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PubMed2005

[Sexual dimorphic patterns of ossificated costal cartilages in humans].

Ossification of costal cartilages is one of many changes reflecting their ageing. It is found only in a limited percentage of population and used to begin at various ages. Shape of these ossification changes is different in men and women. Due to heterogeneity of data in literature and scarce amount of information, we decided to evaluate the occurrence of costal cartilage ossifications in a sample of Czech population. Use of roentgenograms of ossification focuses was based on their contrast in x-rays. We have studied altogether 1044 X-rays archived by Department of Radiology at the Teaching Hospital in Hradec Kráov'e. This set comprised roentgenograms of both men and women in age range from 10 to 95 years. Ossification changes of costal cartilages were described on 18 roentgenograms from dissection material as well. These rtg pictures were taken from chest plates and costal cartilages which were obtained from Department of Anatomy and Department of Forensic Medicine at Faculty of Medicine in Hradec Králové. In this sample of Czech population we confirmed an occurrence of sexual dimorphism of ossified costal cartilages. Statistical evaluation revealed that beginning of these changes depends on the age and sex.

Adolescent↗
PubMed1991

An autopsy case of pancreatic duct cell carcinoma associated with ossification.

A case of pancreatic duct cell carcinoma with ossification was reported. A 71-year-old female died of pancreas carcinoma with liver and diffuse lymph node metastasis. Computed tomography (CT) revealed a punctate calcification of the body of the pancreas. At autopsy, the carcinoma occupied almost all of the pancreas, and histological examination revealed a moderately to well-differentiated adenocarcinoma with mucin production in the glands. The whole of the pancreas was examined microscopically by multiple-step sections, and mature ossification was found in the body, corresponding to its CT localization. Around the ossification were found cancer cells with massive mucin in the cytoplasm, capillary proliferation, scattered necrosis and mesenchymal cells, which were thought to be fibroblasts. But neither cartilage nor calcification was found. The pathogenesis of ossification was believed to be associated with metaplastic changes of mesenchymal cells. This is the fourth case of pancreatic carcinoma with ossification, and the second case of pancreatic duct cell carcinoma with mature bone formation to have been reported.

Adenocarcinoma↗
PubMed1991

Heterotopic ossification and peripheral nerve entrapment: early diagnosis and excision.

Heterotopic ossification can occur in neurologic disorders, burns, musculoskeletal trauma, and metabolic disorders. In addition to producing the complications of contracture, skin breakdown, and pain, it can cause peripheral nerve entrapment. Nerve entrapment due to heterotopic ossification may be misdiagnosed, and it is difficult to evaluate and treat without recurrence. Computed tomography is especially useful in localization before surgical release of the entrapped nerve. Resection of heterotopic ossification can be successful using disodium etidronate to decrease the risk of recurrence, and resection can improve range of motion and nerve function. Two case studies of nerve entrapment due to heterotopic ossification are presented with the results of computed tomography localization, successful resection, and long-term follow-up. Clinicians should be aware of this complication and the potential for rapid nerve injury. If heterotopic ossification is causing clinically significant peripheral nerve entrapment, early surgical treatment may be indicated, and may be successful.

Adult↗
PubMed1991

Effect of aspirin on heterotopic ossification after total hip arthroplasty in men who have osteoarthrosis.

The severity of heterotopic ossification was determined from the radiographs of eighty-three men in whom osteoarthrosis had been treated with a primary total hip arthroplasty with cement. The medical records of these patients were then reviewed, with the reviewer having no knowledge of the radiographic findings. A similar operative approach and technique had been used in all patients. There was no association between the amount of intraoperative loss of blood or the duration of the operation and the severity of formation of heterotopic bone. The over-all rate of occurrence of heterotopic ossification was 72 per cent. Of the fifty-eight patients who had received aspirin throughout their course in the hospital, two (3 per cent) had severe ectopic ossification (grade III or IV8). In contrast, twelve (48 per cent) of the twenty-five patients who had received no aspirin or in whom aspirin had been discontinued so that anticoagulation could be begun had severe heterotopic ossification. The difference in the severity of the ossification between the two groups is significant (p less than 0.0001).

Aged↗
PubMed1986

Ossification of the ligamentum flavum of the thoracic spine in adult kyphosis.

