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Article in Chinese | WPRIM | ID: wpr-879384


OBJECTIVE@#To analyze effect of accordion technique on bone mineralization of extended bone segment in treating tibial bone defect with bone transport.@*METHODS@#From May 2017 to October 2019, 22 patients with tibial bone defects were treated with Ilizarov bone-transport technique, and divided into two groups after bone-transport was completed, 11 patients in each group. In observation group, there were 9 males and 2 females aged from 20 to 60 years old with an average of (42.6± 13.3) years old;the length of bone defect ranged from 3 to 13 cm with an average of(6.4±2.6) cm;2 patients were suffered from upper tibial bone defects, 3 patients were middle and 6 patients were lower;patients were treated with accordion technique for 35 days. In control group, there were 10 males and 1 female aged from 41 to 60 years old with an average of (51.6±6.4) years old;the length of bone defect ranged from 3 to 10.7 cm with an average of (6.6±2.5) cm;1 patient was suffered from upper tibial bone defects, 3 patients were middle and 7 patients were lower;patients were treated with lock external fixator to waiting bone mineralization. The content of hydroxyapatite (HAP) extended bone segment was measured after bone-transport completed immediately, 35, 65 and 95 days after bone-transport was completed, respectively, then the mineralization time and healing time were compared between two groups, and the therapeutic effect of bone defect was evaluated by using Paley scoring criteria.@*RESULTS@#Twenty-two patients were followed up from 18 to 36 months with an average of (27.0±6.3) months. The wounds on the bone defects healed spontaneously during bone transport, and there were no wound complications such as skin infection or skin necrosis occurred. There were statisticaldifference in the content of HAP of the extended bone segments at 35, 65 and 95 days after bone-transport between two groups (@*CONCLUSION@#Accordion technique and locking external fixator mineralization in prolonging bone segment healing after bone-transport have the equal clinical effect, while the accordion technique could significantly accelerate the growth rate of HAP and shorten the mineralization time and healing time.

Adult , Aged , Calcification, Physiologic , External Fixators , Female , Humans , Ilizarov Technique , Infant, Newborn , Male , Middle Aged , Tibia/surgery , Tibial Fractures , Treatment Outcome , Young Adult
Rev. cuba. endocrinol ; 31(3): e188, sept.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156391


Introducción: La terapia de reemplazo con glucocorticoides sigue siendo el paradigma de tratamiento en las formas clásicas de la hiperplasia suprarrenal congénita. Sus efectos sobre la mineralización ósea no están totalmente claros. Objetivo: Describir las variables relacionadas con la masa ósea en pacientes con HSC que reciben tratamiento esteroideo sustitutivo. Método: Se realizó un estudio descriptivo transversal que exploró variables clínicas, bioquímicas, hormonales y de mineralización óseaen 25 pacientes con hiperplasia suprarrenal congénita por déficit de 21OHasa y tratamiento esteroideo. Resultados: 21 (84,0 por ciento) femeninas, el mayor grupo correspondió a los adolescentes entre 10 y 19 años (52 por ciento). Predominaron las formas clásicas con 22 pacientes (88,0 por ciento), de ellas 13 (52 por ciento) fueron perdedoras de sal, 9 virilizantes simples (36,0 por ciento) y solo 3 (12,0 por ciento) formas no clásicas. El esteroide más utilizado fue la hidrocortisona en 16 pacientes (64 por ciento), a una dosis media de 22,10±12,00 mg diarios, correspondiendo con 17,09±5,71 mg/m2sc/día y como promedio llevaban 14,02±6,57 años de terapéutica sustitutiva. No se detectaron alteraciones del metabolismo fosfocálcico. La densidad y el contenido mineral óseo en columna y en fémur mostraron valores superiores en las formas no clásicas de la enfermedad, seguidos de la virilizante simple y finalmente los pacientes perdedores de sal, en ninguno de los casos con significación estadística. Conclusiones: Los pacientes con hiperplasia suprarrenal congénita del presente estudio mostraron en su mayoría una masa ósea conservada(AU)

