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Sample records for asymptomatic local bone

  1. Can medio-lateral baseplate position and load sharing induce asymptomatic local bone resorption of the proximal tibia? A finite element study

    PubMed Central

    Innocenti, Bernardo; Truyens, Evelyn; Labey, Luc; Wong, Pius; Victor, Jan; Bellemans, Johan

    2009-01-01

    Background Asymptomatic local bone resorption of the tibia under the baseplate can occasionally be observed after total knee arthroplasty (TKA). Its occurrence is not well documented, and so far no explanation is available. We report the incidence of this finding in our practice, and investigate whether it can be attributed to specific mechanical factors. Methods The postoperative radiographs of 500 consecutive TKA patients were analyzed to determine the occurrence of local medial bone resorption under the baseplate. Based on these cases, a 3D FE model was developed. Cemented and cementless technique, seven positions of the baseplate and eleven load sharing conditions were considered. The average VonMises stress was evaluated in the bone-baseplate interface, and the medial and lateral periprosthetic region. Results Sixteen cases with local bone resorption were identified. In each, bone loss became apparent at 3 months post-op and did not increase after one year. None of these cases were symptomatic and infection screening was negative for all. The FE analysis demonstrated an influence of baseplate positioning, and also of load sharing, on stresses. The average stress in the medial periprosthetic region showed a non linear decrease when the prosthetic baseplate was shifted laterally. Shifting the component medially increased the stress on the medial periprosthetic region, but did not significantly unload the lateral side. The presence of a cement layer decreases the stresses. Conclusion Local bone resorption of the proximal tibia can occur after TKA and might be attributed to a stress shielding effect. This FE study shows that the medial periprosthetic region of the tibia is more sensitive than the lateral region to mediolateral positioning of the baseplate. Medial cortical support of the tibial baseplate is important for normal stress transfer to the underlying bone. The absence of medial cortical support of the tibial baseplate may lead to local bone resorption at

  2. Asymptomatic Papulo-nodules Localized to One Finger

    PubMed Central

    Rambhia, Kinjal D; Khopkar, Uday S

    2015-01-01

    Subcutaneous or deep granuloma annulare is a benign asymptomatic condition characterized by firm asymptomatic nodules in deep subcutaneous tissues that may be associated with intradermal lesions. A 53-year-old female presented with asymptomatic skin-colored, firm nodules over the right ring finger. Histopathology revealed a palisading granuloma with central degenerated collagen and mucin deposition in the dermis suggestive of granuloma annulare. Isolated and unilateral involvement of a single digit with clusters of nodules of subcutaneous granuloma annulare (GA) in an adult is rare and differentiation from its simulator rheumatoid nodule is essential. PMID:26538728

  3. Primary hyperparathyroidism presenting with acute pancreatitis and asymptomatic bone involvement

    PubMed Central

    Saif, Aasem

    2015-01-01

    Summary A 15-year-old female patient presented to the emergency room with vomiting and abdominal pain. She had two similar attacks in the previous three months both of them were diagnosed as pancreatitis in two different hospitals. On admission, her serum calcium and parathyroid hormone levels were very high. CT scan revealed left inferior parathyroid adenoma. Investigations to rule out possible multiple endocrine neoplasia were all negative. The patient was managed by intravenous fluids and furosemide to lower her serum calcium level. Then, left inferior parathyroidectomy was done. Postoperatively, the patient had hungry bone syndrome with severe hypocalcaemia and was managed by intravenous calcium infusion for five days in the intensive care unit. Later, she was kept on oral calcium and vitamin D supplementation. She became symptom-free and her serum calcium improved gradually. PMID:26604950

  4. Hormonal and Local Regulation of Bone Formation.

    ERIC Educational Resources Information Center

    Canalis, Ernesto

    1985-01-01

    Reviews effects of hormones, systemic factors, and local regulators on bone formation. Identifies and explains the impact on bone growth of several hormones as well as the components of systemic and local systems. Concentrates on bone collagen and DNA synthesis. (Physicians may earn continuing education credit by completing an appended test). (ML)

  5. Asymmetric loading and bone mineral density at the asymptomatic knees of subjects with unilateral hip osteoarthritis

    PubMed Central

    Shakoor, Najia; Dua, Anisha; Thorp, Laura; Mikolaitis, Rachel A.; Wimmer, Markus A.; Foucher, Kharma C.; Fogg, Louis F.; Block, Joel A.

    2011-01-01

    Objective The contralateral knee of those with unilateral endstage hip OA is known to be at greater risk for endstage knee OA compared to the ipsilateral, same side knee. Likewise, in endstage hip OA, this contralateral knee is known to have increased dynamic joint loads compared to the ipsilateral knee. Here, we study a population with unilateral hip OA, who are asymptomatic at the knees, for early asymmetries in knee loading. Methods Data from 62 subjects with unilateral hip OA were evaluated. Subjects underwent gait analyses for evaluation of dynamic knee loads as well as dual energy X-ray absorptiometry for evaluation of bone mineral density (BMD) at both knees. Differences between knees were compared. Results Peak dynamic knee loads were significantly higher at the contralateral knee compared to the ipsilateral knee (2.46±0.71 vs 2.23±0.81 %BW*ht, p=0.029). Similarly, medial compartment tibial BMD was significantly higher at the contralateral knee compared to the ipsilateral knee (0.897±0.208 vs 0.854±0.206 gm/c2, p=0.033). Interestingly, there was a direct correlation between contralteral:ipsilateral dynamic knee load and contralateral:ipsilateral medial compartment tibial BMD (Spearman’s rho= 0.287, p=0.036). Conclusions This study demonstrates that at the contralateral knees of patients with unilateral hip OA, which are at higher risk of developing progressive symptomatic OA compared to the ipsilateral knees, loading and structural asymmetries appear early in the disease course, while the knees are still asymptomatic. These early biomechanical asymmetries may have corresponding long term consequences, providing further support for the potential role of loading in OA onset and progression. PMID:22127702

  6. Asymptomatic localized pleural amyloidosis mimicking malignant pleural mesothelioma: report of a case

    PubMed Central

    Nakano, Tomoyuki; Tetsuka, Kenji; Fukushima, Noriyoshi

    2016-01-01

    We herein report an asymptomatic 65-year-old male with localized pleural amyloidosis mimicking malignant pleural mesothelioma. He had a history of exposure to asbestos and was admitted for investigation of an abnormal pleural thickness detected by chest radiography. Positron emission tomography showed elevation of standardized uptake value corresponding to the pleural thickness. Partial pleurectomy including the tumor was performed for the purpose of diagnosis and local disease control. The pathological examination showed that the tumor was pleural amyloidosis. The tumor was diagnosed as localized primary amyloidosis, because serum monoclonal protein concentration did not increase. Pleural amyloidosis should be considered as a differential diagnosis from pleural mesothelioma. PMID:26904248

  7. Seropositivity to celiac antigens in asymptomatic children with type 1 diabetes mellitus: association with weight, height, and bone mineralization

    PubMed Central

    Artz, Evelyn; Warren-Ulanch, Julia; Becker, Dorothy; Greenspan, Susan; Freemark, Michael

    2016-01-01

    Background Screening for celiac disease (CD) in children with diabetes is controversial because no studies have demonstrated metabolic complications in asymptomatic, seropositive subjects or beneficial effects of dietary intervention. Objective We hypothesized that seropositivity to celiac antigens is associated with decreased growth and bone mineralization in asymptomatic diabetic children. Design/Methods Asymptomatic diabetic children were screened for seropositivity to tissue transglutaminase. Villous atrophy was assessed by small bowel biopsy in a subset of seropositive subjects. We compared measures of growth and bone mineralization in 30 seropositive subjects, and 34 matched seronegative controls. Results Relative to seronegative controls, the seropositive subjects had reductions in insulin-like growth factor (IGF) binding protein 3 z scores (p < 0.05) and bone mineral density (BMD) z scores (p = 0.05). Weight, body mass index, IGF-I, and bone mineral apparent density (BMAD) z scores were marginally lower, but height z scores were comparable. Seropositive patients with severe villous atrophy had lower weight (−0.91 SDs), height (−1.1 SDs), BMD (−2.0 SDs), and BMAD (−2.0 SDs) z scores and significant increases in parathyroid hormone (all p < 0.05). Four patients with severe villous atrophy maintained strict gluten restriction for at least 12 months. Gluten restriction increased BMD and BMAD z scores. Conclusions High-titer seropositivity to celiac antigens is associated with reductions in weight and BMD in diabetic children, justifying screening of high-risk patients. Results suggest that biopsy is required to confirm the diagnosis and assess the severity of CD; those with severe villous atrophy are more likely to have growth failure and osteopenia. Gluten restriction may reverse these complications. PMID:18466211

  8. Asymptomatic Paget's disease of bone in a 62-year-old Nigerian man: three years post-alendronate therapy

    PubMed Central

    Ipadeola, Arinola

    2016-01-01

    Summary Paget's disease is a chronic and progressive disorder of bone characterized by focal areas of excessive osteoclastic resorption accompanied by a secondary increase in the osteoblastic activity. Paget's disease of bone (PBD) is a rare endocrine disease especially among Africans and Asians. Hence the detection of a case in a middle-aged Nigerian is of interest. We present the case of a 62-year-old Nigerian man in apparent good health who was found to have a markedly elevated serum total alkaline phosphatase (ALP) of 1179 U/l (reference range, 40–115 U/l) 4 years ago during a routine medical check-up in the USA. He had no history suggestive of PDB and also had no known family history of bone disease. Examination findings were not remarkable except for a relatively large head. A repeat ALP in our centre was 902 U/l (reference range, 40–120 U/l). Cranial CT scan showed diffuse cranial vault thickening consistent with Paget's disease which was confirmed by Tc-99m hydroxymethylene diphosphonate. He was placed on 40 mg alendronate tablets daily for 6 months. The patient has remained asymptomatic and has been in continuing biochemical remission during the 3-year follow-up period. The most recent ALP result is 88 U/l (reference range, 30–132 U/l) in April 2015. Learning points Serum total alkaline phosphatase remains a sensitive marker of bone turnover and an isolated increase above the upper limit of normal warrants more intense scrutiny in form of investigations targeted at excluding PD.Paget's disease is very rare but can occur in the Africans as seen in this Nigerian man and most patients are asymptomatic.Asymptomatic patients can benefit from treatment if disease is active, polyostotic or the lesions are located in bones with future risk of complications such as long bones, vertebrae and skull.Bisphosphonates are still the mainstay of treatment and alendronate is a useful therapeutic option for treatment. PMID:26870373

  9. Bone scans after total knee arthroplasty in asymptomatic patients. Cemented versus cementless

    SciTech Connect

    Hofmann, A.A.; Wyatt, R.W.; Daniels, A.U.; Armstrong, L.; Alazraki, N.; Taylor, A. Jr. )

    1990-02-01

    The natural history of bone scans after total knee arthroplasty (TKA) was studied in 26 patients with 28 cemented TKAs and 29 patients with 31 cementless TKAs. The bone scans were examined at specified postoperative intervals. Radionuclide activity of the femoral, tibial, and patellar regions was measured. Six patients who developed pain postoperatively were excluded. Bone scans immediately postoperative and at three months demonstrated increased uptake, which gradually decreased to baseline levels at ten to 12 months. Radioisotope uptake was comparable in the cemented and cementless groups, but was highly variable in individual patients and in each of the follow-up periods. A single postoperative bone scan cannot differentiate component loosening from early bone remodeling. Sequential bone scans, as a supplement to the clinical examination and conventional radiography, may prove useful in the diagnosis of TKA failure.

  10. Scintigraphic localization of bone lesions during surgery.

    PubMed

    Harcke, H T; Conway, J J; Tachdjian, M O; Dias, L S; Noble, H B; MacEwen, G D; Weiss, S

    1985-01-01

    Nuclear medicine provides several methods for increasing the accuracy of surgical removal of bone lesions with focally increased uptake. In this paper, three intraoperative procedures are discussed: remote control by imaging, intraoperative control by imaging, and intraoperative control by scintillation probe. All techniques require preoperative injection of bone imaging tracer. Remote operative control calls for a gamma camera to mark the skin over the lesion prior to surgery, providing optimal preoperative localization and imaging of the excised lesion to ensure complete removal. Intraoperative control procedures require that a portable camera or a scintillation probe be used in the operating room; these permit direct monitoring of localization and resection. Our experience with 18 procedures performed on 15 patients suggests that these techniques are worthy of continued use. PMID:3158078

  11. Understanding the local actions of lipids in bone physiology.

    PubMed

    During, Alexandrine; Penel, Guillaume; Hardouin, Pierre

    2015-07-01

    The adult skeleton is a metabolically active organ system that undergoes continuous remodeling to remove old and/or stressed bone (resorption) and replace it with new bone (formation) in order to maintain a constant bone mass and preserve bone strength from micro-damage accumulation. In that remodeling process, cellular balances--adipocytogenesis/osteoblastogenesis and osteoblastogenesis/osteoclastogenesis--are critical and tightly controlled by many factors, including lipids as discussed in the present review. Interest in the bone lipid area has increased as a result of in vivo evidences indicating a reciprocal relationship between bone mass and marrow adiposity. Lipids in bones are usually assumed to be present only in the bone marrow. However, the mineralized bone tissue itself also contains small amounts of lipids which might play an important role in bone physiology. Fatty acids, cholesterol, phospholipids and several endogenous metabolites (i.e., prostaglandins, oxysterols) have been purported to act on bone cell survival and functions, the bone mineralization process, and critical signaling pathways. Thus, they can be regarded as regulatory molecules important in bone health. Recently, several specific lipids derived from membrane phospholipids (i.e., sphingosine-1-phosphate, lysophosphatidic acid and different fatty acid amides) have emerged as important mediators in bone physiology and the number of such molecules will probably increase in the near future. The present paper reviews the current knowledge about: (1°) bone lipid composition in both bone marrow and mineralized tissue compartments, and (2°) local actions of lipids on bone physiology in relation to their metabolism. Understanding the roles of lipids in bone is essential to knowing how an imbalance in their signaling pathways might contribute to bone pathologies, such as osteoporosis. PMID:26118851

  12. Localized sclerotic bone response demonstrated reduced nanomechanical creep properties.

    PubMed

    Chen, Xiuli; Goh, James Cho Hong; Teoh, Swee Hin; De, Shamal Das; Soong, Richie; Lee, Taeyong

    2013-01-01

    Sclerosis (tissue hardening) development is a common occurrence in slow growing or benign osteolytic lesions. However, there is lack of knowledge on the mechanical and material property changes associated with sclerotic bone response. The immune system is postulated to play a relevant role in evoking sclerotic bone responses. In this study, localized sclerotic response in an immunocompetent model of Walker 256 breast carcinoma in SD rats showed an apparent increase in new reactive bone formation. Sclerotic rat femurs had significant increases in bone mineral density (BMD), bone mineral content (BMC), bone volume fraction (BV/TV), bone surface density (BS/TV), trabecular number (Tb.N) and a significant decrease in trabecular separation (Tb.Sp) and structural model index (SMI) as compared to control rat femurs. Significantly reduced creep responses (increased η) were observed for both trabecular and cortical bone in sclerotic bones while no significant difference was observed in elastic modulus (E) and hardness (H) values. Therefore, we conclude that viscoelastic creep property using nanoindentation would serve as a more sensitive indicator of localized bone modeling than elastic properties. Moreover, reduced viscoelasticity can contribute towards increased microcrack propagation and therefore reduced toughness. Since significant positive correlations between elastic properties (E) and (H) with viscosity (η) were also observed, our results indicate that sclerotic response of bone metastasis would cause reduced toughness (increased η) with stiffening of material (increased E and H). PMID:23127639

  13. Controlled Delivery of Zoledronate Improved Bone Formation Locally In Vivo

    PubMed Central

    Peng, Jiang; Lu, Qiang; Wang, Yu; Wang, Aiyuan; Guo, Quanyi; Gao, Xupeng; Xu, Wenjing; Lu, Shibi

    2014-01-01

    Bisphosphonates (BPs) have been widely used in clinical treatment of bone diseases with increased bone resorption because of their strong affinity for bone and their inhibition of bone resorption. Recently, there has been growing interest in their improvement of bone formation. However, the effect of local controlled delivery of BPs is unclear. We used polylactide acid-glycolic acid copolymer (PLGA) as a drug carrier to deliver various doses of the bisphosphonate zoledronate (Zol) into the distal femur of 8-week-old Sprague-Dawley rats. After 6 weeks, samples were harvested and analyzed by micro-CT and histology. The average bone mineral density and mineralized bone volume fraction were higher with medium- and high-dose PLGA-Zol (30 and 300 µg Zol, respectively) than control and low-dose Zol (3 µg PLGA-Zol; p<0.05). Local controlled delivery of Zol decreased the numbers of osteoclast and increased the numbers of osteoblast. Moreover, local controlled delivery of medium- and high-dose Zol accelerated the expression of bone-formation markers. PLGA used as a drug carrier for controlled delivery of Zol may promote local bone formation. PMID:24618585

  14. A community outbreak of Salmonella enterica serotype Typhimurium associated with an asymptomatic food handler in two local restaurants.

    PubMed

    Holman, Emily J; Allen, Keith S; Holguin, John R; Torno, Mauro; Lachica, Miriam

    2014-09-01

    Between January and April 2012, the city of Long Beach Department of Health and Human Services investigated an outbreak involving 19 case patients who had tested positive for Salmonella enterica serotype Typhimurium with indistinguishable pulsed-field gel electrophoresis patterns. All cases were residents of or traveled to the city of Long Beach, California, during their incubation period, and the majority of patients reported eating at one of two restaurants in Long Beach. This article describes the outbreak investigation that traced the source to an asymptomatic food handler working at both restaurants and highlights the importance of maintaining a high index of suspicion for food handlers when faced with local outbreaks of diarrheal illness. PMID:25226780

  15. Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation

    PubMed Central

    Smith, David W.; Gardiner, Bruce S.; Dunstan, Colin

    2012-01-01

    Maintaining bone volume during bone turnover by a BMU is known as bone balance. Balance is required to maintain structural integrity of the bone and is often dysregulated in disease. Consequently, understanding how a BMU controls bone balance is of considerable interest. This paper develops a methodology for identifying potential balance controls within a single cortical BMU. The theoretical framework developed offers the possibility of a directed search for biological processes compatible with the constraints of balance control. We first derive general control constraint equations and then introduce constitutive equations to identify potential control processes that link key variables that describe the state of the BMU. The paper describes specific local bone volume balance controls that may be associated with bone resorption and bone formation. Because bone resorption and formation both involve averaging over time, short-term fluctuations in the environment are removed, leaving the control systems to manage deviations in longer-term trends back towards their desired values. The length of time for averaging is much greater for bone formation than for bone resorption, which enables more filtering of variability in the bone formation environment. Remarkably, the duration for averaging of bone formation may also grow to control deviations in long-term trends of bone formation. Providing there is sufficient bone formation capacity by osteoblasts, this leads to an extraordinarily robust control mechanism that is independent of either osteoblast number or the cellular osteoid formation rate. A complex picture begins to emerge for the control of bone volume. Different control relationships may achieve the same objective, and the ‘integration of information’ occurring within a BMU may be interpreted as different sets of BMU control systems coming to the fore as different information is supplied to the BMU, which in turn leads to different observable BMU behaviors

  16. Asymptomatic bacteriuria

    MedlinePlus

    ... need treatment. This makes it different from a urinary tract infection that is caused by bacteria. Causes Asymptomatic bacteriuria ... bacteriuria causes no symptoms. The symptoms of a urinary tract infection include burning during urination, an increased urgency to ...

  17. Estimation of Local Bone Loads for the Volume of Interest.

    PubMed

    Kim, Jung Jin; Kim, Youkyung; Jang, In Gwun

    2016-07-01

    Computational bone remodeling simulations have recently received significant attention with the aid of state-of-the-art high-resolution imaging modalities. They have been performed using localized finite element (FE) models rather than full FE models due to the excessive computational costs of full FE models. However, these localized bone remodeling simulations remain to be investigated in more depth. In particular, applying simplified loading conditions (e.g., uniform and unidirectional loads) to localized FE models have a severe limitation in a reliable subject-specific assessment. In order to effectively determine the physiological local bone loads for the volume of interest (VOI), this paper proposes a novel method of estimating the local loads when the global musculoskeletal loads are given. The proposed method is verified for the three VOI in a proximal femur in terms of force equilibrium, displacement field, and strain energy density (SED) distribution. The effect of the global load deviation on the local load estimation is also investigated by perturbing a hip joint contact force (HCF) in the femoral head. Deviation in force magnitude exhibits the greatest absolute changes in a SED distribution due to its own greatest deviation, whereas angular deviation perpendicular to a HCF provides the greatest relative change. With further in vivo force measurements and high-resolution clinical imaging modalities, the proposed method will contribute to the development of reliable patient-specific localized FE models, which can provide enhanced computational efficiency for iterative computing processes such as bone remodeling simulations. PMID:27109554

  18. Bioabsorbable bone plates enabled with local, sustained delivery of alendronate for bone regeneration.

    PubMed

    Hur, Woojune; Park, Min; Lee, Jae Yeon; Kim, Myung Hun; Lee, Seung Ho; Park, Chun Gwon; Kim, Se-Na; Min, Hye Sook; Min, Hye Jeong; Chai, Jin Ho; Lee, Sang Jeong; Kim, Sukwha; Choi, Tae Hyun; Choy, Young Bin

    2016-01-28

    We prepared a bone plate enabled with the local, sustained release of alendronate, which is a drug known to inhibit osteoclast-mediated bone resorption and also expedite the bone-remodeling activity of osteoblasts. For this, we coated a bone plate already in clinical use (PLT-1031, Inion, Finland) with a blend of alendronate and a biocompatible polymer, azidobenzoic acid-modified chitosan (i.e., Az-CH) photo-crosslinked by UV irradiation. As we performed the in vitro drug release study, the drug was released from the coating at an average rate of 4.03μg/day for 63days in a sustained manner. To examine the effect on bone regeneration, the plate was fixed on an 8mm cranial critical size defect in living rats and the newly formed bone volume was quantitatively evaluated by micro-computed tomography (micro-CT) at scheduled times over 8weeks. At week 8, the group implanted with the plate enabled with sustained delivery of alendronate showed a significantly higher volume of newly formed bone (52.78±6.84%) than the groups implanted with the plates without drug (23.6±3.81%) (p<0.05). The plate enabled with alendronate delivery also exhibited good biocompatibility on H&E staining, which was comparable to the Inion plate already in clinical use. Therefore, we suggest that a bone plate enabled with local, sustained delivery of alendronate can be a promising system with the combined functionality of bone fixation and its expedited repair. PMID:26682503

  19. An asymptomatic 61-year-old man with BCR-ABL-positive bone marrow following autologous transplantation for multiple myeloma

    PubMed Central

    Roper, Nitin; Deangelo, Daniel; Kuo, Frank; Cin, Paola dal; Ghobrial, Irene; Aster, Jon C.

    2010-01-01

    A 61-year-old man treated with an autologous transplant for multiple myeloma was incidentally found to have a high level of BCR-ABL fusion gene-positive cells in his bone marrow. We describe the clinical decision-making process that led us to initiate therapy with imatinib, despite the absence of any clinical evidence of chronic myelogenous leukemia or other BCR-ABL associated hematologic malignancy. PMID:20730794

  20. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    PubMed

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  1. In Situ Microindentation for Determining Local Subchondral Bone Compressive Modulus

    PubMed Central

    Gardner-Morse, Mack G.; Tacy, Nelson J.; Beynnon, Bruce D.; Roemhildt, Maria L.

    2010-01-01

    Background Alterations to joint tissues, including subchondral bone, occur with osteoarthritis. A microindentation technique was developed to determine the local compressive modulus of subchondral bone. This test in conjunction with a cartilage indentation test at the same location could evaluate changes of these material properties in both tissues. The accuracy of the technique was determined by applying it to materials of known moduli. The technique was then applied to rat tibial plateaus to characterize the local moduli of the subchondral bone. Method of approach An established nanoindentation method was adapted to determine the modulus of subchondral bone following penetration of the overlying articular cartilage. Three cycles of repeated loading were applied (2.452 N, 30 s hold). The slope of the load-displacement response during the unloading portion of the third cycle was used to measure the stiffness. Indentation tests were performed on two polyurethane foams and polymethyl-methacrylate for validation (n=15). Regression analysis was used to compare the moduli with reference values. Subchondral bone moduli of tibial plateaus from Sprague-Dawley rats (n=5) were measured for central and posterior locations of medial and lateral compartments. An ANOVA was used to analyze the effects of compartment and test location. Results The measured moduli of the validation materials correlated with the reference values (R2 = 0.993, p = 0.05). In rat tibial plateaus, the modulus of the posterior location was significantly greater than the center location (4.03±1.00 and 3.35±1.16 GPa respectively, p = 0.03). The medial compartment was not different from the lateral compartment. Conclusions This method for measuring the subchondral bone in the same location as articular cartilage allows studies of the changes of these material properties with the onset and progression of osteoarthritis. PMID:20815650

  2. Clustered local transmission and asymptomatic Plasmodium falciparum and Plasmodium vivax malaria infections in a recently emerged, hypoendemic Peruvian Amazon community

    PubMed Central

    Branch, OraLee; Casapia, W Martin; Gamboa, Dionicia V; Hernandez, Jean N; Alava, Freddy F; Roncal, Norma; Alvarez, Eugenia; Perez, Enrique J; Gotuzzo, Eduardo

    2005-01-01

    Background There is a low incidence of malaria in Iquitos, Peru, suburbs detected by passive case-detection. This low incidence might be attributable to infections clustered in some households/regions and/or undetected asymptomatic infections. Methods Passive case-detection (PCD) during the malaria season (February-July) and an active case-detection (ACD) community-wide survey (March) surveyed 1,907 persons. Each month, April-July, 100-metre at-risk zones were defined by location of Plasmodium falciparum infections in the previous month. Longitudinal ACD and PCD (ACP+PCD) occurred within at-risk zones, where 137 houses (573 persons) were randomly selected as sentinels, each with one month of weekly active sampling. Entomological captures were conducted in the sentinel houses. Results The PCD incidence was 0.03 P. falciparum and 0.22 Plasmodium vivax infections/person/malaria-season. However, the ACD+PCD prevalence was 0.13 and 0.39, respectively. One explanation for this 4.33 and 1.77-fold increase, respectively, was infection clustering within at-risk zones and contiguous households. Clustering makes PCD, generalized to the entire population, artificially low. Another attributable-factor was that only 41% and 24% of the P. falciparum and P. vivax infections were associated with fever and 80% of the asymptomatic infections had low-density or absent parasitaemias the following week. After accounting for asymptomatic infections, a 2.6-fold increase in ACD+PCD versus PCD was attributable to clustered transmission in at-risk zones. Conclusion Even in low transmission, there are frequent highly-clustered asymptomatic infections, making PCD an inadequate measure of incidence. These findings support a strategy of concentrating ACD and insecticide campaigns in houses adjacent to houses were malaria was detected one month prior. PMID:15975146

  3. [Local application of simvastatin to rat incisor sockets augments bone].

    PubMed

    Nishimura, Kenichi

    2008-03-01

    Decrease of the alveolar ridge after tooth extraction causes difficulties in prosthodontic treatment, especially in implant supported prostheses. Statins, which are inhibitors of cholesterol synthesis and therapeutic drugs for hypercholestemia, stimulate BMP-2 expression in osteoblasts. The purpose of the present study was to examine how local application of simvastatin, one of the statins, to the tooth socket after tooth extraction affects alveolar bone. A mixture of lactic acid/glycolic acid copolymer (PLGA), alpha-tricalcium phosphate (alpha-TCP), calcium carbonate was prepared as a carrier for simvastatin. Ninety-six male Wistar rats, 10 weeks old, were used. After right mandibular incisor extraction, they were divided into eight groups and tooth sockets were treated differently: no treatment (control), PLGA carrier only, or PLGA containing 0.1, 0.25, 0.5, 1.0, 2.0, and 4.0 mg simvastatin, respectively. They were sacrificed at 4 and 8 weeks. Bone mineral content (BMC) of the alveolar ridge was measured with dual-energy X-ray absorptiometry and histological analyses were performed. All groups treated with simvastatin showed higher BMC compared to the control group and PLGA carrier group at 4 and 8 weeks. Histological analyses revealed that the thickness of cortical bone of the statin group increased compared to the control group at 4 and 8 weeks; however, newly-formed bone in the tooth socket of the statin group was less than in those of the control group and PLGA carrier group. The results of this study show that local application of simvastatin may enhance bone formation and preserve the alveolar ridge after tooth extraction. PMID:18421951

  4. Asymptomatic dystrophinopathy

    SciTech Connect

    Morrone, A. |; Hoffman, E.P.; Hoop, R.C.

    1997-03-31

    A 4-year-old girl was referred for evaluation for a mild but persistent serum aspartate aminotransferase (AST) elevation detected incidentally during routine blood screening for a skin infection. Serum creatine kinase activity was found to be increased. Immuno-histochemical study for dystrophin in her muscle biopsy showed results consistent with a carrier state for muscular dystrophy. Molecular work-up showed the proposita to be a carrier of a deletion mutation of exon 48 of the dystrophin gene. Four male relatives also had the deletion mutation, yet showed no clinical symptoms of muscular dystrophy (age range 8-58 yrs). Linkage analysis of the dystrophin gene in the family showed a spontaneous change of an STR45 allele, which could be due to either an intragenic double recombination event, or CA repeat length mutation leading to identical size alleles. To our knowledge, this is the first documentation of an asymptomatic dystrophinopathy in multiple males of advanced age. Based on molecular findings, this family would be given a diagnosis of Becker muscular dystrophy. This diagnosis implies the development of clinical symptoms, even though this family is clearly asymptomatic. This report underscores the caution which must be exercised when giving presymptomatic diagnoses based on molecular studies. 28 refs., 4 figs., 1 tab.

  5. Distribution of molecules locally delivered from bone cement.

    PubMed

    Giers, Morgan B; McLaren, Alex C; Schmidt, Kenneth J; Caplan, Michael R; McLemore, Ryan

    2014-05-01

    Revision of infected orthopedic implants is successful in most cases when antimicrobials are delivered locally (mixed with bone cement or bone graft which is placed in the site from which the infected tissue was removed); however, there is still a substantial rate of recurrence most likely due to the antimicrobials not achieving a therapeutic dose at all locations in the tissue. To study transport within this environment, gadolinium chelated in diethylene triamine pentaacetic acid (Gd-DTPA), a MRI contrast agent with size and solubility similar to two common antimicrobials (gentamicin and vancomycin), was mixed with bone cement, implanted in vivo into two models of orthopedic surgical wounds, and imaged using MRI 5.5 h after implantation. Image thresholding was used to create two-dimensional and three-dimensional representations of areas/volumes containing detectable concentrations of Gd-DTPA. Distribution is found to be anisotropic with Gd-DTPA transporting preferentially anterior of the implant toward the skin. When fascia is not closed over the implant site, Gd-DTPA transports to the skin and along the subcutaneous plane. The distance transported indicates that transport is likely driven by convection. Finally, the tissue concentration of Gd-DTPA is much less than the concentration loaded into the bone cement. PMID:24155244

  6. Demineralized Bone Matrix, as a Graft Enhancer of Auto-Local Bone in Posterior Lumbar Interbody Fusion

    PubMed Central

    Moon, Sang Ho; Kim, Tae Woo; Boo, Kyung Hwan; Hong, Sung Won

    2014-01-01

    Study Design A case controlled study with prospective data collection. Purpose To evaluate the early influence and the final consequence of demineralized bone matrix (DBM) on auto-local bone as a graft enhancer in posterior lumbar interbody fusion (PLIF). Overview of Literature DBM is known as an osteoinductive material; however, it has not been clearly recognized to enhance auto-local bone with a small amount. Methods Patients who had a PLIF were allocated into two groups. Group I (70 cases) used auto-local bone chips and group II (44 cases) used DBM as an additive to auto-local bone, 1 mL per a segment. Group selection was alternated. Early assessment was performed by computed tomography at 6 months and final assessment was done by simple radiography after 24 months at least. The degree of bone formation was assessed by 4 grade scale. Results The subjects of both groups were homogenous and had similar Oswestry Disability Index at final assessment. The ratio of auto-local bone chips and DBM was 6:1. The degree of bone formation at 6 months after surgery was superior in group II. However, there was no significant difference between the two groups at the final assessment. Conclusions DBM was not recognized to enhance auto-local bone with small amount. PMID:24761193

  7. [Successful chemoradiation therapy for local control of rectal cancer with multiple bone metastases--a case report].

    PubMed

    Nakamura, Tetsu; Kamigaki, Takashi; Takase, Shiro; Sakai, Tetsuya; Yamashita, Kimihiro; Sumi, Yasuo; Matsuda, Yoshiko; Imanishi, Tatsuya; Suzuki, Satoshi; Iwatani, Yoshiteru; Kuroda, Daisuke; Kuroda, Yoshikazu

    2009-11-01

    A 78-year-old man was admitted to our institute with the symptom of melena. The patient was diagnosed as having advanced rectal cancer (T4N2M1) with multiple bone metastases. Chemoradiation therapy was chosen for the local control because our proposal of colostomy was rejected. Concurrent chemoradiation therapy [46 Gy/23 Fr+tegafur/uraci (l UFT 400 mg/m2)/calcium folinate (Leucovorin: LV 75 mg/body)] resulted in a good partial response and the patient became asymptomatic. UFT/LV were administrated and most of the bone metastases were diminished. After 3 years of disease remission with good quality of life, local tumor recurred with the symptoms of melena and bowel obstruction. Colostomy and additional radiotherapy were performed for the palliation. He died after 4 years from the initial treatment. In advanced rectal cancer with distant metastases, chemoradiation therapy for local control plus systemic chemotherapy could be an alternative to improve quality of life. PMID:20037328

  8. Early tissue responses to zoledronate, locally delivered by bone screw, into a compromised cancellous bone site: a pilot study

    PubMed Central

    2014-01-01

    Background In fracture treatment, adequate fixation of implants is crucial to long-term clinical performance. Bisphosphonates (BP), potent inhibitors of osteoclastic bone resorption, are known to increase peri-implant bone mass and accelerate primary fixation. However, adverse effects are associated with systemic use of BPs. Thus, Zoledronic acid (ZOL) a potent BP was loaded on bone screws and evaluated in a local delivery model. Whilst mid- to long-term effects are already reported, early cellular events occurring at the implant/bone interface are not well described. The present study investigated early tissue responses to ZOL locally delivered, by bone screw, into a compromised cancellous bone site. Methods ZOL was immobilized on fibrinogen coated titanium screws. Using a bilateral approach, ZOL loaded test and non-loaded control screws were implanted into femoral condyle bone defects, created by an overdrilling technique. Histological analyses of the local tissue effects such as new bone formation and osteointegration were performed at days 1, 5 and 10. Results Histological evaluation of the five day ZOL group, demonstrated a higher osseous differentiation trend. At ten days an early influx of mesenchymal and osteoprogenitor cells was seen and a higher level of cellular proliferation and differentiation (p < 5%). In the ZOL group bone-to-screw contact and bone volume values within the defect tended to increase. Local drug release did not induce any adverse cellular effects. Conclusion This study indicates that local ZOL delivery into a compromised cancellous bone site actively supports peri-implant osteogenesis, positively affecting mesenchymal cells, at earlier time points than previously reported in the literature. PMID:24656151

  9. Increased bone formation in a rabbit long-bone defect model after single local and single systemic application of erythropoietin.

    PubMed

    Omlor, Georg W; Kleinschmidt, Kerstin; Gantz, Simone; Speicher, Anja; Guehring, Thorsten; Richter, Wiltrud

    2016-08-01

    Background and purpose - Delayed bone healing with non-union is a common problem. Further options to increase bone healing together with surgery are needed. We therefore evaluated a 1-dose single application of erythropoietin (EPO), applied either locally to the defect or systemically during surgery, in a critical-size rabbit long-bone defect. Material and methods - 19 New Zealand White rabbits received a 15-mm defect in the radius diaphysis. An absorbable gelatin sponge was soaked with saline (control group and systemic treatment group) or EPO (local treatment group) and implanted into the gap. The systemic treatment group received EPO subcutaneously. In vivo micro-CT analysis was performed 4, 8, and 12 weeks postoperatively. Vascularization was evaluated histologically. Results - Semiquantitative histomorphometric and radiological evaluation showed increased bone formation (2.3- to 2.5-fold) in both treatment groups after 12 weeks compared to the controls. Quantitative determination of bone volume and tissue volume showed superior bone healing after EPO treatment at all follow-up time points, with the highest values after 12 weeks in locally treated animals (3.0- to 3.4-fold). More vascularization was found in both EPO treatment groups. Interpretation - Initial single dosing with EPO was sufficient to increase bone healing substantially after 12 weeks of follow-up. Local application inside the defect was most effective, and it can be administered directly during surgery. Apart from effects on ossification, systemic and local EPO treatment leads to increased callus vascularization. PMID:27348783

  10. Locally administered T cells from mice immunized with lipopolysaccharide (LPS) accelerate LPS-induced bone resorption.

    PubMed

    Ozaki, Yukio; Ukai, Takashi; Yamaguchi, Masayuki; Yokoyama, Miho; Haro, Esperanza R Ayón; Yoshimoto, Mayumi; Kaneko, Takashi; Yoshinaga, Miho; Nakamura, Hirotaka; Shiraishi, Chiaki; Hara, Yoshitaka

    2009-06-01

    T cells play important roles in bone destruction and osteoclastogenesis and are found in chronic destructive bone lesions. Lipopolysaccharide (LPS) is one of several pathological factors involved in inflammatory bone destruction. We previously described the importance of T cells in the inflammatory bone resorption that occurs after repeated LPS administration. However, whether local or systemic T cells are important for inflammatory bone resorption and whether immunization of host animals influences bone resorption remain unclear. The present study examines the effects of local extant T cells from LPS-immunized mice on LPS-induced bone resorption. T cells from LPS-immunized or non-immunized mice were injected together with LPS into the gingival tissues of mice with severe combined immunodeficiency disease that lack both T and B cells. We histomorphometrically evaluated bone resorption at sites of T cell injections and examined the influence of T cells from LPS-immunized mice on osteoclastogenesis in vitro. We found that locally administered T cells from LPS-immunized but not non-immunized mice accelerated LPS-induced bone resorption in vivo. Moreover, T cells from LPS-immunized mice increased osteoclastogenesis in vitro induced by receptor activator of NF-kappa B ligand and LPS and anti-tumor necrosis factor (TNF)-alpha antibody inhibited this increase. These results demonstrated that local extant T cells accelerate inflammatory bone resorption. Furthermore, T cells from LPS-immunized mice appear to elevate LPS-induced bone resorption using TNF-alpha. PMID:19437611

  11. Sustained, localized salicylic acid delivery enhances diabetic bone regeneration via prolonged mitigation of inflammation.

    PubMed

    Yu, Weiling; Bien-Aime, Stephan; Mattos, Marcelo; Alsadun, Sarah; Wada, Keisuke; Rogado, Sarah; Fiorellini, Joseph; Graves, Dana; Uhrich, Kathryn

    2016-10-01

    Diabetes is a metabolic disorder caused by insulin resistance and/or deficiency and impairs bone quality and bone healing due to altered gene expression, reduced vascularization, and prolonged inflammation. No effective treatments for diabetic bone healing are currently available, and most existing treatments do not directly address the diabetic complications that impair bone healing. We recently demonstrated that sustained and localized delivery of salicylic acid (SA) via an SA-based polymer provides a low-cost approach to enhance diabetic bone regeneration. Herein, we report mechanistic studies that delve into the biological action and local pharmacokinetics of SA-releasing polymers shown to enhance diabetic bone regeneration. The results suggest that low SA concentrations were locally maintained at the bone defect site for more than 1 month. As a result of the sustained SA release, a significantly reduced inflammation was observed in diabetic animals, which in turn, yielded reduced osteoclast density and activity, as well as increased osteoblastogenesis. Based upon these results, localized and sustained SA delivery from the SA-based polymer effectively improved bone regeneration in diabetic animals by affecting both osteoclasts and osteoblasts, thereby providing a positive basis for clinical treatments. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2595-2603, 2016. PMID:27194511

  12. Strength through structure: visualization and local assessment of the trabecular bone structure

    NASA Astrophysics Data System (ADS)

    Räth, C.; Monetti, R.; Bauer, J.; Sidorenko, I.; Müller, D.; Matsuura, M.; Lochmüller, E.-M.; Zysset, P.; Eckstein, F.

    2008-12-01

    The visualization and subsequent assessment of the inner human bone structures play an important role for better understanding the disease- or drug-induced changes of bone in the context of osteoporosis giving prospect for better predictions of bone strength and thus of the fracture risk of osteoporotic patients. In this work, we show how the complex trabecular bone structure can be visualized using μCT imaging techniques at an isotropic resolution of 26 μm. We quantify these structures by calculating global and local topological and morphological measures, namely Minkowski functionals (MFs) and utilizing the (an-)isotropic scaling index method (SIM) and by deriving suitable texture measures based on MF and SIM. Using a sample of 151 specimens taken from human vertebrae in vitro, we correlate the texture measures with the mechanically measured maximum compressive strength (MCS), which quantifies the strength of the bone probe, by using Pearson's correlation coefficient. The structure parameters derived from the local measures yield good correlations with the bone strength as measured in mechanical tests. We investigate whether the performance of the texture measures depends on the MCS value by selecting different subsamples according to MCS. Considering the whole sample the results for the newly defined parameters are better than those obtained for the standard global histomorphometric parameters except for bone volume/total volume (BV/TV). If a subsample consisting only of weak bones is analysed, the local structural analysis leads to similar and even better correlations with MCS as compared to BV/TV. Thus, the MF and SIM yield additional information about the stability of the bone especially in the case of weak bones, which corroborates the hypothesis that the bone structure (and not only its mineral mass) constitutes an important component of bone stability.

  13. [A new case of African histoplasmosis with multiple localizations in the bones].

    PubMed

    Lecamus, J L; Ribault, L; Floch, J J

    1986-01-01

    Bone localizations of histoplasmosis at H. duboisii are frequent (1 out of 3). Multiple localizations, far less frequent but not exceptional, are immediately diagnosed at the occasion of a systematic X-Ray check-up, or later, as presented in this case. Multiple localizations give evidence of the septicaemic diffusion of the pathogenic agent. PMID:3773689

  14. Unusual Localization of a Primary Hydatid Cyst: Scaphoid Bone

    PubMed Central

    Serbest, Sancar; Tiftikci, Ugur; Uludag, Abuzer

    2016-01-01

    Abstract Because hydatidosis of the bone (echinococcus infection) is a rare parasitic infection, its diagnosis and treatment poses great difficulties. Radiologic imaging findings are generally helpful to make the diagnosis. But occurrence of disease in atypical places and lack of specific radiological findings may complicate differential diagnosis. Nevertheless, familiarity with imaging findings in patients living at endemic areas provides advantages for diagnosis and treatment. We present a cyst hydatic case in scaphoid bone which has been reported in the literature only once previously. PMID:27124019

  15. Local Mechanical Stimuli Regulate Bone Formation and Resorption in Mice at the Tissue Level

    PubMed Central

    Schulte, Friederike A.; Ruffoni, Davide; Lambers, Floor M.; Christen, David; Webster, Duncan J.; Kuhn, Gisela; Müller, Ralph

    2013-01-01

    Bone is able to react to changing mechanical demands by adapting its internal microstructure through bone forming and resorbing cells. This process is called bone modeling and remodeling. It is evident that changes in mechanical demands at the organ level must be interpreted at the tissue level where bone (re)modeling takes place. Although assumed for a long time, the relationship between the locations of bone formation and resorption and the local mechanical environment is still under debate. The lack of suitable imaging modalities for measuring bone formation and resorption in vivo has made it difficult to assess the mechanoregulation of bone three-dimensionally by experiment. Using in vivo micro-computed tomography and high resolution finite element analysis in living mice, we show that bone formation most likely occurs at sites of high local mechanical strain (p<0.0001) and resorption at sites of low local mechanical strain (p<0.0001). Furthermore, the probability of bone resorption decreases exponentially with increasing mechanical stimulus (R2 = 0.99) whereas the probability of bone formation follows an exponential growth function to a maximum value (R2 = 0.99). Moreover, resorption is more strictly controlled than formation in loaded animals, and ovariectomy increases the amount of non-targeted resorption. Our experimental assessment of mechanoregulation at the tissue level does not show any evidence of a lazy zone and suggests that around 80% of all (re)modeling can be linked to the mechanical micro-environment. These findings disclose how mechanical stimuli at the tissue level contribute to the regulation of bone adaptation at the organ level. PMID:23637993

  16. Immunohistochemical localization of tenascin-C in rat periodontal ligament with reference to alveolar bone remodeling.

    PubMed

    Sato, Rei; Fukuoka, Hiroki; Yokohama-Tamaki, Tamaki; Kaku, Masaru; Shibata, Shunichi

    2016-03-01

    We investigated the immunohistochemical localization of tenascin-C in 8-week-old rat periodontal ligaments. Tenascin-C immunoreactivity was detected in zones along with cementum and alveolar bone, and more intensely on the resorption surface of alveolar bone than on the formation surface. On the resorbing surface, tenascin-C immunoreactivity was detected in Howship's lacunae without osteoclasts, and in the interfibrous space of the periodontal ligaments, indicating that this molecule works as an adhesion molecule between bone and fibers of periodontal ligaments. Upon experimental tooth movement by inserting elastic bands (Waldo method), the physiological resorption surface of alveolar bone under compressive force showed enhanced bone resorption and enhanced tenascin-C immunoreactivity. However, on the physiological bone formation surface under compressive force, bone resorption was seen only occasionally, and no enhanced tenascin-C immunoreactivity was noted. In an experiment involving excessive occlusal loading to rat molars, transient bone resorption occurred within interradicular septa, but no enhanced tenascin-C immunoreactivity was seen in the periodontal ligaments. These results indicate that tenascin-C works effectively on the bone resorbing surface of physiological alveolar bone remodeling sites, rather than on the non-physiological transient bone resorbing surface. Fibronectin immunoreactivity was distributed evenly in the periodontal ligaments under experimental conditions. Co-localization of tenascin-C and fibronectin immunoreactivity was observed in many regions, but mutually exclusive expression patterns were also seen in some regions, indicating that fibronectin might not be directly involved in alveolar bone remodeling, but may play a role via interaction with tenascin-C. PMID:25957016

  17. Bone as a stable isotope archive for local climatic information

    NASA Astrophysics Data System (ADS)

    Hedges, Robert E. M.; Stevens, Rhiannon E.; Richards, Michael. P.

    2004-04-01

    This brief review outlines the contribution that the study of stable isotope composition in bone can make to palaeoclimatic investigation, with the focus almost entirely restricted to the last 50,000 years in NW Europe. Bone can provide a useful archive of the prevailing isotopic condition, and represents a quite different, and often less specialised, sampling of the environment than most other archives. On the other hand, chronological sequences—and dating generally—can be a problem, and the link between the isotopic value registered in the bone, and the environmental conditions which gave rise to it, is both complex and not fully understood. Carbon, oxygen and nitrogen isotopes are all available from bone (nitrogen only where sufficient protein (collagen) survives), and are all subject, in different ways, to climatic influences such as temperature, rainfall, changes in floristic composition, and soil chemistry. These are all briefly discussed, and the datasets that are being published are considered in the context of the environmental information they provide. Undoubtedly environmental signals are recoverable, but their interpretation is still primitive. A dataset for carbon and nitrogen isotope composition of herbivores that spans the last 50,000 years is shown together with some of the issues it raises.

  18. Modeling orthotropic elasticity, localized plasticity and fracture in trabecular bone

    NASA Astrophysics Data System (ADS)

    O'Connor, D. T.; Elkhodary, K. I.; Fouad, Y.; Greene, M. S.; Sabet, F. A.; Qian, J.; Zhang, Y.; Liu, W. K.; Jasiuk, I.

    2016-05-01

    This work develops a model for the mechanical response of trabecular bone including plasticity, damage and fracture. It features a resultant lamellar orientation that captures trabecular strut anisotropic elasticity, and introduces asymmetric J2 plasticity with isotropic hardening to capture evolving strut tensile and compressive dissipative properties. A continuum compatibility based damage and fracture criterion is also proposed to model fracture surface generation. We investigated fracture of a trabecular bone network under a compressive load, for which failure modes of both tension and compression were identified at the strut level. The predicted trabecular network response was found to fall within the range of experimental results reported in literature. We also investigated the response of idealized struts under compression, tension and bending using our model. Individual struts were found to exhibit micro-buckling under compression and micro-necking under tension. These instabilities are however masked by the multiplicity and complexity of strut orientations at the trabecular network level.

  19. Modeling orthotropic elasticity, localized plasticity and fracture in trabecular bone

    NASA Astrophysics Data System (ADS)

    O'Connor, D. T.; Elkhodary, K. I.; Fouad, Y.; Greene, M. S.; Sabet, F. A.; Qian, J.; Zhang, Y.; Liu, W. K.; Jasiuk, I.

    2016-09-01

    This work develops a model for the mechanical response of trabecular bone including plasticity, damage and fracture. It features a resultant lamellar orientation that captures trabecular strut anisotropic elasticity, and introduces asymmetric J2 plasticity with isotropic hardening to capture evolving strut tensile and compressive dissipative properties. A continuum compatibility based damage and fracture criterion is also proposed to model fracture surface generation. We investigated fracture of a trabecular bone network under a compressive load, for which failure modes of both tension and compression were identified at the strut level. The predicted trabecular network response was found to fall within the range of experimental results reported in literature. We also investigated the response of idealized struts under compression, tension and bending using our model. Individual struts were found to exhibit micro-buckling under compression and micro-necking under tension. These instabilities are however masked by the multiplicity and complexity of strut orientations at the trabecular network level.

  20. In Vitro Fracture of Human Cortical Bone: Local Fracture Criteria and Toughening Mechanisms

    SciTech Connect

    Nalla, R; Stolken, J; Kinney, J; Ritchie, R

    2004-08-18

    A micro-mechanistic understanding of bone fracture that encompasses how cracks interact with the underlying microstructure and defines their local failure mode is lacking, despite extensive research on the response of bone to a variety of factors like aging, loading, and/or disease. Micro-mechanical models for fracture incorporating such local failure criteria have been widely developed for metallic and ceramic materials systems; however, few such deliberations have been undertaken for the fracture of bone. In fact, although the fracture event in mineralized tissues such as bone is commonly believed to be locally strain controlled, until recently there has been little experimental evidence to support this widely held belief. In the present study, a series of in vitro experiments involving a double-notch bend test geometry are performed in order to shed further light on the nature of the local cracking events that precede catastrophic fracture in bone and to define their relationship to the microstructure. Specifically, crack-microstructure interactions are examined to determine the salient toughening mechanisms in human cortical bone and to characterize how these may affect the anisotropy in fracture properties. Based on preliminary micro-mechanical models of these processes, in particular crack deflection and uncracked ligament bridging, the relative importance of these toughening mechanisms is established.

  1. A reconciliation of local and global models for bone remodeling through optimization theory.

    PubMed

    Subbarayan, G; Bartel, D L

    2000-02-01

    Remodeling rules with either a global or a local mathematical form have been proposed for load-bearing bones in the literature. In the local models, the bone architecture (shape, density) is related to the strains/energies sensed at any point in the bone, while in the global models, a criterion believed to be applicable to the whole bone is used. In the present paper, a local remodeling rule with a strain "error" form is derived as the necessary condition for the optimum of a global remodeling criterion, suggesting that many of the local error-driven remodeling rules may have corresponding global optimization-based criteria. The global criterion proposed in the present study is a trade-off between the cost of metabolic growth and use, mathematically represented by the mass, and the cost of failure, mathematically represented by the total strain energy. The proposed global criterion is shown to be related to the optimality criteria methods of structural optimization by the equivalence of the model solution and the fully stressed solution for statically determinate structures. In related work, the global criterion is applied to simulate the strength recovery in bones with screw holes left behind after removal of fracture fixation plates. The results predicted by the model are shown to be in good agreement with experimental results, leading to the conclusion that load-bearing bones are structures with optimal shape and property for their function. PMID:10790832

  2. Development of a protocol to quantify local bone adaptation over space and time: Quantification of reproducibility.

    PubMed

    Lu, Yongtao; Boudiffa, Maya; Dall'Ara, Enrico; Bellantuono, Ilaria; Viceconti, Marco

    2016-07-01

    In vivo micro-computed tomography (µCT) scanning of small rodents is a powerful method for longitudinal monitoring of bone adaptation. However, the life-time bone growth in small rodents makes it a challenge to quantify local bone adaptation. Therefore, the aim of this study was to develop a protocol, which can take into account large bone growth, to quantify local bone adaptations over space and time. The entire right tibiae of eight 14-week-old C57BL/6J female mice were consecutively scanned four times in an in vivo µCT scanner using a nominal isotropic image voxel size of 10.4µm. The repeated scan image datasets were aligned to the corresponding baseline (first) scan image dataset using rigid registration. 80% of tibia length (starting from the endpoint of the proximal growth plate) was selected as the volume of interest and partitioned into 40 regions along the tibial long axis (10 divisions) and in the cross-section (4 sectors). The bone mineral content (BMC) was used to quantify bone adaptation and was calculated in each region. All local BMCs have precision errors (PE%CV) of less than 3.5% (24 out of 40 regions have PE%CV of less than 2%), least significant changes (LSCs) of less than 3.8%, and 38 out of 40 regions have intraclass correlation coefficients (ICCs) of over 0.8. The proposed protocol allows to quantify local bone adaptations over an entire tibia in longitudinal studies, with a high reproducibility, an essential requirement to reduce the number of animals to achieve the necessary statistical power. PMID:27262181

  3. Influence of whole body irradiation and local shielding on matrix-induced endochondral bone differentiation.

    PubMed

    Wientroub, S; Weiss, J F; Catravas, G N; Reddi, A H

    1990-01-01

    Subcutaneous implantation of demineralized bone matrix into allogeneic rats induces endochondral bone formation. We have investigated the effects of irradiation on the sequelae of the interaction of collagenous matrix and mesenchymal cells and on cartilage and bone differentiation. Rats were irradiated in a vertical direction with a midline dose of 850 rad. Radiation entered the rats ventrally while a small area of the upper thorax was locally shielded. After irradiation, bone matrix was implanted in shielded and nonshielded sites, and the implants were studied at various stages. On day 3, [3H]thymidine incorporation, an index of cell proliferation, was inhibited by 70% in the nonshielded sites compared to nonirradiated control rats. The degree of inhibition (35%) was less pronounced in shielded sites. Furthermore, there was recovery of cell proliferation in the shielded sites as opposed to the nonshielded contralateral site. A similar pattern was observed on day 7 as assessed by 35SO4 incorporation into proteoglycans during chondrogenesis. Bone formation and mineralization were quantified on day 11 by alkaline phosphatase activity and 45Ca incorporation. In nonshielded sites, there was a 73% inhibition of alkaline phosphatase activity. In conclusion, radiation impaired progenitor cell proliferation which resulted in decreased cartilage and bone differentiation. These findings imply that local mesenchymal cells proliferate and differentiate into bone in response to implanted collagenous matrix. PMID:2104773

  4. Navicular tuberculosis: A rare localization of bone tuberculosis

    PubMed Central

    Lemnouer, Abdelhay; Frikh, Mohammed; Belfquih, Bouchra; Jaafar, Abdelwahab; Bouya, Ayoub; Jidal, Mohamed; Boussouga, Mustapha; Elouennass, Mostafa

    2015-01-01

    Tuberculosis (TB) is a global public health problem endemic to Morocco. While extrapulmonary TB uncommonly presents in osteoarticular anatomic locations, tarsal or metatarsal osteitis can occur when TB presents in the tarsal bones. Clinical symptoms are often insidious causing a delay in diagnosis that may lead to bone destruction. While diagnosis can be guided by X-ray imaging, bacteriologic and histologic examination of the tissue allows for pathogen isolation, identification of the bacillus and strain sensitivity to antibacillary treatment. We report a rare case of navicular osteitis associated with tarso-metatarsal arthritis caused by tuberculosis in a 68-year-old man. This case illustrates an exceptional location of osteoarticular TB and support diagnostic difficulties encountered: (i) imaging is not specific; (ii) lesions are paucibacillary which reduces conventional microbiological methods sensitivity and (iii) the peripheral location of the Koch bacillus within the lesion dictates surgical biopsy than percutaneous puncture. We recommend testing for tuberculosis in any case of chronic osteolysis and/or arthritis of the foot, especially in TB endemic countries. PMID:26793464

  5. Bone induction at physiological doses of BMP through localization by clay nanoparticle gels.

    PubMed

    Gibbs, D M R; Black, C R M; Hulsart-Billstrom, G; Shi, P; Scarpa, E; Oreffo, R O C; Dawson, J I

    2016-08-01

    Bone Morphogenic Protein 2 (BMP2) can induce ectopic bone. This ability, which first motivated the widespread application of BMP2 in fracture healing and spinal arthrodesis has, more recently, been indicated as one of several serious adverse effects associated with the supra-physiological doses of BMP2 relied upon for clinical efficacy. Key to harnessing BMPs and other agents safely and effectively will be the ability to localize activity at a target site at substantially reduced doses. Clay (Laponite) nanoparticles can self assemble into gels under physiological conditions and bind growth factors for enhanced and localized efficacy. Here we show the ability to localize and enhance the activity of BMP2 to achieve ectopic bone formation at doses within the sub-microgram per ml range of concentrations sufficient to induce differentiation of responsive cell populations in vitro and at approximately 3000 fold lower than those employed in clinical practice. PMID:27209259

  6. Scaphoid fracture fixation: localization of bones through statistical model to ultrasound registration

    NASA Astrophysics Data System (ADS)

    Anas, Emran Mohammad Abu; Rasoulian, Abtin; St. John, Paul; Pichora, David; Mousavi, Parvin; Lessoway, Victoria A.; Seitel, Alexander; Hacihaliloglu, Ilker; Rohling, Robert; Abolmaesumi, Purang

    2015-03-01

    Percutaneous treatment of scaphoid fractures has found increasing interest in recent years as it promises to minimize soft-tissue damage, and minimizes the risk of infections and the loss of the joint stability. However, as this procedure is mostly performed on 2D fluoroscopic images, the accurate localization of the scaphoid bone for fracture fixation renders extremely challenging. In this work, we thus propose the integration of a statistical wrist model with 3D intraoperative ultrasound for accurate localization of the scaphoid bone. We utilize a previously developed statistical wrist model and register it to bone surfaces in ultrasound images using a probabilistic approach that involves expectation-maximization. We utilize local phase symmetry to detect features in noisy ultrasound images; in addition, we use shadow information in ultrasound images to enhance and set apart bone from other features. Feasibility experiments are performed by registering the wrist model to 3D ultrasound volumes of two different wrists at two different wrist positions. And the result indicates a potential of the proposed technique for localization of the scaphoid bone in ultrasound images.

  7. Localized CCR2 Activation in the Bone Marrow Niche Mobilizes Monocytes by Desensitizing CXCR4

    PubMed Central

    Park, Jeong Eun; Miller, Richard J.

    2015-01-01

    Inflammatory (classical) monocytes residing in the bone marrow must enter the bloodstream in order to combat microbe infection. These monocytes express high levels of CCR2, a chemokine receptor whose activation is required for them to exit the bone marrow. How CCR2 is locally activated in the bone marrow and how their activation promotes monocyte egress is not understood. Here, we have used double transgenic lines that can visualize CCR2 activation in vivo and show that its chemokine ligand CCL2 is acutely released by stromal cells in the bone marrow, which make direct contact with CCR2-expressing monocytes. These monocytes also express CXCR4, whose activation immobilizes cells in the bone marrow, and are in contact with stromal cells expressing CXCL12, the CXCR4 ligand. During the inflammatory response, CCL2 is released and activates the CCR2 on neighboring monocytes. We demonstrate that acutely isolated bone marrow cells co-express CCR2 and CXCR4, and CCR2 activation desensitizes CXCR4. Inhibiting CXCR4 by a specific receptor antagonist in mice causes CCR2-expressing cells to exit the bone marrow in absence of inflammatory insults. Taken together, these results suggest a novel mechanism whereby the local activation of CCR2 on monocytes in the bone marrow attenuates an anchoring signalling provided by CXCR4 expressed by the same cell and mobilizes the bone marrow monocyte to the blood stream. Our results also provide a generalizable model that cross-desensitization of chemokine receptors fine-tunes cell mobility by integrating multiple chemokine signals. PMID:26029924

  8. Localized experimental bone metastasis drives osteolysis and sensory hypersensitivity at distant non-tumor-bearing sites.

    PubMed

    Abdelaziz, Dareen M; Stone, Laura S; Komarova, Svetlana V

    2015-08-01

    Patients with breast cancer metastasis to bone suffer from inadequate pain relief. Animal models provide increased understanding of cancer-induced bone and sensory alterations. The objective of this study was to investigate the measures of pain at distant non-tumor-bearing sites in animals with localized bone metastasis. Immunocompetent BALB/c mice are injected intra-tibially with murine mammary carcinoma cells (4T1) or saline, and the sensitivity to mechanical and thermal stimuli in the contralateral paw was examined. In addition to previously demonstrated development of osteolysis and hypersensitivity to mechanical and thermal stimuli in the cancer-injected tibia, these animals exhibited an increase in sensory hypersensitivity in the contralateral limb. No bone lesions were evident on radiographs of the contralateral limbs. Histomorphometry detected decreased bone volume per tissue volume and increased osteoclast number in the contralateral tibia and vertebral bones of cancer-bearing animals. Neuroplasticity was examined by immunofluorescence for calcitonin gene-related peptide (CGRP) in sensory neurons and glial fibrillary acidic protein (GFAP) in lumbar spinal cords. CGRP-immunoreactivity and GFAP-immunoreactivity were significantly elevated both ipsilateral and contralateral in tumor-bearing animals. The anti-inflammatory and osteolysis-targeting drug rapamycin reduced hypersensitivity to mechanical and cold stimuli, attenuated GFAP over-expression, and lowered osteoclast number. The osteoclast-targeting drug pamidronate reduced sensitivity to cold and protected against bone loss. Localized bone cancer drives hypersensitivity, bone remodeling, and sensory neuron plasticity at sites distant from the primary tumor area. Drugs targeting these mechanisms may be useful in the treatment of pain distant from the primary tumor site. PMID:26208488

  9. Biocompatibility and manageability of a new fixable bone graft for the treatment of localized bone defects: preliminary study in a dog model.

    PubMed

    Fontana, Filippo; Rocchietta, Isabella; Dellavia, Claudia; Nevins, Myron; Simion, Massimo

    2008-12-01

    The present investigation was performed to compare the biocompatibility, safety, and manageability of a newly developed bone block and a deproteinized bovine bone block (Bio-Oss) for the treatment of localized bone defects in a dog model. Two male beagle dogs were used for this study. The mandibular premolars were extracted and two saddle-type defects were created bilaterally in the edentulous area. The defects were filled according to a randomized design with Bio-Oss bone block or with an equine hydroxyapatite plus collagen bone block (eHAC). Most control and test sites developed dehiscences during healing. After 4 weeks, the animals were euthanized and each hemimandible was prepared for histologic examination. No significant difference in terms of local tolerance was observed between test and control sites, and test and control sites showed similar histologic findings. However, a significant difference was noticed between the Bio-Oss block and the new bone block in terms of manageability. PMID:19146056

  10. Is there a relation between local bone quality as assessed on panoramic radiographs and alveolar bone level?

    PubMed

    Nackaerts, Olivia; Gijbels, Frieda; Sanna, Anna-Maria; Jacobs, Reinhilde

    2008-03-01

    The aim was to explore the relation between radiographic bone quality on panoramic radiographs and relative alveolar bone level. Digital panoramic radiographs of 94 female patients were analysed (mean age, 44.5; range, 35-74). Radiographic density of the alveolar bone in the premolar region was determined using Agfa Musica software. Alveolar bone level and bone quality index (BQI) were also assessed. Relationships between bone density and BQI on one hand and the relative loss of alveolar bone level on the other were assessed. Mandibular bone density and loss of alveolar bone level were weakly but significantly negatively correlated for the lower premolar area (r = -.27). The BQI did not show a statistically significant relation to alveolar bone level. Radiographic mandibular bone density on panoramic radiographs shows a weak but significant relation to alveolar bone level, with more periodontal breakdown for less dense alveolar bone. PMID:17690924

  11. The use of liquid nitrogen cryotherapy in the management of locally aggressive bone lesions.

    PubMed

    Pogrel, M A

    1993-03-01

    Cryosurgery has a unique role in the management of locally aggressive osseous lesions. By using a combination of enucleation and cryosurgery to devitalize the surrounding bone, the need for segmental mandibular resection is decreased. This article reviews 37 cases managed successfully in this manner. PMID:8445469

  12. Stress fractures and bone pain

    SciTech Connect

    Groshar, D.; Even-Sapir, E.; Lam, M.; Israel, O.; Front, D.

    1984-01-01

    Stress fractures result from an unusual repetitive physical activity causing absorption of bone in excess of repair and bone formation. This leads to the weakening of the bone and subsequently to a fracture. It is a benign condition that if recognized in time does not need any treatment besides rest. However, if diagnosis is not made and physical activity continues it may result in severe injury to the bone and a frank fracture may result. Pain is the typical clinical feature and bone scintigraphy, being more sensitive than radiography, is done to establish early diagnosis. The presence of asymptomatic sites of abnormal bone uptake typical of stress fracture in which pain appeared only about 2 weeks after scintigraphy, drew the authors' attention to the question of how close is the relationship between stress fractures and bone pain. Sixty-four military recruits diagnosed as suffering from stress fracture were investigated in order to correlate sites with abnormal uptake of Tc-99m MDP on bone scintigraphy with sites of local pain. In 37 (58%) subjects multiple sites of abnormal uptake were recognised. Of 123 sites of abnormal uptake, 31 (25%) were asymptomatic. In three patients bone pain appeared at the site of the abnormal uptake two weeks after scintigraphy. Bone scintigraphy appears to be more sensitive than bone pain in the diagnosis of stress fractures. The osteoblastic activity which manifests itself by abnormal uptake appears in some cases earlier than the pain caused by the fracture. Present findings may suggest that under certain circumstances, in a population prone to stress fracture, bone scan should be considered as a screening method.

