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PubMed1991

Influence of age, gender, height and education on vibration sense. A study by tuning fork in 192 normal subjects.

We measured perception time of the vibratory stimulus from a 128 cps tuning fork in 96 male and 96 female normal subjects equally subdivided into 8 age decades. The following sites were examined: clavicula, olecranon, styloid apophysis of ulna and radius, anterosuperior spina of ilium, rotula (patella), internal and external malleolus. Reproducibility between different examiners and between tests by the same examiner on different days was good. There was a marked regional variation with longer perception times at the distal regions of upper limbs. A non linear age-related decrease in vibration sense was found in all regions. Males had longer perception times at clavicula, females at distal limbs; the latter finding might be explained by shorter stature in females. Perception times at distal limbs were longer in subjects with higher education levels. The study provides normative data for vibration sense in different regions and defines the effects on it of age, gender, height and education.

Adolescent↗
PubMed1985

Fibrous dysplasia of bone and concomitant dysplastic changes in the dentin.

Fibrous dysplasia of bone and dentinal dysplasia have not been classified as related conditions. However, the present report describes a patient with both polyostotic fibrous dysplasia and dysplastic changes in the dentin. One bone lesion was first discovered on the right side of the mandible on a routine roentgenogram. There was an atypical radiolucency apical to a short-rooted molar with an obliterated pulp. Additional lesions were found on the left side of the mandible in the maxilla, in the frontal and occipital bones, in the ilium, in the proximal ulnae, and in the ribs. All lesions demonstrated an increased uptake of Tc99. A biopsy specimen of bone from the right side of the mandible showed small calcified islands in a cell-rich connective tissue. Microscopic analysis of the right first molar showed irregularly shaped dentin with the dentinal tubules arranged in a whorl-like fashion surrounding an almost completely obliterated pulp chamber and canal. Healing after tooth extraction and after the bone biopsy was unremarkable. After 6 months the alveolus was reorganized and the bone patterns appeared normal, although the radiolucent areas inferior to the teeth remained unchanged. The concomitant occurrence of dysplastic changes in bone and teeth may be a sign of a generalized defect in the mesenchymal hard-tissue-forming cells.

Adult↗
PubMed1986

Age-related osteopenia in the mouse: effects of an H1 blocker, a phenothiazine, and promethazine.

Mature and old B6AF1 and B6D2F1 mice were given acidified tap water or promethazine HCl (a phenothiazine with H1 receptor blocking activity), chlorpheniramine (an H1 blocker) or trifluoperazine (a phenothiazine with no H1 blocking activity) in their drinking water, and the effects of these agents on bone mineral content were assessed by intermittently measuring the 24-h whole body retention of Tc 99m methylene diphosphonate (Tc 99m MDP, an indicator of bone metabolism) and at the end of the studies by determining ash weights of femur, ilium and sacrum. It was found that 24-h retention of Tc 99m MDP was elevated in old mice as it is in old osteopenic humans, that promethazine but not chlorpheniramine or trifluoperazine inhibited bone loss in aging mice, and that there was a correlation between decrease in retention of Tc 99m MDP and decreased bone loss. These preliminary results suggest that the ability of promethazine to inhibit age-related bone loss may not be mediated through its action as an H1 blocker or as a phenothiazine. However, more agents of each type need to be tested before this point can be established.

Age Factors↗
PubMed1987

Effects of H1 blocking agents on age-related osteopenia in the mouse.

Old female B6AF1 mice were given acidified tap water, distilled water, one of five H1 blockers or chlorpheniramine (an H1 blocker) and trifluoperazine (a phenothiazine with no H1 blocking activity) in their drinking water for 5 months, and the effects of these agents on bone mineral metabolism were assessed by determining ash weights of femur, ilium and sacrum at the end of the study. In one experiment 24 h whole-body retention (WBR) of Tc 99m methylene diphosphonate (Tc 99m MDP, an indicator of bone metabolism) was measured at the beginning of the study and 40 days later. It was found that: promethazine and dimenhydrinate were the most effective of the H1 blockers in preventing age-related loss of bone mass; distilled water, chlorpheniramine, and chlorpheniramine plus trifluoperazine had no effect on the loss of bone mass; mean bone mass in the groups given meclizine and pyrilamine were greater than but not significantly different from that in the control group given acidified tap water; and only promethazine induced a significant reduction in the WBR of Tc 99m (the other H1 blockers induced small but not significant reductions).

