Biophysical Bone Behaviour

Jitendra Behari, Jawaharlal Nehru University, New Delhi, IndiaJitendra Behari is a Professor of at the School of Environmental Sciences at Jawaharlal Nehru University, New Delhi. His main research interests are in the area of bioelectromagnetics, with emphasis on applications of microwaves and solid state physics techniques in environmental sciences, which includes soil moisture measurement. He has generated over one hundred research publications, four patents, and has developed several instruments in the electromagnetic field. Previous appointments include Adjunct Faculty at Michigan State University and three years with the biomedical engineering unit of IIT and AIIMS, New Delhi. He is a Fellow of the Institution of Electronics and Telecommunications Engineers and the Ultrasonic Society of India, and is a Senior Member of the IEEE. He has served on the executive bodies of the Biomedical Engineering Society of India, the Indian Society of Biomechanics, the Indian Physics Association, the Indian Vacuum Society and the Indian chapters of the IEEE's Electron Device and Microwave Theory and Techniques societies. Behari has also been a member of numerous other commissions and societies, including: Commission K of Union Radio Scientifique Internationale, IEEE Engineering in Medicine and Biology Society, the Electromagnetics Academy (USA), and the Indian Science Congress Association. He has in the past received Fulbright and University Grant Commission fellowships. Behari holds a PhD in Physics and was conferred an honorary D.Sc. in Bioelectromagnetics from Ansted University, UK at Penang, Malaysia.

• Preface xiAcknowledgements xiiiAbout the Book xv1 Elements of Bone Biophysics 11.1 Introduction 11.2 Structural Aspect of Bone 31.2.1 Elementary Constituents of Bone 71.2.2 The Fibers 81.2.3 Collagen Synthesis 111.2.4 Bone Matrix (Inorganic Component) 121.3. Classification of Bone Tissues 171.3.1 Compact Bone 171.3.2 Fine Cancellous Bone 171.3.3 Coarse Cancellous Bone 181.4 Lamellation 181.4.1 The Cement 231.5 Role of Bone Water 231.6 Bone Metabolism 261.6.1 Ca and P Metabolism 261.7 Osteoporosis 271.8 Bone Cells 291.8.1 Osteoblasts 301.8.2 Osteoblast Differentiation 311.8.3 Osteoclast 321.8.4 Osteoclast Differentiation 331.8.5 The Osteocytes 361.8.6 Mathematical Formulation 361.9 Bone Remodeling 381.10 Biochemical Markers of Bone and Collagen 501.11 Summary 512 Piezoelectricity in Bone 532.1 Introduction 532.2 Piezoelectric Effect 542.2.1 Properties Relating to Piezoelectricity 572.3 Physical Concept of Piezoelectricity 592.3.1 Piezoelectric Theory 602.4 Sound Propagated in a Piezoelectric Medium 612.5 Equivalent Single-Crystal Structure of Bone 622.6 Piezoelectric Properties of Dry Compact Bones 622.6.1 Piezoelectric Properties of Dry and Wet Collagens 642.6.2 Measurement of Piezoelectricity in Bone 652.7 Bone Structure and Piezoelectric Properties 692.8 Piezoelectric Transducers 712.8.1 Transducer Vibration 732.8.2 Transverse-Effect Transducer 732.9 Ferroelectricity in Bone 742.9.1 Experimental Details 752.10 Two-Phase Mineral-Filled Plastic Composites 762.10.1 Material Properties 762.10.2 Bone Mechanical Properties 812.11 Mechanical Properties of Cancellous Bone: Microscopic View 932.12 Ultrasound and Bone Behavior 942.12.1 Biochemical Coupling 942.13 Traveling Wave Characteristics 962.14 Viscoelasticity in Bone 982.15 Discussion 