The prognosis of chronic myeloid leukaemia (CML) has improved remarkably over the last 11 years with the introduction of tyrosine kinase inhibitors (TKIs) in clinical practice. Here we intend to ...focus on clinically based problems and their solution based on the evidence from literature and our experience as a centre for excellence.
Recent results from trials with first and second generation TKIs have help to clarify some, but not all, of the common clinical dilemmas that physicians face when treating CML patients.
CML treatment received a paradigm shift with the launch of TKIs. However, questions remain about adherence, tolerability, toxicity, resistance, and management and about the selection of second-generation drugs and the interpretion of responses and the role of stem cell transplantation.
AIM： To transplant undifferentiated embryonic stem （ES） cells into the spleens of carbon tetrachloride （CCl4）-treated mice to determine their ability to differentiate into hepatocytes in the liver.
...METHODS： CCh, 0.5 mL/kg body weight, was injected into the peritoneum of C57BL/6 mice twice a week for 5 wk. In group 1 （n = 12）, 1 × 10^5 undifferentiated ES cells （0.1 mL of 1 × 10^6/mL solution）, genetically labeled with GFP, were transplanted into the spleens 1 d after the second injection. Group 2 mice （n = 12） were injected with 0.2 mL of saline twice a week, instead of CCh, and the same amount of ES cells was transplanted into the spleens. Group 3 mice （n = 6） were treated with CCh and injected with 0.1 mL of saline into the spleen, instead of ES cells. Histochemical analyses of the livers were performed on post-transplantation d （PD） 10, 20, and 30.
RESULTS： Considerable numbers of GFP-immunopositive cells were found in the periportal regions in group 1 mice （CCh-treated） on PD 10, however, not in those untreated with CCh （group 2）. The GFP-positive cells were also immunopositive for albumin （ALB）, alpha-1 antitrypsin, cytokeratin 18, and hepatocyte nuclear factor 4 alpha on PD 20. Interestingly, most of the GFP-positive cells were immunopositive for DLK, a hepatoblast marker, on PD 10. Although very few ES-derived cells were demonstrated immunohistologically in the livers of group 1 mice on PD 30, improvements in liver fibrosis were observed. Unexpectedly, liver tumor formation was not observed in any of the mice that received ES cell transplantation during the experimental period
CONCLUSION： Undifferentiated ES cells developed into hepatocyte-like cells with appropriate integration into tissue, without uncontrolled cell growth.
Biliary anastomotic strictures are one of the most significant postoperative complications after living donor liver transplantations (LDLT), which develop in about 10-30% of recipients. Various ...modalities have been reported to treat these complications with an acceptable success rate. Herein, we present a case of complete anastomotic obstruction of hepaticojejunostomy, for which a successful magnetic compression anastomosis (MCA) was performed. The patient was a 56-year-old man who was given a diagnosis of biliary anastomotic strictures 9 months after LDLT. Conservative treatment, including percutaneous transhepatic biliary drainage (PTBD), was initially undertaken, however, recanalization of the bile duct anastomosis could not be obtained. An MCA was performed 3 months after the initial PTBD, which resulted in a success. In conclusion, MCA is a safe and very effective method to treat complete anastomotic strictures after LDLT.
To evaluate the repair of rotator cuff tear by allogenic cortical bone anchors with the technique of suture bridge.
A total of 18 patients with rotator cuff tear were recruited during the period of ...June 2006 to June 2009. There were 7 males and 11 females with an average age of 45.2 years old (range: 34 - 65). The locations included left shoulder (n = 11) and right shoulder (n = 7). Rotator cuff tear was repaired by allogenic cortical bone anchors with the technique of suture bridge under arthroscopy. The efficacy was evaluated by University of California Los Angeles (UCLA) standard score.
The average follow-up period was 17.6 months (range: 12 - 36). The excellent rate of treatment was 100%. All rotator cuff tears were healed. Only 2 cases had minor pain and there was no limitation of joint activity. The bone anchor fully integrated with the subject area at Month 3 post-operation.
