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At least 307 records · Page 17Linked to original sources

Dielectrophoretic registration of living cells to a microelectrode array.

We present a novel microfabricated device to simultaneously and actively trap thousands of single mammalian cells in alignment with a planar microelectrode array. Thousands of 3 Ipm diameter trapping electrodes were fabricated within the bottom of a parallel-plate flow chamber. Cells were trapped on the electrodes and held against destabilizing fluid flows by dielectrophoretic forces generated in the device. In general, each electrode trapped only one cell. Adhesive regions were patterned onto the surface in alignment with the traps such that cells adhered to the array surface and remained in alignment with the electrodes. By driving the device with different voltages, we showed that trapped cells could be killed by stronger electric fields. However, with weaker fields, cells were not damaged during trapping, as indicated by the similar morphologies and proliferation rates of trapped cells versus controls. As a test of the device, we patterned approximately 20,000 cells onto aI cm2 grid of rectangular adhesive regions, with two electrodes and thus two cells per rectangle. Our method obtained 70 +/- 1% fidelity versus 17 +/- 1% when using an existing cell-registration technique. By allowing the placement of desired numbers of cells at specified locations, this approach addresses many needs to manipulate and register cells to the surfaces of biosensors and other devices with high precision and fidelity.

Animals↗

New approaches to endoscopic therapy for a haemostasis upper GI bleed.

Haematemesis and/or melaena are the most common presentations of upper gastrointestinal bleeding. Endoscopic haemostasis after diagnosis still remains a challenge to the gastroenterologist. Most variceal and peptic ulcer bleeding episodes stop spontaneously, and then prevention of rebleeding might be indicated by endoscopic techniques. In the present article, four less well-known endoscopic haemostasis techniques are discussed and, if available, comparative studies are reviewed.

Clinical Trials as Topic↗

Physiology of the thermophilic acetogen Moorella thermoacetica.

Moorella thermoacetica (originally isolated as Clostridium thermoaceticum) has served as the primary acetogenic bacterium for the resolution of the acetyl coenzyme A (acetyl-CoA) or Wood-Lijungdahl pathway, a metabolic pathway that (i) autotrophically assimilates CO2 and (ii) is centrally important to the turnover of carbon in many habitats. The purpose of this article is to highlight the diverse physiological features of this model acetogen and to examine some of the consequences of its metabolic capabilities.

Acetates↗

Programs of the Robert Wood Johnson Foundation to develop minority medical careers.

The Robert Wood Johnson Foundation (RWJF) is the nation's largest philanthropy devoted to health. The foundation long has been concerned about increasing diversity in the health professions. Between 1972 and 1981, grants totaling nearly $6.7 million were made to medical, medical/dental schools, or other educational organizations to support minority students. Funds enabled students who were interested in applying to medical or dental school to enroll in special preparatory courses. Most students were African American. One program, however, targeted US Puerto Rican students and other Hispanic students. Nearly 2500 students enrolled in these preapplication enrichment programs. Data reported to the foundation on medical or dental school acceptance for 1959 of these students indicated that 57% of students were successful. An additional $10.5 million in grants were awarded during this period: $2.5 million to provide scholarships for minority group medical students, $580,000 to support preceptorships with minority physicians/mentors, and $7.5 million to strengthen Meharry Medical College's Comprehensive Primary Care Health Science Program. In the early 1980s, the RWJF Board of Trustees considered a series of staff analyses, which resulted in additional direct support to historically black medical schools, including Meharry and those at Drew University and Morehouse College. These analyses also set the stage for two RWJF programs, the Minority Medical Faculty Development Program and the Minority Medical Education Program, which exist today. This article describes these programs, along with the more recent Health Professions Partners Initiative, and offers reflection and analysis about their impact on diversity in the medical profession.

Education, Medical↗

Catheter-directed thrombolytic therapy for limb ischemia: current status and controversies.

Absence of urokinase from the United States market for the past 4 years has resulted in increasing experience with other plasminogen activators in catheter-directed thrombolytic therapy. The differences in the pharmacologic properties and biologic behavior of these agents may translate into clinical outcomes that are distinct. Some of these manifestations can be predicted based on the existing large clinical trials in the acute myocardial infarction literature. However, because of the fundamental differences in techniques and thrombolytic regimens, extrapolation of the coronary data may not always predict the performance of these agents in peripheral catheter-directed fibrinolysis. In this article, the current status of the available lytic agents in the treatment of limb ischemia is reviewed.

Arterial Occlusive Diseases↗

Necrotizing fasciitis: pathophysiology and treatment.

Necrotizing fasciitis (NF) is a life-threatening bacterial infection causing necrosis of the fascia, underlying skin, and vasculature. NF spreads rapidly, making immediate diagnosis important for survival. Treatment may involve the administration of several broad-spectrum antibiotics, surgical debridement, and skin grafting. In the following two articles, the pathophysiology, medical management, and nursing care of patients are discussed. An in-depth model care plan illustrates the complexity of the disease and its treatment.

