Endothelial Keratoplasty Without Stripping Descemet Membrane

Cornea. Sep, 2011  |  Pubmed ID: 21775889

Adult Mesenchymal Stem Cells and Cell Surface Characterization - a Systematic Review of the Literature

The Open Orthopaedics Journal. 2011  |  Pubmed ID: 21966340

Human adult mesenchymal stem cells (MSCs) were first identified by Friedenstein et al. when observing a group of cells that developed into fibroblastic colony forming cells (CFU-F). Ever since, the therapeutic uses and clinical applications of these cells have increased research and interest in this field. MSCs have the potential to be used in tissue engineering, gene therapy, transplants and tissue injuries. However, identifying these cells can be a challenge. Moreover, there are no articles bringing together and summarizing the cell surface markers of MSCs in adults. The purpose of this study is to summarize all the available information about the cell surface characterization of adult human MSCs by identifying and evaluating all the published literature in this field. We have found that the most commonly reported positive markers are CD105, CD90, CD44, CD73, CD29, CD13, CD34, CD146, CD106, CD54 and CD166. The most frequently reported negative markers are CD34, CD14, CD45, CD11b, CD49d, CD106, CD10 and CD31. A number of other cell surface markers including STRO-1, SH2, SH3, SH4, HLA-A, HLA-B, HLA-C, HLA-DR, HLA-I, DP, EMA, DQ (MHC Class II), CDIO5, Oct 4, Oct 4A, Nanog, Sox-2, TERT, Stat-3, fibroblast surface antigen, smooth muscle alpha-actin, vimentin, integrin subunits alpha4, alpha5, beta1, integrins alphavbeta3 and alphavbeta5 and ICAM-1 have also been reported. Nevertheless, there is great discrepancy and inconsistency concerning the information available on the cell surface profile of adult MSCs and we suggest that further research is needed in this field to overcome the problem.

Giant Splenic Artery Aneurysm: Case Report

ISRN Surgery. 2011  |  Pubmed ID: 22084756

Splenic artery aneurysm is the third most common location of intra-abdominal aneurysms. Giant splenic artery aneurysm is rarely seen and is at a high risk of rupture. Location and size of the splenic artery aneurysm determine the likelihood of rupture. A case of giant splenic artery aneurysm in a 35-year-old woman is reported. She presented with upper gastrointestinal bleeding. She had splenomegaly and extrahepatic hepatic portal hypertension. Angiography confirmed a giant splenic artery aneurysm measuring 8 × 10 centimeters, located in middle and distal two-thirds of the splenic artery. Surgical treatment in the form of in toto excision of aneurysm with splenectomy and devascularization was performed.

Surface Plasmon Near-field Resonance Characteristics of Silver Shell Nanocylinders Arranged in Triangular Geometry

Applied Optics. Nov, 2011  |  Pubmed ID: 22108888

The optical near-field surface plasmon effects of a triangular system of silver nanoshell cylinders are numerically studied using the two-dimensional finite difference time domain method. The dependence of interparticle distance, shell thickness of the cylinder, dielectric constant of shell core as well as embedding medium, and orientation of the optical source plane on the plasmonic resonances of the nanocylinder shells is studied. The plasmonic resonances are found to have strong dependence on the interparticle distance. As the size of the particle is increased, the field intensity peak shows a redshift. The resonance condition varies with the dielectric constant of the environment as well as the core. In addition, the orientation of the incident source plane has a significant role in the near-field intensity distribution. Since the near-field intensity has the same trend as that of the scattering cross section, the results can be used in the design of various applications like sensing, antennas, and waveguides.

Intracardiac Left Atrial Tuberculoma in an Eleven-month-old Infant: Case Report

BMC Infectious Diseases. 2011  |  Pubmed ID: 22208878

ABSTRACT:

Successful Embolization of a Suprascapular Artery Aneurysm

Annals of Vascular Surgery. May, 2011  |  Pubmed ID: 21620668

A 45-year-old woman was referred to our service because 9 months earlier she had developed a pulsating mass on the right supraclavicular fossa and torticollis. Ultrasounds and computed tomographic arteriography showed the presence of a subclavian collateral artery aneurysm with a diameter of 21 mm. On selective arteriography, an aneurysm of a suprascapular artery arising directly from the right subclavian artery was reported. The presence of thoracic outlet syndrome was excluded. The aneurysm was successfully treated with ethylene-vinyl alcohol polymer, a liquid embolic agent. The patient was discharged on postoperative day 1 in good general condition. After 12 months, control ultrasounds confirmed the complete thrombosis of the aneurysm sac.

