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1.
Surg Res Pract ; 2024: 3550087, 2024.
Article in English | MEDLINE | ID: mdl-38803452

ABSTRACT

Background: Scapular fracture is a rare encounter in blunt trauma patients. The scapula is surrounded by strong groups of muscles offering good protection for the bone. Therefore, a high-energy trauma is needed to cause a scapular fracture. We aim to study scapular fractures and their relation to injury severity and mortality in blunt chest trauma (BCT) patients. Methods: We retrospectively collected data from all patients with BCT who were admitted to our hospital from December 2014 through January 2017. The injury details of all BCT patients were retrieved from the trauma registry of the hospital and were supplemented by patients' electronic files for missing information. Collected data included demography, mechanism of injury, vital signs, Glasgow Coma Score (GCS) on admission, injured body regions, management, Injury Severity Score (ISS), New Injury Severity Score (NISS), length of hospital stay (LOS), and mortality. Results: During the study period, 669 patients had BCT. Scapular fracture was present in 29 (4.3%) of the BCT patients. The scapular fracture was missed by chest X-ray in 35.7% of the patients; however, it was accurately diagnosed by computed tomography (CT) scan of the chest. Neck injury was significantly higher in patients with scapular fracture compared with patients without fracture (p < 0.001). ISS and NISS were significantly higher in patients with scapular fractures compared to other patients without fractures (p=0.04 and p=0.003 Mann-Whitney U test, respectively). Two patients with scapular fractures died due to severe associated injuries (the overall mortality was 9.6%). Conclusions: Scapular fracture in BCT patients indicates a high-energy type of trauma. Compared to a chest X-ray, CT scan was more accurate for the diagnosis of scapular fracture. Associated injuries are the main cause of trauma-related mortality rather than the direct effect of the fractured scapula. Particular attention and meticulous evaluation should be paid to head and neck injuries to avoid missing injuries.

2.
Environ Sci Pollut Res Int ; 30(54): 116214-116226, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37910365

ABSTRACT

Innovative technologies are needed to enhance access to clean water and avoid waterborne diseases. We investigated the performance of cold atmospheric plasma (CAP), a clean and sustainable approach for microbial inactivation and total organic carbon (TOC) degradation in environmental water. Water matrices played a crucial role in the performance of CAP efficacy; for example, complete removal of ɸX174 from dH2O required 1 min of treatment, while ɸX174 reductions of ~ 2log10 and 4log10 were obtained after 10 min of CAP exposure in river water and wastewater samples, respectively. Similarly, after 10 min of CAP treatment, bacterial concentrations decreased by 3 log10 and 4 log10, in river and wastewater samples, respectively. In contrast, after 30 s of contact time, a 4 log10 reduction of bacteria was accomplished in dH2O. Complete removal of Acanthamoeba from dH2O was found after 30 min of CAP treatment, whereas it was not removed from surface water or wastewater at the same exposure time. Additionally, the approach successfully reduced TOC, and the degradation kinetics of TOC were represented by pseudo-first-order. CAP showed higher rates of TOC degradation in the final effluent of the wastewater treatment plant compared to surface water. The difference in CAP performance between river water and wastewater could be attributed to the bulk structure of humic acids in river water compared to small organic byproducts in the final effluent of WWTP. Overall, the findings reported here support the idea that CAP holds promise as a sustainable solution for controlling pathogens, removing organic water pollution, and integrating with traditional purification processes. Low-cost systems may advance CAP technology and increase its widespread use.


Subject(s)
Environmental Pollutants , Viruses , Water Pollutants, Chemical , Water Purification , Wastewater , Waste Disposal, Fluid , Rivers , Bacteria , Water Pollutants, Chemical/analysis , Water
3.
J Emerg Trauma Shock ; 16(3): 127-129, 2023.
Article in English | MEDLINE | ID: mdl-38025498

ABSTRACT

Acute traumatic lumbar hernia (ATLH) is rare in blunt trauma and can be overlooked due to the presence of multiple injuries following the trauma incidence. ATLH is usually found at the time of radiological examination or during surgical exploration. Awareness of the clinicians about the possibility of ATLH can enhance early diagnosis and reduce the occurrence of serious complications including bowel obstruction and strangulation. Herein, we present two cases of ATLH in which one of them was treated conservatively in the acute stage and the other patient was treated surgically. Conservative management can be adopted in the acute stage with the delayed repair of the hernia after resolving the muscles' contusion. However, early operative intervention is essential if conservative management failed or in the event of acute deterioration of the patient's condition.

