Serum levels of soluble receptor activator of nuclear factors-KB ligand [sRANKL], osteoprotegerin [OPG] and bone mineral density in Egyptian osteoporotic elderly women

The aim of this study was to determnine the state of the OPG/RANKL system and its possible role in osteoporotic elderly women. The present study included 40 apparently healthy old osteoporotic women aged 64.5 +/- 4.5 years as group I,[GI] and 30 healthy women of matched age as group II [GII]. The two groups were subjected to complete history taking, thorough clinical examination, routine laboratory investigations, measurement of bone formation markers as serum alkaline phosphatase, serum calcium and serum osteocalcin and measurement of bone resorptiomz markers including: hydroxyproline in urine, serum OPG and serum RANKL CT Bone Density was done as well. In the current study, non significant differences were noted between the 2 studied groups as regard fasting blood glucose, renal amid hepatic function tests. A significant increase in serum alkaline phosphatase and urinary hydroxyproline and a significant decrease in serum calcium and serum osteocalcin was noted in group I compared to group Ii. Serum levels of RANKL were significantly elevated while serum OPG levels were significantly decreased in osteoporotic women compared to healthy controls. Changes in circulating OPG-RANKL correlates with serum osteocalcin and BMD changes. RANKL is an essential cytokine for the formation and activation of osteoclasts and promotes bone resorption, while OPG antagonizes these effects. Estrogen deficiency tilts the RANKL/OPG balance to favor osteoclastic activation and bone loss. RANKL blockade may emerge as a novel therapeutic option for human bone diseases. Further studies are necessary to elucidate the causes of osteoporosis and low bone mass in old women

contralateral ear in acquired cholesteatoma [a clinico-radiological study]

Fifty patients with unilateral cholesteatoma and 25 control subjects with bilateral normal ears were subjected to otomicroscopical and audiological assessment. Axial and coronal sections for the mastoid bone at 1 mm slice thickness were done for all ears. A simplified method was used to find out the surface area [SA] of the air cells at each individual section and automatically calculate the total volume of the mastoid air cells. Otomicroscopically, 72% of the contra lateral ears showed signs of retraction pockets, granulation tissues or chronicity. Audiologically, 20% of the controlled ears showed moderate to severe conductive hearing loss, while 10% showed mixed hearing loss. As regards mastoid pneumatization, the mean air cell volumes were 6.1, 12.68 and 29.92 cc in cholesteatomatous, contralateral and control ears, respectively. This indicated a highly significant difference in the mean air cell volume between the control ears and the other two groups

Role of nitric oxide in essential hypertension and its relationship to ventricular hypertrophy

Patients with essential hypertension exhibit blunted endothelium dependent vasodilator response, which is largely attributable to reduced bioavailability of nitric oxide [NO]. Therefore, this study was designed to estimate, more directly, nitric oxide production in patients with essential hypertension and to examine the possible association between NO and left ventrivular [LV] and vascular hypertrophy. The level of serum total nitrite and nitrate, the stable end products of NO oxidation, was measured in 40 hypertensive patients [group I] and 15 control subjects [group II]. Hypertensive patients were divided according to LV geometry into 21 patients with left ventricular hypertrophy [LVH] [group Ia] and 19 patients with normal LV geometry [group Ib]. Serum total nitrite and nitrate level was significantly lower in patients with essential hypertension compared to normal controls [25.07 +/- 8.78 micro mol/L verses 39.36 +/- 7.07 micro mol/L] [p<0.001]. It was significantly lower in patients with LVH compared to patients without LVH [20.50 +/- 8.07 micro mol/L versus 30.11 +/- 6.60 micro mol/L] [p<0.001]. There was a significant negative correlation between serum total nitrite and nitrate level and LVMI, IVS and PWT [p<0.001]. This study also showed a significant positive correlation between LVMI and carotid, femoral and aortic media to lumen [M/L] ratio [p<0.001]. Serum total nitrite and nitrate level was significantly lower in patients with higher M/L ratio and there was a significant negative correlation between serum total nitrite and nitrate level and carotid, femoral and aortic M/L ratio [p<0.01, p<0.001 and p<0.05 respectively]. It was concluded that NO level is reduced in patients with essential hypertension and that this reduced level has a role in the pathogenesis of left ventricular and vascular hy[ertrophy in patients with essential hyptertension