Biomedical subjects

R S Yang

Publications and source records attributed to R S Yang.

At least 55 records · Page 3Linked to original sources

PubMed1998

Morphological changes induced by prostaglandin E in cultured rat osteoblasts.

Prostaglandin E (PGE)-induced morphological changes of osteoblasts and its possible mechanisms were investigated in cultured calvaria and isolated osteoblasts from long bone fragments of neonatal rats. The control osteoblasts, either on the calvaria or isolated from the long bone fragments, were flat, polygonal in shape, and arranged in a monolayer under scanning electron microscopy (SEM) or phase contrast microscopy. Treatment with 1 mumol/L of prostaglandin E2 (PGE2, 2 h) caused these bone cells to contract a soma, whereas 10 and 100 mumol/L PGE2 (2 h) caused 18%-30% of the bone cells to elongate and expose the undersurface. Incubation of the cultured osteoblasts with PGE2 at different time periods showed a bell-shaped pattern with the optimal response at 2 h of incubation. A similar reaction can be induced by treatment with prostaglandin E1 (PGE1) or dibutyryl cyclic adenosine monophosphate (DBcAMP) in combination with 3-isobutyl-1-methylxanthine (IBMX). Furthermore, we assessed the percentage of responsive isolated bone cells to investigate interactions with other agents. The morphological changes induced by PGEs were inhibited by H-8, a protein kinase inhibitor. On the other hand, elevated intracellular calcium enhanced the PGE-induced morphological changes. Fluorescence labeling showed that PGEs caused the breakdown of the actin microfilaments, but spared the microtubules and vimentin filaments in the isolated osteoblast-like cells. These results suggest that the morphological changes of osteoblasts induced by PGEs may be related to the intracellular cAMP and calcium levels.

1-Methyl-3-isobutylxanthine↗

PubMed1998

Tissue factor activity of SW-480 human colon adenocarcinoma cells is modulated by thrombin and protein kinase C activation.

Expression of tissue factor (TF), a cellular initiator of the extrinsic coagulation cascade, is a feature of many malignant tumours and is intimately involved in the process of metastasis. SW-480 human colon adenocarcinoma cells responded to thrombin (1 U ml(-1)) or phorbol 12-myristate 13-acetate (PMA, 0.1 microM) with a 6.0-fold and a 7.7-fold increase in their procoagulant activity (PCA), respectively, after 4-6 h incubation in serum-free medium. The thrombin-enhanced PCA was significantly inhibited by complexing of thrombin with hirudin, or by serine protease inhibition with 3,4-dichloroisocoumarin. Both effects of thrombin and PMA on PCA in SW-480 cells were blocked by pretreatment of cells with cycloheximide or actinomycin D, indicating that the response required de novo protein and RNA synthesis. The thrombin-enhanced PCA depended on the activation of protein kinase C (PKC) as it was diminished by staurosporine and calphostin C. Moreover, stimulation of SW-480 cells by thrombin or PMA led to a significant increase in TF mRNA within 3 h as measured by the reverse-transcription PCR method, which was also dependent on the activation of PKC. The unaltered decay rate of thrombin-enhanced TF mRNA, evaluated after the addition of staurosporine, suggested that its inhibitory effect occurred at a transcription level. Our data suggest that thrombin enhances TF gene expression and protein synthesis in tumour cells in vitro via PKC activation. The induction of TF expression in tumour cells by thrombin indicates that tumour-associated PCA might have a positive-feedback effect on in vivo local propagation of thrombus by thrombin formation.

Adenocarcinoma↗

PubMed1998

Evidence for hepatocarcinogenic activity of pentachlorobenzene with intralobular variation in foci incidence.

