WorldWideScience

Sample records for unit replaced tissue

  1. Synthetic Versus Tissue-Engineered Implants for Joint Replacement

    Directory of Open Access Journals (Sweden)

    Duncan E. T. Shepherd

    2007-01-01

    Full Text Available Human synovial joints are remarkable as they can last for a lifetime. However, they can be affected by disease that may lead to destruction of the joint surface. The most common treatment in the advanced stages of joint disease is artificial joint replacement, where the diseased synovial joint is replaced with an artificial implant made from synthetic materials, such as metals and polymers. A new technique for repairing diseased synovial joints is tissue engineering where cells are used to grow replacement tissue. This paper explores the relative merits of synthetic and tissue-engineered implants, using joint replacement as an example. Synthetic joint replacement is a well-established procedure with the advantages of early mobilisation, pain relief and high patient satisfaction. However, synthetic implants are not natural tissues; they can cause adverse reactions to the body and there could be a mismatch in mechanical properties compared to natural tissues. Tissue-engineered implants offer great potential and have major advantages over synthetic implants as they are natural tissue, which should ensure that they are totally biocompatible, have the correct mechanical properties and integrate well with the existing tissue. However, there are still many limitations to be addressed in tissue engineering such as scaling up for production, bioreactor design, appropriate regulation and the potential for disease to attack the new tissue-engineered implant.

  2. ISS EPS Orbital Replacement Unit Block Diagrams

    Science.gov (United States)

    Schmitz, Gregory V.

    2001-01-01

    The attached documents are being provided to Switching Power Magazine for information purposes. This magazine is writing a feature article on the International Space Station Electrical Power System, focusing on the switching power processors. These units include the DC-DC Converter Unit (DDCU), the Bi-directional Charge/Discharge Unit (BCDU), and the Sequential Shunt Unit (SSU). These diagrams are high-level schematics/block diagrams depicting the overall functionality of each unit.

  3. Unit Replacement System Analysis I (URSA I).

    Science.gov (United States)

    1982-01-01

    action creates a void in CONUS of one unit. A new unit is formed in CONUS to fill this void . The forming of a new unit is 3-5 -,.. - ..-- o. . CAA-SR-82...compares the observed average regimental strengths with the respective authorizations. Note the E-1 to E-4 and E-5 overfill and the E-6 to E-8 underfill ...When the data is adjusted to compensate for grade substitution flexibility (see Figure 6-26), the E-6 to E-8 underfill is corrected, but the

  4. Optimization criteria for the design of orbital replacement units (ORUs)

    Science.gov (United States)

    Schulze, Manfred W.

    A reduction of life cycle costs of spacecraft or Space Station elements can be achieved by a modular build up which allows an in orbit replacement, maintenance, and service of functional units named Orbital Replacement Units (ORUs). The criteria for an optimal design for an ORU is presented. Requirements involving the user spacecraft configuration, the servicing vehicle, the handling by astronauts and remote manipulator system are considered.

  5. Development of a Tissue Engineered Scaffold for Meniscus Replacement

    Science.gov (United States)

    2008-12-01

    Deliv Rev, 2003. 55(4): p. 447-66. Caruso, A.B., A Collagen Fiber Tissue Engineering Scaffold for Anterior Cruciate Ligament Reconstruction, in...scaffold was axially loaded in compression, it was extruded from the joint. The anterior and posterior anchor points resisted this extrusion...include loss of manpower, rehabilitation costs, waste of training time/money, cost to retrain members as replacements, hospitalization costs, disability

  6. Esophageal tissue engineering: A new approach for esophageal replacement

    Institute of Scientific and Technical Information of China (English)

    Giorgia Totonelli; Panagiotis Maghsoudlou; Jonathan M Fishman; Giuseppe Orlando; Tahera Ansari; Paul Sibbons; Martin A Birchall

    2012-01-01

    A number of congenital and acquired disorders require esophageal tissue replacement.Various surgical techniques,such as gastric and colonic interposition,are standards of treatment,but frequently complicated by stenosis and other problems.Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function.We review the literature of esophageal tissue engineering,discuss its implications,compare the methodologies that have been employed and suggest possible directions for the future.Medline,Embase,the Cochrane Library,National Research Register and ClinicalTrials.gov databases were searched with the following search terms:stem cell and esophagus,esophageal replacement,esophageal tissue engineering,esophageal substitution.Reference lists of papers identified were also examined and experts in this field contacted for further information.All full-text articles in English of all potentially relevant abstracts were reviewed.Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation.When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality.Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration,whilst omental wrapping to induce vascularization of the construct has an uncertain benefit.Decellularized matrices have been recently suggested as the optimal choice for scaffolds,but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution.Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a

  7. Is parenteral phosphate replacement in the intensive care unit safe?

    Science.gov (United States)

    Agarwal, Banwari; Walecka, Agnieszka; Shaw, Steve; Davenport, Andrew

    2014-02-01

    Hypophosphatemia is well recognized in the intensive care setting, associated with refeeding and continuous forms of renal replacement therapy (CCRT). However, it is unclear as to when and how to administer intravenous phosphate supplementation in the general intensive care setting. There have been recent concerns regarding phosphate administration and development of acute kidney injury. We therefore audited our practice of parenteral phosphate administration. We prospectively audited parenteral phosphate administration (20 mmol) in 58 adult patients in a general intensive care unit in a University tertiary referral center. Fifty-eight patients were audited; mean age 57.2 ± 2.0 years, 70.7% male. The median duration of the infusion was 310 min (228-417), and 50% of the patients were on CRRT. 63.8% of patients were hypophosphatemic (phosphate infusion, and serum phosphate increased from 0.79 ± 0.02 to 1.07 ± 0.03 mmol/L, P 1.45 mmol/L). There was no correlation between the change in serum phosphate and the pre-infusion phosphate. Although there were no significant changes in serum urea, creatinine or other electrolytes, arterial ionized calcium fell from 1.15 ± 0.01 to 1.13 ± 0.01 mmol/L, P phosphate did not appear to adversely affect renal function and corrected hypophosphatemia in 67.7% of cases, we found that around 33% of patients who were given parenteral phosphate were not hypophosphatemic, and that the fall in ionized calcium raises the possibility of the formation of calcium-phosphate complexes and potential for soft tissue calcium deposition.

  8. White adipose tissue resilience to insulin deprivation and replacement.

    Science.gov (United States)

    Hadji, Lilas; Berger, Emmanuelle; Soula, Hédi; Vidal, Hubert; Géloën, Alain

    2014-01-01

    Adipocyte size and body fat distribution are strongly linked to the metabolic complications of obesity. The aim of the present study was to test the plasticity of white adipose tissue in response to insulin deprivation and replacement. We have characterized the changes of adipose cell size repartition and gene expressions in type 1 diabetes Sprague-Dawley rats and type 1 diabetic supplemented with insulin. Using streptozotocin (STZ)-induced diabetes, we induced rapid changes in rat adipose tissue weights to study the changes in the distribution of adipose cell sizes in retroperitoneal (rWAT), epididymal (eWAT) and subcutaneous adipose tissues (scWAT). Adipose tissue weights of type 1 diabetic rats were then rapidly restored by insulin supplementation. Cell size distributions were analyzed using multisizer IV (Beckman Coulter). Cell size changes were correlated to transcriptional regulation of genes coding for proteins involved in lipid and glucose metabolisms and adipocytokines. The initial body weight of the rats was 465±5.2 g. Insulin privation was stopped when rats lost 100 g which induced reductions in fat mass of 68% for rWAT, 42% for eWAT and 59% for scWAT corresponding to decreased mode cell diameters by 31.1%, 20%, 25.3%, respectively. The most affected size distribution by insulin deprivation was observed in rWAT. The bimodal distribution of adipose cell sizes disappeared in response to insulin deprivation in rWAT and scWAT. The most important observation is that cell size distribution returned close to control values in response to insulin treatment. mRNAs coding for adiponectin, leptin and apelin were more stimulated in scWAT compared to other depots in diabetic plus insulin group. Fat depots have specific responses to insulin deprivation and supplementation. The results show that insulin is a major determinant of bimodal cell repartition in adipose tissues.

  9. White Adipose Tissue Resilience to Insulin Deprivation and Replacement

    Science.gov (United States)

    Hadji, Lilas; Berger, Emmanuelle; Soula, Hédi; Vidal, Hubert; Géloën, Alain

    2014-01-01

    Introduction Adipocyte size and body fat distribution are strongly linked to the metabolic complications of obesity. The aim of the present study was to test the plasticity of white adipose tissue in response to insulin deprivation and replacement. We have characterized the changes of adipose cell size repartition and gene expressions in type 1 diabetes Sprague-Dawley rats and type 1 diabetic supplemented with insulin. Methods Using streptozotocin (STZ)-induced diabetes, we induced rapid changes in rat adipose tissue weights to study the changes in the distribution of adipose cell sizes in retroperitoneal (rWAT), epididymal (eWAT) and subcutaneous adipose tissues (scWAT). Adipose tissue weights of type 1 diabetic rats were then rapidly restored by insulin supplementation. Cell size distributions were analyzed using multisizer IV (Beckman Coulter). Cell size changes were correlated to transcriptional regulation of genes coding for proteins involved in lipid and glucose metabolisms and adipocytokines. Results The initial body weight of the rats was 465±5.2 g. Insulin privation was stopped when rats lost 100 g which induced reductions in fat mass of 68% for rWAT, 42% for eWAT and 59% for scWAT corresponding to decreased mode cell diameters by 31.1%, 20%, 25.3%, respectively. The most affected size distribution by insulin deprivation was observed in rWAT. The bimodal distribution of adipose cell sizes disappeared in response to insulin deprivation in rWAT and scWAT. The most important observation is that cell size distribution returned close to control values in response to insulin treatment. mRNAs coding for adiponectin, leptin and apelin were more stimulated in scWAT compared to other depots in diabetic plus insulin group. Conclusion Fat depots have specific responses to insulin deprivation and supplementation. The results show that insulin is a major determinant of bimodal cell repartition in adipose tissues. PMID:25170835

  10. Functional tooth regenerative therapy: tooth tissue regeneration and whole-tooth replacement.

    Science.gov (United States)

    Oshima, Masamitsu; Tsuji, Takashi

    2014-07-01

    Oral and general health is compromised by irreversible dental problems, including dental caries, periodontal disease and tooth injury. Regenerative therapy for tooth tissue repair and whole-tooth replacement is currently considered a novel therapeutic concept with the potential for the full recovery of tooth function. Several types of stem cells and cell-activating cytokines have been identified in oral tissues. These cells are thought to be candidate cell sources for tooth tissue regenerative therapies because they have the ability to differentiate into tooth tissues in vitro and in vivo. Whole-tooth replacement therapy is regarded as an important model for the development of an organ regenerative concept. A novel three-dimensional cell-manipulation method, designated the organ germ method, has been developed to recapitulate organogenesis. This method involves compartmentalisation of epithelial and mesenchymal cells at a high cell density to mimic multicellular assembly conditions and epithelial-mesenchymal interactions. A bioengineered tooth germ can generate a structurally correct tooth in vitro and erupt successfully with the correct tooth structure when transplanted into the oral cavity. We have ectopically generated a bioengineered tooth unit composed of a mature tooth, periodontal ligament and alveolar bone, and that tooth unit was successfully engrafted into an adult jawbone through bone integration. Such bioengineered teeth were able to perform normal physiological tooth functions, such as developing a masticatory potential in response to mechanical stress and a perceptive potential for noxious stimuli. In this review, we describe recent findings and technologies underpinning tooth regenerative therapy.

  11. Growth versus metabolic tissue replacement in mouse tissues determined by stable carbon and nitrogen isotope analysis

    Science.gov (United States)

    Macavoy, S. E.; Jamil, T.; Macko, S. A.; Arneson, L. S.

    2003-12-01

    Stable isotope analysis is becoming an extensively used tool in animal ecology. The isotopes most commonly used for analysis in terrestrial systems are those of carbon and nitrogen, due to differential carbon fractionation in C3 and C4 plants, and the approximately 3‰ enrichment in 15N per trophic level. Although isotope signatures in animal tissues presumably reflect the local food web, analysis is often complicated by differential nutrient routing and fractionation by tissues, and by the possibility that large organisms are not in isotopic equilibrium with the foods available in their immediate environment. Additionally, the rate at which organisms incorporate the isotope signature of a food through both growth and metabolic tissue replacement is largely unknown. In this study we have assessed the rate of carbon and nitrogen isotopic turnover in liver, muscle and blood in mice following a diet change. By determining growth rates, we were able to determine the proportion of tissue turnover caused by growth versus that caused by metabolic tissue replacement. Growth was found to account for approximately 10% of observed tissue turnover in sexually mature mice (Mus musculus). Blood carbon was found to have the shortest half-life (16.9 days), followed by muscle (24.7 days). Liver carbon turnover was not as well described by the exponential decay equations as other tissues. However, substantial liver carbon turnover was observed by the 28th day after diet switch. Surprisingly, these tissues primarily reflect the carbon signature of the protein, rather than carbohydrate, source in their diet. The nitrogen signature in all tissues was enriched by 3 - 5‰ over their dietary protein source, depending on tissue type, and the isotopic turnover rates were comparable to those observed in carbon.

  12. Replacement

    Directory of Open Access Journals (Sweden)

    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  13. Epimorphic regeneration approach to tissue replacement in adult mammals

    OpenAIRE

    Agrawal, Vineet; Johnson, Scott A.; Reing, Janet; ZHANG Li; Tottey, Stephen; Wang, Gang; Hirschi, Karen K.; Braunhut, Susan; Gudas, Lorraine J.; Badylak, Stephen F.

    2009-01-01

    Urodeles and fetal mammals are capable of impressive epimorphic regeneration in a variety of tissues, whereas the typical default response to injury in adult mammals consists of inflammation and scar tissue formation. One component of epimorphic regeneration is the recruitment of resident progenitor and stem cells to a site of injury. Bioactive molecules resulting from degradation of extracellular matrix (ECM) have been shown to recruit a variety of progenitor and stem cells in vitro in adult...

  14. Hypophosphatemia on the intensive care unit: individualized phosphate replacement based on serum levels and distribution volume.

    NARCIS (Netherlands)

    Bech, A.; Blans, M.; Raaijmakers, M.; Mulkens, C.; Telting, D.; Boer, H. de

    2013-01-01

    BACKGROUND: Hypophosphatemia occurs in about 25% of patients admitted to the intensive care unit. To date, a safe and validated phosphate replacement protocol is not available. OBJECTIVE: To evaluate an individualized phosphate replacement regimen. DESIGN: Fifty consecutive intensive care unit patie

  15. Epimorphic regeneration approach to tissue replacement in adult mammals.

    Science.gov (United States)

    Agrawal, Vineet; Johnson, Scott A; Reing, Janet; Zhang, Li; Tottey, Stephen; Wang, Gang; Hirschi, Karen K; Braunhut, Susan; Gudas, Lorraine J; Badylak, Stephen F

    2010-02-23

    Urodeles and fetal mammals are capable of impressive epimorphic regeneration in a variety of tissues, whereas the typical default response to injury in adult mammals consists of inflammation and scar tissue formation. One component of epimorphic regeneration is the recruitment of resident progenitor and stem cells to a site of injury. Bioactive molecules resulting from degradation of extracellular matrix (ECM) have been shown to recruit a variety of progenitor and stem cells in vitro in adult mammals. The ability to recruit multipotential cells to the site of injury by in vivo administration of chemotactic ECM degradation products in a mammalian model of digit amputation was investigated in the present study. Adult, 6- to 8-week-old C57/BL6 mice were subjected to midsecond phalanx amputation of the third digit of the right hind foot and either treated with chemotactic ECM degradation products or left untreated. At 14 days after amputation, mice treated with ECM degradation products showed an accumulation of heterogeneous cells that expressed markers of multipotency, including Sox2, Sca1, and Rex1 (Zfp42). Cells isolated from the site of amputation were capable of differentiation along neuroectodermal and mesodermal lineages, whereas cells isolated from control mice were capable of differentiation along only mesodermal lineages. The present findings demonstrate the recruitment of endogenous stem cells to a site of injury, and/or their generation/proliferation therein, in response to ECM degradation products.

  16. Replacing Amalgam Restorations: A Standardized Protocol Based on Analyzing Tissue Physicochemical Modifications.

    Science.gov (United States)

    Decup, Franck; Epaillard, Alexandre; Chemla, Florence

    2015-12-01

    Almost 60% of operative dentistry is devoted to replacing restorations. When practitioners have to replace an amalgam restoration, they tend to opt for an adhesive restoration, as it is conservative of tooth tissues and mimics the natural appearance of teeth. Based on a literature review, the aim of this article is to determine the best tissue approach when replacing an old amalgam by a new adhesive restoration. After analyzing and understanding tissue alterations due to the amalgam corrosion process, the authors propose an analytical approach to managing the situation. Both tissue orientated and specific mechanical approaches are developed and should be implemented to carry out the optimal clinical procedure and achieve the most conservative and durable treatment.

  17. Guided Tissue Regeneration in Heart Valve Replacement: From Preclinical Research to First-in-Human Trials

    OpenAIRE

    Iop, L.; Gerosa, G.

    2015-01-01

    Heart valve tissue-guided regeneration aims to offer a functional and viable alternative to current prosthetic replacements. Not requiring previous cell seeding and conditioning in bioreactors, such exceptional tissue engineering approach is a very fascinating translational regenerative strategy. After in vivo implantation, decellularized heart valve scaffolds drive their same repopulation by recipient’s cells for a prospective autologous-like tissue reconstruction, remodeling, and adaptation...

  18. Renal replacement therapy in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Chacko Jose

    2008-01-01

    Full Text Available Acute renal failure is a frequent complication in critically ill patients that carries with it considerable morbidity and mortality. The management of renal failure in patients with multi-organ failure is different from that of renal failure that presents as a single organ failure. Intermittent haemodialysis, done in the conventional manner may not be tolerated by most critically ill patients. Continuous renal replacement therapy is physiologically superior; however, there is lack of strong evidence to prove a clinical benefit. Hybrid therapies that combine the benefits of intermittent haemodialysis and continuous therapies have emerged in the past few years. These are simpler to carry out, provide more flexibility and may be cost effective and need to be studied in a systematic manner.

  19. Hounsfield unit dynamics of adipose tissue and non-adipose soft tissue in growing pigs

    DEFF Research Database (Denmark)

    Mcevoy, Fintan; Madsen, Mads T.; Strathe, Anders Bjerring;

    2008-01-01

    Changes in the Hounsfield Unit value of adipose tissue and of no-adipose soft tissue during growth are poorly documented. This study examines the HU of these tissues in growing pigs.......Changes in the Hounsfield Unit value of adipose tissue and of no-adipose soft tissue during growth are poorly documented. This study examines the HU of these tissues in growing pigs....

  20. Replacement Capability Options for the United States Space Shuttle

    Science.gov (United States)

    2013-09-01

    first designed for reuse ” (NASA, 2000). 1. United States Space Shuttle Program (1981–2011) The first operational Space Shuttle was Columbia (OV-102...Week article on China’s future plans for their Long March Launch vehicles, “China is developing three basic rocket modules, with diameters of 2.25... wastewater , which will burn up with the spacecraft when it re-enters the Earth’s atmosphere. The Cargo Module can hold 1,000 to 1,700 kilograms (2,205

  1. Live tissue versus simulation training for emergency procedures: Is simulation ready to replace live tissue?

    Science.gov (United States)

    Barnes, Stephen L; Bukoski, Alex; Kerby, Jeffrey D; Llerena, Luis; Armstrong, John H; Strayhorn, Catherine

    2016-10-01

    Training of emergency procedures is challenging and application is not routine in all health care settings. The debate over simulation as an alternative to live tissue training continues with legislation before Congress to banish live tissue training in the Department of Defense. Little evidence exists to objectify best practice. We sought to evaluate live tissue and simulation-based training practices in 12 life-saving emergency procedures. In the study, 742 subjects were randomized to live tissue or simulation-training. Assessments of self-efficacy, cognitive knowledge, and psychomotor performance were completed pre- and post-training. Affective response to training was assessed through electrodermal activity. Subject matter experts gap analysis of live tissue versus simulation completed the data set. Subjects demonstrated pre- to post-training gains in self-efficacy, cognitive knowledge, psychomotor performance, and affective response regardless of training modality (P training modality in the overall group. Risk estimates on the least pretest performance subgroup favored simulation in 7 procedures. Affective response was greatest in live tissue training (P superior. Wholesale abandonment of live tissue training is not warranted. We maintain that combined live tissue and simulation-based training add value and should be continued. Congressional mandates may accelerate simulation development and improve performance. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented.

  3. Guided Tissue Regeneration in Heart Valve Replacement: From Preclinical Research to First-in-Human Trials

    Directory of Open Access Journals (Sweden)

    L. Iop

    2015-01-01

    Full Text Available Heart valve tissue-guided regeneration aims to offer a functional and viable alternative to current prosthetic replacements. Not requiring previous cell seeding and conditioning in bioreactors, such exceptional tissue engineering approach is a very fascinating translational regenerative strategy. After in vivo implantation, decellularized heart valve scaffolds drive their same repopulation by recipient’s cells for a prospective autologous-like tissue reconstruction, remodeling, and adaptation to the somatic growth of the patient. With such a viability, tissue-guided regenerated conduits can be delivered as off-the-shelf biodevices and possess all the potentialities for a long-lasting resolution of the dramatic inconvenience of heart valve diseases, both in children and in the elderly. A review on preclinical and clinical investigations of this therapeutic concept is provided with evaluation of the issues still to be well deliberated for an effective and safe in-human application.

  4. Guided tissue regeneration in heart valve replacement: from preclinical research to first-in-human trials.

    Science.gov (United States)

    Iop, L; Gerosa, G

    2015-01-01

    Heart valve tissue-guided regeneration aims to offer a functional and viable alternative to current prosthetic replacements. Not requiring previous cell seeding and conditioning in bioreactors, such exceptional tissue engineering approach is a very fascinating translational regenerative strategy. After in vivo implantation, decellularized heart valve scaffolds drive their same repopulation by recipient's cells for a prospective autologous-like tissue reconstruction, remodeling, and adaptation to the somatic growth of the patient. With such a viability, tissue-guided regenerated conduits can be delivered as off-the-shelf biodevices and possess all the potentialities for a long-lasting resolution of the dramatic inconvenience of heart valve diseases, both in children and in the elderly. A review on preclinical and clinical investigations of this therapeutic concept is provided with evaluation of the issues still to be well deliberated for an effective and safe in-human application.

  5. [Drugs dosing in intensive care unit during continuous renal replacement therapy].

    Science.gov (United States)

    Bourquin, Vincent; Ponte, Belén; Saudan, Patrick; Martin, Pierre-Yves

    2009-11-01

    Drug dosing in the intensive care unit can be challenging. Acute kidney injury (AKI) is a common complication of sepsis and a part of multiple organ dysfunction syndrome. Continuous renal replacement therapy (CRRT) is increasingly used as dialysis therapy in this critically ill population. Available data demonstrate that sepsis, AKI and different modalities of CRRT can profoundly change drugs pharmacokinetic. The severity of these changes depends on molecules characteristics (volume of distribution, plasma protein binding, molecular weight, plasma half-life, plasma clearance), patient itself (volemia, residual renal function, tissue perfusion, hepatic dysfunction) and modality of CRRT (diffusion, convection, adsorption). There are no available recommendations to adapt drug dosing in a given critically ill patient with a given modality of CRRT. It is necessary to fully understand the different methods of CRRT and drug pharmacokinetic to prescribe the appropriate dose and to avoid under or potentially toxic overdosing. Monitoring the plasma level of drug - when available - can establish a relation between the blood concentration and its effect; thus, facilitating drug dosing.

  6. Demographic screening for MRSA may compromise the effectiveness of ring fencing on a joint replacement unit.

    Science.gov (United States)

    Schmidt, H-M A; Izon, C; Maley, M W

    2012-11-01

    Ring fencing of joint replacement (JR) units has been reported to reduce infections and is recommended by health authorities in Australia and the UK. It has not been determined whether a demographic risk assessment is adequate to prevent the admission of patients colonized with meticillin-resistant Staphylococcus aureus (MRSA) to ring-fenced units. As such, 250 admissions to the JR unit of a suburban Sydney hospital were screened, and MRSA colonization was identified in 2.8% of patients complying with the demographic risk assessment. Demographic risk assessment is not an adequate substitute for physical MRSA screening, and undermines the effectiveness of ring-fencing procedures.

  7. International Space Station (ISS) Orbital Replaceable Unit (ORU) Wet Storage Risk Assessment

    Science.gov (United States)

    Squire, Michael D.; Rotter, Henry A.; Lee, Jason; Packham, Nigel; Brady, Timothy K.; Kelly, Robert; Ott, C. Mark

    2014-01-01

    The International Space Station (ISS) Program requested the NASA Engineering and Safety Center (NESC) to evaluate the risks posed by the practice of long-term wet storage of ISS Environmental Control and Life Support (ECLS) regeneration system orbital replacement units (ORUs). The ISS ECLS regeneration system removes water from urine and humidity condensate and converts it into potable water and oxygen. A total of 29 ORUs are in the ECLS system, each designed to be replaced by the ISS crew when necessary. The NESC assembled a team to review the ISS ECLS regeneration system and evaluate the potential for biofouling and corrosion. This document contains the outcome of the evaluation.

  8. Histological characterization of periprosthetic tissue responses for metal-on-metal hip replacement.

    Science.gov (United States)

    Phillips, Eual A; Klein, Gregg R; Cates, Harold E; Kurtz, Steven M; Steinbeck, Marla

    2014-01-01

    The histology of periprosthetic tissue from metal-on-metal (MOM) hip devices has been characterized using a variety of methods. The purpose of this study was to compare and evaluate the suitability of two previously developed aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) scoring systems for periprosthetic hip tissue responses retrieved from MOM total hip replacement (THR) systems revised for loosening. Two ALVAL scoring systems (Campbell and Oxford) were used to perform histological analyses of soft tissues from 17 failed MOM THRs. The predominant reactions for this patient cohort were macrophage infiltration and necrosis, with less than half of the patients (41%) showing a significant lymphocytic response or a high ALVAL reaction (6%). Other morphological changes varied among patients and included hemosiderin accumulation, cartilage formation, and heterotopic ossification. Both scoring systems are useful for correlating macrophage and lymphocyte responses and for comparison with the other; however, given the diversity and variability of the current responses, the Oxford-ALVAL system is more suitable for scoring tissues from MOM THR patients revised for loosening. It is important that standardized methods of scoring MOM tissue responses be used consistently so multiple study results can be compared and a consensus can be generated.

  9. Comparison of discharge silver concentrations from electrolytic plating and metallic replacement silver recovery units.

    Science.gov (United States)

    Harper, Martin; Siegel, Julie M

    2003-04-01

    Silver-based photographic X-ray film is made of solid crystals of silver chloride or silver bromide suspended in a gelatin and then coated on a film. During the X-ray developing process, the image is processed and the nonimage areas containing solid silver chloride or silver bromide crystals are removed in a solution called the fixer. There may be local environmental regulations that regulate the amount of silver discharged from a facility. To meet these regulations, many facilities have added silver recovery units to their processes. Two different types of recovery processes are in use in a large hospital and three clinics under study. All of the units were claimed by their respective manufacturers to be able to recover silver down to concentrations of 5 mg/L. This concentration would ensure that the building that houses each unit would meet the local county limit of 0.5 mg/L silver for total building silver discharge. The hypothesis for this research is that one system, newer and more expensive, consisting of so-called electrolytic plating units (EPUs) (which are followed by so-called metallic replacement units [MRUs] as a backup), will have better silver recovery than MRUs alone. A total of six units were sampled, three EPUs (in combination with MRUs) and three MRUs. The units were sampled once or twice a day for 10 days for a total of 17 samples from each. The samples then were analyzed by inductively coupled plasma spectroscopy, and an analysis of variance was performed on the results. The range for the electrolytic plating unit/metallic replacement unit combinations was 0.20-99.9 mg/L (mean of 35.15 mg/L; median of 33.8 mg/L). The range for the MRUs alone was 7.2-1112 mg/L (mean of 565.5 mg/L; median of 720 mg/L). Many individual results exceeded 5 mg/L, such that extensive dilution would be required to ensure the building effluent did not exceed 0.5 mg/L. It is suggested that the metallic replacement units be changed to EPUs (with metallic replacement backup

  10. Developing conjugated polymers with high electron affinity by replacing a C-C unit with a B←N unit.

    Science.gov (United States)

    Dou, Chuandong; Ding, Zicheng; Zhang, Zijian; Xie, Zhiyuan; Liu, Jun; Wang, Lixiang

    2015-03-16

    The key parameters of conjugated polymers are lowest unoccupied molecular orbital (LUMO) and highest occupied molecular orbital (HOMO) energy levels. Few approaches can simultaneously lower LUMO and HOMO energy levels of conjugated polymers to a large extent (>0.5 eV). Disclosed herein is a novel strategy to decrease both LUMO and HOMO energy levels of conjugated polymers by about 0.6 eV through replacement of a C-C unit by a B←N unit. The replacement makes the resulting polymer transform from an electron donor into an electron acceptor, and is proven by fluorescence quenching experiments and the photovoltaic response. This work not only provides an effective approach to tune the LUMO/HOMO energy levels of conjugated polymers, but also uses organic boron chemistry as a new toolbox to develop conjugated polymers with high electron affinity for polymer optoelectronic devices.

  11. Instrumental and laboratory assessment of stressful remodelling processes in bone tissue at total hip replacement

    Directory of Open Access Journals (Sweden)

    E.V. Karjakina

    2010-06-01

    Full Text Available Research objective is to estimate stressful remodelling features of bone tissue according to the densitometry data and to the level of biochemical markers of bone resorption and formation in total hip replacement (THR. Bone tissue mineral density (BTMD, condition of calcium-phosphoric metabolism and biochemical markers of bone formation (osteocalcin and bone isoenzyme of alkaline phosphatase and resorption (С-terminal bodypeptide of the I type collagen have been determined in 52 patients with coxarthrosis of ll-lll stages with marked joint dysfunction before and after THR. The control group included 24 donors. The data were considered to be reliable when the probability index was р<0,05. The reliable (р<0,05 change of BTMD was determined only in 3-6 months after the operation, whereas the change of biochemical markers of remodeling had already been done after 1,5-3 months, allowing to define the group of patients with obvious negative bone balance: strong predominance of resorption processes without compensation of the subsequent adequate osteogenesis, that subsequently could lead to significant bone tissue deficiency in the area adjacent to the endoprosthesis. Changes of indices of calcium-phosphoric metabolism were not certain during the investigation term. ln conclusion it is to state that biochemical markers of remodeling in comparison with BTMD allow to estimate objectively features of adaptive bone tissue remodeling after THR in earlier periods and to define group of patients with sharp intensification of metabolism and obvious negative bone balance

  12. UHMWPE wear debris and tissue reactions are reduced for contemporary designs of lumbar total disc replacements.

    Science.gov (United States)

    Veruva, Sai Y; Lanman, Todd H; Isaza, Jorge E; MacDonald, Daniel W; Kurtz, Steven M; Steinbeck, Marla J

    2015-03-01

    Lumbar total disc replacement (L-TDR) is a procedure used to relieve back pain and maintain mobility. Contemporary metal-on-polyethylene (MoP) L-TDRs were developed to address wear performance concerns about historical designs, but wear debris generation and periprosthetic tissue reactions for these newer implants have not been determined. The purpose of this study was to determine (1) whether periprosthetic ultrahigh-molecular-weight polyethylene (UHMWPE) wear debris and biological responses were present in tissues from revised contemporary MoP L-TDRs that contain conventional cores fabricated from γ-inert-sterilized UHMWPE; (2) how fixed- versus mobile-bearing design affected UHMWPE wear particle number, shape, and size; and (3) how these wear particle characteristics compare with historical MoP L-TDRs that contain cores fabricated from γ-air-sterilized UHMWPE. We evaluated periprosthetic tissues from 11 patients who received eight fixed-bearing ProDisc-L and four mobile-bearing CHARITÉ contemporary L-TDRs with a mean implantation time of 4.1 and 2.7 years, respectively. Histologic analysis of tissues was performed to assess biological responses and polarized light microscopy was used to quantify number and size/shape characteristics of UHMWPE wear particles from the fixed- and mobile-bearing devices. Comparisons were made to previously reported particle data for historical L-TDRs. Five of seven (71%) fixed-bearing and one of four mobile-bearing L-TDR patient tissues contained at least 4 particles/mm(2) wear with associated macrophage infiltration. Tissues with wear debris were highly vascularized, whereas those without debris were more necrotic. Given the samples available, the tissue around mobile-bearing L-TDR was observed to contain 87% more, 11% rounder, and 11% less-elongated wear debris compared with tissues around fixed-bearing devices; however, there were no significant differences. Compared with historical L-TDRs, UHMWPE particle number and

  13. Lessons learned from reheater replacements TVA Gallatin Fossil Plant units 1 and 2

    Energy Technology Data Exchange (ETDEWEB)

    Chang, P.S.; Stangarone, R.J. [Tennessee Valley Authority, Chattanooga, TN (United States)

    1996-07-01

    Gallatin Units 1 and 2 have experienced a long history of problems in the reheat front inlet platens and front outlet pendants. Cracks were discovered at lug welds on the reheat inlet platen assemblies after six years of operation. During the next ten years cracking at lugs continued to be a problem in both the inlet platen and front outlet assemblies. Solutions included changing tube material and spacing, and redesigning lugs. None of the solutions were successful. In 1980, a fuel switch to washed coal was made to reduce boiler slagging. Within two years of the fuel change, liquid phase corrosion began to attack the tubes. The corrosion became severe and elements were replaced at seven year intervals. During this time, EPRI sought utilities with boilers experiencing liquid phase corrosion to test new corrosion resistant materials. Gallatin Unit 2 was selected as one of the test units. Probes containing a number of different alloys were inserted into the furnace and subjected to the corrosion attacks. After a five year study, HR3C was selected as the alloy from which to build a complete set of elements for further testing. Reheat assemblies were manufactured from HR3C and installed in Unit 2 and Unit 1 Shortly after Unit 1 returned to service, swages between the front pendant and inlet platen elements failed by brittle fracture due to the cold swaging operation used in fabrication. Cracks were discovered after two years of operation at the tube to lug welds and the new elements were experiencing the same liquid phase corrosion as in the past. The attempt to resolve the liquid phase corrosion problem in Gallatin Units 1 and 2 pendant reheater revealed that past replacements did not address the root cause of the problems. HR3C is a relatively brittle material and manufacturers used traditional methods to design and fabricate the elements. Inadequate fabrication and erection procedures have led to several in-service problems not associated with liquid phase corrosion.

  14. A Two-Unit Cold Standby Repairable System with One Replaceable Repair Facility and Delay Repair:Some Reliability Problems

    Institute of Scientific and Technical Information of China (English)

    WEI Ying-yuan; TANG Ying-hui

    2004-01-01

    This paper considers a two-unit same cold standby repairable system with a replaceable repair facility and delay repair .The failure time of unit is assumed to follow exponential distribution , and the repair time and delay time of failed unit are assumed to follow arbitrary distributions , whereas the failure and replacement time distributions of the repair facility are exponential and arbitrary . By using the Markov renewal process theory, some primary reliability quantities of the system are obtained.

  15. Functional tooth regeneration using a bioengineered tooth unit as a mature organ replacement regenerative therapy.

    Science.gov (United States)

    Oshima, Masamitsu; Mizuno, Mitsumasa; Imamura, Aya; Ogawa, Miho; Yasukawa, Masato; Yamazaki, Hiromichi; Morita, Ritsuko; Ikeda, Etsuko; Nakao, Kazuhisa; Takano-Yamamoto, Teruko; Kasugai, Shohei; Saito, Masahiro; Tsuji, Takashi

    2011-01-01

    Donor organ transplantation is currently an essential therapeutic approach to the replacement of a dysfunctional organ as a result of disease, injury or aging in vivo. Recent progress in the area of regenerative therapy has the potential to lead to bioengineered mature organ replacement in the future. In this proof of concept study, we here report a further development in this regard in which a bioengineered tooth unit comprising mature tooth, periodontal ligament and alveolar bone, was successfully transplanted into a properly-sized bony hole in the alveolar bone through bone integration by recipient bone remodeling in a murine transplantation model system. The bioengineered tooth unit restored enough the alveolar bone in a vertical direction into an extensive bone defect of murine lower jaw. Engrafted bioengineered tooth displayed physiological tooth functions such as mastication, periodontal ligament function for bone remodeling and responsiveness to noxious stimulations. This study thus represents a substantial advance and demonstrates the real potential for bioengineered mature organ replacement as a next generation regenerative therapy.

  16. Livers, guts and gills: mapping the decay profiles of soft tissues to understand authigenic mineral replacement.

    Science.gov (United States)

    Clements, Thomas; Purnell, Mark; Gabbott, Sarah

    2016-04-01

    The hard mineralised parts of organisms such as shells, teeth and bones dominate the fossil record. There are, however, sites around the world where soft-tissues are preserved often through rapid replacement of original tissue by rapidly-precipitating authigenic minerals. These exceptionally well-preserved soft-bodied fossils are much more informative about the anatomy, physiology, ecology and behaviour of ancient organisms as well as providing a more inclusive picture of ecosystems and evolution throughout geological time. However, despite the wealth of information that soft-bodied fossils can provide they must first be correctly interpreted as the processes of both decay and preservation act to modify the carcass from its in vivo condition. Decay leads to alteration of the appearance and topology of anatomy, and ultimately to loss. Preservation is selective with some anatomical features being more likely to be captured than others. These problems are especially germane to the interpretation of deep-time and/or enigmatic fossils where no modern analogue exist for comparative anatomical analysis. It is therefore of vital importance to understand the processes carcasses undergo during the fossilisation process, , in order to interpret the anatomical remains of fossils and thus extract true evolutionary presence or absence of anatomy from absence due to taphonomic biases. We have designed a series of novel experiments to investigate, in real time, how decay processes affect the fossilisation potential of soft-tissues - especially of internal anatomy. Our data allow us to unravel both the timing and sequence of anatomical decay of different organs. At the same time through measuring Eh and pH in selected organs we can predict when anatomical features will fall in to the window of authigenic mineralization and thus potentially become preserved. We can also place constraints on which minerals will operate to capture tissues. Our findings are applied to the fossil record

  17. 3D Printing Facilitated Scaffold-free Tissue Unit Fabrication

    Science.gov (United States)

    Tan, Yu; Richards, Dylan J.; Trusk, Thomas C.; Visconti, Richard P.; Yost, Michael J.; Kindy, Mark S.; Drake, Christopher J.; Argraves, William Scott; Markwald, Roger R.; Mei, Ying

    2014-01-01

    Tissue spheroids hold great potential in tissue engineering as building blocks to assemble into functional tissues. To date, agarose molds have been extensively used to facilitate fusion process of tissue spheroids. As a molding material, agarose typically requires low temperature plates for gelation and/or heated dispenser units. Here, we proposed and developed an alginate-based, direct 3D mold-printing technology: 3D printing micro-droplets of alginate solution into biocompatible, bio-inert alginate hydrogel molds for the fabrication of scaffold-free tissue engineering constructs. Specifically, we developed a 3D printing technology to deposit micro-droplets of alginate solution on calcium containing substrates in a layer-by-layer fashion to prepare ring-shaped 3D hydrogel molds. Tissue spheroids composed of 50% endothelial cells and 50% smooth muscle cells were robotically placed into the 3D printed alginate molds using a 3D printer, and were found to rapidly fuse into toroid-shaped tissue units. Histological and immunofluorescence analysis indicated that the cells secreted collagen type I playing a critical role in promoting cell-cell adhesion, tissue formation and maturation. PMID:24717646

  18. In-situ photopolymerization and monitoring device for controlled shaping of tissue fillers, replacements, or implants

    Science.gov (United States)

    Schmocker, Andreas M.; Khoushabi, Azadeh; Bourban, Pierre-Etienne; Schizas, Constantin; Pioletti, Dominique; Moser, Christophe

    2015-03-01

    Photopolymerization is a common tool to harden materials initially in a liquid state. A surgeon can directly trigger the solidification of a dental implant or a bone or tissue filler simply by illumination. Traditionally, photopolymerization has been used mainly in dentistry. Over the last decade advances in material development including a wide range of biocompatible gel- and cement-systems open up a new avenue for in-situ photopolymerization. However, at the device level, surgical endoscopic probes are required. We present a miniaturized light probe where a photoactive material can be 1) mixed, pressurized and injected 2) photopolymerized or photoactivated and 3) monitored during the chemical reaction. The device enables surgeries to be conducted through a hole smaller than 1 mm in diameter. Beside basic injection mechanics, the tool consists of an optical fiber guiding the light required for photopolymerization and for chemical analysis. Combining photorheology and fluorescence spectroscopy, the current state of the photopolymerization is inferred and monitored in real time. Biocompatible and highly tuneable Poly-Ethylene-Glycol (PEG) hydrogels were used as the injection material. The device was tested on a model for intervertebral disc replacement. Gels were successfully implanted into a bovine caudal model and mechanically tested in-vitro during two weeks. The photopolymerized gel was evaluated at the tissue level (adherence and mechanical properties of the implant), at the cellular level (biocompatibility and cytotoxicity) and ergonomic level (sterilization procedure and feasibility study). This paper covers the monitoring aspect of the device.

  19. Degradation of Beta-Cloth Covering for a Battery Orbital Replacement Unit in Low Earth Orbit

    Science.gov (United States)

    Gaier, James R.; Baldwin, Sammantha; Folz, Angela D.; Waters, Deborah L.; Loos, Alyssa

    2016-01-01

    Samples from the B-cloth cover for a battery orbit replaceable unit from the International Space Station were characterized using optical and electron microscopy, UV-vis-NIR spectrophotometry, and x-ray energy dispersive spectroscopy. Results showed that in areas where the fabric was exposed to solar radiation the absorptance increased by as much as 20 percent, and the peak difference was in the ultraviolet, indicating that the increased absorptance may have been due to radiation. The emissivity of the material over a temperature range of 300 - 700 K was essentially unchanged.

  20. Degradation of Beta Cloth Covering for a Battery Orbital Replacement Unit in Low Earth Orbit

    Science.gov (United States)

    Gaier, James R.; Waters, Deborah L.; Baldwin, Sammantha; Folz, Angela D.; Loos, Alyssa

    2016-01-01

    Samples from the beta cloth cover for a battery orbit replaceable unit from the International Space Station (ISS) were characterized using optical and electron microscopy, UV-vis-NIR spectrophotometry, and x-ray energy dispersive spectroscopy. Results showed that in areas where the fabric was exposed to solar radiation the absorptance increased by as much as 20 percent, and the peak difference was in the ultraviolet, indicating that the increased absorptance may have been due to radiation. The emissivity of the material over a temperature range of 300 to 700 K was essentially unchanged.

  1. Effects of resistance training and estrogen replacement on adipose tissue inflammation in ovariectomized rats.

    Science.gov (United States)

    Rodrigues, Maria Fernanda Cury; Ferreira, Fabiano Candido; Silva-Magosso, Natália Santanielo; Barbosa, Marina Rodrigues; Souza, Markus Vinicius Campos; Domingos, Mateus Moraes; Canevazzi, Gustavo Henrique Rigo; Stotzer, Uliana Sbeguen; Peviani, Sabrina Messa; de Lira, Fábio Santos; Selistre de Araújo, Heloísa Sobreiro; Perez, Sérgio Eduardo de Andrade

    2017-06-01

    Estrogen deficiency is directly related to central obesity and low-grade inflammation. Hormonal replacement and exercise training are both able to decrease fat accumulation and inflammation in postmenopausal women. However, the efficiency of resistance training (RT) and estrogen replacement (ER) in minimizing adiposity and inflammation in the visceral adipose tissue (VAT) of ovariectomized (OVX) rats has not yet been elucidated. In this study, Sprague-Dawley rats were divided into the following 6 groups: sham-operated sedentary (Sham-Sed), OVX-Sed, Sham-RT, OVX-RT, OVX-Sed-ER, and OVX-RT-ER groups. ER was performed by implanting silastic capsules containing 17β-estradiol. For RT, the animals were required to climb a 1.1-m vertical ladder with conical flasks containing weights attached to their tails for 12 weeks. Histological analyses were used to evaluate morphological changes. Gene expression levels were determined by quantitative real-time reverse transcriptase polymerase chain reaction, and protein concentrations were determined using Multiplex/Luminex assays. Ovariectomy increased the body mass (BM), adipocyte area, and inflammation in the VAT, the latter of which was indicated by reduced interleukin-10 (48%) and increased tumor necrosis factor (TNF)-α concentration (∼3%). RT efficiently decreased BM, adipocyte area, and inflammation in the OVX groups. The combination of RT and ER decreased BM (19%) and the TNF-α concentration (18%) and increased the gene and protein expression levels of adiponectin (173% and 18%). These results indicate that RT and the combination of RT and ER are efficient strategies for reducing the BM and improving the inflammatory status of OVX rats.

  2. Long-Term Survival of Dialysis Patients with Bacterial Endocarditis Undergoing Valvular Replacement Surgery in the United States

    Science.gov (United States)

    Leither, Maxwell D.; Shroff, Gautam R.; Ding, Shu; Gilbertson, David T.; Herzog, Charles A.

    2013-01-01

    Background Bacterial endocarditis in dialysis patients is associated with high mortality rates. The literature is limited regarding long-term outcomes of valvular replacement surgery and choice of prosthesis in dialysis patients with bacterial endocarditis. Methods and Results Dialysis patients hospitalized for bacterial endocarditis, 2004-2007, were studied retrospectively using data from the US Renal Data System. Long-term survival of patients undergoing valve replacement surgery with tissue or non-tissue valves was compared using the Kaplan-Meier method. A Cox proportional hazards model was used to identify independent predictors of mortality in patients undergoing valvular replacement surgery. During the study period, 11,156 dialysis patients were hospitalized for bacterial endocarditis and 1267 (11.4%) underwent valvular replacement surgery (tissue valve 44.3%, non-tissue valve 55.7%). In the valve replacement cohort, 60% were men, 50% white, 54% aged 45-64 years, and 36% diabetic. Estimated survival with tissue and non-tissue valves, respectively, at 0.5, 1, 2, and 3 years was 59% and 60%, 48% and 50%, 35% and 37%, and 25% and 30% (log rank P = 0.42). Staphylococcus was the predominant organism (66% of identified organisms). Independent predictors of mortality in patients undergoing valve replacement surgery included older age, diabetes as cause of end-stage renal disease, surgery during index hospitalization, staphylococcus as the causative organism, and dysrhythmias as a comorbid condition. Conclusions Valve replacement surgery is appropriate for well-selected dialysis patients with bacterial endocarditis, but is associated with high mortality rates. Survival does not differ with tissue or non-tissue prosthesis. PMID:23785002

  3. The Modelling Of Basing Holes Machining Of Automatically Replaceable Cubical Units For Reconfigurable Manufacturing Systems With Low-Waste Production

    Science.gov (United States)

    Bobrovskij, N. M.; Levashkin, D. G.; Bobrovskij, I. N.; Melnikov, P. A.; Lukyanov, A. A.

    2017-01-01

    Article is devoted the decision of basing holes machining accuracy problems of automatically replaceable cubical units (carriers) for reconfigurable manufacturing systems with low-waste production (RMS). Results of automatically replaceable units basing holes machining modeling on the basis of the dimensional chains analysis are presented. Influence of machining parameters processing on accuracy spacings on centers between basing apertures is shown. The mathematical model of carriers basing holes machining accuracy is offered.

  4. Effects of different progestin regimens in hormone replacement therapy on blood coagulation factor VII and tissue factor pathway inhibitor

    DEFF Research Database (Denmark)

    Bladbjerg, E-M; Skouby, S O.; Andersen, L F;

    2002-01-01

    BACKGROUND: Long-term hormone replacement therapy (HRT) reduces cardiovascular risk, but an early increased risk was reported in women with coronary heart disease. In such women the arterial intima can express tissue factor, and changes in coagulation factor VII (factor VII) and tissue factor...... after progestin intake. The integrated response, AUC, for TFPI was significantly lower in the HRT groups compared with the reference group. CONCLUSION: The observed changes may increase the early thrombotic risk associated with HRT use. Udgivelsesdato: 2002-Dec...

  5. PEGDA hydrogels as a replacement for animal tissues in mucoadhesion testing.

    Science.gov (United States)

    Eshel-Green, Tal; Eliyahu, Shaked; Avidan-Shlomovich, Shlomit; Bianco-Peled, Havazelet

    2016-06-15

    Utilization of animal parts in ex-vivo mucoadhesion assays is a common approach that presents many difficulties due to animal rights issues and large variance between animals. This study examines the suitability of two PEGDA (poly(ethylene glycol) diacrylate) based hydrogels to serve as tissue mimetics for mucoadhesion evaluation. One hydrogel, termed PEGDA-QT, was composed of pentaerythritol tetrakis (3-mercaptopropionate) and PEG and contained free thiol groups mimicking those found in natural mucosa. The other hydrogel was formed by UV (ultraviolet) curing of PEGDA and mimicked the mechanical property of mucosa but not its chemical constitute. When ranking different first generation mucoadhesive polymers using a tensile assay, both hydrogels showed good agreement with the ranking achieved for porcine small intestine. However, only PEGDA-QT and porcine small intestine shared a similar displacement curve. The same ranking for PEGDA-QT and porcine small intestine was also observed when comparing a second-generation mucoadhesive polymer, thiolated alginate, to native alginate. Our findings suggest that PEGDA-QT could serve as a replacement for porcine small intestine in both mucoadhesion evaluations using a tensile machine and the flow-through method for first and second-generation mucoadhesive polymers. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Morphological changes in muscle tissue of patients with infantile Pompe's disease receiving enzyme replacement therapy.

    Science.gov (United States)

    Winkel, Léon P F; Kamphoven, Joep H J; van den Hout, Hannerieke J M P; Severijnen, Lies A; van Doorn, Pieter A; Reuser, Arnold J J; van der Ploeg, Ans T

    2003-06-01

    Pompe's disease (glycogen storage disease type II) is an autosomal recessive myopathy caused by lysosomal alpha-glucosidase deficiency. Enzyme replacement therapy (ERT) is currently under development for this disease. We evaluated the morphological changes in muscle tissue of four children with infantile Pompe's disease who received recombinant human alpha-glucosidase from rabbit milk for 72 weeks. The patients were 2.5-8 months of age at entry. Prior to treatment, all patients showed lysosomal glycogen storage in skeletal and smooth muscle cells, vascular endothelium, Schwann cells, and perineurium. The first response to treatment was noticed in vascular endothelium and in peripheral nerves after 12 weeks of treatment at an enzyme dose of 15-20 mg/kg. Increasing the dose to 40 mg/kg led, after 72 weeks of treatment, to a reduction of glycogen storage and substantial improvement of muscle architecture in the least affected patient. Not all patients responded equally well, possibly due to differences in degree of glycogen storage and concomitant muscle pathology at the start of treatment. We conclude that intravenous administration of recombinant human alpha-glucosidase from rabbit milk can improve muscle morphology in classic infantile Pompe's disease when treatment is started before irreversible damage has occurred.

  7. Options Studied for Managing Space Station Solar Array Electrical Hazards for Sequential Shunt Unit Replacement

    Science.gov (United States)

    Delleur, Ann M.; Kerslake, Thomas W.; Levy, Robert K.

    2004-01-01

    The U.S. solar array strings on the International Space Station are connected to a sequential shunt unit (SSU). The job of the SSU is to shunt, or short, the excess current from the solar array, such that just enough current is provided downstream to maintain the 160-V bus voltage while meeting the power load demand and recharging the batteries. Should an SSU fail on-orbit, it would be removed and replaced with the on-orbit spare during an astronaut space walk or extravehicular activity (EVA) (see the photograph). However, removing an SSU during an orbit Sun period with input solar array power connectors fully energized could result in substantial hardware damage and/or safety risk to the EVA astronaut. The open-circuit voltage of cold solar-array strings can exceed 320 V, and warm solar-array strings could feed a short circuit with a total current level exceeding 240 A.

  8. Rare complications of osteolysis and periprosthetic tissue reactions after hybrid and non-hybrid total disc replacement.

    Science.gov (United States)

    Veruva, Sai Y; Lanman, Todd H; Hanzlik, Josa A; Kurtz, Steven M; Steinbeck, Marla J

    2015-05-01

    Few complications have been reported for lumbar total disc replacement (TDR) and hybrid TDR fixations. This study evaluated retrieved implants and periprosthetic tissue reactions for two cases of osteolysis following disc arthroplasty with ProDisc-L prostheses. Implants were examined for wear and surface damage, and tissues for inflammation, polyethylene wear debris (polarized light microscopy) and metal debris (energy-dispersive X-ray spectroscopy). Despite initial good surgical outcomes, osteolytic cysts were noted in both patients at vertebrae adjacent to the implants. For the hybrid TDR case, heterotopic ossification and tissue necrosis due to wear-induced inflammation were observed. In contrast, the non-hybrid implant showed signs of abrasion and impingement, and inflammation was observed in tissue regions with metal and polyethylene wear debris. In both cases, wear debris and inflammation may have contributed to osteolysis. Surgeons using ProDisc prostheses should be aware of these rare complications.

  9. Vibration isolation for launch of a space station orbital replacement unit

    Science.gov (United States)

    Maly, Joseph R.; Pendleton, Scott C.; James, George H., III; Mimovich, Mark

    2004-07-01

    Delivery of Orbital Replacement Units (ORUs) to the International Space Station (ISS) and other on-orbit destinations is an important component of the space program. ORUs are integrated on orbit with space assets to maintain and upgrade functionality. For ORUs comprised of sensitive equipment, the dynamic launch environment drives design and testing requirements, and high frequency random vibrations are generally the cause for failure. Vibration isolation can mitigate the structure-borne vibration environment during launch, and hardware has been developed that can provide a reduced environment for current and future launch environments. Random vibration testing of one ORU to equivalent Space Shuttle launch levels revealed that its qualification and acceptance requirements were exceeded. An isolation system was designed to mitigate the structure-borne launch vibration environment. To protect this ORU, the random vibration levels at 50 Hz must be attenuated by a factor of two and those at higher frequencies even more. Design load factors for Shuttle launch are high, so a metallic load path is needed to maintain strength margins. Isolation system design was performed using a finite element model of the ORU on its carrier with representative disturbance inputs. Iterations on the model led to an optimized design based on flight-proven SoftRide MultiFlex isolators. Component testing has been performed on prototype isolators to validate analytical predictions.

  10. Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States.

