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Localization of prostaglandin synthetase in chicken epiphyseal cartilage.

Prostaglandin synthetase activity in high-speed particulate fractions of chick epiphyseal cartilage has been characterized with respect to cofactor requirements, pH optimum, buffer-ion effects, types of prostaglandins formed, and the distribution of prostaglandin synthetase activity in zones of the epiphyseal plate. Direct homogenization of cartilage was found to be more efficacious than releasing chondrocytes by enzymatic digestion for preparation of prostaglandin synthetase, a homogenization time of 4 min yielding maximal activity. The optimal incubation medium contained 50 mM Tris buffer (pH 7.5), 2.5 mM epinephrine, 1 micronM hemoglobin, 3.25 mM glutathione, 200 microgram/ml enzyme protein, and 5 micronM substrate. Glutathione was effective only if present during homogenization. Rates of PGE2 biosynthesis were linear up to 15 min and then rapidly declined, indicative of self-deactivation. The low levels of PGF2alpha formed, and their decrease after 20 min incubation, suggests the possible presence of degradative enzymes. Prostaglandin synthetase was inhibited by aspirin, indomethacin, and vitamin E, but not vitamin K1. Cation concentrations in the physiological range had only modest effects on prostaglandin biosynthesis, and then only if present during tissue homogenization. In the presence of phosphate buffer, Ca2+ was somewhat inhibitory. Since in the absence of phosphate Ca2+ had no deleterious effect, it is probably that the inhibitory effect was caused by precipitation of calcium phosphate. Hypertrophic and calcified cartilage exhibited significantly higher prostaglandin synthetase activity than the proliferating and maturing zones. The increased synthesis of prostaglandins in the low layers of the growth plate may indicate a role of these factors in chondrocyte differentiation and/or calcification.

Alkaline Phosphatase↗

32Pi- and 45Ca-metabolism by matrix vesicle-enriched microsomes prepared from chicken epiphyseal cartilage by isosmotic Percoll density-gradient fractionation.

Matrix vesicle-enriched fractions were isolated from different zones of epiphyseal cartilage by nonenzymatic methods involving tissue homogenization, differential centrifugation, and isosmotic Percoll gradient fractionation. Uptakes of both 32Pi and 45Ca were studied concomitantly over periods from 20 min to 24 h. Percoll density gradients separated epiphyseal microsomes into two alkaline phosphatase-rich fractions: a low-density noncalcifiable fraction (P-I), and a higher-density fraction (P-II) which readily mineralized. The P-II fraction was found only in calcifying regions of the growth plate. Based on chemical and physical properties and enzyme activities, both fractions were similar except that P-II contained significantly higher levels of mineral ions than did P-I, and had lower levels of alkaline phosphatase. The mineral appeared to be primarily in a noncrystalline form. Metabolism of 32Pi and 45Ca by P-II followed a complex kinetic pattern in which accumulation of large amounts of both ions was preceded by an initial limited burst of uptake and a lag-phase of variable duration. During mineral ion loading, the density of the P-II fraction progressively increased as evidenced by co-migration of 45Ca, 32Pi, and alkaline phosphatase to increasingly higher densities. During the period of early mineral deposition (1-5 h), Ca/P uptake ratios were very low (1.0-1.2) and X-ray diffraction patterns showed a predominantly amorphous pattern. This suggests that the mineral accumulated in matrix vesicles is initially some form of noncrystalline calcium monohydrogenphosphate. L-tetramisole, a potent inhibitor of alkaline phosphatase, inhibited accumulation of both 45Ca and 32Pi in the absence of organic P substrates, 32Pi being preferentially inhibited over 45Ca. This finding, coupled with recent studies on the behavior of alkaline phosphatase at physiological pH, suggests that the protein is not acting as a phosphohydrolase, but rather as a Pi-binding or transport agent in vesicle-mediated calcification.

