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Xu H, Hou S, Ruan Z, Liu J. Comparing Anatomical and Functional Outcomes of Two Neovaginoplasty Techniques for Mayer-Rokitansky-Küster-Hauser Syndrome: A Ten-Year Retrospective Study with Swine Small Intestinal Submucosa and Homologous Skin Grafts. Ther Clin Risk Manag 2023; 19:557-565. [PMID: 37425345 PMCID: PMC10329436 DOI: 10.2147/tcrm.s415672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/29/2023] [Indexed: 07/11/2023] Open
Abstract
Objective This study aimed to compare the anatomical and functional outcomes of the modified McIndoe vaginoplasty for Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome using swine small intestinal submucosa (SIS) graft or homologous skin grafts. Methods A total of 115 patients with MRKHs who underwent neovaginoplasty between January 2012 and December 2021 were included in the study. Among them, 84 patients received vaginal reconstruction with SIS graft, whereas 31 neovaginoplasty underwent a skin graft procedure. The length and width of the neovagina were measured, and sexual satisfaction was evaluated using the Female Sexual Function Index (FSFI). The operation details, cost, and complications were also assessed. Results The SIS graft group had a significantly shorter mean operation time (61.13±7.17min) and less bleeding during the operation (38.57±9.46mL) compared to the skin graft group (92.1±9.47min and 55.81±8.28mL, respectively). The mean length and width of the neovagina in the SIS group were comparable to the skin graft group at 6 months follow-up (7.73±0.57 cm versus 7.6±0.62cm, P=0.32). The SIS group had a higher total FSFI index than the skin graft group (27.44±1.58 versus 25.33±2.16, P=0.001). Conclusion The modified McIndoe neovaginoplasty using SIS graft is a safe and effective alternative to homologous skin grafts. It results in comparable anatomical outcomes and superior sexual and functional outcomes. Overall, these results suggest that the modified McIndoe neovaginoplasty using SIS graft is preferred for MRKH patients who require vaginal reconstruction.
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Affiliation(s)
- Hui Xu
- Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China
| | - Shuhui Hou
- Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China
| | - Zhengyi Ruan
- Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China
| | - Jianhua Liu
- Department of Obstetrics and Gynecology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China
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2
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Gundogdu G, Okhunov Z, Cristofaro V, Starek S, Veneri F, Orabi H, Jiang P, Sullivan MP, Mauney JR. Evaluation of Bi-Layer Silk Fibroin Grafts for Tubular Ureteroplasty in a Porcine Defect Model. Front Bioeng Biotechnol 2021; 9:723559. [PMID: 34604185 PMCID: PMC8484785 DOI: 10.3389/fbioe.2021.723559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/31/2021] [Indexed: 02/05/2023] Open
Abstract
Ureteral reconstruction with autologous tissue grafts is often limited by tissue availability and donor site morbidity. This study investigates the performance of acellular, bi-layer silk fibroin (BLSF) scaffolds in a porcine model of ureteroplasty. Tubular ureteroplasty with BLSF grafts in combination with transient stenting for 8 weeks was performed in adult female, Yucatan, mini-swine (N = 5). Animals were maintained for 12 weeks post-op with imaging of neoconduits using ultrasonography and retrograde ureteropyelography carried out at 2 and 4 weeks intervals. End-point analyses of ureteral neotissues and unoperated controls included histological, immunohistochemical (IHC), histomorphometric evaluations as well as ex vivo functional assessments of contraction/relaxation. All animals survived until scheduled euthanasia and displayed mild hydronephrosis (Grades 1-2) in reconstructed collecting systems during the 8 weeks stenting period with one animal presenting with a persistent subcutaneous fistula at 2 weeks post-op. By 12 weeks of scaffold implantation, unstented neoconduits led to severe hydronephrosis (Grade 4) and stricture formation in the interior of graft sites in 80% of swine. Bulk scaffold extrusion into the distal ureter was also apparent in 60% of swine contributing to ureteral obstruction. However, histological and IHC analyses revealed the formation of innervated, vascularized neotissues with a-smooth muscle actin+ and SM22α+ smooth muscle bundles as well as uroplakin 3A+ and pan-cytokeratin + urothelium. Ex vivo contractility and relaxation responses of neotissues were similar to unoperated control segments. BLSF biomaterials represent emerging platforms for tubular ureteroplasty, however further optimization is needed to improve in vivo degradation kinetics and mitigate stricture formation.
