Effect of Motor versus Sensory Nerve Autografts on Regeneration and Functional Outcomes of Rat Facial Nerve Reconstruction.

Cranial nerve injury is disabling for patients, and facial nerve injury is particularly debilitating due to combined functional impairment and disfigurement. The most widely accepted approaches for reconstructing nerve gap injuries involve using sensory nerve grafts to bridge the nerve defect. Prior work on preferential motor reinnervation suggests, however, that motor pathways may preferentially support motoneuron regeneration after nerve injury. The effect of motor versus sensory nerve grafting after facial nerve injury has not been previously investigated. Insights into outcomes of motor versus sensory grafting may improve understanding and clinical treatment of facial nerve paralysis, mitigating facial asymmetry, aberrant reinnervation, and synkinesis. This study examined motor versus sensory grafting of the facial nerve to investigate effect of pathway on regeneration across a 5-mm rodent facial nerve defect. We enrolled 18 rats in 3 cohorts (motor, sensory, and defect) and recorded outcome measures including fiber count/nerve density, muscle endplate reinnervation, compound muscle action potential, and functional whisker twitch analysis. Outcomes were similar for motor versus sensory groups, suggesting similar ability of sensory and motor grafts to support regeneration in a clinically relevant model of facial nerve injury.

PTH decreases in vitro human cartilage regeneration without affecting hypertrophic differentiation.

Regenerated cartilage formed after Autologous Chondrocyte Implantation may be of suboptimal quality due to postulated hypertrophic changes. Parathyroid hormone-related peptide, containing the parathyroid hormone sequence (PTHrP 1-34), enhances cartilage growth during development and inhibits hypertrophic differentiation of mesenchymal stromal cells (MSCs) and growth plate chondrocytes. This study aims to determine the possible anabolic and/or hypertrophic effect of PTH on human articular chondrocytes. Healthy human articular cartilage-derived chondrocytes (n = 6 donors) were cultured on type II collagen-coated transwells with/without 0.1 or 1.0 µM PTH from day 0, 9, or 21 until the end of culture (day 28). Extracellular matrix production, (pre)hypertrophy and PTH signaling were assessed by RT-qPCR and/or immunohistochemistry for collagen type I, II, X, RUNX2, MMP13, PTHR1 and IHH and by determining glycosaminoglycan production and DNA content. The Bern score assessed cartilage quality by histology. Regardless of the concentration and initiation of supplementation, PTH treatment significantly decreased DNA and glycosaminoglycan content and reduced the Bern score compared with controls. Type I collagen deposition was increased, whereas PTHR1 expression and type II collagen deposition were decreased by PTH supplementation. Expression of the (pre)hypertrophic markers MMP13, RUNX2, IHH and type X collagen were not affected by PTH. In conclusion, PTH supplementation to healthy human articular chondrocytes did not affect hypertrophic differentiation, but negatively influenced cartilage quality, the tissues' extracellular matrix and cell content. Although PTH may be an effective inhibitor of hypertrophic differentiation in MSC-based cartilage repair, care may be warranted in applying accessory PTH treatment due to its effects on articular chondrocytes.

Adipose derived mesenchymal stem cells improve the structure and function of autografted mice ovaries through reducing oxidative stress and inflammation: A stereological and biochemical analysis.

The aim was to investigate the effect of injecting adipose derived mesenchymal stem cells (ADSCs) on reducing oxidative stress, inflammation and improving the structure and function of the autografted ovaries through stereological and biochemical evaluations. Mice (4-5 weeks old) were divided into three groups: control, autograft, and autograft + ADSCs (six mice per group). 7 days after ovary autografting and ADSCs injection, serum concentrations of IL-6, TNF-α and IL-10, malondialdehyde and superoxide dismutase activity were measured. On day 28, ovary histology and CD31 expression was assessed. Serum concentrations of progesterone and estradiol were also estimated. in the autograft + ADSCs group, the total volume of the ovary and the volume of the cortex, the number of follicles, the serum concentrations of IL10, estradiol and SOD activity significantly increased compared to the autograft group(P ≤ 0.05). Serum concentrations of IL6, TNFα and MDA in the autograft + ADSCs group were significantly lower than the autograft group (P ≤ 0.05). The localization of CD31-positive cells in the theca layer of follicles improved to the control level following ADSCs transplantation. The ability of ADSCs to reduce oxidative stress and inflammation probably plays a considerable role in improving the structure and function of the autografted ovaries.

Suture Autotransplantation and Dural Stripping for Craniosynostosis: A Long-Term Growth Study in Humans.

OBJECTIVE: Craniosynostosis treatment by suture autotransplantation and dura stripping has proven to be successful in animals. When applied clinically, it may reduce operative morbidity and postoperative growth disturbances known to occur after radical remodeling. It may prevent resynostosis, which is known to occur after simple synostostectomy. It may prevent subcutaneous fluid collections known to occur after synostectomy and dura stripping. STUDY DESIGN: Four synostostic infants have been treated using this concept and followed up by computerized scans. The distance between markers on each side of the transplanted sutures (6 in total) has been monitored from 1.5 to 7 years. RESULTS: The transplanted suture areas remained intact, and the sutures remained patent and experienced growth. A fifth patient with similar results was published earlier as a case report. CONCLUSIONS: Suture transplantation and dural stripping should be further studied in future multicenter studies with larger series, comprising syndromic and nonsyndromic synostosis patients.

Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report.

