Autogenous Group Research Articles

Tissue reaction of deproteinized bovine bone matrix grafting in ectopic site: histological study on sheep

The aim of this paper was to evaluate through histological analysis of the tissue reaction of deproteinized bovine bone matrix (DBBM) when inserted into the site of intramuscular ectopic sheep. In this study, 16 sheep received 3 groups and these were divided into 2 experimental times: Group 1-sham group, Group 2-particulate autogenous bone and Group 3-DBBM granules. All animals underwent surgical procedures for insertion of materials in an ectopic site (muscles of the lower back and after 3 and 6months postoperatively, the samples were evaluated by histological analysis. The results indicated that the Sham group showed dense collagen fibers and thin, characterizing fibrosis at 3 and 6months. In the autograft group there was a significant amount of collagen deposition and decreased inflammation at 6months postoperatively. Group of DBBM, it was noted the presence of dense connective tissue and surrounding remaining particles was observed the formation of with osteoid characteristic tissue. The DBBM demonstrated biocompatibility, osteoconductivity and small osteogenesis capacity on ectopic site.

Differential effects of coping strategies on autogenous and reactive obsessions

IntroductionObsessive thoughts can be categorized into two subtypes, autogenous obsessions and reactive obsessions. Although it has been investigated that each subtype associates with different maladaptive coping strategies, no studies have yet empirically compared the effectiveness of adaptive coping strategies on autogenous and reactive obsessions.ObjectivesIt is hypothesized that acceptance, which is a core therapeutic principle of acceptance-based cognitive therapy (ACT), is more effective on autogenous obsessions, whereas response suppression as a principle of exposure and response prevention (ERP) has a stronger effect on reactive obsessions.AimsTo compare the effectiveness of two coping strategies (acceptance and response suppression) on autogenous and reactive obsessions.MethodsA total of 164 undergraduate students completed questionnaires for obsessional thoughts and coping strategies. According to the most distressing thought, sixty subjects (n = 30 with autogenous obsession, n = 30 with reactive obsession) were randomly assigned to two groups differing in treatment conditions. Individual psychoeducation and practice were performed for four different groups (2 obsessional subtypes × 2 coping strategies).ResultsRepeated measure ANOVA demonstrated that the autogenous obsessional group showed greater distress reduction after acceptance treatment than response suppression treatment, although its effect was not statistically significant. However, the reactive obsessional group did not show the interaction effect between distress reduction and the two coping strategies.ConclusionsThe results suggest that coping strategies have differential effects on distress reduction of obsessional subtypes. Different therapeutic approaches may need to be offered to individuals with autogenous and reactive obsessions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Brain Structural Alterations in Obsessive-Compulsive Disorder Patients with Autogenous and Reactive Obsessions

Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. Although structural brain alterations have been consistently reported in OCD, their interaction with particular clinical subtypes deserves further examination. Among other approaches, a two-group classification in patients with autogenous and reactive obsessions has been proposed. The purpose of the present study was to assess, by means of a voxel-based morphometry analysis, the putative brain structural correlates of this classification scheme in OCD patients. Ninety-five OCD patients and 95 healthy controls were recruited. Patients were divided into autogenous (n = 30) and reactive (n = 65) sub-groups. A structural magnetic resonance image was acquired for each participant and pre-processed with SPM8 software to obtain a volume-modulated gray matter map. Whole-brain and voxel-wise comparisons between the study groups were then performed. In comparison to the autogenous group, reactive patients showed larger gray matter volumes in the right Rolandic operculum. When compared to healthy controls, reactive patients showed larger volumes in the putamen (bilaterally), while autogenous patients showed a smaller left anterior temporal lobe. Also in comparison to healthy controls, the right middle temporal gyrus was smaller in both patient subgroups. Our results suggest that autogenous and reactive obsessions depend on partially dissimilar neural substrates. Our findings provide some neurobiological support for this classification scheme and contribute to unraveling the neurobiological basis of clinical heterogeneity in OCD.

