MyMedR

Current status and prospective application of stem cell-based therapies for spinal cord injury

Das AK, Gopurappilly R, Parhar I

Curr Stem Cell Res Ther, 2011 Jun;6(2):93-104.

PMID: 21190537

Spinal cord injuries (SCIs) are a common form of trauma that leaves a huge trail of morbidity and human suffering in its wake. They occur mostly among the young, causing severe physical, psychological, social and economic burdens. The treatment of this condition has rather been disappointing; most of the management strategies being mainly supportive and prophylactic. In recent years there has been an emerging interest in the use of stem cells to regenerate the nervous tissue that has been damaged or lost. Although there has been much hype and unfounded hope, modest successes have been witnessed, and it is possible that these therapeutic strategies may have much more to offer in the future. This paper will review the current strategies of exploring cell-based therapies, mainly different types of stem cells to treat SCI along with the evidence that has been accumulated over the past decade in a rational bench-to-bedside approach. Furthermore, critical aspects such as the mode of delivery and ethical considerations are also discussed along with feasible suggestions for future translational research to provide a contextual picture of the current state of advancements in this field. The impediments to regeneration in the site of injury are briefly explained along with the benefits and drawbacks of different cell types used in the treatment of this condition. We hope that this review will offer a significant insight into this challenging clinical condition.

Matched MeSH terms: Stem Cell Transplantation*

Fulltext National Transplant Registry

Hooi LS, Lela Yasmin M

Med J Malaysia, 2008 Sep;63 Suppl C:9-12.

PMID: 19230241

Matched MeSH terms: Organ Transplantation/statistics & numerical data*

Posttransplant lymphoproliferative disease masquerading as postbiopsy hematoma

Gan WH, Thye YL, Chang SH, Chua CB, Looi LM, Tan SY

Transplant Proc, 2004 Sep;36(7):2148-9.

PMID: 15518779

Matched MeSH terms: Kidney Transplantation/adverse effects*

Tissue engineering trachea: Malaysian experience

Aminuddin BS

Med J Malaysia, 2004 May;59 Suppl B:3-4.

PMID: 15468790

Management of severe tracheal anomalies remains a clinical challenge. Tissue engineering offers new hope in trachea reconstruction surgery. However to date no optimal technique achieved in the formation of human or animal trachea. The main problem lies on the biomaterial used and the complex city of forming trachea in vivo. This study was aimed at creating tissue-engineered trachea cartilage from easily accessible human and animal nasal septum cartilage using internal scaffold and biodegradable human and animal fibrin.

Matched MeSH terms: Chondrocytes/transplantation*

Fulltext Extended pedicle rectus abdominis myocutaneous flap for thigh reconstruction

Halim AS, Zulmi W

Med J Malaysia, 2005 Mar;60(1):109-11.

PMID: 16250294

A rectus abdominis myocutaneous flap can provide a large amount of tissue for defect coverage. Rarely a flabby and redundant abdominal tissue was used as a huge extended flap. We report a case of recurrence malignant fibrous histiocytoma of the thigh which was radically resected. The resultant massive defect was success reconstructed with an extended pedicle inferiorly based rectus abdominis myocutaneous flap.

Matched MeSH terms: Rectus Abdominis/transplantation*

Liver transplantation--patient selection and timing

McCormick A, Sultan J

Med J Malaysia, 2005 Jul;60 Suppl B:83-7.

PMID: 16108182

Liver transplantation has been successfully used in the treatment of a large number of liver diseases. The largest patient group comprises patients with end stage decompensated liver disease. Decompensation is defined as the presence of cirrhosis and one or more of the following: jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or bleeding oesophageal varices. In general patients in this category should be considered for liver transplantation, if available. Guidelines for liver transplant assessment have been published by both the British Society of Gastroenterology and the American Association for the Study of Liver Disease. These guidelines provide a good basis for patient selection. As new information becomes available the indications for individual diseases may change somewhat. One of the most important changes in recent years was the introduction of the MELD/PELD scoring system. This is the model for end stage liver disease which provides a reasonably robust estimate of prognosis for individual patients. Prior to this patient waiting time on the transplant list was one of the principal determinants of priority for liver allocation. The MELD scoring system has been widely adopted with the aim of allocating the available livers to patients in the greatest clinical need.

Matched MeSH terms: Liver Transplantation*

Darurah (Necessity) and Its Application in Islamic Ethical Assessment of Medical Applications: A Review on Malaysian Fatwa

Isa NM

Sci Eng Ethics, 2016 10;22(5):1319-1332.

