Frequency: Quarterly E- ISSN: 2347-2499 P- ISSN: Awaited Abstracted/ Indexed in: Ulrich's International Periodical Directory, Google Scholar, SCIRUS, getCITED, EBSCO Information Services
Quarterly published in print and online "Inventi Impact: Transplantation (Formerly Inventi Impact: Implants)" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal focuses on replacement, support or enhancement of any biological structure including devices like pacemaker, cochlear implants, subcutaneous drug delivery in form of implantable pills, breast and dental implants.
Background: Staphylococcus epidermidis (S. epidermidis) has emerged as one of the leading pathogens of\nbiomaterial-related infections. Vascular adhesion protein-1 (VAP-1) is an inflammation-inducible endothelial molecule\ncontrolling extravasation of leukocytes. Sialic acid-binding immunoglobulin-like lectin 9 (Siglec-9) is a leukocyte ligand\nof VAP-1. We hypothesized that 68Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-conjugated\nSiglec-9 motif containing peptide (68Ga-DOTA-Siglec-9) could detect inflammatory response due to S. epidermidis\nperi-implant infection by positron emission tomography (PET).\nMethods: Thirty Sprague-Dawley rats were randomized into three groups. A sterile catheter was implanted into\nthe medullary canal of the left tibia. In groups 1 and 2, the implantation was followed by peri-implant injection of\nS. epidermidis or Staphylococcus aureus (S. aureus) with adjunct injections of aqueous sodium morrhuate. In group 3,\nsterile saline was injected instead of bacteria and no aqueous sodium morrhuate was used. At 2 weeks after operation,\n68Ga-DOTA-Siglec-9 PET coupled with computed tomography (CT) was performed with the measurement of the\nstandardized uptake value (SUV). The presence of the implant-related infection was verified by microbiological\nanalysis, imaging with fluorescence microscope, and histology. The in vivo PET results were verified by ex vivo\nmeasurements by gamma counter.\nResults: In group 3, the tibias with implanted sterile catheters showed an increased local uptake of 68Ga-DOTA-Siglec-9\ncompared with the intact contralateral bones (SUVratio +29.5%). 68Ga-DOTA-Siglec-9 PET detected inflammation induced\nby S. epidermidis and S. aureus catheter-related bone infections (SUVratio +58.1% and +41.7%, respectively). The tracer\nuptake was significantly higher in the S. epidermidis group than in group 3 without bacterial inoculation, but the\ndifference between S. epidermidis and S. aureus groups was not statistically significant. The difference between\nthe S. aureus group and group 3 was neither statistically significant.\nConclusion: PET/CT imaging with novel 68Ga-DOTA-Siglec-9 tracer was able to detect inflammatory tissue\nresponse induced by catheter implantation and staphylococcal infections....
Background. Opportunistic infections are common in organ transplant recipients. After 6 months of transplantation, patients have\nthe highest risk of opportunistic infections such as cryptococcosis. Case Presentation. The report presents the case of a 36-year-old\nfemale renal transplant recipient, with complaints of few subcutaneous painful and warm nodules and large, warm, erythematous,\nnontender plaques on the mildly edematous right leg and ankle. Incisional biopsy of the subcutaneous nodule over the leg showed\npanniculitis with small- to medium-sized vasculitis associated with round yeast forms, and culture of the fragments revealed\nC. neoformans var. grubii. Conclusions. This article also reviews in brief the treatment of this rare complication. Reviewing the\nliterature showed that since the cryptococcal cutaneous lesions are often nonspecific, the clinical picture solely is not enough to\nconstruct a definite diagnosis and there must be a high clinical suspicion....
The major challenge for dental implants is achieving optimal esthetic appearance and a concept to fulfill this criterion is evaluated.\r\nThe key to an esthetically pleasing appearance lies in the properly manage the soft tissue profile around dental implants. A novel\r\nimplant restoration technique on the surface was proposed as a way to augment both soft- and hard-tissue profiles at potential\r\nimplant sites. Different levels of roughness can be attained by sandblasting and acid etching, and a tetracalcium phosphate was\r\nused to supply the ions. In particular, the early stage attaching and repopulating abilities of bone cell osteoblasts (MC3T3-E1),\r\nfibroblasts (NIH 3T3), and epithelial cells (XB-2) were evaluated. The results showed that XB-2 cell adhesive qualities of a smooth\r\nsurface were better than those of the roughened surfaces, the proliferative properties were reversed. The effects of roughness on\r\nthe characteristics of 3T3 cells were opposite to the result for XB-2 cells. E1 proliferative ability did not differ with any statistical\r\nsignificance. These results suggest that a rougher surface which provided calcium and phosphate ions have the ability to enhance\r\nthe proliferation of osteoblast and the inhibition of fibroblast growth that enhance implant success ratios....