After a total parathyroidectomy, well-established protocols for the cryopreservation of parathyroid tissue and for the delayed autograft of this tissue exist, especially in cases of secondary hiperparathyroidism (HPT) or familial or sporadic parathyroid hyperplasia. Although delayed autografts are effective, the published success rates vary from 10% to 83%. There are numerous factors that influence the viability, and therefore the success, of an autograft, including cryopreservation time. Certain authors believe that the tissue is only viable for 24 months, but there is no consensus on how long the parathyroid tissue can be preserved. A 63-year-old male who was diagnosed with sporadic multiple endocrine neoplasia type 1 and primary hyperparathyroidism, and was submitted to a total parathyroidectomy and an autograft in the forearm. The implant failed, and the patient developed severe hypoparathyroidism in the months following the surgery. Thirty-six months after the total parathyroidectomy, the cryopreserved autograft was successfully transplanted, and hypoparathyroidism was reversed (most recent systemic parathyroid hormone, PTH, of 36 pg/mL, and total calcium of 9.1 mg/dL; no oral calcium supplementation). The case presented here indicates that cryopreserved parathyroid tissue may remain viable after 24 months in storage, and may retain the capacity to reverse permanent postsurgical hypoparathyroidism. These data provide reasonable evidence that the time limit for cryopreservation remains undetermined and that additional research would be valuable.

Keratinization induced by air exposure in the reconstructed human epidermal model: an in vitro model of a cultured epithelial autograft.

A reconstructed human epidermis, an in vitro model of a cultured epithelial autograft, was used to examine the formation of a stratum corneum induced by exposure to air. A prolonged wet condition and excess application of petrolatum on the dressing reduced efficient production of the stratum corneum.

Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report / Implante bem-sucedido de paratireoide criopreservada por 3 anos: relato de caso

After a total parathyroidectomy, well-established protocols for the cryopreservation of parathyroid tissue and for the delayed autograft of this tissue exist, especially in cases of secondary hiperparathyroidism (HPT) or familial or sporadic parathyroid hyperplasia. Although delayed autografts are effective, the published success rates vary from 10% to 83%. There are numerous factors that influence the viability, and therefore the success, of an autograft, including cryopreservation time. Certain authors believe that the tissue is only viable for 24 months, but there is no consensus on how long the parathyroid tissue can be preserved. A 63-year-old male who was diagnosed with sporadic multiple endocrine neoplasia type 1 and primary hyperparathyroidism, and was submitted to a total parathyroidectomy and an autograft in the forearm. The implant failed, and the patient developed severe hypoparathyroidism in the months following the surgery. Thirty-six months after the total parathyroidectomy, the cryopreserved autograft was successfully transplanted, and hypoparathyroidism was reversed (most recent systemic parathyroid hormone, PTH, of 36 pg/mL, and total calcium of 9.1 mg/dL; no oral calcium supplementation). The case presented here indicates that cryopreserved parathyroid tissue may remain viable after 24 months in storage, and may retain the capacity to reverse permanent postsurgical hypoparathyroidism. These data provide reasonable evidence that the time limit for cryopreservation remains undetermined and that additional research would be valuable. Arq Bras Endocrinol Metab. 2014;58(3):313-6.

O implante de tecido paratireoideano criopreservado após paratireoidectomia total é um procedimento bem estabelecido e, embora tenha sua eficácia comprovada, as taxas de sucesso variam de 10% a 83% na literatura. O tempo de criopreservação é um dos diversos fatores relacionados ao sucesso do implante. Alguns autores defendem que o tecido permanece viável até 24 meses de criopreservação, no entanto, não há consenso. Homem de 63 anos diagnosticado com neoplasia endócrina múltipla tipo I e hiperparatireoidismo primário foi submetido a paratireoidectomia total e autoimplante em membro superior. O implante falhou e o paciente desenvolveu hipoparatireoidismo. Após 36 meses da paratireoidectomia total, foi realizado o implante de paratireoide criopreservada, com sucesso. O hipoparatireoidismo foi revertido e o paciente permanece sem suplementação de cálcio e PTH sistêmico de 36 pg/mL e cálcio total de 9,1 mg/dL. O caso apresentado mostra que o tecido paratireoideano criopreservado pode permanecer viável após 24 meses e há possibilidade de reverter o hipoparatireoidismo pós-cirúrgico. Isso traz evidência de que o tempo limite de criopreservação permanece incerto e que novas pesquisas seriam de grande valia. Arq Bras Endocrinol Metab. 2014;58(3):313-6.

Topical negative pressure improves autograft take by altering nutrient diffusion: A hypothesis.

The one-step surgical procedure for dermal substitutes combined with topical negative pressure (TNP) has proven effective for treating deep skin defects with improved graft take. The primary mechanism by which TNP improves autograft take is unknown. Some studies suggest that TNP promotes the rapid angiogenesis of dermal substitutes, improving graft take. However, at the early stage of one-step transplantation, the vascular system has not formed and imbibition is the main mode of nutrient supply. TNP can shorten the diffusion distance from the wound bed to the graft, leading to the timely renewal of the wound exudate via suction, removing any surplus exudate, and reducing tissue edema. In addition, TNP can regulate the local blood flow and inhibit bacterial colonization. Therefore, we hypothesized that TNP establishes a rapid balance between the nutrient supply to the wound bed and nutritional requirement of the graft via these pathways in the relatively closed, moist environment, improving autograft take. However, this balance could be affected by any negative pressure, intermittent or continuous. It is necessary to test this hypothesis in laboratory and clinical studies of the mode of nutrient supply in the imbibition phase and the change in exudate content.