    Science.gov (United States)

    Rao, Pravin Kumar; Boulet, Sheree L; Mehta, Akanksha; Hotaling, James; Eisenberg, Michael L; Honig, Stanton C; Warner, Lee; Kissin, Dmitry M; Nangia, Ajay K; Ross, Lawrence S

    2017-04-01

    Although testosterone replacement therapy use in the United States has increased dramatically in the last decade, to our knowledge trends in testosterone replacement therapy use among reproductive-age men have not been investigated. We assessed changes in testosterone replacement therapy use and practice patterns among 18 to 45-year-old American men from 2003 to 2013 and compared them to older men. This is a retrospective, cross-sectional analysis of men 18 to 45 and 56 to 64 years old who were enrolled in the Truven Health MarketScan® Commercial Claims Databases throughout each given calendar year from 2003 to 2013, including 5,094,868 men in 2013. Trends in the yearly rates of testosterone replacement therapy use were calculated using Poisson regression. Among testosterone replacement therapy users, the Cochran-Armitage test was used to assess temporal trends in age, formulation type, semen analysis and serum testosterone level testing during the 12 months preceding the documented use of testosterone replacement therapy. Between 2003 and 2013, there was a fourfold increase in the rate of testosterone use among 18 to 45-year-old men from 29.2/10,000 person-years to 118.1/10,000 person-years (p testosterone replacement therapy users, topical gel formulations were initially most used. Injection use then doubled between 2009 and 2012 (23.5% and 46.2%, respectively) and surpassed topical gel use in 2013. In men 56 to 64 years old there was a statistically significant threefold increase in testosterone replacement therapy use (p testosterone replacement therapy use increased fourfold in men 18 to 45 years old compared to threefold in older men. This younger age group should be a focus for future studies due to effects on fertility and unknown long-term sequelae. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. Analysis of Placental Tissue in Fabry Disease With and Without Enzyme Replacement Therapy

    NARCIS (Netherlands)

    M.G. Bouwman; C.E.M. Hollak; M.A. van den Bergh Weerman; F.A. Wijburg; G.E. Linthorst

    2010-01-01

    There are only a few reports on the histology of placental tissue of pregnancies from mothers with Fabry disease. Fabry disease is a lysosomal disorder caused by alpha-galactosidase A deficiency. Extensive glycosphingolipid (GSL) accumulation in fetal and maternal placenta tissue obtained from a Fab

  12. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

    Science.gov (United States)

    Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

    2014-04-16

    Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

  13. Use of Soft-Tissue Procedures for Managing Varus and Valgus Malalignment with Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Elliott, Andrew D

    2015-10-01

    Achieving frontal plane alignment of the ankle joint during total ankle replacement is essential for long-term success. Tendon and ligament lengthening, ligament reinforcement, tendon transfer, nonanatomic tendon transfer ligament reconstruction, and periarticular osteotomies are safe, straightforward, minimally invasive, and reproducible procedures to correct varus and valgus deformities associated with end-stage degenerative joint disease. Using reproducible topographic anatomic landmarks is essential to these techniques properly and limit complications. The approach to frontal plane deformities is stepwise, with liberal use of tendon and ligament lengthening and reconstruction, a low threshold for nonanatomic tendon transfer ligament reconstructions, and tendon transfers and/or periarticular osteotomies.

  14. Comparative evaluation among different materials to replace soft tissue in oral radiology studies

    Directory of Open Access Journals (Sweden)

    Maria de Paula Caldas

    2010-06-01

    Full Text Available OBJECTIVE: The aim of this study was to establish which materials afford better simulation of soft tissues in Oral Radiology studies. MATERIAL AND METHODS: The sample was composed of four materials in eleven different thicknesses to simulate the soft tissues of the face. The mean values of the relative amounts of radiographic contrast of the materials were determined and compared to a gold standard value, which was obtained from 20 patients who were referred to have periapical radiographs taken of the left mandibular molars. Data were subjected to statistical analysis with Dunnett's test (p<0.05. RESULTS: The mean value of the relative amounts of contrast encountered in the patients was 0.47, with a range between 0.36 and 0.64 for all 44 material/thickness combinations. The majority of the tested materials showed values close to those of the patients' tissues, without statistically signifcant differences among them. The values of only three materials/thickness combinations differed statistically from those of the patients' tissues. CONCLUSIONS: Based on the results of the present study, it may be concluded that except for utility wax (4 mm and 8 mm and water (4 mm, all materials tested at different thickness could be used as soft tissue substitute materials in Oral Radiology studies.

  15. ABCC1 confers tissue-specific sensitivity to cortisol versus corticosterone: A rationale for safer glucocorticoid replacement therapy.

    Science.gov (United States)

    Nixon, Mark; Mackenzie, Scott D; Taylor, Ashley I; Homer, Natalie Z M; Livingstone, Dawn E; Mouras, Rabah; Morgan, Ruth A; Mole, Damian J; Stimson, Roland H; Reynolds, Rebecca M; Elfick, Alistair P D; Andrew, Ruth; Walker, Brian R

    2016-08-17

    The aim of treatment in congenital adrenal hyperplasia is to suppress excess adrenal androgens while achieving physiological glucocorticoid replacement. However, current glucocorticoid replacement regimes are inadequate because doses sufficient to suppress excess androgens almost invariably induce adverse metabolic effects. Although both cortisol and corticosterone are glucocorticoids that circulate in human plasma, any physiological role for corticosterone has been neglected. In the brain, the adenosine 5'-triphosphate-binding cassette transporter ABCB1 exports cortisol but not corticosterone. Conversely, ABCC1 exports corticosterone but not cortisol. We show that ABCC1, but not ABCB1, is expressed in human adipose and that ABCC1 inhibition increases intracellular corticosterone, but not cortisol, and induces glucocorticoid-responsive gene transcription in human adipocytes. Both C57Bl/6 mice treated with the ABCC1 inhibitor probenecid and FVB mice with deletion of Abcc1 accumulated more corticosterone than cortisol in adipose after adrenalectomy and corticosteroid infusion. This accumulation was sufficient to increase glucocorticoid-responsive adipose transcript expression. In human adipose tissue, tissue corticosterone concentrations were consistently low, and ABCC1 mRNA was up-regulated in obesity. To test the hypothesis that corticosterone effectively suppresses adrenocorticotropic hormone (ACTH) without the metabolic adverse effects of cortisol, we infused cortisol or corticosterone in patients with Addison's disease. ACTH suppression was similar, but subcutaneous adipose transcripts of glucocorticoid-responsive genes were higher after infusion with cortisol rather than with corticosterone. These data indicate that corticosterone may be a metabolically favorable alternative to cortisol for glucocorticoid replacement therapy when ACTH suppression is desirable, as in congenital adrenal hyperplasia, and justify development of a pharmaceutical preparation

  16. The tissue organization field theory of cancer: A testable replacement for the somatic mutation theory

    Science.gov (United States)

    Soto, Ana M.; Sonnenschein, Carlos

    2014-01-01

    The somatic mutation theory (SMT) of cancer has been and remains the prevalent theory attempting to explain how neoplasms arise and progress. This theory proposes that cancer is a clonal, cell-based disease, and implicitly assumes that quiescence is the default state of cells in multicellular organisms. The SMT has not been rigorously tested, and several lines of evidence raise questions that are not addressed by this theory. Herein, we propose experimental strategies that may validate the SMT. We also call attention to an alternative theory of carcinogenesis, the tissue organization field theory (TOFT), which posits that cancer is a tissue-based disease and that proliferation is the default state of all cells. Based on epistemological and experimental evidence, we argue that the TOFT compellingly explains carcinogenesis, while placing it within an evolutionarily relevant context. PMID:21503935

  17. [Treatment with isoflavones replaces estradiol effect on the tissue fat accumulation from ovariectomized rats].

    Science.gov (United States)

    Torrezan, Rosana; Gomes, Rodrigo M; Ferrarese, Maria L; de Melo, Fernando Ben-Hur; Ramos, Aparecida M D; Mathias, Paulo C F; Scomparin, Dionizia X

    2008-12-01

    Isoflavones (ISO) present in soybean are named phytoestrogens because they show estrogen effect. The use of isoflavones has beneficial effect in disturbance of post-menopause, which is characterized by ovarian function suppression. Decreasing of estrogen secretion and consequent morphologic and metabolic disarrangements are observed in female hormonal decline. The aim of present work was to investigate the effect of ISO on the fat accretion of uterine endometric tissue, and HDL and glucose blood concentration from ovariectomized rats (OVX). Female Wistar rats with 60 days-old were submitted a surgery to remove bilaterally the ovarium. After 8-day recovery period the animals were distributed into three groups: sham operate (GC); OVX ISO untreated (GI) and OVX supplemented with ISO (G II). Total uterus mass, uterus fat and retroperitoneal fat pad, were removed, washed and weighted. Samples of uterus were histological processed to measure endometrium thickness. Blood samples were also collected to analyze the concentration of HDL and glucose. The OVX caused endometric atrophy, decrease of uterus weight and HDL reduction. The treatment with ISO provoked decrease of uterine and retroperitoneal fat pad. HDL increase and glycemia reduction were also observed. However, there was no uterotrophic effect. ISO treatment causes decrease in tissue fat accretion from ovariectomized rats.

  18. New and viable cells to replace lost and malfunctioning myocardial tissue.

    Science.gov (United States)

    Hassink, R J; Passier, R; Goumans, M J; Mummery, C L; Doevendans, P A

    2004-10-01

    The use of stem cells for cardiac repair is a promising opportunity for developing new treatment strategies as the applications are theoretically unlimited and lead to actual cardiac tissue regeneration. Human embryonic stem cells were only recently cloned and their capacity to differentiate into true cardiomyocytes makes them in principle an unlimited source of transplantable cells for cardiac repair, although practical and ethical constraints exist. Also, the study of embryonic stem cells and their differentiation into cardiomyocytes will bring forth new insights into the molecular processes involved in cardiomyocyte-development and -proliferation, which could lead to the development of other strategies to augment in vivo cardiomyocyte numbers. On the other hand, somatic stem cells are alternative cell sources that can be used for cell transplantation purposes. They do not evoke ethical issues and bear less ethical constraints. However, they also appear to be much more restricted in their differentiation potential than the embryonic stem cells. Here we discuss the use of both cell types, embryonic and somatic stem cells, in relation with their importance for the clarification of cardiomyocyte-development and their possible usefulness for clinical therapy.

  19. Potential nutritional and economic effects of replacing juice with fruit in the diets of children in the United States.

    Science.gov (United States)

    Monsivais, Pablo; Rehm, Colin D

    2012-05-01

    To estimate the nutritional and economic effects of substituting whole fruit for juice in the diets of children in the United States. Secondary analyses using the 2001-2004 National Health and Nutrition Examination Survey and a national food prices database. Energy intakes, nutrient intakes, and diet costs were estimated before and after fruit juices were completely replaced with fruit in 3 models that emphasized fruits that were fresh, inexpensive, and widely consumed and in a fourth model that partially replaced juice with fruit, capping juice at recommended levels. A nationwide, representative sample of children in the United States. A total of 7023 children aged 3 to 18 years. Systematic complete or partial replacement of juice with fruit. Difference in energy intakes, nutrient intakes, and diet costs between observed and modeled diets. For children who consumed juice, replacement of all juice servings with fresh, whole fruit led to a projected reduction in dietary energy of 233 kJ/d (-2.6% difference [95% CI, -5.1% to -0.1%]), an increase in fiber of 4.3 g/d (31.1% difference [95% CI, 26.4%-35.9%]), and an increase in diet cost of $0.54/d (13.3% difference [95% CI, 8.8%-17.8%]). Substitution of juice with fresh fruit has the potential to reduce energy intake and improve the adequacy of fiber intake in children's diets. This would likely increase costs for schools, childcare providers, and families. These cost effects could be minimized by selecting processed fruits, but fewer nutritional gains would be achieved.

  20. Unit Manning System: Human Dimensions Field Evaluation of the COHORT company Replacement Model

    Science.gov (United States)

    1994-04-18

    tha: their superiors make such an attempt. Whether we speak of "unit cohesion" (Henderson, 1985; Johns, 1984), "unit morale" (Gal, 1986), "combat...differences. Generally speaking , mean differences on the five point scales must now be in the .4 to .5 range instead of the .2 to .3 range in order to...Marlowe, et al., 1985). Training in basic skiils , along with the maintenance of barracks standards and physical readiness, were all areas where COHORT

  1. The articular surface replacement implant recall: a United Kingdom district hospital experience.

    Science.gov (United States)

    Whitwell, George S; Shine, Ashokan; Young, Steve K

    2012-01-01

    We present our experience of the articular surface replacement (ASR) hip and the implant recall process. One hundred and twenty-one ASR components were implanted (21 resurfacing hip arthroplasty (RHA) and 100 ASR/XL modular total hip replacements). At the time of the implant recall in August 2010 there were 111 surviving hips (92%) with a mean follow-up of 44 months. Nine hips had been revised and one had been listed for revision surgery. Ninety-two percent of surviving implants were reviewed in the recall clinics, and blood metal ion levels or ultrasound scans were indicated in 38 hips (34%). Immediately after the recall process seven hips (6 ASR/XL and 1 RHA) were listed for revision and a further 9 were kept under close surveillance. One year after completion of the recall process 23 hips (19 ASR/XL and 4 RHA's) had been revised. A diagnosis of adverse reaction to metal debris (ARMD) was made at surgery in all but two hips. Our current revision rate for ASR RHA is 19% (mean follow-up 62 months, range 29-80) and for the ASR/XL is 19% (mean follow-up 53 months, range 10-80). The 5-year cumulative survival rates with revision for any reason for the ASR/XL, was 80.8% (95% confidence interval 72.0 - 89.5). Given experience elsewhere we expect this rate may increase significantly with time.

  2. Fabrication method, structure, mechanical, and biological properties of decellularized extracellular matrix for replacement of wide bone tissue defects.

    Science.gov (United States)

    Anisimova, N Y; Kiselevsky, M V; Sukhorukova, I V; Shvindina, N V; Shtansky, D V

    2015-09-01

    the replacement of wide bone tissue defects.

  3. Testosterone replacement therapy outcomes among opioid users: the Testim Registry in the United States (TRiUS).

    Science.gov (United States)

    Blick, Gary; Khera, Mohit; Bhattacharya, Rajib K; Nguyen, Dat; Kushner, Harvey; Miner, Martin M

    2012-05-01

    Among patients with hypogonadism-associated comorbidities, opioid users have the highest incidence of hypogonadism. Data from the Testim Registry in the United States were analyzed to determine the efficacy of testosterone replacement therapy in opioid users vs nonusers. Prospective, 12-month observational cohort registry. Hypogonadal men (N = 849) prescribed Testim (but not necessarily testosterone replacement) for the first time. Testim 1% testosterone gel (5-10 g/day). Total and free testosterone, sex hormone-binding globulin, prostate-specific antigen, sexual function, mood/depression, and anthropometric data were assessed. Changes from baseline were analyzed using repeated measures mixed-effects analysis of variance; multiple linear regressions of changes in testosterone levels with sexual function, mood, and opioid use were computed. 90/849 patients (10.6%) reported opioid use at baseline; 75/90 (83%) used opioids for ≥ 30 days prior to baseline. Baseline total testosterone and prostate-specific antigen were not statistically different between opioid users and nonusers; there was a trend for higher sex hormone-binding globulin (P = 0.08) and lower free testosterone (P = 0.05) in opioid users. After 1 month, both opioid users and nonusers had significant (P testosterone, which continued through 12 months. Sexual function and mood improved significantly in both opioid users and nonusers over 12 months, and significantly correlated with change in total testosterone. Testosterone replacement therapy increased serum testosterone in hypogonadal opioid users and nonusers alike. The data suggest that with testosterone replacement, hypogonadal opioid users might be expected to have similar improvements in sexual function and mood as opioid nonusers. Wiley Periodicals, Inc.

  4. TU-F-CAMPUS-T-05: Replacement Computational Phantoms to Estimate Dose in Out-Of-Field Organs and Tissues

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, K [Oregon State University, Corvallis, Oregon (United States); Oregon Health and Science University, Portland, Oregon (United States); Tannous, J; Nabha, R; Feghali, J; Ayoub, Z; Jalbout, W; Youssef, B [American University of Beirut Medical Center, Beirut (Lebanon); Taddei, P [American University of Beirut Medical Center, Beirut (Lebanon); The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: To estimate the absorbed dose in organs and tissues at risk for radiogenic cancer for children receiving photon radiotherapy for localized brain tumors (LBTs) by supplementing their missing body anatomies with those of replacement computational phantoms. Applied beyond the extent of the RT Images collected by computed tomography simulation, these phantoms included RT Image and RT Structure Set objects that encompassed sufficient extents and contours for dosimetric calculations. Method: Nine children, aged 2 to 14 years, who received three-dimensional conformal radiotherapy for low-grade LBTs, were randomly selected for this study under Institutional-Review-Board protocol. Because the extents of their RT Images were cranial only, they were matched for size and sex with patients from a previous study with larger extents and for whom contours of organs at risk for radiogenic cancer had already been delineated. Rigid fusion was performed between the patients’ data and those of the replacement computational phantoms using commercial software. In-field dose was calculated with a clinically-commissioned treatment planning system, and out-of-field dose was estimated with an analytical model. Results: Averaged over all nine children and normalized for a therapeutic dose of 54 Gy prescribed to the PTV, where the PTV is the GTV, the highest mean organ doses were 3.27, 2.41, 1.07, 1.02, 0.24, and 0.24 Gy in the non-tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs, respectively. The mean organ doses ranged by a factor of 3 between the smallest and largest children. Conclusion: For children receiving photon radiotherapy for LBTs, we found their doses in organs at risk for second cancer to be non-negligible, especially in the non-tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs. This study demonstrated the feasibility for patient dosimetry studies to augment missing patient anatomy by applying size- and sex-matched replacement

  5. Evaluating the quality of patient leaflets about renal replacement therapy across UK renal units.

    Science.gov (United States)

    Winterbottom, Anna; Conner, Mark; Mooney, Andrew; Bekker, Hilary L

    2007-08-01

    Enhancing patient participation is a priority for renal services. Good quality information is fundamental to facilitate patient involvement, but in other health contexts it has been found to be sub-optimal. This research aims to audit the provision of patient information by renal units and charities and to assess the quality of written information about dialysis treatment options. All UK renal units were sent a questionnaire about the patient information they provided. Renal units and charities that provided dialysis leaflets were asked to forward copies. Leaflet quality and content were assessed by a coding frame informed by information and decision aid checklists. Out of 105, 67 completed questionnaires were returned. Services provide patients with large amounts of information in several media (leaflets, meetings with nurses and patients, videos); computers were not used frequently. Out of 47, 32 units forwarded leaflets about dialysis, and 31 different leaflets. Most leaflets were difficult to understand and rarely included risk information or treatment limitations. No leaflets included techniques to assist patient involvement or decision-making; their primary goal was to inform. These data suggest an unsystematic pattern of information provision across the UK. Vast resources have been spent on providing information to patients that is difficult to comprehend and incomplete. Research needs to identify which resources are effective in meeting patient needs and at what point in their illness. A centralized system to guide renal services in the design and development of information resources may help meet the differing goals of education, choice facilitation and preparation for self-management.

  6. Chemical mode in secondary circuit of the Dukovany NPP units after TG condensers replacement

    Energy Technology Data Exchange (ETDEWEB)

    Kopriva, M.; Shejbal, J.; Petrecky, I. [Dukovany NPP (Czech Republic)

    2002-07-01

    The increase of the pH of SG feedwater on the 1. unit of Dukovany NPP led to enhancement of chemical mode of secondary circuit, what was identified in particular by the following: Reduction of concentration of iron in SG feedwater, Reduction of concentration of Sodium and Sulfates in SG blowdown water. This reduction is caused by shutdown of CPS thus by elimination of release of Na ions and SO{sub 4} from wrong operated ion-exchangers and their subsequent regeneration (part of cation exchanger in Na form and part of anion exchanger in SO{sub 4} form). Reduction of the WANO SG chemical index to the minimum theoretical value. It will be necessary to change criteria characterizing this index or to introduce our own modified index. In relation to CPS shutdown the costs for operating chemicals and for demineralized flushing water were reduced. (authors)

  7. Kinetic study of the replacement of porcine small intestinal submucosa grafts and the regeneration of meniscal-like tissue in large avascular meniscal defects in dogs.

    Science.gov (United States)

    Cook, J L; Tomlinson, J L; Arnoczky, S P; Fox, D B; Reeves Cook, C; Kreeger, J M

    2001-06-01

    Porcine small intestinal submucosa (SIS) was used to replace large, avascular defects in the medial menisci of dogs. Twelve dogs received SIS grafts and 3 dogs were left untreated as controls. Dogs were evaluated at 4, 8, and 12 weeks by means of lameness scoring and ultrasonography. Dogs were sacrificed at 1, 6, or 12 weeks after implantation, and the tissue at the site of meniscal resection was evaluated for gross and histologic appearance, cross-sectional and surface area, and collagen types I and II. The femoral and tibial condyles were assessed for articular cartilage damage. Control dogs were significantly more lame than grafted dogs 8 and 12 weeks after instrumentation. Grafted dogs' replacement tissue appeared meniscal-like when evaluated grossly and ultrasonographically 12 weeks after instrumentation. The amount of replacement tissue was significantly greater in both cross-sectional and surface area for grafted dogs than for controls at all time points. Histologically, the SIS biomaterial could be identified in all grafted dogs at 1 week post-implantation, but in none at 6 weeks post-implantation. Subjectively, grafted dogs' replacement tissue was histologically superior to that of controls with respect to tissue type, organization, and architecture. Collagen types I and II immunoreactivity in grafted menisci were similar to that of normal menisci. Control dogs had significantly more articular cartilage damage than grafted dogs. SIS appears to induce regeneration of meniscal-like tissue in large, avascular meniscal defects in dogs, resulting in superior clinical function and articular cartilage protection compared to ungrafted controls.

  8. A First Step in De Novo Synthesis of a Living Pulp Tissue Replacement Using Dental Pulp MSCs and Tissue Growth Factors, Encapsulated within a Bioinspired Alginate Hydrogel.

    Science.gov (United States)

    Bhoj, Manasi; Zhang, Chengfei; Green, David W

    2015-07-01

    A living, self-supporting pulp tissue replacement in vitro and for transplantation is an attractive yet unmet bioengineering challenge. Our aim is to create 3-dimensional alginate-based microenvironments that replicate the shape of gutta-percha and comprise key elements for the proliferation of progenitor cells and the release of growth factors. An RGD-bearing alginate framework was used to encapsulate dental pulp stem cells and human umbilical vein endothelial cells in a ratio of 1:1. The alginate hydrogel also retained and delivered 2 key growth factors, vascular endothelial growth factor-121 and fibroblast growth factor, in a sufficient amount to induce proliferation. A method was then devised to replicate the shape of gutta-percha using RGD alginate within a custom-made mold of thermoresponsive N-isopropylacrylamide. Plugs of alginate containing different permutations of growth factor-based encapsulates were tested and evaluated for viability, proliferation, and release kinetics between 1 and 14 days. According to scanning electron microscopic and confocal microscopic observations, the encapsulated human endothelial cells and dental pulp stem cell distribution were frequent and extensive throughout the length of the construct. There were also high levels of viability in all test environments. Furthermore, cell proliferation was higher in the growth factor-based groups. Growth factor release kinetics also showed significant differences between them. Interestingly, the combination of vascular endothelial growth factor and fibroblast growth factor synergize to significantly up-regulate cell proliferation. RGD-alginate scaffolds can be fabricated into shapes to fill the pulp space by simple templating. The addition of dual growth factors to cocultures of stem cells within RGD-alginate scaffolds led to the creation of microenvironments that significantly enhance the proliferation of dental pulp stem cell/human umbilical vein endothelial cell combinations. Copyright

  9. A rotated palatal flap ridge preservation technique to enhance restorative and hard and soft tissue esthetics for tooth replacement in the anterior maxilla.

    Science.gov (United States)

    Bitter, Robert N

    2010-04-01

    Hard and soft tissue alveolar ridge deformities occur following the extraction of teeth, creating functional and esthetic tooth replacement challenges, especially in the maxillary anterior smile zone. A surgical technique using a rotated palatal flap for ridge preservation is discussed that, whether combined with conventional fixed dentures or implant treatment for tooth replacement, provides the possibility for greatly improved esthetics. This technique, used in combination with or in preparation for implant treatment, allows for preservation of the alveolar bone height and width for improved implant size and placement options. In addition, preservation and enhancement of the soft tissue at the extraction site provides for soft tissue contours adjacent to the definitive restoration that vary little from those of the original natural tooth. Combined with conventional fixed dentures, use of this technique creates a template of the labial and interproximal sulcus of the extracted tooth, allowing for the molding of an ovate pontic replacement tooth. This results in vastly improved restorative emergence profiles with minimal or no change in the height of the labial gingival margin and the form and height of the interproximal papillae with adjacent teeth.

  10. A comparison of the clinical and experimental characteristics of four acute surgical pain models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery.

    Science.gov (United States)

    Singla, Neil K; Desjardins, Paul J; Chang, Phoebe D

    2014-03-01

    When a clinical trial of an analgesic produces a negative finding, it is important to consider the influence (if any) of experimental error on the validity of that result. Although efforts to identify and minimize experimental error in chronic pain investigations have begun in earnest, less work has been performed on the optimization of acute pain methodology. Of the acute surgical pain methodology articles that have been published over the last decade, almost all focus on either the dental or bunion model. Analgesics are typically evaluated in a variety of surgical models that eventually include hospital-based models (eg, joint replacement and soft tissue surgery). Every surgical procedure has unique clinical characteristics that must be considered to optimize study design and conduct. Much of the methodological knowledge garnered from bunion and dental studies is applicable to other surgical models, but some extrapolations are hazardous. The purposes of this review were (1) to qualitatively describe the clinical and experimental characteristics of the 4 classic surgical models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery; and (2) to quantitatively compare the models by analyzing 3 factors: effect size, enrollment rate, and demographics. We found that the dental extraction and bunionectomy models had higher assay sensitivity than the joint replacement and soft tissue surgery models. It is probable that this finding is secondary to the superior experimental conditions under which the dental and bunion models are executed (utilization of few centers that have the ability to reduce surgical, anesthetic, and postoperative confounders).

  11. [Aluminium in chronic renal replacement therapy patients undergoing haemodialysis in two renal units in Bogotá].

    Science.gov (United States)

    Cárdenas, Omayda; Segura, Omar; Puentes, William; Sanabria, Mauricio; Nava, Gerardo; Torrenegra, Rubén

    2010-08-01

    Determining aluminium concentrations in the serum of patients undergoing chronic renal replacement therapy with haemodialysis and concentration in distribution network water and dialysis in two renal units in Bogotá. This was a descriptive study of 63 haemodialysed patients and 20 healthy subjects. Aluminium concentration was determined in water and serum using graphite furnace atomic absorption spectrometry with deuterium lamp background corrector. Average aluminium concentration was 26.5 µg/L in patients (ranging from 11.2 to 49.2 µg/L; 8.03 standard deviation) and 8.05 µg/L in healthy individuals (ranging from undetectable to 17.2 µg/L; 4.31 standard deviation). Aluminium concentration in dialysis water and distribution network water was below 2 µg/L and 200 µg/L, respectively. Aluminium concentration in water and serum in this study was below international standard values, thereby indicating appropriate treatment. Additionally, aluminium concentration in pre-HD and post-HD sera was below that reported previously. Aluminium hydroxide uptake increases aluminium concentration in serum. Personal situation regarding age, gender, civil and work status were not risk factors determining aluminium concentrations in serum.

  12. Improved adipose tissue metabolism after 5-year growth hormone replacement therapy in growth hormone deficient adults: The role of zinc-α2-glycoprotein.

    Science.gov (United States)

    Balaž, Miroslav; Ukropcova, Barbara; Kurdiova, Timea; Vlcek, Miroslav; Surova, Martina; Krumpolec, Patrik; Vanuga, Peter; Gašperíková, Daniela; Klimeš, Iwar; Payer, Juraj; Wolfrum, Christian; Ukropec, Jozef

    2015-01-01

    Growth hormone (GH) supplementation therapy to adults with GH deficiency has beneficial effects on adipose tissue lipid metabolism, improving thus adipocyte functional morphology and insulin sensitivity. However, molecular nature of these effects remains unclear. We therefore tested the hypothesis that lipid-mobilizing adipokine zinc-α2-glycoprotein is causally linked to GH effects on adipose tissue lipid metabolism. Seventeen patients with severe GH deficiency examined before and after the 5-year GH replacement therapy were compared with age-, gender- and BMI-matched healthy controls. Euglycemic hyperinsulinemic clamp was used to assess whole-body and adipose tissue-specific insulin sensitivity. Glucose tolerance was determined by oGTT, visceral and subcutaneous abdominal adiposity by MRI, adipocyte size morphometrically after collagenase digestion, lipid accumulation and release was studied in differentiated human primary adipocytes in association with GH treatment and zinc-α2-glycoprotein gene silencing. Five-year GH replacement therapy improved glucose tolerance, adipose tissue insulin sensitivity and reduced adipocyte size without affecting adiposity and whole-body insulin sensitivity. Adipose tissue zinc-α2-glycoprotein expression was positively associated with whole-body and adipose tissue insulin sensitivity and negatively with adipocyte size. GH treatment to adipocytes in vitro increased zinc-α2-glycoprotein expression (>50%) and was paralleled by enhanced lipolysis and decreased triglyceride accumulation (>35%). Moreover, GH treatment improved antilipolytic action of insulin in cultured adipocytes. Most importantly, silencing zinc-α2-glycoprotein eliminated all of the GH effects on adipocyte lipid metabolism. Effects of 5-year GH supplementation therapy on adipose tissue lipid metabolism and insulin sensitivity are associated with zinc-α2-glycoprotein. Presence of this adipokine is required for the GH action on adipocyte lipid metabolism in vitro.

  13. Tissue structure damage in late-stage knee osteoarthritis: medication, markers, and disease modification before replacement surgery

    NARCIS (Netherlands)

    de Boer, T.N.

    2012-01-01

    The aim of this thesis is to gain more insight in the characteristics of end-stage osteoarthritic patients who are about to undergo total knee replacement surgery. Their use of medication, potential markers of actual characteristics of joint damage and inflammation, and effects of potential disease

  14. Impact of pharmacist antimicrobial dosing adjustments in septic patients on continuous renal replacement therapy in an intensive care unit.

    Science.gov (United States)

    Jiang, Sai-Ping; Zhu, Zheng-Yi; Ma, Kui-Fen; Zheng, Xia; Lu, Xiao-Yang

    2013-12-01

    Correct dosing of antimicrobial drugs in septic patients receiving continuous renal replacement therapy (CRRT) is complex. This study aimed to evaluate the effects of dosing adjustments performed by pharmacists on the length of intensive care unit (ICU) stay, ICU cost, and antimicrobial adverse drug events (ADEs). A single-center, 2-phase (pre-/post-intervention) study was performed in an ICU of a university-affiliated hospital. Septic patients receiving CRRT in the post-intervention phase received a specialized antimicrobial dosing service from critical care pharmacists, whereas patients in the pre-intervention phase received routine medical care without involving pharmacists. The 2 phases were compared to evaluate the outcomes of pharmacist interventions. Pharmacists made 183 antimicrobial dosing adjustment recommendations for septic patients receiving CRRT. Changes in CRRT-related variables (116, 63.4%) were the most common risk factors for dosing errors, and β-lactams (101, 55.2%) were the antimicrobials most commonly associated with dosing errors. Dosing adjustments were related to a reduced length of ICU stay from 10.7 ± 11.1 days to 7.7 ± 8.3 days (p = 0.037) in the intervention group, and to cost savings of $3525 (13,463 ± 12,045 vs. 9938 ± 8811, p = 0.038) per septic patient receiving CRRT in the ICU. Suspected antimicrobial adverse drug events in the intervention group were significantly fewer than in the pre-intervention group (19 events vs. 8 events, p = 0.048). The involvement of pharmacists in antimicrobial dosing adjustments in septic patients receiving CRRT is associated with a reduced length of ICU stay, lower ICU costs, and fewer ADEs. Hospitals may consider employing clinical pharmacists in ICUs.

  15. Analyzing the Function of Cartilage Replacements: A Laboratory Activity to Teach High School Students Chemical and Tissue Engineering Concepts

    Science.gov (United States)

    Renner, Julie N.; Emady, Heather N.; Galas, Richards J., Jr.; Zhange, Rong; Baertsch, Chelsey D.; Liu, Julie C.

    2013-01-01

    A cartilage tissue engineering laboratory activity was developed as part of the Exciting Discoveries for Girls in Engineering (EDGE) Summer Camp sponsored by the Women In Engineering Program (WIEP) at Purdue University. Our goal was to increase awareness of chemical engineering and tissue engineering in female high school students through a…

  16. Analyzing the Function of Cartilage Replacements: A Laboratory Activity to Teach High School Students Chemical and Tissue Engineering Concepts

    Science.gov (United States)

    Renner, Julie N.; Emady, Heather N.; Galas, Richards J., Jr.; Zhange, Rong; Baertsch, Chelsey D.; Liu, Julie C.

    2013-01-01

    A cartilage tissue engineering laboratory activity was developed as part of the Exciting Discoveries for Girls in Engineering (EDGE) Summer Camp sponsored by the Women In Engineering Program (WIEP) at Purdue University. Our goal was to increase awareness of chemical engineering and tissue engineering in female high school students through a…

  17. Characteristics of Bone Tissue and Composite Materials on the Basis of Natural Hydroxyapatite and Endodontic Cement for Replacement of the Tissue

    Science.gov (United States)

    Filipenkov, V. V.; Rupeks, L. E.; Vitins, V. M.; Knets, I. V.; Kasyanov, V. A.

    2017-07-01

    New biocomposites and the cattle bone tissue were investigated. The composites were made from an endodontic cement (EC) and natural hydroxyapatite (NHAp.) The results of experiments performed by the method of infrared spectroscopy showed that protein was removed from the heat-treated specimens of bone tissue practically completely. The structure of bone tissue before and after deproteinization and the structure of the composite materials based on NHAp and EC (with different percentage) were investigated by the method of optical microscopy. The characteristics of mechanical properties (the initial elastic modulus, breaking tensile and compressive stresses, and breaking strain) and the density and porosity of these materials were determined. The new composite materials were implanted in the live tissue of rat. Biocompatibility between the live tissue and the new biocomposites was estimated.

  18. A comparative analysis of the lipid tissue hormones concentration, lipid metabolism and insulin resistance in subclinical hypothyroidism depending on the presence/absence of the levothyroxin replacement therapy

    Directory of Open Access Journals (Sweden)

    N E Altshuler

    2011-09-01

    Full Text Available The aim of the present research was to study the influence of lipid tissue hormones on the mechanisms of insulin resistance development and rates of lipid metabolism in patients with subclinical hypothyroidism (SH aged over 50 years, depending on the body mass index (BMI, as well as the presence or absence of the levothyroxin (L-T4 replacement therapy. In patients with SH there were revealed disturbances of lipid metabolism which were manifested by low concentration of HDL-C, as well as the reduction in insulin sensitivity (an increase in the insulin level in normoglycemia and elevation of HOMA-IR rates. The analyses of lipid tissue hormones levels in studied groups showed an increase in adiponectin level within the reference values range, but they significantly differed from those of the controls. The values of leptin and resistin in the studied groups did not show significant difference from those of the healthy persons of the corresponding age, sex, and BMI. A correlation analysis of the values of lipid tissue hormones, TSH, lipid spectrum, insulin, glucose, and HOMA-IR was carried out. The results obtained were analyzed by two main points: the replacement therapy and BMI. The analyses of the results in accordance with BMI revealed that in patients with the normal body mass (BMI<24.9 kg/m2 the adiponectin rate was higher against the background of the lipid metabolism disturbance. In patients with the excessive body mass (BMI>25–29.9 kg/m2 the values of insulin and HOMA-IR increased, the disturbance of lipid metabolism aggravated, and adiponectin concentration decreased. The L-T4 replacement therapy was effective and resulted in the normalization of the rates of lipid and carbohydrate metabolism, adiponectin, and leptin. However the comparison of the results obtained in the groups with compensated and noncompensated SH shows that after 6 months significant differences were revealed only in the levels of adiponectin, resistin, and insulin.

  19. Use of testosterone replacement therapy in the United States and its effect on subsequent prostate cancer outcomes.

    Science.gov (United States)

    Kaplan, Alan L; Hu, Jim C

    2013-08-01

    To assess utilization trends and determine the effect of testosterone replacement therapy on outcomes in men who subsequently developed prostate cancer. We used linked Surveillance, Epidemiology, and End Results-Medicare data to identify 149,354 men diagnosed with prostate cancer from 1992 to 2007. Of those, 2,237 men (1.5%) underwent testosterone replacement therapy before their prostate cancer diagnosis. Propensity scoring methods were used to assess cancer-specific outcomes of testosterone replacement vs no replacement therapy. Testosterone replacement was associated with older age at cancer diagnosis, nonwhite race, and higher comorbidity (P testosterone vs testosterone before the prostate cancer diagnosis was associated with higher grade (34% vs 30%, P therapy after initial treatment. Through our observational study design, we show that testosterone use was low throughout the study period. Testosterone use was not associated with aggressive prostate cancer and did not affect overall or disease-specific mortality. Although our findings support growing evidence that testosterone replacement is safe with respect to prostate cancer, confirmatory prospective studies are needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Trends in Vascular Complications in High-Risk Patients Following Transcatheter Aortic Valve Replacement in the United States.

    Science.gov (United States)

    Ando, Tomo; Akintoye, Emmanuel; Telila, Tesfaye; Briasoulis, Alexandros; Takagi, Hisato; Grines, Cindy L; Afonso, Luis

    2017-02-10

    Vascular complications (VC) following transcatheter aortic valve replacement (TAVR) are associated with worse outcomes. The trend of VC incidence in patients considered high risk is unclear. We sought to assess the trend of VC after TAVR in patients at high risk. We investigated the VC trend in female, diabetes mellitus, and peripheral vascular disease (PVD) patients. Patients who underwent TAVR from 2011 to 2014 in the United States were identified using the International Classification of Diseases-Ninth Revision code 35.05 from the Nationwide Inpatient Sample database. Frequency of any VC (per 100 transcatheter aortic valve implantation procedure or hospital discharges) for each year from 2011 to 2014 was assessed for the overall population as well as within each category of high-risk cohorts. The overall VC rate was 6.0% (2,044/33,790). Patients who had VC were more likely to be female and had higher rates of PVD at baseline. The annual rate of VC in the overall population from 2011 to 2014 was 4.6%, 9.4%, 6.8%, and 4.4%, respectively. There was a significant increase in VC rate from 2011 to 2012 (p = 0.03), whereas there was a significant decrease in VC rate from 2012 to 2014 (p <0.001). The rate of VC between 2011 and 2014 was similar (p = 0.82). The rate of VC did not increase in any of the high-risk groups from 2011 to 2012. However, the rate of VC from 2012 to 2014 decreased significantly in all the high-risk groups. The VC rate was similar for groups between 2011 and 2014. The overall VC rate among TAVR patients initially increased from 2011 to 2012 but decreased thereafter. Similar trend in VC rate was found among high-risk patients except that the initial increase in rates from 2011 to 2012 did not reach statistical significance. Whether further reduction in VC with improvement in devices and operator/center experience for both overall and high-risk groups in TAVR occurs will require continuous longitudinal monitoring.

  1. Compression Molded Ultra High Molecular Weight Polyethylene-Hydroxyapatite-Aluminum Oxide-Carbon Nanotube Hybrid Composites for Hard Tissue Replacement

    Institute of Scientific and Technical Information of China (English)

    Ankur Gupta; Garima Tripathi; Debrupa Lahiri; Kantesh Balani

    2013-01-01

    Ultra high molecular weight polyethylene (UHMWPE) is widely used for articulating surfaces in total hip and knee replacements.In the present work,UHMWPE based polymer composites were synthesized by synergistic reinforcing of bioactive hydroxyapatite (HA),bioinert aluminum oxide (Al2O3),and carbon nanotubes (CNTs) using compression molding.Phase and microstructural analysis suggests retention of UHMWPE and reinforcing phases in the compression molded composites.Microstructural analysis elicited variation in densification due to the size effect of the reinforcing particles.The hybrid composites exhibited hardness,elastic modulus and toughness comparable to that of UHMWPE.The interfacial effect of reinforcement phases has evinced the effectiveness of Al2O3 over HA and CNT reinforcements,depicting synergistic enhancement in hardness and elastic modulus.Weak interfacial bonding of polymer matrix with HA and CNT requires utilization of coupling agents to achieve enhanced mechanical properties without deteriorating cytocompatible properties.

  2. Dietary fish oil replacement by linseed oil: Effect on growth, nutrient utilization, tissue fatty acid composition and desaturase gene expression in silver barb (Puntius gonionotus) fingerlings.

    Science.gov (United States)

    Nayak, Madhusmita; Saha, Ashis; Pradhan, Avinash; Samanta, Mrinal; Giri, Shiba Shankar

    2017-03-01

    Silver barb (Puntius gonionotus) is considered a promising medium carp species for freshwater aquaculture in Asia. This study in silver barb was carried out to evaluate the effects of total or partial substitution of dietary fish oil (FO) with linseed oil (LO) on growth, nutrient utilization, whole-body composition, muscle and liver fatty acid composition. Fish (12.1±0.4g of initial body weight) were fed for 60days with five experimental iso-proteinous, iso-lipidic and iso-caloric diets in which FO (control diet) was replaced by 33.3%, 50%, 66.7% and 100% LO. Final weight, weight gain, percent weight gain, SGR decreased linearly (p0.05) affect the feed conversion ratio (FCR), protein efficiency ratio (PER) and whole body proximate composition. Furthermore, enhanced level of LO increased α-linolenic acid (ALA; 18:3n3) and linoleic acid (LA; 18:2n6) and decreased eicosapentaenoic acid (EPA; 20:5n3) and docosahexaenoic acid (DHA; 22:6n3) in muscle and liver. To understand the molecular mechanism of long chain-polyunsaturated fatty acid (LC-PUFA) biosynthesis, we cloned and characterized the fatty acyl Δ6 desaturase (Δ6 fad) cDNA and investigated its expression in various organs/tissues following replacement of FO with LO in the diet. The full-length Δ6 fad cDNA was 2056bp encoding 444 amino acids and was widely expressed in various organs/tissues. Replacement of FO with LO increased the expression of Δ6 fad mRNA in liver, muscle and intestine but no significant difference was found in the brain. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Ultrasound-targeted transfection of tissue-type plasminogen activator gene carried by albumin nanoparticles to dog myocardium to prevent thrombosis after heart mechanical valve replacement

    Directory of Open Access Journals (Sweden)

    Ji J

    2012-06-01

    Full Text Available Ji Jun, Ji Shang-Yi, Yang Jian-An, He Xia, Yang Xiao-Han, Ling Wen-Ping, Chen Xiao-LingDepartment of Pathology and Cardiovascular Surgery, Shenzhen Sun Yat-Sen Cardiovascular Hospital, Shenzhen, Guangdong, People's Republic of ChinaBackground: There are more than 300,000 prosthetic heart valve replacements each year worldwide. These patients are faced with a higher risk of thromboembolic events after heart valve surgery and long-term or even life-long anticoagulative and antiplatelet therapies are necessary. Some severe complications such as hemorrhaging or rebound thrombosis can occur when the therapy ceases. Tissue-type plasminogen activator (t-PA is a thrombolytic agent. One of the best strategies is gene therapy, which offers a local high expression of t-PA over a prolonged time period to avoid both systemic hemorrhaging and local rebound thrombosis. There are some issues with t-PA that need to be addressed: currently, there is no up-to-date report on how the t-PA gene targets the heart in vivo and the gene vector for t-PA needs to be determined.Aims: To fabricate an albumin nano-t-PA gene ultrasound-targeted agent and investigate its targeting effect on prevention of thrombosis after heart mechanic valve replacement under therapeutic ultrasound.Methods: A dog model of mechanical tricuspid valve replacement was constructed. A highly expressive t-PA gene plasmid was constructed and packaged by nanoparticles prepared with bovine serum albumin. This nanopackaged t-PA gene plasmid was further cross-linked to ultrasonic microbubbles prepared with sucrose and bovine serum albumin to form the ultrasonic-targeted agent for t-PA gene transfection. The agent was given intravenously followed by a therapeutic ultrasound treatment (1 MHz, 1.5 w/cm2, 10 minutes of the heart soon after valve replacement had been performed. The expression of t-PA in myocardium was detected with multiclonal antibodies to t-PA by the indirect immunohistochemical method

  4. Adipose tissue-derived microvascular fragments: natural vascularization units for regenerative medicine.

    Science.gov (United States)

    Laschke, Matthias W; Menger, Michael D

    2015-08-01

    The establishment of effective vascularization is a key challenge in regenerative medicine. To achieve this, the transplantation of native microvascular fragments has emerged as a promising novel concept. Microvascular fragments can be isolated in large amounts from fat tissue, exhibit a high angiogenic activity, and represent a rich source of mesenchymal stem cells. Originally, microvascular fragments have been used in angiogenesis research for the isolation of capillary endothelium and for functional sprouting assays. More recent studies have demonstrated that they rapidly develop into microvascular networks after transfer into tissue defects. Moreover, they are suitable for the generation of prevascularized tissue constructs. Hence, a wide range of future medical applications may benefit from the use of these natural vascularization units. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The Open Physiology workflow: modeling processes over physiology circuitboards of interoperable tissue units

    Science.gov (United States)

    de Bono, Bernard; Safaei, Soroush; Grenon, Pierre; Nickerson, David P.; Alexander, Samuel; Helvensteijn, Michiel; Kok, Joost N.; Kokash, Natallia; Wu, Alan; Yu, Tommy; Hunter, Peter; Baldock, Richard A.

    2015-01-01

    A key challenge for the physiology modeling community is to enable the searching, objective comparison and, ultimately, re-use of models and associated data that are interoperable in terms of their physiological meaning. In this work, we outline the development of a workflow to modularize the simulation of tissue-level processes in physiology. In particular, we show how, via this approach, we can systematically extract, parcellate and annotate tissue histology data to represent component units of tissue function. These functional units are semantically interoperable, in terms of their physiological meaning. In particular, they are interoperable with respect to [i] each other and with respect to [ii] a circuitboard representation of long-range advective routes of fluid flow over which to model long-range molecular exchange between these units. We exemplify this approach through the combination of models for physiology-based pharmacokinetics and pharmacodynamics to quantitatively depict biological mechanisms across multiple scales. Links to the data, models and software components that constitute this workflow are found at http://open-physiology.org/. PMID:25759670

  6. Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism.

    Science.gov (United States)

    Sayin, Irmak; Erkan, Aycan Fahri; Ekici, Berkay; Kutuk, Utku; Corakci, Ahmet; Tore, Hasan Fehmi

    2016-01-01

    Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment. At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.

  7. Understanding the continuous renal replacement therapy circuit for acute renal failure support: a quality issue in the intensive care unit.

    Science.gov (United States)

    Boyle, Martin; Baldwin, Ian

    2010-01-01

    Delivery of renal replacement therapy is now a core competency of intensive care nursing. The safe and effective delivery of this form of therapy is a quality issue for intensive care, requiring an understanding of the principles underlying therapy and the functioning of machines used. Continuous hemofiltration, first described in 1977, used a system where blood flowed from arterial to venous cannulas through a small-volume, low-resistance, and high-flux filter. Monitoring of these early systems was limited, and without a machine interface, less nursing expertise was required. Current continuous renal replacement therapy machines offer user-friendly interfaces, cassette-style circuits, and comprehensive circuit diagnostics and monitoring. Although these machines conceal complexity behind a user-friendly interface, it remains important that nurses have sufficient knowledge for their use and the ability to compare and contrast circuit setups and functions for optimal and efficient treatment.

  8. Replacing dietary fish oil by vegetable oils has little effect on lipogenesis, lipid transport and tissue lipid uptake in rainbow trout (Oncorhynchus mykiss).

    Science.gov (United States)

    Richard, Nadège; Kaushik, Sadasivam; Larroquet, Laurence; Panserat, Stéphane; Corraze, Geneviève

    2006-08-01

    In order to investigate the effects of dietary lipid sources on mechanisms involved in lipid deposition, two groups of rainbow trout were fed from first-feeding to the commercial size of 1 kg (for 62 weeks) with two diets differing only by lipid source: 100% fish oil or 100% blend of vegetable oils (55% rapeseed oil, 30% palm oil, 15% linseed oil). The activities and levels of gene expression of lipogenic enzymes (fatty acid synthetase, glucose-6-phosphate dehydrogenase and malic enzyme) in liver and of lipoprotein lipase in perivisceral adipose tissue, white muscle and liver were determined. Transport of lipid was studied by determining lipid composition of plasma and lipoprotein classes. We also examined the clearance of LDL by assaying the level of LDL receptor gene expression in several tissues. Total replacement of dietary fish oil by the blend of vegetable oils did not affect growth of rainbow trout and did not modify muscle lipid content. Hepatic lipogenesis and lipid uptake in perivisceral adipose tissue, white muscle and liver were also not modified by dietary treatments. Diets containing the blend of vegetable oils induced a decrease in plasma cholesterol and LDL. In trout fed the vegetable oils diet, expression of LDL receptor gene in the liver was down-regulated.

  9. Unit cell-based computer-aided manufacturing system for tissue engineering.

    Science.gov (United States)

    Kang, Hyun-Wook; Park, Jeong Hun; Kang, Tae-Yun; Seol, Young-Joon; Cho, Dong-Woo

    2012-03-01

    Scaffolds play an important role in the regeneration of artificial tissues or organs. A scaffold is a porous structure with a micro-scale inner architecture in the range of several to several hundreds of micrometers. Therefore, computer-aided construction of scaffolds should provide sophisticated functionality for porous structure design and a tool path generation strategy that can achieve micro-scale architecture. In this study, a new unit cell-based computer-aided manufacturing (CAM) system was developed for the automated design and fabrication of a porous structure with micro-scale inner architecture that can be applied to composite tissue regeneration. The CAM system was developed by first defining a data structure for the computing process of a unit cell representing a single pore structure. Next, an algorithm and software were developed and applied to construct porous structures with a single or multiple pore design using solid freeform fabrication technology and a 3D tooth/spine computer-aided design model. We showed that this system is quite feasible for the design and fabrication of a scaffold for tissue engineering.

  10. In vitro and in vivo evaluation of a new zirconia/niobium biocermet for hard tissue replacement.

    Science.gov (United States)

    Bartolomé, J F; Moya, J S; Couceiro, R; Gutiérrez-González, C F; Guitián, F; Martinez-Insua, A

    2016-01-01

    Metals and ceramics are commonly used in orthopaedics, dentistry and other load bearing applications. However, the use of ceramic matrix composites reinforced with biocompatible metals for heavy load-bearing hard tissue replacement applications has not previously been reported. In order to improve the reliability and the mechanical properties of biomedical implants, new zirconia-Nb composites have been recently developed. The aim of this study was to investigate the biological tolerance of these new zirconia/Nb biocermets implants with both in vitro and in vivo approaches. At first, human bone marrow derived mesenchymal stem cells were cultured on sintered biocermet discs with polished surfaces and were compared with responses to niobium metal. In vitro, the biocermets showed no deleterious effect on cell proliferation, extra-cellular matrix production or on cell morphology. Furthermore, the biocermet showed a higher percentage of cell proliferation than Nb metal. On the other hand, the bone response to these new zirconia/Nb biocermets was studied. Cylinders of biocermets, as well as commercially Nb rod were implanted in the tibiae of New Zealand white rabbits. All the animals were euthanatized after 6 months. The specimens were processed to obtain thin ground sections. The slides were observed in normal transmitted light microscope. A newly formed bone was observed in close contact with material surfaces. No inflamed or multinucleated cells were present. This study concluded that zirconia/Nb composites are biocompatible and osteoconductive. The ceramic-metal composite has even better osteointegration ability than pure Nb. In conclusion, zirconia-Nb biocermet is suitable for heavy load-bearing hard tissue replacement from the point of view of both mechanical properties and biocompatibility.

  11. Improving the Estimates of International Space Station (ISS) Induced K-Factor Failure Rates for On-Orbit Replacement Unit (ORU) Supportability Analyses

    Science.gov (United States)

    Anderson, Leif F.; Harrington, Sean P.; Omeke, Ojei, II; Schwaab, Douglas G.

    2009-01-01

    This is a case study on revised estimates of induced failure for International Space Station (ISS) on-orbit replacement units (ORUs). We devise a heuristic to leverage operational experience data by aggregating ORU, associated function (vehicle sub -system), and vehicle effective' k-factors using actual failure experience. With this input, we determine a significant failure threshold and minimize the difference between the actual and predicted failure rates. We conclude with a discussion on both qualitative and quantitative improvements the heuristic methods and potential benefits to ISS supportability engineering analysis.

  12. Effects of Dexamethasone on Satellite Cells and Tissue Engineered Skeletal Muscle Units.

    Science.gov (United States)

    Syverud, Brian C; VanDusen, Keith W; Larkin, Lisa M

    2016-03-01

    Tissue engineered skeletal muscle has potential for application as a graft source for repairing soft tissue injuries, a model for testing pharmaceuticals, and a biomechanical actuator system for soft robots. However, engineered muscle to date has not produced forces comparable to native muscle, limiting its potential for repair and for use as an in vitro model for pharmaceutical testing. In this study, we examined the trophic effects of dexamethasone (DEX), a glucocorticoid that stimulates myoblast differentiation and fusion into myotubes, on our tissue engineered three-dimensional skeletal muscle units (SMUs). Using our established SMU fabrication protocol, muscle isolates were cultured with three experimental DEX concentrations (5, 10, and 25 nM) and compared to untreated controls. Following seeding onto a laminin-coated Sylgard substrate, the administration of DEX was initiated on day 0 or day 6 in growth medium or on day 9 after the switch to differentiation medium and was sustained until the completion of SMU fabrication. During this process, total cell proliferation was measured with a BrdU assay, and myogenesis and structural advancement of muscle cells were observed through immunostaining for MyoD, myogenin, desmin, and α-actinin. After SMU formation, isometric tetanic force production was measured to quantify function. The histological and functional assessment of the SMU showed that the administration of 10 nM DEX beginning on either day 0 or day 6 yielded optimal SMUs. These optimized SMUs exhibited formation of advanced sarcomeric structure and significant increases in myotube diameter and myotube fusion index, compared with untreated controls. Additionally, the optimized SMUs matured functionally, as indicated by a fivefold rise in force production. In conclusion, we have demonstrated that the addition of DEX to our process of engineering skeletal muscle tissue improves myogenesis, advances muscle structure, and increases force production in the

  13. Effects of fish oil replacement by vegetable oil blend on digestive enzymes and tissue histomorphology of European sea bass (Dicentrarchus labrax) juveniles.

    Science.gov (United States)

    Castro, Carolina; Couto, Ana; Pérez-Jiménez, Amalia; Serra, Cláudia R; Díaz-Rosales, Patricia; Fernandes, Rui; Corraze, Geneviève; Panserat, Stéphane; Oliva-Teles, Aires

    2016-02-01

    The impact of replacing circa 70% fish oil (FO) by a vegetable oil (VO) blend (rapeseed, linseed, palm oils; 20:50:30) in diets for European sea bass juveniles (IBW 96 ± 0.8 g) was evaluated in terms of activities of digestive enzymes (amylase, lipase, alkaline phosphatase, trypsin and total alkaline proteases) in the anterior (AI) and posterior (PI) intestine and tissue morphology (pyloric caeca-PC, AI, PI, distal intestine-DI and liver). For that purpose, fish were fed the experimental diets for 36 days and then liver and intestine were sampled at 2, 6 and 24 h after the last meal. Alkaline protease characterization was also done in AI and PI at 6 h post-feeding. Dietary VO promoted higher alkaline phosphatase activity at 2 h post-feeding in the AI and at all sampling points in the PI. Total alkaline protease activity was higher at 6 h post-feeding in the PI of fish fed the FO diet. Identical number of bands was observed in zymograms of alkaline proteases of fish fed both diets. No alterations in the histomorphology of PC, AI, PI or DI were noticed in fish fed the VO diets, while in the liver a tendency towards increased hepatocyte vacuolization due to lipid accumulation was observed. Overall, and with the exception of a higher intestine alkaline phosphatase activity, 70% FO replacement by a VO blend in diets for European sea bass resulted in no distinctive alterations on the postprandial pattern of digestive enzyme activities and intestine histomorphology.

  14. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... You may not be able to have a total ankle replacement if you have had ankle joint infections in ...