  13. Increased EZH2 and decreased osteoblastogenesis during local irradiation-induced bone loss in rats

    PubMed Central

    Guo, Changjun; Li, Changwei; Yang, Kai; Kang, Hui; Xu, Xiaoya; Xu, Xiangyang; Deng, Lianfu

    2016-01-01

    Radiation therapy is commonly used to treat cancer patients but exhibits adverse effects, including insufficiency fractures and bone loss. Epigenetic regulation plays an important role in osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Here, we reported local bone changes after single-dose exposure to 137CS irradiation in rats. Femur bone mineral density (BMD) and trabecular bone volume in the tibia were significantly decreased at 12 weeks after irradiation. Micro-CT results showed that tBMD, Tb.h and Tb.N were also significantly reduced at 12 weeks after irradiation exposure. ALP-positive OB.S/BS was decreased by 42.3% at 2 weeks after irradiation and was decreased by 50.8% at 12 weeks after exposure. In contrast to the decreased expression of Runx2 and BMP2, we found EZH2 expression was significantly increased at 2 weeks after single-dose 137CS irradiation in BMSCs. Together, our results demonstrated that single-dose 137CS irradiation induces BMD loss and the deterioration of bone microarchitecture in the rat skeleton. Furthermore, EZH2 expression increased and osteoblastogenesis decreased after irradiation. The underlying mechanisms warrant further investigation. PMID:27499068

  14. Increased EZH2 and decreased osteoblastogenesis during local irradiation-induced bone loss in rats.

    PubMed

    Guo, Changjun; Li, Changwei; Yang, Kai; Kang, Hui; Xu, Xiaoya; Xu, Xiangyang; Deng, Lianfu

    2016-01-01

    Radiation therapy is commonly used to treat cancer patients but exhibits adverse effects, including insufficiency fractures and bone loss. Epigenetic regulation plays an important role in osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Here, we reported local bone changes after single-dose exposure to (137)CS irradiation in rats. Femur bone mineral density (BMD) and trabecular bone volume in the tibia were significantly decreased at 12 weeks after irradiation. Micro-CT results showed that tBMD, Tb.h and Tb.N were also significantly reduced at 12 weeks after irradiation exposure. ALP-positive OB.S/BS was decreased by 42.3% at 2 weeks after irradiation and was decreased by 50.8% at 12 weeks after exposure. In contrast to the decreased expression of Runx2 and BMP2, we found EZH2 expression was significantly increased at 2 weeks after single-dose (137)CS irradiation in BMSCs. Together, our results demonstrated that single-dose (137)CS irradiation induces BMD loss and the deterioration of bone microarchitecture in the rat skeleton. Furthermore, EZH2 expression increased and osteoblastogenesis decreased after irradiation. The underlying mechanisms warrant further investigation. PMID:27499068

  15. Local delivery of controlled-release simvastatin/PLGA/HAp microspheres enhances bone repair

    PubMed Central

    Tai, I-Chun; Fu, Yin-Chih; Wang, Chih-Kuang; Chang, Je-Ken; Ho, Mei-Ling

    2013-01-01

    Statins are used clinically for reduction of cholesterol synthesis to prevent cardiovascular disease. Previous in vitro and in vivo studies have shown that statins stimulate bone formation. However, orally administered statins may be degraded during first-pass metabolism in the liver. This study aimed to prevent this degradation by developing a locally administered formulation of simvastatin that is encapsulated in poly(lactic-co-glycolic acid)/hydroxyapatite (SIM/PLGA/HAp) microspheres with controlled-release properties. The effect of this formulation of simvastatin on bone repair was tested using a mouse model of gap fracture bridging with a graft of necrotic bone. The simvastatin released over 12 days from 3 mg and 5 mg of SIM/PLGA/HAp was 0.03–1.6 μg/day and 0.05–2.6 μg/day, respectively. SIM/PLGA/HAp significantly stimulated callus formation around the repaired area and increased neovascularization and cell ingrowth in the grafted necrotic bone at week 2 after surgery. At week 4, both 3 mg and 5 mg of SIM/PLGA/HAp increased neovascularization, but only 5 mg SIM/PLGA/HAp enhanced cell ingrowth into the necrotic bone. The low dose of simvastatin released from SIM/PLGA/HAp enhanced initial callus formation, neovascularization, and cell ingrowth in the grafted bone, indicating that SIM/PLGA/HAp facilitates bone regeneration. We suggest that SIM/PLGA/HAp should be developed as an osteoinductive agent to treat osteonecrosis or in combination with an osteoconductive scaffold to treat severe bone defects. PMID:24143094

  16. Osteoclastogenesis in Local Alveolar Bone in Early Decortication-Facilitated Orthodontic Tooth Movement

    PubMed Central

    Liu, Chang; Jiang, Yu-Xi; Qu, Hong; Li, Cui-Ying; Jiang, Jiu-Hui

    2016-01-01

    Objective In the current study, we aimed to investigate the effects of alveolar decortication on local bone remodeling, and to explore the possible mechanism by which decortication facilitates tooth movement. Materials and Methods Forty rabbits were included in the experiment. The left mandible was subjected to decortication-facilitated orthodontics, and the right mandible underwent traditional orthodontics as a control. The animals were sacrificed on the days 1, 3, 5, 7 and 14, after undergoing orthodontic procedures. Tooth movement was measured by Micro-CT, and the local periodontal tissues were investigated using H&E, Masson's trichrome and tartrate-resistant acid phosphatase (TRAP) staining. The mRNA levels of genes related to bone remodeling in the alveolar bone were analyzed using real-time PCR. Result On days 3, 5, 7 and 14, tooth movement was statistically accelerated by decortication (P < 0.05) and was accompanied by increased hyperemia. Despite the lack of new bone formation in both groups, more osteoclasts were noted in the decorticated group, with two peak counts (P < 0.05). The first peak count was consistent with the maximum values of ctsk and TRAP expression, and the second peak counts accompanied the maximum nfatc1 and jdp2 expression. The increased fra2 expression and the ratio of rankl/opg also accompanied the second peak counts. Conclusions Following alveolar decortication, osteoclastogenesis was initially induced to a greater degree than the new bone formation which was thought to have caused a regional acceleratory phenomenon (RAP). The amount of steoclastogenesis in the decorticated alveolar bone was found to have two peaks, perhaps due to attenuated local resistance. The first peak count in osteoclasts may have been due to previously existing osteoclast precursors, whereas the second may represent the differentiation of peripheral blood mononuclear cells which came from circulation as the result of hyperemia. PMID:27096621

  17. Calcium sensing and cell signaling processes in the local regulation of osteoclastic bone resorption.

    PubMed

    Zaidi, Mone; Moonga, Baljit S; Huang, Christopher L H

    2004-02-01

    The skeletal matrix in terrestrial vertebrates undergoes continual cycles of removal and replacement in the processes of bone growth, repair and remodeling. The osteoclast is uniquely important in bone resorption and thus is implicated in the pathogenesis of clinically important bone and joint diseases. Activated osteoclasts form a resorptive hemivacuole with the bone surface into which they release both acid and osteoclastic lysosomal hydrolases. This article reviews cell physiological studies of the local mechanisms that regulate the resorptive process. These used in vitro methods for the isolation, culture and direct study of the properties of neonatal rat osteoclasts. They demonstrated that both local microvascular agents and products of the bone resorptive process such as ambient Ca2+ could complement longer-range systemic regulatory mechanisms such as those that might be exerted through calcitonin (CT). Thus elevated extracellular [Ca2+], or applications of surrogate divalent cation agonists for Ca2+, inhibited bone resorptive activity and produced parallel increases in cytosolic [Ca2+], cell retraction and longer-term inhibition of enzyme release in isolated rat osteoclasts. These changes showed specificity, inactivation, and voltage-dependent properties that implicated a cell surface Ca2+ receptor (CaR) sensitive to millimolar extracellular [Ca2+]. Pharmacological, biophysical and immunochemical evidence implicated a ryanodine-receptor (RyR) type II isoform in this process and localized it to a unique, surface membrane site, with an outward-facing channel-forming domain. Such a surface RyR might function either directly or indirectly in the process of extracellular [Ca2+] sensing and in turn be modulated by cyclic adenosine diphosphate ribose (cADPr) produced by the ADP-ribosyl cyclase, CD38. The review finishes by speculating about possible detailed models for these transduction events and their possible interactions with other systemic mechanisms involved

  18. Local delivery of nitric oxide: targeted delivery of therapeutics to bone and connective tissues

    PubMed Central

    Nichols, Scott P.; Storm, Wesley L.; Koh, Ahyeon; Schoenfisch, Mark H.

    2012-01-01

    Non-invasive treatment of injuries and disorders affecting bones and connective tissue is a significant challenge facing the medical community. A treatment route that has recently been proposed is nitric oxide (NO) therapy. Nitric oxide plays several roles in physiology with many conditions lacking adequate levels of NO. As NO is a radical, localized delivery via NO donors is essential to promoting biological activity. Herein, we review current literature related to therapeutic NO delivery in the treatment of bone, skin and tendon repair. PMID:22433782

  19. [Intraoperative extracorporeal irradiation and replantation in local treatment of primary malignant bone tumors].

    PubMed

    Sabo, D; Bernd, L; Buchner, M; Treiber, M; Wannenmacher, M; Ewerbeck, V; Parsch, D

    2003-11-01

    In 13 patients with primary malignant bone tumors (10 Ewing's sarcoma, 1 parosteal osteosarcoma, 1 adamantinoma recurrence, and 1 MFH) local therapy was performed as intraoperative extracorporeal irradiation and replantation (IEIR) of the involved bone segment (5 tibia, 2 femur, and 6 pelvis). Of the 13 patients (69%), 9 are alive at the time of the follow-up (5 CDF, 4 AWM(treated)) and 4 patients died of disease (DOD). Up to now during the follow-up of 32 months (6-57), no local recurrence was observed in the replanted bone segments. The complication rate was very high (18 complications in 11 of the 13 patients, including 6 cases with complication V degrees according to Ruggieri with loss of the reconstruction). The typical complication is severe local infection necessitating removal of the replant. In cases of mechanical failure, the replanted segment could mostly be preserved by surgical revision and autologous bone grafting. If serious complications can be managed or avoided, functional results can be achieved. IEIR must be seen as an extraordinary reconstruction procedure in cases where established procedures such as endoprosthesis, biological reconstructions, or rotationplasties cannot be used or are refused by the patient. PMID:14615850

  20. TLR4 drives the pathogenesis of acquired cholesteatoma by promoting local inflammation and bone destruction

    PubMed Central

    Si, Yu; Chen, Yu Bin; Chen, Sui Jun; Zheng, Yi Qing; Liu, Xiang; Liu, Yi; Jiang, Huai Li; Xu, Guo; Li, Zhuo Hao; Huang, Qiu Hong; Xiong, Hao; Zhang, Zhi Gang

    2015-01-01

    Acquired cholesteatoma is a chronic inflammatory disease characterized by both hyperkeratinized squamous epithelial overgrowth and bone destruction. Toll-like receptor (TLR) activation and subsequent inflammatory cytokine production are closely associated with inflammatory bone disease. However, the expression and function of TLRs in cholesteatoma remain unclear.We observed inflammatory cell infiltration of the matrix and prematrix of human acquired cholesteatoma, as well as dramatically increased expression of TLR4 and the pro-inflammatory cytokines TNF-α and IL-1β. TLR2 exhibited an up-regulation that was not statistically significant. TLR4 expression in human acquired cholesteatoma correlated with disease severity; the number of TLR4-positive cells increased with an increased degree of cholesteatoma, invasion, bone destruction, and hearing loss. Moreover, TLR4 deficiency was protective against experimental acquired cholesteatoma-driven bone destruction and hearing loss, as it reduced local TNF-α and IL-1β expression and impaired osteoclast formation by decreasing expression of the osteoclast effectors receptor activator of nuclear factor (NF)-κB ligand (RANKL) and tartrate-resistant acid phosphatase (TRAP). TLR2 deficiency did not relieve disease severity, inflammatory responses, or osteoclast formation. Moreover, neither TLR2 nor TLR4 deficiency had an effect on antimicrobial peptides, inducible iNOS,BD-2 expression or bacterial clearance. Therefore, TLR4 may promote cholesteatoma-induced bone destruction and deafness by enhancing inflammatory responses and osteoclastogenesis. PMID:26639190

  1. Bone segmentation and fracture detection in ultrasound using 3D local phase features.

    PubMed

    Hacihaliloglu, Ilker; Abugharbieh, Rafeef; Hodgson, Antony; Rohling, Robert

    2008-01-01

    3D ultrasound (US) is increasingly considered as a viable alternative imaging modality in computer-assisted orthopaedic surgery (CAOS) applications. Automatic bone segmentation from US images, however, remains a challenge due to speckle noise and various other artifacts inherent to US. In this paper, we present intensity invariant three dimensional (3D) local image phase features, obtained using 3D Log-Gabor filter banks, for extracting ridge-like features similar to those that occur at soft tissue/bone interfaces. Our contributions include the novel extension of 2D phase symmetry features to 3D and their use in automatic extraction of bone surfaces and fractured fragments in 3D US. We validate our technique using phantom, in vitro, and in vivo experiments. Qualitative and quantitative results demonstrate remarkably clear segmentations results of bone surfaces with a localization accuracy of better than 0.62 mm and mean errors in estimating fracture displacements below 0.65 mm, which will likely be of strong clinical utility. PMID:18979759

  2. Local delivery of a selective androgen receptor modulator failed as an anabolic agent in a rat bone marrow ablation model

    PubMed Central

    Aro, Hannu T; Kulkova, Julia; Moritz, Niko; Kähkönen, Esa; Mattila, Riina H

    2015-01-01

    Background and purpose — Selective androgen receptor modulators (SARMs) have been developed to have systemic anabolic effects on bones and muscles without the adverse effects of steroidal androgens. One unexplored therapeutic option is the targeted application of SARMs for the enhancement of local new bone formation. We evaluated the osteogenic efficacy of a locally released SARM (ORM-11984). Methods — ORM-11984 was mixed with a copolymer of L-lactide and ɛ-caprolactone (PLCL). An in vitro dissolution test confirmed the sustainable release of ORM-11984 from the matrix. A bone marrow ablation model was used in female Sprague-Dawley rats. Implants containing 10%, 30%, or 50% ORM-11984 by weight or pure PLCL were inserted into the medullary canal of the ablated tibia. At 6 and 12 weeks, the volume of intramedullary new bone and the perimeter of bone-implant contact were measured by micro-computed tomography and histomorphometry. Results — Contrary to our hypothesis, there was a negative correlation between the amount of new bone around the implant and the dose of ORM-11984. There was only a mild (and not statistically significant) enhancement of bone formation in ablated bones subjected to the lowest dose of the SARM (10%). Interpretation — This study suggests that intramedullary/endosteal osteogenesis had a negative, dose-dependent response to locally released SARM. This result highlights the complexity of androgenic effects on bones and also suggests that there are biological limits to the targeted local application of SARMs. PMID:26198725

  3. Asymptomatic uterine fibroids.

    PubMed

    Divakar, Hema

    2008-08-01

    It is estimated that at least 50% of fibroids are asymptomatic, but this figure is likely to be an underestimate as it is based on women in whom fibroids are found incidentally during another procedure (e.g. cervical screening), and there is little, if any, data from population studies on the true incidence of fibroids. If a prevalence of 50% by 50 years of age is accepted, a large number of women have asymptomatic fibroids. Working on the cliché, 'if it ain't broken, don't fix it', it may seem surprising that there should be a chapter dedicated to the issue of asymptomatic fibroids, since the simplistic approach might be to leave the asymptomatic fibroids well alone. However, asymptomatic fibroids may become symptomatic in the future, so it may be wiser to treat fibroids before they grow to a size when they become symptomatic, or treatment becomes more challenging, especially in young women who may desire fertility at a later stage, and in view of the fact that many women are starting their families in their mid-thirties when they have a 30% chance of having a fibroid(s). Despite their common occurrence, fibroids are still poorly understood. It is not known why they form in the first place, what determines their number and ultimate size, the best treatment approaches, or the factors that determine which women develop symptoms. Even when women present with disorders such as infertility, pelvic pain and abnormal bleeding, it is not always possible to be certain that a given myoma is not simply an innocent bystander rather than the cause of the symptom. This chapter addresses the challenging issue of what to do when fibroids are diagnosed incidentally. Firstly, there is the need to ascertain that the pelvic mass palpated is indeed a fibroid, and not an early, more sinister tumour, especially if conservative management is adopted. In addition, there is the issue of size, position and potential for becoming symptomatic at a later date. With the availability of uterine

  4. Effects of local delivery of BMP2, zoledronate and their combination on bone microarchitecture, biomechanics and bone turnover in osteoporotic rabbits

    PubMed Central

    Jing, Da; Hao, Xuguang; Xu, Fang; Liu, Jian; Xu, Fei; Luo, Erping; Meng, Guolin

    2016-01-01

    The hip fracture is one major clinical challenge associated with osteoporosis, resulting in heavy socioeconomic burdens and high mortality. Systemic therapies of anti-osteoporosis drugs are expensive, time-consuming and also evoke substantial side effects, which fails to provide early protection from fractures. Accumulating evidence demonstrates the high bioavailability and therapeutic efficacy of local drug delivery in accelerating facture healing and bone defect repair. This study aims at investigating the effects of local delivery of BMP2 and zoledronate (two promising anabolic/anti-catobolic reagents) encapsulated by fibrin sealants into femoral necks on regulating bone quality and remodeling in osteoporotic rabbits subjected to combined ovariectomy and glucocorticoid injection. We show that 6-week BMP2 delivery exhibited more prominent effect on mitigating trabecular bone microarchitecture deterioration and mechanical strength reduction of femoral necks than local zoledronate treatment. BMP2 plus zoledronate showed more significant improvement of bone microstructure, mechanical strength and bone formation rate at 12 weeks post injection than single BMP2 or zoledronate delivery via μCT, biomechanical, histomorphometric and serum biochemical analyses. This study enriches our knowledge for understanding the availability of local drug delivery for improving bone quantity and quality, which may lead to earlier, safer and more efficient protection from osteoporosis-induced fractures in clinics. PMID:27329730

  5. Effects of local delivery of BMP2, zoledronate and their combination on bone microarchitecture, biomechanics and bone turnover in osteoporotic rabbits.

    PubMed

    Jing, Da; Hao, Xuguang; Xu, Fang; Liu, Jian; Xu, Fei; Luo, Erping; Meng, Guolin

    2016-01-01

    The hip fracture is one major clinical challenge associated with osteoporosis, resulting in heavy socioeconomic burdens and high mortality. Systemic therapies of anti-osteoporosis drugs are expensive, time-consuming and also evoke substantial side effects, which fails to provide early protection from fractures. Accumulating evidence demonstrates the high bioavailability and therapeutic efficacy of local drug delivery in accelerating facture healing and bone defect repair. This study aims at investigating the effects of local delivery of BMP2 and zoledronate (two promising anabolic/anti-catobolic reagents) encapsulated by fibrin sealants into femoral necks on regulating bone quality and remodeling in osteoporotic rabbits subjected to combined ovariectomy and glucocorticoid injection. We show that 6-week BMP2 delivery exhibited more prominent effect on mitigating trabecular bone microarchitecture deterioration and mechanical strength reduction of femoral necks than local zoledronate treatment. BMP2 plus zoledronate showed more significant improvement of bone microstructure, mechanical strength and bone formation rate at 12 weeks post injection than single BMP2 or zoledronate delivery via μCT, biomechanical, histomorphometric and serum biochemical analyses. This study enriches our knowledge for understanding the availability of local drug delivery for improving bone quantity and quality, which may lead to earlier, safer and more efficient protection from osteoporosis-induced fractures in clinics. PMID:27329730

  6. Poly-cyclodextrin functionalized porous bioceramics for local chemotherapy and anticancer bone reconstruction.

    PubMed

    Chai, Feng; Abdelkarim, Mohamed; Laurent, Thomas; Tabary, Nicolas; Degoutin, Stephanie; Simon, Nicolas; Peters, Fabian; Blanchemain, Nicolas; Martel, Bernard; Hildebrand, Hartmut F

    2014-08-01

    The progress in bone cancer surgery and multimodal treatment concept achieve only modest improvement in the overall survival, due to failure in clearing out residual cancer cells at the surgical margin and extreme side-effects of adjuvant postoperative treatments. Our study aims to propose a new method based on cyclodextrin polymer (polyCD) functionalized hydroxyapatite (HA) for achieving a high local drug concentration with a sustained release profile and a better control of residual malignant cells via local drug delivery and promotion of the reconstruction of bone defects. PolyCD, a versatile carrier for therapeutic molecules, can be incorporated into HA (bone regeneration scaffold) through thermal treatment. The parameters of polyCD treatment on the macroporous HA (porosity 65%) were characterized via thermogravimetric analysis. Good cytocompatibility of polyCD functionalized bioceramics was demonstrated on osteoblast cells by cell vitality assay. An antibiotic (gentamicin) and an anticancer agent (cisplatin) were respectively loaded on polyCD functionalized bioceramics for drug release test. The results show that polyCD functionalization leads to significantly improved drug loading quantity (30% more concerning gentamicin and twice more for cisplatin) and drug release duration (7 days longer concerning gentamicin and 3 days longer for cisplatin). Conclusively, this study offers a safe and reliable drug delivery system for bioceramic matrices, which can load anticancer agents (or/and antibiotics) to reduce local recurrence (or/and infection). PMID:24347296

  7. [Asymptomatic proteinuria in children].

    PubMed

    Marsciani, Martino; Pasini, Andrea; Montini, Giovanni

    2011-01-01

    Asymptomatic proteinuria is a common finding in primary care practice. Most children with asymptomatic proteinuria, diagnosed at screening urinalysis, do not have kidney disease. When proteinuria is detected, it is important to determine whether it is transient, orthostatic or persistent. Transient proteinuria is most often associated with fever, exercise or stress and it resolves on urine testing when the cause is withdrawn. Orthostatic proteinuria is a benign and common condition in school-age children. Persistent proteinuria should be carefully evaluated because it is a marker of renal damage and associated with kidney disease. It is not necessary to extensively investigate all children found to have proteinuria. Children with persistent proteinuria should be referred to a pediatric nephrologist to get a diagnosis and start treatment when necessary. PMID:22028262

  8. Dendritic Glycopolymer as Drug Delivery System for Proteasome Inhibitor Bortezomib in a Calcium Phosphate Bone Cement: First Steps Toward a Local Therapy of Osteolytic Bone Lesions.

    PubMed

    Striegler, Christin; Schumacher, Matthias; Effenberg, Christiane; Müller, Martin; Seckinger, Anja; Schnettler, Reinhard; Voit, Brigitte; Hose, Dirk; Gelinsky, Michael; Appelhans, Dietmar

    2015-09-01

    Establishment of drug delivery system (DDS) in bone substitute materials for local treatment of bone defects still requires ambitious solutions for a retarded drug release. We present two novel DDS, a weakly cationic dendritic glycopolymer and a cationic polyelectrolyte complex, composed of dendritic glycopolymer and cellulose sulfate, for the proteasome inhibitor bortezomib. Both DDS are able to induce short-term retarded release of bortezomib from calcium phosphate bone cement in comparison to a burst-release of the drug from bone cement alone. Different release parameters have been evaluated to get a first insight into the release mechanism from bone cements. In addition, biocompatibility of the calcium phosphate cement, modified with the new DDS was investigated using human mesenchymal stromal cells. PMID:26018141

  9. Local measurements of the diffusion constant in multiple scattering media: Application to human trabecular bone imaging

    NASA Astrophysics Data System (ADS)

    Aubry, Alexandre; Derode, Arnaud; Padilla, Frédéric

    2008-03-01

    We present local measurements of the diffusion constant for ultrasonic waves undergoing multiple scattering. The experimental setup uses a coherent array of programmable transducers. By achieving Gaussian beamforming at emission and reception, an array of virtual sources and receivers located in the near field is constructed. A matrix treatment is proposed to separate the incoherent intensity from the coherent backscattering peak. Local measurements of the diffusion constant D are then achieved. This technique is applied to a real case: a sample of human trabecular bone for which the ultrasonic characterization of multiple scattering is an issue.

  10. Radiation-blocking shields to localize periarticular radiation precisely for prevention of heterotopic bone formation around uncemented total hip arthroplasties

    SciTech Connect

    Jasty, M.; Schutzer, S.; Tepper, J.; Willett, C.; Stracher, M.A.; Harris, W.H. )

    1990-08-01

    Sixteen patients (18 hips) were treated with localized radiation therapy limited to periarticular regions surrounding the femoral neck by shielding the prosthesis and the adjacent regions to prevent heterotopic bone formation around the uncemented prosthesis. All hips received 1500 rads. Eight of these hips were irradiated after excising severe heterotopic bone, five because they developed extensive heterotopic ossification in the opposite hip, and five others because they were considered to be at high risk for developing heterotopic ossification. Only two of the 18 hips developed a small amount of heterotopic bone after localized periarticular radiation. All wounds healed primarily. No progressive radiolucencies developed at the bone-prosthesis interface. There was only one trochanteric nonunion of six trochanteric osteotomies. Localized periarticular radiation therapy with precision shielding of the prosthetic components and adjacent skeletal structures is an effective means to prevent heterotopic bone formation around cementless total hip arthroplasties. It also has the advantage of not adversely affecting the healing of the trochanteric osteotomy.

  11. Local Controlled Release of Polyphenol Conjugated with Gelatin Facilitates Bone Formation.

    PubMed

    Honda, Yoshitomo; Tanaka, Tomonari; Tokuda, Tomoko; Kashiwagi, Takahiro; Kaida, Koji; Hieda, Ayato; Umezaki, Yasuyuki; Hashimoto, Yoshiya; Imai, Koichi; Matsumoto, Naoyuki; Baba, Shunsuke; Shimizutani, Kimishige

    2015-01-01

    Catechins are extensively used in health care treatments. Nevertheless, there is scarce information about the feasibility of local administration with polyphenols for bone regeneration therapy, possibly due to lack of effective delivery systems. Here we demonstrated that the epigallocatechin-3-gallate-conjugated gelatin (EGCG/Gel) prepared by an aqueous chemical synthesis using 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-morpholinium chloride (DMT-MM) gradually disintegrated with time and facilitated bone formation in a critical size defect of a mouse calvaria. Conjugation of EGCG with the Gel generated cross-linking between the two molecules, thereby leading to a retardation of the degradation of the EGCG/Gel and to a delayed release of EGCG. The prepared EGCG/Gels represented significant osteogenic capability compared with that of the uncross-linked Gel and the cross-linked Gel with uncombined-EGCG. In vitro experiments disclosed that the EGCG/Gel induced osteoblastogenesis of a mouse mesenchymal stem cell line (D1 cells) within 14 days. Using fluorescently-labeled EGCG/Gel, we found that the fraction of EGCG/Gel adsorbed onto the cell membrane of the D1 cells possibly via a Gel-cell interaction. The interaction might confer the long-term effects of EGCG on the cells, resulting in a potent osteogenic capability of the EGCG/Gel in vivo. These results should provide insight into local controlled release of polyphenols for bone therapy. PMID:26110386

  12. Automatic adaptive parameterization in local phase feature-based bone segmentation in ultrasound.

    PubMed

    Hacihaliloglu, Ilker; Abugharbieh, Rafeef; Hodgson, Antony J; Rohling, Robert N

    2011-10-01

    Intensity-invariant local phase features based on Log-Gabor filters have been recently shown to produce highly accurate localizations of bone surfaces from three-dimensional (3-D) ultrasound. A key challenge, however, remains in the proper selection of filter parameters, whose values have so far been chosen empirically and kept fixed for a given image. Since Log-Gabor filter responses widely change when varying the filter parameters, actual parameter selection can significantly affect the quality of extracted features. This article presents a novel method for contextual parameter selection that autonomously adapts to image content. Our technique automatically selects the scale, bandwidth and orientation parameters of Log-Gabor filters for optimizing local phase symmetry. The proposed approach incorporates principle curvature computed from the Hessian matrix and directional filter banks in a phase scale-space framework. Evaluations performed on carefully designed in vitro experiments demonstrate 35% improvement in accuracy of bone surface localization compared with empirically-set parameterization results. Results from a pilot in vivo study on human subjects, scanned in the operating room, show similar improvements. PMID:21821346

  13. Histochemical localization of alkaline phosphatase activity in decalcified bone and cartilage.

    PubMed

    Miao, Dengshun; Scutt, Andrew

    2002-03-01

    We have developed methodology that enables alkaline phosphatase (ALP) to be histochemically stained reproducibly in decalcified paraffin-embedded bone and cartilage of rodents. Proximal tibiae and fourth lumbar vertebrae were fixed in periodate-lysine-paraformaldehyde (PLP) fixative, decalcified in an EDTA-G solution, and embedded in paraffin. In the articular cartilage of the proximal tibia, ALP activity was localized to the hypertrophic chondrocytes and cartilage matrix of the deep zone and the maturing chondrocytes of the intermediate zone. The cells and matrix in the superficial zone did not exhibit any enzyme activity. In tibial and vertebral growth plates, a progressive increase in ALP expression was seen in chondrocytes and cartilage matrix, with activity being weakest in the proliferative zone, higher in the maturing zone, and highest in the hypertrophic zone. In bone tissue, ALP activity was detected widely in pre-osteoblasts, osteoblasts, lining cells on the surface of trabeculae, some newly embedded osteocytes, endosteal cells, and subperiosteal cells. In areas of new bone formation, ALP activity was detected in osteoid. In the bone marrow, about 20% of bone marrow cells expressed ALP activity. In adult rats, the thickness of the growth plates was less and ALP activity was enhanced in maturing and hypertrophic chondrocytes, cartilage matrix in the hypertrophic zone, and primary spongiosa. This is the first time that ALP activity has been successfully visualized histochemically in decalcified, paraffin-embedded mineralized tissues. This technique should prove to be a very convenient adjunct for studying the behavior of osteoblasts during osteogenesis. PMID:11850436

  14. The Effect of Local Delivery Doxycycline and Alendronate on Bone Repair.

    PubMed

    Limirio, Pedro Henrique Justino Oliveira; Rocha, Flaviana Soares; Batista, Jonas Dantas; Guimarães-Henriques, João César; de Melo, Geraldo Batista; Dechichi, Paula

    2016-08-01

    The aim of the present study was to investigate the local effect of 10% doxycycline and 1% alendronate combined with poly(lactic-co-glycolic acid) (PLGA) on bone repair. Thirty rats were divided into three groups, as follows: control group (CG), drug group (DG), and vehicle-PLGA group (VG). Bone defect was created in the right femur and filled with the following: blood clot (CG); PLGA gel, 10% doxycycline and 1% alendronate (DG); or vehicle-PLGA (VG). The animals were euthanized 7 or 15 days after surgery. Bone density, bone matrix and number of osteoclasts were quantified. At 7 days, the findings showed increased density in DG (177.75 ± 76.5) compared with CG (80.37 ± 27.4), but no difference compared with VG (147.1 ± 41.5); no statistical difference in bone neoformation CG (25.6 ± 4.8), VG (27.8 ± 4), and DG (18.9 ± 7.8); and decrease osteoclasts in DG (4.6 ± 1.9) compared with CG (26.7 ± 7.4) and VG (17.3 ± 2.7). At 15 days, DG (405.1 ± 63.1) presented higher density than CG (213.2 ± 60.9) and VG (283.4 ± 85.8); there was a significant increase in percentage of bone neoformation in DG (31.5 ± 4.2) compared with CG (23 ± 4), but no difference compared with VG (25.1 ± 2.9). There was a decreased number of osteoclasts in DG (20.7 ± 4.7) and VG (29.5 ± 5.4) compared with CG (40 ± 9.4). The results suggest that the association of 10% doxycycline and 1% alendronate with PLGA-accelerated bone repair. PMID:26381914

  15. Functional adaptation of long bone extremities involves the localized ``tuning'' of the cortical bone composition; evidence from Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Buckley, Kevin; Kerns, Jemma G.; Birch, Helen L.; Gikas, Panagiotis D.; Parker, Anthony W.; Matousek, Pavel; Goodship, Allen E.

    2014-11-01

    In long bones, the functional adaptation of shape and structure occurs along the whole length of the organ. This study explores the hypothesis that adaptation of bone composition is also site-specific and that the mineral-to-collagen ratio of bone (and, thus, its mechanical properties) varies along the organ's length. Raman spectroscopy was used to map the chemical composition of long bones along their entire length in fine spatial resolution (1 mm), and then biochemical analysis was used to measure the mineral, collagen, water, and sulfated glycosaminoglycan content where site-specific differences were seen. The results show that the mineral-to-collagen ratio of the bone material in human tibiae varies by <5% along the mid-shaft but decreases by >10% toward the flared extremities of the bone. Comparisons with long bones from other large animals (horses, sheep, and deer) gave similar results with bone material composition changing across tens of centimeters. The composition of the bone apatite also varied with the phosphate-to-carbonate ratio decreasing toward the ends of the tibia. The data highlight the complexity of adaptive changes and raise interesting questions about the biochemical control mechanisms involved. In addition to their biological interest, the data provide timely information to researchers developing Raman spectroscopy as a noninvasive tool for measuring bone composition in vivo (particularly with regard to sampling and measurement protocol).

  16. Imaging of the symptomatic type II accessory navicular bone.

    PubMed

    Mosel, Leigh D; Kat, Evelyn; Voyvodic, Frank

    2004-06-01

    Accessory ossicles of the foot are commonly mistaken for fractures. The accessory navicular is one of the most common accessory ossicles of the foot. There is a higher incidence in women and the finding might be bilateral in 50-90%. This entity is usually asymptomatic, although populations with medial foot pain have a higher prevalence. Three types of accessory navicular bone have been described. The type II accessory navicular is the most commonly symptomatic variant with localized chronic or acute on chronic medial foot pain and tenderness with associated inflammation of overlying soft tissues. Plain radiographic identification of the accessory navicular is insufficient to attribute symptomatology. Ultrasound allows for comparison with the asymptomatic side and localization of pain. Bone scintigraphy has a high sensitivity but positive findings lack specificity. Magnetic resonance imaging is of high diagnostic value for demonstrating both bone marrow and soft tissue oedema. PMID:15230772

  17. A theory for bone resorption based on the local rupture of osteocytes cells connections: A finite element study.

    PubMed

    Ridha, Hambli; Almitani, Khalid H; Chamekh, Abdessalem; Toumi, Hechmi; Tavares, Joao Manuel R S

    2015-04-01

    In this work, a bone damage resorption finite element model based on the disruption of the inhibitory signal transmitted between osteocytes cells in bone due to damage accumulation is developed and discussed. A strain-based stimulus function coupled to a damage-dependent spatial function is proposed to represent the connection between two osteocytes embedded in the bone tissue. The signal is transmitted to the bone surface to activate bone resorption. The proposed model is based on the idea that the osteocyte signal reduction is not related to the reduction of the stimulus sensed locally by osteocytes due to damage, but to the difficulties for the signal in travelling along a disrupted area due to microcracks that can destroy connections of the intercellular network between osteocytes and bone-lining cells. To check the potential of the proposed model to predict the damage resorption process, two bone resorption mechano-regulation rules corresponding to two mechanotransduction approaches have been implemented and tested: (1) Bone resorption based on a coupled strain-damage stimulus function without ruptured osteocyte connections (NROC); and (2) Bone resorption based on a strain stimulus function with ruptured osteocyte connections (ROC). The comparison between the results obtained by both models, shows that the proposed model based on ruptured osteocytes connections predicts realistic results in conformity with previously published findings concerning the fatigue damage repair in bone. PMID:25640868

  18. Bone tissue incorporates in vitro gallium with a local structure similar to gallium-doped brushite.

    PubMed

    Korbas, M; Rokita, E; Meyer-Klaucke, W; Ryczek, J

    2004-01-01

    During mineral growth in rat bone-marrow stromal cell cultures, gallium follows calcium pathways. The dominant phase of the cell culture mineral constitutes the poorly crystalline hydroxyapatite (HAP). This model system mimics bone mineralization in vivo. The structural characterization of the Ga environment was performed by X-ray absorption spectroscopy at the Ga K-edge. These data were compared with Ga-doped synthetic compounds (poorly crystalline hydroxyapatite, amorphous calcium phosphate and brushite) and with strontium-treated bone tissue, obtained from the same culture model. It was found that Sr(2+) substitutes for Ca(2+) in the HAP crystal lattice. In contrast, the replacement by Ga(3+) yielded a much more disordered local environment of the probe atom in all investigated cell culture samples. The coordination of Ga ions in the cell culture minerals was similar to that of Ga(3+), substituted for Ca(2+), in the Ga-doped synthetic brushite (Ga-DCPD). The Ga atoms in the Ga-DCPD were coordinated by four oxygen atoms (1.90 A) of the four phosphate groups and two oxygen atoms at 2.02 A. Interestingly, the local environment of Ga in the cell culture minerals was not dependent on the onset of Ga treatment, the Ga concentration in the medium or the age of the mineral. Thus, it was concluded that Ga ions were incorporated into the precursor phase to the HAP mineral. Substitution for Ca(2+ )with Ga(3+) distorted locally this brushite-like environment, which prevented the transformation of the initially deposited phase into the poorly crystalline HAP. PMID:14648284

  19. Brown tumor of bone: A potential source of false-positive thallium-201 localization

    SciTech Connect

    Yang, C.J.; Seabold, J.E.; Gurll, N.J.

    1989-07-01

    Brown tumor of bone (osteitis fibrosa cystica) should be included in the differential diagnosis of lesions that cause false-positive thallium-201 localization in patients with primary hyperparathyroidism. We report a case of a brown tumor of the upper sternum mimicking a superior mediastinal parathyroid neoplasm in a patient with persistent hyperparathyroidism 9 years after a negative neck exploration (with subtotal thyroidectomy and thymectomy). A /sup 201/TI//sup 99m/Tc pertechnetate subtraction scintigram demonstrated complete subtraction of this /sup 201/TI focus.

  20. Local radiotherapy for palliation in multiple myeloma patients with symptomatic bone lesions

    PubMed Central

    Lee, Jeong Won

    2016-01-01

    Purpose To evaluate the clinical outcomes of symptomatic bone lesions in patients with multiple myeloma (MM) who received local radiotherapy (LRT). Materials and Methods Fifty-one patients with 87 symptomatic bone lesions treated via LRT were analyzed. LRT was delivered at a median total dose of 21 Gy (range, 12 to 40 Gy) in a median of 7 fractions (range, 4 to 20 fractions). The clinical outcomes of LRT and the factors affecting treatment response were assessed. Results After a median follow-up time of 66.7 weeks, symptom relief was achieved for 85 of 87 lesions (97.7%). The median time to symptom relief was 7 days from the start of LRT (range, 1 to 67 days). The duration of in-field failure-free survival ranged from 1.1 to 450.9 weeks (median, 66.7 weeks). The radiation dose or use of previous and concurrent chemotherapy was not significantly associated with in-field failure for LRT (p = 0.354, 0.758, and 0.758, respectively). Conclusion Symptomatic bone lesions in patients with MM can be successfully treated with LRT. A higher radiation dose or the use of concurrent chemotherapy may not influence the in-field disease control. A relatively low radiation dose could achieve remission of symptoms in patients with MM. PMID:27104168

  1. PTH1-34 alleviates radiotherapy-induced local bone loss by improving osteoblast and osteocyte survival.

    PubMed

    Chandra, Abhishek; Lin, Tiao; Tribble, Mary Beth; Zhu, Ji; Altman, Allison R; Tseng, Wei-Ju; Zhang, Yejia; Akintoye, Sunday O; Cengel, Keith; Liu, X Sherry; Qin, Ling

    2014-10-01

    Cancer radiotherapy is often complicated by a spectrum of changes in the neighboring bone from mild osteopenia to osteoradionecrosis. We previously reported that parathyroid hormone (PTH, 1-34), an anabolic agent for osteoporosis, reversed bone structural deterioration caused by multiple microcomputed tomography (microCT) scans in adolescent rats. To simulate clinical radiotherapy for cancer patients and to search for remedies, we focally irradiated the tibial metaphyseal region of adult rats with a newly available small animal radiation research platform (SARRP) and treated these rats with intermittent injections of PTH1-34. Using a unique 3D image registration method that we recently developed, we traced the local changes of the same trabecular bone before and after treatments, and observed that, while radiation caused a loss of small trabecular elements leading to significant decreases in bone mass and strength, PTH1-34 preserved all trabecular elements in irradiated bone with remarkable increases in bone mass and strength. Histomorphometry demonstrated that SARRP radiation severely reduced osteoblast number and activity, which were impressively reversed by PTH treatment. In contrast, suppressing bone resorption by alendronate failed to rescue radiation-induced bone loss and to block the rescue effect of PTH1-34. Furthermore, histological analyses revealed that PTH1-34 protected osteoblasts and osteocytes from radiation-induced apoptosis and attenuated radiation-induced bone marrow adiposity. Taken together, our data strongly support a robust radioprotective effect of PTH on trabecular bone integrity through preserving bone formation and shed light on further investigations of an anabolic therapy for radiation-induced bone damage. PMID:24998454

  2. PTH1-34 Alleviates Radiotherapy-induced Local Bone Loss by Improving Osteoblast and Osteocyte Survival

    PubMed Central

    Chandra, Abhishek; Lin, Tiao; Tribble, Mary Beth; Zhu, Ji; Altman, Allison R.; Tseng, Weiju; Zhang, Yejia; Akintoye, Sunday O.; Cengel, Keith; Liu, X. Sherry; Qin, Ling

    2014-01-01

    Cancer radiotherapy is often complicated by a spectrum of changes in the neighboring bone from mild osteopenia to osteoradionecrosis. We previously reported that parathyroid hormone (PTH, 1–34), an anabolic agent for osteoporosis, reversed bone structural deterioration caused by multiple microcomputed tomography (microCT) scans in adolescent rats. To simulate clinical radiotherapy for cancer patients and to search for remedies, we focally irradiated the tibial metaphyseal region of adult rats with a newly available small animal radiation research platform (SARRP) and treated these rats with intermittent injections of PTH1–34. Using a unique 3D image registration method that we recently developed, we traced the local changes of the same trabecular bone before and after treatments, and observed that, while radiation caused a loss of small trabecular elements leading to significant decreases in bone mass and strength, PTH1–34 preserved all trabecular elements in irradiated bone with remarkable increases in bone mass and strength. Histomorphometry demonstrated that SARRP radiation severely reduced osteoblast number and activity, which were impressively reversed by PTH treatment. In contrast, suppressing bone resorption by alendronate failed to rescue radiation-induced bone loss and to block the rescue effect of PTH1–34. Furthermore, histological analyses revealed that PTH1–34 protected osteoblasts and osteocytes from radiation-induced apoptosis and attenuated radiation-induced bone marrow adiposity. Taken together, our data strongly support a robust radioprotective effect of PTH on trabecular bone integrity through preserving bone formation and shed light on further investigations of an anabolic therapy for radiation-induced bone damage. PMID:24998454

  3. Direct measurement of local oxygen concentration in the bone marrow of live animals

    NASA Astrophysics Data System (ADS)

    Spencer, Joel A.; Ferraro, Francesca; Roussakis, Emmanuel; Klein, Alyssa; Wu, Juwell; Runnels, Judith M.; Zaher, Walid; Mortensen, Luke J.; Alt, Clemens; Turcotte, Raphaël; Yusuf, Rushdia; Côté, Daniel; Vinogradov, Sergei A.; Scadden, David T.; Lin, Charles P.

    2014-04-01

    Characterization of how the microenvironment, or niche, regulates stem cell activity is central to understanding stem cell biology and to developing strategies for the therapeutic manipulation of stem cells. Low oxygen tension (hypoxia) is commonly thought to be a shared niche characteristic in maintaining quiescence in multiple stem cell types. However, support for the existence of a hypoxic niche has largely come from indirect evidence such as proteomic analysis, expression of hypoxia inducible factor-1α (Hif-1α) and related genes, and staining with surrogate hypoxic markers (for example, pimonidazole). Here we perform direct in vivo measurements of local oxygen tension (pO2) in the bone marrow of live mice. Using two-photon phosphorescence lifetime microscopy, we determined the absolute pO2 of the bone marrow to be quite low (<32 mm Hg) despite very high vascular density. We further uncovered heterogeneities in local pO2, with the lowest pO2 (~9.9 mm Hg, or 1.3%) found in deeper peri-sinusoidal regions. The endosteal region, by contrast, is less hypoxic as it is perfused with small arteries that are often positive for the marker nestin. These pO2 values change markedly after radiation and chemotherapy, pointing to the role of stress in altering the stem cell metabolic microenvironment.

  4. Direct measurement of local oxygen concentration in the bone marrow of live animals.

    PubMed

    Spencer, Joel A; Ferraro, Francesca; Roussakis, Emmanuel; Klein, Alyssa; Wu, Juwell; Runnels, Judith M; Zaher, Walid; Mortensen, Luke J; Alt, Clemens; Turcotte, Raphaël; Yusuf, Rushdia; Côté, Daniel; Vinogradov, Sergei A; Scadden, David T; Lin, Charles P

    2014-04-10

    Characterization of how the microenvironment, or niche, regulates stem cell activity is central to understanding stem cell biology and to developing strategies for the therapeutic manipulation of stem cells. Low oxygen tension (hypoxia) is commonly thought to be a shared niche characteristic in maintaining quiescence in multiple stem cell types. However, support for the existence of a hypoxic niche has largely come from indirect evidence such as proteomic analysis, expression of hypoxia inducible factor-1α (Hif-1α) and related genes, and staining with surrogate hypoxic markers (for example, pimonidazole). Here we perform direct in vivo measurements of local oxygen tension (pO2) in the bone marrow of live mice. Using two-photon phosphorescence lifetime microscopy, we determined the absolute pO2 of the bone marrow to be quite low (<32 mm Hg) despite very high vascular density. We further uncovered heterogeneities in local pO2, with the lowest pO2 (∼9.9 mm Hg, or 1.3%) found in deeper peri-sinusoidal regions. The endosteal region, by contrast, is less hypoxic as it is perfused with small arteries that are often positive for the marker nestin. These pO2 values change markedly after radiation and chemotherapy, pointing to the role of stress in altering the stem cell metabolic microenvironment. PMID:24590072

  5. Single-Dose Local Simvastatin Injection Improves Implant Fixation via Increased Angiogenesis and Bone Formation in an Ovariectomized Rat Model

    PubMed Central

    Tan, Jie; Yang, Ning; Fu, Xin; Cui, Yueyi; Guo, Qi; Ma, Teng; Yin, Xiaoxue; Leng, Huijie; Song, Chunli

    2015-01-01

    Background Statins have been reported to promote bone formation. However, taken orally, their bioavailability is low to the bones. Implant therapies require a local repair response, topical application of osteoinductive agents, or biomaterials that promote implant fixation. Material/Methods The present study evaluated the effect of a single local injection of simvastatin on screw fixation in an ovariectomized rat model of osteoporosis. Results Dual-energy X-ray absorptiometry, micro-computed tomography, histology, and biomechanical tests revealed that 5 and 10 mg simvastatin significantly improved bone mineral density by 18.2% and 22.4%, respectively (P<0.05); increased bone volume fraction by 51.0% and 57.9%, trabecular thickness by 16.4% and 18.9%, trabeculae number by 112.0% and 107.1%, and percentage of osseointegration by 115.7% and 126.3%; and decreased trabeculae separation by 34.1% and 36.6%, respectively (all P<0.01). Bone mineral apposition rate was significantly increased (P<0.01). Furthermore, implant fixation was significantly increased (P<0.05), and bone morphogenetic protein 2 (BMP2) expression was markedly increased. Local injection of a single dose of simvastatin also promoted angiogenesis. Vessel number, volume, thickness, surface area, and vascular volume per tissue volume were significantly increased (all P<0.01). Vascular endothelial growth factor (VEGF), VEGF receptor-2, von Willebrand factor, and platelet endothelial cell adhesion molecule-1 expression were enhanced. Conclusions A single local injection of simvastatin significantly increased bone formation, promoted osseointegration, and enhanced implant fixation in ovariectomized rats. The underlying mechanism appears to involve enhanced BMP2 expression and angiogenesis in the target bone. PMID:25982481

  6. Digital image correlation: a technique for determining local mechanical conditions within early bone callus.

    PubMed

    Thompson, M S; Schell, H; Lienau, J; Duda, G N

    2007-09-01

    Local mechanical conditions are known to play a role during the regeneration of musculoskeletal tissues, and histomorphometrical investigations of the time course of healing have enabled specific conclusions regarding the mechanosensitivity of tissue differentiation. However, the mechanism for this influence is not clearly understood. In order to extend this analysis, it is essential to link local histological understanding with direct characterisation of the local mechanical environment. Digital image correlation (DIC) is a computer-based image analysis technique that enables the non-contact measurement of strains on material surfaces and is finding application in many areas of biomechanics. Here we report a DIC technique to investigate the local distribution of mechanical strain within regenerating soft tissue sections. We provide exemplary data from analysis of a section of sheep bone callus. An assessment of displacement measurement accuracy gave an RMS error of 4.2 microm, corresponding to an estimated strain error of 1.4%. The sections showed concentrations of up to four times the applied strain and comparison of the strain patterns with histological analysis confirmed that these concentrations reflected boundaries between hard and soft callus. PMID:17045512

  7. Local Intramedullary Delivery of Vancomycin Can Prevent the Development of Long Bone Staphylococcus aureus Infection

    PubMed Central

    Wang, Caroline; Canden, Ahranee; Burr, Michael; Agarwal, Jayant

    2016-01-01

    Current treatments for methicillin-resistant Staphylococcus aureus (MRSA) infections require intravenously delivered vancomycin; however, systemically delivered vancomycin has its problems. To determine the feasibility and safety of locally delivering vancomycin hydrochloride (~25 mg/Kg) to the medullary canal of long bones, we conducted a pharmacokinetics study using a rat tibia model. We found that administering the vancomycin intraosseously resulted in very low concentrations of vancomycin in the blood plasma and the muscle surrounding the tibia, reducing the risk for systemic toxicity, which is often seen with traditional intravenous administration of vancomycin. Additionally, we were able to inhibit the development of osteomyelitis in the tibia if the treatment was administered locally at the same time as a bacterial inoculum (i.e., Log10 7.82 CFU/mL or 6.62x107 CFU/mL), when compared to an untreated group. These findings suggest that local intramedullary vancomycin delivery can achieve sufficiently high local concentrations to prevent development of osteomyelitis while minimizing systemic toxicity. PMID:27472197

  8. Strontium localization in bone tissue studied by X-ray absorption spectroscopy.

    PubMed

    Frankær, Christian Grundahl; Raffalt, Anders Christer; Stahl, Kenny

    2014-02-01

    Strontium has recently been introduced as a pharmacological agent for the treatment and prevention of osteoporosis. We determined the localization of strontium incorporated into bone matrix from dogs treated with Sr malonate by X-ray absorption spectroscopy. A new approach for analyzing the X-ray absorption spectra resulted in a compositional model and allowed the relative distribution of strontium in the different bone components to be estimated. Approximately 35-45% of the strontium present is incorporated into calcium hydroxyapatite (CaHA) by substitution of some of the calcium ions occupying highly ordered sites, and at least 30% is located at less ordered sites where only the first solvation shell is resolved, suggesting that strontium is surrounded by only oxygen atoms similar to Sr(2+) in solution. Strontium was furthermore shown to be absorbed in collagen in which it obtains a higher structural order than when present in serum but less order than when it is incorporated into CaHA. The total amount of strontium in the samples was determined by inductively coupled plasma mass spectrometry, and the amount of Sr was found to increase with increasing dose levels and treatment periods, whereas the relative distribution of strontium among the different components appears to be independent of treatment period and dose level. PMID:24101232

  9. Ultrasound bone cutting for surgically assisted rapid maxillary expansion under local anesthesia. Preliminary results.

    PubMed

    Robiony, M; Polini, F; Costa, F; Zerman, N; Politi, M

    2007-06-01

    Surgically assisted rapid maxillary expansion (SARME) is a well-established therapy for correction of maxillary transverse deficiency in adults, when consolidation of sutures has just been completed. It can be performed either under general or under local anesthesia and it can be accomplished with many surgical techniques. One of the most critical steps of SARME is the detachment of the pterygo-maxillary junction, due to the risks connected to such procedure. When required to obtain specific expansion patterns, the pterygo-maxillary separation has been suggested until now only for interventions under general anesthesia, due to the dangerousness and the rawness of this surgical step in awake patients. The authors introduce the use of an ultrasonic bone-cutting device to perform all osteotomic steps of SARME under local anesthesia on an outpatient basis, including pterygo-maxillary detachment. This ultrasonic device is unique in that the osteotomic action occurs only when the tool is employed on mineralized tissues, while it stops on soft tissues. It works in a linear pattern of vibration and it allows precise osteotomies without producing any heat damage to osteotomic surfaces and without any dangerous hammer-related stroke. Due to its precision and safety, this device named Piezosurgery, allows patients to undergo all the steps of SARME under local anesthesia, also without hospitalization. PMID:17625493

  10. Massive Bone Loss Due to Orchidectomy and Localized Disuse: Preventive Effects of a Biosphonsphonate

    NASA Astrophysics Data System (ADS)

    Libouban, H.; Moreau, M. F.; Chappard, D.

    2008-06-01

    Orchidectomy (ORX) and hindlimb paralysis induced by botulinum neurotoxin (BTX) were combined to see if their effects were cumulative and if bone loss could be prevented by an antiresorptive agent (risedronate) or testosterone. Four groups of mature rats were studied for 1 month: SHAM operated; ORX and right hindlimb immobilization (BTX); ORX+BTX+risedronate or testosterone. Bone loss and microarchitecture deterioration were maximized on the immobilized bone. Risedronate but not testosterone prevented trabecular bone loss but was less effective on cortical bone loss. ORX and BTX had additive effects on bone loss which can be prevented by risedronate but not testosterone.

  11. Local plate/rod descriptors of 3D trabecular bone micro-CT images from medial axis topologic analysis

    SciTech Connect

    Peyrin, Francoise; Attali, Dominique; Chappard, Christine; Benhamou, Claude Laurent

    2010-08-15

    Purpose: Trabecular bone microarchitecture is made of a complex network of plate and rod structures evolving with age and disease. The purpose of this article is to propose a new 3D local analysis method for the quantitative assessment of parameters related to the geometry of trabecular bone microarchitecture. Methods: The method is based on the topologic classification of the medial axis of the 3D image into branches, rods, and plates. Thanks to the reversibility of the medial axis, the classification is next extended to the whole 3D image. Finally, the percentages of rods and plates as well as their mean thicknesses are calculated. The method was applied both to simulated test images and 3D micro-CT images of human trabecular bone. Results: The classification of simulated phantoms made of plates and rods shows that the maximum error in the quantitative percentages of plate and rods is less than 6% and smaller than with the structure model index (SMI). Micro-CT images of human femoral bone taken in osteoporosis and early or advanced osteoarthritis were analyzed. Despite the large physiological variability, the present method avoids the underestimation of rods observed with other local methods. The relative percentages of rods and plates were not significantly different between osteoarthritis and osteoporotic groups, whereas their absolute percentages were in relation to an increase of rod and plate thicknesses in advanced osteoarthritis with also higher relative and absolute number of nodes. Conclusions: The proposed method is model-independent, robust to surface irregularities, and enables geometrical characterization of not only skeletal structures but entire 3D images. Its application provided more accurate results than the standard SMI on simple simulated phantoms, but the discrepancy observed on the advanced osteoarthritis group raises questions that will require further investigations. The systematic use of such a local method in the characterization of

  12. Direct measurement of local oxygen concentration in the bone marrow of live animals

    PubMed Central

    Spencer, Joel A.; Ferraro, Francesca; Roussakis, Emmanuel; Klein, Alyssa; Wu, Juwell; Runnels, Judith M.; Zaher, Walid; Mortensen, Luke J.; Alt, Clemens; Turcotte, Raphaël; Yusuf, Rushdia; Côté, Daniel; Vinogradov, Sergei A.; Scadden, David T.; Lin, Charles P.

    2014-01-01

    Characterizing how the microenvironment, or niche, regulates stem cell activity is central to understanding stem cell biology and to developing strategies for therapeutic manipulation of stem cells1. Low oxygen tension (hypoxia) is commonly thought to be a shared niche characteristic in maintaining quiescence in multiple stem cell types2–4. However, support for the existence of a hypoxic niche has largely come from indirect evidence such as proteomic analysis5, expression of HIF-1 and related genes6, and staining with surrogate hypoxic markers (e.g. pimonidazole)6–8. Here we perform direct in vivo measurements of local oxygen tension (pO2) in the bone marrow (BM) of live mice. Using two-photon phosphorescence lifetime microscopy (2PLM), we determined the absolute pO2 of the BM to be quite low (<32 mmHg) despite very high vascular density. We further uncovered heterogeneities in local pO2, with the lowest pO2 (~9.9 mmHg, or 1.3%) found in deeper peri-sinusoidal regions. The endosteal region, by contrast, is less hypoxic as it is perfused with small arteries that are often positive for the marker nestin. These pO2 values change dramatically after radiation and chemotherapy, pointing to the role of stress in altering the stem cell metabolic microenvironment. PMID:24590072

  13. Reconstruction of coup de sabre deformity (linear localized scleroderma) by using galeal frontalis muscle flap and demineralized bone matrix combination.

    PubMed

    Cavusoglu, Tarik; Yazici, Ilker; Vargel, Ibrahim; Karakaya, Esen Ibrahim

    2011-01-01

    In this clinical report, we are presenting the combination of demineralized bone matrix combined with bilateral galea frontalis flaps. Based on our 6-month results, this seems to be a reasonable combination to accomplish long-lasting restoration of forehead defects related to en coup de sabre linear localized scleroderma. PMID:21233742

  14. Localized bone marrow transplantation leads to skin allograft acceptance in nonmyeloablated recipients: comparison of intra-bone marrow and isolated limb perfusion.

    PubMed

    Askenasy, Nadir

    2002-01-01

    It has been shown that engraftment of allogeneic bone marrow cells (BMC) induces tolerance to antigen-matched organs, and infusion of a megadose of cells improves the success of engraftment of T-cell-depleted BMC. This study explores intra-bone marrow injection (IB) and isolated limb perfusion (IL) as means of localized bone marrow transplantation (BMT) and assesses their tolerogenic effect. Intravenous (i.v.), IB, and IL infusion of syngeneic and allogeneic whole BMC rescued 90%-100% of myeloablated recipients. Tracing of PKH-labeled cells revealed early systemic dissipation after IB injection, indicating that it was equivalent to i.v. transplantation. In contrast, IL perfusion led to initial localization of donor BMC. BALB/c recipients conditioned with 70 microg/g busulfan had 58% +/- 5% and 44% +/- 4% donor lymphocytes at 4 weeks after i.v. and IL infusion, respectively, of 10(7) whole BMC from B10 donors. This suggests that cells migrated out of the IL femur and seeded other bones. All recipients accepted donor-matched skin grafts and acutely rejected third party grafts. T-cell depletion lowered the engraftment efficiency of i.v.-BMT by 35% (p < 0.001 versus whole BMC), but not when infused IL (p < 0.001). It is concluded that IL-BMT is a procedure for initial localization of donor cells, which is as efficient as i.v.- and IB-BMT in rescue of myeloablated mice, induction of hemopoietic chimerism, and donor-specific immune nonresponsiveness to secondary skin grafts without myeloablative conditioning. The megadose effect achieved by inoculation of a small hemopoietic space improved engraftment of T-cell-depleted BMC. This approach may have clinical applications. PMID:11796926

  15. Femur bone repair in ovariectomized rats under the local action of alendronate, hydroxyapatite and the association of alendronate and hydroxyapatite

    PubMed Central

    Canettieri, Antonio Carlos Victor; Colombo, Carlos Eduardo Dias; Chin, Chung Man; Faig-Leite, Horácio

    2009-01-01

    An evaluation was made of the local action of alendronate sodium (A), hydroxyapatite (HA) and the association of both substances (A + HA), in different molar concentrations, on the femur bone repair of ovariectomized rats. Ninety-eight animals were divided into seven groups: control (C), starch (S), alendronate 1 mol (A1), alendronate 2 mols (A2), hydroxyapatite 1 mol (HA1), hydroxyapatite 2 mols (HA2) and the association of alendronate + hydroxyapatite (A + HA). Rats weighing about 250 g were ovariectomized and 2.5-mm diameter bone defects were made on the left femur 30 days later. Each experimental group had defects filled with appropriate material, except for group C (control). The animals were killed 7 and 21 days after surgery. Histological, histomorphometric and statistical analyses of bone neoformation in the bone defect site were performed. From the histological standpoint, the major differences occurred after 21 days. All specimens in groups C, S, HA1 and HA2 presented linear closure of the bone defect, and most animals in groups A1, A2 and A + HA showed no bone neoformation in the central area of the defect. No statistically significant difference was found among the experimental groups after 7 days; after 21 days, group HA2 presented the highest amount of neoformed bone. There was no significant difference among groups A1, A2 and A + HA in the two study periods. It was concluded that alendronate, either isolated or in association with hydroxyapatite, had an adverse effect on bone repair in this experimental model. Moreover, the hydroxyapatite used here proved to be biocompatible and osteoconductive, with group HA2 showing the best results. PMID:19765106

  16. Single-Limb Irradiation Induces Local and Systemic Bone Loss in a Murine Model.

    PubMed

    Wright, Laura E; Buijs, Jeroen T; Kim, Hun-Soo; Coats, Laura E; Scheidler, Anne M; John, Sutha K; She, Yun; Murthy, Sreemala; Ma, Ning; Chin-Sinex, Helen J; Bellido, Teresita M; Bateman, Ted A; Mendonca, Marc S; Mohammad, Khalid S; Guise, Theresa A

    2015-07-01

    Increased fracture risk is commonly reported in cancer patients receiving radiotherapy, particularly at sites within the field of treatment. The direct and systemic effects of ionizing radiation on bone at a therapeutic dose are not well-characterized in clinically relevant animal models. Using 20-week-old male C57Bl/6 mice, effects of irradiation (right hindlimb; 2 Gy) on bone volume and microarchitecture were evaluated prospectively by microcomputed tomography and histomorphometry and compared to contralateral-shielded bone (left hindlimb) and non-irradiated control bone. One week postirradiation, trabecular bone volume declined in irradiated tibias (-22%; p < 0.0001) and femurs (-14%; p = 0.0586) and microarchitectural parameters were compromised. Trabecular bone volume declined in contralateral tibias (-17%; p = 0.003), and no loss was detected at the femur. Osteoclast number, apoptotic osteocyte number, and marrow adiposity were increased in irradiated bone relative to contralateral and non-irradiated bone, whereas osteoblast number was unchanged. Despite no change in osteoblast number 1 week postirradiation, dynamic bone formation indices revealed a reduction in mineralized bone surface and a concomitant increase in unmineralized osteoid surface area in irradiated bone relative to contralateral and non-irradiated control bone. Further, dose-dependent and time-dependent calvarial culture and in vitro assays confirmed that calvarial osteoblasts and osteoblast-like MC3T3 cells were relatively radioresistant, whereas calvarial osteocyte and osteocyte-like MLO-Y4 cell apoptosis was induced as early as 48 hours postirradiation (4 Gy). In osteoclastogenesis assays, radiation exposure (8 Gy) stimulated murine macrophage RAW264.7 cell differentiation, and coculture of irradiated RAW264.7 cells with MLO-Y4 or murine bone marrow cells enhanced this effect. These studies highlight the multifaceted nature of radiation-induced bone loss by demonstrating direct

  17. Single-Limb Irradiation Induces Local and Systemic Bone Loss in a Murine Model

    PubMed Central

    Wright, Laura E.; Buijs, Jeroen T.; Kim, Hun-Soo; Coats, Laura E.; Scheidler, Anne M.; John, Sutha K.; She, Yun; Murthy, Sreemala; Ma, Ning; Chin-Sinex, Helen J.; Bellido, Teresita M.; Bateman, Ted A.; Mendonca, Marc S.; Mohammad, Khalid S.; Guise, Theresa A.

    2015-01-01

    Increased fracture risk is commonly reported in cancer patients receiving radiotherapy, particularly at sites within the field of treatment. The direct and systemic effects of ionizing radiation on bone at a therapeutic dose are not well characterized in clinically relevant animal models. Using twenty-week male C57Bl/6 mice, effects of irradiation (right hindlimb; 2 Gy) on bone volume and microarchitecture were evaluated prospectively by microcomputed tomography and histomorphometry and compared to contralateral-shielded bone (left hindlimb) and non-irradiated control bone. One-week post-irradiation, trabecular bone volume declined in irradiated tibiae (−22%; p<0.0001) and femora (−14%; p=0.0586) and microarchitectural parameters were compromised. Trabecular bone volume declined in contralateral tibiae (−17%; p=0.003), and no loss was detected at the femur. Osteoclast number, apoptotic osteocyte number and marrow adiposity were increased in irradiated bone relative to contralateral and non-irradiated bone, while osteoblast number was unchanged. Despite no change in osteoblast number one-week post-irradiation, dynamic bone formation indices revealed a reduction in mineralized bone surface and a concomitant increase in unmineralized osteoid surface area in irradiated bone relative to contralateral and non-irradiated control bone. Further, dose- and time-dependent calvarial culture and in vitro assays confirmed that calvarial osteoblasts and osteoblast-like MC3T3 cells were relatively radioresistant, while calvarial osteocyte and osteocyte-like MLO-Y4 cell apoptosis was induced as early as 48h post-irradiation (4 Gy). In osteoclastogenesis assays, radiation exposure (8 Gy) stimulated murine macrophage RAW264.7 cell differentiation and co-culture of irradiated RAW264.7 cells with MLO-Y4 or murine bone marrow cells enhanced this effect. These studies highlight the multi-faceted nature of radiation-induced bone loss by demonstrating direct and systemic effects on

  18. Improving the textural characterization of trabecular bone structure to quantify its changes: the locally adapted scaling vector method

    NASA Astrophysics Data System (ADS)

    Raeth, Christoph W.; Mueller, Dirk; Boehm, Holger F.; Rummeny, Ernst J.; Link, Thomas M.; Monetti, Roberto

    2005-04-01

    We extend the recently introduced scaling vector method (SVM) to improve the textural characterization of oriented trabecular bone structures in the context of osteoporosis. Using the concept of scaling vectors one obtains non-linear structural information from data sets, which can account for global anisotropies. In this work we present a method which allows us to determine the local directionalities in images by using scaling vectors. Thus it becomes possible to better account for local anisotropies and to implement this knowledge in the calculation of the scaling properties of the image. By applying this adaptive technique, a refined quantification of the image structure is possible: we test and evaluate our new method using realistic two-dimensional simulations of bone structures, which model the effect of osteoblasts and osteoclasts on the local change of relative bone density. The partial differential equations involved in the model are solved numerically using cellular automata (CA). Different realizations with slightly varying control parameters are considered. Our results show that even small changes in the trabecular structures, which are induced by variation of a control parameters of the system, become discernible by applying the locally adapted scaling vector method. The results are superior to those obtained by isotropic and/or bulk measures. These findings may be especially important for monitoring the treatment of patients, where the early recognition of (drug-induced) changes in the trabecular structure is crucial.

  19. Bone involvement in young patients with non-Hodgkin's lymphoma: efficacy of chemotherapy without local radiotherapy.

    PubMed

    Haddy, T B; Keenan, A M; Jaffe, E S; Magrath, I T

    1988-10-01

    Of 95 young non-Hodgkin's lymphoma patients entered consecutively on the National Cancer Institute (NCI) Protocol 7704, 26 (27.4%) had involvement of one or more bones. The mean age of these 26 patients was 16.6 years, and the male to female ratio was 3.3:1. Tumor histology included undifferentiated Burkitt's lymphoma in 12, undifferentiated non-Burkitt's lymphoma in two, undifferentiated, unspecified lymphoma in one, diffuse large cell lymphoma in three, and lymphoblastic lymphoma in eight patients. Most had extensive disease; two patients had isolated bone lesions, one had lesions of two bones without involvement of other tissues, and 23 had either multiple bone lesions or single bone lesions with involvement of other tissues. Eight of the 26 patients had bone marrow involvement. Of a subgroup of 12 patients with jaw disease, 11 had undifferentiated lymphoma and one had diffuse large cell lymphoma. Only one had primary a jaw tumor, with two quadrants of the jaw involved. All 26 patients were treated with chemotherapy; only two received radiotherapy initially for bone lesions. Predicted survival of the 26 patients at 5 years is 53.2%. The 12 patients who remain disease free have a mean survival of 62.1 months (range, 22 to 100 months). Our results call into question the role of radiotherapy in the treatment of bone lesions in non-Hodgkin's lymphoma. PMID:3167201

  20. Is asymptomatic malaria really asymptomatic? Hematological, vascular and inflammatory effects of asymptomatic malaria parasitemia.

    PubMed

    de Mast, Quirijn; Brouwers, Judith; Syafruddin, Din; Bousema, Teun; Baidjoe, Amrish Y; de Groot, Philip G; van der Ven, Andre J; Fijnheer, Rob

    2015-11-01

    Asymptomatic malaria infections are highly prevalent in malaria endemic regions and most of these infections remain undiagnosed and untreated. Whereas conventional malaria symptoms are by definition absent, little is known on the more subtle health consequences of these infections. The aim of our study was to analyze the hematologic, vascular and inflammatory effects of patent and subpatent asymptomatic malaria parasitemia in children and adults on the Indonesian island Sumba. Both children and adults with parasitemia had increased high-sensitive C-reactive protein levels compared to aparasitemic individuals. In addition, children, but not adults with parasitemia also had lower platelet counts and Hb levels and higher levels of von Willebrand factor and platelet factor-4, markers of endothelial and platelet activation, respectively. These findings suggest that asymptomatic malaria infections have subtle health consequences, especially in children, and should be regarded as potentially harmful. PMID:26304688

  1. Orientation-weighted local Minkowski functionals in 3D for quantitative assessment of trabecular bone structure in the hip

    NASA Astrophysics Data System (ADS)

    Boehm, H. F.; Bitterling, H.; Weber, C.; Kuhn, V.; Eckstein, F.; Reiser, M.

    2007-03-01

    Fragility fractures or pathologic fractures of the hip, i.e. fractures with no apparent trauma, represent the worst complication in osteoporosis with a mortality close to 25% during the first post-traumatic year. Over 90% of hip fractures result from falls from standing height. A substantial number of femoral fractures are initiated in the femoral neck or the trochanteric regions which contain an internal architecture of trabeculae that are functionally highly specialized to withstand the complex pattern of external and internal forces associated with human gait. Prediction of the mechanical strength of bone tissue can be achieved by dedicated texture analysis of data obtained by high resolution imaging modalities, e.g. computed tomography (CT) or magnetic resonance tomography (MRI). Since in the case of the proximal femur, the connectivity, regional distribution and - most of all - the preferred orientation of individual trabeculae change considerably within narrow spatial limits, it seems most reasonable to evaluate the femoral bone structure on an orientation-weighted, local scale. In past studies, we could demonstrate the advantages of topological analysis of bone structure using the Minkowski Functionals in 3D on a global and on a local scale. The current study was designed to test the hypothesis that the prediction of the mechanical competence of the proximal femur by a new algorithm considering orientational changes of topological properties in the trabecular architecture is feasible and better suited than conventional methods based on the measurement of the mineral density of bone tissue (BMD).

  2. Vaginal flora in asymptomatic women.

    PubMed

    Tashjian, J H; Coulam, C B; Washington, J A

    1976-09-01

    Four groups of 25 asymptomatic women--pregnant, premenopausal and taking oral contraceptives, premenopausal and not taking oral contraceptives, and postmenopausal--were studied for the presence in vaginal specimens of aerobic bacteria, anaerobic bacteria, fungi, Mycoplasma, Chlamydia, herpes simplex virus, mycobacteria, and Trichomonas. No significant differences in microbial flora were found among the groups. PMID:957791

  3. Quantitative Imaging of Hematopoietic Stem and Progenitor Cell localization and hypoxic status in the Bone Marrow microenvironment

    PubMed Central

    Nombela-Arrieta, César; Pivarnik, Gregory; Winkel, Beatrice; Canty, Kimberly J.; Harley, Brendan; Mahoney, John E.; Park, Shin-Young; Lu, Jiayun; Protopopov, Alexei; Silberstein, Leslie E.

    2014-01-01

    The existence of a hematopoietic stem cell niche as a spatially confined regulatory entity relies on the notion that hematopoietic stem and progenitor cells (HSPCs) are strategically positioned in unique bone marrow (BM) microenvironments with defined anatomical and functional features. Here, we employ a powerful imaging cytometry platform to perform a comprehensive quantitative analysis of HSPC distribution in BM cavities of femoral bones. We find that HSPCs preferentially localize in endosteal zones, where the majority closely interacts with sinusoidal and non-sinusoidal BM microvessels, which form a distinctive circulatory system. In situ tissue analysis reveals that HSPCs exhibit a hypoxic profile, defined by strong retention of pimonidazole and expression of HIF-1α, regardless of localization throughout the BM, adjacency to vascular structures or cell cycle status. These studies argue that the characteristic hypoxic state of HSPCs is not solely the result of a minimally oxygenated niche but may be partially regulated by cell-specific mechanisms. PMID:23624405

  4. Radioisotope scanning of brain, liver, lung and bone with a note on tumour localizing agents

    PubMed Central

    Lavender, J. P.

