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1.
Work ; 48(4): 503-10, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24346266

RESUMO

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are a major public health concern. There has been a strong demand from occupational safety and health agencies and operators to develop simple tools for risk assessment and management of WMSDs. The Quick Exposure Check (QEC) was designed to assess exposure to WMSDs risk factors affecting the back, shoulder/upper arm, wrist/hand, and the neck. It is a valuable observational ergonomic assessment tool, suitable for field-based assessment. OBJECTIVE: This study set out to translate, culturally adapt, and validate a Chinese version of the Quick Exposure Check (CQEC), an observational tool used to assess exposure to physical and psychosocial workplace risk factors for the development of WMSDs in different body sites. METHODS: The CQEC was translated from its original English version using a forward- and back-translation approach. Content validity was examined by an expert panel and expert committee using item- and scale-level content validity indices. The intra-class correlation coefficient (ICC) was used to analyze the inter-rater reliability of the observer's assessment, with kappa statistics and percentage agreements used to estimate the test-retest reliability of the worker's assessment of individual items. RESULTS: The CQEC demonstrated an excellent scale-level content validity index (S-CVI > 0.90). The ICC lay between 0.71 and 0.97, indicating good inter-rater reliability. Test-retest reliability showed substantial agreement between the two measurement occasions for most of the items (kappa=0.68 to 1, percentage agreement=76 to 100%) capturing exposure to risk factors. CONCLUSIONS: The CQEC is a valid and reliable tool that can be used to calculate levels of exposure to risk factors for WMSDs.


Assuntos
Doenças Musculoesqueléticas/prevenção & controle , Saúde Ocupacional , Inquéritos e Questionários , Adulto , China , Ergonomia/métodos , Feminino , Humanos , Masculino , Doenças Musculoesqueléticas/etiologia , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fatores de Risco , Tradução
2.
Mol Cancer Res ; 11(10): 1179-92, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23913164

RESUMO

UNLABELLED: Rhabdomyosarcoma is the most common soft tissue sarcoma in children. Metastatic rhabdomyosarcoma in children has a 5-year event-free survival rate of <30%, and a recent clinical trial with irinotecan, a topoisomerase I inhibitor, failed to improve outcome. Therefore, it was surmised that failure of irinotecan may be the result of overexpression of the DNA repair enzyme tyrosyl-DNA phosphodiesterase (TDP1), which processes topoisomerase I-DNA complexes resulting from topoisomerase I inhibitor treatment. Using human tissue microarrays and gene expression arrays, a marked overexpression of TDP1 protein and mRNA in RMS tumors was observed. Critically, knockdown of TDP1 or inhibition of poly(ADP-ribose) polymerase-1 (PARP-1), an enzyme in the same complex as TDP1, sensitized rhabdomyosarcoma cell lines to analogues of irinotecan. Interestingly, BRCA1/2 mutations or altered expression was not detectable in rhabdomyosarcoma cells; however, TDP1 knockdown and PARP-1 inhibition alone were cytotoxic to a subset of rhabdomyosarcoma cells, suggesting that they harbor genetic lesions in DNA repair components that have synthetic lethal interactions with loss of TDP1 or PARP1 function. Furthermore, culturing embryonal rhabdomyosarcoma cells in serum/nutrient-restricted medium increased cellular cytotoxicity upon PARP-1 inhibition and was intrinsically cytotoxic to alveolar, though not embryonal rhabdomyosarcoma cells. The results of these studies suggest a compensatory role for TDP1 in rhabdomyosarcoma after topoisomerase-I based therapy and further demonstrate that TDP1 knockdown, PARP-1 inhibition, and dietary restriction have therapeutic validity. IMPLICATIONS: Selective targeting of TDP1 and/or PARP-1 in rhabdomyosarcoma induces cytotoxicity and sensitizes to DNA damaging agents.


Assuntos
Diester Fosfórico Hidrolases/genética , Diester Fosfórico Hidrolases/metabolismo , Poli(ADP-Ribose) Polimerases/genética , Poli(ADP-Ribose) Polimerases/metabolismo , Rabdomiossarcoma/genética , Antineoplásicos/farmacologia , Proteína BRCA1/genética , Proteína BRCA2/genética , Camptotecina/análogos & derivados , Camptotecina/farmacologia , Linhagem Celular Tumoral , Criança , Reparo do DNA , Perfilação da Expressão Gênica , Técnicas de Inativação de Genes , Glucose/metabolismo , Humanos , Mutação , Mioblastos Esqueléticos/fisiologia , Poli(ADP-Ribose) Polimerase-1 , Inibidores de Poli(ADP-Ribose) Polimerases , Rabdomiossarcoma/metabolismo , Rabdomiossarcoma/patologia , Soro/metabolismo , Análise Serial de Tecidos
3.
Eur J Haematol ; 90(3): 250-6, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23278107

