Construction of functional soft tissues from premodulated smooth muscle cells using a bioreactor system

Artificial smooth muscle tissues should be constructed with well-differentiated and aligned smooth muscle cells (SMCs) for proper functioning. In a previous study, we produced cell/scaffold hybrids composed of consistently aligned SMCs in a contractile state using cyclic mechanical strain. In this study, the preconditioned hybrids were organized as functional smooth muscle constructs, which had a high cellular density, using a bioreactor system. We determined that the alignment and contractile phenotype of the initially generated SMCs would be retained after a 7-day culture period in a bioreactor. Mechanical properties of the smooth muscle constructs were measured and compared with those of native smooth muscle tissues and acellular scaffolds. The constructs had a denser cell concentration than the preconditioned hybrids, although they were not fully filled with cells. The premodulated cell alignment and contractile phenotype were retained after culture in a bioreactor. The 7-day-cultured constructs had similar allowed stress levels to native tissues while their stiffness was much lower, suggesting that they had malleable and durable characteristics. These results suggest that functional smooth muscle tissues with mechanical stability can be produced using premodulated SMCs and a bioreactor system.     

The impact of genotype on outcome in oligodendroglioma: validation of the loss of chromosome arm 1p as an important factor in clinical decision making

OBJECT: Oligodendrogliomas are rare primary brain tumors. They comprise approximately 5 to 33% of all glial tumors but differ from astrocytomas by being associated with a more favorable prognosis, making their correct identification important. Allelic loss of chromosome arms 1p and 19q is found in a substantial subpopulation of tumors with an oligodendroglioma phenotype. Anaplastic oligodendrogliomas with allelic loss of 1p have been associated with chemosensitivity and a longer patient survival period. METHODS: Oligodendroglial neoplasms were studied using fluorescence in situ hybridization of formalin-fixed, paraffin-embedded tissue specimens; reference and target probe sets were used to map the telomeric regions of 1p and 19q. The results were correlated with the clinical characteristics of patients treated at our institution between 1993 and 2003. Data obtained in 96 patients were analyzed. This included 63 patients (65.6%) with World Health Organization (WHO) Grade II oligodendroglioma, 22 (23%) with Grade III oligodendroglioma, and 11 (11.4%) with mixed oligoastrocytoma. Analysis of 1p in patients with pure oligodendroglioma revealed a loss of 1p in 42 patients (49.4%). In 46 of these patients 19q was lost and in 70 (82.3%) there was concordance for combined loss or retention of both 1p and 19q (p < 0.0001). Patients with oligodendroglioma in whom a loss of 1p was present fared significantly better, and this outcome was unrelated to the treatment modality or WHO grade, compared with patients in whom 1p was intact (p < 0.05). CONCLUSIONS: To the authors' knowledge, this study includes the largest published series of WHO Grade II oligodendroglioma and 1p analysis. The results suggest that the association between long-term survival and 1p loss in oligodendroglioma is unrelated to treatment. The authors of further prospective studies may better determine the true value of the allelic loss of 1p and its implication for clinical decision making.     

Oxidative stress-related gene polymorphism and the risk of preeclampsia

OBJECTIVE: The purpose of this study was to determine whether genetic variability in oxidative stress-related enzymes contributes to individual preeclampsia susceptibility differences. STUDY DESIGN: Polymorphisms in the cytochrome P450 (CYP)1A1 (MspI), CYP1A1(Ile/Val), glutathione S-transferase (GST)M1, GSTT1, myeloperoxidase (MPO), and manganese superoxide dismutase (MnSOD) genes were evaluated by polymerase chain reaction (PCR) or PCR-restriction fragment length polymorphism (RFLP) in 214 healthy controls with an uncomplicated obstetric history, and in 121 preeclampsia patients. Chi2 analyses were used to statistically evaluate differences. RESULTS: No significant differences in the CYP1A1(MspI) or CYP1A1(Ile/Val) genotypes were observed between the healthy controls and the preeclampsia patients (chi2 = 1.43, P = 0.49 versus chi2 = 1.54, P = 0.46). The GSTM1 homozygous null type and GSTT1 homozygous null type were no differences in the patients and controls (chi2 = 0.01, P = 0.92 versus chi(2) = 0.31, P = 0.57), and no significant differences in the polymorphisms of the MPO and MnSOD genotypes were found between the patients and controls (chi2 = 2.00, P = 0.37 versus chi2 = 0.07, P = 0.96). CONCLUSION: Polymorphisms in the oxidative stress-related genes (CYP1A1, GSTM1, GSTT1, MPO, MnSOD) do not seem to be risk factors for preeclampsia.     

Time-limited treatment of hospitalized borderline patients: Considerations

Patients with a diagnosis in the spectrum of “borderline personality organization” represent a significant proportion of inpatient hospital admissions. An intensive, psychodynamically-oriented treatment environment may induce further behavioral disturbances and regressions in such patients.^1,2 Among iatrogenic elements in the therapeutic milieu, which promote ego dedifferentiation and regression, are overgratification of pathologic dependency needs by a permissive supportive staff or inexperienced trainee therapists enmeshed in a quagmire of transference-countertransference difficulties. Borderline patients are often unable to keep a part of their ego available for observation in a therapeutic or working alliance, show marked senses of entitlement, and, by primitive projective mechanisms, protect themselves from seeing the implications of their actions on others. On admission and during a hospitalization, they often present difficult diagnostic and management problems, precipitate endemic psychotic regressions among other patients, or provoke critical staff conflicts.The literature on the “borderline patient”, though clarifying dynamic issues, has tended to emphasize chronicity of the condition and the need for intensive long-term psychotherapy by highly experienced analytically oriented therapists.^3,4 However, limited hospitalization funds and an unavailability of the prescribed outpatient treatment are often issues which generate an atmosphere of therapeutic nihilism. This atmosphere should be metabolized by treatment designs that integrate theory with reality constraints, and allow borderline patients to return to the community in a more functional mode than when they entered the hospital.It is the purpose of this article to identify features important for time-limited hospital treatment of patients with borderline character pathology.     

Evaluation of cardiac function in the presence of frequent ventricular premature beats

Frequent ventricular ectopia in an otherwise healthy person is often benign. Nevertheless, for optimal patient management, serious underlying heart disease should be excluded. The authors illustrate the use of list-mode equilibrium blood-pool ventriculography for defining left ventricular function.     

A socio-psychiatric profile of emergency service patients.

A study of patients using the psychiatric emergency services of the Royal Ottawa Hospital was undertaken to determine their demographic and clinical characteristics, correlations between the two and comparisons with other studies. Special clinical forms of every fifth patient seen were analyzed and the data presented. These data are useful in the planning of and establishing and operating a psychiatric emergency service with an attached short-term inpatient unit, as well as assessing the feasibility and value of crisis intervention and brief psychotherapy in treating patients quickly.