The emerging use of bone marrow-derived mesenchymal stem cells in the treatment of human chronic wounds.

Introduction: Close to 5 million people in the USA are affected by chronic wounds, and billions of dollars are spent annually for their treatment. Despite advances in chronic wound management over the past decades, many patients afflicted with chronic wounds fail to heal or their ulcers recur. There is emerging evidence that the use of bone marrow-derived mesenchymal stem cells (BM-MSCs) can offset this situation of impaired healing.

Patient out-of-pocket expenses in major orthopedic procedures: total hip arthroplasty as a case study.

Total hip arthroplasty (THA) is a successful procedure for improving quality of life. There are few publications regarding out-of-pocket expenses incurred by individuals undergoing uncomplicated THA. Detailed billing and record reviews and patient phone surveys were conducted on 34 Medicare patients identifying charges and reimbursements recorded by the health care system and all out-of-pocket expenses incurred by patients undergoing uncomplicated THA (diagnostic related group [DRG] 209/current procedural terminology [CPT] 27130).

Young, adult, and old rats have similar changes in mRNA expression of many skeletal genes after fracture despite delayed healing with age.

Genes active in fracture healing are not well understood. Because age slows skeletal repair, the change in gene expression between animals of differing ages may illuminate novel pathways important to this healing response. To explore this, 6-, 26-, and 52-week-old female Sprague-Dawley rats were subjected to mid-diaphyseal femoral fracture with intramedullary fixation.

Demographic factors that influence human disc cell proliferation in vitro.

Background Context: Although previous work has shown that greater age, greater disc degeneration, female gender, and surgical derivation of disc tissue had deleterious effects on cell proliferative potential, relatively little is known about the association between disc cell proliferation in vitro and clinical donor characteristics.

Purpose: To identify the relationships between donor characteristic and the in vitro proliferative potential of human disc cells from the annulus.

Study Design/setting: Studies were approved by the human subjects Institutional Review Board.

Gene expression during fracture healing in rats comparing intramedullary fixation to plate fixation by DNA microarray.

Objective: This study was designed to compare mRNA gene expression in healing diaphyseal femoral fractures between those injuries treated with intramedullary nails and those treated with internal plate fixation.

Design: RNA gene expression was measured at 1 day, 3 days, and 1, 2, 4, and 6 weeks after surgery in the fracture callus of rats randomized to femoral shaft fracture with intramedullary nail fixation, rigid plate fixation, or sham fracture.

Setting: AAALAC-accredited vivarium of an independent academic medical center.

Successful replacement of allergen-specific immunotherapy by allergen-mixture therapy.

Background: Some clinicians utilize allergen-specific immunotherapy (specific therapy), employing only the extracts of allergens that produce positive skin tests. Others use allergen-mixture immunotherapy (mixture therapy), employing premixed extracts containing both skin reactive and non-reactive (irrelevant) allergens.

Objective: The purpose of this study was to compare the efficacy of these two approaches and to identify sensitization to irrelevant allergens included in mixture therapy.

Prevalence of avocado allergy among atopic patients.

A 41-year-old woman with known food allergy to avocado was treated for anaphylaxis after eating a meal containing avocado. This prompted a study to determine the prevalence of avocado induced symptoms and skin reactivity in a group of atopic patients. One hundred consecutive atopic patients with allergic rhinitis undergoing skin testing before initiation of immunotherapy were also prick skin tested to avocado.

Antibodies in patients with inflammatory bowel disease and the apparent influence of medications.

Patients with inflammatory bowel disease (IBD) are known to have increased antibodies to several food and bacterial antigens. To assess selected isotype contributions in greater detail, we examined the concentrations of IgA, IgG, IgE, and IgG4 antibodies to five selected antigens, two of bacterial and three of food origin. Thirty patients with IBD and thirty matched healthy controls were studied.

Hypersensitivity to therapeutic murine monoclonal antibodies.

Objective: To determine the predictive value of pre-treatment skin tests and in vitro IgE/IgG4 anti-murine monoclonal antibodies in patients treated with murine monoclonal antibodies.

Design: Patients treated at two cancer institutions were evaluated by skin testing and solid phase immunoassays to detect IgE and IgG4 specific anti-murine monoclonal antibodies. Skin testing by scratch and intradermal skin testing was done on patients before treatment with murine monoclonal antibodies.

Food-induced anaphylaxis.

The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in allergy and immunology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item.

