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Results for “Bone Demineralization, Pathologic”

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PubMedDate not supplied

Bone mineral density and surgical treatment of primary hyperparathyroidism.

The mineral density of bone was measured in 45 patients with primary hyperparathyroidism before surgical treatment and during follow-up averaging 6.5 years, using the Am241 gamma transmission method. Statistically significant demineralization was found at the time of surgery. Removal of pathologic gland(s) was followed by healing of bone density during periods up to 4-5 years. Thereafter bone loss was again faster than in controls. The cause may be a persistent disturbance in the bone-remodelling process.

Adult↗
PubMed1995

Alternatives to Autogenous Bone Graft: Efficacy and Indications.

Bone grafting is frequently used to augment bone healing with the numerous approaches to reconstructing or replacing skeletal defects. Autologous cancellous bone graft remains the most effective grafting material because it provides the three elements required for bone regeneration: osteoconduction, osteoinduction, and osteogenic cells. Autologous cortical bone graft provides these three components to a limited extent as well and also provides the structural integrity important in reconstruction of larger defects. However, because autogenous grafting is associated with several shortcomings and complications, including limited quantities of bone for harvest and donor-site morbidity, alternatives have been used in a wide range of orthopaedic pathologic conditions. Grafting substitutes currently available include cancellous and cortical allograft bone, ceramics, demineralized bone matrix, bone marrow, and composite grafts. No single alternative graft material provides all three components for bone regeneration. The clinical applications for each type of material are dictated by its particular structural and biochemical properties. Composite grafts consisting of several materials are often used to maximize bone healing, especially where the grafting site is compromised.

Journal Article↗
PubMed1995

Long-term healing of bone using recombinant human bone morphogenetic protein 2.

A 2.5-cm-long middiaphyseal plate-stabilized segmental defect in the right femora of 5 adult sheep was implanted with 1.5 mg of recombinant human bone morphogenetic protein 2 mixed with inactivated demineralized ovine bone matrix. Bone healing was evaluated for 12 months using clinical, radiographic, gross pathologic, and histologic techniques. Bone formation within the defect was first visible radiographically between Weeks 2 and 4 after surgery; bone union was apparent between Weeks 12 and 16, at which time the plates were removed. Recanalization of the medullary cavity with neocortex formation was near completion at Week 52. Bone mineral content at the defect sites equaled that of the nonsurgically treated intact femora by Week 16. Perifemoral soft tissue mineralization did not occur, and callus size was not greater than that formed with autograft. By Week 52, the sheep were not lame, and at necropsy the surgically treated femora were rigidly healed. Woven and lamellar bone bridged the defect site. An apparently normal sequence of ossification, modeling, and remodeling events had occurred. Recombinant human bone morphogenetic protein 2 mixed with a suitable carrier could provide an alternative to autograft for use in a variety of orthopaedic procedures.

Absorptiometry, Photon↗
PubMed1983

Pathologic fracture in systemic mastocytosis. Radiographic spectrum and review of the literature.

Systemic mastocytosis is a multiorgan disease that most commonly affects the skin and skeletal system. Radiographically, the skeletal changes in the majority of patients consist of either a wide-spread mixture of bone lysis and osteosclerosis or generalized osteoporosis. The osteoporotic form is less well known but may lead to severe generalized demineralization and pathologic fractures. Mast cells secrete a number of substances, two of which (heparin and prostaglandins) are believed to have a role in the induction of osteoporosis. Sclerotic lesions are induced by another mast cell by-product, histamine. One hundred seventy-eight cases of bony mastocytosis have been reported in the literature, including the four patients in the present report. Special staining procedures are necessary for identification of mast cells. Diagnosis may be delayed in patients who do not have the skin lesions (urticaria pigmentosa) and in the osteoporotic form of the disease.

Adult↗
PubMed1990

[Biphotonic absorptiometry of the foot: methodology and application to algodystrophy].

