Madridge Journal of Internal and Emergency Medicine

ISSN: 2638-1621

2nd International Surgery, Translational and Regenerative Medicine Conference

April 15-16, 2019, Valencia, Spain
Scientific Session Abstracts
DOI: 10.18689/2638-1621.a2.010

Cardiac Fibrosis in Heart Failure: modRNA as New Molecular Therapy

Gianluigi Pironti

Karolinska Institute, Sweden

Background: Cardiac fibrosis is associated with heart failure (HF), which is the number 1 cause of death globally. Although cardiac fibrosis is a physiologic organ response to tissue injury and is necessary for healing, excessive fibrosis disrupts normal cardiac architecture and results in impaired ventricular function leading to sudden death and progressive heart failure.

Methods: Different animal models of HF were used to have a more extended comprehension of treatment for replacement fibrosis, such as myocardial infarct or reactive fibrosis such as pressure overload, PLN R14del transgenic mice or collagen antibody-induced arthritis (CAIA) RA mice.

Results: Hearts from HF mice displayed hypertrophy, fibrosis and reduced left ventricular fractional shortening compared to control. Cardiomyocytes from HF mice showed reduced cytosolic [Ca2+] transient amplitudes that were linked to reductions in sarcoplasmic reticulum (SR) Ca2+ store measured with Ca2+ imaging. Ca2+ handling proteins displayed oxidation-dependent posttranslational modifications that together with an increase in superoxide dismutase expression indicate a cell environment with oxidative stress. Modified mRNA represents a very promising therapy for acquired cardiomyopathy enabling cardiac gene expression manipulation in a rapid and target specific manner without genomic integration and systemic toxicity.

Conclusions: This study gives insights on important molecular mechanisms underlying the pathophysiology of cardiac fibrosis. Indeed molecular therapy based on chemically modified mRNA could be used as therapeutic plan in order to prevent cardiac molecular and physiological changes that impair cardiac function during HF.

Biography:
Dr. Gianluigi Pironti is an Assistant Professor at Karolinska Institutet, Integrated Cardio Metabolic Center (ICMC). He is leading research projects aimed to develop new therapies for cardiovascular diseases models (MI, TAC or transgenic mice) using stem cell, modified mRNA, tissue engineered heart patches introduced by Prof. Kenneth Chien, a pioneer in this field. Dr. Pironti obtained his PhD at University of Naples Federico II (Naples, Italy) in 2012 with program in clinical pathophysiology and experimental medicine. From 2012 until 2015 he was a post doc fellow in the laboratory of Prof. Howard Rockman at Duke University (NC/US) studying mechanism of G Protein Coupled Receptors (GPCRs) signalling in normal and failing hearts involving exosomes. During the years spent in US he had the opportunity to work with Nobel Laureate Prof. Robert Lefkowitz, who inspired him to move and work closer to the source of Nobel prizes, at Karolinska Institutet. There, at department of Pharmacology and Physiology, he initially focused his research on cardiomyocytesʼ calcium signalling and contractility in pathological and physiological condition. Dr. Pironti has more than ten years of experience in the field of translational medicine for heart failure, attested by numerous publications on peer reviewed journals, with great experience in microsurgery on animal models and characterization of physiological parameters invasively (cardiac catheterization) and non-invasively (echocardiography). He is also coordinating and conducting projects for joint collaboration with industry partners (Astra Zeneca).

miR-208a-5p and miR-135a-5p in Formalin Fixed Paraffin Embedded Endo-Myocardial Monitoring Biopsies Discriminate Rejection from Cardiac Infection

Andrea Di Francesco1*, M Fedrigo1, C Castellani1, D Gregori1, G Toscano1, T Bottio1, G Thiene1, M Valente1, C Basso1, G Gerosa1, A Angelini1, D Santovito2, L Natarelli2 and A Schober2

1University of Padua, Italy
2Ludwig-Maximillians University (LMU), Germany

Objectives: The aim of the present study is to test the ability of miRNAs to distinguish infection from rejection.

