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PubMed2001

Testosterone stimulates growth of tibial epiphyseal growth plate and insulin-like growth factor-1 receptor abundance in hypophysectomized and castrated rats.

Puberty is associated with an increase in the plasma concentration of sex steroids, growth hormone (GH), and insulin-like growth factor-1 (IGF-1). Gonadal steroid hormones are important for the normal pubertal growth spurt and skeletal growth. The mechanism by which gonadal steroids induces skeletal growth is still not fully understood. To study the GH-independent effect of testosterone on growth, we investigated the effect of testosterone injections on the tibial epiphyseal growth plate (EGP) in an in vivo model of hypophysectomized and castrated male rats. Four groups (six animals each) of 28-d-old male rats were studied. Groups A, B, and C were hypophysectomized and castrated and received 500 microg/(kg x d) of hydrocortisone and 15 microg/(kg x d) of levothyroxine sodium. Groups A and B were also treated with daily sc injections of 10 microg of testosterone/100 g of body wt and 100 microg of testosterone/100 g of body wt, respectively, for 7 d. Group C was injected with vehicle alone. Group D were intact animals injected with saline (controls). Animals were sacrificed on 8 d. As expected, serum GH levels were found to be very low (1.13+/-0.1 ng/mL) in the hypophysectomized animals (group C, hypopit), and testosterone treatment did not change them significantly. Serum IGF-1 decreased from 502.9+/-13 ng/mL in group D to 167+/-41.4 ng/mL in group C (p < 0.001). Testosterone therapy had no stimulatory effect on serum IGF-1 levels in the hypopit + low-dose group (A) (220+/-94.8 ng/mL) and had an inhibitory effect in the hypopit + high-dose group (B) (39.3+/-17.5). Histomorphometric determinations demonstrated an EGP width of 472.3+/-39 microm in the intact animals but only 336.9+/-1.6 microm in the hypopit group (C) (p < 0.01). High-dose testosterone treatment (group B) significantly increased the EGP width (to 438.8+/-27.8), (p < 0.001), whereas low-dose testosterone (group A) did not. Immunohistochemistry studies revealed that the levels of IGF-1 in the EGP of the control animals were almost negligible and that testosterone did not change them. However, testosterone increased in a dose-dependent manner the abundance of IGF-1 receptor EGP. We conclude that testosterone has a direct, local, GH-independent effect on the EGP growth and IGF-1 receptor abundance.

Animals↗
PubMedDate not supplied

Asymmetrical closure of epiphyses in a patient with sickle cell anemia.

There is a high incidence of delayed sexual development and short stature during childhood in children with sickle cell anemia (SCA). We report a 15 year-old male with SCA who presented with significant short stature after a near death event (involving seizures and prolonged hypoxia). His evaluation showed growth hormone (GH) deficiency with low insulin-like growth factor-I (IGF-I), low IGF binding protein-3, and low GH response to stimulation. He was started on GH replacement with poor response in height gain although with normal response in terms of elongation of his arm span. Further studies showed premature closure of the epiphyses of the femora and tibiae bilaterally. This report demonstrates that children with SCA may present with growth failure not only due to nutritional and GH abnormalities but also due to abnormal growth plates, probably due to local anoxic events. Children with SCA should always have their arm span measured carefully.

Adolescent↗
PubMed2002

Epiphyseal separation of the distal humerus.

A case of epiphyseal separation of the distal humerus is presented, emphasizing the clinical and radiological features of this rare birth trauma. Conservative treatment resulted in complete recovery.

Birth Injuries↗
PubMed2004

Vascularized proximal fibular epiphyseal transfer for distal radial reconstruction.