RESUMO

Immunoglobulin G4-related disease (IgG4-RD) is a recently described entity with protean manifestations. We describe a novel case of IgG4-RD with hypergammaglobulinemic hyperviscosity responsive to fludarabine and rituximab. A 33-year-old Asian man developed bilateral lacrimal gland and submandibular salivary gland swelling with cervical lymphadenopathy. Biopsies of the affected tissues revealed reactive follicular hyperplasia. Seven years later, he presented with bilateral retinal hemorrhages due to hyperviscosity syndrome from profound polyclonal increase in IgG, including marked IgG4 elevation. Despite plasmapheresis, overproduction of IgG continued and he was refractory to systemic steroids, azathioprine, interferon alpha, and cyclophosphamide. IgG4-RD was suspected following a myocardial infarction and detection of aneurysmal coronary arteries indicating large vessel vasculitis. Review of the cervical lymph node and lacrimal gland biopsies with immunohistochemical staining for IgG4-positive plasma cells confirmed IgG4-RD. B-cell depletion with rituximab produced a partial response, but clinical symptoms and elevated protein levels persisted. Fludarabine was added to rituximab to suppress T-cell activity, and this resulted in an excellent clinical and biochemical response. Combination therapy with fludarabine and rituximab in IgG4-RD has not previously been reported and can be considered in patients with severe refractory disease.


Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Hipergamaglobulinemia/tratamento farmacológico , Imunoglobulina G/sangue , Fatores Imunológicos/uso terapêutico , Doenças Linfáticas/tratamento farmacológico , Degeneração Retiniana/tratamento farmacológico , Vidarabina/análogos & derivados , Adulto , Anticorpos Monoclonais Murinos/farmacologia , Quimioterapia Combinada , Humanos , Hipergamaglobulinemia/complicações , Hipergamaglobulinemia/patologia , Fatores Imunológicos/farmacologia , Aparelho Lacrimal/efeitos dos fármacos , Aparelho Lacrimal/patologia , Linfonodos/efeitos dos fármacos , Linfonodos/patologia , Doenças Linfáticas/complicações , Doenças Linfáticas/patologia , Masculino , Degeneração Retiniana/complicações , Degeneração Retiniana/patologia , Rituximab , Vasculite/complicações , Vasculite/tratamento farmacológico , Vasculite/patologia , Vidarabina/farmacologia , Vidarabina/uso terapêutico
4.
Cells Tissues Organs ; 185(1-3): 232-6, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17587829

RESUMO

The molecular and cellular events involved in cancer progression and metastasis remain much less well-defined than those involved in oncogenesis, despite the fact that cell metastasis is the major factor in cancer mortality. Thus, the discovery that the expression of a protein tyrosine phosphatase, protein of regenerating liver-3 (PRL-3), is upregulated in colon cancer metastases provided an exciting indication that the altered regulation of specific protein tyrosine phosphorylation events and signaling pathways might characterize these metastatic cells and/or be key in promoting the tumor-to-metastasis transition in this, and perhaps other, cancers of epithelial origin. However, the cellular substrate(s) of PRL-3 has not been identified, and little is known of PRL-3-mediated cellular signaling pathways. This review illustrates the significance of PRL-3 in promoting metastasis and the importance of determining the endogenous role of PRL-3.


Assuntos
Proteínas Imediatamente Precoces/metabolismo , Proteínas de Neoplasias/metabolismo , Proteínas Tirosina Fosfatases/metabolismo , Animais , Movimento Celular/genética , Movimento Celular/fisiologia , Humanos , Proteínas Imediatamente Precoces/genética , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Metástase Neoplásica/genética , Metástase Neoplásica/patologia , Proteínas de Neoplasias/genética , Proteínas Tirosina Fosfatases/genética
5.
J Orthop Sports Phys Ther ; 32(8): 399-404, 2002 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12168958

