Bone Loss at Implant with Titanium Abutments Coated by Soda Lime Glass Containing Silver Nanoparticles: A Histological Study in the Dog

The aim of the present study was to evaluate bone loss at implants connected to abutments coated with a soda-lime glass containing silver nanoparticles, subjected to experimental peri-implantitis. Also the aging and erosion of the coating in mouth was studied. Five beagle dogs were used in the experiments. Three implants were placed in each mandible quadrant: in 2 of them, Glass/n-Ag coated abutments were connected to implant platform, 1 was covered with a Ti-mechanized abutment. Experimental peri-implantitis was induced in all implants after the submarginal placement of cotton ligatures, and three months after animals were euthanatized. Thickness and morphology of coating was studied in abutment cross-sections by SEM. Histology and histo-morphometric studies were carried on in undecalfied ground slides. After the induced peri-implantitis: 1.The abutment coating shown losing of thickness and cracking. 2. The histometry showed a significant less bone loss in the implants with glass/n-Ag coated abutments. A more symmetric cone of bone resorption was observed in the coated group. There were no significant differences in the peri-implantitis histological characteristics between both groups of implants. Within the limits of this in-vivo study, it could be affirmed that abutments coated with biocide soda-lime-glass-silver nanoparticles can reduce bone loss in experimental peri-implantitis. This achievement makes this coating a suggestive material to control peri-implantitis development and progression.     

Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein

Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both physisorption and covalent coupling of BSP are similarly effective, feasible methods, although a higher BSP concentration is recommended.     

Animal Modelling of Lumbar Corpectomy and Fusion and in vivo Growth of Spine Supporting Bone by Titanium Cage Implants: An Experimental Study

##正## In this study a lumbar spinal fusion animal model is established to assess the effect of spinal fusion cage,and explore theminimum area ratio of titanium cage section to vertebral section that ensures bone healing and biomechanical property.Lumbarcorpectomy was conducted by posterolateral approach with titanium cage implantation combined with plate fixation.Titaniumcages with the same length but different diameters were used.After implantation of titanium cages,the progress of bone healingwas observed and the bone biomechanical properties were measured,including deformation and displacement in axial compression,flexion,extension,and lateral bending motion.The factors affecting the in vivo growth of spine supporting body wereanalyzed.The results show that the area ratio of titanium cage section to vertebral section should reach 1/2 to ensure the bonehealing,sufficient bone intensity and biomechanical properties.Some bone healing indicators,such as BMP,suggest that there isa relationship between the peak time and the peak value of bone formation and metabolism markers and the bone healing strength.     

A Polymethyl Methacrylate Method for Large Specimens of Mineralized Bone with Implants

A simple modified polymethyl methacrylate method is described for large mineralized bone specimens with implants and bioactive materials which produces consistently good histological preservation of the interface between bone and implant. Human femoral heads, whole rabbit condyles and canine tibias and femurs containing implants consisting of hydroxyapatite, smooth polyethylene, porous polyethylene and carbon were dehydrated in ascending grades of ethanol and cleared with xylene on an automated tissue processor which alternated vacuum and pressure for 22 hr. Infiltration was done with washed polymethyl methacrylate at 4 C under vacuum for 13 days. Polymerization was carried out in wide-mouth glass jars at 38 C for 36 hr so that the total processing time was less than 20 days. The only important modification was in the polymethyl methacrylate, which had less plasticizer than usual in order to give a harder block. This enabled production of 4 μm sections with good preservation of mineralized and cellular areas for the study of metabolic bone diseases, morphometry, fluorochrome labelling and interface analysis with the implant in situ.     

Histological Evaluation of the Biocompatibility of Polyurea Crosslinked Silica Aerogel Implants in a Rat Model: A Pilot Study

Background

Aerogels are a versatile group of nanostructured/nanoporous materials with physical and chemical properties that can be adjusted to suit the application of interest. In terms of biomedical applications, aerogels are particularly suitable for implants such as membranes, tissue growth scaffolds, and nerve regeneration and guidance inserts. The mesoporous nature of aerogels can also be used for diffusion based release of drugs that are loaded during the drying stage of the material. From the variety of aerogels polyurea crosslinked silica aerogels have the most potential for future biomedical applications and are explored here.

