Fetal surgical repair with placenta-derived mesenchymal stromal cell engineered patch in a rodent model of myelomeningocele

PURPOSE

The purpose of this study is to determine the feasibility of fetal surgical repair of myelomeningocele (MMC) in a rodent model using human placental mesenchymal stromal cells (PMSCs) seeded onto extracellular matrix (ECM) and to characterize the resulting changes in spinal cord tissue.

METHODS

Fetal rodents with retinoic acid (RA) induced MMC underwent surgical repair of the MMC defect using an ECM patch on embryonic age (EA) 19 and were collected via caesarean section on EA 21. Various seeding densities of PMSC-ECM and ECM only controls were evaluated. Cross-sectional compression (width/height) and apoptotic cell density of the lumbosacral spinal cord were analyzed.

RESULTS

67 dams treated with 40mg/kg of RA resulted in 352 pups with MMC defects. 121 pups underwent MMC repair, and 105 (86.8%) survived to term. Unrepaired MMC pups had significantly greater cord compression and apoptotic cell density compared to normal non-MMC pups. Pups treated with PMSC-ECM had significantly less cord compression and demonstrated a trend towards decreased apoptotic cell density compared to pups treated with ECM only.

CONCLUSION

Surgical repair of MMC with a PMSC-seeded ECM disc is feasible with a postoperative survival rate of 86.8%. Fetal rodents repaired with PMSC-ECM have significantly less cord deformity and decreased histological evidence of apoptosis compared to ECM only controls.

Placental mesenchymal stromal cells seeded on clinical grade extracellular matrix improve ambulation in ovine myelomeningocele

PURPOSE

The purpose of this study was to investigate the effects of placental mesenchymal stromal cells (PMSCs) seeded on a clinical grade porcine small intestinal submucosa (SIS)-derived extracellular matrix (ECM) on hindlimb motor function in an ovine fetal repair model of myelomeningocele (MMC).

METHODS

MMC defects were surgically created in 21 fetuses at median gestational age 78 (range 76-83) days. Fetuses were randomly assigned to repair 25days later with ECM only or PMSC-ECM. Surviving fetuses were delivered at term. Motor function was evaluated using the Sheep Locomotor Rating (SLR) scale (0-15). Histologic analysis of the spinal cord (SC) was completed.

RESULTS

Fetal viability was 71%. 5 of 8 (63%) lambs repaired with PMSC-ECM ambulated independently versus only 1 of 6 (17%) repaired with ECM only (p=0.04, χ2 test). SLR scores and large neuron densities were higher in the PMSC-ECM group. The cross-sectional areas of the SC and the gray matter were equally preserved.

CONCLUSIONS

Fetal repair of MMC with PMSCs seeded on SIS-ECM improves hindlimb motor function in lambs. Using ECM helps to preserve the architecture of the SC, but adding PMSCs improves the lamb's ability to walk and increases large neuron density. Clinical studies are needed to show benefits in humans.

LEVELS OF EVIDENCE/TYPE OF STUDY

Basic Science.

Corrigendum: Towards automatic pulmonary nodule management in lung cancer screening with deep learning

This corrects the article DOI: 10.1038/srep46479.

Parasitological Analysis and Gill Histopathology of Pearl Dace (Semotilus Margarita) and Brook Stickleback (Culaea Inconstans) Collected from the Athabasca Oil Sands Area (Canada)

Pearl dace (Semotilus margarita) and brook stickleback (Culaea inconstans) were collected from tributaries of the Athabasca River (Alberta, Canada), upstream (reference site) and downstream of oil sands deposits where fish were expected to be exposed to naturally occurring oil sands constituents. The objective was to determine if fish collected from these sites exhibited differences in the prevalence or intensity of infection by parasites or in gill histology. Dace did not display significant differences in these parameters. Alternately, upstream stickleback were predominantly infected by complex life history parasites, while downstream fish were primarily infected by parasites with simpler life histories. Moreover, downstream stickleback exhibited significantly more clubbing and aneurysms in secondary gill lamellae relative to upstream fish. This suggested a difference in habitat quality between upstream and downstream sites. However, based on basic body condition parameters of the fish, it would appear that any impacts upon the health of the fish due to the presence of naturally occurring oil sands associated chemical constituents would have been minor.

From WWII to Kingston, Ontario: The History of Queen's University School of Medicine, Division of Plastic and Reconstructive Surgery

OBJECTIVE

To describe the origin and development of the Division of Plastic and Reconstructive Surgery at the Queen's University School of Medicine (Kingston, Ontario).

