Search results for: systemic bone loss

Authors: Nuhi Arslani, Stojan Potrc, Timotej Mikuljan

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Background: In Department of Abdominal and General Surgery of University Medical Centre Maribor, we treated 578 patients for rectal cancer between 2004 and 2014. During and after treatment we especially concentrated on monitoring local and systemic complications. Methods: For analysis, we used data gathered from preoperative diagnostic tests, reports gathered during operation, reports from the pathohistologic review, and reports on complications after surgery and follow up. Results: In the case of 573 (out of 578) patients (99.1%) we performed resection. R0 was achieved in 551 patients (96,1%). R1 was achieved in 8 patients (1,4%). R2 was achieved in 14 patients (2,4%). Local complications were reported in 78 (13.5%) patients and systemic complications were reported in 68 (11.7%). We would like to point out the low number of local and systemic complications. Conclusions: With advances in surgical techniques, with a multimodal-multidisciplinary approach and with the use of total mesorectal excision we experienced a significant improvement in reducing the number of local and systemic complications in patients with rectal cancer. However, there still remains the question for truly optimal care for each patient with rectal cancer and his quality of life after surgical treatment.

Keywords: local complications, rectal cancer, resection, systemic complications

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Najeeb Ullah Khan

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Background: The receptor activator NF-κβ ligand (RANKL) and Osteoprotegerin (OPG) polymorphisms have been associated with the progression of breast cancer to bone metastasis. Here, we aimed to investigate the association of RANKL and OPG gene polymorphism with breast to bone metastasis in the Pashtun population, Pakistan. Methods: Genomic DNA was obtained from all the study subjects (106 breast cancer, 58 breast to bone metastasis, and 51 healthy controls). RANKL (rs9533156) and OPG (rs2073618, rs3102735) polymorphisms were genotyped using Tetra-ARMS PCR. Results: Our results indicated that the frequencies of OPG (rs3102735) risk allele and genotypes carrying risk allele in breast cancer vs healthy control (C- p=0.005; CC- p=0.0208; TC- p=0.0181), bone metastasis vs healthy control (C- p=0.0211; CC- p=0.0153; TC- p=0.0775), and breast cancer vs breast to bone metastasis (C- p=0.0001; CC- p=0.0001; TC- p=0.001) were found significantly associated with disease risk. However, there was no significant association observed for OPG (rs2073618) risk allele and risk allele containing genotypes in all study groups. Similarly, RANKL (rs9533156) risk alleles and corresponding genotypes in breast cancer vs healthy control (C- p=0.0001; CC- p=0.0001; TC- p=0.0084), bone metastasis vs healthy control (C- p=0.0001; CC- p=0.0001; TC- p=0.5593), and breast cancer vs breast to bone metastasis (C- p=0.0185; CC- p=0.6077; TC- p=0.1436) showed significant association except for the risk allele carrying genotypes in breast cancer to bone metastasis (TC, p=0.1436; CC, p=0.6077). Conclusion: OPG (rs3102735) and RANKL (rs9533156) showed significant association with breast to bone metastasis, while OPG (rs2073618) didn’t show a significant association with breast to bone metastasis in Pashtun population of Pakistan. However, more investigation will be required to disseminate the results while gene sequencing or whole-exome sequencing.

Keywords: breast cancer, bone metastasis, OPG, RANKL, polymorphism

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Authors: O. Yu Shchelkova, E. B. Usmanova

