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Charcot-Marie-Tooth Disease: A Clinico-genetic Confrontation

Posted: July 17, 2016 at 6:40 am

Dominant Demyelinating CMT1A PMP-22 17p11.2-12 (duplication/point mutations) myelination, cell growth, differentiation progressive distal muscle weakness and atrophy, mostly at lower extremities, peroneal gait, areflexia MNCV< 38 m/s, median MNCV 15-30m/s, no conduction block CMT1B MPZ/P0 1q22 adhesion proteins onset in first decade, variable degree of progressive distal muscle weakness MNCV < 20 m/s (in patients with early onset) > 38 m/s (in patients with late onset) CMT1C LITAF/SIMPLE 16p13 protein degradation typical CMT1 MNCV 1625 m/s CMT1D EGR2/Krox20 10q21-22 transcription factor upregulation of myelin genes cranial nerve involvement progressive scoliosis MNCV 942 m/s CMT1F NEFL 8q21 neurofilaments organization, axonal transport onset in early childhood, delayed motor development, severe CMT1 phenotype, similar to DSS MNCV 1538 m/s Special forms: HNPP PMP-22 17p11.2-12 deletion/point mutations) episodes of painless weakness, calf hypertrophy, asymmetrical, CNS demyelination, dystonia rarely, corticosteroid efficient in some patients normal, or mild decreasing, conduction block at pressure site, prolonged distal latencies Neuropathy with hearing impairment connexin -31 (GJB3) 1p35.1 ion channel formation predominantly sensory neuropathy, variable disease severity, asymmetrical hearing loss MNCV and SNCV mildly reduced SNAPs and CMAPs mildly decreased Hypomyelinating neuropathy without clinical symptoms ARGHEF 10 8p23 development of peripheral nerve myelination clinically asymptomatic MNCV 2742 m/s, CMAPs and SNAPs normal Dominant:Axonal CMT2A MFN2 1p33-36 GTP-ase, axonal transport of mitochondria severe, early onset, hearing loss, CNS and pyramidal tract involvement very low CMAPs and SNAPs normal or slightly reduced NCV KIF1B 1p33-36 synaptic vesicle transport CMT2B RAB7 3q13-q22, intracellular membrane traffic sensory loss, feet ulcerations distal motor weakness, hyperkeratosis Normal MNCV CMT2C unknown 12q23-q24 diaphragmal and vocal cord paresis, death normal MNCV CMT2D GARS 7p15 translation process, motor neuron integrity small hand muscles atrophy normal MNCV CMT2E NEFL 8p21 axonal transport, neurofilament organization sensory loss of all modalities MNCV 13-38 m/s CMT2F HSPB1 (HSP27) 7q11-q21 protection of the structure of cell proteins sensory loss, motor impairment of different severity, small hand muscles atrophy later in the course of disease reduced or absent CMAPs CMT2G unknown 12q12-13.3 slowly progressive walking difficulties, preserved knee jerks, absent triceps surae jerks MNCV normal or mildly reduced CMT2H/K GDAP1 8q13-21.1 mitochondrial protein expressed mostly in neurons, regulation of mitochondrial dynamics mild clinical phenotype, vocal cord paralysis, slowly progressive course MNCV slightly decreased or in intermediate range CMT 2I/J MPZ 1q22-23 deafness, Adie pupils MNCV <38 m/s, progress to reduced MNCV CMT2L HSPB8/HSP22 12q24.3 mild sensory loss, scoliosis normal MNCV Dominant:Intermediate DI-CMTA unknown 10q24.1-q25.1 CMT phenotype of moderate severity MNCV 25-45 m/s DI-CMTB dynamin 2 19q12-q13.2 vesicular traffic, endocytosis protein synthesis normal or increased tendon reflexes neutropenia DI-CMTC YARS 1p34-p35 CMT phenotype of moderate severity DI-CMTD MPZ 1q22 variable and moderate severity Dominant: X-linked CMTX1 GJB1 Xq13.1 encodes connexin32, transfer of low weight material between cells hand/thenar muscles, CNS involvement, deafness, visual impairment, white matter lesion conduction block, temporal dispersion MNCV 30-40 m/s in males, MNCV 10-37 m/s in severely affected males MNCV 3050 m/s in females, low CMAPs CMT 3A (DSS) PMP22 17p11.2-12 onset<3y,palpable nerves, ataxia, progressive weakness, severe disability, increased CSF protein content, short stature NCV <10 m/s, fibrillation, positive denervation waves CMT 3B MPZ 1q22-23 onset in infancy, hypotonia, respiratory insufficiency and early deaths occasionally MNCV < 15 m/s CMT 3C unknown 8q23-q24 Charcot joints decreased MNCV DSS-EGR EGR2 10q21-22 phenotype consistent with DSS, cranial nerve involvement, respiratory difficulties MNCV < 8 m/s CMT 3D or CMT 4F periaxin 19q13.1 q13.2 maintenance of the peripheral nerve myelin extracelular matrix signaling unusual facies, deafness very slow MNCV Recessive:demyelinating CMT 4A GDAP1 8q13-21.1 early onset, severe motor retardation, progressive scoliosis MNCV 2535 m/s CMT 4B-1 MTMR2 11q22 transcription and cell proliferation cranial nerves affection, blindness, glaucoma, severe disability MNCV 922m/s CMT 4B-2 MTMR13/SBF2 11p15 onset at 5 years, early onset glaucoma, similar to CMT4B1 phenotype MNCV 1530 m/s CMT 4C KIAA1985 5q23-33 unknown function early onset, severe motor retardation, scoliosis respiratory insufficiency MNCV 1034 m/s CMT 4D (HSMN-Lom) NDRG1 8q24.3 cell growth arrest and differentiation deafness, tongue atrophy Roma population MNCV 920 m/s CMT 4E EGR2 10q 21.1-22 17p onset presented at birth, generalized hypotonia, arthrogryposis, cranial nerves involvement MNCV< 8m/s CMT 4F periaxin 19q13.1-q13.3 maintenance of peripheral nerve myelin, extracellular matrix signaling severe DSS or CMT1 phenotype, curvilinear inclusions in nerves MNCV <15 m/s, CMAPs absent or very low CMT 4G (Russe) unknown 10q23.2 severe distal muscle weakness, prominent sensory loss, frequently in Roma population MNCV 3035 m/s CMT 4H unknown 12p11.21 delay in motor development, scoliosis MNCV < 15 m/s low amplitudes CMT 4J FIG4 6q21 phosphoinositides content vesicular trafficking early onset, coordination disorder, severe disability MNCV 27 m/s CMAPs reduced CCFDN CTDP1 18q23 regulation of proteins involved in transcription and mRNA processing congenital cataract, mental retardation, facial dysmorphism, growth retardation, chorea, tremor, rhabdomyolisis, more frequently in Roma population MNCV 1933 m/s