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Pinter Z, Honig R, Sebastian A, Nassr A, Freedman B, Yaszemski M, Huddleston P, Berbari E, Currier B. Does Intrawound Vancomycin Decrease Postoperative Surgical Site Infection in Spine Surgery: A Retrospective Case-control Study. Clin Spine Surg 2024:01933606-990000000-00258. [PMID: 38321609 DOI: 10.1097/bsd.0000000000001578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 10/03/2023] [Indexed: 02/08/2024]
Abstract
STUDY DESIGN Retrospective Case-Control series. OBJECTIVE The objective of this study is to define the overall postoperative rate of surgical site infection (SSI) in patients undergoing spine surgery and examine the effects of intrawound Vancomycin on postoperative infection rates. SUMMARY OF BACKGROUND DATA Surgical site infections (SSI) account for 22% of all health care-associated infections. The use of intrawound Vancomycin in an attempt to reduce the incidence of postoperative SSI has not been sufficiently evaluated in the existing literature. METHODS All spine surgeries (n=19,081) from our institution were reviewed from 2003 to 2013. All cases of verified SSI were identified from the database. Cases were then matched to controls in a 1:1 fashion based on age, gender, and date of surgery (+/-30 d). Patient demographics, comorbidities, estimated blood loss, duration of surgery, intrawound administration of Vancomycin, and smoking status were evaluated. RESULTS At total of 316 cases of SSI after spine surgery were identified, representing an infection rate of 1.7%. The mean follow-up for cases and controls was 31.5 and 41.6 months, respectively. OR for intrawound Vancomycin was 0.44 (95% CI 0.23-0.88, P=0.019). OR for BMI greater than 30 was 1.63 (95% CI 1.04-2.56, P=0.03). CONCLUSIONS In this large cohort of spine surgery patients, administration of intrawound Vancomycin was associated with a significant reduction in postoperative surgical site infections. Further studies are needed to determine appropriate dosing and application as well as long-term safety in spine surgery.
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Serdiuk V, Shogren KL, Kovalenko T, Rasulev B, Yaszemski M, Maran A, Voronov A. Detection of macromolecular inversion-induced structural changes in osteosarcoma cells by FTIR microspectroscopy. Anal Bioanal Chem 2020; 412:7253-7262. [PMID: 32879994 DOI: 10.1007/s00216-020-02858-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/01/2020] [Accepted: 08/03/2020] [Indexed: 11/29/2022]
Abstract
Fourier transform infrared (FTIR) microspectroscopy provides a biochemical fingerprint of the cells. In this study, chemical changes in 143B osteosarcoma cells were investigated using FTIR analysis of cancer cells after their treatment with polymeric invertible micellar assemblies (IMAs) and curcumin-loaded IMAs and compared with untreated osteosarcoma cells. A comprehensive principal component analysis (PCA) was applied to analyze the FTIR results and confirm noticeable changes in cell surface chemical structures in the fingerprint regions of 1480-900 cm-1. The performed clustering shows visible differences for all investigated groups of cancer cells. It is demonstrated that a combination of FTIR microspectroscopy with PCA can be an efficient approach in determining interactions of osteosarcoma cells and drug-loaded polymer micellar assemblies. Graphical abstract.
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Affiliation(s)
- Vitalii Serdiuk
- Department of Orthopedics, Mayo Clinic, Rochester, MN, 55905, USA.,Department of Coatings & Polymeric Materials, North Dakota State University, Fargo, ND, 58105, USA.,Department of Organic Chemistry, Lviv Polytechnic National University, Lviv, 79013, Ukraine
| | | | - Tetiana Kovalenko
- Department of Organic Chemistry, Lviv Polytechnic National University, Lviv, 79013, Ukraine
| | - Bakhtiyor Rasulev
- Department of Coatings & Polymeric Materials, North Dakota State University, Fargo, ND, 58105, USA
| | | | | | - Andriy Voronov
- Department of Coatings & Polymeric Materials, North Dakota State University, Fargo, ND, 58105, USA.
