Autologous fibrin-based tissue-engineered heart valves have demonstrated excellent potential as patient-derived valve replacements. The present pilot study aims to evaluate the structure and mechanical durability of fibrin-based heart valves after implantation in a large-animal model (sheep). Tissue-engineered heart valves were molded using a fibrin scaffold and autologous arterial-derived cells before 28 days of mechanical conditioning. Conditioned valves were subsequently implanted in the pulmonary trunk of the same animals from which the cells were harvested. After 3 months in vivo, explanted valve conduits (n = 4) had remained intact and exhibited native tissue consistency, although leaflets demonstrated insufficiency because of tissue contraction. Routine histology showed remarkable tissue development and cell distribution, along with functional blood vessel ingrowth. A confluent monolayer of endothelial cells was present on the valve surface, as evidenced by scanning electron microscopy and positive von Willebrand factor staining. Immunohistochemistry and extracellular matrix (ECM) assay demonstrated complete resorption of the fibrin scaffold and replacement with ECM proteins. Transmission electron microscopy revealed mature collagen formation and viable, active resident tissue cells. The preliminary findings of implanted fibrin-based tissue-engineered heart valves are encouraging, with excellent tissue remodeling and structural durability after 3 months in vivo. The results from this pilot study highlight the potential for construction of completely "autologous" customized tissue-engineered heart valves based on a patient-derived fibrin scaffold.
MDCT seems to be preferable to conventional radiography in evaluating bone destruction in multiple myeloma. In combination with MR imaging, detailed information for staging these tumors is obtained. For the initial staging in patients with multiple myeloma, MDCT in combination with MR imaging seems to be the method of choice.
So far, developed diagnostic strategies for the early detection of movement disorders due to infantile cerebral palsy (ICP) in newborns are not easily applicable in clinical settings. They are either difficult to acquire or they are too expensive to be established in pediatric clinics and are not sufficiently usable to be integrated into daily routine. The aim of this study therefore was to develop a methodology that allows the objective diagnosis of developing movement disorders in newborns due to ICP. It should be applicable to pediatric offices and should easily integrate in daily routine. To achieve this, a simple to use and low-cost system based on accelerometers was developed to evaluate the newborn's movement. Afterward, a classificator based on a decision tree algorithm was implemented to differentiate between healthy and pathological data in order to propose the most likely diagnosis. The developed methodology was validated in a clinical study with 19 healthy and 4 affected subjects that were evaluated at the first, third and fifths month after birth (corrected age). The overall detection rate of the developed methodology reached between 88 and 92% for all evaluated measurements. The developed methodology is simple to use, therefore is applicable for the objective diagnosis of developing movement disorders in newborns due to ICP and can be established in pediatric offices for use in daily routine.
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