Trabecular Research Articles

Segmentation of cortical bone, trabecular bone, and medullary pores from micro-CT images using 2D and 3D deep learning models.

Computed tomography (CT) enables rapid imaging of large-scale studies of bone, but those datasets typically require manual segmentation, which is time-consuming and prone to error. Convolutional neural networks (CNNs) offer an automated solution, achieving superior performance on image data. In this methodology-focused paper, we used CNNs to train segmentation models from scratch on 2D and 3D patches from micro-CT scans of otter long bones. These new models, collectively called BONe (Bone One-shot Network), aimed to be fast and accurate, and we expected enhanced results from 3D training due to better spatial context. Contrary to expectations, 2D models performed slightly better than 3D models in labeling details such as thin trabecular bone. Although lacking in some detail, 3D models appeared to generalize better and predict smoother internal surfaces than 2D models. However, the massive computational costs of 3D models limit their scalability and practicality, leading us to recommend 2D models for bone segmentation. BONe models showed potential for broader applications with variation in performance across species and scan quality. Notably, BONe models demonstrated promising results on skull segmentation, suggesting their potential utility beyond long bones with further refinement and fine-tuning.

A rapid method for the preparation of an in vitro osteoporosis model of calf vertebrae: histological and biomechanical study

BackgroundIn vitro biomechanical testing is crucial for the preclinical assessment of novel implant designs. Given the constraints of limited supply and high costs associated with human specimens, calf spines are frequently employed as surrogates for human spines in both in vivo and in vitro biomechanical studies.MethodsThis study selected 60 spinal vertebrae from calves aged between 12 and 18 weeks. The specimens were randomly assigned to two treatment groups, A and B, each comprising 30 specimens. Group A served as the control without decalcification, while Group B underwent decalcification using an 18.3% ethylene diamine tetraacetic acid solution. The impact of decalcification was assessed through histological, imaging, and biomechanical analyses.FindingsDecalcification took approximately 2 months, resulting in osteoporotic vertebrae with a bone mineral density reduction of approximately 50.89% compared to pre-decalcification levels. The bone microstructure was significantly altered, characterized by a decrease in trabecular thickness and number and an increase in trabecular separation. Additionally, the trabecular bone pattern factor (TBPf) and Structure Model Index (SMI) increased. The modulus of elasticity, yield stress, and ultimate stress of the vertebral bodies were all reduced in correlation with the decrease in bone mineral density, demonstrating a strong correlation between these parameters.InterpretationThe data from this study indicate that the decalcification method is effective and capable of rapidly establishing an osteoporotic model suitable for biomechanical testing of clinical devices. This method offers the benefits of ease of operation, reliability, and a controllable degree of osteoporosis.

Sericin’s Potential in Osteoporosis Management: The Roles of L-Serine and D-Serine in Bone Metabolism Regulation

Background: Osteoporosis is a bone remodeling disease characterized by an imbalance between bone formation and resorption, leading to bone fragility. Current treatments focus on bone resorption suppression but often have adverse effects. This study aimed to explore the potential of sericin, a silkworm-derived protein, as a dual-action therapeutic agent that enhances bone formation through its component L-serine and inhibits bone resorption via D-serine, which is derived from L-serine by the action of serine racemase. Methods: Cellular experiments were conducted to evaluate the effects of L-serine on osteoblast differentiation and D-serine on osteoclast inhibition. Serum levels of D-serine were measured following sericin administration in an osteoporosis animal model. μ-CT analysis assessed trabecular and cortical bone quality, and bone-related protein expression was analyzed using immunoprecipitation-based high-performance liquid chromatography (IP-HPLC). Results: L-serine significantly upregulated osteogenic markers, including alkaline phosphatase (ALP), Runx2, osterix, and Col1a1, in osteoblasts (p < 0.05). D-serine inhibited osteoclast activation by suppressing cathepsin K expression (p < 0.001). Sericin feeding elevated serum D-serine levels (p < 0.001) and upregulated bone-related proteins such as BMP-2, osterix, and Runx2. Micro-computed tomography (μ-CT) analysis revealed significant improvements in trabecular bone parameters in the OVX-sericin group, including increased trabecular bone volume (Tb.BV/TV; p < 0.05) and reduced trabecular separation (Tb.Sp; p < 0.05), compared to the OVX and OVX-amino acid groups. Cortical bone parameters, including cortical bone volume (Ct.BV/TV) and cortical area (Ct.Ar), did not significantly differ among OVX groups, but all were lower than in the sham group (p < 0.05). Conclusions: This study demonstrates that sericin modulates bone metabolism by enhancing osteoblast activity through L-serine and inhibiting osteoclastogenesis via D-serine. Sericin supplementation improved trabecular bone mass in an osteoporosis model, highlighting its potential for bone health.

