MyMedR

The use of selective estrogen receptor modulators on bone health in men

Wong SK, Mohamad NV, Jayusman PA, Shuid AN, Ima-Nirwana S, Chin KY

Aging Male, 2019 Jun;22(2):89-101.

PMID: 29508640 DOI: 10.1080/13685538.2018.1448058

Selective estrogen receptor modulators (SERMs) represent a class of drugs that act as agonist or antagonist for estrogen receptor in a tissue-specific manner. The SERMs drugs are initially used for the prevention and treatment of osteoporosis in postmenopausal women. Bone health in prostate cancer patients has become a significant concern, whereby patients undergo androgen deprivation therapy is often associated with deleterious effects on bone. Previous preclinical and epidemiological findings showed that estrogens play a dominant role in improving bone health as compared to testosterone in men. Therefore, this evidence-based review aims to assess the available evidence derived from animal and human studies on the effects of SERMs on the male skeletal system. The effects of SERMs on bone mineral density (BMD)/content (BMC), bone histomorphometry, bone turnover, bone strength and fracture risk have been summarized in this review.

Matched MeSH terms: Bone and Bones/pathology

Gross, radiology and ultrasonographic evaluation of coral post-implantation in sheep femur

Fadilah A, Zuki AB, Loqman MY, Zamri-Saad M, Norimah Y, Asnah H

Med J Malaysia, 2004 May;59 Suppl B:178-9.

PMID: 15468876

The study was carried out to evaluate macroscopically the ability of coral to repair a large size bone defect. A total 12 adult, male sheep were used in the study. The large bone defect (2.5cm x 0.5cm x 0.5cm) was created surgically on the left proximal femur and replaced by a block of coral (Porites sp.). Radiographs were obtained immediately after surgery and at 2, 4, 8 and 12 weeks post-implantation. Ultrasonographic examinations were carried out every 2 weeks after implantation up to 12 weeks using ultrasound machine (TOSHIBA Capasee II) connected with 7MHz frequency transducer. The sheep were euthanased at 2, 4, 8, and 12 weeks post-implantation and the bone examined grossly. Both ultrasonographs and radiographs taken at 8 and 12 weeks showed that the implants had been resorbed and left the space that much reduced in size. There was no sign of implant rejection observed in all animals. The results showed that processed coral has potential to become bone substitute for reconstructive bone surgery.

Matched MeSH terms: Bone and Bones/pathology*

Chromosome aberration test for hydroxyapatite in sheep

Kannan TP, Nik Ahmad Shah NL, Azlina A, Samsudin AR, Narazah MY, Salleh M

Med J Malaysia, 2004 May;59 Suppl B:168-9.

PMID: 15468871

The present study is aimed at finding the mutagenicity and cytotoxicity of dense form of synthetic hydroxyapatite (Source: School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia) in the blood of sheep. The biomaterial was implanted in the tibia of Malin, an indigenous sheep breed of Malaysia. Blood was collected from the sheep before implantation of the biomaterial, cultured and a karyological study was made. Six weeks after implantation, blood was collected from the same animal, cultured and screened for chromosome aberrations. The mitotic indices and karyological analysis indicated that the implantation of synthetic hydroxyapatite (dense form) did not produce any cytotoxicity or chromosome aberrations in the blood of sheep.

Matched MeSH terms: Bone and Bones/pathology

Histological evaluation of the early bone response to hydroxyapatite (HA) implanted in rabbit tibia

Khadijah K, Mashita M, Saidu MF, Fazilah F, Khalid KA

Med J Malaysia, 2004 May;59 Suppl B:123-4.

PMID: 15468849

This study is to qualitatively evaluate a locally produced hydroxyapatite (HA), made by AMREC-SIRIM in an experimental animal bone defect using New Zealand White (NZW) rabbits. HA cylindrical blocks measuring 2.5 mm (D) x 1.0 mm (H) were implanted in the rabbits' left tibia. The tibias were harvested within one to three weeks post-implantation. The implantion site was cut into thin undecalcified sections of about 30 microm to 60 microm and stained with Toluidine Blue and Goldner's Masson Trichrome. Microscopic examinations using standard light microscopy of these slides were performed.