Volumetric Changes after Sinus Augmentation Using Blocks of Autogenous Iliac Bone or Freeze-Dried Allogeneic Bone A Non-Randomized Study

Abstract Objectives To compare volumetric bone changes after sinus augmentation for implant positioning using blocks of autogenous iliac bone or freeze-dried allogeneic bone (FDBA) from the hip. Variables were compared between the two sources and for each surgical procedure at set times (pre- and post-augmentation procedure). Patients and methods A non-randomized retrospective chart review of 7 patients who had autogenous and 7 allogeneic block grafts was carried out (1 procedure per patient). Analysis of Computer Tomographic (CT) data of maxillary sinuses, acquired with high-speed, double-detector CT scanner, was performed using dentascan software. The change between the preoperative ( T 0 ) and postoperative volume was measured at 4–6 months ( T 2 ) and 1.5 year after transplantation ( T 3 ). Annual- and overall-rates of bone change were calculated for the two sources. Results All patients were partially edentulous with a residual maxillary floor thickness in the planned implant insertion sites of 2.7 (0.5) mm and 2.8 (0.5) mm for allogeneic and autogenous procedures respectively. From identical intraoperative volume of grafts (2.25 cc at T 1 ), volumetric changes were recorded at T 2 and T 3 . The final volume of the grafts was 1.44 cc for allogeneic group and 1.78 cc for the autogenous group. Significant volumetric changes over time of transplanted grafts for both sources (23% for autograft and 18% for allograft) were found at T 2 . At 1.5-years post-operatively comparisons of volumes and rates of bone loss between sources were not statistically significant. No failure was recorded for either bone grafts or dental implants. Conclusions Short-term sinus grafting procedure for dental implant placement performed with FDBA showed an outcome close to that reported for autogenous bone. Volumetric changes were comparable between the sources. These data suggest that performing maxillary sinus augmentation with dry-preserved bone allogeneic materials in block form could be considered even when the residual floor thickness is less than 3 mm.

Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans

The present study investigated the efficacy of a biphasic calcium phosphate as a bone grafting material for maxillary sinus augmentation in humans. Half of the thirty patients selected for sinus augmentation were grafted with biphasic calcium phosphate, whereas the other half were grafted with autogenous bone chips harvested intraorally. After 9months of healing, bone cores were retrieved from implant sites for histologic and histomorphometric evaluation. The areas augmented with autogenous bone chips showed newly formed bone with a pattern very similar to that of the native area. Histomorphometry demonstrated that the amount of newly formed bone in the autogenous bone group was significantly greater than in the biphasic calcium phosphate group (P<0.05). In the biphasic calcium phosphate group, less bone formation was observed in the area further away from native bone interface than in the area closer to native bone interface (P<0.05), whereas no significant differences were observed between both areas in the autogenous group. In both groups, the implant survival rate was 100% with a minimum 1-year follow-up. The data presented in this work confirm the osteoconductive properties of biphasic calcium phosphate, as well as its use in association with maxillary sinus floor augmentation procedures with successful outcomes.

Hospital Universiti Sains Malaysia Experience in Orbital Floor Reconstruction: Autogenous Graft Versus Medpor

A normally restored orbital structure after reconstructive surgery would accelerate the return of orbital function. The aim of the present study was to compare the outcomes of 2 orbital implants: autogenous grafts and porous polyethylene (Medpor). A longitudinal study was conducted of all patients who had undergone orbital floor reconstruction using an autogenous graft or Medpor. The study participants were divided into 2 groups, and the postoperative outcomes were assessed clinically. Of the 26 patients, 14 (53.0%) had undergone surgery with an autogenous graft and 12 (46.2%) with Medpor. Postoperatively, no diplopia in the primary gaze was noted in any patient. However, down gaze and peripheral diplopia was found in 11.5% and 26.9% in the autogenous group and in 3.8% and 26.9% in the Medpor group, respectively (P = 1.24). Enophthalmos was present in 11.4% of the autogenous graft group and 15.3% of the Medpor group (P = .465). The Hess chart findings were abnormal in 11.4% of both groups (P = .062). Restriction of movement was observed in 1 patient (3.8%) from the autogenous group and 7.7% of the Medpor group (P = .574). Orbital floor reconstruction using an autogenous graft or Medpor showed comparable results.

