Quantitative Densitometry Research Articles

Progression prediction in idiopathic inflammatory myopathy-associated interstitial lung disease: a combination of initial high attenuation areas and anti-melanoma differentiation-associated gene 5-positive.

To analyse quantitative lung densitometry and clinical baseline data of individuals with idiopathic inflammatory myopathy (IIM) and identify risk factors capable of predicting the progression of interstitial lung disease (ILD). We utilised quantitative lung densitometry and clinical baseline data as explanatory variables. Univariate and multivariate Cox regression analyses were employed to pinpoint effective risk factors for predicting ILD progression in IIM patients. The findings from the Cox univariate regression analysis indicate that elevated carcinoembryonic antigen levels (HR=1.036, 95% CI 1.004-1.069) are connected to an elevated risk of ILD progression in patients with IIM (P=0.027), while PO2 (HR=0.980, 95% CI 0.962-0.997) , forced vital capacity (HR=0.551, 95% CI 0.320-0.946) are protective factors for ILD progression in patients with IIM (p=0.025, p=0.031, respectively), anti-EJ positivity (HR=0.399, 95% CI 0.175-0.912) and anti-Ro52 positivity (HR=0.437, 95% CI 0.199-0.960) are risk factors for ILD progression in patients with IIM (p=0.029, p=0.039, respectively). Furthermore, the results of Cox multivariate regression analysis reveal that high attenuation areas (HAA) (>465.745 cm3) (HR=5.007, 95% CI 1.773-14.144) and anti-melanoma differentiation-associated gene 5 (Anti-MDA5) positivity (HR=0.127, 95% CI 0.041-0.396) are autonomous prognostic risk factors for ILD progression in individuals with IIM (p=0.002, p<0.001, respectively). Among IIM patients, those who are anti-MDA5-positive, and exhibit HAA (>465.745cm3) are more likely to experience ILD progression.

Comparison between Quantitative Computed Tomography and Dual-Energy X-Ray Absorptiometry in the Detection of Osteoporosis in Postmenopausal Women

Background: Osteoporosis is denoted by low bone mass and microarchitectural breakdown of bone tissue, directing to increased fracture risk and bone fragility. Fractures may lead to a decreased quality of life and increased medical costs. Thus, osteoporosis is widely considered a significant health concern. Objective. This study aimed to compare quantitative computed tomography (QCT) and dual-energy X-Ray absorptiometry (DXA) to detect osteoporosis in postmenopausal women. Subjects and Methods. We measured spinal volumetric bone mineral density (BMD) with QCT and areal spinal and hip BMD with DXA in 164 postmenopausal women. We calculated the osteopenia and osteoporosis detection rate for the two methods. The difference between these rates for DXA versus QCT was analyzed using the chi-square test. Results. The detection rate of osteoporosis was 57.9% for QCT and 50.6% for DXA (significant difference, p=0.002). At the same time, the detection rate of osteopenia was 36.6% for QCT and 31.7% for DXA (significant difference, p=0.002). Conclusions. Quantitative CT bone densitometry is an excellent tool for the evaluation of BMD. It is more sensitive than DXA for detecting osteoporosis in postmenopausal women.

Evaluation of the effectiveness of treatment and monitoring of patients with systemic bone tissue disorders during dental implantation

The article presents a study of bone mineral density by DEXA and evaluated the effectiveness of correcting therapy using vitamin D by quantitative ultrasound densitometry to increase the effectiveness of the treatment of patients with dental defects in the background of systemic osteoporosis by dental implantation. Materials and methods: 619 people were examined by quantitative ultrasonic densitometry. The dynamics of changes in bone mineralization was studied with an interval of six months and 1 year. A comparative analysis of the average values of quantitative ultrasonic densitometry was carried out at various times after the installation of dental implants in the control and main groups. Results. Sound velocity values in patients with normal bone mass were (4203,3 ± 7,9). In patients with osteopenia, the rate of ultrasound in bone tissue was 3992,2 ± 3,6 (p &lt; 0.001); in patients with osteoporosis 3802,7 ± 14,9 (p &lt; 0.001). All these parameters were obtained after the use of corrective therapy with vitamin D3. Conclusions. The analysis of the results of quantitative ultrasound densitometry revealed that in the group of patients with osteoporosis, the indicators were reduced by an average of 9.5 % compared with patients with normal bone indicators (p &lt; 0.001).

