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At least 919 records · Page 51Linked to original sources
PubMed1989

Adult Wilms' tumor--a case report.

A case of Wilms' tumor in a 67 year-old female is presented. The tumor totally replaced the left kidney with extension to Gerota's fascia, the adrenal gland and ureter, with tumor thrombi in the left renal vein. Multiple bony metastases to the skull, shoulder, rib, ilium, acetabulum and femur were noted also. Microscopically, the tumor was composed predominantly of blastemal tissue with diffuse anaplasia with areas of tubular differentiation and chondroid elements. Clear cell nests were found in the proximal ureter with gradual maturation downward.

Aged↗
PubMed2003

Influence of the intramural innervation on the morphogenesis of the enteroendocrine cells and the genetic construct involved (review).

The influence of intramural intestinal innervation on the morphogenesis of the mucosa and in particular of the enteroendocrine cells (EECs) has been studied on male Wistar rats with morphometric, autoradiographic and immuno-histochemical methods in the duodenum, proximal and distal jejunum and ilium before and after myenteric ablation with benzalkonium chloride (BAC). Twenty-one days after denervation alterations were observed in the mucosal structure with thickening of the mucosa, increase in the proliferation rate and with changes in numerical and spatial distribution of D-cells, I-cells, N-cells, glucagon and glicentin i.r. L-cells and 5-HT i.r. cells which myenteric ablation caused. Analysis of the genetic constructs involved in the alterations of EECs on the EECs provide evidence for the cAMP responsive elements as the main mediator.

Animals↗
PubMedDate not supplied

Cervical spondylotic myelopathy: diagnosis and treatment.

The delineation of cervical spondylotic myelopathy as a clinical entity has improved with the development of high-quality cross-sectional neuroradiologic imaging. The natural history of this disorder is usually slow deterioration in a stepwise fashion, with worsening symptoms of gait abnormalities, weakness, sensory changes, and often pain. The diagnosis can usually be made on the basis of findings from the history, physical examination, and plain radiographs, but confirmation by magnetic resonance imaging or computed tomography and myelography is necessary. Minimal symptoms without hard evidence of gait disturbance or pathologic reflexes warrant nonoperative treatment, but patients with demonstrable myelopathy and spinal cord compression are candidates for operative intervention. Both anterior and posterior approaches have been utilized for surgical treatment of cervical myelopathy. Anterior decompression frequently requires corpectomy at one or more levels and strut grafting with bone from the ilium or fibula. Multilevel laminectomies were initially used for posterior decompression but now are either combined with fusion or replaced by laminoplasty. Any operative technique requires proper patient selection and demands adequate decompression of the canal to effect neurologic improvement. Perioperative complications can be devastating in this group of high-risk patients with cervical spondylotic myelopathy, but careful attention to detail, meticulous technique, and experience can result in excellent outcomes.

Adult↗
PubMed2004

Bone assessment of free-living red squirrels (Sciurus vulgaris) from the United Kingdom.

Metabolic bone disease has been reported in free-living red squirrels (Sciurus vulgaris) in the United Kingdom but the prevalence of this disease is unknown. In this study the bone quality of free-living red squirrels in the UK was assessed by radiology and bone densitometry. The study comprised 20 red squirrels found dead and submitted to the Zoological Society of London (UK) between 1997 and 1998, 10 were from the Isle of Wight (IoW), where gray squirrels (Sciurus carolinensis) are absent, and 10 were from Cumbria (Cu), where gray squirrels are present. Gray squirrels are considered potential competitors for red squirrels. Radiologic evaluation of humerus, femur, tibia, radius, and ilium revealed a slightly lower bone density and thinner cortices in red squirrels from the IoW when compared with those from Cu. Dual-energy X-ray absorptiometry was used to measure bone mineral content and density of the isolated right humerus and femur of 19 of the 20 red squirrels. The bone densitometry study reinforced the radiographic findings. The IoW specimens had lower bone mineral density values, although statistical significance (P<0.05) between animals from the IoW and Cu was only reached for the proximal epiphysis of the femur and between males from the IoW and males from Cu for the proximal epiphysis of the humerus. A highly positive correlation (r>0.94) was found when the bone mineral content and density between the femur and the humerus among groups and within each group were compared, showing a uniform level of mineralization between upper and lower limbs. These findings suggested generalized bone loss for the IoW red squirrels that may be compatible with some degree of osteopenia. Within the wide range of causes that lead to osteopenia, malnutrition (especially protein deficiency), calcium and copper deficiencies, and genetic factors remain as possible etiologies.

