Utjecaj koštanih morfogenetskih proteina 2 i 7 na volumen kosti u štakora s uklonjenom štitnom i doštitnim žlijezdama [Effects of bone morphogenetic protein 2 and 7 on bone volume in rats with removed thyroid and parathyroid glands]

BMP2 and 7 are used locally in FDA approved indications including complicated long bone fractures, non-unions, and spinal fusions. It is unknown whether their systemic release following a local implantation might impact systemically the bone metabolism. Furthermore, it is unknown whether systemic BMP effects on bone are direct or mediated by calciotropic hormones. Removal of thyroid and parathyroid glands (TPTx) in rats resulted in the decreased level of calciotropic hormones and afterwards we initiated the treatment with BMP2 or 7. The administered doses have been calculated according to published bioavailability data from preclinical BMP2 and 7 studies. Additionally, BMP2 and 7 were tested in vitro to estimate their influence on osteoblast and osteoclast activity. TPTx resulted in bone loss which was restored by systemic administration of 10-70 μg/kg of BMP2 and all doses of BMP7. BMP2 showed a higher capacity for increasing trabecular number, while BMP7 augmented trabecular thickness. In vitro experiments revealed that BMP2 and 7, when uncoupled, increased the number and activity of both osteoblasts and osteoclasts. Collectively, locally administered BMP2 and 7 from bone devices might become partially available in circulation but will not mediate a systemic bone loss

OSTEOGROW – nova terapija za koštanu regeneraciju

Cilj ovog istraživanja je procijeniti djelotvornost rhBMP6 (Genera istraživanja) u cijeljenju kritičnog defekta lakatne kosti kod kunića u usporedbi s komercijalno dostupnim nosačem. Model je prethodno opisan u nekoliko objavljenih studija i odobren od strane etičkog povjerenstva Medicinskog fakulteta Sveučilišta u Zagrebu u cilju testiranja sigurnosti i učinkovitosti nove naprave. U navedenom pokusu korišteni su odrasli mužjaci novozelandskih bijelih kunića. Koštani defekti ispunjeni su autolognim krvnim ugruškom sa ili bez dodatka rhBMP6 te rhBMP7 na kolagenoj spužvici kao nosaču. Životinje su praćene u periodu od 8 tjedana. Stvaranje novog koštanog tkiva praćeno je radiografski svaka dva tjedna nakon implantacije. Rezultati pokazuju da su implantati koji su se sastojali od autolognog ugruška i rhBMP6 rezultirali potpunim premoštenjem koštanog defekta ulne. Niti jedna od kontrolnih životinja koje su tretirane samo autolognim ugruškom kao nosačem (bez BMP6) nije postigla premoštenje koštanog defekta. Cijeljenje koštanog defekta korištenjem autolognog ugruška s rhBMP6 u usporedbi s kolagenom spužvicom natopljenom rhBMP7 bilo je puno brže i učinkovitije, bez znakova lokalne upale i edema. Novi autologni nosač s rhBMP6 na novi i učinkovit način rješava problem poticanja i stvaranja novog koštanog tkiva te premoštenje koštanog defekta i tako predstavlja novo moguće rješenje za sve nedostatke koji su proizašli korištenjem postojećih komercijalno dostupnih nosača

Nedostatak dugog dlanskog mišića kod jedne od jednojajčanih blizankinja: prikaz slučaja

Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins.Dugi dlanski mišić je jedan od najvarijabilnijih mišića u tijelu, a često se koristi kao tetivni graft. Opisali smo razlike između jednog para jednojajčanih blizankinja u postojanju dugog dlanskog mišića, koje su slučajno identificirane tijekom ispitivanja prisustva/odsustva ovoga mišića u općoj populaciji. Kod jedne blizankinje dugi dlanski mišić je bio prisutan na obje podlaktice, dok je druga blizankinja bila bez ovoga mišića na objema podlakticama. Pretraživanjem dostupne literature nismo pronašli nijedan objavljen rad o razlikama u prisustvu ili odsustvu dugog dlanskog mišića kod blizanaca