Ossification of the ligamentum flavum has been recognised as a definite clinical entity as is ossification of the posterior longitudinal ligament. The incidence of both is high in Japan. This study demonstrates that the incidence of ossification of the ligamentum flavum in persons who have a kyphosis of the thoracic or lumbar spine is higher than in those who do not. It is considered that localised mechanical stress affecting the ligamentum flavum is a contributing factor to the development of ossification, together with the generalised factors which may favour bone formation. However, the aetiology of this lesion is still obscure as is that of ossification of the posterior longitudinal ligament.

Adult↗
PubMed1986

An epidemiological survey on ossification of ligaments in the cervical and thoracic spine in individuals over 50 years of age.

An epidemiological survey on ossification of the spinal ligaments was performed on a total of 1,058 subjects over the age of 50 years by means of roentgenography of the cervical and thoracic spine. Ossification of the posterior longitudinal ligament (OPLL) of the cervical spine was detected in 34 subjects (3.2%) with a predilection for men, whereas OPLL in the thoracic spine was found in 8 (0.8%). There were 325 cases (30.7%) of ossification of the anterior longitudinal ligament (OALL) of stage II or above by Forestier's classification in the region from the cervical to thoracic vertebrae, and these cases included a significantly greater number of men. Ossification of the ligamenta flava (OLF) was observed in 48 cases (4.5%). As for the coexistence of ossification of these ligaments, 364 individuals (34.4%) had at least one instance of OPLL and OALL (stage II or above) in the region from the cervical to thoracic spine, and OLF in the thoracic spine.

Cervical Vertebrae↗
PubMed1988

[Ossification of the posterior longitudinal ligament of the lumbar spine].

The ossification of the cervical posterior longitudinal ligament (OPLL) is widely known and studied in Japan where a roentgenological incidence of 2.06% adults affected has been found. Data concerning the ossification of the lumbar posterior longitudinal ligament are few and occasional. An epidemiological survey on lumbar OPLL was performed by the authors in Matsumoto, Japan, on a total of 792 subjects, 554 of whom over the age of 35, by means of X-ray of the lumbar spine. Ossification of the lumbar posterior longitudinal ligament was detected in 23 subjects (2.9%), with no significant difference between males (3.0%) and females (2.8). Lumbar OPLL was absent in the 238 subjects aged less than 34; it was the most prevalent after the age of 45 (5.1% in males and 4.5% in females). The ossification developed in two ways: continuous ossified layer extending over several vertebrae; circumscribed ossification of the ligament corresponding to the level of the intervertebral disk (retrodiscal type). The result of this epidemiological survey showed a roentgenological incidence of lumbar OPLL of the same magnitude than that of cervical OPLL.

Adult↗
PubMed1988

Heterotopic ossification as a complication of acetabular fracture. Prophylaxis with low-dose irradiation.

In a retrospective review of thirty-seven patients who had operative treatment for thirty-eight complex acetabular fractures, postoperative low-dose irradiation was administered to seventeen patients (eighteen fractures) to suppress heterotopic ossification. All of the patients had been operated on through either an extended iliofemoral incision or a modified extended iliofemoral incision. The prophylactic radiation was administered using a low-dose protocol; most of the patients received 1,000 rads in 200-rad increments, starting on the third post-operative day. The incidence of heterotopic ossification in the eighteen irradiated limbs was much lower than in the twenty patients who comprised the control group (50 per cent compared with 90 per cent). Only two of the irradiated limbs had Class-3 heterotopic ossification as described by Brooker et al., and no patient had Class-4 (ankylosis of the hip). Of the twenty control-group patients, ten had severe heterotopic ossification: Class 3 in seven and Class 4 in three. The difference in the incidence of severe (Class-3 or 4) heterotopic ossification between the two groups of patients was significant (p less than 0.01).

Acetabulum↗
PubMed1988

Heterotopic ossification after direct lateral approach and transtrochanteric approach to the hip.

The incidence of heterotopic ossification after total hip replacement using the direct lateral approach is compared to the incidence using the transtrochanteric approach. All the initial ectopic ossification occurred by six months following the implant with noncemented fixation. The direct lateral approach adds slightly to the incidence of ectopic ossification as compared to the transtrochanteric approach. Heterotopic ossification of minimal grade did not interfere with any of the planar motions of the hip, whereas severe ectopic ossification disabled the hip in several planes of motion and restricted it significantly in the others. The more severe form of ectopic bone was more common after the transtrochanteric approach to the hip, while the lighter form developed more often following the direct lateral approach.

Adult↗
PubMed1988

[Experimental study on ossification of spinal ligaments in the rabbit under influence of bone morphogenetic protein].

