scholarly journals Тransplantation of autologous stem cells, obtained from adipose tissue, in complex treatment of chronic ischemia of the lower extremities

2018 ◽  
Vol 85 (12) ◽  
pp. 30-34
Author(s):  
V. G. Mishalov ◽  
N. Yu. Litvinova ◽  
O. I. Kefeli-Yanovska ◽  
V. A. Chernyak ◽  
D. E. Dubenko ◽  
...  
Keyword(s):  
Stem Cells ◽  
Lower Extremities ◽  
Walking Distance ◽  
Complex Treatment ◽  
Critical Ischemia ◽  
Simultaneous Application ◽  
Group I ◽  
Autologous Mesenchymal Stem Cells ◽  
One Year

Objective. To investigate the efficacy of application of autologous mesenchymal stem cells (AMSC) in treatment of patients, suffering critical ischemia of the lower extremities (CILE). Маterials and methods. In 2012 - 2015 yrs there was conducted the treatment of 41 patients, suffering CILE: 22 (53.7%) - men, and 19 (46.3%) - women. In the Group I (the main) 21 (51.2%) patients have had obtained a standard course of treatment, using AMSC. In the Group II (the control one) 20 (49.8%) patients have obtained a standard course of conservative treatment, using prostaglandins of group Е1 (PGЕ1). The results were investigated, measuring ankle-brachial pressure index, and the indices of a laser duplex flowmetry and a walking distance. Results. During a one-year follow-up a trustworthy enhancement of microcirculation index was registered in the patients, who were treated, using AMSC, comparing with the patients, who obtained a course of therapy of PGЕ1 (р=0.037). Positive dynamics of the microcirculation index while a PGЕ1application was observed during (1.8 ± 0.3) mo, аnd while application of AMSC the microcirculation index have been enhanced trustworthily in (2.7 ± 0.4) mo and persisted during one-year of follow-up. Conclusion. Development of therapeutic effect in groups of patients, who were treated with AMSC and PGЕ1, did not occur simultaneously, thus , a complex treatment with simultaneous application of both methods and conduction of a dosed physical training may be considered a rational option.

scholarly journals Indirect revascularization in patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus

2021 ◽  
Vol 88 (3-4) ◽  
pp. 21-27
Author(s):  
Yu. V. Ivanova ◽  
I. A. Kryvoruchko ◽  
V. A. Prasol ◽  
K. V. Miasoiedov ◽  
S. A. Andreieshchev
Keyword(s):  
Diabetes Mellitus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Ankle Brachial Index ◽  
Lower Extremities ◽  
Critical Ischemia ◽  
Diabetes Mellitus Type Ii ◽  
Indirect Revascularization ◽  
Autologous Mesenchymal Stem Cells

Objective. Determination of clinical efficacy of the mesenchymal stem cells transplantation in patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus. Materials and methods. There were examined 11 patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus Type II with purulent-necrotic processes of the foot, in whom conditions for the direct revascularization of extremity were absent. Microbiological monitoring for the wound discharge, determination of the ankle brachial index and transcutaneous oximetry was performed. The technology elaborated have consisted of two stages. On the first of them a purulent focus sanation (in all the patients the distal amputations of the foot, preserving arterial arch) was done. On the second stage the therapy of the wounds was conducted, using negative pressure, injections of cellular suspension (mesenchymal stem cells) while applying long fine cannula under aponeurosis into the muscles along obliterated vessels in the (10 ± 5) ml quantity with subsequent closure of the wound surface, using fibroblastic matrix. Results. In a year after the treatment critical ischemia in 1 patient was noted, the ischemia Grade III - in 3, and in 7 a IIB Grade have persisted. Conclusion. Performance of indirect revascularization, using autologous mesenchymal stem cells, constitutes an effective and secure procedure.