Pentachlorobenzene (PeCB) is an important environmental contaminant derived primarily from the by-product contamination of the popular fungicides hexachlorobenzene and pentachloronitrobenzene. Its tumor-promoting activity was studied in a medium-term initiation/promotion assay in male F344 rats. Animals were given a single i.p. injection of diethylnitrosamine (200 mg/kg body weight) and 2 weeks later were administered 0.1 or 0.4 mmol/kg per day PeCB by gavage in a corn oil vehicle, 7 days/week. At the end of week 3, rats were subjected to a partial hepatectomy. Results showed that PeCB, at both doses, significantly increased both the number and area of glutathione S-transferase pi (GST-P) foci (>0.2 mm diameter) (P < 0.05). This trend was dose-dependent. In addition to increases in preneoplastic foci, liver glutathione concentrations and glutathione-associated enzymes showed significant changes in animals treated with PeCB. Glutathione reductase (GR) and gamma-glutamylcysteine synthetase (gamma-GCS) were both significantly induced in the centrilobular region. Changes in oxidized glutathione concentrations corresponded with the increase in GR activity with decreases of 40 and 30% in the low and high dose groups, respectively. No significant changes were detected in reduced glutathione concentrations. Together with changes in GR and gamma-GCS expression, a decrease in GST-P foci around the central veins was significant (P = 0.004) at the high dose. In these animals, 26% of the foci were classified as centrilobular whereas 37 and 39% of the foci were centrilobular in the low dose and control groups, respectively. Because of the co-localized nature of the changes in glutathione-associated enzymes and the decreased incidence of centrilobular foci, our results suggest that the reduced cellular environment may ultimately play a role in negatively selecting for foci growth.

Animals↗

PubMed1998

Some critical issues and concerns related to research advances on toxicology of chemical mixtures.

This paper addresses some of the issues and concerns on research advances on the toxicology of chemical mixtures. Emphases will be selectively given to the following questions and answers: Can mechanistic studies be conducted on chemical mixtures? The fact that any studies, including mechanistic studies, of single chemicals are really the study of the parent chemical plus its metabolites underscores the relevance of mechanistic studies on chemical mixtures. Can predictions be made on the health effects of chemical mixtures? Some successes are already evident in the literature on simpler chemical mixtures. For more complex mixtures, it is possible and we propose an approach here. What can we learn from other disciplines (the importance of interdisciplinary collaboration)? Two aspects, the knowledge and methodologies available in clinical pharmacology and the latest advances in structure-oriented lumping in chemical engineering, are discussed in detail. Unrepeatable results: The possibility of magnification of biologic variability because of low-level exposures to chemical mixtures is suggested with special reference to some known examples, including the controversial study on synergistic interactions of endocrine disruptors. Is the driving force for scientific investigations on chemical mixtures the legislative and regulatory atmosphere? Two laws with chemical mixtures specifically in the language are quoted and discussed. Their implications regarding research funding and activities are described. What are the pitfalls of applying for research funding on investigating chemical mixtures? The dilemma at least one investigator faces in pursuing research funding is elaborated. The questions and issues listed above are not all inclusive, but they represent some of the aspects that need to be brought into the open in the scientific community for discussion and/or debate. Thus, the primary objective of this paper is to provide some momentum for the beginning of a fruitful and stimulating discussion.

Drug Interactions↗

PubMed1998

Approaches to developing alternative and predictive toxicology based on PBPK/PD and QSAR modeling.

Systematic toxicity testing, using conventional toxicology methodologies, of single chemicals and chemical mixtures is highly impractical because of the immense numbers of chemicals and chemical mixtures involved and the limited scientific resources. Therefore, the development of unconventional, efficient, and predictive toxicology methods is imperative. Using carcinogenicity as an end point, we present approaches for developing predictive tools for toxicologic evaluation of chemicals and chemical mixtures relevant to environmental contamination. Central to the approaches presented is the integration of physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) and quantitative structure--activity relationship (QSAR) modeling with focused mechanistically based experimental toxicology. In this development, molecular and cellular biomarkers critical to the carcinogenesis process are evaluated quantitatively between different chemicals and/or chemical mixtures. Examples presented include the integration of PBPK/PD and QSAR modeling with a time-course medium-term liver foci assay, molecular biology and cell proliferation studies. Fourier transform infrared spectroscopic analyses of DNA changes, and cancer modeling to assess and attempt to predict the carcinogenicity of the series of 12 chlorobenzene isomers. Also presented is an ongoing effort to develop and apply a similar approach to chemical mixtures using in vitro cell culture (Syrian hamster embryo cell transformation assay and human keratinocytes) methodologies and in vivo studies. The promise and pitfalls of these developments are elaborated. When successfully applied, these approaches may greatly reduce animal usage, personnel, resources, and time required to evaluate the carcinogenicity of chemicals and chemical mixtures.

Algorithms↗

PubMed1998

Relation between histological intensity of transforming growth factor-beta isoforms in human osteosarcoma and the rate of lung metastasis.

