Bone Sections Research Articles

Implant stability quotient and osteogenic process in dental implant sites prepared using piezoelectric technique: A study in minipigs.

Few studies have explored the bone response in dental implant sites prepared using a piezoelectric device, indicating moderate effectiveness in enhancing secondary stability and osteogenesis. This study seeks to expand our understanding of the changes in biological, clinical, and radiographic parameters, during the initial phases of osseointegration in sites prepared with piezoelectric surgery. Two implant sites were prepared in the tibia of four minipigs. At the time of implant placement (T0), bone cortex thickness and Implant Stability Quotient (ISQ) were assessed. A bone specimen was collected from the tibia and used as the baseline for biomolecular analyses. X-ray was taken after implant insertion. After 14 days (T14), a computed tomography (CT) scan of the tibias was conducted, and ISQ values were reassessed. Histological and biomolecular analyses were performed on bone sections containing the implant. ISQ significantly increased from T0 to T14, in the absence of any correlation between the cortical thickness and ISQ. In two animals, CT showed a slight trabecular bone thickening adjacent to the implants and disorganized radiodense spots; in the other two, no trabecular osseodensification was evident. Newly formed bone was about 48% of the tissue around implants. At T14, an increase in osteogenic factors and a decrease in inflammatory molecules were observed. This study enhances understanding of the biological and clinical responses at bone implant sites following piezoelectric surgery. It highlights the relationship between the rise in certain osteogenic factors and new bone formation, as well as a potential association with increased ISQ.

O-01 A CASE OF LANGERHANS CELL HISTIOCYTOSIS WITH INVOLVEMENT OF THE HYPOTHALAMUS, BONE, AND LIVER

Abstract Introduction Langerhans cell histiocytosis (LCH) is a neoplastic disorder characterized by the abnormal infiltration of Langerhans cells, affecting multiple systems. Here, we report a rare case of LCH with involvement of the hypothalamus, liver, and bone. Clinical Case A 36-year-old female patient presented to the psychiatry department with complaints of anxiety, including sudden behavioral changes, headaches, increased forgetfulness, hypersomnia, and excessive thirst excessive eating, and memory lapses that persisted for three months. A contrast-enhanced pituitary MRI taken revealed a lobulated mass lesion, measuring 15x9x17 mm, extending into the interpeduncular cistern and anteriorly toward the optic chiasm, with cystic necrotic areas located at the base of the third ventricle (Figure 1A). Laboratory examinations indicated panhypopituitarism and central diabetes insipidus. Abdominal ultrasound revealed a hypoechoic area in liver segment 8.PET-CT showed a region of intense metabolic activity in the posterior section of the left mastoid bone (SUVmax: 12.4). In addition, a 14-mm focal area with increased fluorodeoxyglucose uptake was observed in liver segment 8 (SUVmax: 8.4) (Figure 1B).The temporal MRI showed a mass lesion extending to the petrous apex, filling the mastoid cells on the left side, with signal characteristics similar to the hypothalamic lesion (Figure 1C).Biopsy was performed on identified lesions. Both biopsy results were consistent with LCH. She was planned to administer two courses of cladribine therapy. Follow-up PET-CT after chemotherapy indicated that the liver and mastoid bone involvement had resolved. However, the patient’s neuropsychiatric symptoms did not improve following chemotherapy. Paraneoplastic autoimmune encephalitis was primarily suspected, and antibody testing was performed. Due to the progressive nature of the patient’s condition, intravenous immunoglobulin therapy was administered. On the fourth day of this treatment, the patient experienced increased agitation and delusions, and developed disorientation.50 mg of quetiapine was prescribed. Three days after starting quetiapine, the patient developed fever, tachypnea, muscle rigidity, increased confusion, and an acute increase in serum creatine kinase levels (29,000 U/L). The condition was evaluated as a neuroleptic malignant syndrome leading to the discontinuation of quetiapine. The patient was transferred to the intensive care unit (ICU).On the first day of ICU admission, the patient was intubated. Despite cardiac support, the patient died on the third day of ICU admission. Conclusion LCH is a rare but multisystemic inflammatory neoplasm. The absence of specific clinical features can lead to delays in diagnosis. Although LCH most commonly presents with bone and skin lesions, a multidisciplinary approach is crucial for an accurate diagnosis. Albeit rare, LCH should be considered in the differential diagnosis of patients presenting with hypothalamic masses.Figure 1:Magnetic resonance image of the hypothalamic mass (A), Magnetic resonance images revealing a mass lesion in the left mastoid bone (B) and a subcapsular lesion in liver segment 8 (C)