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Introduction: Last decades scientific research of quality of life (QoL) is developing fast worldwide. QoL concept pays attention to emotional experience of disease in patients, particularly to personal sense of possibility to satisfy actual needs and possibility of full social functioning in spite of disease limitations. QoL in oncological patients is studied intensively. Nevertheless, the issue of QoL in patients with bone tumors focused on psychological factors of QoL and relation to disease impact on QoL is not discussed. The aim of the study was to reveal the basic aspects and personality factors of QoL in patients with bone tumor. Results: Study participants were 139 patients with bone tumors. The diagnoses were osteosarcoma (n=42), giant cell tumor (n=32), chondrosarcoma (n=32), Ewing sarcoma (n=10) and bone metastases (n=23). The study revealed that patients with bone metastases assess their health significantly worse than other patients. Besides patients with osteosarcoma evaluate their general health higher than patients with giant cell tumors. Social functioning in patients with chondrosarcoma is higher than in patients with bone metastases and patients with giant cell tumor. Patients with chondrosarcoma have higher physical functioning and less restricted in daily activities than patients with bone metastases. Patients with bone metastases characterize their pain as more widespread than patients with primary bone tumors and have more functional restrictions due to bone incision. Moreover, the study revealed personality significant influence on QoL related to bone tumors. Such characteristics in structure of personality as high degree of self-consciousness, personal resources, cooperation and disposition to positive reappraisal in difficult situation correspond to higher QoL. Otherwise low personal resources and slight problem solving behaviour, low degree of self-consciousness and high social dependence correspond to decrease of QoL in patients with bone tumors. Conclusion: Patients with bone metastasis have lower QoL compared to patients with primary bone tumors. Patients with giant cell tumor have the worth quality of life among patients with primary bone tumors. Furthermore, the results revealed differences in QoL parameters associated with personality characteristics in patients with bone tumors. Such psychological factors as future goals, interest in life and emotional saturation, besides high degree of personal resources and cooperation influence on increasing QoL in patients with bone tumors.

Keywords: quality of life, psychological factors, bone tumor, personality

Procedia PDF Downloads 117

Authors: A. M. Malagon Escandon, J. A. Arenas Alatorre, C. P. Chaires Rosas, N. A. Vazquez Torres, B. Hernandez Tellez, G. Pinon Zarate, M. Herrera Enriquez, A. E. Castell Rodriguez

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The current approach to the treatment of bone defects involves the use of scaffolds that provide a biological and mechanically stable niche to favor tissue repair. Despite the significant progress in the field of bone tissue engineering, several main problems associated are attributed to giving a low biodegradation degree, does not promote osseointegration and regeneration, if the bone is not healing as well as expected or fails to heal, will not be given a proper ossification or new bone formation. The actual approaches of bone tissue regeneration are directed to the use of decellularized native extracellular matrices, which are able of retain their own architecture, mechanic properties, biodegradability and promote new bone formation because they are capable of conserving proteins and other factors that are founded in physiological concentrations. Therefore, we propose an extracellular matrix-based bioscaffolds derived from bovine cancellous bone, which is processed by decellularization, demineralization, and hydrolysis of the collagen protein, these protocols have been successfully carried out in other organs and tissues; the effectiveness of its biosafety has also been previously evaluated in vivo and Food and Drug Administration (FDA) approved. In the specific case of bone, a more complex treatment is needed in comparison with other organs and tissues because is necessary demineralization and collagen denaturalization. The present work was made in order to obtain a temporal scaffold that succeed in degradation in an inversely proportional way to the synthesis of extracellular matrix and the maturation of the bone by the cells of the host.

Keywords: bioactive, biodegradable, bone, extracellular matrix-based bioscaffolds, stem cells, tissue engineering

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Authors: Frank Hespeler, Giuseppe Loiacono

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We propose measures for systemic risk generated through intra-sectorial interdependencies in the hedge fund sector. These measures are based on variations in the average cross-effects of funds showing significant interdependency between their individual returns and the moments of the sector’s return distribution. The proposed measures display a high ability to identify periods of financial distress, are robust to modifications in the underlying econometric model and are consistent with intuitive interpretation of the results.

Keywords: hedge funds, systemic risk, vector autoregressive model, risk monitoring

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Authors: Z. Mowafy Emam Mowafy, Ahmed R. Sayed, M. El Sayed Mohmmed Hassan

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Purpose: to evaluate the effect of low intensity laser on severe tinnitus in idiopathic sudden hearing loss patients. Methods of evaluation (Visual analogue scale and tinnitus handicap inventory scale):- Thirty patients who had unilateral tinnitus with sensorineural hearing loss were participated in the study. Subjects aged from 40 to 50 were randomly divided into two equal groups: group (A): composed of 15 patients who received the routine medical care (Systemic steroids) in addition to the low-intensity laser therapy (LILT) while group (B): composed of 15 patients who received only the routine medical care. Continuous 632.8nm He-Ne laser was used with 5mW power for 15 min\day, 3 days per week for 3 months. Results and conclusion: Results showed that application of the LILT had a valuable effect on severe tinnitus in idiopathic sudden hearing loss patients as evidenced by the highly decreased visual analogue scale and tinnitus handicap inventory scale.

