Current Scenario of Regenerative Medicine: Role of Cell, Scaffold and Growth Factor

Impairment of the clinical tissue-implantation is due to the lack of a suitable organ donor and immunogenic rejection, which leads to the cause for the enormous loss of human life. The introduction of artificial regeneration of tissues by Langer and Vacanti in 1993, has revolutionized in the field of surgical organ transplantation, to alleviate the problem of tissue injury-related death. There is no doubt that the term “regenerative medicine” to open a new space of tissue reconstruction, but the complications that arise due to the proper machinery of the cell, supporting biomaterials and growth factors has yet to be resolved to expand its application in a versatile manner. The chapter would provide a significant overview of the artificial tissue regeneration while a triangular relationship between cells, matrixes, and growth factors should be established mentioning the necessity of biomedical tools as an alternative to organ transplantation.

A case of spontaneous non-penetrating keratoprosthesis during multi-stage implantation of a Fedorov — Zuyev prosthesis in a patient with a severe chemical eye burn

Purpose: to evaluate the results of spontaneous non-penetrating keratoprosthesis with a Fedorov — Zuev prosthesis in a patient with severe chemical burns in both eyes. Material and methods.Patient K., 38, who had sustained a severe burn injury in the past and numerous reconstructive plastic operations on both eyes (amniotic tissue implantation, allolymbal transplantation, layer-by-layer and penetrative keratoplasty, cataract extraction with IOL implantation, total auto-conjunctival corneal plastic surgery) with no functional effect, was subjected to a multi-stage keratoprosthesis of the left eye according to the method practiced by the Helmholtz National Medical Research Center of Eye Diseases. Results.After one of the stages (implantation of the haptic part of the keratoprosthesis with a temporary cylindrical plug), an aseptic necrosis of the tissue above the cylinder occurred. As a result, an unexpected functional effect was revealed: visual acuity of the operated eye 0.02 sph -20.0 D = 0.2. During a dynamic follow-up that lasts 2.5 years, visual acuity remains stable, and the corneallayers behind the cylinder retain transparency. During this time, all stages of keratoprosthesis were performed on the fellow eye with a functional result of 1.0. Conclusion. The long-term result of spontaneous non-penetrating keratoprosthesis indicates the need to study the prospects and develop a method of non-penetrating keratoprosthesis with a Fedorov — Zuyev prosthesis.

Age-Dependent in vitro Maturation Efficacy of Human Oocytes – Is There an Optimal Age?

In vitro maturation of oocytes from antral follicles seen during tissue harvesting is a fertility preservation technique with potential advantages over ovarian tissue cryopreservation (OTC), as mature frozen and later thawed oocyte used for fertilization poses decreased risk of malignant cells re-seeding, as compared to ovarian tissue implantation. We previously demonstrated that in vitro maturation (IVM) performed following OTC in fertility preservation patients, even in pre-menarche girls, yields a fair amount of oocytes available for IVM and freezing for future use. We conducted a retrospective cohort study, evaluating IVM outcomes in chemotherapy naïve patients referred for fertility preservation by OTC that had oocyte collected from the medium with attempted IVM. A total of 133 chemotherapy naïve patients aged 1–35 years were included in the study. The primary outcome was IVM rate in the different age groups – pre-menarche (1–5 and ≥6 years), post-menarche (menarche-17 years), young adults (18–24 years) and adults (25–29 and 30–35 years). We demonstrate a gradual increase in mean IVM rate in the age groups from 1 to 25 years [4.6% (1–5 years), 23.8% (6 years to menarche), and 28.4% (menarche to 17 years)], with a peak of 38.3% in the 18–24 years group, followed by a decrease in the 25–29 years group (19.3%), down to a very low IVM rate (8.9%) in the 30–35 years group. A significant difference in IVM rates was noted between the age extremes – the very young (1–5 years) and the oldest (30–35 years) groups, as compared with the 18–24-year group (p < 0.001). Importantly, number of oocytes matured, percent of patients with matured oocytes, and overall maturation rate differed significantly (p < 0.001). Our finding of extremely low success rates in those very young (under 6 years) and older (≥30 years) patients suggests that oocytes retrieved during OTC prior to chemotherapy have an optimal window of age that shows higher success rates, suggesting that oocytes may have an inherent tendency toward better maturation in those age groups.