MORPHOLOGICAL ASPECTS OF POST-TRAUMATIC LOWER JAW REMODELING IN THE SETTING OF OSTEOPLASTY

Bone tissue regeneration remains a complex and crucial challenge for modern medicine. The unique properties of chitosan, its effects on bone regeneration in the maxillofacial region, as well as the underlying mechanisms and dynamics, remain poorly understood and warrant further investigation. Aim. The aim of the study is to determine the dynamics of morphological, radiological, and lectin-histochemical characteristics of bone-ceramic regenerate after the transplantation of octacalcium phosphate with the addition of chitosan acetate with ampicillin into an experimental defect in the rabbit mandible. Materials and methods. Adult male rabbits aged 6-7 months and weighing 2.5-3 kg were used for the study. The control group consisted of animals with a bone defect that healed under a blood clot. The experimental group consisted of rabbits in which the bone defect was filled with an osteotropic material containing octacalcium phosphate, chitosan acetate, and ampicillin (OCР-N-Chitosan-Ampicillin). Post-traumatic bone tissue status within the defect area was monitored for 84 days. The following methods were employed: bone defect modeling, assessment of jaw macrostructure, radiographic examination, radiovisiography, examination of bone sections under a microscope, and lectin-histochemical analysis of decalcified bone sections. Results. Examination of the macrostructure of the experimental bone defect in the rabbit mandible after implantation of material with octacalcium phosphate, chitosan acetate, and ampicillin (OCР-N -Chitosan-Ampicillin) revealed numerous regenerative changes that occurred after the injury and correlated with the data of radiographic and radiovisiographic examinations. Microscopic examination of bone sections allowed us to establish the phased nature of the dynamics of the studied regenerative changes and the composition of the regenerate. Conclusions. It was established that in the experimental group of animals in which defect repair was performed using OCP-N-Chitosan-Ampicillin material, a shortening of the reactive phase of the post-traumatic inflammatory process was observed, which ensured the active onset of osteoregeneration. The use of this combination of drugs showed accelerated reparative regeneration of the mandible and adjacent mucosa.

MORPHOLOGICAL AND RADIOLOGICAL ASPECTS OF MANDIBULAR BONE REMODELLING AFTER ACTIVATED CHITOSAN IMPLANTATION

Introduction. Bone regeneration remains a complex and challenging area for modern medicine. This study aims to provide a comprehensive understanding of the dynamics of bone tissue remodeling after defect creation and filling with chitosan-based osteoplastic material. While osteoplastic materials are widely used clinically, and chitosan offers unique properties, its impact on maxillofacial bone regeneration, particularly the underlying mechanisms and dynamics, is not fully understood and requires further clarification and detailed investigation. Aim: this study aims to determine and compare the morphological, radiological, and lectin-histochemical characteristics of osteoregeneration after the transplantation of activated chitosan (Chitosan-A) into an experimental defect in the rabbit mandible. Materials and methods. The study was carried out on mature male rabbits aged 6-7 months, weighing 2.5-3 kg. The control group included animals with a bone tissue defect that healed under a blood clot. The experimental group consisted of rabbits in which the bone defect was filled with activated chitosan (Chitosan-A). The post-traumatic state of bone tissue in the defect area was monitored over a period of 84 days using the following methods: bone defect modeling, assessment of jaw macrostructure, radiographic examination, radiovisiography, microscopic analysis of bone sections, and lectin-histochemical analysis of decalcified bone sections. Results. Examination of the macrostructure of the experimental bone defect in the rabbit mandible, following the implantation of chitosan activated with acetic acid (Chitosan-A) into the defect cavity, revealed extensive regenerative changes associated with injury recovery. These findings correlated with data obtained from radiographic and radiovisiographic examinations. Microscopic analysis of bone sections demonstrated a staged progression of regenerative changes and provided insights into the composition of the regenerate. Conclusions. The use of Chitosan-A was shown to modulate tissue development and remodeling throughout the experiment. Bone density in the experimental group approached normal levels, being only 10.2% lower than in the control group at the end of the study. Microscopic examination revealed bone tissue remodeling with incomplete geometry of newly formed osteons and residual traces of the Chitosan-A material.

