Poncirin Inhibits Osteoclast Differentiation and Bone Loss through Down-Regulation of NFATc1 In Vitro and In Vivo

Activation of osteoclast and inactivation of osteoblast result in loss of bone mass with bone resorption, leading to the pathological progression of osteoporosis. The receptor activator of NF-κB ligand (RANKL) is a member of the TNF superfamily, and is a key mediator of osteoclast differentiation. A flavanone glycoside isolated from the fruit of Poncirus trifoliata, poncirin has anti-allergic, hypocholesterolemic, anti-inflammatory and anti-platelet activities. The present study investigates the effect of poncirin on osteoclast differentiation of RANKL-stimulated RAW264.7 cells. We observed reduced formation of RANKL-stimulated TRAP-positive multinucleated cells (a morphological feature of osteoclasts) after poncirin exposure. Real-time qPCR analysis showed suppression of the RANKL-mediated induction of key osteoclastogenic molecules such as NFATc1, TRAP, c-Fos, MMP9 and cathepsin K after poncirin treatment. Poncirin also inhibited the RANKL-mediated activation of NF-κB and, notably, JNK, without changes in ERK and p38 expression in RAW264.7 cells. Furthermore, we assessed the in vivo efficacy of poncirin in the lipopolysaccharide (LPS)-induced bone erosion model. Evaluating the micro-CT of femurs revealed that bone erosion in poncirin treated mice was markedly attenuated. Our results indicate that poncirin exerts anti-osteoclastic effects in vitro and in vivo by suppressing osteoclast differentiation. We believe that poncirin is a promising candidate for inflammatory bone loss therapeutics.

A Case of Lymphomatoid Papulosis of the Eyelid

PURPOSE: Lymphomatoid papulosis (LyP) is one of the primary cutaneous CD30-positive lymphoproliferative disorders. LyP of the eyelid has rarely been reported. Herein, a case of typical LyP of the medial canthal area is reported. In addition, a literature review was performed. CASE SUMMARY: A 40-year-old female presented with a skin mass in the medial canthal area of the left eye that developed 2 months earlier. Initially, a focal skin lesion developed, and even with conservative treatment at a local clinic, progressed to a mass lesion having a central ulceration and adjacent edema. After 6 weeks, the adjacent edema had gradually decreased. On ophthalmic examination, the left medial canthal lesion was a 6 x 6 mm sized elevated mass with a central crater covered by crust. The clinical impression was keratoacanthoma. The lesion was widely excised and reconstructed by a full-thickness skin graft after an incisional biopsy. Histopathologic findings showed dermal infiltration of various inflammatory cells with atypical lymphocytes showing positivity to the CD30 antigen, and LyP was diagnosed. Systemic evaluation showed no evidence of systemic lymphoma and the patient has remained free of recurrence or systemic disease after a 1-year follow-up.

Relationship between Control Grade and Stereoacuity in Basic Intermittent Exotropia

PURPOSE: The present study was conducted to identify the correlation between control grade and stereoacuity in basic intermittent exotropia (X[T]). METHODS: Eighty-six patients with basic X (T) were divided into 3 subgroups according to their control grade and the near and distant stereoacuities were evaluated. RESULTS: Group 1; good control group, consisted of 28 patients, group 2; fair control, 30 patients, and group 3; poor control, 28 patients. Mean near stereoacuities measured by the Titmus test were 58.21 arcseconds in group 1, 75.33 arcseconds in group 2, and 151.43 arcseconds in group 3. The mean distant stereoacuities measured by a Mentor B-VAT(R) II-SG videoacuity tester were 118.93 arcseconds in group 1, 165.33 arcseconds in group 2, and 276.43 arcseconds in group 3. When comparing the 3 groups, the poorer the control grade, the worse were the near and distant stereoacuities (p = 0.002, p < 0.001). When compared in pairs, however, group 1 showed a better near stereoacuity than groups 2 and 3 (p = 0.02, p = 0.002, respectively), while group 2 and group 3 did not show any distinct differences (p = 0.13). Group 1 also showed a better distant stereoacuity than groups 2 and 3 (p = 0.02, p < 0.001, respectively), as did group 2 compared to group 3 (p < 0.001). CONCLUSIONS: Control grade and distant stereoacuity have significant correlation in patients with basic X (T) and can function as helpful indicators for monitoring the deterioration and progression of exodeviation.

