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At least 1,063 records · Page 59Linked to original sources
PubMed1994

Osteomyelitis and disseminated infection caused by Corynebacterium renale in a goat.

A 1.5-year-old female goat was examined for recurrence of lameness involving the right forelimb. Radiography of the thorax and right scapulohumeral joint revealed a pathologic fracture of the supraglenoid tubercle, and circumscribed radiolucent lesions in the right third and fourth ribs, and the base of the spinous process of T3. Bone scintigraphy demonstrated additional lesions in the lumbar spine and the wings of the ilium. At necropsy, disseminated infection and hematogenous osteomyelitis were diagnosed. Corynebacterium renale was cultured from the rib lesions. In food animals, osteomyelitis usually develops secondary to traumatic wounds, and members of the genus Actinomyces are frequently incriminated as the causative organism. This case is unusual because the osteomyelitis was unrelated to a traumatic wound, and the gross and microscopic lesions were reminiscent of caseous lymphadenitis, an infection caused by C pseudotuberculosis.

Animals↗
PubMed1993

Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature.

A case of malignant giant cell tumor of the tendon sheath of the right hip, which developed in a 72-year-old Japanese woman, is described. The tumor exhibited histological similarities to a benign giant cell tumor of the tendon sheath (localized nodular tenosynovitis). The resected tumor, measuring 9 x 9 x 11 cm, was located in the adductor muscle and invaded the proximal femur and acetabulum. The nodule was encapsulated with a thin membrane which was soft and gelatinous in consistency and varied in color from yellow to brown. The synovium of the hip joint was normal. The primary lesion was composed of plump polyhedral and spindle-shaped cells. The nuclei were large, irregular and hyperchromatic, and contained prominent nucleoli. A moderated number of multinucleated giant cells was scattered throughout the lesion. There was little stromal collagen. In the majority of the specimens, pseudoglandular or alveolar spaces were predominant. An ultrastructural study demonstrated three cell types: fibroblast-like, histiocyte-like and an intermediate. The patient underwent reconstructive surgery with a Dacron fabric-enveloped alumina ceramic pelvic prosthesis and total hip components after resection of the primary lesion. Unfortunately, because of a local recurrence, a hemipelvectomy was required 10 months after the initial operation. At that time the intestines were involved with the recurrent tumor, and the patient subsequently died of perforative peritonitis. An autopsy revealed distant metastases to the right pelvis, urinary bladder, right ureter, ilium, mesenterium and lungs.

Aged↗
PubMed1993

[Experimental studies on pasteurized autogenous bone graft].

Previous studies on hyperthermia have suggested that pasteurization makes tumors necrotic. Based on this assumption, replacement with a pasteurized autogenous bone graft after resection of a malignant bone tumor was deemed feasible for reconstruction. However, the extent of osteoinductive activity as well as mechanical strength of pasteurized bone was not clear. Consequently, experimental studies were carried out to test osteoinductivity and mechanical strength of pasteurized bone compared to autoclaved, boiled, and fresh bone. A summary of the results follows. Autoclaved ilium of rabbits resulted in degeneration of the bone material, and grafts were absorbed with little new bone formation and union. In contrast, the structures of pasteurized bones were preserved and the grafts were gradually replaced with viable bone in a manner similar to that of fresh bone graft. Bending and torsion tests of rat femurs indicated that the mechanical strength of autoclaved and boiled bones decreased significantly compared to fresh bones, whereas the mechanical strength of pasteurized bones was similar to that of fresh bones. These results demonstrated that pasteurized autogenous bone grafting can be a useful method for reconstruction after resection of malignant bone tumors.

Animals↗
PubMedDate not supplied

Orthopedic trauma: pelvic fracture.

1. The incidence of pelvic fractures has greatly increased; automobile and motorcycle crashes, pedestrian accidents, and falls from great height are the most common causes. Pelvic fractures caused by high-energy trauma often result in significant morbidity and mortality with mortality rates variously reported at 10% to 50%, dependent upon fracture classification and associated injuries. Mortality occurs from associated trauma to viscera, abdominal organs, and abdominal vessels, and from early complications of hemorrhage. 2. The difficulty in management of patients with pelvic fractures is determining whether fractures are stable or unstable. Single breaks with no displacement in the pelvic ring, which includes injuries to the ischium, ilium, pubis, and sacrum, are stable fractures and account for one third of all pelvic fractures. 3. Increasingly widespread use of surgical stabilization internally via rigid fixation of pelvic fractures has helped reduce the morbidity and mortality related to these fractures. Other benefits that have resulted include shortened hospitalization, decreased complications, and earlier mobility.