  15. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  16. Worth replacing a loss of medial meniscal tissue with a polyurethane substitute (Actifit®) when performing a valgus tibial osteotomy addition

    Science.gov (United States)

    Gelber, Pablo E.; Isart, Anna; Erquicia, Juan I.; Tey, Marc; Pelfort, Xavier; Abat, Ferran; Monllau, Juan Carlos

    2015-01-01

    Introduction: The addition tibial valgus osteotomy (ovat) is a common treatment of symptomatic genu varus. This frequently is accompanied by considerable loss of medial meniscal tissue. The aim was to evaluate, in the context of performing a ovat, restoring the functional impact of this lack of medial meniscal tissue with Actifit® compared with the simple meniscectomy. Material and Methods: Sixty patients with symptomatic genu varo operated with ovat were studied prospectively. In 30 patients we have left a medial meniscal defect> 25 mm (M) and in 30 a medial Actifit® was implanted(A). The evaluations were performed using Womet, IKDC, Kujala, EVA and satisfaction (0-4). Results: Both groups were statistically comparable preoperatively, including follow-up time (31.2 months; range, 24-47.5; p = 0.35). 53.4 ± 8.4 Womet improved and 42.4 ± 17.2 points in M and A (p = 0.002), improved IKDC 56.7 ± 12 and 50.3 ± 15.6 points in M and A (p = 0.107), 50.4 ± 14.7 Kujala improved to 38.9 ± 21.6 points M and A (p = 0.02) and VAS decreased 6.9 ± 2.1 and 4.7 ± 2.8 points in M and A (p = 0.006). The satisfaction was 3.3 ± 0.8 and 3.3 ± 1 in M and A (p = 0.84). Conclusions: The symptomatic genu varus treated with OVAT associated to medial meniscectomy led, compared to when it was associated with the implantation of a medial Actifit®, to a marked improvement in most of the scales tested. There was no difference in the degree of satisfaction. Based on short-term results of this study, restitution replacement with polyurethane substitute can not be recommended to perform a ovat.

  17. Selected persistent organic pollutants in human placental tissue from the United States.

    Science.gov (United States)

    Nanes, Jessica A; Xia, Yulin; Dassanayake, R M A Priyanthi S; Jones, Rachael M; Li, An; Stodgell, Christopher J; Walker, Cheryl; Szabo, Sara; Leuthner, Steve; Durkin, Maureen S; Moye, Jack; Miller, Richard K

    2014-07-01

    Emerging and legacy environmental pollutants such as polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and organochlorine pesticide metabolite DDE are found in human placenta, indicating prenatal exposure, but data from the United States are sparse. We sought to determine concentrations of these compounds in human placentae as part of a formative research project conducted by the National Children's Study Placenta Consortium. A total of 169 tissue specimens were collected at different time points post delivery from 43 human placentae at three U.S. locations, and analyzed by gas chromatography coupled with mass spectrometry following extraction using matrix solid phase dispersion. PBDEs, PCBs, and DDE were detected in all specimens. The concentrations of 10 PBDEs (Σ10PBDEs), 32 PCBs (Σ32PCBs) and p,p'-DDE were 43-1723, 76-856 and 10-1968pgg(-1) wet weight, respectively, in specimens collected shortly after delivery. Significant geographic differences in PBDEs were observed, with higher concentrations in placentae collected in Davis, CA than in those from Rochester, NY or Milwaukee, WI. We combined these with other published data and noted first-order declining trends for placental PCB and DDE concentrations over the past decades, with half-lives of about 5 and 8years, respectively. The effect of time to tissue collection from refrigerated placentae on measured concentrations of these three classes of persistent organic pollutants was additionally examined, with no significant effect observed up to 120h. The results of this work indicate that widespread prenatal exposure to persistent organic pollutants in the United States continues. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Generation of co-culture spheroids as vascularisation units for bone tissue engineering

    Directory of Open Access Journals (Sweden)

    R Walser

    2013-11-01

    Full Text Available Cell spheroids represent attractive building units for bone tissue engineering, because they provide a three-dimensional environment with intensive direct cell-cell contacts. Moreover, they allow for co-culture of both osteoblasts and vessel-forming cells, which may markedly increase their survival and vascularisation after transplantation. To test this hypothesis, we generated co-culture spheroids by aggregating different combinations of primary human osteoblasts (HOB, human dermal microvascular endothelial cells (HDMEC and normal human dermal fibroblasts (NHDF using the liquid overlay technique. Mono-culture spheroids consisting either of HOB or HDMEC served as controls. After in vitro characterisation, the different spheroids were transplanted into dorsal skinfold chambers of CD1 nu/nu mice to study in vivo their viability and vascularisation over a 2-week observation period by means of repetitive intravital fluorescence microscopy and immunohistochemistry. In vitro, co-culture spheroids containing HDMEC rapidly formed dense tubular vessel-like networks within 72 h and exhibited a significantly decreased rate of apoptotic cell death when compared to mono-culture HDMEC spheroids. After transplantation, these networks interconnected to the host microvasculature by external inosculation. Of interest, this process was most pronounced in HOB-HDMEC spheroids and could not further be improved by the addition of NHDF. Accordingly, HOB-HDMEC spheroids were larger when compared to the other spheroid types. These findings indicate that HOB-HDMEC spheroids exhibit excellent properties to preserve viability and to promote proliferation and vascularisation. Therefore, they may be used as functional vascularisation units in bone tissue engineering for the seeding of scaffolds or for the vitalisation of non-healing large bone defects.

  19. Lean tissue mass and energy expenditure are retained in hypogonadal men with spinal cord injury after discontinuation of testosterone replacement therapy.

    Science.gov (United States)

    Bauman, William A; La Fountaine, Michael F; Cirnigliaro, Christopher M; Kirshblum, Steven C; Spungen, Ann M

    2015-01-01

    To determine whether favorable changes to lean tissue mass (LTM), resting energy expenditure (REE), and testosterone (T) that occurred with 12 months of physiological testosterone replacement therapy (TRT) were retained 6 months after discontinuing treatment. Prospective, open-label, controlled drug intervention trial. Metropolitan area hospitals. Eugonadal (n = 11) and hypogonadal (n = 13) men with chronic spinal cord injury (SCI). Hypogonadal subjects received a 5 or 10 mg transdermal T patch daily for 12 months, with adjustment of the dose to normalize the serum T concentration; TRT was discontinued after 12 months (TRT-12M) and subjects were followed for an additional 6 months and re-evaluated (Post-TRT). Total body dual energy X-ray absorptiometry and blood draws were performed at baseline (BL) prior to TRT, TRT-12M, and Post-TRT. Eugonadal subjects did not receive treatment and were evaluated at comparable time points. There were no significant differences between groups prior to TRT at BL for any of the study endpoints. In the hypogonadal group, a significant increase in LTM was observed from BL to TRT-12M (50.2 ± 7.4 vs. 52.9 ± 6.8 kg, P therapy may be associated with persistent beneficial effects on health and physical function of hypogonadal men with chronic SCI.

  20. Effects of Replacing of Inorganic Trace Minerals by Organically Bound Trace Minerals on Growth Performance, Tissue Mineral Status, and Fecal Mineral Excretion in Commercial Grower-Finisher Pigs.

    Science.gov (United States)

    Liu, Bing; Xiong, Pingwen; Chen, Nana; He, Junna; Lin, Gang; Xue, Yan; Li, Weifen; Yu, Dongyou

    2016-10-01

    A total of 180 crossbred pigs (Duroc × Landrace × Large White; BW = 47.1 ± 4.8 kg) were used to investigate the effects of totally replacing inorganic trace minerals (ITMs) by organically bound trace minerals (OTMs) on growth performance, tissue mineral status, liver antioxidant enzyme activities, and fecal mineral excretion in grower-finisher pigs. A randomized complete block design with three treatments and six replicates (n = 10 pigs per pen) was used in this 69-day, 2-phase feeding trial. Experimental treatments were as follows: (1) a basal diet without trace mineral supplementation, (2) basal + ITMs (Fe, Mn, and Zn from sulfates, Cu oxychloride, and sodium selenite providing commercially recommended levels in China at 125, 22.5, 117.5, 30, and 0.3 mg/kg, respectively), and 3) basal + OTMs (Fe, Mn, Zn, and Cu from Bioplex and Se as Sel-Plex (Alltech Inc., Nicholasville, KY) providing levels identical to ITMs). No significant differences (P > 0.05) were observed in ADG, ADFI, or G:F among the treatments during the entire grower-finisher period. Supplementation with minerals, regardless of source, increased (P supplemented. Pigs supplemented with OTMs displayed greater activities of Cu/Zn-SOD, ALP, and GSH-Px in the liver compared to pigs supplemented with ITMs. Dietary mineral supplementation to pig diets greatly increased (P mineral (Fe, Mn, Zn, Cu, and Se) excretion in both grower and finisher phases. Fecal concentrations of Zn, Cu, and Se excretion were lower (P supplementation than that in pigs fed diets containing ITMs. These results indicate that use of organic trace minerals, as well as no trace mineral supplementation, did not influence pig growth performance. Totally replacing ITMs by equivalent levels of OTMs could improve hepatic Cu/Zn-SOD, ALP, and GSH-Px activities and reduce fecal Mn, Cu, and Se excretion for grower-finisher pigs when supplemented at commercially recommended levels.

  1. Safety Management of a Clinical Process Using Failure Mode and Effect Analysis: Continuous Renal Replacement Therapies in Intensive Care Unit Patients.

    Science.gov (United States)

    Sanchez-Izquierdo-Riera, Jose Angel; Molano-Alvarez, Esteban; Saez-de la Fuente, Ignacio; Maynar-Moliner, Javier; Marín-Mateos, Helena; Chacón-Alves, Silvia

    2016-01-01

    The failure mode and effect analysis (FMEA) may improve the safety of the continuous renal replacement therapies (CRRT) in the intensive care unit. We use this tool in three phases: 1) Retrospective observational study. 2) A process FMEA, with implementation of the improvement measures identified. 3) Cohort study after FMEA. We included 54 patients in the pre-FMEA group and 72 patients in the post-FMEA group. Comparing the risks frequencies per patient in both groups, we got less cases of under 24 hours of filter survival time in the post-FMEA group (31 patients 57.4% vs. 21 patients 29.6%; p < 0.05); less patients suffered circuit coagulation with inability to return the blood to the patient (25 patients [46.3%] vs. 16 patients [22.2%]; p < 0.05); 54 patients (100%) versus 5 (6.94%) did not get phosphorus levels monitoring (p < 0.05); in 14 patients (25.9%) versus 0 (0%), the CRRT prescription did not appear on medical orders. As a measure of improvement, we adopt a dynamic dosage management. After the process FMEA, there were several improvements in the management of intensive care unit patients receiving CRRT, and we consider it a useful tool for improving the safety of critically ill patients.

  2. Directed Replacement

    CERN Document Server

    Karttunen, L

    1996-01-01

    This paper introduces to the finite-state calculus a family of directed replace operators. In contrast to the simple replace expression, UPPER -> LOWER, defined in Karttunen (ACL-95), the new directed version, UPPER @-> LOWER, yields an unambiguous transducer if the lower language consists of a single string. It transduces the input string from left to right, making only the longest possible replacement at each point. A new type of replacement expression, UPPER @-> PREFIX ... SUFFIX, yields a transducer that inserts text around strings that are instances of UPPER. The symbol ... denotes the matching part of the input which itself remains unchanged. PREFIX and SUFFIX are regular expressions describing the insertions. Expressions of the type UPPER @-> PREFIX ... SUFFIX may be used to compose a deterministic parser for a ``local grammar'' in the sense of Gross (1989). Other useful applications of directed replacement include tokenization and filtering of text streams.

  3. Knee Replacement

    Science.gov (United States)

    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  4. Replacing penalties

    Directory of Open Access Journals (Sweden)

    Vitaly Stepashin

    2017-01-01

    Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the

  5. Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens

    Directory of Open Access Journals (Sweden)

    Chouksey Akhilesh

    2005-09-01

    Full Text Available Abstract For patients who require replacement therapy for primary immunodeficiency, subcutaneous infusions of immunoglobulin G (IgG may be preferable to intravenous infusions for several reasons. However, at present, there is no preparation marketed for use by this route in North America. In this article, we describe the reasons patients have selected this route of therapy and the range of treatment regimens used. Approximately 20% of our patients have chosen the subcutaneous route, mainly because of adverse effects from intravenous (IV infusions or difficulties with venous access. Unit dose regimens using whole bottles of currently available 16% intramuscular preparations or sucrose-containing lyophilized preparations intended for IV use but reconstituted to 15% IgG for subcutaneous administration were individually tailored to each patient. In most cases, self-infusions or home infusions were administered once or twice a week, most commonly requiring two subcutaneous sites and 2 to 3 hours per infusion. On average, patients took 0.18 mL of IgG per kilogram of body weight per site per hour. There were no systemic adverse effects. In patients for whom comparative data were available, trough serum IgG levels were higher with subcutaneous therapy than with IV therapy.

  6. Tissue versus mechanical valve replacement: Short term outcome among a sample of Egyptian patients with rheumatic mitral valve disease in Minia Governorate

    Directory of Open Access Journals (Sweden)

    Faisal A. Mourad

    2016-12-01

    Conclusion: Tissue mitral valve offers excellent early postoperative results and less complication rate than mechanical mitral valve. The EOA is significantly bigger in the tissue mitral valve in sizes 27–29 thus offering less patient prosthesis mismatch. Tissue valves are suitable for populations with lower socioeconomic status as Minia Governorate.

  7. Esophageal replacement.

    Science.gov (United States)

    Kunisaki, Shaun M; Coran, Arnold G

    2017-04-01

    This article focuses on esophageal replacement as a surgical option for pediatric patients with end-stage esophageal disease. While it is obvious that the patient׳s own esophagus is the best esophagus, persisting with attempts to retain a native esophagus with no function and at all costs are futile and usually detrimental to the overall well-being of the child. In such cases, the esophagus should be abandoned, and the appropriate esophageal replacement is chosen for definitive reconstruction. We review the various types of conduits used for esophageal replacement and discuss the unique advantages and disadvantages that are relevant for clinical decision-making. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Mechanical and biological properties of human hard tissue replacement implants%人体硬组织替代材料的力学及生物学性能研究

    Institute of Scientific and Technical Information of China (English)

    高素霞; 孟和

    2005-01-01

    目的:硬组织(骨、牙等)损伤或病变是临床上常见的事件,如果损伤或病变严重到无法进行药物治疗的程度,需要采取硬组织替代材料进行修复或置换.硬组织替代材料的研究已经成为目前生物材料领域的一个重要研究方向.对人体硬组织替代材料的类型、力学性能及生物学性能等方面进行综述,并指出硬组织替代材料的发展方向.资料来源:检索时间为1998-01/2004-07.中国期刊网CNKI数字图书馆(中国期刊全文数据库)及Science Direct数字图书馆中期刊30种.检索词为硬组织替代材料、人工骨、人工齿根、生物陶瓷、生物涂层等.检索手段包括电子检索和手工检索等.资料选择:选择关于人体硬组织替代材料的200篇相关文献进行分析、总结.数据提炼:对检索到的硬组织替代材料研究文章中相关信息进行综述.资料综合:对各种硬组织替代材料的力学及生物学性能进行比较分析,并了解其在实际应用中的效果.现有的硬组织替代材料,即金属材料、高分子材料、陶瓷材料以及它们的复合材料,已在临床获得比较广泛的应用,但是尚未达力学和生物学性能完美结合的程度.结论:寻找力学与生物学性能和人体固有硬组织完全匹配的替代材料,一直是生物医用材料学界的关注焦点(研究重点).应用仿生技术、纳米技术、复合技术以及组织工程研制的新一代硬组织替代材料有望满足人们日益提高的使用要求.%OBJECTIVE: Injuries and pathological changes of hard tissue(bone, tooth,etc.) are common clinical affairs. If the injuries or pathological changes are too serious to be treated with medication, they should be repaired or replaced by hard tissue replacement implants. Researches of hard tissue replacement implants have become an important research direction in biomaterial field at present. This paper is aimed to summarize the type, mechanical

  9. Children as donors: a national study to assess procurement of organs and tissues in pediatric intensive care units.

    Science.gov (United States)

    Siebelink, Marion J; Albers, Marcel J I J; Roodbol, Petrie F; Van de Wiel, Harry B M

    2012-12-01

    A shortage of size-matched organs and tissues is the key factor limiting transplantation in children. Empirical data on procurement from pediatric donors is sparse. This study investigated donor identification, parental consent, and effectuation rates, as well as adherence to the national protocol. A national retrospective cohort study was conducted in all eight Dutch pediatric intensive care units. Records of deceased children were analyzed by an independent donation officer. Seventy-four (11%) of 683 deceased children were found to be suitable for organ donation and 132 (19%) for tissue donation. Sixty-two (84%) potential organ donors had been correctly identified; the parental consent and effectuation rate was 42%. Sixty-three (48%) potential tissue donors had been correctly identified; the parental consent and effectuation rate was 27%. Correct identification increased with age (logistic regression, organs: P = .024; tissues: P = .011). Although an overall identification rate of 84% of potential organ donors may seem acceptable, the variation observed suggests room for improvement, as does the overall low rate of identification of pediatric tissue donors. Efforts to address the shortage of organs and tissues for transplantation in children should focus on identifying potential donors and on the reasons why parents do not consent.

  10. Intermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial.

    Science.gov (United States)

    Lins, Robert L; Elseviers, Monique M; Van der Niepen, Patricia; Hoste, Eric; Malbrain, Manu L; Damas, Pierre; Devriendt, Jacques

    2009-02-01

    There is uncertainty on the effect of different dialysis modalities for the treatment of patients with acute kidney injury (AKI), admitted to the intensive care unit (ICU). This controlled clinical trial performed in the framework of the multicentre SHARF 4 study (Stuivenberg Hospital Acute Renal Failure) aimed to investigate the outcome in patients with AKI, stratified according to severity of disease and randomized to different treatment options. This was a multicentre prospective randomized controlled trial with stratification according to severity of disease expressed by the SHARF score. ICU patients were eligible for inclusion when serum creatinine was >2 mg/dL, and RRT was initiated. The selected patients were randomized to intermittent (IRRT) or continuous renal replacement therapy (CRRT). A total of 316 AKI patients were randomly assigned to IRRT (n = 144) or CRRT (n = 172). The mean age was 66 (range 18-96); 59% were male. Intention-to-treat analysis revealed a mortality of 62.5% in IRRT compared to 58.1% in CRRT (P = 0.430). No difference between IRRT and CRRT could be observed in the duration of ICU stay or hospital stay. In survivors, renal recovery at hospital discharge was comparable between both groups. Multivariate analysis, including the SHARF score, APACHE II and SOFA scores for correction of disease severity, showed no difference in mortality between both treatment modalities. This result was confirmed in pre-specified subgroup analysis (elderly, patients with sepsis, heart failure, ventilation) and after exclusion of possible confounders (early mortality, delayed ICU admission). Modality of RRT, either CRRT or IRRT, had no impact on the outcome in ICU patients with AKI. Both modalities need to be considered as complementary in the treatment of AKI (Clinical Trial: SHARF 4, NCT00322933, http://ClinicalTrials.gov).

  11. Replacing the Transfusion of 1–2 Units of Blood with Plasma Expanders that Increase Oxygen Delivery Capacity: Evidence from Experimental Studies

    Directory of Open Access Journals (Sweden)

    Amy G. Tsai

    2014-10-01

    Full Text Available At least a third of the blood supply in the world is used to transfuse 1–2 units of packed red blood cells for each intervention and most clinical trials of blood substitutes have been carried out at this level of oxygen carrying capacity (OCC restoration. However, the increase of oxygenation achieved is marginal or none at all for molecular hemoglobin (Hb products, due to their lingering vasoactivity. This has provided the impetus for the development of “oxygen therapeutics” using Hb-based molecules that have high oxygen affinity and target delivery of oxygen to anoxic areas. However it is still unclear how these oxygen carriers counteract or mitigate the functional effects of anemia due to obstruction, vasoconstriction and under-perfusion. Indeed, they are administered as a low dosage/low volume therapeutic Hb (subsequently further diluted in the circulatory pool and hence induce extremely small OCC changes. Hyperviscous plasma expanders provide an alternative to oxygen therapeutics by increasing the oxygen delivery capacity (ODC; in anemia they induce supra-perfusion and increase tissue perfusion (flow by as much as 50%. Polyethylene glycol conjugate albumin (PEG-Alb accomplishes this by enhancing the shear thinning behavior of diluted blood, which increases microvascular endothelial shear stress, causes vasodilation and lowering peripheral vascular resistance thus facilitating cardiac function. Induction of supra-perfusion takes advantage of the fact that ODC is the product of OCC and blood flow and hence can be maintained by increasing either or both. Animal studies suggest that this approach may save a considerable fraction of the blood supply. It has an additional benefit of enhancing tissue clearance of toxic metabolites.

  12. Animal-free toxicology: the use of human tissue to replace the use of animals - examples from human biomonitoring and human placental transport studies.

    Science.gov (United States)

    Knudsen, Lisbeth E

    2013-12-01

    Human data on exposure and adverse effects are the most appropriate for human risk assessment, and modern toxicology focuses on human pathway analysis and the development of human biomarkers. Human biomonitoring and human placental transport studies provide necessary information for human risk assessment, in accordance with the legislation on chemical, medicine and food safety. Toxicology studies based on human mechanistic and exposure information can replace animal studies. These animal-free approaches can be further supplemented by new in silico methods and chemical structure-activity relationships. The inclusion of replacement expertise in the international Three Rs centres, the ongoing exploration of alternatives to animal research, and the improvement of conditions for research animals, all imply the beginning of a paradigm shift in toxicology research toward the use of human data.

  13. Patient dosimetry activities in the United States: the nationwide evaluation of X-ray trends (NEXT) and tissue dose handbooks.

    Science.gov (United States)

    Suleiman, O H; Stern, S H; Spelic, D C

    1999-01-01

    In the United States the Food and Drug Administration (FDA) in collaboration with the Conference of Radiation Control Program Directors (CRCPD) and state and local government agencies surveys clinical facilities about X-ray system air kerma and ancillary data related to patient dosimetry for a variety of diagnostic X-ray examinations. The survey program is known as the Nationwide Evaluation of X-ray Trends (NEXT). The survey utilizes reference patient-equivalent phantoms in the collection of comprehensive technical information. With knowledge of the skin-entrance air kerma, specific tissue doses can be calculated. An overview of NEXT and previously published FDA tissue dose handbooks for diagnostic X-ray examinations is presented.

  14. Spectral analysis of tissues from patients with cancer using a portable spectroscopic diagnostic ratiometer unit

    Science.gov (United States)

    Sordillo, Laura A.; Pu, Yang; Sordillo, Peter P.; Budansky, Yury; Alfano, R. R.

    2014-05-01

    Spectral profiles of tissues from patients with breast carcinoma, malignant carcinoid and non-small cell lung carcinoma were acquired using native fluorescence spectroscopy. A novel spectroscopic ratiometer device (S3-LED) with selective excitation wavelengths at 280 nm and 335 nm was used to produce the emission spectra of the key biomolecules, tryptophan and NADH, in the tissue samples. In each of the samples, analysis of emission intensity peaks from biomolecules showed increased 340 nm/440 nm and 340 nm/460 nm ratios in the malignant samples compared to their paired normal samples. This most likely represented increased tryptophan to NADH ratios in the malignant tissue samples compared to their paired normal samples. Among the non-small cell lung carcinoma and breast carcinomas, it appeared that tumors of very large size or poor differentiation had an even greater increase in the 340 nm/440 nm and 340 nm/460 nm ratios. In the samples of malignant carcinoid, which is known to be a highly metabolically active tumor, a marked increase in these ratios was also seen.

  15. Influence of implant position on clinical crown length and peri-implant soft tissue dimensions at implant-supported single crowns replacing maxillary central incisors

    DEFF Research Database (Denmark)

    Peng, Min; Fei, Wei; Hosseini, Mandana

    2013-01-01

    The aims of the present study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors, and to validate the papilla index score (PIS). Twenty-five patients, who had lost one of ...

  16. Acceptance test for 900 MWe PWR unit replacement steam generators; Essai de reception des generateurs de vapeur de remplacement des tranches REP 900

    Energy Technology Data Exchange (ETDEWEB)

    Gourguechon, B.

    1993-12-31

    During the first half of 1994, the Gravelines 1 steam generators will be replaced (SG replacement procedure). The new SG`s differ from the former components notably by the alloy used for the tube bundle, in this case, the high chromium content Inconel 690. So, from this standpoint, they are to be considered as PWR 900 replacement SG first models and their thermal efficiency has consequently to be assessed. This will provide an opportunity of ensuring that the performance of the components delivered is in compliance with requirements and of making the necessary provisions if significant deviations are observed. The EFMT branch, which has been in charge of the instrumentation and acceptance of the different SG first models since the first PWR plants were commissioned, will be responsible for the acceptance tests and the ultimate validation of a performance assessment procedure applicable to the future replacement steam generators. The methods and tests proposed for SG expert appraisal are based on consideration of the importance of primary measurement quality for satisfactory SG assessment and of the new test facilities with which the 900 and 1 300 PWR plants are gradually being equipped. These facilities provide an on-site computer environment for tests compatible with the tools (PATTERN, etc.) used at EFMT and in other departments. This test is the first of this kind performed by EFMT and the test facility of a nuclear power plant. (author). 6 figs.

  17. [Estrogen replacement].

    Science.gov (United States)

    Søgaard, A J; Berntsen, G K; Magnus, J H; Tollan, A

    1998-02-10

    Recent research on long-term postmenopausal hormone replacement therapy (HRT) indicates a positive effect on both total mortality and morbidity. This has raised the question of widespread preventive long-term use of HRT. Possible side-effects and ideological issues related to preventive HRT have led to debate and uncertainty among health professionals, in the media, and in the population at large. In order to evaluate the level of knowledge about and attitudes towards HRT, a randomly selected group of 737 Norwegian women aged 16-79 was interviewed by the Central Bureau of Statistics. One in three women had received information about HRT in the last two years, mainly through weekly magazines and physicians. The proportion who answered the questions on knowledge correctly varied from 36% to 47%. Those who had been given information by a physician possessed accurate knowledge, had more positive attitudes towards HRT and were more willing to use HRT than women who had reviewed information through other channels. Women with a higher level of education were better informed and more knowledgeable than others, but were nevertheless more reluctant to use HRT than those who were less educated. The limited number of women who actually receive information on HRT, the low level of knowledge and the ambivalent attitudes toward HRT are a major challenge to the public health service.

  18. Influence of implant position on clinical crown length and peri-implant soft tissue dimensions at implant-supported single crowns replacing maxillary central incisors

    DEFF Research Database (Denmark)

    Peng, Min; Fei, Wei; Hosseini, Mandana

    2013-01-01

    as controls. Paired sample t-testand Pearson´s correlation analysis were used to analyze implant position, dimension of crownand papilla fill.Cohen’s ¿ andSpearman correlation were used to validate the PIS.The implant-supported crown was statistically longer than the contra-lateral tooth......The aims of the present study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors, and to validate the papilla index score (PIS). Twenty-five patients, who had lost one......, and there was significant correlation between the oro-facial position of the implant and the crown length difference (r=.607, p=.001). The distalpapilla was significantly shorter than the mesialpapilla at implant-supported crowns (p

  19. Comparison of a ZGP OPO with a Mark-III FEL as a Potential Replacement for Mid-Infrared Soft Tissue Ablation Applications

    CERN Document Server

    Mackanos, M A

    2005-01-01

    A Mark-III FEL, tuned to 6.45 μm has demonstrated minimal collateral damage and high ablation yield in soft tissue. Further clinical advances are limited due to the overhead associated with an FEL; alternative mid-IR sources are needed. The FEL parameters needed to carry out efficient ablation with minimal damage must be determined. Studies by this author have shown that the unique pulse structure of the FEL does not play a role in this process [1]. We focused on comparing the macropulse duration of the FEL with a ZGP-OPO. No difference in pulse structure between the two laser sources with respect to the ablation threshold of water and mouse dermis was seen. There is a difference between the sources with respect to the crater depths in gelatin and mouse dermis. At 6.1 μm, the OPO craters are 8 times the depth of the FEL ones. Brightfield imaging shows the classic ablation mechanism. The timescale of the crater formation, ejection, and collapse occurs on a faster scale for the OPO. Histology ...

  20. Grading the severity of soft tissue changes associated with metal-on-metal hip replacements: reliability of an MR grading system

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Helen; Cahir, John G.; Goodwin, Richard W. [Norfolk and Norwich University Hospital, Department of Radiology, Norwich, Norfolk (United Kingdom); Toms, Andoni Paul [Norfolk and Norwich University Hospital, Department of Radiology, Norwich, Norfolk (United Kingdom); Norwich Radiology Academy, Norwich (United Kingdom); Wimhurst, James; Nolan, John F. [Norfolk and Norwich University Hospital, Department of Orthopaedics, Norwich, Norfolk (United Kingdom)

    2011-03-15

    Metal-on-metal (MoM) soft tissue reactions or aseptic lymphocytic vasculitis-associated lesions (ALVAL) are being recognised using metal artefact reduction (MAR) MR with increasing frequency following the advent of second generation metal-on-metal bearings, but there is no standardised technique for reporting of MR appearances in this disease. The aim of this study was to measure the reliability of a grading system designed for scoring the severity of MoM disease on MRI. MRI examinations of 73 hips in 59 patients were retrospectively selected and then anonymised, randomised and reviewed by three independent observers (musculoskeletal radiologists). Each MR examination was scored as either A: normal, B: infection, C1: mild MoM disease, C2: moderate MoM disease or C3: severe MoM disease according to pre-defined criteria. Kappa correlation statistics were used to compare the observations. There was substantial agreement among all three observers; the correlation coefficient between the two most experienced observers was {kappa} = 0.78 [95% confidence intervals (CI): 0.68-0.88] and when compared with the least experienced observer coefficients were {kappa} = 0.69 (95% CI: 0.57-0.80) and {kappa} = 0.66 (95% CI: 0.54-0.78). The strongest correlation occurred for grades A, C2 and C3. The weakest correlations occurred for grades B and C1. The grading system described in this study is reliable for evaluating ALVAL in MoM prostheses using MR but is limited in differentiating mild disease from infection. (orig.)

  1. Placement of replace select Ti-Unite-coated type implants using a combination of immediate and submerge techniques after tooth extraction

    Directory of Open Access Journals (Sweden)

    Coen Pramono D

    2006-06-01

    Full Text Available The high success rate of immediate implant placement both in the anterior and posterior regions were reported by many authors, therefore applying this techniques can be considered as a safe surgical procedure and minimizing the dental office visit for patient satisfaction. This paper reports the outcome of immediate placement of implants following extraction of anterior maxillary teeth. Combination technique of immediate and submerge implant placements including bone grafting procedure were used. Four implants with TiUnite surface type were placed immediately in two patients with the short-term result indicated that this technique may serve as a simple and safe procedure for immediate implant placement. It was concluded that immediate implant placement technique combined with TiUnite implant surface was successful in treating region directly after tooth extraction therefore this technique can be use as an alternative surgical method for dental implant rehabilitation.

  2. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

    Science.gov (United States)

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y

    2008-09-01

    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  3. OPTIMUM ORDERING POLICY FOR PREVENTIVE AGE REPLACEMENT

    Institute of Scientific and Technical Information of China (English)

    Young T.PARK; Jing SUN

    2009-01-01

    Most of the spare ordering policies treated up to now have assumed that preventive and corrective replacement costs are equal, which implies in essential that there is no significant need for preventive replacement. This paper presents an ordering policy for preventive age replacement with minimal repair. Introducing the replacement, repair, inventory holding and shortage costs, the expected cost rate is derived. A procedure to determine jointly the ordering time for a spare and the preventive replacement time for the operating unit so as to minimize the expected cost rate is proposed. To explain the ordering policy and the optimization procedure, a numerical example is also included.

  4. Persistent organic pollutants in fish tissue in the mid-continental great rivers of the United States

    Science.gov (United States)

    Blacksom, Karen A.; Walters, David M.; Jicha, Terri M.; Lazorchak, James M.; Angradi, Theodore R.; Bolgrien, David W.

    2010-01-01

    Great rivers of the central United States (Upper Mississippi, Missouri, and Ohio rivers) are valuable economic and cultural resources, yet until recently their ecological condition has not been well quantified. In 2004–2005, as part of the Environmental Monitoring and Assessment Program for Great River Ecosystems (EMAP-GRE), we measured legacy organochlorines (OCs) (pesticides and polychlorinated biphenyls, PCBs) and emerging compounds (polybrominated diphenyl ethers, PBDEs) in whole fish to estimate human and wildlife exposure risks from fish consumption. PCBs, PBDEs, chlordane, dieldrin and dichlorodiphenyltrichloroethane (DDT) were detected in most samples across all rivers, and hexachlorobenzene was detected in most Ohio River samples. Concentrations were highest in the Ohio River, followed by the Mississippi and Missouri Rivers, respectively. Dieldrin and PCBs posed the greatest risk to humans. Their concentrations exceeded human screening values for cancer risk in 27–54% and 16–98% of river km, respectively. Chlordane exceeded wildlife risk values for kingfisher in 11–96% of river km. PBDE concentrations were highest in large fish in the Missouri and Ohio Rivers (mean > 1000 ng g−1 lipid), with congener 47 most prevalent. OC and PBDE concentrations were positively related to fish size, lipid content, trophic guild, and proximity to urban areas. Contamination of fishes by OCs is widespread among great rivers, although exposure risks appear to be more localized and limited in scope. As an indicator of ecological condition, fish tissue contamination contributes to the overall assessment of great river ecosystems in the U.S.

  5. A Geothermal Energy Supported Gas-steam Cogeneration Unit as a Possible Replacement for the Old Part of a Municipal CHP Plant (TEKO

    Directory of Open Access Journals (Sweden)

    L. Böszörményi

    2001-01-01

    Full Text Available The need for more intensive utilization of local renewable energy sources is indisputable. Under the current economic circumstances their competitiveness in comparison with fossil fuels is rather low, if we do not take into account environmental considerations. Integrating geothermal sources into combined heat and power production in a municipal CHP plant would be an excellent solution to this problem. This concept could lead to an innovative type of power plant - a gas-steam cycle based, geothermal energy supported cogeneration unit.

  6. Engineering Replacement Tissues with Amniotic Stem Cells

    Science.gov (United States)

    2012-10-01

    chondrogenic conditions (2D) formed tight nodes after 14 days. From left to right, nodes stained positive for alcian blue, safranin -O, and collagen II. 3...potential (alcian blue, safranin -O, collagen II staining) and colony forming ability were established (Figure 2). We were able to expand the cell...groups appear to be negative for Safranin -O stain (Figure 16) and weakly positive for alcian blue stain (Figure 17). Upon examination at a higher

  7. Replacement of HA-MRSA by CA-MRSA infections at an academic medical center in the midwestern United States, 2004-5 to 2008.

    Directory of Open Access Journals (Sweden)

    Michael Z David

    Full Text Available We noted anecdotally that infections designated as health care-associated (HA- MRSA by epidemiologic criteria seemed to be decreasing in incidence at the University of Chicago Medical Center (UCMC after 2004. We compared MRSA patients seen at any site of clinical care at UCMC and the isolates that caused their infections in 2004-5 (n = 545 with those in 2008 (n = 135. The percent of patients with MRSA infections cultured > 2 days after hospital admission decreased from 19.5% in 2004-5 to 7.4% in 2008 (p = 0.001. The percent in 2004-5 compared with 2008 who had a hospitalization (49.1% to 26.7%, p = 0.001 or surgery (43.0% to 14.1%, p<0.001 in the previous year decreased. In 2008 a greater percent of patients was seen in the emergency department (23.1% vs. 39.3% and a smaller percent both in intensive care units (15.6% vs. 6.7% and in other inpatient units (40.7% vs. 32.6% (p<0.001. The percent of patients with CA-MRSA infections by the CDC epidemiologic criteria increased from 36.5% in 2004-5 to 62.2% in 2008 (p<0.001. The percent of MRSA isolates sharing genetic characteristics of USA100 decreased from 27.9% (152/545 to 12.6% (17/135, while the percent with CA-MRSA (USA300 characteristics increased from 53.2% (290/545 to 66.7% (90/135. The percent of infections that were invasive did not change significantly. Our data suggest that HA-MRSA infections, both by epidemiologic and microbiologic criteria, relative to CA-MRSA, decreased between 2004-5 and 2008 at UCMC.

  8. Effect of bovine colostrum feeding in comparison with milk replacer and natural feeding on the immune responses and colonisation of enterotoxigenic Escherichia coli in the intestinal tissue of piglets

    DEFF Research Database (Denmark)

    Sugiharto, Sugiharto; Poulsen, Ann-Sofie Riis; Canibe, Nuria;

    2015-01-01

    (23-d-old) were allocated to one of the following four groups: (1) killed at the beginning of the experiment (Base); (2) separated from the sow and fed BC (BC-fed); (3) separated from the sow and fed a MR (MR-fed); (4) kept with the sow (Sow-Milk). Blood was sampled on days 1 and 8, and faecal samples......The present study investigated the effect of feeding bovine colostrum (BC) to piglets in comparison with feeding a milk replacer (MR) and conventional rearing by the sow on the intestinal immune system and number of enterotoxigenic Escherichia coli (ETEC) colonising the intestinal tissue. Piglets...... were collected on days 1, 3, 5 and 8. On day 8, piglets were killed and gastrointestinal digesta and intestinal segments were collected. The frequency of diarrhoea was found to be higher (P≤ 0·019) in MR-fed piglets than in BC-fed and Sow-Milk piglets. Piglets from the MR-fed group had the lowest...

  9. Women Up, Men Down: The Clinical Impact of Replacing the Framingham Risk Score with the Reynolds Risk Score in the United States Population

    Science.gov (United States)

    Tattersall, Matthew C.; Gangnon, Ronald E.; Karmali, Kunal N.; Keevil, Jon G.

    2012-01-01

    Background The Reynolds Risk Score (RRS) is one alternative to the Framingham Risk Score (FRS) for cardiovascular risk assessment. The Adult Treatment Panel III (ATP III) integrated the FRS a decade ago, but with the anticipated release of ATP IV, it remains uncertain how and which risk models will be integrated into the recommendations. We sought to define the effects in the United States population of a transition from the FRS to the RRS for cardiovascular risk assessment. Methods Using the National Health and Nutrition Examination Surveys, we assessed FRS and RRS in 2,502 subjects representing approximately 53.6 Million (M) men (ages 50–79) and women (ages 45–79), without cardiovascular disease or diabetes. We calculated the proportion reclassified by RRS and the subset whose LDL-C goal achievement changed. Results Compared to FRS, the RRS assigns a higher risk category to 13.9% of women and 9.1% of men while assigning a lower risk to 35.7% of men and 2% of women. Overall, 4.7% of women and 1.1% of men fail to meet newly intensified LDL-C goals using the RRS. Conversely, 10.5% of men and 0.6% of women now meet LDL-C goal using RRS when they had not by FRS. Conclusion In the U.S. population the RRS assigns a new risk category for one in six women and four of nine men. In general, women increase while men decrease risk. In conclusion, adopting the RRS for the 53.6 million eligible U.S. adults would result in intensification of clinical management in 1.6 M additional women and 2.10 M fewer men. PMID:22984495

  10. Women up, men down: the clinical impact of replacing the Framingham Risk Score with the Reynolds Risk Score in the United States population.

    Directory of Open Access Journals (Sweden)

    Matthew C Tattersall

    Full Text Available BACKGROUND: The Reynolds Risk Score (RRS is one alternative to the Framingham Risk Score (FRS for cardiovascular risk assessment. The Adult Treatment Panel III (ATP III integrated the FRS a decade ago, but with the anticipated release of ATP IV, it remains uncertain how and which risk models will be integrated into the recommendations. We sought to define the effects in the United States population of a transition from the FRS to the RRS for cardiovascular risk assessment. METHODS: Using the National Health and Nutrition Examination Surveys, we assessed FRS and RRS in 2,502 subjects representing approximately 53.6 Million (M men (ages 50-79 and women (ages 45-79, without cardiovascular disease or diabetes. We calculated the proportion reclassified by RRS and the subset whose LDL-C goal achievement changed. RESULTS: Compared to FRS, the RRS assigns a higher risk category to 13.9% of women and 9.1% of men while assigning a lower risk to 35.7% of men and 2% of women. Overall, 4.7% of women and 1.1% of men fail to meet newly intensified LDL-C goals using the RRS. Conversely, 10.5% of men and 0.6% of women now meet LDL-C goal using RRS when they had not by FRS. CONCLUSION: In the U.S. population the RRS assigns a new risk category for one in six women and four of nine men. In general, women increase while men decrease risk. In conclusion, adopting the RRS for the 53.6 million eligible U.S. adults would result in intensification of clinical management in 1.6 M additional women and 2.10 M fewer men.

  11. Evaluation of reports of dioxin exposure and soft tissue sarcoma pathology among chemical workers in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fingerhut, M.A.; Halperin, W.E.; Honchar, P.A.; Smith, A.B.; Groth, D.H.; Russell, W.O.

    1984-10-01

    A review of employment records and tissue specimens of seven workers, reported previously as having occupational dioxin exposure and soft tissue sarcomas, confirms that four workers had employment of 2 to 19 years in the production of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) or trichlorophenol, products contaminated with 2,3,7,8-tetrachlorodibenzodioxin, the most toxic dioxin isomer. Of these individuals, two have confirmed soft tissue sarcomas. In addition three individuals who worked for companies which made 2,4,5-T also have confirmed soft tissue sarcomas. Their employment records do not show specific assignment to 2,4,5-T or trichlorophenol departments; however, one individual worked for 10 d in the production of pentachlorophenol, which is contaminated with different isomers of dioxin. Methodological problems are discussed which must be addressed in the epidemiologic evaluation of the outcome of soft tissue sarcoma.

  12. Shoulder Joint Replacement

    Science.gov (United States)

    ... Shoulder Replacement Options Shoulder replacement surgery is highly technical. It should be performed by a surgical team ... area and will meet a doctor from the anesthesia department. You, your anesthesiologist, and your surgeon will ...

  13. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  14. Persistent organic pollutants in fish tissue in the mid-continental great rivers of the United States

    Science.gov (United States)

    The great rivers of the central United States (Upper Mississippi, Missouri, and Ohio rivers) are significant economic and cultural resources, but their ecological condition is not well quantified. The Environmental Monitoring and Assessment Program for Great River Ecosystems (EMA...

  15. Children as donors : a national study to assess procurement of organs and tissues in pediatric intensive care units

    NARCIS (Netherlands)

    Siebelink, Marion J.; Albers, Marcel J. I. J.; Roodbol, Petrie F.; Van de Wiel, Harry B. M.

    2012-01-01

    A shortage of size-matched organs and tissues is the key factor limiting transplantation in children. Empirical data on procurement from pediatric donors is sparse. This study investigated donor identification, parental consent, and effectuation rates, as well as adherence to the national protocol.

  16. Percutaneous tricuspid valve replacement in childhood

    Directory of Open Access Journals (Sweden)

    Mathias Emmel

    2015-01-01

    Full Text Available Percutaneous replacement of the tricuspid valve with a bovine jugular venous valve (melody valve was successfully undertaken in a 9-year-old boy. The patient had a previous history of bacterial endocarditis of the native tricuspid valve in infancy. Initially, a pericardial patch valve was created, followed by surgical replacement of the valve using a biological tissue valve at 4 years of age. Progressive stenosis and regurgitation of the biological valve, with severe venous congestion and resulting hepatic dysfunction prompted percutaneous valve replacement.

  17. Aeronautical Information System Replacement -

    Data.gov (United States)

    Department of Transportation — Aeronautical Information System Replacement is a web-enabled, automation means for the collection and distribution of Service B messages, weather information, flight...

  18. Patients With Burns Versus Patients With Complex Skin and Soft-Tissue Disease: An Analysis of Outcomes in the United States.

    Science.gov (United States)

    Maximus, Steven; Phelan, Michael; Joe, Victor C

    2016-01-01

    With the incidence of burns decreasing nationally, burn units are caring for more patients with nonburn conditions. The American Burn Association National Burn Repository does not currently report data regarding patients cared for in burn units without a diagnosis of burn. Using the National Inpatient Sample, we examined if there was a difference in characteristics and outcomes of patients admitted for burns compared with those with a primary admitting diagnosis of necrotizing skin infections and soft-tissue infections and exfoliative skin conditions. This is a retrospective study querying the National Inpatient Sample database to identify 56,102 patients from 2007 to 2012 who were admitted with a diagnosis of a burn (burn group). This group was then compared with 375,857 patients who had a primary admitting diagnosis of a necrotizing skin and/or soft-tissue infection or exfoliative skin conditions (nonburn group). Clinical and demographic variables were analyzed to determine characteristics of each patient group including length of stay, disposition, complications, comorbidities, and mortality. The average age of the nonburn group was 63.7 years, whereas the average age of the burn group was 40.1 years. Overall length of stay was higher in the nonburn patients than in burn patients (10.5 vs 8.4 days, P Burn patients were more likely to undergo a major operating room procedure (39.3% vs 28.1%) and routine discharge (68.4% vs 26.3%) compared with the nonburn group. Patients with necrotizing skin and soft-tissue infections and exfoliative skin conditions are older, have more comorbidities, higher complication rates, and higher mortality rates than burn patients. Given these findings, burn units may need to adjust their resource utilization, competencies, and research priorities to improve the quality of care being delivered to these two different populations.

  19. United States Transuranium and Uranium Registries: A human tissue research program. USTUR annual report for October 1, 1997 through January 31, 1999

    Energy Technology Data Exchange (ETDEWEB)

    Ehrhart, Susan M. (ed.); Filipy, Ronald E. (ed.)

    1999-10-01

    The United States Transuranium and Uranium Registries (USTUR) are a human tissue research program studying the deposition, biokinetics and dosimetry of the actinide elements in humans with the primary goals of providing data fundamental to the verification, refinement, or future development of radiation protection standards for these and other radionuclides, and of determining possible bioeffects on both a macro and subcellular level attributable to exposure to the actinides. This annual report covers October 1, 1997, through January 31, 1999; the reporting period has been extended so that future annual reports will coincide with the period covered by the grant itself.

  20. Radiation Source Replacement Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  1. Replacing a Missing Tooth

    Science.gov (United States)

    ... vessels in the tooth pulps are rather large. Drilling down these teeth for crowns may expose the ... porcelain replacement tooth is held in place by metal extensions cemented to the backs of the adjacent ...

  2. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  3. Knee joint replacement

    Science.gov (United States)

    ... of your kneecap. Your kneecap is called the patella. The replacement part is usually made from a ... long. Then your surgeon will: Move your kneecap (patella) out of the way, then cut the ends ...

  4. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  5. Product Platform Replacements

    DEFF Research Database (Denmark)

    Sköld, Martin; Karlsson, Christer

    2012-01-01

    Purpose – It is argued in this article that too little is known about product platforms and how to deal with them from a manager's point of view. Specifically, little information exists regarding when old established platforms are replaced by new generations in R&D and production environments...... originality and value is achieved by focusing on product platform replacements believed to represent a growing management challenge....

  6. Utility Values for Advanced Soft Tissue Sarcoma Health States from the General Public in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Julian F. Guest

    2013-01-01

    Full Text Available Soft tissue sarcomas are a rare type of cancer generally treated with palliative chemotherapy when in the advanced stage. There is a lack of published health utility data for locally advanced “inoperable”/metastatic disease (ASTS, essential for calculating the cost-effectiveness of current and future treatments. This study estimated time trade-off (TTO and standard gamble (SG preference values associated with four ASTS health states (progressive disease, stable disease, partial response, complete response among members of the general public in the UK (n=207. The four health states were associated with decreases in preference values from full health. Complete response was the most preferred health state (mean utility of 0.60 using TTO. The second most preferred health state was partial response followed by stable disease (mean utilities were 0.51 and 0.43, respectively, using TTO. The least preferred health state was progressive disease (mean utility of 0.30 using TTO. The utility value for each state was significantly different from one another (P<0.001. This study demonstrated and quantified the impact that different treatment responses may have on the health-related quality of life of patients with ASTS.

  7. The effect of obturator externus in enhanced posterior soft tissue repair of total hip replacement%全髋置换后修补闭孔外肌对髋关节稳定性的影响

    Institute of Scientific and Technical Information of China (English)

    李琪; 杨新东; 张力成; 杨国敬; 唐茂林; 蔡春元; 汤呈宣; 王伟良; 余列道; 余汝堂

    2008-01-01

    Objective To investigate anatomic feature of obturator externus and the region of hip joint capsule covered by it and to probe hip stabilization offered by obturator externus in hip flexion and internal rotation.Methods Ten adult cadaver pelvises were used.Following dissection and measurement,ten left hips were used for obturator externus experiment.After touching and understanding obturator externus in hip flexion and internal rotation,the distance of femoral head cartilage side exceeding acetabular labrum in exposed obturator externus region was measured in hip flexion 30°、60°、90°and internal rotation 15°adding to different hip flexion angle.Ten left hips were used for hip joint capsule experiment.Following dissection,the average thickness of every part of the posterior hip joint capsule was measured and the ischiofemorale ligament was observed.Results Obturator externus was the unique muscle tightly sticking to posteroinferior parts of hip joint capsule.In hip flexion and internal rotation,obturator externus was expanded and pushed by femoral head.The extent of expansion and push increases following hip flexion angle's increase.In the same flexion angle,the extent of expansion and push on internal rotation was greater than that of non-rotation.The thickness in the posterior hip joint capsule was ununiformity.Two weaker parts located at obturator externus region,ischiofemorale ligament trunk did not go through obturator externus region.Obturator externus region of hip capsule was weaker than other region.Conclusion Obturator externus is the unique dynamic sustain muscle to posteroinferior parts of hip joint capsule.Obturator externus and the region of hip joint capsule covered by it mainly are main factor which prevent femoral head from dislocation in hip flexion and internal rotation condition.But this region of hip joint capsule is weaker.So obturator externus should not be ignored in enhanced posterior soft tissue repair of total hip replacement

  8. Regulating tissue engineering

    Directory of Open Access Journals (Sweden)

    Meredith Lloyd-Evans

    2004-05-01

    Full Text Available Tissue engineering is a radical new approach to the repair and replacement of damaged or diseased body tissues. Cells, often seeded into or shaped around a biomaterial matrix, are used to replace damaged or diseased tissue or stimulate repair by the body. Because it is an area of tremendous focus and achievement, there is a risk that technical developments will outstrip the capacity of existing regulatory frameworks to cope with these novel products. Australia, the USA, and Canada are somewhat ahead of Japan in establishing a feasible regulatory approach. All four are currently ahead of the European Union (EU, but individual European countries and the EU as a whole are catching up. However, for the foreseeable future, it may still be possible in certain European countries to use autologous cell therapies in hospitals and market allogeneic tissue-engineered products, especially skin replacements, without regulatory control.

  9. Robotic mitral valve replacement.

    Science.gov (United States)

    Senay, Sahin; Gullu, Ahmet Umit; Kocyigit, Muharrem; Degirmencioglu, Aleks; Karabulut, Hasan; Alhan, Cem

    2014-01-01

    Robotic surgical techniques allow surgeons to perform mitral valve surgery. This procedure has gained acceptance, particularly for mitral valve repair in degenerative mitral disease. However, mitral repair may not always be possible, especially in severely calcified mitral valve of rheumatic origin. This study demonstrates the basic concepts and technique of robotic mitral valve replacement for valve pathologies that are not suitable for repair.

  10. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  11. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  12. The digestive system of 1-week-old Jersey calves is well suited to digest, absorb, and incorporate protein and energy into tissue growth even when calves are fed a high plane of milk replacer.

    Science.gov (United States)

    Liang, Yu; Carroll, Jeffery A; Ballou, Michael A

    2016-03-01

    The objectives of the current study were to determine the apparent digestibilities of nitrogen, organic matter, ash, and energy as well as investigate the nitrogen retention of calves fed different planes of milk replacer nutrition during the first week of life. Twelve Jersey calves were blocked by body weight at birth and randomly assigned to either a high plane of nutrition (HPN) or low plane of nutrition (LPN) treatment. The HPN calves were offered 19.2g of dry matter/kg of body weight of a 28% all-milk crude protein and 20% fat milk replacer. The LPN calves were fed 11.6g of dry matter/kg of body weight of a 20% all-milk crude protein and 20% fat milk replacer. All calves were given 3 L of pooled colostrum within 1h of birth after which they were assigned to treatments; no starter was offered during the study. Calves were given 1 d to adapt to their treatments and environment, so calves were 30 to 36 h old at the start of data collection. The study was divided into two 72-h periods. Total collection of feces occurred over each 72 h period, and total urine was collected for the last 24h of each period. Peripheral blood samples were collected at the beginning and end of each period and analyzed for plasma glucose and urea nitrogen concentrations. Data are reported as HPN vs. LPN, respectively. Fecal scores were greater for HPN calves during both periods; however, no difference was found in the dry matter percentage of feces (30.9 vs. 31.9 ± 0.06). No differences were found between treatments in either digestible or metabolizable energy efficiencies, which averaged 93.3 and 83.7%, respectively. A treatment × period interaction was found on the percentage of intake nitrogen retained, in which calves fed the HPN had a greater percentage of intake nitrogen retained during period 1 (87.9 vs. 78.4 ± 1.79%), but was not different from calves fed the LPN during period 2 (85.4 vs. 84.9 ± 1.79%). From these data therefore, we conclude that healthy neonatal calves have

  13. [Proximal and total femur replacement].

    Science.gov (United States)

    Pennekamp, P H; Wirtz, D C; Dürr, H R

    2012-07-01

    Reconstruction of segmental bone defects of the proximal femur following wide tumor resection or revision arthroplasty. Aggressive benign or primary malignant bone tumors of the proximal femur; destructive metastases; massive segmental bone defects of the proximal femur; periprosthetic fractures. Local infection; very short life expectancy (acetabular bone stock. Anterolateral approach. Exposure and detachment of the iliopsoas and gluteus medius muscle from the proximal femur with a sufficient safety margin to the bone; distal transsection of the vastus lateralis/intermedius and rectus femoris muscle according to the extraosseous tumor extension; distal femur osteotomy al least 3 cm beyond the farthest point of tumor extension; in case of total femur replacement, additional lateral arthrotomy of the knee with resection of the ligaments and menisci; reaming of the medullary canal after securing the shaft with a Verbrugge clamp; trial assembly and reduction followed by the definitive implantation of the prosthesis with adjustment of the femoral neck anteversion in 5° increments; soft tissue reconstruction and fixation to an attachment tube covering the prosthesis; in case of total femur replacement, the preparation of the tibia is followed by the coupling of the tibial and femoral components. Infection prophylaxis, 20 kg partial weight bearing, continuous passive motion. A total of 20  patients with proximal femur replacement and 2 patients with total femur replacement implanted between June 2007 and December 2011 were retrospectively reviewed. Three patients had primary malignant bone tumors, while 19 patients underwent resection for metastatic disease. The mean age at surgery was 62.0 ± 18.1 years (18-82 years). Fifteen patients with a mean follow-up of 20.3 ± 17.2 months (4-51 months) were studied. Among the 22 cases, periprosthetic infection occurred in 3 patients (13.6%), dislocation in 2 patients (9.1%). Evaluation of the functional

  14. Ulnar head replacement.

    Science.gov (United States)

    Herbert, Timothy J; van Schoonhoven, Joerg

    2007-03-01

    Recent years have seen an increasing awareness of the anatomical and biomechanical significance of the distal radioulnar joint (DRUJ). With this has come a more critical approach to surgical management of DRUJ disorders and a realization that all forms of "excision arthroplasty" can only restore forearm rotation at the expense of forearm stability. This, in turn, has led to renewed interest in prosthetic replacement of the ulnar head, a procedure that had previously fallen into disrepute because of material failures with early implants, in particular, the Swanson silicone ulnar head replacement. In response to these early failures, a new prosthesis was developed in the early 1990s, using materials designed to withstand the loads across the DRUJ associated with normal functional use of the upper limb. Released onto the market in 1995 (Herbert ulnar head prosthesis), clinical experience during the last 10 years has shown that this prosthesis is able to restore forearm function after ulnar head excision and that the materials (ceramic head and noncemented titanium stem), even with normal use of the limb, are showing no signs of failure in the medium to long term. As experience with the use of an ulnar head prosthesis grows, so does its acceptance as a viable and attractive alternative to more traditional operations, such as the Darrach and Sauve-Kapandji procedures. This article discusses the current indications and contraindications for ulnar head replacement and details the surgical procedure, rehabilitation, and likely outcomes.

