[Physiological ossification of the falx cerebri. Findings on magnetic resonance].
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This study was undertaken to identify the variations in the physiologic ossification of human laryngeal cartilages by evaluating the lateral cephalometric radiographs of healthy males and females referred to our facility. Lateral cephalometric radiographs of 359 patients (141 male and 218 female; ages 10 to 59 years) referred from various specialty clinics between April 1998 and March 2000 were used. Frequencies and confidence intervals were obtained and tabulated for both thyroid and cricoid ossifications as seen on these cephalometric radiographs. The interobserver agreement was strong for both thyroid (kappa = .986) and cricoid (kappa = .982) observations. Overall, thyroid cartilage was more frequently ossified compared with cricoid. Various degrees of thyroid and cricoid cartilage ossification were found in 186 patients (120 female and 66 male) in the third decade and beyond. Among 173 patients in the first 2 decades (98 females and 75 male), evidence of thyroid ossification was found in 2 male patients aged 14 and 18, and ossification was detected in the cricoid cartilage in 12 patients. There was a preponderance of laryngeal cartilage ossification in men compared with women. Radiographically detectable laryngeal ossification increased with age starting in the third decade. There is a general trend of increase in the ossification of laryngeal cartilages as the age advanced.
At birth, the distal tibial physis is a transverse structure. However, as the tibia enlarges diametrically and the epiphyseal ossification center matures, the physis becomes increasingly undulated, with peripheral lappet formation. The anteromedial area is the first to develop undulation (Poland's hump). This should not be misinterpreted as an injury or premature epiphyseodesis subsequent to trauma. The tibial secondary ossification center forms within the central epiphysis. The medial margin is irregular and may have peripheral foci of ossification. Between the ages of 7 and 8 years, this secondary center extends into the medial malleolus, reaching the distal tip during adolescence. The malleolar tip may develop accessory ossification. Physiologic epiphyseodesis begins over the medial malleolus and then extends laterally, a pattern of closure that affects fracture patterns (e.g., the fracture of Tillaux). The distal fibular physis also begins as a transverse structure that becomes undulated and has extensive peripheral lappet formation. This physis usually becomes level with the articular surface of the distal tibia after the first year. Enchondromalike extensions of the physis into the metaphysis are common. Accessory ossification may develop at the distal end.
The cartilage framework of the patella in rats is capable of inducing ossification after homotransplantation in many various sites: muscle, thyroid, testicle, ovary, kidney, anterior chamber of the eye, etc. The frequency of ossification does not depend on the technical conditions of the transplant, but on the age of the donors and receivers; it approximates 84 p. cent when the two rats are three weeks old. It is close to 100 p. cent in case of autotransplant. It is non-existent in case of heterotransplantation. A cartilage that is killed by alcohol or cold, has no longer osteogenetic abilities, even if it is placed in contact with live cartilage. The transplant of patellar cartilaginous framework represents a model which may be used to study the factors responsible for physiological ossification as well as the effect of various experimental conditions on osteogenesis.
Bilateral apparently bony structures of different forms and sizes located in the inferior and superior ventral parts of the sacroiliac joints were observed on axial CT images of the pelvic region of juvenile patients. No other pathological changes were noted in the sacroiliac joints of these individuals. In one patient the bony structures could also be seen on a conventional plain radiograph. We also examined 3 juvenile autopsy specimens of this joint using radiology, CT, macroscopical evaluation and histology. In two of them, structures could be detected on the CT scans which were similar to those observed in the young patients. Macroscopic investigations revealed the structures to be secondary ossification centres located in the articular cartilage of the lateral part of the os sacrum at the levels of the first and third sacral segments. According to older anatomical literature, these epiphysial ossification centres contribute to the auricular surface of the lateral part of the os sacrum and the free lateral surface of the inferior sacral parts. They can be observed between the ages of 12 and 25 years and begin to synostose with the lateral part around the age of 18 years. In macerated juvenile specimens of the bony pelvis, free ossicles were not detectable in the region of the sacroiliac joints. Histological peculiarities of the ossification process observed are discussed. These physiologically occurring ossification centres are to be differentiated from pathological alterations appearing as bony or bone-like structures on CT scans.
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The accuracy of information obtained from such a simple procedure as looking in the mouth as a measure of child development led to this review. The relationship between dental and physical development has been known for many years. Methods of assessing maturity by counting erupted teeth are described. Measurements taken on two boys illustrated this hypothesis, and from these the close correlation between height and weight, bone age and dental age is shown. It is suggested that physicians and dentists should record the number of erupted teeth on interval examinations, since the pattern of eruption and calcification of teeth may present the first indication of developmental retardation.
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Vascular endothelial growth factor (VEGF)-mediated angiogenesis is an important part of bone formation. To clarify the role of VEGF isoforms in endochondral bone formation, we examined long bone development in mice expressing exclusively the VEGF120 isoform (VEGF120/120 mice). Neonatal VEGF120/120 long bones showed a completely disturbed vascular pattern, concomitant with a 35% decrease in trabecular bone volume, reduced bone growth and a 34% enlargement of the hypertrophic chondrocyte zone of the growth plate. Surprisingly, embryonic hindlimbs at a stage preceding capillary invasion exhibited a delay in bone collar formation and hypertrophic cartilage calcification. Expression levels of marker genes of osteoblast and hypertrophic chondrocyte differentiation were significantly decreased in VEGF120/120 bones. Furthermore, inhibition of all VEGF isoforms in cultures of embryonic cartilaginous metatarsals, through the administration of a soluble receptor chimeric protein (mFlt-1/Fc), retarded the onset and progression of ossification, suggesting that osteoblast and/or hypertrophic chondrocyte development were impaired. The initial invasion by osteoclasts and endothelial cells into VEGF120/120 bones was retarded, associated with decreased expression of matrix metalloproteinase-9. Our findings indicate that expression of VEGF164 and/or VEGF188 is important for normal endochondral bone development, not only to mediate bone vascularization but also to allow normal differentiation of hypertrophic chondrocytes, osteoblasts, endothelial cells and osteoclasts.