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Sample records for graft model autograft

  1. Heterografting with nonself rootstocks induces genes involved in stress responses at the graft interface when compared with autografted controls

    PubMed Central

    Cookson, S. J.

    2014-01-01

    Although grafting is widely used in the agriculture of fruit-bearing crops, little is known about graft union formation in particular when two different species are grafted together. It is fascinating that two different plant species brought together can develop harmoniously as one organism for many decades. The objective of this study was to determine whether grafting two different grapevine genotypes alters gene expression at the graft interface in comparison to the presumably wound-like gene expression changes induced in autografts. Gene expression at the graft interface was studied 3, 7, 14, and 28 d after grafting in hetero- and autografts of grapevine (Vitis spp.). Genes differentially expressed between the hetero- and autografts during graft union formation were identified. These genes were clustered according to their expression profile over the time course. MapMan and Gene Ontology enrichment analysis revealed the coordinated upregulation of genes from numerous functional categories related to stress responses in the hetero- compared to the autografts. This indicates that heterografting with nonself rootstocks upregulates stress responses at the graft interface, potentially suggesting that the cells of the graft interface can detect the presence of a nonself grafting partner. PMID:24692649

  2. Periumbilical fat auto-graft associated to a porous orbital implant for socket reconstruction after enucleation.

    PubMed

    Medel, Ramon; Alonso, Tirso; Pelaez, Francisco; Vasquez, LuzMaria

    2016-08-01

    Having to remove the sclera, fat and the optic nerve in patients undergoing an enucleation, translates in a larger volume that needs to be replaced to achieve good motility and aesthetic results. Using a 20 or 22 mm implant can only partially replace the removed volume. We report the results of our enucleation technique, which includes the use of a porous orbital implant combined with a primary fat graft to replace a higher percentage of the removed volume to achieve a better cosmetic outcome and to avoid implant related complications in high risk patients. Prospective, non-randomized study of enucleated patients for whom porous orbital implantation was performed with anterior placement of a fat auto-graft. The development of implant extrusion or exposure was recorded as well as the presence of conjunctival wound dehiscence and infection. Orbital volume was clinically and radiologically evaluated as well. Twenty-eight patients were included, with a postop follow-up of at least 6 months (6-79 months). No cases of migration or extrusion were found. One case of a large exposure resolved completely. All MRI demonstrated proper implant-graft integration and vascularisation. The aesthetic result and the symmetry were very adequate, with Hertel differences of less than 2 mm in all cases and good motility range. The fat graft is well tolerated, showing low incidence of implant-related complications whilst maintaining good volume and motility. PMID:27322024

  3. Carbon dioxide laser ablation with immediate autografting in a full-thickness porcine burn model.

    PubMed Central

    Glatter, R D; Goldberg, J S; Schomacker, K T; Compton, C C; Flotte, T J; Bua, D P; Greaves, K W; Nishioka, N S; Sheridan, R L

    1998-01-01

    OBJECTIVE: To compare the long-term clinical and histologic outcome of immediate autografting of full-thickness burn wounds ablated with a high-power continuous-wave CO2 laser to sharply débrided wounds in a porcine model. SUMMARY BACKGROUND DATA: Continuous-wave CO2 lasers have performed poorly as tools for burn excision because the large amount of thermal damage to viable subeschar tissues precluded successful autografting. However, a new technique, in which a high-power laser is rapidly scanned over the eschar, results in eschar vaporization without significant damage to underlying viable tissues, allowing successful immediate autografting. METHODS: Full-thickness paravertebral burn wounds measuring 36 cm2 were created on 11 farm swine. Wounds were ablated to adipose tissue 48 hours later using either a surgical blade or a 150-Watt continuous-wave CO2 laser deflected by an x-y galvanometric scanner that translated the beam over the tissue surface, removing 200 microm of tissue per scan. Both sites were immediately autografted and serially evaluated clinically and histologically for 180 days. RESULTS: The laser-treated sites were nearly bloodless. The mean residual thermal damage was 0.18+/-0.05 mm. The mean graft take was 96+/-11% in manual sites and 93+/-8% in laser sites. On postoperative day 7, the thickness of granulation tissue at the graft-wound bed interface was greater in laser-debrided sites. By postoperative day 180, the manual and laser sites were histologically identical. Vancouver scar assessment revealed no differences in scarring at postoperative day 180. CONCLUSIONS: Long-term scarring, based on Vancouver scar assessments and histologic evaluation, was equivalent at 6 months in laser-ablated and sharply excised sites. Should this technology become practical, the potential clinical implications include a reduction in surgical blood loss without sacrifice of immediate engraftment rates or long-term outcome. Images Figure 1. Figure 2. Figure 3

  4. Total venous inflow occlusion and pericardial auto-graft reconstruction for right atrial hemangiosarcoma resection in a dog.

    PubMed

    Verbeke, Fei; Binst, Dominique; Stegen, Ludo; Waelbers, Tim; de Rooster, Hilde; Van Goethem, Bart

    2012-10-01

    A sizeable right atrial hemangiosarcoma in a 6-year-old Bordeaux dog, World Health Organization (WHO) stage 2, was excised using total venous inflow occlusion. The defect was restored with a non-vascularized pericardial auto-graft. The dog had a disease-free interval of 7 mo. The dog was euthanized 9 months later, at which time there were distant metastases but no indication of local recurrence. PMID:23543933

  5. Total venous inflow occlusion and pericardial auto-graft reconstruction for right atrial hemangiosarcoma resection in a dog

    PubMed Central

    Verbeke, Fei; Binst, Dominique; Stegen, Ludo; Waelbers, Tim; de Rooster, Hilde; Van Goethem, Bart

    2012-01-01

    A sizeable right atrial hemangiosarcoma in a 6-year-old Bordeaux dog, World Health Organization (WHO) stage 2, was excised using total venous inflow occlusion. The defect was restored with a non-vascularized pericardial auto-graft. The dog had a disease-free interval of 7 mo. The dog was euthanized 9 months later, at which time there were distant metastases but no indication of local recurrence. PMID:23543933

  6. Posterolateral spinal fusion in a rabbit model using a collagen–mineral composite bone graft substitute

    PubMed Central

    Vizesi, F.; Cornwall, G. B.; Bell, D.; Oliver, R.; Yu, Y.

    2009-01-01

    Choosing the appropriate graft material to participate in the healing process in posterolateral spinal fusion continues to be a challenge. Combining synthetic graft materials with bone marrow aspirate (BMA) and autograft is a reasonable treatment option for surgeons to potentially reduce or replace the need for autograft. FormaGraft, a bone graft material comprising 12% bovine-derived collagen and 88% ceramic in the form of hydroxyapatite (HAp) and beta tricalcium phosphate (β-TCP) was evaluated in three possible treatment modalities for posterior spinal fusion in a standard rabbit model. These three treatment groups were FormaGraft alone, FormaGraft soaked in autogenous BMA, and FormaGraft with BMA and iliac crest autograft. No statistically demonstrable benefits or adverse effects of the addition of BMA were found in the current study based on macroscopic, radiology or mechanical data. This may reflect, in part, the good to excellent results of the collagen HA/TCP composite material alone in a well healing bony bed. Histology did, however, reveal a benefit with the use of BMA. Combining FormaGraft with autograft and BMA achieved results equivalent to autograft alone. The mineral and organic nature of the material provided a material that facilitated fusion between the transverse processes in a standard preclinical posterolateral fusion model. PMID:19475437

  7. A polycaprolactone-tricalcium phosphate composite scaffold as an autograft-free spinal fusion cage in a sheep model.

    PubMed

    Li, Yi; Wu, Zhi-gang; Li, Xiao-kang; Guo, Zheng; Wu, Su-hua; Zhang, Yong-quan; Shi, Lei; Teoh, Swee-hin; Liu, Yu-chun; Zhang, Zhi-yong

    2014-07-01

    Titanium (Ti) based spinal fusion cages are frequently used in the clinics for the treatment of spinal degeneration and related diseases, however, their further clinical application is generally harassed by several drawbacks such as stress shielding, non-biodegradability and additional bone grafting procedure. Our earlier work has demonstrated the efficacy of a biodegradable macro-porous polycaprolactone-tricalcium phosphate (PCL-TCP) composite scaffold in promoting bony tissue ingrowth as well as its ability to sustain mechanical loads upon implantation into an orthotopic defect site. In this study, we investigated the use of PCL-TCP scaffold as an autograft-free spinal fusion cage in a preclinical sheep model over 12 months, and compared the fusion efficacy against Ti cages incorporated with autografts. Results showed that despite PCL-TCP scaffold as an autograft-free cage attaining a slower fusion rate at early stage (6 month), it achieved similar degree of spinal fusion efficacy as Ti cages aided with autograft at 12 month post-operation as evidenced by the radiographic and histological evaluation. PCL-TCP cages alone demonstrated better bone ingrowth with 2.6 fold higher bone/interspace ratio (B/I) and more homogeneous bone tissue distribution compared with that of the Ti cages (88.10  ±  3.63% vs. 33.74  ±  2.78%, p < 0.05) as seen from the histological and micro-CT analysis. Moreover, besides the bone tissue ingrowth, a quantitative approach was illustrated to accurately evaluate the osteointegration of fusion cage with surrounding bone tissue, and showed a 1.36 fold higher degree of osteointegration occurred in PCL-TCP cage group than Ti cage group (CS/PC: 79.31  ±  3.15% vs 58.44  ±  2.43%, p < 0.05). Furthermore, biomechanical analysis showed comparable mechanical strength of fused segments in both groups in terms of the range of motion and stiffness at 12 month (p > 0.05). The degradation profile of the PCL-TCP cages was noted

  8. Free vascularised fibular grafting with OsteoSet®2 demineralised bone matrix versus autograft for large osteonecrotic lesions of the femoral head.

    PubMed

    Feng, Yong; Wang, Shanzhi; Jin, Dongxu; Sheng, Jiagen; Chen, Shengbao; Cheng, Xiangguo; Zhang, Changqing

    2011-04-01

    The aim of this study was to compare the safety and efficacy of OsteoSet®2 DBM with autologous cancellous bone in free vascularised fibular grafting for the treatment of large osteonecrotic lesions of the femoral head. Twenty-four patients (30 hips) with large osteonecrotic lesions of the femoral head (stage IIC in six hips, stage IIIC in 14, and stage IVC in ten, according to the classification system of Steinberg et al.) underwent free vascularised fibular grafting with OsteoSet®2 DBM. This group was retrospectively matched to a group of 24 patients (30 hips) who underwent free vascularised fibular grafting with autologous cancellous bone during the same time period according to the aetiology, stage, and size of the lesion and the mean preoperative Harris hip score. A prospective case-controlled study was then performed with a mean follow-up duration of 26 months. The results show no statistically significant differences between the two groups in overall clinical outcome or the radiographic assessment. Furthermore, no adverse events related to the use of the OsteoSet®2 DBM were observed. The results demonstrate that OsteoSet®2 DBM combined with autograft bone performs equally as well as that of autologous bone alone. Therefore, OsteoSet®2 DBM can be used as a safe and effective graft extender in free vascularised fibular grafting for large osteonecrotic lesions of the femoral head. PMID:20012040

  9. Skin graft

    MedlinePlus

    Skin transplant; Skin autografting; FTSG; STSG; Split thickness skin graft; Full thickness skin graft ... site. Most people who are having a skin graft have a split-thickness skin graft. This takes ...

  10. Adhesion monitoring of skin grafts by photoacoustic measurement: experiment using rat allograft models

    NASA Astrophysics Data System (ADS)

    Yamazaki, Mutsuo; Sato, Shunichi; Saito, Daizo; Okada, Yoshiaki; Ashida, Hiroshi; Obara, Minoru

    2004-07-01

    Adhesion monitoring of grafted skins is very important in successful treatment of severe burns and traumas. However, current diagnosis of skin grafting is usually done by visual observation, which is not reliable and gives no quantitative information on the skin graft adhesion. When the grafted skin adheres well, neovascularities will be generated in the grafted skin tissue, and therefore adhesion may be monitored by detecting the neovascularities. In this study, we attempted to measure photoacoustic signals originate from the neovascularities by irradiating the grafted skins with 532-nm nanosecond light pulses in rat autograft and allograft models. The measurement showed that immediately after skin grafting, photoacoustic signal originate from the blood in the dermis was negligibly small, while 6 - 24 hours after skin grafting, signal was observed from the dermis in the graft. We did not observe a significant difference between the signals from the autograft and the allograft models. These results indicate that neovascularization would take place within 6 hours after skin grafting, and the rejection reaction would make little effect on adhesion within early hours after grafting.

  11. Anterior cruciate ligament reconstruction in a rabbit model using silk-collagen scaffold and comparison with autograft.

    PubMed

    Bi, Fanggang; Shi, Zhongli; Liu, An; Guo, Peng; Yan, Shigui

    2015-01-01

    The objective of the present study was to perform an in vivo assessment of a novel silk-collagen scaffold for anterior cruciate ligament (ACL) reconstruction. First, a silk-collagen scaffold was fabricated by combining sericin-extracted knitted silk fibroin mesh and type I collagen to mimic the components of the ligament. Scaffolds were electron-beam sterilized and rolled up to replace the ACL in 20 rabbits in the scaffold group, and autologous semitendinosus tendons were used to reconstruct the ACL in the autograft control group. At 4 and 16 weeks after surgery, grafts were retrieved and analyzed for neoligament regeneration and tendon-bone healing. To evaluate neoligament regeneration, H&E and immunohistochemical staining was performed, and to assess tendon-bone healing, micro-CT, biomechanical test, H&E and Russell-Movat pentachrome staining were performed. Cell infiltration increased over time in the scaffold group, and abundant fibroblast-like cells were found in the core of the scaffold graft at 16 weeks postoperatively. Tenascin-C was strongly positive in newly regenerated tissue at 4 and 16 weeks postoperatively in the scaffold group, similar to observations in the autograft group. Compared with the autograft group, tendon-bone healing was better in the scaffold group with trabecular bone growth into the scaffold. The results indicate that the silk-collagen scaffold has considerable potential for clinical application. PMID:25938408

  12. Anterior Cruciate Ligament Reconstruction in a Rabbit Model Using Silk-Collagen Scaffold and Comparison with Autograft

    PubMed Central

    Bi, Fanggang; Shi, Zhongli; Liu, An; Guo, Peng; Yan, Shigui

    2015-01-01

    The objective of the present study was to perform an in vivo assessment of a novel silk-collagen scaffold for anterior cruciate ligament (ACL) reconstruction. First, a silk-collagen scaffold was fabricated by combining sericin-extracted knitted silk fibroin mesh and type I collagen to mimic the components of the ligament. Scaffolds were electron-beam sterilized and rolled up to replace the ACL in 20 rabbits in the scaffold group, and autologous semitendinosus tendons were used to reconstruct the ACL in the autograft control group. At 4 and 16 weeks after surgery, grafts were retrieved and analyzed for neoligament regeneration and tendon-bone healing. To evaluate neoligament regeneration, H&E and immunohistochemical staining was performed, and to assess tendon-bone healing, micro-CT, biomechanical test, H&E and Russell-Movat pentachrome staining were performed. Cell infiltration increased over time in the scaffold group, and abundant fibroblast-like cells were found in the core of the scaffold graft at 16 weeks postoperatively. Tenascin-C was strongly positive in newly regenerated tissue at 4 and 16 weeks postoperatively in the scaffold group, similar to observations in the autograft group. Compared with the autograft group, tendon-bone healing was better in the scaffold group with trabecular bone growth into the scaffold. The results indicate that the silk-collagen scaffold has considerable potential for clinical application. PMID:25938408

  13. Interpositional substitution of free vas deferens segment autografts in rat: feasibility and potential implications

    PubMed Central

    2014-01-01

    Background Insufficient vas length for performing a tension-free vasovasostomy is a problem occasionally encountered by microsurgeons. Herein we evaluated utilization of a non-vascularized vas deferens autograft in a rat model. Methods Segments of isolated vas deferens, 2.5 cm in length, were used as bilateral autografts in 15 rats. Each autograft was implanted between the two transected ends of vas deferens using end-to-end anastomosis. Fertility, sperm motility, and graft survival was evaluated and compared with the control group. Results At the end of the 3 months, 9/15 (60%) rats were able to breed successfully and 24 (80%) vas grafts were patent and viable. Large granulomata developed at the proximal anastomosis sites in 6 (20%) autografts that failed. Unilateral minimal fluid leakage was observed in 6 (20%) of the proximal (testicular end) anastomosis sites in those rats that were able to breed. Histological evaluations demonstrated that graft survival was associated with mild to severe changes in the structure of the vas autograft. On semen analysis 76% of the sperms in the experimental group had forward motility compared to 78% in the control group (p > 0.05). Conclusions Vas autograft can successfully be performed in a rat model with ultimate breeding capability. PMID:25103862

  14. Effects of grafting on porous metal ingrowth. A canine model.

    PubMed

    Lewis, C G; Jones, L C; Hungerford, D S

    1997-06-01

    Twenty-five mongrel dogs were studied using implantation of autograft, fresh-frozen allograft, and beta-tricalcium phosphate around a porous-coated chrome-cobalt plug in the distal femoral metaphysis; interference-fit and overreamed control specimens were also studied. Over the course of this 4-month study, bone ingrowth through the grouting materials into the center plug was noted for autologous, allograft, and ceramic specimens. Quantitatively, in terms of push-out strength and histology, there were no significant differences between grafted groups; significantly higher push-out strengths were attained in each grafted subgroup compared with nongrafted, overreamed control subjects. In the setting of uncemented revision total hip arthroplasty, bone-grafting is frequently required. Because of the limited availability of autogenous bone and the potential liabilities of allograft material, attention has been given to bone substitutes. On the basis of this preliminary study, bone ingrowth into a porous metal substrate has been documented to occur through autograft, allograft, or ceramic grouting agents. Within the limits of this nonloaded experimental model, it appears that these materials are comparable in terms of their osteoconductive capability. Even in the optimal laboratory situation, bone ingrowth does not appear to occur in a canine model across a nongrafted 2-mm gap with regularity over a 16-week period. PMID:9195322

  15. A porcine model of full-thickness burn, excision and skin autografting

    PubMed Central

    Branski, Ludwik K.; Mittermayr, Rainer; Herndon, David N.; Norbury, William B.; Masters, Oscar E.; Hofmann, Martina; Traber, Daniel L.; Redl, Heinz; Jeschke, Marc G.

    2008-01-01

    Acute burn wounds often require early excision and adequate coverage to prevent further hypothermia, protein and fluid losses, and the risk of infection. Meshed autologous skin grafts are generally regarded as the standard treatment for extensive full-thickness burns. Graft take and rate of wound healing, however, depend on several endogenous factors. This paper describes a standardized reproducible porcine model of burn and skin grafting which can be used to study the effects of topical treatments on graft take and re-epithelialization. Procedures provide a protocol for successful porcine burn wound experiments with special focus on pre-operative care, anesthesia, burn allocation, excision and grafting, postoperative treatment, dressing application, and specimen collection. Selected outcome measurements include percent area of wound closure by planimetry, wound assessment using a clinical assessment scale, and histological scoring. The use of this standardized model provides burn researchers with a valuable tool for the comparison of different topical drug treatments and dressing materials in a setting that closely mimics clinical reality. PMID:18617332

  16. Increased Risk of Revision after ACL Reconstruction with Soft Tissue Allograft Compared to Autograft

    PubMed Central

    Maletis, Gregory; Chen, Jason; Inacio, Maria Carolina Secorun; Love, Rebecca; Funahashi, Tadashi Ted

    2016-01-01

    Objectives: The use of allograft tissue for anterior cruciate ligament reconstruction (ACLR) remains controversial. Numerous meta-analysis and systematic reviews of small clinical studies have not found differences between autograft and allograft outcomes but large registry studies have shown an increased risk of revision with allografts. The purpose of this study was to compare the risk of aseptic revision between bone-patellar tendon-bone (BPTB) autografts, hamstring tendon autografts and soft tissue allografts. Methods: A retrospective cohort study of prospectively collected data was conducted using an US ACLR Registry. A cohort of primary unilateral ACLR cases reconstructed with BPTB autografts, hamstring autografts and soft tissue allografts (from any site) was identified. Aseptic revision was the end point of the study. Type of graft and allograft processing methods (non-processed, <1.8Mrads with and without chemical processing (Allowash or AlloTrue methods), >1.8 Mrads irradiation with and without chemical processing, and chemical processing alone (BioCleanse)) were the exposures of interest evaluated. Time from surgery was evaluated as an effect modifier. All analyses were adjusted for age, gender, and race. Kaplan-Meier curves and Cox proportional hazard models were employed. Hazard ratios (HR), 95% confidence intervals (CI) are provided. Results: The cohort had 14015 cases, 8924 (63.7%) were male, 6397 (45.6%) were White, 4557 (32.5%) cases used BPTB autograft, 3751 (26.8%) cases used soft tissue allograft and 5707 (40.7%) cases used hamstring autograft. The median age was 34.6 years-old (IQR 24.1-43.2) for allograft cases and 24.3 years-old (IQR 17.7-33.8) for hamstring autograft cases, and 22.0 years-old (IQR 17.6-30.0) for BPTB autograft cases. Compared to hamstring tendon autografts, an increased risk of revision was found in allografts processed with >1.8Mrads without chemical processing after 2.5 years (HR: 3.88 95%CI 1.48-10.12), and >1.8Mrads with

  17. Autograft Substitutes: Conduits and Processed Nerve Allografts.

    PubMed

    Safa, Bauback; Buncke, Gregory

    2016-05-01

    Manufactured conduits and allografts are viable alternatives to direct suture repair and nerve autograft. Manufactured tubes should have gaps less than 10 mm, and ideally should be considered as an aid to the coaptation. Processed nerve allograft has utility as a substitute for either conduit or autograft in sensory nerve repairs. There is also a growing body of evidence supporting their utility in major peripheral nerve repairs, gap repairs up to 70 mm in length, as an alternative source of tissue to bolster the diameter of a cable graft, and for the management of neuromas in non-reconstructable injuries. PMID:27094886

  18. Athymic rat model for evaluation of engineered anterior cruciate ligament grafts.

    PubMed

    Leong, Natalie L; Kabir, Nima; Arshi, Armin; Nazemi, Azadeh; Wu, Ben M; McAllister, David R; Petrigliano, Frank A

    2015-01-01

    Anterior cruciate ligament (ACL) rupture is a common ligamentous injury that often requires surgery because the ACL does not heal well without intervention. Current treatment strategies include ligament reconstruction with either autograft or allograft, which each have their associated limitations. Thus, there is interest in designing a tissue-engineered graft for use in ACL reconstruction. We describe the fabrication of an electrospun polymer graft for use in ACL tissue engineering. This polycaprolactone graft is biocompatible, biodegradable, porous, and is comprised of aligned fibers. Because an animal model is necessary to evaluate such a graft, this paper describes an intra-articular athymic rat model of ACL reconstruction that can be used to evaluate engineered grafts, including those seeded with xenogeneic cells. Representative histology and biomechanical testing results at 16 weeks postoperatively are presented, with grafts tested immediately post-implantation and contralateral native ACLs serving as controls. The present study provides a reproducible animal model with which to evaluate tissue engineered ACL grafts, and demonstrates the potential of a regenerative medicine approach to treatment of ACL rupture. PMID:25867958

  19. Development of a long-term ovine model of cutaneous burn and smoke inhalation injury and the effects of early excision and skin autografting

    PubMed Central

    Yamamoto, Yusuke; Enkhbaatar, Perenlei; Sakurai, Hiroyuki; Rehberg, Sebastian; Asmussen, Sven; Ito, Hiroshi; Sousse, Linda E.; Cox, Robert A.; Deyo, Donald J.; Traber, Lillian D.; Traber, Maret G.; Herndon, David N.; Traber, Daniel L.

    2013-01-01

    Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal experiments support the concept of early burn wound excision, and show improved survival and infectious outcomes, we have developed a new chronic ovine model of burn and smoke inhalation injury with early excision and skin grafting that can be used to investigate lung pathophysiology over a period of 3 weeks. Materials and methods Eighteen female sheep were surgically prepared for this study under isoflurane anesthesia. The animals were divided into three groups: an Early Excision group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke followed by early excision and skin autografting at 24 h after injury, n = 6), a Control group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke without early excision, n = 6) and a Sham group (no injury, no early excision, n = 6). After induced injury, all sheep were placed on a ventilator and fluid-resuscitated with Lactated Ringers solution (4 mL/% TBS/kg). At 24 h post-injury, early excision was carried out to fascia, and skin grafting with meshed autografts (20/1000 in., 1:4 ratio) was performed under isoflurane anesthesia. At 48 h post-injury, weaning from ventilator was begun if PaO2/FiO2 was above 250 and sheep were monitored for 3 weeks. Results At 96 h post-injury, all animals were weaned from ventilator. There are no significant differences in PaO2/FiO2 between Early Excision and Control groups at any points. All animals were survived for 3 weeks without infectious complication in Early Excision

  20. A meta-analysis of hamstring autografts versus bone-patellar tendon-bone autografts for reconstruction of the anterior cruciate ligament.

    PubMed

    Li, ShuZhen; Su, Wei; Zhao, Jinmin; Xu, Yinglong; Bo, Zhandong; Ding, Xiaofei; Wei, Qingjun

    2011-10-01

    The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability. PMID:20850327

  1. Autograft Versus Nonirradiated Allograft Tissue for Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Mariscalco, Michael W.; Magnussen, Robert A.; Mehta, Divyesh; Hewett, Timothy E.; Flanigan, David C.; Kaeding, Christopher C.

    2014-01-01

    Background An autograft has traditionally been the gold standard for anterior cruciate ligament reconstruction (ACLR), but the use of allograft tissue has increased in recent years. While numerous studies have demonstrated that irradiated allografts are associated with increased failure rates, some report excellent results after ACLR with nonirradiated allografts. The purpose of this systematic review was to determine whether the use of nonirradiated allograft tissue is associated with poorer outcomes when compared with autografts. Hypothesis Patients undergoing ACLR with autografts versus nonirradiated allografts will demonstrate no significant differences in graft failure risk, laxity on postoperative physical examination, or differences in patient-oriented outcome scores. Study Design Systematic review. Methods A systematic review was performed to identify prospective or retrospective comparative studies (evidence level 1, 2, or 3) of autografts versus nonirradiated allografts for ACLR. Outcome data included graft failure based on clinical findings and instrumented laxity, postoperative laxity on physical examination, and patient-reported outcome scores. Studies were excluded if they did not specify whether the allograft had been irradiated. Quality assessment and data extraction were performed by 2 examiners. Results Nine studies comparing autografts and nonirradiated allografts were included. Six of the 9 studies compared bone– patellar tendon–bone (BPTB) autografts with BPTB allografts. Two studies compared hamstring tendon autografts to hamstring tendon allografts, and 1 study compared hamstring tendon autografts to tibialis anterior allografts. The mean patient age in 7 of 9 studies ranged from 24.5 to 32 years, with 1 study including only patients older than 40 years and another not reporting patient age. The mean follow-up duration was 24 to 94 months. Six of 9 studies reported clinical graft failure rates, 8 of 9 reported postoperative instrumented

  2. Role of anthropometric data in the prediction of 4-stranded hamstring graft size in anterior cruciate ligament reconstruction.

    PubMed

    Ho, Sean Wei Loong; Tan, Teong Jin Lester; Lee, Keng Thiam

    2016-03-01

    To evaluate whether pre-operative anthropometric data can predict the optimal diameter and length of hamstring tendon autograft for anterior cruciate ligament (ACL) reconstruction. This was a cohort study that involved 169 patients who underwent single-bundle ACL reconstruction (single surgeon) with 4-stranded MM Gracilis and MM Semi-Tendinosus autografts. Height, weight, body mass index (BMI), gender, race, age and -smoking status were recorded pre-operatively. Intra-operatively, the diameter and functional length of the 4-stranded autograft was recorded. Multiple regression analysis was used to determine the relationship between the anthropometric measurements and the length and diameter of the implanted autografts. The strongest correlation between 4-stranded hamstring autograft diameter was height and weight. This correlation was stronger in females than males. BMI had a moderate correlation with the diameter of the graft in females. Females had a significantly smaller graft both in diameter and length when compared with males. Linear regression models did not show any significant correlation between hamstring autograft length with height and weight (p>0.05). Simple regression analysis demonstrated that height and weight can be used to predict hamstring graft diameter. The following regression equation was obtained for females: Graft diameter=0.012+0.034*Height+0.026*Weight (R2=0.358, p=0.004) The following regression equation was obtained for males: Graft diameter=5.130+0.012*Height+0.007*Weight (R2=0.086, p=0.002). Pre-operative anthropometric data has a positive correlation with the diameter of 4 stranded hamstring autografts but no significant correlation with the length. This data can be utilised to predict the autograft diameter and may be useful for pre-operative planning and patient counseling for graft selection. PMID:26984657

  3. Biomechanics of the pulmonary autograft valve in the aortic position.

    PubMed Central

    Gorczynski, A; Trenkner, M; Anisimowicz, L; Gutkowski, R; Drapella, A; Kwiatkowska, E; Dobke, M

    1982-01-01

    Pulmonary autograft valve replacement has been simulated by implanting the pulmonary valve into the aortic position of the same cadaver heart from both human and porcine sources. The forces acting on the pulmonary valve leaflets have been calculated on the basis of a triaxial ellipsoid mathematical model. These forces on the pulmonary autograft valve were shown to be essentially similar to those previously reported for aortic valve leaflets. Biomechanical measurements have been made on the simulated autograft valves and on the isolated pulmonary valve cusps. The tensile strengths of the pulmonary valve cusps in both circumferential and radial directions were roughly three times greater than those of aortic valve cusps. This indicated the ability of the pulmonary valves to accept, ab initio, aortic valve closing pressures. Pressure-induced changes in dimension, calculated on the basis of diameters of the simulated pulmonary autograft root, also indicated that the distensibility of the autograft valve was limited. It reached a maximum at 30 mm Hg (4 kPa) without any suggestion of further distension to the point of distortion and incompetence. The combination of the calculated forces acting on the valve and the biomechanical measurements have shown that pulmonary valves used as autograft aortic valve replacements are able to tolerate aortic pressures from the time of implantation. These experimental results from simulated autografts support the clinical use of this valve over the past 13 years. PMID:7135295

  4. Portocaval shunt for hepatocyte package: challenging application of small intestinal graft in animal models.

    PubMed

    Iwasaki, Junji; Hata, Toshiyuki; Uemoto, Shinji; Fujimoto, Yasuhiro; Kanazawa, Hiroyuki; Teratani, Takumi; Hishikawa, Shuji; Kobayashi, Eiji

    2013-10-01

    In developing therapeutic alternatives to liver transplantation, we have used the strategy of applying a small intestinal segment as a scaffold for hepatocyte transplantation and also as a portocaval shunt (PCS) system to address both liver dysfunction and portal hypertension. The aim of this study was to investigate the feasibility of such an intestinal segment in animal models. Hepatocytes isolated from luciferase-transgenic Lewis rats were transplanted into jejunal segments of wild-type Lewis rats with mucosa removal without PCS application. Luciferase-derived luminescence from transplanted hepatocytes was stably detected for 30 days. Then, we performed autologous hepatocyte transplantation into the submucosal layer of an isolated and vascularized small intestinal segment in pigs. Transplanted hepatocytes were isolated from the resected left-lateral lobe of the liver. On day 7, hepatocyte clusters and bile duct-like structures were observed histologically. To create an intestinal PCS system in pigs, an auto-graft of the segmental ileum and interposing vessel graft were anastomosed to the portal vein trunk and inferior vena cava. However, thrombi were observed in vessels of the intestinal PCSs. We measured the correlation between infusion pressure and flow volume in whole intestines ex vivo in both species and found that the high pressure corresponding to portal hypertension was still insufficient to maintain the patency of the intestinal grafts. In conclusion, we demonstrated the feasibility of the small intestine as a scaffold for hepatocyte transplantation in rat and pig models, but PCS using an intestinal graft failed to maintain patency in a pig model. PMID:23974217

  5. Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon

    PubMed Central

    Darnley, James E.; Léger-St-Jean, Benjamin; Pedroza, Angela D.; Flanigan, David C.; Kaeding, Christopher C.; Magnussen, Robert A.

    2016-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter. Purpose: To compare hybrid autograft/allograft ACL reconstruction to autograft ACL reconstruction, specifically analyzing the patient-reported outcome scores and the risk of revision surgery at 2 years postoperative. Study Design: Cohort study; Level of evidence, 3. Methods: From the years 2002 to 2009, a total of 34 patients were identified from a prospectively collected database as having undergone hybrid ACL reconstruction. Twenty-seven of 34 (79.4%) patients had a 2-year follow-up. These 27 patients were matched by age (within 1 year) and sex to 27 patients who underwent hamstring autograft ACL reconstruction during the same period. At the 2-year mark, revision surgery risk and patient-reported outcome scores were compared between the 2 groups. Results: The mean age for the hybrid and matched groups (±SD) was 20.9 ± 7.0 years. Both the hybrid and control groups had 17 males and 10 females. There was no significant difference in preoperative patient-reported outcome scores, meniscus tears, or cartilage lesions between the 2 groups. Graft size was larger in the hybrid group (9.5 ± 0.6 mm) than in the autograft group (8.4 ± 0.9 mm) (P < .001). At 2 years postoperative, patient-reported outcome scores were similar between the hybrid and autograft groups. Revision surgery was required in 5 (18.5%) patients who underwent hybrid reconstruction compared with 2 (7.4%) of those who underwent autograft reconstruction (P = .26). Conclusion: Patients who undergo ACL reconstruction with hybrid hamstring grafts and hamstring autografts report similar

  6. Comparison of Two Synthetic Bone Graft Products in a Rabbit Posterolateral Fusion Model

    PubMed Central

    Fredericks, Douglas; Petersen, Emily B.; Watson, Nicole; Grosland, Nicole; Gibson-Corley, Katherine; Smucker, Joseph

    2016-01-01

    Background The drawbacks of iliac crest autograft as graft material for spine fusion are well reported. Despite continued modifications to improve bone healing capacity, the efficacy of synthetic graft materials as stand-alone replacements remains uncertain. The rabbit posterolateral fusion model is an established environment for testing of fusion concepts. It offers the opportunity to obtain radiographic, biomechanical and histological data on novel fusion materials. The objective of this study was to compare the spine fusion capability of two synthetic bone graft products in an established rabbit posterolateral spine fusion (PLF) model: Signafuse® Bioactive Bone Graft Putty and Actifuse® ABX. Methods Bilateral intertransverse spine fusion was performed at the L5-L6 transverse processes (TPs) of New Zealand White rabbits using either Signafuse or Actifuse ABX as the bone graft material. Bone remodeling and spine fusion were assessed at 6 and 12 weeks using radiographic, biomechanical and histological endpoints. Results Fusion rate by manual palpation at 6 weeks was greater for Signafuse (33%) compared to Actifuse ABX (0%), and equivalent in both groups at 12 weeks (50%). Biomechanical fusion rate based on flexion-extension data was 80% in Signafuse group and 44% for Actifuse ABX. Histology revealed a normal healing response in both groups. MicroCT and histomorphometric data at 6 weeks showed greater new bone formation in the Signafuse group compared to Actifuse ABX (p <0.05), with no differences detected at 12 weeks. Histological fusion scores were greater in the Signafuse group at 6 and 12 weeks, indicated by higher degree structural remodeling and tendency towards complete bridging of the fusion bed compared to the Actifuse ABX group. Conclusion Confirmed by several metrics, Signafuse outperformed Actifuse ABX as a standalone synthetic bone graft in an established PLF model, demonstrating greater rates of bone remodeling and spine fusion. The combination of 45

  7. Natural history of intrahepatic canine islet cell autografts.

    PubMed Central

    Alejandro, R; Cutfield, R G; Shienvold, F L; Polonsky, K S; Noel, J; Olson, L; Dillberger, J; Miller, J; Mintz, D H

    1986-01-01

    We have serially followed the function of intrahepatic canine islet autografts in 15 beagle dogs for up to 24 mo. Of these, only 20% sustained normal levels of fasting blood glucose for greater than 15 mo posttransplant. Failure of autograft function was accompanied by a preferential loss of well-granulated beta cells in the engrafted islets. The chronic stimulation of an initially marginal intrahepatic beta-cell mass ultimately resulted in metabolic deterioration and loss of beta cells below the minimal threshold required to maintain normal fasting blood glucose levels. It is possible that transplantation of a larger mass of islets would result in indefinite graft function in dogs. However, it remains to be demonstrated in larger mammals, including humans, whether an islet cell mass that is initially adequate in a heterotropic site such as the liver can remain functionally competent over a prolonged period. Images PMID:3095376

  8. The effect of collagen-chitosan porous scaffold thickness on dermal regeneration in a one-stage grafting procedure.

    PubMed

    Haifei, Shi; Xingang, Wang; Shoucheng, Wu; Zhengwei, Mao; Chuangang, You; Chunmao, Han

    2014-01-01

    Dermal substitutes are used as dermal regeneration templates to reduce scar formation and improve wound healing. Unlike autografts, dermal substitutes lack normal vascular networks. The increased distance required for diffusion of oxygen and nutrients to the autograft following interpositioning of the substitute dramatically affects graft survival. To evaluate the effect of collagen-chitosan scaffold thickness on dermal regeneration, single-layer collagen-chitosan porous scaffolds of 0.5-, 1- and 2-mm thicknesses were fabricated and used to treat full-thickness wounds in a one-stage grafting procedure in a rat model. Skin-graft viability, wound contraction, histological changes, and wound tensile strength were evaluated. The results indicated that the distance for the diffusion of oxygen and nutrients to the autograft in the 2-mm-thick scaffold provided less support for graft take, which resulted in graft necrosis, extensive inflammatory reaction, marked foreign-body reaction (FBR), rapid scaffold degradation, and abnormal collagen deposition and remodeling. In contrast, the thinner scaffolds, especially of that 0.5-mm thickness, promoted earlier angiogenesis, ensuring skin-graft viability with a mild FBR, and ordered fibroblast infiltration and better collagen remodeling. It can be concluded that collagen-chitosan porous scaffolds with a thickness of <1mm are more suitable for dermal regeneration and can be used as dermal templates for treatment of dermal defects using a one-stage grafting procedure. PMID:24076783

  9. [Subcutaneous autograft with newly synthesized cartilage using ethisorb polymer in rabbits].

    PubMed

    Capitán Guarnizo, A; Viviente Rodríguez, E; Osete Albaladejo, J M; Torregrosa Carrasquer, C; Díaz Manzano, J A; Pérez-Mateos Cachá, J A; Sprekelsen Gassó, C

    2002-11-01

    We perform a subcutaneous autograft, in animals with preserved immunity (24 rabbits), of cartilage taken from the auricle, treated with tissue engineering thecnics and embeded in a reabsorbable polimer (Ethisorb) that acts as base. We observed a good quality cartilage with the expression of collagen type II and without graft rejection phenomenon. PMID:12584877

  10. Two-dimensional computational model for electrostrictive graft elastomer

    NASA Astrophysics Data System (ADS)

    Wang, Youqi; Sun, Xuekun; Sun, Changjie; Su, Ji

    2003-07-01

    The electrostrictive graft elastomer is a new type of electromechanically active polymer. Recently developed by NASA, it consists of flexible backbone chains, each with side chains, called grafts. Grafts from neighboring backbones physically cross-link and form crystal units. The flexible backbone chains and the crystal graft units are composed of polarized monomers, which contain atoms with electric partial charges, generating dipole moments. Polarized domains are created by dipole moments in the crystal units. When the elastomer is placed into an electric field, external rotating moments are applied to polarized domains. It stimulates the rotation of the polarized crystal graft units, which further induces deformation of the elastomer. In this paper, two-dimensional computational models are established to analyze the deformation mechanism of the graft elastomer.

  11. Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures

    PubMed Central

    Sferopoulos, N.K

    2014-01-01

    Introduction : The rationale for operative treatment of depressed tibial plateau fractures is anatomic reduction, stable fixation and grafting. Grafting options include autogenous bone graft or bone substitutes. Methods : The autograft group included 18 patients with depressed tibial plateau fractures treated with autogenous bone grafting from the ipsilateral femoral condyle following open reduction and internal fixation. According to Schatzker classification, there were 9 type II, 4 type III, 2 type IV and 3 type V lesions. The average time to union and the hospital charges were compared with the bone substitute group. The latter included 17 patients who had an excellent outcome following treatment of split and/or depressed lateral plateau fractures, using a similar surgical technique but grafting with bone substitutes (allografts). Results : Excellent clinical and radiological results were detected in the autograft group after an average follow-up of 28 months (range 12-37). The average time to union in the autograft group was 14 weeks (range 12-16), while in the bone substitute group it was 18 weeks (range 16-20). The mean total cost was 1276 Euros for the autograft group and 2978 Euros for the bone substitute group. Discussion : The use of autogenous graft from the ipsilateral femoral condyle following open reduction and internal fixation of depressed tibial plateau fractures provided enough bone to maintain the height of the tibial plateau and was not associated with any donor site morbidity. Using this method, the surgical time was not significantly elongated and the rehabilitation was not affected. It also exhibited faster fracture healing without postoperative loss of reduction and it was less expensive than the use of bone substitutes. PMID:25317215

  12. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    PubMed Central

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  13. Does Choosing Autograft Hamstring vs. Patellar Tendon by Gender, Sport, Level of Competition or Laxity in High School and College Aged Athletes Improve KOOS, IKDC or Marx?

    PubMed Central

    Huston, Laura J.; Reinke, Emily; Kattan, Michael W.; Chagin, Kevin; Spindler, Kurt P.

    2016-01-01

    Objectives: Physicians’ and patients’ decision-making process between autograft hamstring (HG) vs. patellar tendon (BTB) for ACL reconstruction (ACLR) may be influenced by patient gender, laxity level, sport played, and/or competition level in the young, active athlete. ACLR specific to high school and college-aged athletes with these aforementioned factors in mind has not been evaluated. Therefore, our objectives were twofold: first, to develop a simple web-based risk calculator as a decision-making aid to provide the best estimate of expected 2-year KOOS, IKDC, and Marx outcomes by gender, sport, level of competition, and knee laxity. Second, to identify whether autograft HG or BTB is the optimal graft choice given any combination of the aforementioned variables. Methods: Our inclusion criteria in the MOON cohort were patients aged 11-22 who were injured in sport (football, soccer, basketball, other), who were due to have a unilateral primary ACLR with either an autograft HG or BTB, and who had a contralateral normal knee. Excluded were revisions, allografts, those with a contralateral ACLR and concomitant MCL/LCL/PCL surgery. Laxity was graded as increased (Lachman > 10 mm or a pivot lock) or normal based on the EUA. Our modeling controlled for BMI, ethnicity, and baseline measures of patient-reported outcomes. Our two year outcomes were the KOOS knee related quality of life subscale, KOOS sports and recreation subscale, IKDC, and Marx activity level. Our multivariable modeling for risk online calculator and nomograms was generated in two ways. The performances for our models were measured using R squared, calibration curves, and bootstrapping. Results: 937 patients were eligible, 809 (86%) had 2 year follow-up data. The average age was 17, with 50% females, and the distribution of HG to BTB was 301/508 respectively. First, in evaluating our models for ACLR autograft choice, neither KOOS subscale models performed better than chance. The IKDC and Marx models

  14. Modeling heterogeneous polymer-grafted nanoparticle networks

    NASA Astrophysics Data System (ADS)

    Zhang, Tao; Mbanga, Badel; Yashin, Victor; Balazs, Anna

    Via a dynamic 3D computational approach, we simulate the heterogeneous polymer-grafted nanoparticle networks. The nanoparticles rigid cores are decorated with a corona of grafted polymers, which contain reactive functional groups at the chain ends. With the overlap of grafted polymers, these reactive groups can form weak labile bonds, which can reform after breakage, or stronger bonds, which rupture irreversibly and thus, the nanoparticles are interconnected by dual cross-links. Previous work has been done on homogeneous networks, while we introduce the heterogeneity by considering two types of particles having different reactive functional groups, so that the labile bond energy varies depending on types of the two end reactive groups. We study the effect of tensile and rotational deformations on the network morphology, and observe, in particular, the phase separation of two types of particles. Our results will provide guidelines for designing transformable material that can controllably change structure under mechanical action.

  15. Microphase separation in a model graft copolymer

    SciTech Connect

    Dozier, W.D.; Thiyagarajan, P.; Peiffer, D.G.

    1993-10-01

    We present a preliminary overview of our work on a series of graft copolymers having poly(ethyl acrylate) backbones with pendant chains of polystyrene (PS). The copolymer system appeared to be in the strong segregation limit and exhibited evidence of ordered structures. The morphology of these structures can apparently be very different from what would be expected. For instance, we observed a lamellar structure in a material containing 28 wt.% PS grafts. Samples under uniaxial strain showed either conventional (i.e., affine deformation) and anomalous ({open_quotes}butterfly{close_quotes} isointensity patterns) behavior in small-angle neutron scattering.

  16. Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Autograft Versus Allograft in Young Patients

    PubMed Central

    Atanda, Alfred; O’Brien, Daniel Francis; Kraeutler, Matthew John; Flato, Russell R.; Salminen, Matthew Robert; Henrichsen, Kevin; Kane, Patrick; Dodson, Christopher C.; Cohen, Steven B.; Ciccotti, Michael G.

    2015-01-01

    Objectives: Traditionally, bone-patella tendon-bone (BTB) autograft has been the gold standard graft choice for younger, athletic patients requiring ACL reconstruction. However, donor site morbidity, post-operative patella fracture, and increased operative time have led many surgeons to choose BTB allograft for their reconstructions. Opponents of allografts feel that slower healing time, higher rate of graft failure, and potential for disease transmission makes them undesirable graft choices in athletic patients. The purpose of this study is to evaluate the clinical outcomes, both subjective and objective, of young patients that who have undergone either BTB autograft or allograft reconstructions with a minimum of 2-year follow-up. Methods: One hundred and twenty patients (60 autograft, 60 allograft), age 25 and below at time of surgery, were contacted after being retrospectively identified as patients having an ACL reconstruction with either a BTB allograft or autograft by one senior surgeon. Patients were administered the Lysholm Knee Scoring Scale and IKDC Subjective Knee Evaluation questionnaires. Fifty (25 BTB autograft and 25 BTB allograft) of the 120 returned for physical examination as well as completion of a single leg hop test and laxity evaluation using a KT-1000 arthrometer evaluation. Of the 120 patients contacted, there were a total of 7 failures (5.8%) requiring revision, 6 in the allograft group (86%) and 1 in the autograft group (14%). Results: The average Lysholm scores were 89.0 and 89.56 and the average IKDC scores were 90.8 and 92.1 in the autograft and allograft groups respectively. The differences in the Lysholm scores and the IKDC scores were not significant. The single leg hop and KT-1000 scores were also not significantly different. One autograft patient had a minor motion deficit. Three allograft patients had a grade 1 Lachman and pivot glide. One autograft patient and two allograft patients had mild patellafemoral crepitus. There was no

  17. Computed Tomography and Optical Imaging of Osteogenesis-angiogenesis Coupling to Assess Integration of Cranial Bone Autografts and Allografts.

    PubMed

    Cohn Yakubovich, Doron; Tawackoli, Wafa; Sheyn, Dmitriy; Kallai, Ilan; Da, Xiaoyu; Pelled, Gadi; Gazit, Dan; Gazit, Zulma

    2015-01-01

    A major parameter determining the success of a bone-grafting procedure is vascularization of the area surrounding the graft. We hypothesized that implantation of a bone autograft would induce greater bone regeneration by abundant blood vessel formation. To investigate the effect of the graft on neovascularization at the defect site, we developed a micro-computed tomography (µCT) approach to characterize newly forming blood vessels, which involves systemic perfusion of the animal with a polymerizing contrast agent. This method enables detailed vascular analysis of an organ in its entirety. Additionally, blood perfusion was assessed using fluorescence imaging (FLI) of a blood-borne fluorescent agent. Bone formation was quantified by FLI using a hydroxyapatite-targeted probe and µCT analysis. Stem cell recruitment was monitored by bioluminescence imaging (BLI) of transgenic mice that express luciferase under the control of the osteocalcin promoter. Here we describe and demonstrate preparation of the allograft, calvarial defect surgery, µCT scanning protocols for the neovascularization study and bone formation analysis (including the in vivo perfusion of contrast agent), and the protocol for data analysis. The 3D high-resolution analysis of vasculature demonstrated significantly greater angiogenesis in animals with implanted autografts, especially with respect to arteriole formation. Accordingly, blood perfusion was significantly higher in the autograft group by the 7(th) day after surgery. We observed superior bone mineralization and measured greater bone formation in animals that received autografts. Autograft implantation induced resident stem cell recruitment to the graft-host bone suture, where the cells differentiated into bone-forming cells between the 7(th) and 10(th) postoperative day. This finding means that enhanced bone formation may be attributed to the augmented vascular feeding that characterizes autograft implantation. The methods depicted may serve

  18. A new method for skin grafting in murine model.

    PubMed

    Pakyari, Mohammadreza; Farokhi, Ali; Khosravi-Maharlooei, Mohsen; Kilani, Ruhangiz T; Ghahary, Aziz; Brown, Erin

    2016-07-01

    Skin transplantation provides an excellent potential model to investigate the immunology of allograft rejection and tolerance induction. Despite the theoretical ease of performing skin transplantation, as well as the potential of directly observing the reaction to the transplanted tissue, the poor reliability of skin transplantation in the mouse has largely precluded the use of this model. Furthermore, there is controversy regarding the most appropriate skin graft donor site due to poor success of back skin transplantation, as compared with the thinner ear or tail skin. This study demonstrates a reliable method to successfully perform skin grafts in a mouse model, as well as the clinical and histologic outcome of syngeneic grafts. A total of 287 grafts were performed (in 126 mice) utilizing donor skin from the ear, tail or back. No graft failure or postoperative mortality was observed. Comparison of this technique with two previously established protocols of skin transplantation (5.0 absorbable Suture + tissue glue technique and no-suture technique) demonstrates the significant improvement in the engraftment success of the new technique. In summary, a new technique for murine skin grafting demonstrates improved reliability across donor site locations and strains, increasing the potential for investigating interventions to alter the rejection process. PMID:27197606

  19. Modified two-dimensional computational model for electrostrictive graft elastomer

    NASA Astrophysics Data System (ADS)

    Sun, Changjie; Wang, Youqi; Su, Ji

    2004-07-01

    A modified two-dimensional computational model is developed to calculate the electromechanical properties of the electrostrictive graft elastomer. The electrostrictive graft elastomer, recently developed by NASA, is a type of electro-active polymer. In a previous paper, the authors calculated electrostrictive graft elastomer electromechanical properties using a 2-D atomic force field. For this 2-D polymer structure, a much higher electric field was required to produce strain compared with that required in experiments. Two reasons could explain the higher electric field strength: (1) Polymer chain movement is restricted to a 2-D plane rather than to a 3-D plane. Out-plane dihedral torsional angle change would thus not be modeled. For this reason, 2-D polymer chains are less flexible than actual 3-D polymer chains. (2) Boundary effect of the computational model. In the original model, a unit cell consisting of a single graft unit was developed to simulate the deformation of the electrostrictive graft elastomer. The boundary of the unit cell would restrict the rotation of the graft unit. In this paper, a modified 2-D computational model is established to overcome the above problems. Firstly, three-dimensional deformations, induced by both bending angle and dihedral torsional angle changes, are projected onto a two-dimensional plane. Using both theoretical and numerical analyses, the projected 2-D equilibrium bending angle is shown to have the same value as the 3-D equilibrium bending angle. The 2-D equivalent bending stiffness is derived using a series model based upon the fact that both bending and dihedral torsion produce configuration change. The equivalent stiffness is justified by the characteristics of the polymer chain and end-to-end distance. Secondly, a self-consistent scheme is developed to eliminate the boundary effect. Eight images of the unit cell are created peripherally, with the original unit cell in the center. Thus the boundary can only affect the

  20. Pterygium excision with conjunctival autografting: an effective and safe technique.

    PubMed Central

    Allan, B D; Short, P; Crawford, G J; Barrett, G D; Constable, I J

    1993-01-01

    The optimum mode of treatment for symptomatic pterygia would combine efficacy (a low recurrence rate) with safety (freedom from sight threatening complications), and would not affect visual acuity adversely. The efficacy of pterygium excision with conjunctival autografting in a sun exposed population in which pterygia are prevalent has previously been questioned. A cross sectional review of 93 eyes of 85 patients was carried out by slit-lamp examination a minimum of 6 months (range 6-76 months) after pterygium excision and free conjunctival autografting. Case notes were reviewed to obtain details of complications and visual acuity changes related to surgery. Of six recurrences (6.5%) four of these were asymptomatic with minor recurrences. Two patterns of recurrence were identified: cross graft recurrence (three cases) and outflanking (three cases). Complications (wound dehiscence, three cases; Tenon's granuloma one case; conjunctival cyst, one case) were all corrected by minor surgical revision without sequelae. Unaided acuities were unchanged or improved 3 months after surgery in 86 cases, with a minor diminution (1 Snellen line) in seven cases. This study demonstrates a low recurrence rate for a safe technique in an area in which ongoing ultraviolet light exposure levels are high and pterygia are prevalent. Images PMID:8280682

  1. Sutureless and Glue-free Versus Sutures for Limbal Conjunctival Autografting in Primary Pterygium Surgery: A Prospective Comparative Study

    PubMed Central

    Raj, Hans; Gupta, Aditi; Raina, Amit Vikram

    2015-01-01

    Introduction Sutureless and glue-free conjunctival autograft as a treatment modality for primary pterygium is recently gaining popularity but conventional technique of suturing conjunctival autograft is still practised widely. Aim To compare the outcome of sutureless and glue-free technique with sutures for limbal conjunctival autografting in management of primary pterygium. Materials and Methods A prospective interventional study was carried out in 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Simple excision under local anaesthesia was performed followed by closure of the bare sclera by sutureless and glue-free conjunctival autograft in 25 eyes of 25 patients (group 1) and by the conventional method of suturing conjunctival autograft using interrupted 10-0 nylon sutures in 25 eyes of 25 patients (group 2), followed by bandaging for 24 hours in both the groups. Surgical time was recorded for both the techniques. Postoperative discomfort was assessed using preformed questionnaires. The patients were followed up for 6 months. During follow up, graft related complications and recurrence if any were noted. Results Mean surgical time for group 1 (23.20±1.55 minutes) was significantly less as compared to group 2 (37.76±1.89 minutes); (p=0.001). Postoperative symptoms were seen in less number of patients (20%) and were of shorter duration (2 weeks) in group 1 as compared to group 2 with 20 (80%) patients having symptoms lasting for 4 weeks; (p<0.001). Recurrence rate and conjunctival granuloma formation rate for group 1 (0%) and for group 2 (4%) were statistically insignificant. Conclusion Sutureless and glue-free conjunctival autograft technique is simple, easy, safe, effective and less time consuming than sutured limbal autograft technique with less postoperative discomfort and adverse events encountered with the use of suture material. Postoperative results of both techniques are comparable. Hence sutureless and glue-free conjunctival

  2. Synthetic porous ceramic compared with autograft in scoliosis surgery. A prospective, randomized study of 341 patients.

    PubMed

    Ransford, A O; Morley, T; Edgar, M A; Webb, P; Passuti, N; Chopin, D; Morin, C; Michel, F; Garin, C; Pries, D

    1998-01-01

    We have evaluated the use of a synthetic porous ceramic (Triosite) as a substitute for bone graft in posterior spinal fusion for idiopathic scoliosis. In a prospective, randomised study 341 patients at five hospitals in the UK and France were randomly allocated either to autograft from the iliac crest or rib segments (171) or to receive Triosite blocks (170). All patients were assessed after operation and at 3, 6, 12 and 18 months. The two groups were similar with regard to all demographic and baseline variables, but the 184 treated in France (54%) had Cotrel-Dubouset instrumentation and the 157 treated in the UK usually had Harrington-Luque implants. In the Triosite group the average Cobb angle of the upper curve was 56 degrees, corrected to 24 degrees (57%). At 18 months, the average was 26 degrees (3% loss). In the autograft group the average preoperative upper curve of 53 degrees was corrected to 21 degrees (60%). At 18 months the mean curve was 25 degrees (8% loss). Pain levels after operation were similar in the two groups, being mild in most cases. In the Triosite group only three patients had problems of wound healing, but in the autograft group, 14 patients had delayed healing, infection or haematoma in the spinal wound. In addition, 15 autograft patients had pain at the donor site at three months. Seven had infections, two had haematoma and four had delayed healing. The haematological and serum biochemistry results showed no abnormal trends and no significant differences between the groups. There were no adverse events related to the graft material and no evidence of allergenicity. Our results suggest that Triosite synthetic porous ceramic is a safe and effective substitute for autograft in these patients. Histological findings on biopsy indicate that Triosite provides a favourable scaffolding for the formation of new bone and is gradually incorporated into the fusion mass. PMID:9460945

  3. Hydrophilic Polymers Enhance Early Functional Outcomes after Nerve Autografting

    PubMed Central

    Sexton, Kevin W.; Pollins, Alonda C.; Cardwell, Nancy L.; Del Corral, Gabriel A.; Bittner, George D.; Shack, R. Bruce; Nanney, Lillian B.; Thayer, Wesley P.

    2014-01-01

    Background Approximately 12% of operations for traumatic neuropathy are for patients with segmental nerve loss and less than 50% of these injuries obtain meaningful functional recovery. Polyethylene glycol (PEG) therapy has been shown to improve functional outcomes after nerve severance and we hypothesized this therapy could also benefit nerve autografting. Methods A segmental rat sciatic nerve injury model was used, whereby a 0.5 cm defect was repaired with an autograft using microsurgery. Experimental animals were treated with solutions containing methylene blue (MB) and PEG; control animals did not receive PEG. Compound Actions Potentials (CAPs) were recorded before nerve transection, after solution therapy, and at 72 hours postoperatively. The animals underwent behavioral testing at 24 and 72 hours postoperatively. After sacrifice, nerves were fixed, sectioned, and immunostained to allow for quantitative morphometric analysis. Results The introduction of hydrophilic polymers greatly improved morphological and functional recovery of rat sciatic axons at 1–3 days following nerve autografting. PEG therapy restored CAPs in all animals and CAPs were still present 72 hours postoperatively. No CAPS were detectable in control animals. Footfall asymmetry scores and sciatic functional index scores were significantly improved for PEG therapy group at all time points (p <0.05 and p<0.001; p <0.001 and p <0.01). Sensory and motor axon counts were increased distally in nerves treated with PEG compared to control (p = 0.0189 and p = 0.0032). Conclusions PEG therapy improves early physiologic function, behavioral outcomes, and distal axonal density after nerve autografting. PMID:22521220

  4. In utero fetal lamb thyroidectomy and thyroid autograft transplantation.

    PubMed

    Belin, R P; Hollingsworth, D R; Reid, M C; Davis, S L; Beihn, R

    1976-01-01

    Our fetal surgical model was utilized to perform in utero fetal lamb thyroidectomy and autograft transplantation of thyroid tissue to fetal thigh at 82-93 days gestation. Successful in utero transplantation was possible in two of six experimental animals. In one twin pregnancy with an unoperated control lamb, observations were continued to age six months. The athyrotic lamb with a thigh autograft was larger at birth and had a transient weak sucking reflex and awkward gait. It then grew and developed normally with no stigmata of cretinism or delay in bone maturation. At age six months an increase in thyroid stimulating hormone (oTSH) was the single distinguishing observation in the twin with the transplant. Although oTSH levels were elevated to age six months, the pituitary continued to be responsive to thyrotropin releasing hormone (TRH) stimulation. These findings suggest that in utero transplantation of thyroid tissue is technically feasible and that the previously described development of in utero cretinism following fetal thyroidectomy can be prevented by a functioning autograft. This technique will be useful in attempting allograft transplantation in utero. PMID:821742

  5. A mechanical argument for the differential performance of coronary artery grafts.

    PubMed

    Prim, David A; Zhou, Boran; Hartstone-Rose, Adam; Uline, Mark J; Shazly, Tarek; Eberth, John F

    2016-02-01

    Coronary artery bypass grafting (CABG) acutely disturbs the homeostatic state of the transplanted vessel making retention of graft patency dependent on chronic remodeling processes. The time course and extent to which remodeling restores vessel homeostasis will depend, in part, on the nature and magnitude of the mechanical disturbances induced upon transplantation. In this investigation, biaxial mechanical testing and histology were performed on the porcine left anterior descending artery (LAD) and analogs of common autografts, including the internal thoracic artery (ITA), radial artery (RA), great saphenous vein (GSV) and lateral saphenous vein (LSV). Experimental data were used to quantify the parameters of a structure-based constitutive model enabling prediction of the acute vessel mechanical response pre-transplantation and under coronary loading conditions. A novel metric Ξ was developed to quantify mechanical differences between each graft vessel in situ and the LAD in situ, while a second metric Ω compares the graft vessels in situ to their state under coronary loading. The relative values of these metrics among candidate autograft sources are consistent with vessel-specific variations in CABG clinical success rates with the ITA as the superior and GSV the inferior graft choices based on mechanical performance. This approach can be used to evaluate other candidate tissues for grafting or to aid in the development of synthetic and tissue engineered alternatives. PMID:26437296

  6. Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions.

    PubMed

    Gupta, Ravi; Bahadur, Raj; Malhotra, Anubhav; Masih, Gladson David; Gupta, Parmanand

    2016-04-01

    We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft. PMID:27354946

  7. Cost-Efficacy of Cultured Epidermal Autografts in Massive Pediatric Burns

    PubMed Central

    Barret, Juan P.; Wolf, Steven E.; Desai, Manubhai H.; Herndon, David N.

    2000-01-01

    Objective To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. Summary Background Data Paucity of donor sites in massive burns makes the use of expanded skin of paramount importance. CEA techniques have been used in burned patients with differing and controversial results. The true impact and the efficacy of such techniques in massive burns remain uncertain. Methods Patients with full-thickness burns of more than 90% body surface area treated between May 1988 and May 1998 were studied. Patients grafted with CEA were compared with patients grafted with conventional meshed autografts. Rates of death and complications, length of hospital stay (LOS), hospital cost, acute readmissions for reconstruction, and quality of scars were studied as outcome measures. Results Patients treated with CEA had a better quality of burn scars but incurred a longer LOS and higher hospital costs. Both groups had comparable readmissions for open wounds, but patients treated with CEA required more reconstructive procedures during the first 2 years after the injury. The incidence of sepsis and pneumonia in both groups was comparable. Conclusions Conventional meshed autografts are superior to CEA for containing hospital cost, diminishing LOS, and decreasing the number of readmissions for reconstruction of contractures. However, the use of CEA provides better scar quality such that perhaps future research should focus on bioengineered dermal templates to promote take and diminish long-term fragility. PMID:10816630

  8. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  9. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution

    PubMed Central

    Godzik, Jakub; Ravindra, Vijay M.; Ray, Wilson Z.; Schmidt, Meic H.; Bisson, Erica F.; Dailey, Andrew T.

    2016-01-01

    Object The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. Methods The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1–2 and C2–7 lordotic angles, C2–7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. Results At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1–108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. Conclusions The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated

  10. Implantation of Inferior Vena Cava Interposition Graft in Mouse Model

    PubMed Central

    Lee, Yong-Ung; Yi, Tai; Tara, Shuhei; Lee, Avione Y.; Hibino, Narutoshi; Shinoka, Toshiharu; Breuer, Christopher K.

    2014-01-01

    Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. The long-term clinical results showed excellent patency rates, however, with significant incidence of stenosis. To investigate the cellular and molecular mechanisms of vascular neotissue formation and prevent stenosis development in tissue engineered vascular grafts (TEVGs), we developed a mouse model of the graft with approximately 1 mm internal diameter. First, the TEVGs were assembled from biodegradable tubular scaffolds fabricated from a polyglycolic acid nonwoven felt mesh coated with ε-caprolactone and L-lactide copolymer. The scaffolds were then placed in a lyophilizer, vacuumed for 24 hr, and stored in a desiccator until cell seeding. Second, bone marrow was collected from donor mice and mononuclear cells were isolated by density gradient centrifugation. Third, approximately one million cells were seeded on a scaffold and incubated O/N. Finally, the seeded scaffolds were then implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. The implanted grafts demonstrated excellent patency (>90%) without evidence of thromboembolic complications or aneurysmal formation. This murine model will aid us in understanding and quantifying the cellular and molecular mechanisms of neotissue formation in the TEVG. PMID:24961688

  11. Model membranes grafted with long polymers

    NASA Astrophysics Data System (ADS)

    Nikolov, Vesselin Kirolov

    2004-06-01

    We study the effect on the elastic properties of lipid membranes induced by anchoring of long hydrophilic polymers. Theoretically, two limiting regimes for the membrane spontaneous curvature are expected : i) at low surface polymer concentration (mushroom regime) the spontaneous curvature should scale linearly with the surface density of anchored polymers; ii) at high coverage (brush regime) the dependence should be quadratic. We attempt to test the predictions for the brush regime by monitoring the morphological changes induced on giant vesicles. As long polymers we use fluorescently labeled λ-phage DNA molecules which are attached to biotinylated lipid vesicles with a biotin-avidin-biotin linkage. By varying the amount of biotinylated lipid in the membrane we control the surface concentration of the anchors. The amount of anchored DNA to the membrane is quantified with fluorescence measurements. Changes in the elastic properties of the membrane as DNA grafts to it are monitored via analysis of the vesicle fluctuations. The spontaneous curvature of the membrane increases as a function of the surface coverage. At higher grafting concentrations the vesicles bud. The size of the buds can also be used to assess the membrane curvature. The effect on the bending stiffness is a subject of further investigation. Wir untersuchen, welchen Einfluss die Verankerung von langen, hydrophilen Polymeren in Lipidmembranen auf deren elastische Eigenschaften ausübt. Theoretisch werden zwei Grenzbereiche für die spontane Krümmung der Membran erwartet: i) bei kleinen Oberflächenkonzentrationen des Polymers (Pilzgebiet) sollte die spontane Krümmung linear von der Oberflächendichte des verankerten Polymers abhängen; ii) bei hoher Bedeckung (Bürstengebiet) sollte die Abhängigkeit quadratisch sein. Wir versuchen, Vorhersagen für das Bürstengebiet zu prüfen, indem wir die morphologischen Veränderungen beobachten, die bei Riesen (Giant)- Vesikeln hervorgerufen werden. Als lange

  12. Annular Ligament Reconstruction With Triceps Autograft for Chronic Radial Head Instability.

    PubMed

    Marinello, Patrick G; Wagner, Timothy; Styron, Joseph; Maschke, Steven; Evans, Peter J

    2016-03-01

    We present a modification and revisit of the Bell Tawse technique for annular ligament reconstruction with triceps autograft for chronic radial head instability. In patients with instability stemming from an incompetent annular ligament, this technique has proved successful to restore stability to the proximal radial capitellar joint as an augment after ensuring normal boney anatomy. Through a lateral Kocher approach, an approximately 10 cm × 4 mm strip of lateral triceps tendon is harvested as a free graft for the reconstruction. Following passing of the triceps autograft around the radial neck, it is sutured to a mini-Mitek suture anchor and is placed into a decorticated portion of the proximal ulna to recreate the annular ligament. Finally, we present 2 case illustrations where this technique was successfully used for chronic radial head instability. PMID:26709571

  13. Osteochondral Autograft Transplantation: A Review of the Surgical Technique and Outcomes.

    PubMed

    Richter, Dustin L; Tanksley, John A; Miller, Mark D

    2016-06-01

    Isolated chondral and osteochondral defects of the knee are challenging clinical entities, particularly in younger patients. Cartilage treatment strategies have previously been characterized as palliation (ie, chondroplasty and debridement), repair (ie, drilling and microfracture), or restoration (ie, autologous chondrocyte implantation, osteochondral autograft, and osteochondral allograft). The osteochondral autograft transplantation procedure allows defects to be filled immediately with mature, hyaline articular cartilage by utilizing either an arthroscopic or a mini-open procedure. Graft harvest and placement can be technically demanding, but results show trends toward greater longevity, durability, and improved outcomes in high-demand patients when compared with alternative techniques. Improved results are shown in younger patients with isolated lesions between 1 and 4 cm. PMID:27135290

  14. Topical negative pressure improves autograft take by altering nutrient diffusion: A hypothesis.

    PubMed

    Wang, Xingang; Zhang, Yuanhai; Han, Chunmao

    2014-01-01

    The one-step surgical procedure for dermal substitutes combined with topical negative pressure (TNP) has proven effective for treating deep skin defects with improved graft take. The primary mechanism by which TNP improves autograft take is unknown. Some studies suggest that TNP promotes the rapid angiogenesis of dermal substitutes, improving graft take. However, at the early stage of one-step transplantation, the vascular system has not formed and imbibition is the main mode of nutrient supply. TNP can shorten the diffusion distance from the wound bed to the graft, leading to the timely renewal of the wound exudate via suction, removing any surplus exudate, and reducing tissue edema. In addition, TNP can regulate the local blood flow and inhibit bacterial colonization. Therefore, we hypothesized that TNP establishes a rapid balance between the nutrient supply to the wound bed and nutritional requirement of the graft via these pathways in the relatively closed, moist environment, improving autograft take. However, this balance could be affected by any negative pressure, intermittent or continuous. It is necessary to test this hypothesis in laboratory and clinical studies of the mode of nutrient supply in the imbibition phase and the change in exudate content. PMID:24435118

  15. Minimal Conjunctival Limbal Autograft for Total Limbal Stem Cell Deficiency

    PubMed Central

    Kheirkhah, Ahmad; Raju, Vadrevu K.; Tseng, Scheffer C. G.

    2010-01-01

    Purpose To report the results of one 60° conjunctival limbal autograft (CLAU) combined with amniotic membrane (AM) transplantation for an eye with total limbal stem cell deficiency (LSCD). Methods One eye of a patient with chronic total LSCD and symblepharon caused by chemical burn was subjected to symblepharon lysis, removal of pannus from corneal surface, AM transplantation to cover the conjunctival and corneal surfaces as a permanent graft, one 60° CLAU to the superior limbal area, and insertion of ProKera as a temporary AM patch to cover the CLAU. Results After surgery, corneal epithelialization over the AM was evident adjacent to the CLAU on day 6, progressed to pass the horizontal midline by day 11, and was completed by day 18. During a follow-up of 1 year, the corneal surface remained stable and smooth, and the stroma considerably regained clarity with regression of midstromal vascularization. The best-corrected visual acuity improved from 20/400 to 20/50. The conjunctival inflammation completely resolved, and the fornices were deep. Conclusions One 60° CLAU combined with AM transplantation as both a permanent graft and a temporary patch can restore the entire corneal surface in an eye with total LSCD caused by chemical burn. PMID:18580269

  16. Comparison between sutureless and glue free versus sutured limbal conjunctival autograft in primary pterygium surgery

    PubMed Central

    Elwan, Shaaban A.M.

    2014-01-01

    Purpose To compare and evaluate the safety and efficacy of two surgical techniques for the management of primary pterygium. Design Prospective randomized clinical trial using the CONSORT 2010 Statement (Consolidated Standards of Reporting Trials) for parallel group randomized trials. Setting Department of Ophthalmology, Al-Minya University, Faculty of Medicine, Egypt. Methods The study included 150 eyes of 150 patients with primary pterygium. The mean age was 49 ± 12 years (range 24–74 years). Simple excision under local anesthesia was performed followed by closure of the bare sclera by suture less and glue free conjunctival autograft in 50 eyes of 50 patients (group 1), versus the conventional method of a sutured conjunctival autograft in 100 eyes of 100 patients (group 2). Results The pterygium recurrence rate was 6% for group 1, 8% for group 2. Graft dehiscence occurred in 4 eyes out of 50 (8%) in group 1. Graft retraction occurred in 6 (12%) out of 50 eyes for group 1 versus 6 eyes (6%) in group 2. Pyogenic granuloma occurred in 3 (3%) eyes out of 100 in group 2. No other serious complications were noted. At the 3 week visit the overall patient satisfaction score was statistically significantly higher for group 1 (P < 0.002) compared to group 2. At 3 months postoperatively, the gain in uncorrected visual acuity (UCVA) ranged from 0.2 to 0.5 Log MAR in 10 eyes. Conclusion Sutureless and glue free conjunctival autograft technique is easy, safe, effective, prevents potential adverse reactions encountered with the use of foreign materials. This technique has an acceptable pterygium recurrence rate that is comparable to conventional sutured conjunctival autograft for primary pterygium. PMID:25473346

  17. A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients

    PubMed Central

    Wasserstein, David; Sheth, Ujash; Cabrera, Alison; Spindler, Kurt P.

    2015-01-01

    Context: The advantages of allograft anterior cruciate ligament reconstruction (ACLR), which include shorter surgical time, less postoperative pain, and no donor site morbidity, may be offset by a higher risk of failure. Previous systematic reviews have inconsistently shown a difference in failure prevalence by graft type; however, such reviews have never been stratified for younger or more active patients. Objective: To determine whether there is a different ACLR failure prevalence of autograft compared with allograft in young, active patients. Data Sources: EMBASE, MEDLINE, Cochrane trials registry. Study Selection: Comparative studies of allograft versus autograft primary ACL reconstruction in patients <25 years of age or of high-activity level (military, Marx activity score >12 points, collegiate or semiprofessional athletes). Study Design: Systematic review with meta-analysis. Level of Evidence: Level 3. Data Extraction: Manual extraction of available data from eligible studies. Quantitative synthesis of failure prevalence and Lysholm score (outcomes in ≥3 studies) and I2 test for heterogeneity. Assessment of study quality using CLEAR NPT and Newcastle-Ottawa Scale (NOS). Results: Seven studies met inclusion criteria (1 level 1; 2 level 2, 4 level 3), including 788 patients treated with autograft tissue and 228 with various allografts. The mean age across studies was 21.7 years (64% male), and follow-up ranged between 24 and 51 months. The pooled failure prevalence was 9.6% (76/788) for autografts and 25.0% (57/228) for allografts (relative risk, 0.36; 95% CI, 0.24-0.53; P < 0.00001; I2 = 16%). The number needed to benefit to prevent 1 failure by using autograft was 7 patients (95% CI, 5-10). No difference between hamstrings autograft and patella tendon autograft was noted. Lysholm score was reported in 3 studies and did not differ between autograft and allograft. Conclusion: While systematic reviews comparing allograft and autograft ACLR have been equivocal

  18. Factors Influencing Graft Choice in Revision Anterior Cruciate Ligament Reconstruction in the MARS Group.

    PubMed

    Group, Mars

    2016-08-01

    It has not been known what drives revision anterior cruciate ligament (ACL) reconstruction graft choice in the past. We undertook this study to utilize the Multicenter ACL Revision Study (MARS) group and propensity score statistical analysis to determine the drivers of revision ACL reconstruction graft choice. We hypothesized that propensity analysis would demonstrate that individual surgeons still have significant impact on revision ACL reconstruction. Twelve hundred patients were enrolled in this longitudinal revision cohort by 83 surgeons at 52 sites. The median age was 26 years and 505 (42%) were females. One thousand forty-nine (87%) patients were undergoing their first ACL revision. Graft choice for revision ACL reconstruction for these patients was 48% autograft, 49% allograft, and 3% combination. The independent variables of this model included gender, age, ethnicity, body mass index, smoking status, sport, activity level, previous graft, revision number, surgeon, surgeon's opinion of failure, previous technical aspects, etc. Surgeons were defined as those who contributed more than 15 patients during the enrollment period. . We calculated a propensity score for graft type based on the predicted probability of receiving an allograft from a logistic regression model. Propensity scores demonstrated that surgeon, prior graft choice, and patient age each had significant influence on which graft type was chosen for the revision ACL reconstruction (p  < 0.0001). The revising surgeon had the largest impact upon graft choice: ∼ 5 times that of the second-most important factor (prior graft). If the prior graft type was an autograft, then an allograft was 3.6 times more likely to be chosen for the revision. This current study demonstrates that the individual surgeon is ultimately the most important factor in revision ACL reconstruction graft choice. Additional statistically significant influences of graft choice included age, gender, previous graft choice, ACL

  19. Histological evaluation of an impacted bone graft substitute composed of a combination of mineralized and demineralized allograft in a sheep vertebral bone defect.