Keywords: idiopathic sudden hearing loss, low intensity laser, tinnitus, tinnitus handicap inventory scale and visual analogue scale

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Authors: Shokouh Momeni, Mohammad Reza Salamat, Ali Asghar Rastegari

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Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry(DXA) is an accurate non-invasive system measuring the bone density, with low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase and magnesium were measured by autoanalyzer and serum levels of vitamin D were measured by high-performance liquid chromatography(HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium did not show a significant difference between the two groups(P-value>0.05). In the control group, the relationship between alkaline phosphatase and BMC and BA in the spine was significant with a correlation coefficient of -0.402 and 0.258, respectively(P-value<0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus(Correlation=0.368; P-value=0.038). There was a significant relationship between the Z-score with calcium(Correlation=0.358; P-value=0.044). Conclusion: There was no significant relationship between the values ​​of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium parameters and bone density (spine and hip) in postmenopaus

Keywords: osteoporosis, menopause, bone mineral density, vitamin d, calcium, magnesium, alkaline phosphatase, phosphorus

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Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

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It has been reported that deer antler extract has bone-strengthening activity and effectively used in bone diseases therapy. However, little is known about the cellular and molecular mechanism of this effect. The upper section, mid section, and base of the antler has been known to exhibit different biological properties. Present study investigated the effects of these three parts of deer antler extracts on bone formation and resorption. The effects of deer antler extracts (DH) on bone formation were determined by cell proliferation, alkaline phosphatase (ALP) activity, collagen synthesis, and mineralization in human osteoblastic MG-63 cells. The effect on bone resorption was determined by osteoclastogenesis from bone marrow-derived precursor cells driven by RANKL. Ethanol extracts of DH (50 ~ 100 µg/ml) dose-dependently increased cell proliferation, and upper part increased the cell proliferation by 118.4% while mid and base parts increased proliferation by 107.8% and 102.3%, respectively. ALP activity was significantly increased by upper part of the DH treatment. After enhancement of ALP activity, significant augmentation of collagen synthesis and calcification assessed by Sirus red and Alzarin red staining, respectively, was observed in upper part of the DH treatment. The effect of DH on bone resorption was not observed in all three parts of the DH. These results could provide a mechanistic explanation for the bone-strengthening effects of DH.

Keywords: alkaline phosphatase, collagen synthesis, deer antler, osteoblastic MG-63 cells

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Authors: Deepa Gandhi, Pravin K. Naoghare, Amit Bafana, Krishnamurthi Kannan, Saravanadevi Sivanesana

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Oxidative stress is known to depreciate normal functioning of osteoblast cells. Present study reports oxidative/inflammatory signatures in fluoride exposed human osteosarcoma (HOS) cells and its possible association with the genes involved in bone developmental pathway. Microarray analysis was performed to understand the possible molecular mechanisms of stress-mediated bone lose in HOS cells. Cells were chronically exposed with sub-lethal concentration of fluoride. Global gene expression is profiling revealed 34 up regulated and 2598 down-regulated genes, which were associated with several biological processes including bone development, osteoblast differentiation, stress response, inflammatory response, apoptosis, regulation of cell proliferation. Microarray data were further validated through qRT-PCR and western blot analyses using key representative genes. Based on these findings, it can be proposed that chronic exposure of fluoride may impair bone development via oxidative and inflammatory stress. The present finding also provides important biological clues, which will be helpful for the development of therapeutic targets against diseases related bone.

