scholarly journals Efficacy of Surgery Combined with Autologous Bone Marrow Stromal Cell Transplantation for Treatment of Intracerebral Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jianxin Zhu ◽  
Yilei Xiao ◽  
Zhongmin Li ◽  
Fabin Han ◽  
Taiwu Xiao ◽  
...  

Bone marrow stromal cells (BMSCs) may differentiate into nerve cells under a certain condition; however, the clinical application for treating nervous system disease remains unclear. The aim is to assess the safety profile, feasibility, and effectiveness of surgery combined with autologous BMSCs transplantation for treating ICH. 206 ICH patients who had received surgical procedure were divided into transplantation (n=110) or control group (n=96). For transplantation group, BMSCs were injected into the perihemorrhage area in the base ganglia through an intracranial drainage tube 5.5 (3.01–6.89) days after surgery, followed by a second injection into the subarachnoid space through lumbar puncture 4 weeks later. Neurologic impairment and daily activities were assessed with National Institute Stroke Scale (NIHSS), Barthel index, and Rankin scale before transplantation and 6 months and 12 months after transplantation. Our results revealed that, compared with control group, NIHSS score and Rankin scale were both significantly decreased but Barthel index was increased in transplantation group after 6 months. Interestingly, no significant difference was observed between 12 months and 6 months. No transplantation-related adverse effects were investigated during follow-up assessments. Our findings suggest that surgery combined with autologous BMSCs transplantation is safe for treatment of ICH, providing short-term therapeutic benefits.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yixuan Liu ◽  
Suhong Xie ◽  
Lei Li ◽  
Yanhui Si ◽  
Weiwei Zhang ◽  
...  

Abstract Background This study investigates the effect of autologous bone marrow transfusion (BMT) on the reconstruction of both bone marrow and the immune system in patients with AIDS-related lymphoma (ARL). Methods A total of 32 patients with ARL participated in this study. Among them, 16 participants were treated with conventional surgery and chemotherapy (control group) and the remaining 16 patients were treated with chemotherapy followed by autologous bone marrow transfusion via a mesenteric vein (8 patients, ABM-MVI group) or a peripheral vein (8 patients, ABM-PI group). Subsequently, peripheral blood and lymphocyte data subsets were detected and documented in all patients. Results Before chemotherapy, no significant difference in indicators was observed between three groups of ARL patients. Unexpectedly, 2 weeks after the end of 6 courses of chemotherapy, the ABM-MVI group, and the ABM-PI group yielded an increased level of CD8+T lymphocytes, white blood cells (WBC), and platelet (PLT) in peripheral blood in comparison to the control group. Notably, the number of CD4+T lymphocytes in the ABM-PI group was significantly higher than that in the other two groups. Additionally, no significant difference in haemoglobin levels was observed before and after chemotherapy in both the ABM-MVI and ABM-PI groups, while haemoglobin levels in the control group decreased significantly following chemotherapy. Conclusions Autologous bone marrow transfusion after chemotherapy can promote the reconstruction of both bone marrow and the immune system. There was no significant difference in bone marrow recovery and reconstruction between the mesenteric vein transfusion group and the peripheral vein transfusion group.


2022 ◽  
Vol 12 ◽  
Author(s):  
Esphie Grace Fodra Fojas ◽  
Saradalekshmi Koramannil Radha ◽  
Tomader Ali ◽  
Evan P. Nadler ◽  
Nader Lessan

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.


2020 ◽  
Author(s):  
Hiroki Katagiri ◽  
Yusuke Nakagawa ◽  
Kazumasa Miyatake ◽  
Koji Otabe ◽  
Toshiyuki Ohara ◽  
...  