PMID: 26358749 DOI: 10.1007/s11948-015-9698-1

The discovery and invention of new medical applications may be considered blessings to humankind. However, some applications which might be the only remedy for certain diseases may contain ingredients or involve methods that are not in harmony with certain cultural and religious perspectives. These situations have raised important questions in medical ethics; are these applications completely prohibited according to these perspectives, and is there any room for mitigation? This paper explores the concept of darurah (necessity) and its deliberation in the formulation of fatwas on medicine issued by the National Fatwa Council of Malaysia. Darurah has explicitly been taken into consideration in the formulation of 14 out of 45 fatwas on medicine thus far, including one of the latest fatwas regarding uterine donation and transplantation. These fatwas are not only limited to the issues regarding the use of unlawful things as remedies. They include issues pertaining to organ transplantation, management of the corpse and treatment of brain dead patients. While deliberation of darurah in medicine may vary from issue to issue, darurah applies in a dire situation in which there are no lawful means to prevent harm that may be inflicted upon human life. Nevertheless, other aspects must also be taken into the deliberation. For example, consent must be obtained from the donor or his next of kin (after his death) to conduct a cadaveric organ transplantation.

Matched MeSH terms: Tissue Transplantation/ethics

Stem cells and injectable hydrogels: Synergistic therapeutics in myocardial repair

Sepantafar M, Maheronnaghsh R, Mohammadi H, Rajabi-Zeleti S, Annabi N, Aghdami N, et al.

Biotechnol Adv, 2016 Jul-Aug;34(4):362-379.

PMID: 26976812 DOI: 10.1016/j.biotechadv.2016.03.003

One of the major problems in the treatment of cardiovascular diseases is the inability of myocardium to self-regenerate. Current therapies are unable to restore the heart's function after myocardial infarction. Myocardial tissue engineering is potentially a key approach to regenerate damaged heart muscle. Myocardial patches are applied surgically, whereas injectable hydrogels provide effective minimally invasive approaches to recover functional myocardium. These hydrogels are easily administered and can be either cell free or loaded with bioactive agents and/or cardiac stem cells, which may apply paracrine effects. The aim of this review is to investigate the advantages and disadvantages of injectable stem cell-laden hydrogels and highlight their potential applications for myocardium repair.

Matched MeSH terms: Stem Cell Transplantation*

Fulltext Pregnancy in patients with renal transplants in Malaysia

Hooi LS, Rozina G, Wan Shaariah MY, Teo SM, Tan CHH, Bavanandan S, et al.

Med J Malaysia, 2003 Mar;58(1):27-36.

PMID: 14556324

There were 72 pregnancies in 46 renal transplants (RTs) between 1984 and 2001, 89% from living donors, 11% cadaveric. Mean age at RT was 26.9 +/- 4.3 years and at pregnancy 30.7 +/- 4.7 years. Mean time to pregnancy after RT was 4.5 +/- 3.1 years. 54% were unplanned. 45 (63%) resulted in surviving infants, 37% delivered by Caesarean section. 35% were premature. Mean birth weight was 2.38 +/- 0.57 kg. 64% were on cyclosporine. No patient had an acute rejection during pregnancy; 38% had pre-existing hypertension. Complications include urinary infection (13%), proteinuria (15%) and preeclampsia (15%). Mean serum creatinine before pregnancy was 112.7 +/- 32.6 umol/l, 1 year post-pregnancy it was 119.4 +/- 38.7. The mean time of follow up of mothers is 4.9 +/- 3.5 years. 10 year graft survival was 83% and patient survival 94%.

Matched MeSH terms: Kidney Transplantation/statistics & numerical data*

Fulltext Providing a cure for beta thalassaemia major

Chan LL, Lin HP, Ariffin WA, Ariffin H

Med J Malaysia, 2001 Dec;56(4):435-40.

PMID: 12014762

The current treatment options for beta thalassaemia major patients include conservative treatment with blood cell transfusions and iron chelation or stem cell transplantation. Regular blood transfusions inevitably lead to multi-organ haemosiderosis and are attended by risks of blood-borne infections. Results from stem cell transplantation are good and suggest that this should be offered as first line therapy when a matched sibling donor is available because the patient is often cured and able to live a normal life. Of 38 Malaysian children who underwent bone marrow or cord blood transplantations using matched sibling donors, 29 (76%) are now cured.

