9%, respectively). Intraobserver reproducibility for arterial stiffness and ventriculo-arterial coupling parameters was

the highest for the beta index (+/- 3.8%), and the lowest for the second systolic peak (+/- 22.4%). Interobserver reproducibility and repeatability varied between very good for the wave speed (+/- 5.5 and +/- 4.3%), and unsatisfactory for the negative area (+/- 31.8 and +/- 38.6%). FMD had good reproducibility (intraobserver +/- 11.6%, interobserver +/- 8%, repeatability +/- 7%), whereas augmentation index had only satisfactory results (+/- 17.8, +/- 8.4, +/- 23.8%, respectively). Only some parameters of vascular function have good reproducibility and repeatability, better or similar to other ultrasound methods and, therefore, these are ready to be used in routine clinical practice.”
“Four-dimensional computed ERK inhibitor tomography (4D-CT) plays an important role in lung cancer treatment because of its capability in providing a comprehensive characterization of respiratory motion for high-precision radiation therapy. However, due to the inherent high-dose exposure associated with CT, dense sampling along superior-inferior direction is often not practical, selleck chemicals llc thus resulting in an inter-slice

thickness that is much greater than in-plane voxel resolutions. As a consequence, artifacts such as lung vessel discontinuity and partial volume effects are often observed in 4D-CT images, which may mislead dose administration in radiation therapy. In this paper, we present Selleck MK 2206 a novel patch-based technique for resolution enhancement of 4D-CT images along the superior-inferior direction. Our working premise is that anatomical information that is missing in one particular phase can be recovered from other phases. Based on this assumption, we employ a hierarchical patch-based sparse representation mechanism to enhance the superior-inferior resolution of 4D-CT by reconstructing additional intermediate CT slices. Specifically, for each spatial location on an intermediate CT slice that we intend to reconstruct, we first agglomerate a dictionary of patches from images of

all other phases in the 4D-CT. We then employ a sparse combination of patches from this dictionary, with guidance from neighboring (upper and lower) slices, to reconstruct a series of patches, which we progressively refine in a hierarchical fashion to reconstruct the final intermediate slices with significantly enhanced anatomical details. Our method was extensively evaluated using a public dataset. In all experiments, our method outperforms the conventional linear and cubic-spline interpolation methods in preserving image details and also in suppressing misleading artifacts, indicating that our proposed method can potentially be applied to better image-guided radiation therapy of lung cancer in the future.”
“Objective.

The results support the placement matching hypothesis, suggesting that individuals with more prominent decision-making deficits may particularly benefit from treatment in a residential setting and from the inclusion

of aspects of cognitive rehabilitation in their treatment programme. (C) 2011 Elsevier Ireland Ltd. All rights reserved.”
“Tumours involving the cavernous sinus may be challenging to neurosurgeons and neuro-oncologists to treat. Operation may be hazardous for lesions in this area, radical resection is seldom obtained, and other treatments are often needed. Different types of tumour occur at this location. Radiological examination may not be diagnostic so that a histopathological diagnosis is often needed before treatment can be recommended for the individual patient. If surgical resection YM155 in vivo is less feasible a biopsy will be necessary.

We describe a technique for image-guided percutaneous biopsy EPZ5676 purchase through the oval foramen ovale and its use in two patients with a cavernous sinus tumour. We also describe and highlight the importance of pre- and intraoperative CT imaging in obtaining a safe and conclusive biopsy.”
“Methanolic, chloroform and diethyl ether extracts of

leaves of Indian medicinal plant Adhatoda vasica Linn. were pharmacologically validated for its immunomodulatory properties in experimental animals. Oral administration of extracts at a dose of 400 mg/kg in adult male Wister rats significantly increased the percentage