Fractures, Bone↗
PubMed1993

[A case of multiple sclerosis manifesting piano playing movement].

We report a case of 33-year-old man with multiple sclerosis, showing piano playing movement in both hands. His course of multiple sclerosis was remittent/progressive during 2 years and the clinical manifestation suggested the spinal cord involvement. On July 15, 1991, he was admitted with numbness of the right limbs, and then developed piano playing movement in both hands, more marked in the right side. Neurological examination revealed mild weakness in the right upper extremity, and rough touch, pain, and temperature sensation were slightly decreased. However, there was no deep sensory abnormalities, such as vibration, fine touch, and position senses. Vibration sense was lost below ilium. CSF examination showed elevation of IgG index (1.6), three oligoclonal bands and myelin basic protein content of 2.4 ng/ml. There was no HTLV-I antibody in CSF. SSEP, elicited by median nerve stimulation at the right wrist, showed no N13 and low amplitude of N20. T2-weighted images of cervical MRI revealed area of high signal intensity at the C3-C4 level. The piano playing movement gradually improved and disappeared by the initiation of steroid hormone therapy. It was considered that involuntary movement in this patient was due to the spinal cord lesion caused by multiple sclerosis. These findings suggested that the involuntary movement like pseudoathetosis could present without deep sensory abnormalities.

Adult↗
PubMedDate not supplied

Triple osteotomy of the innominate bone. A procedure to accomplish coverage of the dislocated or subluxated femoral head in the older patient.

The triple osteotomy of the innominate bone is a total redirectional reconstruction and is obtained by circum-acetabular osteotomies through the ilium, ischium and pubis. The method achieves coverage of a dislocated or subluxated femoral head where other iliac osteotomies are ineffective or incomplete. Triple osteotomy was performed on 175 hips including 121 congenital dislocation-subluxations. The patients' ages ranged from 6 to 35, with 70 per cent falling between 9 and 12. Eighty-six per cent had a satisfactory result. Most of the unsatisfactory results were in cerebral palsy, myelodysplasia and peroneal muscular atrophy and associated with uncontrolled muscle contractures or progressive disease.

Adolescent↗
PubMed1993

[Reconstruction for malignant bone tumor defects by a composite graft--plasty of the bone defect not involving a joint].

Malignant bone tumors excluding joints of six patients were resected. The resultant bone defects were reconstructed with a synthetic fabric-enveloped hydroxyapatite spacer in five cases and a filler in one. Dacron fabric was used in four cases and each of Marlex mesh and Dexon mesh were used in one. The grafting and reconstruction processes were studied clinically and roentgenographically. CT scan was used in one case. The synthetic fabrics were helpful in repairing released supporting soft tissue by serving as a scaffold for the formation of new connective tissue. The spacer to the supporting soft tissues was biologically fixed. The synthetic fabrics were capable of inducing and supporting of the ingrowth of vascular connective tissue. The anchor of reconstructed supporting soft tissue became increasingly strong as time passed. For lasting and stable reconstruction, the spacer must be made uniform with the remaining bone by making an extracortical bone bridge using an autogenous bone graft. In two cases, autogenous bone grafts were taken from the ilium to bridge the remaining bone. The autogenous bone grafts were fixed to the spacer by enveloping the bone graft and the spacer with Marlex mesh and Dexon mesh. In the Marlex case roentgenographic findings showed that extracortical bone bridging was completed within six months after the operation. In the Dexon mesh case, extracortical bone bridging was not completed at one year after the operation, however the repair of the released supporting soft tissues was satisfactory. In order to avoid complications, a fabric must be absorbed fully after completion of the biologic fixation and extracortical bone bridging. Yet, further investigations are required to determine which of the synthetic fabrics and mesh sizes to enhance incorporation of the bone graft.

Adult↗
PubMedDate not supplied

[Respiratory function involvement in intestinal chronic inflammatory disease: description of a case].