Absorptiometry, Photon↗
PubMedDate not supplied

Primary stability of acetabular reinforcement implants in revision surgery.

It was the purpose of this biomechanical in vitro study to characterize the initial mechanical stability of 3 different acetabular reinforcement prostheses as a function of implant design and bone stock conditions. Müller and Ganz rings and Burch-Schneider cage (Protek, Münsingen, CH) were fixed using 3 screws in normal acetabuli and in acetabuli with 5 different simulated conditions of segmental bone-stock defects. A servohydraulic testing machine (Instron, Canton, USA) was used for the inquiry. Preparations were tested to determine axial stability (2354 N). Three electromagnetic displacement transducers (Micro-Epsilon, Ortenburg, D) were placed in the 3 main quadrants of the acetabular rim to detect the micromotion of the implant. The amount of micromotion depended on the size of the defect and contact area of the prosthesis. All of the implants were stable (< 123 microns) in all quadrants of normal acetabuli and in case of ectasis, protrusio, and ventral defects. Displacement of more than 200 microns was observed at the ilium with the Muller implant in acetabuli with cranial defect (p < 0.05) and with both rings in acetabuli with dorsal defect. The Burch-Schneider cage was stable in all conditions, but displacement of more than 350 microns was observed in acetabula with pseudoarthrosis. The 3 reinforcement implants showed low displacement rates in most of the acetabular bony defects. The experimental data suggests that careful preoperative evaluation and intraoperative assessment to match bone defects and reinforcement implants are of paramount importance to achieve good stability.

Acetabulum↗
PubMed1998

Human marrow cells-derived cultured bone in porous ceramics.

From four patients (mean age, 60 years; range 51-76 years), 3 ml of bone marrow was collected from the ilium. The marrow was cultured to concentrate and expand the marrow mesenchymal cells on a culture dish. The cultured cells were then subcultured either on another culture dish or in porous areas of hydroxyapatite ceramics in the presence of dexamethasone and beta-glycerophosphate (osteogenic medium). The subcultured tissues on the dishes were analyzed by scanning electron microscopy (SEM), and subcultured tissues in the ceramics were implanted intraperitoneally into athymic nude mice. Vigorous growth of spindle-shaped cells and a marked formation of bone matrix beneath the cell layers was observed on the subculture dishes by SEM. The intraperitoneally implanted ceramics with cultured tissues revealed thick layer of lamellar bone together with active osteoblasts lining in many pore areas of the ceramics after 2 months. The in vitro bone formation on the culture dishes and in vivo bone formation in porous ceramics were detected in all cases. These results indicate that we can assemble an in vitro bone/ceramic construct, and due to the porous framework of the ceramic, the construct has osteogenic potential similar to that of autologous cancellous bone. A significant benefit of this method is that the construct can be made with only a small amount of aspirated marrow cells from aged patients with little host morbidity.

Aged↗
PubMed1993

Dealing with the deficient acetabulum in revision hip arthroplasty: the importance of implant migration and use of the jumbo cup.