PREVALENCE OF OSTEOPOROSIS IN WOMEN AGED 35 TO 65 YEARS IN TEA GARDEN COMMUNITY OF JORHAT DISTRICT

Background: Osteoporosis poses a huge challenge in India, as it is a developing country due to demographic transition and aging of the population along with limited resource availability in rural India.Osteoporosis predominantly affects postmenopausal women. The mal-nutrition, and smoking, consumption of liquor and tobacco may have an effect on bone mineral density (BMD) .Osteoporosis occurs in all populations, but not all populations are at equal risk. According to various studies, Asian women have higher predisposition for osteoporosis than their Caucasian people. Reasons attributed for lower bone mineral density (BMD) in Indians include possible genetic differences, nutritional deciency and smaller skeletal size. Smoking or tobacco intake, malnourishment, alcohol has a negative effect on bone mineral density [BMD]. Tea garden people are probably more affected than other communities in the surrounding area as evidence by high attendance of patients with osteoporosis &amp; fragility fractures in Orthopaedic OPD of JMCH. Increase prevalence in the community might be wholly or partly due to poor socio-economic status , poor nutrition, lack of calcium and vitamin d in diet, dark skin and addiction to alcohol. Purpose of the study: to study the prevalence of osteoporosis in middle-aged to elderly tea garden women of Jorhat district. Materials and Methods: In this community based cross-sectional study, BMD (bone mineral density) of 360 female subjects, aged 35 to 65 years, were calculated using quantitative ultrasound bone densitometry.(QUS) In our study 24.7% were Results: osteoporotic, followed by 39.5% were osteopenic and 35.8% had normal BMD. Thus, the prevalence of osteoporosis in our study, in the female population of tea gardens of Jorhat district was 24.7%

Quantitative CT lung densitometry as an obstructive marker for the diagnosis of bronchiolitis obliterans in children.

The purpose of this study is to evaluate the quantitative diagnostic performance of computed tomography (CT) densitometry in pediatric patients with bronchiolitis obliterans (BO). We measured the mean lung density (MLD) and represented the difference of MLD in inspiratory and expiratory phases (MLDD), the ratio of the MLD (E/I MLD), and the relative volume percentage of lung density at 50-Hounsfield unit (HU) interval threshold (E600 to E950). We calculated the sensitivity, specificity, and diagnostic accuracy of the lung density indices for the diagnosis of BO. A total of 81 patients, including 51 patients with BO and 30 controls, were included in this study. In the BO patients, expiratory (EXP) MLD and MLDD were significantly lower, and E/I MLD and expiratory low attenuation areas below the threshold of −850 HU to −950 HU (E850, E900, and E950) were statistically significantly higher than controls. Multivariate logistic regression analysis showed that MLDD (odds ratio [OR] = 0.98, p < .001), E/I MLD (OR = 1.39, p < .001), and E850 to E950 were significant densitometry parameters for BO diagnosis. In a receiver-operating characteristic analysis, E900 (cutoff, 1.4%; AUC = 0.920), E/I MLD (cutoff, 0.87; AUC = 0.887), and MLDD (cutoff, 109 HU; AUC = 0.867) showed high accuracy for the diagnosis of BO. In conclusion, the lung CT densitometry can serve as a quantitative marker providing additional indications of expiratory airflow limitation in pediatric patients with BO.

Optical bone densitometry robust to variation of soft tissue using machine learning techniques: validation by Monte Carlo simulation.

