MedWorm: Bone Graft

Integra LifeSciences Announces Launch of the Integra(R) Allograft Wedge System for Extremity Reconstruction

Medical News (via PRIMEZONE) — Wed, 08 Feb 2012 12:00:00 +0100

PLAINSBORO, N.J., Feb. 8, 2012 (GLOBE NEWSWIRE) -- Integra LifeSciences Holdings Corporation (Nasdaq:IART) announced today the introduction of Integra(r) Allograft Wedge System, which consists of simple pre-cut allograft wedges for both Evans and Cotton osteotomies and a dedicated instrumentation set that is designed to provide a method of assessing osteotomy space to aid in the selection of the appropriate Integra(r) Allograft Wedge implant. (Source: Medical News (via PRIMEZONE))

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The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery

Knee Surgery, Sports Traumatology, Arthroscopy — Mon, 06 Feb 2012 19:34:15 +0100

Conclusions The clinical outcome 10 years after ACL revision surgery was poor in these four patients. In contrast, the reharvested patellar tendon appeared close to normal on MRI, and the second-look arthroscopy with the concomitant histological findings revealed that the grafts were viable 3 years after revision. Therefore, the reharvested patellar tendon seems to have the potential for ligamentization when used for ACL revision surgery. Level of evidence Case series, Level IV. Content Type Journal ArticleCategory KneePages 1-7DOI 10.1007/s00167-012-1908-7Authors Sven Stener, NU-Hospital Organization, Trollhättan/Uddevalla, SwedenLars Ejerhed, NU-Hospital Organization, Trollhättan/Uddevalla, SwedenTomas Movin, Karolinska University Ho...

Early exposure of interferon-γ inhibits signal transducer and activator of transcription-6 signalling and nuclear factor κB activation in a short-term monocyte-derived dendritic cell culture promoting 'FAST' regulatory dendritic cells.

Clinical and Developmental Immunology — Sun, 05 Feb 2012 16:26:09 +0100

Authors: Rojas-Canales D, Krishnan R, Jessup CF, Coates PT Abstract Interferon (IFN)-γ is a cytokine with immunomodulatory properties, which has been shown previously to enhance the generation of tolerogenic dendritic cells (DC) when administered early ex vivo in 7-day monocyte-derived DC culture. To generate tolerogenic DC rapidly within 48 h, human monocytes were cultured for 24 h with interleukin (IL)-4 and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the presence (IFN-γ-DC) or absence of IFN-γ (500 U/ml) (UT-DC). DC were matured for 24 h with TNF-α and prostaglandin E(2) (PGE(2) ). DC phenotype, signal transducer and activator of transcription-6 (STAT-6) phosphorylation and promotion of CD4(+) CD25(+) CD127(neg/low) forkhead box P3 (FoxP3)(hi) T cell...

Postoperative spondilodiscitis

International Orthopaedics — Fri, 03 Feb 2012 17:12:18 +0100

Conclusions Appropriate management requires aggressive medical treatment and, at times, surgical intervention. If recognised early and treated appropriately, a full recovery can often be expected. Therefore, clinicians should be aware of the clinical presentation of such infections to improve patient outcome. A review of the literature was done to advance our understanding of the diagnosis, treatment, prevention and outcome of these infections. Content Type Journal ArticleCategory Review ArticlePages 1-6DOI 10.1007/s00264-011-1442-0Authors Antoine Gerometta, Spine Services, Lenox Hill Hospital, 130 East, 77th street, 7th floor, New York, NY 10075, USAFabian Bittan, Spine Services, Lenox Hill Hospital, 130 East, 77th street, 7th floor, New York, NY 10075, USAJuan Ca...

Treatment of severe osteochondral defects of the knee by combined autologous bone grafting and autologous chondrocyte implantation using fibrin gel

Knee Surgery, Sports Traumatology, Arthroscopy — Thu, 02 Feb 2012 18:10:22 +0100

Conclusion Combined autologous bone grafting and GACI may offer an alternative surgical option for severe and unstable osteochondral defects of the knee. Level of evidence IV. Content Type Journal ArticleCategory KneePages 1-7DOI 10.1007/s00167-012-1891-zAuthors Yvonne E. Könst, Department of Orthopaedic Surgery, Gemini Ziekenhuis, Huisduinerweg 3, 1780 AT Den Helder, The NetherlandsRob J. Benink, Department of Orthopaedic Surgery, Gemini Ziekenhuis, Huisduinerweg 3, 1780 AT Den Helder, The NetherlandsRon Veldstra, Department of Orthopaedic Surgery, Gemini Ziekenhuis, Huisduinerweg 3, 1780 AT Den Helder, The NetherlandsTjerk J. van der Krieke, Department of Orthopaedic Surgery, Gemini Ziekenhuis, Huisduinerweg 3, 1780 AT Den Helder, The Netherlands...

Early exposure of interferon‐γ inhibits signal transducer and activator of transcription‐6 signalling and nuclear factor κB activation in a short‐term monocyte‐derived dendritic cell culture promoting ‘FAST’ regulatory dendritic cells

Clinical and Experimental Immunology — Thu, 02 Feb 2012 11:18:33 +0100

SummaryInterferon (IFN)‐γ is a cytokine with immunomodulatory properties, which has been shown previously to enhance the generation of tolerogenic dendritic cells (DC) when administered early ex vivo in 7‐day monocyte‐derived DC culture. To generate tolerogenic DC rapidly within 48 h, human monocytes were cultured for 24 h with interleukin (IL)‐4 and granulocyte–macrophage colony‐stimulating factor (GM‐CSF) in the presence (IFN‐γ‐DC) or absence of IFN‐γ (500 U/ml) (UT‐DC). DC were matured for 24 h with TNF‐α and prostaglandin E2 (PGE2). DC phenotype, signal transducer and activator of transcription‐6 (STAT‐6) phosphorylation and promotion of CD4+CD25+CD127neg/lowforkhead box P3 (FoxP3)hi T cells were analysed by flow cytometry. DC nuclear factor (NF)...

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Medial rectus Botox injection with pterygium excision and autograft as a novel technique for management of recurrent pterygium

Clinical and Experimental Ophthalmology — Thu, 02 Feb 2012 05:00:00 +0100

A Cost-Effectiveness Analysis Comparing 3 Anterior Cruciate Ligament Graft Types: Bone-Patellar Tendon-Bone Autograft, Hamstring Autograft, and Allograft

The American Journal of Sports Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions: This model suggests that hamstring autograft ACL reconstruction is the most cost-effective method of surgery for the average patient with ACL deficiency. However, specific clinical scenarios that change postoperative probabilities of the different complications may sway surgeons to choose either allografts or BPTB. Cost-effectiveness analysis is not intended to replace individual clinician judgment but rather is intended to examine both the effectiveness and costs associated with theoretical groups undergoing specific multifactorial decisions. (Source: The American Journal of Sports Medicine)

Biomechanical and Histological Evaluations of the Doubled Semitendinosus Tendon Autograft After Anterior Cruciate Ligament Reconstruction in Sheep

The American Journal of Sports Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: The sheep ACL reconstruction model showed predominant intrinsic fibroblast necrosis in the tendon autograft until 12 weeks. Although the structural properties of the femur-graft-tibia complex gradually improved, they were not completely restored to the femur-ACL-tibia complex level even at 52 weeks. Clinical Relevance: Remodeling of the semitendinosus tendon autograft after ACL reconstruction is not different from that of the bone-tendon-bone graft. This study has suggested that vigorous activity should not be permitted for patients in the early periods after ACL reconstruction using semitendinosus tendon autografts, which are necrotized and weakened after surgery. (Source: The American Journal of Sports Medicine)

Patient and Surgeon Characteristics Associated With Primary Anterior Cruciate Ligament Reconstruction Graft Selection

The American Journal of Sports Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: Gender, age, race, as well as facility and surgeon characteristics such as volume and location are associated with ACL graft choices. (Source: The American Journal of Sports Medicine)

Meniscal Allograft Transplantation Without Bone Plugs: A 3-Year Minimum Follow-up Study

The American Journal of Sports Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: This study found that a single tibial tunnel arthroscopic technique without bone plugs for meniscal allograft transplantation significantly reduced pain and improved knee function in 94% of patients at a minimum 3-year follow-up. (Source: The American Journal of Sports Medicine)

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Does Anterior Cruciate Ligament Reconstruction Lead to Degenerative Disease?: Thirteen-Year Results After Bone-Patellar Tendon-Bone Autograft

The American Journal of Sports Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: At 13 years, BTB ACL reconstruction provides a good outcome. Chondral and meniscal damage at surgery were associated with a poor radiological outcome, indicating that injuries sustained during ACL rupture may be the main predictors of degenerative bone disease. (Source: The American Journal of Sports Medicine)

Differential Expression of MicroRNAs During Allograft Rejection

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

MicrorRNA are small noncoding RNA molecules that regulate the posttranscriptional expression of target genes. In addition to being involved in many biologic processes, microRNAs are important regulators in innate and adaptive immune responses. Distinct sets of expressed microRNAs are found in different cell types and tissues and aberrant expression of microRNAs is associated with many disease states. MicroRNA expression was examined in a model of heterotopic heart transplantation by microarray analyses and a unique profile was detected in rejecting allogeneic transplants (BALB/c → C57BL/6) as compared to syngeneic transplants (C57BL/6 → C57BL/6). The microRNA miR‐182 was significantly increased in rejecting cardiac allografts and in mononuclear cells that infiltrate the grafts. Forkh...

Multiple Hyperacute Rejections in the Absence  of Detectable Complement Activation in a Patient  with Endothelial Cell Reactive Antibody

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

This case involves a 54‐year‐old patient with polycystic kidney disease and a history of hyperacute allograft rejections. Two previous compatible live donor transplants functioned immediately but failed within the first 12 h due to antibody‐injury. This patient was referred for a third transplant due to decreased vascular access and progressive hypotension from uremic autonomic dysfunction. He was broadly sensitized to HLA; however, a live donor was identified through kidney paired donation for whom he had no donor‐specific HLA antibody (HLA‐DSA). This patient received one plasmapheresis (PP) and intravenous immunoglobulin (IVIg) treatment, anti‐CD25, and anti‐CD20 antibodies prior to transplant. The allograft functioned immediately but became anuric within 24 h. A biopsy rev...

Lung Transplantation in Patients with Prior Cardiothoracic Surgical Procedures

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

The full spectrum of prior cardiothoracic procedures in lung transplant candidates and the impact of prior procedures on outcomes after lung transplantation (LTx) remain unknown, though the impact is considered to be large. Patients transplanted at our institution from 2004 to 2009 were identified (n = 554) and divided into two groups: patients who had undergone cardiothoracic surgical (CTS) procedures prior to LTx (n = 238) and patients who had not (non‐CTS: n = 316). Our primary endpoint was survival. Secondary endpoints included allograft function and the incidence of major complications including reexploration due to bleeding, prolonged ventilation, renal insufficiency and primary graft dysfunction. Long‐term survival was not significantly different between the groups whereas posto...

Donor Brain Death Inhibits Tolerance Induction in Miniature Swine Recipients of Fully MHC‐Disparate Pulmonary Allografts

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

We have previously shown that a short course of high‐dose tacrolimus induces long‐term tolerance to fully mismatched lung allografts procured from healthy MHC‐inbred miniature swine. Here, we investigate whether donor brain death affects tolerance induction. Four recipient swine were transplanted with fully mismatched lung grafts from donors that were rendered brain dead and mechanically ventilated for 4 h before procurement (Group 1). These recipients were compared to two control groups (Group 2: 4 h of donor ventilation without brain death [n = 5]; and Group 3: no donor brain death with <1 h of ventilation [n = 6]). All recipients were treated with a 12‐day course of tacrolimus. In contrast to both groups of control animals, the swine transplanted with lung allografts from bra...

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Role of Lentivirus‐Mediated Overexpression of Programmed Death‐Ligand 1 on Corneal Allograft Survival

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

To investigate the role of lentivirus‐mediated overexpression of programmed death‐ligand 1 (PD‐L1) on rat corneal allograft survival. A fully allogeneic rat cornea transplant model was used for in vivo studies. Lentiviral (LV) vectors are efficient tools for ex vivo genetic modification of cultured corneas. LV vector encoding for PD‐L1 (LV.PD‐L1) and LV vector encoding for eGFP (LV.eGFP, as control) were constructed and tested. PD‐L1 or eGFP expression was increased on corneal cells upon LV.PD‐L1 and LV.eGFP transduction, respectively. Both allogeneic controls and allogeneic LV.eGFP transduced corneas were uniformly rejected (MST: 13.8 ± 1.7 days and 12.3 ± 1.9 days, respectively). In contrast, allogeneic LV.PD‐L1 transduced corneas showed a high percentage (83%) of graft...

