Bone microarchitecture in human foetuses

articleBone microarchitecture is receiving increasing attention in theassessment of the biomechanical properties of bone. While it iswell characterized in normal and pathologic human subjects,few quantitative data are available in human fetal development.In this paper, quantitative parameters of bone microarchitecturein developing human bone are reviewed from the literature andsupplemented by new data from the femoral metaphysis of hu-man fetuses. The samples were imaged using synchrotron radi-ation 3D micro-CT and processed using customized analysismethods. This technique provides 3D model independent mor-phometric parameters, anisotropy, connectivity and geometrycharacteristics, as well as information on mineralization.The morphometric parameters obtained on fetal vertebrae andfemurs evidenced a dense trabecular structure as comparedto that of young adults. The histomorphometric and the 3D mi-cro-CT analysis were consistent to show a significant in-crease of trabecular bone volume with gestational age. Tra-becular bone was found isotropic in vertebral bodies andanisotropic in femoral metaphysis, demonstrating a radialgrowth in vertebrae, and a longitudinal spreading out in longbones such as the femurs. Trabecular thickness in the maturebone of vertebral body and femoral metaphysis was around100 μm, which was in agreement with histomorphometric eval-uation. In the femoral metaphysis, three-dimensional analysisconfirmed the thickening of trabeculae with the distance tothe growth plate, and an estimated rate of thickening around 3μm/day previously obtained in histomorphometry. The 3D net-work was highly connected, and our new geometrical analysistechnique showed a strong prevalence of rod structure ascompared to the plate structure in cancellous bone

Quantitative modeling of the physiology of ascites in portal hypertension

Although the factors involved in cirrhotic ascites have been studied for a century, a number of observations are not understood, including the action of diuretics in the treatment of ascites and the ability of the plasma-ascitic albumin gradient to diagnose portal hypertension. This communication presents an explanation of ascites based solely on pathophysiological alterations within the peritoneal cavity. A quantitative model is described based on experimental vascular and intraperitoneal pressures, lymph flow, and peritoneal space compliance. The model's predictions accurately mimic clinical observations in ascites, including the magnitude and time course of changes observed following paracentesis or diuretic therapy

被服に対する意識及び行動とそれに影響する要因

博士（学術）神戸大

[Apropos of 35 total colectomies].

International audienc

Bone mineral density in subjects with mild asthma randomised to treatment with inhaled corticosteroids or non-corticosteroid treatment for two years

BACKGROUND—Inhaled corticosteroids are clearly beneficial for patients with asthma of moderate severity, but the risks and benefits of using them in patients with milder asthma are less clear. We have compared the change in bone mineral density over 2 years in adults with mild asthma randomised to receive an inhaled corticosteroid or non-corticosteroid treatment.
METHODS—Subjects with mild asthma (mean forced expiratory volume in one second (FEV(1)) 86% predicted, mean age 35 years, taking β agonists only) were randomised to receive inhaled budesonide, inhaled beclomethasone dipropionate, or non-corticosteroid treatment for 2 years in a prospective randomised open study in 19 centres in France, New Zealand, Spain, and the UK. The corticosteroid dose was adjusted according to a written self-management plan. The main outcome measure—change in bone mineral density after 6, 12, and 24 months—was measured "blind". Secondary outcomes included lung function, the relation between change in bone density and inhaled steroid dose and change in biochemical markers of bone metabolism.
RESULTS—Of 374 subjects randomised, 239 (64%) completed the study and were included in the analysis. The median daily doses of inhaled budesonide (n=87) and beclomethasone (n=74) were 389 µg and 499 µg, respectively. Subjects treated with an inhaled corticosteroid had better asthma control than those in the reference group (n=78). Change in bone mineral density did not differ between the three groups over the 2 years, nor did it correlate with changes in markers of bone metabolism. The mean change in bone mineral density over 2 years in the budesonide, beclomethasone dipropionate, and reference groups was 0.1%, -0.4%, and 0.4% for the lumbar spine and -0.9%, -0.9%, and -0.4% for neck of the femur. Mean daily dose of inhaled steroid was related to reduction in bone mineral density at the lumbar spine but not at the femoral neck.
CONCLUSION—In subjects with mild asthma an inhaled corticosteroid provided better asthma control than alternative non-corticosteroid treatment with no difference in change in bone mineral density over 2 years. The relation between dose of inhaled corticosteroid and change in bone density at the lumbar spine may be due to a direct effect of inhaled corticosteroids on bone. Since inhaled steroid dose is also related inversely to lung function, an effect of asthma severity on bone density was also possible.