Studio di fase I sulla reinfusione intraepatica di cellule staminali CD 133+ altamente purificate nei pazienti con malattia epatica terminale

Numerose evidenze sperimentali hanno dimostrato il contributo delle cellule staminali di derivazione midollare nei processi di rigenerazione epatica dopo danno tissutale. E’ cresciuto pertanto l’interesse sul loro potenziale impiego in pazienti con cirrosi. Questo studio si propone di valutare la fattibilità e la sicurezza della reinfusione intraepatica di cellule staminali midollari autologhe CD133+ in 12 pazienti con insufficienza epatica terminale definita da un punteggio di Model for End Stage of Liver Disease (MELD) compreso tra 17 e 25. L’efficacia in termini di funzionalità epatica rappresenta un obiettivo secondario. Previa mobilizzazione nel sangue periferico mediante somministrazione di granulocyte-colony stimulating factor (G-CSF) alla dose di 7,5 mcg/Kg/b.i.d. e raccolta per leucoaferesi, le cellule CD133+ altamente purificate vengono reinfuse in arteria epatica a partire da 5x104/Kg fino a 1x106/kg. Nei tre giorni successivi si somministra G-CSF per favorire l’espansione e l’attecchimento delle cellule. Durante la mobilizzazione, la reinfusione e nei 12 mesi successivi i pazienti sono sottoposti a periodici controlli clinici, laboratoristici e strumentali e ad attenta valutazione di effetti collaterali. Lo studio è tuttora in corso e ad oggi, 11 pazienti sono stati sottoposti a reinfusione e 4 hanno completato i 12 mesi di follow-up. Il G-CSF è stato ben tollerato e ha consentito di ottenere una buona espansione cellulare. Dopo la reinfusione sono stati documentati un ematoma inguinale e due episodi transitori di encefalopatia portosistemica. Durante il follow-up 4 pazienti sono stati trapiantati e 2 sono morti. Non è stata osservata alcuna modificazione significativa degli indici di funzione epatica. Questi risultati preliminari confermano la possibilità di mobilizzare e reinfondere un numero adeguato di cellule staminali di derivazione midollare in pazienti con malattia epatica in stadio terminale.

Valutazione dell'efficacia dell'infusione intraepatica di cellule staminali (SC) autologhe CD133+ in pazienti affetti da cirrosi ed insufficienza epatica di grado avanzato

Numerose evidenze sperimentali hanno dimostrato il contributo delle cellule staminali (SC) di derivazione midollare nei processi di rigenerazione epatica dopo danno tissutale. E’ cresciuto pertanto l’interesse sul loro potenziale impiego in pazienti con cirrosi. Questo studio si proponeva di valutare la fattibilità e la sicurezza della reinfusione intraepatica di cellule staminali midollari autologhe CD133+ in 12 pazienti con insufficienza epatica terminale. Previa mobilizzazione nel sangue periferico mediante somministrazione di granulocyte-colony stimulating factor (G-CSF) alla dose di 7,5 mcg/Kg/b.i.d. e raccolta per leucoaferesi (solo se la concentrazione di CD133 + SC era > 8/μL), le cellule CD133+ altamente purificate sono state reinfuse in arteria epatica a partire da 5x104/Kg fino a 1x106/kg. Nei tre giorni successivi è stato somministrato G-CSF per favorire l’espansione e l’attecchimento delle cellule. Durante la fase della mobilizzazione e quella della reinfusione sono stati eseguiti saggi biologici quali: caratterizzazione fenotipica delle SC circolanti, saggi clonogenici, valutazione della concentrazione sierica del Hepatocyte Growth Factor (HGF), Stromal-Derived Factor-1 (SDF-1) ed il Vascular-Endotelial Growth Factor (VEGF) e caratterizzazione fenotipica delle CD133+SC purificate. Fino ad oggi sono stati reinfusi 12 pazienti. Questi dati preliminari suggeriscono che è possibile mobilizzare e reinfondere un numero considerevole di SC autologhe CD133+ altamente purificate in pazienti con ESLD . Gli studi biologici mostrano che: il numero di progenitori ematopoietici ed endoteliali circolanti è aumentato dopo il trattamento con G–CSF; le SCs CD133+ altamente purificato esprimono marcatori emopoietici ed endoteliali; la concentrazione sierica di HGF, SDF-1, VEGF e la capacità clonogenica di progenitori emopoietici sono aumentati durante la mobilitazione e nelle fasi di reinfusione; il potenziale clonogenico dei progenitori endoteliali mostra espressione variabile.

