On reducing hand impact force in forward falls: results of a brief intervention in young males.

OBJECTIVE: To test the working hypotheses that after a brief (10 min) intervention, (a) young adults can volitionally reduce fall-related wrist impact forces, and (b) no difference in impact force would exist between intervention and control groups at 3-weeks or 3-months follow-up. BACKGROUND: The wrist is the most commonly fractured site in the body at any age, most often as a result of impact with the ground while arresting a forward fall.Methods. Twenty-nine healthy young male volunteers participated. A 3-month intervention group (n=10) performed five standardized forward falls before and after a 10-min instructional intervention aimed at reducing wrist impact forces during the baseline visit. They, along with a 3-month control group (n=11) who did not receive the intervention, were remeasured in five trials at 3-weeks and 3-months follow-up, without intervening practice. A baseline control group (n=8) performed the five trials, then repeated them at the baseline visit without receiving the intervention. Unilateral body segment kinematics and bilateral hand-ground impact forces were measured and the hypotheses were tested using repeated measures analysis of variance. RESULTS: At the baseline visit, a significant group-by-trial-block interaction was found (P=0.02): the 3-month intervention group reduced their average maximum impact forces by 18% from initial values (P=0.002); the baseline control group did not do so (0.5% increase, P=0.91). The 3-month intervention (20 falls) and control (15 falls) groups did not differ at the 3-month follow-up (P=0.62); however, when the groups were combined their maximum impact force had decreased significantly (8.9%, P=0.04) over that time. CONCLUSIONS: Healthy young males learned in 10 min to significantly reduce wrist impact forces in forward falls, but retention was poor at 3-weeks follow-up. Irrespective of group, however, after the 5 falls at 3-weeks subjects had taught themselves to reduce their impact forces at the 3-months follow-up. RELEVANCE: A brief educational intervention can significantly reduce forward fall-related impact forces in the short term. However, with or without the brief intervention, the experience of performing between 5-10 forward falls 3 weeks apart apparently resulted in decreased impact forces over the next 2 months, thereby reducing the risk of injury in these forward falls.

Hip fracture prevention trial using hip protectors in Japanese nursing homes.

A method to protect the hips during falls could effectively reduce the incidence of hip fractures. We report the results of the first hip protector trial in Japan, performed between July 1996, and September 1999. One hundred and sixty-four elderly female residents of nursing homes, with Activities of Daily Living above the wheelchair level, agreed to participate in this study. Among them, 88 were randomly selected to wear a hip protector and 76 controls did not. All falls and resulting injuries were recorded daily. In anthropometric measurements and ultrasonic bone evaluation, no significant differences were found between the two groups, except in height. During an average of 377 days, the wearers and the non-wearers fell a total of 131 and 90 times, respectively. Among the wearers, there were two non-hip fractures and one hip fracture, so the annual hip fracture rate was calculated at 1.2%, against 8 hip fractures among the non-wearers, or 9.7% per year. The hip fracture rate was significantly lower among the wearers than non-wearers, while the annual number of falls per subject and the distribution of fallers remained the same. According to Cox's proportional hazard regression analysis, the effect of the hip protector on hip fracture prevention was independent of anthropometric data, ultrasonic bone assessment values or number of falls. Moreover, even after limiting the subjects to fallers only, the annual hip fracture rate in non-wearers was higher than in wearers (19.8% vs 2.0%) and the annual hip fracture rate per fall in wearers was lower than that in non-wearers (0.8% vs 8.2%). It was thus concluded that the hip protector is a beneficial device for the prevention of hip fractures.

Association of transforming growth factor beta1 genotype with spinal osteophytosis in Japanese women.

