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Biomedical subjects

C E Webber

Publications and source records attributed to C E Webber.

At least 37 records · Page 2Linked to original sources
PubMed1998

Relation between image-based assessment of distal radius trabecular structure and compressive strength.

OBJECTIVE: To investigate the degree to which an image-based assessment of trabecular bone structure can predict bone strength. METHODS: Transaxial high-resolution magnetic resonance imaging (MRI) images and peripheral quantitative computed tomography (pQCT) images were obtained for a set of 9 isolated radii. Trabecular bone was segmented from fat, and indices relating to the connectivity of the bone network and the size of the marrow space were derived. Bone mineral density was also assessed in each radius by means of dual-energy x-ray absorptiometry and pQCT. Each bone was subjected to a mechanical load consistent with a fall from a standing height, and measures of density and trabecular structure were compared to the compressive load. RESULTS: In the 9 bones tested, measures of bone mineral density explained approximately 50% of the variability with load (0.52 < r2 < 0.57, p < 0.03), and indices relating to the size of the marrow spaces explained an additional 25% to 30% of the variance. This held true whether the indices quantifying the marrow space were derived from the MRI images (r2 = 0.70, p = 0.03) or the pQCT images (r2 = 0.82, p = 0.006). CONCLUSION: Our findings suggest that image-based assessments of trabecular bone structure relate to bone strength in vitro.

Absorptiometry, Photon↗
PubMed1997

Further experience with bone lead content measurements in residents of southern Ontario.

Bone lead content of the mid-tibia was measured by in vivo fluorescence excitation in 90 females and 59 males aged between 6 and 81. The cross-sectionally derived rate of increase of tibia lead content was 0.24 +/- 0.03 microgram [g mineral]-1 yr-1. In 93 adult women, the corresponding rate of increase for calcaneus lead content was 0.12 +/- 0.11 microgram [g mineral]-1 yr-1. Comparison with European values show that, in Canada, the rates of lead accumulation are greater than those found in N. Sweden and Finland, similar to those of S. Sweden and less than values measured in England.

Adolescent↗
PubMed1997

The feasibility of measuring bone uranium concentrations in vivo using source excited K x-ray fluorescence.

X-ray fluorescence (XRF) has been demonstrated to be an extremely useful technique for measuring trace quantities of heavy metals in various tissues within the body. This study investigates the applicability of XRF to the measurement of bone uranium concentration. The factors affecting the accuracy and minimal detectable concentration of bone uranium in vivo are discussed. The system chosen employs a 57Co source to excite the uranium K x-rays, with the source and detector in an approximate 180 degrees backscatter geometry relative to the sample position. It is demonstrated, with experiment and Monte Carlo simulation, that the x-ray to coherent peak ratio is linearly related to concentration and is independent of variations in source-sample geometry, thickness of overlying tissue and tibia size. Preliminary in vivo measurements indicate that this system has a minimum detectable concentration of approximately 20 micrograms U/g bone mineral which may not be sufficiently precise for a monitoring system for occupational workers. Future work will involve attempts to enhance this precision through the use of alternative sources for the excitation of uranium x-rays as well as possible modifications to the detector and electronics.

Biophysical Phenomena↗
PubMed1997

Gymnastic training and bone density in pre-adolescent females.

Bone mineral density (BMD) was compared between 7-11-yr-old female gymnasts (GYM: N = 16) with a history of high volume impact loading (minimum of 15 h.wk-1 for past 2 yr) and healthy nonathletic controls (CON: N = 16). Whole body (WB) and regional areal BMD measures were determined by dual energy x-ray absorptiometry (DXA) normalized for height and body mass and also converted to bone mineral apparent density (BMAD). Volumetric BMD and bone cross-sectional areas were also measured by peripheral QCT (pQCT) at the left distal radius. GYM were significantly (P < 0.01) shorter (129.3 +/- 5.7 vs 136.7 +/- 4.4 cm; means +/- SD) and leaner (15.1 +/- 1.9 vs 19.6 +/- 4.3% body fat from DXA), and had significantly (P < 0.05) greater femoral neck (0.698 +/- 0.058 vs 0.648 +/- 0.064 g.cm-2) and trochanter (0.616 +/- 0.060 vs 0.530 +/- 0.084 g.cm-2) areal BMD than CON. GYM also had significantly higher whole body (0.101 +/- 0.009 vs 0.094 +/- 0.007 g.cm-3), femoral neck (0.245 +/- 0.060 vs 0.205 +/- 0.049 g.cm-3) and lumbar spine (0.227 +/- 0.014 vs 0.210 +/- 0.026 g.cm-3) BMAD compared with CON. Height normalized areal BMD measures were also significantly higher at all sites in GYM. Radial total (367.7 +/- 51.6 vs 307.4 +/- 27.6 mg.cm-3), trabecular (207.9 +/- 45.3 vs 163.8 +/- 31.4 mg.cm-3), and cortical (496.9 +/- 67.5 vs 429.8 +/- 33.8 mg.cm-3) BMD were also significantly greater in the GYM compared with the CON. In conclusion, high volume impact loading was associated with greater (compared with controls) whole body and regional bone mineral density in pre-adolescent female gymnasts.