4.
Surg Res Pract ; 2023: 8896989, 2023.
Article in English | MEDLINE | ID: mdl-36949736

ABSTRACT

Background: Sternal fractures are not commonly observed in patients with blunt trauma. The routine use of computed tomography (CT) in the evaluation of chest trauma helps identify these fractures. We studied the incidence, injury mechanism, management, and outcome of sternal fractures in patients with blunt trauma treated at our community-based hospital. Methods: We retrospectively reviewed the chest CT scans of all patients with blunt trauma who were presented to our community-based hospital from October 2010 to March 2019. The study variables included age at the time of injury, sex, mechanism of injury, type, and site of fracture, associated injuries, Glasgow Coma Scale, Injury Severity Score, need for intensive care unit admission, hospital stay, and long-term outcome. Results: In total, 5632 patients with blunt trauma presented to our hospital during the study period, and chest CT scan was performed for 2578 patients. Sternal fractures were diagnosed in 63 patients. The primary mechanism of injury was a motor vehicle collision. The most common site of fracture was the body of the sternum (47 patients; 74.6%). Twenty (31.7%) patients had an isolated sternal fracture with no other injuries. Seven (11.1%) patients were discharged directly from the emergency department. Two patients died (overall mortality rate, 3.2%) and two experienced long-term disability. Conclusions: The incidence of sternal fractures in our patient population was similar to that reported by tertiary hospitals. Patients with a sternal fracture and normal cardiac enzyme levels and electrocardiogram may be safely discharged from the emergency department, provided there are no other major injuries.

5.
Sci Rep ; 13(1): 3120, 2023 02 22.
Article in English | MEDLINE | ID: mdl-36813844

ABSTRACT

The need for more efficient drug delivery strategies with ultraprecision and control over the release of drugs has led to the growth of more sophisticated drug-releasing systems as a promising alternative to conventional clinical therapies. This new seed of strategies has explored an encouraging property to overcome the inherent problems of traditional therapies. One of the major challenges for any drug delivery system is the introduction of a complete view of the delivery system. In this article, we intend to elucidate the theoretical proof of concept of the electrosynthesis ATN@DNA core-shell like structure as a model system. Therefore, we present a fractal kinetic model (non-exponential model) taking into consideration the concept of time-dependent diffusion coefficient, which was developed using a numerical method with the help of COMSOL Multiphysics. In addition to that, we present here a general fractional kinetic model in sense of the tempered fractional operator, which leads to better characterized memory properties of the release process. Also, the fractional model is compared with the fractal kinetic model and both offer a good description of drug release processes that present anomalous kinetics. The solutions of the fractal and fractional kinetic models are also fitted successfully with our real-release results.


Subject(s)
Atenolol , Drug Delivery Systems , Drug Liberation , Pharmaceutical Preparations , Models, Biological
6.
Sci Rep ; 12(1): 9850, 2022 06 14.
Article in English | MEDLINE | ID: mdl-35701491

ABSTRACT

This study aimed to investigate the synergistic effect of the cold atmospheric plasma (CAP) and heterogeneous photocatalytic processes in an aqueous solution to enhance water purification efficacy and reduce the energy cost required by CAP. 0.1% Ag/TiO2-reduced graphene oxide (rGO) nanoparticles (NPs) photo-composite were prepared and fully characterized. Data showed that Ag nanoparticles and the rGO play an important role in increasing the efficiency of the whole treatment process and the photo-composite (0.1% Ag/TiO2-1% rGO at 400 °C) revealed the highest phenol removal rate with excellent reusability. Also, complete inactivation (~ 5log10 reduction) of both E. coli and S. aureus by NPs was observed without CAP exposure, whereas a minimal effect (0.1-0.5 log10) on viruses (Adenovirus (AdV), rotavirus, and ɸX174) was observed after 10 min incubation. Interestingly, the photocatalytic virus inactivation test was promising, as it resulted in > 4.7log10 reduction of AdV at 2 min treatment, whereas < 1log10 could be reduced using only CAP at the same treatment time. Accordingly, we believe that this work could provide new insights into how the synergy between CAP and 0.1% Ag/TiO2-1% rGO photo-composite in aqueous media imposes a great potential for environmental applications, such as water purification and microbial inactivation.