RESUMO

STUDY DESIGN: Normative descriptive study. OBJECTIVES: Exploring the isokinetic work ratios of eccentric antagonist/concentric agonist shoulder rotators in the late cocking and deceleration phases of a forehand overhead smash in badminton players. Comparing the work ratios between dominant and nondominant shoulders. BACKGROUND: The strength of shoulder muscles for badminton players has been studied but there is little information on the work output of these muscles for a specific range of movement. METHODS AND MEASURES: Twenty-five skilled men who play badminton at club level with a mean age of 29.4 years (SD = 6.1) were measured for concentric and eccentric isokinetic work (joules) of shoulder internal (IR) and external (ER) rotators on both upper extremities at 120 degrees/s. Bilateral isokinetic work ratios for eccentric IR/concentric ER between 60 degrees and 90 degrees of shoulder external rotation were calculated to denote strength profile in the late cocking phase of the badminton smash. Work ratios for eccentric ER/concentric IR between 10 degrees external rotation and 30 degrees internal rotation were calculated to denote strength profile in the deceleration phase of the badminton smash. The respective work ratios were compared between both shoulders. RESULT: The eccentric IR/concentric ER work ratios in late cocking were 1.9:1 and 1.3:1 (P = 0.001) for the dominant and nondominant shoulders, respectively. The eccentric ER/concentric IR work ratios in the deceleration phase were 1.1:1 and 1.3:1 (P = 0.003) for the dominant and nondominant shoulders, respectively. CONCLUSION: The work ratios of eccentric antagonist/concentric agonist are different between dominant and nondominant shoulders of skilled badminton players. Rehabilitation for injuries of these athletes should aim at developing the optimal antagonist/agonist work ratios to return them to this sport.


Assuntos
Esportes com Raquete/fisiologia , Amplitude de Movimento Articular/fisiologia , Manguito Rotador/fisiologia , Articulação do Ombro/fisiologia , Adulto , Humanos , Cinética , Masculino , Contração Muscular/fisiologia
6.
Tissue Eng ; 8(2): 283-93, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12031117

RESUMO

Studies were performed in a long-term effort to develop clinically translatable, tissue engineered adipose constructs for reconstructive, correctional, and cosmetic indications. Rat preadipocytes were harvested, isolated, expanded ex vivo, and seeded within PLGA scaffolds. Preadipocyte-seeded and acellular (control) scaffolds were implanted for 1-12 months. Explanted scaffolds were stained with osmium tetroxide, processed, and counterstained using H&E. Quantitative histomorphometric analysis was performed on all tissue sections to determine the amount of adipose tissue formed. Analyses revealed maximum adipose formation at 2 months, followed by a decrease at 3 months, and complete absence of adipose and PLGA at 5-12 months. These results extend a previous short-term study (Tissue Engineering 1999;5:134) and demonstrate that adipose tissue can be formed in vivo using tissue engineering strategies. However, the long-term maintenance of adipose tissue remains elusive.


Assuntos
Adipócitos/fisiologia , Tecido Adiposo/citologia , Tecido Adiposo/metabolismo , Materiais Biocompatíveis , Ácido Láctico , Ácido Poliglicólico , Polímeros , Animais , Masculino , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Ratos , Ratos Endogâmicos Lew , Fatores de Tempo , Engenharia Tecidual
7.
Anat Rec ; 263(4): 361-6, 2001 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-11500812

RESUMO

Tissue engineering is a relatively young field that combines engineering, clinical science, and life sciences to, in part, repair or regrow tissues. Adipose tissue has recently become a focus area for tissue engineering, encouraged by the large number of reconstructive, cosmetic, and correctional indications that could be addressed with clinically translatable adipose tissue engineering strategies. This review discusses the three aspects of an adipose construct, namely cell types, scaffold, and microenvironment, and presents current tissue engineering strategies under pursuit.


Assuntos
Tecido Adiposo/fisiologia , Órgãos Bioartificiais , Engenharia Biomédica/métodos , Procedimentos de Cirurgia Plástica , Tecido Adiposo/ultraestrutura , Animais , Procedimentos Cirúrgicos Dermatológicos , Humanos , Pele/anatomia & histologia , Pele/patologia , Cirurgia Plástica/métodos
8.
Tissue Eng ; 7(3): 303-11, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11429150

RESUMO

In this study, human dermal fibroblasts (hDFBs) were genetically modified to release human nerve growth factor (NGF) using an ecdysone-inducible system. NGF cDNA was inserted into the pIND vector and then hDFBs were cotransfected with pIND-NGF and pVgRXR. Muristerone A, an analog of ecdysone, was used as the inducing agent. NGF release from transfected hDFBs was assessed in vitro and in vivo. Transfected hDFBs in the presence of Muristerone A possessed a maximal in vitro release of 8.5 +/- 0.4 pg of NGF/mL per 10(3) cells, demonstrating significantly higher NGF levels compared to control hDFBs. The in vitro release rate curve for transfected hDFBs in the presence of Muristerone A exhibited a maximum of 5.1 +/- 0.2 ng NGF/10(6) cells/day. A PC-12 bioassay demonstrated that the in vitro NGF released is bioactive. When transfected hDFBs in the presence of Muristerone A were placed in vivo in nude rats, NGF levels reach 2074 +/- 257 pg/mL and 1620 +/- 132 pg/mL at 24 and 48 h, respectively. These levels were significantly higher than negative control and wound fluid levels. Results support further in vivo investigation of this molecular "on" switch for peripheral nerve regeneration.