Methods: We chose randomly 46 monitoring FFPE-EMBs from 40 Heart transplanted (HTX) pts in the last two years. Levels of expression of miRNAs signature for ACR: miR-27b-3p; 29b-3p; 199a-3p; 208a-5p; 302b-3p, AMR: 208a-5p, 29b-3p, 135a-5p, 144-3p and for MR: 208a-5p; 126-5p; 135a-5p were quantified by real-time reverse transcription polymerase chain reaction (RT-qPCR). The discriminative ability of each miRNA for comparison between Rejection and Infection was assessed by univariate analysis of variance (ANOVA). Receiver-operating characteristic (ROC) curve analyses were performed to test the discriminating performance of single miRNAs.

Results: We tested all the miRNAs previously identified as biomarkers of rejection on FFPE-EMBs in cases with rejection and infection. The RT-qPCR analysis showed the statistically significant overexpression of miRNA-208a 5p (Bartlettʼs test p=0.0004) and miRNA 135a 5p (Bartlettʼs test p=0.0029) in infection. The ROC curves demonstrated a high sensitivity and sensibility for both miRNAs AUC 0.80 (I.C.95%:0.5981 to 1.002) and AUC: 0.78 (I.C 95%:0, 6228 to 0, 9456) respectively.

Conclusion: miRNA-208a-5p and miRNA-135a-5p tested in FFPE-EMBs have diagnostic ability to discriminate infection from rejection.

Biography:
Dr. Andrea Di Francesco was born in San Benedetto del Tronto (AP, Italy) on 1986.04.18. He holds a degree in Medical Biotechnolgy (2012), with a thesis titled “Functional validation of in vivo interaction between microRNAs and mRNA targets in DNA damage response”. Ph.D. in Cardiovascular Pathology (2017) achieved thanks to his research on microRNAs as new biomarkers of different types of rejections in heart transplanted patients. He has been visiting research fellow at Ludwig-Maximillian University in Munich, Germany (8 months: February-October 2017), where he worked under the supervisor ship of Prof. Andreas Schober on the-in situ PCR applied on monitoring FFPE-EMBs in order to identify the cell type expressing the microRNAs.
Post-doc fellow research in Dept.of Cardiac Thoracic, Vascular Sciences and Public Health at the University of Padua. His research interests concern on microRNAs and exosomes as biomarkers of heart rejection, infections after transplantation and their role in the patho-physiological mechanism of cardiac allograft vasculopathy (CAV) in heart transplant, under supervisor ship of Prof. Annalisa Angelini. The outcome of his research was presented through oral presentations and posters during many national and international meetings. He had published 2 papers as first author in international ISI Journals and many others as co-author.

Enabling Genomic Data Science for Translational Medicine

Jake Y Chen

The University of Alabama, USA

Translational medicine research requires the integrative use of clinical samples from real patients and genome technologies to characterize molecular subtypes of diseases for tailored therapeutic applications in future healthcare practice. The new genomic and clinical data generated calls for new informatics data management, analysis and modeling architecture. We present a new pilot U-BRITE architecture within the Clinical and Translational Science network institutions of the United States southern regions. A few case studies in autoimmune diseases, cancer and complex genetic disorders will be presented. We hope our experience will help others in similar situations to build cyber-enabled architectures and make translational medicine scalable.

Biography:
Dr. Jake Y Chen is a Professor of Genetics, Computer Science, Biomedical Engineering at the University of Alabama at Birmingham (UAB). He is also the Chief Bioinformatics Officer of UABʼs Informatics Institute and Head of the Informatics Section of the Genetics Department. He holds a BS degree in Biochemistry and Molecular Biology and MS and PhD degrees in Computer Science and Engineering. He has more than 20 years of research experience in biological data mining, systems biology and translational bioinformatics, with more than 150 peer-reviewed publications. Prior to join UAB, he holds tenured faculty positions at Indiana University and Purdue University.

Microphysiological Systems as Predictive Tools for Safety and Efficacy Studies

Danilo A Tagle

National Center for Advancing Translational Sciences, USA

Approximately 30% of drugs have failed in human clinical trials due to adverse reactions despite promising pre-clinical studies and another 60% fail due to lack of efficacy. The NIH Tissue Chips program is developing alternative approaches for more reliable readouts of toxicity or efficacy during drug development. Tissue chips are bioengineered microphysiological systems utilizing chip technology and micro fluidics that mimic tissue cyto-architecture and functional units of human organs. These micro fabricated devices are useful for modeling human diseases and for studies in precision medicine and environment exposures.

