Human lung microvascular endothelial cells as potential alternatives to human umbilical vein endothelial cells in bio-3D-printed trachea-like structures.

BACKGROUND: We have been trying to produce scaffold-free structures for airway regeneration using a bio-3D-printer with spheroids, to avoid scaffold-associated risks such as infection. Previous studies have shown that human umbilical vein endothelial cells (HUVECs) play an important role in such structures, but HUVECs cannot be isolated from adult humans. The aim of this study was to identify alternatives to HUVECs for use in scaffold-free structures. METHODS: Three types of structure were compared, made of chondrocytes and mesenchymal stem cells with HUVECs, human lung microvascular endothelial cells (HMVEC-Ls), and induced pluripotent stem cell (iPSC)-derived endothelial cells. RESULTS: No significant difference in tensile strength was observed between the three groups. Histologically, some small capillary-like tube formations comprising CD31-positive cells were observed in all groups. The number and diameters of such formations were significantly lower in the iPSC-derived endothelial cell group than in other groups. Glycosaminoglycan content was significantly lower in the iPSC-derived endothelial cell group than in the HUVEC group, while no significant difference was observed between the HUVEC and HMVEC-L groups. CONCLUSIONS: HMVEC-Ls can replace HUVECs as a cell source for scaffold-free trachea-like structures. However, some limitations were associated with iPSC-derived endothelial cells.

[Important factors surrounding chest surgery for the patients complicated with digestive disease].

OBJECTIVE: Important factors surrounding chest surgery for the patients complicated with digestive disease were discussed according to the experiences of clinical settings. METHODS: Check points regarding each context, preoperative, perioperative, postoperative, and outpatient care were considered independently. RESULTS: If digestive diseases are uncontrolled, the operation should be postponed until they are appropriately cared. Dental problems such as teeth caries or denture insufficiency should be cleared preoperatively. Dysphagia after the head and neck surgery must be evaluated and alternative feeding methods should be established. The patients with digestive tract disorder have malabsorption and are prone to malnutrition. According to the appropriate assessments of digestion and absorption, an enteral nutrition or a total parenteral nutrition should be considered before and after operation, to improve nutrition status. Immunonutrition is particularly beneficial to reduce the postoperative infection or various stresses of invasive operations in the chest surgery. Chronic pancreatitis is characterized by absorption impairment and pancreatic diabetes. They should also be controlled before the operation using digestive enzymes and an exogenous insulin. CONCLUSION: Teeth problems, dysphagia, malabsorption, malnutrition and pancreatic diabetes should be assessed and cared appropriately before and after the chest surgery using compensative therapy.

[Undiversion in a patient with ileal conduit using cecoileal urinary reservoir, a case report].

A case of urinary undiversion in a 19 year old man with high ileal loop, who at the age of 1 year was inadvertently cystectomized for probable acute urinary retention masquerading as acute abdomen, is reported. The ileo-ceco-colonic segment was isolated and the colon was partially detubularized. After ileocecal intussusception and stabilization to the cecal wall (Hendren), a segment of ileal patch was applied to form an Indiana type pouch. The ileal loop was free from the abdominal wall and its distal end was anastomosed to the terminal ileum of the pouch. Undiversion was completed by connecting the pouch at its dependent portion with the remnant prostatic urethra. At 4 months postoperatively the pouch functions quite satisfactorily as a low pressure and good volume reservoir that empties well without reflux. His erectile and ejaculatory function have also been maintained.