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1.
J Orthop Surg Res ; 19(1): 355, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38879553

ABSTRACT

BACKGROUND: The purpose of this study was to clarify (1) the differences in cortical bone thickness (CBT) of the tibial diaphysis between healthy and osteoarthritic knees and (2) the influences of the femorotibial angle (FTA) and inclination of the medial compartment of the proximal tibia (MCT) on tibial CBT. METHODS: The study assessed 60 subjects with varus knee osteoarthritis (OA) (22 males and 38 females; mean age, 74 ± 7 years) and 53 healthy elderly subjects (28 males and 25 females; mean age, 70 ± 6 years). Three-dimensional estimated CBT of the tibial diaphysis was automatically calculated for 2752-11,296 points using high-resolution measurements from CT. The standardized CBT was assessed in 24 regions by combining six heights and four areas. Additionally, the association between the CBT, each FTA, and MCT inclination was investigated. RESULTS: The OA group showed a thicker CBT in the medial areas than in the lateral areas of the proximal tibia, while the healthy group had a thicker lateral CBT. The medial-to-lateral ratio of the proximal tibia was significantly higher in the OA group than in the healthy group. The proximal-medial CBT correlated with FTA and MCT inclinations in the OA group. CONCLUSIONS: This study demonstrated that varus osteoarthritic knees showed a different trend of proximal-medial CBT with associations in FTA and MCT inclination from healthy knees, possibly due to medial load concentration.


Subject(s)
Cortical Bone , Diaphyses , Osteoarthritis, Knee , Tibia , Humans , Male , Female , Tibia/diagnostic imaging , Tibia/pathology , Aged , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/pathology , Cortical Bone/diagnostic imaging , Cortical Bone/pathology , Diaphyses/diagnostic imaging , Diaphyses/pathology , Aged, 80 and over , Tomography, X-Ray Computed , Lower Extremity/diagnostic imaging , Middle Aged
2.
J Craniofac Surg ; 35(4): 1284-1288, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38727232

ABSTRACT

Cortical bone thickness is essential for the mechanical function of bone. Some factors including aging, sex, body size, hormone levels, behavior, and genetics lead to changes in cranial cortical robusticity. Moreover, the skull is one of the hardest and most durable structures in the human body. Schizophrenia is defined as a psychiatric disease characterized by delusions and hallucinations, and these patients have reduced brain volume; however, there is no study including cortical bone structure. For this reason, the aim of this study was to determine whether there is a difference in the skull cortical thickness of patients with schizophrenia and, compare it with healthy subjects. The cranial length, cranial width, anterior cortical thickness, right and left anterior cortical thickness, right and left lateral cortical thickness, right and left posterior lateral thickness, and posterior cortical thickness were measured with axial computed tomography images of 30 patients with schizophrenia and 132 healthy individuals aged between 18 and 69years. A statistically significant difference was found between the two groups in the measurements of right and left posterior lateral thickness, and posterior cortical thickness ( P = 0.006, P = 0.001, and P = 0.047, respectively). The sexes were compared, and it was found that the cranial width, anterior thickness, left anterior thickness, and right and left posterior thickness measurements of patients with schizophrenia showed a statistically significant difference compared with the control group ( P < 0.001, P = 0.003, P = 0.001, P < 0.001 and P < 0.001, respectively). The authors observed that skull cortical thickness may be different in schizophrenia. The results obtained from this study may be beneficial for evaluating these structures for clinical and pathological processes. Furthermore, knowledge about the skull cortical thickness in planning surgical procedures will increase the reliability and effectiveness of the surgical method, and this will minimize the risk of complications.


Subject(s)
Schizophrenia , Skull , Tomography, X-Ray Computed , Humans , Male , Female , Schizophrenia/diagnostic imaging , Schizophrenia/pathology , Adult , Middle Aged , Skull/diagnostic imaging , Tomography, X-Ray Computed/methods , Adolescent , Aged , Young Adult , Cortical Bone/diagnostic imaging , Cortical Bone/pathology , Case-Control Studies
3.
Jt Dis Relat Surg ; 35(2): 417-421, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38727123

ABSTRACT

Although hemangiomas are the most common soft tissue tumors, intramuscular hemangiomas account for only 0.8% of all vascular tumors. These lesions are rarely located adjacent to the bone and cause changes in the adjacent bone. They are often mistakenly diagnosed as bone tumors. In this study, a case of a 19-year-old male patient with intramuscular hemangioma causing cortical thickening was reported.