The complexity of acetabular anatomy makes operative planning for revision difficult. Plain radiographs do not provide as much detail about structural damage to the acetabulum as the surgeon would like in order to decide on the need for special components and bone grafts. The authors have found that analysis of acetabular implant migration has been a reliable surgical planning technique to indirectly assess residual acetabular bone stock. Superior shift on the anterioposterior radiograph implies posterior superior acetabular roof loss, seriously compromising the major weight-bearing area of the acetabulum. Although this may require a structural allograft, the authors have found that bone stock at the level of the true acetabulum is much better than in the false acetabulum created by the migration. Therefore, rather than a small cup placed high on the ilium, a large jumbo cup can frequently restore better hip biomechanics and take advantage of all of the remaining host bone for component stability and support, without the need for structural grafts. Medial shift implies medial superior migration leaving the physiologically strong rim of the acetabulum intact and therefore, less structurally damaging than posterior superior migration. Because the acetabular rim is anatomically designed for load bearing, a rim fit cup restores physiological weight transfer across the pelvis. Bone graft behind such a cup is protected from full weight-bearing forces and has proven to be very reliable.

Acetabulum↗
PubMed1993

Allograft reconstruction of the acetabulum in revision hip surgery.

Acetabular deficiencies seen in revision hip arthroplasty require special attention. Custom components, space-filling cement, relocation of the hip center higher on ilium, and resection arthroplasties have all been used. Allograft reconstruction of acetabular defects has many attractive features, but methods of fixation, long-term success rates, and problems of graft resorption and implant loosening present significant questions. This article presents a classification system for acetabular defects and a surgical technique for correcting them. The results of 218 cementless acetabular reconstructions are reviewed and show the importance of the acetabular rim. When the rim is intact, 97% of reconstructions will remain stable, and 78% of allografts used will consolidate. When the acetabular rim is deficient, special techniques using bulk allograft and internal fixation must be used in order to avoid long-term graft resorption and implant loosening.

Acetabulum↗
PubMed1998

[Hepato-splenic and peritoneal tuberculosis. A difficult diagnosis].

Peritoneal tuberculosis is a rare extra-pulmonary location of Mycobacterium tuberculosis infection arising in the gastrointestinal tract mostly as a complication of the pulmonary location or seldom as a primary involvement. The authors report the case of a 18-year old girl admitted in 1996 to the Infectious Diseases Department of the Umberto I Hospital, "La Sapienza" State University of Rome for the persistence of fever and dry cough, despite a protracted antibiotic treatment performed in previous hospital admissions for a suspicious diagnosis of a "broncho-pneumonia". As the fever didn't decrease and a pain at the right ilium arose, an anti-tuberculous chemotherapeutic treatment was performed (isoniazid and rifampicin), that improved the state of the patient. The pain was resolved by means of a celioscopic operation, showing the evidence of various white nodes on the peritoneal, hepatic and lienal surfaces; all these pathognomonic signs and the anti-tuberculous chemotherapy confirmed the diagnosis of "hepatic, lienal and peritoneal tuberculosis". The patient was subsequently admitted to our institute, where an anti-tuberculous treatment (isoniazid, rifampicin and pyrazinamide) was performed, which caused a further resolution of the clinical and radiological picture.

Adolescent↗
PubMed1999

[A case of pulmonary tuberculosis case with pancytopenia accompanied to bone marrow gelatinous transformation].

A 45-year-old man did not visit a doctor in spite of his complains, cough and sputum lasting, for six months, and he finally could not eat without beer, and as a result, he lost his body weight and currently 52 kg. He became unconsciousness, was carried to a hospital, and was referred to our hospital. His sputum examination for acid fast bacilli was smear positive, Gaffky 6, for M. tuberculosis. His chest roentogenogram revealed large cavitary lesions in bilateral lung fields. On blood examination, WBC was 1100/microL, RBC was 256 x 10(4)/microL, and PLT was 13.4 x 10(4)/microL. Total protein was 4.7 g/dl, albumin was 1.9 mg/dl, and total cholesterol was 65 mg/dl. We tried to aspirate bone marrow from his sternum, but it was impossible. Hence we did biopsy of his ilium. The pathology of his bone marrow revealed gelatinous transformation. It was thought that the marked delay in visiting a doctor caused general consumption and loss of apetite, thus led to gelatinous transformation and finally pancytopenia.