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Tomov M, Alvi MA, Elminawy M, Currier B, Yaszemski M, Nassr A, Huddleston P, Sebastian A, Bydon M, Freedman B. An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging. Asian Spine J 2020; 14:814-820. [PMID: 32460470 PMCID: PMC7788369 DOI: 10.31616/asj.2019.0319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/26/2019] [Indexed: 11/23/2022] Open
Abstract
Study Design A retrospective observational study. Purpose Establish a quantifiable and reproducible measure of sarcopenia in patients undergoing lumbar spine surgery based on morphometric measurements from readily available preoperative computed tomography (CT) imaging. Overview of Literature Sarcopenia—the loss of skeletal muscle mass—has been linked with poor outcomes in several surgical disciplines; however, a reliable and quantifiable measure of sarcopenia for future assessment of outcomes in spinal surgery patients has not been established. Methods A cohort of 90 lumbar spine fusion patients were compared with 295 young, healthy patients obtained from a trauma da¬tabase. Cross-sectional vertebral body (VB) area, as well as the areas of the psoas and paravertebral muscles at mid-point of pedicles at L3 and L4 for both cohorts, was measured using axial CT imaging. Total muscle area-to-VB area ratio was calculated along with intraclass correlation coefficients for interobserver and intraobserver reliability. Finally, T-scores were calculated to help identify those patients with considerably diminished muscle-to-VB area ratios. Results Both muscle mass and VB areas were considerably larger in males compared with those in females, and the ratio of these two measures was not enough to account for large differences. Thus, a gender-based comparison was made between spine patients and healthy control patients to establish T-scores that would help identify those patients with sarcopenia. The ratio for paravertebral muscle area-to-VB area at the L4 level was the only measure with good interobserver reliability, whereas the other three of the four ratios were moderate. All measurements had excellent correlations for intraobserver reliability. Conclusions We postulate that a patient with a T-score <−1 for total paravertebral muscle area-to-VB area ratio at the L4 level is the most reliable method of all our measurements that can be used to diagnose a patient undergoing lumbar spine surgery with sarcopenia.
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Affiliation(s)
- Marko Tomov
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Bradford Currier
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Ahmad Nassr
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Paul Huddleston
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Arjun Sebastian
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Brett Freedman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
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Gaihre B, Liu X, Lee Miller A, Yaszemski M, Lu L. Poly(Caprolactone Fumarate) and Oligo[Poly(Ethylene Glycol) Fumarate]: Two Decades of Exploration in Biomedical Applications. POLYM REV 2020. [DOI: 10.1080/15583724.2020.1758718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Bipin Gaihre
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Xifeng Liu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - A. Lee Miller
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Yaszemski
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Tomov M, Wanderman N, Berbari E, Currier B, Yaszemski M, Nassr A, Huddleston P, Bydon M, Freedman B. An empiric analysis of 5 counter measures against surgical site infections following spine surgery-a pragmatic approach and review of the literature. Spine J 2019; 19:267-275. [PMID: 29864545 DOI: 10.1016/j.spinee.2018.05.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/04/2018] [Accepted: 05/30/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Surgical site infections (SSI) following spine surgery are debilitating complications to patients and costly to the healthcare system. PURPOSE Review the impact and cost effectiveness of 5 SSI prevention interventions on SSI rates in an orthopedic spine surgery practice at a major quaternary healthcare system over a 10-year period. STUDY DESIGN Retrospective observational study. PATIENT SAMPLE All of the surgical patients of the 5 spine surgeons in our department over a 10-year period were included in this study. OUTCOME MEASURES SSI rates per year, standardized infection ratios (SIR) for laminectomies and fusions during the most recent 3-year period, year of implementation, and frequency of use of the different interventions, cost of the techniques. METHODS The SSI prevention techniques described in this paper include application of intrawound vancomycin powder, wound irrigation with dilute betadine solution, preoperative chlorhexidine gluconate scrubs, preoperative screening with nasal swabbing, and decolonization of S. aureus, and perioperative antibiotic administration. Our institution's infection prevention and control data were analyzed for the yearly SSI rates for the orthopedic spine surgery department from 2006 to 2016. In addition, our orthopedic spine surgeons were polled to determine with what frequency and duration they have been using the different SSI prevention interventions. RESULTS SSI rates decreased from almost 6% per year the first year of observation to less than 2% per year in the final 6 years of this study. A SIR of less than 1.0 for each year was observed for laminectomies and fusions for the period from 2013 to 2016. All surgeons polled at our institution uniformly used perioperative antibiotics, Hibiclens scrub, and the nasal swab protocol since the implementation of these techniques. Some variability existed in the frequency and duration of betadine irrigation and application of vancomycin powder. A cost analysis demonstrated these methods to be nominal compared with the cost of treating a single SSI. CONCLUSIONS It is possible to reduce SSI rates in spine surgery with easy, safe, and cost-effective protocols, when implemented in a standardized manner.