Subject(s)
Bone Neoplasms , Hemangioma , Hypertrophy , Muscle Neoplasms , Humans , Male , Hemangioma/pathology , Hemangioma/diagnosis , Hemangioma/diagnostic imaging , Diagnosis, Differential , Young Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Muscle Neoplasms/pathology , Muscle Neoplasms/diagnostic imaging , Muscle Neoplasms/diagnosis , Hypertrophy/pathology , Magnetic Resonance Imaging , Cortical Bone/pathology , Cortical Bone/diagnostic imaging , Tomography, X-Ray Computed
4.
Bone ; 185: 117111, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38679220

ABSTRACT

Chronic heavy alcohol consumption is a risk factor for low trauma bone fracture. Using a non-human primate model of voluntary alcohol consumption, we investigated the effects of 6 months of ethanol intake on cortical bone in cynomolgus macaques (Macaca fascicularis). Young adult (6.4 ± 0.1 years old, mean ± SE) male cynomolgus macaques (n = 17) were subjected to a 4-month graded ethanol induction period, followed by voluntary self-administration of water or ethanol (4 % w/v) for 22 h/d, 7 d/wk. for 6 months. Control animals (n = 6) consumed an isocaloric maltose-dextrin solution. Tibial response was evaluated using densitometry, microcomputed tomography, histomorphometry, biomechanical testing, and Raman spectroscopy. Global bone response was evaluated using biochemical markers of bone turnover. Monkeys in the ethanol group consumed an average of 2.3 ± 0.2 g/kg/d ethanol resulting in a blood ethanol concentration of 90 ± 12 mg/dl in longitudinal samples taken 7 h after the daily session began. Ethanol consumption had no effect on tibia length, mass, density, mechanical properties, or mineralization (p > 0.642). However, compared to controls, ethanol intake resulted in a dose-dependent reduction in intracortical bone porosity (Spearman rank correlation = -0.770; p < 0.0001) and compared to baseline, a strong tendency (p = 0.058) for lower plasma CTX, a biochemical marker of global bone resorption. These findings are important because suppressed cortical bone remodeling can result in a decrease in bone quality. In conclusion, intracortical bone porosity was reduced to subnormal values 6 months following initiation of voluntary ethanol consumption but other measures of tibia architecture, mineralization, or mechanics were not altered.


Subject(s)
Alcohol Drinking , Calcification, Physiologic , Cortical Bone , Macaca fascicularis , Animals , Male , Porosity , Alcohol Drinking/physiopathology , Cortical Bone/drug effects , Cortical Bone/pathology , Cortical Bone/diagnostic imaging , Calcification, Physiologic/drug effects , Biomechanical Phenomena/drug effects , X-Ray Microtomography , Tibia/drug effects , Tibia/diagnostic imaging , Tibia/pathology , Ethanol/pharmacology , Spectrum Analysis, Raman , Bone Density/drug effects
5.
J Prosthodont Res ; 68(2): 264-272, 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-37211410

ABSTRACT

PURPOSE: This study aimed to investigate the effects of chronic kidney disease (CKD) on the structural and mechanical properties of the maxillary and mandibular cortical bone. METHODS: The maxillary and mandibular cortical bones from CKD model rats were used in this study. CKD-induced histological, structural, and micro-mechanical alterations were assessed using histological analyses, micro-computed tomography (CT), bone mineral density (BMD) measurements, and nanoindentation tests. RESULTS: Histological analyses indicated that CKD caused an increase in the number of osteoclasts and a decrease in the number of osteocytes in the maxilla. Micro-CT analysis revealed that CKD induced a void volume/cortical volume (%) increase, which was more remarkable in the maxilla than in the mandible. CKD also significantly decreased the BMD in the maxilla. In the nanoindentation stress-strain curve, the elastic-plastic transition point and loss modulus were lower in the CKD group than that in the control group in the maxilla, suggesting that CKD increased micro fragility of the maxillary bone. CONCLUSIONS: CKD affected bone turnover in the maxillary cortical bone. Furthermore, the maxillary histological and structural properties were compromised, and micro-mechanical properties, including the elastic-plastic transition point and loss modulus, were altered by CKD.


Subject(s)
Maxilla , Renal Insufficiency, Chronic , Rats , Animals , Maxilla/diagnostic imaging , Maxilla/pathology , X-Ray Microtomography , Renal Insufficiency, Chronic/pathology , Bone Density , Cortical Bone/diagnostic imaging , Cortical Bone/pathology
6.
J Mech Behav Biomed Mater ; 145: 106034, 2023 09.
Article in English | MEDLINE | ID: mdl-37494816

