Minimally invasive parathyroid surgery

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Bioprocessing strategies to enhance the challenging isolation of neuro-regenerative cells from olfactory mucosa

Olfactory ensheathing cells (OECs) are a promising potential cell therapy to aid regeneration. However, there are significant challenges in isolating and characterizing them. In the current study, we have explored methods to enhance the recovery of cells expressing OEC marker p75NTR from rat mucosa. With the addition of a 24-hour differential adhesion step, the expression of p75NTR was significantly increased to 73 ± 5% and 46 ± 18% on PDL and laminin matrices respectively. Additionally, the introduction of neurotrophic factor NT-3 and the decrease in serum concentration to 2% FBS resulted in enrichment of OECs, with p75NTR at nearly 100% (100 ± 0% and 98 ± 2% on PDL and laminin respectively), and candidate fibroblast marker Thy1.1 decreased to zero. Culturing OECs at physiologically relevant oxygen tension (2–8%) had a negative impact on p75NTR expression and overall cell survival. Regarding cell potency, co-culture of OECs with NG108-15 neurons resulted in more neuronal growth and potential migration at atmospheric oxygen. Moreover, OECs behaved similarly to a Schwann cell line positive control. In conclusion, this work identified key bioprocessing fundamentals that will underpin future development of OEC-based cell therapies for potential use in spinal cord injury repair. However, there is still much work to do to create optimized isolation methods

Clinical-cytological-grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: The relevance in clinical practice

Chronic rhinosinusitis (CRS) includes two main phenotypes: without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CRSwNP may be associated with comorbidity, mainly concerning asthma, aspirin intolerance, and allergy. CRSwNP patients may also be evaluated by clinical-cytological grading (CCG). The current study investigated the prevalence and characteristics of the different CCG and phenotypes in CRSwNP outpatients examined in clinical practice. This retrospective cross-sectional study enrolled 791 consecutive CRSwNP outpatients (424 males, mean age 48.8 years). In the total population, asthma was a common comorbidity (30.8%) as well as aspirin intolerance (24.8%), and allergy (50.8%). As concerns CCG-grading, 210 (26.5%) outpatients had low-grade, 366 (46.3%) medium, and 215 (27.2%) high. As regards cytological phenotypes, 87 (11%) had neutrophilic type, 371 (46.3%) eosinophilic, 112 (14.2%) mast cell, and 221 (27.9%) mixed. High-grade CCG was significantly associated with more frequent asthma, aspirin intolerance, allergy, recurrent surgery, and mixed cytological phenotype. Low-grade CCG was characterized by fewer comorbidities and operations, and neutrophilic phenotype. Therefore, the present study confirmed that CCG is a useful tool in the management of outpatients with CRSwNP. CRSwNP is frequently associated with asthma, aspirin intolerance, and allergy comorbidity. High-grade CCG is frequently characterized by a mixed cytological phenotype, thus, by more severe progress. These real-world outcomes underline that CRSwNP deserves adequate attention for careful management and optimal identification of the best-tailored therapy; CCG and cytological phenotyping could be fruitful tools in clinical practice. Asthma and aspirin intolerance should be adequately investigated in all CRS patients

Outcome of radiotherapy in T1 glottic carcinoma: A population-based study

We evaluated the radiation outcome and prognostic factors in a population-based study of early (T1N0M0) glottic carcinoma. Survival parameters and prognostic factors were evaluated by uni- and multivariate analysis in 316 consecutive irradiated patients with T1 glottic carcinoma in the Comprehensive Cancer Center West region of the western Netherlands. Median follow-up was 70 months (range 1-190 months). Five and ten-year local control was 86 and 84%. Disease specific survival was 97% at 5 and 10 years. In multivariate analysis, pre-existent laryngeal hypertrophic laryngitis was the only predictive factor for local control (relative risk = 3.0, P = 0.02). Comorbidity was prognostic for overall survival. No factor was predictive for disease specific survival. Pre-existent laryngeal hypertrophic laryngitis is a new risk factor associated with reduced local control in T1 glottic carcinoma treated with radiotherapy

Arts Education of Pupils with Special Educational Needs: Objectives and Principles