Even though adjuvant chemotherapy has improved the 5-year survival rate of osteosarcoma patients, a significant percentage of patients eventually die from lung metastasis. Since transforming growth faCtor-beta (TGF-beta) has been demonstrated to be related to the tumor progression, we investigated the clinical implications of the presence of TGF-beta isoforms in 16 human osteosarcoma tissue. There were 10 males and 6 females with a mean age of 20.8 years of age (range, 8 to 57 years). Biopsied specimen before chemotherapy was fixed in 10% formalin, demineralized and followed by paraffin embedding. The locations of tumor included femur (10), tibia (3), humerus (1), fibula (1), and ilium (1). Histologic subtypes included osteoblastic (11), chondroblastic (2), and fibroblastic (3). All patients were followed for a minimum of 1 year (range 12 to 44 months) or to the development of lung metastasis. Five patients (31.3%) developed subsequent lung metastasis during the follow up. We used immunohistochemistry technique to investigate the presence of the TGF-beta isoforms in osteosarcoma tissue and its relationship to the subsequent pulmonary metastasis. The results showed the presence of one or more TGF-beta isoforms in tumor cells in osteosarcoma tissues (13 of 16, 81.3%) in all of the subtypes. However, minimal presence of TGF-beta isoforms was shown in the tumor bone matrix. The expression of TGF-beta1 or TGF-beta3 isoforms was associated with a higher rate of subsequent lung metastasis (p < 0.05, chi-square test). Further research is warranted to determine the utility of routine TGF-beta analysis in the clinical practice.

Adolescent↗

PubMed1998

Immunohistochemical analysis of matrix proteolytic enzymes in the periprosthetic tissue in the patients with loosening prostheses.

Regional periprosthetic bone resorption plays an important role of prosthesis loosening. In order to study the possible mechanisms of loosening, we investigated the presence of matrix proteolytic enzymes in the periprosthetic tissue by immunohistochemical technique in 72 patients undergoing revision operation of loosened joint prosthesis, including 22 males and 50 females and aged from 19 to 88 years (mean, 61.7 years). Thirty-nine patients had a loosened hip prosthesis (18 males and 21 females) whereas 33 patients had a loosened knee prosthesis (4 males and 29 females). Tissue specimens collected during revision surgery underwent thin slide sections and H & E staining, and were observed under light microscopy and polarized-light microscopy. The results showed many macrophages, histiocytes, fibroblasts, as well as many phagocytosed metal debris and polyethylene debris in the periprosthetic tissues, suggesting an active bone resorption. Furthermore, we used immunohistochemical techniques to detect the distribution of matrix proteolytic enzymes in periprosthetic tissue, including lysosome enzymes (cathepsin B, cathepsin D and cathepsin G), and matrix metalloproteinase (MMPs, MMP-1, MMP-2, MMP-3). The immunostaining were classified as strong positivity, > 70% positive cells; moderate positivity, 20-70% positive cells; weak/negative, < 20% positive cells. The results showed that cathepsin B, cathepsin D and cathepsin G were found in most fibroblasts and macrophage-like cells, including multinuclear giant cells and epithelioid cells. MMPs were found in most fibroblasts and macrophage-like cells, as well as a scant amount in the extracellular matrix. These enzymes were also found in or around blood vessels, the endothelial cells in the richly vascularized tissue. All negative controls showed no staining. The results of immunoreactive staining ranged from 61.1% to 68.1% of strong to moderate positivity. Since these enzymes were related to the degradation of matrix protein, they may be related to the periprosthetic bone resorption. The further clinical significance needs further investigation.

Adult↗

PubMed1998

Concentration of metal elements in the blood and urine in the patients with cementless total knee arthroplasty.