Biography:
Dr. Dan A Tagle is associate director for special initiatives at NCATS. He also recently served as acting director of the NCATS Office of Grants Management and Scientific Review and currently serves as executive secretary to the NCATS Advisory Council and Cures Acceleration Network Review Board. Prior to joining NCATS, Tagle was a program director for neurogenetics at the National Institute of Neurological Disorders and Stroke (NINDS), where he was involved in developing programs concerning genomics-based approaches for basic and translational research in inherited brain disorders.
Prior to joining NINDS in 2001, Tagle was an investigator and section head of molecular neurogenetics at the National Human Genome Research Institute and has been involved in the highly collaborative effort toward the positional cloning of genes for Huntingtonʼs disease, ataxia-telangiectasia and NiemannPick disease type C. He has served on numerous committees and advisory boards, including the editorial boards of the journals Gene and the International Journal of Biotechnology.
Tagle obtained his Ph.D. in molecular biology and genetics from Wayne State University School of Medicine in 1990. He was an NIH National Research Service Award postdoctoral fellow in human genetics in the laboratory of Francis S. Collins, M.D., Ph.D., at the University of Michigan. Tagle has authored more than 150 scientific publications and has garnered numerous awards and patents.

Patient Protection, Engagement & Informed Consent: The Virtual Consent Global Initiative to Enhance Patient Engagement and Reduce Physician Burden

Ronald James Heslegrave

William Osler Health System, University of Toronto, Canada

The broad engagement of patients in medical research is essential for gathering evidence from all parts of society in order to develop innovative therapies and medicines. This assertion has never been more important than today in the era of personalized medicine where efficacy and adverse events are increasingly based on genetic and epigenetic factors. The issue is that research is largely restricted to convenient populations while other populations are excluded for linguistic, cultural or education limitations as many “Informed Consents” require medical literacy. Given that the participation in research is necessarily voluntary, these barriers restrict the voluntariness of Consent and skew the applicable outcomes in favour of participating populations.

This presentation will explore the advantages of a Virtual Consent Platform that can be implemented globally to reduce or eliminatesuch barriers for diverse populations thereby creating greater access for disadvantaged patients to appropriate clinical findings regardless of culture, language, education and literacy globally. Such a platform will increase the understanding and acceptability of potential participants so that the Voluntary Consent is more of a truly “Informed Consent” and less subject to legal challenge for clinicians. A Virtual Consent Platform developed as a “Transactional Consent Process” where participants interact with the consenting process over timeand Consent is tracked, verified and stored for later retrieval. As clinical studies inevitably are amended over time requiring patients to be informed of such changes, such a Platform allows convenient and timely access to patients to inform them of changes that may alter their willingness to voluntarily participate in a study. This presentation will provide a concrete example of a Virtual Consent for neurodegenerative diseases to illustrate how such a simplified system would work to better inform participants considering enrolling in clinical research trials. At the same time, physicians are better protected legally as a result of a documented, transactional Consent process.

Biography:
Ronald J Heslegrave is currently the Corporate Chief of Research at William Osler Health System in Toronto, Ontario, Canada. He has built a vibrant research and innovation program for one of the largest Community Hospital Systems in Canada focusing on the evaluation and implementation of innovative healthcare delivery both in hospitals and the community. In 3-4 years he has grown the research studies conducted from a few interested investigators conducting a very limited number of studies to over 200 studies with budgets totaling more than $5+M. This innovation is designed to provide transformational and integrated health care delivery systems of care through technology in an evidenced-based, system-based approach to care. Previously, he was a Senior Scientist in Research Ethics at the University Health Network, University of Toronto where his interest is in new models of ethics review oversight and developing new processes for protecting and informing participants of research. Previously he was appointed as the Inaugural Executive Director of the newly formed non-profit corporation in Canada called Clinical Trials Ontario supported by the Ministry of Economic Development and Innovation. This is a government-supported initiative which had the mandate to make the Province of Ontario a preferred location for global clinical trials. He also established a single Research Ethics Board for Cancer Research in 2004 which continues to thrive in Ontario. He also served on the Canadian Expert Panel on Research Integrity to establish the way forward for improving research integrity for the oversight of scientists in Canada.