    1973-01-01

    Radioisotopic scanning of brain, liver, lungs and the skeleton is briefly reviewed with a survey of recent developments of clinical significance. In brain scanning neoplasm detection rates of greater than 90% are claimed. The true figure is probably 70-80%. Autopsy data shows a number of false negatives, particularly with vascular lesions. Attempts to make scanning more specific in differentiating neoplasm from vascular lesions by rapid sequence blood flow studies are reviewed. In liver scanning by means of colloids again high success rate is claimed but small metastases are frequently missed and the false negative scan rate is probably quite high. Lung scanning still has its main place in investigating pulmonary embolic disease. Ventilation studies using Xenon 133 are useful, particularly combined with perfusion studies. The various radiopharmaceuticals for use in bone scanning are reviewed. The appearance of technetium labelled phosphate compounds will probably allow much wider use of total skeletal scanning. Research into tumour localizing agents continues, the most recent and interesting being Gallium citrate and labelled bleomycin. Neither agent is predictable however although Gallium may have a place in Hodgkins disease and bronchogenic neoplasm and both may have a place in the detection of cerebral tumours. ImagesFig. 1Fig. 2Fig. 3p452-bFig. 3bFig. 4Fig. 5Fig. 5bFig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 12c & 12dFig. 13Fig. 13 b,c,dFig. 14Fig. 14bFig. 15Fig. 15bFig. 16Fig. 17Fig. 18 PMID:4602127

  5. Pneumonitis in bone marrow transplant recipients results from a local immune response.

    PubMed Central

    Milburn, H J; Du Bois, R M; Prentice, H G; Poulter, L W

    1990-01-01

    Eighteen recipients of allogeneic T cell-depleted bone marrow who developed 22 episodes of interstitial pneumonitis were investigated by bronchoalveolar lavage for the cause of pneumonitis. The cells obtained were examined using a panel of monoclonal antibodies with immunocytochemical techniques to identify lymphocyte subsets and the presence of surface molecules indicative of lymphocyte activation. The majority of patients had an excess of lymphocytes in lavage and most of these cells were positively stained with the McAb recognizing the CD8 antigen (suppressor/cytotoxic type T cells). Although the proportions of CD4+ (helper type) T cells were below normal, the absolute numbers were within normal limits, thus the CD4:CD8 ratio was consistently 1:1 or less. A large proportion of the CD8+ cells displayed HLA-DR molecules (RFDR1+), interleukin-2 (IL-2) receptors (CD25+) and high concentration of CD7 antigen (RFT2+). Further analysis revealed that most CD8+ cells were CD5+ (RFT1+) yet a large proportion (20-40%) were CD5-. A majority of CD8+ cells was also CD38+ (RFT10+) and Leu7+. No clear correlation between the emergence of a raised proportion of activated CD8+ cells and diagnosed cytomegalovirus infection was found. These results demonstrate, however, that cells with the phenotype of the resident T cells of the bronchial epithelium (CD8+CD5-) emerge to the air spaces and express activation markers. This raises the intriguing paradox of an aggressive local immune response occurring in an otherwise immunosuppressed group of patients. PMID:2201468

  6. Molecular evidence for the localization of Plasmodium falciparum immature gametocytes in bone marrow

    PubMed Central

    Aguilar, Ruth; Magallon-Tejada, Ariel; Achtman, Ariel H.; Moraleda, Cinta; Joice, Regina; Cisteró, Pau; Li Wai Suen, Connie S. N.; Nhabomba, Augusto; Macete, Eusebio; Mueller, Ivo; Marti, Matthias; Alonso, Pedro L.; Menéndez, Clara; Schofield, Louis

    2014-01-01

    Plasmodium falciparum immature gametocytes are not observed in peripheral blood. However, gametocyte stages in organs such as bone marrow have never been assessed by molecular techniques, which are more sensitive than optical microscopy. We quantified P falciparum sexual stages in bone marrow (n = 174) and peripheral blood (n = 70) of Mozambican anemic children by quantitative polymerase chain reaction targeting transcripts specific for early (PF14_0748; PHISTa), intermediate (PF13_0247; Pfs48/45), and mature (PF10_0303; Pfs25) gametocytes. Among children positive for the P falciparum housekeeping gene (PF08_0085; ubiquitin-conjugating enzyme gene) in bone marrow (n = 136) and peripheral blood (n = 25), prevalence of immature gametocytes was higher in bone marrow than peripheral blood (early: 95% vs 20%, P < .001; intermediate: 80% vs 16%; P < .001), as were transcript levels (P < .001 for both stages). In contrast, mature gametocytes were more prevalent (100% vs 51%, P < .001) and abundant (P < .001) in peripheral blood than in the bone marrow. Severe anemia (3.57, 95% confidence interval 1.49-8.53) and dyserythropoiesis (6.21, 95% confidence interval 2.24-17.25) were independently associated with a higher prevalence of mature gametocytes in bone marrow. Our results highlight the high prevalence and abundance of early sexual stages in bone marrow, as well as the relationship between hematological disturbances and gametocyte development in this tissue. PMID:24335496

  7. Enhancement of local bone remodeling in osteoporotic rabbits by biomimic multilayered structures on Ti6Al4V implants.

    PubMed

    Huang, Ling; Luo, Zhong; Hu, Yan; Shen, Xinkun; Li, Menghuan; Li, Liqi; Zhang, Yuan; Yang, Weihu; Liu, Peng; Cai, Kaiyong

    2016-06-01

    To enhance long-term survival of titanium implants in patients with osteoporosis, chitosan/gelatin multilayers containing bone morphogenetic protein 2(BMP2) and an antiosteoporotic agent of calcitonin (CT) are deposited on the Ti6Al4V (TC4) implants through layer-by-layer (LBL) electrostatic assembly technique. Here, the obtained titanium alloy implant (TC4/LBL/CT/BMP2) can regulate the release of loaded calcitonin and BMP2 agents in a sustaining manner to accelerate the bone formation and simultaneously inhibit bone resorption. In vitro results show that the bone-related cells on TC4/LBL/CT/BMP2 present the lowest production level of tartrate resistant acid phosphatase (TRAP) but the highest (p < 0.05) level of alkaline phosphatase (ALP) activity, osteocalcin production, mineralization capacity and osteoblast-related gene expression among all groups after treatment for 7 or 21 days, respectively. Besides, in vivo studies of micro-CT analysis, routine histological and immunohistochemical analysis also collectively demonstrate that the TC4/LBL/CT/BMP2 implant can dramatically promote the formation and remodeling of new bone in osteoporotic rabbits after implantation for 30 days and 90 days, respectively. In vivo push-out testing further confirms that the TC4/LBL/CT/BMP2 implant has the highest (p < 0.01) interfacial shear strength and favorable bone-implant osseointegration. Overall, this study establishes a simple and profound methodology to fabricate a biofunctional TC4 implant for the treatment of local osteoporotic fractures in vivo. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1437-1451, 2016. PMID:26822259

  8. Local infusion of FGF-2 enhances bone ingrowth in rabbit chambers in the presence of polyethylene particles.

    PubMed

    Goodman, Stuart B; Song, Yong; Yoo, Juh Yung; Fox, Nora; Trindade, Michael C D; Kajiyama, Glen; Ma, Ting; Regula, Donald; Brown, Jim; Smith, R Lane

    2003-06-15

    Osseointegration of porous-coated implants during revision arthroplasty procedures is often impeded due to the presence of residual granuloma, particulate debris, and a sclerotic, dysvascular bone bed. We hypothesized that local infusion of recombinant fibroblast growth factor (FGF-2) would increase bone ingrowth in an in vivo model of tissue differentiation in the rabbit tibia in the presence of phagocytosable polyethylene particles. A drug test chamber (DTC) was implanted in the proximal medial tibial metaphysis of mature rabbits unilaterally. The chamber contained a 1x 1 x 5-mm tunnel for tissue ingrowth, and was connected to an osmotic diffusion pump. FGF-2 was infused at dosages of 0, 0.5, 5, 50, or 500 ng/day for a 3-week period, with subsequent harvesting of the ingrown tissue after each 3-week treatment. The effects of ultrahigh molecular weight polyethylene particles (0.5-microm diameter) on tissue ingrowth were determined by adding particles to the chamber at concentrations of 5.8 x 10(11) (low dose) or 1.7 x 10(12) (high dose) particles/mL, with and without infusion of 50 ng/day of FGF for 3 weeks. The tissue forming in the chamber was harvested after each treatment for histologic processing and morphometric analysis of bone ingrowth. Statistical analysis was performed using parametric tests (ANOVA), nonparametric tests (Kruskal-Wallis test) and post hoc tests. In the absence of particles, infusion of 50 ng FGF-2 per day yielded the greatest amount of bone ingrowth. The high dose of particles suppressed bone ingrowth into the chamber, but the low dose particles did not (p = 0.0002, 95% confidence limits = 9.19-18.80). Infusion of 50 ng FGF-2 per day significantly increased net bone formation in the presence of high-dose UHMWPE particles (p = 0.039, 95% confidence limits = 1.41-6.79). There was a trend for decreased numbers of vitronectin-receptor positive (osteoclast-like) cells with the addition of FGF-2, compared to particles alone (p = 0.08). Local

  9. A novel injectable borate bioactive glass cement for local delivery of vancomycin to cure osteomyelitis and regenerate bone.

    PubMed

    Cui, Xu; Zhao, Cunju; Gu, Yifei; Li, Le; Wang, Hui; Huang, Wenhai; Zhou, Nai; Wang, Deping; Zhu, Yi; Xu, Jun; Luo, Shihua; Zhang, Changqing; Rahaman, Mohamed N

    2014-03-01

    Osteomyelitis (bone infection) is often difficult to cure. The commonly-used treatment of surgical debridement to remove the infected bone combined with prolonged systemic and local antibiotic treatment has limitations. In the present study, an injectable borate bioactive glass cement was developed as a carrier for the antibiotic vancomycin, characterized in vitro, and evaluated for its capacity to cure osteomyelitis in a rabbit tibial model. The cement (initial setting time = 5.8 ± 0.6 min; compressive strength = 25.6 ± 0.3 MPa) released vancomycin over ~25 days in phosphate-buffered saline, during which time the borate glass converted to hydroxyapatite (HA). When implanted in rabbit tibial defects infected with methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis, the vancomycin-loaded cement converted to HA and supported new bone formation in the defects within 8 weeks. Osteomyelitis was cured in 87 % of the defects implanted with the vancomycin-loaded borate glass cement, compared to 71 % for the defects implanted with vancomycin-loaded calcium sulfate cement. The injectable borate bioactive glass cement developed in this study is a promising treatment for curing osteomyelitis and for regenerating bone in the defects following cure of the infection. PMID:24477872

  10. A Novel Local Autologous Bone Graft Donor Site After Scalp Tissue Expansion in Aplasia Cutis Congenita.

    PubMed

    Hadad, Ivan; Meara, John G; Rogers-Vizena, Carolyn R

    2016-06-01

    Aplasia cutis congenita (ACC) is a rare condition often presenting as an absent area of cutaneous scalp. The calvarium and dura may also be affected. Scalp reconstruction with tissue expansion is often needed for large defects. Patients involving deficient calvarial bone present a dilemma for the reconstructive surgeon, because bone graft donor sites are limited in young children.A thick, bony rim has been noted to form around the periphery of scalp tissue expanders. The authors present a series of 3 patients with ACC for whom this bony hyperostosis was used as donor particulate bone graft at the time of scalp tissue expansion. There was 85 to 100% graft ossification on postoperative computed tomography scan. There were no bone graft-related complications.In conclusion, the hyperostotic rim that forms after scalp tissue expansion can be successfully used as particulate bone graft, decreasing the number of procedures needed for patient with ACC and obviating the need for other donor sites. PMID:27192637

  11. Prediction of Local Ultimate Strain and Toughness of Trabecular Bone Tissue by Raman Material Composition Analysis

    PubMed Central

    Stüssi, Edgar; Müller, Ralph

    2015-01-01

    Clinical studies indicate that bone mineral density correlates with fracture risk at the population level but does not correlate with individual fracture risk well. Current research aims to better understand the failure mechanism of bone and to identify key determinants of bone quality, thus improving fracture risk prediction. To get a better understanding of bone strength, it is important to analyze tissue-level properties not influenced by macro- or microarchitectural factors. The aim of this pilot study was to identify whether and to what extent material properties are correlated with mechanical properties at the tissue level. The influence of macro- or microarchitectural factors was excluded by testing individual trabeculae. Previously reported data of mechanical parameters measured in single trabeculae under tension and bending and its compositional properties measured by Raman spectroscopy was evaluated. Linear and multivariate regressions show that bone matrix quality but not quantity was significantly and independently correlated with the tissue-level ultimate strain and postyield work (r = 0.65–0.94). Principal component analysis extracted three independent components explaining 86% of the total variance, representing elastic, yield, and ultimate components according to the included mechanical parameters. Some matrix parameters were both included in the ultimate component, indicating that the variation in ultimate strain and postyield work could be largely explained by Raman-derived compositional parameters. PMID:25695083

  12. Estimation of local anisotropy of plexiform bone: Comparison between depth sensing micro-indentation and Reference Point Indentation.

    PubMed

    Dall'Ara, E; Grabowski, P; Zioupos, P; Viceconti, M

    2015-11-26

    The recently developed Reference Point Indentation (RPI) allows the measurements of bone properties at the tissue level in vivo. The goal of this study was to compare the local anisotropic behaviour of bovine plexiform bone measured with depth sensing micro-indentation tests and with RPI. Fifteen plexiform bone specimens were extracted from a bovine femur and polished down to 0.05µm alumina paste for indentations along the axial, radial and circumferential directions (N=5 per group). Twenty-four micro-indentations (2.5µm in depth, 10% of them were excluded for testing problems) and four RPI-indentations (~50µm in depth) were performed on each sample. The local indentation modulus Eind was found to be highest for the axial direction (24.3±2.5GPa) compared to the one for the circumferential indentations (19% less stiff) and for the radial direction (30% less stiff). RPI measurements were also found to be dependent on indentation direction (p<0.001) with the exception of the Indentation Distance Increase (IDI) (p=0.173). In particular, the unloading slope US1 followed similar trends compared to the Eind: 0.47±0.03N/µm for axial, 11% lower for circumferential and 17% lower for radial. Significant correlations were found between US1 and Eind (p=0.001; R(2)=0.58), while no significant relationship was found between IDI and any of the micro-indentation measurements (p>0.157). In conclusion some of the RPI measurements can provide information about local anisotropy but IDI cannot. Moreover, there is a linear relationship between most local mechanical properties measured with RPI and with micro-indentations, but IDI does not correlate with any micro-indentation measurements. PMID:26477406

  13. Gallium-67 citrate localization in osteoclast nuclei of Paget's disease of bone

    SciTech Connect

    Mills, B.G.; Masuoka, L.S.; Graham, C.C. Jr.; Singer, F.R.; Waxman, A.D.

    1988-06-01

    Gallium-67 citrate scintigraphy has been used to indicate the extent of bone involvement in patients with Paget's disease of bone and is an excellent marker in monitoring the effects of specific therapy. Since gallium uptake is dependent on cellular function, autoradiographic techniques can be applied to cells of Paget's lesions to understand better the mechanism of (/sup 67/Ga)citrate uptake. Bone biopsies were obtained from sites of increased uptake using (/sup 67/Ga)citrate scintigraphy in two patients with Paget's disease. In both patients electron microscopic autoradiographs demonstrated a high concentration of silver grains over the nuclei of osteoclasts. The cellular mechanism is unknown but may be related to the known inhibitory effect of calcitonin on osteoclast activity. The association of (/sup 67/Ga)citrate with the nucleus of the osteoclasts is unique and different from tumor cells in which there is a high association of (/sup 67/Ga)citrate with the lysosome fraction within the cytoplasm.

  14. Evaluation of analgesic effect of local administration of morphine after iliac crest bone graft harvesting: A double blind study

    PubMed Central

    Singh, Devinder; Gombar, K K; Bhatia, Nidhi; Gombar, Satinder; Garg, Sudhir

    2013-01-01

    Background and Objective: Pain is a complex process influenced by both physiological and psychological factors. In spite of an armamentarium of analgesic drugs and techniques available to combat post-operative pain, appropriate selection, and effective management for relief of post-operative pain still poses unique challenges. The discovery of peripheral opioid receptors has led to growing interest in the use of locally applied opioids (intra-articular, intra-pleural, intra-peritoneal, and perineural) for managing acute pain. As bone graft harvesting is associated with significant post-operative pain and there is a paucity of literature on the use of peripheral opioids at the iliac crest bone harvesting site, the present study was planned to evaluate the analgesic efficacy of local administration of morphine after iliac crest bone graft harvesting. Materials and Methods: A total of 60 patients, 20-50 years of age scheduled to undergo elective surgery for delayed and non-union fracture both bone leg with bone grafting under general anaesthesia (GA) were randomly assigned to one of the four groups of 15 patients each: group 1: 2.5 ml normal saline (NS) +2.5 ml NS infiltrated into the harvest site at 2 sites + 1 ml NS intramuscularly (i/m); Group 2: 2.5 ml NS + 2.5 ml NS infiltrated into the harvest site at 2 sites + 5 mg morphine in 1 ml i/m.; Group 3: 2.5 mg (2.5 ml) morphine + 2.5 mg (2.5 ml) morphine infiltrated into the harvest site at 2 sites + 1 ml NS i/m; Group 4: 0.5 mg naloxone (2.5 ml) +5 mg (2.5 ml) morphine infiltrated into the harvest site at 2 sites + 1 ml NS i/m. Pain from the bone graft site and operative site was assessed for 24 h post-operatively. Results: The patients who had received morphine infiltration (Group 3) had significantly less pain scores at the graft site at 4, 6, and 10 post-operative hours. They also had significantly less morphine consumption and overall better pain relief as compared to the other groups. Conclusions: Morphine

  15. Mesenchymal Stem Cell Expression of Stromal Cell-Derived Factor-1β Augments Bone Formation in a Model of Local Regenerative Therapy

    PubMed Central

    Herberg, Samuel; Kondrikova, Galina; Hussein, Khaled A.; Johnson, Maribeth H.; Elsalanty, Mohammed E.; Shi, Xingming; Hamrick, Mark W.; Isales, Carlos M.; Hill, William D.

    2015-01-01

    Bone has the potential for spontaneous healing. However, this process often fails in patients with co-morbidities requiring clinical intervention. Numerous studies have revealed that bone marrow-derived mesenchymal stem/stromal cells (BMSCs) hold great potential for regenerative therapies. Common problems include poor cell engraftment, which can be addressed by irradiation prior to transplantation. Increasing evidence suggests that stromal cell-derived factor-1 (SDF-1) is involved in bone formation. However, osteogenic contributions of the beta splice variant of SDF-1 (SDF-1β), which is highly expressed in bone, remain unclear. Using the tetracycline (Tet)-regulatory system we have shown that SDF-1β enhances BMSC osteogenic differentiation in vitro. Here we test the hypothesis that SDF-1β augments bone formation in vivo in a model of local BMSC transplantation following irradiation. We found that SDF-1β, expressed at high levels in Tet-Off-SDF-1β BMSCs, augments the cell-mediated therapeutic effects resulting in enhanced bone formation, as evidenced by ex vivo μCT and bone histomorphometry. The data demonstrate the specific contribution of SDF-1β to BMSC-mediated bone formation, and validate the feasibility of the Tet-Off technology to regulate SDF-1β expression in vivo. In conclusion, SDF-1β provides potent synergistic effects supporting BMSC-mediated bone formation and appears a suitable candidate for optimization of bone augmentation in translational protocols. PMID:25351363

  16. Role of computed tomography and radionuclide scintigraphy in the localization of osteomyelitis in flat bones

    SciTech Connect

    Hernandez, R.J.; Conway, J.J.; Poznanski, A.K.; Tachdjian, M.O.; Dias, L.S.; Kelikian, A.S.

    1985-03-01

    The combined use of radionuclide scintigraphy and computed tomography is recommended for evaluating children with laboratory and clinical data suggestive of flat bone osteomyelitis despite normal conventional radiographs. In addition, computed tomography may be helpful in the presence of abnormal radiographs in determining the exact location of the focus of osteomyelitis and the most suitable route for appropriate drainage or to obtain culture material.

  17. Technetium-99m labeled red blood cells for the detection and localization of cavernous hemangiomas of the bone

    SciTech Connect

    Lenane, P.

    1986-09-01

    Labeled red blood cells (RBCs) have already been proven useful in the detection and localization of many vascular abnormalities. One such abnormality is that of a cavernous hemangioma. Cavernous hemangiomas have a distinct circulation and have been found in many areas of the body. The ability to utilize this unique circulation is important to consider when choosing a diagnostic exam. This paper reports a case demonstrating the usefulness of labeled red blood cells for the detection and localization of cavernous hemangioma of the bone. A 31-yr-old female present with a history of persistent generalized headaches for many years. About 1 yr prior to the exam, she noticed that her headaches had become more localized to the right side of her head. Physical examination revealed a palpable lump developing on the right side of her head which was sensitive to the touch. The patient was then scheduled for a CT scan to be followed by both a bone scan and a /sup 99m/Tc blood-pool scan. A flow study using 15 mCi /sup 99m/Tc labeled RBCs was performed in the right lateral position at 1.5 sec/frame for 32 frames. Immediate blood-pool images 30-min, and 1-hr delayed images were recorded.

  18. Asymptomatic Nonsyndromic Multiple Supernumerary Premolars

    PubMed Central

    Goswami, Mridula

    2012-01-01

    ABSTRACT The apparently morphologically normal finding of multiple supernumerary teeth in absence of an associated systemic condition or syndrome is an uncommon phenomenon. Surgical removal of supernumerary teeth is indicated if eruption of the adjacent teeth has been delayed; altered eruption, displacement of adjacent teeth is evident or pathologies such as cystic lesion and resorption of adjacent tooth have occurred. If the risks of surgery outweigh the benefits of removal, the teeth may be left in situ and a regular radiographic monitoring should be made. How to cite this article: Gupta S, Goswami M. Asymptomatic Nonsyndromic Multiple Supernumerary Premolars. Int J Clin Pediatr Dent 2012;5(1):84-86. PMID:25206142

  19. The Enhancement of Bone Allograft Incorporation by the Local Delivery of the Sphingosine 1-phosphate Receptor Targeted Drug FTY720

    PubMed Central

    Aronin, Caren E Petrie; Shin, Soo J; Naden, Kimberly B; Rios, Peter D; Sefcik, Lauren S; Zawodny, Sarah R; Bagayoko, Namory D; Cui, Quanjun; Khan, Yusuf

    2010-01-01

    Poor vascularization coupled with mechanical instability is the leading cause of post-operative complications and poor functional prognosis of massive bone allografts. To address this limitation, we designed a novel continuous polymer coating system to provide sustained localized delivery of pharmacological agent, FTY720, a selective agonist for sphingosine 1-phosphate receptors, within massive tibial defects. In vitro drug release studies validated 64% loading efficiency with complete release of compound following 14 days. Mechanical evaluation following six weeks of healing suggested significant enhancement of mechanical stability in FTY720 treatment groups compared with unloaded controls. Furthermore, superior osseous integration across the host-graft interface, significant enhancement in smooth muscle cell investment, and reduction in leukocyte recruitment was evident in FTY720 treated groups compared with untreated groups. Using this approach, we can capitalize on the existing mechanical and biomaterial properties of devitalized bone, add a controllable delivery system while maintaining overall porous structure, and deliver a small molecule compound to constitutively target vascular remodeling, osseous remodeling, and minimize fibrous encapsulation within the allograft-host bone interface. Such results support continued evaluation of drug-eluting allografts as a viable strategy to improve functional outcome and long-term success of massive cortical allograft implants. PMID:20621764

  20. Micro-compression: a novel technique for the nondestructive assessment of local bone failure.

    PubMed

    Müller, R; Gerber, S C; Hayes, W C

    1998-12-01

    Many bones within the axial and appendicular skeleton are subjected to repetitive, cyclic loading during the course of ordinary daily activities. If this repetitive loading is of sufficient magnitude or duration, fatigue failure of the bone tissue may result. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, and are often preceded by buckling and bending of microstructural elements. However, the relative importance of bone density and architecture in the etiology of these fractures is poorly understood. The aim of the study was to investigate failure mechanisms of 3D trabecular bone using micro-computed tomography (microCT). Because of its nondestructive nature, microCT represents an ideal approach for performing not only static measurements of bone architecture but also dynamic measurements of failure initiation and propagation as well as damage accumulation. For the purpose of the study, a novel micro-compression device was devised to measure loaded trabecular bone specimens directly in a micro-tomographic system. The measurement window in the device was made of a radiolucent, highly stiff plastic to enable X-rays to penetrate the material. The micro-compressor has an outer diameter of 19 mm and a total length of 65 mm. The internal load chamber fits wet or dry bone specimens with maximal diameters of 9 mm and maximal lengths of 22 mm. For the actual measurement, first, the unloaded bone is measured in the microCT. Second, a load-displacement curve is recorded where the load is measured with an integrated mini-button load cell and the displacement is computed directly from the microCT scout-view. For each load case, a 3D snap-shot of the structure under load is taken providing 34 microm nominal resolution. Initial measurements included specimens from bovine tibiae and whale spine to investigate the influence of the structure type on the failure mechanism. In a

  1. Effect of Local Sustainable Release of BMP2-VEGF from Nano-Cellulose Loaded in Sponge Biphasic Calcium Phosphate on Bone Regeneration

    PubMed Central

    Sukul, Mousumi; Nguyen, Thuy Ba Linh; Min, Young-Ki; Lee, Sun-Young

    2015-01-01

    Bone regeneration is a coordinated process mainly regulated by multiple growth factors. Vascular endothelial growth factor (VEGF) stimulates angiogenesis and bone morphogenetic proteins (BMPs) induce osteogenesis during bone healing process. The aim of this study was to investigate how these growth factors released locally and sustainably from nano-cellulose (NC) simultaneously effect bone formation. A biphasic calcium phosphate (BCP)-NC-BMP2-VEGF (BNBV) scaffold was fabricated for this purpose. The sponge BCP scaffold was prepared by replica method and then loaded with 0.5% NC containing BMP2-VEGF. Growth factors were released from NC in a sustainable manner from 1 to 30 days. BNBV scaffolds showed higher cell attachment and proliferation behavior than the other scaffolds loaded with single growth factors. Bare BCP scaffolds and BNBV scaffolds seeded with rat bone marrow mesenchymal stem cells were implanted ectopically and orthotopically in nude mice for 4 weeks. No typical bone formation was exhibited in BNBV scaffolds in ectopic sites. BMP2 and VEGF showed positive effects on new bone formation in BNBV scaffolds, with and without seeded stem cells, in the orthotopic defects. This study demonstrated that the BNBV scaffold could be beneficial for improved bone regeneration. Stem cell incorporation into this scaffold could further enhance the bone healing process. PMID:25808925

  2. Management of Asymptomatic Renal Stones in Astronauts

    NASA Technical Reports Server (NTRS)

    Reyes, David; Locke, James

    2016-01-01

    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  3. Intraperitoneal Follicular Dendritic Cell Sarcoma: Role of Chemotherapy and Bone Marrow Allotransplantation in Locally Advanced Disease?

    PubMed Central

    Liberale, G; Keriakos, K; Azerad, MA; De Saint Aubain, N; El Nakadi, I

    2015-01-01

    We describe a case of a 44 year-old woman diagnosed with follicular dendritic cell sarcoma (FDCS). FDCS is a very rare disease affecting the dendritic antigen presenting cells and is often misdiagnosed. Surgery is considered the best treatment modality, followed by chemotherapy. In our case, surgical excision was not possible, therefore the patient received two lines of chemotherapy followed by bone marrow allotransplantation, then a third line of chemotherapy with a complete metabolic response seen on PET/computed tomography (CT) follow-up 29 months later. A review of the literature has been performed. PMID:25698886

  4. [Screening of parasitic diseases in the asymptomatic immigrant population].

    PubMed

    Goterris, Lidia; Bocanegra, Cristina; Serre-Delcor, Núria; Moure, Zaira; Treviño, Begoña; Zarzuela, Francesc; Espasa, Mateu; Sulleiro, Elena

    2016-07-01

    Parasitic diseases suppose an important health problem in people from high endemic areas, so these must be discarded properly. Usually, these infections develop asymptomatically but, in propitious situations, are likely to reactivate themselves and can cause clinical symptoms and/or complications in the receiving country. Moreover, in some cases it is possible local transmission. Early diagnosis of these parasitic diseases made by appropriate parasitological techniques and its specific treatment will benefit both, the individual and the community. These techniques must be selected according to geoepidemiological criteria, patient's origin, migration route or time spent outside the endemic area; but other factors must also be considered as its sensitivity and specificity, implementation experience and availability. Given the high prevalence of intestinal parasites on asymptomatic immigrants, it is recommended to conduct a study by coproparasitological techniques. Because of its potential severity, the screening of asymptomatic malaria with sensitive techniques such as PCR (polymerase chain reaction) is also advisable. Serological screening for Chagas disease should be performed on all Latin American immigrants, except for people from the Caribbean islands. Other important parasites, which should be excluded, are filariasis and urinary schistosomiasis, by using microscopic examination. The aim of this paper is to review the different techniques for the screening of parasitic diseases and its advices within the care protocols for asymptomatic immigrants. PMID:27474244

  5. Locally aggressive aneurysmal bone cyst of C4 vertebra treated by total en bloc excision and anterior plus posterior cervical instrumentation

    PubMed Central

    Parmar, Himanshu N.; Agrawal, Vinod A.; Shah, Munjal S.; Nanda, Saurav N.

    2015-01-01

    We are presenting a case of cervical (C4) aneurysmal bone cyst in a 13-year-old girl, came to the outpatient department with neck pain and stiffness since 6 months and normal neurology. We did an en bloc excision of locally aggressive tumor through anterior plus posterior approach and stabilization by lateral mass screw fixation and anterior cervical instrumentation. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumor and instrumentation in a single stage to avoid instability. PMID:26288549

  6. Is surgery necessary for 'mild' or 'asymptomatic' hyperparathyroidism?

    PubMed

    Niederle, Bruno; Wémeau, Jean-Louis

    2015-09-01

    A large majority of the currently diagnosed patients with hyperparathyroidism (PHPT) are mild or asymptomatic, mainly women after menopause. Following the debate held at the 16th European Congress of Endocrinology in Wroclaw (Poland) from May 3-7, 2014, arguments are here presented by a surgeon and a medical practitioner considering these situations rather have to profit from surgery, or simply from survey. For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with 'mild' or 'asymptomatic' PHPT. The surgeon and the medical practitioner agree to consider that in patients with 'mild' or 'asymptomatic' disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost/benefit ratios of surgery or survey are also still imperfectly evaluated. PMID:26101370

  7. Bone Quality in Paget's Disease of Bone.

    PubMed

    Singer, Frederick R

    2016-04-01

    Paget's disease of bone is produced by a localized increase in osteoclastic and osteoblastic activity which can progress slowly to involve an entire bone if untreated. A common feature is enlarged bones which are deformed, particularly in weight-bearing regions of the skeleton such as the lower extremity. Pathologic fractures may be a consequence, and nonunion of femoral fractures is not uncommon. Analyses of bone biopsies from patients with Paget's disease indicate that there is a lower, heterogeneous degree of bone mineralization and a younger tissue age than that found in control bone. Pagetic bone also has less resistance to plastic deformation and a straighter crack path than control bone. PMID:26943142

  8. Gingival and localized alveolar bone necrosis related to the use of arsenic trioxide paste--two case reports.

    PubMed

    Chen, Gin; Sung, Po-Ta

    2014-03-01

    The leakage of arsenic trioxide paste from tooth fillings has been associated with widespread necrosis of the supporting periodontal tissues. This report describes two cases of arsenic trioxide paste-induced gingival and localized alveolar bone necrosis in the mandible, following the use of arsenic trioxide paste as a pulp-devitalized agent. The first case was a 54-year-old female complaining of a painful white patch on the gingival tissue of the left mandibular second molar (tooth #37) after treatment by a private dentist. She underwent completely debridement of all necrotic soft tissue with physical saline irrigation. The gingival tissue was gradually replaced with vascular tissue and completely healed after 7 weeks. The second case was a 30-year-old female complaining of severe pain and continuous gingival bleeding from the right maxillary first bicuspid (tooth #14) following treatment by a private dentist. She finally accepted debridement of the sequestrum and necrotic alveolar bone with decortication to induce active bleeding. A partial thickness gingival flap was made to cover the wound. Four weeks later, the supporting tissues had completely healed. Arsenic trioxide paste is a cytotoxic agent and may cause harmful adverse effects on adjacent periodontium and supporting hard tissue if leakage occurs, or it is used carelessly. There is no indication for the use of arsenic trioxide paste in modern dental practice. PMID:24630037

  9. Local delivery of parathyroid hormone-related protein-derived peptides coated onto a hydroxyapatite-based implant enhances bone regeneration in old and diabetic rats.

    PubMed

    Ardura, Juan A; Portal-Núñez, Sergio; Lozano, Daniel; Gutiérrez-Rojas, Irene; Sánchez-Salcedo, Sandra; López-Herradón, Ana; Mulero, Francisca; Villanueva-Peñacarrillo, María L; Vallet-Regí, María; Esbrit, Pedro

    2016-08-01

    Diabetes mellitus (DM) and aging are associated with bone fragility and increased fracture risk. Both (1-37) N- and (107-111) C-terminal parathyroid hormone-related protein (PTHrP) exhibit osteogenic properties. We here aimed to evaluate and compare the efficacy of either PTHrP (1-37) or PTHrP (107-111) loaded into gelatin-glutaraldehyde-coated hydroxyapatite (HA-Gel) foams to improve bone repair of a transcortical tibial defect in aging rats with or without DM, induced by streptozotocin injection at birth. Diabetic old rats showed bone structural deterioration compared to their age-matched controls. Histological and μ-computerized tomography studies showed incomplete bone repair at 4 weeks after implantation of unloaded Ha-Gel foams in the transcortical tibial defects, mainly in old rats with DM. However, enhanced defect healing, as shown by an increase of bone volume/tissue volume and trabecular and cortical thickness and decreased trabecular separation, occurred in the presence of either PTHrP peptide in the implants in old rats with or without DM. This was accompanied by newly formed bone tissue around the osteointegrated HA-Gel implant and increased gene expression of osteocalcin and vascular endothelial growth factor (bone formation and angiogenic markers, respectively), and decreased expression of Sost gene, a negative regulator of bone formation, in the healing bone area. Our findings suggest that local delivery of PTHrP (1-37) or PTHrP (107-111) from a degradable implant is an attractive strategy to improve bone regeneration in aged and diabetic subjects. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2060-2070, 2016. PMID:27086979

  10. An artifacts removal post-processing for epiphyseal region-of-interest (EROI) localization in automated bone age assessment (BAA)

    PubMed Central

    2011-01-01

    Background Segmentation is the most crucial part in the computer-aided bone age assessment. A well-known type of segmentation performed in the system is adaptive segmentation. While providing better result than global thresholding method, the adaptive segmentation produces a lot of unwanted noise that could affect the latter process of epiphysis extraction. Methods A proposed method with anisotropic diffusion as pre-processing and a novel Bounded Area Elimination (BAE) post-processing algorithm to improve the algorithm of ossification site localization technique are designed with the intent of improving the adaptive segmentation result and the region-of interest (ROI) localization accuracy. Results The results are then evaluated by quantitative analysis and qualitative analysis using texture feature evaluation. The result indicates that the image homogeneity after anisotropic diffusion has improved averagely on each age group for 17.59%. Results of experiments showed that the smoothness has been improved averagely 35% after BAE algorithm and the improvement of ROI localization has improved for averagely 8.19%. The MSSIM has improved averagely 10.49% after performing the BAE algorithm on the adaptive segmented hand radiograph. Conclusions The result indicated that hand radiographs which have undergone anisotropic diffusion have greatly reduced the noise in the segmented image and the result as well indicated that the BAE algorithm proposed is capable of removing the artifacts generated in adaptive segmentation. PMID:21952080

  11. Clinical Expression of Calcium Sensing Receptor Polymorphism (A986S) in Normocalcemic and Asymptomatic Hyperparathyroidism.

    PubMed

    Díaz-Soto, G; Romero, E; Castrillón, J L P; Jauregui, O I; de Luis Román, D

    2016-03-01

    Normocalcemic and asymptomatic hyperparathyroidism diagnosis are becoming more common. However, their pathophysiology is incompletely known. The aim of the present study was to evaluate the clinical effect of calcium-sensing receptor polymorphism (A986S) in normocalcemic and asymtomatic HPT. Prospective study conducted with 61 consecutive normocalcemic and asymptomatic HPT patients was followed up during a minimum period of 1 year. Secondary causes of hyperparathyroidism were ruled out. Calcium and phosphorus metabolism parameters were evaluated in at least 2 determinations during follow-up to classify as normocalcemic or asymptomatic hyperparathyroidism. Bone mineral density and A986S polymorphism genotype were also analyzed. Thiry-eight patients (62.3%) had the genotype A986A, and 23 (36.7%) patients had A986S (20 patients, 32.8%) or S986S (3 patients, 4.9%). Age, sex, and genotype distributions were comparable in both normocalcemic and asymptomatic hyperparathyroidism. In normocalcemic patients, S allele genotype was associated to statistically significant higher level of intact PTH: 92.0 (SD 18.5) vs. 110.6 (SD 24.4) pg/ml, p<0.05; and remained significant after adjustment by multiple linear regression. In asymptomatic hyperparathyroidism, A986A genotype resulted in a statistically significant higher level of intact PTH, alkaline phosphatase and procollagen amino-terminal propeptide; but only serum calcium remained as an independent predictor of serum intact PTH levels after a multiple linear regression. Bone mineral densitometry between genotypes did not show statistically significant differences. A986S polymorphism of CaSR is an independent predictor of PTH level in normocalcemic hyperparathyroidism patients, but not in asymptomatic hyperparathyroidism. More studies are needed to evaluate the effect of other polymorphisms in normocalcemic and asymptomatic hyperparathyroidism. PMID:26332755

  12. Effects of Local Administration of Boric Acid on Posterolateral Spinal Fusion with Autogenous Bone Grafting in a Rodent Model.

    PubMed

    Kömürcü, Erkam; Özyalvaçlı, Gülzade; Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Cevizci, Sibel; Adam, Gürhan; Ozden, Raif

    2015-09-01

    Spinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p = 0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft + BA practice increased the histopathological score significantly with regard to the control group (p = 0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p = 0.328 and p = 0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body. PMID:25728510

  13. Antimicrobial Treatment of Asymptomatic Bacteriuria in Healthy Ambulatory Subjects.

    ERIC Educational Resources Information Center

    Zhanel, George G.

    1990-01-01

    The treatment of urinary tract infections is discussed. Specific issues considered include the definition of asymptomatic bacteriuria, the prevalence of asymptomatic bacteriuria, the controversies of who should be treated, and antimicrobial treatment of asymptomatic bacteriuria. (MLW)

  14. Stem cell homing using local delivery of plerixafor and stromal derived growth factor-1alpha for improved bone regeneration around Ti-implants.

    PubMed

    Karlsson, Johan; Harmankaya, Necati; Palmquist, Anders; Atefyekta, Saba; Omar, Omar; Tengvall, Pentti; Andersson, Martin

    2016-10-01

    Triggering of the early healing events, including the recruitment of progenitor cells, has been suggested to promote bone regeneration. In implantology, local drug release technologies could provide an attractive approach to promote tissue regeneration. In this study, we targeted the chemotactic SDF-1α/CXCR4 axis that is responsible e.g. for the homing of stem cells to trauma sites. This was achieved by local delivery of plerixafor, an antagonist to CXCR4, and/or SDF-1α, from titanium implants coated with mesoporous titania thin films with a pore size of 7.5 nm. In vitro drug delivery experiments demonstrated that the mesoporous coating provided a high drug loading capacity and controlled release. The subsequent in vivo study in rat tibia showed beneficial effects with respect to bone-implant anchorage and bone-formation along the surface of the implants when plerixafor and SDF-1α were delivered locally. The effect was most prominent by the finding that the combination of the drugs significantly improved the mechanical bone anchorage. These observations suggest that titanium implants with local delivery of drugs for enhanced local recruitment of progenitor cells have the ability to promote osseointegration. This approach may provide a potential strategy for the development of novel implant treatments. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2466-2475, 2016. PMID:27213764

  15. The effect of local IL-4 delivery or CCL2 blockade on implant fixation and bone structural properties in a mouse model of wear particle induced osteolysis.

    PubMed

    Sato, Taishi; Pajarinen, Jukka; Behn, Anthony; Jiang, Xinyi; Lin, Tzu-Hua; Loi, Florence; Yao, Zhenyu; Egashira, Kensuke; Yang, Fan; Goodman, Stuart B

    2016-09-01

    Modulation of macrophage polarization and prevention of CCL2-induced macrophage chemotaxis are emerging strategies to reduce wear particle induced osteolysis and aseptic total joint replacement loosening. In this study, the effect of continuous IL-4 delivery or bioactive implant coating that constitutively releases a protein inhibitor of CCL2 signaling (7ND) on particle induced osteolysis were studied in the murine continuous femoral intramedullary particle infusion model. Polyethylene particles with or without IL-4 were infused into mouse distal femurs implanted with hollow titanium rods using subcutaneous infusion pumps. In another experimental group, particles were infused into the femur through a 7ND coated rod. After 4 weeks, fixation of the implant was assessed using a pullout test. The volume of trabecular bone and the geometry of the local cortical bone were assessed by µCT and the corresponding structural properties of the cortical bone determined by torsional testing. Continuous IL-4 delivery led to increased trabecular bone volume as well as enhanced local bone geometry and structural properties, while 7ND implant coating did not have effect on these parameters. The results suggest that local IL-4 treatment is a promising strategy to mitigate wear particle induced osteolysis. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2255-2262, 2016. PMID:27114284

  16. Three-phase radionuclide bone scanning in evaluation of local radiation injury. A case report

    SciTech Connect

    Mettler, F.A. Jr.; Monsein, L.; Davis, M.; Rosenberg, R.; Kelsey, C.; Listrom, M.

    1987-10-01

    The management of local radiation injuries is influenced by the degree of vascular compromise within the skin and underlying tissues. Other authors have used thermography and angiography in assessing the blood flow to radiation damaged tissues. This report describes the use of radionuclide imaging in the evaluation of a patient who developed necrosis of his distal digits following a radiation accident. In addition to determining the vascular status of the hands, imaging helped indicate an appropriate level for amputation.

  17. [Asymptomatic kidney stones: active surveillance vs. treatment].

    PubMed

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. PMID:26378390

  18. Asymptomatic gonorrhoea in a male patient.

    PubMed Central

    Chattopadhyay, B.; Teli, J. C.

    1984-01-01

    A case of asymptomatic gonorrhoea in a male patient is described. Failure to isolate Neisseria gonorrhoea from his wife possibly demonstrates inhibitory effect of Candida albicans in vivo on the former organism. PMID:6436805

  19. Asymptomatic bacteriuria. Which patients should be treated?

    PubMed

    Zhanel, G G; Harding, G K; Guay, D R

    1990-07-01

    Asymptomatic bacteriuria is common in both the community nursing home and hospital settings. Few data, however, are available about the potential complications arising from asymptomatic bacteriuria (eg, the development of symptomatic infection and renal damage) for various patient populations and for various medical conditions. On the basis of data in the literature, we believe that neonates and preschool children with asymptomatic bacteriuria should be treated. Pregnant women and "nonelderly" (less than 60 years old) men should be treated. We do not think that school-age children, nonpregnant, nonelderly women, or elderly men and women need antimicrobial treatment if their urinary tracks are normal. In addition, antimicrobial treatment is recommended for patients with asymptomatic bacteriuria and abnormal urinary tracts and those undergoing clean intermittent catheterization, genitourinary manipulation, or instrumentation. Patients with long-term indwelling catheters should not be treated. The treatment of asymptomatic bacteriuria in patients with short-term indwelling catheters and those with ileal conduits is controversial. These treatment recommendations should not necessarily be accepted as the standards of practice, since treatment is often controversial due to the lack of published data describing the natural course of asymptomatic bacteriuria in various patient populations. PMID:2196024

  20. Treatment of liver hydatidosis: How to treat an asymptomatic carrier?

    PubMed Central

    Frider, Bernardo; Larrieu, Edmundo

    2010-01-01

    Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and reaspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective. PMID:20806427

  1. Direct bone marrow HSC transplantation enhances local engraftment at the expense of systemic engraftment in NSG mice

    PubMed Central

    Futrega, Kathryn; Lott, William B.; Doran, Michael R.

    2016-01-01

    Direct bone marrow (BM) injection has been proposed as a strategy to bypass homing inefficiencies associated with intravenous (IV) hematopoietic stem cell (HSC) transplantation. Despite physical delivery into the BM cavity, many donor cells are rapidly redistributed by vascular perfusion, perhaps compromising efficacy. Anchoring donor cells to 3-dimensional (3D) multicellular spheroids, formed from mesenchymal stem/stromal cells (MSC) might improve direct BM transplantation. To test this hypothesis, relevant combinations of human umbilical cord blood-derived CD34+ cells and BM-derived MSC were transplanted into NOD/SCID gamma (NSG) mice using either IV or intrafemoral (IF) routes. IF transplantation resulted in higher human CD45+ and CD34+ cell engraftment within injected femurs relative to distal femurs regardless of cell combination, but did not improve overall CD45+ engraftment at 8 weeks. Analysis within individual mice revealed that despite engraftment reaching near saturation within the injected femur, engraftment at distal hematopoietic sites including peripheral blood, spleen and non-injected femur, could be poor. Our data suggest that the retention of human HSC within the BM following direct BM injection enhances local chimerism at the expense of systemic chimerism in this xenogeneic model. PMID:27065210

  2. RITM and POCI: Pre and per-operative mini {gamma} cameras evaluation for bone tumor localization in theater blocks

    SciTech Connect

    Menard, L.; Mastrippolito, R.; Charon, Y.

    1996-12-31

    We have developed a multi-functional portable {gamma} radio-imager (RITM) based on a position sensitive photomultiplier tube (PSPMT) in order to evaluate the potential of such miniature {gamma} camera concept in radio-pharmacology and nuclear medicine. We report here an evaluation of our RITM device for cancer surgery. It concerns localization of the osteoid osteoma (bone benign tumor) performed in theater block before skin incision and during the surgical lesion extraction. Over 13 cases we studied, the diagnosis furnished by RITM was always confirmed by post-operation anatomo-pathological analysis. This shows how RITM can be used as an additional indicator to monitor the operation. Following this first experience, we are developing a new small field of view {gamma} per operative compact imager (POCI) performing a sub-millimeter spatial resolution. It consists of a high resolution collimator and a YAP:Ce crystal assembly coupled to an intensified position sensitive diode (IPSD). This hand held imaging probe is first dedicated to intra-operative monitoring for thyroid and neuroblastoma tumor removal. Characteristics of the POCI device and preliminary results are presented.

  3. Inhibition of osteolysis and increase of bone formation after local administration of siRNA-targeting RANK in a polyethylene particle-induced osteolysis model.

    PubMed

    Córdova, L A; Trichet, V; Escriou, V; Rosset, P; Amiaud, J; Battaglia, S; Charrier, C; Berreur, M; Brion, R; Gouin, F; Layrolle, P; Passuti, N; Heymann, D

    2015-02-01

    Receptor activator of nuclear factor kappa-B (RANK) and RANK-ligand are relevant targets for the treatment of polyethylene particle-induced osteolysis. This study assessed the local administration of siRNA, targeting both human RANK and mouse Rank transcripts in a mouse model. Four groups of mice were implanted with polyethylene (PE) particles in the calvaria and treated locally with 2.5, 5 and 10 μg of RANK siRNA or a control siRNA delivered by the cationic liposome DMAPAP/DOPE. The tissues were harvested at day 9 after surgery and evaluated by micro-computed tomography, tartrate-resistant acid phosphatase (TRAP) immunohistochemistry for macrophages and osteoblasts, and gene relative expression of inflammatory and osteolytic markers. 10 μg of RANK siRNA exerted a protective effect against PE particle-induced osteolysis, decreasing the bone loss and the osteoclastogenesis, demonstrated by the significant increase in the bone volume (P<0.001) and by the reduction in both the number of TRAP(+) cells and osteoclast activity (P<0.01). A bone anabolic effect demonstrated by the formation of new trabecular bone was confirmed by the increased immunopositive staining for osteoblast-specific proteins. In addition, 5 and 10 μg of RANK siRNA downregulated the expression of pro-inflammatory cytokines (P<0.01) without depletion of macrophages. Our findings show that RANK siRNA delivered locally by a synthetic vector may be an effective approach for reducing osteolysis and may even stimulate bone formation in aseptic loosening of prosthetic implants. PMID:25462844

  4. Serial Scanning and Registration of High Resolution Quantitative Computed Tomography Volume Scans for the Determination of Local Bone Density Changes

    NASA Technical Reports Server (NTRS)

    Whalen, Robert T.; Napel, Sandy; Yan, Chye H.

    1996-01-01

    Progress in development of the methods required to study bone remodeling as a function of time is reported. The following topics are presented: 'A New Methodology for Registration Accuracy Evaluation', 'Registration of Serial Skeletal Images for Accurately Measuring Changes in Bone Density', and 'Precise and Accurate Gold Standard for Multimodality and Serial Registration Method Evaluations.'

  5. Intercellular Communication between Keratinocytes and Fibroblasts Induces Local Osteoclast Differentiation: a Mechanism Underlying Cholesteatoma-Induced Bone Destruction.

    PubMed

    Iwamoto, Yoriko; Nishikawa, Keizo; Imai, Ryusuke; Furuya, Masayuki; Uenaka, Maki; Ohta, Yumi; Morihana, Tetsuo; Itoi-Ochi, Saori; Penninger, Josef M; Katayama, Ichiro; Inohara, Hidenori; Ishii, Masaru

    2016-06-01

    Bone homeostasis is maintained by a balance in activity between bone-resorbing osteoclasts and bone-forming osteoblasts. Shifting the balance toward bone resorption causes osteolytic bone diseases such as rheumatoid arthritis and periodontitis. Osteoclast differentiation is regulated by receptor activator of nuclear factor κB ligand (RANKL), which, under some pathological conditions, is produced by T and B lymphocytes and synoviocytes. However, the mechanism underlying bone destruction in other diseases is little understood. Bone destruction caused by cholesteatoma, an epidermal cyst in the middle ear resulting from hyperproliferation of keratinizing squamous epithelium, can lead to lethal complications. In this study, we succeeded in generating a model for cholesteatoma, epidermal cyst-like tissue, which has the potential for inducing osteoclastogenesis in mice. Furthermore, an in vitro coculture system composed of keratinocytes, fibroblasts, and osteoclast precursors was used to demonstrate that keratinocytes stimulate osteoclast differentiation through the induction of RANKL in fibroblasts. Thus, this study demonstrates that intercellular communication between keratinocytes and fibroblasts is involved in the differentiation and function of osteoclasts, which may provide the molecular basis of a new therapeutic strategy for cholesteatoma-induced bone destruction. PMID:27001307

  6. Evaluation of a thiolated chitosan scaffold for local delivery of BMP-2 for osteogenic differentiation and ectopic bone formation.

    PubMed

    Bae, In-Ho; Jeong, Byung-Chul; Kook, Min-Suk; Kim, Sun-Hun; Koh, Jeong-Tae

    2013-01-01

    Thiolated chitosan (Thio-CS) is a well-established pharmaceutical excipient for drug delivery. However, its use as a scaffold for bone formation has not been investigated. The aim of this study was to evaluate the potential of Thio-CS in bone morphogenetic protein-2 (BMP-2) delivery and bone formation. In vitro study showed that BMP-2 interacted with the Thio-CS and did not affect the swelling behavior. The release kinetics of BMP-2 from the Thio-CS was slightly delayed (70%) within 7 days compared with that from collagen gel (Col-gel, 85%), which is widely used in BMP-2 delivery. The BMP-2 released from Thio-CS increased osteoblastic cell differentiation but did not show any cytotoxicity until 21 days. Analysis of the in vivo ectopic bone formation at 4 weeks of posttransplantation showed that use of Thio-CS for BMP-2 delivery induced more bone formation to a greater extent (1.8 fold) than that of Col-gel. However, bone mineral density in both bones was equivalent, regardless of Thio-CS or Col-gel carrier. Taken together, Thio-CS system might be useful for delivering osteogenic protein BMP-2 and present a promising bone regeneration strategy. PMID:24024213

  7. Local variations in bone mineral density: a comparison of OCT versus x-ray micro-CT

    NASA Astrophysics Data System (ADS)

    Ugryumova, Nadya; Stevens-Smith, Jenna; Scutt, Andrew; Matcher, Stephen J.

    2008-02-01

    We describe variations in the degree of mineralisation within the subchondral bone plate of the equine metacarpophalangeal joint. A comparison of Optical Coherence Tomography, Micro CT, and SEM techniques was performed. These data are compared between sites on a healthy sample and at points on an osteoarthritically degenerated sample. No significant correlation was found between the optical scattering coefficient and the micro-CT derived BMD for comparisons between different sites on the bone surface. Also OCT demonstrated a larger regional variation in scattering coefficient than did micro CT for bone mineral density. This suggests that the optical scattering coefficient of bone is not related solely to the volume-density of calcium-phosphate. Patches of lower optical scattering coefficient were found in the bone structure that was related to the osteoarthritic lesion area on the overlying cartilage. Areas of microcracking, as revealed by both SEM and micro CT produced distinctive granularity in the OCT images. In further experiments, OCT was compared with micro CT and mechanical strength testing (3-point bending) in a small animal model of cardiovascular disease (cholesterol overload in mice). In the cardiovascular diseased mice, micro-CT of the trabecular bone did not demonstrate a significant change in trabecular bone mineral density before and after administration of the high cholesterol diet. However mechanical testing demonstrated a decrease in mechanical strength and OCT demonstrated a corresponding statistically significant decrease in optical scattering of the bone.

  8. Improved outcome in asymptomatic recurrence following curative surgery for gastric cancer.

    PubMed

    Villarreal-Garza, Cynthia; Rojas-Flores, Miriam; Castro-Sánchez, Andrea; Villa, Antonio R; García-Aceituno, Luis; León-Rodríguez, Eucario

    2011-12-01

    The purpose of this study was to compare the outcome and resectability of patients with gastric cancer recurrence after curative surgery detected by follow-up endoscopy, according to the presence or absence of symptoms. All patients with gastric carcinoma, who underwent a curative gastrectomy, were retrospectively identified. We analyzed outcome and survival in patients compliant with routine follow-up who presented symptomatic and asymptomatic recurrence. Of the 119 resected patients, 63.0% had a recurrence, with an overall survival of 20.0 months. Fourteen patients were asymptomatic when recurrence was detected, whereas 61 patients were symptomatic. Median time to recurrence was 16.0 m for both groups. A local curative re-resection was possible in 2/14 (asymptomatic) and 1/61 (symptomatic). Asymptomatic patients had a longer median postrecurrence survival time of 9.0 months, compared with 2.0 months in the symptomatic patients (p=0.034). The median overall survival was greater in the asymptomatic vs symptomatic group (25.0 vs 20.0 months), although this did not reach statistical significance. The results from this study advocate that the presence or absence of symptoms is a good surrogate marker to assess biologic aggressiveness. The value of routine follow-up endoscopy to permit a higher rate of re-resection in asymptomatic patients remains to be established. PMID:20517658

  9. Metastatic prostatic pulmonary nodules with normal bone image

    SciTech Connect

    Petras, A.F.; Wollett, F.C.

    1983-11-01

    Asymptomatic prostatic caricnoma presented as multiple bilateral pulmonary modules in a patient without any evidence of skeletal involvement by normal bone image. Percutaneous biopsy provided the initial clue to diagnosis. The authors recommend that asymptomatic prostatic carcinoma be included in the differential diagnosis of pulmonary nodules, even when there is no evidence of skeletal metastasis.

  10. Synthesis and Characterization of Poly(lactic-co-glycolic) Acid Nanoparticles-Loaded Chitosan/Bioactive Glass Scaffolds as a Localized Delivery System in the Bone Defects

    PubMed Central

    Nazemi, K.; Moztarzadeh, F.; Jalali, N.; Asgari, S.; Mozafari, M.

    2014-01-01

    The functionality of tissue engineering scaffolds can be enhanced by localized delivery of appropriate biological macromolecules incorporated within biodegradable nanoparticles. In this research, chitosan/58S-bioactive glass (58S-BG) containing poly(lactic-co-glycolic) acid (PLGA) nanoparticles has been prepared and then characterized. The effects of further addition of 58S-BG on the structure of scaffolds have been investigated to optimize the characteristics of the scaffolds for bone tissue engineering applications. The results showed that the scaffolds had high porosity with open pores. It was also shown that the porosity decreased with increasing 58S-BG content. Furthermore, the PLGA nanoparticles were homogenously distributed within the scaffolds. According to the obtained results, the nanocomposites could be considered as highly bioactive bone tissue engineering scaffolds with the potential of localized delivery of biological macromolecules. PMID:24949477

  11. Asymptomatic petechial eruption on the lower legs.

    PubMed

    Mendese, Gary; Grande, Donald

    2013-09-01

    The authors report an unusual case of Rocky Mountain spotted fever that presented as an asymptomatic petechial eruption on the lower legs. Rocky Mountain spotted fever is rare in New England and, as such, is typically not on the differential diagnosis when presented with such patients. What began as an asymptomatic eruption progressed to more classic signs of the disease, including a positive Rocky Mountain spotted fever titer. The patient was successfully treated with doxycydine and within a short period of time, was completely back at baseline. PMID:24062875

  12. Bone health in eating disorders.

    PubMed

    Zuckerman-Levin, N; Hochberg, Z; Latzer, Y

    2014-03-01

    Eating disorders (EDs) put adolescents and young adults at risk for impaired bone health. Low bone mineral density (BMD) with ED is caused by failure to accrue peak bone mass in adolescence and bone loss in young adulthood. Although ED patients diagnosed with bone loss may be asymptomatic, some suffer bone pains and have increased incidence of fractures. Adolescents with ED are prone to increased prevalence of stress fractures, kyphoscoliosis and height loss. The clinical picture of the various EDs involves endocrinopathies that contribute to impaired bone health. Anorexia nervosa (AN) is characterized by low bone turnover, with relatively higher osteoclastic (bone resorptive) than osteoblastic (bone formation) activity. Bone loss in AN occurs in both the trabecular and cortical bones, although the former is more vulnerable. Bone loss in AN has been shown to be influenced by malnutrition and low weight, reduced fat mass, oestrogen and androgen deficiency, glucocorticoid excess, impaired growth hormone-insulin-like growth factor 1 axis, and more. Bone loss in AN may not be completely reversible despite recovery from the illness. Treatment modalities involving hormonal therapies have limited effectiveness, whereas increased caloric intake, weight gain and resumption of menses are essential to improved BMD. PMID:24165231

  13. Combined treatment with parathyroid hormone (1-34) and beta-tricalcium phosphate had an additive effect on local bone formation in a rat defect model.

    PubMed

    Tao, Zhou-Shan; Tu, Kai-Kai; Huang, Zheng-Liang; Zhou, Qiang; Sun, Tao; Xu, Hong-Ming; Zhou, Yu-Long; Lv, Yang-Xun; Cui, Wei; Yang, Lei

    2016-09-01

    The objective of this study was to evaluate the effect of following combined treatment with parathyroid hormone (1-34) (PTH) and beta-tricalcium phosphate (β-TCP) on local bone formation in a rat 3-mm critical-size defect at distal femur. Twelve weeks after bilateral ovariectomy (OVX) and sham operation (sham), all animals were randomly divided into four groups: group OVX, group OVX + β-TCP, group sham, and group sham + β-TCP, then all rats underwent bone defect in the bilateral distal femurs, and β-TCP were implanted into critical-sized defects for group OVX + β-TCP and group sham + β-TCP. After defect operation, all animals were received following subcutaneous injections with PTH (60 μg/kg, three times a week) until death at 4 and 8 weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that systemic usage of PTH or local usage of β-TCP can increase the healing of defects in OVX or sham rats. Furthermore, treatments with PTH and β-TCP showed a stronger effect on accelerating the local bone formation than used alone. Osteoporosis can limit the function of PTH and/or β-TCP. The results from our study demonstrate that combination of PTH and β-TCP had an additive effect on local bone formation in non-osteoporosis and/or osteoporosis rats. PMID:26429350

  14. [Metastatic bone disease. Strategies for imaging].

    PubMed

    Scutellari, P N; Antinolfi, G; Galeotti, R; Giganti, M

    2003-04-01

    Skeletal metastases represent the most common malignant bone tumor. They occur mainly in adults and even more frequently in the elderly. The most common metastases in men are from prostate cancer (60%) and in women from breast cancer (70%). Other primitive tumors responsible for bone metastases are: lung, kidney, thyroid, alimentary tract, bladder, and skin. The spine and pelvis are the most common metastatic sites, due to the presence of red (haematopoietic active) bone marrow in a high amount. As a general rule, the radiographic pattern was lytic type; other aspects were osteosclerotic, mixed, lytic vs mixed and osteosclerotic vs lytic patterns. The main symptom is pain, although many bone metastases are asymptomatic. The most severe consequences are pathologic fractures and cord compression. Clinical evaluation of patients with skeletal metastases needs multimodal diagnostic imaging, able to detect lesions, to assess their extension and localization, and eventually drive the biopsy (for histo-morphological diagnosis). These techniques give different performances in terms of sensitivity and specificity; but none of the modalities alone seems to be adequate to yield a reliable diagnostic outcome. Therefore multidisciplinary cooperation is required to optimize the screening, clinical management and follow-up of the patients. In other terms, what is the efficacy of these new diagnostic tests compared to the "older" diagnostic tests? Frequently the new procedures do not replace the older one, but it is added to the diagnostic workup, thereby increasing costs without impacting the "patient's condition". The aim of the present work is to propose an "algorithm" for the detection and diagnosis of skeletal metastases, which may be applied differently in symptomatic and asymptomatic oncologic patients. Bone scintigraphy remains the first choice technique in the evaluation of asymptomatic patients, in whom skeletal metastases are supposed. Although it has a high sensitivity

  15. A High Amount of Local Adipose Tissue Is Associated With High Cortical Porosity and Low Bone Material Strength in Older Women.

    PubMed

    Sundh, Daniel; Rudäng, Robert; Zoulakis, Michail; Nilsson, Anna G; Darelid, Anna; Lorentzon, Mattias

    2016-04-01

    associated with Ct.Po, indicating a possible adverse effect of adipose tissue on bone quality and bone microstructure. Local s.c. fat in tibia was most strongly associated with these bone traits, suggesting a local or paracrine, rather than systemic, negative effect of fat on bone. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR). PMID:26588353

  16. Polycaprolactone-Coated 3D Printed Tricalcium Phosphate Scaffolds for Bone Tissue Engineering: In Vitro Alendronate Release Behavior and Local Delivery Effect on In Vivo Osteogenesis

    PubMed Central

    2015-01-01

    The aim of this work was to evaluate the effect of in vitro alendronate (AD) release behavior through polycaprolactone (PCL) coating on in vivo bone formation using PCL-coated 3D printed interconnected porous tricalcium phosphate (TCP) scaffolds. Higher AD and Ca2+ ion release was observed at lower pH (5.0) than that at higher pH (7.4). AD and Ca2+ release, surface morphology, and phase analysis after release indicated a matrix degradation dominated AD release caused by TCP dissolution. PCL coating showed its effectiveness for controlled and sustained AD release. Six different scaffold compositions, namely, (i) TCP (bare TCP), (ii) TCP + AD (AD-coated TCP), (iii) TCP + PCL (PCL-coated TCP), (iv) TCP + PCL + AD, (v) TCP + AD + PCL, and (vi) TCP + AD + PCL + AD were tested in the distal femoral defect of Sprague–Dawley rats for 6 and 10 weeks. An excellent bone formation inside the micro and macro pores of the scaffolds was observed from histomorphology. Histomorphometric analysis revealed maximum new bone formation in TCP + AD + PCL scaffolds after 6 weeks. No adverse effect of PCL on bioactivity of TCP and in vivo bone formation was observed. All scaffolds with AD showed higher bone formation and reduced TRAP (tartrate resistant acid phosphatase) positive cells activity compared to bare TCP and TCP coated with only PCL. Bare TCP scaffolds showed the highest TRAP positive cells activity followed by TCP + PCL scaffolds, whereas TCP + AD scaffolds showed the lowest TRAP activity. A higher TRAP positive cells activity was observed in TCP + AD + PCL compared to TCP + AD scaffolds after 6 weeks. Our results show that in vivo local AD delivery from PCL-coated 3DP TCP scaffolds could further induce increased early bone formation. PMID:24826838

  17. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings.

    PubMed

    Alhusaini, Saud; Whelan, Christopher D; Doherty, Colin P; Delanty, Norman; Fitzsimons, Mary; Cavalleri, Gianpiero L

    2016-03-01

    Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable. PMID:25576532

  18. Asymptomatic Transhiatal Pancreatic Herniation after Oesophagectomy

    PubMed Central

    Pal, Sujoy; Dash, Nihar Ranjan; Madhusudhan, KS; Srivastava, Deep Narayan

    2014-01-01

    Transhiatal herniation of abdominal organs after oesophageal resection and reconstruction is rare and sparsely described in the literature. The commonest organ to herniate is the colon. Pancreatic herniation has been reported twice before. We report a case of postoesophagectomy transhiatal pancreatic herniation in an asymptomatic patient. PMID:25478403

  19. Asymptomatic Congenital Absence of Lateral Pedal Rays.

    PubMed

    Salvi, Andrea Emilio; Roda, Simone; Chessa, Angelo; Pezzoni, Massimo

    2016-01-01

    Complete absence of 1 or more pedal rays is a rare condition. In the present report, the case of an adult male with complete congenital absence of his right fourth and fifth pedal rays is described. The condition had been asymptomatic until he had sustained an acute third metatarsal fracture and was satisfactorily treated with cast immobilization. PMID:26359621

  20. [Asymptomatic 32 year old female smoker with persistent polyclonal lymphocytosis].

    PubMed

    Chapuy, B; Wulf, G; Tessen, H W; Griesinger, F; Trümper, L; Schroers, R

    2007-03-01

    A 32 year old female smoker (20 pack years) presented with an asymptomatic lymphocytosis of 13,000/nl and splenomegaly. The patient's blood smear showed an absolute lymphocytosis with 65% atypical lymphocytes. A total of 1% of the lymphocytes were bilobulated. Bone marrow histology and immunphenotyping of blood and bone marrow excluded leukemia and non-Hodgkin's lymphoma. IgH-CDR-3 PCR analysis revealed a polyclonal pattern. In summary, a persistent polyclonal B-cell-lymphocytosis (PPBL) was diagnosed. The exact etiology of PPBL is still unclear, however, it is associated with a polyclonal raise in the lymphocyte count of CD27+IgD+-memory-B-lymphocytes due to a defect in apoptosis signaling and leukocyte homing to secondary lymphoid tissues. An association with cigarette smoking is obvious since all patients are smokers. From all published cases, only two developed a malignancy with an uncertain association with PPBL. We have been monitoring our patient for 6.5 years without any evidence of the development of a lymphoma. PMID:17287965

  1. Tissue distribution of Leishmania chagasi and lesions in transplacentally infected fetuses from symptomatic and asymptomatic naturally infected bitches.

    PubMed

    Pangrazio, Kristel Kegler; Costa, Erica A; Amarilla, Shyrley P; Cino, Ada G; Silva, Teane M A; Paixão, Tatiane A; Costa, Luciana F; Dengues, Enrique G; Diaz, Andres Avalos Ruiz; Santos, Renato L

    2009-11-12

    Visceral leishmaniasis (VL) is primarily transmitted by an invertebrate vector, but transmission in the absence of the vector has been reported. Vertical transmission of VL has been described in man and dogs. The aim of this study was to evaluate the distribution of Leishmania amastigotes in fetal organs and histopathologic changes associated with parasitism and to determinate the frequency of transplacental transmission and potential of vertical transmission by symptomatic and asymptomatic pregnant bitches. Symptomatic (n=4) and asymptomatic (n=4) pregnant bitches, serologically and parasitologically positive for Leishmania sp., carrying a total of 53 fetuses (26 from symptomatic and 27 from asymptomatic bitches) were selected at the Veterinary Hospital of the National University of Asuncion, Paraguay. Samples of placenta and fetal organs such as liver, spleen, lymph nodes, bone marrow, kidney and heart were histologically evaluated and processed for immunodetection of amastigotes and PCR. There were no lesions compatible with VL in fetal tissues in spite of the presence of amastigotes, particularly in lymphoreticular tissues. However, fetal hepatocytes had marked degenerative changes that were independent of the presence of amastigotes in liver. Twenty-six out of 53 placentas (13 symptomatic and 13 asymptomatic) and a total of 17 fetuses out of 53 (nine symptomatic and eight asymptomatic) were PCR positive. Together these findings indicate a high frequency of transplacental transmission and no differences in the potential of transmission when symptomatic were compared to asymptomatic pregnant bitches. PMID:19647368

  2. Bone Grafts

    MedlinePlus

    A bone graft transplants bone tissue. Surgeons use bone grafts to repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some ...

