Tissue-Engineered Larynx: Future Applications in Laryngeal Cancer

PURPOSE OF REVIEW: This article reviews the latest developments in tissue engineering for the larynx with a specific focus on the treatment of laryngeal cancer. RECENT FINDINGS: Challenges in tissue engineering a total larynx can be divided into scaffold design, methods of re-mucosalization, and how to restore laryngeal function. The literature described a range of methods to deliver a laryngeal scaffold including examples of synthetic, biomimetic, and biological scaffolds. Methods to regenerate laryngeal mucosa can be divided into examples that use a biological dressing and those that engineer a new mucosal layer de novo. Studies aiming to restore laryngeal function have been reported, but to date, the optimum method for achieving this as part of a total laryngeal transplant is yet to be determined. SUMMARY: There is great potential for tissue engineering to improve the treatments available for laryngeal cancer within the next 10 years. A number of challenges exist however and advances in restoring function must keep pace with developments in scaffold design

Remarks on the extension of the Ricci flow

We present two new conditions to extend the Ricci flow on a compact manifold over a finite time, which are improvements of some known extension theorems.Comment: 9 pages, to appear in Journal of Geometric Analysi

A galaxy-halo model of large-scale structure

We present a new, galaxy-halo model of large-scale structure, in which the galaxies entering a given sample are the fundamental objects. Haloes attach to galaxies, in contrast to the standard halo model, in which galaxies attach to haloes. The galaxy-halo model pertains mainly to the relationships between the power spectra of galaxies and mass, and their cross-power spectrum. With surprisingly little input, an intuition-aiding approximation to the galaxy-matter cross-correlation coefficient R(k) emerges, in terms of the halo mass dispersion. This approximation seems valid to mildly non-linear scales (k < ~3 h/Mpc), allowing measurement of the bias and the matter power spectrum from measurements of the galaxy and galaxy-matter power spectra (or correlation functions). This is especially relevant given the recent advances in precision in measurements of the galaxy-matter correlation function from weak gravitational lensing. The galaxy-halo model also addresses the issue of interpreting the galaxy-matter correlation function as an average halo density profile, and provides a simple description of galaxy bias as a function of scale.Comment: 13 pages, 9 figures, submitted to MNRAS. Minor changes, suggested by refere

Elliptic gradient estimates and Liouville theorems for a weighted nonlinear parabolic equation

Let $(M^N, g, e^{-f}dv)$ be a complete smooth metric measure space with $\infty$-Bakry-\'Emery Ricci tensor bounded from below. We derive elliptic gradient estimates for positive solutions of a weighted nonlinear parabolic equation \begin{align*} \displaystyle \Big(\Delta_f - \frac{\partial}{\partial t}\Big) u(x,t) +q(x,t)u^\alpha(x,t) = 0, \end{align*} where $(x,t) \in M^N \times (-\infty, \infty)$ and $\alpha$ is an arbitrary constant. As Applications we prove a Liouville-type theorem for positive ancient solutions and Harnack-type inequalities for positive bounded solutions.Comment: 18 page

The Postoperative Morbidity Survey was validated and used to describe morbidity after major surgery.

OBJECTIVES: To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative morbidity after major elective surgery using the POMS. STUDY DESIGN AND SETTING: This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative morbidity, was recorded on postoperative days 3, 5, 8, and 15. RESULTS: Inter-rater reliability was perfect for 11/18 items (Kappa=1.0), with Kappa=0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined morbidity was present in 325 of 433 patients (75.1%) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1%) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of morbidity. CONCLUSION: The POMS is a reliable and valid survey of short-term postoperative morbidity in major elective surgery. Many patients remain in hospital without any morbidity as recorded by the POMS