Design and Evaluation of a Synthetic Tissue for Simulation of Laproscopic Knotting and Suturing

Liliana Cuevas-López* and Claudia Marcela Echeverri-Gómez

Pontificia Universidad Javeriana, Colombia

Introduction: The training of a surgical resident should include practical exposure to knowledge that has been translated into motor skills. The skills of suturing and knotting by laparoscopy are usually the first exposure in simulation centers, where the possibility of repeated practice improves the final performance in the residents. Finding in the market a product, that simulates real tissue, like the intestine, easily and affordably, is difficult in our environment. We developed a synthetic tissue, that was manufactured at home, which is economic, reusable, with consistency similar to the intestine and easy to use in the laparoscopic simulation environment.

Materials and Methods: A descriptive observational study was carried out with 25 laparoscopic surgeons who evaluated them entioned tissue through laparoscopic suturing and knotting, by means of a semi-structured perception survey.

Results: The overall score of the experience had a median of 9 on a visual analog scale from 0 to 10 in regard to the specific characteristics of the tissue, the perception that it allows a simple and continuous suture to be per-formed easily, was 68% (n = 17) and 52% (n = 13) respectively and to perform laparoscopic intracorporeal knotting with muchease was 76% (n = 19).

Conclusion: The proposed tissue fulfills the desired characteristics and provides a useful simulation model to improve the learning of knotting and suturing by laparoscopy.

Biography:
Dr. Liliana Cuevas-López is a graduated medical doctor and a general surgeon from Pontificia Universidad Javeriana in 2008 and 2014, respectively. Since then she have been working in the San Ignacio University Hospital (Bogota, Colombia) as a general surgeon and she was assigned in 2015 as an assistant professor by the Department of Surgery of the Javeriana university where she is in charge of the simulation laboratory. In last 4 years she has focused her research in surgical education and minimally invasive surgey.

The Impact of Human Factors and Error Causation Simulation Training for Overseas Surgical Trainees

Tamsin Cooper* and Alka Saksena

University Dental Hospital Manchester, UK

Patient safety is the cornerstone of high quality surgical care, improving the efficacy of safety training is fundamental to advancing quality. This work utilises simulation training to produce lasting impact on the safety behaviours of surgeons. Our work previously illustrated that the use of information technology, via video demonstration does not produce a sustained improvement to safety practices. This research demonstrates the value of simulated surgical serious incidents and near misses on the prolonged safety practices of surgeons.

Method: Overseas postgraduate surgical trainees were observed and graded during their patient interactions and pre-operative checks. New surgical trainees then underwent an induction where actors simulated patient interactions. Previous serious incident and near miss reports were used to give realistic clinical situations where surgical errors could occur. Trainees worked through the simulated situations to see if these errors would be recognised during the pre-operative checks. The learning points were highlighted and six months after the educational interventionthey were re-evaluated.

Results: Only one third of trainees confirmed the treatment plan with the patient pre-operatively, this rose to 100% after the simulation training. All of the trainees after the intervention ensured a surgical “time out” was performed, in line with the WHO surgical safety checks. In 93% of cases these safety checks were verbally confirmed to the rest of the team, this was three times higher than seen prior to the training.

Conclusion: This work illustrates simulation training can provide sustained improvements in safety behaviours in surgical trainees when compared to video and didactic teaching alone. The scenario based training with actors allowed new surgical team members to make errors in a safe environment and all reported it to be of high value. In future we aim to video the simulated scenarios to aid with feedback and training.

Biography:
Tamsin Cooper is currently an oral surgery registrar the University Dental Hospital of Manchester, Manchester University NHS Foundation trust. She is passionate about teaching and has an active role in teaching both undergraduate and post graduate surgical trainees. Tamsin has a particular interest in advancing patient safety and implementing new training initiatives which have received national awards. This has included introducing human factors training and simulation scenarios to improve patient safety and peri-operative patient management.
Dr. Alka Saksena is a consultant oral surgeon at University Dental Hospital Manchester, where she is leads in clinical effectiveness, patient safety, hospital sedation and cross Infection. She is the Training Programme Director for Dental Core Trainees in Health Education Northwest, examiner for RCS England and was transformation lead for Central Manchester Foundation Trust. She graduated in London, completed specialty training in Birmingham in 2007 and was president of the Birmingham Medical Institute, prior to taking up her current post in Manchester in 2008. She has lead patient safety initiatives which have resulted in significant and sustained reduction in adverse surgical incidents and improved patient safety culture at University Dental Hospital Manchester with the organisation being shortlisted for the National Patient Safety Awards in 2014.