Controllable assembly of graphene hybrid materials and their application in energy storage and conversion

Hybrid Elektrodenmaterialien (HEM) sind der Schlüssel zu grundlegenden Fortschritten in der Energiespeicherung und Systemen zur Energieumwandlung, einschließlich Lithium-Ionen-Batterien (LiBs), Superkondensatoren (SCs) und Brennstoffzellen (FCs). Die faszinierenden Eigenschaften von Graphen machen es zu einem guten Ausgangsmaterial für die Darstellung von HEM. Jedoch scheitern traditionelle Verfahren zur Herstellung von Graphen-HEM (GHEM) scheitern häufig an der fehlenden Kontrolle über die Morphologie und deren Einheitlichkeit, was zu unzureichenden Grenzflächenwechselwirkungen und einer mangelhaften Leistung des Materials führt. Diese Arbeit konzentriert sich auf die Herstellung von GHEM über kontrollierte Darstellungsmethoden und befasst sich mit der Nutzung von definierten GHEM für die Energiespeicherung und -umwandlung. Die große Volumenausdehnung bildet den Hauptnachteil der künftigen Lithium-Speicher-Materialien. Als erstes wird ein dreidimensionaler Graphen Schaumhybrid zur Stärkung der Grundstruktur und zur Verbesserung der elektrochemischen Leistung des Fe3O4 Anodenmaterials dargestellt. Der Einsatz von Graphenschalen und Graphennetzen realisiert dabei einen doppelten Schutz gegen die Volumenschwankung des Fe3O4 bei dem elektrochemischen Prozess. Die Leistung der SCs und der FCs hängt von der Porenstruktur und der zugänglichen Oberfläche, beziehungsweise den katalytischen Stellen der Elektrodenmaterialien ab. Wir zeigen, dass die Steuerung der Porosität über Graphen-basierte Kohlenstoffnanoschichten (HPCN) die zugängliche Oberfläche und den Ionentransport/Ladungsspeicher für SCs-Anwendungen erhöht. Desweiteren wurden Stickstoff dotierte Kohlenstoffnanoschichten (NDCN) für die kathodische Sauerstoffreduktion (ORR) hergestellt. Eine maßgeschnittene Mesoporosität verbunden mit Heteroatom Doping (Stickstoff) fördert die Exposition der aktiven Zentren und die ORR-Leistung der metallfreien Katalysatoren. Hochwertiges elektrochemisch exfoliiertes Graphen (EEG) ist ein vielversprechender Kandidat für die Darstellung von GHEM. Allerdings ist die kontrollierte Darstellung von EEG-Hybriden weiterhin eine große Herausforderung. Zu guter Letzt wird eine Bottom-up-Strategie für die Darstellung von EEG Schichten mit einer Reihe von funktionellen Nanopartikeln (Si, Fe3O4 und Pt NPs) vorgestellt. Diese Arbeit zeigt einen vielversprechenden Weg für die wirtschaftliche Synthese von EEG und EEG-basierten Materialien.

Craniofacial morphology in complete unilateral cleft lip and palate patients consecutively treated with 1-stage repair of the cleft

OBJECTIVE: To retrospectively evaluate the craniofacial morphology of children with a complete unilateral cleft lip and palate treated with a 1-stage simultaneous cleft repair performed in the first year of life. METHODS: Cephalograms and extraoral profile photographs of 61 consecutively treated patients (42 boys, 19 girls) who had been operated on at 9.2 (SD, 2.0) months by a single experienced surgeon were analyzed at 11.4 (SD, 1.5) years. The noncleft control group comprised 81 children (43 boys and 38 girls) of the same ethnicity at the age of 10.4 (SD, 0.5) years. RESULTS: In children with cleft, the maxilla and mandible were retrusive; the palatal and mandibular planes were more open, and sagittal maxillomandibular relationship was less favorable in comparison to noncleft control subjects. Soft tissues in patients with cleft reflected retrusive morphology of hard tissues--subnasal and supramental regions were less convex, profile was flatter, and nasolabial angle was more acute relative to those of the control subjects. CONCLUSIONS: Craniofacial morphology after 1-stage repair was deviated in comparison with noncleft control subjects. However, the degree of deviation was comparable with that found after treatment with alternative surgical protocols.

Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants

Objectives: To assess the biological and technical complication rates of single crowns on vital teeth (SC-V), endodontically treated teeth without post and core (SC-E), with a cast post and core (SC-PC) and on implants (SC-I). Material and methods: From 392 patients with chronic periodontitis treated and documented by graduate students during the period from 1978 to 2002, 199 were reexamined during 2005 for this retrospective cohort study, and 64 of these patients were treated with SCs. Statistical analysis included Kaplan–Meier survival functions and event rates per 100 years of object-time. Poisson regression was used to compare the four groups of crowns with respect to the incidence rate ratio of failures, and failures and complications combined over 10 years and the entire observation period. Results: Forty-one (64%) female and 23 (36%) male patients participated in the reexamination. At the time of seating the crowns, the mean patient age was 46.8 (range 24–66.3) years. One hundred and sixty-eight single unit crowns were incorporated. Their mean follow-up time was 11.8 (range 0.8–26.4) years. During the time of observation, 22 biological and 11 technical complications occurred; 19 SC were lost. The chance for SC-V (56) to remain free of any failure or complication was 89.3% (95% confidence interval [CI] 76.1–95.4) after 10 years, 85.8% (95% CI 66–94.5) for SC-E (34), 75.9% for SC-PC (39), (95% CI 58.8–86.7) and 66.2% (95% CI 45.1–80.7) for SC-I (39). Over 10 years, 95% of SC-I remained free of failure and demonstrated a cumulative incidence of failure or complication of 34%. Compared with SC-E, SC-I were 3.5 times more likely to yield failures or complications and SC-PC failed 1.7 times more frequently than did SC-E. SC-V had the lowest rate of failures or complications over the 10 years. Conclusions: While SCs on vital teeth have the best prognosis, those on endodontically treated teeth have a slightly poorer prognosis over 10 years. Crowns on teeth with post and cores and implant-supported SCs displayed the highest incidence of failures and complications.

Quality of reporting of clinical studies to assess and compare performance of implant-supported restorations

The objective of this analysis was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prostheses (FDPs) and single crowns (SCs), and to describe the incidence of biological and technical complications with emphasis on quality of reporting.

Combined bone and soft-tissue augmentation surgery in temporo-orbital contour reconstruction

Temporal hollowing due to temporal muscle atrophy after standard skull base surgery is common. Various techniques have been previously described to correct the disfiguring defect. Most often reconstruction is performed using freehand molded polymethylmethacrylate cement. This method and material are insufficient in terms of aesthetic results and implant characteristics. We herein propose reconstruction of such defects with a polyetheretherketone (PEEK)-based patient-specific implant (PSI) including soft-tissue augmentation to preserve normal facial topography. We describe a patient who presented with a large temporo-orbital hemangioma that had been repaired with polymethylmethacrylate 25 years earlier. Because of a toxic skin atrophy fistula, followed by infection and meningitis, this initial implant had to be removed. The large, disfiguring temporo-orbital defect was reconstructed with a PEEK-based PSI. The lateral orbital wall and the temporal muscle atrophy were augmented with computer-aided design and surface modeling techniques. The operative procedure to implant and adopt the reconstructed PEEK-based PSI was simple, and an excellent cosmetic outcome was achieved. The postoperative clinical course was uneventful over a 5-year follow-up period. Polyetheretherketone-based combined bony and soft contour remodeling is a feasible and effective method for cranioplasty including combined bone and soft-tissue reconstruction of temporo-orbital defects. Manual reconstruction of this cosmetically delicate area carries an exceptional risk of disfiguring results. Augmentation surgery in this anatomic location needs accurate PSIs to achieve satisfactory cosmetic results. The cosmetic outcome achieved in this case is superior compared with previously reported techniques.

