Anesthesia report card - a customizable tool for performance improvement.

Purpose: Measuring and providing performance feedback to physicians has gained momentum not only as a way to comply with regulatory requirements, but also as a way to improve patient care. Measurement of structural, process, and outcome metrics in a reliable, evidence-based, specialty-specific manner maximizes the probability of improving physician performance. The manner in which feedback is provided influences whether the measurement tool will be successful in changing behavior.

Bidirectional developmental potential in reprogrammed cells with acquired pluripotency.

We recently discovered an unexpected phenomenon of somatic cell reprogramming into pluripotent cells by exposure to sublethal stimuli, which we call stimulus-triggered acquisition of pluripotency (STAP). This reprogramming does not require nuclear transfer or genetic manipulation. Here we report that reprogrammed STAP cells, unlike embryonic stem (ES) cells, can contribute to both embryonic and placental tissues, as seen in a blastocyst injection assay.

Stimulus-triggered fate conversion of somatic cells into pluripotency.

Here we report a unique cellular reprogramming phenomenon, called stimulus-triggered acquisition of pluripotency (STAP), which requires neither nuclear transfer nor the introduction of transcription factors. In STAP, strong external stimuli such as a transient low-pH stressor reprogrammed mammalian somatic cells, resulting in the generation of pluripotent cells. Through real-time imaging of STAP cells derived from purified lymphocytes, as well as gene rearrangement analysis, we found that committed somatic cells give rise to STAP cells by reprogramming rather than selection.

Tissue engineering in the trachea.

This review summarizes efforts to generate an autologous tissue-engineered trachea (TET) using various biomaterial or cell sources to make tracheal cartilage to form the structural components of a functional tracheal replacement. Biomechanical assessments of the TET showed that the cartilage stiffness was excellent in the nude models; however, the sheep autologous TET did not provide sufficient support and collapsed easily. As a result, tissue engineering technology is still far from allowing the functional recovery of patients who suffer from severe tracheal disease.

Effect on ligament marker expression by direct-contact co-culture of mesenchymal stem cells and anterior cruciate ligament cells.

Ligament and tendon repair is an important topic in orthopedic tissue engineering; however, the cell source for tissue regeneration has been a controversial issue. Until now, scientists have been split between the use of primary ligament fibroblasts or marrow-derived mesenchymal stem cells (MSCs). The objective of this study was to show that a co-culture of anterior cruciate ligament (ACL) cells and MSCs has a beneficial effect on ligament regeneration that is not observed when utilizing either cell source independently.

Isoflurane decreases self-renewal capacity of rat cultured neural stem cells.

Background: In models, isoflurane produces neural and behavioral deficits in vitro and in vivo. This study tested the hypothesis that neural stem cells are adversely affected by isoflurane such that it inhibits proliferation and kills these cells.

Methods: Sprague-Dawley rat embryonic neural stem cells were plated onto 96-well plates and treated with isoflurane, 0.

The potential of stem cells in adult tissues representative of the three germ layers.

Mature adult tissues contain stem cells that express many genes normally associated with the early stage of embryonic development, when maintained in appropriate environments. Cells procured from adult tissues representative of the three germ layers (spinal cord, muscle, and lung), each exhibiting the potential to mature into cells representative of all three germ layers. Cells isolated from adult tissues of different germ layer origin were propagated as nonadherent clusters or spheres that were composed of heterogeneous populations of cells.

Uncultured marrow mononuclear cells delivered within fibrin glue hydrogels to porous scaffolds enhance bone regeneration within critical-sized rat cranial defects.

For bone tissue engineering, the benefits of incorporating mesenchymal stem cells (MSCs) into porous scaffolds are well established. There is, however, little consensus on the effects of or need for MSC handling ex vivo. Culture and expansion of MSCs adds length and cost, and likely increases risk associated with treatment.

Adult muscle 'stem' cells can be sustained in culture as free-floating myospheres.

The effectiveness of cell-based therapy to treat muscle disease has been hampered by difficulties in isolating, maintaining and propagating the stem cells that are needed for treatment. Here we report the isolation of muscle-derived stem cells from both young and old mice and their propagation over extended periods of time in culture as "free-floating" myospheres. Analysis of these sphere-forming cells showed that they express stem cell antigen-1 (Sca-1), beta1 integrin (CD29), Thy-1 (CD90), and CD34, but did not express CD45, CD31, or myogenic markers (Pax7, Myf5, and MyoD).