Biomechanical Phenomena↗
PubMed1997

In vivo assessment of trabecular bone structure at the distal radius from high-resolution magnetic resonance images.

In this study a method of assessing trabecular bone structure at the distal end of the radius from high-resolution magnetic resonance images is described. Trabecular bone is segmented from the marrow and soft tissue background using an adaptive threshold, a region growth, and a skeletonization step. From the processed image we measured the connectivity and orientation of the trabecular bone network. Connectivity was assessed by a proposed connectivity index (CI) and marrow space was quantitated by a mean hole area (HA). Significant age-related changes in CI and HA were observed in a mixed group of normal volunteers. CI decreased at a rate of 0.18 yr-1 (r = 0.72, n = 14, p < 0.05) and HA increased at a rate of 0.018 mm2 yr-1 (r = 0.69, n = 14, p < 0.05). Gradient analysis was used to examine trabecular orientation, and revealed that the individual trabeculae at the distal end of the radius are organized anisotropically along the bone. These findings suggest that clinical magnetic resonance scanners can be used to assess trabecular bone structure in vivo.

Adolescent↗
PubMed1997

Accumulated body burden and endogenous release of lead in employees of a lead smelter.

Bone lead levels for 367 active and 14 retired lead smelter workers were measured in vivo by X-ray fluorescence in May-June 1994. The bone sites of study were the tibia and calcaneus; magnitudes of concentration were used to gauge lead body burden. Whole blood lead readings from the workers generated a cumulative blood lead index (CBLI) that approximated the level of lead exposure over time. Blood lead values for 204 of the 381 workers were gathered from workers returning from a 10-month work interruption that ended in 1991; their blood level values were compared to their tibia and calcaneus lead levels. The resulting relations allowed constraints to be placed on the endogenous release of lead from bone in smelter works. Calcaneus lead levels were found to correlate strongly with those for tibia lead, and in a manner consistent with observations from other lead industry workers. Relations between bone lead concentration and CBLI demonstrated a distinctly nonlinear appearance. When the active population was divided by date of hire, a significant difference in the bone lead-CBLI slope emerged. After a correction to include the component of CBLI existing before the workers' employment at the smelter was made, this difference persisted. This implies that the transfer of lead from blood to bone in the workers has changed over time, possibly as a consequence of varying exposure conditions.

Adult↗
PubMed1996

Partition of circulating lead between serum and red cells is different for internal and external sources of lead.

Serum lead, whole blood lead, and lead in both tibia and calcaneus were measured in each of 49 active lead workers. Serum lead correlated more strongly with both in vivo bone lead measurements than did whole blood lead. The ratio of serum lead to whole blood lead varied from 0.8% to 2.5% and showed a positive correlation with tibia, and an even stronger correlation with calcaneus lead. This implies that lead released from bone (endogenous exposure) results in a higher proportion of whole blood lead being in serum than is the case for exogenous exposure. This observation needs to be confirmed, and the relationships amongst the parameters must be studied further, particularly in former or retired lead workers. If confirmed, since at least a portion of lead in serum is readily diffusible and thus toxicologically more immediately significant than lead bound to red cells, the health implications of endogenous exposure may have to be reassessed.

Adult↗
PubMed1996

In vivo assessment of trabecular bone structure at the distal radius from high-resolution computed tomography images.

