Human Mesenchymal Stem Cells Enhance Nerve Regeneration in Nerve Gap Repair with Human Epineural Conduit of a Large - Unmatched Diameter
Katarzyna Kozłowska,
Klaudia Różczka,
Marcin Michał Strojny,
Sonia Brodowska,
Amber Lopez,
Maria Siemionow
Issue:
Volume 10, Issue 6, December 2022
Pages:
193-205
Received:
12 September 2022
Accepted:
15 November 2022
Published:
29 November 2022
DOI:
10.11648/j.js.20221006.11
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Abstract: Different therapies have been reported to support nerve gap regeneration following traumatic nerve injuries. Clinically, lack of the donor nerve or nerve conduit match is challenging and may have a negative impact on nerve regeneration and functional outcomes. This study introduces an innovative approach for management of nerve gaps in the cases of nerve conduit mismatch by applying the unmatched human epineural conduit (hEC) of large diameter supported with human mesenchymal stem cells (hMSC). Following resection of 20mm of a sciatic nerve in the athymic nude rat model (Crl: NIH-Foxn1rnu): 24 animals were assessed in four experimental groups of n=6 rats each: Group 1- no repair control, Group 2- nerve autograft repair, Group 3- hEC filled with 1mL of saline, Group 4- hEC filled with 3 × 106 of hMSC. We performed functional tests of: toe-spread and pinprick, Gastrocnemius Muscle Index (GMI) and muscle fiber area ratio, immunofluorescence staining for vWF, VEGF, S-100, GFAP, Laminin B, NGF for assessment of nerve regeneration, assessment of human origin of the MSC by HLA-1, HLA-DR and human MSC labeling with PKH26 dye, and Toluidine blue staining of nerve cross sections for histomorphometric analysis of the myelin thickness, axonal density, fiber diameter, and percentage of the myelinated nerve fibers. The hEC supported with human MSC group was second to regain best recovery, following the autograft group, regarding functional assessments of toe-spread and pinprick (p = 0.0032 and p = 0.0079 respectively). Gastrocnemius Muscle Index analysis revealed comparable results between the autograft and hEC supported with hMSC and significantly better results when compared with no gap repair (p < 0.0001 and p = 0.0092 respectively). Significantly increased number of myelinated fibers was observed in the large diameter hEC enhanced with hMSC when compared with the control group of large diameters hEC filled with saline. The myelin sheath thickness, fiber diameters, axonal density and percentage of myelinated fibers analysis results were comparable between the large diameter hEC enhanced with hMSC and the control group of large diameters hEC filled with saline. We confirmed the supportive role of hMSC in the improvement of nerve regeneration after nerve gap repair with hEC of large-unmatched diameter. At 12-weeks we demonstrated comparable functional recovery, histomorphometric parameters and growth factors expression between the autograft repair and the hEC enhanced with hMSC, whereas significantly worse recovery was noted in the control group of hEC filled with saline, further confirming regenerative potential of MSC.
Abstract: Different therapies have been reported to support nerve gap regeneration following traumatic nerve injuries. Clinically, lack of the donor nerve or nerve conduit match is challenging and may have a negative impact on nerve regeneration and functional outcomes. This study introduces an innovative approach for management of nerve gaps in the cases of...
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Effect of Wearing Brace After PVP on Recovery of Osteoporotic Vertebral Compression Fracture
Mengmeng Xu,
Dingjie Liang,
Jianing Zhang,
Tao He,
Yixuan Zhou,
Weiqing Qian
Issue:
Volume 10, Issue 6, December 2022
Pages:
206-209
Received:
15 November 2022
Accepted:
28 November 2022
Published:
8 December 2022
DOI:
10.11648/j.js.20221006.12
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Abstract: Objective: The objective of this study was to explore the effect of wearing brace after percutaneous vertebro plasty (PVP) on recovery of osteoporotic vertebral compression fracture (OVCF). Methods: A total of 191 patients with OVCF and receiving PVP surgery in our hospital from 2020.07 to 20221.08 were reviewed. Among them, 102 patients wearing brace after surgery were the brace group, and 89 patients without brace were the control group. The Oswestry disability index (ODI), visual analogue score (VAS) and the refractured rate of adjacent vertebra after PVP were compared between the two groups before operation and 1 and 6 months after operation. Results: There was no significant difference in preoperative VAS and ODI between the brace group and the control group. The VAS and ODI at 1 and 6 months after operation in the brace group were significantly lower than those in the control group (P<0.05). There were 15 cases (14.71%) of adjacently vertebral refracture including 12 cases (11.76%) of single-segment vertebral fracture and 3 cases (2.94%) of multiply vertebral fracture in the brace group. In the control group, there were 24 cases (26.97%) of adjacently vertebral refracture including 17 cases (19.10%) of single-segment vertebral fracture and 7 cases (7.87%) of multiply vertebral fracture. There was significant difference in the refractured rate of adjacent vertebra after PVP between the two groups (c2=4.397, P=0.036). Conclusion: Wearing brace after PVP for osteoporotic vertebral compression fracture can relieve pain and restore function of patients, and the refractured rate of adjacent vertebra after PVP is significantly lower than that of patients without brace. Therefore, wearing brace after PVP is not only important, but also necessary.
Abstract: Objective: The objective of this study was to explore the effect of wearing brace after percutaneous vertebro plasty (PVP) on recovery of osteoporotic vertebral compression fracture (OVCF). Methods: A total of 191 patients with OVCF and receiving PVP surgery in our hospital from 2020.07 to 20221.08 were reviewed. Among them, 102 patients wearing br...
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