.Significance: To achieve early detection of osteoporosis, a simple bone densitometry method using optics was proposed. However, individual differences in soft tissue structure and optical properties can cause errors in quantitative bone densitometry. Therefore, developing optical bone densitometry that is robust to soft tissue variations is important for the early detection of osteoporosis.Aim: The purpose of this study was to develop an optical bone densitometer that is insensitive to soft tissue, using Monte Carlo simulation and machine learning techniques, and to verify its feasibility.Approach: We propose a method to measure spatially resolved diffuse light from three directions of the biological tissue model and used machine learning techniques to predict bone density from these data. The three directions are backward, forward, and lateral to the direction of ballistic light irradiation. The method was validated using Monte Carlo simulations using synthetic biological tissue models with 1211 different random structural and optical properties.Results: The results were computed after a 10-fold cross-validation. From the simulated optical data, the machine learning model predicted bone density with a coefficient of determination of 0.760.Conclusions: The optical bone densitometry method proposed in this study was found to be robust against individual differences in soft tissue.

P066 Orthopedic complications of osteogenesis imperfecta

Abstract Background Osteogenesis imperfecta (OI) is an inherited connective tissue disorder including various skeletal manifestations. Bone fragility, vertebral body malformation and length lower limbs inequality are often responsible for orthopedic complications. The aim of our study was to determine orthopedic complications of OI and to specify management modalities in rheumatology. Methods We conduct a retrospective study based on the files of children referred to the rheumatology departement over the last 15 years, for treatment of OI. The evaluation was clinical and radiological. Clinical examination included joint and spine assessment. An X-ray of the spine and painful joints associated with a quantitative densitometry were requested. Results Five patients were collected, their mean age was 9 years. All patients had peripheral fracture. Joint assessment revealed a flessum of the elbow and a reduction of the motion of hip in 40% of cases. Scoliosis was noted also in 40% of cases. The average of spine Z –score was -3, 4. All children had benefited from oral calcium and vitamin D supplementation associated with cyclic intravenous bisphosphonates and an adapted rehabilitation protocol. Surgical management was often needed in 2 cases. Discussion and Conclusion Orthopedic complications during OI are essentially the consequence of lower bone mineral density which would cause peripheral or vertebral fracture. Indeed, some other factors like length inequality, pelvic obliquity, ligamentous laxity and inter-vertebral disc abnormalities could be involved in scoliotic progression. The management of these skeletal complications must be early and multidisciplinary in order to improve the prognosis and the quality of life of the patient

Assessing predictors of rheumatoid arthritis-associated interstitial lung disease using quantitative lung densitometry.

To assess predictors of subclinical RA-associated interstitial lung disease (RA-ILD) using quantitative lung densitometry (qLD). RA patients underwent multi-detector row CT scanning at baseline and after an average of 39 months. Scans were analysed with qLD for the percentage of lung parenchyma with high attenuation areas (%HAA: the percentage of voxels of -600 to -250 Hounsfield units). Additionally, a pulmonary radiologist calculated an expertradiologist scoring (ERS) for RA-ILD features. Generalized linear models were used to identify indicators of baseline %HAA and predictors of %HAA change. Baseline %HAA was assessed in 193 RA patients and 106 had repeat qLD assessment. %HAA was correlated with ERS (Spearman's rho = 0.261; P < 0.001). Significant indicators of high baseline %HAA (>10% of lung parenchyma with high attenuation) included female sex, higher pack-years of smoking, higher BMI and anti-CCP ≥200 units, collectively contributing an area under the receiver operator curve of 0.88 (95% CI 0.81, 0.95). Predictors of %HAA increase, occurring in 49% with repeat qLD, included higher baseline %HAA, presence of mucin 5B (MUC5B) minor allele and absence of HLA-DRB1 shared epitope (area under the receiver operator curve = 0.69; 95% CI 0.58, 0.79). The association of the MUC5B minor allele with %HAA change was higher among men and those with higher cumulative smoking. Within the group with increased %HAA, anti-CCP level was significantly associated with a greater increase in %HAA. %HAA, assessed with qLD, was linked to several known risk factors for RA-ILD and may represent a more quantitative method to identify RA-ILD and track progression than expert radiologist interpretation.

Diagnostic Performance of Conebeam CT Pixel Values in Active Fenestral Otosclerosis.