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Affiliation(s)
- Gokhan Gundogdu
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Vivian Cristofaro
- Division of Urology, Veterans Affairs Boston Healthcare System, Boston, MA, United States.,Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Stephanie Starek
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Faith Veneri
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Hazem Orabi
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Pengbo Jiang
- Department of Urology, University of California, Irvine, Irvine, CA, United States
| | - Maryrose P Sullivan
- Division of Urology, Veterans Affairs Boston Healthcare System, Boston, MA, United States.,Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Joshua R Mauney
- Department of Urology, University of California, Irvine, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States
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3
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Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6178286. [PMID: 32775430 PMCID: PMC7407031 DOI: 10.1155/2020/6178286] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/29/2020] [Accepted: 07/06/2020] [Indexed: 01/12/2023]
Abstract
Ureteroplasty using onlay grafts or flaps emerged as an innovative procedure for the management of proximal and midureteral strictures. Autologous grafts or flaps used commonly in ureteroplasty include the oral mucosae, bladder mucosae, ileal mucosae, and appendiceal mucosae. Oral mucosa grafts, especially buccal mucosa grafts (BMGs), have gained wide acceptance as a graft choice for ureteroplasty. The reported length of BMG ureteroplasty ranged from 1.5 to 11 cm with success rates of 71.4%-100%. However, several studies have demonstrated that ureteroplasty using lingual mucosa grafts yields better recipient site outcomes and fewer donor site complications than that using BMGs. In addition, there is no essential difference in the efficacy and complication rates of BMG ureteroplasty using an anterior approach or a posterior approach. Intestinal graft or flap ureteroplasty was also reported. And the reported length of ileal or appendiceal flap ureteroplasty ranged from 1 to 8 cm with success rates of 75%-100%. Moreover, the bladder mucosa, renal pelvis wall, and penile/preputial skin have also been reported to be used for ureteroplasty and have achieved satisfactory outcomes, but each graft or flap has unique advantages and potential problems. Tissue engineering-based ureteroplasty through the implantation of patched scaffolds, such as the small intestine submucosa, with or without cell seeding, has induced successful ureteral regeneration structurally close to that of the native ureter and has resulted in good functional outcomes in animal models.
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4
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Seifarth V, Grosse JO, Gossmann M, Janke HP, Arndt P, Koch S, Epple M, Artmann GM, Artmann AT. Mechanical induction of bi-directional orientation of primary porcine bladder smooth muscle cells in tubular fibrin-poly(vinylidene fluoride) scaffolds for ureteral and urethral repair using cyclic and focal balloon catheter stimulation. J Biomater Appl 2017; 32:321-330. [PMID: 28750602 DOI: 10.1177/0885328217723178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To restore damaged organ function or to investigate organ mechanisms, it is necessary to prepare replicates that follow the biological role model as faithfully as possible. The interdisciplinary field of tissue engineering has great potential in regenerative medicine and might overcome negative side effects in the replacement of damaged organs. In particular, tubular organ structures of the genitourinary tract, such as the ureter and urethra, are challenging because of their complexity and special milieu that gives rise to incrustation, inflammation and stricture formation. Tubular biohybrids were prepared from primary porcine smooth muscle cells embedded in a fibrin gel with a stabilising poly(vinylidene fluoride) mesh. A mechanotransduction was performed automatically with a balloon kyphoplasty catheter. Diffusion of urea and creatinine, as well as the bursting pressure, were measured. Light and electron microscopy were used to visualise cellular distribution and orientation. Histological evaluation revealed a uniform cellular distribution in the fibrin gel. Mechanical stimulation with a stretch of 20% leads to a circumferential orientation of smooth muscle cells inside the matrix and a longitudinal alignment on the outer surface of the tubular structure. Urea and creatinine permeability and bursting pressure showed a non-statistically significant trend towards stimulated tissue constructs. In this proof of concept study, an innovative technique of intraluminal pressure for mechanical stimulation of tubular biohybrids prepared from autologous cells and a composite material induce bi-directional orientation of smooth muscle cells by locally and cyclically applied mechanical tension. Such geometrically driven patterns of cell growth within a scaffold may represent a key stage in the future tissue engineering of implantable ureter replacements that will allow the active transportation of urine from the renal pelvis into the bladder.
