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Multiple bone fractures found in a young sarcoidosis patient with long stable disease.

A 22-year-old Japanese man was found to have bilateral hilar lymphadenopathy (BHL), and was diagnosed with sarcoidosis in 1995. He was followed without treatment until 2002, when a bone fracture due to osseous sarcoidosis was found in his left thumb. Despite systemic treatment with corticosteroid and methotrexate, a new bone lesion developed in his right foot and his right middle finger was fractured. The patient also suffered multiple organ involvements including brain and muscle lesions. This is the first report of a sarcoidosis patient who presented with BHL, and developed bone fractures after a long stable period of more than 5 years.

Adult↗

The cartilaginous fracture callus in rats.

The right tibia was broken manually in 56 rats weighing 100 g; the fracture was stabilized with an intramedullary steel wire. Groups of rats were killed after 3-30 days. The fracture with its surrounding musculature was dissected out and immediately frozen to -70 degrees C. Cryostat sections of the fracture region were stained with hematoxylin/eosin, toluidine blue, and immunoenzymatically with collagen II antibodies. Another series of 30 fractured rats were killed after 1-15 days, and the fractures were examined histologically after decalcification with EDTA. Two types of callus were observed. The periosteal-endosteal callus started as proliferation of pre-osteoblasts without inflammatory cells on Day 1 and developed bone trabeculae from Day 3 until Days 8-10, but not thereafter. The cartilaginous callus was formed by condensation of fibroblast-like mesenchymal cells mixed with inflammatory cells outside the periosteal callus and started on Day 5 at the fracture fragments denuded of periosteum. The cells differentiating to cartilage seemed to migrate from the surrounding musculature and its newly formed vessels. The enchondral bone formation started close to the periosteal callus from which vessels were piercing into the then hypertrophic and mineralized chondrocytes on Day 11. We conclude that the bridging callus is formed by fundamentals of periosteal callus derived from predetermined cells and the bridge of enchondrally formed bone trabeculae by cells migrating from outside.

Animals↗

Principles of bone healing.

Our contemporary understanding of bone healing has evolved due to knowledge gleaned from a continuous interaction between basic laboratory investigations and clinical observations following procedures to augment healing of fractures, osseous defects, and unstable joints. The stages of bone healing parallel the early stages of bone development. The bone healing process is greatly influenced by a variety of systemic and local factors. A thorough understanding of the basic science of bone healing as well as the many factors that can affect it is critical to the management of a variety of musculoskeletal disorders. In particular, the evolving management of spinal disorders can greatly benefit from the advancement of our understanding of the principles of bone healing.

Animals↗

Subperiosteal implantation of bone morphogenetic protein adsorbed to hydroxyapatite.

Bone development was induced by bone morphogenetic protein (BMP) adsorbed to hydroxyapatite (HAP) under the periosteum of rat parietal bone. The BMP was isolated by Sephacryl-S200 column chromatography after passage through a membrane filter system. The yield of the fraction with BMP activity was 20 times greater than yields obtained by conventional methods. BMP was adsorbed to HAP in vacuo. HAP alone was implanted as a control. The formation of cartilage and bone was observed seven days after the implantation of BMP-HAP, and the newly formed bone fused with the host calvaria after 28 days. In control rats, no bone formation was seen within 56 days after implantation. The BMP-HAP complex was more effective in induced periosteal bone formation than HAP only.

Adsorption↗

Response to demineralized bone matrix implantation in foals and adult horses.

Equine demineralized bone matrix, particle size 2 to 4 mm, was implanted SC and IM in 4 foals and 4 adult horses. The implants were removed between 5 and 8 weeks after implantation. Bone formation was induced by SC and IM implantations in all animals. The implantation site had a marked effect on the amount of bone that developed, bone being formed earlier and in greater amounts when the matrix was implanted IM. The amount of bone formed increased with increasing time after matrix implantation at both sites. Demineralized bone matrix implantation also led to formation of small amounts of chondroid tissue; this tissue was more common in IM than SC matrix implants, and increased in amount with increasing time after implantation. Formation of this chondroid tissue did not precede the formation of bone, and there was no evidence that implantation of demineralized bone matrix in horses induced endochondral ossification. Age of the host did not appear to affect the response.