Recessive:Axonal CMT4C1 or AR CMT 2B1 lamin A/C 1q21.2-q21.3 nuclear lamina component, gene transcription rapid evolution involvement of proximal muscles reduced CMAPs, normal MNCV CMT4C2 or AR-CMT 2C or AR CMT 2H unknown 8q21.3 brisk patellar and upper limbs reflexes, ankle reflexes absent, plantar anattainable normal or mildly reduced MNCV, reduced CMAPs amplitude CMT4C3 Or AR CMT2B2 ARC 92/ACID1 (MED 25) 19q13.3 mediator complex associated with RNA polymerase II typical CMT2 phenotype reduced CMAPs mild decrease of MNCV CMT4C4 Or AR CMT 2K GDAP1 8q13-21.1 early onset, hypotonia, kyphoscoliosis, progressive course, hoarse voice, vocal cord paralysis, respiratory insufficiency MNCV> 40 m/s, absent CMAPs Recessive-X-linked CMTX2 unknown Xq 22.2 areflexia, pes cavus, mental retardation, unaffected females decreased NCV, low CMAPs CMTX3 unknown Xq26.3-q27.1 onset 313 years, progressive muscle weakness, normal mental development low CMAPs and median MNCV 2557 m/s CMTX4 Chowchock syndrome unknown X q24-q26.1 onset in infancy, deafness, mental retardation in 60% MNCV 3356 m/s, decreased sensory NCV CMTX5 unknown Xq21.32-q24 hearing loss, optic neuropathy, females unaffected low or absent CMAPs, mild decreasing of MNCV (4351 m/s) Dominant:axonal CMT (AD) with pyramidal features (HMSN V) mitofusin 2 (MFN2) 1p36.2 mitochondrial GTP-ase regulator of mitochondrial fussion and transport ankle jerk absent, tendon jerks present or increased MNCV decreased, low SNAPs and CMAPs amplitudes CMT with optic atrophy (HMSN VI or CMT 6) MFN2 1p36.2 early onset, optic atrophy MNCV slightly decreased Dominant:distal motor Distal HMN I unknown early onset 220 years, reflexes present or increased, ankle jerks absent, distal weakness and wasting MNCV normal or mildly decreased, SNAPs mildly reduced Distal HMN II HSP22, HSP27 12q24.3, 7q11-21 development of thermotolerance onset 1520 years, rapid progression, exstensor muscle weakness MNCV normal, CMAPs normal or reduced, SNCV normal Distal HMN V (HMN 5A) GARS 7p15 protein biosynthesis, role in translation phase pronounced hand muscles wasting and weakness, spasticity on lower extremities MNCV and CMAPs, normal or mildly reduced Distal HMN V- Silver's syndrome (HMN 5B) BSCL2, seipin 11q12q14 involved in RNA transport and glycosylation pronounced hand muscles wasting and weakness, mild lower extremities spasticity, no sensory/autonomic dysfunction reduced CMAPs, normal or mild reduction of MNCV Distal HMN VII B dynactin 2p13 role in prevention of neurodegeneration adult onset, bilateral vocal cord paralysis, progressive facial weakness and atrophy of hand muscles and distal legs normal MNCV, low CMAPs distally Distal HMN VII A unknown 2q14 onset in second decade, unilateral or bilateral vocal cord paralysis, breathing difficulties, weakness and atrophy of, hands and distal legs muscles Dist. HMN ALS4 SETX 9q34 possible role in RNA processing early onset, pyramidal tract involvement MNCV normal, CMAPs reduced Recessive:distal HMN Distal HMN III unknown telomeric to IGHMBP2 11q13 infantile onset, diaphragmal hypomobility CMAPs low, MNCV normal or mildly reduced Distal HMN IV unknown 11q13 mild neuropathy of late onset in third decade CMAPs low, MNCV normal or mildly reduced Distal HMN VI (SMARD1) IGHMBP2 11q13.2-13.4 RNA processing diaphragmal paresis, IURG, infantile onset, respiratory insufficiency, death low/absent CMAPs, mild decreased MNCV Distal HMN-J unknown 9p21.1-p12 onset between 610 years, first brisk reflexes and Babinski sign followed by areflexia and absent Babinski sign MNCV normal to mildly reduced, CMAP reduced amplitudes SNAP normal Cong. distal SMA unknown 12q23-q24 antenatal onset, arthrogryposis, severe course, paraplegia, scoliosis, trunk weakness MNCV normal X-linked distal HMN unknown Xq13-q21 juvenile onset, mild distal weakness and wasting CMAP amplitudes reduced, MNCV mildly reduced, and SNCV normal HSAN:Autosomal dominant HSAN I SPTLC1 9q22.1-q22.3 sphingolipid synthesis common features of all HSAN types: arthropathy, mutilating, paronychia, ulcers of fingers, pathological fractures, prolonged QT, syncopes, convulsions decreased SNCV HSAN 1B associated with cough and gastroesophageal reflux (GER) unknown 3p22-p24 cough, hoarse voice, syncopes, retinal detachment, hearing loss, GER, rarely ulcers, sensory loss decreased SNCV HSAN:Recessive HSAN II HSN 2 12p13.33 loss of pain, touch and temperature sensation, finger ulcerations, loss of tendon reflexes, mild muscle weakness SNCV decreased, SNAPs absent HSAN III or Riley-Day syndrome IKBKAP 9q31 transcription process onset at birth, hypotonia, defect in lacrimation, thermal dysregulation, postural hypotension, prominent autonomic dysfunction, gastrooesophageal reflux, chronic lung disease, ataxia, convulsions SNCV decreased, SNAPs absent or reduced HSAN IV TRKA/NGF NTRK1 1q21-q22 NGF signaling, thermal regulation via sweating, nociceptive system development pain insensitivity, anhydrosis normal reflexes, mild mental retardation normal MNCV and CMAPs, SNAPs and SNCV mildly reduced HSAN V TRKA/NGF NGF 1q21-q22 1p13.2-11.2 NGF signaling, CNS and peripheral pain pathways development onset at birth, pain insensitivity, bone/joint fractures, episodes of hyperpyrexia, anhydrosis less pronounced than in HSAN IV, hyperkeratosis, normal mental development NCV normal HSAN with deafness and global delay unknown unknown hypotonia, areflexia, developmental delay, hearing loss, dysmorphic features, renal tubular acidosis sensory neuropathy HSAN with spastic paraplegia unknown 5q15.31-14.1 severe sensory neuropathy, trophic ulcers and mutilation, MRI spinal cord atrophy axonal sensory neuropathy, SNAPs amplitudes reduced or absent, MNCV normal or mildly reduced X-linked HSAN associated with deafness (AUNX1) unknown AUNX1 locus Xq23-27.3 progressive auditory neuropathy, decreased otoacustic emission, progressive sensory neuropathy SNAPs reduced or absent, mildly reduced sensory NCV, normal MNCV

