Experiences from tissue microarray in soft tissue sarcomas

The tissue microarray (TMA) technology was introduced in 1998 as a tissue preserving, high-throughput technique that allows studies of multiple markers in large sample sets. TMA slides can be analyzed using techniques such as immunohistochemistry and in situ hybridization and represents a powerful tool for the investigation of potential diagnostic and prognostic markers identified in DNA microarray studies. We review the TMA method, its reproducibility, advantages, limitations and future perspectives with specific focus on soft tissue sarcomas.     

引导组织再生术用于牙周组织再生的影响因素

1982年Nyman S首先提出了引导组织再生（Guided Tissue Regeneration，GTR）的概念。引导组织再生的基本原理是用外科的方法放置一个物理屏障来选择性地分隔不同的牙周组织，即就是阻止牙龈结缔组织来源的成纤维细胞首先与根面接触，在膜与牙根之问形成楔状间隙，引导牙周膜细胞向冠方迁移生长，形成真正的牙周再生。随着GTR膜材料研究的不断深入，     

组织工程与组织器官缺损修复

创伤、肿瘤等原因造成的组织、器官缺损和功能障碍是危害人类健康的重要原因,而缺损组织、器官的修复和功能重建也是目前临床外科面临的主要难题。大面积的缺损通常都需要采用自体或异体组织、器官移植进行修复,自体移植存在着“以创伤修复创伤”的遗憾,而异体移植中供体来源不足、免疫排斥是主要的缺陷。组织工程学(tissue engineering)的提出、建立和发展,为解决这一难题提供了新的途径,它的基本原理是将少量种子细胞经体外扩增后与生物材料复合,构建出新的组织或器官,用于替代和修复病变、缺损的组织器官,重建生理功能。从20世纪80年代初…     

Distribution of thymic tissue in the mediastinal adipose tissue.

The distribution of thymic tissue in the anterior mediastinal, retrocarinal, and preaortic fat was examined histologically in 27 autopsy subjects. Thymic tissue was found in the anterior mediastinal fat in 12 subjects (44.4%), in the retrocarinal fat in two (7.4%), and in the preaortic fat in none. The finding of ectopic thymic tissue in these areas has not been reported previously, would appear to be surgically inaccessible via a median sternotomy, and may be responsible in part for some of the failures of thymectomy in the treatment of myasthenia gravis.     

Free tissue transfer in reconstruction following soft tissue sarcoma resection

Background: Radical surgical resection remains the single‐most important treatment in the curative multimodal therapy of soft tissue sarcomas. Refinements in surgical techniques have resulted in the development of function preserving approaches increasingly avoiding limb amputation. Patients and methods: The records of all patients (n = 34) who underwent microsurgical soft tissue coverage subsequent to primary resection of soft tissue sarcoma of the upper or lower limb from 1999 to 2009 are reviewed regarding postoperative complications, time until start of adjuvant radiation and functional outcome (Toronto Extremity Salvage Score, TESS). Results: Thirty‐four patients (range: 21–86 years) received a total of 35 free flaps. Complete tumor resection was obtained in 33 patients, one patient required re‐excision ultimately resulting in tumor‐free margin status (R0 resection). Major complications were encountered in four cases including one patient with complete flap loss requiring an additional free flap and three patients with partial flap loss requiring split‐thickness skin graft procedures. Minor complications were observed in three patients (9%). Extremity salvage could be achieved in 33 patients with adequate postoperative ambulation (TESS 84 ± 18) and adequate use of the upper extremity (TESS 80 ± 22). One patient underwent amputation. Mean time until start of adjuvant radiotherapy was 37 days (range 24–56 days). Conclusion: A synergetic center‐based interdisciplinary approach is crucial in therapeutical management of soft tissue sarcomas with the aim of R0 resection status and limb preservation. Plastic surgery contributes by offering microsurgical reconstruction using free tissue transfer, thus broadening surgical possibilities. This increases the chance of both adequate oncosurgical resection and limb preservation. © 2011 Wiley‐Liss, Inc. Microsurgery 2011.     