Engineering functional islets from cultured cells.

Objective: Although pancreatic islet transplantation can now be performed minimally invasively in patients with type 1 diabetes, the availability of functional islet donors remains the chief obstacle to widespread clinical application. Tissue engineering islet cells in vitro that function when implanted in vivo provides a solution to this problem.

Research Design And Methods: Rat pancreatic islets were enzymatically dissociated into a single-cell suspension and seeded onto a polyglycolic acid (PGA) scaffold.

Derivation of neurospheres from bone marrow stromal cells.

Nerve stem cells have a unique characteristic in that they form spherical aggregates, also termed neurospheres, in vitro. The study demonstrated the successful derivation of these neurospheres from bone marrow culture. Their plasticity as nerve stem cells was confirmed.

Lidocaine inhibits NIH-3T3 cell multiplication by increasing the expression of cyclin-dependent kinase inhibitor 1A (p21).

Background: We explored molecular mechanisms by which lidocaine inhibits growth in the murine embryonic fibroblast cell line NIH-3T3. Local anesthetics can adversely affect cell growth in vitro. Their effects on wound healing are controversial.

Bioengineered three-layered robust and elastic artery using hemodynamically-equivalent pulsatile bioreactor.

Background: There is an essential demand for tissue engineered autologous small-diameter vascular graft, which can function in arterial high pressure and flow circulation. We investigated the potential to engineer a three-layered robust and elastic artery using a novel hemodynamically-equivalent pulsatile bioreactor.

Methods And Results: Endothelial cells (ECs), smooth muscle cells (SMCs), and fibroblasts were harvested from bovine aorta.

Composite tissue formation derived solely from a blood biological matrix: a preliminary study.

We describe the formation of a new composite tissue containing all of the cellular components of adjacent normal spinal tissue. Four millimeter gaps, surgically created at the level of T8-T9 in the spinal cord of 2 adult female Lewis rats, resulted in complete paralysis of the lower extremities. A biological matrix derived from previously frozen peripheral syngeneic blood was implanted into the created spinal cord defects in 2 experimental animals.

Tissue-engineered endothelial and epithelial implants differentially and synergistically regulate airway repair.

The trilaminate vascular architecture provides biochemical regulation and mechanical integrity. Yet regulatory control can be regained after injury without recapitulating tertiary structure. Tissue-engineered (TE) endothelium controls repair even when placed in the perivascular space of injured vessels.

[Spinal cord injury and regenerative medicine].

Spinal cord injury (SCI) is a trauma problem striking mainly working age adults, therefore affecting society beyond the victims family circle. Most of the victims of SCI will never recover; therapy for this type of injury consists basically on spinal cord support and stabilization. With the discovery of stem cells (SC), SCI treatment has been given another chance.

Nanofabrication and microfabrication of functional materials for tissue engineering.

The burgeoning field of regenerative medicine promises significant progress in the treatment of cardiac ischemia, liver disease, and spinal cord injury. Key to its success will be the ability to engineer tissue safely and reliably. Tissue functionality must be recapitulated in the laboratory and then integrated into surrounding tissue upon transfer to the patient.

Tissue engineered cartilage "bioshell" protective layer for subcutaneous implants.

Objective: One current technique to reconstruct an ear for microtia involves the use of a high density polyethylene auricular implant; however, the implant can extrude if not covered in a temporoparietal fascia flap. Theoretically, an autologous tissue engineered cartilage "bioshell" protective coating around a permanent biocompatible implant might reduce potential extrusion to avoid the flap requirement. We hypothesized that if subjected to intentional exposure, a bioshell coating over an implant would provide enhanced wound healing.

Tissue engineered cartilage: utilization of autologous serum and serum-free media for chondrocyte culture.

Background: Standard culture medium contains bovine serum. If standard culture methodology is used for future human tissue-engineering, unknown risks of infection from bovine disease or immune reaction to foreign proteins theoretically might occur. In this study we wished to evaluate the potential of chondrocyte expansion using autologous and serum free media.