Use of 3D-DXA in the assessment of bone structure among patients with chronic kidney disease

IntroductionPatients in later stages of chronic kidney disease (CKD) have a 2- to 14-fold increase in fracture risk. Bone mineral density (BMD) assessment is limited due to the inability to measure trabecular and cortical bone characteristics and the interference of aortic calcifications.Study objectiveThis study aimed to assess the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in participants across all CKD stages.Patients and methodsIn total, 64 CKD patients (consisting of 28 female participants and 36 male participants, with an average age of 69.5 years) were included. There were 9, 12, 8, 9, 11, and 15 participants in stages G1, G2, G3a, G3b, G4, and G5 of CKD, respectively. BMD at the lumbar spine (LS) and proximal femur, as well as the LS TBS, were analyzed. The proximal femur parameters such as cortical and trabecular volumetric (v)BMD, cortical thickness (CTh), and surface (s)BMD at the total hip (TH) and femoral neck (FN) were analyzed using 3D-Shaper software.ResultsComparison between the earlier stages (G1-G3a) and the later CKD stages (G3b-G5) showed significant differences in carboxy terminal collagen crosslinks (CTx) (386 vs.1053 ng/L), TH areal bone mineral density (aBMD; 0.991 vs. 0.859 g/cm2), cortical TH vBMD (831 vs. 795 mg/cm3), FN (837 vs. 788 mg/cm3), TH cortical sBMD (170 mg/cm2), and TH Cth (2.03 vs. 1.92 mm; all p < 0.05). Cross-sectional comparisons between each CKD stage showed a gradual decrease in the LS BMD, TH cortical vBMD, sBMD (FN and TH), and TH Cth. Strong positive associations between the glomerular filtration rate (GFR) and cortical parameters (FN/TH vBMD and TH Cth) were observed (p < 0.01).ConclusionIn conclusion, advanced stages of CKD (G3b–G5) were associated with lower cortical bone parameters. The majority of the cortical parameters were correlated with the GFR, demonstrating a direct relationship between the kidney function and bone structure.

Impact of Texture Feature Count on the Accuracy of Osteoporotic Change Detection in Computed Tomography Images of Trabecular Bone Tissue

The aim of this study is to compare the classification accuracy depending on the number of texture features used. This study used 400 computed tomography (CT) images of trabecular spinal tissue from 100 patients belonging to two groups (50 control patients and 50 patients diagnosed with osteoporosis). The descriptors of texture features were based on a gray level histogram, gradient matrix, RL matrix, event matrix, an autoregressive model, and wavelet transformation. From the 290 obtained texture features, the features with fixed values were eliminated and structured according to the feature importance ranking. The classification performance was assessed using 267, 200, 150, 100, 50, 20, and 10 texture features to build classifiers. The classifiers applied in this study included Naive Bayes, Multilayer Perceptron, Hoeffding Tree, K-nearest neighbors, and Random Forest. The following indicators were used to assess the quality of the classifiers: accuracy, sensitivity, specificity, precision, negative predictive value, Matthews correlation coefficient, and F1 score. The highest performance was achieved by the K-Nearest Neighbors (K = 1) and Multilayer Perceptron classifiers. KNN demonstrated the best results with 50 features, attaining a highest F1 score of 96.79% and accuracy (ACC) of 96.75%. MLP achieved its optimal performance with 100 features, reaching an accuracy and F1 score of 96.50%. This demonstrates that building a classifier using a larger number of features, without a selection process, allows us to achieve high classification effectiveness and holds significant diagnostic value.

