14751
|
Abstract
PURPOSE Reconstruction of the ruptured distal biceps tendon is best done with a cortical button technique according to recent biomechanical studies. However, clinical outcome studies that evaluate the cortical button reconstruction technique are scarce. The purpose of this study was to evaluate the results of a cortical button reconstruction technique in patients with a traumatic distal biceps tendon rupture. METHODS Twenty-two patients with 24 traumatic distal biceps tendon ruptures underwent surgical treatment. Reconstructions were done using the Endobutton or Toggle Loc. Postoperative evaluation consisted of ROM, strength, stability, neurological status and standard radiographs in AP view and lateral direction. The Mayo Elbow Performance Index (MEPI) and quick Disabilities of Arm, Shoulder and Hand (qDASH) questionnaires were also obtained. RESULTS At a median follow-up of 22 months, the mean strength for flexion was 100 % (SD 21.3) and for supination 97 % (SD 7.8), compared to the contralateral side. There were complications in 8 patients (36 %), and heterotopic ossifications were seen on radiographs in 23 % of patients. Heterotopic ossifications were symptomatic in one patient. CONCLUSIONS The results after distal biceps tendon refixation with a cortical button were good according to ROM, MEPI and qDASH scores and strength. However, this procedure was accompanied with complications; in particular, the formation of heterotopic ossifications was frequently seen, though clinically relevant in only one patient.
Collapse
|
14752
|
Abstract
Femoral neck fractures are a commonly encountered injury in orthopaedic practice and result in significant morbidity and mortality. It is essential that surgeons are able to recognize specific fracture patterns and patient characteristics that indicate the use of particular implants and methods to effectively manage these injuries. Use of the Garden and Pauwels classification systems has remained the practical mainstay of femoral neck fracture characterization that help dictate appropriate treatment. Operative options include in situ fixation, closed or open reduction and internal fixation, hemiarthroplasty, and total hip arthroplasty. Recent reports demonstrate diversity among orthopaedic surgeons in regard to the optimal treatment of femoral neck fractures and changing trends in management. The present discussion focuses on the current indications and methods for femoral neck fracture management to provide direction with respect to appropriate and effective care of these injuries.
Collapse
|
14753
|
Oh JH, Lee JY, Park JH, No JH, Lee NK. Obatoclax regulates the proliferation and fusion of osteoclast precursors through the inhibition of ERK activation by RANKL. Mol Cells 2015; 38:279-84. [PMID: 25666350 PMCID: PMC4363729 DOI: 10.14348/molcells.2015.2340] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/01/2015] [Accepted: 01/05/2015] [Indexed: 11/27/2022] Open
Abstract
Obatoclax, a pan-Bcl2 inhibitor, shows antitumor activities in various solid malignancies. Bcl2-deficient mice have shown the importance of Bcl2 in osteoclasts, as the bone mass of the mice was increased by the induced apoptosis of osteoclasts. Despite the importance of Bcl2, the effects of obatoclax on the proliferation and differentiation of osteoclast precursors have not been studied extensively. Here, we describe the anti-proliferative effects of obatoclax on osteoclast precursors and its negative role on fusion of the cells. Stimulation with low doses of obatoclax significantly suppressed the proliferation of osteoclast precursors in a dose-dependent manner while the apoptosis was markedly increased. Its stimulation was sufficient to block the activation of ERK MAP kinase by RANKL. The same was true when PD98059, an ERK inhibitor, was administered to osteoclast precursors. The activation of JNK1/2 and p38 MAP kinase, necessary for osteoclast differentiation, by RANKL was not affected by obatoclax. Interestingly, whereas the number of TRAP-positive mononuclear cells was increased by both obatoclax and PD98059, fused, multinucleated cells larger than 100 μm in diameter containing more than 20 nuclei were completely reduced. Consistently, obatoclax failed to regulate the expression of osteoclast marker genes, including c-Fos, TRAP, RANK and CtsK. Instead, the expression of DC-STAMP and Atp6v0d2, genes that regulate osteoclast fusion, by RANKL was significantly abrogated by both obatoclax and PD98059. Taken together, these results suggest that obatoclax down-regulates the proliferation and fusion of osteoclast precursors through the inhibition of the ERK1/2 MAP kinase pathway.
Collapse
Affiliation(s)
- Ju Hee Oh
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Chungnam, 336-745,
Korea
| | - Jae Yoon Lee
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Chungnam, 336-745,
Korea
| | - Jin Hyeong Park
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Chungnam, 336-745,
Korea
| | - Jeong Hyeon No
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Chungnam, 336-745,
Korea
| | - Na Kyung Lee
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Chungnam, 336-745,
Korea
| |
Collapse
|
14754
|
Uribe JS, Deukmedjian AR. Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 24 Suppl 3:386-96. [DOI: 10.1007/s00586-015-3806-4] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/08/2015] [Accepted: 02/08/2015] [Indexed: 11/29/2022]
|
14755
|
van Laarhoven JJEM, van Lammeren GW, Houwert RM, van Laarhoven CJHCM, Hietbrink F, Leenen LPH, Verleisdonk EJMM. Isolated hip fracture care in an inclusive trauma system: A trauma system wide evaluation. Injury 2015; 46:1042-6. [PMID: 25769200 DOI: 10.1016/j.injury.2015.02.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 02/17/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Elderly patients with a hip fracture represent a large proportion of the trauma population; however, little is known about outcome differences between different levels of trauma care for these patients. The aim of this study is to analyse the outcome of trauma care in patients with a hip fracture within our inclusive trauma system. MATERIALS AND METHODS Retrospective cohort study. Data were collected from the electronic patient documentation of patients, with an isolated hip fracture (aged ≥ 60), admitted to a level I or level II trauma centre between January 2008 and December 2012. Main outcomes were time to operative treatment, complications, mortality, and secondary surgical intervention rate. RESULTS A total of 204 (level I) and 1425 (level II) patients were admitted. Significantly more ASA4 patients, by the American Society of Anesthesiologists (ASA) classification, were treated at the level I trauma centre. At the level II trauma centre, median time to surgical treatment was shorter (0 days; IQR 0-1 vs 1 day; IQR 1-2; P < 0.001), which was mainly influenced by postponement due to lack of operation room availability (14%, n = 28) and co-morbidities (13%, n = 26) present at the level I trauma centre. At the level II trauma centre, hospital stay was shorter (9 vs 11 days; P < 0.001) and the complication rate was lower (41%; n = 590 vs 53%; n = 108; P = 0.002), as was mortality (4%; n = 54 vs 7%; n = 15; P = 0.018). Secondary surgical intervention was performed less often at the level II trauma centre (6%; n = 91 vs 12%; n = 24; P = 0.005). However, no differences in secondary surgical procedures due to inadequate postoperative outcome or implant failure were observed. CONCLUSION AND RELEVANCE The clinical pathway and the large volume of patients at the level II centre resulted in earlier surgical intervention, lower overall complication and mortality rate, and a shorter length of stay. Therefore, the elderly patient with a hip fracture should ideally be treated in the large-volume level II hospital with a pre-established clinical pathway. However, complex patients requiring specific care that can only be provided at the level I trauma centre may be treated there with similar operative results.
Collapse
Affiliation(s)
| | - G W van Lammeren
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R M Houwert
- Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands; Department of Trauma Care Central Netherlands, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - F Hietbrink
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - L P H Leenen
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | |
Collapse
|
14756
|
Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev 2015; 27:419-40. [PMID: 24982315 DOI: 10.1128/cmr.00092-13] [Citation(s) in RCA: 407] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Propionibacterium acnes is known primarily as a skin commensal. However, it can present as an opportunistic pathogen via bacterial seeding to cause invasive infections such as implant-associated infections. These infections have gained more attention due to improved diagnostic procedures, such as sonication of explanted foreign materials and prolonged cultivation time of up to 14 days for periprosthetic biopsy specimens, and improved molecular methods, such as broad-range 16S rRNA gene PCR. Implant-associated infections caused by P. acnes are most often described for shoulder prosthetic joint infections as well as cerebrovascular shunt infections, fibrosis of breast implants, and infections of cardiovascular devices. P. acnes causes disease through a number of virulence factors, such as biofilm formation. P. acnes is highly susceptible to a wide range of antibiotics, including beta-lactams, quinolones, clindamycin, and rifampin, although resistance to clindamycin is increasing. Treatment requires a combination of surgery and a prolonged antibiotic treatment regimen to successfully eliminate the remaining bacteria. Most authors suggest a course of 3 to 6 months of antibiotic treatment, including 2 to 6 weeks of intravenous treatment with a beta-lactam. While recently reported data showed a good efficacy of rifampin against P. acnes biofilms, prospective, randomized, controlled studies are needed to confirm evidence for combination treatment with rifampin, as has been performed for staphylococcal implant-associated infections.
