Effect of long-term culture on the biological and morphological characteristics of human adipose tissue-derived stem Cells

Mesenchymal stem cells (MSCs) are multipotent cells that can be obtained from different tissues, including bone marrow, adipose tissue, umbilical blood, Wharton's jelly, and dental pulp. Due to their differentiation potential, regenerative and immunosuppressive properties, as well as ability to expand under in vitro conditions, these cells represent a promising therapeutic tool for regenerative medicine. However, the basic prerequisite for the therapeutic utilization of MSCs is obtaining a sufficient amount. While this may be achieved by prolonged cultivation, long-term culture of MSCs is associated with accumulation of morphological and functional changes. In our study, we focused on analyzing morphological and biological changes of cultured adipose tissue-derived stem cells over 30 passages. We performed morphological analysis using light and electron microscopy, as well as analysis of selected biological properties (expression of surface antigens and selected genes involved in cell regulation and apoptosis, cell cycle, and cell senescence) every 5 passages. Our results showed that long-term expansion leads to significant changes in morphology and affects proliferation kinetics and the cell cycle. On the other hand, the MSCs maintained a prototypical immunophenotype, normal cell cycle and apoptosis regulator function, and maintained a low level of telomerase activity during later passages.

Ultrasound monitoring of the treatment of clinically significant knee osteoarthritis

OBJECTIVES

The study presented an ultrasound (US) monitoring of treatment as a new imaging US method with the results of therapy of clinically significant knee osteoarthritis.

BACKGROUND

X-ray is widely used for knee osteoarthritis classification, which does not involve the evaluation of the soft tissue. High frequency and high resolution US of joints (arthrosonography, echoarthrography) assess not only morphologic but also functional changes in the knee joint.

METHODS

In the prospective study, 110 patients with clinically significant knee osteoarthritis were treated non-operative. US examination and US monitoring of therapy was performed during 24 weeks therapy period. A remission of pathomorphologic (marginal osteofytes) and pathophysiologic (effusion in anterior knee and Baker´s cyst) attributes were evaluated according the US classification.

RESULTS

Pathomorphologic attributes changes showed a static state, without remission or progression. Pathophysiologic attributes changes showed a remission during the study period. The highest remission was in the first three weeks, 60 % anterior knee effusion and 62 % Baker´s cyst. At the end of study, no changes from the initial US grade was observed in 16 % of effusion in anterior knee and 22 % of Baker´s cyst. Therapeutic resistant Baker´s cyst was present at the end of study in 36 %.

CONCLUSION

We demonstrated a new method - US monitoring of therapy, which can objectivize the efficiency of treatment of clinically significant knee osteoarthritis. We would recommend US monitoring of therapy for the routine use in orthopedic clinical praxis (Tab. 6, Graph 3, Fig. 3, Ref. 15).

Mesenchymal stem cells - a promising perspective in the orofacial cleft surgery

Autologous bone grafts provide the golden standard for closure of oronasal fistulas in the cleft palate. Augmentation may be performed also by homografts and various xenogenic or alloplastic materials to prevent morbidity at the donor site but they may cause many problems (transmission of infections, immune response etc.). All the mentioned approaches also often reveal recurrences of the fistulas and prolong suffering of the cleft patients. Combination of mesenchymal stem cells (MSCs) and so called "platelet gel" seems to be a perspective method in this way. The platelet gel contains hydroxyapatite particles mixed with platelet rich plasma coagulated under effect of the calcium ions. The MSCs from the pelvic bone marrow aspirate are cultivated on a scaffold (collagen membrane) for 3-4 weeks before placement into the cleft defect. The method provides promising results in the alveolar clefts. Authors document a successful case of the secondary surgery in 25-year-old man with the unilateral complete cleft (Fig. 5, Ref. 10).

Does cell therapy and tissue engineering represent a promising treatment of diabetic foot ulcers?

Diabetes mellitus is one of the most severe and costly chronic disease of our time. Approximately 2-3% of diabetics have an active foot ulcer, and 15% of all patients with diabetes will develop an ulcer during their lifetime. Treatment of foot complications is one of the main items in the absorption of enormous economic and health resources addressed to the diabetic patients. Advances in basic science, tissue culture techniques and cell therapy promise to improve the treatment of diabetes as well as its complications, i.e. also the ischemic ulcers of the foot. At present, the isolation of any specific type of cells, their in vitro expansion and biological characterization of acquired cell population are possible. For the healing process in ischemic diabetic ulcers, stem cells, endothelial progenitor cells and fibroblasts, both in suspension or placed on an extracellular scaffold are used. This process is focused on stimulating the new blood vessels formation. This is stimulated by the paracrine secretion of multiple growth factors and their receptors. Verified are the vascular endothelial growth factor and its receptor, fibroblast growth factor, interleukin-8 and proangiogenic cytokines (Ref. 62).

Diabetes--adult stem cells as an future alternative therapy?

In both types of the diabetes mellitus, the lack of functional beta-cells is crucial, leading to complications associated with development of hyperglycaemia. One way to achieve a constant normoglycemic state without hypoglycemic episodes is either whole pancreas transplantation, or transplantation of isolated islets of Langerhans. Another approach to correct the beta-cell deficit is the stimulation of beta-cells in pancreas to regeneration. The development of new diabetes therapy is the main goal for many scientists around the world. This article is focused on the stem cells and their potential for clinical applications (Ref. 47).