Development of a standardised forearm exercise model to predict surgical outcome

The prediction and measurement of surgical outcome is difficult. Current methods of perioperative risk prediction do not perform particularly well on an individual basis with guidelines suggesting a stepwise approach to perioperative risk assessment. Part of this stepwise approach is an assessment of functional capacity. Cardiopulmonary exercise testing has a body of evidence to support its use as a measurement of functional capacity and predictor of perioperative risk. In addition grip strength as assessed by handgrip dynamometry has been shown to be predictive of surgical outcome. This thesis examines the development and testing of a standardised forearm handgrip exercise model to predict mortality and morbidity in orthopaedic surgical patients. This thesis investigates the development of two standardised forearm handgrip exercise models, one using an intermittent (cyclical) exercise protocol and the other using a static (isometric) protocol. Having established reliable methods of using each as a preoperative test, the metabolic output i.e. the measurable venous products of metabolism; lactate, SO2, PO2, PCO2, pH and tissue oxygenation were compared. The comparison showed that the isometric exercise model was the stronger stimulus for anaerobic respiration. Each exercise model was also compared to an anaerobic threshold as measured by cardiopulmonary exercise testing in the same individuals. The isometric model showed a consistent and statistically significant relationship with the anaerobic threshold as measured by cardiopulmonary exercise testing but not the cyclical model.Finally the isometric forearm exercise model was prospectively tested in a pilot study of 21 orthopaedic patients undergoing joint replacement surgery for its ability to predict surgical outcome. The maximal voluntary contraction from handgrip dynamometry was predictive of complications and length of stay and although not statistically significant there was a clear trend for those with fewer complications and shorter lengths of hospital stay to produce more lactate during isometric forearm exercise testing

GMP compliant isolation of mucosal epithelial cells and fibroblasts from biopsy samples for clinical tissue engineering

Engineered epithelial cell sheets for clinical replacement of non-functional upper aerodigestive tract mucosa are regulated as medicinal products and should be manufactured to the standards of good manufacturing practice (GMP). The current gold standard for growth of epithelial cells for research utilises growth arrested murine 3T3 J2 feeder layers, which are not available for use as a GMP compliant raw material. Using porcine mucosal tissue, we demonstrate a new method for obtaining and growing non-keratinised squamous epithelial cells and fibroblast cells from a single biopsy, replacing the 3T3 J2 with a growth arrested primary fibroblast feeder layer and using pooled Human Platelet lysate (HPL) as the media serum supplement to replace foetal bovine serum (FBS). The initial isolation of the cells was semi-automated using an Octodissociator and the resultant cell suspension cryopreservation for future use. When compared to the gold standard of 3T3 J2 and FBS containing medium there was no reduction in growth, viability, stem cell population or ability to differentiate to mature epithelial cells. Furthermore, this method was replicated with Human buccal tissue, providing cells of sufficient quality and number to create a tissue engineered sheet

Systematic decay studies of even-even 132−138132-138^Nd, 144−158144-158^Gd, 176−196176-196^Hg and 192−198192-198^Pb isotopes

The alpha and cluster decay properties of the $132-138$^Nd, $144-158$^Gd, $176-196$^Hg and $192-198$^Pb even-even isotopes in the two mass regions A = 130-158 and A = 180-198 are analysed using the Coulomb and Proximity Potential Model. On examining the clusters at corresponding points in the cold valleys (points with same A_2) of the various isotopes of a particular nucleus we find that at certain mass numbers of the parent nuclei, the clusters emitted are getting shifted to the next lower atomic number. It is interesting to see that the change in clusters appears at those isotopes where a change in shape is occurring correspondingly. Such a change of clusters with shape change is studied for the first time in cluster decay. The alpha decay half lives of these nuclei are computed and these are compared with the available experimental alpha decay data. It is seen that the two are in good agreement. On making a comparison of the alpha half lives of the normal deformed and super deformed nuclei, it can be seen that the normal deformed $132$^Nd, $176-188$^Hg and $192$^Pb nuclei are found to be better alpha emitters than the super deformed (in excited state) $134,136$^Nd, $190-196$^Hg and $194$^Pb nuclei. The cluster decay studies reveal that as the atomic number of the parent nuclei increases the N \neq Z cluster emissions become equally or more probable than the N=Z emissions. On the whole the alpha and cluster emissions are more probable from the parents in the heavier mass region (A=180-198) than from the parents in the lighter mass region (A= 130-158). The effect of quadrupole ({\beta}_2) and hexadecapole ({\beta}_4) deformations of parent and fragments on half life times are also studied.Comment: 42 pages,19 figure