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Biomedical subjects

R Rizzoli

Publications and source records attributed to R Rizzoli.

At least 109 records · Page 6Linked to original sources

Cytochemistry of the functional domains of the nucleus in normal and in pathologic conditions.

By means of ultrastructural cytochemistry significant advances have been made in understanding the functional roles of many nuclear domains. This review gives schematic information about the main nuclear domains involved in replication, transcription, processing and transport of the transcripts in normal and in pathologic conditions. Particular attention is paid to a functional domain that appears to be involved in signal transduction. Data are reported on the intranuclear specific localization of key elements of the polyphosphoinositide signal transduction system in different cell types including human osteosarcoma cell lines. Compared with the compartmentalization of the cytoplasm, the nucleus has long been considered as relatively unstructured. On the other hand, fundamental nuclear functions, such as DNA replication and RNA transcription, can be molecularly characterized also in cell-free systems, suggesting that supramolecular organization is not so strictly required as for other cell functions occurring within intact cytoplasmic organelles. Nevertheless, a stringent organization is required for packing about 200 cm of DNA in the about 30 micron 3 of the nucleus. In the absence of membrane-delimited organelles, the nuclear organization is based on functional compartments, or domains, whose spatial localization involves the nuclear matrix, which shares many properties with the cytoskeleton. The nuclear domains are defined as structural compartments, not necessarily stable but dynamically variable, which perform specific metabolic functions through the partitioning of molecular complexes. Their identification has been made possible in the last few years by the development of specific nuclear probes for confocal and electron microscope immunocytochemistry. Therefore, the complex network of structures and enzymatic functions that make up the nucleus is in several cases yielding to molecular analysis, but a large part remains unknown (Strouboulis and Wolffe, 1996; Laemmli and Tjian, 1996). Rapid advances in understanding the functional role of the nuclear domains have been made recently: in particular, of the nuclear envelope, of the nucleolus, and of RNA splicing. In other cases, e.g. the precise localization of the nuclear domains involved in signal transduction, much remains to be clarified (Forbes and Johnson, 1997). It is conceivable that in the near future unexpected new nuclear domains will come to light and new nuclear functions may emerge, especially in field of post-transcriptional processing and transport of RNAs, and in the relationships between the nucleo-skeleton and enzymic fixed sites involved in replication, transcription and signal transduction. The aim of this review is to provide information about the morphological characteristics, the associated functions and the molecular composition of the main nuclear domains found to date. To simplify the exposition, the main data on each nuclear domain are reported in Tables, together with the principal references on the subject. Figures refer to original findings on some aspects of nuclear domain organization.

Cell Nucleus↗

Transgenic mice expressing soluble tumor necrosis factor-receptor are protected against bone loss caused by estrogen deficiency.

To evaluate the role of tumor necrosis factor (TNF alpha) in bone loss resulting from estrogen deficiency, the effects of ovariectomy were explored in six-month-old transgenic mice expressing high blood levels of a soluble TNF receptor type I (sTNFR1)-FcIgG3 fusion protein, which neutralizes TNF alpha, and in their nontransgenic littermates used as controls. These transgenic mice were identical to control mice in bone mass (evaluated by bone mineral density and content) and strength. 12 weeks after ovariectomy, the decrease in bone mass and increase in osteocalcin (marker of bone turnover) found in control mice were not observed in transgenic mice, which were not different from sham-operated mice, transgenic or not. This observation suggests a critical role for TNF alpha in the pathogenesis of bone loss induced by estrogen deficiency, a common cause of morbidity in postmenopausal women.

Animals↗

Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.