Pano-GAN: A Deep Generative Model for Panoramic Dental Radiographs

This paper presents the development of a generative adversarial network (GAN) for the generation of synthetic dental panoramic radiographs. While this is an exploratory study, the ultimate aim is to address the scarcity of data in dental research and education. A deep convolutional GAN (DCGAN) with the Wasserstein loss and a gradient penalty (WGAN-GP) was trained on a dataset of 2322 radiographs of varying quality. The focus of this study was on the dentoalveolar part of the radiographs; other structures were cropped out. Significant data cleaning and preprocessing were conducted to standardize the input formats while maintaining anatomical variability. Four candidate models were identified by varying the critic iterations, number of features and the use of denoising prior to training. To assess the quality of the generated images, a clinical expert evaluated a set of generated synthetic radiographs using a ranking system based on visibility and realism, with scores ranging from 1 (very poor) to 5 (excellent). It was found that most generated radiographs showed moderate depictions of dentoalveolar anatomical structures, although they were considerably impaired by artifacts. The mean evaluation scores showed a trade-off between the model trained on non-denoised data, which showed the highest subjective quality for finer structures, such as the mandibular canal and trabecular bone, and one of the models trained on denoised data, which offered better overall image quality, especially in terms of clarity and sharpness and overall realism. These outcomes serve as a foundation for further research into GAN architectures for dental imaging applications.

Bone Health Deterioration in Transfemoral Prosthetic Users: An Analytical Biomechanical Explanation.

There is a five-decade recorded history indicating that persons with transfemoral amputation experience bone loss in their amputated femur at levels seen in bedridden and post-menopausal individuals, irrespective of age or mobility levels. We used computer simulation to recreate the mechanical environment created by the mechanical design of a prosthetic device in the surviving femur of individuals with transfemoral amputations. Finite element models of gait instances were developed from the hip joint computerized tomography scan of a subject along with a coupled ischial containment prosthetic socket fitted as per standard clinical guidelines. Accompanying mirror models, assembled similarly but without the prosthetic socket were used for stimulus comparison. Simulation showed that more than 90% of the trabecular bone volume in the amputated femur with an ischial containment socket registered compressive strain magnitudes below 300με. These strain magnitudes are below the threshold for bone maintenance as per mechanotransduction theory (i.e., they lie within the disuse window). Only 50% of the bone was in the disuse window for the mirror model for the gait instances considered. These results are consistent with reported invivo evidence which shows that transfemoral prosthesis users may lose bone mass irrespective of age or mobility levels when using traditional socket designs. Clinically, this study shows that prosthetic sockets that support load through the ischium alter the kinetic chain and preclude application of mechanical stimulus that sustains healthy levels of bone mass in the proximal femur. The study also shows that femur length, prosthetic alignment and tissue tone influence this stimulus.

The Impact of Body Mass Index and Benign Prostatic Hyperplasia on Bone Health of Middle-Aged and Older Men.

Osteoporosis significantly affects older adults by reducing bone mass and increasing fracture risk, thereby impacting morbidity and mortality. This study aimed to investigate the relationship between bone mineral density (BMD), body mass index (BMI), and trabecular bone score (TBS) among middle-aged and older men with or without benign prostatic hyperplasia (BPH). A retrospective study was conducted using health examination data from male participants aged 50-98years collected at a regional hospital in southern Taiwan. Simple and multiple linear regression analyses were employed to examine the relationships between TBS and the independent variables. A total of 3714 middle-aged and older men were included in the analysis. Findings indicated that higher BMI was associated with greater BMD; however, the relationship with TBS suggested potential bone quality degradation in cases of underweight and obesity. Multiple linear regression analysis demonstrated that age, waist circumference, BMD, underweight status, and obesity were significantly associated with TBS. This study revealed the associative relationship between BMI and bone health: higher BMI was associated with increased bone density but also related to a decline in bone quality as measured by TBS, particularly in cases of obesity. These results emphasized the importance of managing BMI to optimize both bone density and quality, especially in middle-aged and older men with or at risk of BPH.

