Actions of Dopamine on the Skin and the Skeleton
Nira Ben-Jonathan in Dopamine, 2020
The human skeleton provides the internal framework of the human body and is divided into the axial skeleton and appendicular skeleton. The axial skeleton is composed of the vertebral column, rib cage, skull, and other associated bones. The appendicular skeleton is attached to the axial skeleton and is composed of the shoulder and pelvic girdles, and upper and lower limbs. The bone mass in the skeleton reaches its maximal density around age 21, followed by progressive loss of bone tissue with advanced age. The aging bone has reduced mineral content, and is prone to osteoporosis—a condition in which bones are less dense, more fragile, and predisposed to fractures [53]. The human skeleton performs six major functions: support, movement, protection, production of blood cells, storage of minerals, and endocrine regulation. The skeleton protects many vital organs from being damaged. For instance, the skull protects the brain, the vertebrae protect the spinal cord, and the rib cage, spine and sternum protect the lungs, heart and major blood vessels. The skeleton is also the site of hematopoiesis, which takes place in the bone marrow. The bone matrix stores calcium, iron and ferritin and is involved in calcium and iron metabolism. Bone is not only a target of several endocrine signals, but also acts as an endocrine tissue by secreting hormones such as fibroblast growth factor 23 (FGF23) and osteocalcin, which are implicated in the regulation of phosphate homeostasis and of energy metabolism, respectively [54]. Bone is a metabolically active tissue composed of several cell types, including osteoblasts, osteocytes, and osteoclasts.
Trunk
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
Some basic concepts of the development of trunk musculoskeletal tissues have already been covered in Section 2.1 and Boxes 4.1 and 4.2. The axial skeleton is composed of the skull, ribs, sternum, and vertebral column (Plate 6.2). The vertebral column consists of 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3–5 coccygeal vertebrae. This column of bones forms the axis of the body and protects the spinal cord. Cervical, thoracic, and lumbar vertebrae are easily distinguished from one another by several criteria. Generally, vertebrae from more superior regions of the vertebral column have more oval-shaped vertebral bodies and relatively larger vertebral foramina. Each vertebral foramen, through which the spinal cord runs, is bounded on the ventral (anterior) side by the vertebral body and on the dorsal (posterior) side by vertebral arch, formed by the pedicles and lamina. The shapes of the vertebral arches change over a cranio-caudal gradient that reflects their function: The main function of the upper vertebral column is to allow flexibility and movement of the neck and head, while the main function of the lower vertebral column, particularly the sacral region, is to provide support to the upper body and pelvic girdle. In fact, as will be explained below, cervical vertebra 1 (atlas) has no body at all but instead encircles the dens of cervical vertebra 2 (axis), allowing the head to rotate through a large range of motion (Plate 3.31b,c). Another obvious difference between vertebral regions is that only thoracic vertebrae have facets for rib articulations. The rib articulations are located on both the transverse processes (transverse costal facets, because the Latin for ribs is “costae”) and the vertebral bodies (superior and inferior costal facets). The superior and inferior costal facets, also called “demi-facets,” should not be confused with the superior and inferior articular processes of each vertebra, which form synovial joints with the corresponding inferior and superior processes of the adjacent vertebrae.