Subject(s)
Metal Nanoparticles , Plasma Gases , Water Pollutants, Chemical , Water Pollutants , Catalysis , Escherichia coli , Graphite , Oxides/chemistry , Silver/chemistry , Staphylococcus aureus , Titanium , Water , Water Pollutants, Chemical/chemistry
7.
J Emerg Trauma Shock ; 15(4): 162-166, 2022.
Article in English | MEDLINE | ID: mdl-36643773

ABSTRACT

Introduction: Injury caused by large animals varies according to the regional distribution of the animals and their relationship to humans. Camels are usually friendly to humans; however, occasionally they become very hostile, especially in rutting season. Most in-hospital trauma deaths are related to head injury. Very few studies in the literature have discussed camel-related head injuries. We aimed to study the incidence, mechanism of injury, types, and outcome of camel-related head injury in a high-income developing country to give recommendations on preventive measures. Methods: We retrospectively collected data from all patients who were admitted to Al Ain Hospital with a camel-related head injury from January 1, 2015, to January 1, 2021. Data collected included demography, mechanism of injury, anatomical location, severity of the injury, associated injuries, and management. The patients were followed up during their hospital stay to record the length of hospital stay, complications, and outcome. Results: During the study period, 98 patients were admitted to Al Ain Hospital with camel-related injury. Thirty-nine (39.8%) of the admitted patients with a camel-related injury sustained a head injury; a camel-related head injury was more common during August (23.1%). Thirty-four (87.2%) patients were camel caregivers. Thirty-three patients (84.6%) were injured on farms. Seven patients suffered an intracranial hemorrhage, and six (85.7%) of them had a history of fall from a camel. Glasgow Coma Score was significantly correlated to the severity of head injury measured by Abbreviated Injury Severity of the head (P = 0.006, Spearman's correlation). One patient died during the study period after having decompressive craniectomy for subdural hemorrhage (overall mortality 2.6%). Conclusions: The majority of camel-related head injury occurred in camel caregivers at camel farms and can be considered a work-related injury. Careful handling of camels, especially during the summertime can reduce the toll of camel-related head injury and its serious consequences. None of the injured patients was wearing a helmet at the time of injury. Legislation for compulsory helmet usage by camel caregivers at farms may decrease the incidence of head injuries in those patients.

8.
Adv Med Educ Pract ; 12: 769-777, 2021.
Article in English | MEDLINE | ID: mdl-34290542

ABSTRACT

PURPOSE: Learning focus has shifted from conventional teacher-centered to student-centered; therefore, methods used to support and encourage learners must be considered. Meanwhile, the individual differences between learners should be taken into consideration by medical educators. Aiming to achieve a better learning experience, the current study investigates the relationship between personality traits and learning styles and their effect on students' academic achievement. SUBJECTS AND METHODS: An analytical, cross-sectional study, encompassing a sample of 333 undergraduate first-year medical students, at the Faculty of Medicine, Suez Canal University in Egypt was conducted. The Big Five personality traits test and VARK learning styles questionnaires were used to assess students' personality traits and learning styles, respectively, in the medical education module which is a part of the Foundation II module. The former is five weeks' duration and is followed by a summative exam at the end. Students' academic achievement was determined from their grades in Foundation II module by the end of the semester. RESULTS: Study findings generally indicate that the highest domain of learning styles among students is the kinesthetic domain. A statistically significant difference between males and females regarding their learning style preferences was detected. Also, there was a statistically significant relationship between auditory and kinesthetic learning styles and academic achievement. Though there was a significant relationship between kinesthetic learning style with both openness traits and academic achievement, no significant statistical relationship was found between any of the personality traits and academic achievement. CONCLUSION: This study concludes that learning style could affect students' academic achievement. It reveals that the kinesthetic learning style is the most preferred learning style among our medical students, also the agreeableness and openness traits were the most common personality traits among them. No significant relationship was detected between personality traits and academic achievement.