Quantitative bone densitometry on multidetector CT of the temporal bone is a diagnostic adjunct for otosclerosis in its active (spongiotic) phase, but translating this technique to conebeam CT is limited by the technical variability of conebeam CT pixel values. The purpose of this study was to evaluate the performance of internally calibrated conebeam CT pixel value measurements that can enable the determination of active fenestral otosclerosis (otospongiosis). This study included 37 ears in 22 patients with a clinical diagnosis of otospongiosis in those ears and 35 ears in 22 control patients without the diagnosis. Temporal bone conebeam CT was performed. ROIs were set anterior to the oval window, in the lateral semicircular canal bone island, and in a nearby aerated space. Mean conebeam CT pixel values in these regions determined the relative attenuation ratio of the area anterior to the oval window normalized to normal otic capsule bone and air. The relative attenuation ratio for cases of otospongiosis was significantly lower than that for controls (P < .001). Based on receiver operating characteristic analysis, the optimal cutoff relative attenuation ratio was 0.876, which had an accuracy of 97.2% for the diagnosis of otospongiosis. Internally calibrated pixel value ratios in temporal bone conebeam CT can feasibly help diagnose active/spongiotic-phase fenestral otosclerosis in an objective manner.

GDNF signaling in subjects with minimal motor deficits and Parkinson's disease

The failure of glial cell derived neurotropic factor to be efficacious in blinded clinical trials for Parkinson's disease may be due to alterations in signaling receptors and downstream signaling molecules. To test this hypothesis, brain sections were obtained from older adults with no motor deficit (n = 6), minimal motor deficits (n = 10), and clinical diagnosis of Parkinson's disease (n = 10) who underwent motor examination proximate to death. Quantitative unbiased stereology and densitometry were performed to analyze RET and phosphorylated ribosomal protein S6 expression in nigral neurons. Individuals with no motor deficit had extensive and intense RET and phosphorylated ribosomal protein S6 immunoreactive neurons in substantia nigra. The number and staining intensity of RET-immunoreactive neurons were reduced moderately in subjects with minimal motor deficits and severely reduced in Parkinson's disease relative to no motor deficit group. The number and staining intensity of phosphorylated ribosomal protein S6 was more markedly reduced in both subjects with minimal motor deficits and Parkinson's disease. Reductions in levels of RET and phosphorylated ribosomal protein S6 were recapitulated in a non-human primate genetic Parkinson's disease model based on over-expression of human mutant α-synuclein (A53T). These data indicate that for neurotrophic factors to be effective in patients with minimal motor deficits or PD, these factors would likely have to upregulate RET and phosphorylated ribosomal protein S6 immunoreactive neurons in substantia nigra .

Perfusion imaging-based tissue-level collaterals predict ischemic lesion net water uptake in patients with acute ischemic stroke and large vessel occlusion

Ischemic lesion Net Water Uptake (NWU) quantifies cerebral edema formation and likely correlates with the microvascular perfusion status of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We hypothesized that favorable tissue-level collaterals (TLC) predict less NWU and good functional outcomes. We performed a retrospective multicenter analysis of AIS-LVO patients who underwent thrombectomy triage. TLC were measured on cerebral perfusion studies using the hypoperfusion intensity ratio (HIR; volume ratio of brain tissue with [Tmax > 10 sec/Tmax > 6 sec]); favorable TLC were regarded as HIR 0.4. NWU was determined using a quantitative densitometry approach on follow-up CT. Primary outcome was NWU. Secondary outcome was a good functional outcome (modified Rankin Scale [mRS] 0–2). 580 patients met inclusion criteria. Favorable TLC (β: 4.23, SE: 0.65; p < 0.001) predicted smaller NWU after treatment. Favorable TLC (OR: 2.35, [95% CI: 1.31–4.21]; p < 0.001), and decreased NWU (OR: 0.75, [95% CI: 0.70–0.79]; p < 0.001) predicted good functional outcome, while controlling for age, glucose, CTA collaterals, baseline NIHSS and good vessel reperfusion status. We conclude that favorable TLC predict less ischemic lesion NWU after treatment in AIS-LVO patients. Favorable TLC and decreased NWU were independent predictors of good functional outcome.