RENAL AMYLOIDOSIS RESULTING FROM A CHRONICALLY INFECTED BURN

PEDIATRICS ◽  
1963 ◽  
Vol 32 (5) ◽  
pp. 888-894
Author(s):  
Saul Hoffman ◽  
Bernard E. Simon ◽  
Robert A. Fischel ◽  
Donald Gribetz
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Clinical Improvement ◽  
Short Duration ◽  
Unusual Case ◽  
White Male ◽  
Lower Extremities ◽  
Renal Amyloidosis ◽  
One Year

An interesting and unusual case of an 11-year-old white male with chronically infected burns of his lower extremities who developed amyloidosis and the nephrotic syndrome is reported. The case is considered from the following aspects: (1) the rarity of amyloidosis in burns, (2) the short duration between the onset of the primary disease and the amyloidosis, (3) the age of the patient, and (4) the striking clinical improvement of the renal manifestations after the treatment of the burn. The treatment of the burns, using homografts, and the importance of renal biopsy in the diagnosis and follow-up are also discussed. Addendum: A third renal biopsy was performed in August, 1963, about one year following the second one. The amount of amyloid seen in the glomeruli did not seem to have diminished.

scholarly journals NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

2020 ◽  
Vol 18 (6) ◽  
pp. 710-715
Author(s):  
N. N. Ioskevich ◽  
◽  
L. F. Vasilchuk ◽  
P. E. Vankovich ◽  
S. P. Antonenko ◽  
...  
Keyword(s):  
Lower Limb ◽  
Type I Diabetes ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Type I ◽  
Critical Ischemia ◽  
Lower Limb Ischemia ◽  
X Ray ◽  
Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

Multiple Spinal Perimedullary Arteriovenous Fistulae Associated with the Parkes-Weber Syndrome

1998 ◽  
Vol 4 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Y. Niimi ◽  
U. Ito ◽  
O. Tone ◽  
K. Yoshida ◽  
S. Sato ◽  
...  
Keyword(s):  
Lower Extremities ◽  
Arteriovenous Fistulae ◽  
Left Posterior ◽  
Weber Syndrome ◽  
Long Term Follow Up ◽  
History Of ◽  
One Year ◽  
Polyvinyl Alcohol Particles

We present a rare case of multiple spinal perimedullary arteriovenous fistulae associated with the Parkes-Weber (PW) syndrome. A 31-year-old male known to have the PW syndrome involving the left leg since birth, presented with a 7-month-history of progressive myelopathy of the lower extremities and dysfunction of the bladder and bowel. Myelography demonstrated dilated intradural vessels. Angiography demonstrated two distinct single hole perimedullary arteriovenous fistulae near the conus at two different metameres. They were supplied by the left posterior spinal artery. The patient was treated by transarterial embolisation using polyvinyl alcohol particles, which resulted in venous side occlusion of the fistulae. After the treatment, the patient developed transient worsening of the spasticity of the lower extremities, and was treated by heparinization. After heparinization, the patient partially recovered from the pre-embolisation status of his myelopathy. The follow-up angiogram one year after the embolisation demonstrated persistent obliteration of both fistulae. At long-term follow-up, the patient can ambulate without assistance and work as a farmer.

Four-year follow-up of two patients on maintenance therapy with fondaparinux and mycophenolate mofetil for microthrombotic antiphospholipid syndrome

Lupus ◽  
2019 ◽  
Vol 28 (8) ◽  
pp. 1003-1006 ◽  
Author(s):  
B W Baron ◽  
J M Baron
Keyword(s):  
Mycophenolate Mofetil ◽  
Maintenance Therapy ◽  
Antiphospholipid Syndrome ◽  
Warfarin Therapy ◽  
Lower Extremities ◽  
Arterial Disease ◽  
Critical Ischemia ◽  
Intravenous Heparin ◽  
Small Cohort

Objectives We discuss two patients with antiphospholipid syndrome (APS) who presented with critical ischemia of both lower extremities due to arterial microthrombi. They received multimodality therapy emergently: anticoagulation, immunosuppression, and therapeutic plasma exchange (TPE). Then they were maintained on anticoagulation with fondaparinux and immunosuppression with mycophenolate mofetil (MMF), and were followed for 4 years. Methods Two patients with APS with ischemia and necrosis of their distal lower extremities were treated emergently with anticoagulation (intravenous heparin), immunosuppression (prednisone), and TPE. They were maintained on anticoagulation with fondaparinux and immunosuppression with MMF. Results Neither patient had recurrent microthrombotic disease during a 4-year follow-up. Conclusions As described in our small cohort, patients with APS who suffer from microthrombotic arterial disease may benefit from maintenance therapy of anticoagulation with fondaparinux and immunosuppression with MMF, an approach which may be worthy of further trial. Fondaparinux does not require attention to diet, monitoring, and cumbersome bridging that is typical of warfarin therapy. MMF provides immunosuppression while sparing the side effects of steroid treatment.

