Vorachai Sirikulchayanonta

Abnormalities in Bone Mineral Density and Bone Histology in Thalassemia

This study demonstrated that there was extensive iron staining on trabecular surface and marked reduction in trabecular bone volume without significant alteration in bone formation and bone resorption rates as well as significant reduction in bone mineral density in 18 thalassemic patients. Serum IGF‐I was reduced and may modulate the reduction of bone mass.

Bone calcium turnover, formation, and resorption in bromocriptine- and prolactin-treated lactating rats

To evaluate the effect of endogenous prolactin (PRL) on bone metabolism, we studied bone calcium turnover by the 45Ca kinetic method and bone formation and resorption by bone histomorphometry and biochemical markers in 13-wk-old lactating Wistar rats. For 1 wk, the animals received daily administration of 0.9% NaCl (control) intraperitoneally, 6 mg of bromocriptine/kg of body wt intraperitoneally, or 6 mg of bromocriptine/kg of body wt plus 2.5 mg of ovine PRL/kg of body wt subcutaneously. Bromocriptine, a dopaminergic inhibitor of endogenous PRL secretion, significantly decreased calcium ion deposit rate and calcium resorption rate in femur, tibia, vertebrae 5 and 6, and sternum by 20–42%. By contrast, calcium resorption rate of the vertebrae and the sternum of the PRL-treated group was higher than that of controls, whereas the tibia and sternum exhibited a greater net loss of calcium. The suppression of bone calcium turnover in the bromocriptine-treated group was further supported by a significant decrease in the urinary deoxypyridinoline, a biochemical index of bone resorption, and the histomorphometric data, which showed changes indicative of suppressed bone resorption and formation. The histomorphometric data from the PRL-treated group were not different from those of the control group with the exception of an increase in the longitudinal growth rate. The results suggested a role of endogenous PRL in the stimulation of bone turnover during lactation.

Dermabrasion Is an Effective Treatment for Acquired Bilateral Nevus of Ota-like Macules

BACKGROUND Dermal pigmented lesion, or acquired bilateral nevus of Ota‐like macules, is a common entity in Asian skin. There are no established data supporting the safety, effectiveness, and cosmesis of its treatment. The lesions do not respond to bleaching or peeling agents. OBJECTIVE To search for a means of treatment that is cost effective, safe, and yields a good cosmetic result. If possible, these requirement should be accomplished within one session. METHODS Three hundred and twenty patients who presented themselves with acquired bilateral nevus of Ota–like macules were included in the study. Area dermabrasion using a hand engine with a coarse diamond fraise was performed in every case. RESULTS Three hundred and twenty patients (97%) achieved 100% clearance of the pigment. In the remaining 10 patients (3%) there was 5% residual pigment. The wound healed with excellent cosmesis, and without changing skin texture. CONCLUSION Dermabrasion is an excellent modality for the treatment of acquired nevus of Ota‐like macules.

Tuberculous bursitis of the subacromial bursa

Infection originating in a deep bursa is rare and should be differentiated from infected bursitis extending from the nearby septic joint. There are a considerable number of reported cases of septic subacromial bursitis caused by nonspecific organisms3,4,10,11,13,16,17 and rare cases caused by a tuberculous process.5,8,9,12,22 Those reported cases of tuberculous bursitis in this location were mainly secondarily extended from the shoulder joint.15 Primary tuberculosis of the subacromial bursitis, as in our present case, is quite rare and forms the basis of this report.

Epithelioid Hemangioma Involving Three Contiguous Bones: a Case Report with a Review of the Literature

An epithelioid hemangioma involving three contiguous bones in continuity has, to the best of our knowledge, not been reported in the literature. A case of a 48-year-old man presented with radiating pain to the lower thoracic region for two years. A radiograph and CT scan revealed both permeative osteolytic and multiple trabeculated lesions involving the left posterior part of the 10th rib as well as the 9th and 10th vertebral bodies in continuity and was misled as a malignant or infectious lesion. The histopathology and immuno-histochemistry of the lesion confirmed the diagnosis of an epithelioid hemangioma. The lesion was still stable as of three years after surgery.

ULTRASTRUCTURE OF CHORDOMA

A 50‐year‐old male developed a sacro‐coccygeal chordoma. Prior to the surgery, he had experienced back‐pain, numbness of the right thigh and difficulty in voiding and defecation. Total excision of the mass was done and all symptoms were relieved. The light microscopic examination revealed a chordoma. The ultrastructural study was performed with particular interest in physaliferous cells. The fine structure disclosed the prominent associations of mitochondria and rough endoplasmic reticulum. The mitochondria showed irregularities in sizes and shapes but did not attenuate as much as previously reported. The vacuoles that were observed by light microscopy in physaliferous cells were both extra‐cellular and intra‐cellular and contained finely granular material of acid mucopolysaccharides probably of chondroitin type. The presence of both subplasmalemmal linear densities (SLD) and pinocytic vesicles was consistent with the histogenetic conviction that the tumor arose from mesodermal derivatives.

Asymptomatic Paget’s bone disease in ethnic Thais: a series of four case reports and a review of the literature

Paget’s bone disease is quite common in some parts of Europe and countries inhabited by European emigrants, but it is rare in Asia. There have been only 13 reported cases in Southeast Asia, including one reported case from Thailand. Half of the previously reported cases had bone symptoms and the other half were asymptomatic, but were incidentally discovered when patients were being investigated for other medical problems. Here are reported cases of four asymptomatic patients who presented elevation of serum alkaline phosphatase during routine annual medical checkups. All patients were of Chinese descent and all cases were proven by biopsy. Based on this experience, we are of the opinion that a substantial number of unrecognized cases of Paget’s disease exist among ethnic Thais. We feel that they would be revealed if clinicians were alerted of its presence and if they included it as a possible diagnosis together with metastasis and osteoporosis when examining bone lesions or when results for elevated serum alkaline phosphatase are detected during routine checkups. We also anticipate that a higher prevalence of this disease may occur in future Thai generations due to the addition of offspring from Asian–European intermarriages to offspring of Chinese descent in the ethnic Thai population.

Update of osteosarcoma in Ramathibodi, Thailand

Osteosarcoma is the most common primary malignant bone tumor in Thailand [1,2]. The peak age group and skeletal distributions are not different from those of many countries [1,3,4]. Only a minority of cases have been referred to seven tertiary care centers for radio- or chemotherapy throughout the country. Our institute is one of these, and we admit approximately 5–10 referral cases annually.