Collapse
|
14757
|
Chen D, Hao H, Tong C, Liu J, Dong L, Ti D, Hou Q, Liu H, Han W, Fu X. Transdifferentiation of Umbilical Cord–Derived Mesenchymal Stem Cells Into Epidermal-Like Cells by the Mimicking Skin Microenvironment. INT J LOW EXTR WOUND 2015; 14:136-45. [PMID: 25700709 DOI: 10.1177/1534734615569913] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Human umbilical cord–derived mesenchymal stem cells (UC-MSCs) are multipotent, primitive, and have been widely used for skin tissue engineering. Their transdifferentiation is determined by the local microenvironment. In this study, we investigated the potential epidermal differentiation of UC-MSCs and the formation of epidermis substitutes in a 3-dimensional (3D) microenvironment, which was fabricated by UC-MSCs embedded into collagen–chitosan scaffolds (CCSs) combined with an air–liquid interface (ALI) culture system. Using fluorescence microscope, we observed that UC-MSCs were spindle-shaped and evenly distributed in the scaffold. Methyl thiazolyl blue tetrazolium bromide assay and Live/Dead assay indicated that the CCSs have good biocompatibility with UC-MSCs. Immunohistochemistry and western blotting assay showed that UC-MSCs on the surface of the CCSs were positive for the epidermal markers cytokeratin 19 and involucrin at 14 days. In addition, hematoxylin–eosin staining indicated that multilayered epidermis substitutes were established. The constructed epidermis substitutes were applied to treat full-thickness wounds in rats and proved to promote wound healing. In conclusion, manipulating the 3D microenvironment is a novel method for inducing the epidermal differentiation of MSCs to engineer epidermal substitutes, which provides an alternative strategy for skin tissue engineering.
Collapse
Affiliation(s)
- Deyun Chen
- Chinese PLA General Hospital, Beijing, China
| | - Haojie Hao
- Chinese PLA General Hospital, Beijing, China
| | - Chuan Tong
- Chinese PLA General Hospital, Beijing, China
| | - Jiejie Liu
- Chinese PLA General Hospital, Beijing, China
| | - Liang Dong
- Chinese PLA General Hospital, Beijing, China
| | - Dongdong Ti
- Chinese PLA General Hospital, Beijing, China
| | - Qian Hou
- Chinese PLA General Hospital, Beijing, China
| | - Huiling Liu
- Chinese PLA General Hospital, Beijing, China
| | - Weidong Han
- Chinese PLA General Hospital, Beijing, China
| | - Xiaobing Fu
- Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
14758
|
Liu C, Liu MT, Li P, Xu HH. Efficacy evaluation for the treatment of subcapital femoral neck fracture in young adults by capsulotomy reduction and closed reduction. Chin Med J (Engl) 2015; 128:483-8. [PMID: 25673450 PMCID: PMC4836251 DOI: 10.4103/0366-6999.151092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Subcapital femoral neck fracture in young adults has many complications, and the incidence is increasing year-by-year. The selection of the proper operation method to avoid them is an ambiguous matter. This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and internal fixation in young adults. METHODS From March 2003 to February 2010, 65 young patients with subcapital femoral neck fractures were treated, including 39 males and 26 females with average age of 34.5 years (range, 19-50 years); 29 cases of the left side and 36 cases of the right side. They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting. The two groups had no significant differences in sex, age, body mass index and preoperative Harris Hip Score. The observation criteria involved the length of the incision, blood loss, operation time, nonunion rate, avascular necrosis of the femoral head (ANFH) rate and Harris Hip Score. RESULTS Four of 65 patients were lost follow-up, and the follow-up rate was 93.8%, the average follow-up time was 38.7 months (range, 33-47 months). In Group A, the incision length was 5.1 ± 2.2 cm, blood loss was 84.0 ± 13.2 ml, and operation time was 52.9 ± 10.2 min. In Group B, the incision length was 15.4 ± 4.6 cm, blood loss was 396.0 ± 21.3 ml, and operation time was 116.5 ± 15.3 min. Nonunion occurred in 8 patients (25.2%) in Group A and 1 patient (3.3%) in Group B. ANFH occurred in 9 patients (29.1%) in Group A and 2 patients (6.7%) in Group B. Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B. The above index of two groups was considered statistically significant (P < 0.05). CONCLUSIONS Capsulotomy and internal fixation with iliac bone grafting can improve fracture healing, reduce ANFH in young adults. It is a safe and effective operation for subcapital femoral neck fracture.
Collapse
Affiliation(s)
| | | | | | - Hong-Hai Xu
- Department of Orthopaedics, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710061, China
| |
Collapse
|
14759
|
Abstract
Multiple myeloma (MM) is the second most common hematological malignancy and is characterized by the aberrant proliferation of terminally differentiated plasma B cells with impairment in apoptosis capacity. Particularly, osteolytic bone diseases and renal failure resulting from hyperparaproteinemia and hypercalcemia have been the major serious sequelae that are inextricably linked with MM tumor progression. Despite the introduction of new treatment regimens, problematic neuropathy, thrombocytopenia, drug resistance and high MM relapse rates continue to plague the current therapies. New chemical agents are in development on the basis of understanding several signaling pathways and molecular mechanisms like tumor necrosis factor-α, proteasome, PI3K and MARKs. This review focuses on the most recent patents and clinical trials in the development of new medicine for the treatment of multiple myeloma. Furthermore, the important signaling pathways involved in the proliferation, survival and apoptosis of myeloma cells will be discussed.
Collapse
|
14760
|
Wang Y, Dong G, Jeon HH, Elazizi M, La LB, Hameedaldeen A, Xiao E, Tian C, Alsadun S, Choi Y, Graves DT. FOXO1 mediates RANKL-induced osteoclast formation and activity. THE JOURNAL OF IMMUNOLOGY 2015; 194:2878-87. [PMID: 25694609 DOI: 10.4049/jimmunol.1402211] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have previously shown that the transcription factor FOXO1 is elevated in conditions with high levels of bone resorption. To investigate the role of FOXO1 in the formation of osteoclasts, we examined mice with lineage-specific deletion of FOXO1 in osteoclast precursors and by knockdown of FOXO1 with small interfering RNA. The receptor activator for NF-κB ligand (RANKL), a principal bone-resorbing factor, induced FOXO1 expression and nuclear localization 2 d after stimulation in bone marrow macrophages and RAW264.7 osteoclast precursors. RANKL-induced osteoclast formation and osteoclast activity was reduced in half in vivo and in vitro with lineage-specific FOXO1 deletion (LyzM.Cre(+)FOXO1(L/L)) compared with matched controls (LyzM.Cre(-)FOXO1(L/L)). Similar results were obtained by knockdown of FOXO1 in RAW264.7 cells. Moreover, FOXO1-mediated osteoclast formation was linked to regulation of NFATc1 nuclear localization and expression as well as a number of downstream factors, including dendritic cell-specific transmembrane protein, ATP6vod2, cathepsin K, and integrin αv. Lastly, FOXO1 deletion reduced M-CSF-induced RANK expression and migration of osteoclast precursors. In the present study, we provide evidence that FOXO1 plays a direct role in osteoclast formation by mediating the effect of RANKL on NFATc1 and several downstream effectors. This is likely to be significant because FOXO1 and RANKL are elevated in osteolytic conditions.
Collapse
Affiliation(s)
- Yu Wang
- Department of Implantology, School of Stomatology, Jilin University, Changchun 130021, China; Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Guangyu Dong
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Hyeran Helen Jeon
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Mohamad Elazizi
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Lan B La
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Alhassan Hameedaldeen
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - E Xiao
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104; School and Hospital of Stomatology, Peking University, Beijing 100081, China; and
| | - Chen Tian
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Sarah Alsadun
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Yongwon Choi
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Dana T Graves
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104;
| |
Collapse
|
14761
|
Liu Y, Su X, Zhou S, Wang L, Wang C, Liu S. A modified porous tantalum implant technique for osteonecrosis of the femoral head: survivorship analysis and prognostic factors for radiographic progression and conversion to total hip arthroplasty. Int J Clin Exp Med 2015; 8:1918-1930. [PMID: 25932121 PMCID: PMC4402768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
Tantalum rod implant following core decompression is reported to be effective in early stage of osteonecrosis of the femoral head (ONFH). The purpose of this study was to assess the survivorship and prognostic factors for radiographic progression and conversion to total hip arthroplasty (THA) after treatment with a modified tantalum implant technology. 59 consecutive hips (45 patients) in whom ONFH was treated with core decompression, impaction bone grafting of 2 mm-composite bone filling material, and insertion of a porous tantalum implant. 57 hips (44 patients, mean age 43 years, range 21 to 70 years) with Steinberg Stage I-IVA ONFH were available for follow-up at a mean of 44.8 months (rang, 11 to 62 months). Outcome measures included HHS (Harris Hip Score), radiographic outcome, and survivorship analysis with reversion to THA. Radiographic progression occurred in 17 hips (17/57, 29.82%). 11 hips (11/57, 19.30%) were converted to THA. The overall survival rate was 72.49% at 60 months post-operatively. After logistic regression analysis, corticosteroid use and bone marrow edema were found to be predictors of radiographic progression. The Cox proportional-hazard model revealed that bone marrow edema was an independent prognostic factor for conversion to THA. This modified technology may make patients avoid the use of corticosteroid, especially those without bone marrow edema, and obtains encouraging survival rates and a delay in or prevention of THA.