1003 Bioelectric Phenomena in Bone 1033.1 Macroscopic Stress-Generated Potentials of Moist Bone 1033.2 Mechanism of Biopotential Generation 1033.3 Stress-Generated Potentials (SGPs) in Bone 1073.4 Streaming Potentials and Currents of Normal Cortical Bone: Macroscopic Approach 1083.4.1 Streaming Potential and Current Dependence on Bone Structure and Composition: Macroscopic View 1123.5 Microscopic Potentials and Models of SP Generation in Bone 1133.6 Stress-Generated Fields of Trabecular Bone 1143.7 Biopotential and Electrostimulation in Bone 1163.7.1 Electrode Implantation 1163.7.2 Control Data 1163.7.3 Pulsating Fields 1193.7.4 dc Stimulation 1193.7.5 Electromagnetic Field (50 Hz) Stimulation Along with Radio Frequency Field Coupling 1193.7.6 Continuous Fields 1203.7.7 Impedance Measurements 1253.8 Origin of Various Bioelectric Potentials in Bone 1264 Solid State Bone Behavior 1294.1 Introduction 1294.2 Electrical Conduction in Bone 1304.2.1 Bone as a Semiconductor 1304.2.2 Bone Dielectric Properties 1334.3 Microwave Conductivity in Bone 1384.4 Electret Phenomena 1454.4.1 Thermo Electret 1464.4.2 Electro Electret 1464.4.3 Magneto Electret 1464.5 Hall Effect in Bone 1474.5.1 Hall Effect, Hall Mobility and Drift Mobility 1494.5.2 Magnetic Field Dependence of the Hall Coefficient in Apatite 1504.6 Photovoltaic Effect 1524.7 PN Junction Phenomena in Bone 1524.7.1 Breakdown Phenomenon of PN Junction 1554.7.2 Behavior of the PN Junction Under IR and UV Conditions 1574.7.3 Photoelectromagnetic (PEM) Effect 1574.7.4 Life Time of Charge Carriers 1594.8 Bone Electrical Parameters in Microstrip Line Configuration 1614.8.1 Theoretical Formulation 1624.9 Bone Physical Properties and Ultrasonic Transducer 1635 Bioelectric Phenomena: Electrostimulation and Fracture Healing 1735.1 Introduction 1735.2 Biophysics of Fracture 1745.2.1 Mechanisms of Bone Fracture 1745.2.2 Mechanical Stimulation to Enhance Fracture Repair 1775.3 Bone Fracture Healing 1805.3.1 Histologic Fractures 1815.3.2 Growth Hormone (GH) Effect on Fracture Healing 1855.3.3 Biological Principles 1865.3.4 Cell Array Model for Repairing or Remodeling Bone 1865.4 Electromagnetic Field and Fracture Healing 1875.4.1 Methods in Bone Fracture Healing 1885.4.2 Stimulation by Constant Direct Current Sources 1905.4.3 Pulsed Electromagnetic Fields (PEMFs) 1955.4.4 Inductive Coupling 1995.4.5 Capacitive Coupling 2015.4.6 Mechanism of Action 2045.4.7 Mechanism of PEMF Interaction at the Cellular Level 2085.4.8 Spatial Coherence 2115.4.9 Effects of EMFs on Signal Transduction in Bone 2125.4.10 The Biophysical Interaction Concept of Window 2125.4.11 Mechanisms for EMF Effects on Bone Signal Transduction 2155.5 Venous Pressure and Bone Formation 2165.6 Ultrasound and Bone Repair 2175.6.1 Ultrasonic Attenuation 2215.6.2 Measurements on Human Tibiae 2235.6.3 Measurements on Models 2235.7 SNR Analysis for EMF, US and SGP Signals 2255.7.1 Ununited Fractures 2275.8 Low Energy He-Ne Laser Irradiation and Bone Repair 2295.9 Electrostimulation of Osteoporosis 2315.10 Other Techniques: Use of Nanoparticles 2365.11 Possible Mechanism Involved in Osteoporosis 2376 Biophysical Parameters Affecting Osteoporosis 2416.1 Introduction 2416.1.1 Osteoporosis in Women 2456.1.2 Osteoporosis in Men 2456.1.3 Osteoporosis Types 2476.1.4 Spinal Cord Injury (SCI) 2486.1.5 Effect of Microgravity 2486.1.6 Bone Loss 2496.1.7 Secondary Osteoporosis 