In the process of chronic intestinal inflammatory diseases the involvement of other organs and apparatuses is frequent. The respiratory apparatus, however, is not so frequently concerned as other organs, especially with regard to the paediatric age. The rarity of clinical evidences concerning the respiratory apparatus contrasts with the anomalies of the lung functionality tests described in literature. A fifteen year old boy is taken into consideration. He was first examined at the age of nine, when his symptomatology (slight fever and abdominal pain) was regarded as a chronic intestine inflammatory disease and it was treated with salazopyrina and cortisone. Compilations supervened later on, such as ilium arthritis, psoriasis-like dermatitis, perineal abscess. Five years after the beginning of the intestine disease the lungs were also involved and there was evidence of dyspnoea, especially when the patient was under stress. The clinical picture was confirmed by the reduction of the parameters of the respiratory functionality in the sense of an insufficiency of obstructive and restrictive kind. The pulmonary compilation was treated with disodium cromoglycate; such treatment was stopped, after the appearance of headache. After more than a year since the supervening of the lung complication the patient is being kept under periodic control to evaluate his pulmonary functionality. The indexes are constantly altered in the sense of a reduction of FEV 1, of FVC, of FEF 25-75 and of PEF, while the ventilatory and perfusional pulmonary scintigraphy has not shown relevant anomalies.

Child↗
PubMed1995

[Results of the use of parietal bone as bone graft donor site in facial reconstruction. Apropos of 71 cases].

The embryologic origin of the parietal bone is membranous bone. Experimentally, membranous bone grafts, maintain its original size, structure with good osteo-integration contrary to endochondral bone autografted (ilium, rib or tibia). The morbidity of skull bone grafts is much less than other donor site of bone. In our study, between 1988 and 1992, autogenous split calvarial bone grafts were used in maxillo-facial reconstruction of seventy-one patients. We observed no major complication. Patient followup has been from 2 to 6 years and results are better than endochondral grafts (iliac crest, ribs, tibia). Parietal grafts bone have been used in the following case: nasal reconstruction, rehabilitation of defects in the floor of the orbit, maxilla grafts, correction of frontal depression and mandibular reconstruction.

Adolescent↗
PubMedDate not supplied

Osteitis condensans of the clavicle: does fibrocartilage play a role? A report of two cases with spontaneous clinical and roentgenographic resolution.

Two cases of osteitis condensans of the medial clavicle with an unusual course toward spontaneous resolution of clinical and roentgenographic manifestations are reported. The relevant literature is reviewed. A pathogenic hypothesis for condensing osteitis of the clavicle, ilium, and pubis is suggested. At all these sites, the sclerosis occurs in bone overlaid by fibrocartilage. In contrast, joint aspects spared by the sclerosis are covered with hyaline cartilage. We report data documenting this fact at the sternoclavicular joint.

Adult↗
PubMed1995

[Triple osteotomy (modified Tönnis method) for advanced coxarthrosis].

The results of 79 triple osteotomies (modified Tönnis method) for advanced coxarthrosis in 76 patients, performed between 1986 and 1991 in our clinic, were evaluated. The operation was performed for 72 females and 4 males, with a mean age of 45.6 years, ranging from 20 to 59 years. The mean follow-up period was 4 years and 2 months, ranging from 1.6 to 9 years. The operative technique used was a modified Tönnis method originally described by Tönnis in 1981. Using a dorsal approach, the ischium is first osteotomized and then turning the patient to the supine position, the osteotomies of the pubis and ilium are performed through an anterior approach. The osteotomized acetabulum is rotated antero-laterally as much as possible to cover the femoral head sufficiently and is fixed with 4 or 5 Steinmann pins. For the clinical evaluation, we used the Japanese Orthopaedic Association Hip Score. The average score improved from 68 points preoperatively to 90 points postoperatively. The roentogenological evaluation confirmed the following results; excellent in 36 hips (46%) with good joint space and good joint congruity, fair in 35 hips (44%) with good joint space and fair joint congruity, and poor in 8 hips (10%) with narrowed joint space. The average CE angle at follow-up was 40.3 degrees in 36 hips with excellent result, 33.8 degrees in 35 hips with fair, and 32.4 degrees in 8 hips with poor (p < 0.01). Good remodelings are obtained, if the CE angle becomes more than 40 degrees postoperatively in acetabular rotational osteotomy for advanced coxarthrosis.

