Current protocols in the generation of pluripotent stem cells: theoretical, methodological and clinical considerations

Brad B Swelstad, Candace L KerrInstitute for Cell Engineering, Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MA, USAAbstract: Pluripotent stem cells have been derived from various embryonic, fetal and adult sources. Embryonic stem cells (ESCs) and parthenogenic ESCs (pESCs) are derived from the embryo proper while embryonic germ cells (EGCs), embryonal carcinoma cells (ECCs), and germ-line stem cells (GSC) are produced from germ cells. ECCs were the first pluripotent stem cell lines established from adult testicular tumors while EGCs are generated in vitro from primordial germ cells (PGCs) isolated in late embryonic development. More recently, studies have also demonstrated the ability to produce GSCs from adult germ cells, known as spermatogonial stem cells. Unlike ECCs, the source of GSCs are normal, non-cancerous adult tissue. The study of these unique cell lines has provided information that has led to the ability to reprogram somatic cells into an ESC-like state. These cells, called induced pluripotent stem cells (iPSCs), have been derived from a number of human fetal and adult origins. With the promises pluripotent stem cells bring to cell-based therapies there remain several considerations that need to be carefully studied prior to their clinical use. Many of these issues involve understanding key factors regulating their generation, including those which define pluripotency. In this regard, the following article discusses critical aspects of pluripotent stem cell derivation and current issues about their therapeutic potential.Keywords: pluripotency, stem cells, derivation, huma

Breakage of suture material leading to fascial dehiscence

Background: Fascial dehiscence is a feared complication associated with abdominal surgery. This case evaluates a case of dehiscence caused by breakage of the fascial stitch. Case: A 60-year-old woman (G2P1011) underwent abdominal myomectomy. During the closure of the fascia, a single knot within the segment of suture was noted. The knot was then loosened and untied. Thirty hours later, fascial dehiscence was noted secondary to breakage of the suture material at approximately the area where the knot had been noted earlier in the suture. The fascia was closed again and the patient had an unremarkable postoperative course. We could not find a mention in the package insert or the medical literature regarding how a knot could undermine the suture strength. We obtained a new suture and tied a single knot, which was then loosened. The suture was photographed and compared to a control. Conclusions: There is no way to necessarily attribute the compromise in the suture to this event. However, this case report warrants further research to better define all events that could compromise the integrity of suture material