Aging↗
PubMed1991

Musculoskeletal syndromes associated with acne.

The acne conglobata (AC)-, acne fulminans (AF)-, and isotretinoin-associated musculoskeletal syndromes are three distinct clinical entities. The AC-associated musculoskeletal syndrome occurs primarily in black men over the age of 22, who develop sacroilitis with or without a peripheral arthropathy. In contrast, the AF-associated musculoskeletal syndrome is found almost exclusively in white male teenagers. Fever, weight loss, and arthralgias are prominent components of this syndrome. A unique feature of the AF-associated musculoskeletal syndrome is osteolytic lesions that occur most frequently in the clavicle, sternum, long bones, and ilium. The isotretinoin-associated musculoskeletal syndrome occurs with equal frequency in male and female acne patients. Mild, transient myalgias and arthralgias are very common and do not require discontinuation of isotretinoin therapy. Asymptomatic, small, hyperostotic lesions of the spine occur in approximately 10% of acne patients with the isotretinoin-associated musculoskeletal syndrome.

Acne Vulgaris↗
PubMed1989

Sonographic fetometry in the bovine.

The fetuses of 19 heifers were examined a total of 485 times during the course of pregnancy by means of transrectal sonography with sector scanners. Changes in size of organs and parts of the body were fetometrically assessed and the relative frequency of different intrauterine positions during pregnancy was registered. Until the end of Month 4 of gestation, anterior and posterior presentations occurred with equal frequency. During Months 5 to 7 the posterior presentation was found in about 25% of the cases, while after that it was rarely encountered at all. The head, thorax, abdomen and pelvis of the fetuses were readily accessible for transrectal sonography during the first 4 mo. During Months 5 to 7, the thoracic, abdominal and pelvic regions could be examined in at least one third of the cases. The head was accessible in about 80% of the cases examined throughout all stages of pregnancy. Ultrasound fetometry served to assess average growth-rate of a number of organs during pregnancy. The regressions and correlation coefficients between the development of bovine fetuses and the age of gestation were obtained for the following structures: eye, braincase, trachea, stomach, vena cava, urinary bladder, scrotum, ribs, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, coccygeal vertebrae, scapula, humerus, radius and ulna, metacarpus, os ilium, os ischii, femur, tibia, metatarsus, trunk, crown-rump length and umbilical cord. Additionally, the development of the fetal heart rate during pregnancy was observed. It can be concluded that intrauterine development of the bovine fetus and its gestational age may be judged from the size of its organs and parts of the body.

Journal Article↗
PubMed1981

Effects of ethane-1 hydroxy-1, 1-diphosphonate (5 mg/kg/day dose) on quantitative bone histology in Paget's disease of bone.

The effects of ethane hydroxy diphosphonate (EHDP) on quantitative bone histology have been studied in 43 pagetic patients treated for 6 months at a dose of 5 mg/kg/day. To determine the therapeutic effects on pagetic bone and to appreciate the side effects in non-pagetic bone, the patients were biopsied either in pagetic or non-pagetic areas of the ilium before the beginning of the treatment and at 3, 6 and 9 months (i.e. 3 months post-therapy) after the inception of treatment. Tetracycline double labelling of bone was performed before biopsies in each patient to measure the calcification rate. The results demonstrate that 5 mg/kg/day EHDP given for 6 months has a marked antiosteoclastic effect which is prolonged after the cessation of treatment. Pagetic osteoclasts appear more sensitive to EHDP than normal osteoclasts. The new bone formed during treatment has a regular lamellar texture. At the same time, the high appositional rate of pagetic bone is reduced to a normal value. Marrow fibrosis is reduced along with the reduction in the osteoclast population. Thus, pagetic bone changes to bone normal in quantity, quality and metabolism. Dynamically, in nonpagetic areas, a transitory decrease of calcification rate is noted at the end of the treatment, without morphological evidence of osteomalacia, except for 2 out of 43 cases. Histologically, EHDP given at a dose of 5 mg/kg/day for 6 months appears to be an effective and safe treatment for Paget's disease of bone.

