Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: A bone histomorphometric study

Parfitt, A. M.; Pødenphant, Jan; Villanueva, A. R.

doi:10.1016/8756-3282(85)90003-1

Cited by 130 publications

(71 citation statements)

References 43 publications

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“…Osteoblasts continue to synthesize and secrete the matrix, but it does not mineralize. Normally, the analysis of dynamic parameters may reveal a range of severity in mild disease characterized by reduced or undetectable distance between double labels to no tetracycline uptake whatsoever, reflecting absence of mineralization in the most severe cases (23). In the latter case, there is a decrease of MAR, mineralizing surface as well as bone formation rate along with a prolonged mineralization lag time greater than 100 day.…”

Section: Histomorphometric Findings In Clinical Disorders Osteomalaciamentioning

confidence: 99%

“…Most of the time, it is caused by a decrease in circulating calcium versus phosphate product, which in turn, can be due to several pathogenetic mechanisms. The characteristic histomorphometric findings of this disease are an accumulation of osteoid reflected by increased osteoid thickness, surface, and volume ( Figure 2) (22)(23). Cancellous bone volume is normal in osteomalacia.…”

Section: Histomorphometric Findings In Clinical Disorders Osteomalaciamentioning

confidence: 99%

See 1 more Smart Citation

Bone histomorphometry: a concise review for endocrinologists and clinicians

Kulak

Dempster

2010

Arq Bras Endocrinol Metab

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SummaryBone histomorphometry is a quantitative histological examination of an undecalcified bone biopsy performed to obtain quantitative information on bone remodeling and structure. Labeling agents taken before the procedure deposit at sites of bone formation allowing a dynamic analysis. Biopsy is indicated to make the diagnosis of subclinical osteomalacia, to characterize the different forms of renal osteodystrophy and to elucidate cases of unexplained skeletal fragility. Bone histomorphometric parameters are divided into structural and remodeling subgroups, with the latter being subdivided into static and dynamic categories. Metabolic bone disorders such as osteomalacia, hyperparathyroidism, hypothyroidism, osteoporosis and renal osteodystrophy display different histomorphometric profiles. Antiresorptive and anabolic drugs used for the treatment of osteoporosis also induce characteristic changes in the bone biopsy. Bone histomorphometry is an important research tool in the field of bone metabolism and provides information that is not available by any other investigative approach. Arq Bras Endocrinol Metab. 2010;54(2):87-98 Keywords Bone histomorphometry; metabolic bone diseases; bone biopsy; bone structure; osteoporosis drugs Sumário Histomorfometria óssea é uma avaliação histológica quantitativa de uma biópsia óssea calcificada realizada para obter informação sobre a remodelação e a estrutura óssea. Uma análise dinâmica é possível quando substâncias que fazem a marcação do osso são tomadas antes do procedimento e se depositam no local de formação óssea. A biópsia é indicada para diagnós-tico de osteomalácia, diferentes formas de osteodistrofia renal e nos casos não explicados de fragilidade esquelética. O preparo e a análise das amostras necessitam de um laboratório especializado. A histomorfometria avalia parâmetros estruturais e de remodelação óssea, sendo o último subdividido em estático e dinâmico. Doenças osteometabólicas como osteomalácia, hiperparatireoidismo, hipoparatireoidismo, osteoporose e osteodistrofia renal apresentam parâmetros histomorfométricos distintos. Medicações antirreabsortivas e anabólicas usadas no tratamento da osteoporose também induzem alterações características na biópsia óssea. A histomorfometria óssea é uma ferramenta importante no metabolismo ósseo e oferece informação que não é possível por nenhum outro método diagnóstico. Arq Bras Endocrinol Metab. 2010;54(2):87-98

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Section: Histomorphometric Findings In Clinical Disorders Osteomalaciamentioning

confidence: 99%

Section: Histomorphometric Findings In Clinical Disorders Osteomalaciamentioning

confidence: 99%

Bone histomorphometry: a concise review for endocrinologists and clinicians

Kulak

Dempster

2010

Arq Bras Endocrinol Metab

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“…Bone biopsy specimens were obtained, embedded, and stained as previously described (22,23). Using the Zeiss MOP-3 digitizing system, the areas of mineralized bone (MB), unmineralized bone or osteoid (OS), and soft tissue (ST) were measured separately in both cortices and in the entire medullary space; the transitional zone (24), if identifiable, was included with the latter.…”

Section: Methodsmentioning

confidence: 99%

Irreversible bone loss in osteomalacia. Comparison of radial photon absorptiometry with iliac bone histomorphometry during treatment.

