[Primary subacute hematogenous osteomyelitis in children].
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Biomedical subjects
Publications and source records attributed to S Weintroub.
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Vitamin D deficiency is known to cause alterations in the lipid and mineral components of bone and cartilage. In this study, second generation, normal phosphatemic, vitamin D-deficient rats, treated with low and high doses of three different vitamin D metabolites were sacrificed 24 h after treatment and their bones analyzed in order to determine which metabolites were most effective in altering the lipid composition. In the untreated vitamin D-deficient rats, tissues undergoing endochondral ossification (epimetaphyses), periosteal and endosteal bone formation (diaphyseal bone), and intramembranous bone formation (calvaria) all contained lower amounts of complexed acidic phospholipids, as well as decreased amounts of mineral. Twenty-four hours following treatment, the complexed acidic phospholipid content was significantly increased relative to both untreated and normal (vitamin D-replete) animals, the greatest increases occurring in animals treated with 1,25-dihydroxyvitamin D. All metabolites tested altered histomorphometric and/or mineral parameters, but only 1,25-dihydroxyvitamin D, in low and high doses, significantly increased the content of the complexed acidic phospholipids in all tissues studied. High doses of other metabolites increased complexed acidic phospholipid content in some tissues, perhaps due to their conversion to 1,25-dihydroxyvitamin D. Linear relationships between serum 1,25-dihydroxyvitamin D levels and tissue complexed acidic phospholipid content are reported. It is suggested that one way in which this metabolite may directly contribute to calcification is by facilitating formation of lipids involved in this process.
The purpose of this investigation was to verify a long-standing clinical observation that patients with fracture of the proximal end of the femur have less evidence of osteoarthritic changes in their hip joints than would have been expected in patients of similar age groups. The radiographs of 342 patients with fractures and those of 157 controls were examined. The statistical results gave uncontroversial evidence that the incidence of osteoarthritic joints was lower in the fracture group. The difference was even greater with severe osteoarthritic changes. This suggests that patients with osteoarthritis have a "better quality" of bone. They are less likely to be suffering from osteoporosis and less liable to fractures of the proximal end of the femur.
In a review of the roentgenological files of 22 patients suffering from spastic paraplegia due to neurolathyrism, 3 patients were found to present abnormal skeletal findings. 2 patients showed absence of union of the secondary ossification centres of the iliac crests, the ischial tuberosities and the vertebral bodies. Their age at the time of ingestion of poisonous Lathyrus sativus plants was 19 and 20 years. The 3rd patient had bowing and thickening of his right femoral shaft. He was 22 years old at the time of poisoning. These findings which are similar to those found in experimental osteolathyrism have never been described in clinical neurolathyrism. They are of a nature to throw some doubt on the correctness of the currently prevailing concept of sharp distinction between these two pathological entities.
In 2 patients (3 knees) acute infectious arthritis of the knee developed following intra-articular injection of corticosteroids. The pathogenic organism responsible for the infection was found to be Mycobacterium Abscessus (M. Chelonei). Diagnostic difficulties were encountered due to the rarity of such infections and elusive identification of the organism with routine laboratory procedures. Therapeutic approaches necessitated combined radical surgical procedures together with antituberculosis drugs. Surgical treatment also afforded correct and definitive identification of the organism, from material obtained at operation. Although these mycobacteriae were found to be resistent to antituberculosis drugs, these same drugs proved effective clinically.
We determined the acetabular angles, center-edge angles, comprehensive quotients, and Shenton's lines from sequential roentgenograms of thirty-seven children with congenitally dislocated hips treated by closed non-manipulative reduction in early infancy. The values were compared with those obtained from roentgenograms of 164 normal children who ranged in age from three months to five years and of forty-three adolescents and adults. The hip recovering from congenital dislocation developed similarly to the normal hip but differed in that it showed a greater rate of decrease of the acetabular angle and an increase in the center-edge angle. Significant development after the age of five years still was manifested in the reduced hips.
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A 51-year-old man was hospitalized and operated on for gastric carcinoma with widespread metastases and died two months after the laparatomy and biopsy examination. Two years prior to the operation, he deveoped nephrotic syndrome. Anaplastic carcinoma, linitis plastica form, of the stomach was found in the tumor biopsy examination and at autopsy. Light and electron microscopical studies of the kidney biopsy specimen taken at laparatomy confirmed the presence of membranous glomerulopathy. An immunologic basis of the concomitant appearance of malignant neoplasms and nephrotic syndrome is possible, based on reported cases. There is also a possibility that renal damage occurs more commonly in malignant neoplasms, but is not recognized clinically.
A rare case of a solitary benign rectal ulcer in which conservative medical therapy was unsuccessful is described. Diversion of the fecal stream by temporary sigmoidostomy resulted in rapid healing of the ulcer. This entity presents diagnostic and therapeutic problems, which are discussed. The use of temporary sigmoidostomy in such cases is recommended.