1) The physis, also known as the growth plate, is located between the epiphysis and metaphysis of growing bones. It is responsible for the longitudinal growth of bones.
2) The physis contains several zones, including a germinal zone, proliferative zone, hypertrophic zone, and zone of provisional calcification. Blood is supplied to the physis from epiphyseal, perichondrial, and metaphyseal arteries.
3) Physeal injuries are classified using the Salter-Harris system. Type 1 and 2 fractures can usually be treated non-operatively, while more severe types often require open reduction and internal fixation.
conventional plates including different functions of screws, modes of plate application, Compression Mode.
Neutralization Mode.
Buttress plate.
Antiglide plate.
Bridge plating or span plating.
Tension band.
prebending precountouring
working length
lag screw
AO principles
biological fixation
MIPO
conventional plates including different functions of screws, modes of plate application, Compression Mode.
Neutralization Mode.
Buttress plate.
Antiglide plate.
Bridge plating or span plating.
Tension band.
prebending precountouring
working length
lag screw
AO principles
biological fixation
MIPO
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
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The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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2. SPECIFIC LEARNING OBJECTIVES
• At the end of the class , participants should be able to answer:
• What is physis
• What are zones of physis
• Vascular supply of physis
• Types of physeal injuries and management
3. PHYSIS
• Physis is also known as Growth plate
• The physis is a unique cartilaginous structure that varies in
thickness depending on age and location
• Located between epiphysis and metaphysis of growing bones
• Responsible for longitudinal growth of the bones
• Appears radiolucent on X ray
4. The cells on epiphyseal surface of the epiphyseal cartilage plate
continously proliferate until growth in length is completed.
• The mature cells on the diaphyseal surface of the epiphyseal
cartilage plate degenerate and are replaced by bone from the
diaphysis.
5. • When full growth is attained, the epiphyeal cartilage turns into
bone and can longer be found. This occurs between 18 to 25
years.
6.
7. • The peripheral margin of the physis consist of two specialized
areas :-
• ZONE OF RANVIER
• It is a wedge-shaped group of germinal cells that is continous
with the physis.
• It consists of three cell types-osteoblast , chondroblast and
fibroblast.
8. • Osteoblasts form the bony portion of the perichondrial ring at
the metaphysis.
• Chondroblasts contribute to the longitudinal growth
• Fibroblasts circumcsribe the zone and anchor it to
perichondrium above and below the growth plate.
9. • PERICHONDRIAL RING OF LACROIX
• It is a fibrous structure that is continous with the fibroblasts of the zone of
ranvier and the periosteum of the metaphysis.
• Perichondrial ring of LaCroix provides strong mechanical support for the
bone-cartilage junction of the growth plate.
10.
11. 1.GERMINAL ZONE (RESERVE ZONE)
Chondrocytes here are spherical and seperated by more matrix
compared with cells in other zones.
The cells contain many lipid vacuoles and abundant endoplasmic
reticulum, which is indicative of protien production.
12. • ZONE OF PROLIFERATION
• In the proliferative zone , chondrocytes are flattened and alinged in
columns parallel to the long axis of the bone.
• The oxygen tension is higher than in the other zones as is the cell
metabolism, resulting in high concentration of cell metabolism.
• The primary function of this zone is cellular proliferation, other
functions include the formation of intracellular matrix, proteoglycan
and collagen.
13. • ZONE OF HYPERTROPHY
• The chondrocyte become spherical and, at the base of the zone, are
five times the size of chondrocyte in the proliferative zone.
• It has been found that insulin-like growth factor stimulates the
hypertrophy of the chondrocytes in this zone, thus promoting
longitudinal growth.
• The oxygen tension inn this part of the hypertrophic zone is low,
anaerobic metabolism develops, and lactate accumulates.
14. • ZONE OF PROVISIONAL CALCIFICATION
• Very thin layer and adjoins directly to the diaphysis.
• The cells are necrotic and the calcified substance undergoes
cavitation and dissolution.
16. • VASCULAR SUPPLY OF PHYSIS
• EPIPHYSEAL ARTERIES supply blood to the epiphysis via
multiple branches to the growth plate, providing
vascularization into the proliferative zone.
• PERICHONDRIAL ARTERIES supply the fibrous structures
of the growth plate.
17. NUTRIENT ARTERY provides four-fifths of the metaphyseal
blood supply.
METAPHYSEAL ARTERIES supply the remainder of the blood
supply. The terminal branches of these vessels end in small
vascular loops or capillary tufts below the last intact row of
chondrocyte lacunae of growth plate.
19. PHYSEAL INJURIES
It has been estimated that 30% of fractures in children
involve a physis and most heal with out any long-term
complication.
The hypertrophic zone has the lowest resistance to shear
forces and thus is the most common anatomic site of
physeal injuries.
Ligaments in children are functionally stronger than the
physis. Therefore a higher proportion of injuries that
produce sprain in adults result in physeal fractures in
children.
22. • Type 1 fractures occur through the physis only , with or with out
displacement.
• It has good prognosis
• Type 2 fractures have a metaphyseal spike attached to the
seperated epiphysis with or with out displacemet.
• It is the most common type
23. • Type 3 fractures occur through the physis and epiphysis into the
joint with joint incongruity when the joint is displaced.
• Poor prognosis as the proliferative and reserve zones are
interrupted.
• Type 4 fractures occur in the metaphysis and pass through the
physis and epiphysis into the joint. Joint incongruity occurs with
displaced fractures.
24. • Poor prognosis as the proliferative and reserve zones are
interrupted.
• Type 5 fractures, which are usually diagnosed only in
retrospect, are compression or crush fractures of the physis ,
producing permanent damage and growth arrest.
• It has worst prognosis
25. • MANAGEMENT:
• TYPE 1 and 2 fractures can be treated non operatively by
closed reduction and immobiliztion with cast or slab
• Other types: open reduction and internal fixation