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Affiliation(s)
- Marko Tomov
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
| | | | - Elie Berbari
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | | | - Ahmad Nassr
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | - Mohamad Bydon
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
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Wanderman N, Carlson B, Robinson W, Bydon M, Yaszemski M, Huddleston P, Freedman B. Does Recombinant Human Bone Morphogenic Protein 2 Affect Perioperative Blood Loss after Lumbar and Thoracic Spinal Fusion? Asian Spine J 2018; 12:880-886. [PMID: 30213171 PMCID: PMC6147887 DOI: 10.31616/asj.2018.12.5.880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/09/2018] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN Retrospective cohort design. PURPOSE This study aimed to determine whether recombinant human bone morphogenic protein 2 (rhBMP-2) reduces total perioperative blood loss during lumbar and thoracic fusion. OVERVIEW OF LITERATURE Previous studies on rhBMP-2 versus iliac crest bone grafting in thoracic and lumbar fusions have yielded mixed results regarding reductions in blood loss and have largely neglected the postoperative period when analyzing total blood loss. Additionally, these studies have been limited by heterogeneity and sample size. METHODS We analyzed the blood loss patterns of 617 consecutive adult patients undergoing lumbar and/or thoracic fusions requiring subfascial drain placement at a single institution from January 2009 to December 2016. Patients were divided into BMP and non-BMP cohorts, and a propensity score analysis was conducted to account for the differences between cohorts. RESULTS At a per-level fused basis, the BMP group exhibited a significant reduction in the intraoperative (66.1 mL per-level fused basis; 95% confidence interval [CI], 127.9 to 4.25 mL; p =0.036) and total perioperative blood loss (100.7 mL per-level fused basis; 95% CI, 200.9 to 0.5 mL; p =0.049). However, no significant differences were observed in an analysis when not controlling for the number of levels or when examining the postoperative drain output. CONCLUSIONS RhBMP-2 appears to reduce both intraoperative and total blood loss during lumbar and thoracic fusions on a per-level fused basis. This total reduction in blood loss was achieved via intraoperative effects because RhBMP-2 had no significant effect on the postoperative drain output.
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Affiliation(s)
- Nathan Wanderman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Bayard Carlson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - William Robinson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Paul Huddleston
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Brett Freedman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
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Wanderman N, Freedman B, Currier B, Huddleston P, Yaszemski M, Nassr A. Interpreting the DXA analysis: When should you hold off on spinal fusion? ACTA ACUST UNITED AC 2018. [DOI: 10.1053/j.semss.2017.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Parry JA, Olthof MG, Shogren KL, Dadsetan M, Van Wijnen A, Yaszemski M, Kakar S. Three-Dimension-Printed Porous Poly(Propylene Fumarate) Scaffolds with Delayed rhBMP-2 Release for Anterior Cruciate Ligament Graft Fixation. Tissue Eng Part A 2017; 23:359-365. [DOI: 10.1089/ten.tea.2016.0343] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joshua Alan Parry
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Maurits G.L. Olthof
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Kristen L. Shogren
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Mahrokh Dadsetan
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Andre Van Wijnen
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Michael Yaszemski
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Sanjeev Kakar
- Department of Orthopaedic Surgery, Tissue Engineering and Biomaterials Laboratory, Mayo Clinic, Rochester, Minnesota
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Nazarian A, Entezari V, Zurakowski D, Calderon N, Hipp JA, Villa-Camacho JC, Lin PP, Cheung FH, Aboulafia AJ, Turcotte R, Anderson ME, Gebhardt MC, Cheng EY, Terek RM, Yaszemski M, Damron TA, Snyder BD. Treatment Planning and Fracture Prediction in Patients with Skeletal Metastasis with CT-Based Rigidity Analysis. Clin Cancer Res 2015; 21:2514-9. [PMID: 25724521 DOI: 10.1158/1078-0432.ccr-14-2668] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/09/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE Pathologic fractures could be prevented if reliable methods of fracture risk assessment were available. A multicenter prospective study was conducted to identify significant predictors of physicians' treatment plan for skeletal metastasis based on clinical fracture risk assessments and the proposed CT-based Rigidity Analysis (CTRA). EXPERIMENTAL DESIGN Orthopedic oncologists selected a treatment plan for 124 patients with 149 metastatic lesions based on the Mirels method. Then, CTRA was performed, and the results were provided to the physicians, who were asked to reassess their treatment plan. The pre- and post-CTRA treatment plans were compared to identify cases in which the treatment plan was changed based on the CTRA report. Patients were followed for a 4-month period to establish the incidence of pathologic fractures. RESULTS Pain, lesion type, and lesion size were significant predictors of the pre-CTRA plan. After providing the CTRA results, physicians changed their plan for 36 patients. CTRA results, pain, and primary source of metastasis were significant predictors of the post-CTRA plan. Follow-up of patients who did not undergo fixation resulted in 7 fractures; CTRA predicted these fractures with 100% sensitivity and 90% specificity, whereas the Mirels method was 71% sensitive and 50% specific. CONCLUSIONS Lesion type and size and pain level influenced the physicians' plans for the management of metastatic lesions. Physicians' treatment plans and fracture risk predictions were significantly influenced by the availability of CTRA results. Due to its high sensitivity and specificity, CTRA could potentially be used as a screening method for pathologic fractures.
