Pulmonary artery aneurysm is the best-defined type of pulmonary disease in Behçet's disease (BD) with an important morbidity and mortality. The objective of this study was to assess the contribution of high-resolution dynamic chest CT imaging for one of the most serious aspects of BD: pulmonary artery aneurysm and other pulmonary parenchymal involvement. Sixteen BD patients were recruited for this study, (14 men, 87.5%, and 2 women, 12.5%). All patients fulfilled the 1990 American College of Rheumatology criteria for classification of BD [International Study Group for Behçet's Disease, Lancet 335:1078-1080, (1990)]. All patients underwent thorough history taking, full clinical examination, and routine laboratory investigations. Plain chest X-rays and pulmonary CT angiography were performed on all patients in an attempt to assess the pulmonary vasculature and lung parenchyma. Pulmonary vascular abnormalities were as follows: pulmonary artery aneurysms of varying sizes in nine patients (56.3%), main pulmonary artery ectasia in two patients (12.5%), pulmonary artery embolism in two patients (12.5%), venacaval thrombosis in seven patients (43.8%), and pulmonary venous varices in four patients (25%). Pulmonary parenchymal abnormalities were as follows: three patients (18.8%) with mild central bronchiectasis, one patient (6.3%) with atelectasis, one patient (6.3%) with subpleural nodule, and four patients (25%) with interstitial lung disease. Eight of the male patients were smokers. Multislice CT is useful in demonstrating the entire spectrum of thoracic manifestations of BD. Multislice CT is noninvasive and provides excellent delineation of the vessel lumen and wall and perivascular tissues, as well as detailed information concerning the lung parenchyma, pleura, and mediastinal structures.
ObjectiveThe aim of this study was to evaluate the effect of atorvastatin on the bone formation and resorption markers in ovariectomized rats (experimental study), and to study its effect on the bone mineral density (BMD) in postmenopausal osteoporotic women (clinical study).Materials and methodsThe study involved experimental and clinical aspects. In the experimental aspect, 42 female Wistar rats were divided into five groups: Group I (n=6; sham-operated), Group II (n=6; 1 mL of carboxymethyl cellulose [CMC] was administered orally), Group III (n=6; 20 mg/kg orally of atorvastatin was administered), Group IV (n=12; untreated ovariectomized [OVX] rats and served as a model of osteoporosis [OP]) and Group V (n=12; 20 mg/kg orally of atorvastatin was administered to ovariectomized rats). After 4 weeks, serum acid phosphatase, alkaline phosphatase, osteocalcin, total calcium and inorganic phosphorus were assessed. Then, 3 µm thickness lumbar and femur sections were examined using a light microscope to assess cortical thickness, trabecular area, numbers of osteoblasts and osteoclasts. In the clinical aspect, 85 post-menopausal osteoporotic females with recently detected hyperlipidemia participated in the study. Atorvastatin 40 mg/day, calcium carbonate 500 mg/day and vitamin D 800 international units were given to all patients for a period of 18 months. BMD was measured at the start and at the end of the study by dual-energy X-ray absorptiometry (DEXA).ResultsIn the experiment aspect, the biomarkers of bone remodeling were notably elevated in the OVX group. Administration of atorvastatin produced a significant decrease in the level of these bone metabolic markers. Atorvastatin significantly ameliorates osteoporotic changes induced by ovariectomy. In the clinical aspect, after 18 months the DEXA showed improvement in the T-score for the three measured zones; however, these changes were statistically significant only in the femoral neck area.ConclusionAtorvastatin was able to decrease the rate of bone metabolism and increase osteogenic activity. It has dual mode of action; both anabolic and antiresorptive effect on bone. This lipophilic statin member may act as a double weapon drug.
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