BACKGROUND: Treatment of the loss of the distal part of the radius, including the physis and epiphysis, in a skeletally immature patient requires both replacement of the osseous defect and restoration of longitudinal growth. Autologous vascularized epiphyseal transfer is the only possible procedure that can meet both requirements. METHODS: Between 1993 and 2002, six patients with a mean age of 8.4 years (range, six to eleven years) who had a malignant bone tumor in the distal part of the radius underwent microsurgical reconstruction of the distal part of the radius with a vascularized proximal fibular transfer, including the physis and a variable length of the diaphysis. All of the grafts were supplied by the anterior tibial vascular network. The rate of survival and bone union of the graft, the growth rate per year, the ratio between the lengths of the ulna and the reconstructed radius, and the range of motion of the wrist were evaluated for five of the six patients who had been followed for three years or more. RESULTS: The mean duration of follow-up of the six patients was 4.4 years (range, eight months to nine years). All six transfers survived and united with the host bone within two months postoperatively. The five patients who were followed for three years or more had consistent and predictable longitudinal growth. Serial radiographs revealed remodeling of the articular surface. The functional result was rated as excellent for all but one patient, in whom the distal part of the ulna had also been resected because of neoplastic involvement. No major complication occurred at the recipient site, whereas a peroneal nerve palsy occurred at the donor site in three patients. The palsy was transient in two patients, but it persisted in one. No instability of the knee joint was observed. CONCLUSIONS: After radical resection of the distal part of the radius because of a neoplasm in children, vascularized proximal fibular transfer, based on the anterior tibial artery, permits a one-stage skeletal and joint reconstruction, provides excellent function, and minimizes the discrepancy between the distal radial and ulnar lengths.

Bone Neoplasms↗
PubMed2006

Demographic predictors of severity of stable slipped capital femoral epiphyses.

BACKGROUND: The outcome of stable slipped capital femoral epiphysis is directly related to the severity of the slip. If it is assumed that the slip will be less severe if it is diagnosed early, then early diagnosis should improve the prognosis. It was our purpose to determine demographic predictors of the severity of a slipped capital femoral epiphysis. METHODS: A retrospective study of 243 children with a total of 328 stable slipped capital femoral epiphyses was performed. Gender, race, age, and symptom duration were noted. Slip severity was classified as mild (<30 degrees ), moderate (30 degrees to 50 degrees ), or severe (>50 degrees ). Statistical analyses included bivariate, multivariate, linear correlation, and logistic regression techniques. RESULTS: There were 159 boys and eighty-four girls; 149 children had unilateral and ninety-four had bilateral slipped capital femoral epiphysis. Of the bilateral slips, forty-two were simultaneous and fifty-two were sequential. The mean age (and standard deviation) was 12.6 +/- 1.8 years, the mean duration of the symptoms was 5.2 +/- 7.4 months, and the mean slip angle was 29 degrees +/- 20 degrees . There were 199 mild, sixty-eight moderate, and forty-five severe slips. The mean duration of symptoms was 3.5 +/- 5.0 months for the mild slips, 7.7 +/- 9.0 months for the moderate slips, and 8.8 +/- 10.6 months for the severe slips (p < 0.0001). Older children had more severe slips: the average age was 12.3 +/- 1.8 years for the children with a mild slip, 13.0 +/- 1.6 years for those with a moderate slip, and 13.8 +/- 1.8 years for those with a severe slip (p < 0.0001). Multivariate analyses demonstrated that, among the factors studied, only the age of the patient and the duration of the symptoms were associated with the slip severity. Symptom duration and patient age were used as predictors of slip severity in a logistic regression analysis, with > or =30 degrees and <30 degrees used as the categories for slip severity, older than 12.5 years old compared with 12.5 years old or younger used as the categories for age, and more than 2.0 months compared with 2.0 months or less used as the categories for symptom duration. This model predicted the probability of a slip with confidence (p < 0.0001). The odds ratios (with 95% confidence intervals) for age and symptom duration were 2.0 (1.15 to 3.53) and 4.1 (2.34 to 7.12), respectively. Thus, a child with a stable slipped capital femoral epiphysis is 2.0 times more likely to have a moderate or severe slip if he or she is older than 12.5 years of age at the time of the diagnosis and 4.1 times more likely to have a moderate or severe slip if the duration of symptoms was longer than two months. CONCLUSIONS: The only two known significant predictors of the severity of a slipped capital femoral epiphysis are age at diagnosis and symptom duration. For any individual child, slip severity and symptom duration are unique; in a large population, there is a general correlation between slip severity and increases in patient age and increases in the duration of symptoms.

Adolescent↗
PubMed2005

Vascularized proximal fibular epiphyseal transfer for distal radial reconstruction.