Keywords: bone, HOS cells, microarray, stress

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Authors: Xing Wang, Lin Feng, Lingling E., Hongchen Liu

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In patients with type 2 diabetes mellitus (DM) there is poorer quality osseointegration than in non-diabetic (n-DM) patients, and the success of dental implants is less. Recent studies have demonstrated that insulin could stimulate bone cells to produce and accelerate implant osseointegration in DM patients.This raised the question whether insulin could provide local bone anabolic effects in non-diabetic patients. In this study,48 SD rats were divided into four groups randomly: DM group, DM+insulin group, n-DM group, n-DM + insulin group. All rats were implanted the titanium implant near the epiphyseal end of tibia, then the DM + insulin and n-DM + insulin group received twice-daily subcutaneous injections of insulin (10U/day).Two,four and eight weeks after implantation, rats were killed in batches. Histomorphometry and immunohistochemistry were used to evaluate bone formation and osseointegration. The amount of newly formed bone, Implant–bone contact and the expression of OCN,RUNX2 in the DM+insulin, n-DM and n-DM+insulin group were significantly more than in the DM group (p<0.05). Compared with the n-DM group,the Implant–bone contact and expression of OCN,RUNX2 were significantly increased in n-DM+insulin group (p< 0.05). Taken together,these observations provide evidence that insulin has the potential to increase bone formation and osseointegration around implant not only in diabetic subjects but also in non-diabetic subject.

Keywords: insulin, diabetes mellitus, osseointegration, dental implants

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Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Keywords: Bone Anchored Hearing Implant, baha, compression, maximum power output, speech understanding

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Authors: Suraj Muke, Vikas Mankumare, Sadhana Sathaye

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Osteoporosis is the most common metabolic bone disease which affects an estimated 25 million people worldwide, leading to 1 million fractures, 40,000 annual deaths and health costs of billions of dollars. It is estimated that about 80% of total osteoporosis patients are women, amongst which majority are above the age of 45 years. Postmenopausal osteoporosis is associated with lack of intestinal calcium absorption, increasing pro-oxidant and inflammatory mediators. Lawsonia inermis is a biennial dicotyledonous herbaceous shrub is reported to possess a high flavonoid, high phenolic and Inhibitors of osteoclastogenesis like Daphneside and Daphnorin. The present study aimed to screen osteoprotective effect of methanolic extract of Lawsonia inermis (LIM) in rat model along with its antioxidant activity. LIM shows phenolic content 146.3Milligrams of Gallic acid equivalent present per gram of extract and 19.8 Milligrams of rutin per gram of extract of Total flavonoid content with IC50 value 42.99μg/ml. bilateral ovariectomized rat model in which Healthy female wistar rats were used for screening. Treatment with LIM was carried out using graded doses of 25mg/kg, 50mg/kg and 100mg/kg for period of 28 days. The negative control group comprised of ovariectomized rats along with saline treatment for four weeks whereas sham operated rats were used as positive control.LIM showed a decrease in bone turnover by preventing loss of urinary calcium and phosphorous moreover it decreased the alkaline phosphatase levels and loss of bone density is prevented by LIM suggesting decrease in osteoclast activity.

Keywords: antioxidant, osteoclast, osteoporosis, ovariectomized

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Authors: Rezvan Hosseinian

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

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Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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Authors: Yousef M. Alammari, Mahmoud A. Gaddoury, Reem A. Almohaini, Sara A. Alharbi, Lena S. Alsaleem, Lujain H. Allowaihiq, Maha H. Alrashid, Abdullah H. Alghamdi, Abdullah A. Alaryni

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Objective: The goal of this study was to establish the prevalence of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients in Saudi Arabia and the variables that are linked to it. Methods: During June 2021, this cross-sectional study was carried out among SLE patients in Saudi Arabia. The Saudi Rheumatism Association exploited social media platforms to provide a self-administered online questionnaire to SLE patients. All data analyses were performed using the Statistical Packages for Social Sciences (SPSS) version 26. Results: Two hundred and five SLE patients participated in the study (females 91.3 % vs. males 8.7 %). In addition, 13.5 % of patients had a family history of SLE, and 26% had SLE for one to three years. Alteration or loss of sensation (53.4%), Fear (52.4%), and headache (48.1%) were the most prevalent signs of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients. The prevalence of patients with NPSLE was 40%. In a multivariate regression model, fear, altered sensations, cerebrovascular illness, sleep disruption, and diminished interest in routine activities were identified as independent risk variables for NPSLE. Conclusion: Nearly half of SLE patients demonstrated NP manifestations, with significant symptoms including fear, alteration of sensation, cerebrovascular disease, sleep disturbance, and reduced interest in normal activities. To detect the pathophysiology of NPSLE, it is necessary to understand the relationship between neuropsychiatric morbidity and other relevant rheumatic disorders in the SLE population.

