ABSTRACT
Abstract Introduction In surgical training, large animal models are more suitable as their anatomy is more similar to humans. In otology, there have been relatively few studies about large animal models for surgical training. Objective In this study, we aimed to do a neuroradiologic evaluation and surgical insertion of a cochlear implant electrode array on a sheep head model. Methods Twenty cadaveric sheep heads were studied. A computed tomography scan and neuroradiologic evaluation was performed on each head, obtaining measurements of the inner ear for each sheep. Sheep measurements were compared to those from temporal bone computed tomography scans from 20 female humans. Surgical procedures were first trained with 13 of the sheep temporal bones, after which cochlear implantation was performed on the remaining 7 temporal bones. The position of the inserted electrode array insertion was confirmed by computed tomography scan after the procedure. Results Neuroradiologic evaluation showed that, relative to the 20 female humans, the mean ratio for sheep was 0.60 for volume of cochlea, 0.70 for height of cochlea, 0.73 for length of cochlea; ratios for other metrics were >0.80. For the surgical training, the round window was found in all 20 sheep temporal bones. Computed tomography scans confirmed that electrode insertions were fully complete; the mean value of electrode array insertion was 18.3 mm. Conclusion The neuroradiologic and surgical training data suggest that the sheep is a realistic animal model to train cochlear implant surgery and collection of perilymph samples, but less so for surgical training of mastoidectomy due to pneumatization of the mastoid.
Resumo Introdução No treinamento cirúrgico, os modelos animais de grande porte são mais adequados, pois sua anatomia é mais semelhante à humana. Em otologia, existem relativamente poucos estudos com modelo animal de grande porte para treinamento cirúrgico. Objetivo Fazer a avaliação neurorradiológica e a inserção cirúrgica de um eletrodo de implante coclear em um modelo de ovelha. Método Vinte cabeças de cadáveres de ovelhas foram estudadas. Foram feitas tomografia computadorizada e avaliação neurorradiológica de cada cabeça, obtiveram‐se medidas da orelha interna de cada ovelha. As medidas das ovelhas foram comparadas às de tomografias computadorizadas do osso temporal de 20 mulheres. Os procedimentos cirúrgicos foram inicialmente treinados com 13 dos ossos temporais de ovelhas, após o qual o implante coclear foi feito nos 7 ossos temporais restantes. A posição de inserção do arranjo de eletrodos foi confirmada por tomografia computadorizada após o procedimento. Resultados A avaliação neurorradiológica mostrou que, em comparação às 20 mulheres, a proporção média para as ovelhas foi de 0,60 para o volume da cóclea, 0,70 para a altura da cóclea, 0,73 para o comprimento da cóclea; as proporções para as outras medidas foram > 0,80. Em relação ao treinamento cirúrgico, a janela redonda foi encontrada em todos os 20 ossos temporais de ovelhas. A tomografia computadorizada confirmou que as inserções dos eletrodos foram totalmente completas; o valor médio da inserção do arranjo de eletrodos foi de 18,3 mm. Conclusão Os dados do treinamento neurorradiológico e cirúrgico sugerem que a ovelha é um modelo animal realista para o treinamento da cirurgia de implante coclear e coleta de amostras da perilinfa, mas não tão realista para o treinamento cirúrgico de mastoidectomia devido à pneumatização da mastoide.
ABSTRACT
BACKGROUND@#Respiratory mucosa defects result in airway obstruction and infection, requiring subsequent functionalrecovery of the respiratory epithelium. Because site-specific extracellular matrix (ECM) facilitates restoration of organfunction by promoting cellular migration and engraftment, previous studies considered decellularized trachea an idealECM; however, incomplete cell removal from cartilage and mucosal-architecture destruction are frequently reported. Here,we developed a decellularization protocol and applied it to the respiratory mucosa of separated porcine tracheas. @*METHODS@#The trachea was divided into groups according to decellularization protocol: native mucosa, freezing–thawing (FT), FT followed by the use of Perasafe-based chemical agents before mucosal separation (wFTP), after mucosalseparation (mFTP), and followed by DNase decellularization (mFTD). Decellularization efficacy was evaluated by DNAquantification and hematoxylin and eosin staining, and ECM content of the scaffold was evaluated by histologic analysisand glycosaminoglycan and collagen assays. Biocompatibility was assessed by cell-viability assay and in vivotransplantation. @*RESULTS@#The mFTP mucosa showed low antigenicity and maintained the ECM to form a proper microstructure.Additionally, tonsil-derived stem cells remained viable when cultured with or seeded onto mFTP mucosa, and the in vivohost response showed a constructive pattern following implantation of the mFTP scaffolds. @*CONCLUSION@#These results demonstrated that xenogenic acellular respiratory mucosa matrix displayed suitable biocompatibilityas a scaffold material for respiratory mucosa engineering.