Abstract Purpose To improve long-term outcomes of open-wedge high tibial osteotomy (OWHTO), procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The purpose of the present study was to compare short-term clinical and radiological outcomes of medial joint space width (JSW) after the OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. Methods A retrospective review of 50 primary OWHTO patients was conducted. Thirty-five patients included for analysis after exclusion criteria was applied. Twenty-one knee osteoarthritis patients, who underwent the OWHTO with arthroscopic meniscal centralization, were included in the centralization group. Fourteen patients, who underwent solely OWHTO, were included in the control group. Lysholm knee scale, International Knee Documentation Committee (IKDC) subjective score, Knee Osteoarthritis Outcome Score (KOOS), and patient subjective satisfaction scores were recorded at the final follow-up. Radiographic changes of JSW and joint line congruence angle (JLCA) were measured 2 years postoperatively. Patient demographic data were also reviewed. Results IKDC subjective scores, KOOS subgroup scores, patient subjective satisfaction scores, and Lysholm score did not show significant differences between the two groups at the final follow-up. Change of the JSW in the centralization group was significantly greater than that in the control group 2 years postoperatively (Control group: -0.1 mm, Centralization group: 0.8 mm P =0.03). Conclusion Change of JSW after OWHTO aimed at neutral alignment with arthroscopic centralization for extruded medial meniscus was greater than solely OWHTO, and there was no significant difference in the short-term clinical outcomes between the 2 procedures at the final follow-up.


Author(s):  
Kaori Yonezawa ◽  
Megumi Haruna

Abstract Background This study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years. Methods This study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression. Results Of 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years. Conclusions After adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases. Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)


2018 ◽  
Vol 46 (10) ◽  
pp. 2503-2508 ◽  
Author(s):  
Yoshiharu Shimozono ◽  
Eoghan T. Hurley ◽  
Youichi Yasui ◽  
Timothy W. Deyer ◽  
John G. Kennedy

Background: Subchondral bone marrow edema (BME) has been associated with articular cartilage loss, with the potential to be a negative prognostic indicator for clinical outcomes after microfracture. However, no single study has investigated the association between BME and clinical outcomes after microfracture for osteochondral lesions of the talus (OLTs) at midterm follow-up. Purpose: To clarify the association between postoperative subchondral BME and clinical outcomes in patients treated with microfracture for OLTs at both short-term and midterm follow-up using a grading system that classified the extent of BME of the talus. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent microfracture between 2008 and 2013 were assessed at 2- and 4-year postoperative follow-up. BME was evaluated using magnetic resonance imaging, and the presence of subchondral BME was determined with fat-suppressed T2-weighted sequences. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS). P < .05 was considered to be statistically significant. Results: Forty-three (83%) of 52 eligible patients were included. No significant differences were found in the FAOS between the BME and no BME groups at 2-year follow-up (83.1 ± 6.5 vs 88.6 ± 8.0, respectively; P = .109), but there was a significant difference at 4-year follow-up (77.5 ± 11.1 vs 84.7 ± 8.4, respectively; P = .041). A significant difference was found among BME grades at 4-year follow-up (grade 0: 84.7 ± 7.4, grade 1: 80.1 ± 10.5, grade 2: 74.0 ± 10.3, and grade 3: 67.5 ± 7.1; P = .035). A post hoc analysis showed significant differences between grades 0 and 2, 0 and 3, and 1 and 3 ( P = .041, .037, and .048, respectively). In addition, at 4-year follow-up, a significant correlation was noted between the FAOS and BME grade ( r = −0.453, P = .003) but not at 2-year follow-up ( r = −0.212, P = .178). Seventy-four percent of patients still had subchondral BME at 4-year follow-up after microfracture for OLTs. Conclusion: Patients with subchondral BME at midterm follow-up after microfracture for OLTs had worse clinical outcomes than those without subchondral BME. In addition, the degree of subchondral BME at midterm follow-up was correlated with clinical outcomes. However, at short-term follow-up, there were no significant differences in clinical outcomes based on both the presence and degree of BME, and no correlation was found between clinical outcomes and the degree of BME. The current study suggests that BME at short-term follow-up is a normal physiological reaction. However, BME at midterm follow-up after microfracture for OLTs may be pathological and is associated with poorer clinical outcomes.


2020 ◽  
Vol 102-B (2) ◽  
pp. 177-185 ◽  
Author(s):  
Chiao Yee Lim ◽  
Xingyu Liu ◽  
Fangzhou He ◽  
Haijie Liang ◽  
Yi Yang ◽  
...  

