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[Renal cell carcinoma accompanied with ossification: a case report].

Renal cell carcinoma accompanied with ossification reported in Japan is very rare. We report a case of renal cell carcinoma with ossification pathologically in a 61-year-old woman. She suddenly presented with hypercalcemia that caused acute renal failure, 6 months after the operation and died shortly thereafter. We discuss the relationship between the tumor and the hypercalcemia.

Acute Kidney Injury↗

Expression of type I, type II, and type X collagen genes during altered endochondral ossification in the femoral epiphysis of osteosclerotic (oc/oc) mice.

The osteosclerotic (oc/oc) mouse, a genetically distinct murine mutation that has a functional defect in its osteoclasts, also has rickets and shows an altered endochondral ossification in the epiphyseal growth plate. The disorder is morphologically characterized by an abnormal extension of hypertrophic cartilage at 10 days after birth, which is later (21 days after birth) incorporated into the metaphyseal woven bone without breakdown of the cartilage matrix following vascular invasion of chondrocyte lacunae. In situ hybridization revealed that the extending hypertrophic chondrocytes expressed type I and type II collagen mRNA, as well as that of type X collagen and that the osteoblasts in the metaphysis expressed type II and type X collagen mRNA, in addition to type I collagen mRNA. The topographic distribution of the signals suggests a possible co-expression of each collagen gene in the individual cells. Immunohistochemically, an overlapping deposition of type I, type II, and type X collagen was observed in both the extending cartilage and metaphyseal bony trabeculae. Such aberrant gene expression and synthesis of collagen indicate that pathologic ossification takes place in the epiphyseal/metaphyseal junction of oc/oc mouse femur in different way than in normal endochondral ossification. This abnormality is probably not due to a developmental disorder in the epiphyseal plate but to the failure in conversion of cartilage into bone, since the epiphyseal plate otherwise appeared normal, showing orderly stratified zones with a proper expression of cartilage-specific genes.

Animals↗

Sialolith of the submandibular gland with bone formation.

An unusual case of sialolith with bone formation, occurring in the submandibular gland of a 33-year-old woman, is reported. In addition to the irregularly laminated structure of sialolith, sparsely scattered foci of bone tissue were found. Some of them were mature, lamellar bone with lacunae containing osteocytes, endosteum and a bone marrow-like element. Others were immature bone associated with or without multinucleated giant cells. Foci of bone tissue were in contact with caliculi or fibrous tissue, and no epithelial component was seen around them. These observations suggest that bone formation in the present case may be in the nature of pathological ossification, and that in the earlier stage, the bone that is deposited is woven and is replaced through successive remodeling cycles by lamellar bone. This is the first case of sialolith with bone formation, although sialolithiasis is a common disease of the salivary glands.

Adult↗

[The radiogical criteria of juvenile rheumatic cerivical synostosis in adults (author's transl)].

The radiological criteria of juvenile, rheumatic, cervical synostosis discovered in adult life are described and illustrated. These include: involvement of few or many segments, a tendency to bony ankylosis of the diseased intervertebral joints, dysplasias or hypoplasia of the vertebral body and intervertebral disc and dysplasias of the neural arches and hypoplasia of the transverse processes. Pathological ossification may involve the ligamentum flavum, the annulus, or the entire disc. The differential diagnosis of juvenile, rheumatic, cervical synostosis includes congenital block vertebrae, Klippel-Feil syndrome, acquired block vertebrae, juvenile ankylosing spondylitis, synostosing, intervertebral osteochondrosis and myositis ossificans progressiva.

Adolescent↗

Radiologic diagnosis of labyrinthitis ossificans.

Labyrinthitis ossificans is the pathological ossification of the membranous labyrinthine spaces in response to processes which are destructive of the membranous labyrinth or the endosteum of the otic capsule. It has been primarily a histopathologic diagnosis. Complex motion tomography however, allows a detailed view of the osseous labyrinth and permits the diagnosis in the living state. Radiologic documentation of labyrinthitis ossificans is objective evidence of a process destructive of the membranous labyrinth. It supports the likelihood of an absence of cochlear and vestibular function. It alerts the surgeon to the possible obliteration of key inner ear anatomical landmarks.