ABSTRACT
BACKGROUND@#Respiratory mucosa defects result in airway obstruction and infection, requiring subsequent functionalrecovery of the respiratory epithelium. Because site-specific extracellular matrix (ECM) facilitates restoration of organfunction by promoting cellular migration and engraftment, previous studies considered decellularized trachea an idealECM; however, incomplete cell removal from cartilage and mucosal-architecture destruction are frequently reported. Here,we developed a decellularization protocol and applied it to the respiratory mucosa of separated porcine tracheas. @*METHODS@#The trachea was divided into groups according to decellularization protocol: native mucosa, freezing–thawing (FT), FT followed by the use of Perasafe-based chemical agents before mucosal separation (wFTP), after mucosalseparation (mFTP), and followed by DNase decellularization (mFTD). Decellularization efficacy was evaluated by DNAquantification and hematoxylin and eosin staining, and ECM content of the scaffold was evaluated by histologic analysisand glycosaminoglycan and collagen assays. Biocompatibility was assessed by cell-viability assay and in vivotransplantation. @*RESULTS@#The mFTP mucosa showed low antigenicity and maintained the ECM to form a proper microstructure.Additionally, tonsil-derived stem cells remained viable when cultured with or seeded onto mFTP mucosa, and the in vivohost response showed a constructive pattern following implantation of the mFTP scaffolds. @*CONCLUSION@#These results demonstrated that xenogenic acellular respiratory mucosa matrix displayed suitable biocompatibilityas a scaffold material for respiratory mucosa engineering.
ABSTRACT
Objectives: Intermittent antenatal iron supplementation is an attractive alternative to daily dosing during pregnancy, however the impact of this strategy on infant outcomes remains unclear. We compared the effect of intermittent antenatal iron supplementation with daily iron supplementation on maternal and infant outcomes in rural Vietnam. Methods: This cluster randomised trial was conducted in Ha Nam province, Vietnam. 1,258 pregnant women in 104 communes were assigned to daily iron-folic acid (IFA), twice weekly IFA, or twice weekly multiple micronutrient (MMN) supplementation. Primary outcome was birth weight. Results: There was no difference in birth weights of infants of women receiving twice weekly IFA compared to daily IFA (mean difference [MD] 28 g; 95% CI -22 to 78), or twice weekly MMN compared to daily IFA (MD -36.8 g; 95% CI -82 to 8.2). At 32 wk gestation, maternal ferritin was lower in women receiving twice weekly compared to daily IFA (geometric mean ratio (GMR) 0.73; 95% CI 0.67 to 0.80), and in women receiving twice weekly MMN compared to daily IFA (GMR 0.62; 95% CI 0.57 to 0.68), with no difference in hemoglobin levels. Infants of mothers who received twice weekly IFA had higher cognitive scores at 6 mo of age compared to those who received daily IFA (MD 1.89; 95% CI 0.23 to 3.56). Conclusions: Twice-weekly antenatal IFA supplementation achieved similar mean birthweight, and improved cognitive scores in infants at 6 months of age, compared to daily IFA supplementation, and should be considered for use in settings with low anemia prevalence.
ABSTRACT
Background: Acinetobacter spp are present everywhere in the environment and cause many epidemics in tropical countries.\r\n', u'Objectives: This study aims to learn about the status of multidrug resistance in ubiquitous and domination acinetobacter Spp caused nosocomial infections. Subjects and method: A descriptive, epidemiologic cross-sectional study on 65 nosocomial Acinetobacter spp isolated from 244 patients hospitalized at the intensive-care units, Bach Mai hospital and burn patients from the National Burn Institute from April, 2007 to May, 2008. Results: Rates of A.baumannii were 70.8% of the isolates. Acinetobacter spp were isolated from patients in intensive-care units showed resistant to almost all commercially available antibiotics groups, among Penicillin ranged from 94.6 to 97.4%; beta- Lactam ranged from 80.5 to 90%; Cephems were 97.6%; Aminoglycosides group ranged from 62.5 to 100% and Quinolon were 100%. The isolates that were susceptible to Netilmycin was 35% and Imipenem was 34.1%. Acinetobacter spp were isolated from burn patients, which showed resistant to Penicillin was 86, 7%; beta- Lactam was 93, 3%; Aminoglyco- sides ranged from 25% to 87.5% and Quinolon was 81,3%. The isolates were susceptible to Netilmycin was 75% and Imipenem was 31.3%. \r\n', u'Conclusion: Analysis of risk factors may help the study of epidemiology Acinetobacter to prevent hospital infections and reduce the mortality rate. \r\n', u'