neutrophil adhesion to nylon fibers (P<0.001). It extracts were also found to induce Delayed Type Hypersensitivity reaction by sheep erythrocytes (P<0.001). The observed results at different doses were significant when compared to control groups. These findings suggested that the extracts of this plant, A. vasica Linn positively modulates the immunity of the host.”
“Tetrafluoroethylene (TFE) and perfluoropropylvinyl ether (PPVE) were copolymerized in supercritical carbon dioxide (sc-CO2) with a perfluorodiacyl initiator bis(perfluoro-2-n-propoxypropionyl) peroxide (BPPP). The resultant copolymers with stable perfluoroalkyl selleck chemicals llc end groups were obtained, avoiding the decomposition during processing and applications. Reactivity ratios of TFE and PPVE were first reported. The rTFE and rPPVE values are about 8 and 0.08, respectively. Such parameters are significant for the modification of PTFE through copolymerization of TFE and PPVE. It is found that through increasing the reaction pressure from 8.5 to 25 MPa, while rTFE increases by 12.0%, rPPVE decreases by 9.0%, which should be ascribed to the enhancement of the polarity of CO2 under high pressures. Because the reactivity of TFE is by two orders of magnitude higher than that of PPVE; on one hand, the copolymerization rate falls rapidly with the decrease of TFE feed ratio; on the other hand, TFE content in the copolymer decreases with the reaction time.

Summary of Background Data. this website Trans-1 axiaLIF procedure is gaining in popularity for L5-S1 fusion due to the ease

of access to the sacrum through the presacral space. Normally, the midline of the sacrum at S1-S2 is relatively free from neurovascular and intra-abdominal structures, making this level a safe entry point for the axiaLIF procedure. We report a case of high rectal injury during Trans-1 axiaLIF L5-S1 procedure due to altered intra-abdominal anatomy as a result of multifactorial adhesions formation.

Methods. A 44-year-old female patient with a history of previous anterior and posterior spinal surgeries, pelvic inflammatory disease, and non-disclosed previous diverticulitis, developed a high rectal injury PF-03084014 in vivo during Trans-1 axiaLIF L5-S1 fixation.

Results. After Trans-1 axiaLIF L5-S1, the patient presented with an episode of melena

and hypogastric pain with nausea and vomiting. A computed tomography(CT) scan of the abdomen with intravenous and oral contrast showed presacral soft tissue fluid density with fat stranding and extraluminal rectal contrast and gas with some areas of soft tissue enhancement compatible with probable high rectal perforation. Patient’s symptoms gradually subsided during a period of 6 months with aid from a temporary diverting ileostomy and a course of IV antibiotics. No spine implants were removed.

Conclusion. We report a case of high rectal injury during Trans-1 axiaLIF L5-S1 fixation and strongly advice that patients who are candidates Copanlisib for this surgery and have any risk factors

for intra-abdominal adhesion formation, undergo a pelvic CT with rectal contrast before the surgery to evaluate for any signs of altered rectal-sacral anatomy.”
“Lipoprotein lipase is essential for triglyceride hydrolysis. The polymorphisms S447X in exon 9 and HindIII in intron 8 have been associated with lower triglyceride levels and lower cardiovascular risk in adult men. We examined the association of these lipoprotein lipase polymorphisms with high-density lipoprotein (HDL) and triglyceride levels in elderly men. Blood samples were obtained from 87 elderly men, 48 of whom had cardiovascular disease and 39 (controls) had no history of cardiovascular events. The lipoprotein lipase polymorphisms were analyzed by PCR-RFLP. Allele frequencies were H- = 27.9% and X = 21.5%. There were no significant differences in allele frequencies or blood lipid levels between cardiovascular disease and control groups. However, the X allele was associated with a lower triglyceride/HDL ratio, 2.30 vs 3.02 for X allele absent (P = 0.03); the H-X haplotype was associated with lower triglyceride levels compared to the H+ S haplotype (1.22 vs 1.58 mM, respectively) and a lower triglyceride/HDL ratio (2.29 vs 3.26, respectively). The X allele and H-X haplotype were associated with lower triglyceride/HDL ratios in these elderly men, independent of the history of cardiovascular events.

“
“Objective: To assess current management of monoamniotic (MA) twins by US maternal-fetal medicine providers. Methods: We conducted a mailed survey to members of the Society for Maternal-Fetal Medicine regarding fetal surveillance practices and preferred gestational age (GA) for elective delivery