Complications in tissue expansion

Appropriate patient selection, proper informed consent, and a calm and thoughtful approach to problems of implant deflation, infection, and exposure should prevent true "disasters" in tissue expansion.     

Advances in tissue expansion

Tissue expansion offers a versatile new technique in the reconstruction of many areas of the body. The authors discuss laboratory studies that provide insight into the mechanism of the technique and present examples from clinical experience acquired over the past seven years, including applications in breast reconstruction and reconstruction of the scalp, head and neck, and extremities.     

Benign tumors of fibrous tissue and adipose tissue in the hand

This article presents the current understanding of soft tissue hand tumors and the best options for treating them. The majority of soft tissue hand tumors are benign. Discussion includes hand tumors of fibrous and adipose tissue origin, determining the diagnostic and therapeutic pathways for these tumors, and controversial treatment issues.     

Revitalization of biostatic tissue allografts: new perspectives in tissue transplantology

Background

Biostatic (nonvital) tissue allografts have been used for temporary replacement as well as to trigger, stimulate, and ensure space for the regeneration of a recipient's own tissues. Examples of biostatic allografts routinely used in clinic are bone, tendons, skin, and amniotic membrane. A characteristic feature of biostatic allografts is the lack of living cells. In the recipient's body, biostatic allografts function as scaffolds as well as sources of growth, differentiation, and chemotactic factors. After implantation, recipient cells migrate onto the graft, colonize it, and initiate synthesis of extracellular matrix, thereby regenerating the structure of the lost or damaged tissue. The allograft gradually degrades before being remodeled and substituted by the recipient's new tissue. However, this process is not always effective due to a lack of reaction by recipient cells. New concepts have proposed seeding recipient cells onto the allograft prior to implantation, that is, biostatic allografts that are revitalized ex vivo. The aim of this presentation was to review scientific publications to provide essential information on the revitalization of biostatic allografts, as a rising trend in tissue transplantology.

Results

Biostatic allografts show the following advantages: they are human-derived, nontoxic, biocompatible, and, in some cases, already display the desired shape. The process of introducing cells into the biostatic graft is described as “revitalization.” The cells used in the process are recipient autologous elements that are either differentiated or progenitor elements. Cells are seeded onto the graft directly after retrieval or after propagation in culture. Revitalized biostatic allografts can be used orthotopically for the regeneration of the same tissue they have been retrieved from or heterotopically wherein the graft retrieved from a different tissue is used as a carrier for cells typical for the tissue to be regenerated. Examples of orthotopic use include revitalized trachea, tissue-engineered blood vessels, urinary bladder wall, and revitalized trabecular bone cubes. Examples of heterotopic use include: amniotic membrane as a carrier of limbal stem cells to treat corneal defects, or for chondrocytes to treat articular cartilage defects. Various requirements set by law must be met by tissue banks performing cell seeding of grafts. In Europe, the requirements are described in directives: 2004/23/EC, 2006/17/EC, 2006/86/EC), and in the regulation 2007/1394/EC. Revitalization of biostatic allografts gives new, promising tools for creation of functional parts of organs; brings the methodology used in tissue banks closer to tissue engineering; places the enterprise in the mainstream of advanced biotechnology; allows the full potential of tissue allografts; and opens a new, large area for clinical and laboratory research.     