Keywords: neuropsychiatric, systemic lupus erythematosus, NPSLE, prevalence, SLE patients

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Authors: N. Tadayon, H. Yousefnia, S. Zolghadri, A. Ramazani, A. R. Jalilian

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Bone metastases occur in many patients with solid malignant tumors. Recently, 1,2 propylene di-amino tetra methylenephosphonic acid (PDTMP) has been introduced as a suitable carrier in the development of therapeutic bone-avid radiopharmaceuticals. In this study, due to the desirable characteristics of 68Ga, 68Ga-PDTMP was prepared. 68Ga was obtained from SnO2 based generator. A stock solution of PDTMP was prepared by dissolving in 2 N NaOH. A certain volume of the stock solution was added to the vial containing 68GaCl3 and the pH of the mixture was adjusted to 4 using HEPES. Radiochemical purity of the radiolabelled complex was checked by thin layer chromatography. 68Ga-PDTMP was prepared in only 15 min with radiochemical purity of more than 98%. This new bone-seeking complex can be considered as a good candidate of PET-based radiopharmaceutical for imaging of bone metastases.

Keywords: bone metastases, Ga-68, imaging, PDTMP

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Authors: I. Slim, H. Akkari, A. Ben Abdallah, I. Bhouri, M. Hedi Bedoui

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Osteoporosis is a common disease characterized by low bone mass and deterioration of micro-architectural bone tissue, which provokes an increased risk of fracture. This work treats the texture characterization of trabecular bone radiographs. The aim was to analyze according to clinical research a group of 174 subjects: 87 osteoporotic patients (OP) with various bone fracture types and 87 control cases (CC). To characterize osteoporosis, Fractal and MultiFractal (MF) methods were applied to images for features (attributes) extraction. In order to improve the results, a new method of MF spectrum based on the q-stucture function calculation was proposed and a combination of Fractal and MF attributes was used. The Support Vector Machines (SVM) was applied as a classifier to distinguish between OP patients and CC subjects. The features fusion (fractal and MF) allowed a good discrimination between the two groups with an accuracy rate of 96.22%.

Keywords: fractal, micro-architecture analysis, multifractal, osteoporosis, SVM

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Authors: N. Tadayon, H. Yousefnia, S. Zolghadri, A. Ramazani, A. R. Jalilian

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In this study, 68Ga-PDTMP was prepared as a new agent for bone imaging. 68Ga was obtained from SnO2 based generator. A certain volume of the PDTMP solution was added to the vial containing 68GaCl3 and the pH of the mixture was adjusted to 4 using HEPES. Radiochemical purity of the radiolabelled complex was checked by thin layer chromatography. Biodistribution of this new agent was assessed in rats after intravenously injection of the complex. For this purpose, the rats were killed at specified times after injection and the weight and activity of each organ was measured. Injected dose per gram was calculated by dividing the activity of each organ to the total injected activity and the mass of each organ. As expected the most of the activity was accumulated in the bone tissue. The radiolabelled compound was extracted from blood very fast. This new bone-seeking complex can be considered as a good candidate of PET-based radiopharmaceutical for imaging of bone metastases.

