Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 5 uppsatser.

Chi Keung Cheung. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves 219-251). / Chapter CHAPTER I --- LITERATURE REVIEW / Chapter 1 --- The structure of bone --- p.2 / Chapter 1.1. --- The cortical bone --- p.3 / Chapter 1.2. --- The cancellous bone --- p.3 / Chapter 2 --- The composition of bone --- p.3 / Chapter 2.1. --- Bone minerals --- p.4 / Chapter 2.2. --- The organic matrix --- p.4 / Chapter 2.3. --- The bone cells --- p.9 / Chapter 2.3.1. --- The osteoblast and the osteocyte --- p.9 / Chapter 2.3.2. --- The osteoclast --- p.11 / Chapter 3 --- Bone turnover - modelling and remodelling of bone --- p.13 / Chapter 3.1. --- Postulated sequence of bone remodelling --- p.14 / Chapter 4 --- Regulation of bone resorption --- p.16 / Chapter 4.1. --- Role of osteoblast and the lining cell on bone resorption --- p.17 / Chapter 5 --- Regulation of bone formation --- p.19 / Chapter 6 --- Effects of systemic hormones and local factors on bone metabolism --- p.20 / Chapter 6.1. --- Parathyroid hormone --- p.20 / Chapter 6.2. --- "1,25-dihydroxyvitamin D3" --- p.22 / Chapter 6.3. --- Calcitonin --- p.23 / Chapter 6.4. --- Prostaglandins --- p.23 / Chapter 6.5. --- Sex hormones --- p.24 / Chapter 6.6. --- Glucocorticoid --- p.26 / Chapter 6.7. --- Growth hormone --- p.27 / Chapter 6.8. --- Insulin --- p.28 / Chapter 6.9. --- Thyroid hormones --- p.29 / Chapter 6.10. --- Other systemic and local factors --- p.30 / Chapter 7 --- Indices of bone turnover --- p.34 / Chapter 8 --- Non-biochemical indices of bone metabolism --- p.34 / Chapter 8.1. --- Radionuclide bone scan --- p.34 / Chapter 8.2. --- Radiokinetic assessment --- p.35 / Chapter 8.3. --- Bone biopsy --- p.35 / Chapter 8.4. --- Bone densitometry --- p.36 / Chapter 9 --- Biochemical indices of bone metabolism --- p.37 / Chapter 10 --- Biochemical markers of bone formation --- p.38 / Chapter 10.1. --- Alkaline phosphatase --- p.38 / Chapter 10.1.1. --- Role and origin of bone alkaline phosphatase isoenzyme --- p.39 / Chapter 10.1.2. --- Measurement of bone alkaline phosphatase --- p.41 / Chapter 10.1.2.1. --- Heat inactivation --- p.42 / Chapter 10.1.2.2. --- Chemical inactivation --- p.43 / Chapter 10.1.2.3. --- Immunological methods --- p.44 / Chapter 10.1.2.4. --- High performance liquid chromatography --- p.45 / Chapter 10.1.2.5. --- Gel electrophoresis --- p.45 / Chapter 10.1.2.6. --- Isoelectric focusing --- p.47 / Chapter 10.2. --- Osteocalcin --- p.48 / Chapter 10.3. --- Osteonectin --- p.51 / Chapter 10.4. --- Matrix Gla-protein --- p.51 / Chapter 10.5. --- Other non-collagenous proteins --- p.52 / Chapter 10.6. --- Urinary Gla concentration --- p.52 / Chapter 10.7. --- Collagen peptides and extension peptides --- p.54 / Chapter 11 --- Biochemical markers of bone resorption --- p.55 / Chapter 11.1. --- Urine hydroxyproline --- p.55 / Chapter 11.2. --- Pyridinium cross-links --- p.58 / Chapter 11.3. --- Acid phosphatase --- p.60 / Chapter 11.3.1. --- Acid phosphatase isoenzymes --- p.60 / Chapter 11.3.2. --- The band 5 acid phosphatase isoenzyme genetics and characteristics --- p.62 / Chapter 11.3.3. --- Band 5 acid phosphatase as marker of osteoclastic function --- p.64 / Chapter 11.3.4. --- Measurement of osteoclastic acid phosphatase --- p.67 / Chapter 11.3.4.1. --- Specific chemical inhibitor --- p.67 / Chapter 11.3.4.2. --- Electrophoresis --- p.67 / Chapter 11.3.4.3. --- Immunological methods --- p.68 / Chapter 12 --- Problems with current biochemical markers of bone metabolism --- p.68 / Chapter 13 --- Aims of this study --- p.70 / Chapter CHAPTER II --- PURIFICATION OF TARTRATE-RESISTANT ACID PHOSPHATASE AND THE DEVELOPMENT OF AN IMMUNOASSAY FOR IT'S MEASUREMENT / Chapter 1 --- Introduction --- p.72 / Chapter 2 --- Materials and methods --- p.75 / Chapter 2.1. --- Chemicals and reagents --- p.75 / Chapter 2.1.1. --- Apparatus --- p.76 / Chapter 2.2. --- Methods --- p.77 / Chapter 2.2.1. --- Cord serum --- p.77 / Chapter 2.2.2. --- Measurement of tartrate-resistant acid phosphatase activity --- p.77 / Chapter 2.2.3. --- Measurement of protein concentration --- p.80 / Chapter 2.2.4. --- Purification of TRACP from cord plasma --- p.82 / Chapter 2.2.4.1. --- Cation-exchange column chromatography --- p.83 / Chapter 2.2.4.2. --- Gel filtration column chromatography --- p.84 / Chapter 2.2.4.3. --- Concanavalin A-affinity column chromatography --- p.85 / Chapter 2.2.4.4. --- Preparative isoelectric focusing (IEF) --- p.86 / Chapter 2.3. --- Characterisation of purified TRACP --- p.90 / Chapter 2.3.1. --- Polyacrylamide gel electrophoresis (PAGE) --- p.91 / Chapter 2.3.2. --- "Optimum pH, substrate specificity and the effects of potential activators and inhibitors on TRACP activity" --- p.99 / Chapter 2.3.3. --- Amino acid composition of purified TRACP --- p.101 / Chapter 2.4. --- Methods for raising anti-human TRACP antibody and characterisation of the antiserum --- p.102 / Chapter 2.4.1. --- Production of rabbit anti-human TRACP antibody --- p.102 / Chapter 2.4.2. --- Determination of the titre of rabbit anti-human TRACP antibody --- p.103 / Chapter 2.4.3. --- Immunoblotting analyses for cross reactivity study --- p.103 / Chapter 2.4.4. --- Immunohistochemical study for antibody specificity --- p.105 / Chapter 2.4.5. --- Cross reactivity study of the rabbit anti-human TRACP antibody to some tissue preparations --- p.107 / Chapter 2.5. --- Enzyme linked immunosorbent assay for TRACP --- p.109 / Chapter 2.5.1. --- Optimisation and evaluation of the new ELISA method for TRACP --- p.111 / Chapter 3 --- RESULTS --- p.113 / Chapter 3.1. --- "Precision of methods for the determination of protein, TRACP and phosphate." --- p.113 / Chapter 3.2. --- Isolation and purification of TRACP --- p.113 / Chapter 3.2.1. --- Concanavalin A affinity chromatography --- p.120 / Chapter 3.2.2. --- Isoelectric focusing (IEF) --- p.120 / Chapter 3.3. --- Characterisation and homogeneity of purified TRACP --- p.128 / Chapter 3.3.1. --- Characterisation of purified TRACP --- p.128 / Chapter 3.3.2. --- Homogeneity of purified TRACP --- p.132 / Chapter 3.3.3. --- Amino acid composition --- p.136 / Chapter 3.4. --- Characterisation of the rabbit anti-human TRACP antibody --- p.136 / Chapter 3.4.1. --- Antibody specificity - immunoblotting study --- p.139 / Chapter 3.4.2. --- Antibody specificity - cross reactivity with partially purified non-cord plasma TRACP --- p.142 / Chapter 3.4.3. --- Antibody specificity - immunohistochemical study --- p.145 / Chapter 3.5. --- Enzyme linked immunosorbent assay for TRACP --- p.145 / Chapter 3.5.1. --- Optimal concentration of antigen for coating of microtitre plate --- p.145 / Chapter 3.5.2. --- Kinetics of reaction with the primary rabbit anti-human TRACP antibody --- p.149 / Chapter 3.5.3. --- "Precision, recovery and assay range" --- p.149 / Chapter 4 --- DISCUSSION --- p.155 / Chapter 4.1. --- Purification of cord plasma TRACP --- p.155 / Chapter 4.2. --- Characterisation of cord plasma TRACP --- p.158 / Chapter 4.3. --- Characterisation of rabbit anti-human TRACP antibody --- p.163 / Chapter 4.4. --- Enzyme immunoassay for TRACP --- p.165 / Chapter CHAPTER III --- STUDY OF SERUM TRACP IN HEALTHY SUBJECTS AND IN PATIENTS WITH BONE RELATED DISEASES / Chapter 1 --- Introduction --- p.168 / Chapter 2 --- Materials and methods --- p.171 / Chapter 2.1. --- Subjects --- p.171 / Chapter 2.1.1. --- Healthy subjects --- p.171 / Chapter 2.1.2. --- Patients --- p.172 / Chapter 2.1.2.1. --- Post-menopausal women on hormone replacement therapy --- p.172 / Chapter 2.1.2.2. --- Hip fracture patients --- p.173 / Chapter 2.1.2.3. --- Other patients --- p.174 / Chapter 2.3. --- Measurement of other biochemical parameters --- p.175 / Chapter 2.3.1. --- Bone alkaline phosphatase --- p.175 / Chapter 2.3.2. --- "Measurement of urine hydroxyproline, creatinine, calcium, osteocalcin, thyroid hormones and parathyroid hormone" --- p.176 / Chapter 2.4. --- Statistics --- p.178 / Chapter 3 --- RESULTS --- p.179 / Chapter 3.1. --- Healthy subjects --- p.179 / Chapter 3.2. --- Serum TRACP concentration in post-menopausal women before and after hormone replacement therapy --- p.185 / Chapter 3.3. --- TRACP concentration in elderly subjects with hip fractures --- p.189 / Chapter 3.4. --- Serum TRACP concentrations in patients with other bone related diseases --- p.190 / Chapter 3.4.1. --- Hyperthyroidism --- p.194 / Chapter 3.4.2. --- Hyperparathyroidism --- p.198 / Chapter 3.4.3. --- Haemodialysis --- p.201 / Chapter 4 --- DISCUSSION --- p.204 / GENERAL DISCUSSION --- p.216 / REFERENCES --- p.219