A Micro-CT Based Cadaveric Study Investigating Bone Density Changes During Hip Arthroplasty Surgery.

The impact of broaching and uncemented implantation on bone density during total hip arthroplasty (THA) remains unclear. Previous studies have typically examined extracted bone sections, which may not directly correlate with outcomes in human hip systems. This study aimed to evaluate bone density changes resulting from broaching and uncemented implantation using micro-computed tomography (μCT) on cadaveric samples. An in-house density calibration phantom (DCP) was developed by validating the densities of polymer inserts through mass and volume measurements. Its performance was then evaluated using lamb bone in comparison with a commercial DCP (QRM-50124). The sensitivity of density predictions to μCT scan parameters was also evaluated with the lamb bone. Additionally, density predictions from medical-CT and μCT scans were compared using the in-house DCP. Finally, uncemented THA procedures were performed on three cadaveric femurs, each undergoing three μCT scans at various surgical stages to assess changes in bone density. The density predictions obtained using the in-house DCP achieved an accuracy of ±0.097 g/cc compared to QRM-50124, with a precision of ±0.052 g/cc. The sensitivity to changes in μCT scan parameters was ±0.022 g/cc. Notably, density predictions from medical-CT and μCT scans were similar, particularly in cortical bone. Broaching and implantation led to an average increase in bone density of 0.137 g/cc, which was attributed to the accumulation of bone debris around the bone-implant interface. This accumulation raised the bone volume fraction, ranging from 3.31% to 20.69%, which acts as an autograft. These measurements have been made for the first time using a µCT and an in-house DCP.

Determination of individual age and ontogenetic stages of fossil tetrapods using paleohistological methods

The determination of individual age and ontogenetic stage (juvenile, subadult, adult) of fossil vertebrates is important for the initial determination of taxonomic affiliation, as well as for further evolutionary and paleobiological interpretations. Determination of individual age and ontogenetic stage (= relative age) is carried out by various methods, including paleohistological analysis. The study of thin sections of tetrapod bones allows us to assume how many years the animal lived (skeletochronological method) and to determine the ontogenetic stage according to a set of age-related histological markers: change in the type of bone matrix and vascularization, change in the distance between growth marks, formation of the external fundamental system (EFS), formation of the inner (endosteal) and outer (periosteal) circumferential layers (OCL, ICL), occurrences of secondary remodeling – Haversian substitution and formation of trabeculae. Depending on the phylogenetic position and biological peculiarities of the study group of tetrapods, the set of age “histologic markers” may be different.

Scythians in Azerbaijan: the history of one murder (archaeology and anthropology)

The article presents craniological materials of the Early Iron Age (VII–IV centuries BC) from Mingachevir. The study examined the skull of a female (2488) aged 20–30 years with evidence of traumatic injury. Caucasoid, mesocranial, originating from the burial with the skeleton in extended position (No. 137), which correlates with the presence of the Scythians on the territory of our republic. The depressed compression fracture, 0.9 cm in diameter, from which cracks radiate, was marked on the left part of upper section of the frontal bone of the woman’s skull. There are no signs of healing or inflammation. The crime weapon was a hard, blunt object, that broke and pressed the bone, after which a round-shaped dent was formed, and cracks appeared from it, which indicates the significant force of the blow, which led to the death of the woman. We can observe the so-called perimortem trauma - injury got at or near the moment of death. The blow was struck, presumably, from the right and from above; the victim was below the killer, who could be on horseback, and at a distance from the deceased. The case from Mingachevir is currently the only anthropological find of this kind - a fatal compression fracture of the cranial vault from the territory of Azerbaijan during the Early Iron Age.