Changes of Deviation After the Patch and +3.00 Diopter Spherical Lens Test in Basic Intermittent Exotropia

PURPOSE: To assess the change of deviation angle after the patch test and +3.00 diopter (D) spherical lens test in basic intermittent exotropia. METHODS: The present study included 57 patients diagnosed with basic intermittent exotropia. The deviation angles at near and far before and after monocular occlusion of 40 minutes or more were measured. Afterward, change of deviation was also measured by placing +3.00 D spherical lenses at near. RESULTS: Results from the study revealed pre-occlusion mean deviation angles of 23.1 +/- 7.41 prism diopters (PD) at near, and 23.9 +/- 6.56 PD at far. After the patch test, the mean deviation angles were increased to 28.3 +/- 6.50 PD (p < 0.0001) at near, and 25.5 +/- 6.40 PD (p < 0.0001) at far. After the +3.00 D spherical lens test, the angle was increased to 31.5 +/- 7.53 PD (p < 0.0001) at near. Using the gradient method, the average accommodation convergence - accommodation ratio was 1.4 +/- 1.19 PD/D. CONCLUSIONS: Both the patch test and +3.00 D spherical lens test significantly increased the deviation angles at near and far, they helped to find the maximum deviation angle in patients with basic intermittent exotropia.

A Case of Compressive Optic Neuropathy due to Breast Cancer Metastasis

PURPOSE: To report a case of compressive optic neuropathy due to breast cancer metastasis to the periorbital lesion 26 years after the treatment of primary cancer. CASE SUMMARY: A 64-year-old female presented with headache, facial pain and visual disturbance in her left eye for four months. The patient had received chemotherapy and radiotherapy after left breast modified radical mastectomy for invasive ductal carcinoma 26 years previously, and right breast wide resection with axillary dissection nine years earlier. Best corrected visual acuity was 20/20 in the right eye and 8/20 in the left eye. The color perception test showed abnormal findings in the left eye. MRI and PET-CT revealed an enhancing mass in the left periorbital area that was compressing the optic nerve. Partial resection of the tumor and left orbital wall was performed. Adjuvant chemotherapy and radiotherapy was performed after the operation. After two months later, the best corrected visual acuity was 20/20 in the left eye, and the color perception test showed normal findings, which have been maintained for one year. CONCLUSIONS: Prompt management can result in visual recovery in patients with compressive optic neuropathy caused by breast cancer metastasis.

Origins of Dorsal Root Ganglion Cells with CGRP innervating Quadriceps Femoris Tendon of Rat / 대한정형외과학회잡지

PURPOSE: This study was undertaken to determine the origins of dorsal root ganglion (DRG) cells containing calcitonin gene-related peptide (CGRP) which innervate the quadriceps femoris tendon in the rat. MATERIALS AND METHODS: DRG cells containing CGRP, which innervate the quadriceps femoris tendon, from 25 rats (Sprague-Dawley, 200-250 g) were examined using the retrograde tracing technique (neural tracers: horseradish peroxidase and fluorogold) combined with immunohistochemistry. RESULTS: Injection of horseradish peroxidase (HRP) or fluoro-gold (FG) into the quadriceps femoris tendon resulted in the ipsilaterally labelling of cells between L1 and L6 DRGs. However, a large number of the labelled cells innervating the quadriceps femoris tendon were found in the L3 and L4 DRGs. Many DRG cells were immunostained with CGRP antibody in the L1-6 DRGs. The number of CGRP immunoreactive cells in the lumbar DRGs was larger than in the sacral DRG. FG labelled cells containing CGRP immunoreactivity (FG+CGRP cells) were found in the lumbosacral DRGs. Many FG+CGRP cells innervating the quadriceps femoris tendon were located in the L3 and L4 DRGs. CONCLUSION: These results show that the main DRG origin for the sensory innervation of the quadriceps femoris tendon is L3 or L4. The neurogenic pain of the quadriceps femoris tendon may originate from this region, and suggests that this may be important for the release of neurogenic pain.