Titanium (Ti), cobalt (Co) and chromium (Cr) element concentrations in the whole blood and urine specimen in 40 patients with cementless total knee arthroplasty were determined by the electrothermal atomic absorption spectrophotometry. Their ages ranged from 55 to 78 years (mean, 65 years). Twenty of them had loosening of prosthesis and underwent revision surgery, including 4 subjects with Ti-6Al-4V alloy prosthesis and 16 subjects with Co-Cr-Mo alloy prosthesis. The other 20 patients had well-functioning stable prosthesis, including 5 subjects with Ti-6Al-4V alloy prosthesis and 15 subjects with Co-Cr-Mo alloy prosthesis. The mean duration of prostheses implantation in patients with loosened or well-functioning prostheses were 6.5 and 4.0 years, respectively. The control group consisted of 20 age-matched normal subjects who did not undergo any metal implant surgery. Analysis of variance showed that the metal element concentrations in the whole blood, either Co, Cr or Ti, was statistically higher in the patients with loosened prosthesis than the other two groups. However, the metal element concentrations in the urine did not show any difference. The linear regression analysis showed a moderate positive relationship between the metal element concentrations, either Co or Cr elements, in whole blood and urine only in the patients with loosened prostheses. In conclusion, elevated concentration of metal elements may indicate a loosening of prosthesis while the clinical significance of the metal element concentration in the urine needs further investigation.

Aged↗

PubMed1998

The influence of intra-graft heparin injection on the survival of composite grafts.

BACKGROUND: Intra-replant subcutaneous heparin injection has been reported to be an alternative to venous anastomoses in finger replantations. It has also been recommended for composite graft type replants. In this study, we investigated three different regimens of intra-graft heparin injection in a rabbit ear model. Our aim was to determine whether or not continuous oozing from an incision wound on a composite graft made by an intra-graft heparin injection would increase the survival of a larger composite graft. METHODS: A 25-mm-diameter circular composite graft (including dorsal skin and auricular cartilage) was harvested from the mid-portion of a rabbit ear. This size of graft was selected as the study model due to a significantly lower percent graft survival when compared to smaller-sized grafts (17.0 +/- 5.6%, p < 0.05). Three different regimens of intra-graft heparin injection were performed in the study group and the results of percent graft survival were compared. RESULTS: Intra-graft injection of heparin calcium 250 IU/0.1 ml qd for seven days resulted in a significantly higher percent graft survival than the other two regimens and a control group (64.0 +/- 9.7%, p < 0.05). The "flow-through" phenomenon was observed in this study. CONCLUSIONS: Intra-graft heparin injection resulted in a higher percent graft survival than the control group for the 25-mm-diameter circular composite graft. However, the mechanism of graft survival enhancement could not be clearly explained by this study. It is recommended that the clinical application of intra-graft heparin injection should only be used when subgraft hematoma can be avoided and systemic bleeding tendency is being closely monitored.

Animals↗

PubMed1998

Microscopic laminotomies for degenerative lumbar spinal stenosis.

In this retrospective study, we investigated 50 patients who had undergone primary lumbar microsurgical multiple laminotomy without spinal fusion for degenerative spinal stenosis. There were 31 men and 19 women with a median age of 66 years (35-85 years). Thirteen patients had grade I spondylolisthesis, most at L4-L5 levels (11 of 13). Single-level laminotomy was done in 13 patients, two levels in 30, and three levels in 7. The median follow-up period was 27 months (range, 15-48 months). A standardized self-reported questionnaire was used for clinical outcome study. The demographic data and clinical features of these patients were analyzed for the prognostic factors. The analysis showed excellent results in 18 patients, good in 16, fair in 8, and poor in 8, whereas 30 patients reported that they were very satisfied with the surgery results, 10 were somewhat satisfied, 2 were somewhat dissatisfied, and 8 were very dissatisfied. Therefore, the satisfactory rate of the surgery was higher if judged by patient satisfaction. Among the parameters analyzed, the presence of neurogenic claudication (p = 0.008), coexisting disease (p = 0.04), and the absence of motor deficit (p = 0.03) were associated with lower total scores. In addition, longer duration of symptoms (p = 0.04) was associated with less improvement of back pain score, whereas the absence of motor deficit (p = 0.004) was associated with less improvement of leg pain score. The presence of spondylolisthesis did not affect outcomes.

Adult↗

PubMed1997

Intraoperative dermatomal evoked potential monitoring fails to predict outcome from lumbar decompression surgery.

