Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model

2021 ◽  
pp. 036354652199800
Author(s):  
Jani Puhakka ◽  
Teemu Paatela ◽  
Eve Salonius ◽  
Virpi Muhonen ◽  
Anna Meller ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Scoring System ◽  
Femoral Condyle ◽  
Intraclass Correlation ◽  
Type Iii Collagen ◽  
Intrarater Reliability ◽  
Scoring Method ◽  
International Cartilage Repair Society ◽  
Made In

Background: The International Cartilage Repair Society (ICRS) score was designed for arthroscopic use to evaluate the quality of cartilage repair. Purpose: To evaluate the reliability of the ICRS scoring system using an animal cartilage repair model. Study Design: Controlled laboratory study. Methods: A chondral defect with an area of 1.5 cm2 was made in the medial femoral condyle of 18 domestic pigs. Five weeks later, 9 pigs were treated using a novel recombinant human type III collagen/polylactide scaffold, and 9 were left to heal spontaneously. After 4 months, the pigs were sacrificed, then 3 arthroscopic surgeons evaluated the medial femoral condyles via video-recorded simulated arthroscopy using the ICRS scoring system. The surgeons repeated the evaluation twice within a 9-month period using their recorded arthroscopy. Results: The porcine cartilage repair model produced cartilage repair tissue of poor to good quality. The mean ICRS total scores for all observations were 6.6 (SD, 2.6) in arthroscopy, 5.9 (SD, 2.7) in the first reevaluation, and 6.2 (SD, 2.8) in the second reevaluation. The interrater reliability with the intraclass correlation coefficient (ICC) for the ICRS total scores (ICC, 0.46-0.60) and for each individual subscore (ICC, 0.26-0.71) showed poor to moderate reliability. The intrarater reliability with the ICC also showed poor to moderate reliability for ICRS total scores (ICC, 0.52-0.59) and for each individual subscore (ICC, 0.29-0.58). A modified Bland-Altman plot for the initial arthroscopy and for the 2 reevaluations showed an evident disagreement among the observers. Conclusion: In an animal cartilage repair model, the ICRS scoring system seems to have poor to moderate reliability. Clinical Relevance: Arthroscopic assessment of cartilage repair using the ICRS scoring method has limited reliability. We need more objective methods with acceptable reliability to evaluate cartilage repair outcomes.

First-in-Human Pilot Study of Implantation of a Scaffold-Free Tissue-Engineered Construct Generated From Autologous Synovial Mesenchymal Stem Cells for Repair of Knee Chondral Lesions

2018 ◽  
Vol 46 (10) ◽  
pp. 2384-2393 ◽  
Author(s):  
Kazunori Shimomura ◽  
Yukihiko Yasui ◽  
Kota Koizumi ◽  
Ryota Chijimatsu ◽  
David A. Hart ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Magnetic Resonance ◽  
Cartilage Repair ◽  
Femoral Condyle ◽  
Chondral Lesions ◽  
Repair Tissue ◽  
Biopsy Specimens ◽  
Implantation Procedure

Background: Articular cartilage has limited healing capacity, owing in part to poor vascularity and innervation. Once injured, it cannot be repaired, typically leading to high risk for developing osteoarthritis. Thus, cell-based and/or tissue-engineered approaches have been investigated; however, no approach has yet achieved safety and regenerative repair capacity via a simple implantation procedure. Purpose: To assess the safety and efficacy of using a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stem cells (MSCs) for effective cartilage repair. Study Design: Case series; Level of evidence, 4. Methods: Five patients with symptomatic knee chondral lesions (1.5-3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove were included. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC that matched the lesion size. The TECs were then implanted into chondral defects without fixation and assessed up to 24 months postoperatively. The primary outcome was the safety of the procedure. Secondary outcomes were self-assessed clinical scores, arthroscopy, tissue biopsy, and magnetic resonance image–based estimation of morphologic and compositional quality of the repair tissue. Results: No adverse events were recorded, and self-assessed clinical scores for pain, symptoms, activities of daily living, sports activity, and quality of life were significantly improved at 24 months after surgery. Secure defect filling was confirmed by second-look arthroscopy and magnetic resonance imaging in all cases. Histology of biopsy specimens indicated repair tissue approaching the composition and structure of hyaline cartilage. Conclusion: Autologous scaffold-free TEC derived from synovial MSCs may be used for regenerative cartilage repair via a sutureless and simple implantation procedure. Registration: 000008266 (UMIN Clinical Trials Registry number).

scholarly journals Cartilage Repair Capacity within a Single Full-Thickness Chondral Defect in a Porcine Autologous Matrix-Induced Chondrogenesis Model Is Affected by the Location within the Defect