High calcium intake during childhood has been suggested to increase bone mass accrual, potentially resulting in a greater peak bone mass. Whether the effects of calcium supplementation on bone mass accrual vary from one skeletal region to another, and to what extent the level of spontaneous calcium intake may affect the magnitude of the response has, however, not yet been clearly established. In a double-blind, placebo-controlled study, 149 healthy prepubertal girls aged 7.9+/-0.1 yr (mean+/-SEM) were either allocated two food products containing 850 mg of calcium (Ca-suppl.) or not (placebo) on a daily basis for 1 yr. Areal bone mineral density (BMD), bone mineral content (BMC), and bone size were determined at six sites by dual-energy x-ray absorptiometry. The difference in BMD gain between calcium-supplemented (Ca-suppl.) and placebo was greater at radial (metaphysis and diaphysis) and femoral (neck, trochanter, and diaphyses) sites (7-12 mg/cm2 per yr) than in the lumbar spine (2 mg/cm2 per yr). The difference in BMD gains between Ca-suppl. and placebo was greatest in girls with a spontaneous calcium intake below the median of 880 mg/d. The increase in mean BMD of the 6 sites in the low-calcium consumers was accompanied by increased gains in mean BMC, bone size, and statural height. These results suggest a possible positive effect of calcium supplementation on skeletal growth at that age. In conclusion, calcium-enriched foods significantly increased bone mass accrual in prepubertal girls, with a preferential effect in the appendicular skeleton, and greater benefit at lower spontaneous calcium intake.

Absorptiometry, Photon↗

Asynchrony between the rates of standing height gain and bone mass accumulation during puberty.

During puberty, the marked increased in both standing height and bone mass appear to be dissociated in time, the former occurring earlier than the latter. However, the age or pubertal stage at which this dissociation is maximal in girls as opposed to boys, and whether this dissociation is similar at all parts of the skeleton, are not clearly established. Standing height and bone mineral mass, as assessed by measuring areal bone mineral density (BMD), at the levels of the lumbar spine, femoral neck and midfemoral shaft, were measured in 98 females and 100 males between the ages of 9 and 19 years twice at a 1-year interval. In males, the greatest difference between height and BMD gains occurred in the 13-14 year age group and was more pronounced for the lumbar spine and femoral neck than for the midfemoral shaft. In females, the greatest difference was detectable at a younger age (11-12 year age group) and appeared to be of a lower magnitude than in males. In both genders, the maximal difference occurred during the period of peak height velocity, which corresponded to the pubertal stages P2-P3. Such a dissociation between the rates of statural growth and mineral mass accrual could define a state of relatively low bone mass and contribute to the higher incidence of fracture known to occur at the age and/or pubertal stage when this dissociation is maximal.

Adolescent↗

Effect of estrogen deficiency on cancellous and cortical bone structure and strength of the femoral neck in rats.

Eighty mature Sprague-Dawley rats were weight matched before ovariectomy (Ovx) or Sham surgery (Sham). Sham rats had free access to food and water throughout the experiment, whereas Ovx rats were kept on the pair-fed diet. Rats were euthanized at 4, 8, and 12 weeks after surgery, and had received fluorochrome bone markers at 9 and 2 days prior to euthanasia. In addition 10 rats were euthanized at the time of surgery serving as baseline controls. All rats were also scanned for body composition and bone mineral parameters by DEXA before surgery and euthanasia. Left proximal femurs (femoral necks) were used for bone histomorphometry, whereas right femurs were used for in vitro DEXA measurements and mechanical testing. Despite pair-feeding, ovariectomized rats had increased body weights and fat body mass, whereas the percent lean body mass steadily declined throughout the experiment. Mineral density of the whole femur and femoral neck was significantly higher in the Sham rats relative to Ovx animals. Ovariectomy reduced trabecular number and thickness, and increased trabecular separation and bone marrow space at the femoral midneck location. The structure of the remaining trabeculae was dramatically changed toward simpler struts as revealed by nodal analyses. Cortical thickness in Ovx rats was reduced because of the high endocortical resorption, which, in addition to cancellous bone resorption, resulted in fewer endocortico-trabecular connections. Femoral necks obtained from ovariectomized rats had reduced strength and were less stiff relative to controls. Because of the enormous clinical significance of the proximal femur for osteoporosis in humans, and the opportunity for studying bone BMD, mass, structure, and strength at the same skeletal location, the femoral neck appears superior to other skeletal sites routinely used for bone histomorphometry or mechanical testing in the Ovx rat model.