  15. Artificial Disc Replacement

    Science.gov (United States)

    ... Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic Exercise Cervical ... disc is the soft cushioning structure located between the individual bones of the spine, called “vertebra.” It is made of cartilage-like tissue and ...

  16. [Acute renal replacement therapy in pediatrics].

    Science.gov (United States)

    Gaillot, T; Ozanne, B; Bétrémieux, P; Tirel, O; Ecoffey, C

    2013-12-01

    In pediatric intensive care unit, the available modalities of acute renal replacement therapy include intermittent hemodialysis, peritoneal dialysis and continuous renal replacement therapies. No prospective studies have evaluated to date the effect of dialysis modality on the outcomes of children. The decision about dialysis modality should therefore be based on local expertise, resources available, and the patient's clinical status. Poor hemodynamic tolerance of intermittent hemodialysis is a common problem in critically ill patients. Moreover, many pediatric intensive care units are not equipped with dedicated water circuit. Peritoneal dialysis, a simple and inexpensive alternative, is the most widely available form of acute renal replacement therapy. However, its efficacy may be limited in critically ill patients. The use of continuous renal replacement therapy permits usually to reach a greater estimated dialysis dose, a better control of fluid balance, and additionally, to provide adequate nutrition. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  17. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A

    2008-01-01

    BACKGROUND AND AIMS OF THE STUDY: Prompted by anecdotal evidence and observations by surgeons, an investigation was undertaken into the potential differences in implanted aortic valve prosthesis sizes, during aortic valve replacement (AVR) procedures, between northern and southern European...... countries. METHODS: A multi-institutional, non-randomized, retrospective analysis was conducted among 2,932 patients who underwent AVR surgery at seven tertiary cardiac surgery centers throughout Europe. Demographic and perioperative variables including valve size and type, body surface area (BSA) and early...

  18. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  19. The Optimum Replacement of Weapon

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao; ZHANG Jin-chun

    2002-01-01

    The theory of LCC (Life Cycle Cost) is applied in this paper. The relation between the economic life of weapon and the optimum replacement is analyzed. The method to define the optimum replacement time of weapon is discussed.

  20. The utility of trans-catheter aortic valve replacement after commercialization: does the European experience provide a glimpse into the future use of this technology in the United States?

    Science.gov (United States)

    Linke, Axel; Walther, Thomas; Schuler, Gerhard

    2010-03-01

    Treatment of aortic stenosis remains challenging in older individuals, as their perioperative mortality for open heart surgery is increased due to comorbidities. Transcatheter aortic valve implantation using the CoreValve ReValving System (Medtronic, Minneapolis, USA) and the Edwards SAPIEN transcatheter heart valve (THV; Edwards Lifescience, Irvine, California, USA) represents an alternative to conventional valve replacement in elderly patients that have a high risk for conventional surgery. This article summarizes the evidence-base from recent clinical trials. The early results of these landmark studies suggest that transcatheter aortic valve implantation with either one of the prosthesis is feasible, safe, improves hemodynamics and, therefore, might be an alternative to conventional aortic valve replacement in very high-risk patients. However, all of the available transcatheter heart valves have certain disadvantages, limiting their use in daily clinical practice. The process of decision making, which valve to use and which access route to choose is illustrated in this article through clinical case scenarios. Additionally, the lessons learned thus far from the European perspective and the potential impact on the future use in the US are discussed. Despite of the progress in this field, we are still lacking an optimal transcatheter heart valve. Once it is available, we can take the plunge to compare transcatheter valve implantation with convention surgery in severe aortic stenosis!

  1. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self‐funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty‐three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  2. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    HR/SOC

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), in order to fill in a 'fiche individuelle' form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format. The French card in their possession. An A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done...

  4. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division; Cards.Service@cern.ch

    2001-01-01

    The French Ministry of Foreign Affairs is currently replacing all diplomatic cards, special cards and employment permits («attestations de fonctions») held by members of the personnel and their families. These cards are replaced by secure, computerized equivalents. The old cards may no longer be used after 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015) between 8h30 and 12h30, in order to fill in a «fiche individuelle» form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, the French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested...

  5. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel are asked to go to the cards office (33/1-015), taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, The French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested to take these items to the c...

  6. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. A 'personnel office' stamped photocopy of the old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), between 8:30 and 12:30, in order to fill a 'fiche individuelle' form (in black ink only), which has to be personally signed by themselves and another separately signed by members of their family, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format (signed on the back) The French card in their possession an A4 photocopy of the same Fre...

  7. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University's aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  8. Faster Replacement Paths

    CERN Document Server

    Williams, Virginia Vassilevska

    2010-01-01

    The replacement paths problem for directed graphs is to find for given nodes s and t and every edge e on the shortest path between them, the shortest path between s and t which avoids e. For unweighted directed graphs on n vertices, the best known algorithm runtime was \\tilde{O}(n^{2.5}) by Roditty and Zwick. For graphs with integer weights in {-M,...,M}, Weimann and Yuster recently showed that one can use fast matrix multiplication and solve the problem in O(Mn^{2.584}) time, a runtime which would be O(Mn^{2.33}) if the exponent \\omega of matrix multiplication is 2. We improve both of these algorithms. Our new algorithm also relies on fast matrix multiplication and runs in O(M n^{\\omega} polylog(n)) time if \\omega>2 and O(n^{2+\\eps}) for any \\eps>0 if \\omega=2. Our result shows that, at least for small integer weights, the replacement paths problem in directed graphs may be easier than the related all pairs shortest paths problem in directed graphs, as the current best runtime for the latter is \\Omega(n^{2.5...

  9. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  10. Fiscal 1998 regional consortium R and D project (Regional consortium field). Report on R and D of production technology of hybrid-type biocompatible hard tissue replacing materials (1st fiscal year); 1998 nendo chiiki konsoshiamu kenkyu kaihatsu jigyo. Chiiki konsoshiamu bun'ya (hybrid gata seitai yugo kinosei kososhiki daitai sozai seizo gijutsu no kenkyu kaihatsu)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This project aims at development of high-strength high- biocompatible {beta}-type Ti alloy with lower modulli of elasticity composed of non-toxic elements, phosphate calcium ceramics for improving the biocompatibility and coating technology, and establishment of production technology of hybrid-type biocompatible hard tissue replacing materials. In fiscal 1998, the project promoted the following: Design of high-biocompatible {beta}-type Ti alloy materials, development of thermomechanical treatment for improving dynamic characteristics of such alloy, survey on practical melting and casting technologies and dental precision casting process, evaluation of the biocompatibility of the alloy by cytotoxicity, selection of tools for precision machining and surface finishing, control of contents, orientation and precipitation of biocompatible crystals such as {beta}- Ca(PO{sub 3}){sub 2} fibers for further improvement of the biocompatibility. This paper also outlines the survey results on the market needs, market size and market share for the feasibility of these materials. (NEDO)

  11. Turbine casing bolts; a life assessment and bolt replacement strategy

    Energy Technology Data Exchange (ETDEWEB)

    Bulloch, J.H. [ESB, Power Generation, Dublin (Ireland)

    1998-12-31

    The present presentation describes a detailed study concerning the life assessment and replacement strategy of large turbine casing bolts in a 120 MW steam raising unit. After 122000 hours service, circa 1991/92, the Cr-Mo-V steel casing bolts, involving a total of 184 bolts, from two identical 120 MW units, termed Units 1 and 2, were examined to establish the extent of Reverse Temper Embrittlement, RTE, and creep damage suffered during service. The bolt replacement plans for the two units were as follows; Unit 1 bolts were completely replaced with new bolts while Unit 2 embrittled bolts were withdrawn from service and replaced with Non- Embrittled bolts from Unit 1; basically Unit 2 bolts were made up from a mixture of Unit 1 and 2 Non- Embrittled bolts which had been in service for 122000 hours. Remnant life assessments, concerning both embrittlement and creep damage aspects, were earned out on this series of easing bolts at service times 122000, 150000 and 200000 hours. These assessments involved the use of general embrittlement and creep damage laws which were empirically derived and concerned such parameters as microstructural grain size, bulk phosphorus content and accumulated service strain. (orig.) 7 refs.

  12. Spatio-temporal expression of MMP-2, MMP-9 and tissue kallikrein in uteroplacental units of the pregnant guinea-pig (Cavia porcellus

    Directory of Open Access Journals (Sweden)

    Rey Sergio

    2007-07-01

    Full Text Available Abstract Background In humans trophoblast invasion and vascular remodeling are critical to determine the fate of pregnancy. Since guinea-pigs share with women an extensive migration of the trophoblasts through the decidua and uterine arteries, and a haemomonochorial placenta, this species was used to evaluate the spatio-temporal expression of three enzymes that have been associated to trophoblast invasion, MMP-2, MMP-9 and tissue kallikrein (K1. Methods Uteroplacental units were collected from early to term pregnancy. MMP-2, MMP-9 and K1 were analysed by immunohistochemistry and Western blot. The activities of MMP-2 and MMP-9 were assessed by gelatin zymography. Results Immunoreactive MMP-2, MMP-9 and K1 were detected in the subplacenta, interlobar and labyrinthine placenta, syncytial sprouts and syncytial streamers throughout pregnancy. In late pregnancy, perivascular or intramural trophoblasts expressed the three enzymes. The intensity of the signal in syncytial streamers was increased in mid and late pregnancy for MMP-2, decreased in late pregnancy for MMP-9, and remained stable for K1. Western blots of placental homogenates at days 20, 40 and 60 of pregnancy identified bands with the molecular weights of MMP-2, MMP-9 and K1. MMP-2 expression remained constant throughout gestation. In contrast, MMP-9 and K1 attained their highest expression during midgestation. Placental homogenates of 20, 40 and 60 days yielded bands of gelatinase activity that were compatible with MMP-2 and MMP-9 activities. ProMMP-2 and MMP-9 activities did not vary along pregnancy, while MMP-2 and MMP-9 increased at 40 and 40–60 days respectively. Conclusion The spatio-temporal expression of MMPs and K1 supports a relevant role of these proteins in trophoblast invasion, vascular remodeling and placental angiogenesis, and suggests a functional association between K1 and MMP-9 activation.

  13. Toleration, Synthesis or Replacement?

    DEFF Research Database (Denmark)

    Holtermann, Jakob v. H.; Madsen, Mikael Rask

    2016-01-01

    to have considerable problems keeping a clear focus on the key question: What are the implications of this empirical turn in terms of philosophy of legal science, of the social understanding of IL, and, not least, of the place of doctrinal scholarship after the alleged Wende? What is needed, we argue......, in order to answer is not yet another partisan suggestion, but rather an attempt at making intelligible both the oppositions and the possibilities of synthesis between normative and empirical approaches to law. Based on our assessment and rational reconstruction of current arguments and positions, we...... therefore outline a taxonomy consisting of the following three basic, ideal-types in terms of the epistemological understanding of the interface of law and empirical studies: toleration, synthesis and replacement. This tripartite model proves useful with a view to teasing out and better articulating...

  14. An Improved Clearing and Mounting Solution to Replace Chloral Hydrate in Microscopic Applications

    Directory of Open Access Journals (Sweden)

    Thomas S. Villani

    2013-05-01

    Full Text Available Premise of the study: This study presents Visikol™, a new proprietary formulation that can be used as an efficient replacement for chloral hydrate as a clearing agent for microscopic examination. In the United States, chloral hydrate is regulated and therefore difficult to acquire. Methods and Results: Fresh and dry samples of the following plants: ginger (Zingiber officinale, maté (Ilex paraguariensis, lime basil (Ocimum americanum, oregano (Origanum vulgare, and mouse-ear cress (Arabidopsis thaliana, were cleared using Visikol or chloral hydrate solution and compared using a light microscope. Conclusions: This new method can be used successfully to clear specimens, allowing identification of diagnostic characteristics for the identification of plant materials. Visikol is as effective as chloral hydrate in providing clarity and resolution of all tissues examined. Tissues become transparent, allowing observation of deeper layers of cells and making it effective in research, botanical and quality control, and for educational applications.

  15. Mechanical Aspects of Tissue Engineering

    OpenAIRE

    Liebschner, Michael; Bucklen, Brandon; Wettergreen, Matthew

    2005-01-01

    Tissue engineering describes an initiative whereby a deficit of tissue may be replaced with an engineered construct, typically thought to be some combination of a structural support element and a cellular element. There are several mechanical aspects that come into play during the design of such a construct. First, the way in which the mechanical behavior of a tissue is characterized varies depending on the tissue type. For example, one would not consider the ultimate strength of a non–load-b...

  16. Tissue engineering the kidney.

    Science.gov (United States)

    Hammerman, Marc R

    2003-04-01

    The means by which kidney function can be replaced in humans include dialysis and renal allotransplantation. Dialytic therapies are lifesaving, but often poorly tolerated. Transplantation of human kidneys is limited by the availability of donor organs. During the past decades, a number of different approaches have been applied toward tissue engineering the kidney as a means to replace renal function. The goals of one or another of them included the recapitulation of renal filtration, reabsorptive and secretory functions, and replacement of endocrine/metabolic activities. This review will delineate the progress to date recorded for five approaches: (1) integration of new nephrons into the kidney; (2) growing new kidneys in situ; (3) use of stem cells; (4) generation of histocompatible tissues using nuclear transplantation; and (5) bioengineering of an artificial kidney. All five approaches utilize cellular therapy. The first four employ transplantation as well, and the fifth uses dialysis.

  17. Synthetic Hounsfield units from spectral CT data

    Science.gov (United States)

    Bornefalk, Hans

    2012-04-01

    Beam-hardening-free synthetic images with absolute CT numbers that radiologists are used to can be constructed from spectral CT data by forming ‘dichromatic’ images after basis decomposition. The CT numbers are accurate for all tissues and the method does not require additional reconstruction. This method prevents radiologists from having to relearn new rules-of-thumb regarding absolute CT numbers for various organs and conditions as conventional CT is replaced by spectral CT. Displaying the synthetic Hounsfield unit images side-by-side with images reconstructed for optimal detectability for a certain task can ease the transition from conventional to spectral CT.

  18. Dimensionless Units in the SI

    CERN Document Server

    Mohr, Peter J

    2014-01-01

    The International System of Units (SI) is supposed to be coherent. That is, when a combination of units is replaced by an equivalent unit, there is no additional numerical factor. Here we consider dimensionless units as defined in the SI, {\\it e.g.} angular units like radians or steradians and counting units like radioactive decays or molecules. We show that an incoherence may arise when different units of this type are replaced by a single dimensionless unit, the unit "one", and suggest how to properly include such units into the SI in order to remove the incoherence. In particular, we argue that the radian is the appropriate coherent unit for angles and that hertz is not a coherent unit in the SI. We also discuss how including angular and counting units affects the fundamental constants.

  19. Iron replacement therapy

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Coskun, Mehmet; Weiss, Günter

    2016-01-01

    PURPOSE OF REVIEW: Approximately, one-third of the world's population suffers from anemia, and at least half of these cases are because of iron deficiency. With the introduction of new intravenous iron preparations over the last decade, uncertainty has arisen when these compounds should be admini...... treatment, when to follow-up for relapse, which dosage and type of therapy should be recommended or not recommended, and if some patients should not be treated....... be administered and under which circumstances oral therapy is still an appropriate and effective treatment. RECENT FINDINGS: Numerous guidelines are available, but none go into detail about therapeutic start and end points or how iron-deficiency anemia should be best treated depending on the underlying cause...... of iron deficiency or in regard to concomitant underlying or additional diseases. SUMMARY: The study points to major issues to be considered in revisions of future guidelines for the true optimal iron replacement therapy, including how to assess the need for treatment, when to start and when to stop...

  20. Tissue engineering for clinical applications.

    Science.gov (United States)

    Bhatia, Sujata K

    2010-12-01

    Tissue engineering is increasingly being recognized as a beneficial means for lessening the global disease burden. One strategy of tissue engineering is to replace lost tissues or organs with polymeric scaffolds that contain specialized populations of living cells, with the goal of regenerating tissues to restore normal function. Typical constructs for tissue engineering employ biocompatible and degradable polymers, along with organ-specific and tissue-specific cells. Once implanted, the construct guides the growth and development of new tissues; the polymer scaffold degrades away to be replaced by healthy functioning tissue. The ideal biomaterial for tissue engineering not only defends against disease and supports weakened tissues or organs, it also provides the elements required for healing and repair, stimulates the body's intrinsic immunological and regenerative capacities, and seamlessly interacts with the living body. Tissue engineering has been investigated for virtually every organ system in the human body. This review describes the potential of tissue engineering to alleviate disease, as well as the latest advances in tissue regeneration. The discussion focuses on three specific clinical applications of tissue engineering: cardiac tissue regeneration for treatment of heart failure; nerve regeneration for treatment of stroke; and lung regeneration for treatment of chronic obstructive pulmonary disease. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Recombinant Enzyme Replacement Therapy in Hypophosphatasia.

    Science.gov (United States)

    Hofmann, Christine; Jakob, Franz; Seefried, Lothar; Mentrup, Birgit; Graser, Stephanie; Plotkin, Horacio; Girschick, Hermann J; Liese, Johannes

    2015-01-01

    Hypophosphatasia (HPP) is a rare monogenetic and multisystemic disease with involvement of different organs, including bone, muscle, kidney, lung, gastrointestinal tract and the nervous system. The exact metabolic mechanisms of the effects of TNAP deficiency in different tissues are not understood in detail. There is no approved specific treatment for HPP; therefore symptomatic treatment in order to improve the clinical features is of major interest. Enzyme replacement therapy (ERT) is a relatively new type of treatment based on the principle of administering a medical treatment replacing a defective or absent enzyme. Recently ERT with a bone targeted recombinant human TNAP molecule has been reported to be efficient in ten severely affected patients and improved survival of life threatening forms. These results are very promising especially with regard to the skeletal phenotype but it is unclear whether ERT also has beneficial effects for craniosynostosis and in other affected tissues in HPP such as brain and kidney. Long-term data are not yet available and further systematic clinical trials are needed. It is also necessary to establish therapeutic approaches to help patients who are affected by less severe forms of HPP but also suffer from a significant reduction in quality of life. Further basic research on TNAP function and role in different tissues and on its physiological substrates is critical to gain a better insight in the pathogenesis in HPP. This and further experiences in new therapeutic strategies may improve the prognosis and quality of life of patients with all forms of HPP.

  2. Calcifying tissue regeneration via biomimetic materials chemistry

    OpenAIRE

    Green, David W.; Goto, Tazuko K.; Kim, Kye-Seong; Jung, Han-Sung

    2014-01-01

    Materials chemistry is making a fundamental impact in regenerative sciences providing many platforms for tissue development. However, there is a surprising paucity of replacements that accurately mimic the structure and function of the structural fabric of tissues or promote faithful tissue reconstruction. Methodologies in biomimetic materials chemistry have shown promise in replicating morphologies, architectures and functional building blocks of acellular mineralized tissues dentine, enamel...

  3. Biomaterials & scaffolds for tissue engineering

    Directory of Open Access Journals (Sweden)

    Fergal J. O'Brien

    2011-03-01

    Full Text Available Every day thousands of surgical procedures are performed to replace or repair tissue that has been damaged through disease or trauma. The developing field of tissue engineering (TE aims to regenerate damaged tissues by combining cells from the body with highly porous scaffold biomaterials, which act as templates for tissue regeneration, to guide the growth of new tissue. This article describes the functional requirements, and types, of materials used in developing state of the art of scaffolds for tissue engineering applications. Furthermore, it describes the challenges and where future research and direction is required in this rapidly advancing field.

  4. Using your shoulder after replacement surgery

    Science.gov (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  5. Inspection-replacement policy of system under predictive maintenance

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-you; FANG You-tong; WEI Jin-xiang; WANG Yong-liang

    2007-01-01

    In general, every system is in one of the three states: normal, abnormal, or failure state. When the system is diagnosed as abnormal state, it needs predictive maintenance. If the system fails, an identical new one will replace it. The predictive maintenance cannot make the system "as good as new". Under these assumptions, the reliability index and the inspection-replacement policy of a system were studied. The explicit expression of the reliability index and the average income rate (i.e., the long-runaverage income per unit time) are derived by using probability analysis and vector Markov process method. The criterion of feasibility for the optimal inspection-replacement policy under the maximum average income rate is obtained. The numerical example shows the optimal inspection-replacement policy can raise the average income rate when the optimal inspection-replacement policy is feasible.

  6. Lack of cytotoxicity by Trustwater Ecasol™ used to maintain good quality dental unit waterline output water in keratinocyte monolayer and reconstituted human oral epithelial tissue models.

    LENUS (Irish Health Repository)

    Boyle, M A

    2010-11-01

    We previously showed that residual treatment of dental chair unit (DCU) supply water using the electrochemically-activated solution Trustwater Ecasol™ (2.5 ppm) provided an effective long-term solution to the problem of dental unit waterline (DUWL) biofilm resulting in DUWL output water quality consistently superior to potable water.

  7. Educating My Replacement

    Science.gov (United States)

    Tarter, Jill

    , in partnership with the dedicated teachers out there, I think I can help promote the critical thinking skills and scientific literacy of the next generation of voters. Hopefully, I can also help train my replacement to be a better scientist, capable of seizing all the opportunities generated by advances in technology and our improved understanding of the universe to craft search strategies with greater probability of success than those I have initiated.

  8. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  9. Tissue engineered devices for ligament repair, replacement and ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-12-29

    Dec 29, 2009 ... School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, VA, USA, 24060. E-mail: ...... humans. Immunology Today, 14: 3. ... 558-570. Phelps CJ, Koike C, Vaught TD, Boone J, Wells KD, Chen SH, Ball S,.

  10. Electrocatalysts Prepared by Galvanic Replacement

    OpenAIRE

    Athanasios Papaderakis; Ioanna Mintsouli; Jenia Georgieva; Sotiris Sotiropoulos

    2017-01-01

    Galvanic replacement is the spontaneous replacement of surface layers of a metal, M, by a more noble metal, Mnoble, when the former is treated with a solution containing the latter in ionic form, according to the general replacement reaction: nM + mMnoblen+ → nMm+ + mMnoble. The reaction is driven by the difference in the equilibrium potential of the two metal/metal ion redox couples and, to avoid parasitic cathodic processes such as oxygen reduction and (in some cases) hydrogen evolution too...

  11. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy....... The 30-day mortality rate for the 98 patients was zero, although 14 of the 98 mini-sternotomies had to be converted to complete sternotomies intraoperatively due to technical problems. Such conversion doubled the operative time over that of the planned full sternotomies. In the group of patients whose...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  12. Informing tendon tissue engineering with embryonic development

    OpenAIRE

    Glass, Zachary A.; Schiele, Nathan R.; Kuo, Catherine K

    2014-01-01

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies hav...

  13. Radiological assessment of steam generator repair and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Parkhurst, M.A.; Rathbun, L.A.; Murphy, D.W.

    1983-12-01

    Previous analyses of the radiological impact of removing and replacing corroded steam generators have been updated based on experience at Surry Units 1 and 2 and Turkey Point Units 3 and 4. The sleeving repairs of degraded tubes at San Onofre Unit 1, Point Beach Unit 2, and R.E. Ginna are also analyzed. Actual occupational doses incurred during application of the various technologies used in repairs have been included, along with radioactive waste quantities and constituents. Considerable progress has been made in improving radiation protection and reducing worker dose by the development of remotely controlled equipment and the implementation of dose reduction strategies that have been successful in previous repair operations.

  14. Tissue Engineering of the Penis

    Directory of Open Access Journals (Sweden)

    Manish N. Patel

    2011-01-01

    Full Text Available Congenital disorders, cancer, trauma, or other conditions of the genitourinary tract can lead to significant organ damage or loss of function, necessitating eventual reconstruction or replacement of the damaged structures. However, current reconstructive techniques are limited by issues of tissue availability and compatibility. Physicians and scientists have begun to explore tissue engineering and regenerative medicine strategies for repair and reconstruction of the genitourinary tract. Tissue engineering allows the development of biological substitutes which could potentially restore normal function. Tissue engineering efforts designed to treat or replace most organs are currently being undertaken. Most of these efforts have occurred within the past decade. However, before these engineering techniques can be applied to humans, further studies are needed to ensure the safety and efficacy of these new materials. Recent progress suggests that engineered urologic tissues and cell therapy may soon have clinical applicability.

  15. Skeletal tissue engineering using embryonic stem cells

    NARCIS (Netherlands)

    Jukes, Jojanneke Maria

    2009-01-01

    Tissue engineering aims at repairing or replacing damaged or diseased tissue. In this thesis, we investigated the potential of embryonic stem cells (ESCs) for cartilage tissue engineering. After differentiation of mouse and human ESCs into the chondrogenic and osteogenic lineage had been established

  16. Salto Talaris fixed-bearing total ankle replacement system.

    Science.gov (United States)

    Rush, Shannon M; Todd, Nicholas

    2013-01-01

    The Salto Talaris total ankle replacement is an anatomically designed fixed bearing prosthesis available in the United States based on the successful design of the mobile-bearing Salto prosthesis available outside the United States. The original mobile-bearing design was modified and the mobile-bearing was transferred to the precision instrumentation at the trial phase evaluation. Instrumentation and technique allow the surgeon to determine the functional joint axis before final implantation. The Salto Talaris total ankle replacement design blends minimal bone resection and optimizes surface area, cortical contact, and ultra-high molecular weight polyethylene conformity. The authors present an overview of the Salto Talaris total ankle replacement surgical technique and pearls for successful application.

  17. A metabolically active dermal replacement (Dermagraft) for vestibuloplasty.

    Science.gov (United States)

    Raguse, J D; Gath, H J

    2005-05-01

    This article describes the use of tissue-engineered dermal replacement in the vestibular extension instead of palatal donor tissue or (split-thickness) skin graft. In three patients the living human-derived fibroblast skin substitute (Dermagraft) was implanted on the wound surface after mucogingival junction and supraperiosteal dissection. Following application of Dermagraft, epithelial closure starting from the resection margins of the defect was observed, obviating further surgical treatment. Vestibular depth was increased and no scarring or frena occurred. Tissue-engineered dermal replacement consisting of living human fibroblasts appears to be a useful substitute for autogenous grafts in pre-prosthetic surgery, offering the advantages of unlimited availability, good colour match and no donor site morbidity.

  18. Knee Replacement: What you can Expect

    Science.gov (United States)

    ... improves function lessen with each additional surgery. Artificial knees can wear out Another risk of knee replacement ... replacement surgery to last about two hours. After knee replacement surgery After surgery, you're wheeled to ...

  19. Homologous gene replacement in Physarum

    Energy Technology Data Exchange (ETDEWEB)

    Burland, T.G. [Univ. of Wisconsin, Madison, WI (United States); Pallotta, D. [Laval Univ., Quebec (Canada)

    1995-01-01

    The protist Physarum polycephalum is useful for analysis of several aspects of cellular and developmental biology. To expand the opportunities for experimental analysis of this organism, we have developed a method for gene replacement. We transformed Physarum amoebae with plasmid DNA carrying a mutant allele, ardD{Delta}1, of the ardD actin gene; ardD{Delta}1 mutates the critical carboxy-terminal region of the gene product. Because ardD is not expressed in the amoeba, replacement of ardD{sup +} with ardD{Delta}1 should not be lethal for this cell type. Transformants were obtained only when linear plasmid DNA was used. Most transformants carried one copy of ardD{Delta}1 in addition to ardD{sup +}, but in two (5%), ardD{sup +} was replaced by a single copy of ardD{Delta}1. This is the first example of homologous gene replacement in Physarum. ardD{Delta}1 was stably maintained in the genome through growth, development and meiosis. We found no effect of ardD{Delta}l on viability, growth, or development of any of the various cell types of Physarum. Thus, the carboxy-terminal region of the ardD product appears not to perform a unique essential role in growth or development. Nevertheless, this method for homologous gene replacement can be applied to analyze the function of any cloned gene. 38 refs., 6 figs., 1 tab.

  20. Peach Bottom Atomic Power Station recirc pipe dose rates with zinc injection and condenser replacement

    Energy Technology Data Exchange (ETDEWEB)

    DiCello, D.C.; Odell, A.D.; Jackson, T.J. [PECO Energy Co., Delta, PA (United States)

    1995-03-01

    Peach Bottom Atomic Power Station (PBAPS) is located near the town of Delta, Pennsylvania, on the west bank of the Susquehanna River. It is situated approximately 20 miles south of Lancaster, Pennsylvania. The site contains two boiling water reactors of General Electric design and each rated at 3,293 megawatts thermal. The units are BWR 4s and went commercial in 1977. There is also a decommissioned high temperature gas-cooled reactor on site, Unit 1. PBAPS Unit 2 recirc pipe was replaced in 1985 and Unit 3 recirc pipes replaced in 1988 with 326 NGSS. The Unit 2 replacement pipe was electropolished, and the Unit 3 pipe was electropolished and passivated. The Unit 2 brass condenser was replaced with a Titanium condenser in the first quarter of 1991, and the Unit 3 condenser was replaced in the fourth quarter of 1991. The admiralty brass condensers were the source of natural zinc in both units. Zinc injection was initiated in Unit 2 in May 1991, and in Unit 3 in May 1992. Contact dose rate measurements were made in standard locations on the 28-inch recirc suction and discharge lines to determine the effectiveness of zinc injection and to monitor radiation build-up in the pipe. Additionally, HPGe gamma scans were performed to determine the isotopic composition of the oxide layer inside the pipe. In particular, the specific ({mu}Ci/cm{sup 2}) of Co-60 and Zn-65 were analyzed.

  1. Cobra Probes Containing Replaceable Thermocouples

    Science.gov (United States)

    Jones, John; Redding, Adam

    2007-01-01

    A modification of the basic design of cobra probes provides for relatively easy replacement of broken thermocouples. Cobra probes are standard tube-type pressure probes that may also contain thermocouples and that are routinely used in wind tunnels and aeronautical hardware. They are so named because in side views, they resemble a cobra poised to attack. Heretofore, there has been no easy way to replace a broken thermocouple in a cobra probe: instead, it has been necessary to break the probe apart and then rebuild it, typically at a cost between $2,000 and $4,000 (2004 prices). The modified design makes it possible to replace the thermocouple, in minimal time and at relatively low cost, by inserting new thermocouple wire in a tube.

  2. Factors affecting the rise of treatment of resistant bacteria in skin and soft tissue infections in the United States: 1993-2012().

    Science.gov (United States)

    Wetzel, Margaret E; Fleischer, Alan B

    2017-08-01

    Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) prevalence has been steadily increasing for the past 40 years. The increase in such infections has contributed to a change in the treatment patterns of the patient. This study aimed to detail the factors determining prescription practices associated with MRSA-related skin and soft tissue infections. The National Ambulatory Medical Care Survey (NAMCS) was searched for data from 1993 to 2012 regarding the factors associated with resistant vs. non-resistant-antibiotic prescription. Of all physician visits, 34.0% received resistant-antibiotic therapy and 66.0% received non-resistant-antibiotic therapy. Prescription of antibiotic-resistant therapy increased over the time period studied (Odds ratio (OR) = 1.07; 95% CI 1.05, 1.09; p resistant-antibiotics (OR = 0.25; 0.12, 0.53; p = .0003), non-primary care physicians were more likely to prescribe resistant-antibiotics (OR = 2.89; 1.75, 4.77; p resistant antibiotics (OR = 3.03; 1.30, 7.05; p = .01). With the increasing prevalence of MRSA-related SSTIs, the treatment of these infections is changing. Understanding of the factors contributing to the prescription of resistant antibiotics could aid in the selection of appropriate treatment of SSTIs, and hopefully, avoidance of development of additionally resistant organisms.

  3. Registry data trends of total ankle replacement use.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2013-01-01

    Joint arthroplasty registry data are meaningful when evaluating the outcomes of total joint replacement, because they provide unbiased objective information regarding survivorship and incidence of use. Critical evaluation of the registry data information will benefit the surgeon, patient, and industry. However, the implementation and acceptance of registry data for total ankle replacement has lagged behind that of hip and knee implant arthroplasty. Currently, several countries have national joint arthroplasty registries, with only some procuring information for total ankle replacement. We performed an electronic search to identify publications and worldwide registry databanks with pertinent information specific to total ankle replacement to determine the type of prostheses used and usage trends over time. We identified worldwide registry data from 33 countries, with details pertinent to total ankle replacement identified in only 6 countries. The obtained information was arbitrarily stratified into 3 distinct periods: 2000 to 2006, 2007 to 2010, and 2011. Within these study periods, the data from 13 total ankle replacement systems involving 3,980 ankles were identified. The vast majority (97%) of the reported ankle replacements were 3-component, mobile-bearing, uncemented prostheses. Three usage trends were identified: initial robust embracement followed by abrupt disuse, minimal use, and initial embracement followed by sustained growth in implantation. Before the widespread acceptance of new total ankle replacements, the United States should scrutinize and learn from the international registry data and develop its own national joint registry that would include total ankle replacement. Caution against the adoption of newly released prostheses, especially those without readily available revision components, is recommended.

  4. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  5. Prioritization methodology for chemical replacement

    Science.gov (United States)

    Goldberg, Ben; Cruit, Wendy; Schutzenhofer, Scott

    1995-01-01

    This methodology serves to define a system for effective prioritization of efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semi quantitative approach derived from quality function deployment techniques (QFD Matrix). QFD is a conceptual map that provides a method of transforming customer wants and needs into quantitative engineering terms. This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives.

  6. Wafer Replacement Cluster Tool (Presentation);

    Energy Technology Data Exchange (ETDEWEB)

    Branz, H. M.

    2008-04-01

    This presentation on wafer replacement cluster tool discusses: (1) Platform for advanced R and D toward SAI 2015 cost goal--crystal silicon PV at area costs closer to amorphous Si PV, it's 15% efficiency, inexpensive substrate, and moderate temperature processing (<800 C); (2) Why silicon?--industrial and knowledge base, abundant and environmentally benign, market acceptance, and good efficiency; and (3) Why replace wafers?--expensive, high embedded energy content, and uses 50-100 times more silicon than needed.

  7. Load beam unit replaceable inserts for dry coal extrusion pumps

    Science.gov (United States)

    Saunders, Timothy; Brady, John D.

    2012-11-13

    A track assembly for a particulate material extrusion pump according to an exemplary aspect of the present disclosure includes a link assembly with a roller bearing. An insert mounted to a load beam located such that the roller bearing contacts the insert.

  8. Switzerland Replaces United States at Top of Competitiveness Rankings

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    On Sep. 8,2009,Switzerland tops the overall ranking in The Global Competitiveness Report 2009-2010, released by the World Economic Forum ahead of its Annual Meeting of the New Champions 2009 in Dalian.

  9. Primary extra-cranial meningioma following total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)

    2009-01-15

    A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

  10. Single-stage multilevel soft-tissue surgery in the lower limbs with spastic cerebral palsy: Experience from a rehabilitation unit.

    Science.gov (United States)

    Gupta, Anupam; Srivastava, Abhishek; Taly, Arun B; Murali, Thyloth

    2008-10-01

    To assess the effect of single-stage multilevel soft-tissue surgery (Single Event Multiple Level Resections, SEMLR) on deformities and locomotion in patients with cerebral palsy (CP) with static contracture(s) in lower limbs. Study included 34 patients (M:F, 23:11) with mean age of 9.53 +/- 3.92 years (4-16 years). Among them 22 had diplegia and four each had quadriplegia and right and left hemiplegia. Fourteen patients (41.2%) had their intelligence quotient (IQ) in the normal range (IQ >/= 80), while others had mental retardation (MR) of varying severity: borderline MR (IQ = 70-79) in 12, mild MR (IQ = 50-69) in 5, and moderate MR (IQ = 35-49) in patients 3. All patients underwent surgery (total number of procedures 153, average 4.5 procedures/patient) over a period of 30 months (April 2005 to September 2007). Improvement in functional abilities and locomotion was assessed using Gross Motor Functional Classification Scale (GMFCS) scores and by physical examination. Significant improvement in function was observed (P = 0.000) after surgery when comparing the preoperative and postoperative GMFCS scores. All patients were maintaining ambulation at a mean follow-up duration of 13.12 +/- 6.07 months (3-24 months), with five patients using knee-ankle-foot orthoses (KAFO), 22 using ankle-foot orthoses (AFO), and six patients using knee gaiters. Sixteen patients were using walker, and two were using crutches as assistive devices. This study suggests that CP patients with good trunk control and static contractures at multiple joints in the lower limbs can be made ambulant with single-stage multilevel soft-tissue surgery. It has to be a team effort of the surgeon and the rehabilitation team in the postoperative period for the attainment of satisfactory goal.

  11. Single-stage multilevel soft-tissue surgery in the lower limbs with spastic cerebral palsy: Experience from a rehabilitation unit

    Directory of Open Access Journals (Sweden)

    Gupta Anupam

    2008-01-01

    Full Text Available Background: To assess the effect of single-stage multilevel soft-tissue surgery (Single Event Multiple Level Resections, SEMLR on deformities and locomotion in patients with cerebral palsy (CP with static contracture(s in lower limbs. Patients and Methods: Study included 34 patients (M:F, 23:11 with mean age of 9.53 ± 3.92 years (4-16 years. Among them 22 had diplegia and four each had quadriplegia and right and left hemiplegia. Fourteen patients (41.2% had their intelligence quotient (IQ in the normal range (IQ ≥ 80, while others had mental retardation (MR of varying severity: borderline MR (IQ = 70-79 in 12, mild MR (IQ = 50-69 in 5, and moderate MR (IQ = 35-49 in patients 3. All patients underwent surgery (total number of procedures 153, average 4.5 procedures/patient over a period of 30 months (April 2005 to September 2007. Improvement in functional abilities and locomotion was assessed using Gross Motor Functional Classification Scale (GMFCS scores and by physical examination. Results: Significant improvement in function was observed ( P = 0.000 after surgery when comparing the preoperative and postoperative GMFCS scores. All patients were maintaining ambulation at a mean follow-up duration of 13.12 ± 6.07 months (3-24 months, with five patients using knee-ankle-foot orthoses (KAFO, 22 using ankle-foot orthoses (AFO, and six patients using knee gaiters. Sixteen patients were using walker, and two were using crutches as assistive devices. Conclusion: This study suggests that CP patients with good trunk control and static contractures at multiple joints in the lower limbs can be made ambulant with single-stage multilevel soft-tissue surgery. It has to be a team effort of the surgeon and the rehabilitation team in the postoperative period for the attainment of satisfactory goal.

  12. Double emulsions as fat replacers

    NARCIS (Netherlands)

    Oppermann, Anika

    2017-01-01

    The use of double (w1/o/w2) emulsions, in which part of the oil is replaced by small water droplets, is a promising strategy to reduce oil content in food products. For successful applications, (1) significant levels of fat reduction (i.e. significant amounts of water inside the oil droplets) have

  13. Replacement policies for dairy cows

    DEFF Research Database (Denmark)

    Nielsen, Lars Relund

    In a recent paper a hierarchical Markov decision processes (MDP) with finite state and action space was formulated for the dairy cow replacement problem with stage lengths of 1 d. Bayesian updating was used to predict the performance of each cow in the herd and economic decisions were based...

  14. Electrocatalysts Prepared by Galvanic Replacement

    Directory of Open Access Journals (Sweden)

    Athanasios Papaderakis

    2017-03-01

    Full Text Available Galvanic replacement is the spontaneous replacement of surface layers of a metal, M, by a more noble metal, Mnoble, when the former is treated with a solution containing the latter in ionic form, according to the general replacement reaction: nM + mMnoblen+ → nMm+ + mMnoble. The reaction is driven by the difference in the equilibrium potential of the two metal/metal ion redox couples and, to avoid parasitic cathodic processes such as oxygen reduction and (in some cases hydrogen evolution too, both oxygen levels and the pH must be optimized. The resulting bimetallic material can in principle have a Mnoble-rich shell and M-rich core (denoted as Mnoble(M leading to a possible decrease in noble metal loading and the modification of its properties by the underlying metal M. This paper reviews a number of bimetallic or ternary electrocatalytic materials prepared by galvanic replacement for fuel cell, electrolysis and electrosynthesis reactions. These include oxygen reduction, methanol, formic acid and ethanol oxidation, hydrogen evolution and oxidation, oxygen evolution, borohydride oxidation, and halide reduction. Methods for depositing the precursor metal M on the support material (electrodeposition, electroless deposition, photodeposition as well as the various options for the support are also reviewed.

  15. Bonding over Dentin Replacement Materials.

    Science.gov (United States)

    Meraji, Naghmeh; Camilleri, Josette

    2017-08-01

    Dentin replacement materials are necessary in large cavities to protect the pulp and reduce the bulk of filling material. These materials are layered with a composite resin restorative material. Microleakage caused by poor bonding of composite resin to underlying dentin replacement material will result in pulp damage. The aim of this study was to characterize the interface between dentin replacement materials and composite resin and to measure the shear bond strength after dynamic aging. Biodentine (Septodont, Saint Maur-des-Fosses, France), Theracal LC (Bisco, Schaumburg, IL), and Fuji IX (GC, Tokyo, Japan) were used as dentin replacement materials. They were then overlaid with a total-etch and bonding agent or a self-etch primer and composite resin or a glass ionomer cement. All combinations were thermocycled for 3000 cycles. The interface was characterized using scanning electron microscopy and elemental mapping. Furthermore, the shear bond strength was assessed. The Biodentine surface was modified by etching. The Theracal LC and Fuji IX microstructure was unchanged upon the application of acid etch. The Biodentine and glass ionomer interface showed an evident wide open space, and glass particles from the glass ionomer adhered to the Biodentine surface. Elemental migration was shown with aluminum, barium, fluorine, and ytterbium present in Biodentine from the overlying composite resin. Calcium was more stable. The bond strength between Theracal LC and composite using a total-etch technique followed by self-etch primer achieved the best bond strength values. Biodentine exhibited the weakest bond with complete failure of bonding shown after demolding and thermocycling. Dynamic aging is necessary to have clinically valid data. Bonding composite resin to water-based dentin replacement materials is still challenging, and further alternatives for restoration of teeth using such materials need to be developed. Copyright © 2017 American Association of Endodontists

  16. Postoperative Autologous Reinfusion in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    A. Crescibene

    2015-01-01

    Full Text Available Surgeries for total knee replacement (TKR are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p=0.08 and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p=0.03. Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p<0.01, and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR.

  17. Continuous infusion of enzyme replacement therapy is inferior to weekly infusions in MPS I dogs.

    Science.gov (United States)

    Passage, M B; Krieger, A W; Peinovich, M C; Lester, T; Le, S Q; Dickson, P I; Kakkis, E D

    2009-12-01

    Intravenous enzyme replacement therapy with recombinant human α-L-iduronidase (rhIDU) is used weekly to treat mucopolysaccharidosis (MPS) I. We tested continuous administration of rhIDU at two dosing levels (0.58 mg/kg per week and 2 mg/kg per week) in MPS I dogs, and compared the efficacy of continuous infusion with the clinically used 0.58 mg/kg weekly three-hour infusion. Peak plasma concentrations of rhIDU were much higher in weekly-treated dogs (mean 256 units/ml) than steady-state concentrations in dogs treated with continuous infusion (mean 1.97 units/ml at 0.58 mg/kg per week; 8.44 units/ml at 2 mg/kg per week). Dogs receiving continuous IV rhIDU, even at a higher (2 mg/kg per week) dose, had consistently lower iduronidase levels in tissues than dogs receiving a weekly (0.58 mg/kg per week) dose. GAG storage was also less improved by continuous intravenous infusion. Adverse events were similar in all dosing groups. We found that continuous administration of 2 mg/kg per week rhIDU to MPS I dogs was insufficient to achieve GAG storage reduction comparable to 0.58 mg/kg weekly dosing.

  18. Urbanization, Ikization, and Replacement Dynamics

    CERN Document Server

    Chen, Yanguang

    2015-01-01

    The phenomenon of Iks was first found by anthropologists and biologists, but it is actually a problem of human geography. However, it has not yet drawn extensive attention of geographers. In this paper, a hypothesis of ikization is presented that sudden and violent change of geographical environments results in dismantling of traditional culture, which then result in collective depravity of a nationality. By quantitative analysis and mathematical modeling, the causality between urbanization and ikization is discussed, and the theory of replacement dynamics is employed to interpret the process of ikization. Urbanization is in essence a nonlinear process of population replacement. Urbanization may result in ikization because that the migration of population from rural regions to urban regions always give rise to abrupt changes of geographical environments and traditional culture. It is necessary to protect the geographical environment against disruption, and to inherit and develop traditional culture in order t...

  19. [MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT].

    Science.gov (United States)

    Tabata, Minoru

    2016-03-01

    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR.

  20. Mitochondrial Replacement: Ethics And Identity

    OpenAIRE

    Wrigley, Anthony; Wilkinson, Stephen; Appleby, John B

    2015-01-01

    Mitochondrial replacement techniques (MRTs) have the potential to allow prospective parents who are at risk of passing on debilitating or even life-threatening mitochondrial disorders to have healthy children to whom they are genetically related. Ethical concerns have however been raised about these techniques. This article focuses on one aspect of the ethical debate, the question of whether there is any moral difference between the two types of MRT proposed: Pronuclear Transfer (PNT) and Mat...

  1. Replacing magnets at the LHC

    CERN Multimedia

    LHC, LSI2, Point 4

    2013-01-01

    CERN engineers have been working through the night this week to move the final replacement dipole magnets into position on the Large Hadron Collider (LHC). Though there are several still to go, the teams expect to have completed the task by the end of this month. Dipole magnets bend the paths of particles as they travel around the circular accelerator. Of the LHC's 1232 dipoles – each 15 metres long and weighing 35 tonnes – 15 are being replaced as part of the long shutdown of CERN's accelerator complex. These 15 magnets suffered wear and tear during the LHC's first 4-year run. Three quadrupole-magnet assemblies – which help to focus particles into a tight beam – have also been replaced. Moving such heavy magnets requires specially adapted cranes and trailers both above and below ground. There are several access points on the LHC. Some, such as the 100-metre vertical access shaft down to the ALICE experiment, are equipped with lifts to allow technical personnel and visitors down to the caverns. Other ...

  2. Results of Austin Moore replacement.

    Directory of Open Access Journals (Sweden)

    Jadhav A

    1996-04-01

    Full Text Available Forty cases of Austin Moore Replacement done for transcervical fractures of the femur in patients were reviewed after a period of 12 to 48 months postoperatively (mean 26 mth. 30 cases (75% had mild to severe pain of non-infective origin, starting as early as 6 months postoperatively. This was irrespective of the make, size or position (varus/valgus of the prosthesis. Though the Aufranc and Sweet clinical scoring was satisfactory in 65% cases, radiological evidence of complications like sinking, protrusion, etc. were seen in majority of the cases. Calcar resorption was seen in 34 cases (85% as early as 4 months postoperatively. Results of THR and bipolar replacement done for transcervical fractures in recent literature show 85% pain-free cases at 5 years. We feel that Austin Moore Replacement should be reserved for patients more than 65 years of age and those who are less active or debilitated because of other factors, because of increased acetabular wear with time in the younger individual. This is corroborated by unsatisfactory results in patients less than 65 years of age (p < 0.05.

  3. The caudal septum replacement graft.

    Science.gov (United States)

    Foda, Hossam M T

    2008-01-01

    To describe a technique for reconstructing the lost tip support in cases involving caudal septal and premaxillary deficiencies. The study included 120 patients with aesthetic and functional nasal problems resulting from the loss of caudal septal and premaxillary support. An external rhinoplasty approach was performed to reconstruct the lost support using a cartilaginous caudal septum replacement graft and premaxillary augmentation with Mersilene mesh. The majority of cases (75%) involved revisions in patients who had previously undergone 1 or more nasal surgical procedures. A caudal septum replacement graft was combined with premaxillary augmentation in 93 patients (77.5%). The mean follow-up period was 3 years (range, 1-12 years). The technique succeeded in correcting the external nasal deformities in all patients and resulted in a significant improvement in breathing in 74 patients (86%) with preoperative nasal obstruction. There were no cases of infection, displacement, or extrusion. The caudal septum replacement graft proved to be very effective in restoring the lost tip support in patients with caudal septal deficiency. Combining the graft with premaxillary augmentation using Mersilene mesh helped increase support and stability over long-term follow-up.

  4. Aortic valve replacement in a patient with severe hemophilia.

    Science.gov (United States)

    Gasparović, Hrvoje; Zupancic-Salek, Silva; Brida, Vojtjeh; Dulić, Grgur; Jelić, Ivan

    2007-03-01

    Hemophilia A is an inherited bleeding disorder characterized by factor VIII deficiency. The basis for insufficient hemostasis lies within inadequate amplification of factor Xa production with the undersupplied factor VIII. We report on a young patient with critical aortic stenosis bearing all the clinical stigmata of severe hemophilia, in whom aortic valve replacement was performed with a tissue valve in order to avoid the need for long term anticoagulation.

  5. [Chondrocyte mecanobiology. Application in cartilage tissue engineering].

    Science.gov (United States)

    Stoltz, Jean François; Netter, Patrick; Huselstein, Céline; de Isla, Natalia; Wei Yang, Jing; Muller, Sylvaine

    2005-11-01

    Cartilage is a hydrated connective tissue that withstands and distributes mechanical forces within joints. Chondrocytes utilize mechanical signals to maintain cartilaginous tissue homeostasis. They regulate their metabolic activity through complex biological and biophysical interactions with the extracellular matrix (ECM). Some mechanotransduction mechanisms are known, while many others no doubt remain to be discovered. Various aspects of chondrocyte mechanobiology have been applied to tissue engineering, with the creation of replacement tissue in vitro from bioresorbable or non-bioresorbable scaffolds and harvested cells. The tissues are maintained in a near-physiologic mechanical and biochemical environment. This paper is an overview of both chondrocyte mechanobiology and cartilage tissue engineering

  6. Fusion following failed total ankle replacement.

    Science.gov (United States)

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  7. Platelet-rich plasma can replace fetal bovine serum in human meniscus cell cultures

    NARCIS (Netherlands)

    Gonzales, V.K.; Mulder, E.L.W. de; Boer, T. den; Hannink, G.; Tienen, T.G. van; Heerde, W.L. van; Buma, P.

    2013-01-01

    Concerns over fetal bovine serum (FBS) limit the clinical application of cultured tissue-engineered constructs. Therefore, we investigated if platelet-rich plasma (PRP) can fully replace FBS for meniscus tissue engineering purposes. Human PRP and platelet-poor plasma (PPP) were isolated from three h

  8. Tissue tests

    NARCIS (Netherlands)

    Sonneveld, C.; Voogt, W.

    2009-01-01

    Tissue tests are widely used in horticulture practice and have in comparison with soil or substrate testing advantages as well disadvantages in comparison with soil testing. One of the main advantages of tissue tests is the certainty that analysed nutrients in plant tissues are really present in the

  9. Tissue tests

    NARCIS (Netherlands)

    Sonneveld, C.; Voogt, W.

    2009-01-01

    Tissue tests are widely used in horticulture practice and have in comparison with soil or substrate testing advantages as well disadvantages in comparison with soil testing. One of the main advantages of tissue tests is the certainty that analysed nutrients in plant tissues are really present in the

  10. Transcatheter Aortic Valve Replacement: Comprehensive Review and Present Status

    Science.gov (United States)

    Misenheimer, Jacob A.; Ramaraj, Radhakrishnan

    2017-01-01

    Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction. The advent in France of transcatheter aortic valve replacement has raised the hope in the United States for an alternative, less invasive treatment for aortic stenosis. Two recent trials—the Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve (Partner) and the CoreValve US Pivotal—have established transcatheter aortic valve replacement as the preferred approach in patients who are at high or prohibitive surgical risk. The more recently published Partner 2 trial has shown the feasibility of transcatheter aortic valve replacement in intermediate-surgical-risk patients as well. With a profile that promises easier use and better valve performance and delivery, newer-generation valves have shown their potential for further improvement in safety profile and overall outcomes. We review the history and status of this topic. PMID:28265210

  11. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  12. The German Replacement Army (Ersatzheer)

    Science.gov (United States)

    1944-04-01

    Wkr. XIII), 52 (Wkr. X), and 66 (Wkr. XII) the last digit of th ~ number has been found to indicate the Wehrkreis of each unit. Most of the units...regular courses for officer candidates are held: (a) Fahnenjunker-Lehrgang I at Wiinsdorf (Wkr. III), probably now at th ~ School for Panzer Troops I in...Heerweiler tiber Bingen (Wkr. XII), and Wischau near Brunn (Wkr. B.u.M.). (c) Panzerfahrschulen (Tank Driver Schools).-Have been re- ported at Gelnhausen

  13. Development of a tire-replacement handler for large scaled dump trucks

    Energy Technology Data Exchange (ETDEWEB)

    Shimauchi, H. [Aomi Lime Stone Mine, Denkikakgaku-kogyo co. Ltd., Niigata (Japan); Ujihira, M. [Hokkaido Univ., Sapporo (Japan). School of Engineering

    2005-07-01

    Tire replacement for large-scale mine haulage trucks is expensive and poses a burden to mine operators that intend to reduce costs. This study examined a method to move the central axis of a large scale tire to an optional height while remaining horizontal with the ground. The motion of a tire replacement handler system was analyzed both theoretically and experimentally. A tire handler unit attached to a bulldozer was then developed and tire replacement tests were conducted. The study showed that the optional height of the axis of a large diameter tire that has to be replaced can be adjusted smoothly. The rolling test for a large scale tire using a pair of 7 inch diameter steel pipes showed that the total time of front tire replacement was 282-303 minutes. The newly developed and simple tire handler unit was shown to have a broad range of applications and was cost effective. 4 refs., 3 tabs., 8 figs.

  14. Neonatal varicella pneumonia, surfactant replacement therapy

    Directory of Open Access Journals (Sweden)

    Mousa Ahmadpour-kacho

    2015-12-01

    Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

  15. B Plant process piping replacement feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Howden, G.F.

    1996-02-07

    Reports on the feasibility of replacing existing embedded process piping with new more corrosion resistant piping between cells and between cells and a hot pipe trench of a Hanford Site style canyon facility. Provides concepts for replacement piping installation, and use of robotics to replace the use of the canyon crane as the primary means of performing/supporting facility modifications (eg, cell lining, pipe replacement, equipment reinstallation) and operational maintenenace.

  16. REMINDER REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division; Cards.Service@cern.ch

    2001-01-01

    The French Ministry of Foreign Affairs is currently replacing all diplomatic cards, special cards and employment permits («attestations de fonctions») held by members of the personnel and their families. These cards are replaced by secure, computerized equivalents. The old cards may no longer be used after 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015) between 8h30 and 12h30, in order to fill in a «fiche individuelle» form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, the French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested...

  17. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  18. Valve replacement in children: a challenge for a whole life.