  3. Bone tumor

    MedlinePlus

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  4. Asymptomatic memory CD8+ T cells

    PubMed Central

    Khan, Arif Azam; Srivastava, Ruchi; Lopes, Patricia Prado; Wang, Christine; Pham, Thanh T; Cochrane, Justin; Thai, Nhi Thi Uyen; Gutierrez, Lucas; BenMohamed, Lbachir

    2014-01-01

    Generation and maintenance of high quantity and quality memory CD8+ T cells determine the level of protection from viral, bacterial, and parasitic re-infections, and hence constitutes a primary goal for T cell epitope-based human vaccines and immunotherapeutics. Phenotypically and functionally characterizing memory CD8+ T cells that provide protection against herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) infections, which cause blinding ocular herpes, genital herpes, and oro-facial herpes, is critical for better vaccine design. We have recently categorized 2 new major sub-populations of memory symptomatic and asymptomatic CD8+ T cells based on their phenotype, protective vs. pathogenic function, and anatomical locations. In this report we are discussing a new direction in developing T cell-based human herpes vaccines and immunotherapeutics based on the emerging new concept of “symptomatic and asymptomatic memory CD8+ T cells.” PMID:24499824

  5. Treatment approaches to asymptomatic follicular lymphoma.

    PubMed

    Sarkozy, Clémentine; Salles, Gilles

    2013-12-01

    Follicular lymphoma is a heterogeneous disease in which some patients present an indolent evolution for decades and others, a rather aggressive form of the disease requiring immediate therapy. While immunochemotherapy has emerged as a standard of care for symptomatic patients, treatment of the asymptomatic population remains controversial. Since the disease is still considered incurable, delayed initiation of therapy is an acceptable option. However, four single injections of rituximab can result in an acceptable clinical response and can improve the duration of the interval without cytotoxic therapy. With recent therapeutic approaches that enable substantial improvements in life expectancy for follicular lymphoma patients, limiting short- or long-term treatment toxicities appears as a new concern in the asymptomatic population. Based on these options, the challenge is to preserve patient quality of life and prolong survival: from the patient's perspective, his/her opinion is therefore of significant importance. PMID:24219551

  6. Autofluorescence bronchoscopy in volunteer asymptomatic smokers.

    PubMed

    Stringer, M R; Moghissi, K; Dixon, K

    2008-06-01

    We assess the sensitivity of autofluorescence bronchoscopy (AFB) compared to that of white light bronchoscopy (WLB) for identification of pre-invasive neoplastic changes of bronchial mucosa in asymptomatic heavy smokers. WLB was performed using a standard flexible fibre-optic bronchoscope, and AFB carried out using the Xillix LIFE Lung((R)) system. Positive AFB images were indicated in the bronchial tree from 51 of the 93 subjects in the study. Biopsies showed epithelial abnormalities in 27 (15 metaplasia, 12 inflammatory changes) of these. WLB showed abnormality in 1 subject but with no pathological changes revealed by cyto-histology. Therefore, the sensitivity of AFB to metaplasia was 75% compared to zero for WLB. AFB yields positive predictive values for metaplastic and overall mucosal changes of 29.4% and 52.9%, respectively. In summary, over 16% of asymptomatic smokers had metaplastic changes in their bronchial mucosa, and AFB proved more sensitive in revealing early changes than WLB. PMID:19356646

  7. ACR appropriateness criteria on metastatic bone disease.

    PubMed

    Roberts, Catherine C; Daffner, Richard H; Weissman, Barbara N; Bancroft, Laura; Bennett, D Lee; Blebea, Judy S; Bruno, Michael A; Fries, Ian Blair; Germano, Isabelle M; Holly, Langston; Jacobson, Jon A; Luchs, Jonathan S; Morrison, William B; Olson, Jeffrey J; Payne, William K; Resnik, Charles S; Schweitzer, Mark E; Seeger, Leanne L; Taljanovic, Mihra; Wise, James N; Lutz, Stephen T

    2010-06-01

    Appropriate imaging modalities for screening, staging, and surveillance of patients with suspected and documented metastatic disease to bone include (99m)Tc bone scanning, MRI, CT, radiography, and 2-[(18)F]fluoro-2-deoxyglucose-PET. Clinical scenarios reviewed include asymptomatic stage 1 breast carcinoma, symptomatic stage 2 breast carcinoma, abnormal bone scan results with breast carcinoma, pathologic fracture with known metastatic breast carcinoma, asymptomatic well-differentiated and poorly differentiated prostate carcinoma, vertebral fracture with history of malignancy, non-small-cell lung carcinoma staging, symptomatic multiple myeloma, osteosarcoma staging and surveillance, and suspected bone metastasis in a pregnant patient. No single imaging modality is consistently best for the assessment of metastatic bone disease across all tumor types and clinical situations. In some cases, no imaging is indicated. The recommendations contained herein are the result of evidence-based consensus by the ACR Appropriateness Criteria((R)) Expert Panel on Musculoskeletal Radiology. PMID:20522392

  8. Impact of Local Management on Long-Term Outcomes in Ewing Tumors of the Pelvis and Sacral Bones: University of Florida Experience

    SciTech Connect

    Indelicato, Daniel J. Keole, Sameer R.; Shahlaee, Amir H.; Gibbs, C. Parker; Scarborough, Mark T.; Marcus, Robert B.

    2008-09-01

    Purpose: This retrospective analysis describes our 35-year experience with respect to disease control and functional status. Patients and Methods: Thirty-five patients with localized Ewing tumors of the pelvis and sacral bones were treated from 1970 to 2005. Twenty-six patients were treated with definitive radiotherapy (RT), and 9 patients were treated with combined local therapy in the form of surgery + RT. The median RT dose was 55.2 Gy. The patients who received RT alone were more likely to be older men with larger tumors exhibiting soft-tissue extension. Patients in the definitive RT group were more likely to receive etoposide and ifosfamide or undergo bone marrow transplant. Median potential follow-up was 19.4 years. Results: The 15-year actuarial cause-specific survival, freedom from relapse rate, and local control rates were 26% vs. 76% (p = 0.016), 28% vs. 78% (p = 0.015), and 64% vs. 100% (p = 0.087), respectively, for patients treated with definitive RT and combined therapy. Overall, tumors <8 cm had significantly better cause-specific survival, but this was unrelated to local control. The median Toronto Extremity Salvage Score for the definitive RT and combined therapy groups were 99 and 94, respectively (p = 0.19). Seven definitive RT patients (27%) had serious complications. Conclusion: Combined modality local therapy should be considered if pelvic Ewing tumors are resectable. However, because of the extent of local disease, most patients have unresectable or partially resectable tumors and therefore require RT in some capacity. For this reason, innovative RT strategies are needed to improve long-term disease outcomes and minimize side effects while maintaining an acceptable functional result.

  9. Asymptomatic Glomus Tumor of the Mediastinum

    PubMed Central

    Kanakis, Meletios; Rapti, Nikoletta; Chorti, Maria; Lioulias, Achilleas

    2015-01-01

    Glomus tumors are rare benign neoplasms that predominate in limbs. Infrequently, they can occur in a wide anatomic distribution, to include sites not known to contain glomus cells. Although glomus tumors are usually small, pain and tenderness are common clinical symptoms. We report the case of a 69-year-old man with an asymptomatic large mediastinal glomus tumor, who underwent surgical resection. PMID:26442165

  10. Prevalence of asymptomatic urinary abnormalities among adolescents.

    PubMed

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P <0.001). Hematuria was the most common urinary abnormalities detected in 245 (9.8%) adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had <0.5 g/day and twenty (0.8%) individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01) and (P <0.001), respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population. PMID:27215241

  11. Total Body Irradiation Is Permissive for Mesenchymal Stem Cell-Mediated New Bone Formation Following Local Transplantation

    PubMed Central

    Herberg, Samuel; Kondrikova, Galina; Hussein, Khaled A.; Periyasamy-Thandavan, Sudharsan; Johnson, Maribeth H.; Elsalanty, Mohammed E.; Shi, Xingming; Hamrick, Mark W.; Isales, Carlos M.

    2014-01-01

    Skeletal injury is a major clinical challenge accentuated by the decrease of bone marrow-derived mesenchymal stem/stromal cells (BMSCs) with age or disease. Numerous experimental and clinical studies have revealed that BMSCs hold great promise for regenerative therapies due to their direct osteogenic potential and indirect trophic/paracrine actions. Increasing evidence suggests that stromal cell-derived factor-1 (SDF-1) is involved in modulating the host response to the injury. Common problems with BMSC therapy include poor cell engraftment, which can be addressed by total body irradiation (TBI) prior to transplantation. In this study, we tested the hypothesis that direct tibial transplantation of BMSCs drives endogenous bone formation in a dose-dependent manner, which is enhanced by TBI, and investigated the potential role of SDF-1 in facilitating these events. We found that TBI is permissive for transplanted BMSCs to engraft and contribute to new bone formation. Bone marrow (BM) interstitial fluid analysis revealed no differences of SDF-1 splice variants in irradiated animals compared to controls, despite the increased mRNA and protein levels expressed in whole BM cells. This correlated with increased dipeptidyl peptidase IV activity and the failure to induce chemotaxis of BMSCs in vitro. We found increased mRNA expression levels of the major SDF-1-cleaving proteases in whole BM cells from irradiated animals suggesting distinct spatial differences within the BM in which SDF-1 may play different autocrine and paracrine signaling roles beyond the immediate cell surface microenvironment. PMID:24914464

  12. The Nature of Iron Deposits Differs between Symptomatic and Asymptomatic Carotid Atherosclerotic Plaques

    PubMed Central

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef

    2015-01-01

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophages with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. The abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin. PMID:26606178

  13. The nature of iron deposits differs between symptomatic and asymptomatic carotid atherosclerotic plaques

    DOE PAGESBeta

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef; Hagemeyer, Christoph E.

    2015-11-25

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophagesmore » with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. Moreover, the abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin.« less

  14. The nature of iron deposits differs between symptomatic and asymptomatic carotid atherosclerotic plaques

    SciTech Connect

    Kopriva, David; Kisheev, Anastasye; Meena, Deiter; Pelle, Shaneen; Karnitsky, Max; Lavoie, Andrea; Buttigieg, Josef; Hagemeyer, Christoph E.

    2015-11-25

    Iron within atherosclerotic plaque has been implicated as a catalyst of oxidative stress that causes progression of plaque, and plaque rupture. Iron is believed to accumulate within plaque by incorporation of erythrocytes following plaque rupture and hemorrhage. There is only indirect evidence to support this hypothesis. Plaque specimens were obtained from ten symptomatic and fifteen asymptomatic patients undergoing carotid endarterectomy at a single institution. Plaques were sectioned for study using synchrotron radiation induced X-ray fluorescence the study the distribution of zinc, calcium and iron. Histologic staining was carried out with Prussian Blue, and immunohistochemical staining was done to localize macrophages with CD68. Data were compared against patient clinical variables. Ten symptomatic (15 ± 10 days between index symptoms and surgery) and fifteen asymptomatic carotid plaques were studied. Zinc and calcium co-localized in mineralized areas of symptomatic and asymptomatic plaque. Iron was identified away from zinc and calcium in both symptomatic and asymptomatic plaques. Within the symptomatic plaques, iron was found within the thrombus associated with plaque rupture and hemorrhage. It did not stain with Prussian Blue, but was found in association with CD68 positive macrophages. In symptomatic plaques, the abundance of iron showed an association with the source patient’s LDL cholesterol (R2 = 0.39, Significance F = 0.05). Iron in asymptomatic plaque was present as hemosiderin/ferritin that stained positive with Prussian Blue, and was observed in association with CD68 positive macrophages. Iron in acutely symptomatic plaques is found within thrombus, in the presence of macrophages. Moreover, the abundance of iron in symptomatic plaques is associated with the source patient’s LDL cholesterol. Within asymptomatic plaques, iron is found in association with macrophages, as hemosiderin/ferritin.

  15. The Paradigm Shift to Non-Treatment of Asymptomatic Bacteriuria.

    PubMed

    Nicolle, Lindsay E

    2016-01-01

    Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients. PMID:27104571

  16. [The effect of locally applied Grisaldone or choline salicylate gel on bone healing after tooth extraction in animal experiments].

    PubMed

    Cendelin, E; Fröhlich, M

    1977-01-01

    Comparative histological and experimental animal studies of the effects upon bone wound healing of topically applied choline salicylate gel and Grisaldon showed that Grisaldon tends to hinder the course of reparation of bone, whereas choline salicylate gel has no appreciable influence upon the time course of wound healing. This essential difference is considered to be due predominantly to the exactly opposite behavior shown by the two pharmaceutical preparations in regard to their solubility in water. The difficultly watersoluble Grisaldon tends to exert a longer-drawn-out irritant effect upon the tissue and can be detected in alveoli even after twenty-eight days from administration thereof. By contrast, choline salicylate gel, which is known to be readily soluble in water, will be eliminated already after two days from administration thereof. PMID:150157

  17. Probing the calcium and sodium local environment in bones and teeth using multinuclear solid state NMR and X-ray absorption spectroscopy.

    PubMed

    Laurencin, Danielle; Wong, Alan; Chrzanowski, Wojciech; Knowles, Jonathan C; Qiu, Dong; Pickup, David M; Newport, Robert J; Gan, Zhehong; Duer, Melinda J; Smith, Mark E

    2010-02-01

    Despite the numerous studies of bone mineral, there are still many questions regarding the exact structure and composition of the mineral phase, and how the mineral crystals become organised with respect to each other and the collagen matrix. Bone mineral is commonly formulated as hydroxyapatite, albeit with numerous substitutions, and has previously been studied by (31)P and (1)H NMR, which has given considerable insight into the complexity of the mineral structure. However, to date, there has been no report of an NMR investigation of the other major component of bone mineral, calcium, nor of common minority cations like sodium. Here, direct analysis of the local environment of calcium in two biological apatites, equine bone (HB) and bovine tooth (CT), was carried out using both (43)Ca solid state NMR and Ca K-edge X-ray absorption spectroscopy, revealing important structural information about the calcium coordination shell. The (43)Ca delta(iso) in HB and CT is found to correlate with the average Ca-O bond distance measured by Ca K-edge EXAFS, and the (43)Ca NMR linewidths show that there is a greater distribution in chemical bonding around calcium in HB and CT, compared to synthetic apatites. In the case of sodium, (23)Na MAS NMR, high resolution 3Q-MAS NMR, as well as (23)Na{(31)P} REDOR and (1)H{(23)Na} R(3)-HMQC correlation experiments give the first direct evidence that some sodium is located inside the apatite phase in HB and CT, but with a greater distribution of environments compared to a synthetic sodium substituted apatite (Na-HA). PMID:20094673

  18. Dissociation between peripheral blood chimerism and tolerance to hindlimb composite tissue transplants: preferential localization of chimerism in donor bone

    PubMed Central

    Rahhal, Dina N.; Xu, Hong; Huang, Wei-Chao; Wu, Shengli; Wen, Yujie; Huang, Yiming; Ildstad, Suzanne T.

    2009-01-01

    Background Mixed chimerism induces donor-specific tolerance to composite tissue allotransplants (CTA). In the present studies, we used a nonmyeloablative conditioning approach to establish chimerism and promote CTA acceptance. Methods WF (RT1Au) rats were conditioned with 600-300 cGy total body irradiation (TBI, day-1), 100 × 106 T cell-depleted ACI (RT1Aabl) bone marrow cells were transplanted day 0, followed by a 11-day course of tacrolimus and one dose of anti-lymphocyte serum (day 10). Heterotopic osteomyocutaneous flap transplantation was performed 4-6 weeks after bone marrow transplantation. Results Mixed chimerism was initially achieved in almost all recipients, but long-term acceptance of CTA was only achieved in rats treated with 600 cGy TBI. When anti-αβ-TCR mAb (day-3) was added into the regimens, donor chimerism was similar to recipients preconditioned without anti-αβ-TCR mAb. However, the long-term CTA survival was significantly improved in chimeras receiving ≥ 300 cGy TBI plus anti-αβ-TCR mAb. Higher levels of donor chimerism were associated with CTA acceptance. The majority of flap-acceptors lost peripheral blood (PB) chimerism within 6 months. However, donor chimerism persisted in transplanted bone at significantly higher levels compared to other hematopoietic compartments. The compartment donor chimerism may be responsible for the maintenance of tolerance to CTA. Long-term acceptors were tolerant to a donor skin graft challenge even in the absence of PB chimerism. Conclusions Mixed chimerism established by nonmyeloablative conditioning induces long-term acceptance of CTA which is associated with persistent chimerism preferentially in transplanted donor bone. PMID:19920776

  19. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury

    PubMed Central

    Hogendoorn, S.; Duijnisveld, B. J.; van Duinen, S. G.; Stoel, B. C.; van Dijk, J. G.; Fibbe, W. E.; Nelissen, R. G. H. H.

    2014-01-01

    Objectives Traumatic brachial plexus injury causes severe functional impairment of the arm. Elbow flexion is often affected. Nerve surgery or tendon transfers provide the only means to obtain improved elbow flexion. Unfortunately, the functionality of the arm often remains insufficient. Stem cell therapy could potentially improve muscle strength and avoid muscle-tendon transfer. This pilot study assesses the safety and regenerative potential of autologous bone marrow-derived mononuclear cell injection in partially denervated biceps. Methods Nine brachial plexus patients with insufficient elbow flexion (i.e., partial denervation) received intramuscular escalating doses of autologous bone marrow-derived mononuclear cells, combined with tendon transfers. Effect parameters included biceps biopsies, motor unit analysis on needle electromyography and computerised muscle tomography, before and after cell therapy. Results No adverse effects in vital signs, bone marrow aspiration sites, injection sites, or surgical wound were seen. After cell therapy there was a 52% decrease in muscle fibrosis (p = 0.01), an 80% increase in myofibre diameter (p = 0.007), a 50% increase in satellite cells (p = 0.045) and an 83% increase in capillary-to-myofibre ratio (p < 0.001) was shown. CT analysis demonstrated a 48% decrease in mean muscle density (p = 0.009). Motor unit analysis showed a mean increase of 36% in motor unit amplitude (p = 0.045), 22% increase in duration (p = 0.005) and 29% increase in number of phases (p = 0.002). Conclusions Mononuclear cell injection in partly denervated muscle of brachial plexus patients is safe. The results suggest enhanced muscle reinnervation and regeneration. Cite this article: Bone Joint Res 2014;3:38–47. PMID:24565688

  20. Interleukin-1 and Tumor Necrosis Factor Activities Partially Account for Calvarial Bone Resorption Induced by Local Injection of Lipopolysaccharide

    PubMed Central

    Chiang, Cheng-Yang; Kyritsis, George; Graves, Dana T.; Amar, Salomon

    1999-01-01

    The present study was undertaken to test the hypothesis that tumor necrosis factor (TNF) and/or interleukin-1 (IL-1) activity mediates lipopolysaccharide (LPS)-induced bone resorption in vivo. To test this hypothesis, Escherichia coli LPS or Porphyromonas gingivalis LPS was injected into the subcutaneous tissues overlying mouse calvariae. Histological sections, prepared from the center of the lesion, were stained for tartrate-resistant acid phosphatase, and histomorphometric analysis was performed to quantify the osteoclast number and the area of bone resorption. In time course experiments using normal mice, a peak of bone resorption occurred 5 days after endotoxin stimulation. In dose-response experiments, IL-1 receptor type 1 deletion (IL-1R−/−), TNF double-receptor p55/p75 deletion (TNF p55−/−/p75−/−), combined TNF p55 and IL-1 receptor type 1 deletion (TNF p55−/−/IL-1R−/−), and IL-1β-converting enzyme-deficient (ICE−/−) mice and the respective wild-type mice were injected with 500, 100, or 20 μg of P. gingivalis LPS and sacrificed 5 days after LPS injection. At the highest dose (500 μg), significant decreases in osteoclast number occurred in mutant mice compared to wild-type mice: (i) a 64% reduction for the TNF p55−/−/IL-1R−/− mice, (ii) a 57% reduction for the IL-1R−/− mice, (iii) a 41% reduction for the TNF p55−/−/p75−/− mice, and (iv) a 38% reduction for the ICE−/− mice. At the two lower doses, bone resorption was apparent but no significant differences between mutant and wild-type animals were observed. The present data indicate that at higher doses, LPS-induced bone resorption is substantially mediated by IL-1 and TNF receptor signaling. Furthermore, IL-1 receptor signaling appears to be slightly more important than TNF receptor signaling. At lower LPS doses, other pathways leading to osteoclast activity that are independent of TNF and IL-1 are involved. PMID:10417196

  1. Bone Diseases

    MedlinePlus

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  2. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy

    PubMed Central

    Guinto, Valerie T; De Guia, Blanca; Festin, Mario R; Dowswell, Therese

    2014-01-01

    , nausea, or preterm birth. Comparing cycloserine with sulphadimidine, no significant differences in symptomatic, persistent, or recurrent infections were noted. Authors’ conclusions We cannot draw any definite conclusion on the most effective and safest antibiotic regimen for the initial treatment of asymptomatic bacteriuria in pregnancy. One study showed advantages with a longer course of nitrofurantoin, and another showed better tolerability with ampicillin compared with pivmecillinam; otherwise, there was no significant difference demonstrated between groups treated with different antibiotics. Given this lack of conclusive evidence, it may be useful for clinicians to consider factors such as cost, local availability and side effects in the selection of the best treatment option. PMID:20824868

  3. Clinical and radiographic outcomes of the treatment of adolescent idiopathic scoliosis with segmental pedicle screws and combined local autograft and allograft bone for spinal fusion: a retrospective case series

    PubMed Central

    2010-01-01

    Background High morbidity has been reported with iliac crest bone graft harvesting; however, donor bone is typically necessary for posterior spinal fusion. Autograft bone combined with allograft may reduce the morbidity associated with iliac crest bone harvesting and improve the fusion rate. Our aim in this study was to determine the presence of complications, pseudarthrosis, non-union, and infection using combined in situ local autograft bone and freeze-dried cancellous allograft bone in patients undergoing posterior spinal fusion for the treatment of adolescent idiopathic scoliosis. Methods A combination of in situ local autograft bone and freeze-dried cancellous allograft blocks were used in 50 consecutive patients with adolescent idiopathic scoliosis treated by posterior fusion and Moss Miami pedicle screw instrumentation. Results were assessed clinically and radiographically and quality of life and functional outcome was evaluated by administration of a Chinese version of the SRS-22 survey. Results There were 41 female and 9 male patients included for analysis with an average age of 14.7 years (range, 12-17). All patients had a minimum follow-up of 18 months (range, 18 to 40 months). The average preoperative Cobb angle was 49.8° (range, 40° to 86°). The average number of levels fused was 9.8 (range, 6-15). Patients had a minimum postoperative follow-up of 18 months. At final follow-up, the average Cobb angle correction was 77.8% (range, 43.4 to 92.5%). There was no obvious loss in the correction, and the average loss of correction was 1.1° (range, 0° to 4°). There was no pseudarthrosis and no major complications. Conclusions In situ autograft bone combined with allograft bone may be a promising method enhances spinal fusion in AIS treated with pedicle screw placement. By eliminating the need for iliac crest bone harvesting, significant morbidity may be avoided. PMID:20630050

  4. Intermittent applied mechanical loading induces subchondral bone thickening that may be intensified locally by contiguous articular cartilage lesions

    PubMed Central

    Poulet, B.; de Souza, R.; Kent, A.V.; Saxon, L.; Barker, O.; Wilson, A.; Chang, Y.-M.; Cake, M.; Pitsillides, A.A.

    2015-01-01

    Summary Objectives Changes in subchondral bone (SCB) and cross-talk with articular cartilage (AC) have been linked to osteoarthritis (OA). Using micro-computed tomography (micro-CT) this study: (1) examines changes in SCB architecture in a non-invasive loading mouse model in which focal AC lesions are induced selectively in the lateral femur, and (2) determines any modifications in the contralateral knee, linked to changes in gait, which might complicate use of this limb as an internal control. Methods Right knee joints of CBA mice were loaded: once with 2weeks of habitual use (n = 7), for 2weeks (n = 8) or for 5weeks (n = 5). Both left (contralateral) and right (loaded) knees were micro-CT scanned and the SCB and trabecular bone analysed. Gait analysis was also performed. Results These analyses showed a significant increase in SCB thickness in the lateral compartments in joints loaded for 5weeks, which was most marked in the lateral femur; the contralateral non-loaded knee also showed transient SCB thickening (loaded once and repetitively). Epiphyseal trabecular bone BV/TV and trabecular thickness were also increased in the lateral compartments after 5 weeks of loading, and in all joint compartments in the contralateral knee. Gait analysis showed that applied loading only affected gait in the contralateral himd-limb in all groups of mice from the second week after the first loading episode. Conclusions These data indicate a spatial link between SCB thickening and AC lesions following mechanical trauma, and the clear limitations associated with the use of contralateral joints as controls in such OA models, and perhaps in OA diagnosis. PMID:25655679

  5. Adenosine and Bone Metabolism

    PubMed Central

    Mediero, Aránzazu; Cronstein, Bruce N.

    2013-01-01

    Bone is a dynamic organ that undergoes continuous remodeling whilst maintaining a balance between bone formation and resorption. Osteoblasts, which synthesize and mineralize new bone, and osteoclasts, the cells that resorb bone, act in concert to maintain bone homeostasis. In recent years, there has been increasing appreciation of purinergic regulation of bone metabolism. Adenosine, released locally, mediates its physiologic and pharmacologic actions via interactions with G-protein coupled receptors and recent work has indicated that these receptors are involved in the regulation of osteoclast differentiation and function, as well as osteoblast differentiation and bone formation. Moreover, adenosine receptors also regulate chondrocyte and cartilage homeostasis. These recent findings underscore the potential therapeutic importance of adenosine receptors in regulating bone physiology and pathology. PMID:23499155

  6. Differences in toileting habits between children with chronic encopresis, asymptomatic siblings, and asymptomatic nonsiblings.

    PubMed

    Borowitz, S M; Cox, D J; Sutphen, J L

    1999-06-01

    No studies have compared toileting-specific behaviors of encopretic children with those of asymptomatic children and have controlled for environmental factors such as parental attitudes, parenting styles, and bathroom facilities. This study prospectively examined the toileting habits of 86 chronically encopretic children compared with those of 27 asymptomatic siblings and 35 asymptomatic nonsiblings. Although encopretic children experienced significantly more soiling than did controls, the total number of daily bowel movements passed in the toilet (+/-SD) was comparable in the three groups (.92 +/- .76 in encopretic children compared with 1.14 +/- .43 and 1.08 +/- .47 in siblings and nonsiblings, respectively). Encopretic children experienced pain with defecation more often than did controls. During the 14-day study period, encopretic children complained of pain on 2.75 +/- 4.03 days compared with .58 +/- 1.84 days among sibling controls and 2.31 +/- 3.21 days among nonsibling controls. The mean pain score in encopretic children was .76 +/- 1.00 compared with .05 +/- .15 and .26 +/- .38 among siblings and nonsiblings, respectively. All three groups of children sat on the toilet without parental prompting the same number of times each day. In summary, children with chronic encopresis do not seem to avoid toileting, and they exhibit toileting behaviors that are very similar to those of asymptomatic siblings as well as to those of nonsibling controls. PMID:10393070

  7. Neurosyphilis Presenting as Asymptomatic Optic Perineuritis

    PubMed Central

    Parker, Sarah E.; Pula, John H.

    2012-01-01

    Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS) syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was unremarkable, and lumbar puncture revealed a normal opening pressure, with an elevated cerebrospinal fluid white cell count. Orbit MRI showed optic nerve sheath expansion and enhancement, consistent with optic perineuritis. He tested positive for syphilis based on serum RPR and FTA-ABS. Conclusion. Ophthalmologic findings, including disc edema, may be the presenting features of CNS syphilis. Even in asymptomatic persons, perineuritis should be considered early, as diagnosis and treatment are imperative given the progressive nature of the disease. PMID:22606498

  8. Asymptomatic Chlamydia infection in pregnant women.

    PubMed

    Hagley, M T; Costa, A J

    1989-11-01

    Chlamydia trachomatis infection is currently among the most prevalent sexually transmitted diseases in the United States. A review of three textbooks of obstetrics reveals that none of them recommend routine chlamydia screening in prenatal patients, although two recommend routine screening for gonorrhea. A study was done at the Barberton Citizens Hospital Family Practice Residency Program to determine the incidence of asymptomatic chlamydia infection in pregnant women and to compare this to the incidence of asymptomatic Neisseria gonorrhoeae infection in the same population. A total of 69 patients were screened for Neisseria gonorrhoeae and Chlamydia trachomatis as part of their routine prenatal evaluations at the first prenatal visit and the visit of 36 weeks gestation. Neisseria gonorrhoeae was detected by growth on standard Martin-Lewis culture plates. Chlamydia trachomatis was detected by positive immunofluorescence using a standardized specimen kit (Syva Company, Palo Alto, California). The data were collected over a 12-month period from July of 1987 through July of 1988. There were no positive cultures for Neisseria gonorrhoeae (0%) in this group of patients. On the other hand, five patients tested positive for Chlamydia trachomatis (7.2%). The results of this study indicate that routine screening for Chlamydia trachomatis should be considered as part of the routine prenatal care. A larger, multi-centered study could be done in the future to confirm these results, as well as to determine if any regional differences exist. PMID:2601940

  9. ISOLATED HYDATID DISEASE OF THE ILIAC BONE.

    PubMed

    Baf, Morteza Mazloum Farsi; Baf, Mostafa Mazloum Farsi; Sasannejad, Payman

    2015-01-01

    Hydatid disease of the bone usually is asymptomatic and is found as an accidental finding during unrelated imaging. However, they can become symptomatic due to enlargement and pressure effect or being infected by bacteria. Hydatid disease usually involves multiple organs (such as liver, lungs and brain). In our case, hydatid disease had involved bone and the patient presented only with a chronic hip pain without other symptom or sign. Here, a case of isolated ilium hydatidosis is reported. PMID:27004362

  10. Asymptomatic brucellosis infection in humans: implications for diagnosis and prevention.

    PubMed

    Zhen, Q; Lu, Y; Yuan, X; Qiu, Y; Xu, J; Li, W; Ke, Y; Yu, Y; Huang, L; Wang, Y; Chen, Z

    2013-09-01

    Human brucellosis is mainly caused by contact with Brucella-infected animals and their secretions and carcasses. Individuals who are continuously in contact with animals are considered to be at a high risk but only some show symptoms and are diagnosed as cases of brucellosis. Here, we showed that asymptomatic brucellosis infections occur among humans. Asymptomatic infections mainly result from less frequent contact with Brucella and/or contact with low-virulence Brucella. In our study, patients with asymptomatic infection had low antibody titres and different contact patterns. Awareness of asymptomatic infection is important for early diagnosis of brucellosis and prevention of chronic infection. PMID:23668532

  11. Aneurysmal bone cyst of the lunate: Case report and literature review.

    PubMed

    Sá Rodrigues, André; Dopico, Carlos; Matos, Rui; Pinto, Rui; Vidinha, Vitor

    2016-12-01

    The aneurysmal bone cyst (ABC) is a benign osteolytic bone neoplasm. Although most ABC is asymptomatic, in some cases they produce a mass effect, impinging against soft tissues or interfering with joint function. The authors present a rare case report of a lunate ABC successfully treated by curettage and bone grafting, and review the literature of this pathology. PMID:27453641

  12. Time course of bone screw fixation following a local delivery of Zoledronate in a rat femoral model - a micro-finite element analysis.

    PubMed

    Kettenberger, Ulrike; Latypova, Adeliya; Terrier, Alexandre; Pioletti, Dominique P

    2015-05-01

    A good fixation of osteosynthesis implants is crucial for a successful bone healing but often difficult to achieve in osteoporotic patients. One possible solution to this issue is the local delivery of bisphosphonates in direct proximity to the implants, A critical aspect of this method, that has not yet been well investigated, is the time course of the implant fixation following the drug release. Usual destructive mechanical tests require large numbers of animals to produce meaningful results. Therefore, a micro-finite element (microFE) approach was chosen to analyze implant fixation. In vivo micro computed tomography (microCT) scans were obtained, first weekly and later bi-weekly, after implantation of polymeric screws in the femoral condyles of ovariectomized rats. In one half of the animals, Zoledronate was released from a hydrogel matrix directly in the peri-implant bone stock, the other animals were implanted only with screws as control. The time course of the implant fixation was investigated with linear elastic microFE models that were created based on in vivo microCT scans. The numerical models were validated against experimental pullout-tests measurements in an additional cadaver study. The microFE analysis revealed a significant increase in force at yield of the Zoledronate treated group compared to the control group. The force of the treated group was 28% higher after 17 days of screw implantation, 42% higher after 31 days. The significant difference persisted until the end of the in vivo study at day 58 (p<0.01). The early onset and prolonged duration of the implant anchorage improvement that was found in this study indicates the great potential of Zoledronate-loaded hydrogel for an enhancement of osteosynthesis implant fixation in impaired bone. PMID:25679481

  13. Nephrocalcinosis associated with continuous enamel hypoplasia and severe alveolar bone loss: a case report and literature review.

    PubMed

    Ashkenazi, Malka; Rafe, Zvi; Sarnat, Haim; Levin, Liran

    2014-01-01

    Enamel-renal syndrome (ERS) is a rare manifestation of nephrocalcinosis that has been associated with generalized enamel hypoplasia. The purpose of this paper was to describe, for the first time, the association of enamel-renal syndrome with severe localized periodontal bone loss. A 13-year-old boy presented with: generalized hypoplastic enamel; intrapulpal calcifications; retention of primary teeth; delayed eruption of permanent teeth; enlarged dental-follicles; misshaped roots of permanent teeth; gingival overgrowth; severe localized alveolar bone loss; and severe malocclusion. His parents were first cousins, suggesting autosomal recessive inheritance. Further studies are necessary to clarify whether the etiology of the oral disturbances relates to the genetic defect in the dental tissue or to the continuous metabolic distress associated with renal dysfunction. Nevertheless, since nephrocalcinosis is often asymptomatic, dentists should refer children with generalized enamel hypoplasia or/and multiple intrapulpal calcifications to nephrologists. PMID:24960394

  14. Asymptomatic post-rheumatic giant left atrium.

    PubMed

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-06-26

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m(2) for the definition of a "giant left atrium". PMID:27354895

  15. Asymptomatic post-rheumatic giant left atrium

    PubMed Central

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-01-01

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m2 for the definition of a “giant left atrium”. PMID:27354895

  16. Asymptomatic humans transmit dengue virus to mosquitoes

    PubMed Central

    Duong, Veasna; Lambrechts, Louis; Paul, Richard E.; Ly, Sowath; Lay, Rath Srey; Long, Kanya C.; Huy, Rekol; Tarantola, Arnaud; Scott, Thomas W.; Sakuntabhai, Anavaj; Buchy, Philippe

    2015-01-01

    Three-quarters of the estimated 390 million dengue virus (DENV) infections each year are clinically inapparent. People with inapparent dengue virus infections are generally considered dead-end hosts for transmission because they do not reach sufficiently high viremia levels to infect mosquitoes. Here, we show that, despite their lower average level of viremia, asymptomatic people can be infectious to mosquitoes. Moreover, at a given level of viremia, DENV-infected people with no detectable symptoms or before the onset of symptoms are significantly more infectious to mosquitoes than people with symptomatic infections. Because DENV viremic people without clinical symptoms may be exposed to more mosquitoes through their undisrupted daily routines than sick people and represent the bulk of DENV infections, our data indicate that they have the potential to contribute significantly more to virus transmission to mosquitoes than previously recognized. PMID:26553981

  17. Diagnosing and treating asymptomatic tuberculosis infection.

    PubMed Central

    Wang, C. T.

    1999-01-01

    OBJECTIVE: To summarize relevant parts of the guidelines recommended by the Canadian and American Thoracic Societies for diagnosis and management of asymptomatic tuberculosis (TB) infection. QUALITY OF EVIDENCE: The latest guidelines published by the Canadian and American Thoracic Societies were reviewed. Unfortunately, neither of these guidelines state explicitly how recommendations were derived. The references accompanying each set of guidelines, however, suggest that they were developed by extensive literature review of the subject and consensus among expert panels. MAIN MESSAGE: Only higher-risk patients should receive a TB screening test (Mantoux test) to minimize the possibility of false-positive test results. The cutoff points for positive tests vary to reflect the pretest likelihood of TB infection. An induration 5 mm or greater is considered positive in patients at highest risk of TB infection, that is, HIV-infected patients, close contacts of active TB cases, and patients with chest x-ray abnormalities suggestive of previous untreated TB. All other patients are considered positive if they have induration greater than 10 mm according to the Canadian guideline. A 15-mm cutoff point, however, is used for patients without risk factors in the American guideline. All patients with positive Mantoux test results should be considered infected with TB. Infected patients should be offered 6 to 12 months of isoniazid prophylaxis if they have HIV infection, if they have medical conditions that increase the risk of TB activation, or if they are younger than 35 years. CONCLUSIONS: Prophylactic treatment of infected individuals effectively prevents the spread of TB infection. Family physicians, who most often see patients in the asymptomatic stage of TB infection, are uniquely situated to prevent secondary cases of TB by offering appropriate patients prophylactic treatment. Patients should be counseled about the risk and benefit of prophylactic treatment so they give

  18. Asymptomatic SARS coronavirus infection among healthcare workers, Singapore.

    PubMed

    Wilder-Smith, Annelies; Teleman, Monica D; Heng, Bee H; Earnest, Arul; Ling, Ai E; Leo, Yee S

    2005-07-01

    We conducted a study among healthcare workers (HCWs) exposed to patients with severe acute respiratory syndrome (SARS) before infection control measures were instituted. Of all exposed HCWs, 7.5% had asymptomatic SARS-positive cases. Asymptomatic SARS was associated with lower SARS antibody titers and higher use of masks when compared to pneumonic SARS. PMID:16022801

  19. Hepatitis B virus infection and genotype in asymptomatic people from 10 ethnic groups in Yunnan, China

    PubMed Central

    Shen, Yuan-Ying; Hou, Wei; Yang, Zhan-Qiu; Xiao, Wen

    2015-01-01

    AIM: To evaluate the infection and genotype distribution of hepatitis B virus (HBV) in ethnic groups in Yunnan, China. METHODS: Two thousand five hundred and eighty-four asymptomatic local people from 10 ethnic groups were investigated in Yunnan, China. Infection and genotype distribution were evaluated by serological and genetic methods. Genotyping was verified by sequencing. Ethnic genotype distribution was compared by proportion test. RESULTS: Four types of infection model based on HBV serum markers were identified, and the average HBV infection rate was 5.7% in those asymptomatic local people. The genotype prevalence was 59.6% for B, 21.1% for C and 19.3% BC; subgenotypes Ba, Cs and Ce were identified in this study. Hepatitis B surface antigen-positive rate and the proportion of genotype B were significantly lower in ethnic groups with a northern origin compared to those with a southern origin (50% vs 73.9%, P = 0.037; 4.2% vs 10.5%, P = 0.000). CONCLUSION: Genotype B is dominant and genotype BC has high occurrence in asymptomatic local ethnic groups in Yunnan. HBV infection status and genotype distribution may associate with ethnic origin. PMID:26640334

  20. Bone Diseases

    MedlinePlus

    ... also avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... Bones can also develop cancer and infections Other bone diseases, which are caused by poor nutrition, genetics, or ...

  1. Bone Grafts

    MedlinePlus

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  2. Significantly lower femoral neck growth in screw fixation of the asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis.

    PubMed

    Wölfle-Roos, Julia V; Urlaub, Stefanie; Reichel, Heiko; Taurman, Rita

    2016-05-01

    There is an ongoing debate on which fixation technique should be preferred for the prophylactic fixation of the asymptomatic contralateral hip in slipped capital femoral epiphysis (SCFE). In the case of Kirschner-wire (K-wire) fixation, there is a possibility of secondary loss of fixation because of longitudinal growth of the physis, whereas in screw fixation, physeal growth of the femoral neck might be impaired. The aim of this matched-pair study was to compare the longitudinal growth of the femoral neck in screw fixation versus K-wire fixation of the asymptomatic contralateral hip in SCFE. All 18 patients (female : male=3 : 15), who had undergone screw fixation of the asymptomatic contralateral hip between 9/2001 and 9/2011, were matched according to age, bone age, sex, and time to follow-up to another 18 patients with K-wire fixation. The length of the femoral neck of the contralateral hip was measured in parallel to either screw or K-wire from the apex of the femoral head to the opposite cortical bone. The ratio of the femoral neck length measured directly after surgery and on follow-up was defined as femoral neck growth. There was no significant difference between groups with respect to age, modified Oxford Bone age score, and time to follow-up. We found a significant difference in femoral neck growth between patients with screw fixation (5.5±4.3%) compared with K-wire fixation (8.9±5.7%, P=0.048 matched Wilcoxon test). The difference in femoral neck growth of patients with K-wire or screw fixation of the contralateral asymptomatic hip in SCFE was small, but statistically significant. Thus, despite high rates of secondary loss of fixation, K-wire fixation should still be considered, especially in very young patients. PMID:26919622

  3. Local control rates of metastatic renal cell carcinoma to the bone using stereotactic body radiation therapy: Is RCC truly radioresistant?′

    PubMed Central

    Bourlon, Maria T.; Bedrick, Edward; Bhatia, Shilpa; Kessler, Elizabeth R.; Flaig, Thomas W.; Fisher, Christine M.; Kavanagh, Brian D; Lam, Elaine T.; Karam, Sana D.

    2015-01-01

    Purpose We report the radiographic and clinical response rate of stereotactic body radiation therapy (SBRT) compared with conventional fractionated external beam radiation therapy (CF-EBRT) for renal cell carcinoma (RCC) bone lesions treated at our institution. Methods and materials Forty-six consecutive patients were included in the study, with 95 total lesions treated (50 SBRT, 45 CF-EBRT). We included patients who had histologic confirmation of primary RCC and radiographic evidence of metastatic bone lesions. The most common SBRT regimen used was 27 Gy in 3 fractions. Results Median follow-up was 10 months (range, 1-64 months). Median time to symptom control between SBRT and CF-EBRT were 2 (range, 0-6 weeks) and 4 weeks (range, 0-7 weeks), respectively. Symptom control rates with SBRT and CF-EBRT were significantly different (P = .020) with control rates at 10, 12, and 24 months of 74.9% versus 44.1%, 74.9% versus 39.9%, and 74.9% versus 35.7%, respectively. The median time to radiographic failure and unadjusted pain progression was 7 months in both groups. When controlling for gross tumor volume, dose per fraction, smoking, and the use of systemic therapy, biologically effective dose ≥80 Gy was significant for clinical response (hazard ratio [HR], 0.204; 95% confidence interval [CI], 0.043-0.963; P = .046) and radiographic (HR, 0.075; 95% CI, 0.013-0.430; P = .004). When controlling for gross tumor volume and total dose, biologically effective dose ≥80 Gy was again predictive of clinical local control (HR, 0.140; 95% CI, 0.025-0.787; P = .026). Toxicity rates were low and equivalent in both groups, with no grade 4 or 5 toxicity reported. Conclusions SBRT is both safe and effective for treating RCC bone metastases, with rapid improvement in symptoms after treatment and more durable clinical and radiographic response rate. Future prospective trials are needed to further define efficacy and toxicity of treatment, especially in the setting of targeted agents

  4. Noninvasive testing of asymptomatic bilateral hilar adenopathy

    SciTech Connect

    Carr, P.L.; Singer, D.E.; Goldenheim, P.; Bernardo, J.; Mulley, A.G. )

    1990-03-01

    The diagnostic strategy for asymptomatic patients with persistent bilateral bilar adenopathy often involves invasive procedures. The authors used Bayesian analysis to: (1) estimate the relative prevalences of diseases causing bilateral bilar adenopathy; (2) assess changes in the prevalence of disease by race, the presence of other clinical symptoms, and geography; and (3) determine the value of relevant noninvasive tests, including the angiotensin-converting enzyme (ACE) assay, gallium scan, and purified protein derivative (PPD), in order to assess when a strategy of watchful waiting is appropriate. The analysis indicated that the ACE assay, particularly when paired with the PPD, can identify many patients who might safely be managed without immediate invasive biopsy. Patients who are ACE+ and PPD- have an estimated probability of sarcoidosis of 0.95 or greater; patients who are ACE- and PPD+ have a probability of tuberculosis of 0.86 if black, 0.79 if white. In contrast, gallium scanning has no diagnostic role in this clinical situation. Bronchoscopic or mediastinoscopic biopsy has a limited role for patients who are ACE+ PPD- or ACE- PPD+ because of limited sensitivity. Patients who are both ACE- and PPD-, particularly if white, may have a high enough risk of lymphoma to consider invasive biopsy.

  5. Prevalence of asymptomatic urinary tract infections in morbidly obese dogs

    PubMed Central

    Witzel, Angela L.; Bartges, Joseph W.; Moyers, Tamberlyn S.; Kirk, Claudia A.

    2016-01-01

    Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI) may be more prevalent in the obese. Asymptomatic bacteriuria (AB) is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was undertaken to explore a possible association between obesity and asymptomatic bacteriuria. Records from lean, overweight, and obese dogs receiving both a dual energy absorptiometry (DXA) scan and urine culture were included. Results. Six positive urine cultures were identified among 46 dogs fulfilling search criteria. All six positive cultures were found in dogs with body fat percentage of >45%. In dogs with body fat percentage of <45%, there were no positive urine cultures. Discussion. There was an increased prevalence of asymptomatic bacteriuria in the morbidly obese dogs in this study compared to those that were lean, overweight, or moderately obese. Whether antibiotic therapy is necessary in such cases is still being debated, but because asymptomatic bacteriuria may be associated with ascending infections, uroliths, or other complications, the data reported herein support the screening of obese patients for bacteriuria. PMID:26989606

  6. Local delivery of rhVEGF165 through biocoated nHA/coral block grafts in critical-sized dog mandible defects: a histological study at the early stages of bone healing

    PubMed Central

    Du, Bing; Gao, Yao; Deng, Yue; Zhao, Yadong; Lai, Chunhua; Guo, Zehong; Rong, Mingdeng; Zhou, Lei

    2015-01-01

    Alveolar defects of a critical size cannot heal completely without grafting. Thus, they represent a major clinical challenge to reconstructive surgery. Numerous types of grafts have been used to improve bone regeneration. In the case of particle grafts, the capacity for volume rebuilding and space maintaining is still not ideal, particularly for critical-sized bone defects. Although porous block grafts can overcome the above problems of particle grafts, they are still not widely used for critical-sized alveolar defects, because of their reduced efficacy in blood vessel and bone formation. Thus, in the present study, nano-hydroxyapatite/coralline (nHA/coral) blocks were pre-vascularized by coating them with vascular endothelial growth factor (VEGF), and then implanted in dogs with critical-sized mandibular defects. This model has possible applications in orthopedic and implant surgery. In vivo results indicate that the nHA/coral blocks allow cell and collagen ingrowth because of their suitable pore size and interconnectivity of pores. In addition, pre-vascularization properties were obtained by coating the scaffolds with VEGF. Histological and immunohistochemical examinations, as well as fluorescence analysis, revealed that the local delivery of VEGF can significantly improve neovascularization and mineralization of newly formed bone at the early stages of bone healing in this dog implantation model. Our data collectively show that nHA/coral blocks have possible applications in bone tissue engineering, and excellent results can be achieved by pre-vascularization with VEGF. PMID:26131067

  7. Asymptomatic Wolff-Parkinson-White Syndrome Should be Ablated.

    PubMed

    Pappone, Carlo; Santinelli, Vincenzo

    2012-09-01

    Wolff-Parkinson-White syndrome (WPW) is associated with a small but lifetime risk of cardiac arrest and/or sudden cardiac death (SCD). However, the exact risk is not well defined, particularly in asymptomatic persons. Over recent years the authors have collected and reported new follow-up data among a large number of asymptomatic WPW patients, particularly children, intensively followed. These data have significantly contributed to the knowledge and definition of the natural history of WPW from childhood to adulthood. The risk of SCD is higher in asymptomatic children than in adults, and early ablation can be offered only to selected subjects after electrophysiologic testing. PMID:26939947

  8. Hepatitis C virus infection in the asymptomatic British blood donor.

    PubMed

    Mutimer, D J; Harrison, R F; O'Donnell, K B; Shaw, J; Martin, B A; Atrah, H; Ala, F A; Skidmore, S; Hubscher, S G; Neuberger, J M

    1995-01-01

    Blood donor screening for hepatitis C virus (HCV) antibodies is now routine. Most blood transfusion services recommend that seropositive donors are referred for further investigation. Southern European studies suggest that many asymptomatic seropositive donors have clinically significant liver disease. Seropositive donors in areas of high prevalence may not, however, be representative of British donors. We have prospectively examined the prevalence and severity of HCV infection in a British volunteer blood donor population. During a 14 month period, only 0.35% (999/287,332) of all donors in the West Midlands were anti-HCV (screening assay) positive. Only 5% (52/999) of these were confirmed true seropositive. Nearly 80% (41/52) of seropositive donors were referred to the Queen Elizabeth Hospital Liver Unit for further investigation. Most underwent complete investigation, including liver biopsy. Forty of forty-one donors had biochemical, histological, or virological evidence of persistent viral infection. Histological changes were generally mild and none was cirrhotic. Covertly infected patients had less severe disease than those with an overt risk factor for HCV exposure. In the British Midlands, the prevalence of blood donor seropositivity is low. In contrast with seropositive Southern European donors, the British donor is more likely to belong to an at-risk group for parenteral exposure and is less likely to have severe histological changes. This study highlights the importance of developing locally relevant guidelines for the counselling and investigation of anti-HCV-positive blood donors. PMID:7493294

  9. Asymptomatic myocardial ischemia following cold provocation

    SciTech Connect

    Shea, M.J.; Deanfield, J.E.; deLandsheere, C.M.; Wilson, R.A.; Kensett, M.; Selwyn, A.P.

    1987-09-01

    Cold is thought to provoke angina in patients with coronary disease either by an increase in myocardial demand or an increase in coronary vascular resistance. We investigated and compared the effects of cold pressor stimulation and symptom-limited supine bicycle exercise on regional myocardial perfusion in 35 patients with stable angina and coronary disease and in 10 normal subjects. Regional myocardial perfusion was assessed with positron emission tomography and rubidium-82. Following cold pressor stimulation 24 of 35 patients demonstrated significant abnormalities of regional myocardial perfusion with reduced cation uptake in affected regions of myocardium: 52 +/- 9 to 43 +/- 9 (p less than 0.001 vs normal subjects). Among these 24 patients only nine developed ST depression and only seven had angina. In contrast, 29 of 35 patients underwent supine exercise, and abnormal regional myocardial perfusion occurred in all 29, with a reduction in cation intake from 48 +/- 10 to 43 +/- 14 (p less than 0.001 vs normal subjects). Angina was present in 27 of 29 and ST depression in 25 of 29. Although the absolute decrease in cation uptake was somewhat greater following cold as opposed to exercise, the peak heart rate after cold was significantly lower than that after exercise (82 +/- 12 vs 108 +/- 16 bpm, p less than 0.05). Peak systolic blood pressures after cold and exercise were similar (159 +/- 24 vs 158 +/- 28). Thus, cold produces much more frequent asymptomatic disturbances of regional myocardial perfusion in patients with stable angina and coronary disease than is suggested by pain or ECG changes.

  10. Is there a role for screening asymptomatic patients with diabetes?

    PubMed

    Veillet-Chowdhury, Mahdi; Blankstein, Ron

    2015-06-01

    Coronary artery disease (CAD) remains a leading cause of death among patients with diabetes mellitus. However, many patients with diabetes and CAD are asymptomatic and may sustain a myocardial infarction as their presenting symptom of CAD. Non-invasive cardiovascular imaging offers an opportunity to detect the presence and severity of CAD, or its hemodynamic consequences. The Detection of Ischemia in Asymptomatic Diabetics study and the FACTOR-64 study examined the utility of non-invasive imaging tests to evaluate asymptomatic individuals with diabetes mellitus. The results of these trials may have been negative with regard to promoting CAD screening of asymptomatic diabetic patients, but they do strengthen the position of optimal medical management in reducing cardiovascular events. However, performing a trial to include true high-risk patients who have CAD and are more likely to have silent ischemia could lead to prognostically beneficial coronary revascularizations. PMID:25979367

  11. Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients.

    PubMed Central

    Villa, G; Monteleone, D; Marra, C; Bartoli, A; Antinori, A; Pallavicini, F; Tamburrini, E; Izzi, I

    1993-01-01

    Neuropsychological and immunological parameters were studied in 36 AIDS patients with early disease and without clinical, laboratory, and neuroradiological signs of CNS impairment, and also in 33 asymptomatic HIV seropositive subjects. Many AIDS patients performed abnormally on timed psychomotor tasks, tasks involving sequencing and "set-shifting", and memory tasks stressing attention, learning, active retrieval, and monitoring of information. Asymptomatic HIV seropositive subjects as a group did not perform significantly worse than controls. However, on the basis of a cut off number of pathological performances on neuropsychological tasks, 52.8% of AIDS and 30.3% of asymptomatic HIV seropositive subjects had cognitive impairment, compared with 3.9% of HIV seronegative controls. Low values of CD4+ cells and of CD4+/CD8+ ratio and high titres of P-24 antigen in the blood prevailed among subjects with cognitive impairment, especially in the asymptomatic HIV seropositive group. PMID:8350104

  12. Living Bones, Strong Bones

    NASA Video Gallery

    In this classroom activity, engineering, nutrition, and physical activity collide when students design and build a healthy bone model of a space explorer which is strong enough to withstand increas...

  13. Successful Reconstruction of Asymptomatic Bilateral External Carotid Artery Aneurysms.

    PubMed

    Loja, Melissa N; Pevec, William C

    2016-04-01

    True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292

  14. Femoral prosthesis subsidence in asymptomatic patients. A stereophotogrammetric assessment.

    PubMed

    Chafetz, N; Baumrind, S; Murray, W R; Genant, H K

    1984-01-01

    A radiographic stereophotogrammetric technique (SPG) was used to evaluate quantitatively the presence of early femoral prosthesis subsidence after total hip arthroplasty (THA). This paper focuses on the measurement of subsidence in 12 patients who remained asymptomatic during the first two years after surgery. Only one of these had SPG estimated subsidence in excess of one millimeter at any timepoint. These findings are consistent with the conclusion that early postoperative subsidence is not a common finding among asymptomatic THA patients. PMID:6469528

  15. Immunoregulation in human malaria: the challenge of understanding asymptomatic infection

    PubMed Central

    de Mendonça, Vitor R; Barral-Netto, Manoel

    2015-01-01

    Asymptomatic Plasmodium infection carriers represent a major threat to malaria control worldwide as they are silent natural reservoirs and do not seek medical care. There are no standard criteria for asymptomaticPlasmodium infection; therefore, its diagnosis relies on the presence of the parasite during a specific period of symptomless infection. The antiparasitic immune response can result in reducedPlasmodium sp. load with control of disease manifestations, which leads to asymptomatic infection. Both the innate and adaptive immune responses seem to play major roles in asymptomatic Plasmodiuminfection; T regulatory cell activity (through the production of interleukin-10 and transforming growth factor-β) and B-cells (with a broad antibody response) both play prominent roles. Furthermore, molecules involved in the haem detoxification pathway (such as haptoglobin and haeme oxygenase-1) and iron metabolism (ferritin and activated c-Jun N-terminal kinase) have emerged in recent years as potential biomarkers and thus are helping to unravel the immune response underlying asymptomatic Plasmodium infection. The acquisition of large data sets and the use of robust statistical tools, including network analysis, associated with well-designed malaria studies will likely help elucidate the immune mechanisms responsible for asymptomatic infection. PMID:26676319

  16. Asymptomatic rotavirus infections in England: prevalence, characteristics, and risk factors.

    PubMed

    Phillips, Gemma; Lopman, Ben; Rodrigues, Laura C; Tam, Clarence C

    2010-05-01

    Rotavirus is a major cause of infectious intestinal disease in young children; a substantial prevalence of asymptomatic infection has been reported across all age groups. In this study, the authors determined characteristics of asymptomatic rotavirus infection and potential risk factors for infection. Healthy persons were recruited at random from the general population of England during the Study of Infectious Intestinal Disease in England (1993-1996). Rotavirus infection was identified using reverse-transcription polymerase chain reaction. Multivariable logistic regression was used to compare exposures reported by participants with rotavirus infection with those of participants who tested negative. Multiple imputation was used to account for missing responses in the data set. The age-adjusted prevalence of asymptomatic rotavirus infection was 11%; prevalence was highest in children under age 18 years. Attendance at day care was a risk factor for asymptomatic rotavirus infection in children under age 5 years; living in a household with a baby that was still in diapers was a risk factor in older adults. The results suggest that asymptomatic rotavirus infection is transmitted through the same route as rotavirus infectious intestinal disease: person-to-person contact. More work is needed to understand the role of asymptomatic infections in transmission leading to rotavirus disease. PMID:20392863

  17. Bone scan

    MedlinePlus

    ... scan is an imaging test used to diagnose bone diseases and find out how severe they are. How ... a 3-phase bone scan. To evaluate metastatic bone disease, images are taken only after the 3- to ...

  18. Bone Cancer

    MedlinePlus

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  19. Bone scan

    MedlinePlus

    A bone scan is an imaging test used to diagnose bone diseases and find out how severe they are. ... A bone scan involves injecting a very small amount of radioactive material (radiotracer) into a vein. The substance travels through ...

  20. Bone Density

    MedlinePlus

    ... bone health. It compares your bone density, or mass, to that of a healthy person who is ... Whether your osteoporosis treatment is working Low bone mass that is not low enough to be osteoporosis ...

  1. Bone Tumor

    MedlinePlus

    ... most common types of primary bone cancer are: • Multiple myeloma. Multiple myeloma is the most common primary bone cancer. It ... Any bone can be affected by this cancer. Multiple myeloma affects approximately six people per 100,000 each ...

  2. Bone Cancer

    MedlinePlus

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 ...

  3. Early diagenetic stabilization of trace elements in reptile bone remains as an indicator of Maastrichtian Late Paleocene climatic changes: evidence from the Naran Bulak locality, the Gobi Desert (South Mongolia)

    NASA Astrophysics Data System (ADS)

    Samoilov, V. S.; Benjamini, Ch.; Smirnova, E. V.

    2001-08-01

    Maastrichtian dinosaur bone remains from the Naran Bulak locality (the Gobi Desert) with well-preserved bone textural features are enriched in some trace elements, primarily in REE. These features of vertebrate fossils were formed during diagenesis following rapid burial in mudflow sediments, and prior to postfossilization epigenetic changes. Trace elements are mainly concentrated in diagenetic apatite. Their contents in the bones correlate with that in their enclosing sediments for both maxima and minima. Fossil and sediment compositions were established under the influence of paleoclimate. They are correlated with long-term climatic changes with the aridity maximum at the K/T boundary. Climatic changes were recorded via the change of salinity of waters interacting with the buried vertebrate remains.

  4. Laboratory aspects of asymptomatic bacteriuria in pregnancy.

    PubMed

    Mohammad, Marlyn; Mahdy, Zaleha A; Omar, Jamil; Maan, Noorashikin; Jamil, M A

    2002-09-01

    A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro

  5. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

    PubMed

    Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses <1 year old commonly had alterations in the shape and density of the mandibular condyle. Older horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology. PMID:26773281

  6. Combination Therapy with Zoledronic Acid and Parathyroid Hormone Improves Bone Architecture and Strength following a Clinically-Relevant Dose of Stereotactic Radiation Therapy for the Local Treatment of Canine Osteosarcoma in Athymic Rats.

    PubMed

    Curtis, Ryan C; Custis, James T; Ehrhart, Nicole P; Ehrhart, E J; Condon, Keith W; Gookin, Sara E; Donahue, Seth W

    2016-01-01

    Clinical studies using definitive-intent stereotactic radiation therapy (SRT) for the local treatment of canine osteosarcoma (OSA) have shown canine patients achieving similar median survival times as the current standard of care (amputation and adjuvant chemotherapy). Despite this, there remains an unacceptable high risk of pathologic fracture following radiation treatment. Zoledronic acid (ZA) and parathyroid hormone (PTH) are therapeutic candidates for decreasing this fracture risk post-irradiation. Due to differing mechanisms, we hypothesized that the combined treatment with ZA and PTH would significantly improve bone healing more than ZA or PTH treatment alone. Using an orthotopic model of canine osteosarcoma in athymic rats, we evaluated bone healing following clinically-relevant doses of radiation therapy (12 Gy x 3 fractions, 36 Gy total). Groups included 36 Gy SRT only, 36 Gy SRT plus ZA, 36 Gy SRT plus ZA and PTH, 36 Gy SRT plus PTH, and 36 Gy SRT plus localized PTH treatment. Our study showed significant increases in bone volume and increased polar moments of inertia (in the distal femoral metaphysis) 8 weeks after radiation in the combined (ZA/PTH) treatment group as compared to radiation treatment alone. Histomorphometric analysis revealed evidence of active mineralization at the study endpoint as well as successful tumor-cell kill across all treatment groups. This work provides further evidence for the expanding potential indications for ZA and PTH therapy, including post-irradiated bone disease due to osteosarcoma. PMID:27332712

  7. Combination Therapy with Zoledronic Acid and Parathyroid Hormone Improves Bone Architecture and Strength following a Clinically-Relevant Dose of Stereotactic Radiation Therapy for the Local Treatment of Canine Osteosarcoma in Athymic Rats

    PubMed Central

    Curtis, Ryan C.; Custis, James T.; Ehrhart, Nicole P.; Ehrhart, E. J.; Condon, Keith W.; Gookin, Sara E.; Donahue, Seth W.

    2016-01-01

    Clinical studies using definitive-intent stereotactic radiation therapy (SRT) for the local treatment of canine osteosarcoma (OSA) have shown canine patients achieving similar median survival times as the current standard of care (amputation and adjuvant chemotherapy). Despite this, there remains an unacceptable high risk of pathologic fracture following radiation treatment. Zoledronic acid (ZA) and parathyroid hormone (PTH) are therapeutic candidates for decreasing this fracture risk post-irradiation. Due to differing mechanisms, we hypothesized that the combined treatment with ZA and PTH would significantly improve bone healing more than ZA or PTH treatment alone. Using an orthotopic model of canine osteosarcoma in athymic rats, we evaluated bone healing following clinically-relevant doses of radiation therapy (12 Gy x 3 fractions, 36 Gy total). Groups included 36 Gy SRT only, 36 Gy SRT plus ZA, 36 Gy SRT plus ZA and PTH, 36 Gy SRT plus PTH, and 36 Gy SRT plus localized PTH treatment. Our study showed significant increases in bone volume and increased polar moments of inertia (in the distal femoral metaphysis) 8 weeks after radiation in the combined (ZA/PTH) treatment group as compared to radiation treatment alone. Histomorphometric analysis revealed evidence of active mineralization at the study endpoint as well as successful tumor-cell kill across all treatment groups. This work provides further evidence for the expanding potential indications for ZA and PTH therapy, including post-irradiated bone disease due to osteosarcoma. PMID:27332712

  8. Asymptomatic radiopaque lesions of the jaws: a radiographic study using cone-beam computed tomography.

    PubMed

    Araki, Masao; Matsumoto, Naoyuki; Matsumoto, Kunihito; Ohnishi, Masaaki; Honda, Kazuya; Komiyama, Kazuo

    2011-12-01

    Panoramic radiography and cone-beam computed tomography (CT) were used to analyze asymptomatic radiopaque lesions in the jaw bones and determine the diagnostic relevance of the lesions based on their relationships to teeth and site of origin. One hundred radiopaque lesions detected between 1998 and 2002 were examined by both panoramic radiography and cone-beam CT. On the basis of panoramic radiographs, the region was classified as periapical, body, or edentulous, and the site was classified as molar or premolar. Follow-up data from medical records were available for only 36 of these cases. The study protocol for simultaneous use of cone-beam CT was approved by the ethics review board of our institution. A large majority of radiopaque lesions were observed in premolar and molar sites of the mandible; 60% of lesions were periapical, 24% were in the body, and 16% were in the edentulous region. An interesting type of radiopaque lesion, which we named a pearl shell structure (PSS), was observed on cone-beam CT in 34 of the 100 lesions. The PSS is a distinctive structure, and this finding on cone-beam CT likely represents the start of bone formation before bone sclerosis. PMID:22167028

  9. Norovirus in symptomatic and asymptomatic individuals: cytokines and viral shedding.

    PubMed

    Newman, K L; Moe, C L; Kirby, A E; Flanders, W D; Parkos, C A; Leon, J S

    2016-06-01

    Noroviruses (NoV) are the most common cause of epidemic gastroenteritis world-wide. NoV infections are often asymptomatic, although individuals still shed large amounts of NoV in their stool. Understanding the differences between asymptomatic and symptomatic individuals would help in elucidating mechanisms of NoV pathogenesis. Our goal was to compare the serum cytokine responses and faecal viral RNA titres of asymptomatic and symptomatic NoV-infected individuals. We tested serum samples from infected subjects (n = 26; 19 symptomatic, seven asymptomatic) from two human challenge studies of GI.1 NoV for 16 cytokines. Samples from prechallenge and days 1-4 post-challenge were tested for these cytokines. Cytokine levels were compared to stool NoV RNA titres quantified previously by reverse transcription-polymerase chain reaction (RT-qPCR). While both symptomatic and asymptomatic groups had similar patterns of cytokine responses, the symptomatic group generally exhibited a greater elevation of T helper type 1 (Th1) and Th2 cytokines and IL-8 post-challenge compared to the asymptomatic group (all P < 0·01). Daily viral RNA titre was associated positively with daily IL-6 concentration and negatively with daily IL-12p40 concentration (all P < 0·05). Symptoms were not associated significantly with daily viral RNA titre, duration of viral shedding or cumulative shedding. Symptomatic individuals, compared to asymptomatic, have greater immune system activation, as measured by serum cytokines, but they do not have greater viral burden, as measured by titre and shedding, suggesting that symptoms may be immune-mediated in NoV infection. PMID:26822517

  10. Elevated levels of endothelial-derived microparticles, and serum CXCL9 and SCGF-β are associated with unstable asymptomatic carotid plaques.

    PubMed Central

    Schiro, Andrew; Wilkinson, Fiona L.; Weston, Ria; Smyth, J. Vincent; Serracino-Inglott, Ferdinand; Alexander, M. Yvonne

    2015-01-01

    Endothelial microparticles (EMPs) are released from dysfunctional endothelial cells. We hypothesised that patients with unstable carotid plaque have higher levels of circulating microparticles compared to patients with stable plaques, and may correlate with serum markers of plaque instability and inflammation. Circulating EMPs, platelet MPs (PMPs) and inflammatory markers were measured in healthy controls and patients undergoing carotid endarterectomy. EMP/PMPs were quantified using flow cytometry. Bioplex assays profiled systemic inflammatory and bone-related proteins. Immunohistological analysis detailed the contribution of differentially-regulated systemic markers to plaque pathology. Alizarin red staining showed calcification. EMPs and PMPs were significantly higher in patients with carotid stenosis (≥70%) compared to controls, with no differences between asymptomatic vs symptomatic patients. Asymptomatic patients with unstable plaques exhibited higher levels of EMPs, CXCL9 and SCGF-β compared to those with stable plaques. CXCL9, and SCGF-β were detected within all plaques, suggesting a contribution to both localised and systemic inflammation. Osteopontin and osteoprotegerin were significantly elevated in the symptomatic vs asymptomatic group, while osteocalcin was higher in asymptomatic patients with stable plaque. All plaques exhibited calcification, which was significantly greater in asymptomatic patients. This may impact on plaque stability. These data could be important in identifying patients at most benefit from intervention. PMID:26564003

  11. Elevated levels of endothelial-derived microparticles, and serum CXCL9 and SCGF-β are associated with unstable asymptomatic carotid plaques.

    PubMed

    Schiro, Andrew; Wilkinson, Fiona L; Weston, Ria; Smyth, J Vincent; Serracino-Inglott, Ferdinand; Alexander, M Yvonne

    2015-01-01

    Endothelial microparticles (EMPs) are released from dysfunctional endothelial cells. We hypothesised that patients with unstable carotid plaque have higher levels of circulating microparticles compared to patients with stable plaques, and may correlate with serum markers of plaque instability and inflammation. Circulating EMPs, platelet MPs (PMPs) and inflammatory markers were measured in healthy controls and patients undergoing carotid endarterectomy. EMP/PMPs were quantified using flow cytometry. Bioplex assays profiled systemic inflammatory and bone-related proteins. Immunohistological analysis detailed the contribution of differentially-regulated systemic markers to plaque pathology. Alizarin red staining showed calcification. EMPs and PMPs were significantly higher in patients with carotid stenosis (≥ 70%) compared to controls, with no differences between asymptomatic vs symptomatic patients. Asymptomatic patients with unstable plaques exhibited higher levels of EMPs, CXCL9 and SCGF-β compared to those with stable plaques. CXCL9, and SCGF-β were detected within all plaques, suggesting a contribution to both localised and systemic inflammation. Osteopontin and osteoprotegerin were significantly elevated in the symptomatic vs asymptomatic group, while osteocalcin was higher in asymptomatic patients with stable plaque. All plaques exhibited calcification, which was significantly greater in asymptomatic patients. This may impact on plaque stability. These data could be important in identifying patients at most benefit from intervention. PMID:26564003

  12. Coexistent asymptomatic myeloma and hereditary cardiac amyloidosis: an unusual case of heart failure.

    PubMed

    Lee, Lydia; Aziz, Michael; Wechalekar, Ashutosh; Rabin, Neil

    2011-11-01

    A 76-year-old Afro-Caribbean man presenting with heart failure was diagnosed with isolated cardiac amyloid. He had evidence of myeloma on bone marrow biopsy suggesting AL amyloid, the commonest type of systemic amyloidosis, as the underlying cause. He had no other myeloma-related organ damage. However, endocardial biopsy revealed amyloid fibrils composed of transthyretin and genetic typing established heterozygozity for the valine to isoleucine mutation at position 122 (Val122Ile). The diagnosis was therefore hereditary systemic amyloidosis as a result of a genetic transthyretin variant (ATTR) causing cardiac amyloidosis and coexistent asymptomatic myeloma. This requires symptomatic treatment of heart failure only. This article discusses a rare cause of heart failure and uses this case to illustrate that histological confirmation of the amyloid-causing protein is essential. Mistaken assumption of AL amyloid could have resulted in inappropriate cytotoxic therapy targeting the plasma cell clone. PMID:22083004

  13. [Monoclonal gammopathy of undetermined significance and asymptomatic multiple myelom in the year 2014 ].