Methodology

This study assessed the short and long term biocompatibility of polyurea crosslinked silica aerogel implants in a Sprague-Dawley rat model. Implants were inserted at two different locations a) subcutaneously (SC), at the dorsum and b) intramuscularly (IM), between the gluteus maximus and biceps femoris of the left hind extremity. Nearby muscle and other internal organs were evaluated histologically for inflammation, tissue damage, fibrosis and movement (travel) of implant.

Conclusion/Significance

In general polyurea crosslinked silica aerogel (PCSA) was well tolerated as a subcutaneous and an intramuscular implant in the Sprague-Dawley rat with a maximum incubation time of twenty months. In some cases a thin fibrous capsule surrounded the aerogel implant and was interpreted as a normal response to foreign material. No noticeable toxicity was found in the tissues surrounding the implants nor in distant organs. Comparison was made with control rats without any implants inserted, and animals with suture material present. No obvious or noticeable changes were sustained by the implants at either location. Careful necropsy and tissue histology showed age-related changes only. An effective sterilization technique for PCSA implants as well as staining and sectioning protocol has been established. These studies further support the notion that silica-based aerogels could be useful as biomaterials.     

Evaluation of the Preventive Effect of Isoflavone Extract on Bone Loss in Ovariectomized Rats

To examine a potential role for soybean phytoestrogens in postmenopausal bone loss, twenty-four 12-week-old Sprague-Dawley rats were divided randomly into 4 groups and given controlled diets for 16 weeks. The treatment groups were as followed: sham operated, ovariectomized (OVX) control, OVX + isoflavone extract (6.25 g/kg), and OVX + 17β-estradiol (4 mg/kg). OVX treatments reduced femoral and fourth lumbar vertebral bone density and mineral content (p<0.01), decreased uterine weight (p<0.01), accelerated body weight increases (p<0.05), and increased the activities (p<0.01) of both serum alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). Supplementation with isoflavone prevented the losses of bone density and mineral content caused by OVX (p<0.01). Although both isoflavone and 17β-estradiol exhibited similar bone-sparing ability on the OVX-induced bone loss, the effect of isoflavone was not the same as that of 17β-estradiol on the serum ALP and TRAP, body weight increase, and uterine weight change. We concluded that dietary supplementation with soybean isoflavone can prevent postmenopausal bone loss via a different mechanism of estrogen in OVX rats.     

Risk Factors of Bone Mass Loss at the Lumbar Spine: A Longitudinal Study in Healthy Korean Pre- and Perimenopausal Women Older than 40 Years

Longitudinal studies on bone mass decline for healthy women are sparse. We performed a retrospective longitudinal study to evaluate the factor associated with bone mass changes at the lumbar spine in healthy Korean pre- and perimenopausal women over the age of 40. We examined the relation of blood tests including thyroid function tests at baseline and follow-up to the annual percentage changes in average BMD of L2-L4 (A%ΔLSBMD). Four hundred and forty-three subjects without diseases or medications pertaining to bone metabolism were analyzed. The mean A%ΔLSBMD in these subjects was -0.45%/year. Though a significant correlation was observed between the A%ΔLSBMD and age, serum thyroid-stimulating hormone (TSH) level, total cholesterol (TC) level, low-density lipoprotein cholesterol (LDL-C) level, and estimated glomerular filtration rate (eGFR) at baseline and follow-up, there was a weak correlation between A%ΔLSBMD and these variables. From multiple linear regression analyses, the percent body fat, age, serum TSH level, serum uric acid level, and the menopause at follow-up were showed to have a significant association with the A%ΔLSBMD. Unlike age, percent body fat, and menopause at follow-up, which had a negative association with the A%ΔLSBMD, serum TSH level and serum uric acid level, had a positive association with the A%ΔLSBMD. The results from our study showed that the notable risk factors of BMD loss at the lumbar spine in population of our study were advancing age, menopause, higher percent body fat, lower normal TSH, and lower serum uric acid levels.     