Matched MeSH terms: Bone and Bones/pathology

Design and fabrication of scaffolds for anatomic bone reconstruction

Hollister SJ, Lin CY, Lin CY, Schek RD, Taboas JM, Flanagan CL, et al.

Med J Malaysia, 2004 May;59 Suppl B:131-2.

PMID: 15468853

Matched MeSH terms: Bone and Bones/pathology

A case of neurofibromatosis with elephantiasis neuromatosa, bone changes, and coincident pulmonary tuberculosis

MCDOUGALL C

Med J Malaya, 1955 Jun;9(4):265-75.

PMID: 13253126

Matched MeSH terms: Bone and Bones/pathology*

The examination of skeletal remains

Sarvesvaran R, Knight BH

Malays J Pathol, 1994 Dec;16(2):117-26.

PMID: 9053560

The finding of skeletal remains is a common happening and the forensic pathologist is frequently called upon to examine the remains. It is theoretically much better for the pathologist to examine the bones at the site before they are disturbed, but this rarely happens, the bones being recovered by the public, workmen or police and brought in a jumbled condition to the pathologist. Using a systematic process of elimination such as that suggested in this paper, the maximum information can be obtained. Even so, it is common for the bones never to be identified and even the length of time the person has been dead remains unknown, due to lack of corroborative information. However, only by repeated and careful examination of a number of skeletal remains, can the pathologist hope to gain any experience. Probably the most important thing to bear in mind is the danger of being too dogmatic, especially about the date of the remains and not to mislead the investigating authorities by over-optimistic opinions.

Matched MeSH terms: Bone and Bones/pathology*

The pathology of tumour and "tumour-like" lesions of bone in the University Hospital, Kuala Lumpur

Peh SC, Cheah PL, Sengupta S

Malays J Pathol, 1988 Aug;10:45-50.

PMID: 3252076

Matched MeSH terms: Bone and Bones/pathology*

Light chain multiple myeloma: an evaluation of its biochemical investigations

Zahari Sham SY, C Thambiah S, Samsudin IN, Lim SM

Malays J Pathol, 2017 Dec;39(3):311-315.

PMID: 29279596 MyJurnal

Multiple myeloma is a type of plasma cell dyscrasia, characterised by presence of paraprotein or monoclonal (M)-protein in serum or urine. The M-protein may consist of an intact immunoglobulin, the heavy chain only or the light chain only. The latter, designated as light chain multiple myeloma (LCMM) makes up almost 20% of myelomas. Clinical manifestation is often heralded by hypercalcaemia, renal impairment, normocytic normochromic anaemia and bone lesions, reflecting end-organ damage, collectively known as the acronym CRAB. In particular, free light chain nephrotoxicity accounts for the high prevalence of renal impairment seen in LCMM. This case illustrates a typical presentation of LCMM with focal discussion on its initial and diagnostic, as well as prognostic biochemical investigations.

Matched MeSH terms: Bone and Bones/pathology

Subacute osteomyelitis masquerading as primary bone sarcoma: report of six cases

Dhanoa A, Singh VA

Surg Infect (Larchmt), 2010 Oct;11(5):475-8.

PMID: 20858161 DOI: 10.1089/sur.2009.011

We report a series of six immunocompetent patients who were believed initially to have primary bone sarcomas, but turned out to have subacute osteomyelitis.

Matched MeSH terms: Bone and Bones/pathology

Fulltext Benign periarticular, bone and joint lipomatous lesions

Kheok SW, Ong KO

Singapore Med J, 2017 Sep;58(9):521-527.

PMID: 28948289 DOI: 10.11622/smedj.2017087

Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.

Matched MeSH terms: Bone and Bones/pathology

Proliferation and osteogenic differentiation of mesenchymal stromal cells in a novel porous hydroxyapatite scaffold

Krishnamurithy G, Murali MR, Hamdi M, Abbas AA, Raghavendran HB, Kamarul T

Regen Med, 2015;10(5):579-90.

PMID: 26237702 DOI: 10.2217/rme.15.27

To compare the effect of bovine bone derived porous hydroxyapatite (BDHA) scaffold on proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stromal cells (hMSCs) compared with commercial hydroxyapatite (CHA) scaffold.