Textural and geometric measures derived from digital tomosynthesis discriminate women with and without vertebral fracture.

Vertebral fractures are a common and debilitating consequence of osteoporosis. Bone mineral density (BMD), measured by dual energy x-ray absorptiometry (DXA), is the clinical standard for assessing overall bone quantity but falls short in accurately predicting vertebral fracture. Fracture risk prediction may be improved by incorporating metrics of microstructural organization from an appropriate imaging modality. Digital tomosynthesis (DTS)-derived textural and microstructural parameters have been previously correlated to vertebral bone strength in vitro, but the in vivo utility has not been explored. Therefore, the current study sought to establish the extent to which DTS-derived measurements of vertebral microstructure and size discriminate patients with and without vertebral fracture. In a cohort of 93 postmenopausal women with or without history of vertebral fracture, DTS-derived microstructural parameters and vertebral width were calculated for T12 and L1 vertebrae, as well as lumbar spine BMD and trabecular bone score (TBS) from DXA images. Fracture patients had lower BMD and TBS, while DTS-derived degree of anisotropy and vertebral width were higher, compared to nonfracture (p<0.02 to p<0.003) patients. The addition of DTS-derived parameters (fractal dimension, lacunarity, degree of anisotropy and vertebral width) improved discriminative capability for models of fracture status (AUC=0.79) compared to BMD alone (AUC=0.67). For twelve additional participants who were imaged twice, in vivo repeatability errors for DTS parameters were low (0.2% - 7.3%). The current results support the complementary use of DTS imaging for assessing bone quality and improving the accuracy of fracture risk assessment beyond that achievable by DXA alone.

Imaging Studies of the Stifle Joint in Puma concolor (Linnaeus, 1771)

Although the stifle joint of wild felines shares several characteristics observed in domestic cats, other characteristics are specific to each species. This study aimed to evaluate the stifle joints of eight Puma concolor, including two young and six adults, through different imaging examinations. All stifles were assessed using radiographs and computed tomography (CT). Magnetic resonance imaging (MRI) was performed on the stifles of one animal using 7 Tesla equipment. In all imaging modalities, the four sesamoid bones were detected. Meniscal mineralization was identified in the stifles of three adult animals and one young animal. The cruciate ligaments and menisci were identified on CT, with MRI providing better visualization. The mean values of CT measurements (cm2) in the sagittal section included patella (2.475), medial fabella (0.481), lateral fabella (0.772), popliteal sesamoid (0.222), and medial meniscus (0.051). No differences were found in HU values between the central trabecular bone of the patella and popliteal sesamoid, the cortical bone of the patella and lateral and medial fabellas, or the cortical bone of the patella and popliteal sesamoid. In conclusion, the descriptions of the stifle of Puma concolor from the different imaging methods contribute to understanding the species and can serve as a basis for identifying alterations.

Microvasculature and Trabecular Bone in Beagle Proximal Femur: Microstructural Insights

Avascular necrosis of femoral head and malunion are frequent post-operative complications of femoral neck fractures. To optimize surgical techniques, this study aims to provide a microstructural understanding of intraosseous microvasculature and the trabecular bone of the femoral head and neck. This anatomical study analyzed twenty-eight femora from fourteen cadaveric beagles. Common iliac arteries were infused with colored silicone-resin for vascular visualization, followed by non-decalcified hard tissue processing using the EXAKT®, and Masson's trichrome staining. Morphology and histomorphometric analysis were performed by Nikon NIS Elements BR and ImageJ-fiji. Histomorphometry revealed thin, elongated trabeculae with high vascularity aligned parallel in the neck; numerous intraosseous anastomoses at the neck-shaft and head-neck junctions; thick trabeculae with smaller marrow cavities, and dense branching vascular networks near the cortex in the head. Quantitative analysis showed an inverse correlation between trabecular density and mean vascular density/vascular length density, with no significant sex or side differences. Dense connective tissue fibers maintained the microvasculature and trabeculae structure. The femoral neck displayed an outside-in microvascular pattern via retinacular branches. Conversely, the femoral head had an inside-out pattern through epiphyseal branches reinforced by medullary branches. Dense intraosseous microvasculature aligned sub-cortically. The study identified a potential anatomical safe zone for screwing in femoral neck fractures in beagles. These findings provide an anatomical basis for translational research in joint preservation techniques for humans.