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Charcot-Marie-Tooth Disease: A Clinico-genetic Confrontation

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The CaV1.4 Calcium Channel Is a Critical Regulator of T …

Posted: July 17, 2016 at 6:40 am

Summary

The transport of calcium ions (Ca2+) to the cytosol is essential for immunoreceptor signaling, regulating lymphocyte differentiation, activation, and effector function. Increases in cytosolic-free Ca2+ concentrations are thought to be mediated through two interconnected and complementary mechanisms: the release of endoplasmic reticulum Ca2+ stores and store-operated Ca2+ entry via plasma membrane channels. However, the identity of molecular components conducting Ca2+ currents within developing and mature Tcells is unclear. Here, we have demonstrated that the L-type voltage-dependent Ca2+ channel CaV1.4 plays a cell-intrinsic role in the function, development, and survival of naive Tcells. Plasma membrane CaV1.4 was found to be essential for modulation of intracellular Ca2+ stores and Tcell receptor (TCR)-induced rises in cytosolic-free Ca2+, impacting activation of Ras-extracellular signal-regulated kinase (ERK) and nuclear factor of activated Tcells (NFAT) pathways. Collectively, these studies revealed that CaV1.4 functions in controlling naive Tcell homeostasis and antigen-driven Tcell immune responses.

CaV1.4 is required for store-operated calcium entry by naive CD4+ and CD8+ Tcells CaV1.4 regulates TCR-induced Ras-ERK and NFAT signaling CaV1.4 modulates the survival of naive CD4+ and CD8+ Tcells Cav1.4 is critical for pathogen-specific CD4+ and CD8+ Tcell responses

Calcium (Ca2+) ions act as universal second messengers in virtually all cell types, including cells of the immune system. In lymphocytes, Ca2+ signals modulate the activation of calcineurin-nuclear factor of activated Tcells (NFAT) and Ras-Mitogen-activated protein kinases (MAPK) pathways, serving to regulate cell activation, proliferation, differentiation, and apoptosis (Oh-hora, 2009andVig and Kinet, 2009). Tcell receptor (TCR) stimulation invokes rises in cytosolic Ca2+ through the activation of phospholipase C-1 (PLC1) and the associated hydrolysis of phosphatidylinositol-3,4-bisphosphate (PIP2) into inositol-1,4,5-trisphosphate (IP3) and diacylglycerol (DAG). Subsequently, IP3 binds IP3 receptors in the endoplasmic reticulum (ER) and induces Ca2+ release from ER storesthus triggering store-operated Ca2+ entry (SOCE) from outside the cell via plasma membrane channels (Oh-hora, 2009andVig and Kinet, 2009). For Ca2+ signaling to affect Tcell fate or effector functions, sustained Ca2+ influx via plasma membrane channels is probably necessary for a number of hours, maintaining cytoplasmic Ca2+ concentrations higher than resting baseline (Oh-hora, 2009).