    PubMed

    Adam, Zdeněk; Krejčí, Marta; Pour, Luděk; Sevčíková, Eva; Křivanová, Andrea; Rehák, Zdeněk; Koukalová, Renata; Cermáková, Zdeňka; Vaníček, Jíří; Sevčíková, Sabina

    2014-10-01

    Presence of monoclonal immunoglobulin in serum or urine is a relatively common event affecting about 3.2 % of people over 50. Isolated increase of only one type of free light chain, either κ or λ, is detected in 0.7-0.8 % of people over 50. Most people with monoclonal immunoglobulin meet the criteria of the so-called "mono-clonal gammopathy of undetermined significance (MGUS)". MGUS is defined by concentration of monoclonal immunoglobulin in serum < 30 g/l, number of plasma cells in the bone marrow < 10 % and the absence of symptoms of multiple myeloma and other lymphoproliferative diseases. A proportion of people with MGUS gradually progresses from asymptomatic into symptomatic myeloma or other malignant lymphoproliferative disease requiring treatment. Therefore, MGUS is considered to be one of the most common premalignant conditions with an average risk of transformation into malignant disease of 1 % per year. Monoclonal gammopathy of IgG and IgA subtype can develop into multiple myeloma. Light chain monoclonal gammopathy can develop not only into light chain multiple myeloma but also into AL-amyloidosis and light chain deposition disease (amorphous deposits of light chains damaging organs). IgM monoclonal gammopathy may develop into Waldenstrom macroglobulinemia or other lymphoproliferative disorder, or into rare IgM subtype of multiple myeloma. Unfortunately, people with MGUS are threatened by more than an increased risk of transformation into multiple myeloma or other severe hematologic disease. Pre-malignant clone of plasma cells in the bone marrow causes changes in the bone marrow that directly affect the person. For people with MGUS, there is an increased incidence of osteoporosis and increased fracture risk when compared to the general population. People with MGUS also have an increased risk of bacterial infections and thromboembolic complications compared with the same age population without MGUS. Clonal plasma cells, which are the basis of MGUS, may in

  14. Short bones

    MedlinePlus

    Short bones in the human body are often cube-like, their length, width, and height are all about the same. Short bones include the carpal bones of the hands and wrist, and the tarsal bones of the feet and ankles.

  15. CT findings of accidental fish bone ingestion and its complications.

    PubMed

    Venkatesh, Sandeep Halagatti; Venkatanarasimha Karaddi, Nanda Kumar

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  16. CT findings of accidental fish bone ingestion and its complications

    PubMed Central

    Venkatesh, Sandeep Halagatti; Karaddi, Nanda Kumar Venkatanarasimha

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  17. Local delivery of allogeneic bone marrow and adipose tissue-derived mesenchymal stromal cells for cutaneous wound healing in a porcine model.

    PubMed

    Hanson, Summer E; Kleinbeck, Kyle R; Cantu, David; Kim, Jaeyhup; Bentz, Michael L; Faucher, Lee D; Kao, W John; Hematti, Peiman

    2016-02-01

    Wound healing remains a major challenge in modern medicine. Bone marrow- (BM) and adipose tissue- (AT) derived mesenchymal stromal/stem cells (MSCs) are of great interest for tissue reconstruction due to their unique immunological properties and regenerative potential. The purpose of this study was to characterize BM and AT-MSCs and evaluate their effect when administered in a porcine wound model. MSCs were derived from male Göttingen Minipigs and characterized according to established criteria. Allogeneic BM- or AT-MSCs were administered intradermally (1 x 10(6) cells) into partial-thickness wounds created on female animals, and covered with Vaseline® gauze or fibrin in a randomized pattern. Animals were euthanized at 7, 10, 14 and 21 days. Tissues were analyzed visually for healing and by microscopic examination for epidermal development and remodelling. Polymerase chain reaction (PCR) was used to detect the presence of male DNA in the specimens. All wounds were healed by 14 days. MSC-injected wounds were associated with improved appearance and faster re-epithelialization compared to saline controls. Evaluation of rete ridge depth and architecture showed that MSC treatment promoted a faster rate of epidermal maturation. Male DNA was detected in all samples at days 7 and 10, suggesting the presence of MSCs. We showed the safety, feasibility and potential efficacy of local injection of allogeneic BM- and AT-MSCs for treatment of wounds in a preclinical model. Our data in this large animal model support the potential use of BM- and AT-MSC for treatment of cutaneous wounds through modulation of healing and epithelialization. PMID:23418160

  18. A Consortium of Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, and Filifactor alocis Is Present in Sites Prior to Bone Loss in a Longitudinal Study of Localized Aggressive Periodontitis

    PubMed Central

    Markowitz, Kenneth; Fairlie, Karen; Tischio-Bereski, Debbie; Ferrendiz, Javier; Furgang, David; Paster, Bruce J.; Dewhirst, Floyd E.

    2013-01-01

    Aggregatibacter actinomycetemcomitans-induced localized aggressive periodontitis (LAP) in African-American adolescents has been documented but is poorly understood. Two thousand fifty-eight adolescents aged 11 to 17 years were screened for their periodontal status and the presence of A. actinomycetemcomitans in their oral cavity. Seventy-one A. actinomycetemcomitans-negative and 63 A. actinomycetemcomitans-positive periodontally healthy subjects were enrolled, sampled, examined, and radiographed yearly for 3 years. Gingival and periodontal pocket depth and attachment levels were recorded. Disease presentation was characterized by bone loss (BL). Subgingival sites were sampled every 6 months to assess (i) the role of A. actinomycetemcomitans in BL and (ii) the association of A. actinomycetemcomitans and other microbes in their relationships to BL. Sixteen of 63 subjects with A. actinomycetemcomitans developed BL (the other 47 subjects with A. actinomycetemcomitans had no BL). No A. actinomycetemcomitans-negative subjects developed BL. Human oral microbe identification microarray (HOMIM) was used for subgingival microbial assessment. On a subject level, pooled data from A. actinomycetemcomitans-positive subjects who remained healthy had higher prevalences of Streptococcus and Actinomyces species, while A. actinomycetemcomitans-positive subjects with BL had higher prevalences of Parvimonas micra, Filifactor alocis, A. actinomycetemcomitans, and Peptostreptococcus sp. human oral taxon 113 (HOT-113). At vulnerable sites, A. actinomycetemcomitans, Streptococcus parasanguinis, and F. alocis levels were elevated prior to BL. In cases where the three-organism consortium (versus A. actinomycetemcomitans alone) was detected, the specificity for detecting sites of future BL increased from 62% to 99%, with a sensitivity of 89%. We conclude that detecting the presence of A. actinomycetemcomitans, S. parasanguinis, and F. alocis together indicates sites of future BL in LAP. A

  19. Association between Asymptomatic Bacteriuria and Pre-Eclampsia

    PubMed Central

    Rezavand, Negin; Veisi, Firooze; Zangane, Mrayam; Amini, Roghaye; Almasi, Afshin

    2016-01-01

    Asymptomatic bacteriuria is one of the most common and important bacterial infections during pregnancy and can result in progressive infections and endanger maternal as well as fetal health. In this study, we assessed the relationship between asymptomatic bacteriuria and pre-eclampsia. In this case-control study, pregnant women who presented to Imam Reza Hospital in Kermanshah in 2013-14 were studied. The minimum sample size was calculated as 125 pregnant women in each group with a total of 250 subjects. There were 125 women with pre-eclampsia and 125 women without pre-eclampsia (control group). Matching was done for age, gestational age, and parity between case and control groups. Matching was verified by a P value of 0.061 for maternal age and gestational age and 0.77 for parity. The statistical analyses were done by applying the chi-squared test and determining odds ratio (OR) for having bacteriuria in univariate logistic regression as well as multivariate regression with adjusting the effect of maternal age, gestational age, and parity. Pyuria and bacteriuria were significantly more common in pre-eclampsia group than in control group. The results showed that a significant association existed between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was 6.8 times higher in women with pre-eclampsia compared to those without pre-eclampsia. Further studies are required for better clarification of association between asymptomatic bacteriuria and pre-eclampsia. PMID:26925912

  20. Asymptomatic severe aortic stenosis: challenges in diagnosis and management.

    PubMed

    Izumi, Chisato

    2016-08-01

    Optimal management for asymptomatic severe aortic stenosis (AS) remains controversial. Considering the increase in elderly patients, improved surgical outcomes and the introduction of transcatheter aortic valve implantation, we must reconsider the optimal management of asymptomatic severe AS. In this article, previous studies regarding the natural history of asymptomatic severe AS were reviewed to obtain a clinical perspective of AS in the growing elderly patient population. The incidence of sudden death in asymptomatic severe AS varies among studies from 0.25% to 1.7% per year, with differences related to study design and patient background. Except for very severe AS, sudden death or AS-related cardiac death without preceding symptoms is uncommon if 'watchful' waiting strategy is possible. Therefore, early operation is reasonable in very severe AS, but it is not recommended for all patients with severe AS. Using exercise tests, plasma levels of natriuretic peptides and other parameters, risk stratification of asymptomatic severe AS is needed to select patients who may have greater benefit following early operation. On the other hand, 'watchful' waiting is not always possible in real world of our practice. Patient education and periodic echocardiography are essential in 'watchful' waiting, which is not simply waiting strategy without careful monitoring. Individualised discussion regarding the indication for early operation is necessary, considering age, clinical background, predicted natural history and operative risk in each patient. PMID:27091844

  1. Significant asymptomatic bacteriuria among Nigerian type 2 diabetics.

    PubMed Central

    Alebiosu, C. O.; Osinupebi, O. A.; Olajubu, F. A.

    2003-01-01

    Significant asymptomatic bacteriuria is a risk factor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria among our type 2 diabetics with a view to documenting the prevalence, type of organisms responsible and the antibiotic susceptibility pattern. One hundred and twenty-four type 2 Nigerian diabetics (55 males and 69 females) submitted midstream urine specimens for culture. Thirty-three patients had significant bacteriuria (9 males and 24 females), showing the frequency of occurrence of asymptomatic bacteriuria to be 26.6%. The most common organism isolated was Klebsiella pneumonia at 42.4%. Gram-negative bacilli made up about 23 (69.7%) of the isolates. Isolates were poorly sensitive to the readily available antibiotics (ampicillin, tetracycline and cotrimoxazole), but a large number of the organisms isolated were sensitive to nitrofurantoin, gentamicin, ciprofloxacin and ofloxacin. Sensitivity to erythromycin, nalidixic acid and cefuroxime was moderate. Asymptomatic bacteriuria is, thus, more prevalent among the Nigerian diabetic population than in the non-diabetics. A changing pattern of disease is observed with Klebsiella sp. now accounting for the majority of asymptomatic bacteriuria among diabetics. The organisms are not sensitive to the commonly available antibacterial agents. PMID:12793791

  2. Bone scanning.

    PubMed

    Greenfield, L D; Bennett, L R

    1975-03-01

    Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies and some non-neoplastic diseases. The scan is more sensitive than x-ray in the detection of malignant diseases of the skeleton. PMID:1054210

  3. Impregnation of bone chips with alendronate and cefazolin, combined with demineralized bone matrix: a bone chamber study in goats

    PubMed Central

    2012-01-01

    Background Bone grafts from bone banks might be mixed with bisphosphonates to inhibit the osteoclastic response. This inhibition prevents the osteoclasts to resorb the allograft bone before new bone has been formed by the osteoblasts, which might prevent instability. Since bisphosphonates may not only inhibit osteoclasts, but also osteoblasts and thus bone formation, we studied different bisphosphonate concentrations combined with allograft bone. We investigated whether locally applied alendronate has an optimum dose with respect to bone resorption and formation. Further, we questioned whether the addition of demineralized bone matrix (DBM), would stimulate bone formation. Finally, we studied the effect of high levels of antibiotics on bone allograft healing, since mixing allograft bone with antibiotics might reduce the infection risk. Methods 25 goats received eight bone conduction chambers in the cortical bone of the proximal medial tibia. Five concentrations of alendronate (0, 0.5 mg/mL, 1 mg/mL, 2 mg/mL, and 10 mg/mL) were tested in combination with allograft bone and supplemented with cefazolin (200 μg/mL). Allograft not supplemented with alendronate and cefazolin served as control. In addition, allograft mixed with demineralized bone matrix, with and without alendronate, was tested. After 12 weeks, graft bone area and new bone area were determined with manual point counting. Results Graft resorption decreased significantly (p < 0.001) with increasing alendronate concentration. The area of new bone in the 1 mg/mL alendronate group was significantly (p = 0.002) higher when compared to the 10 mg/mL group. No differences could be observed between the group without alendronate, but with demineralized bone, and the control groups. Conclusions A dose-response relationship for local application of alendronate has been shown in this study. Most new bone was present at 1 mg/mL alendronate. Local application of cefazolin had no effect on bone remodelling. PMID:22443362

  4. [Chronic elevation of enzymes of pancreatic origin in asymptomatic patients].

    PubMed

    Quílez, C; Martínez, J; Gómez, A; Trigo, C; Palazón, J M; Belda, G; Pérez-Mateo, M

    1998-05-01

    Chronic asymptomatic elevation of pancreatic enzymes is a well known entity although little has been reported. In most cases chronic asymptomatic elevation of amylase is due to a salival isoamylase increase or macroamylasemia. However, we have studied 10 cases with an increase in amylases due to pancreatic isoamylase and an increase in the remaining pancreatic enzymes which remained elevated during the follow up period ranging from 2 to 60 months. The amylase values ranged from 186 to 1,600; the lipase from 176 to 3,989, trypsin from 476 to 2,430 and pancreatic isoamylase from 122 to 1,263. In all patients CT and echography were carried out, which discarded structural damage. Nonetheless, an indirect test of pancreatic function presented unexplained pathologic values in 4 out of 10 patients. In conclusion, we suggest that chronic asymptomatic elevation of pancreatic enzymes is of unknown etiology with no associated structural pancreatic pathology demonstrable by the usual study methods. PMID:9644872

  5. Management of asymptomatic silicone-injected breast with reduction mammoplasty.

    PubMed

    Prasetyono, Theddeus Octavianus Hari; Sadikin, Patricia Marcellina

    2015-01-01

    Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics. PMID:26933290

  6. Emergency department screening for asymptomatic sexually transmitted infections.

    PubMed Central

    Todd, C S; Haase, C; Stoner, B P

    2001-01-01

    OBJECTIVES: This study assessed the prevalence and correlates of asymptomatic genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis among emergency department patients. METHODS: Individuals seeking emergency department evaluation for nongenitourinary complaints provided urine samples for N gonorrhoeae and C trachomatis testing by ligase chain reaction and completed a sociodemographic and behavioral questionnaire. RESULTS: Asymptomatic N gonorrhoeae or C trachomatis was found in 9.7% of persons tested. Correlates of C trachomatis infection included younger age, residence in high-morbidity zip code areas, previous history of N gonorrhoeae or C trachomatis, and number of sex partners in the past year. CONCLUSIONS: Urine-based screening of asymptomatic emergency department patients detected significant numbers of N gonorrhoeae and C trachomatis infections. Targeted screening programs may contribute to community-level prevention and control of sexually transmitted infections. PMID:11236416

  7. Asymptomatic Cholelithiasis in Children With Sickle Cell Disease

    PubMed Central

    Currò, Giuseppe; Meo, Anna; Ippolito, Daniela; Pusiol, Anna; Cucinotta, Eugenio

    2007-01-01

    Summary Background Data: Our study aimed to evaluate the role of elective laparoscopic cholecystectomy (LC) in children with sickle cell disease (SCD) and asymptomatic cholelithiasis and, furthermore, to determine whether the outcome is related to the operation timing. Methods: The records of 30 children with SCD diagnosed with cholelithiasis from June 1995 to September 2005 were retraspectively reviewed. All 30 children were asymptomatic at the time of the first visit, and an elective LC was proposed to all of them. The operation was accepted in the period of study by 16 children and refused by 14. During medical observation, 10 of the 14 children who refused surgery were admitted for severe biliary colics. Acute cholecystitis was diagnosed by abdominal ultrasound in 3 cases and in 1 case choledocholithiasis, ultrasonographically suspected, was confirmed by magnetic resonance cholangiopancreatography (MRCP) and treated during endoscopic retrograde cholangiopancreatography (ERCP). All children, emergency admitted, underwent LC after the onset of symptoms. The patients were divided up into 2 groups (A: asymptomatic; B: symptomatic) depending on clinical presentation and operation timing and the respective outcomes were compared. Results: Elective LC in asymptomatic children (group A) is safe with no major complications reported. During medical observation in children who refused elective surgery (group B), 6 biliary colics, 3 acute cholecystitis, and 1 choledocholithiasis were observed. Three sickle cell crises occurred in symptomatic children during biliary colics. The correlation between cholecystectomy performed in asymptomatic children (group A) and cholecystectomy performed in symptomatic children (group B) showed significant differences in the outcome. Morbidity rate and postoperative stay increased when children with SCD underwent emergency LC. Conclusions: Elective LC should be the gold standard in children with SCD and asymptomatic cholelithiasis to prevent

  8. Automated trabecular bone histomorphometry

    NASA Technical Reports Server (NTRS)

    Polig, E.; Jee, W. S. S.

    1985-01-01

    The toxicity of alpha-emitting bone-seeking radionuclides and the relationship between bone tumor incidence and the local dosimetry of radionuclides in bone are investigated. The microdistributions of alpha-emitting radionuclides in the trabecular bone from the proximal humerus, distal humerus, proximal ulna, proximal femur, and distal femur of six young adult beagles injected with Am-241 (three with 2.8 micro-Ci/kg and three with 0.9 micro-Ci/kg) are estimated using a computer-controlled microscope photometer system; the components of the University of Utah Optical Track Scanner are described. The morphometric parameters for the beagles are calculated and analyzed. It is observed that the beagles injected with 0.9 micro-Ci of Am-241/kg showed an increase in the percentage of bone and trabecular bone thickness, and a reduction in the width of the bone marrow space and surface/volume ratio. The data reveal that radiation damage causes abnormal bone structure.

  9. Diagnosis and management of patients with asymptomatic severe aortic stenosis

    PubMed Central

    Katayama, Minako; Chaliki, Hari P

    2016-01-01

    Aortic stenosis (AS) is a disease that progresses slowly for years without symptoms, so patients need to be carefully managed with appropriate follow up and referred for aortic valve replacement in a timely manner. Development of symptoms is a clear indication for aortic valve intervention in patients with severe AS. The decision for early surgery in patients with asymptomatic severe AS is more complex. In this review, we discuss how to identify high-risk patients with asymptomatic severe AS who may benefit from early surgery. PMID:26981214

  10. Non-compaction cardiomyopathy in an asymptomatic athlete.

    PubMed

    Manus, Margaret Kapor; Roy, Satyajeet; Stag, Rosemarie; Hyman, Daniel

    2016-01-01

    Prevention of sudden cardiac death in athletes requires the screening and recognition of pathologies that often remain clinically silent for years until provoked by a physiologic stressor. This can result in the manifestation of disease and even death. Left ventricular non-compaction cardiomyopathy (LVNC), newly classified as a distinct entity arising in the adult population, is a cardiomyopathy that at initial presentation can manifest as a wide spectrum of symptoms from asymptomatic to ventricular arrhythmias, systemic embolism and even sudden cardiac death. We present the case of an asymptomatic athlete found to have LVNC and discuss the implications this finding may have on sports participation. PMID:27535732

  11. Low Bone Density

    MedlinePlus

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  12. Asymptomatic embolisation for prediction of stroke in the Asymptomatic Carotid Emboli Study (ACES): a prospective observational study

    PubMed Central

    Markus, Hugh S; King, Alice; Shipley, Martin; Topakian, Raffi; Cullinane, Marisa; Reihill, Sheila; Bornstein, Natan M; Schaafsma, Arjen

    2010-01-01

    Summary Background Whether surgery is beneficial for patients with asymptomatic carotid stenosis is controversial. Better methods of identifying patients who are likely to develop stroke would improve the risk–benefit ratio for carotid endarterectomy. We aimed to investigate whether detection of asymptomatic embolic signals by use of transcranial doppler (TCD) could predict stroke risk in patients with asymptomatic carotid stenosis. Methods The Asymptomatic Carotid Emboli Study (ACES) was a prospective observational study in patients with asymptomatic carotid stenosis of at least 70% from 26 centres worldwide. To detect the presence of embolic signals, patients had two 1 h TCD recordings from the ipsilateral middle cerebral artery at baseline and one 1 h recording at 6, 12, and 18 months. Patients were followed up for 2 years. The primary endpoint was ipsilateral stroke and transient ischaemic attack. All recordings were analysed centrally by investigators masked to patient identity. Findings 482 patients were recruited, of whom 467 had evaluable recordings. Embolic signals were present in 77 of 467 patients at baseline. The hazard ratio for the risk of ipsilateral stroke and transient ischaemic attack from baseline to 2 years in patients with embolic signals compared with those without was 2·54 (95% CI 1·20–5·36; p=0·015). For ipsilateral stroke alone, the hazard ratio was 5·57 (1·61–19·32; p=0·007). The absolute annual risk of ipsilateral stroke or transient ischaemic attack between baseline and 2 years was 7·13% in patients with embolic signals and 3·04% in those without, and for ipsilateral stroke was 3·62% in patients with embolic signals and 0·70% in those without. The hazard ratio for the risk of ipsilateral stroke and transient ischaemic attack for patients who had embolic signals on the recording preceding the next 6-month follow-up compared with those who did not was 2·63 (95% CI 1·01–6·88; p=0·049), and for ipsilateral stroke

  13. Traumatic bone cyst of mandible.

    PubMed

    Surej Kumar, L K; Kurien, Nikhil; Thaha, Khaleel Ahamed

    2015-06-01

    The traumatic bone cyst, an uncommon lesion of the jaws, belongs to the category of 'pseudocyst' owing to its lack of a lining epithelial membrane. It is an asymptomatic lesion, which is often diagnosed accidentally during routine radiological examination commonly present in the posterior mandible as a unilocular radiolucency with scalloping borders. The exact etiopathogenesis of the lesion is still debated, though the role of trauma is often associated. Here we report a rare case of traumatic bone cyst in the anterior mandible, in a 16-year-old female patient with a previous history of trauma to chin; diagnosed and treated successfully in our surgical unit. The case is discussed in relation to its clinical presentation, etiopathogenesis, diagnosis, management and prognosis. PMID:26028875

  14. Co-culture of bone marrow stem cells and macrophages indicates intermediate mechanism between local inflammation and innate immune system in diabetic periodontitis

    PubMed Central

    Wang, Jia; Li, Hao; Li, Bo; Gong, Qiulin; Chen, Xinmin; Wang, Qi

    2016-01-01

    Diabetic periodontitis (DP), which has been shown to cause alveolar bone loss, is among the most common complications associated with diabetes. The precise mechanisms underlying alveolar bone loss in patients with DP remain unclear. Therefore, the present study established a co-culture system of bone marrow stem cells (BMSCs) and macrophages, in order to investigate the potential mechanisms underlying DP-associated alveolar bone loss in vitro. In addition, Porphyromonas gingivalis (PG) periodontal infection and high glucose levels were used to induce DP in mice. The present study evaluated the protein expression levels of various chemokines and the migration of BMSCs and macrophages. The protein expression levels of extracellular signal-regulated kinase 1 and 2, c-Jun N-terminal kinase and p38 mitogen-activated protein kinase (MAPK) were significantly increased in the BMSCs exposed to high glucose and PG, which may have been due to the activation of MAPK. In addition, DP induction in mice was associated with the release of chemokine (C-C motif) ligand 2 (CCL2) from BMSCs and the secretion of chemokine (C-C Motif) receptor 2 (CCR2) and tumor necrosis factor-α from macrophages, which was associated in turn with enhanced adhesion and chemotaxis of macrophages. The results of the present study suggested that DP led to the upregulation of CCL2 in the periodontal tissues and enhanced macrophage infiltration via the CCL2/CCR2 axis, which in turn promoted alveolar bone loss.

  15. Asymptomatic urinary tract infection caused by Shigella sonnei.

    PubMed

    Ekwall, E; Ljungh, A; Selander, B

    1984-01-01

    The first case of asymptomatic urinary tract infection caused by Shigella sonnei in a patient, a 74-yr-old man, who was not a faecal carrier and had no history of dysentery is reported. Treatment with pivmecillinam 400 mg 3 times daily for 14 days was instituted and the bacteria were eradicated. The time and source of infection is unknown. PMID:6364325

  16. Bartonella clarridgeiae bacteremia detected in an asymptomatic blood donor.

    PubMed

    Vieira-Damiani, Gislaine; Diniz, Pedro Paulo Vissotto de Paiva; Pitassi, Luiza Helena Urso; Sowy, Stanley; Scorpio, Diana Gerardi; Lania, Bruno Grosselli; Drummond, Marina Rovani; Soares, Tânia Cristina Benetti; Barjas-Castro, Maria de Lourdes; Breitschwerdt, Edward B; Nicholson, William L; Velho, Paulo Eduardo Neves Ferreira

    2015-01-01

    Human exposure to Bartonella clarridgeiae has been reported only on the basis of antibody detection. We report for the first time an asymptomatic human blood donor infected with B. clarridgeiae, as documented by enrichment blood culture, PCR, and DNA sequencing. PMID:25392353

  17. Bartonella clarridgeiae Bacteremia Detected in an Asymptomatic Blood Donor

    PubMed Central

    Vieira-Damiani, Gislaine; Pitassi, Luiza Helena Urso; Sowy, Stanley; Scorpio, Diana Gerardi; Lania, Bruno Grosselli; Drummond, Marina Rovani; Soares, Tânia Cristina Benetti; Barjas-Castro, Maria de Lourdes; Breitschwerdt, Edward B.; Nicholson, William L.; Velho, Paulo Eduardo Neves Ferreira

    2014-01-01

    Human exposure to Bartonella clarridgeiae has been reported only on the basis of antibody detection. We report for the first time an asymptomatic human blood donor infected with B. clarridgeiae, as documented by enrichment blood culture, PCR, and DNA sequencing. PMID:25392353

  18. Aortic coarctation, aneurysm, and ventricular dysfunction in an asymptomatic infant.

    PubMed

    García, Ana I; Aguilar, Juan M; García, Enrique

    2016-06-01

    Aortic arch coarctation with post-coarctation aneurysm is rare in infants. We present the case of an asymptomatic 3-month-old infant with severe left ventricular dysfunction in this setting. The patient underwent surgical repair, and the left ventricular ejection fraction improved to recovery the 4th post-operative month. PMID:26980403

  19. Rathayibacter iranicus isolated from asymptomatic wheat seeds in Turkey

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Asymptomatic wheat seeds collected from 799 farmers in six central provinces of Turkey were checked for the presence of Rathayibacter species by plating 100 µl of the diluted and undiluted seed wash suspension onto modified 523 agar. Of the 25 isolated strains presumptively identified as Rathayibac...

  20. EFFECTIVENESS OF COUGH FOR ENHANCING MUCUS CLEARANCE IN ASYMPTOMATIC SMOKERS

    EPA Science Inventory

    Using monodisperse aerosols radiolabeled with 99mTc, we studied the effectiveness of ough and rapid inhalations for clearing mucus in en asymptomatic smokers. On three eparate study days, each subject breathed 5 um (MMAD) 99mTc-iron oxide particles under ontrolled breathing condi...

  1. Symptomatic vs. asymptomatic plaque classification in carotid ultrasound.

    PubMed

    Acharya, Rajendra U; Faust, Oliver; Alvin, A P C; Sree, S Vinitha; Molinari, Filippo; Saba, Luca; Nicolaides, Andrew; Suri, Jasjit S

    2012-06-01

    Quantitative characterization of carotid atherosclerosis and classification into symptomatic or asymptomatic type is crucial in both diagnosis and treatment planning. This paper describes a computer-aided diagnosis (CAD) system which analyzes ultrasound images and classifies them into symptomatic and asymptomatic based on the textural features. The proposed CAD system consists of three modules. The first module is preprocessing, which conditions the images for the subsequent feature extraction. The feature extraction stage uses image texture analysis to calculate Standard deviation, Entropy, Symmetry, and Run Percentage. Finally, classification is performed using AdaBoost and Support Vector Machine for automated decision making. For Adaboost, we compared the performance of five distinct configurations (Least Squares, Maximum- Likelihood, Normal Density Discriminant Function, Pocket, and Stumps) of this algorithm. For Support Vector Machine, we compared the performance using five different configurations (linear kernel, polynomial kernel configurations of different orders and radial basis function kernels). SVM with radial basis function kernel for support vector machine presented the best classification result: classification accuracy of 82.4%, sensitivity of 82.9%, and specificity of 82.1%. We feel that texture features coupled with the Support Vector Machine classifier can be used to identify the plaque tissue type. An Integrated Index, called symptomatic asymptomatic carotid index (SACI), is proposed using texture features to discriminate symptomatic and asymptomatic carotid ultrasound images using just one index or number. We hope this SACI can be used as an adjunct tool by the vascular surgeons for daily screening. PMID:21243411

  2. Human giardiasis in Serbia: asymptomatic vs symptomatic infection*

    PubMed Central

    Nikolić, A.; Klun, I.; Bobić, B.; Ivović, V.; Vujanić, M.; Živković, T.; Djurković-Djaković, O.

    2011-01-01

    Despite the public health importance of giardiasis in all of Europe, reliable data on the incidence and prevalence in Western Balkan Countries (Serbia, Bosnia and Herzegovina, Croatia, Montenegro and FYR Macedonia) are scarce, and the relative contribution of waterborne and food-borne, or person-to-person and/or animalto- person, transmission of human giardiasis is not yet clear. To provide baseline data for the estimation of the public health risk caused by Giardia, we here review the information available on the epidemiological characteristics of asymptomatic and symptomatic human infection in Serbia. Although asymptomatic cases of Giardia represent a major proportion of the total cases of infection, high rates of Giardia infection were found in both asymptomatic and symptomatic populations. No waterborne outbreaks of giardiasis have been reported, and it thus seems that giardiasis mostly occurs sporadically in our milieu. Under such circumstances, control measures to reduce the high prevalence of giardiasis in Serbia have focused on person-to-person transmission, encouraging proper hygiene, but for more targeted intervention measures, studies to identify other risk factors for asymptomatic and symptomatic infections are needed. PMID:21678797

  3. Subclinical and asymptomatic parathyroid disease: implications of emerging data.

    PubMed

    Macfarlane, David P; Yu, Ning; Leese, Graham P

    2013-12-01

    Primary hyperparathyroidism, a disorder in which there is a tendency for hypercalcaemia caused by autonomous overproduction of parathyroid hormone, is common, especially in postmenopausal women. Although parathyroidectomy is indicated for symptomatic patients, most individuals with the disorder are asymptomatic and without classic complications, such as renal stones and osteoporosis, at diagnosis. Consensus guidelines suggest which individuals might be suitable for medical follow-up rather than parathyroidectomy, but there are no long-term randomised controlled trials to support the safety of medical surveillance, and some patients progress with time. Data from observational studies suggest that cardiovascular morbidity and mortality are increased in patients with primary hyperparathyroidism, and might be predicted by parathyroid hormone concentrations, even in individuals with asymptomatic primary hyperparathyroidism. Whether parathyroidectomy improves cardiovascular outcomes in patients with asymptomatic primary hyperparathyroidism is unproven, but data suggest that surgery decreases fracture risk and might improve neuropsychological symptoms. Studies also show that patients with normocalcaemic (subclinical) hyperparathyroidism and hypoparathyroidism have a low risk of progression to overt disease, but their long-term risks are not defined. In this Review, we explore the increasing range of asymptomatic parathyroid disorders, focusing on current evidence about their natural history and potential complications, with a particular emphasis on primary hyperparathyroidism. PMID:24622418

  4. Bone Markers

    MedlinePlus

    ... Alkaline Phosphatase; Osteocalcin; P1NP; Procollagen Type 1 N-Terminal Propeptide Formal name: Biochemical Markers of Bone Remodeling ... tests for evaluating bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker ...

  5. Bone tumor

    MedlinePlus

    ... physical exam. Tests that may be done include: Alkaline phosphatase blood level Bone biopsy Bone scan Chest x- ... also affect the results of the following tests: Alkaline phosphatase isoenzyme Blood calcium level Parathyroid hormone Blood phosphorus ...

  6. Bone Infections

    MedlinePlus

    ... of the body, bones can get infected. The infections are usually bacterial, but can also be fungal. ... bloodstream. People who are at risk for bone infections include those with diabetes, poor circulation, or recent ...

  7. Bone cement

    PubMed Central

    Vaishya, Raju; Chauhan, Mayank; Vaish, Abhishek

    2013-01-01

    The knowledge about the bone cement is of paramount importance to all Orthopaedic surgeons. Although the bone cement had been the gold standard in the field of joint replacement surgery, its use has somewhat decreased because of the advent of press-fit implants which encourages bone in growth. The shortcomings, side effects and toxicity of the bone cement are being addressed recently. More research is needed and continues in the field of nanoparticle additives, enhanced bone–cement interface etc. PMID:26403875

  8. Bone Analyzer

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The danger of disuse osteoporosis under weightless condition in space led to extensive research into measurements of bone stiffness and mass by the Biomedical Research Division of Ames and Stanford University. Through its Technology Utilization Program, NASA funded an advanced SOBSA, a microprocessor-controlled bone probe system. SOBSA determines bone stiffness by measuring responses to an electromagnetic shaker. With this information, a physician can identify bone disease, measure deterioration and prescribe necessary therapy. The system is now undergoing further testing.

  9. Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers

    PubMed Central

    Sansores, Raúl H; Velázquez-Uncal, Mónica; Pérez-Bautista, Oliver; Villalba-Caloca, Jaime; Falfán-Valencia, Ramcés; Ramírez-Venegas, Alejandra

    2015-01-01

    Background Physicians do not routinely recommend smokers to undergo spirometry unless they are symptomatic. Objective To test the hypothesis that there are a significant number of asymptomatic smokers with chronic obstructive pulmonary disease (COPD), we estimated the prevalence of COPD in a group of asymptomatic smokers. Methods Two thousand nine hundred and sixty-one smokers with a cumulative consumption history of at least 10 pack-years, either smokers with symptoms or smokers without symptoms (WOS) were invited to perform a spirometry and complete a symptom questionnaire. Results Six hundred and thirty-seven (21.5%) smokers had no symptoms, whereas 2,324 (78.5%) had at least one symptom. The prevalence of COPD in subjects WOS was 1.5% when considering the whole group of smokers (45/2,961) and 7% when considering only the group WOS (45/637). From 329 smokers with COPD, 13.7% were WOS. Subjects WOS were younger, had better lung function and lower cumulative consumption of cigarettes, estimated as both cigarettes per day and pack-years. According to severity of airflow limitation, 69% vs 87% of subjects were classified as Global Initiative for Chronic Obstructive Lung Disease stages I–II in the WOS and smokers with symptoms groups, respectively (P<0.001). A multivariate analysis showed that forced expiratory volume in 1 second (mL) was the only predictive factor for COPD in asymptomatic smokers. Conclusion Prevalence of COPD in asymptomatic smokers is 1.5%. This number of asymptomatic smokers may be excluded from the benefit of an “early” intervention, not just pharmacological but also from smoking cessation counseling. The higher forced expiratory volume in 1 second may contribute to prevent early diagnosis. PMID:26586941

  10. COMPARATIVE STUDY BETWEEN THE PUBIS OF ASYMPTOMATIC ATHLETES AND NON-ATHLETES WITH MRI

    PubMed Central

    Branco, Rodrigo Castelo; da Costa Fontenelle, César Rubens; Miranda, Leandro Marques; Junior, Yonder Archanjo Ching San; Vianna, Evandro Miguelote

    2015-01-01

    Objective: To compare the magnetic resonance imaging findings from the pubis of professional soccer players without any history or clinical findings of groin pain, and from sedentary individuals, also without symptoms, and to determine the prevalence of changes compatible with pubic overload. Methods: Nineteen professional soccer players without complaints of groin pain and seventeen sedentary individuals, also asymptomatic, underwent magnetic resonance imaging of the pubis. The results from the examinations were analyzed regarding the presence of degenerative changes, boned medullary edema and tendinopathy, and the two study groups were compared. Results: High prevalence of bone edema, tendinopathy and degenerative findings in the pubic symphysis was seen in the athletes, with statistically significant higher odds ratios and relative risk in the population studied. Conclusion: Professional soccer players are at a higher risk of developing changes in the pubic region, shown in magnetic resonance images, compared with sedentary individuals. These findings are not necessarily caused by groin pain, and are probably related to intense exertion. PMID:27026970

  11. Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells

    PubMed Central

    Florencio-Silva, Rinaldo; Sasso, Gisela Rodrigues da Silva; Sasso-Cerri, Estela; Simões, Manuel Jesus; Cerri, Paulo Sérgio

    2015-01-01

    Bone tissue is continuously remodeled through the concerted actions of bone cells, which include bone resorption by osteoclasts and bone formation by osteoblasts, whereas osteocytes act as mechanosensors and orchestrators of the bone remodeling process. This process is under the control of local (e.g., growth factors and cytokines) and systemic (e.g., calcitonin and estrogens) factors that all together contribute for bone homeostasis. An imbalance between bone resorption and formation can result in bone diseases including osteoporosis. Recently, it has been recognized that, during bone remodeling, there are an intricate communication among bone cells. For instance, the coupling from bone resorption to bone formation is achieved by interaction between osteoclasts and osteoblasts. Moreover, osteocytes produce factors that influence osteoblast and osteoclast activities, whereas osteocyte apoptosis is followed by osteoclastic bone resorption. The increasing knowledge about the structure and functions of bone cells contributed to a better understanding of bone biology. It has been suggested that there is a complex communication between bone cells and other organs, indicating the dynamic nature of bone tissue. In this review, we discuss the current data about the structure and functions of bone cells and the factors that influence bone remodeling. PMID:26247020

  12. High prevalence of esophageal dysmotility in asymptomatic obese patients

    PubMed Central

    Côté-Daigneault, Justin; Leclerc, Pierre; Joubert, Josette; Bouin, Mickael

    2014-01-01

    BACKGROUND: Obesity is an important health problem affecting >500 million people worldwide. Esophageal dysmotility is a gastrointestinal pathology associated with obesity; however, its prevalence and characteristics remain unclear. Esophageal dysmotilities have a high prevalence among obese patients regardless of gastrointestinal symptoms. OBJECTIVE: To identify the prevalence of esophageal dysmotility among obese patients. The secondary goals were to characterize these pathologies in obese patients and identify risk factors. METHOD: A prospective study from January 2009 to March 2010 at the University of Montreal Hospital Centre (Montreal, Quebec) was performed. Every patient scheduled for bariatric surgery underwent preoperatory esophageal manometry and was included in the study. Manometry was performed according to a standardized protocol with the following measures: superior esophageal sphincter – coordination and release during deglutition; esophageal body – presence, propagation, length, amplitude and type of esophageal waves of contraction; lower esophageal sphincter – localization, tone, release, intragastic pressure and intraesophageal pressure. All reference values were those used in the digestive motility laboratory. A gastrointestinal symptoms questionnaire was completed on the day manometry was performed. Chart reviews were performed to identify comorbidities and treatments that could influence the results. RESULTS: A total of 53 patients were included (mean [± SD] age 43±10 years; mean body mass index 46±7 kg/m2; 70% female). Esophageal manometry revealed dysmotility in 51% (n=27) of the patients. This dysmotility involved the esophageal body in 74% (n=20) of the patients and the inferior sphincter in 11% (n=3). Mixed dysmotility (body and inferior sphincter) was found in 15% (n=4) of cases. The esophageal body dysmotilities were hypomotility in 85% (n=23) of the patients, either from insignificant waves (74% [n=20]), nonpropagated waves (11

  13. Chemical Makeup of Microdamaged Bone Differs from Undamaged Bone

    SciTech Connect

    Ruppel,M.; Burr, D.; Miller, L.

    2006-01-01

    Microdamage naturally occurs in bone tissue as a result of cyclic loading placed on the body from normal daily activities. While it is usually repaired through the bone turnover process, accumulation of microdamage may result in reduced bone quality and increased fracture risk. It is unclear whether certain areas of bone are more susceptible to microdamage than others due to compositional differences. This study examines whether areas of microdamaged bone are chemically different than undamaged areas of bone. Bone samples (L3 vertebrae) were harvested from 15 dogs. Samples were stained with basic fuchsin, embedded in poly-methylmethacrylate, and cut into 5-{micro}m-thick sections. Fuchsin staining was used to identify regions of microdamage, and synchrotron infrared microspectroscopic imaging was used to determine the local bone composition. Results showed that microdamaged areas of bone were chemically different than the surrounding undamaged areas. Specifically, the mineral stoichiometry was altered in microdamaged bone, where the carbonate/protein ratio and carbonate/phosphate ratio were significantly lower in areas of microdamage, and the acid phosphate content was higher. No differences were observed in tissue mineralization (phosphate/protein ratio) or crystallinity between the microdamaged and undamaged bone, indicating that the microdamaged regions of bone were not over-mineralized. The collagen cross-linking structure was also significantly different in microdamaged areas of bone, consistent with ruptured cross-links and reduced fracture resistance. All differences in composition had well-defined boundaries in the microcrack region, strongly suggesting that they occurred after microcrack formation. Even so, because microdamage results in an altered bone composition, an accumulation of microdamage might result in a long-term reduction in bone quality.

  14. BMP signaling mediated by constitutively active Activin type 1 receptor (ACVR1) results in ectopic bone formation localized to distal extremity joints

    PubMed Central

    Agarwal, Shailesh; Loder, Shawn J.; Brownley, Cameron; Eboda, Oluwatobi; Peterson, Jonathan; Hayano, Satoru; Wu, Bingrou; Zhao, Bin; Kaartinen, Vesa; Wong, Victor C.; Mishina, Yuji; Levi, Benjamin

    2015-01-01

    BMP signaling mediated by ACVR1 plays a critical role for development of multiple structures including the cardiovascular and skeletal systems. While deficient ACVR1 signaling impairs normal embryonic development, hyperactive ACVR1 function (R206H in humans and Q207D mutation in mice, ca-ACVR1) results in formation of heterotopic ossification (HO). We developed a mouse line, which conditionally expresses ca-ACVR1 with Nfatc1-Cre+ transgene. Mutant mice developed ectopic cartilage and bone at the distal joints of the extremities including the interphalangeal joints and hind limb ankles as early as P4 in the absence of trauma or exogenous bone morphogenetic protein (BMP) administration. Micro-CT showed that even at later time points (up to P40), cartilage and bone development persisted at the affected joints most prominently in the ankle. Interestingly, this phenotype was not present in areas of bone outside of the joints – tibia are normal in mutants and littermate controls away from the ankle. These findings demonstrate that this model may allow for further studies of heterotopic ossification, which does not require the use of stem cells, direct trauma or activation with exogenous Cre gene administration. PMID:25722188

  15. Accelerated bone ingrowth by local delivery of Zinc from bioactive glass: oxidative stress status, mechanical property, and microarchitectural characterization in an ovariectomized rat model

    PubMed Central

    Samira, Jbahi; Saoudi, Monji; Abdelmajid, Kabir; Hassane, Oudadesse; Treq, Rebai; Hafed, Efeki; Abdelfatteh, Elfeki; Hassib, Keskes

    2015-01-01

    Background Synthetic bone graft substitutes such as bioactive glass (BG) material are developed in order to achieve successful bone regeneration. Zn plays an important role in the proper bone growth, development, and maintenance of healthy bones. Aims This study aims to evaluate in vivo the performance therapy of zinc-doped bioactive glass (BG-Zn) and its applications in biomedicine. Methods Female Wistar rats were ovariectomized. BG and BG-Zn were implanted in the femoral condyles of Wistar rats and compared to that of control group. Grafted bone tissues were carefully removed to evaluate the oxidative stress status, histomorphometric profile, mechanical property, and mineral bone distribution by using inductively coupled plasma optical emission spectrometry. Results A significant decrease of thiobarbituric acid–reactive substances was observed after BG-Zn implantation. Superoxide dismutase, catalase (CAT), and glutathione peroxidase (GPx) activities significantly increased in ovariectomized group implanted with Zinc-doped bioactive glass (OVX-BG-Zn) as compared to ovariectomized group implanted with bioactive glass (OVX-BG). An improved mechanical property was noticed in contact of OVX-BG-Zn (39±6 HV) when compared with that of OVX-BG group (26±9 HV). After 90 days of implantation, the histomorphometric analysis showed that trabecular thickness (Tb.Th) and trabecular number (Tb.N) were significantly increased with 28 and 24%, respectively, in treated rats of OVX-BG-Zn group as compared to those of OVX-BG groups. Trabecular separation (Tb.Sp) and trabecular bone pattern factor (TBPf) were significantly decreased in OVX-BG-Zn group with 29.5 and 54% when compared with those of OVX-BG rat groups. On the other hand, a rise in Ca and P ion concentrations in the implanted microenvironment was shown and lead to the formation/deposition of Ca-P phases. The ratio of pyridinoline [Pyr] to dihydroxylysinonorleucine [DHLNL] cross-links was normalized to the control level

  16. Effect of strontium-containing hydroxyapatite bone cement on bone remodeling following hip replacement.

    PubMed

    Ni, Guo X; Lin, Jian H; Chiu, Peter K Y; Li, Zhao Y; Lu, William W

    2010-01-01

    It is uncertain whether the use of bioactive bone cement has any beneficial effect on local bone adaptation following hip replacement. In this study, twelve goats underwent cemented hip hemiarthroplasty unilaterally, with either PMMA bone cement or strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement. Nine months later, the femoral cortical bones at different levels were analyzed by microhardness testing and micro-CT scanning. Extensive bone remodeling was found at proximal and mid-levels in both PMMA and Sr-HA groups. However, with regard to the differences of bone mineral density, cortical bone area and bone hardness between implanted and non-implanted femur, less decreases were found in Sr-HA group than PMMA group at proximal and mid-levels, and significant differences were shown for bone area and hardness at proximal level. The results suggested that the use of Sr-HA cement might alleviate femoral bone remodeling after hip replacement. PMID:19728042

  17. Genesis of B lymphocytes in the bone marrow: extravascular and intravascular localization of surface IgM-bearing cells in mouse bone marrow detected by electron-microscope radioautography after in vivo perfusion of 125I anti-IgM antibody

    SciTech Connect

    Osmond, D.G.; Batten, S.J.

    1984-07-01

    The role of mammalian bone marrow in generating surface IgM (sIgM)-bearing B lymphocytes is reviewed. Precursor cells in the marrow give rise to large, rapidly dividing cells bearing free cytoplasmic mu chains (c mu). The progeny of the large c mu+ cells form a population of small, nondividing c mu+ cells that mature into small lymphocytes, progressively expressing sIgM and other B-cell surface membrane components. Newly formed sIgM+ cells soon migrate through the bloodstream to the spleen and other lymphoid tissues, where they may die after a short lifespan or be activated to produce antibody molecules. The large-scale lymphocytopoiesis in the bone marrow thus maintains a population of rapidly renewed virgin B lymphocytes in the peripheral lymphoid tissues. A technique for perfusing radiolabeled anti-IgM antibodies in young mice has now permitted sIgM+ cells to be detected radioautographically in histological preparations of bone marrow under the electron microscope. Small sIgM+ lymphocytes are situated either singly or in small groups throughout the extravascular hemopoietic compartment of the bone marrow, often near sinusoid walls adjacent to late erythroblasts and reticular cells. Some regional concentrations of sIgM+ cells are apparent. sIgM+ cells also appear in transit through the sinusoidal endothelium and are markedly concentrated in the lumen of some sinusoids. Intrasinusoidal sIgM+ small lymphocytes have high densities of sIgM and long microvilli, on which sIgM molecules are concentrated. These studies reveal the localization and cell associations of specifically identified sIgM+ small lymphocytes in the extravascular marrow compartment and suggest that these cells may also undergo a transient intravascular storage and maturation phase. Use of this in vivo immunolabeling technique to detect other cell-surface markers may further elucidate the microenvironmental basis of B lymphocyte genesis in the bone marrow.

  18. Paget's disease with craniofacial and skeletal bone involvement.

    PubMed

    Rai, Narendra Prakash; Anekar, Jayaprasad; Mustafa, Shabil Mohamed; Devang Divakar, Darshan

    2016-01-01

    Paget's disease is a metabolic disorder of bone caused due to defect in the remodelling process and is very common in western countries but is very rare in Asians and Africans. It was first described by a British scientist Sir James Paget in 1877. It can be monostotic or polyostotic depending on the number of bones involved. It most commonly affects older people of more than 50 years. Disease involvement can be symptomatic or asymptomatic depending on the extent of the disease process. Diagnosis of Paget's disease can be made by raised serum alkaline phosphatase levels, radiological examination and by radioisotope bone scans. PMID:27587747

  19. Additively Manufactured 3D Porous Ti-6Al-4V Constructs Mimic Trabecular Bone Structure and Regulate Osteoblast Proliferation, Differentiation and Local Factor Production in a Porosity and Surface Roughness Dependent Manner

    PubMed Central

    Cheng, Alice; Humayun, Aiza; Cohen, David J.; Boyan, Barbara D.; Schwartz, Zvi

    2014-01-01

    Additive manufacturing by laser sintering is able to produce high resolution metal constructs for orthopaedic and dental implants. In this study, we used a human trabecular bone template to design and manufacture Ti-6Al-4V constructs with varying porosity via laser sintering. Characterization of constructs revealed interconnected porosities ranging from 15–70% with compressive moduli of 2063–2954 MPa. These constructs with macro porosity were further surface-treated to create a desirable multi-scale micro-/nano-roughness, which has been shown to enhance the osseointegration process. Osteoblasts (MG63 cells) exhibited high viability when grown on the constructs. Proliferation (DNA) and alkaline phosphatase specific activity (ALP), an early differentiation marker, decreased as porosity increased, while osteocalcin (OCN), a late differentiation marker, as well as osteoprotegerin (OPG), vascular endothelial growth factor (VEGF) and bone morphogenetic proteins 2 and 4 (BMP2, BMP4) increased with increasing porosity. 3D constructs with the highest porosity and surface modification supported the greatest osteoblast differentiation and local factor production. These results indicate that additively manufactured 3D porous constructs mimicking human trabecular bone and produced with additional surface treatment can be customized for increased osteoblast response. Increased factors for osteoblast maturation and differentiation on high porosity constructs suggest the enhanced performance of these surfaces for increasing osseointegration in vivo. PMID:25287305

  20. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    SciTech Connect

    Reiss, T.F.; Golden, J. )

    1990-05-01

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.

  1. Diffuse pulmonary uptake of bone-seeking radiotracer in bone scintigraphy of a rare case of pulmonary alveolar microlithiasis

    PubMed Central

    Fallahi, Babak; Ghafary, Bahar Moasses; Fard-Esfahani, Armaghan; Eftekhari, Mohammad

    2015-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare diffuse pulmonary disease representing microliths formed by deposition of calcium phosphonate in the alveolar airspaces. PAM is often diagnosed incidentally during chest X-ray imaging. Most of them are asymptomatic. We present a 39-year-old man referring for a bone scan due to a complaint of right leg pain. Bone scan showed diffuse uptake of bone-seeking radiotracer on both lung fields predominantly in basal regions. The bronchoalveolar lavage test confirmed the diagnosis of PAM. PMID:26170578

  2. Heterogeneous and Dynamic Prevalence of Asymptomatic Influenza Virus Infections.

    PubMed

    Furuya-Kanamori, Luis; Cox, Mitchell; Milinovich, Gabriel J; Magalhaes, Ricardo J Soares; Mackay, Ian M; Yakob, Laith

    2016-06-01

    Influenza infection manifests in a wide spectrum of severity, including symptomless pathogen carriers. We conducted a systematic review and meta-analysis of 55 studies to elucidate the proportional representation of these asymptomatic infected persons. We observed extensive heterogeneity among these studies. The prevalence of asymptomatic carriage (total absence of symptoms) ranged from 5.2% to 35.5% and subclinical cases (illness that did not meet the criteria for acute respiratory or influenza-like illness) from 25.4% to 61.8%. Statistical analysis showed that the heterogeneity could not be explained by the type of influenza, the laboratory tests used to detect the virus, the year of the study, or the location of the study. Projections of infection spread and strategies for disease control require that we identify the proportional representation of these insidious spreaders early on in the emergence of new influenza subtypes or strains and track how this rate evolves over time and space. PMID:27191967

  3. Exercise and the Asymptomatic Individual: Assessment and Advice

    PubMed Central

    Skrastins, Roland; McCans, John L.

    1982-01-01

    With the current popularity of physical fitness, the family physician is often asked to advise asymptomatic individuals who wish to undertake an exercise program. In the majority of cases, adequate assessment consists of a thorough history and physical examination, along with a few simple investigations, including a resting electrocardiogram. Exercise stress testing of asymptomatic individuals produces an unacceptably high frequency of false-positive results, and its use should be restricted to those patients with cardiac symptoms or major cardiac risk factors. The potential benefits of a longterm commitment to regular exercise should be discussed with the patient and guidance provided on the optimal form of exercise program for that individual. Exercise must not be considered in isolation. Other major cardiovascular risk factors should be sought and dealt with appropriately. PMID:21286106

  4. Heterogeneous and Dynamic Prevalence of Asymptomatic Influenza Virus Infections

    PubMed Central

    Furuya-Kanamori, Luis; Cox, Mitchell; Milinovich, Gabriel J.; Magalhaes, Ricardo J. Soares; Mackay, Ian M.

    2016-01-01

    Influenza infection manifests in a wide spectrum of severity, including symptomless pathogen carriers. We conducted a systematic review and meta-analysis of 55 studies to elucidate the proportional representation of these asymptomatic infected persons. We observed extensive heterogeneity among these studies. The prevalence of asymptomatic carriage (total absence of symptoms) ranged from 5.2% to 35.5% and subclinical cases (illness that did not meet the criteria for acute respiratory or influenza-like illness) from 25.4% to 61.8%. Statistical analysis showed that the heterogeneity could not be explained by the type of influenza, the laboratory tests used to detect the virus, the year of the study, or the location of the study. Projections of infection spread and strategies for disease control require that we identify the proportional representation of these insidious spreaders early on in the emergence of new influenza subtypes or strains and track how this rate evolves over time and space. PMID:27191967

  5. Asymptomatic trichomonas and candida colonization and pregnancy outcome.

    PubMed

    Hay, Phillip; Czeizel, Andrew E

    2007-06-01

    Trichomonas vaginalis is a sexually transmitted surface pathogen of the lower urogenital tract, and may be associated with asymptomatic vaginal colonization or intensely symptomatic vaginitis. In pregnancy it is associated with an increased risk of preterm delivery. However, a randomized trial of treatment of asymptomatic trichomonas colonization in pregnancy showed an increase in the risk of preterm delivery in treated women. The reasons for this paradox are yet to be fully elucidated. Candida species, on the other hand, may be present--usually in the yeast form--in the vaginal flora of up to 40% of healthy pregnant women. Although candidiasis is not usually associated with chorioamnionitis or preterm delivery, there is some emerging evidence to suggest that screening for and eradication of candida during pregnancy may reduce the risk of preterm delivery. This chapter reviews the impact of these common vaginal infections on pregnancy outcome and appraises the recent evidence on the role of treatment during pregnancy. PMID:17512254

  6. A Case of Aortopulmonary Window: Asymptomatic until the First Pregnancy

    PubMed Central

    Kose, Murat; Ucar, Serra; Emet, Samim; Akpinar, Timur Selcuk; Yalin, Kıvanc

    2015-01-01

    The aortopulmonary window (APW) is an abnormal communication between the ascending aorta and the pulmonary trunk in the presence of two separate semilunar valves. It is a rare congenital malformation which represents 0.1% of all congenital cardiac diseases. Herein, we report a very rare case of 27-year-old patient with unrepaired APW causing Eisenmenger syndrome and pulmonary hypertension who was asymptomatic until her first pregnancy. The median survival of uncorrected APW is 33 years. Aortopulmonary window is a very rare congenital anomaly. To our knowledge, asymptomatic adult case has not been reported until now. APW should be considered in the differential diagnosis of the severe pulmonary hypertension also in adult patients. PMID:26457208

  7. Bone Targeted Therapies for Bone Metastasis in Breast Cancer

    PubMed Central

    Razaq, Wajeeha

    2013-01-01

    Cancer metastasis to the bone develops commonly in patients with various malignancies, and is a major cause of morbidity and diminished quality of life in many affected patients. Emerging treatments for metastatic bone disease have arisen from advances in our understanding of the unique cellular and molecular mechanisms that contribute to the bone metastasis. The tendency of cancer cells to metastasize to bone is probably the end result of many factors including vascular pathways, the highly vascular nature of the bone marrow (which increases the probability that cancer cells will be deposited in bone marrow capillaries), and molecular characteristics of the cancer cells that allow them to adapt to the bone marrow microenvironment. The goals of treating osseous metastases are manifold. Proper treatment can lead to significant improvements in pain control and function, and maintain skeletal integrity. The treatment plan requires a multidisciplinary approach. Widespread metastatic disease necessitates systemic therapy, while a localized problem is best managed with surgery, external beam radiotherapy, or both. Patients with bone metastasis can have prolonged survival, and proper management can have a significant impact on their quality of life. We will review the factors in this article that are promising molecular bone-targeted therapies or will be likely targets for future therapeutic intervention to restore bone remodeling and suppress tumor growth. PMID:26237142

  8. Prevalence and Risk Factors for Asymptomatic Clostridium difficile Carriage

    PubMed Central

    Alasmari, Faisal; Seiler, Sondra M.; Hink, Tiffany; Burnham, Carey-Ann D.; Dubberke, Erik R.

    2014-01-01

    Background. Clostridium difficile infection (CDI) incidence has increased dramatically over the last decade. Recent studies suggest that asymptomatic carriers may be an important reservoir of C. difficile in healthcare settings. We sought to identify the prevalence and risk factors for asymptomatic C. difficile carriage on admission to the hospital. Methods. Patients admitted to Barnes-Jewish Hospital without diarrhea were enrolled from June 2010 through October 2011. Demographic information and healthcare and medication exposures 90 days prior to admission were collected. Stool specimens or rectal swabs were collected within 48 hours of admission and stored at −30°C until cultured. Clostridium difficile isolates were typed and compared with isolates from patients with CDI. Results. A stool/swab specimen was obtained for 259 enrolled subjects on admission. Two hundred four (79%) were not colonized, 40 (15%) had toxigenic C. difficile (TCD), and 15 (6%) had nontoxigenic C. difficile. There were no differences between TCD-colonized and -uncolonized subjects for age (mean, 56 vs 58 years; P = .46), comorbidities, admission from another healthcare facility (33% vs 24%; P = .23), or recent hospitalization (50% vs 50%; P = .43). There were no differences in antimicrobial exposures in the 90 days prior to admission (55% vs 56%; P = .91). Asymptomatic carriers were colonized with strains similar to strains from patients with CDI, but the relative proportions were different. Conclusions. There was a high prevalence of TCD colonization on admission. In contrast to past studies, TCD colonization was not associated with recent antimicrobial or healthcare exposures. Additional investigation is needed to determine the role of asymptomatic TCD carriers on hospital-onset CDI incidence. PMID:24755858

  9. Asymptomatic “Candidatus Neoehrlichia mikurensis” Infections in Immunocompetent Humans

    PubMed Central

    Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A.

    2014-01-01

    In Europe, human infections with “Candidatus Neoehrlichia mikurensis” have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic “Ca. Neoehrlichia mikurensis” infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with “Ca. Neoehrlichia mikurensis” in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  10. Asymptomatic "Candidatus Neoehrlichia mikurensis" infections in immunocompetent humans.

    PubMed

    Welc-Falęciak, Renata; Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A

    2014-08-01

    In Europe, human infections with "Candidatus Neoehrlichia mikurensis" have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic "Ca. Neoehrlichia mikurensis" infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with "Ca. Neoehrlichia mikurensis" in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  11. Study Protocol: Asymptomatic Intracranial Atherosclerotic Disease in Pakistanis

    PubMed Central

    Kamal, Ayeesha Kamran; Majeed, Farzin; Pasha, Omrana; Islam, Muhammad; Azam, Iqbal; Ilyas, Muhammad Saleem; Hussain, Munawar; Masood, Kamran; Ahmed, Bilal; Nazir, Sumaira; Sajjad, Zafar; Kasner, Scott E.

    2015-01-01

    Background Intracranial atherosclerotic disease (ICAD) is the most frequent subtype of ischemic stroke globally. It is important to describe the determinants of early ICAD as a strategy to prevent strokes from clinically evident and progressive ICAD. Our objective is to report the determinants of asymptomatic ICAD by linking the presence or absence of ICAD on magnetic resonance angiogram (MRA) with detailed risk assessment in asymptomatic adults. Methods This is an observational cross-sectional analytical study. We plan to recruit 200 adult participants from the radiology departments of two tertiary care centers of Karachi, Pakistan. The participants will first be screened for the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS). QVSFS negative will be participants will be eligible. After written informed consent, participants will undergo detailed medical, sociodemographic, lifestyle, and anthropometric evaluation by a detailed interview. They will, in addition, undergo MRA to study the presence, degree, and distribution of asymptomatic ICAD. All MRA scans will be reviewed centrally by vascular neurologists blinded to clinical information. These images would be reviewed on DICOM Viewer 3.0 used for calculating the degree of stenosis using Warfarin–Aspirin Symptomatic Intracranial Disease (WASID) study defined criteria employing electronic calipers. A sample size of 200 will achieve 80% power for detecting a minimum difference of 20% in the prevalence of exposure factors (medical and lifestyle) between asymptomatic ICAD positive and ICAD negative persons. This study will generate regional data on risks for ICAD development and prevention in a high-risk susceptible population. Study ID: NCT02072876 PMID:25825629

  12. Asymptomatic microscopic hematuria in women requires separate guidelines.

    PubMed

    Harmanli, Oz; Yuksel, Beril

    2013-02-01

    The guidelines recently updated by the American Urological Association for the evaluation of asymptomatic microscopic hematuria (AMH) are based on data derived predominantly from men. They cannot be reliably applied to females as the epidemiology of AMH is gender dependent. The research on women in this area has been limited. It is incumbent on the experts in the field of female pelvic medicine to advance the science and develop management algorithms for AMH in women. PMID:23149599

  13. An Asymptomatic Primary Renal Carcinoid Tumor: A Case Report.

    PubMed

    Linke, Colin S; Shie, Scott

    2016-07-01

    Primary renal carcinoid tumors are exceedingly rare, with less than 100 total cases being documented in world literature. A 32-year old male was referred to our service for a slow-growing, renal mass, which was first diagnosed 9-years prior. The patient was successfully treated with radical nephrectomy. In this article, we present our case report on an asymptomatic primary renal carcinoid tumor. PMID:27335800

  14. Norovirus Infections in Symptomatic and Asymptomatic Food Handlers in Japan▿

    PubMed Central

    Ozawa, Kazuhiro; Oka, Tomoichiro; Takeda, Naokazu; Hansman, Grant S.

    2007-01-01

    Noroviruses are the leading cause of outbreaks of gastroenteritis in the world. At present, norovirus genogroup II, genotype 4 (GII/4), strains are the most prevalent in many countries. In this study we investigated 55 outbreaks and 35 sporadic cases of norovirus-associated gastroenteritis in food handlers in food-catering settings between 10 November 2005 and 9 December 2006 in Japan. Stool specimens were collected from both symptomatic and asymptomatic individuals and were examined for norovirus by real-time reverse transcription-PCR; the results were then confirmed by sequence analysis. Norovirus was detected in 449 of 2,376 (19%) specimens. Four genogroup I (GI) genotypes and 12 GII genotypes, including one new GII genotype, were detected. The GII/4 sequences were predominant, accounting for 19 of 55 (35%) outbreaks and 16 of 35 (46%) sporadic cases. Our results also showed that a large number of asymptomatic food handlers were infected with norovirus GII/4 strains. Norovirus GII had a slightly higher mean viral load (1 log unit higher) than norovirus GI, i.e., 3.81 × 108 versus 2.79 × 107 copies/g of stool. Among norovirus GI strains, GI/4 had the highest mean viral load, whereas among GII strains, GII/4 had the highest mean viral load (2.02 × 108 and 7.96 × 109 copies/g of stool, respectively). Importantly, we found that asymptomatic individuals had mean viral loads similar to those of symptomatic individuals, which may account for the increased number of infections and the predominance of an asymptomatic transmission route. PMID:17928420

  15. Arroyo del Vizcaíno, Uruguay: a fossil-rich 30-ka-old megafaunal locality with cut-marked bones

    PubMed Central

    Fariña, Richard A.; Tambusso, P. Sebastián; Varela, Luciano; Czerwonogora, Ada; Di Giacomo, Mariana; Musso, Marcos; Bracco, Roberto; Gascue, Andrés

    2014-01-01

    Human–megafauna interaction in the Americas has great scientific and ethical interest because of its implications on Pleistocene extinction. The Arroyo del Vizcaíno site near Sauce, Uruguay has already yielded over 1000 bones belonging to at least 27 individuals, mostly of the giant sloth Lestodon. The assemblage shows some taphonomic features suggestive of human presence, such as a mortality profile dominated by prime adults and little evidence of major fluvial transport. In addition, several bones present deep, asymmetrical, microstriated, sharp and shouldered marks similar to those produced by human stone tools. A few possible lithic elements have also been collected, one of which has the shape of a scraper and micropolish consistent with usage on dry hide. However, the radiocarbon age of the site is unexpectedly old (between 27 and 30 thousand years ago), and thus may be important for understanding the timing of the peopling of America. PMID:24258717

  16. Arroyo del Vizcaíno, Uruguay: a fossil-rich 30-ka-old megafaunal locality with cut-marked bones.

    PubMed

    Fariña, Richard A; Tambusso, P Sebastián; Varela, Luciano; Czerwonogora, Ada; Di Giacomo, Mariana; Musso, Marcos; Bracco, Roberto; Gascue, Andrés

    2014-01-01

    Human-megafauna interaction in the Americas has great scientific and ethical interest because of its implications on Pleistocene extinction. The Arroyo del Vizcaíno site near Sauce, Uruguay has already yielded over 1000 bones belonging to at least 27 individuals, mostly of the giant sloth Lestodon. The assemblage shows some taphonomic features suggestive of human presence, such as a mortality profile dominated by prime adults and little evidence of major fluvial transport. In addition, several bones present deep, asymmetrical, microstriated, sharp and shouldered marks similar to those produced by human stone tools. A few possible lithic elements have also been collected, one of which has the shape of a scraper and micropolish consistent with usage on dry hide. However, the radiocarbon age of the site is unexpectedly old (between 27 and 30 thousand years ago), and thus may be important for understanding the timing of the peopling of America. PMID:24258717

  17. The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength.

    PubMed

    Jackson, John; Leung, Fay; Duncan, Clive; Mugabe, Clement; Burt, Helen

    2011-04-01

    Bone cement containing antibiotics is commonly used to treat orthopedic related infections. However, effective treatment (especially of resistant bacteria, methacillin-resistant Staphylococcus aureus (MRSA)) is compromised by very low levels of drug release so that typically less than 10% of loaded drug is released over a 6-week period. The objective of this study was to investigate the effect of incorporation of water soluble excipients (polyethylene glycol, sodium chloride, or dextran) into antibiotic-loaded cement on mechanical strength and drug release properties. Poly(methyl methylacrylate) cement implants containing various amounts of drug (vancomycin, linezolid or fusidic acid (all MRSA active)) and excipients were cast in the form of beads or films and characterized using differential scanning calorimetry. Mechanical strength as assessed by Young's modulus was determined by thermo-mechanical analysis. Drug release was measured by incubation in phosphate buffered saline with analysis by HPLC methods. The inclusion of sodium chloride up to 20% w/w caused only minor reductions in Young's modulus. Vancomycin and linezolid released very slowly from unmodified bone cement beads (less than 3% released by 4 weeks) whereas fusidic acid released more quickly (approximately 8% released by 4 weeks). The inclusion of sodium chloride or dextran in bone cement resulted in major increases in the release rate of vancomycin, linezolid and fusidic acid. These studies support the inclusion of sodium chloride and dextran in bone cement to increase the release rate of vancomycin, linezolid, or fusidic acid without compromising the mechanical strength of the composite material. PMID:25788111

  18. A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst

    PubMed Central

    Torun, Mümtaz Taner; Seçkin, Ender; Tuncel, Ümit; Kılıç, Caner; Özkan, Özalkan

    2015-01-01

    Background. Cysts in the larynx are rare and generally asymptomatic. However, large cysts in adults can be symptomatic. If they are symptomatic, they typically present with respiratory and feeding difficulties. They are usually benign in terms of pathology. Several surgical techniques may be used for treatment. Case Report. A 56-year-old man presented to our clinic with hoarseness. Routine laryngeal examination revealed a giant mass and the larynx could not be visualized. At magnetic resonance imaging (MRI), a cystic mass originating from the vallecula was detected. There was no pathology at the glottic level. We planned tracheotomy for the airway and endoscopic surgery for excision. The mass was excised using CO2 laser and was reported as benign. Conclusion. An asymptomatic vallecular cyst may cause difficult intubation in any operation. It may also cause respiratory or other complications. Airway management should be led by an ear, nose, and throat surgeon, since tracheotomy may be required. Endoscopic excision with CO2 laser is a good choice for treatment in elective cases. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst. PMID:26688767

  19. Prevalence and Risk Factors of Asymptomatic Colorectal Polyps in Taiwan

    PubMed Central

    Wang, Fu-Wei; Hsu, Ping-I; Chuang, Hung-Yi; Tu, Ming-Shium; Mar, Guang-Yuan; King, Tai-Ming; Wang, Jui-Ho; Hsu, Chao-Wen; Chang, Chiu-Hua; Chen, Hui-Chun

    2014-01-01

    Purpose. To investigate the prevalence and risk factors of hyperplastic and adenomatous colorectal polyps in a Taiwanese general population. Methods. From January 2009 to December 2011, consecutive asymptomatic subjects undergoing a routine health check-up were evaluated by colonoscopy. The colorectal polyps were assessed, and medical history and demographic data were obtained from each patient. Logistic regression analysis was conducted to search the independent risk factors for asymptomatic hyperplastic and adenomatous colorectal polyps. Results. Of the 1899 asymptomatic subjects, the prevalences of hyperplastic polyps and adenomatous polyps were 11.1% and 16.1%, respectively. Multivariate analysis revealed that high body mass index (BMI > 25: OR, 1.32, 95% CI, 1.05–1.71) and current smoking (OR, 1.87, 95% CI, 1.42–2.71) were independent predictors for hyperplastic colorectal polyps. Age over 60 years old (OR, 3.49, 95% CI, 1.86–6.51), high body mass index (BMI > 25: OR, 1.75, 95% CI, 1.21–2.71), heavy alcohol consumption (OR, 2.01, 95% CI, 1.02–3.99), and current smoking (OR, 1.31, 95% CI, 1.04–1.58) were independent predictors for adenomatous colorectal polyps. Conclusion. High BMI and smoking are common risk factors for both adenomatous and hyperplastic polyps. Old age and alcohol consumption are additional risk factors for the development of adenomatous polyps. PMID:25050119

  20. Asymptomatic spread of huanglongbing and implications for disease control.

    PubMed

    Lee, Jo Ann; Halbert, Susan E; Dawson, William O; Robertson, Cecile J; Keesling, James E; Singer, Burton H

    2015-06-16

    Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period. PMID:26034273

  1. Management of early asymptomatic gastrointestinal stromal tumors of the stomach

    PubMed Central

    Scherübl, Hans; Faiss, Siegbert; Knoefel, Wolfram-Trudo; Wardelmann, Eva

    2014-01-01

    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance. PMID:25031785

  2. Asymptomatic spread of huanglongbing and implications for disease control

    PubMed Central

    Lee, Jo Ann; Halbert, Susan E.; Dawson, William O.; Robertson, Cecile J.; Keesling, James E.; Singer, Burton H.