The Effect of Anti-Activin Receptor Type IIA and Type IIB Antibody on Muscle, Bone and Blood in Healthy and Osteosarcopenic Mice.

Anti-Activin Receptor Type IIA and Type IIB antibody (αActRIIA/IIB ab) is a recently developed drug class that targets the activin receptor signalling pathway. Inhibition of receptor ligands (activins, myostatin, growth differentiation factor 11, etc.) can lead to skeletal muscle hypertrophy, bone formation, and increased haematopoiesis. Despite the αActRIIA/IIB ab, bimagrumab, having progressed to clinical trials, two crucial questions about αActRIIA/IIB ab therapy remain: Does αActRIIA/IIB ab influence bone metabolism and bone strength similarly to its generic classmates (activin receptor-based ligand traps)? Does αActRIIA/IIB ab affect red blood cell parameters, thereby increasing the risk of thromboembolism, similar to its generic classmates? Therefore, the aim of the present study was to investigate the therapeutic potential of αActRIIA/IIB ab in a mouse model of concurrent sarcopenia and osteopenia and to investigate the effect on bone and haematopoiesis in more detail. In C57BL/6JRj mice, combined sarcopenia and osteopenia were induced locally by injecting botulinum toxin A into the right hindlimb, resulting in acute muscle paresis. Immediately after immobilization, mice received twice-weekly intraperitoneal injections with αActRIIA/IIB ab (10 mg/kg) for 21 days, after which they were sacrificed. Muscle mass, skeletal muscle fibre size and Smad2 expression were analysed in the rectus femoris and gastrocnemius muscles. Bone mass and bone microstructure were analysed in the trabecular bone at the distal femoral metaphysis, while the cortical bone was analysed at the femoral mid-diaphysis. In a substudy, the effect on haematopoiesis was explored 2 and 7 days after a single αActRIIA/IIB ab (30 mg/kg) injection in C57BL/6JRj mice. αActRIIA/IIB ab caused a large increase in muscle mass in both healthy (+21%) and immobilized (sarcopenic and osteopenic) (+12%) mice. Furthermore, αActRIIA/IIB ab increased trabecular bone (bone volume fraction) for both healthy (+65%) and immobilized (+44%) mice. For cortical bone, αActRIIA/IIB ab caused a small, but significant, increase in bone area (+6%) for immobilized mice, but not for healthy mice. Treatment with αActRIIA/IIB ab did not change red blood cell count, haemoglobin concentration or mean cell volume after either 2 or 7 days. Treatment with αActRIIA/IIB ab caused a significant increase in both skeletal muscle mass and bone parameters in both healthy and immobilized mice, suggesting a potential in the treatment of concurrent osteopenia and sarcopenia. Interestingly, the bone anabolic effect of the treatment was much more pronounced on trabecular bone than on cortical bone. There was no pronounced effect of short-term treatment on haematopoiesis.

3D evaluation of changes in mandibular condyle morphology following orthognathic surgery in patients with maxillomandibular asymmetry: A retrospective study.

Symmetry is integral for the balance and function of the craniofacial complex and making precise diagnosis of asymmetric craniofacial structures is crucial for treatment planning. This study focuses on maxillomandibular asymmetry, examining its impact on condylar resorption and trabecular bone morphology changes following orthognathic surgery. Cone-beam computed tomography (CBCT) scans of patients with and without asymmetry were analyzed pre- and post-surgery. The deviation group exhibited significant decreases in bone volume (BV) and trabecular thickness (TB.TH), indicating condylar resorption. Non-deviation group showed a significant decrease in TB.TH post-surgery. Interestingly, fractal dimension (FD) increased post-surgery across all groups, indicating increased trabecular bone density. Pairwise comparisons revealed significant differences in BV_CHANGE between deviation and non-deviation groups, suggesting greater resorptive activity in deviated condyles. Additionally, gender-based analyses showed significant differences in BV_CHANGE between males and females. These findings highlight the complexity of condylar changes post-surgery, particularly in asymmetric cases, shedding light on potential implications for temporomandibular joint (TMJ) health. Consideration of factors such as asymmetry direction, patient gender, and bone adaptation capacity are crucial in understanding post-surgical outcomes and potential TMJ implications in maxillomandibular asymmetry patients undergoing orthognathic surgery.

