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Cortisol decreases bone formation by inhibiting periosteal cell proliferation.

We tested the hypothesis that the inhibitory effect of cortisol on bone growth is primarily on the periosteum. Fetal rat calvaria were maintained in organ culture, labeled with radioactive proline or thymidine, and then dissected to separate periosteum from the osteoblast-rich central bone. There was a dose- and time-dependent inhibition of thymidine incorporation into DNA in the periosteum which was significant at 24 h. These observations were further supported by decreases in the dry weight and DNA content of the periosteum at 96 h. Incorporation of thymidine and proline into the central bone were decreased only at 96 h. Pulse-chase studies using a high concentration of cortisol (10(-6) M) indicated that increased cell attrition may also play a role in the inhibitory effect of cortisol. We propose that the primary effect of cortisol on bone growth is an inhibition of proliferation of the periosteal cells which give rise to osteoblasts. The subsequent decrease in the incorporation of proline into the central bone may be the consequence of this inhibition.

Animals↗

Estrogens are essential for male pubertal periosteal bone expansion.

The skeletal response to estrogen therapy was studied in a 17-yr-old boy with congenital aromatase deficiency. As expected, estrogen therapy (1 mg estradiol valeriate/d from age 17 until 20 yr) normalized total and free testosterone and reduced the rate of bone remodeling. Dual-energy x-ray absorptiometry-assessed areal bone mineral density (BMD) of the lumbar spine and femoral neck increased significantly (by 23% and 14%, respectively), but peripheral quantitative computed tomography at the ultradistal radius revealed no gain of either trabecular or cortical volumetric BMD. The increase in areal BMD was thus driven by an increase in bone size. Indeed, longitudinal bone growth (height, +8.5%) and especially cross-sectional area of the radius (+46%) and cortical thickness (+12%), as measured by peripheral quantitative computed tomography, increased markedly during estrogen treatment. These findings demonstrate that androgens alone are insufficient, whereas estrogens are essential for the process of pubertal periosteal bone expansion typically associated with the male bone phenotype.

Adolescent↗

Immunolocalisation of collagenase in rabbit periosteal tissue explants and extraction of the enzyme. The effect of the cytokines IL-1 alpha and EGF.

The effect of interleukin-1 alpha (IL-1 alpha) and murine epidermal growth factor (EGF) on incorporation of endogenously produced collagenase in the extracellular matrix of soft connective tissue was studied in an in vitro model system using periosteal explants obtained from rabbit calvariae. Immunohistochemical analysis indicated the highest level of collagenase in explants cultured for 72 hours with IL-1 alpha in combination with EGF. Most enzyme appeared to be associated with the extracellular matrix, but labeling was also found in numerous fibroblast-like cells. Explants cultured in the presence of IL-1 alpha alone contained less enzyme and in periostea treated without cytokines, or with EGF alone, only a faint label, if any, was seen. Freshly isolated, non-cultured periostea contained no detectable enzyme. Extraction of collagenase from periostea revealed that: (1) non-cultured periosteum did not contain detectable levels of enzyme. (2) The amount of total activatable enzyme synergistically increased (10-fold) under the influence of IL-1 alpha and EGF, whereas IL-1 alpha alone showed a 4-fold enhancement compared to control or EGF-incubated explants. (3) The latent fraction of the enzyme was synergistically increased (up to 100-fold or more) in periostea cultured in the presence of IL-1 alpha + EGF (21.17 mU/explant versus 0.05 mU/explant in controls). (4) Active collagenase, on the other hand, appeared to be present in a relatively high concentration in explants cultured without cytokines (2.45 mU/explant versus 0.36 mU/explant in IL-1 alpha + EGF-treated explants).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Circumferential periosteal release in the treatment of children with leg-length inequality.

We present the results of 38 children with leg inequality treated by circumferential periosteal release. Leg-length discrepancy was expressed as a percentage of the longer limb. All patients showed a decrease in percentage difference at one year after operation, the mean difference dropping from 7.24% to 5.45%. The size of the response was directly related to the age of the patient at operation, being more pronounced in the younger patients. The response was not related to sex, diagnosis, or rate of growth of the patient immediately preceding operation.

Adolescent↗

Perichondrial chondrogenesis and periosteal osteogenesis by localized graft-vs-host reaction in mice.

Localized GvH reaction produced by the subcutaneous injection of parental lymphoid cells into the ear lobe of F1 recipient mice results in local activation of perichondrial chondrogenesis. Similarly, when the GvH reaction was elicited in shanks, the periosteal membranes at the site of immune reaction were stimulated to proliferate and to produce new bone. However, syngeneic lymphocytes activated in vivo by Con A and untreated syngeneic spleen and bone marrow cells administered locally produced similar response of bone and cartilage. Thus the lymphocytes activated either in the course of GvH reaction or syngeneic lymphocytes grafted into heterotopic sites presumably release mediators capable to stimulate periosteal/perichondrial membranes.