    PubMed

    Fujishiro, Takaaki; Bauer, Thomas W; Kobayashi, Naomi; Kobayashi, Hideo; Sunwoo, Moon Hae; Seim, Howard B; Turner, A Simon

    2007-09-01

    Demineralized bone matrix (DBMs) preparations are a potential alternative or supplement to autogenous bone graft, but many DBMs have not been adequately tested in clinically relevant animal models. The aim of current study was to compare the efficacy of a new bone graft substitute composed of a combination of mineralized and demineralized allograft, along with hyaluronic acid (AFT Bone Void Filler) with several other bone graft materials in a sheep vertebral bone void model. A drilled defect in the sheep vertebral body was filled with either the new DBM preparation, calcium sulfate (OsteoSet), autologous bone graft, or left empty. The sheep were euthanized after 6 or 12 weeks, and the defects were examined by histology and quantitative histomorphometry. The morphometry data were analyzed by one-way analysis of variance with the post hoc Tukey-Kramer test or the Student's t-test. All of the bone defects in the AFT DBM preparation group showed good new bone formation with variable amounts of residual DBM and mineralized bone graft. The DBM preparation group at 12 weeks contained significantly more new bone than the defects treated with calcium sulfate or left empty (respectively, p < 0.05, p < 0.01). There was no significant difference between the DBM and autograft groups. No adverse inflammatory reactions were associated with any of the three graft materials. The AFT preparation of a mixture of mineralized and demineralized allograft appears to be an effective autograft substitute as tested in this sheep vertebral bone void model. PMID:17309059

  20. Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report.

    PubMed

    Won, Yougun; Lee, Gi Soo; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu Hyun

    2016-11-01

    As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest. PMID:27593886

  1. Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort

    PubMed Central

    Wright, Rick W.; Huston, Laura J.; Haas, Amanda K.; Spindler, Kurt P.; Nwosu, Sam K.; Allen, Christina R.; Anderson, Allen F.; Cooper, Daniel E.; DeBerardino, Thomas M.; Dunn, Warren R.; Lantz, Brett (Brick) A.; Stuart, Michael J.; Garofoli, Elizabeth A.; Albright, John P.; Amendola, Annunziato (Ned); Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler, J. Brad; Campbell, John D.; Carey, James L.; Carpenter, James E.; Cole, Brian J.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O'Neill, Daniel F.; Owens, Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur C.; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Svoboda, Steven J.; Taft, Timothy N.; Tenuta, Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.

    2015-01-01

    Background Most surgeons believe that graft choice for ACL reconstruction is an important factor related to outcome. Although graft choice may be limited in the revision setting based on previously used grafts, it is still felt to be important. Hypothesis The purpose of this study was to determine if revision ACL graft choice predicts outcomes related to sports function, activity level, OA symptoms, graft re-rupture, and reoperation at two years following revision reconstruction. We hypothesized that autograft use would result in increased sports function, increased activity level, and decreased OA symptoms (as measured by validated patient reported outcome instruments). Additionally, we hypothesized that autograft use would result in decreased graft failure and reoperation rate 2 years following revision ACL reconstruction. Study Design Prospective cohort study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled by 83 surgeons over 52 sites. Data collected included baseline demographics, surgical technique and pathology, and a series of validated patient reported outcome instruments (IKDC, KOOS, WOMAC, and Marx activity rating score). Patients were followed up at 2 years, and asked to complete the identical set of outcome instruments. Incidence of additional surgery and reoperation due to graft failure were also recorded. Multivariate regression models were used to determine the predictors (risk factors) of IKDC, KOOS, WOMAC, Marx scores, graft re-rupture, and reoperation rate at 2 years following revision surgery. Results 1205 patients were successfully enrolled with 697 (58%) males. Median age was 26. In 88% this was their first revision. 341 (28%) were undergoing revision by the surgeon that had performed the previous reconstruction. 583 (48%) underwent revision reconstruction utilizing an autograft, 590 (49%) allograft, and 32 (3%) both autograft and allograft. Median time since their last ACL

  2. Autograft versus sterilized allograft for lateral calcaneal lengthening osteotomies: Comparison of 50 patients.

    PubMed

    Müller, Sebastian A; Barg, Alexej; Vavken, Patrick; Valderrabano, Victor; Müller, Andreas M

    2016-07-01

    Sterilized allografts may be less resistant to collapse and prone to nonunion leading to loss of correction in open wedge osteotomies. These adverse events usually occur at early time points (i.e., < 9 months postoperatively). The goal of this study was to compare sterilized allografts to autologous grafts in respect to secondary loss of hindfoot alignment and graft incorporation after lateral calcaneal lengthening osteotomies.Fifty patients (22 F/ 28 M, age: 16-69 years) who had undergone 50 lateral calcaneal lengthening osteotomies for adult flatfoot deformity were included in this retrospective study. Cortical sterilized allografts were used in 25 patients, autologous grafts in the remaining 25. Patients' preoperative, 6 and 12 weeks, and 6 to 9 months follow-up weight-bearing radiographs of the affected foot were analyzed by 2 blinded radiologists: on each radiograph, graft incorporation, the talo-first metatarsal angle (TFMA), the talo-navicular coverage angle (TNCA), and the calcaneal pitch angle (CPA) were assessed. Loss of hindfoot alignment was defined as an increase of the TFMA or the TNCA or a decrease of the CPA, each by 5°.Inter- and intraclass correlation coefficients for TFMA, TNCA, and CPA measurements ranged from 0.93 to 0.99. At all follow-up visits, the ratio of patients with loss of hindfoot alignment and graft incorporation was not significantly different between the allograft and autograft group. However, loss of correction was associated with failure of graft incorporation.Compared with autografts, sterilized allografts do not increase the risk for loss of hindfoot alignment in lateral column lengthening of the calcaneus. With respect to mechanical resistance, allografts thus mean an equal and valid alternative without risk of donor site morbidities. PMID:27472719

  3. An inside-out vein graft filled with platelet-rich plasma for repair of a short sciatic nerve defect in rats.

    PubMed

    Kim, Ji Yeong; Jeon, Woo Joo; Kim, Dong Hwee; Rhyu, Im Joo; Kim, Young Hwan; Youn, Inchan; Park, Jong Woong

    2014-07-15

    Platelet-rich plasma containing various growth factors can promote nerve regeneration. An inside-out vein graft can substitute nerve autograft to repair short nerve defects. It is hypothesized that an inside-out vein graft filled with platelet-rich plasma shows better effects in the repair of short sciatic nerve defects. In this study, an inside-out vein autograft filled with platelet-rich plasma was used to bridge a 10 mm-long sciatic nerve defect in rats. The sciatic nerve function of rats with an inside-out vein autograft filled with platelet-rich plasma was better improved than that of rats with a simple inside-out vein autograft. At 6 and 8 weeks, the sciatic nerve function of rats with an inside-out vein autograft filled with platelet-rich plasma was better than that of rats undergoing nerve autografting. Compared with the sciatic nerve repaired with a simple inside-out vein autograft, the number of myelinated axons was higher, axon diameter and myelin sheath were greater in the sciatic nerve repaired with an inside-out vein autograft filled with platelet-rich plasma and they were similar to those in the sciatic nerve repaired with nerve autograft. These findings suggest that an inside-out vein graft filled with platelet-rich plasma can substitute nerve autograft to repair short sciatic nerve defects. PMID:25221591

  4. Application of molecular modeling to polymer grafted nanostructures

    NASA Astrophysics Data System (ADS)

    Adiga, Shashishekar P.

    Polymer chains undergo conformational transitions in response to a change in solvent quality of their environment, making them strong candidates to be used in smart nanometer-scale devices. In the present work molecular modeling is used to explore grafted polymer structures with various functionalities. The first part of this research focuses on two examples of selective transport through nanopores modified with polymer brush structures. The first is the investigation of solvent flow through nanopores grafted with linear chains. Molecular dynamics (MD) simulations are used to demonstrate how a stretch-collapse transition in grafted polymer chains can be used to control solvent flow rate through a nanopore in response to environmental stimuli. A continuum fluid dynamics method based on porous layer model for describing flow through the smart nanopore is described and its accuracy is analyzed by comparing with the results from MD simulations. The continuum method is then applied to determine regulation of water permeation in response to pH through a poly(L-glutamic acid) grafted nanoporous membrane. A second example is use of a rod-coil transition in "bottle brush" molecules that are grafted to the inside of a nanopore to size select macromolecules as they diffuse through the functionalized nanopores. These stimuli-responsive nanopores have a variety of potential applications including molecular sorting, smart drug delivery, and ultrafiltration, as well as controlled chemical release. Tethered polymers play an important role in biological structures as well. In the second part of the research, application of atomistic simulations to characterize the effect of phosphorylation on neurofilament structure is presented. Neurofilaments are intermediate filaments that regulate axonal diameter through their long, flexible side arms extending from the central core. Their functionality is imparted by polymer brush like structure that causes steric repulsion between the

  5. Visual outcome and efficacy of conjunctival autograft, harvested from the body of pterygium in pterygium excision

    PubMed Central

    Bhandari, Vipul; Rao, Chandan Latha; Ganesh, Sri; Brar, Sheetal

    2015-01-01

    Purpose To evaluate the efficacy of conjunctival autograft after the pterygium excision with fibrin adhesive using conjunctiva over the pterygium. Patients and methods This prospective study included 25 eyes of 25 patients with a mean age of 40±10 years, who underwent the pterygium excision with conjunctival autograft derived from the body of the pterygium and attached using fibrin glue. The mean follow-up period was 6 months. On all postoperative visits, changes in uncorrected visual acuity, corrected distance visual acuity, astigmatism, complications, and the evidence of recurrence were recorded. Results At the end of mean follow-up, uncorrected visual acuity and corrected distance visual acuity improved by one or two lines in all eyes treated. Mean astigmatism reduced significantly from a preoperative value from 2.308D to 1.248D postoperatively (P<0.026). Minor postoperative complications such as congestion, chemosis, and subconjunctival hemorrhage were seen, which resolved with time. No major sight-threatening or graft-related complications were detected. There was no evidence of recurrence during a follow-up period of 6 months. Conclusion Self-conjunctival autograft following the pterygium excision appears to be a feasible, safe, and effective alternative method for management of pterygium. It also preserves the superior conjunctiva for future surgeries. However, longer follow-up is required to study the long-term outcomes, especially the incidence of recurrence. PMID:26664044

  6. Development and assessment of a biodegradable solvent cast polyester fabric small-diameter vascular graft

    PubMed Central

    Brandes, Zachary R; Jonas, Richard A.; Fisher, John P.

    2014-01-01

    Adjusting the mechanical properties of polyester-based vascular grafts is crucial to achieving long-term success in vivo. While previous studies using a fabric-based approach have achieved some success, a central issue with pure poly(lactic acid) (PLA) or poly(glycolic acid) (PGA) grafts sealed with poly(DL-caprolactone-co-lactic acid) (P(CL/LA)) has been stenosis. Intimal hyperplasia, a leading cause of stenosis, can be caused by the mechanical incompatibility of synthetic vascular grafts. Investigating the performance of poly(glycolic-co-lactic acid) grafts (PGLA) could lead to insight into whether graft stenosis stems from mechanical issues such as non-compliance and unfavorable degradation times. This could be achieved by examining grafts with tunable mechanical properties between the ranges of such properties in pure PGA and PLA based grafts. In this study, we examined PGLA-based grafts sealed with different P(CL/LA) solutions to determine the PGLA-P(CL/LA) grafts' mechanical properties and tissue functionality. Cell attachment and proliferation on graft surfaces were also observed. For in vivo assessment, grafts were implanted in a mouse model. Mechanical properties and degradation times appeared adequate compared to recorded values of vessels used in autograft procedures. Initial neotissue formation was observed in the grafts and patency maintained during the pilot study. This study presents a ~1mm diameter degradable graft demonstrating suitable mechanical properties and in vivo pilot study success, enabling further investigation into the tuning of mechanical properties to reduce complications in degradable polyester fabric-based vascular grafts. PMID:23852776

  7. Traveling waves in the modelling of aerosolised skin grafts

    NASA Astrophysics Data System (ADS)

    Ai, Shangbing

    2008-11-01

    Denman et al. [P.K. Denman, D.L.S. McElwain, J. Norbury, Analysis of travelling waves associated with the modelling of aerosolised skin grafts, Bull. Math. Biol. 69 (2007) 495-523] proposed a novel model on the growth pattern of keratinocyte cell colonies that were sprayed on to a severe burn site to facilitate the healing process. They studied traveling wave solutions of the model by asymptotic analysis and obtained several qualitative properties. In this paper we establish the following result on the traveling waves: there exists a minimal speed c such that the model has a unique biologically meaningful travelling wave solution for each speed c≥c and has no such a solution for any c

  8. Bilateral ACL Reconstructions with Hamstring Autografts.

    PubMed

    Panigrahi, Ranajit; Mahapatra, Amita Kumari; Priyadarshi, Ashok; Palo, Nishit; Biswal, Manas R

    2016-07-01

    Bilateral anterior cruciate ligament (ACL) injuries are rare with incidence between 2 and 4%, and presently no definitive guidelines for proper management exist. Ideal treatment protocol remains controversial between a single-stage and two-stage bilateral ACL reconstruction. The purpose of this study is to evaluate the outcome of single-stage bilateral ACL reconstruction with hamstring tendon autografts in bilateral ACL injuries. A prospective study was undertaken including a total of 14 consecutive patients with bilateral ACL deficient knee who underwent single-stage bilateral ACL reconstruction with hamstring tendon autograft with a mean follow-up duration of 28 months (24-38 months). Functional outcomes were evaluated by range of movements, International Knee Documentation Committee (IKDC), Lysholm and Tegner activity score, and stability tests. The mean age was 30 years (range 18-42 years). Average duration of rehabilitation was 8 weeks. Time to return to full-time work and full sports was 5.6 weeks and 6.2 months, respectively. Clinical examination demonstrated full range of motion; a total of 12 patients (86%) had a negative Lachman test and 13 patients (93%) had a negative pivot shift at the final follow-ups. The mean IKDC evaluation score was 89 points, the mean Tegner activity score was 7 points, and the mean Lysholm knee score was 91 points. A total of 12 patients (86%) returned to their preinjury level of activity and an overall greater than 90% satisfaction rate was achieved. Single-stage bilateral ACL reconstruction using hamstring autografts is clinically safe, effective, and cost-effective with better patient compliance and with comparable functional outcome as opposed to two-stage ACL reconstructions. PMID:26408992

  9. Model for bending actuators that use electrostrictive graft elastomers

    NASA Astrophysics Data System (ADS)

    Costen, Robert C.; Su, Ji; Harrison, Joycelyn S.

    2001-07-01

    Recently, it was reported that an electrostrictive graft elastomer exhibits large electric field-induced strain (4%). Combined with its high mechanical modulus, the elastomer can offer very promising electromechanical properties, in terms of output mechanical energy density, for an electroactive polymeric material. Therefore, it has been considered as one of the candidates that can be used in high performance, low mass actuation devices in many aerospace applications. Various bi-layer-based bending actuators have been designed and fabricated. An analytic model based on beam theory in the strength of materials has been derived for the transverse deflection, or curvature, and the longitudinal strain of the bi-layer beam. The curvature and strain are functions of the applied voltage and the thickness, width, and Young's modulus of the active and passive layers. The model can be used to optimize the performance of electrostrictive graft elastomer-based actuators to meet the requirements of various applications. In this presentation, optimization and sensitivity studies are applied to the bending performance of such actuators.

  10. Model For Bending Actuators That Use Electrostrictive Graft Elastomers

    NASA Technical Reports Server (NTRS)

    Costen, Robert C.; Su, Ji; Harrison, Joycelyn S.

    2001-01-01

    Recently, it was reported that an electrostrictive graft elastomer exhibits large electric field-induced strain (4%). Combined with its high mechanical modulus, the elastomer can offer very promising electromechanical properties, in terms of output mechanical energy density, for an electroactive polymeric material. Therefore, it has been considered as one of the candidates that can be used in high performance, low mass actuation devices in many aerospace applications. Various bilayer- based bending actuators have been designed and fabricated. An analytic model based on beam theory in the strength of materials has been derived for the transverse deflection, or curvature, and the longitudinal strain of the bi-layer beam. The curvature and strain are functions of the applied voltage and the thickness, width, and Young s modulus of the active and passive layers. The model can be used to optimize the performance of electrostrictive graft elastomer-based actuators to meet the requirements of various applications. In this presentation, optimization and sensitivity studies are applied to the bending performance of such actuators.

  11. Grafts for Ridge Preservation

    PubMed Central

    Jamjoom, Amal; Cohen, Robert E.

    2015-01-01

    Alveolar ridge bone resorption is a biologic phenomenon that occurs following tooth extraction and cannot be prevented. This paper reviews the vertical and horizontal ridge dimensional changes that are associated with tooth extraction. It also provides an overview of the advantages of ridge preservation as well as grafting materials. A Medline search among English language papers was performed in March 2015 using alveolar ridge preservation, ridge augmentation, and various graft types as search terms. Additional papers were considered following the preliminary review of the initial search that were relevant to alveolar ridge preservation. The literature suggests that ridge preservation methods and augmentation techniques are available to minimize and restore available bone. Numerous grafting materials, such as autografts, allografts, xenografts, and alloplasts, currently are used for ridge preservation. Other materials, such as growth factors, also can be used to enhance biologic outcome. PMID:26262646

  12. Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss

    PubMed Central

    Tokish, John M.; Fitzpatrick, Kelly; Cook, Jay B.; Mallon, William J.

    2014-01-01

    Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability. PMID:25264509

  13. Vascularized proximal fibular autograft for treatment of post-traumatic segmental bony defects in the distal radius.

    PubMed

    Shimizu, Takamasa; Yajima, Hiroshi; Kobata, Yasunori; Shigematsu, Koji; Kawamura, Kenji; Takakura, Yoshinori

    2008-11-01

    Vascularized proximal fibular autograft is reported as one of the reconstructive procedures for the wrists following tumor resection in the distal end of the radius. However, it is rarely performed for the treatment of segmental bony defects in the distal radius after trauma. A 19-year-old man who had traumatic bony defects in the distal radius involving the articular surface underwent vascularized proximal fibular grafting for reconstruction of the wrist. After surgery, he regained wrist functions, with 40 degrees of flexion, 45 degrees of extension, 90 degrees of pronation, and 45 degrees of supination. No evidence of instability or degenerative changes was noted in the reconstructed wrist at 3 years after surgery. Vascularized proximal fibular autograft appears a useful procedure both for reconstruction of the wrist in cases with segmental bony defects in the distal radius after trauma, as well as for after tumor resection. PMID:18925543

  14. Rat posterior facial vein interpositional graft: a more relevant training model.

    PubMed

    Lee, Nicolas; Daley, Roger A; Cooley, Brian C

    2014-11-01

    Microvascular training models for vein grafting most often use the rat epigastric vein interpositioned to the femoral artery. We describe the rat posterior facial vein as an alternative vein graft model; it has at least a 2:1 diametric ratio to the femoral artery and a tougher connective tissue, making it more similar to clinical vein grafting for reconstructive microsurgery. A series of 24 grafts interpositioned to the femoral artery were done using 11-12 sutures per end-to-end anastomosis and yielded early patency rates of 96% at 20 min and 92% at 2 and 4 weeks for subsets of 12 grafts. As a training model the diametric disparity provides unique challenges with clinical relevance, for which a number of different techniques for matching arterial to venous circumferences can be done. PMID:24848809

  15. Rationale and Practical Techniques for Mouse Models of Early Vein Graft Adaptations

    PubMed Central

    Yu, Peng; Nguyen, Binh T.; Tao, Ming; Campagna, Christina; Ozaki, C. Keith

    2010-01-01

    Mouse models serve as relatively new yet powerful research tools to study intimal hyperplasia and wall remodeling of vein bypass graft failure. Several model variations have been reported in the past decade. However, the approach demands thoughtful preparation, selected sophisticated equipment, microsurgical technical expertise, advanced tissue processing and data acquisition. This review compares several described models, and aims (building on our personal experiences) to practically aid the investigators who want to utilize mouse models of vein graft failure. PMID:20573477

  16. Very low rate of readmission after an early discharge outpatient model for autografting in multiple myeloma patients: an Italian multicenter retrospective study.

    PubMed

    Martino, Massimo; Montanari, Mauro; Ferrara, Felicetto; Ciceri, Fabio; Scortechini, Ilaria; Palmieri, Salvatore; Marktel, Sarah; Cimminiello, Michele; Messina, Giuseppe; Irrera, Giuseppe; Offidani, Massimo; Console, Giuseppe; Castagna, Luca; Milone, Giuseppe; Bruno, Benedetto; Tripepi, Giovanni; Lemoli, Roberto Massimo; Olivieri, Attilio

    2014-07-01

    We analyzed the main modalities and clinical outcomes of the early discharge outpatient model in autologous stem cell transplantation (EDOM-ASCT) for multiple myeloma in Italy. EDOM-ASCT was employed in 382 patients, for a total of 522 procedures, between 1998 and 2012. Our study showed high homogeneity among centers in terms of inclusion criteria, supportive care, and in hospital readmission criteria. Overall, readmissions during the aplastic phase occurred in 98 of 522 transplantations (18.8%). The major extrahematological complication was neutropenic fever in 161 cases (30.8%), which required readmission in 76 cases. The incidence of severe World Health Organization grade 3 to 4 mucositis was 9.6%. By univariate analysis, fever, mucositis, altered renal function at diagnosis, second transplantation, and transplantation performed late in the course of the disease were significantly correlated with readmission, whereas fever, mucositis, altered renal function, and timing of transplantation remained the only independent predictors by multivariate analysis. Overall, transplantation-related mortality was 1.0%. No center effect was observed in this study (P = .36). The safety and low rate of readmission of the EDOM-ASCT in myeloma trial suggest that this strategy could be extended to other transplantation centers if a stringent patient selection and appropriate management are applied. PMID:24699116

  17. Modelling ultrasound-induced mild hyperthermia of hyperplasia in vascular grafts

    PubMed Central

    2011-01-01

    Background Expanded polytetrafluoroethylene (ePTFE) vascular grafts frequently develop occlusive neointimal hyperplasia as a result of myofibroblast over-growth, leading to graft failure. ePTFE exhibits higher ultrasound attenuation than native soft tissues. We modelled the selective absorption of ultrasound by ePTFE, and explored the feasibility of preventing hyperplasia in ePTFE grafts by ultrasound heating. Specifically, we simulated the temperature profiles of implanted grafts and nearby soft tissues and blood under ultrasound exposure. The goal was to determine whether ultrasound exposure of an ePTFE graft can generate temperatures sufficient to prevent cell growth on the graft without damaging nearby soft tissues and blood. Methods Ultrasound beams from two transducers (1.5 and 3.2 MHz) were simulated in two graft/tissue models, with and without an intra-graft cellular layer mimicking hyperplasia, using the finite-difference time-domain (FDTD) method. The resulting power deposition patterns were used as a heat source for the Pennes bioheat equation in a COMSOL® Multiphysics heat transfer model. 50°C is known to cause cell death and therefore the transducer powers were adjusted to produce a 13°C temperature rise from 37°C in the ePTFE. Results Simulations showed that both the frequency of the transducers and the presence of hyperplasia significantly affect the power deposition patterns and subsequent temperature profiles on the grafts and nearby tissues. While neither transducer significantly raised the temperature of the blood, the 1.5-MHz transducer was less focused and heated larger volumes of the graft and nearby soft tissues than the 3.2-MHz transducer. The presence of hyperplasia had little effect on the blood's temperature, but further increased the temperature of the graft and nearby soft tissues in response to either transducer. Skin cooling and blood flow play a significant role in preventing overheating of the native tissues. Conclusions

  18. Two-step grafting significantly enhances the survival of foetal dopaminergic transplants and induces graft-derived vascularisation in a 6-OHDA model of Parkinson's disease.

    PubMed

    Büchele, Fabian; Döbrössy, Máté; Hackl, Christina; Jiang, Wei; Papazoglou, Anna; Nikkhah, Guido

    2014-08-01

    Following transplantation of foetal primary dopamine (DA)-rich tissue for neurorestaurative treatment of Parkinson's disease (PD), only 5-10% of the functionally relevant DAergic cells survive both in experimental models and in clinical studies. The current work tested how a two-step grafting protocol could have a positive impact on graft survival. DAergic tissue is divided in two portions and grafted in two separate sessions into the same target area within a defined time interval. We hypothesized that the first graft creates a "DAergic" microenvironment or "nest" similar to the perinatal substantia nigra that stimulates and protects the second graft. 6-OHDA-lesioned rats were sequentially transplanted with wild-type (GFP-, first graft) and transgenic (GFP+, second graft) DAergic cells in time interims of 2, 5 or 9days. Each group was further divided into two sub-groups receiving either 200k (low cell number groups: 2dL, 5dL, 9dL) or 400k cells (high cell number groups: 2dH, 5dH, 9dH) as first graft. During the second transplantation, all groups received the same amount of 200k GFP+ cells. Controls received either low or high cell numbers in one single session (standard protocol). Drug-induced rotations, at 2 and 6weeks after grafting, showed significant improvement compared to the baseline lesion levels without significant differences between the groups. Rats were sacrificed 8weeks after transplantation for post-mortem histological assessment. Both two-step groups with the time interval of 2days (2dL and 2dH) showed a significantly higher survival of DAergic cells compared to their respective standard control group (2dL, +137%; 2dH, +47%). Interposing longer intervals of 5 or 9days resulted in the loss of statistical significance, neutralising the beneficial two-step grafting effect. Furthermore, the transplants in the 2dL and 2dH groups had higher graft volume and DA-fibre-density values compared to all other two-step groups. They also showed intense growth of

  19. Spectrocolorimetric assessment of cartilage plugs after autologous osteochondral grafting: correlations between color indices and histological findings in a rabbit model

    PubMed Central

    Hattori, Koji; Uematsu, Kota; Tanikake, Yohei; Habata, Takashi; Tanaka, Yasuhito; Yajima, Hiroshi; Takakura, Yoshinori

    2007-01-01

    We investigated the use of a commercial spectrocolorimeter and the application of two color models (L* a* b* colorimetric system and spectral reflectance distribution) to describe and quantify cartilage plugs in a rabbit model of osteochondral autografting. Osteochondral plugs were removed and then replaced in their original positions in Japanese white rabbits. The rabbits were sacrificed at 4 or 12 weeks after the operation and cartilage samples were assessed using a spectrocolorimeter. The samples were retrospectively divided into two groups on the basis of the histological findings (group H: hyaline cartilage, successful; group F: fibrous tissue or fibrocartilage, failure) and investigated for possible significant differences in the spectrocolorimetric analyses between the two groups. Moreover, the relationships between the spectrocolorimetric indices and the Mankin histological score were examined. In the L* a* b* colorimetric system, the L* values were significantly lower in group H than in group F (P = 0.02), whereas the a* values were significantly higher in group H than in group F (P = 0.006). Regarding the spectral reflectance distribution, the spectral reflectance percentage 470 (SRP470) values, as a coincidence index for the spectral reflectance distribution (400 to 470 nm in wavelength) of the cartilage plugs with respect to intact cartilage, were 99.8 ± 6.7% in group H and 119.8 ± 10.6% in group F, and the difference between these values was significant (P = 0.005). Furthermore, the a* values were significantly correlated with the histological score (P = 0.004, r = -0.76). The SRP470 values were also significantly correlated with the histological score (P = 0.01, r = 0.67). Our findings demonstrate the ability of spectrocolorimetric measurements to predict the histological findings of cartilage plugs after autologous osteochondral grafting. In particular, the a* values and SRP470 values can be used to judge the surface condition of an osteochondral

  20. A Computational Model of Optimal Vein Graft Adaptation in an Arterial Environment

    NASA Astrophysics Data System (ADS)

    Ramachandra, Abhay B.; Sankaran, Sethuraman; Humphrey, Jay; Marsden, Alison

    2012-11-01

    In coronary artery disease, surgical revascularization using venous bypass grafts is performed to relieve symptoms and prolong life. Coronary bypass graft surgery is performed on approximately 500,000 people every year in the United States, with graft failure rates as high as 50% within 5 years. When a vein graft is implanted in the arterial system it adapts to the high flow rate and high pressure of the arterial environment by changing composition and geometry, and thus stiffness. Hemodynamic loads, resulting in altered wall shear and intramural stresses, are major factors impacting vein graft remodeling. Here, a constrained mixture theory of growth and remodeling for arteries is extended to model the evolution of a vein graft subjected to arterial flow and pressure conditions. A derivative-free optimization method is used to estimate the optimal set of constitutive parameters that best match passive biaxial mouse inferior vena cava data from experiments. Optimization is performed using surrogate management framework, a pattern search method with established convergence theory. The resulting parameter set is used to predict optimal vein adaptation in an arterial environment for two illustrative cases: a) Step change b) Gradual change in loading. Results are compared against vein graft data from the literature and a possible set of mechanisms for sub-optimal vein graft remodeling is suggested.

  1. Low-intensity pulsed ultrasound treatment improved the rate of autograft peripheral nerve regeneration in rat.

    PubMed

    Jiang, Wenli; Wang, Yuexiang; Tang, Jie; Peng, Jiang; Wang, Yu; Guo, Quanyi; Guo, Zhiyuan; Li, Pan; Xiao, Bo; Zhang, Jinxing

    2016-01-01

    Low intensity pulsed ultrasound (LIPUS) has been widely used in clinic for the treatment of repairing pseudarthrosis, bone fractures and of healing in various soft tissues. Some reports indicated that LIPUS accelerated peripheral nerve regeneration including Schwann cells (SCs) and injured nerves. But little is known about its appropriate intensities on autograft nerves. This study was to investigate which intensity of LIPUS improved the regeneration of gold standard postsurgical nerves in experimental rat model. Sprague-Dawley rats were made into 10 mm right side sciatic nerve reversed autologous nerve transplantation and randomly treated with 250 mW/cm(2), 500 mW/cm(2) or 750 mW/cm(2) LIPUS for 2-12 weeks after operation. Functional and pathological results showed that LIPUS of 250 mW/cm(2) significantly induced faster rate of axonal regeneration. This suggested that autograft nerve regeneration was improved. PMID:27102358

  2. Low-intensity pulsed ultrasound treatment improved the rate of autograft peripheral nerve regeneration in rat

    PubMed Central

    Jiang, Wenli; Wang, Yuexiang; Tang, Jie; Peng, Jiang; Wang, Yu; Guo, Quanyi; Guo, Zhiyuan; Li, Pan; Xiao, Bo; Zhang, Jinxing

    2016-01-01

    Low intensity pulsed ultrasound (LIPUS) has been widely used in clinic for the treatment of repairing pseudarthrosis, bone fractures and of healing in various soft tissues. Some reports indicated that LIPUS accelerated peripheral nerve regeneration including Schwann cells (SCs) and injured nerves. But little is known about its appropriate intensities on autograft nerves. This study was to investigate which intensity of LIPUS improved the regeneration of gold standard postsurgical nerves in experimental rat model. Sprague-Dawley rats were made into 10 mm right side sciatic nerve reversed autologous nerve transplantation and randomly treated with 250 mW/cm2, 500 mW/cm2 or 750 mW/cm2 LIPUS for 2–12 weeks after operation. Functional and pathological results showed that LIPUS of 250 mW/cm2 significantly induced faster rate of axonal regeneration. This suggested that autograft nerve regeneration was improved. PMID:27102358

  3. “Over-inlay” block graft and differential morphometry: a novel block graft model to study bone regeneration and host-to-graft interfaces in rats

    PubMed Central

    2016-01-01

    Purpose The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized “over-inlay” surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an “over-inlay” graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time (24.53%±1.26% at 1 month; 37.73%±0.39% at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue (71.16%±8.06% and 78.30%±2.67%, respectively), while the CA showed high amounts of DBBM at both time points (78.30%±2.67% and 74.68%±1.07%, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions The present model allowed for a standardized investigation of distinct graft

  4. Fresh-frozen Complete Extensor Mechanism Allograft versus Autograft Reconstruction in Rabbits

    PubMed Central

    Chen, Guanyin; Zhang, Hongtao; Ma, Qiong; Zhao, Jian; Zhang, Yinglong; Fan, Qingyu; Ma, Baoan

    2016-01-01

    Different clinical results have been reported in the repair of extensor mechanism disruption using fresh-frozen complete extensor mechanism (CEM) allograft, creating a need for a better understanding of fresh-frozen CME allograft reconstruction. Here, we perform histological and biomechanical analyses of fresh-frozen CEM allograft or autograft reconstruction in an in vivo rabbit model. Our histological results show complete incorporation of the quadriceps tendon into the host tissues, patellar survival and total integration of the allograft tibia, with relatively fewer osteocytes, into the host tibia. Vascularity and cellularity are reduced and delayed in the allograft but exhibit similar distributions to those in the autograft. The infrapatellar fat pad provides the main blood supply, and the lowest cellularity is observed in the patellar tendon close to the tibia in both the allograft and autograft. The biomechanical properties of the junction of quadriceps tendon and host tissues and those of the allograft patellar tendon are completely and considerably restored, respectively. Therefore, fresh-frozen CEM allograft reconstruction is viable, but the distal patellar tendon and the tibial block may be the weak links of the reconstruction. These findings provide new insight into the use of allograft in repairing disruption of the extensor mechanism. PMID:26911538

  5. Time-sequential changes of differentially expressed miRNAs during the process of anterior lumbar interbody fusion using equine bone protein extract, rhBMP-2 and autograft

    NASA Astrophysics Data System (ADS)

    Chen, Da-Fu; Zhou, Zhi-Yu; Dai, Xue-Jun; Gao, Man-Man; Huang, Bao-Ding; Liang, Tang-Zhao; Shi, Rui; Zou, Li-Jin; Li, Hai-Sheng; Bünger, Cody; Tian, Wei; Zou, Xue-Nong

    2014-03-01

    The precise mechanism of bone regeneration in different bone graft substitutes has been well studied in recent researches. However, miRNAs regulation of the bone formation has been always mysterious. We developed the anterior lumbar interbody fusion (ALIF) model in pigs using equine bone protein extract (BPE), recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS), and autograft as bone graft substitute, respectively. The miRNA and gene expression profiles of different bone graft materials were examined using microarray technology and data analysis, including self-organizing maps, KEGG pathway and Biological process GO analyses. We then jointly analyzed miRNA and mRNA profiles of the bone fusion tissue at different time points respectively. Results showed that miRNAs, including let-7, miR-129, miR-21, miR-133, miR-140, miR-146, miR-184, and miR-224, were involved in the regulation of the immune and inflammation response, which provided suitable inflammatory microenvironment for bone formation. At late stage, several miRNAs directly regulate SMAD4, Estrogen receptor 1 and 5-hydroxytryptamine (serotonin) receptor 2C for bone formation. It can be concluded that miRNAs play important roles in balancing the inflammation and bone formation.

  6. Use of the reamer-irrigator-aspirator technique to obtain autograft for ankle and hindfoot arthrodesis.

    PubMed

    Herscovici, D; Scaduto, J M

    2012-01-01

    The use of autograft bone is the best option when undertaking a procedure that requires bone graft because it is osteogenic, osteoconductive and osseo-inductive. Pain, morbidity and complications associated with harvesting iliac or non-iliac sites occur in between 6% and 30% of cases. An alternative source of graft with possibly a lower morbidity is the intramedullary canal. In this study, 28 patients undergoing 30 arthrodesis procedures on the hindfoot had a mean of 48 cm(3) (43 to 50) of bone harvested locally from the hindfoot or the tibial shaft by antegrade or retrograde reaming. No patient sustained a fracture of the calcaneum, talus or tibia. There was no morbidity except for one complication when the reamer breached the medial tibial cortex. This healed uneventfully. This method of using the reamer-irrigator-aspirator system is an extension of the standard technique of intramedullary reaming of the lower limb: it produces good-quality bone graft with viable growth factors consistent with that of the iliac crest, and donor site morbidity is low. This is an efficient method of obtaining autologous bone for use in arthrodesis of the ankle or hindfoot. PMID:22219251

  7. Hydrodynamic radius fluctuations in model DNA-grafted nanoparticles

    NASA Astrophysics Data System (ADS)

    Vargas-Lara, Fernando; Starr, Francis W.; Douglas, Jack F.

    2016-05-01

    We utilize molecular dynamics simulations (MD) and the path-integration program ZENO to quantify hydrodynamic radius (Rh) fluctuations of spherical symmetric gold nanoparticles (NPs) decorated with single-stranded DNA chains (ssDNA). These results are relevant to understanding fluctuation-induced interactions among these NPs and macromolecules such as proteins. In particular, we explore the effect of varying the ssDNA-grafted NPs structural parameters, such as the chain length (L), chain persistence length (lp), NP core size (R), and the number of chains (N) attached to the nanoparticle core. We determine Rh fluctuations by calculating its standard deviation (σRh) of an ensemble of ssDNA-grafted NPs configurations generated by MD. For the parameter space explored in this manuscript, σR h shows a peak value as a function of N, the amplitude of which depends on L, lp and R, while the broadness depends on R.

  8. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft

    PubMed Central

    Sun, Xiujiang; Zhang, Jianfeng; Qu, Xiaoyi

    2015-01-01

    Introduction The aim of the study was to compare and analyze retrospectively the outcomes of arthroscopic posterior cruciate ligament reconstruction with autograft versus allograft. Material and methods Seventy-one patients who underwent arthroscopic posterior cruciate ligament reconstruction with an autograft or allograft met our inclusion criteria. There were 36 patients in the autograft group and 35 patients in the allograft group. All the patients were evaluated by physical examination and a functional ligament test. Comparative analysis was done in terms of operation time, incision length, fever time, postoperative infection rate, incidence of numbness and dysesthesia around the incision, as well as a routine blood test. Results The average follow-up of the autograft group was 3.2 ±0.2 years and that of the allograft group was 3.3 ±0.6 years; there was no significant difference (p > 0.05). No differences existed in knee range of motion, Lysholm scores, International Knee Documentation Committee standard evaluation form and Tegner activity score at final follow-up (p > 0.05), except that patients in the allograft group had a shorter operation time and incision length and a longer fever time (p < 0.05). We found a difference in posterior drawer test and KT-2000 arthrometer assessment (p < 0.05). The posterior tibia displacement averaged 3.8 ±1.5 mm in the autograft group and 4.8 ±1.7 mm in the allograft group (p < 0.05). The incidence of numbness and dysesthesia around the incision in the autograft group was higher than that in the allograft group (p < 0.05). There was no infection postoperatively. The white blood cells and neutrophils in the allograft group increased more than those in the autograft group postoperatively (p < 0.05). Conclusions Both groups of patients had satisfactory outcomes after the operation. However, in the instrumented posterior laxity test, the autograft gave better results than the allograft. No differences in functional scores

  9. Improved survival of young donor age dopamine grafts in a rat model of Parkinson's disease.

    PubMed

    Torres, E M; Monville, C; Gates, M A; Bagga, V; Dunnett, S B

    2007-06-01

    In an attempt to improve the survival of implanted dopamine cells, we have readdressed the optimal embryonic donor age for dopamine grafts. In a rat model of Parkinson's disease, animals with unilateral 6-hydroxydopamine lesions of the median forebrain bundle received dopamine-rich ventral mesencephalic grafts derived from embryos of crown to rump length 4, 6, 9, or 10.5 mm (estimated embryonic age (E) 11, E12, E13 and E14 days post-coitus, respectively). Grafts derived from 4 mm embryos survived poorly, with less than 1% of the implanted dopamine cells surviving. Grafts derived from 9 mm and 10.5 mm embryos were similar to those seen in previous experiments with survival rates of 8% and 7% respectively. The best survival was seen in the group that received 6 mm grafts, which were significantly larger than all other graft groups. Mean dopamine cell survival in the 6 mm group (E12) was 36%, an extremely high survival rate for primary, untreated ventral mesencephalic grafts applied as a single placement, and more than fivefold larger than the survival rate observed in the 10.5 mm (E14) group. As E12 ventral mesencephalic tissues contain few, if any, differentiated dopamine cells we conclude that the large numbers of dopamine cells seen in the 6 mm grafts must have differentiated post-implantation. We consider the in vivo conditions which allow this differentiation to occur, and the implications for the future of clinical trials based on dopamine cell replacement therapy. PMID:17478050

  10. Establishment of an Animal Model of Vascular Restenosis with Bilateral Carotid Artery Grafting

    PubMed Central

    Li, Ruixiong; Lan, Bin; Zhu, Tianxiang; Yang, Yanlong; Wang, Muting; Ma, Chensheng; Chen, Shu

    2014-01-01

    Background Vascular restenosis occurring after CABG is a major clinical problem that needs to be addressed. Vein grafts are associated with a higher degree of stenosis than artery grafts. However, the mechanism responsible for this effect has not been elucidated. We aimed to establish a rabbit model of vascular restenosis after bilateral carotid artery grafting, and to investigate the associated spatiotemporal changes of intimal hyperplasia in carotid artery and jugular vein grafts after surgery. Material/Methods Twenty adult New Zealand white rabbits (10 males; 10 females), weighing 2.0–2.5 kg, were obtained from the Experimental Animal Center of Southern Medical University, Guangzhou, China (License No.: scxk-Guangdong-2006-0015). We quantitatively analyzed intimal thickness, area, and degree of stenosis in carotid artery and jugular vein bridges. Results After 8 weeks of a high-fat diet, rabbit carotid arteries showed early atherosclerotic lesions. With increasing time after surgery, carotid artery and jugular vein grafts showed histopathological and morphological changes, including smooth muscle cell migration, lipid deposition, intimal hyperplasia, and vascular stenosis. The degree of vascular stenosis was significantly higher in vein grafts than in artery grafts at all time points – 35.1±6.7% vs. 16.1±2.6% at Week 12, 56.2±8.5% vs. 23.4±3.4% at Week 16, and 71.2±1.3% vs. 25.2±5.3% at Week 20. Conclusions Rabbit bilateral carotid arteries were grafted with carotid artery and jugular vein bridges to simulate pathophysiological processes that occur in people after CABG surgery. PMID:25549796

  11. Effects of Gaps Induced Into the ACL Tendon Graft on Tendon-Bone Healing in a Rodent ACL Reconstruction Model

    PubMed Central

    Lovric, Vedran; Kanazawa, Tomonoshin; Nakamura, Yoshinari; Oliver, Rema A.; Yu, Yan; Walsh, William Robert

    2011-01-01

    Summary Graft necrosis following ACL reconstruction is often associated with the use of autologous grafts. Host cells rather than graft cells contribute to the repair of the tendon-bone interface and the remodeling of the autologous graft. The native tendon-bone interface is not recreated and the biomechanical properties are not restored back to native values. We examined the effects of introducing gaps within the tendon graft prior to ACL reconstruction in a rodent model. We hypothesised that gaps will make physical way for host cells to infiltrate and repopulate the graft and thus enhance healing. Animals were sacrificed at seven, fourteen, and twenty-eight days for biomechanical testing and histology. Our findings indicate that graft necrosis, usually observed in the initial two weeks of the healing process, is averted. Histological observations showed that tendon-bone healing stages were hastened however this didn’t translate into improved biomechanical properties. PMID:23738254

  12. Meso-scale Modeling of Self-assembly of Polymer-Grafted Nanoparticles

    NASA Astrophysics Data System (ADS)

    Mancini, Derrick; Deshmukh, Sanket; Sankaranarayanan, Subramanian

    2015-03-01

    We develop meso-scale models to explore the self-assembly behavior of polymer-grafted nanoparticles. Specifically, we study nanoparticles with grafts of the thermo-sensitive polymer poly(N-isopropylacrylamide) (PNIPAM), which undergoes a coil-to-globule transition across the LCST at around 305 K. The atomic-scale mechanism of the coil-to-globule transition of polymers grafted nanoparticles and their interactions (agglomeration, assembly behavior) with other particles that are in its vicinity is poorly understood, yet knowledge about these interactions would enable designing novel self-assembled materials with well-defined structural and dynamical properties. Additionally, the effects of chemical nature, geometry, and morphology of the nanoparticle surface on the conformational transition of thermo-sensitive polymers is also unknown. We report on 1) development of all-atom models of polymer-grafted nanoparticles to conduct MD simulations at atomic-levels and 2) perform mesoscopic scaling of the conformational dynamics resulting from the atomistic simulations with the aid of coarse-grained or meso-scale models of PNIPAM and its composites. Coarse-grained simulations allow modeling of larger assemblies of polymer-grafted nanoparticles over longer time scales. This research used resources of the Center for Nanoscale Materials and the Argonne Leadership Computing Facility at Argonne National Laboratory, which is supported by the Office of Science of the U.S. Department of Energy under Contract DE-AC02-06CH11357.

  13. Negative Effect of Rapidly Resorbing Properties of Bioactive Glass-Ceramics as Bone Graft Substitute in a Rabbit Lumbar Fusion Model

    PubMed Central

    Lee, Jae Hyup; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Lee, Do-Yoon; Chang, Bong-Soon

    2014-01-01

    Background Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. Methods This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). Results In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. Conclusions The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass

  14. Effectively Axonal-supercharged Interpositional Jump-Graft with an Artificial Nerve Conduit for Rat Facial Nerve Paralysis

    PubMed Central

    Niimi, Yosuke; Takeuchi, Yuichi; Sasaki, Ryo; Watanabe, Yorikatsu; Yamato, Masayuki; Miyata, Mariko; Sakurai, Hiroyuki

    2015-01-01

    Background: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve. However, for using the technique, an autologous nerve, which should contain the great auricular and sural nerves, must be obtained. Depending on the donor site, unavoidable issues such as nerve disorders and postoperative scarring may appear. To reduce the issues, in this study, the authors developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit and investigated the efficacy of an IPJG with an artificial nerve conduit in a rat facial nerve paresis model. Methods: A ligature clip was used to crush the facial nerve trunk, thereby creating a partial facial nerve paresis model. An artificial nerve conduit was then prepared with a 10-mm-long silicone tube containing 10 μL type I collagen and used to create an IPJG between the facial nerve trunk and the hypoglossal nerve (the silicone tube group). Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve. Results: Retrograde tracer test confirmed a double innervation by the facial and hypoglossal nerve nuclei. In the autograft and silicone tube groups, the regeneration of myelinated axons was observed. Conclusion: In this study, the authors successfully developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit, and revealed that an IPJG in the conduit was effective in the rat facial nerve paresis model. PMID:26180717

  15. Impaction grafted bone chip size effect on initial stability in an acetabular model: Mechanical evaluation

    PubMed Central

    Holton, Colin; Bobak, Peter; Wilcox, Ruth; Jin, Zhongmin

    2013-01-01

    Introduction Acetabular bone defect reconstruction is an increasing problem for surgeons with patients undergoing complex primary or revision total hip replacement surgery. Impaction bone grafting is one technique that has favourable long-term clinical outcome results for patients who undergo this reconstruction method for acetabular bone defects. Creating initial mechanical stability of the impaction bone graft in this technique is known to be the key factor in achieving a favourable implant survival rate. Different sizes of bone chips were used in this technique to investigate if the size of bone chips used affected initial mechanical stability of a reconstructed acetabulum. Methodology Twenty acetabular models were created in total. Five control models were created with a cemented cup in a normal acetabulum. Then five models in three different groups of bone chip size were constructed. The three groups had an acetabular protrusion defect reconstructed using either; 2–4 mm3, 10 mm3 or 20 mm3 bone chip size for impaction grafting reconstruction. The models underwent compression loading up to 9500 N and displacement within the acetabular model was measured indicating the initial mechanical stability. Results This study reveals that, although not statistically significant, the largest (20 mm3) bone chip size grafted models have an inferior maximum stiffness compared to the medium (10 mm3) bone chip size. Interpretations Our study suggests that 10 mm3 size of bone chips provide better initial mechanical stability compared to smaller or larger bone chips. We dismissed the previously held opinion that the biggest practically possible graft is best for acetabular bone graft impaction. PMID:24396238

  16. A new surgical technique to facilitate osteochondral autograft transfer in osteochondral defects of the capitellum: a case report.

    PubMed

    Bilsel, Kerem; Demirhan, Mehmet; Atalar, Ata Can; Akkaya, Semih

    2010-01-01

    A 17-year-old boy who was engaged in amateur weightlifting and body building presented with complaints of right elbow pain and limitation in elbow range of motion. Plain x-rays and magnetic resonance imaging showed an osteochondral defect in the medial third of the capitellum. At surgery, as a new technique, the lateral collateral ligament was detached from the humeral attachment to provide access to the capitellum with a clear and perpendicular exposure. Following removal of loose fragments within the joint, an osteochondral graft harvested from the lateral femoral condyle was implanted to the defect area of the capitellum. Postoperative radiologic controls showed that the defect was entirely filled by the graft with appropriate graft height. On follow-up examination at 12 months, the patient did not have any complaint about his elbow, and had no limitation of movement compared to the left elbow. Magnetic resonance imaging showed that the graft was successfully adapted to the recipient site without any sign of loosening. At final follow-up 40 months after surgery, the surface of the articular cartilage appeared normal. The range of elbow motion was preserved and the patient had no restriction in daily and sports activities. Considering technical difficulties posed by the narrow and complex structure of the elbow joint, this new technique involving detachment of the lateral collateral ligament facilitates perpendicular implantation of the graft. In our opinion, utilization of this new technique will improve functional and radiological results of osteochondral autograft transfer. PMID:20513997

  17. Particles deposition induced by the magnetic field in the coronary bypass graft model

    NASA Astrophysics Data System (ADS)

    Bernad, Sandor I.; Totorean, Alin F.; Vekas, Ladislau

    2016-03-01

    Bypass graft failures is a complex process starting with intimal hyperplasia development which involve many hemodynamic and biological factors. This work presents experimental results regarding the possibility to use magnetic drug delivery to prevent the development of the intimal hyperplasia using a simplified but intuitive model. The primary goal is to understand the magnetic particle deposition in the anastomosis region of the bypass graft taking into account the complex flow field created in this area which involves recirculation region, flow mixing and presence of particles with high residence time. The three-dimensional geometry model was used to simulate the motion and accumulation of the particles under the magnetic field influence in anastomotic region of the coronary bypass graft. The flow patterns are evaluated both numerically and experimentally and show a good correlation in term of flow parameters like vortex length and flow stagnation point positions. Particle depositions are strongly dependent on the magnet position and consequently of the magnetic field intensity and field gradient. Increased magnetic field controlled by the magnet position induces increased particle depositions in the bypass graft anastomosis. The result shows that particle depositions depend on the bypass graft angle, and the deposition shape and particle accumulation respectively, depend by the flow pattern in the anastomosis region.

  18. Evaluation of parathyroid autograft growth and function in hemodialysis patients

    SciTech Connect

    Karsenty, G.; Petraglia, A.; Bourdeau, A.; Gambini, D.J.; Moreau, J.F.; Lecharpentier, Y.; Zingraff, J.; Bournerias, F.; Buisson, C.; Dubost, C.

    1986-07-01

    The aim of our study was to evaluate the function and growth of parathyroid tissue autografted into the forearm of hemodialysis patients using several presently available methods. In a dynamic study, the secretory function of autografted tissue was evaluated in seven patients using either zero calcium dialysate or calcium infusion. In an additional prospective study, seven patients had repeated determinations of plasma immunoreactive parathyroid hormone (iPTH) concentration on samples from both forearms, a radionuclide evaluation of autograft function using thallium-201 chloride, and real time ultrasonography. Light microscopy analysis was performed in two patients. The dynamic study demonstrated that induction of hypocalcemia was followed by an increase, and induction of hypercalcemia by a decrease in circulating iPTH in both forearms using three different radioimmunoassays similar to what has been reported for normal parathyroid tissue. A significant gradient (ie, greater than 2.0) of plasma iPTH concentration in samples from both forearms was observed in only three out of the seven patients of the prospective study. Two of these patients disclosed an increased uptake of /sup 201/TI chloride at the site of autografted tissue and had an echographically detectable mass. In both, hyperplastic parathyroid tissue was removed. At present, the remaining third patient does not have other features of recurrent hyperparathyroidism. In conclusion, autotransplanted parathyroid tissue of hemodialysis patients shows an adequate response to physiologic stimuli such as hypo- and hypercalcemia. Dynamic tests, therefore, appear to be a useful tool in the assessment of its function. In addition, radionuclide and echographic studies may be reliable adjuncts in the detection of marked parathyroid autograft hyperplasia.

  19. Patient-specific multiscale modeling of blood flow for coronary artery bypass graft surgery.

    PubMed

    Sankaran, Sethuraman; Esmaily Moghadam, Mahdi; Kahn, Andrew M; Tseng, Elaine E; Guccione, Julius M; Marsden, Alison L

    2012-10-01

    We present a computational framework for multiscale modeling and simulation of blood flow in coronary artery bypass graft (CABG) patients. Using this framework, only CT and non-invasive clinical measurements are required without the need to assume pressure and/or flow waveforms in the coronaries and we can capture global circulatory dynamics. We demonstrate this methodology in a case study of a patient with multiple CABGs. A patient-specific model of the blood vessels is constructed from CT image data to include the aorta, aortic branch vessels (brachiocephalic artery and carotids), the coronary arteries and multiple bypass grafts. The rest of the circulatory system is modeled using a lumped parameter network (LPN) 0 dimensional (0D) system comprised of resistances, capacitors (compliance), inductors (inertance), elastance and diodes (valves) that are tuned to match patient-specific clinical data. A finite element solver is used to compute blood flow and pressure in the 3D (3 dimensional) model, and this solver is implicitly coupled to the 0D LPN code at all inlets and outlets. By systematically parameterizing the graft geometry, we evaluate the influence of graft shape on the local hemodynamics, and global circulatory dynamics. Virtual manipulation of graft geometry is automated using Bezier splines and control points along the pathlines. Using this framework, we quantify wall shear stress, wall shear stress gradients and oscillatory shear index for different surgical geometries. We also compare pressures, flow rates and ventricular pressure-volume loops pre- and post-bypass graft surgery. We observe that PV loops do not change significantly after CABG but that both coronary perfusion and local hemodynamic parameters near the anastomosis region change substantially. Implications for future patient-specific optimization of CABG are discussed. PMID:22539149

  20. Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability Using a Gracilis Autograft without Bone Tunnel

    PubMed Central

    Kim, Tae-Seong; Kim, Hee-June; Ra, In-Hoo

    2015-01-01

    Background Several tendon graft and fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar dislocation. The purpose of this study was to evaluate the results of MPFL reconstruction using a gracilis autograft fixation without bone tunnel in patients with recurrent patellar instability. Methods Nine patients (four males and five females) diagnosed with recurrent patellar instability from July 2009 to January 2013 and had MPFL reconstruction using a gracilis autograft were included. The average age of the patients was 24.6 years (range, 13 to 48 years), and the average follow-up period was 19.3 months (range, 12 to 30 months). For every patient, femoral attachment was fixed using suture anchors securing the patella by suturing the periosteum and surrounding soft tissue. Clinical evaluation included the Kujala, Lysholm, and Tegner scores; in addition, patients were examined for any complication including recurrent dislocation. The congruence angle and patella alta were assessed radiologically before and after surgery. Results The Kujala score improved from an average of 42.7 ± 8.4 before surgery to 79.6 ± 13.6 (p = 0.008) at final follow-up; the Lysholm score improved from 45.8 ± 5.7 to 82.0 ± 10.5 (p = 0.008); and the Tegner score improved from 2.8 ± 0.8 to 5.6 ± 1.5 (p = 0.007). The Insall-Salvati ratio changed from 1.16 ± 0.1 (range, 0.94 to 1.35) before surgery to 1.14 ± 0.1 (range, 0.96 to 1.29; p = 0.233) at the final follow-up without significance. The congruence angle significantly improved from 26.5° ± 10.6° (range, 12° to 43°) before surgery to -4.0° ± 4.3° (range, -12° to 5°; p = 0.008) at final follow-up. Subluxation was observed in one patient and hemarthrosis occurred in another patient 2 years after surgery, but these patients were asymptomatic. Conclusions We achieved good results with a patellar fixation technique in MPFL reconstruction using a gracilis autograft employing

  1. Transplantation of mesenchymal stem cells, recombinant human BMP-2,and their combination in accelerating the union after osteotomy and increasing, the mechanical strength of extracorporeally irradiated femoral autograft in rat models

    PubMed Central

    Fauzi Kamal, Achmad; Hadisoebroto Dilogo, Ismail; Untung Hutagalung, Errol; Iskandriati, Diah; Susworo, R.; Chaerani Siregar, Nurjati; Aulia Yusuf, Achmad; Bachtiar, Adang

    2014-01-01

    Background: Delayed union, nonunion, and mechanical failure is still problems encountered in limb salvage surgery (LSS) using extracorporeal irradiation (ECI). This study aimed to determine whether bone marrow mesenchymal stem cells (MSC) and recombinant human bone morphogenetic protein-2 (rhBMP-2) improve hostgraft union after osteotomy and also increase its mechanical strength. Methods: Thirty Sprague Dawley rats were randomly divided into five groups. Group I (control) underwent LSS using ECI method with 150 Gy single doses. Similar procedures were applied to other groups. Group II received hydroxyapatite (HA) scaffold. Group III received HA scaffold and MSC. Group IV received HA scaffold and rhBMP-2. Group V received HA scaffolds, MSC, and rhBMP-2. Radiograph were taken at week-2, 4, 6, and 8; serum alkaline phosphatase and osteocalcin were measured at week-2 and 4. Histopathological evaluation and biomechanical study was done at week-8. Results: The highest radiological score was found in group IV and V Similar result was obtained in histological score and ultimate bending force. These results were found to be statistically significant. There was no significant difference among groups in serum alkaline phosphatase and osteocalcin level. Conclusion: Combination of MSC and rhBMP-2 was proven to accelerate union and improve mechanical strength of ECI autograft. PMID:25679008

  2. A new bone-ligament-bone autograft from the plantar plates of the toes and its potential use in scapholunate reconstruction: an anatomical study.

    PubMed

    Müller, Miriam; Reik, Milena; Sauerbier, Michael; Germann, Günter

    2008-10-01

    The study was performed to investigate a new bone-ligament-bone autograft from the plantar plate of the toes. The anatomic properties of the plantar ligaments and the technical feasibility to harvest a bone-ligament-bone graft were examined to evaluate the potential use of this graft for a suitable reconstruction of the scapholunate (SL) interosseous ligament. The plantar plate of the metatarsophalangeal joints of the second to fifth toe and the proximal interphalangeal joints of the second to fourth toe were examined in 20 cadaver feet (15 fresh and 5 embalmed cadavers) and measurements such as length, thickness, and width were taken. The average length of the plantar ligaments of the proximal interphalangeal joint was 0.63 cm (D3) and 0.62 cm (D4). The length of the plantar plates of the proximal interphalangeal joint of the third and fourth toe was found to be similar to that of the SL ligament. In addition to the measurements, a bone-ligament-bone autograft of the plantar plates of the metatarsophalangeal joint was designed as an SL-ligament substitute and successfully transplanted into cadaveric wrists. This new autograft is intercalated between the scaphoid and lunate and, contrary to all previous methods, not simply superimposed upon them. Length of the plantar plates was considered by the authors as the main criteria for selection of the new bone-ligament-bone graft. The plantar plate of the proximal interphalangeal joint of the third and fourth toe showed a similar length compared with the SL ligament. Therefore, it can be concluded from the data that this bone-ligament-bone graft can be a suitable replacement for the SL ligament. PMID:18812722

  3. A phenomenological contact model: Understanding the graft-tunnel interaction in anterior cruciate ligament reconstructive surgery.

    PubMed

    Salehghaffari, Shahab; Dhaher, Yasin Y

    2015-07-16

    In this paper, we sought to expand the fidelity of a validated model of the anterior cruciate ligament reconstruction (ACL-R) procedure by incorporating a stick-slip contact model with linear pressure-overclosure relationship at the interface. The suggested model is characterized by three unknown parameters, friction coefficient, shear stress softening and contact stiffness. In the absence of any isolated experiments exploring the graft-tunnel interactions during an aggregate joint load, the calibration data used in this study are derived from a reported biomechanical study. A Bayesian calibration procedure was employed to find the unknown probability distribution function (PDF) of these contact parameters. Initially, the response surface approximations of the predicted graft forces from laxity test simulations was adopted to estimate the likelihood of noisy experimental data reported in the literature. Then, the wide domain of contact parameters was sampled sequentially based on the Marcov Chain Monte Carlo (MCMC) method with acceptance-rejection criteria to search for population of samples in significantly narrower domain of unknown parameters that are associated with the highest occurrence likelihood of noisy experimental data. Our simulations with calibrated contact parameters indicate that pre-tensioning applied at 30° of flexion leads to larger graft force after the joint is fully extended compared to the graft force when the same pre-tensioning force is applied at full extension. Moreover, regardless of the pre-tensioning force, the graft-tunnel contact pressure is larger when the fixation of the graft is performed at full extension, increasing with the pre-tensioning force. PMID:26100464

  4. Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses.

    PubMed

    Gonzalez-Pinto, I M; Tryphonopoulos, P; Avison, D L; Nishida, S; Tekin, A; Santiago, S; Tzakis, A G

    2013-06-01

    Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors. PMID:23769047

  5. [Vascular graft infection by Staphylococcus epidermidis: efficacy of various perioperative prophylaxis protocols in an animal model].

    PubMed

    Giacometti, A; Cirioni, O; Ghiselli, R; Mocchegiani, F; Riva, A; Saba, V; Scalise, G

    2001-03-01

    A rat model was used to investigate the efficacy of levofloxacin, cefazolin and teicoplanin in the prevention of vascular prosthetic graft infection. Graft infections were established in the subcutaneous tissue of 300 male Wistar rats by implantation of Dacron prostheses followed by topical inoculation with methicillin-susceptible and methicillin-resistant S. epidermidis. The study included a group without contamination, two contaminated groups without prophylaxis, two contaminated groups with intraperitoneal levofloxacin prophylaxis (10 mg/kg), two contaminated groups with intraperitoneal cefazolin prophylaxis (30 mg/kg), two contaminated groups with intraperitoneal teicoplanin prophylaxis (10 mg/kg) and six contaminated groups with rifampin-soaked graft and intraperitoneal levofloxacin, cefazolin or te- icoplanin prophylaxis. The grafts were removed after 7 days and evaluated by quantitative culture. The efficacy of levofloxacin against the methicillin- susceptible strain did not differ from that of cefazolin or teicoplanin. Levofloxacin showed slight less efficacy than teicoplanin against the methicillin-resistant strain. The levofloxacin-rifampin combination proved to be similarly effective to the rifampin-teicoplanin combination and more effective than the rifampin-cefazolin combination against both strains. The rifampin-levofloxacin combination may be useful for the prevention of late-appearing vascular graft infections caused by S. epidermidis because it takes advantage of the good anti-staphylococcal activity of both drugs. PMID:12082344

  6. Neural Stem Cell Grafting in an Animal Model of Chronic Temporal Lobe Epilepsy

    PubMed Central

    Hattiangady, Bharathi; Shetty, Ashok K.

    2016-01-01

    Neural stem cell (NSC) transplantation into the hippocampus could offer an alternative therapy to hippocampal resection in patients with drug-resistant chronic epilepsy, which afflicts ~30% of mesial temporal lobe epilepsy (TLE) cases. Multipotent, self-renewing NSCs could be expanded from multiple regions of the developing and adult brain, human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs). However, to provide a comprehensive methodology involved in testing the efficacy of transplantation of NSCs in a rat model of chronic TLE, NSCs derived from the embryonic medial ganglionic eminence (MGE) are taken as an example in this article. The topics comprise description of the required materials, reagents and equipment, and protocols for expanding MGE-NSCs in culture, generating chronically epileptic rats, the intrahippocampal grafting, the post-grafting evaluation of the effects of NSC grafts on spontaneous recurrent seizures and cognitive impairments, analyses of the yield and the fate of graft-derived cells, and the effects of NSC grafts on the host hippocampus. PMID:21913169

  7. Optogenetic Stimulation of Neural Grafts Enhances Neurotransmission and Downregulates the Inflammatory Response in Experimental Stroke Model.

    PubMed

    Daadi, Marcel M; Klausner, Jill Q; Bajar, Bryce; Goshen, Inbal; Lee-Messer, Christopher; Lee, Soo Yeun; Winge, Mårten C G; Ramakrishnan, Charu; Lo, Maisie; Sun, Guohua; Deisseroth, Karl; Steinberg, Gary K

    2016-01-01

    Compelling evidence suggests that transplantation of neural stem cells (NSCs) from multiple sources ameliorates motor deficits after stroke. However, it is currently unknown to what extent the electrophysiological activity of grafted NSC progeny participates in the improvement of motor deficits and whether excitatory phenotypes of the grafted cells are beneficial or deleterious to sensorimotor performances. To address this question, we used optogenetic tools to drive the excitatory outputs of the grafted NSCs and assess the impact on local circuitry and sensorimotor performance. We genetically engineered NSCs to express the Channelrhodopsin-2 (ChR2), a light-gated cation channel that evokes neuronal depolarization and initiation of action potentials with precise temporal control to light stimulation. To test the function of these cells in a stroke model, rats were subjected to an ischemic stroke and grafted with ChR2-NSCs. The grafted NSCs identified with a human-specific nuclear marker survived in the peri-infarct tissue and coexpressed the ChR2 transgene with the neuronal markers TuJ1 and NeuN. Gene expression analysis in stimulated versus vehicle-treated animals showed a differential upregulation of transcripts involved in neurotransmission, neuronal differentiation, regeneration, axonal guidance, and synaptic plasticity. Interestingly, genes involved in the inflammatory response were significantly downregulated. Behavioral analysis demonstrated that chronic optogenetic stimulation of the ChR2-NSCs enhanced forelimb use on the stroke-affected side and motor activity in an open field test. Together these data suggest that excitatory stimulation of grafted NSCs elicits beneficial effects in experimental stroke model through cell replacement and non-cell replacement, anti-inflammatory/neurotrophic effects. PMID:26132738

  8. Intrastriatal Grafting of Chromospheres: Survival and Functional Effects in the 6-OHDA Rat Model of Parkinson's Disease

    PubMed Central

    Boronat-García, Alejandra; Palomero-Rivero, Marcela; Guerra-Crespo, Magdalena; Millán-Aldaco, Diana; Drucker-Colín, René

    2016-01-01

    Cell replacement therapy in Parkinson’s disease (PD) aims at re-establishing dopamine neurotransmission in the striatum by grafting dopamine-releasing cells. Chromaffin cell (CC) grafts produce some transitory improvements of functional motor deficits in PD animal models, and have the advantage of allowing autologous transplantation. However, CC grafts have exhibited low survival, poor functional effects and dopamine release compared to other cell types. Recently, chromaffin progenitor-like cells were isolated from bovine and human adult adrenal medulla. Under low-attachment conditions, these cells aggregate and grow as spheres, named chromospheres. Here, we found that bovine-derived chromosphere-cell cultures exhibit a greater fraction of cells with a dopaminergic phenotype and higher dopamine release than CC. Chromospheres grafted in a rat model of PD survived in 57% of the total grafted animals. Behavioral tests showed that surviving chromosphere cells induce a reduction in motor alterations for at least 3 months after grafting. Finally, we found that compared with CC, chromosphere grafts survive more and produce more robust and consistent motor improvements. However, further experiments would be necessary to determine whether the functional benefits induced by chromosphere grafts can be improved, and also to elucidate the mechanisms underlying the functional effects of the grafts. PMID:27525967

  9. Intrastriatal Grafting of Chromospheres: Survival and Functional Effects in the 6-OHDA Rat Model of Parkinson's Disease.

    PubMed

    Boronat-García, Alejandra; Palomero-Rivero, Marcela; Guerra-Crespo, Magdalena; Millán-Aldaco, Diana; Drucker-Colín, René

    2016-01-01

    Cell replacement therapy in Parkinson's disease (PD) aims at re-establishing dopamine neurotransmission in the striatum by grafting dopamine-releasing cells. Chromaffin cell (CC) grafts produce some transitory improvements of functional motor deficits in PD animal models, and have the advantage of allowing autologous transplantation. However, CC grafts have exhibited low survival, poor functional effects and dopamine release compared to other cell types. Recently, chromaffin progenitor-like cells were isolated from bovine and human adult adrenal medulla. Under low-attachment conditions, these cells aggregate and grow as spheres, named chromospheres. Here, we found that bovine-derived chromosphere-cell cultures exhibit a greater fraction of cells with a dopaminergic phenotype and higher dopamine release than CC. Chromospheres grafted in a rat model of PD survived in 57% of the total grafted animals. Behavioral tests showed that surviving chromosphere cells induce a reduction in motor alterations for at least 3 months after grafting. Finally, we found that compared with CC, chromosphere grafts survive more and produce more robust and consistent motor improvements. However, further experiments would be necessary to determine whether the functional benefits induced by chromosphere grafts can be improved, and also to elucidate the mechanisms underlying the functional effects of the grafts. PMID:27525967

  10. ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft*

    PubMed Central

    Sun, Kang; Tian, Shao-qi; Zhang, Ji-hua; Xia, Chang-suo; Zhang, Cai-long; Yu, Teng-bo

    2009-01-01

    Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the

  11. Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries.

    PubMed

    Fang, Taolin; Lineaweaver, William C; Sailes, Frederick C; Kisner, Carson; Zhang, Feng

    2014-11-01

    Achieving permanent replacement of skin in extensive full-thickness and deep partial-thickness burn injuries and chronic wounds remains one of the fundamental surgical problems. Presently, split-thickness skin grafts are still considered the best material for surgical repair of an excised burn wound. However, in burns that affect greater than 50% of total body surface area, the patient has insufficient areas of unaffected skin from which split-thickness skin grafts can be harvested. The use of cultured epithelial (or epidermal) autografts (CEAs) has achieved satisfactory results. But the take rate of CEAs is poor in full-thickness bed or in chronically infected area. Providing temporary cover with allograft skin, or a more permanent allodermis, may increase clinical take. This review aims to (1) describe the use of CEAs in the regeneration of the epidermis, (2) introduce the application of the acellular dermal matrices (ADMs) in the clinics, and (3) enhance understanding of the CEAs applied with ADM as an appropriate strategy to treat the extended burn injuries. The current evidence regarding the cultured epithelial cell or keratinocyte autograft and dermal grafts applied in the treatment of burn injuries was investigated with an extensive electronic and manual search (MEDLINE and EMBASE). The included literature (N=136 publications) was critically evaluated focusing on the efficacy and safety of this technique in improving the healing of the deep dermal and full-thickness burn injuries. This review concluded that the use of ADM with CEAs is becoming increasingly routine, particularly as a life-saving tool after acute thermal trauma. PMID:24322642

  12. A modified self-consistent computational model for an electrostrictive graft elastomer

    NASA Astrophysics Data System (ADS)

    Sun, Changjie; Wang, Youqi; Zhang, Congjian; Zhou, Eric; Su, Ji

    2008-04-01

    An electrostrictive graft elastomer, as recently developed by NASA, is a type of electro-active polymer. In this paper, a 2D computational model with a self-consistent boundary is developed. Firstly, three-dimensional deformations, induced by both bending angle and dihedral torsional angle changes, are projected onto a two-dimensional plane. Using both theoretical and numerical analyses, the projected 2D equilibrium bending angle is shown to have the same value as the 3D equilibrium bending angle. The 2D equivalent bending stiffness is derived using a series model based upon the fact that both bending and dihedral torsion produce a configurational change. Equivalent stiffness is justified by polymer chain end-to-end distance characteristics. Secondly, a self-consistent scheme is developed to eliminate the boundary effect. Eight images of the unit cell are created peripherally, with the original unit cell in the center. Thus the boundary can only affect the rotation of the eight images, not the central unit cell. A computational model is employed to determine the electromechanical properties of the electrostrictive graft elastomer. Relations between electric field induced strain and electric field strength are calculated. The effect of molecular scale factors, such as free volume fraction, graft weight percentage and graft orientation, are also discussed.

  13. Cilostazol, Not Aspirin, Prevents Stenosis of Bioresorbable Vascular Grafts in a Venous Model

    PubMed Central

    Tara, Shuhei; Kurobe, Hirotsugu; de Dios Ruiz Rosado, Juan; Best, Cameron A.; Shoji, Toshihiro; Mahler, Nathan; Yi, Tai; Lee, Yong-Ung; Sugiura, Tadahisa; Hibino, Narutoshi; Partida-Sanchez, Santiago; Breuer, Christopher K.

