The promise of organ and tissue preservation to transform medicine.

The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science.

Towards the lean lab: the industry challenge.

In anatomic pathology, the current state encompassing the pre-analytic processes of tissue collection, handling, examination, preparation, processing, and storage are largely uncontrolled, inconsistently performed, and/or not standardized according to the sound scientific data. Pre-analytic defects result in nearly three-quarters of the problems in laboratory diagnostics. This is evident in quality surveys from well-respected institutions that document high miss rates in the required basics of information related to patient and tissue identity, let alone parameters documenting quality aspects related to the surgical specimen and its preservation. This talk will describe the historical approach to tissue processing and identify gaps from worldwide observations in current laboratory practices. It will also offer potential methodological and technological solutions and process improvements that laboratories may consider in serving the ultimate users of pathology information: the clinician and the patient. It illustrates the need for scientifically validated specimen guidelines and a performance based, standardized and documented "chain of custody" of the pre-analytical steps from the patient's body through fixation. For thought leaders and professional standard setters, opportunities for optimizing molecular studies exist in specimen collection, transfer, grossing, fixation, and decalcification protocols. In this evolving era of molecular profiling and personalized therapeutic decision-making, a well-reasoned and coordinated focus on pre-analytic processes that optimizes specimens for subsequent testing will result in: Improved specimen quality for molecular testing Improved accuracy of diagnostic and molecular test results Reduced Turnaroundtimes for same-day diagnosis Enhanced satisfaction of clinicians and patients.

From germ cell preservation to regenerative medicine: an exciting research career in biotechnology.

Collection, manipulation, assessment, and storage of mammalian gametes, embryos, and stem cells are providing important opportunities in agriculture, research, and medicine. Semen and embryo freezing in livestock are used in breeding schemes, especially in cattle and for international trade, with no risk of spreading disease. In human medicine, they are used in treatment of infertility. Usually, knowledge gained in one species is applicable in the others. In one exception, some ruminant embryos cultured according to protocols used in human in vitro fertilization become unusually large offspring. This is due to disturbances in expression of imprinted genes. The nuclear transfer procedure developed at the Roslin Institute is being used to make genetic modifications in livestock to either direct production of biomedical proteins, create animal models of human disease, or enhance animal health and productivity. Human pluripotent cells are being used in Edinburgh to identify drugs to treat degenerative diseases.

Corneal endothelium--past, present, and future.

OBJECTIVE: To review the history of the growth in knowledge about the corneal endothelium. METHODS: Publications concerning the corneal endothelium were reviewed. RESULTS: Highpoints in the growth of knowledge about the corneal endothelium include discovery of barrier and pump functions, specular microscopy, reduction in surgical trauma, corneal preservation, and future advances. CONCLUSIONS: The highpoints in the history of the growth in knowledge about the corneal endothelium were elucidated.

Estudio de la conservación del globo ocular con un abordaje multiterapéutico en el melanoma uveal / Ocular retention in patients with uveal melanoma managed by a multimodality approach

Objetivo: Analizar la supervivencia de los globosoculares afectados de melanoma uveal sometidos atratamiento conservador, en un centro que aplicatodas las modalidades de tratamiento.Métodos: Se han incluido en el estudio los pacientesdiagnosticados de melanoma de úvea tratadosentre septiembre de 1990 y abril de 2007 en la unidadde Oncología Ocular del Hospital Clínico Universitariode Valladolid realizándose un estudio decohortes histórico.Resultados: De los 273 pacientes incluidos en elestudio, se trataron 193 pacientes con terapias conservadoras(70,69%), mientras que se enuclearon deforma primaria 80 (29,30%). Se enuclearon de formasecundaria 14 de los sometidos a tratamientoconservador (7,2%) El análisis de supervivencia deKaplan-Meier reveló que tras la aplicación de untratamiento conservador, la probabilidad de conservacióndel globo ocular a los 5 años es del 88% y alos 10 años es del 83%.Conclusiones: El presente estudio pone de manifiestola seguridad de los tratamientos conservadores en el melanoma uveal, especialmente de la braquiterapiaepiescleral, en cuanto a control local dela enfermedad y a tasa de efectos secundarios(AU)

Objective: to analyze ocular survival in eyes withuveal melanoma treated with conservative therapies,in a centre that applies all treatment modalities.Methods: Patients diagnosed with uveal melanomaand treated between September 1990 and April2007 were included in an historical cohorts study.Results: 273 patients were included. 193 were treatedwith conservative treatments (70.69%) and 80were enucleated as primary treatment. 14 patientswere enucleated after conservative treatment(7.2%). Kaplan-Meier survival analysis showed an88% survival probability of the eye in the first 5years after conservative treatment and 83% at 10years.Conclusions: Conservative treatments for uvealmelanoma, especially brachitherapy, are safe andeffective in relation to tumor control and rate ofsecondary effects(AU)

Transplante de tecido ovariano / Ovarian tissue transplant

O congelamento de tecido ovariano para ser transplantado é um procedimento que pode reservar a função reprodutiva e endócrina desse órgão no futuro. Constitui uma alternativa para pacientes jovens com câncer e submetidas a quimioterapia, sem prole constituída, que desejam engravidar. Embora a lesão celular e as modificações moleculares possam ocorrer em decorrência do processo de congelamento e de descongelamento, há relatos de transplantes bem sucedidos tanto em animais quanto em seres humanos. A técnica de congelamento pode ter aplicações nos programas de Reprodução Humana, além de poder ser útil para evitar eventuais repercussões do hipoestrogenismo em mulheres que foram ooforectomizadas precocemente devido ao tratamento de neoplasias.