Adult↗
PubMed1996

Bone marrow scintigraphy using technetium-99m-antigranulocyte antibody in hematologic disorders.

UNLABELLED: Bone marrow is the primary site for many hematologic disorders. To date, however, no suitable bone marrow imaging method has been found. The present study investigates the usefulness of bone marrow immunoscintigraphy using 99mTc-labeled antigranulocyte antibody (anti-NCA-95) in 31 patients with hematologic disorders. METHODS: One milligram of antibody labeled with 259-370 MBq 99mTc was injected intravenously, and bone marrow images were taken 4 hr later. We also calculated the uptake ratios of lumbar bone marrow-to-background (L/B) and ilium-to-background (I/B). RESULTS: Of 15 patients with aplastic anemia, 7 showed diffusely decreased antibody uptake (L/B = 2.3 +/- 0.8, I/B = 3.0 +/- 0.8) compared to control patients (n = 21, L/B = 8.2 +/- 2.5, I/B = 10.3 +/- 3.1) Six patients had both decreased and increased uptake areas and two had normal to slightly increased uptake. Of those patients receiving various types of therapy for aplastic anemia, all but one showed increased or irregular uptake. The degree of antibody uptake in the bone marrow correlated with peripheral blood analyses (hemoglobin, white blood cells, platelets). Of six patients with myelodysplastic syndrome, four had irregular uptake and two diffusely decreased uptake. Four patients with myelogenous leukemia showed normal uptake, whereas two with lymphocytic leukemia had decreased uptake. Patients with iron deficiency anemia, pure red cell aplasia or thalassemia minor exhibited normal uptake with bone marrow expansion. CONCLUSION: Immunoscintigraphy with antigranulocyte antibody is a useful method for evaluating the bone marrow status of patients with various hematologic disorders.

Adolescent↗
PubMed1995

[Radiological signs of type I primary hyperoxaluria].

The authors report the radiological signs observed in 14 patients between the ages of 3 months and 16 years, suffering from type I primary hyperoxaluria. Four of these patients were being treated conservatively for renal failure and ten had reached end-stage renal failure. Stones were demonstrated in 9 patients. Nephrocalcinosis was present on the plain abdominal x-ray in 6 patients before dialysis, and in all patients dialysed for more than 3 months. Bone signs characteristic of type I primary hyperoxaluria were only observed in children with end-stage renal failure. Metaphyseal dense bands were revealed in 5 patients. Metaphyseal clear bands, observed in 4 patients, occurred later and appeared to replace dense bands which moved towards the diaphysis. The other signs detected were osteosclerosis of the vertebrae and ilium (4 patients) and epiphyseal subchondral clear bands (one patient).

Adolescent↗
PubMed1996

The osteology of the African elephant (Loxodonta africana): vertebral column, ribs and sternum.

The vertebral column, sternum and ribs of the African elephant were studied and illustrated. In the cervical series, the vertebrae are characterized by very short (compressed) vertebral bodies and short spinous processes. There are 20-21 thoracic vertebrae that carry ribs, and three lumbar vertebrae. The neural arches of the five sacral vertebrae fuse with each other as well as with the wings of the ilium, while the intervertebral discs do not ossify and the vertebral bodies remain separate. There are 19-21 caudal vertebrae. In the latter, the neural arches of only the first five to six vertebrae fuse dorsally, the vertebral foramens of the other vertebrae as well as the vertebral canal remain open dorsally. The body of the first rib is greatly expanded while that of the last three to four ribs are reduced. The cartilages of the first six ribs articulate with the sternum, the last five to six ribs do not bear costal cartilages and are not attached to the costal arch. The sternum consists of five sternabrae that form three approximately equal, but separate, segments. The first segment is formed by the first sternabra, the second segment is formed by the second to fourth sternabrae and the last segment is formed by the fifth sternabra. The first and second sternabrae articulate with each other by means of a synovial joint, the second to fourth sternabrae are fused to each other and the fourth and fifth sternabrae are loosely attached to each other by connective tissue.

Animals↗
PubMed1996

Possibility of blocking n. ischiadicus within foramen ischiadicum majus in sheep.