9.
Trauma Case Rep ; 33: 100478, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33997225

ABSTRACT

Blunt civilian perineal laceration with anorectal avulsion is rare and usually associated with severe pelvic trauma. The principles of management of these injuries consist of repair of the laceration (primarily or secondary), diversion of fecal stream, and presacral drainage of the wound. Unnecessary diversion of fecal stream may add complications and increases patient's morbidity. We report a case of severe blunt traumatic perineal laceration associated with partially avulsed anus which was managed without colostomy. The wound healed completely with preserved anal sphincter function. To our knowledge, no similar cases of anal avulsion were treated without diversion of the fecal stream in the English literature.

10.
J Hand Surg Asian Pac Vol ; 25(1): 87-94, 2020 Mar.
Article in English | MEDLINE | ID: mdl-32000594

ABSTRACT

Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian population is 20%. It is important for Hand, Orthopaedic and Neurosurgeons to be aware of this anatomic variation in order to explain paradoxical motor and sensory loss in patients.


Subject(s)
Action Potentials/physiology , Forearm/innervation , Median Nerve/abnormalities , Median Nerve/physiopathology , Ulnar Nerve/abnormalities , Ulnar Nerve/physiopathology , Adult , Anatomic Variation , Egypt , Female , Humans , Male , Middle Aged , Muscle, Skeletal/innervation , Prevalence
11.
J Med Virol ; 91(1): 93-101, 2019 01.
Article in English | MEDLINE | ID: mdl-30133717

ABSTRACT

Egypt is one of the highest prevalence rates of hepatitis C virus (HCV) infection worldwide. HCV is among major reasons for chronic liver diseases. MicroRNA (miRNAs), small noncoding regulatory molecules play a key role in the pathogenesis of liver. Circulating miRNAs represent potential noninvasive biomarkers for diagnosis and monitoring patients with liver diseases progression. To investigate the potential role of circulating miRNAs for surveillance of liver disease progression, we assessed the expression of 20 liver-related miRNAs in sera of 47 chronic hepatitis C Egyptian patients compared with 25 controls using quantitative reverse-transcription polymerase chain reaction assay. The sensitivity and specificity were evaluated using receiver operating characteristic (ROC) curve. The correlations between their levels and the clinicopathological features were assessed. Fourteen miRNAs showed upregulation and six miRNAs showed downregulation. ROC curve analyses revealed that the explored miRNAs could serve as valuable biomarkers for chronic hepatitis with an area under the curve ranged from 0.708 (95% confidence interval [95% CI], 0.587 to 0.829; P = 0.004) for miR-199 up to 0.974 (95% CI, 0.943 to 1.00; P < 0.001) for miR-23b. The expression level of miR-21 demonstrated significant correlation with age, liver enzymes, ALT/AST, and α-fetoprotein level. AST level was directly correlated with miR-122, while an inversely correlated with miR-23b. Fibrosis and steatosis stages possessed positive correlation with miR-199 expression and negative correlation with miR-27a and miR-93. In conclusion, miR-23b and miR-106 might be a useful biomarker for chronic hepatitis C (CHC). MiR-27a, miR-93, and miR-199 might have a potential role in the progression of liver diseases. Unravel the role of these miRNAs in CHC patients might lead to precise prognosis and management.


Subject(s)
Biomarkers/blood , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/pathology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/pathology , MicroRNAs/blood , Molecular Diagnostic Techniques/methods , Adult , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Disease Progression , Egypt , Female , Humans , Male , Middle Aged , ROC Curve , Real-Time Polymerase Chain Reaction/methods , Sensitivity and Specificity
12.
Sci Rep ; 7(1): 2791, 2017 06 05.
Article in English | MEDLINE | ID: mdl-28584285

ABSTRACT

Cold physical plasma has been suggested as a powerful new tool in oncology. However, some cancer cells such as THP-1 leukaemia cells have been shown to be resistant towards plasma-induced cell death, thereby serving as a good model for optimizing plasmas in order to foster pro-apoptotic anticancer effects. A helium/oxygen radio frequency driven atmospheric plasma profoundly induced apoptosis in THP-1 cells whereas helium, humidified helium, and humidified helium/oxygen plasmas were inefficient. Hydrogen peroxide - previously shown as central plasma-derived agent - did not participate in the killing reaction but our results suggest hypochlorous acid to be responsible for the effect observed. Proteomic analysis of THP-1 cells exposed to He/O2 plasma emphasized a prominent growth retardation, cell stress, apoptosis, and a pro-immunogenic profile. Altogether, a plasma setting that inactivates previously unresponsive leukaemia cells is presented. Crucial reactive species in the plasma and liquid environment were identified and discussed, deciphering the complexity of plasma from the gas phase into the liquid down to the cellular response mechanism. These results may help tailoring plasmas for clinical applications such as oxidation-insensitive types of cancer.