Subject(s)
Cross InfectionABSTRACT
Background: Burn patients are at high risk of occasional infection because microorganism can penetrate through the wound easily. Objective: To identify bacteria species that most often cause occasional infections in burn patients and evaluate the rate of resistance to antibiotics of the isolated bacteria species. Subject and Method: A cross-sectional study was carried out on 126 patients treated at the National Institute of Burns from 4/2007 to 3/2008. Result: Rates of bacteria species were Pseudomonas aeruginosa (45.98%), after that was S.aureus (25.29%); Abaumannii (9.2%); E.coli (3.45%) and Kpneunwniae (2.87%). Rate ofresistance to antibiotics of P.aeruginosa among aminoglycoside ranged from 22.54% to 80.56%; quinolone from 39.44% to 41.1%; Cephems from 68.49% to 80.56% and penicillin from 67.61% to 78.87%; Imipenem was 27.4%. Anti-biotics resistance of Abaumannii among aminoglycoside ranged from aminoglycoside from 25.0% to 87.5%; quinolone was 81.25%; cephems was 93.33% and penicillin was 86.67%; lmipenem was 50% and Aztreonam was 93.75%. S.aureus were sensitive to Vancomycin was 1000%, but resistant to lmipenem (72.73); Gentamicin (71.43); Kanamycin (83.33); Tobramycin (83.33%); Ticarcillin / Clavulanic acid (75.61%) and Ceftazidine (75.61%).Conclusion: Isolated bacteria species, which caused occasional infections in burn patients, are mainly P.aeruginosa, S.aureus and A.baumannii. Those species resist many kinds of antibiotic.\r\n', u'\r\n', u'
Subject(s)
Drug Resistance, Multiple , Burns , BacteriaABSTRACT
Background: Systemic lupus erythematosus (SLE) is an unknown cause chronic autoimmune disorder which characterized by the spread of the lesion in many organs of body. Childhood-onset systemic lupus erythematosus is often more acute and severe than adult-onset systemic lupus erythematosus. Objective: 1. To survey clinical, laboratory and immunological symptoms of childhood-onset SLE. 2. To survey immune disorders of childhood-onset SLE. Subjects and method: A retrospective study on clinical, laboratory and immunological indexes was carried out in 29 patients with childhood-onset SLE admitted in the Department of Allergy and Clinical Immunity, Bach Mai hospital, from June/2001 to June/2006.Results: The female to male ratio was 13.5:1, and the mean age at disease onset was 12.3\xb12.4 years. The most common initial manifestations were arthritis (62.1%), malar or butterfly rash (41.4%), fatigue, malaise, weight loss (41.4%) and fever (38%). The most common manifestations in the advanced stage of the disease were arthritis (82.8%), alopecia (62.1%), nephritis (89.7), anemia (72.4%), leucopenia (58.6%), thrombocytopenia (51.7%), neurological disorders (58.6%), fever (55.2%) and malar rash (48.3%). 93.1% of the patients had elevated erythrocyte sedimentation rate. The rates of patients with ANA, anti ds-DNA antibody and LE cells were 88%, 64%, and 10.5%, respectively. Conclusion: The author recommended that on the suspicious cases, necessary tests for detecting childhood onset SLE should be conducted soon for differential diagnosis. The SLE with onset in childhood, often more severe than later life must be aggressively treated.
Subject(s)
Child , PathologyABSTRACT
Background: Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood. Objectives: To study the situations of use of blood and blood products, the indications for transfusion and transfusion reactions in some clinical departments of Bach Mai Hospital. Subjects and method: Retrospective study from January 2005 to December 2005 and perspective study from January 2006 to June 2006 through blood records, patient chart and patients. Results & Conclusion: from January 2005 to June 2006, Bach mai Hospital used 45318 units of blood and products, most were erythrocyte concentration (57,9%), plasma (24,9%) and (12,3%). The most used blood group were group 0 (44,5%). Blood-erythrocyte concentration and platelet concentration were most used in Hematology and Transfusion Department, plasma were most used in ICU. 31,1 % and 27,8% of patients were laboratory evaluation before transfusion of erythrocyte concentration and platelet concentration, respectively. The rate of transfusion reactions were 1,04%, most were pruritus - 83,7%. Highest rate of transfusion reaction were belonged to blood (3,4%) and platelet concentration (3%). From January 2005 to June 2006, Bach Mai Hospital used 45318 units of blood and products, most were erythrocyte concentration, plasma, platelet concentration and blood 31,1 % and 27,8% of patients were laboratory evaluation before transfusion of erythrocyte concentration and platelet concentration, respectively.