Apical and marginal bone alterations around implants in maxillary sinus augmentation grafted with autogenous bone or bovine bone material and simultaneous or delayed dental implant positioning

A re-pneumatization phenomenon was recorded in sinuses grafted with different materials. The specific aims of this paper were to assess the dental implant survival rate and the behavior of marginal and apical bone remodeling around dental implants placed following sinus augmentation. A retrospective study was conducted on consecutive patients treated in two surgical centers. Different surgical techniques were adopted for sinus augmentation: simultaneous or delayed dental implant insertion with bovine bone-material augmentation or autologous bone grafting (chin and iliac crest). Survival rates were recorded for the overall number of implants (patients of group A). Apical and marginal bone levels (ABL and MBL, respectively) were radiographically measured, and statistical analysis was performed in implants of a subgroup of patients (group B). A total of 282 dental implants were positioned. Recorded cumulative survival rates (CSRs) were 95.6% and 100% for autogenous and bovine bone material, respectively, while CSRs at 2-year follow-up for immediate and delayed procedures were 99.3% and 96.5%. For the subgroup B, 57 sinus augmentation procedures were performed in 39 patients, with the positioning of 154 implants. Generally, the apical- and marginal-bone resorption of the bovine bone-material group was less than that of the autogenous group. The differences between the ABL values of the bovine bone-material and iliac-crest groups were statistically significant at 1 year, whereas this significance disappeared at the 2-year follow-up; tests showed that a statistical difference was recorded in the bovine bone-material group between the 1- and 2-year follow-ups. With regard to MBL comparisons between simultaneous and delayed implantation, the differences maintained their significance at the 2-year follow-up also. Differences regarding apical bone alteration between autogenous bone from the iliac crest and bovine bone material at the 1- and 2-year follow-ups, as well as in the bovine bone-material group between the 1- and 2-year follow-ups, attested to slower but more prolonged physiologic bone remodeling in the bovine-graft-material group than in the autogenous-bone group. The MBL analysis showed that remodeling in the delayed implant group demonstrated a greater resorption in the cervical portion than was seen in the simultaneous implant group.

Condyle replacement after tumor resection: comparison of individual prefabricated titanium implants and costochondral grafts

The indications for temporomandibular joint (TMJ) reconstruction are well established, but the method of reconstruction is controversial. The purpose of this retrospective study was to compare individual prefabricated condyle implants and costochondral grafts in condyle reconstruction after tumor resection. We conducted a retrospective review of a case series with 28 patients treated with costochondral grafting and 23 patients treated with individual prefabricated titanium implants. For each patient, variables included both subjective (pain and interference with eating) and objective (interincisal distance) data. Baseline patient characteristics were similar in the 2 groups; all patients were followed for a minimum of 2 years. Patients in both groups showed an improvement in symptoms. Those treated with individual prefabricated implants had greater improvement and fewer complications than those in the costochondral group; also, more patients in the autogenous group required reoperation. Individual prefabricated condyle implants are effective in reconstruction of TMJ tumor defects. These prostheses are a viable choice in the setting of tumor resection and reconstruction, with improvement of jaw function, reduction of joint pain, and esthetic improvement.

Sinus floor elevation using autogenous bone or bone substitute combined with platelet-rich plasma

Sinus augmentation is a common approach for patients with severe alveolar ridge atrophy. However, autogenous bone sometimes results in donor site complications. Bone substitutes with platelet-rich plasma (PRP) promote early bone formation with autogenous bone. Use of PRP on autogenous bone and a bovine bone substitute were investigated in this split-mouth animal study. Premolars were extracted from minipigs. Each animal received sinus augmentation using a lateral approach with simultaneous insertion of 3 implants in each site. Groups were randomized using autogenous bone alone and combined with PRP or a bovine hydroxyapatite alone in combination with PRP. Microradiographic findings in the autogenous group did not show significantly different rates by using autogenous bone alone or combined with PRP. Using the bovine hydroxyapatite as augmentation material only at 8 weeks, a nonsignificant effect in the PRP group could be seen. At all other observation periods, no significant influence was observed. No significant influence of PRP was found.