    Science.gov (United States)

    Henaine, Roland; Roubertie, François; Vergnat, Mathieu; Ninet, Jean

    2012-10-01

    Valvular pathology in infants and children poses numerous challenges to the paediatric cardiac surgeon. Without question, valvular repair is the goal of intervention because restoration of valvular anatomy and physiology using native tissue allows for growth and a potentially better long-term outcome. When reconstruction fails or is not feasible, valve replacement becomes inevitable. Which valve for which position is controversial. Homograft and bioprosthetic valves achieve superior haemodynamic results initially but at the cost of accelerated degeneration. Small patient size and the risk of thromboembolism limit the usefulness of mechanical valves, and somatic outgrowth is an universal problem with all available prostheses. The goal of this article is to address valve replacement options for all four valve positions within the paediatric population. We review current literature and our practice to support our preferences. To summarize, a multitude of opinions and surgical experiences exist. Today, the valve choices that seem without controversy are bioprosthetic replacement of the tricuspid valve and Ross or Ross-Konno procedures when necessary for the aortic valve. On the other hand, bioprostheses may be implanted when annular pulmonary diameter is adequate; if not or in case of right ventricular outflow tract discontinuity, it is better to use a pulmonary homograft with the Ross procedure. Otherwise, a valved conduit. Mitral valve replacement remains the most problematic; the mechanical prosthesis must be placed in the annular position, avoiding oversizing. Future advances with tissue-engineered heart valves for all positions and new anticoagulants may change the landscape for valve replacement in the paediatric population.

  19. SE Marine Mammal Histology/Tissue data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Tissue samples are collected from stranded marine mammals in the Southeastern United States. These tissue samples are examined histologically and evaluated to...

  20. The internal micropore structures in biomimetic artificial bone scaffold touches on whether the scaffolds can replace the natural bone to implant the growth factors,bone cells and other active substances in order to promote the growth of bony tissue.Using%人工骨支架内部微结构两相流数值模拟

    Institute of Scientific and Technical Information of China (English)

    王丽丽; 党新安; 杨立军; 齐艳梅

    2012-01-01

    人工骨仿生支架内部微孔结构关系到支架能否替代自然骨,植入骨生长因子、成骨细胞等活性物质,促进骨组织的生长.利用Fluent软件,对中心为球体,边缘为圆柱体的单元微结构进行了细胞和营养液的两相流数值模拟,分析了中心球半径R及连通孔径d对系统压力、流速及细胞相体积分数的影响规律,为人工骨支架微结构的优化及仿形研究奠定了基础.结果表明中心球半径R对系统压力影响很小,较大的连通孔径d比较适合细胞的增殖与粘附;最大流速在0.011m/s-0.018m/s范围内,d恒定时,随着的R的增加,流速分布很均匀,但是值却稍微有些降低.R恒定时,随着连通孔径d增大,流速分布越均匀,速度值也越大.%The internal micropore structures in biomimetic artificial bone scaffold touches on whether the scaffolds can replace the natural bone to implant the growth factors,bone cells and other active substances in order to promote the growth of bony tissue.Using the software of Fluent,there is a two-phase flow numerical simulation about cells and nutrient solution for the micropore structures which have a sphere in the .center and cylinders at the edge. The influence law of the radius R of the center sphere and the connected aperture d on system pressure,flow velocity and the volume fraction of cell phase are analyzed, which lays a good foundation for the optimisation of micropore structures and the profile research.The conclusion shows that the radius of center sphere has poor effect on the system pressure, and the more larger connected aperture is beneficial to the proliferation and adhesion of cells; the maximum velocity between 0.011m/s and 0.0l8m/sWhen d is constant, the distribution of velocity is very uniform with the increase of R, but the value is slightly lower.When the R is constant, the distribution of velocity is more uniform and the value is greater with the increase of d.

  1. Feed water distribution pipe replacement at Loviisa NPP

    Energy Technology Data Exchange (ETDEWEB)

    Savolainen, S.; Elsing, B. [Imatran Voima Loviisa NPP (Finland)

    1995-12-31

    Imatran Voima Oy operates two WWER-440 reactors. Unit 1 has been operating since 1977 and unit 2 since 1981. First damages of feed water distribution (FWD) pipe were observed in 1989. The FWD-pipe T-connection had suffered from severe erosion corrosion damages. Similar damages have been been found also in other WWER-440 type NPPs. In 1989 the nozzles of the steam generator YB11 were inspected. No signs of the damages or signs of erosion were detected. The first damaged nozzles were found in 1992 in steam generators of both units. In 1992 it was started studying different possibilities to either repair or replace the damaged FWD-pipes. Due to the difficult conditions for repairing the damaged nozzles it was decided to study different FWD-pipe constructions. In 1991 two new feedwater distributors had been implemented at Dukovany NPP designed by Vitckovice company. Additionally OKB Gidropress had presented their design for new collector. In spring 1994 all the six steam generators of Rovno NPP unit 1 were replaced with FWD-pipes designed by OKB Gidropress. After the implementation an experimental program with the new systems was carried out. Due to the successful experiments at Rovno NPP Unit 1 it was decided to implement `Gidropress solution` during 1994 refueling outage into the steam generator YB52 at Loviisa 2. The object of this paper is to discuss the new FWD-pipe and its effects on the plant safety during normal and accident conditions. (orig.).

  2. 右美托咪定联合心理干预对神经阻滞下单侧全膝关节置换术患者心理应激反应的影响%Influence on mental stress reaction of dexmedetomidine uniting psycholog-ical intervention of the patients with unilateral total knee replacement un-der nerve block

    Institute of Scientific and Technical Information of China (English)

    周强

    2015-01-01

    Objective To explore the influence on mental stress reaction of dexmedetomidine uniting psychological in-tervention of the patients with unilateral total knee replacement under nerve block. Methods 60 patients with one sided total knee replacement under nerve block from October 2014 to march 2015 in our hospital were choosed,they were di-vided into study group (30 cases) and control group (30 cases) by random number table method,the two groups were all given psychological intervention,Study group was given dexmedetomidine,control group was given 0.9% saline solution. Before and after operation,the difference of HR、MAP、serum cortisol, ATII between two groups was compared respec-tively.At the same time,the mental condition between two groups were compared using S-AI,HAD,AVAT. Results Be-fore operation,the score of S-AI,HAD,AVAT,and HR、MAP、serum cortisol、ATII between two groups was no statistical differenc(P>0.05).After operation,HR、MAP、serum cortisol、ATII of study group was[(80±5) mm Hg、(80±8)/min、(308±116)nmol/L、(15±5)ng/L] lower than [(86±6)mm Hg、(84±9)/min、(356±136)nmol/L、(21±7)ng/L] in control group respec-tively,with statistical difference(P0.05);术后,研究组MAP、HR、血清皮质醇、ATⅡ分别为(80±5)mm Hg、(80±8)/min、(308±116) nmol/L、(15±5) ng/L,低于对照组的(86±6)mm Hg、(84±9)/min、(356±136)nmol/L、(21±7)ng/L,差异有统计学意义(P<0.05);术后研究组S-AI、HAD、AVAT评分分别为(9±4)、(9±3)、(53±5)分,低于对照组的(12±5)、(12±4)、(60±5)分,差异有统计学意义(P<0.05)。结论右美托咪定联合心理干预能减少腰丛与坐骨神经联合阻滞下行单侧全膝关节置换术患者的心理应激反应,明显减轻患者心理压力,保障血流动力学平稳。

  3. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    Science.gov (United States)

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  4. Ulnar Head Replacement and Related Biomechanics

    Science.gov (United States)

    Sauerbier, Michael; Arsalan-Werner, Annika; Enderle, Elena; Vetter, Miriam; Vonier, Daniel

    2013-01-01

    A stable distal radioulnar joint (DRUJ) is mandatory for the function and load transmission in the wrist and forearm. Resectional salvage procedures such as the Darrach procedure, Bowers arthroplasty, and Sauvé-Kapandji procedure include the potential risk of radioulnar instability and impingement, which can lead to pain and weakness. Soft tissue stabilizing techniques have only limited success rates in solving these problems. In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head. The prostheses can be used for secondary treatment of failed ulnar head resection, but they can also achieve good results in the primary treatment of osteoarthritis of the DRUJ. Our experience consists of twenty-five patients (follow-up 30 months) with DRUJ osteoarthritis who were treated with an ulnar head prosthesis, with improvement in pain, range of motion, and grip strength. An ulnar head prosthesis should be considered as a treatment option for a painful DRUJ. PMID:24436786

  5. ORO. The physical developer replacement?

    Science.gov (United States)

    Wood, Michael A; James, Tim

    2009-12-01

    In the process of fingerprint development Physical Developer has been largely the method of choice on porous surfaces after coming into contact with wet environments. It is only recently that a new technique has been identified which could replace this standard technique. This study aims to build on previous research and expand knowledge regarding the technique. The study built on previous research and compared Physical Developer to Oil Red O, testing both on four paper types, while being placed in three different water types and an accelerant for various amounts of time. Marks were placed with both heavily 'loaded' sebaceous fingers and 'normal' un-washed fingers. Results show that Oil Red O consistently produced clearer more detailed marks from the 'loaded' fingers, but neither technique proved to work better on the 'normal' marks. Neither technique developed any prints from the accelerant.

  6. Optimal randomized scheduling by replacement

    Energy Technology Data Exchange (ETDEWEB)

    Saias, I.

    1996-05-01

    In the replacement scheduling problem, a system is composed of n processors drawn from a pool of p. The processors can become faulty while in operation and faulty processors never recover. A report is issued whenever a fault occurs. This report states only the existence of a fault but does not indicate its location. Based on this report, the scheduler can reconfigure the system and choose another set of n processors. The system operates satisfactorily as long as, upon report of a fault, the scheduler chooses n non-faulty processors. We provide a randomized protocol maximizing the expected number of faults the system can sustain before the occurrence of a crash. The optimality of the protocol is established by considering a closely related dual optimization problem. The game-theoretic technical difficulties that we solve in this paper are very general and encountered whenever proving the optimality of a randomized algorithm in parallel and distributed computation.

  7. Controversies in hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    A. Baziad

    2001-09-01

    Full Text Available Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine. (Med J Indones 2001; 10: 182-6Keywords: controversies, HRT

  8. Replacement reactor to revolutionise magnets

    CERN Document Server

    Atkins, G

    2002-01-01

    Electric motors, hearing aids and magnetic resonance imaging are only some of the applications that will benefit from the first advances in magnets in a quarter of a century. Magnets achieve their characteristics when electrons align themselves to produce a unified magnetic field. Neutrons can probe these magnetic structures. The focus is not just on making more powerful magnets, but also identifying the characteristics that make magnets cheaper and easier for industry to manufacture. Staff from the ANSTO's Neutron Scattering Group have already performed a number of studies on the properties of magnets using using HIFAR, but the Replacement Research Reactor that will produce cold neutrons would allow scientists to investigate the atomic properties of materials with large molecules. A suite of equipment will enable studies at different temperatures, pressures and magnetic fields

  9. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Noordzij, Marlies; Kramer, Anneke; Abad Diez, José M

    2014-01-01

    BACKGROUND: This article provides a summary of the 2011 ERA-EDTA Registry Annual Report (available at www.era-edta-reg.org). METHODS: Data on renal replacement therapy (RRT) for end-stage renal disease (ESRD) from national and regional renal registries in 30 countries in Europe and bordering the .......6-47.0], and on dialysis 39.3% (95% CI 39.2-39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2-87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6-95.0) for kidneys from living donors....

  10. Leptin replacement improves cognitive development.

    Directory of Open Access Journals (Sweden)

    Gilberto J Paz-Filho

    Full Text Available BACKGROUND: Leptin changes brain structure, neuron excitability and synaptic plasticity. It also regulates the development and function of feeding circuits. However, the effects of leptin on neurocognitive development are unknown. OBJECTIVE: To evaluate the effect of leptin on neurocognitive development. METHODOLOGY: A 5-year-old boy with a nonconservative missense leptin gene mutation (Cys-to-Thr in codon 105 was treated with recombinant methionyl human leptin (r-metHuLeptin at physiologic replacement doses of 0.03 mg/kg/day. Cognitive development was assessed using the Differential Ability Scales (DAS, a measure of general verbal and nonverbal functioning; and selected subtests from the NEPSY, a measure of neuropsychological functioning in children. PRINCIPAL FINDINGS: Prior to treatment, the patient was morbidly obese, hypertensive, dyslipidemic, and hyperinsulinemic. Baseline neurocognitive tests revealed slower than expected rates of development (developmental age lower than chronological age in a majority of the areas assessed. After two years, substantial increases in the rates of development in most neurocognitive domains were apparent, with some skills at or exceeding expectations based on chronological age. We also observed marked weight loss and resolution of hypertension, dyslipidemia and hyperinsulinemia. CONCLUSIONS: We concluded that replacement with r-metHuLeptin is associated with weight loss and changes in rates of development in many neurocognitive domains, which lends support to the hypothesis that, in addition to its role in metabolism, leptin may have a cognitive enhancing role in the developing central nervous system. TRIAL REGISTRATION: ClinicalTrials.gov NCT00659828.

  11. Valve replacement in pediatric patients:a single center experience

    Institute of Scientific and Technical Information of China (English)

    YU Jian-hua; GUO Hong-wei; ZHANG Gong; WU Shu-ming; SONG Guang-min; SUN Wen-yu

    2011-01-01

    Background Reconstructive surgery is the primary goal in pediatric patients with valve disease.However,in cases with irreparable valve lesions,valve replacement is the only option.This study aimed to retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.Methods Between January 1990 and July 2009,35 pediatric patients (16 boys,19 girls) underwent mechanical valve replacement in Shandong University Qilu Hospital.The ages ranged from 2.5 to 14 years (mean,(8.8±3.8) years) and body weight varied from 11 to 37 kg (mean,(22.1±5.2) kg).Mechanical valve replacement was performed because of congenital heart disease in 23 patients,rheumatic disease in ten patients and infective endocarditis in two patients.St.Jude bileaflet mechanical valves were implanted in all the 35 patients including mitral valve replacement (MVR) in 18,aortic valve replacement (AVR) in 12,tricuspid valve replacement (TVR) in two,AVR and MVR in two and MVR and TVR in one.The size of the prostheses ranged between 19 and 27 mm.All patients received long-term anticoagulation treatment with sodium warfarin,aiming to maintain an international normalized ratio between 1.5 to 2.0.Follow-up was performed in all the patients with a total follow-up of 119.4 patient-years.Results The operative mortality was 8.57% (3/35).One patient,who underwent cardiac debridement and AVR,died 2 hours after being admitted to the intensive care unit because of severe low cardiac output syndrome and ventricular fibrillation.Two patients died of cardiogenic shock and renal failure during initial hospitalization after the operation.One patient who received replacement of a tricuspid valve developed complete heart block requiring temporary pacing and recovered sinus rhythm 4 days later.Thirty-two patients survived and their cardiac function was in New York Heart Association (NYHA) class Ⅰ to class Ⅱ when discharged.Late events included hemorrhage and endocarditis.Two patients required

  12. Early-switch/early-discharge opportunities for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections: proof of concept in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    El Houfi A

    2015-06-01

    Full Text Available Ashraf El Houfi,1 Nadeem Javed,2 Caitlyn T Solem,3 Cynthia Macahilig,4 Jennifer M Stephens,3 Nirvana Raghubir,5 Richard Chambers,6 Jim Z Li,7 Seema Haider81Dubai Hospital, Dubai, UAE; 2Rashid Hospital, Dubai, UAE; 3Pharmerit International, Bethesda, MD, USA; 4Medical Data Analytics, Parsippany, NJ, USA; 5Pfizer, New York, NY, USA; 6Pfizer, Collegeville, PA, USA; 7Pfizer, La Jolla, CA, USA; 8Pfizer, Groton, CT, USAObjectives: To describe real-world treatment patterns and health care resource use and to estimate opportunities for early-switch (ES from intravenous (IV to oral (PO antibiotics and early-discharge (ED for patients hospitalized in the United Arab Emirates (UAE with methicillin-resistant Staphylococcus aureus (MRSA complicated skin and soft tissue infections.Methods: This retrospective observational medical chart review study enrolled physicians from four UAE sites to collect data for 24 patients with documented MRSA complicated skin and soft tissue infections, hospitalized between July 2010 and June 2011, and discharged alive by July 2011. Data include clinical characteristics and outcomes, hospital length of stay (LOS, MRSA-targeted IV and PO antibiotic use, and ES and ED eligibility using literature-based and expert-validated criteria.Results: Five included patients (20.8% were switched from IV to PO antibiotics while being inpatients. Actual length of MRSA-active treatment was 10.8±7.0 days, with 9.8±6.6 days of IV therapy. Patients were hospitalized for a mean 13.9±9.3 days. The most frequent initial MRSA-active therapies used were vancomycin (37.5%, linezolid (16.7%, and clindamycin (16.7%. Eight patients were discharged with MRSA-active antibiotics, with linezolid prescribed most frequently (n=3; 37.5%. Fifteen patients (62.5% met ES criteria and potentially could have discontinued IV therapy 8.3±6.0 days sooner, and eight (33.3% met ED criteria and potentially could have been discharged 10.9±5.8 days earlier

  13. Tissue types (image)

    Science.gov (United States)

    There are 4 basic types of tissue: connective tissue, epithelial tissue, muscle tissue, and nervous tissue. Connective tissue ... and binds them together (bone, blood, and lymph tissues). Epithelial tissue provides a covering (skin, the linings of ...

  14. The effects of growth hormone deficiency and replacement on glucocorticoid exposure in hypopituitary patients on cortisone acetate and hydrocortisone replacement.

    Science.gov (United States)

    Swords, F M; Carroll, P V; Kisalu, J; Wood, P J; Taylor, N F; Monson, J P

    2003-11-01

    11 beta-hydroxysteroid dehydrogenase type 1 (11 beta HSD1) converts inactive cortisone to active cortisol. 11 beta HSD1 activity is increased in GH deficiency and inhibited by GH and IGF-I in acromegaly. However it is not known whether these changes in cortisol metabolism exert significant effects during hydrocortisone therapy, and the effect has not been studied in patients taking cortisone acetate. We have studied the effect of GH induced 11 beta HSD1 inhibition in hypopituitary adults with severe GH deficiency to determine whether this inhibition has a different magnitude of effect when patients are taking different forms of glucocorticoid replacement therapy. We have taken the ratio of 11-hydroxy/11-oxo cortisol metabolites (Fm/Em), an established measure of net 11 beta HSD activity to reflect the likely balance of cortisol to cortisone exposure in tissues expressing 11 beta HSD1, principally the liver and adipose tissue. We recruited 10 hypopituitary adults all on established glucocorticoid replacement therapy, but who were not receiving GH. Patients were treated with their standard hydrocortisone therapy for one week and an equivalent dose of cortisone acetate in its place for one week in random order. Serial serum cortisol assessments and urine steroid profiles were performed on each treatment. All patients were then established on GH therapy for at least three months before the two-week cycle was repeated. Fm/Em was also measured in a control population (20F, 20M). Prior to GH, the ratio Fm/Em was greater with hydrocortisone compared with cortisone acetate replacement (1.17 +/- 0.28 and 0.52 +/- 0.09 respectively, P cortisol/cortisone did not change indicating unchanged 11 beta HSD2 activity. Mean circulating cortisol also fell in all subjects after GH. This effect was greater during cortisone acetate treatment (-18.7%, P tissue exposure to glucocorticoid is supra-physiological in hypopituitary patients with untreated GH deficiency taking hydrocortisone

  15. Severe impingement of lumbar disc replacements increases the functional biological activity of polyethylene wear debris.

    Science.gov (United States)

    Baxter, Ryan M; Macdonald, Daniel W; Kurtz, Steven M; Steinbeck, Marla J

    2013-06-05

    Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size

  16. Severe Impingement of Lumbar Disc Replacements Increases the Functional Biological Activity of Polyethylene Wear Debris

    Science.gov (United States)

    Baxter, Ryan M.; MacDonald, Daniel W.; Kurtz, Steven M.; Steinbeck, Marla J.

    2013-01-01

    Background: Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. Methods: The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Results: Grouping of particles by size ranges that represented high biological relevance (10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size ranges. In both cohorts, the functional biological activity correlated with the

  17. Salvage of a failed Sauve-Kapandji procedure using a total distal radio-ulnar joint replacement.

    Science.gov (United States)

    Atwal, N S; Clark, D A; Amirfeyz, R; Bhatia, R

    2010-01-01

    This is the first report in the literature of a patient treated with a DRUJ replacement after Sauvé-Kapandji procedure failed due to pain and instability. The DRUJ replacement is an unconstrained, biomechanically more advantageous implant which can confer stability in cases where soft tissues are inadequate. We describe the treatment and outcome of persistent ulnar instability with a distal radio-ulnar joint replacement following failed salvage procedures for a malunion of a distal radius fracture.

  18. [Renal replacement therapy for refractory heart failure].

    Science.gov (United States)

    Schwenger, V; Remppis, A B

    2012-07-01

    After broad cardiological and nephrological evaluation and consideration of optimal conservative options according to national and international guidelines, renal replacement therapy might be helpful in patients with refractory heart failure even if they are not dialysis-dependent. This is even more important as renal failure is a strong predictor for mortality in patients with severe congestive heart failure (CHF) and CHF is one of the fastest growing morbidities in western countries. Although peritoneal dialysis (PD) is frequently used in patients with CHF its role remains unclear. Acute chronic volume overload in refractory CHF is still an unresolved clinical problem. In patients with acute heart and renal failure with need of management in an intensive care unit, extracorporeal ultrafiltration or a dialysis modality should be preferred. In patients with chronic refractory CHF, volume overload and renal failure, peritoneal dialysis should be the therapy of choice. Due to the limited data available, treatment and outcome parameters should be recorded in the registry of the German Society of Nephrology (http://www.herz-niere.de).

  19. Effectiveness of a laboratory-scale vertical tower static chamber steam pasteurization unit against Escherichia coli O157:H7, Salmonella typhimurium, and Listeria innocua on prerigor beef tissue.

    Science.gov (United States)

    Retzlaff, Deanna; Phebus, Randall; Nutsch, Abbey; Riemann, James; Kastner, Curtis; Marsden, James

    2004-08-01

    A laboratory-scale vertical tower steam pasteurization unit was evaluated to determine the antimicrobial effectiveness of different exposure times (0, 3, 6, 12, and 15 s) and steam chamber temperatures (82.2, 87.8, 93.3, and 98.9 degrees C) against pathogens (Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria innocua) inoculated onto prerigor beef tissue. Samples were collected and microbiologically analyzed immediately before and after steam treatment to quantify the effectiveness of each time-temperature combination. The 0-s exposure at all chamber temperatures (cold water spray only, no steam treatment) was the experimental control and provided 0.05) at all exposure times. At 93.3 degrees C, significant reductions (> 1.0 log CFU/cm2) were observed at exposure times of > or = 6 s, with 15 s providing approximately 1 log cycle greater reductions than 12 s of exposure. The 98.9 degrees C treatment was consistently the most effective, with exposure times of > or = 9 s resulting in >3.5 log CFU/cm2 reductions for all pathogens.

  20. 3D Nanoprinting Technologies for Tissue Engineering Applications

    OpenAIRE

    Jin Woo Lee

    2015-01-01

    Tissue engineering recovers an original function of tissue by replacing the damaged part with a new tissue or organ regenerated using various engineering technologies. This technology uses a scaffold to support three-dimensional (3D) tissue formation. Conventional scaffold fabrication methods do not control the architecture, pore shape, porosity, or interconnectivity of the scaffold, so it has limited ability to stimulate cell growth and to generate new tissue. 3D printing technologies may ov...

  1. TOTAL JOINT REPLACEMENT OF THE LOWER EXTREMITY IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

    OpenAIRE

    Стюарт Б. Гудмэн

    2014-01-01

    Joint replacement of the lower extremity in Juvenile Idiopathic Arthritis (JIA) is becoming more commonly performed worldwide. These young adults experience severe pain and disability from end-stage arthritis, and require joint replacement of the hip or knee to alleviate pain, and restore ambulation and function. These procedures are very challenging from the anesthesia and surgical point of view, due to small overall proportions, numerous bony and other deformities and soft tissue contractur...

  2. Valve-in-Valve Replacement Using a Sutureless Aortic Valve

    Science.gov (United States)

    Dohmen, Pascal M.; Lehmkuhl, Lukas; Borger, Michael A.; Misfeld, Martin; Mohr, Friedrich W.

    2016-01-01

    Patient: Female, 61 Final Diagnosis: Tissue degeneration Symptoms: Dyspnea Medication: — Clinical Procedure: Redo valve replacement Specialty: Surgery Objective: Rare disease Background: We present a unique case of a 61-year-old female patient with homograft deterioration after redo surgery for prosthetic valve endocarditis with root abscess. Case Report: The first operation was performed for type A dissection with root, arch, and elephant trunk replacement of the thoracic aorta. The present re-redo surgery was performed as valve-in-valve with a sutureless aortic biopros-thesis. The postoperative course was uneventful and the patient was discharged on day 6. Conclusions: The current case report demonstrates that sutureless bioprostheses are an attractive option for surgical valve-in-valve procedures, which can reduce morbidity and mortality. PMID:27694795

  3. Tissue engineering and biotechnology in general thoracic surgery.

    Science.gov (United States)

    Molnar, Tamas F; Pongracz, Judit E

    2010-06-01

    Public interest in the recent progress of tissue engineering, a special line of biotechnology, makes the current review on thoracic surgery highly relevant. In this article, techniques, materials and cellular processes are discussed alongside their potential applications in tissue repair. Different applications of tissue engineering in tracheo-bronchial replacement, lung tissue cultures and chest-wall reconstruction are also summarised in the article. Potential tissue engineering-based solutions for destructive, chronic lung-injury-related conditions and replacement of tubular structures in the central airways are also examined. Copyright 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  4. Replacing paper with digital recording.

    Science.gov (United States)

    Amin, Kawa

    2015-01-01

    Addressing the needs to achieve the highest standards at multidisciplinary team meetings at the Stroke Unit of Broomfield Hospital, an electronic version is applied instead of the traditional paper model. This is to ensure that patients within the unit are receiving appropriate care and their progress is monitored throughout their entire journey. This also enables the stroke team to retrieve old information anywhere in the hospital, electronically, from previous documentations to compare progress of rehabilitation. The electronic model also helps when assessing readmission or those who attend the stroke clinics to clarify new onset changes from residual weakness. The tool kit estimates Barthel Index score for activities of daily living and Rivermead Mobility Index for physical capacity assessment weekly as the team attending the meetings. The goals from all disciplines, physiotherapists, occupational therapists, speech and language therapists, and nurses are clearly documented along with patient cognition, emotion, and perception. This initiative commenced in late April 2013 and the first clinical outcome assessments performed at the beginning of September 2013, enabling the stroke team to assess rehabilitation activities and achievements. Front-line staff expressed satisfaction with the initiative model, which successfully managed to monitor and analyze the rehabilitation activities within the stroke unit.

  5. Use of internal references for assessing CT density measurements of the pelvis as replacement for use of an external phantom

    Energy Technology Data Exchange (ETDEWEB)

    Boomsma, Martijn F.; Slouwerhof, Inge; Dalen, Jorn A. van [Isala Hospital, Department of Radiology, Zwolle (Netherlands); Edens, Mireille A. [Isala Hospital, Department of Innovation and Science, Zwolle (Netherlands); Mueller, Dirk [Philips Healthcare systems, Hamburg (Germany); Milles, Julien [Philips Healthcare Benelux, Eindhoven (Netherlands); Maas, Mario [AMC, Department of Radiology, Amsterdam (Netherlands)

    2015-11-15

    The purpose of this research is to study the use of an internal reference standard for fat- and muscle as a replacement for an external reference standard with a phantom. By using a phantomless internal reference standard, Hounsfield unit (HU) measurements of various tissues can potentially be assessed in patients with a CT scan of the pelvis without an added phantom at time of CT acquisition. This paves the way for development of a tool for quantification of the change in tissue density in one patient over time and between patients. This could make every CT scan made without contrast available for research purposes. Fifty patients with unilateral metal-on-metal total hip replacements, scanned together with a calibration reference phantom used in bone mineral density measurements, were included in this study. On computed tomography scans of the pelvis without the use of intravenous iodine contrast, reference values for fat and muscle were measured in the phantom as well as within the patient's body. The conformity between the references was examined with the intra-class correlation coefficient. The mean HU (± SD) of reference values for fat for the internal- and phantom references were -91.5 (±7.0) and -90.9 (±7.8), respectively. For muscle, the mean HU (± SD) for the internal- and phantom references were 59.2 (±6.2) and 60.0 (±7.2), respectively. The intra-class correlation coefficients for fat and muscle were 0.90 and 0.84 respectively and show excellent agreement between the phantom and internal references. Internal references can be used with similar accuracy as references from an external phantom. There is no need to use an external phantom to asses CT density measurements of body tissue. (orig.)

  6. Gene replacement in Penicillium roqueforti.

    Science.gov (United States)

    Goarin, Anne; Silar, Philippe; Malagnac, Fabienne

    2015-05-01

    Most cheese-making filamentous fungi lack suitable molecular tools to improve their biotechnology potential. Penicillium roqueforti, a species of high industrial importance, would benefit from functional data yielded by molecular genetic approaches. This work provides the first example of gene replacement by homologous recombination in P. roqueforti, demonstrating that knockout experiments can be performed in this fungus. To do so, we improved the existing transformation method to integrate transgenes into P. roqueforti genome. In the meantime, we cloned the PrNiaD gene, which encodes a NADPH-dependent nitrate reductase that reduces nitrate to nitrite. Then, we performed a deletion of the PrNiaD gene from P. roqueforti strain AGO. The ΔPrNiaD mutant strain is more resistant to chlorate-containing medium than the wild-type strain, but did not grow on nitrate-containing medium. Because genomic data are now available, we believe that generating selective deletions of candidate genes will be a key step to open the way for a comprehensive exploration of gene function in P. roqueforti.

  7. VNR CMS Pixel detector replacement

    CERN Document Server

    2017-01-01

    Joel Butler, spokesperson of the CMS collaboration explains how a team from many different partner institutes installed a new detector in CMS. This detector is the silicon pixel detector and they’ve been working on it for about five years, to replace one of our existing detectors. This detectors measures particles closer to the beam than any of the other components of this huge detector behind me. It gives us the most precise picture of tracks as they come out of the collisions and expand and travel through the detector. This particular device has twice as many pixels, 120 million, as opposed to about 68 million in the old detector and it can take data faster and pump it out to the analysis more quickly. 00’53’’ Images of the descent, insertion and installation of first piece of the Pixel detector on Tue Feb 28. Images of the descent, insertion and installation of second piece of the Pixel and the two cylinders being joined.

  8. Orthogonal Matching Pursuit with Replacement

    CERN Document Server

    Jain, Prateek; Dhillon, Inderjit S

    2011-01-01

    In this paper, we consider the problem of compressed sensing where the goal is to recover almost all the sparse vectors using a small number of fixed linear measurements. For this problem, we propose a novel partial hard-thresholding operator that leads to a general family of iterative algorithms. While one extreme of the family yields well known hard thresholding algorithms like ITI (Iterative Thresholding with Inversion) and HTP (Hard Thresholding Pursuit), the other end of the spectrum leads to a novel algorithm that we call Orthogonal Matching Pursuit with Replacement (OMPR). OMPR, like the classic greedy algorithm OMP, adds exactly one coordinate to the support at each iteration, based on the correlation with the current residual. However, unlike OMP, OMPR also removes one coordinate from the support. This simple change allows us to prove that OMPR has the best known guarantees for sparse recovery in terms of the Restricted Isometry Property (a condition on the measurement matrix). In contrast, OMP is kn...

  9. Visual Image Sensor Organ Replacement

    Science.gov (United States)

    Maluf, David A.

    2014-01-01

    This innovation is a system that augments human vision through a technique called "Sensing Super-position" using a Visual Instrument Sensory Organ Replacement (VISOR) device. The VISOR device translates visual and other sensors (i.e., thermal) into sounds to enable very difficult sensing tasks. Three-dimensional spatial brightness and multi-spectral maps of a sensed image are processed using real-time image processing techniques (e.g. histogram normalization) and transformed into a two-dimensional map of an audio signal as a function of frequency and time. Because the human hearing system is capable of learning to process and interpret extremely complicated and rapidly changing auditory patterns, the translation of images into sounds reduces the risk of accidentally filtering out important clues. The VISOR device was developed to augment the current state-of-the-art head-mounted (helmet) display systems. It provides the ability to sense beyond the human visible light range, to increase human sensing resolution, to use wider angle visual perception, and to improve the ability to sense distances. It also allows compensation for movement by the human or changes in the scene being viewed.

  10. [Animal experiment, can we replace?

    Science.gov (United States)

    Combrisson, H

    2017-09-01

    Animal experiment is a subject of controversies. Some people, defenders of animals, think that it is not acceptable to use for scientific purposes at the risk of making them suffer or assert that the results obtained with animals are not transposable in the human beings. Others, in particular researchers in biology or medicine, think that the animal models are essential for the biomedical search. This confrontation of the opinions bases largely on an evolution of the place of animals in our society. The regulations authorize the use of animals for scientific purposes but oblige to make it under restrictive conditions. The application of 3Rs - replacement, reduction, and refinement - expressed in 1959 by Russel and Burch is an ethical guide to improve the welfare of animals in research. The alternative methods do not allow, in the present state of the knowledge, to answer all the scientific questions in biology and medicine research. They are, most of the time, complementary methods of the in vivo methods. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Techniques for managing varus and valgus malalignment during total ankle replacement.

    Science.gov (United States)

    Choi, Woo Jin; Yoon, Hang Seob; Lee, Jin Woo

    2013-01-01

    The ultimate goal of primary total ankle replacement is to provide a well-balanced soft-tissue envelope around a well-aligned, well-fixated implant. Some surgeons have emphasized that good outcomes in total ankle replacement are more dependent on ligament balancing, along with the procedure itself, than the extent of preoperative coronal deformity in the ankle. Thus, it is imperative that the surgeon be familiar with additional procedures to address the varus, valgus, and other associated deformities commonly encountered in primary total ankle replacement.

  12. Biology of tooth replacement in amniotes

    Institute of Scientific and Technical Information of China (English)

    John A Whitlock; Joy M Richman

    2013-01-01

    Tooth replacement is a common trait to most vertebrates, including mammals. Mammals, however, have lost the capacity for continuous tooth renewal seen in most other vertebrates, and typically have only 1–2 generations of teeth. Here, we review the mechanisms of tooth replacement in reptiles and mammals, and discuss in detail the current and historical theories on control of timing and pattern of tooth replacement and development.

  13. Tissue Engineering-Current Challenges and Expanding Opportunities

    Science.gov (United States)

    Griffith, Linda G.; Naughton, Gail

    2002-02-01

    Tissue engineering can be used to restore, maintain, or enhance tissues and organs. The potential impact of this field, however, is far broader-in the future, engineered tissues could reduce the need for organ replacement, and could greatly accelerate the development of new drugs that may cure patients, eliminating the need for organ transplants altogether.

  14. Surfactant replacement therapy--economic impact.

    Science.gov (United States)

    Pejaver, R K; al Hifzi, I; Aldussari, S

    2001-06-01

    Surfactant replacement is an effective treatment for neonatal respiratory distress syndrome. (RDS). As widespread use of surfactant is becoming a reality, it is important to assess the economic implications of this new form of therapy. A comparison study was carried out at the Neonatal Intensive Care Unit (NICU) of Northwest Armed Forces Hospital, Saudi Arabia. Among 75 infants who received surfactant for RDS and similar number who were managed during time period just before the surfactant was available, but by set criteria would have made them eligible for surfactant. All other management modalities except surfactant were the same for all these babies. Based on the intensity of monitoring and nursing care required by the baby, the level of care was divided as: Level IIIA, IIIB, Level II, Level I. The cost per day per bed for each level was calculated, taking into account the use of hospital immovable equipment, personal salaries of nursing, medical, ancillary staff, overheads and maintenance, depreciation and replacement costs. Medications used, procedures done, TPN, oxygen, were all added to individual patient's total expenditure. 75 infants in the Surfactant group had 62 survivors. They spent a total of 4300 days in hospital. (av 69.35) Out of which 970 d (av 15.65 per patient) were ventilated days. There were 56 survivors in the non-surfactant group of 75. They had spent a total of 5023 days in the hospital (av 89.69/patient) out of which 1490 were ventilated days (av 26.60 d). Including the cost of surfactant (two doses), cost of hospital stay for each infant taking the average figures of stay would be SR 118, 009.75 per surfactant treated baby and SR 164, 070.70 per non-surfactant treated baby. The difference of 46,061 SR is 39.03% more in non-surfactant group. One Saudi rial = 8 Rs (approx at the time study was carried out.) Medical care cost varies from place to place. However, it is definitely cost-effective where surfactant is concerned. Quality adjusted

  15. Tissue Classification

    DEFF Research Database (Denmark)

    Van Leemput, Koen; Puonti, Oula

    2015-01-01

    Computational methods for automatically segmenting magnetic resonance images of the brain have seen tremendous advances in recent years. So-called tissue classification techniques, aimed at extracting the three main brain tissue classes (white matter, gray matter, and cerebrospinal fluid), are now...... well established. In their simplest form, these methods classify voxels independently based on their intensity alone, although much more sophisticated models are typically used in practice. This article aims to give an overview of often-used computational techniques for brain tissue classification...

  16. CROSS-SECTIONAL IMAGING EVALUATION OF RENAL REPLACEMENT LIPOMATOSIS (RRL

    Directory of Open Access Journals (Sweden)

    Deb Kumar Boruah

    2016-06-01

    Full Text Available BACKGROUND Renal replacement lipomatosis is an uncommon benign entity where abundance of fibrofatty tissue proliferation occurs in renal sinus with further extension of proliferated fatty tissues into renal hilum, perinephric and periureteric spaces. It is usually associated with renal atrophy and marked renal parenchymal destruction. Aim of our study was cross-sectional imaging evaluation of Renal Replacement Lipomatosis (RRL. METHODS A hospital based cross-sectional retrospective study was conducted. The study group comprised of 16 patients presenting to the Departments of Radio-diagnosis, Surgery and Urology in a tertiary care hospital from May 2014 to April 2016. All patients were initially evaluated clinically and ultrasonographically followed by cross-sectional imaging modality like Computed Tomography (CT, Magnetic Resonance Imaging (MRI or both. RESULTS Out of 16 patients of renal replacement lipomatosis, 15 patients (93.8% had associated renal pelvic or ureteric calculus while 1 patient (6.2% had left para-aortic mass without associated calculus. Out of fifteen patients of calculus related RRL, 8 patients (53.3% had calculus size more than 40 mm, followed by 4 patients (26.7% who had size from 20 to 40 mm and 3 patients (20% had size less than 20 mm. The mean CT HU value of calculus was 1334±84.5 in our study. Three patients (18.8% had only renal hilar fatty excessive deposition, 1 patient (6.2% had renal hilar and perinephric space fat depositions, 3 patients (18.8% had renal hilar, perinephric and periureteric spaces depositions and 9 patients (56.2% had renal hilar and periureteric excessive fatty depositions. Delayed renal functioning was noted in 9 patients (56%, followed by non-functioning in 5 patients (31.2% and 2 patients (12.5% had normally functioning kidneys. CONCLUSION Cross-sectional imaging like CT and MRI scan helps in diagnosing RRL and proper delineation of extensions of excessive fatty tissue proliferation.

  17. SU-C-BRC-01: A Monte Carlo Study of Out-Of-Field Doses From Cobalt-60 Teletherapy Units Intended for Historical Correlations of Dose to Normal Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Petroccia, H [University of Florida, Gainesville, FL (United States); Olguin, E [Gainesville, FL (United States); Culberson, W [University of Wisconsin Madison, Madison, WI (United States); Bednarz, B [University of Wisconsin, Madison, WI (United States); Mendenhall, N [UF Health Proton Therapy Institute, Jacksonville, FL (United States); Bolch, W [University Florida, Gainesville, FL (United States)

    2016-06-15

    Purpose: Innovations in radiotherapy treatments, such as dynamic IMRT, VMAT, and SBRT/SRS, result in larger proportions of low-dose regions where normal tissues are exposed to low doses levels. Low doses of radiation have been linked to secondary cancers and cardiac toxicities. The AAPM TG Committee No.158 entitled, ‘Measurements and Calculations of Doses outside the Treatment Volume from External-Beam Radiation Therapy’, has been formed to review the dosimetry of non-target and out-of-field exposures using experimental and computational approaches. Studies on historical patients can provide comprehensive information about secondary effects from out-of-field doses when combined with long-term patient follow-up, thus providing significant insight into projecting future outcomes of patients undergoing modern-day treatments. Methods: We present a Monte Carlo model of a Theratron-1000 cobalt-60 teletherapy unit, which historically treated patients at the University of Florida, as a means of determining doses located outside the primary beam. Experimental data for a similar Theratron-1000 was obtained at the University of Wisconsin’s ADCL to benchmark the model for out-of-field dosimetry. An Exradin A12 ion chamber and TLD100 chips were used to measure doses in an extended water phantom to 60 cm outside the primary field at 5 and 10 cm depths. Results: Comparison between simulated and experimental measurements of PDDs and lateral profiles show good agreement for in-field and out-of-field doses. At 10 cm away from the edge of a 6×6, 10×10, and 20×20 cm2 field, relative out-of-field doses were measured in the range of 0.5% to 3% of the dose measured at 5 cm depth along the CAX. Conclusion: Out-of-field doses can be as high as 90 to 180 cGy assuming historical prescription doses of 30 to 60 Gy and should be considered when correlating late effects with normal tissue dose.

  18. Aortic valve replacement in octogenarians

    Directory of Open Access Journals (Sweden)

    Dark John H

    2007-07-01

    Full Text Available Abstract Background and Aims As our population ages and life expectancy increases the number of people aged over 80 and more referred for cardiac surgery is growing. This study sought to identify the outcome of aortic valve replacement (AVR in octogenarians. Methods 68 patients aged 80 years or more underwent AVR at the Freeman Hospital, between April 2001 and April 2004. A retrospective review of the notes and outcomes from the patients' GP and the NHS strategic tracking service was performed. 54% (37 underwent isolated AVR whilst 46% (31 underwent combined AVR and CABG. Results Follow up was 100% complete. The mean age was 83.1 ± s.d. 2.9 years, a mean gradient of 83 ± s.d. 31 mmHg and mean AVA of 0.56 cm2. The mean additive EuroSCORE was 8.6 ± s.d. 1.2, the logistic EuroSCORE mean 12.0 ± s.d. 5.9. In hospital 30 day mortality was 13 %. Survival was 80% at 1 year and 78% at 2 years. Median follow up was for 712 days. Stepwise logistic regression identified chronic obstructive airways disease as an independent predictor of mortality (p Conclusion Our study demonstrates that the operative mortality for AVR in the over eighties is good, whilst the mid to long term outcome is excellent There is a very low attrition rate with those undergoing the procedure living as long than their age matched population. This study confirms AVR is a safe, acceptable treatment for octogenarians with excellent mid term outcomes.

  19. Menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2001-12-01

    Full Text Available The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many  menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an  important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT. Natural HRT is usually prefened. Synthetic  estrogen in oral contraceptives (oc are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death. (Med J Indones 2001;10: 242-51Keywords: estrogen deficiency, climacteric phases, tibolone.

  20. Total joint replacement preadmission programs.

    Science.gov (United States)

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems.

  1. Biomechanics and mechanobiology in functional tissue engineering

    Science.gov (United States)

    Guilak, Farshid; Butler, David L.; Goldstein, Steven A.; Baaijens, Frank P.T.

    2014-01-01

    The field of tissue engineering continues to expand and mature, and several products are now in clinical use, with numerous other preclinical and clinical studies underway. However, specific challenges still remain in the repair or regeneration of tissues that serve a predominantly biomechanical function. Furthermore, it is now clear that mechanobiological interactions between cells and scaffolds can critically influence cell behavior, even in tissues and organs that do not serve an overt biomechanical role. Over the past decade, the field of “functional tissue engineering” has grown as a subfield of tissue engineering to address the challenges and questions on the role of biomechanics and mechanobiology in tissue engineering. Originally posed as a set of principles and guidelines for engineering of load-bearing tissues, functional tissue engineering has grown to encompass several related areas that have proven to have important implications for tissue repair and regeneration. These topics include measurement and modeling of the in vivo biomechanical environment; quantitative analysis of the mechanical properties of native tissues, scaffolds, and repair tissues; development of rationale criteria for the design and assessment of engineered tissues; investigation of the effects biomechanical factors on native and repair tissues, in vivo and in vitro; and development and application of computational models of tissue growth and remodeling. Here we further expand this paradigm and provide examples of the numerous advances in the field over the past decade. Consideration of these principles in the design process will hopefully improve the safety, efficacy, and overall success of engineered tissue replacements. PMID:24818797

  2. Pulp and periodontal tissue repair - regeneration or tissue metaplasia after dental trauma. A review.

    Science.gov (United States)

    Andreasen, Jens O

    2012-02-01

    Healing subsequent to dental trauma is known to be very complex, a result explained by the variability of the types of dental trauma (six luxations, nine fracture types, and their combinations). On top of that, at least 16 different cellular systems get involved in more severe trauma types each of them with a different potential for healing with repair, i.e. (re-establishment of tissue continuity without functional restitution) and regeneration (where the injured or lost tissue is replaced with new tissue with identical tissue anatomy and function) and finally metaplasia (where a new type of tissue replaces the injured). In this study, a review is given of the impact of trauma to various dental tissues such as alveolar bone, periodontal ligament, cementum, Hertvigs epithelial root sheath, and the pulp.

  3. Pulp and periodontal tissue repair - regeneration or tissue metaplasia after dental trauma. A review

    DEFF Research Database (Denmark)

    Andreasen, Jens O

    2012-01-01

    Healing subsequent to dental trauma is known to be very complex, a result explained by the variability of the types of dental trauma (six luxations, nine fracture types, and their combinations). On top of that, at least 16 different cellular systems get involved in more severe trauma types each o...... of tissue replaces the injured). In this study, a review is given of the impact of trauma to various dental tissues such as alveolar bone, periodontal ligament, cementum, Hertvigs epithelial root sheath, and the pulp....... of them with a different potential for healing with repair, i.e. (re-establishment of tissue continuity without functional restitution) and regeneration (where the injured or lost tissue is replaced with new tissue with identical tissue anatomy and function) and finally metaplasia (where a new type...

  4. APPLICATION OF A BIODEGRADABLE MATERIAL FOR BONE REPLACEMENT IN TRAUMATOLOGY

    Directory of Open Access Journals (Sweden)

    T. V. Druzhinina

    2014-01-01

    Full Text Available 20 men (medium age (31.5 ± 13.5 years were studied. All patients underwent arthroscopic auditing plastic anterior cruciate ligament of the knee. Osteoregeneration dynamics were determined by biochemical testing of blood serum and X-ray computed tomography (CT of the fracture in 1–4 months after surgery. As a result, an estimation of the bone tissue reparative regeneration according to CT data in 10 patients with a defect of the patella, treated with the material is provided. The obtained results of the clinical study indicate the reparative effect of the biodegradable material for bone replacing on bone regeneration

  5. Stem cell-derived hepatocytes for functional liver replacement

    Directory of Open Access Journals (Sweden)

    Bruno eChrist

    2012-06-01

    Full Text Available Mesenchymal stem cells (MSC represent an alternate cell source to substitute for primary hepatocytes in hepatocyte transplantation because of their multiple differentiation potential and nearly unlimited availability. They may differentiate into hepatocyte-like cells in vitro and maintain specific hepatocyte functions also after transplantation into the regenerating livers of mice or rats both under injury and non-injury conditions. Depending on the underlying liver disease their mode of action is either to replace the diseased liver tissue or to support liver regeneration through their anti-inflammatory and anti-apoptotic as well as their pro-proliferative action.

  6. Surgical replacement of iatrogenically prolapsed penis in a dromedary camel

    Directory of Open Access Journals (Sweden)

    S.A.T. Al-Qubati

    2012-11-01

    Full Text Available Prolapse of the penis through an iatrogenic incision on the right side of the preputial base in a five year old dromedary camel was handled surgically and the organ was successfully replaced into the preputial cavity. The condition occurred as a result of draining an abscess at the base of the prepuce by a quack about eight months earlier. The reason to report this case lies in its peculiarity that although the penis remained outside the preputial cavity for about eight months exposed to the external environment, yet no complications pertaining to its fragile tissue and urination occurred during this long period as seen in cases of paraphimosis.

  7. Temporomandibular joint reconstruction with total alloplastic joint replacement.

    Science.gov (United States)

    Jones, R H B

    2011-03-01

    This paper is a preliminary paper which presents the early findings of an ongoing prospective trial on the use of the TMJ Concepts and Biomet Lorenz total joint replacement systems for the reconstruction of the temporomandibular joint (TMJ). Total alloplastic replacement of the TMJ has become a viable option for many people who suffer from TMJ disease where surgical reconstruction is indicated. Degenerative joint diseases such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, TMJ ankylosis, malunited condylar fractures and tumours can be successfully treated using this technique. There are a number of TMJ prostheses available. Two of the joint replacement products, which have been found to be most reliable and have FDA approval in the United States, are the TMJ Concepts system and the Biomet Lorenz system, and for this reason they are being investigated in this study. This study presents the findings of seven patients with a total of 12 joint replacements using either the TMJ Concepts system or the Biomet Lorenz joint system. Two patients (3 joints) had the TMJ Concepts system and five patients (9 joints) had the Biomet Lorenz system. Although still early, the results were generally pleasing, with the longest replacement having been in position for three years and the most recent six months. The average postoperative mouth opening was 29.7 mm (range 25-35 mm) with an average pain score of 1.7 (range 0-3, minimum score of 0 and maximum 10). Complications were minimal and related to sensory disturbance to the lip in one patient and joint dislocation in two patients.

  8. [Extracorporeal renal replacement therapies in acute renal failure].

    Science.gov (United States)

    Schaefer, R M; Barenbrock, M; Teschner, M; Bahner, U

    2000-05-15

    The most serious forms of acute renal failure (ARF) are nowadays encountered in the intensive care unit (ICU), where up to 25% of new patients are reported to develop ARF. Lethality rates may reach 50 to 90% when the ARF is part of a multiple organ dysfunction syndrome. A multitude of extracorporeal procedures have been introduced into intensive care medicine. Applied with adequate skills and experience, most of these techniques will suffice to replace excretory renal function. However, because of low efficacy arterio-venous procedures (CAVH and CAVHD) have been abandoned for the veno-venous, pump-driven techniques (CVVH and CVVHD). Up to now, there is no consensus whether continuous or intermittent renal replacement therapy is more advantageous. In many cases, oliguric patients with circulatory instability will be treated by CVVH, even though there is no prospective study to show that in terms of outcome continuous treatment is superior to intermittent hemodialysis. It is equally conceivable to treat such patients with daily, prolonged (intermittent) hemodialysis. Apparently, the dose of replacement therapy, be it continuous filtration (36 to 48 l/24 h) or intermittent hemodialysis (daily 3 to 4 h) with a target BUN of less than 50 mg/dl, is more important than the modality of treatment. Moreover, there is good evidence that the use of biocompatible membranes (no complement- or leukocyte activation) is preferable and that with high-volume hemofiltration bicarbonate-containing replacement fluids should be used. However, despite all the technical advances, we firmly believe that the skills and the experience of those physicians and nurses who actually perform renal replacement therapy in the ICU are more important than the modality of treatment applied.

  9. Treatment of delayed rupture of the left ventricle after mitral valve replacement

    Directory of Open Access Journals (Sweden)

    Gomes Walter J.

    2002-01-01

    Full Text Available Rupture of the left ventricle following mitral valve replacement is a catastrophic complication with deadly consequences. We report here the case of a 75-year-old man who underwent elective mitral valve replacement for severe mitral regurgitation. Delayed type 1 rupture of the left ventricle developed 3 hours postoperatively in the intensive care unit. A salvaging maneuver was used, which gained time, allowing reoperation and successful intraventricular repair.

  10. Transcatheter Aortic Valve Replacement in Europe

    DEFF Research Database (Denmark)

    Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan;

    2013-01-01

    The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

  11. Chitin Scaffolds in Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Tetsuya Furuike

    2011-03-01

    Full Text Available Tissue engineering/regeneration is based on the hypothesis that healthy stem/progenitor cells either recruited or delivered to an injured site, can eventually regenerate lost or damaged tissue. Most of the researchers working in tissue engineering and regenerative technology attempt to create tissue replacements by culturing cells onto synthetic porous three-dimensional polymeric scaffolds, which is currently regarded as an ideal approach to enhance functional tissue regeneration by creating and maintaining channels that facilitate progenitor cell migration, proliferation and differentiation. The requirements that must be satisfied by such scaffolds include providing a space with the proper size, shape and porosity for tissue development and permitting cells from the surrounding tissue to migrate into the matrix. Recently, chitin scaffolds have been widely used in tissue engineering due to their non-toxic, biodegradable and biocompatible nature. The advantage of chitin as a tissue engineering biomaterial lies in that it can be easily processed into gel and scaffold forms for a variety of biomedical applications. Moreover, chitin has been shown to enhance some biological activities such as immunological, antibacterial, drug delivery and have been shown to promote better healing at a faster rate and exhibit greater compatibility with humans. This review provides an overview of the current status of tissue engineering/regenerative medicine research using chitin scaffolds for bone, cartilage and wound healing applications. We also outline the key challenges in this field and the most likely directions for future development and we hope that this review will be helpful to the researchers working in the field of tissue engineering and regenerative medicine.

  12. Replacing lactose from calf milk replacers : effects on digestion and post-absorptive metabolism

    NARCIS (Netherlands)

    Gilbert, M.S.

    2015-01-01

    Summary PhD thesis Myrthe S. Gilbert Replacing lactose from calf milk replacers – Effects on digestion and post-absorptive metabolism Veal calves are fed milk replacer (MR) and solid feed. The largest part of the energy provided to veal calves originates from

  13. Aortic valve replacement with the Nicks annulus enlargement procedure 12 years after mitral valve replacement.

    Science.gov (United States)

    Kazama, S; Kurata, A; Yamashita, Y

    1999-10-01

    An aortic valve replacement was successfully performed employing the Nicks annulus enlargement procedure in a case of aortic valve stenosis with small annulus 12 years after mitral valve replacement. Previous mitral valve replacement does not preclude feasibility of the Nicks procedure.

  14. Long-term cryopreservation of decellularised oesophagi for tissue engineering clinical application

    NARCIS (Netherlands)

    Urbani, L. (Luca); Maghsoudlou, P. (Panagiotis); Milan, A. (Anna); Menikou, M. (Maria); Hagen, C.K. (Charlotte Klara); Totonelli, G. (Giorgia); Camilli, C. (Carlotta); S. Eaton (Simon); A.J. Burns (Alan); Olivo, A. (Alessandro); P. de Coppi (Paolo)

    2017-01-01

    textabstractOesophageal tissue engineering is a therapeutic alternative when oesophageal replacement is required. Decellularised scaffolds are ideal as they are derived from tissue-specific extracellular matrix and are non-immunogenic. However, appropriate preservation may significantly affect

  15. Hydrogels as a Replacement Material for Damaged Articular Hyaline Cartilage

    Directory of Open Access Journals (Sweden)

    Charlotte M. Beddoes

    2016-06-01

    Full Text Available Hyaline cartilage is a strong durable material that lubricates joint movement. Due to its avascular structure, cartilage has a poor self-healing ability, thus, a challenge in joint recovery. When severely damaged, cartilage may need to be replaced. However, currently we are unable to replicate the hyaline cartilage, and as such, alternative materials with considerably different properties are used. This results in undesirable side effects, including inadequate lubrication, wear debris, wear of the opposing articular cartilage, and weakening of the surrounding tissue. With the number of surgeries for cartilage repair increasing, a need for materials that can better mimic cartilage, and support the surrounding material in its typical function, is becoming evident. Here, we present a brief overview of the structure and properties of the hyaline cartilage and the current methods for cartilage repair. We then highlight some of the alternative materials under development as potential methods of repair; this is followed by an overview of the development of tough hydrogels. In particular, double network (DN hydrogels are a promising replacement material, with continually improving physical properties. These hydrogels are coming closer to replicating the strength and toughness of the hyaline cartilage, while offering excellent lubrication. We conclude by highlighting several different methods of integrating replacement materials with the native joint to ensure stability and optimal behaviour.

