scholarly journals Reduction of epidural fibrosis after laminectomy in rabbits by omental free graft

2013 ◽  
Vol 58 (No. 1) ◽  
pp. 25-31 ◽  
Author(s):  
N. Brkljaca Bottegaro ◽  
J. Kos ◽  
B. Pirkic ◽  
O. Smolec ◽  
Z. Grabarevic ◽  
...  
Keyword(s):  
Foreign Body ◽  
Dura Mater ◽  
Foreign Body Reaction ◽  
Fibrous Tissue ◽  
Scar Tissue ◽  
Control Group ◽  
Epidural Fibrosis ◽  
Free Graft ◽  
Increased Risk ◽  
Experimental Group

Epidural fibrosis is an extradural scar tissue formed after a laminectomy procedure. It is associated with persistent pain after spinal surgery and an increased risk of complications during revision surgery. The aim of this study was to determine the preventive effects of local application of an omental free graft in minimising spinal epidural fibrosis in a rabbit laminectomy model. Twenty two rabbits were randomly divided in two groups, a control group of seven and an experimental group of 15 animals. A dorsal laminectomy at levels L<sub>1</sub> to L<sub>3 </sub>was performed on each rabbit of both groups. Prior to the laminectomy procedure, the animals from the experimental group were submitted to a laparotomy in order to obtain the free omental graft. The graft was then applied to the same animal at the dural deffect. All rabbits were euthanised six weeks after surgery and spine segments L<sub>1</sub> to L<sub>3</sub> were removed. Histological sections were evaluated for fibrosis intensity at the laminectomy level, the adhesion degree between dura mater and fibrous tissue and the presence of the foreign body reaction. A statistically significant correlation was established for the foreign body reaction presence and belonging to the group, which can be explained by the omental effects on inflammation reduction and healing promotion. The degree of adhesion between the dura mater and fibrous tissue and the intensity of the fibrous tissue at the laminectomy level were lower in the experimental group although the differences were not statistically significant. The use of free omental grafts is thus a promising technique in epidural fibrosis prevention.

Use of pimecrolimus to prevent epidural fibrosis in a postlaminectomy rat model

2009 ◽  
Vol 11 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Berker Cemil ◽  
Kagan Tun ◽  
Erkan Kaptanoglu ◽  
Figen Kaymaz ◽  
Banu Cevirgen ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Dura Mater ◽  
Inflammatory Diseases ◽  
Scar Tissue ◽  
Control Group ◽  
Epidural Fibrosis ◽  
Treatment Groups ◽  
Lumbar Level ◽  
Spinal Epidural ◽  
Preventive Effects

Object Epidural fibrosis is the scar tissue formed over the dura mater after a laminectomy. Extensive epidural fibrosis may be an important underlying cause of failed back syndrome. Pimecrolimus, an ascomycin derivative, is one of the new classes of immunomodulating macrolactams and was specifically developed for the treatment of inflammatory diseases. This study examined the preventive effects of the local application of pimecrolimus in minimizing spinal epidural fibrosis in a rat laminectomy model. Methods Thirty Wistar rats were divided into 3 equal groups: control, mitomycin C (MMC), and pimecrolimus groups. Each rat underwent a laminectomy at the L-3 lumbar level. In the experimental groups, a cotton pad soaked with MMC (0.5 mg/ml) or 5 mg pimecrolimus was placed on the exposed dura mater. No treatment was performed in the control group rats. Thirty days after surgery, the rats were killed and the dura mater thickness, epidural fibrosis, and arachnoidal involvement were quantified. Results The mean dura thickness was measured at 9.28 ± 3.39 μm in the MMC group and at 8.69 ± 2.32 μm in the pimecrolimus group, compared with 14.70 ± 4.14 μm in the control group. In addition, the epidural fibrosis and arachnoidal involvement were reduced significantly in the treatment groups compared with the control group. Conclusions In this animal model, it was shown that locally applied pimecrolimus effectively reduces epidural fibrosis and dural adherence in rats that underwent lumbar laminectomy. Mitomycin C was equally effective as pimecrolimus in reducing epidural fibrosis and dural adherence in this study.