Does Quantitative Ultrasound at the Calcaneus Predict an Osteoporosis Diagnosis in Postmenopausal Women from the Silesia Osteo Active Study?

The aims of the study were to assess the clinical conformity between quantitative ultrasound (QUS) and densitometry with use of the standard World Health Organization T-score thresholds to determine optimal diagnostic cutoff values for QUS T-scores in different age groups. Three hundred sixty-five postmenopausal Caucasian women were enrolled into the study and divided into two age groups (<65 y and ≥65 y). Skeletal status was assessed using QUS measurements at the calcaneus and bone densitometry at the spine and proximal femur (Hologic Explorer, Bedford, MA, USA). QUS measurement results expressed as the stiffness index (SI) correlated significantly with both femoral neck bone mineral density (r = 0.51, p < 0.0001) and lumbar spine bone mineral density (r = 0.52, p < 0.0001). On the basis of receiver operating characteristic curve analyses, the thresholds for correspondence between QUS T-score values and T-score –2.5SD in dual X-ray absorptiometry (DXA) were established. They ranged between –1.63SD and –1.70SD in relation to femoral neck DXA and between –1.22SD and –1.51SD in relation to lumbar spine DXA, depending on age category. In conclusion, the study described here confirmed that QUS measurements at the calcaneus may provide information comparable to DXA examinations at the femoral neck and lumbar spine in postmenopausal women.

Associations between Bone Material Strength Index, Calcaneal Quantitative Ultrasound, and Bone Mineral Density in Men.

ObjectivesImpact micro-indentation (IMI) measures bone material strength index (BMSi) in vivo. This study investigated how IMI is associated with calcaneal quantitative ultrasound and bone densitometry parameters in men.MethodsBMSi was measured on the tibial plateau using the OsteoProbe in 377 men (age 33-96 years) from the Geelong Osteoporosis Study. Broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) were assessed at the calcaneus using an ultrasonometer. Areal BMD was measured at several skeletal sites using dual-energy x-ray absorptiometry. Linear associations between parameters were tested using Pearson’s correlation. Multivariable regression techniques were used to determine associations between BMSi and other measures of bone, independent of confounders.ResultsBMSi was negatively correlated with age (r = –0.171, P = .001), weight (r = –0.100, P = .052), and body mass index (r = –0.187, P = .001), and positively with height (r = +0.109, P = .034). There was some evidence to support a positive association between BMSi and BUA (β = 0.052, P = .037), SOS (β = 0.013, P = .144), and SI (β = 0.036, P = .051). After age adjustment, this association was attenuated. No correlations were observed between BMSi and BMD at any skeletal site (r values ranged from –0.006 to +0.079, all P ≥ .13).ConclusionThere was a small positive association between BMSi and quantitative ultrasound (QUS) parameters, which were not independent of age. No associations were detected between BMSi and BMD. This suggests that BMSi and QUS are capturing common age-dependent properties of bone. Further research on the utility of IMI alone and complementary to conventional bone testing methods for predicting fracture risk is warranted.

Revisiting the radiographic assessment of osteoporosis-Osteopenia in children 0-2 years of age. A systematic review.

BackgroundImaging for osteoporosis has two major aims, first, to identify the presence of low bone mass (osteopenia), and second, to quantify bone mass using semiquantitative (conventional radiography) or quantitative (densitometry) methods. In young children, densitometry is hampered by the lack of reference values, and high-quality radiographs still play a role although the evaluation of osteopenia as a marker for osteoporosis is subjective and based on personal experience. Medical experts questioned in court over child abuse, often refer to the literature and state that 20–40% loss of bone mass is warranted before osteopenia becomes evident on radiographs. In our systematic review, we aimed at identifying evidence underpinning this statement. A secondary outcome was identifying normal references for cortical thickness of the skeleton in infants born term, < 2 years of age.MethodsWe undertook systematic searches in Medline, Embase and Svemed+, covering 1946–2020. Unpublished material was searched in Clinical trials and International Clinical Trials Registry Platform (ICTRP). Both relevant subject headings and free text words were used for the following concepts: osteoporosis or osteopenia, radiography, children up to 6 years.ResultsA total 5592 publications were identified, of which none met the inclusion criteria for the primary outcome; the degree of bone loss warranted before osteopenia becomes visible radiographically. As for the secondary outcome, 21 studies were identified. None of the studies was true population based and none covered the pre-defined age range from 0–2 years. However, four studies of which three having a crossectional and one a longitudinal design, included newborns while one study included children 0–2 years.ConclusionsDespite an extensive literature search, we did not find any studies supporting the assumption that a 20–40% bone loss is required before osteopenia becomes visible on radiographs. Reference values for cortical thickness were sparse. Further studies addressing this important topic are warranted.

