Necrosis

Question: How do I find out if my husband has avascular necrosis? We live in Florida and we have no insurance, he was previously diagnosed by some uncaring big dollar fat cat doctor as having unitary sacrelitis of the hips (which does not exist) after researching I found a disease that matches many of his symptoms, He cannot get out of bed most mornings, he has great difficulty getting around most days, he is 24 and has to walk with a cane, Avascular necrosis is a disesae in wich the blood supply is lost to the bones and the bones eventually die, but how can I find out if this is his issue? Someone please help, if you know anyone with this disease or have any info, please relay any help over to me, thank you.

Answer: Since you have no insurance, I would start at the closest county facility to save $. A plain xray of the hip might show radiographic findings suggestive of AVN; he will probably need further testing but that is a cheaper way to start. Also, if you go to a larger medical facility they will be able to get consultations with an orthopedic specialist easier. Since this is not technically an emergency,save yourself the hefty ER fee & try to get into an urgent care or clinic at the facility. Try not to put it off as the damage is cumulative.

Question: Does a torn rotator resemble avascular necrosis when looking at the results of an MRI? Why would one doc say it's a torn rotator and the other say it's avascular necrosis when they're looking at the same films and doing the same tests?

Answer: A couple of thoughts...I'm not a radiologist, but my first question would be - were both of these docs radiologists? Because a torn rotator involves soft tissue and avascular necrosis involves bony tissue, I would think they could be differentiated on the MRI as long as you had a good quality MRI done on an up-to-date machine and read by a radiologist. I'd get a third opinion that includes comments on the quality of the scan. These 2 problems are treated so differently, you really need to find out which one it is.

Question: Where can I find more detail about the disease process NECROSIS? I need to explain the tissue changes in the disease process, I have chosen Necrosis of the hip, Can anyone point me in the right direction to where to find wensites / books that will help me. Or can anyone give me a brief outline. I understand that necrosis stops oxygen /blood supply to the bone but I want to know how the tissues are affected. Thanks

Answer: everyone suggested a website so i'll suggest a book. try something about Pathology or Pathophysiology

Question: Why does steroids cause avascular necrosis of the femural head? This comes in context of Hodgkin's Lymphoma where prednisolone is give as a drug for it and one of the complication is avascular necrosis of the femural head.

Answer: Good question. (femoral) Here's an excellent analysis from emedicine/WebMD updated recently in August 2008. Various mechanisms are discussed if you read this article, but the bottom line is that no one really knows for sure. http://www.emedicine.com/RADIO/topic70.htm

Question: Will physical therapy to treat TMD actually work when there is already bone necrosis? I have severe pain and loss of range of motion in my TMJ (I can't eat anything but very soft foods or liquids), an MRI showed acute avascular necrosis of the TMJ on the left side and my doctors want to try physical therapy first to see if it will help. I am just wondering if it is possible that this can give me relief or if it is already beyond such simple treatment.

Answer: I would venture to say no...the bone is dying..unless they think the vascular supply will reestablish itself. You may or may not be a surgical candidate, but I would get the opinion of a maxilofacial surgeon right away.

Question: How to differentiate between hyaline deposition and fibrinoid necrosis in blood vessel? Especially in HE staining, when no other staining is available.

Answer: hyaline is a more homogeneous and glassy, and caseous necrosis. fibrinoid necrosis - usually contain fibrin

Question: Can Avascular Necrosis of the shoulders be caused by a work related strain or joint pressure? I used to work in a factory lifting very heavy materials when I got this disease first in the right shoulder...then the left.

Answer: Avascular necrosis?! That sounds terrible! Do you still have arms? Usually that disease is seen in the feet and toes of diabetics. I've never heard of such poor circulation that people have had SHOULDER problems. No, I don't think you'll have much luck blaming your previous employer. God bless.

Question: How to measure apoptosis / necrosis in a cell culture system? I'm trying to think of the simpliest way - perhaps some sort of assay from the supernatant? Any help would be much appreciated!