The identity and number of plasma membrane channels mediating sustained Ca2+ entry into Tcells is unclear (Kotturi etal., 2006). One well-characterized mechanism of entry is through Ca2+ release-activated calcium (CRAC) channels (Oh-hora, 2009). In the CRAC pathway, the Ca2+ sensor STIM1 responds to decreases in ER Ca2+ stores by associating with the CRAC channel pore subunit ORAI1 and activating SOCE. However, loss of ORAI1 in naive Tcells has been found to have minimal effects on their ability to flux Ca2+ or proliferate upon TCR stimulation (Gwack etal., 2008andVig etal., 2008). Other candidate plasma membrane Ca2+ channels operating in lymphocytes include the P2X receptor, transient receptor potential (TRP) cation channels, TRP vanilloid channels, TRP melastatin channels, and voltage-dependent Ca2+ channels (VDCC). It is unknown whether the repertoire of Ca2+ channels operating in Tcells remains constant or changes during various stages of development or differentiation.

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The CaV1.4 Calcium Channel Is a Critical Regulator of T ...

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Dr Ad Meyer | Cosmetic and Reconstructive Dentist …

Posted: July 17, 2016 at 6:40 am

Dr. Meyer has been passionately involved with the CEREC (CAD/CAM) system for the past ten years. She specializes in front crowns and veneers (smile makeovers), and full mouth rehabilitations as well as teeth whitening. She understands the high aesthetic demands of her patients very well, and can meet them with her expertise and has a highly specialized dental practice. The most modern updated equipment includes CEREC 3D computers, milling units, lasers, baking ovens and the absolute state of the art X-ray Galileos CT unit. For more info on our services follow the links below: Teeth Whitening CEREC Crowns CEREC Veneers Dental Implants Stem Cell Harvesting

Dentistry, Full Mouth Rehabilitations, Gum Surgery Cosmetic Dentistry, CEREC Crowns, CEREC Veneers, Dental Implants, Gum Surgery, Tooth Whitening, Stem Cell Harvesting, Botox Tooth Decay, Broken/missing teeth, Old silver/amalgam fillings,Antibiotic stained, Chipped or mild crooked teeth,Yellow teeth,Loss of a tooth,Loose and/or ill fitting dentures,Severe grinding,Bad breath and/or periodontal (gum) disease CAD/CAM (computer aided design/computer aided milling) system, CEREC Cosmetic Dentist, Crowns, Veneers, Dental Implants, Dentist, Tooth Whitening, Tooth decay Most procedures can be done in +/- 1 hour in the dental chair, All procedures are fully computerized, Our practice is fitted and equipped with the latest state of the art technology and equipment that is available in the world today.

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Dr Ad Meyer | Cosmetic and Reconstructive Dentist ...

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New research hints at stem cell treatments for cataracts

Posted: July 17, 2016 at 6:40 am

The first study, conducted by Osaka University Graduate School of Medicine in Japan and published Tuesday in the journal Nature, examined the use of induced pluripotent stem cells (aka iPS cells, those gathered from adult donors) as the basis for growing replacement corneas. They found that iPS cells could be coerced to grow into discs containing several types of eye tissue. These discs can be separated, their various cell types isolated and used in transplants. The Osaka University team successfully pulled corneal cells from one disc and managed to transplant them into the eyes of rabbits.

The second study, conducted by teams at UC San Diego and Sun Yat-sen University in Guangzhou, looked at whether doctors could get the body to regenerate its own corneas -- specifically in children born with cataracts. Doctors have long had issue with implanted artificial corneas becoming cloudy as the body's cells grew over them, now they want to simply do away with artificial lenses altogether. They found that lens epithelial stem/progenitor cells (LECs), did in fact, regenerate corneas if given the chance (about 3 months). After numerous animal trials, the team successfully regrew the corneas of 12 infant humans.

"This is just a change in a surgical procedure," James Funderburgh, a cell biologist at the University of Pittsburgh School of Medicine, told Nature News. "They are not putting in an artificial lens: they are just letting the lens regrow." What's more, this new technique has a complication rate of just 17 percent compared to the 92 percent rate when implanting artificial lenses.

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New research hints at stem cell treatments for cataracts

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International Society for Stem Cell Research

Posted: July 17, 2016 at 6:40 am

02 March, 2016

The ISSCR annual meeting is a cornerstone of the Society. It provides a core forum for dissemination of ground-breaking research in all areas of stem cell science and translation, with participants from academic, industry, ethics and government settings world-wide. One of the Societys objectives is to choose venues for the annual meeting that reflect its international character, as well as allowing the ISSCR to highlight the contributions of the scientific community in the host region.

26 February, 2016

The International Society for Stem Cell Research (ISSCR) is the worlds leading professional organization of stem cell scientists, representing more than 4,000 members in 45 U.S. states and 65 countries around the world. The ISSCR is opposed to recent efforts to inappropriately limit or prohibit biomedical research using fetal tissue. These proposals, if enacted, would obstruct critical biomedical research and inhibit efforts to improve human health. If enacted in the past, such limits would have delayed or prevented the development of therapies that have saved millions of lives.

26 February, 2016

Growing up, former gymnast and current University of Southern California PhD Candidate Kimberley Nicole Babos, BS always wanted to be a medical doctor, not a scientist doctor (an important distinction for a 12 year old). Find out how identifying roadblocks to efficient induced motor neuron production became the unlikely crux of her PhD thesis in this months Member Spotlight.

