Treatment of failed articular cartilage reconstructive procedures of the knee: A systematic review

Background: Symptomatic articular cartilage lesions of the knee are common and are being treated surgically with increasing frequency. While many studies have reported outcomes following a variety of cartilage restoration procedures, few have investigated outcomes of revision surgery after a failed attempt at cartilage repair or reconstruction. Purpose: To investigate outcomes of revision cartilage restoration procedures for symptomatic articular cartilage lesions of the knee following a previously failed cartilage reconstructive procedure. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed by use of the PubMed, EMBASE, and MEDLINE/Ovid databases for relevant articles published between 1975 and 2017 that evaluated patients undergoing revision cartilage restoration procedure(s) and reported outcomes using validated outcome measures. For studies meeting inclusion criteria, relevant information was extracted. Results: Ten studies met the inclusion criteria. Lesions most commonly occurred in the medial femoral condyle (MFC) (52.8%), with marrow stimulation techniques (MST) the index procedure most frequently performed (70.7%). Three studies demonstrated inferior outcomes of autologous chondrocyte implantation (ACI) following a previous failed cartilage procedure compared with primary ACI. One study comparing osteochondral allograft (OCA) transplant following failed microfracture (MFX) with primary OCA transplant demonstrated similar clinical outcomes and graft survival at midterm follow-up. No studies reported outcomes following osteochondral autograft transfer (OAT) or newer techniques. Conclusion: This systematic review of the literature reporting outcomes following revision articular cartilage restoration procedures (most commonly involving the MFC) demonstrated a high proportion of patients who underwent prior MST. Evidence is sufficient to suggest that caution should be taken in performing ACI in the setting of prior MST, likely secondary to subchondral bone compromise. OCA appears to be a good revision treatment option even if the subchondral bone has been violated from prior surgery or fracture. </jats:sec

HEG87-211 For Sale By Owner: The Right Choice For You?

The purpose of this NebGuide is to help you decide if a do-it-yourself home sale is an appropriate choice. Steps in preparing and marketing a home are reviewed. Ideas to promote the sale and a decision-making checklist are included. The decision to sell your home yourself requires careful consideration. Saving the cost of a real estate agent\u27s commission is a primary reason for do-it-yourself sales. However, this type of sale is not all profit. It is necessary to invest time, money and other resources, in preparing and marketing your house

HEG87-211 For Sale By Owner: The Right Choice For You?

The purpose of this NebGuide is to help you decide if a do-it-yourself home sale is an appropriate choice. Steps in preparing and marketing a home are reviewed. Ideas to promote the sale and a decision-making checklist are included. The decision to sell your home yourself requires careful consideration. Saving the cost of a real estate agent\u27s commission is a primary reason for do-it-yourself sales. However, this type of sale is not all profit. It is necessary to invest time, money and other resources, in preparing and marketing your house

Double sequential encrypted targeting sequence: A new concept for bone cancer treatment

The selective transportation of therapeutic agents to tumoral cells is usually achieved by their conjugation with targeting moieties able to recognize these cells. Unfortunately, simple and static targeting systems usually show selectivity lacks. Herein, double sequential encrypted targeting system is proposed as stimuliresponsive targeting analogue for selectivity enhancement. The system is able to recognize diseased bone tissue in first place, and once there, a hidden secondary targeting group is activated by the presence of an enzyme overproduced in the malignant tissue (cathepsin K), triggering the recognition of diseased cells. Transporting the cell targeting agent in a hidden conformation which contains a high selective tissular primary targeting, could avoid not only its binding to similar cell receptors but also the apparition of the binding-site barrier effect, which can enhance the penetration of the therapeutic agent within the affected zone. This strategy could be applied not only to conjugate drugs but also to drug loaded nanocarriers in order to improve the efficiency for bone cancer treatments

Usefulness of Current Patient-Reported Outcome Scales for ACL Injury: A Mixed-Methods Evaluation of Stakeholder-Perceived Utility of Specific Constructs and Items Across the Rehabilitation Timeline

BACKGROUND: Numerous patient-reported outcome measures (PROMs) have been used in patients with anterior cruciate ligament reconstruction (ACLR), often with overlapping constructs of interest and limited content validity. Inefficient scale application increases burden and diminishes overall usefulness for both the patient and practitioner. PURPOSE: To isolate specific PROM items across a diverse set of constructs that patients and practitioners perceive as having the greatest value at various stages of recovery and return to sport (RTS) in patients after ACLR. STUDY DESIGN: Cross-sectional study. METHODS: A combined 77 stakeholders participated in this 2-phase mixed-methods investigation. In phase 1, a total of 27 patients and 21 practitioners selected individual PROM items from various constructs that had the greatest utility or importance. In phase 2, the highest rated items were further tested in a head-to-head comparison with 29 stakeholders who attended the 2022 ACL Injury Research Retreat. In addition to the utility assessment, practitioners answered other questions related to importance and timing of PROM assessments. RESULTS: In phase 1, both patients and practitioners shared the same top item in 6 of the 8 (75%) constructs assessed. In phase 2, the construct of psychological burden was rated as extremely important by 59% of respondents, followed by physical function (54%), symptoms (35%), and donor site issues (10%). The PROM items of confidence, perceived likelihood of reinjury, and difficulty stopping quickly were rated by a respective 93%, 89%, and 86% of the sample as either very useful or extremely useful. All constructs except donor site issues were rated by most stakeholders to be absolutely necessary to evaluate treatment progress and RTS readiness at the 6-month postoperative time and at RTS. CONCLUSION: Overall, psychological burden, with specific items related to confidence and reinjury likelihood, were rated as most important and useful by both patients and practitioners. The second most important and useful PROM item was related to higher intensity function (eg, decelerating or jumping/landing activities during sports)