The role of mitomycin C in reducing recurrence of epidural fibrosis after repeated operation in a laminectomy model in rats

2006 ◽  
Vol 4 (4) ◽  
pp. 329-333 ◽  
Author(s):  
Jin-Yul Lee ◽  
Werner Stenzel ◽  
Mario Löhr ◽  
Hartmut Stützer ◽  
Ralf-Ingo Ernestus ◽  
...  
Keyword(s):  
Side Effects ◽  
Mitomycin C ◽  
Fibrous Tissue ◽  
Scar Tissue ◽  
Lumbar Spine Surgery ◽  
Control Group ◽  
Epidural Fibrosis ◽  
The Reformation ◽  
Secondary Procedures

Object Extensive peridural fibrosis after lumbar spine surgery may contribute to poor outcome and recurrent symptoms leading to repeated operation. Secondary procedures are considerably hampered by the presence of scar tissue. Moreover, after excision of the peridural scar, the fibrous tissue may recur, leading to unsuccessful surgical outcome. Mitomycin C (MMC), an alkylating antibiotic substance isolated from Streptomyces caespitosus, potentially suppresses fibroblast proliferation after surgical intervention. The authors investigated the effect of MMC on the reformation of epidural fibrosis in a laminectomy model in rats. Methods Twenty-four Wistar rats underwent a repeated lumbar laminectomy 3 months after the first operation. In 12 rats, MMC in a concentration of 1 mg/ml was locally applied to the laminectomy site. No treatment was performed in the control group of the other 12 rats. All rats underwent clinical evaluation. Mobility ratings and any evidence of neurological deficit were recorded. Twelve weeks after the second operation, the animals were killed for histological examination. The extent of epidural fibrosis and dural adherence was evaluated. All MMC-treated animals showed reduced epidural scarring, compared with the control group. In nine MMC-treated rats (75%), dural adhesions were moderate. In contrast, all control sites showed dense epidural fibrosis with marked dural adherence. No side effects of the treatment were observed. Conclusions In this experimental study, MMC in a concentration of 1 mg/ml locally applied significantly reduced recurrence of epidural fibrosis and dural adhesions without any side effects after repeated spinal surgery in a laminectomy model in rats.

scholarly journals Foreign Body Reaction Associated With Artificial LARS Ligaments: A Retrieval Study

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881160 ◽  
Author(s):  
Zachary Paul Sinagra ◽  
Alan Kop ◽  
Moreica Pabbruwe ◽  
Jeremy Parry ◽  
Gavin Clark
Keyword(s):  
Foreign Body ◽  
Foreign Body Reaction ◽  
Fibrous Tissue ◽  
Case Series ◽  
Significant Degree ◽  
Level Of Evidence ◽  
Tissue Ingrowth ◽  
Artificial Ligaments ◽  
Clinically Significant ◽  
Improved Design

Background: Artificial ligaments have been developed and used in the treatment of ligamentous injuries since the 1970s. The early generation of artificial ligaments showed promising short-term results but resulted in high rates of rupture and inflammatory reaction in the surrounding tissues. Purpose: To determine whether the use of Ligament Augmentation and Reconstruction System (LARS) ligaments is associated with the development of intra-articular foreign body reaction. Study Design: Case series; Level of evidence, 4. Methods: LARS ligaments were explanted from 15 patients under 6 consultant orthopaedic surgeons at 8 surgical centers. Of these, 14 explanted samples were sent for macroscopic and histological analysis, with the 1 remaining sample sent for scanning electron microscopy, to assess for inflammatory change as well as the degree of fibrous tissue ingrowth. Results: We observed a foreign body reaction in 10 of 14 explanted LARS ligaments. Seven samples demonstrated fibrous tissue ingrowth, with 5 producing only focal or incomplete ingrowth. The 2 samples with extensive fibrous coverage were completely free of any foreign body reaction, while all 5 remaining samples with only focal or partial fibrous ingrowth were associated with at least some degree of harmful immune response. Conclusion: The LARS ligament is still associated with a clinically significant degree of foreign body reaction despite the LARS Company’s efforts to reduce complications through improved design. The development and completion of fibrous tissue ingrowth may work to reduce the occurrence of a foreign body reaction.

The Use of Particulated Juvenile Allograft Cartilage for the Repair of Porcine Articular Cartilage Defects

2019 ◽  
Vol 47 (10) ◽  
pp. 2308-2315 ◽  
Author(s):  
Yunong Ao ◽  
Zhong Li ◽  
Qi You ◽  
Chengchang Zhang ◽  
Liu Yang ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Statistical Difference ◽  
Fibrous Tissue ◽  
Cartilage Defects ◽  
Control Group ◽  
General View ◽  
Full Thickness ◽  
Femoral Trochlea ◽  
Articular Cartilage Defects ◽  
Experimental Group