METHODS

Resarch ethics board approval and privacy agreements from the Kingston General Hospital (KGH, Kingston, Ontario) medical archives were obtained. Primary and secondary data sources were identified. A systematic examination of newspaper archives, research literature, KGH medical advisory committee meeting minutes, and testimonies from Dr Kenneth Wyllie and Dr John Davidson were obtained.

RESULTS

In 1949, Dr Albert Ross Tilley arrived at Queen's University in Kingston, Ontario. There, Tilley initiated the Burn Unit at the KGH and began monthly teaching during the academic semester. Ken Wyllie (Meds '55), Lloyd Carlson (Meds '57) and John Emery (Meds '57) were the notable progeny of his early initiatives. In 1963, Kenneth Wyllie founded the Division of Plastic and Reconstructive Surgery in Kingston, Ontario, having completed plastic surgery training in Toronto and Edinburgh with experiences in Stockholm (Sweden), Paris (France) and Baltimore (Maryland, USA). He was shortly joined by Pat Shoemaker (Meds '66). John Davidson (Meds '82) arrived in 1989, bringing an interest in microsurgery and critical inquiry to the division. Five notable surgeons, Cartotto (Meds '88), Watkins, Watters, Meathrel (Meds '03) and McKay, further enhanced the Division's clinical and academic mission.

CONCLUSIONS

The collective activity of the Division of Plastic and Reconstructive Surgery at Queen's School of Medicine in its 66-year history has encouraged more than 40 others to pursue distinguished careers in the specialty throughout North America, including three past presidents of the Canadian Society of Plastic Surgeons.

Severe polyarthralgia, high-grade fever, diffuse maculopapular rash on trunk and extremities · Dx?

The patient was nauseous, and had been experiencing headaches, generalized weakness, and fatigue. Her physical exam revealed a maculopapular rash on her trunk and upper extremities. She had tenderness and pain, as well as decreased range of motion in her ankles, knees, and wrists. The patient had no erythema, swelling, petechiae, or bruising. She had a past medical history of Graves' disease and had received all of her childhood immunizations.

From WWII to Kingston, Ontario: The History of Queen's University School of Medicine, Division of Plastic and Reconstructive Surgery

Objective

To describe the origin and development of the Division of Plastic and Reconstructive Surgery at the Queen's University School of Medicine (Kingston, Ontario).

Methods

Resarch ethics board approval and privacy agreements from the Kingston General Hospital (KGH, Kingston, Ontario) medical archives were obtained. Primary and secondary data sources were identified. A systematic examination of newspaper archives, research literature, KGH medical advisory committee meeting minutes, and testimonies from Dr Kenneth Wyllie and Dr John Davidson were obtained.

Results

In 1949, Dr Albert Ross Tilley arrived at Queen's University in Kingston, Ontario. There, Tilley initiated the Burn Unit at the KGH and began monthly teaching during the academic semester. Ken Wyllie (Meds '55), Lloyd Carlson (Meds '57) and John Emery (Meds '57) were the notable progeny of his early initiatives. In 1963, Kenneth Wyllie founded the Division of Plastic and Reconstructive Surgery in Kingston, Ontario, having completed plastic surgery training in Toronto and Edinburgh with experiences in Stockholm (Sweden), Paris (France) and Baltimore (Maryland, USA). He was shortly joined by Pat Shoemaker (Meds '66). John Davidson (Meds '82) arrived in 1989, bringing an interest in microsurgery and critical inquiry to the division. Five notable surgeons, Cartotto (Meds '88), Watkins, Watters, Meathrel (Meds '03) and McKay, further enhanced the Division's clinical and academic mission.

Conclusions

The collective activity of the Division of Plastic and Reconstructive Surgery at Queen's School of Medicine in its 66-year history has encouraged more than 40 others to pursue distinguished careers in the specialty throughout North America, including three past presidents of the Canadian Society of Plastic Surgeons.

Neuro-Behçet's disease presenting with tumour-like lesions and responding to rituximab

We describe a patient with neuro-Behçets disease (NBD) that presented with symptoms of raised intracranial pressure including papilloedema. MRI revealed tumour-like lesions which, on biopsy, confirmed an active vasculitis. Treatment was commenced with prednisone and cyclophosphamide which proved unsuccessful with enlargement of the cerebral mass lesions. Infliximab and mycophenolate were trialled also without benefit. The patient required ventriculoperitoneal shunts to relieve the symptoms of hydrocephalus. Rituximab was then commenced with significant symptomatic and imaging improvement. The case is unique, in our experience, in the need for shunting to relieve the symptoms of hydrocephalus related to vasculitis.