    2015-01-01

    Objective— Despite successful translation of bioresorbable vascular grafts for the repair of congenital heart disease, stenosis remains the primary cause of graft failure. In this study, we investigated the efficacy of long-term treatment with the antiplatelet drugs, aspirin and cilostazol, in preventing stenosis and evaluated the effect of these drugs on the acute phase of inflammation and tissue remodeling. Approach and Results— C57BL/6 mice were fed a drug-mixed diet of aspirin, cilostazol, or normal chow during the course of follow-up. Bioresorbable vascular grafts, composed of poly(glycolic acid) mesh sealed with poly(l-lactide-co-ε-caprolactone), were implanted as inferior vena cava interposition conduits and followed up for 2 weeks (n=10 per group) or 24 weeks (n=15 per group). Both aspirin and cilostazol suppressed platelet activation and attachment onto the grafts. On explant at 24 weeks, well-organized neotissue had developed, and cilostazol treatment resulted in 100% graft patency followed by the aspirin (67%) and no-treatment (60%) groups (P<0.05). Wall thickness and smooth muscle cell proliferation in the neotissue of the cilostazol group were decreased when compared with that of the no-treatment group at 24 weeks. In addition, cilostazol was shown to have an anti-inflammatory effect on neotissue at 2 weeks by regulating the recruitment and activation of monocytes. Conclusions— Cilostazol prevents stenosis of bioresorbable vascular graft in a mouse inferior vena cava implantation model up to 24 weeks and is accompanied by reduction of smooth muscle cell proliferation and acute inflammation. PMID:26183618

  14. Autograft ossicle selection in cholesteatomatous ear disease: histopathological considerations.

    PubMed

    Rupa, V; Krishnaswami, H; Job, A

    1997-09-01

    In order to determine whether selection of autograft ossicles in cholesteatomatous ear disease should be based upon their appearance under the surgical operating microscope, we studied the histopathological features of 113 such ossicles. We attempted to correlate the extent of erosion of the ossicle, as noted under the surgical operating microscope, with their histopathological appearance. There were 60 mallei and 53 includes. Seventy-nine ossicles were eroded and 34 were intact. The commonest abnormality noted was erosion of the long process of the incus (75 per cent). Both intact and eroded ossicles had similar histological features. There was no evidence of intra-ossicular cholesteatoma. The results suggest that the extent of erosion of these ossicles as seen under the surgical operating microscope should in no way prejudice their use as autografts when required. PMID:9373543

  15. Free biceps tendon autograft to augment arthroscopic rotator cuff repair.

    PubMed

    Obma, Padraic R

    2013-01-01

    Arthroscopic rotator cuff repairs have become the standard of treatment for all sizes of tears over the past several years. Current healing rates reported in the literature are quite good, but improving the healing potential of rotator cuff repairs remains a challenging problem. There has been an increase recently in the use of augmentation of rotator cuff repairs with xenografts or synthetics for large and massive tears. Biceps tenodesis is often indicated as part of the treatment plan while one is performing rotator cuff surgery. A subpectoral biceps tenodesis provides a source of autograft to augment rotator cuff repairs of all sizes. Two techniques are presented to augment rotator cuff repairs with a free biceps tendon autograft. This is a novel idea in an attempt to improve healing rates and long-term results of rotator cuff repairs of all sizes. PMID:24400197

  16. Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

    NASA Astrophysics Data System (ADS)

    Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

    1997-05-01

    Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

  17. Functional Integration of Grafted Neural Stem Cell-Derived Dopaminergic Neurons Monitored by Optogenetics in an In Vitro Parkinson Model

    PubMed Central

    Tønnesen, Jan; Parish, Clare L.; Sørensen, Andreas T.; Andersson, Angelica; Lundberg, Cecilia; Deisseroth, Karl; Arenas, Ernest; Lindvall, Olle; Kokaia, Merab

    2011-01-01

    Intrastriatal grafts of stem cell-derived dopamine (DA) neurons induce behavioral recovery in animal models of Parkinson's disease (PD), but how they functionally integrate in host neural circuitries is poorly understood. Here, Wnt5a-overexpressing neural stem cells derived from embryonic ventral mesencephalon of tyrosine hydroxylase-GFP transgenic mice were expanded as neurospheres and transplanted into organotypic cultures of wild type mouse striatum. Differentiated GFP-labeled DA neurons in the grafts exhibited mature neuronal properties, including spontaneous firing of action potentials, presence of post-synaptic currents, and functional expression of DA D2 autoreceptors. These properties resembled those recorded from identical cells in acute slices of intrastriatal grafts in the 6-hydroxy-DA-induced mouse PD model and from DA neurons in intact substantia nigra. Optogenetic activation or inhibition of grafted cells and host neurons using channelrhodopsin-2 (ChR2) and halorhodopsin (NpHR), respectively, revealed complex, bi-directional synaptic interactions between grafted cells and host neurons and extensive synaptic connectivity within the graft. Our data demonstrate for the first time using optogenetics that ectopically grafted stem cell-derived DA neurons become functionally integrated in the DA-denervated striatum. Further optogenetic dissection of the synaptic wiring between grafted and host neurons will be crucial to clarify the cellular and synaptic mechanisms underlying behavioral recovery as well as adverse effects following stem cell-based DA cell replacement strategies in PD. PMID:21394212

  18. Modeling the Assembly of Polymer-Grafted Nanoparticles at Oil-Water Interfaces.

    PubMed

    Yong, Xin

    2015-10-27

    Using dissipative particle dynamics (DPD), I model the interfacial adsorption and self-assembly of polymer-grafted nanoparticles at a planar oil-water interface. The amphiphilic core-shell nanoparticles irreversibly adsorb to the interface and create a monolayer covering the interface. The polymer chains of the adsorbed nanoparticles are significantly deformed by surface tension to conform to the interface. I quantitatively characterize the properties of the particle-laden interface and the structure of the monolayer in detail at different surface coverages. I observe that the monolayer of particles grafted with long polymer chains undergoes an intriguing liquid-crystalline-amorphous phase transition in which the relationship between the monolayer structure and the surface tension/pressure of the interface is elucidated. Moreover, my results indicate that the amorphous state at high surface coverage is induced by the anisotropic distribution of the randomly grafted chains on each particle core, which leads to noncircular in-plane morphology formed under excluded volume effects. These studies provide a fundamental understanding of the interfacial behavior of polymer-grafted nanoparticles for achieving complete control of the adsorption and subsequent self-assembly. PMID:26439456

  19. Fibroblast and vascular endothelial growth factor coating of decellularized vascular grafts stimulates undesired giant cells and graft encapsulation in a rat model.

    PubMed

    Heidenhain, Christoph; Veeravoorn, Ariyakhagorn; Vachkov, Blagovest; Weichert, Wilko; Schmidmaier, Gerhard; Wildemann, Britt; Neuhaus, Peter; Heise, Michael

    2011-01-01

    Replacing an infected prosthesis with a bioimplant provides a hopeful alternative in septic vascular surgery. The objective of this study was to determine the effect of fibroblast endothelial growth factors (FGF) and vascular endothelial growth factors (VEGF) coating on a decellularized vascular graft in a rat model and the possible impact on recellularization processes. Rat aortas were decellularized, crosslinked with genipin, and coated with poly-(D, L) lactide containing either FGF or VEGF. Observation periods were 6 and 12 weeks. Surprisingly, we found moderate accumulation of giant cells around the grafts that contained poly-(D, L) lactide acid. FGF and VEGF grafts showed massive stimulation of giant cells and eosinophils leading to complete graft encapsulation (P < 0.05). Pseudointmal hyperplasia was significantly increased in the FGF group (P < 0.05). Both results can only be interpreted as very negative. We achieved a situation in diametric opposition to that which we had hoped for. These data demonstrate that the use of growth factors may produce harmful side effects. PMID:20883449

  20. The Significance of Neuregulin-1/ErbB Expression in Autogenous Vein Grafts in a Diabetic Rat Model.

    PubMed

    Huang, Qiangxin; Zhang, Jueyu; Liang, Ludong; Lan, Zhicun; Huo, Tianming; Li, Shikang

    2015-09-01

    Diabetes mellitus (DM) is an important risk factor for increased vein graft failure after bypass surgery. The neuregulin-1 (NRG-1)/ErbB signaling system plays a critical role in neointimal formation after vascular injury as well as the proliferation and migration of mitogen-induced vascular smooth muscle cells; however, changes in NRG-1/ErbB signaling leading to vein grafts attrition in DM remain largely unexplored. Therefore, the aim of this study was to investigate changes in NRG-1/ErbB signaling in vein grafts in diabetic rats. To do this, a rat model of DM was established by streptozotocin injection followed by engraftment of autologous jugular veins to carotid arteries to induce intimal hyperplasia. After vein graft harvest, a pathohistological examination was performed; changes in NRG-1 and ErbB expression were also assessed. NRG-1 and ErbB expression localized to endothelial cells and vascular smooth muscle cells, which is consistent with the arterialization of vein grafts. NRG-1, ErbB2, and ErbB4 expression significantly decreased in vein grafts over time. Our findings show that NRG-1/ErbB signaling is impaired in vein grafts of diabetic rats, suggesting an important role for this pathway in the pathogenesis of intimal hyperplastic lesions in vein grafts of patients with DM. PMID:25978692

  1. Engineering an Endothelialized Vascular Graft: A Rational Approach to Study Design in a Non-Human Primate Model

    PubMed Central

    Anderson, Deirdre E. J.; Glynn, Jeremy J.; Song, Howard K.; Hinds, Monica T.

    2014-01-01

    After many years of research, small diameter, synthetic vascular grafts still lack the necessary biologic integration to perform ideally in clinical settings. Endothelialization of vascular grafts has the potential to improve synthetic graft function, and endothelial outgrowth cells (EOCs) are a promising autologous cell source. Yet no work has established the link between endothelial cell functions and outcomes of implanted endothelialized grafts. This work utilized steady flow, oscillatory flow, and tumor necrosis factor stimulation to alter EOC phenotype and enable the formulation of a model to predict endothelialized graft performance. To accomplish this, EOC in vitro expression of coagulation and inflammatory markers was quantified. In parallel, in non-human primate (baboon) models, the platelet and fibrinogen accumulation on endothelialized grafts were quantified in an ex vivo shunt, or the tissue ingrowth on implanted grafts were characterized after 1mth. Oscillatory flow stimulation of EOCs increased in vitro coagulation markers and ex vivo platelet accumulation. Steady flow preconditioning did not affect platelet accumulation or intimal hyperplasia relative to static samples. To determine whether in vitro markers predict implant performance, a linear regression model of the in vitro data was fit to platelet accumulation data—correlating the markers with the thromboprotective performance of the EOCs. The model was tested against implant intimal hyperplasia data and found to correlate strongly with the parallel in vitro analyses. This research defines the effects of flow preconditioning on EOC regulation of coagulation in clinical vascular grafts through parallel in vitro, ex vivo, and in vivo analyses, and contributes to the translatability of in vitro tests to in vivo clinical graft performance. PMID:25526637

  2. Review of the biomechanics and biotribology of osteochondral grafts used for surgical interventions in the knee

    PubMed Central

    Bowland, Philippa; Ingham, E; Jennings, Louise; Fisher, John

    2015-01-01

    A review of research undertaken to evaluate the biomechanical stability and biotribological behaviour of osteochondral grafts in the knee joint and a brief discussion of areas requiring further improvement in future studies are presented. The review takes into consideration osteochondral autografts, allografts, tissue engineered constructs and synthetic and biological scaffolds. PMID:26614801

  3. Effect of Intraoperative Platelet-Rich-Plasma Treatment on Post Operative Donor Site Knee Pain in Patellar Tendon Autograft ACL Reconstruction

    PubMed Central

    Walters, Brian L.; Hobart, Sarah; Porter, David; Hogan, Daniel E.; McHugh, Malachy P.; Bedford, Benjamin B.; Nicholas, Stephen J.; Klein, Devon; Harousseau, Kendall

    2016-01-01

    Objectives: Donor site morbidity in the form of anterior knee pain is a frequent complication after bone-patellar tendon-bone (BPTB) autograft ACL reconstruction. The purpose of this Level I study was to examine the effect of the intraoperative administration of platelet-rich plasma on post operative knee pain and patellar defect healing. Methods: Fifty-nine patients (29±12 y/o) undergoing BPTB ACL reconstruction and eligible to enter the study, were randomized to the treatment (PRP; n=31) or non treatment (sham n=28) arms of the study just prior to surgery. In either case, 10 cc of venous blood was drawn prior to the induction of anesthesia and either discarded (sham) or processed (PRP) for preparation of a PRP gel to be later mixed with donor site bone chips and inserted into the patellar defect. At 12 weeks and 6 months after surgery, patients completed IKDC forms and VAS pain scores for ADLs and kneeling (0-10 scale). Healing indices at the donor site were assessed by MRI at 6 months and included the following measurements taken from axial sequences: AP tendon dimensions at the level of the superior tibial cortex, roof of the intercondylar notch and width at the largest patella graft deficit. Mixed model ANOVA was used to assess the effect of PRP on patient symptoms and MRI indices of donor site healing. The primary dependent variable was VAS kneeling pain. It was estimated that with 25 patients per group there would be 80% power to detect a 1.5-point difference in kneeling pain between treatments at P<0.05. A between group difference of 1.5-points in VAS for kneeling pain was deemed to represent a clinically relevant difference. Results: VAS Kneeling Pain at 12 weeks tended to be lower in the PRP versus placebo group (4.5±3.6 vs. 6.2±2.4, P=0.051) but no difference was apparent at 6 months (3.7±3.2 vs. 4.4±2.9, P=0.41). Kneeling pain decreased from 12 weeks to 6 months (P<0.001) with a trend for a greater decrease in the placebo group (Time by Treatment P

  4. Hydrogen-rich saline promotes motor functional recovery following peripheral nerve autografting in rats

    PubMed Central

    ZHANG, YONG-GUANG; SHENG, QING-SONG; WANG, ZHI-JUN; LV, LI; ZHAO, WEI; CHEN, JIAN-MEI; XU, HAO

    2015-01-01

    Despite the application of nerve grafts and considerable microsurgical innovations, the functional recovery across a long peripheral nerve gap is generally partial and unsatisfactory. Thus, additional strategies are required to improve nerve regeneration across long nerve gaps. Hydrogen possesses antioxidant and anti-apoptotic properties, which could be neuroprotective in the treatment of peripheral nerve injury; however, such a possibility has not been experimentally tested in vivo. The aim of the present study was to investigate the effectiveness of hydrogen-rich saline in promoting nerve regeneration after 10-mm sciatic nerve autografting in rats. The rats were randomly divided into two groups and intraperitoneally administered a daily regimen of 5 ml/kg hydrogen-rich or normal saline. Axonal regeneration and functional recovery were assessed through a combination of behavioral analyses, electrophysiological evaluations, Fluoro-Gold™ retrograde tracings and histomorphological observations. The data showed that rats receiving hydrogen-rich saline achieved better axonal regeneration and functional recovery than those receiving normal saline. These findings indicated that hydrogen-rich saline promotes nerve regeneration across long gaps, suggesting that hydrogen-rich saline could be used as a neuroprotective agent for peripheral nerve injury therapy. PMID:26622383

  5. Epiphyseal Sparing and Reconstruction by Frozen Bone Autograft after Malignant Bone Tumor Resection in Children

    PubMed Central

    Hamed Kassem Abdelaal, Ahmed; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchi, Akihiko; Miwa, Shinji; Tsuchiya, Hiroyuki

    2015-01-01

    Limb salvage surgery has become the standard treatment for malignant primary bone tumors in the extremities. Limb salvage represents a challenge in skeletally immature patients. Several treatment options are available for limb reconstruction after tumor resection in children. We report our results using the technique of epiphyseal sparing and reconstruction with frozen autograft bone in 18 children. The mean follow-up period for the all patients included in this study is 72 ± 26 m. Eight patients remained disease-free, seven patients lived with no evidence of disease, two were alive but with disease, and one patient died of the disease. Five- and ten-year rates of survival were 94.4%. Graft survival at 5 and 10 years was 94.4%. Functional outcome using the Enneking scale was excellent in 17 patients (94.4%) and poor in one patient (5.5%). Complications include 2 nonunions, 2 fractures, 2 deep infections, 1 soft tissue recurrence, and leg length discrepancy in 7 cases. This technique is a good reconstructive choice in a child with a nonosteolytic primary or secondary bone tumor, responsive to chemotherapy, without involvement of the articular cartilage. It is a straight forward, effective, and biological technique, which affords immediate mobilization of joints and possible cryoimmune effects, with excellent long term functional outcome and less complication. PMID:27034614

  6. A Novel Nude Mouse Model of Hypertrophic Scarring Using Scratched Full Thickness Human Skin Grafts

    PubMed Central

    Alrobaiea, Saad M.; Ding, Jie; Ma, Zengshuan; Tredget, Edward E.

    2016-01-01

    Objective: Hypertrophic scar (HTS) is a dermal form of fibroproliferative disorder that develops following deep skin injury. HTS can cause deformities, functional disabilities, and aesthetic disfigurements. The pathophysiology of HTS is not understood due to, in part, the lack of an ideal animal model. We hypothesize that human skin with deep dermal wounds grafted onto athymic nude mice will develop a scar similar to HTS. Our aim is to develop a representative animal model of human HTS. Approach: Thirty-six nude mice were grafted with full thickness human skin with deep dermal scratch wound before or 2 weeks after grafting or without scratch. The scratch on the human skin grafts was made using a specially designed jig that creates a wound >0.6 mm in depth. The xenografts were morphologically analyzed by digital photography. Mice were euthanized at 1, 2, and 3 months postoperatively for histology and immunohistochemistry analysis. Results: The mice developed raised and firm scars in the scratched xenografts with more contraction, increased infiltration of macrophage, and myofibroblasts compared to the xenografts without deep dermal scratch wound. Scar thickness and collagen bundle orientation and morphology resembled HTS. The fibrotic scars in the wounded human skin were morphologically and histologically similar to HTS, and human skin epithelial cells persisted in the remodeling tissues for 1 year postengraftment. Innovation and Conclusions: Deep dermal injury in human skin retains its profibrotic nature after transplantation, affording a novel model for the assessment of therapies for the treatment of human fibroproliferative disorders of the skin. PMID:27366591

  7. Free Vascularized Fibular Strut Autografts to the Lumbar Spine in Complex Revision Surgery: A Report of Two Cases

    PubMed Central

    Levy, David M.; Vakhshori, Venus; DeWald, Christopher J.

    2015-01-01

    This case report presents two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodeses. A case review of the Electronic Medical Record at the index institution was performed to evaluate the timeline of events of the two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodesis, including imaging studies, progress notes, and laboratory results. One patient had developed chronic L3 vertebral body osteomyelitis from a prior fibular allograft and instrumentation placed for a traumatic burst fracture. The second patient had a severe scoliosis recalcitrant to prior arthrodeses in the context of Marfan syndrome and a persistent L4-5 pseudarthrosis. Both patients underwent free vascularized fibular autograft revision arthrodeses. At most recent long-term follow-up, both patients had improved clinically and neither had required further revision. The use of free vascularized fibular grafting is an excellent option for a variety of spinal indications, and these two reports indicate that the technology may have an indication for use after multiple failed surgeries for osteomyelitis or correction of a multi-level large spinal deformity secondary to Marfan syndrome. PMID:26512280

  8. Sex, Age, and Graft Size as Predictors of ACL Re-tear

    PubMed Central

    Nguyen, Duong

    2016-01-01

    Objectives: The minimum size required for a successful quadrupled hamstring autograft ACL reconstruction remains controversial. The risks of ACL re-tear in younger patients who tend to participate in a higher level of sports activity, and female athletes who have numerous predisposing factors, are poorly defined. Purpose: To identify risk factors for graft re-tears within 2 years of ACL surgery. The hypotheses are that female sex, a smaller size graft, and younger patients will increase the odds of failure. Study Design Cohort Study. Level of evidence, 3. Methods: A cohort of 503 athletes undergoing primary, autograft hamstring ACL reconstruction, performed by a single surgeon using the same surgical technique and rehabilitation protocol, between September-December 2012, was followed for a total duration of 2 years. Return to play was allowed between 6 and 12 months post-surgery upon completion of functional testing. Exclusion criteria included infections, revisions, double bundle techniques, multi-ligament injuries, non-compliance, BTB/allografts/hybrid grafts. Primary outcome consisted of binary data (ACL graft re-tear or no tear) as measured on physical exam (Lachman and pivot shift) and MRI. Multivariate logistic regression statistical analysis with model fitting was used to investigate the predictive value of sex, age, and graft size on ACL re-tear. Secondary sensitivity analyses were performed on the adolescent subgroup, age and graft size as categorical variables, and testing for interactions among variables. Sample size was calculated based on the rule of 10 events per independent variable for logistic regression. Results: The mean age of the 503 athletes was 27.5 (SD 10.6; range = 12-61). There were 235 females (47%) and 268 males (53%) with a 6% rate of re-tears (28 patients; 17 females). Mean graft size was 7.9 (SD 0.6; range = 6-10). Univariate analyses of graft size, sex, and age only in the model showed that younger age (odds ratio [OR] = 0.86; 95

  9. Neuroprotective and reparative effects of carotid body grafts in a chronic MPTP model of Parkinson's disease.

    PubMed

    Muñoz-Manchado, Ana B; Villadiego, Javier; Suárez-Luna, Nela; Bermejo-Navas, Alfonso; Garrido-Gil, Pablo; Labandeira-García, José L; Echevarría, Miriam; López-Barneo, José; Toledo-Aral, Juan J

    2013-03-01

    Intrastriatal transplantation of dopaminergic carotid body (CB) cells ameliorates parkinsonism in animal models and, with less efficacy, in Parkinson's disease patients. CB-based cell therapy was initially proposed because of its high dopamine content. However, later studies suggested that its beneficial effect might be due to a trophic action exerted on nigrostriatal neurons. Compatible with this concept are the high levels of neurotrophic factors encountered in CB cells. To test experimentally this idea, unilateral striatal transplants were performed with a sham graft in the contralateral striatum, as a robust internal control. Thereafter, the dopaminergic neurotoxin 1-methyl-4-phenyl-1,2,3,6, -tetrahydropyridine was injected during 3 months. CB grafts protected from degeneration ipsilateral nigral dopaminergic neurons projecting to the transplant in a dose-dependent manner regarding size and glial cell line-derived neurotrophic factor expression. Grafts performed at different times after the onset of the neurotoxic treatment demonstrated with histological and behavioral methods protection and repair of the nigrostriatal pathway by CB transplants. This study provides a mechanistic explanation for the action of CB transplants on parkinsonian models. It should also help to improve cell therapy approaches to Parkinson's disease. PMID:22743091

  10. Computational modeling of mechanical response of dual cross-linked polymer grafted nanoparticle networks

    NASA Astrophysics Data System (ADS)

    v S, Balaji; Yashin, Victor; Salib, Isaac; Kowalewski, Tomasz; Matyjaszewski, Krzystof; Balazs, Anna; Anna Balazs Collaboration; Krzystof Matyjaszewski Collaboration

    2013-03-01

    We develop a hybrid computational model for the behavior of a network of cross-linked polymer-grafted nanoparticles (PGNs). The individual nanoparticles are composed of a rigid core and a corona of grafted polymers that encompass reactive end groups. With the overlap of the coronas on adjacent particles, the reactive end groups can form permanent or labile bonds, which lead to the formation of a ``dual cross-linked'' network. To capture these multi-scale interactions, our approach integrates the essential structural features of the polymer grafted nanoparticles, the interactions between the overlapping coronas, and the kinetics of bond formation and rupture between the reactive groups on the chain ends. We investigate the mechanical response of the dual-cross linked network to an applied tensile deformation. We find that the response depends on the bond energies of the labile bonds, the fraction of permanent bonds in the network, and thickness of the corona. This model provides a powerful tool for the computational design of dual cross-linked PGN's by predicting how the structural features of the system affect the mechanical performance.

  11. Microstructural Remodeling of Articular Cartilage Following Defect Repair by Osteochondral Autograft Transfer

    PubMed Central

    Raub, CB; Hsu, SC; Chan, EF; Shirazi, R; Chen, AC; Chnari, E; Semler, EJ; Sah, RL

    2013-01-01

    Objective To assess collagen network alterations occurring with flow and other abnormalities of articular cartilage at medial femoral condyle (MFC) sites repaired with osteochondral autograft (OATS) after 6 and 12 months, using quantitative polarized light microscopy (qPLM) and other histopathological methods Design The collagen network structure of articular cartilage of OATS-repaired defects and non-operated contralateral control sites were compared by qPLM analysis of parallelism index (PI), orientation angle (α) relative to the local tissue axes, and retardance (Γ) as a function of depth. qPLM parameter maps were also compared to ICRS and Modified O’Driscoll grades, and cell and matrix sub-scores, for sections stained with H&E and Safranin-O, and for Collagen-I and II Results Relative to non-operated normal cartilage, OATS-repaired regions exhibited structural deterioration, with low PI and more horizontal α, and unique structural alteration in adjacent host cartilage: more aligned superficial zone, and reoriented deep zone lateral to the graft, and matrix disorganization in cartilage overhanging the graft. Shifts in α and PI from normal site-specific values were correlated with histochemical abnormalities and co-localized with changes in cell organization/orientation, cloning, or loss, indicative of cartilage flow, remodeling, and deterioration, respectively Conclusions qPLM reveals a number of unique localized alterations of the collagen network in both adjacent host and implanted cartilage in OATS-repaired defects, associated with abnormal chondrocyte organization. These alterations are consistent with mechanobiological processes and the direction and magnitude of cartilage strain. PMID:23528954

  12. Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years.

    PubMed

    Abdel, Matthew P; Stryker, Louis S; Trousdale, Robert T; Berry, Daniel J; Cabanela, Miguel E

    2014-11-19

    We previously reported the five to twelve-year results of total hip arthroplasty with an uncemented acetabular component and an autogenous femoral head graft in forty-four consecutive hips with developmental dysplasia. The goal of the present study was to report the implant survival rate, status of bone grafts, and clinical outcomes in thirty-five of these hips (in twenty-nine patients) followed for a mean of 21.3 years. Functional, radiographic, and survivorship results were examined. Radiographic analysis revealed an average cup inclination angle of 43° and a mean arc of cup coverage by the graft of 30°. The twenty-year survivorship free from acetabular revision was 66% (twelve acetabular revisions; eight since our previous report). Of the twelve revisions, nine were for liner wear and/or osteolysis, one was for a liner fracture, one was for aseptic loosening, and one was for instability. All bone grafts healed to the pelvis. The graft facilitated revision cup placement as no additional structural grafts or metal augments were required. We concluded that an uncemented porous-coated socket used in conjunction with a bulk femoral head autograft provides good long-term fixation and restores bone stock. PMID:25410505

  13. First experience using cultured epidermal autografts in Taiwan for burn victims of the Formosa Fun Coast Water Park explosion, as part of Japanese medical assistance.

    PubMed

    Matsumura, Hajime; Harunari, Nobuyuki; Ikeda, Hiroto

    2016-05-01

    On June 27, 2015, a flammable starch-based powder exploded at Formosa Fun Coast in Taipei, Taiwan, injuring 499 people, and more than 200 people were in critical condition with severe burns. Although a cultured epidermal autograft (CEA) was not approved or used in clinical practice, the Taiwan Food and Drug Administration requested a Japanese CEA manufacturer to donate CEA for the burn victims as part of international medical assistance. The authors cooperated in this project and participated in the patient selection, wound bed management for CEA, and technical assistance for CEA use. Here, we provide an overview of the project. Nine patients were enrolled, and two patients were excluded from the skin biopsy; seven skin biopsies were collected approximately 1 month after the disaster. The average TBSA% burned was 81.0%, and the mean age was 20.1 years. CEA was grafted in five patients; wound closure had been obtained in one patient, and one patient was severely ill at the time of grafting. The CEA was combined with a wide split auto mesh graft or patch graft. The mean re-epithelization rate at 4 weeks after the grafting was 84.2% by patient, and all of the patients survived. Although this project had many obstacles to overcome, CEA grafting was successful and contributed to wound closure and survival. PMID:26818956

  14. Nogo-A Neutralization Improves Graft Function in a Rat Model of Parkinson's Disease.

    PubMed

    Seiler, Stefanie; Di Santo, Stefano; Widmer, Hans Rudolf

    2016-01-01

    Transplantation of fetal human ventral mesencephalic (VM) dopaminergic neurons into the striatum is a promising strategy to compensate for the characteristic dopamine deficit observed in Parkinson's disease (PD). This therapeutic approach, however, is currently limited by the high number of fetuses needed for transplantation and the poor survival and functional integration of grafted dopaminergic neurons into the host brain. Accumulating evidence indicates that contrasting inhibitory signals endowed in the central nervous system (CNS) might support neuronal regeneration. Hence, in the present study we aimed at improving survival and integration of grafted cells in the host brain by neutralizing Nogo-A, one of the most potent neurite growth inhibitors in the CNS. For that purpose, VM tissue cultures were transplanted into rats with a partial 6-hydroxydopamine (6-OHDA) lesion causing a hemi-PD model and concomitantly treated for 2 weeks with intra-ventricular infusion of neutralizing anti-Nogo-A antibodies. Motor behavior using the cylinder test was assessed prior to and after transplantation as functional outcome. At the end of the experimental period the number of dopaminergic fibers growing into the host brain, the number of surviving dopaminergic neurons in the grafts as well as graft size was examined. We found that anti-Nogo-A antibody infusion significantly improved the asymmetrical forelimb use observed after lesions as compared to controls. Importantly, a significantly three-fold higher dopaminergic fiber outgrowth from the transplants was detected in the Nogo-A antibody treated group as compared to controls. Furthermore, Nogo-A neutralization showed a tendency for increased survival of dopaminergic neurons (by two-fold) in the grafts. No significant differences were observed for graft volume and the number of dopaminergic neurons co-expressing G-protein-coupled inward rectifier potassium channel subunit two between groups. In sum, our findings support the

  15. Nogo-A Neutralization Improves Graft Function in a Rat Model of Parkinson’s Disease

    PubMed Central

    Seiler, Stefanie; Di Santo, Stefano; Widmer, Hans Rudolf

    2016-01-01

    Transplantation of fetal human ventral mesencephalic (VM) dopaminergic neurons into the striatum is a promising strategy to compensate for the characteristic dopamine deficit observed in Parkinson’s disease (PD). This therapeutic approach, however, is currently limited by the high number of fetuses needed for transplantation and the poor survival and functional integration of grafted dopaminergic neurons into the host brain. Accumulating evidence indicates that contrasting inhibitory signals endowed in the central nervous system (CNS) might support neuronal regeneration. Hence, in the present study we aimed at improving survival and integration of grafted cells in the host brain by neutralizing Nogo-A, one of the most potent neurite growth inhibitors in the CNS. For that purpose, VM tissue cultures were transplanted into rats with a partial 6-hydroxydopamine (6-OHDA) lesion causing a hemi-PD model and concomitantly treated for 2 weeks with intra-ventricular infusion of neutralizing anti-Nogo-A antibodies. Motor behavior using the cylinder test was assessed prior to and after transplantation as functional outcome. At the end of the experimental period the number of dopaminergic fibers growing into the host brain, the number of surviving dopaminergic neurons in the grafts as well as graft size was examined. We found that anti-Nogo-A antibody infusion significantly improved the asymmetrical forelimb use observed after lesions as compared to controls. Importantly, a significantly three-fold higher dopaminergic fiber outgrowth from the transplants was detected in the Nogo-A antibody treated group as compared to controls. Furthermore, Nogo-A neutralization showed a tendency for increased survival of dopaminergic neurons (by two-fold) in the grafts. No significant differences were observed for graft volume and the number of dopaminergic neurons co-expressing G-protein-coupled inward rectifier potassium channel subunit two between groups. In sum, our findings support the

  16. Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine.

    PubMed

    Chau, Anthony Minh Tien; Xu, Lileane Liang; Wong, Johnny Ho-Yin; Mobbs, Ralph Jasper

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) and anterior lumbar interbody fusion (ALIF) are common surgical procedures for degenerative disc disease of the cervical and lumbar spine. Over the years, many bone graft options have been developed and investigated aimed at complimenting or substituting autograft bone, the traditional fusion substrate. Here, we summarise the historical context, biological basis and current best evidence for these bone graft options in ACDF and ALIF. PMID:23743981

  17. Multiscale modeling and simulation of blood flow in coronary artery bypass graft surgeries

    NASA Astrophysics Data System (ADS)

    Sankaran, Sethuraman; Esmaily Moghadam, Mahdi; Kahn, Andy; Marsden, Alison

    2011-11-01

    We present a computational framework for modeling and simulation of blood flow in patients who undergo coronary artery bypass graft (CABG) surgeries. We evaluate the influence of shape on the homeostatic state, cardiac output, and other quantities of interest. We present a case study on a patient with multiple CABG. We build a patient-specific model of the blood vessels comprised of the aorta, vessels branching from the top of the aorta (brachiocephalic artery and carotids) and the coronary arteries, in addition to bypass grafts. The rest of the circulatory system is modeled using lumped parameter 0D models comprised of resistances, compliances, inertances and elastance. An algorithm is presented that computes these parameters automatically given constraints on the flow. A Finite element framework is used to compute blood flow and pressure in the 3D model to which the 0D code is coupled at the model inlets and outlets. An adaptive closed loop BC is used to capture the coupling of the various outlets of the model with inlets, and is compared with a model with fixed inlet BC. We compare and contrast the pressure, flowrate, coronary perfusion, and PV curves obtained in the different cases. Further, we compare and contrast quantities of interest such as wall shear stress, wall shear stress gradients and oscillatory shear index for different surgical geometries and discuss implications of patient-specific optimization. I would like to acknowlege AHA for funding this work.

  18. Bone Grafts

    MedlinePlus

    A bone graft transplants bone tissue. Surgeons use bone grafts to repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some ...

  19. Exogenous erythropoietin provides neuroprotection of grafted dopamine neurons in a rodent model of Parkinson's disease.

    PubMed

    Kanaan, Nicholas M; Collier, Timothy J; Marchionini, Deanna M; McGuire, Susan O; Fleming, Matthew F; Sortwell, Caryl E

    2006-01-12

    Parkinson's disease (PD) is a neurodegenerative disease marked by severe loss of dopamine (DA) neurons in the nigrostriatal system, which results in depletion of striatal DA. Transplantation of embryonic ventral mesencephalic (VM) DA neurons into the striatum is a currently explored experimental treatment aimed at replacing lost DA in the nigrostriatal system, but is plagued with poor survival (5-20%) of implanted neurons. Here, we tested the ability of erythropoietin (Epo) to provide neuroprotection for embryonic day 14 (E14) VM DA neurons. Epo was tested in vitro for the ability to augment tyrosine hydroxylase-immunoreactive (TH-ir) neuron survival under normal cell culture conditions. In vitro, Epo did not increase the number of TH-ir neurons when administered at the time of plating the E14 VM cells in culture. We also tested the efficacy of Epo to enhance E14 VM transplants in vivo. Rats unilaterally lesioned with 6-hydroxydopamine received transplants that were incubated in Epo. Treatment with Epo produced significant increases in TH-ir neuron number, soma size, and staining intensity. Animals receiving Epo-treated grafts exhibited significantly accelerated functional improvements and significantly greater overall improvements from rotational asymmetry compared to control grafted rats. These data indicate that the survival of embryonic mesencephalic TH-ir neurons is increased when Epo is administered with grafted cells in a rodent model of PD. As direct neurotrophic effects of Epo were not observed in vitro, the mechanism of Epo neuroprotection remains to be elucidated. PMID:16368081

  20. A biomimetic approach for designing stent-graft structures: Caterpillar cuticle as design model.

    PubMed

    Singh, Charanpreet; Wang, Xungai

    2014-02-01

    Stent-graft (SG) induced biomechanical mismatch at the aortic repair site forms the major reason behind postoperative hemodynamic complications. These complications arise from mismatched radial compliance and stiffness property of repair device relative to native aortic mechanics. The inability of an exoskeleton SG design (an externally stented rigid polyester graft) to achieve optimum balance between structural robustness and flexibility constrains its biomechanical performance limits. Therefore, a new SG design capable of dynamically controlling its stiffness and flexibility has been proposed in this study. The new design is adopted from the segmented hydroskeleton structure of a caterpillar cuticle and comprises of high performance polymeric filaments constructed in a segmented knit architecture. Initially, conceptual design models of caterpillar and SG were developed and later translated into an experimental SG prototype. The in-vitro biomechanical evaluation (compliance, bending moment, migration intensity, and viscoelasticity) revealed significantly better performance of hydroskeleton structure than a commercial SG device (Zenith(™) Flex SG) and woven Dacron(®) graft-prosthesis. Structural segmentation improved the biomechanical behaviour of new SG by inducing a three dimensional volumetric expansion property when the SG was subjected to hoop stresses. Interestingly, this behaviour matches the orthotropic elastic property of native aorta and hence proposes segmented hydroskeleton structures as promising design approach for future aortic repair devices. PMID:24216309

  1. Physiologic Responses to Laparoscopic Aortofemoral Bypass Grafting in an Animal Model

    PubMed Central

    Byrne, John; Hallett, John W.; Ilstrup, Duane M.

    2000-01-01

    Objective To measure and compare the physiologic, metabolic, and hemodynamic responses to aortofemoral bypass grafting by three techniques: open or conventional laparotomy, laparoscopic-assisted (minilaparotomy), and totally laparoscopic grafting. Methods Twenty-four laboratory-bred hounds were randomized to one of three groups (open, laparoscopic-assisted, or totally laparoscopic). Four sets of parameters were measured: hemodynamic (intraoperative continuous cardiac output monitoring), inflammatory or hematologic (serial leukocyte and platelet levels), metabolic responses (serial blood glucose, serum cortisol and insulin, plasma epinephrine, plasma norepinephrine, and dopamine levels), and catabolic (24-hour urinary nitrogen excretion). Results Cardiac output increased transiently with aortic cross-clamping, more in the laparoscopic-assisted and total laparoscopic groups than in the open group, but the differences were not significant. White blood counts nearly doubled within 12 hours of surgery but were similar in all three groups. Platelet counts decreased significantly in all three groups, but no significant intergroup effects were observed. Metabolic parameters (e.g., blood glucose, cortisol, and catecholamine) rose significantly during surgery but fell to normal within 24 hours, with no important difference between groups. For the first 24 hours, urinary urea excretion fell by 50% but returned to normal by 7 days in all three groups. Conclusions In the experimental animal model, the hemodynamic, hematologic, and metabolic responses to laparoscopic and laparoscopic-assisted aortofemoral bypass grafting are similar to those produced by conventional laparotomy graft placement. These data call into question whether laparoscopic techniques for aortic surgery have a significant physiologic advantage in humans. PMID:10749611

  2. A System for Computer-Assisted Design of Stent-Grafts for Aortic Aneurysms Using 3-D Morphological Models

    SciTech Connect

    Imai, Yasuhiro; Urayama, Shin-ich; Uyama, Chikao; Inoue, Kanji; Ueno, Katsuya; Kuribayashi, Sachio; Takamiya, Makoto; Hamada, Seiki; Hirane, Yoshihisa

    2001-07-15

    A three-dimensional model was constructed from helical CT images for abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA). A stent-graft was designed and positioned endoluminally on the computer. One hundred and nine stent-grafts for 101 patients were designed by this method and deployed well in all patients. The design time was reduced from 4 to 0.5 hr.

  3. Assessment of Novel Anti-thrombotic Fusion Proteins for Inhibition of Stenosis in a Porcine Model of Arteriovenous Graft

    PubMed Central

    Terry, Christi M.; Zhuplatov, Ilya; He, Yuxia; Wun, Tze-Chein; Kim, Seong-Eun; Cheung, Alfred K.

    2015-01-01

    Background Hemodialysis arteriovenous synthetic grafts (AVG) provide high volumetric blood flow rates shortly after surgical placement. However, stenosis often develops at the vein-graft anastomosis contributing to thrombosis and early graft failure. Two novel fusion proteins, ANV-6L15 and TAP-ANV, inhibit the tissue factor/factor VIIa coagulation complex and the factor Xa/factor Va complex, respectively. Each inhibitor domain is fused to an annexin V domain that targets the inhibitor activity to sites of vascular injury to locally inhibit thrombosis. This study’s objective was to determine if these antithrombotic proteins are safe and effective in inhibiting AVG stenosis. Methods A bolus of either TAP-ANV or ANV-6L15 fusion protein was administered intravenously immediately prior to surgical placement of a synthetic graft between the external jugular vein and common carotid artery in a porcine model. At surgery, the vein and artery were irrigated with the anti-thrombotic fusion protein. Control animals received intravenous heparin. At 4 weeks, MRI was performed to evaluate graft patency, the pigs were then euthanized and grafts and attached vessels were explanted for histomorphometric assessment of neointimal hyperplasia at the vein-graft anastomosis. Blood was collected at surgery, immediately after surgery and at euthanasia for serum metabolic panels and coagulation chemistries. Results No acute thrombosis occurred in the control group or in either experimental group. No abnormal serum chemistries, activated clotting times or PT, PTT values were observed after treatment in experimental or control animals. However, at the vein-graft anastomosis, there was no difference between the control and experimental groups in cross-sectional lumen areas, as measured on MRI, and no difference in hyperplasia areas as determined by histomorphometry. These results suggest that local irrigation of TAP-ANV or ANV-6L15 intra-operatively was as effective in inhibiting acute graft

  4. Kinetics of corneal epithelial maintenance and graft loss. A population balance model.

    PubMed

    Sharma, A; Coles, W H

    1989-09-01

    We use a population balance model to study the mechanism and the rate of centripetal migration of epithelial cells, renewal of the corneal epithelial population by the cell derived from (progeny of) the limbal stem cells and the kinetics of the replacement of the donor corneal epithelium. The epithelial mass is constant under the normal circumstances and therefore the rate of cellular entry due to centripetal motion and mitosis into any epithelial volume must equal the cell loss from the same volume. The magnitude of the centripetal velocity and the rate of replacement of the donor tissue following keratoplasty are shown to depend only on the following directly quantifiable factors--the difference in the mitotic rates of the corneal and limbal epithelia and the radii of these two epithelia. The a priori model predictions are found to be in very good agreement with the observed centripetal velocities and the rate of corneal graft replacement. The model provides an independent support for the hypothesis that the stem cells for the corneal epithelium are located in the limbus and are responsible for a slow replenishment of the corneal epithelial cell. The model suggests some factors that diminish the centripetal supply of cells and thus provides insights into the pathogenesis of persistent corneal defects and delayed reepithelialization of defects and grafts. The model is suitable for interpreting and quantitatively correlating the influence of some epithelial alterations and drugs on the centripetal supply of epithelial cells. PMID:2674050

  5. Grafting of higher-order correlations of real financial markets into herding models

    NASA Astrophysics Data System (ADS)

    Ahn, Sanghyun; Lim, Gyuchang; Kim, Sooyong; Kim, Kyungsik

    2009-08-01

    In this work, we graft the volatility clustering observed in empirical financial time series into the Equiluz and Zimmermann (EZ) model, which was introduced to reproduce the herding behaviors of a financial time series. The original EZ model failed to reproduce the empirically observed power-law exponents of real financial data. The EZ model ordinarily produces a more fat-tailed distribution compared to real data, and a long-range correlation of absolute returns that underlie the volatility clustering. As it is not appropriate to capture the empirically observed correlations in a modified EZ model, we apply a sorting method to incorporate the nonlinear correlation structure of a real financial time series into the generated returns. By doing so, we observe that the slow convergence of distribution of returns is well established for returns generated from the EZ model and its modified version. It is also found that the modified EZ model leads to a less fat-tailed distribution.

  6. Immune Reconstitution and Graft-Versus-Host Reactions in Rat Models of Allogeneic Hematopoietic Cell Transplantation

    PubMed Central

    Zinöcker, Severin; Dressel, Ralf; Wang, Xiao-Nong; Dickinson, Anne M.; Rolstad, Bent

    2012-01-01

    Allogeneic hematopoietic cell transplantation (alloHCT) extends the lives of thousands of patients who would otherwise succumb to hematopoietic malignancies such as leukemias and lymphomas, aplastic anemia, and disorders of the immune system. In alloHCT, different immune cell types mediate beneficial graft-versus-tumor (GvT) effects, regulate detrimental graft-versus-host disease (GvHD), and are required for protection against infections. Today, the “good” (GvT effector cells and memory cells conferring protection) cannot be easily separated from the “bad” (GvHD-causing cells), and alloHCT remains a hazardous medical modality. The transplantation of hematopoietic stem cells into an immunosuppressed patient creates a delicate environment for the reconstitution of donor blood and immune cells in co-existence with host cells. Immunological reconstitution determines to a large extent the immune status of the allo-transplanted host against infections and the recurrence of cancer, and is critical for long-term protection and survival after clinical alloHCT. Animal models continue to be extremely valuable experimental tools that widen our understanding of, for example, the dynamics of post-transplant hematopoiesis and the complexity of immune reconstitution with multiple ways of interaction between host and donor cells. In this review, we discuss the rat as an experimental model of HCT between allogeneic individuals. We summarize our findings on lymphocyte reconstitution in transplanted rats and illustrate the disease pathology of this particular model. We also introduce the rat skin explant assay, a feasible alternative to in vivo transplantation studies. The skin explant assay can be used to elucidate the biology of graft-versus-host reactions, which are known to have a major impact on immune reconstitution, and to perform genome-wide gene expression studies using controlled combinations of minor and major histocompatibility between the donor and the recipient

  7. Serotonergic and dopaminergic mechanisms in graft-induced dyskinesia in a rat model of Parkinson's disease.

    PubMed

    Shin, Eunju; Garcia, Joanna; Winkler, Christian; Björklund, Anders; Carta, Manolo

    2012-09-01

    Dyskinesia seen in the off-state, referred as graft-induced dyskinesia (GID), has emerged as a serious complication induced by dopamine (DA) cell transplantation in parkinsonian patients. Although the mechanism underlying the appearance of GID is unknown, in a recent clinical study the partial 5-HT(1A) agonist buspirone was found to markedly reduce GID in three grafted patients, who showed significant serotonin (5-HT) hyperinnervation in the grafted striatum in positron emission tomography scanning (Politis et al., 2010, 2011). Prompted by these findings, this study was performed to investigate the involvement of serotonin neurons in the appearance of GID in the rat 6-hydroxydopamine model. L-DOPA-primed rats received transplants of DA neurons only, DA plus 5-HT neurons or 5-HT neurons only into the lesioned striatum. In DA cell-grafted rats, with or without 5-HT neurons, but not in 5-HT grafts, GID was observed consistently after administration of amphetamine (1.5mg/kg, i.p.) indicating that grafted DA neurons are required to induce GID. Strikingly, a low dose of buspirone produced a complete suppression of GID. In addition, activation of 5-HT(1A) and 5-HT(1B) receptors by 8-OH-DPAT and CP 94253, known to inhibit the activity of 5-HT neurons, significantly reduced GID, whereas induction of neurotransmitter release by fenfluramine administration significantly increased GID, indicating an involvement of the 5-HT system in the modulation of GID. To investigate the involvement of the host 5-HT system in GID, the endogenous 5-HT terminals were removed by intracerebral injection of 5,7-dihydroxytryptamine, but this treatment did not affect GID expression. However, 5-HT terminal destruction suppressed the anti-GID effect of 5-HT(1A) and 5-HT(1B) agonists, demonstrating that the 5-HT(1) agonist combination exerted its anti-GID effect through the activation of pre-synaptic host-derived receptors. By contrast, removal of the host 5-HT innervation or pre-treatment with a 5

  8. Vascular replacement using a layered elastin-collagen vascular graft in a porcine model: one week patency versus one month occlusion

    PubMed Central

    Koens, M J W; Krasznai, A G; Hanssen, A E J; Hendriks, T; Praster, R; Daamen, W F; van der Vliet, J A; van Kuppevelt, T H

    2015-01-01

    abstract A persistent clinical demand exists for a suitable arterial prosthesis. In this study, a vascular conduit mimicking the native 3-layered artery, and constructed from the extracellular matrix proteins type I collagen and elastin, was evaluated for its performance as a blood vessel equivalent. A tubular 3-layered graft (elastin-collagen-collagen) was prepared using highly purified type I collagen fibrils and elastin fibers, resembling the 3-layered native blood vessel architecture. The vascular graft was crosslinked and heparinised (37 ± 4 μg heparin/mg graft), and evaluated as a vascular graft using a porcine bilateral iliac artery model. An intra-animal comparison with clinically-used heparinised ePTFE (Propaten®) was made. Analyses included biochemical characterization, duplex scanning, (immuno)histochemistry and scanning electron microscopy. The tubular graft was easy to handle with adequate suturability. Implantation resulted in pulsating grafts without leakage. One week after implantation, both ePTFE and the natural acellular graft had 100% patencies on duplex scanning. Grafts were partially endothelialised (Von Willebrand-positive endothelium with a laminin-positive basal membrane layer). After one month, layered thrombi were found in the natural (4/4) and ePTFE graft (1/4), resulting in occlusion which in case of the natural graft is likely due to the porosity of the inner elastin layer. In vivo application of a molecularly-defined tubular graft, based on nature's matrix proteins, for vascular surgery is feasible. PMID:26060888

  9. Vascular replacement using a layered elastin-collagen vascular graft in a porcine model: one week patency versus one month occlusion.

    PubMed

    Koens, M J W; Krasznai, A G; Hanssen, A E J; Hendriks, T; Praster, R; Daamen, W F; van der Vliet, J A; van Kuppevelt, T H

    2015-01-01

    A persistent clinical demand exists for a suitable arterial prosthesis. In this study, a vascular conduit mimicking the native 3-layered artery, and constructed from the extracellular matrix proteins type I collagen and elastin, was evaluated for its performance as a blood vessel equivalent. A tubular 3-layered graft (elastin-collagen-collagen) was prepared using highly purified type I collagen fibrils and elastin fibers, resembling the 3-layered native blood vessel architecture. The vascular graft was crosslinked and heparinised (37 ± 4 μg heparin/mg graft), and evaluated as a vascular graft using a porcine bilateral iliac artery model. An intra-animal comparison with clinically-used heparinised ePTFE (Propaten®) was made. Analyses included biochemical characterization, duplex scanning, (immuno)histochemistry and scanning electron microscopy. The tubular graft was easy to handle with adequate suturability. Implantation resulted in pulsating grafts without leakage. One week after implantation, both ePTFE and the natural acellular graft had 100% patencies on duplex scanning. Grafts were partially endothelialised (Von Willebrand-positive endothelium with a laminin-positive basal membrane layer). After one month, layered thrombi were found in the natural (4/4) and ePTFE graft (1/4), resulting in occlusion which in case of the natural graft is likely due to the porosity of the inner elastin layer. In vivo application of a molecularly-defined tubular graft, based on nature's matrix proteins, for vascular surgery is feasible. PMID:26060888

  10. Mild anastomotic stenosis in patient-specific CABG model may enhance graft patency: a new hypothesis.

    PubMed

    Huo, Yunlong; Luo, Tong; Guccione, Julius M; Teague, Shawn D; Tan, Wenchang; Navia, José A; Kassab, Ghassan S

    2013-01-01

    It is well known that flow patterns at the anastomosis of coronary artery bypass graft (CABG) are complex and may affect the long-term patency. Various attempts at optimal designs of anastomosis have not improved long-term patency. Here, we hypothesize that mild anastomotic stenosis (area stenosis of about 40-60%) may be adaptive to enhance the hemodynamic conditions, which may contribute to slower progression of atherosclerosis. We further hypothesize that proximal/distal sites to the stenosis have converse changes that may be a risk factor for the diffuse expansion of atherosclerosis from the site of stenosis. Twelve (12) patient-specific models with various stenotic degrees were extracted from computed tomography images using a validated segmentation software package. A 3-D finite element model was used to compute flow patterns including wall shear stress (WSS) and its spatial and temporal gradients (WSS gradient, WSSG, and oscillatory shear index, OSI). The flow simulations showed that mild anastomotic stenosis significantly increased WSS (>15 dynes · cm(-2)) and decreased OSI (<0.02) to result in a more uniform distribution of hemodynamic parameters inside anastomosis albeit proximal/distal sites to the stenosis have a decrease of WSS (<4 dynes · cm(-2)). These findings have significant implications for graft adaptation and long-term patency. PMID:24058488

  11. The development of a normalization method for comparing nerve regeneration effectiveness among different graft types

    PubMed Central

    Chang, Wei; DeVince, Jeffrey; Green, Gabriella; Shah, Munish B.; Johns, Michael S.; Meng, Yan; Yu, Xiaojun

    2013-01-01

    The inability to compare directly different nerve grafts has been a significant factor hindering the advance of nerve graft development. Due to the abundance of variables that exist in nerve graft construction and multiple assessment types, there has been limited success in comparing nerve graft effectiveness among experiments. Using mathematical techniques on nerve conduction velocity (NCV) autograft data, a normalization function was empirically derived that normalizes differences in gap lengths. Further analysis allowed for the development of the Relative Regeneration Ratio (RRR). The RRR function allows researchers to directly compare nerve graft results based on the NCV data from their respective studies as long as the data was collected at the same post-operation time. This function also allows for comparisons between grafts tested at different gap lengths. Initial testing of this RRR function provided confidence that the function is accurate for a continuum of gap lengths and different nerve graft types. PMID:24118184

  12. Hamstring graft size and anthropometry in south Indian population

    PubMed Central

    Challa, Supradeeptha; Satyaprasad, Jonnalagedda

    2013-01-01

    Background and Aim The role of anthropometric measurements in the prediction of hamstring autograft size in Indian population remains unclear. Till now, no studies have been done on Indian population. Methods We evaluated 41 consecutive patients (34 males, 7 females) prospectively with anterior cruciate ligament deficiency scheduled for reconstruction using hamstring autograft at our institution between June 2011 and June 2013. Preoperatively we recorded age, gender, height, weight, body mass index, and activity level. Intraoperative measurements of semitendinosus tendon like absolute length, diameter before fashioning the graft and final diameter of the tripled graft using sizing tubes calibrated to 1 mm. Correlation coefficient (Pearson's r) analysis was used. Results As per study there is no correlation between graft diameter, age, sex, weight, activity, and body mass index, of patients. Height of patients correlated to graft diameter in both Indian men and women (p < 0.001). Conclusion Anthropometric measurements such as weight, gender, activity level cannot be used as definitive predictors for the hamstring graft diameter during harvest but height of the patients can be taken as good predictor in Indian population. PMID:26403553

  13. Electrospun Vascular Grafts with Improved Compliance Matching to Native Vessels

    PubMed Central

    Nezarati, Roya M.; Eifert, Michelle B.; Dempsey, David K.; Cosgriff-Hernandez, Elizabeth

    2014-01-01

    Coronary artery bypass grafting (CABG) is one of the most commonly performed major surgeries in the United States. Autologous vessels such as the saphenous vein are the current gold standard for treatment; however, synthetic vascular prostheses made of expanded poly(tetrafluoroethylene) (ePTFE) or poly(ethylene terephthalate) (PET) are used when autologous vessels are unavailable. These synthetic grafts have a high failure rate in small diameter (<4 mm) applications due to rapid re-occlusion via intimal hyperplasia. Current strategies to improve clinical performance are focused on preventing intimal hyperplasia by fabricating grafts with compliance and burst pressure similar to native vessels. To this end, we have developed an electrospun vascular graft from segmented polyurethanes with tunable properties by altering material chemistry and graft microarchitecture. Relationships between polyurethane tensile properties and biomechanical properties were elucidated to select polymers with desirable properties. Graft thickness, fiber tortuosity, and fiber fusions were modulated to provide additional tools for controlling graft properties. Using a combination of these strategies, a vascular graft with compliance and burst pressure exceeding the saphenous vein autograft was fabricated (compliance = 6.0 ± 0.6 %/mmHg × 10−4, burst pressure = 2260 ± 160 mmHg). This graft is hypothesized to reduce intimal hyperplasia associated with low compliance in synthetic grafts and improve long term clinical success. Additionally, the fundamental relationships between electrospun mesh microarchitecture and mechanical properties identified in this work can be utilized in various biomedical applications. PMID:24846218

  14. Three-Layered PCL Grafts Promoted Vascular Regeneration in a Rabbit Carotid Artery Model.

    PubMed

    Wang, Kai; Zheng, Wenting; Pan, Yiwa; Ma, Shaoyang; Guan, Yong; Liu, Ruming; Zhu, Meifeng; Zhou, Xin; Zhang, Jun; Zhao, Qiang; Zhu, Yan; Wang, Lianyong; Kong, Deling

    2016-04-01

    In this study, a three layered poly (ε-caprolactone) (PCL) graft (tPCL) was fabricated by electrospinning PCL and electrospraying poly (ethylene oxide) (PEO), which has a thin dense inner layer, a loose middle layer, and a dense outer layer. Regular PCL grafts (rPCL) with only a dense layer were used as control. In vivo evaluation was performed in rabbit carotid artery. Enhanced cell infiltration, rapid regeneration of endothelium and smooth muscle layers, and increased elastin deposition were observed within the tPCL graft wall. After 3 months, tPCL grafts showed faster PCL degradation than the rPCL grafts. Infiltrated macrophages in the tPCL grafts secreted higher level of monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) which enhanced vascular regeneration. In conclusion, the tPCL graft may be a useful vascular prosthesis and worth for further investigation. PMID:26756321

  15. Physiologically Modeled Pulse Dynamics to Improve Function in In Vitro-Endothelialized Small-Diameter Vascular Grafts.

    PubMed

    Uzarski, Joseph S; Cores, Jhon; McFetridge, Peter S

    2015-11-01

    The lack of a functional endothelium on small-diameter vascular grafts leads to intimal hyperplasia and thrombotic occlusion. Shear stress conditioning through controlled hydrodynamics within in vitro perfusion bioreactors has shown promise as a mechanism to drive endothelial cell (EC) phenotype from an activated, pro-inflammatory wound state toward a quiescent functional state that inhibits responses that lead to occlusive failure. As part of an overall design strategy to engineer functional vascular grafts, we present a novel two-phase shear conditioning approach to improve graft endothelialization. Axial rotation was first used to seed uniform EC monolayers onto the lumenal surface of decellularized scaffolds derived from the human umbilical vein. Using computer-controlled perfusion circuits, a flow-ramping paradigm was applied to adapt endothelia to arterial levels of fluid shear stress and pressure without graft denudation. The effects of constant pulse frequencies (CF) on EC quiescence were then compared with pulse frequencies modeled from temporal fluctuations in blood flow observed in vivo, termed physiologically modeled pulse dynamics (PMPD). Constructs exposed to PMPD for 72 h expressed a more functional transcriptional profile, lower metabolic activity (39.8% ± 8.4% vs. 62.5% ± 11.5% reduction, p = 0.012), and higher nitric oxide production (80.42 ± 23.93 vs. 48.75 ± 6.93 nmol/10(5) cells, p = 0.028) than those exposed to CF. By manipulating in vitro flow conditions to mimic natural physiology, endothelialized vascular grafts can be stimulated to express a nonactivated phenotype that would better inhibit peripheral cell adhesion and smooth muscle cell hyperplasia, conditions that typically lead to occlusive failure. Development of robust, functional endothelia on vascular grafts by modulation of environmental conditions within perfusion bioreactors may ultimately improve clinical outcomes in vascular bypass grafting. PMID:25996580

  16. Modeling heterogeneous polymer-grafted nanoparticle networks having biomimetic core-shell structure

    NASA Astrophysics Data System (ADS)

    Mbanga, Badel L.; Yashin, Victor V.; Holten-Andersen, Niels; Balazs, Anna C.

    Inspired by the remarkable mechanical properties of such biological structures as mussel adhesive fibers, we use 3D computational modeling to study the behavior of heterogeneous polymer-grafted nanoparticle (PGN) networks under tensile deformation. The building block of a PGN network is a nanoparticle with grafted polymer chains whose free ends' reactive groups can form both permanent and labile bonds with the end chains on the nearby particles. The tunable behavior of cross-linked PGN networks makes them excellent candidates for designing novel materials with enhanced mechanical properties. Here, we consider the PGN networks having the core-shell structures, in which the type and strength of the inter-particle bonds in the outer shell differ from those in the core. Using the computer simulations, we obtain and compare the ultimate tensile properties (strength, toughness, ductility) and the strain recovery properties for the uniform samples and various core-shell structures. We demonstrate that the core-shell structures could be designed to obtain highly resilient self-healing materials

  17. Chemical Control of Grafted Human PSC-Derived Neurons in a Mouse Model of Parkinson's Disease.

    PubMed

    Chen, Yuejun; Xiong, Man; Dong, Yi; Haberman, Alexander; Cao, Jingyuan; Liu, Huisheng; Zhou, Wenhao; Zhang, Su-Chun

    2016-06-01

    Transplantation of human pluripotent stem cell (hPSC)-derived neurons is a promising avenue for treating disorders including Parkinson's disease (PD). Precise control over engrafted cell activity is highly desired, as cells do not always integrate properly into host circuitry and can cause suboptimal graft function or undesired outcomes. Here, we show tunable rescue of motor function in a mouse model of PD, following transplantation of human midbrain dopaminergic (mDA) neurons differentiated from hPSCs engineered to express DREADDs (designer receptors exclusively activated by designer drug). Administering clozapine-N-oxide (CNO) enabled precise DREADD-dependent stimulation or inhibition of engrafted neurons, revealing D1 receptor-dependent regulation of host neuronal circuitry by engrafted cells. Transplanted cells rescued motor defects, which could be reversed or enhanced by CNO-based control of graft function, and activating engrafted cells drives behavioral changes in transplanted mice. These results highlight the ability to exogenously and noninvasively control and refine therapeutic outcomes following cell transplantation. PMID:27133795

  18. Grafting of a model protein on lactide and caprolactone based biodegradable films for biomedical applications

    PubMed Central

    Larrañaga, Aitor; Guay-Bégin, Andrée-Anne; Chevallier, Pascale; Sabbatier, Gad; Fernández, Jorge; Laroche, Gaétan; Sarasua, Jose-Ramon

    2014-01-01

    Thermoplastic biodegradable polymers displaying elastomeric behavior and mechanical consistency are greatly appreciated for the regeneration of soft tissues and for various medical devices. However, while the selection of a suitable base material is determined by mechanical and biodegradation considerations, it is the surface properties of the biomaterial that are responsible for the biological response. In order to improve the interaction with cells and modulate their behavior, biologically active molecules can be incorporated onto the surface of the material. With this aim, the surface of a lactide and caprolactone based biodegradable elastomeric terpolymer was modified in two stages. First, the biodegradable polymer surface was aminated by atmospheric pressure plasma treatment and second a crosslinker was grafted in order to covalently bind the biomolecule. In this study, albumin was used as a model protein. According to X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM), albumin was efficiently immobilized on the surface of the terpolymer, the degree of albumin surface coverage (ΓBSA) reached ~35%. Moreover, gel permeation chromatography (GPC) studies showed that the hydrolytic degradation kinetic of the synthesized polymer was slightly delayed when albumin was grafted. However, the degradation process in the bulk of the material was unaffected, as demonstrated by Fourier transform infrared (FTIR) analyses. Furthermore, XPS analyses showed that the protein was still present on the surface after 28 days of degradation, meaning that the surface modification was stable, and that there had been enough time for the biological environment to interact with the modified material. PMID:24509417

  19. Grafting of a model protein on lactide and caprolactone based biodegradable films for biomedical applications.

    PubMed

    Larrañaga, Aitor; Guay-Bégin, Andrée-Anne; Chevallier, Pascale; Sabbatier, Gad; Fernández, Jorge; Laroche, Gaétan; Sarasua, Jose-Ramon

    2014-01-01

    Thermoplastic biodegradable polymers displaying elastomeric behavior and mechanical consistency are greatly appreciated for the regeneration of soft tissues and for various medical devices. However, while the selection of a suitable base material is determined by mechanical and biodegradation considerations, it is the surface properties of the biomaterial that are responsible for the biological response. In order to improve the interaction with cells and modulate their behavior, biologically active molecules can be incorporated onto the surface of the material. With this aim, the surface of a lactide and caprolactone based biodegradable elastomeric terpolymer was modified in two stages. First, the biodegradable polymer surface was aminated by atmospheric pressure plasma treatment and second a crosslinker was grafted in order to covalently bind the biomolecule. In this study, albumin was used as a model protein. According to X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM), albumin was efficiently immobilized on the surface of the terpolymer, the degree of albumin surface coverage (ΓBSA) reached ~35%. Moreover, gel permeation chromatography (GPC) studies showed that the hydrolytic degradation kinetic of the synthesized polymer was slightly delayed when albumin was grafted. However, the degradation process in the bulk of the material was unaffected, as demonstrated by Fourier transform infrared (FTIR) analyses. Furthermore, XPS analyses showed that the protein was still present on the surface after 28 days of degradation, meaning that the surface modification was stable, and that there had been enough time for the biological environment to interact with the modified material. PMID:24509417

  20. Patient-Derived Endothelial Progenitor Cells Improve Vascular Graft Patency in Rodent Model

    PubMed Central

    Stroncek, JD; Ren, LC; Klitzman, B; Reichert, WM

    2011-01-01

    Late outgrowth endothelial progenitor cells (EPCs) derived from the peripheral blood of patients with significant coronary artery disease were sodded into the lumens of small diameter expanded polytetrafluoroethylene (ePTFE) vascular grafts. Grafts (1 mm inner diameter) were denucleated and sodded either with native EPCs or with EPCs transfected with an adenoviral vector containing the gene for human thrombomodulin (EPC+AdTM). EPC+AdTM was shown to increase the in vitro rate of graft activated protein C (APC) production 4-fold over grafts sodded with untransfected EPCs (p<0.05). Unsodded control and EPC-sodded and EPC+AdTM-sodded grafts were implanted bilaterally into the femoral arteries of athymic rats for 7 or 28 days. Unsodded control grafts, both with and without denucleation treatment, each exhibited 7-day patency rates of 25%. Unsodded grafts showed extensive thrombosis and were not tested for patency over 28 days. In contrast, grafts sodded with untransfected EPCs or EPC+AdTM both had 7-day patency rates of 88-89% and 28-day patency rates of 75-88%. Intimal hyperplasia was observed near both the proximal and distal anastomoses in all sodded graft conditions but did not appear to be the primary occlusive failure event. This in vivo study suggests autologous EPCs derived from the peripheral blood of patients with coronary artery disease may improve the performance of synthetic vascular grafts, although no differences were observed between untransfected EPCs and TM transfected EPCs. PMID:21945828

  1. Patient-derived endothelial progenitor cells improve vascular graft patency in a rodent model.

    PubMed

    Stroncek, J D; Ren, L C; Klitzman, B; Reichert, W M

    2012-01-01

    Late outgrowth endothelial progenitor cells (EPCs) derived from the peripheral blood of patients with significant coronary artery disease were sodded into the lumens of small diameter expanded polytetrafluoroethylene (ePTFE) vascular grafts. Grafts (1mm inner diameter) were denucleated and sodded either with native EPCs or with EPCs transfected with an adenoviral vector containing the gene for human thrombomodulin (EPC+AdTM). EPC+AdTM was shown to increase the in vitro rate of graft activated protein C (APC) production 4-fold over grafts sodded with untransfected EPCs (p<0.05). Unsodded control and EPC-sodded and EPC+AdTM-sodded grafts were implanted bilaterally into the femoral arteries of athymic rats for 7 or 28 days. Unsodded control grafts, both with and without denucleation treatment, each exhibited 7 day patency rates of 25%. Unsodded grafts showed extensive thrombosis and were not tested for patency over 28 days. In contrast, grafts sodded with untransfected EPCs or EPC+AdTM both had 7 day patency rates of 88-89% and 28 day patency rates of 75-88%. Intimal hyperplasia was observed near both the proximal and distal anastomoses in all sodded graft conditions but did not appear to be the primary occlusive failure event. This in vivo study suggests autologous EPCs derived from the peripheral blood of patients with coronary artery disease may improve the performance of synthetic vascular grafts, although no differences were observed between untransfected EPCs and TM transfected EPCs. PMID:21945828

  2. Vein Graft-Coated Vascular Stents: A Feasibility Study in a Canine Model

    SciTech Connect

    Schellhammer, Frank; Haberstroh, Joerg; Wakhloo, Ajay K.; Gottschalk, Eva; Schumacher, Martin

    1998-03-15

    Purpose: To evaluate different vein grafts for luminal coating of endovascular stents in normal canine arteries. Methods: Twenty-four tantalum Strecker stents were coated with either autologous (n= 10), denatured heterologous (n= 11), or denatured homologous vein grafts (n= 3). The carotid artery (n= 11) and the iliac artery (n= 13) were stented using a transfemoral approach. Angiograms were performed at days 0, 7, and 21, and months 3, 6, and 9. All grafts underwent histological examination. Results: Eight of 10 autologous vein grafts showed patency during the whole observation period of 9 months, without histological signs of inflammation. Denatured heterologous vein grafts revealed acute (n= 3), subacute (n= 5), or delayed (n= 3) vessel occlusion. Hyaloid transformation of the vein graft and lympho-plasmacellular formations were seen. Denatured homologous vein grafts showed acute vessel occlusion. Although significant inflammatory tissue response was seen, no host-versus-graft reaction was present. Conclusion: Autologous vein graft-coated stents showed good biocompatibility in canine arteries. Preparation was cumbersome and required surgical venae-sectio. Denatured vein grafts, however, were limited by inflammatory reactions.

  3. Evolution of shear stress, protein expression, and vessel area in an animal model of arterial dilatation in hemodialysis grafts

    PubMed Central

    Misra, Sanjay; Fu, Alex A.; Misra, Khamal D.; Glockner, James F.; Mukhopadyay, Debabrata

    2010-01-01

    Purpose To evaluate the wall shear stress, protein expression of matrix metalloproteinases-2 (MMP-2), -9 (MMP-9), and the inhibitors (tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), and -2 (TIMP-2)), and vessel area over time in a porcine model for hemodialysis polytetrafluoroethylene (PTFE) grafts. Materials and methods In 21 pigs, subtotal renal infarction was performed and 28 days later, a PTFE graft was placed to connect the carotid artery to the ipsilateral jugular vein. Phase contrast MR was used to measure blood flow and vessel area at 1, 3, 7, and 14 days after graft placement. Wall shear stress was estimated from Poiseuille’s law. Animals were sacrificed at day 3 (N=7), day 7 (N=7), and day 14 (N=7) and expression of MMP-2, MMP-9, TIMP-1, and TIMP-2 were determined at the grafted and control arteries. Results The mean wall shear stress of the grafted artery was higher than the control artery at all time points (P<0.05). It peaked by day 3 and decreased by days 7–14 as the vessel area nearly doubled. By days 7–14, there was a significant increase in active MMP-2 followed by a significant increase in pro and active MMP-9 by day 14 (P<0.05, grafted artery versus control). TIMP-1 expression peaked by day 7 and then decreased while TIMP-2 expression was decreased at days 7–14. Conclusions The wall shear stress of the grafted artery peaks by day 3 with increased MMP-2 activity by days 7–14 followed by pro and active MMP-9 by day 14 and the vessel area nearly doubled. PMID:20123196

  4. Autologous Graft-versus-Tumor Effect: Reality or Fiction?

    PubMed Central

    2016-01-01

    In contrast to allogeneic hematopoietic stem cell transplantation, the current dogma is not an evidence of graft-versus-tumor effect in autologous hematopoietic stem cell transplantation; thus, it is assumed that autologous hematopoietic stem cell transplantation only relies on the high-dose chemotherapy to improve clinical outcomes. However, recent studies argue in favor of the existence of an autologous graft-versus-tumor without the detrimental complications of graft-versus-host disease due to the nonspecific immune response from the infused donor alloreactive immune effector cells in allogeneic hematopoietic stem cell transplantation. Herein, this paper reviews the clinical evidence of an autologous graft-versus-tumor effect based on the autograft collected and infused host immune effector cells and host immunity recovery after autologous hematopoietic stem cell transplantation affecting clinical outcomes in cancer patients.

  5. Clinical Study of Graft Selection in Malaysian Rhinoplasty Patients

    PubMed Central

    2013-01-01

    Graft selection remains the greatest challenge for surgeons performing rhinoplasty. The preferred choice thus far for nasal reconstruction would be autograft compared to allograft due to its lower rate of infection and extrusion as it does not induce an immune response. We have evaluated 26 patients who underwent open structured rhinoplasty at our center and compared our experience regarding the operative technique, graft availability, indications, and limitations. The racial distribution was 18 Indians, 5 Chinese, and 3 Malays with a mean age, hospitalization, and followup of 30.5 years, 16.9 months, and 4.4 days, respectively. Majority of the patients (57.6%) presented with twisted nose and 30.7% of the patients presented with history of nasal trauma. All the patients had deviated septum of varying severity. The most common graft used was quadrangular cartilage graft and the common complications noted were ala deformity and tip anaesthesia in 7.6% patients respectively. PMID:24078883

  6. Hydroxyapatite-Based Biomaterials vs. Autologous Bone Graft in Spinal Fusion: An in Vivo Animal Study.

    PubMed

    Bròdano, Giovanni Barbanti; Giavaresi, Gianluca; Lolli, Francesco; Salamanna, Francesca; Parrilli, Annapaola; Martini, Lucia; Griffoni, Cristiana; Greggi, Tiziana; Arcangeli, Elena; Pressato, Daniele; Boriani, Stefano; Fini, Milena

    2014-04-01

    Study Design. An in vivo study was designed to compare the efficacy of biomimetic Magnesium-Hydroxyapatite (MgHA) and of human demineralised bone matrix (HDBM), both dispersed in a mixture of biomimetic Mg-HA nanoparticles, with that of an autologous bone graft.Objective. The objective of this study was to evaluate two new bone substitutes as alternatives to a bone autograft for spinal fusion, determining their osteoinductive and osteoconductive properties, and their capacity of remodeling, using a large animal model.Summary of Background Data. Spinal fusion is a common surgical procedure and it is performed for different conditions. A successful fusion requires potentially osteogenic, osteoinductive and osteoconductive biomaterials.Methods. A posterolateral spinal fusion model involved 18 sheep, bilaterally implanting test materials between the vertebral transverse processes. The animals were divided into two groups: one fusion level was treated with MgHA (Group 1) or with HDBM-MgHA (Group 2). The other fusion level received bone autografts in both groups.Results. Radiographic, histological and microtomographic results indicated good osteointegration between the spinous process and the vertebral foramen for both materials. Histomorphometry revealed no significant differences between MgHA and autologous bone for all the parameters examined while significantly lower values of bone volume were observed between HDBM-MgHA and autologous bone. Moreover, the normalisation of the histomorphometrical data with autologous bone revealed that MgHA showed a significantly higher value of bone volume and a lower value of trabecular number, more similar to autologous bone, in comparison to HDBM-MgHA.Conclusion. The study showed that the use of MgHA in an ovine model of spinal fusion led to the deposition of new bone tissue without qualitative and quantitative differences with respect to new bone formed with autologous bone while the HDBM-MgHA led to a reduced deposition of newly

  7. μCT-Based Measurement of Cortical Bone Graft-to-Host Union

    PubMed Central

    Reynolds, David G.; Shaikh, Saad; Papuga, Mark Owen; Lerner, Amy L.; O'Keefe, Regis J.; Schwarz, Edward M.; Awad, Hani A.

    2009-01-01

    Evaluation of structural bone grafts risk of failure requires noninvasive quantitative predictors of functional strength. We hypothesized that a quantitative graft-to-host union biometric would correlate significantly with biomechanical properties as a surrogate for the risk of fracture. To test this, we developed a novel algorithm to compute the union between host callus and graft, which was termed the union ratio. We compared the union ratio of live autografts to devitalized allografts implanted into the mid-diaphysis of mouse femurs for 6 and 9 wk. Surprisingly, the autograft union ratio decreased from 0.228 ± 0.029 at 6 wk to 0.15 ± 0.011 at 9 wk (p < 0.05) and did not correlate with the torsional properties of the autografts . The allograft union ratio was 0.105 ± 0.023 at 6 wk but increased to 0.224 ± 0.029 at 9 wk (p < 0.05). As a single variable, the union ratio correlated significantly with ultimate torque (R 2 = 0.58) and torsional rigidity (R 2 = 0.51) of the allografts. Multivariable regression analyses of allografts that included the union ratio, the graft bone volume, the maximum and minimum polar moment of inertia, and their first-order interaction terms with the union ratio as independent variables resulted in significant correlations with the ultimate torque and torsional rigidity (adjusted R 2 = 0.80 and 0.89, respectively). These results suggest that, unlike live autografts, the union between the devitalized allograft and host contributes significantly to the strength of grafted bone. The union ratio has important clinical implications as a novel biometric for noninvasive assessment of functional strength and failure risk. PMID:19063685

  8. Scaffolds from alternating block polyurethanes of poly(ɛ-caprolactone) and poly(ethylene glycol) with stimulation and guidance of nerve growth and better nerve repair than autograft.

    PubMed

    Niu, Yuqing; Li, Linjing; Chen, Kevin C; Chen, Feiran; Liu, Xiangyu; Ye, Jianfu; Li, Wei; Xu, Kaitian

    2015-07-01

    Nerve repair scaffolds from novel alternating block polyurethanes (PUCL-alt-PEG) based on PCL and PEG without additional growth factors or proteins were prepared by a particle leaching method. The scaffolds have pore size 10-20 µm and porosity 92%. Mechanical tests showed that the polyurethane scaffolds have maximum loads of 5.97 ± 0.35 N and maximal stresses of 8.84 ± 0.5 MPa. Histocompatiblity of the nerve repair scaffolds was tested in a SD rat model for peripheral nerve defect treatment. Two types of treatments including PUCL-alt-PEG scaffolds and autografts were compared in rat model. After 32 weeks, bridging of a 12 mm defect gap by the regenerated nerve was observed in all rats. The nerve regeneration was systematically characterized by sciatic function index (SFI), electrophysiology, histological assessment including HE staining, immunohistochemistry, ammonia sliver staining, Masson's trichrome staining and TEM observation. Results revealed that nerve repair scaffolds from PUCL-alt-PEG exhibit better regeneration effects compared to autografts. Electrophysiological recovery was seen in 90% and 87% of rats in PUCL-alt-PEG and autograft groups respectively. Biodegradation in vitro and in vivo shows good degradation match of PUCL-alt-PEG scaffolds with nerve regeneration. It demonstrates that plain nerve repair scaffolds from PUCL-alt-PEG biomaterials can achieve peripheral nerve regeneration satisfactorily. PMID:25410272

  9. Long-term survival and integration of porcine expanded neural precursor cell grafts in a rat model of Parkinson's disease.

