cholecalciferol and Femoral-Fractures

Currently, there are no reports of diaphyseal femoral fracture equivalent to atypical femoral fractures (AFFs) in patients receiving long-term hemodialysis (HD).. A 56-year-old Japanese man receiving long-term HD for 34 years was admitted to our hospital due to a delay in postoperative healing. The patient began maintenance hemodialysis at 22 years of age. The patient then underwent surgical parathyroidectomy (PTX) for secondary hyperparathyroidism at 43 years of age, which resulted in decreased levels of parathyroid hormone (PTH). Thereafter, this patient's serum 1,25(OH)

Topics: Adult; Cholecalciferol; Diaphyses; Femoral Fractures; Humans; Male; Middle Aged; Parathyroid Hormone; Renal Dialysis; Young Adult

A procedure to generate functional osteoblasts from human somatic cells may pave the way to a novel and effective transplantation therapy in bone disorders. Here, we report that human fibroblasts were induced to show osteoblast phenotypes by culturing with ALK5 i II, which is a specific inhibitor for activin-like kinase 5 (ALK5) (tumor growth factor-β receptor 1 (TGF-β R1)). Cells cultured with ALK5 i II expressed osteoblast-specific genes and massively produced calcified bone matrix, similar to the osteoblasts induced from mesenchymal stem cells (MSC-OBs). Treatment with vitamin D3 in addition to ALK5 i II induced more osteoblast-like characters, and the efficiency of the conversion reached approximately 90%. The chemical compound-mediated directly converted osteoblasts (cOBs) were similar to human primary osteoblasts in terms of expression profiles of osteoblast-related genes. The cOBs abundantly produced bone matrix in vivo and facilitated bone healing after they were transplanted into immunodeficient mice at an artificially induced defect lesion in femoral bone. The present procedure realizes a highly efficient direct conversion of human fibroblasts into transgene-free and highly functional osteoblasts, which might be applied in a novel strategy of bone regeneration therapy in bone diseases.

Topics: Animals; Benzamides; Bone Regeneration; Cells, Cultured; Cholecalciferol; Dioxoles; Femoral Fractures; Femur; Fibroblasts; Humans; Imidazoles; Male; Mice; Mice, Inbred NOD; Osteoblasts; Phenotype; Receptor, Transforming Growth Factor-beta Type I; Signal Transduction; Smad2 Protein; Transcriptome; X-Ray Microtomography

Discrepancies in bone healing between osteoporotic and non-osteoporotic bone remain uncertain. The focus of the current work is to evaluate potential healing discrepancies in a metaphyseal defect model in rat femora. Female Sprague-Dawley rats were either ovariectomized (OVX, n=14) and combined with a calcium-, phosphorus- and vitamin D3-, soy- and phytoestrogen-free diet or received SHAM operation with standard diet rat (SHAM, n=14). Three months post-ovariectomy, DEXA measurement showed a reduction of bone mineral density reflecting an osteoporotic bone status in OVX rats. Rats then underwent a 3 mm wedge-shaped osteotomy at the distal metaphyseal area of the left femur stabilized with a T-shaped mini-plate and allowed to heal for 6 weeks. Biomechanical competence by means of a non-destructive three-point bending test showed significant lower flexural rigidity in the OVX rats at 3 mm lever span compared to SHAM animals (p=0.048) but no differences at 10 mm lever span. Microcomputer tomography (μCT) showed bridging cortices and consolidation of the defect in both groups, however, no measurable differences were found in either total ossified tissue or vascular volume fraction. Furthermore, histology showed healing discrepancies that were characterized by cartilaginous remnant and more unmineralized tissue presence in the OVX rats compared to more mature consolidation appearance in the SHAM group. In summary, bone defect healing in metaphyseal bone slightly differs between osteoporotic and non-osteoporotic bone in the current 3 mm defect model in both 3mm lever span biomechanical testing and histology.

Topics: Animals; Bone Density; Calcium; Cholecalciferol; Disease Models, Animal; Ergocalciferols; Female; Femoral Fractures; Fracture Healing; Osteoporosis; Osteoporotic Fractures; Ovariectomy; Rats; Rats, Sprague-Dawley; Vitamin D Deficiency

A 93 year-old woman with Paget's disease of bone had been treated with etidronate without interruption during 20 years. The daily dose was usual (5mg/kg/day) but this prescription had never been stopped by her physicians. Two fractures had already occurred in pagetic (right tibia) and non pagetic bones (right fibula) within the last 2 years, and she presented rib fractures, another right tibia fracture and right femur fracture during hospitalization time. X-rays films showed major osteolysis of left ulna and right tibia. Blood samples and technetium bone scan brought no evidence for sarcoma or lytic evolution of the disease. A transiliac bone biopsy on non pagetic bone site confirmed the diagnosis of osteomalacia (increased osteoid parameters), with secondary hyperparathyroidism (hook resorption). In Paget's disease of bone, continuous treatment by etidronate may induce generalized osteomalacia, and increase the risk of fracture in both pagetic and non-pagetic bones. Whereas physicians and pharmaceutical industry try to improve the observance of those drugs, this striking observation also points out that a prescription always needs to be updated.