ABSTRACT

Microstructural and compositional changes that occur due to aging, pathological conditions, or pharmacological treatments alter cortical bone fracture resistance. However, the relative importance of these changes to the fracture resistance of cortical bone has not been quantified in detail. In this technical note, we developed an integrated experimental-computational framework utilizing human femoral cortical bone biopsies to advance the understanding of how fracture resistance of cortical bone is modulated due to modifications in its microstructure and material properties. Four human biopsy samples from individuals with varying fragility fracture history and osteoporosis treatment status were converted to finite element models incorporating specimen-specific material properties and were analyzed using fracture mechanics-based modeling. The results showed that cement line density and osteonal volume had a significant effect on crack volume. The removal of cement lines substantially increased the crack volume in the osteons and interstitial bone, representing straight crack growth, compared to models with cement lines due to the lack of crack deflection in the models without cement lines. Crack volume in the osteons and interstitial bone increased when mean elastic modulus and ultimate strength increased and mean fracture toughness decreased. Crack volume in the osteons and interstitial bone was reduced when material property heterogeneity was incorporated in the models. Although both the microstructure and the heterogeneity of the material properties of the cortical bone independently increased the fracture toughness, the relative contribution of the microstructure was more significant. The integrated experimental-computational framework developed here can identify the most critical microscale features of cortical bone modulated by pathological processes or pharmacological treatments that drive changes in fracture resistance and improve our understanding of the relative influence of microstructure and material properties on fracture resistance of cortical bone.


Subject(s)
Fractures, Bone , Models, Biological , Humans , Finite Element Analysis , Cortical Bone/pathology , Bone and Bones/pathology , Fractures, Bone/pathology
7.
Front Endocrinol (Lausanne) ; 13: 831369, 2022.
Article in English | MEDLINE | ID: mdl-35222286

ABSTRACT

Exposure to hypobaric hypoxia at high altitude puts mountaineers at risk of acute mountain sickness. The carbonic anhydrase inhibitor acetazolamide is used to accelerate acclimatization, when it is not feasible to make a controlled and slow ascend. Studies in rodents have suggested that exposure to hypobaric hypoxia deteriorates bone integrity and reduces bone strength. The study investigated the effect of treatment with acetazolamide and the bisphosphonate, zoledronate, on the skeletal effects of exposure to hypobaric hypoxia. Eighty 16-week-old female RjOrl : SWISS mice were divided into five groups: 1. Baseline; 2. Normobaric; 3. Hypobaric hypoxia; 4. Hypobaric hypoxia + acetazolamide, and 5. Hypobaric hypoxia + zoledronate. Acetazolamide was administered in the drinking water (62 mg/kg/day) for four weeks, and zoledronate (100 µg/kg) was administered as a single subcutaneous injection at study start. Exposure to hypobaric hypoxia significantly increased lung wet weight and decreased femoral cortical thickness. Trabecular bone was spared from the detrimental effects of hypobaric hypoxia, although a trend towards reduced bone volume fraction was found at the L4 vertebral body. Treatment with acetazolamide did not have any negative skeletal effects, but could not mitigate the altitude-induced bone loss. Zoledronate was able to prevent the altitude-induced reduction in cortical thickness. In conclusion, simulated high altitude affected primarily cortical bone, whereas trabecular bone was spared. Only treatment with zoledronate prevented the altitude-induced cortical bone loss. The study provides preclinical support for future studies of zoledronate as a potential pharmacological countermeasure for altitude-related bone loss.


Subject(s)
Acetazolamide/therapeutic use , Altitude Sickness , Altitude , Cancellous Bone/drug effects , Cortical Bone/drug effects , Zoledronic Acid/therapeutic use , Absorptiometry, Photon , Altitude Sickness/pathology , Altitude Sickness/physiopathology , Animals , Bone Density , Cancellous Bone/pathology , Cortical Bone/pathology , Female , Mice , Quadriceps Muscle/pathology
8.
Front Endocrinol (Lausanne) ; 12: 775066, 2021.
Article in English | MEDLINE | ID: mdl-34803931

ABSTRACT

Chronic kidney disease (CKD) has a significant negative impact on bone health. However, the mechanisms of cortical bone deterioration and cortical porosity enlargement caused by CKD have not been fully described. We therefore examined the association of CKD stages with cortical porosity index (PI), and explored potential mediators of this association. Double-echo ultrashort echo-time magnetic resonance imaging (UTE MRI) provides the possibility of quantifying cortical porosity in vivo. A total of 95 patients with CKD stages 2-5 underwent 3D double-echo UTE-Cones MRI (3.0T) of the midshaft tibia to obtain the PI. PI was defined as the ratio of the image signal intensity of a sufficiently long echo time (TE) to the shortest achievable TE. Parathyroid hormone (PTH), ß-CrossLaps (ß-CTX), total procollagen type I amino-terminal propeptide (T-P1NP), osteocalcin (OC), 25-hydroxyvitamin D (25OHD), and lumbar bone mineral density (BMD) were measured within one week of the MRI. Partial correlation analysis was performed to address associations between PI, eGFR and potential mediators (PTH, ß-CTX, T-P1NP, OC, 25OHD, BMD, and T-score). Multiple linear regression models were used to assess the association between CKD stages and PI value. Then, a separate exploratory mediation analysis was carried out to explore the impact of CKD stages and mediators on the PI value. The increasing CKD stages were associated with a higher PI value (Ptrend < 0.001). The association of CKD stages and PI mediated 34.4% and 30.8% of the total effect by increased PTH and ß-CTX, respectively. Our study provides a new idea to monitor bone health in patients with CKD, and reveals the internal mechanism of bone deterioration caused by CKD to some extent.