with respect to MA twins. Results: Responses from 837 (43%) were received with most (83.9%) recommending elective admission for inpatient monitoring, 53.5% favoring 26-28 weeks as earliest GA for admission and 75% performing intermittent fetal monitoring (of these 81% monitored 2-3 times/day). Respondents in practice less than 10 years were less likely to use outpatient management (p < 0.05). Median GA for elective delivery was 34 weeks but was higher for those who favored outpatient management, admitted Selleck Fer-1 >28 weeks, and were private practitioners (p < 0.05). Conclusions: Despite a paucity of evidence, most practitioners admit MA to perform daily intermittent fetal monitoring and deliver at 34 weeks. Antenatal management protocols may also influence timing of delivery. Due to their rarity, a national registry may be a better tool to analyze the outcomes of these pregnancies.”
“Paclitaxel Inj. [NK] (test;

paclitaxel, CAS 33069-62-4) is a generic version of the drug from the originator (reference). Both drugs contain the same active ingredient and showed identical pharmacokinetics in patients in the previous study; however, these two drugs may have different safety profiles because they contain different inactive ingredients. Thus, in this study, peripheral neurotoxicity, NU7441 one of the dose-limiting toxicities of the reference, was compared between the test and the reference in rats electrophysiologically and histopathologically. In a nerve conduction study, the amplitude of the caudal sensory

nerve action potential decreased significantly after either the test or the reference administration, compared with the amplitude after saline administration, but no significant differences were observed between the two drugs. Histopathologically, apparent degeneration of the myelinated fibers in the sciatic and the sural nerves was seen after either the test or the reference PFTα injection, compared with after saline injection, but no apparent differences were observed between the two formulations. These results suggest that no significant difference in peripheral neurotoxicity exists between the test and the reference in rats.”
“Objective: The authors of this paper present the results of laser treatment in twin-to-twin transfusion syndrome. Methods: Laser photocoagulation of communicating vessels was performed on 91 patients from April 2005 to June 2010, at the Medical University of Gdansk (Poland). Results of treatment were analyzed. Results: The following results were achieved: at least one survival at delivery in 71 patients (83.5%), two survivors in 49 women (57.6%), and an overall survival rate of 70.6%.

Practicing urologists do not have the time to keep up to date with the continuous incoming literature

and CPGs are a great tool to give the highest quality of care to our patients.”
“A fundamentally new approach was developed to designing pyrrole and dihydropyridine rings from available allenes and isothiocyanates involving a single preparative stage. Applying the reaction of lithiated alkoxyallenes with aliphatic isothiocyanates we have synthesized previously unknown 1-alkyl(cycloalkyl) pyrroles and 2,3-dihydropyridines with rare alkoxy- and alkylsulfanyl MAPK inhibitor substituents. It was proved that the five- and six-membered azaheterocycles formed as a result of competing reactions of direct intramolecular

cyclization of S-alkylated adducts of lithiated alkoxyallenes with isothiocyanates (1-aza-1,3,4-trienes) into pyrroles and of [1,5]-sigmatropic rearrangement into conjugated 2-aza-1,3,5-trienes with subsequent closure into dihydropyridine ring (through 6 pi-electrocyclization).”
“In wheat, monocarpic senescence is a tightly BAY 80-6946 regulated process during which nitrogen (N) and micronutrients stored pre-anthesis are remobilized from vegetative tissues to the developing grains. Recently, a close connection between senescence and remobilization was shown through the map-based cloning of the GPC (grain protein content) selleck chemical gene in wheat. GPC-B1 encodes a NAC transcription factor associated with earlier senescence and increased grain protein, iron and zinc content, and is deleted or non-functional in most commercial wheat varieties. In the current research, we identified ‘loss of function’

ethyl methanesulfonate mutants for the two GPC-B1 homoeologous genes; GPC-A1 and GPC-D1, in a hexaploid wheat mutant population. The single gpc-a1 and gpc-d1 mutants, the double gpc-1 mutant and control lines were grown under field conditions at four locations and were characterized for senescence, GPC, micronutrients and yield parameters. Our results show a significant delay in senescence in both the gpc-a1 and gpc-d1 single mutants and an even stronger effect in the gpc-1 double mutant in all the environments tested in this study. The accumulation of total N in the developing grains showed a similar increase in the control and gpc-1 plants until 25 days after anthesis (DAA) but at 41 and 60 DAA the control plants had higher grain N content than the gpc-1 mutants. At maturity, GPC in all mutants was significantly lower than in control plants while grain weight was unaffected. These results demonstrate that the GPC-A1 and GPC-D1 genes have a redundant function and play a major role in the regulation of monocarpic senescence and nutrient remobilization in wheat.