Collapse
Affiliation(s)
- Yaosheng Liu
- Department of Orthopaedics, The 307 Hospital, PLABeijing 100071, People’s Republic of China
| | - Xiuyun Su
- Department of Orthopaedics, The 307 Hospital, PLABeijing 100071, People’s Republic of China
| | - Shiguo Zhou
- Statistics Room, Capital Medical University Affiliated Beijing Friendship HospitalBeijing 100050, People’s Republic of China
| | - Lei Wang
- Department of Orthopaedics, The 307 Hospital, PLABeijing 100071, People’s Republic of China
| | - Cheng Wang
- Department of Orthopaedics, The 307 Hospital, PLABeijing 100071, People’s Republic of China
| | - Shubin Liu
- Department of Orthopaedics, The 307 Hospital, PLABeijing 100071, People’s Republic of China
| |
Collapse
|
14762
|
Yoneda T, Hiasa M, Nagata Y, Okui T, White F. Contribution of acidic extracellular microenvironment of cancer-colonized bone to bone pain. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2015; 1848:2677-84. [PMID: 25687976 DOI: 10.1016/j.bbamem.2015.02.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/01/2015] [Accepted: 02/05/2015] [Indexed: 12/31/2022]
Abstract
Solid and hematologic cancer colonized bone produces a number of pathologies. One of the most common complications is bone pain. Cancer-associated bone pain (CABP) is a major cause of increased morbidity and diminishes the quality of life and affects survival. Current treatments do not satisfactorily control CABP and can elicit adverse effects. Thus, new therapeutic interventions are needed to manage CABP. However, the mechanisms responsible for CABP are poorly understood. The observation that specific osteoclast inhibitors can reduce CABP in patients indicates a critical role of osteoclasts in the pathophysiology of CABP. Osteoclasts create an acidic extracellular microenvironment by secretion of protons via vacuolar proton pumps during bone resorption. In addition, bone-colonized cancer cells also release protons and lactate via plasma membrane pH regulators to avoid intracellular acidification resulting from increased aerobic glycolysis known as the Warburg effect. Since acidosis is algogenic for sensory neurons and bone is densely innervated by sensory neurons that express acid-sensing nociceptors, the acidic bone microenvironments can evoke CABP. Understanding of the mechanism by which the acidic extracellular microenvironment is created in cancer-colonized bone and the expression and function of the acid-sensing nociceptors are regulated should facilitate the development of novel approaches for management of CABP. Here, the contribution of the acidic microenvironment created in cancer-colonized bone to elicitation of CABP and potential therapeutic implications of blocking the development and recognition of acidic microenvironment will be described. This article is part of a Special Issue entitled: Membrane channels and transporters in cancers.
Collapse
Affiliation(s)
- Toshiyuki Yoneda
- Department of Medicine, Hematology/Oncology, Indiana University School of Medicine, 980 W. Walnut Street, Indianapolis, IN 46202, USA.
| | - Masahiro Hiasa
- Department of Medicine, Hematology/Oncology, Indiana University School of Medicine, 980 W. Walnut Street, Indianapolis, IN 46202, USA.
| | - Yuki Nagata
- Department of Medicine, Hematology/Oncology, Indiana University School of Medicine, 980 W. Walnut Street, Indianapolis, IN 46202, USA.
| | - Tatsuo Okui
- Department of Medicine, Hematology/Oncology, Indiana University School of Medicine, 980 W. Walnut Street, Indianapolis, IN 46202, USA.
| | - Fletcher White
- Department of Anesthesia, Paul and Carole Stark Neurosciences Research Institute, Indiana University, 320 West 15th Street, Indianapolis, IN 46202, USA.
| |
Collapse
|
14763
|
Izzo R, Popolizio T, D'Aprile P, Muto M. Spinal pain. Eur J Radiol 2015; 84:746-56. [PMID: 25824642 DOI: 10.1016/j.ejrad.2015.01.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 12/19/2022]
Abstract
The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic pain, much more difficult to treat. The clinical assessment of pain source can be a challenge because of the complex anatomy and function of the spine; the advanced imaging methods are often not sufficient for a definitive diagnosis because similar findings could be present in either asymptomatic and symptomatic subjects: a clinical correlation is always mandatory and the therapy cannot rely uniquely upon any imaging abnormalities. Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. Special attention will be done to the discogenic pain, actually considered as the most frequent cause of chronic low back pain.
Collapse
Affiliation(s)
- R Izzo
- Neuroradiology Department, A. Cardarelli Hospital, Naples, Italy.
| | - T Popolizio
- Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg), Italy.
| | - P D'Aprile
- Neuroradiology Department, San Paolo Hospital, Bari, Italy.
| | - M Muto
- Neuroradiology Department, A. Cardarelli Hospital, Napoli, Italy.
| |
Collapse
|
14764
|
Pauksch L, Franke J, Schnettler R, Lips KS. Synergistic Toxicity of Gentamicin- and Nanosilver-Doped Polymethylmethacrylate Bone Cement on Primary Human Osteoclasts. Cells Tissues Organs 2015; 199:384-92. [DOI: 10.1159/000371341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/19/2022] Open
|
14765
|
Wydo SM, Seamon MJ, Melanson SW, Thomas P, Bahner DP, Stawicki SP. Portable ultrasound in disaster triage: a focused review. Eur J Trauma Emerg Surg 2015; 42:151-9. [PMID: 26038019 DOI: 10.1007/s00068-015-0498-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/04/2015] [Indexed: 12/13/2022]
Abstract
Ultrasound technology has become ubiquitous in modern medicine. Its applications span the assessment of life-threatening trauma or hemodynamic conditions, to elective procedures such as image-guided peripheral nerve blocks. Sonographers have utilized ultrasound techniques in the pre-hospital setting, emergency departments, operating rooms, intensive care units, outpatient clinics, as well as during mass casualty and disaster management. Currently available ultrasound devices are more affordable, portable, and feature user-friendly interfaces, making them well suited for use in the demanding situation of a mass casualty incident (MCI) or disaster triage. We have reviewed the existing literature regarding the application of sonology in MCI and disaster scenarios, focusing on the most promising and practical ultrasound-based paradigms applicable in these settings.
Collapse
Affiliation(s)
- S M Wydo
- Cooper University Hospital, Camden, NJ, USA
| | - M J Seamon
- The Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - S W Melanson
- St Luke's University Health Network, Bethlehem, PA, USA
| | - P Thomas
- St Luke's University Health Network, Bethlehem, PA, USA
| | - D P Bahner
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - S P Stawicki
- Department of Research and Innovation, St Luke's University Health Network, Bethlehem, PA, 18015, USA.
| |
Collapse
|
14766
|
Prevalence and possible risk factors of low bone mineral density in untreated female patients with systemic lupus erythematosus. BIOMED RESEARCH INTERNATIONAL 2015; 2015:510514. [PMID: 25738154 PMCID: PMC4337055 DOI: 10.1155/2015/510514] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/19/2015] [Indexed: 11/24/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation. Different studies have shown decreased bone mineral density (BMD) in patients with SLE. The objective of this study was to investigate the prevalence and possible risk factors of low BMD in untreated female patients with SLE in Chinese population. A total of 119 untreated female patients with SLE were included. BMD was measured at lumbar spine and at total hip by dual-energy X-ray absorptiometry. The associations between decreased BMD and demographic variables, clinical variables, and bone metabolism variables were analyzed. These SLE patients had the following characteristics: mean age was 32.6 ± 11.9 years, mean disease duration was 22.1 ± 34.5 months, and mean SLEDAI was 11.4 ± 5.4. Osteopenia was present in 31.1% of the patients and osteoporosis in 8.5%. A significant negative association between low density lipoprotein cholesterol (LDL-c) and BMD at the lumbar spine (correlation coefficient = −0.242; P = 0.023) and total hip (correlation coefficient = −0.259; P = 0.019) was shown. These results seem to indicate that increased LDL-c may be an important risk factor for low BMD at lumbar spine and total hip in untreated female SLE patients.
Collapse
|
14767
|
Harrison R, Criss ZK, Feller L, Modi SP, Hardy JG, Schmidt CE, Suggs LJ, Murphy MB. Mechanical properties of α-tricalcium phosphate-based bone cements incorporating regenerative biomaterials for filling bone defects exposed to low mechanical loads. J Biomed Mater Res B Appl Biomater 2015; 104:149-57. [PMID: 25677680 DOI: 10.1002/jbm.b.33362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 10/30/2014] [Accepted: 12/17/2014] [Indexed: 12/25/2022]
Abstract
Calcium phosphate-based cements with enhanced regenerative potential are promising biomaterials for the healing of bone defects in procedures such as percutaneous vertebroplasty. With a view to the use of such cements for low load bearing applications such as sinus augmentation or filling extraction sites. However, the inclusion of certain species into bone cement formulations has the potential to diminish the mechanical properties of the formulations and thereby reduce their prospects for clinical translation. Consequently, we have prepared α-tricalcium phosphate (α-TCP)-based bone cements including materials that we would expect to improve their regenerative potential, and describe the mechanical properties of the resulting formulations herein. Formulations incorporated α-TCP, hydroxyapatite, biopolymer-thickened wetting agents, sutures, and platelet poor plasma. The mechanical properties of the composites were composition dependent, and optimized formulations had clinically relevant mechanical properties. Such calcium phosphate-based cements have potential as replacements for cements such as those based on polymethylmethacrylate.
Collapse
Affiliation(s)
- Reed Harrison
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Zachary K Criss
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Lacie Feller
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Shan P Modi
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - John G Hardy
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, 32611-6131
| | - Christine E Schmidt
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, 32611-6131
| | - Laura J Suggs
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Matthew B Murphy
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| |
Collapse
|
14768
|
Yoon JP, Lee BJ, Nam SJ, Chung SW, Jeong WJ, Min WK, Oh JH. Comparison of results between hook plate fixation and ligament reconstruction for acute unstable acromioclavicular joint dislocation. Clin Orthop Surg 2015; 7:97-103. [PMID: 25729525 PMCID: PMC4329540 DOI: 10.4055/cios.2015.7.1.97] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/25/2014] [Indexed: 01/28/2023] Open
Abstract
Background In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. Methods Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. Results The mean VAS scores at the final follow-up were 1.6 ± 1.5 and 1.3 ± 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 ± 9.9 and 89.2 ± 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% ± 50.9% preoperatively to 106.1% ± 10.2% at the final follow-up in group I, and from 239.9% ± 59.2% preoperatively to 133.6% ± 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. Conclusions In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.