Dog Movie Stars and Dog Breed Popularity: A Case Study in Media Influence on Choice

Fashions and fads are important phenomena that influence many individual choices. They are ubiquitous in human societies, and have recently been used as a source of data to test models of cultural dynamics. Although a few statistical regularities have been observed in fashion cycles, their empirical characterization is still incomplete. Here we consider the impact of mass media on popular culture, showing that the release of movies featuring dogs is often associated with an increase in the popularity of featured breeds, for up to 10 years after movie release. We also find that a movie''s impact on breed popularity correlates with the estimated number of viewers during the movie''s opening weekend—a proxy of the movie''s reach among the general public. Movies'' influence on breed popularity was strongest in the early 20^th century, and has declined since. We reach these conclusions through a new, widely applicable method to measure the cultural impact of events, capable of disentangling the event''s effect from ongoing cultural trends.     

Dog Ownership in the West Indies: A Case Study From the Bahamas

ABSTRACT

Results from several studies in The Bahamas, which included 511 interviews with residents and data on 776 dogs, are reported. The composition and characteristics of the dog population are described. The majority of dogs, both owned and unowned, are local mongrels called “potcakes.” The median age of the dog population is three years. Potcakes are given a lower level of health care than dogs considered to resemble a recognised breed. Many dogs have no place in the household and are able to roam. The dynamics of the owned and unowned dog populations are derived, and abandoned dogs are shown to sustain the free-roaming population. The free-roaming dog population breeds throughout the year but it has a breeding cycle longer than six months, which is probably caused by its ill health. Despite the nuisance caused by unowned dogs, residents are tolerant towards them, and over half the households feed dogs they do not own. The changes in pet ownership required to increase the welfare of dogs are discussed.     

Vitamin D Supplementation Enhances the Fixation of Titanium Implants in Chronic Kidney Disease Mice

Vitamin D (Vit D) deficiency is a common condition in chronic kidney disease (CKD) patients that negatively affects bone regeneration and fracture healing. Previous study has shown that timely healing of titanium implants is impaired in CKD. This study aimed to investigate the effect of Vit D supplementation on implant osseointegration in CKD mice. Uremia was induced by 5/6 nephrectomy in C57BL mice. Eight weeks after the second renal surgery, animals were given 1,25(OH)₂D₃ three times a week intraperitoneally for four weeks. Experimental titanium implants were inserted into the distal end of femurs two weeks later. Serum measurements confirmed decreased 1,25(OH)₂D levels in CKD mice, which could be successfully corrected by Vit D injections. Moreover, the hyperparathyroidism observed in CKD mice was also corrected. X-ray examination and histological sections showed successful osseointegration in these mice. Histomorphometrical analysis revealed that the bone-implant contact (BIC) ratio and bone volume (BV/TV) around the implant were significantly increased in the Vit D-supplementation group. In addition, resistance of the implant, as measured by a push-in method, was significantly improved compared to that in the vehicle group. These results demonstrate that Vit D supplementation is an effective approach to improve the fixation of titanium implants in CKD.     

A Novel Strategy for Control of Microbial Biofilms through Generation of Biocide at the Biofilm-Surface Interface

Biofilms of a mucoid clinical isolate of Pseudomonas aeruginosa (24 h; ca. 10(sup6) CFU/cm(sup2)) were established by immersion of polymer discs in nutrient broth cultures at 37(deg)C. Biofilms exposed for 30 min to various concentrations (0 to 3 mg/ml) of hydrogen peroxide or potassium monopersulfate were rinsed and shaken vigorously in sterile saline to detach loosely associated cells, and the residual viable attached population was quantified by a blot succession method on agar plates. Incorporation of copper and cobalt phthalocyanine catalysts within the polymers significantly enhanced the activity of these oxidizing biocides towards biofilm bacteria by several orders of magnitude. Biofilms established on the control discs resisted treatment with concentrations of either agent of up to 3 mg/ml. Enhancement through incorporation of a catalyst was such that concentrations of potassium monopersulfate of as low as 20 (mu)g/ml gave no recoverable survivors either on the discs or within the washings. Catalysts such as these will promote the formation of active oxygen species from a number of oxidizing agents such as peroxides and persulfates, and it is thought that generation of these at the surface-biofilm interface concentrates the antimicrobial effect to the interfacial cells and generates a diffusion pump which further provides active species to the biofilm matrix. The survivors of low-concentration treatments with these agents were more readily removed from the catalyst-containing discs than from the control discs. This indicated advantages gained in hygienic cleansing of such modified surfaces.     