IgG deficiency in adults with recurrent respiratory infections.

Total IgA, IgM, IgG, and IgG subclasses were measured in 136 consecutive adults with recurrent respiratory infections. Sinus and chest radiographs were also obtained. IgG antibodies to H.

IgG subclass deficiency associated with corticosteroids in obstructive lung disease.

IgG subclass levels were measured in three groups of adult patients with obstructive airways disease to discern the relationships among depressed IgG subclass levels, chronic corticosteroid use, and recurrent sinopulmonary infections. Group 1 consisted of patients with corticosteroid-dependent bronchial asthma, group 2 patients had corticosteroid-dependent chronic bronchitis/emphysema, and group 3 was comprised of asthma patients not requiring oral corticosteroids but associated with recurrent sinopulmonary infections. One or more IgG subclass deficiencies were noted in 66.

Immunoglobulin G subclasses in human colostrum, milk and saliva.

Previous studies have suggested local production of IgG4 in human colostrum and mature milk. We extended these observations to examine all IgG subclasses in mammary secretions and in saliva, a mucosal secretion. In human colostrum and milk, the geometric mean percentages of IgG contributed by IgG2 were 44% and 43%, respectively, and by IgG4, 6% in both.

Immunoglobulin E and G4 antibodies in cysticercosis.

The importance of immunoglobulin G (IgG) subclass responses in different infections has been elucidated for a number of organisms, but few parasitic organisms have been examined in this regard. In the current study, quantitative radioimmunoassays were used to examine the IgE and IgG4 subclass responses to larval Taenia solium. Patients were divided into clinically infected (CI) and probably uninfected (PU) groups.

A human IgG 3 is opsonic in vitro against type III group B streptococci.

Preparations of IgG 3 isolated by absorption of IgG 1, IgG 2, and IgG 4 from a human iv immunoglobulin with protein A-Sepharose were evaluated for their opsonic activities against type III group B streptococcal (GBS) strains. The resulting preparations were free of IgG 1 and IgG 2 and contained only trace amounts of IgG 4 (less than 2% of total IgG). These IgG 3 preparations exhibited excellent opsonic activities against type III GBS strains, similar to those of the unfractionated iv immunoglobulin (based on total IgG concentrations in the opsonic assays).

Abnormal maxillary sinus radiographs in children: do they represent bacterial infection?

Thirty-three children with chronic tonsillitis and/or adenoid enlargement and without previous diagnosis of sinusitis were studied regarding the bacterial flora of their maxillary sinuses. Puncture of maxillary sinus was performed at surgery (adenoidectomy and/or tonsillectomy) and aspirates were cultured. Streptococcus pneumoniae was isolated from 8 of 12 (66.

Quantitative immunoglobulins and IgG subclasses in patients with corticosteroid-dependent reversible airway obstruction.

Six of 12 patients with corticosteroid-dependent bronchial asthma and recurrent sinopulmonary infections were found to have significant abnormalities in quantitative immunoglobulins and/or IgG subclasses. Five patients had a combined quantitative immunoglobulin and IgG subclass deficiency and one patient had an isolated IgG deficiency. Combined IgG subclass deficiencies were observed in two patients, both with deficiencies of IgG2 and IgG3.

Familial IgE deficiency associated with sinopulmonary disease.

Three generations of relatives of 58-year-old nonidentical twins with chronic bronchitis and fibrotic lung disease were evaluated. Sera of 23 family members, 14 with a history of excessive sinopulmonary infections, were examined for deficiencies of immunoglobulin classes, IgG subclasses, and specific antibody to tetanus toxoid and Hemophilus influenzae type b. Of 14 symptomatic family members, 12 had serum IgE concentrations less than 5 IU/ml.

IgG4 in human colostrum and human milk: continued local production or selective transport from serum.

Colostrum, mature milk, and paired plasma samples were obtained from 10 postpartum women who had not been previously studied. The geometric mean concentration of IgG4 in colostrum (3.3 micrograms/ml) was similar to the mean concentration in mature milk (3.

IgG4 immunodeficiency.

IgG4 deficiency can be an isolated phenomenon, or it can occur in combination with deficiencies of IgG2, IgA, and/or IgG1 (in order of decreasing frequency). Isolated deficiency of IgG4 is associated with symptoms and signs which are similar to those associated with other IgG subclass deficiencies. The most common manifestation is an unusual frequency of pyogenic infections, most often of the respiratory tract.