STUDY DESIGN: Thirty-three patients with single-level, unilateral lumbosacral radiculopathy underwent micro-decompression and intraoperative dermatomal evoked potential monitoring. Side-to-side latency asymmetry was calculated. A criteria for "abnormal" was defined. Intraoperative dermatomal evoked potentials were obtained before and after decompression. The changes were correlated with clinical outcome at the 3-month follow-up examination. OBJECTIVES: To determine whether intraoperative dermatomal evoked potential latency asymmetry confirms nerve root compression and whether an improvement of latency asymmetry after decompression predicts a good clinical outcome. SUMMARY OF BACKGROUND DATA: Intraoperative dermatomal evoked potential has been proposed as a test to assess the adequacy of nerve root decompression. Initial reports suggested improvement of dermatomal evoked potential amplitude and latency after decompression. The clinical efficacy is controversial because of its technical difficulty and inherent variation. METHODS: Cervical recording was chosen to reduce the effects of anesthesia. The asymptomatic nerve root was used as a control. Quality of the tracings was determined by evoked potentials-to-noise amplitude ratio. Clinical outcome was based on patient's pain relief and satisfaction. RESULTS: Tracings of acceptable quality were obtained at baseline in 57.6% (19 of 33) of patients. A side-to-side latency asymmetry > 5% was defined as abnormal. Before decompression, 68.4% (13 of 19) of patients had an abnormal dermatomal evoked potential. After decompression, latency asymmetry returned to normal in every patient. Clinical outcome was good or excellent in 13 patients, fair in four patients, and poor in two patients. Dermatomal evoked potential latency improvements were not related to variation in clinical outcome. CONCLUSIONS: Intraoperative dermatomal evoked potential monitoring is technically demanding. Finding reproducible potentials is difficult. More research is necessary before general use of dermatomal evoked potentials for monitoring nerve root decompression.

Adult↗

PubMed1997

Regulation of quantal secretion by neurotrophic factors at developing motoneurons in Xenopus cell cultures.

1. The ability of different neurotrophic factors to maintain and regulate synaptic function at the developing motoneuron was studied in Xenopus nerve-muscle co-cultures. Spontaneous synaptic currents (SSCs) were measured by using whole-cell voltage-clamped myocytes. 2. Compared with natural synapses, motoneurons without contact on a myocyte (naive neurons) released ACh in smaller quantal packets, the amplitude being inversely proportional to the days in culture. The mean SSC amplitudes of naive neurons, which were measured by manipulating a myoball into contact with the myocyte-free nerve terminals to form a manipulated synapse, were 99.5 +/- 6.7 and 48.2 +/- 1.9 pA for day-1 and day-3 cultures, respectively. 3. Chronic treatment of day-1 cultures with brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), neurotrophin-4 (NT-4), ciliary neurotrophic factor (CNTF) or glial cell line-derived neurotrophic factor (GDNF) for 2 days, increased the ACh quantal size of naive motoneurons in a concentration-dependent manner, whereas insulin-like growth factor-1 (IGF-1) and basic fibroblast growth factor (bFGF) had no effect, even at high concentrations. 4. The interaction of various neurotrophic factors was examined, using concentrations that gave maximal effects. Combination of CNTF plus BDNF or CNTF plus NT-3 had synergistic effects in potentiating SSC amplitude of the manipulated synapse of naive neurons, whereas NT-3 plus BDNF, NT-3 plus GDNF, BDNF plus GDNF or CNTF plus GDNF had no synergistic action. 5. Chronic treatment with d-tubocurarine for 2 days resulted in a reduction of the quantal size of natural synapses. Concomitant treatment with BDNF, NT-3, GDNF, CNTF but not bFGF or IGF-1, reconstituted the SSC amplitude. 6. Taken together, these findings suggest that BDNF, NT-3, NT-4, CNTF and GDNF may regulate and maintain the synaptic function of developing motoneurons, and different neurotrophic factors utilizing distinct signalling mechanisms may have synergistic actions.

Acetylcholine↗

PubMed1997

Risk of underestimation of the bone mineral density of proximal femur.