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Affiliation(s)
- Volker Seifarth
- 1 Institute for Bioengineering (IfB), Laboratory of Medical and Molecular Biology, FH Aachen, Aachen, Germany.,2 Department of Urology, RWTH Aachen University Hospital, Aachen, Germany
| | - Joachim O Grosse
- 2 Department of Urology, RWTH Aachen University Hospital, Aachen, Germany
| | - Matthias Gossmann
- 1 Institute for Bioengineering (IfB), Laboratory of Medical and Molecular Biology, FH Aachen, Aachen, Germany
| | - Heinz Peter Janke
- 3 Department of Urology, Radboud Institute for Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Patrick Arndt
- 2 Department of Urology, RWTH Aachen University Hospital, Aachen, Germany
| | - Sabine Koch
- 4 AME-Helmholtz Institute for Biomedical Engineering, Biohybrid & Medical Textiles (BioTex), RWTH Aachen University, Aachen, Germany
| | - Matthias Epple
- 5 Department for Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Essen, Germany
| | - Gerhard M Artmann
- 6 Institute for Bioengineering (IfB), Laboratories of Cell Biophysics, FH Aachen, Campus Jülich, Jülich, Germany
| | - Aysegül Temiz Artmann
- 7 Institute for Bioengineering (IfB), Laboratories of Medical and Molecular Biology, FH Aachen, Campus Jülich, Jülich, Germany
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Sousa ELD, Wouk AFPDF, Malafaia O, Ribas-Filho JM, Noronha L, Cirio SM, PimpãoVII CT, Marinho CH, Torres MF, Graça YLSDS, Ferrarin DD. Immediate postoperative evaluation of enteric anastomosis after the use of meloxicam in rats. Acta Cir Bras 2016; 31:320-6. [PMID: 27275853 DOI: 10.1590/s0102-865020160050000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/22/2016] [Indexed: 07/19/2024] Open
Abstract
PURPOSE To compare ileal anastomoses in the immediate postoperative healing period after meloxicam use. METHODS Forty two male Wistar rats were randomly divided into two groups of 21, COX and control group. To COX meloxicam in combination with morphine was given in 3 days period. Control group received only morphine during the same period. Each group was divided into three sub-groups of 7, which were euthanized at 5, 10, and 21 days postoperatively. Comparison was based in histological evaluation of collagen type I and III using sirius red, immunohistochemical through vascular endothelial growth factor and matrix metalloproteinase-9. RESULTS Healing process in scheduled periods did not show significant differences (p>0.05) between the COX and control groups during any of the periods. CONCLUSION The use of meloxicam in the postoperative period following ileal anastomosis did not affect healing.
