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Clinical characteristics, treatment modalities, and potential contributing and prognostic factors in patients with bone metastases from gynecological cancers: A systematic review

The purpose of this study is to review the clinical characteristics, treatment modalities, and potential contributing and prognostic factors of bone metastases from gynecological cancers (GCs). A systematic literature search on PubMed, Scopus, Web of Science Core Collection and Cochrane Central Register of Controlled Trials databases was conducted. Thirty-one studies, all retrospective, were included in this review, for a total of 2880 patients with GC bone metastases. Primary tumors leading to bone metastases included endometrial cancer (EC), cervical cancer (CC), ovarian cancer (OC), uterine sarcoma (US) and vulvar cancer (VuC), mainly with an International Federation of Gynecology and Obstetrics (FIGO) Stage of III and IV. The main bone metastatic lesion site was the vertebral column, followed by the pelvic bone and lower extremity bones. The median survival rate after bone metastases diagnosis ranged from 3.0 to 45 months. The most frequent treatments were palliative and included radiotherapy and chemotherapy, followed by surgery. The findings of this review give a first dataset for a greater understanding of GC bone metastases that could help clinicians move toward a more “personalized” and thus more effective patient management

The effects of mechanical forces on bones and joints. Experimental study on the rat tail.

We have used an experimental model employing the bent tail of rats to investigate the effects of mechanical forces on bones and joints. Mechanical strain could be applied to the bones and joints of the tail without direct surgical exposure or the application of pins and wires. The intervertebral disc showed stretched annular lamellae on the convex side, while the annulus fibrosus on the concave side was pinched between the inner corners of the vertebral epiphysis. In young rats with an active growth plate, a transverse fissure appeared at the level of the hypertrophic cell layer or the primary metaphyseal trabecular zone. Metaphyseal and epiphyseal trabeculae on the compressed side were thicker and more dense than those of the distracted part of the vertebra. In growing animals, morphometric analysis of hemiepiphyseal and hemimetaphyseal areas, and the corresponding trabecular bone density, showed significant differences between the compressed and distracted sides. No differences were observed in adult rats. We found no significant differences in osteoclast number between compressed and distracted sides in either age group. Our results provide quantitative evidence of the working of 'Wolff's law'. The differences in trabecular density are examples of remodelling by osteoclasts and osteoblasts; our finding of no significant difference in osteoclast numbers between the hemiepiphyses in the experimental and control groups suggests that the response of living bone to altered strain is mediated by osteoblasts

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 17: Bone growth stimulators as an adjunct for lumbar fusion

pre-printThe relationship between the formation of a solid arthrodesis and electrical and electromagnetic energy is well established; most of the information on the topic, however, pertains to the healing of long bone fractures. The use of both invasive and noninvasive means to supply this energy and supplement spinal fusions has been investigated. Three forms of electrical stimulation are routinely used: direct current stimulation (DCS), pulsed electromagnetic field stimulation (PEMFS), and capacitive coupled electrical stimulation (CCES). Only DCS requires the placement of electrodes within the fusion substrate and is inserted at the time of surgery. Since publication of the original guidelines, few studies have investigated the use of bone growth stimulators. Based on the current review, no conflict with the previous recommendations was generated. The use of DCS is recommended as an option for patients younger than 60 years of age, since a positive effect on fusion has been observed. The same, however, cannot be stated for patients over 60, because DCS did not appear to have an impact on fusion rates in this population. No study was reviewed that investigated the use of CCES or the routine use of PEMFS. A single low-level study demonstrated a positive impact of PEMFS on patients undergoing revision surgery for pseudarthrosis, but this single study is insufficient to recommend for or against the use of PEMFS in this patient population

THE APPLICATION OF AN INDEX TO DETERMINE GENETIC AND ENVIRONHENTAL CONTRIBUTIONS TO DENTOFACIAL GROWTH IN TWINS AND SIBLINGS