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Affiliation(s)
- Ara Nazarian
- Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Vahid Entezari
- Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - David Zurakowski
- Departments of Anesthesia and Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Juan C Villa-Camacho
- Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Patrick P Lin
- Section of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Felix H Cheung
- Department of Orthopaedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | | | - Robert Turcotte
- Department of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Megan E Anderson
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts
| | - Mark C Gebhardt
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts
| | - Edward Y Cheng
- Department of Orthopaedic Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Richard M Terek
- Department of Orthopaedic Surgery, Rhode Island Hospital, Providence, Rhode Island
| | - Michael Yaszemski
- Departments of Orthopedic Surgery and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Timothy A Damron
- Department of Orthopaedic Surgery, Upstate Medical University, Syracuse, New York
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Grahn PJ, Vaishya S, Knight A, Chen BK, Schmeichel A, Currier B, Spinner R, Yaszemski M, Windebank A. Implantation of cauda equina nerve roots through a biodegradable scaffold at the conus medullaris in rat. Spine J 2014; 14:2172-7. [PMID: 24509005 PMCID: PMC4125550 DOI: 10.1016/j.spinee.2014.01.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 12/17/2013] [Accepted: 01/29/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Traumatic injuries occurring at the conus medullaris of the spinal cord cause permanent damage both to the central nervous system and to the cauda equina nerve roots. PURPOSE This proof-of-concept study was to determine whether implanting the nerve roots into a biodegradable scaffold would improve regeneration after injury. METHODS All experimental works involving rats were performed according to the approved guidelines by the Mayo Clinic Institutional Animal Care and Use Committee. Surgical procedures were performed on 32 Sprague-Dawley rats. Four ventral cauda equina nerve roots were reimplanted either directly into the ventral cord stump or through a poly(lactic-co-glycolic acid) (PLGA) scaffold. These experimental groups were compared with a control group in which the nerves were inserted into a muscle fascia barrier that was placed between the spinal cord and the nerve roots. Animals were sacrificed at 4 weeks. RESULTS There was no difference in motor neuron counts in the spinal cord rostral to the injury in all treatment groups, implying equal potential for the regeneration into implanted nerve roots. One-way analysis of variance testing, with Tukey post hoc test, showed a statistically significant improvement in axon regeneration through the injury in the PLGA scaffold treatment group compared with the control (p<.05, scaffold n=11, control n=11). CONCLUSIONS This pilot study demonstrated that a PLGA scaffold improved regeneration of axons into peripheral nerve roots. However, the number of regenerating axons observed was limited and did not lead to functional recovery. Future experiments will employ a different scaffold material and possible growth factors or enzymes to increase axon populations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Anthony Windebank
- Mayo Graduate School, Mayo Clinic,Department of Neurology, Mayo Clinic
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Luangphakdy V, Walker E, Shinohara K, Pan H, Hefferan T, Bauer TW, Stockdale L, Saini S, Dadsetan M, Runge MB, Vasanji A, Griffith L, Yaszemski M, Muschler GF. Evaluation of osteoconductive scaffolds in the canine femoral multi-defect model. Tissue Eng Part A 2013; 19:634-48. [PMID: 23215980 DOI: 10.1089/ten.tea.2012.0289] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Treatment of large segmental bone defects remains an unsolved clinical challenge, despite a wide array of existing bone graft materials. This project was designed to rapidly assess and compare promising biodegradable osteoconductive scaffolds for use in the systematic development of new bone regeneration methodologies that combine scaffolds, sources of osteogenic cells, and bioactive scaffold modifications. Promising biomaterials and scaffold fabrication methods were identified in laboratories at Rutgers, MIT, Integra Life Sciences, and Mayo Clinic. Scaffolds were fabricated from various materials, including poly(L-lactide-co-glycolide) (PLGA), poly(L-lactide-co-ɛ-caprolactone) (PLCL), tyrosine-derived polycarbonate (TyrPC), and poly(propylene fumarate) (PPF). Highly porous three-dimensional (3D) scaffolds were fabricated by 3D printing, laser stereolithography, or solvent casting followed by porogen leaching. The canine femoral multi-defect model was used to systematically compare scaffold performance and enable selection of the most promising substrate(s) on which to add cell sourcing options and bioactive surface modifications. Mineralized cancellous allograft (MCA) was used to provide a comparative reference to the current clinical standard for osteoconductive scaffolds. Percent bone volume within the defect was assessed 4 weeks after implantation using both MicroCT and limited histomorphometry. Bone formed at the periphery of all scaffolds with varying levels of radial ingrowth. MCA produced a rapid and advanced stage of bone formation and remodeling throughout the defect in 4 weeks, greatly exceeding the performance of all polymer scaffolds. Two scaffold constructs, TyrPC(PL)/TCP and PPF4(SLA)/HA(PLGA) (Dip), proved to be significantly better than alternative PLGA and PLCL scaffolds, justifying further development. MCA remains the current standard for osteoconductive scaffolds.