Introduction: Glucocorticoid replacement therapy is still the treatment´s paradigm in the classic forms of congenital adrenal hyperplasia. Its effects on bone mineralization are not entirely clear. Objective: Describe bone mass-related variables in congenital adrenal hyperplasia patients receiving substitute steroid treatment. Method: A cross-sectional descriptive study was conducted exploring clinical, biochemical, hormonal and bone mineralization variables in 25 patients with congenital adrenal hyperplasia caused by 21OHase deficiency and steroid treatments. Results: 21 women (84.0 percent); the largest group was of adolescents between the age of 10 and 19 years (52 percent).Classical forms predominated with 22 patients (88.0 percent), including 13 of them (52 percent) that were salt losers, 9 simple virilizers (36.0 percent) and only 3 (12.0 percent) of non-classical forms. The most commonly used steroid was hydrocortisone in 16 patients (64 percent), at an average dose of 22.10±12.00 mg daily, corresponding to 17.09±5.71 mg/m2sc/day and on average carried 14.02±6.57 years of substitute therapy. No alterations in the phosphocalcic metabolism were detected. Density and bone mineral content in the spinal column and femur showed higher values in non-classical forms of the disease, followed by simple virilizing and finally the salt loser patients, in none of the cases with statistical significance. Conclusions: Patients with congenital adrenal hyperplasia in this study showed mostly preserved bone mass(AU)

Humans , Female , Child , Adolescent , Calcification, Physiologic/physiology , Hydrocortisone/therapeutic use , Bone Density , Adrenal Hyperplasia, Congenital/therapy , Epidemiology, Descriptive , Cross-Sectional Studies
Autops. Case Rep ; 10(1): 2019133, Jan.-Mar. 2020. ilus
Article in English | LILACS | ID: biblio-1052963


Pulmonary alveolar microlithiasis (PAM) is a rare entity, presenting mostly as an incidental finding. This disease has an autosomal recessive inheritance with inactivating mutations in the gene "solute carrier family 34 member 2". The present study was conducted to bring attention to this rare though preventable disease. The study was a cross-sectional descriptive study, conducted at the Department of Pathology, of a tertiary care hospital in New Dehli-India. PAMs were incidentally seen in two patients diagnosed with micronodular hepatic cirrhosis leading to reanalysis of 212 autopsies, retrospectively. Statistical analysis was done using Stata 14.0. We observed three forms (Type A, B and C) of round hyaline bodies measuring in diameter with thin delicate, radiating fibrils. These bodies were PAS positive, showed black discolouration of the pigment with von Kossa stain and birefringence on polarized microscopy using Congo red stain, however the refringence was light green as compared to apple green birefringence seen with amyloid deposition. PAM has a slow progressive course leading to a high rate of incidental detection. Drugs known to inhibit the micro-crystal growth of hydroxyapatite may slow the disease progression. The family members of patients with PAM may also be kept on follow up with regular imaging. Key messages: It is important to bring out the incidental finding as, seemingly innocuous observations may provide valuable insight into incurable diseases, especially rare diseases.

Humans , Male , Adult , Middle Aged , Incidental Findings , Lung Diseases/pathology , Autopsy , Calcification, Physiologic , Rare Diseases
J. Health Biol. Sci. (Online) ; 8(1): 1-6, 20200101. ilus
Article in English | LILACS | ID: biblio-1130007


Objective: To investigate the prevalence of calcified triticeous cartilage (CTC)-compatible images on digital panoramic radiographs of a significant Brazilian population sample. Methods: In this retrospective study, 2500 digital panoramic radiographs were analyzed by a trained examiner using contrast and brightness adjustments of the Adobe® Photoshop® CC 2015 software. Data were collected and exported for statistical analysis (p-value <0.05 was considered statistically significant). Results: The prevalence of CTC-compatible images was 4.5% (61.1% in women and 38.9% in men). The most prevalent age ranged between 51 and 60 years (32.7%), and bilateral occurrence had a higher prevalence (46.9%). Women between the ages of 61 and 70 years showed a significantly higher prevalence of CTC-compatible images (p=0.027). Conclusion: This study showed a low prevalence of CTC-compatible images, which mainly occurred in women close to 70 years of age.

Objetivo: Investigar a prevalência de imagens compatíveis com calcificação da cartilagem tritícea (CCT) em radiografias panorâmicas digitais de uma significante amostra populacional brasileira. Métodos: Neste estudo retrospectivo, 2500 radiografias panorâmicas digitais foram analisadas por um examinador treinado utilizando ajustes de contraste e brilho através do software Adobe® Photoshop® CC 2015. Os dados foram coletados e exportados para análise estatística (p<0,05 foi considerado como valor estatisticamente significante). Resultados: A prevalência de imagens compatíveis com CCT foi de 4,5% (61.1% em mulheres e 38.9% em homens). A idade mais prevalente variou entre 51 e 60 anos (32,7%), sendo a ocorrência bilateral a mais comum (46,9%). Mulheres com idade entre 61 e 70 anos apresentaram prevalência significativamente maior de imagens compatíveis com CCT (p=0,027). Conclusão: O presente estudo evidenciou uma baixa prevalência de imagens compatíveis com CCT, que ocorreram, principalmente, em mulheres com idade próxima aos 70 anos.