The method of principal components may be used to reduce a large quantity of data for an individual into a single statistic, a growth index, indicative of overall facial growth, and to make a determination of the relative contribution of each variable, as well as the genotype and the environment, to the variation between individuals, When this method is applied to four consecutive years of cephalometric and anthropometric data from each of 95 children, consisting of Caucasian and Negro monozygotic twins, like-sexed dizygotic twins, and their siblings of both sexes, it discloses that: 1. The relative contributions of the variables studied to the variation among individuals are as follows: facial depth variables \u3e facial height variables \u3e facial width variables. 2. No differences in growth rates, as represented by the growth index, are apparent between males and females entering the study during the same age interval, between members of the same sex entering the study during two age intervals, between sexes including all age intervals, and between races. Failure of the investigation to disclose any such differences may result from the design of the experiments. 3. A very highly significant environmental component of variability for the growth index is found in the population studied, which suggests the need for further studies of specific environmental agents affecting the growth rates of the variables involved. 4. A very highly significant genetic component of variability for the growth index also is found, however, the complicated polygenic nature of facial inheritance renders analysis of the specific genetic factors involved quite difficult, because of the present limited knowledge of the inheritance of quantitative traits. 5. A very highly significant extrafamilial (genetic and environmental) component of variability for the growth index also is found. 6. The sources of variability for the growth index for twins, have the following relative magnitudes: extra-familial \u3e genetic \u3e environmental \u3e error. For siblings the relative magnitudes of the sources of variability are: extrafamilial \u3e environmental\u3e genetic \u3e error. Thus, as expected, environmental factors are relatively more important between siblings than between twins

Biomechanical evolution of solid bones in large animals: a microanatomical investigation

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Bone tissue and hyperhomocysteinemia.

Bone tissue quality is determined not only by multiple architectural variables, but also by the mechanical properties of collagen type 1. Homocysteinuria is a genetic disease whose manifestations include severe hyperhomocysteinemia and decreased bone strength. The effects of smaller homocysteine elevations on bone tissue are difficult to demonstrate in clinical studies. Studies in animals and in humans suggest that homocysteine may weaken collagen crosslinks and, if present in large amounts, interfere with bone remodeling. Whether routine homocysteine assays should be performed to detect bone frailty remains unclear. In clinical practice, the focus should be on identifying patients with potential causes of homocysteine elevation (e.g., medications), who should then be given vitamin D and folic acid supplementation if needed. This approach may improve not only bone health, but also vascular and general health

Osteoconductive properties of poly(96L/4D-lactide)/beta-tricalcium phosphate in long term animal model

The objective of this study was to determine the effect of calcium phosphate mineral content on the bone in-growth at the expense of composite of co-polylactide polymer charged with 2 different ratios of β-TCP granules (10 and 24 w-% of β-TCP). The evaluation was realized in a long term rabbit bone model. After 24, 48 and 76 weeks, the implants were examined by micro CT, scanning electron microscopy (SEM) using backscattered electron (BSE) and light microscopy (polarized and blue light microscopy). No foreign body reaction was detected during the 76 weeks follow-up in any of the test samples. Polymer hydrolysis began at approximately 24 weeks, by 76 weeks, the pure polymer implant had begun to release P(96L/4D)LA particles and show signs of peripheral localized bone resorption. A decrease in the amount of CaP was noticed between 24 and 76 weeks in both 10 wt-% and 24 wt-% β-TCP/P(96L/4D)LA composites. The study showed that the highest bone in-growth was with 24 wt-% β-TCP/P(96L/4D)LA composite. Bone in-growth and mineralization were evident for the composites associated with specific peripheral bone architecture. Fluorescent labelling demonstrated high bone in-growth and remodeling at the interface, while for pure co-polymer no bone remodeling or bone activity was maintained after 48 weeks. The study demonstrated the positive effect of calcium phosphate content into P(96L/4D)LA. This kind of composite is a suitable resorbable osteoconductive matrix, which provides long term stability required for ligament fixation device

Contextual Hierarchies in Classification Schemes

This paper is concerned with the encoding of contextual hierarchies. In particular, such hierarchies make it possible to create a single, complete classified display of very large thesauri. This classification may use the same descriptor with different views, as evidenced by the same descriptor as more than one node in the classification, where the nodes have different sets of children. This son of knowledge organization requires special computer representation techniques using contextual indicators for encoding the parent-child relationship. One solution" is to avoid having a unified classification in favor of many hierarchical families as used by the INSPEC® and ERIC® thesauri. However, this author considers it a particular strength to have a unified classification, of which the Medical Subject Headings (MeSH®) tree structures is a primary example. This paper describes the traditional method of using tree numbers as contextual indicators. We then propose a new experimental method of semantic labels, developed for the MedIndEx™ prototype, as possibly having certain advantages over tree numbers. We conclude with the hope that this workshop will provide feedback regarding the significance of the problem and substance of our proposal