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[The effect of local growth in long bones following two different epiphyseal-stimulating procedures: an experimental study].

OBJECTIVE: To study the effect of local growth in long bones of the rabbits following two different epiphyseal-stimulating procedures. METHODS: These were osteotomy in the metaphysis near the proximal tibial epiphyseal plate and hemicirecumferential periosteal excision on the proximal tibial epiphysis. Tibia roentgenography, tetracycline labelling, histological method and electron microscopy were used. RESULTS: The local stimulating effect following hemi-circumferential periosteal excision was more evident than following osteotomy. CONCLUSION: The procedure of periosteal excision could be good for the treatment of children knee' deformity.

Animals↗

Epiphyseal involvement of simple bone cysts.

Epiphyseal involvement of a simple bone cyst (SBC) is uncommon. Eight patients are reported in whom an SBC was found to cross the growth plate, involving the epiphysis in seven patients and the apophysis in one. All patients had more than two pathologic fractures. In seven patients growth disturbance was found. Functional impairment did not develop in any patient. Radiographically, all lesions presented a characteristic involvement of the epiphysis and metaphysis in various proportions. Only one of four cysts treated with methylprednisolone acetate injections showed incomplete healing; the others failed to respond. After percutaneous grafting of autologous bone marrow, three of seven cysts healed and the others attained incomplete healing. Epiphyseal involvement of SBC should be considered a more aggressive form of an active lesion.

Adolescent↗

Chondro-epiphyseal separation of the distal humerus in the newborn. A case report and review of the literature.

Chondro-epiphyseal separation of the distal humerus is a rare injury, and when it occurs in the newborn, it may be difficult to diagnose and is easily mistaken for a dislocation of the elbow. The unimpressive clinical appearance of such an injury of the elbow in an infant, as well as the absence of ossific nuclei of the distal humerus in the newborn, are responsible for the dilemma in making the diagnosis. Ultrasonography, a readily available, non-invasive technique, can be used to evaluate the non-ossified epiphysis about the elbow of infants to demonstrate dislocations, fractures, and physeal separations. Closed reduction with or without percutaneous Kirschner wire fixation is the treatment of choice for these injuries. In this article, we report on a case of complete epiphyseal separation in a neonate and discuss the problems arising in its diagnosis.

Birth Injuries↗

Treatment of leg length discrepancy with temporary epiphyseal stapling in children with juvenile idiopathic arthritis during 1957-99.

Temporary epiphyseal stapling is a flexible method for correction of leg length discrepancy. Due to a high risk of premature epiphyseal plate closure and other complications reported in previous studies, the technique has not been in wide use. In this study a retrospective analysis of 71 knees in patients with juvenile idiopathic arthritis was performed to determine the safety and effectiveness of the method. Only seven minor reversible complications were encountered, and the authors found the method suitable even for immunologically compromised patients.

Arthritis, Juvenile↗

[Effects of zinc deficiency on the c-fos gene expression and transcription in the epiphyses of fetal mouse long bone in culture].

The effects of zinc on c-fos gene expression and transcription in the epiphyses of fetal long bone were studied in mice. The long bones of 16-day fetal mouse were cultured for 48 hours(in medium GBJb) and then used for measuring c-fos gene expression and transcription by immunohistochemistry and in situ hybridization. The result was analyzed by an imaged-analyses system. The experiment was divided into zinc control group(ZC), zinc deficiency group(ZD), zinc deficiency replenish group(ZDR) and zinc stimulatory group(ZS) respectively. The result showed that 1) zinc deficiency caused c-fos protein and mRNA expression and the number of reactive cell decreased. 2) when zinc concentration of medium was 100 mumol/L, the expression and transcription of c-fos gene were increased in hypertrophic, proliferative and resting zone of epiphyses. The research suggested that zinc could affect the expression of c-fos gene in mouse fetal long bone.

Animals↗

Morphology of epiphyseal apparatus of a ranid frog (Rana Esculenta)

Morphological, histochemical and ultrastructural investigations on epiphyseal apparatus of Rana Esculenta were made. The most important findings were the following: 1) metaphyseal cartilage is localized inside proximal diaphyseal compact bone as a plug; 2) metaphyseal cartilage do not reduce in thickness during ageing; 3) metaphyseal cartilage do not show vascular invasion and do not mineralize in degenerative zone; 4) trabecular bone was not at all evident in this animal; 5) external periosteum is well vascularized and proliferates in correspondence to marginal epiphyseal end of the diaphyseal. From these results the hypothesis that the ranid frog bone growth is not due to metaphyseal metabolism (as in avian and mammals) but to bone periosteal marginal mineralization is reached.

Age Factors↗

[Reduction of epiphyseal displacement and fixation in the treatment of unstable slipped capital femoral epiphysis].

