A simple tissue model for practicing ultrasound guided vascular cannulation

Introduction: The use of ultrasound in anaesthetic practice continues to be more established and the use of ultrasound guidance in establishing vascular access is recommended by various groups. We have developeda tissue model for the practice and skills development in ultrasound vascular access.Method: The tissue model consist of a piece of “pork belly”, a longitudinal shaped balloon inserted between two muscle layers at a chosen depth of the tissue model (mimics a blood vessel), a bag of intravenous fluid (e.g. Ringer’s Lactate) together with a giving set and a short piece of extension tubing connected to a threeway tap used to expel air from the system. One end of the balloon is tied to the giving set with the intravenous fluid. The other end is tied to the short tubing with the three-way tapResults: Ultrasound images of the fluid filled balloon mimic a blood vessel. It is possible under ultrasound guidance to puncture the balloon several times (>10times) and still be able to distend the balloon with fluid.Interpretation: Ultrasound guided techniques require practice to improve hand-eye coordination. The “pork belly” tissue model allows multiple needle puncture without losing its functional integrity.Conclusion: We believe the “pork belly” tissue model adds to the range of models that can be used to practice ultrasound guided vascular access. The components required for this model are readily available locally and affordable.Keywords: Ultrasound-guided, vascular access, tissue model, pork belly, training, skills acquisitio

Rupture of sinus of valsalva aneurysm: Case report

Sinus of Valsalva aneurysms are uncommon. Aortic sinus aneurysm may be complicated by endocarditis or rupture. A 26 year old native Ghanaian presented with dyspnoea, raised jugular venous pressure (JVP), tender hepatomegaly, peripheral oedema, a thrill and a continuous murmur at the upper left sternal edge. Two-dimensional doppler echocardiography with colour flow mapping revealed a large aneurysm of the right sinus of Valsalva (4cm diameter) that abutted the right ventricular out-flow tract with distortion of the pulmonary valve. Colour flow revealed left to right shunting of blood from the aortic root into the right atrium. A year later he presented with a febrile illness, weight loss, night sweats and wasdiagnosed as having culture negative infective endocarditis. Following a course of antibiotics, he underwent successful cardiopulmonary bypass surgery with repair of the ruptured aneurysm of the right sinus of Valsalva

Surgically correctable adrenal-dependent hypertension: a report of five cases

Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patientsinclude young individuals, those with difficult- to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratoryparameters well-known to be associated with Cushing’s syndrome, Conn’s syndrome or phaeochromocytoma. This paper reports on 5 patients identified over a 2-year period with various hormonally-activeadrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients’ histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigationsand management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenalrelated hypertension is good and can result in significantcost savings in the long term

Statistical evaluation of a new resistance model for cold-formed stainless steel cross-sections subjected to web crippling

This paper presents a statistical evaluation according to Annex D of EN 1990 (2002) of a new resistance function for web crippling design of cold-formed stainless steel cross-sections. This resistance function was derived by Bock et al. (2013) through the use of carefully validated numerical models with the aim to propose a design expression for stainless steel sections, which are currently designed following the provisions for cold-formed carbon steel sections given in EN 1993-1-3 (2006). Although it was shown that the proposed design equation is appropriate for application to various stainless steels, the statistical uncertainties in material properties that the different types of stainless steels exhibit require an assessment of various partial safety factors. The statistical assessment showed that the proposed resistance function by Bock et al. (2013) requires adjustment to satisfy the safety level set out in EN 1993-1-4 (2006); A recalibration is performed herein. The web crippling design provisions given in EN 1993-1-3 (2006) and SEI/ASCE 8-02 (2002) American standard for application to stainless steel are also statistically evaluated herein. Comparison with test and numerical data showed that the predictions of the recalibrated resistance function are better suited and consistent than existing design provisionsResearch Fund for Coal and Stee

