Sang Ho Bae

Occlusive arterial disease continues to be a leading contributor to morbidity and mortality, and the ongoing lack of small-diameter vascular grafts (<6 mm) significantly restricts surgical interventions. In this work, we present a new core/shell fibrous vascular graft (C/S PE) created through coaxial electrospinning, consisting of a polycaprolactone (PCL) core and a cardiac extracellular matrix (cECM)-enriched shell designed for ex vivo endothelialization. Proteomic profiling confirmed that the cECM preserved angiogenic and cell-adhesive components capable of guiding vascular lineage commitment. To enhance luminal cellular organization prior to implantation, a dynamic ex vivo perfusion strategy was applied to induce mesenchymal stem cell differentiation under gradually increasing shear conditions designed to emulate early physiological adaptation. This approach enabled the formation of a confluent endothelial-like layer after two weeks. RNA-seq analysis revealed activation of pathways associated with endothelial proliferation, angiogenesis, extracellular matrix remodeling, etc. Following implantation in the rat abdominal aorta model, the ex vivo endothelialized (C/S PE-EC) grafts maintained 100% patency and progressive host-driven remodeling characterized by endothelial regeneration, smooth muscle layer formation, and a shift toward a pro-healing macrophage phenotype. Importantly, the C/S PE (EC) grafts reached nearly complete endothelial coverage and functional eNOS expression within one month, suggesting the synergistic role of biomimetic matrix composition and biomechanical conditioning in accelerating vascular integration. By integrating synthetic strength, ECM bioactivity, and stem cell–derived endothelialization, this approach offers a promising pathway toward clinically translatable small-diameter vascular grafts, particularly appropriate for scheduled procedures such as Fontan surgery and hemodialysis access.

BACKGROUND Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organ systems. Lupus enteritis is a rare but potentially life-threatening gastrointestinal manifestation characterized by immune complex-mediated inflammation that may cause edema, ischemia, or intestinal perforation. Because abdominal symptoms often overlap with those of infection or drug toxicity, an accurate diagnosis requires a high index of suspicion supported by characteristic radiologic findings. CASE SUMMARY A 47-year-old female with a known history of SLE and membranous glomerulonephritis presented with acute epigastric pain. Contrast-enhanced computed tomography revealed venous-type ischemia involving the second portion of the duodenum and proximal jejunum. Despite intensive medical management, progressive ischemic changes necessitated surgical resection and duodenojejunostomy. Postoperatively, the patient developed pancreatitis and biliary obstruction at the ampulla of Vater, requiring coordinated multidisciplinary care, including rheumatologic evaluation for disease flares, radiology-guided percutaneous transhepatic biliary drainage, internal stent placement, and pathological confirmation of small-vessel vasculitis. Both complications resolved after intervention. Duodenal involvement in lupus enteritis is exceptionally rare, and cases requiring surgical intervention are even rarer. Consequently, only a few cases have been reported. CONCLUSION Prompt recognition and multidisciplinary management are essential for favorable outcomes in patients with severe lupus enteritis and duodenal involvement.

2-Deoxy-2-[¹⁸F]fluoro-d-glucose (FDG) uptake of the reticuloendothelial system on positron emission tomography/computed tomography (PET/CT) is known to be related to systemic inflammatory response to cancer cells in patients with diverse malignancies. This retrospective study aimed to investigate whether FDG uptake by the reticuloendothelial system had a prognostic value in predicting progression-free survival (PFS) and overall survival (OS) in 138 cholangiocarcinoma patients. Quantifying FDG uptake of the aorta, bone marrow (BM), liver, and spleen from staging FDG PET/CT images, we found significant correlations between the BM-to-aorta uptake ratio (BAR), spleen-to-aorta uptake ratio, and BM-to-liver uptake ratio with tumor stage and serum inflammatory markers. In the multivariate survival analysis, BAR was an independent predictor of PFS (p = 0.016; hazard ratio, 2.308) and OS (p = 0.030; hazard ratio, 2.645). Patients with stages III–IV of the disease and a high BAR exhibited low 1-year PFS (35.8%) and OS (60.2%) rates, while those with stages I–II of the disease and low BAR showed robust rates of 90.0% and 96.7%, respectively. BAR measured on staging FDG PET/CT might be a potential imaging biomarker offering insights into the systemic inflammatory response and predicting prognosis in cholangiocarcinoma. This study highlights BAR as a promising, independent predictor with potential for personalized prognostication and treatment strategies.