Calcification, Physiologic , Cartilage , Population , Thyroid Cartilage , Women , Radiography, Panoramic , Prevalence , Men
Article in English | WPRIM | ID: wpr-786141


OBJECTIVE: The microRNA (miR)-10b is the T helper (Th) 17 cell specific in patients with ankylosing spondylitis (AS). The interleukin (IL)-22, which is closely related to Th17 cells, has been implicated in the regulation of new bone formation in experimental models. Therefore, the aim of this study was to evaluate whether miR-10b affects bone formation via the IL-22 pathway in AS.METHODS: Primary CD4+ T cells from AS were purified and transfected with miR-10b, anti-miR-10b, or scramble. Cell-surface markers and cytokine expression were analyzed by flow cytometry and enzyme-linked immunosorbent assay. Primary bone-derived cells (BdCs) from the facet joints of the spine were isolated, then osteogenic differentiation of primary BdCs was performed. We assessed alkaline phosphatase (ALP) activity and staining of BdCs at early time points. Alizarin red S staining of BdCs was performed at late time points.RESULTS: Overexpression of miR-10b reduced both IL-22 producing cell frequencies and cytokine production in T cells from the patients with AS. The IL-22 significantly increased ALP staining and bone mineralization. The ALP promotor activity of AS-BdCs was notably higher for the IL-22 concentration. The supernatants of the miR-10b overexpression group suppressed ALP activity on osteogenic progenitor cells from the facet joints of the spine in patients with AS.CONCLUSION: Our data suggest that miR-10b suppresses IL-22 production, which was involved in osteogenic proliferation in AS. Therefore, miR-10b might be a potential therapeutic candidate for regulation of new bone formation in patients with AS.

Alkaline Phosphatase , Calcification, Physiologic , Enzyme-Linked Immunosorbent Assay , Flow Cytometry , Humans , Interleukins , MicroRNAs , Models, Theoretical , Osteogenesis , Spine , Spondylitis, Ankylosing , Stem Cells , T-Lymphocytes , Th17 Cells , Zygapophyseal Joint
Rev. cuba. reumatol ; 21(2): e90, mayo.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093809


Introducción: la osteomalacia se caracteriza por la falta de mineralización de la sustancia osteoide, que afecta al hueso cortical y al hueso esponjoso maduro. Es una enfermedad que se presenta en adultos y niños, aunque la causa es diferente en cada uno. Objetivo: exponer la generalidad de la osteomalacia por ser una enfermedad que produce serias afectaciones a la población que la padece, especialmente a los niños. Se enfatiza en el diagnóstico y su tratamiento. Desarrollo: a fin de resumir los elementos esenciales para establecer el diagnóstico de osteomalacia hay que plantear en primer lugar, la presencia de un trastorno de la mineralización ósea, de ahí que además de tener en cuenta las causas de la enfermedad, su curso clínico y la sintomatología. Conclusiones: una recomendación importante es no tener en cuenta la posibilidad de complicaciones en el curso de la enfermedad, como las fracturas, que, aunque sean parte del cuadro clínico, al producirse pueden ocasionar graves problemas, como el caso de las que aparecen en las costillas, que si se desplazan pueden interesar órganos vitales, de modo que en este tipo de pacientes no debe excluirse la posibilidad de emergencias o de urgencias reumatológicas tanto en los adultos como en los niños(AU)

Introduction: osteomalacia is characterized by the lack of mineralization of the osteoid substance, which affects cortical bone and mature cancellous bone. It is a disease that occurs in adults and children, although the cause is different in each. Objective: to expose the generality of osteomalacia for being a disease that causes serious affectations to the population that suffers it, especially to children. Emphasis is placed on the diagnosis and its treatment. Development: in order to summarize the essential elements to establish the diagnosis of osteomalacia, we must first consider the presence of a bone mineralization disorder, hence, in addition to taking into account the causes of the disease, its clinical course and the symptomatology. Conclusions: an important recommendation is not to take into account the possibility of complications in the course of the disease, such as fractures, which, although they are part of the clinical picture, can cause serious problems when they occur, as in the case of those that appear in the ribs, which if they move may involve vital organs, so that in this type of patients should not exclude the possibility of emergencies or rheumatological emergencies in both adults and children(AU)

Humans , Osteomalacia/diagnosis , Vitamin D Deficiency/prevention & control , Calcification, Physiologic , Emergencies , Fractures, Bone , Cancellous Bone , Osteomalacia/drug therapy , Calcium, Dietary/therapeutic use , Early Diagnosis , Sunbathing/standards
Rev. colomb. radiol ; 30(2): 5158-5163, Jun. 2019. ilus, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1290883


