Carcinoid tumour of the kidney in a Chinese woman presenting with loin pain

Renal carcinoid tumours are uncommon. The aetiology is not yet fully understood and there is still no useful diagnostic tool for detecting them. We report our experience managing a Chinese woman with a primary renal carcinoid tumour.published_or_final_versio

Direct ink writing of polycaprolactone / polyethylene oxide based 3D constructs

There has been increasing interest over recent years in the application of three-dimensional (3D) printing technologies in the biomedical field. One such method is Direct Ink Writing (DIW); this approach has the potential advantage of allowing room-temperature deposition of materials, presented as an ink, to build complex architectures. DIW offers the ability to process biomaterials containing temperature-sensitive components. Due to the fabrication principles of DIW, there are specific rheological requirements that the ink must exhibit for the 3D construction. For this reason, hydrogel-based liquid feed stocks have been the focal point of ink development. As a consequence, studies based on inks comprising hydrophobic biomaterials, which are insoluble in water and hence unsuited to the hydrogel approach, have been limited. In this study, we investigate novel inks that utilize polycaprolactone (PCL), a hydrophobic polymer, as the primary constituent by dissolving the polymer in solvent systems based on dichloromethane (DCM) and acetone (ACE). Moreover, polyethylene oxide (PEO) was incorporated into the PCL systems in order to extend the range of hydrophilicity of the systems. The rheological properties of the inks were investigated as a function of polymer composition and solvent system. Woodpile constructs of PCL and PCL/PEO were fabricated using DIW method and were assessed by a series of material characterisation. The type of solvent system had a noticeable impact on the ink rheology, which ultimately affected the surface properties. The incorporation of PEO particularly enhanced the roughness and wettability of the constructs. Our results support the use of DIW as a new means to process hydrophobic polymers for biomedical applications

Comparative study of conversion of coral with ammonium dihydrogen phosphate and orthophosphoric acid to produce calcium phosphates

© 2014, Australasian Ceramic Society. All rights reserved. Biogenic materials like corals, which are readily available, could be used to produce bioceramic materials and address significant advantages due to their unique structures and chemical compositions that contain Mg and Sr. Many conversion processes has been in the past proposed. In this work, a comparison study between the conversion of coral with orthophosphoric acid and ammonium dihydrogen phosphate was conducted. The resultant structures and compositions were studied using XRD, ICP-MS, SEM and FTIR. The results show that with phosphoric acid the coral was converted into mainly monetite (92%). The ammonium dihydrogen phosphate converted approximately 76% of the coral to hydroxyapatite through solid state reactions. The two routes proved to be effective in producing bioceramic materials from corals under moderate conditions of temperature with a basic condition favouring the yield of hydroxyapatite

Limited versus full sternotomy for aortic valve replacement

Copyright \ua9 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. BACKGROUND: Aortic valve disease is a common condition easily treatable with cardiac surgery. This is conventionally performed by opening the sternum (\u27median sternotomy\u27) and replacing the valve under cardiopulmonary bypass. Median sternotomy is well tolerated, but as less invasive options become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access have raised safety concerns with regard to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure. These difficulties may increase operating times, affecting outcome. The benefits of smaller incisions are thought to include decreased pain; improved respiratory mechanics; reductions in wound infections, bleeding, and need for transfusion; shorter intensive care stay; better cosmesis; and a quicker return to normal activity. This is an update of a Cochrane review first published in 2017, with seven new studies. OBJECTIVES: To assess the effects of minimally invasive aortic valve replacement via a limited sternotomy versus conventional aortic valve replacement via median sternotomy in people with aortic valve disease requiring surgical replacement. SEARCH METHODS: We performed searches of CENTRAL, MEDLINE and Embase from inception to August 2021, with no language limitations. We also searched two clinical trials registries and manufacturers\u27 websites. We reviewed references of primary studies to identify any further studies of relevance. SELECTION CRITERIA: We included randomised controlled trials comparing aortic valve replacement via a median sternotomy versus aortic valve replacement via a limited sternotomy. We excluded trials that performed other minimally invasive incisions such as mini-thoracotomies, port access, transapical, transfemoral or robotic procedures. Although some well-conducted prospective and retrospective case-control and cohort studies exist, these were not included in this review. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial papers to extract data, assess quality, and identify risk of bias. A third review author provided arbitration where required. We determined the certainty of evidence using the GRADE methodology and summarised results of patient-relevant outcomes in a summary of findings table. MAIN RESULTS: The review included 14 trials with 1395 participants. Most studies had at least two domains at high risk of bias. We analysed 14 outcomes investigating the effects of minimally invasive limited upper hemi-sternotomy on aortic valve replacement as compared to surgery performed via full median sternotomy. Upper hemi-sternotomy may have little to no effect on mortality versus full median sternotomy (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.45 to 1.94; 10 studies, 985 participants; low-certainty evidence). Upper hemi-sternotomy for aortic valve replacement may increase cardiopulmonary bypass time slightly, although the evidence is very uncertain (mean difference (MD) 10.63 minutes, 95% CI 3.39 to 17.88; 10 studies, 1043 participants; very low-certainty evidence) and may increase aortic cross-clamp time slightly (MD 6.07 minutes, 95% CI 0.79 to 11.35; 12 studies, 1235 participants; very low-certainty evidence), although the evidence is very uncertain. Most studies had at least two domains at high risk of bias. Postoperative blood loss was probably lower in the upper hemi-sternotomy group (MD -153 mL, 95% CI -246 to -60; 8 studies, 767 participants; moderate-certainty evidence). Low-certainty evidence suggested that there may be no change in pain scores by upper hemi-sternotomy (standardised mean difference (SMD) -0.19, 95% CI -0.43 to 0.04; 5 studies, 649 participants). Upper hemi-sternotomy may result in little to no difference in quality of life (MD 0.03 higher, 95% CI 0 to 0.06 higher; 4 studies, 624 participants; low-certainty evidence). Two studies reporting index admission costs concluded that limited sternotomy may be more costly at index admission in the UK National Health Service (MD 1190 GBP more, 95% CI 420 GBP to 1970 GBP, 2 studies, 492 participants; low-certainty evidence). AUTHORS\u27 CONCLUSIONS: The evidence was of very low to moderate certainty. Sample sizes were small and underpowered to demonstrate differences in some outcomes. Clinical heterogeneity was also noted. Considering these limitations, there may be little to no effect on mortality. Differences in extracorporeal support times are uncertain, comparing upper hemi-sternotomy to full sternotomy for aortic valve replacement. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from also performing a robust cost analysis. Growing patient preference for minimally invasive techniques merits thorough quality of life analyses to be included as end points, as well as quantitative measures of physiological reserve

