Bone Disorders : Biology, Diagnosis, Prevention, Therapy by Reiner Bartl, Christoph Bartl

By Reiner Bartl, Christoph Bartl

This accomplished advisor covers the research, analysis, prevention, and treatment of the entire bone problems encountered in clinical perform. Written in an easy-to-read type, it updates physicians at the present wisdom of bone constitution, body structure, and pathology, with emphasis at the analysis and therapy of universal bone ailments. at the present time, either clinical practitioners and experts want easy access to info on “bone difficulties” so one can aid sufferers and their households. as a result this booklet offers with every thing from the fundamental body structure of bone and mineral metabolism to the software of radiologic imaging and really good exams in bone analysis and present therapy suggestions. it's scientifically dependent yet offers transparent guidance for dealing with bone difficulties and for lifelong upkeep of skeletal constitution and serve as. it is going to support not just within the supply of powerful remedy but additionally in illness prevention.

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Additional resources for Bone Disorders : Biology, Diagnosis, Prevention, Therapy

Example text

The endosteal lining cells also participate in bone Bone Remodelling Units There are 2–5 million bone remodelling units (BRU) of the skeletal system (Fig. 14). 2). The total quantity of the bone decreases if more bone is resorbed than is produced over the years. It has been estimated that osteoporosis develops when for every 30 units of bone resorbed, only 29 are produced. This negative “bone balance” has three possible causes: • Increased osteoclastic activity without increased osteoblastic activity (“high turnover”) • Normal osteoclastic but decreased osteoblastic activity (“low turnover”) • Decreased osteoclastic and osteoblastic activity (“atrophic” or “adynamic” bone) Consequently an overall decrease in the bone correlates primarily with the number of BRU and with the lack of coordination between the cells of the BRU.

14). 2). The total quantity of the bone decreases if more bone is resorbed than is produced over the years. It has been estimated that osteoporosis develops when for every 30 units of bone resorbed, only 29 are produced. This negative “bone balance” has three possible causes: • Increased osteoclastic activity without increased osteoblastic activity (“high turnover”) • Normal osteoclastic but decreased osteoblastic activity (“low turnover”) • Decreased osteoclastic and osteoblastic activity (“atrophic” or “adynamic” bone) Consequently an overall decrease in the bone correlates primarily with the number of BRU and with the lack of coordination between the cells of the BRU.

Recruitment, differentiation and activation of osteoclasts are accomplished by numerous systemic hormones (such as parathyroid hormones, oestrogens, androgens, leptin and thyroid hormones) as well as cytokines. Various growth factors are also involved. Recent investigations of the RANK/ RANKL signalling pathway in the osteoclast have clarified mechanisms of stimulation and activation of resorption. Osteoclasts possess oestrogen receptors, by means of which oestrogen inhibits their recruitment. Androgens also act on osteoclasts.

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