El dedo (falange) pélvico es una alteración benigna resultante de una anomalía en el desarrollo óseo, donde se encuentra una estructura ósea con apariencia radiológica característica en los tejidos blandos, especialmente en relación con la articulación coxofemoral, aunque puede tener otras localizaciones. Se trata de una entidad benigna que usualmente es asintomática y se encuentra como hallazgo incidental. Conocer su origen y características imaginológicas es de gran importancia para poderla diferenciar de otras lesiones como osificaciones postraumáticas o lesiones por avulsión, que son frecuentes en esta misma localización. Se presentan seis casos con hallazgo incidental de dedo pélvico en diferentes modalidades diagnósticas

The pelvic digit is a benign entity resulting from an abnormality in bone development, where a bony structure with a characteristic radiological appearance is found in the soft tissues, especially in relation to the hip joint, although it may be found at other locations. It is usually asymptomatic and is found as an incidental finding. Knowing its origin and imaging characteristics is of great importance to differentiate it from other injuries such as post-traumatic ossification or avulsion injuries, which are frequent in this same location. Six cases, from the institution, with incidental finding of pelvic digit in different diagnostic modalities are presented.

Bone Development , Pelvic Bones , Calcification, Physiologic , Hip Joint
J. appl. oral sci ; 27: e20180014, 2019. graf
Article in English | LILACS, BBO | ID: biblio-975888


Abstract Stanozolol (ST) is a synthetic androgen with high anabolic potential. Although it is known that androgens play a positive role in bone metabolism, ST action on bone cells has not been sufficiently tested to support its clinical use for bone augmentation procedures. Objective: This study aimed to assess the effects of ST on osteogenic activity and gene expression in SaOS-2 cells. Material and Methods: SaOS-2 deposition of mineralizing matrix in response to increasing doses of ST (0-1000 nM) was evaluated through Alizarin Red S and Calcein Green staining techniques at 6, 12 and 24 days. Gene expression of runt-related transcription factor 2 (RUNX2), vitamin D receptor (VDR), osteopontin (SPP1) and osteonectin (ON) was analyzed by RT-PCR. Results: ST significantly influenced SaOS-2 osteogenic activity: stainings showed the presence of rounded calcified nodules, which increased both in number and in size over time and depending on ST dose. RT-PCR highlighted ST modulation of genes related to osteogenic differentiation. Conclusions: This study provided encouraging results, showing ST promoted the osteogenic commitment of SaOS-2 cells. Further studies are required to validate these data in primary osteoblasts and to investigate ST molecular pathway of action.

Humans , Osteogenesis/drug effects , Stanozolol/pharmacology , Gene Expression/drug effects , Anabolic Agents/pharmacology , Osteoblasts/drug effects , Time Factors , Calcification, Physiologic/drug effects , Linear Models , Osteonectin/analysis , Osteonectin/drug effects , Reproducibility of Results , Analysis of Variance , Receptors, Calcitriol/analysis , Receptors, Calcitriol/drug effects , Cell Line, Tumor/drug effects , Core Binding Factor Alpha 1 Subunit/analysis , Core Binding Factor Alpha 1 Subunit/drug effects , Osteopontin/analysis , Osteopontin/drug effects , Real-Time Polymerase Chain Reaction
J. appl. oral sci ; 27: e20180574, 2019. graf
Article in English | LILACS, BBO | ID: biblio-1040233


Abstract Hypertension is one of the main causes of premature death in the world; also, it is associated with several bone alterations. Preclinical studies have demonstrated delayed alveolar bone healing in hypertensive rats. However, losartan has been favorable for consolidation of bone grafts and reduction in active periodontitis. Therefore, losartan is suggested to be effective in bone formation stages, as well as in the synthesis of matrix proteins and mineralization. Objectives: To evaluate the alveolar bone dynamics in hypertensive rats treated with losartan by laser confocal microscopy and histological analysis. Methodology: Thirty-two rats, 16 spontaneously hypertensive rats (SHR) and 16 Wistar albinus rats, treated or not with losartan (30 mg/kg/day) were used. Calcein fluorochrome at 21 days and alizarin red fluorochrome at 49 days were injected in rats (both 20 mg/kg). The animals were submitted to euthanasia 67 days after treatment, and then the right maxilla was removed for laser confocal microscopy analysis and the left maxilla for histological analysis. Results: This study showed a greater calcium marking in normotensive animals treated with losartan in relation to the other groups. Laser confocal microscopy parameters showed higher values of bone volume formed, mineralized surface, active surface of mineralization and bone formation rate in normotensive animals treated with losartan. However, a smaller mineralized surface was observed in all hypertensive animals. Conclusion: Losartan can improve bone mineralization parameters under normal physiological conditions, but the same anabolic effect does not occur under hypertension.

