Real-World Evidence for Safety and Effectiveness of Repeated Courses of Hyaluronic Acid Injections on the Time to Knee Replacement Surgery.

Osteoarthritis (OA) of the knee is a top cause of disability among the elderly. Total knee replacement (TKR) has been available as an effective and definite surgical method to treat severe OA of the knee. However, TKR is a significant procedure with potential risk for serious complications and high costs.

Differentiation of in vitro-modified human peripheral blood monocytes into hepatocyte-like and pancreatic islet-like cells.

Background & Aims: Adult stem cells provide a promising alternative for the treatment of diabetes mellitus and end-stage liver diseases. We evaluated the differentiation potential of human peripheral blood monocytes into hepatocyte-like and pancreatic islet-like cells.

Methods: Monocytes were treated with macrophage colony-stimulating factor and interleukin 3 for 6 days, followed by incubation with hepatocyte and pancreatic islet-specific differentiation media.

Human monocyte-derived neohepatocytes: a promising alternative to primary human hepatocytes for autologous cell therapy.

Background: There is growing interest in new therapeutic options for the treatment of end-stage liver diseases. In addition to mechanical devices supporting liver function, such as bioreactors, the transplantation of hepatocyte-like cells derived from (adult) stem cells offer great perspectives. We have generated hepatocyte-like (NeoHep) cells from terminally differentiated peripheral blood monocytes and, in this study, have evaluated these cells as a possible tool for autologous cell therapy.

Induction, expression and maintenance of cytochrome P450 isoforms in long-term cultures of primary human hepatocytes.

Within the past decade, tremendous progress has been made in the isolation and culture of human hepatocytes for drug metabolism and toxicology, which could potentially reduce the number of animal experiments performed. However, human hepatocyte cultures are still not widely used for preclinical drug testing, partly due to inconsistent supply and quality of human tissue. Thus, the aim of this study was to evaluate primary cultured human hepatocytes from different patients over a study period of 14 days, by assays that characterise cell quality and function.

Technique and first clinical results of robot-assisted total knee replacement.

Total knee replacement (TKR) is a common procedure for treatment of severe gonarthrosis, but the outcome may be unsatisfactory due to primary malalignment of the prosthetic components. In order to improve precision and accuracy of this surgical procedure, a commercial robotic surgical system (CASPAR) has been adapted to assist the surgeon in the preoperative planning and intraoperative execution of TKR. So far, 70 patients with idiopathic gonarthrosis were successfully treated with a robot-assisted technique in our institution.

Molecular and functional observations on the donor intestinal muscularis during human small bowel transplantation.

Background & Aims: Ischemia-reperfusion injury or intestinal manipulation evokes an inflammatory response within the intestinal muscularis that is associated with intestinal dysmotility. We hypothesize that human small intestinal transplantation induces an analogous response.

Methods: Human intestinal graft specimens were obtained during transplantation and compared with specimens removed early during elective bowel resections.

[Computer assisted surgery, 2001 development and prospects. Results of a congress at Reisensburg Castle, 23-24 November 2000]].

The progress in computer assisted surgery (CAS) is influenced by new technologies in imaging as well as by the input of the users. At present, CAS procedures are established in dorsal spine instrumentation, prosthetics and long bone surgery. Present status and future of CAS was a topic of an expert meeting at the Reisensburg castle.

[Computer-assisted surgery: developments and prospects in 2001. Results of a workshop at Schloss Reisenburg, 23-24 November 2000].

The progress in computer assisted surgery (CAS) is influenced by new technologies in imaging as well as by the input of the users. At present, CAS procedures are established in dorsal spine instrumentation, prosthetics and long bone surgery. Present status and future of CAS was a topic of an expert meeting at the Reisensburg castle.

Short-bowel syndrome - surgical treatment with long-term benefit?

Survival and management of patients with irreversible intestinal failure has been made possible by the development of total parenteral nutrition (TPN). Despite the progress of TPN severe and even fatal complications might occur. Different non-surgical and surgical therapies can be employed to either improve intestinal function or restore enteral autonomy to obviate the need for TPN.

Heterotopic intestinal transplantation aggravates the insult of chronic rejection.

Background: Intestinal grafts are placed either heterotopically (out of continuity) or orthotopically (in continuity); the latter is believed to be advantageous, as intraluminal nutrients and intestinal secretions might modulate the intestinal immune status and possibly delay rejection.

Methods: This study was designed to delineate the effects of heterotopic versus orthotopic allograft position on the morphology and function of intestinal smooth muscle in our rat model of chronic rejection. Syngeneic orthotopic grafts were evaluated to control for changes due to the transplantation process.

Chronic rejection causes early destruction of the intrinsic nervous system in rat intestinal transplants.

Chronic rejection is the major cause of late intestinal allograft dysfunction. We have previously shown that chronic rejection alters the muscularis externa of the graft. This study determined structural and functional changes to the enteric nerves during chronic rejection.

Increased expression of interferon-gamma in a rat model of chronic intestinal allograft rejection.

Chronic rejection remains a major cause of late graft dysfunction. Although much research has focused on acute rejection, little is known about the mechanisms of chronic rejection. Our group has recently reported evidence of significant intestinal smooth muscle hypertrophy and hyperplasia associated with abnormal contractile and electrical activities in a rat model of chronic intestinal rejection.

[Multicentric gastric carcinoid in autoimmune gastritis].

History And Findings: A now 54-year-old woman was 32 years ago found to have immune thrombocytopenia and 3 years ago ANA-positive and HBsAg-negative hepatitis with cirrhotic metaplasia. Numerous small asymptomatic carcinoids with marked hypergastrinaemia (1626 ng/l) were also first found 3 years ago. No gastrinoma could be found.

[Indications for total parenteral nutrition or small intestine transplantation?--Prognostic factors in short bowel syndrome].

After massive intestinal resection resulting in short bowel syndrome it is often unclear if the patient will remain on total parenteral nutrition (TPN) or regain enteral autonomy. Small bowel transplantation or bowel-lengthening procedures could potentially be a therapeutic option for patients confined to life-long parenteral nutrition. Initiated early in the course of the disease this could prevent frequent serious complications of long-term parenteral nutrition.

Postoperative selective bowel decontamination prevents gram-negative bacterial translocation in small-bowel graft recipients.

Gram-negative septic episodes are a potential risk of small-bowel transplantation; bacterial translocation through the graft is considered the mechanism. As a measure to prevent this complication, we evaluated postoperative selective bowel decontamination (SBD) in the rat model of orthotopic small-bowel transplantation [Lewis (LEW) and Brown-Norway (BN) rats as donors and recipients]. For 4 days after transplantation we gave FK 506, 2 mg/kg, which prevents rejection and results in indefinite recipient survival.

Decreased mucosal IgA levels in ileum of patients with chronic ulcerative colitis.

Patients with chronic ulcerative colitis (CUC) are known to have decreased spontaneous IgA secretion by colonic mononuclear cells. The aim of this study was to determine whether a similar alteration exists in the apparently healthy ileum of patients with CUC. The concentration of IgA was measured in the supernatant from homogenized mucosal ileal biopsies using a sandwich-type ELISA.