Early Metabolic Markers that Anticipate Loss of Insulin Independence in Type 1 Diabetic Islet Allograft Recipients

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

In conclusion, AIRGLU is an early metabolic assay capable of anticipating loss of insulin independence at 1 year in T1D patients undergoing PIT and constitutes a valuable, simple and reliable method to follow patients after transplant. (Source: American Journal of Transplantation)

A New Diagnostic Algorithm for Antibody‐Mediated Microcirculation Inflammation in Kidney Transplants

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

We studied the significance of microcirculation inflammation in kidney transplants, including 329 indication biopsies from 251 renal allograft recipients, who were mostly nonpresensitized (crossmatch negative). Glomerulitis (g) and peritubular capillaritis (ptc) were often associated with antibody‐mediated rejection (65% and 75%, respectively), but were also found in other diseases in the absence of donor‐specific antibody (DSA): T‐cell‐mediated rejection (ptc, g), glomerulonephritis (g) and acute tubular necrosis (ptc). To develop rules for reducing the nonspecificity of microcirculation inflammation and defining the best grading thresholds associated with DSA, we built and validated a decision tree to predict DSA. The decision tree revealed that g + ptc sum (addition of g‐score...

A Common Peripheral Blood Gene Set for Diagnosis of Operational Tolerance in Pediatric and Adult Liver Transplantation

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

To identify biomarkers of operational tolerance in pediatric and adult liver transplant recipients, transcriptional profiles were examined from 300 samples by microarrays and Q‐PCR measurements of blood specimens from pediatric and adult liver transplant recipients and normal tissues. Tolerance‐specific genes were validated in independent samples across two different transplant programs and validated by Q‐PCR. A minimal set of 13 unique genes, highly expressed in natural killer cells (p = 0.03), were significantly expressed in both pediatric and adult liver tolerance, irrespective of different clinical and demographic confounders. The performance of this gene set by microarray in independent samples was 100% sensitivity and 83% specificity and the AUC was 0.988 for only three genes b...

Deleterious Effect of CTLA4‐Ig on a Treg‐Dependent Transplant Model

American Journal of Transplantation — Thu, 02 Feb 2012 05:00:00 +0100

This study confirms the importance of the B7:CD28 pathway in Treg homeostasis in an in vivo transplant model and suggests that hCTLA4Ig therapy may be deleterious in circumstances where engraftment is dependent on Tregs. (Source: American Journal of Transplantation)

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Effect of dietary polyunsaturated fatty acids on castration-resistant Pten-null prostate cancer

Carcinogenesis — Thu, 02 Feb 2012 05:00:00 +0100

A common treatment of advanced prostate cancer involves the deprivation of androgens. Despite the initial response to hormonal therapy, eventually all the patients relapse. In the present study, we sought to determine whether dietary polyunsaturated fatty acid (PUFA) affects the development of castration-resistant prostate cancer. Cell culture, patient tissue microarray, allograft, xenograft, prostate-specific Pten knockout and omega-3 desaturase transgenic mouse models in conjunction with dietary manipulation, gene knockdown and knockout approaches were used to determine the effect of dietary PUFA on castration-resistant Pten-null prostate cancer. We found that deletion of Pten increased androgen receptor (AR) expression and Pten-null prostate cells were castration resistant. Omega-3 PUFA...

Mitochondrial haplogroups associated with end-stage heart failure and coronary allograft vasculopathy in heart transplant patients

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions Mitochondrial haplogroups behave like risk factors for the progress to end-stage HF in a Spanish cardiac transplant population. Mitochondrial DNA variants may have some influence on the appearance of cardiac transplant complications. (Source: European Heart Journal)

Comparison between anterior and posterior decompression for cervical spondylotic myelopathy: subjective evaluation and cost analysis

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Both anterior and posterior decompressions (with instrumentation) are effective procedures for improving the neurological outcomes of patients with CSM. However, although the two approaches have similar health care costs, anterior cervical corpectomy (with instrumentation) seems to be subjectively assessed by patients as better. (Source: Orthopaedic Surgery)

Sinusoidal C4d deposits in liver allografts indicate an antibody mediated response: Diagnostic considerations in the evaluation of liver allografts

Liver Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

AbstractThere is a paucity of data concerning the correlation of C4d staining in liver allografts with antibody mediated rejection (AMR). Data regarding location and character of C4d deposits in native and allograft liver tissue are inconsistent. We performed C4d immunofluorescence (IF) on 141 fresh frozen liver allograft biopsies and native livers, documented the pattern of C4d IF staining and correlated the findings with the presence of donor specific antibodies (DSA). A linear/granular sinusoidal pattern of C4d IF was noted in 18 of 28 biopsies obtained post transplant in patients with positive crossmatch and detectable DSA (pos XM/DSA). In patients with negative XM/DSA none was C4d positive of 59 tested (p > 0.001). No significant association was found between positive XM/DSA and C4...

Effect of simvastatin on development of obliterative airway disease: An experimental study

The Journal of Heart and Lung Transplantation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Simvastatin treatment inhibited adaptive T-cell alloimmune activation as depicted by reduced expression of lymphocyte chemokine and pro-inflammatory cytokine mRNA and reduced allograft infiltration by inflammatory cells. Importantly, simvastatin inhibits the development of OAD and this effect is partially mediated by increased nitric oxide activity. These results suggest a role for simvastatin in the prevention of obliterative bronchiolitis. (Source: The Journal of Heart and Lung Transplantation)

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Salvaging kidneys with renal allograft compartment syndrome

Transplant International — Wed, 01 Feb 2012 05:00:00 +0100

SummaryRenal allograft compartment syndrome is an under recognized cause of early allograft dysfunction which can be reversed by early intervention. It occurs early after renal transplantation where closure of the anterior abdominal wall seems to compress the transplant in the limited retroperitoneal space. The literature about this syndrome in renal transplantation is sparse. Our report describes the diagnostic criteria and the management of two renal transplant recipients with this syndrome. Its diagnosis depends upon duplex vascular scan findings of reversed or absent diastolic flow in the renal vasculature in the absence of any perigraft collection or severe acute tubular necrosis. In our hands emergency laparotomy, decompression of the transplant and closure with interposition mesh sa...

Telescopic mating technique for bulk allograft reconstruction.

Orthopedics — Wed, 01 Feb 2012 05:00:00 +0100

This article describes the telescopic mating technique, which allows for substantially greater bone contact across the allograft-host junction site. PMID: 22300990 [PubMed - in process] (Source: Orthopedics)

Chondrogenic potential and homogeneity of cell populations of donor and recipient cells in a fresh osteochondral allograft: a case report.

The Journal of Bone and Joint Surgery. American volume — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Haudenschild DR, Hong E, Hatcher S, Jamali AA PMID: 22298063 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Function After Injection of Benign Bone Lesions with a Bioceramic.

Clinical Orthopaedics and Related Research — Tue, 31 Jan 2012 05:00:00 +0100

CONCLUSION: Patients treated with this material reported high MSTS functional scores more than 24 months after operative intervention and experienced low complication rates. We believe the novel bioceramic to be a reasonable treatment option for benign bone lesions. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID: 22290129 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Spinal cord herniation: Management and outcome in a series of 12 consecutives patients and review of the literature

Acta Neurochirurgica — Mon, 30 Jan 2012 16:06:08 +0100

Conclusions The authors present one of the largest studies to date regarding patients with spinal cord herniation and emphasize that the possibility of this condition must be kept in mind when addressing all patients with progressive myelopathy. Content Type Journal ArticleCategory Clinical ArticlePages 1-8DOI 10.1007/s00701-011-1265-1Authors Francesco Prada, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalyAndrea Saladino, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalySergio Giombini, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133 Milan, ItalyAlessandra Erbetta, Department of Neuroradiology, F...

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

International Journal of Radiation Oncology * Biology * Physics — Mon, 30 Jan 2012 09:33:54 +0100

Conclusions: A low single-dose of β-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. (Source: International Journal of Radiation Oncology * Biology * Physics)

Two‐dimensional speckle tracking echocardiography of acute cardiac transplant rejection following pregnancy

Journal of Clinical Ultrasound — Mon, 30 Jan 2012 09:24:16 +0100

AbstractA 44‐year‐old woman, who had undergone orthotopic cardiac transplantation in 1999, presented acute allograft rejection 4 months after childbirth. Analysis of myocardial deformation by speckle tracking echocardiography showed, in contrast with traditional markers of systolic function, a strong reduction of left ventricular strain, which recovered, together with rejection, under pharmacological treatment. This case documents the potential advantages of speckle tracking echocardiography in the noninvasive management of transplant recipients. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012 (Source: Journal of Clinical Ultrasound)

The impact of hepatitis C virus donor and recipient status on long‐term kidney transplant outcomes: University of Wisconsin experience

Clinical Transplantation — Sun, 29 Jan 2012 05:00:00 +0100

Singh N, Neidlinger N, Djamali A, Leverson G, Voss B, Sollinger HW, Pirsch JD. The impact of hepatitis C virus donor and recipient status on long‐term kidney transplant outcomes: University of Wisconsin experience.  Clin Transplant 2012 DOI: 10.1111/j.1399‐0012.2011.01583.x.  © 2012 John Wiley & Sons A/S.Abstract: The survival benefit of transplanting hepatitis C (HCV)‐positive donor kidneys into HCV‐positive recipients remains uncertain. The purpose of this study was to assess the effect of HCV‐status of the donor (D) kidney on the long‐term outcomes in kidney transplant recipients (R). We evaluated 2169 consecutive recipients of deceased‐donor kidney transplants performed between 1991 and 2007. The following HCV cohorts were identified: D−/R− (n = 1897),...

The PROMISE Study: A Phase 2b Multicenter Study of Voclosporin (ISA247) Versus Tacrolimus in De Novo Kidney Transplantation

Nephrology Now — Sat, 28 Jan 2012 08:25:59 +0100

Voclosporin is a new calcineurin inhibitor being assessed for transplantation. In this dose-ranging non-inferiority trial, three therapeutic levels of voclosporin were compared to tacrolimus in new renal transplant recipients. The incidence of acute rejection was similar in all voclosporin groups compared to tacrolimus. The incidence of diabetes increased in the higher-dose voclosporin group. Further studies will be needed to show whether voclosporin is an improvement over tacrolimus. : Reduced Exposure to Calcineurin Inhibitors in Renal Transplantation Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial The ORION Study: Comparison of Two Sirolimus-Based Regimens versus Tacrolimus and Mycophenolate Mofetil in Rena...

Impact of Early Conversion From Tacrolimus to Sirolimus on Chronic Allograft Changes in Kidney Recipients on Rapid Steroid Withdrawal

Nephrology Now — Sat, 28 Jan 2012 08:21:27 +0100

This randomized controlled trial assessed the effect of conversion from tacrolimus to sirolimus at one month post-transplant. In comparison to other such trials of early conversion to an mTOR inhibitor, this trial was notable for including protocol biopsies. Conversion to sirolimus did not affect the frequency of chronic changes seen on biopsy at one year post-transplant. : The ORION Study: Comparison of Two Sirolimus-Based Regimens versus Tacrolimus and Mycophenolate Mofetil in Renal Allograft Recipients Subclinical Rejection in Stable Positive Crossmatch Kidney Transplant Patients: Incidence and Correlations Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial (Source: Nephrology Now)

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Development of organ‐specific donor risk indices

Liver Transplantation — Sat, 28 Jan 2012 05:00:00 +0100

AbstractDue to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ‐specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C‐positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease...

Rehabilitation following osteochondral injury to the knee

Current Reviews in Musculoskeletal Medicine — Fri, 27 Jan 2012 17:54:53 +0100

Abstract Articular cartilage injuries of the knee can be debilitating if not treated properly. Once an articular cartilage injury is sustained there are a variety of surgical interventions depending on the severity of the injury. The most common of these procedures are: osteochondral autograft transplantation (OATS), autologous chondrocyte implantation (ACI) and microfracture. The rehabilitation outlined in this article is specific to the exact surgical procedure performed and the location in the knee. The outcomes of these procedures are also discussed. Content Type Journal ArticleCategory Knee Rehabilitation (J Cavanaugh, Section Editor)Pages 1-10DOI 10.1007/s12178-011-9108-5Authors Timothy F. Tyler, Nicholas Institute for Sports Medicine and Athletic Trauma (NISMAT...

Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions

Knee Surgery, Sports Traumatology, Arthroscopy — Fri, 27 Jan 2012 17:53:00 +0100

Conclusions This work corroborates that mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint is effective to treat osteochondral defects in the knee joint. No relevant complications related to donor zone were registered. Level of evidence Case series, Level IV. Content Type Journal ArticleCategory KneePages 1-7DOI 10.1007/s00167-012-1910-0Authors João Espregueira-Mendes, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Porto, PortugalHélder Pereira, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Porto, PortugalNuno Sevivas, Saúde Atlântica Sports Center–F.C. Porto Stadium, Minho University and Porto University, Po...

