SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A case is presented in which plain films revealed a short band of ossification adjacent to the inferior aspect of the lateral part of the clavicle. CT findings indicated that the ossification was situated in the coracoclavicular ligament and was not a manifestation of clavicular 'duplication'.
Heterotopic bone formation caused by urothelial carcinoma is rare. The precise mechanism of heterotopic ossification is still unknown. We report a case of urothelial carcinoma with heterotopic bone formation in a metastatic site and investigate the expression of bone morphogenetic protein 2 (BMP-2) and the BMP receptor (BMPR)-Ib using immunohistochemistry. Positive staining of BMP-2 was observed in the cytoplasm of tumor cells in both bladder and psoas lesions. In addition, positive staining of BMPR-Ib was seen in osteoblast-like cells adjacent to bone formation in the psoas metastasis. The heterotopic ossification may result from the metaplasia of pluripotent stem cells into osteoblast cells induced by BMP-2 in a paracrine fashion.
A patient with secondary infertility and endometrial ossification after a spontaneous is described. The aetiology and pathogenesis of endometrial ossification are discussed.
Lectin binding sites and immunohistochemically detectable fibronectin and carbonic anhydrase II (CA II) were examined in induced bone structure of calcifying epithelioma of Malherbe. Pathological features of ossification were particularly evident in the border zone between tumor epithelium and stroma, and epithelial foci adjacent to sites of bone formation were conspicuously basophilic. The use of lectin binding in these foci coincided with the basophilic epithelial zones: Con A, RCA-1, PNA, SBA, and WGA bound strongly, indicating the presence of glucose (Glu), mannose (Man), galactose (Gal), N-acetyl-D-galactosamine (GalNAC), and N-acetyl-D-glucosamine (GlcNAC). Fibronectin was also detected in the same epithelial-mesenchymal interacting layers as the positive lectin-binding sites. Staining for CA II was strongly positive in giant cells and in epithelial zones in the bone-inducing areas. The bond induction mechanism in the stromal tissue of calcifying epithelioma of Malherbe may initially involve the action CA II in the epithelial-mesenchymal interacting zone, which then brings about ossification of the matrix which is fibronectin-positive and rich in lectin-binding sites.
The cases are reported of two patients with coxopathy associated with ankylosing spinal hyperostosis who showed ossification of the ligamentum teres. It is suggested that considerable ossification at the medial acetabular floor including the ligamentum teres can explain the mechanism of development of coxopathy with lateral subluxation of the femoral head which is often seen in patients with ankylosing spinal hyperostosis.
A patient with chronic renal failure, a dialysis encephalopathy syndrome and renal osteodystrophy associated with aluminium intoxication developed an avascular necrosis of the left femoral head. Histological examination of the excised head confirmed the zone of avascular necrosis and demonstrated an exuberant formation of cartilage around this zone. Calcification was sparse and the cartilage exhibited histological features similar to those seen in classical rickets. Histochemical and electron probe x-ray microanalysis demonstrated aluminium in the matrix around hypertrophic chondrocytes, at the tide mark of articular cartilage and at the mineralised tissue/osteoid interface of trabecular bone. Aluminium, therefore, preferentially localises at sites of calcification and possibly exerts an inhibitory effect on this reaction. This is taken to account for the relative failure of endochrondral ossification and the development of a rachitic appearance. A comparison with five other examples of avascular necrosis of the femoral head (occurring after renal transplantation, as an idiopathic phenomenon and as a complication of steroid therapy) showed that, in addition to the more commonly described appositional bone formation, cartilage formation and endochondral ossification were present in three of these comparison cases, although less prominent and of considerably less degree than in the main case.
A 62-year-old man with idiopathic hypoparathyroidism and extensive paravertebral and ligamentous ossification is reported. The clinical and radiological findings of this, and other reported cases, are discussed and compared with other causes of paravertebral ossification.