Prevalence of Hypertension, Obesity, Diabetes, and Metabolic Syndrome in Nepal

International Journal of Hypertension. 2011  |  Pubmed ID: 21629873

Background. This study was carried out to establish the prevalence of cardiovascular risks such as hypertension, obesity, and diabetes in Eastern Nepal. This study also establishes the prevalence of metabolic syndrome (MS) and its relationships to these cardiovascular risk factors and lifestyle. Methods. 14,425 subjects aged 20-100 (mean 41.4 ± 15.1) were screened with a physical examination and blood tests. Both the International Diabetic Federation (IDF) and National Cholesterol Education Programme's (NCEP) definitions for MS were used and compared. Results. 34% of the participants had hypertension, and 6.3% were diabetic. 28% were overweight, and 32% were obese. 22.5% of the participants had metabolic syndrome based on IDF criteria and 20.7% according to the NCEP definition. Prevalence was higher in the less educated, people working at home, and females. There was no significant correlation between the participants' lifestyle factors and the prevalence of MS. Conclusion. The high incidence of dyslipidemia and abdominal obesity could be the major contributors to MS in Nepal. Education also appears to be related to the prevalence of MS. This study confirms the need to initiate appropriate treatment options for a condition which is highly prevalent in Eastern Nepal.

Assessing Candidacy for Bilateral Cochlear Implants: A Survey of Practices in the United States and Canada

Cochlear Implants International. May, 2011  |  Pubmed ID: 22333494

OBJECTIVES: There are currently no agreed-upon criteria to establish candidacy for bilateral cochlear implants (CIs). This study categorized practice patterns for establishing bilateral CI candidacy. METHODS: A postal survey was sent to all practices performing CIs in the United States and Canada. The survey queried centers regarding candidacy criteria for bilateral implantation, testing parameters, definition of ????best aided condition????, use of testing in noise, localization, and quality-of-life questionnaires. The survey was resent to non-responding centers 4 weeks after the initial mailing. RESULTS: The overall response rate was 40%. ????Best aided condition???? (70%) and hearing in noise (52%) were used to establish bilateral candidacy, while 45% of centers offered bilateral implants to all candidates. The majority of respondents defined ????best aided???? as hearing aids only (57% non-exclusive) or CI and hearing aid together (57%). Only 25% considered a CI alone as best aided. Nearly 5% considered no aiding to be the best aided. Sound localization was used by 8% of respondents for candidacy assessment. Reimbursement affected candidacy decision for 45%. There was variability in stimulus levels (60, 50, 45, and 55????dB), signal-to-noise ratios, and speaker orientations used. DISCUSSION: There are no consistent criteria to assess patients for bilateral CIs. This practice variation makes comparing outcomes across centers challenging and leaves open the possibility of having external standards imposed by regulators or payors. Standardization of candidacy assessment is necessary to develop best practices for bilateral cochlear implantation both to optimize patient outcomes and to ensure the continuity of coverage for these services.

Assessment of Intracochlear Trauma Caused by the Insertion of a New Straight Research Array

Cochlear Implants International. Jun, 2011  |  Pubmed ID: 22333934

OBJECTIVE: To assess the degree of intracochlear trauma using the Cochlear™ Straight Research Array (SRA). This electrode has recently been released by Cochlear™ on the CI422 implant. BACKGROUND: Electroacoustic stimulation (EAS) enables recipients to benefit from cochlear implantation while retaining their natural low-frequency hearing. A disadvantage of short EAS electrodes is that short electrodes provide limited low-frequency stimulation. Thus, loss of the residual hearing may require reimplantation with a longer electrode. In order to overcome this problem, the slim diameter SRA with increased length (20-25 mm) has been designed to provide a deeper, yet non-traumatic insertion. METHODS: Two insertion studies into temporal bones were undertaken. The first involved dissection of the cochlea to gain a view into the scala vestibuli and insertion of the SRA and control electrodes with a microactuator for a surgeon-independent yet controlled insertion. High-speed photography was used to record data. The second study involved a high-resolution X-ray microcomputed tomography (microCT) study to assess electrode placement and tissue preservation in surgeon-implanted bones. RESULTS: The SRA had a smooth insertion trajectory. The average angular insertion depth was 383° when inserted until resistance was encountered, and 355° if inserted to a predetermined mark for EAS use. In addition, microCT data showed that this caused no significant trauma or distortion of the basilar membrane up to 20 mms depth. CONCLUSION: Temporal bone studies show that the SRA appears to cause no intracochlear trauma if used as an EAS electrode up to 20 mm depth of insertion.

