The effect of bone marrow graft composition on pediatric bone marrow transplantation outcomes.

Hematopoietic stem cell graft cellular composition has been generally accepted to impact outcomes. Recent studies question this hypothesis. We conducted a single-center retrospective study of sixty-one pediatric BMT recipients for malignant (68%) and nonmalignant diseases (32%) examining effects of graft composition on engraftment, acute GVHD, chronic GVHD, and survival at day 100 and 1 year. Grafts contained a median of 3.63 x  08 TNC/kg (range: 0.031-10.31 x 108 TNC/kg) and 4.09 x 106 CD34+ /kg (range: 0.76-24.15 x 106 CD34+ /kg) with median neutrophil and platelet engraftment times of 17 and 29 days, respectively. A univariate analysis showed a trend for increasing TNC and increasing time to neutrophil engraftment HR: 0.875; CI: 0.075-1.001). Increasing CD34+ counts shortened time to platelet engraftment (HR: 1.085; CI: 1.015-1.161). No significant relationship was found between TNC, CD34+ , or CD3+ and acute or chronic GVHD. TNC or CD34+ did not affect day 100, 1-year survival, or 2-year survival. Increasing CD3+ counts demonstrated a negative trend on day 100 survival (HR: 1.108; CI: 1.001-1.036) but not 1-year survival or 2-year survival. These results add additional data questioning the effect of graft composition on outcomes in pediatric BMT patients with important ramifications for the management of donors.

Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries.

Peripheral nerve injuries requiring surgical repair affect over 100,000 individuals in the US annually. Three accepted methods of peripheral repair include end-to-end, end-to-side, and side-to-side neurorrhaphy, each with its own set of indications. While it remains important to understand the specific circumstances in which each method is employed, a deeper understanding of the molecular mechanisms underlying the repair can add to the surgeon's decision-making algorithm when considering each technique, as well as help decide nuances in technique such as the need for making epineurial versus perineurial windows, length and dept of the nerve window, and distance from target muscle. In addition, a thorough knowledge of individual factors that are active in a particular repair can help guide research into adjunct therapies. This paper serves to summarize the similarities and divergences of the three commonly used nerve repair strategies and the scope of molecular mechanisms and signal transduction pathways in nerve regeneration as well as to identify the gaps in knowledge that should be addressed if we are to improve clinical outcomes in our patients.

Social Disparities in Thoracic Surgery Education.

Despite an ever-diversifying US population, women, and underrepresented minorities lack proportionate membership in the CT surgery workforce. CT surgery is the surgical specialty practiced by the oldest surgeons as a group. This highlights a deficit within our specialty and foreshadows a shrinking of the CT surgery workforce that will be compounded by a lack of diversity as the workforce ages. If CT surgery is to continue to advance forward and attract the brightest, most skilled, and innovative people, we must invite, encourage, and guide qualified individuals from all races, cultures, genders, sexual orientations, and experiences to join us.

In Vitro, In Vivo and Ex Vivo Models for Peripheral Nerve Injury and Regeneration.

Peripheral Nerve Injuries (PNI) frequently occur secondary to traumatic injuries. Recovery from these injuries can be expectedly poor, especially in proximal injuries. In order to study and improve peripheral nerve regeneration, scientists rely on peripheral nerve models to identify and test therapeutic interventions. In this review, we discuss the best described and most commonly used peripheral nerve models that scientists have and continue to use to study peripheral nerve physiology and function.