Matched MeSH terms: Bone and Bones/pathology

Catechin-rich oil palm leaf extract enhances bone calcium content of estrogen-deficient rats

Bakhsh A, Mustapha NM, Mohamed S

Nutrition, 2013 Apr;29(4):667-72.

PMID: 23290096 DOI: 10.1016/j.nut.2012.09.005

Postmenopausal estrogen deficiency often causes bone density loss and osteoporosis. This study evaluated the effects of an oral administration of oil palm leaf extract (OPL) on bone calcium content and structure, bone density, ash weights, and serum total alkaline phosphatase (T-ALP) of estrogen-deficient ovariectomized (OVX) rats.

Matched MeSH terms: Bone and Bones/pathology

Noni leaf and black tea enhance bone regeneration in estrogen-deficient rats

Shalan NA, Mustapha NM, Mohamed S

Nutrition, 2017 Jan;33:42-51.

PMID: 27908549 DOI: 10.1016/j.nut.2016.08.006

OBJECTIVE: Black tea and Nonileaf are among the dietary compounds that can benefit patients with bone resorption disorders. Their bone regeneration effects and their mechanisms were studied in estrogen-deficient rats.

METHODS: Noni leaves (three doses) and black tea water extracts were fed to ovariectomized rats for 4 mo, and their effects (analyzed via mechanical measurements, micro-computed tomography scan, and reverse transcriptase polymerase chain reaction mRNA) were compared with Remifemin (a commercial phytoestrogen product from black cohosh).

RESULTS: The water extracts (dose-dependently for noni leaves) increased bone regeneration biomarker (runt-related transcription factor 2, bone morphogenetic protein 2, osteoprotegerin, estrogen receptor 1 [ESR1], collagen type I alpha 1A) expressions and reduced the inflammatory biomarkers (interleukin-6, tumor necrosis factor-α, nuclear factor [NF]-κB, and receptor activator of NF-κB ligand) mRNA expressions/levels in the rats. The extracts also improved bone physical and mechanical properties. The extracts demonstrated bone regeneration through improving bone size and structure, bone mechanical properties (strength and flexibility), and bone mineralization and density.

CONCLUSIONS: The catechin-rich extract favored bone regeneration and suppressed bone resorption. The mechanisms involved enhancing osteoblast generation and survival, inhibiting osteoclast growth and activities, suppressing inflammation, improving bone collagen synthesis and upregulating ESR1 expression to augment phytoestrogenic effects. Estrogen deficiency bone loss and all extracts studied (best effect from Morinda leaf at 300 mg/kg body weight) mitigated the loss, indicating benefits for the aged and menopausal women.

Matched MeSH terms: Bone and Bones/pathology

Bisphenol A exposure disturbs the bone metabolism: An evolving interest towards an old culprit

Thent ZC, Froemming GRA, Muid S

Life Sci, 2018 Apr 01;198:1-7.

PMID: 29432759 DOI: 10.1016/j.lfs.2018.02.013

Bisphenol A (BPA) (2,2,-bis (hydroxyphenyl) propane), a well-known endocrine disruptor (ED), is the exogenous chemical that mimic the natural endogenous hormone like oestrogen. Due to its extensive exposure to humans, BPA is considered to be a major toxicological agent for general population. Environmental exposure of BPA results in adverse health outcomes including bone loss. BPA disturbs the bone health by decreasing the plasma calcium level and inhibiting the calcitonin secretion. BPA also stimulated differentiation and induced apoptosis in human osteoblasts and osteoclasts. However, little is known about the underlying mechanisms of the untoward effect of BPA against bone metabolism. The present review gives an overview on the possible mechanisms of BPA towards bone loss. The previous literature shows that BPA exerts its toxic effect on bone cells by binding to the oestrogen related receptor-gamma (ERγ), reducing the bone morphogenic protein-2 (BMP-2) and alkaline phosphatase (ALP) activities. BPA interrupts the bone metabolism via RANKL, apoptosis and Wnt/β-catenin signaling pathways. It is, however, still debated on the exact underlying mechanism of BPA against bone health. We summarised the molecular evidences with possible mechanisms of BPA, an old environmental culprit, in bone loss and enlightened the underlying understanding of adverse action of BPA in the society.