Background: The repair of porcine articular cartilage defects by using particulated juvenile allograft cartilage (PJAC) has demonstrated good short-term clinical efficacy, but the repair process and mechanism have not been fully elucidated. Purpose: To study the efficacy of PJAC in repairing full-thickness cartilage defects and to provide an experimental basis for its clinical application. Study Design: Controlled laboratory study. Methods: Thirty Guizhou minipigs were randomly divided into an experimental group and control group. An 8-mm cylindrical full-thickness cartilage defect was created in the femoral trochlea of either knee in all minipigs. The experimental group received the PJAC transplantation (PJAC group; n = 15) and the control group received autologous cartilage chips (ACC group; n = 15). Five minipigs were euthanized at 1, 3, and 6 months in each group to obtain samples, which were evaluated by general view of the knee joint and histomorphometry of the chondral defect area (hematoxylin and eosin, safranin O). International Cartilage Repair Society (ICRS) II semiquantitative evaluation and collagen type II staining immunohistochemistry were also performed. Results: All 30 Guizhou minipigs were followed; there was no infection or incision healing disorder after the operation. At 1 month postoperatively, more hyaline cartilage was found in the ACC group (29.4%) compared with the PJAC group (20.1%) ( P < .05); there was no statistical difference between the 2 groups at 3 and 6 months after operation. The fibrocartilage content in the ACC group was significantly more than that in the PJAC group at 1 and 3 months postoperatively (27.4% vs 18.2% and 49.9% vs 41.1%, respectively; P < .05); significant differences disappeared at 6 months postoperatively. The PJAC group produced more fibrous tissue than the ACC group at 1 and 3 months postoperatively (60.1% vs 40.6% and 38.8% vs 24.4%, respectively; P < .05) but showed no statistical difference at 6 months postoperatively. Regarding the ICRS II scores, those of the ACC group were significantly better than the scores of the PJAC group in some subclasses at 3 and 6 months postoperatively. The positive rates of immunohistochemical staining in the ACC group were higher at 1 and 3 months postoperatively than those in the PJAC group (54.2% vs 37.8% and 46.4% vs 34.4%, respectively; P < .05). The difference was not statistically significant between the 2 groups at 6 months postoperatively. Conclusion: Both PJAC and ACC can produce a good repair effect on cartilage defects. At 1 and 3 months postoperatively, ACC resulted in better outcomes than PJAC, but there was no statistical difference in the repair effect between the 2 techniques at 6 months postoperatively. Clinical Relevance: Based on this animal experiment, further clinical studies are needed to investigate PJAC as a possible alternative first-line treatment for cartilage defects.

Effect of education on anxiety and depression in patients with myocardial infarction

2011 ◽  
Vol 26 (S2) ◽  
pp. 133-133
Author(s):  
N. Aghakhani
Keyword(s):  
Myocardial Infarction ◽  
Medical Science ◽  
Anxiety And Depression ◽  
Control Group ◽  
Face To Face ◽  
Risk Of Death ◽  
Increased Risk ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Experimental Group

IntroductionAbout 65 percent of patients with myocardial infarction experience mental and emotional problems like depression and anxiety that causes delay in the return to work, decreased quality of life and increased risk of death.The purpose of this study was to determine the effect of education on anxiety and depression in patients with myocardial infarction in Urmia hospitals in 2009.MethodsThis study was a quasi-experimental study that compares the effect of education on anxiety and depression in patients with myocardial infarction in the Urmia University of medical science hospitals. 124 patients were selected randomly and divided into two groups. The experimental group was educated through face to face training and educational booklet. Control group did not receive any intervention.Level of anxiety and depression was evaluated by using HADS questionnaire at 3 intervals after 48 hours of admission, discharge day and 2 months after discharge.ResultsThere was no significant difference between control and experimental groups before the intervention, But after the intervention, anxiety and depression in the experimental group was significantly less than controls, p < 0.05.ConclusionConsidering the beneficial results obtained from education on reducing anxiety and depression in patients with myocardial infarction, it should be one of the health care goals.

scholarly journals Mechanical matching of implant to host minimises foreign body reaction

2019 ◽  
Author(s):  
Alejandro Carnicer-Lombarte ◽  
Damiano G. Barone ◽  
Ivan B. Dimov ◽  
Russell S. Hamilton ◽  
Malwina Prater ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Body Reaction ◽  
Scar Tissue ◽  
Host Tissue ◽  
Medical Implants ◽  
Implant Surface ◽  
Biomedical Implant ◽  
Manufacturing Techniques ◽  
Implant Coatings