Effective pharmacotherapy of osteoporosis in perimenopause

Osteoporosis (OP) is a disease characterized by a decrease in bone mineral density (BMD) and a high risk of fractures. In perimenopausal women with a disturbed hormonal background, the risk of developing this pathology increases significantly. Special diagnostic methods and therapy that take into account the etiopathogenesis of the disease can reduce the disability rates associated with OP among patients of this group. The article provides data on the results of examination and treatment of 57 perimenopausal women with OP and reveals the potential of diagnostics that allows evaluating the effectiveness of therapy. The drug "Osteomed Forte" has shown effectiveness in reducing and closing cavities in the trabecular bone sections in patients with verified OP and androgen deficiency, and improving hormonal status in perimenopause allowed to suspend the development of OP and even achieve its partial regression.

Image-based finite element model stiffness and vBMD by single and dual energy CT reconstruction kernel

Single-energy quantitative computed tomography (SEQCT) provides volumetric bone mineral density (vBMD) measures for bone analysis and input to image-based finite element models (FEMs). Dual-energy CT (DECT) improves vBMD by accounting for voxel-specific material variations utilizing scans at multiple x-ray energies. vBMD is also altered by reconstruction kernel that cannot be accounted for using calibration phantoms. This study compared vBMD and FEM stiffness derived from SEQCT and DECT images reconstructed with two common kernels. SEQCT and DECT images of cadaveric shoulders (n = 10) were collected using standard (STD) and boneplus (BONE) kernels. Hounsfield Units were converted to vBMD using specimen-specific calibrations. DECT STD and BONE images were generated using an established material decomposition method with 40 and 90 keV simulated monochromatic images. A proximal humerus bone section below the anatomic neck was used for vBMD analysis and FEM generation. FEMs were loaded to 1% apparent strain for stiffness measurements.Between STD and BONE kernel images, average vBMD differed 0.9 mgK2HPO4/cc and 4.1 mg K2HPO4/cc, in SEQCT and DECT images, respectively. Significant differences occurred in DECT images (p = 0.001). BONE reconstructed images produced higher vBMD measures across both SEQCT and DECT images. The difference between STD and BONE in both SEQCT- and DECT-based FEMs persisted, with larger estimated stiffness in BONE models. For six of the models DECT-based had higher stiffness than SEQCT-based models using the same kernel, although these models differed between STD and BONE kernels. Differences in stiffness between STD and BONE derived models were similar across image types (DECT: 17.5 kN/mm; SEQCT: 19.0 kN/mm). Stiffness values were significantly different within SECT kernels and between SEQCT BONE and DECT STD models. This study shows important differences in vBMD and FEM stiffness that occur due to CT-based imaging parameters alone. These results indicate that consistent imaging parameters should be used for vBMD analysis and FEM input to avoid systematic measurement errors.

Biofilm-Induced Bone Degradation in Osteomyelitis

Objectives: Osteomyelitis, marked by bone inflammation due to microbial infection, presents significant healthcare challenges. While the protective role of biofilm in bacterial immunity and persistence is well-documented, its direct impact on bone degradation in osteomyelitis remains inadequately characterized. This study aims to comprehensively examine the direct effects of biofilm-forming pathogens on human bone, providing new insights into the mechanisms of bone destruction in osteomyelitis. Methods: Bone sections were collected from patients undergoing total knee replacement surgery between January 2021 and December 2022 for this study at Sultan Qaboos University Hospital. Then samples were inoculated with Staphylococcus aureus to simulate in-vitro bone infection. We then used Raman spectroscopy and Scanning Electron Microscopy (SEM) for detailed analysis of the bacterial interaction with bone tissue. Results: SEM images depicted trabecular destruction caused by biofilm. Biofilm-forming pathogens contribute directly to bone exhibited by SEM images with marked trabecular destruction. Raman analysis showed a significant increase in the carbonate-phosphate ratio in inoculated samples (619%) compared to controls (47%). Mineral content decreased in inoculated samples, and the carbonate-to-amide I ratio reduced by 47% in inoculated and 80% in controls. The inoculated samples exhibited an 82% shift in collagen crosslinking compared to 72% in controls. Conclusion: This research enhances our comprehension of the mechanisms behind bone destruction in osteomyelitis and underscores the intricate role of biofilm in the disease's development. These findings highlight the importance of biofilm in bone degradation and its potential implications for managing infections.