Answer: There are lots of apoptosis assays available. One good assay is the TUNEL (Terminal dUTP Nicked-End Labelling) assay, which can be used with FACS or in fluorescent microscopy. It uses a DNA ligase enzyme to conjugate tagged oligonucleotides to the nicked-ends of apoptotically-cleaved DNA in apoptosing cells. This therefore specifically labels the nuclei of apoptotic cells. It is available from Boeringer as the "In Situ Cell Death Detection Kit" - which is what I use. Another assay based on DNA cleavage is the "comet assay". You embed your cell suspension in agar, permeablise their membranes; you then perform electrophoresis on the gel, and stain with ethidium bromide. The cleaved DNA in apoptotic cells should electrophoretically move out of the cells in a "comet-tail", while the intact DNA in non-apoptotic cells is relatively immobile. Apoptotic cells also display phosphatidylserine on the outer leaflet of their plasma membranes, due to the deactivation of "flipase" enzymes which normally keep it on the inner leaflet. This is an important in vivo "label" which allows phagocytes to recognise and consume them. Labelled annexin will bind to this phosphatidylserine, so can be used as a stain for FACS and fluorescent microscopy. There are also several apoptotically-expressed proteins that can be stained for (like activated caspases, or caspase-cleaved proteins like PARP) by immunohistochemistry. Again - FACS or microscopy can detect this; or if you lyse the cells and extract the proteins, a Western-blot will detect them. The simplest and cheapest (but most laborious) method would be to stain your cells with a DNA stain like DAPI or Hoescht. This labels ALL cells - but apoptotic cells have nuclei which are "pyknotic" (the chromatin has collapsed, and the nucleus has shrunk). These have to be identified by manual counting, unfortunately - but this is very do-able. For necrosis, membrane permeation assays work well. Trypan blue or nigerosine should be excluded by live cells, but will penetrate dead cells. A similar assay (the "LIVE/DEAD" assay) is based on two fluorescent dyes - calcein AM and ethidium homodimer. Calcein enters all cells, and is enzymically processed by cytoplasmic enzymes in live cells - staining them green. Ethidium is excluded by live cells, but will enter dead cells and stain their nucleir red. FACS or microscopy can be used to get the data.

Question: What is the outer lining of the heart called? What does necrosis mean? *Must answer both questions to recieve "best answer". Also the fastest to have the correct answer.

Answer: pericardium is the outer lining and necrosis is dying or dead tissue

Question: I have necrosis in my heart and parts of my brain. What is the prognosis? Is this normal? The left side of my body hurts all the time, I have a constant headache, I am dizzy, and there is always a sharp pain in my heart.

Answer: You may have cardiovascular disease. Consult the doctor.

Question: Whats the difference between necrosis and cell death in animals?? We call cell death in planst as necrosis!!! but actual meaning for necrosis is just cell death! so why cant we call the cell death of animals as necrosis

