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Biochemical Biopsy of Skeletal System Lesions APPLICATION OF QUANTITATIVE MICROCHEMICAL TECHNIQUES
ROBERT E. KUHLMAN; MARY ELLEN DOWNS
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From the Orthopedic Laboratory, Department of Surgery, the Division of Surgical Pathology and the Department of Pathology, Washington University School of Medicine, St. Louis
1963 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1963; 45:742-752 
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Abstract

Utilizing quantitative microchemical techniques developed by Lowry, an attempt was made to obtain biochemical biopsy specimens and to determine the enzyme content of morphologically selected areas from malignant and benign lesions of the skeletal system. Osteosarcoma, chondrosarcoma, proliferating bone from Paget's disease, and tissue from polyostotic fibrous dysplasia were analyzed for enzymes of carbohydrate metabolism, hexosamine, and total phosphate content. Generally the areas and lesions characterized by rapid proliferation were the most active enzymatically and in the selections from malignant neoplasms lactic dehydrogenase was predominant. Benign proliferating bone in Paget's disease was featured by more active aerobic pathways with more malic dehydrogenase.

Comparison of neoplastic cartilage from the osteosarcoma with the morphologically similar cartilage from chondrosarcoma demonstrated considerable chemical differences between the two cartilage types. In general, the clinical course and manifestations of the lesions studied could be correlated with the metabolic activity as determined by the alkaline phosphatase and carbohydrate intermediate enzyme content.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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