Bone Health and Linear Growth in Children with Familial Hypoparathyroidism Treated with Human Parathyroid Hormone 1-34.

Our study explores the impact of human PTH 1-34 injections (PTH therapy) on growth, areal bone mineral density (BMD), and bone quality (measured by trabecular bone score, TBS) in hypoparathyroidism due to autoimmune polyendocrine syndrome type 1 (APS-1) or an activating variant of the calcium sensing receptor (CaR). To assess associations of 1) age and PTH therapy duration with age-standardized Z-scores for height (HAZ), BMD (BMD-Z), and TBS (TBS-Z) in CaR or APS-1, and 2) APS-1 disease severity with BMD-Z and TBS-Z. This secondary analysis pooled linear growth and lumbar spine (LS) DXA data from studies of hypoparathyroidism with mean baseline age of 13.7±5.5y. Comparing the two diagnostic etiologies (18 APS-1 and 9 CaR), we examined the impact of age and PTH duration on HAZ, LS-BMD-Z, and LS-TBS-Z using longitudinal mixed-effects modeling. During PTH therapy, mean HAZ remained below zero in the APS-1 group at all ages, whereas HAZ increased in the CaR group (age by group interaction p<0.0001). Mean LS-BMD-Z were normal (BMD-Z:0±1) for both groups. Mean LS-TBS-Z were near or above zero and differed by group; CaR showed an upward trajectory according to time on PTH whereas the APS-1 group maintained a LS-TBS-Z of approximately 0 (time by group interaction p=0.02). The APS-1 group with greater disease severity (≥7 manifestations) had lower LS-BMD-Z and LS-TBS-Z compared to the less severe APS-1 or CaR groups. Our study highlights distinct growth and BMD patterns in APS-1 and CaR and underscores the need for careful monitoring and tailored treatment strategies to optimize growth and bone health.

Oncogenic FLT3 internal tandem duplications (ITD) and CD45/PTPRC control osteoclast functions and bone microarchitecture.

Activating internal tandem duplications (ITD) in the juxtamembrane domain of receptor tyrosine kinase FLT3 occur frequently in patients with acute myeloid leukemia (AML). Constitutive active FLT3-ITD mutations induce aberrant signaling and promote leukemic cell transformation. Inactivation of the attenuating receptor protein tyrosine phosphatase CD45 (PTPRC) in FLT3-ITD mice resulted in the development of a severe hematopoietic phenotype with characteristics of AML. In addition, abnormal bone structures and ectopic bone formation were observed in these mice, suggesting a previously unknown role of FLT3 to control bone development and remodeling. While Ptprc knockout and Flt3-ITD mutant mice showed a largely normal bone microarchitecture, micro-CT analysis of femurs from Flt3-ITD Ptprc knockout mice revealed trabecularization of the cortical bone. This resulted in increased trabecular bone volume at the metaphysis, while the cortical bone at the diaphysis was thinner and less dense. In the metaphysis, severely reduced osteoclast and osteoblast numbers were observed. Reduced capacity of ex vivo differentiation of CD11b-positive bone marrow stem cells to mature osteoclast was accompanied by their abnormal morphology and reduced size. Transcriptome analysis revealed reduced expression of osteoclastogenic genes. Unexpectedly, cumulative resorption activity of osteoclasts was increased. Size and structure of resorption pits of differentiated osteoclasts remained similar to those observed in osteoclast cultures derived from control animals. Enhanced proliferation of cells in osteoclast cultures derived from FLT3-ITD-expressing mice was mediated by increased expression of STAT5 target genes. Transcriptome analysis of differentiated osteoclasts showed dysregulated signaling pathways influencing their differentiation as well as the coupling of bone resorption and formation. Taken together, inactivation of attenuating CD45 in mice expressing oncogenic FLT3-ITD resulted in marked abnormalities of the osteo-hematopoietic niche, which can be explained by aberrant STAT5 activation.