Alkaline Phosphatase↗

The comparative effects of vitamin d deficiency and ethane-1-hydroxy-1,1-diphosphonate administration on the histology and glycolysis of chick epiphyseal and articular cartilage.

A comparison has been made between the effect of a vitamin D--deficient diet and treatment with disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) on the morphology of chick epiphyseal cartilage and on the production of lactate in vitro by epiphyseal and articular cartilage. The cell populations in the growth plate were different following the two treatments. Vitamin D deficiency was characterized by an increase in proliferating cells, with a relative paucity of hypertrophic cells; EHDP treatment was characterized by an increase in hypertrophic cells. When similar cell types were compared, neither treatment changed lactate production from the control value. This stresses the need to correlate the morphology of cell types with their metabolic function. The present results indicate that the major effect of vitamin D deficiency in the chick is to block the differentiation of proliferating to hypertrophic cells. In contrast, EHDP may act by inhibiting calcification directly. Even though EHDP at the doses used is known to interfere with the production of 1,25-dihydroxycholecalciferol there is no block to cell differentiation under EHDP similar to that seen in dietary deficiency of vitamin D.

Animals↗

Significance of corrective growth of opposite physes in the surgical correction of deformity following epiphyseal injury around the knee joint.

Deformation due to growth disturbance after epiphyseal fractures around the knee may involve more than the primarily injured epiphysis, as spontaneous corrective growth of the opposite epiphyseal plate can take place in an attempt to maintain overall alignment of the leg. As a result, there will be an inclination in the knee joint line if corrective osteotomy is only performed for the primary angulation. We report two cases of this complex deformity in which corrective osteotomies of both the distal femur and the proximal tibia were performed, resulting in correct alignment of the overall leg axis and knee joint axis.

Adolescent↗

Epiphyseal extension of a unicameral bone cyst.

Epiphyseal extension of a unicameral bone cyst is rare. We report a case of a 13-year-old boy with three pathological fractures through a unicameral bone cyst with epiphyseal involvement in the proximal humerus. These lesions initially tends to expand the humeral epiphysis laterally and progress medially. They also commonly cause a slip of the epiphysis in a medical direction. They also have a greater association with growth retardation and lesser degree of recurrence than their metaphyseal counterpart.

Adolescent↗

Correction of length discrepancies and angular deformities of the leg by Blount's epiphyseal stapling.

UNLABELLED: The management of leg length difference (LLD) and angular deformities of the leg remains controversial. Numerous treatment options have been proposed over the past years depending on the patient's general condition, skeletal age, function, and degree and configuration of the deformity. Our retrospective study consisted of 48 patients with 58 legs treated between 1970 and 1991 by Blount's epiphyseal stapling to equalise length or correct angular deformity. After an average follow-up of 16.5 years, all patients with idiopathic bow-legs or knock-knees (n=12) and 71% of LLD caused by overgrowth (e.g. Klippel-Trenaunay syndrome) showed good and excellent results at skeletal maturity, whereas the results of the treatment of LLD with undergrowth of the leg and angular deformities due to trauma, infection or general dysplasia and malformation were fair to poor because of the difficulty in prediction of growth development and growth potential, allowing only for partial correction of the deformity. Besides the restriction of the stapling procedure due to the aetiology of the deformity, the age of the patients at the time of surgery is important, as it determines the complication rate of this technique (loosening or dislocation of staples). Thus Blount's epiphyseodesis should not be performed before the age of 9 years in girls and 11 years in boys. CONCLUSION: Blount's epiphyseal stapling can be recommended as a safe procedure with predictably good results in idiopathic angular deformities of the leg and leg length difference caused by overgrowth.

Adolescent↗

Free microvascular epiphyseal transplantation: an experimental study in dogs.

Orthopic and heterotopic microvascular epiphyseal transplants based on periosteal blood supply were performed in 2 experiments. Heterotopic transplants averaged 69 per cent of growth of non-operated control bones. Orthopic transplants achieved a better result but the number of dogs available for evaluation was too small to be conclusive. The question is raised whether additional blood supply to the epiphyseal side of the transplant could improve the results.