OBJECTIVE: To examine the possible relationship between a T-->C polymorphism at nucleotide position 29 of the transforming growth factor beta1 (TGFbeta1) gene and genetic susceptibility to radiographic spinal osteophytosis. METHODS: A total of 540 postmenopausal Japanese women were subjected to radiography of the spine and determination of bone mineral density (BMD) for the lumbar spine and total body. Changes in lumbar intervertebral discs were examined in 67 individuals with either osteoporosis or spinal osteophytosis by magnetic resonance imaging (MRI). TGFbeta1 genotype was determined with an allele-specific polymerase chain reaction assay. The serum concentration of TGFbeta1 was measured in 29 control subjects and in 36 patients with spinal osteophytosis. RESULTS: Among all study subjects, the prevalence of radiographic spinal osteophytosis in individuals with the CC genotype was greater than that in those with the TC or TT genotype. Logistic regression analysis, adjusted for age, height, body weight, time since menopause, smoking status, body fat, lean mass, and either lumbar spine or total body BMD, demonstrated that the frequency of the C allele in subjects with spinal osteophytosis was significantly greater than that in those without this condition. Comparison among control, osteoporosis, and spinal osteophytosis groups also revealed that the C allele was more prevalent in subjects with osteophytosis than in controls, even after adjustment for BMD. In contrast, as previously shown, the frequency of the C allele was lower in osteoporosis patients than in controls. The intervertebral disc area and the ratio of disc area to vertebral body area, as determined by MRI, were also lowest in subjects with the CC genotype. The serum concentration of TGFbeta1 increased with the number of C alleles in both controls and patients with spinal osteophytosis. CONCLUSION: The T29-->C polymorphism of the TGFbeta1 gene exhibited inverse patterns of association with genetic susceptibility to spinal osteophytosis and with osteoporosis. Although radiographic evaluation of osteophytes might not reflect the actual disease severity, the C allele, which protects against osteoporosis, may be a risk factor for genetic susceptibility to spinal osteophytosis.

Effect on the femur of a new hip fracture preventive system using dropped-weight impact testing.

To reduce hip fractures during falls, we devised a new hip fracture preventive system to attenuate impact on the greater trochanteric region and studied the effects of the system on the femur. Twelve coupled, embalmed, cadaveric femora were used. Right femora were fractured without protection as a control and compared with left femora covered by the protection system, which consisted of a silicone gel pad or the silicone gel pad combined with a resin cover. The impact of a fall was simulated by mounting a femur in the horizontal plane and dropping an 8.4 kg mass on its greater trochanteric region. The impact load and time were measured using a load cell within the mass. The maximum strain during impact at the inferior side of the femoral neck was determined from an attached strain gauge. Trochanteric fractures were produced in 18 of the 24 femora (75%). The mean impact load for a drop height of 25 cm was reduced from 3117 N to 2176 N by silicone gel (p < 0.01) and to 1681 N by the addition of the resin cover (p < 0.01). The mean maximum strain was similarly reduced from 2276 microvarepsilon to 1872 microvarepsilon (p = 0.15) and to a mean 1559 microvarepsilon (p < 0. 05). The mean impact time was prolonged from 13 ms to 20 ms (p < 0. 01) and 22 ms (p < 0.01), respectively. The effect of the cover became more conspicuous as height increased. We concluded that the silicone gel pad provided effective impact attenuation, and the addition of the rigid cover was even more effective for impact reduction. This system was thought to be clinically useful in preventing hip fractures.

Association of a polymorphism of the transforming growth factor-beta1 gene with genetic susceptibility to osteoporosis in postmenopausal Japanese women.

