Cultivo de condrocitos sobre una matriz acelular derivada de membrana amniocoriónica

BackgroundHyaline cartilage has only a very restricted capability of regeneration in the adult. The incidence of chondral lesions at the knee is high, especially those of Grade II/III (Outerbridge). Therapies combining cells and biological scaffolds are promising biological approaches for the treatment of cartilage defects. The aim of this study is to analyze the characteristics of in vitro culture of human chondrocytes on decellularized amniochorionic membrane (ACM).MethodsBetween December 2010 and December 2011, 16 samples of cartilage from a living donor were processed, but only 7 of them were analyzed. Chondrocytes were grown and amplified on plastic and on ACM. The following analyses were carried out with those cells: interactions between cells and ACM; ACM capacity as a matrix for cells; and behavior of cells cultured on ACM.ResultsIn vitro chondrocytes exhibited phenotypic changes in the presence of ACM. The cells were able to adhere and remain on the spongy region of the membrane. Electron microscopy of cultured ACM showed cells, well preserved organelles, endoplasmic reticulum and desmosomes junctions.ConclusionsThe feasibility of culturing chondrocytes on ACM was shown in this work. The cells were able to adhere, remain and differentiate on this membrane during the study period.IntroducciónEl tejido cartilaginoso articular presenta escasa capacidad regenerativa.Existe alta incidencia de lesiones condrales en rodilla, especialmente de Grado II/III (Outerbridge). El uso combinado de células autólogas cultivadas con membranas biológicas, es una posibilidad terapéutica. El objetivo del presente trabajo es analizar las características del desarrollo in vitro de condrocitos humanos sobre membrana amniocoriónica acelular (MAC).Material y métodosEntre diciembre 2010 y diciembre 2011 se procesaron 16 muestras de cartílago de donante vivo, de las cuales fueron analizadas7. Los condrocitos fueron cultivados y amplificados sobre plástico, a partir de lo cual se realizaron los siguientes análisis: interacción entre células y MAC, capacidad de la MAC como matriz para las células, y comportamiento de las células cultivadas sobre la MAC.ResultadosLos condrocitos in vitro mostraron cambios fenotípicos en presencia de MAC. Las células fueron capaces de adherirse y permanecer en la región esponjosa de la membrana. La microscopía electrónica de las MAC cultivadas mostró presencia de células, organelas celulares bien conservadas, retículo endoplásmico y uniones tipo desmosomas.ConclusionesEste trabajo muestra la factibilidad de cultivar condrocitos sobre MAC. Las células fueron capaces de adherirse, permanecer y diferenciarse sobre la membrana durante el tiempo de estudio

Cultivo de condrocitos sobre una matriz acelular derivada de membrana amniocoriónica. [Culture of chondrocytes on an acellular matrix derived from amniochorionic membrane]

Introducción El tejido cartilaginoso articular presenta escasa capacidad regenerativa.Existe alta incidencia de lesiones condrales en rodilla, especialmente de Grado II/III (Outerbridge). El uso combinado de células autólogas cultivadas con membranas biológicas, es una posibilidad terapéutica. El objetivo del presente trabajo es analizar las características del desarrollo in vitro de condrocitos humanos sobre membrana amniocoriónica acelular (MAC). Material y métodos Entre diciembre 2010 y diciembre 2011 se procesaron 16 muestras de cartílago de donante vivo, de las cuales fueron analizadas7. Los condrocitos fueron cultivados y amplificados sobre plástico, a partir de lo cual se realizaron los siguientes análisis: interacción entre células y MAC, capacidad de la MAC como matriz para las células, y comportamiento de las células cultivadas sobre la MAC. Resultados Los condrocitos in vitro mostraron cambios fenotípicos en presencia de MAC. Las células fueron capaces de adherirse y permanecer en la región esponjosa de la membrana. La microscopía electrónica de las MAC cultivadas mostró presencia de células, organelas celulares bien conservadas, retículo endoplásmico y uniones tipo desmosomas. Conclusiones Este trabajo muestra la factibilidad de cultivar condrocitos sobre MAC. Las células fueron capaces de adherirse, permanecer y diferenciarse sobre la membrana durante el tiempo de estudio

Pseudomyogenic hemangioendothelioma with bone and soft tissue involvement with favorable response to pamidronate: A case report and systematic review of the literature

Pseudomyogenic hemangioendothelioma (PMH) can be a challenge for diagnosis and might be confused with other tumors, such as epithelioid sarcoma. Here we present a case and a systematic review of the literature to identify and discuss PMH treatment in primary bone involvement. A 25-year-old woman was referred for bone pain (10/10) in the left lower limb. Magnetic resonance imaging (MRI) showed multiple bone lesions (left femur, tibia, patella, ankle, and foot) with well-defined borders without signs of local aggressiveness. Positron Emission Tomography-Computed Tomography (PET-CT) showed multiple metabolic musculoskeletal lesions in the left lower limb. A CT scan–guided biopsy was performed. Histological and immunohistochemical findings confirmed the diagnosis of PMH. After treatment with intravenous pamidronate (90 mg/monthly), the patient had clinical improvement, mild pain 2/10 without the use of non-steroidal anti-inflammatory drugs or opiates. Follow-up was assessed by MRI and PET-CT. PET-CT showed metabolic resolution of most of the bone and muscular lesions and a significant improvement of the femoral lesion. MRI showed that the lesions in the left femur, tibia, and foot had a marked decrease in size without intravenous post-contrast enhancement and smaller lesions had disappeared. After a 3-year follow-up, PET-CT showed no metabolically active images. Literature review identified 31 records including 58 clinical cases of PMH with primary bone involvement and treatment description for qualitative analysis. Most lesions (69%) were treated by local excision or curettage. In addition, amputations were performed in a significant percentage of cases (20.7%). In the last years, mTOR inhibitors (n = 7) and anti-resorptive treatments (n = 4) were considered as alternative treatment options, especially in multifocal lesions.Fil: Brance, María Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Reumatología y Enfermedades Óseas Rosario; Argentina. Universidad Nacional de Rosario; ArgentinaFil: Cóccaro, Nicolás M.. Sanatorio Britanico; ArgentinaFil: Roitman, Pablo Daniel. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Castiglioni, Alejandro Enrique. Sanatorio Britanico; ArgentinaFil: Agostinis, Florencia. Sanatorio Britanico; ArgentinaFil: Spense, Mariel. Sanatorio Britanico; ArgentinaFil: Scheitlin, Bárbara. Sanatorio Britanico; ArgentinaFil: Rene, Nicholas. Centro de Radioterapia; ArgentinaFil: Brun, Lucas Ricardo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario; Argentin

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)