by Chak Chi Wai. / Thesis (M.Phil)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves 142-155). / ACKNOWLEDGMENTS --- p.i / TABLE OF CONTENT --- p.ii / LIST OF ABBREVIATION --- p.viii / ABSTRACT --- p.x / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- INTRODUCTION TO ALKALINE PHOSPHATASE --- p.2 / Chapter 1.1.1 --- The Alkaline Phosphatase Isoenzymes --- p.2 / Chapter 1.1.2 --- The Properties of Alkaline Phosphatases --- p.5 / Chapter 1.1.3 --- Serum Alkaline Phosphatases --- p.7 / Chapter 1.1.3.1 --- Intestinal Alkaline Phosphatase --- p.8 / Chapter 1.1.3.2 --- Placental Alkaline Phosphatase --- p.8 / Chapter 1.1.3.3 --- Renal Alkaline Phosphatase --- p.9 / Chapter 1.1.3.4 --- Skeletal Alkaline Phosphatase --- p.9 / Chapter 1.1.3.5 --- Hepatic Alkaline Phosphatase --- p.10 / Chapter 1.1.3.6 --- Miscellaneous Alkaline Phosphatases --- p.10 / Chapter 1.1.4 --- Problems in Discriminating the Skeletal and Hepatic Alkaline Phosphatase in Serum --- p.12 / Chapter 1.1.5 --- Wheat Germ Lectin Precipitation of the Bone- Specific Alkaline Phosphatase --- p.13 / Chapter 1.2 --- STRUCTURE OF BONE AND MECHANISMS OF CALCIFICATION --- p.15 / Chapter 1.2.1 --- Gross Structure of Bone --- p.15 / Chapter 1.2.2 --- The Elements of Bone --- p.17 / Chapter 1.2.2.1 --- Bone Cells --- p.17 / Chapter 1.2.2.2 --- Organic Substances of Bone --- p.19 / Chapter 1.2.2.3 --- Inorganic Substances of Bone --- p.21 / Chapter 1.2.3 --- Mechanisms of Calcification --- p.22 / Chapter 1.3 --- BONE FRACTURE HEALING --- p.24 / Chapter 1.3.1 --- Types of Fracture --- p.24 / Chapter 1.3.2 --- The Process of Bone Fracture Healing --- p.26 / Chapter 1.3.2.1 --- Stage of Hematoma --- p.26 / Chapter 1.3.2.2 --- Stage of Subperiosteal and Endosteal Cellular Proliferation --- p.28 / Chapter 1.3.2.3 --- Stage of Fibrocartilaginous Callus --- p.28 / Chapter 1.3.2.4 --- Stage of Bony Callus --- p.30 / Chapter 1.3.2.5 --- Stage of Remodeling --- p.31 / Chapter 1.4 --- THE OSTEOBLASTIC CHARACTERS OF UMR-106 OSTEOSARCOMA CELL LINE --- p.32 / Chapter 1.4.1 --- Classification of Osteosarcoma --- p.32 / Chapter 1.4.2 --- Derivation of UMR-106 Osteosarcoma Cell Line --- p.33 / Chapter 1.4.3 --- Osteoblastic Characters of UMR-106 --- p.34 / Chapter 1.4.3.1 --- ALP Expression --- p.34 / Chapter 1.4.3.2 --- Hormone Responsive Adenylate Cyclase System --- p.35 / Chapter 1.4.3.3 --- "Cytosolic Receptors for 1,25-Dihydroxy- cholecalciferol" --- p.35 / Chapter 1.5 --- IN VITRO CULTURE OF FETAL RAT CALVARIAL OSTEOBLASTS --- p.37 / Chapter 1.6 --- AIM AND SCOPE OF THIS DISSERTATION --- p.39 / Chapter CHAPTER TWO: --- MATERIALS AND METHODS / Chapter 2.1 --- BONE FRACTURE OPERATION --- p.42 / Chapter 2.1.1 --- Animals --- p.42 / Chapter 2.1.2 --- Blood Sampling and Preparation of Plasma Samples --- p.42 / Chapter 2.1.3 --- Bone Fracture Operation --- p.43 / Chapter 2.1.3.1 --- Reagents and Apparatus --- p.43 / Chapter 2.1.3.2 --- Procedures --- p.44 / Chapter 2.1.4 --- Radiography --- p.50 / Chapter 2.1.5 --- Removal of Tibiae --- p.51 / Chapter 2.1.6 --- Extraction of Callus ALP --- p.51 / Chapter 2.1.6.1 --- Reagent --- p.51 / Chapter 2.1.6.2 --- Homogenization of the Callus --- p.51 / Chapter 2.1.6.3 --- Extraction of ALP --- p.52 / Chapter 2.1.7 --- Assay for Bone-Specific ALP --- p.53 / Chapter 2.1.7.1 --- Reagents --- p.53 / Chapter 2.1.7.2 --- Procedures --- p.54 / Chapter 2.1.8 --- Normal Curve for Plasma Bone-Specific ALP in Rabbits --- p.56 / Chapter 2.1.9 --- The Effects of Tibial Fracture on the Plasma Level of Bone-Specific ALP in Rabbits --- p.56 / Chapter 2.1.10 --- Profile of Plasma Bone-Specific ALP upon a Fracture Healing --- p.57 / Chapter 2.1.11 --- Profile of Callus Bone-Specific ALP at Different Stages of Fracture Healing --- p.57 / Chapter 2.2 --- CLINICAL STUDIES OF PLASMA BONE-SPECIFIC ALP --- p.58 / Chapter 2.2.1 --- Patient Groups --- p.58 / Chapter 2.2.1.1 --- Normal Adults --- p.58 / Chapter 2.2.1.2 --- Fracture Group --- p.58 / Chapter 2.2.1.3 --- Tumor Group --- p.59 / Chapter 2.2.2 --- Assays for Plasma Bone-Specific ALP --- p.59 / Chapter 2.3 --- "IN VITRO CULTURES OF FETAL, RAT OSTEOBLASTS AND UMR-106 OSTEOSARCOMA cell line" --- p.60 / Chapter 2.3.1 --- Animals --- p.60 / Chapter 2.3.2 --- UMR-106 Cell Line --- p.60 / Chapter 2.3.3 --- General Reagents Used for Cell Culture --- p.60 / Chapter 2.3.4 --- Isolation of Calvarial Osteoblasts --- p.64 / Chapter 2.3.4.1 --- Tools and Reagents --- p.64 / Chapter 2.3.4.2 --- Procedures --- p.65 / Chapter 2.3.5 --- Storage of UMR-106 Cell Line --- p.67 / Chapter 2.3.6 --- Subculture of Confluent Monolayer --- p.68 / Chapter 2.3.6.1 --- Reagents --- p.68 / Chapter 2.3.6.2 --- Procedures --- p.69 / Chapter 2.3.7 --- Staining for Calcium Deposits --- p.69 / Chapter 2.3.7.1 --- Reagents --- p.70 / Chapter 2.3.7.2 --- Procedures --- p.70 / Chapter 2.3.8 --- Protein Determination --- p.71 / Chapter 2.3.8.1 --- Reagents --- p.71 / Chapter 2.3.8.2 --- Procedures --- p.71 / Chapter 2.3.9 --- Microdetermination of Inorganic Phosphate --- p.72 / Chapter 2.3.9.1 --- Reagents --- p.72 / Chapter 2.3.9.2 --- Procedures --- p.73 / Chapter 2.3.10 --- Determination of Calcium --- p.73 / Chapter 2.3.10.1 --- Reagent --- p.73 / Chapter 2.3.10.2 --- Procedures --- p.73 / Chapter 2.3.11 --- Extraction and Assay for Cellular ALP --- p.74 / Chapter 2.3.11.1 --- Reagents --- p.74 / Chapter 2.3.11.2 --- Procedures --- p.75 / Chapter 2.3.12 --- Cell Surface ALP Assay --- p.75 / Chapter 2.3.12.1 --- Reagents --- p.75 / Chapter 2.3.12.2 --- Procedures --- p.76 / Chapter 2.3.13 --- Extraction of Calcium Phosphate Deposits --- p.76 / Chapter 2.3.13.1 --- Reagent --- p.76 / Chapter 2.3.13.2 --- Procedures --- p.76 / Chapter 2.3.14 --- Collagen Synthesis Assay --- p.77 / Chapter 2.3.14.1 --- Reagents --- p.77 / Chapter 2.3.14.2 --- Procedures --- p.78 / Chapter CHAPTER THREE: --- EFFECTS OF TIBIAL FRACTURE ON THE LEVEL OF BONE-SPECIFIC ALKALINE PHOSPHATASE IN RABBITS / INTRODUCTION --- p.81 / results: / Chapter 3.1 --- normal curve for plasma bone-specific alp in rabbits --- p.82 / Chapter 3.2 --- THE EFFECTS OF TIBIAL FRACTURE ON THE PLASMA LEVEL OF BONE-SPECIFIC ALP IN RABBITS --- p.84 / Chapter 3.3 --- PROFILE OF THE PLASMA ALP LEVEL UPON HEALING OF TIBIAL FRACTURE --- p.86 / Chapter 3.4 --- RADIOGRAPHY --- p.89 / Chapter 3.5 --- PROFILE OF CALLUS BONE-SPECIFIC ALP ACTIVITY UPON HEALING OF TIBIAL FRACTURE --- p.93 / DISCUSSION --- p.95 / Chapter CHAPTER FOUR: --- CLINICAL STUDIES OF PLASMA BONE-SPECIFIC ALKALINE PHOSPHATASE / INTRODUCTION --- p.100 / RESULTS: / Chapter 4.1 --- NORMAL VALUES --- p.100 / Chapter 4.2 --- FRACTURE GROUP --- p.101 / Chapter 4.3 --- BONE TUMOR GROUP --- p.102 / DISCUSSION --- p.102 / Chapter CHAPTER FIVE: --- IN VITRO CULTURE OF FETAL RAT OSTEOBLASTS AND UMR-106 CELL LINE / INTRODUCTION --- p.105 / RESULTS: / Chapter 5.1 --- IN VITRO MINERALIZATION OF UMR-106 CELLS AND PRIMARY RC CELLS --- p.107 / Chapter 5.2 --- STUDY OF BONE-SPECIFIC ALP RELEASED INTO MEDIUM BY UMR-106 CELLS AND PRIMARY RC CELLS --- p.113 / Chapter 5.3 --- STUDY OF CELLULAR ALP ACTIVITIES AND CALCIUM PHOSPHATE DEPOSITS --- p.116 / Chapter 5.4 --- STUDIES OF CELLULAR ALP ACTIVITIES AND RELATIVE RATES OF COLLAGEN SYNTHESIS --- p.125 / DISCUSSION --- p.128 / Chapter CHAPTER SIX: --- GENERAL DISCUSSION --- p.136 / BIBLIOGRAPHY --- p.142 / APPENDIX --- p.156

published_or_final_version / abstract / Medicine / Doctoral / Doctor of Philosophy

Thesis (M.Sc.(Occupational Therapy))--University of the Witwatersrand, Faculty of Health Sciences, 2014.