A simple methodology for the evaluation of the bone mineral content of the foot by biphotonic absorptiometry is described. From the study of a test population, a pathological demineralization threshold of 10%, given that the measurement is expressed in g, has been defined at the level of the forepart of the tarsus. This threshold enables the significant distinction between the test population and a population with algodystrophy. Biphotonic absorptiometry seems to provide a quantitative diagnostic argument to complement the radiographical and scintigraphical examinations.

Absorptiometry, Photon↗
PubMed1986

[Partial algodystrophy].

Two patients are described with parcellar algodystrophy, a special form of algodystrophy. Bone biopsy in one patient revealed increased bone resorption and irregular new bone formation. Parcellar algodystrophy is characterized by the very localized pathological changes in the region of a joint. Only a small area of demineralization may be visible on X-ray. Skeletal scintigraphy shows hyperfixation of technetium-99m already in an early stage. Although the inflammatory signs are clinically impressive, the ESR may be normal. History may reveal previous involved joints. Parcellar algodystrophy normally runs a benign course. The difficulty of correct diagnosis is discussed. The changes are compared to those of partial algodystrophy and algodystrophy with no radiological abnormality throughout the course of the disease.

Bone Resorption↗
PubMed2002

Biological and medical significance of calcium phosphates.

The inorganic part of hard tissues (bones and teeth) of mammals consists of calcium phosphate, mainly of apatitic structure. Similarly, most undesired calcifications (i.e. those appearing as a result of various diseases) of mammals also contain calcium phosphate. For example, atherosclerosis results in blood-vessel blockage caused by a solid composite of cholesterol with calcium phosphate. Dental caries result in a replacement of less soluble and hard apatite by more soluble and softer calcium hydrogenphosphates. Osteoporosis is a demineralization of bone. Therefore, from a chemical point of view, processes of normal (bone and teeth formation and growth) and pathological (atherosclerosis and dental calculus) calcifications are just an in vivo crystallization of calcium phosphate. Similarly, dental caries and osteoporosis can be considered to be in vivo dissolution of calcium phosphates. On the other hand, because of the chemical similarity with biological calcified tissues, all calcium phosphates are remarkably biocompatible. This property is widely used in medicine for biomaterials that are either entirely made of or coated with calcium phosphate. For example, self-setting bone cements made of calcium phosphates are helpful in bone repair and titanium substitutes covered with a surface layer of calcium phosphates are used for hip-joint endoprostheses and tooth substitutes, to facilitate the growth of bone and thereby raise the mechanical stability. Calcium phosphates have a great biological and medical significance and in this review we give an overview of the current knowledge in this subject.

Animals↗
PubMedDate not supplied

Anterior lumbar interbody fusion with titanium mesh cages, coralline hydroxyapatite, and demineralized bone matrix as part of a circumferential fusion.

BACKGROUND CONTEXT: Anterior lumbar interbody fusion (ALIF) has become one of the primary choices for eliminating motion between vertebral segments in patients with severe discogenic pain and other lumbar pathologies. Autograft is the gold standard for spinal fusion. However, multiple authors have reported complication and morbidity rates associated with iliac crest harvesting to be as high as 25%. Drawbacks to the use of allograft in the anterior column include slower incorporation rates, the possibility for disease transmission, increasing cost resulting from stringent processing and unavailability on a worldwide basis resulting from religious and economic concerns. PURPOSE: To determine the clinical and arthrodesis efficacy of coralline hydroxyapatite as an osteoconductive bone graft substitute in the anterior lumbar spine using a titanium mesh cage. STUDY DESIGN: A series of 50 patients returning for long-term prospective follow-up, implanted with titanium mesh cages filled with coralline hydroxyapatite and demineralized bone matrix for ALIF as part of a circumferential fusion. PATIENT SAMPLE: Long-term clinical and radiographic follow-up were examined for the first 50 patients undergoing this technique by one surgeon. OUTCOME MEASURES: Pain was measured with a visual analog scale and function was measured with the Oswestry Disability Index. METHODS: All 50 patients underwent successful ALIF with titanium mesh cages, coralline hydroxyapatite and demineralized bone matrix, as well as an autologous posterolateral fusion with rigid posterior instrumentation. Patients filled out follow-up questionnaires and appropriate radiographs were taken. RESULTS: A solid fusion rate of 96% was achieved. Mean pain decrease was 60% overall. A total of 70% of all patients either returned to work or to full home activities at a mean of 8 months after surgery. Ninety percent felt the surgery was successful. CONCLUSIONS: The combination of titanium mesh cages, coralline hydroxyapatite and demineralized bone matrix is effective for anterior interbody fusion of the lumbar spine when used as part of a rigidly instrumented circumferential fusion.