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Affiliation(s)
- Viviane Luangphakdy
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
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Caralla T, Joshi P, Fleury S, Luangphakdy V, Shinohara K, Pan H, Boehm C, Vasanji A, Hefferan TE, Walker E, Yaszemski M, Hascall V, Zborowski M, Muschler GF. In vivo transplantation of autogenous marrow-derived cells following rapid intraoperative magnetic separation based on hyaluronan to augment bone regeneration. Tissue Eng Part A 2012; 19:125-34. [PMID: 23082937 DOI: 10.1089/ten.tea.2011.0622] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION This project was designed to test the hypothesis that rapid intraoperative processing of bone marrow based on hyaluronan (HA) could be used to improve the outcome of local bone regeneration if the concentration and prevalence of marrow-derived connective tissue progenitors (CTPs) could be increased and nonprogenitors depleted before implantation. METHODS HA was used as a marker for positive selection of marrow-derived CTPs using magnetic separation (MS) to obtain a population of HA-positive cells with an increased CTP prevalence. Mineralized cancellous allograft (MCA) was used as an osteoconductive carrier scaffold for loading of HA-positive cells. The canine femoral multidefect model was used and four cylindrical defects measuring 10 mm in diameter and 15 mm in length were grafted with MCA combined with unprocessed marrow or with MS processed marrow that was enriched in HA(+) CTPs and depleted in red blood cells and nonprogenitors. Outcome was assessed at 4 weeks using quantitative 3D microcomputed tomography (micro-CT) analysis of bone formation and histomorphological assessment. RESULTS Histomorphological assessment showed a significant increase in new bone formation and in the vascular sinus area in the MS-processed defects. Robust bone formation was found throughout the defect area in both groups (defects grafted with unprocessed marrow or with MS processed marrow.) Percent bone volume in the defects, as assessed by micro-CT, was greater in defects engrafted with MS processed cells, but the difference was not statistically significant. CONCLUSION Rapid intraoperative MS processing to enrich CTPs based on HA as a surface marker can be used to increase the concentration and prevalence of CTPs. MCA grafts supplemented with heparinized bone marrow or MS processed cells resulted in a robust and advanced stage of bone regeneration at 4 weeks. A greater new bone formation and vascular sinus area was found in defects grafted with MS processed cells. These data suggest that MS processing may be used to enhance the performance of marrow-derived CTPs in clinical bone regeneration procedures. Further assessment in a more stringent bone defect model is proposed.
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Affiliation(s)
- Tonya Caralla
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Piper KE, Fernandez-Sampedro M, Steckelberg KE, Mandrekar JN, Karau MJ, Steckelberg JM, Berbari EF, Osmon DR, Hanssen AD, Lewallen DG, Cofield RH, Sperling JW, Sanchez-Sotelo J, Huddleston PM, Dekutoski MB, Yaszemski M, Currier B, Patel R. C-reactive protein, erythrocyte sedimentation rate and orthopedic implant infection. PLoS One 2010; 5:e9358. [PMID: 20179760 PMCID: PMC2825262 DOI: 10.1371/journal.pone.0009358] [Citation(s) in RCA: 156] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 02/03/2010] [Indexed: 02/02/2023] Open
Abstract
Background C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been shown to be useful for diagnosis of prosthetic hip and knee infection. Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants. Methods/Results We analyzed preoperative CRP and ESR in 636 subjects who underwent knee (n = 297), hip (n = 221) or shoulder (n = 64) arthroplasty, or spine implant (n = 54) removal. A standardized definition of orthopedic implant-associated infection was applied. Receiver operating curve analysis was used to determine ideal cutoff values for differentiating infected from non-infected cases. ESR was significantly different in subjects with aseptic failure infection of knee (median 11 and 53.5 mm/h, respectively, p = <0.0001) and hip (median 11 and 30 mm/h, respectively, p = <0.0001) arthroplasties and spine implants (median 10 and 48.5 mm/h, respectively, p = 0.0033), but not shoulder arthroplasties (median 10 and 9 mm/h, respectively, p = 0.9883). Optimized ESR cutoffs for knee, hip and shoulder arthroplasties and spine implants were 19, 13, 26, and 45 mm/h, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 89 and 74% for knee, 82 and 60% for hip, and 32 and 93% for shoulder arthroplasties, and 57 and 90% for spine implants. CRP was significantly different in subjects with aseptic failure and infection of knee (median 4 and 51 mg/l, respectively, p<0.0001), hip (median 3 and 18 mg/l, respectively, p<0.0001), and shoulder (median 3 and 10 mg/l, respectively, p = 0.01) arthroplasties, and spine implants (median 3 and 20 mg/l, respectively, p = 0.0011). Optimized CRP cutoffs for knee, hip, and shoulder arthroplasties, and spine implants were 14.5, 10.3, 7, and 4.6 mg/l, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 79 and 88% for knee, 74 and 79% for hip, and 63 and 73% for shoulder arthroplasties, and 79 and 68% for spine implants. Conclusion CRP and ESR have poor sensitivity for the diagnosis of shoulder implant infection. A CRP of 4.6 mg/l had a sensitivity of 79 and a specificity of 68% to detect infection of spine implants.