    2015-01-01

    Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period. PMID:26034273

  3. Isolation of an inhibitory insulin-like growth factor (IGF) binding protein from bone cell-conditioned medium: A potential local regulator of IGF action

    SciTech Connect

    Mohan, S.; Bautista, C.M.; Wergedal, J.; Baylink, D.J. )

    1989-11-01

    Inhibitory insulin-like growth factor binding protein (In-IGF-BP) has been purified to homogeneity from medium conditioned by TE89 human osteosarcoma cells by two different methods using Sephadex G-100 gel filtration, FPLC Mono Q ion-exchange, HPLC C{sub 4} reverse-phase, HPLC CN reverse-phase and affinity chromatographies. In-IGF-BP thus purified appeared to be homogeneous and unique by the following criteria. (i) N-terminal sequence analysis yielded a unique sequence (Asp-Glu-Ala-Ile-His-Cys-Pro-Pro-Glu-Ser-Glu-Ala-Lys-Leu-Ala). (ii) Amino acid composition of In-IGF-BP revealed marked differences with the amino acid compositions of other known PBs. (iii) In-IGF-BP exhibited a single band with molecular mass of 25 kDa under reducing conditions on sodium dodecyl sulfate/polyacrylamide gels. IGF-I and IGF-II but not insulin displaced the binding of {sup 125}I-labeled IGF-I or {sup 125}I-labeled IGF-II binding to In-IGF-BP. In-IGF-BP inhibited basal, IGF-stimulated bone cell proliferation and serum-stimulated bone cell proliferation. Forskolin increases synthesis of In-IGF-BP in TE85 human osteosarcoma cells in a dose-dependent manner. Based on these findings, the authors conclude that In-IGF-BP is a protein that has a unique sequence and significant biological actions on bone cells.

  4. Animal Models of Bone Metastasis.

    PubMed

    Simmons, J K; Hildreth, B E; Supsavhad, W; Elshafae, S M; Hassan, B B; Dirksen, W P; Toribio, R E; Rosol, T J

    2015-09-01

    Bone is one of the most common sites of cancer metastasis in humans and is a significant source of morbidity and mortality. Bone metastases are considered incurable and result in pain, pathologic fracture, and decreased quality of life. Animal models of skeletal metastases are essential to improve the understanding of the molecular pathways of cancer metastasis and growth in bone and to develop new therapies to inhibit and prevent bone metastases. The ideal animal model should be clinically relevant, reproducible, and representative of human disease. Currently, an ideal model does not exist; however, understanding the strengths and weaknesses of the available models will lead to proper study design and successful cancer research. This review provides an overview of the current in vivo animal models used in the study of skeletal metastases or local tumor invasion into bone and focuses on mammary and prostate cancer, lymphoma, multiple myeloma, head and neck squamous cell carcinoma, and miscellaneous tumors that metastasize to bone. PMID:26021553

  5. Animal Models of Bone Metastasis

    PubMed Central

    Simmons, J. K.; Hildreth, B. E.; Supsavhad, W.; Elshafae, S. M.; Hassan, B. B.; Dirksen, W. P.; Toribio, R. E.; Rosol, T. J.

    2015-01-01

    Bone is one of the most common sites of cancer metastasis in humans and is a significant source of morbidity and mortality. Bone metastases are considered incurable and result in pain, pathologic fracture, and decreased quality of life. Animal models of skeletal metastases are essential to improve the understanding of the molecular pathways of cancer metastasis and growth in bone and to develop new therapies to inhibit and prevent bone metastases. The ideal animal model should be clinically relevant, reproducible, and representative of human disease. Currently, an ideal model does not exist; however, understanding the strengths and weaknesses of the available models will lead to proper study design and successful cancer research. This review provides an overview of the current in vivo animal models used in the study of skeletal metastases or local tumor invasion into bone and focuses on mammary and prostate cancer, lymphoma, multiple myeloma, head and neck squamous cell carcinoma, and miscellaneous tumors that metastasize to bone. PMID:26021553

  6. [Bone diseases].

    PubMed

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  7. In Vivo Measurement of the Subchondral Bone Thickness of Lumbar Facet Joint Using Magnetic Resonance Imaging

    PubMed Central

    Duan, C. Y.; Espinoza Orías, A. A.; Shott, S.; An, H. S.; Andersson, G.B.J.; Hu, J.Z.; Lu, H. B.; Inoue, N.

    2010-01-01

    Summary Objective To measure in vivo thicknesses of the facet joint subchondral bone across genders, age groups, with or without low back pain symptom groups and spinal levels. Methods Lumbar (L1–L2 to L5-S1) magnetic resonance (MR) imaging was performed in 81 subjects (41 males and 40 females, mean age 37.6 years). Thicknesses of the subchondral bone were measured in 1,620 facet joints using the MR images with custom-written image processing algorithms together with a multi-threshold segmentation technique using each facet joint’s middle axial-slice. This method was validated with 12 cadaver facet joints, scanned with both MR and micro-computed tomography images. Results An overall average thickness value for the 1,620 analyzed joints was measured as 1.56 ± 0.01 mm. The subchondral bone thickness values showed significant increases with successive lower spinal levels in the subjects without low back pain. The facet joint subchondral bone thickness in asymptomatic females was much smaller than in asymptomatic males. Mean subchondral bone thickness in the superior facet was greater than that in the inferior facet in both female and male asymptomatic subjects. Conclusions This study is the first to quantitatively show subchondral bone thickness using a validated MR-based technique. The subchondral bone thickness was greater in asymptomatic males and increased with each successive lower spinal level. These findings may suggest that the subchondral bone thickness increases with loading. Furthermore, the superior facet subchondral bone was thicker than the inferior facet in all cases regardless of gender, age or spinal level in the subjects without low back pain. More research is needed to link subchondral bone microstructure to facet joint kinematics and spinal loads. PMID:21034837

  8. Analysis of Global Sagittal Postural Patterns in Asymptomatic Chinese Adults

    PubMed Central

    Hu, Panpan; Yu, Miao; Sun, Zhuoran; Li, Weishi; Jiang, Liang; Wei, Feng; Chen, Zhongqiang; Liu, Zhongjun

    2016-01-01

    Study Design A prospective imaging study. Purpose To characterize the distribution of the global sagittal postural patterns in asymptomatic Chinese adults using Roussouly classification. Overview of Literature The norms of sagittal parameters in asymptomatic Chinese population have been previously described, but no report described their global sagittal postural patterns as characterized by Roussouly classification. Methods A cohort of 272 asymptomatic Chinese adults was recruited. Data was assimilated by reviewing the films for each subject. Sagittal parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. The pattern distributions were compared across genders within the study cohort. We also compared the data across different ethnicities from our study and a previous study to further characterize Chinese sagittal postures. Results The cohort included 161 males and 111 females, with mean age of 23.2±4.4 years. The average descriptive results were as below: pelvic incidence (PI) 46.4°±9.6°, thoracic kyphosis (TK) 24.2°±9.0°, lumbar lordosis (LL) 50.6°±10.6°, sacral slope (SS) 37.2°±7.6°, pelvic tilt (PT) 9.4°±6.8°, spinosacral angle (SSA) 131.1°±7.5° and sagittal vertical axis (SVA) 17.24±32.36 mm. Despite a significant difference between two genders in LL, PI, SSA, and SVA, no difference was found in the distribution of Roussouly types among them. 47.8% of our cohort belonged to Roussouly type 3, while type 1, 2 and 4 comprised 23.2%, 14.0% and 15.1% of the subjects, respectively. Roussouly classification was capable of categorizing sagittal parameters except for the PT. This study also found that 4.4% of the recruited subjects belonged to the C7-anterior subgroup. Conclusions From a characterization of the sagittal postural patterns of asymptomatic Chinese adults using Roussouly classification, the distribution was similar between Chinese males and females; however, from a cross

  9. Joint bone radiobiology workshop

    SciTech Connect

    Tomich, P.A.

    1991-01-01

    The Joint Bone Radiobiology Workshop was held on July 12--13, 1991 in Toronto, Canada. This document contains the papers presented at the meeting. The five sections were: Dose-effects, Endogenous Cofactors, Tumorigenesis, New Methods and Medical Implications. The papers covered risk assessment, tissue distribution of radionuclides, lifetime studies, biological half-lifes, the influence of age at time of exposure, tumor induction by different radionuclides, microscopic localization of radionuclides, and nuclear medicine issues including tissue distribution in the skeleton and bone marrow transplantation. (MHB)

  10. From bench to clinic and back: skeletal stem cells and impaction bone grafting for regeneration of bone defects.

    PubMed

    Aarvold, A; Smith, J O; Tayton, E R; Jones, A M H; Dawson, J I; Lanham, S; Briscoe, A; Dunlop, D G; Oreffo, R O C

    2014-10-01

    Tissue engineering offers enormous potential for bone regeneration. Despite extensive in vitro and in vivo work, few strategies translate into clinical practice. This paper describes the combination of skeletal stem cells (SSCs) and impaction bone grafting (IBG) for the treatment of patients with bone defects associated with avascular necrosis of the femoral head. SSCs and milled allograft were impacted into necrotic bone in the femoral heads of four patients. Three patients remained asymptomatic at 22-44 month follow-up, but one patient has required total hip replacement (both hips). This has allowed retrieval of the femoral heads, which were analysed structurally and functionally by μCT, histology and mechanical testing. A central channel of impacted bone was found in the femoral heads, which displayed a mature trabecular micro-architecture. The impacted bone was denser than the surrounding trabecular bone, as strong in compression and with histological micro-architecture comparable to that of trabecular bone. Analysis of the retrieved femoral head samples has demonstrated that this tissue-engineering strategy regenerates bone that is both structurally and functionally analogous to normal trabecular bone. SSCs, together with IBG, have proved an effective treatment for avascular necrosis of the femoral head and offer significant potential for the broader spectrum of bone defects. PMID:23038218

  11. Talking Bones.

    ERIC Educational Resources Information Center

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  12. Bone Infections

    MedlinePlus

    ... include those with diabetes, poor circulation, or recent injury to the bone. You may also be at risk if you are having hemodialysis. Symptoms of bone infections include Pain in the infected area Chills and fever Swelling, warmth, and redness A blood ...

  13. Receptor tyrosine kinase inhibition causes simultaneous bone loss and excess bone formation within growing bone in rats

    SciTech Connect

    Nurmio, Mirja; Joki, Henna; Kallio, Jenny; Maeaettae, Jorma A.; Vaeaenaenen, H. Kalervo; Toppari, Jorma; Jahnukainen, Kirsi; Laitala-Leinonen, Tiina

    2011-08-01

    During postnatal skeletal growth, adaptation to mechanical loading leads to cellular activities at the growth plate. It has recently become evident that bone forming and bone resorbing cells are affected by the receptor tyrosine kinase (RTK) inhibitor imatinib mesylate (STI571, Gleevec (registered)) . Imatinib targets PDGF, ABL-related gene, c-Abl, c-Kit and c-Fms receptors, many of which have multiple functions in the bone microenvironment. We therefore studied the effects of imatinib in growing bone. Young rats were exposed to imatinib (150 mg/kg on postnatal days 5-7, or 100 mg/kg on postnatal days 5-13), and the effects of RTK inhibition on bone physiology were studied after 8 and 70 days (3-day treatment), or after 14 days (9-day treatment). X-ray imaging, computer tomography, histomorphometry, RNA analysis and immunohistochemistry were used to evaluate bone modeling and remodeling in vivo. Imatinib treatment eliminated osteoclasts from the metaphyseal osteochondral junction at 8 and 14 days. This led to a resorption arrest at the growth plate, but also increased bone apposition by osteoblasts, thus resulting in local osteopetrosis at the osteochondral junction. The impaired bone remodelation observed on day 8 remained significant until adulthood. Within the same bone, increased osteoclast activity, leading to bone loss, was observed at distal bone trabeculae on days 8 and 14. Peripheral quantitative computer tomography (pQCT) and micro-CT analysis confirmed that, at the osteochondral junction, imatinib shifted the balance from bone resorption towards bone formation, thereby altering bone modeling. At distal trabecular bone, in turn, the balance was turned towards bone resorption, leading to bone loss. - Research Highlights: > 3-Day imatinib treatment. > Causes growth plate anomalies in young rats. > Causes biomechanical changes and significant bone loss at distal trabecular bone. > Results in loss of osteoclasts at osteochondral junction.

  14. Asymptomatic Tuberculosis-Induced Ileal Perforation in an HIV- Infected Individual; A Case Report

    PubMed Central

    Tahmasebi, Sedigheh; Moslemi, Sam; Tahamtan, Maryam; Taheri, Lohrasb; Davarpanah, Mohammad Ali

    2013-01-01

    The co-existence of acquired immune deficiency syndrome (AIDS) and tuberculosis is a major cause of morbidity and mortality because of a widespread organ involvement. The gastrointestinal tract is a common site for localization of opportunistic microorganisms in AIDS. However, surgical abdominal emergencies such as intestinal perforation resulted from tuberculosis are uncommon in these patients. The asymptomatic occurrence of such intestinal perforation has not been reported our knowledge. We represent an HIV and HCV co-infected man with miliary tuberculosis and an incidentally detected free air under  diaphragm in the chest X-ray eventually resulting in exploratory laparotomy which then revealed two tubercular-induced intestinal perforations. It seems that as the tuberculosis is increasing in incidence, mostly due to reactivation in HIV-infected patients especially in developing countries, we should not underestimate its acute abdominal emergencies such as bowel perforation. PMID:27162854

  15. The nucleocytoplasmic shuttling protein CIZ reduces adult bone mass by inhibiting bone morphogenetic protein-induced bone formation.

    PubMed

    Morinobu, Mikihiko; Nakamoto, Tetsuya; Hino, Kazunori; Tsuji, Kunikazu; Shen, Zhong-Jian; Nakashima, Kazuhisa; Nifuji, Akira; Yamamoto, Haruyasu; Hirai, Hisamaru; Noda, Masaki

    2005-03-21

    Osteoporosis is a major health problem; however, the mechanisms regulating adult bone mass are poorly understood. Cas-interacting zinc finger protein (CIZ) is a nucleocytoplasmic shuttling protein that localizes at cell adhesion plaques that form where osteoblasts attach to substrate. To investigate the potential role of CIZ in regulating adult bone mass, we examined the bones in CIZ-deficient mice. Bone volume was increased and the rates of bone formation were increased in CIZ-deficient mice, whereas bone resorption was not altered. CIZ deficiency enhanced the levels of mRNA expression of genes encoding proteins related to osteoblastic phenotypes, such as alkaline phosphatase (ALP) as well as osterix mRNA expression in whole long bones. Bone marrow cells obtained from the femora of CIZ-deficient mice revealed higher ALP activity in culture and formed more mineralized nodules than wild-type cells. CIZ deficiency enhanced bone morphogenetic protein (BMP)-induced osteoblastic differentiation in bone marrow cells in cultures, indicating that BMP is the target of CIZ action. CIZ deficiency increased newly formed bone mass after femoral bone marrow ablation in vivo. Finally, BMP-2-induced bone formation on adult mouse calvariae in vivo was enhanced by CIZ deficiency. These results establish that CIZ suppresses the levels of adult bone mass through inhibition of BMP-induced activation of osteoblasts. PMID:15781586

  16. [Value of the exercise test in asymptomatic myocardial ischemia].

    PubMed

    Iturralde, P; Hernández, D; de Micheli, A; Colín, L; Romero, L; Villarreal, A; Férez, S; Miguel Casanova, J; Barrera, M; González-Hermosillo, J A

    1990-01-01

    To evaluate the predictive value of ischemic ST segment depression without associated chest pain during exercise testing, data were analyzed from 7305 studies. Two hundred thirty six patients were included in this study and were separated in 2 groups. Group A consisted of 169 patients without chest pain who, during exercise testing, showed a positive ST segment response (at least 1.5 mm of horizontal or downward ST segment depression for at least 0.08 second, compared with the resting baseline value), and Group B consisted of 67 patients who had both chest pain and a positive ST segment response. Selective coronary angiogram was performed on all patients. Each Group was separated into 3 sub-group according to the Cohn criteria: sub-group I (asymptomatic persons 8.3 vs 19.4%); sub-group II (patients with history of Myocardial Infarction 36.7% vs 19.4%); sub-group III (patients with chronic angina 55% vs 61.2%). The clinical characteristics, coronary risk factors, distribution of coronary artery disease, and exercise test response were similar in both groups. During treadmill exercise, the mean heart rate was 140.6 +/- 22 in group A versus 127.1 +/- 23 in the group B. The pressure-rate product was 2.4 +/- 0.8 versus 1.9 +/- 0.5, respectively (P less than or equal to 0.05). The predictive value for severe coronary artery disease of an exercise test in patients with asymptomatic ischemia was 77.5% as compared with 89.6% in the group with angina. This study confirms the high frequency of asymptomatic myocardial ischemia during exercise testing, compared with patients who had angina during exercise testing, with high percentage of prediction (77.5%) for coronary artery disease. PMID:2344225

  17. Dipstick urine analysis screening among asymptomatic school children

    PubMed Central

    Hajar, Farah; Taleb, Mohamad; Aoun, Bilal; Shatila, Ahmad

    2011-01-01

    Background: Mass urinary screening is a useful tool to identify children with asymptomatic progressive renal diseases. A dipstick urinalysis screening was conducted to detect such prevalence and to set up a more effective screening program for children. Patients and Methods: A cross sectional study was carried out in seven nurseries and primary schools in different regions of Lebanon (Beirut, North Lebanon, and Valley of Bekaa) between February 2010 and March 2010. Eight hundred seventy asymptomatic children were enrolled in this study. First morning mid steam urine samples were obtained from students and were tested by dipstick method. Children with abnormal findings were re-tested after fifteen days. Results: Twenty five (2.9%) children had urinary abnormalities at the first screening; Eighteen (72%) of them still had abnormal results at the second screening. Among all the students, hematuria was the most common abnormality found with a prevalence of 1.5%, followed by nitrituria (0.45%), combined hematuria and nitrituria (0.45%) and proteinuria (0.1%). Urinary abnormalities were more common in females than in males. With respect to age, most positive results were detected at 6 years of age. Hematuria and proteinuria were mainly present in the North of Lebanon. Conclusion: Asymptomatic urinary abnormalities might be detected by urine screening program at school age. Further work-up should be offered to define the exact etiology of any abnormal finding and to determine whether early detection of renal disorders in childhood will lead to effective interventions and reduction in the number of individuals who develop end-stage renal disease. PMID:22540088

  18. Education, individual time preferences, and asymptomatic disease detection.

    PubMed

    Kim, Younoh; Radoias, Vlad

    2016-02-01

    Asymptomatic conditions such as hypertension are generally hard to diagnose, absent routine medical examinations. This is especially problematic in developing countries, where most citizens do not engage in routine examinations due to limited economic resources. We study the roles of education and individual time preferences in asymptomatic disease detection and management. Using discrete choice models on a sample of 4209 hypertensive Indonesian adults surveyed between November 2007 and April 2008, we find that both education and individual time preferences play important roles. However, the effects are different for people in good health than they are for people in bad health. Education does not seem to matter for disease detection when respondents are in good general health, and its effects on disease management vary largely in magnitudes between these groups. In terms of disease detection, more educated respondents have a higher probability of being diagnosed, but only conditional on being in poor general health. Time preferences, on the other hand, matter for respondents in good general health, but the effect is not significant for those in bad health. More impatient respondents that are in good health have a higher probability of being under-diagnosed because they are more likely to forgo routine physicals. The findings point to two distinct channels through which education can affect health, and suggest that different types of policies need to be implemented, in order to reach the entire population. Traditional programs that stimulate education and improve the socio-economic status of individuals in developing countries are helpful, but they do not address the whole problem. Besides its more usual positive effects, education can also negatively affect the health of asymptomatic patients, because it reflects a higher opportunity cost of engaging in preventative health screenings. PMID:26722984

  19. Paget's Disease of Bone

    MedlinePlus

    ... page please turn Javascript on. Paget's Disease of Bone What is Paget's Disease of Bone? Click for more information Enlarged and Misshapen Bones Paget's disease of bone causes affected bones to ...

  20. Metastatic Bone Disease

    MedlinePlus

    ... Bone Disease cont. Page ( 4 ) MBD vs. Primary Bone Cancer The diagnosis of metastatic bone disease should not ... from an unknown primary carcinoma or a primary bone cancer (sarcoma). For example, if an area of bone ...

  1. Bone x-ray

    MedlinePlus

    ... or broken bone Bone tumors Degenerative bone conditions Osteomyelitis (inflammation of the bone caused by an infection) ... Multiple myeloma Osgood-Schlatter disease Osteogenesis imperfecta Osteomalacia Osteomyelitis Paget disease of the bone Rickets X-ray ...

  2. High prevalence of asymptomatic malaria in south-eastern Bangladesh

    PubMed Central

    2014-01-01

    Background The WHO has reported that RDT and microscopy-confirmed malaria cases have declined in recent years. However, it is still unclear if this reflects a real decrease in incidence in Bangladesh, as particularly the hilly and forested areas of the Chittagong Hill Tract (CHT) Districts report more than 80% of all cases and deaths. surveillance and epidemiological data on malaria from the CHT are limited; existing data report Plasmodium falciparum and Plasmodium vivax as the dominant species. Methods A cross-sectional survey was conducted in the District of Bandarban, the southernmost of the three Hill Tracts Districts, to collect district-wide malaria prevalence data from one of the regions with the highest malaria endemicity in Bangladesh. A multistage cluster sampling technique was used to collect blood samples from febrile and afebrile participants and malaria microscopy and standardized nested PCR for diagnosis were performed. Demographic data, vital signs and splenomegaly were recorded. Results Malaria prevalence across all subdistricts in the monsoon season was 30.7% (95% CI: 28.3-33.2) and 14.2% (95% CI: 12.5-16.2) by PCR and microscopy, respectively. Plasmodium falciparum mono-infections accounted for 58.9%, P. vivax mono-infections for 13.6%, Plasmodium malariae for 1.8%, and Plasmodium ovale for 1.4% of all positive cases. In 24.4% of all cases mixed infections were identified by PCR. The proportion of asymptomatic infections among PCR-confirmed cases was 77.0%, oligosymptomatic and symptomatic cases accounted for only 19.8 and 3.2%, respectively. Significantly (p < 0.01) more asymptomatic cases were recorded among participants older than 15 years as compared to younger participants, whereas prevalence and parasite density were significantly (p < 0.01) higher in patients younger than 15 years. Spleen rate and malaria prevalence in two to nine year olds were 18.6 and 34.6%, respectively. No significant difference in malaria prevalence and

  3. Dataset of mitochondrial genome variants associated with asymptomatic atherosclerosis

    PubMed Central

    Sazonova, Margarita A.; Zhelankin, Andrey V.; Barinova, Valeria A.; Sinyov, Vasily V.; Khasanova, Zukhra B.; Postnov, Anton Y.; Sobenin, Igor A.; Bobryshev, Yuri V.; Orekhov, Alexander N.

    2016-01-01

    This dataset report is dedicated to mitochondrial genome variants associated with asymptomatic atherosclerosis. These data were obtained using the method of next generation pyrosequencing (NGPS). The whole mitochondrial genome of the sample of patients from the Moscow region was analyzed. In this article the dataset including anthropometric, biochemical and clinical parameters along with detected mtDNA variants in patients with carotid atherosclerosis and healthy individuals was presented. Among 58 of the most common homoplasmic mtDNA variants found in the observed sample, 7 variants occurred more often in patients with atherosclerosis and 16 variants occurred more often in healthy individuals. PMID:27222855

  4. Nearly Asymptomatic Eight-Month Thoracic Aortic Dissection

    PubMed Central

    Kumar, Arjun; Kumar, Krishan; Zeltser, Roman; Makaryus, Amgad N.

    2016-01-01

    Thoracic aortic dissection is a rare, but lethal, medical condition that is either misdiagnosed as a myocardial infarction or overlooked completely. Though thoracic aortic dissections are commonly diagnosed in patients exhibiting sharp chest pain, there are some notable cases where patients do not report the expected severity of pain. We report a unique case of a patient with a thoracic aortic dissection who was initially nearly asymptomatic for eight months, in order to heighten awareness, highlight diagnosis protocol, and improve prognosis for this commonly misdiagnosed, but fatal, condition. PMID:27257400

  5. Dataset of mitochondrial genome variants associated with asymptomatic atherosclerosis.

    PubMed

    Sazonova, Margarita A; Zhelankin, Andrey V; Barinova, Valeria A; Sinyov, Vasily V; Khasanova, Zukhra B; Postnov, Anton Y; Sobenin, Igor A; Bobryshev, Yuri V; Orekhov, Alexander N

    2016-06-01

    This dataset report is dedicated to mitochondrial genome variants associated with asymptomatic atherosclerosis. These data were obtained using the method of next generation pyrosequencing (NGPS). The whole mitochondrial genome of the sample of patients from the Moscow region was analyzed. In this article the dataset including anthropometric, biochemical and clinical parameters along with detected mtDNA variants in patients with carotid atherosclerosis and healthy individuals was presented. Among 58 of the most common homoplasmic mtDNA variants found in the observed sample, 7 variants occurred more often in patients with atherosclerosis and 16 variants occurred more often in healthy individuals. PMID:27222855

  6. Periostin action in bone.

    PubMed

    Bonnet, Nicolas; Garnero, Patrick; Ferrari, Serge

    2016-09-01

    Periostin is a highly conserved matricellular protein that shares close homology with the insect cell adhesion molecule fasciclin 1. Periostin is expressed in a broad range of tissues including the skeleton, where it serves both as a structural molecule of the bone matrix and a signaling molecule through integrin receptors and Wnt-beta-catenin pathways whereby it stimulates osteoblast functions and bone formation. The development of periostin null mice has allowed to elucidate the crucial role of periostin on dentinogenesis and osteogenesis, as well as on the skeletal response to mechanical loading and parathyroid hormone. The use of circulating periostin as a potential clinical biomarker has been explored in different non skeletal conditions. These include cancers and more specifically in the metastasis process, respiratory diseases such as asthma, kidney failure, renal injury and cardiac infarction. In postmenopausal osteoporosis, serum levels have been shown to predict the risk of fracture-more specifically non-vertebral- independently of bone mineral density. Because of its preferential localization in cortical bone and periosteal tissue, it can be speculated that serum periostin may be a marker of cortical bone metabolism, although additional studies are clearly needed. PMID:26721738

  7. Whole-Body MRI Screening in Asymptomatic Subjects; Preliminary Experience and Long-Term Follow-Up Findings

    PubMed Central

    Ulus, Sila; Suleyman, Erdogan; Ozcan, Umit Aksoy; Karaarslan, Ercan

    2016-01-01

    Summary Background The aim of this study is to describe the technique and to evaluate the results of whole-body magnetic resonance imaging in an asymptomatic population. Material/Methods Between March 2009 and December 2011, 118 consecutive subjects undergoing thorough medical check-up were prospectively included in the study. MRI was performed with a 205-cm moving table, parallel imaging and automatic image composing software. Results In 83 subjects (70%), 103 benign lesions were detected. Two malignant (adrenal and renal carcinoma) lesions and one precancerous (pancreatic mucinous carcinoma) lesion were detected. The most common lesions were renal cysts, liver hemangiomas, liver cysts, thyroid nodules, and uterine leiomyomas. Conclusions WB-MRI is able to cover area from head to toes in one diagnostic work-up, and besides the anatomic regions evaluated by conventional radiological modalities, i.e. brain parenchyma, bones and extremities, can be evaluated in one examination.

  8. Asymptomatic renal cell carcinoma with metastasis to the skin and duodenum: a case report and review of the literature

    PubMed Central

    Mandal, Adhip; Littler, Yvonne; Libertiny, Gabor

    2012-01-01

    Renal cell carcinoma is known to have blood-borne metastasis. This is usually to the bone, lungs and brain. Other unusual metastatic presentations such as skin and bowel metastasis have also been described. In most cases, the metastasis occurs as a late manifestation in a patient with known primary renal cell carcinoma. A rare synchronous presentation of skin and duodenal metastasis in an otherwise asymptomatic patient is reported here. This patient presented with a skin lesion that, on excision, brought up the diagnosis of metastatic renal cell carcinoma. While the patient was waiting for surgery, she also developed melena that, on gastroscopy, confirmed a duodenal metastasis. This case highlights the importance of early recognition of otherwise unrelated lesions as presentations for an advanced renal malignancy. PMID:22684828

  9. Combination of Local Transplantation of In Vitro Bone-marrow Stromal Cells and Pulsed Electromagnetic Fields Accelerate Functional Recovery of Transected Sciatic Nerve Regeneration: A Novel Approach in Transected Nerve Repair.

    PubMed

    Mohammadi, Rahim; Mahmoodzadeh, Sirvan

    2015-01-01

    Effect of combination of undifferentiated bone marrow stromal cells (BMSCs) and pulsed electromagnetic fields (PEMF) on transected sciatic nerve regeneration was assessed in rats. A 10 mm nerve segment was excised and a vein graft was used to bridge the gap. Twenty microliter undifferentiated BMSCs (2× 107 cells /mL) were administered into the graft inBMSC group with no exposure to PEMF. In BMSC/PEMF group the whole body was exposed to PEMF (0.3 mT, 2Hz) for 4h/day within 1-5 days. In PEMF group the transected nerve was bridged and phosphate buffered saline was administered into the graft. In authograft group (AUTO), the transected nervesegments were reimplanted reversely and the whole body was exposed to PEMF. The regenerated nerve fibers were studied within 12 weeks after surgery. Behavioral, functional, electrophysiological, biomechanical, gastrocnemius muscle mass findings, morphometric indices and immuonohistochemical reactions confirmed faster recovery of regenerated axons in BMSC/PEMF group compared to those in the other groups (P<0.05). The use of undifferentiated BMSCs with whole body exposure to PEMF improved functional recovery. Combination of local transplantation of in vitro bone-marrow stromal cells and pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice. PMID:26044808

  10. Seroprevalence of asymptomatic dengue infection in children in Lahore.

    PubMed

    Mohsin, S N; Ghafoor, F; Saleem, M; Ghous, R; Aasim, M

    2016-08-01

    Dengue has become a global problem in past few decades, with half of the world's population at risk of infection. For some countries of Asia and Latin America, severe dengue is a major cause of serious illness and even death in children. Pakistan has been reported as a hyperendemic area for dengue infection. Our study aimed to find seroprevalence of past dengue infection in asymptomatic children of Lahore with no previous history of dengue infection. A total of 400 samples were collected from children aged 1-12 years in Lahore using random sampling. The inclusion criteria were children aged 1-12 years, who had no previous symptoms of dengue fever during their lives. Children with known immunodeficiency status or fever at the time of recruitment were excluded from the study. Commercially available ELISA kits were used to determine the IgG status in sera of children. The data obtained was entered and analysed using SPSS v. 20.0. The overall prevalence of asymptomatic dengue infection was found to be 25%. There was no statistically significant difference between prevalence of infection in male and female children. There was, however, a strong relationship between increasing age of the child and number of cases with infection, with low incidence in children aged ⩽5 years. PMID:27019361

  11. Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients.

    PubMed

    Mills, Paul J; Wilson, Kathleen; Iqbal, Navaid; Iqbal, Fatima; Alvarez, Milagros; Pung, Meredith A; Wachmann, Katherine; Rutledge, Thomas; Maglione, Jeanne; Zisook, Sid; Dimsdale, Joel E; Lunde, Ottar; Greenberg, Barry H; Maisel, Alan; Raisinghani, Ajit; Natarajan, Loki; Jain, Shamini; Hufford, David J; Redwine, Laura

    2015-06-01

    Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p < 0.02), less fatigue (p < 0.001), better sleep (p < 0.04), and more spiritual wellbeing (p < 0.01) (overall model F = 26.6, p < 0.001, adjusted R square = 0.629). Further analyses indicated that the meaning (p < 0.01) and peace (p < 0.01) subscales, but not the faith (p = 0.332) subscale, of spiritual wellbeing were independently associated with fewer depressive symptoms. Interventions aimed at increasing spiritual wellbeing in patients lives, and specifically meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure. PMID:25533643

  12. Asymptomatic Gastric Band Erosion Detected during Routine Gastroduodenoscopy.

    PubMed

    Yun, Gee Young; Kim, Woo Sub; Kim, Hye Jin; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

    2016-05-01

    The incidence of gastric band erosion has decreased to 1%. Gastric band erosion can manifest with various clinical symptoms, although some patients remain asymptomatic. We present a case of a mostly asymptomatic patient who was diagnosed with gastric band erosion during a routine health check-up. A 32-year-old man without any underlying diseases except for non-alcoholic fatty liver underwent laparoscopic adjustable gastric band surgery in 2010. He had no significant complications postoperatively. He underwent routine health check-ups with near-normal gastroduodenoscopic findings through 2014. However, in 2015, routine gastroduodenoscopy showed that the gastric band had eroded into the stomach. His gastric band was removed laparoscopically, and the remaining gastric ulcer perforation was repaired using an omental patch. Due to the early diagnosis, the infection was not serious. The patient was discharged on postoperative day 3 with oral antibiotics. This patient was fortunately diagnosed early by virtue of a routine health check-up; thus, eliminating the possibility of serious complications. PMID:26867553

  13. Asymptomatic Gastric Band Erosion Detected during Routine Gastroduodenoscopy

    PubMed Central

    Yun, Gee Young; Kim, Woo Sub; Kim, Hye Jin; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

    2016-01-01

    The incidence of gastric band erosion has decreased to 1%. Gastric band erosion can manifest with various clinical symptoms, although some patients remain asymptomatic. We present a case of a mostly asymptomatic patient who was diagnosed with gastric band erosion during a routine health check-up. A 32-year-old man without any underlying diseases except for non-alcoholic fatty liver underwent laparoscopic adjustable gastric band surgery in 2010. He had no significant complications postoperatively. He underwent routine health check-ups with near-normal gastroduodenoscopic findings through 2014. However, in 2015, routine gastroduodenoscopy showed that the gastric band had eroded into the stomach. His gastric band was removed laparoscopically, and the remaining gastric ulcer perforation was repaired using an omental patch. Due to the early diagnosis, the infection was not serious. The patient was discharged on postoperative day 3 with oral antibiotics. This patient was fortunately diagnosed early by virtue of a routine health check-up; thus, eliminating the possibility of serious complications. PMID:26867553

  14. Articulated dental cast analysis of asymptomatic and symptomatic populations.

    PubMed

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  15. Articulated dental cast analysis of asymptomatic and symptomatic populations

    PubMed Central

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  16. Crosstalk between cartilage and bone: when bone cytokines matter.

    PubMed

    Funck-Brentano, Thomas; Cohen-Solal, Martine

    2011-04-01

    The cartilage damage which characterizes osteoarthritis is often accompanied by bone lesions. Joint integrity results from the balance in the physiological interactions between bone and cartilage. Several local factors regulate the physiological remodeling of cartilage, the disequilibrium of these leading to a higher cartilage catabolism. Several cytokines secreted by bone cells can induce chondrocyte differentiation, which suggests their role in the dialogue between both cells. Accumulative in vivo evidence shows that increased bone resorption occurs at an early stage in the development of osteoarthritis and that blocking bone-resorbing cytokines prevents cartilage damage, confirming the role of bone factors in the crosstalk of both tissues. Recently, molecules of the Wnt pathway have emerged as key regulators of bone and cartilage. Activation of Wnt/βcatenin induces an imbalance in cartilage homeostasis, and agonists/antagonists of Wnt are potential candidates for this interaction. This review will summarize what is known about the contribution of bone cytokines to the physiological remodeling of cartilage and in the pathophysiology of osteoarthritis. PMID:21596615

  17. A decade of bisphosphonate bone complications: what it has taught us about bone physiology.

    PubMed

    Marx, Robert E

    2014-01-01

    While the AIDS epidemic of the 1980s taught the medical and dental professions much about immune cells and the immune system's cellular relationships, the bisphosphonate-induced osteonecrosis epidemic of the past decade has taught these same professions much about bone turnover, bone cell cross talk, the response and functional relationship of bone cells to loading, and drug effects on cellular dynamic relationships. The present article explores the literature as well as both evidence- and experience-based data to discuss known bone pathologies and physiologic mechanisms as well as uncover new findings: (1) bone remodeling is the mechanism by which bone adapts to loading stresses, termed either bone modeling or Wolff's law, and it is also the mechanism for bone renewal; (2) osteoclastic bone resorption triggers bone renewal at a rate of about 0.7%/day by its release of growth factors; (3) bisphosphonates prevent the renewal of old and injured bone, thus making it brittle and more likely to fracture over time; (4) bisphosphonates have a half-life in bone of 11 years because of their irreversible binding to bone via their central carbon atom; (5) when administered intravenously, bisphosphonate loads bone and accumulates in bone 142.8 times faster than when administered orally; (6) osteoclastic resorption of bisphosphonate-loaded bone results in osteoclast death in which the cell bursts, releasing the bisphosphonate molecules to reenter the local bone or bone marrow in a re-dosing effect; (7) endosteal osteoblasts are dependent on the osteoclastic resorption/growth factor release/new bone formation mechanism of bone renewal, whereas periosteal osteoblasts are not; and (8) it is likely that endosteal osteoblasts and periosteal osteoblasts have different cell membrane receptors and arise from separate embryologic niches. PMID:24683588

  18. Successful treatment of pain in melorheostosis with zoledronate, with improvement on bone scintigraphy.

    PubMed

    Slimani, Samy; Nezzar, Adlen; Makhloufi, Hachemi

    2013-01-01

    Melorheostosis is a very rare sclerosing bone disorder that involves frequently one limb. It may be asymptomatic, but pain and limb deformity may occur and can be very debilitating. Different reports have indicated efficacy of bisphosphonates (pamidronate and etidronate) on symptoms. We report an adult patient with a very painful melorheostosis, who  improved after treatment with zoledronate, either on symptoms or on bone scans. PMID:23813581

  19. Clinical, lifestyle, socioeconomic determinants and rate of asymptomatic intracranial atherosclerosis in stroke free Pakistanis

    PubMed Central

    2014-01-01

    Background Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region. Methods The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used in the Warfarin–Aspirin Symptomatic Intracranial Disease study. The risk factors associated with asymptomatic ICAD are reported along with prevalence ratios. Results Of the 200 participants, ICAD was found in 34.5% (n = 69) of the participants. Mean age was 37.1 (S.D 15.1) years with 62% younger than 45 years. Self-reported hypertension was found in 26.5% subjects, diabetes in 9%, dyslipidemia in 5% and depression in 60%. Smokeless tobacco (Adjusted PR 3.27 (1.07-6.05)), Western diet, high socioeconomic status (Adjusted PR 2.26 (1.99-5.62)) and dyslipidemia (Adjusted PR 1.88 (1.25-2.21)) had significant associations with ICAD after multivariable analysis. Age, gender, diabetes, hypertension, depression and physical activity did not have a significant association. Conclusion ICAD was found on MRI in one in three asymptomatic Pakistanis and was associated with modifiable risks. Initiatives targeting primary prevention may be able to decrease the burden of disease caused by stroke due to ICAD. Study Registration Number NCT02072876 2/25/2014 PMID:25124284

  20. Rare giant cell tumor involvement of the olecranon bone

    PubMed Central

    Yang, Chen; Gong, Yubao; Liu, Jianguo; Qi, Xin

    2014-01-01

    Giant cell tumor (GCT) of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence. PMID:25197303

  1. Molecular Profiling of Giant Cell Tumor of Bone and the Osteoclastic Localization of Ligand for Receptor Activator of Nuclear Factor κB

    PubMed Central

    Morgan, Teresa; Atkins, Gerald J.; Trivett, Melanie K.; Johnson, Sandra A.; Kansara, Maya; Schlicht, Stephen L.; Slavin, John L.; Simmons, Paul; Dickinson, Ian; Powell, Gerald; Choong, Peter F.M.; Holloway, Andrew J.; Thomas, David M.

    2005-01-01

    Giant cell tumor of bone (GCT) is a generally benign, osteolytic neoplasm comprising stromal cells and osteoclast-like giant cells. The osteoclastic cells, which cause bony destruction, are thought to be recruited from normal monocytic pre-osteoclasts by stromal cell expression of the ligand for receptor activator of nuclear factor κB (RANKL). This model forms the foundation for clinical trials in GCTs of novel cancer therapeutics targeting RANKL. Using expression profiling, we identified both osteoblast and osteoclast signatures within GCTs, including key regulators of osteoclast differentiation and function such as RANKL, a C-type lectin, osteoprotegerin, and the wnt inhibitor SFRP4. After ex vivo generation of stromal- and osteoclast-enriched cultures, we unexpectedly found that RANKL mRNA and protein were more highly expressed in osteoclasts than in stromal cells, as determined by expression profiling, flow cytometry, immunohistochemistry, and reverse transcriptase-polymerase chain reaction. The expression patterns of molecules implicated in signaling between stromal cells and monocytic osteoclast precursors were analyzed in both primary and fractionated GCTs. Finally, using array-based comparative genomic hybridization, neither GCTs nor the derived stromal cells demonstrated significant genomic gains or losses. These data raise questions regarding the role of RANKL in GCTs that may be relevant to the development of molecularly targeted therapeutics for this disease. PMID:15972958

  2. The response of bone to unloading

    NASA Technical Reports Server (NTRS)

    Bikle, D. D.; Halloran, B. P.

    1999-01-01

    Skeletal unloading leads to decreased bone formation and decreased bone mass. Bone resorption is uncoupled from bone formation, contributing to the bone loss. During spaceflight bone is lost principally from the bones most loaded in the 1-g environment, and some redistribution of bone from the lower extremities to the head appears to take place. Although changes in calcitropic hormones have been demonstrated during skeletal unloading (PTH and 1,25(OH)2D decrease), it remains unclear whether such changes account for or are in response to the changes in bone formation and resorption. Bed rest studies with human volunteers and hindlimb elevation studies with rats have provided useful data to help explain the changes in bone formation during spaceflight. These models of skeletal unloading reproduce a number of the conditions associated with microgravity, and the findings from such studies confirm many of the observations made during spaceflight. Determining the mechanism(s) by which loading of bone is sensed and translated into a signal(s) controlling bone formation remains the holy grail in this field. Such investigations couple biophysics to biochemistry to cell and molecular biology. Although studies with cell cultures have revealed biochemical responses to mechanical loads comparable to that seen in intact bone, it seems likely that matrix-cell interactions underlie much of the mechanocoupling. The role for systemic hormones such as PTH, GH, and 1,25(OH)2D compared to locally produced factors such as IGF-I, PTHrP, BMPs, and TGF-beta in modulating the cellular response to load remains unclear. As the mechanism(s) by which bone responds to mechanical load with increased bone formation are further elucidated, applications of this knowledge to other etiologies of osteoporosis are likely to develop. Skeletal unloading provides a perturbation in bone mineral homeostasis that can be used to understand the mechanisms by which bone mineral homeostasis is maintained, with

  3. Bone marrow transplant

    MedlinePlus

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; ...

  4. Bone marrow transplant

    MedlinePlus

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity, nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  5. Timing of testing and treatment for asymptomatic diseases

    SciTech Connect

    Kırkızlar, Eser; Faissol, Daniel M.; Griffin, Paul M.; Swann, Julie L.

    2010-07-01

    Many papers in the medical literature analyze the cost-effectiveness of screening for diseases by comparing a limited number of a priori testing policies under estimated problem parameters. However, this may be insufficient to determine the best timing of the tests or incorporate changes over time. In this paper, we develop and solve a Markov Decision Process (MDP) model for a simple class of asymptomatic diseases in order to provide the building blocks for analysis of a more general class of diseases. We provide a computationally efficient method for determining a cost-effective dynamic intervention strategy that takes into account (i) the results of the previous test for each individual and (ii) the change in the individual’s behavior based on awareness of the disease. We demonstrate the usefulness of the approach by applying the results to screening decisions for Hepatitis C (HCV) using medical data, and compare our findings to current HCV screening recommendations.

  6. Management of asymptomatic gene carriers of transthyretin familial amyloid polyneuropathy.

    PubMed

    Schmidt, Hartmut H-J; Barroso, Fabio; González-Duarte, Alejandra; Conceição, Isabel; Obici, Laura; Keohane, Denis; Amass, Leslie

    2016-09-01

    Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a rare, severe, and irreversible, adult-onset, hereditary disorder caused by autosomal-dominant mutations in the TTR gene that increase the intrinsic propensity of transthyretin protein to misfold and deposit systemically as insoluble amyloid fibrils in nerve tissues, the heart, and other organs. TTR-FAP is characterized by relentless, progressively debilitating polyneuropathy, and leads to death, on average, within 10 years of symptom onset without treatment. With increased availability of disease-modifying treatment options for a wider spectrum of patients with TTR-FAP, timely detection of the disease may offer substantial clinical benefits. This review discusses mutation-specific predictive genetic testing in first-degree relatives of index patients diagnosed with TTR-FAP and the structured clinical follow-up of asymptomatic gene carriers for prompt diagnosis and early therapeutic intervention before accumulation of substantial damage. Muscle Nerve 54: 353-360, 2016. PMID:27273296

  7. MRSA infected emphysematous bullae in an asymptomatic COPD patient

    PubMed Central

    Zaman, Shahriar Raj

    2013-01-01

    This is a case of a 57-year-old gentleman with a history of chronic obstructive pulmonary disease (COPD) who presented with diarrhoea of more than 4 weeks in length. On chest x-ray, he was incidentally found to have a large cavitating lesion in his right lung. He denied having any respiratory distress at any stage and clinically he had been completely asymptomatic. The CT-guided biopsy confirmed a methicillin-resistant Staphylococcus aureus positive lung cavitation, most likely secondary to his poor dentition. A full dental clearance was performed, and he was treated with a course of intravenous vancomycin and oral clindamycin with good effect. PMID:23386490

  8. Asymptomatic myocardial infarction in Kawasaki disease: Long-term prognosis

    SciTech Connect

    Shiraishi, I.; Onouchi, Z.; Hayano, T.; Hamaoka, K.; Kiyosawa, N. )

    1991-04-01

    Eight patients with Kawasaki disease who had sustained asymptomatic myocardial infarction 8-15 years ago (mean, 13.1 years) were reexamined by various noninvasive cardiac function tests to assess long-term prognosis. At present, electrocardiograms (ECGs) are normal in six patients. However, all eight patients had a prolonged preejection period (PEP) to left ventricular ejection time (LVET) ratio 30 s after amylnitrate (AN) inhalation. Six patients had perfusion defects by exercise thallium-201 myocardial scintigraphy, and two patients developed ST segment depression in treadmill exercise testing. These patients are symptom-free even though their physical activity has not been restricted. Yet they proved to have serious abnormalities suggesting sequelae of myocardial infarction or existing myocardial ischemia. Judging from the results of noninvasive cardiac function tests and recently performed coronary angiography, five of the eight patients require coronary bypass surgery.

  9. Bone-derived IGF mediates crosstalk between bone and breast cancer cells in bony metastases

    PubMed Central

    Hiraga, Toru; Myoui, Akira; Hashimoto, Nobuyuki; Sasaki, Akira; Hata, Kenji; Morita, Yoshihiro; Yoshikawa, Hideki; Rosen, Clifford J.; Mundy, Gregory R.; Yoneda, Toshiyuki

    2012-01-01

    The continuous release of bone-stored growth factors following bone resorption promotes the colonization of circulating cancer cells. However, the precise role of each of the various growth factors remains unclear. In this study, we investigated the role of bone-derived insulin-like growth factor (IGF) in the development of bone metastases in an animal model of breast cancer. We found that local stimulation of calvarial bone resorption prior to cell inoculation stimulated subsequent bone metastases to that site in vivo, while inhibition of bone resorption inhibited bone metastases. Anchorage-independent growth of cancer cells was stimulated by the culture supernatants from resorbed bones, which contained elevated levels of IGF type I (IGF-1). This stimulation was blocked by IGF-1 receptor (IGF1R) neutralizing antibody, but not antibody targeting other bone-stored growth factors including TGFβ, fibroblast growth factors, and platelet derived growth factors. While recombinant human IGF-I caused IGFIR tyrosine autophosphorylation, followed by activation of Akt and NF-κB in cancer cells, dominant-negative inhibition of IGFIR, Akt, or NF-κB significantly reduced bone metastases with increased apoptosis and decreased mitosis in metastatic cells. Together, our findings suggest that bone-derived IGF-I bridges the crosstalk between bone and metastasized cancer cells via activation of the IGFIR/Akt/NF-κB pathway. Disruption of this pathway therefore may represent a promising therapeutic intervention for bone metastasis. PMID:22738911

  10. Skeletal cell fate decisions within periosteum and bone marrow during bone regeneration.

    PubMed

    Colnot, Céline

    2009-02-01

    Bone repair requires the mobilization of adult skeletal stem cells/progenitors to allow deposition of cartilage and bone at the injury site. These stem cells/progenitors are believed to come from multiple sources including the bone marrow and the periosteum. The goal of this study was to establish the cellular contributions of bone marrow and periosteum to bone healing in vivo and to assess the effect of the tissue environment on cell differentiation within bone marrow and periosteum. Results show that periosteal injuries heal by endochondral ossification, whereas bone marrow injuries heal by intramembranous ossification, indicating that distinct cellular responses occur within these tissues during repair. [corrected] Next, lineage analyses were used to track the fate of cells derived from periosteum, bone marrow, and endosteum, a subcompartment of the bone marrow. Skeletal progenitor cells were found to be recruited locally and concurrently from periosteum and/or bone marrow/endosteum during bone repair. Periosteum and bone marrow/endosteum both gave rise to osteoblasts, whereas the periosteum was the major source of chondrocytes. Finally, results show that intrinsic and environmental signals modulate cell fate decisions within these tissues. In conclusion, this study sheds light into the origins of skeletal stem cells/progenitors during bone regeneration and indicates that periosteum, endosteum, and bone marrow contain pools of stem cells/progenitors with distinct osteogenic and chondrogenic potentials that vary with the tissue environment. PMID:18847330

  11. Local administration of AAV-DJ pseudoserotype expressing COX2 provided early onset of transgene expression and promoted bone fracture healing in mice.

    PubMed

    Lakhan, R; Baylink, D J; Lau, K-H W; Tang, X; Sheng, M H-C; Rundle, C H; Qin, X

    2015-09-01

    We have previously obtained compelling proof-of-principle evidence for COX2 gene therapy for fracture repair using integrating retroviral vectors. For this therapy to be suitable for patient uses, a suitable vector with high safety profile must be used. Accordingly, this study sought to evaluate the feasibility of AAV as the vector for this COX2 gene therapy, because AAV raises less safety issues than the retroviral vectors used previously. However, an appropriate AAV serotype is required to provide early increase in and adequate level of COX2 expression that is needed for fracture repair. Herein, we reported that AAV-DJ, an artificial AAV pseudoserotype, is highly effective in delivering COX2 gene to fracture sites in a mouse femoral fracture model. Compared with AAV-2, the use of AAV-DJ led to ~5-fold increase in infectivity in mesenchymal stem cells (MSCs) and provided an earlier and significantly higher level of transgene expression at the fracture site. Injection of this vector at a dose of 7.5 × 10(11) genomic copies led to high COX2 level at the fracture site on day 3 after injections and significantly promoted fracture union at 21 days, as analyzed by radiography and μ-CT. The therapeutic effect appears to involve enhanced osteoblastic differentiation of MSCs and remodeling of callus tissues to laminar bone. This interpretation is supported by the enhanced expression of several key genes participating in the fracture repair process. In conclusion, AAV-DJ is a promising serotype for the AAV-based COX2 gene therapy of fracture repair in humans. PMID:25965395

  12. Congenital asymptomatic diaphragmatic hernias in adults: a case series

    PubMed Central

    2013-01-01

    Introduction Congenital diaphragmatic hernia is a major malformation occasionally found in newborns and babies. Congenital diaphragmatic hernia is defined by the presence of an orifice in the diaphragm, more often to the left and posterolateral, that permits the herniation of abdominal contents into the thorax. The aim of this case series is to provide information on the presentation, diagnosis and outcome of three patients with late-presenting congenital diaphragmatic hernias. The diagnosis of congenital diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray films and computed tomography scans. Case presentations In the present report three cases of asymptomatic abdominal viscera herniation within the thorax are described. The first case concerns herniation of some loops of the large intestine into the left hemi-thorax in a 75-year-old Caucasian Italian woman. The second case concerns a rare type of herniation in the right side of the thorax of the right kidney with a part of the liver parenchyma in a 57-year-old Caucasian Italian woman. The third case concerns herniation of the stomach and bowel into the left side of the chest with compression of the left lung in a 32-year-old Caucasian Italian man. This type of hernia may appear later in life, because of concomitant respiratory or gastrointestinal disease, or it may be an incidental finding in asymptomatic adults, such as in the three cases featured here. Conclusions Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms, and diagnosis may be difficult. Additional investigation and research appear necessary to better explain the development and progression of this type of disease. PMID:23668793

  13. DXA parameters: beyond bone mineral density.

    PubMed

    Briot, Karine

    2013-05-01

    Dual-energy X-ray absorptiometry (DXA) is the reference standard for measuring bone mineral density (BMD) to diagnose osteoporosis. However, BMD measurement alone does not reliably predict the fracture risk. DXA can be used to assess other parameters (e.g. presence of vertebral fractures, bone microarchitecture, bone geometry, and body composition) simultaneously with BMD measurements, to help identify individuals at high fracture risk. Among these parameters, some are suitable for use in clinical practice, whereas others are reserved for research. Vertebral fracture assessment (VFA) is a very low radiation-dose method for detecting thoracic and lumbar vertebral fractures. Compared to standard radiography, VFA can be used in a broader population to detect asymptomatic vertebral fractures. The very good negative predictive value of VFA leads, in one-third of cases, to changes in patient management (drug treatment and prescription of radiographs). The trabecular bone score (TBS) is a noninvasively measured texture parameter that correlates with 3D bone microarchitecture parameters independently from BMD and that can be determined from lumbar-spine DXA images. Several cross-sectional studies and a prospective study established that the TBS was effective in identifying individuals with fractures. Additional studies will have to be performed to determine whether TBS determination can be recommended for everyday practice when treatment decisions are difficult. PMID:23622733

  14. Celiac disease and metabolic bone disease.

    PubMed

    Xing, Yanming; Morgan, Sarah L

    2013-01-01

    Celiac disease is a common autoimmune gastrointestinal disorder affecting multiple organs, precipitated in genetically vulnerable persons by the ingestion of gluten. Gluten is poorly digested and is presented to the intestinal mucosa as a large polypeptide. Binding to human leukocyte antigen-DQ2 and human leukocyte antigen-DQ8 molecules on antigen-presenting cells stimulates cellular and humeral immune reactions. Although common serological tests are available to diagnose celiac disease, the diagnosis of celiac disease is often delayed or missed because of lack of recognition as the disease presentation in adults is highly variable and may be asymptomatic. Celiac disease is a common secondary cause of metabolic bone disease and delayed treatment with gluten-free diet affects bone mineral density and fracture risk, so it is crucial to diagnose and treat celiac disease promptly. In this article, we will review recent studies of celiac disease in adults and provide practical, easily accessible information for busy clinicians. PMID:24090646

  15. [Metabolic bone disease osteomalacia].

    PubMed

    Reuss-Borst, M A

    2014-05-01

    Osteomalacia is a rare disorder of bone metabolism leading to reduced bone mineralization. Underlying vitamin D deficiency and a disturbed phosphate metabolism (so-called hypophosphatemic osteomalacia) can cause the disease. Leading symptoms are dull localized or generalized bone pain, muscle weakness and cramps as well as increased incidence of falls. Rheumatic diseases, such as polymyalgia rheumatica, rheumatoid arthritis, myositis and fibromyalgia must be considered in the differential diagnosis. Alkaline phosphatase (AP) is typically elevated in osteomalacia while serum phosphate and/or 25-OH vitamin D3 levels are reduced. The diagnosis of osteomalacia can be confirmed by an iliac crest bone biopsy. Histological correlate is reduced or deficient mineralization of the newly synthesized extracellular matrix. Treatment strategies comprise supplementation of vitamin D and calcium and for patients with intestinal malabsorption syndromes vitamin D and calcium are also given parenterally. In renal phosphate wasting syndromes substitution of phosphate is the treatment of choice, except for tumor-induced osteomalacia when removal of the tumor leads to a cure in most cases. PMID:24811356

  16. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with symptomatic versus asymptomatic irreversible pulpitis.

    PubMed

    Argueta-Figueroa, Liliana; Arzate-Sosa, Gabriel; Mendieta-Zeron, Hugo

    2012-01-01

    This study sought to determine the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in patients with symptomatic and asymptomatic irreversible pulpitis in mandibular posterior teeth and if individual patient factors, pulpal disease characteristics, and previous medication are correlated to local anesthetic success. A second objective was to determine the specificity and sensibility of a cold test for prediction of anesthetic success prior to endodontic treatment. Seventy patients diagnosed with irreversible pulpitis in mandibular posterior teeth received 1.6 mL of 4% articaine with 1:100,000 epinephrine for an inferior alveolar nerve block (IANB) using a metal guide. The anesthetic solution was injected with a computer-preprogrammed delivery system for local anesthesia. Endodontic access was begun 15 minutes after solution deposition; later, patients rated their discomfort using the visual analog scale (VAS). The success rate for the IA NB using articaine was 64.2% in patients with symptomatic irreversible pulpitis and 86.9% in patients with asymptomatic irreversible pulpitis. Cold test prior to root canal treatment had a specificity and sensibility of 12.5% and 87.1%, respectively. The anesthetic efficacy of articaine in irreversible pulpitis is moderately acceptable, and anesthetic success increases when the patient has been premedicated with NSAIDs. The cold test appears to be a favorable indicator for predicting anesthetic success. PMID:22313992

  17. Bone Marrow Diseases

    MedlinePlus

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. ... the platelets that help with blood clotting. With bone marrow disease, there are problems with the stem cells ...

  18. Bone Marrow Transplantation

    MedlinePlus

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. ... platelets, which help the blood to clot. A bone marrow transplant is a procedure that replaces a person's ...

  19. Genetics of Bone Density

    MedlinePlus

    ... study linked 32 novel genetic regions to bone mineral density. The findings may help researchers understand why ... or treating osteoporosis. Bones are made of a mineral and protein scaffold filled with bone cells. Bone ...

  20. Calcium and bones

    MedlinePlus

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  1. Bone biopsy (image)

    MedlinePlus

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  2. Bone lesion biopsy

    MedlinePlus

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  3. The osteocyte: key player in regulating bone turnover

    PubMed Central

    Goldring, Steven R

    2015-01-01

    Osteocytes are the most abundant cell type in bone and are distributed throughout the mineralised bone matrix forming an interconnected network that ideally positions them to sense and to respond to local biomechanical and systemic stimuli to regulate bone remodelling and adaptation. The adaptive process is dependent on the coordinated activity of osteoclasts and osteoblasts that form a so called bone multicellular unit that remodels cortical and trabecular bone through a process of osteoclast-mediated bone resorption, followed by a phase of bone formation mediated by osteoblasts. Osteocytes mediate their effects on bone remodelling via both cell–cell interactions with osteoclasts and osteoblasts, but also via signaling through the release of soluble mediators. The remodelling process provides a mechanism for adapting the skeleton to local biomechanical factors and systemic hormonal influences and for replacing bone that has undergone damage from repetitive mechanical loading. PMID:26557372

  4. Bone development: overview of bone cells and signaling.

    PubMed

    Teti, Anna

    2011-12-01

    Vertebrates evolved elaborating a structure made up of more than 200 bones and cartilages articulated with one another to form the skeleton, through which locomotion, organ protection, lodging of hematopoiesis, and mineral homeostasis are allowed. Skeletogenesis starts at the fetal stage, along with marrow hematopoiesis, and evolves postnatally through modeling and remodeling processes that permit skeletal mass buildup. Preservation of skeletal mass is then implemented by balanced remodeling, which ensures continuous renovation of the tissue to allow its mechanical, structural, and metabolic properties to remain unaltered until ageing or diseases disrupt this equilibrium. Skeletal homeostasis is fulfilled by specialized bone cells in association with systemic and local regulators. Herein I review landmark discoveries that shed light on the intricate mesh connecting bone cells among themselves and with other systems, thus representing the cellular basis of normal and abnormal bone development and homeostasis. PMID:21948208

  5. BONE BANKS

    PubMed Central

    de Alencar, Paulo Gilberto Cimbalista; Vieira, Inácio Facó Ventura

    2015-01-01

    Bone banks are necessary for providing biological material for a series of orthopedic procedures. The growing need for musculoskeletal tissues for transplantation has been due to the development of new surgical techniques, and this has led to a situation in which a variety of hospital services have been willing to have their own source of tissue for transplantation. To increase the safety of transplanted tissues, standards for bone bank operation have been imposed by the government, which has limited the number of authorized institutions. The good performance in a bone bank depends on strict control over all stages, including: formation of well-trained harvesting teams; donor selection; conducting various tests on the tissues obtained; and strict control over the processing techniques used. Combination of these factors enables greater scope of use and numbers of recipient patients, while the incidence of tissue contamination becomes statistically insignificant, and there is traceability between donors and recipients. This paper describes technical considerations relating to how a bone bank functions, the use of grafts and orthopedic applications, the ethical issues and the main obstacles encountered. PMID:27026958

  6. Broken bone

    MedlinePlus

    ... from a height Motor vehicle accidents Direct blow Child abuse Repetitive forces, such as those caused by running, ... you can clearly see a deformity, assume the child has a broken bone and get medical help. Prevention Take the following steps to reduce your risk ...

  7. Late diagnosis of celiac disease in an asymptomatic infant with growth failure.

    PubMed

    Bozzola, Mauro; Bozzola, Elena; Pagani, Sara; Mascolo, Amelia; Porto, Rossella; Meazza, Cristina

    2014-01-01

    The clinical spectrum for celiac disease (CD) is broad and includes cases with either typical (intestinal) or atypical (extraintestinal) features, often making the diagnosis of CD very difficult.We describe the case of a girl presenting with stunted growth and malnourishment. She was evaluated at 14 months for decreased growth rate without any signs of gastrointestinal, renal or endocrine disorders. She was evaluated for CD, but resulted negative for anti-tTG antibodies.At the age of 4.1 years, she exhibited basal dental enamel hypoplasia, iron deficiency anaemia despite repeated iron supplementation, with persistent reduced height (-2.79 SDS), BMI (-0.76 SDS), growth velocity (-1.79 SDS) and delayed bone age (1.5 year). The CD screening was repeated and very high anti-tTG-IgA (128 IU/ml, normal values < 7 IU/ml) and anti-tTG-IgG (77 IU/ml, normal values < 7 IU/ml) values were found. HLA genotyping revealed an HLA DQ2 haplotype. A duodenal biopsy revealed severe villous atrophy with crypt hyperplasia and increased intraepithelial lymphocytes (> 40 IELs/100 epithelial cells) confirming the diagnosis of CD. A gluten-free diet was started and after only four months, her growth velocity increased from 4.83 cm/year (-1.79 SDS) to 6.53 cm/year (-0.15 SDS).In conclusion, we report the development of a positive serology for CD in an asymptomatic child with growth retardation, who previously was investigated for CD and resulted negative. Therefore, when faced with retarded growth in young patients, after excluding other malabsorption conditions and even when CD serological markers are negative, the paediatric endocrinologist should request HLA genotyping, before the intestinal biopsy, in order to check for the presence of risk alleles. PMID:24428915

  8. Assessing bone banking activities at University of Malaya medical centre.

    PubMed

    Mohd, Suhaili; Samsuddin, Sharifah Mazni; Ramalingam, Saravana; Min, Ng Wuey; Yusof, Norimah; Zaman, T Kamarul; Mansor, Azura

    2015-12-01

    The main advantage of establishing in-house bone banks is its ability to readily provide allograft bones for local surgeries. Bone procurement activities of our university bone bank during the 10 years of operation were reviewed. Socio-demographic data of donors, types of bone procured, cases of rejected bones and types of allograft bones transplanted are presented. From 179 potential donors, 73 % were accepted with 213 procured bones. Femoral head was the common bone transplanted (45 %), as it was also the most common procured (82 %). Bones were rejected mainly due to non-technical reasons (83 %) rather than positive results of microbiological (13 %) and serological (4 %) tests. Comprehensive data could not be obtained for further analysis due to difficulties in retrieving information. Therefore, quality assurance system was improved to establish more systematic documentations, as the basis of good banking practice with process control hence allowing traceability. PMID:25656787

  9. Asymptomatic Unilateral Hyperlucent Lung in a Prospective Kidney Donor.

    PubMed

    Lunia, Prajay; Karkhanis, Vinaya; Joshi, J M

    2015-09-01

    A 50 year old lady, prospective kidney donor was referred to our department for opinion in view of abnormal clinical findings during preoperative evaluation. She was asymptomatic from respiratory point of view. Her vital parameters were normal and on auscultation found to have decreased breath sounds and fine crackles throughout left hemithorax. Chest x-ray (CXR) showed left sided hyperlucency with small hilum (Figure 1). High resolution computed tomography (HRCT) showed scattered areas of bronchiectasis with associated air trapping throughout left lung with small left pulmonary artery (Figure 2). Sputum for acid fast bacilli (AFB) was negative. Spirometry showed moderate obstructive abnormality with forced expiratory volume in one second (FEV1) - 51% predicted, forced vital capacity (FVC) - 60% and FEV1/FVC - 76% with no bronchodilator reversibility. On post bronchodilator study there was paradoxical fall in FEV1/FVC to 72% consistent with small airway disease. Arterial blood gas analysis was normal. Technetium (Tc) 99m MAA lung perfusion scan (Figure3) showed normal perfusion of right lung contributing 75.4% of relative function and left lung contributing only 24.6%. Diagnosis of Swyer-James-MacLeod syndrome (SJMS) probably due to a childhood viral infection was made. Operative complications in such cases like difficult weaning and extubation, post-operative respiratory infections, collapse and respiratory failure are likely. However, our patient had an uneventful operative and post-operative course. SJMS is characterized by unilateral hyperlucency of a part of or the entire lung which was first described in 1953 by Swyer and James and later in 1954 by Macleod.1,2 It is considered to be an acquired disease as a result of post-infectious obliterative bronchiolitis. Productive cough, shortness of breath and sometimes hemoptysis are presenting symptoms. Some patients are asymptomatic and not diagnosed until they are adults.3 Radiologically it presents as predominant

  10. Seroepidemiology of Asymptomatic Dengue Virus Infection in Jeddah, Saudi Arabia

    PubMed Central

    Jamjoom, Ghazi A.; Azhar, Esam I.; Kao, Moujahid A.; Radadi, Raja M.