Anorexia↗
PubMed1999

Prenatal development of the human pelvis and acetabulum.

The prenatal development of the human pelvic bone and acetabulum has been studied by means of classical histology and microradiography. The embryonic phase leads to a fully developed hip within 8 weeks of gestation. The fetal period is a growth phase, including the following main features: endochondral ossification of the ilium from the ninth week, asymmetrical development of the iliac shaft from the fifteenth week, "chondroid-like" tissue formation above the acetabulum from the twenty-sixth week and haversian bone remodelling from the twenty-eighth week. The fetal development of the pelvis and acetabulum seems to be highly related to mechanical stimuli, the most important being the gluteal muscular activity and the simultaneous pressure of the femoral head.

Acetabulum↗
PubMed2000

[Primary leiomyosarcoma of bone. Report of 5 anatomo-clinical cases and review of the literature].

INTRODUCTION: Leiomyosarcoma is a malignant smooth muscle tumor occurring most frequently in uterus or soft tissues and more rarely in bone. MATERIALS AND METHODS: We report the clinicopathologic, immunohistochemical and ultrastructural findings of five cases of primary leiomyosarcoma of bone treated in our Department between 1991 and 1994. The pertinent medical literature is discussed. RESULTS: The tumors were located respectively in the distal tibia (n=2), the distal femur, the sternum and the ilium (n=1). Four lesions were high-grade and one low-grade. All patients (3 women and 2 men) underwent wide surgical resection associated with polychemotherapy in four cases. Two patients died of metastatic disease, two had local recurrence and one is alive with no evidence of disease at the last follow-up. DISCUSSION: Excluding cases which involve the facial skeleton, there are to our knowledge 95 cases of primary leiomyosarcoma of bone reported in the literature. This tumor arises more commonly in adults (mean age: 49 years) with an equal gender distribution and involves predominantly the long bones near the knee. In the majority of cases, plain X-rays exhibit an osteolytic lesion with cortical penetration and indistinct margins. The diagnosis is based on microscopic features demonstrating fusiform tumor cells arranged in interwoven bundles, and the immunohistochemical results of widespread cytoplasmic positivity for smooth muscle actin. The best pronostic parameter is the histologic grade correlated with both the recurrence and metastatic rates as well as the survival rate. Surgery constitutes the main treatment since chemotherapy or radiotherapy did not provide an improved prognosis over a wide resection.

Adult↗
PubMed2000

[Osteopoikilosis: report of 3 cases and review of the literature].

Osteopoikilosis, osteopathia condensans disseminata, is a rare hereditary autosomal dominant sclerosing bone dysplasia, more common in males. The diagnosis is usually made incidentally from radiographs which show multiple, small, well-defined, variably shaped and widely distributed (over the skeleton) sclerotic areas. The involvement is symmetrical, and the predilected locations are the phalanges of the hand, carpal bones, metacarpals, foot phalanges, metatarsals, tarsal bones, ilium, femur, radio and sacrum. It must be distinguished from melorheostosis, osteopathia striata and fundamentally from osteoblastic bone metastases, on the basis of the clinical, radiological (roentgenographs, computed tomography and magnetic resonance) and radionuclide scanning characteristics. Histologically, there are focal condensations of compact lamellar bone within the spongiosa. We report three cases of osteopoikilosis and review the literature. Two cases didn't have affectation in phalanges of the hand, which had not been previously reported, to our knowledge.

Adult↗
PubMed2000

Simple bone cyst in cervical vertebral spinous process and laminae: report of a case.