Association of keel bone morphometry with keel bone damage and skeletal quality in the laying hen

ABSTRACT 1. The aim of this work was to identify a heritable keel bone phenotype with a correlation to keel bone damage and/or skeletal bone strength that could be easily measured in the living hen to aid selection to prevent welfare issues. 2. The scoring system used reflected the observed damage, keel bone dimensions and shape compared to traditional measurements of bone quality. 3. Increased keel bone damage was associated with poor humerus and tibia breaking strengths (p < 0.01). Bone damage was associated with higher whole keel density (p < 0.01) due to the effect of callus formation. 4. Keel bone depth and area was moderately heritable at indices of 0.32 and 0.40, respectively. Keel bone depth was genetically correlated with tibia (0.36) and humerus density (0.68) and keel bone area was correlated with humerus density (0.59). Deeper keel bones and those with larger areas had small, negative phenotypic correlations with keel bone damage (−0.07 and −0.11, respectively). The second principal component of keel bone shape represented the caudal section of the keel bone and cranial edge concavity. The third principal component represented the differences in the caudal tip of the keel bone, the concavity of the dorsal edge and convexity of the ventral edge. Heritability estimates were 0.44 and 0.39, respectively. 5. The results suggested that genetics contribute to morphometric traits. Hens with poorer skeletal quality are likely to accumulate more damage. Some of the traits may be a predictor of damage, although mid keel depth or concavity may simply reflect the effect of damage or deviation.

The effect of prenatal fumonisin B exposure on bone innervation in newborn Wistar rats.

This study explored the effects of prenatal exposure to fumonisins B (FB) on bone innervation in newborn Wistar rats. Pregnant dams (n = 6 per group) were assigned to either the control or one of two FB-exposed groups (60 mg or 90 mg/kg body weight) from the 7th day of gestation until parturition. On the day of parturition, one male pup from each litter (n = 6 per group) was randomly selected and euthanised, and their femurs were dissected for analysis. Bone innervation was quantified by examining the morphology patterns of sympathetic, parasympathetic, sensory and cocaine- and amphetamine-regulated transcript (CART)-positive fibres. Prepared bone sections were analysed using immunohistochemistry staining for protein gene product 9.5, tyrosine hydroxylase, choline acetyltransferase, vasoactive intestinal peptide (VIP), substance P and CART-positive neurons. The group that received a higher dose of FB demonstrated an increase in both the size and complexity of the complete bone neuronal network together with heightened sympathetic and sensory innervation, and displayed a decrease in neuron density and sympathetic innervation. Fumonisin B exposure led to a decrease in galanin-positive and VIP-positive bone neuronal networks in both groups exposed to FB, while in the lower-dose group, there was also a decrease in CART-positive innervation. Prenatal FB exposure significantly influences the neuronal bone network of rats, which is essential for maintaining bone homeostasis. These findings emphasise the necessity for further research to understand the lasting effects and underlying mechanisms of alterations induced by FB.