Topics: Aged, 80 and over; Alkaline Phosphatase; Biopsy; Bone Density Conservation Agents; Calcification, Physiologic; Calcium Carbonate; Cholecalciferol; Etidronic Acid; Female; Femoral Fractures; Fibula; Fractures, Spontaneous; Humans; Hyperparathyroidism, Secondary; Iatrogenic Disease; Osteitis Deformans; Osteolysis; Osteomalacia; Parathyroid Hormone; Radionuclide Imaging; Rib Fractures; Tibial Fractures; Ulna; Vitamin D

In this report, we describe the management of a multiple sclerosis patient with a femoral fracture who had severe vitamin D deficiency. After the patient's preoperative laboratory studies revealed a normal platelet count, the orthopedic surgeon performed an intramedullary rod fixation on the patient's left femoral fracture. After the surgery, the diagnosis of vitamin D deficiency was made by measuring the circulating serum concentration of 25-dihydroxyvita-min D (25(OH)D) via Disorin's Vitamin D immunochemiluminometric assay LIASION by LabCorp (Laboratory Corporation of America). The patient's postoperative management included the oral administration of 4000 IU of vitamin D3 in a gel-cap suspension that resulted in an elevation of the blood serum concentration of 25(OH)D to an optimal concentration of >80 nmol/L (32 ng/ml).

Topics: Aged; Bone Nails; Calcifediol; Cholecalciferol; Femoral Fractures; Fracture Fixation, Intramedullary; Humans; Male; Multiple Sclerosis; Postoperative Care; Vitamin D Deficiency

The cause of an increased number of femoral fractures in market pigs from a single producer is described. Blood chemical, bone ash, radiographic, and feed analyses revealed that the fractures were caused by insufficient calcium in the diet. Associated economic and welfare implications are discussed.

Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Blood Chemical Analysis; Calcium; Calcium, Dietary; Cholecalciferol; Commerce; Femoral Fractures; Phosphorus; Swine

Topics: Age Factors; Aged; Aged, 80 and over; Cholecalciferol; Clinical Trials as Topic; Female; Femoral Fractures; Fractures, Bone; Humans; Male; Osteoporosis; Risk Factors; Time Factors; Vitamin D; Vitamin D Deficiency

In a previous ultrastructural study, the benefit of a single high dose of vitamin D3 on fracture healing in a healthy animal model was demonstrated. This study examined the biomechanical consequences of applying a single high dose of vitamin D3 in a healthy rabbit model subsequent to femoral fracture. The fracture load, the values of energy absorbed until fracture and the flexural rigidity values of the vitamin D group were significantly higher than the corresponding ones of the control group in the case of fracture. On the other hand, for intact bones, those values did not differ significantly between the two groups. It was concluded that single high-dose vitamin D3 application had positive effects on fracture healing in a healthy animal model, as far as the parameters related to mechanical strength are concerned.

Topics: Animals; Biomechanical Phenomena; Cholecalciferol; Femoral Fractures; Femur; Fracture Healing; Injections, Intramuscular; Male; Rabbits

The effect of a pulse dose of Vitamin D3 on uptake of [99mTc]MDP by fractured and osteoporotic bone, respectively, was compared with D3's effect on uptake by normal bone in rats. At 4, 7, and 14 days, respectively, after femoral fracture, basal uptake was significantly (p less than 0.005) increased at the fracture site by 336.8, 276.1, and 183.5%, respectively, over the contralateral control site. D3-treated rats had lower uptakes than untreated controls at all three fracture sites and at 12 of 15 normal bone sites but analysis of variance showed the uptake differences were not significant. Cortisone-induced osteoporosis caused a significant (p less than 0.05) decrease in basal uptake. The decrease occurred in all nine bone areas studied. D3 caused a significant (p less than 0.05) increase (mean 16.2%) in uptake by these osteoporotic bones, but a significant (0.1 greater than p greater than 0.05) decrease (mean 13.0%) in uptake by the same bones in normal controls. Thus, D3 had an effect on uptake by the bone lesion, osteoporosis, that differed from D3's effect on uptake by fracture or normal bone.

Topics: Animals; Bone and Bones; Cholecalciferol; Cortisone; Diphosphonates; Female; Femoral Fractures; Femur; Male; Osteoporosis; Rats; Rats, Inbred Strains; Technetium; Technetium Tc 99m Medronate; Time Factors

Calcitonin and 1.25(OH)2D3 have opposite effects on the serum concentrations of Ca and P, as well as on bone resorption, and can be observed in the process of healing of standardized fracture in adult rats. The rats given 1.25(OH)2D3 had a stronger fracture callus and slightly less pronounced postfracture osteopenia. Calcitonin did not significantly influence the fracture healing but had a pronounced effect in preventing the osteopenia. The effects of 1.25(OH)2D3 are believed to be indirect, i.e., through the changes in the serum Ca X P product, whereas the osteopenia preventing action of calcitonin may come from direct effect on bone.

Topics: Animals; Body Weight; Bony Callus; Calcitonin; Calcium; Cholecalciferol; Femoral Fractures; Male; Phosphorus; Rats; Tensile Strength; Wound Healing