Engineering the Extracellular Matrix for Organoid Culture

Organoids show great potential in clinical translational research owing to their intriguing properties to represent a near physiological model for native tissues. However, the dependency of organoid generation on the use of poorly defined matrices has hampered their clinical application. Current organoid culture systems mostly reply on biochemical signals provided by medium compositions and cell-cell interactions to control growth. Recent studies have highlighted the importance of the extracellular matrix (ECM) composition, cell-ECM interactions, and mechanical signals for organoid expansion and differentiation. Thus, several hydrogel systems prepared using natural or synthetic-based materials have been designed to recreate the stem cell niche in vitro, providing biochemical, biophysical, and mechanical signals. In this review, we discuss how recapitulating multiple aspects of the tissue-specific environment through designing and applying matrices could contribute to accelerating the translation of organoid technology from the laboratory to therapeutic and pharmaceutical applications.

Factors Affecting Postoperative Complications and Outcomes of Cervical Spondylotic Myelopathy with Cerebral Palsy : A Retrospective Analysis

Objective@#: Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. @*Methods@#: Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained preand postoperatively and compared between those with and without postoperative complications. @*Results@#: Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. @*Conclusion@#: The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.

Factors Affecting Postoperative Complications and Outcomes of Cervical Spondylotic Myelopathy with Cerebral Palsy : A Retrospective Analysis

Objective@#: Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. @*Methods@#: Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained preand postoperatively and compared between those with and without postoperative complications. @*Results@#: Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. @*Conclusion@#: The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.

Multiple Territory Ischemic Stroke Aggravated by Severe Anemia

While acute anemia is regarded as a precipitating factor of ischemic stroke, there have been few reports on the evolution of infarction in the acute period of ischemic stroke by anemia. We describe a 71-year-old man with acute multiple territory infarction who had progressive neurologic deficits of paraparesis and dysarthria. This case suggests that sustained severe anemia due to intractable intestinal bleeding is an important cause of aggravation of ischemic stroke.

The Stability Score of the Intramedullary Nailed Intertrochanteric Fractures: Stability of Nailed Fracture and Postoperative Patient Mobilization

BACKGROUND: Intertrochanteric fractures of the femur are the most common type of fracture, and are an increasing occurrence due to the aging of the population. The objectives of our study are to predict the fate of intertrochanteric fractures treated with intramedullary hip nails by assessing the postoperative fracture stability utilizing the newly developed scoring system, and to help rehabilitate these patients. METHODS: Eighty-two patients with intertrochanteric fractures that were treated with intramedullary hip nails between December, 2004 and January, 2011 were subjected to this study. The patients who could be followed for a minimum of one year postoperatively were enrolled. The immediate postoperative conditions were determined by radiograms: reduction status (3 parameters/4 points: contact accuracy of posteromedial cortex, severity of angulation, and distraction), fixation status (3 parameters/3 points: tip-apex distance, location of tip of the lag screw, entry point of the intramedullary nail), and fracture type (1 parameter/1 point: stable or unstable type by the Kyle's classification). Postoperative reduction loss and fixation failure were checked by radiograms taken at a minimum 3 months postoperative. RESULTS: Reduction loss and fixation failure were observed in 14 consecutive patients (17%). The fixation failure rate was 100% (2 patients) in score 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8 patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups. There were fixation failures only in 1 out of 13 patients with score 5, and in 1 out of 18 patients with score 6. There was no fixation failure in 17 patients with score 7 and 11 patients with score 8. CONCLUSIONS: Maintenance of the fracture reduction by the stable fixation in the patient scores over 5 could be predicted by the postoperative radiograms.

