Objectives/Aims:The requisite conditions for successful bone tissue engineering are efficient stem cell differentiation into osteogenic cells and a suitable scaffold. In this study, we investigated in vivo bone regeneration from transplanted induced pluripotent stem cells (iPSCs).Materials and Methods:Two critical-sized calvarial bone defects were created in 36 rats. The surgical sites were randomly assigned to one of three treatments to test the healing effectiveness of the scaffold alone, scaffold with iPSCs or a salt solution as a control. The effectiveness of the treatments was evaluated after 2 or 4 weeks using radiographic and histological analyses of bone regeneration in the six groups.Results:Micro-computed tomography (CT) analysis of the bone defects found minimal bone regeneration with the salt solution and nanofiber scaffold and increased bone regeneration in defects repaired with iPSCs delivered in the nanofiber scaffold.Conclusion:Transplanted iPSCs encapsulated in a nanofiber scaffold can regenerate bone in critical-sized defects.
This study aimed to assess the combined application of two biomaterials, a selfassembling peptide hydrogel (SPH) and an atelocollagen sponge (ACS). The ACS was combined with SPH (PuraMatrix Ⓡ or PanaceaGel Ⓡ ) and its osteogenic effects on mouse osteoblastic cell line MC3T3 then evaluated. Each type of SPH was successfully incorporated into the ACS. The MC3T3 cells showed uniform distribution within the scaffold. No necrotic cells were observed throughout the experimental procedures. When the SPH was combined with the ACS, the MC3T3 cells differentiated toward the osteo-lineage, expressing Alp, Runx2, Osx, Bsp, and Oc. PanaceaGel Ⓡ exhibited a stronger osteogenic effect on the cells than PuraMatrix Ⓡ .
We present a case of a centenarian patient in whom preexisting left bundle branch block (LBBB) transiently reverted to normal ventricular conduction during general anesthesia. A 104-year-old woman with a history of hypertension, chronic heart failure, and cognitive impairment was admitted for surgical repair of a femoral neck fracture. The standard 12-lead electrocardiogram (ECG) on admission revealed left axis deviation and complete LBBB with a heart rate (HR) of 60 bpm. Echocardiography indicated left ventricular dyssynchrony with an ejection fraction of 51%. Due to her restless and agitated behavior, general anesthesia was selected for surgery.On arrival in the operating room, the patient's blood pressure (BP) was 170/110 mmHg and HR was 110 bpm with a regular rhythm. ECG monitoring showed a wide QRS complex (140 ms) with RsrS pattern (Fig. 1a). Anesthesia was induced with fentanyl, remifentanil, propofol, and rocuronium, followed by insertion of a supraglottic airway, and maintained with desflurane, remifentanil, and fentanyl. Her lungs were mechanically ventilated. Twenty minutes after the commencement of anesthesia, the QRS complex abruptly narrowed to an rSr′ pattern (80 ms) with a HR of 80 bpm and BP of 100/50 mmHg (Fig. 1b). Surgery was commenced after femoral nerve block using levobupivacaine.Intraoperatively, HR, BP, S P O 2 , and end-tidal CO 2 were maintained at 50-80 bpm, 90/40-120/60 mmHg, 99-100%, and 32-43 mmHg, respectively. At the end of the surgery that lasted for 33 min, the QRS complex widened to an RSr pattern (140 ms) at a HR of 50 bpm and BP of 100/60 mmHg (Fig. 1c) for a few minutes.
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