Collapse
Affiliation(s)
- Jong Pil Yoon
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Byoung-Joo Lee
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Jin Nam
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seok Won Chung
- Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Won-Ju Jeong
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Woo-Kie Min
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Joo Han Oh
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
14769
|
Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 24:800-9. [DOI: 10.1007/s00586-015-3796-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 02/02/2015] [Accepted: 02/02/2015] [Indexed: 11/25/2022]
|
14770
|
Antiosteoporosis Activity of New Oriental Medicine Preparation (Kyungokgo Mixed with Water Extract of Hovenia dulcis) on the Ovariectomized Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:373145. [PMID: 25737735 PMCID: PMC4337257 DOI: 10.1155/2015/373145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/10/2015] [Accepted: 01/19/2015] [Indexed: 12/29/2022]
Abstract
Protective effect of new oriental medicine (Kyungokgo mixed with water extract of Hovenia dulcis, KOGHD) was assessed on the bone loss induced mice by ovariectomy. In the in vivo experiments, antiosteoporosis effect of KOGHD was investigated using ovariectomized osteoporosis mice model. After 6 weeks of treatment, the mice were euthanized, and the effect of Kyungokgo (KOG) and KOGHD on body weight, spleen weigh, thymus weight, uterine weight, serum biochemical indicators, bone weight and length, immune cell population, bone morphometric parameters, and histological stains was observed. Our results showed that KOGHD prevented the deterioration of trabecular microarchitecture caused by ovariectomy, which were accompanied by the lower levels of bone turnover markers and immune cell population as evidenced by the inhibition of RANKL-mediated osteoclast differentiation without cytotoxic effect on bone marrow derived macrophages (BMMs). Therefore, these results suggest that the Hovenia dulcis (HD) supplementation in the KOG may also prevent and treat bone loss.
Collapse
|
14771
|
Pasold J, Zander K, Heskamp B, Grüttner C, Lüthen F, Tischer T, Jonitz-Heincke A, Bader R. Positive impact of IGF-1-coupled nanoparticles on the differentiation potential of human chondrocytes cultured on collagen scaffolds. Int J Nanomedicine 2015; 10:1131-43. [PMID: 25709437 PMCID: PMC4327566 DOI: 10.2147/ijn.s72872] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE In the present study, silica nanoparticles (sNP) coupled with insulin-like growth factor 1 (IGF-1) were loaded on a collagen-based scaffold intended for cartilage repair, and the influence on the viability, proliferation, and differentiation potential of human primary articular chondrocytes was examined. METHODS Human chondrocytes were isolated from the hyaline cartilage of patients (n=4, female, mean age: 73±5.1 years) undergoing primary total knee joint replacement. Cells were dedifferentiated and then cultivated on a bioresorbable collagen matrix supplemented with fluorescent sNP coupled with IGF-1 (sNP-IGF-1). After 3, 7, and 14 days of cultivation, cell viability and integrity into the collagen scaffold as well as metabolic cell activity and synthesis rate of matrix proteins (collagen type I and II) were analyzed. RESULTS The number of vital cells increased over 14 days of cultivation, and the cells were able to infiltrate the collagen matrix (up to 120 μm by day 7). Chondrocytes cultured on the collagen scaffold supplemented with sNP-IGF-1 showed an increase in metabolic activity (5.98-fold), and reduced collagen type I (1.58-fold), but significantly increased collagen type II expression levels (1.53-fold; P=0.02) after 7 days of cultivation compared to 3 days. In contrast, chondrocytes grown in a monolayer on plastic supplemented with sNP-IGF-1 had significantly lower metabolic activity (1.32-fold; P=0.007), a consistent amount of collagen type I, and significantly reduced collagen type II protein expression (1.86-fold; P=0.001) after 7 days compared to 3 days. CONCLUSION Collagen-based scaffolds enriched with growth factors, such as IGF-1 coupled to nanoparticles, represent an improved therapeutic intervention for the targeted and controlled treatment of articular cartilage lesions.
Collapse
Affiliation(s)
- Juliane Pasold
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| | - Kathleen Zander
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| | - Benjamin Heskamp
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| | | | - Frank Lüthen
- Institute of Cell Biology, University Medicine Rostock, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| | - Anika Jonitz-Heincke
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| | - Rainer Bader
- Department of Orthopaedics, Biomechanics and Implant Technology Laboratory, University Medicine Rostock, Rostock, Germany
| |
Collapse
|
14772
|
Minimally displaced radial head/neck fractures (Mason type-I, OTA types 21A2.2 and 21B2.1): are we "over treating" our patients? J Orthop Trauma 2015; 29:e31-5. [PMID: 24978945 DOI: 10.1097/bot.0000000000000173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the nonoperative treatment strategies for Mason-Johnson type-I radial head fractures. DESIGN AND SETTING Retrospective review of every patient with a closed radial head/neck fracture who presented to our tertiary care specialty institution in the past 2 years. PATIENTS/PARTICIPANTS A search of ICD-9 code 813.05, closed fracture of the radial head/neck, in our electronic record system yielded 82 consecutive patients. MAIN OUTCOME MEASUREMENTS Complications and treatment interventions were recorded. Demographic, radiographic, and physical examination data were collected for all patients treated nonoperatively and analyzed for association with recommendation for continued follow-up and radiographic assessment. RESULTS Fifty-four patients (68%) had 56 nondisplaced or minimally displaced (<2 mm) radial head or neck fractures without an additional injury to the affected limb. All patients were treated nonoperatively, and no patient in this cohort developed a complication or had any medical or surgical intervention other than physical therapy. No radiographic or physical examination measure was significantly associated with recommendation for the second outpatient follow-up, third outpatient follow-up, or with the number of additional radiographs ordered beyond the initial examination. An average of 4.4 (SD, 3.3) additional x-rays were taken of each affected elbow after initial outpatient presentation. CONCLUSIONS Orthopaedic surgeons are likely over treating patients with Mason-Johnson type-I radial head fractures by recommending frequent radiographic follow-up without modifying treatment, leading to unnecessary patient visits, radiation exposure, and increased costs. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Collapse
|
14773
|
|
14774
|
Kalbasi Anaraki P, Patecki M, Tkachuk S, Kiyan Y, Haller H, Dumler I. Urokinase receptor mediates osteoclastogenesis via M-CSF release from osteoblasts and the c-Fms/PI3K/Akt/NF-κB pathway in osteoclasts. J Bone Miner Res 2015; 30:379-88. [PMID: 25196912 DOI: 10.1002/jbmr.2350] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 08/24/2014] [Accepted: 08/28/2014] [Indexed: 12/31/2022]
Abstract
Bone remodeling is a dynamic process based on a fine-tuned balance between formation and degradation of bone. Osteoblasts (OBLs) are responsible for bone formation and bone resorption is mediated by osteoclasts (OCLs). The mechanisms regulating the OBL-OCL balance are critical in health and disease; however, they are still far from being understood. We reported recently that the multifunctional urokinase receptor (uPAR) mediates osteogenic differentiation of mesenchymal stem cells (MSCs) to OBLs and vascular calcification in atherosclerosis. Here, we address the question of whether uPAR may also be engaged in regulation of osteoclastogenesis. We show that uPAR mediates this process in a dual fashion. Thus, uPAR affected OBL-OCL interplay. We observed that osteoclastogenesis was significantly impaired in co-culture of monocyte-derived OCLs and in OBLs derived from MSCs lacking uPAR. We show that expression and release, from OBLs, of macrophage colony-stimulating factor (M-CSF), which is indispensable for OCL differentiation, was inhibited by uPAR loss. We further found that uPAR, on the other hand, controlled formation, differentiation, and functional properties of macrophage-derived OCLs. Expression of osteoclastogenic markers, such as tartrate-resistant acid phosphatase (TRAP) and cathepsin K, was impaired in OCLs derived from uPAR-deficient macrophages. The requirement of uPAR for osteoclastogenesis was further confirmed by immunocytochemistry and in bone resorption assay. We provide evidence that the underlying signaling mechanisms involve uPAR association with the M-CSF binding receptor c-Fms followed by c-Fms phosphorylation and activation of the PI3K/Akt/NF-κB pathway in OCLs. We further show that uPAR uses this pathway to regulate a balance between OCL differentiation, apoptosis, and cell proliferation. Our study identified uPAR as an important and multifaceted regulator of OBL-OCL molecular interplay that may serve as an attractive target in bone disease and ectopic calcification.
Collapse
|
14775
|
Taylor DW, Ahmed N, Parreno J, Lunstrum GP, Gross AE, Diamandis EP, Kandel RA. Collagen Type XII and Versican Are Present in the Early Stages of Cartilage Tissue Formation by Both Redifferentating Passaged and Primary Chondrocytes. Tissue Eng Part A 2015; 21:683-93. [DOI: 10.1089/ten.tea.2014.0103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Drew W. Taylor
- BioEngineering of Skeletal Tissues Team, CIHR, Ottawa, Ontario, Canada
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Nazish Ahmed
- BioEngineering of Skeletal Tissues Team, CIHR, Ottawa, Ontario, Canada
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Justin Parreno
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Allan E. Gross
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Eleftherios P. Diamandis
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rita A. Kandel
- BioEngineering of Skeletal Tissues Team, CIHR, Ottawa, Ontario, Canada
- Department of Pathology and Laboratory Medicine and Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
14776
|
Abstract
The mitochondrial myopathies include a diverse group of disorders characterized by morphological abnormalities of muscle mitochondria. Little is reported about spinal deformity associated with this syndrome.This study presents a case of scoliosis occurring in the setting of mitochondrial myopathies and explores the possible mechanisms between the 2 diseases.A previously unreported scoliosis in mitochondrial myopathies is described. The patient was a 16-year-old Chinese adolescent boy undergoing a posterior correction at thoracic 2-lumbar 3 (T2-L3) levels using the Moss-SI spinal system. At 48-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. After evaluating 60 mitochondrial myopathies, patients referred to Peking Union Medical College Hospital from February 2009 to May 2013, the prevalence of scoliosis among patients with mitochondrial myopathies was 5% (3/60), much higher than that among general population (2%).The scoliosis in mitochondrial myopathies is usually extensive and progressively aggravated and the correction of the associated spinal deformities is generally difficult. Therefore, the exact role of mitochondrial myopathy in the development of scoliosis requires further study for a better understanding of the disease, as well as adequate and effective patient care.