A dedicated computed tomography system was used to acquire transaxial images of the distal radius to assess trabecular bone structure in vivo. We segmented trabecular bone from the marrow and soft tissue background by postprocessing the image with a region grow and skeletonization step. From the processed image we assessed the integrity of the bone by examining the continuity of its trabecular network and by determining the area of the holes comprising its marrow space. The continuity of the bone imaged was assessed by a proposed connectivity index (CI) and the size of the marrow spaces was assessed by calculating a mean hole area (H(A)) in the bone cross-section. Repeat measurements revealed that the intra-subject variability in CI and H(A) was small (CV < 6%). Both CI and H(A) were sensitive enough to reflect differences in structure at the head of the radius and at several sites along its shaft. We tested the diagnostic value of assessing bone structure at the distal end of the radius by measuring trabecular bone density, CI and H(A) in a mixed group of 26 subjects, nine of whom had suffered a wrist fracture. We found that a trabecular bone density threshold of 116 mg cm-3, corresponding to two standard deviations below the mean density in the 17 non-fractured subjects, separated fractured from non-fractured subjects with a sensitivity of 22% and a specificity of 100%. A CI threshold of -4.7 doubled the sensitivity (44%) and maintained the 100% specificity. An H(A) threshold of 4.5 mm2 achieved a sensitivity of 89% and a specificity of 94%. This increased sensitivity achieved by our indices suggests that an in vivo assessment of trabecular bone structure can contribute significantly to the identification of persons at risk of fracture.

Adult↗
PubMed1996

A longitudinal trial of weight training in the elderly: continued improvements in year 2.

We conducted a 2-year (42 weeks of consecutive training in each year, separated by 10 weeks of testing and vacation time) randomized, controlled trial of weight training in 142 healthy male and female subjects, aged 60 to 80 years. Measurements included dynamic strength, symptom-limited endurance in cycling, treadmill walking and stair climbing, muscle size, and bone mineral density and content of the lumbar spine and whole body. One hundred and thirteen subjects completed the study (57 exercise, 56 control), with a mean attendance of 85% among the exercisers. Muscle strength was unchanged in the control subjects but increased (collapsed across age and gender) from 32% (leg press) to 90% (military press) in the exercisers. Symptom-limited endurance in cycling, treadmill walking, and stair climbing increased in the exercisers by (mean +/- SE) 6.2 +/- 0.8%, 29.2 +/- 7.3%, and 57 +/- 12%, respectively; the only change in the controls was an unanticipated 33% increase in stair climbing performance during the first year. These values were unchanged in the controls. Cross-sectional area of the knee extensors increased by 8.7 +/- 0.9% in the trained subjects and was unchanged in controls. Measures of whole body, lumbar spine bone mineral density, and lumbar spine bone mineral content were unchanged in the exercisers, but whole body bone mineral content decreased by 1%. In contrast, there were small increases (< 4.0%) in bone mineral density among the controls. Long-term weight training proved to be a safe and well-tolerated mode of exercise for the elderly. Increased strength was associated with muscle hypertrophy in each year, and with increased endurance in cycling, walking, and stair climbing. There were no changes in bone mineral density but a small reduction in whole body bone mineral content.

Aged↗
PubMed1996

The effects of long-term heparin therapy during pregnancy on bone density. A prospective matched cohort study.

We performed a prospective matched cohort study to investigate the effects of long-term (> 1 month) heparin therapy on lumbar spine bone density. Twenty-five women who received heparin during pregnancy, and 25 matched controls underwent dual photon absorptiometry of the lumbar spine in the post-partum period. Zero of 25 heparin-treated patients developed fractures. Heparin-treated patients had a 0.082 g/cm2 lower bone density compared to untreated controls, which is clinically and statistically significant (p = 0.0077). There were 6 matched pairs in which only the heparin-treated patient had a bone density below 1.0 g/cm2, compared to only one pair in which only the control patient had a bone density below this level (p = 0.089). The correlation coefficients of the difference in bone density in each matched pair, and the duration of heparin therapy, the mean daily dose, and the total dose of heparin were 0.042, - 0.015, and 0.021, respectively; none of these values is statistically significant. We conclude: 1) long-term heparin therapy was associated with a significant reduction in bone density, although fractures are uncommon, 2) there was no significant correlation between lumbar bone density and the dose or duration of heparin.

Absorptiometry, Photon↗
PubMed1996

Postmenopausal bone mineral density: relationship to calcium intake, calcium absorption, residual estrogen, body composition, and physical activity.