Immune response to an adjuvanted influenza A H1N1 vaccine (Pandemrix(R)) in renal transplant recipients

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. These data suggest that Pandemrix® does not provide a protective immune response in the majority of kidney transplant recipients. Therefore, for new vaccines, efficacy as well as safety profiles should be evaluated in this subgroup of patients. (Source: Nephrology Dialysis Transplantation)

Impact of CMV infection on acute rejection and long-term renal allograft function: a systematic analysis in patients with protocol biopsies and indicated biopsies

Nephrology Dialysis Transplantation — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. Our data suggests that the link between CMV and AR is far less significant than previously thought. Outcome in patients with CMV may be more determined by coexisting conditions like high donor age and delayed graft function. (Source: Nephrology Dialysis Transplantation)

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Proteasome inhibitors: an expanding army attacking a unique target.

Chemistry and Biology — Fri, 27 Jan 2012 05:00:00 +0100

Authors: Kisselev AF, van der Linden WA, Overkleeft HS Abstract Proteasomes are large, multisubunit proteolytic complexes presenting multiple targets for therapeutic intervention. The 26S proteasome consists of a 20S proteolytic core and one or two 19S regulatory particles. The 20S core contains three types of active sites. Many structurally diverse inhibitors of these active sites, both natural product and synthetic, have been discovered in the last two decades. One, bortezomib, is used clinically for treatment of multiple myeloma, mantle cell lymphoma, and acute allograft rejection. Five more recently developed proteasome inhibitors are in trials for treatment of myeloma and other cancers. Proteasome inhibitors also have activity in animal models of autoimmune and inflammatory di...

Silent Ischemia: Clinical Relevance

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:10 +0100

Myocardial ischemia can occur without overt symptoms. In fact, asymptomatic (or silent) ST-segment depression during ambulatory electrocardiogram monitoring occurs more often than symptomatic ST-segment depression in patients with coronary artery disease. Initial studies documented that silent ischemia provided independent prediction of adverse outcomes in patients with known and unknown coronary artery disease. The ACIP (Asymptomatic Cardiac Ischemia Pilot Study) enrolled patients in the 1990s and found that revascularization was better than medical therapy in reducing silent ischemic episodes and possibly cardiovascular (CV) events. However, the more recent COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial found similar CV event rates between pa...

Sinus augmentation using rhBMP‐2/ACS in a mini‐pig model: relative efficacy of autogenous fresh particulate iliac bone grafts

Clinical Oral Implants Research — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionrhBMP‐2/ACS induces bone of superior quality compared with an iliac crest particulate autogenous cancellous bone graft when used for maxillary sinus augmentation, and should perhaps be considered the new standard for this indication. (Source: Clinical Oral Implants Research)

Effects of nicotine on guided bone augmentation in rat calvarium

Clinical Oral Implants Research — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionNicotine jeopardized, but did not prevent, the process of guided bone augmentation in a rat model. (Source: Clinical Oral Implants Research)

Black‐blood steady‐state free precession (SSFP) coronary wall MRI for cardiac allografts: A feasibility study

Journal of Magnetic Resonance Imaging — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion:Black‐blood SSFP coronary wall MRI provides higher image quality, SNR, and CNR than traditional TSE does in HTx recipients. It has the potential to become an alternative means to noninvasive imaging of cardiac allografts. J. Magn. Reson. Imaging 2012;. © 2012 Wiley Periodicals, Inc. (Source: Journal of Magnetic Resonance Imaging)

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[DC-F technique cartilage graft for nasal saddle correction.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Thu, 26 Jan 2012 05:00:00 +0100

We describe the technical procedure used to correct severe nasal saddles with stable results. DISCUSSION: Diced cartilage grafts wrapped in temporal fascia is an interesting alternative in rhinoplasty with dorsal augmentation: this composite graft is malleable and can be used whatever the quality of the recipient site. It remains malleable postoperatively. PMID: 22284847 [PubMed - as supplied by publisher] (Source: Revue de Stomatologie et de Chirurgie Maxillo-Faciale)

Ten-Year Outcome after Rapid Discontinuation of Prednisone in Adult Primary Kidney Transplantation.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsPrednisone-related side effects can be minimized in a protocol incorporating rapid discontinuation of prednisone for maintenance immunosuppression. Ten-year patient and graft outcomes remain acceptable. PMID: 22282482 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Long-Term Kidney Allograft Function and Survival in Prednisone-Free Regimens: Tacrolimus/Mycophenolate Mofetil versus Tacrolimus/Sirolimus.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 26 Jan 2012 05:00:00 +0100

ConclusionsThis study shows that, in a prednisone-free immunosuppressive regimen, long-term renal graft survival and function are significantly worse in the tacrolimus/sirolimus group than the tacrolimus/mycophenolate mofetil group. The synergistic nephrotoxic effect and higher acute rejection rates in the tacrolimus/sirolimus compared with the tacrolimus/mycophenolate mofetil group adversely affect graft survival. PMID: 22282478 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Therapeutic Plasma Exchange for Renal‐Related Conditions in the Elderly: Ten Years Experience in One Center

Seminars In Dialysis — Wed, 25 Jan 2012 05:00:00 +0100

AbstractThe elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal indications at our institution between January 1, 2000 and June 30, 2010 and compared renal indications and mortality associated with the use of TPE in older versus younger patients. During this period, 621 patients underwent 4722 sessions of TPE. Of them, 191 patients were elderly (30.7%) and they underwent 1289 sessions (27.3%) of TPE. A total of 104 patients (16.7%) underwent 593 sessions of TPE because of renal‐related indications: 26 patients in the elderly gro...

[Reconstruction of the lateral ankle ligaments with hamstring tendon autograft in patients with chronic ankle instability.]

Operative Orthopadie und Traumatologie — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Richter J, Volz R, Immendörfer M, Schulz M Abstract OBJECTIVE: Reconstruction of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligament in patients with chronic lateral ankle instability. INDICATIONS: Symptomatic chronic lateral ankle instability. CONTRAINDICATIONS: Bony malalignment, advanced arthritic changes of the ankle joint, diabetic foot syndrome. SURGICAL TECHNIQUE: Reconstruction of the ATFL and CFL with a free gracilisor or semitendinosus tendon graft through a V-shaped tunnel at the insertion site of the ATFL on the talar neck as well as a transfibular tunnel directed anterior to posterior through the fibula tip to a blind ending tunnel in the cal...

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Therapeutic Plasma Exchange for Renal-Related Conditions in the Elderly: Ten Years Experience in One Center.

Seminars in Dialysis — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Hayes JS, Balogun RA, Chang J, Abdel Rahman EM Abstract The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal indications at our institution between January 1, 2000 and June 30, 2010 and compared renal indications and mortality associated with the use of TPE in older versus younger patients. During this period, 621 patients underwent 4722 sessions of TPE. Of them, 191 patients were elderly (30.7%) and they underwent 1289 sessions (27.3%) of TPE. A total of 104 patients (16.7%) underwent 593 sessions of TPE becau...

Allograft Anterior Cruciate Ligament Reconstruction: Indications, Techniques, and Outcomes.

Physical Therapy — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Vyas D, Rabuck SJ, Harner CD Abstract Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-...

Suppression of bronchiolitis obliterans in allogeneic rat lung transplantation-Effectiveness of everolimus.

Experimental and Toxicologic Pathology — Wed, 25 Jan 2012 05:00:00 +0100

CONCLUSION: The effectiveness of everolimus after rat LTX depended on the grade of inflammation of the allograft before initiation of drug treatment. Only allografts with no or low grade AR benefit from long-term treatment with everolilmus in the prevention of BO after LTX. It could be speculated that conversion to an everolimus-based immunosuppression after LTX might only be successful in patients free of BO. PMID: 22284335 [PubMed - as supplied by publisher] (Source: Experimental and Toxicologic Pathology)

Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial

Knee Surgery, Sports Traumatology, Arthroscopy — Tue, 24 Jan 2012 12:26:04 +0100

Conclusions The kinematic tests in this study found evidence suggesting that the DB ACL reconstruction improved rotatory laxity better than the SB ACL reconstruction at 30° and 60° of flexion, but there was no difference in functional outcome at 2 years follow-up between SB and DB groups. Level of evidence Prospective comparative study, Level II. Content Type Journal ArticleCategory KneePages 1-10DOI 10.1007/s00167-012-1880-2Authors Sahnghoon Lee, Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110744 KoreaHyoungmin Kim, Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110744 KoreaJak Jang, Department of Orthop...

A Between Sex Comparison of Anterior-Posterior Knee Laxity after Anterior Cruciate Ligament Reconstruction with Patellar Tendon or Hamstrings Autograft: A Systematic Review

Sports Medicine — Tue, 24 Jan 2012 10:49:37 +0100

(Source: Sports Medicine)

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Mesenchymal stem cells differentially mediate regulatory T cells and conventional effector T cells to protect fully allogeneic islet grafts in mice

Diabetologia — Tue, 24 Jan 2012 07:29:35 +0100

Conclusions/interpretation We demonstrate that MSCs are capable of regulating Teff and Treg cells differentially in vitro. MSCs inhibit Teff cells by inducing apoptosis and impairing the proliferative response to IL-2 in Teff cells, but favour the survival and expansion of Treg cells. This result is further demonstrated in mice that have undergone allogeneic islet transplantation, in which MSCs suppress alloreactive Teff cells while favouring the induction of Treg cells, thus protecting the islet allografts from rejection. Content Type Journal ArticleCategory ArticlePages 1-12DOI 10.1007/s00125-011-2433-9Authors D. M. Xu, Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republi...

Repair of critical long bone defects using frozen bone allografts coated with an rhBMP-2-retaining paste

Journal of Orthopaedic Science — Tue, 24 Jan 2012 07:21:07 +0100

Conclusions This experimental study suggest that allogeneic bone grafting in combination with rhBMP-2 and its local delivery system may represent an innovative approach to the reconstruction of bone defects. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00776-012-0196-xAuthors Hiroyuki Yasuda, Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585 JapanKoichi Yano, Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585 JapanShigeyuki Wakitani, Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585 JapanTomiya Matsumot...

Improved Survival but Marginal Allograft Function in Patients Treated With Extracorporeal Membrane Oxygenation After Lung Transplantation [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Advances in ECMO technology, particularly VV ECMO, have greatly improved the ability to support patients with severe PGD after lung transplantation. VV ECMO is an important tool in the armamentarium of any lung transplant program to optimize patient outcomes; however, strategies to improve lung allograft function in patients experiencing severe PGD are still needed. (Source: The Annals of Thoracic Surgery)

Long-Term Results of 203 Young and Middle-Aged Patients With More Than 10 Years of Follow-Up After the Original Subcoronary Ross Operation [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Long-term results of the original subcoronary Ross operation reveal normal survival, excellent hemodynamics, low risk of thromboembolism or bleeding, and small risk for reoperation. These results favor the pulmonary autograft concept in young and middle-aged patients in experienced centers and may serve to better define its role in surgical treatment of aortic valve disease in these patients. (Source: The Annals of Thoracic Surgery)

Reoperation After the Ross Procedure: Incidence, Management, and Survival [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Autograft dilatation was the leading cause of reoperation in patients who underwent root replacement. Long-term follow-up is mandatory to determine whether modifications of the operative technique could limit autograft dilatation. (Source: The Annals of Thoracic Surgery)

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Evolution of Mitral Valve Replacement in Children: A 40-Year Experience [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Pediatric MVR can be performed with low initial mortality but should be reserved for medical and reconstruction failure because reoperation, valve-related complications, and late mortality are high. Bileaflet prostheses larger than 23 mm have the lowest reoperation risk. Ross MVR may offer select patients a durable tissue valve without lifelong anticoagulation and its associated complications. (Source: The Annals of Thoracic Surgery)

Similar Survival but Better Function for Patients after Limb Salvage versus Amputation for Distal Tibia Osteosarcoma.

Clinical Orthopaedics and Related Research — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSION: Patients treated with either limb salvage or amputation experience similar survival, local recurrence, and complications, but better function is achievable for patients treated with limb salvage versus amputation. Local recurrence and complications are more common in patients with limb salvage. LEVEL OF EVIDENCE: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence. PMID: 22270466 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Composite Tissue Allograft

Journal of Reconstructive Microsurgery — Tue, 24 Jan 2012 05:00:00 +0100

J reconstr Microsurg 2012; 28: 01-02DOI: 10.1055/s-0031-1300807Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents | Full text (Source: Journal of Reconstructive Microsurgery)

Autogenous Bone Graft: Is this still Justified?