Sezamoiditis - radiološka dijagnostika i konzervativno liječenje

Sesamoid bones play an essential role in first metatarsophalangeal (MTP) joint biomechanics, together with other articular surfaces, joint capsule, plantar fascia, ligaments and tendons. They are prone to different acute and chronic injuries, such as acute fracture, stress fractures, chondromalacia, avascular necrosis, bursitis degenerative changes, inflammation etc., all of which clinically manifest as a painful condition and are often diagnosed under a broad term called sesamoiditis. The mechanism of injury is most commonly associated with overuse of the anterior part of the sole of the foot accompanied by excessive dorsiflexion of the great toe. Sesamoiditis presents with pain and localized swelling in the projection of the tibial sesamoid bone, which is affected more frequently than the fibular one. Diagnostic radiology plays a key role in determination of etiology of the disease, as well as in planning of it’s treatment. Typical radiological examination includes weight-bearing dorsoplantar, lateral, oblique medial and oblique lateral radiographs of the foot, together with a direct axial radiograph of sesamoid bones. Computerized tomography is used for distinction of acute fractures and early stage of stress fractures from other pathological conditions. Magnetic resonance imaging allows differentiation between bony pathology and soft tissue conditions. Sesamoiditis management is primarily conservative and it depends on duration and severity of the condition. Orthotic insoles customized according to pedobarographic findings may be useful for solving biomechanical deformities that could have led to development of sesamoiditis. Specific pads placed under the first MTP joint in order to prevent the great toe from dorsiflexion proved to be a very effective conservative treatment option. Surgical treatment is considered if conservative methods fail to provide sufficient management of the condition.Sezamske kosti u području metatarzofalangealnog zgloba nožnog palca (hallux) dio su anatomsko-biomehaničkog kompleksa kojeg čine zglobna tijela, čahura, plantarna fascija, sveze i tetive mišića. U sklopu navedenog komplek- sa sezamske kosti podložne su raznim akutnim i kroničnim oštećenjima u smislu prijeloma, stres prijeloma, hon- dromalacije, avaskularne nekroze, burzitisa, degenerativnih promjena, upala itd., a što se sve klinički očituje kao bolno stanje i sve se podvodi pod široki pojam sesamoiditisa. Mehanizam koji dovodi do sesamoiditisa najčešće je vezan uz prenaprezanje prednjeg dijela stopala praćenog ekscesivnom dorzifleksijom nožnog palca. U kliničkoj sli- ci sesamoiditisa najčešći simptom je bol i lokalizirana oteklina i to u području tibijalne sezamske kosti koja je dale- ko češće zahvaćena u odnosu na fibularnu sezamsku kost. Radiološka dijagnostika je značajna kako u otkrivanju etiologije tako i u planiranju liječenja sesamoiditisa. Standardna radiološka pretraga obuhvaća antero-posteriornu snimku pod opterećenjem stopala, lateralnu snimku, kose snimke te aksijalnu snimku sezamskih kostiju. Komp- juterizirana tomografija pokazala se korisnom za razlikovanje akutnog prijeloma i ranog stadija stres prijeloma sezamske kosti od drugih patologija koje mogu zahvatiti sezamske kosti. MRI omogućuje diferencijaciju između koštanih promjena i promjena na mekom tkivu. Liječenje sezamoiditisa je prvenstveno konzervativno i uvelike ovisno o uznapredovalosti promjena u području cijelog metatarzofalangealnog kompleksa. Ortopedski ulošci nakon pedobarografske analize opterećenja stopala mogu otkloniti biomehaničke deformacije koje su potencijalno pridonijele razvoju sesamoiditisa. Posebni podlošci ispod metatarzofalangealnog zgloba palca u smislu sprečavanja dorzifleksije palca su vrlo korisni i efikasni u konzervativnom liječenju sesamoiditisa. Kirurško liječenje može biti preporučeno nakon neuspjelog konzervativnog liječenja

Current therapeutic approach to hypertrophic scars

Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scars (HSs), which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients' expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome

Association of generalized psoriasis and mixed glomerulonephritis in a 10-year-old girl