Polydopamine grafting polyether ether ketone to stabilize growth factor for efficient osteonecrosis repair

This study examines the biocompatibility, osteogenic potential, and effectiveness of polyether ether ketone (PEEK) composites for treating osteonecrosis, seeking to establish a theoretical basis for clinical application. A range of PEEK composite materials, including sulfonated polyether ether ketone (SPEEK), polydopamine-sulfonated polyether ether ketone (SPEEK-PDA), bone-forming peptide-poly-dopamine-sulfonated polyether ether ketone (SPEEK-PDA-BFP), and vascular endothelial growth factor-poly-dopamine-sulfonated polyether ether ketone (SPEEK-PDA-VEGF), were constructed by concentrated sulfuric acid sulfonation, polydopamine modification and grafting of bioactive factors. The experiments involved adult male New Zealand rabbits aged 24–28 weeks and weighing 2.6–4 kg. The SPEEK-PDA-BFP possesses the smallest water contact angle, indicating the highest hydrophilicity, with its surface characterized by a rich density of clustered BFP particles. The SPEEK-PDA-BFP exhibits superior adhesion, proliferation, and differentiation capabilities, along with pronounced bacteriostatic effects, which are attributed to its dense particle clusters. The SPEEK-PDA-BFP facilitates the formation of regular and dense bone trabeculae. Comparative study on treating osteonecrosis with SPEEK-PDA-VEGF and SPEEK-PDA-BFP highlighted the superior formation of mature bone trabeculae and angiogenic protein CD31 around SPEEK-PDA-VEGF. The PEEK composite materials have good biocompatibility, osteogenic activity and bone repair activity. In particular, SPEEK-PDA-VEGF composite materials have the best effect on bone repair.

Blood monocyte fraction and computed tomography attenuation value of bone marrow in fever of unknown origin: A retrospective analysis for differentiating adult-onset Still's disease and intravascular large B-cell lymphoma.

To investigate the factors affecting laboratory data and computed tomography (CT) attenuation values of L1 trabecular and femoral bone marrow, potential markers for differentiating between adult-onset Still's disease and intravascular large B-cell lymphoma. We conducted a retrospective observational study on patients diagnosed with adult-onset Still's disease or intravascular large B-cell lymphoma. Clinical and laboratory data, and CT attenuation values of the bone marrow were compared. An exploratory analysis was conducted to identify factors useful for discriminating between the two groups. 30 patients with adult-onset Still's disease and 14 with intravascular large B-cell lymphoma were included; among them, 17 and 14 patients, respectively, underwent plain CT. No significant differences in CT attenuation values were noted; however, significant differences in various clinical and laboratory data, including neutrophil counts and soluble interleukin 2 receptor levels, were observed. Exploratory analysis of the monocyte fraction, guided by previous reports, suggested a cutoff of ≥ 9.65% for intravascular large B-cell lymphoma, with a sensitivity of 64.3% and specificity of 96.7%. This study suggests that, besides neutrophil counts and soluble interleukin 2 receptor levels, monocyte fractionation is a useful differentiation criterion between adult-onset Still's disease and intravascular large B-cell lymphoma.

Implant stability quotient and osteogenic process in dental implant sites prepared using piezoelectric technique: A study in minipigs.

Few studies have explored the bone response in dental implant sites prepared using a piezoelectric device, indicating moderate effectiveness in enhancing secondary stability and osteogenesis. This study seeks to expand our understanding of the changes in biological, clinical, and radiographic parameters, during the initial phases of osseointegration in sites prepared with piezoelectric surgery. Two implant sites were prepared in the tibia of four minipigs. At the time of implant placement (T0), bone cortex thickness and Implant Stability Quotient (ISQ) were assessed. A bone specimen was collected from the tibia and used as the baseline for biomolecular analyses. X-ray was taken after implant insertion. After 14 days (T14), a computed tomography (CT) scan of the tibias was conducted, and ISQ values were reassessed. Histological and biomolecular analyses were performed on bone sections containing the implant. ISQ significantly increased from T0 to T14, in the absence of any correlation between the cortical thickness and ISQ. In two animals, CT showed a slight trabecular bone thickening adjacent to the implants and disorganized radiodense spots; in the other two, no trabecular osseodensification was evident. Newly formed bone was about 48% of the tissue around implants. At T14, an increase in osteogenic factors and a decrease in inflammatory molecules were observed. This study enhances understanding of the biological and clinical responses at bone implant sites following piezoelectric surgery. It highlights the relationship between the rise in certain osteogenic factors and new bone formation, as well as a potential association with increased ISQ.

