• Title/Summary/Keyword: Local bone

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Exploring and calibrating local curvature effect of cortical bone for quantitative ultrasound (QUS)

  • Chen, Jiangang;Su, Zhongqing;Cheng, Li;Ta, De-An
    • Structural Engineering and Mechanics
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    • v.48 no.4
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    • pp.501-518
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    • 2013
  • Apart from thinning of cortical layers, the local bone curvature, varying along bone periphery, modulates ultrasound waves as well, which is however often underestimated or overlooked in clinical quantitative ultrasound (QUS). A dedicated three-dimensional finite element modelling technique for cortical bones was established, for quantitatively exploring and calibrating the effect of local curvature of cortical bone on ultrasound. Using a correlation-based mode extraction technique, high-velocity group (HVG) and low-velocity group (LVG) wave modes in a human radius were examined. Experimental verification using acrylic cylinders and in vitro testing using a porcine femur were accomplished. Results coherently unravelled the cortical curvature exerts evident influence on bone-guided ultrasound when RoC/${\lambda}$ <1 for HVG mode and RoC/${\lambda}$ <2 for LVG mode (RoC/${\lambda}$: the ratio of local bone curvature radius to wavelength); the sensitivity of LVG mode to bone curvature is higher than HVG mode. It has also been demonstrated the local group velocity of an HVG or LVG mode at a particular skeletal site is equivalent to the velocity when propagating in a uniform cylinder having an outer radius identical to the radius of curvature at that site. This study provides a rule of thumb to compensate for the effect of bone curvature in QUS.

Finger reduction of nasal bone fracture under local anesthesia: outcomes and patient reported satisfaction

  • Lee, Young-Jae;Lee, Kyeong-Tae;Pyon, Jai-Kyong
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.24-30
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    • 2019
  • Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

EFFECT OF TUMOR NECROSIS FACTOR-α ON THE BONE METABOLISM (Tumor Necrosis Factor-α가 골대사에 미치는 영향)

  • Kim, Sang-Sub;Lee, Su-Jong
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.187-199
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    • 1999
  • Bone remodeling is characterized by the continuing processes of osteoblast-mediated bone formation and osteoclast-mediated bone resorption. Bone metabolism is tightly regulated at the local level by networks of hormones, cytokines, and other factors. In pathological conditions of bone remodeling, including osteoporosis and periodontal diseases, inflammatory cytokines and local mediators are responsible for enhancement of osteoclast resorption and inhibition of repair at the sites of bone resorption. TNF-${\alpha}$ is a pleiotropic hormone with actions on the differentiation, growth, and functional activities of normal and malignant cells from numerous tissues. TNF-${\alpha}$ has been proposed as a local mediator of the control of bone turnover in situations of chronic inflammation, and it has been assumed that the local source of TNF-${\alpha}$ is the monocyte in the adjacent bone marrow or the local circulation. TNF-${\alpha}$ is a potent inducer of bone resorption. TNF-${\alpha}$ is known to induce the activation of apoptotic signaling pathway, which leads to the apoptosis of bone cells. We demonstrated that treatment of murine osteoblastic MC3T3E1 cells with TNF-${\alpha}$ decreases proliferation as well as alkaline phosphatase (ALP) activity in a dose depenent manner. In addition, TNF-${\alpha}$ increases osteoclast-like cell formation in $1{\alpha}$, 25(OH)2D3 or PGE2-treated bone marrow cell culture. When cells were cultured in TNF-${\alpha}$ free ${\alpha}$-MEM, this inhibitory effect of ALP activity was reversible up to 10 ng/ml TNF-${\alpha}$, in contrast, at the 20 ng/ml TNF-${\alpha}$, irreversible. In this concentration, TNF-${\alpha}$ may induce apoptosis in MC3T3E1 cells. In this study, TNF-${\alpha}$ induces apoptosis resulting in chromosomal DNA fragmentation, preceded by JNK/SAPKs and caspase-3 activation. Our present results show that JNK/SAPKs and caspase-3 are activated by TNF-${\alpha}$, suggesting that the JNK/SAPKs and caspase-3 participate in the bone resorption, associated with apoptosis.