Transforming growth factor-beta (TGF-beta) is both abundant in bone and an important regulator of bone metabolism. A T-->C transition at nucleotide 29 in the signal sequence region of the TGF-beta1 gene results in a Leu-->Pro substitution at amino acid position 10. The possible association of this polymorphism with bone mass and the prevalence of osteoporosis has now been investigated in a total of 287 postmenopausal women from two regions (Obu City, Aichi Prefecture, and Sanda City, Hyogo Prefecture) of Japan. A significant association of TGF-beta1 genotype with bone mass was detected in both populations; bone mineral density (BMD) at the lumbar spine was greater in individuals with the CC genotype than in those with the TT or TC genotype. The frequency of vertebral fractures was significantly lower in individuals with the CC genotype than in those with the TC or TT genotypes. For each region, multivariable logistic regression analysis revealed that the frequency of the T allele was significantly higher in subjects with osteoporosis than in controls. Also, the serum concentration of TGF-beta1 in individuals with the CC genotype was significantly higher than that in age-matched subjects with the TC or TT genotype in osteoporotic or osteopenic as well as healthy control groups. These results suggest that the T/C polymorphism of the TGF-beta1 gene is one of the genetic determinants of bone mass and that the T allele is an independent risk factor for the genetic susceptibility to osteoporosis in postmenopausal Japanese women. Thus, analysis of the TGF-beta1 genotype may be useful in the prevention and management of osteoporosis.

Genetic profile of the SMXA recombinant inbred mouse strains revealed with restriction landmark genomic scanning.

We have applied the restriction landmark genomic scanning (RLGS) method to the SMXA recombinant inbred (RI) mouse strain set to reveal its detailed genetic profile. A total of 663 polymorphic RLGS spot loci were identified, 576 of which were assigned to chromosomes. Strain distribution patterns (SDPs) at 55 microsatellite marker loci were also obtained. As a result, the total number of loci with distinct SDPs on chromosomes increased to 400. These loci were dispersed on all chromosomes, except for the Chromosome (Chr) Y, and effectively covered the genome with an average spacing of 4 cM. The SMXA RI strain set, hereby, would be of value for genetic study.

Correlation between bone mineral density and intervertebral disc degeneration.

STUDY DESIGN: Intervertebral disc area, disc bulge ratio, and bone mineral density were measured in 86 postmenopausal women and the data analyzed. OBJECTIVE: To examine quantitatively the correlation between intervertebral disc degeneration and bone mass. SUMMARY OF BACKGROUND DATA: In results of previous studies, an inverse correlation between osteoporosis and spondylosis has been reported. In these studies, only radiographic findings were used to evaluate spondylosis; changes in the intervertebral disc itself were not investigated. METHODS: To determine bone mass, total-body bone mineral density, lumbar bone mineral density, and age-matched control values of bone mineral density were measured by dual-energy X-ray absorptiometry in all cases. To evaluate intervertebral disc degeneration, disc area and disc bulge ratio (calculated by measuring the areas protruding from lines connecting the middle points of the anterior and posterior borders of the vertebral bodies) were obtained from four discs, using magnetic resonance images of the lumbar spine. The correlation between bone mass data and disc area data was analyzed. RESULTS: Bone mineral density showed a significant decrease with increasing age. Disc area and disc bulge ratio had no relation to age. There was a negative correlation between total-body bone mineral density, lumbar bone mineral density, and age-matched control values versus disc area, and a positive correlation between all bone mineral density data and the disc bulge ratio. CONCLUSIONS: According to the results of the analysis by disc morphology and bone mass, especially total body bone mineral density, bone mass has an inverse correlation to intervertebral disc degeneration--i.e., reduction and disc bulge--which is important when considering degenerative spinal diseases and osteoporosis.

Restriction landmark genomic scanning (RLGS-M)-based genome-wide scanning of mouse liver tumors for alterations in DNA methylation status.