Simple (unicameral or solitary) bone cysts are the only true cysts of primary intraosseous origin. These cysts involve the metaphysis of long tubular bones such as the proximal humerus and proximal femur and, occasionally, the proximal tibia, distal femur, patella, ilium, rib, and calcaneus. They are very rarely found in vertebrae, especially in the cervical vertebral spinous process and laminae. We report a 14-year-old boy with an expansile, bubbly cystic lesion in the spinous process and laminae of the seventh cervical vertebra. Histopathologic examination showed a cyst surrounded by thin fibrous or fibro-osseous wall without any lining epithelial cells, compatible with a simple bone cyst. As far as we know, this is the first case of simple bone cyst involving the spinous process and laminae of a cervical vertebra reported in Taiwan.

Adolescent↗
PubMed2000

A modified technique for insertion of a unit rod into the pelvis.

The use of a pedicle probe facilitated insertion of a unit rod into the ilium of five patients with neuromuscular scoliosis. Compared to the standard technique, the pedicle probe method greatly reduced soft-tissue dissection and also provided better perception of rod alignment and cortical perforation.

Humans↗
PubMed1998

[Treatment of avascular necrosis of femoral head by periosteal cell transplantation: an experimental study].

OBJECTIVE: To investigate the effect of periosteal cell transplantation on the repair of avascular necrosis of femoral head (ANFH). On the basis of successful culture of periosteal cells in vitro. METHODS: The tibial periostea of new born dog were excised and cultured under aseptic conditions. Eight adult dogs were used and divided into 2 groups: experimental group and control group. The animal model of ANFH was made by transferring the freed femoral head into the muscle under the ilium on one side in each dog. Two weeks after the establishment of ANFH, the cultured periosteal cells were collected and transplanted into the necrotic femoral heads in the experimental group, and the femoral heads without periosteal cell transplantation served as the control. Six weeks after cell transplantation, the femoral heads were taken out and histological examination was made. RESULTS: There was active bone formation in the experimental group. The new bone was arranged into bone trabeculae, most of which were covered by a monolayer of osteoblasts. Between bone trabeculae were fibrous tissue rich in blood vessels. In the control group, the bone trabeculae withered and remained necrotic. There were fibrous tissues with few blood vessels between bone trabeculae. CONCLUSION: Periosteal cell transplantation can improve the repair of ANFH.

Animals↗
PubMed2000

[Pedicled osteocutaneous groin flap in the compound reconstruction procedures of the fingers].

The paper presents the authors own experiences with pedicled oseocutaneous groin flaps based on superficial circumflex iliac vessels with a vascularized bone graft (size ranging from 2.5 cm to 5 cm) from the ilium. Eight patients, 7 males and 1 female, (aged 9-46 years, mean age 24 years) were treated using this method because a bone defect of the first metacarpal bone or the middle phalanx of the III finger. The flap pedicle was cut off after 17-36 days. Treatment was successful in all patients, although complications of the healing process were noted in 7 flaps. In 5 cases an inflammatory reaction around the sutures or superficial necrosis of the skin was observed. In two cases extensive infection of the flap's tissues was noted which in one case lead to partial necrosis of the soft tissues.

Adolescent↗
PubMedDate not supplied

Case report of secondary chondrosarcoma showing spontaneous regression after frequent recurrences.

We report a case of secondary chondrosarcoma arising in the ilium showing spontaneous regression after frequent local tumor recurrences followed by multiple surgeries of marginal or intralesional excision. The patient was a 16-year-old boy who had been diagnosed as having multiple exostosis from 9 years of age. He experienced an increasing abdominal tumor mass that formed a huge tumor. Although marginal resection of the tumor was attempted, intraperitoneal dissemination was caused by rupture of the tumor capsule and the peritoneum, as a result of severe tumor adhesion to the peritoneum. During the 5 years after the initial operation, local recurrences occurred seven times in various areas of the intra- or retro-peritoneum and marginal or intralesional excision was performed every time for a total of 14 tumors. However, since the seventh operation, the patient has had no evidence of recurrence or metastasis of the disease for more than 10 years. Therefore, we considered that the cancer might have spontaneously regressed.

Adolescent↗