Telephone consent in tissue donation: effectiveness and efficiency in postmortem tissue generation

One reason for the loss of donors is the impossibility to contact family members for an interview. We sought to determine the effectiveness [(donors/total deaths) x 100] and efficiency [(donors/potential donors) x 100] of the telephone interview to obtain tissue for transplant purposes. METHODS: A prospective, comparative cross-sectional study was performed on the personal and telephone interviews with family members during the tissue donation application process from January 1, 2004 to December 31, 2005. RESULTS: Of the 3625 deaths hospital registered, we obtained 770 potential donors (21%). On 65% of occasions (503/770), the interview was held personally; on 29% (222/770), it had to be held over the telephone; and on 6% (45/770), family members could not be located. The refusals by family members over the telephone represented 48% (106/222), and the refusals during personal interviews were 37% (188/503). A positive family answer was obtained over the telephone on 116/431 donations (27%), and in the physical presence of the coordinator for 315/431 donors (73%). The donations obtained over the telephone were only for corneas in 83% (96/116) of cases, and for multiple tissues in 17% (20/116). The donor-generation effectiveness reached 9% in personal interviews and 12% if the telephone interviews were included. The donor generation efficiency reached 43% for personal interviews and 59% when telephone interviews were included. The use of the telephone enabled a 16% increase in tissue generation with a year-on-year increase of 4%. CONCLUSIONS: The telephone has shown itself to be a useful tool for obtaining tissues postmortem.     

Pokemon在肝细胞癌及癌旁、癌以远组织、肝硬化组织及正常肝组织中的表达

目的检测和分析Pokemon在肝细胞癌及癌旁组织、癌以远组织、肝硬化组织及正常肝组织中的表达。方法40例肝癌组织、距癌组织1cm以上的癌旁组织、距癌组织5 cm以上癌以远组织取自肝细胞癌合并乙型肝炎后肝硬化行肝移植患者切除病肝。20例肝硬化组织取自肝硬化行断流手术患者。20例正常肝组织取自健康供体标本。用real-time PCR(实时定量PCR,RT- PCR)法检测Pokemon蛋白mRNA在这些组织中的表达。结果肝癌组织、癌旁组织的Pokemon蛋白tuRNA的表达水平显著高于癌以远组织、肝硬化组织、正常肝组织(P<0.05)。肝癌组织与癌旁组织则差异无统计学意义(P>0.05)。癌以远组织、肝硬化组织及正常肝组织之间差异也无统计学意义(P>0.05)。结论Pokemon在肝细胞癌中存在异常高表达。癌旁组织可能存在着亦有Poke- mon蛋白mRNA高表达的的癌前病变。癌以远组织、肝硬化组织Pokemon蛋白mRNA表达水平与正常肝组织差异无统计学意义。     

NIR laser tissue welding of in vitro porcine cornea and sclera tissue

BACKGROUND AND OBJECTIVE: The objective of this study was to test the hypothesis that an near infrared (NIR) laser system (1,455 nm) in combination with a motorized translational stage to control the position and speed of the laser beam and a shutter to control the laser exposure to the tissue being welded could be used to successfully weld ocular tissues. STUDY DESIGN/MATERIALS AND METHODS: Seventy-five porcine corneas and 23 porcine scleral tissues were welded in vitro in this study. The welded tissues were examined using histopathology and tensile strength analysis. Eight different welding conditions were analyzed for porcine cornea and one for sclera tissues. The tensile strength of the welded groups was compared to a sutured cornea control group. RESULTS: The NIR laser welding system provides strong, full thickness welds and does not require the use of extrinsic dyes, chromophores, or solders. Mean weld strengths of 0.15-0.45 kg/cm(2) were obtained for the cornea and 1.01 kg/cm(2) for sclera welds. The native H(2)O in the ocular tissue serves as an absorber of the 1,455 nm radiation and helps to induce the welds. CONCLUSIONS: We conclude that an NIR laser system using an optimal laser radiation wavelength of 1,455 nm can effectively weld cornea and sclera tissue and that this laser tissue welding (LTW) methodology typically causes minimal disruption of tissue, and thus, avoids opacities and irregularities in the tissue which may result in decreased visual acuity. The optimization of a laser welding system that leads to a strong full thickness tissue bond without tissue destruction, an instant seal that promotes wound healing, and the absence of a continued presence of a foreign substance like a suture, is of considerable importance to the ophthalmology medical community. This need is especially apparent with respect to corneal transplantation and fixing the position of corneal flaps in Laser-Assisted In Situ Keratomileusis (LASIK), a laser procedure used to permanently change the shape of the cornea.     

