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This literature search concerning the potential role of spinal orthoses for rehabilitation and treatment of atraumatic vertebral fractures between Th4 and L5 with osteoporosis and without any evidence for a secondary cause, provided no evidence for the benefits of traditional rigid thoracolumbar corsets, which only had a poor compliance. In addition, there are indications that these rigid corsets may even worsen the disease condition especially in the long-term. Wearing these corsets can result in further loss of muscle mass and strength followed by loss of bone and bone mass. Both together can worsen the functional capabilities of patients. On the other hand the functional capabilities of patients suffering from acute or subacute vertebral fractures due to osteoporosis can be improved by flexible backpack orthoses. These spinal orthoses generate an extension moment about the spine, increase perception of one's own body posture via biofeedback and therefore lead to improved posture. This results in a strengthening of the trunk musculature, a more stable equilibrium and a reduction of pain, which are associated with an increase in functional capabilities and improvement in the parameters of the quality of life. During a long-term phase of rehabilitation individually tailored spinal orthoses guarantee a high level of compliance and adherence. Finally, there is high-quality evidence that spinal orthoses with additional weighting can improve the equilibrium in women with vertebral osteoporosis and hyperkyphosis. Future studies should also be carried out with other groups of patients.

. Glucose-dependent expansion of pancreatic ␤-cells by the protein p8 in vitro and in vivo. Am J Physiol Endocrinol Metab 291: E1168 -E1176, 2006. First published July 18, 2006 doi:10.1152/ajpendo.00436.2005.-p8 protein expression is known to be upregulated in the exocrine pancreas during acute pancreatitis. Own previous work revealed glucose-dependent p8 expression also in endocrine pancreatic ␤-cells. Here we demonstrate that glucose-induced INS-1 ␤-cell expansion is preceded by p8 protein expression. Moreover, isopropylthiogalactoside (IPTG)-induced p8 overexpression in INS-1 ␤-cells (p8-INS-1) enhances cell proliferation and expansion in the presence of glucose only. Although ␤-cell-related gene expression (PDX-1, proinsulin I, GLUT2, glucokinase, amylin) and function (insulin content and secretion) are slightly reduced during p8 overexpression, removal of IPTG reverses ␤-cell function within 24 h to normal levels. In addition, insulin secretion of p8-INS-1 ␤-cells in response to 0 -25 mM glucose is not altered by preceding p8-induced ␤-cell expansion. Adenovirally transduced p8 overexpression in primary human pancreatic islets increases proliferation, expansion, and cumulative insulin secretion in vitro. Transplantation of mock-transduced control islets under the kidney capsule of immunosuppressed streptozotocin-diabetic mice reduces blood glucose and increases human C-peptide serum concentrations to stable levels after 3 days. In contrast, transplantation of equal numbers of p8-transduced islets results in a continuous decrease of blood glucose and increase of human C-peptide beyond 3 days, indicating p8-induced expansion of transplanted human ␤-cells in vivo. This is underlined by a doubling of insulin content in kidneys containing p8-transduced islet grafts explanted on day 9. These results establish p8 as a novel molecular mediator of glucoseinduced pancreatic ␤-cell expansion in vitro and in vivo and support the notion of existing ␤-cell replication in the adult organism.diabetes; islet transplantation; insulin secretion; ␤-cell proliferation TO DATE, IT IS CONTROVERSIAL whether neogenesis from pancreatic precursor cells present in ducts (2) and islets of Langerhans (45) or self duplication of existing ␤-cells (12) contributes to the formation of new pancreatic ␤-cells in the adult organism. The debate highlights that mechanisms of ␤-cell homeostasis and regenerative repair are not well understood. In particular, knowledge about molecular regulation of pancreatic ␤-cell mass expansion is limited. Important examples of factors associated with ␤-cell expansion are the incretin hormone glucagon-like peptide (GLP)-1, the GLP-1 analogon exendin (Ex)-4 (28), and the cellular molecular mediator cyclin D2 (17).Here we report on ␤-cell-expanding properties of the protein p8, which is considered to be a member of the high-mobility group (HMG)-I/Y transcription factor family despite low sequence homology (14). p8 is expressed in a broad range of tissues (25, 41) and is degraded via the ubiquitin/proteasome pathw...

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Osteomalacia is a bone disease caused by impaired skeletal mineralization. Vitamin D dependent types have to be distinguished from hypophosphatemic forms. Typical signs and symptoms include diffuse bone pain, muscle weakness and fragility fractures. The fracture pattern in osteomalacia is typically different from that of osteoporosis. Fragility fractures of the pelvis, sacrum, distal parts of the foot, proximal tibia and ribs are indicators for osteomalacia, whereas femoral neck and vertebral fractures (wedged vertebra, fish vertebra, vertebra plana and cover plate impression fractures) are typical for osteoporosis. Unspecific clinical features may be the reason for a delayed diagnosis. The correct classification of the complaint is dependent on the knowledge of the pathophysiology of osteomalacia and performance of additional bone-specific examinations. Determination of specific laboratory parameters should follow a rational algorithm, supplemented by imaging methods and a bone biopsy.

Three different biotopes, groundwater, surface water, and activated sludge, were examined and the total colony count on nutrient agar determined. The bacteria that could be isolated from the agar plates were identified and their in vitro activities investigated. Three principal approaches were used: (1) isolates were identified and the results used in a numerical analysis to determine their similarity; (2) the different physiological properties of isolates originating from a single biotope were compiled and used to characterize the community (collective total activity); and (3) the diversity of the physiological properties of the isolates of all populations was determined; on the basis of main characters a "heterotrophic" diversity index was calculated. The possibility of using a polyphasic ecological study to characterize aquatic bacterial communities is considered.

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Pregnancy and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis, which occurs in the last trimester or postpartum. So far 100 cases have been published. The leading symptoms are severe low back pain or less frequently hip pain. Many patients develop postpartum depression due to inability to care for the baby and vertebral fractures. The therapeutic decision has to be made individually but teriparatid and bisphosphonates seem to be the best option. We report the clinical course (16 years) of a 37-year-old patient with PLO, who suffered 6 vertebral fractures. There were severe physical limitations and mental problems caused by the disease. The patient was treated by multimodal therapy including physiotherapy and psychotherapy and bisphosphonates were given. The time between the onset of symptoms and diagnosis was 5 months. No further fractures occurred in the following 16 years. The physical and mental condition significantly improved.