- MeSH
- chrupavka transplantace MeSH
- endotel transplantace MeSH
- glottis fyziologie transplantace MeSH
- kochleární implantáty MeSH
- kostní náhrady klasifikace MeSH
- krev MeSH
- krevní náhražky terapeutické užití MeSH
- lidé MeSH
- nanočástice využití MeSH
- protézy kloubů klasifikace MeSH
- sluch fyziologie MeSH
- transplantace kmenových buněk využití MeSH
- transplantace kůže MeSH
- transplantace rohovky MeSH
- umělá kůže MeSH
- Check Tag
- lidé MeSH
- MeSH
- autologní transplantace MeSH
- chondrocyty transplantace MeSH
- chrupavka transplantace MeSH
- kloubní chrupavka chirurgie MeSH
- kolenní kloub chirurgie MeSH
- králíci MeSH
- modely u zvířat MeSH
- plazma bohatá na destičky * MeSH
- přežívání štěpu MeSH
- transplantace kostí * metody MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- zvířata MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- artroplastiky kloubů MeSH
- artróza kolenních kloubů * terapie MeSH
- chrupavka transplantace MeSH
- dospělí MeSH
- lidé MeSH
- osteotomie metody MeSH
- patelofemorální kloub chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE OF THE STUDY The aim of this presentation is to inform the medical community about causal therapy (transhumeral head plasty or massive osteochondral allograft transplantation) for large Hill-Sachs lesions which frequently cause failure of anterior stabilisation following ventral shoulder dislocations. MATERIAL Seven men with an average age of 26 years (19 to 33 years) undergoing surgery in 2006 and 2007 were evaluated. The minimum follow-up was 18 months (41 to 18 months). Impressions on more than 30 % of the articular surface, or those whose critical size was larger than one-eighth of the humeral diameter (on CT scan) were taken as indications for surgery. Four patients had had previous surgery for anterior instability and three had a primary procedure. Four men underwent acute surgery and three had elective operations. Transhumeral head plasty was used in five and massive osteochondral allograft in two patients. METHODS In the patients with large lesions in the anterior aspect of the shoulder joint, transhumeral head plasty involving repair of the ventral structures from the anterior approach was indicatedúúú in those with an isolated posterior bony defect, a massive osteochondral allograft was transplanted through the posterior approach. The Constant-Murley score was used to assess clinical status before (not in acute conditions) and after surgery. RESULTS All patients reported improved clinical status. The average Constant-Murley score at final follow-up was 95.9 points (83-100 points), in the patients not having an acute procedure in whom pre-operative Constant-Murley scores were obtained, the average improvement was by 22.7 points (8 - 37 points). No general surgical complications were recorded. All patients reported subjective satisfaction and willingness to undergo surgery under the same conditions again. DISCUSSION A Hill-Sachs lesion is a frequent injury to the humeral head resulting from anterior shoulder dislocation. To distinguish between major and minor defects in terms of clinical significance is essential for the choice of appropriate shoulder treatment. Up to now large lesions have mostly been managed by non-causal techniques affecting shoulder biomechanics. Transhumeral head plasty or transplantation of a massive osteochondral allograft, on the other hand, offers a causal treatment. However, these two methods have rarely been mentioned in the international literature, and usually only as case reports. CONCLUSIONS Transhumeral head plasty and transplantation of a massive osteochondral allograft offer a causal therapy for the management of Hill-Sachs lesions that does not alter shoulder biomechanics. They are not associated with a higher percentage of post-operative complications. Neither technique is more demanding than non-causal procedures. Operations carried out as primary and not as "salvage" procedures restored the function of the shoulder joint to normal. After secondary surgery, occasional shoulder pain may persist as well as its restricted range of motion.
