Common Degenerative Changes Research Articles

Senile scleral plaque – Clinical and anterior segment optical coherence tomography correlation

Senile scleral plaques are common age-related degenerative changes quite often diagnosed on routine examination. We report a case of an elderly female, incidentally noted to have clinical findings suggestive of a senile scleral plaque. Anterior segment optical coherence tomography (AS-OCT) concurred with clinical findings. They are in general non-progressive or slowly progressive. Although the risk of progression is rare, considering the rare possibility of perforation, we recommend periodic review both clinically and with AS-OCT. Imaging may also be valuable in patients with senile scleral plaques undergoing scleral procedures and repeated intravitreal injections to understand the possible risks of perforation.

Autologous Bone Graft vs PEEK Cage in Patients with Cervical Spondylotic Myelopathy

Background: Cervical spine stenosis is one of the most common degenerative changes of cervical spondylotic myelopathy (CSM) and results in severe dysfunction of the cervical spinal cord. The conventional treatment of such degenerative cervical spine conditions is anterior cervical discectomy and fusion (ACDF). Strut graft remains the gold standard in ACDF with excellent patient recovery but has many shortcomings. Polyetheretherketone (PEEK) cages have recently become popular as a replacement for strut grafts in patients undergoing ACDF.
 Objective: This study was carried out to compare the clinical and radiographic outcomes of autologous bone grafts versus PEEK cages in patients undergoing ACDF surgery.
 Materials and Methods: It was a randomized controlled trial conducted at the Neurosurgery Department Punjab Institute of Neurosciences for three years. Patients who consented to be a part of this study and fulfilled our predefined inclusion criteria were recruited and randomized into 2 groups. One group underwent ACDF with auto bone graft whereas the other group underwent ACDF with PEEK cage.
 Results: A total of 198 subjects were included in this study. The mean age was calculated as 47.60 ± 9.17 years in the PEEK cage group and 46.74 ± 8.87 years in the Autologous bone graft group. Males accounted for 59.6% of the study population. The fusion rate was found to be higher in the PEEK cage group with a p-value of 0.002.
 Conclusion: PEEK cages are superior to strut grafts as they have lesser morbidity after ACDF surgery in patients with CSM.

Ultrasound of cervical nerve root enlargement in polyneuropathy is not confounded by neuroforaminal stenoses

ObjectiveUltrasound can detect enlargement of cervical nerve roots, which has been described in polyneuropathies (PNP), mainly of demyelinating pathology. This study investigates whether neuroforaminal stenosis, as a common but often asymptomatic degenerative change, is associated with nerve root enlargement on ultrasound and whether neuroforaminal stenosis thus confounds cervical nerve root ultrasound findings in the diagnostic assessment of PNP. MethodsWe retrospectively studied 182 patients (62 demyelinating, 71 axonal PNP; 49 without evidence of PNP) who had undergone ultrasound of the cervical nerve roots C5 and C6 and magnetic resonance or computed tomography of the cervical spine that was reviewed with respect to neuroforaminal stenoses. ResultsPatients with demyelinating PNP had larger nerve roots than those with axonal/without PNP. No significant differences in cervical nerve root diameters were found between groups with vs. without neuroforaminal stenosis. The diagnostic performance of the discrimination of PNP subtypes based on ultrasound nerve root measurements did not differ significantly when including or excluding subjects with neuroforaminal stenoses. ConclusionsNeuroforaminal stenosis per se does not entail relevant cervical nerve root enlargement detectable by nerve ultrasound. SignificanceUltrasound assessment of cervical nerve root size in the diagnostic evaluation of PNP is unlikely to be confounded by common degenerative changes of the cervical spine.

Osseous metaplasia in multiple broad ligament leiomyomas: An extreme rarity

Osseous metaplasia in a leiomyoma is an uncommon clinical entity with the presence of mature and immature bone in a leiomyoma. Infection, necrosis, hyaline degeneration, calcification and myxoid degeneration are the most common secondary degenerative changes seen in cases of leiomyoma. Calcified and ossified leiomyomas are uncommon and is rarely reported in literature. We report one such case in a 45 year old perimenopausal female who presented clinically with abnormal uterine bleeding. Multiple nodules were seen in bilateral broad ligaments, which on histopathology revealed features of osseous metaplasia in hyalinized degenerated leiomyomas, an extremely rare clinical entity.