Postcardiac arrest neurological prognostication with quantitative regional cerebral densitometry

PurposeTo quantitatively assess the severity of anoxic-ischemic brain injury early after cardiac arrest (CA) using a novel automated method applied to head computed tomography (HCT). MethodsAdult patients who were comatose and underwent HCT < 24 h after arrest were included in a retrospective analysis. Principal endpoint was unfavorable outcome (UO) defined as Cerebral Performance Category (CPC) of 3–5 at hospital discharge. We developed an automated processing algorithm for HCT images to be registered, atlas-segmented in 181 regions, and region-specific radiologic densities determined in Hounsfield Units. This approach was compared with an established manual method evaluating grey-white matter ratios (GWR). We tested univariable and multivariable prognostic models which integrated clinical and HCT features including densities in lobes and in nodes of cerebral networks linked to CA recovery. ResultsNinety-one patients were enrolled among whom 66 (73%) had an UO. HCTs were interpreted as normal or without acute abnormality by a neuroradiologist in 77 cases (85%). Compared to the favorable outcome group, UO patients had significantly lower densities in all lobes and in nodes of cerebral networks. A model combining clinical variables with the automated method applied to cerebral network nodes had the highest prognostic performance although not significantly different than the combined clinical-GWR method (AUC [95% CI] 0.94 [0.86−1.00] and 0.92 [0.83−1.00] respectively). ConclusionIn comatose survivors of CA, automated quantitative analysis of HCT revealed very early multifocal changes in brain tissue density which are mostly overlooked on conventional neuroradiologic interpretation and are associated with neurological outcome.

Studi korelasi antara sarkopenia dengan nilai bone mineral density (BMD) pada populasi geriatri di Desa Adat Kapal

Background: Sarcopenia is a common condition in geriatric population. Prior studies suggest its relationship with decreased bone mineral density (BMD) level.&#x0D; Objective: To determine the correlation between sarcopenia and bone mineral density among geriatric population.&#x0D; Methods: This cross-sectional study employed random sampling method to select for participants. Study were invited to attend for assessments including bioelectrical impedance analysis (BIA) and digital handgrip dynamometer from which muscle mass and power were determined respectively, whilst bone mineral density was assessed using quantitative ultrasound densitometry (QUS). Data analysis was performed using SPSS 16.&#x0D; Results: Sixty-six samples aged 60 to 77 years contributed data to the analysis in which 22.73% was sarcopenic. Abnormal BMD level (53%), low muscle mass (38%), low muscle power (28%), and low physical performance (29%) were assessed accordingly. Data analysis revealed correlation between BMD with muscle mass (r=0.282; p=0.023), age (r=-0.131; p=0.298), physical performance (r=-0.578; p=0.000), and handgrip (r=0.434; p=0.000). Comparative test yielded mean BMD level of -2,37 and -1,59 in sarcopenic and non-sarcopenic study respectively (p=0.003). There was positive correlation between sarcopenia and BMD level (r=0.373; p= 0.002).&#x0D; Conclusion: Sarcopenia prevalence is relatively high in geriatric population. Lower BMD level is observed in sarcopenic population. There is strong positive correlation between sarcopenia and BMD level, thus reflecting lower level of BMD in sarcopenic patient. Factors associated with BMD level according to the strength of correlation are physical performance, muscle power, muscle mass, and age.