Anti-Bacterial Agents↗

Tumor necrosis factor gene polymorphisms and inflammatory response in coronary artery bypass grafting patients.

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha), a key factor in the inflammatory cascade, has been implicated in coronary artery disease. Two biallelic polymorphisms in the TNF gene locus (TNFA at position -308 and TNFB at +252) may influence TNF-alpha production. Individuals with the rare TNFA2 allele or TNFB2 homozygosity have augmented TNF-alpha production. We investigated the genotypes associated with increased TNF-alpha production in coronary artery bypass grafting (CABG) patients and if these genotypes influence the magnitude of the postoperative inflammatory response. METHODS: TNF gene polymorphisms were analyzed by multiplex fluorescent solid-phase minisequencing in 86 CABG patients. Plasma concentrations of TNF-alpha, IL-6 and C3a and C-reactive protein (CRP) were analyzed before and after surgery in 45 of the patients and compared with genetically high and low TNF-alpha producers. RESULTS: Thirty percent of the patients carried the TNFA2 allele and 45% were TNFB2 homozygous. The allelic frequencies were TNFA1/TNFA2=0.84/0.16 and TNFB1/TNFB2=0.32/0.68. Pre- and postoperative levels of TNF-alpha, IL-6, C3a and CRP did not differ significantly between genetically high and low TNF-alpha producers. CONCLUSIONS: The frequency of high TNF-alpha producing genotypes in a CABG population was comparable to that previously reported from normal populations. Furthermore, we found no evidence that the investigated TNF-alpha gene polymorphisms influence postoperative inflammatory response after uncomplicated coronary surgery.

Aged↗

Internet resources for occupational and environmental health professionals.

The Internet's global reach offers new powerful tools to professionals in Occupational and Environmental Health (OEH). The World Wide Web includes extensive free and commercially available reference materials on toxicology, regulatory issues, environmental epidemiology and prevention programs. Much of this especially useful content is inaccessible to general Web-based search engines. Effective use of the Web requires discovery and familiarity with sites housing query engines for technical databases. Although the Web's structure and capacity is so dynamic that any listing is incomplete, introductions to many resources are provided in this article. The Internet also offers professionals electronic access to one another, for collegial discourse. Electronic mailing lists provide assembly points for collaboration and guidance about technical issues. Several specialty forums for OEH professionals are also discussed.

Databases as Topic↗

Prenatal intervention for isolated congenital diaphragmatic hernia.

PURPOSE OF REVIEW: We aim to review the recent literature regarding early prenatal prediction of outcome in babies diagnosed with isolated congenital diaphragmatic hernia, as well as results of fetal therapy for this condition. RECENT FINDINGS: Current survival rates in population-based studies are around 55-70%. Highly specialized centers report 80% and more, but discount the hidden mortality, mainly in the antenatal period. Fetuses presenting with liver herniation and a lung-to-head ratio of less than 1.0 measured in midgestation have a poor prognosis. Other volumetric techniques are being evaluated for use in midtrimester. Recently, a randomized trial failed to show benefit from prenatal therapy, but lacked power to document the potential advantage of prenatal therapy in severe cases. We proposed percutaneous fetal endoluminal tracheal occlusion with a balloon at 26-28 weeks through a 3.3 mm incision. In severe cases, fetal endoluminal tracheal occlusion increased lung size as well as survival, with an early (7 day) survival, late neonatal (28 day) survival and survival at discharge of 75, 58 and 50%, respectively, comparing favorably with 9% in contemporary controls. Airways can be restored prior to birth improving neonatal survival (83.3% compared with 33.3%). The procedure carries a risk for preterm prelabour rupture of the fetal membranes, although that may decrease with experience. SUMMARY: Fetuses with severe congenital diaphragmatic hernia can be identified in the second trimester. Fetal endoluminal tracheal occlusion can be considered as a minimally invasive fetal therapy, improving outcome in such highly selected cases.

Female↗

Intermittent exotropia increasing with near fixation: a "soft" sign of neurological disease.

AIM: To examine the association of distance-near disparity with neurological disease in children with intermittent exotropia. METHODS: A retrospective analysis was performed of the medical records of all children with intermittent exotropia examined at the Arkansas Children's Hospital between 1989 and 2002. The study group consisted of children with intermittent exotropia who had a near deviation that exceeded the deviation at distance by at least 10 prism dioptres. The control group consisted of children with intermittent exotropia who had a distance deviation greater than or equal to the deviation at near. The main outcome measure was the prevalence of neurological abnormalities in the study and control groups. RESULTS: Among the 29 patients in the study group, 19 (66%) had a history of concurrent neurological abnormalities. Associated neurological conditions included developmental delay (10 patients), attention deficit disorder (four patients), cerebral palsy (four patients), history of intracranial haemorrhage (four patients), periventricular leucomalacia (three patients), seizures (two patients), cortical visual impairment (two patients), hydrocephalus (one patient), history of anoxic brain damage (one patient), history of encephalitis (one patient), and autism (one patient). Among the 37 patients in the control group, seven (19%) had a history of concurrent neurological abnormalities. The difference in the prevalence of neurological disease between the study group and the control group was significant (p=0.0002). CONCLUSION: Intermittent exotropia increasing with near fixation is associated with neurological disease in children.