Adult↗
PubMed1986

Use of autogenous cranial bone grafts in maxillofacial surgery: a preliminary report.

In conventional reconstruction of the facial skeleton, bone grafts are usually harvested from distant sites such as the ilium or ribs. Because of the morbidity associated with the use of these sites, the calvarium was studied as an alternate donor site. Twenty-three patients underwent bone grafting using autogenous calvarial bone. Reconstructive procedures included alveolar cleft grafts, Le Fort I osteotomies, midface onlay grafts, and grafting of a mandibular continuity defect. Intraoperative and postoperative morbidity associated with the bone donor site was minimal, and there was good incorporation of all the grafts. Long-term follow up is necessary before definitive conclusions about the response of the grafted bone can be made, but short-term results were promising.

Adolescent↗
PubMed1988

Enhancement of angiogenesis by bFGF in mandibular bone graft healing in the rabbit.

The effectiveness of basic fibroblast growth factor (bFGF) as an in vivo angiogenic factor was evaluated in autogeneic bone grafts to the rabbit mandible. Block cortical grafts harvested from the ilium were implanted into sites in the mandibular ramus or body. The basic fibroblast growth factor was continuously introduced over a period of 14 days through subcutaneous osmotic pumps. Increased vascularity, as assessed by vessel number and depth of penetration into the grafts, was noted at 10 days postoperatively in the bFGF stimulated side as compared to contralateral control grafts. At the fourteenth postoperative day, bFGF administration was discontinued and a decrease in angiogenesis was noted over the ensuing 2 weeks so that after 1 postoperative month, little difference could be detected between the stimulated and nonstimulated grafts. Assessment of osseous healing at the 1 month postoperative interval using triple fluorochrome labeling did not reveal evidence of accelerated osteogenesis on the previously stimulated side.

Angiography↗
PubMed2006

Using intraoperative pelvic landmarks for acetabular component placement in total hip arthroplasty.

Dislocation after total hip arthroplasty is frequently due to acetabular malpositioning. Positioning of the acetabular component using anatomical landmarks may reduce the incidence of dislocation from improper acetabular orientation. The pelvis provides 3 bony landmarks (ilium, superior pubic ramus, and superior acetabulum), which, when used to define a plane, allows cup orientation in abduction and version. Landmarks evaluated in 24 cadaveric acetabuli allowed slightly increased abduction and anteversion of the cup, compared with native acetabuli. Six hundred seventeen primary total hip arthroplasties were performed between 1996 and 2003 using this technique. Mean cup abduction was 44.4 degrees with 13.2 degrees of anteversion. This technique allows satisfactory reproducible cup orientation based on individual pelvic morphology. Review of patient outcome data suggest high patient satisfaction and lower dislocation rate without additional equipment, time, or cost.

Acetabulum↗
PubMed2005

Primary desmoplastic small round cell tumor of bone: report of a case with cytogenetic confirmation.

We report a case of desmoplastic small round cell tumor occurring in the right ilium of a 13-year-old boy. Morphologically, the neoplasm consisted of small round cells of primitive appearance with a diffuse growth pattern replacing marrow space and eroding bone. Immunohistochemical staining was positive for vimentin, synapsin, CD99 (MIC2 protein), and FLI-1, prompting an initial diagnosis of Ewing sarcoma/primitive neuroectodermal tumor. However, a diagnosis of desmoplastic small round cell tumor was rendered after the detection by cytogenetic analysis of the reciprocal chromosomal translocation, t(11;22)(p13;q12), which is uniquely associated with this tumor. This is the first documented instance of desmoplastic small round cell tumor arising in bone.

Bone Neoplasms↗
PubMed2005

Langerhans cell histiocytosis presenting as blueberry muffin baby.

