Symptom: spontaneous pneumothorax. Indications for drainage therapy?]

Spontaneous pneumothoraces follow lesions of pleuropulmonary tissues. Improvements of diagnostical and therapeutical management seem to change the traditional way by using thoracic drainage-systems. What value does drainage-therapy still have?     

Consciousness Indexing and Outcome Prediction with Resting-State EEG in Severe Disorders of Consciousness

We applied the following methods to resting-state EEG data from patients with disorders of consciousness (DOC) for consciousness indexing and outcome prediction: microstates, entropy (i.e. approximate, permutation), power in alpha and delta frequency bands, and connectivity (i.e. weighted symbolic mutual information, symbolic transfer entropy, complex network analysis). Patients with unresponsive wakefulness syndrome (UWS) and patients in a minimally conscious state (MCS) were classified into these two categories by fitting and testing a generalised linear model. We aimed subsequently to develop an automated system for outcome prediction in severe DOC by selecting an optimal subset of features using sequential floating forward selection (SFFS). The two outcome categories were defined as UWS or dead, and MCS or emerged from MCS. Percentage of time spent in microstate D in the alpha frequency band performed best at distinguishing MCS from UWS patients. The average clustering coefficient obtained from thresholding beta coherence performed best at predicting outcome. The optimal subset of features selected with SFFS consisted of the frequency of microstate A in the 2–20 Hz frequency band, path length obtained from thresholding alpha coherence, and average path length obtained from thresholding alpha coherence. Combining these features seemed to afford high prediction power. Python and MATLAB toolboxes for the above calculations are freely available under the GNU public license for non-commercial use (https://qeeg.wordpress.com)     

In vitro comparative study of human mesenchymal stromal cells from dermis and adipose tissue for application in skin wound healing

Novel strategies combining cell therapy, tissue engineering, and regenerative medicine have been developed to treat major skin wounds. Although mesenchymal stromal cells (MSCs) from different tissues have similar stem cell features, such as self‐renewing mesodermal differentiation potential and expression of immunophenotypic markers, they also have distinct characteristics. Therefore, we aimed to characterize the application of MSCs derived from the dermis and adipose tissue (DSCs and ASCs, respectively) in cutaneous wound healing by in vitro approaches. Human DSC and ASC were obtained and evaluated for their isolation efficiency, stemness, proliferative profile, and genetic stability over time in culture. The ability of wound closure was first assessed by direct cell scratch assay. The paracrine effects of DSC‐ and ASC‐conditioned medium in dermal fibroblasts and keratinocytes and in the induction of tubule formation were also investigated. Although the ASC isolation procedures resulted in 100 times more cells than DSC, the latter had a higher proliferation rate in culture. Both presented low frequency of nuclear alterations over time in culture and showed similar characteristics of stem cells, such as expression of immunophenotypic markers and differentiation potential. DSCs showed increased healing capacity, and their conditioned media had greater paracrine effect in closing the wound of dermal fibroblasts and keratinocytes and in inducing angiogenesis. In conclusion, the therapeutic potential of MSCs is influenced by the obtainment source. Both ASCs and DSCs are applicable for skin wound healing; however, DSCs have an improved potential and should be considered for future applications in cell therapy.     

Anterior (cranial) cruciate ligament transection in the dog: a bona fide model of osteoarthritis, not merely of cartilage injury and repair

To help elucidate the longterm outcome in the unstable knees of dogs that have undergone anterior cruciate ligament (ACL) transection, conventional radiography, gait analysis and magnetic resonance imaging (MRI) were performed serially on 3 dogs over a 45-month period after ACL transection. Gait analysis showed that vertical forces generated by the cruciate deficient leg were smaller than those produced by the contralateral leg, but the decrease in loading was not progressive and clinical findings did not suggest that the dogs developed pain in the unstable limb. Despite progressive osteophytosis and subchondral sclerosis, as seen on plain radiographs, MRI demonstrated that articular cartilage in the unstable knee was thicker than that in the contralateral knee 36 months after ACL transection. Nine months later, however, striking focal loss of articular cartilage was seen in the unstable knee of each dog. Our study, which provides the first longterm observations of the changes in the unstable knee after ACL transection, shows that they represent progressive osteoarthritis and emphasizes that a prolonged phase of cartilage hypertrophy may precede the stage of cartilage breakdown.