Anterior cruciate ligament reconstruction augmented with Leeds-Keio polyester mesh in rabbits

The objective of this study was to compare a nonaugmented autogenous anterior cruciate ligament (ACL) graft with an autogenous graft augmented with Leeds-Keio polyester mesh (L-K mesh) when the augmentation was fixed to bone at both ends or fixed to bone at one end. Twenty-six rabbits were divided into 3 groups (nonaugmented, augmented with one-end fixation and augmented with two-end fixation), and were evaluated 12 weeks postoperatively. The gross findings demonstrated adhesion of the proliferated infrapatellar fat pad to the reconstructed ACL in the autogenous group, but not in the augmentation groups. The microangiographic study revealed poor revascularization in the augmentation groups. Histologically, in the L-K two-end fixation group, the biological segment of the reconstructed ACL remained necrotic. The biomechanical study showed that the augmentation groups were significantly stiffer and stronger than the nonaugmented graft

Longitudinal assessment of symptom and subtype categories in obsessive–compulsive disorder

Although it has been postulated that symptom subtypes are potential predictors of treatment response, few data exist on the longitudinal course of symptom and subtype categories in obsessive-compulsive disorder (OCD). Putative subtypes of OCD have gradually gained more recognition, but as yet there is no generally accepted subtype discrimination. Subtypes, it has been suggested, could perhaps be discriminated based on autogenous versus reactive obsessions stemming from different cognitive processes. In this study, our aim was to assess whether symptom and subtype categories change over time. Using the Yale-Brown Obsessive Compulsive Symptom Checklist (Y-BOCS-SC), we assessed 109 patients who met DSM-IV criteria for OCD to establish baseline values, then reassessed 91 (83%) of the initial group after 36+/-8.2 months. Upon reassessment, we found significant changes from baseline within aggressive, contamination, religious, symmetry and miscellaneous obsessions and within checking, washing, repeating, counting and ordering compulsion categories. Sexual, hoarding, and somatic obsessions, and hoarding and miscellaneous compulsions, did not change significantly. In accordance with the relevant literature, we also assigned patients to one of three subtypes--autogenous, reactive, or mixed groups. Though some changes in subtype categories were found, no subtype shifts (e.g., autogenous to reactive or reactive to autogenous) were observed during the course of the study. Significantly more patients in the autogenous group did not meet OCD criteria at follow-up than did patients in the other groups. Our results suggest that the discrimination between these two types of obsession might be highly valid, because autogenous and reactive obsessions are quite different, both in the development and maintenance of their cognitive mechanisms, and in their outcome.

A Discrimination Based on Autogenous Versus Reactive Obsessions in Obsessive-Compulsive Disorder and Related Clinical Manifestations

Although putative subtypes of obsessive-compulsive disorder (OCD) have been gradually more recognized, there is no generally accepted subtype discrimination. It has been suggested that autogenous and reactive obsessions stem from different cognitive process. This study aimed to assess existence of gender, age at onset of illness, and comorbidity differences in OCD patients suffering from autogenous and reactive obsessions. The medical records of 177 OCD patients were evaluated retrospectively for gender, age at onset, comorbid diagnoses, and predisposing life events. Obsessions and compulsions were coded according to the Yale-Brown Obsessive-Compulsive Scale. All patients were grouped as the patients with autogenous (autogenous group [AG] n=32), reactive (reactive group [RG] n=77) and mixed obsessions (mixed group [MG] n=68). AG patients were significantly more likely to be male, compared with the RG and MG patients. They also had significantly later onset of illness. Dissociative disorders were less common among AG patients compared with the other groups. Results suggest that the discrimination between autogenous and reactive obsessions are not only based on their development and maintenance mechanism through different cognitive process but that there also clinical manifestations of this discrimination.