Efficacy and safety of teriparatide in kidney transplant recipients with osteoporosis and low bone turnover: a real-world experience.

Kidney transplantation is the preferred treatment for end-stage kidney disease (ESKD), enhancing survival and quality of life. However, kidney transplant recipients (KTRs) are at high risk for bone disorders, particularly low bone turnover disease, which increases fracture risk. Teriparatide, an anabolic agent, may provide a beneficial treatment option for these patients. This single-center, retrospective observational study involved 18 KTRs with osteoporosis, low bone turnover, and a history of vertebral or non-vertebral fractures. Patients received teriparatide (20μg/day) for up to 2 years. Areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), femoral neck (FN), and trabecular bone score (TBS) were measured at baseline, 1 year, and 2 years. In addition, bone turnover markers (BTMs), serum calcium, phosphorus, parathyroid hormone (PTH), and kidney function were monitored. Significant increases in LS aBMD were observed after 1 year (0.941 ± 0.152 vs 1.043 ± 0.165, p = 0.04) and maintained after 2 years compared to baseline (0.941 ± 0.152 vs 1.074 ± 0.154, p = 0.03). TH aBMD significantly increased after 2 years (0.753 ± 0.145 vs 0.864 ± 0.141, p = 0.04), while FN and TBS showed non-significant improvement. Teriparatide was well-tolerated, with mild and transient hypercalcemia and hypophosphatemia. Teriparatide significantly improved BMD at the LS and TH in KTRs with osteoporosis and low bone turnover, showing a favorable safety profile.

The influence of fructose on structural and metabolic features of the tooth-jaw system of rats under conditions of iodine deficiency

The aim of the study was to investigate an oxidative processes intensity and structural organisation of hard and soft periodontal tissues in rats under conditions of high-fructose diet against the background of iodine deficiency (research group) and standard diet and drinking regime (intact animals). It was found that carbohydrate metabolism was impaired in rats of the research group (glucose content increased by 63.3%, insulin – by 48.2% in blood serum, glycated haemoglobin of whole blood – by 2.1 time, HOMAIR index – by 2.1 times compared to the data in intact rats) and thyroid status (free triiodothyronine and thyroxine content in blood serum decreased by 46.8 and 42.7%, respectively, compared to the control). Under such conditions, the intensity of lipid and protein peroxidation processes in periodontal tissues increases. In particular, the accumulation of diene conjugates and products that react to thiobarbituric acid in the mucous membrane of the alveolar process (by 19.0 and 7.1 times), in the teeth pulp (by 2.2 and 6.3 times) compared to the values in intact animals was found. The activation of peroxidative destruction of proteins is confirmed by an increase in the content of all fractions of their oxidative modification in the studied tissues by 2.8-8.4 times compared to the control values. The results of the histological examination of the alveolar process indicate thinning of the periosteum, disruption of the structural organisation of osteon, reduction in the thickness of bone trabeculae (by 21.8%), optical density of the osteogenic matrix (by 8.9%), area of intertrabecular connective tissue (by 61.0%). Mucosal edema of connective tissue, accumulation of glycosaminoglycans, hypertrophy of all epithelial layers (basal, prickle, keratinized layers – by 25.5-55.9%, granular layer – by 2.3 times), changes of the microcirculatory net were observed in the mucous membrane of the alveolar process. Thus, the combination of high-fructose and iodine-deficient diets causes the development of oxidative stress and destructive changes of the dentoalveolar complex of research animals, which characterises an increase of the risks of dental pathology development.