Engineered Fat Graft Enhanced with Adipose-Derived Stromal Vascular Fraction Cells for Regenerative Medicine: Clinical, Histological and Instrumental Evaluation in Breast Reconstruction

The areas in which Stromal Vascular Fraction cells (SVFs) have been used include radiotherapy based tissue damage after mastectomy, breast augmentation, calvarial defects, Crohn’s fistulas, and damaged skeletal muscle. Currently, the authors present their experience using regenerative cell therapy in breast reconstruction. The goal of this study was to evaluate the safety and efficacy of the use of Engineered Fat Graft Enhanced with Adipose-derived Stromal Vascular Fraction cells (EF-e-A) in breast reconstruction. 121 patients that were affected by the outcomes of breast oncoplastic surgery were treated with EF-e-A, comparing the results with the control group (n = 50) treated with not enhanced fat graft (EF-ne-A). The preoperative evaluation included a complete clinical examination, a photographic assessment, biopsy, magnetic resonance (MRI) of the soft tissue, and ultrasound (US). Postoperative follow-up took place at two, seven, 15, 21, 36 weeks, and then annually. In 72.8% (n = 88) of breast reconstruction treated with EF-e-A, we observed a restoration of the breast contour and an increase of 12.8 mm in the three-dimensional volume after 12 weeks, which was only observed in 27.3% (n = 33) of patients in the control group that was treated with EF-ne-A. Transplanted fat tissue reabsorption was analyzed with instrumental MRI and US. Volumetric persistence in the study group was higher (70.8%) than that in the control group (41.4%) (p < 0.0001 vs. control group). The use of EF-e-A was safe and effective in this series of treated cases.

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Effect of cervical headgear on dental arch area, shape and interarch dimensions

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-020-00264-0 ◽

2020 ◽

Author(s):

Toni Heino ◽

Heta Kokko ◽

Ville Vuollo ◽

Pertti Pirttiniemi

Keyword(s):

Standard Deviation ◽

Early Phase ◽

Three Dimensional ◽

Polynomial Equation ◽

Control Group ◽

Dental Arch ◽

Study Group ◽

Class Ii Malocclusion ◽

Angle Class Ii

Abstract Purpose The goal was to study the effects of early cervical headgear treatment on maxillary and mandibular dental arch area, shape and interarch dimensions. Methods The total study group comprised 67 children aged 7.6 years (standard deviation 0.3) with Angle class II malocclusion collected between 1992 and 1996. The children were randomly divided into two groups of equal size. In the first group, cervical headgear treatment was started immediately and undertaken for 2 years. The remaining patients served as untreated controls. Dental casts were taken and scanned at the beginning of treatment (T0) and at the 2‑year (T1) and 4‑year follow-up (T2). Three-dimensional landmarks describing the positions of maxillary and mandibular incisors, canines, first and second premolars and first molars were used to calculate and visualize the maxillary and mandibular dental arch area and shape using the polynomial equation y = Ax6 + Bx2. Results Significant changes in the shape and area of both maxillary and mandibular dental arches were induced with cervical headgear. The headgear increased dental arch area, sagittal dimensions at the mid-sagittal line and transversal dimensions at all of the measured levels in both dental arches compared to the control group. Conclusions Cervical headgear is an effective treatment device to gain space in both dental arches. Furthermore, when used as an early phase treatment, relapse is relatively small compared to the gained space.

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A Prospective and Controlled Clinical Trial on Stromal Vascular Fraction Enriched Fat Grafts in Secondary Breast Reconstruction

Stem Cells International ◽

10.1155/2016/2636454 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 22

Author(s):

L. A. L. Tissiani ◽

N. Alonso

Keyword(s):