Animals , Male , Losartan/pharmacology , Alveolar Process/drug effects , Alveolar Process/physiopathology , Hypertension/physiopathology , Antihypertensive Agents/pharmacology , Osteogenesis/drug effects , Rats, Inbred SHR , Time Factors , Blood Pressure/drug effects , Bone Regeneration/drug effects , Calcification, Physiologic/drug effects , Reproducibility of Results , Rats, Wistar , Microscopy, Confocal , Alveolar Process/pathology , Fluoresceins/analysis
Rev. MED ; 26(2): 65-70, jul.-dic. 2018. graf
Article in Spanish | LILACS | ID: biblio-1115212


Resumen El síndrome de Eagle se considera como la elongación del proceso estiloides con osificación del ligamento estilohioideo o sin él, que se extiende entre el hueso temporal y el hioides. El diagnóstico puede ser realizado principalmente con tomograña computarizada (TC) o radiografía panorámica, por su puesto sin dejar de lado la variedad de signos y síntomas, como dolor cervical, sensación de cuerpo extraño en la faringe, limitaciones en la apertura bucal, dificultad para la fonación, disfagia, otalgia, tinnitus, trismo y movilidad reducida del cuello. Ya identificada la elongación, el paciente podrá recibir un tratamiento conservador o quirúrgico dependiendo de la severidad de los síntomas. El manejo conservador incluye fisioterapia, infiltración con anestésicos locales o corticosteroides y el tratamiento con fármacos antiinflamatorios, anticonvulsivos o antidepresivos. El manejo quirúrgico consiste en fracturar el proceso estiloides bajo anestesia general, a través de abordajes transorales o transcervicales. A continuación, expondremos información pertinente sobre el síndrome de Eagle y posteriormente presentaremos un caso clínico de una paciente con dicho síndrome del servicio de Cirugía Oral y Maxilofacial del Hospital Militar Central.

Abstract Eagle syndrome is considered as the elongation of the styloid process with or without ossification of the stylohyoid ligament, which extends between the temporal bone and the hyoid. The diagnosis can be made mainly with computed tomography (CT) or panoramic radiography, of course without neglecting the variety of signs and symptoms, such as cervical pain, foreign body sensation in the pharynx, limitations in oral opening, difficulty in phonation, dysphagia, otalgia, tinnitus, trismus and reduced neck mobility. Once the elongation has been identified, the patient may receive conservative or surgical treatment depending on the severity of the symptoms. Conservative management includes physiotherapy, infiltration with local anesthetics or corticosteroids and treatment with anti-inflammatory, anticonvul sant or antidepressant drugs. Surgical management consists in fracturing the styloid process under general anesthesia, through transoral or transcervical approaches. Next, we will present pertinent information about the Eagle syndrome and then we will present a clinical case of a patient with said syndrome of the Oral and Maxillofacial Surgery service of the Hospital Militar Central.

Resumo A síndrome de Eagle considera-se como o alongamento do processo estiloide com ossificação do ligamento estilo-hioideo ou sem ele, que se estende entre o osso temporal e os hioides. O diagnóstico pode ser realizado principalmente com tomografia computadorizada (TC) ou radiografia panorâmica, obviamente sem deixar de lado a variedade de sinais e sintomas, como dor cervical, sensação de corpo estranho na faringe, limitações na abertura bucal, dificuldade para a fonação, disfagia, otalgia, zumbido, trismo e mobilidade reduzida do pescoço. Já identificado o alongamento, o paciente poderá receber um tratamento conservador ou cirúrgico dependendo da gravidade dos sintomas. O tratamento conservador inclui fisioterapia, infiltração com anestésicos locais ou corticosteroides e o tratamento com fármacos anti-inflamatórios, anticonvulsivos ou antidepressivos. O tratamento cirúrgico consiste em fraturar o processo estiloide sob anestesia geral, por meio de abordagens intraorais ou transcervicais. A seguir, exporemos informação pertinente sobre a síndrome de Eagle e, posteriormente, apresentaremos um caso clínico de uma paciente com essa síndrome do serviço de Cirurgia Oral e Maxilofacial do Hospital Militar Central.