Comparison of Rotary and Cryostat Microtomes in the Skeletochronology on Green Turtle Humerus Bones

Skeletochronology is a powerful tool that provides information on the age of sea turtles. Digital images of histologically prepared humerus bone sections are commonly used for age determination. The quality of digital images, which is critical for robust age estimation, varies depending on the type and histological technique associated with microtome. This study aimed to compare the quality of digital image sections of humerus bones prepared by rotary and cryostat microtomes. The humerus bones of 11 juvenile stranded (dead) green turtles (mean CCL 292.1 mm) on Samandağ beach during the 2021 nesting season were used for the study. Three readers scored the quality of histologic sections prepared with two different microtomes and associated protocols, as well as the readability of the lines of arrested growth (LAGs), which they saw from 0 to 5. The Wilcoxon-signed rank-paired test was used to ascertain the disparities between the quality scores of the two protocols. In addition, the compatibility of readers was evaluated by determining the proportion of specimens with at least two identical scores for each protocol. The scores obtained from the cryostat microtome protocol had a wider variation compared to the rotary microtome protocol. The rotary microtome protocol has higher median score values (4) than the cryostat microtome protocol (3) (p

In situ metabolomic analysis of osteonecrosis of the femoral head (ONFH) using MALDI MSI.

Osteonecrosis of the femoral head (ONFH) is a common orthopedic disease characterized by disability and deformity. To better understand ONFH at molecular level and to explore the possibility of early diagnosis, instead of diagnosis based on macroscopic spatial characteristics, a matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) method was developed for ONFH disease for the first time. The most challenging step for ONFH MSI is to deal with human bone tissues which are much harder than the other biological samples studied by the reported MSI studies. In this work, the MSI sectioning method of hard bone tissues was established using tender acids and a series of test criteria. Small-molecule metabolites, such as lipids and amino acids, were detected in bone sections, realizing the in situ detection of spatial distribution of biometabolites.By comparing the distribution of metabolites from different regions of normal femoral head, ONFH bone tissue (ONBT), and adjacent ONFH bone tissue (ANBT), the whole process of femoral head from normal stage to necrosis was monitored and visualized at molecular level. Moreover, this developed MSI method was used for metabolomics study of ONFH. 72 differential metabolites were identified, suggesting that disturbances in energy metabolism and lipid metabolism affected the normal life activities of osteoblasts and osteoclasts. This study provides new perspectives for future pathological studies of ONFH.

Impact of Freeze-dried Corticocancellous Bone Allograft Combined with Enamel Matrix Derivative in the Treatment of Critical-sized Calvarial Bone Defects: An Animal Study.

This study compared the quality and quantity of newly formed bone in rabbits' critical-sized calvarial defects filled with enamel matrix derivative (EMD) combined with freeze-dried bone allograft (FDBA) vs FDBA alone. A total of 24 adult male white New Zealand rabbits were included. In each rabbit, three bone defects with a diameter of 8 mm were created on the calvarium bone; the first defect was left untreated, while the second was filled with FDBA, and the third was filled with EMD + FDBA. Twelve rabbits were randomly euthanized after a month, and the remaining 2 month postsurgery. Bone sections were histologically evaluated by hematoxylin and eosin and vascular endothelial growth factor (VEGF), alkaline phosphatase (ALP), osteoprotegerin (OPG), and receptor activator of NF-kappaB (RANK) immune-histochemical staining. An improvement in the newly formed bone percentage was found in the defects filled with EMD + FDBA in comparison with FDBA and control defects at 1 month and 2 months postsurgery. Additionally, the expression of VEGF, ALP, OPG, and RANK showed highly significant differences in the defects filled with EMD + FDBA compared to the FDBA and control ones at 1 month postsurgery (p = 0.001). Meanwhile, VEGF and ALP expression showed a significant decrease in defects filled with EMD + FDBA compared to the FDBA and control ones (p = 0.001), while OPG and RANK expression showed non-significant differences between treated groups at 2 months postsurgery. Enamel matrix derivative combined with FDBA has a synergistic effect on bone formation and graft substitution. This combination accelerates the expression of VEGF, ALP, OPG, and RANK. The combination of EMD and FDBA accelerates and ameliorates the quality of newly formed bone, aiding in maxillofacial reconstruction. How to cite this article: Zakri RN, Grawish ME, Mowafey B, et al. Impact of Freeze-dried Corticocancellous Bone Allograft Combined with Enamel Matrix Derivative in the Treatment of Critical-sized Calvarial Bone Defects: An Animal Study. J Contemp Dent Pract 2024;25(5):424-431.