Cartilage ◽  
2021 ◽  
pp. 194760352110309
Author(s):  
E. Salonius ◽  
A. Meller ◽  
T. Paatela ◽  
A. Vasara ◽  
J. Puhakka ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Cartilage Defect ◽  
Femoral Condyle ◽  
Cartilage Defects ◽  
Lateral Part ◽  
Type Iii Collagen ◽  
Full Thickness ◽  
Chondral Defect ◽  
Repair Capacity ◽  
Biomaterial Scaffold

Objective Large articular cartilage defects are a challenge to regenerative surgery. Biomaterial scaffolds might provide valuable support for restoration of articulating surface. The performance of a composite biomaterial scaffold was evaluated in a large porcine cartilage defect. Design Cartilage repair capacity of a biomaterial combining recombinant human type III collagen (rhCo) and poly-(l/d)-lactide (PLA) was tested in a porcine model. A full-thickness chondral defect covering the majority of the weightbearing area was inflicted to the medial femoral condyle of the right knee. Spontaneous cartilage repair and nonoperated healthy animals served as controls. The animals were sacrificed after a 4-month follow-up. The repair tissue was evaluated with the International Cartilage Repair Society (ICRS) macroscopic score, ICRS II histological score, and with micro-computed tomography. Additionally, histopathological evaluation of lymph nodes and synovial samples were done for toxicological analyses. Results The lateral half of the cartilage defect in the operated groups showed better filling than the medial half. The mean overall macroscopic score for the rhCo-PLA, spontaneous, and nonoperated groups were 5.96 ± 0.33, 4.63 ± 0.42, and 10.98 ± 0.35, respectively. The overall histological appearance of the specimens was predominantly hyaline cartilage in 3 of 9 samples of the rhCo-PLA group, 2 of 8 of the spontaneous group, and 9 of 9 of the nonoperated group. Conclusions The use of rhCo-PLA scaffold did not differ from spontaneous healing. The repair was affected by the spatial properties within the defect, as the lateral part of the defect showed better repair than the medial part, probably due to different weightbearing conditions.

scholarly journals The New Jersey Bowel Preparation Scale: A More Objective and Detailed Scoring System for Screening Colonoscopies

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Qasim Salimi ◽  
Thayer Nasereddin ◽  
Neel Patel ◽  
Reza Hashemipour ◽  
Augustine Tawadros ◽  
...  
Keyword(s):  
New Jersey ◽  
Bowel Preparation ◽  
Scoring System ◽  
Intraclass Correlation ◽  
Scoring Systems ◽  
University Hospital ◽  
Screening Colonoscopy ◽  
Single Center ◽  
Hospital Patients

Goals. The goal of this study was to develop an objective and detailed scoring system to assess the quality of bowel preparation. Background. The quality of bowel preparation impacts the success of the colonoscopy. We developed and compared a new bowel preparation scoring system, the New Jersey Bowel Preparation Scale (NJBPS), with existing systems that are limited by a lack of detail and objectivity in the Boston Bowel Preparation Scale (BBPS) and the Ottawa Bowel Preparation Scale (OBPS). Methods. This was a single-center, prospective, dual-observer study performed at Rutgers New Jersey Medical School University Hospital. Patients who were at medium risk for colorectal cancer and undergoing outpatient screening colonoscopy were enrolled in the study, and their bowel preparation was assessed separately by an attending and a fellow using each of the bowel preparation scoring systems. Results. 98 patients were analyzed in the study, of which 59% were female. Most of the patient population was African American (65%) or Hispanic (25%). The average age of the patient was 60 years. Chi-squared analysis using SPSS software revealed intraclass correlation coefficient values between attending and fellow scores for each scale. The NJBPS had the highest value at 0.988, while the BBPS and OBPS had values of 0.883 and 0.894. Limitations. Single-center study. Conclusions. The NJBPS and BBPS scores demonstrated a statistically significant agreement with each other. Overall, there was good interobserver agreement for all three scoring systems when comparing attendings to fellows for the same scoring system. However, the NJBPS possessed a stronger correlation.

scholarly journals Development of a radiographic scoring system for new bone formation in gout

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Chang-Nam Son ◽  
Ken Cai ◽  
Sarah Stewart ◽  
John Ferrier ◽  
Karen Billington ◽  
...  
Keyword(s):  
Bone Formation ◽  
Scoring System ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Scoring Systems ◽  
Joint Analysis ◽  
New Bone Formation ◽  
Scoring Method ◽  
Tophaceous Gout ◽  
Ct Measurements