Restriction landmark genomic scanning for methylation (RLGS-M) was used to detect, and subsequently clone, genomic regions with alterations in DNA methylation associated with tumorigenesis. Use of a methylation-sensitive enzyme for the landmark cleavage allows analysis of changes in methylation patterns. In this study, we used RLGS-M to analyze SV40 T antigen-induced mouse liver tumors derived from interspecific F1 hybrids between Mus spretus (S) and C57BL/6 (B6). Because 575 S- and B6-specific RLGS loci/spots have been mapped, tumor-related alterations in the RLGS profile could be immediately localized to specific chromosomal regions. We previously found that the loss of contiguous loci/spots could be attributed primarily to DNA loss, whereas loss of solitary loci/spots could be attributed primarily to DNA methylation. In this study, we examined 30 mouse liver tumor samples for loss of the 507 mapped loci/spots. Fourteen solitary loci/spots found to be absent or reduced in more than 75% of tumor samples were cloned and subjected to DNA sequence analyses. Two loci were identified as alpha4 integrin and p16/CDKN2, genes reported to be involved in tumorigenesis. Thus, RLGS-M can detect alterations in the methylation status of known tumor suppressor genes and provide a method for detecting and subsequently cloning novel genomic regions that undergo alterations in methylation during tumorigenesis.

Linkage map of Syrian hamster with restriction landmark genomic scanning.

We have constructed the linkage map with precise genetic analysis of the Syrian hamster, Mesocricetus auratus, according to the restriction landmark genomic scanning (RLGS) spot mapping method. Although only 3.2-6.6% of the total RLGS spots between the two strains, ACN and BIO 14.6, showed genetic variance, 572 loci were found to be polymorphic. Out of 569 RLGS loci and 3 other loci, 531 were mapped with the backcross (ACN x BIO 14.6) F1 x BIO 14.6. The cumulative map was 1111.6 cM, indicating that the spots/loci are located throughout the genome at 1.94 cM intervals on average. Thus, RLGS provides us with a rapid tool to construct the genetic map of any species, even if it has less genetic variation.

Five candidate genes for hamster cardiomyopathy did not map to the cardiomyopathy locus by FISH analysis.

The Syrian cardiomyopathic hamster (BIO14.6), that develops both muscular dystrophy and progressive cardiomyopathy, is widely used as an animal model of autosomal recessive cardiomyopathy mimicking human hypertrophic cardiomyopathy, and five genes have been proposed as strong candidates for the cause of cardiomyopathy. We recently mapped the cardiomyopathy locus of the hamster to the centromeric region of chromosome 9qa2.1-b1 by construction of a genetic linkage map of the Syrian hamster. Thus, we analyzed the loci of the five candidate genes, alpha tropomyosin, cardiac troponin T, adhalin, calpain 3 and cardiac myosin binding protein-C, by the FISH method, and found that these genes were mapped on the distal portion of chromosome 12qa5 and 4pa2 and the proximal portion of chromosomes 9qb7, 1qc1.1 and 1qb3, respectively. These results provide strong evidence that the five candidate genes previously proposed are not related to the hamster cardiomyopathy.

A genetic linkage map of the Syrian hamster and localization of cardiomyopathy locus on chromosome 9qa2.1-b1 using RLGS spot-mapping.

The Syrian cardiomyopathic hamster (BIO14.6) has an inherited form of progressive myocardial necrosis and congestive heart failure. Although widely studied as an animal model for human hypertrophic cardiomyopathy, further genetic analysis has been limited by a scarcity of DNA markers. Until now, only six autosomal linkage groups have been described and the number of polymorphic loci was extremely limited. In this study, we applied the restriction landmark genome scanning (RLGS) spot-mapping method to construct a genetic map of the Syrian hamster (Mesocricetus auratus) using 72 back-cross progeny. Although the polymorphic rate is very low (3-7%) between the strains, 531 polymorphic spots/loci were mapped, showing the power of this approach and reasonable applicability to other organisms lacking a well-defined genetic map. Further, the spot markers which flank the cardiomyopathy (cm) locus were cloned to determine the chromosomal location of cm by fluorescent in situ hybridization (FISH) analysis, resulting in the assignment of the locus to the centromeric region of hamster chromosome 9qa2.1-b1. Several candidate genes responsible for hypertrophic cardiomyopathy in humans have been excluded.

Loss of heterozygosity in chromosomes 1, 5, 7 and 13 in mouse hepatoma detected by systematic genome-wide scanning using RLGS genetic map.

