Fabrication of Functional Cell Sheets with Human Thyrocytes from Non-Tumorous Thyroid Tissue

BACKGROUND: Engineered cell sheet transplantation has been considered an alternative physiological therapy for endocrine disorders. In this study, we attempted to fabricate functional human thyroid cell sheets using the engineering technology by culturing primary thyrocytes in free-feeder monolayers and assessed their proliferation and function in two different media. METHODS: The non-tumorous tissues (approximately 2 g) were dissected during surgery. Primary human thyroid cells were isolated by mechanical dispersion and treatment with isolation solution. The cells were cultured on tissue culture dishes or temperature-responsive culture dishes to induce the formation of detached cell sheets. RESULTS: Primary thyroid cells isolated from nine patients were positive for thyroid transcription factor 1, thyroglobulin (TG) and cytokeratin 7. Cell sheets with follicles were fabricated by cells incubated in both Dulbecco's Modified Eagle Medium (DMEM) and hepatocyte-defined medium (HDM) culture medium. The diameter and thickness of sheets fabricated in HDM were larger and thicker than those fabricated from DMEM. Furthermore, the cells incubated in HDM secreted higher levels of fT3 and fT4 than those incubated in DMEM. The thyroid peroxidase and TG mRNA of cells maintained in HDM were higher than those in cells maintained in DMEM. CONCLUSION: HDM appears suitable as a culture medium for maintaining primary thyrocytes and fabricating functional cell sheets. These in vitro findings may contribute to the development of appropriate culture conditions for human thyrocytes as well as engineered functional cell sheets.

Obturator hernia in an ageing society

<p><b>INTRODUCTION</b>Obturator hernia is an important cause of small bowel obstruction and is associated with difficult diagnosis and high mortality.</p><p><b>MATERIALS AND METHODS</b>We reviewed 22 cases of intestinal obstruction due to obturator hernia that necessitated surgical intervention over the last 17 years and evaluated the changes in the number of patients based on the census data.</p><p><b>RESULTS</b>All cases were elderly females. The Howship-Romberg sign was present in 15 patients (68%). Computed tomography (CT) correctly diagnosed 13/15 (87%) of cases in which it was performed prospectively. The median time to surgery was 7.5+/-5.2 days for those patients with bowel resection, compared to 0.8+/-1.3 days for those without (P <0.05). The number of patients with obturator hernia has increased with an ageing society.</p><p><b>CONCLUSIONS</b>The rising incidence of obturator hernia is probably linked to an ageing society. CT of the pelvis was helpful in obtaining the correct diagnosis. The shorter the delay between admission and surgery, the lower the bowel resection rate. Laparotomy at an early stage is recommended in such patients as it leads to reduced morbidity and mortality.</p>