AbstractMedical implants offer a unique and powerful therapeutic approach in many areas of medicine. However, their lifetime is often limited as they may cause a foreign body reaction (FBR) leading to their encapsulation by scar tissue1–4. Despite the importance of this process, how cells recognise implanted materials is still poorly understood5, 6. Here, we show how the mechanical mismatch between implants and host tissue leads to FBR. Fibroblasts and macrophages, which are both crucially involved in mediating FBR, became activated when cultured on materials just above the stiffness found in healthy tissue. Coating implants with a thin layer of hydrogel or silicone with a tissue-like elastic modulus of ∼1 kPa or below led to significantly reduced levels of inflammation and fibrosis after chronic implantation both in peripheral nerves and subcutaneously. This effect was linked to the nuclear localisation of the mechanosensitive transcriptional regulator YAP in vivo. Hence, we identify the mechanical mismatch between implant and tissue as a driver of FBR. Soft implant coatings matching the mechanical properties of host tissue minimized FBR and may be used as a novel therapeutic strategy to improve long-term biomedical implant stability without extensive modification of current implant manufacturing techniques, thus facilitating clinical translation.One sentence summaryForeign body reaction to medical implants can be avoided by matching the stiffness of the implant surface to that of the host tissue.

scholarly journals Autologous omentum transposition for regeneration of a renal injury model in rats

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Tayfun Bilgiç ◽  
Ümit İnce ◽  
Fehmi Narter
Keyword(s):  
Foreign Body ◽  
Foreign Body Reaction ◽  
Primary Repair ◽  
Healing Process ◽  
Kidney Injury ◽  
Control Group ◽  
Albino Rats ◽  
Loss Of Function ◽  
Omentum Transposition ◽  
Process Completion

Abstract Background After renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. This study aimed to evaluate the effect of autologous omentum flaps on injured renal tissues in a rat model. Methods A total of 30 Wistar albino rats were included and randomly divided equally into a control group and four intervention groups. Iatrogenic renal injuries were repaired using a surgical technique (primary repair 1 group and primary repair 2 group) or transposition of the autologous omentum (omentum repair 1 group and omentum repair 2 group). Blood samples were taken preoperatively and on the 1st and 7th postoperative days in all groups and on the 18th postoperative day in the control and two intervention groups. All rats were sacrificed on the 7th or 18th day postoperatively, and their right kidneys were taken for histopathological evaluation. Results The mean urea level significantly decreased from day 1 to day 7 and from day 1 to day 18 in the omentum repair 2 group (P = 0.005 and P = 0.004, respectively). There were no other significant changes in urea or creatinine levels within the intervention groups (P > 0.05). There was no significant correlation between the urea and creatinine levels and the histological scores (P > 0.05). The primary repair 1 and 2 groups had significantly higher median granulation and inflammation scores in the kidney specimen than the control and omentum repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). The completion score for the healing process in the kidney specimen was significantly higher in the omentum repair groups than in the primary repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). Granulation degree in the kidney specimen was strongly and positively correlated with the inflammation degree (r = 0.824, P < 0.001) and foreign body reaction in the kidney specimen (r = 0.872, P < 0.001) and a strong and negative correlation with the healing process completion score in the kidney (r = − 0.627, P = 0.001). Inflammation degree in the kidney specimen was strongly and positively correlated with the foreign body reaction in the kidney specimen (r = 0.731, P = 0.001) and strongly and negatively correlated with the healing process completion score in the kidney specimen (r = − 0.608, P = 0.002). Conclusion Autologous omentum tissue for kidney injury repair attenuated inflammation and granulation. Additionally, the use of omental tissue to facilitate healing of kidney injury may theoretically lead to a more effective healing process and reduced fibrosis and tissue and function loss.

‘You are Okay’: Effects of a support and educational program for children with mild intellectual disability and their parents with mental health concerns

2020 ◽  
pp. 174462952095376
Author(s):  
Ivon Riemersma ◽  
F Van Santvoort ◽  
KTM Van Doesum ◽  
CMH Hosman ◽  
JMAM Janssens ◽  
...  
Keyword(s):  
Mental Health ◽  
Group Care ◽  
Behavioural Problems ◽  
Control Group ◽  
Emotional And Behavioural Problems ◽  
Health Concerns ◽  
Increased Risk ◽  
Intermediate Outcomes ◽  
Mental Health Concerns ◽  
Experimental Group

Background: Children with mild intellectual disabilities and emotional and behavioural problems whose parents have mental health concerns are at an increased risk of developing problems themselves. This study analysed the effectiveness of the ‘You are Okay’-program aimed to support these children and parents and to reduce the risk of problem development in children. Method: A quasi-experimental design was used to compare the experimental group (‘care as usual’ and ‘You are Okay’) with the control group (‘care as usual’) on the main outcome of emotional and behavioural problems and proposed intermediate outcomes. Results: Children in the experimental group reported a significant medium to large decrease in emotional and behavioural problems compared to the control group. The effects on the intermediate outcomes were non-significant. Conclusions: This specific study population comprising a vulnerable group of children seems to benefit from this specially adapted ‘You are Okay’-program. More research is necessary to draw further conclusions.