    2016-01-01

    BACKGROUND Although virologically confirmed dengue fever has been recognized in Jeddah, Saudi Arabia, since 1994, causing yearly outbreaks, no proper seroepidemiologic studies on dengue virus have been conducted in this region. Such studies can define the extent of infection by this virus and estimate the proportion that may result in disease. The aim of this study was to measure the seroprevalence of past dengue virus infection in healthy Saudi nationals from different areas in the city of Jeddah and to investigate demographic and environmental factors that may increase exposure to infection. METHODS Sera were collected from 1984 Saudi subjects attending primary health care centers in six districts of Jeddah. These included general patients of various ages seeking routine vaccinations, antenatal care or treatment of different illnesses excluding fever or suspected dengue. A number of blood donors were also tested. Serum samples were tested by enzyme immunoassay (EIA) for IgG antibodies to dengue viruses 1, 2, 3, 4. A questionnaire was completed for each patient recording various anthropometric data and factors that may indicate possible risk of exposure to mosquito bites and dengue infection. Patients with missing data and those who reported a history of dengue fever were excluded from analysis, resulting in a sample of 1939 patients to be analyzed. RESULTS The overall prevalence of dengue virus infection as measured by anti-dengue IgG antibodies from asymptomatic residents in Jeddah was 47.8% (927/1939) and 37% (68/184) in blood donors. Infection mostly did not result in recognizable disease, as only 19 of 1956 subjects with complete information (0.1%) reported having dengue fever in the past. Anti dengue seropositivity increased with age and was higher in males than females and in residents of communal housing and multistory buildings than in villas. One of the six districts showed significant increase in exposure rate as compared to the others. Availability of

  11. Molecular detection and genetic characterization of kobuviruses and astroviruses in asymptomatic local pigs in East Africa

    PubMed Central

    Okoth, Edward; Junga, Joseph O.; Ogara, William O.; Njahira, Moses N.; Wang, Qiuhong; Vlasova, Anastasia N.; Djikeng, Appolinaire

    2014-01-01

    In this study, swine fecal specimens (n = 251) collected from nursing and weaned piglets raised under smallholder production systems were screened for the presence of kobuviruses by RT-PCR. Porcine kobuviruses were detected in 13.1 % (33/251) of the samples. We demonstrated that porcine kobuvirus infections exist in indigenous pigs in Kenya and Uganda and that the prevalence was higher in young piglets than older pigs: nursing piglets (15 %), post-weaning (3-month-old) pigs (17 %), 4-month-old pigs (10 %). Genetic analysis of the partial RNA-dependent RNA polymerase (RdRp) region (690 nt) revealed that kobuviruses circulating in East Africa are diverse, sharing nucleotide sequence identities ranging from 89.7 to 99.1 % and 88 to 92.3 % among them and with known porcine kobuviruses, respectively. The nucleotide sequence identities between our kobuvirus strains and those of human, bovine and canine kobuviruses were 69.4-70.7 %, 73.1-74.4 % and 67-70.7 %, respectively. Additionally, upon sequencing selected samples that showed consistent 720-bp RT-PCR bands while using the same primer set, we detected porcine astroviruses in our samples belonging to type 2 and type 3 mamastroviruses. To our knowledge, this study reports the first detection and molecular analysis of both porcine kobuviruses and astroviruses in an African region. Further studies are required to determine the role of these viruses in gastrointestinal infections of pigs in this region and to determine the genetic diversity of the circulating strains to develop accurate diagnostic tools and implement appropriate control strategies. PMID:24327095

  12. Segregation of a M404V mutation of the p62/sequestosome 1 (p62/SQSTM1) gene with polyostotic Paget's disease of bone in an Italian family

    PubMed Central

    Falchetti, Alberto; Di Stefano, Marco; Marini, Francesca; Del Monte, Francesca; Gozzini, Alessia; Masi, Laura; Tanini, Annalisa; Amedei, Antonietta; Carossino, Annamaria; Isaia, Giancarlo; Brandi, Maria Luisa

    2005-01-01

    Mutations of the p62/Sequestosome 1 gene (p62/SQSTM1) account for both sporadic and familial forms of Paget's disease of bone (PDB). We originally described a methionine→valine substitution at codon 404 (M404V) of exon 8, in the ubiquitin protein-binding domain of p62/SQSTM1 gene in an Italian PDB patient. The collection of data from the patient's pedigree provided evidence for a familial form of PDB. Extension of the genetic analysis to other relatives in this family demonstrated segregation of the M404V mutation with the polyostotic PDB phenotype and provided the identification of six asymptomatic gene carriers. DNA for mutational analysis of the exon 8 coding sequence was obtained from 22 subjects, 4 PDB patients and 18 clinically unaffected members. Of the five clinically ascertained affected members of the family, four possessed the M404V mutation and exhibited the polyostotic form of PDB, except one patient with a single X-ray-assessed skeletal localization and one with a polyostotic disease who had died several years before the DNA analysis. By both reconstitution and mutational analysis of the pedigree, six unaffected subjects were shown to bear the M404V mutation, representing potential asymptomatic gene carriers whose circulating levels of alkaline phosphatase were recently assessed as still within the normal range. Taken together, these results support a genotype–phenotype correlation between the M404V mutation in the p62/SQSTM1 gene and a polyostotic form of PDB in this family. The high penetrance of the PDB trait in this family together with the study of the asymptomatic gene carriers will allow us to confirm the proposed genotype–phenotype correlation and to evaluate the potential use of mutational analysis of the p62/SQSTM1 gene in the early detection of relatives at risk for PDB. PMID:16277682

  13. Symptomatic versus asymptomatic pyeloplasties: A single institution review

    PubMed Central

    Metcalfe, Peter D.; Assmus, Mark; Kiddoo, Darcie

    2014-01-01

    Introduction: Historically, pyeloplasties have been performed after symptoms and radiographic confirmation of an ureteropelvic junction obstruction (UPJO). However, with prenatal ultrasonography, the approach to patients has fundamentally changed. Increasingly, patients are diagnosed and treated before the advent of morbidity, based on imaging findings alone. However, optimum screening strategies and thresholds for intervention vary significantly, are controversial, and are not founded on outcome-based evidence. We examined all pyeloplasties performed at our institution and reviewed their indication for surgery. We hypothesized that, despite ubiquitous screening for UPJO, most pyeloplasties had been performed secondary to symptoms and did not benefit from antenatal screening. Methods: A retrospective chart review was performed of all pyeloplasties performed at the Stollery Children’s Hospital, Edmonton, Alberta, over the past 8 years. Patients were categorized according to indication for surgery: symptomatic or asymptomatic. Results: Most (60%) of our pyeloplasties were performed for symptomatic indications. Furthermore, 12% of these patients had antenatally detected hydronephrosis that was thought to have resolved spontaneously during follow-up. Of our symptomatic patients, 37% were undergoing surveillance with the expectation for spontaneous resolution. Of the 29 patients who underwent pyeloplasty, 8 suffered a preoperative loss of function on renal scans; however, only 50% returned to within 90% of their original function. Conclusion: Despite active surveillance of antenatally detected hydronephrosis, most pyeloplasties at our institution were performed for de-novo symptoms. We believe that this simple observation reinforces that our current surveillance strategies are unable to predict and eliminate all morbidity from UPJO. PMID:25553157

  14. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population.

    PubMed Central

    Caugant, D A; Høiby, E A; Magnus, P; Scheel, O; Hoel, T; Bjune, G; Wedege, E; Eng, J; Frøholm, L O

    1994-01-01

    To estimate the extent of meningococcal carriage in the Norwegian population and to investigate the relationship of several characteristics of the population to the carrier state, 1,500 individuals living in rural and small-town areas near Oslo were selected at random from the Norwegian National Population Registry. These persons were asked to complete a questionnaire and to volunteer for a bacteriological tonsillopharyngeal swab sampling. Sixty-three percent of the selected persons participated in the survey. Ninety-one (9.6%) of the volunteers harbored Neisseria meningitidis. The isolates were serogrouped, serotyped, tested for antibiotic resistance, and analyzed by multilocus enzyme electrophoresis. Eight (8.8%) of the 91 isolates represented clones of the two clone complexes that have been responsible for most of the systemic meningococal disease in Norway in the 1980s. Age between 15 and 24, male sex, and active and passive smoking were found to be independently associated with meningococcal carriage in logistic regression analyses. Working outside the home and having an occupation in transportation or industry also increased the risk for meningococcal carriage in individuals older than 17, when corrections for gender and smoking were made. Assuming that our sample is representative of the Norwegian population, we estimated that about 40,000 individuals in Norway are asymptomatic carriers of isolates with epidemic potential. Thus, carriage eradication among close contacts of persons with systemic disease is unlikely to have a significant impact on the overall epidemiological situation. PMID:8150942

  15. Asymptomatic Isolated Retroperitoneal Castleman's Disease: A Case Report.

    PubMed

    Rajabiani, Afsaneh; Abdollahi, Alireza; Farahani, Zahra

    2015-09-01

    Castleman's disease, giant lymph node hyperplasia, is a kind of benign lymphoproliferative disease with gentle behavior. Its etiology and prevalence are unclear. This rare disease is usually found in mediastinal area asymptomatically and incidentally. It is also rare to see this tumor in the retroperitoneum. In this study, we have introduced a 34-year-old woman who referred just with occasional abdominal pain caused by compressive symptoms. Laboratory findings only reported microcytic anemia (MCH: 18.5, MCV: 63, Hemoglobin 10.2 g/dl). Chest and abdominal X-ray imaging showed no remarkable point. In abdominal ultrasonography, a solid and firm tumor with 12.2×5.3×6.6 cm was reported in patient's retroperitoneum. Patient's surgery was done and the tumor (covered by a fibrous thick capsule, with no bizarre appearance and bleeding) was completely removed. Pathologic examination indicated a Castleman's tumor, type of unicentric and hyaline-vascular. This item had been one of the rare reported items of Castleman's disease in the retroperitoneal space. PMID:26379356

  16. Asymptomatic Primary Merkel Cell Polyomavirus Infection among Adults

    PubMed Central

    Tolstov, Yanis L.; Knauer, Alycia; Chen, Jian Guo; Kensler, Thomas W.; Kingsley, Lawrence A.; Moore, Patrick S.

    2011-01-01

    Merkel cell polyomavirus (MCV) is a recently discovered virus that causes 80% of Merkel cell carcinomas. We examined data for 564 gay/bisexual male participants >18 years of age in the Multicenter AIDS Cohort Study in Pittsburgh, Pennsylvania, USA, and found that 447 (79.3%) were MCV-antibody positive at initial enrollment. Of the 117 MCV-seronegative men, 31 subsequently seroconverted over a 4-year follow-up period, corresponding to a 6.6% annual conversion rate. MCV immunoglobulin G levels remained detectable up to 25 years after exposure. No signs, symptoms, or routine diagnostic test results were associated with MCV infection, and no correlation between HIV infection or AIDS progression and MCV infection was noted. An initial correlation between chronic hepatitis B virus infection and MCV prevalence could not be confirmed among MCV seroconverters or in studies of a second hepatitis B virus–hyperendemic cohort from Qidong, China. In adults, MCV is typically an asymptomatic, common, and commensal viral infection that initiates rare cancers after virus (rather than host cell) mutations. PMID:21801612

  17. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    PubMed Central

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  18. Outcome and survival of asymptomatic PML in natalizumab-treated MS patients

    PubMed Central

    Dong-Si, Tuan; Richman, Sandra; Wattjes, Mike P; Wenten, Made; Gheuens, Sarah; Philip, Jeffrey; Datta, Shoibal; McIninch, James; Bozic, Carmen; Bloomgren, Gary; Richert, Nancy

    2014-01-01

    Objective As of 3 September 2013, 399 cases of natalizumab-associated progressive multifocal leukoencephalopathy (PML) were confirmed in multiple sclerosis (MS) patients. We evaluated outcomes of natalizumab-treated MS patients who were asymptomatic at PML diagnosis. Methods Analyses included data available as of 5 June 2013. Asymptomatic patients diagnosed with PML by magnetic resonance imaging (MRI) findings and JC virus DNA detection in the central nervous system were compared with patients presenting with symptoms at diagnosis. Demographics, MRI, and survival over 12 months were analyzed. Expanded Disability Status Scale (EDSS) and Karnofsky Performance Scale (KPS) scores were recorded pre-PML, at diagnosis, and at 6 and 12 months post-diagnosis. Results A total of 372 PML cases were analyzed; 30 patients were asymptomatic and 342 were symptomatic at PML diagnosis. Classifications of PML lesions on MRI in asymptomatic versus symptomatic patients were unilobar in 68% versus 37%, multilobar in 21% versus 24%, and widespread in 11% versus 40%. In both groups with unilobar lesions, frontal lobe lesions predominated. Prior to PML, mean EDSS and KPS scores were similar for asymptomatic and symptomatic patients. At diagnosis, mean EDSS score was significantly lower for asymptomatic patients (4.1; n = 11) than for symptomatic patients (5.4; n = 193; P = 0.038). Six months after PML diagnosis, asymptomatic patients had less functional disability than symptomatic patients. As of 5 June 2013, 96.7% of asymptomatic patients and 75.4% of symptomatic patients were alive. Interpretation PML patients asymptomatic at diagnosis had better survival and less functional disability than those who were symptomatic at diagnosis. PMID:25493267

  19. A Prospective Study of Asymptomatic Intracranial Atherosclerotic Stenosis in Neurologically Normal Volunteers in a Japanese Cohort

    PubMed Central

    Matsui, Ryukichi; Nakagawa, Tomonori; Takayoshi, Hiroyuki; Onoda, Keiichi; Oguro, Hiroaki; Nagai, Atsushi; Yamaguchi, Shuhei

    2016-01-01

    Atherosclerotic stenosis of major intracranial arteries is a leading cause of ischemic stroke in Asia. However, the long-term prognosis of asymptomatic intracranial atherosclerotic stenosis (ICAS) in healthy volunteers has not been fully examined. Here, we conducted a longitudinal study to examine the prognosis of healthy volunteers with asymptomatic ICAS and to determine the risk factors for ICAS, including asymptomatic brain parenchymal lesions. We studied 2,807 healthy Japanese volunteers with no history of stroke (mean age, 62.0 years). They were followed for a mean interval of 64.5 months. The degree of ICAS and the presence of asymptomatic brain lesions were assessed by using magnetic resonance imaging. Asymptomatic ICAS was detected in 166 volunteers (5.9%) at the initial examination. Moderate and mild stenoses were observed in 1.5 and 4.4% of patients, respectively. Significant risk factors for ICAS were older age and a history of hypertension and/or dyslipidemia. During follow-up, ischemic stroke developed in 32 volunteers. Seven strokes occurred in the ICAS group, whose stroke incidence rate was higher than that in the non-ICAS group (0.78 vs. 0.18% per year). According to a Cox regression analysis, asymptomatic ICAS was an independent risk factor for future ischemic stroke after adjustment for age. Furthermore, after asymptomatic brain lesions were taken into account, ICAS was still a significant risk factor for stroke onset. In conclusion, even mild to moderate asymptomatic ICAS was a significant risk factor for future stroke, independent of asymptomatic brain lesions, in a healthy Japanese population. Mild to moderate ICAS might be a therapeutic target for stroke prevention. PMID:27047445

  20. Bone banking and sterilization of bones

    NASA Astrophysics Data System (ADS)

    Minamisawa, I.; Itoman, M.; Maehara, H.; Kobayashi, A.; Watanabe, T.

    1995-08-01

    The use of banked bone (preserved allograft bone) is various and essential, because it has numerous advantages including the relative ease in retrieval a large amount of bone material and requisite shape and size. But bone banking and allografting must be promoted under obligation to stably supply safe and high-quality bone. To avoid transferring disease perfectly, irradiation sterilization is especially recommended at the present time.

  1. Comparison of Epicardial Adipose Tissue Volume and Coronary Artery Disease Severity in Asymptomatic Adults with versus without Diabetes Mellitus

    PubMed Central

    Groves, Elliott M.; Erande, Ashwini S.; Le, Christine; Salcedo, Jonathan; Hoang, Khiet C.; Kumar, Shivesh; Mohar, Dilbahar S.; Saremi, Farhood; Im, Jiye; Agrawal, Yashwant; Nadeswaran, Pradeep; Naderi, Nassim; Malik, Shaista

    2014-01-01

    Epicardial adipose tissue (EAT) has been shown to have important effects on the development of coronary artery disease (CAD) via local paracrine influences on the vascular bed. We compared a cohort of asymptomatic patients with Type II Diabetes (DM) without known CAD to an age and gender matched group of asymptomatic patients without DM from the CTRAD study in which patients underwent a cardiac computed tomography angiogram (CTA), for early detection of CAD. Mean EAT volumes of 118.6 ± 43.0 and 70.0 ± 44.0 cm3 were found in the DM and non-DM groups respectively. When stratified by presence and severity of CAD, it was found that in the DM (p=0.003) and non-DM groups (p<0.001) there was a statistically significant increase in EAT volume as the patients were found to have increasingly severe CAD. After adjusting for age, race, gender, DM, hypertension, insulin use, BMI, and coronary artery calcium (CAC) score, the presence of >120 cm3 of EAT was found to be highly correlated with the presence of significant CAD (Adjusted Odds Ratio 4.47, 95% CI (1.35–14.82)). We found that not only is EAT volume an independent predictor of CAD, but that an increasing volume of EAT predicted increasing severity of CAD even after adjustment for CAC score. PMID:25037677

  2. Handheld fluorescence imaging device detects subclinical wound infection in an asymptomatic patient with chronic diabetic foot ulcer: a case report.

    PubMed

    Wu, Yichao C; Smith, Marlie; Chu, Ashley; Lindvere-Teene, Liis; Starr, Danielle; Tapang, Kim; Shekhman, Rachel; Wong, Olive; Linden, Ron; DaCosta, Ralph S

    2016-08-01

    Chronic wounds are a significant burden to global patient and health care infrastructures, and there is a need for better methods of early wound diagnosis and treatment. Traditional diagnosis of chronic wound infection by pathogenic bacteria, using clinical signs and symptoms, is based on visual inspection under white light and microbiological sampling (e.g. swabbing and/or biopsy) of the wound, which are subjective and suboptimal. Diagnosing microbial infection based on traditional clinical signs and symptoms in wounds of asymptomatic patients is especially challenging at the bedside. Bacteria are invisible to the unaided eye and wound sampling for diagnostic testing can cause unacceptable delays in diagnosis and treatment. To address this problem, we developed a new prototype handheld, portable fluorescence imaging device that enables non-contact, real-time, high-resolution visualisation of pathogenic bacteria and tissues in wounds. Herein, we report the clinical use of this imaging device in detecting subsurface heavy bacterial load and subclinical local infection in an asymptomatic 50-year-old patient with a non-healing diabetic foot ulcer. PMID:25907362

  3. Loosening of the total knee arthroplasty: detection by radionuclide bone scanning. [/sup 99m/Tc-methylene diphosphonate

    SciTech Connect

    Hunter, J.C.; Hattner, R.S.; Murray, W.R.; Genant, H.K.

    1980-07-01

    Pain after total knee arthroplasty is a common clinical problem in orthopedics, and prosthetic loosening, often requiring surgical revision, is usually the etiology. Since standard clinical and radiographic diagnostic measures have not proven totally satisfactory, a study of the utility of bone scintigraphy to assess stability of the knee prosthesis was done. Thirty-five patients with 39 prostheses were studied. Seventeen patients with 21 total knee arthroplasties served as controls and were asymptomatic, were stable at surgery, or improved with conservative management. Eighteen knees in 18 symptomatic patients composed the experimental group. Of these, 11 knees were loose at surgery and seven have had surgery recommended. Scintigrams of the knees were obtained using /sup 99m/Tc-MDP, and ranked 0-3 corresponding to increasingly abnormal localization by three observers. Highly significant differences were observed between the abnormal and control groups (p<0.001). Reciprocal changes in sensitivity and specificity with increasingly stringent criteria were shown. While it is apparent that the bone scan cannot be used as the sole diagnostic method for evaluation of prosthetic stability, it does seem to be a useful adjunct along with clinical criteria and radiographic studies.

  4. Internal channel structures in trabecular bone

    NASA Astrophysics Data System (ADS)

    Scherf, Heike; Beckmann, Felix; Fischer, Jens; Witte, Frank

    2004-10-01

    Material properties of bone are crucial for studies regarding the mechanical behavior of bone. The mechanical behavior depends on the macro- and micro-architecture as well as the organic and mineral content of bone. The marco-architecture of bone is normally analyzed by plane radiographs. The micro-architecture of the trabecular bone can be imaged by high resolution CT imaging techniques using conventional x-ray tubes. However, fine structures in bone architecture cannot be sufficiently analyzed by this technique due to its limited resolution. High resolution CT imaging technique using synchrotron radiation generates images with a high spatial resolution of bone structures on a micron scale. Additionally, this imaging technique provides superior determination of local differences in the bone mineral density. Two microtomography techniques, first: based on conventional x-ray tubes and second: based on synchrotron radiation were compared in this study to detect fine bone structures such as inner trabecular channels. In two red howler monkeys (Alouatta seniculus) femora channel structures were found inside the trabecular bone by both techniques. Only synchrotron-based microtomography was able to detect layers of lower mineral density in the channel walls. The found structures in trabecular bone are normally expected in the Haversian channel walls of the cortical bone. However, the origin of the trabecular channel structure is not fully understood. We found, that synchrotron-based microtomography is a very valuable technique in the research of fine bone structures. Further research should focus on the impact of these findings on the mechanical properties of trabecular bone.

  5. Spatial audio through a bone conduction interface.

    PubMed

    MacDonald, Justin A; Henry, Paula P; Letowski, Tomasz R

    2006-10-01

    Headphones are the standard presentation device for radio communication in the military. Although bone conduction devices possess several advantages over headphones for some military applications, they are generally considered inappropriate for inclusion in a multi-channel system. The current study tested the feasibility of a multi-channel bone conduction system by measuring the localizability of spatialized auditory stimuli presented through a pair of bone conduction vibrators. Listeners localized a Gaussian noise stimulus spatialized with individualized head-related transfer functions (HRTFs). The sounds were presented from eight virtual locations on the horizontal plane (0, +/-45, +/-90, +/-135, and 180 degrees ) through either stereo headphones or a stereo bone conduction system. Localization performance was found to be nearly identical for both audio systems, indicating that bone conduction systems can be effectively used for displaying spatial information. PMID:17062501

  6. [Bone quantitative ultrasound].

    PubMed

    Matsukawa, Mami

    2016-01-01

    The conventional ultrasonic bone densitometry system can give us information of bone as ultrasonic wave velocity and attenuation. However, the data reflect both structural and material properties of bone. In order to focus only on the bone matrix properties without the effect of bone structure, studies of microscopic Brillouin scattering technique are introduced. The wave velocity in a trabecula was anisotropic and depended on the position and structure of the cancellous bone. The glycation also affected on the wave velocities in bone. As a new bone quality, the piezoelectricity of bone is also discussed. PMID:26728531

  7. [Long Bone Nonunion].

    PubMed

    Schmidmaier, G; Moghaddam, A

    2015-12-01

    The percentage of delayed or non-unions after fractures of long bones depends on the individual risk profile at approximately 10 %. The current definition states that a non-union is a fracture that will not consolidate without any further intervention - independent from the treatment time. At the early stage of a non-union a conservative treatment is possible in case of an adequately stable situation. The operative treatment depends on the type of the non-union. There are one-step or two-step procedures, all according to the principles of the "diamond concept". This means improvement of the mechanical situation - in most cases by means of a reosteosynthesis - and vascularization, local application of osteoconductive carriers e.g. tricalciumphosphate, vital cells from autologous bone and osteoinductive substances like bone morphogenetic proteins (BMP-2 or BMP-7). Hypertrophic and atrophic non-unions without large defect gaps or signs of infection can be treated with a one-step procedure. For treating infected non-unions or non-unions with large defect gaps the Masquelet technique is recommended. PMID:26670151

  8. Infection, Inflammation, and Bone Regeneration

    PubMed Central

    Thomas, M.V.; Puleo, D.A.

    2011-01-01

    Various strategies have been developed to promote bone regeneration in the craniofacial region. Most of these interventions utilize implantable materials or devices. Infections resulting from colonization of these implants may result in local tissue destruction in a manner analogous to periodontitis. This destruction is mediated via the expression of various inflammatory mediators and tissue-destructive enzymes. Given the well-documented association among microbial biofilms, inflammatory mediators, and tissue destruction, it seems reasonable to assume that inflammation may interfere with bone healing and regeneration. Paradoxically, recent evidence also suggests that the presence of certain pro-inflammatory mediators is actually required for bone healing. Bone injury (e.g., subsequent to a fracture or surgical intervention) is followed by a choreographed cascade of events, some of which are dependent upon the presence of pro-inflammatory mediators. If inflammation resolves promptly, then proper bone healing may occur. However, if inflammation persists (which might occur in the presence of an infected implant or graft material), then the continued inflammatory response may result in suboptimal bone formation. Thus, the effect of a given mediator is dependent upon the temporal context in which it is expressed. Better understanding of this temporal sequence may be used to optimize regenerative outcomes. PMID:21248364

  9. Abnormal systolic and diastolic myocardial function in obese asymptomatic adolescents.

    PubMed

    Batalli-Këpuska, Arbnora; Bajraktari, Gani; Zejnullahu, Murat; Azemi, Mehmedali; Shala, Mujë; Batalli, Arlind; Ibrahimi, Pranvera; Jashari, Fisnik; Henein, Michael Y

    2013-10-01

    Structural and functional cardiac changes are known in obese adults. We aimed to assess the relationship between body mass index (BMI) and cardiac function in overweight and obese asymptomatic adolescents. Ninety three healthy adolescents, aged 12.6 ± 1.2 years, received weight, height, BMI, waist, hips, waist/hips ratio assessment, hematology and biochemistry tests and an echocardiogram. Based on BMI, subjects were divided into: lean (L, n=32), overweight (Ov, n=33) and obese (Ob, n=32). Interventricular septal and LV posterior wall thickness were increased parallel to the BMI (L: 0.84 ± 0.1cm, Ov: 0.88 ± 0.1cm, Ob: 0.96 ± 0.1cm, p<0.001, and L: 0.78 ± 0.1cm, Ov: 0.8 ± 0.1cm, Ob: 0.94 ± 0.1cm, p<0.001, respectively) as were relative wall thickness (RWT) and mass index (LVMI) (L: 0.34 ± 0.05, Ov: 0.34 ± 0.05, Ob: 0.40 ± 0.04, p<0.001, and L: 47.7 ± 8.4 g/m(2), Ov: 51.9 ± 8.3g/m(2), Ob: 65.2 ± 13.3g/m(2), p=0<001, respectively). LV early diastolic (E') lateral and septal velocities (L: 15.3 ± 3.9 cm/s, Ov: 13.6 ± 4 cm/s, Ob: 10.5 ± 3.4 cm/s, p<0.001, and L: 12.2 ± 2.3 cm/s, Ov: 11.1 ± 2.4 cm/s, Ob: 9.8 ± 3.1cm/s, p=0.003, respectively), and systolic (S') velocities (L: 9.2 ± 1.4 cm/s, Ov: 9.3 ± 2.3 cm/s, Ob: 8.04 ± 1.5 cm/s, p=0.018, and L: 9.05 ± 2.3 cm/s, Ov: 9 ± 2.4 cm/s, Ob: 7.6 ± 1.1cm/s, p=0.014, respectively) were all reduced, only in obese adolescents. LV lateral E' (r=-0.44, p<0.001) and S' (r=-0.29, p=0.005) correlated with BMI. In asymptomatic adolescents, LV wall is thicker and diastolic function impaired and correlate with BMI. These findings demonstrate early cardiac functional disturbances which might explain the known obesity risk for cardiac disease. PMID:23416017

  10. [Insights into cystic fibrosis-related bone disease].

    PubMed

    Braun, C; Bacchetta, J; Reix, P

    2016-08-01

    With the increasing life expectancy of patients with cystic fibrosis (CF), prevalence of late complications such as CF-related bone disease (CFBD) has increased. It was initially described in 24% of the adult population with CF and has also been reported in the pediatric population. CFBD is multifactorial and progresses in different steps. Both decreased bone formation and increased bone resorption (in different amounts) are observed. CFBD is likely primitive (directly related to the CFTR defect itself), but is also worsened by acquired secondary factors such as lung infections, chronic inflammation, denutrition, vitamin deficiency, and decreased physical activity. CFBD may be clinically apparent (i.e., mainly vertebral and costal fractures), or clinically asymptomatic (therefore corresponding to abnormalities in bone density and architecture). CFBD management mainly aims to prevent the occurrence of fractures. Prevention and regular monitoring of bone disease as early as 8 years of age is of the utmost importance, as is the control of possible secondary deleterious CFBD factors. New radiological tools, such as high-resolution peripheral quantitative computed tomography, allow an accurate evaluation of cortical and trabecular bone micro-architecture in addition to compartmental density; as such, they will likely improve the assessment of the bone fracture threat in CF patients in the near future. PMID:27345551

  11. Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers.

    PubMed

    Mashberg, A; Samit, A

    1995-01-01

    An examination of the oral cavity and oropharynx in asymptomatic patients at high risk requires an orderly visual inspection of the entire oral and oropharyngeal mucosa with particular attention to the tongue, floor of mouth, soft palate, uvula, tonsillar pillars, and the lingual aspects of the retromolar trigones. Completion and clear documentation of the entire examination should be recorded. Detected lesions that do not resolve in a reasonable length of time--two to three weeks--require intense and assiduous investigation. The following specifics should be considered. 1. Alcohol drinkers and cigarette smokers, especially those 40 years of age and older, are at very high risk for the development of upper aerodigestive tract and lung squamous carcinomas. 2. The floor of the mouth, the ventrolateral tongue, and the soft palate complex are the high-risk sites within the oral cavity and oropharynx. 3. Persistent mucosal erythroplasia rather than leukoplakia is the earliest visual sign of oral and oropharyngeal carcinoma. These lesions should not be regarded merely as precancerous changes. The evidence indicates that these lesions in high-risk sites should be considered to be invasive carcinoma or carcinoma in situ unless proven otherwise by biopsy. 4. Toluidine blue staining is a useful diagnostic adjunct, particularly as a method of ruling out false-negative clinical impressions. It may also be used as a rinse in high-risk patients to encompass the entire oral mucosa after a negative clinical examination and as a guide to improve biopsy yields. 5. If oral or oropharyngeal cancer is identified, evaluations of the larynx, hypopharynx, esophagus, and lungs should be performed to rule out multiple primary cancers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7583906

  12. T1 Relaxation Time in Lungs of Asymptomatic Smokers

    PubMed Central

    Alamidi, Daniel F.; Kindvall, Simon S. I.; Hubbard Cristinacce, Penny L.; McGrath, Deirdre M.; Young, Simon S.; Naish, Josephine H.; Waterton, John C.; Wollmer, Per; Diaz, Sandra; Olsson, Marita; Hockings, Paul D.; Lagerstrand, Kerstin M.; Parker, Geoffrey J. M.; Olsson, Lars E.

    2016-01-01

    Purpose Interest in using T1 as a potential MRI biomarker of chronic obstructive pulmonary disease (COPD) has recently increased. Since tobacco smoking is the major risk factor for development of COPD, the aim for this study was to examine whether tobacco smoking, pack-years (PY), influenced T1 of the lung parenchyma in asymptomatic current smokers. Materials and Methods Lung T1 measurements from 35 subjects, 23 never smokers and 12 current smokers were retrospectively analyzed from an institutional review board approved study. All 35 subjects underwent pulmonary function test (PFT) measurements and lung T1, with similar T1 measurement protocols. A backward linear model of T1 as a function of FEV1, FVC, weight, height, age and PY was tested. Results A significant correlation between lung T1 and PY was found with a negative slope of -3.2 ms/year (95% confidence interval [CI] [-5.8, -0.6], p = 0.02), when adjusted for age and height. Lung T1 shortens with ageing among all subjects, -4.0 ms/year (95%CI [-6.3, -1.7], p = 0.001), and among the never smokers, -3.7 ms/year (95%CI [-6.0, -1.3], p = 0.003). Conclusions A correlation between lung T1 and PY when adjusted for both age and height was found, and T1 of the lung shortens with ageing. Accordingly, PY and age can be significant confounding factors when T1 is used as a biomarker in lung MRI studies that must be taken into account to detect underlying patterns of disease. PMID:26958856

  13. Nasopharyngeal carcinoma with bone marrow metastasis.

    PubMed

    Zen, H G; Jame, J M; Chang, A Y; Li, W Y; Law, C K; Chen, K Y; Lin, C Z

    1991-02-01

    Five of 23 patients with recurrent nasopharyngeal carcinoma (NPC) were diagnosed to have bone marrow metastasis. They all had advanced local-regional disease, and were treated with neoadjuvant chemotherapy and definitive radiotherapy after the initial diagnosis. Bone marrow metastasis developed 4-24 months later. The clinical features were anemia (5 of 5), leukopenia (3 of 5), thrombocytopenia (4 of 5), sepsis (3 of 5), tenderness of the sternum (3 of 5), and fever (4 of 5). Patients frequently had elevation of serum lactic dehydrogenase (LDH), alkaline phosphatase (ALK-P), and IgG and IgA antibody titers to Epstein-Barr viral capsid antigen when bone marrow involvement was diagnosed. However, clinical manifestations and laboratory tests were not specific. It is important that three patients had normal bone scans. All five patients had a rapid downhill course; four patients died within 23 days, and the fifth 3 months after the diagnosis of bone marrow metastasis. We concluded that bone marrow was a common metastatic site in NPC patients. Bone marrow metastasis adversely affected patients' survival and required a high index of suspicion for diagnosis. We suggested that bone marrow biopsy should be considered as a routine staging procedure in NPC patients and indicated especially when patients presented with abnormal blood counts, sepsis, bone pain, or tenderness of the sternum. It may be positive in the face of a normal bone scan. PMID:1987743

  14. Bone Adaptation and Regeneration - New Developments

    NASA Astrophysics Data System (ADS)

    Klein-Nulend, Jenneke; Bacabac, Rommel Gaud

    Bone is a dynamic tissue that is constantly renewed and adapts to its local loading environment. Mechanical loading results in adaptive changes in bone size and shape that strengthen bone structure. The mechanisms for adaptation involve a multistep process called mechanotransduction, which is the ability of resident bone cells to perceive and translate mechanical energy into a cascade of structural and biochemical changes within the cells. The transduction of a mechanical signal to a biochemical response involves pathways within the cell membrane and cytoskeleton of the osteocytes, the professional mechansensor cells of bone. During the last decade the role of mechanosensitive osteocytes in bone metabolism and turnover, and the lacuno-canalicular porosity as the structure that mediates mechanosensing, is likely to reveal a new paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Strain-derived fluid flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, as well as ensures transport of cell signaling molecules, nutrients and waste products. Cell-cell signaling from the osteocyte sensor cells to the effector cells (osteoblasts or osteoclasts), and the effector cell response - either bone formation or resorption, allow an explanation of local bone gain and loss as well as remodeling in response to fatigue damage as processes supervised by mechanosensitive osteocytes. The osteogenic activity of cultured bone cells has been quantitatively correlated with varying stress stimulations highlighting the importance of the rate of loading. Theoretically a possible mechanism for the stress response by osteocytes is due to strain amplification at the pericellular matrix. Single cell studies on molecular responses of osteocytes provide insight on local architectural alignment in bone during remodeling. Alignment seems to occur as a result of the

  15. Physiological bases of bone regeneration II. The remodeling process.

    PubMed

    Fernández-Tresguerres-Hernández-Gil, Isabel; Alobera-Gracia, Miguel Angel; del-Canto-Pingarrón, Mariano; Blanco-Jerez, Luis

    2006-03-01

    Bone remodeling is the restructuring process of existing bone, which is in constant resorption and formation. Under normal conditions, this balanced process allows the renewal of 5-10% of bone volume per year. At the microscopic level, bone remodeling is produced in basic multicellular units, where osteoclasts resorb a certain quantity of bone and osteoblasts form the osteoid matrix and mineralize it to fill the previously created cavity. These units contain osteoclasts, macrophages, preosteoblasts and osteoblasts, and are controlled by a series of factors, both general and local, allowing normal bone function and maintaining the bone mass. When this process becomes unbalanced then bone pathology appears, either in excess (osteopetrosis) or deficit (osteoporosis). The purpose of this study is to undertake a revision of current knowledge on the physiological and biological mechanisms of the bone remodeling process; highlighting the role played by the regulating factors, in particular that of the growth factors. PMID:16505794

  16. Bone scan appearances following bone and bone marrow biopsy

    SciTech Connect

    McKillop, J.H.; Maharaj, D.; Boyce, B.F.; Fogelman, I.

    1984-01-01

    Bone marrow and bone biopsies are performed not infrequently in patients referred for bone scans and represent a potential cause of a ''false positive'' focal abnormality on the bone scan. The authors have therefore examined the scan appearances in a series of patients who had undergone either sternal marrow biopsy, (Salah needle, diameter 1.2 mm) trephine iliac crest marrow biopsy (Jamshidi 11 gauge needle, diameter 3.5 mm) or a transiliac bone biopsy (needle diameter 8 mm). Of 18 patients studied 1 to 45 days after sternal marrow 17 had normal scan appearances at the biopsy site and 1 had a possible abnormality. None of 9 patients studied 4 to 19 days after trephine iliac crest marrow biopsy had a hot spot at the biopsy site. A focal scan abnormality was present at the biopsy site in 9/11 patients studied 5 to 59 days after a trans iliac bone biopsy. No resultant scan abnormality was seen in 4 patients imaged within 3 days of the bone biopsy or in 3 patients imaged 79 to 138 days after the procedure. Bone marrow biopsy of the sternum or iliac crest does not usually cause bone scan abnormalities. A focal abnormality at the biopsy site is common in patients imaged 5 days to 2 months after bone biopsy. The gauge of the needle employed in the biopsy and thus the degree of bone trauma inflicted, is likely to be main factor determining the appearance of bone scan abnormalities at the biopsy site.

  17. Asymptomatic natural Chlamydia pecorum infection reduces growth rates in calves by up to 48 percent

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Intracellular Chlamydia (C.) bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. Much more frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infecti...

  18. Bone site-specific delivery of siRNA

    PubMed Central

    Liu, Xinli

    2016-01-01

    Abstract Small interfering RNAs (siRNA) have enormous potential as therapeutics to target and treat various bone disorders such as osteoporosis and cancer bone metastases. However, effective and specific delivery of siRNA therapeutics to bone and bone-specific cells in vivo is very challenging. To realize the full therapeutic potential of siRNA in treating bone disorders, a safe and efficient, tissue- and cell-specific delivery system must be developed. This review focuses on recent advances in bone site-specific delivery of siRNA at the tissue or cellular level. Bone-targeted nanoparticulate siRNA carriers and various bone-targeted moieties such as bisphosphonates, oligopeptides (Asp)8 and (AspSerSer)6, and aptamers are highlighted. Incorporation of these bone-seeking targeting moieties into siRNA carriers allows for recognition of different sub-tissue functional domains of bone and also specific cell types residing in bone tissue. It also provides a means for bone-formation surface-, bone-resorption surface-, or osteoblast-specific targeting and transportation of siRNA therapeutics. The discussion mainly focuses on systemic and local bone-specific delivery of siRNA in osteoporosis and bone metastasis preclinical models. PMID:26642236

  19. Stafne’s Bone Cavity: A Diagnostic Challenge

    PubMed Central

    Das, Sunanda; Gupta, Swati; Patel, Pranay; Saha, Nairita

    2015-01-01

    Stafne’s bone cavity is a rare, asymptomatic, unilateral oval shaped radiolucent defect in the posterior region of the mandible below the inferior alveolar canal. The prevalence ranges from 0.10% to 0.48% and more common in males. It is mostly an incidental finding on panoramic radiograph. This radiolucency is considered to be a deformity of the medial cortex. This article presents five rare cases of Stafne’s bone cavity which were referred for opinion or wrongly diagnosed by practicing health professionals as jaw tumour leading to psychological distress in these patients. This article also focuses on reviewing the published literature, differential diagnosis along with use of various diagnostic imaging resources for this bone defect and to add five new Indian cases to the literature. PMID:26673626

  20. Whole body bone scintigraphy in osseous hydatosis: a case report

    PubMed Central

    Ebrahimi, Abdolali; Assadi, Majid; Saghari, Mohsen; Eftekhari, Mohammad; Gholami, Amir; Ghasemikhah, Reza; Assadi, Sakineh

    2007-01-01

    Hydatid disease is common in many parts of the world, and causes considerable health and economic loss. This disease may develop in almost any part of the body. Bone involvement is often asymptomatic, and its diagnosis is primarily based on radiographic findings. A whole body bone scan is able to show the extent and distribution of lesions. We describe an unusual case of multifocal skeletal hydatosis and also explain the clinical and diagnostic points. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider this disease as a differential diagnosis in cases of multiple abnormal activity in bone scintigraphy especially among people in endemic areas. PMID:17880713

  1. Asymptomatic Intrahepatic Portosystemic Venous Shunt: To Treat or Not To Treat?

    PubMed

    Palvanov, Arkadiy; Marder, Ruth Leah; Siegel, David

    2016-09-01

    Intrahepatic portosystemic venous shunts (IPSVSs) are rare vascular malformations. They can be asymptomatic or present with various symptoms including encephalopathy. We present two cases of IPSVS, one involving a patient presenting with altered mental status and the other discovered incidentally. While there is no question that patients presenting with symptomatic IPSVS should undergo definitive treatment, there is no consensus regarding elective therapy for asymptomatic lesions. PMID:27574389

  2. Impact of Daily Cotrimoxazole on Clinical Malaria and Asymptomatic Parasitemias in HIV-Exposed, Uninfected Infants

    PubMed Central

    Davis, Nicole L.; Barnett, Eric J.; Miller, William C.; Dow, Anna; Chasela, Charles S.; Hudgens, Michael G.; Kayira, Dumbani; Tegha, Gerald; Ellington, Sascha R.; Kourtis, Athena P.; van der Horst, Charles; Jamieson, Denise J.; Juliano, Jonathan J.

    2015-01-01

    Background. Cotrimoxazole preventive therapy (CPT) is recommended for all human immunodeficiency virus (HIV)–exposed infants to avoid opportunistic infections. Cotrimoxazole has antimalarial effects and appears to reduce clinical malaria infections, but the impact on asymptomatic malaria infections is unknown. Methods. We conducted an observational cohort study using data and dried blood spots (DBSs) from the Breastfeeding, Antiretrovirals and Nutrition study to evaluate the impact of CPT on malaria infection during peak malaria season in Lilongwe, Malawi. We compared malaria incidence 1 year before and after CPT implementation (292 and 682 CPT-unexposed and CPT-exposed infants, respectively), including only infants who remained HIV negative by 36 weeks of age. Malaria was defined as clinical, asymptomatic (using DBSs at 12, 24, and 36 weeks), or a composite outcome of clinical or asymptomatic. Linear and binomial regression with generalized estimating equations were used to estimate the association between CPT and malaria. Differences in characteristics of parasitemias and drug resistance polymorphisms by CPT status were also assessed in the asymptomatic infections. Results. CPT was associated with a 70% (95% confidence interval, 53%–81%) relative reduction in the risk of asymptomatic infection between 6 and 36 weeks of age. CPT appeared to provide temporary protection against clinical malaria and more sustained protection against asymptomatic infections, with no difference in parasitemia characteristics. Conclusions. CPT appears to reduce overall malaria infections, with more prolonged impacts on asymptomatic infections. Asymptomatic infections are potentially important reservoirs for malaria transmission. Therefore, CPT prophylaxis may have important individual and public health benefits. PMID:25900173

  3. Plastin 3 is upregulated in iPSC-derived motoneurons from asymptomatic SMN1-deleted individuals.

    PubMed

    Heesen, Ludwig; Peitz, Michael; Torres-Benito, Laura; Hölker, Irmgard; Hupperich, Kristina; Dobrindt, Kristina; Jungverdorben, Johannes; Ritzenhofen, Swetlana; Weykopf, Beatrice; Eckert, Daniela; Hosseini-Barkooie, Seyyed Mohsen; Storbeck, Markus; Fusaki, Noemi; Lonigro, Renata; Heller, Raoul; Kye, Min Jeong; Brüstle, Oliver; Wirth, Brunhilde

    2016-05-01

    Spinal muscular atrophy (SMA) is a devastating motoneuron (MN) disorder caused by homozygous loss of SMN1. Rarely, SMN1-deleted individuals are fully asymptomatic despite carrying identical SMN2 copies as their SMA III-affected siblings suggesting protection by genetic modifiers other than SMN2. High plastin 3 (PLS3) expression has previously been found in lymphoblastoid cells but not in fibroblasts of asymptomatic compared to symptomatic siblings. To find out whether PLS3 is also upregulated in MNs of asymptomatic individuals and thus a convincing SMA protective modifier, we generated induced pluripotent stem cells (iPSCs) from fibroblasts of three asymptomatic and three SMA III-affected siblings from two families and compared these to iPSCs from a SMA I patient and control individuals. MNs were differentiated from iPSC-derived small molecule neural precursor cells (smNPCs). All four genotype classes showed similar capacity to differentiate into MNs at day 8. However, SMA I-derived MN survival was significantly decreased while SMA III- and asymptomatic-derived MN survival was moderately reduced compared to controls at day 27. SMN expression levels and concomitant gem numbers broadly matched SMN2 copy number distribution; SMA I presented the lowest levels, whereas SMA III and asymptomatic showed similar levels. In contrast, PLS3 was significantly upregulated in mixed MN cultures from asymptomatic individuals pinpointing a tissue-specific regulation. Evidence for strong PLS3 accumulation in shaft and rim of growth cones in MN cultures from asymptomatic individuals implies an important role in neuromuscular synapse formation and maintenance. These findings provide strong evidence that PLS3 is a genuine SMA protective modifier. PMID:26573968

  4. Localized scleroderma.

    PubMed

    Kreuter, Alexander

    2012-01-01

    Localized scleroderma (also called morphea) is a term encompassing a spectrum of sclerotic autoimmune diseases that primarily affect the skin, but also might involve underlying structures such as the fat, fascia, muscle, and bones. Its exact pathogenesis is still unknown, but several trigger factors in genetically predisposed individuals might initially lead to an immunologically triggered release of pro-inflammatory cytokines, resulting in a profound dysregulation of the connective tissue metabolism and ultimately to induction of fibrosis. To date, there are no specific serological markers available for localized scleroderma. Within the last years, several validated clinical scores have been introduced as potential outcome measures for the disease. Given the rarity of localized scleroderma, only few evidence-based therapeutical treatment options exist. So far, the most robust data is available for ultraviolet A1 phototherapy in disease that is restricted to the skin, and methotrexate alone or in combination with systemic corticosteroids in more severe disease that additionally affects extracutaneous structures. This practical review summarizes relevant information on the epidemiology, pathogenesis, clinical subtypes and classifications, differential diagnoses, clinical scores and outcome measures, and current treatment strategies of localized scleroderma. PMID:22741933

  5. Asymptomatic and chronic carriage of Leptospira interrogans serovar Pomona in California sea lions (Zalophus californianus).

    PubMed

    Prager, K C; Greig, Denise J; Alt, David P; Galloway, Renee L; Hornsby, Richard L; Palmer, Lauren J; Soper, Jennifer; Wu, Qingzhong; Zuerner, Richard L; Gulland, Frances M D; Lloyd-Smith, James O

    2013-05-31

    Since 1970, periodic outbreaks of leptospirosis, caused by pathogenic spirochetes in the genus Leptospira, have caused morbidity and mortality of California sea lions (Zalophus californianus) along the Pacific coast of North America. Yearly seasonal epizootics of varying magnitude occur between the months of July and December, with major epizootics occurring every 3-5 years. Genetic and serological data suggest that Leptospira interrogans serovar Pomona is the infecting serovar and is enzootic in the California sea lion population, although the mechanism of persistence is unknown. We report asymptomatic carriage of Leptospira in 39% (33/85) of wild, free-ranging sea lions sampled during the epizootic season, and asymptomatic seroconversion with chronic asymptomatic carriage in a rehabilitated sea lion. This is the first report of asymptomatic carriage in wild, free-ranging California sea lions and the first example of seroconversion and asymptomatic chronic carriage in a sea lion. Detection of asymptomatic chronic carriage of Leptospira in California sea lions, a species known to suffer significant disease and mortality from the same Leptospira strain, goes against widely-held notions regarding leptospirosis in accidental versus maintenance host species. Further, chronic carriage could provide a mechanism for persistent circulation of Leptospira in the California sea lion population, particularly if these animals shed infectious leptospires for months to years. PMID:23419822

  6. High Prevalence of Plasmodium falciparum Infection in Asymptomatic Individuals from the Democratic Republic of the Congo

    PubMed Central

    Mvumbi, Dieudonné Makaba; Bobanga, Thierry Lengu; Melin, Pierrette; De Mol, Patrick; Kayembe, Jean-Marie Ntumba; Situakibanza, Hippolyte Nani-Tuma; Mvumbi, Georges Lelo; Nsibu, Célestin Ndosimao; Umesumbu, Solange Efundu; Hayette, Marie-Pierre

    2016-01-01

    Malaria remains a major public health problem in the Democratic Republic of Congo (DRC) with 14 million cases reported by the WHO Malaria Report in 2014. Asymptomatic malaria cases are known to be prevalent in endemic areas and are generally untreated, resulting in a significant source of gametocytes that may serve as reservoir of disease transmission. Considering that microscopy certainly underestimates the prevalence of Plasmodium infections within asymptomatic carriers and that PCR assays are currently recognized as the most sensitive methods for Plasmodium identification, this study was conducted to weigh the asymptomatic carriage in DRC by a molecular method. Six provinces were randomly selected for blood collection in which 80 to 100 individuals were included in the study. Five hundred and eighty blood samples were collected and molecular diagnosis was performed. Globally, almost half of the samples collected from asymptomatic individuals (280/580; 48.2%) had Plasmodium infections and the most species identified was P. falciparum alone in combination with P. malariae. The high prevalence reported here should interpellate the bodies involved in malaria control in DR Congo to take into account asymptomatic carriers in actions taken and consider asymptomatic malaria as a major hurdle for malaria elimination. PMID:26942036

  7. Gray matter volumes in symptomatic and asymptomatic offspring of parents diagnosed with bipolar disorder.

    PubMed

    Hanford, Lindsay C; Hall, Geoffrey B; Minuzzi, Luciano; Sassi, Roberto B

    2016-09-01

    Children of parents diagnosed with bipolar disorder (BD), termed high-risk offspring (HRO), are at greater risk of developing psychiatric disorders compared to healthy children of healthy parents (HCO). Gray matter volume (GMV) abnormalities have been observed in HRO, however, these reports are inconsistent. We posit that this variability may be attributed to differences in methodology among offspring studies; in particular, the presence of psychiatric symptoms in HRO. Here, we directly compared GMVs between symptomatic and asymptomatic HRO, and HCO. High-resolution T1-weighted MR images were collected from 31 HRO (18 symptomatic and 13 asymptomatic) and 20 age- and sex-matched HCO. HRO had at least one parent diagnosed with BD. Symptomatic HRO were defined as having a psychiatric diagnosis other than BD, while asymptomatic HRO were required to be free of any psychiatric diagnosis. Scans were processed using voxel-based morphometry methods and between group analyses were performed in SPM. Compared to HCO, the HRO group showed decreased GMV in the right inferior orbitofrontal, right middle frontal, and bilateral superior and middle temporal regions. Both symptomatic and asymptomatic HRO groups showed decreased GMV in these regions separately when compared to HCO. When comparing symptomatic and asymptomatic HRO, GMVs were comparable in all regions except the lateral occipital cortex. Our study compared symptomatic and asymptomatic HRO directly. In doing so, we provided further support for the presence of discrete GMV deficits in HRO, and confirmed that these deficits are present irrespective of the presence of symptoms in HRO. PMID:26767977

  8. Transcriptional regulation differs in affected facioscapulohumeral muscular dystrophy patients compared to asymptomatic related carriers

    PubMed Central

    Arashiro, Patricia; Eisenberg, Iris; Kho, Alvin T.; Cerqueira, Antonia M. P.; Canovas, Marta; Silva, Helga C. A.; Pavanello, Rita C. M.; Verjovski-Almeida, Sergio; Kunkel, Louis M.; Zatz, Mayana

    2009-01-01

    Facioscapulohumeral muscular dystrophy (FSHD) is a progressive muscle disorder that has been associated with a contraction of 3.3-kb repeats on chromosome 4q35. FSHD is characterized by a wide clinical inter- and intrafamilial variability, ranging from wheelchair-bound patients to asymptomatic carriers. Our study is unique in comparing the gene expression profiles from related affected, asymptomatic carrier, and control individuals. Our results suggest that the expression of genes on chromosome 4q is altered in affected and asymptomatic individuals. Remarkably, the changes seen in asymptomatic samples are largely in products of genes encoding several chemokines, whereas the changes seen in affected samples are largely in genes governing the synthesis of GPI-linked proteins and histone acetylation. Besides this, the affected patient and related asymptomatic carrier share the 4qA161 haplotype. Thus, these polymorphisms by themselves do not explain the pathogenicity of the contracted allele. Interestingly, our results also suggest that the miRNAs might mediate the regulatory network in FSHD. Together, our results support the previous evidence that FSHD may be caused by transcriptional dysregulation of multiple genes, in cis and in trans, and suggest some factors potentially important for FSHD pathogenesis. The study of the gene expression profiles from asymptomatic carriers and related affected patients is a unique approach to try to enhance our understanding of the missing link between the contraction in D4Z4 repeats and muscle disease, while minimizing the effects of differences resulting from genetic background. PMID:19339494

  9. Facts about Broken Bones

    MedlinePlus

    ... las fracturas de huesos Your bones are tough stuff — but even tough stuff can break. Like a wooden pencil, bones will ... that? Get a lot of physical activity, especially stuff like jumping and running. Feed your bones the ...

  10. Bone marrow aspiration

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003658.htm Bone marrow aspiration To use the sharing features on this page, please enable JavaScript. Bone marrow is the soft tissue inside bones that helps ...

  11. Bone density scan (image)

    MedlinePlus

    ... bone the higher the risk of fractures. A bone scan, along with a patient's medical history, is a ... and whether any preventative treatment is needed. A bone density scan has the advantage of being painless and exposing ...

  12. Smoking and Bone Health

    MedlinePlus

    ... direct relationship between tobacco use and decreased bone density. Analyzing the impact of cigarette smoking on bone ... hard to determine whether a decrease in bone density is due to smoking itself or to other ...

  13. Menopause and Bone Loss

    MedlinePlus

    ... You reach your highest bone mass (size and density) at about age 30. Then, sometime between age ... your bones, your doctor may do a bone density test (DEXA scan). This test gives exact measurements ...

  14. [Evaluation of bone sterngth].

    PubMed

    Mashiba, Tasuku

    2016-01-01

    Biomechanical testing of the bone provides the most important and direct information about bone strength. This article explains biomechanical priciples including structural mechanical properties and intrinsic material properties, and serves actual biomechanical testing tedhniques for bone specimens. PMID:26728529

  15. Bone marrow biopsy

    MedlinePlus

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used. Marrow is removed ...

  16. Body Composition in Individuals with Asymptomatic Osteoarthritis of the Knee.

    PubMed

    Ho-Pham, Lan T; Lai, Thai Q; Mai, Linh D; Doan, Minh C; Nguyen, Tuan V

    2016-02-01

    Greater body mass index (BMI) is associated with a greater risk of osteoarthritis (OA). This study sought to investigate whether the association is mediated by fat mass or lean mass. The study involved 170 men and 488 women aged between 20 and 90 (average age: 55) who were randomly recruited from Ho Chi Minh City, Vietnam. The presence of knee OA was radiographically diagnosed based on the Kellgren-Lawrence criteria. Lean mass (LM) and fat mass (FM) were obtained from the DXA whole body scan (Hologic QDR-4500). The relationship between OA, LM, and FM was analyzed by a series of multiple linear regression models which take into account the effects of gender and age. As expected, men and women with knee OA were older than those without OA (65 vs 51 year in men, and 64 vs 52 year in women). After adjusting for age, OA was associated with greater FM and percent body fat (PBF), but the association was only observed in women, not in men. There was no statistically significant difference in LM between OA and non-OA individuals. Moreover, after adjusting for age and BMI or PBF, bone density in OA patients was not significantly different from non-OA individuals. Women with OA of the knee have greater fat mass than non-OA individuals, and that there is no significant difference in bone density between OA and non-OA individuals. Thus, the association between body mass index and OA is mainly mediated by fat mass. PMID:26590808

  17. A study of stress-free living bone and its application to space flight

    NASA Technical Reports Server (NTRS)

    Leblanc, A.; Spira, M.

    1983-01-01

    Observations of animals and human subjects in weightless space flight (Skylab and COSMOS) document altered bone metabolism. Bone metabolism is affected by a number of local and systemic factors. The calcification and growth of transplanted bone is independent of local muscle, nervous, and mechanical forces; therefore, transplanted bone would provide data on the role of local vs. systematic factors. Bone metabolism in living transplanted bone, devoid of stress, was investigated as a possible tool for the investigation of countermeasures against disuse bone loss. An animal model using Sprague-Dawley rats was developed for transplantation of femur bone tissue on a nutrient vascular pedicel. The long term course of these implants was assessed through the measure of regional and total bone mineral, blood flow, and methylene diphosphonate (MDP) uptake. Clomid, an estrogen agonist/antagonist, was shown to protect bone from disuse loss of minerals by retarding trabecular and cortical resorption.

  18. Computed tomography analysis of guinea pig bone: architecture, bone thickness and dimensions throughout development

    PubMed Central

    Witkowska, Agata; Alibhai, Aziza; Hughes, Chloe; Price, Jennifer; Klisch, Karl; Sturrock, Craig J.

    2014-01-01

    The domestic guinea pig, Cavia aperea f. porcellus, belongs to the Caviidae family of rodents. It is an important species as a pet, a source of food and in medical research. Adult weight is achieved at 8–12 months and life expectancy is ∼5–6 years. Our aim was to map bone local thickness, structure and dimensions across developmental stages in the normal animal. Guinea pigs (n = 23) that had died of natural causes were collected and the bones manually extracted and cleaned. Institutional ethical permission was given under the UK Home Office guidelines and the Veterinary Surgeons Act. X-ray Micro Computed Tomography (microCT) was undertaken on the left and right scapula, humerus and femur from each animal to ascertain bone local thickness. Images were also used to undertake manual and automated bone measurements, volumes and surface areas, identify and describe nutrient, supratrochlear and supracondylar foramina. Statistical analysis between groups was carried out using ANOVA with post-hoc testing. Our data mapped a number of dimensions, and mean and maximum bone thickness of the scapula, humerus and femur in guinea pigs aged 0–1 month, 1–3 months, 3–6 months, 6 months–1 year and 1–4 years. Bone dimensions, growth rates and local bone thicknesses differed between ages and between the scapula, humerus and femur. The microCT and imaging software technology showed very distinct differences between the relative local bone thickness across the structure of the bones. Only one bone showed a singular nutrient foramen, every other bone had between 2 and 5, and every nutrient canal ran in an oblique direction. In contrast to other species, a supratrochlear foramen was observed in every humerus whereas the supracondylar foramen was always absent. Our data showed the bone local thickness, bone structure and measurements of guinea pig bones from birth to 4 years old. Importantly it showed that bone development continued after 1 year, the point at which most

  19. The Celiac Disease and Diabetes-Dietary Intervention and Evaluation Trial (CD-DIET) protocol: a randomised controlled study to evaluate treatment of asymptomatic coeliac disease in type 1 diabetes

    PubMed Central

    Mahmud, Farid H; De Melo, Emilia N; Noordin, Karima; Assor, Esther; Sahota, Kamaljeet; Davies-Shaw, Jolie; Cutz, Ernest; Somers, Gino; Lawson, Margaret; Mack, David R; Gallego, Patricia; McDonald, Charlotte; Beaton, Melanie D; Bax, Kevin; Saibil, Fred; Gilbert, Jeremy; Kirsch, Susan; Perkins, Bruce A; Cino, Maria; Szentgyorgyi, Eva; Koltin, Dror; Parikh, Amish; Mukerji, Geetha; Advani, Andrew; Lou, Olivia; Marcon, Margaret A

    2015-01-01

    Introduction Coeliac disease (CD) is an autoimmune condition characterised by gluten-induced intestinal inflammation, and observed at a 5–10 fold greater prevalence in type 1 diabetes. While universal screening for CD in patients with diabetes is frequently advocated, objective data is limited as to benefits on diabetes control, bone health or quality of life related to the adoption of a gluten-free diet (GFD) in the large proportion of patients with diabetes with asymptomatic CD. The Celiac Disease and Diabetes-Dietary Intervention and Evaluation Trial (CD-DIET) study is a multicenter, randomised controlled trial to evaluate the efficacy and safety of a GFD in patients with type 1 diabetes with asymptomatic CD. Methods and analysis Children and adults (8–45 years) with type 1 diabetes will be screened for asymptomatic CD. Eligible patients with biopsy-proven CD will be randomly assigned in a 1:1 ratio to treatment with a GFD for 1 year, or continue with a gluten-containing diet. The primary outcome will evaluate the impact of the GFD on change in glycated haemoglobin. Secondary outcomes will evaluate changes in bone mineral density, blood glucose variability and health-related quality of life between GFD-treated and the regular diet group over a 1-year period. The study was initiated in 2012 and has subsequently expanded to multiple paediatric and adult centres in Ontario, Canada. Ethics and dissemination The findings from this study will provide high-quality evidence as to the impact of GFD treatment on glycaemic control and complications in asymptomatic children and adults with CD and type 1 diabetes. Trial registration number NCT01566110. PMID:25968008

  20. Combined spinal-epidural anesthesia for lumbar discectomy in a patient with asymptomatic severe aortic stenosis: a case report

    PubMed Central

    Kim, Young Sung; Park, Ji Hye; Lee, Shin Young; Kim, Heezoo; Lee, Il-ok; Kong, Myoung-Hoon

    2014-01-01

    The use of neuraxial anesthesia has traditionally been contraindicated in patients with severe aortic stenosis. However, general anesthesia can be riskier than neuraxial anesthesia for severe aortic stenosis patients undergoing spinal surgeries in the prone position as this can cause a major reduction in cardiac output secondary to diminished preload. In addition, general anesthesia, muscle relaxation, and positive-pressure ventilation can decrease venous return and reduce vascular tone, further compromising cardiac output. Combined spinal-epidural anesthesia with closely monitored, careful titration of the local anesthetic dose can be an efficient and safe anesthetic method for managing such patients. We describe the successful management of combined spinal-epidural anesthesia in an asymptomatic severe aortic stenosis patient scheduled for lumbar discectomy. PMID:25237450

  1. Bone marrow transplant - discharge

    MedlinePlus

    Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity; Non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - ...

  2. Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

    PubMed Central

    Koycheva, Reneta Yovcheva; Cholakov, Vasil; Andreev, Jivko; Penev, Margarit; Iliev, Rosen; Nancheva, Krasimira; Tsoneva, Vanya

    2016-01-01

    BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure. MATERIAL AND METHODS: We studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH), and gr B - 8 patients (without LVH). RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05) after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47) and weaker with hs CRP (r = 0.163). Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966), for NT-proBNP (r = 0.918) and for hs CRP (r = 0.859). It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng/mL, p < 0.05) and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg/mL, p < 0.05). Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

  3. Aneurysmal bone cyst of medial end of clavicle in a child, a rare case report.

    PubMed

    Yashavntha, Kumar C; Nalini, K B; Menon, Jagdish; Patro, D K

    2014-06-01

    Aneurysmal bone cyst is a locally aggressive benign tumor accounting for 3 % of all benign bone tumors. It most commonly arises from ends of long bones and relatively rare in flat bones. Clavicle is a very rare site for bone tumors with secondaries more common than primaries. Very few cases of aneurysmal bone cyst have been reported in literature. We hereby report interesting and a rare case of aneurysmal bone cyst of medial end of clavicle in a eight year old lady which was treated with extended curettage and calcium sulfate bone grafting. PMID:25114473

  4. Bone demineralization

    NASA Technical Reports Server (NTRS)

    Mack, P. B.; Vose, G. P.; Vogt, F. B.; Lachance, P. A.

    1971-01-01

    Crew members of the Gemini 4, Gemini 5, and Gemini 7 missions were compared regarding skeletal changes in three major anatomic sites with respect to changes in skeletal density during space flight. Bone-mass changes have been found for the command pilot and the pilot of each mission in the conventional os calcis section, in the combined sections covering 60 percent of the os calcis, and in hand phalanges 5-2 and 4-2. Comparison of radiographically determined losses in X-ray absorbence with X-ray absorbence losses in healthy young men subjected to bedrest immobilization for the same length of time showed that losses for the crewmembers exceeded losses for the bedrest subjects in all cases; this was an indication that restriction of body movement did not represent the only factor involved.

  5. Exercise, lifestyle, and your bones

    MedlinePlus

    Osteoporosis - exercise; Low bone density - exercise ... Osteoporosis is a disease that causes bones to become brittle and more likely to fracture (break). With osteoporosis, the bones lose density. Bone density is the amount of bone ...

  6. Investigation of Gastroduodenal Mucosal Injury in Japanese Asymptomatic Antiplatelet Drug Users.

    PubMed

    Sogabe, Masahiro; Okahisa, Toshiya; Nakasono, Masahiko; Fujino, Yasuteru; Mitsui, Yasuhiro; Takaoka, Yoshihumi; Kimura, Tetsuo; Okamoto, Koichi; Muguruma, Naoki; Takayama, Tetsuji

    2015-07-01

    Antiplatelet drugs are widely used for the prevention of cardiovascular disease and cerebral vascular disorders. Although there have been several studies on gastroduodenal mucosal injury with gastrointestinal (GI) symptoms such as GI bleeding, in antiplatelet drug users (including low-dose aspirin (LDA)), there have been few reports on the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users. This study was a cross-sectional study elucidating the association between antiplatelet drug use and gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Subjects were 186 asymptomatic Japanese antiplatelet drug users who underwent a regular health checkup. Subjects were divided into those with and without gastroduodenal mucosal injury endoscopically, and the association between gastroduodenal mucosal injury and other data in asymptomatic antiplatelet drug users was investigated.The prevalence of males and drinkers were significantly higher in subjects with gastroduodenal mucosal injury than in those without. In addition, the prevalence of proton pump inhibitor (PPI) users was significantly lower in subjects with gastroduodenal mucosal injury than in subjects without gastroduodenal mucosal injury. Logistic regression analysis showed PPI (odds ratios: 0.116; 95% confidence intervals: 0.021-0.638; P < 0.05) was a significant predictor of a decreased prevalence of gastroduodenal mucosal injury and closed-type (C-type) atrophy (3.172; 1.322-7.609; P < 0.01) was a significant predictor of an increased prevalence of severe gastroduodenal mucosal injury in asymptomatic antiplatelet drug users.Gender and lifestyle, such as drinking, may have an impact on risk of gastroduodenal mucosal injury in asymptomatic subjects taking antiplatelet drugs. Although PPI is a significant predictor of a decreased prevalence of gastroduodenal mucosal injury, including in asymptomatic antiplatelet drug users, status of

  7. Increased microcirculation detected by dynamic contrast-enhanced magnetic resonance imaging is of prognostic significance in asymptomatic myeloma.

    PubMed

    Hillengass, Jens; Ritsch, Judith; Merz, Maximilian; Wagner, Barbara; Kunz, Christina; Hielscher, Thomas; Laue, Hendrik; Bäuerle, Tobias; Zechmann, Christian M; Ho, Anthony D; Schlemmer, Heinz-Peter; Goldschmidt, Hartmut; Moehler, Thomas M; Delorme, Stefan

    2016-07-01

    This prospective study aimed to investigate the prognostic significance of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) as a non-invasive imaging technique delivering the quantitative parameters amplitude A (reflecting blood volume) and exchange rate constant kep (reflecting vascular permeability) in patients with asymptomatic monoclonal plasma cell diseases. We analysed DCE-MRI parameters in 33 healthy controls and 148 patients with monoclonal gammopathy of undetermined significance (MGUS) or smouldering multiple myeloma (SMM) according to the 2003 IMWG guidelines. All individuals underwent standardized DCE-MRI of the lumbar spine. Regions of interest were drawn manually on T1-weighted images encompassing the bone marrow of each of the 5 lumbar vertebrae sparing the vertebral vessel. Prognostic significance for median of amplitude A (univariate: P < 0·001, hazard ratio (HR) 2·42, multivariate P = 0·02, HR 2·7) and exchange rate constant kep (univariate P = 0·03, HR 1·92, multivariate P = 0·46, HR 1·5) for time to progression of 79 patients with SMM was found. Patients with amplitude A above the optimal cut-off point of 0·89 arbitrary units had a 2-year progression rate into symptomatic disease of 80%. In conclusion, DCE-MRI parameters are of prognostic significance for time to progression in patients with SMM but not in individuals with MGUS. PMID:26991959

  8. Morphological Changes in the Bone Marrow of the Dogs with Visceral Leishmaniasis

    PubMed Central

    Jacintho, Ana Paula Prudente; Moreira, Pamela Rodrigues Reina; Munari, Danísio Prado; Machado, Gisele Fabrino; Vasconcelos, Rosemeri de Oliveira

    2014-01-01

    The aim of this study was to evaluate the most frequent lesions in the bone marrow of dogs naturally infected by Leishmania (Leishmania) chagasi. Thirty-three dogs sacrificed at the Zoonosis Control Center of Araçatuba, a municipality endemic for visceral leishmaniasis (VL), were used. The animals were classified as asymptomatic, oligosymptomatic, and symptomatic groups. At the necropsy, bone marrow samples were collected from the femur, fixed, processed, and stained with hematoxylin and eosin. The lesion intensity was classified as mild, moderate, or severe. The parasite load was determined using immunohistochemistry. The most important lesions consisted of multifocal to diffuse granulomas, megakaryocytic dysplasia, and medullary aplasia. There were no statistical differences between the three clinical groups regarding parasite load and lesion intensity. Asymptomatic dogs also presented high parasitism in the bone marrow as dogs with clinical signs of VL. It was concluded that, regardless of clinical group, the bone marrow is a site for multiplication of Leishmania chagasi. Possibly, the bone marrow dysplasia may arise from the presence of many parasitized and activated macrophages in this organ. Consequently, it affects the profile of hematopoietic cells in the bone marrow and systemic circulation. PMID:24744957

  9. Effects of simulated weightlessness on bone mineral metabolism

    NASA Technical Reports Server (NTRS)

    Globus, R. K.; Bikle, D. D.; Morey-Holton, E.