Hung Wing Yin Vivian. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 128-142). / Abstracts in English and Chinese ; appendix in Chinese. / ABSTRACT --- p.i / ABSTRACT (in Chinese) --- p.iv / ACKNOWLEDGMENT --- p.vii / TABLE OF CONTENTS --- p.viii / LIST OF TABLES --- p.xiv / LIST OF FIGURES --- p.xvi / LIST OF ABBREVIATIONS --- p.xix / Chapter I. --- INTRODUCTION --- p.1 / Chapter 1.1. --- Scoliosis --- p.1 / Chapter 1.1.1. --- Classification of scoliosis --- p.1 / Chapter 1.1.2. --- Idiopathic scoliosis --- p.1 / Chapter 1.1.3. --- Clinical examination --- p.2 / Chapter 1.1.4. --- Curve pattern --- p.2 / Chapter 1.2. --- Etiology of AIS --- p.3 / Chapter 1.2.1. --- Prevalence of AIS --- p.5 / Chapter 1.2.2. --- Anthropometric Measurement in AIS --- p.5 / Chapter 1.2.3. --- Bone mass --- p.6 / Chapter 1.2.4. --- Bone mineral density measurements --- p.6 / Chapter 1.2.5. --- Osteopenia in AIS --- p.7 / Chapter 1.3. --- Natural history ofAIS --- p.8 / Chapter 1.3.1. --- Curve progression --- p.9 / Chapter 1.3.2. --- Treatment of scoliosis --- p.11 / Chapter 1.4. --- Research questions --- p.12 / Chapter 1.5. --- Objectives --- p.13 / Chapter II. --- METHODOLOGY --- p.20 / Chapter 2.1 --- Study Design --- p.20 / Chapter 2.2 --- Subject recruitment --- p.20 / Chapter 2.2.1 --- AIS patients --- p.20 / Chapter 2.2.2 --- Inclusion criteria --- p.20 / Chapter 2.2.3 --- Exclusion criteria --- p.20 / Chapter 2.2.4 --- Informed consent --- p.21 / Chapter 2.3 --- Grouping for chronological age --- p.21 / Chapter 2.4 --- Radiography assessments --- p.21 / Chapter 2.4.1 --- Cobb angle measurement --- p.21 / Chapter 2.4.2 --- Curve pattern --- p.22 / Chapter 2.4.3 --- Risser grade --- p.22 / Chapter 2.5 --- Definition of curve progression --- p.22 / Chapter 2.6 --- Bone mineral density (BMD) measurements --- p.23 / Chapter 2.6.1 --- Dual energy X-ray Absorptiometry (DXA) --- p.23 / Chapter 2.6.2 --- Peripheral quantitative computed tomography (pQCT) --- p.24 / Chapter 2.6.3 --- Definition of osteopenia or low bone mass --- p.24 / Chapter 2.7 --- Anthropometric measurements --- p.25 / Chapter 2.7.1 --- Body height --- p.25 / Chapter 2.7.2 --- Body weight --- p.26 / Chapter 2.7.3 --- Arm span --- p.26 / Chapter 2.7.4 --- Sitting height --- p.27 / Chapter 2.8 --- Family history --- p.27 / Chapter 2.9 --- Menstrual status --- p.27 / Chapter 2.10 --- Medication and fracture history --- p.27 / Chapter 2.11 --- Statistical analysis --- p.27 / Chapter 2.11.1 --- Sample size power calculation --- p.28 / Chapter 2.11.2 --- Student t test --- p.28 / Chapter 2.11.3 --- Paired t-test --- p.28 / Chapter 2.11.4 --- Predicting the incidence of curve progression --- p.28 / Chapter 2.11.4.1 --- Predictive outcome --- p.28 / Chapter 2.11.4.2 --- Potential risk factors --- p.28 / Chapter 2.11.4.3 --- Coding system for categorical variables --- p.29 / Chapter 2.11.4.4 --- Univariate analysis --- p.30 / Chapter 2.11.4.5 --- Logistic regression --- p.30 / Chapter 2.11.4.6 --- Receiver operating characteristics (ROC) curves --- p.32 / Chapter III. --- RESULTS --- p.54 / Chapter 3.1 --- Patients Characteristics --- p.54 / Chapter 3.1.1 --- Sample size --- p.54 / Chapter 3.1.2 --- Distribution of patient characteristics --- p.54 / Chapter 3.1.3 --- Drop out --- p.54 / Chapter 3.1.4 --- Prevalence of osteopenia (BMDage-adjusted ≤ -1) and low bone mass (BMCage-adjusted ≤ -1) --- p.55 / Chapter 3.1.5 --- Comparison between the BMD of the bilateral hip and tibia --- p.55 / Chapter 3.2 --- Comparison of AIS patients with osteopenia and with normal bone status --- p.55 / Chapter 3.3 --- Univariate analysis --- p.56 / Chapter 3.3.1 --- Growth related factors --- p.56 / Chapter 3.3.2 --- "Skeletal related parameters (areal BMD, volumetric BMD and BMC)" --- p.56 / Chapter 3.3.2.1 --- DXA lumbar spine --- p.56 / Chapter 3.3.2.2 --- DXA proximal femur at the convex-side hip --- p.56 / Chapter 3.3.2.3 --- DXA proximal femur at the concave-side hip --- p.57 / Chapter 3.3.2.4 --- pQCT at non-dominant distal radius --- p.57 / Chapter 3.3.2.5 --- pQCT - vBMD at convex-side distal tibia --- p.57 / Chapter 3.3.2.6 --- pQCT - vBMD at concave-side distal tibia --- p.58 / Chapter 3.3.3 --- Curve related factors --- p.58 / Chapter 3.3.4 --- Anthropometrics parameters --- p.58 / Chapter 3.3.5 --- Family history --- p.58 / Chapter 3.3.6 --- Summary of univariate analysis --- p.59 / Chapter 3.4 --- Logistic regression model (single factor) --- p.59 / Chapter 3.5 --- Logistic regression model (multiple factors) --- p.60 / Chapter 3.5.1 --- BMD inclusive model --- p.60 / Chapter 