Subject(s)
Bone Density/physiology , Bone and Bones/metabolism , Renal Insufficiency, Chronic , Absorptiometry, Photon , Adult , Biomarkers/metabolism , China/epidemiology , Cohort Studies , Cortical Bone/metabolism , Cortical Bone/pathology , Cross-Sectional Studies , Disease Progression , Female , Health Status Indicators , Humans , Kidney Function Tests , Male , Mediation Analysis , Middle Aged , Porosity , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/metabolism , Renal Insufficiency, Chronic/pathology
9.
PLoS One ; 16(10): e0258254, 2021.
Article in English | MEDLINE | ID: mdl-34610044

ABSTRACT

Epidemiology and pathogenesis of cardiovascular diseases (CVD) and osteoporosis are strikingly overlapping. This study presents matrix metalloproteinase-9 (MMP-9), as a simple molecular link more consistently associated with the pathophysiology of both osteoporosis and CVD risk factors. 40 adult female rats were randomly distributed into 4 groups [control sham-operated, untreated osteoporosis, carvedilol-treated osteoporosis and alendronate-treated osteoporosis]. After 8 weeks, blood samples were collected to estimate Lipid profile (Total cholesterol, HDL, Triglycerides), inflammatory markers (IL-6, TNF alpha, CRP and NO), and Bone turnover markers (BTM) (Alkaline phosphatase, osteocalcin and pyridinoline). The tibias were dissected to estimate MMP-9 and NF-kB gene expression, OPG, RANKL levels and for histological examination. Induction of osteoporosis resulted in a significant elevation in BTM, inflammatory markers and dyslipidemia. MMP-9 was significantly elevated and positively correlated with BTM, inflammation and dyslipidemia markers. Carvedilol and alendronate exerted a bone preservative role and attenuated dyslipidaemia and inflammation in accordance with their respective effect on MMP-9.


Subject(s)
Cardiovascular Diseases/metabolism , Matrix Metalloproteinase 9/metabolism , Osteoporosis, Postmenopausal/metabolism , Osteoprotegerin/metabolism , Ovariectomy , RANK Ligand/metabolism , Alkaline Phosphatase/metabolism , Amino Acids/metabolism , Animals , Bone Remodeling/genetics , Cholesterol/blood , Cortical Bone/pathology , Disease Models, Animal , Female , Gene Expression Regulation , Humans , Inflammation/blood , Inflammation/pathology , Lipoproteins, HDL/blood , Matrix Metalloproteinase 9/genetics , NF-kappa B/metabolism , Osteocalcin/metabolism , Osteoporosis, Postmenopausal/blood , Osteoporosis, Postmenopausal/genetics , Rats , Risk Factors , Tibia/pathology , Triglycerides/blood
10.
Isr Med Assoc J ; 23(8): 501-505, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34392626

ABSTRACT

BACKGROUND: Multiple myeloma (MM) affects the long bones in 25% of patients. The advent of positron-emission tomography/computed tomography (PET/CT) scanners offers the possibility of both metabolic and radiographic information and may help determine fracture risk. To the best of our knowledge, no published study correlates these two factors with long bone fractures. OBJECTIVES: To evaluate the impact of PET/CT on fracture risk assessment in multiple myeloma patients. METHODS: We identified all bone marrow biopsy proven multiple myeloma patients from 1 January 2010 to 31 January 2015 at a single institution. We prospectively followed patients with long bone lesions using PET/CT scan images. RESULTS: We identified 119 patients (59 males/60 females) with 256 long bone lesions. Mean age at diagnosis was 58 years. The majority of lesions were in the femur (n=150, 59%) and humerus (n=84, 33%); 13 lesions in 10 patients (8%) required surgery for impending (n=4) or actual fracture (n=9). Higher median SUVmax was measured for those with cortical involvement (8.05, range 0-50.8) vs. no involvement (5.0, range 2.1-18.1). SUVmax was found to be a predictor of cortical involvement (odds ratio = 1.17, P = 0.026). No significant correlation was found between SUVmax and pain or fracture (P = 0.43). CONCLUSIONS: Improved medical treatment resulted improvement in 8% of patients with an actual or impending fracture. The orthopedic surgeons commonly use the Mirels classification for long bone fracture prediction. Adding PET/CT imaging to study in myeloma long bone lesions did not predict fracture risk directly but suggested it indirectly by cortical erosion.