The advantages of repairing rotator cuff tear by allograft cortical bone anchors with the technique of suture bridge includes min
Soon after the first experimental scientific investigations of cell transplantation in various animal models of myocardial infarction and left ventricular dysfunction, a growing number of clinical ...trials evaluated the effects of intracoronary injection of peripheral blood- or bone marrow-derived cells in patients with myocardial infarction or chronic ischemic heart disease. In most of these trials, changes in parameters of left ventricular remodeling over time, such as left ventricular volumes, ejection fraction or infarct size, were used as trial end points, whereas information on mortality and morbidity after cell transplantation is sparse. Several meta-analyses, each including various sets of studies, estimated that intracoronary cell therapy was associated with small reductions in left ventricular end-systolic volumes and a moderate increase in left ventricular ejection fraction of 2.9-6.1% over time compared with control patients. As most of the clinical trials included a limited number of patients, results vary substantially between different studies. When evaluating whether effects of intracoronary cell transplantation on parameters of left ventricular remodeling may be transferable to meaningful consequences in terms of clinical outcome, the following aspects appear to be imperative. Robust data on mortality and clinical events based on a sufficient number of patients are required. Furthermore, effects of cell therapy must be compared with established therapeutic concepts for the treatment of myocardial infarction, such as reperfusion therapy or pharmacological interventions aiming at favorably influencing the remodeling process. Moreover, the potential effects of cell therapy must be evaluated as treatment options additive to established therapeutic strategies.
To understand the biological characteristics and osteogenic potential of hVEGF-165 gene modified marrow stromal stem cells and investigate the effect and value of treatment for osteonecrosis of ...femoral head by hVEGF-165 gene modified marrow stromal stem cells under arthroscope.
rAAV-2-hVEGF-165 plasmids were extracted and transfected into rabbit marrow stromal stem cells. hVEGF-165 mediated by adeno-associated virus (AAV) was used to transfect rMSCs. The transfection efficiency was detected with enhanced green fluorescent protein under fluorescence microscope. hVEGF-165 mediated by adeno-associated virus (AAV) was used to transfect rMSCs. Virus transfection stayed overnight after 90% cell converged. MOI was 105. The transcription and expression of hVEGF-165 protein expression were detected by RT-PCR and Western blot. The necrotic bone was emptied and then MSCs were implanted under arthroscope. The histology of femoral head was inspected at postoperative 2 - 8 weeks.
The expression of hVEGF-165 gene could be found distinctly in the transfected rabbit MSCs and hVEGF-165 protein in the supernatants of transfected cell cultures. The transfection efficiency of adeno-associated virus (AAV) transfected rMSCs was 70%. And rAAV-2-hVEGF-165 transfected rMSCs achieved an effective expression by RT-PCR and Western blot. hVEGF-165 could be found after a 48-hour transfection and peaked at Day 10. Immunohistochemical detection showed that the implanted rMSCs was positive at Week 2 and strong positive at Week 8. The compressive strength of the hVEGF-165 gene group approached that of normal control.
hVEGF-165 gene transfected rabbit MSCs can express hVEGF-165 with highly biological activity. It provides provided a basis for employing hVEGF-165 gene and MSCs based gene therapy for ONFH repairing and regeneration. rAAV-2-hVEGF-165/MSCs may be implanted accurately under arthroscope. Implantation of human BMP-2 gene transfected BMSCs can repair early-stage experimental femoral head necrosis.
En este artículo se describe el estado actual del trasplante de páncreas, los tipos de trasplante más frecuentes –trasplante de páncreas aislado, trasplante de páncreas riñón– sus indicaciones, ...resultados y las características de receptores y donantes.
This article describes pancreas transplantation, the more frequent modalities such as pancreas transplantation alone and simultaneous pancreas kidney transplantation, their indications and outcomes, as well as the characteristics of suitable recipients and donors.
Chronic myelogenous leukemia (CML) is a hematopoietic stem cell disorder in which allogeneic stem cell transplantation remains the only curative option, but its use is limited by donor availability ...and treatment-related morbidity and mortality. Imatinib mesylate is a targeted agent for CML with efficacy to date, which is superior to all other nontransplant therapy and has limited toxicity. The curative potential of imatinib remains to be proven and may be limited to a small number of patients. Optimal decision making regarding the use of these divergent therapies has not been defined. This paper reviews critical data relevant to these treatment options and provides an approach to current management of the CML patient.
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