Prevalence of Spinal and Bony Structural Disorders in Saudi Adult Using MRI in Different Genders

Background: Magnetic resonance imaging is the primary imaging modality for the evaluation of spinal cord and spinal column disorder. Aims: to assess the prevalence of bony structure and spinal disorders in the Saudi population and to find a correlation between patient age and gender. Material and Methods: A retrospective study was conducted using magnetic resonance imaging in Al-Taif city from November 2020 to February 2021 at King Abdul-Aziz Specialist Hospital and King Faisal Hospital in Taif City, Kingdom of Saudi Arabia, to assess the prevalence of bony structure and spinal disorders in the Saudi population. The data was collected after gaining ethical approval from the directorate of health affairs in Taif’s administration of research and studies, and then analyzed using SPSS version 25 to determine the frequency and percentage of disorder. To check if there was a significant difference between the two groups, the Pearson’s chi square test was utilized. Results: One hundred young adults underwent MR examination of the spine. The results show that the most common age group affected by spinal disorders is over 50 years (53%), the most common bony structural spinal disorders are straightening 59%, followed by lordosis (20%), and the most common disc disorders are disc bulges (15%), and the most common degenerative changes are spondylo-degenerative changes (21%), and there is no significant correlation between genders and MRI findings (p-value). Conclusion: The study found that straightening is the most prevalent MRI-diagnosed spine disorder, followed by degenerative illnesses and that there is no significant association between gender and the type of MRI-diagnosed spinal disorders.

Assessment of Correlation Between Bone Quality and Degenerative Bone Changes in Temporomandibular Joint by Computed Tomography - A Retrospective Study

Objectives: This study was performed to assess the correlation between bone quality and degenerative bone changes in temporomandibular joints on computed tomographic images. Methods: Temporomandibular joints of 100 patients who underwent computed tomography were analyzed retrospectively. Sagittal and coronal images of the joint (condyle and articular eminence) were assessed for bone quality type 1 to 4 and degenerative bone changes. A Chi-square test was used to assess the descriptive statistics. One-way ANOVA was used to compare the degenerative changes in different age groups and gender. The post hoc Tukey honesty significance test was used to assess the presence of a statistically significant difference between the degenerative changes and bone quality. A value P < 0.005 was considered statistically significant. Results: The retrospective analysis included 48 women and 52 men with ages ranging from 17 to 85 years (mean age 52 years). D3 quality of bone was most commonly observed in the condyle and articular eminence. Osteophytes were the most common degenerative changes observed in the condyle and no significant degenerative changes were seen in the articular eminence. There was a correlation between degenerative changes and bone quality of condyle with respect to age. There was no correlation between the bone quality of the condylar head and its degenerative changes. Conclusion: There was no correlation between the type of bone quality and degenerative bony changes of the condyle and articular eminence, but most of the patients with degenerative changes had a poor-quality bone.

Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study.

Population-based cohort study. We examined associations between common lumbar degenerative changes observed on magnetic resonance imaging (MRI) and present or future low back pain (LBP). The association between lumbar MRI degenerative findings and LBP is unclear. Longitudinal studies are sparse. Participants (n = 3369) from a population-based cohort study were imaged at study entry, with LBP status measured at baseline and 6-year follow-up. MRI scans were reported on for the presence of a range of MRI findings. LBP status was measured on a 0 to 10 scale. Regression models were used to estimate the cross-sectional and longitudinal associations between individual and multiple MRI findings and LBP severity. Separate longitudinal analyses were conducted for participants with and without baseline pain. MRI findings were present in persons with and without back pain at baseline. Higher proportions were found in older age groups. 76.4% of participants had a least one MRI finding and 8.3% had five or more different MRI findings. Cross-sectionally, most MRI findings were slightly more common in those with LBP and pain severity was slightly higher in those with MRI findings (ranging from 0.06 for high intensity zone to 0.83 for spondylolisthesis). In the longitudinal analyses, we found most MRI findings were not associated with future LBP-severity regardless of the presence or absence of baseline pain. Compared to zero MRI findings, having multiple MRI findings (five or more) was associated with mildly greater pain-severity at baseline (0.84; 0.50-1.17) and greater increase in pain-severity over 6 years in those pain free at baseline (1.21; 0.04-2.37), but not in those with baseline pain (-0.30; -0.99 to 0.38). Our study shows that the MRI degenerative findings we examined, individually or in combination, do not have clinically important associations with LBP, with almost all effects less than one unit on a 0 to 10 pain scale.Level of Evidence: 3.