2526.2 Senile and Postmenopausal Osteoporosis 2526.2.1 Type of Bone Pathogenesis 2546.2.2 Risk Factors for Fractures 2566.2.3 Fracture Risk Models 2576.3 Theoretical Analysis of Fracture Prediction by Distant BMD Measurement Sites 2596.4 Markers of Osteoporosis 2616.4.1 Structural Changes 2616.4.2 Biophysical Parameters 2626.5 Osteoporosis Interventions 2646.6 Role of Estrogen 2646.6.1 Steroid-Induced Osteoporosis 2646.6.2 Impact of HRT on Osteoporotic Fractures 2706.6.3 Role of Estrogen–Progesterone Combination 2716.7 Glucocorticoid 2726.8 Vitamin D and Osteoporosis 2746.9 Role of Calcitonin 2796.10 Calcitonin and Glucocorticoids 2816.11 Parathyroid Hormone (PTH) 2816.12 Role of Prostaglandins 2846.13 Thiazide Diuretics (TD) 2856.14 Effects of Fluoride 2866.15 Role of Growth Hormone (GH) 2886.16 Cholesterol 2896.17 Interleukin 1 (IL-1) 2896.18 Bisphosphonates (BPs) 2906.19 Adipocyte Hormones 2916.20 Mechanism of Action of Antiresorptive Agents 2936.21 Genetic Studies of Osteoporosis 2946.22 Nutritional Aspects in Osteoporosis 2956.22.1 Biochemical Markers 2956.22.2 Salt Intake 2956.22.3 Calcium 2966.22.4 Protein 3006.22.5 Lactose 3016.22.6 Phosphorous 3016.22.7 Lymphotoxin 3026.22.8 Dietary Fiber, Oxalic Acid and Phytic Acid 3026.22.9 Alcohol 3026.22.10 Caffeine 3036.22.11 Other Factors 3056.23 Osteoporosis: Prevention and Treatment 3056.23.1 Gene Therapy 3086.24 Non-invasive Techniques 3096.24.1 Electrical Stimulation and Osteoporosis 3096.24.2 Ultrasonic Methods 3116.25 Conclusion 3157 Non-Invasive Techniques used to Measure Osteoporosis 3177.1 Introduction 3177.2 Measurement of the Mineral Content 3207.2.1 Clinical Measurements 3227.2.2 Calibration and Accuracy 3227.2.3 Limitations 3237.2.4 Singh Index 3247.3 Bone Densitometric Methods 3257.3.1 Radiographic Methods 3287.4 X-ray Tomography 3287.5 Skeleton Roentgenology 3297.6 Metacarpal Index 3307.7 Analysis of Radiographic Methods 3327.8 Direct Photon Absorption Method 3337.8.1 Theory 3337.8.2 Clinical Applications 3367.9 Limitations of the Method 3387.10 Dual-Photon Absorptiometry (DPA) 3397.10.1 Theoretical Background 3417.10.2 Procedure 3427.10.3 Nature of Attenuation 3427.10.4 Reproducibility 3437.11 Computed Tomography (CT) 3447.11.1 Instrumentation and Clinical Procedure 3447.11.2 Quantitative Computed Tomography (QCT) 3467.12 Modification of CT Methods 3497.12.1 CT Methods: Benefits and Risks 3507.12.2 Discussion 3517.13 Methods Based on Compton Scattering 3527.13.1 Technique 3547.14 Coherent and Compton Scattering 3557.14.1 Clinical Applications 3587.15 Dual Energy Technique 3607.15.1 Dual Energy X-ray Absorptiometry (DEXA) 3607.15.2 Theoretical Formulation and Instrumentation 3617.15.3 Technical Details 3637.15.4 Simulation Studies 3667.16 Neutron Activation Analysis 3697.16.1 Technique 3697.16.2 Site Choice 3717.16.3 Dose 3727.16.4 Limitations 3727.17 Infrasound Method for Bone Mass Measurements 3727.17.1 The Ultrasonic Measurement: Concepts and Technique 3737.17.2 Stress Wave Propagation in Bone and its Clinical Use 3767.17.3 Measurement of Bone Parameters 3787.17.4 Ultrasound System 3797.17.5 Procedure for Obtaining Patient Data 3797.17.6 Analysis of Patient Data 3807.17.7 Verification of the In Vivo Bone Parameters 3817.18 Other Techniques 3837.18.1 Magnetic Resonance Imaging (MRI) 3837.19 Relative Advantages and Disadvantages of the Various Techniques 386References 389Index 479