Predictors of Antiplatelet Treatment Failure in Noncardioembolic Stroke

BACKGROUND: The purpose of this study is to identify the differences of risk factors and stroke mechanism between early and late recurrence in patients with long-term antiplatelet therapy for stroke prevention. METHODS: We enrolled 114 consecutive patients with recurrent infarction who had been taking antiplatelet agents regularly since previous noncardioembolic cerebral infarction. Total 81 patients (49 men and 32 women) were met to the inclusion criteria through standardized evaluation. Subjects were classified into two groups depending on the time-to-recurrence after antiplatelet therapy: early antiplatelet failure (within 2 years, n=41, hereafter as "EAF") and later antiplatelet failure (after 2 years, n=40, hereafter as "LAF"). We investigated the differences of clinical factors between two groups using univariate and multivariate analysis. RESULTS: Family history of stroke (29.3% in EAF vs. 10% in LAF, p=0.029) was more frequent in EAF group. Low HDL-cholesterol and High total cholesterol/HDL-cholesterol ratio were associated with the LAF group (p=0.042, 0.005 respectively). Multivariate analysis showed that family history of stroke (OR=5.283, 95%CI 1.178-23.699, p=0.030) and previous infarction classified as large artery atherosclerosis (OR=8.497, 95%CI 1.444-50.015, p=0.018) were significant predictors for EAF whereas total cholesterol/HDL-cholesterol ratio (OR=2.002, 95%CI 1.183-3.389, p=0.010) was for LAF. CONCLUSIONS: This study suggests that family history of stroke and cerebral infarction due to large artery atherosclerosis are more responsible for the early recurrence while dyslipidemic condition is more related to the late recurrence during long-term antiplatelet therapy in patients with previous cerebral infarction.

Improvement of andropause symptoms by dandelion and rooibos extract complex CRS-10 in aging male

Many aging male suffer various andropause symptoms including loss of physical and mental activities. This study evaluated the putative alleviative effects of CRS-10 dandelion and rooibos extract complex (CRS-10) on the symptoms of andropause. The survival rate of TM3 Leydig cells (TM3 cells) treated with CRS-10 was measured based on typical physiological stress. After daily intake of CRS-10 for 4 weeks, the level of testosterone, physical activity and both the number and activity of sperm in older rats (18 weeks) were measured. Furthermore, thirty males were surveyed with AMS (Aging Males' Symptoms) questionnaire after intake of 400 mg of CRS-10. Overall, CRS-10 protected TM3 cells from serum restriction and oxidative stress via activation of ERK and Akt pathways. The level of testosterone and activation of spermatogenesis in rats were significantly enhanced. In addition, physical locomotion was markedly improved. Daily intake of 400 mg of CRS-10 improved the quality of life among agingmale respondents, according to a clinical survey using the AMS. The results indicate the potential of CRS-10 as a safe and efficacious natural substance for reducing or alleviating andropause symptoms.

Comparing the Efficacy of Aquatic Physiotherapy and Land-based Physiotherapy for Patients after Total Knee Replacement Surgery / 대한정형외과연구학회지

PURPOSE: The purpose of this study is to compare the rehabilitation effects between aquatic physiotherapy and land-based physiotherapy after total knee arthroplasty. PARTICIPANTS AND METHODS: The study was performed by patients with TKA caused by knee OA. The participants were divided into two groups based on random sampling method. One group received aquatic physiotherapy while the other received land-base physiotherapy. Each physiotherapy program lasted 40 minutes a day, 5 days a week, for 1 week starting a week after the operation. Pertinent indicators, knee extensor strength, knee flexor strength, walking speed, knee circumference, WOMAC index and Visual analogue scale were recorded before and after the physiotherapy programs, 1 week, 2weeks and 6 weeks after the operation. RESULTS: The aquatic physiotherapy group showed statistically significant improvements in knees circumference and VAS scores, compared to the land-based physiotherapy group between 1week and 2 weeks after the operation, whereas no statistical differences were found in Knee extensor strength, knee flexor strength, walking speed and WOMAC index. CONCLUSION: The aquatic physiotherapy group showed statistically significant improvements in knee circumference and VAS scores compared to the land-based physiotherapy group between 1 and 2 weeks after the operation. Further studies are required to confirm these findings. We were able to conclude that aquatic physiotherapy is an alternative rehabilitation program for patients with TKA.