In Vivo Tissue Implantation Model of In Vivo Tissue Implantation Model of Lidocaine (LCH)-Encapsulated Dextran (DEX)/Glycol (GLY) Nanoparticles Delivery for Pain Management

Lidocaine-loaded nanoparticles are versatile nanomaterials that may be used in pain treatment due to their wound healing properties. The current study describes a wound dressing formulation focused on lidocaine-loaded dextran/ethylene glycol nanoparticles (an anesthetic drug). The lidocaine-loaded dextran/ethylene glycol membranes were fabricated using lidocaine solutions inside the dextran/ethylene glycol medium. The influence of various experimental conditions on dextran/ethylene glycol nanoparticle formations were examined. The sizes of dextran/ethylene glycol and lidocaine-loaded dextran/glycol nanoparticles were examined through the HR-SEM. Moreover, the efficacy antibacterial activity of dextran/glycol and lidocaine-loaded dextran/ethylene glycol nanoparticles was evaluated against the microorganisms grampositive and negative. Furthermore, we observed the In Vivo wound healing of wounds in skin using a mice model over a 16 days period. In this difference to the wounds of untreated mouse, quick healing was observed in the lidocaine-loaded dextran/glycol nanoparticles-treated wounds with fewer injury. These results specify that lidocaine-loaded dextran/ethylene glycol nanoparticles-based dressing material could be a ground-breaking nanomaterial having wound repair and implantations potential required for wound injury in pain management, which was proven using an animal model.

Care of Children with DiGeorge Before and After Cultured Thymus Tissue Implantation

Background Children with complete DiGeorge anomaly (cDGA) have congenital athymia plus a myriad of other challenging clinical conditions. The term cDGA encompasses children with congenital athymia secondary to 22q11.2DS, CHARGE syndrome (coloboma, heart defects, choanal atresia, growth or mental retardation, genital abnormalities, and ear abnormalities and/or deafness), and other genetic abnormalities. Some children have no known genetic defects. Since 1993, more than 100 children with congenital athymia have been treated with cultured thymus tissue implantation (CTTI). Naïve T cells develop approximately 6 to 12 months after CTTI. Most of the children had significant comorbidities such as heart disease, hypoparathyroidism, and infections requiring complex clinical care post cultured thymus tissue implantation (CTTI). Objective The purpose of this guidance is to assist multidisciplinary teams in caring for children with cDGA both before and after CTTI. Methods Thirty-one specialists, in addition to the authors, were asked to share their experience in caring for children with cDGA at Duke University Health System, before and after CTTI. These specialists included physicians, nurses, dentists, therapists, and dieticians. Results The goal of a multidisciplinary approach is to have children in the best possible condition for receiving CTTI and provide optimal care post CTTI through development of naïve T cells and beyond. The CTT (cultured thymus tissue) must be protected from high doses of steroids which can damage CTT. Organs must be protected from adverse effects of immunosuppression. Conclusion Creating a multidisciplinary team and a detailed plan of care for children with cDGA is important for optimal outcomes.

The War after War: Volumetric Muscle Loss Incidence, Implication, Current Therapies and Emerging Reconstructive Strategies, a Comprehensive Review

Volumetric muscle loss (VML) is the massive wasting of skeletal muscle tissue due to traumatic events or surgical ablation. This pathological condition exceeds the physiological healing process carried out by the muscle itself, which owns remarkable capacity to restore damages but only when limited in dimensions. Upon VML occurring, the affected area is severely compromised, heavily influencing the affected a person’s quality of life. Overall, this condition is often associated with chronic disability, which makes the return to duty of highly specialized professional figures (e.g., military personnel or athletes) almost impossible. The actual treatment for VML is based on surgical conservative treatment followed by physical exercise; nevertheless, the results, in terms of either lost mass and/or functionality recovery, are still poor. On the other hand, the efforts of the scientific community are focusing on reconstructive therapy aiming at muscular tissue void volume replenishment by exploiting biomimetic matrix or artificial tissue implantation. Reconstructing strategies represent a valid option to build new muscular tissue not only to recover damaged muscles, but also to better socket prosthesis in terms of anchorage surfaces and reinnervation substrates for reconstructed mass.