The Shapiro Design Lab Residency

A publication documenting the inaugural year of the Shapiro Design Lab Residency.https://deepblue.lib.umich.edu/bitstream/2027.42/142813/1/DesignLabResidency_Publication.pdfDescription of DesignLabResidency_Publication.pdf : PDF of publicatio

3D time series analysis of cell shape using Laplacian approaches

Background: Fundamental cellular processes such as cell movement, division or food uptake critically depend on cells being able to change shape. Fast acquisition of three-dimensional image time series has now become possible, but we lack efficient tools for analysing shape deformations in order to understand the real three-dimensional nature of shape changes. Results: We present a framework for 3D+time cell shape analysis. The main contribution is three-fold: First, we develop a fast, automatic random walker method for cell segmentation. Second, a novel topology fixing method is proposed to fix segmented binary volumes without spherical topology. Third, we show that algorithms used for each individual step of the analysis pipeline (cell segmentation, topology fixing, spherical parameterization, and shape representation) are closely related to the Laplacian operator. The framework is applied to the shape analysis of neutrophil cells. Conclusions: The method we propose for cell segmentation is faster than the traditional random walker method or the level set method, and performs better on 3D time-series of neutrophil cells, which are comparatively noisy as stacks have to be acquired fast enough to account for cell motion. Our method for topology fixing outperforms the tools provided by SPHARM-MAT and SPHARM-PDM in terms of their successful fixing rates. The different tasks in the presented pipeline for 3D+time shape analysis of cells can be solved using Laplacian approaches, opening the possibility of eventually combining individual steps in order to speed up computations

Sheet metal plate design: a structured approach to product optimization in the presence of technological constraints

Geometrical optimization of structural components is a topic of high interest for engineers involved with design activities mainly related to mass reduction. The study described in these pages focuses on the optimization of plates subjected to bending for which stiffness is obtained by a pattern of ribs. Although stiffening by means of ribs is a well-known and old technique, the design of ribs for maximum stiffness is often based on practice and experience. Classical optimization methods such as topological, topographical and parametric optimization fail to give an efficient design with a reasonable programming effort, especially when dealing with many and complex constraints. These constraints are both technical and technological. A most promising technique to obtain optimal rib patterns was to define a set of feasible rib trajectories and then to select the subset with the most efficient combinations. The result is not unique and a method to select the optimal patterns is required. In fact, the stiffening effect increases with increasing rib length, but at a greater cost. A trade-off must be found between structural performance and cost: The tools to guide this selection process is the main objective of the paper, with particular attention in evaluating the stiffening due to the presence of beads on the plate with a close link with the production system and possible technological constraints which can occur during manufacturing processes, such as minimum rib distance or the presence of discontinuities or the presence of holes or other elements on the plate. A special tool with enforced rib cross section is considered, and optimal rib deployment has to be found. Numerical examples attached show the methodology and obtainable results. \ua9 2011 Springer-Verlag London Limited

Gabapentin for complex regional pain syndrome in Machado-Joseph disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Chronic pain is a common problem for patients with Machado-Joseph disease. Most of the chronic pain in Machado-Joseph disease has been reported to be of musculoskeletal origin, but now there seems to be different chronic pain in patients with Machado-Joseph disease.</p> <p>Case presentation</p> <p>A 29-year-old man (Han Chinese, Hoklo) with Machado-Joseph disease experienced severe chronic pain in both feet, cutaneous thermal change, thermal hypersensitivity, focal edema, and sweating and had a history of bone fracture. These symptoms were compatible with a diagnosis of complex regional pain syndrome. After common analgesics failed to relieve his pain, gabapentin was added and titrated to 2000 mg/day (500 mg every six hours) in less than two weeks. This relieved 40% of his pain and led to significant clinical improvement.</p> <p>Conclusions</p> <p>The pathophysiology of complex regional pain syndrome includes peripheral and central sensitizations, the latter of which might be associated with the neurodegeneration in Machado-Joseph disease. In this report, we suggest that gabapentin could inhibit central sensitization as an adjunct for complex regional pain syndrome in patients with Machado-Joseph disease.</p