Collapse
Affiliation(s)
- Zheng Li
- From the Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | |
Collapse
|
14777
|
Muthusamy S, Subhawong T, Conway SA, Temple HT. Locally aggressive fibrous dysplasia mimicking malignancy: a report of four cases and review of the literature. Clin Orthop Relat Res 2015; 473:742-50. [PMID: 25212962 PMCID: PMC4294916 DOI: 10.1007/s11999-014-3926-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/27/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fibrous dysplasia is a benign fibroosseous bone tumor that accounts for 5% to 10% of benign bone tumors. It can present as monostotic fibrous dysplasia (70% to 80%), polyostotic fibrous dysplasia (20% to 30%), McCune-Albright syndrome (2% to 3%), or Mazabraud's syndrome in rare cases. Bone lesions in fibrous dysplasia arise in the medullary canal and usually are confined to the bone. Cortical destruction and extension into soft tissue usually indicates malignant transformation or secondary aneurysmal bone cyst formation. Locally aggressive fibrous dysplasia with cortical destruction and extension into soft tissue in the absence of these two possibilities is extremely rare. It is important for the treating physician to distinguish this entity from more aggressive or malignant tumors to avoid overtreating the patient for a benign condition or inattention to a malignant tumor. CASE DESCRIPTIONS We report four unusual cases of fibrous dysplasia with an aggressive radiographic appearance. They occurred in the rib (1), ilium (2), and distal femur (1). Two patients had pain and two had swelling. Radiologically, all were associated with cortical destruction and an associated soft tissue mass, and initially they were interpreted as potentially malignant. Three patients underwent biopsy and one patient did not have a biopsy. Histopathologic analysis by an experienced bone pathologist confirmed fibrous dysplasia in all patients. Two patients were treated surgically; one patient with zoledronic acid and one patient currently is being followed by observation alone. LITERATURE REVIEW There are only a few reports in the literature that describe the locally aggressive variant of fibrous dysplasia that presents with pain and progressive swelling clinically and with cortical destruction and soft tissue extension on imaging which suggest malignancy. We could not find any article that describes the use of bisphosphonates in such lesions or the response to bisphosphonates clinically, on laboratory parameters or imaging. To our knowledge, this is the largest case report published regarding locally aggressive fibrous dysplasia arising outside the craniofacial skeleton. CLINICAL RELEVANCE The locally aggressive variant of fibrous dysplasia may be confused with a malignant tumor or malignant degeneration of fibrous dysplasia. It is important to properly evaluate these lesions to ensure that a proper diagnosis is made, especially with respect to a malignant versus benign mass.
Collapse
Affiliation(s)
- Saravanaraja Muthusamy
- />Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL USA
| | - Ty Subhawong
- />Department of Radiology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Sheila A. Conway
- />Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL USA
| | - H. Thomas Temple
- />Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL USA
| |
Collapse
|
14778
|
Sugiura T, Kashii M, Matsuo Y, Morimoto T, Honda H, Kaito T, Iwasaki M, Yoshikawa H. Intermittent administration of teriparatide enhances graft bone healing and accelerates spinal fusion in rats with glucocorticoid-induced osteoporosis. Spine J 2015; 15:298-306. [PMID: 25110274 DOI: 10.1016/j.spinee.2014.08.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 07/07/2014] [Accepted: 08/02/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT There has been no study regarding the effect of intermittent administration of teriparatide (TPTD [recombinant human parathyroid hormone (1-34)]) on spinal fusion in patients with glucocorticoid-induced osteoporosis (GIOP). PURPOSE To elucidate the effect of intermittent administration of TPTD on spinal fusion in rats with GIOP. STUDY DESIGN An experimental animal study of rats under continuous glucocorticoid (GC) exposure undergoing spinal fusion surgery and administration of TPTD or saline. METHODS Male 8-week-old rats (n=18) were administered 5 mg/kg methylprednisolone (MP) for 12 weeks. After 6 weeks of MP administration, the rats underwent posterolateral spinal fusion (L4-L5) with iliac crest autograft. Then, five times a week, they were given either saline or 40 μg/kg TPTD for 6 weeks. The following assessments were performed: time-course bone microstructural analysis of the fusion mass and adjacent vertebrae (L6), with in vivo microcomputed tomography (μCT); fusion assessment, with manual palpation testing and three-dimensional CT images; and bone histomorphometrical analysis of the fusion mass. RESULTS In the TPTD group, values for bone volume and other bone microstructural parameters at the fusion mass increased and peaked 4 weeks after surgery, and these values were significantly greater than those for the control (CNT) group at 4 and 6 weeks after surgery. Fusion assessment showed that fusion rate was higher in the TPTD group than in the CNT group (CNT group: 56%, TPTD group: 89%). Bone histomorphometry revealed that values for bone formation parameters were significantly higher in the TPTD group than in the CNT group. CONCLUSIONS Under continuous GC exposure in a rat model of spinal fusion, intermittent TPTD administration accelerated bone modeling and remodeling predominantly by stimulating bone formation at the fusion mass and increasing the fusion rate. Intermittent TPTD administration also improved bone microarchitecture of adjacent vertebrae.
Collapse
Affiliation(s)
- Tsuyoshi Sugiura
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masafumi Kashii
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yohei Matsuo
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tokimitsu Morimoto
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hirotsugu Honda
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Motoki Iwasaki
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hideki Yoshikawa
- Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| |
Collapse
|
14779
|
Varley I, Hughes DC, Greeves JP, Stellingwerff T, Ranson C, Fraser WD, Sale C. RANK/RANKL/OPG pathway: genetic associations with stress fracture period prevalence in elite athletes. Bone 2015; 71:131-6. [PMID: 25464125 DOI: 10.1016/j.bone.2014.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/09/2014] [Accepted: 10/09/2014] [Indexed: 01/13/2023]
Abstract
CONTEXT The RANK/RANKL/OPG signalling pathway is important in the regulation of bone turnover, with single nucleotide polymorphisms (SNPs) in genes within this pathway associated with bone phenotypic adaptations. OBJECTIVE To determine whether four SNPs associated with genes in the RANK/RANKL/OPG signalling pathway were associated with stress fracture injury in elite athletes. DESIGN, PARTICIPANTS, AND METHODS Radiologically confirmed stress fracture history was reported in 518 elite athletes, forming the Stress Fracture Elite Athlete (SFEA) cohort. Data were analysed for the whole group and were sub-stratified into male and cases of multiple stress fracture groups. Genotypes were determined using proprietary fluorescence-based competitive allele-specific PCR assays. RESULTS SNPs rs3018362 (RANK) and rs1021188 (RANKL) were associated with stress fracture injury (P<0.05). 8.1% of the stress fracture group and 2.8% of the non-stress fracture group were homozygote for the rare allele of rs1021188. Allele frequency, heterozygotes and homozygotes for the rare allele of rs3018362 were associated with stress fracture period prevalence (P<0.05). Analysis of the male only group showed 8.2% of rs1021188 rare allele homozygotes had suffered a stress fracture whilst 2.5% of the non-stress fracture group were homozygous. In cases of multiple stress fractures, homozygotes for the rare allele of rs1021188 and individuals possessing at least one copy of the rare allele of rs4355801 (OPG) were shown to be associated with stress fracture injury (P<0.05). CONCLUSIONS The data support an association between SNPs in the RANK/RANKL/OPG signalling pathway and the development of stress fracture injury. The association of rs3018362 (RANK) and rs1021188 (RANKL) with stress fracture injury susceptibility supports their role in the maintenance of bone health and offers potential targets for therapeutic interventions.