    PubMed

    Harrower, T P; Tyers, P; Hooks, Y; Barker, R A

    2006-01-01

    Porcine fetal neural tissue has been considered as an alternative source to human allografts for transplantation in neurodegenerative disorders by virtue of the fact that it can overcome the ethical and practical difficulties using human fetal neural tissue. However, primary porcine neural xenografts are rejected while porcine expanded neural precursor neural cells (PNPCs) seem to be less immunogenic and thus survive better [Armstrong, R.J., Harrower, T.P., Hurelbrink, C.B., McLaughin, M., Ratcliffe, E.L., Tyers, P., Richards, A., Dunnett, S.B., Rosser, A.E., Barker, R.A., 2001a. Porcine neural xenografts in the immunocompetent rat: immune response following grafting of expanded neural precursor cells. Neuroscience 106, 201-216]. In this study, we extended these observations to investigate the long-term survival of such transplants in immunosuppressed rats. Unilateral 6 OHDA lesioned rats received grafts into the dopamine denervated striatum of either primary porcine fetal neural tissue dissected from the E26 cortex or cortically derived neural stem cells which had been derived from the same source but expanded in vitro for 21 days. All cortically derived neural stem cell grafts survived up to 5 months in contrast to the poor survival of primary porcine xenografts. Histological analysis demonstrated good graft integration with fibers extending into the surrounding host tissue including white matter with synapse formation, and in addition there was evidence of host vascularization and myelinated fibers within the graft area. This study has therefore shown for the first time the reliable long-term survival of grafts derived from porcine expanded neural precursors in a rat model of PD, with maturation and integration into the host brain. This demonstrates that such xenografted cells may be able to recreate the damaged circuitry in PD although strategies for dopaminergic differentiation of the porcine neural precursor cell remain to be refined. PMID:16246328

  10. Propagation of Neuronal Damage to Embryonic Grafts Transplanted in the Hippocampus of Murine Models of Alzheimer's Disease.

    PubMed

    Sadallah, Mohcene; Labat-Gest, Vivien; Tempia, Filippo

    2015-12-01

    Alzheimer's disease (AD) is the most common form of dementia, characterized by the presence of two principal hallmarks-amyloid plaques and neurofibrillary tangles. The primary cause of the majority of AD cases is not known. Likewise, the mechanisms underlying the propagation of the pathology from affected tissue to neighboring healthy neurons are largely unknown, but knowledge about them could be helpful to design strategies aimed at halting the progression of the disease. To throw light on the mechanisms of propagation of neuronal damage to healthy tissue, wild-type (WT) hippocampal solid tissue chunks derived from green fluorescent protein (GFP)-positive embryos were grafted into the hippocampus of 6-month-old WT and 3xTg-AD mice, a triple-transgenic mouse model that exhibits both amyloid-beta (Aβ) and tau protein pathology. The histological and morphological alterations of the grafted tissues were assessed 3 months post-transplantation. Tissues grafted in 3xTg-AD hosts, compared to those grafted in WT recipients, presented a significant decrease in neurite outgrowth (35.4%) and dendritic spine density (41.3%), mainly due to a reduction of stubby and thin-shaped spines. Moreover, some cells of the tissue transplanted in 3xTg-AD hosts accumulated intracellular amyloid peptide deposits similar to the cells of the host. Furthermore, the immunohistochemical examination of reactive astrocytes and microglia revealed the presence of more inflammation in the grafted tissues hosted in 3xTg-AD compared to WT recipients. These results show a propagation of neuronal damage to initially healthy embryonic grafts, validating this methodology for future studies on the mechanisms of the progression of AD pathology to surrounding regions. PMID:26540615

  11. Lethal graft-versus-host disease in nude mice. I. Establishment of model systems

    SciTech Connect

    Kuribayashi, K.; Masuda, T.; Hanaoka, M.

    1988-08-01

    We examined whether nude mice, which are deficient in T cell function, could be used as a model for induction of lethal graft-versus-host disease. Nude mice injected with MHC-disparate spleen cells exhibited only transient GVH reaction such as splenomegaly. Inoculation of B6 spleen cells into BALB/c nude mice produced high titers of alloantibodies to the donor cells. These alloantibodies eliminated host-MHC-reactive donor T cells from the host. After abolition by 400 rads irradiation of the capacity of nude mice to produce antibody, lethal GVHD could be induced by allogeneic spleen cell transfer and was mediated by donor T cells. This lethal GVHD was prevented by prior administration of antidonor alloantibody to the irradiated recipients at least 24 hr before donor-cell grafting. The role of alloantibody was substantiated in 2 other combinations in which little or no alloantibodies to donor spleen cells were produced. Engraftment of either MHC-identical but non-MHC disparate donor spleen cells into BALB/c nude mice or of parental spleen cells into F1 nude mice resulted in death mediated by T cells. In addition, irradiated BALB/c nude mice inoculated with non-MHC-incompatible B10.D2 spleen cells were much more sensitive to alloaggression by the donor cells than were nonirradiated hosts, indicating the presence of some radiation-sensitive component(s) acting in nude mice against GVHD induction by donor T cells. Thus the nude mouse is considered to be a useful recipient for clarifying the basic mechanisms involved in lethal GVHD.

  12. Clinical and radiographic outcomes of the treatment of adolescent idiopathic scoliosis with segmental pedicle screws and combined local autograft and allograft bone for spinal fusion: a retrospective case series

    PubMed Central

    2010-01-01

    Background High morbidity has been reported with iliac crest bone graft harvesting; however, donor bone is typically necessary for posterior spinal fusion. Autograft bone combined with allograft may reduce the morbidity associated with iliac crest bone harvesting and improve the fusion rate. Our aim in this study was to determine the presence of complications, pseudarthrosis, non-union, and infection using combined in situ local autograft bone and freeze-dried cancellous allograft bone in patients undergoing posterior spinal fusion for the treatment of adolescent idiopathic scoliosis. Methods A combination of in situ local autograft bone and freeze-dried cancellous allograft blocks were used in 50 consecutive patients with adolescent idiopathic scoliosis treated by posterior fusion and Moss Miami pedicle screw instrumentation. Results were assessed clinically and radiographically and quality of life and functional outcome was evaluated by administration of a Chinese version of the SRS-22 survey. Results There were 41 female and 9 male patients included for analysis with an average age of 14.7 years (range, 12-17). All patients had a minimum follow-up of 18 months (range, 18 to 40 months). The average preoperative Cobb angle was 49.8° (range, 40° to 86°). The average number of levels fused was 9.8 (range, 6-15). Patients had a minimum postoperative follow-up of 18 months. At final follow-up, the average Cobb angle correction was 77.8% (range, 43.4 to 92.5%). There was no obvious loss in the correction, and the average loss of correction was 1.1° (range, 0° to 4°). There was no pseudarthrosis and no major complications. Conclusions In situ autograft bone combined with allograft bone may be a promising method enhances spinal fusion in AIS treated with pedicle screw placement. By eliminating the need for iliac crest bone harvesting, significant morbidity may be avoided. PMID:20630050

  13. In Vivo Evaluation of Electrospun Polycaprolactone Graft for Anterior Cruciate Ligament Engineering

    PubMed Central

    Arom, Gabriel A.; Nazemi, Azadeh N.; Yeranosian, Michael G.; Wu, Benjamin M.; McAllister, David R.

    2015-01-01

    The anterior cruciate ligament (ACL) is critical for the structural stability of the knee and its injury often requires surgical intervention. Because current reconstruction methods using autograft or allograft tissue suffer from donor-site morbidity and limited supply, there has been emerging interest in the use of bioengineered materials as a platform for ligament reconstruction. Here, we report the use of electrospun polycaprolactone (PCL) scaffolds as a candidate platform for ACL reconstruction in an in vivo rodent model. Electrospun PCL was fabricated and laser cut to facilitate induction of cells and collagen deposition and used to reconstruct the rat ACL. Histological analysis at 2, 6, and 12 weeks postimplantation revealed biological integration, minimal immune response, and the gradual infiltration of collagen in both the bone tunnel and intra-articular regions of the scaffold. Biomechanical testing demonstrated that the PCL graft failure load and stiffness at 12 weeks postimplantation (13.27±4.20N, 15.98±5.03 N/mm) increased compared to time zero testing (3.95±0.33N, 1.95±0.35 N/mm). Taken together, these results suggest that electrospun PCL serves as a biocompatible graft for ACL reconstruction with the capacity to facilitate collagen deposition. PMID:25412879

  14. Submillimeter Diameter Poly(Vinyl Alcohol) Vascular Graft Patency in Rabbit Model.

    PubMed

    Cutiongco, Marie F A; Kukumberg, Marek; Peneyra, Jonnathan L; Yeo, Matthew S; Yao, Jia Y; Rufaihah, Abdul Jalil; Le Visage, Catherine; Ho, Jackie Pei; Yim, Evelyn K F

    2016-01-01

    Microvascular surgery is becoming a prevalent surgical practice. Replantation, hand reconstruction, orthopedic, and free tissue transfer procedures all rely on microvascular surgery for the repair of venous and arterial defects at the millimeter and submillimeter levels. Often, a vascular graft is required for the procedure as a means to bridge the gap between native arteries. While autologous vessels are desired for their bioactivity and non-thrombogenicity, the tedious harvest process, lack of availability, and caliber or mechanical mismatch contribute to graft failure. Thus, there is a need for an off-the-shelf artificial vascular graft that has low thrombogenic properties and mechanical properties matching those of submillimeter vessels. Poly(vinyl alcohol) hydrogel (PVA) has excellent prospects as a vascular graft due to its bioinertness, low thrombogenicity, high water content, and tunable mechanical properties. Here, we fabricated PVA grafts with submillimeter diameter and mechanical properties that closely approximated those of the rabbit femoral artery. In vitro platelet adhesion and microparticle release assay verified the low thrombogenicity of PVA. A stringent proof-of-concept in vivo test was performed by implanting PVA grafts in rabbit femoral artery with multilevel arterial occlusion. Laser Doppler measurements indicated the improved perfusion of the distal limb after implantation with PVA grafts. Moreover, ultrasound Doppler and angiography verified that the submillimeter diameter PVA vascular grafts remained patent for 2 weeks without the aid of anticoagulant or antithrombotics. Endothelial cells were observed in the luminal surface of one patent PVA graft. The advantageous non-thrombogenic and tunable mechanical properties of PVA that are retained even in the submillimeter diameter dimensions support the application of this biomaterial for vascular replacement in microvascular surgery. PMID:27376059

  15. Submillimeter Diameter Poly(Vinyl Alcohol) Vascular Graft Patency in Rabbit Model

    PubMed Central

    Cutiongco, Marie F. A.; Kukumberg, Marek; Peneyra, Jonnathan L.; Yeo, Matthew S.; Yao, Jia Y.; Rufaihah, Abdul Jalil; Le Visage, Catherine; Ho, Jackie Pei; Yim, Evelyn K. F.

    2016-01-01

    Microvascular surgery is becoming a prevalent surgical practice. Replantation, hand reconstruction, orthopedic, and free tissue transfer procedures all rely on microvascular surgery for the repair of venous and arterial defects at the millimeter and submillimeter levels. Often, a vascular graft is required for the procedure as a means to bridge the gap between native arteries. While autologous vessels are desired for their bioactivity and non-thrombogenicity, the tedious harvest process, lack of availability, and caliber or mechanical mismatch contribute to graft failure. Thus, there is a need for an off-the-shelf artificial vascular graft that has low thrombogenic properties and mechanical properties matching those of submillimeter vessels. Poly(vinyl alcohol) hydrogel (PVA) has excellent prospects as a vascular graft due to its bioinertness, low thrombogenicity, high water content, and tunable mechanical properties. Here, we fabricated PVA grafts with submillimeter diameter and mechanical properties that closely approximated those of the rabbit femoral artery. In vitro platelet adhesion and microparticle release assay verified the low thrombogenicity of PVA. A stringent proof-of-concept in vivo test was performed by implanting PVA grafts in rabbit femoral artery with multilevel arterial occlusion. Laser Doppler measurements indicated the improved perfusion of the distal limb after implantation with PVA grafts. Moreover, ultrasound Doppler and angiography verified that the submillimeter diameter PVA vascular grafts remained patent for 2 weeks without the aid of anticoagulant or antithrombotics. Endothelial cells were observed in the luminal surface of one patent PVA graft. The advantageous non-thrombogenic and tunable mechanical properties of PVA that are retained even in the submillimeter diameter dimensions support the application of this biomaterial for vascular replacement in microvascular surgery. PMID:27376059

  16. Augmentation of arthrodesis in dogs using a free autogenous omental graft.

    PubMed

    Ree, Jennifer J; Baltzer, Wendy I; Townsend, Katy L

    2016-08-01

    A technique for using free autogenous omental grafting with arthrodesis in dogs is described and radiographic osseous union and complications after surgery are evaluated. This retrospective study matched body weight and procedure type for 8 cases of pancarpal arthrodesis, 4 cases of pantarsal arthrodesis, and 2 cases of partial tarsal arthrodesis in dogs with omental and cancellous bone autograft (OBG group) and with cancellous bone autograft alone (BG group). Radiographs were reviewed 9 to 12 weeks after surgery to compare scores of radiographic osseous union and it was found that the OBG group had higher scores than the BG group. The BG group had significantly more major complications that required re-operation for implant removal or treatment of a deep infection compared to the OBG group. Overall, free autogenous omental grafts may be used to augment arthrodesis in dogs without significant morbidity and further investigation of its use to reduce major complications and speed bone healing are warranted. PMID:27493282

  17. Immunologic Autograft Engineering and Survival in Non-Hodgkin Lymphoma.

    PubMed

    Porrata, Luis F; Burgstaler, Edwin A; Winters, Jeffrey L; Jacob, Eapen K; Gastineau, Dennis A; Suman, Vera J; Inwards, David J; Ansell, Stephen M; Micallef, Ivana N; Johnston, Patrick B; Nevala, Wendy; Markovic, Svetomir N

    2016-06-01

    Retrospective studies have reported that the collected and infused autograft absolute lymphocyte count (A-ALC) affects clinical outcomes after autologous peripheral hematopoietic stem cell transplantation (APHSCT). We hypothesized that manipulation of the apheresis machine to target a higher A-ALC dose would translate into prolonged progression-free survival (PFS) in patients with non-Hodgkin lymphoma (NHL) undergoing APHSCT. Between December 2007 and October 2010, we performed a double-blind, phase III, randomized study randomly assigning 122 patients with NHL to undergo collection with the Fenwal Amicus Apheresis system with our standard settings (mononuclear cells offset of 1.5 and RBC offset of 5.0) or at modified settings (mononuclear cells offset of 1.5 and RBC of 6.0). The primary endpoint was PFS. Neither PFS (hazard ratio [HR] of modified to standard, 1.13; 95% confidence interval [CI], .62 to 2.08; P = .70) nor overall survival (OS) (HR modified to standard, .85; 95% CI, .39 to 1.86; P = .68) were found to differ by collection method. Collection of A-ALC between both methods was similar. Both PFS (P = .0025; HR, 2.77; 95% CI, 1.39 to 5.52) and OS (P = .004; HR, 3.38; 95% CI, 1.27 to 9.01) were inferior in patients infused with an A-ALC < .5 × 10(9) lymphocytes/kg compared with patients infused with an A-ALC ≥ .5 × 10(9) lymphocytes/kg, regardless of the method of collection. We did not detect significant differences in clinical outcomes or in the A-ALC collection between the modified and the standard Fenwal Amicus settings; however, despite physician discretion on primary number of collections and range of cells infused, higher A-ALC infused dose were associated with better survival after APHSCT. PMID:26826432

  18. Miniature Swine as a Clinically Relevant Model of Graft-Versus-Host Disease

    PubMed Central

    Duran-Struuck, Raimon; Huang, Christene A; Orf, Katherine; Bronson, Roderick T; Sachs, David H; Spitzer, Thomas R

    2015-01-01

    Miniature swine provide a preclinical model of hematopoietic cell transplantation (HCT) for studies of graft-versus-host disease. HCT between MHC-matched or ‑mismatched pigs can be performed to mimic clinical scenarios with outcomes that closely resemble those observed in human HCT recipients. With myeloablative conditioning, HCT across MHC barriers is typically fatal, with pigs developing severe (grade III or IV) GVHD involving the gastrointestinal tract, liver, and skin. Unlike rodent models, miniature swine provide an opportunity to perform extended longitudinal studies on individual animals, because multiple tissue biopsies can be harvested without the need for euthanasia. In addition, we have developed a swine GVHD scoring system that parallels that used in the human clinical setting. Given the similarities of GVHD in pigs and humans, we hope that the use of this scoring system facilitates clinical and scientific discourse between the laboratory and the clinic. We anticipate that results of swine studies will support the development of new strategies to improve the identification and treatment of GVHD in clinical HCT scenarios. PMID:26473348

  19. Changes in the expression of epidermal differentiation markers at sites where cultured epithelial autografts were transplanted onto wounds from burn scar excision.

    PubMed

    Kadoya, Kuniko; Amano, Satoshi; Nishiyama, Toshio; Inomata, Shinji; Tsunenaga, Makoto; Kumagai, Norio; Matsuzaki, Kyoichi

    2016-06-01

    This study investigated the recovery process during which grafted cultured epithelium formed normal epidermis. The subjects were 18 patients whose burn scars were excised at a depth not exposing the fat layer and who subsequently received cultured epithelial autografts. A total of 24 samples were obtained from the grafted sites: 6 samples within 6 weeks (stage 1), 5 samples after 6 weeks and within 6 months (stage 2), 6 samples after 6 months and within 18 months (stage 3) and 7 samples beyond 18 months (stage 4) after transplantation. These samples were stained for monoclonal antibodies against filaggrin, transglutaminase (TG), cytokeratin 6 and involucrin. Their expressions were examined in the epidermis. The expression patterns were classified using a six-grade scale. The grades of filaggrin and TG were significantly higher at stage 3 and 4 compared with stage 1. There was a marginally significant increase in the grade of cytokeratin 6 at stage 3 and it was significantly higher at stage 4 compared with stage 1. These results showed that wound healing continued at a molecular level until the end of stage 3. The recovery of involucrin was delayed compared with that of other markers. TG and involucrin are thought to be regulated independently at the grafted sites. PMID:25040836

  20. Future Economics of Liver Transplantation: A 20-Year Cost Modeling Forecast and the Prospect of Bioengineering Autologous Liver Grafts.

    PubMed

    Habka, Dany; Mann, David; Landes, Ronald; Soto-Gutierrez, Alejandro

    2015-01-01

    During the past 20 years liver transplantation has become the definitive treatment for most severe types of liver failure and hepatocellular carcinoma, in both children and adults. In the U.S., roughly 16,000 individuals are on the liver transplant waiting list. Only 38% of them will receive a transplant due to the organ shortage. This paper explores another option: bioengineering an autologous liver graft. We developed a 20-year model projecting future demand for liver transplants, along with costs based on current technology. We compared these cost projections against projected costs to bioengineer autologous liver grafts. The model was divided into: 1) the epidemiology model forecasting the number of wait-listed patients, operated patients and postoperative patients; and 2) the treatment model forecasting costs (pre-transplant-related costs; transplant (admission)-related costs; and 10-year post-transplant-related costs) during the simulation period. The patient population was categorized using the Model for End-Stage Liver Disease score. The number of patients on the waiting list was projected to increase 23% over 20 years while the weighted average treatment costs in the pre-liver transplantation phase were forecast to increase 83% in Year 20. Projected demand for livers will increase 10% in 10 years and 23% in 20 years. Total costs of liver transplantation are forecast to increase 33% in 10 years and 81% in 20 years. By comparison, the projected cost to bioengineer autologous liver grafts is $9.7M based on current catalog prices for iPS-derived liver cells. The model projects a persistent increase in need and cost of donor livers over the next 20 years that's constrained by a limited supply of donor livers. The number of patients who die while on the waiting list will reflect this ever-growing disparity. Currently, bioengineering autologous liver grafts is cost prohibitive. However, costs will decline rapidly with the introduction of new manufacturing

  1. Enhancement of Polyethylene Terephthalate Artificial Ligament Graft Osseointegration using a Periosteum Patch in a Goat Model.

    PubMed

    Dai, Z; Bao, W; Li, S; Li, H; Jiang, J; Chen, S

    2016-06-01

    The purpose of this study is to investigate whether a periosteum patch could enhance polyethylene terephthalate (PET) artificial ligament graft osseointegration in a bone tunnel. 12 female goats underwent ACL reconstruction with a PET artificial ligament graft in the right knees. Right knees in 6 goats were reconstructed with periosteum patch-enveloped PET grafts (Periosteum group) in the tibia bone tunnel, whereas the other 6 goats had no periosteum patch and served as the Control group. All the goats were sacrificed at 12 months after surgery. 3 tibial-graft complex samples in each group were harvested consecutively for microcomputed tomography (micro-CT) scan, magnetic resonance imaging (MRI) scan and histological evaluation. The other 3 tibial-graft complex samples in each group were harvested for biomechanical testing. The mean pull-out load of the Periosteum group (208±25 N) at 12 months was significantly higher than that of the Control group (107±13 N) (p=0.0044). According to the micro-CT scan, more new bone formation was observed at the graft-bone interface in the Periosteum group compared with the Control group. Furthermore, MRI showed that the Periosteum group appeared to have a better graft osseointegration within the bone tunnel compared with the Control group. Histologically, application of a periosteum patch induced more new bone and Sharpey's fiber formation between the graft and bone tunnel compared with the controls. The study has shown that periosteum enveloping of the PET artificial ligament has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel. PMID:26990720

  2. A Rabbit Model of Fat Graft Recipient Site Preconditioning Using External Negative Pressure

    PubMed Central

    Lee, Jung Woo; Han, Yea Sik; Kim, Sin Rak; Kim, Han Kyeol; Kim, Hyun

    2015-01-01

    Background Fat is widely used in soft tissue augmentation. Nevertheless, it has an unpredictably high resorption rate. Clinically, external expansion with negative pressure is used to increase fat graft survival. In this study, fat graft recipient sites were preconditioned by external application of negative pressure in order to test for improvements in vascularity and fat graft survival. Methods Negative pressure was applied randomly to either the left or right dorsal ear of 20 New Zealand male white rabbits at a pressure of -125 mm Hg. The negative pressure was removed one week after the skin perfusion was measured. The skin flap at each ear was elevated, and 1 g of fat was grafted above the dorsal perichondrium. After one week, the fat weight, microvessel density, mature vessel density of the skin and fat, and amount of glycerol released were measured. Three months after the grafting, the same measurements were performed, with the exception of glycerol release. Results The fat survival rate of the experimental group (75.4%±3.9%) was higher than that of the control group (53.1%±4.3%) (P<0.001). Skin perfusion was higher in the experimental group. The glycerol release in the experimental group was significantly higher than in the control. The microvessel density of the skin and fat was significantly higher in the experimental group. Three months after the grafting, the skin and fat mature vessel density was significantly higher in the experimental groups. Conclusions Negative pressure prior to fat grafting increased the vascularity of the recipient site, and, accordingly, enhanced fat graft survival. PMID:25798385

  3. Anterior cruciate ligament reconstruction graft harvesting: pitfalls and tips.

    PubMed

    McGuire, David A; Hendricks, Stephen D

    2007-12-01

    Surgical treatment for anterior cruciate ligament deficiency has relied predominantly on reconstruction with autografts. Grafts taken from patients' own central third of their patellar tendon, bone-patellar tendon bone, or one or more of the hamstring tendons, semitendinosus, and gracilis, constitute the majority of grafts used for these purposes. Although there is no single graft option that clearly outperforms another, an abundance of articles replete with complications associated with harvest and use are available from peer-reviewed journals. It is these complications and their prevention that will be addressed in the following chapter. The idea in mind is that the reader might adopt these techniques to improve their patient outcomes by minimizing, or eliminating, the ongoing problems that such complications produce. PMID:18004217

  4. Results of reconstruction of acute ruptures of the anterior cruciate ligament with an iliotibial band autograft.

    PubMed

    Bak, K; Jørgensen, U; Ekstrand, J; Scavenius, M

    1999-01-01

    Forty patients with an acute complete tear of the anterior cruciate ligament (ACL) underwent primary reconstruction with an iliotibial band autograft after median 15 (range 0-90) days. Objective and functional evaluation was performed after median 37 (range 24-87) months by two independent observers using the International Knee Documentation Committee (IKDC) knee evaluation form, the Lysholm knee function score, and the Tegner activity score. During the observation period 5 patients sustained an ACL tear in the contralateral knee, and 1 patient (2.5%) sustained a graft rupture and underwent re-reconstruction. For the remaining 34 knees the Lysholm score at follow-up was median 100 (range 84-100, mean 97 [+/- 4]), all patients scoring excellent (n = 28) or good (n = 6). Three patients (9%) had more than 3 mm side-to-side difference in anteroposterior laxity. All 4 ligament failures occurred in patients operated on within the first 2 weeks after the injury. Twenty-six patients (76%) returned to the same level of activity as prior to the injury. Of 8 who dropped to a lower activity level, only one ascribed this to problems with the operated knee, meaning that 26 of 27 (96%) returned to their desired level of activity. According to the overall IKDC evaluation, 14 patients (40%) had a normal knee (A), 13 (37%) had a nearly normal knee (B), 5 (14%) had an abnormal knee (C), and 2 (9%) had a severely abnormal knee (D). Ten patients (25%) had the staples removed due to local irritation, and further 6 (15%) had local symptoms from the tibial staples. The harvest site gave 8 (20%) patients cosmetic complaints, but all graded this as slight, and 3 (8%) had slight pain during activity from the lateral muscular hernia. In selected individuals performing vigorous knee activities, autologous reconstruction of acute ACL disrupted knees with a combined internal and external iliotibial band transfer demonstrates excellent results after median 3 years. The failure rate is comparable

  5. Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears

    PubMed Central

    Jia, Yu-Hua; Sun, Peng-Fei

    2015-01-01

    Background: Hamstring (HS) autograft and bone-patellar tendon-bone allograft are the most common choice for reconstruction of anterior cruciate ligament (ACL). There was a little report about the clinical outcome and difference of arthroscopic ACL reconstruction using allograft and autograft. This study aimed to compare the clinical outcome of autograft and allograft reconstruction for ACL tears. Methods: A total of 106 patients who underwent surgery because of ACL tear were included in this study. The patients were randomly divided into two groups, including 53 patients in each group. The patients in group I underwent standard ACL reconstruction with HS tendon autografts, while others in group II underwent reconstruction with bone-patellar tendon-bone allograft. All the patients were followed up and analyzed; the mean follow-up was 81 months (range: 28–86 months). Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm scores, physical instability tests, and patient satisfaction questionnaires. The complication rates of both groups were compared. Tibial and femoral tunnel widening were assessed using lateral and anteroposterior radiographs. Results: At the end of follow-up, no significant differences were found between the groups in terms of IKDC, Lysholm scores, physical instability tests, patient satisfaction questionnaires, and incidences of arthrofibrosis. Tibial and femoral tunnel widening was less in the HS tendon autografts. This difference was more significant on the tibial side. Conclusions: In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly. PMID:26612290

  6. Autologous apoptotic cells preceding transplantation enhance survival in lethal murine graft-versus-host models

    PubMed Central

    Florek, Mareike; Sega, Emanuela I.; Leveson-Gower, Dennis B.; Baker, Jeanette; Müller, Antonia M. S.; Schneidawind, Dominik; Meyer, Everett

    2014-01-01

    Acute graft-versus-host disease (GVHD) is induced by alloreactivity of donor T cells toward host antigens presented on antigen-presenting cells (APCs). Apoptotic cells are capable of inducing tolerance by altering APC maturation. Apoptosis can be induced by extracorporeal photopheresis (ECP). We demonstrate that the use of ECP as a prophylaxis prior to conditioning significantly improves survival (P < .0001) after bone marrow transplantation (BMT) by inhibiting the initiation phase of acute GVHD in a murine BMT model. ECP-treated autologous splenocytes resulted in immune tolerance in the host, including reduced dendritic cell activation with decreased nuclear factor-κB engagement, increased regulatory T-cell (Treg) numbers with enhanced expression of cytolytic T lymphocyte-associated antigen 4, potentiating their suppressive function. The protective effect required host production of interleukin-10 and host Tregs. Conventional T cells that entered this tolerant environment experienced reduced proliferation, as well as a reduction of tissue homing and expression of activation markers. The induction of this tolerant state by ECP was obviated by cotreatment with lipopolysaccharide, suggesting that the inflammatory state of the recipient prior to treatment would play a role in potential clinical translation. The use of prophylactic ECP may provide an alternative and safe method for immunosuppression in the bone marrow transplant setting. PMID:25030062

  7. Autologous apoptotic cells preceding transplantation enhance survival in lethal murine graft-versus-host models.

    PubMed

    Florek, Mareike; Sega, Emanuela I; Leveson-Gower, Dennis B; Baker, Jeanette; Müller, Antonia M S; Schneidawind, Dominik; Meyer, Everett; Negrin, Robert S

    2014-09-11

    Acute graft-versus-host disease (GVHD) is induced by alloreactivity of donor T cells toward host antigens presented on antigen-presenting cells (APCs). Apoptotic cells are capable of inducing tolerance by altering APC maturation. Apoptosis can be induced by extracorporeal photopheresis (ECP). We demonstrate that the use of ECP as a prophylaxis prior to conditioning significantly improves survival (P < .0001) after bone marrow transplantation (BMT) by inhibiting the initiation phase of acute GVHD in a murine BMT model. ECP-treated autologous splenocytes resulted in immune tolerance in the host, including reduced dendritic cell activation with decreased nuclear factor-κB engagement, increased regulatory T-cell (Treg) numbers with enhanced expression of cytolytic T lymphocyte-associated antigen 4, potentiating their suppressive function. The protective effect required host production of interleukin-10 and host Tregs. Conventional T cells that entered this tolerant environment experienced reduced proliferation, as well as a reduction of tissue homing and expression of activation markers. The induction of this tolerant state by ECP was obviated by cotreatment with lipopolysaccharide, suggesting that the inflammatory state of the recipient prior to treatment would play a role in potential clinical translation. The use of prophylactic ECP may provide an alternative and safe method for immunosuppression in the bone marrow transplant setting. PMID:25030062

  8. Use of grafting to prevent Hypsipyla grandella (Zeller) (Lepidoptera: Pyralidae) damage to new world Meliaceae species.

    PubMed

    Perez, Julian; Eigenbrode, Sanford D; Hilje, Luko; Tripepi, Robert R; Aguilar, Maria E; Mesen, Francisco

    2010-01-01

    The susceptible species Cedrela odorata and Swietenia macrophylla to attack by Hypsipyla grandella (Zeller) larvae were grafted onto the resistant species Khaya senegalensis and Toona ciliata. Six-month-old grafted plants were then compared to their reciprocal grafts and to both intact (non-grafted) and autografted plants for damage due to H. grandella larvae and for their effects on larval performance. Two experiments were conducted: one in which the apical bud of the main plant shoot was inoculated with H. grandella eggs, and the other in which the bud was inoculated with third instars. Damage in each experiment was assessed by the number of frass piles, number and length of tunnels, number of damaged leaves, and damage to the apical bud. Larval performance was evaluated in terms of time to reach pupation and pupal weight and length. In both experiments, plant damage differed significantly among treatments (P < 0.03). Resistant rootstocks conferred resistance to susceptible scions. In both experiments, grafting by itself, regardless of the rootstock and scion combination, also reduced damage caused by H. grandella larvae. Scions of autografted susceptible species had similar resistance to susceptible scions grafted on resistant rootstocks. Few larvae reached pupation, and their pupal weight and length were similar. PMID:20878001

  9. Matched Comparison of Fusion Rates between Hydroxyapatite Demineralized Bone Matrix and Autograft in Lumbar Interbody Fusion

    PubMed Central

    Kim, Dae Hwan; Lee, Nam; Shin, Dong Ah; Yi, Seong; Kim, Keung Nyun

    2016-01-01

    Objective To compare the fusion rate of a hydroxyapatite demineralized bone matrix (DBM) with post-laminectomy acquired autograft in lumbar interbody fusion surgery and to evaluate the correlation between fusion rate and clinical outcome. Methods From January 2013 to April 2014, 98 patients underwent lumbar interbody fusion surgery with hydroxyapatite DBM (HA-DBM group) in our institute. Of those patients, 65 received complete CT scans for 12 months postoperatively in order to evaluate fusion status. For comparison with autograft, we selected another 65 patients who underwent lumbar interbody fusion surgery with post-laminectomy acquired autograft (Autograft group) during the same period. Both fusion material groups were matched in terms of age, sex, body mass index (BMI), and bone mineral density (BMD). To evaluate the clinical outcomes, we analyzed the results of visual analogue scale (VAS), Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Results We reviewed the CT scans of 149 fusion levels in 130 patients (HA-DBM group, 75 levels/65 patients; Autograft group, 74 levels/65 patients). Age, sex, BMI, and BMD were not significantly different between the groups (p=0.528, p=0.848, p=0.527, and p=0.610, respectively). The HA-DBM group showed 39 of 75 fused levels (52%), and the Autograft group showed 46 of 74 fused levels (62.2%). This difference was not statistically significant (p=0.21). In the HA-DBM group, older age and low BMD were significantly associated with non-fusion (61.24 vs. 66.68, p=0.027; -1.63 vs. -2.29, p=0.015, respectively). VAS and ODI showed significant improvement after surgery when fusion was successfully achieved in both groups (p=0.004, p=0.002, HA-DBM group; p=0.012, p=0.03, Autograft group). Conclusion The fusion rates of the hydroxyapatite DBM and Autograft groups were not significantly different. In addition, clinical outcomes were similar between the groups. However, older age and low BMD are risk factors that might

  10. Cyclooxygenase-2 inhibition does not impair block bone grafts healing in rabbit model.

    PubMed

    Moreschi, Eduardo; Biguetti, Claudia Cristina; Comparim, Eliston; De Andrade Holgado, Leandro; Ribeiro-Junior, Paulo Domingos; Nary-Filho, Hugo; Matsumoto, Mariza Akemi

    2013-12-01

    Success of alveolar reconstructions using onlay autogenous block bone grafts depends on their adequate integration to the recipient bed influenced by a number of local molecules. Considering the fundamental role of cyclooxygenase (COX-2) in bone repair, the aim of this study was to analyze the effect of its inhibition in the integration of endochondral (EC) iliac crest, and intramembranous (IM) calvaria bone grafts. Thirty-two rabbits were divided into 4 groups: Calvaria Control (CC) and Iliac Control--treated with oral 0.9 % saline solution, and Calvarial-NSAID (C-NSAID) and Iliac-NSAID (I-NSAID) groups--treated with oral 6 mg/Kg non-steroidal anti-inflammatory drug etoricoxib. After 7, 14, 30 and 60 days the animals were euthanized and the specimens removed for histological, histomorphometric and immunohistochemistry analysis. At day 60, a tight integration of IM blocks could be seen with the presence of remodeling bone, whereas integration of EC grafts was mainly observed at the edges of the grafts. A significant higher percentage of bone matrix in the interface region of the CC grafts in comparison to C-NSAID only at day 14, whereas no differences were detected comparing the EC grafts. No differences were observed in Runx-2 and vascular endothelial growth factor (VEGF) immunolabeling when comparing CC and C-NSAID groups, while a significant weaker Runx-2 and VEGF labeling was detected in I-NSAID group at day 60. Although some influence was detected in osteogenesis, it is concluded that drug induced inhibition of COX-2 does not impair onlay bone grafts' healing of both embryologic origins in rabbits. PMID:23783533

  11. Controlling Bone Graft Substitute Microstructure to Improve Bone Augmentation.

    PubMed

    Sheikh, Zeeshan; Drager, Justin; Zhang, Yu Ling; Abdallah, Mohamed-Nur; Tamimi, Faleh; Barralet, Jake

    2016-07-01

    Vertical bone augmentation procedures are frequently carried out to allow successful placement of dental implants in otherwise atrophic ridges and represent one of the most common bone grafting procedures currently performed. Onlay autografting is one of the most prevalent and predictable techniques to achieve this; however, there are several well documented complications and drawbacks associated with it and synthetic alternatives are being sought. Monetite is a bioresorbable dicalcium phosphate with osteoconductive and osteoinductive potential that has been previously investigated for onlay bone grafting and it is routinely made by autoclaving brushite to simultaneously sterilize and phase convert. In this study, monetite disc-shaped grafts are produced by both wet and dry heating methods which alter their physical properties such as porosity, surface area, and mechanical strength. Histological observations after 12 weeks of onlay grafting on rabbit calvaria reveal higher bone volume (38%) in autoclaved monetite grafts in comparison with the dry heated monetite grafts (26%). The vertical bone height gained is similar for both the types of monetite grafts (up to 3.2 mm). However, it is observed that the augmented bone height is greater in the lateral than the medial areas of both types of monetite grafts. It is also noted that the higher porosity of autoclaved monetite grafts increases the bioresorbability, whereas the dry heated monetite grafts having lower porosity but higher surface area resorb to a significantly lesser extent. This study provides information regarding two types of monetite onlay grafts prepared with different physical properties that can be further investigated for clinical vertical bone augmentation applications. PMID:27214877

  12. How much hamstring graft needs to be in the femoral tunnel? A MOON cohort study

    PubMed Central

    Mariscalco, Michael W.; Magnussen, Robert A.; Mitchell, Joshua; Pedroza, Angela D.; Jones, Morgan H.; Andrish, Jack T.; Parker, Richard D.; Kaeding, Christopher C.; Flanigan, David C.

    2014-01-01

    Background Recent evidence that smaller hamstring graft diameter is associated with increased failure risk following anterior cruciate ligament (ACL) reconstruction has increased the popularity of graft configurations that increase graft diameter at the expense of graft length. A key question is how much graft needs to be in contact with the femoral tunnel to ensure that healing occurs. We hypothesize that no difference in two-year patient-reported outcomes or failure risk exists based on the amount of graft in the femoral tunnel. Methods Through the use of prospectively collected cohort data augmented with retrospective chart review, 120 of 181 consecutive patients (66.3 %) undergoing primary ACL reconstruction with hamstring autograft were evaluated. Patient and surgical factors along with pre-operative and two-year postoperative knee injury and osteoarthritis outcome score (KOOS) and International Knee Documentation Committee (IKDC) scores and whether each patient underwent revision ACL reconstruction during the two-year follow-up period were recorded. Results No differences in two-year patient-reported outcome scores were noted between patients with graft length in the femoral tunnel less than 25 mm and those with graft length in the femoral tunnel of at least 25 mm. Controlling for age, sex, BMI, and femoral tunnel technique, no correlation was noted between KOOS or IKDC scores and either the length of graft in the femoral tunnel or the contact area between the graft and the tunnel. Conclusions Variation of the length of hamstring autograft in the femoral tunnel between 14 and 35 mm does not predict KOOS or IKDC scores at 2 years postoperative. PMID:25984246

  13. Grafting with rootstocks induces extensive transcriptional re-programming in the shoot apical meristem of grapevine

    PubMed Central

    2013-01-01

    Background Grafting is widely used in the agriculture of fruit-bearing crops; rootstocks are known to confer differences in scion biomass in addition to improving other traits of agricultural interest. However, little is known about the effect of rootstocks on scion gene expression. The objective of this study was to determine whether hetero-grafting the grapevine variety Vitis vinifera cv. 'Cabernet Sauvignon N’ with two different rootstocks alters gene expression in the shoot apex in comparison to the auto-grafted control. Cabernet Sauvignon was hetero-grafted with two commercial rootstock genotypes and auto-grafted with itself. Vigor was quantified by measurements of root, stem, leaf and trunk biomass. Gene expression profiling was done using a whole genome grapevine microarray; four pools of five shoot apex samples were harvested 4 months after grafting for each scion/rootstock combination. Results The rootstocks increased stem biomass or conferred increased vigor by the end of the first growth cycle. Globally hetero-grafting two different genotypes together triggered an increase in shoot apex gene expression; however no genes were differentially expressed between the two hetero-grafts. The functional categories related to DNA, chromatin structure, histones, flavonoids and leucine rich repeat containing receptor kinases were the most enriched in the up-regulated genes in the shoot apex of hetero-grafted plants. Conclusions The choice of rootstock genotype had little effect on the gene expression in the shoot apex; this could suggest that auto- and hetero-grafting was the major factor regulating gene expression. PMID:24083813

  14. Evaluation of Polycaprolactone Scaffold with Basic Fibroblast Growth Factor and Fibroblasts in an Athymic Rat Model for Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Kabir, Nima; Arshi, Armin; Nazemi, Azadeh; Wu, Ben; Petrigliano, Frank A.; McAllister, David R.

    2015-01-01

    Anterior cruciate ligament (ACL) rupture is a common ligamentous injury often necessitating surgery. Current surgical treatment options include ligament reconstruction with autograft or allograft, which have their inherent limitations. Thus, there is interest in a tissue-engineered substitute for use in ACL regeneration. However, there have been relatively few in vivo studies to date. In this study, an athymic rat model of ACL reconstruction was used to evaluate electrospun polycaprolactone (PCL) grafts, with and without the addition of basic fibroblast growth factor (bFGF) and human foreskin fibroblasts. We examined the regenerative potential of tissue-engineered ACL grafts using histology, immunohistochemistry, and mechanical testing up to 16 weeks postoperatively. Histology showed infiltration of the grafts with cells, and immunohistochemistry demonstrated aligned collagen deposition with minimal inflammatory reaction. Mechanical testing of the grafts demonstrated significantly higher mechanical properties than immediately postimplantation. Acellular grafts loaded with bFGF achieved 58.8% of the stiffness and 40.7% of the peak load of healthy native ACL. Grafts without bFGF achieved 31.3% of the stiffness and 28.2% of the peak load of healthy native ACL. In this in vivo rodent model study for ACL reconstruction, the histological and mechanical evaluation demonstrated excellent healing and regenerative potential of our electrospun PCL ligament graft. PMID:25744933

  15. Evaluation of polycaprolactone scaffold with basic fibroblast growth factor and fibroblasts in an athymic rat model for anterior cruciate ligament reconstruction.

    PubMed

    Leong, Natalie Luanne; Kabir, Nima; Arshi, Armin; Nazemi, Azadeh; Wu, Ben; Petrigliano, Frank A; McAllister, David R

    2015-06-01

    Anterior cruciate ligament (ACL) rupture is a common ligamentous injury often necessitating surgery. Current surgical treatment options include ligament reconstruction with autograft or allograft, which have their inherent limitations. Thus, there is interest in a tissue-engineered substitute for use in ACL regeneration. However, there have been relatively few in vivo studies to date. In this study, an athymic rat model of ACL reconstruction was used to evaluate electrospun polycaprolactone (PCL) grafts, with and without the addition of basic fibroblast growth factor (bFGF) and human foreskin fibroblasts. We examined the regenerative potential of tissue-engineered ACL grafts using histology, immunohistochemistry, and mechanical testing up to 16 weeks postoperatively. Histology showed infiltration of the grafts with cells, and immunohistochemistry demonstrated aligned collagen deposition with minimal inflammatory reaction. Mechanical testing of the grafts demonstrated significantly higher mechanical properties than immediately postimplantation. Acellular grafts loaded with bFGF achieved 58.8% of the stiffness and 40.7% of the peak load of healthy native ACL. Grafts without bFGF achieved 31.3% of the stiffness and 28.2% of the peak load of healthy native ACL. In this in vivo rodent model study for ACL reconstruction, the histological and mechanical evaluation demonstrated excellent healing and regenerative potential of our electrospun PCL ligament graft. PMID:25744933

  16. Comparison of the Application of Allogeneic Fibroblast and Autologous Mesh Grafting With the Conventional Method in the Treatment of Third-Degree Burns.

    PubMed

    Moravvej, Hamideh; Hormozi, Abdoljalil Kalantar; Hosseini, Seyed Nejat; Sorouri, Rahim; Mozafari, Naser; Ghazisaidi, Mohammad Reza; Rad, Mahnaz Mahmoudi; Moghimi, Mohammad Hossein; Sadeghi, Shahin Mohammad; Mirzadeh, Hamid

    2016-01-01

    Wound healing is a multipart process involving different cell types and growth factors. Third-degree burns are usually treated by early excision and skin grafting. Tissue engineering has been developed in this field in response to limitations associated with autografts. Allogeneic fibroblasts on meshed split thickness skin grafts (STSGs) are known to have useful properties in wound healing and can be used to construct a new model of living skin substitute. Fourteen patients were chosen from June 2009 until December 2010 as the sample for this study. After debridement and wound excision, meshed STSG was used to cover the entire wound. Alloskin (allofibroblasts cultured on a combination of silicone and glycosaminoglycan) was applied on one side and petroleum jelly-impregnated gauze (Iran Polymer and Petrochemical Institute) was applied on the other. The healing time, scar formation, and pigmentation score were assessed for the patients. All analyses were undertaken with SPSS 17 software. Alloskin demonstrated good properties compared to petroleum jelly-impregnated gauze. The average healing time and hypertrophic scar formation were significantly different between the two groups. In addition, the skin pigmentation score in the alloskin group was closer to normal. Alloskin grafting, including fibroblasts on meshed STSG, may be a useful method to reduce healing time and scar size and may require less autologous STSG in extensive burns where a high percentage of skin is burned and there is a lack of available donor sites. PMID:22683986

  17. Model for Estimating the Threshold Mechanical Stability of Structural Cartilage Grafts Used in Rhinoplasty

    PubMed Central

    Zemek, Allison; Garg, Rohit; Wong, Brian J. F.

    2014-01-01

    Objectives/Hypothesis Characterizing the mechanical properties of structural cartilage grafts used in rhinoplasty is valuable because softer engineered tissues are more time- and cost-efficient to manufacture. The aim of this study is to quantitatively identify the threshold mechanical stability (e.g., Young’s modulus) of columellar, L-strut, and alar cartilage replacement grafts. Study Design Descriptive, focus group survey. Methods Ten mechanical phantoms of identical size (5 × 20 × 2.3 mm) and varying stiffness (0.360 to 0.85 MPa in 0.05 MPa increments) were made from urethane. A focus group of experienced rhinoplasty surgeons (n = 25, 5 to 30 years in practice) were asked to arrange the phantoms in order of increasing stiffness. Then, they were asked to identify the minimum acceptable stiffness that would still result in favorable surgical outcomes for three clinical applications: columellar, L-strut, and lateral crural replacement grafts. Available surgeons were tested again after 1 week to evaluate intra-rater consistency. Results For each surgeon, the threshold stiffness for each clinical application differed from the threshold values derived by logistic regression by no more than 0.05 MPa (accuracy to within 10%). Specific thresholds were 0.56, 0.59, and 0.49 MPa for columellar, L-strut, and alar grafts, respectively. For comparison, human nasal septal cartilage is approximately 0.8 MPa. Conclusions There was little inter- and intra-rater variation of the identified threshold values for adequate graft stiffness. The identified threshold values will be useful for the design of tissue-engineered or semisynthetic cartilage grafts for use in structural nasal surgery. PMID:20513022

  18. Non-contact scanning diffuse correlation tomography system for three-dimensional blood flow imaging in a murine bone graft model.

    PubMed

    Han, Songfeng; Johansson, Johannes; Mireles, Miguel; Proctor, Ashley R; Hoffman, Michael D; Vella, Joseph B; Benoit, Danielle S W; Durduran, Turgut; Choe, Regine

    2015-07-01

    A non-contact galvanometer-based optical scanning system for diffuse correlation tomography was developed for monitoring bone graft healing in a murine femur model. A linear image reconstruction algorithm for diffuse correlation tomography was tested using finite-element method based simulated data and experimental data from a femur or a tube suspended in a homogeneous liquid phantom. Finally, the non-contact system was utilized to monitor in vivo blood flow changes prior to and one week after bone graft transplantation within murine femurs. Localized blood flow changes were observed in three mice, demonstrating a potential for quantification of longitudinal blood flow associated with bone graft healing. PMID:26203392

  19. Non-contact scanning diffuse correlation tomography system for three-dimensional blood flow imaging in a murine bone graft model

    PubMed Central

    Han, Songfeng; Johansson, Johannes; Mireles, Miguel; Proctor, Ashley R.; Hoffman, Michael D.; Vella, Joseph B.; Benoit, Danielle S. W.; Durduran, Turgut; Choe, Regine

    2015-01-01

    A non-contact galvanometer-based optical scanning system for diffuse correlation tomography was developed for monitoring bone graft healing in a murine femur model. A linear image reconstruction algorithm for diffuse correlation tomography was tested using finite-element method based simulated data and experimental data from a femur or a tube suspended in a homogeneous liquid phantom. Finally, the non-contact system was utilized to monitor in vivo blood flow changes prior to and one week after bone graft transplantation within murine femurs. Localized blood flow changes were observed in three mice, demonstrating a potential for quantification of longitudinal blood flow associated with bone graft healing. PMID:26203392

  20. Accelerated adhesion of grafted skin by laser-induced stress wave-based gene transfer of hepatocyte growth factor

    NASA Astrophysics Data System (ADS)

    Aizawa, Kazuya; Sato, Shunichi; Terakawa, Mitsuhiro; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Obara, Minoru

    2009-11-01

    Gene therapy using wound healing-associated growth factor gene has received much attention as a new strategy for improving the outcome of tissue transplantation. We delivered plasmid DNA coding for human hepatocyte growth factor (hHGF) to rat free skin grafts by the use of laser-induced stress waves (LISWs); autografting was performed with the grafts. Systematic analysis was conducted to evaluate the adhesion properties of the grafted tissue; angiogenesis, cell proliferation, and reepithelialization were assessed by immunohistochemistry, and reperfusion was measured by laser Doppler imaging as a function of time after grafting. Both the level of angiogenesis on day 3 after grafting and the increased ratio of blood flow on day 4 to that on day 3 were significantly higher than those in five control groups: grafting with hHGF gene injection alone, grafting with control plasmid vector injection alone, grafting with LISW application alone, grafting with LISW application after control plasmid vector injection, and normal grafting. Reepithelialization was almost completed on day 7 even at the center of the graft with LISW application after hHGF gene injection, while it was not for the grafts of the five control groups. These findings demonstrate the validity of our LISW-based HGF gene transfection to accelerate the adhesion of grafted skins.

  1. Osteochondral Autograft Transfer for Treatment of Metacarpophalangeal and Interphalangeal Cartilage Defects.

    PubMed

    Micev, Alan J; Gaspar, Michael P; Culp, Randall W

    2016-09-01

    There is no general consensus regarding the optimal surgical treatment for cartilage defects of the metacarpophalangeal and interphalangeal joints in active patients who wish to preserve motion and functionality. We describe our technique of arthroscopically harvested femoral osteochondral autograft for treatment of metacarpophalangeal and interphalangeal cartilage defects. PMID:27280753

  2. Neuro-peptide treatment with Cerebrolysin improves the survival of neural stem cell grafts in an APP transgenic model of Alzheimer disease.

    PubMed

    Rockenstein, Edward; Desplats, Paula; Ubhi, Kiren; Mante, Michael; Florio, Jazmin; Adame, Anthony; Winter, Stefan; Brandstaetter, Hemma; Meier, Dieter; Masliah, Eliezer

    2015-07-01

    Neural stem cells (NSCs) have been considered as potential therapy in Alzheimer's disease (AD) but their use is hampered by the poor survival of grafted cells. Supply of neurotrophic factors to the grafted cells has been proposed as a way to augment survival of the stem cells. In this context, we investigated the utility of Cerebrolysin (CBL), a peptidergic mixture with neurotrophic-like properties, as an adjunct to stem cell therapy in an APP transgenic (tg) model of AD. We grafted murine NSCs into the hippocampus of non-tg and APP tg that were treated systemically with CBL and analyzed after 1, 3, 6 and 9months post grafting. Compared to vehicle-treated non-tg mice, in the vehicle-treated APP tg mice there was considerable reduction in the survival of the grafted NSCs. Whereas, CBL treatment enhanced the survival of NSCs in both non-tg and APP tg with the majority of the surviving NSCs remaining as neuroblasts. The NSCs of the CBL treated mice displayed reduced numbers of caspase-3 and TUNEL positive cells and increased brain derived neurotrophic factor (BDNF) and furin immunoreactivity. These results suggest that CBL might protect grafted NSCs and as such be a potential adjuvant therapy when combined with grafting. PMID:26209890

  3. Bone Grafts

    MedlinePlus

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  4. Rib cartilage grafting in upper limb surgery: an overview

    PubMed Central

    Obert, Laurent; Loisel, François; Gindraux, Florelle; Tropet, Yves; Lepage, Daniel

    2015-01-01

    Introduction: Used routinely in maxillofacial reconstructive surgery, the chondrocostal graft is also used in hand surgery. The purpose of this overview was to analyze at long follow-up the radiological and histological evolution of this autograft, in the hand and wrist surgery. Materials and methods: Since 1992, 144 patients have benefitted from a chondrocostal autograft: 116 osteoarthritis of the thumb carpometacarpal joint, 18 radioscaphoid arthritis, six articular malunions of the distal radius, four kienbock, and four traumatic loss of cartilage of the PIP joint. Magnetic Resonance Imaging (MRI) was performed in 19 patients and histological study in 12 patients with a mean follow-up of 68 months (4–159). Results: Whatever the indication, the reconstruction by a chondrocostal or ostochondrocostal graft has allowed us to obtain satisfactory clinical results at long follow-up. The main question was the viability of the graft. The radiological study has shown the non-wear of the graft and a certain degree of ossification. The MRI confirmed a very small degree of osseous metaplasia but its viability. The biopsies showed a neo-vascularization of the cartilage. Conclusion: Despite the strong mechanical strain in the hand and wrist, the chondrocostal graft is a biological arthroplasty, trustworthy and secure at long time even if it can cause infrequent complications inherent to this type of surgery. Despite the inevitable histological modification, the cartilage remains alive and is of satisfactory quality at long term follow-up and fulfilling the requirements for interposition and reconstruction of an articular surface. PMID:27163069

  5. The effect of sterilization methods on the osteoconductivity of allograft bone in a critical-sized bilateral tibial defect model in rabbits.

    PubMed

    Russell, Nicholas; Oliver, Rema A; Walsh, William R

    2013-11-01

    Clinically, allogeneic bone graft is used extensively because it avoids the donor site morbidity associated with autograft. However, there are concerns over the optimal sterilization method to eliminate immunological risks whilst maintaining the biological efficacy of the graft. This study compared the effect of Supercritical fluid (SCF) treatment and gamma irradiation at 25 kGy on the osteoconductivity of allograft bone in a bilateral critical sized defect rabbit model. Osteoconductivity was evaluated at 2 and 4 weeks using X-ray, CT, histology (qualitative and quantitative) and immunohistochemistry (Alkaline Phosphatase and Cathepsin-K). Both grafts were well tolerated and osteoconductive. At 2 weeks, there was decreased bone volume and density in the gamma irradiated graft compared to the SCF treated graft, corresponding with a greater inflammatory response histologically and increased Cathepsin-K expression. Catabolic activity predominated at 4 weeks, with both grafts undergoing significant resorption and remodeling inside the defect. Alkaline Phosphatase expression was greater in the SCF group at both time points indicative of a more anabolic response. Allograft bone sterilized with either gamma irradiation or SCF treatment was osteoconductive and capable of healing a critical sized tibial defect in a rabbit. Gamma irradiated allografts elicited an acute inflammatory reaction when implanted which may increase the amount of graft resorption compared to the SCF treated bone. PMID:23891084

  6. Optimal Covering Material for Stent-Grafts Placed in the Portal Vein in a Canine Model

    SciTech Connect

    Ishii, Seigo; Sato, Morio Sonomura, Tetsuo; Yamada, Katsuyuki; Tanihata, Hirohiko; Ishikawa, Hime; Terada, Masaki; Sahara, Shinya; Kawai, Nobuyuki; Kimura, Masashi; Mori, Ichiro

    2005-06-15

    Purpose. We evaluated the suitability of Dacron, polytetrafluoroethylene (PTFE), and small intestinal submucosa (SIS) as a covering material for stent-grafts placed in the portal vein as compared with a bare stent. Methods. Using 24 beagle dogs, either bare stents or stent-grafts covered with Dacron, PTFE, or SIS were placed in the main trunk of the portal vein in 6 animals each. Portography was performed immediately after stent placement, and at 2, 4, and 12 weeks thereafter. Next, the extracted stents or stent-grafts were examined histopathologically. Neointimal thickness adjacent to the stent wire and at the midportion between the stent wires was compared among the groups. Then, the neointimal thickness at the sub- and supragraft sites was compared between each stent-graft group. Serial changes in the histologic features of the thickened neointima were also investigated. Results. No significant difference was noted in the mean stenotic ratio of the portal vein diameter between the bare stent and PTFE groups, whereas it was significantly higher in the Dacron and SIS groups compared with the bare stent group. In neither of the studies on neointimal thickness adjacent to the stent wire and at the midportion between the stent wires were any significant differences noted between the neointimal thickness of the bare stent group and the sum of the neointimal thickness of the PTFE group, whereas the sum of the neointimal thickness of the Dacron and SIS groups was significantly greater than that of the bare stent group at both sites. In the comparison of the supragraft neointimal thickness, the SIS group showed significantly greater thickness than the PTFE group, while the difference between the Dacron and PTFE groups was not significant. In the comparison of the subgraft neointimal thickness, the Dacron and SIS groups showed significantly greater thickness than the PTFE group. Conclusion. The present results indicate that of the three covering materials examined here

  7. High compliance vascular grafts based on semi-interpenetrating networks

    PubMed Central

    Dempsey, David K.; Nezarati, Roya M.; Mackey, Calvin E.

    2014-01-01

    Current synthetic vascular grafts have poor patency rates in small diameter applications (<6 mm) due to intimal hyperplasia arising from a compliance mismatch between the graft and native vasculature. Enormous efforts have focused on improving biomechanical properties; however, polymeric grafts are often constrained by an inverse relationship between burst pressure and compliance. We have developed a new, semi-interpenetrating network (semi-IPN) approach to improve compliance without sacrificing burst pressure. The effects of heat treatment on graft morphology, fiber architecture, and resultant biomechanical properties are presented. In addition, biomechanical properties after equilibration at physiological temperature were investigated in relation to polyurethane microstructure to better predict in vivo performance. Compliance values as high as 9.2 ± 2.7 %/mmHg x 10−4 were observed for the semi-IPN graft while also maintaining high burst pressure, 1780 ± 230 mm Hg. The high compliance of these heat-treated poly(carbonate urethane) (PCU) and semi-IPN grafts is expected to improve long-term patency rates beyond even saphenous vein autografts by preventing intimal hyperplasia. The fundamental structure-property relationships gained from this work may also be utilized to advance biomedical device designs based on thermoplastic polyurethanes. PMID:25601822

  8. Future Economics of Liver Transplantation: A 20-Year Cost Modeling Forecast and the Prospect of Bioengineering Autologous Liver Grafts

    PubMed Central

    Habka, Dany; Mann, David; Landes, Ronald; Soto-Gutierrez, Alejandro

    2015-01-01

    During the past 20 years liver transplantation has become the definitive treatment for most severe types of liver failure and hepatocellular carcinoma, in both children and adults. In the U.S., roughly 16,000 individuals are on the liver transplant waiting list. Only 38% of them will receive a transplant due to the organ shortage. This paper explores another option: bioengineering an autologous liver graft. We developed a 20-year model projecting future demand for liver transplants, along with costs based on current technology. We compared these cost projections against projected costs to bioengineer autologous liver grafts. The model was divided into: 1) the epidemiology model forecasting the number of wait-listed patients, operated patients and postoperative patients; and 2) the treatment model forecasting costs (pre-transplant-related costs; transplant (admission)-related costs; and 10-year post-transplant-related costs) during the simulation period. The patient population was categorized using the Model for End-Stage Liver Disease score. The number of patients on the waiting list was projected to increase 23% over 20 years while the weighted average treatment costs in the pre-liver transplantation phase were forecast to increase 83% in Year 20. Projected demand for livers will increase 10% in 10 years and 23% in 20 years. Total costs of liver transplantation are forecast to increase 33% in 10 years and 81% in 20 years. By comparison, the projected cost to bioengineer autologous liver grafts is $9.7M based on current catalog prices for iPS-derived liver cells. The model projects a persistent increase in need and cost of donor livers over the next 20 years that’s constrained by a limited supply of donor livers. The number of patients who die while on the waiting list will reflect this ever-growing disparity. Currently, bioengineering autologous liver grafts is cost prohibitive. However, costs will decline rapidly with the introduction of new manufacturing

  9. Application of acellular dermis and autograft on burns and scars.

    PubMed

    Ramos Duron, L E; Martínez Pardo, M E; Olivera Zavaleta, V; Silva Diaz, T; Reyes Frías, M L; Luna Zaragoza, D

    1999-01-01

    The cases of two patients with burns treated with dermis allograft and of one patient for lip reconstructive aesthetic filling treated with less than one mm3 of radiosterilised acellular dermis are presented. This paper emphasizes the treatment with radiosterilised dermal grafts with a permanent character so far. Hospitals, therefore, can satisfy the demand for this kind of tissue in the case of disaster and patients with serious injuries. In the cases cited, histocompatibility analysis was not required, thus having the advantage of long-time storage of the radiosterilised dermis used on these patients. Neither inflammatory reaction nor acute phase re-absorption were observed. Moreover, shrink (contract) healing was diminished. After two years, the results are still satisfactory. PMID:10853787

  10. Histological and biochemical characteristics of the rabbit anterior cruciate ligament in comparison to potential autografts.

    PubMed

    Hoyer, Mariann; Meier, Carola; Kohl, Benjamin; Lohan, Anke; Kokozidou, Maria; Schulze-Tanzil, Gundula

    2016-08-01

    Tissue engineering of an anterior cruciate ligament (ACL) implant with ACL cells requires detailed analysis of the tissue characteristics that should be mimicked. Therefore, we studied the histological and biochemical properties of rabbit derived ACLs in comparison to other knee-associated tendons that are used as autografts in men. Rabbit derived ACLs and Musculus (M.) semimembranosus, M. semitendinosus tendons and patellar ligaments were explanted from adult New Zealand white rabbits and analyzed histologically for tissue organization (e.g. cellularity, nuclear shapes, elastic fibers), total collagen and sulfated glycosaminoglycan (sGAG) contents. Gene expression analysis was performed for the main extracellular matrix (ECM) components type I collagen, decorin and the glycoprotein tenomodulin. The ACLs had a dimension of 1.39x0.39x0.1 cm in situ. They were characterized by high sGAG content in comparison to the other tendons/ligaments, whereas the total collagen content did not differ. ACLs possessed higher cellularity and lower feret diameter of the cell nuclei compared with the investigated rabbit-derived tendons. In ACLs long elastic fibers were observed. Concerning the gene expression level, lower transcription of tenomodulin was detected in the ACL compared with the other tendons, without significant difference in the decorin gene expression. The M. semitendinosus tendon had a significantly higher type I collagen expression than the ACL and the other investigated tendons. This phenotypical characterization of the lapine ACL presented in this study provides some key standards to evaluate tissue engineered ACL constructs to be tested in the rabbit model. PMID:26791991

  11. A spun elastomeric graft for dialysis access.

    PubMed

    Drasler, W J; Wilson, G J; Stenoien, M D; Jenson, M L; George, S A; Dutcher, R G; Possis, Z C

    1993-01-01

    A new composite vascular graft was developed using electrostatic spinning technology. The graft is primarily microfibrous polydimethylsiloxane spun onto a mandrel; a small diameter polyester yarn provides additional strength while minimizing wall thickness, and a helical bead provides crush and kink resistance. Eighteen grafts were implanted in a mongrel canine arteriovenous shunt model for 12 months. The grafts were implanted in femoral artery to femoral vein loops and were cannulated using three pairs of 16 gauge dialysis needles per week. Grafts were evaluated during each puncture session, and also followed using angiography. Histologic study of explanted grafts, regional lymph nodes, and lungs was performed. The grafts provided excellent handling and puncture characteristics, with no bleeding through the graft wall at puncture sites. Cumulative patency of these punctured grafts was 88% at 6 months and 80% at 1 year. Histologic study showed external fibroconnective tissue encapsulation of the grafts, with tissue growth through the interstices of the graft consisting of a microvascular network surrounded predominantly by histiocytes, many multinucleated foreign body giant cells, with some fibroblasts and collagen formation also present. Little luminal thrombus was seen at puncture sites in the patent grafts, and there was no evidence of pulmonary thromboemboli. This new elastomeric graft shows excellent promise for dialysis access; similar grafts under development may also find application for small diameter peripheral vascular reconstruction. PMID:8324257

  12. Grafting fibroblasts genetically modified to produce L-dopa in a rat model of Parkinson disease

    SciTech Connect

    Wolff, J.A.; Fisher, L.J.; Xu, L.; Jinnah, H.A.; Rosenberg, M.B.; Shimohama, S.; Gage, F.H. ); Langlais, P.J. School of Medicine and Veterans Administration Medical Center, La Jolla San Diego State Univ., CA ); Iuvone, P.M. ); O'Malley, K.L. )

    1989-11-01

    Rat fibroblasts were infected with a retroviral vector containing the cDNA for rat tyrosine hydroxylase. A TH-positive clone was identified by biochemical assay and immunohistochemical staining. When supplemented in vitro with pterin cofactors required for TH activity, these cells produced L-dopa and released it into the cell cultured medium. Uninfected control cells and fibroblasts infected with the TH vector were grafted separately to the caudate of rats with unilateral 6-hydroxydopamine lesions of the nigrostriatal pathway. Only grafts containing TH-expressing fibroblasts were found to reduce rotational asymmetry. These results have general implications for the application of gene therapy to human neurological disease and specific implications for Parkinson disease.

  13. Reconstruction of the anterior cruciate ligament with the iliotibial band autograft in patients with chronic knee instability.

    PubMed

    Jørgensen, U; Bak, K; Ekstrand, J; Scavenius, M

    2001-05-01

    We performed combined internal and external anterior cruciate ligament (ACL) reconstruction with the iliotibial band autograft in 169 consecutive patients with chronic ACL insufficiency who were followed up for 24-61 months. Of these, 155 (91%) agreed to an additional independent observer follow-up after 24-92 months. Eight patients (5%) had sustained a rerupture/elongation of the graft and were operated on again; nine (6%) had sustained a tear of the contralateral ACL. Knee function and activity increased after the reconstruction. Lysholm scores improved from median 81 preoperatively to 99 at follow-up and Tegner scores from median 4 to 7. At follow-up 97 (71%) were active at the same level as prior to injury. In 17 of the 40 patients (12%) dropping to a lower activity level this was due to knee problems. The side-to-side difference in anterior-posterior knee laxity was more than 3 mm in 18 knees (13%) and more than 5 mm in 3 knees (2%). Including eight reruptures, this results in a "stability" failure rate of 8.8%. The overall IKCD rating showed normal knee function in 88 (73%) and nearly normal knee function in 30 (25%). Anterior knee pain was present in 14 (10%) of the patients at follow-up. Patients with isolated ACL injury had higher Lysholm scores and Tegner scores than patients with associated injuries. No clinical signs of varus knee development were seen. Of the 155 patients 94% would have the procedure repeated if necessary with the knowledge that they have today. The combined internal and external iliotibial band procedure can restore knee stability and function in the majority of chronic ACL-insufficient knees. PMID:11420786

  14. Effects of Ischemic Preconditioning of Different Intraoperative Ischemic Times of Vascularized Bone Graft Rabbit Models

    PubMed Central

    Wan Ahmad Kamal, Wan Syazli Rodzaia; Noor, Norizal Mohd; Abdullah, Shafie

    2013-01-01

    Background Ischemic preconditioning has been shown to improve the outcomes of hypoxic tolerance of the heart, brain, lung, liver, jejunum, skin, and muscle tissues. However, to date, no report of ischemic preconditioning on vascularized bone grafts has been published. Methods Sixteen rabbits were divided into four groups with ischemic times of 2, 6, 14, and 18 hours. Half of the rabbits in each group underwent ischemic preconditioning. The osteomyocutaneous flaps consisted of the tibia bone, from which the overlying muscle and skin were raised. The technique of ischemic preconditioning involved applying a vascular clamp to the pedicle for 3 cycles of 10 minutes each. The rabbits then underwent serial plain radiography and computed tomography imaging on the first, second, fourth, and sixth postoperative weeks. Following this, all of the rabbits were sacrificed and histological examinations were performed. Results The results showed that for clinical analysis of the skin flaps and bone grafts, the preconditioned groups showed better survivability. In the plain radiographs, except for two non-preconditioned rabbits with intraoperative ischemic times of 6 hours, all began to show early callus formation at the fourth week. The computed tomography findings showed more callus formation in the preconditioned groups for all of the ischemic times except for the 18-hour group. The histological findings correlated with the radiological findings. There was no statistical significance in the difference between the two groups. Conclusions In conclusion, ischemic preconditioning improved the survivability of skin flaps and increased callus formation during the healing process of vascularized bone grafts. PMID:24286040

  15. Polymer-Grafted Nanoparticles in Polymer Melts: Modeling using Combined SCFT-DFT Approach

    NASA Astrophysics Data System (ADS)

    Ginzburg, Valeriy

    2014-03-01

    Nanoparticles (silica, carbon black, etc.) are often used as fillers to improve physical (thermal conductivity, coefficient of thermal expansion) and mechanical (modulus, strength) properties of polymer materials. In many cases, however, lack of nanoparticle dispersion in the polymer limits the utility of a resulting nanocomposite material. To improve dispersion, one often grafts organic chains (``ligands'') onto the surface of the particles; if the ligands are chemically miscible with the matrix polymer, it helps the particles to disperse more uniformly. In recent years, many new morphologies (``wires'', ``sheets'', ``networks'', etc.) were observed in such nanocomposites. Here, we adapt our earlier formalism combining Self-Consistent Field Theory (SCFT) for polymers with Density Functional Theory (DFT) for the particles; the modified formalism explicitly incorporates the grafted chains into SCFT. We then perform several simulations to study the dependence of morphology on the length and density of grafted chains, as well as the nanoparticle loading. The results are in qualitative agreement with predictions of earlier theories in the limit of lower particle loadings, and predict new morphologies (``bundles of wires'') for the case of larger particle loadings. The method can be easily extended to more complex cases (for example, where the matrix and/or ligand itself is a blend or block copolymer).

  16. Correlation Analysis of Potential Factors Influencing Graft Maturity After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Li, Hong; Chen, Shuang; Tao, Hongyue; Li, Hongyun; Chen, Shiyi

    2014-01-01

    Background: Postoperatively, signal changes of the reconstructed anterior cruciate ligament (ACL) graft on magnetic resonance imaging (MRI) images commonly occurs, which may be a cause for concern. The signal intensity changes are usually expressed by signal/noise quotient (SNQ) value, representing graft maturity. To date, little is known about the factors influencing the SNQ value of the reconstructed ACL graft. Purpose: To evaluate ACL graft SNQ value and associated factors after ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Male patients who underwent ACL reconstruction using autograft or allograft tendon from September 2004 to September 2011 were randomly invited to take part in this investigation, including functional scores, physical examination, and MRI scan. The femoral side graft was fixed with Endobutton CL or Rigidfix pins, and the tibial side graft was fixed with a bio-intrafix. SNQ values of each graft were measured on MRI to represent graft maturity. Sagittal ACL angle, ACL–Blumensaat line angle, and medial and lateral posterior tibial slope (PTS) were measured using MRI 3-dimensional dual-echo steady-state images. Potential risk factors, including age, body mass index, postoperative time, Tegner activity scale (TAS), sagittal ACL angle, ACL–Blumensaat line angle, medial PTS, lateral PTS, and primary graft diameter, were tested for their association with the graft SNQ value by multivariate stepwise regression analysis. Results: A total of 104 male subjects (mean follow-up, 30.7 months) were examined, including 62 allograft and 42 autograft reconstructions. There was a significant association between graft SNQ and postoperative time (r = −0.431, P < .001), TAS (r = 0.295, P = .002), and ACL–Blumensaat line angle (r = −0.304, P = .002). Univariate regression analysis showed that TAS (β = 6.15, P < .001) positively correlated, postoperative time (β = −0.26, P < .001) negatively correlated, and ACL

  17. Performance Measurements in Endolaparoscopic Infrarenal Aortic Graft Implantation using Computer-enhanced Instrumentation: a Laboratory Model for Training

    PubMed Central

    Martinez, Bernardo D.; Mendez, Jose

    2007-01-01

    Background: Performance measurements in an endolaparoscopic aortic animal laboratory model have been reported since Dion's work (1995). The purpose of this paper is to report performance measurements using computer-enhanced surgical instrumentation in a porcine model. Methods: From February 2000 to December 2002, training in robotic instrumentation consisted of implantation of infrarenal aortic grafts in 3 groups of 5 animals each. The time frame to complete all 15 procedures reflects 2 major difficulties: the need to schedule procedures based on the surgeon's time off from his solo practice and the availability of laboratory sites to complete the procedures. A full endolaparoscopic technique was used to perform 2 endto-end anastomoses through an intraperitoneal approach. A different method of computer-enhanced instrumentation was used for each group of animals as follows: (1) AESOP robotic arm and HERMES integrated voice control instrumentation, (2) AESOP-HERMES-ZEUS robotic systems, (3) da Vinci robotic system. The aortic clamp time, total operative time, and blood loss were recorded for each procedure. Secondary endpoints included spinal cord ischemia, graft thrombosis, and bleeding. Results: All animals tolerated the procedure. All grafts were patent and suture anastomoses intact. Two instances of bleeding, both of which were controlled laparoscopically, occurred. Aortic clamping time was significantly improved in Group 3 compared with that in Group 2 (P=0.008). Conclusion: The results of the first group reflect previous experience with the AESOP-HERMES instrumentation. However, the times of the ZEUS group and da Vinci group reflect initial exposure to the technology. The remote position of the surgeon at the console did not appear to affect the performance as shown in the last group. The da Vinci group provides an advantage compared with the ZEUS group. Both systems showed adaptability and versatility in controlling adverse bleeding encounters. PMID:17931515

  18. Neural Stem Cell or Human Induced Pluripotent Stem Cell-Derived GABA-ergic Progenitor Cell Grafting in an Animal Model of Chronic Temporal Lobe Epilepsy.

    PubMed

    Upadhya, Dinesh; Hattiangady, Bharathi; Shetty, Geetha A; Zanirati, Gabriele; Kodali, Maheedhar; Shetty, Ashok K

    2016-01-01

    Grafting of neural stem cells (NSCs) or GABA-ergic progenitor cells (GPCs) into the hippocampus could offer an alternative therapy to hippocampal resection in patients with drug-resistant chronic epilepsy, which afflicts >30% of temporal lobe epilepsy (TLE) cases. Multipotent, self-renewing NSCs could be expanded from multiple regions of the developing and adult brain, human embryonic stem cells (hESCs), and human induced pluripotent stem cells (hiPSCs). On the other hand, GPCs could be generated from the medial and lateral ganglionic eminences of the embryonic brain and from hESCs and hiPSCs. To provide comprehensive methodologies involved in testing the efficacy of transplantation of NSCs and GPCs in a rat model of chronic TLE, NSCs derived from the rat medial ganglionic eminence (MGE) and MGE-like GPCs derived from hiPSCs are taken as examples in this unit. The topics comprise description of the required materials, reagents and equipment, methods for obtaining rat MGE-NSCs and hiPSC-derived MGE-like GPCs in culture, generation of chronically epileptic rats, intrahippocampal grafting procedure, post-grafting evaluation of the effects of grafts on spontaneous recurrent seizures and cognitive and mood impairments, analyses of the yield and the fate of graft-derived cells, and the effects of grafts on the host hippocampus. © 2016 by John Wiley & Sons, Inc. PMID:27532817

  19. Autograft HIV-DNA Load Predicts HIV-1 Peripheral Reservoir After Stem Cell Transplantation for AIDS-Related Lymphoma Patients

    PubMed Central

    Bortolin, Maria Teresa; Pratesi, Chiara; Tedeschi, Rosamaria; Basaglia, Giancarlo; Abbruzzese, Luciano; Mazzucato, Mario; Spina, Michele; Vaccher, Emanuela; Tirelli, Umberto; Rupolo, Maurizio; Michieli, Mariagrazia; Di Mascio, Michele; De Paoli, Paolo

    2015-01-01

    Abstract Autologous stem cell transplantation (ASCT) is a widely used procedure for AIDS-related lymphomas, and it represents an opportunity to evaluate strategies curing HIV-1 infection. The association of autograft HIV-DNA load with peripheral blood HIV-1 reservoir before ASCT and its contribution in predicting HIV-1 reservoir size and stability during combination antiretroviral therapy (cART) after transplantation are unknown. Aiming to obtain information suggesting new functional cure strategies by ASCT, we retrospectively evaluated HIV-DNA load in autograft and in peripheral blood before and after transplantation in 13 cART-treated HIV-1 relapse/refractoring lymphoma patients. Among them seven discontinued cART after autograft infusion. HIV-DNA was evaluated by a sensitive quantitative real-time polymerase chain reaction (PCR). After debulking chemotherapy/mobilization, the autograft HIV-1 reservoir was higher than and not associated with the peripheral HIV-1 reservoir at baseline [median 215 HIV-DNA copies/106 autograft mononuclear cells, range 13–706 vs. 82 HIV-DNA copies/106 peripheral blood mononuclear cells (PBMCs), range 13–479, p=0.03]. After high dose chemotherapy and autograft infusion, HIV-DNA levels reached a plateau between month 6 and 12 of follow-up. No association was found between peripheral HIV-DNA levels at baseline and after infusion in both cART interrupting and not interrupting patients. Only in the last subgroup, a stable significant linear association between autograft and peripheral blood HIV-1 reservoir emerged from month 1 (R2=0.84, p=0.01) to month 12 follow-up (R2=0.99, p=0.0005). In summary, autograft HIV-1 reservoir size could be influenced by the mobilization phase and predicts posttransplant peripheral HIV-1 reservoir size in patients on continuous cART. These findings could promote new research on strategies reducing the HIV-1 reservoir by using the ASCT procedure. PMID:25581618

  20. Adequacy of Semitendinosus Tendon Alone for Anterior Cruciate Ligament Reconstruction Graft and Prediction of Hamstring Graft Size by Evaluating Simple Anthropometric Parameters

    PubMed Central

    Stergios, Papastergiou G.; Georgios, Konstantinidis A.; Konstantinos, Natsis; Efthymia, Papathanasiou; Nikolaos, Koukoulias; Alexandros, Papadopoulos G.

