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Oral administration of beta-cryptoxanthin prevents bone loss in ovariectomized rats.

The effect of beta-cryptoxanthin, a kind of carotenoid, on ovariectomy-induced bone loss was investigated. beta-cryptoxanthin was isolated from Satsuma mandarin (Citrus unshu. MARC). beta-cryptoxanthin (5 or 10 microg/100 g body weight) was orally administered once daily for 3 months to ovariectomized (OVX) rats. OVX induced a significant increase in body weight and a significant decrease in serum calcium and inorganic phosphorus concentrations as compared with those of sham-operated (control) rats. These alterations induced by OVX were significantly prevented by the administration of beta-cryptoxanthin (5 or 10 microg/100 g). The analysis using a peripheral quantitative computed tomography (pQCT) showed that OVX induced a significant decrease in mineral content and mineral density in the femoral-diaphyseal and -metaphyseal tissues and polar strength strain index in the metaphyseal tissues. These decreases were significantly prevented by the administration of beta-cryptoxanthin (5 or 10 microg/100 g). Moreover, OVX induced a significant decrease in calcium content and alkaline phosphatase activity in the femoral-diaphyseal and -metaphyseal tissues and deoxyribonucleic acid (DNA) content in the metaphyseal tissues. These decreases were significantly prevented by the administration of beta-cryptoxanthin (5 or 10 microg/100 g). This study demonstrates that beta-cryptoxanthin has a preventive effect on OVX-induced bone loss in vivo.

Administration, Oral↗

Bone density study at the distal radius, using pQCT analysis, in Greek thalassemic patients.

BACKGROUND: Expansion of marrow spaces in thalassemia patients contributes to reduced bone density and increased risk of fractures. Peripheral quantitative computed tomography (pQCT) measures the volumetric bone mineral density (vBMD) independently in different compartments. OBJECTIVE AND METHODS: To study the regional bone structure in thalassemia, we performed pQCT (XCT-2000 Scanner, Stratec Inc.) in 57 young adult patients with beta-thalassemia major, aged 21-44 years (32 females). The vBMDs (total, trabecular, cortical + subcortical), Stress-Strain Index (SSI) and the cross-sectional area (CSA) were determined at the "4% site" of the distal radius; data were compared to reference values. RESULTS: Total vBMD, trabecular, cortical plus subcortical vBMD in thalassemics were significantly lower than in healthy adults (p<0.005). Thalassemic males had significant higher values of vBMD, SSI and CSA than females (p<0.005). CONCLUSIONS: In Greek thalassemic patients a significant reduction in bone density, associated with increased morbidity and risk of fractures, has been detected on pQCT examination.

Adult↗

Paraarticular trabecular bone loss at the ultradistal radius and increased arterial stiffening in postmenopausal patients with rheumatoid arthritis.

OBJECTIVE: We recently reported enhanced arterial thickening in patients with rheumatoid arthritis (RA) and the importance of increased bone resorption in this process. Our aim was to examine whether arterial stiffening, another aspect of atherosclerosis, is also increased in patients with RA, and to determine if it is an important risk factor. METHODS: The subjects were 47 patients with RA and 49 healthy controls, all postmenopausal women. Subjects having risk factors for atherosclerosis were excluded. Femoral-ankle (fa) pulse wave velocity (PWV) and brachial-ankle (ba) PWV were measured in all patients using a waveform analyzer. Bone mineral density (BMD) at the ultradistal radius was assessed by peripheral quantitative computed tomography. Inflammation markers (C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, platelet count) and bone resorption markers (urinary excretion of deoxypyridinoline and N-terminal telopeptide) were also measured. RESULTS: The median values of faPWV and baPWV in RA patients were 1124 cm/s [interquartile range (IQR) 1040-1175] and 1539 cm/s (IQR 1297-1738), respectively, which were significantly greater than the respective values of 982 cm/s (IQR 819-1054; p < 0.001) and 1322 cm/s (IQR 1112-1398; p = 0.004) in controls. In multiple regression analysis, the presence of RA emerged as an independent factor associated with the greater faPWV and baPWV when adjusted for age, blood pressure, and smoking. In RA patients alone, BMD in the trabecular bone component, but not for the total bone (cortical plus trabecular), at the ultradistal radius correlated significantly with both faPWV and baPWV. Multiple regression analysis showed that trabecular BMD at the distal radius was a significant factor independently associated with greater faPWV and baPWV when adjusted for age, blood pressure, and smoking. None of the measured inflammation markers or bone resorption markers correlated with either faPWV or baPWV in patients with RA. CONCLUSION: Patients with RA show increased arterial stiffening, in addition to the arterial thickening we have previously reported, supporting the notion of enhanced atherosclerosis in RA patients. Paraarticular bone loss in the trabecular bone component at the ultradistal radius is a factor significantly associated with increased arterial stiffening in RA patients.