Low-dose MDCT: evaluation of the impact of systematic tube current reduction and sparse sampling on the detection of degenerative spine diseases

ObjectivesTo investigate potential radiation dose reduction for multi-detector computed tomography (MDCT) exams of the spine by using sparse sampling and virtually lowered tube currents combined with statistical iterative reconstruction (SIR).MethodsMDCT data of 26 patients (68.9 ± 11.7 years, 42.3% males) were retrospectively simulated as if the scans were acquired at 50%, 10%, 5%, and 3% of the original X-ray tube current or number of projections, using SIR for image reconstructions. Two readers performed qualitative image evaluation considering overall image quality, artifacts, and contrast and determined the number and type of degenerative changes. Scoring was compared between readers and virtual low-dose and sparse-sampled MDCT, respectively.ResultsImage quality and contrast decreased with virtual lowering of tube current and sparse sampling, but all degenerative changes were correctly detected in MDCT with 50% of tube current as well as MDCT with 50% of projections. Sparse-sampled MDCT with only 10% of initial projections still enabled correct identification of all degenerative changes, in contrast to MDCT with virtual tube current reduction by 90% where non-calcified disc herniations were frequently missed (R1: 23.1%, R2: 21.2% non-diagnosed herniations). The average volumetric CT dose index (CTDIvol) was 1.4 mGy for MDCT with 10% of initial projections, compared with 13.8 mGy for standard-dose imaging.ConclusionsMDCT with 50% of original tube current or projections using SIR still allowed for accurate diagnosis of degenerative changes. Sparse sampling may be more promising for further radiation dose reductions since no degenerative changes were missed with 10% of initial projections.Key Points• Most common degenerative changes of the spine can be diagnosed in multi-detector CT with 50% of tube current or number of projections.• Sparse-sampled multi-detector CT with only 10% of initial projections still enables correct identification of degenerative changes, in contrast to imaging with 10% of original tube current.• Sparse sampling may be a promising option for distinct lowering of radiation dose, reducing the CTDIvolfrom 13.8 to 1.4 mGy in the study cohort.

Imaging of the degenerative spine using a sagittal T2-weighted DIXON turbo spin-echo sequence

PurposeTo evaluate the diagnostic performance of a sagittal T2-weighted DIXON turbo spin-echo (TSE) sequence and to assess whether fat-only images could replace dedicated sagittal T1-weighted sequences for magnetic resonance imaging (MRI) of the degenerative spine. Method35 patients (56.5 ± 19.8 years, 62.9 % males) with lumbar back pain (LBP) who underwent MRI of the lumbar spine including a sagittal T2-weighted DIXON sequence (acquisition time: 3:25 min) and T1-weighted sequence (acquisition time: 3:03 min) were included. Two image layouts (layout 1: fat-only AND water-only AND in-phase images of the DIXON sequence; layout 2: water-only AND in-phase images of the DIXON sequence AND T1-weighted images) were evaluated by two readers (R1 and R2) concerning degenerative changes including diagnostic confidence (1 – low, 2 – intermediate, and 3 – high) and signal changes of vertebral bone marrow (BM). Results were compared between readers and layouts. ResultsNo differences were observed in the number of detected pathologies on a segment-wise level, nor in the number of segments affected by degenerative changes when comparing evaluations of layout 1 and layout 2 for each reader. Diagnostic confidence was high without a statistically significant difference between the readings of both layouts (R1: layout 1: 2.79 ± 0.41, layout 2: 2.81 ± 0.39, p = 0.53; R2: layout 1: 2.99 ± 0.07, layout 2: 2.99 ± 0.07, p = 0.99). ConclusionsIn patients with LBP, MRI using a sagittal T2-weighted DIXON sequence and no separate T1-weighted sequence might be sufficient to accurately detect common degenerative changes with high diagnostic confidence. Sparing dedicated T1-weighted sequences can considerably reduce overall scan time.