Subject(s)
Apoptosis/genetics , Oxygen/chemistry , Plasma Gases/chemistry , Plasma Gases/pharmacology , Apoptosis/drug effects , Cell Survival/drug effects , Helium/chemistry , Humans , Proteomics/methods , THP-1 Cells
13.
Int J Comput Assist Radiol Surg ; 10(6): 707-15, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25930713

ABSTRACT

INTRODUCTION: Hip resurfacing is a surgical option for osteoarthritis young and active patients. Early failures has been reported due to improper implant placement. Computer-assisted surgery is a promising avenue for more successful procedures. PURPOSE: This paper presents a novel automatic surgical planning for computer-assisted hip resurfacing procedures. The plan defined the femoral head axis that was used to place the implant. The automatic planning was based on a Lie group statistical shape model. METHODS: A statistical shape model was constructed using 50 femurs from osteoarthritis patients who underwent computer-assisted hip resurfacing. The model was constructed using product Lie groups representation of shapes and nonlinear analysis on the manifold of shapes. A surgical plan was drawn for the derived base shape. The base shape was transformed to 14 femurs with known manual plans. The transformed base plan was used as the computed plan for each femur. Both actual and computed plans were compared. RESULTS: The method showed a success by computing plans that differ from the actual plans within the surgical admissible ranges. The minimum crossing distance between the two plans had a mean of 0.75 mm with a standard deviation of 0.54 mm. The angular difference between the two plans had the mean of 5.94° with a standard deviation of 2.145.94°. CONCLUSION: Product Lie groups shape models were proved to be successful in automatic planning for hip resurfacing computer-assisted surgeries. The method can be extended to other orthopedic and general surgeries.


Subject(s)
Femur Head/surgery , Hip Joint/surgery , Models, Anatomic , Orthopedic Procedures/methods , Osteoarthritis, Hip/surgery , Surgery, Computer-Assisted/methods , Humans , Preoperative Period
14.
Stud Health Technol Inform ; 196: 163-9, 2014.
Article in English | MEDLINE | ID: mdl-24732500

ABSTRACT

Statistical shape models using a principal-component analysis are inadequate for studying shapes that are in non-linear manifolds. Principal tangent components use a matrix Lie group that maps a non-linear manifold to a corresponding linear tangent space. Computations that are performed on the tangent space of the manifold use linear statistics to analyze non-linear shape spaces. The method was tested on bone surface from proximal femurs. Using only three components, the new model recovered 94% of the medical dataset, whereas a conventional method that used linear principal components needed 24 components to achieve the same reconstruction accuracy.


Subject(s)
Bone and Bones/anatomy & histology , Computer Simulation , Models, Anatomic , Algorithms , Imaging, Three-Dimensional
15.
Rheumatol Int ; 33(10): 2561-7, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23681020

ABSTRACT

Fibromyalgia (FM) is the most common chronic pain syndrome encountered in medical practice, affecting females more than males, and the estimated prevalence of FM in Egypt is 1.3 %. The aim was to translate and adapt the Fibromyalgia Impact Questionnaire (FIQ) into Arabic and assess reliability and validity. The Arabic version of Fibromyalgia Impact Questionnaire (FIQ-A) was adapted following the forward/backward translation approach. Fifty-one female patients with FM were studied to assess psychometric properties of the FIQ-A. Reliability was analyzed by the correlation coefficient between test and retest. Internal consistency was checked by the Cronbach's alpha coefficient. Construct validity was assessed comparing FIQ-A with Health Assessment Questionnaire (HAQ), Health Assessment Questionnaire of Fibromyalgia (FHAQ), The Medical Outcome Survey Short-Form-36 (SF-36), and the Total Visual Analog Scale (TVAS) for FM symptom, and feasibility was assessed by the time taken in completing the FIQ-A and the proportion of patients completed the questionnaire. Patients studied were 33.2 ± 9.8 years old. Translation was concordant. Adaptation affected 4 sub-items of physical function. Test-retest correlation coefficient was 0.89 for total FIQ-A and Cronbach's alpha was 0.76. Excellent to good statistically significant correlations (p < 0.05) were found between the FIQ-A items and HAQ, FHAQ, and SF-36. The FIQ-A is a reliable, valid for measuring health status and physical function in Arabic-speaking FM patients.


