are presented. These studies reveal that phosphorus is contained in only the basophilic part of the calculus and sulphur in both the basophilic and the eosinophilic parts.

Adult↗
PubMed2003

Effect of decalcification on the immunohistochemical expression of ABH blood group isoantigens.

Immunohistochemical stains for ABH blood group antigens were recently shown to be useful ancillary tools for sorting out specimen mix-ups in surgical pathology, irrespective of the fixatives used. However, the effects of decalcification on the expression of these antigens are not known. Therefore, to examine the validity of using ABH blood group immunohistochemistry in decalcified tissues, we studied the immunohistochemical expression of ABH blood group antigens in B5-fixed, decalcified, paraffin-embedded archival bone marrow specimens from 43 consecutive patients (13 blood group A, 6 group B, 20 group O, and 4 group AB). Immunohistochemical staining for A, B, and H blood group antigens was performed with monoclonal antibodies and an avidin-biotin detection method with citrate antigen retrieval. The results of immunohistochemistry were correlated with patients' blood groups as determined by serology. Immunohistochemical expression of the A and B blood group antigens with good staining intensity was detected in erythrocytes and endothelial cells. The immunoreactivity for H blood group antigen was attenuated by the decalcification process and could not be enhanced with citrate antigen retrieval. However, in all 43 cases, the A and B antigen staining pattern was concordant with patients' blood groups as determined with serology. These results show that decalcification does not have adverse effects on immunohistochemical expression of the A and B blood group antigens in tissue sections but may nullify the expression of H isoantigen. However, based on A and B immunoreactivity patterns, immunostaining for ABH blood group antigens can be helpful in resolving problems of specimen mix-ups and tissue floaters in decalcified specimens.

ABO Blood-Group System↗
PubMed1992

Fresh, frozen, or decalcified bone grafts: a study of early vascularisation and mineralisation of allogeneic and syngeneic bone grafts in rats.

The incorporation of syngeneic and allogeneic bone grafts pretreated by freezing or demineralisation was studied in 10 rats. Fresh, decalcified, or frozen cancellous bone of syngeneic or allogeneic origin was transplanted to intramuscular pouches. Revascularisation was evaluated with radioactive microspheres; formation of new bone was assessed by incorporation of strontium, and resorption was assessed by measuring the reduction of graft weight. Three weeks after grafting, fresh syngeneic and allogeneic bone differed significantly in all three variables. Frozen syngeneic bone was revascularised significantly better than frozen allogeneic bone, but there was no difference in formation of new bone or resorption. There were no significant differences between syngeneic and allogeneic decalcified bone in any of the variables studied. We conclude that differences in incorporation between syngeneic and allogeneic bone grafts are reduced by pretreatment with deep-freezing or demineralisation. Both forms of pretreatment affect the incorporation of the grafts.

Animals↗
PubMed1992

Histological changes in the aortic valve after balloon dilatation: evidence for a delayed healing process.

OBJECTIVE: To investigate whether balloon dilatation of the aortic valve induces long-term macroscopic or histological changes or both to explain the restenosis process. DESIGN: Prospective study of 39 consecutive patients. Sixteen later (mean (SD) 12 (10) months) required operation. This non-randomised subgroup was compared with 10 patients who had aortic valve replacement without prior dilatation. SETTING: University cardiology and cardiac surgery centre and pathology department. PATIENTS: 16 patients who had aortic valve replacement because of failure of or restenosis after balloon dilatation of the aortic valve. Twelve resected valves were examined. INTERVENTIONS: Percutaneous balloon dilatation of the aortic valve (maximal balloon size: trefoil 3 x 12 mm balloon or bifoil 2 x 19 mm balloon) and surgical inspection before excision of the aortic valve leaflets during open-chest aortic valve replacement. Fixation, decalcification, and staining for histology. MAIN OUTCOME MEASURES: Presence of long-term pathological changes in the resected valve and their relation to restenosis after balloon dilatation. RESULTS: Macroscopically the previously dilated valves were indistinguishable from valves from the patients who had valve replacement only. Microscopically, the dilated aortic valves showed areas of young scar tissue that were not seen in a control group of surgically excised stenotic aortic valves. This persistent scarring reaction was seen around small tears or lacerations of the collagenous valve stroma, fractures in calcified areas, and splits in commissures. Young scar tissue without collagenisation was still present 24 months after dilatation. CONCLUSION: Organisation and collagenisation of scar tissue develops slowly after balloon dilatation of the aortic valve. This prolonged scarring reaction may explain the late development of restenosis in some patients.

Aged↗
PubMed1991

[Pathological and X-ray study on bony specimens of rickets from 124 fetal and infantile autopsies].

The results of pathological and X-ray study on rickets of bony specimens from fetal and infantile autopsies are reported. Three important links were stressed in designing the study. The cases were divided into two groups: "congenital" and "postnatal". Each case has pathological slides and X-ray photographs of the rib, ulna and radius. GMA sections were used in this study to avoid decalcification and constriction of the bony specimens. The results showed that: Congenital rickets is existent in Beijing. Its incidence is 25.4%. The bony change was seen as early as 30 weeks of pregnancy. The pathological and X-ray features are not different between the "congenital" and "postnatal" groups; The incidence of fetal and infantile rickets is 35.5%. It is the highest in the rib, moderate in the ulna and lowest in the radius. The correlation of X-ray and pathological rickets was found to be 82.5% (rib), 77.3% (ulna) and 50% (radius). It can be seen that X-ray examination of the rib may raise the diagnostic rate to 12 times of that based on traditional wrist examination.

Fetus↗
PubMed1990

The innervation of human teeth and gingival epithelium as revealed by means of an antiserum for protein gene product 9.5 (PGP 9.5).

The innervation of human teeth and oral mucosa has been studied in the past by different methods, none of which offered a clear description of the precise morphology of nerve fibers and terminals and of nerve organization as a whole. Recently, interesting findings have been obtained by means of immunohistochemical investigations for neurofilaments and S-100 proteins. A new brain-specific molecule, protein gene product 9.5 (PGP 9.5), has been used for the first time in the present research to investigate the distribution of nerves in human oral mucosa and decalcified teeth, about which there is a paucity of information. The data provided in this study, confirming previous work in other species, may be of value for understanding the anatomy of human oral innervation. In the oral mucosa, the antiserum labels nerve fibers, corpuscles, and neuroendocrine (Merkel) cells. In sections of decalcified teeth, numerous PGP 9.5 positive fibers are demonstrated in the pulp and in the inner 100 microns of dentin. The novel nerve tissue protein used, PGP 9.5, thus appears to be a reliable marker for studies of nerve fibers in human tissues and not to be affected by decalcification procedures. It could then be used for investigations on the innervation of normal and pathological calcified human tissues.

Dentin↗