Age Factors↗

Effect of alcohol consumption on adult and aged bone: composition, morphology, and hormone levels of a rat animal model.

To determine the effect of life-long alcohol consumption on the adult and aged rat model, 4-week-old, female Sprague-Dawley rats were divided into three diet groups. Alcohol-treated animals were fed a modified Lieber-DeCarli diet ad libitum containing 35% ethanol-derived calories, whereas the pair-fed animals (weight-matched to ethanol rats) received an isocaloric liquid diet in which maltose-dextrin substituted calories supplied by ethanol. Chow animals were fed a standard rat chow ad libitum. Proximal tibiae (primarily cancellous bone) and femora (primarily cortical bone) were removed for analysis after 3, 6, 9, 12, or 18 months on the diets. Serum was collected for analysis of calcium levels, the calcium regulating hormones; parathyroid hormone, 25-hydroxyvitamin D, calcitonin, corticosterone, estradiol, testosterone, and IGF-1. Creatinine, SGOT/AST, and SGPT/ALT levels were measured to determine kidney and liver integrity. Previous studies, with young animals, showed that chronic alcohol consumption during the age of bone development reduced bone density and bone mass in both cortical and cancellous bone. The present study demonstrates that these reductions last throughout life, whereas morphological values, such as length and diameter, attain control levels. Calcium regulating hormones and sex hormones are essentially normal and do not appear to be the primary causative agent for adult alcohol-induced osteopenia, but it appears to be due to a more direct effect of alcohol on bone cells.

Aging↗

BMP signalling in early Xenopus development.

Bone morphogenetic proteins (BMPs) are typically members of the transforming growth factor beta (TGF-beta) family with diverse roles in embryonic development. At least five genes with homology to BMPs are expressed during Xenopus development, along with their receptors and intracellular signalling pathways. The evidence suggests that BMPs have roles to play in both mesoderm induction and dorsoventral patterning. Studies in Xenopus have also identified a number of inhibitory binding proteins for the classical BMPs, encoded by genes such as chordin and noggin. These proteins appear to be responsible for establishing a morphogen gradient of BMP4 activity, which specifies different dorsoventral fates in early gastrulae. An emerging theme is that inhibition of BMP signalling is an important mechanism regulating cell fate decisions in early development.

Animals↗

Gene expression of MMP8 and MMP13 during embryonic development of bone and cartilage in the rat mandible and hind limb.

Matrix metalloproteinases (MMPs) 8 and 13 comprise the collagenase subfamily in rats and mice, and only MMP13 has been implicated in degradation of the collagenous matrices during development of bone and cartilage. On the hypothesis that MMP8 is also involved in bone and cartilage development, the present study was designed to investigate gene expression of MMP8 in rat embryonic mandibles and hind limbs. Expression of MMP8 was examined with in situ hybridization and RT-PCR and was compared with that of MMP13. Osteoblastic and chondrocytic cells expressing collagenous matrix molecules were identified using in situ hybridization for collagen Types I and II. The results demonstrated that MMP8 is expressed by osteoblastic progenitors, differentiated osteoblasts, osteocytes, and chondrocytes in the growth plate for the first time. Furthermore, the expression of MMP8 is much broader than that of MMP13, for which expression is confined to differentiated phenotypes of osteoblastic and chondrocytic lineage.

Animals↗

The development of bone after perichondrial grafting: an experimental study using ear and rib perichondrium in rabbits.

The development of bone after perichondrial grafting was investigated using rabbit ear and rib perichondrium. Sixty-four white adult female rabbits were used. Both free and vascularised perichondrial grafts were undertaken. In each case the chondrogenic potential of perichondrium was proved. Furthermore, when the perichondrium was vascularised or grafted in recipient sites having good blood circulation, the development of large areas of bone was observed around the regenerated cartilage.