UNLABELLED: Reduction of epiphyseal displacement by manipulation in the treatment of unstable slipped capital femoral epiphysis (scfe) can lead to very severe complications as avascular necrosis or acute necrosis of cartilage. The aim of this study is to analyze the results of treatment of unstable scfe with open reduction and fixation. Material consists of 14 patients (10 boys and 4 girls) with 15 hips treated surgically because of unstable scfe with an average follow up of 10 years and 6 months (ranged from 2 to 26 yrs). The age of the patients ranged from 9 to 17 yrs (mean 13). There was 14 cases of acute-on-chronic slips and 1 acute slip. The slip angle measured on anteroposterior radiographs ranged from 27 degrees to 57 degrees (mean 39 degrees) and on frog lateral radiographs ranged from 52 degrees to 81 degrees (mean 67 degrees). In all of the cases manipulated reduction and internal fixation was done. The mean amount of correction was 30 degrees measured on anteroposterior radiographs (from 7 degrees to 55 degrees) and 37 degrees on frog lateral radiographs (from 8 degrees to 82 degrees). An end results were classified according to Hall and Southwick classification with Szypryt modification. RESULTS: Excellent result was achieved in 6 hips (40%), good in 4 hips (27%), fair in 3 (20%) and poor in 2 (13%). Avascular necrosis developed in 2 hips. There was no cases with acute necrosis of cartilage. CONCLUSION: Reduction of epiphyseal displacement and fixation is a save procedure in the treatment of unstable slipped capital femoral epiphysis. Severe under-correction as well as over-reduction can lead to unsatisfactory results.

Adolescent↗

Comparison of ages of epiphyseal union in North American and Bosnian skeletal material.

The accurate determination of age at death is a critical component in the analysis of human skeletal remains. Population specific techniques are often used without due consideration of the provenance of the material being studied. This communication considers the ages at which epiphyseal union occur in young Bosnian males and compares those findings to data published by McKern and Stewart on young North American soldiers killed during the Korean War. Of the ten epiphyses considered in this study, all elements were observed to be at least two years in advance in the Bosnian sample compared to the American sample. This article demonstrates that whilst standards based on an American sample produce broadly applicable age ranges for use on forensic work in the Balkans, the age ranges generated produce an upper age limit that is often two or more years older than the chronological age. Therefore, it is desirable, that wherever possible, appropriate standards should be devised for more accurate aging reflecting population specific profiles.

Adolescent↗

In vitro epiphyseal-plate growth in various constant electrical fields.

An in vitro epiphyseal-plate model was subjected to various electrical fields. At a voltage gradient of 1500 volts per centimeter, a consistent, highly significant acceleration of growth of the epiphyseal plate occurred as measured from photomacrographs and as indicated by incorporation of 45Ca, 35S, and 3H-thymidine. The growth acceleration was due to voltage gradients and not to current flow. Although the mechanism of action of the electrical field is not known, it is obvious that the voltage gradient, either directly or indirectly, incites a physiological response of the growth-plate chondrocyte.

Animals↗

Epiphyseal cartilage cAMP changes produced by electrical and mechanical perturbations.

Epiphyseal cartilage from chick embryo was subjected in vitro for one to 15 minutes to static compressive forces or oscillating electric fields. The same stimuli were applied to suspensions of cells isolated from the epiphyses. At the end of the perturbation cAMP was measured in the tissue or cell extracts by radioimmunoassay. It was found that a physiological (60 g/cm2) static pressure reduced the cAMP content in the tissue and the separated cells. An oscillating electric field above 900 V/1.5 cm, 5Hz, enhanced the cAMP accumulation in the intact tissue. This effect was produced only when the long axis of the bones was oriented parallel to the electric field. In isolated cells an electric field above 750 V/1.5 cm, 5Hz, caused a decrease in cAMP content. Charged matrix macromolecules and orientation of the cells within the cell matrix may have a modulating effect on the initiation of this response. It is postulated that the change in cAMP is the early cellular signal in the response to an electrical or mechanical perturbation which leads to bone remodeling.

Animals↗

[Lengthening of long bones by the method of slow lysis of the epiphyses. Preliminary report].

The authors have presented a preliminary report on the results of elongation of the lower extremities by the bloodless method of slow disruption of the long bones epiphyses based on the observation of 6 cases. The treatment was applied in the children just before bone growth has been finished. Bone rebuilding at the site of elongation was obtained at 4 to 6 months after the start of distraction. In that period, union of the epiphyseal cartilage was present in 5 from 6 treated patients. The authors believe that the presented method of elongation of the lower extremities can be recommended.

Adolescent↗

Growth of condylar, epiphyseal and spheno-occipital synchrondrosal cartilages cultured on medium BGJ.

The purpose of this experiment was to examine the growth of condylar, epiphyseal, and spheno-occipital synchrondrosal cartilages cultured on medium BGJ. Materials from 12 neonatal rabbits were cultured for 7 days on this medium with the addition of 0, 10, or 20% fetal calf serum. Epiphyseal cartilages cultured with the addition of 20% fetal calf serum showed slightly better maintenance of in situ state, though little morphological changes were observed during 7 days. Spheno-occipital synchondrosal cartilages cultured with the addition of 10% or 20% fetal calf serum were histologically relatively similar to in situ state than those cultured without fetal calf serum, but no growth in length and width of these cartilages was observed. On the other hand, cultured condylar cartilages showed the least maintenance of histological and histochemical features. It was assumed that medium BGJ was not a recommendable medium for the organ culture of condylar cartilage.