Bone morphogenetic protein (BMP) is known to induce cartilage from mesenchymal cells in organ culture. The purpose of the present study was to determine whether spinal ligaments differentiate into cartilage when cultured with BMP. Implantation of BMP into the yellow ligament was also done to make a model of the ossification of yellow ligament. The rabbit was employed as an experimental animal. In organ culture, BMP induced new cartilage from the posterior longitudinal ligament, the yellow ligament and the supraspinous ligament. This indicates that spinal ligaments have the potential to ossify, and bone or periosteum may not have a direct relationship with spinal ligament ossification. Ossification of the yellow ligament was produced by implantation of BMP. Blood vessels are thought to have some role in the ossification of spinal ligaments. The spinal cord was compressed posteriorly by the ossified yellow ligament. This ossification of the yellow ligament resembled that of human beings and may be regarded as a useful experimental model.

Animals↗
PubMed1977

Ectopic ossification after total hip arthroplasty. Predisposing factors, frequency, and effect on results.

In a statistical analysis of 398 consecutive patients with 507 total hip arthroplasties which was designed to identify factors predisposing to ectopic ossification and to determine the frequency of ossification and its effect on the results, it was found that male patients with considerable bilateral osteophytic osteoarthritis were statistically most likely to have ectopic ossification, especially if ossification had existed before arthroplasty consequent to previous surgery. Ectopic ossification which was first noted six weeks after total hip arthroplasty in 96 per cent of the cases did not change in amount thereafter, though the bone did mature. Both the range of motion of the hip and the function of the patient were affected by the ectopic bone during the first postoperative year, but after that only the range of hip motion was influenced.

Arthroplasty↗
PubMed1983

[Ossification arising in the atypical epithelium in primary stomach cancer--report of a case].

We report a case of primary stomach carcinoma arising in the atypical epithelium, which was accompanied with ossification. The patient was a 73-year-old man, who was operated because of the possibility of advanced Type IIa carcinoma. Grossly, a large papillary polypoid lesion was recognized in the anterior wall of the antrum near the pylorus ring. Histological study revealed well differentiated tubular adenocarcinoma arising in the atypical epithelium; ossification was found in the stroma without necrosis, calcification or chondrification. Ossification arising in primary stomach carcinoma is very rare. Only five cases of ossification in primary stomach carcinoma have been reported in the world literature; two of these were Japanese patients. Probably ours is the first reported case with both stomach carcinoma and ossification arising in the atypical epithelium.

Adenocarcinoma↗
PubMedDate not supplied

Labyrinthine ossification secondary to childhood bacterial meningitis: implications for cochlear implant surgery.

Of 20 children who underwent cochlear implantation for profound sensorineural hearing loss secondary to bacterial meningitis, 14 had round-window and cochlear ossification at surgery. Preoperative polytomography demonstrated ossification in 11 of these. The incidence of ossification was highest after meningitis secondary to pneumococcal pneumonia. In only one of four children with severe ossification of the labyrinth was implant surgery unsuccessful. Preliminary results indicate that mild labyrinthine ossification is not a contraindication to cochlear implantation.

Bacterial Infections↗
PubMed1981

[Histopathological findings of the ossification of the posterior longitudinal ligament of the cervical spine and their significance (author's transl)].

Characteristics features of the histopathological findings of the ossification of the posterior longitudinal ligament (OPLL) of the cervical spine are as follows: 1. In the segmental type of OPLL, the ossification of fibers usually initiates near the posterior border of the vertebral body and in those fibers which attach to the edge of the vertebral body. 2. At the axial ossifying point, degeneration of fibers occurs and enchondral ossification process follows, while in other part of the ossifying area, different types of ossification processes may also occur. 3. In association with OPLL, especially in the hyperostotic type, other paraspinal soft tissues may exhibit proliferation of the cartilage cells with or without ossification, implying the presence of ossifying tendency of the whole body. Of these tissues, the periosteum, the annulus fibrosus and/or the dura mater demonstrate proliferating changes in direct contact with OPLL, and the involvement of the periosteum precedes the other changes including OPLL, suggesting some influence from the vertebral side over the ossifying process of the paraspinal soft tissues.

Adult↗
PubMed1995

[Affinity of estrogen binding in the cultured spinal ligament cells: an in vitro study using cells from spinal ligament ossification patients].