BACKGROUND: Treatment of the loss of the distal part of the radius, including the physis and epiphysis, in a skeletally immature patient requires both replacement of the osseous defect and restoration of longitudinal growth. Autologous vascularized epiphyseal transfer is the only possible procedure that can meet both requirements. METHODS: Between 1993 and 2002, six patients with a mean age of 8.4 years (range, six to eleven years) who had a malignant bone tumor in the distal part of the radius underwent microsurgical reconstruction of the distal part of the radius with a vascularized proximal fibular transfer, including the physis and a variable length of the diaphysis. All of the grafts were supplied by the anterior tibial vascular network. The rate of survival and bone union of the graft, the growth rate per year, the ratio between the lengths of the ulna and the reconstructed radius, and the range of motion of the wrist were evaluated for five of the six patients who had been followed for three years or more. RESULTS: The mean duration of follow-up of the six patients was 4.4 years (range, eight months to nine years). All six transfers survived and united with the host bone within two months postoperatively. The five patients who were followed for three years or more had consistent and predictable longitudinal growth. Serial radiographs revealed remodeling of the articular surface. The functional result was rated as excellent for all but one patient, in whom the distal part of the ulna had also been resected because of neoplastic involvement. No major complication occurred at the recipient site, whereas a peroneal nerve palsy occurred at the donor site in three patients. The palsy was transient in two patients, but it persisted in one. No instability of the knee joint was observed. CONCLUSIONS: After radical resection of the distal part of the radius because of a neoplasm in children, vascularized proximal fibular transfer, based on the anterior tibial artery, permits a one-stage skeletal and joint reconstruction, provides excellent function, and minimizes the discrepancy between the distal radial and ulnar lengths.

Bone Neoplasms↗
PubMed1983

Premature fusion of the proximal humeral epiphyses in thalassemia.

Premature fusion of the proximal humeral epiphyses with varus deformity is a common and characteristic radiologic finding in thalassemia anemia. A review of 17 cases with bilateral and one case with unilateral involvement, coupled with known anatomic and mechanical factors, suggested an explanation for this phenomenon. Hypertrophied marrow will thin the trabeculae and cortex, perforate the cortex through normal fenestrations, and proliferate subperiosteally. Normal force vectors result in medial humeral compression and ultimately premature fusion.

Adolescent↗
PubMed1997

Radiographic anthropometry in patients with multiple epiphyseal dysplasia.

OBJECTIVE: This study investigated the diagnostic value of radiographic anthropometry in patients with multiple epiphyseal dysplasia (MED). SUBJECTS AND METHODS: In 15 children of one family with MED (12 affected, three unaffected), all of whom were less than 16 years old, measurements were made of the distal femoral metaphysis and epiphysis on standard anteroposterior radiographs of the knee. In each individual, the height of the epiphysis was plotted against the width of both the epiphysis and the metaphysis. Sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: In 11 of 12 children with MED, the plotted values were more than 2 SDs below the mean. Sensitivity was 92%, specificity was 100%, and positive predictive value was 100%. CONCLUSION: Anthropometry is useful to detect involvement of a child in a family with MED. For this particular family, anthropometry had a high positive predictive value.

Adolescent↗
PubMed1978

Proteogylcan heterogeneity in embryonic chick articular and epiphyseal cartilages.

Proteoglycans from two regions of the chick limb rudiment (articular and epiphyseal) were examined for chemical microheterogeneity. These cartilages are composed of at least two series of proteoglycan variants whose glycosaminoglycan side chains display microheterogeneity with respect to the proportions of 4- and 6-linked ester sulfate. Other differences are noted which are consonant with the hypothesis that extracellular matrix components may be structurally adapted to a tissue's developmental fate or function.

Animals↗
PubMed1989

Epiphyseal osteoid osteoma. Two case reports.

Two cases of epiphyseal osteoid osteoma presented with a 1-2 year history of monarthritis with swelling and impaired function of the knee and ankle, respectively. In both cases, removal of the lesion resulted in complete recovery.

Adolescent↗
PubMed1976

Epiphyseal cartilage cyclic nucleotide phosphodiesterase: partial purification and kinetic characteristics of multiple enzymes.

Partial purification of chicken epiphyseal PDE activity by centrifugation and column chromatography has defined two distinct peaks of PDE activity. The faster eluting peak (I) has a higher apparent Km for cyclic AMP than the slower eluting major peak (IIs and II). Peak I has greater activity towards cyclic AMP as a substrate than towards cyclic GMP but does use both substrates. Peak I is not inhibited by T-3 or indomethacin at physiological concentrations. Substrates studies demonstrate the presence of at least two overlapping PDE species in the major peak(IIs and II). There is suggestive evidence that indomethacin is a more potent inhibitor of peak IIs which can use either cyclic AMP or cyclic GMP as substrates, whereas T-3 is a more potent inhibitor of fractions eluting where the enzyme only has activity with cyclic AMP.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1983

Sonographic evaluation of the distal femoral epiphyseal ossification center.