Animals↗

Different roles of Runx2 during early neural crest-derived bone and tooth development.

UNLABELLED: We compared gene expression profiles between Runx2 null mutant mice and their wildtype littermates. Most Runx2-dependent genes in bones were different from those in teeth, implying that the target genes of Runx2 are tissue-dependent. In vitro experiments determined that Runx2 is a part of the FGF and BMP signaling pathways in tooth and bone development, respectively. INTRODUCTION: Runx2 (Cbfa1) is expressed in the neural crest-derived mesenchyme of developing bone and tooth. Runx2 homozygous null mice lack bone through a failure in osteoblast differentiation and have arrested tooth development at the late bud stage. The aim of this study was to discover and compare the identities and the roles of Runx2 target genes in bone and tooth development. MATERIALS AND METHODS: Wildtype and Runx2-/- tissue was collected from mouse embryos, and gene expression was compared by Affymetrix microarray analysis and radioactive in situ hybridization of embryonic tissue sections (E12-E14). Induction of target genes by growth factors in bone and tooth tissue was studied using in vitro experiments, including a novel method involving hanging-drop cultures and RT-PCR. RESULTS: Thirteen bone and four tooth genes were identified that are Runx2-dependent. The identities of these genes do not significantly overlap between bone and tooth, indicating tissue specificity of several genes regulated by Runx2. Genes downregulated in bone development in Runx2 null mutants were Bambi, Bmp4, Bono1, Dkk1, Fgf receptor1, Gli1, Lef1, Patched, Prostaglandin F receptor1, Tcf1, Tgfbeta1, Wnt10a, and Wnt10b. Several of these genes were induced by BMPs in bone tissue in a Runx2-independent manner. Genes downregulated in tooth development were Dkk1, Dusp6, Enpp1, and Igfbp3. These genes were all induced by fibroblast growth factors (FGFs) in dental tissue. FGF-induction of Dkk1 was completely dependent on Runx2 function. CONCLUSIONS: The contrasting identities and distinctive mechanisms that stimulate the expression of Runx2-dependent genes in bone and tooth development imply that the developmental roles of Runx2 in these separate tissues are different. In tooth development, Dkk1 may be a direct transcriptional target of Runx2. Bone genes were stimulated by BMP4 before the formation of the ossification center, suggesting that BMPs may mediate the early epithelial-mesenchymal interactions involved in bone formation.

Animals↗

[Effect of iron and zinc levels in diet on development of bone in growing rats exposed to lead].

OBJECTIVE: The purpose of this paper was to explore the effect of iron and zinc in diet on development of bone in growing rats exposed to lead and observed the change of bone mineral content (BMC) and bone mineral density (BMD). METHODS: The growing rats were fed with diet added with different levels of iron, zinc and lead for 12 weeks. RESULTS: Long-term exposure to lead may inhibit the development of bone and reduce BMC and BMD, it can be improved the weight and length of bone and increased BMC and BMD following the increased in iron and zinc levels in the diets, but the lead level of bone increases. CONCLUSION: Supplementary suitable iron or/and zinc could improve the BMC and BMD, the mechanism of iron and zinc in diets on bone exposed to lead should be further research.

Animals↗

Association of EXT1 and EXT2, hereditary multiple exostoses gene products, in Golgi apparatus.

We prepared the specific antibodies for EXT1 and EXT2, hereditary multiple exostoses (HME) gene products, and characterized their expression, subcellular localization, and protein association among EXT members. Biochemical analyses indicate that EXT1 and EXT2 can associate and form homo/hetero-oligomers in vivo with or without HME-linked mutations, EXT1 (R340C) and EXT2 (D227N), when exogenously expressed in COS-7 cells. An immunocytochemical analysis showed that both EXT1 and EXT2 localized in Golgi apparatus, irrespective of HME mutations. An immunohistochemical analysis on developing bones further showed that both EXT1 and EXT2 were concomitantly expressed in hypertrophic chondrocytes of forelimb bones from 1-day-old neonatal mouse, but down-regulated in maturing chondrocytes of developing cartilage from 21-day-old mouse. Taken together with the recent finding that EXTs encode for the glycosyltransferase required for the synthesis of heparan sulfate [Lind, T., Tufaro, F., McCormick, C., Lindahl, U., and Lindholt, K. (1998) J. Biol. Chem. 273, 26265-26268], our results implied a molecular basis that a HME-linked mutation found in EXT genes could interfere the physiological function(s) of EXT homo/hetero-oligomers as glycosyltransferases in the developing bones of HME patients.

