allografting

对位漂流
  • 文章类型: Journal Article
    跟骨的单纯性骨囊肿(SBC)和骨内脂肪瘤(IOL)是罕见的肿瘤实体,主要是由于非特异性足跟痛而诊断。偶然发现,或很少由于病理性骨折。与传统的开放性肿瘤切除术相比,这些良性肿瘤的内镜切除术旨在在不影响安全性的前提下最大限度地降低手术发病率和提高手术效率.定期进行移植以降低复发的风险并刺激溶解性病变的骨性巩固。由于发病率低,治疗策略不同,对于跟骨单纯囊肿或骨内脂肪瘤的治疗尚无明确共识。这项研究的目的是(a)在内窥镜切除和同种异体松质骨或生物可吸收的羟基磷灰石和硫酸钙水泥移植后呈现中长期结果,和(b)为讨论跟骨SBC和IOL在不同发育阶段是否是同一实体增加进一步的证据。在2012年至2019年之间,通过内窥镜切除和移植的A.T.治疗了25个良性骨肿瘤,其中包括17个SBC和8个IOL。包括迄今为止最大的队列。为了嫁接,12例患者接受同种异体松质骨(A组),13例患者接受可注射骨替代物(B组)。使用X线平片和MRI进行术前和术后成像回顾性分析,平均随访时间为24.5个月,以评估肿瘤大小。骨固结(修正的Neer分类),和肿瘤复发。使用改良的Clavien-Dindo分类(CD1-3)进行了回顾性图表分析,重点分析了不良的围手术期和围手术期事件以及与外科手术相关的其他并发症。共12/13例同种异体植骨,经内镜切除肿瘤病灶Neer1型骨性愈合,而只有5/11例具有可注射骨替代物的病例显示出足够的愈合(1型和2型)。使用可注射骨替代物后,有三个复发性囊肿(Neer4)和两个持续性囊肿(Neer3)。A组观察到两种CD1并发症(伤口引流时间延长,腓肠神经炎)和B组8种并发症(6×CD1,2×CD3)。术前使用MRI诊断的至少两个IOL最终在组织病理学检查后被鉴定为SBC。跟骨SBC或IOL内窥镜切除后的同种异体松质骨移植显示,在我们的研究中,并发症发生率非常低,没有肿瘤复发。另一方面,根据使用的材料,可注射骨替代物显示出很高的“白化”率(过度引流),导致多种并发症,如伤口愈合时间延长,永久性缺陷填充不足,复发,和翻修手术。随着时间的推移,跟骨SBC可能转变为IOL,在骨镜检查和组织病理学分析中同时表现出两种实体的不同特征。
    Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign tumors aims to minimize surgical morbidity and maximize surgical efficiency without compromising safety. Grafting is regularly performed to reduce the risk of recurrence and stimulate osseous consolidation of the lytic lesion. As the incidence is low and treatment strategies are heterogeneous, there is no clear consensus for the treatment of simple cysts or intraosseous lipomas of the calcaneus. The objectives of this study are (a) to present medium to long-term results after endoscopic resection and grafting with allogenic cancellous bone or bioresorbable hydroxyapatite and calcium sulfate cement, and (b) to add further evidence to the discussion of whether calcaneal SBC and IOL are the same entity at different developmental stages. Between 2012 and 2019, a total of 25 benign bone tumors consisting of 17 SBCs and 8 IOLs were treated by A.T. with endoscopic resection and grafting, comprising the largest cohort to date. For grafting, 12 patients received allogenic cancellous bone (group A) and 13 patients received injectable bone substitute (group B). Pre- and postoperative imaging using plain X-rays and MRI was retrospectively analyzed with a mean follow-up time of 24.5 months to assess tumor size, osseous consolidation (modified Neer classification), and tumor recurrence. A retrospective chart analysis focusing on adverse intra- and perioperative events and other complications associated with the surgical procedure was performed using the modified Clavien-Dindo classification (CD1-3). A total of 12/13 cases with allogenic bone grafting showed a Neer Type 1 osseous healing of the tumorous lesion after endoscopic resection, whereas only 5/11 cases with injectable bone substitute showed sufficient healing (types 1 and 2). There were three recurrent cysts (Neer 4) and two persistent cysts (Neer 3) after using injectable bone substitute. Two CD1 complications were observed in group A (prolonged wound drainage, sural neuritis) and eight complications were observed in group B (6× CD1, 2× CD3). At least two IOLs diagnosed preoperatively using MRI were ultimately identified as SBCs upon histopathologic examination. Allogenic cancellous bone grafting after endoscopic resection of calcaneal SBC or IOL showed a very low rate of complications and no tumor recurrence in our series. On the other hand, depending on the material used, injectable bone substitute showed a high rate of \"white-out\" (excessive drainage), resulting in multiple complications such as prolonged wound healing, insufficient permanent defect filling, recurrence, and revision surgery. Over time, calcaneal SBC may transform into IOL, exhibiting distinct features of both entities simultaneously during ossoscopy and histopathological analysis.