Abstract Background Features of new bone formation (NBF) are common in tophaceous gout. The aim of this project was to develop a plain radiographic scoring system for NBF in gout. Methods Informed by a literature review, scoring systems were tested in 80 individual 1st and 5th metatarsophalangeal joints. Plain radiography scores were compared with computed tomography (CT) measurements of the same joints. The best-performing scoring system was then tested in paired sets of hand and foot radiographs obtained over 2 years from an additional 25 patients. Inter-reader reproducibility was assessed using intraclass correlation coefficients (ICC). NBF scores were correlated with plain radiographic erosion scores (using the gout-modified Sharp-van der Heijde system). Results Following a series of structured reviews of plain radiographs and scoring exercises, a semi-quantitative scoring system for sclerosis and spur was developed. In the individual joint analysis, the inter-observer ICC (95% CI) was 0.84 (0.76–0.89) for sclerosis and 0.81 (0.72–0.87) for spur. Plain radiographic sclerosis and spur scores correlated with CT measurements (r = 0.65–0.74, P < 0.001 for all analyses). For the hand and foot radiograph sets, the inter-observer ICC (95% CI) was 0.94 (0.90–0.98) for sclerosis score and 0.76 (0.65–0.84) for spur score. Sclerosis and spur scores correlated highly with plain radiographic erosion scores (r = 0.87 and 0.71 respectively), but not with change in erosion scores over 2 years (r = −0.04–0.15). Conclusion A semi-quantitative plain radiographic scoring method for the assessment of NBF in gout is feasible, valid, and reproducible. This method may facilitate consistent measurement of NBF in gout.

A critical appraisal of the quality of glioma imaging guidelines using the AGREE II tool: A EuroAIM initiative.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13553-e13553
Author(s):  
Sotirios Bisdas ◽  
Valeria Romeo ◽  
Arnaldo Stanzione ◽  
Lorenzo Ugga ◽  
Renato Cuocolo ◽  
...  
Keyword(s):  
Public Involvement ◽  
Critical Appraisal ◽  
Intraclass Correlation ◽  
Patient And Public Involvement ◽  
Agree Ii ◽  
Agree Ii Instrument ◽  
Good Agreement ◽  
Made In ◽  
Agree Ii Tool

e13553 Background: Following the EuroAIM initiative to assess the quality of medical imaging guidelines by using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, we aimed to evaluate the quality of the current imaging guidelines in patients with gliomas. Methods: A literature search was conducted to identify eligible imaging guidelines considered in the management of adult patients with gliomas. The selected guidelines were evaluated using the AGREE II instrument by four independent appraisers. The agreement among the four appraisers was estimated using the intraclass correlation coefficient (ICC) analysis. Results: Seven guidelines were selected for the appraisal. Six out of the seven guidelines showed an average level of quality with only one showing a low quality. The highest scores were found in Domain 1 “Scope and purpose” (mean score = 81.2%) and Domain 4 “Clarity of presentation” (mean score = 77.6%). The remaining domains showed a low level of quality and, in particular, Domain 5 “Applicability” was the most critical with a mean score of 41.7%. The ICC analysis showed a very good agreement among the four appraisers with ICC values ranging from 0.907 to 0.993. Conclusions: The available guidelines on glioma imaging emerged as of average quality according to the AGREE II tool analysis. Based on these results, further efforts should be made in order to involve different professional bodies and stakeholders and increase patient and public involvement in any future guideline drafting as well as to improve the applicability of these guidelines into the clinical practice.

A New Histology Scoring System for the Assessment of the Quality of Human Cartilage Repair: ICRS II

2010 ◽  
Vol 38 (5) ◽  
pp. 880-890 ◽  
Author(s):  
Pierre Mainil-Varlet ◽  
Boudewijn Van Damme ◽  
Dobrila Nesic ◽  
Gunnar Knutsen ◽  
Rita Kandel ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Scoring System ◽  
Human Cartilage

COMPARISION OF DENTAL SCORING SYSTEM WITH RADIOGRAPHIC SKELETAL SYSTEM IN AGE ESTIMATION

JKCD ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 9-11
Author(s):  
Sadaf Ambreen
Keyword(s):  
Age Estimation ◽  
Scoring System ◽  
Skeletal Age ◽  
Chronological Age ◽  
Age Group ◽  
Dental Age ◽  
Scoring Method ◽  
Cross Sectional ◽  
Study Results ◽  
Male Subjects

Objectives: To compare Demirjian Dental scoring method with Greulich-Pyle (GP) Skeletal method of age estimation in pubertal children. Materials and Methods: Sample of the study included 267 male healthy subjects of 11-16 years of age group.. Demirjian Scoring system was utilized to evaluate the orthopantomograms to assess their Dental age and the Hand-Wrist radiographs were analyzed to calculate the skeletal age by utilizing GP atlas. Chronological age was obtained from the date of birth of the subject .Both methods were compared with one another and with the chronological age. It was a cross-sectional study and only healthy male subjects without any clinical abnormalities were included in the study. Results: A total of 267 male subjects of 11-16 years of age group were assessed by Demirjian and Greulich Pyle Methods. Both were compared with Chronological Age. Data obtained was statistically analyzed and the Student “t” test was applied in the study population. The mean difference between Chronolgical age and dental age was 0.69years and that of chronological age and skeletal age was 0.87 years. It was observed from dental age assessment that it does not differ much from the skeletal age. Conclusion: It was concluded that Demirjian method of Age Estimation is more precise than Greulich Pyle method of Age Estimation. Furthermore both methods can be used selectively in Medicolegal cases to access bone age which can be easily correlated to chronological age.