Keywords: biodistribution, Ga-68, imaging, PDTMP

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Authors: Sungging Pintowantoro, Yuli Setiyorini, Rochman Rochim, Agung Purniawan

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The bacterial infections are frequent and undesired occurrences after bone fracture treatment. One approach to reduce the incidence of bone fracture infection is the additional of microbial agents into bone cement. In this study, the synthesis of bone cement from re-cycles biowaste was successfully conducted completed with anti-bacterial function. The re-cycle of biowaste using microwave assisted was done in our previous studies in order to produce some of powder (calcium carbonate, carbonated-hydroxyapatite and chitosan). The ratio of these powder combined with methylmethacrylate (MMA) as the matrix in bone cement were investigated using XRD, FTIR, SEM-EDX, hardness test and anti-bacterial test, respectively. From the XRD, FTIR and EDX were resulted the formation of carbonated-hydroxyapatite, calcium carbonate and chitosan. The morphology was revealed porous structure both C2H3K1L and C2H1K3L, respectively. The antibacterial activity was tested against Staphylococcus aureus (S. aureus) for 24 hours. The inhibition of S. aureus was clearly shown, the hollow zone was resulted in various distance 14.2mm, 7.5mm, and 7.7mm, respectively. The hardness test was depicted in various results, however, C2H1K3L can be achived 36.84HV which is closed to dry cancelous bone 35HV. In general, this study results was promising materials to use as bone cement materials.

Keywords: biomaterials, biowaste recycling, materials processing, microwave processing

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Authors: Lin Feng, E. Lingling, Hongchen Liu

Abstract:

In order to evaluate the effects of autologous blood vessels and nerves on vascularization. A dog model of tissue-engineered bone vascularization was established by constructing inferior alveolar neurovascular bundles through the mandibular canal. Sixteen 12-month-old healthy beagles were randomly divided into two groups (n=8). Group A retained inferior alveolar neurovascular bundles, and Group B retained inferior alveolar nerves. Bone marrow mesenchymal stem cells were injected into β-tricalcium phosphate to prepare internal tissue-engineered bone scaffold. A personalized titanium mesh was then prepared by rapid prototyping and fixed by external titanium scaffold. Two dogs in each group were sacrificed on the 30th, 45th, 60th, and 90th postoperative days respectively. The bone was visually examined, scanned by CT, and subjected to HE staining, immunohistochemical staining, vascular casting and PCR to detect the changes in osteogenesis and vascularization.The two groups had similar outcomes in regard to osteogenesis and vascularization (P>0.05) both showed remarkable regenerative capacities. The model of tissue-engineered bone vascularization is potentially applicable in clinical practice to allow satisfactory osteogenesis and vascularization.

Keywords: inferior alveolar neurovascular bundle, osteogenesis, tissue-engineered bone, vascularization

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Authors: A. Elsariti, T. Evans

Abstract:

The propagation mechanisms in the trabecular bone are poorly understood and have been the subject of extended debate; also, steel wool has been evaluated as a potential bone mimic, Its advantages are ready availability, low cost and a wide range of sizes. In this study, both distilled and tap water were used to estimate the ultrasonic attenuation in coarse steel wool. It is clear from the results that the attenuation of coarse steel wool increased as the distance between the transducers decreased, and it is higher in tap water than distilled water. At 9cm distance between the transducers the attenuation was approximately 0.97 and 4.7 dB in distilled and tap water respectively. While it is 6.97 and 12.2 dB in distilled and tap water respectively at distance 4cm. This change in the attenuation between both distilled and tap water is probably due to gas bubbles in the tap water.

Keywords: bone mimic, porosity, tap water, distilled water, ultrasonic attenuation

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Authors: Yunwei Zhang, Na Li, Yuhong Niu

Abstract:

Bone tissue engineering scaffold was regarded as an important clinical technology of curing bony defect. The patent protection of bone tissue engineering scaffold had been paid more attention and strengthened all over the world. This study analyzed the future development trends of international technologies in the field of bone tissue engineering scaffold and its patent protection. This study used the methods of data classification and classification indexing to analyze 2718 patents retrieved in the patent database. Results showed that the patents coming from United States had a competitive advantage over other countiries in the field of bone tissue engineering scaffold. The number of patent applications by a single company in U.S. was a quarter of that of the world. However, the capability of R&D in China was obviously weaker than global level, patents mainly coming from universities and scientific research institutions. Moreover, it would be predicted that synthetic organic materials as new materials would be gradually replaced by composite materials. The patent technology protections of composite materials would be more strengthened in the future.