Collapse
Affiliation(s)
- Ian Varley
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| | - David C Hughes
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| | - Julie P Greeves
- Department of Occupational Medicine, Headquarters Army Recruiting and Training Division, UK.
| | | | - Craig Ranson
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK.
| | | | - Craig Sale
- Biomedical Life and Health Sciences Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| |
Collapse
|
14780
|
Abstract
BACKGROUND A relatively high percentage of monoblock metal-on-metal total hip arthroplasties (THAs) undergo early revision. Revision of these THAs poses challenges unique to this implant type. The early complications after these revisions remain unreported as do the clinical and demographic factors associated with these complications. QUESTIONS/PURPOSES We describe (1) the frequency of early complications after revision of monoblock metal-on-metal THA; and (2) the clinical and demographic factors associated with complications. METHODS A review of our institution's total joint registry identified 107 patients who underwent 114 revisions of monoblock metal-on-metal THAs. Mean patient age at revision was 60 years (range, 17-84 years), and 65% of the patients were women. Mean followup after revision was 14 months (range, 0-122 months). Revision diagnoses included metallosis (51%), aseptic loosening (27%), infection (7%), pain (6%), malposition (4%), instability (3%), iliopsoas impingement (2%), and periprosthetic fracture (1%). Major complications (instability, infection, aseptic loosening, and wound complications) were documented and included in the analysis. Minor postoperative complications such as urinary tract infection were excluded. RESULTS Twenty-three of 114 procedures (20%) involved at least one early complication after revision of monoblock metal-on-metal THA with 18 (16%) undergoing at least one additional subsequent surgery. The most common complications included aseptic loosening (6%), deep infection (6%), dislocation (4%), and acetabular fracture (3%). Patients who sustained a complication after revision surgery were older on average than those who did not (66 years versus 58 years, p=0.003). There were no differences in complication rate with respect to sex, time to revision, or revision diagnosis. CONCLUSIONS Complications and reoperations occur frequently after revision for failed monoblock metal-on-metal THA (20% and 16%, respectively), and older patients appear to be at greater risk for complications after these revisions. Aseptic loosening, deep infection, and instability are all of great concern after revision and surgeons should be aware of these potential complications when undertaking revision of these THAs. LEVEL OF EVIDENCE Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Collapse
|
14781
|
Cunin V. Early-onset scoliosis: current treatment. Orthop Traumatol Surg Res 2015; 101:S109-18. [PMID: 25623270 DOI: 10.1016/j.otsr.2014.06.032] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/12/2014] [Accepted: 06/05/2014] [Indexed: 02/02/2023]
Abstract
Early-onset scoliosis, which appears before the age of 10, can be due to congenital vertebral anomalies, neuromuscular diseases, scoliosis-associated syndromes, or idiopathic causes. It can have serious consequences for lung development and significantly reduce the life expectancy compared to adolescent scoliosis. Extended posterior fusion must be avoided to prevent the crankshaft phenomenon, uneven growth of the trunk and especially restrictive lung disease. Conservative (non-surgical) treatment is used first. If this fails, fusionless surgery can be performed to delay the final fusion procedure until the patient is older. The gold standard delaying surgical treatment is the implantation of growing rods as described by Moe and colleagues in the mid-1980s. These rods, which are lengthened during short surgical procedures at regular intervals, curb the scoliosis progression until the patient reaches an age where fusion can be performed. Knowledge of this technique and its complications has led to several mechanical improvements being made, namely use of rods that can be distracted magnetically on an outpatient basis, without the need for anesthesia. Devices based on the same principle have been designed that preferentially attach to the ribs to specifically address chest wall and spine dysplasia. The second category of surgical devices consists of rods used to guide spinal growth that do not require repeated surgical procedures. The third type of fusionless surgical treatment involves slowing the growth of the scoliosis convexity to help reduce the Cobb angle. The indications are constantly changing. Improvements in surgical techniques and greater surgeon experience may help to reduce the number of complications and make this lengthy treatment acceptable to patients and their family. Long-term effects of surgery on the Cobb angle have not been compared to those involving conservative "delaying" treatments. Because the latter has fewer complications associated with it than surgery, it should be the first-line treatment for most cases of early-onset scoliosis.
Collapse
Affiliation(s)
- V Cunin
- Service D'orthopédie Et Traumatologie Pédiatrique, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 59, boulevard Pinel, 69500 Bron, France.
| |
Collapse
|
14782
|
Mollazadeh S, Fazly Bazzaz BS, Kerachian MA. Role of apoptosis in pathogenesis and treatment of bone-related diseases. J Orthop Surg Res 2015; 10:15. [PMID: 25627748 PMCID: PMC4327805 DOI: 10.1186/s13018-015-0152-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 01/02/2015] [Indexed: 12/14/2022] Open
Abstract
In this article, bone cells and their intercellular communications have been reviewed. Gap junctions and hemichannels are the main routes of interactions in bone tissue. They play a substantial role in survival and cell death, since pro-apoptotic signals can propagate through them. Different adhesion molecules are required for apoptosis, particularly caspase family as well as noncaspase proteases. The disruption outcome of apoptosis could result in bone-related diseases such as osteonecrosis. Anti-apoptotic strategies include inhibition of caspase, poly [ADP-ribose] polymerase (PARP), and Bcl-2 proteins as well as induction of the PKB/Akt pathway and inhibitors of apoptosis (IAP) family of proteins. Thus, understanding the mechanism of apoptosis gives detailed insights of anti-apoptotic molecular targets. Based on these targets, different treatments were designed and produced such as estrogen replacement therapy, administration of different bisphosphonates, raloxifene, calcitonin, sodium fluoride, calcium, and vitamin D. As a result, new applicable drugs for treatment of related bone problems can be proposed for clinical approach especially in the early stage of diseases.
Collapse
|
14783
|
miR-375 regulates the canonical Wnt pathway through FZD8 silencing in arthritis synovial fibroblasts. Immunol Lett 2015; 164:1-10. [PMID: 25619565 DOI: 10.1016/j.imlet.2015.01.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/30/2014] [Accepted: 01/15/2015] [Indexed: 12/23/2022]
Abstract
Whether the rheumatoid arthritis (RA) pathogenesis is regulated by microRNA (miRNA) is not entirely clear. In this study, we found that miR-375 was down-regulated significantly in fibroblast-like synoviocytes (FLS) in adjuvant-induced arthritis (AIA) rat model compared with control. Because the web-based software TargetScan and PicTar predict Frizzled 8 (FZD8) as the target of miR-375, we investigated whether up-regulated miR-375 plays a role in the activation of the canonical Wnt signaling by targeting the FZD8. Furthermore, the purpose of the present experiments was also to determine the role of miR-375 in the pathogenesis of AIA rat model and to ascertain the effects of FZD8 in this process. Real time qPCR, Western blotting, ELISA and ChIP assay were used to assess the inhibited role of miR-375 in the pathogenesis of AIA rat model and the canonical Wnt signaling. RNA interference was also used to detect the role of knockdown of dephosphorylated β-catenin. Luciferase reporter gene and related methods were performed to determine the FZD8 as the target of miR-375. The increased miR-375 inhibited the pathogenesis of AIA rat model as indicated by decreases in the several disease markers, such as MMP3 and fibronectin. Interestingly, miR-375 also inhibited the canonical Wnt signaling, and the stabilized form of β-catenin blocked the miR-375 effects. FZD8 was identified as the target of miR-375 in AIA rat model by the firefly luciferase reporter gene. In summary, our results demonstrate that miR-375 regulates the pathogenesis of AIA rat model through the canonical Wnt signaling pathway. This discovery may provide new targets for therapeutic intervention to benefit RA patients.
Collapse
|
14784
|
Dabaja AA, Bryson CF, Schlegel PN, Paduch DA. The effect of hypogonadism and testosterone-enhancing therapy on alkaline phosphatase and bone mineral density. BJU Int 2015; 115:480-5. [PMID: 25046796 DOI: 10.1111/bju.12870] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the relationship of testosterone-enhancing therapy on alkaline phosphatase (AP) in relation to bone mineral density (BMD) in hypogonadal men. PATIENTS AND METHODS Retrospective review of 140 men with testosterone levels of <350 ng/dL undergoing testosterone-enhancing therapy and followed for 2 years. Follicle-stimulating hormone, luteinising hormone, free testosterone, total testosterone, sex hormone binding globulin, calcium, AP, vitamin D, parathyroid hormone, and dual-energy X-ray absorptiometry (DEXA) scans were analysed. A subgroup of 36 men with one DEXA scan before and one DEXA 2 years after initiating treatment was performed. RESULTS Analysis of the relationship between testosterone and AP at initiation of therapy using stiff linear splines suggested that bone turnover occurs at total testosterone levels of <250 ng/dL. In men with testosterone levels of <250 ng/dL, there was a negative correlation between testosterone and AP (R(2) = -0.347, P < 0.001), and no correlation when testosterone levels were between 250 and 350 ng/dL. In the subgroup analysis, the mean (sd) testosterone level was 264 (103) ng/dL initially and 701 (245), 539 (292), and 338 (189) ng/dL at 6, 12, and 24 months, respectively. AP decreased from a mean (sd) of 87 (38) U/L to 57 (12) U/L (P = 0.015), 60 (17) U/L (P < 0.001), and 55 (10) U/L (P = 0.03) at 6, 12, and 24 months, respectively. The BMD increased by a mean (sd) of 20 (39)% (P = 0.003) on DEXA. CONCLUSION In hypogonadal men, the decrease in AP is associated with an increase in BMD on DEXA testing. This result suggests the use of AP as a marker of response to therapy.
Collapse
Affiliation(s)
- Ali A Dabaja
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | | | | | | |
Collapse
|
14785
|
Scheufler KM, Diesing D. Einsatz von Knochenersatzmaterialien bei Fusionen der Wirbelsäule. DER ORTHOPADE 2015; 44:146-53. [DOI: 10.1007/s00132-014-3069-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14786
|
Abstract
Dislocation remains among the most common complications of, and reasons for, revision of both primary and revision total hip replacements (THR). Hence, there is great interest in maximising stability to prevent this complication. Head size has been recognised to have a strong influence on the risk of dislocation post-operatively. As femoral head size increases, stability is augmented, secondary to an increase in impingement-free range of movement. Larger head sizes also greatly increase the 'jump distance' required for the head to dislocate in an appropriately positioned cup. Level-one studies support the use of larger diameter heads as they decrease the risk of dislocation following primary and revision THR. Highly cross-linked polyethylene has allowed us to increase femoral head size, without a marked increase in wear. However, the thin polyethylene liners necessary to accommodate larger heads may increase the risk of liner fracture and larger heads have also been implicated in causing soft-tissue impingement resulting in groin pain. Larger diameter heads also impart larger forces on the femoral trunnion, which may contribute to corrosion, metal release, and adverse local tissue reactions. Alternative large bearings including large ceramic heads and dual mobility bearings may mitigate some of these risks, and several of these devices have been used with clinical success.