  16. Mathematical aspects of molecular replacement. II. Geometry of motion spaces.

    Science.gov (United States)

    Chirikjian, Gregory S; Yan, Yan

    2012-03-01

    Molecular replacement (MR) is a well established computational method for phasing in macromolecular crystallography. In MR searches, spaces of motions are explored for determining the appropriate placement of rigid models of macromolecules in crystallographic asymmetric units. In the first paper of this series, it was shown that this space of motions, when endowed with an appropriate composition operator, forms an algebraic structure called a quasigroup. In this second paper, the geometric properties of these MR search spaces are explored and analyzed. This analysis includes the local differential geometry, global geometry and symmetry properties of these spaces.

  17. Tissue Classification

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, David Gerald [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-01-01

    The project began as a e ort to support InLight and Lumidigm. With the sale of the companies to a non-New Mexico entity, the project then focused on supporting a new company Medici Technologies. The Small Business (SB) is attempting to quantify glucose in tissue using a series of short interferometer scans of the nger. Each scan is produced from a novel presentation of the nger to the device. The intent of the project is to identify and, if possible, implement improved methods for classi cation, feature selection, and training to improve the performance of predictive algorithms used for tissue classi cation.

  18. Developmental biology and tissue engineering.

    Science.gov (United States)

    Marga, Francoise; Neagu, Adrian; Kosztin, Ioan; Forgacs, Gabor

    2007-12-01

    Morphogenesis implies the controlled spatial organization of cells that gives rise to tissues and organs in early embryonic development. While morphogenesis is under strict genetic control, the formation of specialized biological structures of specific shape hinges on physical processes. Tissue engineering (TE) aims at reproducing morphogenesis in the laboratory, i.e., in vitro, to fabricate replacement organs for regenerative medicine. The classical approach to generate tissues/organs is by seeding and expanding cells in appropriately shaped biocompatible scaffolds, in the hope that the maturation process will result in the desired structure. To accomplish this goal more naturally and efficiently, we set up and implemented a novel TE method that is based on principles of developmental biology and employs bioprinting, the automated delivery of cellular composites into a three-dimensional (3D) biocompatible environment. The novel technology relies on the concept of tissue liquidity according to which multicellular aggregates composed of adhesive and motile cells behave in analogy with liquids: in particular, they fuse. We emphasize the major role played by tissue fusion in the embryo and explain how the parameters (surface tension, viscosity) that govern tissue fusion can be used both experimentally and theoretically to control and simulate the self-assembly of cellular spheroids into 3D living structures. The experimentally observed postprinting shape evolution of tube- and sheet-like constructs is presented. Computer simulations, based on a liquid model, support the idea that tissue liquidity may provide a mechanism for in vitro organ building.

  19. Post-Remediation Biomonitoring of Pesticides in Marine Waters Near the United Heckathorn Superfund Site, Richmond, California

    Energy Technology Data Exchange (ETDEWEB)

    LD Antrim; NP Kohn

    2000-09-05

    This report, PNNL-11911 Rev. 1, was published in July 2000 and replaces PNNL-11911, which was published in September 1998. The revision corrects tissue concentration units that were reported as dry weight but were actually wet weight, and updates conclusions based on the correct reporting units. Marine sediment remediation at the United Heckathorn Superfund Site was completed in April 1997. Water and mussel tissues were sampled in January 1998 from four stations near Lauritzen Canal in Richmond, California, for the first post-remediation monitoring of marine areas near the United Heckathorn Site. Dieldrin and DDT were analyzed in water samples, tissue samples from resident mussels, and tissue samples from transplanted mussels deployed for 4 months. Concentrations of dieldrin and total DDT in water and total DDT in tissue were compared to pre-remediation data available from the California State Mussel Watch program (tissues) and the Ecological Risk Assessment for the United Heckathorn Superfund Site (tissues and water). Chlorinated pesticide concentrations in water samples were similar to pre-remediation levels and did not meet remediation goals. Mean dieldrin concentrations in water ranged from 0.65 ng/L to 18.1 ng/L and were higher than the remediation goal (0.14 ng/L) at all stations. Mean total DDT concentrations in water ranged from 0.65 ng/L to 103 ng/L and exceeded the remediation goal of 0.59 ng/L. The highest concentrations of both pesticides were found in Lauritzen Canal, and the lowest levels were from the Richmond Inner Harbor Channel water. Unusual amounts of detritus in the water column at the time of sampling, particularly in Lauritzen Canal, could have contributed to the elevated pesticide concentrations and poor analytical precision.

  20. Cardiovascular Tissue Engineering Research Support at the National Heart, Lung, and Blood Institute

    OpenAIRE

    Lundberg, Martha Shauck

    2013-01-01

    Tissue engineering aims at building three-dimensional living substitutes that are equal to or better than the damaged tissue to be replaced. The development of such a tissue replacement requires a multidisciplinary approach and careful attention to the optimal cell source, the interactions of growth factors and extracellular milieu, and the scaffolding design. This article is a review of the National Heart, Lung, and Blood Institute's (NHLBI) tissue engineering programs, which support researc...

  1. [Arthrodesis versus total joint replacement of the ankle].

    Science.gov (United States)

    Mittlmeier, T

    2013-06-01

    In general, for the treatment of end-stage osteoarthritis of the ankle joint arthrodesis is considered to be the gold standard based on its versatility and eligibility for numerous indications. Nowadays, total ankle arthroplasty represents a viable alternative to ankle arthrodesis taking into account distinct premises as both procedures provide a calculable reduction of the preoperative pain level and a comparable functional gain. Furthermore, current 10-year-survival rates of total ankle replacement are reported to range between 76 % and 89 %. Revision rates of up to 10 % for both techniques have been reported with manifest differences within the respective spectrum of complications. Due to the fact that more than two thirds of patients suffer from post-traumatic osteoarthritis with a relatively low average of age concomitant malalignment, soft tissue damage or instability may frequently occur. A restoration of anatomic axes and an adequate centering of the talus under the tibia appear to be crucial for the outcome as well as an adequate soft tissue balancing, in particular in total ankle replacement. Thus, the selection of the correct indication and the right choice of treatment on the basis of complete preoperative diagnostics considering necessary additive surgical measures are of paramount importance for the final outcome.

  2. Conceptual Design Plan SM-43 Replacement Project

    Energy Technology Data Exchange (ETDEWEB)

    University of California, Los Alamos National Laboratory, SCC Project Office

    2000-11-01

    The Los Alamos National Laboratory Conceptual Design Plan for the SM-43 Replacement Project outlines plans for replacing the SM-43 Administration Building. Topics include the reasons that replacement is considered a necessity; the roles of the various project sponsors; and descriptions of the proposed site and facilities. Also covered in this proposal is preliminary information on the project schedule, cost estimates, acquisition strategy, risk assessment, NEPA strategy, safety strategy, and safeguards and security. Spreadsheets provide further detail on space requirements, project schedules, and cost estimates.

  3. Enzyme replacement therapy in a mouse model of aspartylglycosaminuria.

    Science.gov (United States)

    Dunder, U; Kaartinen, V; Valtonen, P; Väänänen, E; Kosma, V M; Heisterkamp, N; Groffen, J; Mononen, I

    2000-02-01

    Aspartylglycosaminuria (AGU), the most common lysosomal disorder of glycoprotein degradation, is caused by deficient activity of glycosylasparaginase (AGA). AGA-deficient mice share most of the clinical, biochemical and histopathologic characteristics of human AGU disease. In the current study, recombinant human AGA administered i.v. to adult AGU mice disappeared from the systemic circulation of the animals in two phases predominantly into non-neuronal tissues, which were rapidly cleared from storage compound aspartylglucosamine. Even a single AGA injection reduced the amount of aspartylglucosamine in the liver and spleen of AGU mice by 90% and 80%, respectively. Quantitative biochemical analyses along with histological and immunohistochemical studies demonstrated that the pathophysiologic characteristics of AGU were effectively corrected in non-neuronal tissues of AGU mice during 2 wk of AGA therapy. At the same time, AGA activity increased to 10% of that in normal brain tissue and the accumulation of aspartylglucosamine was reduced by 20% in total brain of the treated animals. Immunohistochemical studies suggested that the corrective enzyme was widely distributed within the brain tissue. These findings suggest that AGU may be correctable by enzyme therapy.-Dunder, U., Kaartinen, V., Valtonen, P., Väänänen, E., Kosma, V.-M., Heisterkamp, N., Groffen, J., Mononen, I. Enzyme replacement therapy in a mouse model of aspartylglycosaminuria.

  4. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management.

  5. Renal Replacement Therapy [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Zaccaria Ricci

    2016-01-01

    Full Text Available During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients’ clinical picture (e.g. sepsis, fluid overload, pediatric. The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the “Tower of Babel” of critical care nephrology.

  6. Construction of Tissue Engineering Artificial Cornea with Skin Stem Cells

    Institute of Scientific and Technical Information of China (English)

    Yuan LIU; Yan JIN

    2005-01-01

    @@ 1 Introduction The clinical need for an alternative to donor corneal tissue has encouraged much interests in recent years. An artificial cornea must fulfill the functions of the cornea it replaces. More recently, the idea of a bio-engineered cornea has risen. Corneal equivalents have been reconstructed by tissue engineering method. Aim of this study is to construct an artificial rabbit cornea by employing tissue engineering method and to determine if skin stem cells have a role in tissue engineered cornea construction.

  7. Enzyme replacement therapy in newborn mucopolysaccharidosis IVA mice: early treatment rescues bone lesions?

    Science.gov (United States)

    Tomatsu, Shunji; Montaño, Adriana M; Oikawa, Hirotaka; Dung, Vu Chi; Hashimoto, Amiko; Oguma, Toshihiro; Gutiérrez, Monica L; Takahashi, Tatsuo; Shimada, Tsutomu; Orii, Tadao; Sly, William S

    2015-02-01

    We treated mucopolysaccharidosis IVA (MPS IVA) mice to assess the effects of long-term enzyme replacement therapy (ERT) initiated at birth, since adult mice treated by ERT showed little improvement in bone pathology [1]. To conduct ERT in newborn mice, we used recombinant human N-acetylgalactosamine-6-sulfate sulfatase (GALNS) produced in a CHO cell line. First, to observe the tissue distribution pattern, a dose of 250units/g body weight was administered intravenously in MPS IVA mice at day 2 or 3. The infused enzyme was primarily recovered in the liver and spleen, with detectable activity in the bone and brain. Second, newborn ERT was conducted after a tissue distribution study. The first injection of newborn ERT was performed intravenously, the second to fourth weekly injections were intraperitoneal, and the remaining injections from 5th to 14th weeks were intravenous into the tail vein. MPS IVA mice treated with GALNS showed clearance of lysosomal storage in the liver and spleen, and sinus lining cells in bone marrow. The column structure of the growth plate was organized better than that in adult mice treated with ERT; however, hyaline and fibrous cartilage cells in the femur, spine, ligaments, discs, synovium, and periosteum still had storage materials to some extent. Heart valves were refractory to the treatment. Levels of serum keratan sulfate were kept normal in newborn ERT mice. In conclusion, the enzyme, which enters the cartilage before the cartilage cell layer becomes mature, prevents disorganization of column structure. Early treatment from birth leads to partial remission of bone pathology in MPS IVA mice. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Trials and Tribulations with VH Replacement

    Directory of Open Access Journals (Sweden)

    Wenzhao eMeng

    2014-01-01

    Full Text Available VH replacement is a type of antibody gene rearrangement in which an upstream heavy chain variable gene segment (VH invades a pre-existing rearrangement (VDJ. In this Hypothesis and Theory article, we begin by reviewing the mechanism of VH replacement, its developmental timing and its potential biological consequences. Then we explore the hypothesis that specific sequence motifs called footprints reflect VH replacement vs. other processes. We provide a compilation of footprint sequences from different regions of the antibody heavy chain, include data from the literature and from a high throughput sequencing experiment to evaluate the significance of footprint sequences. We conclude by discussing the difficulties of attributing footprints to VH replacement.

  9. Gyrator-type circuits replace ungrounded inductors

    Science.gov (United States)

    Deboo, G. J.

    1968-01-01

    Gyrator circuits using only transistors, capacitors, and resistors which can replace both grounded and ungrounded inductors have been developed to permit complete microminiaturization of circuitry by integration of the components.

  10. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  11. Minimally Invasive Transcatheter Aortic Valve Replacement (TAVR)

    Medline Plus

    Full Text Available Watch a Broward Health surgeon perform a minimally invasive Transcatheter Aortic Valve Replacement (TAVR) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. ...

  12. Total ankle replacement - surgical treatment and rehabilitation.

    Science.gov (United States)

    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  13. 47 CFR 13.17 - Replacement license.

    Science.gov (United States)

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS General § 13.17 Replacement... Operator License, Marine Radio Operator Permit, First Class Radiotelegraph Operator's Certificate, Second... Radio Operator's License, Restricted GMDSS Radio Operator License, GMDSS Radio Maintainer's License,...

  14. Renal replacement therapy for acute renal failure.

    Science.gov (United States)

    Macedo, E; Bouchard, J; Mehta, R L

    2009-09-01

    Renal replacement therapy became a common clinical tool to treat patients with severe acute kidney injury (AKI) since the 1960s. During this time dialytic options have expanded considerably; biocompatible membranes, bicarbonate dialysate and dialysis machines with volumetric ultrafiltration control have improved the treatment for acute kidney injury. Along with advances in methods of intermittent hemodialysis, continuous renal replacement therapies have gained widespread acceptance in the treatment of dialysis-requiring AKI. However, many of the fundamental aspects of the renal replacement treatment such as indication, timing of dialytic intervention, and choice of dialysis modality are still controversial and may influence AKI patient's outcomes. This review outlines current concepts in the use of dialysis techniques for AKI and suggests an approach for selecting the optimal method of renal replacement therapy.

  15. Minimally Invasive Transcatheter Aortic Valve Replacement (TAVR)

    Medline Plus

    Full Text Available Watch a Broward Health surgeon perform a minimally invasive Transcatheter Aortic Valve Replacement (TAVR) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. ...

  16. SYNERGISTIC WOOD PRESERVATIVES FOR REPLACEMENT OF CCA

    Science.gov (United States)

    The objective of this project was to evaluate the potential synergistic combinations of environmentally-safe biocides as wood preservatives. These wood preservatives could be potential replacements for the heavy-metal based CCA.Didecyldimethylammonium chloride [DDAC] was...

  17. Bone Marrow Transplantation (BMT) and Gene Replacement ...

    African Journals Online (AJOL)

    Bone Marrow Transplantation (BMT) and Gene Replacement Therapy (GRT) In Sickle Cell Anemia. ... manifesting clinical disease, while the heterozygoste(AS) are clinically ... medicine, we argue here the case for Bone marrow transplantation

  18. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj;

    2013-01-01

    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  19. [Replacement of tracheo-esophageal Provox prosthesis].

    Science.gov (United States)

    Biacabe, B; Laccourreye, O; Ménard, M; Hans, S; Brasnu, D

    2000-02-01

    To compare anesthesic techniques used between 1992 and 1997 at Laënnec Hospital for replacement by tracheo-esophageal Provox prosthesis: local and general anesthesia. Theoretical financial cost for replacement was estimated according to anaesthetic techniques. Provox in situ lifetime was calculated in 58 patients who underwent 115 and 49 replacements under general and local anaesthesia respectively. Age, sex, surgical and radiotherapy backgrounds, complications and anaesthetic techniques were studied as potential factors correlated with Provox in situ lifetime. Theoretical financial cost for replacement was estimated according to anaesthetic techniques. In 1992, 12% of Provox prosthesis were inserted under local anaesthesia and 54% in 1997. Provox in situ lifetime was either not influenced by anaesthetic techniques or other factors under analysis. The theoretical financial cost was estimated at 14, 341 FFrs and 6,048 FFrs for replacement under general and local anaesthesia respectively. Due to increased control of health care costs, we advocated local anaesthesia for Provox prosthesis replacement if control endoscopy is not required.

  20. Strategic vehicle fleet management - the replacement problem

    Directory of Open Access Journals (Sweden)

    Adam Redmer

    2016-03-01

    Full Text Available Background: Fleets constitute the most important production means in transportation. Their appropriate management is crucial for all companies having transportation duties. The paper is the third one of a series of three papers that the author dedicates to the strategic vehicle fleet management topic. Material and methods: The paper discusses ways of building replacement strategies for companies' fleets of vehicles. It means deciding for how long to exploit particular vehicles in a fleet (the fleet replacement problem - FR. The essence of this problem lies in the minimization of vehicle / fleet exploitation costs by balancing ownership and utilization costs and taking into account budget limitations. In the paper an original mathematical model (an optimization method allowing for the FR analysis is proposed. Results: An application of the proposed optimization method in a real-life decision situation (the case study within the Polish environment and the obtained solution are presented. The solution shows that there exist optimal exploitation periods of particular vehicles in a fleet. However, combination of them gives a replacement plan for an entire fleet violating budget constraints. But it is possible to adjust individual age to replacement of particular vehicles to fulfill budget constraints without losing economical optimality of a developed replacement plan for an entire fleet. Conclusions: The paper is the last one of a series of three papers that the author dedicated to the strategic vehicle fleet management topic including the following managerial decision problems: MAKE-or-BUY, sizing / composition and replacement.

  1. Cardiac crossroads: deciding between mechanical or bioprosthetic heart valve replacement

    Directory of Open Access Journals (Sweden)

    Maggie N Tillquist

    2011-02-01

    Full Text Available Maggie N Tillquist1, Thomas M Maddox21School of Medicine, University of Colorado Denver, Denver, CO, USA; 2VA Eastern Colorado Health Care System, and Department of Medicine (Cardiology, University of Colorado Denver, Denver, CO, USAAbstract: Nearly 15 million people in the United States suffer from either aortic or mitral valvular disease. For patients with severe and symptomatic valvular heart disease, valve replacement surgery improves morbidity and mortality outcomes. In 2009, 90,000 valve replacement surgeries were performed in the United States. This review evaluates the advantages and disadvantages of mechanical and bioprosthetic prosthetic heart valves as well as the factors for consideration in deciding the appropriate valve type for an individual patient. Although many caveats exist, the general recommendation is for patients younger than 60 to 65 years to receive mechanical valves due to the valve's longer durability and for patients older than 60 to 65 years to receive a bioprosthetic valve to avoid complications with anticoagulants. Situations that warrant special consideration include patient co-morbidities, the need for anticoagulation, and the potential for pregnancy. Once these characteristics have been considered, patients' values, anxieties, and expectations for their lifestyle and quality of life should be incorporated into final valve selection. Decision aids can be useful in integrating preferences in the valve decision. Finally, future directions in valve technology, anticoagulation, and medical decision-making are discussed.Keywords: prosthetic heart valves, patient preference, valve type, anticoagulant, structural valve deterioration 

  2. Post-Remediation Biomonitoring of Pesticides and Other Contaminants in Marine Waters and Sediment Near the United Heckathorn Superfund Site, Richmond, California

    Energy Technology Data Exchange (ETDEWEB)

    LD Antrim; NP Kohn

    2000-09-06

    This report, PNNL-1 3059 Rev. 1, was published in July 2000 and replaces PNNL-1 3059 which is dated October 1999. The revision corrects tissue concentration units that were reported as dry weight but were actually wet weight, and updates conclusions based on the correct reporting units. Marine sediment remediation at the United Heckathorn Superfund Site was completed in April 1997. Water and mussel tissues were sampled in February 1999 from four stations near Lauritzen Canal in Richmond, California, for Year 2 of post-remediation monitoring of marine areas near the United Heckathom Site. Dieldrin and dichlorodiphenyl trichloroethane (DDT) were analyzed in water samples, tissue samples from resident mussels, and tissue samples from transplanted mussels deployed for 4 months. Concentrations of dieldrin and total DDT in water and total DDT in tissue were compared with Year 1 of post-remediation monitoring, and with preremediation data from the California State Mussel Watch program (tissue s) and the Ecological Risk Assessment for the United Heckathorn Superfund Site (tissues and water). Mussel tissues were also analyzed for polychlorinated biphenyls (PCB), which were detected in sediment samples. Chlorinated pesticide concentrations in water samples were similar to preremediation levels and did not meet remediation goals. Mean dieldrin concentrations in water ranged from 0.62 ng/L to 12.5 ng/L and were higher than the remediation goal (0.14 ng/L) at all stations. Mean total DDT concentrations in water ranged from 14.4 ng/L to 62.3 ng/L and exceeded the remediation goal (0.59 ng/L) at all stations. The highest concentrations of both DDT and dieldrin were found at the Lauritzen Canal/End station. Despite exceedence of the remediation goals, chlorinated pesticide concentrations in Lauritzen Canal water samples were notably lower in 1999 than in 1998. PCBS were not detected in water samples in 1999.

  3. Our Experience with Short Stem Hip Replacement Surgery

    Directory of Open Access Journals (Sweden)

    Sumeet Rastogi

    2016-07-01

    Full Text Available Context- A short anatomical metaphyseal femoral stem is a desirable hip implant for bone and soft tissue preserving hip replacing surgery in young arthritic patients. Physiological loading of the proximal femur prevents stress shielding and preserves bone stock of the femur in the long run. Thus it is an ideal hip implant suited for conservative hip surgeries in active young adults with arthritic hips. Materials and methods- 50 Proxima hip replacements were performed on 41 patients with a mean age of 45 over a 3-year period (between July 2006 and September 2009. Diagnosis of hip pathologies varied from osteoarthritis secondary to avascular necrosis, rheumatoid arthritis, post-tubercular arthritis to dysplastic hips. 9 of these patients had symptomatic bilateral hip involvement and underwent bilateral hip replacement in a single sitting. All patient had a Proxima metaphyseal stem implantation( DePuy, Warsaw with either a large diameter metal on metal or pinnacle articulation. Clinical and radiological evaluation was done at 3 months, 6 months, 1 year and then yearly thereafter. Statiscal analysis used- VAS and Harris hip score formed the basis of evaluation Results- These patients were followed up for a mean period of 49 months (Range 36-72 months. The average incision size was 14.38 cm (10-18 cm and blood loss was 269 ml (175-450 ml. There was no peri-operative mortality or serious morbidity in any patients. One patient had an intraoperative lateral cortex crack that required only delayed rehabilitation. Five of the 41 patients (12.1 % had complications with three recovering completely and one requiring revision of femoral stem for aseptic loosening. One patient was lost in follow-up. Harris hip score improved from 52 to 89.3 at last follow-up. Overall 95.1% (39/41 patients had an excellent outcome at last follow-up. Conclusion- We conclude that Proxima metaphyseal stem provided clinically and radiologically stable fixation through snug fit

  4. Nuclear facilities: repair and replacement technologies; Installations nucleaires: technologies de reparation et de remplacement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The oldest operating reactors are more than 35 years old and are now facing major maintenance operations. The first replacement of a pressurizer took place in autumn 2005 at the St-Lucie plant (Usa) while steam generators have been currently replaced since 1983. Nuclear industry has to adapt to this new market by proposing innovative technological solutions in the reactor maintenance field. This document gathers the 9 papers presented at the conference. The main improvements concern repair works on internal components of PWR-type reactors, the replacement of major components of the primary coolant circuit and surface treatments to limit the propagation of damages. The first paper shows that adequate design and feedback experience are good assets to manage the ageing of a nuclear unit. Another paper shows that a new repair method of a relief valve can avoid its replacement. (A.C.)

  5. Effect of replacement interval of nutrients solution and concentration of replenishment solution on growth of lettuce (Lactuca sativa L. under floating culture

    Directory of Open Access Journals (Sweden)

    R. Barzegar

    2016-06-01

    Full Text Available Floating culture of lettuce is developing because of the increase in water use efficiency and chemical fertilizers. In order to assess replacement time of nutrient solution and concentration of replenishment solution on growth and yield of Butterhead lettuce, a factorial experiment was conducted through completely randomized design with three replications. Each experimental unit was a 60×40×15 cm (36 L plastic box, and four plants were grown in a spacing of 20×25 cm apart on polyester sheets. The nutrient solutions were replaced with new solutions once every 3, 4 and 5 weeks. For compensating the removed water and depleted nutrients from the solution, replenishment solutions with ⅓ and ⅔ strength were added to the tank once a week. Plants were harvested 35 days after transplanting. Results showed that there was no significant difference in fresh head weight, head periphery, number of leaves per plant, leaf dry weight, root weight, and stem length and diameter among treatments. The interaction effects between replacement time × concentration of replenishment solution was not significant for none of the growth parameters. Fresh head weight and number of leaves per plant were 265-312 g (mean 286 g and 32-37 leaves, respectively. Chemical analysis of lettuce-head tissue indicated that concentration of macro-and-micronutrients was in optimum range in all the treatments. Head weight per plant was found significantly and positively correlated with number of leaves/plant, root weight, stem diameter and head periphery. Results of the present experiment indicated that lettuce growth and nutrients could be managed well by adding replenishment solution with ⅓ strength, without replacing the nutrients solution.

  6. Dynamic Torque Calibration Unit

    Science.gov (United States)

    Agronin, Michael L.; Marchetto, Carl A.

    1989-01-01

    Proposed dynamic torque calibration unit (DTCU) measures torque in rotary actuator components such as motors, bearings, gear trains, and flex couplings. Unique because designed specifically for testing components under low rates. Measures torque in device under test during controlled steady rotation or oscillation. Rotor oriented vertically, supported by upper angular-contact bearing and lower radial-contact bearing that floats axially to prevent thermal expansion from loading bearings. High-load capacity air bearing available to replace ball bearings when higher load capacity or reduction in rate noise required.

  7. Mechanics of oriented electrospun nanofibrous scaffolds for annulus fibrosus tissue engineering.

    Science.gov (United States)

    Nerurkar, Nandan L; Elliott, Dawn M; Mauck, Robert L

    2007-08-01

    Engineering a functional replacement for the annulus fibrosus (AF) of the intervertebral disc is contingent upon recapitulation of AF structure, composition, and mechanical properties. In this study, we propose a new paradigm for AF tissue engineering that focuses on the reconstitution of anatomic fiber architecture and uses constitutive modeling to evaluate construct function. A modified electrospinning technique was utilized to generate aligned nanofibrous polymer scaffolds for engineering the basic functional unit of the AF, a single lamella. Scaffolds were tested in uniaxial tension at multiple fiber orientations, demonstrating a nonlinear dependence of modulus on fiber angle that mimicked the nonlinearity and anisotropy of native AF. A homogenization model previously applied to native AF successfully described scaffold mechanical response, and parametric studies demonstrated that nonfibrillar matrix, along with fiber connectivity, are key contributors to tensile mechanics for engineered AF. We demonstrated that AF cells orient themselves along the aligned scaffolds and deposit matrix that contributes to construct mechanics under loading conditions relevant to the in vivo environment. The homogenization model was applied to cell-seeded constructs and provided quantitative measures for the evolution of matrix and interfibrillar interactions. Finally, the model demonstrated that at fiber angles of the AF (28 degrees -44 degrees ), engineered material behaved much like native tissue, suggesting that engineered constructs replicate the physiologic behavior of the single AF lamella. Constitutive modeling provides a powerful tool for analysis of engineered AF neo-tissue and native AF tissue alike, highlighting key mechanical design criteria for functional AF tissue engineering.

  8. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.

    Science.gov (United States)

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-03-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.

  9. Microfabricated biomaterials for engineering 3D tissues.

    Science.gov (United States)

    Zorlutuna, Pinar; Annabi, Nasim; Camci-Unal, Gulden; Nikkhah, Mehdi; Cha, Jae Min; Nichol, Jason W; Manbachi, Amir; Bae, Hojae; Chen, Shaochen; Khademhosseini, Ali

    2012-04-10

    Mimicking natural tissue structure is crucial for engineered tissues with intended applications ranging from regenerative medicine to biorobotics. Native tissues are highly organized at the microscale, thus making these natural characteristics an integral part of creating effective biomimetic tissue structures. There exists a growing appreciation that the incorporation of similar highly organized microscale structures in tissue engineering may yield a remedy for problems ranging from vascularization to cell function control/determination. In this review, we highlight the recent progress in the field of microscale tissue engineering and discuss the use of various biomaterials for generating engineered tissue structures with microscale features. In particular, we will discuss the use of microscale approaches to engineer the architecture of scaffolds, generate artificial vasculature, and control cellular orientation and differentiation. In addition, the emergence of microfabricated tissue units and the modular assembly to emulate hierarchical tissues will be discussed. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Tooth regeneration: implications for the use of bioengineered organs in first-wave organ replacement.

    Science.gov (United States)

    Nakahara, Taka; Ide, Yoshiaki

    2007-08-01

    Experiments with animal models have shown that the tooth crown structure can be regenerated using tissue engineering techniques that combine tooth bud cells and biodegradable materials, or by using embryonic tissue and adult stem cells. Moreover, tooth roots and periodontal tissues have been reconstructed by grafting dental stem cells, which leads to the recovery of tooth function, suggesting that tooth regeneration will become possible in humans in the near future. The present article reviews current research on tooth regeneration, discusses a model of tooth replacement that could be used clinically, and proposes a new tooth regeneration approach that overcomes the difficulties associated with the tooth replacement model. Tooth regeneration is an important stepping stone in the establishment of engineered organ transplantation, which is one of the ultimate goals of regenerative therapies.

  11. Imaging in cellular and tissue engineering

    CERN Document Server

    Yu, Hanry

    2013-01-01

    Details on specific imaging modalities for different cellular and tissue engineering applications are scattered throughout articles and chapters in the literature. Gathering this information into a single reference, Imaging in Cellular and Tissue Engineering presents both the fundamentals and state of the art in imaging methods, approaches, and applications in regenerative medicine. The book underscores the broadening scope of imaging applications in cellular and tissue engineering. It covers a wide range of optical and biological applications, including the repair or replacement of whole tiss

  12. Wear study of Total Ankle Replacement explants by microstructural analysis.

    Science.gov (United States)

    Cottrino, S; Fabrègue, D; Cowie, A P; Besse, J-L; Tadier, S; Gremillard, L; Hartmann, D J

    2016-08-01

    The implantation of Total Ankle Replacement (TAR) prostheses generally gives satisfactory results. However, a high revision rate is associated with the Ankle Evolutive System (AES) implant, due to periprosthetic osteolysis that generates significant cortical lesions and bone cysts in the periprosthetic region. Radioclinical and histological analyses of peri-implant tissues show the presence of numerous foreign particles that may come from the implant. It is known that a precocious wear of materials may lead to an important rate of foreign body in tissues and may generate osteolysis lesions and inflammatory reactions. Thus the objectives of this retrospective study of 10 AES TAR implants (recovered after revision surgeries) are to understand how the prostheses wear out, which part is the most stressed and to determine the nature and size of foreign body particles. A better understanding of friction mechanisms between the three parts of the implant and of the nature and morphology of foreign particles generated was needed to explain the in vivo behavior of the implant. This was achieved using microstuctural and tomographic analysis of both implants parts and periprosthetic tissues.

  13. Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy

    NARCIS (Netherlands)

    Royakkers, A.A.N.M.; Korevaar, J.C.; van Suijlen, J.D.E.; Hofstra, L.S.; Kuiper, M.A.; Spronk, P.E.; Schultz, M.J.; Bouman, C.S.C.

    2011-01-01

    To evaluate whether cystatin C in serum (sCyC) and urine (uCyC) can predict early acute kidney injury (AKI) in a mixed heterogeneous intensive care unit (ICU), and also whether these biomarkers can predict the need for renal replacement therapy (RRT). Multicenter prospective observational cohort stu

  14. Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy.

    NARCIS (Netherlands)

    Royakkers, A.A.N.M.; Korevaar, J.C.; Suijlen, J.D.E. van; Hofstra, L.S.; Kuiper, M.A.; Spronk, P.E.; Schultz, M.J.; Bouman, C.S.C.

    2011-01-01

    Purpose : To evaluate whether cystatin C in serum (sCyC) and urine (uCyC) can predict early acute kidney injury (AKI) in a mixed heterogeneous intensive care unit (ICU), and also whether these biomarkers can predict the need for renal replacement therapy (RRT). Methods: Multicenter prospective obser

  15. Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy.

    NARCIS (Netherlands)

    Royakkers, A.A.N.M.; Korevaar, J.C.; Suijlen, J.D.E. van; Hofstra, L.S.; Kuiper, M.A.; Spronk, P.E.; Schultz, M.J.; Bouman, C.S.C.

    2011-01-01

    Purpose : To evaluate whether cystatin C in serum (sCyC) and urine (uCyC) can predict early acute kidney injury (AKI) in a mixed heterogeneous intensive care unit (ICU), and also whether these biomarkers can predict the need for renal replacement therapy (RRT). Methods: Multicenter prospective obser

  16. Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy

    NARCIS (Netherlands)

    Royakkers, A.A.N.M.; Korevaar, J.C.; van Suijlen, J.D.E.; Hofstra, L.S.; Kuiper, M.A.; Spronk, P.E.; Schultz, M.J.; Bouman, C.S.C.

    2011-01-01

    To evaluate whether cystatin C in serum (sCyC) and urine (uCyC) can predict early acute kidney injury (AKI) in a mixed heterogeneous intensive care unit (ICU), and also whether these biomarkers can predict the need for renal replacement therapy (RRT). Multicenter prospective observational cohort stu

  17. Aortic Valve Replacement: Treatment by Sternotomy versus Minimally Invasive Approach

    Directory of Open Access Journals (Sweden)

    Renata Tosoni Rodrigues Ferreira

    Full Text Available Abstract Objective: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach. Methods: Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection. Results: Sternotomy was used in 22 patients and minimally invasive surgery in 15 patients. The minimally invasive approach had significantly higher time values of cardiopulmonary bypass (114.3±23.9 versus 86.7±19.8min.; P=0.003, aortic clamping (87.4±19.2 versus 61.4±12.9 min.; P<0.001 and mechanical ventilation (287.3±138.9 versus 153.9±118.6 min.; P=0.003. No difference was found in outcomes surgical bleeding volume, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit and time of hospital discharge. No cases of short-term mortality or surgical wound infection were documented. Conclusion: The less invasive approach presented with longer times of cardiopulmonary bypass, aortic clamping and mechanical ventilation than sternotomy, however without prejudice to the length of stay in intensive care unit, time of hospital discharge and morbidity.

  18. Tissue-specific stem cells: friend or foe?

    Institute of Scientific and Technical Information of China (English)

    Joerg Huelsken

    2009-01-01

    @@ In the face of a hostile environ-ment, the integrity of many tissues in the adult organism is maintained by a constant replacement of cells. This involves a hierarchical organization of the tissue with rare multi-potent stem cells giving rise to proliferating cells of limited proliferative capacity which in turn produce differentiating cells.

  19. Testosterone replacement therapy and prostate health.

    Science.gov (United States)

    Polackwich, A Scott; Ostrowski, Kevin A; Hedges, Jason C

    2012-12-01

    There is an emerging evolution in the understanding of the relationship between the prostate and testosterone. It has long been generally believed that with testosterone replacement therapy (TRT), increasing serum testosterone levels led to prostatic growth and worsening of voiding dysfunction and associated complications. A new theory, the Saturation Model of Testosterone and its effect on the Prostate has gained attention. This theory suggests that the prostate's response to increasing levels of serum testosterone reaches a limit beyond which there is minimal effect. This model predicts that testosterone replacement therapy occurs above this saturation point, and replacing testosterone to eugonadal levels should not worsen prostate related benign disease. We evaluated the recent published data, with an emphasis on clinical studies done within the last 3 years, for the effects of testosterone supplementation on benign prostatic disease.

  20. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

    Ravn, S H; Rosenberg, J; Bostofte, E

    1994-01-01

    in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin....... Physical activity should be promoted, and cigarette smoking reduced if possible. Women at risk of cardiovascular disease will also benefit from hormone replacement therapy. There is overwhelming evidence that hormone therapy will protect against both coronary heart disease and stroke...... suggest that every woman showing any signs of hormone deprivation should be treated with hormone replacement therapy. This includes women with subjective or objective vaso-motor symptoms, genito-urinary symptoms, women at risk of osteoporosis (fast bone losers), and women at risk of cardiovascular...

  1. Double Valve Replacement for Lupus Valvulitis

    Science.gov (United States)

    Ferraris, Victor A.; Hawksley, Vaughn C.; Rabinowitz, Max; Coyne, Carolyn M.; Sullivan, Thomas J.; Sprague, Merle S.

    1990-01-01

    Hemodynamically significant lupus valvulitis, requiring valve replacement, is rare: 21 cases have been reported so far in the literature, and only 2 of these have involved double valve replacement. We describe an additional case of double valve replacement in a patient with systemic lupus erythematosus. The histopathologic and clinical features of this case suggest that valvular involvement resulted from both acute and chronic disease processes. Medical success in the treatment of systemic lupus erythematosus, especially that achieved through prolonged or high-dose steroid therapy, may cause chronic valvular disease to become a more common surgical problem. A review of the literature supports this contention. (Texas Heart Institute Journal 1990;17:56-60) Images PMID:15227191

  2. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...... ). Results - 3,416 patients were included (2,064 females (60%)). AKI (according to KDIGO criteria) was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD of class 3-5, indicating moderately to severely...

  3. OPTIMAL MAINTENANCE AND REPLACEMENT OF EXTRACTION MACHINERY

    Institute of Scientific and Technical Information of China (English)

    Suresh P.SETHI; Hong-Mo YEH; Rong ZHANG; Andrew K.S.JARDINE

    2008-01-01

    This paper considers a problem of optimal preventive maintenance and replacement schedule ofequipment devoted to extracting resources from known deposits. Typical examples are oil drills, mine shovels, etc. At most one replacement of the existing machinery by a new one is allowed. The problem is formulated as an optimal control problem subject to the state constraint that the remaining deposit at any given time is nonnegative. We show that the optimal preventive maintenance, production rates, and the replacement and salvage times of the existing machinery and the new one, if required, can be obtained by solving sequentially a series of free-end-point optimal control problems. Moreover, an algorithm based on this result is developed and used to solve two illustrative examples.

  4. Dead pixel replacement in LWIR microgrid polarimeters.

    Science.gov (United States)

    Ratliff, Bradley M; Tyo, J Scott; Boger, James K; Black, Wiley T; Bowers, David L; Fetrow, Matthew P

    2007-06-11

    LWIR imaging arrays are often affected by nonresponsive pixels, or "dead pixels." These dead pixels can severely degrade the quality of imagery and often have to be replaced before subsequent image processing and display of the imagery data. For LWIR arrays that are integrated with arrays of micropolarizers, the problem of dead pixels is amplified. Conventional dead pixel replacement (DPR) strategies cannot be employed since neighboring pixels are of different polarizations. In this paper we present two DPR schemes. The first is a modified nearest-neighbor replacement method. The second is a method based on redundancy in the polarization measurements.We find that the redundancy-based DPR scheme provides an order-of-magnitude better performance for typical LWIR polarimetric data.

  5. Hip or knee replacement - after - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  6. Hip or knee replacement - before - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  7. Synthetic biology meets tissue engineering.

    Science.gov (United States)

    Davies, Jamie A; Cachat, Elise

    2016-06-15

    Classical tissue engineering is aimed mainly at producing anatomically and physiologically realistic replacements for normal human tissues. It is done either by encouraging cellular colonization of manufactured matrices or cellular recolonization of decellularized natural extracellular matrices from donor organs, or by allowing cells to self-organize into organs as they do during fetal life. For repair of normal bodies, this will be adequate but there are reasons for making unusual, non-evolved tissues (repair of unusual bodies, interface to electromechanical prostheses, incorporating living cells into life-support machines). Synthetic biology is aimed mainly at engineering cells so that they can perform custom functions: applying synthetic biological approaches to tissue engineering may be one way of engineering custom structures. In this article, we outline the 'embryological cycle' of patterning, differentiation and morphogenesis and review progress that has been made in constructing synthetic biological systems to reproduce these processes in new ways. The state-of-the-art remains a long way from making truly synthetic tissues, but there are now at least foundations for future work. © 2016 Authors; published by Portland Press Limited.

  8. Tubular heart valves from decellularized engineered tissue.

    Science.gov (United States)

    Syedain, Zeeshan H; Meier, Lee A; Reimer, Jay M; Tranquillo, Robert T

    2013-12-01

    A novel tissue-engineered heart valve (TEHV) was fabricated from a decellularized tissue tube mounted on a frame with three struts, which upon back-pressure cause the tube to collapse into three coapting "leaflets." The tissue was completely biological, fabricated from ovine fibroblasts dispersed within a fibrin gel, compacted into a circumferentially aligned tube on a mandrel, and matured using a bioreactor system that applied cyclic distension. Following decellularization, the resulting tissue possessed tensile mechanical properties, mechanical anisotropy, and collagen content that were comparable to native pulmonary valve leaflets. When mounted on a custom frame and tested within a pulse duplicator system, the tubular TEHV displayed excellent function under both aortic and pulmonary conditions, with minimal regurgitant fractions and transvalvular pressure gradients at peak systole, as well as well as effective orifice areas exceeding those of current commercially available valve replacements. Short-term fatigue testing of one million cycles with pulmonary pressure gradients was conducted without significant change in mechanical properties and no observable macroscopic tissue deterioration. This study presents an attractive potential alternative to current tissue valve replacements due to its avoidance of chemical fixation and utilization of a tissue conducive to recellularization by host cell infiltration.

  9. Biomimetic materials design for cardiac tissue regeneration.

    Science.gov (United States)

    Dunn, David A; Hodge, Alexander J; Lipke, Elizabeth A

    2014-01-01

    Cardiovascular disease is the leading cause of death worldwide. In the absence of sufficient numbers of organs for heart transplant, alternate approaches for healing or replacing diseased heart tissue are under investigation. Designing biomimetic materials to support these approaches will be essential to their overall success. Strategies for cardiac tissue engineering include injection of cells, implantation of three-dimensional tissue constructs or patches, injection of acellular materials, and replacement of valves. To replicate physiological function and facilitate engraftment into native tissue, materials used in these approaches should have properties that mimic those of the natural cardiac environment. Multiple aspects of the cardiac microenvironment have been emulated using biomimetic materials including delivery of bioactive factors, presentation of cell-specific adhesion sites, design of surface topography to guide tissue alignment and dictate cell shape, modulation of mechanical stiffness and electrical conductivity, and fabrication of three-dimensional structures to guide tissue formation and function. Biomaterials can be engineered to assist in stem cell expansion and differentiation, to protect cells during injection and facilitate their retention and survival in vivo, and to provide mechanical support and guidance for engineered tissue formation. Numerous studies have investigated the use of biomimetic materials for cardiac regeneration. Biomimetic material design will continue to exploit advances in nanotechnology to better recreate the cellular environment and advance cardiac regeneration. Overall, biomimetic materials are moving the field of cardiac regenerative medicine forward and promise to deliver new therapies in combating heart disease.

  10. The echocardiography of replacement heart valves

    Science.gov (United States)

    2016-01-01

    This is a practical description of how replacement valves are assessed using echocardiography. Normal transthoracic appearances including normal variants are described. The problem of differentiating normal function, patient–prosthesis mismatch and pathological obstruction in aortic replacement valves with high gradients is discussed. Obstruction and abnormal regurgitation is described for valves in the aortic, mitral and right-sided positions and when to use echocardiography in suspected infective endocarditis. The roles of transoesophageal and stress echocardiography are described and finally when other imaging techniques may be useful. PMID:27600454

  11. Apical Na+ permeability of frog skin during serosal Cl- replacement.

    Science.gov (United States)

    Leibowich, S; DeLong, J; Civan, M M

    1988-05-01

    Gluconate substitution for serosal Cl- reduces the transepithelial short-circuit current (Isc) and depolarizes short-circuited frog skins. These effects could result either from inhibition of basolateral K+ conductance, or from two actions to inhibit both apical Na+ permeability (PapNa) and basolateral pump activity. We have addressed this question by studying whole-and split-thickness frog skins. Intracellular Na+ concentration (CcNa) and PapNa have been monitored by measuring the current-voltage relationship for apical Na+ entry. This analysis was conducted by applying trains of voltage pulses, with pulse durations of 16 to 32 msec. Estimates of PapNa and CcNa were not detectably dependent on pulse duration over the range 16 to 80 msec. Serosal Cl- replacement uniformly depolarized short-circuited tissues. The depolarization was associated with inhibition of Isc across each split skin, but only occasionally across the whole-thickness preparations. This difference may reflect the better ionic exchange between the bulk medium and the extracellular fluid in contact with the basolateral membranes, following removal of the underlying dermis in the split-skin preparations. PapNa was either unchanged or increased, and CcNa either unchanged or reduced after the anionic replacement. These data are incompatible with the concept that serosal Cl- replacement inhibits PapNa and Na,K-pump activity. Gluconate substitution likely reduces cell volume, triggering inhibition of the basolateral K+ channels, consistent with the data and conclusions of S.A. Lewis, A.G. Butt, M.J. Bowler, J.P. Leader and A.D.C. Macknight (J. Membrane Biol. 83:119-137, 1985) for toad bladder. The resulting depolarization reduces the electrical force favoring apical Na+ entry. The volume-conductance coupling serves to conserve volume by reducing K+ solute loss. Its molecular basis remains to be identified.

  12. Upgrade or replace?: The effect of the EPBD on the choice between improvement or replacement

    NARCIS (Netherlands)

    Thomsen, A.F.; Van der Flier, C.L.

    2010-01-01

    What is better: improvement or replacement by new construction? The choice between life cycle extension and replacement of existing buildings is at itself a vital but very difficult decision, involving a wide range of different aspects and affecting several contrary and often conflicting interests.

  13. Serum Testosterone Level, Testosterone Replacement Treatment, and Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Ali Atan

    2013-01-01

    Full Text Available There has been an increase in the number of individuals seeking testosterone (T replacement treatment (TRT due to a decrease in their blood T levels. Prostate cancer (PCa is also an important issue in the same age group. However, we, urologists, are anxious about PCa development after T treatment. This is because it has been assumed that T may cause PCa or exacerbate insidious PCa which is already present. In this paper, recent developments regarding the relationship between serum levels of sex hormone and prostate tissue, the causal relationship between T and development of PCa, the effect of TRT on the group of patients who are at high risk of developing PCa, the suitability of TRT for patients who have already been diagnosed with PCa, and the effect of TRT on serum prostate-specific antigen level are analyzed.

  14. Risk assessment of replacing conventional P fertilizers with biomass ash

    DEFF Research Database (Denmark)

    Cruz Paredes, Carla; Lopez Garcia, Alvaro; Rubæk, Gitte H.;

    2017-01-01

    Reutilizing biomass ashes in agriculture can substitute inputs of P from finite primary sources. However, recycling of ashes is disputed due to their content of toxic substances such as heavy metals. This study evaluates the potential risk of replacing easily soluble inorganic P fertilizer with P...... application, grain, straw and root dry matter yield, and P and Cd uptake were determined. Resin-extractable P was measured in soil and the symbiotic arbuscular mycorrhizal fungal activity, colonization, and community composition were assessed. Crop yield was not affected by ash application, while P......-uptake and mycorrhizal status were slightly enhanced with high ash applications. Changes to the mycorrhizal community composition were evident with high ash doses. Cadmium uptake in aboveground plant tissue was unaffected by ash treatments, but increased in roots with increasing doses. Consequently, we conclude...

  15. Aortic valve replacement in familial hypercholesterolemia: not an ordinary procedure.

    Science.gov (United States)

    Muretti, Mirko; Massi, Francesco; Coradduzza, Enrico; Portoghese, Michele

    2015-04-28

    Familial hypercholesterolemia is an inherited disorder with incidences of approximately 1:500 and 1:1,000,000 in heterozygous and homozygous form respectively. Affected patients usually show early coronary artery disease and severe aortic root calcification, despite optimization of therapy. We report a case of a 64-year-old woman affected by heterozygous familial hypercholesterolemia which presented dyspnea and anginal symptoms due to a severely calcified aortic root causing valve stenosis and narrowed sinotubular junction. Aortic valve replacement and aortic root enlargement were performed using the Manougian procedure. Even for experiences surgeons, this surgery could prove challenging for this group of patients due to aggressive degenerative tissue calcification of the aortic root, which often presents an extremely calcified aortic valve with a small annulus associated to a narrowed sinotubular junction.

  16. Autogenous tooth transplantation: an alternative to replace extracted tooth

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2015-09-01

    Full Text Available Background: The gold standard treatment to replace missing tooth is dental implants, however, in certain cases, such as in young patients its placement is contraindicated. Autogenous tooth transplantation, which has been widely done in Scandinavian countries for many years, may become a good alternative to overcome this problem. Purpose: This article attempted to provide information about the indication, treatment planning, surgical technique and the successful result of autogenous tooth transplantation. Case: A fifteen year old male patient presented with large caries and periapical disease of his lower left first molar, which was partially erupted and the roots was not fully formed in radiograph. Case management: Autogenous tooth transplantation procedure was performed consisting of extraction of #36, odontectomy of #38 followed by its implantation to socket #36 and fixation of the transplanted tooth to the adjacent teeth. Post operative evaluation was done on regular basis within 18 months period. There was no complaint, the tooth was clinically stable and no evidence of periodontal problem. Serial radiographs showed healing of alveolar bone and periodontal tissue, and the complete root formation was evident by 18 months post operatively. Conclusion: Autogenous tooth transplantation is a potential alternative to replace extracted tooth. Provided that the case be properly planned and operation carefully performed, successful result of this treatment can be achieved.

  17. Patient outcome and valve performance following a second aortic valve homograft replacement.

    Science.gov (United States)

    Hasnat, K; Birks, E J; Liddicoat, J; Hon, J K; Edwards, S; Glennon, S; Yacoub, M H

    1999-11-09

    Homograft valves offer many advantages; however, there is concern about their use in second aortic valve replacement because of the complexity of the procedure and the possibility of accelerated degeneration. One hundred and forty-four patients underwent a second aortic homograft replacement between 1973 and 1997 (mean follow-up 6.5+/-5 years, range 1 to 20 years). Eighty-three were male, and 61 were female, aged 17 to 77 years, mean 49.0 years. All patients had undergone previous aortic valve replacement with a homograft. The indication for reoperation was aortic regurgitation in 75 patients (52.1%), aortic stenosis in 28 (19.4%), and mixed aortic valve disease in 41 (28.5%). Root replacement was performed in 54 patients (38%) and subcoronary in 90 (62.5%). Early mortality was 3.4%. The actuarial survival rate was 93% and 82% at 5 and 10 years, respectively. Freedom from tissue degeneration was 96% and 80% at 5 and 10 years, respectively, and freedom from reoperation was 97% and 82% at 5 and 10 years, respectively. This study shows that a second aortic valve homograft replacement results in good early and long-term survival. Accelerated degeneration does not occur. Left ventricular performance is improved, and earlier surgery could further improve outcome, indicating that an aortic homograft is a safe, durable option for patients requiring a second aortic valve replacement.

  18. Photochemical tissue bonding

    Science.gov (United States)

    Redmond, Robert W.; Kochevar, Irene E.

    2012-01-10

    Photochemical tissue bonding methods include the application of a photosensitizer to a tissue and/or tissue graft, followed by irradiation with electromagnetic energy to produce a tissue seal. The methods are useful for tissue adhesion, such as in wound closure, tissue grafting, skin grafting, musculoskeletal tissue repair, ligament or tendon repair and corneal repair.

  19. Biomechanics and mechanobiology in functional tissue engineering.

    Science.gov (United States)

    Guilak, Farshid; Butler, David L; Goldstein, Steven A; Baaijens, Frank P T

    2014-06-27

    The field of tissue engineering continues to expand and mature, and several products are now in clinical use, with numerous other preclinical and clinical studies underway. However, specific challenges still remain in the repair or regeneration of tissues that serve a predominantly biomechanical function. Furthermore, it is now clear that mechanobiological interactions between cells and scaffolds can critically influence cell behavior, even in tissues and organs that do not serve an overt biomechanical role. Over the past decade, the field of "functional tissue engineering" has grown as a subfield of tissue engineering to address the challenges and questions on the role of biomechanics and mechanobiology in tissue engineering. Originally posed as a set of principles and guidelines for engineering of load-bearing tissues, functional tissue engineering has grown to encompass several related areas that have proven to have important implications for tissue repair and regeneration. These topics include measurement and modeling of the in vivo biomechanical environment; quantitative analysis of the mechanical properties of native tissues, scaffolds, and repair tissues; development of rationale criteria for the design and assessment of engineered tissues; investigation of the effects biomechanical factors on native and repair tissues, in vivo and in vitro; and development and application of computational models of tissue growth and remodeling. Here we further expand this paradigm and provide examples of the numerous advances in the field over the past decade. Consideration of these principles in the design process will hopefully improve the safety, efficacy, and overall success of engineered tissue replacements. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Imaging challenges in biomaterials and tissue engineering.

    Science.gov (United States)

    Appel, Alyssa A; Anastasio, Mark A; Larson, Jeffery C; Brey, Eric M

    2013-09-01

    Biomaterials are employed in the fields of tissue engineering and regenerative medicine (TERM) in order to enhance the regeneration or replacement of tissue function and/or structure. The unique environments resulting from the presence of biomaterials, cells, and tissues result in distinct challenges in regards to monitoring and assessing the results of these interventions. Imaging technologies for three-dimensional (3D) analysis have been identified as a strategic priority in TERM research. Traditionally, histological and immunohistochemical techniques have been used to evaluate engineered tissues. However, these methods do not allow for an accurate volume assessment, are invasive, and do not provide information on functional status. Imaging techniques are needed that enable non-destructive, longitudinal, quantitative, and three-dimensional analysis of TERM strategies. This review focuses on evaluating the application of available imaging modalities for assessment of biomaterials and tissue in TERM applications. Included is a discussion of limitations of these techniques and identification of areas for further development.

  1. Design Strategies and Applications of Tissue Bioadhesives

    Science.gov (United States)

    Mehdizadeh, Mohammadreza; Yang, Jian

    2013-01-01

    In the past two decades tissue adhesives and sealants have revolutionized hemostasis and wound management in traumatic and surgical injuries. Various biological-driven glues and synthetic adhesives are clinically utilized either as an adjunct to conventional hemostats and wound closure techniques, such as suturing, or as a replacement to them. The ability to effectively and promptly control bleeding, thus, reducing the risk of complications due to severe blood loss, in addition to convenience of use render medical adhesive a highly suitable tool for wound management. This review focuses on existing tissue adhesive systems, their structure, functioning mechanism, indicated and off-label applications, and limitations. It also includes the latest advances in the development of new tissue adhesives as well as the emerging applications in regenerative medicine. We expect that this review will provide insightful discussion on tissue bioadhesive design and lead to innovations for the development of the next generation of tissue bioadhesives and their related biomedical applications. PMID:23225776

  2. Tissue Photolithography

    Science.gov (United States)

    Wade, Lawrence A.; Kartalov, Emil; Shibata, Darryl; Taylor, Clive

    2011-01-01

    Tissue lithography will enable physicians and researchers to obtain macromolecules with high purity (greater than 90 percent) from desired cells in conventionally processed, clinical tissues by simply annotating the desired cells on a computer screen. After identifying the desired cells, a suitable lithography mask will be generated to protect the contents of the desired cells while allowing destruction of all undesired cells by irradiation with ultraviolet light. The DNA from the protected cells can be used in a number of downstream applications including DNA sequencing. The purity (i.e., macromolecules isolated form specific cell types) of such specimens will greatly enhance the value and information of downstream applications. In this method, the specific cells are isolated on a microscope slide using photolithography, which will be faster, more specific, and less expensive than current methods. It relies on the fact that many biological molecules such as DNA are photosensitive and can be destroyed by ultraviolet irradiation. Therefore, it is possible to protect the contents of desired cells, yet destroy undesired cells. This approach leverages the technologies of the microelectronics industry, which can make features smaller than 1 micrometer with photolithography. A variety of ways has been created to achieve identification of the desired cell, and also to designate the other cells for destruction. This can be accomplished through chrome masks, direct laser writing, and also active masking using dynamic arrays. Image recognition is envisioned as one method for identifying cell nuclei and cell membranes. The pathologist can identify the cells of interest using a microscopic computerized image of the slide, and appropriate custom software. In one of the approaches described in this work, the software converts the selection into a digital mask that can be fed into a direct laser writer, e.g. the Heidelberg DWL66. Such a machine uses a metalized glass plate (with

  3. Potential of Microbubbles as Fat Replacer

    NARCIS (Netherlands)

    Rovers, T.A.M.; Sala, Guido; Linden, Van der Erik; Meinders, M.B.J.