Erhöhung der Achtsamkeit durch Taiji-Training - Ergebnisse aus einer randomisierten Warteliste-kontrollierten Studie mit gesunden Versuchspersonen

Hintergrund: Taiji ist eine meditative Bewegungsform mit Ursprung in den chinesischen Kampfkünsten. In mehreren Studien konnten positive Effekte von Taiji auf das psychische und körperliche Wohlbefinden nachgewiesen werden. Eine mögliche Wirkkomponente von Taiji könnte die Förderung von Achtsamkeit sein. Studienergebnisse, welche eine Verbesserung der Körperwahrnehmung durch Taiji nahe legen, stützen diese Annahme. Mit der vorliegenden Arbeit wurde untersucht, inwiefern sich Taiji auf die allgemeine Achtsamkeit im Sinne eines erweiterten multidimensionalen Konzeptes als auch auf den achtsamen Umgang mit sich selbst in belastenden Situationen auswirkt. Methoden: 70 gesunde Versuchspersonen wurden randomisiert einer Taiji-Interventionsgruppe oder zu einer Warteliste-Kontrollgruppe zugeteilt. Die Interventionsgruppe erhielt während drei Monaten zweimal wöchentlich je eine Stunde Taiji-Unterricht. Die allgemeine Achtsamkeit wurde mittels dem Freiburger Fragebogens zur Achtsamkeit (FFA-Kurzform), die Achtsamkeit in belastenden Situationen wurde über die Subskala „Achtsamkeit“ der Self-Compassion-Scale (SCS) vor Beginn und nach Beendigung der Intervention gemessen. Resultate: Die Interventionsgruppe (N=28) wies nach Kursende im Vergleich zur Kontrollgruppe (N=31) einen signifikanten Anstieg der Achtsam-keitswerte im FFA (F(1, 34.70) = 4.29, p = 0.043) und in der SCS-Subskala (F(1, 3.58) = 4.62, p = 0.036) auf. Schlussfolgerung: Die gegenwärtigen Studienergebnisse sprechen dafür, dass bei gesunden Personen Achtsamkeit im Allgemeinen als auch in schwierigen Lebenslagen durch das Üben von Taiji gefördert werden kann.

N-H center dot center dot center dot pi hydrogen-bonding and large-amplitude tipping vibrations in jet-cooled pyrrole-benzene

The N-H center dot center dot center dot pi hydrogen bond is an important intermolecular interaction in many biological systems. We have investigated the infrared (IR) and ultraviolet (UV) spectra of the supersonic-jet cooled complex of pyrrole with benzene and benzene-d(6) (Pyr center dot Bz, Pyr center dot Bz-d(6)). DFT-D density functional, SCS-MP2 and SCS-CC2 calculations predict a T-shaped and (almost) C(s) symmetric structure with an N-H center dot center dot center dot pi hydrogen bond to the benzene ring. The pyrrole is tipped by omega(S(0)) = +/- 13 degrees relative to the surface normal of Bz. The N center dot center dot center dot ring distance is 3.13 angstrom. In the S(1) excited state, SCS-CC2 calculations predict an increased tipping angle omega(S(1)) = +/- 21 degrees. The IR depletion spectra support the T-shaped geometry: The NH stretch is redshifted by -59 cm(-1), relative to the "free" NH stretch of pyrrole at 3531 cm(-1), indicating a moderately strong N-H center dot center dot center dot pi interaction. The interaction is weaker than in the (Pyr)(2) dimer, where the NH donor shift is -87 cm(-1) [Dauster et al., Phys. Chem. Chem. Phys., 2008, 10, 2827]. The IR C-H stretch frequencies and intensities of the Bz subunit are very similar to those of the acceptor in the (Bz)(2) dimer, confirming that Bz acts as the acceptor. While the S(1) <- S(0) electronic origin of Bz is forbidden and is not observable in the gas-phase, the UV spectrum of Pyr center dot Bz in the same region exhibits a weak 0(0)(0) band that is red-shifted by 58 cm(-1) relative to that of Bz (38 086 cm(-1)). The origin appears due to symmetry-breaking of the p-electron system of Bz by the asymmetric pyrrole NH center dot center dot center dot pi hydrogen bond. This contrasts with (Bz)(2), which does not exhibit a 0(0)(0) band. The Bz moiety in Pyr center dot Bz exhibits a 6a(0)(1) band at 0(0)(0) + 518 cm(-1) that is about 20x more intense than the origin band. The symmetry breaking by the NH center dot center dot center dot pi hydrogen bond splits the degeneracy of the v(6)(e(2g)) vibration, giving rise to 6a' and 6b' sub-bands that are spaced by similar to 6 cm(-1). Both the 0(0)(0) and 6(0)(1) bands of Pyr center dot Bz carry a progression in the low-frequency (10 cm(-1)) excited-state tipping vibration omega', in agreement with the change of the omega tipping angle predicted by SCS-MP2 and SCS-CC2 calculations.

Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years

To assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological, technical, and aesthetic complications. The focused question was: What is the survival rate of implants supporting single crowns and implant-supported crowns with a mean follow-up of 5 years and to which extent do biological, technical, and aesthetic complications occur?

Comparative expression profiling of E. coli and S. aureus inoculated primary mammary gland cells sampled from cows with different genetic predispositions for somatic cell score

BACKGROUND: During the past ten years many quantitative trait loci (QTL) affecting mastitis incidence and mastitis related traits like somatic cell score (SCS) were identified in cattle. However, little is known about the molecular architecture of QTL affecting mastitis susceptibility and the underlying physiological mechanisms and genes causing mastitis susceptibility. Here, a genome-wide expression analysis was conducted to analyze molecular mechanisms of mastitis susceptibility that are affected by a specific QTL for SCS on Bos taurus autosome 18 (BTA18). Thereby, some first insights were sought into the genetically determined mechanisms of mammary gland epithelial cells influencing the course of infection. METHODS: Primary bovine mammary gland epithelial cells (pbMEC) were sampled from the udder parenchyma of cows selected for high and low mastitis susceptibility by applying a marker-assisted selection strategy considering QTL and molecular marker information of a confirmed QTL for SCS in the telomeric region of BTA18. The cells were cultured and subsequently inoculated with heat-inactivated mastitis pathogens Escherichia coli and Staphylococcus aureus, respectively. After 1, 6 and 24 h, the cells were harvested and analyzed using the microarray expression chip technology to identify differences in mRNA expression profiles attributed to genetic predisposition, inoculation and cell culture. RESULTS: Comparative analysis of co-expression profiles clearly showed a faster and stronger response after pathogen challenge in pbMEC from less susceptible animals that inherited the favorable QTL allele 'Q' than in pbMEC from more susceptible animals that inherited the unfavorable QTL allele 'q'. Furthermore, the results highlighted RELB as a functional and positional candidate gene and related non-canonical Nf-kappaB signaling as a functional mechanism affected by the QTL. However, in both groups, inoculation resulted in up-regulation of genes associated with the Ingenuity pathways 'dendritic cell maturation' and 'acute phase response signaling', whereas cell culture affected biological processes involved in 'cellular development'. CONCLUSIONS: The results indicate that the complex expression profiling of pathogen challenged pbMEC sampled from cows inheriting alternative QTL alleles is suitable to study genetically determined molecular mechanisms of mastitis susceptibility in mammary epithelial cells in vitro and to highlight the most likely functional pathways and candidate genes underlying the QTL effect.

A systematic review of the 5-year survival and complication rates of implant-supported single crowns

OBJECTIVES: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications. METHODS: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS: Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9-97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5-95.9%) after 5 years of function. The survival rate of metal-ceramic crowns, 95.4% (95% CI: 93.6-96.7%), was significantly (P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8-94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%. CONCLUSION: It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent.

Cost-effective patient-specific intraoperative molded cranioplasty

Intraoperative molding of polymethyl-methacrylate into complex three-dimensional shapes with correct thickness is often a time-consuming process and may lead to unsatisfying cosmetical results. This article describes an intraoperative technique to assemble a polymethyl-methacrylate implant as a replica of the patient's bone flap. This approach provides a fast and inexpensive alternative technique with good cosmetic outcome. The technique is feasible and can be applied in early and delayed cranioplasty procedures. In selected patients, immediate single-stage reconstruction avoids a second operation.