Chondroid lipoma: multimodality imaging in a 9-year-old female.

Chondroid lipomas are rare, benign lipomatous tumors that occur most frequently in adults during the fourth decade of life. While a female predominance was observed in the initial series of 20 cases described in 1993, the subsequent 49 reported cases do not support a strong gender predilection. We report a case of a chondroid lipoma presenting in a 9-year-old female as a painless, enlarging, left gluteal mass.

Early versus late surgical management of complicated appendicitis in children: A statewide database analysis with one-year follow-up.

Background: Complicated appendicitis is common in children, yet the timing of surgical management remains controversial. Some support initial antibiotics with delayed operation whereas others support immediate operation. While a few randomized trials have evaluated this question, they have been small, single-center trials with limited follow-up.

Use of white blood cell count and negative appendectomy rate.

Background: Despite increased utilization of laboratory, radiologic imaging, and scoring systems, negative appendectomy (NA) rates in children remain above 3% nationwide. We reviewed the clinical data of patients undergoing appendectomy to further reduce our NA rate.

Methods: A retrospective review was conducted of all appendectomies performed for suspected appendicitis at a tertiary children's hospital during a 42-month period.

Individualized image display improves performance in laparoscopic surgery.

Background: Laparoscopic surgery has made great advances over the years, but it is still dependent on a single viewpoint. This single-lens system impedes multitasking and may provide suboptimal views of the operative field. We have previously developed a prototype of interactive laparoscopic image display to enable individualized manipulation of the displayed image by each member of the operating team.

Preclinical regulatory validation of an engineered diaphragmatic tendon made with amniotic mesenchymal stem cells.

Purpose: Under a Food and Drug Administration directive, we examined definite long-term safety and efficacy aspects of an engineered diaphragmatic tendon graft as a regulatory prerequisite for clinical trials.

Methods: Newborn lambs (N = 27) underwent partial diaphragmatic replacement with a Teflon patch, a composite acellular bioprosthesis, or the same bioprosthesis seeded with autologous amniotic mesenchymal stem cells processed under Good Manufacturing Practice guidelines. Multiple safety and efficacy analyses were performed at different time points up to 14 months of age (ovine adulthood).

Amniotic mesenchymal stem cells enhance normal fetal wound healing.

Fetal wound healing involves minimal inflammation and limited scarring. Its mechanisms, which remain to be fully elucidated, hold valuable clues for wound healing modulation and the development of regenerative strategies. We sought to determine whether fetal wound healing includes a hitherto unrecognized cellular component.

Structural and biomechanical characteristics of the diaphragmatic tendon in infancy and childhood: an initial analysis.

Background: Engineered tendon grafts have been shown, experimentally, to be promising alternatives for partial diaphragmatic replacement. This study was aimed at determining the cellularity, extracellular matrix composition, and biomechanical characteristics of the diaphragmatic tendon in infants and children to be used as a reference for proper diaphragmatic graft engineering.

Methods: The left diaphragmatic tendon was procured at autopsy from 13 patients divided into 2 groups.

Chest wall repair with engineered fetal bone grafts: an efficacy analysis in an autologous leporine model.

Purpose: We sought to compare the efficacy of engineered fetal bone grafts with acellular constructs in an autologous model of chest wall repair.

Methods: Rabbits (n = 10) with a full-thickness sternal defect were equally divided in 2 groups based on how the defect was repaired, namely, either with an autologous bone construct engineered with amniotic mesenchymal stem cells on a nanofibrous scaffold or a size-matched identical scaffold with no cells. Animals were killed at comparable time-points 18 to 20 weeks postimplantation for multiple analyses.

Optical properties of human amniotic fluid: implications for videofetoscopic surgery.

Objective: Videofetoscopy typically demands the substitution of oft-turbid amniotic fluid with clear crystalloid. This maneuver can be cumbersome and may lead to complications. We sought to determine the optical properties of the amniotic fluid, as a pre-requisite for optimizing video image processing during videofetoscopy and eventually avoid amniotic fluid replacement.

Sternal repair with bone grafts engineered from amniotic mesenchymal stem cells.

Purpose: We aimed at determining whether osseous grafts engineered from amniotic mesenchymal stem cells (aMSCs) could be used in postnatal sternal repair.

Methods: Leporine aMSCs were isolated, identified, transfected with green fluorescent protein (GFP), expanded, and seeded onto biodegradable electrospun nanofibrous scaffolds (n = 6). Constructs were dynamically maintained in an osteogenic medium and equally divided into 2 groups with respect to time in vitro as follows: 14.

Differential risk for neonatal surgical airway intervention in prenatally diagnosed neck masses.

Purpose: We aimed to identify risk factors for neonatal surgical airway intervention among fetuses with prenatally diagnosed cervical masses.

Methods: An 8-year retrospective review identified 23 consecutive patients with a prenatal diagnosis of a neck mass, managed at a single tertiary center. Variables analyzed included anticipated diagnosis, extent of the mass, need for any surgical airway intervention in the neonatal period, final histopathology data, and survival.

Isolation of mesenchymal stem cells from amniotic fluid and placenta.

Diverse progenitor cell populations, including mesenchymal, hematopoietic, trophoblastic, and possibly more primitive stem cells can be isolated from the amniotic fluid and the placenta. At least some of the amniotic and placental cells share a common origin, namely the inner cell mass of the morula. Indeed, most types of progenitor cells that can be isolated from these two sources share many characteristics.

Preclinical regulatory validation of a 3-stage amniotic mesenchymal stem cell manufacturing protocol.

Purpose: Because of the 4 to 6-month interval between a diagnostic amniocentesis and birth, clinical application of amniotic mesenchymal stem cell (AMSC)-based therapies demands a 3-stage cell manufacturing process, including isolation/primary expansion, cryopreservation, and thawing/secondary expansion. We sought to determine the feasibility and cell yield of such a staged cell manufacturing process, within regulatory guidelines.

Methods: Human AMSCs isolated from diagnostic amniocentesis samples (n = 11) were processed under Food and Drug Administration-accredited good manufacturing practice.

A comparative analysis of cartilage engineered from different perinatal mesenchymal progenitor cells.

We sought to compare engineered cartilaginous constructs derived from different perinatal mesenchymal progenitor cell (MPC) sources. Ovine MPCs isolated from amniotic fluid (AF, n = 8), neonatal bone marrow (BM, n = 6), and preterm umbilical cord blood (CB, n = 12) were expanded and comparably seeded onto synthetic scaffolds. Constructs were maintained in chondrogenic media containing transforming growth factor-beta.