Implementing Effective Noise Reduction Techniques in Implantable NIRS Sensors.

Near-Infrared Spectroscopy (NIRS) is a noninvasive optical method widely used for evaluating tissue hemodynamics and various physiological characteristics. Despite its advantages, NIRS faces limitations in light sampling depth and spatial resolution, which has led to the development of implantable NIRS sensors. However, these implantable sensors are prone to Common-Mode Voltage (CMV) interference due to their increased sensor-to-tissue capacitance, which can compromise the signal-to-noise ratio and accuracy of measurements.In this paper, we present a novel active CMV reduction technique that enhances the signal-to-noise ratio of NIRS signals. We propose an electrical model of a patient's body and NIRS sensor to characterize the CMV interference and the active CMV cancellation (ACC) electronic circuit. The ACC circuit measures CMV through a common-mode amplifier, which then inverts and introduces the amplified signal to the patient's body via an additional surface electrode. This technique effectively attenuates the CMV (50 and 60 Hz) by 80 to 90 dB, significantly improving the signal quality without causing system instability.The method has been validated through both analytical simulations and experimental measurements, demonstrating the circuit's ability to suppress CMV within a bandwidth of 0.1 to 100 Hz. Experimental verification of the active noise cancellation method was conducted by recording data from the fingertip and palm, showing effective suppression of the CMV. The proposed method has substantial clinical relevance as it enhances the reliability and accuracy of implantable NIRS sensors, enabling more precise monitoring of internal organs and improved patient care.

Topical vitamin C, vitamin E, and acetylcysteine as corneal wound healing agents: A comparative study.

PURPOSE: The purpose of this study was to evaluate wound healing abilities and efficacy of topical Vitamin C, Vitamin E, and acetylcysteine for their possible clinical use. METHODS: The study was conducted on 36 eyes of 18 single-breed rabbits, Oryctolagus cuniculus, of both sexes. A 7.5 mm calibrated vacuum corneal trephine was used to induce a defect of 100 micron depth in center of both the corneas. The right eye of rabbits was selected as the control eye and the left eye as the trial eye, which received eyedrops as Group 1-10% Vitamin C eyedrops, Group 2-3% acetylcysteine eye drops, and Group 3-1% Vitamin E eye drops. Control eyes received ringer lactate. Evaluation was done for fluorescein stain positivity, epithelial defect size, and corneal haze on Day 2, Day 7, and Day 14 post induction of the epithelial defect. RESULTS: On day 14, three eyes of control group, all Vitamin C and acetylcysteine treated eyes, and four Vitamin E treated eyes were fluorescein stain negative. The mean defect area on day 14 was 0, 0, 0.13, and 1.86 mm2 in Vitamin C, Vitamin E, acetylcysteine, and control eyes, respectively. Vitamin C and Vitamin E control corneal haze better than acetylcysteine in experimentally induced corneal wounds in rabbits. CONCLUSION: The three trial drugs with different mechanism of action showed similar effect on healing of the experimentally created corneal wounds in rabbits, with comparison showing statistical insignificance.

Energy band diagram of device-grade silicon nanocrystals.

Device grade silicon nanocrystals (NCs) are synthesized using an atmospheric-pressure plasma technique. The Si NCs have a small and well defined size of about 2.3 nm. The synthesis system allows for the direct creation of thin films, enabling a range of measurements to be performed and easy implementation of this material in different devices. The chemical stability of the Si NCs is evaluated, showing relatively long-term durability thanks to hydrogen surface terminations. Optical and electrical characterization techniques, including Kelvin probe, ultraviolet photoemission spectroscopy and Mott-Schottky analysis, are employed to determine the energy band diagram of the Si NCs.

Maternal Thyroid Function and Autoimmunity in 3 Trimesters of Pregnancy and their Offspring's Thyroid Function.

