RESUMEN
Bone allografts (BA) are a cost-effective and sustainable alternative in orthopedic practice as they provide a permanent solution for preserving skeletal architecture and function. Such BA however, must be processed to be disease free and immunologically safe as well as biologically and clinically useful. Here, we have demonstrated a processing protocol for bone allografts and investigated the micro-structural properties of bone collected from osteoporotic and normal human donor samples. In order to characterize BA at different microscopic levels, a combination of techniques such as Solid State Nuclear Magnetic Resonance (ssNMR), Scanning Electron Microscope (SEM), micro-computed tomography (µCT) and Thermal Gravimetric Analysis (TGA) were used for delineating the ultra-structural property of bone. ssNMR revealed the extent of water, collagen fine structure and crystalline order in the bone. These were greatly perturbed in the bone taken from osteoporotic bone donor. Among the processing methods analyzed, pasteurization at 60 °C and radiation treatment appeared to substantially alter the bone integrity. SEM study showed a reduction in Ca/P ratio and non-uniform distribution of elements in osteoporotic bones. µ-CT and MIMICS (Materialize Interactive Medical Image Control System) demonstrated that pasteurization and radiation treatment affects the BA morphology and cause a shift in the HU unit. However, the combination of all these processes restored all-important parameters that are critical for BA integrity and sustainability. Cross-correlation between the various probes we used quantitatively demonstrated differences in morphological and micro-structural properties between BA taken from normal and osteoporotic human donor. Such details could also be instrumental in designing an appropriate bone scaffold. For the best restoration of bone microstructure and to be used as a biomaterial allograft, a step-wise processing method is recommended that preserves all critical parameters of bone, showing a significant advancements over currently existing methods.
Asunto(s)
Trasplante Óseo , Huesos/diagnóstico por imagen , Colágeno/química , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Microscopía Electrónica de Rastreo , Termogravimetría , Trasplante Homólogo , Agua/química , Microtomografía por Rayos XRESUMEN
A country, state or hospital may have the latest medical technology and infrastructure as well as qualified professionals for organ transplantation, but unless there is an adequate donor population the waiting lists for transplants will continue to be long and for some patients, hopeless. Public and professional awareness programmes are key factor in the donation process. Social education that explains the life-saving benefits of organ transplantation, the enormous need for organ donation, the concept of brain death and religious teachings related to these issues is vital for creating a conducive environment for the organ transplant co-ordinator or physician soliciting the donation. The education of hospital medical, nursing and administrative personnel is also essential to both miximise opportunities for donation, as well as to prevent loss of potential organs after donor consent. Other target populations are medical examiners or coroners, and police personnel under whose jurisdiction the donations occur, as their co-operation and guidance is necessary for meeting statutory requirements. The involvement of government officials and politicians is also valuable, as their active intervention is essential for the introduction and amendment of rules and laws to promote the donation and transplantation of organs. The present paper describes communication strategies for the development of an efficient education plan that will provide information about organ transplantation, explain the desired outcome, address potential queries, misconceptions or obstacles, and identify potential sources of support.
Asunto(s)
Medios de Comunicación de Masas , Trasplante de Órganos , Comunicación Persuasiva , Obtención de Tejidos y Órganos , Humanos , Desarrollo de ProgramaRESUMEN
Demineralised, freeze-dried bone allografts (DFDBA) have been used extensively by dentists in the treatment of periodontal and periapical osseous defects resulting from inflammatory diseases. Their use in India however, is limited by the availability of quality allografts and the high cost of imported alternatives. A study was conducted to assess the osteogenic potential of DFDBA prepared for the first time in India by the Tata Memorial Hospital (TMH) Tissue Bank. The DFDBA was used in the treatment of osseous defects after removal of periapical lesions associated with devitalised teeth in 10 healthy patients. At the 6-month recall visit all the patients showed a remarkable decrease in the grades of mobility, and 9 out of the 10 patients showed radiographic evidence of complete healing of the osseous defects with evidence of normal bony trabaeculae. These findings indicate that the indigenously prepared DFDBA is a cost effective, biocompatible material with osteogenic potential that can be used effectively in treating osseous defects of periapical lesions associated with non vital teeth.
Asunto(s)
Enfermedades Óseas/patología , Enfermedades Óseas/terapia , Trasplante Óseo , Calcificación Fisiológica/efectos de la radiación , Rayos gamma , Boca/patología , Adulto , Femenino , Liofilización , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Trasplante HomólogoRESUMEN
Burns, non-healing wounds and pressure sores cause extensive damage to the skin leading to infection and loss of precious body fluids. Despite advances in burn management the mortality rate continues to be high and the search for an economical and easily available dressing to control burn wound infection continues. Autologous skin has limited availability and is associated with additional scarring. Conventional dressings require frequent changes which can be painful and may even require anaesthesia. Amnion is an excellent biological dressing and its use in the treatment of burns has special appeal in India as there are religious barriers to the acceptance of bovine and porcine skin.Lyophilised, irradiated amnion provided for the first time in the country by the Tata Memorial Hospital Tissue Bank was evaluated as a temporary biological dressing. It was used to treat 35 patients with burns, 21 patients with bedsores and non-healing ulcers and the skin graft donor sites of 11 patients. The amnion was easy to handle and stuck well to the raw wound bed. An open dressing was used in most of the second degree burns which healed with hyperemia and early pigmentation. In patients with third degree burns, ulcers or skin graft donor sites, closed dressings were used. The exudate and induration were reduced and patients were more comfortable and experienced less pain. There was healthy granulation with good re-epithelialisation. Amnion was not used in patients with infected third degree burns.