Adult↗
PubMedDate not supplied

[Effect of vitamin D2 and 1 alpha-hydroxycholecalciferol on bone tissue in rats with femoral fractures].

Formation of the callus at the site of a femoral fracture in rats without vitamin D deficiency is accompanied by an increase in the specific mass and mineralization of the unaffected pair bone, which indicates general intensification of the processes of mineralization occurring in the skeleton during fractures. Vitamin D deficiency leads to hypocalcemia, retardation of callus mineralization, and drastic demineralization of the intact thighbone thus pointing to pathological enhancement of skeleton resorption as the main source of calcium required for covering bodily requirements. Like vitamin D2 in a dose of 0.300 microgram, administration of 1 alpha-hydroxyvitamin D3 (1 alpha-HCD3) in a dose of 0.025 microgram daily to rats with femoral fractures kept on the vitamin D-deficient diet provides for effective calcium homeostasis maintenance and mineralization of the callus and unaffected bones. This demonstrates high biological activity of 1 alpha-HCD3 and its efficacy in promoting the processes of mineralization during fractures. The increase in the phosphorus content in the diet until the calcium/phosphorus ratio reaches 1:2 (instead of the optimal 1:1), aggravates hypocalcemia and sharply enhances demineralization of the intact bone in vitamin d-deficient rats with femoral fractures and reduces mineralization of the callus in rats given 1 alpha-HCD3. The data obtained indicate the necessity of reliable correction of potential vitamin D deficiency and optimization of the calcium-phosphorus ratio in the diet and preparations, as well as a possibility of applying 1 alpha-HCD3 in the combined treatment of fractures.

Animals↗
PubMedDate not supplied

Computed tomography of the neck.

Thorough familiarity with the anatomy of the neck depicted in axial sections is fundamental to the interpretation of computed tomography (CT) scans. Fifteen consecutive sections are selected at 1 cm-intervals beginning at the level of the nasopharynx and extending down to the level of the thoracic inlet. Each scan is referenced to a profile drawing of the neck. Each CT scan is reproduced in the line drawing, which is labeled for major organs and discrete structures appearing in that section. Twelve representative cases illustrate the usefulness of CT in the evaluation of neck masses by documenting tumor size, location and relationship to adjacent structures. Intravenous contrast improves recognition of vascular structures and distinguishes lymph nodes from blood vessels. The location and relative density of lesions facilitate their specific identification. Demineralization of bone and cartilage is accurately documented in the illustrative cases. Symmetry is the key to the interpretation of subtle pathologies.

Carotid Arteries↗
PubMed1989

[Experience with the clinical use of demineralized bone autografts in traumatology and orthopedics].

The authors analyse the results of clinical application of osseous allografts demineralized by 1, 2-2, 4-3, 6 N solutions of hydrochloric acid. Of 92 patients with various pathologies of the locomotor system the postoperative results were positive in 85 cases (92.4%) and negative in 7 cases (7.6%). The analysis has demonstrated that the negative results were not connected with the kind of the osteoplastic material.

Adolescent↗
PubMed2002

[Bone metabolism and bone mass loss in eating disorders].

