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Prevention and Treatment of Bone Metastases in Breast Cancer.

In breast cancer patients, bone is the most common site of metastases. Medical therapies are the basic therapy to prevent distant metastases and recurrence and to cure them. Radiotherapy has a primary role in pain relief, recalcification and stabilization of the bone, as well as the reduction of the risk of complications (e.g., bone fractures, spinal cord compression). Bisphosphonates, as potent inhibitors of osteoclastic-mediated bone resorption are a well-established, standard-of-care treatment option to reduce the frequency, severity and time of onset of the skeletal related events in breas

Severe neuronopathic autosomal recessive osteopetrosis due to homozygous deletions affecting OSTM1.

Autosomal recessive osteopetrosis (ARO, MIM 259700) is a genetically heterogeneous rare skeletal disorder characterized by failure of osteoclast resorption leading to pathologically increased bone density, bone marrow failure, and fractures. In the neuronopathic form neurological complications are especially severe and progressive. An early identification of the underlying genetic defect is imperative for assessment of prognosis and treatment by hematopoietic stem cell transplantation. Here we describe for the first time homozygous microdeletions of different sizes affecting the OSTM1 gene in

Role of RANKL (TNFSF11)-dependent osteopetrosis in the dental phenotype of Msx2 null mutant mice.

The MSX2 homeoprotein is implicated in all aspects of craniofacial skeletal development. During postnatal growth, MSX2 is expressed in all cells involved in mineralized tissue formation and plays a role in their differentiation and function. Msx2 null (Msx2 (-/-)) mice display complex craniofacial skeleton abnormalities with bone and tooth defects. A moderate form osteopetrotic phenotype is observed, along with decreased expression of RANKL (TNFSF11), the main osteoclast-differentiating factor. In order to elucidate the role of such an osteopetrosis in the Msx2 (-/-) mouse dental phenotype, a

Anti-oxidation treatment of ultra high molecular weight polyethylene components to decrease periprosthetic osteolysis: evaluation of osteolytic and osteogenic properties of wear debris particles in a murine calvaria model.

Wear debris-induced osteolysis remains the greatest limitation of long-term success for total joint replacements with ultra-high molecular weight polyethylene (UHMWPE) bearings. To address oxidative degradation post-gamma irradiation, manufacturers are investigating the incorporation of antioxidants into PE resins. Similarly, larger molecular weight monomers have been developed to increase crosslinking and decrease wear debris, and ultimately osteolysis. However, the effects of modifying monomer size, crosslink density, and antioxidant incorporation on UHMWPE particle-induced osteoclastic bone

Chondroblastoma of the fourth lumbar vertebra diagnosed by aspiration biopsy: case report and review of the literature.

BACKGROUND: A chondroblastoma is a primary benign bone tumor typically involving the epiphysis of long tubular bones. The occurrence of chondroblastoma in the vertebral column is exceptional. To the best of our knowledge, aspiration biopsy (AB) findings of a lumbar chondroblastoma have only been reported in 1 previous case. CASE: A 30-year-old female presented with lower back pain with a duration of 1 month. A CT scan of the 4th lumbar vertebra showed a heterogeneous lytic zone within the body and the right side pedicle surrounded by marginal sclerosis. A CT-fluoroscopy-guided AB was performe

[Nutrition and osteoporosis in elderly].

Osteoporosis concerns 50% of women over 80 years. Prevalence of energizing and protein malnutrition is high as for institutional elderly people as for community dwelling elderly people. Malnutrition, physical inactivity and many etiological factors lead to tissular losses especially on protein compartment, named sarcopenia. Among the common etiological factors, some cytokines have an effect on proteolysis and bone restructuring, interfering with osteoclast metabolism. Inflammation or stress, mechanisms which product cytokines, are responsible for unfavourable bone restructuring and for a loss

Bone anabolic agents for the treatment of multiple myeloma.

The majority of patients with multiple myeloma develop bone osteolytic lesions, which may lead to severe complications, including pain and fractures. The pathogenesis of bone disease depends on uncoupled bone remodeling, characterized by increased bone resorption due to upregulation of osteoclast activity and decreased bone formation due to osteoblast inhibition. In myeloma, impaired osteoblast differentiation and increased apoptosis have been described. Responsible for these effects are integrin-mediated adhesion to tumor cells and soluble factors, including WNT antagonists, BMP2 inhibitors a

Deoxyactein stimulates osteoblast function and inhibits bone-resorbing mediators in MC3T3-E1 cells.