Subject(s)
Disability Evaluation , Fibromyalgia/diagnosis , Fibromyalgia/physiopathology , Adult , Egypt , Female , Health Status , Humans , Middle Aged , Pain Measurement , Psychometrics , Reproducibility of Results , Sickness Impact Profile , Surveys and Questionnaires , Translations
16.
Stud Health Technol Inform ; 184: 195-201, 2013.
Article in English | MEDLINE | ID: mdl-23400155

ABSTRACT

One marker for early-onset hip arthritis is femoral acetabular impingement. The current standard way of quantifying impingement is manual calculation of anatomical measures on plain radiographs, including the α-angle. Such measurements are user-dependent and prone to error. We provided a robust computational alternative and proposed using numerical fitting of geometrical shapes. We applied least-squares fitting of an ellipse to the femoral head contour and used the difference between the ellipse axes as a quantification method. The results showed a good correlation between the new measure and previous definitions of the α-angle.


Subject(s)
Arthrography/methods , Femoracetabular Impingement/complications , Femoracetabular Impingement/diagnostic imaging , Osteoarthritis, Hip/diagnostic imaging , Osteoarthritis, Hip/etiology , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Early Diagnosis , Humans , Reproducibility of Results , Sensitivity and Specificity
17.
World J Stem Cells ; 4(10): 101-9, 2012 Oct 26.
Article in English | MEDLINE | ID: mdl-23189211

ABSTRACT

AIM: To investigate the effect of human umbilical cord stem cells, both mesenchymal and hematopoietic (CD34+), in the treatment of arthritis. METHODS: Mesenchymal stem cells (MSCs) and hematopoietic (CD34+) stem cells (HSC) were isolated from human umbilical cord blood obtained from the umbilical cord of healthy pregnant donors undergoing full-term normal vaginal delivery. MSC, HSC, methotrexate (MTX) and sterile saline were injected intra-articularly into the rat hindpaw with complete freunds adjuvant (CFA) induced arthritis after the onset of disease (day 34), when arthritis had become well established (arthritis score ≥ 2). Arthritic indices were evaluated and the levels of interleukin (IL)-1, tumor necrosis factor (TNF)-α and interferon (IFN)-γ and anti-inflammatory cytokine IL-10 in serum were determined using enzyme-linked immunosorbent assay. Animals of all groups were sacrificed 34 d after beginning treatment, except positive control (PC) which was sacrificed at 10, 21 and 34 d for microscopic observation of disease progression. We used hematoxylin, eosin and Masson's trichrome stains for histopathological examination of cartilage and synovium. RESULTS: The mean arthritis scores were similar in all groups at 12 and 34 d post immunization, with no statistical significant difference. Upon the injection of stem cells (hematopoietic and mesenchymal), the overall arthritis signs were significantly improved around 21 d after receiving the injection and totally disappeared at day 34 post treatment in MSC group. Mean hindpaw diameter (mm) in the MSC rats was about half that of the PC and MTX groups (P = 0.007 and P = 0.021, respectively) and 0.6 mm less than the HSC group (P = 0.047), as indicated by paw swelling. Associated with these findings, serum levels of TNF-α, IFN-γ and IL-1 decreased significantly in HSC and MSC groups compared to PC and MTX groups (P < 0.05), while the expression of IL-10 was increased. Histopathological examination with H and E stain revealed that the MTX treated group showed significant reduction of leucocytic infiltrate and hypertrophy of the synovial tissue with moderate obliteration of the joint cavity. Stem cells treated groups (both hematopoietic CD34+ and mesenchymal), showed significant reduction in leucocytic infiltrate and hypertrophy of the synovial tissue with mild obliteration of the joint cavity. With Masson's trichrome, stain sections from the PC group showed evidence of vascular edema of almost all vessels within the synovium in nearly all arthritic rats. Vacuoles were also visible in the outer vessel wall. The vessel became hemorrhagic and finally necrotic. In addition, there was extensive fibrosis completely obliterating the joint cavity. The mean color area percentage of collagen in this group was 0.324 ± 0.096, which was significantly increased when compared to the negative control group. The mean color area percentage of collagen in hematopoietic CD34+ and mesenchymal groups was 0.176 ± 0.0137 and 0.174 ± 0.0197 respectively, which showed a marked decrement compared to the PC group, denoting a mild increase in synovial tissue collagen fibers. CONCLUSION: MSC enhance the efficacy of CFA-induced arthritis treatment, most likely through the modulation of the expression of cytokines and amelioration of pathological changes in joints.