Absorptiometry, Photon↗

Proteins and bone health.

Hip fracture consecutive to osteoporosis represents a major health problem in terms of both morbidity and financial burden for the community. Deficiency in nutritional elements appear to play a major role in the pathogenesis of osteoporosis and of fractures in elderly. Correction of an inadequate supply in both calcium and vitamin D can reduce bone loss and fracture incidence in elderly subjects. In addition, low protein intake could be particularly detrimental for the conservation of bone integrity with aging. Thus, in hospitalized elderly patients reduced protein intake is associated with lower femoral neck bone mineral density (BMD) and poor physical performance. Furthermore, state of malnutrition or undernutrition is often observed in elderly patients with hip fracture. In these patients, in who we detected very low femoral neck (BMD) at the level of the proximal femur, the self-selected intake of protein and energy was insufficient during their hospitalization. Interestingly, the clinical outcome after hip fracture was significantly improved by daily oral nutritional supplement normalizing the protein intake, documented as a reduction in both complication rate and median duration of hospital stay. Further studies showed that normalization of the protein intake, independently of that of energy, calcium and vitamin D, was responsible for this more favorable outcome, and could prevent further bone loss, at least at the level of weight-bearing cortical bone. In undernourished elderly subjects an increase in the protein intake, from low to normal, could be beneficial for bone integrity. This could act through an increase in the growth factor IGF-1 which has been found to decrease with aging.

Aged↗

Histo-anatomy of the proximal femur in rats: impact of ovariectomy on bone mass, structure, and stiffness.

BACKGROUND: Hip fractures are the most devastating consequence of osteoporosis in humans. Since the ovariectomized (ovx) rat is a useful model of estrogen-deficient osteoporosis, the purposes of this study were to describe the histo-anatomical features of the rat hip and to determine changes in the proximal femur induced by ovariectomy to evaluate the use of this skeletal site for future bone studies. METHODS: Changes in body mass and composition and in bone mineral content and density were determined by DEXA at 12 weeks after ovariectomy. Gross and histo-anatomy of the rat hip was studied by light microscopy and histomorphometry. Cancellous and cortical bone changes induced by ovx at the femoral midneck were determine using dynamic, static, and structural histomorphometric techniques. The stiffness of the femoral neck was determined by biomechanical testing, and the results were correlated with histological observations and the histomorphometric data. RESULTS: The bony structures of the rat hip, articular cartilage, and muscular and capsular attachments are very similar to the human. Rats, however, have an active growth plate and a well-vascularized periosteum covering the intracapsular portion of the femoral neck, which is different from the adult humans. Rats in the sham and ovx groups exhibited similar biological variations in the thickness of the femoral neck and epiphyseal bone and cartilaginous composition. Ovariectomy promoted periosteal modeling and induced endocortical and cancellous bone remodeling, with a net loss of bone mass due to excess bone resorption. The ovx-induced increase in resorption resulted in reduced trabecular number, thickness, and endocortico-trabecular connectivity, which likely contributed to less bone stiffness in ovx rats relative to the sham controls. CONCLUSIONS: There are numerous similarities in the structure and histology of the rodent and human hip. Skeletal changes induced by ovariectomy in rats, particularly those at the endocortical surface and in the cancellous bone, are very similar to changes observed in the proximal femur in osteoporotic women. In addition, ovx in the rat had compromised the biomechanical properties at the femoral neck, similar to what occurs in the postmenopausal women. Data presented here confirmed responsiveness of the proximal femur in rat to ovarian hormone deficiency, which appears to be a useful and relevant site to investigate mechanisms and interventions relative to human disease.

Absorptiometry, Photon↗

A prospective study on socioeconomic aspects of fracture of the proximal femur.