Breast Reconstruction ◽

Controlled Trial ◽

Statistical Significance ◽

Stromal Vascular Fraction ◽

Cell Counting ◽

Fat Graft ◽

Control Group ◽

Controlled Clinical Trial ◽

Fat Grafts ◽

Significant Difference

Background.Fat grafting is a tremendous tool in secondary breast reconstruction. Stromal vascular fraction (SVF) enriched fat grafts have been presenting promising results regarding volume maintenance.Methods.We developed a method that produces a superior SVF enrichment rate (2 : 1) in the operating theatre. This prospective and controlled trial analyzed quantitatively and qualitatively fat grafts with (stem cells group, SG) and without (control group, CG) SVF enrichment in secondary breast reconstruction, through MRI-based volumetry, immunophenotyping, and cell counting. Also, patient satisfaction, aesthetic outcomes, and complications were analyzed.Results.Volumetric persistence in the SG was 78,9% and 51,4% in the CG; however it did not reach statistical significant difference. CD90 was the only marker highly expressed in the SG and showed a positive correlation with volumetric persistence (r=0.651,p=0.03). Fat necrosis occurred in 4 patients in the SG and in none in the CG. Patients in the CG showed a trend to be more satisfied. Considering aesthetics, both groups presented improvements. No locoregional recurrences were observed.Conclusions.Results are encouraging despite the fact that SVF enrichment in a higher supplementation rate did not improve, with statistical significance, fat graft volumetric persistence. Enriched fat grafts have proven to be safe in a 3-year follow-up.

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Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

Scientific Reports ◽

10.1038/s41598-021-94549-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Michał Waszczykowski ◽

Bożena Dziankowska-Bartkowiak ◽

Michał Podgórski ◽

Jarosław Fabiś ◽

Arleta Waszczykowska

Keyword(s):

Systemic Sclerosis ◽

Hand Function ◽

Exercise Program ◽

Rehabilitation Program ◽

Long Term Results ◽

Home Exercise ◽

Control Group ◽

Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

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Facial Rejuvenation with Concentrated Lipograft—A 12 Month Follow-Up Study

Cells ◽

10.3390/cells10030594 ◽

2021 ◽

Vol 10 (3) ◽

pp. 594

Author(s):

Lukas Prantl ◽

Eva Brix ◽

Sally Kempa ◽

Oliver Felthaus ◽

Andreas Eigenberger ◽

...

Keyword(s):

Stromal Vascular Fraction ◽

Facial Rejuvenation ◽

Fat Graft ◽

Volume Loss ◽

Patient’S Satisfaction ◽

Resazurin Assay ◽

Long Term Follow Up ◽

The Difference

Lipofilling is a popular technique to treat volume loss in aging patients. The isolated adipose tissue is composed of adipocytes and stromal vascular fraction cells, which include adipose-derived stem cells (ASC). We hypothesize that the patient’s wrinkle severity scale (WSS) and patient’s satisfaction on the global aesthetic improvement scale (GAIS) can be improved after using concentrated lipoaspirate. Fourteen patients (54 years ± 11.09 years) with volume loss in the midface area underwent waterjet-assisted liposuction (Human Med AG, Schwerin, Germany). Fat was centrifuged in an ACP Double Syringe (Arthrex GmbH, Munich, Germany) using Rotofix 32A centrifuge (Andreas Hettich, GmbH & Co.KG, Tuttlingen, Germany). Homogenization was performed using the double syringe and a 1.4 mm female–female luerlock connector. After a second centrifugation, patients received periorbital (PO) and nasolabial (NL) lipografting. ASC count was performed after enzymatical digestion. Vitality of cells was assessed using a resazurin assay. During long-term follow up (12 months, n = 10), we found a high patient’s satisfaction (GAIS 1+/−0.52) and a good improvement of the WSS during short- and long-term follow-up. The ASC count of processed lipoaspirate was 2.1-fold higher than of unprocessed lipoaspirate (p < 0.001). The difference of ASC in sedimented and simply centrifuged lipoaspirate was also significant (p < 0.05). Facial rejuvenation with concentrated fat graft offers good results concerning objective aesthetic outcome and patient’s satisfaction.

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Outcomes More Than 2 Years After Meniscal Repair for Longitudinal Tears of the Lateral Meniscus Combined With Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546520981976 ◽

2021 ◽

pp. 036354652098197

Author(s):

Akira Tsujii ◽

Yasukazu Yonetani ◽

Kazutaka Kinugasa ◽

Tomohiko Matsuo ◽

Kenji Yoneda ◽

...