Amino Acids↗

In vivo axial dynamization of canine tibial fractures using the Securos external skeletal fixation system.

Bilateral transverse mid-shaft tibial osteotomies, with a 4-mm gap, were performed in purpose-bred research dogs and stabilized using a Securos Type 2 external skeletal fixotor (ESF). Full (100%) axial dynamization of one randomly selected ESF in each dog was performed at 31 days postoperatively. Caudo-cranial radiographs were obtained at weekly intervals, which were qualitatively and quantitatively evaluated (densitometry and ImageJ analysis). The dogs were euthanatized 13 weeks postoperatively, at which time dual energy x-ray absorptiometry (DEXA), peripheral quantitative computed tomography (pQCT), mechanical testing in torsion, and qualitative histological analysis were performed. A two-tailed paired Student's t-test was performed for statistical analysis of all parameters of interest, with significance set at p < 0.05. Three of five dynamized bones bridged quicker, and four of five dynamized bones appeared to have greater callus formation, however, statistically significant differences could not be definitively determined. Statistically significant differences were not found with densitometry (any time frame), DEXA, pQCT, torsional stiffness or maximum torque. Despite the lack of statistically relevant data, trends were observed with larger callus size and density in the dynamized tibiae. The dynamized tibiae appeared to fracture more consistently outside of the area of the healing callus as compared to the control tibiae. Histological evaluation showed greater remodelling in four of five control limbs when compared to the dynamized limb. Dynamization at 31 days post-operatively may delay bone remodelling, despite a trend towards a larger callus size. The results of this study failed to show a definitive role for early full axial dynamization.

Animals↗

Designing screened enclosures: Part III.

The engineer will be able to design a successful screened enclosure using careful selection of materials, gaskets and, if necessary, screened optical windows. Many of the techniques covered in this series of articles can be employed during the research and development stage to arrive at a cost-effective solution that offers the required mechanical, aesthetical, environmental and electrical properties.

Computer Peripherals↗

Evaluation of CoViSTA - an automated vital sign documentation system - in an inpatient hospital setting.

The aim of this study was to compare the efficiency and acceptance of the CoViSTA system with the current practice of collecting vital signs. CoViSTA (Computerized Vital Sign Transfer Application) was designed to integrate with the existing hospital network and automate the process of vital sign data entry in hospital wards. The system was evaluated with 6 nurses across 60 patients and was found to significantly reduce errors, improve efficiency and increase satisfaction among the staff.

Adult↗

The muscle-bone unit in adulthood: influence of sex, height, age and gynecological history on the bone mineral content and muscle cross-sectional area.

Bone and muscle development are both strongly influenced by sex hormones. The purpose of this study was to examine the changes in bone and muscle parameters (bone mineral content - BMC, muscle cross-sectional area - MA) in 130 men aged 31 -60 years, and in 180 pre-menopausal women aged 30-53 years with respect to age, body height and, with the women, their gynecological history (age-at-menarche, number of pregnancies, duration of lactation and use of oral contraception). The study was performed using peripheral quantitative computed tomography (pQCT) at a 65% site of the forearm length. Both BMC and MA were dependent on body height (p<0.0001), but not on age. The BMC/MA ratio was dependent neither on age nor on body height in both genders. MA as well as BMC were found significantly higher in males than in females (p<0.0001 for both variables). We observed a significantly higher BMC/MA ratio in females than in males (p<0.0001). We found no effect either of the analyzed variables of gynecological history on bone/muscle characteristics. The findings highlight the necessity of involving height-adjusted parameters and BMC/MA ratio into bone analysis in adults.