Tobacco Addiction and The Risk of Upper Aerodigestive Tract Cancer in A Multicenter Case-Control Study

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337537

BACKGROUND: While previous studies on tobacco and alcohol and the risk of upper aerodigestive tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and/or alcohol, studies on addiction to tobacco itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is a risk factor for UADT SCC risk in the multicenter case-control study (ARCAGE) in Western Europe independent of tobacco smoking or alcohol drinking intensity or duration.METHODS: The analyses included 1,905 ever smoking UADT SCC cases (871 oral cavity/oropharynx, 814 hypopharynx/larynx, 127 esophagus, and 93 overlapping oral cavity/pharynx) and 1,489 ever smoking controls. The addiction variables included first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden, and cigarettes per day. Odds ratios (OR) and 95% confidence intervals (95% CI) for UADT cancers with addiction variables were estimated with unconditional logistic regression, adjusting for center, age, sex, education level, alcohol consumption, and tobacco smoking.RESULTS: Among current smokers, 76.47% of cases were categorized in the highest addiction level, whereas 54.69% of controls were in that category. The participants who smoked their first cigarette within 5 minutes of waking up were two times more likely to develop UADT SCC (OR = 2.22, 95% CI 1.57-3.15) than those who smoked 60 minutes after waking up. A higher modified Fagerstram score, reflecting greater tobacco addiction, was associated with an increased risk of UADT SCC among current smokers, but not among former smokers.CONCLUSION: We observed that time to first cigarette after waking up was associated with UADT SCC risk, regardless of heavy smoking or alcohol drinking behaviors. These results are consistent with residual effect of smoking that was not captured by the questionnaire responses alone. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Benefits and Harms of Screening Mammography Frequency by Age and Comorbidity Score

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337538

BACKGROUND: There is uncertainty about the appropriate use of screening mammography in older women. We compared the benefits and harms of screening mammography frequency according to age and comorbidity scores. METHODS: We conducted analyses within a prospective cohort study of four mammography registries in the Breast Cancer Surveillance Consortium that had mammography data linked to Medicare claims information. Participants included 137,949 women aged 66-89 years without breast cancer and 2,993 women with breast cancer. We estimated odds of advanced (IIb, III, IV) stage, large tumor size (>20 millimeters), and estrogen receptor (ER) negative tumors and cumulative probability of false-positive mammography after 10 years of screening by mammography frequency, age and comorbidity score as determined by the Charlson Comorbidity Index. RESULTS: Mammography biennially vs. annually for women aged 66-89 years does not increase risk of tumors with unfavorable characteristics regardless of women's comorbidity score. Cumulative probability of a false-positive result for annual and biennial screening of women aged 66-89 years with a comorbidity score of ≥1 was 48 (46.1, 49.9) and 29 (28.1, 29.9) respectively. False-positives were more common among annual screeners than among those screened biennially irrespective of women's comorbidity score. CONCLUSION: Mammography annually vs. biennially does not have added benefit for women aged 66-89 years, even among those in good overall health as reflected by the lack of comorbidity. Risk of false-positive mammography is much higher with annual mammography.

Epidemiological Risk Factors Associated with Inflammatory Breast Cancer Triple Negative Subtype

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337546

BACKGROUND: Inflammatory breast cancer (IBC) is rare and accounts for ∼1% of all invasive breast cancers. The 5-year survival rates are significantly lower than for other types of breast cancer, highlighting the significance of cancer prevention in IBC. A disproportionately higher percentage of IBC patients have triple-negative breast cancer (TNBC; ER(-), PR(-) and Her2(-)) than patients with non-IBC. TNBCs are thought to arise from normal breast stem cells. Our preliminary data indicates that normal breast stem cells are enriched in adjacent normal tissues of patients with TN IBC. We hypothesize that parity and breastfeeding, risk factors that influence the normal stem cell compartment in the breast, will differ between TN IBC and non-TN IBC subtypes.METHODS: We identified 144 patients diagnosed with IBC in 1991-2011 at MD Anderson. Breast cancer risk factors including parity and breast-feeding were compared between patients with TN and non-TN IBC with chi square or Wilcoxon rank sum tests.RESULTS: The average age at diagnosis was 54 years; 83% of patients were non-Hispanic white; and 36% were TN IBC. We found that patients with TN IBC had significantly lower frequency (p = 0.02) and duration of breastfeeding (p = 0.02) compared with non-TN IBC patients. No differences were found in the frequency of other breast cancer risk factors.CONCLUSION: The association between breastfeeding and TNBC indicates that stem cells that are retained in the absence of breastfeeding may be the cell of origin for TN IBC. These results highlight the importance of evaluating epidemiologic risk factors of IBC according to receptor subtype, which could lead to the identification of distinct etiologic pathways that could be targeted for prevention. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Race and Risk of Large Bowel Polyps in Younger and Older Patients