Evaluation of the relationship between tympanic plate morphology and degenerative bone changes of condyle and articular eminence

IntroductionThis study aimed to evaluate the relationship between tympanic plate morphology and degeneration of temporomandibular joint (TMJ) condyle and articular eminence (AE). Material and methodsCone beam computed tomography images of 700 patients (345 males, 355 females) were evaluated. The prevalence and location of tympanic plate pneumatization (TPP) and foramen tympanicum (FT) were recorded. Sagittal scans of the TMJs were classified according to the degenerative bone changes of condyle and AE (flattening, osteophytes, erosion, sclerosis, and subcortical cysts). ResultsTPP was found in 106 of 700 patients (15.2%) while FT was found in 165 (23.2%) of the patients. TPP and FT were bilateral in 52 (49.1%) patients and 46 (27.9%) patients, respectively. The mean axial diameter of FT was 2.53mm and the mean sagittal diameter was 2.52mm. The most common degenerative changes for condyle and AE were flattening. ConclusionTo know these structures is important for surgical operations in the region of TMJ and ear to prevent complications. CBCT is useful to evaluate these anatomical landmarks and the relationship between them and the degenerative bone changes of condyle and AE.

Exosomes Isolated From Adipose-Derived Stem Cells: A New Cell-Free Approach to Prevent the Muscle Degeneration Associated With Torn Rotator Cuffs

Background: Fatty infiltration, inflammation, and apoptosis are common degenerative changes in patients with chronic rotator cuff tears that can lead to muscle atrophy and can even result in massive irreparable rotator cuff tears. Some data have demonstrated the proregenerative, anti-inflammatory, and anti-apoptotic properties of stem cell–derived exosomes in some orthopaedic disorders, but their effect on torn rotator cuff muscles has never been investigated. Purpose: To study the effect of exosomes isolated from human adipose-derived stem cells (ASCs-Exos) on muscle degeneration, regeneration, and biomechanical properties in a rat model of a massive rotator cuff tear (MRCT). Study Design: Controlled laboratory study. Methods: A bilateral supraspinatus and infraspinatus tenotomy was performed on rats to create an MRCT model. Forty-two rats were randomly assigned to 3 groups: the sham surgery group, the saline group (lesions treated with a saline injection), and the ASCs-Exos group (lesions treated with an ASCs-Exos injection). Wet muscle weight, fatty infiltration, inflammation, vascularization, regeneration, and biomechanical properties were evaluated at 8 and 16 weeks after surgery. Results: The results revealed that the ASCs-Exos treatment could prevent the atrophy, fatty infiltration, inflammation, and vascularization of muscles in the MRCT model (P < .001). Additionally, the myofiber regeneration and biomechanical properties of ASCs-Exos-treated rotator cuffs were significantly elevated compared with those in the saline-treated group (P < .001). Conclusion: This study demonstrates that ASCs-Exos can effectively decrease atrophy and degeneration and improve muscle regeneration and biomechanical properties in torn rotator cuff muscles. Clinical Relevance: ASCs-Exos can be used as a new cell-free approach to prevent the muscle degeneration associated with torn rotator cuffs and may be helpful to repair torn rotator cuffs. Nevertheless, further work needs to be done in a large animal model owing to the inherent regenerative potential possessed by rodents.

Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms.

Our aim was to describe 3-dimensional condylar deformation of the temporomandibular joint (TMJ) and symptoms and signs of temporomandibular dysfunction (TMD) in patients with idiopathic condylar resorption (ICR). We included 25 patients with ICR and 25 controls. We performed cone-beam computed tomographic scans and analyzed condylar width, length, and height as well as the condylar axial angle and the condylar neck angle. TMJ cross sections were evaluated for degenerative characteristics and location of bony deformations. Furthermore, symptoms and signs of TMD were described in the ICR group. In the ICR group, we found statistically significantly reduced condylar width (mean difference, 2.0mm), height (mean difference, 4.9mm), and condylar axial angle (mean difference, 10.6°); 84% of the TMJs had a posterior condylar neck angle (control group, 22%). The most common degenerative changes were noncongruent shape of the condyle-fossa relationship (72%), condylar resorption (56%), and nonintact cortex (40%). More than 70% of the joints with bony deformations showed changes along the entire condylar head. Most patients with ICR showed symptoms and signs of TMD; nevertheless, 12% had no signs or symptoms of TMD. ICR in the TMJ changes the shape and reduces the size of the condyle. Deformity locations are unspecified, and the entire condyle is often affected. Most patients with ICR have signs or symptoms of TMD; however, a small group was asymptomatic and without clinical signs.

Lumbar Retrolisthesis in Aging Spine: What are the Associated Factors?