Reduction and Fixation of Sacroiliac joint Dislocation by the Combined Use of S1 Pedicle Screws and an Iliac Rod
Kai-Uwe Lewandrowski, Donald L. Wise, Debra J. Trantolo, Michael J. Yaszemski, Augustus A. White in Advances in Spinal Fusion, 2003
J Bone Miner.Res 2002; 17:898-906.43.Cells, Signals, and Scaffolds: The Future of Spinal FusionLeon J. NestiWalter Reed Army Medical Center, Washington, D.C., U.S.A. and Thomas Jefferson University Philadelphia, Pennsylvania, U.S.A. Timothy R. KukloWalter Reed Army Medical Center Washington, D.C, U.S.A. Edward J. CatersonThomas Jefferson University Philadelphia, Pennsylvania, U.S.A IINTRODUCTIONThe vertebral column is the center of the axial skeleton and provides structural support, bending motion, and protection of the spinal cord. The column is comprised of several components: bone, intervertebral disc, muscle tendons and ligaments, and neural elements. Failure of one or any combination of these components may lead to spinal disease in which the normal mechanics of the vertebral column is disrupted. This results in a variety of clinical sequela including back pain, stiffness, or neurological compromise. The current therapy for many of these spinal disorders includes spinal fusion, in which segmental motion is sacrificed for pain relief and structural stability. Spinal fusion has inherent limitations, because restoration of structural stability, while necessary, is unable to address the entire spectra of underlying pathology. Questions arise as to the number of segments to fuse, the approach and method of fusion, and whether or not to use “biologies” to assist with the fusion process and minimize the potential complication of nonunion. In this chapter we do not present new methods of spinal fusion, nor do we claim to have the definitive technique in treating spinal disease; we do, however, present a basic foundation for the understanding of the cell biology and material science involved in novel tissue regeneration approaches for reconstruction of the spine. These approaches arise from the relatively new discipline of tissue engineering (TE) in which clinical considerations and scientific principles intersect to address disease pathology (Fig. 1). We have now gained a better understanding of the cells involved in bone and cartilage regeneration, the signals required to direct these cells, and the environment in which to create new tissue for use in spinal fusion. Figure 1 Paradigm of cell-based tissue engineering.
Biomarkers in psoriatic arthritis: a systematic literature review
Published in Expert Review of Clinical Immunology, 2016
Elena Generali, Carlo A. Scirè, Ennio G. Favalli, Carlo Selmi
Psoriatic arthritis (PsA) is characterized by chronic inflammation of peripheral joints and axial skeleton, associated with a strong genetic background. Clinics include enthesitis or dactylitis and extra-articular involvement as uveitis or inflammatory bowel disease, while treatment options range from nonsteroidal anti-inflammatory drugs (NSAIDs) to biologics, targeting TNF α or Th17. No serum autoantibody is associated with PsA, while other biomarkers have been proposed for early diagnosis or to predict treatment response. To better discuss this area of growing interest we performed a systematic review of the literature on biomarkers in PsA. Our research retrieved 408 papers, and 38 were included in the analysis. Based on the available literature, we draw some recommendations for the use of biomarkers in the management of patients with PsA.
Metastatic prostate carcinoma to the orbit as the first presentation of disease
Published in Orbit, 2017
Adam C. AufderHeide, Benjamin J. Bernard, Reid A. Mollman, Alan R. Hromas, Paul J. Camarata, Phillip D. Hylton, Koji C. Ebersole, Jason A. Sokol
Prostate carcinoma is a common tumor of the older adult male. It is associated with bony metastases, particularly to the axial skeleton. We present two case histories; in both cases, the patients had no prior history of prostate carcinoma. Both cases were diagnosed with CT imaging, elevated PSA, and biopsy. Additionally, they were treated with surgical resection and hormone modulation therapy. While bony metastases are frequently associated with advanced disease, they can also be a cause of presenting symptoms. The CT imaging in these two cases showed the classic hyperostotic findings of prostate cancer. Prostate cancer may cause osteoblastic lesions in contrast to other metastatic bone lesions, which cause destructive osteolytic lesions. During excisional surgery, the tumor was inspected and many stalactite-like lesions were present on the gross sample. We present these and compare them to the CT imaging.
Golimumab for the treatment of axial spondyloarthritis
Published in Expert Review of Clinical Immunology, 2016
Gita Gelfer, Lisa Perry, Atul Deodhar
Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disease of the axial skeleton that includes ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). Patients with AS experience chronic pain due to sacroiliac joint and spinal inflammation, and may develop spinal ankylosing with syndesmophyte formation. Tumor necrosis factor α inhibitors (TNFi) have shown promise in the management of AS and axSpA by targeting the underlying inflammatory process, and providing symptomatic relief. Whether they alter the progression of the disease is uncertain. Golimumab is a fully human IgG1 monoclonal antibody that targets and downregulates the pro-inflammatory cytokine TNF-α. The use of golimumab has been shown to reduce the signs and symptoms of axSpA as well as improve patient function and quality reported outcomes. This review focuses on the biological rationale and the results of clinical trials with golimumab for the treatment of axSpA.