Analysis of mandible trabecular structure using digital periapical radiographs to assess low bone quality in postmenopausal women

PurposeTo analyze the quality of mandibular trabecular structure in postmenopausal women using periapical radiographs. Postmenopausal women are subjected to low bone quality; hence, early detection methods are needed. In addition to bone mineral density (BMD), trabecular architecture must be assessed to determine bone quality. The mandible represents bone quality and allows the assessment of trabecular structure from periapical radiographs.Material and MethodsLumbar (BMDL) and femoral BMD (BMDF) examinations were performed using dual-energy X-ray absorptiometry (DXA) in 31 postmenopausal women and divided into normal, osteopenia, and osteoporotic groups. Periapical radiographs were taken at both posterior sites of the mandible. The region of interest was taken 2 mm from the apical root of the first molar. Trabecular parameters consisting of trabecular thickness (Tb.Th) and bone percentage (BA/TA) were measured using BoneJ.ResultsBoth trabecular parameters were significantly correlated with BMDF [BA/TA ​​(r = 0.3796; p < 0.05) and Tb.Th (r = 0.508; p < 0.05)]. BA/TA and Tb.Th were significantly different between the osteoporosis and normal groups (p < 0.05) contrast to osteopenia and normal groups (p > 0.05).ConclusionChanges in mandibular trabeculae structure in postmenopausal women can be assessed using periapical radiographs.     

Significance of ER–Src axis in hormonal therapy resistance

The estrogen receptor (ER) is implicated in the progression of breast cancer. Despite positive effects of hormonal therapy, initial or acquired resistance to endocrine therapies frequently occurs. Recent studies suggested ERα-coregulator PELP1 and growth factor receptor ErbB2/HER2 play an essential role in hormonal therapy responsiveness. Src axis couples ERα with HER2 and PELP1, thus representing a new pathway for targeted therapy resistance. To establish the significance of ER–Src axis in PELP1 and HER2 mediated therapy resistance, we have generated model cells that stably express Src-shRNA under conditions of PELP1, HER2 deregulation. Depletion of Src using shRNA substantially reduced E2 mediated activation of Src and MAPK activation in resistant model cells. Pharmacological inhibition of Src using dasatinib, an orally available inhibitor substantially inhibited the growth of therapy resistant MCF7–PELP1, MCF7–HER2, and MCF7–Tam model cells in proliferation assays. In post-menopausal xenograft based studies, treatment with dasatinib significantly inhibited the growth of therapy resistant cells. IHC analysis revealed that the tumors were ERα positive, and dasatinib treated tumors exhibited alterations in Src and MAPK signaling pathways. Combinatorial therapy of tamoxifen with dasatinib showed better therapeutic effect compared to single agent therapy on the growth of therapy resistant PELP1 driven tumors. The results from our study showed that ER–Src axis play an important role in promoting hormonal resistance by proto-oncogenes such as HER2, PELP1, and blocking this axis prevents the development of hormonal independence in vivo. Since PELP1, HER2, and Src kinase are commonly deregulated in breast cancers, combination therapies using both endocrine agents and dasatinib may have better therapeutic effect by delaying the development of hormonal resistance.     

Relationship between age and metabolic disorders in the population of Bali

Background/Purpose

The purpose of this study is to examine the association between age and metabolic disorders in the population of Bali.

Method

A cross-sectional study was conducted on metabolic syndrome (MS) as defined on the basis of recommended parameters for diagnosis of the syndrome in the population of seven villages of Bali comprising six villages and one suburban area. At least three of the five parameters must be present for the diagnosis. Three hundred ten elderly people aged 60 years or more, with a male:female ratio of 168:142, of 1840 subjects were recruited in the study. The criteria for obesity were based on the 2000 World Health Organization recommendations for Asia Pacific population, for prediabetes [impaired fasting glycemia (IFG) and impaired glucose tolerance] and diabetes mellitus (DM) by American Diabetes Association (2009), and for MS by a joint statement of International Diabetes Federation, National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity (2009).

