Gas Physiology in Diving

Lundgren, Ceg; Harabin, A. L.; Bennett, Peter B.; Liew, Hugh D. Van; Thalmann, ED

doi:10.1002/cphy.cp040243

Cited by 2 publications

(1 citation statement)

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“…Hyperoxygenation also induces the precursors of the multipotential mesenchymal cells to mature into osteoblasts and at the same time encourages osteoclastic osteolysis such that remodeling is enhanced overall [90-96]. Finally, HBO-induced suppression of the inflammatory response promotes osteogenesis [97]. Acting in concert, these consequences of HBO therapy influence the cascade of events so that bone turnover is accelerated.…”

Section: Therapeutic Trialsmentioning

confidence: 99%

Vasculature deprivation – induced osteonecrosis of the rat femoral head as a model for therapeutic trials

Bejar

Peled

Boss

2005

Theor Biol Med Model

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Experimental Osteonecrosis: The authors' experience with experimentally produced femoral capital osteonecrosis in rats is reviewed: incising the periosteum at the base of the neck of the femur and cutting the ligamentum teres leads to coagulation necrosis of the epiphysis. The necrotic debris is substituted by fibrous tissue concomitantly with resorption of the dead soft and hard tissues by macrophages and osteoclasts, respectively. Progressively, the formerly necrotic epiphysis is repopulated by hematopoietic-fatty tissue, and replaced by architecturally abnormal and biomechanically weak bone. The femoral heads lose their smooth-surfaced hemispherical shape in the wake of the load transfer through the hip joint such that, together with regressive changes of the joint cartilage and inflammatory-hyperplastic changes of the articular membrane, an osteoarthritis-like disorder ensues.Therapeutic Choices: Diverse therapeutic options are studied to satisfy the different opinions concerning the significance of diverse etiological and pathogenic mechanisms: 1. Exposure to hyperbaric oxygen. 2. Exposure to hyperbaric oxygen and non-weight bearing on the operated hip. 3. Medication with enoxaparin. 4. Reduction of intraosseous hypertension, putting to use a procedure aimed at core decompression, namely drilling a channel through the femoral head. 5. Medication with vascular endothelial growth factor with a view to accelerating revascularization. 6. Medication with zoledronic acid to decrease osteoclastic productivity such that the remodeling of the femoral head is slowed.Glucocorticoid-related osteonecrosis appears to be apoptosis-related, thus differing from the vessel-deprivation-induced tissue coagulation found in idiopathic osteonecrosis. The quantities of TNF-α, RANK-ligand and osteoprotegerin are raised in glucocorticoid-treated osteoblasts so that the differentiation of osteoclasts is blocked. Moreover, the osteoblasts and osteocytes of the femoral cortex mostly undergo apoptosis after a lengthy period of glucocorticoid medication.

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Section: Therapeutic Trialsmentioning

confidence: 99%