Physical and lifestyle data were collected from 62 postmenopausal women who had declined hormone replacement therapy. Potential predictor variables were examined for their associations with bone mineral density (BMD) of the lumbar spine and femoral neck as assessed by dual x-ray absorptiometry. Body weight demonstrated the strongest association with lumbar BMD; lean body mass demonstrated the strongest association with femoral BMD. Together with the natural logarithm of the number of years since menopause (ln YSM) these anthropometric variables explained 36 and 34% of the variability of femoral and lumbar BMD, respectively. Serum estradiol levels demonstrated a weak positive association with BMD, which lost statistical significance after adjustment for body mass. Similarly, cardiovascular fitness was positively associated with femoral BMD prior to but not following adjustment for body mass. Controlling for years since menopause and body mass, the product of dietary calcium and calcium absorption demonstrated a weak positive correlation with femoral BMD (partial r = 0.30). The intake of tea was positively and significantly associated with both bone density measurements. In multiple regression analysis, femoral BMD was best explained by the lean body mass, ln YSM, and the daily intake of tea (r2 = 0.50). Similarly, lumbar BMD was best explained by body weight, ln YSM, and intake of tea (r2 = 0.44). Body mass is a major predictor of postmenopausal bone density at the hip and spine. A positive association between dietary calcium and BMD was detected only by taking into account the intestinal absorptive efficiency.

Absorption↗
PubMed1996

Effects of resistance training on bone mineral content and density in adolescent females.

Postmenarcheal adolescent girls performed resistance training (RT) for 26 weeks, which consisted of 4 sets of 13 exercises of varying and progressive intensity performed 3 times weekly on hydraulic resistance machines. Bone mineral was assessed by dual photon absorptiometry. Resistance training resulted in significant increases (pre-post) in biceps curl (21.4%), triceps press (21.5%), knee extension (25.1%), knee flexion (52.8%), and squat press (21.5%) strength. There were no significant differences between RT and control (C) groups initially, and no significant effects of training (pre-post) for total body (TB) or lumbar spine (LS) bone mineral content (BMC) or bone mineral density (BMD). The largest increases in LS bone mineral occurred during the first 13 weeks, and although not significant, the increases in LS BMC (g) (3.9 vs. 5.9%), LS BMC (g.cm-1) (2.6 vs. 5.9%), LS areal BMD (g.cm-2) (1.48 vs. 4.75%), and LS bone mineral apparent density (BMAD, g.cm-3) (0.47 vs. 4.13%) were greater in the RT compared with the C group during this period. In conclusion, resistance training resulted in a trend towards a transient increase in LS bone mineral during the first 13 weeks, but despite significant strength gains, there were no significant changes in TB or LS bone mineral after 26 weeks of training.

Adolescent↗
PubMed1996

Twenty weeks of weight training increases lean tissue mass but not bone mineral mass or density in healthy, active young women.

Twenty young women (20.3 +/- 1.0 years) participated in a weight training program in which upper and lower body exercises were done twice per week for 20 weeks. Ten other women (20.2 +/- 0.4 years) served as a control group. Training resulted in significant (p < 0.05) increases in arm curl (73%), bench press (33%), and leg press (23%) lifting performance. Whole body (3.7%), trunk (3.0%), arm (9.7%), and leg (3.3%) lean tissue mass also increased significantly, based on measurements made by dual energy x-ray absorptiometry (DEXA). Changes in the control group were small and nonsignificant. In contrast, training did not increase DEXA-measured bone mineral content (BMC) and density (BMD) in a whole body measure nor in arm, leg, ribs, thoracic and lumbar spine, and pelvis segments. Similarly, hip BMC and BMD at femoral neck, trochanter, intertrochanter, and Ward's triangle sites, and total hip did not increase with training. The data indicate that a resistance training program that effectively increases strength and lean tissue mass in young women may fail to increase BMC or BMD over a 20-week training period.

Adult↗
PubMed1995

Mineral homeostasis and bone mass at diagnosis in children with acute lymphoblastic leukemia.

OBJECTIVE: To determine whether the osteopenia and unusual fractures observed in children with acute lymphoblastic leukemia (ALL) were related to the disease rather than to its treatment. DESIGN: Prospective analysis of the bone and mineral status in 40 consecutive children with ALL seen in a pediatric tertiary-care referral center. METHODS: Biochemical indicators of mineral, endocrine, and vitamin D status were measured before initiation of therapy. Bone mass was determined radiographically and by dual-photon absorptiometry of the lumbar region of the spine (L2-L4). Correlations between clinical observations, leukemia variables, bone mass, and biochemical assessment were determined. RESULTS: At the time of diagnosis musculoskeletal pain was present in 36% of patients and was more common in children with CD10-positive leukemia and leukocyte counts less than 20 x 10(9) cells/L. Radiographic evidence of osteopenia and fractures was observed in 13% and 10% of children, respectively. The mean bone mineral content was normal. Bone mass measurement z scores correlated with plasma 1,25-dihydroxyvitamin D3 concentrations (r = 0.43, p < 0.05). Plasma calcium, magnesium, phosphorus, and 25-hydroxyvitamin D3 levels were normal. Low plasma osteocalcin (mean +/- SD, 1.6 +/- 1.6 nmol/L) and 1,25-dihydroxyvitamin D3 (33.4 +/- 26.4 pmol/L) values were observed. Parathyroid hormone levels were low in 14% of children. Hypercalciuria was detected in 64% of children. Urinary deoxypyridinoline was lower (p < 0.01) than in age-matched control subjects. Histomorphometric measurements of iliac bone showed abnormalities in mineralization in the biopsy specimens from three of nine children. CONCLUSION: Most children with ALL have alterations in bone metabolism and bone mass when first examined. These data suggest defective mineralization as the mechanism for decreased bone mass and implicate the leukemic process as causative.