Primary graft dysfunction (PGD) is the clinical syndrome of acute lung injury after lung transplantation (LTx). However, PGD is an umbrella term that encompasses the ongoing pathophysiological and -biological mechanisms occurring in the lung grafts. Therefore, we aim to provide a focused review on the clinical, physiological, radiological, histological and cellular level of PGD. PGD is graded based on hypoxemia and chest X-ray (CXR) infiltrates. High-grade PGD is associated with inferior outcome after LTx. Lung edema is the main characteristic of PGD and alters pulmonary compliance, gas exchange and circulation. A conventional CXR provides a rough estimate of lung edema, while a chest computed tomography (CT) results in a more in-depth analysis. Macroscopically, interstitial and alveolar edema can be distinguished below the visceral lung surface. On the histological level, PGD correlates to a pattern of diffuse alveolar damage (DAD). At the cellular level, ischemia-reperfusion injury (IRI) is the main trigger for the disruption of the endothelial-epithelial alveolar barrier and inflammatory cascade. The multilevel approach integrating all PGD-related aspects results in a better understanding of acute lung failure after LTx, providing novel insights for future therapies....
To systematically measure and compare the stress distribution on the bone around an implant in the anterior maxilla using angled\nabutments by means of finite element analysis, three-dimensional finite element simplified patient-specific models and simplified\nmodels were created and analyzed. Systematically varied angled abutments were simulated, with angulation ranging from0? to 60?.\nThe materials in the current study were assumed to be homogenous, linearly elastic, and isotropic. Force of 100N was applied to\nthe central node on the top surface of the abutments to simulate the occlusal force. To simulate axial and oblique loading, the angle\nof loading was 0?, 15?, and 20? to the long axis of implant, respectively. There was the strong resemblance between the response\ncurves for simplified patient-specific models and simplified models. Response curves under oblique loading were similar in both\nmodels.With abutments angulation increased, maximum vonMises stress firstly decreased to minimum point and then gradually\nincreased to higher level. From a biomechanical point of view, favorable peri-implant stress levels could be induced by angled\nabutments under oblique loading if suitable angulation of abutments was selected....
Organ Donation and Transplantation is an issue that has widespread ramifications. In addition to the medical/\ntechnical aspects, there are legal, moral, ethical, economic, logistical and humanitarian aspects. Each of these\naspects may have some peculiarity related to the donor and recipient. This paper deals primarily with the moral,\nethical and humanitarian aspects of the issue. From the viewpoint of Islam, organ transplantation is an acceptable\ntherapeutic value provided the following criteria are fulfilled:\n1. There is no other equally effective therapeutic solution available that is simpler, safer and/or more cost\neffective.\n2. The organ donation does not result in any harm to the donor\n3. The organ donation is done with the free will and full approval of the donor, or in the case of an unconscious\ndonor, or an organ donation taken from a cadaver, the approval of the next of kin or legal guardian.\n4. In the case of the donation of a single organ upon which the life of the donor depends, e.g., the heart or liver,\nthe organ may not be removed from the donor until the donor�s brain stem death is ascertained.\n5. The donated organ is a gift and is not sold.\n6. If the transaction results in material or monetary gain to the donor or to the donor�s family, the gain must\nnot be in the form of price, but the donor or his/her family may accept a gift as a token of appreciation since\nthe donated organ is considered a gift to the recipient.\n7. The transplantation of active reproductive organs is categorically forbidden.\n8. The basic rule governing the entire transaction is that organ transplantation is considered a humanitarian act\nof mercy accomplished with the free will and approval of all parties involved under no pressure, coercion or\ninjustice....
There is currently a lack of standard kidney-only procurement technique. Known\ntechniques such as kidney-only procurement using the standard multi-organ procurement\ntechnique could potentially cause more iatrogenic injuries due to less adequate\nexposure. An alternative using the live open kidney donation technique could\nalso be less than ideal due to prior unknown anatomical variation and potential the\ninability to adequately topically cool the kidneys. We describe here a novel easy kidney-\nonly technique leading to an improved exposure, better cold perfusion and topical\ncooling. Herein we show how total bowel evisceration can be achieved by stapling\nthe hepatic hilum, superior mesenteric artery and coeliac trunk. There is a need of a\nkidney only procurement in order to increase the quality of deceased kidney donation\nin our opinion. Results have to be compared in the future to determine the potential\nbenefits....