Towards a framework for work package allocation for GSD

Proceeding of: Proceeding of: OTM 2011 Workshops: Confederated International Workshops and Posters: EI2N+NSF ICE, ICSP+INBAST, ISDE, ORM, OTMA, SWWS+MONET+SeDeS, and VADER 2011, Hersonissos, Crete, Greece, October 17-21, 2011Global software development is an inexorable trend in the software industry. The impact of the trend in conventional software development can be found in many of its aspects. One of them is task or work package allocation. Task allocation was traditionally driven by resource competency and availability but GSD introduces new complexities to this process including time-zones differences, costs and cultural differences. In this work a report on the construction of a framework for work-package allocation within GSD projects is presented. This framework lies on three main pillars: individual and organizational competency, organizational customization and sound assessment methods.This work is supported by the Spanish Centro para el Desarrollo Tecnológico Industrial (CDTI) under the Eureka Project E! 6244 PROPS-Tour and the national cooperation project SEM-IDi (IDI-20091150)

Comparative characterization of mesenchymal stem cells from eGFP transgenic and non-transgenic mice

Abstract Background Adipose derived- and bone marrow-derived murine mesenchymal stem cells (mMSCs) may be used to study stem cell properties in an in vivo setting for the purposes of evaluating therapeutic strategies that may have clinical applications in the future. If these cells are to be used for transplantation, the question arises of how to track the administered cells. One solution to this problem is to transplant cells with an easily identifiable genetic marker such as enhanced green fluorescent protein (eGFP). This protein is fluorescent and therefore does not require a chemical substrate for identification and can be visualized in living cells. This study seeks to characterize and compare adipose derived- and bone marrow-derived stem cells from C57Bl/6 mice and eGFP transgenic C57Bl/6 mice. Results The expression of eGFP does not appear to affect the ability to differentiate along adipogenic or osteogenic lineages; however it appears that the tissue of origin can influence differentiation capabilities. The presence of eGFP had no effect on cell surface marker expression, and mMSCs derived from both bone marrow and adipose tissue had similar surface marker profiles. There were no significant differences between transgenic and non-transgenic mMSCs. Conclusion Murine adipose derived and bone marrow derived mesenchymal stem cells from non-transgenic and eGFP transgenic C57Bl/6 mice have very similar characterization profiles. The availability of mesenchymal stem cells stably expressing a genetic reporter has important applications for the advancement of stem cell research.</p

Erythroid Promoter Confines FGF2 Expression to the Marrow after Hematopoietic Stem Cell Gene Therapy and Leads to Enhanced Endosteal Bone Formation

Fibroblast growth factor-2 (FGF2) has been demonstrated to be a promising osteogenic factor for treating osteoporosis. Our earlier study shows that transplantation of mouse Sca-1+ hematopoietic stem/progenitor cells that are engineered to express a modified FGF2 leads to considerable endosteal/trabecular bone formation, but it also induces adverse effects like hypocalemia and osteomalacia. Here we report that the use of an erythroid specific promoter, β-globin, leads to a 5-fold decrease in the ratio of serum FGF2 to the FGF2 expression in the marrow cavity when compared to the use of a ubiquitous promoter spleen focus-forming virus (SFFV). The confined FGF2 expression promotes considerable trabeculae bone formation in endosteum and does not yield anemia and osteomalacia. The avoidance of anemia in the mice that received Sca1+ cells transduced with FGF2 driven by the β-globin promoter is likely due to attenuation of high-level serum FGF2-mediated stem cell mobilization observed in the SFFV-FGF2 animals. The prevention of osteomalacia is associated with substantially reduced serum Fgf23/hypophosphatemia, and less pronounced secondary hyperparathyroidism. Our improved stem cell gene therapy strategy represents one step closer to FGF2-based clinical therapy for systemic skeletal augmentation

Analysis of Allogenicity of Mesenchymal Stem Cells in Engraftment and Wound Healing in Mice