A prospective survey of hip fracture incidence and outcome was conducted to evaluate their socioeconomic impact. Over the course of 1 year, 404 hip fractures were recorded in 339 women and 65 men following minor or moderate trauma. The subjects' ages were 82.8 +/- 10.0 years (mean +/- SD): 84.1 +/- 9.2 in female and 76.4 +/- 13.7 in male subjects. The overall annual incidence was 104.4/100,000; the incidence in women was 167.1 versus 35.3 in men, with a crude female-to-male ratio of 4.7. However, when adjusted for age, this ratio was 2.7. When adjusted to the 1985 U.S.A. population, the incidence rates were 68.6 overall, 108.8 female, and 26.3 male, and were, respectively, 119.1, 188.8, and 46.1 when adjusted to the 1992 Swiss population. As compared with 105 age-matched non-hip-fracture fallers studied in the same emergency ward, fracture subjects lived more often in nursing homes and took cardiovascular drugs (p < 0.001). The mean length of stay in the orthopedic ward was 16.3 +/- 12.0 days (median 14; range 2-193 days), for a total of 6566 bed-days representing 19.8% of available bed-days. The mean length of stay in rehabilitation hospitals was 63.6 +/- 52.6 days (median 50; range 2-349 days), for a total of 17,099 bed-days, representing 5.2% of available bed-days. For patients who where independent before fracture, the greater length of stay was associated with advanced age and consumption of cardiovascular drugs. The total cost of hospital stay amounted to approximately $44,000 per patient. Mortality was 3.2% in the orthopedic ward and 10.8% in rehabilitation hospitals, for an overall in-hospital mortality rate of 10.4%. Overall, the 1-year mortality was 23.8% (21.5% for women and 35.4% for men), and it was significantly higher than in the general population (p < 0.001). Prognostic factors for mortality were age, sex, consumption of cardiovascular drugs, and previous living circumstances. One year after fracture, 62.6% of the fracture patients had returned to their previous living circumstances, but 17.9% needed a more care-intensive environment. The likelihood of returning to autonomous living circumstances 1 year after fracture was higher in younger subjects, in females, in those living with a partner, and in those in overall better health before the fracture. This prospective survey highlights the high socioeconomic impact and burden of osteoporotic fractures of the proximal femur.

Aged↗

Early events of liver regeneration in rats: a multiparametric analysis.

5-Bromodeoxyuridine (BrdU), a synthetic analogue of thymidine, has been utilized in vivo to detect the proliferation which occurs in the liver after two-thirds surgical hepatectomy. Immunocytochemical detection of BrdU incorporation has been carried out at both the morphological and flow cytometrical level, while structural changes of regenerating liver have been investigated, using Mallory-Azan-stained paraffin sections, by means of an image analyser. The results obtained show that in vivo DNA synthesis progression throughout S phase follows a pattern similar to that previously described in vitro in both 3T3 fibroblasts and Friend erythroleukemia cells and also demonstrate a precise correlation between morphological patterns of BrdU incorporating cells and their lobular distribution. Moreover, the activation of at least two proliferation waves can be detected from 18 to 34 h after hepatectomy: the former, starting from adjacent regions of contiguous lobules, apparently induces an irregular increase of lobular dimension; the latter, involving both inner and peripheral lobular domains, seems to be correlated with the appearance of nodule-like structures at the lobule periphery. In view of these results the role of the hepatic acinus and the hypothesis of a streaming of parenchymal cells during liver regeneration have been discussed.

Animals↗

Bone density and shape as determinants of bone strength in IGF-I and/or pamidronate-treated ovariectomized rats.

Areal bone mineral density (BMD) is a major determinant of bone strength and thereby of fracture risk. Other factors including trabecular microarchitecture and bone dimensions also contribute to bone strength. To investigate the relative importance for bone strength of BMD and bone dimensions, the relations between strength and the latter variables were evaluated under different experimental conditions in ovariectomized rats. Bone strength was assessed in compression and bending with measurement of BMD by dual-energy X-ray absorptiometry. Interventions were designed to increase trabecular BMD in rats with estrogen deficiency-induced bone loss (OVX) by treatment with pamidronate, an inhibitor of bone resorption, or to modify bone dimensions, particularly diameter, by administration of the growth factor IGF-I. In OVX rats, pamidronate treatment increased BMD with a commensurate increase in bone strength at the level of lumbar vertebrae and femoral neck (r = 0.789, p < 0.0001 and r = 0.535, p < 0.001, respectively). IGF-I increased the external diameter of midshaft tibia and femoral neck, which also correlated with bone strength (r = 0.678,p < 0.0001 and r = 0.507,p < 0.0002, respectively). Thus, both bone dimensions and BMD contributed to the determination of bone strength. In conclusion, adult rats with estrogen deficiency-induced bone loss represent a useful experimental model for investigating bone strength and its determinants such as BMD and external bone dimensions.

