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PubMed2002

Scala vestibuli cochlear implantation in patients with partially ossified cochleas.

Partial cochlear obstruction is a relatively common finding in candidates for cochlear implants and frequently involves the inferior segment of the scala tympani in the basal turn of the cochlea. In such patients, the scala vestibuli is often patent and offers an alternative site for implantation. The current report describes two patients with such partial obstruction of the inferior segment of the basal cochlear turn, caused in one case by systemic vasculitis (Takayasu's disease) and in the other by obliterative otosclerosis. A scala vestibuli implantation allowed for complete insertion of the electrode array. No problems were encountered during the surgical procedures and the good post-operative hearing and communicative outcomes achieved were similar to those reported in patients without cochlear ossification. The importance of accurate pre-operative radiological study of the inner ear is underscored, to disclose the presence and define the features of the cochlear ossification and ultimately to properly plan the surgical approach.

Adult↗
PubMed1997

Fibroblasts of spinal ligaments pathologically differentiate into chondrocytes induced by recombinant human bone morphogenetic protein-2: morphological examinations for ossification of spinal ligaments.

To elucidate the process of ossification in spinal ligaments, an aqueous solution containing recombinant human bone morphogenetic protein (BMP)-2 (40 micrograms/100 microL) was injected into murine ligamenta flava, and the ossification process was analyzed morphologically. In the control group, the solution administered lacked the protein; these flattened ligamentous fibroblasts possessing BMP receptors type IA and type II existed among type I collagen bundles. In the week immediately following the injection of BMP-2, ligamentous fibroblasts began to proliferate, differentiating into alkaline phosphatase-positive chondrocytes surrounded by an extracellular matrix composed of type I and II collagen. By the second week, differentiated chondrocytes of various stages were observed in type II collagen-rich matrix. These chondrocytes showed an abundance of BMP receptors type IA and II. The pathologically induced cartilage was resorbed by chondroclasts, permitting migration of blood vessels and osteogenic cells, as well as providing a site for endochondral ossification. By the third week, BMP-induced ossification had compressed the spinal cord, and by the sixth week, the ligamentous tissue had been almost completely replaced by bone. Ligamentous fibroblasts appeared to possess BMP receptors, as well as the potentiality to differentiate into chondrocytes. BMP receptors were upregulated during chondrification of ligamentous fibroblasts induced by exogenous BMP-2, suggesting that BMPs may play an important role in ossification of spinal ligaments.

Acid Phosphatase↗
PubMed2001

[Endometrial ossification. 6 cases].

Endometrial ossification is a rare and benign pathology. The etiopathogenesis of this pathology is controversial. Findings suggestive of diagnosis are fairly well know, menstrual irregularities is the main clinical symptoms, expulsion of bony fragments is a rare but pathognomonic event. Pelvic ultrasonography suggested an intrauterine foreign body and hysteroscopy was necessary to make the correct diagnosis. Six cases of endometrial ossification diagnosis and treated at obstetrics and gynaecology department A of centre of La Rabta teaching hospital (Tunis) are reported.

Adult↗
PubMed1990

The importance of standardised radiographs when assessing hip dysplasia.

The reliability of radiological criteria in the diagnosis of congenital dislocation of the hip is discussed. In a review of 20 normal infant patients the variability of the radiographic relationship between the ossific nucleus of the proximal femoral epiphysis and the acetabulum is identified. Hip arthrography in 10 patients and pathological examination of femoral heads confirm that the ossific nucleus lies superiorly within the infant femoral head and may be displaced from the true centre of the femoral head by up to 40% of it's radius. As the ossific nucleus of the capital femoral epiphysis is shown to originate eccentrically within the spherical cartilaginous anlage it is suggested that standardisation of hip radiographs is required in the routine clinical assessment of the infant hip, particularly in the presence of dysplasia.

Arthrography↗
PubMed1995

Calcification and fibrosis in mesenteric carcinoid tumor: CT findings and pathologic correlation.

OBJECTIVE: The purposes of this study were to determine the frequency and characteristics of calcification and fibrosis in mesenteric carcinoid tumor as seen on CT scans and to evaluate their possible role in diagnosis. MATERIALS AND METHODS: The CT findings in 29 cases of proved mesenteric carcinoid tumor were analyzed retrospectively. Tumors were assessed for size, margin, density, radiating strands, calcification, and associated thickening of the small-bowel wall. Matching histologic sections were available for 21 of the cases. They were reviewed independently for histologic pattern, degree of fibrosis, degree of infiltration along neurovascular bundles, necrosis, lymph node architecture, and calcification or ossification within the mass. CT and pathologic findings were then assessed for possible relationships. RESULTS: Calcification was detected by CT in 70% (21 of 30) of mesenteric masses. Three patterns of calcification were noted: small, stippled calcification (n = 11); coarse, dense calcification (n = 7); and diffuse calcification (n = 3). All calcification was localized within areas of poorly cellular mature fibrous tissue. The degree of radiating strands detected by CT tended to increase with the degree of fibrosis seen histopathologically (p = .06). CONCLUSION: Calcification in mesenteric carcinoid tumors was observed by CT in most cases of this series. The triad of a calcified mesenteric mass, radiating strands, and adjacent bowel-wall thickening should be considered highly suggestive of carcinoid tumor.