This study was performed to evaluate maternal thyroid dysfunction and autoimmunity during pregnancy and its correlation with thyroid function of offspring. In this cohort study, Serum TT4, TT3, T3U, TSH, TPOAb, and TgAb were measured. Serum samples of 120 pregnant women were collected during 3 trimesters as well as in 57 cord bloods, 69 neonates, 34, 37, and 36 infants aged 2, 4, and 6 months. Repeated measure and Pearson correlation test were used to compare thyroid hormone values and to assess the correlations, respectively. Main outcomes were correlations between thyroid hormones and antibodies in mothers and offspring. An increasing trend for TT3 (p for trend < 000.1) and TSH (p for trend 0.01) was found over the course of gestation. Among 120 mothers, 10 (8%) had subclinical hyperthyroidism and 18 mothers (15%) showed subclinical hypothyroidism. We found one hypothyroid (0.8%) and 3 hyperthyroid (2.5%) mothers during pregnancy. Correlations among maternal thyroid hormones were found but not with auto-antibodies. A positive correlation between maternal thyroid auto-antibodies in all trimesters with cord blood and neonates was found. Cord blood TSH had a good correlation with maternal TSH, but only in the first trimester (r=0.29, p<0.05). A positive correlation between neonatal TSH and maternal TT4 was found only in the third trimester (r=0.25, p<0.05). Subclinical hypothyroidism was the most common thyroid dysfunction in the pregnant women studied. The association between maternal auto-antibodies and thyroid hormones of offspring was observed mostly in the neonatal period and became weaker after one month of age.

Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal proliferation.

PURPOSE: To evaluate the outcome of scleral buckling surgery in patients with rhegmatogenous retinal detachment (RRD) with subretinal proliferation. METHODS: In this retrospective study, a chart review of all patients with RRD associated with subretinal proliferation who were primarily treated with scleral buckling procedure, from April 2007 to April 2014, was undertaken. Main outcome measures were anatomical retinal reattachment and visual acuity. RESULTS: Forty-four eyes of 43 patients including 24 males and 19 females with a mean age of 26.5±13.1 years were evaluated. Immediately after the surgery, retina was reattached in all eyes. However, five eyes (11.3%) needed additional surgery for retinal redetachment. Single surgery anatomical success rate was 88.7%. Four eyes (9.1%), needed pars plana vitrectomy for the treatment of redetachment associated with proliferative vitreoretinopathy and scleral buckle revision surgery was successfully performed in the other eye. Best corrected visual acuity improved from 1.5±0.9 logMAR before surgery to 1.1±0.7 logMAR after surgery (P<0.001). An improvement in BCVA of >2 lines was found in 23 eyes (52.2%) and worsening of best corrected visual acuity of >2 lines was observed in 2 eyes (4.5%). CONCLUSIONS: Scleral buckling surgery is highly successful in eyes with RRD associated with subretinal proliferation.

Ultrasonic pretreatment for hydrothermal synthesis of SAPO-34 nanocrystals.

Synthesis of SAPO-34 nanocrystals which has been recently considered as a challenging task was successfully performed by sonochemical method using TEAOH as structure directing agent (SDA). The products were characterized by XRD, SEM, EDX, BET and TGA. The average crystal size of the final product prepared sonochemically is 50 nm that is much smaller than that of synthesized under hydrothermal condition and the morphology of the crystals changes from uniform spherical nanoparticles to spherical aggregates of cube type SAPO-34 crystals respectively. In the case of sample synthesized sonochemically with aid of hydrothermal condition, the surface area is significantly upper than that of obtained by the conventional static hydrothermal technology with almost the same crystallinity. SAPO-34 framework synthesized by just ultrasonic treatment is unstable and a significant part of SAPO-34 nanocrystals is transformed to the dense phase of AlPO(4) structure, i.e., Cristobalite. Contrary to hydrothermal method that at least 24h of the synthesis time is required to obtain fully crystalline SAPO-34, sonochemical-assisted hydrothermal synthesis of samples leads to form fully crystalline SAPO-34 crystals taking only 1.5h. In a sonochemical process, a huge density of energy for crystallization is provided by the collapse of bubbles which formed by ultrasonic waves. The fact that small SONO-SAPO-34 crystals could be prepared by the sonochemical method suggests a high nucleation density in the early stages of synthesis and slow crystal growth after nucleation.