A retrospective radiographic study. The aim of this study is to demonstrate that lumbar retrolisthesis serves as an important compensatory mechanism and to identify the possible factor related to lumbar retrolisthesis. Lumbar instability is one of the common degenerative changes, which presents as 2 radiologic features: anterolisthesis and retrolisthesis. Compared with the extensive studies on anterolisthesis, limit data are available on the characteristics and clinical relevance of lumbar retrolisthesis. In this study, 105 adult patients with low back pain were prospectively recruited, of which 60 patients had retrolisthesis (group 1) and 45 patients had anterolisthesis (group 2). Another 40 healthy age-matched adults (group 3) were also included to serve as the control group. Sagittal spinopelvic parameters were measured from the standing lateral radiograph, including thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT), sagittal vertical axis (SVA), spinosacral angle (SSA), and C7 tilt (C7T). In addition, disk degeneration was quantitatively evaluated by Pfirrmann score on T2-weighted magnetic resonance images in patients with retrolisthesis. For all the sagittal parameters, SVA, PI, SS, and LL in retrolisthesis group were found to be significantly lower than those in the anterolisthesis group and in the control group, respectively (P<0.05), whereas TLK in retrolisthesis group was significantly larger than other 2 groups (P<0.01). In addition, the average Pfirrmann disk score was 2.11 at levels with retrolisthesis indicating that the disks were not severely degenerated. Lumbar retrolisthesis, together with thoracolumbar kyphosis, appears to be associated with mechanisms associated with regulation of sagittal balance. Low PI and disk instability due to degeneration may contribute to the development and progression of retrolisthesis.

Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study

Introduction Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango). Methods 36 patients were included in this single-center, prospective, observational study from January 2013 to June 2014. Data were collected from the Spine Tango or DWG Register. The core outcome measure index (COMI), Oswestry Disability Index (ODI), and the quality of life questionnaire EuroQoL-5D were used. Data were collected prior to surgery as well as six weeks, six months, and twelve months after the operation. Results The patient cohort comprised 13 females and 23 males (36.1 and 63.9 %). Complete 12-month follow-up data on 21 patients were available for analysis. Compared to preoperative measures, the COMI score increased 8.1 ± 1.5 over the entire follow up, with 4.5 ± 3.1 at 6 weeks (p < 0.001), 4.8 ± 3.1 at 6 months, and 3.8 ± 3.2 at 12 months. ODI scores, measuring spinal function impairment, were significantly better than preoperative values overall (47.5 ± 17.3) and after 6 weeks (29.1 ± 22.4; p < 0.005), 6 months (30.0 ± 19.3), and 12 months (23.8 ± 18.2). Quality of life measures improved in a similar manner (preoperative: 0.36 ± 0.38; 6 weeks: 0.57 ± 0.34 (p < 0.019); 6 months: 0.62 ± 0.28; 12 months: 0.67 ± 0.31). Conclusion Our study shows that LSS patients without previous surgery and neurologic deficits can expect significant pain relief and improved quality of life already six weeks after undergoing stabilizing decompression. There was an increase in positive postoperative effects over 12 months. The DWG Register provides a standardized and validated means to compare non-operative and operative treatments of the spine over the long term.

Morphometric and Histological Study of Osteophytes in Human Cadaveric Lumbar Vertebrae

Introduction: Osteophytes are bony outgrowth on the vertebral column. Its prevalence in the lumbar region and clinical importance mandates to conduct a detailed study of lumbar osteophytes in the cadaveric vertebral column. Aim: The present study was conducted to study the detailed features of lumbar osteophytes and document its prevalence, morphometric and histological structure. Materials and Methods: This was an observational study in which frequency of occurrence of lumbar osteophytes was studied in 40 cadaveric vertebral columns over a period of four years. The lumbar part of the vertebral columns was dissected and examined meticulously. The occurrence of lumbar osteophytes with their vertebral levels and morphometric measurements were recorded. A small excision of the osteophyte was processed histologically to study its microscopic details using routine Haematoxylin & Eosin stain. Results: Lumbar osteophytes were present in 4 specimens (10%). They were mostly found on the right side of the vertebral bodies. Histopathological examination of the osteophytes revealed degenerative osteophytic cartilage and fibrillation overlying the trabecular bone enclosing fatty marrow spaces containing haematopoietic elements. Conclusion: Lumbar osteophytes were found in 10% of the specimens studied and it is assumed that these cadaveric reports deserve further attention given their potential clinical implications. Knowledge regarding occurrence and incidence of osteophytes is essential for management of common degenerative changes of the vertebral column.