The blocking of the ischiadic nerve within foramen ischiadicus majus of 8 sheep was performed with 6-12 ml 2% xylocain from three different places: 1. From the middle of a line joining the top of processus spinosus of the 1st sacral vertebra and the peak of trochanter major. The needle pierces vertically through the skin, gluteal fascia and m. gluteus medius till foramen ischiadicum majus. 2. Along the most prominent part of crista iliaca on the gluteal surface of ala ossis ilium along the medial side of well expressed linea glutea. The needle pierces by an angle of 45 degrees through the skin, gluteal fascia and m. gluteus medius till the nerve itself. When the nerve is touched the animal makes a jerk. 3. Along the caudal part of tuber sacrale with the needle orientated caudo-ventro-laterally through the skin, gluteal fascia and m. gluteus medius toward foramen ischiadicum majus. The most appropriate approach for blocking is along crista glutea on the gluteal surface of ala assis ilii. In this approach the success is complete. The symptoms of the blocking appear immediately after the application. The complete akinesia of the limb appears 15 minutes after the application of 6 ml, and 5-10 minutes after being applied 12 ml of 2% xylocain. The blocking symptoms disappear within 90-100 or 120-140 minutes. Beside the blocking of n. ischiadicus, a simultaneous blocking of n. gluteus cranialis, n. caudalis and n. cutaneus femoris caudalis as well was performed within foramen ischiadicus majus.

Anesthetics, Local↗
PubMed1996

Anatomic considerations of an anterior approach to the sacroiliac joint.

This anatomic study was performed on 25 disarticulated pelves and 10 embalmed cadavers to evaluate an anterior approach to the sacroiliac joint. The angle of inclination of the superior limb of the sacroiliac joint was 15 degrees superolateral to inferomedial in the sagittal plane, and the inferior limb was parallel to the sagittal plane. The cranial lateral part of the ala overlapped the joint space and the adjacent part of the ilium. Elevation of a rectangular bone block on the cranial part of the ala removed the joint space from the superior limb and provided direct access to the joint space of the inferior limb.

Anthropometry↗
PubMedDate not supplied

Observations on the initial stability of acetabular components in total hip arthroplasty. An experimental study.

It was the purpose of the study to investigate the initial stability, with or without screws, of 3 acetabular components with press-fit anchoring, by measuring bone-prosthesis micromovements during the application of physiological loading on the hip simulated in the laboratory. The prostheses, already used clinically, were characterized by different shapes and coatings. For the purposes of the study a total of 30 acetabula were used in 10 human pelves in polyurethane and 5 human pelves preserved at -20 degrees. The pelves were assembled on a hydraulic bench test with a steel jig that could be oriented, and they were cemented with polymethylmethacrylate. Three electromagnetic transducers with sensitivity of up to 1 micron (+ 500 microns) were used to measure the micromovements between the prosthesis and the acetabular rim in its three anatomical quadrants. Bone-prosthesis micromovements were recorded during 5 consecutive load tests, from 0 to 2.39 kN (244 kg). Experimental studies have shown that bone-prosthesis micromovement that exceeds 150 microns obstructs bone integration. The most significant micromovement was observed for all of the prostheses, without accessory screws, in the iliac quadrant, but only the hemispherical one with a semi-smooth surface in zirconium oxide surpassed the threshold of 150 microns. Prostheses with a porous surface demonstrated good stability (102 +/- 33 microns and 94 +/- 36 microns, respectively). None of the prostheses demonstrated micromovement exceeding 90 microns in the area corresponding to the pubis and the ischium. The use of 2 accessory screws sensitively increased the stability of all of the prostheses on the ilium, reducing the average micromovement by 40 microns. Reduction of micromovement was less on the pubis and on the ischium.

Acetabulum↗
PubMed1996

[The microsurgical treatment of idiopathic varicocele (preliminary report)].

A new therapeutic approach to idiopathic varicocele, promoting restoration of the venous return in a physiological manner is described. The procedure consist in the creation of anastomosis between the veins of plexus pampiniformis and vena circumflexa ilium profunda or vena epigastrica inferior profunda using microvascular surgical technique. A brief literature survey of the existing microsurgical methods of varicocele treatment is done. The new method is applied to thirty-seven patients. The microsurgical technique, used in 1991 for the first time, is described in details. The early postoperative results are analyzed. Venous return through the newly constructed anastomosis is verified by Doppler sonography.

Adolescent↗