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Anterior Cervical Discectomy and Fusion Using a Stand-Alone Polyetheretherketone Cage Packed with Local Autobone : Assessment of Bone Fusion and Subsidence

  • Park, Jeong-Ill;Cho, Dae-Chul;Kim, Kyoung-Tae;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.189-193
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    • 2013
  • Objective : It remains debatable whether cervical spine fusion cages should be filled with any kind of bone or bone substitute. Cortical and subcortical bone from the anterior and posterior osteophytes of the segment could be used to fill the cage. The purposes of the present study are to evaluate the clinical outcomes and radiological outcomes including bone fusion and subsidence that occurred after anterior cervical discectomy and fusion using a stand-alone cage packed with local autobone graft. Methods : Thirty-one patients who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage packed with local autobone graft from July 2009 to december 2011 were enrolled in this study. Bone fusion was assessed by cervical plain radiographs and computed tomographic scan. Nonunion was evaluated according to the absence of bony bridge on computed tomographic scan. Subsidence was defined as a ${\geq}2$ mm decrease of the interbody height at the final follow-up compared to that measured at the immediate postoperative period. Results : Subsidence was observed in 7 patients (22.6%). Of 7 patients with subsidence greater 2 mm, nonunion was developed in 3. Three patients with subsidence greater 2 mm were related with endplate damage during intraoperative endplate preparation. Solid bone fusion was achieved in 28 out of 31 patients (90.3%). Conclusion : With proper patient selection and careful endplate preparation, anterior cervical discectomy and fusion (ACDF) using a stand-alone PEEK cage packed with local autobone graft could be a good alternative to the standard ACDF techniques with plating.

Comparison between Use of PSA Kinetics and Bone Marrow Micrometastasis to Define Local or Systemic Relapse in Men with Biochemical Failure after Radical Prostatectomy for Prostate Cancer

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Orellana, Nelson;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8387-8390
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    • 2016
  • Background: Treatment of biochemical failure after radical prostatectomy for prostate cancer is largely empirically based. The use of PSA kinetics has been used as a guide to determine local or systemic treatment of biochemical failure. We here compared PSA kinetics with detection of bone marrow micrometastasis as methods to determine local or systemic relapse. Materials and Methods: A transversal study was conducted of men with biochemical failure, defined as a serum PSA >0.2ng/ml after radical prostatectomy. Consecutive patients having undergone radical prostatectomy and with biochemical failure were enrolled and clinical and pathological details were recorded. Bone marrow biopsies were obtained from the iliac crest and touch prints made, micrometastasis (mM) being detected using anti-PSA. The clinical parameters of total serum PSA, PSA velocity, PSA doubling time and time to biochemical failure, age, Gleason score and pathological stage were registered. Results: A total of 147 men, mean age $71.6{\pm}8.2years$, with a median time to biochemical failure of 5.5 years (IQR 1.0-6.3 years) participated in the study. Bone marrow samples were positive for micrometastasis in 98/147 (67%) of patients at the time of biochemical failure. The results of bone marrow micrometastasis detected by immunocytochemistry were not concordant with local relapse as defined by PSA velocity, time to biochemical failure or Gleason score. In men with a PSA doubling time of < six months or a total serum PSA of >2,5ng/ml at the time of biochemical failure the detection of bone marrow micrometastasis was significantly higher. Conclusions: The detection of bone marrow micrometastasis could be useful in defining systemic relapse, this minimally invasive procedure warranting further studies with a larger group of patients.

One-Stage Treatment of Chronic Calcaneal Osteomyelitis with Bone Morphogenetic Protein 2 and Local Antibiotic Delivery in a Cat

  • Kim, Hyungkyoo;Jeong, Heejun;Park, Chul;So, Kyung-Min;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.300-303
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    • 2016
  • An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. A physical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal joint was markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, and osteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided during surgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect ($1.5cm{\times}0.5cm{\times}0.5cm$) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneus bone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite was implanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plate to deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test results was administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing was confirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The use of rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronic osteomyelitis.