Matched MeSH terms: Hematopoietic Stem Cell Transplantation*

Fulltext Cholestatic fibrosing hepatitis and hepatitis B after bone marrow transplantation

Suresh RL, Merican I, Chang KM, Yong SM, Purusothaman V

Med J Malaysia, 2001 Dec;56(4):508-11.

PMID: 12014774

In the setting of transplantation and chronic hepatitis B viral infection there is a unique histological feature termed cholestatic fibrosing hepatitis. The use of nucleoside analogues in the treatment of this condition has been successful. We describe a case of cholestatic fibrosing hepatitis, which occurred after intense immunosuppression for graft versus host disease in a patient with bone marrow transplantations. She was commenced on lamivudine therapy and showed good clinical, biochemical and virological response. However she succumbed due to sepsis.

Matched MeSH terms: Bone Marrow Transplantation/adverse effects*

Fulltext Multiple coronary artery bypass grafting in dextrocardia: case report

Wong PS, Chong CL

Med J Malaysia, 1999 Dec;54(4):514-6.

PMID: 11072472

This is a case report of an unusual case of a patient with dextrocardia and "situs inversus totalis" who presented with unstable angina. Coronary angiography revealed severe main stem and severe triple vessel coronary artery disease. The patient later underwent successful emergency coronary artery bypass graft surgery. To the authors' knowledge this is the first reported case in Malaysia and also, the first ever report in the literature of multiple vessel coronary artery grafting, including the use of the right internal mammary artery.

Matched MeSH terms: Mammary Arteries/transplantation

Patterns of tissue damage produced by repeated use of a corneal trephine: a scanning electron microscopic study

Jaais F, Dutton GN

Ophthalmic Surg, 1992 Mar;23(3):210-4.

PMID: 1574293

We studied by scanning electron microscopy the effects of the repeated use of a newly-designed, disposable, suction trephine (Microsurgical, Ltd, Bedfordshire, England) on the nature of the cut of successive corneal buttons from sheep eyes. After the trephine was used more than nine times, the cut edge became more irregular as successive buttons were produced. Also, progressively greater degrees of endothelial cells adjacent to the cut edge were lost. Although the corneal buttons initially were circular, those produced after the 20th cut became more oval. These results suggest that a disposable corneal trephine should be reused no more than nine times.

Matched MeSH terms: Corneal Transplantation/instrumentation*

Cyclosporine in clinical transplantation and autoimmune disease. The Third Asian Sandimmun Workshop. Penang, Malaysia, November 12-13, 1989. Kaoshing, Taiwan, ROC, November 19-20, 1989. Proceedings

Transplant Proc, 1989 Jun;21(3 Suppl 1):1-113.

PMID: 2741210

Matched MeSH terms: Transplantation Immunology*

Fulltext Retrospective study of anaesthesia for renal transplantation during the years 1979 till 1984

Satgurunathan P

Med J Malaysia, 1985 Dec;40(4):271-5.

PMID: 3916211

In this project, a retrospective study regarding the anaesthetic techniques, complications and the relevant monitoring aids needed during the procedure, is made from analysis of the 100 available anaesthetic records of cases done during the five years at the Urology Department, General Hospital, Kuala Lumpur. The total number of cases done during 1979-1984 was 112 but 12 anaesthetic record sheets were missing. The patients requiring renal transplant operation were representative of the end-stage chronic renal failure population of Malaysia with the usual high incidence of cardiovascular and biochemical abnormalities. Except for two cases of epidural anaesthesia, all the other patients received general anaesthesia. Induction was with intravenous barbiturate followed by muscle relaxant, neurolept or narcotic and halothane supplement for maintenance. There were no intraoperative or postoperative deaths due to anaesthetic complications. There were five cases of anaesthetic morbidity of which three cases had inadequate reversal of neuromuscular blocking agents and required postoperative ventilation and two cases had poor respiratory effort and required naloxone supplement. Less serious complications such as allergic manifestations were seen in three cases with use of the new muscle relaxant atracurium. The conclusion was that general anaesthesia using thiopentone for induction, pancuronium bromide for intubation and maintenance of muscle relaxation and neurolept fentanyl/droperidol and halothane supplement, all in doses tailored to the requirements ofa renal failure patient, is a suitable technique of anaesthesia for renal transplant operation. Atracurium, the new muscle relaxant, seems to be a favourable alternative to pancuronium bromide. However, as only five cases in our study received atracurium, further studies would have to be done to support it.