Absorbable collagen sponges loaded with recombinant bone morphogenetic protein 9 induces greater osteoblast differentiation when compared to bone morphogenetic protein 2

The use of growth factors for the regeneration of soft and hard tissues has been utilized extensively in dental medicine over the past decade. Recently our group found that recombinant human bone morphogenetic protein 9 (rhBMP9) was more osteopromotive than recombinant human bone morphogenetic protein 2 (rhBMP2) when combined with a deprotenized bovine bone mineral bone grafting material. The aim of the present in vitro study was to evaluate the regenerative potential of an absorbable collagen sponge(ACS) specifically designed for extraction socket healing loaded with rhBMP9 when compared to rhBMP2. The adsorption and release kinetics of rhBMP2 and rhBMP9 were first investigated by enzymeâ linked immunosorbent assay quantification. Then, the cellular effects of stromal cell line (ST2) preosteoblasts were investigated utilizing four groups including rhBMP2 and rhBMP9 at both low(10 ng/ml) and high(100 ng/ml) concentrations loaded onto ACS. Cellular attachment(8 hours) and proliferation(1, 3, and 5 days) as well as osteoblast differentiation were investigated by realâ time polymerase chain reaction (PCR) at 3 and 14 days, alkaline phosphatase (ALP) activity at 7 days, and alizarin red staining at 14 days. ACS fully adsorbed both rhBMP2 and rhBMP9 that were slowly released up to 10 days. Although neither rhBMP2 nor rhBMP9 had any effects on cell attachment or proliferation, pronounced effects were observed on osteoblast differentiation. ALP activity was increased sevenâ fold with rhBMP2â high, whereas a marked 10â fold and 20â fold increase was observed with rhBMP9â low and high loaded to ACS, respectively. Furthermore, mRNA levels of collagen1, ALP, bone sialoprotein, and osteocalcin were all significantly higher for rhBMP9 when compared to control or rhBMP2 groups. Alizarin red staining further confirmed that rhBMP9â low and high demonstrated marked increases in mineralization potential when compared to rhBMP2â high. The results demonstrate the marked effect of rhBMP9 on osteoblast differentiation when combined with ACS in comparison to rhBMP2 at doses as much as 10 times lower. Further in vivo studies are necessary to investigate whether the regenerative potential is equally as potent.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136307/1/cre255.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136307/2/cre255_am.pd

Pepper quality in terms of piperine content

Cílem této bakalářské práce bylo zjistit kvalitu pepře dostupného v obchodní síti ČR. Kvalita vzorků pepře byla zjišťována na základě obsahu piperinu. Piperin byl ze vzorků pepře extrahován pomocí acetonu a extrakty byly následně analyzovány pomocí vysoko-účinné kapalinové chromatografie s hmotnostním detektorem. Ve všech vzorcích byl stanoven obsah vody titračně podle Karl-Fishera a obsah piperinu ve vzorcích byl následně přepočten na sušinu. Obsah piperinu v pepři se pohyboval od 49 do 90 mg/g a splňoval požadavky platné legislativy, která udává minimální obsah piperinu v pepři 4 %. Statistická analýza prokázala, že mezi jednotlivými vzorky pepře je z hlediska obsahu piperinu statisticky významný rozdíl, což poukazuje na fakt, že pepř od různých výrobců pochází z rozdílných zdrojů.The aim of this bachelor's thesis was to determine the quality of pepper available in the commercial network of the Czech Republic. The quality of the pepper samples was determined based on the piperine content. Piperine was extracted from pepper samples using acetone and the extracts were subsequently analyzed using high-performance liquid chromatography with a mass detector. In all samples, the water content was determined by Karl-Fisher titration, and the piperine content in the samples was subsequently converted to dry matter. The content of piperine in pepper varied from 49 to 90 mg/g and met the requirements of the current legislation, which specifies a minimum piperine content of 4 % in pepper. Statistical analysis showed that there is a statistically significant difference between individual pepper samples in terms of piperine content, which points to the fact that pepper from different producers comes from different sources.