A Study of Adaptive Bone Remodeling by Cellular Automata Method (복잡계의 세포자동화법을 이용한 뼈의 적응적 재구축에 관한 연구)

  • Moon, Byung-Young;Park, Jung-Hong;Son, Kwon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.27 no.7
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    • pp.1103-1109
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    • 2003
  • An adaptive bone remodeling is simulated by using the cellular automata (CA) method. It is assumed that bone tissue consist of bone marrow, osteoclast, osteoblast cell or osteoprogenitor cell. Two types of local rule are adopted; those are the metabolism rule and adaptive bone formation rule. The metabolism rule is based on the interactions of cells and the bone formation rule is based on the adaptation against the mechanical stimulus. The history of load and memory of mechanical stimulus are also considered in the local rules. As a result, the pattern of distribution of the bone tissue is dynamically adequate and it is similar to intact cancellous bone.

Effects of Cervi Pantotrichum Cornu and Cervi Cornu on Longitudinal Bone Growth in Adolescent Male Rats (녹용(鹿茸)과 녹각(鹿角)의 성장기 흰쥐 장골 길이성장에 대한 효과)

  • Kim, Ki-Tae;Kim, Myung-Gyou;Leem, Kang-Hyun
    • The Korea Journal of Herbology
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    • v.21 no.1
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    • pp.63-69
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    • 2006
  • Objectives : This study was designed to investigate the effects of Cervi Pantotrichum Cornu and Cervi Cornu on the growth of longitudinal bone in the adolescent male rats. Methods : Longitudinal bone growth was measured by fluorescence microscopy. To examine the effects on the growth plate metabolism, the heights of growth plate and the induction of local bone morphogenetic protein-2 were measured. Results : Treatment of Cervi Pantotrichum Cornu significantly enhanced longitudinal bone growth compared with control group. However, Cervi Cornu did not show the significant effects. Conclusion : Cervi Pantotrichum Cornu enhanced longitudinal bone growth and promoted the induction of local bone morphogenetic protein-2 of growth plate in adolescence male rats.

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Analysis on Statins for The Treatment of Bone Fracture (스타틴계 고지혈증치료제의 골절치료효과에 대한 분석)

  • Choi, Byung-Chul
    • YAKHAK HOEJI
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    • v.53 no.4
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    • pp.206-216
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    • 2009
  • 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (Statins) are potent inhibitors of cholesterol biosynthesis. Cholesterol-lowering therapy using statins significantly reduces the risk of coronary heart disease. Various discovery of statins as bone anabolic agents has spurred a great deal of interest among both basic and clinical bone researchers. In-vitro and some animal studies suggest that statins increase the bone mass by enhancing bone morphogenetic protein-2 (BMP-2)-mediated osteoblast expression. Clinical and animal test results of statins focusing on the prevention and treatment of bone fractures was collected. Three independent literature searches were performed by using from January 1, 2002 to September 2008 for clinical and animal test results. Search term included statins, HMG-CoA reductase inhibitors, pleiotropic effects, fracture, osteoporosis and clinical and animal test. No consensus has been reached whether clinical use of statins has beneficial effects on bone health, partly due to lower statin concentrations because of first-pass metabolism by the liver. Experimental use of statins as stimulators of bone formation suggests that they may have widespread applicability in the field of orthopaedics. With their combined effects on osteoblasts and osteoclasts, statins have the potential to enhance resorption of synthetic materials and improve bone ingrowth. In conclusion, The use of statins in the prevention and treatment of bone fractures requires further study. But observational studies suggest that statins for decreasing bone fractures including osteoporosis have to be considered local direct administration like transdermal or subcutaneous type over oral adminstration.

Usefulness of Ultrasonography-Assisted Closed Reduction for Nasal Fracture under Local Anesthesia

  • Kim, Dae-Hyun;Kim, Kyung-Sik
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.151-153
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    • 2015
  • Closed reduction is the treatment of choice for most nasal bone fractures. In this technique, the nasal bone cannot be directly visualized, proper reduction is confirmed by palpation of the bony contour. This confirmation-via-palpation is in most cases too uncomfortable or painful for patients, and this is the reason why most closed reductions of nasal bone fractures are performed under general anesthesia. Recently, ultrasonography has been adopted as a useful diagnostic method and operative adjunct. In this report, we report the use of ultrasonography as a means to provide palpation-less confirmation of proper reduction, which in turn allows for nasal bone reduction under local anesthesia.