Aims To investigate the benefits of denosumab in combination with nerve-sparing surgery for treatment of sacral giant cell tumours (GCTs). Methods This is a retrospective cohort study of patients with GCT who presented between January 2011 and July 2017. Intralesional curettage was performed and patients treated from 2015 to 2017 also received denosumab therapy. The patients were divided into three groups: Cohort 1: control group (n = 36); cohort 2: adjuvant denosumab group (n = 9); and cohort 3: neo- and adjuvant-denosumab group (n = 17). Results There were 68 patients within the study period. Six patients were lost to follow-up. The mean follow-up was 47.7 months (SD 23.2). Preoperative denosumab was found to reduce intraoperative haemorrhage and was associated with shorter operating time for tumour volume > 200 cm3. A total of 17 patients (27.4%) developed local recurrence. The locoregional control rate was 77.8% (7/9) and 87.5% (14/16) respectively for cohorts 2 and 3, in comparison to 66.7% (24/36) of the control group. The recurrence-free survival (RFS) rate was significantly higher for adjuvant denosumab group versus those without adjuvant denosumab during the first two years: 100% vs 83.8% at one year and 95.0% vs 70.3% at two years. No significant difference was found for the three-year RFS rate. Conclusion Preoperative denosumab therapy was found to reduce intraoperative haemorrhage and was associated with shorter operating times. Adjuvant denosumab was useful to prevent early recurrence during the first two years after surgery. Cite this article: Bone Joint J 2020;102-B(2):177–185.


2012 ◽  
Vol 13 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Fabiana Santos Gonçalves ◽  
Carolina Dolabela Leal Castro ◽  
Audrey Cristina Bueno ◽  
Amanda Beatriz Dadah Aniceto de Freitas ◽  
Alysson Nogueira Moreira ◽  
...  

ABSTRACT Aim The aim of this randomized clinical trial was to compare the proximal contact of a silorane-based resin composite with a conventional methacrylate-based resin composite in class II restorations after a 6 months follow-up period. Materials and methods After obtaining informed consent, 33 patients were randomly allocated into a test group (Filtek P90/Adhesive System-3M ESPE) or control group (Filtek P60/ Adper SE Plus-3M ESPE), and 100 direct resin composite restorations (n = 50) were placed. A single operator performed the cavities and restorations. After rubber dam placement, a metal matrix and wooden wedge were placed. The restorative systems were applied according to the manufacturer's instructions. After 1 week, the restorations were finished and polished. The proximal contacts were assessed blindly and independently by two calibrated examiners (kW = 0.8) at the baseline and after 6 months according to a three-step grading criteria. Data were analyzed with the Mann-Whitney U-test and Wilcoxon signed Rank tests (α = 0.05). Results: After 6 months, 96% of the restoration contacts were present for evaluation. The frequencies of restorations classified as Bravo in control and test groups were 6 and 8% at the baseline, and 6.25 and 12.75% after 6 months. No significant difference was found between the restorative materials (p > 0.05; Mann-Whitney U-test) neither between baseline and 6 months period (p > 0.05; Wilcoxon signed Rank tests). Conclusion Both materials performed satisfactorily over 6 months follow-up period. Clinical significance The short-term clinical performance of a silorane-based resin composite in the proximal contacts of class II restorations was similar to the well-known methacrylate-based resin composite. How to cite this article Gonçalves FS, Castro CDL, Bueno AC, de Freitas ABDA, Moreira AN, Magalhães CS. The Shortterm Clinical Performance of a Silorane-based Resin Composite in the Proximal Contacts of Class II Restorations. J Contemp Dent Pract 2012;13(3):251-256.