Subject(s)
Femoral Fractures , Humeral Fractures , Multiple Myeloma , Positron Emission Tomography Computed Tomography/methods , Risk Assessment/methods , Biopsy/methods , Bone Marrow/pathology , Cortical Bone/diagnostic imaging , Cortical Bone/pathology , Female , Femoral Fractures/diagnosis , Femoral Fractures/etiology , Femoral Fractures/surgery , Fluorodeoxyglucose F18/pharmacology , Fracture Fixation/methods , Fracture Fixation/statistics & numerical data , Humans , Humeral Fractures/diagnosis , Humeral Fractures/etiology , Humeral Fractures/surgery , Israel/epidemiology , Male , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/diagnostic imaging , Multiple Myeloma/pathology , Predictive Value of Tests , Radiopharmaceuticals/pharmacology , Retrospective Studies
11.
J Clin Endocrinol Metab ; 106(12): e5088-e5096, 2021 11 19.
Article in English | MEDLINE | ID: mdl-34270719

ABSTRACT

CONTEXT: Recent studies suggest that cortical bone could also play a role in vertebral fracture (VF) development in acromegaly. OBJECTIVE: Evaluate the occurrence of VFs and their relationship to dual energy x-ray absorptiometry-derived bone parameters. METHODS: A single-center 2-year prospective study of acromegaly patients was conducted. Each subject had L1-4 spine, femoral neck and total hip (TH) areal BMD measured using DXA, and trabecular bone score (TBS) measurement performed. 3D Shaper™ was used to assess proximal femur trabecular and cortical volumetric (v)BMD, cortical surface (s)BMD, and cortical thickness (Cth). VF assessment was performed using the lateral spine imaging IVA™ mode with a Hologic Horizon® densitometer using a semiquantitative approach. Study outcomes were assessed at 2 time points: baseline and month 24. RESULTS: 70 acromegaly patients (34 M/36F; average 55.1 years) were studied, including 26 with active disease. In 13 patients, 9 with controlled disease, VF was observed. A decrease in TBS, sBMD, neck trabecular vBMD, TH, and neck cortical vBMD in VF compared with non-VF subjects was observed (P < .05). Multivariate analysis of fracture prediction showed TH cortical vBMD as the best fracture prediction parameter with area under the curve of 0.774. TBS was negatively associated with fasting plasma glucose and glycated hemoglobin (HBA1c) at each time point during the follow-up. CONCLUSION: From the total number of 13 VF subjects, 9 were in the controlled disease group. The most sensitive and specific predictor of incident VF was TH cortical vBMD, suggesting that cortical bone is involved in fracture development.


Subject(s)
Acromegaly/physiopathology , Bone Density , Cortical Bone/pathology , Spinal Fractures/epidemiology , Acromegaly/therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Slovakia/epidemiology
12.
J Clin Endocrinol Metab ; 106(12): e5021-e5029, 2021 11 19.
Article in English | MEDLINE | ID: mdl-34297085

ABSTRACT

CONTEXT: In a recent study a pattern of 27 metabolites, including serum glycine, associated with bone mineral density (BMD). OBJECTIVE: To investigate associations for serum and urinary glycine levels with BMD, bone microstructure, and fracture risk in men. METHODS: In the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (men, 69-81 years) serum glycine and BMD were measured at baseline (n = 965) and 5-year follow-up (n = 546). Cortical and trabecular bone parameters of the distal tibia were measured at follow-up using high-resolution peripheral quantitative computed tomography. Urinary (n = 2682) glycine was analyzed at baseline. X-ray-validated fractures (n = 594) were ascertained during a median follow-up of 9.6 years. Associations were evaluated using linear regression (bone parameters) or Cox regression (fractures). RESULTS: Circulating glycine levels were inversely associated with femoral neck (FN)-BMD. A meta-analysis (n = 7543) combining MrOS Sweden data with data from 3 other cohorts confirmed a robust inverse association between serum glycine levels and FN-BMD (P = 7.7 × 10-9). Serum glycine was inversely associated with the bone strength parameter failure load in the distal tibia (P = 0.002), mainly as a consequence of an inverse association with cortical cross-sectional area and a direct association with cortical porosity. Both serum and urinary glycine levels predicted major osteoporotic fractures (serum: hazard ratio [HR] per SD increase = 1.22, 95% CI, 1.05-1.43; urine: HR = 1.13, 95% CI, 1.02-1.24). These fracture associations were only marginally reduced in models adjusted by FRAX with BMD. CONCLUSIONS: Serum and urinary glycine are indirectly associated with FN-BMD and cortical bone strength, and directly associated with fracture risk in men.