Step trajectory analysis of spinal cord injured rats trained with neuromuscular electrical stimulation coordinated with robotic treadmill training.

Applying neuromuscular electrical stimulation (NMES) during treadmill training (TT) has been shown to improve functional outcomes, such as gait speed and walking distance, in spinal cord injury (SCI) patients. However, ways to improve this combined NMES+TT therapy have not been investigated. We have developed NMES system for a rodent model of SCI to investigate whether and how more precisely timing the stimulation to robotically assisted hindlimb position might achieve rehabilitation of independent stepping after SCI. In our therapy (NMES+RTT), rodent ankle flexor muscles are stimulated while the hindlimbs are robotically driven through pre-programmed trajectories during treadmill training. The objectives of the work presented here were to quantify changes in step trajectory resulting from our combined NMES+RTT therapy and compare those effects with those induced by robotic treadmill training (RTT) alone. Animals were spinally contused to model severe SCI, and either received 2 weeks of NMES+RTT followed by 2 weeks of RTT (n=6) or 2 weeks of RTT followed by 2 weeks of NMES+RTT (n=7). Changes in step trajectories after training were analyzed. According to a deviation measure we developed, the step trajectories improved after either NMES+RTT or RTT training but more closely matched the desired pre-programmed trajectories after NMES+RTT than after RTT only. The step trajectories are also more consistent, as indicated by a coefficient of variation measure, after training and more so after NMES+RTT than after RTT only. These preliminary results from our NMES+RTT vs. RTT study are consistent with the hypothesis that appropriately timing NMES with hindlimb movements during stepping is an effective therapy for restoring the ability to step after spinal cord injury.

Effect of functional electrical stimulation (FES) combined with robotically assisted treadmill training on the EMG profile.

Functional electrical stimulation (FES) is used to assist spinal cord injury patients during walking. However, FES has yet to be shown to have lasting effects on the underlying neurophysiology which lead to long-term rehabilitation. A new approach to FES has been developed by which stimulation is timed to robotically controlled movements in an attempt to promote long-term rehabilitation of walking. This approach was tested in a rodent model of spinal cord injury. Rats who received this FES therapy during a 2-week training period exhibited peak EMG activity during the appropriate phase of the gait cycle; whereas, rats who received stimulation which was randomly timed with respect to their motor activity exhibited no clear pattern in their EMG profile. These results from our newly developed FES system serve as a launching point for many future studies to test and understand the long-term effect of FES on spinal cord rehabilitation.

The alpha(1,3)fucosyltransferases FucT-IV and FucT-VII exert collaborative control over selectin-dependent leukocyte recruitment and lymphocyte homing.

E-, P-, and L-selectin counterreceptor activities, leukocyte trafficking, and lymphocyte homing are controlled prominently but incompletely by alpha(1,3)fucosyltransferase FucT-VII-dependent fucosylation. Molecular determinants for FucT-VII-independent leukocyte trafficking are not defined, and evidence for contributions by or requirements for other FucTs in leukocyte recruitment is contradictory and incomplete. We show here that inflammation-dependent leukocyte recruitment retained in FucT-VII deficiency is extinguished in FucT-IV(-/-)/FucT-VII(-/-) mice. Double deficiency yields an extreme leukocytosis characterized by decreased neutrophil turnover and increased neutrophil production. FucT-IV also contributes to HEV-born L-selectin ligands, since lymphocyte homing retained in FucT-VII(-/-) mice is revoked in FucT-IV(-/-)/FucT-VII(-/-) mice. These observations reveal essential FucT-IV-dependent contributions to E-, P-, and L-selectin ligand synthesis and to the control of leukocyte recruitment and lymphocyte homing.