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  • 文章类型: Journal Article
    将球形核植入受体牡蛎是使用珍珠牡蛎Pinctadafucatamartensii生产人造珍珠的关键步骤。然而,关于翻译后修饰(PTM)在珍珠牡蛎对此操作的反应中的作用知之甚少。赖氨酸乙酰化,一个高度保守的PTM,可能是管理多种生物或非生物胁迫的基本适应性策略。我们对P.f.martensiig进行了第一次赖氨酸乙酰化分析。核植入后12小时,使用串联质量标签(TMT)标记和Kac亲和富集。我们在1301蛋白中鉴定出2443个乙酰化位点,895个蛋白质上的1511个位点具有定量信息。我们从所有确定的赖氨酸位点发现了25个保守的基序,特别是主题KacH,KacS,KacY非常保守,其中KacY,KacH,YKac,KACK,Kac*K,KacR,和KacF已在其他物种中观察到,因此高度保守。我们确定了58个位点在P.f.martensii中响应于同种异体移植而显著不同的乙酰化(|倍数变化|>1.2,P值≤0.05);38个新乙酰化和20个脱乙酰化。根据GO功能分析,地下室位置,和KOG分类,这些蛋白质分为四类:细胞骨架,对刺激的反应,新陈代谢,和其他。差异乙酰化蛋白(DAP)富集途径包括氨酰基-tRNA生物合成,沙门氏菌感染,和长寿调节途径-蠕虫-秀丽隐杆线虫(线虫)。平行反应监测(PRM)验证了10个随机选择的差异乙酰化位点的差异乙酰化。这些结果表明我们的乙酰化分析结果是足够可靠和可重复的。这些结果为深入探索海洋无脊椎动物和P.f.martensii中与赖氨酸乙酰化相关的应激反应和适应机制提供了必要的资源。
    Implanting a spherical nucleus into a recipient oyster is a critical step in artificial pearl production using the pearl oyster Pinctada fucata martensii. However, little is known about the role of post-translational modifications (PTMs) in the response of the pearl oyster to this operation. Lysine acetylation, a highly conserved PTM, may be an essential adaptive strategy to manage multiple biotic or abiotic stresses. We conducted the first lysine acetylome analysis of the P. f. martensii gill 12 h after nucleus implantation, using tandem mass tags (TMT) labeling and Kac affinity enrichment. We identified 2443 acetylated sites in 1301 proteins, and 1511 sites on 895 proteins were quantitatively informative. We found 25 conserved motifs from all of the identified lysine sites, particularly motifs Kac H, Kac S, and Kac Y were strikingly conserved, of which Kac Y, Kac H, Y Kac, Kac K, Kac *K, Kac R, and Kac F which have been observed in other species and are therefore highly conserved. We identified 58 sites that were significantly differently acetylated in P. f. martensii in response to allograft (|fold change|>1.2, P-value ≤ 0.05); 38 newly acetylated and 20 deacetylated. According to GO functional analysis, subcellar location, and KOG classIfication, these proteins were divided into four categories: cytoskeleton, response to stimulus, metabolism, and other. The differentially acetylated proteins (DAPs) enriched pathways include aminoacyl-tRNA biosynthesis, salmonella infection, and longevity regulating pathway-worm-Caenorhabditis elegans (nematode). Parallel reaction-monitoring (PRM) validation of the differential acetylation of 10 randomly selected differentially acetylated sites from the acetylome analysis. These results indicated that our acetylome analysis results were sufficiently reliable and reproducible. These results provide an essential resource for in-depth exploration of the stress responses and adaptation mechanisms associated with lysine acetylation in marine invertebrates and P. f. martensii.
