ABSTRACT
El síndrome de POEMS es un trastorno paraneoplásico asociado a discrasia de células plasmáticas que reúne, entre sus criterios diagnósticos mayores, la presencia de polineuropatía y de gammapatía monoclonal, entre otras como esclerosis ósea y/o cutánea. Se reportó un caso que reúne las características dominantes del síndrome
POEMS syndrome is a paraneoplastic disorder associated with plasma cell dyscrasia which joins among itsmajor diagnostic criteria, the presence of polyneuropathy and monoclonal gammopathy, such as bone and / or skin sclerosis. a case that meets the key features of the syndrome is reported
Subject(s)
Humans , Female , Adult , Polyneuropathies/physiopathology , POEMS Syndrome/diagnosis , POEMS Syndrome , Case ReportsABSTRACT
[Objective]To investigate the pathogenesis of osteoarthritis by increasing stiffness of subchondral bone to simulate subchondral bone sclerosis to induce the osteoarthritis.[Methods]The proportion between polymethylmethacrylate(PMMA),methylmethacrylate(MMA),hydroxyapatite(HA) and distilled water was adjusted to keep the maximum reaction temperature under 40℃.The composite material PMMA/HA was obtained and compressed on a mechanical material machine to determine its ultimate strength and stiffness,which were compared with those of subchondral bone.The subchondral bone of medial tibial plateau was scraped,where the composite material PMMA /HA was implanted into.Rabbits were sacrificed at 3,6,9 and 12 weeks,respectively.The articular cartilages of the medial tibial plateau were harvested for histological observation.Immunohistochemical analysis was adopted to record the expression and distribution of collagen type Ⅱ and MMP-1 in cartilage at protein level,which were compared with the blank and control groups.Transmission electron microscope was used to examine the ultramicroscopic changes of chondrocytes in blank and 6,12-week-postsurgery groups.[Results]With the time going,the experimental groups gradually presented degeneration,and had increased histological Mankin score.TEM demonstrated degenerative changes of chondrocytes.Collagen type Ⅱ expressed mainly in transition zone and upper deep zone,and MMP-1 expressed predominantly in the superficial and upper intermediate layers of cartilage.Both expressions steadily increased with time passing.[Conclusion]The increased stiffness of subchondral bone induced osteoarthritis in rabbits,which suggests that subcondral bone sclerosis may induce cartilage damage,and that subcondral bone sclerosis is one of the initial pathogenesis of osteoarthritis.
ABSTRACT
Many studies have proved that the subchondral bone plays an important role in the development of osteoarthritis,and may be the initial factor of the disease,but the exact relationship between articular cartilage degeneration and subchondral bone sclerosis is still unclear.Subchondral bone sclerosis caused by bone remodeling abnormality severely decreases the ability of subchondral bone stress absorption and protective function of articular cartilage,which finally leads to cartilage degeneration and osteoarthritis deterioration.Studying the role of subchondral bone in the pathogenesis of osteoarthritis and developing potential drugs to regulate subchondral bone remodeling will provide a new way of prevention and treatment for osteoarthritis.