MINERAL DENSITY OF BONE TISSUE AND INDICATORS OF BONE REMODELING IN HIGHLY SKILLED ATHLETES IN THE ANNUAL TRAINING CYCLE

Aim. The article aims at studying the relationship between the mineral density of heel bone and bone remodeling in cyclistduring the annual training cycle. Materials and methods. The study involved 14 highly skilled male cyclists (cycle track, MS, MSIC) aged 20–25 years with a sports experience of 5 to 16 years. The measurements were performed in the preparatory, pre-competitive and competitive periods of the annual training cycle. Bone mineral density (BMD) was measured by the method of quantitative ultrasound densitometry (QUS) using the Achilles Express ultrasonometer (Lunar, USA). BMD was estimated as a percentage of the peak norm for a given section of the skeleton (reference norms for 20–29 years). Results. The dynamics of BMD in the annual cycle correlates with a change in bone remodeling and phosphorus-calcium metabolism. A decrease in BMD during the competitive period is associated with an increase in β-Cross Laps and a decrease in osteocalcin, alkaline phosphatase, ionized calcium and serum phosphorus. Conclusion. A decrease in BMD is associated with an increase in the activity of osteoclasts and a decrease in osteoblastic activity. Indicators of bone remodeling and phosphorus-calcium metabolism reflect the status of bone tissue and the processes of general adaptation to training loads, and can be used as markers of risk of decreased BMD. The heel bone QUS method can be used to identify athletes at risk for hypotrophic conditions.

Long-lasting prothrombotic state implied by changes of plasma von Willebrand factor parameters after radical prostatectomy for prostate malignancy

ObjectivesThromboembolic complications are present in 0.8%–16.8% of the cases after radical prostatectomy (RP). Association between elevated plasma von Willebrand factor (VWF) levels—as an endothelial activation marker—and increased risk of thrombotic events has been evidenced.We aimed to elicit new data on the VWF after RP in prostate cancer patients and explore the role of it as a thrombotic risk factor. Upon perioperative plasma VWF levels (VWF:Ag) its collagen-binding (CB) activity (VWF:CB), multimerization, and cleaving enzyme (ADAMTS13 [a disintegrin and metalloprotease with thrombospondin type repeats, motif 1, type 13]) of the VWF multimers were quantitated along with Factor VIII and routine laboratory parameters in this observational pilot study. MethodsPlasma samples of 24 prostate cancer patients were collected before (-1 day; D-1) and after RP (1 hour, 6 days, 1 month, and 10 months; H1, D6, M1, and M10). VWF:Ag, VWF:CB, ADAMTS13:Ag were measured by ELISA, and the multimer distribution by electrophoresis and quantitative densitometry. Factor VIII, fibrinogen, D-dimer, and other routine laboratory parameters were determined as well. Preoperative values served as baselines which were compared to controls (24 healthy individuals). ResultsVWF:Ag and CB elevated by 122% and 143% respectively at H1 after RP then plateaued at D6 compared to baseline values. ADAMTS13/VWF:Ag ratio reduced by 41% at H1, and by 46% at D6, meanwhile the ratio of high molecular weight multimers increased as well. Values returned to baseline at M1 and further reduced to the levels of the controls at M10. All of the 24 patients at H1 and D6 and 14 at M10 were in potential prothombotic state according ROC analysis of the VWF parameters as indicators. ConclusionsProstate malignancy and then surgical stress, and inflammatory reactions induced release of VWF from the endothelial cells, along with an increasing amount of large multimers and relative reduction of ADAMTS13 level. Because these changes mark a prothrombotic state even at M1 after RP, more than 1 month follow-up and prophylactic targeting through the thrombotic and inflammatory activity of the VWF is proposed. Evaluation of VWF parameters provides new information about the long-term disturbances of primary hemostasis after radical pelvic oncologic surgery like RP and might improve the understanding the physiological and pathological recovery.