Protein analysis via SDS-PAGE and identification of Tandem MS/MS afterwards showed that outer membrane protein (Omp) primarily deals with decolorization as a channeling regulation. Moreover, molecular modeling and bioinformatics data also provided OSI-906 clinical trial detailed evidences to confirm the biological significance of Omp.”
“The beta-thalassemias are characterized by a quantitative deficiency of beta-globin chains under-laid by a striking heterogeneity of molecular defects. Although most of the molecular lesions involve the structural beta gene directly, some down-regulate the gene through distal cis effects, and rare trans-acting mutations have also been identified. Most beta-thalassemias

are inherited in a Mendelian recessive fashion but there is a subgroup of beta-thalassemia Nepicastat clinical trial alleles that behave as dominant negatives. Unraveling the molecular

basis of beta-thalassemia has provided a paradigm for understanding of much of human genetics.”
“Polycystic ovary syndrome (PCOS) presents with a range of clinical complications including hyperandrogenism, polycystic ovaries, chronic oligo/anovulation, infertility, and metabolic alterations related to insulin resistance. Because the mechanism by which this disorder develops is poorly understood, information from experimental models of human disease phenotypes may help to define the mechanisms for the initiation and development of PCOS-related pathological events. The establishment of animal models compatible with human PCOS is challenging, and applying the lessons learned from these models to human PCOS is often complicated. In this mini-review we provide examples of currently available genetic mouse models, their ovarian phenotypes,

and their possible relationship to different aspects of human PCOS. Because of the practical and ethical limitations of studying PCOS-related events in humans, our understanding of the mechanisms that contribute to the etiology of human PCOS may be enhanced through further study of these transgenic and knockout mouse models.”
“Ulcerated diabetic foot is a complex problem. Ischaemia, neuropathy and infection are the three pathological components that lead to diabetic foot complications, and they frequently occur SB525334 research buy together as an aetiologic triad. Neuropathy and ischaemia are the initiating factors, most often together as neuroischaemia, whereas infection is mostly a consequence. The role of peripheral arterial disease in diabetic foot has long been underestimated as typical ischaemic symptoms are less frequent in diabetics with ischaemia than in non-diabetics. Furthermore, the healing of a neuroischaemic ulcer is hampered by microvascular dysfunction. Therefore, the threshold for revascularising neuroischaemic ulcers should be lower than that for purely ischaemic ulcers. Previous guidelines have largely ignored these specific demands related to ulcerated neuroischaemic diabetic feet.

Double positivity for both proteins was identified in 44 cases (75%). Ultrastructurally, vacuolar structures were seen in the cytoplasm of basal cells and upper dermis in all

cases examined. We observed elimination processes of damaged basal keratinocytes, which were probably produced by ultraviolet (UV) irradiation, into the papillary dermis. The segregated damaged cell bodies containing melanin granules seemed to be phagocytosed by poorly immunostimulatory selleck inhibitor macrophages labeled immunohistochemically by CD163 and factor X IIIa, contributing to prolonged pigmentation of SL. In addition, repeated basal keratinocyte damages may be in association with altered CK and p63 expression patterns in the constituent cells of SL.”
“Nyctanthes arbortristis Linn. (Oleaceae) is one of the well known medicinal plants. It is commonly known as ‘Night Jasmine’. As traditionally the plant is used in the treatment of asthma and cough it was our objective to study its antiasthmatic potential

using suitable models. Various extracts of the plant were screened for antihistaminic selleckchem activity by studying the effect of the extracts on clonidine and haloperidol-induced catalepsy in mice. Antiallergic effect was studied by checking effect of the extracts on milk-induced leukocytosis and eosinophilia. Mast cell stabilization by the extracts was studied in mice. Results showed that petroleum ether extract had better antihistaminic, antiallergic and mast cell stabilization property than other extracts. beta-sitosterol was identified from the petroleum ether extract having antiasthmatic activity, so we can say that the antiasthmatic activity of N. arbortristis leaves is may be due to presence of beta-sitosterol.”
“Background: Scientific evidence is mounting for an association between traumatic brain injury and enhanced osteogenesis. The aim of this study was to correlate the in vitro osteoinductive potential of serum with the features of fracture-healing and the extent of brain damage Selleck Erastin in patients with severe traumatic brain injury and bone fracture.