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. In order to improve the treatment of osteoporosis, identification of anabolic agents with minimal side effects is highly desirable. Cimicifuga racemosa has a long and diverse history of medicinal use and deoxyactein isolated from this species is one of the major constituents. In the present study, the effect of deoxyactein on the function of osteoblastic MC3T3-E1 cells was studied. Deoxyactei

[Osteoplastic decompressive craniotomy--indication and surgical technique].

Decompressive craniotomy is usually carried out using decompressive craniectomy (osteoclastic decompressive craniotomy) when the bone flap is removed. In situations when the level of expansion does not call for decomopressive craniectomy, we do not remove the bone flap and we perform osteoplastic decompressive craniotomy. The indication is based on assessment and cross correlation of the following parameters: intracranial pressure,midline shift and the number of pathologies on CT, actual influence of antiedematous therapy, expected cerebral oedema progression and especially according to the si

Management of osteoporosis in the aging male: focus on zoledronic acid.

Osteoporosis in the aging male remains an important yet under-recognized and undertreated disease. Current US estimates indicate that over 14 million men have osteoporosis or low bone mass, and men suffer approximately 500,000 osteoporotic fractures each year. Men experience fewer osteoporotic fractures than women but have higher mortality after fracture. Bisphosphonates are potent antiresorptive agents that inhibit osteoclast activity, suppress in vivo markers of bone turnover, increase bone mineral density, decrease fractures, and improve survival in men with osteoporosis. Intravenous zoledr

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… allow osteoclast attachment to bone. 41 Biopsies of alendronate-treated bone show greater numbers of osteoclasts and abnormal giant, hypernucleated osteoclasts detached from bone. … also inhibit osteoclast precursor differentiation and inhibit osteoblast-mediated osteoclast activation. 38 Evidence of benefit Pamidronate Several randomized controlled trials of pamidronate for the treatment of osteoporosis include men. …

Current options for the treatment of Paget's disease of the bone.

Paget's disease of bone (PDB) is a chronic bone remodelling disorder characterized by increased osteoclast-mediated bone resorption, with subsequent compensatory increases in new bone formation, resulting in a disorganized mosaic of woven and lamellar bone at affected skeletal sites. This disease is most often asymptomatic but can be associated with bone pain or deformity, fractures, secondary arthritis, neurological complications, deafness, contributing to substantial morbidity and reduced quality of life. Neoplastic degeneration of pagetic bone is a relatively rare event, occurring with an i

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… In in vitro studies this compound showed potent inhibition of bone resorption by direct effects on osteoclasts or other bone cells in the immediate microenvironment of the osteoclasts. 67 Preliminary observation also demonstrated a direct effect of this aminobisphosphonate in enhancing the differentiation … hypernucleated, detached osteoclasts undergoing protracted apoptosis. 105 This issue deserves further investigation with the inclusion of the other amino bisphosphonates. …

Treatment and management of osteoporosis-pseudoglioma syndrome.

Osteoporosis-pseudoglioma syndrome (OPPG; MIM 259770) is a very rare genetic disorder with an autosomal recessive mode of inheritance, characterized by congenital or infancy-onset visual loss and skeletal fragility, diagnosed during childhood. This syndrome can lead to severe disability and chronic bone pain. Low-density lipoprotein receptor-related protein 5 (LRP5) is the gene mutated and inactivated in OPPG, and plays a pivotal role in bone accrual and skeletal remodeling by controlling bone formation through activators, such as Wnt proteins, or inhibitors, such as DKK1. OPPG should be diffe

NFkappaB gene silencing inhibits wear particles-induced inflammatory osteolysis.

Wear particles-induced periprosthetic osteolysis involved in proinflammatory cytokine production and osteoclastogenesis, is the major cause of prosthetic join implant loosening. Recent advances in our understanding of cellular and molecular mechanisms of periprosthetic osteolysis have highlighted cytokine release and osteoclast function controlled by numerous intracellular signaling pathway, one of which is nuclear factor kappa B (NFkappaB). Direct inhibition of NFkappaB is an efficient therapy to block bone erosion associated with inflammatory arthritis. There are no approved nonoperative tre

Bone changes after maxillary sinus surgery: an experimental scanning electron microscopy study.