Antiresorptive Agents Increase the Effects of Exercise on Preventing Postmenopausal Bone Loss in Women: A Meta-Analysis

Background and Objectives

It remains unknown whether the combination of antiresorptive agents and exercise would generate additive effects on bone mineral density (BMD) in postmenopausal women, though their separate roles in preventing bone loss have been well established. This meta-analysis aimed to evaluate the combined impact of antiresorptive treatment and exercise on the lumbar spine and femoral neck BMD in postmenopausal women compared with an exercise-only intervention.

Methods

A systematic literature search of PubMed, EMBASE, SportDiscus and ProQuest up to Jun 2014 was conducted to identify the influence of antiresorptive agents and exercise on BMD in postmenopausal women. The study quality of the included trials was evaluated. The effect sizes were estimated by calculating the standardized mean difference (SMD). Subgroup analyses were conducted by pharmacological regimens and exercise categories.

Results

Nine studies with a total of 1,248 postmenopausal women met the inclusion criteria. The heterogeneity between the studies was evident at the spine (I² = 78.7%) and hip (I² = 41.7%) measurements; random-effects models were used in the data analysis. The pooled effect sizes associated with the combined interventions of antiresorptive agents and exercise were significant at the lumbar spine BMD (SMD = 0.511, 95% CI = 0.118-0.904, p = 0.011). Combining hormone replacement therapy (HRT) and exercise training generated greater beneficial effects on lumbar spine (SMD = 0.729, 95% CI = 0.186-1.273, p = 0.009) and femoral neck BMD (SMD = 0.220, 95% CI = 0.0110-429, p = 0.039) than the exercise-only intervention. Impact exercise was sensitive to antiresorptive agents in preventing postmenopausal bone loss both at the spine (SMD = 1.252, 95%CI = 0.465-2.039, p = 0.002) and hips (SMD = 0.414, 95%CI = 0.106-0.723, p = 0.008).

Conclusions

Our findings indicate that antiresorptive agents significantly increase the impact of exercise on the prevention of bone loss in postmenopausal women, which implies that the combination of antiresorptive agents and exercise may generate additive effects.     

The Use of Biodegradable Implants in the Fixation of Small Animal Cancellous Bone Fractures

In this study the cancellous bone fractures of 10 dogs and 2 cats were surgically treated with biodegradable implants to fixate the fractures. The implants were made of selfreinforced PGA homopolymers. The patients were allowed to walk on their operated limbs immediately after the fixation and they started to use them within one week. All patients except one used their operated limbs without lameness in 6 weeks and the twelfth case in 8 weeks, due to a postoperative periosteal infection. Radiographically, the fractures of 10 patients healed in 6 weeks and in 12 weeks in 2 cases. No other pathological reactions in the bone could be seen in the radiographs than the periosteal infection. Because the implants resolved spontaneously there was no need for a second operation to remove them.     

A Retrospective Study of Conservative Treatment of Gastric Dilatation-Volvulus in the Dog

A retrospective study of 103 dogs with gastric dilatation-volvulus (GDV) treated conservatively during the period 1985–1989 was performed. The date and number of recurrences, and the date and cause of death along with breed, age and sex were collected from clinic records and from a questionnaire sent to the owners (77% response). The treatment consisted of emptying the stomach with a stomach tube, gastrocentesis if necessary and treating shock. All of the affected dogs were from moderate to large sized breeds and the study showed that particular breeds appear to be predisposed to GDV. The average age was 7.2 years and there was no gender predisposition. Sixty-six per cent of the dogs survived the initial treatment and 50% of the dogs were still alive 1 month after treatment. Thirty-nine dogs (71%) received recurrence between 5–760 days after initial treatment. Fifty-six per cent had recurrence within 3 months and all except 2 dogs, within 1 year. Data for the time of death, regardless of cause, was available for 68 dogs. Of these 59 (81% ) died within a year after initial treatment. Conservative treatment was found to be an adequate life-saving procedure in the acute stage of GDV, but could not alone prevent recurrence of the disease.     

