No abstract

We report a prospective study of the influence of various factors on the six-month mortality of 531 patients with subcapital hip fractures. We performed univariate and multivariate analyses on the 403 patients treated surgically. The most significant predictors of the six-month mortality were dementia, postoperative chest infection, malignant neoplasia, old age and deep-wound infection, in that order. A simple test of mental ability was the most significant prognostic indicator and this test should be included in future studies of the management of hip fractures in the elderly.

The nucleation and crystallization behavior of a series of glasses based on 4.5SiO2-3Al2O3-YP2O5-3CaO-1.51CaF2 was studied. The parameter Y was varied to give calcium to phosphate ratios between one and two. All of the glasses studied crystallized firstly to fluorapatite (Ca5PO4)3F). The glass with a calcium to phosphate ratio of 1.67, corresponding to apatite, bulk nucleated to give fluorapatite (FAP). The glasses with calcium : phosphate ratios either less than that of apatite, or greater than that of apatite all exhibited surface nucleation of FAP. However, following a nucleation hold of one hour at approximately 50 K above the glass transition temperature these glasses exhibited bulk nucleation of FAP.

No abstract

A human phosphophoryn (PP) cDNA was previously cloned from immature root apex total RNA in our laboratory. This cDNA comprises 2,364 bp, encoding 788 amino acids. More than 80% of the sequences are arranged as (DSS)(n) (n = 1-16), DS, and NSS motifs. We hypothesize that the capability of PP to bind Ca(2+) and nucleate hydroxyapatite may depend on these repeated sequences. Two polypeptides were synthesized based on the human PP cDNA sequence to test the hypothesis. One polypeptide has the amino acid sequence DDPNSSDESNGNDD (synthetic polypeptide 1, SP1), which is from the N-terminal end of PP; the other polypeptide, DSKSDSSKSESDSS (synthetic polypeptide 2, SP2), is the PP repeated sequence motif. Phosphorylation of the polypeptides was accomplished by reacting them with adenosine triphosphate and casein kinases I and II. The ability of these molecules to cause mineralization was tested in a steady-state agarose gel system. The results show that phosphorylated SP2 (P-SP2) precipitated approximately 60% of the total Ca + PO(4) precipitated by PP. P-SP1 precipitated about 23% of that precipitated by PP and was similar to the amount precipitated in the control gel, that is, without added peptides. Transmission electron microscopy and X-ray diffraction analysis showed that the precipitate formed in the P-SP2-containing gel was hydroxyapatite. The capability of P-SP2 to nucleate Ca + PO(4) and precipitate hydroxyapatite is a result of the repeated sequence motif, which contains a high percentage of phosphorylated serine. This molecule could be used in the repair and regeneration of dental tissue.

No abstract

The relationship between bone mass and dementia in elderly hip fracture patients from areas with different aluminium concentrations in water supplies has been investigated, to determine whether a high concentration of aluminium in the drinking water and the negative calcium balance of age-related osteoporosis together predispose to senile dementia. Mental test scores were recorded on admission to hospital, and Singh indices of radiographs taken at that time assessed blind by a single trained observer. No significant difference in either mental test score (chi 2 = 1.253, df = 2, P = 0.53) or Singh index (chi 2 = 1.039, df = 5, P = 0.96) was found between patients resident in high versus low water aluminum areas. No correlation was detectable between mental test score and Singh index (chi 2 = 0.95, df = 1, P = 0.33).

No abstract