Dental Implants Discussed by Experts — Sun, 22 Jan 2012 21:10:23 +0100

With all these other graft materials available, and their proven efficacy, is there still justification for creating a second surgical site to harvest an autogenous graft? (Source: Dental Implants Discussed by Experts)

Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction

Knee Surgery, Sports Traumatology, Arthroscopy — Thu, 19 Jan 2012 06:55:58 +0100

Conclusion Our study did not detect any difference in rotational laxity and proprioception between the reconstructed and the healthy knee. Therefore, partial ACL reconstruction appears to restore satisfactory knee laxity and function in case of partial ACL tear. Level of evidence IV. Content Type Journal ArticleCategory KneePages 1-5DOI 10.1007/s00167-012-1879-8Authors J. Chouteau, Service de chirurgie orthopédique, de traumatologie et de médecine du sport, Centre Hospitalier Lyon-Sud, Chemin du Grand Revoyet, 69495 Pierre Bénite, Cedex, FranceR. Testa, Service de chirurgie orthopédique, de traumatologie et de médecine du sport, Centre Hospitalier Lyon-Sud, Chemin du Grand Revoyet, 69495 Pierre Bénite, Cedex, FranceA. Viste, Service de chirur...

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Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

Aesthetic Plastic Surgery — Thu, 19 Jan 2012 06:44:33 +0100

Conclusion The results of this experimental study showed that acellular dermis (AlloDerm®) or solvent-dehydrated pericardium (Tutogen) may be used successfully as an “onlay” graft for dorsal nasal problems compared to autogenous cartilage, which is commonly used for this purpose. There has been more cartilage resorption than thought. This should be considered when overcorrection is performed. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00266-011-9...

CD27 costimulation augments the survival and antitumor activity of redirected human T cells in vivo

Blood — Thu, 19 Jan 2012 05:00:00 +0100

The costimulatory effects of CD27 on T lymphocyte effector function and memory formation has been confined to evaluations in mouse models, in vitro human cell culture systems, and clinical observations. Here, we tested whether CD27 costimulation actively enhances human T-cell function, expansion, and survival in vitro and in vivo. Human T cells transduced to express an antigen-specific chimeric antigen receptor (CAR-T) containing an intracellular CD3 zeta (CD3) chain signaling module with the CD27 costimulatory motif in tandem exerted increased antigen-stimulated effector functions in vitro, including cytokine secretion and cytotoxicity, compared with CAR-T with CD3 alone. After antigen stimulation in vitro, CD27-bearing CAR-T cells also proliferated, up-regulated Bcl-XL protein expression...

Perfusion MRI for Monitoring the Effect of Sorafenib on Experimental Prostate Carcinoma: A Validation Study

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Tumor perfusion quantified with gadobutrol-enhanced dynamic contrast-enhanced MRI can be used as a noninvasive surrogate parameter for monitoring the antiangiogenic, antiproliferative, and proapoptotic effects of sorafenib on prostate carcinoma allografts as validated with immunohistochemical analysis. (Source: American Journal of Roentgenology)

The Impact of the Activated Stroma on Pancreatic Ductal Adenocarcinoma Biology and Therapy Resistance.

Current Molecular Medicine — Thu, 19 Jan 2012 05:00:00 +0100

Authors: Erkan M, Reiser-Erkan C, Michalski CW, Kong B, Esposito I, Friess H, Kleeff J Abstract Around 95% of patients diagnosed with pancreatic cancer will die of their disease within 5 years, three quarters within a year. The major hurdle in improving prognosis is the lack of a therapeutic time window. Early cancerous lesions are far beneath our threshold of detection. Therefore, at the time of diagnosis even early (T1) tumors can be metastatic and resistant to conventional treatments. Several therapies targeting epithelial tumor cells-all showing impressive results in vitro and in animal experiments-have failed to show relevant effects in clinical trials. This discrepancy between experimental data and clinical reality results mostly from the inefficiency of our current experimen...

Complement fixing donor‐specific antibodies and allograft loss

Pediatric Transplantation — Thu, 19 Jan 2012 00:59:07 +0100

(Source: Pediatric Transplantation)

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Infiltrating cellular pattern in kidney graft biopsies translates into forkhead box protein 3 up-regulation and p16(INK) (4α) senescence protein down-regulation in patients treated with belatacept compared to cyclosporin A.

Clinical and Developmental Immunology — Wed, 18 Jan 2012 21:36:48 +0100

This study was conducted to document the proportion of CD4(+) /interleukin (IL)-17A(+) -, CD16(+) /indoleamine 2, 3-dioxygenase (IDO(+) )-, forkhead box protein P3 (FoxP3(+) )-expressing cells, senescent cells (p16(INK) (4α) ) and the percentage of interstitial fibrosis (IF) in graft biopsies of kidney transplant recipients participating in the BENEFIT (Bristol-Myers Squibb IM103008) study. CD4(+) /IL-17A(+) , CD16(+) /IDO(+) , FoxP3(+) and p16(INK) (4α+) cells were evaluated by immunohistochemistry, and the percentage of IF by morphometry on graft biopsies obtained at time 0 (pre-implantation) and at 12 months post-transplant. Senescent cells and CD4(+) /IL-17A(+) cells were increased among graft biopsies in subjects receiving cyclosporin A (CsA) compared to those under bela...

Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Graft: Comparison of Autograft, Fresh-Frozen Allograft, and γ-Irradiated Allograft

Arthroscopy — Wed, 18 Jan 2012 12:06:12 +0100

Conclusions: The study showed a statistically poorer KT-1000 result and higher failure rate in the γ-irradiated allograft group compared with the autograft and fresh-frozen allograft groups. This may suggest that γ-irradiated allograft is not a good candidate graft for ACL reconstruction. Power analysis showed that the study was underpowered, so further research and longer follow-up study are needed to make this point clearer. Level of Evidence: Level III, retrospective comparative study. (Source: Arthroscopy)

Evaluation of coronary allograft vasculopathy using multi-detector row computed tomography: a systematic review [TX [amp ] MCS]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

This article systematically reviews the literature to determine the accuracy of MDCT in CAV assessment. An English-language literature search was performed using EMBASE, OVID, PubMed, and Cochrane Library databases. Studies that directly compared MDCT with CCA and/or IVUS for the detection of coronary artery stenosis or significant intimal thickening in cardiac transplant patients were analyzed. Data were pooled to obtain weighted sensitivities, specificities, and diagnostic accuracies. Negative and positive predictive values (NPV/PPV) were calculated. A total of seven studies with a sum of 272 patients were included in this review. There were three studies examining 16-slice MDCTand four studies looking at 64-slice MDCT in CAV. Using per-segment analysis, MDCTassessed between 91% and 96% ...

Pushing the envelope: living donor pancreas transplantation.

Current Opinion in Organ Transplantation — Tue, 17 Jan 2012 15:06:32 +0100

Pushing the envelope: living donor pancreas transplantation. Curr Opin Organ Transplant. 2012 Feb;17(1):106-15 Authors: Sutherland DE, Radosevich D, Gruessner R, Gruessner A, Kandaswamy R Abstract PURPOSE OF REVIEW: More than 160 living donor segmental pancreas/islet transplants have been done since the first in 1977, more than three-quarters at one institution. We review this three-decade experience to project future application. Initially, living donor pancreas transplants were done because the results with deceased donors were poor. As the results with deceased donors improved, the incentive to do living donor transplants declined but never disappeared. A living donor simultaneous pancreas-kidney transplant in a uremic diabetic can correct diabetes and pre-empt dialysis ...

Toxoplasmosis after allogeneic stem cell transplantation—a single centre experience

Annals of Hematology — Tue, 17 Jan 2012 07:12:45 +0100

In conclusion, we suggest a rigorous real-time PCR monitoring for high-risk patients or patients with signs of infections suspicious for toxoplasmosis, even though low-copy results are presently difficult to interpret. Our reported cases might also encourage the use of trimethoprim–sufmethoxazole instead of pentamidine for PcP prophylaxis in those patients. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00277-012-1406-5Authors Christoph Busemann, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanySilvia Ribback, Institute for Pathology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, Germ...

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Complete Immunosuppression Withdrawal and Subsequent Allograft Function Among Pediatric Recipients of Parental Living Donor Liver Transplants [Preliminary Communication]

JAMA — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion In this pilot study, 60% of pediatric recipients of parental living donor liver transplants remained off immunosuppression therapy for at least 1 year with normal graft function and stable allograft histology. (Source: JAMA)

Association studies of Toll‐like receptor gene polymorphisms with allograft survival in renal transplant recipients of North India

Clinical Transplantation — Tue, 17 Jan 2012 05:00:00 +0100

Srivastava P, Singh A, Kesarwani P, Jaiswal PK, Singh V, Mittal RD. Association studies of Toll‐like receptor gene polymorphisms with allograft survival in renal transplant recipients of North India. Clin Transplant 2012 DOI: 10.1111/j.1399‐0012.2011.01577.x. © 2012 John Wiley & Sons A/S.Abstract: Organ transplantation itself inevitably activates the innate immune system by Toll‐like receptors (TLRs), potentially leading to allograft rejection and graft failure. We evaluated the possible association of TLR2, TLR3, and TLR9 polymorphisms of donor‐recipient pairs and acute rejection in renal transplant patients of North India. TLR2 (−196 to −174 del), TLR3 (c.1377C/T; rs 3775290), and TLR9 (+2848 G/A; rs 352140) were genotyped using DNA samples from 200 donor‐recipien...

Can we predict allograft tolerance in experimental animal models of transplantation?

Liver Transplantation — Tue, 17 Jan 2012 05:00:00 +0100

(Source: Liver Transplantation)

[Mastoid bone graft in implantology. A case report.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Tue, 17 Jan 2012 05:00:00 +0100

DISCUSSION: Mastoid cortical bone is a source of bone usable in oral implantology. Its use has been proved to be reliable in oto-surgery. Mastoid bone harvesting implies the presence of ENT surgeon; it is nevertheless interesting to know this site from a biological point of view and because of its functional and economical aspects. PMID: 22261153 [PubMed - as supplied by publisher] (Source: Revue de Stomatologie et de Chirurgie Maxillo-Faciale)

Cytomegalovirus associated corneal endotheliitis after penetrating keratoplasty in a patient with Fuchs corneal endothelial dystrophy

British Journal of Ophthalmology — Mon, 16 Jan 2012 05:00:00 +0100

Corneal endotheliitis, a specific inflammation targeted primarily to the corneal endothelium, is characterised by cornea oedema, keratic precipitates (KPs) and a mild anterior chamber reaction.1–3 Several viruses, including herpes simplex virus (HSV), varicella zoster virus (VZV), mumps and cytomegatovirus (CMV), have been implicated in the aetiology of the disease.1–3 Based on its definition, allograft endothelial rejection after keratoplasty can be included in the corneal endotheliitis. Here, we report a patient with corneal endotheliitis occurring after penetrating keratoplasty for Fuchs corneal endothelial dystrophy. Case report A 65-year-old Taiwanese female without previous ocular illness but arrhythmias and mitral valve prolapse history presented with progressive corneal...

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Renal allograft loss in the first post‐operative month: causes and consequences

Clinical Transplantation — Mon, 16 Jan 2012 05:00:00 +0100

In conclusion, early renal allograft failure is associated with a survival disadvantage, but has thankfully become less common in recent years. (Source: Clinical Transplantation)

Tolerance Towards a Mismatched Vascularized Composite Allograft in a Large Animal Model Using Either Bone Marrow or G-CSF Mobilized Stem Cells to Induce Mixed Chimerism

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Therapeutic Drug Monitoring of Everolimus Reduces Early Post-Transplant Proteinuria- a Prognostic Factor for Long Term Glomerular Filtration Rate (Gfr) and Kidney Allograft Survival

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Near-Infrared Imaging for Intra-operative Assessment of Perfusion in Vascularized Bone Flaps

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:48 +0100

Conclusions: Currently there are no established techniques to effectively monitor the viability of vascularized bone grafts. in our initial pilot study, results suggest that NIR fluorescence has the capability to assess perfusion and viability of bone. This emergent technology shows promise in the ability to assess tissue and bone perfusion during the elevation and harvest of vascularized bone in addition to monitor perfusion after microsurgical anastamosis. NIR fluorescence imaging proves to be highly valuable in reconstruction of large bone defects. (Source: Journal of Surgical Research)

Assessment of Perfusion in a Partial Face Transplanation Model With a Near-Infrared Imaging System

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:48 +0100

Conclusions: The ability to evaluate and assess perfusion and viability of composite tissue is highly valuable in facial transplantation. in our initial pilot study, our results suggest that NIR fluorescence has the capability to assess perfusion and viability of partial facial CTAs. This emergent technology shows promise in the ability to assess tissue perfusion during the elevation and harvest of a composite flap in addition to monitor perfusion after microsurgical anastamosis. NIR fluorescence imaging proves to be highly valuable in monitoring the viability of transplanted microsurgical grafts to decrease the failure rate of composite tissue flaps. (Source: Journal of Surgical Research)

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Donor Treatment With Inhaled Hydrogen Gas Induces Clara Cell Protein 16 and Mitigates Cold Ischemia/Reperfusion Injury in Rats

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:12 +0100

Conclusions: Ventilation of lung donors with hydrogen significantly ameliorated lung cold I/R injury and was accompanied by increased expression of CC16 in the lung grafts. Our results showed that CC16 may be involved in the cytoprotection afforded by hydrogen and may define a novel mechanism underlying the protective effects of inhaled hydrogen. (Source: Journal of Surgical Research)

Transplanting Whole Livers from Donors Less Than 6 Kilograms -- is it Prudent?