Decreased bone mineral density (BMD) in the elderly increases the risk of hip fracture. Measurement of proximal femoral BMD can help us predict the risk of hip fracture, especially in the elderly. Since the BMD of proximal femur is usually measured on the unilateral side, we studied the risk of underestimation with measurement of unilateral proximal femur BMD in 266 normal Chinese women. In order to evaluate the effect of age, these subjects were divided into group A (18-59 years, n = 189) and group B (60-88 years, n = 77). BMDs of both proximal femurs were assessed with Norland 2600 dual photon absorptiometry. Using a cutoff T score of -1, the negative predictive value (NPV) in the entire group was 86.9% for femoral neck BMD and 85.7% for trochanter, and 82.2% for Ward's triangle: in group A, the NPV was 88.9% for femoral neck, 88.8% for trochanter, and 97.2% for Ward's triangle, but in group B, the NPV was 60.0% for femoral neck, 71.0% for trochanter, and 24.1% for Ward's triangle. The accuracy in the entire group was 86.1% for femoral neck, 84.2% for trochanter, and 86.3% for Ward's triangle: in group A the accuracy was 84.6% for femoral neck, 84.9% for trochanter, and 92.8% for Ward's triangle, but in group B, the accuracy was 89.6% for femoral neck, 81.7% for trochanter, and 90.0% for Ward's triangle. In general, NPV and accuracy increased at the expense of positive predictive value when the cutoff T score was changed to -2.5. This study suggested that measurement of unilateral proximal femur BMD was sufficient for screening the contralateral hip BMD in group A at a cutoff T score of -1. However, a T score of -2.5 was recommended for group B, and one should be careful in its application to Ward's triangle.

Adult↗

PubMed1997

Vitamin D stores of urban women in Taipei: effect on bone density and bone turnover, and seasonal variation.

This study was performed to survey the vitamin D nutritional status of urban Chinese women, and to define its role in determining bone metabolic rate and bone mineral density (BMD). We measured serum 25-hydroxyvitamin D (25-OHD), the major storage form of vitamin D, and BMD, at the spine, hip, and total body skeleton, of 262 healthy Chinese women aged from 40 to 72 years, residing in Taipei city. Bone turnover markers, including serum osteocalcin, bone alkaline phosphatase isozyme, and C-terminal propeptide of type I procollagen, and a urinary bone resorption marker, N-terminal crosslinked fragment of type I collagen, were also measured. We found generally adequate vitamin D nutritional stores. The mean concentration of serum 25-OHD was 30.7 (SD = 8.2) ng/mL for all 262 subjects and there were no significant age-related changes. Those who had serum sampled during the summer showed higher serum 25-OHD levels (N = 138; mean +/- SD: 32.7 +/- 7.6 ng/mL) than those who had serum sampled during winter (N = 124; mean +/- SD: 28.5 +/- 8.3 ng/mL; Student's t-test, p < 0.001), but these two groups showed similar BMD and bone marker values. Those with serum 25-OHD concentration in the lowest or highest tertile did not show different BMD or bone marker values than those in the other tertiles. Multiple regression demonstrated no correlation between 25-OHD and any bone marker or BMD at any site. Thus, in this free-living urban Chinese population, in a subtropical region, we could not demonstrate a role of vitamin D stores in determining bone turnover rate or BMD in women aged 40-70 years.

Absorptiometry, Photon↗

PubMed1997

Bone densitometry of proximal femur in Chinese subjects: gender differences in bone mass and bone areas.

Bone mineral content (BMC), bone areas (BA), and bone mineral density (BMD) of the proximal femur were measured in 202 healthy Chinese men and 507 healthy Chinese women, aged 21-70 years, to investigate gender differences in densitometry of the femur. Densitometric values measured at the femoral neck, trochanter, and Ward's triangle were generally greater in men than women of the same age, except at Ward's triangle. While BMD decreased with aging with similar slopes of -0.2 approximately -1% per year, the actual readings were 10%-15% lower than those of Caucasian subjects of the same age and gender for Chinese men and women. Furthermore, with increasing age, trochanteric BA increased in women but not in men, and femoral neck BA increased in men but not in women. These different trends of change in bone dimensions were independent of weight or height. They may reflect a structural difference at the proximal femur and imply differences in mechanical strength, and thus may have played some roles in the different incidence of hip fractures between the elderly men and women.

Absorptiometry, Photon↗

PubMed1997

Effect of bone area on spine density in Chinese men and women in Taiwan.