Effects of platelet-rich plasma on bone healing in combination with autogenous bone and bone substitutes in critical-size defects. An animal experiment.

An animal study was carried out to investigate the influence of platelet-rich plasma (PRP) on the regeneration of bony defects. Critical-size defects in the forehead region of a mini-pig were filled with randomly distributed combinations of autogenous bone, tricalcium-phosphate granules (CeraSorb), bovine spongious blocks (BioOss) and a bovine bone inducing collagenous sponge (Colloss) with and without PRP in two preparations (Cusasan, 3i). The animals were killed after 2, 4 and 12 weeks. The specimens were evaluated microradiographically and immunohistologically. Autologous bone (38 +/- 9.9%) and Colloss (52.6 +/- 4.0%) showed the highest remineralization rates at 2 weeks. The initial high expression of BMP-2 in the Colloss-group gives evidence of an early initiation of bony regeneration. At 2 weeks PRP ad modum 3i was able to enhance bone healing significantly (P=0.028) only when applied in combination with autogenous bone (62.8 +/- 1.6%). Four weeks after surgery, both PRP preparations did no longer increase bony regeneration in the autogenous groups. The osteoconductive effect of Bio-Oss (38.7 +/- 5.5%) and CeraSorb (41+/-4.9%) was remarkable as well 4 weeks after surgery. Nevertheless, the addition of PRP hardly influenced bony regeneration, ceramic degradation or cytokine expression when bone substitutes were applied. At 12 weeks, the level of reossification had adjusted similarly in all groups. PRP did not add additional benefit when xenogenic bone substitutes were used. However, a significant effect on bone regeneration was found in the autogenous group initially when PRP is added.

Superiority of Autogenous Arteriovenous Hemodialysis Access: Maintenance of Function with Fewer Secondary Interventions

The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF K/DOQI) guidelines have advocated autogenous arteriovenous fistulae as a primary procedure for hemodialysis access. This study compared the clinical outcomes between autogenous and prosthetic arteriovenous hemodialysis accesses, determining factors contributing to primary and secondary patency and function. Associated risk factors and number of interventions required to maintain secondary patency in each cohort were also assessed. A vascular database review of consecutive hemodialysis access procedures performed during a 36-month period (January 1999 to December 2001) at an academic institution was conducted. Life-table and log-rank analyses were used to analyze patency rates. Univariate and multivariate analysis was used to analyze risk factor influence on patency and function. A total of 231 upper extremity arteriovenous access procedures were performed in 209 patients during this period. One hundred autogenous accesses were created in 100 patients, 68 being forearm Brescia-Cimino arteriovenous fistulae. A total of 131 prosthetic accesses (ePTFE) grafts were also placed during this period in 109 patients. The demographic profiles of both cohorts were similar. Primary patency at 1 and 2 years was 56% (CI 45-76%) and 39% (CI 28-50%), respectively, in the autogenous group, and 36% (CI 26-45%) and 9% (CI 3-14%), respectively, in the prosthetic group. Differences in secondary patency at 1 year and 2 years were not significant (64% [CI 54-74%] and 53% [CI 42-65%] in the autogenous group vs. 65% [CI 55-73%] and 46% [CI 36-55%] in the prosthetic group). Secondary interventions were required in 87% of the prosthetic cohort (average 0.92 procedures/patient/year) and 57% of the autogenous cohort (average 0.53 procedures/patient/year). Multivariate analysis of associated risk factors demonstrated no significant effects on either primary or secondary patency in both groups. Autogenous accesses have superior primary patency and maintain equal secondary patency with significantly fewer interventions. These data strongly support the NKF K/DOQI guidelines recommending creation of autogenous access whenever possible. These outcomes can provide significant health-care cost benefits when using an algorithm favoring primary creation of autogenous access for hemodialysis.