Parfitt¹,

Rao²,

Stanciu³

et al. 1985

J. Clin. Invest.

124

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We examined the relationships between the changes in bone mineral deficit in the radius, determined by single-energy photon absorptiometry at standard proximal and distal sites, and in the ilium, determined by bone histomorphometry, during the treatment of osteomalacia of diverse etiology in 28 patients. In the ilium, relative osteoid volume decreased by 75-80% in both cortical bone (from 6.0% to 1.5%) and trabecular bone (from 30.1% to 6.6%) during a mean treatment duration of 2 yr. There was also a significant fall in iliac cortical porosity from 10.3% to 7.8%. As a result, mineralized bone volume increased by 7.5% in cortical and by 40.1% in trabecular bone; the cortical and trabecular increments were correlated (r = 0.69, P < 0.001). The properly weighted increase for the entire tissue sample was 18.6%. By contrast, there was no change in bone mineral at either radial site, although there was a 2% increase at both sites when allowance was made for age-related bone loss during treatment. The proximal and distal age-adjusted increments were correlated (r = 0.76, P < 0.001), but there was no correlation between the changes in any photon absorptiometric and any histomorphometric index. In that iliac cortical bone turnover in normal subjects was 7.2%/yr, we estimated the rate of bone turnover to be <2%/yr at both proximal and distal radial sites, including any trabecular bone present at the distal site. Compared to appropriate control subjects, the bone mineral deficits fell during treatment from 19.2% to 17.1% at the proximal radius (>95% cortical bone) and from 20.5% to 18.5% at the distal radius (>75% cortical bone). In the ilium the deficits, assuming attainment of normal values for osteoid volume and cortical porosity, fell from 41.7% to 36.1% in cortical and from 31.5% to 6.3% in trabecular bone, the properly weighted combined deficit falling from 38.6% to 27.7%. The irreversible iliac cortical deficit was entirely due to cortical thinning because of increased net endosteal resorption; the resultant expansion of the marrow cavity offset the modest loss of fractional trabecular mineralized bone. We conclude: (a) in osteomalacia there is a large irreversible and a small reversible bone mineral deficit at both proximal and distal radial sites, in similar proportion to the iliac cortex but of smaller This work was presented in part at the Third International Workshop

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“…Transiliac bone biopsies, which were collected from white females, were in the control group of a subset of biopsies from a previous sodium fluoride treatment study. The transiliac bone biopsies were obtained, processed, stained, sectioned, and examined as described in the previous studies [47][48][49]. Briefly, the cylindrical bone biopsies were fixed in 70% ethanol, prestained using the Villanueva method, and embedded in polymethyl methacrylate [50].…”

Section: Bone Specimens and Fe Modelsmentioning

confidence: 99%

Cancellous bone lamellae strongly affect microcrack propagation and apparent mechanical properties: Separation of patients with osteoporotic fracture from normal controls using a 2D nonlinear finite element method (biomechanical stereology)

Wang

Zauel

Rao

et al. 2008

Bone

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Biomechanical stereology is proposed as a two-dimensional (2D) finite element (FE) method to estimate the ability of bone tissue to sustain damage and to separate patients with osteoporotic fracture from normal controls. Briefly, 2D nonlinear compact tension FE models were created from quantitative back scattered electron images taken of iliac crest bone specimens collected from the individuals with or without osteoporotic fracture history. The effects of bone mineral microstructure on predicted bone fracture toughness and microcrack propagation were examined. The 2D FE models were used as surrogates for the real bone tissues. The calculated microcrack propagation results and bone mechanical properties were examined as surrogates for measurements from mechanical testing of actual specimens. The results for the 2D FE simulation separated patients with osteoporotic fracture from normal controls even though only the variability in tissue mineral microstructure was used to build the models. The models were deliberately created to ignore all differences in mean mineralization. Hence, the current results support the following hypotheses: (1) that material heterogeneity is important to the separation of patients with osteoporotic fracture from normal controls and; and (2) that 2D nonlinear finite element modeling can produce surrogate mechanical parameters that separate patients with fracture from normal controls.

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Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: A bone histomorphometric study

Cited by 130 publications

References 43 publications

Bone histomorphometry: a concise review for endocrinologists and clinicians

Bone histomorphometry: a concise review for endocrinologists and clinicians

Irreversible bone loss in osteomalacia. Comparison of radial photon absorptiometry with iliac bone histomorphometry during treatment.

Cancellous bone lamellae strongly affect microcrack propagation and apparent mechanical properties: Separation of patients with osteoporotic fracture from normal controls using a 2D nonlinear finite element method (biomechanical stereology)

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