Adipose-derived stromal vascular fraction improves tendon healing in rabbits

Objective:To evaluate the potential effects of uncultured adipose-derived stromal vascular fraction on tendon healing.Methods:Twenty five adult male New Zealand white rabbits weighing 2.5-3.0 kg were used.Five rabbits were used as donors of adipose tissue and the rest were divided into control and treatment groups.The injury model was completed by unilateral tenotomy through the middle one third of deep digital flexor tendon.Immediately after suture repair,either fresh stromal vascular fraction from enzymatic digestion of adipose tissue or placebo was intratendinously injected at tendon stumps in treatment and control groups,respectively.Immobilization with cast was continued for two weeks after surgery.Animals were sacrificed at eight weeks after surgery and tendons underwent histological,immunohistochemical,and mechanical evaluations.Statistical analyses of quantitative and qualitative data were assessed using one-way analysis of variance and MannWhitney U-test,respectively.Results:Histological evaluations demonstrated superior fibrillar linearity and continuity,and decreased vascularity in treatment group indicated improved organization and remodeling of neotendons.Immunohistochemistry demonstrated a significant increase in collagen I expression in treatment group.Ultimate load and energy absorption capacity were both significantly increased in cell-treated repairs compared with controls.Conclusion: The present study shows that intratendinous injection of uncultured adipose-derived stromal vascular fraction results in improved structural and mechanical properties of tendon repairs and it could be an effective modality for treating tendon injury.     

Phase I,pharmacokinetic study of temsirolimus administered orally to patients with advanced cancer

An oral formulation of temsirolimus (Torisel?), an inhibitor of the mammalian target of rapamycin, was evaluated on an intermittent schedule (once daily for 5 days every 2 weeks) in patients with advanced cancer. The maximum tolerated dose was determined to be 75 mg after dose-limiting toxicities of grade 3 elevated aminotransferases (1 patient) and grade 3 rash (1 patient) occurred with a 100-mg dose. The most common temsirolimus-related adverse events were mucositis, rash/maculopapular rash, and asthenia. Six of 12 patients who received the 75-mg dose required dose reductions due to temsirolimus-related adverse events. Two patients who received 75-mg temsirolimus and did not have dose reductions had minor tumor responses. Relative exposure from contributions of both temsirolimus and sirolimus, the principal metabolite, was 17.9% of the 75-mg dose. Thus, oral temsirolimus, 75 mg administered once daily for 5 days every 2 weeks, was further evaluated in patients with metastatic breast cancer.     

Rarity of encephalopathy associated with autoimmune thyroiditis: a case series from Mayo Clinic from 1950 to 1996.

Corticosteroid-responsive encephalopathy associated with autoimmune thyroiditis (also called Hashimoto's encephalopathy) is a rare, life-threatening, treatable, and possibly autoimmune condition. We identified nine patients (with the diagnosis made after 1979) who had relapsing encephalopathy compatible with previous reports of Hashimoto's encephalopathy and no other identifiable cause of encephalopathy at Mayo Clinic Rochester. Of these nine patients, three were clinically hypothyroid, four were subclinically hypothyroid, and two were euthyroid. Thyroid antibodies were positive in eight of eight patients in whom these measurements were made. Electroencephalographic abnormalities were identified in eight of the nine patients (89%). Magnetic resonance imaging (MRI) abnormalities considered etiologically related to encephalopathy were present in three patients (33%). An increased protein concentration was noted on cerebrospinal fluid examination in seven patients (78%). Of the six patients who received high-dose glucocorticoid therapy, 5 (83%) had improvement of neurologic symptoms. In conclusion, encephalopathy associated with autoimmune thyroiditis is rare but important to recognize because it may be responsive to high-dose glucocorticoid therapy. We believe that this condition is not caused by thyroid dysfunction or antithyroid antibodies but represents an association of an uncommon autoimmune encephalopathy with a common autoimmune thyroid disease. The term Hashimoto's encephalopathy is a misnomer and should not be used.     

Fundus laser coagulation using a video system of scanning laser ophthalmoscope

We modified a scanning laser ophthalmoscope for simultaneous photocoagulation of the retina and video recording. Using a diode laser (810 nm wavelength), we produced fundus lesions that scarred within 14 days. © 1993 Wiley-Liss, Inc.     

Meningeal Gadolinium Enhancement in Low-pressure Headaches

Three patients with headaches in erect but not recumbent positions had barely measurable cerebrospinal fluid (CSF) pressures and aseptic but abnormal CSF findings with variable pleocytosis and elevated protein content. The CSF glucose level was normal and there were no blasts or malignant cells. Gadolinium-enhanced magnetic resonance imaging (MRI) in all 3 showed diffuse meningeal enhancement. In 2, headaches and MRI abnormalities completely resolved spontaneously. The third patient, who had a prior ventriculoperitoneal shunt, improved after shunt revision.     

MICA gene and ankylosing spondylitis: linkage analysis via a transmembrane-encoded triplet repeat polymorphism

In order to address the possibility that the MICA gene located 47 kb upstream from HLA-B is involved in the pathogenesis of ankylosing spondylitis (AS), we have investigated microsatellite polymorphism in the transmembrane region of MICA in Caucasian patients with AS. The microsatellite allele consisting of 4 repetitions of GCT/AGC was present at significantly higher frequency in the patient group (Pc<0.0000001) than in the ethnically matched control group. However, the frequency of the (GCT/AGC)₄ allele was significantly low in the B27-positive patients than in the B27-positive healthy controls (Pc=0.0145). These observations suggest that B27 itself remains the primary genetic marker for AS, although the significantly dissimilar pheno-type frequency of the (GCT/AGC)₄ allele in B27-positive patients and healthy individuals may reflect the existence of other genetic factor(s) in the HLA-B27 haplotype involved in the development of AS.     

Outcomes of complex retinal detachment surgery after 1000 and 5000 centistoke silicone oil removals

In 82 eyes with complex retinal detachment requiring internal tamponade, 53 were filled with 5000-cs and 29 with 1000-cs silicone oil. Use of high-viscosity silicone oil (5000 cs) may be associated with a poorer anatomic and functional outcome compared with lower viscosity silicone oil (1000 cs).