- MeSH
- artroplastika metody MeSH
- chrupavka transplantace MeSH
- dospělí MeSH
- humerus chirurgie patologie MeSH
- lidé MeSH
- luxace ramenního kloubu chirurgie MeSH
- mladý dospělý MeSH
- nestabilita kloubu chirurgie MeSH
- transplantace kostí MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Úvod: Polymery představují materiály vhodné pro náhrady subchondrálních defektů. Cílem této práce bylo zhodnotit vliv povrchové modifikace cykloolefinového kopolymeru (COC) a COC-blendu kolagenem typu II na viabilitu a genovou expresi chondrocytů. Materiál a metody: Humánní chondrocyty byly pěstovány v kultivačním médiu na povrchu biomateriálů COC a COC-blend. Polovina materiálů měla plazmaticky modifikovaný povrch atomy dusíku a kyslíku pro vazbu kolagenu typu II. Genová exprese matrixových metaloproteináz (MMP-1,-3,-13), prozánětlivých cytokinů (IL-1, TNF-?) a apoptotických molekul (BAX, Bcl-2) byla hodnocena pomocí kvantitativní Taq-Man PCR po 48 hodinách inkubace. Viabilita chondrocytů byla hodnocena MTT testem po 2, 4 a 8 dnech inkubace. Syntéza MMPs byla měřena pomocí ELISA eseje v buněčném médiu po 48 hodinách inkubace. Výsledky: Chondrocyty pěstované na plazmaticky modifikovaném povrchu kopolymerů kolagenem typu II vykazovaly průměrně až 2,8násobně vyšší expresi mRNA IL-1 a 8,2násobně vyšší expresi mRNA MMP-1. Všechny testované MMPs byly zvýšeně produkované do buněčného média chondrocyty pěstovanými na plazmaticky modifikovaném povrchu polymerů. Nemodifikované COC a COC-blend polymery naopak expresi mRNA MMPs snižovaly. Modifikované materiály oproti nemodifikovaným polymerům snižovaly v závislosti na délce expozice viabilitu chonodrocytů. Genová exprese TNF-? a apoptotických molekul chondrocyty se významně mezi testovanými materiály nelišila. Závěr: Cykloolefinové kopolymery COC a COC-blend mohou představovat vhodné materiály pro tkáňové inženýrství, ale jejich plazmatická modifikace může, alespoň v podmínkách „in vitro“, snižovat viabilitu chondrocytů a indukovat jejich pro-destruktivní potenciál. Výhody nebo nevýhody plazmatické modifikace materiálů pro náhrady osteochondrálních defektů ukáží až další studie.
Introduction: Polymers represent materials suitable for replacement of subchondral defects. The aim of this study was to evaluate the impact of superficial modification of cycloolefin copolymer (COC) and COC blend with collagen type II on the viability and gene expression of chondrocytes. Material and methods: Human chondrocytes were grown in cell culture medium on the surface of COC and COC blend biomaterials. The surface of a half of the materials was plasmatically modified by atoms of nitrogen and oxygen for bond of collagen type II. The gene expression of matrix metalloproteinases (MMP-1,-3,-13), proinflammatory cytokines (IL-1, TNF-alfa) and apoptotic molecules (BAX, Bcl-2) was evaluated by quantitative Taq-Man PCR after 48 hours of incubation. Viability of chondrocytes was evaluated by MTT test after 2, 4, and 8 days of incubation. The synthesis of MMPs was measured by ELISA in cell medium after 48 hours of incubation. Results: Chondrocytes cultured on the surface of copolymers plasmatically modified had an average mRNA expression 2.8-fold increased for IL-1 and 8.2-fold increased for MMP-1. All of tested MMPs were increasingly produced into cell medium by chondrocytes cultured on the plasmatically modified surface of expression of MMPs mRNA. Modified materials, compared to unmodified polymers, decreased viability of chondrocytes according to the length of exposition. The gene expression of TNF-? and apoptotic molecules by chondrocytes did not differ among tested materials. Conclusion: Cycloolefin copolymers COC and COC blend can represent suitable materials for tissue engineering, but their plasmatic modification can, at least in „in vitro“ conditions, decrease viability of chondrocytes and induce their pro-destructive potential. The advantages and disadvantages of the plasmatic modification of materials for replacement of osteochondral defects may be unveiled by further studies.
A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma Grade 1 from the biopsy specimen obtained during panendoscopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of all the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment of cartilage graft from the nasal septum.
- MeSH
- biopsie MeSH
- cartilago cricoidea * MeSH
- časové faktory MeSH
- chondrosarkom * chirurgie MeSH
- chrupavka * transplantace MeSH
- laryngektomie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- nádory hrtanu * chirurgie MeSH
- nosní přepážka * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
27 s. : il. ; 28 cm
Autori prezentujú alternatívny spôsob rekonštrukcie viac než polovičnej straty horného viečka. V situácii, keď štandardné techniky vzhľadom na špecifickosť lokálneho nálezu nemôžu byť využité, sa popísaná metodika javí ako vhodná rekonštrukčná alternatíva.
The authors wish to present an alternative technique of more than half upper lid defect reconstruction. In a situation, where the standard techniques couldn't be used due to the specific nature of the local findings, the described method seems to be a sound alternative for the lid reconstruction.
- MeSH
- chrupavka transplantace MeSH
- lidé MeSH
- oči chirurgie MeSH
- pohyby očí MeSH
- protézy a implantáty metody MeSH
- Check Tag
- lidé MeSH