Assuntos
Ecdisterona/análogos & derivados , Ecdisterona/farmacologia , Fibroblastos/metabolismo , Engenharia Genética/métodos , Fator de Crescimento Neural/genética , Fator de Crescimento Neural/metabolismo , Nervos Periféricos/crescimento & desenvolvimento , Animais , Materiais Biocompatíveis , Diferenciação Celular , Linhagem Celular , Cultura em Câmaras de Difusão , Humanos , Masculino , Reação em Cadeia da Polimerase , Ratos , Ratos Nus/imunologia , Pele/citologia , Transfecção
9.
Ann Plast Surg ; 47(6): 660-5, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11756838

RESUMO

Current surgical strategies for repair of critical nerves involves the transfer of normal donor nerve from an uninjured body location. One possible alternative to autogenous tissue replacement is the development of engineered constructs to replace those elements necessary for axonal proliferation. Delivery of growth factors is one strategy to enhance synthetic nerve constructs. Thus, this study focused on the delivery of nerve growth factor (NGF) by genetic engineering to begin approaching the microenvironment dictated, in part, by Schwann's cells. Rat dermal fibroblasts (DFBs) were modified genetically to release rat NGF. The reporter gene LacZ was used to assess the optimum nonviral transfection method commercially available before NGF transfection. FuGENE6 provided the optimum transfection efficiency (24% maximum, 20.1 +/- 1.9% 5-day average) as measured by beta-galactosidase catalytic activity. NGF release from transfected DFBs was assessed over a 3-day period. Compared with control (no transfection) DFBs and DFBs transfected with vector alone, DFBs transfected with an expression vector encoding rat beta-NGF demonstrated significantly (p < 0.05) higher levels of NGF, with a 3-day maximum of 111 pg NGF per milliliter. When normalized to cell number, NGF-transfected DFBs released 1.2 pg NGF per milliliter/10(3) cells. The NGF-transfected DFBs demonstrated a maximal NGF release rate at day 1 (1.2 ng NGF/10(6) cells per day), followed by a markedly lower, sustained release rate at days 2 and 3 (0.44 ng NGF/10(6) cells per day and 0.48 ng NGF/10(6) cells per day respectively). The release rate curves for control and vector-transfected DFBs also exhibited a maximal NGF release rate at day 1, but were followed by a decreasing release rate, potentially representing in vitro degradation of NGF present in fetal bovine serum. Although not first with the development of growth factor delivery through fibroblasts, these findings suggest that rat DFBs can be modified genetically to act like Schwann's cells to deliver NGF.


Assuntos
Fibroblastos/metabolismo , Fator de Crescimento Neural/genética , Transfecção/métodos , Animais , Engenharia Genética , Fator de Crescimento Neural/metabolismo , Ratos , Ratos Sprague-Dawley , Células de Schwann/metabolismo , Pele/metabolismo , Fatores de Tempo
11.
Oncogene ; 19(42): 4864-75, 2000 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-11039904

RESUMO

The over-expression of c-erbB-2/ HER-2, a receptor tyrosine kinase, correlates with poor prognosis in patients with breast and ovarian cancer. In the human breast cancer cell line, MDA-MB-435, c-erbB-2 over-expression results in increased chemoinvasion and higher metastatic properties in nude mice. However, the mechanisms by which c-erbB-2 increases the malignant potential of cells remains unclear. We have determined that over-expression of c-erbB-2 in MDA-MB-435 cells, and in some additional breast cancer cell lines, is associated with graphic increases in mRNA and protein levels of the actin bundling protein fascin. Heightened fascin expression has been observed in other systems to result in greatly increased cell motility, and indeed, our work employing semi-automated time-lapse microscopy demonstrates that MDA-MB-435 cells over-expressing c-erbB-2 exhibit significantly heightened cellular dynamics and locomotion, while visualization of bundled microfilaments within fixed cells revealed enhanced formation of dendritic-like processes, microspikes and other dynamic actin based structures. To address the means by which c-erbB-2 over-expression might result in elevated fascin levels, we identified multiple perfect match TCF and NF-kappaB consensus sites in fascin's promoter and first intron, which appeared consistent with the greater endogenous transcriptional activities of TCF and NF-kappaB in c-erbB-2 over-expressing MDA-MB-435 cells. While such transcriptional modulation may occur in the context of the intact gene/chromatin, subsequent tests using reporter constructs did not support involvement of these signaling pathways. In conclusion, highly increased fascin levels were observed in MDA-MB-435 over-expressing c-erbB-2, likely contributing to these cells' altered actin dynamics, and increased cell motility and malignancy. Studies in progress aim to discern the means by which c-erbB-2 over-expression leads to transcriptional activation of the fascin gene.


