These results demonstrate that hyperhomocysteinemia reduced bone strength via a reduction of enzymatic cross-links and an increase of nonenzymatic cross-links. RLX may ameliorate hyperhomocysteinemia-induced detrimental cross-linking in rabbits with OVX and may improve bone strength via the amelioration of collagen cross-links.

GFP reporter mice previously developed to assess levels of osteoblast differentiation were employed in a tibial long bone fracture model using a histological method that preserves fluorescent signals in non-decalcified sections of bone. Two reporters, based on Col1A1 (Col3.6GFPcyan) and osteocalcin (OcGFPtpz) promoter fragments, were bred into the same mice to reflect an early and late stage of osteoblast differentiation. Three observations were apparent from this examination. First, the osteoprogenitor cells that arise from the flanking periosteum proliferate and progress to fill the fracture zone. These cells differentiate to osteoblasts, chondrocytes, to form the outer cortical shell. Second, the hypertrophic chondrocytes are dispersed and the cartilage matrix mineralized by the advancing Col3.6þ osteoblasts. The endochondral matrix is removed by the following osteoclasts. Third, a new cortical shell develops over the cartilage core and undergoes a remodeling process of bone formation on the inner surface and resorption on the outer surface. The original fractured cortex undergoes resorption as the outer cortical shell remodels inward to become the new diaphyseal bone. The fluorescent microscopy and GFP reporter mice used in this study provide a powerful tool for appreciating the molecular and cellular processes that control these fundamental steps in fracture repair, and may provide a basis for understanding fracture nonunion. ß

Once-weekly preventive administration of hPTH(1-34) increased the total contents of immature and mature enzymatic cross-links, which contributed significantly to vertebral cancellous bone strength.

Study Design: Prospective cross-sectional study. Objectives: To investigate the timing of deep vein thrombosis (DVT) onset secondary to spinal cord injury without anticoagulant therapies. Setting: Spinal Cord Injury Center in Hokkaido, Japan. Methods: Between November 2012 and June 2013, patients with spinal cord injury who were admitted to our hospital within 1 day after the injury and treated surgically within 24 h underwent a neurological examination, leg vein ultrasonography and D-dimer test 1, 3, 7, 14 and 28 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings, but without any anticoagulant. Results: DVT developed in 12 patients (11 men and 1 women), with a mean age of 62.2 years (range, 41-80 years; mean age of total sample, 63.2 years (range, 25-78 years)), all distal to the popliteal vein. DVT occurred more often with a more severe paralysis (66.3%, AIS A and B). The median (± standard error) length of time from the operation to DVT detection was 7.5 ± 2.2 days. The mean D-dimer level upon DVT detection was 14.6 ± 11.8 μg ml − 1 , with no significant differences between those who developed DVT and those who did not at any of the time points. Conclusion: These results suggest that DVT can develop at the very-acute stage of spinal cord injury and the incidence increases with a more severe paralysis. DVT detection was more reliable with ultrasonography, which should be used with DVT-preventive measures, beginning immediately after the injury, for the management of patients with spinal cord injury. INTRODUCTIONDeep vein thrombosis (DVT) is one of the most dangerous complications of a spinal cord injury. DVT has a high incidence in patients with spinal cord injury as compared with patients with other diseases 1 with a high mortality rate if complicated by pulmonary embolism. 2 Although prevention, early detection and timely treatment of DVT are important during the management of patients with spinal cord injury, the timing of DVT onset secondary to a spinal cord injury has not yet been determined. In order to clarify these problems, this study aimed to investigate the timing of DVT onset by prospectively analyzing the patients immediately after a spinal cord injury.

Object The purpose of this study was to evaluate the linear and angular parameters of the vertebral body (VB) required for cervical pedicle screw (CPS) insertion by using multiplanar computerized tomography (CT) reconstructions. Methods Three hundred fifteen vertebrae from C-3 to C-7 in 63 patients were studied. Pedicle dimensions such as pedicle transverse angle (PTA), pedicle sagittal angle (PSA), and pedicle outer width (POW) were measured on axial CT reconstructions, as were linear parameters including the lateral mass thickness (LMT), the anteroposterior (AP) and mediolateral distances between spinal canal and transverse foramen, and spinal canal longitudinal and transverse diameter. In addition, the correlations between PTA and other parameters were calculated using univariate linear regression analysis. The overall mean LMT ranged from 10.7 to 12.6 mm. The smallest mean AP spinal canal–transverse foramen distance was found at C-7 (1.1 mm),whereas the largest mean distance was at C-4 (3.1 mm). The smallest mean mediolateral spinal canal–transverse foramen distance was found at C-4 (1.2 mm), whereas the largest mean distance was at C-7 (4.7 mm). There were significant intergroup differences between male and female patients except for PTA and spinal canal longitudinal diameter. The PTA had a direct linear correlation with AP and mediolateral spinal canal–transverse foramen distances. The largest Pearson coefficient was 0.71 between the PTA and AP spinal canal–transverse foramen distance and the inverse one was −0.73 between the PTA and mediolateral spinal canal–transverse foramen distance. Conclusions Analysis of the data obtained in this study suggests that not only pedicle dimensions but also linear and angular parameters of the VB can be useful data when inserting a CPS.