A 72-year-old Woman with Dyspnea and Thrombocytosis

&lt;p&gt;原發性血小板增多症的臨床表徵並不典型且早期診斷不易，往往多數病人於診斷前已發生動靜脈血栓形成及出血併發症。本個案一位72歲女性，有高血壓及胃食道逆流病史並按時門診追蹤服藥，五天前注射新冠疫苗後，呼吸喘、乾咳併胸悶至診所就醫未改善，於急診初步診斷急性支氣管炎。入院後感心悸且胸悶，藉由病史詢問、檢驗及理學檢查，顯示心肌酵素正常但心電圖呈現陣發性心室上心搏過速，安排冠狀動脈血管攝影攝影後排除急性心肌梗塞，但呼吸急促未見好轉呈現低血氧，經胸腔電腦斷層為肺栓塞。疑似新冠疫苗後引起的免疫併發症，直到右手食指及中指末梢腫、痛且發紺症狀出現，筆者再次重新檢視病史資料，發現血小板異常，透過骨髓穿刺切片是發現巨核細胞（megakaryocyte）增生，病理報告判斷為骨髓增生性腫瘤，基因檢測結果為JAK2V617F 突變，最後確診是原發性血小板增多症併發肺栓塞，接受Hydroxyurea合併口服抗凝血劑治療，症狀改善且血小板數值趨於穩定。藉此案例分享提醒當發現病人有不明血栓產生時須考慮將相關血液疾病列入鑑別診斷，期能及早發現疾病，掌握治療時機。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;The clinical symptoms of essential thrombocythemia are not typical and early diagnosis is difficult.Most patients have arteriovenous thrombosis and bleeding complications before diagnosis. In this case, a 72-year-old woman had a history of hypertension and gastroesophageal reflux and was taking medication regularly at the outpatient clinic. After being injected with the COVID-19 vaccine five days ago, her breathing, dry cough, and chest tightness did not improve when she went to the clinic. She was initially diagnosed with acute bronchitis in the emergency department. After being admitted to the hospital, she felt palpitations and chest tightness. The medical history, examination and physical examination showed that myocardial enzymes were normal, but the electrocardiogram showed Parox-ysmal supraventricular tachycardia. Coronary angiography was arranged to rule out acute myocardial infarction, but the shortness of breath persisted with hypoxemia, and the computed tomography of the chest showed pulmonary embolism. Immune complications caused by the COVID-19 vaccine were suspected, symptoms of swelling, pain and cyanosis appeared in the distal part of the right index fin-ger and middle finger appeared. The author re-examined the medical history data and found abnormal platelets. Through bone marrow aspiration and sectioning, megakaryocyte hyperplasia was found. Pa-thology report determined that the patient suffered from myeloproliferative neoplasm, and the genetic test result was the JAK2V617F mutation. The patient was finally diagnosed with essential thrombocythe-mia complicated by pulmonary embolism. She was treated with Hydroxyurea combined with oral an-ticoagulants. The symptoms improved and the platelet level stabilized. This case serves as a reminder that when a patient is found to have unknown thrombosis, related blood diseases must be considered in the differential diagnosis, so that the disease can be detected early and proper treatments can be pro-vided.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Retrospective isotope analysis of ancient remains to distinguish between tamed and wild animals

The origin and process of the domestication of wild animals have long fascinated scientists. However, there are no reliable methods to distinguish between tamed and wild animals. Here, we present a new method to identify tamed and wild juvenile brown bears (Ursus arctos) using retrospective isotope analysis of the femur. We used femurs from the nine bear cubs and the tibia from one domesticated dog excavated from the Nijibetsu Shuwan Kumaokuriba site, Hokkaido Islands, Japan (late 19th century–1939 AD). These bears were potentially tamed by indigenous Ainu people, and the domesticated dog was used as a reference of a tamed animal. We subdivided these bones into 10 sections along the growing axis, extracted collagen and measured the stable nitrogen isotope ratios (δ15N). The bone sections of the domesticated dog had constant δ15N values that were as high as that of salmon, suggesting that tamed animals exclusively consumed a marine diet fed to them by the Ainu. Notably, two of nine brown bear cubs showed a temporal elevation of δ15N to the similar isotope ratios of the dog tibia, which is unlikely to occur in the wild condition, strongly suggesting that they were tamed and fed by the Ainu people.