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Affiliation(s)
- Kerryl E. Piper
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Marta Fernandez-Sampedro
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Kathryn E. Steckelberg
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Jayawant N. Mandrekar
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Melissa J. Karau
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - James M. Steckelberg
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Elie F. Berbari
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Douglas R. Osmon
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Arlen D. Hanssen
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - David G. Lewallen
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Robert H. Cofield
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - John W. Sperling
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Joaquin Sanchez-Sotelo
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Paul M. Huddleston
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Mark B. Dekutoski
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Michael Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Bradford Currier
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
| | - Robin Patel
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
- * E-mail:
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15
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Halder C, Ossendorf C, Maran A, Yaszemski M, Bolander ME, Fuchs B, Sarkar G. Preferential expression of the secreted and membrane forms of tumor endothelial marker 7 transcripts in osteosarcoma. Anticancer Res 2009; 29:4317-4322. [PMID: 20032373 PMCID: PMC2800050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND High expression of tumor endothelial marker 7 (TEM7) is correlated with osteogenic sarcoma (OS) metastasis and poor survival of patients. The TEM7 gene produces four alternatively spliced transcripts with distinct functional domains; the expression pattern of these transcripts in OS is unknown. MATERIALS AND METHODS mRNA expression was assessed in 5 OS cell lines, 7 normal bone, and 9 OS tumor specimens by reverse transcriptase polymerase chain reaction. RESULTS All OS cell lines, 6/9 tumors but none of the bone specimens expressed mRNA of TEM7 secreted forms 1 and 2. A total of 3/5 OS cell lines, 8/9 of tumors and 4/7 of bone specimens expressed mRNA of the TEM7 intracellular form. One out of 5 cell lines, 2/7 tumors and none of the bone specimens expressed mRNA of the TEM7 membrane form. The secreted forms had 20-fold higher expression in metastatic (LM7) compared to non-metastatic (SAOS-2) cells. CONCLUSION The mRNA of secreted and the membrane forms of TEM7 are preferentially expressed in OS.
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Affiliation(s)
- Chandralekha Halder
- Department of Orthopedic Research, Mayo Clinic and Foundation, Rochester, MN 55905. USA
| | - Christian Ossendorf
- Department of Orthopedic Research, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Avudaiappan Maran
- Department of Orthopedic Research, Mayo Clinic and Foundation, Rochester, MN 55905. USA
| | - Michael Yaszemski
- Department of Orthopedic Research, Mayo Clinic and Foundation, Rochester, MN 55905. USA
| | - Mark E. Bolander
- Department of Orthopedic Research, Mayo Clinic and Foundation, Rochester, MN 55905. USA
| | - Bruno Fuchs
- Department of Orthopedic Research, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Gobinda Sarkar
- Department of Orthopedic Research, Mayo Clinic and Foundation, Rochester, MN 55905. USA
- Department of Experimental Pathology, Mayo Clinic and Foundation, Rochester, MN 55905. USA
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16
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Yuan J, Ossendorf C, Szatkowski JP, Bronk JT, Maran A, Yaszemski M, Bolander ME, Sarkar G, Fuchs B. Osteoblastic and osteolytic human osteosarcomas can be studied with a new xenograft mouse model producing spontaneous metastases. Cancer Invest 2009. [PMID: 19212826 DOI: 10.1080/07357900802491477.osteoblastic] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
There is no animal model that reflects the histological and radiographical heterogeneity of osteosarcoma. We assessed seven osteosarcoma cell lines for their potential to develop orthotopic tumors and lung metastasis in SCID mice. Whereas radiologically, 143B developed osteolytic tumors, SaOS-LM7 developed osteoblastic primary tumors. The mineralization status was confirmed by assessing the alkaline phosphatase activity and the microarray expression profile. We herein report a xenograft orthotopic osteosarcoma mouse model to assess osteoblastic and osteolytic lesions, which may contribute in the search for new diagnostic and therapeutic approaches.
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Affiliation(s)
- Jun Yuan
- Children's Cancer Institute of Australia for Medical Research, Randwick, Australia
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17
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Yuan J, Ossendorf C, Szatkowski JP, Bronk JT, Maran A, Yaszemski M, Bolander ME, Sarkar G, Fuchs B. Osteoblastic and osteolytic human osteosarcomas can be studied with a new xenograft mouse model producing spontaneous metastases. Cancer Invest 2009; 27:435-42. [PMID: 19212826 DOI: 10.1080/07357900802491477] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There is no animal model that reflects the histological and radiographical heterogeneity of osteosarcoma. We assessed seven osteosarcoma cell lines for their potential to develop orthotopic tumors and lung metastasis in SCID mice. Whereas radiologically, 143B developed osteolytic tumors, SaOS-LM7 developed osteoblastic primary tumors. The mineralization status was confirmed by assessing the alkaline phosphatase activity and the microarray expression profile. We herein report a xenograft orthotopic osteosarcoma mouse model to assess osteoblastic and osteolytic lesions, which may contribute in the search for new diagnostic and therapeutic approaches.