Studies have shown that allogeneic (allo-) bone marrow derived mesenchymal stem cells (BM-MSCs) may enhance tissue repair/regeneration. However, recent studies suggest that immune rejection may occur to allo-MSCs leading to reduced engraftment. In this study, we compared allo-BM-MSCs with syngeneic BM-MSCs or allo-fibroblasts in engraftment and effect in wound healing. Equal numbers of GFP-expressing allo-BM-MSCs, syngeneic BM-MSCs or allo-fibroblasts were implanted into excisional wounds in GFP-negative mice. Quantification of GFP-expressing cells in wounds at 7, 14 and 28 days indicated similar amounts of allogeneic or syngeneic BM-MSCs but significantly reduced amounts of allo-fibroblasts. With healing progression, decreasing amounts of allogeneic and syngeneic BM-MSCs were found in the wound; however, the reduction was more evident (2 fold) in allo-fibroblasts. Similar effects in enhancing wound closure were found in allogeneic and syngeneic BM-MSCs but not in allo-fibroblasts. Histological analysis showed that allo-fibroblasts were largely confined to the injection sites while allo-BM-MSCs had migrated into the entire wound. Quantification of inflammatory cells in wounds showed that allo-fibroblast- but not allo-BM-MSC-treated wounds had significantly increased CD45+ leukocytes, CD3+ lymphocytes and CD8+ T cells. Our study suggests that allogeneic BM-MSCs exhibit ignorable immunogenicity and are equally efficient as syngeneic BM-MSCs in engraftment and in enhancing wound healing

Software quality management improvement through mentoring: an exploratory study from GSD projects

Proceeding of: OTM 2011 Workshops: Confederated InternationalWorkshops and Posters: EI2N+NSF ICE, ICSP+INBAST, ISDE, ORM, OTMA, SWWS+MONET+SeDeS, and VADER 2011, Hersonissos, Crete, Greece, October 17-21, 2011Software Quality Management (SQM) is a set of processes and procedures designed to assure the quality of software artifacts along with their development process. In an environment in which software development is evolving to a globalization, SQM is seen as one of its challenges. Global Software Development is a way to develop software across nations, continents, cultures and time zones. The aim of this paper is to detect if mentoring, one of the lead personnel development tools, can improve SQM of projects developed under GSD. The results obtained in the study reveal that the influence of mentoring on SQM is just temperate

Efficient Enrichment of Hepatic Cancer Stem-Like Cells from a Primary Rat HCC Model via a Density Gradient Centrifugation-Centered Method

Background: Because few definitive markers are available for hepatic cancer stem cells (HCSCs), based on physical rather than immunochemical properties, we applied a novel method to enrich HCSCs. Methodology: After hepatic tumor cells (HTCs) were first isolated from diethylinitrosamine-induced F344 rat HCC model using percoll discontinuous gradient centrifugation (PDGC) and purified via differential trypsinization and differential attachment (DTDA), they were separated into four fractions using percoll continuous gradient centrifugation (PCGC) and sequentially designated as fractions I–IV (FI–IV). Morphological characteristics, mRNA and protein levels of stem cell markers, proliferative abilities, induced differentiation, in vitro migratory capacities, in vitro chemo-resistant capacities, and in vivo malignant capacities were determined for the cells of each fraction. Findings: As the density of cells increased, 22.18%, 11.62%, 4.73 % and 61.47 % of primary cultured HTCs were segregated in FI–FIV, respectively. The cells from FIII (density between 1.041 and 1.062 g/ml) displayed a higher nuclear-cytoplasmic ratio and fewer organelles and expressed higher levels of stem cell markers (AFP, EpCAM and CD133) than cells from other fractions (P,0.01). Additionally, in vitro, the cells from FIII showed a greater capacity to self-renew, differentiate into mature HTCs, transit across membranes, close scratches, and carry resistance to chemotherapy than did cells from any other fraction; in vivo, injection of only 1610 4 cells from FIII could generate tumors not only in subcutaneous tissue but also in th