    1984-01-01

    It is pointed out that prolonged space flight, bedrest, and immobilization are three factors which can produce a negative calcium balance, osteopenia, and an inhibition of bone formation. It is not known whether the effects of gravity on bone mineral metabolism are mediated by systemic endocrine factors which affect all bones simultaneously, or by local factors which affect each bone individually. The present investigation has the objective to test the relative importance of local vs. systemic factors in regulating the bone mineral response to conditions simulating weightlessness. Experiments were conducted with male Sprague-Dawley rats. The test conditions made it possible to compare the data from weighted and unweighted bones in the same animal. The obtained findings indicate that a decrease in bone mass relative to control value occurs rapidly under conditions which simulate certain aspects of weightlessness. However, this decrease reaches a plateau after 10 days.

  10. Stafne’s bone cavity: An unusual case with involvement of the buccal and lingual mandibular plates

    PubMed Central

    Figueiredo, Rui; Gay-Escoda, Cosme

    2014-01-01

    Lingual mandibular bone defects, also known as Stafne bone cavity (SC), are unilateral asymptomatic radiolucencies, generally seen in the mandibular angle, below the inferior alveolar canal. Although panoramic radiographies normally offer enough information to make a correct diagnosis, additional studies are often required, especially in atypical cases. The present report describes an atypical presentation of a Stafne’s bone cavity in a 78 years-old male patient. In this particular case, an asymptomatic and radiolucid lesion was observed during a routine dental examination. The computed tomography (CT) showed an involvement of both lingual and buccal mandibular plates producing a tunnel-like lesion. No history of mandibular trauma or surgery was refered. An additional magnetic resonance imaging (MRI) was made to discard submandibular gland pathology and to confirm the diagnosis. Since SC is asymptomatic and nonprogressive, a conservative approach based in clinical and radiological follow-ups was considered to be the most suitable treatment option. Key words:Stafne bone cavity, lingual mandibular bone defect, case report. PMID:24596643

  11. Bone scan appearances following biopsy of bone and bone marrow

    SciTech Connect

    McKillop, J.H.; Maharaj, D.; Boyce, B.F.; Fogelman, I.

    1984-10-01

    The influence of sternal marrow aspiration, iliac crest marrow aspiration, and iliac crest bone biopsy on bone scan appearances was examined. Eighteen patients were scanned a mean of 9.9 days after sternal marrow aspiration with a Salah needle. Bone scans obtained in 9 patients a mean of 10 days aftr iliac crest trephine marrow biopsy with a Jamshidi needle showed no abnormality at the biopsy site. In 18 patients with metabolic bone disease who had undergone iliac crest bone biopsy with an 8 mm needle, a scan abnormality due to the biopsy was usually present when the interval between the biopsy and the scan was 5 days to 2 months. Patients who were scanned within 3 days of iliac crest bone biopsy or more than 2 months after biopsy had normal scan appearance at the biopsy site.

  12. A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter.

    PubMed

    Santhosh, Sampath; Bhattacharya, Anish; Verma, Roshan Kumar; Lal, Anupam; Mittal, Bhagwant Rai

    2016-01-01

    A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions. PMID:26917894

  13. A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter

    PubMed Central

    Santhosh, Sampath; Bhattacharya, Anish; Verma, Roshan Kumar; Lal, Anupam; Mittal, Bhagwant Rai

    2016-01-01

    A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions. PMID:26917894

  14. Effects of prostaglandin on experimental bone malignancy and on scintigrams of bone and marrow. [Rabbits

    SciTech Connect

    Otsuka, N.; Ito, Y.; Nagai, K.; Terashima, H.; Yanagimoto, S.; Muranaka, A.

    1981-05-01

    The correlation between prostaglandin E (PgE) and scintigrams of bone (Tc-99m MDP) and bone marrow (Tc-99m SC) was investigated in normal and VX-2-bearing rabbits. PgE in plasma of normal rabbits was 486.2. In rabbits with VX-2 transplanted into femoral muscles, PgE was in the normal range unless the tumor invaded bone. PgE was not increase significantly in rabbits when the tumor was transplanted into the marrow cavity. When tumor invaded bone, PgE increassed markedly (to 1335). Elevation of PgE did not necessarily coincide with the appearance of positive bone scans. PgE in an indomethacin-treated group did not necessarily coincide with the appearance of positive bone scans. PgE in an indomethacin-treated group did not higher than in the untreated group. Indomethacin may suppress the local acceleration of calcium metabolism.

  15. Postmenopausal bone loss and the risk of osteoporosis.

    PubMed

    Christiansen, C

    1994-01-01

    The two most important risk factors for long-term skeletal health are the peak bone mass and the subsequent rate of bone loss. The rate of bone loss after skeletal maturity is determined by both genetic factors and environmental factors. Furthermore, all factors that impair estrogen production will increase bone loss. The present risk of developing osteoporosis and fractures may be assessed by bone mass measurements in the total skeleton, or in local parts of the skeleton such as the spine, hip and forearm, by single-photon/X-ray absorptiometry (SPA or SXA), dual-photon/energy X-ray absorptiometry (DPA or DXA), or quantitative computed tomography (QCT). Furthermore, the rate of bone loss in postmenopausal women may be assessed by means of a number of biochemical markers. The fútúre risk of developing osteoporosis may thus be determined by combining the values for bone mineral content and bone loss. PMID:8081059

  16. Bone grafts in dentistry

    PubMed Central

    Kumar, Prasanna; Vinitha, Belliappa; Fathima, Ghousia

    2013-01-01

    Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation. PMID:23946565

  17. Bone Marrow Transplantation

    MedlinePlus

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The ... platelets, which help the blood to clot. A bone marrow transplant is a procedure that replaces a ...

  18. New therapeutic targets for cancer bone metastases

    PubMed Central

    Krzeszinski, Jing Y.; Wan, Yihong

    2015-01-01

    Bone metastases are dejected consequences of many types of tumors including breast, prostate, lung, kidney and thyroid cancers. This complicated process begins with the successful tumor cell epithelial–mesenchymal transition, escape from the original site, and penetration into circulation. The homing of tumor cells to the bone depends on both tumor-intrinsic traits and various molecules supplied by the bone metastatic niche. The colonization and growth of cancer cells in the osseous environment, which awaken their dormancy to form micro- and macro-metastasis, involve an intricate interaction between the circulating tumor cells and local bone cells including osteoclasts, osteoblasts, adipocytes and macrophages. In this review, we discuss the most recent advances in the identification of new molecules and novel mechanisms during each step of bone metastasis that may serve as promising therapeutic targets. PMID:25962679

  19. [Palliative radiotherapy for metastatic bone tumor].

    PubMed

    Yoshida, Kenji; Hiratsuka, Junichi

    2006-04-01

    Bone metastases are one of the most common conditions requiring radiation therapy today. Its main aim is relief of bone pain, prevention of pathological bone fractures as well as its healing, with anticipated effect upon improving mobility, function, and quality of life. For localized bone pain, external beam radiation therapy (EBRT) will be successful in reducing pain in some 80% of patients. However, optimal fraction dose and total doses of EBRT required for pain relief have been unknown. According to the recent reports, carbon ion radiotherapy seems to be a safe and effective modality in the management of metastatic bone tumor not eligible for conventional EBRT. For scattered painful metastases, the systemic administration of radioisotopes is thought to be effective. PMID:16582516

  20. Microtomographic imaging in the process of bone modeling and simulation

    NASA Astrophysics Data System (ADS)

    Mueller, Ralph

    1999-09-01

    Micro-computed tomography ((mu) CT) is an emerging technique to nondestructively image and quantify trabecular bone in three dimensions. Where the early implementations of (mu) CT focused more on technical aspects of the systems and required equipment not normally available to the general public, a more recent development emphasized practical aspects of micro- tomographic imaging. That system is based on a compact fan- beam type of tomograph, also referred to as desktop (mu) CT. Desk-top (mu) CT has been used extensively for the investigation of osteoporosis related health problems gaining new insight into the organization of trabecular bone and the influence of osteoporotic bone loss on bone architecture and the competence of bone. Osteoporosis is a condition characterized by excessive bone loss and deterioration in bone architecture. The reduced quality of bone increases the risk of fracture. Current imaging technologies do not allow accurate in vivo measurements of bone structure over several decades or the investigation of the local remodeling stimuli at the tissue level. Therefore, computer simulations and new experimental modeling procedures are necessary for determining the long-term effects of age, menopause, and osteoporosis on bone. Microstructural bone models allow us to study not only the effects of osteoporosis on the skeleton but also to assess and monitor the effectiveness of new treatment regimens. The basis for such approaches are realistic models of bone and a sound understanding of the underlying biological and mechanical processes in bone physiology. In this article, strategies for new approaches to bone modeling and simulation in the study and treatment of osteoporosis and age-related bone loss are presented. The focus is on the bioengineering and imaging aspects of osteoporosis research. With the introduction of desk-top (mu) CT, a new generation of imaging instruments has entered the arena allowing easy and relatively inexpensive access to

  1. Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis: A Single Center Experience in Japan

    PubMed Central

    Horiguchi, Sadaaki; Shirato, Hiroyuki; Kawakami, Toshimitsu; Ono, Hisako; Yabuki, Shiho; Jojima, Kumiko; Niimi, Masanori

    2015-01-01

    Objective: Prevalence of asymptomatic deep vein thrombosis (DVT) in patients with primary varicose veins remains unclear. Materials and Methods: Here, we conducted a retrospective study to clarify the incidence of asymptomatic DVT in patients with varicose veins, especially focusing on those with superficial thrombophlebitis (STP). Results: Among 431 patients with primary varicose veins with saphenous vein incompetence, 20 (4.64%) had asymptomatic DVT. The presence of STP was a significant risk factor for asymptomatic DVT as 10 of the 24 (41.7%) patients with STP had asymptomatic DVT, and all cases having calf muscle vein thrombosis. In contrast, of the patients with primary varicose veins without STP only 2.46% had asymptomatic DVT. Conclusions: In patients with primary varicose veins with STP, significant risk factors for DVT were being over C3 on the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. (This article is a translation of Jpn J Phlebol 2014; 25: 13–19.) PMID:27087866

  2. Should radiofrequency current ablation be performed in asymptomatic patients with the Wolff-Parkinson-White syndrome?

    PubMed

    Steinbeck, G

    1993-03-01

    The exiting new method of ablation of accessory pathways using radiofrequency current applied by catheters will dramatically change our therapeutic decisions in these patients in the near future. This brief survey reviews the existing literature about the risk of the disease as well as of the procedure of catheter ablation. From these data, the risk of sudden death appears to be extremely low in asymptomatic Wolff-Parkinson-White (WPW) individuals. Side effects of catheter ablation may result from the invasive procedure as well as from radiation exposure (the latter to the patient as well as to operating physicians). While the complication rate in experienced centers is extremely low, a multicenter registry of the success and complication rate is urgently needed in view of the many centers starting with catheter ablation. Based on a subjective benefit-to-risk analysis, asymptomatic WPW individuals should be offered catheter ablation only under special circumstances (high risk profession, athletes, family history of sudden death). On the other hand, catheter ablation need not be and should not be considered generally in asymptomatic individuals with WPW pattern. Finally, this author cannot imagine that the energy, time, and money spent for mass screening and eventual catheter ablation of asymptomatic WPW individuals with its attending risks can be outweighed by the potential benefits for these asymptomatic individuals. PMID:7681970

  3. A new screening pathway for identifying asymptomatic patients using dental panoramic radiographs

    NASA Astrophysics Data System (ADS)

    Hayashi, Tatsuro; Matsumoto, Takuya; Sawagashira, Tsuyoshi; Tagami, Motoki; Katsumata, Akitoshi; Hayashi, Yoshinori; Muramatsu, Chisako; Zhou, Xiangrong; Iida, Yukihiro; Matsuoka, Masato; Katagi, Kiyoji; Fujita, Hiroshi

    2012-03-01

    To identify asymptomatic patients is the challenging task and the essential first step in diagnosis. Findings of dental panoramic radiographs include not only dental conditions but also radiographic signs that are suggestive of possible systemic diseases such as osteoporosis, arteriosclerosis, and maxillary sinusitis. Detection of such signs on panoramic radiographs has a potential to provide supplemental benefits for patients. However, it is not easy for general dental practitioners to pay careful attention to such signs. We addressed the development of a computer-aided detection (CAD) system that detects radiographic signs of pathology on panoramic images, and the design of the framework of new screening pathway by cooperation of dentists and our CAD system. The performance evaluation of our CAD system showed the sensitivity and specificity in the identification of osteoporotic patients were 92.6 % and 100 %, respectively, and those of the maxillary sinus abnormality were 89.6 % and 73.6 %, respectively. The detection rate of carotid artery calcifications that suggests the need for further medical evaluation was approximately 93.6 % with 4.4 false-positives per image. To validate the utility of the new screening pathway, preliminary clinical trials by using our CAD system were conducted. To date, 223 panoramic images were processed and 4 asymptomatic patients with suspected osteoporosis, 7 asymptomatic patients with suspected calcifications, and 40 asymptomatic patients with suspected maxillary sinusitis were detected in our initial trial. It was suggested that our new screening pathway could be useful to identify asymptomatic patients with systemic diseases.

  4. Asymptomatic Malaria and Associated Risk Factors among School Children in Sanja Town, Northwest Ethiopia

    PubMed Central

    Worku, Ligabaw; Damtie, Demekech; Endris, Mengistu; Getie, Sisay

    2014-01-01

    Introduction. Asymptomatic malaria is prevalent in highly endemic areas of Africa and is new challenge for malaria prevention and control strategies. Objective. To determine the prevalence of asymptomatic malaria and associated risk factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March 2013, on 385 school children selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. Giemsa-stained thin and thick blood films were examined for detection, identification, and quantification of malaria parasites. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of asymptomatic malaria was 6.8% (n = 26). The majority of parasitemic study participants had low parasite density 65.5% (17/26). Level of grade, age, bed net usage, and frequent exposure to malaria infection were associated with risk of asymptomatic malaria. Conclusion. Asymptomatic malaria was low in this study area and is associated with level of grade, age, bed net usage, and frequent exposure to malaria infection. PMID:27355032

  5. The complexities of malaria disease manifestations with a focus on asymptomatic malaria

    PubMed Central

    2012-01-01

    Malaria is a serious parasitic disease in the developing world, causing high morbidity and mortality. The pathogenesis of malaria is complex, and the clinical presentation of disease ranges from severe and complicated, to mild and uncomplicated, to asymptomatic malaria. Despite a wealth of studies on the clinical severity of disease, asymptomatic malaria infections are still poorly understood. Asymptomatic malaria remains a challenge for malaria control programs as it significantly influences transmission dynamics. A thorough understanding of the interaction between hosts and parasites in the development of different clinical outcomes is required. In this review, the problems and obstacles to the study and control of asymptomatic malaria are discussed. The human and parasite factors associated with differential clinical outcomes are described and the management and treatment strategies for the control of the disease are outlined. Further, the crucial gaps in the knowledge of asymptomatic malaria that should be the focus of future research towards development of more effective malaria control strategies are highlighted. PMID:22289302

  6. Gas Bubbles in the Bone: A Case Report

    PubMed Central

    Abbasi, Bita; Seilanian-Toosi, Farrokh; Nekooei, Sirous; Kakhki, Behrang Rezvani

    2016-01-01

    Intraosseous pneumatocysts are benign gas-filled cavities within bones which are most commonly found in ilium, sacrum and vertebrae. The lesions are asymptomatic and found incidentally while evaluating for other injuries. Here, we present an intraosseous pneumatocyst of ilium in a 23-year-old male patient. Although once thought to be rare, intraossseous pneumatocyst are now believed to be more common. Thus, familiarity with their appearance is essential to avoid unnecessary workup. Intraosseous pneumatocysts are differentiated from more clinically significant differential diagnoses like osteonecrosis and osteomyelitis by their characteristic appearance of intraosseous air collections with sclerotic rim.

  7. Does running strengthen bone?

    PubMed

    Boudenot, Arnaud; Achiou, Zahra; Portier, Hugues

    2015-12-01

    Bone is a living tissue needing mechanical stress to maintain strength. Traditional endurance exercises offer only modest effects on bone. Walking and running produce low impact but lead to bone fatigue. This article is specifically addressed to therapists and explains the mechanisms involved for the effects of exercise on bone. Intermittent exercise limits bone fatigue, and downhill exercises increase ground impact forces and involve eccentric muscle contractions, which are particularly osteogenic. PMID:26562001

  8. Basic bone radiology

    SciTech Connect

    Griffiths, H.J.

    1987-01-01

    This clinical book surveys the skeletal system as seen through radiological imaging. It emphasizing abnormalities, disease, and trauma, and includes vital information on bones, bone growth, and the cells involved in bone pathology. It covers many bone diseases and injuries which are rarely covered in medical texts, as well as descriptions of radiologic procedures that specifically relate to the skeleton. This edition includes many illustrations, information on MR imaging and CT scanning, and discussions of osteoporosis, dysplasias, and metabolic bone disease.

  9. Imaging appearance of bone tumors of the maxillofacial region

    PubMed Central

    Razek, Ahmed Abdel Khalek Abdel

    2011-01-01

    This paper reviews the imaging appearance of benign and malignant bone tumors of the maxillofacial region. A benign bone tumor commonly appears as a well circumscribed lesion. The matrix of the tumor may be calcified or sclerotic. Malignancies often display aggressive characteristics such as cortical breakthrough, bone destruction, a permeative pattern and associated soft-tissue masses. Computed tomography scan is an excellent imaging modality for accurate localization of the lesion, characterization of the tumor matrix and detection of associated osseous changes such as bone remodeling, destruction or periosteal reaction. Magnetic resonance imaging is of limited value in the evaluation of maxillofacial bone tumors. PMID:21666818

  10. Anorexia nervosa and bone.

    PubMed

    Misra, Madhusmita; Klibanski, Anne

    2014-06-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure, and reduced bone strength, all of which contribute to increased fracture risk. Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising additional concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, and hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiological estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age, given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  11. Anorexia Nervosa and Bone

    PubMed Central

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiologic estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  12. Electrophysiology testing and catheter ablation are helpful when evaluating asymptomatic patients with Wolff-Parkinson-White pattern: the pro perspective.

    PubMed

    Pappone, Carlo; Santinelli, Vincenzo

    2015-09-01

    Important advances in the natural history and diagnosis of, and therapy for, asymptomatic Wolff-Parkinson-White (WPW) syndrome have been made in the last decade by our group. These data have necessitated revisiting current practice guidelines to decide on the optimal management of the asymptomatic WPW population. There has also been an emphasis on identifying initially asymptomatic individuals who are at risk by nationwide screening programs using the electrocardiogram for prophylactic catheter ablation to prevent the lifetime risk of sudden cardiac death, particularly in young asymptomatic people, because only a subgroup of them is at high risk, requiring early catheter ablation. PMID:26304515

  13. Management of soft tissue and bone sarcomas

    SciTech Connect

    Van Oosterom, A.T.; Van Unnik, J.A.M.

    1986-01-01

    This book contains 32 papers. Some of the titles are: Adjuvant Treatment for Osteosarcoma of the Limbs; Trial 20781 of the SIOP and the EORTC Radiotherapy/Chemotherapy; Application of Magnetic Resonance Imaging (MRI) in Diagnosis and Follow-up During Treatment of Bone Tumors; Radiological Assessment of Local Involvement in Bone Sarcomas; and Prevention of Lung Metastases by Irradiation Alone or Combined with Chemotherapy in an Animal Model.

  14. Neonatal osteomyelitis examined by bone scintigraphy

    SciTech Connect

    Bressler, E.L.; Conway, J.J.; Weiss, S.C.

    1984-09-01

    Thirty-three infants less than six weeks of age and suspected of having osteomyelitis were examined by bone scintigraphy. Each of the 25 sites of proved osteomyelitis in 15 individuals demonstrated abnormal radionuclide localization. Ten additional scintigraphically positive but radiographically normal sites were detected. Optimal quality scintigrams of the growth plate complex and osteomyelitis in neonates appeared similar to those in older children. All neonates suspected of having osteomyelitis should be studied with bone scintigraphy following initial radiographs.

  15. Natural History, Diagnostic Approaches, and Therapeutic Strategies for Patients With Asymptomatic Severe Aortic Stenosis.

    PubMed

    Généreux, Philippe; Stone, Gregg W; O'Gara, Patrick T; Marquis-Gravel, Guillaume; Redfors, Björn; Giustino, Gennaro; Pibarot, Philippe; Bax, Jeroen J; Bonow, Robert O; Leon, Martin B

    2016-05-17

    Aortic stenosis (AS) is one of the most common valvular diseases encountered in clinical practice. Current guidelines recommend aortic valve replacement (AVR) when the aortic valve is severely stenotic and the patient is symptomatic; however, a substantial proportion of patients with severe AS are asymptomatic at the time of first diagnosis. Although specific morphological valve features, exercise testing, stress imaging, and biomarkers can help to identify patients with asymptomatic severe AS who may benefit from early AVR, the optimal management of these patients remains uncertain and controversial. The current report presents a comprehensive review of the natural history and the diagnostic evaluation of asymptomatic patients with severe AS, and is followed by a meta-analysis from reported studies comparing an early AVR strategy to active surveillance, with an emphasis on the level of evidence substantiating the current guideline recommendations. Finally, perspectives on directions for future investigation are discussed. PMID:27049682

  16. Antibody isotypes in urethral swabs of symptomatic and asymptomatic men infected with Trichomonas vaginalis.

    PubMed

    Imam, Naglaa F A; Eassa, Ahmed H A; Shoeib, Eman Y S; Abo-Raia, Gamal Y S

    2007-12-01

    Trichomoniasis may be asymptomatic or symptomatic in both sexes. The outcome of infection depends on the virulence factors of T. vaginalis, but these factors remain unclear. Genetic variability of the isolates and the host's immune response are likely to be key factors in that respect. Symptomatic and asymptomatic males infected with T. vaginalis were compared regarding the differences in antibody subclasses response in the urethral samples. In symptomatic cases there was a significant elevation in IgM, IgG1 & IgG2b levels in urethral samples, and a little, non-significant rise in IgG2a levels. However, there were no statistically significant differences between levels of IgA, IgG3 & IgG4. The results showed that specific IgG1 & IgM and to a lesser extent IgG2 may be involved in established symptomatic trichomoniasis in men, compared to asymptomatic ones. PMID:18383797

  17. Asymptomatic severe aortic stenosis with normal left ventricular function - A review.

    PubMed

    Sathyamurthy, I; Jayanthi, K

    2016-01-01

    Aortic stenosis (AS) is one of the commonest forms of acquired valvular heart disease. Aortic valve replacement (AVR) is the treatment of choice for symptomatic severe AS. Conservative management is usually advocated for asymptomatic severe AS. But there are data on predictors to identify subsets of asymptomatic AS patients at high risk of cardiac events in whom early surgical intervention is warranted. Non-invasive tests like exercise stress test, exercise echocardiography will help us to identify those who are at high risk of developing early symptoms due to LV dysfunction and also those at high risk of sudden death. In this article, an attempt is made to review the literature on this subset of asymptomatic severe AS to help clinicians to decide regarding the need for early aortic valve replacement in them. PMID:27543485

  18. Asymptomatic reproductive tract infections/sexually transmitted infections among HIV positive women.

    PubMed

    Bhattar, S; Bhalla, P; Rawat, D; Tripathi, R; Kaur, R; Sardana, K

    2015-01-01

    This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one-third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs. PMID:26068345

  19. Clinical Utility of Serologic Testing for Celiac Disease in Asymptomatic Patients

    PubMed Central

    2011-01-01

    Executive Summary Objective The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. Clinical Need and Target Population Celiac Disease Celiac disease is an autoimmune disease characterized by a chronic inflammatory state of the proximal small bowel mucosa accompanied by structural and functional changes. Technology Under Evaluation Serologic Tests for Celiac Disease There are a number of serologic tests for celiac disease available. Serologic tests are automated with the exception of the anti-endomysial antibody test, which is more time-consuming and operator-dependent than the other tests. Research Questions What is the prevalence of asymptomatic celiac disease in patients presenting with one of the non-gastrointestinal conditions evaluated? What is the effect of the gluten-free diet on condition-specific outcomes in patients with asymptomatic celiac disease presenting with one of the non-gastrointestinal conditions evaluated? What is the clinical utility of serologic testing for celiac disease in asymptomatic patients presenting with one of the non-gastrointestinal conditions evaluated? The clinical utility was defined as the impact of the GFD on disease specific outcomes. What is the risk of all-cause mortality and lymphoma in individuals with asymptomatic celiac disease? What is the budget impact of serologic testing for celiac disease in asymptomatic subjects presenting with one of the non-gastrointestinal conditions evaluated? Research Methods Study Population The study population consisted of individuals with newly diagnosed celiac

  20. Arabidopsis thaliana is an asymptomatic host of Alfalfa mosaic virus.

    PubMed

    Balasubramaniam, Muthukumar; Ibrahim, Amr; Kim, Bong-Suk; Loesch-Fries, L Sue

    2006-11-01

    The susceptibility of Arabidopsis thaliana ecotypes to infection by Alfalfa mosaic virus (AMV) was evaluated. Thirty-nine ecotypes supported both local and systemic infection, 26 ecotypes supported only local infection, and three ecotypes could not be infected. No obvious symptoms characteristic of virus infection developed on the susceptible ecotypes under standard conditions of culture. Parameters of AMV infection were characterized in ecotype Col-0, which supported systemic infection and accumulated higher levels of AMV than the symptomatic host Nicotiana tabacum. The formation of infectious AMV particles in infected Col-0 was confirmed by infectivity assays on a hypersensitive host and by electron microscopy of purified virions. Replication and transcription of AMV was confirmed by de novo synthesis of AMV subgenomic RNA in Col-0 protoplasts transfected with AMV RNA or plasmids harboring AMV cDNAs. PMID:16875753

  1. Thymidine kinase-mediated shut down of bone morphogenetic protein-4 expression allows regulated bone production.

    PubMed

    Lombardo, Barbara; Rocco, Teresa; Esposito, Maria T; Cantilena, Bruno; Gargiulo, Sara; Greco, Adelaide; Montanaro, Donatella; Brunetti, Arturo; Pastore, Lucio

    2013-06-01

    Bone morphogenetic Proteins (BMPs) are growth factors also involved in ossification and chondrogenesis that have generated interest for their efficiency in inducing bone neo-synthesis. BMPs expression in engineered cells has been successful in stimulating osteoblastic differentiation and ectopic and orthotopic bone formation in vivo. We have previously shown that an adenoviral vector expressing bone morphogenetic protein type-4 (BMP-4) is able to efficiently drive bone formation in a rabbit model of discontinuous bone lesions. However, unregulated secretion of BMPs has also been implicated in bone overproduction and exostosis. We have constructed a replication-defective first generation adenoviral (FG-Ad) vector containing a cassette for the expression of BMP-4 associated with the Herpes Simplex virus thymidine kinase (TK) gene (FG-B4TK) in order to shut down BMP-4 expression and, therefore, regulate bone production. TK expression does not interfere with BMP-4 ability to induce ectopic bone formation in athymic nude mice. Administration of ganciclovir blocks ectopic bone production in quadriceps muscle transduced with the FG-B4TK with no effect on the contralateral muscle transduced with a vector expressing only BMP-4. Histological findings confirmed the pro-apoptotic activity of TK and the reduction of mineralized areas in the quadriceps transduced with FG-B4TK in mice treated with ganciclovir. We have generated a system to block BMP-4 secretion by inducing apoptosis in transduced cells therefore blocking unwanted bone formation. This system is an additional tool to generate regulated amount of bone in discontinuous bone lesions and can be easily coupled with biomaterials capable of recruiting cells and generating a local bioreactor. PMID:23317056

  2. Remodeling in bone without osteocytes: Billfish challenge bone structure–function paradigms

    PubMed Central

    Atkins, Ayelet; Dean, Mason N.; Habegger, Maria Laura; Motta, Phillip J.; Ofer, Lior; Repp, Felix; Shipov, Anna; Weiner, Steve; Currey, John D.; Shahar, Ron

    2014-01-01

    A remarkable property of tetrapod bone is its ability to detect and remodel areas where damage has accumulated through prolonged use. This process, believed vital to the long-term health of bone, is considered to be initiated and orchestrated by osteocytes, cells within the bone matrix. It is therefore surprising that most extant fishes (neoteleosts) lack osteocytes, suggesting their bones are not constantly repaired, although many species exhibit long lives and high activity levels, factors that should induce considerable fatigue damage with time. Here, we show evidence for active and intense remodeling occurring in the anosteocytic, elongated rostral bones of billfishes (e.g., swordfish, marlins). Despite lacking osteocytes, this tissue exhibits a striking resemblance to the mature bone of large mammals, bearing structural features (overlapping secondary osteons) indicating intensive tissue repair, particularly in areas where high loads are expected. Billfish osteons are an order of magnitude smaller in diameter than mammalian osteons, however, implying that the nature of damage in this bone may be different. Whereas billfish bone material is as stiff as mammalian bone (unlike the bone of other fishes), it is able to withstand much greater strains (relative deformations) before failing. Our data show that fish bone can exhibit far more complex structure and physiology than previously known, and is apparently capable of localized repair even without the osteocytes believed essential for this process. These findings challenge the unique and primary role of osteocytes in bone remodeling, a basic tenet of bone biology, raising the possibility of an alternative mechanism driving this process. PMID:25331870

  3. Mortality rates and risk factors for asymptomatic deep vein thrombosis in medical patients.

    PubMed

    Vaitkus, Paul T; Leizorovicz, Alain; Cohen, Alexander T; Turpie, Alexander G G; Olsson, Carl-Gustav; Goldhaber, Samuel Z

    2005-01-01

    The clinical importance of asymptomatic proximal and distal deep vein thrombosis (DVT) remains uncertain and controversial. The aim of this retrospective, post-hoc analysis was to examine mortality and risk factors for development of proximal DVT in hospitalized patients with acute medical illness who were recruited into a randomized, prospective clinical trial of thromboprophylaxis with dalteparin (PREVENT). We analyzed 1738 patients who had not sustained a symptomatic venous thromboembolic event by Day 21 and who had a complete compression ultrasound of the proximal and distal leg veins on Day 21. We examined the 90-day mortality rates in patients with asymptomatic proximal DVT (Group I, N=80), asymptomatic distal DVT (Group II, N=118) or no DVT (Group III, N=1540). The 90-day mortality rates were 13.75%, 3.39%, and 1.92% for Groups I-III, respectively. The difference in mortality between Group I and Group III was significant (hazard ratio 7.63, 95% CI=3.8-15.3; p <0.0001), whereas the difference between Groups II and III did not reach significance (hazard ratio 1.36, 95% CI=0.41-4.45). The association of asymptomatic proximal DVT with increased mortality remained highly significant after adjusting for differences in baseline demographics and clinical variables. Risk factors significantly associated with the development of proximal DVT included advanced age (p=0.0005), prior DVT (p=0.001), and varicose veins (p=0.04). In conclusion, the high mortality rate in patients with asymptomatic proximal DVT underscores its clinical relevance and supports targeting of asymptomatic proximal DVT as an appropriate endpoint in clinical trials of thromboprophylaxis. PMID:15630494

  4. Asymptomatic group B streptococcal bacteriuria among pregnant women in Saudi Arabia.

    PubMed

    Ahmad, S

    2015-01-01

    This study aims to determine the asymptomatic bacteriuria in pregnancy due to GBS and its antimicrobial sensitivity pattern for planning strategy for the management of these cases and also to determine the relationship between asymptomatic bacteriuria and pyuria. A total of 3863 consecutive urine specimens were collected from 3863 pregnant women with asymptomatic bacteriuria attending the obstetrics and gynaecology department of our hospital over a period of two years. Specimens were processed using standard microbiological procedures. All the subjects were evaluated for bacteriuria. The prevalence of asymptomatic bacteriuria due to group B streptococci (GBS) was 82/3863 (2.1%) among pregnant women in Saudi Arabia. Among these, 69/82 patients (84.2%) had clinical and microbiological features consistent with cystitis, versus 13/82 (15.8%) for pyelonephritis. About 51.2% (42/82) of the patients who had urine analysis performed had positive results based on positive urinary leucocyte esterase and pyuria. Disc-diffusion analysis of all 82 GBS isolates showed that they were highly susceptible to Augmentin and linezolid. Screening for bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women. Further, ongoing surveillance and evaluation of outcomes in pregnancies complicated by GBS bacteriuria is required to optimise maternal and newborn care. PMID:26510270

  5. Clinical characteristics of patients with asymptomatic intracranial meningiomas and results of their surgical management.

    PubMed

    Zeng, Lingcheng; Wang, Long; Ye, Fei; Chen, Jingcao; Lei, Ting; Chen, Jian

    2015-07-01

    Surgery performed during the asymptomatic phase of meningioma remains controversial. The effects of surgery and the factors associated with postsurgical complications and patient prognosis were studied to optimize surgical decisions for clinicians who treat asymptomatic patients. The medical records of 513 patients with meningiomas (112 patients were asymptomatic) treated at our hospital from May 2007 to April 2012 were retrospectively reviewed. The results were analyzed with univariate and multivariate analyses. Asymptomatic meningiomas were characterized by a more common cerebral hemispheric location, a smaller size, and a lack of peritumoral edema. A significantly higher Simpson I resection rate of 95.2 % was achieved in tumors located in the cerebral hemisphere; in contrast, a rate of 66.7 % was obtained in tumors located at the skull base (P = 0.003). The overall postsurgical complication rate was 13.6 %, which was lower than the rate of 21.7 % in the symptomatic patients. Hemiplegia was the most common complication, which occurred most often in the patients with tumors in parietal locations (P = 0.015). Ninety-two percent of the asymptomatic patients achieved a Glasgow Outcome Scale (GOS) score of 5 1 year after the operation, and significantly more patients younger than 60 years of age obtained a GOS score of 5 compared with patients older than 60 years of age (P = 0.006). To achieve maximal tumor resection and good patient recovery, tumor location and patient age should be carefully considered prior to choosing to perform surgery in asymptomatic patients. PMID:25697143

  6. Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases

    PubMed Central

    Owen, Dawn; Laack, Nadia N.; Mayo, Charles S.; Garces, Yolanda I.; Park, Sean S.; Bauer, Heather J.; Nelson, Kathryn; Miller, Robert W.; Brown, Paul D.; Olivier, Kenneth R.

    2015-01-01

    Purpose Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases. Methods and Materials Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity <90 days) and late toxicity (defined as toxicity ≥90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria. Results The median age of patients treated was 60 years. The most common histology was prostate cancer (31%) and most patients had fewer than 3 sites of disease at the time of simulation (64%). Most of the non-spine bony sites lay within the pelvis (65%). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8% at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 1–2 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities. Conclusions Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects. PMID:24890360

  7. [Management of bone metastases].

    PubMed

    Nagykálnai, Tamás; Landherr, László

    2014-02-01

    The skeleton is the most common site to be affected by advanced breast, prostatic, lung, kidney, thyroid and other solid tumors (in addition to myeloma multiplex). Bone metastases cause significant morbidity with nearly always fatal outcome. Over 600 000 new patients diagnosed in the developed countries yearly. On average every 4-6 months patients suffer from series of severe skeletal complications such as pathologic fractures, spinal cord compression, hypercalcemic events, etc., besides the permanent pain. Local external beam radiotherapy, systemic radioisotope-, endocrine-, and chemotherapy, oral and i.v. bisphosphonates and recently s.c. denosumab are the mainstays of treatment, in addition to pain-killers and other usual "classical" interventions. The modern treatments singificantly reduce the probability of skeletal complications and improve the patients' quality of life and, sometimes, they extend the survival as well. The authors briefly summarize the available treatment options. PMID:24486845

  8. Asymptomatic (Subclinical) Meningitis in One of Premature Triplets with Simultaneous Enteroviral Meningitis: A Case Report

    PubMed Central

    Gupta, Ashish; Tolan, Robert W.

    2011-01-01

    Most enterovirus infection in the neonate and young infant is asymptomatic, but serious disease may occur, especially if acquired perinatally. We report the first case, to our knowledge, of asymptomatic enterovirus aseptic meningitis, and of concurrent enterovirus aseptic meningitis in premature triplets. Ten-week-old, 31-week-estimated gestational age premature triplet boys were diagnosed with enterovirus aseptic meningitis on the same day. Two of the triplets developed symptoms on the day of admission, while the third remained symptom free throughout the infection. All three recovered completely and are healthy more than a decade later. PMID:23946897

  9. [To treat or not to treat asymptomatic bacteriuria before methylprednisolone perfusion].

    PubMed

    Donzé, C; Dinh, A; Heinzlef, O; Hautecoeur, P

    2015-09-01

    The prescription of methylprednisolone for multiple sclerosis acute relapse involves sterilization of urine. An observational study was conducted to clarify the benefit of antibiotic prophylaxis in case of asymptomatic bacteriuria found before methylprednisolone. Ninety-seven patients were included; 32 patients had asymptomatic bacteriuria. Seventeen patients were treated and 15 were not. The number of urinary tract infections in the month following the methylprednisolone was the same in the two groups. The results seem in favor of a therapeutic abstention. A larger study will be performed to confirm these results and determine appropriate recommendations. PMID:26318899

  10. Bisphosphonates and bone quality

    PubMed Central

    Pazianas, Michael; van der Geest, Stefan; Miller, Paul

    2014-01-01

    Bisphosphonates (BPs) are bone-avid compounds used as first-line medications for the prevention and treatment of osteoporosis. They are also used in other skeletal pathologies such as Paget's and metastatic bone disease. They effectively reduce osteoclast viability and also activity in the resorptive phase of bone remodelling and help preserve bone micro-architecture, both major determinants of bone strength and ultimately of the susceptibility to fractures. The chemically distinctive structure of each BP used in the clinic determines their unique affinity, distribution/penetration throughout the bone and their individual effects on bone geometry, micro-architecture and composition or what we call ‘bone quality'. BPs have no clinically significant anabolic effects. This review will touch upon some of the components of bone quality that could be affected by the administration of BPs. PMID:24876930

  11. [Microdestruction of the bone].

    PubMed

    Iankovskiĭ, V É

    2014-01-01

    The objective of the present study was the detection of microcracks in the compact bone tissue surrounding the fracture and in deformed bone undergoing subcritical loading. The portions of deformed bone tissue and terminal fragments of broken bones were obtained in the form of blocks longitudinally sawcut from the regions of primary and secondary bone rupture. A total of 300 such blocks were available for the examination. All portions of the deformed bone tissue and terminal fragments of broken bones showed up microcracks commensurate with the bone structures. They were actually hardened traces of deformation that preceded the fracture and reflected the volume of the destroyed bone tissue; moreover, in certain cases they allowed to identify the kind of the object that exerted the external action (either a blow or slow bending). PMID:25269164

  12. Screw insertion in trabecular bone causes peri-implant bone damage.

    PubMed

    Steiner, Juri A; Ferguson, Stephen J; van Lenthe, G Harry

    2016-04-01

    Secure fracture fixation is still a major challenge in orthopedic surgery, especially in osteoporotic bone. While numerous studies have investigated the effect of implant loading on the peri-implant bone after screw insertion, less focus has been put on bone damage that may occur due to the screw insertion process itself. Therefore, the aim of this study was to localize and quantify peri-implant bone damage caused by screw insertion. We used non-invasive three-dimensional micro-computed tomography to scan twenty human femoral bone cores before and after screw insertion. After image registration of the pre- and post-insertion scans, changes in the bone micro-architecture were identified and quantified. This procedure was performed for screws with a small thread size of 0.3mm (STS, N=10) and large thread size of 0.6mm (LTS, N=10). Most bone damage occurred within a 0.3mm radial distance of the screws. Further bone damage was observed up to 0.6mm and 0.9mm radial distance from the screw, for the STS and LTS groups, respectively. While a similar amount of bone damage was found within a 0.3mm radial distance for the two screw groups, there was significantly more bone damage for the LTS group than the STS group in volumes of interest between 0.3-0.6mm and 0.6-0.9mm. In conclusion, this is the first study to localize and quantify peri-implant bone damage caused by screw insertion based on a non-invasive, three-dimensional, micro-CT imaging technique. We demonstrated that peri-implant bone damage already occurs during screw insertion. This should be taken into consideration to further improve primary implant stability, especially in low quality osteoporotic bone. We believe that this technique could be a promising method to assess more systematically the effect of peri-implant bone damage on primary implant stability. Furthermore, including peri-implant bone damage due to screw insertion into patient-specific in silico models of implant-bone systems could improve the

  13. Cost-efficacy modeling of functional testing with perfusion imaging to detect asymptomatic restenosis following percutaneous transluminal coronary angioplasty.

    PubMed

    Mak, K H; Eisenberg, M J; Shaw, J

    1999-12-01

    The objective of this study was to perform a theoretical cost-efficacy analysis on the use of routine functional testing with perfusion imaging to identify patients with asymptomatic restenosis following percutaneous transluminal coronary angioplasty (PTCA) procedures. Approximately 50% of patients with restenosis following PTCA are asymptomatic. Routine functional testing is commonly performed at 3 to 6 months to identify these patients. The cost-efficacy associated with this strategy is unknown. Theoretical models were constructed based on assumed costs for functional testing (U.S. $1,300) and coronary angiography (U.S. $3,000). Restenosis rates were assumed to be 40%, and half of patients with restenosis were assumed to be asymptomatic. To provide a range of costs to identify a patient with asymptomatic restenosis, three scenarios were constructed based on the diagnostic test characteristics of functional testing. Sensitivity analyses were performed using a range of costs for functional testing, restenosis rates, and proportion of patients with restenosis who are asymptomatic. Depending on the diagnostic accuracy of functional testing, it costs $8,200 to $22,400 to identify an asymptomatic patient with restenosis following PTCA. The cost to identify a patient with asymptomatic restenosis varies inversely with the rates of restenosis. When restenosis rates are < 20%, the cost to identify a patient with asymptomatic restenosis exceeds $10,000. Similarly, the cost to identify a patient with asymptomatic restenosis increases when the proportion of patients with asymptomatic restenosis decreases. The cost, associated with the use of routine functional testing for the identification of asymptomatic patients with restenosis appears exorbitant. However, a formal study is warranted to determine the cost-efficacy of such a strategy. Cathet. Cardiovasc. Intervent. 48:352-356, 1999. PMID:10559811

  14. In vivo bone aluminum measurements in patients with renal disease

    SciTech Connect

    Ellis, K.J.; Kelleher, S.P.

    1986-01-01

    Contamination of the dialysis solution with trace amounts of aluminum and long-term use of aluminum-based phosphate binders have led to increased body burden of aluminum in patients with end-stage renal disease. A significant clinical problem associated with aluminum-overload is the early diagnosis of aluminum-induced dialysis dementia and osteomalacic osteodystrophy. There are few, if any, blood or urine indices that provide an early monitor of this bone disease, especially in the asymptomatic patient. Although a bone biopsy is usually the basis for the final clinical diagnosis, this procedure is not recommended for routine monitoring of patients. The present technique demonstrates the direct in vivo measurement of bone aluminum levels in patients with renal failure. The interference normally present from activation of bone phosphorus is eliminated by using a thermal/epithermal neutron beam. For the clinical management of the patients, the Al/Ca ratio for the hand may be more useful than an absolute measurement of the total body or skeletal aluminum burden. The relationship between the increased serum Al levels following disferrioxamine infusion and the direct in vivo measurement of bone aluminum using the Al/Ca ratio are currently under investigation. The neutron activation procedure presented in this pilot study is a promising new technique with an immediate clinical application. 5 refs., 3 figs., 1 tab.

  15. Gelatin-Modified Bone Substitute with Bioactive Molecules Enhance Cellular Interactions and Bone Regeneration.

    PubMed

    Teotia, Arun Kumar; Gupta, Ankur; Raina, Deepak Bushan; Lidgren, Lars; Kumar, Ashok

    2016-05-01

    In this work, we have synthesized injectable bone cement incorporated with gelatin to enhance cellular interaction. Human osteosarcoma Saos-2 cells derived bone morphogenetic proteins (BMP's) and a bisphosphonate (zoledronic acid (0.2 mM)) were also incorporated to cement. In vitro studies conducted using Saos-2 demonstrated enhanced cell proliferation on gelatin (0.2%w/v) cement. The differentiation of C2C12 mouse myoblast cells into bone forming cells showed 6-fold increase in ALP levels on gelatin cement. Polymerase chain reaction (PCR) for bone biomarkers showed osteoinductive potential of gelatin cement. We investigated efficacy for local delivery of these bioactive molecules in enhancing bone substitution qualities of bone cements by implanting in 3.5 mm critical size defect in tibial metaphysis of wistar rats. The rats were sacrificed after 12 weeks and 16 weeks post implantation. X-ray, micro-CT, histology, and histomorphometry analysis were performed to check bone healing. The cement materials slowly resorbed from the defect site leaving HAP creating porous matrix providing surface for bone formation. The materials showed high biocompatibility and initial bridging was observed in all the animals but maximum bone formation was observed in animals implanted with cement incorporated with zoledronic acid followed by cement with BMP's compared to other groups. PMID:27077816

  16. Bone strength: current concepts.

    PubMed

    Turner, Charles H

    2006-04-01

    Bones serve several mechanical functions, including acoustic amplification in the middle ear, shielding vital organs from trauma, and serving as levers for muscles to contract against. Bone is a multiphase material made up of a tough collagenous matrix intermingled with rigid mineral crystals. The mineral gives bone its stiffness. Without sufficient mineralization, bones will plastically deform under load. Collagen provides toughness to bone making it less brittle so that it better resists fracture. Bone adapts to mechanical stresses largely by changing its size and shape, which are major determinants of its resistance to fracture. Tissue is added in regions of high mechanical stress providing an efficient means for improving bone strength. Experiments have shown that small additions of bone mineral density (BMD) (5-8%) caused by mechanical loading can improve bone strength by over 60% and extend bone fatigue life by 100-fold. Consequently, it is clear that bone tissue possesses a mechanosensing apparatus that directs osteogenesis to where it is most needed for improving bone strength. The biological processes involved in bone mechanotransduction are poorly understood and further investigation of the molecular mechanisms involved might uncover drug targets for osteoporosis. Several pathways are emerging from current research, including membrane ion channels, ATP signaling, second messengers, such as prostaglandins and nitric oxide, insulin-like growth factors, and Wnt signaling. PMID:16831941

  17. Bone and heart abnormalities of subclinical hyperthyroidism in women below the age of 65 years.

    PubMed

    Rosario, Pedro Weslley

    2008-12-01

    The objective of the present study was to evaluate bone and cardiac abnormalities and symptoms and signs of thyroid hormone excess in women with subclinical hyperthyroidism (SCH) aged < 65 years. Forty-eight women with SCH were evaluated. The control group consisted of 48 euthyroid volunteers. The mean symptom rating scale score was significantly higher in patients. Cardiac involvement, both morphological and affecting systolic and diastolic functions, was also observed in patients. Women with SCH showed a significant increase in serum markers of bone formation and resorption. In addition, bone mineral density (BMD) was lower in the femoral neck but not in the lumbar spine in patients before menopause, whereas a lower BMD was observed at both sites in postmenopausal patients. SCH is not completely asymptomatic in women aged < 65 years, and is associated with heart abnormalities and with increased bone turnover and reduced BMD even before menopause. PMID:19197452

  18. Vanishing bone disease (Gorham-Stout syndrome): A review of a rare entity

    PubMed Central

    Nikolaou, Vasileios S; Chytas, Dimitrios; Korres, Demitrios; Efstathopoulos, Nicolas

    2014-01-01

    Vanishing bone disease (Gorham-Stout syndrome) is a rare entity of unknown etiology, characterized by destruction of osseous matrix and proliferation of vascular structures, resulting in destruction and absorption of bone. Despite the extensive investigation of the pathogenetic mechanisms of the disease, its etiology hasn’t been clarified and several theories exist. The syndrome can affect one or multiple bones of the patient, including the skull, the upper and lower extremities, the spine and pelvis. The clinical presentation of a patient suffering from vanishing bone disease includes, pain, functional impairment and swelling of the affected region, although asymptomatic cases have been reported, as well as cases in which the diagnosis was made after a pathologic fracture. In this short review we summarize the theories regarding the etiology as well as the clinical presentation, the diagnostic approach and treatment options of this rare disease. PMID:25405099

  19. Os trigonum syndrome: use of bone scan in the diagnosis

    SciTech Connect

    Johnson, R.P.; Collier, B.D.; Carrera, G.F.

    1984-08-01

    The os trigonum is an accessory bone of the foot found in 7% of the normal adult population. It is located at the posterolateral projection of the talus, and can occasionally give rise to symptoms of acute and chronic unexplained ankle pain. We report three patients, one with acute fracture and two with chronic ankle symptoms. Technetium 99 methylene diphosphonate showed intense focal uptake at the posterior talus pointing to the os trigonum as the site of symptoms. It was excised in two patients with complete relief. The third went on to develop an asymptomatic nonunion. We recommend bone scanning as a procedure that is helpful in delineating obscure pain in the ankle that may be due to chronic irritative nonunion of the os trigonum.

  20. Mechanics of intact bone marrow.

    PubMed

    Jansen, Lauren E; Birch, Nathan P; Schiffman, Jessica D; Crosby, Alfred J; Peyton, Shelly R

    2015-10-01

    The current knowledge of bone marrow mechanics is limited to its viscous properties, neglecting the elastic contribution of the extracellular matrix. To get a more complete view of the mechanics of marrow, we characterized intact yellow porcine bone marrow using three different, but complementary techniques: rheology, indentation, and cavitation. Our analysis shows that bone marrow is elastic, and has a large amount of intra- and inter-sample heterogeneity, with an effective Young׳s modulus ranging from 0.25 to 24.7 kPa at physiological temperature. Each testing method was consistent across matched tissue samples, and each provided unique benefits depending on user needs. We recommend bulk rheology to capture the effects of temperature on tissue elasticity and moduli, indentation for quantifying local tissue heterogeneity, and cavitation rheology for mitigating destructive sample preparation. We anticipate the knowledge of bone marrow elastic properties for building in vitro models will elucidate mechanisms involved in disease progression and regenerative medicine. PMID:26189198

  1. Bone marrow (stem cell) donation

    MedlinePlus

    Stem cell transplant; Allogeneic-donation ... There are two types of bone marrow donation: Autologous bone marrow transplant is when people donate their own bone marrow. "Auto" means self. Allogenic bone marrow transplant is when another person ...

  2. How Is Bone Cancer Diagnosed?

    MedlinePlus

    ... Topic How is bone cancer staged? How is bone cancer diagnosed? A patient’s symptoms, physical exam, and results ... and other imaging tests. Imaging tests to detect bone cancer X-rays Most bone cancers show up on ...

  3. NSAIDs can have adverse effects on bone healing.

    PubMed

    van Esch, Robert W; Kool, Maurice M; van As, Saskia

    2013-08-01

    The science of osteoimmunology, a relatively new field of research, reveals the important interactions between the immune system and skeletal system. Interactions occur between prostaglandin metabolism, inflammatory proteins and bone metabolism. Systemic as well as local sources of inflammation appear to be actively involved in both bone formation and resorption. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) can play a detrimental role in bone fractures, opposing the aim of the intervention, and can have such a negative impact on the synthesis of prostaglandins that they could even promote bone resorption. When used for a prolonged time, NSAIDs can also cause the development of an inflammatory cascade starting from the gastro-intestinal system, possibly resulting in bone resorption. Several studies show that the use of either selective or non-selective NSAIDs are intimately related to disturbances in immunological allostasis, bone metabolism and the inhibition or impediment of bone healing. PMID:23680000

  4. Mammalian cortical bone in tension is non-Haversian

    NASA Astrophysics Data System (ADS)

    Mayya, Ashwij; Banerjee, Anuradha; Rajesh, R.

    2013-08-01

    Cortical bone, found in the central part of long bones like femur, is known to adapt to local mechanical stresses. This adaptation has been linked exclusively with Haversian remodelling involving bone resorption and formation of secondary osteons. Compared to primary/plexiform bone, the Haversian bone has lower stiffness, fatigue strength and fracture toughness, raising the question why nature prefers an adaptation that is detrimental to bone's primary function of bearing mechanical stresses. Here, we show that in the goat femur, Haversian remodelling occurs only at locations of high compressive stresses. At locations corresponding to high tensile stresses, we observe a microstructure that is non-Haversian. Compared with primary/plexiform bone, this microstructure's mineralisation is significantly higher with a distinctly different spatial pattern. Thus, the Haversian structure is an adaptation only to high compressive stresses rendering its inferior tensile properties irrelevant as the regions with high tensile stresses have a non-Haversian, apparently primary microstructure.

  5. Three-Dimensional Geometric Analysis of Felid Limb Bone Allometry

    PubMed Central

    Doube, Michael; Conroy, Alexis Wiktorowicz; Christiansen, Per; Hutchinson, John R.; Shefelbine, Sandra

    2009-01-01

    Background Studies of bone allometry typically use simple measurements taken in a small number of locations per bone; often the midshaft diameter or joint surface area is compared to body mass or bone length. However, bones must fulfil multiple roles simultaneously with minimum cost to the animal while meeting the structural requirements imposed by behaviour and locomotion, and not exceeding its capacity for adaptation and repair. We use entire bone volumes from the forelimbs and hindlimbs of Felidae (cats) to investigate regional complexities in bone allometry. Method/Principal Findings Computed tomographic (CT) images (16435 slices in 116 stacks) were made of 9 limb bones from each of 13 individuals of 9 feline species ranging in size from domestic cat (Felis catus) to tiger (Panthera tigris). Eleven geometric parameters were calculated for every CT slice and scaling exponents calculated at 5% increments along the entire length of each bone. Three-dimensional moments of inertia were calculated for each bone volume, and spherical radii were measured in the glenoid cavity, humeral head and femoral head. Allometry of the midshaft, moments of inertia and joint radii were determined. Allometry was highly variable and related to local bone function, with joint surfaces and muscle attachment sites generally showing stronger positive allometry than the midshaft. Conclusions/Significance Examining whole bones revealed that bone allometry is strongly affected by regional variations in bone function, presumably through mechanical effects on bone modelling. Bone's phenotypic plasticity may be an advantage during rapid evolutionary divergence by allowing exploitation of the full size range that a morphotype can occupy. Felids show bone allometry rather than postural change across their size range, unlike similar-sized animals. PMID:19270749

  6. Influence of Insurance Status and Demographic Features on Recognition of Symptomatic and Asymptomatic Gonorrhea Cases.

    PubMed

    Flynn, Colleen; Anschuetz, Greta; Asbel, Lenore; Madera, Robbie; Johnson, Caroline C

    2015-08-01

    A random sample of individuals diagnosed as having gonorrhea from 2009 to 2013 were interviewed. Demographic and clinical features for asymptomatic and symptomatic individuals were examined to elucidate trends in medical care. Age, race, and sexually transmitted disease history had no association with the absence of symptoms (e.g., infection found by screening), whereas insurance coverage did for women. PMID:26165432

  7. Premenstrual Assessment Form Typological Categories: Classification of Self-Defined Premenstrually Symptomatic and Asymptomatic Women.

    ERIC Educational Resources Information Center

    Youdale, J. Valda M.; Freeman, Richard J.

    1987-01-01

    Investigated use of newly developed assessment instrument for premenstrual syndrome, the Premenstrual Assessment Form (PAF), as a retrospective assessment instrument, and the PAF subtypes as accurate reflectors of subjective premenstrual symptomatology. Severely premenstrually symptomatic and asymptomatic women completed the PAF. Results partially…

  8. Differential Prognostic Value of Coronary Computed Tomography Angiography in Relation to Exercise Electrocardiography in Asymptomatic Subjects

    PubMed Central

    Lee, Sang-Eun; Cho, Iksung; Hong, Geu-Ru; Sung, Ji Min; Cho, In-Jeong; Shim, Chi Young; Choi, Byoung Wook; Chung, Namsik

    2015-01-01

    Background To explore the prognostic performance of coronary computed tomography angiography (CCTA) and exercise electrocardiography (XECG) in asymptomatic subjects. Methods We retrospectively enrolled 812 (59 ± 9 years, 60.8% male) asymptomatic subjects who underwent CCTA and XECG concurrently from 2003 through 2009. Subjects were followed-up for major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, unstable angina, and revascularization after 90 days from index CCTA. Results The prevalence of occult coronary artery disease (CAD) detected by CCTA was 17.5% and 120 subjects (14.8%) had positive XECG. During a mean follow-up of 37 ± 16 months, nine subjects experienced MACE. In multivariable Cox-regression analysis, only the presence of CAD by CCTA independently predicted future MACE (p = 0.002). Moreover, CAD by CCTA improved the predictive value when added to a clinical risk factor model using the likelihood ratio test (p < 0.001). Notably, the prognostic value of CCTA persisted in the moderate-to-high-risk group as classified by the Duke treadmill score (p = 0.040), but not in the low-risk group (p = 0.991). Conclusion CCTA provides incremental prognostic benefit over and above XECG in an asymptomatic population, especially for those in a moderate-to-high-risk group as classified by the Duke treadmill score. Risk stratification using XECG may prove valuable for identifying asymptomatic subjects who can benefit from CCTA. PMID:26755933

  9. Detection of asymptomatic enthesitis in psoriasis patients: An onset of psoriatic arthritis?

    PubMed

    Takata, Tomoya; Takahashi, Aya; Taniguchi, Yoshinori; Terada, Yoshio; Sano, Shigetoshi

    2016-06-01

    Presence of asymptomatic joint involvement is recognized in patients with psoriasis. However, it remains elusive whether such patients develop psoriatic arthritis (PsA). The aim of the present study was to examine the incidence of asymptomatic joint lesions, in particular, enthesitis in patients with psoriasis vulgaris (PsV) and to further assess the clinical features. Eighteen PsV and 28 PsA patients were enrolled for examination by positron emission tomography/computed tomography (PET/CT) using (18) F-fluorodeoxyglucose (FDG). Any nail, scalp and intergluteal involvements were reported. Levels of serum C-reactive protein (CRP), white blood cell (WBC) counts and erythrocyte sedimentation rate (ESR) were examined. All of the PsA patients showed FDG accumulation in the affected joints. Notably, asymptomatic enthesitis was detected in six out of 18 PsV patients (33%), and they were diagnosed as having subclinical PsA. Incidences of scalp, intergluteal and nail psoriasis in subclinical PsA patients were 100%, 83% and 64%, respectively, which were higher than those in PsV patients (67%, 25% and 40%, respectively). CRP, WBC counts and ESR were invariable between PsV and subclinical PsA groups. PET/CT imaging could discover asymptomatic enthesitis. Our data suggested that the subpopulation of subclinical PsA was much higher than expected. Higher prevalence of nail, scalp and intergluteal psoriasis confirmed the risk of PsA as previously described. PMID:26666215

  10. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    PubMed Central

    Ciccone, Marco Matteo; Niccoli-Asabella, Artor; Scicchitano, Pietro; Gesualdo, Michele; Notaristefano, Antonio; Chieppa, Domenico; Carbonara, Santa; Ricci, Gabriella; Sassara, Marco; Altini, Corinna; Quistelli, Giovanni; Lepera, Mario Erminio; Favale, Stefano; Rubini, Giuseppe

    2011-01-01

    Introduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis. Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries. Results: A statistically significant relationship (P = 0.023) was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively. Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in patients with asymptomatic carotid plaques, considering eventually plaque morphology (symmetry, composition, eccentricity or concentricity of the plaque, etc) for patient stratification. PMID:21468172

  11. Semi-quantitative analysis of cytokine expression in asymptomatic canine leishmaniasis.

    PubMed

    Chamizo, Cristina; Moreno, Javier; Alvar, Jorge

    2005-01-10

    The dog is the main reservoir of Leishmania infantum, the parasite responsible for visceral leishmaniasis in Mediterranean countries. The infection in dogs shows different clinical presentations, from subclinical/asymptomatic to a fully developed disease, depending on the host's immune responses. The Th1/Th2 dichotomy is not clear in the different forms of canine leishmaniasis, since the data available from studies of immunity response in canine leishmaniasis are scarce and fragmented. The present work describes the cytokine expression in peripheral blood mononuclear cells (PBMC) obtained from asymptomatic dogs experimentally infected with L. infantum that present a cellular protective immune response. The results obtained from freshly isolated PBMC showed expressions of TNF-alpha, IL-2, IFN-gamma, IL-10 and IL-18 mRNA, similar to those from non-infected dogs. However, there was almost no expression of IL-4 mRNA detected in the asymptomatic infected dogs compared to the control dogs. Unspecific stimulation with ConA promoted the expression in a greater or lower degree of all the cytokines studied. In vitro stimulation of PBMC with soluble leishmanial antigen (SLA) promoted the expression of IL-2, IFN-gamma, TNF-alpha, IL-18, IL-4, IL-6 and IL-10 mRNA, with the two first being specifically induced. Although both Th1 and Th2 cytokines are produced, cell mediated immunity observed in these L. infantum-infected asymptomatic dogs depended on the preferential expression of Th1 cytokines. PMID:15626462

  12. NON TYPHOIDAL SALMONELLA FROM HUMAN CLINICAL CASES ASYMPTOMATIC CARRIERS AND RAW RETAIL MEATS IN YUCATAN MEXICO

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: We report the results of a 3-year Salmonella surveillance study of persons with diarrhea; asymptomatic children; and retail pork, poultry and beef in Yucatan, Mexico. Methods: Isolates were characterized for serotype, antimicrobial susceptibility and genetic relatedness using pulsed-fi...

  13. Management of Asymptomatic Erosive Esophagitis: An E-Mail Survey of Physician's Opinions

    PubMed Central

    Lim, Seong Woo; Kim, Jie-Hyun; Kim, Jeong Hwan; Kim, Heung Up; Jeon, Seong Woo

    2013-01-01

    Background/Aims The management of asymptomatic erosive esophagitis is controversial. We surveyed physicians' opinions on asymptomatic erosive esophagitis using e-mail. Methods All members of the Korean Society of Neurogastro-enterology and Motility were invited to answer the questionnaire on the treatment and follow-up of patients with asymptomatic erosive esophagitis by e-mail. Results A total of 73 members answered the questionnaire (response rate, 18%). As initial management, 41% of respondents chose pharmacologic treatment, whereas 59% chose nonpharmacologic treatment. In the case of pharmacologic treatment, proton pump inhibitors were the preferred medication. The most common treatment duration was 4 weeks (43%), followed by 8 weeks (38%), and 6 months (11%). Sixty-two percent of the respondents recommended follow-up endoscopy annually, whereas 29% chose no endoscopic follow-up. Thirty-four percent of the respondents answered that they would talk about reflux-related sleep disturbances. Only 25% of the respondents explained the possibility of Barrett's esophagus or esophageal adenocarcinoma to their patients. Conclusions There are substantial practice variations in the management of asymptomatic erosive esophagitis in Korea. PMID:23710309

  14. Improved sexual history taking in the 2012 BASHH asymptomatic screening re-audit.

    PubMed

    Menon-Johansson, A S; McClean, H; Carne, C A; Estreich, S; Knapper, C; Sethi, G; Smith, A; Sullivan, A K

    2014-04-01

    Effective asymptomatic screening for sexually transmitted infections is an important public health service because a significant proportion of sexually transmitted infections do not present with symptoms. In 2009, the National Audit Group of the British Association of Sexual Health and HIV (BASHH) audited the management of asymptomatic patients and recommended increased documentation about oral and anal sex, regional strategies for nucleic acid amplification test (NAAT) use for gonorrhoea, improved screening for hepatitis B in men who have sex with men and an increase in screening for HIV. The 2012 audit used web-based forms to collect submissions from 180 consultant-led centres (65% response rate) that included episodes of care from 6669 asymptomatic patients. An improvement was demonstrated for all the areas measured during the 2009 audit. A doubling of gonorrhoea testing using NAATs was seen and yet 10% of asymptomatic patients continued to have microscopy despite these tests not being recommended by BASHH guidelines. This audit recommends universal adoption of gonorrhoea NAATs across the United Kingdom. PMID:24047881

  15. The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

    PubMed Central

    Ozkan, Levend; Tarcan, Tufan

    2010-01-01

    Purpose The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. Materials and Methods A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. Results Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. Conclusions Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC. PMID:20428428

  16. Exercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

    PubMed Central

    Henri, Christine

    2014-01-01

    The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical outcomes. However, the risk-benefit ratio should be carefully evaluated and early surgery only be proposed to a subset of asymptomatic patients considered at higher risk. Exercise echocardiography can help unmask symptomatic patients combined with assessment of the hemodynamic consequences of AS. Recent studies have demonstrated that exercise echocardiography can provide incremental prognostic value to identify patients who may benefit most from early surgery. In "truly" asymptomatic patients, an increase in mean aortic gradient ≥ 18-20 mmHg, a limited left ventricular contractile reserve or a pulmonary hypertension during exercise are predictive parameters of adverse cardiac events. Exercise echocardiography is low-cost, safe and available in many referral centers, and does not expose patients to radiation. The purpose of this article is to describe the role of exercise testing and echocardiography in the management of asymptomatic patients with severe AS and preserved left ventricular ejection fraction. PMID:24753801

  17. No evidence of asymptomatic variant CJD infection in immunodeficiency patients treated with UK-sourced immunoglobulin.

    PubMed

    Helbert, M R; Bangs, C; Bishop, M; Molesworth, A; Ironside, J

    2016-04-01

    Surveillance of 75 immunodeficiency patients exposed to UK-sourced immunoglobulin, including batches derived from donors who went on to develop vCJD, has not detected any clinical cases of vCJD, or of asymptomatic infection in 15 patients with available tissue samples of sufficient quality for testing. PMID:26529032

  18. Prevalence of asymptomatic genital infection among pregnant women in Benin City, Nigeria.

    PubMed

    Akerele, John; Abhulimen, Philip; Okonofua, Friday

    2002-12-01

    The prevalence of asymptomatic genital infection among pregnant women and their susceptibility to antibacterial agents was investigated to provide baseline data on common asymptomatic genital microorganisms and identify potentials for development of clinical disease among this cohort of patients. High vaginal swabs were obtained from five hundred consecutive and consenting pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital (UBTH) and the Central Hospital, both in Benin City, Nigeria. A total of three hundred specimens showed significant microbial growth, giving a prevalence rate of 60% for asymptomatic genital infections. Candida albicans (65%), Staphylococcus aureus (51.8%) and Enterobacteriacae (E. coli and Klebsiella species) were predominantly isolated, followed by Trichomonas vaginalis and Neisseria gonorrhoea. Most of the bacterial isolates were susceptible to ciprofloxacin, ceftazidime, cotrimoxazole, norfloxacin and augmentin. All the isolates except Streptococcus faecalis were resistant to ampicillin. These results show a high rate of asymptomatic genital tract infections among pregnant women in Benin City, which have implications for adverse maternal and neonatal outcomes. PMID:12685413

  19. Atheromatic™: symptomatic vs. asymptomatic classification of carotid ultrasound plaque using a combination of HOS, DWT & texture.

    PubMed

    Acharya, U Rajendra; Faust, Oliver; Sree, S Vinitha; Alvin, Ang Peng Chuan; Krishnamurthi, Ganapathy; Seabra, José C R; Sanches, João; Suri, Jasjit S

    2011-01-01

    Quantitative characterization of carotid atherosclerosis and classification into either symptomatic or asymptomatic is crucial in terms of diagnosis and treatment planning for a range of cardiovascular diseases. This paper presents a computer-aided diagnosis (CAD) system (Atheromatic™, patented technology from Biomedical Technologies, Inc., CA, USA) which analyzes ultrasound images and classifies them into symptomatic and asymptomatic. The classification result is based on a combination of discrete wavelet transform, higher order spectra and textural features. In this study, we compare support vector machine (SVM) classifiers with different kernels. The classifier with a radial basis function (RBF) kernel achieved an accuracy of 91.7% as well as a sensitivity of 97%, and specificity of 80%. Encouraged by this result, we feel that these features can be used to identify the plaque tissue type. Therefore, we propose an integrated index, a unique number called symptomatic asymptomatic carotid index (SACI) to discriminate symptomatic and asymptomatic carotid ultrasound images. We hope this SACI can be used as an adjunct tool by the vascular surgeons for daily screening. PMID:22255336

  20. Risk stratifying asymptomatic aortic stenosis: role of the resting 12-lead ECG.

    PubMed

    Greve, Anders M

    2014-02-01

    Despite being routinely performed in the clinical follow-up of asymptomatic AS patients, little or no evidence describes the prognostic value of ECG findings in asymptomatic AS populations. This PhD thesis examined the correlates of resting 12-lead ECG variables with echocardiographic measures of AS severity and cardiovascular outcomes in the till date largest cohort (n=1,563) of asymptomatic patients with mild-to-moderate AS. Most importantly, this PhD thesis demonstrated that QRS-duration adds independent predictive value of sudden cardiac death and that the additional presence of ECG LVH/strain for fixed AS severity represents a lethal risk attribute. Finally, ECG abnormalities displayed low/moderate concordance with echocardiographic parameters. This argues that the ECG should be regarded as a separate tool for obtaining prognostically important information. Treatment was not randomized by ECG findings, future studies should therefore examine if and which ECG variables should elicit closer follow-up and/or earlier intervention to improve prognosis in asymptomatic AS populations. PMID:24495893