Constriction of the Maxillary Dental Arch by Mucoperiosteal Denudation of the Palate

2002 ◽  
Vol 39 (4) ◽  
pp. 425-431 ◽  
Author(s):  
Takenori Kim ◽  
Hiroyuki Ishikawa ◽  
Soowon Chu ◽  
Asako Handa ◽  
Junichiro Iida ◽  
...  
Keyword(s):  
Laser Scanning ◽  
Scar Tissue ◽  
Confocal Laser Scanning Microscope ◽  
Confocal Laser ◽  
Control Group ◽  
Dental Arch ◽  
Lateral Growth ◽  
Two Factors ◽  
Palatal Bone ◽  
Experimental Group

Objective This study examined the influence of two factors in the constriction of the maxillary dental arch by mucoperiosteal denudation of the palate: (1) inhibition of lateral growth and (2) medial inclination of teeth. Method Thirty-five male 20-day-old Wistar rats were divided into experimental and control groups. The experimental group had bilateral mucoperiosteum excised in the lateral one third of the palate. Methyl methacrylate resin–embedded frontal sections were prepared from both groups after alternate weekly injections of tetracycline and calcein in the dorsal subcutaneous area. The sections were observed and photographed under either a confocal laser scanning microscope, a fluorescence microscope, or both. Chronological changes in lateral palatal growth, maxillary dental arch width, and inclination of the upper first molars were examined up to 8 weeks after the operation. Paraffin-embedded frontal sections were also made and stained with Elastica van Gieson stain. Results The scar tissue formed on the rat palate by the mucoperiosteal denudation was tightly connected to the palatal bone and teeth. The intervals between the labeling lines of the experimental group were less definite during the first 2 weeks after the operation. Increments of palatal and maxillary dental arch widths were smaller in the experimental group than in the control group. The upper first molars in the control group gradually inclined laterally, whereas those in the experimental group inclined medially with age. Conclusion Medial inclination of teeth is a stronger influence than inhibition of lateral growth on constriction of the rat maxillary dental arch.

scholarly journals Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study

2015 ◽  
Vol 22 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Semra Isık ◽  
M. Özgür Taşkapılıoğlu ◽  
Fatma Oz Atalay ◽  
Seref Dogan
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
High Molecular Weight ◽  
Sham Group ◽  
Fibrous Tissue ◽  
Fibroblast Cell ◽  
Control Group ◽  
Epidural Fibrosis ◽  
Sprague Dawley ◽  
Positive Effects

OBJECT Epidural fibrosis is nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in the intimate vicinity of and around the origin of the radicular sheath. The formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, the formation of scar tissue may cause problems during reoperation. The authors aimed to investigate the effects of cross-linked high-molecular-weight hyaluronic acid (HA), an HA derivative known as HA gel, on the prevention of epidural fibrosis by using histopathological and biochemical parameters. METHODS Fifty-six adult female Sprague-Dawley rats were evaluated. The rats were divided into 4 groups. Rats in the sham group (n = 14) underwent laminectomy and discectomy and received no treatment; rats in the control group (n = 14) underwent laminectomy and discectomy and received 0.9% NaCl treatment in the surgical area; rats in the HA group (n = 14) received HA treatment at the surgical area after laminectomy and discectomy; and rats in the HA gel group (n = 14) underwent laminectomy and discectomy in addition to receiving treatment with cross-linked high-molecular-weight HA in the surgical area. All rats were decapitated after 4 weeks, and the specimens were evaluated histopathologically and biochemically. The results were statistically compared using the Mann-Whitney U-test. RESULTS Compared with the sham and control groups, the HA and HA gel groups showed significantly lower fibroblast cell density and tissue hydroxyproline concentrations (p < 0.05). There was statistically significant lower dural adhesion and foreign-body reaction between the control and HA gel groups (p < 0.05). Granulation tissue and epidural fibrosis were significantly lower in the HA and HA gel groups compared with the sham group (p < 0.05). There were no significant differences in any histopathological parameters or biochemical values between Groups 3 and 4 (p > 0.05). CONCLUSIONS Cross-linked high-molecular-weight HA had positive effects on the prevention of epidural fibrosis and the reduction of fibrotic tissue density. The efficacy of this agent should also be verified in further experimental and clinical studies.

Sign in / Sign up

Export Citation Format

Share Document