Generalized psoriasis and renal function disorder were previously described in sporadic adult cases, revealing a new entity – psoriatic nephropathy. So far there have been only two cases describing this association in children. We present and discuss a case of 10-year-old girl with the unique biopsy findings of double glomerulonephritis associated with the simultaneous onset of generalized psoriasis. </p

Association of generalized psoriasis and mixed glomerulonephritis in a 10-year-old girl

Generalized psoriasis and renal function disorder were previously described in sporadic adult cases, revealing a new entity – psoriatic nephropathy. So far there have been only two cases describing this association in children. We present and discuss a case of 10-year-old girl with the unique biopsy findings of double glomerulonephritis associated with the simultaneous onset of generalized psoriasis. </p

Imaging Features of Triple N Negative Breast Cancers – Mammography, Ultrasound and Magnetic Resonance Imaging

Breast cancer (BC) is a highly heterogeneous disease. Aim was to evaluate imaging features of triple negative breast cancers (TNBC) in comparison to non-TNBC. We reviewed data of 30 patients who had been diagnosed as having TNBC and 37 patients with non-TNBC (control group) using criteria described for mammography (MMG), ultrasound (US) and magnetic resonance imaging (MRI) in Breast Imaging-Reporting and Data System (BI-RADS) lexicon for image interpretation. Age of patients, size of tumor, multifocality, histological type, tumor grade and status of lymph nodes were reviewed. TNBC were more often histological grade 3 and had significantly more positive lymph nodes at the time of diagnosis on pathology reports. On MMG, US and MRI TNBC mostly appeared as regularly shaped masses. On US as hypoechogenic masses with no posterior acoustic features and on MRI as masses with rim type of enhancement, fast wash-in and plateau type of curves. Most frequent category reported after MMG and US was BI RADS 4, and after MRI BI RADS 5. In conclusion, our study confirmed higher histological grade of TNBC, as well as more frequent lymph node involvement in comparation to the non-TNBC. TNBC showed tendency to affect younger women and to be larger than non-TNBC. Although, they most often presented as a mass on mammography and sonography, in a significant number of cases they remained miscategorized, due to the benign imaging features. All cases are recognized on MRI where they appear as rim enhancing masses

Iron overload in aging Bmp6−/− mice induces exocrine pancreatic injury and fibrosis due to acinar cell loss

The relationship between hemochromatosis and diabetes has been well established, as excessive iron deposition has been reported to result in impaired function of the endocrine and exocrine pancreas. Therefore, the objective of the present study was to analyze the effects of iron accumulation on the pancreata and glucose homeostasis in a bone morphogenetic protein 6‑knockout (Bmp6‑/‑) mouse model of hemochromatosis. The sera and pancreatic tissues of wild‑type (WT) and Bmp6‑/‑ mice (age, 3 and 10 months) were subjected to biochemical and histological analyses. In addition, 18F‑fluorodeoxyglucose biodistribution was evaluated in the liver, muscle, heart, kidney and adipose tissue of both animal groups. The results demonstrated that 3‑month‑old Bmp6‑/‑ mice exhibited iron accumulation preferentially in the exocrine pancreas, with no signs of pancreatic injury or fibrosis. No changes were observed in the glucose metabolism, as pancreatic islet diameter, insulin and glucagon secretion, blood glucose levels and glucose uptake in the liver, muscle and adipose tissue remained comparable with those in the WT mice. Aging Bmp6‑/‑ mice presented with progressive iron deposits in the exocrine pancreas, leading to pancreatic degeneration and injury that was characterized by acinar atrophy, fibrosis and the infiltration of inflammatory cells. However, the aging mice exhibited unaltered blood glucose levels and islet structure, normal insulin secretion and moderately increased α‑cell mass compared with those in the age‑matched WT mice. Additionally, iron overload and pancreatic damage were not observed in the aging WT mice. These results supported a pathogenic role of iron overload in aging Bmp6‑/‑ mice leading to iron‑induced exocrine pancreatic deficiency, whereas the endocrine pancreas retained normal function