Matched MeSH terms: Kidney Transplantation*

Fulltext Experimental use of a free pericardial patch in the repair of a defect in the esophagus of dogs

Yeoh NTL, Looi LM, Smiley TB

Med J Malaysia, 1984 Jun;39(2):127-30.

PMID: 6513850

This paper discusses the feasibility of using a free pericardial patch in repairing defects of the esophagus. The experimental model used is the dog. A piece of the side wall of the esophagus is first excised. This defect in the esophagus is then covered
with a free patch of pericardium. The animals are then sacrificed at sequential dates and the grafted site submitted for microscopic examination. The results show that a free graft of pericardium when used as a patch can prevent leakage of esophageal contents and allow healing of the defect without gross narrowing of the lumen.

Matched MeSH terms: Pericardium/transplantation*

Internal iliac artery graft in the management of ruptured mycotic aneurysm of the femoral artery

Leong YP, Lokman S

J Cardiovasc Surg (Torino), 1989 Nov-Dec;30(6):955-6.

PMID: 2600128

The use of an autologous ipsilateral internal iliac artery to restore circulation after excision of a ruptured femoral aneurysm in a patient addicted to drugs is described. Autogenous vein graft was not available. The advantages of using the internal iliac artery in this situation are discussed. The use of internal iliac artery graft in this situation has not been previously described in the literature.

Matched MeSH terms: Iliac Artery/transplantation*

Fulltext Peritoneal implantation of ureter in a cadaveric kidney transplant recipient

Tan SY, Lim CS, Teo SM, Lee SH, Razack A, Loh CS

Med J Malaysia, 2003 Dec;58(5):769-70.

PMID: 15190667

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.

Matched MeSH terms: Kidney Transplantation/methods*

Fulltext Role of Primary Autologous Bone Graft at Docking Site in the Treatment of Infected Non-union Tibia Using Rail Fixation System

Mudiganty S, Austine J

Malays Orthop J, 2021 Mar;15(1):27-31.

PMID: 33880145 DOI: 10.5704/MOJ.2103.005

Introduction: Distraction osteogenesis has been used effectively in the management of tibia non-unions with skeletal defect. A retrospective case series study of the infected non-union tibia managed with acute docking in a rail fixation system was conducted at a tertiary care hospital in South India. It was designed to evaluate the use of autologous bone graft at the docking site in achieving an early union with a seven years follow-up period.

Materials and Methods: From 2010 to 2017, a total of 19 patients with infected tibia non-union and a bone defect less than 3cm, were treated with debridement and a monolateral frame fixation with acute shortening and lengthening. The patients were divided into two groups: one in which no bone graft was used at the docking site during early years of the study; and a later group in which autologous bone graft was used at the acute docking site primarily in addition to compression. Consolidation at the docking site was assessed both radiographically and clinically, and the results were statistically analysed.

Results: There were 12 patients in Group I without bone graft, where consolidation at the docking site was noted after a mean duration of 22.08 ± 3.87 weeks. There were seven patients in Group II with bone graft, where the mean time for docking site consolidation was significantly lower at 16.57 ± 3.82 weeks. No docking site complications were noted in either group.

Conclusion: Primary autologous bone graft enhances docking site consolidation in acute shortening. The routine use of bone graft at the docking site in acute shortening will expedite the docking site union with reduction of treatment time.

Matched MeSH terms: Transplantation, Autologous; Bone Transplantation

Lung transplantation for patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome

Luh SP, Lee YC, Chang YL, Wu HD, Kuo SH, Chu SH

Clin Transplant, 1999 Dec;13(6):496-503.

PMID: 10617240

Sauropus androgymus (SA), a vegetable of the Euphorbiaceae family, is a common food source in Malaysia. In Taiwan, over 30 patients have developed progressive respiratory failure after consuming the extract from raw SA leaves as a means of losing weight. Symptoms consistent with a severe obstructive ventilatory defect progressed, despite cessation of SA intake and treatment with bronchodilators, corticosteroids, cytotoxic agents and plasmaphresis. Five patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome underwent lung transplantation. There was no early mortality. One patient died of post-transplant lymphoproliferative disorder and another patient died of bronchial stenosis with infection, 5 and 3.5 months, respectively, post-transplantation. The remaining 3 patients have been followed from 29 to 34 months, with improved general condition and pulmonary function. Perfusion/ventilation scans revealed that these improvements were exclusively attributed to the functional grafts. We believe that lung transplantation is the only effective modality of treatment for patients with end-stage SABO syndrome.

Matched MeSH terms: Lung Transplantation*

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