Keywords: bone tissue engineering, patent analysis, Scaffold material, patent protection

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Authors: Yu-Chen Hu

Abstract:

Gene editing by CRISPR and gene regulation by microRNA or CRISPR activation have dramatically changed the way to manipulate cellular gene expression and cell fate. In recent years, various gene editing and gene manipulation technologies have been applied to control stem cell differentiation to enhance tissue regeneration. This research will focus on how to develop CRISPR, CRISPR activation (CRISPRa), CRISPR inhibition (CRISPRi), as well as bi-directional CRISPR-AI gene regulation technologies to control cell differentiation and bone regeneration. Moreover, in this study, CRISPR/Cas13d-mediated RNA editng for miRNA editing and bone regeneration will be discussed.

Keywords: gene therapy, bone regeneration, stem cell, CRISPR, gene regulation

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Authors: Maryam Firouzmandi, Moosa Miri

Abstract:

Common reasons for early tooth loss are trauma, extraction due to caries or periodontal disease and congenital missing. The remaining space after tooth loss may cause functional and esthetic problems. Therefore restorative dentists should attempt to manage these spaces using conservative methods. The goal is to restore the lost esthetic and function, prevent phonetic, self-esteem and personality problems and tongue habits. Preserving alveolar bone is also of great importance during the growth stage. Purpose: When deciding about the management of the missing tooth, space implants are contradicted until the completion of dentoalveolar development. Even in adulthood, due to systemic or periodontal problems or biological and economic issues, the implant might not be indicated. In this article, the alternative conservative restorative methods of space maintenance are going to be discussed. Essix retainers are made chair-side as easy as forming a custom bleaching tray with some modifications. They are esthetically acceptable and not expensive. These temporaries provide support for the lips but could not be used during function. Mini-screw-supported temporaries are another option for maintaining the space, especially after orthodontic treatment when there is a time lag between the termination of orthodontic treatment and definitive restoration. Two techniques will be presented for this kind of restoration: Denture tooth pontic or a composite crown. The benefits are alveolar bone preservation, Physiologic pressure on the alveolar ridge to increase its density and even can be retained until the completion of the definitive treatment. Bonded fixed partial denture includes Maryland bridge, fiber-reinforced composite bridge, resin-bonded bridge, and ceramic bonded bridge. These types of bridges are recommended to be used after a pubertal growth spurt and a recent meta-analysis considered their clinical success similar to conventional FDPs and implant-supported crowns. However, they have several advantages that are going to be discussed by presenting some clinical examples. Practical instruction on how to construct an FRC bridge and a novel chair-side Maryland bridge will be given by means of clinical cases. Clinical relevance: minimally invasive options should always be considered and destruction of healthy enamel and dentin during the preparation phase should be avoided as much as possible.

Keywords: tooth missing, fiber-reinforced composite, Maryland, Essix retainers, screw-retained restoration

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Authors: Gileade P. Freitas, Helena B. Lopes, Alann T. P. Souza, Paula G. F. P. Oliveira, Adriana L. G. Almeida, Paulo G. Coelho, Marcio M. Beloti, Adalberto L. Rosa

Abstract:

Bone tissue presents great capacity to regenerate when injured by trauma, infectious processes, or neoplasia. However, the extent of injury may exceed the inherent tissue regeneration capability demanding some kind of additional intervention. In this scenario, cell therapy has emerged as a promising alternative to treat challenging bone defects. This study aimed at evaluating the effect of local injection of bone marrow-derived mesenchymal stem cells (BM-MSCs) and adipose tissue-derived mesenchymal stem cells (AT-MSCs) on bone regeneration of rat calvaria defects. BM-MSCs and AT-MSCs were isolated and characterized by expression of surface markers; cell viability was evaluated after injection through a 21G needle. Defects of 5 mm in diameter were created in calvaria and after two weeks a single injection of BM-MSCs, AT-MSCs or vehicle-PBS without cells (Control) was carried out. Cells were tracked by bioluminescence and at 4 weeks post-injection bone formation was evaluated by micro-computed tomography (μCT) and histology, nanoindentation, and through gene expression of bone remodeling markers. The data were evaluated by one-way analysis of variance (p≤0.05). BM-MSCs and AT-MSCs presented characteristics of mesenchymal stem cells, kept viability after passing through a 21G needle and remained in the defects until day 14. In general, injection of both BM-MSCs and AT-MSCs resulted in higher bone formation compared to Control. Additionally, this bone tissue displayed elastic modulus and hardness similar to the pristine calvaria bone. The expression of all evaluated genes involved in bone formation was upregulated in bone tissue formed by BM-MSCs compared to AT-MSCs while genes involved in bone resorption were upregulated in AT-MSCs-formed bone. We show that cell therapy based on the local injection of BM-MSCs or AT-MSCs is effective in delivering viable cells that displayed local engraftment and induced a significant improvement in bone healing. Despite differences in the molecular cues observed between BM-MSCs and AT-MSCs, both cells were capable of forming bone tissue at comparable amounts and properties. These findings may drive cell therapy approaches toward the complete bone regeneration of challenging sites.

Keywords: cell therapy, mesenchymal stem cells, bone repair, cell culture

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Authors: Margarita A. Belousova, Sergey N. Ermoliev, Nina K. Loginova

Abstract:

The method of intraoral ultrasound densitometry developed to diagnose mineral density of alveolar bone jaws during retention period of orthodontic treatment (Patent of Russian Federation № 2541038). It was revealed significant decrease of the ultrasonic wave speed and bone mineral density in patients with relapses dentition anomalies during retention period of orthodontic treatment.

Keywords: intraoral ultrasonic densitometry, speed of sound, alveolar jaw bone, relapses of dentition anomalies, retention period of orthodontic treatment

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Authors: Rajendra Kumar Kanojia

Abstract:

Correction of the gap created by the resection of large juxtra-articular tumours of the femur would be difficult to manage, several bone substitutes, bone grafts, and artificial bone granules were tried but the results were not as good as with the distraction osteogensis, by the help of either Ilizarov ring fixator or the mono-rail fixators. We are presenting a small study of five cases of malignant tumours of the distal femur, removed, custom made mega prosthesis was applied and that failed twice in a span of five years. We had no better option left then to apply mono-rail fixator, and start the process of distraction osteogeneis, we got the union, gap was filled with new bone and patient has been made walking in few months.

Keywords: distal femur tumour, resection, defect non-union, mono-rail fixator

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Authors: Kang-Hyun Leem, Myung-Gyou Kim, Hye Kyung Kim

Abstract:

Eggs have long been an important contributor to the nutritional quality of the human, and recognized as a very valuable source of proteins for human nutrition. Egg yolk is composed of various important chemical substances for human health. Growth means not only the increase of body weight but also the elongation of height and the enlargement of each organ's anatomical and morphological size. A calcium shortage causes the growth retardation on the body growth. In this study, we examined the therapeutic effects of egg yolk peptide (EYP) on the retardation of the longitudinal bone growth induced by low-calcium diet (0.05%) in adolescent rats. Low calcium diets were administrated for 15 days. During the last five days, calcium and/or vitamin D and/or EYP were administrated. The body weights, longitudinal bone growth rates, the heights of growth plates, and bone morphogenetic protein (BMP)-2 and insulin-like growth factor (IGF)-1 expressions were measured using histochemical analysis. Low calcium diets caused the significant reduction in body weight gains and the longitudinal bone growth. The heights of growth plates and the expressions of BMP-2 and IGF-1 showed the impairment of body growth as well. Calcium and/or vitamin D administration could not significantly increase the longitudinal bone growth. However, calcium, vitamin D, and EYP administration significantly increased the bone growth, the growth plate height, and BMP-2 and IGF-1 expressions. These results suggest that EYP enhances the longitudinal bone growth in the calcium and/or vitamin D deficiency and it could be a promising agent for the treatment of children suffering from malnutrition.

Keywords: egg yolk peptide, low-calcium diet, longitudinal bone growth, morphogenetic protein-2, insulin-like growth factor-1, vitamin D

Procedia PDF Downloads 419