This immunological study investigated the effects of estrogen as a potential causative factor for spinal ligament ossification (such as ossification of the posterior longitudinal ligament, OPLL; ossification of the yellow ligament, OYL; and ossification of the anterior longitudinal ligament, OALL). The serum total estrogen (estron + estradiol + estriol) level in the OPLL patients and controls was measured by radioimmunoassay. To determine any difference in the affinity of the estrogen, 3,17 beta-estradiol receptors of cultured spinal ligament cells obtained from OPLL patient were detected by receptor binding assay, and compared with cells from controls. Additionally, to evaluate the responses of cultured spinal ligament cells to stimulation by 3,17 beta-estradiol, examined the production of bone Gla protein (BGP) in medium, the rate of tritiated thymidine (3H-TdR) uptake, and change in affinity of transforming growth factor-beta 1 (TGF-beta 1) receptor on those cells with 3,17 beta-estradiol added (E2+ group), and compared the results with those when 3,17 beta-estradiol was not added (E2- group). The serum total estrogen level was significantly higher in OPLL patients than in controls, and the level increased with increasing extent of ligament ossification. Cultured cells obtained from OPLL patients had receptors with a higher affinity for 3,17 beta-estradiol than did cells from controls. Cells obtained from OPLL patients responded to the stimulation by 3,17 beta-estradiol, accelerated BGP production, and elevated the 3H-TdR uptake. However, cells from controls showed no change in the stimulation by 3,17 beta-estradiol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Naproxen for 8 days can prevent heterotopic ossification after hip arthroplasty.

The effect of 1 week of treatment with naproxen on the formation of heterotopic ossification after cemented total hip arthroplasty was studied in a prospective trial. Twenty-seven patients received 500 mg naproxen twice daily for 7 days postoperatively. The medication was started on the morning of the operation. The results were compared with a control group of 23 patients from a previous study who had not received any type of non-steroidal antiinflammatory drug. All radiographs were mixed randomly, and patient identification was blinded. Three months after the operation, heterotopic ossification had developed in 12 (52%) patients in the control group and in 3 (11%) patients in the naproxen-treated group. One year after the operation, 4 (17%) patients in the naproxen-treated group and 12 (52%) in the control group had heterotopic ossification (p < 0.05). Severe ossification developed in 3 patients in the control group and in none in the naproxen-treated group. The authors conclude that naproxen given for 1 week can decrease the incidence of heterotopic ossification after total hip arthroplasty.

Adult↗
PubMed1994

[The radiotherapy of hyperplastic heterotopic ossification in osteogenesis imperfecta. 2 case reports].

PURPOSE: Osteogenesis imperfecta is a rare hereditary disease of connective tissue with a genetic defect in collagen synthesis. In osteogenesis imperfecta hyperplastic heterotopic ossification can be induced by hyperplastic callus formation caused by trauma or operation. Heterotopic ossifications can be found in numerous benign diseases. The successful use of low dose radiotherapy in the treatment of heterotopic ossifications is well-known from the literature. PATIENTS AND METHODS: We treated two children (a 13-year-old girl and a ten-year-old boy) with heterotopic ossifications of the lower extremities in osteogenesis imperfecta type IV (Lobstein) with a low dose irradiation (10 x 1 Gy, respectively 6 x 1 Gy) under megavoltage conditions. RESULTS: After radiotherapy the children were painfree and the hyperplastic callus was considerably reduced. The previously immobilized patients could partly be mobilized. Thereby it could be contributed to the rehabilitation of the patients. New hyperplastic callus formation was not observed in the irradiated areas so far. CONCLUSION: Analogous to the successful radiation of heterotopic ossifications in other benign diseases radiation therapy seems to be a successful treatment of hyperplastic callus formation in osteogenesis imperfecta. Despite the late risks of radiotherapy radiation treatment of benign diseases in children might be indicated.

Adolescent↗
PubMed1976

Retardation of ossification of the lumbar vertebral column in ankylosing spondylitis by means of phenylbutazone.

Does phenylbutazone exert an inhibitory influence on the progression of ossification of the lumbar vertebral column? In a retrospective study of 40 definite cases of ankylosing spondylitis the case histories were divided into periods demarcated by the radiological examinations. An adequately exact method was used for quantitative assessment of ossification. The periods were divided into three groups: (A) continuous phenylbutazone medication; (B) phenylbutazone medication, but not throughout the period; (C) no phenylbutazone medication. Rapid progression of ossification had occurred in group C. In group A, ossification had either remained absent or, if already in progress, had been arrested or substantially delayed. In early or relatively early stages of ankylosing spondylitis, continuous phenylbutazone medication can completely or largely control ossification of the vertebral column. Possibilities of further improvement of this therapy are discussed.

Humans↗