    2012-01-01

    Introduction. Preoperative identification of patients with inadequate hamstring grafts for anterior cruciate ligament reconstruction is still a subject of interest. Purpose. The purpose of this study was to determine whether the semitendinosus tendon length is adequate for four-strand graft harvested by common technique (without bone plug) and whether there is correlation of gracilis and semitendinosus tendon grafts length and diameter of quadrupled graft with anthropometric parameters. Materials and Methods. In this retrospective study, 61 patients (45 males, 16 females) undergoing ACL reconstruction using four-strand hamstring autograft tendons were included. Results. The length of semitendinosus tendon, harvested by the common technique, was in 21% of our cases inadequate in order to be used alone as a four-strand graft especially in females (43%). There was moderate correlation between semitendinosus and gracilis graft diameter and patient's height and weight and fair correlation to BMI. We found no statistically important predictor for graft diameter in female patients. Conclusions. The length of semitendinosus tendon, harvested by common technique, is usually inadequate to be used alone as a four-strand graft especially in females. The most reliable predictor seems to be patient's height in males. In female patients, there is no statistically important predictor. PMID:22900187

  1. Predicting Hamstring Graft Diameter Using MRI and Anthropometry

    PubMed Central

    Fritsch, Brett A; Mhaskar, Vikram A; An, Vincent Vinh Gia; Scholes, Corey

    2016-01-01

    Objectives: Graft diameter is one variable that may affect outcome of ACL reconstruction. The ability to predict the size of a graft in a given patient pre-operatively may help guide graft selection and preparation technique. Various papers have correlated anthropometric data and MRI tendon measurements to intraoperative graft diameter, although no papers have investigated these together. The intra-operative diameter of a hamstring autograft will be influenced by graft preparation technique. Our study aimed to investigate the prediction of intraoperative graft diameter of 2 different graft construct techniques (4-strand semitendinosus versus quadrupled semitendinosus) using anthropometry and MRI measurements. Methods: Retrospective review of two groups of ACL reconstruction using different graft preparation techniques was performed. “Conventional” 4-strand gracilis + semitendinosus with fixed suspension at the femur and screw fixation at the tibia were compared with quadrupled semitendinosus grafts with adjustable suspensory fixation at each end (Graftlink). Cross-sectional areas (XSA) of the semitendinosus and gracilis tendons was measured in the axial slice of a T2 weighted MRI image using a region-of-interest tool. Stepwise linear regression using intraoperative graft diameter as the dependant variable was performed using MRI XSA of the semitendinosus and gracilis tendons, gender and height as predictors. Results: 129 ACL Reconstruction in 127 patients were done in the time period, 89 of which were done conventionally, and 40 which employed the Graftlink construct. The median graft diameter in the Graftlink group (8.5mm IQR8-9) was greater than that of the conventional group (8mm, IQR 7.5-8) (p < 0.001). MRI XSA of semitendinosus and height were statistically significant predictors of diameter in the Graftlink group (R2 = 51%), whilst MRI XSA of semitendinosus + gracilis and gender were predictors in the conventional group (R2 = 36%). Conclusion: Graftlink

  2. Histopathology of Ossicular Grafts and Implants in Chronic Otitis Media

    PubMed Central

    Bahmad, Fayez; Merchant, Saumil N.

    2008-01-01

    Objectives We describe the histopathology of ossicular grafts and implants so as to provide insight into factors that may influence functional results after surgery for chronic otitis media. Methods Histopathologic observations were made on 56 cases: 50 surgical specimens and 6 temporal bone cases in which the graft was sectioned in situ. Results and Conclusions Autogenous malleus, incus, and cortical bone grafts behaved in a similar manner and maintained their morphological size, shape, and contour for extended periods of time, at least up to 30 years. These histopathologic observations support the continued use of autograft ossicular and cortical bone grafts for middle ear reconstruction. Cartilage grafts developed chondromalacia with resulting loss of stiffness and showed a tendency to undergo resorption. Synthetic prostheses made of porous plastic (Plastipore, Polycel) elicited foreign body giant cell reactions with various degrees of biodegradation of the implants. Prostheses made of hydroxyapatite and Bioglass were enveloped by a lining of connective tissue and mucosal epithelium. The Bioglass material was broken down into small fragments and partially resorbed by a host response within the middle ear. These results warrant caution in the use of prostheses made of porous plastic or Bioglass. PMID:17419521

  3. Bone graft substitutes for spine fusion: A brief review

    PubMed Central

    Gupta, Ashim; Kukkar, Nitin; Sharif, Kevin; Main, Benjamin J; Albers, Christine E; El-Amin III, Saadiq F

    2015-01-01

    Bone graft substitutes are widely used in the field of orthopedics and are extensively used to promote vertebral fusion. Fusion is the most common technique in spine surgery and is used to treat morbidities and relieve discomfort. Allograft and autograft bone substitutes are currently the most commonly used bone grafts to promote fusion. These approaches pose limitations and present complications to the patient. Numerous alternative bone graft substitutes are on the market or have been developed and proposed for application. These options have attempted to promote spine fusion by enhancing osteogenic properties. In this review, we reviewed biology of spine fusion and the current advances in biomedical materials and biological strategies for application in surgical spine fusion. Our findings illustrate that, while many bone graft substitutes perform well as bone graft extenders, only osteoinductive proteins (recombinant bone morphogenetic proteins-2 and osteogenic protein-1) provide evidence for use as both bone enhancers and bone substitutes for specific types of spinal fusion. Tissue engineered hydrogels, synthetic polymer composites and viral based gene therapy also holds the potential to be used for spine fusion in future, though warrants further investigation to be used in clinical practice. PMID:26191491

  4. Bone graft substitutes for spine fusion: A brief review.

    PubMed

    Gupta, Ashim; Kukkar, Nitin; Sharif, Kevin; Main, Benjamin J; Albers, Christine E; El-Amin Iii, Saadiq F

    2015-07-18

    Bone graft substitutes are widely used in the field of orthopedics and are extensively used to promote vertebral fusion. Fusion is the most common technique in spine surgery and is used to treat morbidities and relieve discomfort. Allograft and autograft bone substitutes are currently the most commonly used bone grafts to promote fusion. These approaches pose limitations and present complications to the patient. Numerous alternative bone graft substitutes are on the market or have been developed and proposed for application. These options have attempted to promote spine fusion by enhancing osteogenic properties. In this review, we reviewed biology of spine fusion and the current advances in biomedical materials and biological strategies for application in surgical spine fusion. Our findings illustrate that, while many bone graft substitutes perform well as bone graft extenders, only osteoinductive proteins (recombinant bone morphogenetic proteins-2 and osteogenic protein-1) provide evidence for use as both bone enhancers and bone substitutes for specific types of spinal fusion. Tissue engineered hydrogels, synthetic polymer composites and viral based gene therapy also holds the potential to be used for spine fusion in future, though warrants further investigation to be used in clinical practice. PMID:26191491

  5. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon

    PubMed Central

    Shimazaki, J.; Shinozaki, N.; Tsubota, K.

    1998-01-01

    AIM—Treatment of recurrent pterygium associated with symblepharon requires both suppression of fibrosis and reconstruction of limbal barrier. To achieve this, human amniotic membrane was transplanted and limbal autografts performed.
METHODS—Four patients with severe symblepharon resulting from multiple surgeries for pterygium were treated. Human amniotic membrane was obtained at caesarean section and preserved until surgery. After excision of the fibrous tissues, the amniotic membrane was placed on the sclera, and a limbal autograft transplantation was performed using limbal tissues taken from the affected eye.
RESULTS—Recurrence of symblepharon was not observed in any of the patients and significant suppression of the subconjunctival fibrosis was achieved. Ocular movement improved in all cases. Complete remission of pterygium regrowth occurred in three cases, and a slight (about 1 mm) recurrence occurred in one case. The limbal donor site showed the presence of mild depressions without the formation of pseudopterygium.
CONCLUSION—Transplantation of human amniotic membrane with a limbal autograft appears to be a promising surgical treatment for reconstructing the ocular surface in patients with recurrent pterygium associated with symblepharon.

 Keywords: pterygium; limbal transplantation; amniotic membrane; symblepharon PMID:9602618

  6. Modelling and simulation of the mechanical response of a Dacron graft in the pressurization test and an end-to-end anastomosis.

    PubMed

    Bustos, Claudio A; García-Herrera, Claudio M; Celentano, Diego J

    2016-08-01

    This work presents the modeling and simulation of the mechanical response of a Dacron graft in the pressurization test and its clinical application in the analysis of an end-to-end anastomosis. Both problems are studied via an anisotropic constitutive model that was calibrated by means of previously reported uniaxial tensile tests. First, the simulation of the pressurization test allows the validation of the experimental material characterization that included tests carried out for different levels of axial stretching. Then, the analysis of an end-to-end anastomosis under an idealized geometry is proposed. This case consists in evaluating the mechanical performance of the graft together with the stresses and deformations in the neighborhood of the Dacron with the artery. This research contributes important data to understand the functioning of the graft and the possibility of extending the analysis to complex numerical cases like its insertion in the aortic arch. PMID:26826765

  7. Computational blood flow and vessel wall modeling in a CT-based thoracic aorta after stent-graft implantation

    NASA Astrophysics Data System (ADS)

    Hazer, Dilana; Stoll, Markus; Schmidt, Eduard; Richter, Goetz-M.; Dillmann, Rüdiger

    2010-03-01

    Abnormal blood flow conditions and structural fatigue within stented vessels may lead to undesired failure causing death to the patient. Image-based computational modeling provides a physical and realistic insight into the patientspecific biomechanics and enables accurate predictive simulations of development, growth and failure of cardiovascular diseases as well as associated risks. Controlling the efficiency of an endovascular treatment is necessary for the evaluation of potential complications and predictions on the assessment of the pathological state. In this paper we investigate the effects of stent-graft implantation on the biomechanics in a patient-specific thoracic aortic model. The patient geometry and the implanted stent-graft are obtained from morphological data based on a CT scan performed during a controlling routine. Computational fluid dynamics (CFD) and computational structure mechanics (CSM) simulations are conducted based on the finite volume method (FVM) and on the finite element method (FEM) to compute the hemodynamics and the elastomechanics within the aortic model, respectively. Physiological data based on transient pressure and velocity profiles are used to set the necessary boundary conditions. Further, the effects of various boundary conditions and definition of contact interactions on the numerical stability of the blood flow and the vessel wall simulation results are also investigated. The quantification of the hemodynamics and the elastomechanics post endovascular intervention provides a realistic controlling of the state of the stented vessel and of the efficiency of the therapy. Consequently, computational modeling would help in evaluating individual therapies and optimal treatment strategies in the field of minimally invasive endovascular surgery.

  8. A new harvest site for bone graft in anterior cruciate ligament revision surgery.

    PubMed

    Franceschi, Francesco; Papalia, Rocco; Di Martino, Alberto; Rizzello, Giacomo; Allaire, Robert; Denaro, Vincenzo

    2007-05-01

    During revision anterior cruciate ligament (ACL) surgery, femoral interference screws frequently require removal. This may lead to significant tunnel widening and possible graft fixation failure as a result. Solutions include drilling the revision tunnel in a different location, using stacked interference screws, or using bone graft to fill the defect. Autogenous iliac crest graft and allograft are both used, but there are significant comorbidities associated with each. We developed a new technique for harvesting autogenous bone graft that avoids many of the complications associated with other graft sources. By use of the existing surgical incision from the initial harvest of the bone-patellar tendon-bone autograft, bone from the medial tibial metaphyseal safe zone is harvested via an OATS tube harvester (Arthrex, Naples, FL). A bone plug 1 mm larger in size than the femoral defect is harvested and arthroscopically inserted via a press-fit technique. At 3 months after bone grafting, patients undergo revision ACL reconstruction. The proximal tibial metaphysis is a safe bone graft harvest site in revision ACL surgery and offers an effective method for filling large bony defects, allowing anatomic reconstruction of the ACL after bone healing has occurred. Furthermore, it eliminates the problems associated with allograft or use of a remote graft donor site. PMID:17478290

  9. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    PubMed

    Tatara, Alexander M; Kretlow, James D; Spicer, Patrick P; Lu, Steven; Lam, Johnny; Liu, Wei; Cao, Yilin; Liu, Guangpeng; Jackson, John D; Yoo, James J; Atala, Anthony; van den Beucken, Jeroen J J P; Jansen, John A; Kasper, F Kurtis; Ho, Tang; Demian, Nagi; Miller, Michael John; Wong, Mark E; Mikos, Antonios G

    2015-05-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material. PMID:25603924

  10. Autologously Generated Tissue-Engineered Bone Flaps for Reconstruction of Large Mandibular Defects in an Ovine Model

    PubMed Central

    Tatara, Alexander M.; Kretlow, James D.; Spicer, Patrick P.; Lu, Steven; Lam, Johnny; Liu, Wei; Cao, Yilin; Liu, Guangpeng; Jackson, John D.; Yoo, James J.; Atala, Anthony; van den Beucken, Jeroen J.J.P.; Jansen, John A.; Kasper, F. Kurtis; Ho, Tang; Demian, Nagi; Miller, Michael John; Wong, Mark E.

    2015-01-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material. PMID:25603924

  11. Effect of acute and chronic graft-versus-host disease on relapse and survival after reduced-intensity conditioning allogeneic transplantation for myeloma

    PubMed Central

    Ringdén, Olle; Shrestha, Smriti; da Silva, Gisela Tunes; Zhang, Mei-Jie; Dispenzieri, Angela; Remberger, Mats; Kamble, Rammurti; Freytes, Cesar O.; Gale, Robert Peter; Gibson, John; Gupta, Vikas; Holmberg, Leona; Lazarus, Hillard; McCarthy, Philip; Meehan, Kenneth; Schouten, Harry; Milone, Gustavo A.; Lonial, Sagar; Hari, Parameswaran N

    2011-01-01

    We evaluated the effect of acute and chronic graft-versus-host disease (GVHD) on relapse and survival after allogeneic haematopoietic stem cell transplantation (HSCT) for multiple myeloma (MM) using non-myeloablative conditioning (NMA) and reduced-intensity conditioning (RIC). The outcomes of 177 HLA-identical sibling HSCT recipients between 1997 and 2005 following NMA (n=98) or RIC (n=79) were analyzed. In 105 patients, autografting was followed by planned NMA/RIC allogeneic transplantation. The impact of GVHD was assessed as a time-dependent covariate using Cox models. The incidence of acute GVHD (grades I–IV) was 42% (95% confidence interval (CI) 35 – 49%) and of chronic GVHD at five years was 59% (95% CI 49 – 69%), with 70% developing extensive chronic GVHD. In multivariate analysis, acute GVHD (≥ grade I) was associated with an increased risk of TRM (relative risk (RR)=2.42; p=0.016), whereas limited chronic GVHD significantly decreased the risk of myeloma relapse (RR=0.35, p=0.035) and was associated with superior event-free survival (RR=0.40, p=0.027). Acute GVHD had a detrimental effect on survival, especially in those receiving autologous followed by allogeneic HSCT (RR=3.52; p=0.001). The reduction in relapse risk associated with chronic GVHD is consistent with a beneficial graft-versus-myeloma effect, but this did not translate into a survival advantage. PMID:21946381

  12. Penile enhancement using a porcine small intestinal submucosa graft in a rat model.

    PubMed

    Leungwattanakij, S; Pummangura, N; Ratana-Olarn, K

    2006-01-01

    Several biodegradable materials have been experimented for penile enhancement, but none show the potential for clinical use. This study was designed to use porcine small intestinal submucosa (SIS) augmenting the normal tunica albuginea to increase the functional girth of the rat penis. In all, 20 adult male Sprague-Dawley rats constituted the study population. The animals were divided into two groups: group 1 consisted of the control (n=10) and group 2 (n=10) consisted of rats that underwent penile enhancement by a longitudinal I-shaped incision of the tunica albuginea on both sides, and the dissection of the plane between tunica albuginea and cavernosal tissue was carried out (n=10). The incision was then patched with a 3 x 10 mm2 piece of SIS, using a 6/0 nylon suture material. The penile length and mid-circumference were then measured using a Vernier Caliper before and 2 months after surgery. All rat penises underwent histological examination using Masson's trichome and Verhoff's van Giesen's stain for collagen and elastic fibers. The penile length, mid-circumference and degree of fibrosis score were expressed as mean+/-s.e. (standard error) and analyzed using a Wilcoxon rank-sum test. A statistical significance was accepted at P-value < or =0.05. Our results showed similar preoperative penile length and circumference in both groups. However, 2 months after the surgery, the mean penile circumference of the SIS group has grown significantly larger than the control group, while the mean penile length remained unchanged. The histological study of the rat penises revealed minimal amounts of fibrosis under the graft, and the elastic fibers of the graft showed orientation in a circular manner. In conclusion, SIS appears promising for material use in a penile enhancement. PMID:16049525

  13. Technique for 3-Dimesional (3D) Modeling of Osteoarticular Medial Femoral Condyle Vascularized Grafting to Replace the Proximal Pole of Unsalvagable Scaphoid Nonunions.

    PubMed

    Houdek, Matthew T; Matsumoto, Jane M; Morris, Jonathan M; Bishop, Allen T; Shin, Alexander Y

    2016-09-01

    This study describes a novel technique for the preoperative surgical planning for an osteoarticular medial femoral condyle (MFC) graft to replace the proximal pole of a scaphoid. In cases of proximal pole scaphoid nonunion or in Preiser disease, fragmentation of the articular surface can occur, leading to significant pain and disability. Osteoarticular MFC bone grafting can be used to treat these injuries by providing a vascularized osteoarticular surface. Using 3-dimensional imaging and printing we are able to precisely model the injured scaphoid, and also accurately plan the harvest of MFC osteoarticular graft. This technique allows for accurate preoperative planning of a complex 3-dimensional bone, and has improved our execution of the plan intraoperatively. PMID:27466049

  14. Effect of bidispersity in grafted chain length on grafted chain conformations and potential of mean force between polymer grafted nanoparticles in a homopolymer matrix.

    PubMed

    Nair, Nitish; Wentzel, Nathaniel; Jayaraman, Arthi

    2011-05-21

    In efforts to produce polymeric materials with tailored physical properties, significant interest has grown around the ability to control the spatial organization of nanoparticles in polymer nanocomposites. One way to achieve controlled particle arrangement is by grafting the nanoparticle surface with polymers that are compatible with the matrix, thus manipulating the interfacial interactions between the nanoparticles and the polymer matrix. Previous work has shown that the molecular weight of the grafted polymer, both at high grafting density and low grafting density, plays a key role in dictating the effective inter-particle interactions in a polymer matrix. At high grafting density nanoparticles disperse (aggregate) if the graft molecular weight is higher (lower) than the matrix molecular weight. At low grafting density the longer grafts can better shield the nanoparticle surface from direct particle-particle contacts than the shorter grafts and lead to the dispersion of the grafted particles in the matrix. Despite the importance of graft molecular weight, and evidence of non-trivial effects of polydispersity of chains grafted on flat surfaces, most theoretical work on polymer grafted nanoparticles has only focused on monodisperse grafted chains. In this paper, we focus on how bidispersity in grafted chain lengths affects the grafted chain conformations and inter-particle interactions in an implicit solvent and in a dense homopolymer polymer matrix. We first present the effects of bidispersity on grafted chain conformations in a single polymer grafted particle using purely Monte Carlo (MC) simulations. This is followed by calculations of the potential of mean force (PMF) between two grafted particles in a polymer matrix using a self-consistent Polymer Reference Interaction Site Model theory-Monte Carlo simulation approach. Monte Carlo simulations of a single polymer grafted particle in an implicit solvent show that in the bidisperse polymer grafted particles

  15. Synovial Mesenchymal Stem Cells Promote Meniscus Regeneration Augmented by an Autologous Achilles Tendon Graft in a Rat Partial Meniscus Defect Model

    PubMed Central

    Ozeki, Nobutake; Muneta, Takeshi; Matsuta, Seiya; Koga, Hideyuki; Nakagawa, Yusuke; Mizuno, Mitsuru; Tsuji, Kunikazu; Mabuchi, Yo; Akazawa, Chihiro; Kobayashi, Eiji; Saito, Tomoyuki; Sekiya, Ichiro

    2015-01-01

    Although meniscus defects and degeneration are strongly correlated with the later development of osteoarthritis, the promise of regenerative medicine strategies is to prevent and/or delay the disease's progression. Meniscal reconstruction has been shown in animal models with tendon grafting and transplantation of mesenchymal stem cells (MSCs); however, these procedures have not shown the same efficacy in clinical studies. Here, our aim was to investigate the ability of tendon grafts pretreated with exogenous synovial-derived MSCs to prevent cartilage degeneration in a rat partial meniscus defect model. We removed the anterior half of the medial meniscus and grafted autologous Achilles tendons with or without a 10-minute pretreatment of the tendon with synovial MSCs. The meniscus and surrounding cartilage were evaluated at 2, 4, and 8 weeks (n = 5). Tendon grafts increased meniscus size irrespective of synovial MSCs. Histological scores for regenerated menisci were better in the tendon + MSC group than in the other two groups at 4 and 8 weeks. Both macroscopic and histological scores for articular cartilage were significantly better in the tendon + MSC group at 8 weeks. Implanted synovial MSCs survived around the grafted tendon and native meniscus integration site by cell tracking assays with luciferase+, LacZ+, DiI+, and/or GFP+ synovial MSCs and/or GFP+ tendons. Flow cytometric analysis showed that transplanted synovial MSCs retained their MSC properties at 7 days and host synovial tissue also contained cells with MSC characteristics. Synovial MSCs promoted meniscus regeneration augmented by autologous Achilles tendon grafts and prevented cartilage degeneration in rats. Stem Cells 2015;33:1927–1938 PMID:25993981

  16. Electrical Nerve Stimulation Enhances Perilesional Branching after Nerve Grafting but Fails to Increase Regeneration Speed in a Murine Model.

    PubMed

    Witzel, Christian; Brushart, Thomas M; Koulaxouzidis, Georgios; Infanger, Manfred

    2016-07-01

    Background Electrical stimulation immediately following nerve lesion helps regenerating axons cross the subsequently grafted nerve repair site. However, the results and the mechanisms remain open to debate. Some findings show that stimulation after crush injury increases axonal crossing of the repair site without affecting regeneration speed. Others show that stimulation after transection and fibrin glue repair doubles regeneration distance. Methods Using a sciatic-nerve-transection-graft in vivo model, we investigated the morphological behavior of regenerating axons around the repair site after unilateral nerve stimulation (20 Hz, 1 hour). With mice expressing axonal fluorescent proteins (thy1-YFP), we were able to calculate the following at 5 and 7 days: percentage of regenerating axons and arborizing axons, branches per axon, and regeneration distance and speed. Results Brief stimulation significantly increases the percentage of regenerating axons (5 days: 35.5 vs. 27.3% nonstimulated, p < 0.05; 7 days: 43.3 vs. 33.9% nonstimulated, p < 0.05), mainly by increasing arborizing axons (5 days: 49.3 [4.4] vs. 33.9 [4.1]% [p < 0.001]; 7 days: 42.2 [5.6] vs. 33.2 [3.1]% [p < 0.001]). Neither branches per arborizing axon nor regeneration speed were affected. Conclusion Our morphological data analysis revealed that electrical stimulation in this model increases axonal crossing of the repair site and promotes homogeneous perilesional branching, but does not affect regeneration speed. PMID:26975563

  17. Grafting-responsive miRNAs in cucumber and pumpkin seedlings identified by high-throughput sequencing at whole genome level.

    PubMed

    Li, Chaohan; Li, Yansu; Bai, Longqiang; Zhang, Tieyao; He, Chaoxing; Yan, Yan; Yu, Xianchang

    2014-08-01

    Grafting is an important agricultural technique widely used for improving growth, yields and tolerance of crops to abiotic and biotic stresses. As one type of endogenous, non-coding small RNAs, microRNAs (miRNAs) regulate development and responsiveness to biotic and abiotic stresses by negatively mediating expression of target genes at the post-transcriptional level. However, there have been few detailed studies to evaluate the role of miRNAs in mediation of grafting-induced physiological processes in plants. Cucumis sativus and Cucurbita moschata are important vegetables worldwide. We constructed eight small RNA libraries from leaves and roots of seedlings that were grafted in the following four ways: (1) hetero-grafting, using cucumber as scion and pumpkin as rootstock; (2) hetero-grafting, with pumpkin as scion and cucumber as rootstock; (3) auto-grafting of cucumbers and (4) auto-grafting of pumpkins. High-throughput sequencing was employed, and more than 120 million raw reads were obtained. We annotated 112 known miRNAs belonging to 40 miRNA families and identified 48 new miRNAs in the eight libraries, and the targets of these known and novel miRNAs were predicted by bioinformatics. Grafting led to changes in expression of most miRNAs and their predicted target genes, suggesting that miRNAs may play significant roles in mediating physiological processes of grafted seedlings by regulating the expression of target genes. The potential role of the grafting-responsive miRNAs in seedling growth and long-distance transport of miRNA was discussed. These results are useful for functional characterization of miRNAs in mediation of grafting-dependent physiological processes. PMID:24279842

  18. Primordial Follicle Transplantation within Designer Biomaterial Grafts Produce Live Births in a Mouse Infertility Model

    PubMed Central

    Kniazeva, E.; Hardy, A. N.; Boukaidi, S. A.; Woodruff, T. K.; Jeruss, J. S.; Shea, L. D.

    2015-01-01

    The gonadotoxic effects of chemotherapy and radiation may result in premature ovarian failure in premenopausal oncology patients. Although autotransplantation of ovarian tissue has led to successful live births, reintroduction of latent malignant cells inducing relapse is a significant concern. In this report, we investigated the design of biomaterial grafts for transplantation of isolated ovarian follicles as a means to preserve fertility. Primordial and primary ovarian follicles from young female mice were extracted and encapsulated into biomaterials for subsequent transplantation into adult mice. Among the formulations tested, aggregated follicles encapsulated within fibrin had enhanced survival and integration with the host tissue following transplantation relative to the fibrin-alginate and fibrin-collagen composites. All mice transplanted with fibrin-encapsulated follicles resumed cycling, and live births were achieved only for follicles transplanted within VEGF-loaded fibrin beads. The extent to which these procedures reduce the presence of metastatic breast cancer cells among the isolated follicles was evaluated, with significantly reduced numbers of cancer cells present relative to intact ovaries. This ability to obtain live births by transplanting isolated primordial and primary follicles, while also reducing the risk of re-seeding disease relative to ovarian tissue transplantation, may ultimately provide a means to preserve fertility in premenopausal oncology patients. PMID:26633657

  19. Primordial Follicle Transplantation within Designer Biomaterial Grafts Produce Live Births in a Mouse Infertility Model.

    PubMed

    Kniazeva, E; Hardy, A N; Boukaidi, S A; Woodruff, T K; Jeruss, J S; Shea, L D

    2015-01-01

    The gonadotoxic effects of chemotherapy and radiation may result in premature ovarian failure in premenopausal oncology patients. Although autotransplantation of ovarian tissue has led to successful live births, reintroduction of latent malignant cells inducing relapse is a significant concern. In this report, we investigated the design of biomaterial grafts for transplantation of isolated ovarian follicles as a means to preserve fertility. Primordial and primary ovarian follicles from young female mice were extracted and encapsulated into biomaterials for subsequent transplantation into adult mice. Among the formulations tested, aggregated follicles encapsulated within fibrin had enhanced survival and integration with the host tissue following transplantation relative to the fibrin-alginate and fibrin-collagen composites. All mice transplanted with fibrin-encapsulated follicles resumed cycling, and live births were achieved only for follicles transplanted within VEGF-loaded fibrin beads. The extent to which these procedures reduce the presence of metastatic breast cancer cells among the isolated follicles was evaluated, with significantly reduced numbers of cancer cells present relative to intact ovaries. This ability to obtain live births by transplanting isolated primordial and primary follicles, while also reducing the risk of re-seeding disease relative to ovarian tissue transplantation, may ultimately provide a means to preserve fertility in premenopausal oncology patients. PMID:26633657

  20. Graft-mediated functional recovery on a skilled forelimb use paradigm in a rodent model of Parkinson's disease is dependent on reward contingency.

    PubMed

    Cordeiro, Karina Kohn; Jiang, Wei; Papazoglou, Anna; Tenório, Sérgio Bernardo; Döbrössy, Máté; Nikkhah, Guido

    2010-10-15

    The Staircase test measures lateralised deficits in skilled paw reaching in rodents, and there is a long-standing discrepancy in the literature on whether the paradigm is sensitive to graft-mediated functional recovery in the rodent model of Parkinson's disease. The aim of the current study was to evaluate the critical influence of test conditions like pellet density on dopamine-dependent graft-mediated functional recovery. Rats were pre-trained on the Staircase test with a configuration of 8 pellets in each of the 6 wells bilaterally prior to receiving unilateral 6-OHDA lesions of the medial forebrain bundle. Later, the lesioned animals received E14 VM grafts into the striatum, and were tested on the Staircase test under one of two test configurations: bilaterally, either with 10 (HIGH) or with 2 (LOW) pellets per well. Subsequent sessions included unilateral forced-choice testing under the same pellet configuration, and second bilateral and forced-choice sessions with the pellet density configurations switched around between the groups (Cross-over). Animals were also tested on the Corridor and the Cylinder test, and subjected to drug-induced rotation. Graft-mediated functional recovery was observed in the pellets taken criteria only under the HIGH pellet configuration during the bilateral and the forced choice condition. When tested under the LOW configuration, the graft provided no measurable benefit. The presence of VM grafts reduced lateralised motor deficits in the Cylinder test, the adjacent version of the Corridor test, and drug-induced rotation. Our results confirm that VM transplants can partially restore skilled forelimb sensorimotor deficits under specific testing configuration. PMID:20394782

  1. A New Method for Xenogeneic Bone Graft Deproteinization: Comparative Study of Radius Defects in a Rabbit Model

    PubMed Central

    Lei, Pengfei; Sun, Rongxin; Wang, Long; Zhou, Jialin; Wan, Lifei; Zhou, Tianjian; Hu, Yihe

    2015-01-01

    Background and Objectives Deproteinization is an indispensable process for the elimination of antigenicity in xenograft bones. However, the hydrogen peroxide (H2O2) deproteinized xenograft, which is commonly used to repair bone defect, exhibits limited osteoinduction activity. The present study was designed to develop a new method for deproteinization and compare the osteogenic capacities of new pepsin deproteinized xenograft bones with those of conventional H2O2 deproteinized ones. Methods Bones were deproteinized in H2O2 or pepsin for 8 hours. The morphologies were compared by HE staining. The content of protein and collagen I were measured by the Kjeldahl method and HPLC-MS, respectively. The physical properties were evaluated by SEM and mechanical tests. For in vivo study, X-ray, micro-CT and HE staining were employed to monitor the healing processes of radius defects in rabbit models transplanted with different graft materials. Results Compared with H2O2 deproteinized bones, no distinct morphological and physical changes were observed. However, pepsin deproteinized bones showed a lower protein content, and a higher collagen content were preserved. In vivo studies showed that pepsin deproteinized bones exhibited better osteogenic performance than H2O2 deproteinized bones, moreover, the quantity and quality of the newly formed bones were improved as indicated by micro-CT analysis. From the results of histological examination, the newly formed bones in the pepsin group were mature bones. Conclusions Pepsin deproteinized xenograft bones show advantages over conventional H2O2 deproteinized bones with respect to osteogenic capacity; this new method may hold potential clinical value in the development of new biomaterials for bone grafting. PMID:26719896

  2. Effects of Local Administration of Boric Acid on Posterolateral Spinal Fusion with Autogenous Bone Grafting in a Rodent Model.

    PubMed

    Kömürcü, Erkam; Özyalvaçlı, Gülzade; Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Cevizci, Sibel; Adam, Gürhan; Ozden, Raif

    2015-09-01

    Spinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p = 0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft + BA practice increased the histopathological score significantly with regard to the control group (p = 0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p = 0.328 and p = 0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body. PMID:25728510

  3. Allogeneic Versus Autologous Derived Cell Sources for Use in Engineered Bone-Ligament-Bone Grafts in Sheep Anterior Cruciate Ligament Repair

    PubMed Central

    Mahalingam, Vasudevan D.; Behbahani-Nejad, Nilofar; Horine, Storm V.; Olsen, Tyler J.; Smietana, Michael J.; Wojtys, Edward M.; Wellik, Deneen M.; Arruda, Ellen M.

    2015-01-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use. PMID:25397361

  4. Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

    PubMed

    Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

    2015-03-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use. PMID:25397361

  5. Reconstruction of chronic patellar tendon rupture with contralateral BTB autograft: a case report.

    PubMed

    Milankov, Miroslav Z; Miljkovic, Natasa; Stankovic, Milan

    2007-12-01

    Chronic patellar tendon rupture is a rare disabling injury that is technically difficult to repair. Many different surgical methods have been reported for the reconstruction of chronic patellar tendon ruptures. We are reporting the use of contralateral bone-tendon-bone (BTB) autograft for chronic patellar tendon rupture reconstruction followed by double-wire loop reinforcement and without postoperative immobilization. One year after the operation, our patient had full knee extension and up to 130 degrees of flexion. He had good quadriceps strength, and isokinetic muscle testing showed no deficit comparing to his right leg. Patient returned to playing basketball in his spare time, without having any limitation. PMID:17579835

  6. Preclinical models of acute and chronic graft-versus-host disease: how predictive are they for a successful clinical translation?

    PubMed

    Zeiser, Robert; Blazar, Bruce R

    2016-06-23

    Despite major advances in recent years, graft-versus-host disease (GVHD) remains a major life-threatening complication of allogeneic hematopoietic cell transplantation (allo-HCT). To improve our therapeutic armory against GVHD, preclinical evidence is most frequently generated in mouse and large animal models of GVHD. However, because every model has shortcomings, it is important to understand how predictive the different models are and why certain findings in these models could not be translated into the clinic. Weaknesses of the animal GVHD models include the irradiation only-based conditioning regimen, the homogenous donor/recipient genetics in mice, canine or non-human primates (NHP), anatomic site of T cells used for transfer in mice, the homogenous microbial environment in mice housed under specific pathogen-free conditions, and the lack of pharmacologic GVHD prevention in control groups. Despite these major differences toward clinical allo-HCT, findings generated in animal models of GVHD have led to the current gold standards for GVHD prophylaxis and therapy. The homogenous nature of the preclinical models allows for reproducibility, which is key for the characterization of the role of a new cytokine, chemokine, transcription factor, microRNA, kinase, or immune cell population in the context of GVHD. Therefore, when carefully balancing reasons to apply small and large animal models, it becomes evident that they are valuable tools to generate preclinical hypotheses, which then have to be rigorously evaluated in the clinical setting. In this study, we discuss several clinical approaches that were motivated by preclinical evidence, novel NHP models and their advantages, and highlight the recent advances in understanding the pathophysiology of GVHD. PMID:26994149

  7. The Effects of Exendin-4 Treatment on Graft Failure: An Animal Study Using a Novel Re-Vascularized Minimal Human Islet Transplant Model

    PubMed Central

    Sahraoui, Afaf; Winzell, Maria Sörhede; Gorman, Tracy; Smith, Dave M.; Skrtic, Stanko; Hoeyem, Merete; Abadpour, Shadab; Johansson, Lars; Korsgren, Olle; Foss, Aksel; Scholz, Hanne

    2015-01-01

    Islet transplantation has become a viable clinical treatment, but is still compromised by long-term graft failure. Exendin-4, a glucagon-like peptide 1 receptor agonist, has in clinical studies been shown to improve insulin secretion in islet transplanted patients. However, little is known about the effect of exendin-4 on other metabolic parameters. We therefore aimed to determine what influence exendin-4 would have on revascularized minimal human islet grafts in a state of graft failure in terms of glucose metabolism, body weight, lipid levels and graft survival. Introducing the bilateral, subcapsular islet transplantation model, we first transplanted diabetic mice with a murine graft under the left kidney capsule sufficient to restore normoglycemia. After a convalescent period, we performed a second transplantation under the right kidney capsule with a minimal human islet graft and allowed for a second recovery. We then performed a left-sided nephrectomy, and immediately started treatment with exendin-4 with a low (20μg/kg/day) or high (200μg/kg/day) dose, or saline subcutaneously twice daily for 15 days. Blood was sampled, blood glucose and body weight monitored. The transplanted human islet grafts were collected at study end point and analyzed. We found that exendin-4 exerts its effect on failing human islet grafts in a bell-shaped dose-response curve. Both doses of exendin-4 equally and significantly reduced blood glucose. Glucagon-like peptide 1 (GLP-1), C-peptide and pro-insulin were conversely increased. In the course of the treatment, body weight and cholesterol levels were not affected. However, immunohistochemistry revealed an increase in beta cell nuclei count and reduced TUNEL staining only in the group treated with a low dose of exendin-4 compared to the high dose and control. Collectively, these results suggest that exendin-4 has a potential rescue effect on failing, revascularized human islets in terms of lowering blood glucose, maintaining beta

  8. Long-term in vivo regeneration of peripheral nerves through bioengineered nerve grafts.

    PubMed

    di Summa, P G; Kalbermatten, D F; Pralong, E; Raffoul, W; Kingham, P J; Terenghi, G

    2011-05-01

    Although autologous nerve graft is still the first choice strategy in nerve reconstruction, it has the severe disadvantage of the sacrifice of a functional nerve. Cell transplantation in a bioartificial conduit is an alternative strategy to improve nerve regeneration. Nerve fibrin conduits were seeded with various cell types: primary Schwann cells (SC), SC-like differentiated bone marrow-derived mesenchymal stem cells (dMSC), SC-like differentiated adipose-derived stem cells (dASC). Two further control groups were fibrin conduits without cells and autografts. Conduits were used to bridge a 1 cm rat sciatic nerve gap in a long term experiment (16 weeks). Functional and morphological properties of regenerated nerves were investigated. A reduction in muscle atrophy was observed in the autograft and in all cell-seeded groups, when compared with the empty fibrin conduits. SC showed significant improvement in axon myelination and average fiber diameter of the regenerated nerves. dASC were the most effective cell population in terms of improvement of axonal and fiber diameter, evoked potentials at the level of the gastrocnemius muscle and regeneration of motoneurons, similar to the autografts. Given these results and other advantages of adipose derived stem cells such as ease of harvest and relative abundance, dASC could be a clinically translatable route towards new methods to enhance peripheral nerve repair. PMID:21371534

  9. MR imaging of osteochondral grafts and autologous chondrocyte implantation

    PubMed Central

    Millington, S. A.; Szomolanyi, P.; Marlovits, S.

    2006-01-01

    Surgical articular cartilage repair therapies for cartilage defects such as osteochondral autograft transfer, autologous chondrocyte implantation (ACI) or matrix associated autologous chondrocyte transplantation (MACT) are becoming more common. MRI has become the method of choice for non-invasive follow-up of patients after cartilage repair surgery. It should be performed with cartilage sensitive sequences, including fat-suppressed proton density-weighted T2 fast spin-echo (PD/T2-FSE) and three-dimensional gradient-echo (3D GRE) sequences, which provide good signal-to-noise and contrast-to-noise ratios. A thorough magnetic resonance (MR)-based assessment of cartilage repair tissue includes evaluations of defect filling, the surface and structure of repair tissue, the signal intensity of repair tissue and the subchondral bone status. Furthermore, in osteochondral autografts surface congruity, osseous incorporation and the donor site should be assessed. High spatial resolution is mandatory and can be achieved either by using a surface coil with a 1.5-T scanner or with a knee coil at 3 T; it is particularly important for assessing graft morphology and integration. Moreover, MR imaging facilitates assessment of complications including periosteal hypertrophy, delamination, adhesions, surface incongruence and reactive changes such as effusions and synovitis. Ongoing developments include isotropic 3D sequences, for improved morphological analysis, and in vivo biochemical imaging such as dGEMRIC, T2 mapping and diffusion-weighted imaging, which make functional analysis of cartilage possible. PMID:16802126

  10. Chronic graft-versus-host disease in the rat radiation chimera. III. Immunology and immunopathology in rapidly induced models

    SciTech Connect

    Beschorner, W.E.; Tutschka, P.J.; Santos, G.W.

    1983-03-01

    Although chronic graft-versus-host disease (GVHD) frequently develops in the long-term rat radiation chimera, we present three additional models in which a histologically similar disease is rapidly induced. These include adoptive transfer of spleen and bone marrow from rats with spontaneous chronic GVHD into lethally irradiated rats of the primary host strain; sublethal irradiation of stable chimeras followed by a booster transplant; and transfer of spleen cells of chimeras recovering from acute GVHD into second-party (primary recipient strain) or third-party hosts. Some immunopathologic and immune abnormalities associated with spontaneous chronic GVHD were not observed in one or more of the induced models. Thus, IgM deposition in the skin, antinuclear antibodies, and vasculitis appear to be paraphenomena. On the other hand, lymphoid hypocellularity of the thymic medulla, immaturity of splenic follicles, and nonspecific suppressor cells were consistently present in the long term chimeras, and in all models. These abnormalities therefore may be pathogenetically important, or closely related to the development of chronic GVHD.

  11. Autograft HIV-DNA load predicts HIV-1 peripheral reservoir after stem cell transplantation for AIDS-related lymphoma patients.

    PubMed

    Zanussi, Stefania; Bortolin, Maria Teresa; Pratesi, Chiara; Tedeschi, Rosamaria; Basaglia, Giancarlo; Abbruzzese, Luciano; Mazzucato, Mario; Spina, Michele; Vaccher, Emanuela; Tirelli, Umberto; Rupolo, Maurizio; Michieli, Mariagrazia; Di Mascio, Michele; De Paoli, Paolo

    2015-01-01

    Autologous stem cell transplantation (ASCT) is a widely used procedure for AIDS-related lymphomas, and it represents an opportunity to evaluate strategies curing HIV-1 infection. The association of autograft HIV-DNA load with peripheral blood HIV-1 reservoir before ASCT and its contribution in predicting HIV-1 reservoir size and stability during combination antiretroviral therapy (cART) after transplantation are unknown. Aiming to obtain information suggesting new functional cure strategies by ASCT, we retrospectively evaluated HIV-DNA load in autograft and in peripheral blood before and after transplantation in 13 cART-treated HIV-1 relapse/refractoring lymphoma patients. Among them seven discontinued cART after autograft infusion. HIV-DNA was evaluated by a sensitive quantitative real-time polymerase chain reaction (PCR). After debulking chemotherapy/mobilization, the autograft HIV-1 reservoir was higher than and not associated with the peripheral HIV-1 reservoir at baseline [median 215 HIV-DNA copies/10(6) autograft mononuclear cells, range 13-706 vs. 82 HIV-DNA copies/10(6) peripheral blood mononuclear cells (PBMCs), range 13-479, p = 0.03]. After high dose chemotherapy and autograft infusion, HIV-DNA levels reached a plateau between month 6 and 12 of follow-up. No association was found between peripheral HIV-DNA levels at baseline and after infusion in both cART interrupting and not interrupting patients. Only in the last subgroup, a stable significant linear association between autograft and peripheral blood HIV-1 reservoir emerged from month 1 (R(2) = 0.84, p = 0.01) to month 12 follow-up (R(2) = 0.99, p = 0.0005). In summary, autograft HIV-1 reservoir size could be influenced by the mobilization phase and predicts posttransplant peripheral HIV-1 reservoir size in patients on continuous cART. These findings could promote new research on strategies reducing the HIV-1 reservoir by using the ASCT procedure. PMID:25581618

  12. Vertical and horizontal ridge augmentation in anterior maxilla using autograft, xenograft and titanium mesh with simultaneous placement of endosseous implants

    PubMed Central

    Deshpande, Sudhendra; Deshmukh, Jeevanand; Deshpande, Sumeet; Khatri, Richa; Deshpande, Shubha

    2014-01-01

    Endosseous implants have revolutionized the field of Implants and Periodontics. Implant placement is a viable option in the treatment of partial and full edentulism. However, placement of implants in alveolar deficiencies may lead to adverse angulations, mechanical overload and esthetic dissatisfaction. When minimum dimensions for implant placement are not present in alveolar process, it is necessary to augment the size of the ridge. This can be achieved by various methods and materials. Here we present a successful case of vertical and horizontal ridge augmentation in anterior maxilla using autograft, xenograft and titanium mesh with simultaneous placement of implants, where autograft was obtained from the same site avoiding secondary surgical site. PMID:25425833

  13. Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

    PubMed Central

    2012-01-01

    Background If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique. Methods Fifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs. Results Good overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003). According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05). Conclusions ACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for

  14. The A9 dopamine neuron component in grafts of ventral mesencephalon is an important determinant for recovery of motor function in a rat model of Parkinson's disease.

    PubMed

    Grealish, Shane; Jönsson, Marie E; Li, Meng; Kirik, Deniz; Björklund, Anders; Thompson, Lachlan H

    2010-02-01

    Grafts of foetal ventral mesencephalon, used in cell replacement therapy for Parkinson's disease, are known to contain a mix of dopamine neuronal subtypes including the A9 neurons of the substantia nigra and the A10 neurons of the ventral tegmental area. However, the relative importance of these subtypes for functional repair of the brain affected by Parkinson's disease has not been studied thoroughly. Here, we report results from a series of grafting experiments where the anatomical and functional properties of grafts either selectively lacking in A9 neurons, or with a typical A9/A10 composition were compared. The results show that the A9 component of intrastriatal grafts is of critical importance for recovery in tests on motor performance, in a rodent model of Parkinson's disease. Analysis at the histological level indicates that this is likely to be due to the unique ability of A9 neurons to innervate and functionally activate their target structure, the dorsolateral region of the host striatum. The findings highlight dopamine neuronal subtype composition as a potentially important parameter to monitor in order to understand the variable nature of functional outcome better in transplantation studies. Furthermore, the results have interesting implications for current efforts in this field to generate well-characterized and standardized preparations of transplantable dopamine neuronal progenitors from stem cells. PMID:20123725

  15. Neuropeptide Treatment with Cerebrolysin Enhances the Survival of Grafted Neural Stem Cell in an α-Synuclein Transgenic Model of Parkinson’s Disease

    PubMed Central

    Rockenstein, Edward; Desplats, Paula; Ubhi, Kiren; Mante, Michael; Florio, Jazmin; Adame, Anthony; Winter, Stefan; Brandstaetter, Hemma; Meier, Dieter; Moessler, Herbert; Masliah, Eliezer

    2015-01-01

    Neuronal stem cell (NSC) grafts have been investigated as a potential neuro-restorative therapy in Parkinson’s disease (PD) but their use is compromised by the death of grafted cells. We investigated the use of Cerebrolysin (CBL), a neurotrophic peptide mixture, as an adjunct to NSC therapy in the α-synuclein (α-syn) transgenic (tg) model of PD. In vehicle-treated α-syn tg mice, there was decreased survival of NSCs. In contrast, CBL treatment enhanced the survival of NSCs in α-syn tg groups and ameliorated behavioral deficits. The grafted NSCs showed lower levels of terminal deoxynucleotidyl transferase dUTP nick end labeling positive cells in the CBL-treated mice when compared with vehicle-treated α-syn tg mice. No evidence of tumor growth was detected. Levels of α-syn were similar in the vehicle in CBL-treated tg mice. In conclusion, CBL treatment might be a potential adjuvant for therapeutic NSC grafting in PD. PMID:27429559

  16. Cartilage defect of lunate facet of distal radius after fracture treated with osteochondral autograft from knee.

    PubMed

    Mall, Nathan A; Rubin, David A; Brophy, Robert H; Goldfarb, Charles A

    2013-07-01

    We describe using an osteochondral autograft from the lateral femoral condyle of the knee to treat a symptomatic die-punch lesion of the lunate facet of the distal radius. An 18-year-old woman who sustained a distal radius fracture remained symptomatic after nonoperative treatment and diagnostic wrist arthroscopy with microfracture. We used a commercial harvesting system to transfer an osteochondral plug into a cartilage defect involving the lunate facet of the distal radius. At final follow-up, 34 months after surgery, the patient was assessed with a visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores and with a comprehensive physical examination. Magnetic resonance arthrogram was used to assess articular cartilage status. VAS pain score improved from 7 before surgery to 0.5 after surgery. Postoperative DASH score was 0. The patient was asymptomatic and had satisfactory wrist motion without mechanical symptoms. Magnetic resonance arthrogram showed the transferred osteochondral autograft incorporated in excellent position. PMID:24078947

  17. Evaluation of small intestinal submucosa grafts for meniscal regeneration in a clinically relevant posterior meniscectomy model in dogs.

    PubMed

    Cook, James L; Fox, Derek B; Malaviya, Prasanna; Tomlinson, James L; Farr, Jack; Kuroki, Keiichi; Cook, Cristi Reeves

    2006-07-01

    Large meniscal defects are a common problem for which treatment options are limited. Successful meniscal regeneration has been achieved by using grafts of small intestinal submucosa in posterior, vascular meniscal defects in a dog model. This study investigates the long-term effects of a tibial tunnel fixation technique and a clinically based meniscectomy defect on meniscal regeneration using this model. Eight mongrel dogs underwent medial arthrotomy and partial meniscectomy. The dogs were divided into groups based on defect treatment: small intestinal submucosa (n = 4) or meniscectomy (n = 4). Dogs were scored for lameness by subjective scoring postoperatively, sacrificed at 6 months, and assessed for articular cartilage damage, gross and histologic appearance of the operated meniscus, amount of new tissue in the defect, and relative compressive stiffness of articular cartilage. Dogs in the meniscectomy group were significantly (P = .002) more lame than dogs treated with small intestinal submucosa. Small intestinal submucosa-treated joints had significantly (P = .01) less articular cartilage damage than meniscectomy joints. Small intestinal submucosa meniscal implants resulted in production of meniscal-like replacement tissue, which was consistently superior to meniscectomy in amount, type, and integration of new tissue, chondroprotection, and limb function during the study period. Small intestinal submucosa implants may be useful for treatment of large posterior vascular meniscal defects in humans. The tibial tunnel technique used for fixation may have clinical advantages and therefore warrants further investigation. PMID:16893153

  18. Disease Severity and Mortality Can Be Independently Regulated in a Mouse Model of Experimental Graft versus Host Disease

    PubMed Central

    Galvani, Rômulo G.; Lemos, Ramon; Areal, Rômulo B.; Salvador, Pollyanna A.; Zamboni, Dario S.; Wanderley, João Luiz M.; Bonomo, Adriana

    2015-01-01

    Graft versus host disease (GVHD) is the major limitation of allogeneic hematopoietic stem cell transplantation (HSCT) presenting high mortality and morbidity rates. However, the exact cause of death is not completely understood and does not correlate with specific clinical and histological parameters of disease. Here we show, by using a semi-allogeneic mouse model of GVHD, that mortality and morbidity can be experimentally separated. We injected bone marrow-derived dendritic cells (BMDC) from NOD2/CARD15-deficient donors into semi-allogeneic irradiated chimaeras and observed that recipients were protected from death. However, no protection was observed regarding clinical or pathological scores up to 20 days after transplantation. Protection from death was associated with decreased bacterial translocation, faster hematologic recovery and epithelial integrity maintenance despite mononuclear infiltration at day 20 post-GVHD induction with no skew towards different T helper phenotypes. The protected mice recovered from aGVHD and progressively reached scores compatible with healthy animals. Altogether, our data indicate that severity and mortality can be separate events providing a model to study transplant-related mortality. PMID:25643148

  19. Quercitrin ameliorates the development of systemic lupus erythematosus-like disease in a chronic graft-versus-host murine model.

    PubMed

    Li, Wei; Li, Hu; Zhang, Mu; Wang, Mengqi; Zhong, Youxiu; Wu, Hezhen; Yang, Yanfang; Morel, Laurence; Wei, Qun

    2016-07-01

    Systemic lupus erythematosus (SLE) is a serious disorder of immune regulation characterized by overproduction of autoantibodies, lupus nephritis, CD4+ T cell aberrant activation, and immune complex-mediated inflammation. The chronic graft vs. host disease (cGVHD) mouse model is a well-established model of SLE. Quercitrin is a natural compound found in Tartary buckwheat with a potential anti-inflammatory effect that is used to treat heart and vascular conditions. In our previous study, we determined that quercitrin is an immunosuppressant with beneficial effects in mouse models of immune diseases. We hypothesized that quercitrin could prevent lupus nephritis in the cGVHD mouse model by decreasing the production of autoantibodies and inflammatory cytokines, and reducing immune cell activation. cGVHD was induced by injecting DBA/2 spleen cells into the tail vein of BDF1 mice. The cGVHD mice exhibited significant proteinuria, which is a marker of nephritis. Quercitrin decreased the number of serum antibodies, CD4+ T cell activation, as well as the expression levels of T-bet, GATA-3, and selected cytokines. Moreover, quercitrin treatment decreased the expression of inflammatory genes and cytokines in the kidney, as well as in peritoneal macrophages. In addition, quercitrin inhibited LPS-induced cytokines as well as the phosphorylation of ERK, p38 MAPK, and JNK in Raw264.7 cells. Overall, quercitrin ameliorated the symptoms of lupus nephritis in the cGVHD mouse model, which may be due to the inhibition of CD4 T cell activation and anti-inflammatory effects on macrophages. PMID:26911849

  20. Prevalence of Endogenous CD34+ Adipose Stem Cells Predicts Human Fat Graft Retention in a Xenograft Model

    PubMed Central

    Philips, Brian J.; Grahovac, Tara L.; Valentin, Jolene E.; Chung, Christopher W.; Bliley, Jacqueline M.; Pfeifer, Melanie E.; Roy, Sohini B.; Dreifuss, Stephanie; Kelmendi-Doko, Arta; Kling, Russell E.; Ravuri, Sudheer K.; Marra, Kacey G.; Donnenberg, Vera S.; Donnenberg, Albert D.; Rubin, J. Peter

    2014-01-01

    Background Fat grafting is a promising technique for soft-tissue augmentation, although graft retention is highly unpredictable and factors that affect graft survival have not been well defined. Because of their capacity for differentiation and growth factor release, adipose-derived stem cells may have a key role in graft healing. The authors’ objective was to determine whether biological properties of adipose-derived stem cells present within human fat would correlate with in vivo outcomes of graft volume retention. Methods Lipoaspirate from eight human subjects was processed using a standardized centrifugation technique and then injected subcutaneously into the flanks of 6-week-old athymic nude mice. Graft masses and volumes were measured, and histologic evaluation, including CD31+ staining for vessels, was performed 8 weeks after transplantation. Stromal vascular fraction isolated at the time of harvest from each subject was analyzed for surface markers by multi-parameter flow cytometry, and also assessed for proliferation, differentiation capacity, and normoxic/hypoxic vascular endothelial growth factor secretion. Results Wide variation in percentage of CD34+ progenitors within the stromal vascular fraction was noted among subjects and averaged 21.3 ± 15 percent (mean ± SD). Proliferation rates and adipogenic potential among stromal vascular fraction cells demonstrated moderate interpatient variability. In mouse xenograft studies, retention volumes ranged from approximately 36 to 68 percent after 8 weeks, with an overall average of 52 ± 11 percent. A strong correlation (r = 0.78, slope = 0.76, p < 0.05) existed between stromal vascular fraction percentage of CD34+ progenitors and high graft retention. Conclusion Inherent biological differences in adipose tissue exist between patients. In particular, concentration of CD34+ progenitor cells within the stromal vascular fraction may be one of the factors used to predict human fat graft retention. (Plast

  1. Comparison of the Human Bone Matrix Gelatin (HBMG) with Autogenous Bone Graft in Reconstruction of the Parietal Bone Defects in Rat: A Histological and Radiographic Study

    PubMed Central

    Shahoon, Hossein; Azimi, Hamid Reza; Kianbakht, Camellia

    2009-01-01

    Background and aims Autogenous bone graft is commonly used for reconstruction of bone defects in routine surgical procedures. The complexity of producing bone grafts and their application has lead to the use of human bone matrix gelatin (HBMG). The present study was conducted to compare the efficacy of HBMG and autograft on the reconstruction of bone defects in rats. Materials and methods In this cross-sectional, experimental study, two defects were put on left and right sides of parietal bone of rats. HBMG was placed randomly on defects of one side and autograft in the defects of the other side. All specimens were assessed and compared with each other according to histological and radiographic characteristics. Other assessments included amount and the rate of bone formation, inflammation signs, fibrosis tissue and cartilage formation and also radio-graphic characteristics of grafts, assessed by digital and film-based methods. Mann-Whitney U test was used for statistical analysis. Results The results showed a reduction of inflammation and an increase in new bone formation in both groups in 7, 14, 28 and 60 days after surgery. Bone formation with HBMG on day 24 was more than autograft. However, there was no sig-nificant difference between the groups on day 60. Superiority of digital method to film-based method of imaging was also observed. Conclusion Although HBMG has the same efficacy as autograft, the rate of bone reconstruction with HBMG is higher. HBMG also induces focal, rather than peripheral, bone construction in the defect. PMID:23230480

  2. An equivalent astable multivibrator model to assess flow instability and dysfunction risk in in-vitro stenotic arteriovenous grafts.

    PubMed

    Lin, Chia-Hung; Kan, Chung-Dann; Chen, Wei-Ling; Wu, Ming-Jui; Yu, Fan-Ming

    2016-05-18

    Narrowed vessel accesses produce blood flow changes, and induce flow instability and vessel wall vibration, resulting in blood pressure, flow velocity, and flow resistance increases. The vessel wall vibrates and propagates the low axial blood flow, as representing the resistance (R) to blood flow. The compliance is a blood pressure-blood volume relation, representing the systole and diastole capacity of the blood vessel. These dynamic behaviors increase blood flow resistances and reduce blood vessel compliances. Vibration phenomena result on the elastic vessel walls and induce simple harmonic motion due to transverse vibration pressure (TVP). The rise time, amplitude, and pulse duration of transverse waves are determined by the flow resistances (R) and vessel compliances (C). Thus, a stenotic arteriovenous access has high resistance and low compliance, which can be expressed an astable multivibrator as an equivalent model consisting of a lumped resistor (R) and a lumped capacitor (C). TVP's oscillation frequency, rise time, and amplitude are determined by the flow resistances and vessel compliances. Hence, an astable multivibrator is used to model TVP parameters to estimate negative time constants, τ=(R× C), which are used to evaluate the flow instability and the dysfunction risk in in-vitro arteriovenous grafts (AVGs). Experimental results show the average negative time constants have the positive correlation as the degree of stenosis (DOS) increases (R2 = 0.8944), and their variations with the flow resistance and vessel compliance are also validated. Positive pole values, s=(-1/τ), are used to show that the force responses of the vessel walls grow in a finite time, 0.5415 ± 7.60 × 10-3 sec, and the equivalent model would be also unstable as DOS increases (R2 = 0.8802). By comparison with hemodynamic analysis, the finding of proposed model can be further carried out for screening AVG dysfunction risk during hemodialysis treatment. PMID:26835723

  3. The Effect of Hyaluronate-Carboxymethyl Cellulose on Bone Graft Substitute Healing in a Rat Spinal Fusion Model

    PubMed Central

    Lee, Jung Hee

    2011-01-01

    Objective The aim of this study was to evaluate the impact of sodium hyaluronate-sodium carboxymethyl cellulose (HA-CMC), an anti-adhesive material for spinal surgery, on bone fusion by applying it to rat spinal models after lumbar posterolateral fusion. Methods Lumbar posterolateral fusion was performed at L4-5 using bone graft substitutes in 30 rats. HA-CMC was injected in 15 rats at a dose of 0.2 cc (HA-CMC group) and a saline solution of 0.2 cc in the other 15 rats (control group). Simple radiographs were taken until postoperative 9 weeks with an interval of one week. At postoperative 4 and 9 weeks, three dimensional computed tomography (3D CT) scanning was performed to observe the process of bone fusion. At 9 weeks, bone fusion was confirmed by gross examination and manual palpation. Results There were no statistically significant differences in bone fusion between the two groups. 3D CT scanning did not reveal significant differences between the groups. The gross examination and manual palpation after autopsy performed at 9 weeks confirmed bone union in 93.3% of both groups. Conclusion The anti-adhesive material used for spinal surgery did not have adverse effects on spinal fusion in rats. PMID:22259686

  4. Inhibition of EGFR Tyrosine Kinase by Erlotinib Prevents Sclerodermatous Graft-Versus-Host Disease in a Mouse Model.

    PubMed

    Morin, Florence; Kavian, Niloufar; Marut, Wioleta; Chéreau, Christiane; Cerles, Olivier; Grange, Philippe; Weill, Bernard; Nicco, Carole; Batteux, Frédéric

    2015-10-01

    Chronic graft-versus-host disease (GVHD) follows allogeneic hematopoietic stem cell transplantation. It results from alloreactive processes induced by minor histocompatibility antigen incompatibilities leading to the activation of CD4 T cells and the development of fibrosis and inflammation of the skin and visceral organs and autoimmunity that resemble systemic sclerosis. EGFR is a ubiquitous cell receptor deeply involved in cell proliferation, differentiation, and motility. EGFR has recently been implicated in autoimmune and fibrotic diseases. Therefore, we tested whether Erlotinib, an EGFR tyrosine kinase inhibitor, can prevent sclerodermatous GVHD (Scl-GVHD). Scl-GVHD was induced in BALB/c mice by B10.D2 bone marrow and spleen cell transplantation. Transplanted mice displayed severe clinical symptoms including alopecia, fibrosis of the skin and visceral organs, vasculitis, and diarrhea. The symptoms were reversed in mice treated with Erlotinib. These beneficial effects were mediated by the decreased production of activated/memory CD4(+) T cells and the reduction in T-cell infiltration of the skin and visceral organs along with a decrease in IFN-γ and IL-13 production and autoimmune B-cell activation. The improvement provided by Erlotinib in the mouse model of Scl-GVHD supplies a rationale for the evaluation of Erlotinib in the management of patients affected by chronic GVHD. PMID:25938558

  5. Graft compliance and anastomotic flow patterns.

    PubMed

    Wang, L C; Guo, G X; Tu, R; Hwang, N H

    1990-01-01

    The oscillatory flow patterns at the venous anastomosis of a hemodialysis angioaccess loop graft system were studied using two new compliant vascular prostheses: a longitudinally compliant polytetrafluoroethylene-composite (Baxter Ultraflex PTFE-Plus) graft (BA) and a radially compliant ultrafine polyester fiber (TORAY-UFPF) graft (TR). A non-compliant Gore-Tex polytetrafluoroethylene graft was used as the control. The experimental grafts were 8 mm inside diameter x 25 cm long. Flow experiments were done in a transparent, elastic bench-top flow model; fabrication was based on silicone rubber casts obtained from femoral-to-femoral arteriovenous loop grafts surgically implanted in dogs. The loop graft constructed in the dog model was made to mimic the branchial-to-cephalic angioaccess loop graft commonly used in hemodialysis patients. The flow model was connected to a pulse generator, an adjustable arterial afterload, and a venous afterload. Under identical input conditions, the pressure and flow waveforms were monitored simultaneously at the proximal and distal ends of both the arterial and venous anastomoses. For each graft studied, the anastomotic flow field was visualized using laser illuminated hydrogen bubbles as tracers. At pulse rates of 60 and 90 beats/min, graft flow rates were 2.2 and 2.5 L/min, respectively. Among the grafts studied, measurable differences in pressure and flow wave attenuation and their respective phase lags resulted in characteristically dissimilar flow patterns at the venous anastomosis. Growth of the separation zone at the toe of the anastomosis, and the pattern of retrograde flow in the distal vein are visibly different in all three grafts. PMID:2340213

  6. Lapidus arthrodesis plus osteochondral autograft transplantation in the management of hallux rigidus with an elevated first ray.

    PubMed

    Klos, Kajetan; Simons, Paul

    2014-04-01

    The range of joint-sparing treatments for advanced hallux rigidus is still very limited. The authors describe an osteochondral autograft transplantation technique combined with Lapidus arthrodesis as a novel method of obtaining a relatively symptom-free first metatarsophalangeal joint function in patients with hallux rigidus and first-ray elevation. PMID:24379451

  7. [Elimination of isolated gingival atrophy by laterally positioned flap and free mucogingival autografts in combination with coronally positioned flap].

    PubMed

    Kovaćević, K; Leković, V

    1991-01-01

    Mucogingival surgical procedures such as laterally (horizontally) positioned flap, double papillae positioned flap and free mucogingival autografts have been recommended for the prevention and treatment of isolated gingival atrophy. These procedures can bi performed either independently or in combination with coronally positioned flap. In our study, for covering of exposed tooth roots, we applied laterally positioned flap and free mucogingival autografts in combination with coronally positioned flap. The obtained therapeutic results showed that six months after the surgery the exposure of tooth necks in patients treated by laterally positioned flap, decreased by 2.54 mm. Somewhat better results were obtained in the group of patients treated by fre mucogingival autografts in combination with coronally positioned flap. Within the same time interval, the total surface area of exposed tooth roots decreased by 59.76% in the group of patients treated by laterally positioned flap, i.e. by 62.25% in the group of patients treated by free mucogingival autografts in combination with coronally positioned flap. PMID:1785128

  8. Deformation mechanisms of electrostrictive graft elastomer

    NASA Astrophysics Data System (ADS)

    Wang, Youqi; Sun, Changjie; Zhou, Eric; Su, Ji

    2004-12-01

    The electrostrictive graft elastomer is a new type of electroactive polymer. Recently developed by NASA, it consists of flexible backbone chains, each with side chains, called grafts. Neighboring backbone grafts physically cross-link and form crystal units. The flexible backbone chain and the crystal graft unit consist of polarized monomers, which contain atoms with electric partial charges, generating dipole moments. When the elastomer is placed into an electric field, external rotating moments are applied to the dipole moment. This stimulates electrostrictive strain in the graft elastomer. In this paper, the deformation of the elastomer under the action of an electric field is explained by means of two dominant mechanisms: crystal graft unit rotation and backbone chain reorientation. A two-dimensional computational model is established to analyze the deformation.

  9. Sphincter Contractility After Muscle-Derived Stem Cells Autograft into the Cryoinjured Anal Sphincters of Rats

    PubMed Central

    Kang, Sung-Bum; Lee, Haet Nim; Lee, Ji Young; Park, Jun-Seok; Lee, Hye Seung

    2008-01-01

    Purpose This study was designed to determine whether the injection of muscle-derived stem cells into the anal sphincter can improve functional properties in a fecal incontinence rat model. Methods Cryoinjured rats were utilized as a fecal incontinence model. The gastrocnemius muscles of normal three-week-old female Sprague-Dawley rats were used for the purification of the muscle-derived stem cells. The experimental group was divided into three subgroups: normal control; cryoinjured; and muscle-derived stem cells (3 × 106 cells) injection group of cryoinjured rats. All groups were subsequently employed in contractility experiments using muscle strips from the anal sphincter, one week after preparation. Results Contractility in the cryoinjured group was significantly lower than in the control after treatment with acetylcholine and KCl. In the muscle-derived stem cells injection group, contraction amplitude was higher than in the cryoinjured group but not significantly (20.5 ± 21.3 vs. 17.3 ± 3.4 g per gram tissue, with acetylcholine (10−4 mol/l); 31 ± 14.2 vs. 18.4 ± 7.9 g per gram tissue, with KCl (10−4 mol/l)). PKH-26-labeled transplanted cells were detected in all of the grafted sphincters. Differentiated muscle masses stained positively for alpha smooth muscle actin and myosin heavy chain at the muscle-derived stem cells injection sites. Conclusions This is the first study reporting that autologous muscle-derived stem cell grafts may be a tool for improving anal sphincter function. PMID:18536965

  10. Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

    SciTech Connect

    Eppley, B.L.; Connolly, D.T.; Winkelmann, T.; Sadove, A.M.; Heuvelman, D.; Feder, J. )

    1991-07-01

    A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically in all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts.

  11. Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI.

    PubMed

    Simpfendorfer, Claus; Miniaci, Anthony; Subhas, Naveen; Winalski, Carl S; Ilaslan, Hakan

    2015-08-01

    Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a "cyclops lesion," on MR imaging. Careful review of the direction of graft fibers on MR imaging in the "pseudocyclops" lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The "pseudocyclops" lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. PMID:25620690

  12. Poor Sleep Quality in Patients after Coronary Artery Bypass Graft Surgery: An Intervention Study Using the PRECEDE-PROCEED Model

    PubMed Central

    Ranjbaran, Soheila; Dehdari, Tahereh; Sadeghniiat-Haghighi, Khosro; Majdabadi, Mahmood Mahmoodi

    2015-01-01

    Abstract Background: Poor sleep quality (SQ) is common among patients after coronary artery bypass graft surgery (CABG). This study attempted to determine the status of SQ following an intervention based on the PRECEDE-PROCEED model in patients with poor SQ after CABG. Methods: This study was a randomized clinical trial. The study sample, including 100 patients referred to the Cardiac Rehabilitation Clinic of Tehran Heart Center, was assigned either to the intervention (recipient of exercise and lifestyle training plus designed intervention based on the PRECEDE-PROCEED model) or to the control group (recipient of exercise and lifestyle training). Eight training sessions over 8 weeks were conducted for the intervention group. Predisposing, enabling, and reinforcing factors as well as social support and SQ were measured in the intervention group before and one month after the intervention and compared to those in the control group at the same time points. Results: The mean age of the patients in the intervention (24% women) and control (24% women) groups was 59.3 ± 7.3 and 59.5 ± 9.3 years, respectively. The results showed that the mean scores of SQ (p value < 0.001), knowledge (p value < 0.001), beliefs (p value < 0.001), sleep self-efficacy (p value < 0.001), enabling factors (p value < 0.001), reinforcing factors (p value < 0.001), and social support (p value < 0.001) were significantly different between the intervention and control groups after the intervention. Conclusion: Adding an intervention based on the PRECEDE-PROCEED model to the cardiac rehabilitation program may further improve the SQ of patients. PMID:26157457

  13. Electrostrictive Graft Elastomers

    NASA Technical Reports Server (NTRS)

    Su, Ji (Inventor); Harrison, Joycelyn S. (Inventor); St.Clair, Terry L. (Inventor)

    2003-01-01

    An electrostrictive graft elastomer has a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules. The polar graft moieties have been rotated by an applied electric field, e.g., into substantial polar alignment. The rotation is sustained until the electric field is removed. In another embodiment, a process for producing strain in an elastomer includes: (a) providing a graft elastomer having a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules; and (b) applying an electric field to the graft elastomer to rotate the polar graft moieties, e.g., into substantial polar alignment.

  14. Human Fetal Brain-Derived Neural Stem/Progenitor Cells Grafted into the Adult Epileptic Brain Restrain Seizures in Rat Models of Temporal Lobe Epilepsy

    PubMed Central

    Lee, Haejin; Yun, Seokhwan; Kim, Il-Sun; Lee, Il-Shin; Shin, Jeong Eun; Park, Soo Chul; Kim, Won-Joo; Park, Kook In

    2014-01-01

    Cell transplantation has been suggested as an alternative therapy for temporal lobe epilepsy (TLE) because this can suppress spontaneous recurrent seizures in animal models. To evaluate the therapeutic potential of human neural stem/progenitor cells (huNSPCs) for treating TLE, we transplanted huNSPCs, derived from an aborted fetal telencephalon at 13 weeks of gestation and expanded in culture as neurospheres over a long time period, into the epileptic hippocampus of fully kindled and pilocarpine-treated adult rats exhibiting TLE. In vitro, huNSPCs not only produced all three central nervous system neural cell types, but also differentiated into ganglionic eminences-derived γ-aminobutyric acid (GABA)-ergic interneurons and released GABA in response to the depolarization induced by a high K+ medium. NSPC grafting reduced behavioral seizure duration, afterdischarge duration on electroencephalograms, and seizure stage in the kindling model, as well as the frequency and the duration of spontaneous recurrent motor seizures in pilocarpine-induced animals. However, NSPC grafting neither improved spatial learning or memory function in pilocarpine-treated animals. Following transplantation, grafted cells showed extensive migration around the injection site, robust engraftment, and long-term survival, along with differentiation into β-tubulin III+ neurons (∼34%), APC-CC1+ oligodendrocytes (∼28%), and GFAP+ astrocytes (∼8%). Furthermore, among donor-derived cells, ∼24% produced GABA. Additionally, to explain the effect of seizure suppression after NSPC grafting, we examined the anticonvulsant glial cell-derived neurotrophic factor (GDNF) levels in host hippocampal astrocytes and mossy fiber sprouting into the supragranular layer of the dentate gyrus in the epileptic brain. Grafted cells restored the expression of GDNF in host astrocytes but did not reverse the mossy fiber sprouting, eliminating the latter as potential mechanism. These results suggest that human fetal

  15. Modified Extracorporeal Photopheresis with Cells from a Healthy Donor for Acute Graft-versus-Host Disease in a Mouse Model

    PubMed Central

    Budde, Holger; Kolb, Susanne; Salinas Tejedor, Laura; Wulf, Gerald; Reichardt, Holger M.; Riggert, Joachim; Legler, Tobias J.

