Skeletal tumor

Due to significant susceptibility artifact created by surgical hardware, MRl is not the study of choice for postoperative evaluations, especially for the assessment of healing of treated fractures and complications such as osteomyelitis or recurrence of a skeletal tumor (Fayad et al. 2005). When hardware is present, postoperative review of patients can be effectively accomplished by 3D volume rendering... 

Symptoms that are not a result of the direct effects of the tumor are termed paraneoplastic syndromes. They may be caused by substances secreted by the tumor or in response to the tumor and often occur in tissues far from the site of malignancy. Fhraneoplastic syndromes are numerous and affect a wide variety of systems, including the endocrine, neurologic, skeletal, renal, metabolic, vascular, and hematologic systems. 

Metastatic spread can occur by local extension, lymphatic drainage, or hematogenous dissemination.17 Lymph node metastases are more common in patients with large, undifferentiated tumors that invade the seminal vesicles. The pelvic and abdominal lymph node groups are the most common sites of lymph node involvement (Fig. 89-1). Skeletal metastases from hematogenous spread are the most common sites of distant... 

Bone is one of the few tissues capable of self-regeneration during skeletal deficiency, but this regeneration is limited by the nature and size of the defect. In general, skeletal deficiency occurs as a result of trauma, tumor, bone disease, or abnormality. In the case of severe fracture, bone will not heal by itself. For this reason, artificial bone substitutes may be required to restore routine function without damaging living tissue, and the selection of the bone graft substitute is the most important factor for better performance in vivo. 

In humans, also, preferential sites exist for the formation of metastasis from various primary tumors [reviewed in Zetter (Zl)]. Thus, bone is a preferred site for metastasis from primary malignancies in breast, prostate, and kidney, while liver is a frequent metastatic site for tumors originating in the colon. Different types of leukemias vary widely in their ability to spread to liver, lymph, bone, and spleen. Some organs, however, are rarely colonized by metastatic growth. These resistant sites include skeletal muscle, heart, and skin. 

Kim, N., Odgren, P.R., Kim, D K., Marks, S.C. Jr, and Choi, Y. (2000) Diverse Roles of the Tumor Necrosis Factor Family Member TRANCE in Skeletal Physiology Revealed by TRANCE Deficiency and Partial Rescne by a Lymphocyte-Expressed TRANCE Transgene. Proceedings of the National Academy of Sciences of the USA 97, 10905-10910. 

Metastatic cancer- May be used secondarily in women with advancing inoperable metastatic (skeletal) breast cancer who are 1 to 5 years postmenopausal. Primary goals of therapy include ablation of the ovaries. This treatment has been used in premenopausal women with breast cancer who have benefited from oophorectomy and have a hormone-responsive tumor. 

Sarcomas are tumors of mesenchymal origin, arising in skeletal tissues and extra-skeletal connective tissues including the nerves. They are very rare and mainly effect a younger population. Sarcomas of soft tissues are relatively insensitive to drug treatment and are therefore not discussed in detail in this chapter. A systematic review of fourteen trials of doxorubicin-based adjuvant chemotherapy for the treatment of soft tissue sarcomas involving 1568 patients concluded Doxorubicin-based adjuvant chemotherapy appears to significantly improve time to local and distant recurrence and overall recurrence-free survival in adults with localised resectable soft tissue sarcoma. There is some evidence of a trend towards improved overall survival (see Sarcoma Meta-analysis Collaboration, 1999). 

Skeletal sarcomas can be largely divided into osteosarcomas on one hand and the Ewings family of sarcomas, including peripheral neuro-ectodermal tumors or PNETs, on the other hand. Both groups share a sensitivity to chemotherapy and need to be managed by multidisciplinary teams to optimize potential curability. 

Mechanism of Action A bisphosphonate that inhibits the resorption of mineralized bone and cartilage inhibits increased osteoclastic activity and skeletal calcium release induced by stimulatory factors produced by tumors. Therapeutic Effect Increases urinary calcium and phosphorus excretion decreases serum calcium and phosphorus levels. 

Bone tissue has a rather unique capability among human tissues in response to injury or other changes that alter its mechanical requirements it can continuously remodel itself to meet those mechanical needs best [51, 52], For example, when a bone fractures, the body creates new bone to connect the broken fragments together, and then remodels the new bone to optimize its mechanical function in the particular region of the skeleton that the fracture has occurred. Human skeletal tissue has several functions, but, when a bone is fractured by trauma, or removed surgically due to disease or tumor formation, we only seek solutions so that its mechanical function can be carried out [53, 54],... 

The major problem associated with plasmid based gene delivery to skeletal muscle is the relatively low efficiency of transfection. Recent developments have demonstrated improved delivery associated with the application of an electrical field to the muscle after injection of the plasmid DNA (109). It is clear that the application of naked DNA close to the site of pathology and away from degradative elements such as plasma is thus a viable strategy for gene delivery. However, this method is ineffective if DNA dosing to anatomically inaccessible sites (e.g., solid tumors in organs) is desired. 

Kawase, A., Nomura, T., Yasuda, K., Kobayashi, N., Hashida, M., Takakura, Y. (2003). Disposition and gene expression characteristics in solid tumors and skeletal muscle after direct injection of naked plasmid DNA in mice. J. Pharm. Sci., 92(6), 1295-1304. 

Chemicals known as piperazines have industrial applications worldwide, and it is legal to purchase bulk quantities of these chemicals on the Internet for this purpose. By changing chemical groups added to the basic piperazine skeletal structure, different chemicals can be formed that vary considerably in their industrial, medical, and mind-altering properties. Piperazine citrate and related compounds destroy intestinal worms, making these chemicals useful in both medical and veterinary preparations. Other medicinal and mind-altering qualities of piperazines are being exploited as possible treatments of depression, psychosis, Alzheimer s disease, and tumors. 

Transfection efficacy of naked DNA can be increased by physical methods such as electroporation and sonication. Electroporation employs electric pulses to punch holes in the cell membrane, usually smaller than 10 nm but larger than oligonucleotides. With the use of electroporation, DNA was delivered into the cytosol of cells by diffusion. Since its introduction in 1982, in vivo transfection has been achieved in skeletal muscle, fiver, skin, tumors, testis, and the kidney. Tsujie et al. (2001) developed a method to target glomeruli using electroporation in vivo wherein injection of plasmid DNA via the renal artery was followed by application of electric fields. The kidney was electroporated by sandwiching the organ... 

Figure 6. Whole body nitrogen balance and cellular hydration of skeletal muscle. Data were obtained from humans. A healthy subjects (n = 17) B liver tumors (n = 5), C polytrauma day 2 and D day 9 after trauma (n = 11) E acute necrotizing pancreatitis (n = 6) F burn patients (n = 4). (From Haussinger et. al., 1993.)...

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