Aged↗
PubMed1991

[Pigmented nevus and cutaneous ossifications. Apropos of 125 cases of osteonevi].

In a series of 86,400 pathological examinations 125 cases of pigmented naevus associated with one or several foci of cutaneous ossification were observed. This association, known as osteonaevus of Nanta, account for 1.4 p. 100 of all pigmented naevi. In our series of examinations, osteonaevus was the most frequent cause (62 p. 100) of the 201 skin ossifications observed, the other causes being keratinizing basal cell epithelioma (7 p. 100) and pilomatricoma (5.5 p. 100). The patients' mean age was 46 years (range: 21-80 years), and 81 p. 100 of them were women. In almost every case the lesions were located on the head. The clinical diagnosis was always pigmented naevus, but it coexisted with inflammatory changes in 8 cases, and an underlying induration could be perceived at palpation in 4 cases. In 123 or ou 125 cases the pigmented naevus was restricted to the dermis, junctional theques being present in only 2 cases. The number of ossified foci varied from 1 in 45 p. 100 of the cases to 2 to 4 in 91 p. 100, and in 1 patient up to 8 foci were visible on the same section plane. The lesions presented as compact balls (135 cases), or lamellated bone (126 cases), or spicules of unorganized bone formations. They varied in size from 0.5 mm for balls to 1.5 mm for elements with a central cavity. In the latter were rudiments of bone marrow with capillary vessels, osteoclasts, adipose cells and cells that could be regarded as having haemopoietic functions. All naevi contained hair follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Foreign body giant cell reactions and ossification associated with benign melanocytic naevi.

AIMS: To assess the incidence of foreign body giant cell reactions and ossification in benign/melanocytic naevi; and to examine their pathological features to gain an insight into their pathogenesis. METHODS: Intradermal (n = 185) and compound naevi (n = 110) from a routine histology service, together with 60 naevi submitted to an ophthalmic pathologist, were examined for foreign body reactions and ossification. Additional cases were identified prospectively in the course of routine reporting. The clinical and pathological features of positive cases were assessed. RESULTS: Foreign body reactions were identified in nine (4.9%) intradermal and four (3.6%) compound naevi, but in none of the naevi from around the eye. One intradermal naevus showed ossification. A further 11 naevi showing foreign body reaction and five showing ossification alone were identified prospectively. The 24 naevi showing a foreign body reaction had a similar age and sex distribution to controls but were more likely to occur on the head and neck. The reaction usually occurred deep to the naevus, sometimes in relation to a hair follicle, and fragments of hair or keratin were identified in most. Osteoid or bone was present within the reaction in five. In six other naevi, all from the head and neck of women, osteoid or mature bone was present deep to the naevus in the absence of a giant cell reaction. CONCLUSIONS: Foreign body giant cell reactions occur not uncommonly in relation to benign naevi, as a result of follicular damage, possibly due to trauma. The similar siting of foci of bone suggests that ossification occurs as a secondary phenomenon in these cases.

Adult↗
PubMedDate not supplied

Heterotopic ossification about the elbow: a therapist's guide to evaluation and management.

Heterotopic ossification (HO) is a form of pathologic bone that often occurs in the elbow after a substantial traumatic injury and can complicate the functional outcome of the affected upper extremity. This article is designed to help the treating therapist better understand the complex process of HO. The pathophysiology, causes, associated risk factors, and signs and symptoms of HO are discussed in depth. The physician's management, including a classification system, diagnostic tools, and prophylactic measures, are explained. An extensive review of the literature regarding the therapist's management of HO reveals current misconceptions about passive range of motion (PROM). Traditional thought has advocated that PROM is a contraindication when HO is present because it can lead to the development or exacerbate the formation of HO. A review of the literature only reveals a few scientific studies that concluded that forcible manipulation of stiff joints can lead to myositis ossification. Most of the articles that have concluded that PROM is contraindicated have been erroneously based on anecdotal findings. This conclusion is misleading because forcible manipulation of a joint is not synonymous with PROM exercises. This article challenges popular belief and offers some alternative thinking for the therapist treating an elbow injury with HO as well as guidelines for the rehabilitation program.

Elbow Joint↗
PubMed1983

Myositis ossificans circumscripta: computed tomographic diagnosis.

Computed tomography was performed in five patients with myositis ossificans circumscripta. In three cases, and possibly four, CT scans obtained during the active stage of the pathologic process demonstrated findings that in general corresponded to the "zone phenomenon" seen on histology, although a distinct peripheral ring of ossification was not always present. In these patients, CT was useful in limiting the differential diagnosis and obviating surgery. In the fifth patient, with long-standing myositis ossificans, CT showed complete ossification indicative of the mature phase of the pathologic process and was helpful in planning surgical resection.

Adolescent↗
PubMed1986

[Calcium metabolism in dogs].