The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology.

Cross-sectional study. To investigate the relation between lumbosacropelvic morphology and the presence and degree of facet joint degeneration. Osteoarthritis of the facet joints is one of the most common degenerative changes in the spine. It is considered to be formed secondary to repetitive stress or trauma and spinal deformity with secondary overload. The cause(s) of facet joints osteoarthritis, however, have not been clearly identified. Abdominal computed tomography (CT) images of 723 patients which were taken between the years 2010 and 2014 were evaluated retrospectively. Patients with prior lumbar spinal surgery, serious congenital anomalies on CT, incomplete or complete lumbosacral transition, severe scoliosis, were excluded from the study. To eliminate the age- and sex-related differences in spinopelvic morphology, a study group was formed of the remaining subjects by including patients from a specific age group (30-35 yr) and same sex (females). For each patient the presence and grade of facet joint degeneration was investigated. In addition, pelvic incidence (PI), sacral slope and the angles of L1-L5 lumbar lordosis, sacral table, L5 vertebra posterior, and sacral kyphosis were measured for each patient. Sacral slope, sacral kyphosis, and L1-L5 lumbar lordosis angle were significantly higher in patients with osteoarthritic compared with normal subjects (P = 0.015, P = 0.018, P = 0.016). L5 vertebra posterior and sacral table angle were found to be significantly lower in patients with osteoarthritic than in normal subjects (P = 0.019, P = 0.007). The degree of facet joint degeneration was noticed to increase parallel to the decrease in the sacral table angle and L5 vertebra posterior angle, and to the increase in the L1-L5 lumbar lordosis, PI, and sacral slope. A close relation exists between the presence and degree of degeneration in the facet joint and lumbosacral pelvic morphology. Prevalence and degree of the degeneration in facet joint increases as the angle of sacral slope, L1-L5 lumbar lordosis, and PI increases or the angle of sacral table and L5 vertebra posterior decreases. 4.

Histopathological alterations in the vital organs of Indian Major Carps with parasitic infestation in fish farms West Bengal, India

The study was conducted to investigate the histological changes of vital organs such as kidney, gills and brain with the mixed infestation of parasites in Indian Major Carps (IMC). The parasites such as Myxobolus spp., Thelohanellus spp., Trichodina spp., Dactylogyrus spp., Gyrodactylus spp. and Nematodes were observed in three IMC. Several histological alterations were observed in the kidney of Catla catla, Labeo rohita and Cirrhinus mrigala, which includes vacuolar degeneration in the epithelium of renal tubules, focal areas of necrosis, proliferation of bowman's capsule and many cases the renal tubules lost its shape and canalculi formation was observed. The gills showed focal areas of necrosis, exacerbated swelling of gill arch, deposition of distinct black melanin pigmentation at the basal point of the gill arch, loss of primary and secondary lamellae, prominent vacuolar degeneration and formation of vacuoles. The presence of protozoan parasites in brain tissue resulted necrosis of the brain tissue, black pigmentation, vacuolization of myelin sheath of nerve fibers and common degenerative changes. Aims: To study histological changes of vital organs such as kidney, gills and brain with the mixed infestation of parasites in Indian Major Carps (IMC). Settings and Design: The organs fixed in 4% formalin are transferred to 50% ethyl alcohol and stored for further analysis. Materials and Methods: Histopathological analysis was made as described by Roberts. Statistical Analysis Used: Nil. Results: Described in text. Conclusions: The present study brings about conclusion that impact of mixed infestation of the parasites on their hosts was severe. Histopathological changes were observed in vital organs which might be due to toxins released by different parasites or physical damage of tissue with the presence of parasites.

Characterization of muscle alteration in oral submucous fibrosis-seeking new evidence.