Muscular tissue engineering: capillary-incorporated hybrid muscular tissues in vivo tissue culture

Requirements for a functional hybrid muscular tissue are 1) a high density of multinucleated cells, 2) a high degree of cellular orientation, and 3) the presence of a capillary network in the hybrid tissue. Rod-shaped hybrid muscular tissues composed of C2C12 cells (skeletal muscle myoblast cell line) and type I collagen, which were prepared using the centrifugal cell-packing method reported in our previous article, were implanted into nude mice. The grafts, comprised three hybrid tissues (each dimension, diameter, approximately 0.3 mm, length, approximately 1 mm, respectively), were inserted into the subcutaneous spaces on the backs of nude mice. All nude mice that survived the implantation were sacrificed at 1, 2, and 4 wk after the implantation. The grafts were easily distinguishable from the subcutaneous tissues of host mice with implantation time. The grafts increased in size with time after implantation, and capillary networks were formed in the vicinities and on the surfaces of the grafts. One week after implantation, many capillaries formed in the vicinities of the grafts. In the central portion of the graft, few capillaries and necrotic cells were observed. Mononucleated myoblasts were densely distributed and a low number of multinucleated myotubes were scattered. Two weeks after implantation, the formation of a capillary network was induced, resulting in the surfaces of the grafts being covered by capillaries. Numerous elongated multinucleated myotubes and mononucleated myoblasts were densely distributed and numerous capillaries were observed throughout the grafts. Four weeks after implantation a dense capillary network was formed in the vicinities and on the surfaces of the grafts. In the peripheral portion of the graft, multinucleated myotubes in the vicinities of the rich capillaries were observed. Thus, hybrid muscular tissues in vitro preconstructed was remodeled in vivo, which resulted in facilitating the incorporation of capillary networks into the tissues.     

Adipocyte microinfiltration in the face or tissue restructuration with fat tissue graft

The author presents his experience of the autologous fatty tissue transplantation. He calls his method microinfiltration of adipocytes (MIA). The fat of the body is harvested with the technique of syringe liposuccion without trauma and is refined and placed in an intricate layering of autologous fatty tissue with anatomic patented microcanulaes. This procedure named Lipostructure by Coleman is not a lipofilling or "liposculpture" as described by P. Fournier in 1989. By focusing on the procedure as autotransplantation fat grafting technique and fully respecting the delicate nature of the fat cell, the author has been able to document a high rate of success with 3 years follow-up.     

Study of levels of latamoxef in prostatic tissue and bladder mucosal tissue

The concentration of Latamoxef (LMOX) in the serum, prostatic tissue and bladder mucosal tissue of 20 patients with benign prostatic hypertrophy and bladder cancer was measured after intravenous infusion of 1 g or 2 g of LMOX. Serum, prostatic tissue and bladder mucosal tissue levels of LMOX responded satisfactorily to the dose of LMOX. The bladder mucosal tissue level was higher than the prostatic tissue levels. Judging from the inhibitory concentration of LMOX (MIC 80), the concentration was sufficiently effective against infections caused by gram-negative, gram-positive and anaerobic bacilli.     

皮肤牵张带治疗皮肤软组织缺损

2004年2月～2007年3月，我们应用皮肤牵张带治疗皮肤软组织缺损19例，效果满意。 1材料与方法 1．1病例资料本组19例，男14例，女5例，年龄19～54岁。开放性骨折伴皮肤缺损、骨外露6例，骨筋膜间室综合征行筋膜室切开减张术致皮肤缺损4例，体表巨痣、纹身、瘢痕切除致皮肤缺损5例，手术切口裂开2例，糖尿病足踝部溃疡2例。缺损位于四肢12例，躯干5例，腹部2例。缺损面积：3．5cm×3．0cm～16．0cm×5．0cm。