Methods:

Patients with a long-bone fracture and a traumatic brain injury (seventeen patients) or without a brain injury (twenty-four patients) were recruited. The Glasgow Coma Scale score was determined on admission. Radiographs of the fracture were made before surgery, at six weeks, and at three, six, and twelve months after surgery. The time to union was estimated clinically and radiographically, and the callus ratio to, shaft diameter was calculated. Serum samples were collected at six, twenty-four, seventy-two, and 168 hours after injury, and their osteogenic potential was determined by measurement of the in vitro proliferation rate of the human fetal osteoblastic cell line hFOB1.19.

Results: Patients with a traumatic brain injury had a twofold shorter time to union (p = 0.01), a 37% to 50% increased callus ratio (p < 0.01), and their sera induced a higher proliferation rate in hFOB cells (p < 0.05).

Postoperative complications, length of hospital stay, and neurologic status were recorded. For this report, perioperative data (inclusive of outcomes through the 6-week postoperative clinic visit) were evaluated.

Results. In all, 107 patients (mean age, 68 years; range, 45-87) were treated

with XLIF; 28% had at least 1 comorbidity. A mean of 4.4 levels (range, 1-9) were treated per patient. Supplemental pedicle screw fixation was used in 75.7% of patients, 5.6% had lateral fixation, and 18.7% had stand-alone XLIF. Mean operative time and blood loss were 178 minutes (58 minutes/level) and 50 to 100 mL. Mean hospital stay was 2.9 days (unstaged), 8.1 day (staged, 16.5%), 3.8 days overall. Five patients LM-1149 (4.7%) received a transfusion, 3 (2.8%) required intensive care unit admission, and 1 (0.9%) required rehabilitation services. Major complications occurred in 13 patients (12.1%): 2 (1.9%) medical, 12 (11.2%) surgical. Of procedures that involved only less invasive techniques (XLIF stand-alone or with percutaneous instrumentation), 9.0% had one or more major complications. In those with supplemental open posterior instrumentation, 20.7% had one or more major complication. Early reoperations (3) (all for deep wound infections) were associated with open posterior instrumentation procedures.

Conclusion. The morbidity in adult scoliosis

surgery GSI-IX clinical trial is minimized with less invasive techniques. The rate of major complications in this study (12.1%) compares favorably to that reported from other studies of surgery for degenerative deformity.”
“Virtually all eukaryotic alpha-tubulins harbour a C-terminal tyrosine that can be reversibly removed and religated, catalysed by a specific tubulin-tyrosine carboxypeptidase (TTC) and a specific tubulin-tyrosine ligase (TTL), respectively. The biological function

of this post-translational modification has remained enigmatic. 3-nitro-L-tyrosine this website (nitrotyrosine, NO(2)Tyr), can be incorporated into detyrosinated alpha-tubulin instead of tyrosine, producing irreversibly nitrotyrosinated alpha-tubulin. To gain insight into the possible function of detyrosination, the effect of NO(2)Tyr has been assessed in two plant model organisms (rice and tobacco). NO(2)Tyr causes a specific, sensitive, and dose-dependent inhibition of cell division that becomes detectable from 1 h after treatment and which is not observed with non-nitrosylated tyrosine. These effects are most pronounced in cycling tobacco BY-2 cells, where the inhibition of cell division is accompanied by a stimulation of cell length, and a misorientation of cross walls. NO(2)Tyr reduces the abundance of the detyrosinated form of alpha-tubulin whereas the tyrosinated alpha-tubulin is not affected. These findings are discussed with respect to a model where NO(2)Tyr is accepted as substrate by TTL and subsequently blocks TTC activity.

01). Interventions resulting in delivery were more necessary in the first stage of labor than in the second stage of labor in cases of levels 3 and more. Conclusions: Five-tier system for FHR tracing interpretation proposed by JSOG intercorrelates with the fetal acid-base balance well. Categorization of FHR tracings by uniform diagnostic criteria will be useful R788 clinical trial to standardize therapeutic strategy by sharing common perception among obstetrical

staff.”
“Background: Advances in technology have made prehospital ultrasound (US) examination available. Whether US in the prehospital setting can lead to improvement in clinical outcomes is yet unclear.

Objective: The aim of this systematic review was to assess whether prehospital US improves clinical outcomes for non-trauma patients.