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Affiliation(s)
- Jun Yuan
- Children's Cancer Institute of Australia for Medical Research, Randwick, Australia
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18
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Fuchs B, Mahlum E, Halder C, Maran A, Yaszemski M, Bode B, Bolander M, Sarkar G. High expression of tumor endothelial marker 7 is associated with metastasis and poor survival of patients with osteogenic sarcoma. Gene 2007; 399:137-43. [PMID: 17560052 PMCID: PMC2066185 DOI: 10.1016/j.gene.2007.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 04/24/2007] [Accepted: 05/05/2007] [Indexed: 11/29/2022]
Abstract
Our objective is to identify genes regulating metastasis of osteogenic sarcoma (OGS) since metastasis is the primary cause of mortality among patients with OGS. To identify such genes, we first created a database of differentially expressed genes between six low-grade and six high-grade OGS tumors, and between a normal immortalized osteoblast cell line (FOB) and four commercially available OGS-derived cell lines. We specifically searched for surface proteins over-expressed in high-grade OGS, since we hypothesize that tumor-cell specific surface markers are key to metastasis. A gene encoding Tumor Endothelial Marker7 (TEM7) was selected as a candidate for further study. TEM7 expression pattern was assessed by RT-PCR, Western blotting and immunostaining. TEM7 mRNA was abundantly expressed in SAOS cells (derived from high-grade OGS), but not in FOB or MG63 cells (derived from low-grade OGS). Virtually no expression of TEM7 protein was observed in FOB cells but abundant expression was noted in SAOS and TE85 cells. Employing immunostaining of 92 human OGS specimens (50 high-grade and 42 low-grade) collected before chemotherapy show 97% (37 of 38) of high-grade OGS specimens with metastasis have high TEM7 staining. Further, we found that elevated expression of TEM7 correlated with poor survival (p<0.04) of affected patients. Inhibiting TEM7 function by siRNA inhibited invasion and migration of OGS cells with metastatic potential. Our results suggest TEM7 expression level closely parallels histology-based prognostication of OGS metastasis and, therefore, it is a therapeutic target. This is the first demonstration of a link between TEM7 and cancer metastasis.
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Affiliation(s)
- Bruno Fuchs
- Department of Orthopedics, Mayo Clinic, 200 1st St Rochester, Minnesota 55905, United States
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19
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Liao E, Yaszemski M, Krebsbach P, Hollister S. Tissue-Engineered Cartilage Constructs Using Composite Hyaluronic Acid/Collagen I Hydrogels and Designed Poly(Propylene Fumarate) Scaffolds. ACTA ACUST UNITED AC 2007; 13:537-50. [PMID: 17319795 DOI: 10.1089/ten.2006.0117] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Our approach to cartilage tissue-engineering scaffolds combines image-based design and solid free-form (SFF) fabrication to create load-bearing constructs with user-defined parameters. In this study, 3-dimensional scaffolds with cubic and ellipsoidal pore architecture were fabricated using poly(propylene fumarate) (PPF). To increase seeding efficiency and cellular retention, hydrogels were used to deliver cells into the scaffolds. The first objective of this study was to evaluate the concentrations of composite hyaluronic acid (HyA) and collagen I hydrogels best able to stimulate proteoglycan synthesis in porcine chondrocytes in vitro and in vivo. The second objective was to evaluate the differences in extracellular matrix production due to pore geometry and scaffold design. For the in vitro assessment, chondrocytes were encapsulated in collagen I hydrogels with varying concentrations of HyA. Hydrogels were cultured for 1 and 2 weeks, and then the sulfated glycosaminoglycan (sGAG) content was quantified using a dimethyl-methylene blue assay. The concentration of HyA best able to increase ECM synthesis was 5% HyA/collagen I, or 0.23 mg/mL HyA. The results from the in vitro experiment were used as culture parameters for the in vivo analysis. Composite 5% HyA/collagen I or collagen I-only hydrogels were used to seed chondrocytes into SFF-fabricated scaffolds made of PPF with designed cubic or ellipsoidal pore geometry. The scaffolds were implanted subcutaneously in immunocompromised mice for 4 weeks. Histomorphometric analyses of sections stained with Safranin O were used to quantify the amount of ECM deposited by cells in the scaffolds. Scaffolds seeded with 5% HyA/collagen hydrogels had significantly greater areas of positive Safranin O staining (approximately 60%, compared with 30% for scaffolds with collagen I hydrogels only), indicating that greater numbers of chondrocytes retained their metabolic activity in the ectopic environment. These scaffolds also had greater stain intensities (corresponding to greater amounts of sGAG in the ECM) than their counterparts seeded with collagen I hydrogels alone. Significant differences in matrix production were not found between the scaffold pore designs. Overall, these results indicate that a combination of composite HyA hydrogels and designed SFF scaffolds could provide a functional tissue-engineered construct for cartilage repair with enhanced tissue regeneration in a load-bearing scaffold.