Background: Donor-derived cell free DNA (ddcf DNA) has been reported as\na universal noninvasive biomarker for rejection monitoring in heart, kidney,\nliver, and lung transplantation. Current approaches based on next-generation\nsequencing for quantification of ddcf DNA, although promising, may be restricted\nby the requirement for donor material, as donor samples may not be\navailable. Methods: We proposed a novel next-generation sequencing approach\nwithout donor-derived material and compared the non-donor-derived\napproach and the donor-derived approach using simulation testing and 69\nclinical specimens. We also evaluated the performance for acute rejection and\ninfection monitoring in lung transplantation. Results: The non-donor-derived\napproach reached similar efficacy as the donor-derived approach with a significant\nlinear correlation of R2 = 0.98. Subsequent validation in clinical specimens\ndemonstrated significant difference between the acute rejection group (4.83% ± 2.11%, mean ± SD) and the non-rejection group (1.61% ±\n0.63%, mean ± SD) (P < 0.0001, Welchâ??s t test). With the cut-off value of\n2.999, our approach had 90.48% sensitivity (95% CI, 69.62% - 98.83%), 100%\nspecificity (95% CI, 91.59% - 100%), and AUC 0.9266 (95% CI, 0.8277 -\n1.026). The test also had the ability to simultaneously detect infectious agents,\nespecially cytomegalovirus, as compared with the clinical test. Conclusion:\nThe proposed approach without donor-derived material could potentially be\nused to monitor acute rejection and infection in lung transplantation and\nmay be applied to other types of solid organ transplantation....
Background: Total tooth loss (edentulism) can be a debilitating condition, impacting on ability to chew, speak and\ninteract with others. The most common treatment is with complete removable dentures, which may be successful,\nbut in the lower jaw, bone resorption that worsens over time makes denture-wearing difficult. Two dental implants\nin the mandible to retain the lower denture has been advocated as the gold standard of treatment, but has not\nbeen universally provided due largely to financial constraints and also patient fear. Mini implants (MI) are cheaper\nand less invasive than conventional implants (CI), but may not have equivalent longevity. Therefore, it is unknown\nwhether they represent a cost-effective treatment modality over time. The aim of this pilot randomised controlled\ntrial was to assess the feasibility of carrying out a trial on this cohort of patients, and to inform the study design of\na large multicentre trial.\nMethods: Forty-six patients were randomly allocated to receive either two mini implants or two conventional\nimplants in the mandible to retain their lower dentures. Quality of life (QoL) questionnaires, pain and anxiety scores,\nand an objective ââ?¬Å?gummy jellyââ?¬Â chewing test were carried out at multiple timepoints, along with detailed health\neconomics information. Implants were placed one-stage, and an early loading protocol was utilised. Patients were\nreviewed 8 weeks post-placement, and finally at 6 months. Implant failure, recruitment and retention rates were\nrecorded and analysed.\nResults: The pilot study demonstrated that it is possible to recruit, randomise and retain edentulous (mainly elderly)\npatients for an implant trial. We recruited to target and retention rates were acceptable. The large number of\nquestionnaires was onerous for participants to complete, but the distribution of scores and feedback from participants\nhelped inform the choice of primary and secondary outcomes in a full trial. The chewing test was time-consuming and\ninconsistent. Implant failure rate was low (1/46). The data on indirect costs gathered at every visit was viewed as\nrepetitive and unnecessary, as there was little or no change between visits.\nConclusions: The pilot study has shown that acceptable recruitment and retention rates are achievable in this population\nof patients for this intervention. The results provide valuable information for selection of outcome variables and sample size\ncalculations for future trials....
The neutrophilic component in bronchiolitis obliterans syndrome (BOS, the main form of\nchronic lung rejection), plays a crucial role in the pathogenesis and maintenance of the disorder.\nHuman Neutrophil Elastase (HNE), a serine protease responsible of elastin degradation whose\naction is counteracted by alpha 1-antitrypsin (AAT), a serum inhibitor specific for this protease. This\nwork aimed to investigate the relationship between HNE and AAT in bronchoalveolar lavage fluid\n(BALf) from stable lung transplant recipients and BOS patients to understand whether the\nimbalance between proteases and inhibitors is relevant to the development of BOS. To reach this\ngoal a multidisciplinary procedure was applied which included: (i) the use of\nelectrophoresis/western blotting coupled with liquid chromatography-mass spectrometric analysis;\n(ii) the functional evaluation of the residual antiprotease activity, and (iii) a neutrophil count.\nThe results of these experiments demonstrated, for the first time, the presence of the complex\nbetween HNE and AAT in a number of BALf samples. The lack of this complex in a few specimens\nanalyzed was investigated in relation to a patientâ??s lung inflammation.\nThe neutrophil count and the determination of HNE and AAT activities allowed us to speculate that\nthe presence of the complex correlated with the level of lung inflammation....
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