    2014-01-01

    Background Graft-versus-host disease (GvHD) is a major challenge after hematopoietic stem cell transplantation but treatment options for patients are still limited. In many cases first-line treatment with glucocorticoids is not successful. Among second-line therapies the extracorporeal photopheresis (ECP) is frequently performed, due to induction of selective tolerance instead of general immunosuppression. However, for some patients with severe acute GvHD the leukapheresis step of the ECP procedure is physically exhausting and limits the number of ECP cycles. Methods We hypothesized that leukocytes from healthy cell donors could be used as a replacement for ECP leukocytes gained from the GvHD patient. For this purpose we used a well established mouse model of acute GvHD. The ECP therapy was based on cells with the genetic background of the initial donor of the stem cell transplantation. As a precondition we developed a protocol representing conventional ECP in mice equivalent to clinical used ECP setup. Results We could demonstrate that conventional, clinically derived ECP setup is able to alleviate acute GvHD. By using leukocytes obtained from healthy mice with the bone marrow donor’s genetic background we could not observe a statistically significant therapeutic effect. Conclusions Conventional human ECP setup is effective in the mouse model of severe acute GvHD. In addition we could not prove that ECP cells from healthy mice with bone marrow donor’s genetic background are as effective as ECP cells derived from GvHD mice. Based on our findings, new questions arise for further studies, in which the cellular characteristics for ECP mediated immune tolerance are a matter of investigation. PMID:25148404

  16. Fifteen Year Prospective Comparison of Patellar & Hamstring Tendon Grafts for ACL Reconstruction

    PubMed Central

    Roe, Justin; Salmon, Lucy; Kok, Alison; Linklater, James; Pinczewski, Leo

    2016-01-01

    Objective: This prospective longitudinal study compares isolated endoscopic ACL reconstruction utilizing 4-strand hamstring tendon (HT) or patellar tendon (PT) autograft over a 15-year period with respect to clinical outcomes and the development of osteoarthritis. Method: 90 consecutive patients with isolated ACL rupture were reconstructed with a PT autograft and 90 patients received HT autograft, with an identical surgical technique. Patients were assessed at 2, 5, 7, 10 and 15 years. Assessment included the IKDC Knee Ligament Evaluation including radiographic evaluation, KT1000, kneeling pain, and clinical outcomes. Results: Subjects who received the PT graft had significantly worse outcomes at 15 years for the variables of radiologically detectable osteoarthritis (p=0.001), motion loss (p=0.02), single leg hop test (p=0.002), participation in strenuous activity (p=0.03), knee related decrease in activity level (p=0.002) and kneeling pain (p=0.03). There was no significant difference between the HT and PT groups in overall IKDC grade (p=0.28). ACL graft rupture occurred in 16% of HT group and 8% of the PT group (p=0.10). Contralateral ACL rupture occurred in significantly more PT patients (24%) than HT patients (12%) (p=0.03). Conclusion: Significant differences have developed at 15 years after surgery which were not seen at earlier reviews. Compared to the HT Group, the PT group had significantly worse outcomes with respect to radiological osteoarthritis, range of motion and functional tests but no significant difference in laxity was identified. There was a high incidence of ACL injury after reconstruction, to both the reconstructed and the contralateral knee.

  17. Steroid-induced femoral head osteonecrosis in immune thrombocytopenia treatment with osteochondral autograft transplantation.

    PubMed

    Fotopoulos, Vasileios Ch; Mouzopoulos, George; Floros, Themistoklis; Tzurbakis, Matthaios

    2015-09-01

    Osteonecrosis of the femoral head is a devastating complication of steroid administration and has rarely been observed in the treatment of immune thrombocytopenia. The treatment of osteochondral defects in advanced stages of avascular necrosis (AVN), characterized by collapse of the subchondral bone, remains an unsolved burden in orthopedic surgery. In this report, we present a case of a 19-year-old female that was admitted in the Emergency Department with walking disability and painful hip joint movement due to steroid-induced femoral head osteonecrosis. Two years before she was diagnosed with immune thrombocytopenia, for which she received pulse steroid therapy with high dose of dexamethasone and underwent a splenectomy. This case report is the first to describe the use of osteochondral autograft transplantation as a treatment of steroid-induced AVN of the femoral head due to immune thrombocytopenia at the age of 19 years with very good clinical and radiological results 3 years postoperatively. PMID:25173503

  18. Therapeutic effects of glatiramer acetate and grafted CD115⁺ monocytes in a mouse model of Alzheimer's disease.

    PubMed

    Koronyo, Yosef; Salumbides, Brenda C; Sheyn, Julia; Pelissier, Lindsey; Li, Songlin; Ljubimov, Vladimir; Moyseyev, Michelle; Daley, David; Fuchs, Dieu-Trang; Pham, Michael; Black, Keith L; Rentsendorj, Altan; Koronyo-Hamaoui, Maya

    2015-08-01

    Weekly glatiramer acetate immunization of transgenic mice modelling Alzheimer's disease resulted in retained cognition (Morris water maze test), decreased amyloid-β plaque burden, and regulation of local inflammation through a mechanism involving enhanced recruitment of monocytes. Ablation of bone marrow-derived myeloid cells exacerbated plaque pathology, whereas weekly administration of glatiramer acetate enhanced cerebral recruitment of innate immune cells, which dampened the pathology. Here, we assessed the therapeutic potential of grafted CD115(+) monocytes, injected once monthly into the peripheral blood of transgenic APPSWE/PS1ΔE9 Alzheimer's disease mouse models, with and without weekly immunization of glatiramer acetate, as compared to glatiramer acetate alone. All immune-modulation treatment groups were compared with age-matched phosphate-buffered saline-injected control transgenic and untreated non-transgenic mouse groups. Two independent cohorts of mice were assessed for behavioural performance (6-8 mice/group); treatments started in 10-month-old symptomatic mice and spanned a total of 2 months. For all three treatments, our data suggest a substantial decrease in cognitive deficit as assessed by the Barnes maze test (P < 0.0001-0.001). Improved cognitive function was associated with synaptic preservation and reduction in cerebral amyloid-β protein levels and astrogliosis (P < 0.001 and P < 0.0001), with no apparent additive effects for the combined treatment. The peripherally grafted, green fluorescent protein-labelled and endogenous monocytes, homed to cerebral amyloid plaques and directly engulfed amyloid-β; their recruitment was further enhanced by glatiramer acetate. In glatiramer acetate-immunized mice and, moreover, in the combined treatment group, monocyte recruitment to the brain was coupled with greater elevation of the regulatory cytokine IL10 surrounding amyloid-β plaques. All treated transgenic mice had increased cerebral levels of MMP9

  19. Therapeutic effects of glatiramer acetate and grafted CD115+ monocytes in a mouse model of Alzheimer’s disease

    PubMed Central

    Koronyo, Yosef; Salumbides, Brenda C.; Sheyn, Julia; Pelissier, Lindsey; Li, Songlin; Ljubimov, Vladimir; Moyseyev, Michelle; Daley, David; Fuchs, Dieu-Trang; Pham, Michael; Black, Keith L.; Rentsendorj, Altan

    2015-01-01

    Weekly glatiramer acetate immunization of transgenic mice modelling Alzheimer’s disease resulted in retained cognition (Morris water maze test), decreased amyloid-β plaque burden, and regulation of local inflammation through a mechanism involving enhanced recruitment of monocytes. Ablation of bone marrow-derived myeloid cells exacerbated plaque pathology, whereas weekly administration of glatiramer acetate enhanced cerebral recruitment of innate immune cells, which dampened the pathology. Here, we assessed the therapeutic potential of grafted CD115+ monocytes, injected once monthly into the peripheral blood of transgenic APPSWE/PS1ΔE9 Alzheimer’s disease mouse models, with and without weekly immunization of glatiramer acetate, as compared to glatiramer acetate alone. All immune-modulation treatment groups were compared with age-matched phosphate-buffered saline-injected control transgenic and untreated non-transgenic mouse groups. Two independent cohorts of mice were assessed for behavioural performance (6–8 mice/group); treatments started in 10-month-old symptomatic mice and spanned a total of 2 months. For all three treatments, our data suggest a substantial decrease in cognitive deficit as assessed by the Barnes maze test (P < 0.0001–0.001). Improved cognitive function was associated with synaptic preservation and reduction in cerebral amyloid-β protein levels and astrogliosis (P < 0.001 and P < 0.0001), with no apparent additive effects for the combined treatment. The peripherally grafted, green fluorescent protein-labelled and endogenous monocytes, homed to cerebral amyloid plaques and directly engulfed amyloid-β; their recruitment was further enhanced by glatiramer acetate. In glatiramer acetate-immunized mice and, moreover, in the combined treatment group, monocyte recruitment to the brain was coupled with greater elevation of the regulatory cytokine IL10 surrounding amyloid-β plaques. All treated transgenic mice had increased cerebral levels of

  20. Conjunctival Autograft Alone or Combined With Adjuvant Beta-Radiation? A Randomized Clinical Trial

    SciTech Connect

    Arruda Viani, Gustavo; Carrara Fonseca, Ellen; De Fendi, Ligia Issa; Melani Rocha, Eduardo

    2012-03-01

    Purpose: To evaluate the effectiveness and safety of postoperative low single-dose of beta-irradiation ({beta}-RT) in pterygium comparing conjunctival autograft (CAG) surgery with CAG plus adjuvant {beta}-RT in a randomized clinical trial. Methods: This trial was designed as a prospective, randomized, single-center study. Surgery was performed in all cases according to the CAG technique. One hundred and eight pterygia were postoperatively randomized to CAG + {beta}-RT or CAG alone. In the case of {beta}-RT, a (90) Sr eye applicator was used to deliver 10 Gy to the sclera surface at a dose rate of between 200 and 250 cGy/min. After treatment, both an ophthalmologist and a radiation oncologist performed the follow-up examinations. The accumulated data were analyzed using a group sequential test. Results: Between February 2008 and September 2008, 116 eyes with primary pterygium were operated on according to the trial protocol. Adjuvant treatment was performed within 24 h postoperatively. Eight patients were lost to follow-up, resulting in 108 patients who could be analyzed. At a mean follow-up of 18 months (range, 8-33), in the 54 eyes randomized to receive CAG + {beta}-RT, 5 relapses occurred compared with 12 recurrences in the 54 eyes in CAG, for a crude control rate of 90.8 % vs. 78%; p = 0.032, respectively. The treatment complications as hyperemia, total dehiscence of the autograft and dellen were significantly more frequent in the CAG (p < 0.05). The arm of {beta}-RT resulted in better cosmetic results and improves of symptoms than CAG. Conclusions: A low single-dose of {beta}-RT of 10 Gy after CAG surgery was a simple, effective, and safe treatment that reduced the risk of primary pterygium recurrence, improved symptoms after surgery, resulting in a better cosmetic effect than only CAG.

  1. Prospective Analysis of a New Bone Graft in Lumbar Interbody Fusion: Results of a 2- Year Prospective Clinical and Radiological Study

    PubMed Central

    Raskin, Yannic

    2015-01-01

    Background This study examined the efficacy and safety of bone graft material ABM/P-15 (iFACTOR) for use in posterior lumbar interbody fusion. ABM/P-15 has been used safely for more than a decade in dental applications. Methods Forty patients underwent PLIF surgery, with each patient as control. Assessments up to 24 months included radiographs, CT scan, VAS, and ODI. Primary success criteria were fusion and safety. Results Intra-cage bridging bone occurred earlier with ABM/P-15 than autograft (97.73% vs. 59.09% at 6 months). On average pain decreased 29 points and function improved 43 points. Radio dense material outside the disk space occurred more frequently with ABM/P-15 than autograft, without clinical consequence. Conclusions This study suggests that ABM/P-15 has equal or greater efficacy at 6 and 12 months. Pain improvements exceeded success criteria at all time points. Functional improvement exceeded success criteria at all time points. Clinical Relevance This study explores the safety and efficacy of an osteobiologic peptide enhanced bone graft material as a viable alternative to autograft and its attendant risks. PMID:25709887

  2. Design of Phosphonated Imidazolium-Based Ionic Liquids Grafted on γ-Alumina: Potential Model for Hybrid Membranes.

    PubMed

    Pizzoccaro, Marie-Alix; Drobek, Martin; Petit, Eddy; Guerrero, Gilles; Hesemann, Peter; Julbe, Anne

    2016-01-01

    Imidazolium bromide-based ionic liquids bearing phosphonyl groups on the cationic part were synthesized and grafted on γ-alumina (γ-Al₂O₃) powders. These powders were prepared as companion samples of conventional mesoporous γ-alumina membranes, in order to favor a possible transfer of the results to supported membrane materials, which could be used for CO₂ separation applications. Effective grafting was demonstrated using energy dispersive X-ray spectrometry (EDX), N₂ adsorption measurements, fourier transform infrared spectroscopy (FTIR), and special attention was paid to (31)P and (13)C solid state nuclear magnetic resonance spectroscopy (NMR). PMID:27472321

  3. Design of Phosphonated Imidazolium-Based Ionic Liquids Grafted on γ-Alumina: Potential Model for Hybrid Membranes

    PubMed Central

    Pizzoccaro, Marie-Alix; Drobek, Martin; Petit, Eddy; Guerrero, Gilles; Hesemann, Peter; Julbe, Anne

    2016-01-01

    Imidazolium bromide-based ionic liquids bearing phosphonyl groups on the cationic part were synthesized and grafted on γ-alumina (γ-Al2O3) powders. These powders were prepared as companion samples of conventional mesoporous γ-alumina membranes, in order to favor a possible transfer of the results to supported membrane materials, which could be used for CO2 separation applications. Effective grafting was demonstrated using energy dispersive X-ray spectrometry (EDX), N2 adsorption measurements, fourier transform infrared spectroscopy (FTIR), and special attention was paid to 31P and 13C solid state nuclear magnetic resonance spectroscopy (NMR). PMID:27472321

  4. Specific Biomimetic Hydroxyapatite Nanotopographies Enhance Osteoblastic Differentiation and Bone Graft Osteointegration

    PubMed Central

    Loiselle, Alayna E.; Wei, Lai; Faryad, Muhammad; Paul, Emmanuel M.; Lewis, Gregory S.; Gao, Jun; Lakhtakia, Akhlesh

    2013-01-01

    Impaired healing of cortical bone grafts represents a significant clinical problem. Cadaveric bone grafts undergo extensive chemical processing to decrease the risk of disease transmission; however, these processing techniques alter the bone surface and decrease the osteogenic potential of cells at the healing site. Extensive work has been done to optimize the surface of bone grafts, and hydroxyapatite (HAP) and nanotopography both increase osteoblastic differentiation. HAP is the main mineral component of bone and can enhance osteoblastic differentiation and bone implant healing in vivo, while nanotopography can enhance osteoblastic differentiation, adhesion, and proliferation. This is the first study to test the combined effects of HAP and nanotopographies on bone graft healing. With the goal of identifying the optimized surface features to improve bone graft healing, we tested the hypothesis that HAP-based nanotopographic resurfacing of bone grafts improves integration of cortical bone grafts by enhancing osteoblastic differentiation. Here we show that osteoblastic cells cultured on processed bones coated with specific-scale (50–60 nm) HAP nanotopographies display increased osteoblastic differentiation compared to cells on uncoated bone, bones coated with poly-l-lactic acid nanotopographies, or other HAP nanotopographies. Further, bone grafts coated with 50–60-nm HAP exhibited increased formation of new bone and improved healing, with mechanical properties equivalent to live autografts. These data indicate the potential for specific HAP nanotopographies to not only increase osteoblastic differentiation but also improve bone graft incorporation, which could significantly increase patient quality of life after traumatic bone injuries or resection of an osteosarcoma. PMID:23510012

  5. Mechanical characterization of matrix-induced autologous chondrocyte implantation (MACI®) grafts in an equine model at 53 weeks.

    PubMed

    Griffin, Darvin J; Bonnevie, Edward D; Lachowsky, Devin J; Hart, James C A; Sparks, Holly D; Moran, Nance; Matthews, Gloria; Nixon, Alan J; Cohen, Itai; Bonassar, Lawrence J

    2015-07-16

    There has been much interest in using autologous chondrocytes in combination with scaffold materials to aid in cartilage repair. In the present study, a total of 27 animals were used to compare the performance of matrix-assisted chondrocyte implantation (MACI®) using a collagen sponge as a chondrocyte delivery vehicle, the sponge membrane alone, and empty controls. A total of three distinct types of mechanical analyses were performed on repaired cartilage harvested from horses after 53 weeks of implantation: (1) compressive behavior of samples to measure aggregate modulus (HA) and hydraulic permeability (k) in confined compression; (2) local and global shear modulus using confocal strain mapping; and (3) boundary friction coefficient using a custom-built tribometer. Cartilage defects receiving MACI® implants had equilibrium modulus values that were 70% of normal cartilage, and were not statistically different than normal tissue. Defects filled with Maix™ membrane alone or left empty were only 46% and 51-63% of control, respectively. The shear modulus of tissue from all groups of cartilage defects were between 4 and 10 times lower than control tissue, and range from 0.2 to 0.4 MPa. The average values of boundary mode friction coefficients of control tissue from all groups ranged from 0.42 to 0.52. This study represents an extensive characterization of the mechanical performance of the MACI® grafts implant in a large animal model at 53 weeks. Collectively, these data demonstrate a range of implant performance, revealing similar compressive and frictional properties to native tissue, with inferior shear properties. PMID:25920896

  6. Cultured human chromaffin cells grafted in spinal subarachnoid space relieves allodynia in a pain rat model

    PubMed Central

    Jeon, Younghoon; Baek, Woon Yi; Chung, Seung Hyun; Shin, Nari; Kim, Hye Rim

    2011-01-01

    Background Implantation of xenogenic chromaffin cells into the spinal subarachnoid space can produce analgesia in neuropathic pain models. However, transplantation of xenogeneic chromaffin cell has a potential risk of viral or bacterial infections from animals to humans including encephalopathy due to prion transmission. The aim of this study was to investigate the possibility of developing a homogeneic source of therapeutic chromaffin cells. Methods Anti-allodynic effects of human chromaffin cells (HCCs) were evaluated in a neuropathic pain model in rats induced by chronic constriction injury of the sciatic nerve. HCCs encapsulated with alginate-poly-L-lysine-alginate were intrathecally implanted into rats (n = 10), while empty capsules were intrathecally implanted as a control (n = 8). Levels of norepinephrine from encapsulated HCCs before and after nicotinic stimulation were measured. We then perfomed a behavior test (cold allodynia) with acetone. In addition, to assess the potential contribution to pain reduction of opioid peptides released from the HCCs, all animals were injected with naloxone. Results The concentration of norepinephrine after nicotine stimulation was significantly increased compared to basal levels. Intrathecal implantation of encapsulated HCCs, significantly reduced cold allodynia as compared to rats receiving empty capsules (P < 0.05). Fifteen minutes after the injection of naloxone, cold allodynia significantly decreased in rats with HCCs (P < 0.05), while the degree of cold allodynia in control animals was unaltered. Conclusions From these results, it appears that HCCs have a possibility as an analgesic source for transplants delivering pain-reducing neuroactive substances. PMID:21716909

  7. Difference in canal encroachment by the fusion mass between anterior cervical discectomy and fusion with bone autograft and anterior plating, and stand-alone cage.

    PubMed

    Lee, Soo Eon; Chung, Chun Kee; Kim, Chi Heon

    2016-07-01

    We conducted a prospective randomized study comparing stand-alone cage and bone autograft and plate implants in anterior cervical discectomy and fusion (www.clinicaltrials.gov, NCT01011569). Our interim analysis showed autologous bone graft with plating was superior to a stand-alone cage for segmental lordosis. During this analysis, we noted a difference in canal encroachment by the fusion mass between the two fusion groups. A narrow cervical spinal canal is an important factor in the development of cervical spondylotic myelopathy, therefore this unexpected potential risk of spinal cord compression necessitated another interim analysis to investigate whether there was a difference in canal encroachment by the fusion mass between the two groups. Patients had a minimum 1year of follow-up. The Neck Disability Index, neck and arm pain Visual Analog Scales and lateral radiographs, including bone fusion patterns, were evaluated. Twenty-seven (16 males, 11 females, mean age 54.8years) and 31 (24 males, seven females, mean age 54.5years) patients were in the cage and plate group, respectively. Both groups improved after surgery. Fusion began at 2.6months and 1.3months and finished at 6.7months and 4.0months in 24 (88.9%) and 28 (90.3%) patients in the cage and plate group, respectively. Encroachment into the spinal canal by the fusion mass was significantly different between the fusion types, occuring in 21 (77.8%) patients in the cage group versus six (19.4%) in the plate group (p=0.003). There was a high incidence of spinal canal encroachment by the fusion mass in the stand-alone cage group, possibly limiting use in narrow spinal canals. PMID:27234609

  8. Osteointegration of soft tissue grafts within the bone tunnels in anterior cruciate ligament reconstruction can be enhanced.

    PubMed

    Kuang, Guan-Ming; Yau, W P; Lu, William W; Chiu, K Y

    2010-08-01

    Anterior cruciate ligament reconstruction with a soft tissue autograft (hamstring autograft) has grown in popularity in the last 10 years. However, the issues of a relatively long healing time and an inferior histological healing result in terms of Sharpey-like fibers connection in soft tissue grafts are still unsolved. To obtain a promising outcome in the long run, prompt osteointegration of the tendon graft within the bone tunnel is essential. In recent decades, numerous methods have been reported to enhance osteointegration of soft tissue graft in the bone tunnel. In this article, we review the current literature in this research area, mainly focusing on strategies applied to the local bone tunnel environment. Biological strategies such as stem cell and gene transfer technology, as well as the local application of specific growth factors have been reported to yield exciting results. The use of biological bone substitute and physical stimulation also obtained promising results. Artificially engineered tissue has promise as a solution to the problem of donor site morbidity. Despite these encouraging results, the current available evidence is still experimental. Further clinical studies in terms of randomized control trial in the future should be conducted to extrapolate these basic science study findings into clinical practice. PMID:19779894

  9. Covalent grafting of carbon nanotubes with a biomimetic heme model compound to enhance oxygen reduction reactions.

    PubMed

    Wei, Ping-Jie; Yu, Guo-Qiang; Naruta, Yoshinori; Liu, Jin-Gang

    2014-06-23

    The oxygen reduction reaction (ORR) is one of the most important reactions in both life processes and energy conversion systems. The replacement of noble-metal Pt-based ORR electrocatalysts by nonprecious-metal catalysts is crucial for the large-scale commercialization of automotive fuel cells. Inspired by the mechanisms of dioxygen activation by metalloenzymes, herein we report a structurally well-defined, bio-inspired ORR catalyst that consists of a biomimetic model compound-an axial imidazole-coordinated porphyrin-covalently attached to multiwalled carbon nanotubes. Without pyrolysis, this bio-inspired electrocatalyst demonstrates superior ORR activity and stability compared to those of the state-of-the-art Pt/C catalyst in both acidic and alkaline solutions, thus making it a promising alternative as an ORR electrocatalyst for application in fuel-cell technology. PMID:24842193

  10. IL-25 promotes the function of CD4+CD25+ T regulatory cells and prolongs skin-graft survival in murine models.

    PubMed

    Tang, Jiayou; Zhou, Xiaohui; Liu, Jie; Meng, Qingshu; Han, Yang; Wang, Zhulin; Fan, Huimin; Liu, Zhongmin

    2015-10-01

    Interleukin (IL)-25, also known as IL-17E, belongs to the IL-17 family of cytokines. Unlike other IL-17 family members, IL-25 promotes Th2-type immune responses, stimulating IL-4, IL-5, and IL-13 production. Here, we employed murine models of skin graft to explore the role of IL-25 in suppression of graft rejection. We found that IL-25 expression is increased during allograft rejection, and allograft rejection was enhanced in IL-25 KO mice. IL-25 KO was associated with down-regulation of Foxp3 expression in CD4+ T cells. Further, while adoptive transfer of WT regulatory T cells (Tregs) protected against allograft rejection, adoptive transfer of IL-25 deficient Tregs failed to protect against allograft rejection. Exogenous IL-25 restored Foxp3 expression and Treg function in vitro. Moreover, IL-25 promoted phosphorylation of NFAT2. Thus, IL-25 may enhance Treg function by up-regulating NFAT2 phosphorylation. Our findings suggest that IL-25 can sustain Foxp3 expression, enhance the suppressive function of Tregs, and prolong skin-graft survival. PMID:25864622

  11. Mathematical Model analysis of Wallstent and Aneurx: dynamic responses of bare-metal endoprosthesis compared with those of stent-graft.

    PubMed

    Canic, Suncica; Ravi-Chandar, K; Krajcer, Zvonimir; Mirkovic, Dragan; Lapin, Serguei

    2005-01-01

    We performed this study in order to analyze the mechanical properties of bare-metal Wallstent endoprostheses and of AneuRx stent-grafts and to compare their responses to hemodynamic forces. Mathematical modeling, numerical simulations, and experimental measurements were used to study the 2 structurally different types of endoprostheses. Our findings revealed that a single bare-metal Wallstent endoprosthesis is 10 times more flexible (elastic) than is the wall of the aneurysmal abdominal aorta. Graphs showing the changes in the diameter and length of the stent when exposed to a range of internal and external pressures were obtained. If the aorta is axially stiff and resists length change, a force as large as 1 kg can act in the axial direction on the aortic wall. If the stent is not firmly anchored, it will migrate. In contrast, a fabric-covered, fully supported, stent-graft such as the AneuRx is significantly less compliant than the aorta or the bare-metal stent. During each cardiac cycle, the stent frame tends to move due to its higher elasticity, while the fabric resists movement, which might break the sutures that join the fabric to the frame. Elevated local transmural pressure, detected along the prosthesis graft, can contribute to material fatigue. PMID:16429893

  12. Diffusion and Perfusion: The Keys to Fat Grafting

    PubMed Central

    Khouri, Roger K.; Khouri, Raoul-Emil R.; Lujan-Hernandez, Jorge R.; Khouri, Khalil R.; Lancerotto, Luca

    2014-01-01

    Background: Fat grafting is now widely used in plastic surgery. Long-term graft retention can be unpredictable. Fat grafts must obtain oxygen via diffusion until neovascularization occurs, so oxygen delivery may be the overarching variable in graft retention. Methods: We studied the peer-reviewed literature to determine which aspects of a fat graft and the microenvironment surrounding a fat graft affect oxygen delivery and created 3 models relating distinct variables to oxygen delivery and graft retention. Results: Our models confirm that thin microribbons of fat maximize oxygen transport when injected into a large, compliant, well-vascularized recipient site. The “Microribbon Model” predicts that, in a typical human, fat injections larger than 0.16 cm in radius will have a region of central necrosis. Our “Fluid Accommodation Model” predicts that once grafted tissues approach a critical interstitial fluid pressure of 9 mm Hg, any additional fluid will drastically increase interstitial fluid pressure and reduce capillary perfusion and oxygen delivery. Our “External Volume Expansion Effect Model” predicts the effect of vascular changes induced by preoperative external volume expansion that allow for greater volumes of fat to be successfully grafted. Conclusions: These models confirm that initial fat grafting survival is limited by oxygen diffusion. Preoperative expansion increases oxygen diffusion capacity allowing for additional graft retention. These models provide a scientific framework for testing the current fat grafting theories. PMID:25426403

  13. Immunohistochemical, Ultrastructural and Functional Analysis of Axonal Regeneration through Peripheral Nerve Grafts Containing Schwann Cells Expressing BDNF, CNTF or NT3

    PubMed Central

    Godinho, Maria João; Teh, Lip; Pollett, Margaret A.; Goodman, Douglas; Hodgetts, Stuart I.; Sweetman, Iain; Walters, Mark; Verhaagen, Joost; Plant, Giles W.; Harvey, Alan R.

    2013-01-01

    We used morphological, immunohistochemical and functional assessments to determine the impact of genetically-modified peripheral nerve (PN) grafts on axonal regeneration after injury. Grafts were assembled from acellular nerve sheaths repopulated ex vivo with Schwann cells (SCs) modified to express brain-derived neurotrophic factor (BDNF), a secretable form of ciliary neurotrophic factor (CNTF), or neurotrophin-3 (NT3). Grafts were used to repair unilateral 1 cm defects in rat peroneal nerves and 10 weeks later outcomes were compared to normal nerves and various controls: autografts, acellular grafts and grafts with unmodified SCs. The number of regenerated βIII-Tubulin positive axons was similar in all grafts with the exception of CNTF, which contained the fewest immunostained axons. There were significantly lower fiber counts in acellular, untransduced SC and NT3 groups using a PanNF antibody, suggesting a paucity of large caliber axons. In addition, NT3 grafts contained the greatest number of sensory fibres, identified with either IB4 or CGRP markers. Examination of semi- and ultra-thin sections revealed heterogeneous graft morphologies, particularly in BDNF and NT3 grafts in which the fascicular organization was pronounced. Unmyelinated axons were loosely organized in numerous Remak bundles in NT3 grafts, while the BDNF graft group displayed the lowest ratio of umyelinated to myelinated axons. Gait analysis revealed that stance width was increased in rats with CNTF and NT3 grafts, and step length involving the injured left hindlimb was significantly greater in NT3 grafted rats, suggesting enhanced sensory sensitivity in these animals. In summary, the selective expression of BDNF, CNTF or NT3 by genetically modified SCs had differential effects on PN graft morphology, the number and type of regenerating axons, myelination, and locomotor function. PMID:23950907

  14. Bone grafts in dentistry

    PubMed Central

    Kumar, Prasanna; Vinitha, Belliappa; Fathima, Ghousia

    2013-01-01

    Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation. PMID:23946565

  15. Osteochondral allograft transplantation in cartilage repair: Graft storage paradigm, translational models, and clinical applications.

    PubMed

    Bugbee, William D; Pallante-Kichura, Andrea L; Görtz, Simon; Amiel, David; Sah, Robert

    2016-01-01

    The treatment of articular cartilage injury and disease has become an increasingly relevant part of orthopaedic care. Articular cartilage transplantation, in the form of osteochondral allografting, is one of the most established techniques for restoration of articular cartilage. Our research efforts over the last two decades have supported the transformation of this procedure from experimental "niche" status to a cornerstone of orthopaedic practice. In this Kappa Delta paper, we describe our translational and clinical science contributions to this transformation: (1) to enhance the ability of tissue banks to process and deliver viable tissue to surgeons and patients, (2) to improve the biological understanding of in vivo cartilage and bone remodeling following osteochondral allograft (OCA) transplantation in an animal model system, (3) to define effective surgical techniques and pitfalls, and (4) to identify and clarify clinical indications and outcomes. The combination of coordinated basic and clinical studies is part of our continuing comprehensive academic OCA transplant program. Taken together, the results have led to the current standards for OCA processing and storage prior to implantation and also novel observations and mechanisms of the biological and clinical behavior of OCA transplants in vivo. Thus, OCA transplantation is now a successful and increasingly available treatment for patients with disabling osteoarticular cartilage pathology. PMID:26234194

  16. CAN OSTEOCHONDRAL GRAFTING BE AUGMENTED WITH MICROFRACTURE IN AN EXTENDED SIZED LESION OF ARTICULAR CARTILAGE

    PubMed Central

    Lane, JG; Healey, RM; Sah, RL; Chen, AC-S; Amiel, D

    2014-01-01

    BACKGROUND Both microfracture and osteochondral autografting procedures have been useful in treating osteochondral lesions. HYPOTHESIS Combining microfracture and osteochondral autografting procedures can extend the size of lesions which can be treated with either technique. STUDY DESIGN Descriptive laboratory study. METHODS Eight adult goats underwent osteochondral autograft transfer of a 4.5mm femoral trochlea plug into an 8mm full thickness chondral defect in the weight bearing portion of the medial femoral condyle. In the gap region surrounding the autograft, microfracture was performed. The animals were allowed normal activity until the end of the experiment at 6 months, at which time the knees were harvested. At harvest the knees were assessed grossly, and then evaluation was performed by histology and histomorphometry, biochemistry and biomechanics. One animal died at 6 wks from gastroenteritis. RESULTS The osteochondral plugs healed well, with integration of the bone and preservation of the chondral cap. The chondral gap between the host site articular cartilage and the transferred plug had decreased from 3 mm at implant to less than 0.1 mm. Histological analysis demonstrated regions of variable cartilage repair, with integration of the cartilage layer at some sites but incomplete healing at others. Histomorphometry demonstrated filling of the chondral gap to 75–85% of the normal volume. Biochemical analysis revealed greater than 90% type II collagen at most sites with some areas containing 80% type II collagen. Biomechanical indentation testing, indicated that the repaired area had variable thickness and stiffness, with a trend of increased stiffness in the bulk graft and decreased softness at the proximal microfracture interface site. CONCLUSIONS The performance of a combined microfracture and osteochondral autograft transfer (OATS) procedure to resurface a large chondral defect appears promising. Transferred cartilage tissue can successfully be

  17. Doppler derived quantitative flow estimate in coronary artery bypass graft: a computational multiscale model for the evaluation of the current clinical procedure.

    PubMed

    Ponzini, Raffaele; Lemma, Massimo; Morbiducci, Umberto; Montevecchi, Franco M; Redaelli, Alberto

    2008-09-01

    In order to investigate the reliability of the so called mean velocity/vessel area formula adopted in clinical practice for the estimation of the flow rate using an intravascular Doppler guide wire instrumentation, a multiscale computational model was used to give detailed predictions on flow profiles within Y-shaped coronary artery bypass graft (CABG) models. At this purpose three CABG models were built from clinical patient's data and used to evaluate and compare, in each model, the computed flow rate and the flow rate estimated according to the assumption of parabolic velocity profile. A consistent difference between the exact and the estimated value of the flow rate was found in every branch of all the graft models. In this study we showed that this discrepancy in the flow rate estimation is coherent to the theory of Womersley regarding spatial velocity profiles in unsteady flow conditions. In particular this work put in evidence that the error in flow rate estimation can be reduced by using the estimation formula recently proposed by Ponzini et al. [Ponzini R, Vergara C, Redaelli A, Veneziani A. Reliable CFD-based estimation of flow rate in haemodynamics measures. Ultrasound Med Biol 2006;32(10):1545-55], accounting for the unsteady nature of blood, applicable in the clinical practice without resorting to further measurements. PMID:17980641

  18. In Vivo Bone Formation Within Engineered Hydroxyapatite Scaffolds in a Sheep Model.

    PubMed

    Lovati, A B; Lopa, S; Recordati, C; Talò, G; Turrisi, C; Bottagisio, M; Losa, M; Scanziani, E; Moretti, M

    2016-08-01

    Large bone defects still represent a major burden in orthopedics, requiring bone-graft implantation to promote the bone repair. Along with autografts that currently represent the gold standard for complicated fracture repair, the bone tissue engineering offers a promising alternative strategy combining bone-graft substitutes with osteoprogenitor cells able to support the bone tissue ingrowth within the implant. Hence, the optimization of cell loading and distribution within osteoconductive scaffolds is mandatory to support a successful bone formation within the scaffold pores. With this purpose, we engineered constructs by seeding and culturing autologous, osteodifferentiated bone marrow mesenchymal stem cells within hydroxyapatite (HA)-based grafts by means of a perfusion bioreactor to enhance the in vivo implant-bone osseointegration in an ovine model. Specifically, we compared the engineered constructs in two different anatomical bone sites, tibia, and femur, compared with cell-free or static cell-loaded scaffolds. After 2 and 4 months, the bone formation and the scaffold osseointegration were assessed by micro-CT and histological analyses. The results demonstrated the capability of the acellular HA-based grafts to determine an implant-bone osseointegration similar to that of statically or dynamically cultured grafts. Our study demonstrated that the tibia is characterized by a lower bone repair capability compared to femur, in which the contribution of transplanted cells is not crucial to enhance the bone-implant osseointegration. Indeed, only in tibia, the dynamic cell-loaded implants performed slightly better than the cell-free or static cell-loaded grafts, indicating that this is a valid approach to sustain the bone deposition and osseointegration in disadvantaged anatomical sites. PMID:27075029

  19. Structural exploration and Förster theory modeling for the interpretation of gas-phase FRET measurements: Chromophore-grafted amyloid-β peptides

    NASA Astrophysics Data System (ADS)

    Kulesza, Alexander; Daly, Steven; MacAleese, Luke; Antoine, Rodolphe; Dugourd, Philippe

    2015-07-01

    The distance-dependence of excitation energy transfer, e.g., being described by Förster theory (Förster resonance energy transfer (FRET)), allows the use of optical techniques for the direct observation of structural properties. Recently, this technique has been successfully applied in the gas phase. The detailed interpretation of the experimental FRET results, however, relies on the comparison with structural modeling. We therefore present a complete first-principles modeling approach that explores the gas-phase structure of chromophore-grafted peptides and achieves accurate predictions of FRET efficiencies. We apply the approach to amyloid-β 12-28 fragments, known to be involved in amyloid plaque formation connected to Alzheimer's disease. We sample structures of the peptides that are grafted with 5-carboxyrhodamine 575 (Rh575) and QSY-7 chromophores by means of replica-exchange molecular dynamics simulations upon an Amber-type forcefield parametrization as a function of the charge state. The generated ensembles provide chromophore-distance and -orientation distributions which are used with the spectral parameters of the Rh575/QSY-7 chromophores to model FRET-efficiencies for the systems. The theoretical values agree with the experimental average "action"-FRET efficiencies and motivate to use the herein reported parametrization, sampling, and FRET-modeling technique in future studies on the structural properties and aggregation-behavior of related systems.

  20. Structural exploration and Förster theory modeling for the interpretation of gas-phase FRET measurements: Chromophore-grafted amyloid-β peptides.

    PubMed

    Kulesza, Alexander; Daly, Steven; MacAleese, Luke; Antoine, Rodolphe; Dugourd, Philippe

    2015-07-14

    The distance-dependence of excitation energy transfer, e.g., being described by Förster theory (Förster resonance energy transfer (FRET)), allows the use of optical techniques for the direct observation of structural properties. Recently, this technique has been successfully applied in the gas phase. The detailed interpretation of the experimental FRET results, however, relies on the comparison with structural modeling. We therefore present a complete first-principles modeling approach that explores the gas-phase structure of chromophore-grafted peptides and achieves accurate predictions of FRET efficiencies. We apply the approach to amyloid-β 12-28 fragments, known to be involved in amyloid plaque formation connected to Alzheimer's disease. We sample structures of the peptides that are grafted with 5-carboxyrhodamine 575 (Rh575) and QSY-7 chromophores by means of replica-exchange molecular dynamics simulations upon an Amber-type forcefield parametrization as a function of the charge state. The generated ensembles provide chromophore-distance and -orientation distributions which are used with the spectral parameters of the Rh575/QSY-7 chromophores to model FRET-efficiencies for the systems. The theoretical values agree with the experimental average "action"-FRET efficiencies and motivate to use the herein reported parametrization, sampling, and FRET-modeling technique in future studies on the structural properties and aggregation-behavior of related systems. PMID:26178129

  1. The effects of the centrifugation speed on the survival of autogenous fat grafts in a rat model.

    PubMed

    Bozkurt, Mehmet; Kapı, Emin; Şirinoğlu, Hakan; Güvercin, Emre; Filinte, Gaye Taylan; Filinte, Deniz

    2016-06-01

    Purpose The most important problem in fat transplantation is the durability, which is closely associated with the applied technique. This study includes the comparison of different centrifugation speeds on the survival of autogenous fat grafts in rats. Materials and methods Forty-nine Sprague-Dawley rats were divided into seven groups and the left inguinal fat pad was extracted and re-implanted under the scalp after performing appropriate preparation processes. In the first group the fatty tissue was re-implanted in en-bloc fashion and in the second group it was re-implanted after trimming. After trimming, centrifugation with a G-force of 111.8 (1000 rpm) was performed in the third group, 447.2 (2000 rpm) in the fourth group, 1006.2 (3000 rpm) in the fifth group, 1788.8 (4000 rpm) in the sixth group, and 2795 (5000 rpm) in the seventh group for 4 minutes. The fat grafts were taken after 3 months and histopathological and statistical evaluations were performed. Results The rate of viable fat grafts was significantly higher in the 4th and 5th groups comparing to the first three groups. Total weight and volume amounts of the 4th and 5th groups were also significantly higher comparing to the first three groups. Conclusion Maximal long-term durability and fat cell viability results were obtained in the groups with 2000 rpm or 447.2 G-force/4 minutes and 3000 rpm or 1006.2 G-force/4 minutes centrifugation speed, indicating that 4 minutes centrifugation with an average G-force of 698.75 or 2500 rpm provides the best results for the survival of autogenous fat grafts. PMID:26898924

  2. Sonic Hedgehog Controls the Phenotypic Fate and Therapeutic Efficacy of Grafted Neural Precursor Cells in a Model of Nigrostriatal Neurodegeneration

    PubMed Central

    Madhavan, Lalitha; Daley, Brian F.; Davidson, Beverly L.; Boudreau, Ryan L.; Lipton, Jack W.; Cole-Strauss, Allyson; Steece-Collier, Kathy; Collier, Timothy J.

    2015-01-01

    The expression of soluble growth and survival promoting factors by neural precursor cells (NPCs) is suggested to be a prominent mechanism underlying the protective and regenerative effects of these cells after transplantation. Nevertheless, how and to what extent specific NPC-expressed factors contribute to therapeutic effects is not well understood. Using RNA silencing, the current study investigated the roles of two donor NPC molecules, namely glial cell-line derived neurotrophic factor (GDNF) and sonic hedgehog (SHH), in the protection of substantia nigra dopamine neurons in rats treated with 6-hydroxydopamine (6-OHDA). Analyses indicate that as opposed to the knock-down of GDNF, SHH inhibition caused a profound decline in nigrostriatal neuroprotection. Further, SHH silencing also curbed endogenous neurogenesis and the migration of host brdU+/dcx+ neural precursors into the striatum, which was present in the animals receiving control or GDNF silenced NPCs. A change in graft phenotype, mainly reflected by a reduced proportion of undifferentiated nestin+ cells, as well as a significantly greater host microglial activity, suggested an important role for these processes in the attenuation of neuroprotection and neurogenesis upon SHH silencing. Overall these studies reveal core mechanisms fundamental to grafted NPC-based therapeutic effects, and delineate the particular contributions of two graft-expressed molecules, SHH and GDNF, in mediating midbrain dopamine neuron protection, and host plasticity after NPC transplantation. PMID:26340267

  3. A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: a dressing comparison study.

    PubMed

    Silver, Geoffrey M; Robertson, Symanthia W; Halerz, Marcia M; Conrad, Peggie; Supple, Kathy G; Gamelli, Richard L

    2007-01-01

    In an effort to optimize the management of freshly grafted burn wounds, a silver-coated, low-adherence dressing, Acticoat (Smith & Nephew Inc., Largo, FL), was compared with 5% sulfamylon-soaked Exu-Dry burn wound dressings. Twenty subjects admitted to the Loyola University Medical Center were randomized to either Acticoat dressings or 5% sulfamylon-soaked burn wound dressings. Dressings were applied immediately after grafting in the operating room. Acticoat dressings were left in place for 3 days and then changed every 3 days thereafter. Sulfamylon-soaked dressings were changed at 48 hours and then every day. Subjects continued to have dressing changes on a twice-daily basis to wounds that were not grafted managed. Subjects were assessed for graft take, time to wound healing, and the number of dressings required until healing. Hospital charges and labor costs were retrospectively tabulated, yielding an expense estimate for each group. There were no significant differences between the two groups with respect to age, %TBSA, %TBSA of the grafted test sites, graft take, time to graft healing, or infectious complications. The median number of dressing changes to the test site was significantly less in the Acticoat group (P < .05). The average expense per dressing change was not significantly different between the two groups; however, the average total expense per patient was significantly lower for the Acticoat group because of the reduced number of dressing changes. Acticoat and 5% sulfamylon-soaked burn wound dressings were equivalent with respect to wound healing and infectious complications. The use of Acticoat was found to be a safe alternative to the use of 5% sulfamylon as a postsurgical dressing in this group of subjects. Because of the reduced number of dressing changes, the use of Acticoat was a less expensive alternative to 5% sulfamylon dressing changes in this study. PMID:17667837

  4. Intraoperative Fluorescein Staining of Cryopreserved Amniotic Membrane Grafts to Improve Visualization During and After Pterygium Surgery: A Novel Technique

    PubMed Central

    Martinez, J. Alberto; Korchak, Michael; Cremers, Sandra L.

    2016-01-01

    Purpose: To describe a new method of enhancing the visualization of amniotic membrane grafts with fluorescein staining during pterygium surgery. Methods: Pterygium excision surgery using intraoperatively stained cryopreserved amniotic membranes was performed on 346 eyes. A sterile 0.6 mg sodium fluorescein strip was placed directly onto the amniotic membrane in the manufacturer's original packaging, and the stained allograft was then transplanted onto the planned site. Staining intensities, at 3, 5, and 10 minutes of dye immersion, were compared. Immediate postoperative pain rating (scale 0–10), visibility of the fluorescein-stained amniotic membrane graft, and conjunctival autograft and amniotic membrane graft elevation, dehiscence, retraction, or displacement were recorded. The recurrence rate of the study population was compared with that of a previous cohort of 121 patients who underwent pterygium excision with conjunctival autograft without stained amniotic membrane. Results: Direct contact of the fluorescein strip on the amniotic membrane at 3, 5, and 10 minutes showed no differences in subjective staining intensity. Fluorescein-stained amniotic membrane was easily detected on the ocular surface during and 24 hours after pterygium surgery. The average immediate postoperative pain rating was 0.8 ± 1.8. No intraoperative complications or postoperative amniotic membrane graft dehiscence, retraction, or displacement occurred. The recurrence rate using fluorescein-stained amniotic membrane (3 patients, 0.9%, mean follow-up time 31.8 ± 18.6 weeks) did not differ from that of the previous cohort without the stained amniotic membrane (2.5%; χ2(1) = 1.837, P = 0.183). Conclusions: Fluorescein strip staining of the amniotic membrane is a novel and safe intraoperative method to enhance visualization and handling of the graft during and after ocular surgeries. PMID:26751995

  5. A nude mouse model of hypertrophic scar shows morphologic and histologic characteristics of human hypertrophic scar.

    PubMed

    Momtazi, Moein; Kwan, Peter; Ding, Jie; Anderson, Colin C; Honardoust, Dariush; Goekjian, Serge; Tredget, Edward E

    2013-01-01

    Hypertrophic scar (HSc) is a fibroproliferative disorder that occurs following deep dermal injury. Lack of a relevant animal model is one barrier toward better understanding its pathophysiology. Our objective is to demonstrate that grafting split-thickness human skin onto nude mice results in survival of engrafted human skin and murine scars that are morphologically, histologically, and immunohistochemically consistent with human HSc. Twenty nude mice were xenografted with split-thickness human skin. Animals were euthanized at 30, 60, 120, and 180 days postoperatively. Eighteen controls were autografted with full-thickness nude mouse skin and euthanized at 30 and 60 days postoperatively. Scar biopsies were harvested at each time point. Blinded scar assessment was performed using a modified Manchester Scar Scale. Histologic analysis included hematoxylin and eosin, Masson's trichrome, toluidine blue, and picrosirius red staining. Immunohistochemistry included anti-human human leukocyte antigen-ABC, α-smooth muscle actin, decorin, and biglycan staining. Xenografted mice developed red, shiny, elevated scars similar to human HSc and supported by blinded scar assessment. Autograft controls appeared morphologically and histologically similar to normal skin. Xenografts survived up to 180 days and showed increased thickness, loss of hair follicles, adnexal structures and rete pegs, hypercellularity, whorled collagen fibers parallel to the surface, myofibroblasts, decreased decorin and increased biglycan expression, and increased mast cell density. Grafting split-thickness human skin onto nude mice results in persistent scars that show morphologic, histologic, and immunohistochemical consistency with human HSc. Therefore, this model provides a promising technique to study HSc formation and to test novel treatment options. PMID:23126488

  6. Tuberculin-induced delayed-type hypersensitivity reaction in a model of hu-PBMC-SCID mice grafted with autologous skin.

    PubMed Central

    Tsicopoulos, A.; Pestel, J.; Fahy, O.; Vorng, H.; Vandenbusche, F.; Porte, H.; Eraldi, L.; Wurtz, A.; Akoum, H.; Hamid, Q.; Wallaert, B.; Tonnel, A. B.

    1998-01-01

    We have developed an animal model to study human delayed-type hypersensitivity reactions. Previous studies in humans have shown after tuberculin injection the presence of a mononuclear cell infiltration, with almost no eosinophils, associated with a preferential Th-1-type cytokine profile. Human skin graft obtained from tuberculin-reactive donors was grafted onto the back of severe combined immunodeficient mice. After healing, mice were reconstituted intraperitoneally with peripheral mononuclear cells. Tuberculin and diluent were injected intradermally, and skin biopsies were performed 72 hours later. Skin grafts were divided into two parts, one for immunohistochemistry and one for in situ hybridization studies. Immunohistochemistry was performed on cryostat sections using the alkaline phosphatase anti-alkaline phosphatase technique. In the tuberculin-injected sites as compared with the diluent-injected sites, there were significant increases in the number of CD45+ pan leukocytes and CD4+, CD8+, CD45RO+ T cells but not in CD68+ monocytes/macrophages and EG2 or MBP+ eosinophils. The activation markers CD25 and HLA-DR were up-regulated in the tuberculin-injected sites. In situ hybridization was performed using 35S-labeled riboprobes for interleukin (IL)-2, interferon (IFN)-gamma, IL-4, and IL-5. After tuberculin injection, a preferential Th-1-type cytokine profile was observed with significant increases in the numbers of IL-2 and IFN-gamma mRNA-expressing cells. These results are similar to those reported after tuberculin-induced delayed-type hypersensitivity in humans, suggesting that this model might be useful to study cutaneous inflammatory reaction. Images Figure 4 PMID:9626072

  7. Tuberculin-induced delayed-type hypersensitivity reaction in a model of hu-PBMC-SCID mice grafted with autologous skin.

    PubMed

    Tsicopoulos, A; Pestel, J; Fahy, O; Vorng, H; Vandenbusche, F; Porte, H; Eraldi, L; Wurtz, A; Akoum, H; Hamid, Q; Wallaert, B; Tonnel, A B

    1998-06-01

    We have developed an animal model to study human delayed-type hypersensitivity reactions. Previous studies in humans have shown after tuberculin injection the presence of a mononuclear cell infiltration, with almost no eosinophils, associated with a preferential Th-1-type cytokine profile. Human skin graft obtained from tuberculin-reactive donors was grafted onto the back of severe combined immunodeficient mice. After healing, mice were reconstituted intraperitoneally with peripheral mononuclear cells. Tuberculin and diluent were injected intradermally, and skin biopsies were performed 72 hours later. Skin grafts were divided into two parts, one for immunohistochemistry and one for in situ hybridization studies. Immunohistochemistry was performed on cryostat sections using the alkaline phosphatase anti-alkaline phosphatase technique. In the tuberculin-injected sites as compared with the diluent-injected sites, there were significant increases in the number of CD45+ pan leukocytes and CD4+, CD8+, CD45RO+ T cells but not in CD68+ monocytes/macrophages and EG2 or MBP+ eosinophils. The activation markers CD25 and HLA-DR were up-regulated in the tuberculin-injected sites. In situ hybridization was performed using 35S-labeled riboprobes for interleukin (IL)-2, interferon (IFN)-gamma, IL-4, and IL-5. After tuberculin injection, a preferential Th-1-type cytokine profile was observed with significant increases in the numbers of IL-2 and IFN-gamma mRNA-expressing cells. These results are similar to those reported after tuberculin-induced delayed-type hypersensitivity in humans, suggesting that this model might be useful to study cutaneous inflammatory reaction. PMID:9626072

  8. An experiment to study the effects of space flight cells of mesenchymal origin in the new model 3D-graft in vitro

    NASA Astrophysics Data System (ADS)

    Volova, Larissa

    One of the major health problems of the astronauts are disorders of the musculoskeletal system, which determines the relevance of studies of the effect of space flight factors on osteoblastic and hondroblastic cells in vitro. An experiment to study the viability and proliferative activity of cells of mesenchymal origin on culture: chondroblasts and dermal fibroblasts was performed on SC "BION -M" № 1 with scientific equipment " BIOKONT -B ." To study the effect of space flight conditions in vitro at the cellular level has developed a new model with 3D- graft as allogeneic demineralized spongiosa obtained on technology Lioplast ®. For space and simultaneous experiments in the laboratory of the Institute of Experimental Medicine and Biotechnology Samara State Medical University were obtained from the cell culture of hyaline cartilage and human skin, which have previously been grown, and then identified by morphological and immunohistochemical methods. In the experiment, they were seeded on the porous 3D- graft (controlled by means of scanning electron and confocal microscopy) and cultured in full growth medium. After completion of the flight of spacecraft "BION -M" № 1 conducted studies of biological objects using a scanning electron microscope (JEOL JSM-6390A Analysis Station, Japan), confocal microscopy and LDH - test. According to the results of the experiment revealed that after a 30- day flight of the cells not only retained vitality, but also during the flight actively proliferate, and their number has increased by almost 8 times. In synchronous experiment, all the cells died by this date. The experimentally confirmed the adequacy of the proposed model 3D- graft in studying the effect of space flight on the morphological and functional characteristics of cells in vitro.

  9. Design and optimization of a tissue-engineered bone graft substitute

    NASA Astrophysics Data System (ADS)

    Shimko, Daniel Andrew

    2004-12-01

    In 2000, 3.1 million surgical procedures on the musculoskeletal system were reported in the United States. For many of these cases, bone grafting was essential for successful fracture stabilization. Current techniques use intact bone obtained either from the patient (autograft) or a cadaver (allograft) to repair large defects, however, neither source is optimal. Allografts suffer integration problems, and for autografts, the tissue supply is limited. Because of these shortcomings, and the high demand for graft tissues, alternatives are being explored. To successfully engineer a bone graft replacement, one must employ a three pronged research approach, addressing (1) the cells that will inhabit the new tissue, (2) the culture environment that these cells will be exposed to, and (3) the scaffold in which these cells will reside. The work herein examines each of these three aspects in great detail. Both adult and embryonic stem cells (ESCs) were considered for the tissue-engineered bone graft. Both exhibited desirable qualities, however, neither were optimal in all categories examined. In the end, the possibility of teratoma formation and ethical issues surrounding ESCs, made the use of adult marrow-derived stem cells in the remaining experiments obligatory. In subsequent experiments, the adult stem cells' ability to form bone was optimized. Basic fibroblast growth factor, fetal bovine serum, and extracellular calcium supplementation studies were all performed. Ultimately, adult stem cells cultured in alpha-MEM supplemented with 10% fetal bovine serum, 10mM beta-glycerophosphate, 10nM dexamethasone, 50mug/ml ascorbic acid, 1%(v/v) antibiotic/antimycotic, and 10.4mM CaCl2 performed the best, producing nearly four times more mineral than any other medium formulation. Several scaffolds were then investigated including those fabricated from poly(alpha-hydroxy esters), tantalum, and poly-methylmethacrylate. In the final study, the most appealing cell type, medium

  10. A Pilot Clinical Study of Olfactory Mucosa Autograft for Chronic Complete Spinal Cord Injury

    PubMed Central

    IWATSUKI, Koichi; TAJIMA, Fumihiro; OHNISHI, Yu-ichiro; NAKAMURA, Takeshi; ISHIHARA, Masahiro; HOSOMI, Koichi; NINOMIYA, Koshi; MORIWAKI, Takashi; YOSHIMINE, Toshiki

    2016-01-01

    Recent studies of spinal cord axon regeneration have reported good long-term results using various types of tissue scaffolds. Olfactory tissue allows autologous transplantation and can easily be obtained by a simple biopsy that is performed through the external nares. We performed a clinical pilot study of olfactory mucosa autograft (OMA) for chronic complete spinal cord injury in eight patients according to the procedure outlined by Lima et al. Our results showed no serious adverse events and improvement in both the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade and ASIA motor score in five patients. The preoperative post-rehabilitation ASIA motor score improved from 50 in all cases to 52 in case 2, 60 in case 4, 52 in case 6, 55 in case 7, and 58 in case 8 at 96 weeks after OMA. The AIS improved from A to C in four cases and from B to C in one case. Motor evoked potentials (MEPs) were also seen in one patient, reflecting conductivity in the central nervous system, including the corticospinal tract. The MEPs induced with transcranial magnetic stimulation allow objective assessment of the integrity of the motor circuitry comprising both the corticospinal tract and the peripheral motor nerves.We show the feasibility of OMA for chronic complete spinal cord injury. PMID:27053327

  11. Cellular repopulation of deep-frozen meniscal autografts: an experimental study in the dog.

    PubMed

    Arnoczky, S P; DiCarlo, E F; O'Brien, S J; Warren, R F

    1992-01-01

    This study evaluated the cellular repopulation of deep-frozen meniscal autografts. Medial menisci of adult dogs were excised, deep-frozen in liquid nitrogen (-196 degrees C) for 10 min, and orthotopically reimplanted into the joint. Deep-freezing was found to effectively kill all the cells within the meniscus as determined by the absence of Na(2)35SO4 incorporation. Following orthotopic replacement within the knee joint, menisci were repopulated with cells that seemed to originate from the adjacent synovium. These cells migrated over the surface of the meniscus and began to invade the deeper layers of the tissue. However, even after 6 months, the central core of the meniscus remained acellular. While the new cells appeared to modulate into cells that are similar in appearance to meniscal fibrochondrocytes, the exact phenotypic expression of these newly differentiated cells has yet to be determined. Histological alterations, as manifested by a loss of normal orientation of the collagen architecture of the superficial layers of the meniscus; was evident at 6 months and suggests that a remodeling phenomenon may be associated with the cellular repopulation. While biomaterial studies have not been carried out on these specimens, the morphologic alterations observed in the collagen orientation would suggest a possible alteration in the material properties of the repopulated meniscus. The clinical implication of this study is that the structural remodeling associated with the cellular repopulation of deep-frozen meniscal allografts may make the transplanted meniscus more susceptible to injury. PMID:1466700

  12. A Pilot Clinical Study of Olfactory Mucosa Autograft for Chronic Complete Spinal Cord Injury.

    PubMed

    Iwatsuki, Koichi; Tajima, Fumihiro; Ohnishi, Yu-Ichiro; Nakamura, Takeshi; Ishihara, Masahiro; Hosomi, Koichi; Ninomiya, Koshi; Moriwaki, Takashi; Yoshimine, Toshiki

    2016-06-15

    Recent studies of spinal cord axon regeneration have reported good long-term results using various types of tissue scaffolds. Olfactory tissue allows autologous transplantation and can easily be obtained by a simple biopsy that is performed through the external nares. We performed a clinical pilot study of olfactory mucosa autograft (OMA) for chronic complete spinal cord injury in eight patients according to the procedure outlined by Lima et al. Our results showed no serious adverse events and improvement in both the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade and ASIA motor score in five patients. The preoperative post-rehabilitation ASIA motor score improved from 50 in all cases to 52 in case 2, 60 in case 4, 52 in case 6, 55 in case 7, and 58 in case 8 at 96 weeks after OMA. The AIS improved from A to C in four cases and from B to C in one case. Motor evoked potentials (MEPs) were also seen in one patient, reflecting conductivity in the central nervous system, including the corticospinal tract. The MEPs induced with transcranial magnetic stimulation allow objective assessment of the integrity of the motor circuitry comprising both the corticospinal tract and the peripheral motor nerves.We show the feasibility of OMA for chronic complete spinal cord injury. PMID:27053327

  13. DNA nanosensor surface grafting and salt dependence

    NASA Astrophysics Data System (ADS)

    Carvalho, B. G.; Fagundes, J.; Martin, A. A.; Raniero, L.; Favero, P. P.

    2013-02-01

    In this paper we investigated the Paracoccidoides brasiliensis fungus nanosensor by simulations of simple strand DNA grafting on gold nanoparticle. In order to improve the knowledge of nanoparticle environment, the addiction of salt solution was studied at the models proposed by us. Nanoparticle and DNA are represented by economic models validated by us in this paper. In addition, the DNA grafting and salt influences are evaluated by adsorption and bond energies calculations. This theoretical evaluation gives support to experimental diagnostics techniques of diseases.

  14. Graft selection strategy in adult-to-adult living donor liver transplantation: When both hemiliver grafts meet volumetric criteria.

    PubMed

    Kurihara, Takeshi; Yoshizumi, Tomoharu; Yoshida, Yoshihiro; Ikegami, Toru; Itoh, Shinji; Harimoto, Norifumi; Ninomiya, Mizuki; Uchiyama, Hideaki; Okabe, Hirohisa; Kimura, Koichi; Kawanaka, Hirofumi; Shirabe, Ken; Maehara, Yoshihiko

    2016-07-01

    To ensure donor safety in living donor liver transplantation (LDLT), the left and caudate lobe (LL) is the preferred graft choice. However, patient prognosis may still be poor even if graft volume (GV) selection criteria are met. Our aim was to evaluate the effects of right lobe (RL) donation when the LL graft selection criteria are met. Consecutive donors (n = 135) with preoperative LL graft volumetric GV/standard liver volume (SLV) of ≥35% and RL remnant of ≥35% were retrospectively studied. Patients were divided into 2 groups: LL graft and RL graft. Recipient's body surface area (BSA), Model for End-Stage Liver Disease (MELD) score, and the donor's age were higher in the RL group. The donor's BSA and preoperative volumetric GV/SLV of the LL graft were smaller in the RL group. The predicted score (calculated using data for graft size, donor age, MELD score, and the presence of portosystemic shunt, which correlated well with graft function and with 6-month graft survival) of the RL group, was significantly lower if the LL graft were used, but using the actual RL graft improved the score equal to that of the LL group. Six-month and 12-month graft survival rates did not differ between the 2 groups. In patients with a poor prognosis, a larger RL graft improved the predicted score and survival was equal to that of patients who received LL grafts. In conclusion, graft selection by GV, donor age, and recipient MELD score improves outcomes in LDLT. Liver Transplantation 22 914-922 2016 AASLD. PMID:26953726

  15. A minimum 2-year comparative study of autologous cancellous bone grafting versus beta-tricalcium phosphate in anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage.

    PubMed

    Yamagata, Toru; Naito, Kentaro; Arima, Hironori; Yoshimura, Masaki; Ohata, Kenji; Takami, Toshihiro

    2016-07-01

    Although titanium stand-alone cages are commonly used in anterior cervical discectomy and fusion (ACDF), there are several concerns such as cage subsidence after surgery. The efficacy of β-tricalcium phosphate (β-TCP) granules as a packing material in 1- or 2-level ACDF using a rectangular titanium stand-alone cage is not fully understood. The purpose of this study is to investigate the validity of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP. This retrospective study included 55 consecutive patients who underwent ACDF with autologous iliac cancellous bone grafting and 45 consecutive patients with β-TCP grafting. All patients completed at least 2-year postoperative follow-up. Univariate and multivariate analyses were performed to examine the associations between study variables and nonunion after surgery. Significant neurological recovery after surgery was obtained in both groups. Cage subsidence was noted in 14 of 72 cages (19.4 %) in the autograft group and 12 of 64 cages (18.8 %) in the β-TCP group. A total of 66 cages (91.7 %) in the autograft group showed osseous or partial union, and 58 cages (90.6 %) in the β-TCP group showed osseous or partial union by 2 years after surgery. There were no significant differences in cage subsidence and the bony fusion rate between the two groups. Multivariate analysis using a logistic regression model showed that fusion level at C6/7, 2-level fusion, and cage subsidence of grades 2-3 were significantly associated with nonunion at 2 years after surgery. Although an acceptable surgical outcome with negligible complication appears to justify the use of rectangular titanium stand-alone cages in 1- and 2-level ACDF with β-TCP, cage subsidence after surgery needs to be avoided to achieve acceptable bony fusion at the fused segments. Fusion level at C6/7 or 2-level fusion may be another risk factor of nonunion. PMID:27098659

  16. A Modification to Simplify the Harvest of a Hemi-hamate Autograft.

    PubMed

    DeNoble, Peter H; Record, Nicole C

    2016-05-01

    Hemi-hamate arthroplasty is a valuable option for subacute dorsal fracture-dislocations of the proximal interphalangeal joint. Various harvesting techniques have been recommended via both anterograde and retrograde directions, both posing some technical challenges. We propose a technique for simplifying the hemi-hamate graft harvest by creating a window of visualization onto the dorsal hamate articular surface. This is achieved by resection of the dorsal-ulnar base of fourth metacarpal and the dorsal-radial base of the fifth metacarpal. This makes it easier to measure and cut the hamate articular surface. It also provides a properly shaped graft that can be inset in the middle phalangeal defect without using backgrafting, and allowing screws to be placed perpendicular to the graft defect to obtain direct compression. PMID:27039348

  17. Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model.

    PubMed

    Hu, Ming-Hsien; Lee, Pei-Yuan; Chen, Wen-Cheng; Hu, Jin-Jia

    2014-12-01

    This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4-L5 vertebrae in fifteen adult rats (n=5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion. PMID

  18. Modeling and optimization of the flocculation processes for removal of cationic and anionic dyes from water by an amphoteric grafting chitosan-based flocculant using response surface methodology.

    PubMed

    Wu, Hu; Yang, Ran; Li, Ruihua; Long, Chao; Yang, Hu; Li, Aimin

    2015-09-01

    In this study, an amphoteric grafting chitosan-based flocculant (carboxymethyl chitosan-graft-poly(2-methacryloyloxyethyl) trimethyl ammonium chloride, denoted as CMC-g-PDMC) was applied to removal of the anionic and cationic dyes, acid Green 25 (AG25) and Basic Bright Yellow (7GL), from water. Flocculation conditions have been optimized by response surface methodology (RSM) on the basis of central composite design (CCD) using flocculant dosage, initial solution pH and temperature as input variables. The second-order and cubic regression models, which have been both tested by the analysis of variance (ANOVA), were constructed to link the output response (the dye removal factor) with the aforementioned input variables, respectively. The second-order regression model well described the process of AG25 removal, whereas the cubic one is more suitable for that of 7GL. The effects of those variables on the flocculation performance of CMC-g-PDMC for removal of the two dyes containing opposite charges from aqueous solutions have been studied, and the flocculation mechanisms including the interactive effects between various influencing factors have been discussed in detail also. PMID:25921759

  19. Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model

    PubMed Central

    Hasatsri, Sukhontha; Angspatt, Apichai; Aramwit, Pornanong

    2015-01-01

    We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

  20. Development of a method to extend by boron neutron capture process the therapeutic possibilities of a liver autograft

    NASA Astrophysics Data System (ADS)

    Pinelli, Tazio; Altieri, Saverio; Fossati, F.; Zonta, Aris; Prati, U.; Roveda, L.; Nano, Rosanna

    1997-02-01

    We present results on surgical technique, neutron filed and irradiation facility concerning the original treatment of the liver diffused metastases. Our method plans to irradiate the isolated organ at a thermal neutron field soon after having been explanted and boron enriched and before being grafted into the same donor. In particular the crucial point of boron uptake was investigated by a rat model with a relevant number of procedure. We give for the first time statistically significant results on the selective boron absorption by tumor tissues.

  1. Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature

    PubMed Central

    Ventura, Alberto; Terzaghi, Clara; Borgo, Enrico; Albisetti, Walter

    2010-01-01

    Anterior cruciate ligament (ACL) rupture, one of the most common knee injuries in sports, results in anteroposterior laxity, which often leads to an unstable knee. Traditional ACL reconstruction is performed with autograft; disadvantages of this technique are donor site morbidity and a long rehabilitation period. In the 1980s, artificial ligaments became an attractive alternative to biological grafts. The initial enthusiasm surrounding their introduction stemmed from their lack of donor morbidity, their abundant supply and significant strength, immediate loading and reduced postoperative rehabilitation. Synthetic grafts made of different materials such as carbon fibers, polypropylene, Dacron and polyester have been utilised either as a prosthesis or as an augmentation for a biological ACL graft substitute. Nevertheless, every material presented serious drawbacks: cross-infections, immunological responses, breakage, debris dispersion leading to synovitis, chronic effusions, recurrent instability and knee osteoarthritis. Recently, a resurgence of interest in the use of synthetic prostheses has occurred and studies regarding new artificial grafts have been reported. Although many experimental studies have been made and much effort has been put forth, currently no ideal prosthesis mimicking natural human tissue has been found. PMID:20157811

  2. Adaptive significance of root grafting in trees

    SciTech Connect

    Loehle, C.; Jones, R.

    1988-12-31

    Root grafting has long been observed in forest trees but the adaptive significance of this trait has not been fully explained. Various authors have proposed that root grafting between trees contributes to mechanical support by linking adjacent root systems. Keeley proposes that this trait would be of greatest advantage in swamps where soils provide poor mechanical support. He provides as evidence a greenhouse study of Nyssa sylvatica Marsh in which seedlings of swamp provenance formed between-individual root grafts more frequently than upland provenance seedlings. In agreement with this within-species study, Keeley observed that arid zone species rarely exhibit grafts. Keeley also demonstrated that vines graft less commonly than trees, and herbs never do. Since the need for mechanical support coincides with this trend, these data seem to support his model. In this paper, the authors explore the mechanisms and ecological significance of root grafting, leading to predictions of root grafting incidence. Some observations support and some contradict the mechanical support hypothesis.

  3. Heat shock protein 60 affects behavioral improvement in a rat model of Parkinson's disease grafted with human umbilical cord mesenchymal stem cell-derived dopaminergic-like neurons.

    PubMed

    Zhao, Can; Li, Hui; Zhao, Xian-Jing; Liu, Zheng-Xia; Zhou, Ping; Liu, Ying; Feng, Mei-Jiang

    2016-06-01

    Parkinson's disease (PD) is a neurodegenerative disorder that is caused by a loss of dopaminergic (DAergic) neurons in mesencephalic substantia nigra (SN). Human umbilical cord mesenchymal stem cells (hUC-MSCs) are capable of self-renewal and differentiation into multiple cell lineages, including DAergic neurons. Thus, hUC-MSCs could be a promising alternative to compensate for the loss of DAergic neurons in PD. In the current study, hUC-MSCs and hUC-MSCs-derived DAergic-like neurons were transplanted into the striatum and SN of a rat model of PD that is induced by 6-hydroxydopamine (6-OHDA). We evaluated their therapeutic effects on improving rotation behavior in the rat and on modulating the level of heat shock protein 60 (Hsp60) expression in the brain. After transplantation, an amelioration of rotation behavior was observed in rats that underwent cell grafting, and hUC-MSCs-derived DAergic-like neurons were superior to hUC-MSCs at inducing behavioral improvement. Western blot and immunohistochemistry analysis indicated significantly elevated levels of Hsp60 in cell-grafted rats compared to 6-OHDA-lesioned (PD) rats. These results demonstrate that hUC-MSCs-based cell transplantation is potential therapeutic treatment for PD, and hUC-MSCs-derived DAergic-like neurons appear to be favorable candidates for cell replacement therapy in PD. Finally, Hsp60 could be involved in a mechanism of behavioral recovery. PMID:26758268

  4. Nanocomposite Treatment Reduces Disease and Lethality in a Murine Model of Acute Graft-versus-Host Disease and Preserves Anti-Tumor Effects

    PubMed Central

    Resende, Carolina B.; De Paula, Talles P.; Reis, Alesandra C.; Gonçalves, William A.; Vieira, Elias G.; Pinheiro, Maurício V. B.; Souza, Danielle G.; Castor, Marina G. M.; Teixeira, Mauro M.; Pinho, Vanessa

    2015-01-01

    Graft versus host disease (GVHD) is an immunological disorder triggered by bone marrow transplantation that affects several organs, including the gastrointestinal tract and liver. Fullerenes and their soluble forms, fullerols, are nanocomposites with a closed symmetrical structure with anti-inflammatory and anti-oxidant properties. The present study evaluated the effects of treatment with the fullerol (C60(OH)18-20) in the development and pathogenesis of GVHD in a murine model. Mice with experimental GVHD that were treated with the fullerol showed reduced clinical signs of disease and mortality compared with untreated mice. Treatment with the fullerol decreased the hepatic damage associated with reduced hepatic levels of reactive oxygen species, pro-inflammatory cytokines and chemokines (IFN-γ TNF-α, CCL2, CCL3 and CCL5) and reduced leukocyte accumulation. The amelioration of GVHD after treatment with the fullerol was also associated with reduced intestinal lesions and consequent bacterial translocation to the blood, liver and peritoneal cavity. Moreover, the fullerol treatment alleviated the GVHD while preserving effects of the graft against a leukemia cell line (GFP+P815). In summary, the fullerol was effective in reducing the GVHD inflammatory response in mice and may suggest novel ways to treat this disease. PMID:25875016

  5. Inhibition of indoleamine 2,3-dioxygenase by stereoisomers of 1-methyl tryptophan in an experimental graft-versus-tumor model.

    PubMed

    Lim, Ji-Young; Lee, Sung-Eun; Park, Gyenogsin; Choi, Eun Young; Min, Chang-Ki

    2014-10-01

    Indoleamine 2,3-dioxygenase (IDO) is a rate-limiting enzyme in tryptophan catabolism that plays an important role in the induction of immune tolerance. Its role in graft-versus-tumor effect after allogeneic stem cell transplantation (allo-SCT) remains unclear. Using a murine graft-versus-tumor model of reduced-intensity allo-HSCT followed by donor leukocyte infusion (DLI), we examined the role of IDO inhibition. Two stereoisomers of 1-methyl tryptophan (1-MT), a small-molecule inhibitor of IDO, reduced the growth of inoculated tumor in the mice that received DLI and had higher expression of IDO1 and IFNγ. However, L-1MT, but not D-1MT, mitigated tumor growth in mice that did not receive DLI and did not express IDO1 and IFNγ. Accordingly, both stereoisomers reduced plasma kynurenine concentrations early after DLI and enhanced in vitro cytotoxic lymphocyte function after allogeneic mixed lymphocyte reaction. Furthermore, L-1MT was more efficient in causing direct cytotoxic effects than D-1MT. Our results suggest that IDO inhibition can benefit anti-tumor therapy in the setting of reduced-intensity allo-SCT using DLI. PMID:24971697

  6. Bone graft and mesenchimal stem cells: clinical observations and histological analysis

    PubMed Central

    Bertolai, Roberto; Catelani, Carlo; Aversa, Alessandro; Rossi, Alessandro; Giannini, Domenico; Bani, Daniele

    2015-01-01

    Summary Autologous bone, for its osteoconductive, osteoinductive and osteogenetic properties, has been considered to be the gold standard for maxillary sinus augmentation procedures. Autograft procedures bring also some disadvantages: sometimes the limited amount of available intraoral bone makes necessary to obtain bone from an extraoral site, and this carries an associated morbidity. To overcome this problem we started using homologous freeze-dried bone in maxillary sinus augmentation procedures. This bone is industrially processed with γ-irradiation to eliminate its disease transmission potential and it’s considered safe, but this treatment also eliminates the osteoinductive and osteogenetic properties, making it just an inert scaffold for regeneration. Mesenchymal stem cells are successfully used in and orthopedic surgery for their amplification potential of healing mechanisms. We assumed that mesenchymal stem cells can restore the osteogenetic and osteoinductive properties in homologous bone grafts. The aim of this study was an histological evaluation of bone regeneration in maxillary sinus elevation using: 1) mesenchymal stem cells engineered freeze-dried bone allografts; 2) freeze-dried bone allografts. Twenty patients (10M, 10F) with a mean age of 55.2 years affected by severe maxillary atrophy were treated with bilateral maxillary sinus floor elevation. For each patient were randomly assigned a “test” side and a “control” side, different from each other exclusively in the composition of the graft material. The “control” sides were composed by corticocancellous freeze-dried bone chips and the “test” sides were composed by corticocancellous freeze-dried bone chips engineered in a bone marrow mesenchymal stem cells concentrate. After three months bone biopsies were performed on the grafts and histological specimens were made in order to evaluate the healed bone from an histological point of view. Histologically all the specimens showed

  7. Targeted SPECT/CT Imaging of Matrix Metalloproteinase Activity in the Evaluation of Remodeling Tissue-Engineered Vascular Grafts Implanted in a Growing Lamb Model

    PubMed Central

    Stacy, Mitchel R.; Naito, Yuji; Maxfield, Mark W.; Kurobe, Hirotsugu; Tara, Shuhei; Chan, Chung; Rocco, Kevin A.; Shinoka, Toshiharu; Sinusas, Albert J.; Breuer, Christopher K.