Eating disorders (anorexia and bulimia nervosa) are present in 1-3% of young female women. A later beginning, prolonged amenorrhea and low body mass index are risk factors of osteopenia in bulimic patients. Bone demineralization in anorexia nervosa is due to a greater resorption than bone formation leading to osteopenia, secondary osteoporosis and increased risk of pathologic fractures. Pathophysiology of bone disease includes factors as long duration of amenorrhea, deficient absorption of calcium, extreme physical exercise, 1.25 vitamin D deficiency, low creatinine clearance, increased blood and urinary cortisol and high levels of GH. Proposed treatments are nutritional improvement and weight gain (the most important), calcium supplementation, moderate exercise, estrogens, antidepressive drugs, fluoride in selected cases, byphosphonates and recombinant human IGF-1. An adequate questionnaire is essential in women with slightly decreased weight and menstrual disorders.

Anorexia↗
PubMed1996

Long-term bone loss in kidney transplant recipients: a cross-sectional and longitudinal study.

Organ transplantation is associated with an early bone loss that subsequently increases the risk of osteopenia and bone fractures. It is not known whether bone loss continues in long-term survivors, but persistent bone demineralization could further jeopardize an already diminished bone mass. To better define long-term bone status of kidney transplant recipients (KTR), we conducted cross-sectional and longitudinal evaluations of bone mineral density (BMD) in 70 KTR with a mean posttransplantation time of 8.1 years. BMD was determined by dual-energy X-ray absorptiometry and was repeated in 55 of the patients after a mean follow-up period of 22 +/- 5 months. Lumbar and femoral osteopenia, defined as a BMD lower than 2 standard deviations from mean value of sex- and age-matched controls, was present in 28.6% and 10.5% of patients, respectively. There was a significant negative correlation between cumulative prednisone dose and adjusted lumbar as well as femoral BMD (R = 0.45, P < 0.001 and R = 0.29, P < 0.05, respectively). Five patients had a vertebral BMD below a fracture threshold of 0.777 g/cm2. Vertebral fractures (VF) were found in four men and were associated with higher prednisone dosage (P < 0.05), larger cumulative prednisone dose (P < 0.05), and significantly lower BMD values. According to World Health Organization recent criteria for women, prevalences of lumbar and femoral osteopenia and lumbar and femoral osteoporosis in female patients reach 75%, 65%, 33%, and 10%, respectively. The longitudinal part of the study showed a persistent pathological lumbar demineralization process. Over the study period, BMD, expressed as a percentage of that of controls, decreased from 89 +/- 14% to 86 +/- 14% (P < 0.001). Annual change of bone mass was -1.7 +/- 2.8% per year. Accelerated vertebral bone loss (defined as a decrease of BMD, expressed as a percentage of that of controls, of more than 1% per year) was present in 56% of patients and was associated with higher prednisone dosage (P < 0.01). In conclusion, although VF are relatively infrequent in long-term survivors of renal transplantation, osteopenia is a frequent finding, and a substantial proportion of women present lumbar osteoporosis. An ongoing demineralization process of the spine is also demonstrated and probably contributes to long-term spinal osteoporosis incidence. Prednisone dosage remains the most constantly isolated risk factor.

Adult↗
PubMed1984

Bone mineralization in infants.

The major physiologic control of bone mineralization in infancy involves calcium and phosphorus. Ca and P metabolism in turn is affected by endogenous stores at birth and the ability to deliver and absorb exogenous sources of these minerals. Calciotropic hormones (parathyroid hormone, calcitonin and 1,25 dihydroxyvitamin D) modulate the response of major end organs - intestine, kidney and bone - to balance the need to maintain a relatively stable extracellular biochemical environment with the need for adequate mineralization of the bone. Many other factors such as glucocorticoids under pathological circumstances may disturb bone mineralization; however, the mechanisms by which they control bone mineralization in infancy under physiologic circumstances is ill understood. Clinical bone demineralization occurs primarily in infants born with extreme prematurity. In the presence of conventional vitamin D supplementation, deficiency of calcium and phosphorus appears to play a major role in its causation.

24,25-Dihydroxyvitamin D 3↗