Nepriklausomybės laikotarpiu prasidėjusią neįgaliųjų integraciją Lietuvoje keičia įtraukiojo (inkliuzinio) ugdymo poreikis. Atliekami moksliniai tyrimai, analizuojantys, kaip keičiasi visuomenės požiūris į negalią turinčius žmones, tiriama meno įtaka neįgaliųjų socializacijai, stiprinama juridinė šių asmenų ugdymo bazė. Meninio ugdymo dalykai (muzika, dailė, šokis, teatras) taip pat padeda ugdyti mokinių kompetencijas, reikalingas mokymuisi ir bendravimui, kūrybingai saviraiškai, komunikacijai ir individo vidinei darnai. Straipsnio tikslas – pasitelkiant mokslinės literatūros analizės metodą išryškinti specialiųjų ugdymosi poreikių turinčių mokinių meninio ugdymo tikslus ir principus.Changes in society, democratisation of education enable to shift towards persons with disabilities, in order to integrate them into society without causing discomfort neither the person, nor those around him. Categorization of disabilities and disorders according to medical criteria does not meet the educational objectives of pupils with special educational needs, as both developmental disorders and learning difficulties create the variety of abilities, needs and interests of pupils in the class. Such variety refers to school for all pupils, to involving (inclusive) education. According to the results of surveys, although the pupils with special educational needs are involved in general education, the teacher still remains alone with his philosophy and methods, without being offered an opportunity for cooperation, consultancy support, which is one of conditions for success in the involving (inclusive) education. Lack of systematic research is still observed, which brings out the didactics issues of art education of pupils with special educational needs, therefore, the analysed scientific problem is relevant. The objectives of special art education are focused not only on the pupils having special educational needs, but also to the surrounding people – teachers, classmates, family, society, and even more, to their mutual interactions. Such change of didactic goals reveals the new art education principles. The subjects of the article are the didactic goals and principles, educating the pupils with special needs by art. Applying the method of analysis of the scientific literature, the article reveals the research of the world and Lithuanian scientists in the field of special art pedagogy and theoretically justifies six principles of art education: art education focused on the emotionally positive interaction between the learner and teacher, directed to the learner’s family and society; art education is of moral aspect; content of art education is integral and perceived; educational methods are applied in complex; in the process of art education the verbal and nonverbal reflections predominate; art education is personally and socially meaningful for the pupils with special educational needs

Power tracking with maximum efficiency for wireless charging of E-bikes

Wireless charging techniques, based on Inductive Power Transfer (IPT), are attractive for Electric Vehicles (EV), due to benefits such as convenience and safety. An accurate valuation of the maximum achievable efficiency in an IPT system is extremely unlikely due to the high sensitivity to parasitic elements variations. Therefore, an "on site" procedure of power efficiency characterization is useful to get a precise description of the efficiency curve and obtain the actual maximum efficiency. In this paper, a power tracking algorithm aiming at efficiency maximization is proposed for a Wireless Charging system. The algorithm aims at finding the maximum power transfer efficiency with respect to two control variable

Use of a rapid intraoperative parathyroid hormone assay in the surgical management of parathyroid disease.

OBJECTIVE: To evaluate the utility of a rapid intraoperative parathyroid hormone (PTH) immunoradiometric assay in the surgical management of parathyroid disease, particularly with reference to limiting extent of cervical exploration. DESIGN: Nonrandomized prospective study. SETTING: Academic tertiary care center. PATIENTS: Forty-three consecutive patients undergoing parathyroid exploration for adenoma or hyperplasia had rapid PTH assays performed from blood drawn at induction and 7 minutes after resection of all hyperfunctioning parathyroid tissue. OUTCOME MEASURES: Excision of all hyperfunctioning parathyroid tissue as assessed by bilateral neck exploration, postoperative normalization of serum calcium and PTH levels, and resolution of clinical symptoms. RESULTS: The intraoperative rapid PTH assay accurately reflected whether all hyperfunctioning parathyroid tissue was excised in every patient. In 41 patients, all hyperfunctioning parathyroid tissue was resected at the time of surgery and confirmed by a corresponding decrease in the intraoperative postexcision rapid PTH determination as well as by subsequent normalization of postoperative serum calcium and PTH levels and resolution of clinical symptoms. In 2 patients, the postexcision rapid PTH assay determination was not consistent with removal of all hyperfunctioning parathyroid disease and both patients demonstrated persistent hyperparathyroidism postoperatively. CONCLUSIONS: The intraoperative rapid PTH assay may be of significant benefit in permitting directed unilateral parathyroid explorations for adenoma when combined with preoperative localization with a technetium-99m sestamibi scan. Additionally, the rapid PTH assay has proved to be of benefit in confirming excision of all hyperfunctioning parathyroid tissue in patients with multiple gland hyperplasia, particularly those who may harbor ectopic parathyroid tissue