Animals↗

Epiphyseal-based designs for tibial plateau components--II. Stress analysis in the sagittal plane.

A two-dimensional, finite element study was undertaken to establish the stresses in the proximal tibia before and after total knee arthroplasty. Equivalent-thickness models in a sagittal plane were created for the natural, proximal tibia and for the proximal tibia with two different types of tibial plateau components. All components simulated bony ingrowth fixation, i.e. no cement layer existed between component and bone. In addition, the interface between component and bone was assumed to be intimately connected, representing complete bony ingrowth and a rigid state of fixation. Two load cases were considered: a joint reaction force acting in conjunction with a patellar ligament force, simulating the knee at 40 degrees of flexion; and a joint reaction force directed along the long axis of the tibia. For the natural tibia model, the pattern of principal stresses for loadcase 1 more closely corresponds to the epiphyseal plate geometry and trabecular morphology than do the principal stress patterns for loadcase 2. Judging from the distribution of principal stresses, loadcase 1 represents a more severe test of implant design than does loadcase 2. The model of the component with a peg predicted that the trabecular bone near the tip of the peg will experience higher than normal stresses, while the bone stresses near the posterior aspect adjacent to the metal tray will be reduced. A component without pegs that incorporates a posterior chamfer and an anterior lip lead to stress distributions closer to those existing in the natural tibia. The interface geometry for this design is based upon the contour of the epiphyseal plate.

Epiphyses↗

Biosynthesis and metabolism of prostaglandins in chick epiphyseal cartilage.

Microsomal fractions of cells isolated from chick epiphyseal cartilage catalyzed the synthesis of prostaglandins from radiolabeled delta8,11,14-eicosatrienoic and from arachidonic acids. In addition, the microsomal supernatants contained both 15-hydroxyprostaglandin dehydrogenase and prostaglandin 15-keto delta13,14-reductase activities. Two major classes of prostaglandins (E and F) were synthesized; however, a major product which chromatographically behaves as PGA was also isolated. Synthetase activities were analyzed for pH optima and response to known stimulators and inhibitors of prostaglandin systhesis. The different activators had varying stimulatory effects on prostaglandin synthesis; the anti-inflammatory drugs were all strongly inhibitory. Synthetase activity in the growth plate was highest in the zone of hypertrophy, declining substantially in the more heavily calcified regions. Degradative enzyme activities were highest in the zone of maturation and significantly lower in the adjacent hypertrophic zone. The net effect of these opposing activities would be to elevate prostaglandin levels at the zone of hypertrophy, a finding which suggests that prostaglandins may play a role in the modulation of epiphyseal cartilage metabolism.

8,11,14-Eicosatrienoic Acid↗

Time of fusion of epiphyses at the elbow and wrist joints in girls of northwest India.

A radiological examination of both elbows and wrists of 149 Northwest Indian schoolgirls between the ages of 11 and 19 years, of middle socio-economic status, was undertaken to determine the time of fusion of the epiphyses with the metaphyses of the medial epicondyle of the humerus, the proximal end of the radius and the distal ends of both radius and ulna. The data were subjected to discriminant function tests as well as sensitivity and specificity tests. If the epiphysis of the medial epicondyle of the humerus or that of the head of the radius has not fused with metaphysis completely, the age of the girl would be < 16 years. However, the age of the girl should be > 16 years if the distal epiphyses of the radius and the ulna show complete fusion with their respective metaphyses. Discriminant function tests show that 91.95% of girls can be correctly classified as being above or below the age of 16 years.

Adolescent↗

Epiphyseal fusion assessment based on wavelets decomposition analysis.

