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A quantitative histomorphometric comparison of 40 micron thick Paragon® sections with 5 micron thick goldner sections in the study of undecalcified bone

  • Arnold J. Felsenfeld
  • John M. Harrelson
  • Robert A. Gutman
Clinical Investigations

Summary

The value of quantitative histomorphometric analysis of undecalcified stained sections of bone is widely recognized. Five micron thick sections have been regarded as essential to carry out this analysis, but their production requires expensive equipment. Our laboratory was equipped initially only for the production of Paragon®-stained 40µm thick sections. These thicker sections have been used traditionally to guide the planimetric analysis of microradiographs. However, we found that they could be used for the simpler eyepiece graticule histomorphometric analysis in the same way that 5µm sections have been examined. Sequential sections from iliac bone biopsy of 12 different patients with renal osteodystrophy were examined using each method. For 7 histologic features, the analysis of the thick sections compared very well with that of the Goldner-stained thin sections. The correlation coefficients varied from 0.88 for osteoid volume to 0.99 for osteoid surface. Other features compared included active and inactive osteoclastic surface activity. Further evidence of the usefulness of these thicker sections come from three other analyses. The expected close coupling of osteoblastic and osteoclastic activity was demonstrated (N=56,r=0.87,P<0.001). For 19 additional patients, two forms of histologic evidence of the degree of hyperparathyroidism correlated very well with the measured immunoreactive PTH (r=0.93 and 0.93). Finally, normal values obtained with our method compare favorably with published normal values.