Animals↗

Ibandronate decreases bone disease development and osteoclast stimulatory activity in an in vivo model of human myeloma.

The benefits of bisphosphonate therapy for multiple myeloma bone disease have been clearly documented. However, the effects of bisphosphonates on the osteoclast stimulatory activity (OSA) that is present in the marrow of patients with multiple myeloma, even before the bone disease is detectable, are unknown. Therefore, we examined the effects of ibandronate (IB) treatment prior to the development of bone disease in a murine model of human myeloma. Sublethally irradiated severe combined immunodeficient (SCID) mice were transplanted with ARH-77 cells on day 0. These ARH-77 mice were treated daily with subcutaneous injections of IB started before or at different times after tumor injection as follows: group 1 was started on day -7; group 2 on day 0; group 3 on day +7; group 4 on day +14 after IB administration; and group 5 (control) received no IB. Mice were sacrificed after they developed paraplegia. The onset of paraplegia was delayed in group 1 vs all other groups (mean day 27 vs day 32; p = 0.0098). The number of lytic lesions and the bone surface area of resorption (mm(2)) were significantly decreased in groups 1, 2, and 3, which were treated early with IB, when compared with groups 4 and 5 (p = 0.003 and 0.002, respectively). OSA, as measured by the capacity of bone marrow plasma from ARH-77 mice to induce osteoclast (OCL) formation in human bone marrow cultures, was decreased proportionally to the length of IB treatment. Group 1 had the lowest OSA compared with the other groups (p = 0.003). However, all mice eventually developed paraplegia, and at time of sacrifice, tumor burden was not grossly different among the groups. Interestingly, macroscopic abdominal tumors were more frequent in mice treated with IB. These data demonstrate that early treatment of ARH-77 mice with IB prior to development of myeloma bone disease decreases OSA and possibly retards the development of lytic lesions, but not eventual tumor burden.

Animals↗

Fos and bone cell development: lessons from a nuclear oncogene.

Vertebrate embryologists are beginning to understand the early developmental decisions that control the origin and patterning of skeletal elements. However, the regulators governing the development of the cells that form the skeleton, namely, bone and cartilage cells, are poorly understood. Recent studies using transgenic and knockout mice have established a unique role for the proto-oncogene and nuclear transcription factor, Fos, in regulating the differentiation and activity of specific bone cell populations, both during normal development and in bone disease.

Animals↗

Bone metastasis after a resection of stage I and II primary lung cancer.

In the present study, we reviewed the patients who developed bone metastases after a surgical resection of primary lung cancer and evaluated their clinicopathological features. From 1992 to 1995, 177 patients with stage I and II primary lung cancer underwent a surgical resection at the Kitakyushu Municipal Medical Center. Bone metastases were detected in 14 patients (7.9%) by follow-up examinations including bone scintigraphy (scan). Bone metastasis was one of the most frequent extra-thoracic recurrent forms. Patients with adenocarcinoma tended to develop bone metastases more frequently than those with squamous cell carcinoma. In the preoperative bone scans, an abnormal uptake was observed in 76 patients (42.9%), and 10 (13.1%) of them were found to develop bone metastases in the follow-up studies. A microscopic examination of the primary tumor demonstrated close correlation between intratumoral and peritumoral lymphatic vessel invasion and postoperative development of bone metastases. A bone scan is a very useful and indispensable procedure for diagnosing bone metastases. However, this scan may also show false positive finding in a number of benign conditions. Therefore, a surgical resection should be considered as the first-line treatment for patients with positive findings in the bone scan when the diagnosis of bone metastasis can not be confirmed based on both their symptoms and other clinical examinations.