10 February, 2016

The International Society for Stem Cell Research (ISSCR) is excited to announce the societys 2016 award recipients, who will be formally recognized at its annual meeting, taking place 22-25 June, 2016 in San Francisco, California, U.S.

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International Society for Stem Cell Research

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Miami Stem Cell Treatment Center

Posted: July 17, 2016 at 6:40 am

The Advancement of Stem Cell Technology

At the Miami Stem Cell Treatment Center we provide consultation relating to clinical research and deployment of stem cell therapy for patients suffering from diseases that may have limited treatment options. Stem cell therapy is not for everyone but under the right circumstances and under the right conditions there may be an opportunity for stem cell therapy to be effective. But stem cell therapy is not, at present time, is not the holy grail we all would like it to be.

Our expertise involves a deep commitment and long-term understanding, knowledge and experience in clinical research and the advancement of regenerative medicine.

We firmly support respected guidance regarding stem cell therapy indicating that it should be autologous, include ONLY minimal manipulation of regenerative cells, and be consistent with homologous use.

We do NOT advise the addition of chemicals or enzymes to produce the stromal vascular fraction (SVF).

We believe that treatment protocols ought to be reviewed and approved by an IRB (Institutional Review Board) which is registered with the U.S. Department of Health, Office of Human Research Protection (OHRP) or United States F.D.A, or both.

Because we are committed to the principles and ideals of regenerative medicine, we are continuously updating, researching, and learning more on how to help patients and advance the state of the art of regenerative medicine. Accordingly we provide all patients who are interested in considering stem cell therapy an honest opinion as to the potential benefits and risks of stem cell therapy for their presenting condition.

At the Miami Stem Cell Treatment Center we will review your medical records and condition, and then consider an array of ongoing IRB-approved protocols, registered with Clnicaltrials.gov, a service of the National Institute of Health and the National Library of Congress, to provide patients with a wide variety of treatment options and considerations for medical disorders that may benefit from adult stem cell-based regenerative therapy.

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Miami Stem Cell Treatment Center

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Stem Cells Sarasota, Tampa, Venice, Bradenton – Dr. Bennett

Posted: July 17, 2016 at 6:40 am

William F. Bennett, MD Board Certified Orthopedic Surgeon Designated one of the Top Orthopedic Surgeons in Sarasota by U.S. News and World Reports, Dr. Bennett has been practicing since 1995. He was ranked a Top Doctor for Orthopedic Surgery for 2013 by Sarasota Magazine and Castle Connolly Medical.

Yes, adult stem cells, not embryonic, nor fetal are found throughout our body ranging from our own blood to fat, to bone marrow, just to name a few. These cells have the ability to differentiate into bone, cartilage, tendons and ligaments and aid in the regeneration of injured tissue and accelerate healing. Dr. Bennett uses adult bone marrow derived stem cells typically procurred from the back of the pelvis bone.

There are three (3) sources of stem cells being used in orthopedics; cells from fat, cells from blood, and cells from bone marrow.

Why do we prefer bone marrow? Bone marrows progenitor/stem cells are better suited for regenerating cartilage, ligament and tendon and can be used as a direct application (in-office-injection) or as an adjunct in surgery to aid in regeneration and healing of injured tissue. This technique is point-of-care, the cells are not manipulated and are utilized as treatment at the same time of the harvest. The harvest is from the posterior (back) portion of the pelvic bone; a very short anesthesia is required. Patients rarely complain of any discomfort following the harvest, and the marrow taken grows back!

Evidence Based Applications! There continues to be expanding indications for the use of bone marrow derived adult stem cells. We are using them for cartilage damage, arthritis, rotator cuff tears, tendon tears and hip labral injuries.

Why do we not use stem cells from fat? The harvesting of cells from fat has carried over into orthopedic applications from plastic surgery applications. While they are a great source for plastic surgery and there are large numbers of them found in fat, cells, whilst lower in number, from the bone marrow are better suited for orthopedic applications.

Improvement from stem cell Injections? Early decrease in pain may be seen as quickly as 2 weeks, but the whole event may not be optimized for 3-4 months.

How long would you estimate this treatment would be effective?

This is an evolving field; and as such, it is still considered investigational from an insurance standpoint. However, the cells will help to regenerate new tissue in the proper environment and the science suggests that the tissue may be as robust as nor mal tissue. People who have had shoulder surgery and cartilage surgery with stem cells applied recovered quicker than those with the same surgery without stem cells.

What are the advantages of doing Stem Cell Therapy as opposed to a surgical procedure?

Firstly, as opposed to surgery, the risks associated with the procedure are minimal with the greatest risk being the possibility that it doesnt work. The bone marrow is replenished, rarely do hematomas form from the aspiration site and because only one aspiration from the pelvis is performed, the risk of any bone fracture is negligible. The advantages are similar in the sense that tissue regeneration may be achieved without surgery.

Steps:

Bone marrow is aspirated. The aspirate is filtered to remove bone fragments. Using a special centrifuge with aspirate container, the cells are separated from the other main components The concentrated cells are suspended in plasma and injected with PRP.

What is Stem Cell Therapy?

Bennett Orthopedics utilizes only bone marrow aspirate concentrate with no manipulation of cells as an adjunct to treating arthritis, cartilage, tendons and rotator cuff injuries.

Below is a list of just a few articles in Medical Journals discussing the research on the benefits of using Stem Cell Therapy in orthopedic applications.