Areal bone mineral density (BMD), the quotient of bone mineral content (BMC) divided by the projectional bone area (BA), measured with dual-energy X-ray absorptiometers (DXA), is the most common parameter used today to evaluate spinal osteoporosis. To evaluate whether gender, age, weight, and height can determine spinal BA, and to compare BA and analyze its effects on spinal density in the two genders, we measured BA and BMC, and calculated areal BMD, and the bone mineral apparent density (BMAD = BMD/the square root of BA) of the L-2 to L-4 vertebrae of 604 female and 223 male Chinese volunteers from 20 to 70 years of age using a Norland XR-26 DXA. Standardized for height and weight, BA showed a relatively large variation and a significant increase with increasing age in both genders. On the other hand, BMC stayed unchanged in men > 50 years of age and decreased with aging in postmenopausal women. Younger men (< 51 years) had a much larger mean BA (by 15.5%) and larger mean BMC (only 10%) than that of age-matched women. As a result, younger men had a slightly and significantly lower areal BMD (by 7.1%) and a much lower BMAD (by 16%) (p < 0.0001 for both) than premenopausal women of similar age. Men had higher areal BMD and BMAD values than age-matched women only after age 50 years. Although taller body height, heavier weight, and increasing age were associated with a larger BA, these factors could not explain most of the interindividual variations in BA in both genders. Thus anteroposterior BA of lumbar vertebrae measured with DXA seems to affect the areal BMD and BMAD readings in the two genders. The larger BA caused a low BMAD and probably underestimated the true volumetric spine density in men.

Absorptiometry, Photon↗

PubMed1997

In vivo rotational stability of the kinematic rotating hinge knee prosthesis.

The in vivo rotary laxity and torsional stiffness of the knee joint were measured in 20 patients with wide intraarticular resection of the distal femoral tumor followed by reconstruction with a custom Kinematic rotating hinge endoprosthesis. The contralateral normal knee served as natural control. Twenty patients underwent 29 measurements, including 9 at the first year, 10 at the second year (4 of these also measured at year 1), and 10 at the third year (3 of these also measured at years 1 and 2; 2 also measured at year 2). The mean followup for the 15 survivors was 134 months (range, 102-156 months). The total rotatory laxity of the hinged knee was significantly greater than that of the contralateral knee. The torsional stiffness in external rotation of the hinged knee was 30.4% less than that of the contralateral knee in the first postoperative year, whereas the torsional stiffness in internal rotation was similar to that of the contralateral knee. Torsional stiffness of the hinged knee in the second year was significantly less than that of the contralateral knee whereas it was within the normal range of stiffness in the third year. The total rotatory laxity and torsional stiffness of the hinged knee in the early postoperative years could not predict the risk of late loosening. In vitro rotational stability of the rotating hinge device with axial load bearing was 6.7 and 8.1 Newton-meters (N-m) at 0 degrees and 20 degrees knee flexion, respectively, under an axial tibial load of 945 Newtons.

Adolescent↗

PubMed1997

Flexor tendon graft for late management of isolated rupture of the profundus tendon.

BACKGROUND: Late management options for the neglected flexor tendon injury include arthrodesis, tenodesis, tendon advancement, or tendon grafting. Although the clinical outcomes of single-stage and second-stage flexor tendon grafting are satisfactory, many controversies exist. The present study retrospectively reviewed the clinical outcomes of flexor tendon grafting for 15 patients with isolated profundus rupture. METHODS: Fifteen cases of isolated rupture of the flexor profundus tendon were treated by free tendon graft. The age of the patients ranged from 13 to 21 years (mean, 17.3 years). The time from injury to operation ranged from 4 to 14 weeks (mean, 8.3 weeks). All tendon grafts were passed through the intact superficialis tendon to repair the injured profundus tendon. These patient were followed up from 14 to 62 months after treatment mean, 31.3 months). RESULTS: All but one patient had less than 3.2 cm of flexion from fingertip to mid-palmar crease. Fourteen patients achieved active distal interphalangeal (DIP) joint flexion of more than 20 degrees. Four patients developed extension loss of the proximal interphalangeal (PIP) joint of more than 30 degrees after surgery. The mean active flexion after surgery was 33 degrees (range, 15-55 degrees) for DIP joints and 91.3 degrees (range, 80-100 degrees) for PIP joints. Three patients had combined extension loss of PIP and DIP joints of more than 40 degrees for the index and middle fingers. Twelve patients (80%) had satisfactory results, whereas treatment of the other 3 patients was considered unsuccessful. CONCLUSION: Flexor tendon graft can be used to reconstruct the isolated rupture of the profundus tendon and achieve satisfactory results for properly selected patients.

Adolescent↗