(5) The biochemical markers of bone turnover such as serum bone
glaprotein, bone alkaline phosphatase, urinary pyridinoline and
urinary deoxypyridinoline were detected with enzyme linked im-
munosorbent assay. Results: (1) Five hundred ninety-one cases were
up to standard, with ages from 48 to 84, average age 62.19±6.32 years.
(2) There were no significant differences in bone mineral density of
lumbar spine, femoral neck, trochanter and Ward's triangle among
genotypes of Alu I polymorphism sites (p <0.05). (3) Urinary
pyridinoline was lower in TT genotype than in CC genotype and TC
genotype (p< 0.05), but there were no significant differences in serum
bone glaprotein, bone alkaline phosphatase and urinary deoxypyr-
idinoline among genotypes of Alu I polymorphism sites (p< 0.05). (4)
There were no significant differences in the incidence of osteoporosis
among genotypes of Alu I polymorphism sites (p < 0.05). (5) There
were no significant differences in the incidence of postmenopausal
fracture among genotypes of Alu I polymorphism sites (p <0.05).
Conclusion: These findings indicate that Alu I polymorphism of the
calcitonin receptor gene are not associated with osteoporosis in
Fuzhou postmenopausal women, and calcitonin receptor gene Alu I
alleles are not regarded as genetic markers in predicting the risk of
developing osteoporosis in Fuzhou postmenopausal women.
Acknowledgment
Supported by The National Natural Science Foundation of China.
No. 30672703.
doi:10.1016/j.bone.2010.09.146
79
The change of BMD in postmenopausal osteoporosis women
receiving an injection of rPTH 1-34 for 6 months and then no
injection for 18 months
Aijun Chao, Weihong Yu, Wei Hu, Li Wang, Decheng Kong Decheng
The Cadre Department of Tianjin Hospital, Tianjin, China
Objective: To investigate the change of bone mineral density (BMD)
in postmenopausal osteoporosis Chinese women who received an
injection of rPTH1-34 for 6 months, and then no injection for 18 months.
Methods: Thirty postmenopausal osteoporosis Chinese women who
met the including criteria without excluding the condition were
randomly divided into 2 groups, trial group and control group. rPTH1-
34 20 μg and 600 mg elementary calcium were given to the trial group
daily. The control group received Alfacalcidol 0.5 μg and elementary
calcium 600 mg daily. The treatment continued for 6 months and was
followed by stopping the anti-osteoporosis medicine for 18 months.
BMD was measured before taking the medicine (baseline value) and
after stopping for 18 months. The site included vertebrae L2-4, femoral
neck and whole hip. In the two groups, the BMD ratio was higher than
the baseline value after stopping treatment. Results: There were 4
subjects in the control group and 11 subjects in the trial group who
completed the trial. In the control group, all 4 of the subject's BMD were
lower than baseline after stopping the treatment for 18 months in all
sites. There were 81.82% (9 cases) in the vertebral L2-4, 54.55% (6 cases)
in the femur and 63.64% (7 cases) in the whole hip's BMD that were
higher than baseline, p<0.05 in vertebral and whole hip contrast to
control group, and p < 0.057 in femoral neck. Conclusion: When
stopping treatment for 18 months after injecting rPTH1-34 for six, there
was a higher ratio of those whose BMD could be preserved. It showed
that rPTH1-34 is an effective medicine in the treatment of Chinese
women with postmenopausal osteoporosis.
doi:10.1016/j.bone.2010.09.147
80
Bone flap storage following craniectomy: A survey of practices in
major Australian neurosurgical centers
Ivan Bhaskar
1
, Nyi Zaw
1
, Minghao Zheng
2
, Gabriel Lee
1,2
1
Sir Charles Gairdner Hospital, Western Australia, Australia
2
University of Western Australia, Western Australia, Australia
Introduction: The resurgence of decompressive craniectomy sur-
geries for management of intracranial hypertension has led to a parallel
increase in cranioplasty procedures for subsequent reconstruction of the
extensive skull defects. Most commonly, cranioplasties are performed
using the patients’ own cryopreserved skull flaps. Currently, there are no
standardized guidelines for freeze-storage of bone flaps either nationally
or internationally. In this initial study, the authors surveyed major
neurosurgical centers throughout Australia to document current clinical
practices. Methodology: Twenty-five neurosurgical centers affiliated
with major public, teaching hospitals in all Australian states were
included in the current survey study. A standardized survey guide
incorporating standardized questions was used for data collection either
by phone interviews and/or electronic (e-mail) communication. Details
regarding bone flap preparation following craniectomy, temperature
and duration of freeze-storage, infection control/micro-contamination
detection protocols, pre-implantation procedures were specifically
recorded. Results: Cranioplasty using cyropreserved autogenous bone
flaps remains the most common (96%) mode of skull defect reconstruc-
tion in major neurosurgical centers throughout Australia. Following the
initial craniotomy, the harvested skull flaps were most frequently (88%)
double- or triple-bagged under dry, sterile conditions. In 12% of
hospitals, skull flaps were irrigated either with antibiotic mixed-saline
or Betadine prior to cryopreservation. Skull biopsies or swabs were
obtained from the skull flaps for micro-contamination studies in
accordance with departmental protocol in 68% of hospitals surveyed.
Subsequently, the bone flaps were cryopreserved at wide ranging
temperatures between -18 °C to -83 °C, for variable time intervals
(6 months to “until patient deceased”). Twelve neurosurgical centers
(48%) elected for bone flap storage to be undertaken at the local bone
bank. In the remainder (52%) of hospitals, bone flaps were cryopre-
served in locally maintained freezers. Prior to re-implantation of the
skull flaps at subsequent cranioplasty surgeries, six (24%) of the
neurosurgical centers had specific thawing procedures involving
immersion of the frozen bone flaps in Ringer's solution and/or Betadine.
Further pre-implantation bacteriological cultures from bone biopsies or
swabs were obtained only in 3 (12%) hospitals. Conclusions: This study
has documented highly varied skull flap cryopreservation and storage
practices in neurosurgical centers throughout Australia. These differ-
ences may contribute to relatively high complication rates of infection
and bone resorption reported in the literature. The results of the current
study argue for the further need of high quality clinical and basic science
research, with the ultimate goal of introducing standardized, evidence-
based guidelines to optimize patient outcomes.
doi:10.1016/j.bone.2010.09.148
81
Do cryopreserved autogenous cranial bone flaps remain viable
at cranioplasty?
Kristen Georgiou
1
, Chiaming Fan
1
, Yeap Ng
2
, Tetyana Shandala
2
,
Tristan King
1
, Michaela Scherer
2
, Jo Cool
3
, Yin-chin Yip
2
,
Blair Hopwood
2
, Bruce Foster
3
, Cory Xian
2
1
University Of Adelaide, Australia
2
University Of South Australia, Australia
3
Womens And Children's Hospital, Australia
Abstracts / Bone 47 (2010) S385–S458 S387