Osteochondral Lesions of the Knee: A new one step repair technique with Bone Marrow-Derived Cells. Robert Budaa, Journal Bone and Joint Surgery, 2011

-Application of Bone Marrow-Derived Mesenchymal Stem Cell in a Rotator Cuff Repair Model Lawrence V Gullotta, MD, The American ]ournal of Sports Medicine, 2009

Concentration of Bone Marrow Total Nucleated Cells by a Point-of-Care Device Provides a High Yield and Preserves Their Functional Activity Patrick C. Herman Cell Transplantation Vol.16 2008

Dr. Bennett is an esteemed, experienced Sarasota orthopedic surgeon, internationally known as an expert shoulder and knee specialist. Designated one of the Top Orthopedic Surgeons in Sarasota by U.S. News and World Reports, Dr. Bennett has been practicing since 1995. As a sportsmedicine physician, he treats all injuries, but has been a pioneer in the areas of shoulder surgery, adult stem cells, and platelet rich plasma (PRP) treatment of joints. He sees patients from various parts of the world who seek his advanced expertise in treating hip, knee, elbow, and shoulder injuries. Arthroscopic rotator cuff surgery, minimally invasive custom knee replacement, cartilage regeneration, meniscus surgery, ACL reconstruction and hip arthroscopy are common procedures performed by Dr. Bennett. You will find you have come to the right place at Bennett Orthopedics and Sportsmedicine. Regenerating the Youth in You! Call at 941-404-2703 or submit our online form.

Additional Resources and Information about Stem Cells

What is Stem Cell Therapy?

Stem Cell Treatment Prices

Adult bone marrow derived Stem Cell treatment prices- $7800- in office

Adult Autologous Hematopoietic Stem Cells/PRP- $3,000

*Adult Autologous Bone Marrow Derived Stem Cells-$7,800

*Adult Autologous Bone Marrow Derived Stem Cells- bilateral-$14,000

Stem Cells: Cost, Controversy, and Clarification

Much of the controversy surrounding stem cell treatment is the result of common misunderstandings about the source of the stem cells used. The stem cells used by Dr. Bennett to treat hip, knee, and shoulder injuries come directly from the adult patients own body. No embryonic or fetal stem cells are ever used by Dr. Bennett! Your own body is a rich source of stem cells. They are present in every tissue: bone marrow, blood, fat, heart, tendonseven brain tissue. This fact is especially important, because certain types of stem cells (synovial cell derived, bone marrow, etc,) are better suited for certain types of injuries. Bone marrow and synovial stem cells are ideal for treating orthopedic injuries, while fat stem cells are more appropriate for plastic surgery.

To a lesser extent, there is also some lingering controversy about the newness and lack of long term studies of stem cells. However, Dr. Bennett, as a pioneer in the orthopedic use of stem cells, has been performing these procedures for years, which has allowed him to track his patients results and further refine his methods. As evidence of the effectiveness of stem cell treatments continues to grow, some have suggested that joint replacement surgeries will eventually be thought of as barbaric compared to less invasive injections of ones own cells.

This is a simple injection of stem cells into the knee. Research has shown that stem cells delay cartilage deterioration.

Another controversial aspect of stem cell treatment is the concern that storing stem cells damages DNA. This is not relevant to the treatment provided by expert orthopedic surgeon Dr. William Bennett, who uses the stem cells immediately after they are extracted from your bone marrow. Your stem cells are never sent to a lab or grown offsite. They are ready and used immediately to heal your injury.

Stem cells from the bone marrow are best for orthopedic bone, cartilage, tendon, ligament repair.

Some doctors are calling platelet rich plasma (PRP) stem cells, and offering the cheaper prices normally associated with PRP. While the blood and some types of PRP do have some stem cell content, these hematologic (blood-derived) stem cells are not the best-suited for regenerating tendons, bone, cartilage, or ligaments. Other doctors may offer fat cells, which are also less than ideal for specific orthopedic uses. Dr. Bennett, the Sarasota orthopedic surgeon who was one of the first in his field to include stem cells as a major part of his practice, only uses bone marrow derived stem cells to repair shoulders, knees, and hips. So while Dr. Bennetts price may not be the cheapest, he offers the best value, since you are getting the most appropriate cells most likely result in the best outcomes.

This patron polo player won the US Open Polo championship following adult stem cell treatment for a hip condition.

You might be wondering why, since stem cells are made by your own body, Dr. Bennett charges $7,800 for stem cell treatment. Dr. Bennetts $7,800 price includes extraction of cells from your bone marrow, and also one additional PRP injection, in order to optimize your results. Other doctors may quote cheap prices, but it is important to discern how many injections are in included and any facility or other add-on fees. Dr. Bennett prefers to provide his patients with a reliable, accurate price for the entire treatment, not just pieces of it. th stem-cells-knee-cartilage-injury-jpgThis patient was treated with stem cells following a patellar tendon disruption, one year earlier.

Dr. Bennett uses stem cells alone, instead of surgery, and he sometimes uses them in combination with surgery. As an expert shoulder specialist and knee specialist, he uses his years of stem cell experience to make the best recommendation for your unique case.