Adenocarcinoma↗

Immunolocalization of heat shock protein 27 in developing jaw bones and tooth germs of human fetuses.

27 kDa Heat shock protein (Hsp27), which is also identified as p29 estrogen-receptor associated protein, plays a crucial role in specific growth stages. It also seems to be involved in the balance between differentiation and apoptosis. To determine whether Hsp27 is involved during craniofacial development and odontogenesis, its expression was studied through immunohistochemistry of developing jaw bone as well as the odontogenesis of heads from human fetuses. Formalin-fixed paraffin-embedded specimens of 7 human fetuses (3 female, 4 male), obtained from miscarriages occurring between the 9th and 16th weeks of pregnancy, were examined by using a monoclonal antibody against Hsp27. Staining intensity (weak, +; moderate, ++; strong, +++) was evaluated semiquantitatively. The sample slice was cut through a coronal plane, which included eyes, nasal cavities, tongue, and primitive dental lamina with tooth germs. A transient and spatially restricted expression of Hsp27 in developing human jaw bones and teeth was observed. Osteoblasts around the uncalcified bone matrix showed Hsp27 immunoreaction products (+++), whereas osteocytes were not immunolabeled. In mandibular condyle, immunolabeling was restricted to hypertrophic chondrocytes (++). In developing tooth germs, Hsp27 immunostaining was detected throughout the bud (+++). At the early cap stage, a strong immunolabeling for Hsp27 was seen in the dental lamina (+++), and a moderate staining was seen in the outer dental epithelium (++). At the late cap stage, Hsp27 expression was detected in the outer dental epithelium (++) as well as in the cells of the future stellate reticulum (++). The spatiotemporal-restricted expression of Hsp27 in craniofacial bones during development suggests that this protein could be involved in the balance between differentiation and apoptosis, by modulating the viability of osteoblasts and chondrocytes. The specific regional and temporal expression patterns of Hsp27 during tooth development sustains that this small Hsp might be related to the morphogenesis and cytodifferentiation processes of tooth germs.

Female↗

Bone morphogenetic protein-mediated interaction of periosteum and diaphysis. Citric acid and other factors influencing the generation of parosteal bone.

In rabbits, after long-bone growth is complete and the cambium layer regresses, mesenchymal-type cells with embryonic potential (competence) for bone development persist in the adventitial layer of periosteum. These cells are not determined osteoprogenitor cells (stem cells) because bone tissue differentiation does not occur when adult periosteum is transplanted into a heterotopic site. In this respect, adventitial cells differ from bone marrow stroma cells. In a parosteal orthotopic site in the space between the adult periosteum and diaphysis, implants of bone morphogenetic protein (BMP) and associated noncollagenous proteins (BMP/NCP) induce adventitia and adjacent muscle connective-tissue-derived cells to switch from a fibrogenetic to a chondroosteoprogenetic pattern of bone development. The quantity of induced bone is proportional to the dose of BMP/NCP in the range from 10 to 50 mg; immature rabbits produced larger deposits than mature rabbits in response to BMP/NCP. Preoperative local intramuscular injections of citric, edetic, or hyaluronic acids in specified concentrations markedly enhanced subperiosteal BMP/NCP-induced bone formation. The quantity of bovine or human BMP/NCP-induced bone formation in rabbits is also increased by very low-dose immunosuppression but not by bone mineral, tricalcium phosphate ceramic, inorganic calcium salts, or various space-occupying, unspecific chemical irritants. Although composities of BMP/NCP and allogeneic rabbit tendon collagen increased the quantity of bone in a parosteal site, in a heterotopic site the composite failed to induce bone formation. In a parosteal site, the conditions permitting BMP/NCP-induced bone formation develop, and the end product of the morphogenetic response is a duplicate diaphysis. How BMP reactivates the morphogenetic process in postfetal mesenchymal-type adventitial cells persisting in adult periosteum (including adjacent muscle attachments) is not known.

Animals↗