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:08 +0100

Introduction: Our experience suggests transplanting whole liver allografts (WL) from donors weighing (Source: Journal of Surgical Research)

Inhibition of Cold Ischemia and Reperfusion Injury Mediated by Matrix Metalloproteinases (MMPs) by NFkB Inhibitor PS-341

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:00 +0100

Conclusions: PS-341 effectively inhibits MMP-9 and MMP-2 expression along with pro-inflammatory cytokines at 2-hours following the reperfusion of steatotic allografts in an OLT model in Zucker rats. Therefore, proteosome inhibition using PS-341 may represent a novel therapeutic strategy to improve early post-transplant allograft dysfunction due to steatosis. (Source: Journal of Surgical Research)

5-Fluorouracil versus mitomycin C as adjuncts to conjunctival autograft in preventing pterygium recurrence

International Ophthalmology — Sat, 14 Jan 2012 16:41:27 +0100

Abstract To compare the efficacy of 5-fluorouracil (5-FU) with mitomycin C (MMC) in preventing pterygium recurrence when used as an adjuvant following pterygium excision with conjunctival autograft. Low-dose MMC combined with conjunctival autograft is an effective treatment for preventing recurrence following pterygium excision, but safety, cost, and availability limit its use in developing countries. There is a paucity of data on the efficacy of 5-FU when used in Africa as an adjuvant to conjunctival autograft following pterygium excision. This is a randomized controlled prospective trial using either 50 mg/ml 5-FU or 0.01% MMC. Eighty eyes of 80 subjects were studied. Forty-six subjects with a mean age 49.8 ± 13.8 years were treated with 5-FU (USD 13...

Anterior Reconstruction With Nano-hydroxyapatite/polyamide-66 Cage After Thoracic and Lumbar Corpectomy.

Orthopedics — Sat, 14 Jan 2012 15:24:05 +0100

Authors: Yang X, Song Y, Liu L, Liu H, Zeng J, Pei F Abstract Cages are used to regain stability of the anterior spinal column following vertebrectomy, which could prevent significant donor-site morbidity from the iliac autograft harvesting and the risk of disease transmission associated with the allograft. The hollow, porous, cylindrical nanohydroxyapatite/polyamide 66 (n-HA/PA66) cage is a new nonmetallic cage device made by combining nanohydroxyapatite with polyamide 66. Few studies have examined its effectiveness and outcomes over a follow-up >2 years.We retrospectively studied 51 consecutive patients with acute traumatic thoracic or lumbar burst fracture who underwent anterior reconstruction with the n-HA/PA66 cage following single-level corpectomy. Radiologic parameters (r...

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Epithelioid hemangioma of the distal humerus with pathologic fracture.

Orthopedics — Sat, 14 Jan 2012 15:24:05 +0100

This article describes a case of epithelioid hemangioma involving the distal humerus, which initially presented with progressive pain and fracture of the lateral condyle. The aggressive appearance on plain radiographs and MRI suggested a malignant bone tumor. This preliminary diagnosis was confirmed due to the presence of local lymph node spread on positron emission tomography/computed tomography. After a core needle biopsy revealed nondiagnostic tissue, rather than performing a wide resection based on a presumptive malignant diagnosis, we followed the standard diagnostic algorithm and performed an open biopsy with temporary internal stabilization. The tissue sample was adequate and revealed a diagnosis of epithelioid hemangioma. Based on this finding, we were able to proceed with surgical...

Nano-scale encapsulation enhances allograft survival and function of islets transplanted in a mouse model of diabetes

Diabetologia — Sat, 14 Jan 2012 06:54:48 +0100

Conclusions/interpretation Nano-scale encapsulation offers localised immune protection for implanted islets, and may be able to limit early allograft loss and extend survival of transplanted islets. This versatile coating scheme has the potential to be integrated with tolerance induction mechanisms, thereby achieving long-term success in islet transplantation. Content Type Journal ArticleCategory ArticlePages 1-10DOI 10.1007/s00125-011-2431-yAuthors Z.-l. Zhi, Diabetes Research Group, King’s College London School of Medicine, Guy’s Hospital Campus, London, SE1 1UL UKA. Kerby, Diabetes Research Group, King’s College London School of Medicine, Guy’s Hospital Campus, London, SE1 1UL UKA. J. F. King, Diabetes Research Group, King’s College London School of Med...

Safe zone for bone harvesting from the interforaminal region of the mandible

Clinical Oral Implants Research — Fri, 13 Jan 2012 21:16:59 +0100

ConclusionsWhile acknowledging that there is human variability, this study provides an accurate anatomic location of the MIC, which in turn helps to determine a safe zone for chin bone graft harvesting. This information can become a useful guide in centers where CBCT is not available. (Source: Clinical Oral Implants Research)

Infiltrating cellular pattern in kidney graft biopsies translates into forkhead box protein 3 up‐regulation and p16INK4α senescence protein down‐regulation in patients treated with belatacept compared to cyclosporin A

Clinical and Experimental Immunology — Fri, 13 Jan 2012 11:17:47 +0100

This study was conducted to document the proportion of CD4+/interleukin (IL)‐17A+‐, CD16+/indoleamine 2, 3‐dioxygenase (IDO+)‐, forkhead box protein P3 (FoxP3+)‐expressing cells, senescent cells (p16INK4α) and the percentage of interstitial fibrosis (IF) in graft biopsies of kidney transplant recipients participating in the BENEFIT (Bristol‐Myers Squibb IM103008) study. CD4+/IL‐17A+, CD16+/IDO+, FoxP3+ and p16INK4α+ cells were evaluated by immunohistochemistry, and the percentage of IF by morphometry on graft biopsies obtained at time 0 (pre‐implantation) and at 12 months post‐transplant. Senescent cells and CD4+/IL‐17A+ cells were increased among graft biopsies in subjects receiving cyclosporin A (CsA) compared to those under belatacept treatment. Meanwhile, CD16+/ID...

Expression of GSK-3beta in Renal Allograft Tissue and Its Significance in Pathogenesis of Chronic Allograft Dysfunction

Diagnostic Pathology — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion: There might be a positive correlation between either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy and high GSK-3beta expression in renal allograft tissue.Virtual slides: The virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/9924478946162998 (Source: Diagnostic Pathology)

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Prolonged cold ischemia accelerates cellular and humoral chronic rejection in a rat model of kidney allotransplantation

Transplant International — Fri, 13 Jan 2012 05:00:00 +0100

SummaryOne of the leading causes of long‐term kidney graft loss is chronic allograft injury (CAI), a pathological process triggered by alloantigen‐dependent and alloantigen‐independent factors. Alloantigen‐independent factors, such as cold ischemia (CI) may amplify the recipient immune response against the graft. We investigated the impact of prolonged cold ischemia and the subsequent delayed graft function on CAI in a fully MHC‐mismatched rat model of kidney allotransplantation. Prolonged CI was associated with anticipation of proteinuria onset and graft function deterioration (ischemia: 90d; no ischemia: 150d), more severe tubular atrophy, interstitial fibrosis, and glomerulosclerosis, and increased mortality rate (180d survival, ischemia: 0%; no ischemia: 67%). In ischemic all...

Recent Developments on Coronary Microvasculopathy after Heart Transplantation: A New Target in the Therapy of Cardiac Allograft Vasculopathy.

Current Vascular Pharmacology — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Tona F, Marra MP, Fedrigo M, Famoso G, Bellu R, Thiene G, Gerosa G, Angelini A, Iliceto S Abstract Heart transplantation (HTx) is the treatment of choice for patients with refractory end-stage heart diseases. Although the procedure is considered effective in extending and improving quality of life, the onset of cardiac allograft vasculopathy (CAV) continues to limit the long-term success of HTx. Emerging data indicate that the endothelium plays a significant role in the onset, progression and complication of this multifactorial disease, with both immunologic and non-immunologic risk factors contributing to its development. Improving our understanding of the integral role of the coronary microcirculation in CAV is of crucial clinical interest since it could provide further ...

Post Transplant Lymphoproliferative Disorders: Risk, Classification, and Therapeutic Recommendations

Current Treatment Options in Oncology — Thu, 12 Jan 2012 16:47:55 +0100

Opinion statement Post transplant lymphoproliferative disorder (PTLD) is a heterogeneous disease that may occur in recipients of solid organ transplants (SOT) and hematopoietic stem cell transplant. The risk of lymphoma is increased 20–120% compared with the general population with risk dependent in part on level of immune suppression. In addition, recent data have emerged, including HLA and cytokine gene polymorphisms, regarding genetic susceptibility to PTLD. Based on morphologic, immunophenotypic, and molecular criteria, PLTD are classified into 4 pathologic categories: early lesions, polymorphic, monomorphic, and classical Hodgkin lymphoma. Evaluation by expert hematopathology is critical in establishing the diagnosis. The aim of therapy for most patients is cure wit...

Ossiculoplasty: Revisited

Indian Journal of Otolaryngology and Head and Neck Surgery — Thu, 12 Jan 2012 06:43:00 +0100

Abstract Conductive hearing loss from ossicular chain abnormalities may result from either discontinuity or fixation of the ossicular chain. The ideal prosthesis for ossicular reconstruction should be biocompatible, stable, safe, readily available, and capable of yielding optimal sound transmission. At present ossiculoplasty techniques using alloplast materials are becoming popular but the fate of these synthetic materials in human middle ear requires further study. Autologous ossicle or cortical bone grafts maintain their morphologic contour, size, shape, and physical integrity for long periods of time, over 25 years making them still the choice at present. The choice of technique will still depend on the causative pathology, availability of graft, surgical experienc...

Phenotypic and functional heterogeneity of human NK cells developing after umbilical cord blood transplantation: a role for human cytomegalovirus?

Blood — Thu, 12 Jan 2012 05:00:00 +0100

In this study, we analyzed the development of NK cells after intrabone umbilical cord blood (CB) transplantation in 18 adult patients with hematologic malignancies. Our data indicate that, also in this transplantation setting, NK cells are the first lymphoid population detectable in peripheral blood. However, different patterns of NK-cell development could be identified. Indeed, in a group of patients, a relevant fraction of NK cells expressed a mature phenotype characterized by the KIR+NKG2A– signature 3-6 months after transplantation. In other patients, most NK cells maintained an immature phenotype even after 12 months. A possible role for cytomegalovirus in the promotion of NK-cell development was suggested by the observation that a more rapid NK-cell maturation together with exp...

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Joint Use of a Chitosan/PLGA Scaffold and MSCs to Bridge an Extra Large Gap in Dog Sciatic Nerve

Neurorehabilitation and Neural Repair — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion. Introduction of autologous MSCs to a chitosan/PLGA scaffold improved the repair and rehabilitation of a large gap after peripheral nerve injury in dogs. Autologous MSCs may be a source of support cells for neural tissue engineering. (Source: Neurorehabilitation and Neural Repair)

Genetic Association of FOXP3 Gene Polymorphisms with Allograft Rejection in Renal Transplant Patients

Nephrology — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion: Our study suggests an association between FOXP3 rs3761548 polymorphisms and allograft rejection in renal transplantation. This association should be further proven in large prospective studies because of the small sample size and confounding factors in this retrospective study. (Source: Nephrology)

Blockade of the Nuclear Factor Kappa B Pathway Prolonged Islet Allograft Survival

Artificial Organs — Thu, 12 Jan 2012 05:00:00 +0100

In this study, the islets were divided into the control group, Ad‐green fluorescent protein, and the adenovirus transfected with inhibitor kappa B group. The proliferation index of peripheral blood mononuclear cells and the islets apoptosis index were examined after mixed lymphocyte‐islet reaction with inverted fluorescence microscopy. Moreover, mRNA expression of inflammatory cytokines was measured by reverse transcription polymerase chain reaction. The islet graft survival time in diabetic rats, insulin in grafts, and cytokine concentrations in the supernatant were determined by immunohistochemistry and enzyme‐linked immunosorbent assay. We found that blocking of NF‐κB activation in β‐cells significantly downregulated inflammatory chemokine production by islets cells in vitro...

Outcome after Renal Transplantation in 26 Dogs

Veterinary Surgery — Thu, 12 Jan 2012 05:00:00 +0100

ConclusionsCanine renal transplantation in clinical patients is associated with a high morbidity and mortality and increasing recipient age has a negative association with outcome. Thromboembolic complications are a major cause of death in the immediate postoperative period and effective anticoagulation protocols may greatly improve survival in the future. (Source: Veterinary Surgery)

[Kidney allograft: A target for systemic disease.]