Answer: Necrosis means dying-dead tissue regardless of whether it is plant of animal, and typically is seen as a darkening of tissue, esp if it is "meat-flesh-muscle-skin" (Necro means BLACK-dead.) However cells of plants or animals tissues-organs die naturally throughout life when they reach the end of their natural life cycle. If an animal is single celled and dies,that is its END. When a patch of visible tissue looks dead-dying macroscopically, we call it "necrotic." Necrosis is common in gangrene, a bacterial infection microscopically, for example. Necrosis may also imply a "spreading" of the diseased-dying tissues amongst the healthy cells which are being OVERTAKEN-PROCESSED by the putrification microscopic organisms of nature, as is common in gangrene of diabetes (or non-diabetes) after neuropathy increases loss of feeling and thus an injured limb has no feeling and the wounds natural healing does not take place and the microbes begin to take advantage and get the upper hand. The high blood sugar makes it ideal for the putrification microbes to grow and prosper and speed the process of "parasitism" of tissues we don't want to die so that it occurs faster than cell multiplication necessary for healing. Basically if cell death is FASTER than cell mitosis-healing,then we would call that necrosis. It may or not be "rotting" per se. Rotting is a "slang" non-technical term usually ascribed to meat-foodstuffs putrifying by bacteria-fungus. It describes the NATURAL microscopic process of putrification by natures laws, but we may not like it or think of it as "good," THE MAJORITY of organisms-cells of this planet are involved with microscopic putrification processes (bacteria and fungia specifically) and it helps to clean up and recycle the micro and macromolecules of all organic material of life so that new-fresh tissues can be made from the old dead stuff. Without necrosis and putrification the planet would be overrun with piles of garbage! A compost pile is the perfect example of putrification-rotting process that we like and do not associate with disease, but macroscopically the composte pile is not any different from necrotic meat. Putrid refers to the smell of putrification and is accompanied by specific gaseous by-products these putrification microbes make while they are doing their clean up work. Warm-humid weather makes the process of putrification-necrosis happen faster. The tropics are an ideal place for wounds to become necrotic faster, for the body or compost piles to rot faster. Hot humid days in NY york during a garbage strike are horrible examples too. As global warming increases it will increase-move the amount of tropical zones on this planet and thus putrification and necrosis "diseases" of plants or animal tissues. The microbes are having a great time and are thriving while we think it is "bad," but we need these processes! BTW, the more preservatives we use in our food, the slower the putrification process becomes. Some say that the natural rottingof human cadaveris slower if the person who owned that vehicle before death ate a lot of preservtives. Also, some corpses insealed coffins putrify slower than innon-sealed coffins. Some laws require coffins to be sealed so that the "disease: organisms don't get in the soil and spread. How fast will your body rot after death? Have you eated a lot of preservatives?Will you be buried-cremated? Will the coffin be sealed-unsealed? Will your body macromolecules be easily recycled back into quickly or more slowly. If you die in a hot jungle your body may be gone quickly, esp if flesh eating scavengers like beetles get to it before they find your body. Personally, I had part of my plantar fascia on the bottom of my rt foot become necrotic after I stepped on a toothpick and they could not find it and get it out after 6 hours in the ER and several xrays, which can't see wood. Within three months I was very ill. When they did exploratory surgery, they found the toothpick embedded between bones of a joint and part of the bottom of my foot was "dead" necrotic. They removed toothpick finally, cleaned the necrosis out and the infection was controlled with antibiotics. Only some of the tissue was able to heal and regrow. I do not have the normal amount of plantar fascia now 22 years later.

Question: how can I prevent further necrosis after a tummy tuck? my mom had a tummy tuck, and now has necrosis on the upper flap. The doc cut alot away, leaving a square hole about 3"x6"x1" (w x l x depth) cut out of her belly skin right down to the parietal pericardium. Now the upper flap seems to be turning dark again. What should we do?

Answer: To tell you the truth there is nothing you can really do.If your mom is a smoker that is most likely the cause and if she stops immediately it may be possible for her body to reverse the damage that has just started to occur.Smoking decreases blood flow over time and makes it more difficult to heal.If she is not a smoker then the only thing you can do is make sure she follows all the post op instructions to the letter and keep a close eye on the area.Take her to the doctor at the first sign of anything going wrong.Her recovery time will be increased ,but you can speed it up by making sure she gets alot of rest and follows a proper diet,because the longer it takes to heal the more opportunity for further damage.I hope she gets better soon.

Question: Is it possible to get necrosis while your alseep? Like falling asleep on your arm or something?

Answer: necrosis is the death of cells and is usually caused by infection or cancer, so technically your arm can die in your sleep. for an example, if a wound were infected the cells would start to die and your arm would turn black and rot. but paresthesia, otherwise known as pins and needles, is related to nerve/brain communication. it's only a feeling of numbness.

Question: I have avascular necrosis of hip and today i fell on that hip could i have fractured it? I'm in a lot of pain and cannot walk very good.

Answer: Avascular necrosis causes the hip portion of the leg bone (femur) to be weaker than normal. Even a normal-strength hip can fracture after a fall (depending on how bad the all is, how strong the muscles in that area are, whether the person has osteoporosis/osteopenia, etc). So unfortunately, you will need to see a doctor and have tests done (like x-rays or even a CT scan) to find out if you fractured anything in your hip area. Good luck!

Question: To a Nephrologist: What is the prognosis of a young and healthy person with papillary necrosis? How does this happen to a "healthy" person who doesn't abuse any drugs, doesn't have sickle cell anemia, hypertension, diabetes etc. It seems to have been caught in the early stages, can you shed any light on the prognosis, in your opinion. Thank you.

Answer: Call this number : (770) 991-2510...Southern Crescent Nephrology (in Atlanta, GA). Ask whoever answers the phone to have the nurse or possibly the doctor to return your call because you have questions about Papillary Necrosis. They should be able to help you. They're a very good group of Nephrologists. My Great Aunt was a patient there. Good Luck.