Keyword(s):

Ligament Reconstruction ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Complete Healing ◽

Control Group ◽

Study Group ◽

Meniscal Extrusion ◽

Second Look ◽

Anterior Cruciate

Background: Meniscal function after repair of longitudinal tears of the lateral meniscus (LM) with anterior cruciate ligament reconstruction (ACLR) has not been comprehensively investigated. Purpose: To evaluate not only the clinical outcomes and radiographic findings of patients who underwent repair of longitudinal tears of the LM combined with ACLR but also the healing status of the repaired meniscus and changes in chondral status with second-look arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: Among 548 patients who underwent primary anatomic ACLR at our institution between 2010 and 2017, 39 who had concomitant longitudinal tears of the LM and underwent repair were studied. During follow-up for more than 2 years, all patients were evaluated clinically (pain, range of motion, swelling, and knee instability) and with imaging (plain radiograph and magnetic resonance imaging [MRI]), and compared with a matched control group (based on age, sex, body mass index, and follow-up period) without any concomitant injuries who underwent ACLR. Measurements on MRI were recorded preoperatively, immediately after surgery, and at final follow-up, and the change in the values over time was assessed. Of the 39 patients in each group, 24 were assessed by second-look arthroscopy with hardware removal 2 years postoperatively. Results: The mean follow-up times of the study and control group were at a mean of 42.4 and 45.4 months, respectively. There were no significant differences in clinical findings, lateral joint space narrowing on radiographs, and chondral status at the lateral compartment between groups, whereas lateral and posterior meniscal extrusion on MRI progressed significantly in the study group (0.43 ± 1.0 mm vs -0.29 ± 1.1 mm, P = .003; 1.9 ± 1.9 mm vs 0.14 ± 1.1 mm, P < .0001, respectively). Second-look arthroscopy revealed complete healing in 12 patients (50%), partial healing in 9 (37.5%), and failure in 3 (12.5%) in the study group, and no new tear in the control group. Conclusion: The clinical and imaging outcomes after repair of longitudinal tears of the LM combined with anatomic ACLR were successful and comparable with those after isolated ACLR without any other injuries at 42 months postoperatively, although meniscal extrusion showed progression on coronal/sagittal MRI. Based on the MRI findings and the result that only half of patients achieved complete healing, meniscal function could not be fully restored even after repair. Although degenerative changes were not apparent, longer-term follow-up is needed.

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Monitoring changes in the shape of the spine in children with postural disorders

10.21203/rs.3.rs-311523/v1 ◽

2021 ◽

Author(s):

Arkadiusz Żurawski ◽

Zbigniew Śliwiński ◽

Grażyna Nowak Starz ◽

Wojciech Kiebzak (Kiebzak)

Keyword(s):

Three Dimensional ◽

Control Group ◽

Spine Deformity ◽

Study Group ◽

Lateral Deviation ◽

Method Of Measurement ◽

The Individual ◽

Post Hoc ◽

And Control ◽

Postural Disorders

Abstract BackgroundDue to numerous complications of an abnormal shape of the spine, it is extremely important to systematically monitor its shape. Precise and routine method of measurement enables comparison of the scores obtained over time and possible early intervention in order to avoid complications.The aim of the work is to present the pattern for monitoring changes in the shape of the spine in children with postural deformities.MethodsThe study group (n = 211) consisted of the patients with diagnosed shape of the spine deformity, who underwent a four-month therapy, supervised by a physiotherapist. The control group (n = 101) were the children with no shape of spine deformity.The children in the study group underwent a three-dimensional computer analysis of the shape of the spine. The DIERS test was performed in both groups (study and control). In the study group it was performed four times. It involved the measurement of seven parameters enabling a complete assessment of body posture.ResultsStatistically significant scores of the Friedman test for imbalance, pelvic tilt, kyphosis angle, lordosis angle, and lateral deviation were observed. Therefore, a series of post-hoc analyzes were performed using Dunn-Bonferroni tests. It was observed that changes in individual parameters analyzed in the authors' study come up at a different pace.ConclusionsDetailed monitoring of the parameters describing the position of the spine makes it possible to control the course of the treatment process of patients with disorders of the position of the spine. The dynamics of changes taking place within the spine position varies for the individual parameters analyzed.