Presse Medicale — Thu, 12 Jan 2012 05:00:00 +0100

Authors: Canaud G, Legendre C Abstract Recurrence of disease after transplantation is frequent and represents the third cause of allograft loss. Recurrence of lupus nephritis after transplantation is rare. Kidney transplantation in patients with antiphospholipid syndrome or lupus anticoagulant is challenging due to the high risk of immediate post-transplant thrombosis and bleeding risk associated to the subsequent anticoagulation. Moreover, vascular changes associated to the presence of antiphospholipid antibodies negatively impact allograft rate survival. Recurrence of pauci immune glomerulonephritis or Goodpasture syndrome is exceptional. PMID: 22244721 [PubMed - as supplied by publisher] (Source: Presse Medicale)

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Mechanical treatment and autoclaving of middle ear ossicles from cholesteatomatous ears

Central European Journal of Medicine — Wed, 11 Jan 2012 17:53:19 +0100

Conclusion Authors recommend using mechanical cleaning in cases of mildly eroded ossicles. In cases of badly eroded ossicles authors recommend to either apply a combination of mechanical and autoclaving treatment. The study proved that 4 minutes of autoclaving at 134°C after mechanical cleaning provides safe bone autografts. Content Type Journal ArticleCategory Research ArticlePages 1-4DOI 10.2478/s11536-011-0140-zAuthors Lukas Skoloudik, Department of Otorhinolaryngology, Charles University Faculty of Medicine and University Hospital, Hradec Kralove 1, 500 38 Prague, Czech RepublicJan Vokurka, Department of Otorhinolaryngology, Charles University Faculty of Medicine and University Hospital, Hradec Kralove 1, 500 38 Prague, Czech RepublicEva Simakova, Department of...

Systemic immunoregulatory and proteogenomic effects of tacrolimus to sirolimus conversion in liver transplant recipients

Hepatology — Wed, 11 Jan 2012 05:00:00 +0100

Conclusions:Tacrolimus to sirolimus conversion increases systemic Tregs, DCregs and immunoregulatory proteogenomic signatures in liver transplant recipients and may therefore facilitate immunosuppression minimization or withdrawal. (HEPATOLOGY 2012.) (Source: Hepatology)

Immunotoxicity of Tannery Effluent to the Freshwater Fish Cyprinous carpio.

Bulletin of Environmental Contamination and Toxicology — Wed, 11 Jan 2012 05:00:00 +0100

This study was undertaken to determine the effect of chronic exposure to sub-lethal concentrations of tannery effluent (TE) on the humoral antibody response and the cell-mediated immune response of the fish Cyprinous carpio. The LC(50) value of the TE for C. carpio was determined by bioassay to be 3.8%. Sub-lethal concentrations of TE (0.6% and 0.3%) significantly suppressed the humoral and cell-mediated immune responses. Exposure of C. carpio to the TE had a significant effect on mean acceptance time (MAT) for transplanted scales. MAT was found to be 5-8 days for autografts and 4-7 days for allografts. The somatic indices of the kidney and spleen were reduced compared with controls. PMID: 22234677 [PubMed - as supplied by publisher] (Source: Bulletin of Environmental Contamination a...

Abnormal accumulation of human transmembrane (TMEM)-176A and 176B proteins is associated with cancer pathology.

Acta Histochemica — Wed, 11 Jan 2012 05:00:00 +0100

Authors: Cuajungco MP, Podevin W, Valluri VK, Bui Q, Nguyen VH, Taylor K Abstract Transmembrane (TMEM)-176A and 176B proteins belong to the MS4A family of proteins whose function in the immune system remains unclear. TMEM176A transcripts were previously shown to be elevated in liver cancer or kidney tissue with proteinuria, while marked changes in TMEM176B transcripts have been found in tolerated tissue allografts and neoplastic fibroblasts. To study the functional relationship between human TMEM176A and 176B and their putative link to cancer, we used polymerase chain reaction and biochemical assays. Here, we show that TMEM176A and 176B are widely expressed in all human tissues examined. Co-immunoprecipitation of heterologously expressed TMEM176A and 176B revealed direct physical i...

A selective and potent CXCR3 antagonist SCH 546738 attenuates the development of autoimmune diseases and delays graft rejection

BMC Immunology — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions: SCH 546738 is a novel, potent and non-competitive small molecule CXCR3 antagonist. It is efficacious in multiple preclinical disease models. These results demonstrate that therapy with CXCR3 antagonists may serve as a new strategy for treatment of autoimmune diseases, including rheumatoid arthritis and multiple sclerosis, and to prevent transplant rejection. (Source: BMC Immunology)

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Pseudarthrosis of the surgical neck of humerus treated by buttressing with a medial cortico-cancellous graft

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: The medial buttressing by strut graft with external fixation by laterally placed fixed angle plate is successful to achieve fracture union in pseudarthrosis of surgical neck of humerus. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Recurrent Dense Deposit Disease After Renal Transplantation: An Emerging Role for Complementary Therapies

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

Dense deposit disease is a rare glomerulonephritis caused by uncontrolled stimulation of the alternative complement pathway. Allograft survival after kidney transplantation is significantly reduced by the high rate of disease recurrence. No therapeutic interventions have consistently improved outcomes for patients with primary or recurrent disease. This is the first reported case of recurrent dense deposit disease being managed with eculizumab. Within 4 weeks of renal transplantation, deteriorating graft function and increasing proteinuria were evident. A transplant biopsy confirmed the diagnosis of recurrent dense deposit disease. Eculizumab was considered after the failure of corticosteroid, rituximab and plasmapheresis to attenuate the rate of decline in allograft function. There was a ...

Sirolimus Conversion Regimen Versus Continued Calcineurin Inhibitors in Liver Allograft Recipients: A Randomized Trial

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

In conclusion, liver transplantation patients showed no demonstrable benefit 1 year after conversion from CNI‐ to SRL‐based immunosuppression. (Source: American Journal of Transplantation)

Long‐Term Pancreatic Allograft Survival After Renal Retransplantation in Prior Simultaneous Pancreas–Kidney Recipients

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

Over a 23‐year period, our center performed 82 renal retransplants in prior simultaneous pancreas–kidney recipients with functioning pancreatic allografts. All patients were insulin‐independent at retransplantation. We aimed to quantify the risk of returning to insulin therapy and to identify factors that predispose patients to pancreatic allograft failure after renal retransplantation. Among these 82 patients, pancreatic allograft survival after renal retransplantation was 78%, 49% and 40% at 1, 5 and 10 years. When analyzing risk factors, we unexpectedly found no clear relationship between the cause of primary renal allograft failure, hemoglobin A1c (HbA1c) or fasting C‐peptide level at retransplant and subsequent pancreatic allograft failure. An elevated HbA1c in the month after...

Development of Donor‐Specific Isohemagglutinins Following Pediatric ABO‐Incompatible Heart Transplantation

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

Graft acceptance following pediatric ABO‐incompatible heart transplantation has been associated with a deficiency of donor‐specific isohemagglutinins (DSI) due to B‐cell elimination. Recent observations suggest that some of these patients do produce DSI. The purpose of this study was to examine the pattern of, risk factors for development and clinical impact of DSI. All children who underwent an ABO‐incompatible heart transplant (1996–2009) were included. Serial postheart transplantation DSI titers and clinical outcomes were reviewed. DSI were produced in 27% of the patients (n = 11/41). Anti‐A production was significantly greater in “at risk” patients than Anti‐B (39% vs. 8%; p = 0.04). Risk factors associated with the development of DSI included: older age at transplant...

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The Pathology and Clinical Features of Early Recurrent Membranous Glomerulonephritis

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

We assessed the earliest manifestations of recurrent membranous glomerulonephritis (MGN) in renal allografts. Clinical, laboratory and pathologic data were reviewed in 21 patients at the initial biopsy within 4 months post‐transplant with evidence of MGN and on follow‐up biopsies, compared to a biopsy control group of eight transplants without recurrent MGN. The mean time of first biopsy with pathologic changes was 2.7 months. In each earliest biopsy, immunofluorescence (IF) showed granular glomerular basement membrane (GBM) staining for C4d, IgG, kappa and lambda. IF for C3 was negative or showed trace staining in 16/21. On each MGN biopsy positive by IF, 14/19 showed absence of deposits or rare tiny subepithelial deposits by electron microscopy (EM). At the earliest biopsy, the mean ...

Abnormal CX3CR1+ Lamina Propria Myeloid Cells from Intestinal Transplant Recipients with NOD2 Mutations

American Journal of Transplantation — Tue, 10 Jan 2012 05:00:00 +0100

Although progress has been made in intestinal transplantation, chronic inflammation remains a challenge. We have reported that the risk of immunological graft loss is almost 100‐fold greater in recipients who carry any of the prevalent NOD2 polymorphisms associated with Crohn's disease, and have shown that the normal levels of a key antimicrobial peptide produced by the Paneth cells of the allograft, fall as the graft becomes repopulated by hematopoietic cells of the NOD2 mutant recipient. These studies are extended in this report. Within several months following engraftment into a NOD2 mutant recipient the allograft loses its capacity to prevent adherence of lumenal microbes. Despite the significantly increased expression of CX3CL1, a stress protein produced by the injured enterocyte, N...

Renal Graft Outcome in Combined Heart–Kidney Transplantation Compared to Kidney Transplantation Alone: A Single-Center, Matched-Control Study

The Thoracic and Cardiovascular Surgeon — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions Our results with excellent long-term graft function and survival after combined HKTx indicate that this procedure is a valuable option for a growing number of patients suffering from coexistent cardiac and renal failure.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents | Abstract | Full text (Source: The Thoracic and Cardiovascular Surgeon)

Renal Graft Outcome in Combined Heart-Kidney Transplantation Compared to Kidney Transplantation Alone: A Single-Center, Matched-Control Study.

The Thoracic and Cardiovascular Surgeon — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions Our results with excellent long-term graft function and survival after combined HKTx indicate that this procedure is a valuable option for a growing number of patients suffering from coexistent cardiac and renal failure. PMID: 22234489 [PubMed - as supplied by publisher] (Source: The Thoracic and Cardiovascular Surgeon)

New Grading System to Improve the Surgical Outcome of Multirecurrent Pterygia [Clinical Sciences]

Archives of Opthalmology — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions Caruncle morphological characteristics and residual conjunctiva measurement help grade the severity of recurrent pterygium, guide surgical techniques, and predict outcomes. Sealing of the gap is important to create a strong barrier for preventing recurrence, restoring caruncle morphological characteristics, and regaining full motility in multirecurrent pterygia. (Source: Archives of Opthalmology)

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[About the article of S. Huard, S. Rochet, D. Lepage, P. Garbuio and L. Obert: New treatment of advanced Kienböck disease: Replacement of lunate with costochondral autograft. Chir Main 2011;30(3):211-217.]

Chirurgie de la Main — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Allieu Y PMID: 22301090 [PubMed - as supplied by publisher] (Source: Chirurgie de la Main)

Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study

Irish Journal of Medical Science — Sat, 07 Jan 2012 16:56:58 +0100

Conclusions Use of autologous or allogenic bone graft allows better recovery of long-term flexion, possibly due to reduced inflammatory response compared with synthetic bone composites. However, all other parameters, such as maintenance of joint reduction and subjective outcome measures were comparable with the use of hydroxyapatite calcium carbonate bone graft. This study shows that synthetic bone graft may be a suitable alternative in fixation of unstable tibia plateau fractures, avoiding risk of disease transmission with allograft and donor site morbidity associated with autograft. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s11845-011-0797-yAuthors J. C. Y. Ong, Department of Trauma and Orthopaedics, Cork University Hospital, Wilt...

Recurrence and rejection in liver transplantation for primary sclerosing cholangitis.

World Journal of Gastroenterology : WJG — Sat, 07 Jan 2012 05:00:00 +0100

Authors: Fosby B, Karlsen TH, Melum E Abstract Primary sclerosing cholangitis (PSC) is a chronic progressive inflammatory disease affecting the bile ducts, leading to fibrosis and eventually cirrhosis in most patients. Its etiology is unknown and so far no effective medical therapy is available. Liver transplantation (LTX) is the only curative treatment and at present PSC is the main indication for LTX in the Scandinavian countries. Close to half of the PSC patients experience one or more episodes of acute cellular rejection (ACR) following transplantation and approximately 1/5 of the transplanted patients develop recurrent disease in the graft. In addition, some reports indicate that ACR early after LTX for PSC can influence the risk for recurrent disease. For these important post...