Subject(s)
Blood , Blood TransfusionABSTRACT
Background: Scleroderma is a rare autoimmune disease occurs with an annual rate of about 2-20 cases / 1 million people. Objectives: To evaluate the common clinical and laboratory manifestaions of scleroderma associated renal disease. Subjects and method: A restrospective study of clinical, urinary analysis, biochemical and blood count analysis and renal artery dopper ultrasonography indexes in 147 patients with scleroderma. Results: The commonest nonrenal clinical manifestations were skin thickening (100%), pigmentation (71,43%), arthalgia/ arthritis (83%), Raynaud phenomenon (62,58%) and gastroentrological syndrome (50,34%). 11,56% of patients had signs and symptoms of kidney involvement such us hypertension (10,2%), edema (9,52%), oliguria (3,4%). 14,29%, 10,88% and 18,18% of patients had abnomalities on urinary analysis, increased blood urea and renal artery stenosis on dooper ultrasonography, respectively. Conclusion: 11,56% of patients had rena manifestationsin clinical, the commonest is hypertension, edema and oliguria. 14,29%, 10,88% and 18,18% of patients had positive proteinuria of hematuria, increased blood urea and renal artery stenosis on dopper ultrasonography, respectively.
Subject(s)
Kidney DiseasesABSTRACT
Background: In the past decades, preventive medicine had achieved significant success by promoting the effective prevention. However, we were facing with the rising again of dangerous infectious diseases that had been controlled. Ministry of Health had approved the development support project for preventive medicine system to strengthen early detection and control diseases in time. Objectives: To survey the manpower and the demand for training in basic microbiology technique of Centres for preventive medicine. Subjects and method: Technicians of 29 centres for preventive medicine in North provinces were surveyed and the results were studied by the described cross method. Results: Number of technicians graduated difference, fluctuated from 3 to 14 person per unit. The women were 80.4%; men were 19.6%. The staff who have degrees of postgraduate was 5.3%; University graduated was 41.2%; middle-ranking was 53.6%. Their specialities were very different: medicine doctor was 15.2%; biologists were 8.8%. The rest were nurse, technicians convalesce nurse, Medical Public Health...(34.4%). Among the demand for obtain the train in Microbiology, basic and advance labiratory techniques, 19.4% were the requests for training in basic microbiology; 16.4% were for molecular technology; 21.4% were for bacterium isolate technology and 19.4% were for virus technology. Conclusion: The results were the basis of creating a appropriate technical training strategy to contribute to the success of the project.
Subject(s)
Clinical Laboratory Techniques , EducationABSTRACT
Background: system lupus erythematosus (SLE) is an autoimmune disease, characterized by a variety of antibodies generated against the body itself, causing damage in all organs: skin, mucous membranes, joint-skeletal-muscle, heart, kidneys, lungs, nervous, mental, blood and lymph,... The disease progresses in waves, more and more serious and lead to death. Objectives: to study on characteristics of patients with the end stage SLE and to evaluate results of some tests in these patients. Subjectives and Method: a retrospective and cross sectional study was carried out on forty two end stage SLE patients at Department of Allergology and Clinical Immunology of Bach Mai hospital were studied between 1998 and 2004. Results: the majority of SLE patients were female (90.48%) and in group of 16-39 years old. Number of female patients was 14 times more than male patients. All 42 patients decreased peripheral blood cell amount: reducing both red and white blood cells (71.43%), reducing both three type (11.90%). 21/32 cases with severe hemoglobin reduction (65.53%). 38/42 cases of medium and severe neutropenia (90.48%). 33/42 cases with end-stage renal failure (78.57%). 13 cases of low blood Na+, 9 cases of increased blood K+. 30 cases with positive proteinuria (90.91%). 17/20 cases with pericardial effusion (85.00%). 35/42 cases with lung lesion images on ultrasound and x-rays (83.33%). 9 cases (30.00%) with increased AST and ALT above 100 U/l. 5 cases (16.67%) with meningitis. Conclusions: dramatic decrease in blood cell count, particularly in white blood cells. Most patients had renal failure at stage III, mainly with high blood potassium, and high protein and red blood cells in urine. Others included pericarditis, pneumonia, liver and neurological disorders.
Subject(s)
/epidemiologyABSTRACT
Background: Maternal and child healthcare is a leading priority in the health care strategy of Viet Nam. Motherhood safety is amongst contents of reproductive healthcare strategy to ensure safe delivery, reduce maternal and neonatal morbidity as well as mortality. Aims: To discover the utilization of delivery care and related factors to women in selecting location for delivery. Subjects and method: The study was carried out in Chillilab \u2013 Demographic and Epidemiological Surveillance was set up in Chi Linh district, Hai Duong province by the School of Public Health. A combination of quantitative and qualitative methods was used in collecting the data. Results: 97% of pregnant women chose public health facilities as their delivery place and 2.5% of pregnant women had homebirths. The main reasons for delivery in hospitals were trust on care quality and sufficient equipment for emergency care. The complicated delivery rate was 14% and Cesarean section delivery was 12%. Hospitalized deliveries were more common in the women with higher education and/or better economic status. Conclusion: There should be improved healthcare communications to encourage all women to give birth at health facilities. Improving the quality of delivery care in community health stations is important to give opportunities for deprived women to receive safer deliveries.