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  • 文章类型: Journal Article
    周围神经系统的缺陷在创伤和手术中极为常见,并且具有很高的社会经济成本。如果无法直接缝合病变,即,神经间隙>2厘米,有必要使用移植物。虽然黄金标准是自体移植,它有与收获有关的缺点,不可避免的功能缺陷和进一步的发病率。自体移植的替代方案以脱细胞神经同种异体移植(ANA)为代表,避免了自体移植收获和新鲜同种异体移植排斥的缺点。在这项研究中,作者打算将一种新技术转移到人类神经中,以前在动物模型中实施,使神经去细胞化.新方法基于将神经组织浸入去细胞溶液中,同时将超声波和冻融循环相关联。它是在不中断无菌链的情况下进行的,这样新的移植物可能不需要生产后的γ射线照射,怀疑会影响组织的结构和功能质量。新方法快速,安全,如果与可用的商业ANA相比,价格低廉。组织学和免疫组织化学已被用于评估新的脱细胞神经。研究表明,新方法可应用于人体神经样本,获得类似的,and,有时更好,结果与所选控制方法进行比较,Hudson技术.
    Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. If the direct suture of a lesion is not possible, i.e., nerve gap > 2 cm, it is necessary to use grafts. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable functional deficit and further morbidity. An alternative to autografting is represented by the acellular nerve allograft (ANA), which avoids disadvantages of autograft harvesting and fresh allograft rejection. In this research, the authors intend to transfer to human nerves a novel technique, previously implemented in animal models, to decellularize nerves. The new method is based on soaking the nerve tissues in decellularizing solutions while associating ultrasounds and freeze-thaw cycles. It is performed without interrupting the sterility chain, so that the new graft may not require post-production γ-ray irradiation, which is suspected to affect the structural and functional quality of tissues. The new method is rapid, safe, and inexpensive if compared with available commercial ANAs. Histology and immunohistochemistry have been adopted to evaluate the new decellularized nerves. The study shows that the new method can be applied to human nerve samples, obtaining similar, and, sometimes better, results compared with the chosen control method, the Hudson technique.
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  • 文章类型: Journal Article
    OBJECTIVE: Long-term outcomes following the use of human dermal allografts in the treatment of symptomatic irreparable rotator cuff tears are not known. The aim of this study was to evaluate these outcomes, and to investigate whether this would be a good form of treatment in young patients in whom a reverse shoulder arthroplasty should ideally be avoided.
    METHODS: This prospective study included 47 shoulders in 45 patients who underwent an open reconstruction of the rotator cuff using an interposition GraftJacket allograft to bridge irreparable cuff tears, between January 2007 and November 2011. The Oxford Shoulder Score (OSS), pain score, and range of motion (ROM) were recorded preoperatively and at one year and a mean of 9.1 years (7.0 to 12.5) postoperatively.
    RESULTS: There was significant improvement in the mean OSS from 24.7 (SD 5.4) preoperatively to 42.0 (SD 6.3) at one year, and this improvement was maintained at 9.1 years (p < 0.001), with a score of 42.8 (SD 6.8). Similar significant improvements in the pain score were seen and maintained at the final follow-up from 6.1 (SD 1.6) to 2.1 (SD 2.3) (p < 0.001). There were also significant improvements in the ROM of the shoulder, and patient satisfaction was high.
    CONCLUSIONS: The use of an interposition human dermal allograft in patients with an irreparable rotator cuff tear leads to good outcomes that are maintained at a mean of nine years postoperatively. Cite this article: Bone Joint J 2022;104-B(1):91-96.