The Effect of Hyperbaric Therapy on the Development of Brown Adipose Tissue: A Controlled Animal Study

Chang-Hyung Lee*, Young-A Choi, So Young Jo and Sung Jin Heo

Pusan National University Yangsan Hospital, South Korea

Brown adipose tissue (BAT) plays a critical role in energy homeostasis and thermo genesis in mammals, protecting against diet-induced metabolic syndrome and hypothermia via the action of uncoupling protein 1 (UCP-1). The enormous energy-consuming capacity of BAT evidenced by great amount of oxygen consumption, suggest hyperbaric therapy may promote BAT development. The purpose of our study was to determine the effect of hyperbaric therapy on BAT and to compare the amount of BAT produced with that induced by cold exposure in a rat model. A total of 15 female Sprague-Dawley rats were used. Five rats were randomly assigned to a non-treatment group, a cold temperature group (CTG), or a hyperbaric therapy group (HTG). The expressions of UCP-1 (a marker of BAT production) and PGC-1α (a transcriptional regulator) were measured by western blot. Volume of fluorodeoxyglucose (FDG) uptake was determined by positron emission tomography/computed tomography (PET/CT) in all groups. Significantly more BAT development was observed, as determined by FDG PET/CT volume, in the CTG and the HTG than in the control group [F(2,12)=185.72, p=.000]. The protein levels of UCP-1 and PGC-1α of BAT had a statistically significant increase in HTG and CTG compared with control group. These results indicate hyperbaric therapy, like exposure to cold, up-regulate the expressions of UCP-1 and PGC-1α in BAT and contribute to BAT development in rodents. This study shows for the first time that hyperbaric treatment induced BAT development and thus, suggests hyperbaric treatment as a potential therapeutic means of metabolic disorders with minimal side effects.

Biography:
Dr. Chang-Hyung Lee is a specialist for physical medicine and rehabilitation. He has been interested in various topics related to musculoskeletal diseases. In addition to these clinical topics, his major concern is also focussed to sports medicine about elite athletes. He worked as a Korean team physician in Beijing olympics, Doha asian games, Jangchun asian games and Bangkok universiade games so far. Recently, he worked as a Venue Medical Officer for Speed skating games in Pyeongchang winter Olympic Games. However, his interests are not only limited to clinical field. As a basic researcher, he has been studying the development and genetic analysis of Brown Adipose Tissue (BAT) using controlled animal study. Also, lordotic curve controlled traction devices on cervical and lumbar spines have been studied since 3 years ago. His current topic for this year is about Biomechanical analysis of Golf swing which is coincide with todayʼs topic. He hopes to have a chance to discuss and co-work with other researchers from overseas.

Minimally-Invasive Surgery of Phalangeal Fractures of the Fingers

Emilio-José Baixauli Perelló

University of Valencia, Spain

Fractures of the phalangeal bones of the hand are frequent injuries. It is very important to treat them properly in order to achieve good results. Most of these fractures can be treated conservatively. Displaced and unstable fractures need operative stabilization. When treating phalangeal fractures is important to avoid twoma incomplicactions: deformity and stiffness. The surgical techniques have to offer enough fracture sit estabilization to allow early post operative movilization. But one has also to take in mind, that surgery implies an additional agression to the injured finger. When surgically treating phalangeal fractures of the fingers is very important to use Minimally invasive techniques to obtain fracture healing without deformity but with a good range of movement of the injured finger.

Biography:
Dr. Emilio-José Baixauli Perelló is an Orthopaedic and trauma Surgeon and Chief of Upperlimb and peripheral nerve Unit at the Orthopaedic Surgery Service. La Fe University and Politecnic Hospital, Valencia Spain and Associate Professor of Orthopaedic Surgery, Surgery Department of Valencia University, Spain.