3.5.2 --- BMC inclusive model --- p.61 / Chapter 3.5.3 --- Conventional model --- p.63 / Chapter 3.6 --- ROC curve --- p.63 / Chapter 3.6.1 --- BMD inclusive model --- p.64 / Chapter 3.6.2 --- Conventional model --- p.64 / Chapter 3.7 --- Predictive equation obtained from different logistic regression models --- p.64 / Chapter 3.7.1 --- BMD inclusive model --- p.65 / Chapter 3.7.2 --- Conventional model --- p.65 / Chapter IV. --- DISCUSSION --- p.105 / Chapter 4.1 --- Prognostic factors for curve progression --- p.105 / Chapter 4.1.1 --- Well-known prognostic factors --- p.105 / Chapter 4.1.1.1 --- Growth-related factors --- p.106 / Chapter 4.1.1.2 --- Initial curve magnitude --- p.107 / Chapter 4.1.2 --- A new predictor 一 Osteopenia --- p.107 / Chapter 4.2 --- Non-significant prognostic factors for curve progression --- p.109 / Chapter 4.2.1 --- Anthropometric parameters --- p.109 / Chapter 4.2.2 --- Family History --- p.110 / Chapter 4.2.3 --- Curve pattern --- p.110 / Chapter 4.3 --- Predictive model --- p.111 / Chapter 4.4 --- Comparison of predictive models between BMD inclusive model and conventional model derived from our population --- p.115 / Chapter 4.5 --- Possible relationship between osteopenia and etiopathogensis of AIS --- p.116 / Chapter 4.6 --- Axial measurement has a better predictive power in curve progression than peripheral measurement --- p.117 / Chapter 4.7 --- Discordance of BMD in bilateral hips --- p.118 / Chapter 4.8 --- Method justifications --- p.119 / Chapter 4.8.1 --- Definition of curve progression --- p.119 / Chapter 4.8.2 --- Incidence of progression as the outcome of prediction --- p.119 / Chapter 4.8.3 --- Selection on bone densitometers --- p.119 / Chapter 4.9 --- Clinical significance --- p.121 / Chapter 4.10 --- Limitations and Future Studies --- p.122 / Chapter 4.10.1 --- Limited follow-up time --- p.122 / Chapter 4.10.2 --- No defined cutoff value for 226}0´ببosteopenia 226}0ح or low BMC in paediatric area --- p.122 / Chapter 4.10.3 --- Predictive model could only applied in local population --- p.122 / Chapter 4.10.4 --- Intrinsic error in Risser grade measurement --- p.123 / Chapter 4.10.5 --- Further studies --- p.123 / Chapter 4.10.5.1 --- Validation of the newly developed predictive model --- p.123 / Chapter 4.10.5.2 --- Possible intervention of osteopenia --- p.124 / Chapter 4.10.5.3 --- Long term follow-up BMD measurements and fracture risk in AIS patients --- p.124 / Chapter 4.10.5.4 --- Discordance of bilateral hips BMD contributed by the shift of center of gravity --- p.125 / Chapter 4.10.5.5 --- Axial QCT can be an alternative method in assessing BMDin scoliotic patients --- p.125 / Chapter V. --- CONCLUSION --- p.126 / Chapter VI. --- APPENDIX --- p.127 / Chapter VII. --- BIBLIOGRAPHY --- p.128 / Chapter VIII. --- CONFERENCE PUBLICATIONS --- p.142

The purpose of this study was to determine whether radiologists could accurately assess osteopenia on chest plain films. Two chest radiologists evaluated lateral chest films from 100 patients (80 female and 20 male), ranging in age from 16 to 86 years, for osteopenia and its associated findings. Intra- and interobserver agreement was determined using weighted kappa statistics, and accuracy was assessed by making comparisons to bone mineral density as measured by the non-invasive gold standard of dual-energy x-ray absorptiometry (DXA). Overall, radiologists were good at identifying signs of late, but not early, disease. Intraobserver consistency was substantial for fish vertebrae (Kw1=0.638; Kw2=0.0.712) with moderate interobserver agreement (Kw=0.45). Similarly for wedged vertebrae, intraobserver consistency was substantial to moderate (Kw1=0.654; Kw2=0.533) with substantial interobserver agreement (Kw=0.622). These radiographic signs correlated with true disease as shown by high specificity values. Therefore, this study indicates that if osteopenia is suspected (i.e., there is a wedge or fish vertebra) or its associated features are seen on a CXR, it is crucial for radiologists to comment on it. The literature suggests that referring physicians do not pay attention to such findings in radiology reports. Radiologists could effect change in clinical treatment by not burying these findings in the report body, but instead putting it in the impression, along with a recommendation that the finding be followed up with DXA. Because effective interventions for women with osteoporosis exist, the results of this study will contribute to a major change in the practice of chest radiology and improve womens health by preventing the devastating disability associated with osteoporosis.