Method: We conducted a systematic review on non-trauma patients who had an US examination performed in the prehospital setting. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the ISI Web of Science and the references of the included studies for additional relevant studies. We then performed a risk of bias analysis and descriptive data analysis.

Results: We identified 1707 unique citations and included ten studies with a total of 1068 patients undergoing prehospital US examination. Included publications ranged from case series https://www.selleckchem.com/products/lazertinib-yh25448-gns-1480.html to non-randomized, descriptive studies, and all showed a high risk of bias. The large heterogeneity between the different studies made further statistical analysis impossible.

Conclusion: There are currently no randomized, controlled studies on the use of US for non-trauma patients in the prehospital setting. The included S63845 research buy studies were of large heterogeneity and all showed a high risk of bias. We were thus unable to assess the effect of prehospital US on clinical outcomes. However, consistent reports suggested that US may improve patient management with respect to diagnosis, treatment, and hospital referral. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“The purpose of this study was to evaluate the impact of human epidermal growth

factor receptor 2 (HER2) status and trastuzumab treatment on the prognosis of patients with advanced gastric cancer (AGC).

We retrospectively analyzed 364 AGC patients who received systemic chemotherapy. To evaluate the impact of trastuzumab exposure during any type of chemotherapy, our analysis used time-varying covariates to avoid a possible lead-time bias.

Among the 364 patients, 58 (15.9 %) were HER2-positive. The median overall survival of the HER2-positive patients treated with trastuzumab (n = 43) was significantly longer than that of the HER2-negative patients [n = 306; 24.7 vs. 13.9 months, with an adjusted hazard ratio (HR) of 0.58; 95 % confidence interval (CI), 0.36-0.95; P = 0.03]. Notably, 22 patients continued with trastuzumab beyond the date of progression.

Targeting these mediators is a promising area of drug discovery.”
“Research regarding the potency and potential of the fracture hematoma has begun to receive increasing attention. However, currently there is a paucity of relevant literature on the capability and composition of the fracture hematoma. This review briefly summarizes the regenerative fracture healing process and the close interplay between the skeletal and immune systems. The role of immune cells in wound healing is also discussed to clarify their involvement in immunological processes during regeneration. We attempt to

describe the current state of knowledge regarding the fracture hematoma as the initial stage of the regenerative process of fracture healing. The review discusses how a better understanding of immune reactions in the hematoma CBL0137 mw may have implications for bone tissue engineering strategies. We conclude the review by emphasizing how additional investigations of the initial phase of healing will allow us to better differentiate between deleterious and beneficial aspects of inflammation, thereby facilitating improved fracture treatment strategies.”
“Purpose of review

Pulmonary fibrosis is a devastating disease that JNK signaling pathway inhibitor affects millions of people worldwide. Among the most common

forms of lung fibrosis are idiopathic pulmonary fibrosis (IPF) and scleroderma-related interstitial lung disease (SSc-ILD). Despite a wealth of literature regarding each of these diseases, studies that directly compare IPF and SSc-ILD are rare.

Recent findings

This review compares the salient features of IPF and SSc-ILD. Clinical presentation and

demographics will be presented, along with the newly released radiographic and pathologic criteria for IPF. Evolving concepts of pathogenesis including the role of structural cell injury, the pathogenic role of macrophages and lymphocytes, and the origin of fibroblasts are described. We conclude with new developments in the search for predictive biomarkers of disease progression, such as markers of epithelial injury, lymphocyte subsets, and circulating fibrocytes, will Buparlisib PI3K/Akt/mTOR inhibitor be presented. We conclude with a discussion of the results of recent clinical trials.

Summary

It is found that despite differences in clinical presentation and response to treatment, similarities are noted in proposed pathogenesis and putative biomarkers. It is hoped that this information will lead to studies aimed at understanding the factors driving these difficult to treat and often deadly diseases.”
“The ability of bone-marrow-derived mesenchymal stem cells (MSCs) and adipose-derived stem cells (ASCs) to undergo chondrogenic differentiation has been studied extensively, and it has been suggested that the chondrogenic potential of these stem cells differ from each other. Here, we provide a comprehensive review and analysis of the various growth factor induction agents for MSC and ASC three-dimensional in vitro chondrogenic differentiation.