Agreement between different methods of measuring height in elderly patients.

BACKGROUND: The present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients. METHODS: Fifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height. RESULTS: The measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to -4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to -9.8 cm and +9.4 to -6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to -9.3 cm. CONCLUSIONS: When measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort.

CHARACTERIZATION OF A LITHIUM FORMATE EPR-DOSIMETRY SYSTEM FOR PROTON RADIATION THERAPY.

The specific aim for the characterization of the lithium formate dosimetry system is to determine response and stability in a proton beam. The long-term goal for this investigation is an audit system for proton therapy like the end-to-end dose determinations performed for radiotherapy with photons. For a 150-MeV proton beam, the dose response was found to be linear in the dose interval 0-8.8 Gy. The accuracy of dose reconstruction was controlled in a blind test, in which the dose of 6.63 Gy was measured in samples irradiated with a real dose of 6.70 Gy. The stability was determined by irradiations of sets of four dosimeters every week during 1 month and analyzed at the same day thereafter. The fitting of the fading curve was done with a second-order polynomial resulting in a 6.6% lower value compared to the reference after 31 d.

Guided bone regeneration using individualized ceramic sheets.

Guided bone regeneration (GBR) describes the use of membranes to regenerate bony defects. A membrane for GBR needs to be biocompatible, cell-occlusive, non-toxic, and mouldable, and possess space-maintaining properties including stability. The purpose of this pilot study was to describe a new method of GBR using individualized ceramic sheets to perfect bone regeneration prior to implant placement; bone regeneration was assessed using traditional histology and three-dimensional (3D) volumetric changes in the bone and soft tissue. Three patients were included. After full-thickness flap reflection, the individualized ceramic sheets were fixed. The sites were left to heal for 7 months. All patients were evaluated preoperatively and at 7 months postoperative using cone beam computed tomography and 3D optical equipment. Samples of the regenerated bone and soft tissue were collected and analyzed. The bone regenerated in the entire interior volume of all sheets. Bone biopsies revealed newly formed trabecular bone with a lamellar structure. Soft tissue biopsies showed connective tissue with no signs of an inflammatory response. This was considered to be newly formed periosteum. Thus ceramic individualized sheets can be used to regenerate large volumes of bone in both vertical and horizontal directions independent of the bone defect and with good biological acceptance of the material.

Effect of low-temperature degradation on the mechanical and microstructural properties of tooth-colored 3Y-TZP ceramics.

The aim of the present study was to evaluate the effects of low-temperature degradation (LTD) induced by autoclaving on the mechanical and microstructural properties of tooth-colored 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP). In total, 162 disc-shaped 3Y-TZP specimens were prepared. Two-thirds of the specimens were shaded by either the infiltration or powder mixing methods while the remaining specimens were used without coloring. The specimens were autoclaved at 134 °C for 0, 10, and 100 h to induce LTD (n=18 for each group). Chemical compositions were analyzed with X-ray fluorescence spectroscopy. Biaxial flexural strength was measured using a piston-on-three-ball test. The surface fraction and penetration depth of the monoclinic phase were examined using X-ray diffraction and scanning electron microscopy, respectively. The tooth-colored 3Y-TZP specimens contained Fe2O3 and Er2O3 (infiltration technique), and Fe2O3 (powder mixing method) at concentrations of<0.5 wt%. The tooth-colored 3Y-TZP had higher strength than the non-colored material after 100 h of autoclaving. In terms of surface fraction and penetration depth, the generation of monoclinic phase was significantly lower in the tooth-colored 3Y-TZP than in the non-colored material. The tooth-colored 3Y-TZP possessed equivalent biaxial flexural strength to that of the non-colored material and higher resistance to LTD regardless of the coloring technique (infiltration technique or powder mixing method) when the coloring pigments were contained at concentrations used in the present study.

Zirconia-fluorapatite materials produced by HIP.

Composites of tetragonal zirconia and fluorapatite were sealed in steel tubes and hot isostatically pressed at 1200 degrees C. The phases formed in the samples were evaluated by X-ray powder diffraction. When the composites contained larger amounts of fluorapatite, the tetragonal zirconia changed gradually into the cubic phase with decreasing zirconia content. These phase changes occurred due to a transfer of calcium from fluorapatite, which acted as an additional dopant in zirconia. Small amounts of monoclinic zirconia were also present in all samples. The cell dimension in fluorapatite was changed with the composition of the composite. However, decomposition of the fluorapatite was not possible to detect. Vickers hardness and fracture toughness were measured and ranged from 5.1 to 10.8 GPa and 0.9-5.5 MPam1/2, respectively. Microstructures in the composites were studied with scanning electron microscopy.

High-resolution mapping of 1D and 2D dose distributions using X-band electron paramagnetic resonance imaging.

Electron paramagnetic resonance imaging (EPRI) was performed to visualise 2D dose distributions of homogenously irradiated potassium dithionate tablets and to demonstrate determination of 1D dose profiles along the height of the tablets. Mathematical correction was applied for each relative dose profile in order to take into account the inhomogeneous response of the resonator using X-band EPRI. The dose profiles are presented with the spatial resolution of 0.6 mm from the acquired 2D images; this value is limited by pixel size, and 1D dose profiles from 1D imaging with spatial resolution of 0.3 mm limited by the intrinsic line-width of potassium dithionate. In this paper, dose profiles from 2D reconstructed electron paramagnetic resonance (EPR) images using the Xepr software package by Bruker are focussed. The conclusion is that using potassium dithionate, the resolution 0.3 mm is sufficient for mapping steep dose gradients if the dosemeters are covering only ±2 mm around the centre of the resonator.

EPR imaging of dose distributions aiming at applications in radiation therapy.

A one-dimensional electron paramagnetic resonance (EPR) imaging method for visualisation of dose distributions in photon fields has been developed. Pressed pellets of potassium dithionate were homogeneously irradiated in a (60)Co radiation field to 600 Gy. The EPR analysis was performed with an X-Band (9.6 GHz) Bruker E540 EPR and EPR imaging spectrometer equipped with an E540 GC2X two-axis X-band gradient coil set with gradients along the y axis (along the sample tube) and z axis (along B0) and an ER 4108TMHS resonator. Image reconstruction, including deconvolution, baseline corrections and corrections for the resonator sensitivity, was performed using an in-house-developed Matlab code for the purpose to have a transparent and complete algorithm for image reconstruction. With this method, it is possible to visualise a dose distribution with an accuracy of ∼5 % within ±5 mm from the centre of the resonator.

Bone apposition to laminin-1 coated implants: histologic and 3D evaluation.

Laminin-1 has been reported as one of the factors responsible for the nucleation of calcium phosphates and, in vitro, has been reported to selectively recruit osteoprogenitors. This article focused on its in vivo effects, and evaluated the effect of laminin-1 local application on osseointegration. Polished cylindrical hydroxyapatite implants were coated with laminin-1 (test) and the bone responses in the rabbit tibiae after 2 and 4 weeks were evaluated and compared to the non-coated implants (control). Before the samples were processed for histological sectioning, they were three-dimensionally analysed with micro computed tomography (µCT). Both evaluation methods were analysed with regards to bone area around the implant and bone to implant contact. From the histologic observation, new bone formation around the laminin-1 coated implant at 2 weeks seemed to have increased the amount of supporting bone around the implant, however, at 4 weeks, the two groups presented no notable differences. The two-dimensional and three-dimensional morphometric evaluation revealed that both histologic and three-dimensional analysis showed some tendency in favour of the test group implants, however there was no statistical significance between the test and control group results.