18.
Gastrointest Endosc ; 73(1): 123-7, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21184877

ABSTRACT

BACKGROUND: One of the challenges in natural orifice transluminal endoscopic surgery (NOTES) is spatial orientation. The Queen's NOTES group has devised a novel method of orientation by using a magnetic device that passes within an endoscope channel allowing for 3-dimensional imaging of the shape and orientation of the endoscope. OBJECTIVE: To assess the feasibility and utility of a novel orientation device. DESIGN: Randomized, controlled trial. SETTING: Animal research laboratory study on four 25-kg pigs. INTERVENTION: The device was tested by 6 endoscopists and 6 laparoscopic surgeons. Starting at the gastrotomy, the time to identify 4 targets was recorded. Participants were required to identify and touch the gallbladder, the fallopian tube, a clip on the abdominal wall, and the liver edge. Use of the orientation device was randomized for each session. MAIN OUTCOME MEASUREMENTS: Time to identify targets with and without the device. Secondary analysis assessed differences between medical specialties and level of training. RESULTS: The mean time to identify all 4 targets with the device was 75.08 ± 42.68 seconds versus 100.20 ± 60.70 seconds without the device (P <.001). The mean time to identify all 4 targets on the first attempt was 102.29 ± 61.36 seconds versus 72.99 ± 40.19 seconds on the second attempt (P <.001). No differences based on specialty or level of training were identified. LIMITATIONS: Small sample size and simplicity of tasks. CONCLUSION: Regardless of randomization order, both groups were faster with the device. These encouraging results warrant further study using more complex scenarios.


Subject(s)
Endoscopes , Natural Orifice Endoscopic Surgery/instrumentation , Natural Orifice Endoscopic Surgery/methods , Space Perception , Time and Motion Studies , Animals , Female , Gastroenterology , Humans , Prospective Studies , Random Allocation , Stomach/surgery , Swine
19.
Med Image Comput Comput Assist Interv ; 11(Pt 2): 493-500, 2008.
Article in English | MEDLINE | ID: mdl-18982641

ABSTRACT

We present a quantitative model to analyze the detrimental effects of for edema on the quality of prostate brachytherapy implants We account for both tissue expansion and implant migration by mapping intra-operative ultrasound and post-implant CT. We pre-process the ultrasound with a phase congruency filter, and map it to the volume CT using a B-spline deformable mutual information similarity metric. To test the method, we implanted a standard training phantom with 48 seeds, imaged the phantom with ultrasound and CT and registered the two for ground truth. Edema was simulated by distorting the CT volume by known transformations. The objective was to match the distorted implant to the intra-operative ultrasound. Performance was measured relative to ground truth. We successfully mapped 100% of deformed seeds to ground truth under edematic expansion up to 40% of volume growth. Seed matching performance was 98% with random seed migration of 3mm superimposed on 10% edematic volume growth. This method promises to be clinically applicable as the first quantitative analysis tool to measure edematic implant deformations occurring between the operating room and post-operative CT imaging.


Subject(s)
Brachytherapy/adverse effects , Edema/diagnostic imaging , Edema/etiology , Prostatic Diseases/diagnostic imaging , Prostatic Diseases/etiology , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Algorithms , Brachytherapy/instrumentation , Humans , Male , Pattern Recognition, Automated/methods , Prostatic Neoplasms/complications , Prostatic Neoplasms/radiotherapy , Prosthesis Implantation/adverse effects , Radiographic Image Enhancement/methods , Reproducibility of Results , Sensitivity and Specificity , Treatment Outcome
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