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  • 文章类型: Journal Article
    背景:用间充质干细胞(MSC)或雪旺氏细胞(SC)再细胞化的脱细胞神经同种异体移植物(ANA)是,目前,周围神经损伤(PNI)的治疗选择。这项研究旨在评估再细胞化同种异体移植(RA)与PNI自体移植神经重建的再生和功能能力。
    方法:将14只羊随机分为两组(n=7)。切除长30毫米的腓骨神经间隙,神经修复是通过自体移植或带有SC样细胞的再细胞化同种异体移植进行的。评估包括对ANA的组织形态学分析,MSC预分化为SC样细胞,在一年的随访中,肢体功能恢复(支持和步态),使用神经生理学测试和组织形态学分析进行神经再生。将所有评估与作为对照的对侧后肢进行比较。
    结果:移植神经成功脱细胞,70%以上的MSC预分化为SC样细胞。两个治疗组中的功能评估随时间相似地改善(p<0.05)。神经生理学结果(潜伏期,振幅,和传导速度)在12个月时两个治疗组也有所改善。组织学结果表明,在12个月时,与对照相比,两个治疗组的神经纤维排列较少(p<0.05),具有活跃的髓鞘再生过程(p<0.05)。
    结论:用SC样细胞再细胞化的ANA被证明是治疗神经间隙的成功方法。与未治疗的对侧神经相比,两个移植组的运动恢复和神经再生均令人满意。该方法可用于PNI的临床治疗。
    BACKGROUND: Acellular nerve allografts (ANA) recellularized with mesenchymal stem cells (MSC) or Schwann cells (SC) are, at present, a therapeutic option for peripheral nerve injuries (PNI). This study aimed to evaluate the regenerative and functional capacity of a recellularized allograft (RA) compared with autograft nerve reconstruction in PNI.
    METHODS: Fourteen ovines were randomly included in two groups (n=7). A peroneal nerve gap 30 mm in length was excised, and nerve repair was performed by the transplantation of either an autograft or a recellularized allograft with SC-like cells. Evaluations included a histomorphological analysis of the ANA, MSC pre differentiated into SC-like cells, at one year follow-up functional limb recovery (support and gait), and nerve regeneration using neurophysiological tests and histomorphometric analysis. All evaluations were compared with the contralateral hindlimb as the control.
    RESULTS: The nerve allograft was successfully decellularized and more than 70% of MSC were pre differentiated into SC-like cells. Functional assessment in both treated groups improved similarly over time (p <0.05). Neurophysiological results (latency, amplitude, and conduction velocity) also improved in both treated groups at twelve months. Histological results demonstrated a less organized arrangement of nerve fibers (p <0.05) with an active remyelination process (p <0.05) in both treated groups compared with controls at twelve months.
    CONCLUSIONS: ANA recellularized with SC-like cells proved to be a successful treatment for nerve gaps. Motor recovery and nerve regeneration were satisfactorily achieved in both graft groups compared with their contralateral nontreated nerves. This approach could be useful for the clinical therapy of PNI.
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  • 文章类型: Journal Article
    Meniscal tears are still one of the most frequent lesions in the knee joint. The relevance of meniscus loss for the development of osteoarthritis is undisputed. Meniscus repair, replacement and transplantation play an important role in the treatment of early arthritis, especially when they are a part of a master plan including alignment correction, stabilization and cartilage surgery, if needed. Scientific data show evidence concerning the protection of osteoarthritis, even though a lack of studies including comparison groups has to be admitted.
    UNASSIGNED: Meniskusverletzungen zählen unverändert zu den häufigsten Verletzungen des Kniegelenks. Die Relevanz des Meniskusverlustes für die Entstehung der Arthrose ist unbestritten. Meniskuserhalt, -ersatz und -transplantation spielen eine wichtige Rolle bei der Behandlung der Früharthrose, besonders wenn sie in ein komplettes Behandlungskonzept mit Berücksichtigung aller möglichen Komorbiditäten, wie Achsenfehler, Instabilitäten und Knorpelschäden, eingebettet sind. Wissenschaftliche Daten sprechen für eine Evidenz betreffend Arthroseprotektion, wenngleich das Fehlen von Studien mit Vergleichsgruppen eingestanden werden muss.