Adult↗

Persistent osteopenia in adolescent idiopathic scoliosis--longitudinal monitoring of bone mineral density until skeletal maturity.

The aim of this study was to monitor BMD changes occurring during periods of rapid growth and to investigate whether osteopenia was a persistent phenomenon in skeletally matured AIS girls. 196 AIS Chinese girls and 122 healthy controls, aged 11-16, were follow-up for 3.5 years. Bilateral femoral neck bone mineral density (BMD) and volumetric BMD (vBMD) of the distal tibia were obtained by dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). Osteopenia was defined if the age-adjusted BMD was below or equal to -1 standard deviation (SD). The average age at the final follow-up was 16.8 years old. The median initial Cobb angle for this group of patients was 26 degrees. The prevalence of osteopenia at the baseline measurement was 35.9%. Longitudinal BMD results demonstrated that 86.0% of osteopenic AIS girls had persistently low BMD at the time of skeletal maturity (age of 16). vBMD of distal tibia of AIS was significantly lower than that of the controls throughout the age of 13 to 17 during the period of rapid growth. In addition, there were also significant differences in vBMD among AIS (moderate and severe group) and the controls by one-way ANOVA (p<0.05). The present study for the first time revealed that over 86% of osteopenic AIS patients had persistently low BMD, at both distal tibia and femoral neck regions, at the time of skeletal maturity. Early detection and treatment of AIS-related osteopenia might help in maximizing peak bone mass during peripubertal growth that thereby minimizing risks of developing osteoporotic fractures later in life.

Adolescent↗

Lower degree of mineralization found in cortical bone of adolescent idiopathic scoliosis (AIS).

UNLABELLED: A lowered bone mineral density (BMD) was observed in trabecular bone in a significant number of AIS patients. The present study aims at investigating whether lower BMD is a systemic phenomenon, which would also be present in the cortical component of long bone. SUBJECTS AND METHODS: 78 AIS girls (age:15-18y.o) with either moderate (Cobb: 20-40) or severe (Cobb: >40) curve and 44 age-matched controls were recruited. The BMD of the distal region and the mid-shaft of radius were measured with a multi-layer peripheral quantitative computed tomography (pQCT). The trabecular bone and cortical bone BMD and the morphology of mid-shaft were compared. RESULTS: Both trabecular and cortical BMD in severe AIS group was significantly lower than the control by 8.7% and 1.7% (p<0.05 for both), respectively. However, the cortical bone area of the mid-shaft did not show any differences from the normal control subjects. DISCUSSION: This study demonstrates a systemic low BMD including the cortical bone. It is suggested that AIS girls may have disturbance in mineralization and ossification during peripubertal growth.

Adolescent↗

Geometry and bone density.

Bone development is a key process in the growing child. It is, therefore, of paramount importance to survey this process, which is characterized by increasing length and size of the bone together with its progressive mineralization. The bone status can be evaluated by different techniques, each of them having its pros and cons. Furthermore, it should be underlined that the results of bone assessment depend not only from the employed technique but also from the auxological characteristics of the subjects. It is, therefore, the aim of this review to examine the characteristics of the various methods of bone evaluation, such as dual energy X-ray absorptiometry (DEXA), peripheral quantitative computed tomography (pQCT), ultrasound and metacarpal index and to explain how changes in bone structure and geometry may influence the results.

Absorptiometry, Photon↗

Effect of a single botulinum toxin injection on bone development in growing rabbits.