Akademisk avhandling--Universitetet i Göteborg. / Extra t.p., with thesis statement, inserted. Bibliography: p. 88-95.

Made available in DSpace on 2016-02-05T18:30:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-07-28. Added 1 bitstream(s) on 2016-02-05T18:34:16Z : No. of bitstreams: 1 000857773.pdf: 1062070 bytes, checksum: 71a62107765cf558c1418c16cda5314d (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo desse estudo foi analisar se há diferenças no efeito do desuso e da deficiência de estrógeno sobre o tecido ósseo trabecular e cortical, e se estes efeitos influenciam na qualidade do tecido ósseo aumentando sua fragilidade. Para este estudo, 30 ratas Wistar com 19 semanas de idade foram distribuídas nos grupos: controle (CON), descarregamento dos membros posteriores (HLU) e ovariectomizado (OVX). As análises da densidade óssea in vivo (DXA) dos fêmures e tíbias e as dosagens plasmáticas de cálcio, fósforo, fosfatase alcalina, TRAP (espectrofotometria) e E2 (ELISA) foram realizadas no início e fim do experimento, com 19 e 27 semanas de idade respectivamente. Na 27a semana, os fêmures e as tíbias foram desarticulados e armazenados para avaliar a microestrutura do osso trabecular e cortical (microtomografia computadorizada), além das propriedades biomecânicas do colo femoral e da diáfise femoral e tibial (ensaio mecânico). O grupo HLU apresentou diminuição na concentração plasmática de cálcio e atividade da fosfatase alcalina total, diminuição na DMOa do fêmur com aumento na porosidade cortical e diminuição na resistência óssea, entretanto, não foram observadas estas alterações na tíbia. O grupo OVX apresentou diminuição nas concentrações plasmáticas de cálcio, diminuição da DMOa do fêmur, deterioração trabecular no fêmur e na tíbia, com maior deterioração nas trabéculas ósseas tibiais, sem alteração na resistência óssea em ambos os ossos. Esses resultados demonstram que apesar do grupo HLU e OVX apresentassem alterações na densidade mineral óssea e microarquitetura óssea, podemos concluir que o desuso determinou maior perda no tecido cortical e na resistência óssea em relação à deficiência de estrógeno. Portanto, as análises da estrutura do tecido cortical, como a porosidade cortical, podem ser preponderantes para prever o risco de fratura / The objective of this study was to analyze whether there are differences in the effect of disuse and estrogen deficiency on trabecular and cortical bone tissue, and whether these effects influence the quality of bone tissue increasing its fragility. For this study, 30 Wistar rats with 19 weeks old, were divided into groups: control (CON), hindlimb unloading (HLU) and ovariectomy (OVX). In vivo analysis of bone density (DXA) from femurs and tibias and plasma levels of calcium, phosphorus, alkaline phosphatase, TRAP (spectrophotometry) and E2 (ELISA) were performed at the beginning and end of the experiment, and 19 age 27 weeks, respectively. In the 27th week, the femur and tibia were disjointed and stored to assess the microstructure of trabecular and cortical bone (microcomputed tomography) and biomechanical properties of the femoral neck and femoral shaft and tibial (mechanical tests). The HLU group showed a decrease in plasma calcium concentration and total alkaline phosphatase activity, decreased femoral BMAD with increased cortical porosity and decrease in bone strength, however, there were no such changes in the tibia. The OVX group showed a decrease in plasma concentrations of calcium, decreased femoral BMAD, trabecular deterioration in the femur and tibia, with further deterioration in the tibial trabecular bone, with no change in bone strength in both bones. These results demonstrate that although the HLU and OVX group showed changes in bone mineral density and bone microarchitecture, we can conclude that the in disuse determined higher cortical tissue loss and bone strength relative to estrogen deficiency. Therefore, the analysis of the cortical tissue structure, such as cortical porosity can be prevalent to predict fracture risk