Humans , Female , Prune Belly Syndrome , Facial Pain , Calcification, Physiologic , Neuralgia
Article in English | WPRIM | ID: wpr-772300


Amelogenin (AMG) is a cell adhesion molecule that has an important role in the mineralization of enamel and regulates events during dental development and root formation. The purpose of the present study was to investigate the effects of recombinant human AMG (rhAMG) on mineralized tissue-associated genes in cementoblasts. Immortalized mouse cementoblasts (OCCM-30) were treated with different concentrations (0.1, 1, 10, 100, 1000, 10,000, 100,000 ng · mL) of recombinant human AMG (rhAMG) and analyzed for proliferation, mineralization and mRNA expression of bone sialoprotein (BSP), osteocalcin (OCN), collagen type I (COL I), osteopontin (OPN), runt-related transcription factor 2 (Runx2), cementum attachment protein (CAP), and alkaline phosphatase (ALP) genes using quantitative RT-PCR. The dose response of rhAMG was evaluated using a real-time cell analyzer. Total RNA was isolated on day 3, and cell mineralization was assessed using von Kossa staining on day 8. COL I, OPN and lysosomal-associated membrane protein-1 (LAMP-1), which is a cell surface binding site for amelogenin, were evaluated using immunocytochemistry. F-actin bundles were imaged using confocal microscopy. rhAMG at a concentration of 100,000 ng · mL increased cell proliferation after 72 h compared to the other concentrations and the untreated control group. rhAMG (100,000 ng · mL) upregulated BSP and OCN mRNA expression levels eightfold and fivefold, respectively. rhAMG at a concentration of 100,000 ng · mL remarkably enhanced LAMP-1 staining in cementoblasts. Increased numbers of mineralized nodules were observed at concentrations of 10,000 and 100,000 ng · mL rhAMG. The present data suggest that rhAMG is a potent regulator of gene expression in cementoblasts and support the potential application of rhAMG in therapies aimed at fast regeneration of damaged periodontal tissue.

Alkaline Phosphatase , Metabolism , Amelogenin , Physiology , Animals , Biomarkers , Metabolism , Calcification, Physiologic , Cell Adhesion Molecules , Metabolism , Cell Proliferation , Cementogenesis , Physiology , Collagen Type I , Metabolism , Core Binding Factor Alpha 1 Subunit , Metabolism , Gene Expression Regulation , In Vitro Techniques , Integrin-Binding Sialoprotein , Metabolism , Mice , Microscopy, Confocal , Osteocalcin , Metabolism , Osteopontin , Metabolism , Real-Time Polymerase Chain Reaction
Article in Korean | WPRIM | ID: wpr-718965


Vitamin D plays a major role in bone metabolism, and its deficiency has an impact on fracture risk and healing. Low vitamin D levels are a cause of poor bone mineralization and have been associated with a significantly higher risk of physeal injury in children. This paper presents a case of a 13-year-old boy with a vitamin D deficiency, who sustained multiple sequential epiphyseal injuries at various areas. This report suggests that vitamin D deficiency is not only a significant cause of the clinical disease itself, but also an important factor affecting the successful recovery of injuries.

Adolescent , Calcification, Physiologic , Child , Humans , Male , Metabolism , Vitamin D Deficiency , Vitamin D , Vitamins
Article in English | WPRIM | ID: wpr-741799


Tumor-induced osteomalacia (TIO), also known as oncogenic osteomalacia, is a rare paraneoplastic syndrome characterized by hypophosphatemia resulting from decreased tubular phosphate reabsorption, with a low or inappropriately normal level of active vitamin D. The culprit tumors of TIO could produce fibroblast growth factor 23 which plays a role in regulating renal Pi handling and 25-hydroxyvitamin D 1α-hydroxylase activity. Chronic hypophosphatemia could eventually lead to inadequate bone mineralization, presenting as osteomalacia. The diagnosis should be considered when patients manifest as hypophosphatemia and osteomalacia, or rickets and needs to be differentiated from other disorders of phosphate metabolism, such as the inhereditary diseases like X-linked hypophosphataemic rickets, autosomal dominant hypophosphataemic rickets, autosomal recessive hypophosphataemic rickets and acquired diseases like vitamin D deficiency. Localization of responsible tumors could be rather difficult since the vast majority are very small and could be everywhere in the body. A combination of thorough physical examination, laboratory tests and imaging techniques should be applied and sometimes a venous sampling may come into handy. The technology of somatostatin-receptor functional scintigraphy markedly facilitates the localization of TIO tumor. Patients undergoing complete removal of the causative neoplasm generally have favorable prognoses while a few have been reported to suffer from recurrence and metastasis. For those undetectable or unresectable cases, phosphate supplements and active vitamin D should be administrated and curative intended radiotherapy or ablation is optional.