Molecular mechanisms of lymphocyte homing to peripheral lymph nodes.

To characterize the adhesion cascade that directs lymphocyte homing to peripheral lymph nodes (PLNs), we investigated the molecular mechanisms of lymphocyte interactions with the microvasculature of subiliac lymph nodes. We found that endogenous white blood cells and adoptively transferred lymph node lymphocytes (LNCs) tethered and rolled in postcapillary high endothelial venules (HEVs) and to a lesser extent in collecting venules. Similarly, firm arrest occurred nearly exclusively in the paracortical HEVs. Endogenous polymorphonuclear (PMNs) and mononuclear leukocytes (MNLs) attached and rolled in HEVs at similar frequencies, but only MNLs arrested suggesting that the events downstream of primary rolling interactions critically determine the specificity of lymphocyte recruitment. Antibody inhibition studies revealed that L-selectin was responsible for attachment and rolling of LNCs, and that LFA-1 was essential for sticking. LFA-1-dependent arrest was also abolished by pertussis toxin, implicating a requirement for G alpha i--protein-linked signaling. alpha 4 integrins, which play a critical role in lymphocyte homing to Peyer's Patches, made no significant contribution to attachment, rolling, or sticking in resting PLNs. Velocity analysis of interacting LNCs revealed no detectable contribution by LFA-1 to rolling. Taken together, our results suggest that lymphocyte- HEV interactions within PLNs are almost exclusively initiated by L-selectin followed by a G protein-coupled lymphocyte-specific activation event and activation-induced engagement of LFA-1. These events constitute a unique adhesion cascade that dictates the specificity of lymphocyte homing to PLNs.

A novel role for the beta 2 integrin CD11b/CD18 in neutrophil apoptosis: a homeostatic mechanism in inflammation.

In mice selectively deficient in CD11b/CD18, a beta 2 integrin, chemoattractant-induced leukocyte adhesion to microvascular endothelium in vivo was reduced. Paradoxically, thioglycollate-induced neutrophil accumulation in the peritoneal cavity was increased and was associated with a significant delay in apoptosis of extravasated cells. The extravasated cells had a near absence of neutrophil phagocytosis and a reduction in oxygen free radical generation, which may contribute to the observed defect in apoptosis. This is supported by our in vitro studies, in which phagocytosis of opsonized particles by human neutrophils rapidly induced apoptosis that could be blocked with CD11b/ CD18 antibodies. Reactive oxygen species are the intracellular link in this process: phagocytosis-induced apoptosis was blocked both in neutrophils treated with the flavoprotein inhibitor diphenylene iodonium and in neutrophils from patients with chronic granulomatous disease, which lack NADPH oxidase. Thus, CD11b/CD18 plays a novel and unsuspected homeostatic role in inflammation by accelerating the programmed elimination of extravasated neutrophils.

Bellevue pouch: ileocolonic continent urinary reservoir.

The technique for the Bellevue Pouch, another continent intestinal reservoir, is described. A large-capacity low-pressure reservoir is created from detubularized ascending colon, cecum, and terminal ileum. Continence is achieved by means of an intussuscepted segment of ileum and a modulating colonic pressure cuff wrapped around it. The operation has been performed on 19 patients, all of whom achieved satisfactory continence. Two patients were converted to free drainage systems at a later date. Average follow-up was twenty-five months.

Ureteral obstruction in a patient with Burkitt's lymphoma and AIDS.

Burkitt's lymphoma presenting as an intrinsic ureteral mass is rare. We report on an immunocompromised patient with hydronephrosis secondary to direct involvement of the ureter by this non-Hodgkin's lymphoma. This case illustrates one of the manifestations of AIDS and the treatment of this manifestation. The relationship of AIDS and its sequela to the genitourinary system is discussed.

Transpubic approach for lower urinary tract surgery: a 15-year experience.