Reuse of Sludge from Pulp and Paper Industry Pilot and Full Scale Applications

1993 ◽  
Vol 28 (2) ◽  
pp. 17-26 ◽  
Author(s):  
V. Eroǧlu ◽  
A. M. Saatçi
Keyword(s):  
Economic Analysis ◽  
Paper Industry ◽  
Pulp And Paper Industry ◽  
Pulp And Paper ◽  
Full Scale ◽  
Primary Sludge ◽  
Recent Advances ◽  
Made In

Recent advances made in the reuse of pulp and paper industry sludges in hardboard production are explained. Data obtained from pilot and full-scale plants using primary sludge of a pulp and paper industry as an additive in the production of hardboard is presented. An economic analysis of the reuse of pulp and paper primary sludge in hardboard manufacturing is given. The quality of the hardboard produced is tested and compared with the qualities of the hardboard produced by the same plant before the addition of primary sludge. The hardboard with primary sludge additive has been used in Turkey for about a year in the manufacturing of office and home furniture. The results are very satisfactory when the primary sludge is used at 1/4 ratio.

scholarly journals Determination of Environmental Factors for the Implementation of the Exploitability Index in Industrial Aggregate Mining Using Multi-Criteria Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 196
Author(s):  
Julio Manuel de Luis-Ruiz ◽  
Benito Ramiro Salas-Menocal ◽  
Gema Fernández-Maroto ◽  
Rubén Pérez-Álvarez ◽  
Raúl Pereda-García
Keyword(s):  
Environmental Factors ◽  
Environmental Factor ◽  
Human Life ◽  
Accurate Estimation ◽  
Analytic Hierarchy ◽  
Main Components ◽  
Hierarchy Process ◽  
Made In

The quality of human life is linked to the exploitation of mining resources. The Exploitability Index (EI) assesses the actual possibilities to enable a mine according to several factors. The environment is one of the most constraining ones, but its analysis is made in a shallow way. This research is focused on its determination, according to a new preliminary methodology that sets the main components of the environmental impact related to the development of an exploitation of industrial minerals and its weighting according to the Analytic Hierarchy Process (AHP). It is applied to the case of the ophitic outcrops in Cantabria (Spain). Twelve components are proposed and weighted with the AHP and an algorithm that allows for assigning a normalized value for the environmental factor to each deposit. Geographic Information Systems (GISs) are applied, allowing us to map a large number of components of the environmental factors. This provides a much more accurate estimation of the environmental factor, with respect to reality, and improves the traditional methodology in a substantial way. It can be established as a methodology for mining spaces planning, but it is suitable for other contexts, and it raises developing the environmental analysis before selecting the outcrop to be exploited.

scholarly journals Downregulation of exosomal let-7d and miR-16 in idiopathic pulmonary fibrosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Piera Soccio ◽  
Massimo Conese ◽  
Lucia Catucci ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Therapy Response ◽  
Down Regulation ◽  
Cross Sectional ◽  
Exosomal Mirnas ◽  
Different Types ◽  
Sectional Analysis ◽  
Made In

Abstract Background Idiopathic Pulmonary Fibrosis (IPF) is a degenerative interstitial lung disease with both a poor prognosis and quality of life once the diagnosis is made. In the last decade many features of the disease have been investigated to better understand the pathological steps that lead to the onset of the disease and, moreover, different types of biomarkers have been tested to find valid diagnostic, prognostic and therapy response predictive ones. In the complexity of IPF, microRNA (miRNAs) biomarker investigation seems to be promising. Methods We analysed the expression of five exosomal miRNAs supposed to have a role in the pathogenesis of the disease from serum of a group of IPF patients (n = 61) and we compared it with the expression of the same miRNAs in a group of healthy controls (n = 15). Results In the current study what emerged is let-7d down-regulation and, unexpectedly, miR-16 significant down-regulation. Moreover, through a cross-sectional analysis, a clustering of the expression of miR-16, miR-21 and miR-26a was found. Conclusions These findings could help the individuation of previously unknown key players in the pathophysiology of IPF and, most interestingly, more specific targets for the development of effective medications.

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