Calcification, Physiologic , Diagnosis , Fibroblast Growth Factors , Humans , Hypophosphatemia , Metabolism , Neoplasm Metastasis , Osteomalacia , Paraneoplastic Syndromes , Physical Examination , Prognosis , Radionuclide Imaging , Radiotherapy , Recurrence , Rickets , Vitamin D , Vitamin D Deficiency
Article in English | WPRIM | ID: wpr-741784


Osteoporosis and fragility fractures have become major global public health concerns, and they can be prevented by maximizing peak bone mass during childhood and adolescence with weight-bearing physical activity, which can result in stronger and healthier bones that significantly decrease the risk of osteoporosis and fragility fractures in adulthood and the elderly years. From a public health perspective, implementing weight-bearing physical activity for children and adolescents is best achieved with school-based exercise interventions, and a review of school-based exercise interventions was conducted to determine their effectiveness in increasing bone mineral density (BMD) and/or bone mineral content (BMC). Seventeen studies were reviewed, all school-based exercise interventions utilized jumping exercises, and 15 of the 17 studies found at least one significant increase in measures of BMD and/or BMC for the total body, and/or at the hip, vertebrae, and/or wrist. One study that found no significant differences did report significant increases in bone structural strength, and the other study with no significant differences had exercises that measured and reported the lowest ground reaction forces (GRFs) of only 2–3 times body weight (BW), whereas the other studies that showed significant increase(s) in BMD and/or BMC had exercise with measured and reported GRFs ranging from 3.5 × to 8.8 × BW. School-based exercise interventions are time- and cost-efficient and effective in increasing BMD and/or BMC in children and adolescents, but must incorporate high-intensity exercise, such as high-impact jumping of sufficient GRFs, in order to significantly increase bone mineralization for osteoporosis and fragility fracture prevention later in life.

Adolescent , Aged , Body Weight , Bone Density , Calcification, Physiologic , Child , Exercise , Hip , Humans , Motor Activity , Osteoporosis , Public Health , Spine , Weight-Bearing , Wrist
Article in English | WPRIM | ID: wpr-717401


PURPOSE: Zinc (Zn) is an essential trace element for bone mineralization and osteoblast function. We examined the effects of Zn deficiency on osteoblast differentiation and mineralization in MC3T3-E1 cells. METHODS: Osteoblastic MC3T3-E1 cells were cultured at concentration of 1 to 15 µM ZnCl2 (Zn− or Zn+) for 5, 15 and 25 days up to the calcification period. Extracellular matrix mineralization was detected by staining Ca and P deposits using Alizarin Red and von Kossa stain respectively, and alkaline phosphatase (ALP) activity was detected by ALP staining and colorimetric method. RESULTS: Extracellular matrix mineralization was decreased in Zn deficiency over 5, 15, and 25 days. Similarly, staining of ALP activity as the sign of an osteoblast differentiation, was also decreased by Zn deficiency over the same period. Interestingly, the gene expression of bone-related markers (ALP, PTHR; parathyroid hormone receptor, OPN; osteopontin, OC; osteocalcin and COLI; collagen type I), and bone-specific transcription factor Runx2 were downregulated by Zn deficiency for 5 or 15 days, however, this was restored at 25 days. CONCLUSION: Our data suggests that Zn deficiency inhibits osteoblast differentiation by retarding bone marker gene expression and also inhibits bone mineralization by decreasing Ca/P deposition as well as ALP activity.

Alkaline Phosphatase , Calcification, Physiologic , Collagen , Extracellular Matrix , Gene Expression , Methods , Miners , Osteoblasts , Osteocalcin , Osteopontin , Receptor, Parathyroid Hormone, Type 1 , Transcription Factors , Zinc
Rev. Soc. Cardiol. Estado de Säo Paulo ; 27(2): 88-95, abr.-jun. 2017. ilus, graf
Article in Portuguese | LILACS | ID: biblio-847873


O escore de cálcio coronariano (CAC) é obtido por meio de tomografia de tórax sem contraste, acoplada a eletrocardiograma com baixa dose de radiação e baixo custo. Atualmente, acessível na grande maioria de tomógrafos de múltiplos detectores, o exame tem como objetivo a identificação da carga de aterosclerose associada à presença de cálcio na topografia das artérias coronárias. Seu valor diagnóstico e prognóstico para doença arterial coronária subclínica foi demonstrado em diversos estudos pregressos envolvendo dezenas de milhares de pacientes com seguimento prolongado, de até 15 anos. O escore de cálcio mostrou-se superior aos escores clínicos tradicionais na predição de eventos cardiovasculares em indivíduos assintomáticos, sobretudo naqueles com risco intermediário pré-teste, em que pode haver dúvida sobre a melhor abordagem de tratamento. O achado de um escore de cálcio zero está associado a um risco cardiovascular significativamente baixo, enquanto um escore elevado re-estratifica o indivíduo para uma classe de risco superior. Grande parte das diretrizes clínicas indica o exame exatamente neste paciente ou nos indivíduos com risco inicial mais baixo, mas com antecedente familiar fortemente positivo. Embora não haja trabalhos randomizados com desfechos clínicos primários guiados pelo CAC, ao menos três estudos prospectivos demonstraram benefícios com seu uso, além dos inúmeros trabalhos observacionais e estudos de coorte que demonstraram excelente valor prognóstico. Recentemente, recomendações de como guiar a terapia de prevenção primária de acordo com o resultado do escore de cálcio foram publicadas com base em opiniões de especialistas, e uma proposta de estudo randomizado vem sendo discutida de forma intensa. Finalmente, o escore de cálcio também passou a ser visto como possível indicação para complementar outros exames, como tomografia de tórax, avaliação pulmonar ou em associação com exames funcionais, além de aumento de adesão à terapia