Collapse
Affiliation(s)
- H J Cooper
- Lenox Hill Hospital, Department of Orthopaedic Surgery, 130 East 77th Street, New York, 10075, USA
| | - C J Della Valle
- Rush University Medical Center, Department of Orthopaedic Surgery, 1611 West Harrison Street, Chicago, Illinois, 60612, USA
| |
Collapse
|
14787
|
|
14788
|
Kuipers AL, Miljkovic I, Carr JJ, Terry JG, Nestlerode CS, Ge Y, Bunker CH, Patrick AL, Zmuda JM. Association of circulating sclerostin with vascular calcification in Afro-Caribbean men. Atherosclerosis 2015; 239:218-23. [PMID: 25618029 DOI: 10.1016/j.atherosclerosis.2015.01.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/02/2015] [Accepted: 01/10/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Sclerostin, a Wingless (Wnt) pathway antagonist, is an established regulator of bone mineralization in humans but its potential importance in the regulation of vascular calcification is less clear. Therefore, our objective was to assess the relationship of serum sclerostin levels with coronary and aortic artery calcification (CAC and AAC, respectively) in Afro-Caribbean men on the island of Tobago. METHODS Serum sclerostin levels and computed tomography of CAC and AAC were measured in 191 men (age mean(SD): 62.9(8.0)years) recruited without regard to health status. Multivariable logistic regression models were used to assess the cross-sectional association of sclerostin with prevalent arterial calcification. RESULTS Mean(SD) sclerostin was 45.2 pmol/L (15.6 pmol/L). After adjusting for risk factors including age, physical and lifestyle characteristics, comorbidities, lipoproteins and kidney function, 1 SD greater sclerostin level was associated with a 1.61-times (95%CI 1.02-2.53) greater odds of having CAC. Sclerostin was not associated with AAC in any model. CONCLUSIONS This is the first study to show that, among Afro-Caribbean men, greater serum sclerostin concentrations were associated with prevalence and extent of CAC. Further studies are needed to better define the role of the Wnt signaling pathway in arterial calcification in humans.
Collapse
Affiliation(s)
- Allison L Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Jeffery Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cara S Nestlerode
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yaorong Ge
- Department of Software and Information Sciences, University of North Carolina, Charlotte, NC, USA
| | - Clareann H Bunker
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alan L Patrick
- Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago
| | - Joseph M Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
14789
|
Choi B, Lee EJ, Song DH, Yoon SC, Chung YH, Jang Y, Kim SM, Song Y, Kang SW, Yoon SY, Chang EJ. Elevated Pentraxin 3 in bone metastatic breast cancer is correlated with osteolytic function. Oncotarget 2015; 5:481-92. [PMID: 24457902 PMCID: PMC3964223 DOI: 10.18632/oncotarget.1664] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Pentraxin 3 (PTX3), a modulator of tumor-associated inflammation, is known to be positively correlated with tumor grade and severity of malignancies, but its exact role remains unclear. This study found that PTX3 expression was up-regulated in distant bone metastases of breast cancer compared to lung, liver, and brain metastases in 64 human breast cancer patients. Elevated expression of PTX3 was correlated with poor survival in patients with breast cancer. PTX3 expression was also up-regulated in a bone metastatic breast cancer cell line and further enhanced by pro-inflammatory cytokine TNFα. Administration of PTX3 promoted the migratory potential of breast cancer cells and the mobilization of macrophages, a precursor of osteoclasts (OCs), toward breast cancer cells. In addition, elevated expression of PTX3 by TNFα led to enhanced OC formation, implying the distinct role of PTX3 in osteolytic bone metastasis of breast cancer cells. Furthermore, PTX3 silencing using siRNA-specific siRNA prevented breast cancer cell migration, macrophage Chemotaxis, and subsequent OC formation. These findings provide an important insight into the key role of PTX3 in inflammation-associated osteolytic complications of breast cancer.
Collapse
Affiliation(s)
- Bongkun Choi
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14790
|
Clarke MJ, Vrionis FD. Spinal tumor surgery: management and the avoidance of complications. Cancer Control 2015; 21:124-32. [PMID: 24667398 DOI: 10.1177/107327481402100204] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Complication avoidance is paramount to the success of any surgical procedure. In the case of spine tumor surgery, the risk of complications is increased because of the primary disease process and the radiotherapy and chemotherapeutics used to treat the disease. If complications do occur, then life-saving adjuvant treatment must be delayed or withheld until the issue is resolved, potentially impacting overall disease control. METHODS We reviewed the literature and our own best practices to provide recommendations on complication avoidance as well as the management of complications that may occur. Appropriate workup of suspected complications and treatment algorithms are also discussed. RESULTS Appropriate patient selection and a multidisciplinary workup are imperative in the setting of spinal tumors. Intraoperative complications may be avoided by employing proper surgical technique and an understanding of the pathological changes in anatomy. Major postoperative issues include wound complications and spinal reconstruction failure. Preoperative surgical planning must include postoperative reconstruction. Patients undergoing spinal tumor resection should be closely monitored for local tumor recurrence, recurrence along the biopsy tract, and for distant metastatic disease. Any suspected recurrence should be closely watched, biopsied if necessary, and promptly treated. CONCLUSIONS Because patients with spinal tumors are normally treated with a multidisciplinary approach, emphasis should be placed on the recognition of surgical complications beyond the surgical setting.
Collapse
|
14791
|
Ferrucci L, Baroni M, Ranchelli A, Lauretani F, Maggio M, Mecocci P, Ruggiero C. Interaction between bone and muscle in older persons with mobility limitations. Curr Pharm Des 2015; 20:3178-97. [PMID: 24050165 DOI: 10.2174/13816128113196660690] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/13/2013] [Indexed: 12/18/2022]
Abstract
Aging is associated with a progressive loss of bone-muscle mass and strength. When the decline in mass and strength reaches critical thresholds associated with adverse health outcomes, they are operationally considered geriatric conditions and named, respectively, osteoporosis and sarcopenia. Osteoporosis and sarcopenia share many of the same risk factors and both directly or indirectly cause higher risk of mobility limitations, falls, fractures and disability in activities of daily living. This is not surprising since bones adapt their morphology and strength to the long-term loads exerted by muscle during anti-gravitational and physical activities. Non-mechanical systemic and local factors also modulate the mechanostat effect of muscle on bone by affecting the bidirectional osteocyte-muscle crosstalk, but the specific pathways that regulate these homeostatic mechanisms are not fully understood. More research is required to reach a consensus on cut points in bone and muscle parameters that identify individuals at high risk for adverse health outcomes, including falls, fractures and disability. A better understanding of the muscle-bone physiological interaction may help to develop preventive strategies that reduce the burden of musculoskeletal diseases, the consequent disability in older persons and to limit the financial burden associated with such conditions. In this review, we summarize age-related bone-muscle changes focusing on the biomechanical and homeostatic mechanisms that explain bone-muscle interaction and we speculate about possible pathological events that occur when these mechanisms become impaired. We also report some recent definitions of osteoporosis and sarcopenia that have emerged in the literature and their implications in clinical practice. Finally, we outline the current evidence for the efficacy of available anti-osteoporotic and proposed antisarcopenic interventions in older persons.
Collapse
Affiliation(s)
| | | | | | | | | | | | - C Ruggiero
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, S. Andrea delle Fratte, 06100, Perugia, Italy.
| |
Collapse
|
14792
|
Mazzie JP, Brooks MK, Gnerre J. Imaging and management of postoperative spine infection. Neuroimaging Clin N Am 2015; 24:365-74. [PMID: 24792614 DOI: 10.1016/j.nic.2014.01.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Imaging evaluation of postoperative spinal infection is challenging. A systematic approach and keen understanding of multimodality imaging techniques, as well as knowledge of the patient's surgical procedure and clinical presentation, are critical for the radiologist to render an accurate diagnosis. Because of the overlap between diagnostic imaging findings in the postoperative spine and the infected spine, in those situations in which the index of clinical suspicion for spine infection is high, then immediate consideration ought to be given to performing a spine biopsy.
Collapse
Affiliation(s)
- Joseph P Mazzie
- Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA.
| | - Michael K Brooks
- Division of Musculoskeletal and Interventional Radiology, Stony Brook University School of Medicine, Stony Brook, NY 11794, USA
| | - Jeffrey Gnerre
- New York Medical College at Westchester Medical Center, Valhalla, NY 10595, USA
| |
Collapse
|
14793
|
Bittane RM, de Moura AB, Lien RJ. The postoperative spine: what the spine surgeon needs to know. Neuroimaging Clin N Am 2015; 24:295-303. [PMID: 24792609 DOI: 10.1016/j.nic.2014.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Radiologists are often required to evaluate postoperative spine imaging to assist the surgeon with further clinical management. This article reviews common spine surgical techniques and their proper evaluation on imaging from a surgical perspective. The article attempts to provide a basic surgical foundation for radiologists and a clearer delineation of important points and complications that should be commented on when evaluating the postoperative spine on imaging.