    2016-01-01

    The potential of microbubbles as fat replacers and texture modifiers was assessed by comparison of the rheological and tribological properties of model food systems that contained (1) microbubbles, (2) emulsion droplets or (3) no added colloidal structures. We used (a) liquids with thickener, (b)

  4. Predictors of mortality after aortic valve replacement

    NARCIS (Netherlands)

    Tjang, Yanto Sandy; van Hees, Yvonne; Koerfer, Reiner; Grobbee, Diederick E.; van der Heijden, Geert J. M. G.

    Aortic valve replacement (AVR) is recommended as a standard surgical procedure for aortic valve disease. Still the evidence for commonly claimed predictors of post-AVR prognosis, in particular mortality, appears scant. This systematic review reports on the evidence for predictors of post-AVR

  5. Is physiological glucocorticoid replacement important in children?

    Science.gov (United States)

    Porter, John; Blair, Joanne; Ross, Richard J

    2017-01-01

    Cortisol has a distinct circadian rhythm with low concentrations at night, rising in the early hours of the morning, peaking on waking and declining over the day to low concentrations in the evening. Loss of this circadian rhythm, as seen in jetlag and shift work, is associated with fatigue in the short term and diabetes and obesity in the medium to long term. Patients with adrenal insufficiency on current glucocorticoid replacement with hydrocortisone have unphysiological cortisol concentrations being low on waking and high after each dose of hydrocortisone. Patients with adrenal insufficiency complain of fatigue, a poor quality of life and there is evidence of poor health outcomes including obesity potentially related to glucocorticoid replacement. New technologies are being developed that deliver more physiological glucocorticoid replacement including hydrocortisone by subcutaneous pump, Plenadren, a once-daily modified-release hydrocortisone and Chronocort, a delayed and sustained absorption hydrocortisone formulation that replicates the overnight profile of cortisol. In this review, we summarise the evidence regarding physiological glucocorticoid replacement with a focus on relevance to paediatrics. PMID:27582458

  6. 25 CFR 700.53 - Dwelling, replacement.

    Science.gov (United States)

    2010-04-01

    ... § 700.55. (b) May include existing dwellings for resale, new construction, modular homes, mobile homes... person if, after he receives a replacement housing payment and any available housing assistance payments... supplemental income payments received from public agencies. If the person's monthly income pattern is...

  7. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...

  8. Criteria for the replacement of restorations

    DEFF Research Database (Denmark)

    Wilson, Nairn; Lynch, Christopher; Brunton, Paul Brunton

    2016-01-01

    The replacement of a restoration is one of the most common procedures in dentistry. However, the criteria for such intervention, excluding catastrophic failure and persistent discomfort and pain, continue to be the subject of considerable debate. The decision-making process remains subjective...

  9. Measure Guideline: Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P.

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  10. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...

  11. Method of replacing corrupted audio data

    NARCIS (Netherlands)

    Stemerdink, J.; Meijerink, Arjan

    2006-01-01

    A decoding method for coded data representing original data. Corrupted data is detected and replaced with buffered data. The buffered data is stored in the buffer a time interval corresponding to an estimated periodicity or an integer multiple thereof before the corrupted data was received. The esti

  12. Analogue Assessment of the Replacement Behavior

    Science.gov (United States)

    Cipani, Ennio

    2008-01-01

    The use of experimental analyses in determining behavioral function for problems behaviors is well established. Such analyses lead to functional treatment prescriptions for the target problem behavior. However, data indicative of the strength of the replacement behavior are often not collected during a functional behavioral assessment. I examine…

  13. Hormone replacement therapy and risk of glioma

    DEFF Research Database (Denmark)

    Andersen, Lene; Friis, Søren; Hallas, Jesper;

    2013-01-01

    Aim: Several studies indicate that use of hormone replacement therapy (HRT) is associated with an increased risk of intracranial meningioma, while associations between HRT use and risk of other brain tumors have been less explored. We investigated the influence of HRT use on the risk of glioma...

  14. Aggression Replacement Training and Childhood Trauma

    Science.gov (United States)

    Amendola, A. Mark; Oliver, Robert W.

    2013-01-01

    Aggression Replacement Training (ART) was developed by the late Arnold Goldstein of Syracuse University to teach positive alternatives to children and youth with emotional and behavioral problems (Glick & Gibbs, 2011; Goldstein, Glick, & Gibbs, 1998). ART provides cognitive, affective, and behavioral interventions to build competence in…

  15. Probability Issues in without Replacement Sampling

    Science.gov (United States)

    Joarder, A. H.; Al-Sabah, W. S.

    2007-01-01

    Sampling without replacement is an important aspect in teaching conditional probabilities in elementary statistics courses. Different methods proposed in different texts for calculating probabilities of events in this context are reviewed and their relative merits and limitations in applications are pinpointed. An alternative representation of…

  16. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  17. [Hormone replacement therapy: curse or blessing?].

    Science.gov (United States)

    Schmidt, M; Fink, D; Lang, U; Kimmig, R

    2006-01-01

    There is a controversial discussion on the risks and benefits of hormonal replacement therapy (HRT), and many women and doctors have revised their opinions of HRT over the last few years. Complementary and alternative therapies can be considered an option to treat menopausal symptoms. The following issue summarizes the actual knowledge of treatment options of menopausal symptoms.

  18. Enzyme replacement therapy for alpha-mannosidosis

    DEFF Research Database (Denmark)

    Borgwardt, Line Gutte; Dali, Christine I.; Fogh, J

    2013-01-01

    Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intrave...... intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment....

  19. The benefits and risks of testosterone replacement therapy: a review

    Directory of Open Access Journals (Sweden)

    Nazem Bassil

    2009-06-01

    Full Text Available Nazem Bassil1, Saad Alkaade2, John E Morley1,31Division of Geriatric Medicine; 2Internal Medicine, Saint Louis University Health Sciences Center, St. Louis, Missouri, USA; 3GRECC, VA Medical Center, St. Louis, Missouri, USAAbstract: Increased longevity and population aging will increase the number of men with late onset hypogonadism. It is a common condition, but often underdiagnosed and undertreated. The indication of testosterone-replacement therapy (TRT treatment requires the presence of low testosterone level, and symptoms and signs of hypogonadism. Although controversy remains regarding indications for testosterone supplementation in aging men due to lack of large-scale, long-term studies assessing the benefits and risks of testosterone-replacement therapy in men, reports indicate that TRT may produce a wide range of benefits for men with hypogonadism that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease. Perhaps the most controversial area is the issue of risk, especially possible stimulation of prostate cancer by testosterone, even though no evidence to support this risk exists. Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years. The physician should discuss with the patient the potential benefits and risks of TRT. The purpose of this review is to discuss what is known and not known regarding the benefits and risks of TRT.Keywords: hypogonadism, testosterone replacement therapy, erectile dysfunction, osteoporosis, cardiovascular disease

  20. Life Functions and Cells: Level II, Unit 7, Lesson 1; Cell Structure: Lesson 2; Tissues, Organs, Systems: Lesson 3; Growth and Nutrition: Lesson 4; Metabolism: Lesson 5. Advanced General Education Program. A High School Self-Study Program.

    Science.gov (United States)

    Manpower Administration (DOL), Washington, DC. Job Corps.

    This self-study program for high-school level contains lessons on: Life Functions and Cells; Cell Structure; Tissues, Organs, Systems; Growth and Nutrition; and Metabolism. Each of the lessons concludes with a Mastery Test to be completed by the student. (DB)

  1. Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

    Science.gov (United States)

    Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

    2016-01-01

    This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints.

  2. Competitive analysis of soybean and sudangrass using replacement series design

    Directory of Open Access Journals (Sweden)

    Mauro Antônio Rizzardi

    Full Text Available ABSTRACT Competition is the best known form of direct interference of weeds on agricultural crops. However, there is relatively little information on the competition of the weed sudangrass on soybean, which has been common in agricultural areas in the southern of Rio Grande do Sul. The objective of this study was to evaluate the competition between sudangrass and soybeans using replacement series experiments. The experiment was carried out in a greenhouse in a completely randomized design with four replications. The treatments consisted of soybean and sudangrass associations. The experimental units were 8-L plastic pots, in the proportions 0: 8, 2: 6, 4: 4, 6: 2, 8: 0, corresponding to 0, 25, 50, 75 and 100% of the crop and weed respectively. Shoot, root and total dry matter and plant height were analyzed through diagrams applied to replacement series and competitive indices. Soybean showed competitive superiority in coexistence with sudangrass in relation to shoot, root and total dry matter. The intraspecific competition was more significant for the crop and inter-specific competition was more important for the weed.

  3. Robotic joint replacement surgery: does technology improve outcomes?

    Science.gov (United States)

    Hill, Chelsea; El-Bash, Reem; Johnson, Leslie; Coustasse, Alberto

    2015-01-01

    Osteoarthritis is a common disease that leads patients to seek total joint replacement (TJR). Component misalignment leads to failure of TJR. Computer navigation enhances the precision of component alignment, but the addition of robotic guidance can boost TJR to a higher level of accuracy. Some 29 English-language peer-reviewed articles from 2002 to 2013 and 1 Web site were reviewed. A conceptual framework was adapted to explain benefits and barriers of adoption of robotic TJR. A total of 10 studies were reviewed with focus on more precise alignment, outcomes, length of stay, and costs. Cost to obtain robotic surgical equipment was found to be about $1 million with maintenance costs approaching $350 000. Robotic techniques compared with conventional orthopedic surgery showed slight variances in favor of robotic procedures. Although hospitals have the potential to reduce costs and improve outcomes with robotic TJR, the expenditure and maintenance have not been proven a clear return on investment. As surgical robotic technology evolves in accuracy and accessibility, joint replacement surgery may benefit from improved precision and decreased health care costs. However, equipment purchase and upkeep costs and surgeon training may impede use to its full potential in orthopedic surgery in the United States.

  4. Evaluation of novel injectable hydrogels for nucleus pulposus replacement.

    Science.gov (United States)

    Vernengo, J; Fussell, G W; Smith, N G; Lowman, A M

    2008-01-01

    Branched copolymers composed of poly(N-isopropylacrylamide) (PNIPAAm) and poly(ethylene glycol) (PEG) are being investigated as an in situ forming replacement for the nucleus pulposus of the intervertebral disc. A family of copolymers was synthesized by varying the molecular weight of the PEG blocks and molar ratio of NIPAAm monomer units to PEG branches. Gel swelling, dissolution, and compressive mechanical properties were characterized over 90 days and stress relaxation behavior over 30 days immersion in vitro. It was found that the NIPAAm to PEG molar ratio did not affect the equilibrium swelling and compressive mechanical properties. However, gel elasticity exhibited a dependency on both the PEG block molecular weight and content. The equilibrium gel water content increased and compressive modulus decreased with increasing PEG block size. While all of the branched copolymers showed significant increases in stress relaxation time constant compared to the homopolymer (p < 0.05), the high PEG content PNIPAAm-PEG (4600 and 8000 g/mol) exhibited the maximum elasticity. Because of its high water content, requisite stiffness and high elastic response, PNIPAAm-PEG (4600 g/mol) will be further evaluated as a candidate material for nucleus pulposus replacement.

  5. [Pharmacokinetics of antibiotics in continuous renal replacement therapies (CRRT)].

    Science.gov (United States)

    Morabito, Santo; Pistolesi, Valentina; Maggiore, Umberto; Fiaccadori, Enrico; Pierucci, Alessandro

    2012-01-01

    In the critically ill patient, acute kidney injury (AKI) is frequently associated with infective complications requiring appropriate antimicrobial treatment. AKI and multiple organ dysfunction syndrome can affect the pharmacokinetic parameters of many drugs. Furthermore, the start of renal replacement therapy (RRT) is an additional variable to be taken into consideration to avoid inappropriate antimicrobial therapy. Continuous renal replacement therapies (CRRT) are widely adopted in the intensive care unit (ICU) and antibiotics that are significantly eliminated by the kidney are likely to be removed during RRT. Generally, drug-dosing adjustments are required if the extracorporeal clearance accounts for more than 25-30% of the total body clearance. The molecular weight cutoffs of the more widely used membranes are much higher than the molecular weight of most drugs. Therefore, molecular size will not be a limitation for the removal of the unbound fraction of the antibiotics most commonly used in ICU patients. However, CRRTs are still not standardized and the impact of RRT on plasma drug concentrations can be substantially different depending on the CRRT modality (diffusive, convective or both), membrane characteristics and delivered dialysis dose. In any case, drug-dosing adjustments should be based on the knowledge of the pharmacokinetic and pharmacodynamic properties of the different classes of antimicrobials, taking into account that high extracorporeal clearances could lead to drug underexposure in clinical conditions where appropriate antibiotic treatment is essential.

  6. 25 CFR 700.183 - Determination of replacement housing benefit.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Determination of replacement housing benefit. 700.183... RELOCATION PROCEDURES Replacement Housing Payments § 700.183 Determination of replacement housing benefit. (a) Amount of benefit. The replacement housing benefit for a certified eligible head-of-household is...

  7. The development of transcatheter aortic valve replacement in the USA.

    Science.gov (United States)

    Dvir, Danny; Barbash, Israel M; Ben-Dor, Itsik; Okubagzi, Petros; Satler, Lowell F; Waksman, Ron; Pichard, Augusto D

    2012-03-01

    The penetration rate of devices in general, and in transcatheter aortic valve replacement (TAVR) specifically, is significantly delayed in the United States of America (USA) compared with in Europe. This is mostly due to the mission statement of the regulatory agencies in the USA, which requires very rigorous clinical testing of a device prior to its approval. The USA had a major role in the development and evaluation of this technology and USA research has enabled clinicians inside and outside of the USA to conduct a concise scientifically based assessment of the performance of TAVR devices in terms of safety and efficacy. In the following review, we provide data on the development of TAVR in the USA, revealing the critical role the USA has played in this extraordinary process.

  8. Failures of the RM finger prosthesis joint replacement system.

    Science.gov (United States)

    Middleton, A; Lakshmipathy, R; Irwin, L R

    2011-09-01

    In our unit a high failure rate of the RM finger prosthesis joint replacement system was noted, prompting a review of cases. A series of patients underwent implantation under the care of one surgeon and the results were monitored. Twenty-one devices were implanted of which 16 were inserted for rheumatoid disease. Patients were reviewed regularly and the implant performance was assessed critically along with survival of the implant to revision, infection or death of the patient. The mean follow-up was 32 months. Unacceptable failure rates at early and medium term stages were identified, with 15 of the implants revised by 2 years. Loosening was the commonest mode of failure. The authors do not recommend the use of this implant, especially in cases of rheumatoid arthritis.

  9. [Mitral valve replacement in a patient with Sheehan's syndrome].

    Science.gov (United States)

    Morokuma, H; Nakayama, Y; Minematsu, N

    2008-09-01

    Sheehan' syndrome is caused by pituitary apoplexy occurring during parturition and results in hypopituitarism, adrenal insufficiency and hypothyroidism. A 66-year-old woman with Sheehan's syndrome had received corticosteroids and thyroid hormones for about 18 years. The patient underwent mitral valve replacement for mitral regurgitation. Intraoperatively, just after the initiation of cardiopulmonary bypass, hypotension and severe edema suddenly occurred. Crystalloid fluid was rapidly administered to increase intravascular volumes. Postoperatively the body weight increased by 9.4 kg. The patient was intubated for 64 hours, stayed in the intensive care unit (ICU) for 7 days and was discharged from hospital on the postoperative day 36. Careful perioperative hormone supplementation is necessary for patients with Sheehan's syndrome.

  10. Tissue engineering chamber promotes adipose tissue regeneration in adipose tissue engineering models through induced aseptic inflammation.

    Science.gov (United States)

    Peng, Zhangsong; Dong, Ziqing; Chang, Qiang; Zhan, Weiqing; Zeng, Zhaowei; Zhang, Shengchang; Lu, Feng

    2014-11-01

    Tissue engineering chamber (TEC) makes it possible to generate significant amounts of mature, vascularized, stable, and transferable adipose tissue. However, little is known about the role of the chamber in tissue engineering. Therefore, to investigate the role of inflammatory response and the change in mechanotransduction started by TEC after implantation, we placed a unique TEC model on the surface of the groin fat pads in rats to study the expression of cytokines and tissue development in the TEC. The number of infiltrating cells was counted, and vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) expression levels in the chamber at multiple time points postimplantation were analyzed by enzyme-linked immunosorbent assay. Tissue samples were collected at various time points and labeled for specific cell populations. The result showed that new adipose tissue formed in the chamber at day 60. Also, the expression of MCP-1 and VEGF in the chamber decreased slightly from an early stage as well as the number of the infiltrating cells. A large number of CD34+/perilipin- perivascular cells could be detected at day 30. Also, the CD34+/perilipin+ adipose precursor cell numbers increased sharply by day 45 and then decreased by day 60. CD34-/perilipin+ mature adipocytes were hard to detect in the chamber content at day 30, but their number increased and then peaked at day 60. Ki67-positive cells could be found near blood vessels and their number decreased sharply over time. Masson's trichrome showed that collagen was the dominant component of the chamber content at early stage and was replaced by newly formed small adipocytes over time. Our findings suggested that the TEC implantation could promote the proliferation of adipose precursor cells derived from local adipose tissue, increase angiogenesis, and finally lead to spontaneous adipogenesis by inducing aseptic inflammation and changing local mechanotransduction.

  11. Apoptosis, stem cells, and tissue regeneration.

    Science.gov (United States)

    Bergmann, Andreas; Steller, Hermann

    2010-10-26

    Most metazoans have at least some ability to regenerate damaged cells and tissues, although the regenerative capacity varies depending on the species, organ, or developmental stage. Cell replacement and regeneration occur in two contexts: renewal of spent cells during tissue homeostasis (homeostatic growth), and in response to external injury, wounding, or amputation (epimorphic regeneration). Model organisms that display remarkable regenerative capacity include amphibians, planarians, Hydra, and the vertebrate liver. In addition, several mammalian organs--including the skin, gut, kidney, muscle, and even the human nervous system--have some ability to replace spent or damaged cells. Although the regenerative response is complex, it typically involves the induction of new cell proliferation through formation of a blastema, followed by cell specification, differentiation, and patterning. Stem cells and undifferentiated progenitor cells play an important role in both tissue homeostasis and tissue regeneration. Stem cells are typically quiescent or passing slowly through the cell cycle in adult tissues, but they can be activated in response to cell loss and wounding. A series of studies, mostly performed in Drosophila as well as in Hydra, Xenopus, and mouse, has revealed an unexpected role of apoptotic caspases in the production of mitogenic signals that stimulate the proliferation of stem and progenitor cells to aid in tissue regeneration. This Review summarizes some of the key findings and discusses links to stem cell biology and cancer.

  12. Utilizing stem cells for three-dimensional neural tissue engineering.

    Science.gov (United States)

    Knowlton, Stephanie; Cho, Yongku; Li, Xue-Jun; Khademhosseini, Ali; Tasoglu, Savas

    2016-05-26

    Three-dimensional neural tissue engineering has made great strides in developing neural disease models and replacement tissues for patients. However, the need for biomimetic tissue models and effective patient therapies remains unmet. The recent push to expand 2D neural tissue engineering into the third dimension shows great potential to advance the field. Another area which has much to offer to neural tissue engineering is stem cell research. Stem cells are well known for their self-renewal and differentiation potential and have been shown to give rise to tissues with structural and functional properties mimicking natural organs. Application of these capabilities to 3D neural tissue engineering may be highly useful for basic research on neural tissue structure and function, engineering disease models, designing tissues for drug development, and generating replacement tissues with a patient's genetic makeup. Here, we discuss the vast potential, as well as the current challenges, unique to integration of 3D fabrication strategies and stem cells into neural tissue engineering. We also present some of the most significant recent achievements, including nerve guidance conduits to facilitate better healing of nerve injuries, functional 3D biomimetic neural tissue models, physiologically relevant disease models for research purposes, and rapid and effective screening of potential drugs.

  13. Automated adipose study for assessing cancerous human breast tissue using optical coherence tomography (Conference Presentation)

    Science.gov (United States)

    Gan, Yu; Yao, Xinwen; Chang, Ernest W.; Bin Amir, Syed A.; Hibshoosh, Hanina; Feldman, Sheldon; Hendon, Christine P.

    2017-02-01

    Breast cancer is the third leading cause of death in women in the United States. In human breast tissue, adipose cells are infiltrated or replaced by cancer cells during the development of breast tumor. Therefore, an adipose map can be an indicator of identifying cancerous region. We developed an automated classification method to generate adipose map within human breast. To facilitate the automated classification, we first mask the B-scans from OCT volumes by comparing the signal noise ratio with a threshold. Then, the image was divided into multiple blocks with a size of 30 pixels by 30 pixels. In each block, we extracted texture features such as local standard deviation, entropy, homogeneity, and coarseness. The features of each block were input to a probabilistic model, relevance vector machine (RVM), which was trained prior to the experiment, to classify tissue types. For each block within the B-scan, RVM identified the region with adipose tissue. We calculated the adipose ratio as the number of blocks identified as adipose over the total number of blocks within the B-scan. We obtained OCT images from patients (n = 19) in Columbia medical center. We automatically generated the adipose maps from 24 B-scans including normal samples (n = 16) and cancerous samples (n = 8). We found the adipose regions show an isolated pattern that in cancerous tissue while a clustered pattern in normal tissue. Moreover, the adipose ratio (52.30 ± 29.42%) in normal tissue was higher than the that in cancerous tissue (12.41 ± 10.07%).

  14. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

    Directory of Open Access Journals (Sweden)

    Mi Z

    2014-12-01

    Full Text Available Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA, are statistically conservative. Hsu’s multiple comparisons with the best (MCB – adapted from the Dunnett’s multiple comparisons with control (MCC – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM or generalized linear mixed models (GLMM, and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS, among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

  15. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M. S.; Pantophlet, A. J.; van den Borne, J. J. G. C.; Hendriks, W. H.; Schols, H. A.; Gerrits, W. J. J.

    2016-01-01

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on energy

  16. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M.S.; Pantophlet, A.J.; Borne, van den J.J.G.C.; Hendriks, W.H.; Schols, H.A.; Gerrits, W.J.J.

    2016-01-01

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on

  17. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M. S.; Pantophlet, A. J.; van den Borne, J. J. G. C.; Hendriks, W. H.; Schols, H. A.; Gerrits, W. J. J.

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on energy

  18. Hormone replacement therapy and the prevention of postmenopausal osteoporosis.

    Science.gov (United States)

    Gambacciani, Marco; Levancini, Marco

    2014-09-01

    Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR), is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC), is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

  19. Hormone replacement therapy and the prevention of postmenopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    Marco Gambacciani

    2014-09-01

    Full Text Available Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT at different doses rapidly normalizes turnover, preserves bone mineral density (BMD at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR, is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC, is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

  20. Estrogen replacement therapy and cardioprotection: mechanisms and controversies

    Directory of Open Access Journals (Sweden)

    M.T.R. Subbiah

    2002-03-01

    Full Text Available Epidemiological and case-controlled studies suggest that estrogen replacement therapy might be beneficial in terms of primary prevention of coronary heart disease (CHD. This beneficial effect of estrogens was initially considered to be due to the reduction of low density lipoproteins (LDL and to increases in high density lipoproteins (HDL. Recent studies have shown that estrogens protect against oxidative stress and decrease LDL oxidation. Estrogens have direct effects on the arterial tissue and modulate vascular reactivity through nitric oxide and prostaglandin synthesis. While many of the effects of estrogen on vascular tissue are believed to be mediated by estrogen receptors alpha and ß, there is evidence for `immediate non-genomic' effects. The role of HDL in interacting with 17ß-estradiol including its esterification and transfer of esterified estrogens to LDL is beginning to be elucidated. Despite the suggested positive effects of estrogens, two recent placebo-controlled clinical trials in women with CHD did not detect any beneficial effects on overall coronary events with estrogen therapy. In fact, there was an increase in CHD events in some women. Mutations in thrombogenic genes (factor V Leiden, prothrombin mutation, etc. in a subset of women may play a role in this unexpected finding. Thus, the cardioprotective effect of estrogens appears to be more complicated than originally thought and requires more research.

  1. Generating Units

    Data.gov (United States)

    Department of Homeland Security — Generating Units are any combination of physically connected generators, reactors, boilers, combustion turbines, and other prime movers operated together to produce...

  2. Transcatheter aortic valve replacement in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Dimytri Siqueira; Alexandre Abizaid; Magaly Arrais J.; Eduardo Sousa

    2012-01-01

    Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement (TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

  3. Mitochondrial replacement therapy in reproductive medicine.

    Science.gov (United States)

    Wolf, Don P; Mitalipov, Nargiz; Mitalipov, Shoukhrat

    2015-02-01

    Mitochondrial dysfunction is implicated in disease and age-related infertility. Mitochondrial replacement therapies (MRT) in oocytes or zygotes, such as pronuclear (PNT), spindle (ST), or polar body (PBT) transfer, could prevent second-generation transmission of mitochondrial DNA (mtDNA) defects. PNT, associated with high levels of mtDNA carryover in mice but low levels in human embryos, carries ethical issues secondary to donor embryo destruction. ST, developed in primates, supports normal development to adults and low mtDNA carryover. PBT in mice, coupled with PN or ST, may increase the yield of reconstructed embryos with low mtDNA carryover. MRT also offers replacement of the deficient cytoplasm in oocytes from older patients, with the expectation of high pregnancy rates following in vitro fertilization.

  4. Nicotine replacement therapies: patient safety and persistence

    Directory of Open Access Journals (Sweden)

    Ferguson SG

    2011-06-01

    Full Text Available Stuart G Ferguson1,2, Saul Shiffman3,4, Joseph G Gitchell51School of Pharmacy, 2Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia; 3Pinney Associates, 4University of Pittsburgh, Pittsburgh, PA, USA; 5Pinney Associates, Bethesda, MD, USAAbstract: Nicotine replacement therapy (NRT has become a central part of the treatment of nicotine dependence. However, NRT’s potential efficacy is limited to some extent by patient adherence and persistence. Here we review the relationship between NRT compliance and adherence, and overall treatment outcome. We then examine the factors that likely impact on treatment compliance and persistence, with a special focus on users’ perceptions of treatment safety and efficacy as possible mediators. Potential clinical strategies for improving suboptimal medication use are also discussed.Keywords: nicotine replacement therapy, compliance, safety

  5. Replacements For Ozone-Depleting Foaming Agents

    Science.gov (United States)

    Blevins, Elana; Sharpe, Jon B.

    1995-01-01

    Fluorinated ethers used in place of chlorofluorocarbons and hydrochlorofluorocarbons. Replacement necessary because CFC's and HCFC's found to contribute to depletion of ozone from upper atmosphere, and manufacture and use of them by law phased out in near future. Two fluorinated ethers do not have ozone-depletion potential and used in existing foam-producing equipment, designed to handle liquid blowing agents soluble in chemical ingredients that mixed to make foam. Any polyurethane-based foams and several cellular plastics blown with these fluorinated ethers used in processes as diverse as small batch pours, large sprays, or double-band lamination to make insulation for private homes, commercial buildings, shipping containers, and storage tanks. Fluorinated ethers proved useful as replacements for CFC refrigerants and solvents.

  6. The pure relationship and below replacement fertility

    Directory of Open Access Journals (Sweden)

    David R. Hall

    2003-12-01

    interest from demographers. Despite the fact that researchers have extensively modeled recent demographic changes such as skyrocketing divorce rates, rising common-law union formation, delayed childbearing, and the decline to belowreplacement fertility levels, our understanding of the causes of these trends, and the possible connections between them remains theoretically fragmented and incomplete. The goal of this paper is to advance our understanding in this area by exploring the insights on modern family formation of prominent sociologist Anthony Giddens. Specifically, this study examines whether Giddens’ “pure relationship” concept can shed light on the trend toward very low fertility. The results of this inquiry suggest that couples in both marriages and common-law unions who conform to key aspects of Giddens pure relationship are more likely to have uncertain or below-replacement fertility intentions, and less likely to embrace above-replacement fertility goals.

  7. Autogenous Transplantation for Replacing a Hopeless Tooth

    Science.gov (United States)

    Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon

    2017-01-01

    Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption. PMID:28179939

  8. Liver replacement for alpha1-antitrypsin deficiency

    Science.gov (United States)

    Putnam, Charles W.; Porter, Kendrick A.; Peters, Robert L.; Ashcavai, Mary; Redeker, Allan G.; Starzl, Thomas E.

    2010-01-01

    A 16-year-old girl with advanced cirrhosis and severe alpha1-antitrypsin deficiency of the homozygous PiZZ phenotype was treated by orthotopic liver transplantation. After replacement of the liver with a homograft from a donor with the normal PiMM phenotype, the alpha1-antitrypsin concentration in the recipient’s serum rose to normal; it had the PiMM phenotype. Two and a third years later, chronic rejection necessitated retransplantation. Insertion of a homograft from a heterozygous PiMZ donar was followed by the identification of that phenotype in the recipient’s serum. Neither liver graft developed the alpha1-antitrypsin glycoprotein deposits seen with the deficiency state. These observations confirm that this hepatic- based inborn error metabolism is metabolically cured by liver replacement. PMID:320694

  9. Estudo comparativo experimental de compósito bioativo de matriz polimérica para aplicação em cirurgia plástica ocular na substituição tecidual Experimental comparative study of bioactive composite with polymeric matrix for applications to oculoplastic surgery for tissue replacement

    Directory of Open Access Journals (Sweden)

    Valênio Pérez França

    2005-08-01

    - Brazil, with two similar materials as control: MedporTM (Porex Surgical Inc. - USA e PoliporeTM (Homus Com. Ind. Ltda - BRASIL. METHODS: In vivo randomized experimental double blind study: a transconjunctival approach was performed in both cartilaginous superior orbital walls of 28 rabbits for 56 implants divided into 4 groups: GI: Composite 10%/MedporTM; GII: Composite 10%/PoliporeTM; GIII: Composite 20%/MedporTM; GIV: Composite 20%/PoliporeTM. The mean rate for implant time of permanence was 19.7 weeks. The Student's t test was used for statistical analysis. RESULTS: Revealed similar biocompatibility of all materials and none of the implants was extruded; one Composite 20% had partial exposure. Histomorphometry showed a greater bioactivity of the composites with significantly thicker fibrous encapsulation, with more collagen and fibroblasts, exuberant angiogenesis, and a lower inflammatory cell mean compared to controls. The presence of precipitation of a hydroxycarbonate apatite layer, which acts as an implant-tissue bond was confirmed. Composites presented a smaller tissular invasion index of the pores compared to controls. CONCLUSIONS: The composites showed a good biocompatibility and some additional advantageover the MedporTM and PoliporeTM controls.

  10. Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project

    OpenAIRE

    Best, A. J.; Fender, D.; Harper, W. M.; McCaskie, A. W.; Oliver, K; Gregg, P J

    1999-01-01

    As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. ...

  11. Which design and biomaterial factors affect clinical wear performance of total disc replacements? A systematic review.

    Science.gov (United States)

    Veruva, Sai Y; Steinbeck, Marla J; Toth, Jeffrey; Alexander, Dominik D; Kurtz, Steven M

    2014-12-01

    Total disc replacement was clinically introduced to reduce pain and preserve segmental motion of the lumbar and cervical spine. Previous case studies have reported on the wear and adverse local tissue reactions around artificial prostheses, but it is unclear how design and biomaterials affect clinical outcomes. Which design and material factors are associated with differences in clinical wear performance (implant wear and periprosthetic tissue response) of (1) lumbar and (2) cervical total disc replacements? We performed a systematic review on the topics of implant wear and periprosthetic tissue response using an advanced search in MEDLINE and Scopus electronic databases. Of the 340 references identified, 33 were retrieved for full-text evaluation, from which 16 papers met the inclusion criteria (12 on lumbar disc replacement and five on cervical disc replacement; one of the included studies reported on both lumbar and cervical disc replacement), which involved semiquantitative analysis of wear and adverse local tissue reactions along with a description of the device used. An additional three papers were located by searching bibliographies of key articles. There were seven case reports, three case series, two case-control studies, and seven analytical studies. The Methodological Index for Non-randomized Studies (MINORS) Scale was used to score case series and case-control studies, which yielded mean scores of 10.3 of 16 and 17.5 of 24, respectively. In general, the case series (three) and case-control (two) studies were of good quality. In lumbar regions, metal-on-polymer devices with mobile-bearing designs consistently generated small and large polymeric wear debris, triggering periprosthetic tissue activation of macrophages and giant cells, respectively. In the cervical regions, metal-on-polymer devices with fixed-bearing designs had similar outcomes. All metal-on-metal constructs tended to generate small metallic wear debris, which typically triggered an

  12. Risks of testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    E Charles Osterberg

    2014-01-01

    Full Text Available Testosterone replacement therapy (TRT is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction.

  13. Alternatives to testosterone replacement: testosterone restoration.

    Science.gov (United States)

    McCullough, Andrew

    2015-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH.

  14. Alternatives to testosterone replacement: testosterone restoration

    OpenAIRE

    Andrew McCullough

    2014-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supp...

  15. Current concepts in total femoral replacement

    OpenAIRE

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K.; Higuera, Carlos A.; Barsoum, Wael K.; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing li...

  16. Mitochondrial Replacement Therapy in Reproductive Medicine

    OpenAIRE

    Wolf, Don P; Mitalipov, Nargiz; Mitalipov, Shoukhrat

    2014-01-01

    Mitochondrial dysfunction is implicated in disease and in age-related infertility. Mitochondrial replacement therapies (MRT) in oocytes or zygotes such as pronuclear (PNT), spindle (ST) or polar body (PBT) transfer could prevent second generation transmission of mitochondrial DNA (mtDNA) defects. PNT, associated with high levels of mtDNA carryover in mice but low levels in human embryos, carries ethical issues secondary to donor embryo destruction. ST, developed in primates, supports normal d...

  17. Mineralogical correlation between primary and replacement dolomites

    Institute of Scientific and Technical Information of China (English)

    黄志诚; 杨守业; 陈智娜

    1997-01-01

    Primary dolostones occur in the Upper Sinian Dengying Formation. Based on mineralogieal study the indicators for correlation between the primary dolomites which are not influenced by the diagenesis and the replacement dolomites of different periods have been obtained. It is shown that the primary dolomites are characterized by crystal forms precipitated and deposited directly from sea water, stable and homogeneous distribution of Mg and Ca, ideal chemical composition, regular modulated microstructures, low positive δ13C and low negative δ18O.

  18. Drug Dosing During Continuous Renal Replacement Therapies

    OpenAIRE

    Thompson, A. Jill

    2008-01-01

    Continuous renal replacement therapies (CRRT) are used to manage fluid overload and/or renal failure. The continuous nature of the fluid and solute removal has less impact on hemodynamic variables in critically ill patients, making CRRT preferred over intermittent hemodialysis for some patients in the intensive care arena. The impact of CRRT on drug removal is variable depending on the CRRT modality, the ultrafiltrate and dialysate flow rates, the filter, and the patient's residual renal func...

  19. VH replacement in primary immunoglobulin repertoire diversification.

    Science.gov (United States)

    Sun, Amy; Novobrantseva, Tatiana I; Coffre, Maryaline; Hewitt, Susannah L; Jensen, Kari; Skok, Jane A; Rajewsky, Klaus; Koralov, Sergei B

    2015-02-01

    The genes encoding the variable (V) region of the B-cell antigen receptor (BCR) are assembled from V, D (diversity), and J (joining) elements through a RAG-mediated recombination process that relies on the recognition of recombination signal sequences (RSSs) flanking the individual elements. Secondary V(D)J rearrangement modifies the original Ig rearrangement if a nonproductive original joint is formed, as a response to inappropriate signaling from a self-reactive BCR, or as part of a stochastic mechanism to further diversify the Ig repertoire. VH replacement represents a RAG-mediated secondary rearrangement in which an upstream VH element recombines with a rearranged VHDHJH joint to generate a new BCR specificity. The rearrangement occurs between the cryptic RSS of the original VH element and the conventional RSS of the invading VH gene, leaving behind a footprint of up to five base pairs (bps) of the original VH gene that is often further obscured by exonuclease activity and N-nucleotide addition. We have previously demonstrated that VH replacement can efficiently rescue the development of B cells that have acquired two nonproductive heavy chain (IgH) rearrangements. Here we describe a novel knock-in mouse model in which the prerearranged IgH locus resembles an endogenously rearranged productive VHDHJH allele. Using this mouse model, we characterized the role of VH replacement in the diversification of the primary Ig repertoire through the modification of productive VHDHJH rearrangements. Our results indicate that VH replacement occurs before Ig light chain rearrangement and thus is not involved in the editing of self-reactive antibodies.

  20. Multiscale mechanical modeling of soft biological tissues

    Science.gov (United States)

    Stylianopoulos, Triantafyllos

    2008-10-01

    Soft biological tissues include both native and artificial tissues. In the human body, tissues like the articular cartilage, arterial wall, and heart valve leaflets are examples of structures composed of an underlying network of collagen fibers, cells, proteins and molecules. Artificial tissues are less complex than native tissues and mainly consist of a fiber polymer network with the intent of replacing lost or damaged tissue. Understanding of the mechanical function of these materials is essential for many clinical treatments (e.g. arterial clamping, angioplasty), diseases (e.g. arteriosclerosis) and tissue engineering applications (e.g. engineered blood vessels or heart valves). This thesis presents the derivation and application of a multiscale methodology to describe the macroscopic mechanical function of soft biological tissues incorporating directly their structural architecture. The model, which is based on volume averaging theory, accounts for structural parameters such as the network volume fraction and orientation, the realignment of the fibers in response to strain, the interactions among the fibers and the interactions between the fibers and the interstitial fluid in order to predict the overall tissue behavior. Therefore, instead of using a constitutive equation to relate strain to stress, the tissue microstructure is modeled within a representative volume element (RVE) and the macroscopic response at any point in the tissue is determined by solving a micromechanics problem in the RVE. The model was applied successfully to acellular collagen gels, native blood vessels, and electrospun polyurethane scaffolds and provided accurate predictions for permeability calculations in isotropic and oriented fiber networks. The agreement of model predictions with experimentally determined mechanical properties provided insights into the mechanics of tissues and tissue constructs, while discrepancies revealed limitations of the model framework.

  1. Transdermal testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    Ullah MI

    2014-01-01

    Full Text Available M Iftekhar Ullah,1 Daniel M Riche,1,2 Christian A Koch1,31Department of Medicine, University of Mississippi Medical Center, 2Department of Pharmacy Practice, The University of Mississippi, 3GV (Sonny Montgomery VA Medical Center, Jackson, MS, USAAbstract: Androgen deficiency syndrome in men is a frequently diagnosed condition associated with clinical symptoms including fatigue, decreased libido, erectile dysfunction, and metabolic syndrome. Serum testosterone concentrations decline steadily with age. The prevalence of androgen deficiency syndrome in men varies depending on the age group, known and unknown comorbidities, and the respective study group. Reported prevalence rates may be underestimated, as not every man with symptoms of androgen deficiency seeks treatment. Additionally, men reporting symptoms of androgen deficiency may not be correctly diagnosed due to the vagueness of the symptom quality. The treatment of androgen deficiency syndrome or male hypogonadism may sometimes be difficult due to various reasons. There is no consensus as to when to start treating a respective man or with regards to the best treatment option for an individual patient. There is also lack of familiarity with treatment options among general practitioners. The formulations currently available on the market are generally expensive and dose adjustment protocols for each differ. All these factors add to the complexity of testosterone replacement therapy. In this article we will discuss the general indications of transdermal testosterone replacement therapy, available formulations, dosage, application sites, and recommended titration schedule.Keywords: hypogonadism, transdermal, testosterone, sexual function, testosterone replacement therapy, estradiol

  2. The pure relationship and below replacement fertility

    Directory of Open Access Journals (Sweden)

    Hall, David R.

    2003-01-01

    Full Text Available Of the many changes which have characterized the second demographic transition, shifts in fertility and union formation have attracted a great deal of interest from demographers. Despite the fact that researchers have extensively modeled recent demographic changes such as skyrocketing divorce rates, rising common-law union formation, delayed childbearing, and the decline to below-replacement fertility levels, our understanding of the causes of these trends, and the possible connections between them remains theoretically fragmented and incomplete. The goal of this paper is to advance our understanding in this area by exploring the insights on modern family formation of prominent sociologist Anthony Giddens. Specifically, this study examines whether Giddens' "pure relationship" concept can shed light on the trend toward very low fertility. The results of this inquiry suggest that couples in both marriages and common-law unions who conform to key aspects of Giddens pure relationship are morel likely to have uncertain or below-replacement fertility intentions, and less likely to embrace above-replacement fertility goals.

  3. Flow boiling test of GDP replacement coolants

    Energy Technology Data Exchange (ETDEWEB)

    Park, S.H. [comp.

    1995-08-01

    The tests were part of the CFC replacement program to identify and test alternate coolants to replace CFC-114 being used in the uranium enrichment plants at Paducah and Portsmouth. The coolants tested, C{sub 4}F{sub 10} and C{sub 4}F{sub 8}, were selected based on their compatibility with the uranium hexafluoride process gas and how well the boiling temperature and vapor pressure matched that of CFC-114. However, the heat of vaporization of both coolants is lower than that of CFC-114 requiring larger coolant mass flow than CFC-114 to remove the same amount of heat. The vapor pressure of these coolants is higher than CFC-114 within the cascade operational range, and each coolant can be used as a replacement coolant with some limitation at 3,300 hp operation. The results of the CFC-114/C{sub 4}F{sub 10} mixture tests show boiling heat transfer coefficient degraded to a minimum value with about 25% C{sub 4}F{sub 10} weight mixture in CFC-114 and the degree of degradation is about 20% from that of CFC-114 boiling heat transfer coefficient. This report consists of the final reports from Cudo Technologies, Ltd.

  4. Retention Benefit Based Intelligent Cache Replacement

    Institute of Scientific and Technical Information of China (English)

    李凌达; 陆俊林; 程旭

    2014-01-01

    The performance loss resulting from different cache misses is variable in modern systems for two reasons: 1) memory access latency is not uniform, and 2) the latency toleration ability of processor cores varies across different misses. Compared with parallel misses and store misses, isolated fetch and load misses are more costly. The variation of cache miss penalty suggests that the cache replacement policy should take it into account. To that end, first, we propose the notion of retention benefit. Retention benefits can evaluate not only the increment of processor stall cycles on cache misses, but also the reduction of processor stall cycles due to cache hits. Then, we propose Retention Benefit Based Replacement (RBR) which aims to maximize the aggregate retention benefits of blocks reserved in the cache. RBR keeps track of the total retention benefit for each block in the cache, and it preferentially evicts the block with the minimum total retention benefit on replacement. The evaluation shows that RBR can improve cache performance significantly in both single-core and multi-core environment while requiring a low storage overhead. It also outperforms other state-of-the-art techniques.

  5. Experimental replacement of an obligate insect symbiont.

    Science.gov (United States)

    Moran, Nancy A; Yun, Yueli

    2015-02-17

    Symbiosis, the close association of unrelated organisms, has been pivotal in biological diversification. In the obligate symbioses found in many insect hosts, organisms that were once independent are permanently and intimately associated, resulting in expanded ecological capabilities. The primary model for this kind of symbiosis is the association between the bacterium Buchnera and the pea aphid (Acyrthosiphon pisum). A longstanding obstacle to efforts to illuminate genetic changes underlying obligate symbioses has been the inability to experimentally disrupt and reconstitute symbiont-host partnerships. Our experiments show that Buchnera can be experimentally transferred between aphid matrilines and, furthermore, that Buchnera replacement has a massive effect on host fitness. Using a recipient pea aphid matriline containing Buchnera that are heat sensitive because of an allele eliminating the heat shock response of a small chaperone, we reduced native Buchnera through heat exposure and introduced a genetically distinct Buchnera from another matriline, achieving complete replacement and stable inheritance. This transfer disrupted 100 million years (∼ 1 billion generations) of continuous maternal transmission of Buchnera in its host aphids. Furthermore, aphids with the Buchnera replacement enjoyed a dramatic increase in heat tolerance, directly demonstrating a strong effect of symbiont genotype on host ecology.

  6. Autologous adipose stem cells and polylactide discs in the replacement of the rabbit temporomandibular joint disc

    Science.gov (United States)

    Ahtiainen, Katja; Mauno, Jari; Ellä, Ville; Hagström, Jaana; Lindqvist, Christian; Miettinen, Susanna; Ylikomi, Timo; Kellomäki, Minna; Seppänen, Riitta

    2013-01-01

    The temporomandibular joint (TMJ) disc lacks functional replacement after discectomy. We investigated tissue-engineered bilayer polylactide (PLA) discs and autologous adipose stem cells (ASCs) as a potential replacement for the TMJ disc. These ASC discs were pre-cultured either in control or in differentiation medium, including transforming growth factor (TGF)-β1 for one week. Prior to implantation, expression of fibrocartilaginous genes was measured by qRT-PCR. The control and differentiated ASC discs were implanted, respectively, in the right and left TMJs of rabbits for six (n = 5) and 12 months (n = 5). Thereafter, the excised TMJ areas were examined with cone beam computed tomography (CBCT) and histology. No signs of infection, inflammation or foreign body reactions were detected at histology, whereas chronic arthrosis and considerable condylar hypertrophy were observed in all operated joints at CBCT. The left condyle treated with the differentiated ASC discs appeared consistently smoother and more sclerotic than the right condyle. The ASC disc replacement resulted in dislocation and morphological changes in the rabbit TMJ. The ASC discs pre-treated with TGF-β1 enhanced the condylar integrity. While adverse tissue reactions were not shown, the authors suggest that with improved attachment and design, the PLA disc and biomaterial itself would hold potential for TMJ disc replacement. PMID:23720535

  7. Autologous adipose stem cells and polylactide discs in the replacement of the rabbit temporomandibular joint disc.

    Science.gov (United States)

    Ahtiainen, Katja; Mauno, Jari; Ellä, Ville; Hagström, Jaana; Lindqvist, Christian; Miettinen, Susanna; Ylikomi, Timo; Kellomäki, Minna; Seppänen, Riitta

    2013-08-06

    The temporomandibular joint (TMJ) disc lacks functional replacement after discectomy. We investigated tissue-engineered bilayer polylactide (PLA) discs and autologous adipose stem cells (ASCs) as a potential replacement for the TMJ disc. These ASC discs were pre-cultured either in control or in differentiation medium, including transforming growth factor (TGF)-β1 for one week. Prior to implantation, expression of fibrocartilaginous genes was measured by qRT-PCR. The control and differentiated ASC discs were implanted, respectively, in the right and left TMJs of rabbits for six (n = 5) and 12 months (n = 5). Thereafter, the excised TMJ areas were examined with cone beam computed tomography (CBCT) and histology. No signs of infection, inflammation or foreign body reactions were detected at histology, whereas chronic arthrosis and considerable condylar hypertrophy were observed in all operated joints at CBCT. The left condyle treated with the differentiated ASC discs appeared consistently smoother and more sclerotic than the right condyle. The ASC disc replacement resulted in dislocation and morphological changes in the rabbit TMJ. The ASC discs pre-treated with TGF-β1 enhanced the condylar integrity. While adverse tissue reactions were not shown, the authors suggest that with improved attachment and design, the PLA disc and biomaterial itself would hold potential for TMJ disc replacement.

  8. UNIT, TIBET.

    Science.gov (United States)

    Louisiana Arts and Science Center, Baton Rouge.

    THE UNIT OF STUDY DESCRIBED IN THIS BOOKLET DEALS WITH THE GEOGRAPHY AND HISTORY OF TIBET. THE UNIT COVERS SOME OF THE GENERAL FEATURES OF THE COUNTRY AND THEIR EFFECT UPON THE LIVES OF THE TIBETAN PEOPLE. DISCUSSION QUESTIONS ARE INSERTED TO STIMULATE THOUGHT. THE RELIGION OF TIBET IS DISCUSSED IN RELATION TO ITS INFLUENCE ON THE ART AND CULTURE…

  9. Compartment syndrome following total knee replacement: A case report and literature review

    Science.gov (United States)

    Shaath, Mohammed; Sukeik, Mohamed; Mortada, Saadallah; Masterson, Sean

    2016-01-01

    Compartment syndrome is a rare complication of total knee replacement (TKR) surgery that needs prompt diagnosis and treatment as it may be associated with high morbidity and mortality. We have found very few reports in the literature describing compartment syndrome after TKRs and therefore, present a relevant case which occurred in the immediate postoperative phase and was treated with fasciotomy and subsequent operations to close the soft tissue defects. PMID:27672575

  10. Drug dosing during intermittent hemodialysis and continuous renal replacement therapy : special considerations in pediatric patients.

    Science.gov (United States)

    Veltri, Michael A; Neu, Alicia M; Fivush, Barbara A; Parekh, Rulan S; Furth, Susan L

    2004-01-01

    Chronic renal failure is, fortunately, an unusual occurrence in children; however, many children with various underlying illnesses develop acute renal failure, and transiently require renal replacement therapy - peritoneal dialysis, intermittent hemodialysis (IHD), or continuous renal replacement therapy (CRRT). As children with acute and chronic renal failure often have multiple comorbid conditions requiring drug therapy, generalists, intensivists, nephrologists, and pharmacists need to be aware of the issues surrounding the management of drug therapy in pediatric patients undergoing renal replacement therapy. This article summarizes the pharmacokinetics and dosing of many drugs commonly prescribed for pediatric patients, and focuses on the management of drug therapy in pediatric patients undergoing IHD and CRRT in the intensive care unit setting. Peritoneal dialysis is not considered in this review. Finally, a summary table with recommended initial dosages for drugs commonly encountered in pediatric patients requiring IHD or CRRT is presented.

  11. Unique method of tooth replacement in durophagous placodont marine reptiles, with new data on the dentition of Chinese taxa.

    Science.gov (United States)

    Neenan, James M; Li, Chun; Rieppel, Olivier; Bernardini, Federico; Tuniz, Claudio; Muscio, Giuseppe; Scheyer, Torsten M

    2014-05-01

    The placodonts of the Triassic period (~252-201 mya) represent one of the earliest and most extreme specialisations to a durophagous diet of any known reptile group. Exceptionally enlarged crushing tooth plates on the maxilla, dentary and palatine cooperated to form functional crushing areas in the buccal cavity. However, the extreme size of these teeth, combined with the unusual way they occluded, constrained how replacement occurred. Using an extensive micro-computed tomographic dataset of 11 specimens that span all geographic regions and placodont morphotypes, tooth replacement patterns were investigated. In addition, the previously undescribed dental morphologies and formulae of Chinese taxa are described for the first time and incorporated into the analysis. Placodonts have a unique tooth replacement pattern and results follow a phylogenetic trend. The plesiomorphic Placodus species show many replacement teeth at various stages of growth, with little or no discernible pattern. On the other hand, the more derived cyamodontoids tend to have fewer replacement teeth growing at any one time, replacing teeth unilaterally and/or in functional units, thus maintaining at least one functional crushing area at all times. The highly derived placochelyids have fewer teeth and, as a result, only have one or two replacement teeth in the upper jaw. This supports previous suggestions that these taxa had an alternative diet to other placodonts. Importantly, all specimens show at least one replacement tooth growing at the most posterior palatine tooth plates, indicating increased wear at this point and thus the most efficient functional crushing area.

  12. Total replacement of the exocrine pancreas with fat following multiple blunt injuries.

    Science.gov (United States)

    Hayashi, Takahito; Yoshida, Aichi; Ago, Kazutoshi; Ago, Mihoko; Ogata, Mamoru

    2010-04-01

    We describe an unusual case of total replacement of the exocrine pancreas with fat, which was observed in an autopsy of an assaulted victim. A woman in her early 80s was kicked, stamped and hit several times with firewood. She was hospitalized with disturbance of consciousness, left haemothorax and multiple fractures, and died about three months later. Postmortem examination revealed extensive abrasions and bruises, multiple fractures and internal organ injuries such as contusion and haemorrhage, as well as bronchopneumonia. It was concluded that the cause of her death was hypostatic pneumonia followed by traumatic shock due to multiple blunt injuries. Further, complete replacement of the pancreas with fat was observed in addition to a calculus in the main pancreatic duct and fibrous hypertrophy of the ductal wall. Histopathological examination revealed almost complete replacement of the pancreatic acini by fat tissue, whereas the islets of Langerhans were mostly intact. Antemortem laboratory data showed that serum amylase levels were almost within normal range before hospital admission, but underwent a transient abnormal elevation at admission followed by extremely low levels thereafter. Previous reports suggest that obstruction of both the main pancreatic duct and the artery, due to tumour formation or calculus in combination with arteriolar sclerosis, are necessary to induce total replacement of the pancreas with fat. Since arteriolar sclerosis was not remarkable in this case, we speculated that pancreatic ischaemia due to circulatory disturbance caused by traumatic shock, in combination with pre-existing calculus, may have contributed to the development of total replacement with fat. The temporal alterations in serum amylase levels support our speculation. There are few, if any, reports regarding organ replacement with fat in association with trauma. This case suggests that multiple injuries followed by traumatic shock may advance pre-existing replacement of

  13. Distilling complexity to advance cardiac tissue engineering

    OpenAIRE

    Ogle, Brenda M.; Bursac, Nenad; Domian, Ibrahim; Huang, Ngan F.; Menasché, Philippe; Murry, Charles; Pruitt, Beth; Radisic, Milica; Wu, Joseph C; Wu, Sean M.; Zhang, Jianyi; Zimmermann, Wolfram-Hubertus; Vunjak-Novakovic, Gordana

    2016-01-01

    The promise of cardiac tissue engineering is in the ability to recapitulate in vitro the functional aspects of healthy heart and disease pathology as well as to design replacement muscle for clinical therapy. Parts of this promise have been realized; others have not. In a meeting of scientists in this field, five central challenges or “big questions” were articulated that, if addressed, could substantially advance the current state-of-the-art in modeling heart disease and realizing heart repa...

  14. Airway tissue engineering for congenital laryngotracheal disease

    OpenAIRE

    Maughan, E.; Lesage, F; Butler, C. R.; Hynds, R.E. (Robert E.); Hewitt, R; Janes, S. M.; Deprest, J. A.; Coppi, P. D.

    2016-01-01

    Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper...

  15. The autologus graft of epithelial tissue culture

    Directory of Open Access Journals (Sweden)

    Minaee B

    1999-08-01

    Full Text Available With the intention of research about culture and autologus graft of epithelial tissue we used 4 french Albino Rabbits with an average age of 2 months. After reproduction on the support in EMEM (Eagle's Minimum Essential Medium we used this for graft after 4 weeks. This region which grafted total replaced. After fixation of this sample and passing them through various process, histological sections were prepared. These sections were stained with H & E and masson's trichrome and studied by light microscope. We succeeded in graft. We hope in the near future by using the method of epithelium tissue culture improving to treat burned patients.