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AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov20157438-42 ◽

2015 ◽

Vol 7 (4) ◽

pp. 38-42 ◽

Cited By ~ 1

Author(s):

A V Sotnikov ◽

V M Melnikov ◽

R V Almadi ◽

G N Gorbunov

Keyword(s):

Cardiac Surgery ◽

Wound Infection ◽

Incidence Rate ◽

Control Group ◽

Study Group ◽

Intravenous Injections ◽

Deep Wound Infection ◽

Period 2 ◽

Deep Wound

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

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Uni-port total thoracoscopic surgery versus median sternotomy for redo tricuspid valve replacement: A retrospective study

10.21203/rs.3.rs-17615/v1 ◽

2020 ◽

Author(s):

Licheng Yan ◽

Fuzhen Zheng ◽

Haiyu Chen ◽

Jiayin Bao ◽

Guoxing Weng

Keyword(s):

Valve Replacement ◽

Tricuspid Valve ◽

Thoracoscopic Surgery ◽

Median Sternotomy ◽

Control Group ◽

Study Group ◽

Valve Regurgitation ◽

Tricuspid Valve Replacement ◽

Tricuspid Valve Regurgitation

Abstract BACKGROUNDː This study compared the perioperative and follow-up period data of patients who underwent redo tricuspid valve replacements performed via thoracoscopic surgery or median sternotomy. The purpose was to evaluate the feasibility, safety, and surgical outcomes of redo tricuspid valve replacement via uni-port thoracoscopic surgery. METHODSː Forty-nine patients with severe tricuspid valve regurgitation after left-side valve replacement underwent redo tricuspid valve replacements in our hospital from April 2012 to September 2019. 26 patients underwent uni-port total thoracoscopy surgery, whereas 23 patients had the surgery performed via median sternotomy. We collected perioperative and 3- to 36-month postoperative data. RESULTSː No deaths occurred in the intraoperative period. Time of cardiopulmonary bypass in the study group was significantly longer than that in the control group (P<0.05), but the operative times in the study and control groups were not significantly different. Thoracic drainage, length of ICU stay, postoperative hospital stay and complication rates in the study group were significantly different from those in the control group (P<0.05). Throughout the follow-up period, uni-port total thoracoscopic TVR is not inferior to traditional surgery with respect to cardiac function and recurrence of tricuspid valve regurgitation. CONCLUSIONSː Uni-port total thoracoscopic tricuspid valve replacement is safe, feasible and effective, and that can be considered as a primary treatment strategy for patients with severe TR after previous left-sided valve procedure.

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Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors: an empirical analysis of 290 patients

10.21203/rs.3.rs-26361/v1 ◽

2020 ◽

Author(s):

Feiya Yang ◽

Lianjie Mou ◽

Nianzeng Xing

Keyword(s):

Partial Nephrectomy ◽

Preoperative Evaluation ◽

Three Dimensional ◽

Intraoperative Ultrasound ◽

Operation Time ◽

Laparoscopic Partial Nephrectomy ◽

Renal Tumors ◽

Significant Difference ◽

Group A

Abstract Objective To explore the feasibility of laparoscopic partial nephrectomy(LPN) in the treatment of renal hilar tumors. Methods Clinical data of 290 patients undergoing laparoscopic partial nephrectomy from January 2013 to August 2019 were retrospectively analyzed, including 27 patients with renal hilar tumors and 263 patients with non-hilar renal tumors. Perioperative data and follow-up results were compared between the two groups. Results Tumor size in Group A is smaller(2.97±0.88 vs 3.55±1.46,p<0.05), R.E.N.A.L. nephrometry score of Group A is higher(8.4±1.3 vs 6.5±1.7,p<0.01).The operation time, WIT and intraoperative blood loss in the Group A were slightly higher, but with no statistical difference (p>0.05). There was no significant difference between the two groups in intraoperative ultrasound rate, collection system repair rate, drainage time,postoperative hospital stay, and eGFR changes (p>0.05).The median follow-up period was 40 months. One patient with postoperative pathologic report of angiomyolipoma was found tumor recurrence and was currently undergoing regular reexamination. Conclusion Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors is safe and feasible after detailed preoperative evaluation of the tumor and selection of appropriate surgical strategies.

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Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial

Journal of Wound Care ◽

10.12968/jowc.2020.29.sup3.s13 ◽

2020 ◽

Vol 29 (Sup3) ◽

pp. S13-S18 ◽

Cited By ~ 2

Author(s):

Gholamreza Esmaeeli Djavid ◽

Seyed Mehdi Tabaie ◽

Siamak Bashardoust Tajali ◽

Mehrangiz Totounchi ◽

Amirreza Farhoud ◽

...

Keyword(s):

Diabetic Foot ◽

Wound Care ◽

Healing Process ◽

Collagen Matrix ◽

Complete Healing ◽

Randomised Control Trial ◽

Control Group ◽

Study Group ◽

Number Of Patients

Objective: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU. Method: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up. Results: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively). Conclusion: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.

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