Adolescent↗
PubMed1995

Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone.

We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength, peak power output in cycle ergometry, symptom limited endurance during progressive treadmill walking and stair climbing, knee extensor cross-sectional areas, and bone mineral density and content in healthy males and females aged 60-80 years, currently enrolled in a 2-year resistance training program. Subjects were randomized into either exercise (EX) or control (CON) groups (60-70 years: 38 males and 36 females; 70-80 years: 25 males and 43 females). EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50-80% of the load that they could lift once only (1 RM); CON did usual daily activities. After the 10 months there was no change in 1 RM strength in CON, but significant gains (mean increases up to 65%) in EX (no independent age or gender effects); 30% and 47% of the increase in 1 RM had occurred by 6 and 12 weeks, respectively. In EX, the 7.1% increase in peak cycling power output was significantly greater than in CON (+1.1%). The 17.8% improvement in symptom limited treadmill walking endurance was also greater than in CON (+3.4%), but the difference between groups during stair climbing was not significant (EX + 57%, CON + 33%). The cross-sectional areas of the knee extensors increased significantly by 5.5% in EX but were unchanged in CON. There were no changes in bone mineral density or content in either group. We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength, muscle size, and functional capacity.

Aged↗
PubMed1995

Hormone replacement therapy may reduce the return of endogenous lead from bone to the circulation.

Hormone replacement therapy (HRT) in postmenopausal women suppresses the increase in bone resorption expected as circulating levels of endogenous estrogen decline. We tested the hypothesis that bone lead content might remain elevated in women on HRT. Fifty six women who at recruitment were on average 35 years postmenopausal were placed on calcium supplementation. Six months later 33 of these women were prescribed either low dose or moderate dose hormone replacement in addition to the calcium supplementation. After approximately 4 years of hormone replacement, lead content was measured at the tibia and calcaneus by in vivo fluorescence excitation, and lead concentrations were measured in serum, whole blood, and urine. Women not taking hormones had significantly lower lead concentrations in cortical bone compared to all women on HRT (p = 0.007). Tibia lead content (mean +/- SD) for women on calcium only was 11.13 +/- 6.22 microgram/g bone mineral. For women on HRT, tibia bone lead was 19.37 +/- 8.62 micrograms/g bone mineral on low-dose HRT and 16.87 +/- 11.68 micrograms/g bone mineral on moderate-dose HRT. There were no differences between groups for lead concentrations measured in trabecular bone, whole blood, serum or urine. Hormone replacement maintains cortical bone lead content. In women not on HRT, there will be a perimenopausal release of lead from bone.

Bone and Bones↗
PubMed1995

Exercise and bone mineral density.

A decrease in physical activity may lead to an increased loss of bone and an increase in the incidence of osteoporotic fractures. Studies have demonstrated increases in bone formation in animals and increases in bone mineral density in humans. Studies of animals show that bone has enhanced physical and mechanical properties following periods of increased stress. Strains which are high in rate and magnitude, and of abnormal distribution, but not necessarily long in duration, are best for inducing new bone formation, resulting in the strengthening of bone by increased density. Cross-sectional studies show that athletes, especially those who are strength-trained, have greater bone mineral densities than nonathletes, and that strength, muscle mass and maximal oxygen uptake correlate with bone density. Longitudinal training studies indicate that strength training and high impact endurance training increase bone density. Strain induction, the deformation that occurs in bone under loading, may cause a greater level of formation and an inhibition of resorption within the normal remodelling cycle of bone, or it may cause direct activation of osteoblastic bone formation from the quiescent state. Various mechanisms have been proposed for the transformation of mechanical strain into biochemical stimuli to enhance bone formation. These include prostaglandin release, piezoelectric and streaming potentials, increased bone blood flow, microdamage and hormonally mediated mechanisms. These mechanisms may act on their own or in concert, depending on the loading situation and the characteristics of the bone.

Animals↗