London Bridge Hospital

About: London Bridge Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Antiphospholipid syndrome & Systemic lupus erythematosus. The organization has 107 authors who have published 122 publications receiving 4523 citations.

Stem cell therapy in discogenic back pain

Abstract: Chronic low back pain has both substantial social and economic impacts on patients and healthcare budgets. Adding to the magnitude of the problem is the difficulty in identifying the exact causes of disc degeneration with modern day diagnostic and imaging techniques. With that said, current non-operative and surgical treatment modalities for discogenic low back pain fails to meet the expectations in many patients and hence the challenge. The objective for newly emerging stem cell regenerative therapy is to treat degenerative disc disease (DDD) by restoring the disc's cellularity and modulating the inflammatory response. Appropriate patient selection is crucial for the success of stem cell therapy. Regenerative modalities for discogenic pain currently focus on the use of either primary cells harvested from the intervertebral discs or stem cells from other sources whether autogenic or allogenic. The microenvironment in which stem cells are being cultured has been recognized to play a crucial role in directing or maintaining the production of the desired phenotypes and may enhance their regenerative potential. This has led to a more specific focus on innovating more effective culturing techniques, delivery vehicles and scaffolds for stem cell application. Although stem cell therapy might offer an attractive alternative treatment option, more clinical studies are still needed to establish on the safety and feasibility of such therapy. In this literature review, we aim to present the most recent in vivo and in vitro studies related to the use of stem cell therapy in the treatment of discogenic low back pain.

Immunosuppressive activity in human in vitro fertilization (IVF) culture supernatants and prediction of the outcome of embryo transfer: a multicenter trial.

Abstract: The supernatants from cultured human oocytes fertilized in vitro contain low molecular weight factors that can suppress or stimulate the proliferative response of lymphocytes in vitro. The inhibitory and stimulatory effects are nonspecific and may be detected using cultured human or murine tumor cell lines. Using such a bioassay, we previously tested fetal cord serum-supplemented culture supernatant and found that an absence of suppression was correlated with an absence of subsequent pregnancy. To test this association further, additional samples were obtained from four different in vitro fertilization (IVF) units and studied blindly without knowledge of the pregnancy outcome. In this series, samples were obtained after the first 12–24 hr of sperm-oocyte incubation and all of the supernatants were from individual embryo cultures. The average number of preembryos transferred to those achieving pregnancy did not differ significantly from the number transferred to those not achieving pregnancy but the level of suppression was greater (8.7±1.9%) in those becoming pregnant compared to those not achieving pregnancy (0.8±1.5%). Twenty-two of 61 patients who received at least one embryo with a suppressive supernatant achieved pregnancy, whereas 0 of 19 patients received embryos lacking suppressive supernatants became pregnant. Two patients who received a single embryo from cultures with suppression became pregnant. Several problems with the bioassay method were defined. The culture medium in this series was always supplemented with adult serum, usually from the patient herself, and this serum could be suppressive. Also, cultures containing sperm were suppressive to a greater extent than could be explained by the serum. High-performance liquid chromatographic (HPLC) analysis indicated that the suppressive effect of the serum was related to molecules greater than 100,000 kd and that sperm supernatants contained additional activity in this size range. Pooled supernatants from patients with suppression achieving pregnancy confirmed the presence of two low molecular weight species of approximately 3700 and 1200, and these moieties were absent in those patients with suppressive supernatants who failed to become pregnant. Similar low molecular weight molecules were also present in supernatants from sperm alone, suggesting sperm as a possible origin. The data indicate that the presence of certain types of molecules in human IVF supernatants may predict an increased likelihood of implantation and subsequent pregnancy, whereas a deficiency of these molecules predicts failure. A more rapid assay to detect specifically the presence or absence of these molecules in supernatants from the first 24 hr of human IVF culture could be useful in sparing patients the transfer of embryos unlikely to succeed and in selecting embryos with an optimal chance of success.

Sexual Response in Cardiovascular Disease

Abstract: The cardiovascular response to sexual activity in men and women is similar to other daily activities and not excessive between couples in a long-standing relationship. The risk of an ischemic event...

Blood concentrations of estradiol and sex hormone-binding globulin in relation to age at menarche in premenopausal British and Japanese women.

Abstract: In a cross-sectional study, serum estradiol (E2) and sex hormone-binding globulin (SHBG) concentrations were not significantly related to age at menarche in premenopausal British women in the luteal or follicular phases of the cycle. In Japanese subjects in the luteal phase, a marginally higher concentration of E2 was observed in those who had undergone an early rather than a late menarche. In British women, previous oral contraceptive users had significantly lower luteal phase E2 concentrations than never users.

Posterior approach vertebrectomy in the thoracolumbar spine with expandable cage reconstruction: indications and techniques based on eight cases.

Abstract: We present a series of eight patients undergoing circumferential neural decompression and stabilization of the thoracolumbar spine via a single midline posterior approach, with complete vertebrectomy for a variety of indications. Four had primary tumours, two secondary tumours, one patient had tuberculosis and one had delayed deformity due to trauma. This single posterior approach is made possible via the use of an expandable cage that may be expanded in situ to offer anterior and middle column reconstruction. There were no major neurological complications and all patients with deficits improved postoperatively. Extensive posterior fixation was avoided with five patients undergoing a one above/one below fixation and three undergoing a two above/two below fixation. When combined with pedicle screw and rod fixation this anterior reconstruction makes a sound construct. The flexibility of this approach in the thoracolumbar spine, some of the biomechanical advantages and pitfalls are considered.