Matched MeSH terms: Bone and Bones/pathology

Fulltext A novel design, analysis and 3D printing of Ti-6Al-4V alloy bio-inspired porous femoral stem

Mehboob H, Tarlochan F, Mehboob A, Chang SH, Ramesh S, Harun WSW, et al.

J Mater Sci Mater Med, 2020 Aug 20;31(9):78.

PMID: 32816091 DOI: 10.1007/s10856-020-06420-7

The current study is proposing a design envelope for porous Ti-6Al-4V alloy femoral stems to survive under fatigue loads. Numerical computational analysis of these stems with a body-centered-cube (BCC) structure is conducted in ABAQUS. Femoral stems without shell and with various outer dense shell thicknesses (0.5, 1.0, 1.5, and 2 mm) and inner cores (porosities of 90, 77, 63, 47, 30, and 18%) are analyzed. A design space (envelope) is derived by using stem stiffnesses close to that of the femur bone, maximum fatigue stresses of 0.3σys in the porous part, and endurance limits of the dense part of the stems. The Soderberg approach is successfully employed to compute the factor of safety Nf > 1.1. Fully porous stems without dense shells are concluded to fail under fatigue load. It is thus safe to use the porous stems with a shell thickness of 1.5 and 2 mm for all porosities (18-90%), 1 mm shell with 18 and 30% porosities, and 0.5 mm shell with 18% porosity. The reduction in stress shielding was achieved by 28%. Porous stems incorporated BCC structures with dense shells and beads were successfully printed.

Matched MeSH terms: Bone and Bones/pathology

Glycyrrhizic acid (GCA) as 11β-hydroxysteroid dehydrogenase inhibitor exerts protective effect against glucocorticoid-induced osteoporosis

Ramli ES, Suhaimi F, Asri SF, Ahmad F, Soelaiman IN

J. Bone Miner. Metab., 2013 May;31(3):262-73.

PMID: 23274351 DOI: 10.1007/s00774-012-0413-x

Rapid onset of bone loss is a frequent complication of systemic glucocorticoid therapy which may lead to fragility fractures. Glucocorticoid action in bone depends upon the activity of 11β-hydroxysteroid dehydrogenase type 1 enzyme (11β-HSD1). Regulations of 11β-HSD1 activity may protect the bone against bone loss due to excess glucocorticoids. Glycyrrhizic acid (GCA) is a potent inhibitor of 11β-HSD. Treatment with GCA led to significant reduction in bone resorption markers. In this study we determined the effect of GCA on 11β-HSD1 activity in bones of glucocorticoid-induced osteoporotic rats. Thirty-six male Sprague-Dawley rats (aged 3 months and weighing 250-300 g) were divided randomly into groups of ten. (1) G1, sham operated group; (2) G2, adrenalectomized rats administered with intramuscular dexamethasone 120 μg/kg/day and oral vehicle normal saline vehicle; and (3) G3, adrenalectomized rats administered with intramuscular dexamethasone 120 μg/kg/day and oral GCA 120 mg/kg/day The results showed that GCA reduced plasma corticosterone concentration. GCA also reduced serum concentration of the bone resorption marker, pyridinoline and induced 11β-HSD1 dehydrogenase activity in the bone. GCA improved bone structure, which contributed to stronger bone. Therefore, GCA has the potential to be used as an agent to protect the bone against glucocorticoid induced osteoporosis.

Matched MeSH terms: Bone and Bones/pathology

Fulltext The Role of Piper sarmentosum Aqueous Extract as a Bone Protective Agent, a Histomorphometric Study

Mohamad Asri SF, Soelaiman IN, Mohd Moklas MA, Mohd Nor NH, Mohamad Zainal NH, Mohd Ramli ES

Int J Mol Sci, 2020 Oct 19;21(20).

