Sarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of... Show moreSarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of sarcopenia. The aim of the research presented in this thesis was to assess the implications of the use of different diagnostic criteria for sarcopenia, and to define the most accurate criteria for sarcopenia. Currently used diagnostic criteria for sarcopenia can be divided into criteria based on (1) low muscle mass, (2) low muscle strength, and (3) low walking speed. This thesis describes how muscle mass can be further divided into relative muscle mass and absolute muscle mass. A higher body or fat mass is associated with a lower relative muscle mass and with a higher absolute muscle mass. Higher relative muscle mass at old age is associated with better physical performance and with less insulin resistance. It is suggested to reserve the term sarcopenia to describe a low muscle mass and dynapenia to describe a low muscle strength. Most importantly, this research illustrates that it is impossible to compare studies about sarcopenia in scientific literature due to the use of different diagnostic criteria for sarcopenia. Show less
Pouwels, S.; Boer, A. de; Javaid, M.K.; Hilton-Jones, D.; Verschuuren, J.; Cooper, C.; ... ; Vries, F. de 2013
This thesis evaluates the benefit and safety of the treatment of painful long-standing osteoporotic vertebral compression fractures with percutaneous vertebroplasty. In addition, benefit and safety... Show moreThis thesis evaluates the benefit and safety of the treatment of painful long-standing osteoporotic vertebral compression fractures with percutaneous vertebroplasty. In addition, benefit and safety were investigated for specific treatment indications, risk factors for the occurrence of the two most common adverse events were identified and methods for optimization of the timing and execution of the procedure were explored. Show less
This thesis focuses on indications for and the clinical outcome of PVP for the treatment of long-standing OVCFs (i.e. after more than 8 weeks after onset of symptoms). Secondly, emphasis is made on... Show moreThis thesis focuses on indications for and the clinical outcome of PVP for the treatment of long-standing OVCFs (i.e. after more than 8 weeks after onset of symptoms). Secondly, emphasis is made on the value of vertebral body biopsy during the vertebroplasty procedure in order to aid in early diagnosis of unexpected conditions. Thirdly, in line with the worldwide emerging registration and control of medical implants, emphasis is put on the need for careful registration of cement leakages, since these count for the largest number of clinically relevant complications of the vertebroplasty procedure. The correlation between the amount of BME and the clinical outcome (pain) of PVP is discussed in Chapter 2. In Chapter 3, the outcome of a routine bone biopsy during PVP in treatment of __osteoporotic__ vertebral fractures, was studied. A prospective follow-up study on the clinical outcome (Quality of Life as measured with the SF 36) up to 36 months after PVP for long-standing OVCFs, is discussed in Chapter 4. In Chapter 5, the clinical outcome of PVP in patients with long-standing OVCFs, treated with either low or medium viscosity PMMA bone cement, was evaluated in a prospective comparative follow-up study. In Chapter 6, a new system for Evaluation and registration of eXtra vertebral cement leakage based on Anatomy and Volume of the leakage using CT-scan analysis (the EXACT classification system), is proposed. Finally, in Chapter 7 a review of the scientific evidence for PVP is presented. Show less
Vochteloo, A.J.H.; Burg, B.L.S.B. van der; Roling, M.A.; Leeuwen, D.H. van; Berg, P. van den; Niggebrugge, A.H.P.; ... ; Pilot, P. 2012
The basis of the presented investigations in this thesis is the modulation of signal inducers and their respective activated signaling cascades through intrinsic antagonistic feedback- and/or feed... Show moreThe basis of the presented investigations in this thesis is the modulation of signal inducers and their respective activated signaling cascades through intrinsic antagonistic feedback- and/or feed forward-loops. In particular, signal inducers of the transforming growth factor-_ superfamily were investigated on their impact on tissue development and maintenance. Thereby, the main focus lies on a group of proteins that are known as bone morphogenetic proteins (BMPs). Due to their wide impact, Dr. H. Reddi recently proposed a more suitable name to this cytokines: body morphogenetic proteins. The distinct terminology is also reflected in this book. Not only does this book discuss the impact of BMP signal modulation on osteoblast differentiation, it also focuses on BMPs as potential inducers of signaling drifts in fibrotic traits. Interestingly, BMPs can relay signals with different outcomes. They can be signal triggers themselves as investigated in the case of osteoblast differentiation, but they can also arrest signaling cascades, as shown for TGF-_ induced fibrosis. Up to date, more than fifteen different BMPs are known. One aim of this book is to biochemically characterize different BMPs on their potential to relay signals and how this signals can be governed to yield a specific medical benefit. It is well known that BMPs are tightly regulated on diverse interfaces throughout the cell. Thereby, the presented investigations focus on innate extracellular signaling modulators, as well as on synthetic small molecule inhibitors that have the potential to facilitate the development of new treatment strategies of certain human diseases. Show less
Berg, M. van den; Verdijk, N.A.; Bergh, J.P.W. van den; Geusens, P.P.; Talboom-Kamp, E.P.W.A.; Leusink, G.L.; Pop, V.J.M. 2011