Assuntos
Neoplasias da Mama/patologia , Proteínas de Transporte/biossíntese , Movimento Celular/genética , Regulação Neoplásica da Expressão Gênica , Proteínas dos Microfilamentos/biossíntese , Proteínas de Neoplasias/fisiologia , Receptor ErbB-2/fisiologia , Transativadores , Actinas/metabolismo , Sítios de Ligação , Proteínas de Transporte/genética , Sequência Consenso , Proteínas do Citoesqueleto/metabolismo , Proteínas de Ligação a DNA/metabolismo , Feminino , Genes Reporter , Humanos , Fator 1 de Ligação ao Facilitador Linfoide , Proteínas dos Microfilamentos/genética , Microscopia de Vídeo , NF-kappa B/metabolismo , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Fosforilação , Regiões Promotoras Genéticas , Processamento de Proteína Pós-Traducional , RNA Mensageiro/biossíntese , RNA Neoplásico/biossíntese , Proteínas Recombinantes de Fusão/fisiologia , Transdução de Sinais , Fatores de Transcrição/metabolismo , Transfecção , Células Tumorais Cultivadas/metabolismo , Células Tumorais Cultivadas/fisiologia , Células Tumorais Cultivadas/ultraestrutura , beta Catenina
12.
J Biomed Mater Res ; 51(3): 383-90, 2000 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-10880080

RESUMO

Poly(DL-lactide-co-glycolide) (PLGA)/polyethylene glycol (PEG) microspheres are one modality of controlled delivery of biologically active molecules that would further the development of engineered tissues. As a possible mechanism to stimulate angiogenesis within an engineered tissue, vascular endothelial growth factor (VEGF) and bovine serum albumin (BSA) were coencapsulated into microspheres fabricated from PEG and 50/50 PLGA using a solid-encapsulation/single-emulsion/solvent extraction technique. Two VEGF/BSA ratios were studied: 1:2000 and 1:10,000. Analysis consisted of the loading efficiency, particle size distribution, bright-field microscopy, scanning electron microscopy, release kinetics, and an in vitro human umbilical vein endothelial cell proliferation assay to assess biological activity of the released VEGF. Results show the microspheres could be manufactured, stored, and degraded over 28 days. The burst release rates for 1:2000 and 1:10,000 VEGF/BSA microspheres were 71.87 +/- 8.11 and 27.91 +/- 1.71 ng/mL (mean +/- standard error of the mean), respectively; steady-state release rates were 6.56 +/- 1.10 and 2.21 +/- 0.47 ng/mL, respectively. The microspheres released biologically active VEGF, and the VEGF increased the proliferation of HUVECs in culture (p <.05). The successful development of a novel, cost-effective, scalable technique for producing microspheres loaded with biologically active proteins is presented. Using the data obtained from these studies, a defined concentration of microspheres will deliver a quantifiable level of VEGF at a known release rate.


Assuntos
Materiais Biocompatíveis , Fatores de Crescimento Endotelial/administração & dosagem , Linfocinas/administração & dosagem , Polietilenoglicóis , Poliglactina 910 , Animais , Engenharia Biomédica , Bovinos , Divisão Celular/efeitos dos fármacos , Células Cultivadas , Preparações de Ação Retardada , Sistemas de Liberação de Medicamentos , Emulsões , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Humanos , Técnicas In Vitro , Teste de Materiais , Microscopia Eletrônica de Varredura , Microesferas , Proteínas Recombinantes/administração & dosagem , Solventes , Fator A de Crescimento do Endotélio Vascular , Fatores de Crescimento do Endotélio Vascular
13.
Semin Surg Oncol ; 19(3): 302-11, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11135487

RESUMO

Reconstructive surgeons have always been at the forefront of medical technology. The history of reconstructive surgery began with ablative surgery, which was followed by tissue and organ transplantation, leading to contemporary tissue reconstruction. The field of reconstructive surgery is poised at the next stage of its evolution, namely tissue regeneration. The field of tissue engineering has largely defined this evolutionary leap. One active area of investigation is the development of tissue engineering strategies for adipose tissue. Bioengineers, life scientists, and reconstructive surgeons are synergistically coupling expertise in areas such as cell culture technology, tissue transfer, cell differentiation, angiogenesis, computer modeling, and polymer chemistry to regenerate adipose tissue de novo for breast replacement and soft-tissue augmentation following tumor resection. This work presents the current state of the art in adipose tissue engineering, as well the clinically translatable strategies currently under development. Semin. Surg. Oncol. 19:302-311, 2000.


