Endometriosis

From the *Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Sciences Center at Houston, ** Department of Orthopaedic Surgery, Zuckerberg San Francisco General Hospitial, University of California, San Francisco; *** Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, **** University of Iowa Department of Orthopaedics and Rehabilitation, Iowa City, ***** Department of Orthopaedic Surgery; University of Louisville School of Medicine Disclosure: The authors report no conflicts of interest. Material presented in this Compendium is based on the Comprehensive Classification of Fractures of Long Bones by M.E. Müller, J. Nazarian, P. Koch and J. Schatzker, Springer-Verlag, Berlin, 1990. The Orthopaedic Trauma Association is indebted to Professor Maurice Müller for allowing use of the system. Correspondence: James F. Kellam, Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Sciences Center at Houston, 6431 Fannin Street, MSB 6.146, Houston Texas, 77030 (e-mail: James.F.Kellam@uth.tmc.edu) Copyright © 2017 by AO Foundation, Davos, Switzerland; Orthopaedic Trauma Association, IL, US To encourage the use of this classification and this fracture classification compendium, the figures may be reproduced and the classification may be used for research, educational and or medical purposes without the need to request permission from the OTA, AO Foundation or the publisher. It cannot be used commercially or for-profit without permission. Foreword

Fracture and Dislocation Classification Compendium-2018

Fracture and dislocation classification compendium - 2007

BACKGROUND
The molecular mechanisms by which physical training improves peripheral and coronary artery disease are poorly understood. Bone marrow-derived endothelial progenitor cells (EPCs) are thought to exert beneficial effects on atherosclerosis, angiogenesis, and vascular repair.


METHODS AND RESULTS
To study the effect of physical activity on the bone marrow, EPCs were quantified by fluorescence-activated cell sorter analysis in mice randomized to running wheels (5.1+/-0.8 km/d, n=12 to 16 per group) or no running wheel. Numbers of EPCs circulating in the peripheral blood of trained mice were enhanced to 267+/-19%, 289+/-22%, and 280+/-25% of control levels after 7, 14, and 28 days, respectively, accompanied by a similar increase of EPCs in the bone marrow and EPCs expanded from spleen-derived mononuclear cells. eNOS-/- mice and wild-type mice treated with N(G)-nitro-l-arginine methyl ester showed lower EPC numbers at baseline and a significantly attenuated increase of EPC in response to physical activity. Exercise NO dependently increased serum levels of vascular endothelial growth factor and reduced the rate of apoptosis in spleen-derived EPCs. Running inhibited neointima formation after carotid artery injury by 22+/-2%. Neoangiogenesis, as assessed in a subcutaneous disc model, was increased by 41+/-16% compared with controls. In patients with stable coronary artery disease (n=19), moderate exercise training for 28 days led to a significant increase in circulating EPCs and reduced EPC apoptosis.


CONCLUSIONS
Physical activity increases the production and circulating numbers of EPCs via a partially NO-dependent, antiapoptotic effect that could potentially underlie exercise-related beneficial effects on cardiovascular diseases.

P3461 Physical training increases endothelial progenitor cells, inhibits neointima formation and enhances angiogenesis

The relationship of endometriosis and ovarian malignancy: a review

Development of a reliable non-union model in mice.

Background Emergency devices for pelvic ring stabilization include circumferential sheets, pelvic binders, and c-clamps. Our knowledge of the outcome of these techniques is currently based on limited information. Methods Using the dataset of the German Pelvic Trauma Registry, demographic and injury-associated characteristics as well as the outcome of pelvic fracture patients after sheet, binder, and c-clamp treatment was compared. Outcome parameters included transfusion requirement of packed red blood cells, length of hospital stay, mortality, and incidence of lethal pelvic bleeding. Results Two hundred seven of 6137 (3.4%) patients documented in the German Pelvic Trauma Registry between April 30th 2004 and January 19th 2012 were treated by sheets, binders, or c-clamps. In most cases, c-clamps (69%) were used, followed by sheets (16%), and binders (15%). The median age was significantly lower in patients treated with binders than in patients treated with sheets or c-clamps (26 vs. 47 vs. 42 years, p  = 0.01). Sheet wrapping was associated with a significantly higher incidence of lethal pelvic bleeding compared to binder or c-clamp stabilization (23% vs. 4% vs. 8%). No significant differences between the study groups were found in sex, fracture type, blood haemoglobin concentration, arterial blood pressure, Injury Severity Score, the incidence of additional pelvic packing and arterial embolization, need of red blood cell transfusion, length of hospitalisation, and mortality. Conclusions The data suggest that emergency stabilization of the pelvic ring by binders and c-clamps is associated with a lower incidence of lethal pelvic bleeding compared to sheet wrapping. Level of evidence Level III.