Effect of estrogen receptor-α gene polymorphism on serum osteoprotegerin and calcaneus bone density in postmenopausal women in Guangxi Zhuang nationality

Objective To investigate the effect of estrogen receptor-α gene polymorphism on osteoprotegerin(OPG)and calcaneus bone density in early and late postmenopausal women in Guangxi Zhuang nationality, in order to provide the theoretical basis for the early prevention and treatment of postmenopausal osteoporosis caused by estrogen receptor gene-induced osteoprotegerin reduction. Methods The broadband ultrasound attenuation in the right heel bone was measured by quantitative ultrasound bone densitometry in 621 postmenopausal women of Guangxi Zhuang nationality.Peripheral blood mononuclear cells and their DNA were extracted.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to detect the estrogen receptor-α gene polymorphism.Serum osteoprotegerin level was determined by enzyme-linked immunosorbent assay.The differences of data distribution of OPG and calcaneus bone density were compared between five items of 3 genotypes and 2 alleles at the same age group of 40-, 45-, 50-, 55-, 60-, 65-, 70-, 75-80 years. Results Women aged 60 years and over versus those aged 40-59 years showed that serum osteoprotegerin(OPG)and bone mineral density(BMD)were decreased(P 0.05). Women aged 60 years and over showed that ER-α Puv Ⅱ polymorphism of allele big P versus p, Pp, pp, PP in the same age groups had significantly decreased serum osteoprotegerin and bone mineral density.Women aged 65 years and over showed that ER-α XbaⅠpolymorphism of heterozygote Xx versus xx, XX, X, x in the same age groups had a significantly increased serum osteoprotegerin and bone mineral density(P<0.05). Conclusions Women with big P allele of ER-α PvuⅡpolymorphism have low serum osteoprotegerin level and a decreased bone mineral density, who are prone to postmenopausal osteoporosis.Thus, P allele of ER-α PvuⅡpolymorphism is a causative agent.More attention should be paid to early prevention and treatment.But, women with the Xx heterozygote of ER-α XbaⅠpolymorphism have high serum osteoprotegerin level and an increased bone mineral density, who are not easy to suffer from postmenopausal osteoporosis.Therefore, Xx heterozygote of ER-α XbaⅠpolymorphism is a protective agent.The prevention and treatment of postmenopausal osteoporosis should be individualized based on estrogen receptor-α gene polymorphism. Key words: Zhuang nationality; Receptors, estrogen; Polymorphism, single nucleotide; Osteoprotegerin

GAD mRNA in Orbital Prefrontal Cortex and Anterior Cingulate Cortex in Alcoholics Compared with Nonpsychiatric Controls: A Negative Postmortem Study.

Alcohol increases inhibitory neurotransmission, an effect mediated through GABA receptors. With chronic alcohol exposure, the inhibitory effects diminish. Glutamic acid decarboxylase (GAD) catalyzes glutamate in the synthesis of GABA. We sought to determine the amount of GAD65/67 mRNA in anterior cingulate cortex (BA24) and orbital prefrontal cortex (BA45) of medication-free alcoholics and nonpsychiatric controls postmortem.Studies were performed in 16 pairs of nonpsychiatric controls and alcoholics, matched for age, sex and PMI. DSM-IV diagnosis of alcohol use disorder (AUD) was made by the SCID I in a psychological autopsy. Frozen blocks of BA24 or BA45 were sectioned (10 µm) for in situ hybridization of 35S-labelled riboprobe for GAD65/67 mRNA and autoradiograms were analyzed by quantitative densitometry. Three isodensity bands of labeling were evident, with different relative amounts of GAD65 and GAD67 (outer and inner, predominantly GAD65, intermediate predominantly GAD67), and the isodensity bands were analyzed separately.GAD65/67 mRNA levels were not different between alcoholics and controls in the gray matter of BA24 (p = 0.53) or BA45 (p = 0.84) or in any of the three isodensity bands in which the GAD65/67 mRNA was distributed. GAD65/67 mRNA in white matter underlying either region was also not different in alcoholics (p > 0.05). GAD65/67 mRNA levels did not correlate with age, sex or duration of alcoholism in either BA24 or BA45.Effects on inhibitory neurotransmission in alcoholics do not appear to be associated with change in the levels of GAD65 or GAD67 mRNA.