ISTO Technologies Announces Participation in the Regenerative Medicine Insight Track at the Biotech Showcase

Medical News (via PRIMEZONE) — Fri, 06 Jan 2012 17:49:00 +0100

ST. LOUIS, Jan. 6, 2012 (GLOBE NEWSWIRE) -- ISTO Technologies, Inc., today announced that Scott Gill, Chief Financial Officer, will be participating in a panel session at the Regenerative Medicine Insight Track at the Biotech Showcase being held January 9-11, 2012 in San Francisco. Mr. Gill will discuss the state of the regenerative medicine market in the context of ISTO's orthobiologic platform and commercialized bone graft extender substitute. (Source: Medical News (via PRIMEZONE))

Mannan‐Binding Lectin Mediates Renal Ischemia/Reperfusion Injury Independent of Complement Activation

American Journal of Transplantation — Fri, 06 Jan 2012 05:00:00 +0100

Ischemia/reperfusion injury (IRI) remains a major problem in renal transplantation. Clinical studies have identified that high serum levels of Mannan‐binding lectin (MBL), the initiator of the lectin pathway of complement activation, are associated with inferior renal allograft survival. Using a rat model, we identified an entirely novel role for MBL in mediating renal IRI. Therapeutic inhibition of MBL was protective against kidney dysfunction, tubular damage, neutrophil and macrophage accumulation, and expression of proinflammatory cytokines and chemokines. Following reperfusion, exposure of tubular epithelial cells to circulation‐derived MBL resulted in internalization of MBL followed by the rapid induction of tubular epithelial cell death. Interestingly, this MBL‐mediated tubular...

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Local autograft retrieval from a cervical vertebral body: biomechanical consequences.

Journal of Neurosurgery.Spine — Fri, 06 Jan 2012 05:00:00 +0100

Conclusions There does not appear to be a significant early biomechanical weakening of adjacent vertebrae caused by aforementioned technique of local bone harvest. PMID: 22225490 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Spontaneous resolution of acute T cell-mediated rejection in a renal transplant patient

International Urology and Nephrology — Thu, 05 Jan 2012 17:06:36 +0100

Abstract This case report presents spontaneous resolution of acute rejection in a 66-year-old man who underwent a kidney transplant and developed acute rejection and pneumonia. Our main concern in this case was how to treat the concurrent infection while maintaining the immunosuppressive therapy with a narrow available therapeutic range, in order to save the renal allograft without increasing antirejection therapy. Content Type Journal ArticleCategory Nephrology – Case ReportPages 1-3DOI 10.1007/s11255-011-0114-8Authors Y. M. Hong, Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, 634-18, Keum-Am Dong, Jeonju, 561-712 Republic of KoreaS. H. Kim, Department of Internal Medicine, Research Institute of ...

Kidney Allograft Inflammation and Fibrosis, Causes and Consequences

American Journal of Transplantation — Thu, 05 Jan 2012 05:00:00 +0100

This study assessed the development of allograft interstitial fibrosis and inflammation (GIF+“i”), a histologic pattern associated with reduced graft survival. Included are 795 adults, recipients of kidney allografts from 2000 to 2006. GIF+“i” was diagnosed in surveillance and clinical biopsies that had no transplant glomerulopathy. With time, posttransplant increasing number of grafts showed GIF+“i” and these patients had reduced death‐censored graft survival (HR = 4.33 (2.49–7.53), p < 0.0001). Development of GIF+“i” was related to prior acute cellular rejection (ACR), BK nephropathy (PVAN), increasing number of HLA mismatches, retransplantation and DGF. However, 46.4% of GIF+“i” cases had no history of ACR or PVAN. Anti‐HLA antibodies at transplant did not r...

Preservation Solutions for Static Cold Storage of Kidney Allografts: A Systematic Review and Meta‐Analysis

American Journal of Transplantation — Thu, 05 Jan 2012 05:00:00 +0100

Static cold storage is the most prevalent method for renal allograft preservation. Several solutions have been designed to counteract the detrimental effects of cold ischemia and reperfusion. The aim of this study was to appraise the evidence for the currently available preservation solutions. We performed a systematic literature search using MEDLINE, EMBASE, the Cochrane Library, the Transplant Library and trial registries. Inclusion criteria specified any comparative, prospective study for deceased donor renal allografts. Studies were assessed for methodological quality. The primary outcome was delayed graft function (DGF). Fifteen trials with a total of 3584 kidneys were included. Eurocollins was associated with a higher risk of DGF than University of Wisconsin solution (UW) in two rand...

Tolerogenic dendritic cells: applications for solid organ transplantation.

Current Opinion in Organ Transplantation — Thu, 05 Jan 2012 05:00:00 +0100

Tolerogenic dendritic cells: applications for solid organ transplantation. Curr Opin Organ Transplant. 2012 Jan 5; Authors: Beriou G, Moreau A, Cuturi MC Abstract PURPOSE OF REVIEW: We discuss the use of tolerogenic dendritic cells (TolDCs) as a therapeutic tool in solid organ transplantation, with particular emphasis on recent experimental and preclinical data supporting the clinical translation of TolDC therapy. RECENT FINDINGS: TolDC have been successfully used in rodents to promote long-term allograft survival. Although most studies have focused on donor dendritic cells or donor antigen-pulsed dendritic cells, our group investigated a strategy based on the administration of autologous dendritic cells (not pulsed with donor antigens). We discuss the therapeutic efficacy,...

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Distinctive morphological features of antibody-mediated and T-cell-mediated acute rejection in pancreas allograft biopsies.

Current Opinion in Organ Transplantation — Thu, 05 Jan 2012 05:00:00 +0100

Authors: Papadimitriou JC, Drachenberg CB Abstract PURPOSE OF REVIEW: Two main histopathological types of acute rejection are recognized in solid organ transplantation: T-cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR). In pancreas allografts the contrasting morphological features of these entities have only recently been described. RECENT FINDINGS: Acute TCMR is characterized by active septal infiltrates composed predominantly of T cells and often involving veins (venulitis) and ducts (ductitis). Inflammation of the arterial endothelium (intimal arteritis or endarteritis) may be present. Focal or diffuse acinar inflammation (acinitis) is also typical of TCMR. Acute AMR in contrast, is characterized by predominantly macrophagic (± neutrophilic) inflammation,...

New workhorse flaps in hand reconstruction

Hand — Wed, 04 Jan 2012 07:01:12 +0100

Abstract With the passage of time, certain hand surgery procedures are anecdotally dubbed “workhorse” techniques. These are procedures that are extremely reliable and have repeatedly demonstrated good results. However, with time, paradigms undergo shifts, and this is as true for hand surgery as any other field. In this article, we will describe the use of three new “workhorse” flaps that we have found to have reliable results in complex hand reconstruction: the pedicled radial forearm fascia flap for dorsal hand reconstruction, the free anterolateral thigh flap for mangled hand reconstruction, and the medial femoral condyle vascularized bone graft for scaphoid fracture nonunion reconstruction. Content Type Journal ArticleCategory Review Articles of topicsPages ...

Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient

International Urology and Nephrology — Wed, 04 Jan 2012 06:59:18 +0100

We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction. Our patient was a 50-year-old male renal allograft recipient, with diabetes mellitus and hypertension, who was diagnosed with pneumonia and cytomegalovirus retinitis. High-resolution computed tomography scan of the thorax and bronchoscopy revealed nocardial pneumonia. The patient responded well to ceftriaxone and was later switched to oral minocycline. To our knowledge, this is the first report of a successful treatment of co-infection with Nocardia pneumonia and cytomegalovirus retinitis in a renal transplant patient, with early diagnosis and prompt treatment. Content Type Journal ArticleCategory Nephrology – Case Repor...

Opening wedge high tibial osteotomy using tibial wedge allograft: a case series study

European Journal of Orthopaedic Surgery and Traumatology — Wed, 04 Jan 2012 06:58:28 +0100

Abstract High tibial osteotomy has been established as an effective surgical intervention in patients with unicompartment osteoarthritis of the knee associated with varus deformity and abnormal load through the medial compartment. The aims of this study were to report the result of open-wedge osteotomy performed with allograft bone and also to evaluate the postoperative clinical results in a series of patients. There are still little medical literatures regarding the use of an allograft bone transplant in open-wedge osteotomy. 37 consecutive cases that had undergone opening wedge osteotomy using allograft bone were studied. They were followed each 2 months after surgery until 6 month. There were 7 men and 30 women, aged ranging from 16 to 66. All patients were fo...

Impact of recurrent lupus nephritis on lupus kidney transplantation

Clinical Rheumatology — Wed, 04 Jan 2012 06:57:52 +0100

This study was conducted to delineate the frequency of recurrent lupus nephritis in a Chinese kidney transplant cohort and to estimate its impact on long-term transplant outcomes. A total of 32 lupus transplant patients were enrolled in this study, and the medical records were retrospectively reviewed. Patients with unexplained graft abnormalities were subjected to allograft biopsy. Recurrent lupus nephritis was diagnosed by light microscopy, immunofluorescence, and electron microscopy. In addition, to determine the clinical manifestations of recurrent lupus GN in these patients, serum original systemic lupus erythematosus disease activity index (SLEDAI) scores while undergoing allograft biopsy were evaluated. In total, six out of 32 patients (18.8%; mean age, 40.5 ± 9.1 ye...

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The surgical treatment and related management for post-tubercular kyphotic deformity of the cervical spine or the cervico-thoracic spine

International Orthopaedics — Wed, 04 Jan 2012 06:48:05 +0100

Conclusion One-stage anterior debridement, instrumentation and fusion for cervical spinal TB and single posterior instrumentation for cervico-thoracic spinal TB followed by chemotherapy is practical to correct PTK. The procedure has the advantage of lower blood loss, effective kyphosis correction and minimal complications. To patients with severe deformity, skeletal traction seemed indispensible. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s00264-011-1438-9Authors Yang Liu, Orthopedics Research Institute of the Chinese People’s Liberation Army, Orthopedics Department of Changzheng Hospital, Changzheng, ChinaYuanyuan Chen, Orthopedics Research Institute of the Chinese People’s Liberation Army, Orthopedics Department of Changzheng Hosp...

Influence of flow‐rate and scaffold pore size on cell behaviour during mechanical stimulation in a flow perfusion bioreactor

Biotechnology and Bioengineering — Wed, 04 Jan 2012 05:00:00 +0100

In this study we employed a combined computational modelling and experimental approach to examine how the scaffold mean pore size influences cell attachment morphology and subsequently impacts upon cell deformation and detachment when subjected to fluid‐flow. Cell detachment from osteoblast‐seeded collagen‐GAG scaffolds was evaluated experimentally across a range of scaffold pore sizes subjected to different flow‐rates and exposure times in a perfusion bioreactor. Cell detachment was found to be proportional to flow‐rate and inversely proportional to pore size. Using this data, a theoretical model was derived that accurately predicted cell detachment as a function of mean shear stress, mean pore size and time. Computational modelling of cell deformation in response to fluid flow ...

How to Treat Osteochondritis Dissecans of the Knee: Surgical Techniques and New Trends: AAOS Exhibit Selection.

The Journal of Bone and Joint Surgery. American volume — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSIONS: All of the techniques were effective in achieving good clinical and radiographic results in patients with osteochondritis dissecans, and the effectiveness of autologous chondrocyte implantation was confirmed at a mean follow-up of five years. Newer techniques such as MaioRegen implantation and the "one-step" transplantation technique are based on different rationales; the first relies on the characteristics of the scaffold and the second on the regenerative potential of mesenchymal cells. Both of these newer procedures have the advantage of being minimally invasive and requiring a single operation. PMID: 22218387 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Influence of flow rate and scaffold pore size on cell behavior during mechanical stimulation in a flow perfusion bioreactor

Biotechnology and Bioengineering — Wed, 04 Jan 2012 05:00:00 +0100

In this study, we employed a combined computational modeling and experimental approach to examine how the scaffold mean pore size influences cell attachment morphology and subsequently impacts upon cell deformation and detachment when subjected to fluid‐flow. Cell detachment from osteoblast‐seeded collagen–GAG scaffolds was evaluated experimentally across a range of scaffold pore sizes subjected to different flow rates and exposure times in a perfusion bioreactor. Cell detachment was found to be proportional to flow rate and inversely proportional to pore size. Using this data, a theoretical model was derived that accurately predicted cell detachment as a function of mean shear stress, mean pore size, and time. Computational modeling of cell deformation in response to fluid flow show...

Role of Primary Bacterial Contamination of a Pulmonary Homograft for Ross Operation: Report of a Case and Review of the Literature.

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

Authors: Blehm A, Schurr P, Lichtenberg A Abstract In a 43-year-old female, Ross operation was performed with annular reinforcement of the autograft and a cryo-fixed homograft that proved to be contaminated with enterobacter cloacae and klebsiella pneumoniae at the time of operation. Clinical course was unremarkable, perhaps due to effective antibiotic prophylaxis and treatment. In the literature, little is known about intraoperative bacterial contamination and early endocarditis. The authors report what they believe is the second reported case. Particular resistibilities of homograft and autograft might make early endocarditis unlikely. PMID: 22215504 [PubMed - as supplied by publisher] (Source: The Thoracic and Cardiovascular Surgeon)

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Autograft Mitral Valve Replacement: A New Technique.