Orientador: Mário Jefferson Quirino Louzada / Banca: William Dias Belangero / Banca: José Carlos Camargo Filho / Resumo: O objetivo desse estudo foi analisar se há diferenças no efeito do desuso e da deficiência de estrógeno sobre o tecido ósseo trabecular e cortical, e se estes efeitos influenciam na qualidade do tecido ósseo aumentando sua fragilidade. Para este estudo, 30 ratas Wistar com 19 semanas de idade foram distribuídas nos grupos: controle (CON), descarregamento dos membros posteriores (HLU) e ovariectomizado (OVX). As análises da densidade óssea in vivo (DXA) dos fêmures e tíbias e as dosagens plasmáticas de cálcio, fósforo, fosfatase alcalina, TRAP (espectrofotometria) e E2 (ELISA) foram realizadas no início e fim do experimento, com 19 e 27 semanas de idade respectivamente. Na 27a semana, os fêmures e as tíbias foram desarticulados e armazenados para avaliar a microestrutura do osso trabecular e cortical (microtomografia computadorizada), além das propriedades biomecânicas do colo femoral e da diáfise femoral e tibial (ensaio mecânico). O grupo HLU apresentou diminuição na concentração plasmática de cálcio e atividade da fosfatase alcalina total, diminuição na DMOa do fêmur com aumento na porosidade cortical e diminuição na resistência óssea, entretanto, não foram observadas estas alterações na tíbia. O grupo OVX apresentou diminuição nas concentrações plasmáticas de cálcio, diminuição da DMOa do fêmur, deterioração trabecular no fêmur e na tíbia, com maior deterioração nas trabéculas ósseas tibiais, sem alteração na resistência óssea em ambos os ossos. Esses resultados demonstram que apesar do grupo HLU e OVX apresentassem alterações na densidade mineral óssea e microarquitetura óssea, podemos concluir que o desuso determinou maior perda no tecido cortical e na resistência óssea em relação à deficiência de estrógeno. Portanto, as análises da estrutura do tecido cortical, como a porosidade cortical, podem ser preponderantes para prever o risco de fratura / Abstract: The objective of this study was to analyze whether there are differences in the effect of disuse and estrogen deficiency on trabecular and cortical bone tissue, and whether these effects influence the quality of bone tissue increasing its fragility. For this study, 30 Wistar rats with 19 weeks old, were divided into groups: control (CON), hindlimb unloading (HLU) and ovariectomy (OVX). In vivo analysis of bone density (DXA) from femurs and tibias and plasma levels of calcium, phosphorus, alkaline phosphatase, TRAP (spectrophotometry) and E2 (ELISA) were performed at the beginning and end of the experiment, and 19 age 27 weeks, respectively. In the 27th week, the femur and tibia were disjointed and stored to assess the microstructure of trabecular and cortical bone (microcomputed tomography) and biomechanical properties of the femoral neck and femoral shaft and tibial (mechanical tests). The HLU group showed a decrease in plasma calcium concentration and total alkaline phosphatase activity, decreased femoral BMAD with increased cortical porosity and decrease in bone strength, however, there were no such changes in the tibia. The OVX group showed a decrease in plasma concentrations of calcium, decreased femoral BMAD, trabecular deterioration in the femur and tibia, with further deterioration in the tibial trabecular bone, with no change in bone strength in both bones. These results demonstrate that although the HLU and OVX group showed changes in bone mineral density and bone microarchitecture, we can conclude that the in disuse determined higher cortical tissue loss and bone strength relative to estrogen deficiency. Therefore, the analysis of the cortical tissue structure, such as cortical porosity can be prevalent to predict fracture risk / Mestre