Blueberry muffin baby is a descriptive term for purpuric lesions reflective of extramedullary hematopoeisis. The clinical lesions most commonly result from intrauterine infections, such as rubella and cytomegalovirus, and less commonly with malignancy and hematologic disorders. Langerhans cell histiocytosis is a clonal proliferation of dendritic histiocytes in the skin. This has very rarely been associated with a blueberry muffin presentation. We report the case of a newborn with typical lesions of cutaneous hematopoiesis and lytic bone lesions related to Langerhans cell histiocytosis. At birth, approximately 40 2 mm to 5 mm purpuric, nonblanching macules were scattered on the trunk, extremities, and soles of our patient. Laboratory studies were unremarkable and cultures were negative. Skin biopsy showed a dermal proliferation of histiocytes staining positive for S100 and Cd1a. Pediatric bone surveys, chest radiographs, and computed tomography scans of the head were normal. Six months later, the skin lesions had resolved, but radiographs revealed lytic bone lesions of the right tibia, right ilium, and left pubic ramus, consistent with skeletal Langerhans cell histiocytosis.

Biopsy↗
PubMed2004

Reconstruction of mandibular defects with autologous tissue-engineered bone.

PURPOSE: Maxillofacial reconstructive procedures often require bone graft harvesting, which results in donor site morbidity; the use of tissue-engineered bone would eliminate this problem. In this study, a novel scaffold design and new fabrication protocol were used to produce autologous tissue-engineered constructs (scaffolds seeded with cells) to reconstruct segmental mandibular defects in a minipig model. MATERIALS AND METHODS: Porcine mesenchymal stem cells were isolated from the ilium. They were expanded in culture and seeded onto poly-dl-lactic-coglycolic acid scaffolds. The constructs were placed in a bioreactor and incubated for 10 days in medium and osteogenic supplements. Four full-thickness bony defects (2 x 2 cm) were created in the same pig's mandible. The constructs (n = 2) were placed into 2 of the defects as autologous grafts. One unseeded scaffold and 1 empty defect served as controls. At 6 weeks postimplantation, the pig was sacrificed, the mandible was harvested, and the grafted sites were evaluated by clinical, radiographic, and histologic methods. RESULTS: The construct-implanted defects appeared to be filled with hard tissue resembling bone, whereas controls were filled with fibrous tissue. Radiographically, the tissue-engineered constructs were uniformly radiodense with bone distributed throughout. The interface between native bone and constructs was indistinct. Complete bone ingrowth was not observed in control defects. Osteoblasts, osteocytes, bone trabeculae, and blood vessels were identified throughout the defects implanted with constructs. CONCLUSION: This "proof-of-principle" study indicates that porcine mandibular defects can be successfully reconstructed by in vitro cultured autologous porcine mesenchymal stem cells on a biodegradable polymer scaffold with penetration of bone and blood vessels.

Animals↗
PubMed2004

Design and fabrication of custom mandible titanium tray based on rapid prototyping.

UNLABELLED: During the past few years, the combination of medical imaging and rapid manufacturing technique has proven to be a very important development. On the other hand, the conventional method has some drawbacks. For example, it takes longer time to complete an operation and it also presents some difficulty in matching the repaired contours. With advanced software and hardware, an image of an undamaged bone similar to that of the patient can be made from computerised tomography (CT); and a physical object constructed by the mirror-processed image data can be quickly fabricated with a high degree of fitting with the patient's bone. This paper presents a methodology for the design and fabrication of an individual titanium tray for the repair of mandible defects. Methods for the tray modeling using CAD system are presented: A 3D model of the bony defect is generated after the acquisition of helical CT data. An individual tray is designed using freeform surfaces geometries and fabricated by rapid prototyping (RP) technology. The results of tray filling with bone-grafting materials are then presented. RESULT: the tray is inserted into the patient mandible segment. The symmetry and reconstruction quality contour of the repaired mandible was satisfactory. Thus, the patient is able to eat normally. The bone-grafting material harvested from the anterior ilium was low. The clinical experience showed that rapid prototyping and reverse engineering software are effective methods of fabricating custom trays for mandibular reconstruction after bone loss due to a tumor.

Adult↗
PubMed2006

Finite element modelling of the pelvis: inclusion of muscular and ligamentous boundary conditions.