We have developed an RLGS-based scanning system to detect DNA alteration in tumor tissues, using 575 mapped spots/loci in a single gel. This system is very powerful for screening and identifying not only loss of heterozygosity (LOH) but also DNA methylation change. In this study, we applied this system to search for the LOH of hepatoma from an interspecific F1 hybrid between Mus spretus and C57BL/6 with SV40 early T antigen transgene connected to a mouse major urinary protein enhancer/promoter. Comparing the RLGS profiles of each tumor to that of the normal tissue showed significant LOH in chromosomes 1, 5, 7 and 13.

Direct detection and isolation of restriction landmark genomic scanning (RLGS) spot DNA markers tightly linked to a specific trait by using the RLGS spot-bombing method.

We have developed a technique for isolating DNA markers tightly linked to a target region that is based on RLGS, named RLGS spot-bombing (RLGS-SB). RLGS-SB allows us to scan the genome of higher organisms quickly and efficiently to identify loci that are linked to either a target region or gene of interest. The method was initially tested by analyzing a C57BL/6-GusS mouse congenic strain. We identified 33 variant markers out of 10,565 total loci in a 4.2-centimorgan (cM) interval surrounding the Gus locus in 4 days of laboratory work. The validity of RLGS-SB to find DNA markers linked to a target locus was also tested on pooled DNA from segregating backcross progeny by analyzing the spot intensity of already mapped RLGS loci. Finally, we used RLGS-SB to identify DNA markers closely linked to the mouse reeler (rl) locus on chromosome 5 by phenotypic pooling. A total of 31 RLGS loci were identified and mapped to the target region after screening 8856 loci. These 31 loci were mapped within 11.7 cM surrounding rl. The average density of RLGS loci located in the rl region was 0.38 cM. Three loci were closely linked to rl showing a recombination frequency of 0/340, which is < 1 cM from rl. Thus, RLGS-SB provides an efficient and rapid method for the detection and isolation of polymorphic DNA markers linked to a trait or gene of interest.

An expanded system of restriction landmark genomic scanning (RLGS Ver. 1.8).

The restriction landmark genomic scanning (RLGS) method is a high-speed genome scanning system which is based on the concept that restriction enzyme sites can be used as landmarks throughout the genome. It employs direct end-labeling of the genomic DNA digested with a rare-cutting restriction enzyme, followed by high-resolutional two-dimensional electrophoresis. Recently, this system was further developed to lower cost and to simplify the procedure. This paper reviews the RLGS principle and the breakthroughs enabling its further development. Also presented is the precise protocol of the newest version (RLGS Ver. 1.8) that offers cost effectiveness and an expanded production system. Finally, the advantages of this new RLGS method and prospects for its widespread application are discussed.

Genetic mapping of restriction landmark genomic scanning loci in the mouse.

Restriction landmark genomic scanning (RLGS) was originally proposed as a high-speed method for surveying a large number of restriction landmarks in genomic DNA. The effort to apply this method to genetic analysis has been made, resulting in developing the new approach for the rapid construction of the genetic map of complex mammalian genomes (RLGS spot mapping). Especially, the use of NotI as the restriction landmark for genetic studies suggests that there is a high probability that a significant number of these RLGS loci will be associated with CpG islands of functional genes. Moreover, it is possible to use the RLGS spot mapping to analyze genetic map-poor species very rapidly for linkage of recessive mutations or segregating traits, because it does not rely upon cloned probes or sequences. In this paper, we summarize the progress that has been made in the practical application of the RLGS method to genetic analysis using congenic strains, recombinant inbred (RI) strains, and in interspecific backcrosses of mice.

A single gel analysis of 575 dominant and codominant restriction landmark genomic scanning loci in mice interspecific backcross progeny.