Results

The prevalence of IFG and DM were twofold in the elderly as compared with those in the younger-aged groups (21.4 vs. 11.7; 11.7 vs. 4.8, respectively). Blood pressure and fasting blood sugar levels were higher in the elderly than in the younger-aged group (133/81 mmHg vs. 117/76 mmHg; 102.7 mg/dL vs. 93.0 mg/dL, respectively; p < 0.001). There was no statistically significant difference in triglyceride and high-density lipoprotein cholesterol levels between both groups. Waist circumferences were lower among the elderly than among younger-aged groups (75.8 cm vs. 80.9 cm; p < 0.001). The elderly, with lower waist circumference, revealed significantly higher prevalence of MS as compared with the younger-aged group {22.9% vs. 17.3%; p = 0.026; prevalence risk 1.423 [confidence interval (CI) = 1.043G–1.944]}. The subjects who had 1, 2, 3, 4, and 5 components of MS were 34.6%, 23.8%, 13.0%, 4.3%, and 0.9%, respectively. The prevalence risk of each component of MS for the occurrence of MS were: elevated triglyceride [30.2 (CI = 14.5G–63.1)], elevated fasting blood sugar [8.5 (CI = 4.5G–15.8)], increased waist circumference [8.1 (CI = 4.3G–15.0)], reduced high-density lipoprotein cholesterol [4.4 (CI = 2.4G–7.9)], and elevated blood pressure [3.7 (CI = 1.9G–7.2)].

Conclusions

It could be inferred that in comparison with the younger-age group, the elderly had higher (twice) prevalence of IFG and DM, lower prevalence of central obesity, but higher prevalence of MS. Old age (60 years and more) had 1.4-fold risk for MS as compared with that in the younger-aged group, and elevated triglyceride levels appeared to be the most important risk factor for MS.     

Anti-urolithiatic effects of Punica granatum in male rats

Ethnopharmacological relevance

The traditional use of Punica granatum has been reported to regulate urine discharge and controls the burning sensation of urine.

Materials and methods

Animals model of calcium oxalate urolithiasis was developed in male rats by adding ethylene glycol 0.75% in drinking water. The Punica granatum chloroform extract (PGCE) and Punica grantum methanol extract (PGME) orally at 100, 200 and 400 mg/kg, respectively, were administered along with ethylene glycol for 28 days. On 28 day, 24 h urine was collected from individual rats and used for estimation of urine calcium, phosphate and oxalate. The serum creatinine, urea and uric acid levels were estimated in each animal. The kidney homogenate was used for the estimation of renal oxalate contents. The paraffin kidney sections were prepared to observe the CaOx deposits.

Results

The ethylene glycol control (Gr.-II) had significant (P < 0.001 vs. normal) increase in levels of urine oxalate, calcium and phosphate, serum creatinine, urea and uric acid and renal tissues oxalates, as compared to normal (Gr.-I). The paraffin kidney sections show significant histopathological changes. The treatment of PGCE and PGME at 100, 200 and 400 mg/kg doses, significantly (P < 0.001 vs. control) decreased the urine oxalate, calcium and phosphate, renal tissue oxalates and serum creatinine, urea and uric acid, in EG induced urolithiasis after 28 days.

Conclusions

The PGCE and PGME at the doses of 400 mg/kg, found to be more effective in decreasing the urolithiasis and regeneration of renal tissues in male rats.     

Primary cutaneous mucormycosis (zygomycosis) caused by Apophysomyces elegans

A 53 year-old male diabetic presented with a month-old, painful ulcer with necrotic margins over the right thigh. Wound debridement was done twice and the ulcer showed recurrent growth of a white, cottony filamentous structure. Cutaneous mucormycosis was suspected and confirmed by histopathology and a culture isolate of Apophysomyces elegans . The patient was treated with liposomal amphotericin-B and itraconazole followed by partial thickness skin grafting, and then discharged after being prescribed posaconazole syrup for three weeks. Regular follow-up was done and during the last visit after six months following discharge, the ulcer was found to have healed well with no recurrence of the fungus.