BackgroundThe aim of the study was to assess the progression of Oral Submucous Fibrosis (OSF) by investigating the correlation between clinical mouth opening and muscle-epithelial distance in tissue sections. Characterization of changes involving muscle was ascertained.Material and Methods50 cases and 10 controls were included in this case-control study. Inter-incisal mouth opening was measured and classified according to Lai et al. as Group A (more than 35mm), Group B (30 to 35mm), Group C (20 to 30mm), Group D (less than 20mm). Histopathological sections were graded as very early, early, moderately advanced, advanced OSF. Muscle-epithelial distance was calculated using image analysis software. The four most common degenerative changes observed in muscles, namely fragmentation, highly eosinophilic areas with loss of striations, nucleus internalization and multiple pyknotic nuclei were also assessed.ResultsComparisons of muscle-epithelial distance were made between the clinical and histopathological groups to those of controls. The mean muscle-epithelial distance was: Group A-626.8±309.36 µm, B-827.5±549.72 µm, C-673.2±321.93 µm, D-439.9±173.84µm, Controls-1222.19 ±441.7µm. Post-hoc Bonferroni Test revealed a statistically significant reduction in the muscle-epithelial distance in Group C (p-value = 0.001) and D (p-value = 0.001) as compared to controls. The mean muscle-epithelial distance in very early, early, moderately advanced and advanced OSF was 732.73±232.81µm, 726.54±361.63 µm, 548.36±273.13 and 172.40±58.41 µm respectively. Highly significant difference in muscle-epithelial distance was seen between controls as compared to early (p-value =0.002), moderately advanced (p-value = 0.001) and advanced OSF (p-value = 0.001. Fragmentation and highly eosinophilic areas were invariably noticed in advanced OSF. Multiple pyknotic nuclei were variable with no specificity.ConclusionsReduction in muscle-epithelial distance may prove to be a significant predictor of OSF progression. Degenerative changes must be noted while observing OSF cases, irrespective of the histopathological grade. Key words:Oral submucous fibrosis, muscle changes, muscle-epithelial distance.

Distinguishing cystic degeneration from other aging lesions in the adrenal cortex of Sprague-Dawley rats.

Cystic degeneration of the adrenal cortex is a common age-related finding in the Sprague-Dawley (SD) rat strain occurring more frequently in females. Compression of the adjacent cortex, a common hallmark of benign adrenal cortical tumors, often accompanies foci of cystic degeneration, creating a diagnostic challenge. Accurately differentiating these relatively common degenerative changes from proliferative lesions is critical in safety assessment studies. Cystic degeneration typically arises in the zona fasciculata of the adrenal cortex and often causes compression along the margin of the lesion. The degenerating cells are large, with abundant eosinophilic cytoplasm, or contain clear cytoplasmic vacuoles. Mitotic figures are generally uncommon. In many cases, cystic degeneration appears to arise in areas of hypertrophy in the zona fasciculata. In contrast, adrenal cortical hyperplasia and adrenal cortical adenoma are frequently comprised of smaller cells that cause compression of adjacent cortex, and in some cases mitotic figures are observed. Cytological detail and growth patterns should be considered more useful criteria than compression alone for separating degenerative cystic lesions from proliferative lesions in the adrenal cortex of SD rats.

The mechanical response of the lumbar spine to different combinations of disc degenerative changes investigated using randomized poroelastic finite element models

Degeneration of the intervertebral disc is related to progressive changes in the disc tissue composition and morphology, such as water loss, disc height loss, endplate calcification, osteophytosis. These changes may be present separately or, more frequently, in various combinations. This work is aimed to the biomechanical investigation of a wide range of clinical scenarios of disc degeneration, in which the most common degenerative changes are present in various combinations. A poroelastic non-linear finite element model of the healthy L4-L5 human spine segment was employed and randomly scaled to represent ten spine segments from different individuals. Six different degenerative characteristics (water loss in the nucleus pulposus and annulus fibrosus; calcification and thickness reduction of endplate cartilage; disc height loss; osteophyte formation; diffuse sclerosis) were modeled in 30 randomly generated models, 10 for each overall degree of degeneration (mild, moderate, severe). For each model, a daily loading cycle including 8 h of rest, 16 h in the standing position with superimposed two flexion-extension motion cycles was simulated. A tendency to an increase of stiffness with progressing overall degeneration was observed, in compression, flexion and extension. Hence, instability for mild degeneration was not predicted. Facet forces and fluid loss decreased with disc degeneration. Nucleus, annulus and endplate degeneration, disc height loss, osteophytosis and diffuse sclerosis all induced a statistically significant decrease in the total daily disc height variation, facet force and flexibility in flexion-extension. Therefore, grading systems for disc degeneration should include all the degenerative changes considered in this work, since all of them had a significant influence on the spinal biomechanics.