Question: Is there excercises you can to to help prevent the pain caused from avascular necrosis.? I was diagnosed with avascular necrosis of the hip. I think it is a type of degenerative bone disease. I'm in my early 40, s and don't want to do the recommended hip replacement at my age. does anyone know anyone with is condition and what are recommendations?

Answer: AVN of the hip is a situation where the head of the femur loses its blood supply. It can happen for a number of reasons, sometimes the cause is unknown. The reason your doctor is not screaming for you to have surgery is that it is not an emergency. The ball on the femur will eventually regain its blood supply, but the problem is that it can also remodel. If you give you hip total rest the prognosis is good, if you don't the ball will begin to look like a mushroom and then the hip will not function properly. If the ball on the femur does look like a mushroom by the time the blood supply is back that is permanent and you stand a very good chance of getting osteoarthritis in you hip, at this point surgery is needed. So don't freak out just take it easy and listen to your doctor.

Question: Avascular necrosis of the hip joint, How to start the progress of treatment ? My brother 30 year old, he have fell when he was 4 or 5 year old and his hip joint was collapsed, after procedured to push the joint back to the hip bone for 25 years later, he's suffering in pain everytime he walk, please let me know how to start or which Doctor to recommendation for this progress? Thanks.

Answer: you should see an orthopedics doctor. here is a website that talks about avascular necrosis and the various treatments: http://healthlink.mcw.edu/article/926046182.html

Question: Doctor said I have avascular necrosis of the wrist (Kienbock's Disease). What can I do about it? I hurt my wrist last year. Back then, doctor said it was a sprain. Kept hurting, went and had an MRI and the surgeon who saw the films diagnosed a fracture and a dying lunate bone. What can I do now?

Answer: pray and lessen your pap ,

Question: Does anyone have any personal experience with amazon foot necrosis? My bird is a 2yr old male yellow naped amazon who recently got amazon foot necrosis. We have tried everything, including an avian specialist.I'm looking to find out if anyone has any personal experience with their birds with this and how they coped, as it is very stressful on myself and my family. Everything we do is a catch 22, if we keep our eyes on him so he doesn't make his feet bleed, then the second we turn away he starts biting again. If we leave him alone, when we return he is worse off. We can't win!!

Answer: I don't have an amazon, so I've never dealt with this particular problem. I doubt you'll find someone here who has. You might consider visiting one of the message boards at UpAtSix (link below) to see if anyone there can help you. In the absence of personal experience, I did a bit of research for you. Since you've already been to an avian vet, you may already know some or all of this, but it's probably worth a read anyway. Amazon foot necrosis seems to be an irritation caused by allergies or sensitivities to things you may have on your hands. You can help prevent it by getting into the habit of washing your hands before handling him. Nicotine left on the fingers by smoking, topical steroid creams, and any hand lotion can cause irritation in the bird's feet. If he spends a lot of time on your shoulders, knees, or other clothed parts of your body, it's possible he could be sensitive to your laundry detergent. As for the mutilation, what I have read indicates that they DO and WILL pick at their feet because they're irritated. Has your vet suggested bandages? You might consider this as a possibility, though it's certainly no guarantee. It may give him something else to chew on besides his feet. I would also look into providing him a more comfortable perch. It seems to me that if his perching surface is softer or gives his feet more "air" that he will be more comfortable and maybe chew on his feet less. You might try a cotton rope perch or a length of cholla, which has holes in it that may provide some relief of pressure. Since it's wintertime, dry indoor air may be aggravating the necrosis too. Even healthy parrots can get dry, cracked feet from too much dry air. I'd ask your vet about using a humidifier around him. Do ask the vet though, because more humidity might give bacteria an easier hold. Unless your vet has said not to, be sure to offer him plenty of opportunities to bathe. This may give him something else to focus on and relieve some of the discomfort. If all else fails, you might seek the assistance of a parrot behaviorist. Liz Wilson is a wonderful behaviorist who may be able to help you out with this. Good luck - I hope some of this info helps.

Question: What is meant by hypo densities within the mass likely representing areas of necrosis? this is about the ct scan reports that i could not understand

Answer: hypo means low. dead cells lyse, and material gets carried away, causing shrinkage, sometimes being replaced by fluid. this is clearly visible on a ct scan.