Benign giant cell tumor of bone may be implanted into the surrounding soft tissues at the time of surgery or pathologic fracture. These soft-tissue implants may produce ossification that is radiographically visible. A review of the available radiographs of 400 cases of giant cell tumor from the Mayo Clinic and 700 cases seen in consultation yielded 17 examples of this phenomenon. In all but one case, the ossification was found at the periphery of the implant. The radiographic appearance of these implants is characteristic. Recognition of this appearance is necessary so that the tumor may be totally eradicated.
The rare fact of endometrial ossification can be found after abortion or chronic inflammation. We describe a case from our clinic. Despite repeated curettages new ossifications occurred. The resulting secondary infertility is persisting.
Intraocular ossification was investigated in a series of 20 eyes. Only 12 eyes were phthisical. The etiological factors were trauma, inflammation, glaucoma and massive intraocular gliosis. Bone tissue was of the compact and spongy type. A correlation was found between the intraocular ossification and retinal detachment, intraocular hemorrhage, intraocular neovascularization and uveitis.
This paper is a retrospective review of 5 patients with various degrees of cochlear ossification who were implanted with the CLARION Multi-Strategy Cochlear Implant. Preoperative computed tomography scans, intraoperative findings, surgical technique, and hearing outcomes are discussed in a case report format. Full implantation was achieved in all cases by a systematic approach that included drill-through of proximal obstruction (2 cases), scala vestibuli insertion (2 cases), and complete drill-out (1 case). The only complication was delayed wound healing in a patient with sickle cell disease, chronic active hepatitis, and steroid dependency on antimetabolite therapy. Early results show that the 4 patients with at least 3 months of experience have a mean open-set sentence recognition score of 55% and a mean open-set word recognition score of 24%. The conclusion is that implantation of the Clarion device in ossified cochleas can be successful in all degrees of ossification and can provide significant hearing benefit.
This report describes a 37-year-old man presenting with a gait disturbance due to spastic paraparesis. Physical findings showed typical features of Albright's hereditary osteodystrophy, including short stature, obesity, brachydactyly and dental hypoplasia. He was diagnosed as having pseudohypoparathyroidism type Ia, on the basis of his hypocalcaemia, hyperphosphataemia, increased plasma level of parathyroid hormone (PTH), and the unresponsiveness to exogenous PTH loading of his urinary excretion of both nephrogenous cyclic adenosine monophosphate and phosphate. Magnetic resonance imaging and myelographic computed tomographic scans clearly demonstrated severe compression of the spinal cord at T 9/10 by tumour-like ossifications of the paravertebral ligaments. Neurosurgical decompression therapy was, therefore, performed to alleviate his spastic paraparesis. This was a rare case of pseudohypoparathyroidism complicated with spinal cord compression caused by ectopic ossification of the ligaments.
Heterotopic ossification has been reported only rarely within the abdominal cavity, specifically in a mesenteric location (heterotopic mesenteric ossification). We describe the case of a 76-year-old man with no history of previous surgery who developed small bowel obstruction associated with multiple foci of heterotopic bone formation within the small bowel mesentery. He underwent small bowel and mesentery resection and is disease-free 9 months later.
Heterotopic ossification (HO) is a form of pathologic bone that often occurs in the elbow after a substantial traumatic injury and can complicate the functional outcome of the affected upper extremity. This article is designed to help the treating therapist better understand the complex process of HO. The pathophysiology, causes, associated risk factors, and signs and symptoms of HO are discussed in depth. The physician's management, including a classification system, diagnostic tools, and prophylactic measures, are explained. An extensive review of the literature regarding the therapist's management of HO reveals current misconceptions about passive range of motion (PROM). Traditional thought has advocated that PROM is a contraindication when HO is present because it can lead to the development or exacerbate the formation of HO. A review of the literature only reveals a few scientific studies that concluded that forcible manipulation of stiff joints can lead to myositis ossification. Most of the articles that have concluded that PROM is contraindicated have been erroneously based on anecdotal findings. This conclusion is misleading because forcible manipulation of a joint is not synonymous with PROM exercises. This article challenges popular belief and offers some alternative thinking for the therapist treating an elbow injury with HO as well as guidelines for the rehabilitation program.
Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare entity causing thoracic myelopathy. Its surgical decompression is still challenging. Three patients admitted with progressive myelopathy due to thoracic OPLL are described. A transthoracic anterolateral approach was used in the first and second cases, in which OPLL was located at the T3-T4 and T5-T6 and at the T7-T8 levels, respectively. In the third case, a transsternal approach was adopted for OPLL at the T1-T2 level. The OPLL, including dural ossification, was removed by microsurgical techniques as extensively as possible. Myelopathy in all three cases became relieved or stable postoperatively. Operative procedures are described in detail. From the viewpoint of surgical anatomy, the selection of operative approach depends on the level of the OPLL. The authors emphasize that a transthoracic anterolateral approach is the treatment of choice for extensive anterior pathology such as OPLL involving more than two thoracic bodies below the T4. A transsternal approach can provide excellent access to a lesion at the upper three thoracic bodies.
OBJECTIVE: We retrospectively analyzed the clinical and radiological characteristics of ossification of the anterior longitudinal ligament (OALL). METHODS: Seventeen patients with OALL who underwent surgery between 1995 and 2003 were reviewed. Symptomatic OALL was found in four patients. In 13 asymptomatic OALL patients who experienced mild to severe myelopathy, no swallowing difficulty was noted. The OALL was classified into three types by sagittal computed tomographic (CT) scans as segmental, continuous, and mixed and three types on axial CT scans as flat, nodular, and globular type. The thickness, numbers of involved vertebral bodies, and type and shape for symptomatic OALL were analyzed and compared with those for asymptomatic OALL. RESULTS: The mean thickness of 13.5 mm for symptomatic OALL was significantly higher than that of 6.5 mm for asymptomatic OALL (P = 0.0009). A globular shape on axial CT was common for symptomatic OALL. There were no differences in the numbers of involved vertebral bodies and types of OALL on sagittal CT scans. Surgical excision of OALL was performed for all cases of symptomatic OALL. In 7 of 13 asymptomatic cases, OALL was simultaneously removed during anterior decompressive surgery for the associated pathology. CONCLUSION: The thickness on axial CT scans was an important contributing factor to dysphagia and hoarseness as was the shape of the OALL. The type of OALL on sagittal CT scans was similar to that of ossification of the posterior longitudinal ligament but did not influence the development of dysphagia. Good relief from symptoms was achieved for symptomatic OALL after removal of OALL.
To understand the molecular pathogenesis of ossification of the posterior longitudinal ligament of the spine (OPLL), an ectopic bone formation disease, we performed cDNA microarray analysis on cultured ligament cells from OPLL patients to understand the molecular pathogenesis of OPLL. We identified promyelotic leukemia zinc finger (PLZF) as one of up-regulated genes and tumor necrosis factor-alpha-stimulated gene 6 (TSG-6) as one of down-regulated gene during osteoblastic differentiation. We investigated the roles of PLZF in the regulation of osteoblastic differentiation of human mesenchymal stem cells (hMSCs) and C2C12 cells. siRNA-mediated gene-silencing of PLZF resulted in a reduction of the expression of osteoblast-specific genes such as the alkaline phosphatase, collagen 1A1, Runx2/CBFA1, and osteocalcin genes in the presence of osteogenic differentiation medium (OS) in hMSCs. The overexpression of PLZF induced CBFA1 induction, suggesting that PLZF is an upstream regulator of CBFA1 and thereby participates in promoting the ossification of spinal ligament cells in OPLL patients. Adenovirus-mediated TSG-6 overexpression in hMSCs resulted in suppression of osteoblastic differentiation induced by either BMP-2 or OS. TSG-6 can bind to BMP-2 directly and thereby could inhibit BMP-2 signaling. Taken together, these findings indicate that PLZF and TSG-6 play important roles in early osteoblastic differentiation.
"The Japanese disease" or ossification of the posterior longitudinal ligament of the cervical spine was initially thought to affect only the Japanese people. Non-Japanese Asian and Caucasian cases have been reported but appear to be exceedingly rare. The reason is unknown. Although the disease appears to be generally benign, it can cause a myelopathy. We present here 16 non-Japanese patients in Singapore who were found to have ossification of the posterior longitudinal ligament in the cervical, thoracic and lumbar spine.