Key words

Osteoclast Osteoblast Trabecular bone Endosteal fibrosis Osteoid 

References

  1. 1.
    Byers, P. D.: The diagnostic value of bone biopsies. In L. V. Avioli, S. M. Krane (eds.): Metabolic Bone Disease, pp. 183–236. Academic Press, New York, 1977Google Scholar
  2. 2.
    Ritz, E., Malluche, H. H., Krempien, B., Mehls, O.: Bone histology in renal insufficiency. In D. S. David (ed.): Calcium Metabolism in Renal Failure and Nephrolithiasis, pp. 197–233. John Wiley & Sons, New York, 1977Google Scholar
  3. 3.
    Bordier, P. J., Tun, C. S.: Quantitative histology of metabolic bone disease, Clin. Endocrinol. Metabol.1:197–215, 1972CrossRefGoogle Scholar
  4. 4.
    Merz, W. A., Schenk, R. K.: Quantitative structural analysis of human cancellous bone, Acta Anat. (Basel) 75:54–66, 1970PubMedGoogle Scholar
  5. 5.
    Sherrard, D. J., Baylink, D. J., Wergedal, J.: Bone disease in uremia, Trans. Am. Soc. Artif. Intern. Organs 18:412–415, 1972PubMedGoogle Scholar
  6. 6.
    Hruska, K. A., Teitelbaum, S. L., Kopelman, R., Richardson, C. A., Miller, P., Debman, J., Martin, K., Slatopolsky, E.: The predictability of the histological features of uremic bone disease by non-invasive techniques, Metab. Bone Dis. Rel. Res.1:39–44, 1978CrossRefGoogle Scholar
  7. 7.
    Schenk, R. K., Merz, W. A., Muller, J.: A quantitative histological study on bone resorption in human cancellous bone, Acta Anat. (Basel)74:44–53, 1969PubMedCrossRefGoogle Scholar
  8. 8.
    Garner, A., Ball, J.: Quantitative observations on mineralized and unmineralized bone in chronic renal azotemic and intestinal malabsorption syndrome, J. Pathol. Bacteriol.91:545–558, 1966CrossRefPubMedGoogle Scholar
  9. 9.
    Ritz, E., Krempien, B., Mehls, O., Malluche, H. H.: Skeletal abnormalities in chronic renal insufficient before and during maintenance hemodialysis, Kidney Int.4:116–127, 1973PubMedGoogle Scholar
  10. 10.
    Duursma, S. A., Visser, W. J., Zoeren, M., Korver, M. F.: A bone biopsy procedure, Calcif. Tissue Res.4:269–273, 1969CrossRefPubMedGoogle Scholar
  11. 11.
    Frost, H. M.: Microscopy, depth of focus, optical sectioning, and integrating eyepiece measurement, Henry Ford Hosp. Bull.10:247–285, 1962Google Scholar
  12. 12.
    Jowsey, J.: Quantitative microradiography: a new approach in the evaluation of metabolic bone disease, Am. J. Med.40:485–491, 1966CrossRefGoogle Scholar
  13. 13.
    Jowsey, J., Johnson, W. J., Taver, D. R., Kelly, P. J.: Effects of dialysate calcium and fluoride on bone disease during regular hemodialysis, J. Lab. Clin. Med.79:204–214, 1972PubMedGoogle Scholar
  14. 14.
    Jowsey, J.: The Bone Biopsy. Plenum Medical Book Corporation, New York, 1977Google Scholar
  15. 15.
    Malluche, H. H., Ritz, E., Lange, H. P., Kutschera, J., Hodgson, M., Seiffert, U., Schoeppe, W.: Bone histology in incipient and advanced renal failure, Kidney Int.9:355–362, 1976PubMedGoogle Scholar
  16. 16.
    Merz, W. A., Schenk, R. K.: A quantitative histological study on bone formation in human cancellous bone, Acta Anat (Basel)76:1–15, 1970PubMedGoogle Scholar
  17. 17.
    Sherrard, D. J., Baylink, D. J., Wergedal, J. E., Maloney, N. A.: Quantitative histological studies on the pathogenesis of uremic bone disease, J. Clin. Endocrinol. Metab.39:119–135, 1974PubMedGoogle Scholar
  18. 18.
    Eastwood, J. B., Bordier, P. J., Wardener, H. E. de: Some biochemical, histological, radiological, and clinical features of renal osteodystrophy, Kidney Int.4:128–140, 1973PubMedGoogle Scholar
  19. 19.
    Binswanger, U., Sherrard, D. J., Rich, C., Curtis, F. K.: Dialysis bone diseases. A quantitative histologic study, Nephron12:1–9, 1974PubMedGoogle Scholar
  20. 20.
    Ellis, H. A., Peart, K. M.; Azotemic renal osteodystrophy. A quantitative study on iliac bone, J. Clin. Pathol.26:83–101, 1973PubMedGoogle Scholar
  21. 21.
    Bordier, P. J., Marie, P. J., Arnaud, C. D.: Evolution of renal osteodystrophy: correlation of bone histomorphometry and serum mineral and immunoreactive parathyroid hormone values before and after treatment with calcium carbonate or 25-hydroxycholecalciferol. Kidney Int. [Suppl. 2]:S102–S112, 1975Google Scholar
  22. 22.
    Krempien, B., Ritz, E., Beck, U., Keilbach, H.: Osteopathy in maintenance hemodialysis. Micromorphometric and microradiographic studies with correlations to serum parathyroid hormone and calcitonin levels, Virchow Arch.357:257–274, 1972CrossRefGoogle Scholar
  23. 23.
    Rasmussen, H., Bordier P.: The Physiological and Cellular Basis of Metabolic Bone Disease. Williams & Wilkins Co., Baltimore, 1974Google Scholar
  24. 24.
    Vaughan, J. M.: The Physiology of Bone. Clarendon Press, Oxford, 1975Google Scholar
  25. 25.
    Shen, F. H., Baylink, D. J., Sherrard, D. J., Shen, L., Maloney, N. A., Wergedal, J.: Serum immunoreactive parathyroid hormone and 25 hydroxyvitamin D in patients with uremic bone diseases, J. Clin. Endocrinol. Metab.40:1009–1017, 1975PubMedCrossRefGoogle Scholar
  26. 26.
    Raina, V.: Normal osteoid tissue, J. Clin. Pathol.25:229–232, 1972PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • Arnold J. Felsenfeld
    • 1
    • 2
    • 3
  • John M. Harrelson
    • 1
    • 2
    • 3
  • Robert A. Gutman
    • 1
    • 2
    • 3
  1. 1.The Durham and Oklahoma City Veterans Administration Medical CentersUSA
  2. 2.The Division of Nephrology and Department of PathologyDuke University and University of Oklahoma Medical CenterDurhamUSA
  3. 3.The Division of Nephrology and Department of PathologyDuke University and University of Oklahoma Medical CenterOklahoma CityUSA

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