Amputees in Limburg: Incidence, morbidity and mortality, prosthetic supply, care utilisation and functional level after one year

2000 ◽  
Vol 24 (2) ◽  
pp. 90-96 ◽  
Author(s):  
H. F. M. Pernot ◽  
G. M. M. Winnubst ◽  
J. J. M. Cluitmans ◽  
L. P. de Witte
Keyword(s):  
Lower Limb ◽  
Walking Distance ◽  
Limb Amputation ◽  
Functional Level ◽  
Level Of Functioning ◽  
Care Utilisation ◽  
Anonymized Data ◽  
One Year ◽  
Daily Function

Objectives: To describe for the province of Limburg, the Netherlands, the incidence of lower limb amputation (LLA), the demographic characteristics of the amputees, reason and level of amputation, care the amputees receive, prosthetic supply and functional level after one year.Design: A prospective descriptive cohort study.Methods: Anonymized data on all amputees in all nine hospitals were collected during 1994. Followup was one year.Results: 191 major lower limb amputations in 164 patients. Incidence was 17.1 per 100,000. Amputation levels: 77 transtibial, 52 transfemoral and 43 knee disarticulation. Twenty (20) patients died during hospitalisation. Eightyseven (87) amputees gave permission for followup, 60 could be actually followed. Twentytwo (22) patients received inpatient rehabilitation, 16 primary daycare, 21 went to a nursing home and one went home without rehabilitation. The mean duration of rehabilitation was 35 weeks. In 53 patients a functional prosthesis was indicated. Fortythree (43) of these patients walked with the prosthesis after one year, 7 of whom more than 500 metres. Nineteen (19) amputees performed the Get Up and Go Test (GUGT) safely. Amputees on average have a low level of functioning, as indicated by SIP68 and Barthel Index Scores. The ability to walk is closely related to this daily function and quality of life.Conclusion: After one year the majority of amputees have low walking skills and the walking distance is limited. They are often ADLdependent and their amputation greatly limits their daily function.

scholarly journals An Ex-Press implant versus trabeculectomy in a fibrotic bleb with late failure after previous trabeculectomy

2021 ◽  
Vol 14 (3) ◽  
pp. 383-387
Author(s):  
Faried Wagdy ◽  
◽  
Hisham Elsorogy ◽  
Ahmed Alnagdy ◽  
Dina Abd Elfattah ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Open Angle Glaucoma ◽  
Implant Surgery ◽  
Late Failure ◽  
Group I ◽  
The Mean ◽  
The Difference ◽  
One Year ◽  
Age Range

AIM: To compare the outcome of an Ex-Press implant and subscleral trabeculectomy (SST) in the management of glaucoma after previous trabeculectomy on a fibrotic bleb. METHODS: This randomized prospective study included 28 eyes from 28 patients (age range: 42-55y) with primary open angle glaucoma (POAG) presented with elevated intraocular pressure (IOP) with fibrotic bleb despite previous SST for more than 4mo. The eyes enrolled in the study were divided into two groups: group I (subjected to Ex-Press implant surgery) and group II [subjected to SST with mitomycin C (MMC)]. The follow-up continued one year after surgery to evaluate IOP, visual acuity (VA), visual field (VF), and postoperative complications. RESULTS: A significant decrease in IOP was found in both groups with a higher reduction in Ex-Press implant surgery with the mean IOP of 14.50 mm Hg (P=0.001), while the SST group recorded the mean IOP of 16.50 mm Hg (P=0.001) after one year. However, the difference between the two groups in terms of the decrease in IOP was insignificant. Fewer postoperative complications were recorded in the Ex-Press implant surgery and more cases requiring further anti-glaucomatous medications were seen in the SST group. Both groups showed stability in terms of VA and VF. CONCLUSION: Ex-Press implant surgery and SST with MMC are two surgical alternatives for controlling IOP in late failure that occurs more than 4mo after previous SST with a fibrotic bleb. However, Ex-Press shunt is a safer surgery with fewer complications.

scholarly journals Clinical reasoning of application of stem cells in the treatment of gingival recession