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Affiliation(s)
- Elly Liao
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
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20
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Mandal D, Srivastava A, Mahlum E, Desai D, Maran A, Yaszemski M, Jalal SM, Gitelis S, Bertoni F, Damron T, Irwin R, O'connor M, Schwartz H, Bolander ME, Sarkar G. Severe suppression of Frzb/sFRP3 transcription in osteogenic sarcoma. Gene 2006; 386:131-8. [PMID: 17079093 DOI: 10.1016/j.gene.2006.08.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 07/27/2006] [Accepted: 08/21/2006] [Indexed: 11/20/2022]
Abstract
Deciphering the molecular basis of cancer is critical for developing novel diagnostic and therapeutic strategies. To better understand the early molecular events involving osteogenic sarcoma (OGS), we have initiated a program to identify potential tumor suppressor genes. Expression profiling of total RNA from ten normal bone cell lines and eleven OGS-derived cell lines by microarray showed 135-fold lower expression of FRZB/sFRP3 mRNA in OGS cells compared to bone cells; this down-regulation of Frzb/sFRP3 mRNA expression was found to be serum-independent. Subsequently, fourteen OGS biopsy specimens showed nine-fold down-regulation of Frzb/sFRP3 mRNA expression compared to expression in eight normal bone specimens as determined by microarray. FRZB /sFRP3 protein level was also found to be at a very low level in 4/4 OGS cell lines examined. Quantitation by RT-PCR indicated approximately 70% and approximately 90% loss of Frzb/sFRP3 mRNA expression in OGS biopsy specimens and OGS-derived cell lines respectively, compared to expression in bone (p<0.0001). Hybridization experiments of a cDNA microarray containing paired normal and tumor specimens from nineteen different organs did not show any significant difference in the level of Frzb/sFRP3 mRNA expression between the normal and the corresponding tumor tissues. Exogenous expression of FRZB/sFRP3 mRNA in two OGS-derived cell lines lacking endogenous expression of the mRNA produced abundant mRNA from the exogenous gene, eliminating degradation as a possibility for very low level of FRZB/sFRP3 mRNA in OGS specimens. Results from PCR-based experiments suggest that the FRZB/sFRP3 gene is not deleted in OGS cell lines, however, karyotyping shows gross abnormalities involving chromosome 2 (location of the FRZB gene) in five of twelve OGS-derived cell lines. Together, these data suggest a tumor-suppressive potential for FRZB/sFRP3 in OGS.
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Affiliation(s)
- Deendayal Mandal
- Department of Orthopedic Research, Mayo Clinic and Foundation, 200 1st St. SW, Rochester, MN 55905, USA
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21
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De Ruiter G, Malessy M, Spinner R, Moore M, Sorenson E, Currier B, Yaszemski M, Windebank A. Accuracy of Motor Axon Regeneration across Single Lumen and Multi-Channel Nerve Tubes. J Reconstr Microsurg 2006. [DOI: 10.1055/s-2006-949716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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De Ruiter G, Spinner R, Currier B, Koch A, Malessy M, Yaszemski M, Kaufman K, Windebank A. 2-D Digital Video Ankle Motion Analysis as Evaluation Method for Functional Recovery in the Rat Sciatic Nerve Model. J Reconstr Microsurg 2006. [DOI: 10.1055/s-2006-949706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
UNLABELLED Fungal infections of the spine are relatively uncommon. Fungi such as Coccidioides immitis and Blastomyces dermatitidis are limited to specific geographical areas whereas cryptococcus, candida, and aspergillus are found worldwide. Candida and aspergillus are normal commensals of the body and produce disease in susceptible organisms when they gain access to the vascular system through intravenous lines, during implantation of prosthetic devices, or during surgery. For the other fungi, spinal involvement usually is the result of hematogenous or direct spread of organisms from an initial pulmonary source of infection. Involvement of the vertebral bodies can lead to vertebral compression fractures and gross deformity of the spine. Spread of infection along the anterior longitudinal ligament can lead to psoas or paravertebral abscesses. Early recognition of the disease requires a high index of suspicion, proper travel history, and a detailed physical examination. Treatment relies on the prompt institution of appropriate pharmacotherapy and constant monitoring of clinical progress. Resistance to medical therapy, spinal instability, and neurologic deficits are indications for débridement and stabilization with spinal fusion. Prognosis depends on the premorbid state of the patient, the type of fungal organism, and the timing of treatment. LEVEL OF EVIDENCE Level V (expert opinion). Please see the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Choll W Kim
- Department of Orthopaedic Surgery, University of California, San Diego, California, USA.
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24
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Lu L, Zhu X, Pederson LG, Jabbari E, Currier B, O'Driscoll S, Yaszemski M. Effects of Dynamic Fluid Pressure on Chondrocytes Cultured in Biodegradable Poly(glycolic acid) Fibrous Scaffolds. ACTA ACUST UNITED AC 2005; 11:1852-9. [PMID: 16411831 DOI: 10.1089/ten.2005.11.1852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Lichun Lu
- Orthopedic Surgery and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota 55902-0002, USA
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