MANAGEMENT OF AVASCULAR NECROSIS THROUGH PANCHTIKTA KSHEER BASTI: PILOT STUDY

Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and cause the bone to collapse. The process usually takes months to years. A broken bone or dislocated joint can stop the blood flow to a section of bone.

EPSTI1 promotes osteoclast differentiation and bone resorption by PKR/NF-κB signaling

BackgroundEpithelial stromal interaction 1 (EPSTI1) plays an important role in M1 macrophages, which induce osteoclastogenesis. One recent genome-wide association study (GWAS) involving 426,824 individuals has shown that EPSTI1 is strongly associated with osteoporosis (P < 5E-8). Therefore, we speculate that EPSTI1 participates in the modulation of osteoporosis through osteoclastogenesis. The roles of EPSTI1 in osteoclastogenesis and bone resorption remain unclear. MethodsFemur specimens were collected from osteoporotic patients and control patients. Immunofluorescence staining was used to detect the expression of EPSTI1 and signaling pathways. The osteoclastic potential of RAW264.7 cells with Sh-EPSTI1 lentivirus infection was tested using tartrate-resistant acid phosphatase (TRAP) staining, western blotting, and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Western blotting was also used to examine signaling pathways. ResultsIn this study, EPSTI1 was found to be significantly increased in tartrate-resistant acid phosphatase positive (ACP5+) osteoclasts of bone sections from osteoporotic patients. Next, we identified EPSTI1 as a positive regulator of osteoclastogenesis and osteoclast differentiation capability. Diminished EPSTI1 expression resulted in reduced osteoclastic resorption. Mechanistically, EPSTI1-driven osteoclastogenesis was regulated by NF-κB pathway, which was mediated by the phosphorylation of protein kinase R (p-PKR). Furthermore, EPSTI1 participating in the modulation of osteoporosis via PKR/NF-κB pathway was also verified in the bone samples of osteoporotic patients. ConclusionsCollectively, our findings suggest that EPSTI1 may regulate osteoclast differentiation and bone resorption through PKR/NF-κB pathway and in vivo experiments are needed to further verify EPSTI1 as the therapy target for osteoporosis.

A Comparative Analysis on the Histomorphometric Pattern of Various Segments of Adult Male Long Bones: Forensic Implication

Abstract Background: Human bone analysis is a useful tool in assessing and identifying skeletal remains. To make this easier, newer and modified approaches have often being documented. Aims and Objectives: The aim of this study is to analyze the histomorphometric features of various bone segments and its relevance in forensic case diagnosis. Materials and Methods: The human bones used were that of cadaveric bone samples harvested from three adult male Nigerians. The proximal, midshaft and distal segments of the femur, tibia, and humerus were utilized for the study. The bone sections were subjected to processing using Frost’s rapid manual preparation of ground sections techniques. Histomorphometric evaluation studied the number of primary osteons, secondary osteons, and osteon fragments, as well as the Haversian canal diameter (HCD). Results: The primary osteons, secondary osteons, osteon fragments, and HCD in each of the segments of the long bones show that the F values are less than the F critical for an alpha level of 0.05. This shows that there is no statistically significant (P &gt; 0.05) variation in the histomorphometric pattern for the various segments of the bones studied. Again differences in the haversian canal diameter of the various segments of the long bones shows statistically significant variation (P&lt; 0.05) among the long bones investigated. Conclusion: These findings have laid to rest the challenges with using the only available bone fragment for forensic case investigation as no notable variations exist across various segments.