Animals↗

Split thickness flap, apically replaced, with protected linear periosteal fenestration.

The split thickness flap, apically replaced, with internal linear periosteal fenestration, is a combination of two known techniques. This procedure is another choice to solve mucogingival problems. The advantages in addition to securing a firmer bond of periosteum to bone and mucosa to periosteum at the selected position are: there is no bone exposed, healing is apparently faster and postoperative pain is minimal. An experimental work, carried out on dogs to study the histological reactions after this procedure, is in progress. The results of these observations will be reported in a future publication.

Fenestration, Labyrinth↗

Periosteal ossifying fibroma of the palate.

An unusual case of the ossifying fibroma of a 54-year-old woman is reported. Clinically the lesion appeared as an exophytic mass on the hard palate and apparently originated outside of bone. Histologically the resected tumor is well encapsulated and made up of a richly cellular fibroblastic stroma containing foci of mature bone with a predominantly lamellar structure. While the possibility exists that the lesion is reactive, it appears to be a true neoplastic growth and a purely soft tissue process arising from the periosteum of the palate. Thus, we proposed the term periosteal ossifying fibroma for this distinct lesion in order to distinguish it from the common peripheral ossifying fibroma.

Diagnosis, Differential↗

The use of autogenous periosteal grafts as barriers for the treatment of intrabony defects in humans.

The purpose of this study was to evaluate the clinical effectiveness of a connective tissue graft including periosteum used as a barrier for guided periodontal tissue regeneration in interproximal bony defects. An open flap debridement of a comparable interproximal bony defect in the same patient was used as a control. This study was performed at 2 different clinical centers. Six paired defects were treated at one center, and 16 paired defects at the other. Reentry surgeries were performed at 6 months. Preoperative comparisons of control and experimental sites with respect to clinical parameters and osseous measurements were similar. Post-surgical experimental sites produced more gain in clinical attachment (1.25 mm on buccal and 1.25 mm on lingual sites at center A and 1.26 mm on buccal and 1.18 mm on lingual sites at center B) and osseous defect fill (1.84 mm on buccal and 2.00 mm on lingual sites at center A and 1.66 mm on buccal and 2.04 mm on lingual sites at center B) when compared to control sites. The results of this trial indicate that clinical resolution of interproximal periodontal defects can be obtained with periosteal grafts used as barriers.

Alveolar Bone Loss↗

Effect of hemi-circumferential periosteal transection and elevation in foals with experimentally induced angular limb deformities.

OBJECTIVE: To evaluate the effect of hemi-circumferential periosteal transection and elevation (HCPTE) in foals with, experimentally induced angular limb deformities. DESIGN: Prospective study. ANIMALS: 10 healthy foals. PROCEDURE: When foals were 30 days old, transphyseal bridge implants were placed on the lateral aspects of both distal radial physes. At 90 days of age (or when 15 degrees of angulation had developed), implants were removed, and HCPTE was performed on 1 limb. Foals were confined in small pens after surgery; the front feet of the foals were rasped weekly to maintain medial-to-lateral hoof wall balance. Dorsopalmar radiographic projections of the carpi were obtained before HCPTE and 2, 4, 6, 8, and 48 weeks later. RESULTS: At the time of transphyseal bridge removal and HCPTE, both treated and control limbs were observed to have a significantly greater carpal valgus, compared with the initial degree of angulation at 30 days of age. Following HCPTE or sham surgery, all limbs straightened over the subsequent 2 months of the study. Median angulation was not significantly different between treated and control limbs at any time during the study. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in foals with experimentally induced limb deformities, HCPTE was no more effective than stall confinement and hoof trimming alone for correction of the deformity.

Animals↗

Parosteal (periosteal) lipoma.

Parosteal (periosteal) lipoma is a rare tumour, comprising 0.3% of all lipomas. A parosteal lipoma of the mid humerus which presented in a female of 22 years was associated with changes in the adjacent bone. A review of the literature revealed only one previously reported similar case. The etiology, presenting symptoms, complications, differential diagnosis, treatment and prognosis of parosteal lipoma are discussed.

Adult↗

Periosteal epithelioid hemangioendothelioma with leptomeric fibrils.