AT/RT: (Atypical Teratoid Rhabdoid Tumor): Palliative Surgical Approach

Meenakshi Rattan

Wyong Hospital, University of Sydney, Australia

It is a rare malignant embryonal CNS tumor typically seen in young children with a peak incidence during the first 2 years of life. AT/RT represents 2–3% of all paediatric brain tumors and 10–15% of brain tumors in children less than 3 years old. It was first included in the World Health Organization classification of tumors of the CNS in 2000, although it had been recognized during the early 1980s as a rhabdoid tumor of the CNS with an unfavourable prognosis. In CNS tumors, the clinical presentation is related more to the tumor location at the time of diagnosis than to the histology. Clinical manifestations are usually non-specific and in children younger than 3 years clinical manifestations are less specific, including lethargy, vomiting or failure to thrive. Head tilt, cranial nerve palsies, headache and focal neurological deficit are more prevalent in older children. As with other malignant paediatric brain tumours, gross total resection seemed to be associated with better outcome. However, death often occurs within a year of diagnosis despite multimodality therapy. Multi-agent systemic agents, including anthracyclines, intrathecal chemotherapy and radiotherapy, demonstrated positive impact on overall survival. The overall survival ranges from 0 to 45% and salvage is extremely rare after progression or recurrence.

Biography:
Dr. Meena Rattan is general Paediatrician from Sydney working as consultant at Wyong hospital in Central Coast NSW Australia. She has special interest in paediatric endocrinology, child psychiatry, neurodevelopmental and behavioural Paediatrics. She is trainer for Rhesus 4 kids and also for neonatal resuscitation.

Necrotising Fasciitis- The Current Scenario

Deepak Ghuliani

Maulana Azad Medical College, India

Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection involving subcutaneous tissue up to the fascia that easily spreads along the fascial planes resulting in local soft tissue necrosis and life threatening severe sepsis. It is characterised by a fulminant course with a high morbidity and mortality. Jones, who first described NF, reported a mortality rate of 46% but recent studies have reported the mortality rates in the range of 16-24%. The aetiology is not fully understood, but most of these patients have some underlying pre-disposing factors which makes them vulnerable to infection. Most studies have revealed a polymicrobial nature of the disease with most cultures yielding a mixture of aerobes, anaerobes and facultative anaerobes. Infection with single organism is reported in about 15% of cases.

Early recognition may be difficult as the disease is often clinically indistinguishable from other soft tissue infections early in the course of its evolution. Knowledge of all available tools is a key for an early accurate diagnosis. The laboratory risk indicator score can be useful for differentiating it from cases of cellulitis which can be managed by antimicrobial therapy alone. The mainstay of treatment is early complete surgical debridement with broad spectrum antibiotics, physiological support and a close intensive monitoring. Novel treatment strategies like hyperbaric Oxygen and Intravenous immunoglobulins have been proposed but their role still remains debatable.

Biography:
Dr. Deepak Ghuliani presently working as a Professor of Surgery at Maulana Azad Medical College, India. He has a vast experience in all types of elective and emergency surgeries involving various subspecialties like general surgery, endocrine & breast surgery, gastrointestinal and hepatobiliary including oncology. Besides clinical practice he has a passion for teaching and all types of academic activities. He has several publications in National and International journals. Recently he has become the Fellow of American College of Surgeons. Working as Professor of Surgery not only is he conducting research and teaching undergraduate and postgraduate medical students but also actively involved in conferences, CMEʼs, skills workshops, updates in the role of speaker, chairperson, judge, trainer and also a quiz master.

Reconstruction of Segmental Trachea Defects based on Laser Micropore Technique and Decellularization Method

Yong Xu*, Liang Duan and Gening Jiang

Tongji University, China

Objective: Reconstruction of segmental trachea using laser micropore technique and decellularization method.