COLLAGEN BIOSTIMULATOR WITH POLYMETHYLMETHACRYLATE

Introduction: Polymethylmethacrylate (PMMA) is a potent agent that induces neocolagenesis and neoangiogenesis when used in dermal and subcutaneous tissue implantation techniques. In this study, the collagen biostimulation technique with PMMA is presented, with adequate and safe concentrations for facial lifting in different laxity degrees. To present the Objective: PMMA using technique in collagen´s face biostimulation. Material (PMMA) Methods: characteristics, concentrations, suspension technique, injection technique, areas subject to treatment, risk areas and post-treatment assessment in several facial laxity degrees were described. Conclusion: This study described the particularities of the use of PMMA as an effective and potent biostimulator. The technique proved to be effective in treating varying degrees of facial laxity.

Comparative Osteointegration Testing of Titanium Implants in Relation to Gender After One Month of Implantation in Rabbit Femur

The biologic material used in this study is represented by 6 rabbits, 3 males and 3 females, aged 11 months and having an average weight of 4 kg. After general anaesthesia was performed, 2 mm diameter titanium implants were surgically inserted in the femur. Postoperative care of the animals included daily observation. After 4 weeks the animals were euthanized according to the guidelines. The femurs were collected along with the implants and processed for histological examination. The samples were placed in Stieve mixture for fixation, dehydrated with ethylic alcohol, clarified with 1-Butanol, and followed by paraffin embedding. 5 micrometers sections were cut using a microtome, and then stained using the Goldner trichrome staining method and were examined using an Olympus BX41 microscope with an attached digital camera for image capturing. In all animals, the implant was well tolerated by the bone and soft tissue implantation bed. The osteointegration process took place through bone formation around the implant, with variations in thickness and structure throughout the bone-implant interface. Except for the accelerated speed of osteointegration steps, observed in males, the osteointegration process follows certain stages and no gender related differences. The rapid progress of osteointegration in males resulted in a faster process in this gender compared to females. This aspect is clinically relevant for the appropriate evaluation of waiting periods from implant placement to prosthetic mounting, which according to this study is different in males and females.

Environmental Screening of Fonsecaea Agents of Chromoblastomycosis Using Rolling Circle Amplification

Chromoblastomycosis is a chronic, cutaneous or subcutaneous mycosis characterized by the presence of muriform cells in host tissue. Implantation disease is caused by melanized fungi related to black yeasts, which, in humid tropical climates, are mainly members of the genus Fonsecaea. In endemic areas of Brazil, F. pedrosoi and F. monophora are the prevalent species. The current hypothesis of infection is traumatic introduction via plant materials, especially by plant thorns. However, isolation studies have demonstrated a low frequency of the agents in environmental substrates. The present study aimed to detect F. pedrosoi and F. monophora in shells of babassu coconuts, soil, plant debris, and thorns from endemic areas of chromoblastomycosis in Maranhão state, northern Brazil, using Rolling Circle Amplification (RCA) with padlock probes as a new environmental screening tool for agents of chromoblastomycosis. In addition to molecular screening, the environmental samples were analyzed by fungal isolation using mineral oil flotation. The limit of detection of the RCA method was 2.88 × 107 copies of DNA per sample for the used padlock probes, indicating that this represents an efficient and sensitive molecular tool for the environmental screening of Fonsecaea agents. In contrast, with isolation from the same samples using several selective methods, no agents of chromoblastomycosis were recovered.