Visceral adiposity is known to be related to poor prognosis in patients with cholangiocarcinoma; however, the prognostic significance of the qualitative features of adipose tissue in cholangiocarcinoma has yet to be well defined. This study investigated the prognostic impact of adipose tissue imaging parameters reflecting the quantity and qualitative characteristics of subcutaneous (SAT) and visceral (VAT) adipose tissue on recurrence-free survival (RFS) and overall survival (OS) in 94 patients undergoing resection of cholangiocarcinoma. The area, mean computed tomography (CT) attenuation, and mean 2-deoxy-2-[¹⁸F]fluoro-D-glucose (FDG) uptake of SAT and VAT on positron emission tomography (PET)/CT for staging work-up were measured, and the relationship of these adipose tissue imaging parameters with clinicopathological factors and survival was assessed. TNM stage, histologic grade, lymphovascular invasion, and the size of cholangiocarcinoma showed positive correlations with adipose tissue imaging parameters. Multivariate survival analysis demonstrated that the visceral-to-subcutaneous adipose tissue area ratio (VSR) (p = 0.024; hazard ratio, 1.718) and mean FDG uptake of VAT (p = 0.033; hazard ratio, 9.781) were significant predictors for RFS, but all of the adipose tissue imaging parameters failed to show statistical significance for predicting OS. In addition to visceral adiposity, FDG uptake of VAT might be a promising prognostic parameter for predicting RFS in patients with cholangiocarcinoma.

Designing a functional and efficient blood-clotting agent is a major challenge. In this research, hemostatic scaffolds (GSp) were prepared from the superabsorbent, inter-crosslinked polymer sodium polyacrylate (Sp) bound to a natural protein gelatin (G) loaded with thrombin (Th) by a cost-effective freeze-drying method. Five compositions were grafted (GSp0.0, Gsp0.1, GSp0.2, GSp0.3, GSp0.3-Th) where the concentration of Sp varied but the ratios of G remained the same. The fundamental physical characteristics that increased the amounts of Sp with G gave synergistic effects after interacting with thrombin. Due to the presence of superabsorbent polymer (SAP) swelling capacities in GSp0.3 and GSp0.3-Th surge forward 6265% and 6948%, respectively. Pore sizes became uniform and larger (ranging ≤ 300 μm) and well-interconnected. The water-contact angle declined in GSp0.3 and GSp0.3-Th to 75.73 ± 1.097 and 75.33 ± 0.8342 degrees, respectively, thus increasing hydrophilicity. The pH difference was found to be insignificant as well. In addition, an evaluation of the scaffold in in vitro biocompatibility with the L929 cell line showed cell viability >80%, so the samples were nontoxic and produced a favorable environment for cell proliferation. The composite GSp0.3-Th revealed the lowest HR (%) (2.601%), and the in vivo blood-clotting time (s) and blood loss (gm) supported hemostasis. Overall, the results showed that a novel GSp0.3-Th scaffold can be a potential candidate as a hemostatic agent.

The present study focused on the combination of biphasic calcium phosphate (BCP) nanoparticles into the modified hyaluronic acid based injectable hydrogels for bone tissue engineering. Self-cross-linked thiolated hyaluronic acid (HA-HS) injectable hydrogels loaded with biphasic calcium phosphate (BCP) nanoparticles were prepared by disulfide cross-linking to mimic the extracellular matrix as a potential material for bone treatment. Varying concentration of HA-HS ranging between 1 and 5w/v% was tested to optimize the optimum concentration and were further modified with varying BCP concentrations for final optimization. Physico-chemical characterizations of the prepared hydrogel such as SEM, EDS, FT-IR, and XRD confirmed that the BCP has effectively loaded and distributed homogeneously in the HA-HS hydrogel. The results showed that the 3% (w/v) HA-HS hydrogel exhibits the appropriate properties for injectable hydrogel system such as gelation times, swelling rate and in vitro degradation behavior among all tested concentrations. Cell viability and cell proliferation using osteoblast cells (MC3T3-E1) demonstrated that the BCP laden modified hydrogel are biocompatible in vitro. In light of the encouraging results obtained, BCP laden HA-HS hydrogels might offer the potential to be used as injectable hydrogel in bone tissue engineering.

Yun JH, et al. Ann Surg Treat Res. 2017 Mar;92(3):143-148. https://doi.org/10.4174/astr.2017.92.3.143

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