2019 ◽  
Vol 63 (4) ◽  
pp. 476-484 ◽  
Author(s):  
Sergei P. Rubnikovich ◽  
Igor D. Volotovsky ◽  
Yulia L. Denisova ◽  
Vasilina A. Andreeva ◽  
Galina Yu. Panasenkova
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Orthodontic Treatment ◽  
Good Condition ◽  
Gingival Recession ◽  
Long Term Results ◽  
Cell Transplant ◽  
Complex Treatment ◽  
Periodontal Tissues ◽  
Autologous Mesenchymal Stem Cells

The aim of the study is to improve the results of complex treatment of patients with gingival recession on the basis of validation of new, highly effective methods using autologous mesenchymal stem cells. A complex treatment was conducted in 93 patients with an anatomical recession of the gum in combination with dentoalveolar anomalies at the age of 20 to 29 years. Patients were divided into 3 groups depending on the treatment used. All patients underwent periodontological treatment. In the 2nd group, patients underwent periodontological treatment including orthodontic equipment, in the 3rd group, they underwent orthodontic treatment, and a cell transplant based on a mixture of autologous mesenchymal stem cells and sterile bioplastic collagen material “Collost” was used. A comprehensive assessment of the periodontal tissue of the three groups showed that among the patients who received the standard treatment complex, a good condition of the periodontal tissues in 1 to 2 years after treatment was noted only in 16.7 % of the patients of the 1st group. Inclusion of orthodontic treatment made it possible to obtain good results in 25 % of patients in the 2nd group, which is 8 % more than in the 1st group. At the same time, good treatment results were revealed in 94 % of the 3rd group patients, who underwent periodontological and orthodontic treatment using autologous mesenchymal stem cells, which confirms the need for measures aimed to normalize the position of teeth, dentition and bite with the use of small orthodontic long-acting forces, to improve the microcirculation of periodontal tissues, and to restore the contour of marginal dreams. Inclusion of autologous mesenchymal stem cells in the complex treatment of patients with gingival recession is accompanied by a 1.6-fold decrease in the prevalence and gum recession (1.15 mm), and a 2.6-fold increase in the tissue volume, by the stimulation of periodontal microcirculation processes (the capillary periodontal pressure is increased by a factor of 1.1 time and the intensity of periodontic microcirculation is increased by a factor of 3.1 times), as well as by the normalization of the position of teeth, dentition and occlusion, which allowed one to obtain good long-term results in 94 % of patients.

scholarly journals Functional outcome after open reduction and internal fixation for traumatic diastasis of the pubic symphysis a one year follow-up study

2016 ◽  
Vol 2 (4) ◽  
pp. 256
Author(s):  
B. L. S. Kumar Babu ◽  
Biju Ravindran
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
High Energy ◽  
Walking Distance ◽  
Early Weight Bearing ◽  
Dual Plating ◽  
Pubic Diastasis ◽  
One Year

<p class="abstract"><strong>Background:</strong> Pubic diastasis often results in anteroposterior compression (APC) injuries based on Young and Burgess classification. It is caused due to high-energy trauma and of much clinical importance is given when coexists with urogenital and neurological complications with hemodynamic instability. Open reduction and internal fixation with plating facilitates early mobilisation with better results and is the preferable mode of stabilisation. We evaluated the clinical and functional outcome of such patients in a one-year follow-up period.</p><p class="abstract"><strong>Methods:</strong> In our study, we included 20 patients with APC II injuries who underwent an open reduction by single or dual plating technique by the Pfannenstiel approach, were followed for one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 20 patients, 14 patients (70%) were operated with single superior plating, six patients (30%) were performed with dual plating, i.e., both superior and anterior plating. Among 20 patients, two patients (10%) were operated for primary arthrodesis with double plating. Only one among 20 (5%) had implant failure due to early weight bearing and were re-operated with primary arthrodesis with plating. Results were analysed based on a scoring system which includes five criteria such as anterior pelvic pain, dyspareunia and sexual dysfunction, ability to sit, gait abnormalities and walking distance. Among 20 patients ten patients (50%) had excellent results, six patients (30%) had good results, two patients (10%) had fair results, two patients (10%) had poor results.</p><p><strong>Conclusions:</strong> Open reduction and internal fixation of traumatic pubic diastasis in type II APC injuries with single or dual plating had given better results and early functional recovery.</p>

Sign in / Sign up

Export Citation Format

Share Document