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337553

Electrophrenic Pacing and Decannulation for High-level Spinal Cord Injury: A Case Series

The Journal of Spinal Cord Medicine. Feb, 2012  |  Pubmed ID: 22333657

BACKGROUND: In 1997, guidelines were developed for the management of high-level ventilator-dependent patients with spinal cord injury who had little or no ventilator-free breathing ability (VFBA). This article describes the three categories of patients, the decannulation criteria, and the successful decannulation of four patients with no VFBA and electrophrenic/diaphragm pacing, using these criteria. METHOD: Case series. CONCLUSION: Lack of VFBA in patients with high-level spinal cord injury does not mandate tracheostomy or electrophrenic/diaphragm pacing.

Visual and Hearing Impairment Among Rural Elderly of South India: a Community-based Study

Geriatrics & Gerontology International. Jan, 2012  |  Pubmed ID: 21702873

Of India's population, 76.6 million (7.2%) are aged above 60 years. Increasing age is associated with increasing disability and functional impairments such as low vision, loss of mobility and hearing impairment. Hence, the purpose of this paper is to study the prevalence of hearing and visual impairment among a rural elderly population in South India and its association with selected variables.

PIVKA-II Plasma Levels As Markers of Subclinical Vitamin K Deficiency in Term Infants

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. Feb, 2012  |  Pubmed ID: 22280352

Abstract Background: As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-?-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD). Objectives: To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast fed newborns. Methods: A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg im) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 ?g/die of vitamin K (G I), 12 ?g/die (G II) or placebo (G III). PIVKA II and PT were measured on 30th and 90th days of life. Results: G III and GII showed a significant increase in PIVKA II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p<0.001). No significant changes were found in GI. PT showed no significant changes among groups. Conclusions: PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 ?g/die avoids an increase of PIVKA II. Despite increased PIVKA II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.

Clofarabine, Cyclophosfamide, and Etoposide for the Treatment of Relapsed or Resistant Acute Leukemia in Pediatric Patients

Leukemia & Lymphoma. Feb, 2012  |  Pubmed ID: 22303898

ABSTRACT Clofarabine is a promising, new chemotherapeutic agent that is active in the treatment of pediatric acute leukemia. Forty children ( 16 AML, 24 ALL), aged 1-20 years (median 7.6 years) with relapsed or refractory Acute Lymphoblastic Leukemia (ALL) or Acute Myeloid Leukemia (AML) were treated because of resistance to first line treatment (5) , or for first (22) , second (11), or third relapse (2) . They received clofarabine (40 mg/m(2)/day) associated with etoposide (100 mg/m(2)/day) and Cyclophosphamide (440 mg/m(2)/day) administered as 1 or 2 induction cycles (5 days of chemotherapy) in an attempt to reach complete remission (CR) or CR without platelet recovery (CRp). This was followed by 1 to 3 consolidation cycles (4 days of chemotherapy) for a maximum of 4 cycles. Seven (44%) out of 16 and 10 (42%) out of 24 evaluable children with AML and ALL respectively, responded to treatment. The most common adverse events were infections and gastrointestinal and hepatic toxicity. Thirteen (76%) out of 17 responders underwent SCT. 24-month OS was 25%, while it was 59% among patients who responded to the first induction cycle. Our study suggests that this drug regimen is well tolerated and can be effective in heavily pretreated relapsed or refractory pediatric patients with acute leukemia.