    2014-01-01

    Objective(s) The clinical translation of tissue-engineered vascular grafts has been demonstrated in children. The remodeling of biodegradable, cell-seeded scaffolds to functional neovessels is partially attributed to matrix metalloproteinases. Noninvasive assessment of matrix metalloproteinase activity may indicate graft remodeling and elucidate the progression of neovessel formation. Therefore, matrix metalloproteinase activity was evaluated in grafts implanted in lambs using in vivo and ex vivo hybrid imaging. Graft growth and remodeling was quantified using in vivo X-ray computed tomography angiography. Methods Cell-seeded and unseeded scaffolds were implanted in lambs (n=5) as inferior vena cava interposition grafts. At 2 and 6 months post-implantation, in vivo angiography assessed graft morphology. In vivo and ex vivo single photon emission tomography/X-ray computed tomography imaging was performed with a radiolabeled compound targeting matrix metalloproteinase activity at 6 months. Neotissue was examined at 6 months using qualitative histologic and immunohistochemical staining and quantitative biochemical analysis. Results Seeded grafts demonstrated significant luminal and longitudinal growth from 2 to 6 months. In vivo imaging revealed subjectively higher matrix metalloproteinase activity in grafts vs. native tissue. Ex vivo imaging confirmed a quantitative increase in matrix metalloproteinase activity and demonstrated higher activity in unseeded vs. seeded grafts. Glycosaminoglycan content was increased in seeded grafts vs. unseeded grafts, without significant differences in collagen content. Conclusions Matrix metalloproteinase activity remains elevated in tissue-engineered grafts 6 months post-implantation and may indicate remodeling. Optimization of in vivo imaging to noninvasively evaluate matrix metalloproteinase activity may assist in serial assessment of vascular graft remodeling. PMID:24952823

  8. Skin flaps and grafts - self-care

    MedlinePlus

    ... Regional flaps - self-care; Distant flaps - self-care; Free flap - self-care; Skin autografting - self-care ... the dressing and area around it clean and free from dirt or sweat. Don't let the ...

  9. Comparison between conventional salvage therapy and high-dose therapy with autografting for recurrent or refractory Hodgkin's disease.

    PubMed

    Yuen, A R; Rosenberg, S A; Hoppe, R T; Halpern, J D; Horning, S J

    1997-02-01

    Sixty patients with Hodgkin's disease, refractory to or at first recurrence after chemotherapy, received cytoreductive therapy followed by high-dose etoposide, cyclophosphamide and either total body irradiation or carmustine and autografting (median follow-up, 3.6 years; range, 1.1 to 7.5 years). A matched conventional salvage group of 103 patients was selected from patients treated at Stanford University Medical Center between January 1976 and January 1989 (median follow-up, 10.3 years; range, 3.0 to 15.7 years). Overall survival (OS), event-free survival (EFS), and freedom from progression (FFP) at 4 years follow-up favored patients who received high-dose therapy compared with conventional salvage treatment (OS: 54% v 47%, P = .25; EFS: 53% v 27%, P < .01; FFP: 62% v 32%, P < .01). In Cox regression analysis, response to cytoreductive or salvage therapy and B symptoms at relapse were the most important predictors of OS. The use of high-dose therapy at relapse, a longer duration of remission, and favorable response to cytoreductive or salvage therapy were most predictive of superior FFP and EFS. These data from a single institution comparing conventional and high-dose therapy in matched patients demonstrate an advantage for high-dose therapy and autografting in the sustained control of Hodgkin's disease. As with primary therapy, it is difficult to demonstrate a statistically significant survival advantage, despite an apparently superior cure rate. However, patients failing induction therapy or relapsing within 1 year benefited significantly from high-dose therapy by all outcome measures (OS, EFS, FFP). As the transplant-related mortality rates decline in Hodgkin's disease, it is predicted that cure rates and late effects will become ultimate determinants of the success of high-dose therapy and autografting. PMID:9028312

  10. Irradiation autogenous mandibular grafts in primary reconstructions

    SciTech Connect

    Hamaker, R.C.

    1981-07-01

    The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

  11. Extracorporeally irradiated autograft-prosthetic composite arthroplasty with vascular reconstruction for primary bone tumor of the proximal tibia.

    PubMed

    Emori, Makoto; Hashimoto, Nobuyuki; Hamada, Ken-Ichiro; Naka, Norifumi; Takami, Hiroshi; Araki, Nobuhito

    2011-02-01

    The proximal tibia is a common site for primary bone tumors. Proximal tibial tumors may invade the adjacent soft-tissue by destroying the cortex and may further invade neurovascular bundles. We treated a patient with primary bone tumor of the proximal tibia with neurovascular invasion by extracorporeally irradiated autograft-prosthetic composite arthroplasty with vascular reconstruction. In cases of concomitant allograft arthroplasty and vascular reconstruction, we recommend that vascular reconstruction be performed before arthroplasty to minimize ischemia time. Good oncological and functional outcomes were achieved 75 months after surgery. Therefore, this reconstruction technique can be considered as a good treatment option. PMID:20926245

  12. Epithelial-differentiated adipose-derived stem cells seeded bladder acellular matrix grafts for urethral reconstruction: an animal model.

    PubMed

    Li, Hongbin; Xu, Yuemin; Xie, Hong; Li, Chao; Song, Lujie; Feng, Chao; Zhang, Qin; Xie, Minkai; Wang, Ying; Lv, Xiangguo

    2014-02-01

    The limited amount of available epithelial tissue is considered a main cause of the high rate of urethral reconstruction failures. The aim of this study was to investigate whether epithelial-differentiated rabbit adipose-derived stem cells (Epith-rASCs) could play a role of epithelium in vivo functionally and be a potential substitute of urothelium. Substitution urethroplasty was performed to repair an anterior urethral defect in male New Zealand rabbits using Epith-rASCs seeded bladder acellular matrix grafts (BAMGs) after 5-bromo-2'-deoxyuridine (BrdU) labeling, based on the in vitro epithelial induction system we previously described. Urethroplasty with cell-free BAMGs and with undifferentiated rASCs (Und-rASCs) seeded BAMGs were performed as controls. After surgery, a notable amelioration of graft contracture and recovery of urethral continuity were observed in the Epith-rASCs/BAMG group by retrograde urethrograms and macroscopic inspection. Immunofluorescence revealed that the BrdU-labeled Epith-rASCs/Und-rASCs colocalized with cytokeratin 13 or myosin. Consistent with the results of western blotting, at early postimplantation stage, the continuous epithelial layer with local multilayered structure was observed in the Epith-rASCs/BAMG group, whereas no significant growth and local monolayer growth profile of epithelial cells were observed in the BAMG and Und-rASCs/BAMG group, respectively. The results showed that Epith-rASCs could serve as a potential substitute of urothelium for urethral tissue engineering and be available to prevent lumen contracture and subsequent complications including recurrent stricture. PMID:24329501

  13. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution.

    PubMed

    Zuhr, Otto; Bäumer, Daniel; Hürzeler, Markus

    2014-04-01

    Soft tissue replacement grafts have become a substantial element to increase tissue volume in plastic periodontal and implant surgery. Autogenous subepithelial connective tissue grafts are increasingly applied in aesthetic indications like soft tissue thickening, recession treatment, ridge preservation, soft tissue ridge augmentation and papilla re-construction. For the clinical performance of connective tissue graft harvesting and transplantation, a fundamental understanding of the anatomy at the donor sites and a sound knowledge of tissue integration and re-vascularization processes are required. Possible donor sites are the anterior and posterior palate including the maxillary tuberosity, providing grafts of distinct geometric shape and histologic composition. The selective clinical application of different grafts depends on the amount of required tissue, the indication and the personal preference of the treating surgeon. One of the main future challenges is to volumetrically evaluate and compare the efficacy and long-term stability of soft tissue autografts and their prospective substitutes. The aim of this review was to discuss the advantages and shortfalls of different donor sites, substitute materials and harvesting techniques. Although standardized recommendations regarding treatment choice and execution can hardly be given, guidelines for predictable and successful treatment outcomes are provided based on clinical experience and the available scientific data. PMID:24640997

  14. Arthroscopic Labrum Reconstruction in the Hip Using the Indirect Head of Rectus Femoris as a Local Graft: Surgical Technique.

    PubMed

    Sharfman, Zachary T; Amar, Eyal; Sampson, Thomas; Rath, Ehud

    2016-04-01

    The importance of the acetabular labrum has been well documented for the health and function of the hip joint. Labral reconstruction has proven effective but often requires the use of a cadaveric allograft or auto graft from the fascia lata or gracilis. The indirect head of the rectus femoris is in close proximity with the anterior superior acetabulum, which is the most common site of labral tears. Using the indirect head of the rectus femoris as a local graft minimizes surgical invasiveness by mitigating the need to harvest the graft from a different location, in case of an autograft, and by minimizing donor site morbidity and damage to local tissues. The graft is harvested and fixed to the acetabular rim through the same arthroscopic portals. Hip labral reconstruction using the reflected head of the rectus femoris tendon is a minimally invasive surgical procedure that restores stability to the hip joint, is applicable in all patients undergoing hip labral reconstruction, and offers decreased tissue morbidity compared with other grafting techniques. PMID:27462534

  15. Biology of cancellous bone grafts.

    PubMed

    Heiple, K G; Goldberg, V M; Powell, A E; Bos, G D; Zika, J M

    1987-04-01

    Despite 30 years of experimental bone grafting research, the fresh cancellous bone graft remains the most osteogenic and reliable bone grafting material. Recent experimental data suggest that modification of the graft-host interaction by antigen matching or immune manipulation may allow increasingly successful use of allografts. PMID:3550570

  16. Hepatocyte spheroid culture on fibrous scaffolds with grafted functional ligands as an in vitro model for predicting drug metabolism and hepatotoxicity.

    PubMed

    Yan, Shili; Wei, Jiaojun; Liu, Yaowen; Zhang, Hong; Chen, Jianmei; Li, Xiaohong

    2015-12-01

    The identification of a biologic substrate for maintaining hepatocyte functions is essential to provide reliable and predictable models for in vitro drug screening. In the current study, a three-dimensional culture of hepatocytes was established on highly porous fibrous scaffolds with grafted galactose and RGD to afford extensive cell-cell and cell-scaffold interactions spatially. The pore size and ligand densities indicated significant effects on the formation of hepatocyte spheroids in balancing the cell retention, adhesion, and migration on fibrous scaffolds. Fibrous scaffolds with an average pore size of 60 μm and surface grafting densities of galactose at 5.9 nmol/cm(2) and RGD at 6.9 pmol/cm(2) provided optimal microenvironments for hepatocyte infiltration and multicellular spheroid formation. Significant promotions were also demonstrated in the syntheses of albumin and urea and the activities of phase I (CYP 3A11 and CYP 2C9) and phase II enzymes. The in vitro metabolism tests on testosterone and acetaminophen by hepatocytes on the optimal scaffolds indicated the predicated clearance rates of 50.7 and 22.6 ml/min/kg, respectively, which were comparable to the in vivo values of rats. The in vitro hepatotoxicity tests on amiodarone hydrochloride and acetaminophen predicted the half maximal effective concentrations (EC50) to reflect the in vivo toxic plasma concentrations in human. In addition, the enzyme activities, predicted clearance rates and hepatotoxicity values of hepatocytes on the optimal scaffolds experienced sensitive responsiveness to specific inducers or inhibitors of CYP 3A11 and phase II enzymes, exhibiting in vivo-in vitro correlations to a certain extent. These results demonstrate the feasibility of hepatocyte spheroid culture on fibrous scaffolds as an potential in vitro testing model to predict the in vivo drug metabolism, hepatotoxicity, and drug-drug interactions. PMID:26409440

  17. Utility of a 3-dimensional full-scale NaCl model for rib strut grafting for anterior fusion for cervicothoracic kyphosis

    PubMed Central

    Kobayashi, Kazuyoshi; Imagama, Shiro; Muramoto, Akio; Ito, Zenya; Ando, Kei; Yagi, Hideki; Hida, Tetsuro; Ito, Kenyu; Ishikawa, Yoshimoto; Tsushima, Mikito; Ishiguro, Naoki

    2015-01-01

    ABSTRACT In severe spinal deformity, pain and neurological disorder may be caused by spinal cord compression. Surgery for spinal reconstruction is desirable, but may be difficult in a case with severe deformity. Here, we show the utility of a 3D NaCl (salt) model in preoperative planning of anterior reconstruction using a rib strut in a 49-year-old male patient with cervicothoracic degenerative spondylosis. We performed surgery in two stages: a posterior approach with decompression and posterior instrumentation with a pedicle screw; followed by a second operation using an anterior approach, for which we created a 3D NaCl model including the cervicothoracic lesion, spinal deformity, and ribs for anterior reconstruction. The 3D NaCl model was easily scraped compared with a conventional plaster model and was useful for planning of resection and identification of a suitable rib for grafting in a preoperative simulation. Surgery was performed successfully with reference to the 3D NaCl model. We conclude that preoperative simulation with a 3D NaCl model contributes to performance of anterior reconstruction using a rib strut in a case of cervicothoracic deformity. PMID:26412901

  18. Corneal recovery in a rabbit limbal stem cell deficiency model by autologous grafts of tertiary outgrowths from cultivated limbal biopsy explants

    PubMed Central

    Durak, Ismet; Gürdal, Mehmet; Baysal, Kemal; Ates, Halil; Ozbek, Zeynep; Wang, Zheng; Wu, Albert; Wolosin, J. Mario

    2016-01-01

    Purpose To determine the corneal regenerative capacity of sequentially generated primary, secondary, and tertiary limbal explant outgrowths in a limbal stem cell deficiency (LSCD) surgical model. Methods Two-millimeter-long limbal shallow biopsies were surgically excised from the upper quadrant of the right eye of rabbits and set on preserved amniotic membrane for explant culture. After the generation of primary outgrowth, the biopsies were sequentially transferred to new amniotic membrane to generate secondary and then tertiary outgrowths. Eighteen rabbits were subjected to a 360° limbal peritomy extending into the scleral zone and combined with superficial keratectomy of the corneal periphery and thorough mechanical debridement of the central cornea in their left eye. Right eye outgrowths, six of each generation, were engrafted on the ocular surface. Clinical outcomes (neovascularization, corneal clarity, and corneal fluorescein staining) were graded after 6 months. Post-mortem corneas were compared with histology, immunochemistry for p63 and Krt3, ABCG2-dependent dye exclusion, and capacity for outgrowths in explant culture. Results Immunohistology and western blot of the outgrowths for p63 and Krt3 indicated no differences in expression between the primary and tertiary outgrowths for these two markers of growth and differentiation. Clinically, all rabbits treated with amniotic membrane alone developed severe LSCD. Most rabbits grafted with cell outgrowths from all three outgrowth generations achieved stable (>6 months) recovery of the ocular surface. There were partial failures of grafts performed with two secondary and tertiary outgrowths. However, Kruskal–Wallis statistical analysis of the clinical scores yielded no significant difference between the three groups (p=0.524). Histology showed full anatomic recovery of grafts made with primary and tertiary outgrowths. Krt3 and p63 expression throughout the whole limbal corneal epithelium with primary or

  19. A comprehensive flow-cytometric analysis of graft infiltrating lymphocytes, draining lymph nodes and serum during the rejection phase in a fully allogeneic rat cornea transplant model

    PubMed Central

    Maenz, Martin; Morcos, Mourice

    2011-01-01

    Purpose To establish a cornea transplant model in a pigmented rat strain and to define the immunologic reaction toward corneal allografts, by studying the cellular and humoral immune response after keratoplasty. Methods Full thickness penetrating keratoplasty was performed on Brown Norway (RT1n) recipients using fully major histocompatibility complex (MHC)-mismatched Piebald-Viral-Glaxo (PVG; RT1c) donors. Using multicolor flow cytometry (FACS) we quantified and compared the cellular composition of draining versus non-draining lymph nodes (LN). Furthermore, we developed an isolation method to release viable graft infiltrating lymphocytes (GIL) and subjected them to phenotypic analysis and screened serum from transplanted animals for allo-antibodies. Results Assessing ipsi-lateral submandibular LN we find ample evidence for post surgical inflammation such as elevated absolute numbers of cluster of differentiation (CD)4+, CD8+, B-cells, and differential expression of CD134. However, we could not unequivocally identify an allo-antigen-specific immune response. FACS analysis of lymphocytes isolated from collagenase digested rejected corneas revealed the following six distinct subpopulations: MHC-2+ cells, CD4+ T-cells, CD8+ T-cells, CD161dull large granular lymphocytes, CD3+ CD8+ CD161dull natural killer (NK)-T-cells and CD161high CD3- NK cells. At post-operation day (POD)-07 only CD161dull MHC-2neg large granular lymphocytes (LGLs) were detected in syngeneic and allo-grafts. In concordance with an increase in B-cell numbers we often detected copious amounts of allo-antibodies in serum of rejecting animals, in particular immunoglobulin (Ig) M (IgM), immunoglobulin (Ig) G1 (IgG1), and IgG2a. Conclusions Our results demonstrate that despite its immune privileged status and low-responder characteristics of the strain combination, allogeneic corneal grafts mount a full fledged T helper1 (Th1) and Th2 response. The presence of NK-T-cells and NK-cells in rejecting corneas

  20. Autologous Hamstring Anterior Cruciate Ligament Graft Failure Using the Anteromedial Portal Technique With Suspensory Femoral Fixation

    PubMed Central

    Galdi, Balazs; Reyes, Allan; Brabston, Eugene W.; Levine, William N.

    2015-01-01

    Background: The anteromedial portal technique for drilling of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction has been advocated by many surgeons as allowing improved access to the anatomical footprint. Furthermore, suspensory fixation of soft tissue grafts has become popularized because of complications associated with cross-pin fixation. Concerns regarding the use of both have recently arisen. Purpose: To raise awareness of the increased risk of graft failure when using the anteromedial portal technique with suspensory femoral fixation during ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: From November 1998 to August 2012, a total of 465 primary ACL reconstructions were performed using quadrupled hamstring autograft tendons, with drilling of the femoral tunnel performed via the transtibial portal. Graft fixation on the femur was achieved with cross-pin fixation, while interference screw fixation was used on the tibia. From September 2012 to October 2013, there were 69 reconstructions performed through an anteromedial portal. While there was no change in graft choice, a change was made to using suspensory femoral fixation. No other surgical or postoperative rehabilitation changes were made. Results: During the 14-year period in which ACL reconstructions were performed via the transtibial portal and with cross-pin fixation, 2 graft failures (0.4% failure rate) were reported. After switching to the anteromedial portal with suspensory fixation, 7 graft failures (10.1% failure rate) were reported over a 13-month period. These were 5 male and 2 female patients, with a mean age of 18.8 years—all elite athletes. The same surgical technique was used in all patients, and all patients had at least an 8 mm–diameter graft. Patients were cleared to return to sport at an average of 8.4 months postoperatively, after completing functional performance tests. Of the 7 patients, 6 sustained a rerupture of the graft within

  1. Insolubilisation of biologically active materials with novel radiation graft copolymers

    NASA Astrophysics Data System (ADS)

    Garnett, J. L.; Jankiewicz, S. V.; Levot, R.; Sangster, D. F.

    The use of radiation grafting to immobilise a typical enzyme, trypsin, is reported. The technique involves radiation grafting to a backbone polymer a monomer containing an appropriate functional group to which the enzyme is bonded. In the present work, p-nitrostyrene has been grafted to representative trunk polymers, polypropylene and PVC, the nitro group in the resulting copolymer converted to the isothiocyanato derivative to which trypsin is attached. Of importance to this insolubilisation process, especially for radiation sensitive backbone polymers, is the inclusion of additives which enhance grafting. A new class of additives which increase the grafting yields is reported using as representative backbone polymers, naturally occurring cellulose and synthetic low density polyethylene. The new additives are specific metal salts such as LiClO 4. The reactivity of these salts in grafting enhancement has been compared with that of mineral acid which has previously been used as an additive to increase grafting yields in both preirradiation and simultaneous techniques. A new model for grafting enhancement in the presence of the metal salts as well as acids is proposed whereby increased grafting yields are attributed to increased partitioning of monomer into the graft region in the presence of ionic solutes. The value of these additives in preparing copolymers suitable for general reagent insolubilisation reactions is discussed.

  2. PRFM enhance wound healing process in skin graft.

    PubMed

    Reksodiputro, Mirta; Widodo, Dini; Bashiruddin, Jenny; Siregar, Nurjati; Malik, Safarina

    2014-12-01

    Facial plastic and reconstructive surgery often used skin graft on defects that cannot be covered primarily by a local flap. However, wound healing using skin graft is slow, most of the time the graft is contractured and the take of graft is not optimal. Platelet rich fibrin matrix (PRFM) is a new generation of concentrated platelets that produce natural fibrin and reported to speed up the healing process. Application of PRFM in the skin graft implants is expected to increase the survival of the graft. We used porcine as animal models to elucidate the effect of autologous PRFM on wound healing in full-thickness (FTSG) and split-thickness (STSG) skin grafts. Survival level of the skin graft was determined by using ImageJ software based on the formation of collagen type 1 and graft take. We observed that the use of PRFM in FTSG and STSG increased type 1 collagen formation. We also found that PRFM addition in STSG gave the best skin graft take. PMID:25536135

  3. The effects of early postoperative radiation on vascularized bone grafts

    SciTech Connect

    Evans, H.B.; Brown, S.; Hurst, L.N. )

    1991-06-01

    The effects of early postoperative radiation were assessed in free nonvascularized and free vascularized rib grafts in the canine model. The mandibles of one-half of the dogs were exposed to a cobalt 60 radiation dose of 4080 cGy over a 4-week period, starting 2 weeks postoperatively. The patency of vascularized grafts was confirmed with bone scintigraphy. Histological studies, including ultraviolet microscopy with trifluorochrome labeling, and histomorphometric analyses were performed. Osteocytes persist within the cortex of the vascularized nonradiated grafts to a much greater extent than in nonvascularized, nonradiated grafts. Cortical osteocytes do not persist in either vascularized or nonvascularized grafts subjected to radiation. New bone formation is significantly retarded in radiated grafts compared with nonradiated grafts. Periosteum and endosteum remained viable in the radiated vascularized grafts, producing both bone union and increased bone turnover, neither of which were evident to any significant extent in nonvascularized grafts. Bone union was achieved in vascularized and non-vascularized nonradiated bone. In the radiated group of dogs, union was only seen in the vascularized bone grafts.

  4. Proximal Tibial Bone Graft

    MedlinePlus

    ... Complications Potential problems after a PTBG include infection, fracture of the proximal tibia and pain related to the procedure. Frequently Asked Questions If proximal tibial bone graft is taken from my knee, will this prevent me from being able to ...

  5. Epidermal skin grafting.

    PubMed

    Herskovitz, Ingrid; Hughes, Olivia B; Macquhae, Flor; Rakosi, Adele; Kirsner, Robert

    2016-09-01

    Autologous skin grafts, such as full- and split-thickness, have long been part of the reconstructive ladder as an option to close skin defects. Although they are effective in providing coverage, they require the need for a trained surgeon, use of anaesthesia and operating room and creation of a wound at the donor site. These drawbacks can be overcome with the use of epidermal skin grafts (ESGs), which can be harvested without the use of anaesthesia in an office setting and with minimal to no scarring at the donor site. ESGs consist only of the epidermal layer and have emerged as an appealing alternative to other autologous grafts for the treatment of acute and chronic wounds. In this article, we provide an overview of epidermal grafting and its role in wound management. PMID:27547964

  6. Sizing of crimped Dacron grafts.

    PubMed

    Reid, J D; Sladen, J G

    1992-05-01

    The aim of this study was to correlate the stated size of Dacron grafts (Microvel) with their actual internal diameter and to compare this with measurements by ultrasound in the early postoperative period. Grafts of stated diameters of 7, 8, 9, and 10 mm were studied. Grafts were measured by graded probes and by measuring the width of the longitudinally opened graft and calculating the diameter. Each graft accepted a probe 1 mm larger than its stated size very easily and 2 mm greater when stretched. By open measurement, the grafts were 1.3 to 1.8 mm greater than their stated diameter without stretching. Twenty grafts were studied by duplex ultrasound for diameter and peak systolic velocity within 3 months of implantation. The grafts were 12% larger than their stated graft size. Some of the larger grafts showed low velocity and wall thrombus. We conclude that Microvel grafts are larger than their stated diameter. The same size discrepancy was seen in in vitro measurements of Vascutek (Dacron) grafts but not in polytetrafluoroethylene (Gortex) grafts. Since flow velocity is related to the diameter of the graft, this information should be useful when choosing the diameter of a prosthetic vascular graft. PMID:1533494

  7. Histology and ultrastructure of the coenenchyme of the octocoral Swiftia exserta, a model organism for innate immunity/graft rejection

    PubMed Central

    Menzel, L.P.; Tondo, C.; Stein, B.; Bigger, C.H.

    2015-01-01

    The octocoral Swiftia exserta has been utilized extensively in our laboratory to study innate immune reactions in Cnidaria such as wound healing, auto- and allo-graft reactions, and for some classical “foreign body” phagocytosis experiments. All of these reactions occur in the coenenchyme of the animal, the colonial tissue surrounding the axial skeleton in which the polyps are embedded, and do not rely on nematocysts or directly involve the polyps. In order to better understand some of the cellular reactions occurring in the coenenchyme, the present study employed several cytochemical methods (periodic acid–Schiff reaction, Mallory’s aniline blue collagen stain, and Gomori’s trichrome stain) and correlated the observed structures with electron microscopy (both scanning and transmission). Eight types of cells were apparent in the coenenchyme of S. exserta, exclusive of gastrodermal tissue: (i) epithelial ectoderm cells, (ii) oblong granular cells, (iii) granular amoebocytes, (iv) morula-like cells, (v) mesogleal cells, (vi) sclerocytes, (vii) axial epithelial cells, and (viii) cnidocytes with mostly atrichous isorhiza nematocysts. Several novel organizational features are now apparent from transmission electron micrographs: the ectoderm consists of a single layer of flat epithelial cells, the cell types of the mesoglea extend from beneath the thin ectoderm throughout the mesogleal cell cords, the organization of the solenia gastroderm consists of a single layer of cells, and two nematocyst types have been found. A new interpretation of the cellular architecture of S. exserta, and more broadly, octocoral biology is now possible. PMID:25596959

  8. [Zaidemberg's vascularized radial graft].

    PubMed

    Saint-Cast, Y

    2010-12-01

    In 1991, Carlos Zaidemberg described a new technique to repair scaphoid non-unions with a vascularized bone graft harvested from the radial styloid process. An anatomic study based on 30 dissections after colorized latex injection established the constancy of the radial styloid process's artery, while showing that its origin, course and length were subject to variations. In a retrospective series of 38 cases over a period of 10 years, the vascularized bone graft was indicated for: (1) scaphoid non-union with the presence of avascular changes of the proximal fragment (23 cases); (2) failed prior reconstruction with bone graft and internal fixation (nine cases); (3) degenerative styloid-scaphoid arthritis (three cases); (4) fracture on Preiser dystrophy (three cases). The five steps of the simplified operative technique without dissection of the vascular pedicle include: (1) longitudinal dorso-radial approach, identification of the periosteal portion of the radial styloid process artery; (2) incision of the first and second compartments, longitudinal arthrotomy under the second compartment; (3) styloidectomy and transversal resection of the scaphoid non-union and sclerotic bone; (4) elevation of the vascularized bone graft; (5) transversal and radial insertion of the vascularized bone graft, osteosynthesis by two or three K-wire touching the scaphoid's radial edge. Scaphoid union was obtained in 33 cases out of 38. The only postoperative complications were two transient radial paresthesia. The standardized surgical procedure using vascularized bone graft harvested from the radial styloid process provides an efficient scaphoid reconstruction. PMID:21087882

  9. Therapeutic efficacy of cord blood-derived mesenchymal stromal cells for the prevention of acute graft-versus-host disease in a xenogenic mouse model.

    PubMed

    Gregoire-Gauthier, Joëlle; Selleri, Silvia; Fontaine, François; Dieng, Mame Massar; Patey, Natalie; Despars, Geneviève; Beauséjour, Christian M; Haddad, Elie

    2012-07-01

    Human mesenchymal stromal cells (MSCs) have been successfully utilized for the treatment of refractory graft-versus-host disease (GvHD). Despite the large number of in vitro and in vivo models developed for clarifying their immunomodulatory properties, the mechanism of action of MSCs remains elusive and their efficacy controversial. Here, we tested the ability of cord blood-derived MSCs to alleviate the symptoms of GvHD induced by the injection of human peripheral blood mononuclear cells into NOD/SCID/γc(-) mice. In this in vivo xeno-GvHD model, we demonstrate that a single MSC injection is able to inhibit GvHD in terms of clinical signs and related mortality. We also show that in this model MSCs act by both immunomodulating T-cells and fostering recovery after irradiation. The translational impact of these findings could provide a reliable preclinical model for studying the efficacy, dosage, and time of administration of human MSCs for the prevention of acute GvHD. PMID:21910645

  10. Late outcomes after grafting of the severely burned face: a quality improvement initiative.

    PubMed

    Philp, Lauren; Umraw, Nisha; Cartotto, Robert

    2012-01-01

    Many approaches to surgical management of the severely burned face are described, but there are few objective outcome studies. The purpose of this study was to perform a detailed evaluation of the late outcomes in adult patients who have undergone grafting using a standardized surgical and rehabilitation approach for full-thickness (FT) facial burns to identify areas for improvement in the treatment strategy of authors. This was a prospective observational study in which patients who had undergone grafting for FT facial burns by the senior investigator at a regional burn centre between 1999 and 2010 were examined by a single evaluator. The surgical approach included tangential excision based on the facial aesthetic units, temporary cover with allograft then autografting with scalp skin preferentially, split grafts for the upper eyelid, and FT grafts for the lower eyelid. Rehabilitation included compression (uvex and or soft cloth), scar massage, and silicone gel sheeting. Of 35 patients with facial grafts, 14 subjects (age 43 ± 16 years with 22 ± 21% TBSA burns) returned for late follow-up at 40 ± 33 months (range, 5-91 months). A mean of four facial aesthetic units per patient were grafted (range, 1-9 units), with six full facial grafts performed. Scalp was used as donor in 10 of 14 cases. Scalp donor sites were well tolerated with minor alopecia visible in only one case although the donor site visibly extended slightly past the hairline in two cases. Color match with native skin was rated at 8.8 ± 0.8 of 10 when scalp skin was used compared with 7.5 ± 1.6 with other donor sites (P = .06). On the lip and chin, hypertrophic scars were significantly worse compared with the rest of the facial grafts (Vancouver scar scale 8 ± 2 vs 3 ± 1, P < .01). Sensory recovery was poor with overall moving two-point discrimination at 11 ± 3 mm (range, 4-15 mm), and monofilament light touch was 3.8 ± 0.6. Graft borders were significantly more elevated than graft seams. On

  11. Compliance mismatch and compressive wall stresses drive anomalous remodelling of pulmonary trunks reinforced with Dacron grafts.

    PubMed

    Nappi, Francesco; Carotenuto, Angelo Rosario; Cutolo, Arsenio; Fouret, Pierre; Acar, Christophe; Chachques, Juan Carlos; Fraldi, Massimiliano

    2016-10-01

    Synthetic grafts are often satisfactory employed in cardiac and vascular surgery, including expanded poly(ethylene terephthalate) or expanded poly(tetrafluoroethylene). However, accumulating evidences suggest the emergence of worrisome issues concerning the long-term fate of prosthetic grafts as large vessel replacement. Disadvantages related to the use of synthetic grafts can be traced in their inability of mimicking the elasto-mechanical characteristics of the native vascular tissue, local suture overstress leading to several prosthesis-related complications and retrograde deleterious effects on valve competence, cardiac function and perfusion. Motivated by this, in the present work it is analyzed - by means of both elemental biomechanical paradigms and more accurate in silico Finite Element simulations - the physical interaction among aorta, autograft and widely adopted synthetic (Dacron) prostheses utilized in transposition of pulmonary artery, highlighting the crucial role played by somehow unexpected stress fields kindled in the vessel walls and around suture regions, which could be traced as prodromal to the triggering of anomalous remodelling processes and alterations of needed surgical outcomes. Theoretical results are finally compared with histological and surgical data related to a significant experimental animal campaign conducted by performing pulmonary artery transpositions in 30 two-month old growing lambs, followed up during growth for six months. The in vivo observations demonstrate the effectiveness of the proposed biomechanical hypothesis and open the way for possible engineering-guided strategies to support and optimize surgical procedures. PMID:27442920

  12. Allogeneic bone marrow transplantation in models of experimental autoimmune encephalomyelitis: evidence for a graft-versus-autoimmunity effect.

    PubMed

    Van Wijmeersch, Bart; Sprangers, Ben; Rutgeerts, Omer; Lenaerts, Caroline; Landuyt, Willy; Waer, Mark; Billiau, An D; Dubois, Bénédicte

    2007-06-01

    Autologous hematopoietic stem cell transplantation (HSCT) is being explored in the treatment of severe multiple sclerosis (MS), and is based on the concept of "resetting" the immune system. The use of allogeneic HSCT may offer additional advantages, such as the replacement of the autoreactive immune compartment by healthy allogeneic cells and development of a graft-versus-autoimmunity (GVA) effect. However, in clinical practice, the genetic susceptibility to MS of allogeneic stem cell donors is generally unknown, and GVA may therefore be an important mechanism of action. Experimental autoimmune encephalomyelitis (EAE)-susceptible and -resistant mouse strains were used to determine the roles of genetic susceptibility, level of donor-chimerism, and alloreactivity in the therapeutic potential of syngeneic versus allogeneic bone marrow transplant (BMT) for EAE. After transplantation and EAE induction, animals were evaluated for clinical EAE and ex vivo myelin oligodendrocyte glycoprotein-specific proliferation. Early after BMT, both syngeneic and allogeneic chimeras were protected from EAE development. On the longer term, allogeneic but not syngeneic BMT conferred protection, but this required high-level donor-chimerism from EAE-resistant donors. Importantly, when EAE-susceptible donors were used, robust protection from EAE was obtained when active alloreactivity, induced by donor lymphocyte infusions, was provided. Our findings indicate the requirement of a sufficient level of donor-chimerism from a nonsusceptible donor in the therapeutic effect of allogeneic BMT. Importantly, the data indicate that, independently of genetic susceptibility, active alloreactivity is associated with a GVA effect, thereby providing new evidence to support the potential role of allogeneic BMT in the treatment of MS. PMID:17531772

  13. Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model

    PubMed Central

    Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.

    2013-01-01

    Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority. PMID:25289278

  14. The Synaptic Impact of the Host Immune Response in a Parkinsonian Allograft Rat Model: Influence on Graft-Derived Aberrant Behaviors

    PubMed Central

    Soderstrom, KE; Meredith, G; Freeman, TB; McGuire, SO; Collier, TJ; Sortwell, CE; Wu, Qun; Steece-Collier, K

    2010-01-01

    Graft-induced dyskinesias (GIDs), side-effects found in clinical grafting trials for Parkinson’s disease (PD), may be associated with the withdrawal of immunosuppression. The goal of this study was to determine the role of the immune response in GIDs. We examined levodopa-induced dyskinesias (LIDs), GIDs-like behaviors, and synaptic ultrastructure in levodopa-treated, grafted, parkinsonian rats with mild (sham), moderate (allografts) or high (allografts plus peripheral spleen cell injections) immune activation. Grafts attenuated amphetamine-induced rotations and LIDs, but two abnormal motor syndromes (tapping stereotypy, litter retrieval/chewing) emerged and increased with escalating immune activation. Immunohistochemical analyses confirmed immune activation and graft survival. Ultrastructural analyses showed increases in tyrosine hydroxylase-positive (TH+) axo-dendritic synapses, TH+ asymmetric specializations, and non-TH+ perforated synapses in grafted, compared to intact, striata. These features were exacerbated in rats with the highest immune activation and correlated statistically with GIDs-like behaviors, suggesting immune-mediated aberrant synaptology may contribute to graft-induced aberrant behaviors. PMID:18672063

  15. A continuum model for the bio-mechanical interactions between living tissue and bio-resorbable graft after bone reconstructive surgery

    NASA Astrophysics Data System (ADS)

    Madeo, Angela; Lekszycki, Tomasz; dell'Isola, Francesco

    2011-10-01

    We introduce a two-constituent porous continuum as a model describing the long-term growth/resorption phenomena in bone tissues grafted with bio-resorbable materials as driven by mechanical loads. The proposed model is able to account for the interplay between mechanical and biological phenomena which are known to be important for the bone tissue synthesis and the resorption of both bone tissue and bio-material. In particular, in the presented model the Lagrangian apparent mass densities of the natural bone and of the artificial material evolve in time according to precise ordinary differential equations. These latter are obtained by postulating a growth/resorption law and suitable constitutive equations conceived to account for the influence on bone resorption and synthesis of the action of different applied external loads as mediated by biological stimulus. The considered constitutive equations are chosen on the basis of the known biological phenomena occurring in bone resorption and synthesis. We present some numerical simulations for rod-bones subjected to axial external load. These numerical simulations allow for the description of the most desirable situation in which a gradual resorption of the artificial material takes place together with the contemporary formation of new bone, finally giving rise to an almost complete replacement of the artificial material with natural living tissue.

  16. Time-dependent bladder tissue regeneration using bilayer bladder acellular matrix graft-silk fibroin scaffolds in a rat bladder augmentation model.

    PubMed

    Zhao, Yang; He, Yi; Zhou, Zhe; Guo, Jian-hua; Wu, Jia-sheng; Zhang, Ming; Li, Wei; Zhou, Juan; Xiao, Dong-dong; Wang, Zhong; Sun, Kang; Zhu, Ying-jian; Lu, Mu-jun

    2015-09-01

    With advances in tissue engineering, various synthetic and natural biomaterials have been widely used in tissue regeneration of the urinary bladder in rat models. However, reconstructive procedures remain insufficient due to the lack of appropriate scaffolding, which should provide a waterproof barrier function and support the needs of various cell types. To address these problems, we have developed a bilayer scaffold comprising a porous network (silk fibroin [SF]) and an underlying natural acellular matrix (bladder acellular matrix graft [BAMG]) and evaluated its feasibility and potential for bladder regeneration in a rat bladder augmentation model. Histological (hematoxylin and eosin and Masson's trichrome staining) and immunohistochemical analyses demonstrated that the bilayer BAMG-SF scaffold promoted smooth muscle, blood vessel, and nerve regeneration in a time-dependent manner. At 12weeks after implantation, bladders reconstructed with the BAMG-SF matrix displayed superior structural and functional properties without significant local tissue responses or systemic toxicity. These results demonstrated that the bilayer BAMG-SF scaffold may be a promising scaffold with good biocompatibility for bladder regeneration in the rat bladder augmentation model. PMID:26049152

  17. Protective constriction of coronary vein grafts with knitted nitinol

    PubMed Central

    Moodley, Loven; Franz, Thomas; Human, Paul; Wolf, Michael F.; Bezuidenhout, Deon; Scherman, Jacques; Zilla, Peter

    2013-01-01

    .00001) in CO + FS vs 82 ± 61% in ME + FS (P < 0.007). CONCLUSIONS In a senescent non-human primate model for coronary artery bypass grafts, constrictive, external mesh support of saphenous veins with knitted nitinol prevented focal, irregular graft narrowing and suppressed neointimal tissue proliferation by a factor of 2.5. The lower degree of suppression of IH compared with previous infrainguinal grafts coincided with a lesser reduction of calibre mismatch in the coronary grafts. PMID:23295444

  18. Assessment of SiCaP-30 in a Rabbit Posterolateral Fusion Model with Concurrent Chemotherapy.

    PubMed

    Smucker, Joseph D; Petersen, Emily B; Al-Hili, Ali; Nepola, James V; Fredericks, Douglas C

    2015-01-01

    Chemotherapy derivatives of the rabbit posterolateral fusion model are considered a challenging environment in which to test bone graft materials. The purpose of this study was to determine the performance characteristics of SiCaP-30 as a bone graft substitute relative to autograft (iliac crest bone graft [ICBG]), Actifuse ABX and β-Tricalcium Phosphate-Bioactive Glass-Type I Collagen (βTCP-BG) in a rabbit posterolateral spine fusion model with concurrent chemotherapy treatment This was a randomized, controlled study in a laboratory setting with blinded assessment of fusion by manual palpation and flexibility testing. Sixty rabbits were entered into the study with 45 used for analysis. Chemotherapeutic agents, doxorubicin and cis-platin (2.5 mg/kg), were administered one week prior to surgery, and one, two and three weeks post surgery. Bilateral posterolateral lumbar intertransverse process fusions were performed at L5-L6. The lateral two thirds of the transverse processes were decorticated and covered with 3cc/side of one of the following graft materials: autologous ICBG, Actifuse ABX (ApaTech Ltd, UK), Vitoss BA (Orthovita, USA) or SiCaP-30 (ApaTech Ltd., UK). Animals were euthanized 12 weeks post surgery. The ICBG group had a 45% (5/11) manual palpation fusion rate and correlated with motion analysis fusion results of 36% (4/11). The Actifuse ABX group had a 33% (4/12) manual palpation fusion rate and a motion analysis fusion rate of 25% (3/12). No motion segments in the Vitoss BA group (0/11) showed any signs of fusion. The SiCaP-30 group demonstrated a statistically higher manual palpation and motion analysis fusion rate of 82% (9/11; p<0.05) and produced superior bone formation compared with Actifuse ABX and βTCP-BG. PMID:26361457

  19. Preoperative selective desensitization of live donor liver transplant recipients considering the degree of T lymphocyte cross-match titer, model for end-stage liver disease score, and graft liver volume.

    PubMed

    Hong, Geun; Yi, Nam-Joon; Suh, Suk-won; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, YoungRok; Lee, Kyungbun; Lee, Kwang-Woong; Park, Myoung Hee; Suh, Kyung-Suk

    2014-05-01

    Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. We performed desensitization for the selected patients according to the degree of T lymphocyte cross-match titer, model for end-stage liver disease (MELD) score, and graft liver volume. We retrospectively evaluated 230 consecutive ALDLT recipients for 5 yr. Eleven recipients (4.8%) showed a positive XM. Among them, five patients with the high titer (> 1:16) by antihuman globulin-augmented method (T-AHG) and one with a low titer but a high MELD score of 36 were selected for desensitization: rituximab injection and plasmapheresis before the transplantation. There were no major side effects of desensitization. Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P=1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe. PMID:24851018

  20. Use of a strontium-enriched calcium phosphate cement in accelerating the healing of soft-tissue tendon graft within the bone tunnel in a rabbit model of anterior cruciate ligament reconstruction.

    PubMed

    Kuang, G M; Yau, W P; Lu, W W; Chiu, K Y

    2013-07-01

    We investigated whether strontium-enriched calcium phosphate cement (Sr-CPC)-treated soft-tissue tendon graft results in accelerated healing within the bone tunnel in reconstruction of the anterior cruciate ligament (ACL). A total of 30 single-bundle ACL reconstructions using tendo Achillis allograft were performed in 15 rabbits. The graft on the tested limb was treated with Sr-CPC, whereas that on the contralateral limb was untreated and served as a control. At timepoints three, six, nine, 12 and 24 weeks after surgery, three animals were killed for histological examination. At six weeks, the graft-bone interface in the control group was filled in with fibrovascular tissue. However, the gap in the Sr-CPC group had already been completely filled in with new bone, and there was evidence of the early formation of Sharpey fibres. At 24 weeks, remodelling into a normal ACL-bone-like insertion was found in the Sr-CPC group. Coating of Sr-CPC on soft tissue tendon allograft leads to accelerated graft healing within the bone tunnel in a rabbit model of ACL reconstruction using Achilles tendon allograft. PMID:23814244

  1. Engineering anatomically shaped human bone grafts

    PubMed Central

    Grayson, Warren L.; Fröhlich, Mirjam; Yeager, Keith; Bhumiratana, Sarindr; Chan, M. Ete; Cannizzaro, Christopher; Wan, Leo Q.; Liu, X. Sherry; Guo, X. Edward; Vunjak-Novakovic, Gordana

    2009-01-01

    The ability to engineer anatomically correct pieces of viable and functional human bone would have tremendous potential for bone reconstructions after congenital defects, cancer resections, and trauma. We report that clinically sized, anatomically shaped, viable human bone grafts can be engineered by using human mesenchymal stem cells (hMSCs) and a “biomimetic” scaffold-bioreactor system. We selected the temporomandibular joint (TMJ) condylar bone as our tissue model, because of its clinical importance and the challenges associated with its complex shape. Anatomically shaped scaffolds were generated from fully decellularized trabecular bone by using digitized clinical images, seeded with hMSCs, and cultured with interstitial flow of culture medium. A bioreactor with a chamber in the exact shape of a human TMJ was designed for controllable perfusion throughout the engineered construct. By 5 weeks of cultivation, tissue growth was evidenced by the formation of confluent layers of lamellar bone (by scanning electron microscopy), markedly increased volume of mineralized matrix (by quantitative microcomputer tomography), and the formation of osteoids (histologically). Within bone grafts of this size and complexity cells were fully viable at a physiologic density, likely an important factor of graft function. Moreover, the density and architecture of bone matrix correlated with the intensity and pattern of the interstitial flow, as determined in experimental and modeling studies. This approach has potential to overcome a critical hurdle—in vitro cultivation of viable bone grafts of complex geometries—to provide patient-specific bone grafts for craniofacial and orthopedic reconstructions. PMID:19820164

  2. Sinus lift tissue engineering using autologous pulp micro-grafts: A case report of bone density evaluation

    PubMed Central

    Brunelli, Giorgio; Motroni, Alessandro; Graziano, Antonio; D’Aquino, Riccardo; Zollino, Ilaria; Carinci, Francesco

    2013-01-01

    Background: Although autografts are the standard procedure for bone grafting, the use of bone regeneration by means of dental pulp stem cell is an alternative that opens a new era in this field. Rigenera Protocol is a new technique able to provide the surgeon autologous pulp micro-grafts. Materials and Methods: At the Department of Oral Surgery, Don Orione Hospital, Bergamo, Italy, one patient underwent sinus lift elevation with pulp stem micro-grafts gentle poured onto collagen sponge. A CT scan control was performed after 4 months and DICOM data were processed with medical imaging software which gives the possibility to use a virtual probe to extract the bone density. Pearson's Chi-square test was used to investigate difference in bone density (BD) between native and newly formed bone. Results: BD in newly formed bone is about the double of native bone. Conclusion: This report demonstrated that micro-grafts derived from dental pulp poured onto collagen sponge are a useful method for bone regeneration in atrophic maxilla. PMID:24174760

  3. Application of discordant sib-pair linkage analysis for mapping minor histocompatibility antigen loci in a novel graft-vs-host-disease model.

    PubMed

    Araki, J; Ohashi, J; Muramatsu, M

    2004-09-01

    Graft-vs-host disease (GVHD) is an adverse effect of allogenic bone marrow transplantation. Although a major cause of GVHD following bone marrow transplantation is incompatibility of major histocompatibility antigen (human leukocyte antigen, HLA) in donor-recipient pairs, the incompatibility of minor histocompatibility antigen (mHa) is known as another cause, especially in HLA-matched donor-recipient pairs. In 1998, Lunetta and Rogus proposed the use of discordant sib-pair (DSP) linkage analysis for detecting mHa and calculated the statistical power using the GVHD model, assuming single mHa locus with multiple alleles. Recently, we proposed a different GVHD model, assuming multiple mHa loci with two alleles (biallelic), considering the single-nucleotide polymorphisms. When the effect of each mHa locus on the occurrence of GVHD is independent, the possible triangle for DSP proposed by Lunetta and Rogus is not optimum, but a new possible triangle, named here as GVHD region, is needed. We evaluated, based on Monte Carlo simulation, the test criteria [log of odds (lod) score cutoffs] and power of DSP using the GVHD region for various parameter sets. The GVHD region showed a higher power than the DSP and entire regions in plausible situations. Our results suggest that the application of GVHD region to DSP is effective for the screening of mHa loci. PMID:15304004

  4. Matrix-associated autologous chondrocyte transplantation combined with iliac crest bone graft for reconstruction of talus necrosis due to villonodular synovitis.

    PubMed

    Dickschas, Jörg; Welsch, Götz; Strecker, Wolf; Schöffl, Volker

    2012-01-01

    We report the case of a 24-year-old driving instructor with osteonecrosis of the talus and a large articular cartilage and osseous defect. The cystic lesion was caused by villonodular synovitis. After magnetic resonance imaging detection and arthoscopic analysis, the defect was filled with a bone graft, followed by matrix-associated autologous chondrocyte transplantation (MACT) combined with a total synovectomy. In general, lesions similar to the one described in this case are treated using osteochondral autografts, but in our case the osseous defect was too large to perform an osteochondral autograft. Our choice of treatment with an iliac crest bone graft combined with a MACT simultaneously has not yet been published, as far as we know. The patient returned to his former activities of daily living and sport activities, without restrictions or complaints, and with only a slight deficit in range of motion. Morphological and biochemical magnetic resonance imaging 12 months after surgery showed excellent bone healing with no intraosseous edema. The MACT resulted in a good clinical outcome, with 100% defect filling and excellent integration and surface and signal intensity of the cartilage repair tissue, and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score increased from 47 to 79 points. PMID:22104171

  5. Grafting Technique to Eliminate Rootstock Suckering of Grafted Tomatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vegetable grafting has been proposed as a technique for avoiding disease problems in tomatoes in open field production. In this study we investigated the current use of grafting in an open field scenario and found a serious problem with the grafting techniques. In the Fall of 2007, commercially pr...

  6. Alveolar bone grafting

    PubMed Central

    Lilja, Jan

    2009-01-01

    In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft. PMID:19884665

  7. A Novel Surgical Technique for Right-Sided Interrupted Aortic Arch by Interposition of a Pulmonary Autograft Tube.

    PubMed

    Kato, Nobuyasu; Yamagishi, Masaaki; Miyazaki, Takako; Maeda, Yoshinobu; Asada, Satoshi; Hongu, Hisayuki; Yamashita, Eijiro; Yaku, Hitoshi

    2016-08-01

    Right-sided interrupted aortic arch (IAA) is a rare cardiac anomaly. In general, the right bronchus sits higher than the left bronchus, so aortic arch reconstruction with a direct anastomosis has a risk of tracheal and bronchial obstruction. This report describes the successful definitive repair of a right-sided IAA in a 2.5-kg neonate by aortic arch reconstruction with a pulmonary autograft tube (PA tube). Postoperative three-dimensional multidetector computed tomography showed the reconstructed aortic arch without airway obstruction or aortic stenosis. The use of a PA tube is a simple and useful technique for aortic arch reconstruction in patients with a high risk of tracheal andbronchial obstruction, such as right-sided IAA. PMID:27449446

  8. Predicting emergency coronary artery bypass graft following PCI: application of a computational model to refer patients to hospitals with and without onsite surgical backup

    PubMed Central

    Syed, Zeeshan; Moscucci, Mauro; Share, David; Gurm, Hitinder S

    2015-01-01

    Background Clinical tools to stratify patients for emergency coronary artery bypass graft (ECABG) after percutaneous coronary intervention (PCI) create the opportunity to selectively assign patients undergoing procedures to hospitals with and without onsite surgical facilities for dealing with potential complications while balancing load across providers. The goal of our study was to investigate the feasibility of a computational model directly optimised for cohort-level performance to predict ECABG in PCI patients for this application. Methods Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry data with 69 pre-procedural and angiographic risk variables from 68 022 PCI procedures in 2004–2007 were used to develop a support vector machine (SVM) model for ECABG. The SVM model was optimised for the area under the receiver operating characteristic curve (AUROC) at the level of the training cohort and validated on 42 310 PCI procedures performed in 2008–2009. Results There were 87 cases of ECABG (0.21%) in the validation cohort. The SVM model achieved an AUROC of 0.81 (95% CI 0.76 to 0.86). Patients in the predicted top decile were at a significantly increased risk relative to the remaining patients (OR 9.74, 95% CI 6.39 to 14.85, p<0.001) for ECABG. The SVM model optimised for the AUROC on the training cohort significantly improved discrimination, net reclassification and calibration over logistic regression and traditional SVM classification optimised for univariate performance. Conclusions Computational risk stratification directly optimising cohort-level performance holds the potential of high levels of discrimination for ECABG following PCI. This approach has value in selectively referring PCI patients to hospitals with and without onsite surgery. PMID:26688738

  9. Amphetamine-induced abnormal movements occur independently of both transplant- and host-derived serotonin innervation following neural grafting in a rat model of Parkinson's disease.

    PubMed

    Lane, Emma Louise; Brundin, Patrik; Cenci, M Angela

    2009-07-01

    Serotonin has been postulated to play a role in the transplant-induced involuntary movements that occur following intrastriatal grafts of ventral mesencephalic tissue in the treatment of Parkinson's disease. Serotonin innervation of the striatum may be derived from either the donor graft tissue or the normal host projections from the midbrain. In two sets of experiments we study the impact of graft- versus host-derived serotonin innervation. All experiments were performed in l-DOPA treated rats with unilateral 6-hydroxydopamine lesions. As expected, following intrastriatal transplantation of embryonic ventral mesencephalon all the transplanted rats exhibited pronounced contralateral rotation in response to amphetamine and some animals also showed severe abnormal involuntary movements (AIMs). In the first set of experiments, all types of AIMs (axial, limb, orolingual and locomotor) were markedly reduced when amphetamine was co-administered with either the D(2) dopamine receptor antagonist raclopride or the D(1) receptor antagonist SCH23390. Cotreatment with the 5-HT(1A) agonist 8-OH-DPAT significantly attenuated the amphetamine-induced axial and limb dyskinesias, whilst locomotor scores remained unchanged. These data point to a major role for dopamine receptors, and to a modulatory role for 5-HT(1A) receptors, in post-grafting dyskinesias. In the second experiment, grafted rats exhibiting amphetamine-induced dyskinesia were subjected to 5,7-dihydroxytryptamine injections into the midbrain in order to destroy the host serotonin innervation. This intervention had no effect on either amphetamine-induced AIMs or contralateral rotation. Histological examination of all grafted rats showed similar numbers of dopaminergic neurons and a very low number of serotonin neurons within the transplants, regardless of AIMs expression. Our results suggest that amphetamine-induced AIMs in grafted animals primarily depend on an activation of dopamine receptors, and that serotonin

  10. Novel Technique: Knee Arthrodesis Using Trabecular Metal Cones with Intramedullary Nailing and Intramedullary Autograft.

    PubMed

    Peterson, Blake E; Bal, Sonny; Aggarwal, Ajay; Crist, Brett D

    2016-08-01

    The failed total knee arthroplasty is a challenge to the surgeon and the patient. Infection, bone loss, and instability lead to a chronically painful and dysfunctional limb. Two-stage revision arthroplasty has been successful in clearing a majority of periprosthetic joint infections. However, there are many cases when the multiply revised and infected total knee arthroplasty cannot be salvaged. We report, a review of knee arthrodesis and a novel technique to manage significant bone loss. The use of trabecular metal cones and a long intramedullary nail can be used in concert with an autologous intramedullary bone graft to provide a stable, length restoring construct with sufficient biology to heal very large bone voids. With this technique we have successfully restored function and stability in the failed knee arthroplasty. PMID:26551067

  11. Nerve regeneration and elastin formation within poly(glycerol sebacate)-based synthetic arterial grafts one-year post-implantation in a rat model

    PubMed Central

    Allen, Robert A.; Wu, Wei; Yao, Mingyi; Dutta, Debaditya; Duan, Xinjie; Bachman, Timothy N.; Champion, Hunter C.; Stolz, Donna B.; Robertson, Anne M.; Kim, Kang; Isenberg, Jeffrey S.; Wang, Yadong

    2013-01-01

    The objective of this study was to evaluate the long term performance of cell-free vascular grafts made from a fast-degrading elastic polymer. We fabricated small arterial grafts from microporous tubes of poly(glycerol sebacate) (PGS) reinforced with polycaprolactone (PCL) nanofibers on the outer surface. Grafts were interpositioned in rat abdominal aortas and characterized at 1 year post-implant. Grafts remodeled into “neoarteries” (regenerated arteries) with similar gross appearance to native rat aortas. Neoarteries mimic arterial tissue architecture with a confluent endothelium and media and adventita-like layers. Patent vessels (80%) showed no significant stenosis, dilation, or calcification. Neoarteries contain nerves and have the same amount of mature elastin as native arteries. Despite some differences in matrix organization, regenerated arteries had similar dynamic mechanical compliance to native arteries in vivo. Neoarteries responded to vasomotor agents, albeit with different magnitude than native aortas. These data suggest that an elastic vascular graft that resorbs quickly has potential to improve the performance of vascular grafts used in small arteries. This design may also promote constructive remodeling in other soft tissues. PMID:24119457

  12. Hybrid Biosynthetic Autograft Extender for Use in Posterior Lumbar Interbody Fusion: Safety and Clinical Effectiveness.

    PubMed

    Chedid, Mokbel K; Tundo, Kelly M; Block, Jon E; Muir, Jeffrey M

    2015-01-01

    Autologous iliac crest bone graft is the preferred option for spinal fusion, but the morbidity associated with bone harvest and the need for graft augmentation in more demanding cases necessitates combining local bone with bone substitutes. The purpose of this study was to document the clinical effectiveness and safety of a novel hybrid biosynthetic scaffold material consisting of poly(D,L-lactide-co-glycolide) (PLGA, 75:25) combined by lyophilization with unmodified high molecular weight hyaluronic acid (10-12% wt:wt) as an extender for a broad range of spinal fusion procedures. We retrospectively evaluated all patients undergoing single- and multi-level posterior lumbar interbody fusion at an academic medical center over a 3-year period. A total of 108 patients underwent 109 procedures (245 individual vertebral levels). Patient-related outcomes included pain measured on a Visual Analog Scale. Radiographic outcomes were assessed at 6 weeks, 3-6 months, and 1 year postoperatively. Radiographic fusion or progression of fusion was documented in 221 of 236 index levels (93.6%) at a mean (±SD) time to fusion of 10.2+4.1 months. Single and multi-level fusions were not associated with significantly different success rates. Mean pain scores (+SD) for all patients improved from 6.8+2.5 at baseline to 3.6+2.9 at approximately 12 months. Improvements in VAS were greatest in patients undergoing one- or two-level fusion, with patients undergoing multi-level fusion demonstrating lesser but still statistically significant improvements. Overall, stable fusion was observed in 64.8% of vertebral levels; partial fusion was demonstrated in 28.8% of vertebral levels. Only 15 of 236 levels (6.4%) were non-fused at final follow-up. PMID:26161161

  13. Progressive Evaluation of Apoptosis, Proliferation, and Angiogenesis in Fresh Rat Ovarian Autografts Under Remote Ischemic Preconditioning.

    PubMed

    Damous, Luciana Lamarão; Silva, Sônia Maria da; Carbonel, Adriana Aparecida Ferraz; Simões, Manuel de Jesus; Baracat, Edmund Chada; Montero, Edna Frasson de Souza

    2016-06-01

    This study evaluated the remote ischemic preconditioning (R-IPC) early and late repercussion on fresh ovarian transplants, aiming to assess a probable protective effect in ovarian follicular pool. Sixty Wistar EPM-1 rats were used, divided in 2 study groups: ovarian transplantation (Tx) and Tx + R-IPC, submitted to ovary transplant with or without R-IPC, respectively. These groups were subdivided according to the date for euthanasia: 4th, 7th, 14th, 21st, and 30th days of the postoperatory period. Morphology, morphometry, neoangiogenesis (vascular endothelial growth factor [VEGF]), proliferative activity (Ki-67), and apoptosis (cleaved caspase-3) were evaluated. Remote ischemic preconditioning was performed in the common iliac artery. Fresh autologous ovarian tissue was implanted integrally in the retroperitoneum. All animals showed resumption of estrous phase after ovary transplantation. Remote ischemic preconditioning attenuated the lesions progressively from the 7th day, with greater number of the immature follicles (14 days, P < .05), but didn't affect mature follicles and corpora lutea (P > .05). Immunohistochemical analyzes, taken as a whole, show that R-IPC benefic effect is more evident in the later periods of evaluation, when a greater proliferative activity (14, 21, and 30 days, P < .05) and lesser cell apoptotic activity (21 and 30 days, P < .05). The VEGF expression was similar in all times (P > .05). Remote ischemic preconditioning could have a benefic effect in the progressive evaluation of freshly grafted ovarian, especially on the latest phases of the posttransplant period. The 14th day was a landmark in the recuperation of the graft. Further investigations are necessary to determine the role of R-IPC in this scenario and its effect in frozen-thawed ovarian tissue. PMID:26674322

  14. Skin grafting of the horse.

    PubMed

    Schumacher, J; Hanselka, D V

    1989-12-01

    Free autogenous skin grafting of the horse is indicated for wounds too large to heal by contraction and epithelization. Techniques of pinch, punch, tunnel, and sheet grafting are described. Allografting and storage of skin for delayed grafting are discussed. PMID:2691033

  15. Bone Grafts in Craniofacial Surgery

    PubMed Central

    Elsalanty, Mohammed E.; Genecov, David G.

    2009-01-01

    Reconstruction of cranial and maxillofacial defects is a challenging task. The standard reconstruction method has been bone grafting. In this review, we shall describe the biological principles of bone graft healing, as pertinent to craniofacial reconstruction. Different types and sources of bone grafts will be discussed, as well as new methods of bone defect reconstruction. PMID:22110806

  16. Predicting reintubation, prolonged mechanical ventilation and death in post-coronary artery bypass graft surgery: a comparison between artificial neural networks and logistic regression models

    PubMed Central

    Mendes, Renata G.; de Souza, César R.; Machado, Maurício N.; Correa, Paulo R.; Di Thommazo-Luporini, Luciana; Arena, Ross; Myers, Jonathan; Pizzolato, Ednaldo B.

    2015-01-01

    Introduction In coronary artery bypass (CABG) surgery, the common complications are the need for reintubation, prolonged mechanical ventilation (PMV) and death. Thus, a reliable model for the prognostic evaluation of those particular outcomes is a worthwhile pursuit. The existence of such a system would lead to better resource planning, cost reductions and an increased ability to guide preventive strategies. The aim of this study was to compare different methods – logistic regression (LR) and artificial neural networks (ANNs) – in accomplishing this goal. Material and methods Subjects undergoing CABG (n = 1315) were divided into training (n = 1053) and validation (n = 262) groups. The set of independent variables consisted of age, gender, weight, height, body mass index, diabetes, creatinine level, cardiopulmonary bypass, presence of preserved ventricular function, moderate and severe ventricular dysfunction and total number of grafts. The PMV was also an input for the prediction of death. The ability of ANN to discriminate outcomes was assessed using receiver-operating characteristic (ROC) analysis and the results were compared using a multivariate LR. Results The ROC curve areas for LR and ANN models, respectively, were: for reintubation 0.62 (CI: 0.50–0.75) and 0.65 (CI: 0.53–0.77); for PMV 0.67 (CI: 0.57–0.78) and 0.72 (CI: 0.64–0.81); and for death 0.86 (CI: 0.79–0.93) and 0.85 (CI: 0.80–0.91). No differences were observed between models. Conclusions The ANN has similar discriminating power in predicting reintubation, PMV and death outcomes. Thus, both models may be applicable as a predictor for these outcomes in subjects undergoing CABG. PMID:26322087

  17. Grafting for disease resistance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The primary purpose of grafting vegetables worldwide has been to provide resistance to soil-borne diseases. The potential loss of methyl bromide as a soil fumigant combined with pathogen resistance to commonly used pesticides will make resistance to soil-borne pathogens even more important in the fu...

  18. Acrylonitrile grafted to PVDF

    SciTech Connect

    Yang, Jin; Eitouni, Hany Basam

    2015-03-31

    PVDF-g-PAN has been synthesized by grafting polyacrylonitrile onto polyvinylidene fluoride using an ATRP/AGET method. The novel polymer is ionically conducive and has much more flexibility than PVDF alone, making it especially useful either as a binder in battery cell electrodes or as a polymer electrolyte in a battery cell.

  19. Investigation of bone allografts representing different steps of the bone bank procedure using the CAM-model.

    PubMed

    Holzmann, Philipp; Niculescu-Morzsa, Eugenia; Zwickl, Hannes; Halbwirth, Florian; Pichler, Monika; Matzner, Michael; Gottsauner-Wolf, Florian; Nehrer, Stefan

    2010-01-01

    Bone grafting is commonly used to treat large bone defects. Since autografts are limited and frequently associated with postoperative donor morbidity, allografts from bone banks are often used. However, vascularisation of the allograft is often impaired, resulting in inadequate bone healing and functional graft failure. In bone bank processing, tissue is stored at -80 degree Celsius and subsequently subjected to a harsh multi-step cleaning and sterilisation procedure to prevent immune rejection or transmission of diseases. To determine which step of this procedure diminishes the ability of allografts to induce or promote vascularisation, we used the chick chorioallantoic membrane (CAM) model to monitor the vascular reaction to sample bone chips representing the respective procedural steps. The CAM model monitors the angiogenic potency of xenogeneic and, hence, potentially immunogeneic materials (e.g. cells, tissues, tissue-engineered matrices). Due to the chicken embryo's lack of a fully functional immune system, it provides test conditions that are analogous to immunologically incompetent mice and is a well-suited alternative to their use. Bone chips were placed onto the CAM, and vascular reactions were quantified by image analysis after 48 h incubation. The vascular reaction was most pronounced to fresh, untreated bone chips that had been kept at +2 degree Celsius prior to the experiment. Surprisingly, storage of bone samples at -80 degree Celsius was sufficient to drastically reduce the vascular reaction. Consistent with this, samples representing different stages of the subsequent procedure showed similarly low vascular indices. PMID:20686742

  20. Following-up changes in red blood cell deformability and membrane stability in the presence of PTFE graft implanted into the femoral artery in a canine model

    NASA Astrophysics Data System (ADS)

    Toth, Csaba; Kiss, Ferenc; Klarik, Zoltan; Gergely, Eszter; Toth, Eniko; Peto, Katalin; Vanyolos, Erzsebet; Miko, Iren; Nemeth, Norbert

    2014-05-01

    It is known that a moderate mechanical stress can even improve the red blood cells' (RBC) micro-rheological characteristics, however, a more significant stress causes deterioration in the deformability. In this study, we aimed to investigate the effect of the presence of artificial graft on the RBC deformability and membrane stability in beagles. In the Control group only anesthesia was induced and in the postoperative (p.o.) period blood samplings were carried out. In the Grafted group under general anesthesia, the left femoral artery was isolated, from which a 3.5 cm segment was resected and a PTFE graft (O.D.: 3 mm) of equal in length was implanted into the gap. On the 1st, 3rd, 5th, 7th and 14th p.o. days blood was collected the cephalic veins and RBC deformability was determined ektacytometry (LoRRca MaxSis Osmoscan). Membrane stability test consisted of two deformability measurements before and after the cells were being exposed to mechanical stress (60 or 100 Pa for 300 seconds). Compared to the Control group and the baseline values the red blood cell deformability showed significant deterioration on the 3rd, 5th and mainly on the 7th postoperative day after the graft implantation. The membrane stability of erythrocyte revealed marked inter-group difference on the 3rd, 5th and 7th day: in the Grafted group the deformability decreased and during the membrane stability test smaller difference was observed between the states before and after shearing. We concluded that the presence of a PTFE graft in the femoral artery may cause changes in RBC deformability in the first p.o. week. RBC membrane stability investigation shows a lower elongation index profile for the grafted group and a narrowed alteration in the deformability curves due to mechanical stress.

  1. Endothelialized ePTFE Graft by Nanobiotechnology

    ClinicalTrials.gov

    2013-11-29

    The Apparatus for Processing the Tubular Graft Modification Will be Designed and Evaluated.; The On-site Capturing of the Endothelial (Progenitor) Cells by Peptide-mediated Selective Adhesion in Vitro and in Vivo Will Also be Elucidated.; The Patency Rate of ITRI-made Artificial Blood Vessels Will be Evaluated by the Porcine Animal Model.

  2. Preliminary Study on Electrophysiological Changes After Cellular Autograft in Age-Related Macular Degeneration

    PubMed Central

    Limoli, Paolo Giuseppe; Vingolo, Enzo Maria; Morales, Marco Ulisses; Nebbioso, Marcella; Limoli, Celeste

    2014-01-01

    Abstract Evolving atrophic macular degeneration represents at least 80% of all macular degenerations and is currently without a standardized care. Autologous fat transplantation efficacy was demonstrated by several studies, as these cells are able to produce growth factors. The aim of the work was to demonstrate possible therapeutic effect of the joined suprachoroidal graft of adipocytes, adipose-derived stem cells (ADSCs) in stromal vascular fractions (SVFs) of adipose tissue, and platelet-rich plasma (PRP). Twelve eyes in 12 dry age-related macular degeneration (AMD) patients, aged 71.25 (SD ± 6.8) between 62 and 80 years, were analyzed. A complete ocular evaluation was performed using best corrected visual acuity (BCVA), retinographic analysis, spectral-domain optical coherence tomography, microperimetry, computerized visual field, and standard electroretinogram (ERG). Each eye received a cell in graft between choroid and sclera of mature fat cells and ADSCs in SVF enriched with PRP by means of the variant second Limoli (Limoli retinal restoration technique [LRRT]). In order to test if the differences pre- and post-treatment were significant, the Wilcoxon signed-rank test has been performed. Adverse effects were not reported in the patients. After surgery with LRRT, the most significant increase in the ERG values was recorded by scotopic rod-ERG (answer coming from the rods), from 41.26 to 60.83 μV with an average increase of 47.44% highly significant (P < 0.05). Moderately significant was the one recorded by scotopic maximal ERG (answer coming from the rods and cones), from 112.22 to 129.68 μV with an average increase of 15.56% (P < 0.1). Cell-mediated therapy based on growth factors used appears interesting because it can improve the retinal functionality responses in the short term. The ERG could, therefore, be used to monitor the effect of cell-mediated regenerative therapies. PMID:25546695

  3. Bone grafts and their substitutes.

    PubMed

    Fillingham, Y; Jacobs, J

    2016-01-01

    The continual cycle of bone formation and resorption is carried out by osteoblasts, osteocytes, and osteoclasts under the direction of the bone-signaling pathway. In certain situations the host cycle of bone repair is insufficient and requires the assistance of bone grafts and their substitutes. The fundamental properties of a bone graft are osteoconduction, osteoinduction, osteogenesis, and structural support. Options for bone grafting include autogenous and allograft bone and the various isolated or combined substitutes of calcium sulphate, calcium phosphate, tricalcium phosphate, and coralline hydroxyapatite. Not all bone grafts will have the same properties. As a result, understanding the requirements of the clinical situation and specific properties of the various types of bone grafts is necessary to identify the ideal graft. We present a review of the bone repair process and properties of bone grafts and their substitutes to help guide the clinician in the decision making process. PMID:26733632

  4. Graft-versus-host disease versus graft-versus-leukemia.

    PubMed

    Negrin, Robert S

    2015-01-01

    Graft-versus-host disease (GVHD) is a significant clinical problem after allogenic hematopoietic cell transplantation (HCT) associated with substantial morbidity and mortality that limits the potential utility of transplantation. Associated with GVHD is the well-recognized phenomenon of the graft-versus-leukemia (GVL) effect that results in reduced risk of disease relapse. GVL effects have been observed after treatment for a broad range of hematological malignancies. Both GVHD and GVL are the results of T cell-effector functions that frames a major question in the field of how linked are these two phenomena. A major goal of basic science and translational research has been to develop strategies to reduce the risk of GVHD while maintaining or enhancing GVL. In this review, a number of different strategies developed from preclinical animal models will be explored with a focus on those approaches that have been extended to the clinic in an attempt to achieve this goal. Needless to say, there is no proven strategy; however, with the use of modern technology and clinical translation, there has been substantial progress toward this goal of reducing the risks of GVHD while promoting and enhancing GVL responses. PMID:26637726

  5. CTL-Promoting Effects of IL-21 Counteract Murine Lupus in the Parent→F1 Graft-versus-Host Disease Model.

    PubMed

    Nguyen, Vinh; Rus, Horea; Chen, Ching; Rus, Violeta

    2016-02-15

    IL-21 promotes B cell and CTL responses in vivo, conferring IL-21 with a role in both humoral and cellular responses. Because CTL can target and eliminate autoreactive B cells, we investigated whether IL-21R signaling in CD8 T cells would alter the expansion of autoreactive B cells in an autoimmune setting. We addressed this question using the parent→F1 murine model of acute and chronic (lupus-like) graft-versus-host disease (GVHD) as models of a CTL-mediated or T-dependent B cell-mediated response, respectively. Induction of acute GVHD using IL-21R-deficient donor T cells resulted in decreased peak donor CD8 T cell numbers and decreased CTL effector function due to impaired granzyme B/perforin and Fas/Fas ligand pathways and a phenotype of low-intensity chronic GVHD with persistent host B cells, autoantibody production, and mild lupus-like renal disease. CTL effector maturation was critically dependent on IL-21R signaling in Ag-specific donor CD8, but not CD4, T cells. Conversely, treatment of DBA/2J→F1 chronic GVHD mice with IL-21 strongly promoted donor CD8 T cell expansion and rescued defective donor anti-host CTLs, resulting in host B cell elimination, decreased autoantibody levels, and attenuated renal disease, despite evidence of concurrently enhanced CD4 help for B cells and heightened B cell activation. These results demonstrate that, in the setting of lupus-like CD4 T cell-driven B cell hyperactivity, IL-21 signaling on Ag-specific donor CD8 T cells is critical for CTL effector maturation, whereas a lack of IL-21R downregulates CTL responses that would otherwise limit B cell hyperactivity and autoantibody production. PMID:26792801

  6. Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study

    PubMed Central

    Chen, Shao-Wei; Chang, Chih-Hsiang; Fan, Pei-Chun; Chen, Yung-Chang; Chu, Pao-Hsien; Chen, Tien-Hsing; Wu, Victor Chien-Chia; Chang, Su-Wei; Lin, Pyng-Jing; Tsai, Feng-Chun

    2016-01-01

    Objectives Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with short-term and long-term adverse outcomes. The European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, the Society of Thoracic Surgeons (STS) score and Age, Creatinine and Ejection Fraction (ACEF) score, have been widely used for predicting the operative risk of cardiac surgery. The aim of this study is to investigate the discriminant ability among current available models in predicting postoperative AKI. Methods From January 2010 to December 2012, 353 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes and scores of prognostic models were collected. The primary outcome was postoperative AKI, defined based on the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline for AKI, in 2012. Results 102 patients (28.9%) developed postoperative AKI. For AKI prediction, EuroSCORE II, STS score and ACEF score were all good tools for stage-3 AKI. The ACEF score was shown to have satisfied discriminant ability to predict postoperative AKI with area under a receiver operating characteristic curve: 0.781±0.027, (95% CI 0.729 to 0.834, p value <0.001). Multivariate logistic analysis identified that lower ejection fraction and higher serum creatinine were independent risk factors for AKI. Conclusions The simple and extremely user-friendly ACEF score can accurately identify the risk of postoperative AKI and has shown satisfactory discriminant ability when compared with other systems. The ACEF score might be the easiest tool for predicting postoperative AKI. PMID:27354068

  7. Epoxy and Silicone Optical Nanocomposites Filled with Grafted Nanoparticles

    NASA Astrophysics Data System (ADS)

    Tao, Peng

    , the grafted PGMA brushes effectively screen the van der Waals attraction between the particles, and homogenous nanoparticle dispersions of grafted nanoparticles were obtained. Transparent high refractive index TiO2/epoxy thin film and bulk nancomposites were obtained by dispersing PGMA brushes-grafted TiO2 nanoparticles into a commercial epoxy matrix. The refractive index of the nanocomposites showed a linear dependence on the volume fraction of TiO2 nanoparticles and the optical transparency could be generally described by the Rayleigh scattering model. This powerful dispersing technique was further employed to make visibly transparent, UV/IR blocking ITO/epoxy nanocomposites which can be easily applied onto glass and plastic substrates as energy saving optical coating materials. To produce transparent silicone nanocomposites, we directly coupled phosphate-terminated PDMS chains onto the optical nanoparticle surface. It was observed that the mono-modal PDMS-grafted particles usually formed agglomerates within silicone matrices, whereas the bimodal PDMS-grafted particles were able to be individually dispersed even within high molecular weight matrices. Transparent high refractive index bulk TiO2/silicone nanocomposites were successfully prepared by filling with bimodal PDMS-grafted TiO2 nanoparticles. Furthermore, we used the PDMS-grafted TiO2/silicone nanocomposite as a model system to create a methodology to predict and control the dispersion behavior of grafted nanoparticles. The good agreement between experimental observation of dispersion of mono-modal and bimodal grafted particles and theoretical prediction would better guide future experiments and lead to predictability in polymer composite design. Finally, the bimodal grafted chain design was implemented in the preparation of transparent and luminescent CdSe/silicone nanocomposites with potential application as non-scattering light conversion materials for LEDs. The homogeneous dispersion of bimodal PDMS-grafted

  8. Endothelial Dysfunction of Bypass Graft: Direct Comparison of In Vitro and In Vivo Models of Ischemia-Reperfusion Injury

    PubMed Central

    Veres, Gábor; Hegedűs, Péter; Barnucz, Enikő; Zöller, Raphael; Klein, Stephanie; Schmidt, Harald; Radovits, Tamás; Korkmaz, Sevil; Karck, Matthias; Szabó, Gábor

    2015-01-01

    Background Although, ischemia/reperfusion induced vascular dysfunction has been widely described, no comparative study of in vivo- and in vitro-models exist. In this study, we provide a direct comparison between models (A) ischemic storage and in-vitro reoxygenation (B) ischemic storage and in vitro reperfusion (C) ischemic storage and in-vivo reperfusion. Methods and Results Aortic arches from rats were stored for 2 hours in saline. Arches were then (A) in vitro reoxygenated (B) in vitro incubated in hypochlorite for 30 minutes (C) in vivo reperfused after heterotransplantation (2, 24 hours and 7 days reperfusion). Endothelium-dependent and independent vasorelaxations were assessed in organ bath. DNA strand breaks were assessed by TUNEL-method, mRNA expressions (caspase-3, bax, bcl-2, eNOS) by quantitative real-time PCR, proteins by Western blot analysis and the expression of CD-31 by immunochemistry. Endothelium-dependent maximal relaxation was drastically reduced in the in-vivo models compared to ischemic storage and in-vitro reperfusion group, and no difference showed between ischemic storage and control group. CD31-staining showed significantly lower endothelium surface ratio in-vivo, which correlated with TUNEL-positive ratio. Increased mRNA and protein levels of pro- and anti-apoptotic gens indicated a significantly higher damage in the in-vivo models. Conclusion Even short-period of ischemia induces severe endothelial damage (in-vivo reperfusion model). In-vitro models of ischemia-reperfusion injury can be limitedly suited for reliable investigations. Time course of endothelial stunning is also described. PMID:25875813

  9. A device for a noninvasive evaluation of coronary bypass grafts.

    PubMed

    McInerney, J J; Lamser, D G; Herr, M D

    1994-01-01

    A new device is presented for evaluating the patency of coronary bypass grafts. Bypass grafts are located within the chest cavity using a Compton backscatter imaging (CBI) technique that creates frontal plane tomographic images. The tomographic image pixels are mapped into computer memory and displayed. A display pointer is used to mark the position of the bypass graft. The computer uses that information to subsequently position a radiation detector, such that it "looks" at the location of the bypass graft within the closed chest. The patency of the graft is then evaluated by monitoring an X-ray induced iodine fluorescence transient in the graft, subsequent to a peripheral intravenous contrast injection. This imaging and graft evaluation device is relatively inexpensive and its application does not require cutdowns or catheterization. The associated radiation dose is 1/10 to 1/50 of that associated with alternative X-ray graft patency evaluation techniques. Preliminary testing has been performed on mechanical and animal models. PMID:18218544

  10. Effect of Impaction Sequence on Osteochondral Graft Damage: The Role of Repeated and Varying Loads

    PubMed Central

    Kang, Richard W.; Friel, Nicole A.; Williams, James M.; Cole, Brian J.; Wimmer, Markus A.