Assuntos
Tecido Adiposo , Implantes de Mama , Neoplasias da Mama/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Neoplasias de Tecidos Moles/cirurgia , Engenharia Biomédica/tendências , Mama/irrigação sanguínea , Diferenciação Celular , Técnicas de Cultura/métodos , Feminino , Humanos , Masculino , Mastectomia , Microcirculação , Neovascularização Fisiológica , Retalhos Cirúrgicos
14.
J Biomater Sci Polym Ed ; 11(8): 869-78, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11211097

RESUMO

It was the purpose of this study to evaluate the clinical long-term effects of PLLA degradation in vivo on nerve regeneration in the rat sciatic nerve model. Thirty-one Sprague Dawley rats were utilized. Two groups of animals were selected. The control group of 10 animals received a 12 mm reversed isograft into the right sciatic nerve from 5 donor animals. The experimental group (n = 21) received a 12 mm empty PLLA conduits placed into a 12 mm defect in the right sciatic nerve. The left leg served as an internal control. Walking track analysis was performed monthly through 8 months. At the end of 4 and 8 months, animals in the control isograft and experimental group had the medial and lateral gastrocnemius muscles harvested and weighed for comparison. The midconduit/isograft and the distal nerve in these same animals were harvested and histomorphologically analyzed. Multiple samples were collected and expressed as means +/- standard error. A two-sample t-test and Wilcoxon rank sum test was used to compare the variables. Significance level was set at alpha = 0.05. After Bonferroni correction for multiple testing, a p value of < or = 0.01 was considered statistically significant. Throughout all time periods, the PLLA conduit remained structurally intact and demonstrated tissue incorporation and vascularization. There was no evidence of conduit collapse or breakage with limb ambulation. Moreover, there was no evidence of conduit elongation at 8 months as previously observed with the 75:25 poly(DL-lactic-co-glycolic acid) (PLGA) conduits. The mean absolute value of the sciatic functional index (SFI) demonstrated no group differences from isograft controls measured over the 8 months except at 3 months where the isograft values were higher (p = 0.0379) and at 7 months were the isograft group was significantly lower (p = 0.0115). At 4 and 8 months, the weight of the gastrocnemius muscles of the experimental group was not significantly different from isografts. At 4 months the number of axons/mm2 and nerve fiber density was not significantly different between the isograft control and experimental groups in either the midconduit/isograft or distal nerve. At 8 months the number of axons/mm2 was significantly lower in the isograft compared to the midconduit experimental group (p = 0.006). The number of axons/mm2 in the distal nerve and the nerve fiber density in the midconduit and distal nerve were not significantly different between the two groups. The study confirmed our initial hypothesis that PLLA conduits are a viable scaffold for clinical long-term nerve gap replacement. We are critically aware however that longer evaluation of polymer degradation is warrented. Further studies on these individual nerve components are continuing, with the ultimate goal being the fabrication of a bioactive conduit that meets or exceeds the functional results of isografts.


Assuntos
Ácido Láctico/química , Membranas Artificiais , Nervos Periféricos/metabolismo , Nervos Periféricos/fisiologia , Polímeros/química , Próteses e Implantes , Regeneração , Animais , Axônios/fisiologia , Ácido Láctico/farmacologia , Músculo Esquelético/fisiologia , Fibras Nervosas/fisiologia , Poliésteres , Polímeros/farmacologia , Ratos , Ratos Sprague-Dawley , Nervo Isquiático/química , Fatores de Tempo , Caminhada
15.
Microsurgery ; 19(5): 254-7, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10413792

RESUMO

The purpose of this study was to evaluate blood flow and transcutaneous partial oxygen pressure (TcPO(2)) in adjacent tissues to free and pedicled flaps following reconstructive procedures used in conjunction with radical surgery for head and neck cancers. Fifty patients were included. Fourteen patients had reconstruction with pedicled flaps and 36 with free flaps. For each patient, TcPO(2) and laser Doppler flow measurements were taken at the center of the flap, in adjacent tissue, and in a corresponding contralateral site. Three laser Doppler measurements were performed at each site and a mean value recorded. All patients had undergone reconstruction up to 6 months prior to the time of the measurements. The collected data were analyzed using a Wilcoxon signed rank test. There were no statistically significant differences in partial oxygen tension or laser Doppler values between tissues adjacent to free compared to pedicled flaps. Although there is strong evidence to support that free flaps have improved blood flow and partial oxygen tension over pedicled flaps, further study is required to evaluate adjacent tissues. Flap choice may assist with alteration in blood flow in less favorable defects such as those in previously irradiated fields and those resulting from burn scars or chronic infections.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Oxigênio/metabolismo , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Monitorização Transcutânea dos Gases Sanguíneos , Feminino , Humanos , Fluxometria por Laser-Doppler , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Retalhos Cirúrgicos/fisiologia
16.
Tissue Eng ; 5(2): 139-51, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10358221