Reconstruction of the temporomandibular joint autogenous compared with alloplastic

The aims of and indications for temporomandibular joint (TMJ) reconstruction are well-established but the method of reconstruction is controversial. We describe a retrospective, two-centre audit of 49 patients treated with costochondral grafting and 50 patients treated with alloplastic joints. The characteristics of the patients were similar in both centres and the minimum follow-up period was 2 years. For each patient a number of variables were recorded including both subjective scores (pain and interference with eating) and objective data (interincisal distance). Patients in both groups showed an improvement in symptoms but more patients required reoperation in the autogenous group.

Glutaraldehyde-tanned microvascular grafts

In this study the efficacy of preserving microvascular heterografts with glutaraldehyde tanning was investigated. These were compared with glutaraldehyde-tanned autografts. Previous studies have found that untreated autograft veins maintain a 95% patency rate, whilst untreated heterograft veins (Group 1) had a 15% patency rate at 4 weeks in this study. Autogenous glutaraldehyde-tanned rabbit carotid arterial grafts (Group 2) and glutaraldehyde-tanned human chorionic veins (Group 3) were interposed in rabbit femoral or carotid arteries. Fifty per cent and 75% patency rates were achieved respectively at 4 weeks. The low patency rate of the autogenous group suggests that the glutaraldehyde tanning technique itself is largely responsible for the low patency of glutaraldehyde-tanned human chorionic veins rather than any immunological response. Therefore if human chorionic veins are to be used as a readily available preserved microvascular graft, further investigation is required to develop another technique which will reduce antigenicity without promoting thrombosis.

Autogenous Profundaplasty

The records of 281 patients undergoing aortic grafting to 522 femoral arteries over a period of 18 years were reviewed. Fifty-four patients suffering graft limb occlusion to 71 femoral arteries requiring subsequent secondary repair were identified for detailed analysis. Occlusive disease of the profunda femoris artery was identified as the primary cause of thrombosis. Repair consisted of profunda femoris angioplasty, and transfemoral retrograde graft thrombectomy was possible in all but three instances which were managed by cross-over femoral-femoral bypass. In no instance was laparotomy and abdominal graft replacement necessary. The 30 day operative survival and graft patency were 100%. Analysis of factors that have influenced late graft patency demonstrated that the key factors were the method of profundaplasty and the association of diabetes mellitus. When autogenous profundaplasty (on-lay arterial patches, saphenous vein, or limited endarterectomy) was employed, the overall patency combining diabetics and non-diabetics was two and one-half times greater than when profundaplasty was performed with an on-lay Dacron((R)) patch. If diabetics were separated from nondiabetics in the autogenous angioplasty group, the 36 month patency for non-diabetics was 85%, and 0% for diabetics. We conclude that autogenous profundaplasty provides considerable advantage from the standpoint of long-term patency and that the diabetic patients are relatively poor candidates for secondary arterial repair of an occluded aortofemoral bypass graft.

A Clinical Comparative Study of Autogenous and Homogenous-Bone Grafts

In the past ten years, 137 autogenous and 143 merthiolate-preserved, homogenous-bone-grafting procedures have been performed. Twenty-four additional procedures were done in which a combination of autogenous and homogenous-bone grafts was used. Thus there is a total of 304 surgical procedures. There were sixteen (12 per cent) failures in the autogenous group, thirty-three (23 per cent) in the homogenous group, and five (21 per cent) in the group in which a combination of autogenous and homogenous-bone grafts were used. All failures were included regardless of the reason, and no distinction was made as to the etiology of the non-union. The incidence of failure with autogenous chips was 8 per cent. When a full-thickness autogenous-bone block was used, the incidence of failure was 17 per cent. The incidence of failure with homogenous chips was 19 per cent; when a full-thickness block graft was used the incidence was 31 per cent. A combination of autogenous and homogenous chips resulted in an 18 per cent incidence of failure. The occurrence of infection with merthiolate-preserved homogenous grafts was less than that with autogenous grafts. Bone grafts inserted in the presence of infection usually resulted in failure. No allergic reaction or sensitivity to merthiolate occurred unless one concludes that the greater number of failures from the use of merthiolate bone is on this basis.