Animals↗

[Epiphyseal points of the fetal knee. The impact of growth disorders on bone maturation].

The radiological appearance of bone maturity can be used as a criterion for fetal maturity. This examination with limited irradiation to the fetus is an alternative to amniocentesis. The practice of the latter is not without risk. The authors carried out 194 examinations of the contents of the uterus to look at the epiphyses of the knee between the 34th and 40th week of amenorrhoea. The found three groups: 1) those with normal development; 2) those with delayed development and 3) those with more advanced development. They did not find significant correlation between small-for-dates growth and bony maturity. On the other hand, where there was increased growth of the fetus in cases where maternal diabetes was excluded there was demonstrated that bony maturity accelerated with the presence of Béclard's point from the 34th week onwards. With such great variation in the dates of the appearance of points of ossification the presence of epiphyseal points in the knee cannot be taken as a criterion to establish fetal maturity nor the minimum duration of the pregnancy.

Birth Weight↗

Organization of extracellular matrix in epiphyseal growth plate.

Three cations of varying size and charge density, egg-white lysozyme, protamine and ruthenium red, were used to stain the extracellular matrix of epiphyseal cartilage growth plate. With these stains, it was possible to distinguish three types of proteoglycans or materials associated with them, which may well have as their major differences the type of cross linking to the tissue. One type was stained by ruthenium red and protamine but not by lysozyme, was extractable with 3 M guanidinium chloride and was relatively uniformly dispersed throughout the matrix of the growth plate. The other two types were stained by all three cations, were not extractable with 3 M guanidinium chloride and were intimately associated with fibrils. One of these was found on the collagen fibrils, was relatively scanty in the resting zone near the articular surface, relatively restricted to the extralacunar area in the columnar zones and appeared to diminish in amount in the hypertrophic zone. This material often had a 640-A periodic array on the surface of collagen fibrils. The third type also was stained by all three cations and was not extractable with 3 M guanidinium chloride. It was distinguished from the other class of lysozyme-reactive matrix components by the larger volume of distribution occupied by the stained material. It also had a different distribution in that it was widely dispersed in the resting zone, was restricted to the lacuna in the columnar zone and was absent in the hypertrophic zone. Thus, cartilage matrix as well as the chondrocytes undergo differentiation in the epiphyseal growth plate.

Animals↗

Epiphyseal stapling for angular deformity at the knee.

Fifty six patients with angular deformities of eighty-two knees were treated with epiphyseal stapling between 1954 and 1973 and followed until maturity. There were sixty-four knock-knees and eighteen bowlegs. In twelve patients with concurrent leg-length discrepancies, long legs were stapled asymmetrically. The deformities were allowed to overcorrect before the staples were removed, but the rebound phenomenon occurred in twenty-two patients with thirty-five deformities. In older children the staples were taken out when the legs looked straight. Exaggerated physiological deformities may correct spontaneously. They should not be stapled before the skeletal age of eleven in girls and twelve in boys. Secondary deformities are corrected earlier. There were no significant complications. Ten revisions of staples were necessary because of extrusion or shifting. The results were satisfactory or improved in 87 per cent of the deformities. When it is indicated epiphyseal stapling is a safe and effective method of correcting angular deformity at the knee in growing children.

Adolescent↗

Lipids of mineralizing epiphyseal tissues in the bovine fetus.

Because lipids had been consistently detected histologically at sites of new calcification, the lipids of epiphyseal cartilage and bone in various stages of mineralization were examined. Lipids were extracted before and after demineralization and analyzed. Lipid content increased during proliferation and calcification of epiphyseal cartilage. Much less was seen in the adjacent cancellous bone; this corroborates histochemical findings. Similar phospholipid compositions were seen in the total lipids of cartilage and bone. Neutral (dipolar) phospholipids accounted for nearly 90% of the total lipid P and were almost completely extracted before demineralization. Serine- and inositol-containing phospholipids and two other, unidentified, acidic lipids could not be effectively extracted from calcifying tissues until after demineralization. Since the extraction of the acidic lipids was closely related to the degree of mineralization, it is possible that they form part of a lipoprotein-mineral complex in the calcifying matrix. Lysophospholipids were detected in all extracts, but primarily in those made after decalcification. It is concluded that acidic lipids are mainly responsible for the sudanophilia detected histologically at sites of new calcification.

Animals↗

[Histofluorescence study of epiphyseal monoamines in the garden dormouse (Eliomys quercinus L.) during various experimental conditions in hibernation period (author's transl)].

During the hibernation period, the epiphyseal catecholamine charge is well detected in the garden dormouse; it appears more important in darkened animals at 22 degrees C and much less in animals under continuous lighting. Serotoninergic elements have only been shown in animals living under complete darkness. An important catecholaminergic and indolaminergic charge appears in sexually-hypoactive-animals; during ovarian activation after illumination a diminution (of this charge) is observed. In this species, an inverse relation exists between the importance of epiphyseal monoaminergic metabolism and the hypothalamic gonadostimulating catecholamine discharge.

Animals↗