  16. The accuracy of stereolithography in planning craniofacial bone replacement.

    Science.gov (United States)

    Chang, Peter Shih-Hsin; Parker, Thornwell H; Patrick, Charles W; Miller, Michael J

    2003-03-01

    Stereolithography can be used to produce physical models of the craniofacial skeleton from three-dimensional computed tomography (CT) data. The purpose of this study was to assess its accuracy for modeling osseous defects of the midface. Maxillary resections simulating unilateral maxillectomy (N = 3), bilateral maxillectomy (N = 3), and unilateral orbitomaxillectomy (N = 3) were performed as for sinus tumor resection on nine fresh cadaver skulls. Stereolithographic models (SLMs) were made from the specimen's CT data. The accuracy of SLMs was determined by comparing distances between key landmarks on the skulls and SLMs. Each SLM was grossly accurate with some loss of thin delicate structures. The mean differences in overall dimensions between the SLMs and skull specimens were 1.5 mm (range: 0-5.5 mm) for craniofacial measures, 1.2 mm (range: 0-4.8 mm) for skull base measures, 1.6 (range: 0-5.8 mm) for midface measures, 1.9 mm (range: 0-7.9 mm) for maxilla measures, and 1.5 mm (range: 0-5.7 mm) for orbital measures. The mean differences in defect dimensions were 1.9 mm (range: 0.1-5.7 mm) for unilateral maxillectomy, 0.8 mm (range: 0.2-1.5 mm) for bilateral maxillectomy, and 2.5 mm (range: 0.2-7.0 mm) for orbitomaxillectomy defects. Midface SLMs may be more prone to error than those of other craniofacial regions because of the presence of thin walls and small projections. Thus, one should consider designing midface bone replacements that are larger in critical dimensions than those predicted by preoperative modeling. These findings have important implications for the planning of current surgical methods as well as future applications of tissue-engineered bone replacement.

  17. Informing tendon tissue engineering with embryonic development

    Science.gov (United States)

    Glass, Zachary A.; Schiele, Nathan R.; Kuo, Catherine K.

    2014-01-01

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies have relied on adult tissue homeostatic and healing factors to influence stem cell differentiation, but have yet to achieve tissue regeneration. A novel paradigm is to use embryonic developmental factors as cues to promote tendon regeneration. Embryonic tendon progenitor cell differentiation in vivo is regulated by a combination of mechanical and chemical factors. We propose that these cues will guide stem cells to recapitulate critical aspects of tenogenesis and effectively direct the cells to differentiate and regenerate new tendon. Here, we review recent efforts to identify mechanical and chemical factors of embryonic tendon development to guide stem/progenitor cell differentiation toward new tendon formation, and discuss the role this work may have in the future of tendon tissue engineering. PMID:24484642

  18. Informing tendon tissue engineering with embryonic development.

    Science.gov (United States)

    Glass, Zachary A; Schiele, Nathan R; Kuo, Catherine K

    2014-06-27

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies have relied on adult tissue homeostatic and healing factors to influence stem cell differentiation, but have yet to achieve tissue regeneration. A novel paradigm is to use embryonic developmental factors as cues to promote tendon regeneration. Embryonic tendon progenitor cell differentiation in vivo is regulated by a combination of mechanical and chemical factors. We propose that these cues will guide stem cells to recapitulate critical aspects of tenogenesis and effectively direct the cells to differentiate and regenerate new tendon. Here, we review recent efforts to identify mechanical and chemical factors of embryonic tendon development to guide stem/progenitor cell differentiation toward new tendon formation, and discuss the role this work may have in the future of tendon tissue engineering.

  19. Delay in onset of metabolic alkalosis during regional citrate anti-coagulation in continous renal replacement therapy with calcium-free replacement solution

    Directory of Open Access Journals (Sweden)

    See Kay

    2009-01-01

    Full Text Available Regional citrate anti-coagulation for continuous renal replacement therapy chelates calcium to produce the anti- coagulation effect. We hypothesise that a calcium-free replacement solution will require less citrate and produce fewer metabolic side effects. Fifty patients, in a Medical Intensive Care Unit of a tertiary teaching hospital (25 in each group, received continuous venovenous hemofiltration using either calcium-containing or calcium-free replacement solutions. Both groups had no significant differences in filter life, metabolic alkalosis, hypernatremia, hypocalcemia, and hypercalcemia. However, patients using calcium-containing solution developed metabolic alkalosis earlier, compared to patients using calcium-free solution (mean 24.6 hours,CI 0.8-48.4 vs. 37.2 hours, CI 9.4-65, P = 0.020. When calcium-containing replacement solution was used, more citrate was required (mean 280ml/h, CI 227.2-332.8 vs. 265ml/h, CI 203.4-326.6, P = 0.069, but less calcium was infused (mean 21.2 ml/h, CI 1.2-21.2 vs 51.6ml/h, CI 26.8-76.4, P ≤ 0.0001.

  20. Experimental replacement of aragonite by hydroxyapatite

    Science.gov (United States)

    Kasioptas, A.; Perdikouri, C.; Geisler, T.; Putnis, A.

    2009-04-01

    Hydrothermal treatment of aragonite with (NH4)2HPO4 solution has been shown to produce hydroxyapatite (HAP) with an overall identical and thus pre-determined morphology (Kasioptas et al, 2008). The preservation of the morphology is an outcome of the pseudomorphic nature of this particular reaction. We have investigated the mechanism of the replacement of aragonite by HAP using single, natural, inorganic aragonite crystals. Isothermal experiments were carried out with small crystals placed and sealed in autoclaves with (NH4)2HPO4 solution. After the experiments the aragonite crystals are partly replaced by a new phase. X-ray powder diffraction confirmed that the product phase is indeed HAP; however electron microprobe measurements revealed that the HAP is probably non-stoichiometric. Even when completely converted to HAP, scanning electron microscopy showed that the fine-structure of the aragonite has perfectly been retained. It was also observed that the HAP product phase exhibited a high porosity and was separated from the aragonite parent phase by a sharp interface (on the micrometer scale). The replacement of aragonite by HAP in an aqueous solution can be described in terms of a coupled dissolution-reprecipitation mechanism that takes place at an inward moving reaction front (Putnis& Putnis, 2007). The porosity in the HAP product phase allows the solution to reach the reaction interface. In addition, we have performed experiments with (NH4)2HPO4 solutions prepared with H2O enriched with 97 at.% 18O. The solutions were pre-heated separately to equilibrate the oxygen isotopes in the solution. Raman spectroscopy of the HAP product was used to identify the different vibration modes in the PO43-molecule due to the exchange of 16O with 18O atoms. Apart from the main ?1(PO4) band located near 962 cm-1, we observed four new bands near 945, 931, 919 and 908 cm-1. We have attributed the generation of these new bands to four different degrees of 18O atomic substitutions in

  1. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  2. Mactaquac intake tendons removal and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, I. [NB Power Generation Corp., Mactaquac Generating Station, Keswick Ridge, NB (Canada); Mee, A. [Hatch Energy, Niagara Falls, ON (Canada)

    2007-07-01

    In 1988 and 1989, multi-strand tendons were installed in the intake structure of the Mactaquac generating station. In order to control displacements caused by alkali aggregate reaction (AAR), they were installed in preparation for a slot cutting program in the intake structure to guard against the possibility of a sliding failure of a section of the structure along a plane coincident with the bottom of the water passage. Unique problems for the designers were present in the expansion affect of AAR that were compounded by field conditions that resulted in further difficulties. For example, concrete expansion required the installation of a thick shim pack under the upper anchor head and the periodic testing of the tendons. Once tested, shims could be gradually removed to maintain the correct load over the life of the tendon. However, during the first round of testing and de-stressing five years after the original installation, it was found that some of the tendons had already failed. Over half of the tendons have been replaced in the 20 years since the installation. This paper discussed the original design considerations and examined the conditions that contributed to the premature failure of the tendons. It outlined the history of tendon testing procedures, tendon failure modes and tendon replacement methods. Specifically, the paper discussed the remedial techniques that were employed and the iterations that lead to the current repair approach, while considering the unique field conditions. The application of various corrosion protection schemes and installation and testing methodologies were discussed. It was concluded that tendons were successfully installed in numerous concrete dams around the world but have needed replacement for a variety of reasons. 1 ref., 10 figs.

  3. Turnley Unit

    Data.gov (United States)

    Federal Laboratory Consortium — Facilities at this unit include cattle working pens, hydraulic squeeze chute and electronic scale, a maintenance building, and four hay storage sheds. There is one...

  4. Operable Units

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of operable unit data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different times and...

  5. Detector Unit

    CERN Multimedia

    1960-01-01

    Original detector unit of the Instituut voor Kernfysisch Onderzoek (IKO) BOL project. This detector unit shows that silicon detectors for nuclear physics particle detection were already developed and in use in the 1960's in Amsterdam. Also the idea of putting 'strips' onto the silicon for high spatial resolution of a particle's impact on the detector were implemented in the BOL project which used 64 of these detector units. The IKO BOL project with its silicon particle detectors was designed, built and operated from 1965 to roughly 1977. Detector Unit of the BOL project: These detectors, notably the ‘checkerboard detector’, were developed during the years 1964-1968 in Amsterdam, The Netherlands, by the Natuurkundig Laboratorium of the N.V. Philips Gloeilampen Fabrieken. This was done in close collaboration with the Instituut voor Kernfysisch Onderzoek (IKO) where the read-out electronics for their use in the BOL Project was developed and produced.

  6. Tooth replacement and putative odontogenic stem cell niches in pharyngeal dentition of medaka (Oryzias latipes).

    Science.gov (United States)

    Abduweli, Dawud; Baba, Otto; Tabata, Makoto J; Higuchi, Kazunori; Mitani, Hiroshi; Takano, Yoshiro

    2014-04-01

    The small-sized teleost fish medaka, Oryzias latipes, has as many as 1000 pharyngeal teeth undergoing continuous replacement. In this study, we sought to identify the tooth-forming units and determine its replacement cycles, and further localize odontogenic stem cell niches in the pharyngeal dentition of medaka to gain insights into the mechanisms whereby continuous tooth replacement is maintained. Three-dimensional reconstruction of pharyngeal epithelium and sequential fluorochrome labeling of pharyngeal bones and teeth indicated that the individual functional teeth and their successional teeth were organized in families, each comprising up to five generations of teeth and successional tooth germs, and that the replacement cycle of functional teeth was approximately 4 weeks. BrdU label/chase experiments confirmed the existence of clusters of label-retaining epithelial cells at the posterior end of each tooth family where the expression of pluripotency marker Sox2 was confirmed by in situ hybridization. Label-retaining cells were also identified in the mesoderm immediately adjacent to the posterior end of each tooth family. These data suggest the importance of existence of slow-cycling dental epithelial cells and Sox2 expressions at the posterior end of each tooth family to maintain continuous tooth formation and replacement in the pharyngeal dentition of medaka.

  7. Alternatives to testosterone replacement: testosterone restoration

    Directory of Open Access Journals (Sweden)

    Andrew McCullough

    2015-04-01

    Full Text Available The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH.

  8. Sex hormone replacement in Turner syndrome

    DEFF Research Database (Denmark)

    Trolle, Christian; Hjerrild, Britta; Cleemann, Line Hartvig

    2012-01-01

    osteoporosis seen in Turner syndrome. But sex hormone insufficiency is also involved in the increased cardiovascular risk, state of physical fitness, insulin resistance, body composition, and may play a role in the increased incidence of autoimmunity. Severe morbidity and mortality affects females with Turner...... syndrome. Recent research emphasizes the need for proper sex hormone replacement therapy (HRT) during the entire lifespan of females with TS and new hypotheses concerning estrogen receptors, genetics and the timing of HRT offers valuable new information. In this review, we will discuss the effects...

  9. Immunoglobulin Replacement Therapy for Primary Immunodeficiency.

    Science.gov (United States)

    Sriaroon, Panida; Ballow, Mark

    2015-11-01

    Immunoglobulin replacement therapy has been standard treatment in patients with primary immunodeficiency diseases for the past 3 decades. The goal of therapy is to reduce serious bacterial infections in individuals with antibody function defects. Approximately one-third of patients receiving intravenous immunoglobulin treatment experience adverse reactions. Recent advances in manufacturing processes have resulted in products that are safer and better tolerated. Self-infusion by the subcutaneous route has become popular and resulted in better quality of life. This review summarizes the use of immunoglobulin therapy in primary immunodeficiency diseases including its properties, dosing, adverse effects, and different routes of administration.

  10. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...

  11. To learn more about BHT replacement

    CERN Document Server

    2002-01-01

    Following the article 'An improved financial tool to replace BHT' which appeared in Bulletin No 41/2002, dates of 4 general presentations were published. Please note that the time of the first presentation has changed from 16.00 hrs to 14.00 hrs. The dates/times are now as follows: Wednesday 16 October 14.00 hrs* IT Auditorium (English) *note change of time. Friday 18 October 16.00 hrs, SL Auditorium (French) Monday 21 October 10.00 hrs, LHC Auditorium (French) Wednesday 23 October 10.00 hrs, Council Chamber (English)

  12. Trials and Tribulations with VH Replacement.

    Science.gov (United States)

    Meng, Wenzhao; Jayaraman, Sahana; Zhang, Bochao; Schwartz, Gregory W; Daber, Robert D; Hershberg, Uri; Garfall, Alfred L; Carlson, Christopher S; Luning Prak, Eline T

    2014-01-01

    VH replacement (VHR) is a type of antibody gene rearrangement in which an upstream heavy chain variable gene segment (VH) invades a pre-existing rearrangement (VDJ). In this Hypothesis and Theory article, we begin by reviewing the mechanism of VHR, its developmental timing and its potential biological consequences. Then we explore the hypothesis that specific sequence motifs called footprints reflect VHR versus other processes. We provide a compilation of footprint sequences from different regions of the antibody heavy chain, and include data from the literature and from a high throughput sequencing experiment to evaluate the significance of footprint sequences. We conclude by discussing the difficulties of attributing footprints to VHR.

  13. Infective endocarditis following transcatheter aortic valve replacement-

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars

    2013-01-01

    Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

  14. Aortic Annular Enlargement during Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Selman Dumani

    2016-09-01

    Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

  15. Can electronic stability control replace studded tyres?

    Science.gov (United States)

    Elvik, Rune

    2015-12-01

    Based on recent studies, this paper examines whether an increased use of electronic stability control can replace studded tyres. A re-analysis of a study that evaluated the effects on accidents of changes in the use of studded tyres in major cities in Norway is presented. It is found that if all cars have electronic stability control, the use of studded tyres can be reduced to about 15 percent before any increase in the number of accidents occurs. Even if studded tyres were eliminated entirely, any increase in the number of accidents is likely to be considerably smaller than it would have been if electronic stability control had never been invented.

  16. Replacing the Beam Dump at the Booster

    CERN Multimedia

    2013-01-01

    The PS Booster Dump, designed in the 1960’s to cope with beam energies in the order of 800 MeV, has been dismantled and replaced with a new one, capable of withstanding the 2 GeV beam provided by the upcoming LINAC4 at CERN. This video shows the installation of that new dump core inside a one-metre diameter cavity, surrounded by five shielding rings made of concrete and steel. It is the culmination of months of preparation, an interdisciplinary work involving several teams from the Engineering, Beams and Technology Departments, as well as the collaboration and supervision of radio-protection experts.

  17. Replacing the Beam Dump at the Booster

    CERN Multimedia

    2013-01-01

    The PS Booster Dump, designed in the 1960’s to cope with beam energies in the order of 800 MeV, has been dismantled and replaced with a new one, capable of withstanding the 2 GeV beam provided by the upcoming LINAC4 at CERN. This video shows the installation of that new dump core inside a one-metre diameter cavity, surrounded by five shielding rings made of concrete and steel. It is the culmination of months of preparation, an interdisciplinary work involving several teams from the Engineering, Beams and Technology Departments, as well as the collaboration and supervision of radio-protection experts.

  18. Prosthetic replacement of the medial meniscus in cadaveric knees: does the prosthesis mimic the functional behavior of the native meniscus?

    NARCIS (Netherlands)

    Tienen, T.G. van; Verdonschot, N.J.J.; Heijkants, R.G.J.C.; Buma, P.; Scholten, J.G.; Kampen, A. van; Veth, R.P.H.

    2004-01-01

    Meniscus replacement by a polymer meniscus prosthesis in dogs resulted in generation of new meniscal tissue. HYPOTHESIS: Optimal functioning of the prosthesis would involve realistic deformation and motion patterns of the prosthesis during knee joint motion. STUDY DESIGN: Controlled laboratory study

  19. Prosthetic replacement of the medial meniscus in cadaveric knees - Does the prosthesis mimic the functional behavior of the native meniscus?

    NARCIS (Netherlands)

    Tienen, TG; Verdonschot, N; Heijkants, RGJC; Buma, R; Scholten, JGF; van Kampen, A; Veth, RPH

    2004-01-01

    Meniscus replacement by a polymer meniscus prosthesis in dogs resulted in generation of new meniscal tissue. Hypothesis: Optimal functioning of the prosthesis would involve realistic deformation and motion patterns of the prosthesis during knee joint motion. Study Design: Controlled laboratory study

  20. Engineering Complex Orthopaedic Tissues via Strategic Biomimicry

    Science.gov (United States)

    Qu, Dovina; Mosher, Christopher Z.; Boushell, Margaret K.; Lu, Helen H.

    2014-01-01

    The primary current challenge in regenerative engineering resides in the simultaneous formation of more than one type of tissue, as well as their functional assembly into complex tissues or organ systems. Tissue-tissue synchrony is especially important in the musculoskeletal system, whereby overall organ function is enabled by the seamless integration of bone with soft tissues such as ligament, tendon, or cartilage, as well as the integration of muscle with tendon. Therefore, in lieu of a traditional single-tissue system (e.g. bone, ligament), composite tissue scaffold designs for the regeneration of functional connective tissue units (e.g. bone-ligament-bone) are being actively investigated. Closely related is the effort to re-establish tissue-tissue interfaces, which is essential for joining these tissue building blocks and facilitating host integration. Much of the research at the forefront of the field has centered on bioinspired stratified or gradient scaffold designs which aim to recapitulate the structural and compositional inhomogeneity inherent across distinct tissue regions. As such, given the complexity of these musculoskeletal tissue units, the key question is how to identify the most relevant parameters for recapitulating the native structure-function relationships in the scaffold design. Therefore, the focus of this review, in addition to presenting the state-of-the-art in complex scaffold design, is to explore how strategic biomimicry can be applied in engineering tissue connectivity. The objective of strategic biomimicry is to avoid over-engineering by establishing what needs to be learned from nature and defining the essential matrix characteristics that must be reproduced in scaffold design. Application of this engineering strategy for the regeneration of the most common musculoskeletal tissue units (e.g. bone-ligament-bone, muscle-tendon-bone, cartilage-bone) will be discussed in this review. It is anticipated that these exciting efforts will

  1. Engineering complex orthopaedic tissues via strategic biomimicry.

    Science.gov (United States)

    Qu, Dovina; Mosher, Christopher Z; Boushell, Margaret K; Lu, Helen H

    2015-03-01

    The primary current challenge in regenerative engineering resides in the simultaneous formation of more than one type of tissue, as well as their functional assembly into complex tissues or organ systems. Tissue-tissue synchrony is especially important in the musculoskeletal system, wherein overall organ function is enabled by the seamless integration of bone with soft tissues such as ligament, tendon, or cartilage, as well as the integration of muscle with tendon. Therefore, in lieu of a traditional single-tissue system (e.g., bone, ligament), composite tissue scaffold designs for the regeneration of functional connective tissue units (e.g., bone-ligament-bone) are being actively investigated. Closely related is the effort to re-establish tissue-tissue interfaces, which is essential for joining these tissue building blocks and facilitating host integration. Much of the research at the forefront of the field has centered on bioinspired stratified or gradient scaffold designs which aim to recapitulate the structural and compositional inhomogeneity inherent across distinct tissue regions. As such, given the complexity of these musculoskeletal tissue units, the key question is how to identify the most relevant parameters for recapitulating the native structure-function relationships in the scaffold design. Therefore, the focus of this review, in addition to presenting the state-of-the-art in complex scaffold design, is to explore how strategic biomimicry can be applied in engineering tissue connectivity. The objective of strategic biomimicry is to avoid over-engineering by establishing what needs to be learned from nature and defining the essential matrix characteristics that must be reproduced in scaffold design. Application of this engineering strategy for the regeneration of the most common musculoskeletal tissue units (e.g., bone-ligament-bone, muscle-tendon-bone, cartilage-bone) will be discussed in this review. It is anticipated that these exciting efforts will

  2. The effect of fat replacers on batter and cake properties.

    Science.gov (United States)

    Psimouli, Vassiliki; Oreopoulou, Vassiliki

    2013-10-01

    Fat was replaced at 35% to 100% in cakes by maltodextrin (dextrose equivalent = 3), inulin (high performance and granulated), oligofructose, citrus pectin, and microparticulated protein. Fat replacement by 35% did not induce significant differences in general. Above 65% fat replacement resulted in statistically significant (P < 0.05) decreased viscosity (except for pectin) that was followed by statistically significant decrease in air incorporation and broader bubble size distribution. The starch gelatinization temperature showed a statistically significant increase when fat was replaced by fructose oligosaccharides. The cakes presented statistically significant increase of hardness, elasticity, and decrease of volume development as fat replacement increased above 65%. Also cakes with increased fat replacement received lower scores on taste and flavor, whereas at total fat replacement they were evaluated as not acceptable. Nevertheless, at 65% fat replacement, the samples presented acceptable textural, physical, and sensorial attributes. © 2013 Institute of Food Technologists®

  3. The use of limestone powder as an alternative cement replacement ...

    African Journals Online (AJOL)

    The use of limestone powder as an alternative cement replacement material: An ... The laboratory test results revealed that up to 15% replacement of clinker by fine ... Early strength, Limestone filler, Loss on ignition, Portland limestone cement ...

  4. Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder

    Science.gov (United States)

    ... 1999 Spotlight on Research 2014 February 2014 (historical) Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder Replacing a protein that is crucial to ensuring that the skin’s ...

  5. Tissue reaction around loosened prostheses: a histological, X-ray microanalytic and immunological study.

    Directory of Open Access Journals (Sweden)

    Hayashi,Takashi

    1986-10-01

    Full Text Available Tissue reactions at the cement-bone and artificial implant-bone interface were examined light and electron microscopically in thirty-six patients who underwent revisory operation of hip or knee replacement. The reactions were classified into three types: inert tissue, active tissue with giant cell proliferation, and active tissue with predominant foamy cell proliferation. The third type of reaction was found only in total hip replacement with bone cement. No evidence of allergic reaction to implanted materials was found in any replacement, though active cellular infiltrations were observed around loosened prostheses especially in cemented arthroplasty. The tissue reactions always occurred around instable or loosened prostheses. Thus, the present study shows that mechanical instability is the primary cause of such undesired tissue reactions.

  6. Cardiovascular implantable electronic device replacement infections and prevention: results from the REPLACE Registry.

    Science.gov (United States)

    Uslan, Daniel Z; Gleva, Marye J; Warren, David K; Mela, Theofanie; Chung, Mina K; Gottipaty, Venkateshwar; Borge, Richard; Dan, Dan; Shinn, Timothy; Mitchell, Kevin; Holcomb, Richard G; Poole, Jeanne E

    2012-01-01

    Infection following cardiovascular implantable electronic device (CIED) replacement is a serious complication, and rates of infection have increased. Analysis of procedural and clinical data from device replacement procedures collected by the REPLACE Registry may provide insights into infection prevention strategies and outcomes. We prospectively evaluated procedural complications in patients undergoing CIED replacement over 6 months from 72 U.S. sites. Major and minor infections were predefined and adjudicated by an independent blinded clinical events committee. Data regarding infection prevention strategies and infectious outcomes were analyzed for their potential relationships. A total of 1,744 patients were included in REPLACE. All patients received preoperative intravenous antibiotics and 68.7% received postoperative systemic antibiotic therapy. CIED infection developed in 22 patients (1.3%), of which 14 cases were major (0.8%, 95% confidence interval [CI] 0.4%-1.3%) and eight were minor (0.5%, 95% CI 0.2%-0.9%). Patients with infections were more likely to have had postoperative hematomas (five of 22 [22.7%] vs 17 of 1,722 [0.98%], P = 0.002). Participating sites experiencing infection rates >5% were more likely to use povidone-iodine for topical antisepsis, had lower implantation volume, and had patients with higher Charlson Comorbidity Index (2.79 vs 2.32, 95% CI for difference 0.08-0.86, P = 0.019). In this multicenter prospective study with 6 months of follow-up, infections associated with CIED replacements were surprisingly infrequent, possibly due to the use of preoperative antibiotics. Patients with infections were more likely to have had a postoperative hematoma, and sites with higher infection rates had sicker patients and lower overall procedural volume. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

  7. Undifferentiated Connective Tissue Disease

    Science.gov (United States)

    ... Home Conditions Undifferentiated Connective Tissue Disease (UCTD) Undifferentiated Connective Tissue Disease (UCTD) Make an Appointment Find a Doctor ... L. Goldstein, MD, MMSc (February 01, 2016) Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune disease. This ...

  8. Property Assessment of Sponge Cake Added with Egg Replacer

    OpenAIRE

    Yaqiang He; Linlin Wang; Qian Lu

    2015-01-01

    Chicken egg which is always used in sponge cake production is likely to deteriorate during storage or transportation. This weakness prevents the wide use of chicken egg in sponge cake making. In order to solve this problem, egg replacer has been developed. In this study, effect of egg replacer on the property of sponge cake was analyzed. The result indicated egg replacer could improve the yield rate and specific volume of sponge cake. However, high content of egg replacer would negatively imp...

  9. Biomimetic material strategies for cardiac tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Prabhakaran, Molamma P., E-mail: nnimpp@nus.edu.sg [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Venugopal, J. [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Kai, Dan [NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore (Singapore); Ramakrishna, Seeram [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore)

    2011-04-08

    Cardiovascular disease precedes many serious complications including myocardial infarction (MI) and it remains a major problem for the global community. Adult mammalian heart has limited ability to regenerate and compensate for the loss of cardiomyocytes. Restoration of cardiac function by replacement of diseased myocardium with functional cardiomyocytes is an intriguing strategy because it offers a potential cure for MI. Biomaterials are fabricated in nanometer scale dimensions by combining the chemical, biological, mechanical and electrical aspects of material for potential tissue engineering (TE) applications. Synthetic polymers offer advantageous in their ability to tailor the mechanical properties, and natural polymers offer cell recognition sites necessary for cell, adhesion and proliferation. Cardiac tissue engineering (TE) aim for the development of a bioengineered construct that can provide physical support to the damaged cardiac tissue by replacing certain functions of the damaged extracellular matrix and prevent adverse cardiac remodeling and dysfunction after MI. Electrospun nanofibers are applied as heart muscle patches, while hydrogels serve as a platform for controlled delivery of growth factors, prevent mechanical complications and assist in cell recruitment. This article reviews the applications of different natural and synthetic polymeric materials utilized as cardiac patches, injectables or 3D constructs for cardiac TE. Smart organization of nanoscale assemblies with synergistic approaches of utilizing nanofibers and hydrogels could further advance the field of cardiac tissue engineering. Rapid innovations in biomedical engineering and cell biology will bring about new insights in the development of optimal scaffolds and methods to create tissue constructs with relevant contractile properties and electrical integration to replace or substitute the diseased myocardium.

  10. Transdermal testosterone replacement therapy in men.

    Science.gov (United States)

    Ullah, M Iftekhar; Riche, Daniel M; Koch, Christian A

    2014-01-01

    Androgen deficiency syndrome in men is a frequently diagnosed condition associated with clinical symptoms including fatigue, decreased libido, erectile dysfunction, and metabolic syndrome. Serum testosterone concentrations decline steadily with age. The prevalence of androgen deficiency syndrome in men varies depending on the age group, known and unknown comorbidities, and the respective study group. Reported prevalence rates may be underestimated, as not every man with symptoms of androgen deficiency seeks treatment. Additionally, men reporting symptoms of androgen deficiency may not be correctly diagnosed due to the vagueness of the symptom quality. The treatment of androgen deficiency syndrome or male hypogonadism may sometimes be difficult due to various reasons. There is no consensus as to when to start treating a respective man or with regards to the best treatment option for an individual patient. There is also lack of familiarity with treatment options among general practitioners. The formulations currently available on the market are generally expensive and dose adjustment protocols for each differ. All these factors add to the complexity of testosterone replacement therapy. In this article we will discuss the general indications of transdermal testosterone replacement therapy, available formulations, dosage, application sites, and recommended titration schedule.

  11. Testosterone replacement therapy in obese males.

    Science.gov (United States)

    Drewa, Tomasz; Olszewska-Słonina, Dorota; Chlosta, Piotr

    2011-01-01

    Controversy surrounds testosterone replacement therapy in obese ageing due to no generally accepted lower limits of normal testosterone level and high prevalence of hypogonadal symptoms in the ageing male population and the non-specific nature of these symptoms. Late onset hypogonadism is a clinical and biochemical syndrome associated with advancing age, often coexisting with obesity and metabolic syndrome. High fat and carbohydrates (fructose) consumption is responsible for development of obesity and metabolic syndrome which is one of risk factors for hypogonadism in older men. High fructose intake has been shown to cause dyslipidemia and to impair hepatic insulin sensitivity. Obesity and lack of physical activity negatively influence testosterone level. Low testosterone level should be regarded as an effect of obesity, but reverse relationship has not been proved yet. The management of late-onset hypogonadism symptoms has to be treated by a change of a life style and prevented with healthy nutrition and physical activity. The question related to rational indications for testosterone replacement therapy in obese males seems to be still actual.

  12. An improved financial tool to replace BHT

    CERN Multimedia

    2002-01-01

    In November, the BHT tool used to control financial data will be replaced by an improved and more powerful system, called CET for CERN Expenditure Tracking. The team in charge of CET. From left to right, sitting, Martyn Rankin, David McGlashan, standing, Per Gunnar Jonsson, James Purvis and Mikael Angberg. After 10 years of BHT at CERN, in order to face the challenges of the LHC era, and following the recommendations of the External Review Committee, the BHT application will be replaced by an improved and more powerful expenditure tracking tool called CET for CERN Expenditure Tracking. For those who are not familiar with it, the BHT, Budget Holders Toolkit, is a utility that provides a way to view CERN financial data. It is available for users who have access to at least one budget code. The new CET represents a tool that not only allows powerful analysis of the past, but also assists in forecasting the future. CET will offer significantly more functionality than BHT, including extended contract analysis, ...

  13. LS1 Report: Replacing an antique

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    At the PS Booster, the old beam dump and the shielding blocks surrounding it have been removed (see here). Installation of the new beam dump is now under way (see video).   The new PSB beam dump during its installation. At the PS, replacement of the old cooling and ventilation system, which dated back to 1957, is progressing well. The dismantling phase has just been completed and the tunnel is being prepared to receive a brand new ventilation system offering more efficient aeration of radioactive areas. At the same time, testing of the newly installed access system is under way. At the SPS, all the equipment of the Long Straight Section 1 (LSS1) has been removed to make way for the campaign to replace the irradiated cables, which started this week. In the LHC, the Radiation to Electronics (R2E) campaign is still progressing at a good clip, especially at Point 1, where the teams are two and a half months ahead of schedule. The Superconducting Magnets and Circuits Consolidation (SMACC) proje...

  14. Toward replacement fertility in Egypt and Tunisia.

    Science.gov (United States)

    Eltigani, Eltigani E

    2009-09-01

    Egypt and Tunisia began their fertility transition at almost identical fertility levels and at roughly the same time period, yet the difference in the pace of decline has been such that the total fertility rate (TFR) in Tunisia reached replacement level by the year 2001, whereas the TFR in Egypt remains above three live births per woman. This article draws on the secondary literature and on several nationally representative surveys from the two countries between 1978 and 2005 to provide empirical evidence of the difference in the pace of fertility decline and to analyze the determinants of the differential. Findings include (a) variation across the two countries in the consistency of fertility decline among the segments of the population leading the transition; (b) that the success of each country's family planning program was influenced by the role of political leaders and the extent of the program's integration within socioeconomic development objectives; (c) that the impact of contraception on TFR decline became an important factor in the mid-1980s; and (d) that the greatest determinant of the discrepancy in the pace of fertility decline is the disparity in age at marriage, which rose more significantly in Tunisia than in Egypt. The latter finding indicates that reaching replacement fertility in Egypt hinges primarily on further declines in marital fertility, resulting from reduction of wanted fertility and from an expansion of family planning program coverage and improved efficiency of service delivery and use.

  15. Hypoparathyroidism: Replacement Therapy with Parathyroid Hormone

    Directory of Open Access Journals (Sweden)

    Lars Rejnmark

    2015-12-01

    Full Text Available Hypoparathyroidism (HypoPT is characterized by low serum calcium levels caused by an insufficient secretion of parathyroid hormone (PTH. Despite normalization of serum calcium levels by treatment with activated vitamin D analogues and calcium supplementation, patients are suffering from impaired quality of life (QoL and are at increased risk of a number of comorbidities. Thus, despite normalization of calcium levels in response to conventional therapy, this should only be considered as an apparent normalization, as patients are suffering from a number of complications and calcium-phosphate homeostasis is not normalized in a physiological manner. In a number of recent studies, replacement therapy with recombinant human PTH (rhPTH(1-84 as well as therapy with the N-terminal PTH fragment (rhPTH(1-34 have been investigated. Both drugs have been shown to normalize serum calcium while reducing needs for activated vitamin D and calcium supplements. However, once a day injections cause large fluctuations in serum calcium. Twice a day injections diminish fluctuations, but don't restore the normal physiology of calcium homeostasis. Recent studies using pump-delivery have shown promising results on maintaining normocalcemia with minimal fluctuations in calcium levels. Further studies are needed to determine whether this may improve QoL and lower risk of complications. Such data are needed before replacement with the missing hormone can be recommended as standard therapy.

  16. Concomitant aortic valve replacement and myocardial revascularization.

    Science.gov (United States)

    Craver, J M; Jones, E L; Hatcher, C R; Farmer, J H

    1977-01-01

    Twenty-six consecutive patients underwent combined aortic valve replacement and myocardial revascularization at the Emory University Affiliated Hospitals between May, 1973 and March, 1976. Acute myocardial infarction resulted in two operative deaths (8%). There have been four late deaths, all Class IV preoperative. The age range was 37 to 79 years with an average age of 60. Preoperatively all patients were Class IV or late Class III. Twenty-three patients had symptoms of angina pectoris; congestive heart failure was evident in 56%. Postoperatively, 70% are now Class 1 or II. Single coronary bypass was performed in 16 patients, double in 6, and triple in three. Double bypass plus mitral valve replacement was required in two with aneurysmectomy in one. The rate of intraoperative infarction was 27% for the series but only 7% in the last year. The methods of intraoperative myocardial preservation and the technical approach for the operative procedures were variable. Results with each method are correlated, and currently preferred techniques are presented and discussed. Best results were obtained in patients who presented early in their symptomatic course with isolated proximal coronary lesions and good renoff vessels. Excellent results could be achieved despite advanced age of patients, requirement for multiple bypass grafts, and correction of other associated cardiac lesions. Poorest results were obtained when long-standing ventricular failure was combined with poor vessels distal to coronary stenoses. PMID:860881

  17. BABAR IFR Replacement R and D

    CERN Document Server

    Berry, M

    2003-01-01

    The Instrumented Flux Return (IFR) of the BaBar detector will soon need to be replaced by a more robust muon detection system. Scintillator bars with embedded Wavelength Shifting (WLS) fibers and Limited Streamer Tubes are two replacement technology options. The scintillator bars are tested for attenuation length; and causes for the large width of the Photo Multiplier Tube (PMT) signal are analyzed by Monte Carlo simulation. Cooling techniques for Avalanche Photo Diodes (APD) are investigated. The fairly high attenuation length coupled with the narrow PMT signal make the scintillator a viable option for a muon detecting system. Continuing work will focus on increasing timing resolution using an APD to read the signal from the WLS fibers, and investigating the lifetime of the APD. The ability to read a signal from the LST on external copper strips is tested and signals are found to be clearly distinguishable from noise. The voltage is compared to count rate to find that the optimal operating voltage for the LS...

  18. Limitations to fluid replacement during exercise.

    Science.gov (United States)

    Maughan, R J; Leiper, J B

    1999-04-01

    Fluid replacement during exercise is essential for endurance exercise performance and reducing the risk of heat illness. Fluids supply water, which ameliorates dehydration, and also substrate for the working muscles. Absorption of water and nutrients occurs in the upper part of the small intestine, and replacement may be limited by the rate at which fluid is emptied from the stomach or absorbed in the intestine. Gastric emptying of liquids is influenced primarily by the volume of fluid in the stomach and by its energy density. Increasing the volume will speed emptying, but increasing the nutrient content will slow emptying. Osmolality, temperature, and pH of drinks, as well as exercise intensity, are of minor importance. Intestinal water absorption is a passive process: water follows osmotic gradients but will also follow the active absorption of nutrients, especially glucose, which is actively co-transported with sodium. Water transport is maximised by the presence in the intestine of hypotonic solutions of glucose and sodium. Hypertonic solutions promote net water secretion into the intestinal lumen, resulting in a temporary net loss of water from the body. The amount of fluid ingested by athletes is normally much less than can be tolerated, therefore issues such as palatability and practising drinking during training are important.

  19. Neutron scattering at Australia's replacement research reactor

    Science.gov (United States)

    Robinson, R. A.; Kennedy, S. J.

    2002-01-01

    On August 25 1999, the Australian government gave final approval to build a research reactor to replace the existing HIFAR reactor at Lucas Heights. The replacement reactor, which will commence operation in 2005, will be multipurpose in function, with capabilities for both neutron-beam research and radioisotope production. Regarding beams, cold and thermal neutron sources are to be installed and the intent is to use supermirror guides, with coatings with critical angles up to 3 times that of natural Ni, to transport cold and thermal neutron beams into a large modern guide hall. The reactor and all the associated infrastructure, with the exception of the neutron beam instruments, is to be built by INVAP, SE and subcontractors in a turnkey contract. The goal is to have at least eight leading-edge neutron-beam instruments ready in 2005, and they will be developed by ANSTO and other contracted organisations, in consultation with the Australian user community and interested overseas parties. A review of the planned scientific capabilities, a description of the facility and a status report on the activities so far is given.

  20. Construction of Tissue Engineering Artificial Cornea with Skin Stem Cells

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    1 IntroductionThe clinical need for an alternative to donor corneal tissue has encouraged much interests in recent years. An artificial cornea must fulfill the functions of the cornea it replaces. More recently, the idea of a bio-engineered cornea has risen. Corneal equivalents have been reconstructed by tissue engineering method. Aim of this study is to construct an artificial rabbit cornea by employing tissue engineering method and to determine if skin stem cells have a role in tissue engineered cornea co...

  1. Biodegradable and biocompatible polymers for tissue engineering application: a review.

    Science.gov (United States)

    Asghari, Fatemeh; Samiei, Mohammad; Adibkia, Khosro; Akbarzadeh, Abolfazl; Davaran, Soodabeh

    2017-03-01

    Since so many years ago, tissue damages that are caused owing to various reasons attract scientists' attention to find a practical way to treat. In this regard, many studies were conducted. Nano scientists also suggested some ways and the newest one is called tissue engineering. They use biodegradable polymers in order to replace damaged structures in tissues to make it practical. Biodegradable polymers are dominant scaffolding materials in tissue engineering field. In this review, we explained about biodegradable polymers and their application as scaffolds.

  2. Laser Tissue Welding - Poised for the New Millenium.

    Science.gov (United States)

    Poppas, Dix P; Rucker, G Bino; Scherr, Douglas S

    2000-10-01

    Laser tissue welding is a relatively new technique, which was initially described only about 30 years ago. Over the past 10 years, the implementation of protein solders has redefined the field. Alternative methods of wound closure and of tissue approximation have been quickly accepted in clinical medicine. The techniques and theory involved in performing laser tissue welding may soon be essential knowledge for all surgeons. Just as laparoscopy has become a mainstay for general surgeons and urologists, novel mechanisms of tissue approximation will continue to replace older, less efficacious techniques.

  3. Optical Coherence Tomography in Tissue Engineering

    Science.gov (United States)

    Zhao, Youbo; Yang, Ying; Wang, Ruikang K.; Boppart, Stephen A.

    Tissue engineering holds the promise for a therapeutic solution in regenerative medicine. The primary goal of tissue engineering is the development of physiologically functional and biocompatible tissues/organs being implanted for the repair and replacement of damaged or diseased ones. Given the complexity in the developing processes of engineered tissues, which involves multi-dimensional interactions among cells of different types, three-dimensionally constructed scaffolds, and actively intervening bioreactors, a capable real-time imaging tool is critically required for expanding our knowledge about the developing process of desired tissues or organs. It has been recognized that optical coherence tomography (OCT), an emerging noninvasive imaging technique that provides high spatial resolution (up to the cellular level) and three-dimensional imaging capability, is a promising investigative tool for tissue engineering. This chapter discusses the existing and potential applications of OCT in tissue engineering. Example OCT investigations of the three major components of tissue engineering, i.e., cells, scaffolds, and bioreactors are overviewed. Imaging examples of OCT and its enabling functions and variants, e.g., Doppler OCT, polarization-sensitive OCT, optical coherence microscopy are emphasized. Remaining challenges in the application of OCT to tissue engineering are discussed, and the prospective solutions including the combination of OCT with other high-contrast and high-resolution modalities such as two-photon fluorescence microscopy are suggested as well. It is expected that OCT, along with its functional variants, will make important contributions toward revealing the complex cellular dynamics in engineered tissues as well as help us culture demanding tissue/organ implants that will advance regenerative medicine.

  4. Lineage plasticity and cell biology of fibrocartilage and hyaline cartilage: Its significance in cartilage repair and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Freemont, Anthony J. [Regenerative Medicine Research Group, University of Manchester, England (United Kingdom)]. E-mail: Tony.freemont@man.ac.uk; Hoyland, Judith [Regenerative Medicine Research Group, University of Manchester, England (United Kingdom)

    2006-01-15

    Cartilage repair is a major goal of modern tissue engineering. To produce novel engineered implants requires a knowledge of the basic biology of the tissues that are to be replaced or reproduced. Hyaline articular cartilage and meniscal fibrocartilage are two tissues that have excited attention because of the frequency with which they are damaged. A basic strategy is to re-engineer these tissues ex vivo by stimulating stem cells to differentiate into the cells of the mature tissue capable of producing an intact functional matrix. In this brief review, the sources of cells for tissue engineering cartilage and the culture conditions that have promoted differentiation are discussed within the context of natural cartilage repair. In particular, the role of cell density, cytokines, load, matrices and oxygen tension are discussed.

  5. 48 CFR 908.7101-4 - Replacement of motor vehicles.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Replacement of motor....7101-4 Replacement of motor vehicles. (a) The replacement of motor vehicles shall be in accordance with... Heads of Contracting Activities may arrange to sell, as exchange sales, used motor vehicles...

  6. 21 CFR 874.3450 - Partial ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Partial ossicular replacement prosthesis. 874.3450 Section 874.3450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A partial ossicular replacement prosthesis is a device intended...

  7. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A total ossicular replacement prosthesis is a device intended...

  8. 21 CFR 870.3710 - Pacemaker repair or replacement material.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker repair or replacement material. 870.3710... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3710 Pacemaker repair or replacement material. (a) Identification. A pacemaker repair or replacement material is an...

  9. 14 CFR 21.9 - Replacement and modification articles.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Replacement and modification articles. 21.9... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS General § 21.9 Replacement and modification articles. (a) If a person knows, or should know, that a replacement or modification article is reasonably likely to...

  10. Human tissue valves in aortic position: determinants of reoperation and valve regurgitation

    NARCIS (Netherlands)

    T.P. Willems (Tineke); E.W. Steyerberg (Ewout); V.E. Kleyburg-Linkers; E. Bos (Egbert); L.A. van Herwerden (Lex); J.R.T.C. Roelandt (Jos); J.J.M. Takkenberg (Hanneke)

    2001-01-01

    textabstractBACKGROUND: Human tissue valves for aortic valve replacement have a limited durability that is influenced by interrelated determinants. Hierarchical linear modeling was used to analyze the relation between these determinants of durability and valve

  11. Adipose and mammary epithelial tissue engineering.

    Science.gov (United States)

    Zhu, Wenting; Nelson, Celeste M

    2013-01-01

    Breast reconstruction is a type of surgery for women who have had a mastectomy, and involves using autologous tissue or prosthetic material to construct a natural-looking breast. Adipose tissue is the major contributor to the volume of the breast, whereas epithelial cells comprise the functional unit of the mammary gland. Adipose-derived stem cells (ASCs) can differentiate into both adipocytes and epithelial cells and can be acquired from autologous sources. ASCs are therefore an attractive candidate for clinical applications to repair or regenerate the breast. Here we review the current state of adipose tissue engineering methods, including the biomaterials used for adipose tissue engineering and the application of these techniques for mammary epithelial tissue engineering. Adipose tissue engineering combined with microfabrication approaches to engineer the epithelium represents a promising avenue to replicate the native structure of the breast.

  12. miR-965 controls cell proliferation and migration during tissue morphogenesis in the Drosophila abdomen

    DEFF Research Database (Denmark)

    Verma, Pushpa; Cohen, Stephen M

    2015-01-01

    Formation of the Drosophila adult abdomen involves a process of tissue replacement in which larval epidermal cells are replaced by adult cells. The progenitors of the adult epidermis are specified during embryogenesis and, unlike the imaginal discs that make up the thoracic and head segments...

  13. Design and fabrication of new ceramic-metal composites (biocermets) for hard tissue replacement applications

    OpenAIRE

    Smirnov, Anton

    2016-01-01

    Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias, Departamento de Física Aplicada. Fecha de lectura: 17 de marzo de 2016 Hasta la fecha los biomateriales utilizados en implantes estructurales han sido seleccionados por sus propiedades mecánicas y por tener una influencia nula o muy pequeña en los tejidos vivos que los rodean. Estos materiales satisfacen exclusivamente las condiciones de carga impuestas en entornos fisiológicos pero no reproducen fielm...

  14. A low percentage of autologous serum can replace bovine serum to engineer human nasal cartilage

    Directory of Open Access Journals (Sweden)

    F Wolf

    2008-02-01

    Full Text Available For the generation of cell-based therapeutic products, it would be preferable to avoid the use of animal-derived components. Our study thus aimed at investigating the possibility to replace foetal bovine serum (FBS with autologous serum (AS for the engineering of cartilage grafts using expanded human nasal chondrocytes (HNC. HNC isolated from 7 donors were expanded in medium containing 10% FBS or AS at different concentrations (2%, 5% and 10% and cultured in pellets using serum-free medium or in Hyaff®-11 meshes using medium containing FBS or AS. Tissue forming capacity was assessed histologically (Safranin O, immunohistochemically (type II collagen and biochemically (glycosaminoglycans -GAG- and DNA. Differences among experimental groups were assessed by Mann Whitney tests. HNC expanded under the different serum conditions proliferated at comparable rates and generated cartilaginous pellets with similar histological appearance and amounts of GAG. Tissues generated by HNC from different donors cultured in Hyaff®-11 had variable quality, but the accumulated GAG amounts were comparable among the different serum conditions. Staining intensity for collagen type II was consistent with GAG deposition. Among the different serum conditions tested, the use of 2% AS resulted in the lowest variability in the GAG contents of generated tissues. In conclusion, a low percentage of AS can replace FBS both during the expansion and differentiation of HNC and reduce the variability in the quality of the resulting engineered cartilage tissues.

  15. Apparent Skin Discoloration about the Knee Joint: A Rare Sequela of Metallosis after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Narlaka Jayasekera

    2015-01-01

    Full Text Available Introduction. Metallosis is a phenomenon most commonly associated with hip replacement. However it can occur in any metallic implant subject to wear. Wear creates metal debris, which is deposited in the surrounding soft tissue. This leads to many local adverse reactions including, but not limited to, implant loosening/osteolysis, pain, and effusion. In the deeper joints, for example, the hip, metal deposits are mostly only seen intraoperatively. Case Study. A 74-year-old lady represented to orthopaedic outpatient clinic. Her principle complaint was skin discolouration, associated with pain and swelling over the left knee, on the background of a previous total knee replacement with a metal backed patella resurfacing six years. A plain radiograph revealed loosening of the patellar prosthesis. A diagnosis of metallosis was made; the patient underwent debridement of the stained soft tissue and primary revision of the prosthesis. She remained symptom-free five years after revision. Discussion. Metallosis results in metallic debris which causes tissue staining, often hidden within the soft tissue envelope of the hip, but more apparent in the knee. Metallosis may cause pain, effusion, and systemic symptoms because of raised levels of serum-metal ions. Surgical intervention with revision and debridement can have good functional results.

  16. Conjunctival Changes in Wearers of Frequent Replacement Hydrogel and Frequent Replacement Silicone Hydrogel Contact Lenses: Comparison Using Impression Cytology Technique

    Directory of Open Access Journals (Sweden)

    Rukiye Aydın FEBO

    2014-01-01

    Full Text Available Objectives: To compare the level of conjunctival changes using conjunctival impression cytology in wearers of frequent replacement hydrogel (FRHL and frequent replacement silicone hydrogel contact lens FRSHL. Materials and Methods: Forty-two contact lens users who were seen at the Cornea and Contact Lens Unit, Department of Ophthalmology, Dokuz Eylül University were evaluated in this study. The first group consisted of wearers of FRHL used for minimum one year and maximum five years. The second group consisted of wearers who used FRSHL for minimum one year and maximum 5 years. Twenty healthy individuals with no contact lens history were included in the control group. Conjunctival impression cytology was applied to all contact lens users and the control group in order to evaluate the conjunctival changes, and the results of impression cytology were graded by the Nelson’s method. Results: In the comparison of the groups according to impression cytology scoring, there was no difference between the users of FRHL and FRSHL. Similar amounts of squamous metaplasia and goblet cell loss were encountered in both groups. Nonetheless, impression cytology grading was significantly lower in the control group than in the other two groups. Conclusion: In conclusion, the use of FRHL and FRSHL for over a year causes some histological changes in the conjunctiva such as squamous metaplasia and goblet cell loss eventually leading to dry eye symptoms. However, no differences were determined between FRHL and FRSHL users with regard to severity of conjunctival changes. (Turk J Ophthalmol 2014; 44: 47-52

  17. Intrahost Evolution of Methicillin-Resistant Staphylococcus aureus USA300 Among Individuals With Reoccurring Skin and Soft-Tissue Infections.

    Science.gov (United States)

    Azarian, Taj; Daum, Robert S; Petty, Lindsay A; Steinbeck, Jenny L; Yin, Zachary; Nolan, David; Boyle-Vavra, Susan; Hanage, W P; Salemi, Marco; David, Michael Z

    2016-09-15

    Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is the leading cause of MRSA infections in the United States and has caused an epidemic of skin and soft-tissue infections. Recurrent infections with USA300 MRSA are common, yet intrahost evolution during persistence on an individual has not been studied. This gap hinders the ability to clinically manage recurrent infections and reconstruct transmission networks. To characterize bacterial intrahost evolution, we examined the clinical courses of 4 subjects with 3-6 recurrent USA300 MRSA infections, using patient clinical data, including antibiotic exposure history, and whole-genome sequencing and phylogenetic analysis of all available MRSA isolates (n = 29). Among sequential isolates, we found variability in diversity, accumulation of mutations, and mobile genetic elements. Selection for antimicrobial-resistant populations was observed through both an increase in the number of plasmids conferring multidrug resistance and strain replacement by a resistant population. Two of 4 subjects had strain replacement with a genetically distinct USA300 MRSA population. During a 5-year period in 4 subjects, we identified development of antimicrobial resistance, intrahost evolution, and strain replacement among isolates from patients with recurrent MRSA infections. This calls into question the efficacy of decolonization to prevent recurrent infections and highlights the adaptive potential of USA300 and the need for effective sampling. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  18. Cell Sheet-Based Tissue Engineering for Organizing Anisotropic Tissue Constructs Produced Using Microfabricated Thermoresponsive Substrates.

    Science.gov (United States)

    Takahashi, Hironobu; Okano, Teruo

    2015-11-18

    In some native tissues, appropriate microstructures, including orientation of the cell/extracellular matrix, provide specific mechanical and biological functions. For example, skeletal muscle is made of oriented myofibers that is responsible for the mechanical function. Native artery and myocardial tissues are organized three-dimensionally by stacking sheet-like tissues of aligned cells. Therefore, to construct any kind of complex tissue, the microstructures of cells such as myotubes, smooth muscle cells, and cardiomyocytes also need to be organized three-dimensionally just as in the native tissues of the body. Cell sheet-based tissue engineering allows the production of scaffold-free engineered tissues through a layer-by-layer construction technique. Recently, using microfabricated thermoresponsive substrates, aligned cells are being harvested as single continuous cell sheets. The cell sheets act as anisotropic tissue units to build three-dimensional tissue constructs with the appropriate anisotropy. This cell sheet-based technology is straightforward and has the potential to engineer a wide variety of complex tissues. In addition, due to the scaffold-free cell-dense environment, the physical and biological cell-cell interactions of these cell sheet constructs exhibit unique cell behaviors. These advantages will provide important clues to enable the production of well-organized tissues that closely mimic the structure and function of native tissues, required for the future of tissue engineering. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Counseling patients on facial volume replacement and adherence with posttreatment instructions

    Directory of Open Access Journals (Sweden)

    Doris Day

    2010-07-01

    Full Text Available Doris DayDay Dermatology and Aesthetics New York, USAAbstract: Use of injectable volume replacement products has increased dramatically in the US in recent years. An optimal outcome with volume replacement depends on a thorough ­knowledge of the products on the part of the dermatologic/aesthetic physician specialist, identification of patients with a likelihood of benefiting from volume replacement procedures, selection of an appropriate product for the individual patient, and effective patient counseling to ensure adherence to posttreatment care instructions. Adherence to physician instructions in the field of dermatology appears limited, and there is very little published information on adherence to physician instructions following facial volume replacement procedures. The purpose of this review is to provide strategies for understanding and overcoming the barriers to adherence with the widely used dermal fillers. Strategies include using patient-centered techniques, such as a motivational interview encouraging the patient to follow postprocedure care instructions, eg, massage. In this case, demonstrating massage techniques while the patient is still in the office, with patient participation and detailed feedback, also contributes to good adherence with posttreatment care instructions. Telephone counseling, reminder postcards, and text messages may help improve clinic attendance for follow-up. Motivated patients who demonstrate good ­adherence to physician instructions generally respond well to volume replacement treatments, and usually experience fewer adverse events than patients who do not follow instructions. Although promoting adherence to pretreatment and posttreatment protocols remains a challenge, patient counseling throughout the treatment process can lead to successful results.Keywords: improving adherence, injectable volume replacement, product selection, ­rejuvenation procedure, soft tissue augmentation

  20. Orthodontic retraction of autotransplanted premolar to replace ankylosed maxillary incisor with replacement resorption.

    Science.gov (United States)

    Choi, Yoon Jeong; Shin, Sujung; Kim, Kyung-Ho; Chung, Chooryung J

    2014-04-01

    This case report describes the successful treatment of an adult with lip protrusion and a previously traumatized maxillary central incisor that had experienced replacement root resorption. An extracted premolar was transplanted into the incisor space and retracted orthodontically. Autotransplantation was successful with complete root formation and, combined with orthodontic treatment, provided a satisfying esthetic outcome.