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Affiliation(s)
- Eros Luiz de Sousa
- Fellow Master degree, Postgraduate Program in Animal Sciences, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba-PR, Brazil. Acquisition, analysis and interpretation of data; manuscript writing., Pontifícia Universidade Católica do Paraná, Pontificia Universidade Católica do Paraná, Curitiba PR , Brazil
| | - Antônio Felipe Paulino de Figueiredo Wouk
- PhD, Full Professor, Postgraduate Program in Animal Sciences, PUCPR, Curitiba-PR, Brazil. Scientific and intellectual content of the study, critical revision., Pontifícia Universidade Católica do Paraná, PUCPR, Curitiba PR , Brazil
| | - Osvaldo Malafaia
- PhD, Full Professor, Postgraduate Program in Principles of Surgery, Faculdade Evangélica do Paraná (FEPAR), Curitiba-PR, Brazil. Critical revision, final approval the version to be published., Faculdade Evangélica do Paraná, Curitiba PR , Brazil
| | - Jurandir Marcondes Ribas-Filho
- PhD, Full Professor, Postgraduate Program in Principles of Surgery, Faculdade Evangélica do Paraná (FEPAR), Curitiba-PR, Brazil. Critical revision, final approval the version to be published., Faculdade Evangélica do Paraná, Curitiba PR , Brazil
| | - Lucia Noronha
- PhD, Full Professor. Postgraduate Program in Health Sciences, PUCPR, Curitiba-PR, Brazil. Scientific and intellectual content of the study, critical revision., Pontifícia Universidade Católica do Paraná, PUCPR, Curitiba PR , Brazil
| | - Silvana Maris Cirio
- PhD, Assistant Professor, FEPAR, Curitiba-PR, Brazil. Scientific and intellectual content of the study, critical revision., FEPAR, Curitiba PR , Brazil
| | - Claudia Turra PimpãoVII
- PhD, Full Professor. Postgraduate Program in Animal Sciences, PUCPR, Curitiba-PR, Brazil. Scientific and intellectual content of the study, statistical analyses, critical revision, final approval the version to be published., Pontifícia Universidade Católica do Paraná, PUCPR, Curitiba PR , Brazil
| | - Carlos Hespanha Marinho
- Fellow Postdoc degree, Postgraduate Program in Principles of Surgery, FEPAR, Curitiba-PR, Brazil. Technical procedures., FEPAR, Curitiba PR , Brazil
| | - Maria Fernanda Torres
- PhD, Full Professor, School of Veterinary Medicine, Universidade Federal do Paraná (UFPR), Curitiba-PR, Brazil. Scientific and intellectual content of the study, critical revision., Universidade Federal do Paraná, School of Veterinary Medicine, Universidade Federal do Paraná, Curitiba PR , Brazil
| | - Yorgos Luiz Santos de Salles Graça
- Graduate student, School of Medicine, FEPAR, Curitiba-PR, Brazil. Technical procedures., School of Medicine, FEPAR, Curitiba PR , Brazil
| | - Daniel Dantas Ferrarin
- MD, Gastrointestinal Surgeon, Hospital Angelina Caron, Campina Grande do Sul-PR, Brazil. Technical procedures., Hospital Angelina Caron, Campina Grande do Sul PR , Brazil
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6
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Tissue engineering and ureter regeneration: is it possible? Int J Artif Organs 2013; 36:392-405. [PMID: 23645581 DOI: 10.5301/ijao.5000130] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 12/11/2022]
Abstract
Large ureter damages are difficult to reconstruct. Current techniques are complicated, difficult to perform, and often associated with failures. The ureter has never been regenerated thus far. Therefore the use of tissue engineering techniques for ureter reconstruction and regeneration seems to be a promising way to resolve these problems. For proper ureter regeneration the following problems must be considered: the physiological aspects of the tissue, the type and shape of the scaffold, the type of cells, and the specific environment (urine).
This review presents tissue engineering achievements in the field of ureter regeneration focusing on the scaffold, the cells, and ureter healing.