Calcium homeostasis is controlled both directly and by hormones. Directly as a result of the fact that the uptake of calcium from the intestine and its excretion by the intestine, kidney and skeleton are well attuned to one another. A process of diffusion of calcium through the intestinal wall occurs in addition to active absorption of calcium, particularly in young animals. The maximum excretion of calcium by the kidneys is one per cent of the amount of circulating calcium. The skeleton acts as a calcium buffer in which 99.5 per cent of the body calcium is present. As regards hormones, the calciotropic hormones (parathormone, calcitonin and vitamin D) are the most important factors, which particularly affect the processes of absorption, resorption and accretion of calcium. The effects on the excretion of calcium are very slight. The system of calcium homeostasis is designed to maintain a normal level of calcium in blood (dog less than twelve months: 2.5-2.9 mmol/l; dog greater than twelve months: 2.2-3.0 mmol/l). A prolonged abnormal calcium intake will result in skeletal changes, particularly in young dogs. Inhibition of remodelling reconstruction of the skeleton and disturbance of enchondral ossification, which became clinically apparent, among other things, in the canine Wobbler syndrome and osteochondritis dissecans, were observed in Great Danes dogs having a high calcium intake. A low calcium intake in Great Danes dogs resulted in osteoporosis and pathological fractures without any impairment of enchondral ossification being observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

Effects of antitumor drugs on offspring.

The offspring of Wistar rats obtained from parents, one of which received platinum-containing drug Platidiam (cisplatin) or anthracycline antibiotics Doxorubicin and Farmorubicin was characterized by low viability (embryonic death increased 4-30-fold compared to control) and congenital malformations. The fetuses displayed pathology in internal organs and low ossification rates. Newborn rats are characterized by low survival rate and retarded physical development.

Animals↗
PubMedDate not supplied

Cervical laminoplasty.

Laminoplasty was developed to treat multilevel pathology of the cervical spine, namely ossification of the posterior longitudinal ligament and cervical spondylotic myelopathy. Laminoplasty was popularized in the 1980s, and since then many variations on the theme have been developed. All are similar in that they expand the cervical canal while leaving the protective dorsal elements in place. Advocates claim that this prevents the formation of the "postlaminectomy" membrane, maintains spinal alignment, and should aid in maintaining cervical range of motion. The aforementioned are all potential shortcomings of laminectomy or laminectomy and fusion. The procedure has proven to be essentially equal to other cervical decompressive procedures in the neutral or lordotic spine, and outcome has been shown to be durable.

Cervical Vertebrae↗
PubMed1990

Arachnoiditis ossificans with arachnoid cyst after cranial tuberculous meningitis.

A 34-year-old woman developed symptomatic arachnoiditis ossificans and an arachnoid cyst as a consequence of tuberculous meningitis adequately treated 20 years before. Surgical decompression of the cyst stopped the progression of her spastic paraparesis. Pathologic examination confirmed the presence of ossification of the arachnoid.

Adult↗
PubMed1984

Giant cell tumor: ossification in soft-tissue implants.

Benign giant cell tumor of bone may be implanted into the surrounding soft tissues at the time of surgery or pathologic fracture. These soft-tissue implants may produce ossification that is radiographically visible. A review of the available radiographs of 400 cases of giant cell tumor from the Mayo Clinic and 700 cases seen in consultation yielded 17 examples of this phenomenon. In all but one case, the ossification was found at the periphery of the implant. The radiographic appearance of these implants is characteristic. Recognition of this appearance is necessary so that the tumor may be totally eradicated.

Adolescent↗
PubMed2002

Myelopathy caused by ossification of ligamentum flavum.

STUDY DESIGN: Retrospective study of seven cases of ossification of ligamentum flavum from two urban hospitals in a Chinese population. OBJECTIVES: To inspect the epidemiology, clinical presentation, pathology, and treatment outcome in these Chinese patients with ossification of ligamentum flavum. SUMMARY OF BACKGROUND DATA: Ossification of ligamentum flavum involving the lower thoracic region is relatively common in the Japanese population. It is usually presented with myelopathy of progressive nature. MATERIALS AND METHODS: Five patients were male and two were female. The mean age was 52 years (range 41-73 years). Diagnosis was made by CT scan, MRI, and subsequent histology. Six patients have been treated by laminectomy and one by laminoplasty. The average follow-up duration is 34 months (range 26-44 months). The outcome is evaluated by Japanese Orthopaedics Association (JOA) score. RESULTS: The average time of presentation from the onset of symptoms was 9 months (range 3-12 months). Most of the patients presented with lower limb numbness and gait disturbance. One case was presented after a minor trauma. Mean JOA score was 4.8 (range 2-7, of 11). The lower thoracic level was the most frequently involved region. One case was associated with ossification of the posterior longitudinal ligament. Two patients had transient postoperative neurologic deterioration, which improved subsequently. Mean percentage of recovery after surgery in terms of JOA score is 65% (25-100%), with a mean final JOA score of 7.8. CONCLUSION: Ossification of ligamentum flavum is an uncommon cause of myelopathy in the Chinese population. It can present acutely after minor trauma. Posterior decompression, especially with en bloc dissection of laminae, gives satisfactory results.

Adult↗