Intramuscular injections with botulinum toxin A (BTX-A) lead to a rapid decrease in muscle mass and force, but the effect of this drug on bone development is unclear. In the present pilot study we evaluated the effect of a one-time injection of BTXA in growing rabbits. Twelve young (weight 1.5 kg) New Zealand rabbits were randomly assigned to receive either BTX-A (total dose 8 units per kg body weight) or sodium chloride 0.9% injections into the left quadriceps and gastrocnemius muscles. Both groups continued to gain weight in a similar manner following the injection. However, when the animals were sacrificed at five weeks after the injection, the group receiving BTX-A had a significant deficit (of 10%) in gastrocnemius muscle mass on the injected side, whereas no significant side-difference was found for the quadriceps. BTX-A injections did not affect the length of the tibia. Nevertheless, bone mineral content of the whole tibia, as measured by dual-energy X-ray absorptiometry, was 7% lower in the BTX-A injected side than on the contralateral side. Peripheral quantitative computed tomography showed that this bone mass deficit was larger in the metaphysis than in the epiphysis or diaphysis. In the diaphysis, the bone mass deficit was due to a reduction in cross-sectional bone dimensions, which equally affected the cross-section of the entire bone, the cortical compartment and the marrow space. BTX-A injections did not have a detectable effect on cortical bone mineral density. The bone mass deficit in the diaphysis thus appeared to be caused by a lack of periosteal bone apposition rather than increased endocortical or intracortical resorption. These preliminary data suggest that intramuscular BTX-A injections can have a deleterious effect on the development of bones that are loaded by the injected muscles.

Animals↗

Effects of joint unloading and reloading on human cartilage morphology and function, muscle cross-sectional areas, and bone density - a quantitative case report.

Recent studies have shown that thinning of human cartilage occurs with unloading, but no data are available on the effect of remobilization (after immobilization) on knee joint cartilage status in humans. We examined a 36-year-old patient after 6 weeks of unilateral immobilization. Knee joint cartilage morphology (patella and tibia), patellar cartilage deformation, and thigh muscle cross-sectional areas were assessed with quantitative MR imaging and bone density with peripheral quantitative computed tomography (pQCT) during 24 months of remobilization. The immobilized limb displayed lower muscle cross-sectional areas (MCSA) of the knee extensors (-36%), lower bone density of the femur and tibia (-12/-6%), lower patellar cartilage thickness (-14%), but no side differences of tibial cartilage thickness. During remobilization, side differences decreased to -4% for knee extensor MCSAs, to -6%/-3% for femoral and tibial BMD, and to -8% for patellar cartilage thickness. No change was observed in tibial cartilage. Patellar deformation decreased from 9% to 4% after 15 months. In conclusion, we observed substantial changes of thigh MCSAs, but little (patella) to no (tibia) change in cartilage thickness during remobilization. These preliminary results indicate that human cartilage macro-morphology may be less adaptive to variations of the mechanical loading than muscle and bone.

Adult↗

The need and user requirements for integrating images with radiology reports.

Radiology reports are likely to be more useful if they contain appropriate graphic material. Diagnostic conclusions and recommendations become more convincing and useful when the clinician personally can review the image on which these are based. Modern desk-top publishing techniques make it possible to incorporate radiographic images, appropriately selected and annotated, as part of the radiology report. It is believed that such illustrated reports would be preferred by referring physicians, notwithstanding a significant loss of image detail. A survey of these referring physicians was carried out to determine whether this hypothesis was correct.

Computer Peripherals↗

Optical mark reader technology and data base development in anesthesiology and critical care medicine at the Johns Hopkins Medical Institutions.

The Department of Anesthesiology and Critical Care Medicine (DACCM) has substantially upgraded its computer resources within the past two years by installing a local area network (LAN) and replacing low-end PC's with PC's utilizing Intel 80286 or 80386 microprocessor technology. Data base development has now become a priority. Data bases are being developed for both clinical and administrative purposes. We are replacing the traditional method of "keypunching" with optical card scanners which results in faster and more accurate data entry directly into the data bases. Previously, such card scanners have been confined to large organizations. We describe a method of data capture and data base development with wide applicability in medicine.

Anesthesiology↗