Aged↗

[Labyrinthitis ossificans after pneumococcal meningitis].

In labyrinthitis ossificans the membranous labyrinth and the endosteum are obliterated by pathological ossification. The pathogenesis, differential diagnosis and radiological findings of a case of labyrinthitis ossificans caused by pneumococcal meningitis are described. The destructive process in the membranous labyrinth can be shown by radiology. The importance of early diagnosis for rehabilitation of hearing loss after treatment is demonstrated.

Audiometry, Pure-Tone↗

[Prevalence, morphology, and pathologic implications of ossification of lumbar ligamenta flava: a large prospective CT study].

Ossifications of the ligamenta flava are described in all parts of the spine, particularly in the dorsal segment where they can produce thoracic myelopathy. Rarely reported in the cervical spine, they are only occasionally mentioned in the lumbar spine where the main reported pathology of the ligamentum flavum is the arthrosynovial cyst. To study the morphological appearances, the prevalence and the pathological implications of the lumbar ossified ligamenta flava, 1021 lower lumbar CT studies are prospectively reviewed totalizing 6080 ligamenta flava. The prevalence of clearly defined ossifications is 5.44%; it appears relatively independent from the age, sex, vertebral level and presence of spondylolysis. It significant increases with the presence and the stage of articular osteoarthritis. In more than 96% of cases, the ossifications remain confined to the lateral articular portion of the ligament and more central ossifications are very rare; therefore, the essential differential diagnosis is osteophytosis. The ossifications never cause radiculopathy except rarely, in association with more classical processes such as disk protrusions and osteophytosis. Our findings favours an essentially idiopathic and--to a lessen extent--a mechanical cause to explain ossification of the ligamenta flava.

Adolescent↗

Pathology of labyrinthine ossification.

Ossification of the inner ear is the result of multifactorial pathogeneses, such as infection or malignant infiltration, and otosclerosis. Ossification of the inner ear spaces is a well documented sequela of suppurative labyrinthitis. In this study of human temporal bones, sections from 14 patients (28 temporal bones) were studied. In addition to the osseous tissue within the inner ear, findings included neoplasms, otosclerosis, otitis media, trauma, and Fabry's disease. We have attempted to correlate these conditions and their influence on the formation of osseous tissue within the spaces of the inner ear. Tympanogenic infection and vascular compromise were found to play an important role in ossification. The scala tympani of the basal turn of the cochlea was frequently the site involved.

Adult↗

Pathological studies on the ossification of the posterior longitudinal ligament (opll).

Ossification of the posterior longitudinal ligament (OPLL), which causes marked spinal cord compression, occurs more frequently in Japan than in other parts of the world. To investigate the mechanism of this ossification, we examined two cases of mixed type of OPLL inducing severe neurological signs due to spinal cord compression and three cases of segmental OPLL type without neurological signs. Ossification of the ligament begins at the upper end of posterior margin of the vertebral body and distends mainly downward along the posterior longitudinal ligament (PLL) and finally replaces the PLL completely. Ossification consists of compact bones with lamellar structures. In the upper end of the posterior margin of the vertebral body, where the PLL fuses with the cortical bone of vertebral body, ossification always has a direct contact with cortical bone and in this portion proliferation of cartilaginous tissue and calcification were observed. Proliferation of cartilaginous tissue plays a key role in the formation of OPLL and occurs mainly by an enchondral ossification. In three among twenty one cases of cervical vertebrae examined as the control, small foci of ossification were observed which might be related to the initial phase of OPLL. Spinal cords of case 1 and 2 showed marked indentation and flattening with the loss of nerve cells, severe fibrous gliosis of the gray matter and demyelination of the anterior column. Venous congestion due to compression and vulnerability of gray matter to anoxia is important for the histological changes of spinal cord.

Adult↗