A case of recurrent periosteal epithelioid hemangioendothelioma of the right femur in a 66-year-old woman is reported. Microscopic examination showed epithelioid tumor cells with frequent intracytoplasmic vacuoles arranged in small nests or cords in hyalinized stroma. Immuno- and lectin-histochemical studies for factor VIII-related antigen and ulex europaeus I lectin indicated the endothelial nature of the tumor cells. Ultrastructurally, a few tumor cells contained leptomeric fibrils and crystalline filamentous aggregates in addition to showing certain features of endothelial cells. There seems to be no previous report of a vascular tumor containing leptomeric fibrils, which are often noted in normal striated muscle cells and their tumors. The bland appearance of the epithelioid tumor cells, poor vasoformative nature and prolonged clinical course differentiated this tumor from conventional angiosarcoma and so-called hemangioendothelioma of bone.

Aged↗

Long term results in cleft and palate repair with modified periosteal flap technique.

The authors describe their multidisciplinary approach to cleft lip and palate repair. The preoperative treatment is performed only in a few selected cases. The lip is operated on at 3 months of age with a periosteal flap, slightly modifying Skoog's technique. The cleft palate is closed at 18 months (Langenbeck method). The orthodontic treatment is undertaken at 6 or 7 years. 45 cases are periodically investigated (casts, masks, X-ray, cephalograms, records, films). Our follow-up covers a range of 9 years. Results are satisfactory.

Alveoloplasty↗

Cytokines modulate contraction of periosteal explants from rabbit calvariae.

Periosteal explants obtained from rabbit calvariae are introduced as a model system to study contraction of soft connective tissue. Culturing of these explants resulted in a substantial time-dependent decrease of the surface area which coincided with a similar decrease in volume. A 75% reduction of the initial explant surface area was observed after a culture period of 72h in the presence of 10% serum. Also in the absence of serum contraction of explants was found, indicating that serum components were not essential. Following devitalization of the explants no contraction did occur. A strong inhibition of contraction was found following interference with the formation of microfilaments, microtubules or intracellular cyclic-AMP levels by using cytochalasin B, colchicine or dibutyryl-cAMP, respectively. These data indicated that viable cells and an intact cytoskeleton were a prerequisite for contraction to occur. A number of cytokines (EGF, aFGF, bFGF, IGF-1, PDGF, TGF-beta and IL-1alpha) was tested for their ability to influence contraction. IL-1alpha was shown to inhibit contraction from the 48h culture period on. Anti-IL-1alpha-serum completely abolished this effect. The IL-1alpha-inducible inhibition of contraction was also partially blocked by indomethacin. TGF-beta enhanced contraction dose-dependently during the 24-48h culture period, whereas TGF-1 and IL-1alpha, added to the cultures in combination, proved to antagonize each other. The other growth factors did neither influence contraction not the IL-1alpha-induced inhibition of contraction.

Actin Cytoskeleton↗

The osteogenic capacity of free periosteal and osteoperiosteal grafts. A comparative study in growing rabbits.

The behaviour of free periosteal and 200 micron thick osteoperiosteal grafts was studied histologically in 40 six-week-old rabbits. The grafts were taken from the tibia and fixed on either side of the same lumbar vertebra between the spinous and mamillary processes. The free stripped periosteum had better osteogenic activity than the 200 micron thick osteoperiosteum. The new bone was formed by the osteogenic cells of the cambium layer in both types of graft.

Age Factors↗

Reconstruction of articular cartilage defects with free periosteal grafts. An experimental study.

The chondrogenic potential of free autogenous periosteal grafts was studied histologically in 6-month-old rabbits. The grafts were taken from the tibia and transplanted to 7 x 14 mm large artificial defects of the femoral articular cartilage. The results revealed that the defects were repaired and filled after 4 weeks with a hyaline-like cartilage which was histologically similar to the cartilage adjacent to the transplant. The tissue maintained this morphology after 1 year of observation. In control animals where no periosteum was transplanted to the defect, no real cartilage was found. The tissue which partially filled the defect was a variable mixture of fibrous tissue and fibrocartilage.

Animals↗

Effects of joint motion on the repair of articular cartilage with free periosteal grafts.

The effects of joint motion on the chondrogenic potential of free autogenous periosteal grafts were studied histologically in 6-month-old rabbits. The grafts were taken from the tibia and transplanted to artificial defects of the femoral articular cartilage. The joint was postoperatively first immobilized and then remobilized for various periods. The results revealed that immobilization for 3 weeks had an inhibitor effect on the chondrogenesis, which was even more pronounced after 6 weeks of immobilization. After remobilization the chondrogenesis partially recovered. This recovery of chondrogenesis was more pronounced after 3 weeks' immobilization than after 6 weeks' immobilization. However, degenerative changes were observed in both series.

Animals↗