Congelamento de óvulos / Oocyte cryopreservation

A Medicina Reprodutiva tem feito notáveis avanços tecnológicos, ajudando muitos casais que até há pouco tempo não conseguiriam concretizar o sonho de ter filhos. O congelamento de óvulos é um dos mais recentes avanços nesta área e como todos os outros que vieram anteriormente, está passando por um período de questionamento, próprio das novas técnicas. O primeiro caso de gravidez utilizando-se óvulo congelado ocorreu em 1986. Durante todos esses anos passados, e até há pouco tempo, os resultados eram muito precários com uma taxa de gravidez baixa, ao redor de 1 porcento. Atualmente, com o aprimoramento da técnica de congelamento dos óvulos as taxas de gravidez já alcançam 20 porcento, e acreditamos ser uma ótima alternativa para a preservação da fertilidade feminina que pode ser indicada em casos selecionados

Scanning electron microscopy of cell surface morphology.

The surface of metazoan cells is a landscape not clearly visualized by light microscopy. Many cells elaborate protrusive structures such as microvilli, filopodia, lamellipodia, and surface ruffles that play important roles in the interaction between the cell and its environment. The high resolution of scanning electron microscopy makes it an ideal technique for studies of the cell surface; however, preservation of fine surface structure can be problematic. Here we highlight the critical factors in sample preparation to ensure optimal high-resolution imaging of the surface of mammalian cells and tissues.

Ethics of testicular stem cell medicine.

The ethical issues raised by advances in reproductive technology allowing the transplantation of testicular stem cells to enable infertile men and cancer patients, including the pre-pubertal, to have children, and to provide new contraceptive prospects for fertile men are discussed. Consideration of respect for the patient's autonomy, the need for informed consent and the health of any offspring resulting from such a procedure are included. Topics covered include: the problems raised by cases needing consent for the transplantation of testicular stem cells from pre-pubertal and adolescent patients; the legal status of stem cells; the arguements for treating such tissue as property which might serve as a means of guaranteeing respect for patients' rights in disputed cases; aspects of patents and the ethics of allowing commercial traffic of such material; questions relating to health and safety, as well as xenotransplantation technology in humans; and posthumous procurement use of germ cells from minors. Proposals are made to enhance informed and effective consent, while supporting patient determination, choice, autonomy and technological advances. The paper appeals to the emerging EU directives in relation to tissue procurement, storing and use of tissue and cells to adopt a pragmatic and meaningful position which will help enhance patient determination and autonomy in relation to the emerging technologies in reproductive medicine, whilst providing a pragmatic way forward for fertility clinics and laboratories to function.

Cell and tissue preservation and storage for transplantation. Present and future.

Historical remarks and data concerning the present status of tissue preservation and storage are presented. Even though, the need for preserved tissue allografts is still very high and tissue bank services are very popular, the opinion is expressed that the future of tissue banking may be correlated with organ and tissue engineering.

Estado actual de la ingeniería de tejidos en urología. Revisión de la literatura / Current state of the tissue engineering in urology. Revision of the literature

En la década de los 80 surge un nuevo campo de la medicina que aplica los principios del cultivo celular a polímeros sintéticos biodegradables de soporte con el fin de crear sustitutos biológicos autólogos que puedan mejorar, mantener o restaurar la función de órganos o tejidos dañados. La Ingeniería Tisular constituye una nueva disciplina en plena fase de desarrollo, especialmente en USA, con múltiples potenciales aplicaciones en las diferentes especialidades médicas. Nuestra especialidad no puede permanecer ajena al interés y esperanzador futuro suscitado por esta nueva ciencia. En el presente trabajo realizamos una amplia revisión bibliográfica en Medline con objeto de conocer los antecedentes, estado actual y las posibles aplicaciones futuras de la Ingeniería de Tejidos en Urología

In the eighties a new field of the medicine appears wich applies the principles of cellular cultivation to synthetic biodegradable polymers scaffolds with the purpose of creating autologous biological substitutes that could improve, maintain or restore the function of organs or damaged tissues. The Tissue Engineering constitutes a new discipline in full phase of development especially in USA, with multiple potential applications in several medical specialities. Our speciality can’t remain indifferent to interest and encouraging future originated by this new science. In this work we have made a wide bibliographical revision in the Medline to know the antecedents, current state and the possible future applications of Tissue Engineering in Urology

Hypothermic preservation of hepatocytes.

This paper presents a review of recent research on the hypothermic storage of hepatocytes. The first focus is on the diversity of methodologies currently employed in this area. The cell damage caused by hypothermic preservation and its possible mechanism are then investigated on both morphological and molecular biology. Later, the gene expressions on a mRNA level or enzyme level after hypothermic preservation are further discussed. Finally, the improvement of hypothermic storage by preconditioning, such as by increasing temperature, is explored.