2020 ◽  
Vol 33 (08) ◽  
pp. 838-846 ◽  
Author(s):  
Mustafa Akkaya ◽  
Mehmet Emin Şimşek ◽  
Safa Gürsoy ◽  
Nurdan Çay ◽  
Murat Bozkurt

AbstractThe objective of this study is to show the short-term clinical and radiological outcomes of concentrated bone marrow aspirate (CBMA) injection administered in combination with medial meniscus scaffold implantation. Twenty-three patients who received intra-articular CBMA injection in combination with polyurethane-based medial meniscus scaffold implantation were evaluated within the scope of this study. The International Knee Documentation Committee (IKDC) questionnaire and the Knee injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the results, and the visual analog scale was used to assess the pain scores. Magnetic resonance imaging (MRI) scans were obtained in the preoperative period and at postoperative months 1, 12, 24, and 36 to assess the scaffold position as well as chondral degeneration/damage in a comparative manner. MRI assessment was performed by using the modified Outerbridge scale for cartilage and the Genovese scoring system for the meniscal implant. Twenty-three patients who were included in the study were evaluated for a mean follow-up period of 38.3 months. Patients exhibited statistically significant improvement according to all scoring data from the preoperative period until the follow-up period. The mean postoperative extrusion at year 3 was 2.39 mm (distribution 2.30–2.56 mm). There was no significant difference in the distribution of the degree of chondral damage between the preoperative and 3-year follow-up periods. Four patients did not show any improvement nor had lower scores according to the assessment. Medial meniscus scaffold implantation combined with intra-articular CBMA injection resulted in a significant improvement in all functions and pain scores as well as a statistically significant clinical improvement in IKDC and KOOS values in the short-term follow-up. The Level of evidence for this study is IV.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0011
Author(s):  
Yoshiharu Shimozono ◽  
Eoghan Hurley ◽  
John Kennedy

Category: Ankle Introduction/Purpose: Subchondral bone marrow edema (BME) has been associated with articular cartilage loss, with the potential to be a negative prognostic indicator for clinical outcome following microfracture. However, no single study has investigated the influence of BME on clinical outcome following microfracture for osteochondral lesions of the talus (OLT) at mid-term follow-up. The purpose of this study was to clarify the influence of postoperative subchondral BME on the clinical outcome in patients treated with microfracture for OLT at both short- and mid-term. Methods: Patients who underwent microfracture between 2008 and 2013 were assessed at 2- and 4-year postoperative follow-up. BME was evaluated using magnetic resonance imaging (MRI), and the presence of subchondral BME was determined with fat-suppressed T2-weighted sequences. BME was graded on a 0-3 scale based on the relation to total talar volume as follows: 0, no BME; 1, <25% of talar volume; 2, 25%<, >50% of talar volume; 3, >50% of talar vome. Clinical outcomes were evaluated using the Foot and Ankle Outcome Scores (FAOS). The influence of postoperative subchondral BME on the clinical outcomes were evaluated as following; 1) the FAOS between the BME and the no BME groups were compared at 2 and 4 years post surgery, 2) the FAOS based on the BME grades were compared at each time point, and 3) correlation between the FAOS and BME grade was evaluated at each time point. Results: Forty-three (83%) of 52 eligible patients were included. No significant differences were found in FAOS between BME and no BME groups at 2-year follow-up (p=0.109), but there was a significant difference at 4-year follow-up (p = 0.041). A significant difference was found among BME grades at 4-year follow-up (p=0.035) (Table 1). A post hoc analysis showed significant differences between grade 0 and 2, 0 and 3, and 1 and 3 (p=0.041, 0.037 and 0.048, respectively). In addition, at 4-years follow-up, a significant correlation was noted between FAOS and BME grade (r= -0.453, p = 0.003) (Table 1), but not at 2-years (r = -0.212, p = 0.178). Seventy-four percent of patients still had subchondral BME at 4-year follow-up after microfracture for OLT. Conclusion: Patients with the presence of subchondral BME at mid-term follow-up after microfracture for OLT had worse clinical outcomes than those without subchondral BME. In addition, the degree of subchondral BME at mid-term follow-up was correlated with clinical outcome. However, in the short-term follow-up, there were no significant differences in clinical outcomes based on both the presence and degree of BME. The current study suggests that BME at short-term follow-up is a normal physiologic reaction. However, BME at mid-term following microfracture for OLT may be pathological, and is related to poorer clinical outcomes.


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