Subject(s)
Biomarkers/blood , Bone Density , Cortical Bone/pathology , Glycine/blood , Osteoporotic Fractures/epidemiology , Risk Assessment/methods , Aged , Aged, 80 and over , Cortical Bone/metabolism , Cross-Sectional Studies , Follow-Up Studies , Humans , Male , Osteoporotic Fractures/blood , Osteoporotic Fractures/pathology , Prognosis , Prospective Studies , Sweden/epidemiology
13.
PLoS One ; 16(7): e0253862, 2021.
Article in English | MEDLINE | ID: mdl-34197561

ABSTRACT

A finite element analysis was performed to evaluate the stresses around nails and cortical bones in subtrochanteric (ST) fracture models fixed using short cephalomedullary nails (CMNs). A total 96 finite element models (FEMs) were simulated on a transverse ST fracture at eight levels with three different fracture gaps and two different distal locking screw configurations in both normal and osteoporotic bone. All FEMs were fixed using CMNs 200 mm in length. Two distal locking screws showed a wider safe range than 1 distal screw in both normal and osteoporotic bone at fracture gaps ≤ 3 mm. In normal bone FEMs fixed even with two distal locking screws, peak von Mises stresses (PVMSs) in cortical bone and nail constructs reached or exceeded 90% of the yield strength at fracture levels 50 mm and 0 and 50 mm, respectively, at all fracture gaps. In osteoporotic bone FEMs, PVMSs in cortical bone and nail constructs reached or exceeded 90% of the yield strength at fracture levels 50 mm and 0 and 50 mm, respectively, at a 1-mm fracture gap. However, at fracture gaps ≥ 2 mm, PVMSs in cortical bone reached or exceeded 90% of the yield strength at fracture levels ≥ 35 mm. PVMSs in nail showed the same results as 1-mm fracture gaps. PVMSs increased and safe range reduced, as the fracture gap increased. Short CMNs (200 mm in length) with two distal screws may be considered suitable for the fixation of ST transverse fractures at fracture levels 10 to 40 mm below the lesser trochanter in normal bone and 10 to 30 mm in osteoporotic bone, respectively, under the assumptions of anatomical reduction at fracture gap ≤ 3 mm. However, the fracture gap should be shortened to the minimum to reduce the risk of refracture and fixation failure, especially in osteoporotic fractures.


Subject(s)
Bone Nails , Cortical Bone/injuries , Fracture Fixation, Intramedullary/instrumentation , Hip Fractures/surgery , Osteoporosis/surgery , Biomechanical Phenomena , Bone Screws , Cortical Bone/pathology , Cortical Bone/surgery , Finite Element Analysis , Hip Fractures/etiology , Hip Fractures/pathology , Humans , Osteoporosis/complications , Osteoporosis/pathology
14.
PLoS One ; 16(4): e0250745, 2021.
Article in English | MEDLINE | ID: mdl-33930057

ABSTRACT

Computed tomography studies and histological analyses were performed on the mummified remains found in the Chehrabad salt mine in northwestern Iran. The ancient salt mummies are dated to the Achaemenid (550-330 BC) and Sassanid (3rd-7th century AD) time period and died in mining incidents. The aim of the study was to describe the radiological and histological findings of several ancient Iranian salt mummies with special interest in pathological and postmortem changes. The mummified remains show multiple traumatic alterations, such as fractures and signs of massive compression. Histological analyses can clearly differentiate soft tissue, however the preservation status is variable. These Iranian salt mummies are a rare example of the ancient Iranian population. The soft tissue and organs are well preserved, however in different degrees due to the varying conditions.


Subject(s)
Mummies/pathology , Archaeology , Cortical Bone/pathology , History, Ancient , Humans , Iran , Mummies/diagnostic imaging , Mummies/history , Pharynx/pathology , Sodium Chloride/chemistry , Tomography, X-Ray Computed
15.
PLoS One ; 16(4): e0250438, 2021.
Article in English | MEDLINE | ID: mdl-33891630

ABSTRACT

Chronic kidney disease (CKD) causes bone loss, particularly in cortical bone, through formation of cortical pores which lead to skeletal fragility. Animal models of CKD have shown variability in the skeletal response to CKD between males and females suggesting sex may play a role in this variation. Our aim was to compare the impact of adenine-induced CKD on cortical parameters in skeletally mature male and female C57Bl/6 mice. After 10-weeks of adenine-induced CKD, both male and female adenine mice had high serum parathyroid hormone (PTH), high bone turnover, and cortical porosity compared to non-CKD controls. Both sexes had lower cortical thickness, but only male mice had lower cortical bone area. CKD imparted greater deficits in mechanical properties of male mice compared to female mice. These data demonstrate that both male and female mice develop high PTH/high bone turnover in response to adenine-induced CKD and that cortical bone phenotypes are slightly more severe in males, particularly in mechanical properties deficits.