Collapse
Affiliation(s)
- Roi M Bittane
- Department of Radiology, Winthrop University Hospital, Mineola, NY 11501, USA.
| | | | - Ruby J Lien
- Department of Radiology, Winthrop University Hospital, Mineola, NY 11501, USA
| |
Collapse
|
14794
|
Willson T, Nelson SD, Newbold J, Nelson RE, LaFleur J. The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol 2015; 7:65-76. [PMID: 25657593 PMCID: PMC4295898 DOI: 10.2147/clep.s40966] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Osteoporosis, a musculoskeletal disease characterized by decreased bone mineral density (BMD) and an increased risk of fragility fractures, is now recognized as an important public health problem in men. Osteoporotic fractures, particularly of the hip, result in significant morbidity and mortality in men and lead to considerable societal costs. Many national and international organizations now address screening and treatment for men in their osteoporosis clinical guidelines. However, male osteoporosis remains largely underdiagnosed and undertreated. The objective of this paper is to provide an overview of recent findings in male osteoporosis, including pathophysiology, epidemiology, and incidence and burden of fracture, and discuss current knowledge about the evaluation and treatment of osteoporosis in males. In particular, clinical practice guidelines, fracture risk assessment, and evidence of treatment effectiveness in men are addressed.
Collapse
Affiliation(s)
- Tina Willson
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
- Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Scott D Nelson
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
- Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
| | | | - Richard E Nelson
- Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Joanne LaFleur
- University of Utah College of Pharmacy, Salt Lake City, UT, USA
- Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA
| |
Collapse
|
14795
|
Rouhandeh A, Joslin C. Non-invasive assessment of soft-tissue artefacts in hip joint kinematics using motion capture data and ultrasound depth measurements. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:4342-5. [PMID: 25570953 DOI: 10.1109/embc.2014.6944585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In human movement analysis, the hip joint centre can be estimated using a functional method based on the relative motion of the femur to the pelvis measured using reflective markers attached to the skin surface by an optical motion capture system. The principal source of errors in estimating the hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone; one of the main objectives in human movement analysis is the assessment of soft tissue artefact. Various studies have described the movement of soft tissue artefact and compensated for it invasively; examples include: intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess soft tissue artefact using optical motion capture data and tissue thickness from ultrasound measurements during flexion and abduction (both with the knee extended) of the hip joint. Results showed that the skin marker displacements caused by the artefact are non-linear and larger in areas closer to the hip joint. It was also found that the marker displacements are dependent on the movement type and relatively larger in abduction movement.
Collapse
|
14796
|
Cernaro V, Lucisano S, Buemi A, Visconti L, Lacava V, Lacquaniti A, Santoro D, Loddo S, Buemi M. Semaphorin 3A serum levels are influenced by haemodialysis: what clinical significance? Nephrology (Carlton) 2015; 20:236-42. [PMID: 25560370 DOI: 10.1111/nep.12393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2014] [Indexed: 11/28/2022]
Abstract
AIM Semaphorin 3A urinary levels represent an early, predictive biomarker of acute kidney injury and positively correlate with albumin-to-creatinine ratio and serum creatinine in hypertensive patients with chronic kidney disease. Our purpose has been to evaluate semaphorin 3A serum levels in a cohort of haemodialysis (HD) patients, the influence of a single HD session on its concentrations, and the potential correlation with clinical and biochemical parameters. METHODS We enrolled 18 patients receiving HD with Acetate-Free Biofiltration technique and 16 healthy subjects as controls. Peripheral venous blood samples were obtained from patients at different intervals: start of dialysis (pre-HD), middle, and end of the treatment (post-HD). We also collected dialysate samples by the Quantiscan monitoring system (Hospal, Bologna, Italy). RESULTS Semaphorin 3A was significantly lower in HD patients at baseline compared to controls (median 19.50 (interquartile range 1.00-65.00) versus 97.50 (23.50-161.00) ng/mL, P = 0.0237). A statistically significant reduction was seen during a single HD session (from 19.50 (1.00-65.00) to 0.86 (0.82-4.21) ng/mL, P < 0.0001), with a reduction ratio of 65.92 ± 33.51%. The median concentration in dialysate was 54.00 (15.00-102.00) ng/mL. Pre-HD values were directly related to serum vitamin D (r = 0.872; P = 0.001) and inversely correlated with calcium levels (r = -0.426; P = 0.012) and calcium × phosphate product (r = -0.422; P = 0.0252). CONCLUSION Semaphorin 3A removal during HD may be clinically relevant due to its involvement in different aspects of cell physiology and in bone remodelling. Semaphorin 3A both inhibits osteoclastic bone reabsorption and increases osteoblastic new bone formation, thus playing a dual osteoprotective role.
Collapse
Affiliation(s)
- Valeria Cernaro
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
14797
|
Bosshardt DD, Stadlinger B, Terheyden H. Cell-to-cell communication--periodontal regeneration. Clin Oral Implants Res 2015; 26:229-39. [PMID: 25639287 DOI: 10.1111/clr.12543] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although regenerative treatment options are available, periodontal regeneration is still regarded as insufficient and unpredictable. AIM This review article provides scientific background information on the animated 3D film Cell-to-Cell Communication - Periodontal Regeneration. RESULTS Periodontal regeneration is understood as a recapitulation of embryonic mechanisms. Therefore, a thorough understanding of cellular and molecular mechanisms regulating normal tooth root development is imperative to improve existing and develop new periodontal regenerative therapies. However, compared to tooth crown and earlier stages of tooth development, much less is known about the development of the tooth root. The formation of root cementum is considered the critical element in periodontal regeneration. Therefore, much research in recent years has focused on the origin and differentiation of cementoblasts. Evidence is accumulating that the Hertwig's epithelial root sheath (HERS) has a pivotal role in root formation and cementogenesis. Traditionally, ectomesenchymal cells in the dental follicle were thought to differentiate into cementoblasts. According to an alternative theory, however, cementoblasts originate from the HERS. What happens when the periodontal attachment system is traumatically compromised? Minor mechanical insults to the periodontium may spontaneously heal, and the tissues can structurally and functionally be restored. But what happens to the periodontium in case of periodontitis, an infectious disease, after periodontal treatment? A non-regenerative treatment of periodontitis normally results in periodontal repair (i.e., the formation of a long junctional epithelium) rather than regeneration. Thus, a regenerative treatment is indicated to restore the original architecture and function of the periodontium. Guided tissue regeneration or enamel matrix proteins are such regenerative therapies, but further improvement is required. As remnants of HERS persist as epithelial cell rests of Malassez in the periodontal ligament, these epithelial cells are regarded as a stem cell niche that can give rise to new cementoblasts. Enamel matrix proteins and members of the transforming growth factor beta (TGF-ß) superfamily have been implicated in cementoblast differentiation. CONCLUSION A better knowledge of cell-to-cell communication leading to cementoblast differentiation may be used to develop improved regenerative therapies to reconstitute periodontal tissues that were lost due to periodontitis.
Collapse
Affiliation(s)
- Dieter D Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, University of Bern, Bern, Switzerland; Department of Periodontology, University of Bern, Bern, Switzerland; Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | | | | |
Collapse
|
14798
|
Matsuda T, Fujita A, Hara M, Nishio M, Umekawa H. Tea Extract Modulates the Expression of DC-STAMP mRNA in RAW264.7 Cells. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2015. [DOI: 10.3136/fstr.21.869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tomoko Matsuda
- Graduate School of Bioresources, Mie University
- Mie Prefecture Agricultural Research Institute
| | | | | | | | | |
Collapse
|
14799
|
Abstract
The chest is a dynamic structure. For normal movement it relies on a coordinated movement of the multiple bones, joints and muscles of the respiratory system. While muscle weakness can have clear impact on respiration by decreasing respiratory motion, so can conditions that cause chest wall hypoplasia and produce an immobile chest wall. These conditions, such as Jarcho-Levin and Jeune syndrome, present significantly different challenges than those faced with early onset scoliosis in which chest wall mechanics and thoracic volume may be much closer to normal. Because of this difference more aggressive approaches to clinical and surgical management are necessary.
Collapse
Affiliation(s)
- Oscar Henry Mayer
- Associate Professor of Clinical Pediatrics, Perelman School of Medicine at The University of Pennsylvania, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104.
| |
Collapse
|
14800
|
Stavrakis AI, SooHoo NF, Lieberman JR. A comparison of the incidence of complications following total hip arthroplasty in patients with or without osteonecrosis. J Arthroplasty 2015; 30:114-7. [PMID: 25201256 DOI: 10.1016/j.arth.2014.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/05/2014] [Accepted: 08/09/2014] [Indexed: 02/01/2023] Open
Abstract
Osteonecrosis (ON) is a common cause of hip arthritis requiring arthroplasty (THA). ON patients often have associated conditions that place them at a greater risk for complications. The aim of this study is to determine complication rates of ON versus other THA patients. Statewide hospital admissions for THA were identified (1995-2010). THA procedures and ON diagnosis were identified using ICD-9 codes. Logistic regression analysis was used to determine the role of ON as a predictor of complications. ON led to an increased risk of sepsis and readmission. There was no significant difference in mortality rate. This study demonstrates that patients with ON undergoing THA have increased rates of readmission and sepsis. These findings are helpful in allocating resources for treating this patient group.
Collapse
Affiliation(s)
- A I Stavrakis
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, California; UCLA Santa Monica Orthopaedic Center, 1250 16th Street, Suite 2100, Santa Monica, CA 90404
| | - N F SooHoo
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, California; UCLA Santa Monica Orthopaedic Center, 1250 16th Street, Suite 2100, Santa Monica, CA 90404
| | - J R Lieberman
- Department of Orthopaedic Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California; Department of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033
| |
Collapse
|