Evaluation of Dog Bones in the Indirect Assessment of Environmental Contamination with Trace Elements

The aim of this paper was to determine the level of five elements, two essential for life [zinc (Zn) and copper (Cu)] and three distinctly toxic [lead (Pb), cadmium (Cd), and mercury (Hg)], in four types of biological material in bones of the dog Canis lupus familiaris. The experiment was carried out on bones from the hip joints of dogs. The samples of cartilage, compact bone, spongy bone, and cartilage with adjacent compact bone came from 26 domestic dogs from northwestern Poland. Concentrations of Cu, Zn, Pb, and Cd were determined by ICP-AES (atomic absorption spectrophotometry) in inductively coupled argon plasma, using a Perkin-Elmer Optima 2000 DV. Determination of Hg concentration was performed by atomic absorption spectroscopy. In the examined bone material from the dog, the greatest concentrations (median) were observed for Zn and the lowest for Hg (98 mg Zn/kg and 0.0015 mg Hg/kg dw, respectively). In cartilage and spongy bone, metal concentrations could be arranged in the following descending order: Zn > Pb > Cu > Cd > Hg. In compact bone, the order was slightly different: Zn > Pb > Cd > Cu > Hg (from median 70 mg/kg dw to 0.002 mg/kg dw). The comparisons of metal concentrations between the examined bone materials showed distinct differences only in relation to Hg: between concentrations in spongy bone, compact bone, and in cartilage, being greater in cartilage than in compact bone, and lower again in spongy bone.     

A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders

Differentiation and activation of osteoclasts play a key role in the development of musculoskeletal diseases as these cells are primarily involved in bone resorption. Osteoclasts can be generated in vitro from monocyte/macrophage precursor cells in the presence of certain cytokines, which promote survival and differentiation. Here, both in vivo and in vitro techniques are demonstrated, which allow scientists to study different cytokine contributions towards osteoclast differentiation, signaling, and activation. The minicircle DNA delivery gene transfer system provides an alternative method to establish an osteoporosis-related model is particularly useful to study the efficacy of various pharmacological inhibitors in vivo. Similarly, in vitro culturing protocols for producing osteoclasts from human precursor cells in the presence of specific cytokines enables scientists to study osteoclastogenesis in human cells for translational applications. Combined, these techniques have the potential to accelerate drug discovery efforts for osteoclast-specific targeted therapeutics, which may benefit millions of osteoporosis and arthritis patients worldwide.     

A Longitudinal Study of Decision Making in the Process of Acquiring a Dog

To prevent potential problems in the relationship between people and their dogs, it is important to engage in a thoughtful decision-making process with regard to acquiring a dog. To map the most important elements in the decision-making process, a social cognitive model was applied using seven psychological constructs: perceived advantages of having a dog; perceived disadvantages; the social norm; self-efficacy; optimism; expected commitment; and the intention to acquire a dog. People who were planning to acquire a dog within one year were asked to fill in an online questionnaire and another one 14 months later. The social cognitive constructs were operationalized in the baseline questionnaire, and in the follow-up participants were asked to report whether they had actually acquired a dog during the 14-month interval. The sample (n?=?588) largely consisted of females (88%) and those who had a high level of education (64%). The mean age of the participants was 40.9 years. The data showed significant relations among the decision-making variables, and significant differences between demographic variables related to these. In univariate longitudinal analyses, several social cognitive variables significantly predicted acquiring a dog in the 14-month period. When intention to acquire a dog was entered into the multivariate model, it remained the only predictor (OR = 2.16, p?<?0.001); the model explained 33% of the variance in acquiring a dog. It was possible to assess the main constructs that play a role in decision making regarding acquiring a dog: Most baseline measures were related to actual later behavior, also when taking into account all changes in other internal and external factors that may have taken place. Insight into the decision-making process makes it possible to intervene in it for the good of people, dogs, and their relationships.     

High Serum Carotenoids Associated with Lower Risk for Bone Loss and Osteoporosis in Post-Menopausal Japanese Female Subjects: Prospective Cohort Study

Introduction

Recent epidemiological studies show that high intakes of carotenoids might be useful to maintain bone health, but little is known about the association of serum carotenoids with change of bone mineral density (BMD). The objective of this study was to investigate longitudinally whether serum carotenoids are associated with bone loss.

Methods

We conducted a follow-up on 146 male and 99 pre- and 212 post-menopausal female subjects from the Mikkabi study. Those who participated in previous BMD surveys and completed four years of follow-up were examined longitudinally.