RESUMO

Adipose tissue equivalents have not been addressed as yet despite the clinical need in congenital deformities, posttraumatic repair, cancer rehabilitation, and other soft tissue defects. Preadipocytes were successfully harvested from rat epididymal fat pads of Sprague-Dawley and Lewis rats and expanded ex vivo. In vitro cultures demonstrated full differentiation of preadipocytes into mature adipocytes with normal lipogenic activity. The onset of differentiation was well-controlled by regulating preadipocyte confluency. Poly(lactic-co-glycolic) acid (PLGA) polymer disks with 90% porosity, 2.5 mm thick, 12 mm diameter, pore size range of 135-633 microm were fabricated and seeded with preadipocytes at 10(5) cells/mL. Disks in vitro demonstrated fully differentiated mature adipocytes within the pores of the disks. Short-term in vivo experiments were conducted by implanting preseeded disks subcutaneously on the flanks of rats for 2 and 5 weeks. Histologic staining of harvested disks with osmium tetroxide (OsO4) revealed the formation of adipose tissue throughout the disks. Fluorescence labeling of preadipocytes confirmed that formed adipose tissue originated from seeded preadipocytes rather than from possible infiltrating perivascular tissue. This study demonstrates the potential of using primary preadipocytes as a cell source in cell-seeded polymer scaffolds for tissue engineering applications.


Assuntos
Adipócitos/citologia , Tecido Adiposo/citologia , Órgãos Artificiais , Materiais Biocompatíveis , Engenharia Biomédica , Ácido Láctico , Ácido Poliglicólico , Polímeros , Animais , Técnicas de Cultura de Células/métodos , Diferenciação Celular , Células Cultivadas , Microscopia Eletrônica de Varredura , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Próteses e Implantes , Ratos , Ratos Sprague-Dawley
17.
Biomaterials ; 20(12): 1109-15, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10382826

RESUMO

The present study provides in vivo trials of poly(L-lactic acid) (PLLA) as a porous biodegradable nerve conduit using a 10 mm sciatic nerve defect model in rats. The PLLA conduits, fabricated by an extrusion technique, had an inner diameter of 1.6 mm, an outer diameter of 3.2 mm, and a length of 12 mm. They were highly porous with an interconnected pore structure (of 83.5% porosity and 12.1 microm mean pore size). The conduits were interposed into the right sciatic nerve defect of Sprague Dawley rats using microsurgical techniques; nerve isografts served as controls. Walking track analysis was performed after conduit placement monthly through 16 weeks. At the conclusion of 6 and 16 weeks, sections from the isograft/conduit and distal nerve were harvested for histomorphometric analysis. The right gastrocnemius muscle was also harvested and its weight was determined. All conduits remained intact without breakage. Moreover, no conduit elongated during the 16 weeks of placement. Walking track analysis and gastrocnemius muscle weight demonstrated increasing regeneration over the 16 weeks in both the conduit and isograft control groups, with control values significantly greater. The nerve fiber density in the distal sciatic nerve for the PLLA conduits (0.16+/-0.07) was similar to that for the control isografts (0.19+/-0.05) at 16 weeks. The number of axons/mm2 in the distal sciatic nerve for the PLLA conduits was lower than that for the isografts (13 800+/-2500 vs. 10700+/-4700) at 16 weeks. The results for PLLA were significantly improved over those for 75:25 poly(DL-lactic-co-glycolic acid) of a previous study and suggest that PLLA porous conduits may serve as a scaffold for peripheral nerve regeneration.


Assuntos
Materiais Biocompatíveis/química , Ácido Láctico/química , Regeneração Nervosa/fisiologia , Polímeros/química , Nervo Isquiático/fisiologia , Animais , Masculino , Poliésteres , Ratos , Ratos Sprague-Dawley , Nervo Isquiático/lesões , Nervo Isquiático/transplante , Transplante Autólogo , Transplante Isogênico
18.
Plast Reconstr Surg ; 104(2): 464-9, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10654689

RESUMO

Current treatment modalities for extremity sarcoma often include tumor extirpation plus neoadjuvant therapy. Limb-sparing surgery may require reconstruction of critical nerve defects. Neurotoxic side effects from adjuvant chemotherapy have been reported and raise concerns regarding the effects of chemotherapy on nerve regeneration. In an attempt to define the effects of adjuvant chemotherapy on peripheral nerve regeneration, cisplatin and vincristine were administered to rats following isografting of the posterior tibial nerve. Parameters used to assess peripheral nerve regeneration included walking track analysis and histomorphology. Sixty 250-g Sprague-Dawley rats were randomly allocated into one of three treatment groups. Each animal underwent a 15-mm reversed interposition nerve isograft from 30 donor rats into the right posterior tibial nerve. Ten animals served as control. The remaining animals were divided into two groups of 25 animals each. One group received cisplatin (75 mg/m2) and the other group received vincristine (1 mg/m2). Chemotherapy was administered at 4-week cycles for a total of six cycles (24 weeks). Walking track analysis was performed monthly. Nerve specimens were harvested from the grafted segment and the distal posterior tibial nerve for histomorphology. Walking track analysis demonstrated no statistical difference in print length between the control and chemotherapeutic groups at the conclusion of the study. The number of axons per square millimeter and nerve fiber density were not statistically different between control and chemotherapeutic groups. In the rodent posterior tibial nerve model, postoperative adjuvant therapy does not significantly alter functional outcome in peripheral nerve regeneration. The practice of immediate nerve grafting after tumor extirpation, despite planned postoperative chemotherapy, is supported.