In vitro evaluation of the cytotoxicity and genotoxicity of resorcylidene aminoguanidine in human diploid cells B-HNF-1

RAG belongs to appropriate inhibitors of protein glycation, i.e. formation of advanced glycation end products, which are thought to be responsible for some complications of DM, including neuropathy, angiopathy, retinopathy and nephropathy. In the present study authors have evaluated the genotoxic effect of RAG on the cell culture of human neonatal fibroblasts (B-HNF-1) in regard to its potential clinical application as inhibitor of advanced glycation end products in relationships to the pathogenesis of chronic diabetic complications. The direct contact cytotoxicity assay and micronucleus test were performed. The results showed that RAG in the concentration range of 1 x 10-4 to 1 x 10-6 mol.l-1 did not induce any changes in the morphology of exposed B-HNF-1 cells. The frequency of micronuclei was not significantly increased as well. The inhibitive effect of resorcylidene aminoguanidine was directly proportional to its concentration. It can be concluded that RAG at the selected concentrations has an inhibitive effect on proliferation of the treated cells and, at the same time, does not display any genotoxic effects on B-HNF-1 cells.

Results and perspectives of the treatment of skeletal neoplasms

Improvements in the therapy of skeletal neoplasms at the end of the 20th century are the reason for a retrospective view on the development of the therapy of skeletal neoplasms, especially in the Slovak Republic. Up to the sixties years of the 20th century was amputation the imperative in the surgical treatment of malignant tumors, above all tumors of the extremities. Then chemotherapy was introduced into the treatment of these tumors, in Slovak Republic it was later. Bone transplantations were widely used in the 70 and 80 years of 20th century. Autotransplantations of bone grafts were used at the Orthopaedic department in Bratislava already in the year 1953, but low number of appropriate grafts limited their use in clinical practice. In the 70 and 80 years development of bone banks was observed. Results of the treatment of malignant diseases with this technique are considered poor. Only few patients survived more than 5 years after the surgery, mainly due to inappropriate techniques of detection, localization and determination of the size of the tumor. Biopsy played above all at this time an important role in the diagnostics of bone tumors. Apart from basic examinations of the fixed material, processed after it was imbedded in particular medium, perioperative biopsy is recently being performed with the technique of frozen sections from unfixed tissue obtained during the surgery. This type of material processing prolongs the period from obtaining the material till making the diagnosis, but the advantages of this type of examination are undoubted. (Ref. 17.).

Transtrochanteric rotational osteotomy, section after Sugioka

BACKGROUND

Femoral caput necrosis is an actual therapeutic problem, because it appears mainly in mid-aged people. The necrotic focus is most often localized in the proximal and ventral parts of the femoral bone capitulum, which, from the biomechanical point of view is the most loaded part. These cases can be possibly treated by transtrochanteric rotational osteotomy. By means of this operation we rotate the necrotic focus to the less loaded part of the joint in correlation with the acetabulum.

PURPOSE

The aim of this paper is to inform about a rarely performed operation after Sugioka: transtrochanteric rotational osteotomy in coincidence with avascular necrosis of the femoral bone caput. We would like to point to the possibility of a joint-saving operation, which enables to postpone implantation of total endoprosthesis to older age.

METHODS

We analyzed the operational therapy performed at our department in the period 1998-2000, focusing especially on joint-saving operations due to femoral caput necrosis. We turned our attention to transtrochanteric rotational osteotomy after Sugioka. In four casuistics, we describe the results of these operations.

RESULTS

Transtrochanteric rotational osteotomy was performed in 12 patients. The treatment is described in four casuistics. The results after 1-3 years are good. The illness has not progressed in any of patients, pain has regressed, mobility improved and it was not necessary to implant total endoprosthesis.

CONCLUSION

We consider the transtrochanteric rotational osteootomy, section after Sugioka, as one of the possible treatments in mid-aged patients. Our effort is to perform joint-saving operations in order to postpone the implantation of total endoprosthesis. (Fig. 10, Ref. 13.)

High tibial osteotomy and debridement of the knee joint in treatment of varotic gonarthrosis

BACKGROUND OF THE PROBLEM: We perform high tibial osteotomy with knee debridement and forage.

GOAL

We evaluated the results of operations in 47 patients, who were operated from 1st January 1998 to 31st of December 2000.

RESULTS

We examined the patients before operation and 2, 4, 6, 12, 24 and 30 months after it. The follow up was from 6 months to two and a half years after operation. The results after the operation were evaluated by both the patient (pain) and the doctor. The doctor evaluated the axial state of the extremity, the range of movement in the knee joint, present synovitis and the X-ray. The youngest woman was 52 years old, the oldest woman was 71 years old. The average age was 63.3 years. The youngest man was 25 years old, the oldest was 67 years old. The average age was 57.2 years. Patient's evaluation after the operation: 34 percent had no pain, 43 percent felt pain after excessive loading at the joint, 19 percent did not register any change and 4 reported increased pain. Doctor's evaluation: In 23 percent of patients, excellent results were achieved, 47 percent had good results, in 21 percent, they were satisfactory and in 9 percent, unsatisfactory results were recorded.

CONCLUSION

After the theoretic analysis and evaluation of the group of operated patients, the authors indicate the possibility to perform high tibial osteotomy with debridement and forage as a joint saving knee operation in varotic gonarthrosis. (Fig. 1, Ref. 6.)

[DNA analysis of partial and complete hydatid mole]

DNA analysis enables an unambiquous recognition of partial and complete hydatiform moles and at the same time to distinguish the homozygous and heterozygous forms of KHM, the fact of which has its significance for target investigation of the course of the post-intervention period in mostly endangered patients. All investigated patients with gestational choriocarcinomas are proved to have molar pregnancy in their case histories.