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Stem Cells Sarasota, Tampa, Venice, Bradenton - Dr. Bennett

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Embryonic stem cell research: an ethical dilemma | Europe’s …

Posted: July 17, 2016 at 6:40 am

A human embryo can split into twins or triplets until about 14 days after fertilization

Egg and sperm: some people believe an embryo must be fully protected from conception onwards (Wellcome Images/Spike Walker)

Human blastocyst on the tip of a pin: embryonic stem cells can be grown from cells found in the blastocyst (Wellcome Images/Yorgos Nikas)

Some people think an embryo deserves special protection from about 14 days after fertilization

Many patients could one day benefit from embryonic stem cell research

The rules controlling embryonic stem cell research vary around the world and have been the topic of much discussion

Embryonic stem cell research poses a moral dilemma. It forces us to choose between two moral principles:

In the case of embryonic stem cell research, it is impossible to respect both moral principles.To obtain embryonic stem cells, the early embryo has to be destroyed. This means destroying a potential human life. But embryonic stem cell research could lead to the discovery of new medical treatments that would alleviate the suffering of many people. So which moral principle should have the upper hand in this situation? The answer hinges on how we view the embryo. Does it have the status of a person?

Chapter 1 of this film introduces some of the key ethical arguments. Watch this film and others on our films page.

The moral status of the embryo is a controversial and complex issue. The main viewpoints are outlined below.

1. The embryo has full moral status from fertilization onwards Either the embryo is viewed as a person whilst it is still an embryo, or it is seen as a potential person. The criteria for personhood are notoriously unclear; different people define what makes a person in different ways.

Development from a fertilized egg into to baby is a continuous process and any attempt to pinpoint when personhood begins is arbitrary. A human embryo is a human being in the embryonic stage, just as an infant is a human being in the infant stage. Although an embryo does not currently have the characteristics of a person, it will become a person and should be given the respect and dignity of a person.

An early embryo that has not yet implanted into the uterus does not have the psychological, emotional or physical properties that we associate with being a person. It therefore does not have any interests to be protected and we can use it for the benefit of patients (who ARE persons).

The embryo cannot develop into a child without being transferred to a womans uterus. It needs external help to develop. Even then, the probability that embryos used for in vitro fertilization will develop into full-term successful births is low. Something that could potentially become a person should not be treated as if it actually were a person

2. There is a cut-off point at 14 days after fertilization Some people argue that a human embryo deserves special protection from around day 14 after fertilization because:

3. The embryo has increasing status as it develops An embryo deserves some protection from the moment the sperm fertilizes the egg, and its moral status increases as it becomes more human-like.

There are several stages of development that could be given increasing moral status:

1. Implantation of the embryo into the uterus wall around six days after fertilization. 2. Appearance of the primitive streak the beginnings of the nervous system at around 14 days. 3. The phase when the baby could survive if born prematurely. 4. Birth.

If a life is lost, we tend to feel differently about it depending on the stage of the lost life. A fertilized egg before implantation in the uterus could be granted a lesser degree of respect than a human fetus or a born baby.

More than half of all fertilized eggs are lost due to natural causes. If the natural process involves such loss, then using some embryos in stem cell research should not worry us either.

We protect a persons life and interests not because they are valuable from the point of view of the universe, but because they are important to the person concerned. Whatever moral status the human embryo has for us, the life that it lives has a value to the embryo itself.

If we judge the moral status of the embryo from its age, then we are making arbitrary decisions about who is human. For example, even if we say formation of the nervous system marks the start of personhood, we still would not say a patient who has lost nerve cells in a stroke has become less human.

If we are not sure whether a fertilized egg should be considered a human being, then we should not destroy it. A hunter does not shoot if he is not sure whether his target is a deer or a man.

4. The embryo has no moral status at all An embryo is organic material with a status no different from other body parts.

Fertilized human eggs are just parts of other peoples bodies until they have developed enough to survive independently. The only respect due to blastocysts is the respect that should be shown to other peoples property. If we destroy a blastocyst before implantation into the uterus we do not harm it because it has no beliefs, desires, expectations, aims or purposes to be harmed.

By taking embryonic stem cells out of an early embryo, we prevent the embryo from developing in its normal way. This means it is prevented from becoming what it was programmed to become a human being.

Different religions view the status of the early human embryo in different ways. For example, the Roman Catholic, Orthodox and conservative Protestant Churches believe the embryo has the status of a human from conception and no embryo research should be permitted. Judaism and Islam emphasize the importance of helping others and argue that the embryo does not have full human status before 40 days, so both these religions permit some research on embryos. Other religions take other positions. You can read more about this by downloading the extended version of this factsheet below.

Extended factsheet with a fuller discussion of the issues by Kristina Hug (pdf) EuroStemCell film "Conversations: ethics, science, stem cells" EuroStemCell factsheet on ethical issues relating to the sources of embyronic stem cells EuroStemCell factsheet on the science of embryonic stem cells EuroStemCell FAQ on human embryonic stem cells and their use in research EuroStemCell summaries of regulations on stem cell research in Europe Booklet for 16+ year olds about stem cells and ethics from the BBSRC Research paper on the ethics of embryonic stem cell research by Kristina Hug

This factsheet was created by Kristina Hug and reviewed by Gran Hermern.

Images courtesy of Wellcome Images: Egg and sperm by Spike Walker; Blastocyst on pin by Yorgos Nikas; Diabetes patient injecting insulin by the Wellcome library, London.

Other images from "Conversations : ethics, science, stem cells", a film by EuroStemCell.

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Injecting the Heart With Stem Cells Helps Chest Pain – ABC …

Posted: November 5, 2015 at 4:45 am

George Reed's heart wasn't doing so well: He's 71, and after suffering a heart attack years earlier, Reed had undergone open heart surgery and was put on multiple medications. But nothing seemed to help the dizziness and chest pain he experienced daily.

"I'd get dizzy and just fall over -- sometimes twice a day. I would run my head into the concrete. I was a bloody mess," the Perry, Ohio, native says. Despite his doctor's best efforts, Reed continued to experience angina, a type of chest pain that occurs when the heart doesn't get enough oxygen-rich blood; it can be accompanied by dizziness. So when he was recommended for an experimental study that would inject his own stem cells into his damaged heart, Perry signed on. "I needed something to change," he says.