Epiphyseal fusion is a finding frequently analysed in hand wrist radiographs. It is tested in the bone age assessment, the gonadal dysgenesis, etc. The computerized fusion analysis is performed on an automatically selected region of interest containing the lower edge of epiphysis and the upper edge of metaphysis. In the analysis a wavelets decomposition approach is employed. The wavelets decomposition components are first subjected to a preliminary test which rejects the overexposed images whose analysis would not give reasonable results. This increases the accuracy of the algorithm and a chance for an unsupervised application. Then, a quantitative measure is found. Its value decreases while the epiphyseal fusion proceeds. The analysis yields an assignment of fusion to one of four stages: no fusion, early stage of fusion, advanced stage of fusion, and fusion completed. The results show that wavelets decomposition components may efficiently be applied to a texture analysis.

Age Determination by Skeleton↗

MR imaging of epiphyseal lesions of the knee: current concepts, challenges, and controversies.

This article focuses on spontaneous painful conditions involving the subchondral bone and marrow of mature knee epiphyses. MR imaging is the technique of choice for the work-up of these lesions and enables distinction of two main categories of lesions on the basis of T1-weighted images: avascular necrosis, and lesions presenting the bone marrow edema pattern. This latter category encompasses spontaneous osteonecrosis of the knee, and a variety of self-resolving conditions that may be differentiated by the study of the subchondral bone marrow area on T2-weighted images. Behind definite appellation of lesions, the challenge for the radiologist is to provide a prognosis: the distinction between self-resolving lesions from those that may evolve to epiphyseal collapse and joint impairment should be possible in most cases.

Bone Diseases↗

Leber's congenital amaurosis associated with familial juvenile nephronophthisis and cone-shaped epiphyses of the hands (the Saldino-Mainzer syndrome).

Three affected children (a 13-year-old girl and her 7- and 8-year-old brothers) in a sibship of eight had findings consistent with the Saldino-Mainzer syndrome (skeletal dysplasia associated with Leber's congenital amaurosis, familial juvenile nephronophthisis, and cone-shaped epiphyses of the hands). Two also had pigmented midline nevi. Although tapetoretinal degeneration and familial juvenile nephronophthisis are associated in the inherited Senior-Loken syndrome, the rare association of these abnormalities with cone-shaped epiphyses of the hands suggested an autosomal recessive syndrome with variable expression remarkably similar to the Saldino-Mainzer syndrome, which may or may not be distinct from the Senior-Loken syndrome. The association of tapetoretinal degeneration with skeletal dysplasia may indicate asymptomatic renal or hepatic disease.

Adolescent↗

Epiphyseal fractures of the proximal tibia.

Fractures of the proximal tibial epiphysis and apophysis are rare. Data of ten patients seen in the last 17 yr with an epiphyseal (6) or apophyseal (4) fracture of the proximal tibia were reviewed. Three patients with an epiphyseal fracture were treated by open reduction and fixation, the other three by closed reduction. All apophyseal fractures were treated by open reduction and internal fixation. No major complications occurred. The final results were good.

Accidents, Traffic↗

Fontanel size and epiphyseal ossification in neonatal twins discordant by weight.

Size of the anterior fontanel and ossification of the epiphyseal centers at the knee were measured in 13 "discordant" twin pairs. There was a highly significant (p smaller than 0.01) negative correlation between fontanel size and epiphyseal ossification. Severe intrauterine growth retardation (demonstrated by the lighter twin) may result in retardation of membranous as well as enchondral ossification.

Birth Weight↗

Dorsally displaced epiphyseal fracture of the phalangeal base.

A dorsally displaced epiphyseal fracture of the middle phalanx (Salter-Harris Type I) is described. The epiphyseal fragments were attached to the central slip of the extensor tendon and collateral ligaments. The articular surface of the PIP joint was intact and smooth. The epiphysis was reduced and fixed without cutting the central slip or the collateral ligaments 8 months after injury. This kind of fracture can occur in the PIP and DIP joints, and presents special diagnostic difficulties. Open reduction is evidently necessary to correct the displacement.

Child↗