Previous finite element studies of the pelvis, including subject-specific studies have made extensive simplifications with regards to the boundary conditions used during analysis. Fixed boundary conditions are generally utilised at the pubis and superior part of the ilium. While it can be demonstrated that these models provide a close match for certain in vitro experiments that use similar boundary conditions, the resulting stress-strain fields in the cortex in particular are unlikely to be those found in vivo. This study presents a finite element analysis in which the pelvis is supported by muscular and ligamentous boundary conditions, applied using spring elements distributed over realistic attachment sites. The analysis is compared to an analysis in which the pelvis is restrained by fixed boundary conditions applied at the sacro-iliac joints. Striking differences in the stress-strain fields observed in cortical bone in particular, are found between the two analyses. The inclusion of muscular and ligamentous boundary conditions is found to lower the occurrence of stress concentrations within the cortex.

Computer Simulation↗
PubMed1987

Embryotoxicity, teratogenicity, and aryl hydrocarbon hydroxylase activity in Forster's terns on Green Bay, Lake Michigan.

Known reproductive problems, including congenital malformations and poor hatching success, exist for the state endangered Forster's tern (Sterna forsteri) in Green Bay, Wisconsin. Twenty Forster's tern eggs were collected from separate nests at a natural colony with documented reproductive problems, situated at Green Bay, Lake Michigan, and an inland colony at Lake Poygan (control) where reproduction was documented as normal. Eggs from the two locations were placed in the same laboratory incubator and candled throughout incubation. Hatching success of Green Bay eggs was 52% of that for controls. Several early embryonic deaths occurred, but most mortality occurred close to the time of hatching. Liver microsomal aryl hydrocarbon hydroxylase activity was elevated approximately threefold in Green Bay hatchlings compared to controls. Green Bay terns that hatched weighed less than controls, had an increased liver to body weight ratio, and had a shorter femur length. Two Green Bay embryos that failed to hatch had anomalies, one with a crossed beak and one with poor ossification of the foot. One Green Bay hatchling had an abnormally ossified ilium. These effects were observed in eggs where there were measureable levels of aryl hydrocarbon hydroxylase inducers including polychlorinated biphenyls and polychlorinated dibenzo-p-dioxins.

Animals↗
PubMed1998

Reconstruction of the penis after severe injury.

Since 1986, five cases of one-stage reconstruction of the injured penis using microsurgical techniques have been successfully carried out. A piece of ilium based upon the deep circumflex iliac vessels is used to form the penis prop and a skin flap of the forearm is transferred to form the urethra and foreskin to encircle the prop. Then the vessels and nerves of the skin flap of the forearm are anastomosed with the vessels and nerves of the thigh. Postoperative follow-up showed the constructed penis to be satisfactory in contour, allow free flow of urine, provide cutaneous sensory recovery and satisfactory sexual function in four married patients. Radiography showed the bony structure of the penis prop to be normal. This method has advantages over the one-stage procedure in terms of contour, urinary flow, satisfactory sexual function and long-term benefits. Most of all it has solved the problem of poor blood supply into the reconstructed penis prop.

Adult↗
PubMed1998

Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases.

In a study of the clinical, radiographic, and pathological features of chondromyxoid fibroma, the tumor was slightly more common in men, usually in the second decade of life. Almost half of the tumors involved the long bones, although the ilium and the small bones were also common sites. Roentgenograms showed a sharply marginated, lobulated, lucent defect in the metaphysis. The tumor involved the medullary bone in an eccentric fashion, and the cortex was thinned and expanded. Periosteal reaction and soft tissue extension were uncommon. Mineralization was identified in 13% of the lesions. Histologically, the tumors were almost always arranged in lobules, which were prominent (macrolobular) or somewhat indistinct (microlobular). The tumor cells were spindle-shaped or stellate and arranged in a myxoid matrix. Calcification was seen in more than one third of the cases but was rarely prominent. Hyaline cartilage and chondroblastoma-like areas were not uncommon. Approximately 18% of tumors showed bizarre nuclei. Permeation of bony trabeculae was uncommon. Treatment was conservative surgical removal; approximately one fourth of the patients had recurrence.

Adolescent↗