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

We describe a new technique wherein we have used the Ionescu Ross Wooler stent for housing the pulmonary autograft. We believe that this technique is easy and reproducible and offers many advantages over the previously described techniques. PMID: 22215498 [PubMed - as supplied by publisher] (Source: The Thoracic and Cardiovascular Surgeon)

Dermal Tissue Allograft for the Repair of Massive Irreparable Rotator Cuff Tears

The American Journal of Sports Medicine — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: In our series of carefully selected candidates, all patients demonstrated a significant improvement in pain, range of motion, and strength. Subjective outcome measures, including mean ASES and SF-12 scores, also demonstrated significant improvement at an average 3-year follow-up. (Source: The American Journal of Sports Medicine)

Relationships Among Tendon Regeneration on MRI, Flexor Strength, and Functional Performance After Anterior Cruciate Ligament Reconstruction With Hamstring Autograft

The American Journal of Sports Medicine — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: Hamstring tendons regenerated after harvest for ACL reconstruction in a high proportion of the patients. The flexor strength with both the standard and prone position isokinetic tests differed in the 3 groups. The number of regenerated hamstring tendons was significantly correlated with performance on the carioca test. Proximal shifting of the musculotendinous junction was significantly correlated with flexor deficit on the hyperflexion isokinetic test. (Source: The American Journal of Sports Medicine)

Prolonged renal allograft survival by donor interleukin-6 deficiency: association with decreased alloantibodies and increased intragraft T regulatory cells

AJP: Renal Physiology — Tue, 03 Jan 2012 05:00:00 +0100

In conclusion, the lack of graft-producing IL-6 significantly prolongs renal allograft survival, which is associated with reduced alloantibody production and/or increased intragraft Treg cell population, implying that targeting donor IL-6 may effectively prevent both humoral and cellular rejection of kidney transplants. (Source: AJP: Renal Physiology)

Belatacept: A New Biologic and Its Role in Kidney Transplantation (January).

The Annals of Pharmacotherapy — Tue, 03 Jan 2012 05:00:00 +0100

CONCLUSIONS:Belatacept provides a new option for maintenance immunosuppression in adult KTR. Further research is needed to compare its efficacy and safety with standard tacrolimus-based regimens, to evaluate whether increased drug costs are offset by long-term improvements in patient and allograft survival, and to establish its role in the immunosuppression armamentarium. PMID: 22215686 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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Autograft Mitral Valve Replacement: A New Technique

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

We describe a new technique wherein we have used the Ionescu Ross Wooler stent for housing the pulmonary autograft. We believe that this technique is easy and reproducible and offers many advantages over the previously described techniques.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents | Abstract | Full text (Source: The Thoracic and Cardiovascular Surgeon)

Role of Primary Bacterial Contamination of a Pulmonary Homograft for Ross Operation: Report of a Case and Review of the Literature

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

Thorac cardiovasc SurgDOI: 10.1055/s-0031-1293601In a 43-year-old female, Ross operation was performed with annular reinforcement of the autograft and a cryo-fixed homograft that proved to be contaminated with enterobacter cloacae and klebsiella pneumoniae at the time of operation. Clinical course was unremarkable, perhaps due to effective antibiotic prophylaxis and treatment. In the literature, little is known about intraoperative bacterial contamination and early endocarditis. The authors report what they believe is the second reported case. Particular resistibilities of homograft and autograft might make early endocarditis unlikely.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents | Abstract | Full text (...

Role of diffusion-weighted MRI in diagnosis of acute renal allograft dysfunction: a prospective preliminary study.

The British Journal of Radiology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: These results show how DW MRI is a promising new technique for the diagnosis of acute renal transplant dysfunction. PMID: 22215880 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

CRP and acute renal rejection: a marker to the point

International Urology and Nephrology — Mon, 02 Jan 2012 16:50:33 +0100

Conclusion Elevated pretransplant serum CRP level is a risk predictor for acute rejection episodes and may be a useful predictive marker in the follow-up of post-transplantation patients. Content Type Journal ArticleCategory Nephrology - Original PaperPages 1-5DOI 10.1007/s11255-011-0098-4Authors Amin Roshdy, Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, EgyptMohamed M. El-Khatib, Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, EgyptMary N. Rizk, Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, EgyptAmal M. El-shehaby, Medical Biochemistry Department, Faculty of Medicine, Cairo University, Giza, Egypt Journal International Urology and NephrologyOnline ISSN 1573-2584Print ISSN 030...

MedWorm: Bone Graft

Integra LifeSciences Announces Launch of the Integra(R) Allograft Wedge System for Extremity Reconstruction

The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery

Early exposure of interferon-γ inhibits signal transducer and activator of transcription-6 signalling and nuclear factor κB activation in a short-term monocyte-derived dendritic cell culture promoting 'FAST' regulatory dendritic cells.

Postoperative spondilodiscitis

Treatment of severe osteochondral defects of the knee by combined autologous bone grafting and autologous chondrocyte implantation using fibrin gel

Early exposure of interferon‐γ inhibits signal transducer and activator of transcription‐6 signalling and nuclear factor κB activation in a short‐term monocyte‐derived dendritic cell culture promoting ‘FAST’ regulatory dendritic cells

Medial rectus Botox injection with pterygium excision and autograft as a novel technique for management of recurrent pterygium

A Cost-Effectiveness Analysis Comparing 3 Anterior Cruciate Ligament Graft Types: Bone-Patellar Tendon-Bone Autograft, Hamstring Autograft, and Allograft

Biomechanical and Histological Evaluations of the Doubled Semitendinosus Tendon Autograft After Anterior Cruciate Ligament Reconstruction in Sheep

Patient and Surgeon Characteristics Associated With Primary Anterior Cruciate Ligament Reconstruction Graft Selection

Meniscal Allograft Transplantation Without Bone Plugs: A 3-Year Minimum Follow-up Study

Does Anterior Cruciate Ligament Reconstruction Lead to Degenerative Disease?: Thirteen-Year Results After Bone-Patellar Tendon-Bone Autograft

Differential Expression of MicroRNAs During Allograft Rejection

Multiple Hyperacute Rejections in the Absence of Detectable Complement Activation in a Patient with Endothelial Cell Reactive Antibody

Lung Transplantation in Patients with Prior Cardiothoracic Surgical Procedures

Donor Brain Death Inhibits Tolerance Induction in Miniature Swine Recipients of Fully MHC‐Disparate Pulmonary Allografts

Role of Lentivirus‐Mediated Overexpression of Programmed Death‐Ligand 1 on Corneal Allograft Survival

Early Metabolic Markers that Anticipate Loss of Insulin Independence in Type 1 Diabetic Islet Allograft Recipients

A New Diagnostic Algorithm for Antibody‐Mediated Microcirculation Inflammation in Kidney Transplants

A Common Peripheral Blood Gene Set for Diagnosis of Operational Tolerance in Pediatric and Adult Liver Transplantation

Deleterious Effect of CTLA4‐Ig on a Treg‐Dependent Transplant Model

Effect of dietary polyunsaturated fatty acids on castration-resistant Pten-null prostate cancer

Mitochondrial haplogroups associated with end-stage heart failure and coronary allograft vasculopathy in heart transplant patients

Comparison between anterior and posterior decompression for cervical spondylotic myelopathy: subjective evaluation and cost analysis

Sinusoidal C4d deposits in liver allografts indicate an antibody mediated response: Diagnostic considerations in the evaluation of liver allografts

Effect of simvastatin on development of obliterative airway disease: An experimental study

Salvaging kidneys with renal allograft compartment syndrome

Telescopic mating technique for bulk allograft reconstruction.

Chondrogenic potential and homogeneity of cell populations of donor and recipient cells in a fresh osteochondral allograft: a case report.

Function After Injection of Benign Bone Lesions with a Bioceramic.

Spinal cord herniation: Management and outcome in a series of 12 consecutives patients and review of the literature

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

Two‐dimensional speckle tracking echocardiography of acute cardiac transplant rejection following pregnancy

The impact of hepatitis C virus donor and recipient status on long‐term kidney transplant outcomes: University of Wisconsin experience

The PROMISE Study: A Phase 2b Multicenter Study of Voclosporin (ISA247) Versus Tacrolimus in De Novo Kidney Transplantation

Impact of Early Conversion From Tacrolimus to Sirolimus on Chronic Allograft Changes in Kidney Recipients on Rapid Steroid Withdrawal

Development of organ‐specific donor risk indices

Rehabilitation following osteochondral injury to the knee

Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions

Immune response to an adjuvanted influenza A H1N1 vaccine (Pandemrix(R)) in renal transplant recipients

Impact of CMV infection on acute rejection and long-term renal allograft function: a systematic analysis in patients with protocol biopsies and indicated biopsies

Proteasome inhibitors: an expanding army attacking a unique target.

Silent Ischemia: Clinical Relevance

Sinus augmentation using rhBMP‐2/ACS in a mini‐pig model: relative efficacy of autogenous fresh particulate iliac bone grafts

Effects of nicotine on guided bone augmentation in rat calvarium

Black‐blood steady‐state free precession (SSFP) coronary wall MRI for cardiac allografts: A feasibility study

[DC-F technique cartilage graft for nasal saddle correction.]

Ten-Year Outcome after Rapid Discontinuation of Prednisone in Adult Primary Kidney Transplantation.

Long-Term Kidney Allograft Function and Survival in Prednisone-Free Regimens: Tacrolimus/Mycophenolate Mofetil versus Tacrolimus/Sirolimus.

Therapeutic Plasma Exchange for Renal‐Related Conditions in the Elderly: Ten Years Experience in One Center

[Reconstruction of the lateral ankle ligaments with hamstring tendon autograft in patients with chronic ankle instability.]

Therapeutic Plasma Exchange for Renal-Related Conditions in the Elderly: Ten Years Experience in One Center.

Allograft Anterior Cruciate Ligament Reconstruction: Indications, Techniques, and Outcomes.

Suppression of bronchiolitis obliterans in allogeneic rat lung transplantation-Effectiveness of everolimus.

Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial

A Between Sex Comparison of Anterior-Posterior Knee Laxity after Anterior Cruciate Ligament Reconstruction with Patellar Tendon or Hamstrings Autograft: A Systematic Review

Mesenchymal stem cells differentially mediate regulatory T cells and conventional effector T cells to protect fully allogeneic islet grafts in mice

Repair of critical long bone defects using frozen bone allografts coated with an rhBMP-2-retaining paste

Improved Survival but Marginal Allograft Function in Patients Treated With Extracorporeal Membrane Oxygenation After Lung Transplantation [ORIGINAL ARTICLES: GENERAL THORACIC]

Long-Term Results of 203 Young and Middle-Aged Patients With More Than 10 Years of Follow-Up After the Original Subcoronary Ross Operation [ORIGINAL ARTICLES: ADULT CARDIAC]

Reoperation After the Ross Procedure: Incidence, Management, and Survival [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

Evolution of Mitral Valve Replacement in Children: A 40-Year Experience [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

Similar Survival but Better Function for Patients after Limb Salvage versus Amputation for Distal Tibia Osteosarcoma.

Composite Tissue Allograft

Autogenous Bone Graft: Is this still Justified?

Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction

Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

CD27 costimulation augments the survival and antitumor activity of redirected human T cells in vivo

Perfusion MRI for Monitoring the Effect of Sorafenib on Experimental Prostate Carcinoma: A Validation Study

The Impact of the Activated Stroma on Pancreatic Ductal Adenocarcinoma Biology and Therapy Resistance.

Complement fixing donor‐specific antibodies and allograft loss

Infiltrating cellular pattern in kidney graft biopsies translates into forkhead box protein 3 up-regulation and p16(INK) (4α) senescence protein down-regulation in patients treated with belatacept compared to cyclosporin A.

Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Graft: Comparison of Autograft, Fresh-Frozen Allograft, and γ-Irradiated Allograft

Evaluation of coronary allograft vasculopathy using multi-detector row computed tomography: a systematic review [TX [amp ] MCS]

Pushing the envelope: living donor pancreas transplantation.

Toxoplasmosis after allogeneic stem cell transplantation—a single centre experience

Complete Immunosuppression Withdrawal and Subsequent Allograft Function Among Pediatric Recipients of Parental Living Donor Liver Transplants [Preliminary Communication]

Association studies of Toll‐like receptor gene polymorphisms with allograft survival in renal transplant recipients of North India

Can we predict allograft tolerance in experimental animal models of transplantation?

Multiple Hyperacute Rejections in the Absence  of Detectable Complement Activation in a Patient  with Endothelial Cell Reactive Antibody