AIMS: The purpose of this study was to explore the pathogenic role of bone in sinus surgery, and to determine whether mucosal disease after sinus surgery may be induced by underlying disease within the bone. MATERIAL AND METHODS: Twenty-five rabbits were divided into five groups. In group one, wide surgical removal of the maxillary sinus mucosa and creation of a nasoantral window were undertaken. In group two, only nasoantral window creation was undertaken. In group three, the mucosa of the anterior maxillary sinus was removed. In group four, a strip of mucosa around the ostium was removed. G

[Oguchi disease or stationary congenital night blindness: a case report].

INTRODUCTION: Oguchi disease, originally described in Japanese people, is a rare form of stationary night blindness in patients with normal acuity. OBSERVATION: We report the case of an 8-year-old girl who presented with an abnormal terrified behavior in the dark. Thorough questioning revealed hemeralopia. Her clinical examination (visual acuity, Goldmann visual field, and color vision) were normal. The fundus examination showed golden-brown color, grayish, almost greenish yellow discoloration in the peripheral area with no osteoclast. This abnormality disappeared after prolonged dark adaptat

Extra- and intracranial dumbbell-shaped hemangiopericytoma.

Hemangiopericytomas are malignant tumors arising from pericytic cells and account for less than 1% of all vascular neoplasms. We report a rare case of an extra- and intracranial dumbbell-shaped hemangiopericytoma originating from the soft tissue of the neck and penetrating the skull base with invasion into the posterior cranial fossa. The 59-year-old female patient presented with a large pulsating neck mass and reported weakness, abnormal fatigue and headache. MRI revealed an inhomogeneously enhancing tumor and cerebral angiography showed intensive vascularization. Preoperative embolization wa

Osteochemonecrosis of jaws and bisphosphonates.

Osteochemonecrosis of the jaws is a well described side effect of bisphosphonate therapy. Bisphosphonates are non metabolised analogues of pyrophosphate that are capable of localizing to bone, slowing both rate of growth and rate of dissolution therefore reducing the rate of bone turnover. Although the exact mechanism is not clear but it has been established that bisphosphonates target osteoclast, inhibiting their function in several ways: There are two types of bisphosphonates. The first are oral preparations of bisphosphonates, which include Alendronate and Risedronate. They are indicated fo

RANKL increase in compressed periodontal ligament cells from root resorption.

The ligand receptor activator of NFkappaB (RANKL) plays an important role in osteoclast formation. However, very little is known about the relationship between external apical root resorption during orthodontic treatment and RANKL. We hypothesized that compressive force is responsible for RANKL formation and up-regulation of osteoclastogenesis in periodontal ligament (PDL) cells from patients with severe orthodontically induced external apical root resorption. RANKL and osteoprotegerin (OPG) production, TRAP-positive cells, and resorptive pits were determined. The increase of RANKL and the dec

Malignant infantile osteopetrosis: dental effects in paediatric patients. Case reports.

AIM: Malignant Infantile Osteopetrosis is a hereditary pathology caused due to osteoclastic cells which are incapable of carrying out their functions and hence do not resorb osseous tissue where required. Thus the consequence is that during growth phase, the medullary cavities and nervous tissue cavities do not undergo sufficient growth and the corresponding organs do not develop adequately. The aim of this study is to outline the role of the pediatric dentist who has to carry out protocols of primary, secondary, tertiary prevention intervening at many levels. Clinical features and dental effe

Cannabinoid receptor type 2 gene is associated with human osteoporosis.

Osteoporosis is one of the most common degenerative diseases. It is characterized by reduced bone mineral density (BMD) with an increased risk for bone fractures. There is a substantial genetic contribution to BMD, although the genetic factors involved in the pathogenesis of human osteoporosis are largely unknown. Mice with a targeted deletion of either the cannabinoid receptor type 1 (Cnr1) or type 2 (Cnr2) gene show an alteration of bone mass, and pharmacological modification of both receptors can regulate osteoclast activity and BMD. We therefore analyzed both genes in a systematic genetic