Emergency stabilization of the pelvic ring: Clinical comparison between three different techniques

Development of a locking femur nail for mice

A new tool (OpenGo, Moticon GmbH) was introduced to continuously measure kinetic and temporospatial gait parameters independently through an insole over up to 4 weeks. The goal of this study was to investigate the validity and reliability of this new insole system in a group of healthy individuals. Gait data were collected from 12 healthy individuals on a treadmill at two different speeds. In total, six trials of three minutes each were performed by every participant. Validation was performed with the FDM-S System (Zebris). Complete sensor data were used for a within test reliability analysis of over 10000 steps. Intraclass correlation was calculated for different gait parameters and analysis of variance performed. Intraclass correlation for the validation was >0.796 for temporospatial and kinetic gait parameters. No statistical difference was seen between the insole and force plate measurements (difference between means: 36.3 ± 27.19 N; p = 0.19 and 0.027 ± 0.028 s; p = 0.36). Intraclass correlation for the reliability was >0.994 for all parameters measured. The system is feasible for clinical trials that require step by step as well as grouped analysis of gait over a long period of time. Comparable validity and reliability to a stationary analysis tool has been shown.

/pdf/validation-and-reliability-testing-of-a-new-fully-integrated-nehd21n36n.pdf

Validation and reliability testing of a new, fully integrated gait analysis insole

Background and purpose:

Rapamycin is a widely used drug with antifungal, immunosuppressant and antiangiogenic effects. Herein, we studied whether immunosuppressive doses of rapamycin are capable of influencing endometriotic lesions.



Experimental approach:

We tested in vitro the potential of rapamycin to inhibit endothelial cell sprouting using the aortic ring assay and we further studied its effect on the expression of proliferating cell nuclear antigen (PCNA), apoptotic cell death-associated activated caspase-3 and vascular endothelial growth factor (VEGF) in cultured endometrial tissue fragments. In addition, we analyzed the drug in vivo after induction of endometriotic lesions by transplanting isolated endometrial fragments into the dorsal skinfold chamber of Syrian golden hamsters. Using intravital fluorescence microscopy, we repetitively analyzed angiogenesis, neovascularization and microcirculatory parameters over a time period of 14 days in rapamycin-treated animals and DMSO-treated controls.



Key results:

Administration of rapamycin significantly reduced the size of the endometriotic lesions. This was associated by inhibition of VEGF-mediated angiogenesis as indicated by a suppression of endothelial cell sprouting in vitro and a reduction of microvessel density in endometriotic lesions in vivo. Moreover, rapamycin directly inhibited cell proliferation within endometrial tissue, while manifestation of apoptotic cell death remained unaffected.



Conclusions and implications:

Our data indicate that administration of rapamycin may represent a novel therapeutic approach for an antiangiogenic treatment of endometriosis.



British Journal of Pharmacology (2006) 149, 137–144. doi:10.1038/sj.bjp.0706857

https://bpspubs.onlinelibrary.wiley.com/doi/pdf/10.1038/sj.bjp.0706857

Jörg H. Holstein

Papers

Development of a reliable non-union model in mice.

Emergency stabilization of the pelvic ring: Clinical comparison between three different techniques

Development of a locking femur nail for mice

Validation and reliability testing of a new, fully integrated gait analysis insole

Rapamycin induces regression of endometriotic lesions by inhibiting neovascularization and cell proliferation.