Articular cartilage is difficult to heal once injury or disease occurs. Autologous chondrocyte transplantation is a biological treatment with good prognosis, but donor site morbidity and limited cell source are disadvantages. Currently, mesenchymal stem cells (MSCs) are a promising approach for cartilage regeneration. Despite there being various sources, the best candidate for cartilage regeneration is the one with the greatest chondrogenic potential and the least hypertrophic differentiation. These properties are able to insure that the regenerated tissue is hyaline cartilage of high quality. This review article will summarize relevant literature to justify synovium-derived stem cells (SDSCs) as a tissue-specific stem cell for chondrogenesis by comparing synovium and cartilage with respect to anatomical location and functional structure, comparing the growth characterization and chondrogenic capacity of SDSCs and MSCs, evaluating the application of SDSCs in regenerative medicine and diseases, and discussing potential future directions.

This study trialled the controlled delivery of growth factors within a biodegradable scaffold in a large segmental bone defect model. We hypothesised that co-delivery of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) followed by bone morphogenetic protein-2 (BMP-2) could be more effective in stimulating bone repair than the delivery of BMP-2 alone. Poly(lactic-co-glycolic acid) (PLGA ) based microparticles were used as a delivery system to achieve a controlled release of growth factors within a medical-grade Polycaprolactone (PCL) scaffold. The scaffolds were assessed in a well-established preclinical ovine tibial segmental defect measuring 3 cm. After six months, mechanical properties and bone tissue regeneration were assessed. Mineralised bone bridging of the defect was enhanced in growth factor treated groups. The inclusion of VEGF and PDGF (with BMP-2) had no significant effect on the amount of bone regeneration at the six-month time point in comparison to BMP-2 alone. However, regions treated with VEGF and PDGF showed increased vascularity. This study demonstrates an effective method for the controlled delivery of therapeutic growth factors in vivo, using microparticles.

Our hypothesis in this study is that low seeding density expansion could retain human synovium-derived stem cell (hSDSC) "stemness", defined as higher proliferation and multi-differentiation capacity; retention of "stemness" probably occurs through the mitogen-activated protein kinase (MAPK) signaling pathway. hSDSCs were expanded in conventional plastic flasks for two consecutive passages at either low or high density (30 or 3,000 cells/cm(2)). Expanded cells were assessed for the effect of seeding density on their morphology, proliferation, apoptosis, stem cell surface markers, and multi-lineage differentiation capacity (chondrogenic, adipogenic, and osteogenic differentiation) using flow cytometry, biochemical analysis, histology, immunostaining, and real-time polymerase chain reaction. The MAPK signaling pathway (Erk1/2, p38, and JNK) and senescence-associated markers (p21 and caveolin) were also evaluated for their role in cell density-based monolayer expansion using western blot. Our data suggested that low seeding density expansion yielded hSDSCs with enhanced proliferation and multi-differentiation capacity compared to those grown at high seeding density, despite the fact that the cells expanded at both high and low density had lower osteogenic capacity. Low seeding density also down-regulated Erk1/2 and JNK expression and up-regulated p38 expression, which might be responsible for the retained "stemness" in the cells expanded at low density. Low seeding density expansion could retain hSDSC proliferation and multi-differentiation capacity and protect cells from replicative senescence.

Background. Gallstone ileus is an infrequent cause of small bowel obstructions (SBO), accounting for only 0.1-5% of SBOs and 25% of nonstrangulating causes of SBO in the elderly population. There is scant literature available regarding the use of laparoscopy to treat gallstone ileus. Currently, much of the literature available is limited to case reports only. Methods. A complete laparoscopic approach was utilized to manage a 65-year-old woman with morbid obesity who presented with gallstone ileus. With regard to our technical approach, we describe the technical approach that facilitates safe laparoscopic examination of the entire small bowel and can be applied to other acute care surgery cases involving small bowel pathology. Results. The patient’s postoperative course was complicated by new-onset atrial fibrillation which was treated medically with good response. She was safely discharged on postoperative day 2. Conclusion. Laparoscopy is a feasible option for the management of gallstone ileus and can lead to decreased morbidity compared to laparotomy. The technique described allows for laparoscopic examination of the entire small bowel.

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Objective: Endovenous thermal ablation has become the procedure of choice in the treatment of superficial venous reflux disease. The current armamentarium of devices and techniques aimed at the elimination of saphenous reflux offers surgeons and interventionalists a variety of treatment options; however, there is a lack of data comparing the safety of these products. The most concerning complication after endovenous thermal ablation is endothermal heat-induced thrombosis (EHIT) because of the risk of progression to deep venous thrombosis. This study aimed to compare the incidence rate of EHIT between radiofrequency ablation (RFA) and endovenous laser therapy (EVLT).Methods: This was a single-center, office-based, retrospective study during the course of 5 years, in which 3218 consecutive patients underwent 10,029 endovenous saphenous ablations. The patient cohort was 66.2% female, with an average age of 61.9 years. At the time of each indi-

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