PMID: 33086468 DOI: 10.3390/ijms21207715

Glucocorticoids are one of the causes of secondary osteoporosis. The aqueous extract of Piper sarmentosum contains flavonoids that possess antioxidant effects. In this study, we determined the effects of aqueous Piper sarmentosum leaf extract on structural, dynamic and static histomorphometric changes from osteoporotic bones of rats induced with glucocorticoids. Thirty-two Sprague-Dawley rats were divided equally into four groups-Sham control group given vehicles (intramuscular (IM) olive oil and oral normal saline); AC: Adrenalectomised (Adrx) control group given IM dexamethasone (DEX) (120 μg/kg/day) and vehicle (oral normal saline); AP: Adrx group administered IM DEX (120 μg/kg/day) and aqueous Piper sarmentosum leaf extract (125 mg/kg/day) orally; and AG: Adrx group administered IM DEX (120 μg/kg/day) and oral glycyrrhizic acid (GCA) (120 mg/kg/day). Histomorphometric measurements showed that the bone volume, trabecular thickness, trabecular number, osteoid and osteoblast surfaces, double-labelled trabecular surface, mineralizing surface and bone formation rate of rats given aqueous Piper sarmentosum leaf extract were significantly increased (p < 0.05), whereas the trabecular separation and osteoclast surface were significantly reduced (p < 0.05). This study suggests that aqueous Piper sarmentosum leaf extract was able to prevent bone loss in prolonged glucocorticoid therapy. Thus, Piper sarmentosum has the potential to be used as an alternative medicine against osteoporosis and osteoporotic fractures in patients undergoing long-term glucocorticoid therapy.

Matched MeSH terms: Bone and Bones/pathology*

Fulltext Calcaneal quantitative ultrasound as a determinant of bone health status: what properties of bone does it reflect?

Chin KY, Ima-Nirwana S

Int J Med Sci, 2013;10(12):1778-83.

PMID: 24273451 DOI: 10.7150/ijms.6765

Quantitative ultrasound (QUS) has emerged as a convenient and popular screening tool for osteoporosis. This review aimed to provide basic information on the principle of QUS measurement and discuss the properties of bone reflected by QUS indices. QUS employed high frequency sound waves generated by the device to determine bone health status in humans. In vitro studies showed that QUS indices were significantly associated with bone mineral density (BMD), bone microarchitecture and mechanical parameters. In humans, QUS indices were found to be associated with BMD as well. In addition, QUS could discriminate subjects with and without fracture history and predict risk for future fracture. In conclusion, QUS is able to reflect bone quality and should be used in the screening of osteoporosis, especially in developing countries where dual-X-ray absorptiometry devices are less accessible to the general population.

Matched MeSH terms: Bone and Bones/pathology

Fulltext The Skeletal Effects of Short-Term Triple Therapy in a Rat Model of Gastric Ulcer Induced by Helicobacter pylori Infection

Ekeuku SO, Thong BKS, Quraisiah A, Annuar F, Hanafiah A, Nur Azlina MF, et al.

Drug Des Devel Ther, 2020;14:5359-5366.

PMID: 33324037 DOI: 10.2147/DDDT.S287239

Purpose: Triple therapy is the standard therapy to eradicate Helicobacter pylori (H.pylori) infection. Chronic use of proton pump inhibitors (PPIs), a component of triple therapy, is associated with osteoporosis. However, the skeletal effects of short-term triple therapy containing PPI remain elusive. This study aims to determine the skeletal effect of short-term triple therapy in a rat model of gastric ulcer induced by H. pylori.

Methods: Three-month-old male Sprague Dawley rats were assigned to normal control, H. pylori-inoculated group (negative control) and H. pylori-inoculated group receiving triple therapy consisting of omeprazole [2.035 mg/kg body weight (b.w)], amoxicillin (102.80 mg/kg b.w) and clarithromycin (51.37 mg/kg b.w) (n=6/group). H. pylori infection developed for four weeks after inoculation, followed by two-week triple therapy. At the end of the treatment period, femoral bones of the rats were harvested for analysis. Bone mineral density and content of the femurs were determined using dual-energy X-ray absorptiometry, while bone strength was measured with a universal mechanical tester.

Results: Bone mineral content was significantly lower in the negative control group compared to the triple therapy group (p=0.014). Triple therapy decreased strain (vs negative control, p=0.002) and displacement of the femur (vs normal control, p=0.004; vs untreated control, p=0.005). No significant difference was observed in other parameters among the study groups (p>0.05).

Conclusion: Short-term triple therapy increases bone mineral content but decreases bone strength of rats. Skeletal prophylaxis should be considered for patients on short-term triple therapy containing PPI.

Matched MeSH terms: Bone and Bones/pathology

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