Assuntos
Antineoplásicos/farmacologia , Cisplatino/farmacologia , Regeneração Nervosa/efeitos dos fármacos , Nervo Tibial/fisiologia , Vincristina/farmacologia , Animais , Axônios/fisiologia , Quimioterapia Adjuvante , Membro Posterior , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Sarcoma Experimental/tratamento farmacológico , Sarcoma Experimental/cirurgia , Nervo Tibial/efeitos dos fármacos , Caminhada
19.
Biomaterials ; 19(21): 1945-55, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9863528

RESUMO

We have fabricated porous, biodegradable tubular conduits for guided tissue regeneration using a combined solvent casting and extrusion technique. The biodegradable polymers used in this study were poly(DL-lactic-co-glycolic acid) (PLGA) and poly(L-lactic acid) (PLLA). A polymer/salt composite was first prepared by a solvent casting process. After drying, the composite was extruded to form a tubular construct. The salt particles in the construct were then leached out leaving a conduit with an open-pore structure. PLGA was studied as a model polymer to analyze the effects of salt weight fraction, salt particle size, and processing temperature on porosity and pore size of the extruded conduits. The porosity and pore size were found to increase with increasing salt weight fraction. Increasing the salt particle size increased the pore diameter but did not affect the porosity. High extrusion temperatures decreased the pore diameter without altering the porosity. Greater decrease in molecular weight was observed for conduits manufactured at higher temperatures. The mechanical properties of both PLGA and PLLA conduits were tested after degradation in vitro for up to 8 weeks. The modulus and failure strength of PLLA conduits were approximately 10 times higher than those of PLGA conduits. Failure strain was similar for both conduits. After degradation for 8 weeks, the molecular weights of the PLGA and PLLA conduits decreased to 38% and 43% of the initial values, respectively. However, both conduits maintained their shape and did not collapse. The PLGA also remained amorphous throughout the time course, while the crystallinity of PLLA increased from 5.2% to 11.5%. The potential of seeding the conduits with cells for transplantation or with biodegradable polymer microparticles for drug delivery was also tested with dyed microspheres. These porous tubular structures hold great promise for the regeneration of tissues which require tubular scaffolds such as peripheral nerve, long bone, intestine, or blood vessel.


Assuntos
Materiais Biocompatíveis/química , Regeneração Tecidual Guiada/métodos , Ácido Láctico/química , Ácido Poliglicólico/química , Polímeros/química , Varredura Diferencial de Calorimetria , Fenômenos Químicos , Físico-Química , Regeneração Tecidual Guiada/instrumentação , Microscopia Eletrônica de Varredura , Tamanho da Partícula , Poliésteres , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Porosidade , Temperatura
20.
Anal Quant Cytol Histol ; 20(3): 199-206, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9642447

RESUMO

OBJECTIVE: To develop a computer-assisted histometric technique that quantitatively determines the amount of regenerating bone, while excluding fibrovascular tissue and void spaces, in tissue-engineered bone constructs. To this end, a histometric technique was developed that couples digital tiling with adaptive, multiband color thresholding (AMBCT). STUDY DESIGN: To test the technique, a previously described model bone tissue-engineered construct filled with morcellized bone graft was employed. Histometric techniques were applied to quantify the amount of bone formed following eight weeks of implantation. RESULTS: The histometric technique was able to yield quantitative information regarding the amount of bone despite intrahistologic and interhistologic differences in staining. The technique is user friendly and highly automated. In addition to area fractions, the technique can provide bone ingrowth profiles as a function of geometry and implantation time. CONCLUSION: Digital tiling coupled with AMBCT offers an easy, fast and reproducible technique that aids in quantification of bone within histologic sections. In addition, the technique can be adapted to quantification of other tissues. Further studies are under way to investigate the potential of correlating the histometric technique with mechanical strength analyses of tissue-engineered bone specimens.


Assuntos
Regeneração Óssea/fisiologia , Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Animais , Transplante Ósseo/métodos , Modelos Biológicos , Ovinos
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