Pediatric patients with Osteogenesis Imperfecta (OI), a heritable connective tissue disorder, frequently suffer from long bone deformations. Surgical correction often results in bone non-unions, ...necessitating revision surgery with autogenous bone grafting using bone-marrow-derived stem cells (BM-SC) to regenerate bone. BM-SC harvest is generally invasive and limited in supply; thus, adipose tissue's stromal vascular fraction (SVF) has been introduced as an alternative stem cell reservoir. To elucidate if OI patients' surgical site dissected adipose tissue could be used as autologous bone graft in future, we investigated whether the underlying genetic condition alters SVF's cell populations and in vitro differentiation capacity. After optimizing SVF isolation, we demonstrate successful isolation of SVF of pediatric OI patients and non-OI controls. The number of viable cells was comparable between OI and controls, with about 450,000 per gram tissue. Age, sex, type of OI, disease-causing collagen mutation, or anatomical site of harvest did not affect cell outcome. Further, SVF-containing cell populations were similar between OI and controls, and all isolated SVF's demonstrated chondrogenic, adipogenic, and osteogenic differentiation capacity in vitro. These results indicate that SVF from pediatric OI patients could be used as a source of stem cells for autologous stem cell therapy in OI.
Osteogenesis imperfecta (OI) is a heritable connective tissue disorder often associated with long- bone deformation and bone fragility that are a major impediment to daily activities. The standard of ...care includes bisphosphonates and surgical correction of bone deformities with osteotomy and intramedullary rodding. However, delayed union or non-union of osteotomy site is a common adverse event from this surgery, leading to pain, bending of the fixation rods, repeated fractures, and loss of ambulation. Therefore, alternative solutions are required. Bone grafts or bone-marrow-derived mesenchymal stem cells (BM-MSC) that have been studied for bone regeneration have their limitations. However, a new stem cell source, the autologous adipose tissue-derived stromal vascular fraction (aSVF) is acknowledged as an easily accessible source of a heterogeneous mix of non-expanded cells derived from enzymatically digested adipose tissue and has anti-inflammatory, angiogenic, immunomodulatory, and regenerative properties. The mesenchymal stem cells of the aSVF (ASCs) has multi-differentiation capacity as BM-MSCs. And its regenerative properties have been studied extensively in the past two decades; however, to our knowledge, the healing and regenerative potential of aSVF has not been explored in OI. Here, we describe for the first time, the isolation of SVF from OI patients' adipose tissue; and its cellular characterization and functional capacity as a new source for bone regeneration. In this study, we obtained 42 adipose tissue samples derived from pediatric patients either diagnosed with OI (38 donors; age range: 2–22 years; 19 males, 19 females); or non-OI (controls; n= 4; age range: 4–14 years; 1 male, 3 females) undergoing corrective bone surgeries at the Shriners Hospital for Children (Montreal, Canada). The overall mean weight of harvested adipose tissue was 6.70 g in the OI group and 7.48 g in controls. And the overall number of isolated viable cells and nucleated cells was comparable between HC and OI (OI aSVF was 85.6±3.8 and 80.5±5.3% in the control group). Further, type of OI, gender, age, and anatomical site of harvest had no effect on overall number of isolated viable cells. Characterization of the SVF cellular populations revealed significantly fewer endothelial progenitor cells in OI than in controls. Other cell populations such as MSCs (CD45-/CD34+/CD73+/CD90+) were similar between OI and controls. The distribution of SVF cell populations was similar between OI types. Moreover, control and OI MSCs had similar capacity of differentiation into osteogenic, adipogenic, and chondrogenic lineages. These results strengthen the hypothesis that SVF from OI patients' adipose tissue has the potential of being a new source of MSCs for autologous stem cell therapy in OI
Study Objectives
This study attempted to assess sleep quality among medical students and examine the relationship between social network use and sleep quality.
Methods
Descriptive cross-sectional ...study, enrolling medical students of King Abdulaziz University and Batterjee Medical College. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.
Results
Of the 702 medical students who responded to our survey (410 females and 292 males), more than 66% suffered from poor sleep quality. Approximately 92.3% of the surveyed students used electronic devices before they fell asleep, and 88.4% used these devices for social networking purposes. Female students were found to suffer more than male students, and they also reported spending more time on social networking sites before sleeping (
p
= .006).
Conclusion
This study suggests that students who reported poor sleep spent an average of 64.38 min on social networking sites before sleeping; this duration was negatively associated with medical students’ sleep quality.
Case:
A 32-year-old patient was diagnosed with a vertical patella fracture nonunion after a bone–patellar tendon–bone (BTB) anterior cruciate ligament reconstruction. In addition, a 1 × 2 × 1 cm ...patellar bone defect was noticed at the graft harvesting site. The patient was treated surgically with open reduction and internal fixation and iliac crest bone autograft which resulted in fracture union.
Conclusion:
Many intraoperative and postoperative risk factors for iatrogenic patella fracture when harvesting BTB autograft were identified. Surgeons should be aware of technical skills needed to prevent this complication and should treat the fracture appropriately to avoid nonunion and optimize the outcome.
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