Subject(s)
Adenine/pharmacology , Bone Diseases, Metabolic/genetics , Parathyroid Hormone/blood , Renal Insufficiency, Chronic/genetics , Adenine/adverse effects , Animals , Bone Diseases, Metabolic/blood , Bone Diseases, Metabolic/chemically induced , Bone Diseases, Metabolic/pathology , Bone and Bones/metabolism , Bone and Bones/pathology , Cortical Bone/metabolism , Cortical Bone/pathology , Diet , Disease Models, Animal , Female , Femur/drug effects , Femur/metabolism , Femur/pathology , Humans , Kidney/metabolism , Kidney/pathology , Male , Mice , Mice, Inbred C57BL , Muscle, Skeletal/metabolism , Muscle, Skeletal/pathology , Phenotype , Porosity/drug effects , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/chemically induced , Renal Insufficiency, Chronic/pathology , Sex Characteristics
16.
Med Sci Monit ; 27: e929908, 2021 Mar 28.
Article in English | MEDLINE | ID: mdl-33774647

ABSTRACT

BACKGROUND In edentulous patients, the concept of 4 implants with early loading has been widely used in clinical settings. In the case of bone atrophy in the anterior maxilla, using short implants or an angulated implant may be a good choice for treatment. The occlusal scheme remains a key aspect of All-on-4. The aim of this study was to use the 3-dimensional (3D) finite element method (FEM) to evaluate how different All-on-4 designs for canine-guided and group function occlusion affected the distribution of stress in the atrophic premaxilla. MATERIAL AND METHODS A 3D edentulous maxilla model was created and in 3D FEM, 3 different configurations - M4, All-on-4, and short implant - were modeled by changing the anterior implants and using 2 different occlusal schemes. For each model, the occlusal load was applied to simulate lateral movements. For cortical bone, the maximum and minimum principal stress values were generated, and for ductile materials, von Mises stress values were obtained. RESULTS No significant differences were detected among the models; generally, however, the highest stress values were observed in the M-4 model and the models with short implants. Slightly higher stress values were observed in the group function occlusion group than in the canine-guided occlusion group. CONCLUSIONS To promote better primary stabilization, M-4 or short implant configurations with canine-guided occlusion appear to be preferable for patients who have severe atrophy in the anterior maxilla.


Subject(s)
Alveolar Bone Loss/diagnosis , Maxilla/pathology , Maxillary Diseases/diagnosis , Alveolar Bone Loss/surgery , Animals , Biomechanical Phenomena , Computer Simulation , Cortical Bone/pathology , Dental Implants , Dental Stress Analysis , Dogs , Finite Element Analysis , Humans , Maxilla/surgery , Maxillary Diseases/surgery , Stress, Mechanical
17.
Korean J Radiol ; 22(5): 782-791, 2021 05.
Article in English | MEDLINE | ID: mdl-33660460

ABSTRACT

OBJECTIVE: To evaluate the signal intensity of the periosteum using ultrashort echo time pulse sequence with three-dimensional cone trajectory (3D UTE) with or without fat suppression (FS) to distinguish from artifacts in porcine tibias. MATERIALS AND METHODS: The periosteum and overlying soft tissue of three porcine lower legs were partially peeled away from the tibial cortex. Another porcine tibia was prepared as three segments: with an intact periosteum outer and inner layer, with an intact periosteum inner layer, and without periosteum. Axial T1 weighted sequence (T1 WI) and 3D UTE (FS) were performed. Another porcine tibia without periosteum was prepared and subjected to 3D UTE (FS) and T1 WI twice, with positional changes. Two radiologists analyzed images to reach a consensus. RESULTS: The three periosteal tissues that were partially peeled away from the cortex showed a high signal in 3D UTE (FS) and low signal on T1 WI. 3D UTE (FS) showed a high signal around the cortical surface with an intact outer and inner periosteum, and subtle high signals, mainly around the upper cortical surfaces with the inner layer of the periosteum and without periosteum. T1 WI showed no signal around the cortical surfaces, regardless of the periosteum state. The porcine tibia without periosteum showed changes in the high signal area around the cortical surface as the position changed in 3D UTE (FS). No signal was detected around the cortical surface in T1 WI, regardless of the position change. CONCLUSION: The periosteum showed a high signal in 3D UTE and 3D UTE FS that overlapped with artifacts around the cortical bone.


Subject(s)
Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging , Periosteum/diagnostic imaging , Animals , Artifacts , Cortical Bone/diagnostic imaging , Cortical Bone/pathology , Image Processing, Computer-Assisted , Models, Animal , Periosteum/pathology , Swine , Tibia/diagnostic imaging
18.
Forensic Sci Int ; 319: 110661, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33360603

ABSTRACT

Cut marks provide essential knowledge to interpret which and how tools were used, both in archaeological and forensic context. Lots of studies focused on experimentally produced cut marks on animal models to develop methods for stabbing incidents. However, animal models are criticized to be morphologically different in comparison to human bones. This study analyzed the bone composition and experimentally obtained cut marks done on ribs from humans, pigs and goats. Methods included a qualitative description of differences between the species and a quantitative analysis of the cut mark proportions in histological thin sections and micro CT scans. The results indicated that especially the cortical bone of non-human ribs was different in comparison to human bone tissue as they were more robust and usually juvenile. Plexiform bone dominates and remodeled lamellar bone is rarely visible. The knife impact tends to create debris inside the cut mark and stress fractures along lamellae and cement lines perpendicular to the cut mark. Moreover, entheses of the intercostal muscles are always affected by the incision. Pig ribs were shown to be better suited as a model for sharp force trauma than goat ribs in comparison to humans. Though, plexiform bone and non-remodeled bone made it not quite ideal. We suggested to use bone material from animals used for breeding instead of meat production as they are slaughtered at higher ages.