We identified 575 new NotI landmarks of C57BL/6(B)- and M. spretus (S)-specific, dominant and codominant loci which were segregated in B x S interspecific backcrosses (BSS), using the restriction landmark genomic scanning (RLGS) spot mapping method. All of these loci were visualized on a single RLGS profile which was produced with NotI-PvuII-PstI. These landmarks include 250 newly identified S-specific spots in addition to the previously reported 325 B-specific spots. The S-specific spots were identified by reading full or half intensity, based on the property that the spot intensity of the autoradiographic signal reflected the copy number of an end-labeled restriction landmark. The cumulative map is 1341 cM and it is based upon 985 meiotic events in 72 backcross progeny. This map covers 90% of the total estimated length of the mouse genetic map. This map provides a good tool for the high-speed genome scanning assay in the mouse genome by a single RLGS gel analysis.

A genetic linkage map of the mouse using an expanded production system of restriction landmark genomic scanning (RLGS Ver.1.8).

We have developed an expanded system (RLGS Ver.1.8) for producing RLGS patterns that result in a 16-fold increase in the number of gels produced and a 10-fold reduction in the total cost per gel. The major modifications include: 1) performing the blocking and labeling step without phenol extraction or ethanol precipitation; 2) minimizing the reaction volume and the enzyme units in each step; 3) developing a long vertical agarose disc gel electrophoresis for the 1st-dimension; and 4) developing a new apparatus for multiplex vertical 2nd-dimensional electrophoresis. RLGS Ver.1.8 was used with a new combination of restriction enzymes to identify variation for 209 loci between C57BL/6J and DBA/2J. Twenty-six BXD RI strains were analyzed and 195/209 loci were genetically mapped. These loci were mapped in one week of laboratory work by two people. This system provides an important tool for the genetic analysis of new loci in similar genetic resources.

Application of the RLGS method to large-size genomes using a restriction trapper.

We developed a method for producing restriction landmark genomic scanning (RLGS) profiles of large-size genomes, such as those of higher plants or amphibians using a restriction trapper. Use of the conventional RLGS method is limited to genomes smaller than 3 x 10(9) bp, because the larger genomic DNAs, especially those of more than 1 x 10(10) bp, produce high background due to incorporation of radioactivity at non-specifically damaged sites. Our new method reduces the background levels by reducing genome complexity to 1/200-1/300 using a purification step to enrich DNA fragments carrying specific restriction landmarks at their ends using a restriction trapper. This step makes it possible to obtain RLGS patterns of larger genomes. Our paper describes the practical application for the RLGS method using a restriction trapper with the pine tree genome (3 x 10(10) bp/haploid genome; Pinus koraiensis Sieb. et Zucc.) as an example.

Identification of an imprinted U2af binding protein related sequence on mouse chromosome 11 using the RLGS method.

A new imprinted gene has been discovered in mice using the technique of restriction landmark genomic scanning (RLGS) with methylation sensitive enzymes. Eight out of 3,100 strain-specific NotI and BssHII spots were identified as imprinted in reciprocal F1 hybrids. Subsequently, we isolated a genomic clone for one locus on proximal chromosome 11 near the Glns locus, an imprinted region in uniparental disomic mice, and its corresponding cDNA clone. Expression of this transcript from the paternal allele was established using RT-PCR of reciprocal F1-hybrid mice. The amino-acid sequence deduced from the cDNA showed significant homology to the U2 small nuclear ribonucleoprotein auxiliary factor 35 kDa subunit.

Molecular cloning of polymorphic markers on RLGS gel using the spot target cloning method.

A new method for target cloning of DNA fragments corresponding to spots on the two-dimensional restriction landmark genomic scanning (RLGS) profile has been developed (targeted spot cloning). We used a Not I restriction trapper to select target DNA fragments from Not I, Eco RV double digests of genomic DNA. The use of the restriction trapper substantially reduces the background clones that are established from the direct recovery of RLGS spot DNA from the two-dimensional gels. Genomic DNA clones were isolated in this study as mouse genome markers for 58 spot loci that were previously characterized using RLGS spot mapping. This method provides a powerful tool for isolating DNA clones after their identification by RLGS system.