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What can we do about osteoarthritis?
Osteoarthritis is complex in genetics, pathogenesis, monitoring and treatment. Current treatment of osteoarthritis does not influence progression. Much could be gained by more effective 'low-tech-low-cost' treatment. However, many patients have rapidly progressive disease, multiple joint involvement, and severe disease. We need to clarify the genetics of osteoarthritis, identify those at risk for progression and severe disease, and identify molecular processes critical for joint survival and failure. Will saving the cartilage improve patient pain and function? Effective outcome measures are needed to accelerate testing of new treatments. Further improvement is needed in joint implant technology to decrease costs, wear and loosening.
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Articular cartilage and changes in Arthritis: Cell biology of osteoarthritis
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The reaction patterns of chondrocytes in osteoarthritis can be summarized in five categories: (1) proliferation and cell death (apoptosis); changes in (2) synthetic activity and (3) degradation; (4) phenotypic modulation of the articular chondrocytes; and (5) formation of osteophytes. In osteoarthritis, the primary responses are reinitiation of synthesis of cartilage macromolecules, the initiation of synthesis of types IIA and III procollagens as markers of a more primitive phenotype, and synthesis of active proteolytic enzymes. Reversion to a fibroblast-like phenotype, known as 'dedifferentiation', does not appear to be an important component. Proliferation plays a role in forming characteristic chondrocyte clusters near the surface, while apoptosis probably occurs primarily in the calcified cartilage.
아주대학교 산학협력단 - 폐경 후 여성 및 60대 이상의 남성의 골밀도(BMD) 데이터
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▪ 요추 X-ray 영상에서 L1~L4에 한 개의 질환(Normal, Osteopenia, Osteoporosis)이 라벨링 되어 있는 데이터셋으로 남녀 성비, 질환 분포의 다양성을 확보한 데이터 ▪ 전문의들이 X-Ray 영상과 진단데이터를 활용하여 판독한 골다공증 관련 서비스 활용에 신뢰성 있는 데이터
Lack of microbiological concordance between bone and non-bone specimens in chronic osteomyelitis: an observational study
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Background Prognosis of chronic osteomyelitis depends heavily on proper identification and treatment of the bone-infecting organism. Current knowledge on selecting the best specimen for culture is confusing, and many consider that non-bone specimens are suitable to replace bone cultures. This paper compares the microbiology of non-bone specimens with bone cultures, taking the last as the diagnostic gold standard. Methods Retrospective observational analysis of 50 patients with bacterial chronic osteomyelitis in a 750-bed University-based hospital. Results Concordance between both specimens for all etiologic agents was 28%, for Staphylococcus aureus 38%, and for organisms other than S. aureus 19%. The culture of non-bone specimens to identify the causative organisms in chronic osteomyelitis produced 52% false negatives and 36% false positives when compared against bone cultures. Conclusions Diagnosis and therapy of chronic osteomyelitis cannot be guided by cultures of non-bone specimens because their microbiology is substantially different to the microbiology of the bone.
The Role of PTHrP in Osteoblast Response to Microgravity: Implications for Osteoporosis Development.
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Prolonged skeletal unloading through bedrest results in bone loss similar to that observed in elderly osteoporotic patients but with an accelerated timeframe. This rapid effect on weight-bearing bones is also observed in astronauts who lose up to 2% of their bone mass per month spent in Space. Despite important implications for Spaceflight travellers and bedridden patients on Earth the exact mechanisms involved in disuse osteoporosis have not been elucidated. Parathyroid hormone-related protein (PTHrP) regulates many physiological processes including skeletal development and has been proposed as a gravisensor. To investigate the role of PTHrP in microgravity-induced bone loss trabecular osteoblasts (TOs) from Pthrp+/+ and -/- mice were exposed to simulated microgravity for 6 days. Viability of TOs decreased in inverse proportion to PTHrP expression levels. Microarray analysis of Pthrp+/+ TOs after 6 days at 0g revealed expression changes in genes encoding prolactins,apoptosis and survival molecules bone metabolism and extra-cellular matrix composition proteins chemokines IGF family and Wnt-related signalling molecules. Importantly 88% of 0g-induced expression changes in Pthrp+/+ cells overlap those observed in Pthrp-/- cells in normal gravity. Pulsatile treatment with PTHrP1-36 peptide during microgravity exposure reversed a large proportion of 0g-induced changes in Pthrp+/+ TOs. Our results confirm PTHrP efficacy as an anabolic agent to prevent microgravity-induced cell death in TOs. Total RNA samples extracted from Pthrp+/+and -/- trabecular osteoblasts (TOs) exposed for 6 days to simulated 0g in Synthecon rotating cell or left 6 days in culture at 1g. Cells had either been treated with a pulsatile treatment (2 h/day) of PTHrP1-36 peptide (10-8M) or received a change in growth medium. In total: 8 different conditions with 2 replicates each i.e. Pthrp+/+ TOs at 0g or 1g with or without PTHrP1-36 treatment and Pthrp-/- TOs at 0g or 1 g,with or without PTHrP1-36 treatment.
Anti-TNF-α therapy as a clinical intervention for periprosthetic osteolysis
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Aseptic loosening of total joint arthroplastics due to periprosthetic osteolysis is a frequent cause of implant failure. The absence of clinical interventions to arrest or prevent this complication limits the use of total joint replacement especially in younger patients. Here we review recent studies implicating tumor necrosis factor (TNF)-α in periprosthetic osteolysis and the rationale for clinical studies of anti-TNF therapy and other interventions for periprosthetic loosening.
Osteocytes transcriptome is altered during spaceflight
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Bone loss is one of the major health problems for astronauts during long-term spaceflight and for patients during prolonged bed rest or paralysis. Growing evidence suggests that osteocytes, the most abundant cells in the mineralized bone matrix, play a key role in sensing mechanical forces applied to the skeleton and in transducing them into subcellular biochemical signals to modulate bone homeostasis. However, the precise molecular mechanisms underlying both mechanosensation and mechanotransduction in osteocytes under the real microgravity (µG) condition are poorly understood. To unravel the mechanisms by which osteocyte, sense and responds to mechanical unloading, we exposed murine osteocytic cell line, Ocy454, seeded on a highly porous polystyrene 3D scaffold, to 2, 4, or 6 days of µG on board the International Space Station (ISS) and compared their gene expression with cells at 1G on Earth. Bioinformatics analysis of cells exposed to µG revealed several pathways differentially regulated upon exposure to microgravity.