Subject(s)
Rib Fractures/pathology , Ribs/injuries , Ribs/pathology , Wounds, Stab/pathology , Aged , Animals , Cancellous Bone/injuries , Cancellous Bone/pathology , Cortical Bone/injuries , Cortical Bone/pathology , Forensic Pathology , Fractures, Stress/diagnostic imaging , Fractures, Stress/pathology , Goats , Humans , Male , Models, Animal , Rib Fractures/diagnostic imaging , Ribs/diagnostic imaging , Swine , Wounds, Stab/diagnostic imaging , X-Ray Microtomography
19.
J Biol Chem ; 296: 100177, 2021.
Article in English | MEDLINE | ID: mdl-33303631

ABSTRACT

Increasing evidence emphasizes the importance of chemokines and chemokine receptors as regulators of bone remodeling. The C-C chemokine receptor 3 (CCR3) is dramatically upregulated during osteoclastogenesis, but the role of CCR3 in osteoclast formation and bone remodeling in adult mice is unknown. Herein, we used bone marrow macrophages derived from adult male CCR3-proficient and CCR3-deficient mice to study the role of CCR3 in osteoclast formation and activity. CCR3 deficiency was associated with formation of giant hypernucleated osteoclasts, enhanced bone resorption when cultured on bone slices, and altered mRNA expression of related chemokine receptors and ligands. In addition, primary mouse calvarial osteoblasts isolated from CCR3-deficient mice showed increased mRNA expression of the osteoclast activator-related gene, receptor activator of nuclear factor kappa-B ligand, and osteoblast differentiation-associated genes. Microcomputed tomography analyses of femurs from CCR3-deficient mice revealed a bone phenotype that entailed less cortical thickness and volume. Consistent with our in vitro studies, the total number of osteoclasts did not differ between the genotypes in vivo. Moreover, an increased endocortical osteoid mineralization rate and higher trabecular and cortical bone formation rate was displayed in CCR3-deficient mice. Collectively, our data show that CCR3 deficiency influences osteoblast and osteoclast differentiation and that it is associated with thinner cortical bone in adult male mice.


Subject(s)
Bone and Bones/pathology , Cortical Bone/metabolism , Osteoblasts/pathology , Osteoclasts/metabolism , RANK Ligand/metabolism , Receptors, CCR3/deficiency , Animals , Bone and Bones/metabolism , Cell Differentiation/physiology , Cells, Cultured , Cortical Bone/pathology , Disease Models, Animal , Male , Mice , Mice, Inbred BALB C , Mice, Knockout , NF-kappa B/metabolism , Osteoblasts/metabolism , Osteoclasts/pathology , Receptors, CCR3/genetics , Receptors, CCR3/metabolism , X-Ray Microtomography/methods
20.
Anat Sci Int ; 96(2): 315-318, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33001387

ABSTRACT

Hyperostosis frontalis interna (HFI) is a condition characterized by abnormal bone outgrowth on the inner surface of the frontal bone. Most HFI cases occur in post-menopausal elderly women. The pathology of HFI development is uncertain. The estimated incidence of HFI ranges from 5 to 12% in Western countries, but few cases have been reported in the Japanese population. Here, we report a case of HFI in an 86-year-old Japanese female cadaver. Macroscopically, the internal surface of the frontal bone exhibited bilateral nodular protrusion with sparing of the midline, while the external surface was normal. According to the morphological classification of HFI proposed by Hershkovitz et al. this case belongs to type D, the most severe type. Using computed tomography (CT), we defined five layers, designated as I-V from the inner to the outer layer, in the nodular region of HFI; however, the normal frontal bone is composed of three layers. Histological results demonstrated that layers I, III, and V consisted of the cortical bone, and layers II and IV consisted of the trabecular bone. We also observed increases in the numbers of lamellar bone and blood vessels on the dural side of layer I, indicating increased vascularization and active osteogenesis. These results indicate that layer II represents a new diploe within the inner table, which split into layers I and III, suggesting that diploization within the inner table by activated remodeling may be involved in the development of hyperostosis in this case.


Subject(s)
Cortical Bone/pathology , Frontal Bone/pathology , Hyperostosis Frontalis Interna/pathology , Aged, 80 and over , Cadaver , Cortical Bone/diagnostic imaging , Female , Frontal Bone/diagnostic imaging , Humans , Hyperostosis Frontalis Interna/diagnostic imaging , Japan , Tomography, X-Ray Computed
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