Comparing the Efficacy of Aquatic Physiotherapy and Land-based Physiotherapy for Patients after Total Knee Replacement Surgery / 대한정형외과연구학회지

PURPOSE: The purpose of this study is to compare the rehabilitation effects between aquatic physiotherapy and land-based physiotherapy after total knee arthroplasty. PARTICIPANTS AND METHODS: The study was performed by patients with TKA caused by knee OA. The participants were divided into two groups based on random sampling method. One group received aquatic physiotherapy while the other received land-base physiotherapy. Each physiotherapy program lasted 40 minutes a day, 5 days a week, for 1 week starting a week after the operation. Pertinent indicators, knee extensor strength, knee flexor strength, walking speed, knee circumference, WOMAC index and Visual analogue scale were recorded before and after the physiotherapy programs, 1 week, 2weeks and 6 weeks after the operation. RESULTS: The aquatic physiotherapy group showed statistically significant improvements in knees circumference and VAS scores, compared to the land-based physiotherapy group between 1week and 2 weeks after the operation, whereas no statistical differences were found in Knee extensor strength, knee flexor strength, walking speed and WOMAC index. CONCLUSION: The aquatic physiotherapy group showed statistically significant improvements in knee circumference and VAS scores compared to the land-based physiotherapy group between 1 and 2 weeks after the operation. Further studies are required to confirm these findings. We were able to conclude that aquatic physiotherapy is an alternative rehabilitation program for patients with TKA.

Effect of Amniotic Membrane Extract on the Tenon's Capsule Fibroblasts

PURPOSE: To investigate the effect of amniotic membrane extract (AME) on the survival, nitric oxide production by cultured human Tenon's capsule fibroblasts (HTCF) and contraction of collagen gels. METHODS: After exposure to 5~20 g/ml AME for 5 days, the survival and nitrite production of the primarily cultured HTCF were assessed with MTT and Griess assays respectively. Acridine orange/Hoechst 33342 double staining and flow cytometric analysis using FITC-Annexin/propidium iodide double staining were done to evaluate AME-induced apoptosis of HTCF. The effect of AME on the contraction of collagen gels cultured with fibroblast was also evaluated. RESULTS: AME decreased cellular survival in a dose-dependent manner and did not affect the production of nitric oxide. AME caused apoptotic death of HTCF in a dose-dependent manner and caused necrosis at high concentration (20 g/ml). AME did not affect on the contraction of collagen gel. CONCLUSIONS: AME decreased cellular survival of HTCF by apoptosis and did not affect the contraction of collagen gels. Thus AME could modulate conjunctival wound healing by suppressing the cellular survival and activity of HTCF.

Effect of Nitric Oxide on the Proliferation of Cultured Porcine Trabecular Meshwork Cells

To investigate the effect of nitric oxide (NO) on the proliferation of trabecular meshwork (TM) cells, primarily cultured porcine TM cells were exposed to NO donor (SNAP, -nitroso-N-acetyl-D, L-penicillamine) with and without its inhibitor (L-NAME, N (w) -Nitro-L-arginine methyl ester). The proliferation of TM cells was quantified by a rapid colorimetric assay. Acridine orange/Hoechest 33342 staining and flow cytometry with annexin-PI were done. As a result, NO inhibited the proliferation of TM cells significantly in a dose-dependent manner and this inhibitory effect was abolished by L-NAME. Fluorescent microscopy and flow cytometric analysis revealed that NO induced apoptotic cell death. The current results suggest that NO inhibit the proliferation of TM cells and apoptosis may be involved in some degree.

the Effects of Mono-Poly on The Soft Denture Liners / 대한치과보철학회지

Soft denture liners or conditioners may be valuable therapeutic materials. The life of these liners is short and varies, but it can be extended by the use of a mono-poly(polymethyl methacrylate coating material). This study determined whether coating three temporary soft denture liners with mono-poly affected the resiliency of soft liners, and evaluated the ability of mono-poly to prevent water absorption and alcohol loss from the underlying soft liners. 20x12mm cylindrical specimens of Coe-Soft, Soft-Liner, Coe-Comfort soft lining materials were made and divided into two groups of mono-poly uncoated(control) and mono-poly coated specimens. Specimens were immersed in water and compressed on an instron universal testing machine and weighted at initial, 24 hours, 1 week, 2 weeks, and 4 weeks. resiliency was determined by measuring the energy absorbed by the soft liners when stressed to a specific yield point. Mono-poly coating significantly increased the resiliency of the Soft-Liner, but had no effect on the other soft liners. Among the 3 soft liners, Soft-Liner showed the hightest resiliency and modulus of elasticity. The weight loss in Soft-Liner was the least among the 3 liners, and the weight loss in Coe-Soft was decreased by monopoly coating.