A Comparative Evaluation of the Anti-Bacterial Efficacy of Honey, In Vitro and Anti-Plaque Efficacy in a 4 Day Plaque Regrowth Model In Vivo - Preliminary Results

Journal of Periodontology. Feb, 2012  |  Pubmed ID: 22309178

Background: Honey has a potent broad-spectrum antibacterial action which may make it suitable for "anti-infective" treatment of periodontal disease. Aim: 1) To evaluate the anti bacterial efficacy of honey against oral bacteria and compare the same with 0.2% chlorhexidine 2) Compare anti-plaque efficacy in vivo with chlorhexidine. Material and Methods: The study was conducted in two parts: an invitro part wherein the inhibitory effects of three test agents, 0.2% chlorhexidine gluconate, honey mouthwash and saline, against 6 oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256 and 512 micrograms per millliter were tested in duplicate. The MIC (minimum inhibitory concentration) was set as the lowest concentration of the agent that completely inhibited the growth of the test species. The in vivo part consisted of a double blind parallel clinical trial based on a 4 day plaque regrowth model. Sixty six volunteers aged 20-24 years participated in the study and the plaque scores were compared at baseline and at the end of 4 days. Kruskal Wallis test was used for significance and Mann Whitney U test was used for pairwise comparison of the groups. The mean plaque scores were 1.77±0.86, 1.64±0.90, 3.27±0.83 for groups 1, 2 and 3 respectively. Results: The honey mouthrinse effectively inhibited the 6 tested microorganisms. The chlorhexidine gluconate rinse had the lowest MICs in comparison with honey and saline rinses, for all test species examined. The in vivo results revealed that plaque formation was inhibited/ reduced by chlorhexidine and honey rinses. Conclusion: Honey has antibacterial action against tested oral microorganisms and also has anti-plaque action.

Blood Compatibility of Iron Doped Nano Hydroxyapatite and Its Drug Release

ACS Applied Materials & Interfaces. Feb, 2012  |  Pubmed ID: 22316071

Nanosize hydroxyapatite (nHAp) doped with varying levels of Fe3+ (Fe-nHAp of average size 75 nm) was synthesized by hydrothermal and microwave techniques. The samples were characterized for physiochemical properties by X-Ray Diffraction (XRD), Fourier-Transform Infrared Spectroscopy (FT-IR), Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES), Transmission Electron Microscopy (TEM), Vibrating Sample Magnetometer (VSM), mechanical and dielectric properties. The biological properties like haemocompatibility, antibacterial efficacy, in vitro bioactivity and the cell proliferation of the samples were determined. XRD pattern of the samples were of single phase hydroxyapatite. As the content of Fe3+ increased, the crystallite size as well as crystallinity decreased along with a morphological change from spherulites to rods. The dielectric constants and Vickers hardness were enhanced on Fe3+ doping. The VSM studies revealed that the saturation magnetization (Ms) and retentivity (Mr) were found to increase for Fe-nHAp. nHAp impregnated with an antibiotic as a new system for drug delivery in the treatment of chronic osteomyelitis was also attempted. The in vitro drug release with an antibiotic amoxicillin and anticancer drug 5-fluorouracil showed sustained release for the lowest concentration of Fe3+, while with an increase in the content; there was a rapid release of the drug. The haemolytic assay of Fe3+ doped samples revealed high blood compatibility (< 5% haemolysis). The antibacterial activities of the antibiotic impregnated materials were tested against a culture of E. coli, S. epidermidis and S. aureus by agar diffusion test. The in vitro bioactivity test using Simulated Body Fluid (SBF) showed better bone bonding ability by the formation of an apatite layer on the doped samples. The growth of the apatite layer on the samples surface has been confirmed by EDS analysis. The proliferative potential of MG63 cells by MTT assay confirmed the non-cytotoxicity of the samples.

Implantation of the Common Cavity Malformation May Prevent Meningitis

Cochlear Implants International. Feb, 2012  |  Pubmed ID: 22333042

Objectives and importance: Children with certain congenital malformations of the inner ear, including those with a common cavity defect, have a higher incidence of spontaneous cerebrospinal fluid (CSF) leak and resulting meningitis. However, they may also benefit from cochlear implantation. We suggest that surgical management may be possible that both prevents meningitis and provides hearing rehabilitation during the same procedure. CLINICAL PRESENTATION: A 2-year-old girl with bilateral common cavity defects who had previously undergone cochlear implantation developed contralateral CSF leak resulting in meningitis. INTERVENTION: After resolution of the infection, cochlear implantation was performed at the same time as definitive CSF leak repair. Simultaneous cochlear implantation and repair of the CSF leak successfully decreased the chance of recurrent meningitis in this case. She has been deriving hearing benefit from the bilateral implants. CONCLUSION: This case suggests a role for cochlear implantation to be combined with simultaneous CSF leak repair in children with a cochlear malformation. Furthermore, bilateral cochlear implantation at an early age may be warranted in these patients before CSF leaks and meningitis have occurred.