Absorptiometry, Photon↗

Does puberty alter dietary habits in adolescents living in a western society?

PURPOSE: Puberty is considered to be a period with major behavioral changes and alterations in lifestyle. It is also assumed that important modifications in food habits would occur during pubertal maturation, particularly in affluent societies. To test this hypothesis, we conducted a prospective survey in 193 adolescents (95 females and 98 males) aged 9-19 years. METHODS: Food intake was assessed using a 5-day dietary diary method with weighing of most food intakes. Diaries were analyzed for macronutrient consumption with a nutrition determination software integrating food composition tables and 103 local food items. The stage of puberty or sexual maturity was clinically assessed and rated from stage P1 (prepubertal) to P5 (adult). RESULTS: The total energy intake which was within the recommended dietary allowances (RDA) was significantly influenced by both pubertal maturation and sex when expressed in absolute terms, but by pubertal stages only when adjusted per kilogram of body weight. Compared with RDA, the macronutrient distribution of the total energy intake showed an excessive quantity of fat (especially saturated fatty acids) and an insufficient amount of carbohydrate-rich fibers. The intakes of proteins, of which two out of three came from animal sources, were above RDA. Overall, these inadequacies in the macronutrient intake distribution were constant throughout pubertal maturation. CONCLUSION: This study indicates that the type of diet which has been linked with several chronic diseases in adults living in developed countries already prevails before pubertal maturation. This dietary pattern changes marginally during pubertal development. Therefore, our investigation does not support the notion that "bad" food habits become particularly worse during the years of pubertal maturation.

Adolescent↗

Nutritional aspects of hip fractures.

Prevalence of malnutrition, particularly undernutrition, increases with advancing age, and patients with hip fracture are often particularly malnourished and/or undernourished. Deficiency in both micronutrients and macronutrients appears to be strongly implicated in the pathogenesis and the consequences of hip fracture in osteoporotic elderly. Such deficiencies can accelerate age-dependent bone loss, increase the propensity to fall by impairing movement coordination, and affect protective mechanisms that reduce the impact of falling. With respect to micronutrients, the most documented information concerns calcium and vitamin D. Studies conducted in the elderly have shown that administration of calcium and vitamin D can reduce femoral bone loss and, in institutionalized patients, lower the incidence of hip fracture. Besides hypovitaminosis D, deficiency in vitamin K has been suggested to contribute to bone fragility in patients sustaining hip fracture. As far as macronutrients are concerned, low protein intake appears to play a distinct detrimental role in the causes and complications of hip fracture. In a recent survey in hospitalized elderly patients, reduced protein intake was associated with lower femoral neck bone mineral density (BMD) and poor physical performance. This observation is in keeping with several studies in which a state of energy-protein malnutrition was documented in elderly patients with hip fracture. In these patients, in whom we detected very low femoral neck bone mineral density at the level of the proximal femur, the self-selected intake of protein and energy was insufficient during their hospital stay. Interestingly, the clinical outcome after hip fracture was significantly improved by daily oral nutritional supplement normalizing the protein intake, documented as a reduction in both complication rate and median duration of hospital stay. Further studies showed that normalization of the protein intake, independently of that of energy, calcium, and vitamin D, was responsible for this more favorable outcome. Preliminary data suggest that protein supplementation may also reduce further bone loss in elderly patients having sustained hip fracture. Increasing the protein intake from low to normal could act through an increase in the plasma level of IGF-I, a growth factor that exerts a positive effect on bone mass and that has been found to decrease with aging.

Aging↗