The coronary artery calcium score (CAC) is obtained through a computed tomography (CT) of the chest without the need for contrast, coupled with low radiation dose electrocardiogram and low cost. The exam is currently available in most multidetector tomographs, and its objective is to identify coronary atherosclerotic burden associated with the presence of calcium in the topography of the coronary arteries. Its diagnostic and prognostic value for subclinical coronary arterial disease has been demonstrated in many studies involving tens of thousands of patients, with long follow-up times of more than 15 years. The calcium score has been shown to be superior to most traditional clinical scores for predicting cardiovascular events in asymptomatic individuals, particularly those with moderate pre-test risk, where there might be more uncertainty in selecting the best treatment approach. A finding of a calcium score of zero is associated with a very low cardiovascular risk, while a high score re-stratifies an individual to a higher risk class. Most of the clinical guidelines recommend the exam in these patients, or in individuals with an initial low risk category but a strong positive familiar history for cardiovascular disease. Although there are currently no randomized controlled trials with outcomes guided by the use of CAC, at least three prospective studies have demonstrated the benefits of its use, and numerous observational works and cohort studies have demonstrated its excellent prognostic value. Recently, recommendations on how to guide primary preventive therapy based on the results of the calcium score have been published based on specialist opinions, and a randomized controlled trial is now in advanced discussions. Finally, the calcium score is now seen as a possible indication to complement other exams, such as chest CT, pulmonary evaluation, or in association with other functional stress exams, and adhesion to therapy has increased

Humans , Tomography, X-Ray Computed/methods , Calcium/analysis , Coronary Vessels , Atherosclerosis/diagnosis , Prognosis , Radiation , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Calcification, Physiologic , Predictive Value of Tests , Dyslipidemias , Heart Rate
Electron. j. biotechnol ; 25: 21-27, ene. 2017. ilus, graf, tab
Article in English | LILACS | ID: biblio-1008381


Background: Biomineralization is a significant process performed by living organisms in which minerals are produced through the hardening of biological tissues. Herein, we focus on calcium carbonate precipitation, as part of biomineralization, to be used in applications for environmental protection, material technology, and other fields. A strain GM-1, Microbacterium sp. GM-1, isolated from active sludge, was investigated for its ability to produce urease and induce calcium carbonate precipitation in a metabolic process. Results: It was discovered that Microbacterium sp. GM-1 resisted high concentrations of urea up to 60 g/L. In order to optimize the calcification process of Microbacterium sp. GM-1, the concentrations of Ni2+ and urea, pH value, and culture time were analyzed through orthogonal tests. The favored calcite precipitation culture conditions were as follows: the concentration of Ni2+ and urea were 50 µM and 60 g/L, respectively, pH of 10, and culture time of 96 h. Using X-ray diffraction analysis, the calcium carbonate polymorphs produced by Microbacterium sp. GM-1 were proven to be mainly calcite. Conclusions: The results of this research provide evidence that Microbacterium sp. GM-1 can biologically induce calcification and suggest that strain GM-1 may play a potential role in the synthesis of new biominerals and in bioremediation or biorecovery.

Actinobacteria/metabolism , Chemical Precipitation , Urea/metabolism , Calcification, Physiologic , Calcium Carbonate/metabolism , Actinobacteria/isolation & purification , Actinobacteria/chemistry , Hydrolysis , Nickel/metabolism
Journal of Bone Metabolism ; : 201-206, 2017.
Article in English | WPRIM | ID: wpr-158835


Bleeding disorders, including hemophilia, can be seen in every ethnic population in the world. Among various bleeding disorders, reduced bone density has been addressed in hemophilia A. In recent years, there has been an increasing interest in addressing osteopenia and osteoporosis in hemophilia A. There is little or no study about the possible susceptibility of other individuals with bleeding disorders to reduced bone density. Questions have been raised about the role of blood coagulation factors in bone mineralization. This review provides new insight and ideas for further survey in the field of bleeding disorders and reduced bone density.

Blood Coagulation Factors , Bone Density , Bone Diseases, Metabolic , Calcification, Physiologic , Hemophilia A , Hemophilia B , Hemorrhage , Osteoporosis , von Willebrand Diseases