Researchers gave Reed a drug commonly used in bone marrow transplants that stimulates the marrow to make more stem cells. Then they removed some of Reed's blood, isolated the stem cells and injected them into and around the damaged areas of his heart.

"The goal was to grow new blood vessels with stem cells from the patient's own body," says Dr. Tim Henry, a co-author of the study and director of research at the Minneapolis Heart Institute Foundation.

Within a few months, Reed, along with many of the other 100 or so patients at 26 hospital centers who'd received this stem cell treatment, reported feeling better than he had in years.

"When it started kicking in, I felt like a kid. I felt good," Reed says. He wasn't passing out and falling down anymore.

For Jay Homstad, 49, who was part of the Minnesota branch of the study, he felt the changes most in his ability to walk and be active.

"My activity level increased tenfold. Before, I struggled with chest pain every day. My activity level was about as close to zero as you could get. Now I can participate ... just in life. It may sound silly, but the best part is that in the wintertime I could go out and walk with my dog along the Red River. When you're walking through snow that is waist deep, you can tell there's a difference," Homstad says.

Homstad had had about a dozen surgeries and nine stents put in before he enrolled in the study, but he still struggled with angina daily. Within a few months of the stem cell shots, he could walk farther, and his chest pain subsided and was kept at bay for nearly four years.

"These are people for whom other treatment hasn't worked. They're debilitated by their chest pain, but their other options are really limited, that's why we picked them," says Henry. If the positive results seen in this study hold up in the next phase of the study, which is set to begin enrollment in the fall, this type of cardiac stem cell injection could be added to the arsenal of weapons against angina. The upcoming phase three trial has already been approved by the Food and Drug Administration.

Shot to the Heart, Before It's too Late

While several smaller studies have suggested that injecting stem cells into damaged heart tissue might be effective, this study, in its scope and rigor, was the first of its kind. A total of 167 patients were recruited and randomly assigned to receive a lower dose of stem cells, a higher dose or a placebo. The patients didn't know who got what treatment, and neither did the doctors treating them.

When tracked for a year after the injection, patients who received the lower dose of stem cells could last longer during a treadmill exercise than those who had received the placebo, and they averaged seven fewer episodes of chest pain in a week. To put this in perspective, a popular drug to treat angina, Ranolazine, reduced chest pain by fewer than two episodes a week in clinical trials.

Although the goal of the stem cell shots was to grow new blood vessels, it's impossible to tell if these stem cells were actually growing into blood vessels or if they were just triggering some other kind of healing process in the body, Henry says. Tests in animal models, however, do suggest that new blood vessels are forming, says Dr. Marco Costa, a co-author of the study and George Reed's doctor at UH Case Medical Center in Cleveland.

For now, the only gauge of the injections is improvement in symptoms.

Despite the positive results of the study, cardiologists remain "cautiously optimistic" about stem cells as a treatment for angina.

"The number of patients is relatively small, so this trial would probably not carry much scientific weight," says Dr. Jeff Brinker, a professor of cardiology at Johns Hopkins University. The results did justify the next, larger trial, he says, which would offer more answers as to whether this treatment is actually working the way researchers suspect.

The fact that lower doses of stem cells were puzzlingly more effective than larger ones is cause for caution, says Dr. Steve Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic.

"The jury is still out for stem cell therapies to treat heart disease," says Dr. Cam Paterson, a cardiologist at the University of North Carolina at Chapel Hill.

But the results so far provide cautious hope for heart patients like George Reed and Jay Homstad.

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Department of Genetic Medicine (Research) | – | Weill …

Posted: November 5, 2015 at 2:44 am

The Department of Genetic Medicine at Weill Cornell Medicine is a highly specialized form of personalized medicine that involves the introduction of genetic material into a patients cells to fight or prevent disease. This experimental approach requires the use of information and data from an individual's genotype or specific DNA signature, to challenge a disease, select a medication or its dosage, provide a specific therapy, or initiate preventative measures specifically suited to the patient. While this technology is still in its infancy, gene therapy has been used with some success and offers the promise of regenerative cures.

As none of New York's premier healthcare networks, Weill Cornell Medicine's genetic research program includes close collaborations with fellow laboratories such as Memorial Sloan Kettering Cancer Center for stem cell projects, Weill Cornell Medical College in Qatar and Hamad Medical Corporation in Doha, Qatar and Bioinformatics and Biostatistical Genetics at Cornell-Ithaca.

Department of Genetic Medicine Services

Our translational research program includes many projects in the fields of genetic therapies and personalized medicine, and we arestudying gene therapy for a number of diseases, such as combined immuno-deficiencies, hemophilia, Parkinson's, cancer and even HIV using a number of different approaches.

Patients interested in gene therapy are invited to participate in our full range of services, including:

-diagnostic testing

-imaging

-laboratory analysis

-clinical informatics

-managed therapies

In addition, we offer genetic testing to provide options for individuals and families seeking per-emptive strategies for addressing the uncertainties surrounding inherited diseases.The Department of Genetic Medicine at Weill Cornell is a pioneer in the advancement of genetics for patients and their families. These are the strengths we draw upon as we collaborate with our integrated network of partners, including the #1 hospital in New York, New York Presbyterian, to make breakthroughs a reality for our patients.

For more information or to schedule an appointment, call us toll-free at 1-855-WCM-WCMU.

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