Results

During a 4-year follow-up, 15 of the post-menopausal female subjects developed new-onset osteoporosis. In contrast, none of the male and pre-menopausal female subjects did. In male and pre-menopausal female subjects, the six serum carotenoids at the baseline were not associated with bone loss. On the other hand, in post-menopausal female subjects, the 4-year bone loss of radius was inversely associated with the serum carotenoid concentrations, especially in β-carotene. After adjustments for confounders, the odds ratios (OR) for osteoporosis in the highest tertiles of serum β-carotene and β-cryptoxanthin against the lowest tertiles were 0.24 (95% confidence interval 0.05–1.21) and 0.07 (CI: 0.01–0.88), respectively. Serum β-cryptoxanthin was also inversely associated with the risk for osteopenia and/or osteoporosis (P for trend, 0.037). In addition, our retrospective analysis revealed that subjects who developed osteoporosis and/or osteopenia during the survey period had significantly lower serum concentrations of β-cryptoxanthin and β-carotene at the baseline than those in the normal group.

Conclusions

Antioxidant carotenoids, especially β-cryptoxanthin and β-carotene, are inversely associated with the change of radial BMD in post-menopausal female subjects.     

Bone Mineral Density,Bone Turnover Markers and Fractures in Patients with Systemic Sclerosis: A Case Control Study

Objective

The aim of our study was to elucidate the pathophysiology of systemic sclerosis-related osteoporosis and the prevalence of vertebral fragility fracture in postmenopausal women with systemic sclerosis (SSc).

Methodology

Fifty-four postmenopausal women with scleroderma and 54 postmenopausal controls matched for age, BMI, and smoking habits were studied. BMD was measured by dual energy-x-ray absorptiometry at spine and femur, and by ultrasonography at calcaneus The markers of bone turnover included serum osteocalcin and urinary deoxypyridinoline. All subjects had a spine X-ray to ascertain the presence of vertebral fractures.

Results

bone mineral density at lumbar spine (BMD 0.78±0.08 vs 0.88±0.07; p<0,001), femoral neck (BMD: 0.56±0.04 vs 0.72±0.07; p<0,001) and total femur (BMD: 0.57±0.04 vs 0.71±0.06; p<0,001) and ultrasound parameter at calcaneus (SI: 80.10±5.10 vs 94.80±6.10 p<0,001) were significantly lower in scleroderma compared with controls; bone turnover markers and parathyroid hormone level were significantly higher in scleroderma compared with controls, while serum of 25(OH)D3 was significantly lower. In scleroderma group the serum levels of 25(OH)D3 significantly correlated with PTH levels, BMD, stiffness index and bone turnover markers. One or more moderate or severe vertebral fractures were found in 13 patients with scleroderma, wherease in control group only one patient had a mild vertebral fracture.

Conclusion

Our data shows, for the first time, that vertebral fractures are frequent in subjects with scleroderma, and suggest that lower levels of 25(OH)D3 may play a role in the risk of osteoporosis and vertebral fractures.     

DEXA对骨髓炎骨缺损治疗中骨痂密度的评价

目的：探讨DEXA对骨髓炎骨缺损治疗中骨痂密度的评价及意义。方法：严格按照纳入排除标准,选取21例骨髓炎清创后伴大段皮质骨缺损一期植骨的病人。术后4,6,8,10个月后对骨折端骨痂行双能X线骨密度仪检测,并进行X摄片以及Enneking评分,从而明确植骨区愈合骨痂的密度变化趋势,骨愈合情况以及症状改善情况。结果：（1）X线摄片结果显示：4个月后：骨缺损区依然清晰可见,内有少量稀疏骨痂通过,少量外骨痂形成。6个月后：植骨区内骨痂含量明显增多,且外骨痂膨大。8个月：缺损区模糊,有较致密骨痂生成,且外骨痂逐渐减少。10个月：植骨区骨痂更加致密,且部份髓腔再通。（2）Enneking评分：患者术后第10个月功能恢复情况评估正常功能20例,20分以下的患者1例。（3）BMD测定：骨折端的骨密度及骨密度比率随时间延长而增加,植骨10个月后患侧的骨密度已可基本上达到正常对照侧的骨密度水平。结论：双能X线骨密度测量从一定程度上反映出骨痂的力学强度特性。在感染性骨缺损治疗中可以作为检测植骨区的恢复情况的参考。