Efficacy and safety of stem cell therapies for patients with stroke: a systematic review and single arm meta-analysis.

BACKGROUND AND OBJECTIVES: Stem cell-based therapy is a potential new approach in the treatment of stroke. However, the efficacy and safety of these treatments are not yet fully understood. Therefore, we performed a meta-analysis of available single-arm studies using stem cell-based therapy in patients with stroke. METHODS: We searched MEDLINE, EMBASE, and the Cochrane database for studies of stem cell therapy in patients with stroke from its inception through July 2014. The articles included in the search were restricted to the English language, studies with at least 5 patients, and those using cell-based therapies for treating stroke. RESULTS: Fourteen studies included in the meta-analysis. The pooled mean difference in National Institutes of Health Stroke Scale (NIHSS) scores from baseline to follow-up points was 5.7 points (95%CI: -8.2 to -3.2, I(2) =91.5%) decreased. Also the pooled mean difference in modified Bathel index (BI) score was increased by 31.5 points (95%CI: 35.6∼14.9, I(2) =52.7%) and the pooled incidence rate to achieve on modified Rankin score (mRS)≤2 was 40% (95% CI: 30%∼51%, I(2) =35.4%) at follow-up points. The pooled incidence rates of death, seizure, and infection were 13% (95%CI, 8∼23%), 15% (95%CI, 8∼25%), and 15% (95%CI, 8∼23%), respectively. CONCLUSIONS: The published data suggest that stem cell-based therapy for patients with stroke can be judged as effective based on single arm clinical studies. However, clinical benefits of stem cell therapy for patients with stroke need further investigation and reevaluation to test the clinical efficacy.

A comparative study of bone formation following grafting with different ratios of particle dentin and tricalcium phosphate combinations.

This study aimed to evaluate the bone regeneration relative to tooth powder and tricalcium phosphate (TCP) mixing ratios using the rabbit cranium defect model. The tooth powder was mixed with TCP in 1:1, 3:1, and 1:3 ratios, and the different ratios were implanted in the rabbit cranium defect for 4 and 8 weeks. Powders crystal structure evaluated using scanning electron microscopy (SEM), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), and new bone formation (NBF) was analyzed using micro-computed tomography (CT) and histologic examination. NBF in the control group was restricted to the defect margins. More NBF was observed around the defect margins in the experimental groups compared with the control group. Specifically, active NBF was identified around the implant materials of the centrifugal part of the defect and defect margins in the 3:1 tooth powder: TCP group. Our results suggested that tooth powder and TCP may be useful in bone regeneration.

Effect of platelet-rich plasma and platelet-rich fibrin on peri-implant bone defects in dogs.

The purpose of this study was to evaluate the effect of tooth ash and platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) grafts into bone defects around implants on bone formation. Six adult dogs were used as experimental subjects. Graft materials were used to create a particulate material. Forty-eight tapered-type implants, 3.7 mm in diameter, 10 mm in length, and with surface treated with hydroxyapatite (HA) coating, were used as implant fixtures. Using a trephine bur, four bone defects were formed and implants were placed in the femurs of the adult dogs. Bone grafts were not performed in the control group. Tooth ash was grafted into the defects in group 1. In group 2, a mixture of tooth ash and PRP (1:1 ratio by volume) was grafted into the defects. In group 3, a mixture of tooth ash and PRF (ratio of 1:1) was grafted in the defect area. Animals were sacrificed after 4 or 8 weeks. Based on histopathological examination, the amount and rate of new bone formation were evaluated. Histomorphometric examination revealed that the rate of new bone formation in group 3 of the 4-week group was significantly higher than that in the control group. In addition, in the 8-week group, a significant increase in new bone formation was confirmed in group 3. In this study, a bone graft method using a mixture of tooth ash and PRF was found to increase new bone formation compared to the method using PRP. In addition, it was confirmed that this effect was more prominent in the initial stage of the bone graft.

Association between work conditions and smoking in South Korea.

BACKGROUND: A variety of sociodemographic factors, such as gender, age, household income, and educational level, influence individuals' likelihood of smoking. Work-related factors may also be linked to smoking behavior. We sought to investigate the relationship between smoking and work environment in South Korea. METHODS: We analyzed data from the Fifth Korean National Health and Nutrition Examination Survey to determine whether there was an association between smoking and occupation type (e.g., manual, nonmanual, or service work), night-shift work, and hours worked/week (e.g., <40, 40-48, 49-60, or >60 hours) for 4,685 workers. Regression models were adjusted for sociodemographic variables such as age, recent alcohol consumption, hours slept, educational level, and household income. RESULTS: The prevalence of smoking was 50.1% in men and 7.2% in women. For women, manual workers had 2.34 times [95% confidence interval (CI): 1.02-5.36] greater odds of smoking compared with nonmanual workers, whereas service workers had 2.37 times greater odds (95% CI: 1.28-4.40). Furthermore, women who worked 49-60 hours had 2.21 times greater odds of smoking (95% CI: 1.10-3.75) as compared with women who worked 40-48 hours. CONCLUSION: Women who work long hours or who are employed in service or manual positions are more likely to smoke. These results indicate a need in South Korea to target these specific groups when creating nonsmoking policies.