Two hundred and twenty fetuses more than 29 weeks of gestational age were examined for the presence of the ossification center of the distal femoral epiphysis. One hundred and three fetuses did not demonstrate any ossification. There were 44 fetuses than demonstrated a small slit-like ossification center, at a mean age of 33.6 weeks, and 73 that demonstrated a large globular epiphyseal center, at a mean age of 35.4 weeks. There is good correlation of the ultrasonic appearance of the ossification center of the distal femoral epiphysis with the radiographic appearance.

Epiphyses↗
PubMed1999

Distal tibial epiphyseal fractures in adolescents.

The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture and the "juvenile" fracture of Tillaux in adolescents. The application of external rotation force produces Tillaux and triplane fractures of the lateral portion of the distal tibial epiphysis in patients with a mean age of 13.5 years. Eight patients, 13 to 15 years of age, with distal tibial epiphyseal fractures were treated in the last 12 years. Three of the fractures were classified as "juvenile" Tillaux fractures and five were triplane fractures. Open reduction and fixation of the tibia was accomplished by using either malleolar screws or K-wires. Follow-up time ranged from 1.5 to 11 years. All patients were evaluated subjectively and objectively after surgery. Objective evaluation included clinical assessment and radiographic evaluation. All patients regained full range of motion and no one complained of pain or joint stiffness. Radiographs confirmed that all fractures have healed without articular incongruity.

Adolescent↗
PubMed1975

Ultrastructural abnormalities of the chondrocytes of the growth cartilage of a type of poly-epiphyseal dysplasia with a probable autosomal recessive transmission.

In two cases of polyepiphyseal dysplasia with a probable autosomal recessive transmission, ultrastructural abnormalities were found in the chondrocytes of the tibial epiphyseal growth plate. The largest part of the chondrocytes is occupied by many large vacuoles. They are bounded by a single membrane and have an electron-lucent background in which electron-opaque granules and delicate spiral filaments are visible. The ultrastructural abnormalities suggest a storage disorder probably limited to the chondrocytes.

Epiphyses↗
PubMedDate not supplied

[Physiological and pharmacological characteristics of epiphyseal neuropeptides].

Various epiphyseal neuropeptides, participating in regulation of the secretory processes, are capable of inducing systemic changes. This circumstance determines both pharmacological and therapeutic properties. The drug elitalamine, representing a polypeptide extract, ensures effective treatment of the immune system and brain disorders and tumors and allows a prophylaxis of tissue aging.

Adjuvants, Immunologic↗
PubMed2001

[MRI appearance of a primary leiomyosarcoma of bone with epiphyseal involvement].

Primary leiomyosarcoma of bone is a rarely reported tumor of elderly subjects. It usually shows an aggressive osteolytic pattern on plain radiographs and involves predominantly the metaphyses of long bones. We report a case of primary leiomyosarcoma of bone, which is atypical by its epiphyseal location, a non-aggressive pattern on plain radiographs and its MR imaging features.

Aged↗
PubMed1975

Multiple epiphyseal dysplasia. 2. Morphological and histochemical investigation of cartilage matrix, particularly in the pre-calcification stage.

The cartilage of epiphysis and cuboid bones from three Beagle puppies bred from parents with a constant heredity of multiple epiphyseal dysplasia, was examined macroscopically, histomorphologically and histochemically. The puppies were euthanized at the age of one week, three weeks and five weeks, respectively. The investigation showed the foci of the disease develop in a broad subarticular zone where normally strong three-dimensional growth of the cartilage takes place. The first signs of the disease appeared about the time of birth and new foci reached a climax when the puppies were about three weeks old. Histomorphological and histochemical examination of the cartilage showed that the disease developed in a sequence of confluent stages. In the initial stage, there was an accumulation of abnormal cartilage matrix in the chondrocyte and/or chondrocyte lacunae. The abnormal substance consisted apparently of concentrated or free chondroitin sulphates not bound to protein. Then followed a second stage of liquefaction and coalescence of the abnormal cartilage matrix which formed cysts of different sizes, some of them visible macroscopically. In the third stage of calcification of the cyst content and surrounding abnormal cartilage, it was found that the calcium was deposited in grains bound to chondroitin sulphates. The results of the present study of the pre-calcification stage of the disease in Beagle dogs seem to be comparable with or equivalent to the results of the study of the post-natal stage of the disease in children and may explain something of the prenatal pathogenesis in children.

Age Factors↗