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7
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Zhang J, Gu GL, Liu GH, Jiang JT, Xia SJ, Sun J, Zhu YJ, Zhu J. Ureteral reconstruction using autologous tubular grafts for the management of ureteral strictures and defects: an experimental study. Urol Int 2012; 88:60-5. [PMID: 22222954 DOI: 10.1159/000335002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 11/08/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate whether the peritoneal cavity could function as a bioreactor to produce autologous tubular grafts for ureteral reconstruction in beagles. MATERIALS AND METHODS 8-Fr Silastic tubes were implanted into the peritoneal cavities of 6 female beagles. At 3 weeks, the tubes were harvested and the tubular tissue covering the tubes was gently everted. A segment 3 cm in length of the right mid-ureter, involving two thirds of its diameter, was removed parallel to the ureteral axis, leaving a third of the ureteral wall. A 5-Fr double-J stent was inserted into the ureter through the created defect, and two thirds of the graft were anastomosed to both edges of the ureteral defect. One third of the graft was overlapped with the retained normal ureter and anastomosed to the external surface of the lumens. Thus, the graft was partly encapsulated by the remainder of ureteral wall. The stent was maintained for 6 weeks and removed. Excretory urography was performed at 8 (n = 3) and 12 weeks (n = 3), postoperatively. Meanwhile, the neoureter was harvested and analyzed. The left ureter served as the control and a simple intubated ureterotomy was performed. RESULTS Histological analysis of the tubular tissue demonstrated transversely arranged myofibroblasts and an outer layer of mesothelium. The tissue was easily everted and transplanted as a ureteral graft. Eight weeks postoperatively, the neoureter demonstrated normal ureteral architecture, composed of multilayers of urothelium surrounded by smooth muscle bundles, which became increasingly organized with time. Excretory urography indicated no stenosis or hydronephrosis. CONCLUSIONS These results show that autologous tubular tissue grown within the recipients' peritoneal cavity can be used for ureteral reconstruction in the beagle model.
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Affiliation(s)
- Jie Zhang
- Department of Urology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, PR China
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8
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Koziak A, Salagierski M, Marcheluk A, Szcześniewski R, Sosnowski M. Early experience in reconstruction of long ureteral strictures with allogenic amniotic membrane. Int J Urol 2007; 14:607-10. [PMID: 17645603 DOI: 10.1111/j.1442-2042.2007.01781.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To present our experience with the application of human amniotic membrane for the reconstruction of extensive ureteral wall defects. METHODS Between 2003 and 2006, 11 patients underwent reconstructive surgery of the ureter. A human amniotic membrane allograft was used to supplement ureteral wall defects. Indications for the procedure included ureteral strictures of a 5.5 cm average (range, 3-8 cm) localized in different parts of the ureter: upper (5), middle (5) and lower (3). The etiology of ureteral loss was: postinflammatory after a complicated stone disease (5), iatrogenic (4) and idiopathic (2). Diagnosis of ureteral stricture was based on antegrade pyelography and excretory urography. Two patients had synchronous treatment for upper and middle ureteral stenosis. Treatment efficacy was assessed by excretory urography and ultrasound. RESULTS The mean hospitalization time was 11.9 days, mean operation time 128 min and with an average follow up of 25.2 months. Complications included: stricture recurrence (1) and symptomatic urinary tract infections (2). Excretory urography showed lack of obstruction and normal width of ureters. In one patient, residual hydronephrosis was present on ultrasound. CONCLUSIONS The described method seems to be a promising tool in the reconstruction of extensive ureteral strictures.