Methods: Allogenic trachea, stripped of overlying soft tissue, was processed using a BD-01 CO2 laser cutting machine. Key parameters, including output power, pulse width, spot diameter and repeat times were investigated to optimize the porosity and mechanical strength of samples; LMT-treated trachea was decellularized using conventional detergent-enzymatic method and digested at three different temperatures (4°C, 25°C, and 37°C), in order to obtained a scaffold with sufficient mechanical property. After chondrocytes were combined with LMT-treated DTM (LDTM) and cultured for 8 weeks in vitro, it was observed whether chondrocytes could grow into bilateral surfaces of scaffolds and micropores and formed integral tubular cartilage; Then, the complex was implanted into the subcutaneous of nude mice and rabbits to further demonstrated that this complex can form more mature tubular cartilage in vivo environment; Pre-cultured in vitro for 8 weeks, the neocartilage was implanted into the left sternohyoid muscles for 4 weeks, in order to achieve pre-vascularization of the trachea. Finally, the muscles were fully freed under the premise of protecting blood vessels to form double-pedicle muscle flaps. Then the trachea was transplanted in situ and observed the postoperative survival rates.

Result: The laser micropore technology turns the acellular matrix into a porous structure, which is beneficial to both the decellularization process and the growth of cells into the matrix. Decellularization can be performed 12 times at an enzyme digestion temperature of 25°C to achieve thorough decellularization and ensure sufficient mechanical property. Chondrocytes combined with laser microporous acellular matrix can regenerate neocartilage in vitro and in vivo; this new vascular tube cartilage can achieve longterm segmental tracheal repair in rabbit model.

Conclusion: LDTM is an ideal tissue engineering tracheal regeneration scaffold, providing a new idea for functional tubular tracheal reconstruction.

Biography:
Dr. Yong Xu received his bachelor and master degree from Tongji University, Shanghai, China, in 2015, 2018, respectively. And now, he is pursuing a PhD degree for thoracic surgery in Shanghai Pulmonary hospital. His supervisor is Professor Gening Jiang. He has been engaged in the study of tissue engineered trachea since 2015. His research results were published in Acta biomaterialia, Journal of the Mechanical Behavior of Biomedical Materials, ACS applied materials & interfaces et al.

Regenerative Care for Wound Management – A Novel Concept

Sandeep Shrivastava*, Priyal Shrivastava, Pankaj Kharabe and Sujatha

Datta Meghe Institute of Medical Sciences, India

In day to day practice, the wounds particularly complex ones like - infected and necrotising; with exposed tendons, bones, implants; chronic & non-healing ulcers-pressure sore present a substantial clinical challenge. They need intense management with multiple surgical intervention, antimicrobial/antibiotics, analgesics and local care requiring huge resources, skilled manpower and experts. Despite best of care the results are unpredictable and may be associated with severe morbidity, at times. This study is undertaken to develop a comprehensive solution based on regenerative medicine for such enormous health problem. The Intervention “STARS therapy (Sandeepʼs technique for assisted regeneration of skin)” with Autologous Platelet Rich Plasma (PRP) has been developed and clinically piloted on 300 wounds.

A new concept of “Regenerative Care is propagated through a mono therapy with PRP” based on triggering and assisting the skin regenerations in wounds. The results reveal a complete healing with control of infection, filling up of defects and assisted regeneration of skin. For the first time, reversal and revival of necrosis and devitalized tissues such as tendons, muscles and bones has been clinically achieved. The history of wound management over 4000 years have been till now have been consisting of mostly care of “in situ milieu” wounds through local applications & Dressings, Drugs and Devices such as negative suctions etc. With development of regenerative medicine, we are looking into an exciting option and possibilities. The PRP is one of the simplest Regenerative medicine products having huge possibility of reproducibility amongst all health settings across the globe.

This novel concept of “Regenerative care and assisted skin regeneration for wound management is a comprehensive effective solution which will have a huge impact in improving wound care. The “STARS therapy” is a simple safe and effective solution and a complete Game Changer.

Biography:
Dr. Sandeep Shrivastva is the Director of Centre of Autologous Platelet Biotechnological interventions, at Datta Meghe Institute of Medical Sciences, Warda India. He is Director-Professor of Orthopaedics having done his MS, DNB and Ph.D. He is also Chief Executive Officer, Hospitals and Ex DEAN of JNMC. In the field of Regenerative Medicine, he has pioneered the wound management with PRP, by developing the clinical Protocol of “Sandeepʼs Technique for Assisted Regeneration of Skin (STARS Therapy). His work is widely published and presented across the World. He has 2 books, 63 Publications and 76 presentations, including Orations, Key Note addresses, Guest lectures and Conducts workshops on the same.

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