Adolescent↗

Microscopic evidence against HIV-1 infection of germ cells or attachment to sperm.

For a number of years we have intensively investigated the localization of HIV-1 in male genital tract tissues and secretions using a variety of microscopy techniques including immunocytochemistry, in situ hybridization, in situ PCR and electron microscopy. Our studies have failed to demonstrate an association between HIV-1 and either testicular germ cells or spermatozoa. In this article we present our results in the context of other related studies, and discuss the strengths and weaknesses of the techniques that have been used to address this important research question.

HIV Infections↗

The preceptor--preceptee model for faculty "cross-training".

In the review of the literature, the author notes several discussions concerning collaboration between nursing education and service agencies for updating faculty clinical practice. This article addresses the Preceptor-Preceptee model for Faculty "Cross-training," including the permission process, method, needs analysis, and evaluation. A concluding statement by the author strongly recommends the utilization of the faculty practice model to enhance the faculty's competence in clinical nursing areas.

Clinical Competence↗

Nutritional management of the metabolically stressed patient.

The nutritional management of the critically ill metabolically stressed patient has changed drastically within the last two decades. Alterations in carbohydrate, fat, and protein metabolism following severe injury affect effective substrate utilization and the provision of nutritional or metabolic support. This article describes the acute alterations in carbohydrate, fat, and protein metabolism during severe metabolic stress; reviews nutritional assessment and requirements during metabolic stress; and presents recent findings that influence nutritional support during metabolic stress. The role of gut in the provision of nutritional support and the pharmacologic properties of select enteral nutrients are reviewed.

Critical Illness↗

The release, absorption and possible health effects of mercury from dental amalgam: a review of recent findings.

Recently many articles have appeared on the subject of mercury from dental amalgam and some of these have questioned its safety as a dental material. This article reviews critically the evidence on mercury release from dental amalgam restorations, its absorption, accumulation and excretion by the body, and its possible relationship to ill-effects. Finally, brief recommendations are given for the handling and usage of dental amalgam.

Abnormalities, Drug-Induced↗

Pharmaceutical risk management: special problems encountered in the hospital setting.

This article (1) reviews the types of adverse drug reactions that can occur, (2) discusses liability issues for hospitals and healthcare professionals who practice in a hospital or nursing home setting, and (3) presents risk management strategies for maximizing the quality of pharmaceutical care while minimizing exposure to risk.

Adverse Drug Reaction Reporting Systems↗

A review of calibration techniques for freehand 3-D ultrasound systems.

Three-dimensional (3-D) ultrasound (US) is an emerging new technology with numerous clinical applications. Ultrasound probe calibration is an obligatory step to build 3-D volumes from 2-D images acquired in a freehand US system. The role of calibration is to find the mathematical transformation that converts the 2-D coordinates of pixels in the US image into 3-D coordinates in the frame of reference of a position sensor attached to the US probe. This article is a comprehensive review of what has been published in the field of US probe calibration for 3-D US. The article covers the topics of tracking technologies, US image acquisition, phantom design, speed of sound issues, feature extraction, least-squares minimization, temporal calibration, calibration evaluation techniques and phantom comparisons. The calibration phantoms and methods have also been classified in tables to give a better overview of the existing methods.

Algorithms↗

Electrodialytic phenomena and their applications in the dairy industry: a review.

Electrodialysis (ED) is an electrochemical separation process by which electrically-charged species are transportedfrom one solution to another ED is a combined method of dialysis and electrolysis and can be performed with two main cell types: multi-membrane cells for dilution-concentration and water dissociation applications (membrane phenomena), and electrolysis cells for redox reactions (electrode phenomena). The dilution-concentration principle applications in the dairy industry consist mainly of the demineralization of milk or milk by-products. The use of ED with monopolar membrane for protein separation and acid caseinate production, and in bioreactors for organic acid production, is also studied in the dairy industry. The interest of ED as a membrane process has been triggered recently by the development of a new membrane type, bipolar membrane. This membrane carries out the dissociation of water molecules. ED with bipolar membranes was applied very recently to the production of lactic acid from whey product fermentation, production of caseinates, and fractionation of whey proteins. Two principle applications of electrode reactions were published: electrochemical coagulation (EC) to precipitate milk proteins, and electroreduction for the reduction of disulfide bonds in the proteins. It appears in this article that processes using membrane phenomena are more numerous and developed than electrolytic applications. This is the composition of milk and the lack of knowledge of redox reactions of the different food compounds that limit the applications and the development of electrolytic phenomena. Electrodialytic phenomena present a great potential for application in the dairy industry, and more generally, in the food industry; many of these applications have to be discovered.

Animals↗