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  • 文章类型: Journal Article
    The increasing indications for allogeneic stem-cell transplant in patients with hematologic malignancies and non-malignant diseases combined with improved clinical outcomes have contributed to increase the number of long-term survivors. However, survivors are at increased risk of developing a unique set of complications and late effects, besides graft-versus-host disease and disease relapse. In this setting, the management capacity of a single health-care provider can easily be overwhelmed. Thus, to provide appropriate survivorship care, a multidisciplinary approach for the long-term follow-up is essential. This review aims at summarizing the most relevant information that a health-care provider should know to establish a follow-up care plan, in the light of individual exposures and risk factors, that includes all organ systems and considers the psychological burden of these patients.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    The majority of Hodgkin lymphoma patients are now cured with conventional first-line therapy; however, 10-15% of early-stage disease and less than 30% of advanced-stage patients are refractory(rare) or relapsed. Salvage second-line therapy combined with high-dose therapy and autologous stem-cell transplantation can cure 40-50% of patients. Recently novel agents (Brentuximab Vedotin and Immune Checkpoint inhibitors) have demonstrated evidence of therapeutic activity and are potential bridge to an allogeneic stem-cell transplantation. The review is aimed to present not only salvage strategies; indeed, the paper contains paragraphs about therapy and new treatment options at diagnosis.
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  • 文章类型: Journal Article
    Is transplantation of cryopreserved ovarian tissue from patients with borderline ovarian tumors (BOTs) a safe procedure?
    BOT cells were found in frozen-thawed and xenografted ovarian tissue in 1 of 11 BOT patients.
    The risk of reintroducing malignant cells upon ovarian tissue transplantation has been subject of debate for many years. Reimplantation of cryopreserved ovarian tissue from leukemia patients is unsafe, while results from studies of cryopreserved ovarian tissue from other forms of cancer, such as Hodgkin\'s lymphoma, are reassuring.
    Prospective experimental study conducted in an academic research unit using ovarian tissue from 11 patients undergoing cryopreservation for BOTs.
    Histology, immunohistochemistry (IHC) for mucin 1 (MUC1) and cytokeratin 7 (CK7) and molecular analysis by reverse transcription quantitative polymerase chain reaction (RT-qPCR) for CK7 and MUC1 were performed on frozen-thawed ovarian tissue from 11 patients. Long-term (5 months) xenografting of ovarian tissue in immunodeficient mice was performed. The xenografts were analyzed by histology, IHC and RT-qPCR, furthermore IHC for CD10, a marker of endometriosis, was performed on a selected sample.
    Analysis by histology, IHC and RT-qPCR indicated 10 of the ovarian tissue samples were negative. Analysis of the xenograft samples indicated nine were negative for malignant cells but in two xenografts glandular lesions were detected by histology. In these two xenografts, CK7 and MUC1 markers were demonstrated by IHC and CK7 expression also by RT-qPCR. A BOT was confirmed in the xenograft in which the original ovarian tissue was positive, while in the other case IHC demonstrated expression of endometriosis marker CD10.
    Cryopreserved ovarian fragments cannot be tested before transplantation, therefore the preimplantation analysis cannot guarantee that all cryopreserved fragments will be free of BOT cells.
    BOT cells can be found in cryopreserved ovarian tissue from BOT patients, therefore preimplantation analysis is an absolute prerequisite. Endometriosis can also be detected in cryopreserved ovarian tissue and caution should also be exercised in this scenario.
    This study was supported by grants from the Fonds National de la Recherche Scientifique de Belgique (FNRS-PDR Convention T.0077.14, Télévie Grant 7.4590.16 awarded to Rossella Masciangelo, and Grant 5/4/150/5 awarded to Marie-Madeleine Dolmans), the Fonds Speciaux de Recherche, and the Foundation Against Cancer. None of the authors have any conflicting interests to declare.
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