    2013-01-01

    Background Osteochondral autografts and allografts require mechanical force for proper graft placement into the defect site; however, impaction compromises the tissue. This study aimed to determine the effect of impaction force and number of hits to seat the graft on cartilage integrity. Hypothesis Under constant impulse conditions, higher impaction load magnitudes are more detrimental to cell viability, matrix integrity and collagen network organization and will result in proteoglycan loss and nitric oxide release. Study Design Controlled laboratory study Methods Osteochondral explants, harvested from fresh bovine trochleas, were exposed to a series of consistent impact loads delivered by a pneumatically driven device. Each plug received the same overall impulse of 7 Ns, reflecting the mean of 23 clinically inserted plugs. Impaction loads of 37.5N, 75N, 150N, and 300N were matched with 74, 37, 21, and 11 hits respectively. Following impaction, the plugs were harvested and cartilage was analyzed for cell viability, histology by safranin-o and picosirius red, and release of sulfated glycosaminoglycans and nitric oxide. Data were compared with non-impacted control. Results Impacted plugs had significantly lower cell viability than non-impacted plugs. A dose response relationship in loss of cell viability with respect to load magnitude was seen immediately and after 4 days but lost after 8 days. Histologic analysis revealed intact cartilage surface in all samples (loaded or control), with loaded samples showing alterations in birefringence. While the sulfated GAG release was similar across varying impaction loads, release of nitric oxide increased with increasing impaction magnitudes and time. Conclusions Impaction loading parameters have a direct effect on the time course of the viability of the cartilage in the graft tissue. Clinical Relevance Optimal loading parameters for surgical impaction of osteochondral grafts are those with lower load magnitudes and a greater

  11. Direct Lentiviral-Cyclooxygenase 2 Application to the Tendon-Bone Interface Promotes Osteointegration and Enhances Return of the Pull-Out Tensile Strength of the Tendon Graft in a Rat Model of Biceps Tenodesis

    PubMed Central

    Wergedal, Jon E.; Stiffel, Virginia; Lau, Kin-Hing William

    2014-01-01

    This study sought to determine if direct application of the lentiviral (LV)-cyclooxygenase 2 (COX2) vector to the tendon-bone interface would promote osteointegration of the tendon graft in a rat model of biceps tenodesis. The LV-COX2 gene transfer strategy was chosen for investigation because a similar COX2 gene transfer strategy promoted bony bridging of the fracture gap during bone repair, which involves similar histologic transitions that occur in osteointegration. Briefly, a 1.14-mm diameter tunnel was drilled in the mid-groove of the humerus of adult Fischer 344 rats. The LV-COX2 or βgal control vector was applied directly into the bone tunnel and onto the end of the tendon graft, which was then pulled into the bone tunnel. A poly-L-lactide pin was press-fitted into the tunnel as interference fixation. Animals were sacrificed at 3, 5, or 8 weeks for histology analysis of osteointegration. The LV-COX2 gene transfer strategy enhanced neo-chondrogenesis at the tendon-bone interface but with only marginal effect on de novo bone formation. The tendon-bone interface of the LV-COX2-treated tenodesis showed the well-defined tendon-to-fibrocartilage-to-bone histologic transitions that are indicative of osteointegration of the tendon graft. The LV-COX2 in vivo gene transfer strategy also significantly enhanced angiogenesis at the tendon-bone interface. To determine if the increased osteointegration was translated into an improved pull-out mechanical strength property, the pull-out tensile strength of the LV-COX2-treated tendon grafts was determined with a pull-out mechanical testing assay. The LV-COX2 strategy yielded a significant improvement in the return of the pull-out strength of the tendon graft after 8 weeks. In conclusion, the COX2-based in vivo gene transfer strategy enhanced angiogenesis, osteointegration and improved return of the pull-out strength of the tendon graft. Thus, this strategy has great potential to be developed into an effective therapy to

  12. Direct lentiviral-cyclooxygenase 2 application to the tendon-bone interface promotes osteointegration and enhances return of the pull-out tensile strength of the tendon graft in a rat model of biceps tenodesis.

    PubMed

    Rundle, Charles H; Chen, Shin-Tai; Coen, Michael J; Wergedal, Jon E; Stiffel, Virginia; Lau, Kin-Hing William

    2014-01-01

    This study sought to determine if direct application of the lentiviral (LV)-cyclooxygenase 2 (COX2) vector to the tendon-bone interface would promote osteointegration of the tendon graft in a rat model of biceps tenodesis. The LV-COX2 gene transfer strategy was chosen for investigation because a similar COX2 gene transfer strategy promoted bony bridging of the fracture gap during bone repair, which involves similar histologic transitions that occur in osteointegration. Briefly, a 1.14-mm diameter tunnel was drilled in the mid-groove of the humerus of adult Fischer 344 rats. The LV-COX2 or βgal control vector was applied directly into the bone tunnel and onto the end of the tendon graft, which was then pulled into the bone tunnel. A poly-L-lactide pin was press-fitted into the tunnel as interference fixation. Animals were sacrificed at 3, 5, or 8 weeks for histology analysis of osteointegration. The LV-COX2 gene transfer strategy enhanced neo-chondrogenesis at the tendon-bone interface but with only marginal effect on de novo bone formation. The tendon-bone interface of the LV-COX2-treated tenodesis showed the well-defined tendon-to-fibrocartilage-to-bone histologic transitions that are indicative of osteointegration of the tendon graft. The LV-COX2 in vivo gene transfer strategy also significantly enhanced angiogenesis at the tendon-bone interface. To determine if the increased osteointegration was translated into an improved pull-out mechanical strength property, the pull-out tensile strength of the LV-COX2-treated tendon grafts was determined with a pull-out mechanical testing assay. The LV-COX2 strategy yielded a significant improvement in the return of the pull-out strength of the tendon graft after 8 weeks. In conclusion, the COX2-based in vivo gene transfer strategy enhanced angiogenesis, osteointegration and improved return of the pull-out strength of the tendon graft. Thus, this strategy has great potential to be developed into an effective therapy to

  13. Stabilization of surface-immobilized enzymes using grafted polymers

    NASA Astrophysics Data System (ADS)

    Moskovitz, Yevgeny; Srebnik, Simcha

    2004-09-01

    We introduce a two-dimensional lattice model of immobilization and stabilization of proteinlike polymers using grafted polymers. The protein is designed to have a specific bulk conformation reproducing a catalytic cleft of natural enzymes. Our model predicts a first order denaturing adsorption transition of free proteins. On the other hand, for an immobilized protein we observe a more gradual disappearance of the hydrophobic centers accompanied by adsorption. We show that, using hydrophilic grafted polymers of proper length and grafting density, the conformation as well as the hydrophobic centers of the protein can be restored.

  14. Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction

    NASA Astrophysics Data System (ADS)

    Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

    2016-05-01

    Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction.

  15. Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction.

    PubMed

    Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

    2016-01-01

    Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction. PMID:27210585

  16. Magnesium inference screw supports early graft incorporation with inhibition of graft degradation in anterior cruciate ligament reconstruction

    PubMed Central

    Cheng, Pengfei; Han, Pei; Zhao, Changli; Zhang, Shaoxiang; Zhang, Xiaonong; Chai, Yimin

    2016-01-01

    Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction. PMID:27210585

  17. Biomechanical evaluation of an endplate-conformed polycaprolactone-hydroxyapatite intervertebral fusion graft and its comparison with a typical nonconformed cortical graft.

    PubMed

    Agarwal, Aakash; Palepu, Vivek; Agarwal, Anand K; Goel, Vijay K; Yildirim, Eda D

    2013-06-01

    In the thoracolumbar region, between 7% and 30% of spinal fusion failures are at risk for pseudarthrosis. From a biomechanical perspective, the nonconformity of the intervertebral graft to the endplate surface could contribute to pseudarthrosis, given suboptimal stress distributions. The objective of this study was to quantify the effect of endplate-graft conformation on endplate stress distribution, maximum Von Mises stress development, and stability. The study design used an experimentally validated finite element (FE) model of the L4-L5 functional spinal unit to simulate two types of interbody grafts (cortical bone and polycaprolactone (PCL)-hydroxyapatite (HA) graft), with and without endplate-conformed surfaces. Two case studies were completed. In Case Study I, the endplate-conformed grafts and nonconformed grafts were compared under without posterior instrumentation condition, while in Case Study II, the endplate-conformed and nonconformed grafts were compared with posterior instrumentation. In both case studies, the results suggested that the increased endplate-graft conformity reduced the maximum stress on the endplate, created uniform stress distribution on endplate surfaces, and reduced the range of motion of L4-L5 segments by increasing the contact surface area between the graft and the endplate. The stress distributions in the endplate suggest that the load sharing is greater with the endplate-conformed PCL-HA graft, which might reduce the graft subsidence possibility. PMID:23699717

  18. Siloxane-grafted membranes

    DOEpatents

    Friesen, Dwayne T.; Obligin, Alan S.

    1989-01-01

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional groups. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  19. Siloxane-grafted membranes

    DOEpatents

    Friesen, D.T.; Obligin, A.S.

    1989-10-31

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional group. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  20. A diagnostic window for the treatment of acute graft-versus-host disease prior to visible clinical symptoms in a murine model

    PubMed Central

    2013-01-01

    Background Acute graft-versus-host disease (aGVHD) poses a major limitation for broader therapeutic application of allogeneic hematopoietic cell transplantation (allo-HCT). Early diagnosis of aGVHD remains difficult and is based on clinical symptoms and histopathological evaluation of tissue biopsies. Thus, current aGVHD diagnosis is limited to patients with established disease manifestation. Therefore, for improved disease prevention it is important to develop predictive assays to identify patients at risk of developing aGVHD. Here we address whether insights into the timing of the aGVHD initiation and effector phases could allow for the detection of migrating alloreactive T cells before clinical aGVHD onset to permit for efficient therapeutic intervention. Methods Murine major histocompatibility complex (MHC) mismatched and minor histocompatibility antigen (miHAg) mismatched allo-HCT models were employed to assess the spatiotemporal distribution of donor T cells with flow cytometry and in vivo bioluminescence imaging (BLI). Daily flow cytometry analysis of peripheral blood mononuclear cells allowed us to identify migrating alloreactive T cells based on homing receptor expression profiles. Results We identified a time period of 2 weeks of massive alloreactive donor T cell migration in the blood after miHAg mismatch allo-HCT before clinical aGVHD symptoms appeared. Alloreactive T cells upregulated α4β7 integrin and P-selectin ligand during this migration phase. Consequently, targeted preemptive treatment with rapamycin, starting at the earliest detection time of alloreactive donor T cells in the peripheral blood, prevented lethal aGVHD. Conclusions Based on this data we propose a critical time frame prior to the onset of aGVHD symptoms to identify alloreactive T cells in the peripheral blood for timely and effective therapeutic intervention. PMID:23692886

  1. Platelet-rich plasma increases transforming growth factor-beta1 expression at graft-host interface following autologous osteochondral transplantation in a rabbit model

    PubMed Central

    Boakye, Lorraine A; Ross, Keir A; Pinski, John M; Smyth, Niall A; Haleem, Amgad M; Hannon, Charles P; Fortier, Lisa A; Kennedy, John G

    2015-01-01

    AIM: To explore the effect of platelet-rich plasma on protein expression patterns of transforming growth factor-beta1 (TGF-β1) in cartilage following autologous osteochondral transplantation (AOT) in a rabbit knee cartilage defect model. METHODS: Twelve New Zealand white rabbits received bilateral AOT. In each rabbit, one knee was randomized to receive an autologous platelet rich plasma (PRP) injection and the contralateral knee received saline injection. Rabbits were euthanized at 3, 6 and 12 wk post-operatively. Articular cartilage sections were stained with TGF-β1 antibody. Histological regions of interest (ROI) (left, right and center of the autologous grafts interfaces) were evaluated using MetaMorph. Percentage of chondrocytes positive for TGF-β1 was then assessed. RESULTS: Percentage of chondrocytes positive for TGF-β1 was higher in PRP treated knees for selected ROIs (left; P = 0.03, center; P = 0.05) compared to control and was also higher in the PRP group at each post-operative time point (P = 6.6 × 10-4, 3.1 × 10-4 and 7.3 × 10-3 for 3, 6 and 12 wk, respectively). TGF-β1 expression was higher in chondrocytes of PRP-treated knees (36% ± 29% vs 15% ± 18%) (P = 1.8 × 10-6) overall for each post-operative time point and ROI. CONCLUSION: Articular cartilage of rabbits treated with AOT and PRP exhibit increased TGF-β1 expression compared to those treated with AOT and saline. Our findings suggest that adjunctive PRP may increase TGF-β1 expression, which may play a role in the chondrogenic effect of PRP in vivo. PMID:26716092

  2. An Injectable Hydrogel as Bone Graft Material with Added Antimicrobial Properties

    PubMed Central

    Tommasi, Giacomo; Perni, Stefano

    2016-01-01

    Currently, the technique which provides the best chances for a successful bone graft, is the use of bone tissue from the same patient receiving it (autograft); the main limitations are the limited availability and the risks involved in removing living bone tissue, for example, explant site pain and morbidity. Allografts and xenografts may overcome these limitations; however, they increase the risk of rejection. For all these reasons the development of an artificial bone graft material is particularly important and hydrogels are a promising alternative for bone regeneration. Gels were prepared using 1,4-butanediol diacrylate as crosslinker and alpha tricalciumphosphate; ZnCl2 and SrCl2 were added to the aqueous phase. MTT results demonstrated that the addition of strontium had a beneficial effect on the osteoblast cells density on hydrogels, and zinc instead did not increase osteoblast proliferation. The amount of calcium produced by the osteoblast cells quantified through the Alizarin Red protocol revealed that both strontium and zinc positively influenced the formation of calcium; furthermore, their effect was synergistic. Rheology properties were used to mechanically characterize the hydrogels and especially the influence of crosslinker's concentration on them, showing the hydrogels presented had extremely good mechanical properties. Furthermore, the antimicrobial activity of strontium and zinc in the hydrogels against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis was determined. PMID:27174392

  3. An Injectable Hydrogel as Bone Graft Material with Added Antimicrobial Properties.

    PubMed

    Tommasi, Giacomo; Perni, Stefano; Prokopovich, Polina

    2016-06-01

    Currently, the technique which provides the best chances for a successful bone graft, is the use of bone tissue from the same patient receiving it (autograft); the main limitations are the limited availability and the risks involved in removing living bone tissue, for example, explant site pain and morbidity. Allografts and xenografts may overcome these limitations; however, they increase the risk of rejection. For all these reasons the development of an artificial bone graft material is particularly important and hydrogels are a promising alternative for bone regeneration. Gels were prepared using 1,4-butanediol diacrylate as crosslinker and alpha tricalciumphosphate; ZnCl2 and SrCl2 were added to the aqueous phase. MTT results demonstrated that the addition of strontium had a beneficial effect on the osteoblast cells density on hydrogels, and zinc instead did not increase osteoblast proliferation. The amount of calcium produced by the osteoblast cells quantified through the Alizarin Red protocol revealed that both strontium and zinc positively influenced the formation of calcium; furthermore, their effect was synergistic. Rheology properties were used to mechanically characterize the hydrogels and especially the influence of crosslinker's concentration on them, showing the hydrogels presented had extremely good mechanical properties. Furthermore, the antimicrobial activity of strontium and zinc in the hydrogels against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis was determined. PMID:27174392

  4. Computer-aided osteotomy design for harvesting autologous bone grafts in reconstructive surgery

    NASA Astrophysics Data System (ADS)

    Krol, Zdzislaw; Zerfass, Peter; von Rymon-Lipinski, Bartosz; Jansen, Thomas; Hauck, Wolfgang; Zeilhofer, Hans-Florian U.; Sader, Robert; Keeve, Erwin

    2001-05-01

    Autologous grafts serve as the standard grafting material in the treatment of maxillofacial bone tumors, traumatic defects or congenital malformations. The pre-selection of a donor site depends primarily on the morphological fit of the available bone mass and the shape of the part that has to be transplanted. To achieve sufficient incorporation of the autograft into the host bone, precise planning and simulation of the surgical intervention based on 3D CT studies is required. This paper presents a method to identify an optimal donor site by performing an optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization task in the donor site CT data set. The following fully automatic optimization stage delivers a set of sub-optimal and optimal donor sites for a given template. All generated solutions can be explored interactively on the computer display using an efficient graphical interface. Reconstructive operations supported by our system were performed on 28 patients. We found that the operation time can be considerably shortened by this approach.

  5. Antioxidant therapy reverses impaired graft healing in hypercholesterolemic rabbits

    PubMed Central

    Rosenbaum, Michael A.; Miyazaki, Keiko; Colles, Scott M.; Graham, Linda M.

    2009-01-01

    intimal hyperplasia. Reducing oxidative stress may promote healing of prosthetic grafts. Clinical Relevance Hypercholesterolemia is associated with an increased inflammatory response, elevated oxidative stress, and increased intimal hyperplasia following stent or vein graft placement in animal models and in humans. Reduced endothelialization is seen following stent or graft placement in hypercholesterolemic animals, and reduced EC growth and patency of EC-seeded grafts is found in humans with elevated serum lipid levels. Our results suggest that antioxidants are effective in reducing this pathologic response and improving graft healing. PMID:19939614

  6. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction. PMID:16875525

  7. Well-organized neointima of large-pore poly(l-lactic acid) vascular graft coated with poly(l-lactic-co-ε-caprolactone) prevents calcific deposition compared to small-pore electrospun poly(l-lactic acid) graft in a mouse aortic implantation model

    PubMed Central

    Tara, Shuhei; Kurobe, Hirotsugu; Rocco, Kevin A.; Maxfield, Mark W.; Best, Cameron A.; Yi, Tai; Naito, Yuji; Breuer, Christopher K.; Shinoka, Toshiharu

    2014-01-01

    Objective Tissue engineering techniques have emerged that allow bioresorbable grafts to be implanted that restore function and transform into biologically active arteries. However, these implants are susceptible to calcification during the remodeling process. The objective of this study was to evaluate the role of pore size of bioabsorbable grafts in the development of calcification. Methods Two types of grafts were prepared: a large-pore graft constructed of poly(l-lactic acid) (PLA) fibers coated with poly(l-lactide-co-ε-caprolactone) (PLCL) (PLA-PLCL), and a small-pore graft made of electrospun PLA nanofibers (PLA-nano). Twenty-eight PLA-PLCL grafts and twenty-five PLA-nano grafts were implanted as infra-renal aortic interposition conduits in 8-week-old female SCID/Bg mice, and followed for 12 months after implantation. Results Large-pore PLA-PLCL grafts induced a well-organized neointima after 12 months, and Alizarin Red S staining showed neointimal calcification only in the thin neointima of small-pore PLA-nano grafts. At 12 months, macrophage infiltration, evaluated by F4/80 staining, was observed in the thin neointima of the PLA-nano graft, and there were few vascular smooth muscle cells (VSMCs) in this layer. On the other hand, the neointima of the PLA-PLCL graft was composed of abundant VSMCs, and a lower density of macrophages (F4/80 positive cells, PLA-PLCL; 68.1±41.4/mm2 vs PLA-nano; 188.3±41.9/mm2, p = 0.007). The VSMCs of PLA-PLCL graft expressed transcription factors of both osteoblasts and osteoclasts. Conclusion These findings demonstrate that in mouse arterial circulation, large-pore PLA-PLCL grafts created a well-organized neointima and prevented calcific deposition compared to small-pore, electrospun PLA-nano grafts. PMID:25463106

  8. Human Urine-derived Stem Cells Seeded Surface Modified Composite Scaffold Grafts for Bladder Reconstruction in a Rat Model

    PubMed Central

    Kim, Jong Kun

    2015-01-01

    We conducted this study to investigate the synergistic effect of human urine-derived stem cells (USCs) and surface modified composite scaffold for bladder reconstruction in a rat model. The composite scaffold (Polycaprolactone/Pluronic F127/3 wt% bladder submucosa matrix) was fabricated using an immersion precipitation method, and heparin was immobilized on the surface via covalent conjugation. Basic fibroblast growth factor (bFGF) was loaded onto the heparin-immobilized scaffold by a simple dipping method. In maximal bladder capacity and compliance analysis at 8 weeks post operation, the USCs-scaffoldheparin-bFGF group showed significant functional improvement (2.34 ± 0.25 mL and 55.09 ± 11.81 µL/cm H2O) compared to the other groups (2.60 ± 0.23 mL and 56.14 ± 9.00 µL/cm H2O for the control group, 1.46 ± 0.18 mL and 34.27 ± 4.42 µL/cm H2O for the partial cystectomy group, 1.76 ± 0.22 mL and 35.62 ± 6.69 µL/cm H2O for the scaffold group, and 1.92 ± 0.29 mL and 40.74 ± 7.88 µL/cm H2O for the scaffoldheparin-bFGF group, respectively). In histological and immunohistochemical analysis, the USC-scaffoldheparin-bFGF group showed pronounced, well-differentiated, and organized smooth muscle bundle formation, a multi-layered and pan-cytokeratin-positive urothelium, and high condensation of submucosal area. The USCs seeded scaffoldheparin-bFGF exhibits significantly increased bladder capacity, compliance, regeneration of smooth muscle tissue, multi-layered urothelium, and condensed submucosa layers at the in vivo study. PMID:26713050

  9. Azide functional monolayers grafted to a germanium surface: model substrates for ATR-IR studies of interfacial click reactions.

    PubMed

    Zhang, Shuo; Koberstein, Jeffrey T

    2012-01-10

    High-quality azide-functional substrates are prepared by a low temperature reaction of 11-bromoundecyltrichlorosilane with UV-ozone-treated germanium ATR-IR plates followed by nucleophilic substitution of the terminal bromine by addition of sodium azide. The resulting monolayer films are characterized by atomic force microscopy (AFM), contact angle analysis, X-ray photoelectron spectroscopy (XPS), attenuated total reflectance infrared spectroscopy (ATR-IR), and ellipsometry. XPS and ellipsometric thickness data correspond well to the results of molecular model calculations confirming the formation of a densely packed azide-functional monolayer. These azide-functional substrates enable interfacial "click" reactions with complementary alkyne-functional molecules to be studied in situ by ATR-IR. To illustrate their potential utility for kinetic studies we show that, in the presence of copper(I) catalyst, the azide-modified surfaces react rapidly and quantitatively with 5-chloro-pentyne to form triazoles via a 1,3-dipolar cycloaddition reaction. Time-resolved ATR-IR measurements indicate that the interfacial click reaction is initially first order in azide concentration as expected from the reaction mechanism, with a rate constant of 0.034 min(-1), and then transitions to apparent second order dependence, with a rate constant of 0.017 min(-1)/(chains/nm(2)), when the surface azide and triazole concentrations become similar, as predicted by Oyama et al. The reaction achieves an ultimate conversion of 50% consistent with the limit expected due to steric hindrance of the 5-chloro-pentyne reactant at the surface. PMID:22081885

  10. Analysis of cartilage-polydioxanone foil composite grafts.

    PubMed

    Kim, James H; Wong, Brian

    2013-12-01

    This study presents an analytical investigation into the mechanical behavior of a cartilage-polydioxanone (PDS) plate composite grafts. Numerical methods are used to provide a first-order, numerical model of the flexural stiffness of a cartilage-PDS graft. Flexural stiffness is a measure of resistance to bending and is inversely related to the amount of deformation a structure may experience when subjected to bending forces. The cartilage-PDS graft was modeled as a single composite beam. Using Bernoulli-Euler beam theory, a closed form equation for the theoretical flexural stiffness of the composite graft was developed. A parametric analysis was performed to see how the flexural properties of the composite model changed with varying thicknesses of PDS foil. The stiffness of the cartilage-PDS composite using 0.15-mm-thick PDS was four times higher than cartilage alone. The composite with a 0.5-mm-thick PDS graft was only 1.7 times stiffer than the composite with the 0.15-mm-thick PDS graft. Although a thicker graft material will yield higher flexural stiffness for the composite, the relationship between composite stiffness and PDS thickness is nonlinear. After a critical point, increments in graft thickness produce gradually smaller improvements in flexural stiffness. The small increase in stiffness when using the thicker PDS foils versus the 0.15 mm PDS foil may not be worth the potential complications (prolonged foreign body reaction, reduction in nutrient diffusion to cartilage) of using thicker artificial grafts. PMID:24327249

  11. ACL reconstruction using bone-tendon-bone graft engineered from the semitendinosus tendon by injection of recombinant BMP-2 in a rabbit model.

    PubMed

    Hashimoto, Yusuke; Naka, Yoshifumi; Fukunaga, Kenji; Nakamura, Hiroaki; Takaoka, Kunio

    2011-12-01

    We attempted to generate a bone-tendon-bone structure by injecting human-type recombinant human bone morphogenetic protein-2 (rhBMP-2) into the semitendinosus tendon, and an anterior cruciate ligament (ACL) defect was reconstructed by grafting the engineered bone-tendon-bone graft. Two ossicles with a separation distance of 1 cm were generated within the left semitendinosus tendon of a rabbit 6 weeks after the injection of rhBMP-2 (15 µg at each site). The engineered bone-tendon-bone graft was transplanted in order to reconstruct the ACL by passing the graft through the bone tunnels. In the control group, the ACL was reconstructed with the semitendinosus tendon without BMP-2 using the same methods as those used in the experimental group. The animals were harvested at 4 or 8 weeks after surgery and examined by radiographic, histological, and biomechanical methods. In the experimental group, ossicles in the bone-tendon-bone graft were successfully integrated into the host bone of the femur and tibia. Histological analysis revealed that characteristic features identical to the normal direct insertion morphology had been restored. Biomechanical pull-out testing showed that the ultimate failure load and stiffness of the reconstructed ACL in the experimental group were significantly higher than those in the control group at both 4 and 8 weeks (p < 0.05). These results indicate the potential of regenerative reconstruction of the ACL, and the reconstruction resulted in the restoration of morphology and function equivalent to those of the normal ACL. PMID:21557301

  12. Osteochondral autograft transplantation or autologous chondrocyte implantation for large cartilage defects of the knee: a meta-analysis.

    PubMed

    Li, Zeng; Zhu, Tianyi; Fan, Weimin

    2016-03-01

    Autologous chondrocyte implantation (ACI) and osteochondral autograft transplantation (OAT or mosaicplasty) are two effective surgeries for the treatment of large cartilage defects for more than two decades. But there are always some controversies about which one has the better outcomes for the patients. The purpose of this meta-analysis is to compare the outcomes of these two surgeries and give an advice to the clinical practices. The literature search was performed on multiple electronic databases with specific included criteria. After the assessments, five Randomized controlled trials (level II) were included and two of them were in the same cohort. The continuous data of outcomes were categorized into ranked ones (excellent, good, fair and poor) for comparisons. In the six comparisons of excellent or good results and poor results, the outcomes of ACI were significantly better than OAT in only one comparison (RR 2.57, 95 % CI 1.09-6.07, P = 0.03) while others had no significant differences. We may reach a primary conclusion that there is no significant different outcome between ACI and OAT in a short-term follow-up but it may indicate that the patients with OAT may be more likely to have worse condition than that with ACI for a long-term period. PMID:26068598

  13. Live birth in a woman without ovaries after autograft of frozen-thawed ovarian tissue combined with growth factors

    PubMed Central

    2013-01-01

    Currently, cryopreservation of oocytes, embryos and ovarian tissue is considered the basis of fertility preservation programs for women with cancer and other diseases who are rendered sterile by gonadotoxic drugs or radiation. Numerous studies have confirmed that autograft of frozen-thawed ovarian tissue can restore ovarian function and fertility. A total of twenty-two live births have been reported but we still have to consider this technique as experimental. The main problem is that the implant undergoes ischemia until neoangiogenesis is restored, resulting in significant follicular loss. At the moment, there are numerous publications in different medical fields that publish successful experiences with plasma rich in platelets (PRP) in different clinical situations promoting angiogenesis. Thus, we considered the possibility of using it in the field of ovarian autologous transplantation in order to improve the vascularization of the implant and its quality. For this, both thawed ovarian tissue as practiced pockets on the rear side of the broad ligament which have been placed, have been impregnated with PRP. We can say that the implant treated in this way has had a rapid and successful response. We report a special interesting case because this is the first time that this technique is performed successfully in a woman without ovaries combined with growth factors to promote neoangiogenesis. Obviously, the results of the hormonal response come exclusively from the implanted tissue in these special conditions. PMID:23647552

  14. Hydrogen, a potential safeguard for graft-versus-host disease and graft ischemia-reperfusion injury?

    PubMed Central

    Yuan, Lijuan; Shen, Jianliang

    2016-01-01

    Post-transplant complications such as graft-versus-host disease and graft ischemia-reperfusion injury are crucial challenges in transplantation. Hydrogen can act as a potential antioxidant, playing a preventive role against post-transplant complications in animal models of multiple organ transplantation. Herein, the authors review the current literature regarding the effects of hydrogen on graft ischemia-reperfusion injury and graft-versus-host disease. Existing data on the effects of hydrogen on ischemia-reperfusion injury related to organ transplantation are specifically reviewed and coupled with further suggestions for future work. The reviewed studies showed that hydrogen (inhaled or dissolved in saline) improved the outcomes of organ transplantation by decreasing oxidative stress and inflammation at both the transplanted organ and the systemic levels. In conclusion, a substantial body of experimental evidence suggests that hydrogen can significantly alleviate transplantation-related ischemia-reperfusion injury and have a therapeutic effect on graft-versus-host disease, mainly via inhibition of inflammatory cytokine secretion and reduction of oxidative stress through several underlying mechanisms. Further animal experiments and preliminary human clinical trials will lay the foundation for hydrogen use as a drug in the clinic.

  15. Bioresorbable bone graft substitutes of different osteoconductivities: a histologic evaluation of osteointegration of poly(propylene glycol-co-fumaric acid)-based cement implants in rats.

    PubMed

    Lewandrowski, K U; Gresser, J D; Wise, D L; Trantol, D J

    2000-04-01

    Bioresorbable bone graft substitutes may significantly reduce the disadvantages associated with autografts, allografts and other synthetic materials currently used in bone graft procedures. We investigated the biocompatibility and osteointegration of a bioresorbable bone graft substitute made from the unsaturated polyester poly(propylene-glycol-co-fumaric acid), or simply poly(propylene fumarate), PPF, which is crosslinked in the presence of soluble and insoluble calcium filler salts. Four sets of animals each having three groups of 8 were evaluated by grouting bone graft substitutes of varying compositions into 3-mm holes that were made into the anteromedial tibial metaphysis of rats. Four different formulations varying as to the type of soluble salt filler employed were used: set 1--calcium acetate, set 2--calcium gluconate, set 3--calcium propionate, and set 4--control with hydroxapatite, HA, only. Animals of each of the three sets were sacrificed in groups of 8 at postoperative week 1, 3, and 7. Histologic analysis revealed that in vivo biocompatibility and osteointegration of bone graft substitutes was optimal when calcium acetate was employed as a soluble salt filler. Other formulations demonstrated implant surface erosion and disintegration which was ultimately accompanied by an inflammatory response. This study suggested that PPF-based bone graft substitutes can be designed to provide an osteoconductive pathway by which bone will grow in faster because of its capacity to develop controlled porosities in vivo. Immediate applicability of this bone graft substitute, the porosity of which can be tailored for the reconstruction of defects of varying size and quality of the recipient bed, is to defects caused by surgical debridement of infections, previous surgery, tumor removal, trauma, implant revisions and joint fusion. Clinical implications of the relation between developing porosity, resulting osteoconduction, and bone repair in vivo are discussed. PMID

  16. Antimicrobial Graft Copolymer Gels.

    PubMed

    Harvey, Amanda C; Madsen, Jeppe; Douglas, C W Ian; MacNeil, Sheila; Armes, Steven P

    2016-08-01

    In view of the growing worldwide rise in microbial resistance, there is considerable interest in designing new antimicrobial copolymers. The aim of the current study was to investigate the relationship between antimicrobial activity and copolymer composition/architecture to gain a better understanding of their mechanism of action. Specifically, the antibacterial activity of several copolymers based on 2-(methacryloyloxy)ethyl phosphorylcholine [MPC] and 2-hydroxypropyl methacrylate (HPMA) toward Staphylococcus aureus was examined. Both block and graft copolymers were synthesized using either atom transfer radical polymerization or reversible addition-fragmentation chain transfer polymerization and characterized via (1)H NMR, gel permeation chromatography, rheology, and surface tensiometry. Antimicrobial activity was assessed using a range of well-known assays, including direct contact, live/dead staining, and the release of lactate dehydrogenase (LDH), while transmission electron microscopy was used to study the morphology of the bacteria before and after the addition of various copolymers. As expected, PMPC homopolymer was biocompatible but possessed no discernible antimicrobial activity. PMPC-based graft copolymers comprising PHPMA side chains (i.e. PMPC-g-PHPMA) significantly reduced both bacterial growth and viability. In contrast, a PMPC-PHPMA diblock copolymer comprising a PMPC stabilizer block and a hydrophobic core-forming PHPMA block did not exhibit any antimicrobial activity, although it did form a biocompatible worm gel. Surface tensiometry studies and LDH release assays suggest that the PMPC-g-PHPMA graft copolymer exhibits surfactant-like activity. Thus, the observed antimicrobial activity is likely to be the result of the weakly hydrophobic PHPMA chains penetrating (and hence rupturing) the bacterial membrane. PMID:27409712

  17. Fabrication of Custom-Shaped Grafts for Cartilage Regeneration

    PubMed Central

    Koo, Seungbum; Hargreaves, Brian A.; Gold, Garry E.; Dragoo, Jason L.

    2011-01-01

    Transplantation of engineered cartilage grafts is a promising method to treat diseased articular cartilage. The interfacial areas between the graft and the native tissues play an important role in the successful integration of the graft to adjacent native tissues. The purposes of the study were to create a custom shaped graft through 3D tissue shape reconstruction and rapid-prototype molding methods using MRI data, and to test the accuracy of the custom shaped graft against the original anatomical defect. An iatrogenic defect on the distal femur was identified with a 1.5 Tesla MRI and its shape was reconstructed into a three-dimensional (3D) computer model by processing the 3D MRI data. First, the accuracy of the MRI-derived 3D model was tested against a laser-scan based 3D model of the defect. A custom-shaped polyurethane graft was fabricated from the laser-scan based 3D model by creating custom molds through computer aided design and rapid-prototyping methods. The polyurethane tissue was laser-scanned again to calculate the accuracy of this process compared to the original defect. The volumes of the defect models from MRI and laser-scan were 537 mm3 and 405 mm3, respectively, implying that the MRI model was 33% larger than the laser-scan model. The average (±SD) distance deviation of the exterior surface of the MRI model from the laser-scan model was 0.4±0.4 mm. The custom-shaped tissue created from the molds was qualitatively very similar to the original shape of the defect. The volume of the custom-shaped cartilage tissue was 463 mm3 which was 15% larger than the laser-scan model. The average (±SD) distance deviation between the two models was 0.04±0.19 mm. Custom-shaped engineered grafts can be fabricated from standard sequence 3-D MRI data with the use of CAD and rapid-prototyping technology, which may help solve the interfacial problem between native cartilage and graft, if the grafts are custom made for the specific defect. The major source of error in

  18. Efficient Gene Transfer and Durable Transgene Expression in Grafted Rabbit Veins

    PubMed Central

    Du, Liang; Zhang, Jingwan; Clowes, Alexander W.

    2015-01-01

    Abstract Venous bypass grafts are useful treatments for obstructive coronary artery disease. However, their usefulness is limited by accelerated atherosclerosis. Genetic engineering of venous bypass grafts that prevented atherosclerosis could improve long-term graft patency and clinical outcomes. We used a rabbit model of jugular vein-to-carotid interposition grafting to develop gene therapy for vein-graft atherosclerosis. Rabbit veins were easily transduced in situ with a first-generation adenoviral vector; however, most transgene expression (∼80%) was lost within 3 days after arterial grafting. This rapid loss of transgene expression was not prevented by transducing veins after grafting or by prolonged ex vivo transduction. However, delaying vein-graft transduction for 28 days (after the vein had adapted to the arterial circulation) prevented this early loss of transgene expression. We used the delayed transduction approach to test the durability of expression of a therapeutic transgene (apolipoprotein A-I) expressed from a helper-dependent adenoviral (HDAd) vector. HDAd DNA and apolipoprotein A-I mRNA were easily detectable in transduced vein grafts. Vector DNA and mRNA declined by 4 weeks, and then persisted stably for at least 6 months. Delaying transduction for 28 days after grafting permitted initiation of vein-graft neointimal growth and medial thickening before gene transfer. However, vein-graft lumen diameter was not compromised, because of gradual outward remodeling of grafted veins. Our data highlight the promise of HDAd-mediated gene therapy, delivered to arterialized vein grafts, for preventing vein-graft atherosclerosis. PMID:25383597

  19. Efficient gene transfer and durable transgene expression in grafted rabbit veins.

    PubMed

    Du, Liang; Zhang, Jingwan; Clowes, Alexander W; Dichek, David A

    2015-01-01

    Venous bypass grafts are useful treatments for obstructive coronary artery disease. However, their usefulness is limited by accelerated atherosclerosis. Genetic engineering of venous bypass grafts that prevented atherosclerosis could improve long-term graft patency and clinical outcomes. We used a rabbit model of jugular vein-to-carotid interposition grafting to develop gene therapy for vein-graft atherosclerosis. Rabbit veins were easily transduced in situ with a first-generation adenoviral vector; however, most transgene expression (∼80%) was lost within 3 days after arterial grafting. This rapid loss of transgene expression was not prevented by transducing veins after grafting or by prolonged ex vivo transduction. However, delaying vein-graft transduction for 28 days (after the vein had adapted to the arterial circulation) prevented this early loss of transgene expression. We used the delayed transduction approach to test the durability of expression of a therapeutic transgene (apolipoprotein A-I) expressed from a helper-dependent adenoviral (HDAd) vector. HDAd DNA and apolipoprotein A-I mRNA were easily detectable in transduced vein grafts. Vector DNA and mRNA declined by 4 weeks, and then persisted stably for at least 6 months. Delaying transduction for 28 days after grafting permitted initiation of vein-graft neointimal growth and medial thickening before gene transfer. However, vein-graft lumen diameter was not compromised, because of gradual outward remodeling of grafted veins. Our data highlight the promise of HDAd-mediated gene therapy, delivered to arterialized vein grafts, for preventing vein-graft atherosclerosis. PMID:25383597

  20. Grafting techniques for Peyronie's disease.

    PubMed

    Hatzichristodoulou, Georgios

    2016-06-01

    Peyronie's disease (PD) is a benign fibrotic condition of the penile tunica albuginea. PD can be associated with penile pain, curvature, shortening, and erectile dysfunction (ED). The predominant and most bothersome symptom in affected patients is penile curvature, which can lead to inability to have sexual intercourse. In such cases, surgical correction of the curvature may be required. Plication techniques to correct curvature can cause penile shortening and therefore are generally reserved for curvatures <60°. Penile prosthesis implantation with simultaneous correction of curvature by various means is recommended in PD patients with ED not responding to medical therapy. Grafting techniques are the preferred surgical treatment in patients with penile curvatures >60°, short penis, or hourglass deformity. Patients scheduled for grafting surgery are required to have satisfactory erectile rigidity preoperatively. There are various grafting materials that can be used for closure of the tunica albuginea defect following plaque incision/excision. Both autologous and non-autologous grafts have been used for PD reconstructive surgery, and each graft has its advantages and disadvantages. Novel grafting materials are presented and discussed in this review. A major advantage of the available "off-the-shelf" grafts is that there is no harvesting from a donor site and, thus, morbidity is reduced, and operative times are minimized. Further investigations in regard to tissue-engineered grafts to improve surgical handling and postoperative outcomes are ongoing. Surgeon experience, careful patient selection, patient preference and type of penile deformity affect the choice of graft. This review summarizes the literature within the past 5 years regarding grafting techniques in PD. Surgical outcomes and limitations of grafting techniques are reported. A major objective of this review is dedicated to preoperative considerations and indications for grafting procedures, with the aim

  1. Applications of skin grafting in large animals.

    PubMed

    Wilson, D G

    1990-09-01

    Injuries involving full-thickness skin wounds are common in large animals. Skin grafting can shorten the healing time and improve the cosmetic result. Techniques that have been used successfully in the management of full-thickness skin wounds include full-thickness skin grafts, split-thickness skin grafts, tunnel grafts, pinch/punch grafts, and immediate split-thickness skin grafts. The technical aspects of each of these procedures are detailed and representative cases are presented. PMID:2134606

  2. Response of canine bone to a synthetic bone graft material.

    PubMed

    St John, K R; Zardiackas, L D; Black, R J; Armstrong, R

    1993-01-01

    A model simulating a spiral diaphyseal fracture with butterfly fragments and bone loss was utilized to evaluate an hydroxyapatite/tricalcium phosphate, and collagen composite bone graft substitute in twelve dogs. The resultant grafted and contralateral control femora were tested in torsion at one year. This study examines the histological response to the graft material as well as crack propagation and fracture surface morphology using light microscopy and SEM. SEM and gross evaluation of the grafted bones revealed that 8/12 had fractured through bone outside the osteotomy site and all fractures included bone outside the graft site. No graft material was demonstrated at the points of initiation or termination of fracture for any of the bones. It was apparent that recorticalization had begun to occur at the graft site but the canal had not yet fully formed. The HA/TCP was seen to be tightly bound in tissue which had the appearance of new bone. Bone was found to be in direct apposition to the surface of the ceramic and within pores with no intervening soft tissue. Much of the new bone had remodeled into well organized Haversian systems with some patchy areas of woven bone and osteoid seen with polarized light illumination. PMID:10148784

  3. Poly(amide-graft-acrylate) interfacial compounds

    NASA Astrophysics Data System (ADS)

    Zamora, Michael Perez

    Graft copolymers with segments of dissimilar chemistries have been shown to be useful in a variety of applications as surfactants, compatibilizers, impact modifiers, and surface modifiers. The most common route to well defined graft copolymers is through the use of macromonomers, polymers containing a reactive functionality and thus capable of further polymerization. However, the majority of the studies thus far have focused on the synthesis of macromonomers capable of reacting with vinyl monomers to form graft copolymers. This study focused on the synthesis of macromonomers capable of participating in condensation polymerizations. A chain transfer functionalization method was utilized. Cysteine was evaluated as a chain transfer agent for the synthesis of amino acid functionalized poly(acrylate) and poly(methacrylate) macromonomers. Low molar mass, functionalized macromonomers were produced. These macromonomers were proven to be capable of reacting with amide precursors to form poly(amide-g-acrylate) graft copolymers. Macromonomers and graft copolymers were characterized by gel permeation chromatography (GPC), Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance (NMR) spectroscopy, elemental analysis (EA), inductively coupled plasma (ICP), and differential scanning calorimetry (DSC). The second part of this research involved poly(dimethacrylate) dental restorative materials. Volumetric shrinkage during the cure of these resins results in a poor interface between the resin and the remaining tooth structure, limiting the lifetime of these materials. Cyclic anhydrides were incorporated into common monomer compositions used in dental applications. Volume expansion from the ring opening hydrolysis of these anhydrides was shown to be feasible. The modified dental resins were characterized by swelling, extraction and ultraviolet spectroscopy (UV), and density measurements. Linear poLymers designed to model the crosslinked dental resins were

  4. Comparative Analysis of Interbody Cages Versus Tricortical Graft with Anterior Plate Fixation for Anterior Cervical Discectomy and Fusion in Degenerative Cervical Disc Disease

    PubMed Central

    Singh, Pritish; Shekhawat, Vishal

    2016-01-01

    Introduction Multiple techniques and modalities of fixation are used in Anterior Cervical Discectomy and interbody Fusion (ACDF), each with some merit and demerit against others. Such pool of techniques reflects lack of a consensus method conducive to uniformly good results. Aim A prospective study was done to analyse safety and efficacy of tricortical autograft and anterior cervical plate (Group A) with cylindrical titanium cage filled with cancellous bone (Group B) in procedure of ACDF for single level degenerative cervical disc disease. Materials and Methods Twenty patients with degenerative cervical disc disease were included in study for ACDF. After a computer generated randomisation, ten patients (10 segments) were operated with anterior locking plating and tricortical iliac crest graft (Group A, Tricortical graft group), while ten patients(10 segments) were operated with standalone cylindrical titanium cages filled with cancellous bone harvested using minimally invasive methods (Group B, Cage group) from April 2012 to May 2015. Odoms’s criteria, visual pain analogue score and sequential plain radiographs were obtained to assess for clinic-radiological outcome. Results According to Odom’s system of functional assessment, 9 patients from each group (90%) experienced good to excellent functional recovery and 9 of 10 (90%) patients of each groups were satisfied with outcome. In both groups, relief in neck pain or arm pain was similar without any statistical difference as assessed by visual analogue score. Fusion was present in 10 of 10 (100%) patients in tricortical graft group and 10 of 10 (100%) in cage group at the end of 6 months. There was no implant related complications in cage group. Transient postoperative dysphagia was recorded in 3 patients (2 in Group A and 1 in group B), which resolved within 3 days. In tricortical graft group, graft collapse and partial extrusion was detected in one patient, which did not correspond with good results obtained

  5. Polyether/Polyester Graft Copolymers

    NASA Technical Reports Server (NTRS)

    Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

    1986-01-01

    Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

  6. Gluteus augmentation with fat grafting.

    PubMed

    Perén, P A; Gómez, J B; Guerrerosantos, J; Salazar, C A

    2000-01-01

    This study presents the authors' experience with gluteus augmentation with autologus fat grafts and liposuction methods, having recorded the evolution of gluteus reshaping with autologus intramuscular fat graft injections for the past 5 years. Preoperative shape is discussed and patient evaluations, operative techniques, postoperative management, and longterm results are emphasized. PMID:11246428

  7. Grafting effects on vegetable quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vegetable grafting began in the 1920s to control soil-borne disease. It is now a common practice in Asia, parts of Europe, and the Middle East. In Japan and Korea most of the cucurbits and tomatoes (Lycopersicon esculentum Mill.) grown are grafted. This practice is rare in the U.S. and there have...

  8. Listeria monocytogenes Endovascular Graft Infection

    PubMed Central

    Heysell, Scott K.; Hughes, Molly A.

    2016-01-01

    Although best managed by surgical resection, we present a case of Listeria monocytogenes endovascular graft infection alternatively treated with graft retention and antibiotic induction followed by a lifelong suppressive course. The epidemiological, pathological, and clinical features of this unique entity are reviewed. PMID:26835477

  9. Soluble epoxide hydrolase expression in a porcine model of arteriovenous graft stenosis and anti-inflammatory effects of a soluble epoxide hydrolase inhibitor

    PubMed Central

    Sanders, William G.; Morisseau, Christophe; Hammock, Bruce D.; Cheung, Alfred K.

    2012-01-01

    Synthetic arteriovenous (AV) grafts, placed between an artery and vein, are used for hemodialysis but often fail due to stenosis, typically at the vein-graft anastomosis. This study recorded T lymphocyte and macrophage accumulation at the vein-graft anastomosis, suggesting a role for inflammation in stenosis development. Epoxyeicosatrienoic acids (EETs), products of cytochrome P-450 epoxidation of arachidonic acid, have vasculoprotective and anti-inflammatory effects including inhibition of platelet activation, cell migration, and adhesion. EETs are hydrolyzed by soluble epoxide hydrolase (sEH) to less active diols. The effects of a specific inhibitor of sEH (sEHI) on cytokine release from human monocytes and mouse bone marrow–derived macrophages (BMMΦ) from wild-type (WT) and sEH knockout (KO) animals were investigated. Expression of sEH protein increased over time at the anastomosis as evaluated by immunohistochemistry. Pre-exposure of adherent human monocytes to sEHI (5 μM) significantly inhibited lipopolysaccharide-induced release of monocyte chemotactic protein-1 (MCP-1) and tumor necrosis factor-α and enhanced the EET-to-diol ratio. Release of MCP-1 from WT BMMΦ was significantly inhibited but release from sEH KO BMMΦ was not attenuated indicating the specificity of the sEHI. In contrast, sEHI did not inhibit the release of macrophage inflammatory protein-1 or interleukin-6. Nuclear translocation of NF-κB, as assessed by immunocytochemical staining, was not decreased with sEHI in monocytes, but the phosphorylation of JNK was completely abrogated, suggesting this pathway is the target of sEHI effects in monocytes. These results suggest that sEHI may be useful for inhibition of inflammation and subsequently stenosis in AV grafts. PMID:22621785

  10. [Stent Grafting for Aortic Dissection].

    PubMed

    Uchida, Naomichi

    2016-07-01

    The purpose of stent graft for aortic dissection is to terminate antegrade blood flow into the false lumen through primary entry. Early intervention for primary entry makes excellent aortic remodeling and emergent stent grafting for complicated acute type B aortic dissection is supported as a class I. On the other hand stent grafting for chronic aortic dissection is controversial. Early stent grafting is considered with in 6 months after on-set if the diameter of the descending aorta is more than 40 mm. Additional interventions for residual false lumen on the downstream aorta are still required. Stent graft for re-entry, candy-plug technique, and double stenting, other effective re-interventions were reported. Best treatment on the basis of each anatomical and physical characteristics should be selected in each institution. Frozen elephant trunk is alternative procedure for aortic dissection without the need to take account of proximal anatomical limitation and effective for acute type A aortic dissection. PMID:27440026

  11. ACL Reconstruction: Choosing the Graft

    PubMed Central

    Cerulli, Giuliano; Placella, Giacomo; Sebastiani, Enrico; Tei, Matteo Maria; Speziali, Andrea; Manfreda, Francesco

    2013-01-01

    Summary Rupture of the anterior cruciate ligament is one of the most common ligament injuries in sports traumatology. The need for surgical anterior cruciate ligament reconstruction is justified by its anatomical characteristics. Key considerations when choosing a graft include the potential for bone integration and the risk of failure. Bone sclerosis around the tunnel affects the integration of the graft. For this reason, one aspect upon which orthopedic surgeons should focus is the biology of the bone-graft interface. Although the BPTB graft is still used, hamstrings and synthetic grafts have become increasingly widespread and popular over the years. An allograft certainly requires more long-term follow-up to validate its use in response to functional, clinical and biological requirements. PMID:25606507

  12. Motexafin lutetium in graft coronary artery disease

    NASA Astrophysics Data System (ADS)

    Woodburn, Kathryn W.; Rodriquez, Shari L.; Yamaguchi, Atsushi; Hayase, Motoya; Robbins, Robert C.; Kessel, David

    2000-03-01

    Graft coronary artery disease (GCAD) is the chief complication following cardiac transplantation. Presently, there are limited treatment options. Insights into more expedient diagnosis and amelioration, if only partially, of GCAD are fervently sought. The selectivity of Antrin Injection (Lu-Tex) with subsequent photoactivation has been evaluated in several preclinical atherosclerosis models. The inhibitory effect of Lu-Tex induced photosensitization was demonstrated with human bypass coronary smooth muscle cells. The biodistribution of Lu-Tex was evaluated in a rat model of heterotopic cardiac allografts 60 days following transplantation. Lu-Tex was retained in the cardiac allograft, exhibiting a five-fold increase in retention between the allograft and native heart. These findings lead us to suggest that further studies are warranted to ascertain the merits of Lu-Tex for the diagnosis and possible attenuation of chronic graft vascular disease.

  13. Assessment laser phototherapy on bone defects grafted or not with biphasic synthetic micro-granular HA + β-tricalcium phosphate: histological study in an animal model

    NASA Astrophysics Data System (ADS)

    Soares, Luiz Guilherme P.; Marques, Aparecida M. C.; Aciole, Jouber Mateus S.; Trindade, Renan; Santos, Jean N.; Pinheiro, Antônio Luiz B.

    2014-02-01

    Beside of biomaterials, Laser phototherapy has shown positive results as auxiliary therapy on bone repair. The aim of this study was to evaluate, through histological analysis, the influence of Laser phototherapy in the process of repair of bone defects grafted or not with Hydroxyapatite. Forty rats were divided into 4 groups each subdivided into 2 subgroups according to the time of sacrifice. Surgical bone defects were made on femur of each animal with a trephine drill. On animals of group Clot the defect was filled only by blood, on group Laser the defect filled with the clot and further irradiated. In group Biomaterial the defect was filled with HA + β-TCP graft. In group Laser + Biomaterial, the defect was filled with biomaterial and further irradiated. The irradiation protocols were performed every 48 hours during for 15 days. Animal death occurred after 15 and 30 days. The specimens were routinely processed and evaluated by light microscopy. Qualitative analysis showed that group Laser + Biomaterial was in a more advanced stage of repair at the end of the experimental time. It was concluded that the Laser irradiation improved the repair of bone defects grafted or not.

  14. Radiation grafting on natural films

    NASA Astrophysics Data System (ADS)

    Lacroix, M.; Khan, R.; Senna, M.; Sharmin, N.; Salmieri, S.; Safrany, A.

    2014-01-01

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37-40 N mm-1) and puncture deformation (PD=6.5-9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282-296 N mm-1 and PD of 5.0-5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films.

  15. P-15 small peptide bone graft substitute in the treatment of non-unions and delayed union. A pilot clinical trial

    PubMed Central

    Orozco, Rafael; Villar, Jose Luis; Arrizabalaga, Federico

    2006-01-01

    Treatment of non-unions and delayed unions often requires osteogenic material. Recently, a biomimetic bone matrix that simulates the cellular environment of hard tissue, identified as P-15, was introduced to the orthopaedic community. A total of 22 patients with mal-union or delayed union fractures was treated from June 2000 to October 2003 with P15- bone graft substitute (P15-BGS) in the site of fracture and mostly with internal fixation. Patients were examined by independent radiographic analysis. Assessment criteria included time elapsed until bone bridging and time to full consolidation. In addition, histological assessment of the callus was done at the time of recovery of metal implants in five patients. Full consolidation was achieved in 90% (20 out of 22) of the patients treated with P15-BGS. The average time for full consolidation was 4.2 months. Histological assessment of the fracture callus in five of the patients confirmed the positive clinical and radiographic results. P15-BGS appears to offer a safe, economical and clinically useful alternative to autograft in the repair of ununited fractures. These results compare favourably with those in the published literature as an alternative to autograft. PMID:16761146

  16. Treatment of aggressive multiple myeloma by high-dose chemotherapy and total body irradiation followed by blood stem cells autologous graft

    SciTech Connect

    Fermand, J.P.; Levy, Y.; Gerota, J.; Benbunan, M.; Cosset, J.M.; Castaigne, S.; Seligmann, M.; Brouet, J.C.

    1989-01-01

    Eight patients with stage III aggressive multiple myeloma, refractory to current chemotherapy in six cases, were treated by high-dose chemotherapy (nitrosourea, etoposide, and melphalan) (HDC) and total body irradiation (TBI), followed by autografting with blood stem cells. These cells were previously collected by leukapheresis performed during hematologic recovery following cytotoxic drug-induced bone marrow aplasia. Seven patients were alive 9 to 17 months after HDC-TBI and graft. One died at day 40 from cerebral bleeding. All living patients achieved a 90% or greater reduction in tumor mass. In two cases, a complete remission (CR) has persisted at a follow-up of 15 and 16 months. Three patients have been well and off therapy with stable minimal residual disease (RD) since 10, 11, and 17 months, respectively. A patient in apparent CR and another with RD have relapsed 9 to 12 months posttreatment. Autologous blood-derived hematopoietic stem cells induced successful and sustained engraftment in all living patients. These results, although still preliminary, indicate that HDC and TBI, followed by blood stem cells autograft, which has both practical and theoretical interest over allogeneic or autologous bone marrow transplantation, deserve consideration in selected patients with multiple myeloma.

  17. Outcome of Simultaneous Arthroscopic Anterior Cruciate Ligament and Posterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: A Multicenter Prospective Study

    PubMed Central

    Panigrahi, Ranajit; Kumari Mahapatra, Amita; Priyadarshi, Ashok; Singha Das, Dibya; Palo, Nishit; Ranjan Biswal, Manas

    2016-01-01

    Background: Multiligamentous injuries of knee are a complex problem in orthopaedics. Combined ACL-PCL injuries are uncommon, usually associated with knee dislocations. Extremity vascular status is essential because of possible arterio-venous compromise. These complex injuries require a systematic evaluation and treatment. Single setting simultaneous arthroscopic ACL and PCL reconstruction or a staged approach can be adopted to treat these cases. Objectives: To evaluate functional outcome of simultaneous arthroscopic ACL and PCL reconstruction with hamstring tendon autograft in multiligamentous knee injuries. Patients and Methods: This prospective study was performed on 20 patients with combined ACL-PCL injuries who underwent simultaneous arthroscopic ACL-PCL reconstruction with hamstring tendon. Evaluation of functional outcome was by IKDC and Lysholm-Tegner scores. Results: In 20 patients, mean age 34 years, return to full-time work and to full sports was 8 weeks and 6.2 months respectively. All patients had full range of motion except 2 patients with < 5 degrees flexion loss; 90% had negative Lachmann test; 95% had negative pivot shift and 10% patients had mild posterior drawer at 90 degrees (1+) at final follow up. Mean IKDC score was 90 (range 81 - 94); mean Tegner activity score was 7 and mean Lysholm knee score was 89. 85% returned to preinjury activity level and a 90% satisfaction rate. Conclusions: Simultaneous arthroscopic ACL and PCL reconstructions using hamstring tendon for combined ACL and PCL injuries is a clinically effective, safe, time saving and cost-effective procedure with better patient compliance and reproducible for a timely return of motion, strength, and function with favorable outcome. PMID:27217932

  18. The Periosteal Autografts Transplantation for Cartilage Defects of the Hip in Older Children With Developmental Dysplasia as an Adjunctive Procedure

    PubMed Central

    Du, Ming-Hua; Ding, Yu; Shi, Xian; Xu, Rui-Jiang

    2016-01-01

    Abstract Cartilage lesions are at a high prevalence in dysplastic hips and may relate to arthritic changes and hip joint dysfunction. To date, the effectiveness of repair of articular cartilage defects in the dysplastic hips has not yet been thoroughly evaluated. Here we retrospectively reviewed the effects of acetabuloplasty procedures with/without concomitant autologous tibial periosteal transplantation (ATPT) for articular cartilage defects of the hip in older children with developmental dysplasia of the hip (DDH). Older DDH children with focal cartilage defects of the acetabular or femoral cartilage or both in the hip joint were treated by acetabuloplasty procedures with (Group I) or without (Group II) concomitant ATPT to evaluate the improvements in range of motion (ROM), pain relief of hip, walking tolerability (WL), radiologic evaluations, and outcomes in the long-term follow-up. More satisfactory functional outcome is readily achieved among patients treated with combined acetabuloplasty and ATPT, evidenced by marked pain relief and improved ROM and WL. The latest favorable radiologic evaluation was 70.6% in Group I and 60.0% in Group II, respectively. More hips exhibited congruency between the femoral head and the shell, with less deformity of femoral head and acetabulum or narrowed joint space in Group I. Few major complications were recorded in Group I. Application of periosteal autograft for repair of cartilage defects within the hip joint might be an effective adjunctive treatment for acetabuloplasty in preventing stiffness, reducing pain, and improving ROM and outcomes in hip rehabilitation in the long-term follow-up in older children with DDH. PMID:27124031

  19. Effects of bone marrow mesenchymal stem cells on hematopoietic recovery and acute graft-versus-host disease in murine allogeneic umbilical cord blood transplantation model.

    PubMed

    Li, Zhen Yu; Wang, Chun Qing; Lu, Guang; Pan, Xiu Ying; Xu, Kai Lin

    2014-09-01

    To investigate the effect of bone marrow mesenchymal stem cells (MSC) on hematopoietic recovery and acute graft-versus-host disease (GVHD) in a murine allogeneic umbilical cord blood transplantation (allo-UCBT) model. MSCs were obtained from C57/BL mouse bone marrow. The MSC phenotypes were identified by flow cytometry (FCM), and their ability to differentiate into osteoblasts and adipocytes was tested. Once murine allo-UCBT and aGVHD models were established, mice were divided into five groups: (1) total body irradiation (TBI) group, each mouse receiving 0.3 ml sterile saline infusion after TBI and used as control; (2) UCB group, receiving 2 × 10(6) umbilical cord blood mononuclear cells (UCB-MNC) after TBI; (3) UCB+MSC group, receiving 2 × 10(6) UCB-MNC and 2 × 10(7) MSC after TBI; (4) UCB+SC group, receiving 2 × 10(6) UCB-MNC and 2 × 10(6) spleen cells after TBI; and (5) UCB+SC+MSC group, receiving 2 × 10(6) UCB-MNC, 2 × 10(7) MSC and 2 × 10(6) spleen cells after TBI. To evaluate the engraftment of HSC, the white blood cells, red blood cells, and platelets counts were tested at different time points after transplantation, and the ratio of chimerism was identified by FCM. The acute GVHD clinical scores, recipient mice survival, and the histopathological analyses were used to evaluate the effect of MSC on acute GVHD. MSCs were successfully obtained in vitro and FCM analysis showed that these cells are highly positive for CD90.2, CD44, and negative for CD34, CD45, and they are capable to differentiate into osteoblasts and adipocytes after being induced. Compared to UCB group, the UCB+MSC mice had shorter duration of myelosuppression and higher percentage of donor-derived cells which was up to 22.87 ± 4.3 % and the white blood cell (WBC), red blood cell (RBC), and platelet counts started to increase by day 6 after transplantation. Moreover, the average survival time for UCB+MSC mice was 25.0 ± 10.55 days, while for the UCB group it was 15.5 ± 12.50 days

  20. Endothelial preservation in reversed and in situ autogenous vein grafts. A quantitative experimental study.

    PubMed Central

    Cambria, R P; Megerman, J; Abbott, W M

    1985-01-01

    The hypothesis that superior endothelial preservation occurs when in situ (as opposed to harvested and reversed) autogenous veins are used as arterial grafts was investigated in a canine model by quantitating endothelial loss as seen on scanning electron micrographs. In situ grafts were compared to atraumatically dissected, nondistended, reversed grafts and to grafts distended to 500 mmHg pressure. Two hours after arterial transplantation, endothelial denudation averaged 3.9 +/- 6.7% on in situ grafts, 18.6 +/- 5.9% on reversed grafts (p less than 0.01), and 35.3 +/- 5.4% on reversed and distended grafts (p less than 0.001). At 24 hours after grafting, a significant increase (p less than 0.01) in endothelial destruction on in situ grafts resulted in a smaller, yet still significant difference in endothelial preservation between in situ and reversed grafts (15.2 +/- 9.5% vs. 25.1 +/- 23.4%, p less than 0.05). Endothelial healing was largely accomplished at 2 weeks regardless of technique. No difference in endothelial fibrinolytic activity could be detected between in situ and gently handled, reversed grafts at 24 hours or 6 weeks after surgery. An obligatory, although modest, degree of endothelial destruction occurred on the undissected portion of in situ grafts as a consequence of exposure to arterial hemodynamics. However, in the immediate postoperative period, endothelial preservation on in situ grafts surpassed that seen in even the most gently handled reversed vein grafts. Images FIGS. 1A and B. FIG. 2. FIG. 3. PMID:4015211

  1. Intraarterial 9-beta-methyl carbacyclin improves canine polytetrafluoroethylene graft patency

    SciTech Connect

    Dacey, L.J.; Hees, P.S.; Cronenwett, J.L.

    1988-07-01

    This study examined the effect of 9-beta-methyl carbacyclin, a synthetic, stable prostacyclin analog, on canine polytetrafluoroethylene (PTFE) graft patency. Twenty-five dogs had 4 mm x 7 cm PTFE grafts implanted bilaterally into the femoral arteries. A subcutaneous infusion pump was used to deliver either saline solution (control) or 9-beta-methyl carbacyclin (Ciprostine) at 100 (CARB-100) or 200 ng/kg/min (CARB-200) through a femoral artery branch just proximal to one of the femoral grafts, with the contralateral graft serving as a noninfused control. Graft-platelet deposition (with /sup 111/In-labeled platelets) was measured between the fifth and seventh days, with patency determined on the seventh day. Dogs were classified as aggregators (AGG (+)) if the preoperative epinephrine-enhanced sodium arachidonate platelet aggregation was greater than 20%. CARB-200 infusion significantly improved ipsilateral graft patency (80%) compared with noninfused grafts (50%, p less than 0.05), or grafts in control and CARB-100 dogs (43%, p less than 0.05). Anastomotic platelet deposition was decreased bilaterally in CARB-200 dogs by 45% to 59% compared with CARB-100 and control dogs (p less than 0.05). With the exception of grafts infused with CARB-200, AGG (+) dogs had significantly lower graft patency (26%) than nonaggregator AGG (-) dogs (71%, p less than 0.01). CARB-200 infusion significantly improved graft patency in AGG (+) dogs (71%), compared with control and CARB-100-infused grafts (19%, p less than 0.025). Intra-arterial 9-beta-methyl carbacyclin improved early PTFE graft patency and inhibited platelet deposition in a severe canine model, independent of baseline platelet aggregation status, which also had an important effect on graft patency.

  2. Vascular grafts in microvascular surgery. An experimental study

    SciTech Connect

    Marrangoni, A.G.; Marcelli, G.; Culig, M.; Simone, S.T.

    1988-02-01

    The patency of microvascular grafts depends on the luminal diameter, which is determined by the amount of fibrin and platelets deposited on the intraluminal surface and the anastomotic site, and the extent of pseudointimal formation. An experimental microvascular model in rats has been developed in our laboratory using Indium-111-labeled platelets to measure the amount of deposition on grafts inserted into the infrarenal aorta. This study was designed to assess the patency rates in these grafts and the pathologic maturation as determined by light and electron microscopy. Our study suggests that substantial patency rates can be achieved in aspirin-treated rats, although there was little influence on the pathologic maturation. Indium-111 oxine-labeled platelets can be used to document platelet aggregation, and the technique can be a valuable adjunct in the study of microvascular grafts.

  3. The Effect of Graft Strength on Knee Laxity and Graft In-Situ Forces after Posterior Cruciate Ligament Reconstruction

    PubMed Central

    Lai, Yu-Shu; Chen, Wen-Chuan; Huang, Chang-Hung; Cheng, Cheng-Kung; Chan, Kam-Kong; Chang, Ting-Kuo

    2015-01-01

    Surgical reconstruction is generally recommended for posterior cruciate ligament (PCL) injuries; however, the use of grafts is still a controversial problem. In this study, a three-dimensional finite element model of the human tibiofemoral joint with articular cartilage layers, menisci, and four main ligaments was constructed to investigate the effects of graft strengths on knee kinematics and in-situ forces of PCL grafts. Nine different graft strengths with stiffness ranging from 0% (PCL rupture) to 200%, in increments of 25%, of an intact PCL’s strength were used to simulate the PCL reconstruction. A 100 N posterior tibial drawer load was applied to the knee joint at full extension. Results revealed that the maximum posterior translation of the PCL rupture model (0% stiffness) was 6.77 mm in the medial compartment, which resulted in tibial internal rotation of about 3.01°. After PCL reconstruction with any graft strength, the laxity of the medial tibial compartment was noticeably improved. Tibial translation and rotation were similar to the intact knee after PCL reconstruction with graft strengths ranging from 75% to 125% of an intact PCL. When the graft’s strength surpassed 150%, the medial tibia moved forward and external tibial rotation greatly increased. The in-situ forces generated in the PCL grafts ranged from 13.15 N to 75.82 N, depending on the stiffness. In conclusion, the strength of PCL grafts have has a noticeable effect on anterior-posterior translation of the medial tibial compartment and its in-situ force. Similar kinematic response may happen in the models when the PCL graft’s strength lies between 75% and 125% of an intact PCL. PMID:26001045

  4. Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration in a rodent model: a description of the bone repair by light microscopy

    NASA Astrophysics Data System (ADS)

    Pinheiro, Antonio Luiz B.; Aciole, Gilberth T. S.; Soares, Luiz G. P.; Correia, Neandder A.; N. dos Santos, Jean

    2011-03-01

    We carried out a histological analysis on surgical bone defects grafted or not with MTA, treated or not with LED, BMPs and GBR. We have used several models to assess the effects of laser on bone. Benefits of the isolated or combined use them on bone healing has been suggested. There is no previous report on their association with LED light. 90 rats were divided into 10 groups. On Groups II and I the defect were filled with the clot. On Group II, were further irradiated. On groups III-VI, defect was filled with MTA + Collagen gel (III); animals of group IV were further irradiated. On groups V and VI, the defects filled with the MTA were covered with a membrane. Animals of Group VI were further irradiated. On Groups VII and VIII a pool of BMPs was added to the MTA and was further irradiated. On groups IX and X, the MTA + BMP graft was covered with a membrane. On group X, the defect was further irradiated. LED (λ850 +/- 10nm, 150mW, A= 0.5cm2, 54s, 0.3W/cm2, 16 J/cm2) was applied at 48 h intervals during 15 days. Specimens were taken, processed, cut and stained with H&E and Sirius red and underwent histological analysis. The results showed that MTA seemed not being affected by LED light. However, its use positively affected healing around the graft. It is concluded that MTA is not affected by the LED light due to it characteristics, but beneficial results with LED usage was found.

  5. Secondary alveolar bone grafting: our experience with olecranon bone graft.

    PubMed

    Nadal, Emmanuela; Sabás, Mariana; Dogliotti, Pedro; Espósito, Raquel

    2010-03-01

    Management of alveolar cleft has dramatically changed during the last century: secondary alveolar bone grafting is now an integral part of cleft palate and craniofacial center's protocols. The objectives of alveolar repair and bone grafting are as follows: providing a continuous and stable maxillary dental arch, closure of oronasal fistulae, adequate bone for tooth eruption or orthodontic movement, and nasal base support, improving facial aesthetic. Although cancellous iliac bone is the donor site selected more frequently, bone grafts harvested from different sites have been advocated to decrease donor site morbidity.The aim of this study was to propose and evaluate the use of olecranon as a donor site in 24 patients with secondary alveolar cleft. The graft is taken as a single piece to fit the alveolar cleft defect, and it includes periosteum and corticocancellous bone to improve early vascularization and greater volume maintenance. PMID:20186086

  6. An Exploratory Clinical Trial of a Novel Treatment for Giant Congenital Melanocytic Nevi Combining Inactivated Autologous Nevus Tissue by High Hydrostatic Pressure and a Cultured Epidermal Autograft: Study Protocol

    PubMed Central

    Jinno, Chizuru; Sakamoto, Michiharu; Kakudo, Natsuko; Yamaoka, Tetsuji; Kusumoto, Kenji

    2016-01-01

    Background Giant congenital melanocytic nevi (GCMNs) are large brown to black skin lesions that appear at birth and are associated with a risk of malignant transformation. It is often difficult to reconstruct large full-thickness skin defects after the removal of GCMNs. Objective To overcome this difficulty we developed a novel treatment to inactivate nevus tissue and reconstruct the skin defect using the nevus tissue itself. For this research, we designed an exploratory clinical study to investigate the safety and efficacy of a novel treatment combining the engraftment of autologous nevus tissue inactivated by high hydrostatic pressurization with a cultured epidermal autograft (CEA). Methods Patients with congenital melanocytic nevi that were not expected to be closed by primary closure will be recruited for the present study. The target number of nevi is 10. The full-thickness nevus of the target is removed and pressurized at 200 MPa for 10 minutes. The pressurized and inactivated nevus is sutured to the original site. A small section of the patient’s normal skin is taken from around the nevus region and a CEA is prepared after a 3-week culturing process. The CEA is then grafted onto the engrafted inactivated nevus at four weeks after its retransplantation. The primary endpoint is the engraftment of the CEA at 8 weeks after its transplantation and is defined as being engrafted when the engraftment area of the inactivated nevus is 60% or more of the pretransplantation nevus area and when 80% or more of the transplanted inactivated nevus is epithelialized. Results The study protocol was approved by the Institutional Review Board of Kansai Medical University (No. 1520-2, January 5, 2016: version 1.3). The study opened for recruitment in February 2016. Conclusions This protocol is designed to show feasibility in del