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Affiliation(s)
- Andrzej Koziak
- Urology Department, Specialized Regional Hospital in Siedlce, Siedlce, Poland
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9
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Su Y, Zeng BF, Zhang CQ, Zhang KG, Xie XT. Study of biocompatibility of small intestinal submucosa (SIS) with Schwann cells in vitro. Brain Res 2007; 1145:41-7. [PMID: 17367764 DOI: 10.1016/j.brainres.2007.01.138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2006] [Revised: 01/10/2007] [Accepted: 01/17/2007] [Indexed: 01/12/2023]
Abstract
No satisfactory method currently exists for repairing long peripheral nerve defects. Efforts have been made to fabricate bioactive artificial nerve conduits, comprised of a biomaterial pre-seeded with Schwann cells (SCs), which creating a favorable micro-environment for axonal regeneration, to be an alternative to autografting by means of tissue engineering. Small intestinal submucosa (SIS) possesses special biological characteristics and is comprehensively researched for tissue repairing at varied tissues and organs. This study investigated the biocompatibility of SIS with SCs in vitro. Cultured rat SCs were seeded on SIS. Cell morphology was observed by light microscopy, scanning electron microscopy and transmission electron microscope. The viability of SCs was measured by MTT assay. Secretion of NGF-beta and BDNF was quantitatively assessed by ELISA, and NGF-beta mRNA and BDNF mRNA were semi-quantitatively assessed by RT-PCR. The results indicated that SCs could adhere, migrate and proliferate on the surface of SIS in good condition with productive function of secreting growth factors. SIS has a good biocompatibility with SCs and SIS pre-seeded with SCs has potential to be an alternate candidate of autografting for repairing long peripheral nerve defects.
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MESH Headings
- Animals
- Animals, Newborn
- Biocompatible Materials/therapeutic use
- Brain-Derived Neurotrophic Factor/genetics
- Brain-Derived Neurotrophic Factor/metabolism
- Cell Adhesion/physiology
- Cell Movement/physiology
- Cell Proliferation
- Cell Survival/physiology
- Cells, Cultured
- Graft Survival/physiology
- Intestinal Mucosa/physiology
- Intestinal Mucosa/ultrastructure
- Intestine, Small/physiology
- Intestine, Small/ultrastructure
- Microscopy, Electron, Scanning
- Microscopy, Electron, Transmission
- Nerve Growth Factor/genetics
- Nerve Growth Factor/metabolism
- Nerve Regeneration/physiology
- Peripheral Nerves/cytology
- Peripheral Nerves/physiology
- Peripheral Nerves/surgery
- Peripheral Nervous System Diseases/therapy
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Schwann Cells/metabolism
- Schwann Cells/ultrastructure
- Sus scrofa
- Tissue Engineering/methods
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Affiliation(s)
- Yan Su
- Department of Orthopaedics, The Sixth Affiliated People's Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, China
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10
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Tanaka H, Kobayashi E. Education and research using experimental pigs in a medical school. J Artif Organs 2006; 9:136-43. [PMID: 16998697 DOI: 10.1007/s10047-006-0343-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 06/07/2006] [Indexed: 01/20/2023]
Abstract
Medium-sized animals such as miniature pigs are considered to be important for education and training in medical schools to master the skills required in surgical treatment. Much still remains to be done to establish total management for animal experiments using pigs. Improvement of the effective utilization of pigs is also required from the economical and ethical points of view. We have been providing a support system at a facility for experimental animals in a medical school for 3 years, and herein we introduce our personal experiments as an instructional lecture. Before starting surgical training using live pigs, sufficient education concerning animal ethics and dry laboratory training was completed. Four kinds of miniature pigs have been used as experimental animals; porcine rearing pens have been improved and a postoperative care system has been implemented. Moreover, staff at the center offer a preoperative service of anesthesia for surgical education, training, and research. Chronic experiments have increased to represent 35% and 48% of experiments using pigs in 2003 and 2004, respectively. Experimental pigs have undergone secondary use after being killed to reduce the number of animals used in experiments. Sharing and reuse have allowed effective use of miniature pig tissues and cells for research, and have reduced the number of animals used. We recommend that researchers consider use of our total systems because they can improve the quality of medical education and research and facilitate effective use of tissues and cells by sharing and reuse among different departments.
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Affiliation(s)
- Hozumi Tanaka
- Center for Experimental Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotuke, Tochigi 329-0498, Japan
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