Surgery on lower urinary tract organs sometimes is hindered by the symphysis pubis, which by its position and bulk could severely restrict maneuverability. Since 1972 we used a transpubic approach to improve surgical exposure in 287 patients operated on for prostate, bladder or urethral cancer, post-traumatic strictures and other conditions. The type of pubectomy performed (total, partial superior or partial inferior) depended upon whether a suprapelvic or infrapelvic diaphragm organ was the primary target of the approach. Total pubectomy was used in 137 patients, partial superior bone resection in 140 and partial inferior resection in 10 patients. Technical details for each type of pubectomy are illustrated. The transpubic approach was particularly useful for repair of posterior urethral strictures or removal of bulky tumors. Among the 3 types of approaches used, total pubectomy was associated with a high complication rate including bleeding, pelvic instability, urinary incontinence and stricture of the vesicourethral anastomosis. Therefore, we have abandoned the technique since 1978. Partial pubectomy provides exposure comparable to that of total pubectomy but with minimal complications, making it an alternative to the standard approach in difficult cases.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonian syndrome in Macaca fascicularis: which midbrain dopaminergic neurons are lost?

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) produces, in both human and non-human primates, a syndrome very similar to idiopathic Parkinson's disease. The syndrome is associated with degeneration of the dopamine-containing neurons in the substantia nigra, many of which project to the neostriatum. The purpose of the present study was to quantify the regional distribution of midbrain dopamine neurons remaining after MPTP administration to the monkey (Macaca fascicularis) and to develop alternative procedures for maintaining the normal nutrition in MPTP-treated animals. Three monkeys were treated with MPTP and three served as controls. Representative sections were examined from rostral to caudal through the midbrain dopamine cell nuclei and the location of every tyrosine hydroxylase-containing cell was entered into a computer. Midbrain dopamine neuronal cell loss ranged from 36-78%, being most extensive in the two monkeys which exhibited the most severe parkinsonian syndrome. The greatest cell loss (46-93%) occurred in the substantia nigra pars compacta, or nucleus A9, and the loss was primarily in the ventral portion of the nucleus. Contrary to most previous reports, however, there was also a loss of cells in the ventral tegmental area (28-57%) and ventral reticular formation (33-87%), corresponding to nuclei A10 and A8, respectively. Since neuroanatomical tracing studies have shown that the dorsal and lateral portions of the striatum (areas showing the greatest dopamine depletion after MPTP) receive input from cells in the ventral A9 and from cells in the A8 and A10 areas, the present data suggest that MPTP preferentially destroys dopamine cells that project to the striatum (i.e. the mesostriatal cells).

Radical prostatectomy for stage D1 prostate cancer. Prognostic variables and results of treatment.

Surgical extirpation of the primary tumor together with the involved regional nodes has been considered ineffective treatment for locally disseminated prostatic carcinoma. We retrospectively reviewed our experience with 42 patients with Stage D1 disease who underwent radical prostatectomy and bilateral pelvic lymphadenectomy and who had a follow-up of one to thirteen years (mean 5 years). The following variables affecting survival and tumor progression were analyzed: (1) tumor grade and local extent; (2) number of positive lymph nodes, and (3) adjuvant therapy. The overall five- and ten-year survival was 79.5 per cent and 28 per cent compared with the expected survival of an age-matched control group of 88 per cent and 28 per cent, respectively. The degree of tumor differentiation had no effect on prognosis, but local tumor bulk and the number of involved lymph nodes significantly changed the disease progression and survival rate. Patients with low local tumor bulk and one positive node survived as long as the age-matched male population group. Our data suggest that radical prostatectomy may represent a valuable treatment in selected patients with Stage D1 prostate carcinoma.

Effects of ultrasound on ultrastructure of human testes.

Studies to detect ultrastructural changes in testicular tissues after a fifteen-minute exposure to ultrasonic waves were done in 10 men undergoing bilateral orchiectomies for prostatic carcinoma. Examination of Sertoli cells and germ cells in different stages of differentiation failed to reveal significant differences between exposed and control testes.