Induced pluripotent stem cells and regenerative medicine

AbstractStem cells, a special subset of cells derived from embryo or adult tissues, are known to present the characteristics of self-renewal, multiple lineages of differentiation, high plastic capability, and long-term maintenance. Recent reports have further suggested that neural stem cells (NSCs) derived from the adult hippocampal and subventricular regions possess the utilizing potential to develop the transplantation strategies and to screen the candidate agents for neurogenesis, neuroprotection, and neuroplasticity in neurodegenerative diseases. In this article, we review the roles of NSCs and other stem cells in neuroprotective and neurorestorative therapies for neurological and psychiatric diseases. We show the evidences that NSCs play the key roles involved in the pathogenesis of several neurodegenerative disorders, including depression, stroke, and Parkinson’s disease. Moreover, the potential and possible utilities of induced pluripotent stem cells, reprogramming from adult fibroblasts with ectopic expression of four embryonic genes, are also reviewed and further discussed. An understanding of the biophysiology of stem cells could help us elucidate the pathogenicity and develop new treatments for neurodegenerative disorders. In contrast to cell transplantation therapies, the application of stem cells can further provide a platform for drug discovery and small molecular testing, including Chinese herbal medicines. In addition, the high-throughput stem cell-based systems can be used to elucidate the mechanisms of neuroprotective candidates in translation medical research for neurodegenerative diseases

Dexmedetomidine to Help Nerve Regeneration in a Rat Sciatic Nerve Injury Model

Background. Several studies have shown that dexmedetomidine (DXM), a selective α2-adrenoceptor agonist, also has neuroprotective effects. However, its effect on impaired peripheral nerve regeneration has not been studied. Materials and Methods. Forty-five Sprague-Dawley rats were randomly assigned to three groups: group 1 (control SHAM), group 2 (sciatic nerve injury + normal saline), and group 3 (sciatic nerve injury + DXM). The rats of group 3 were subdivided into the following three groups: DXM 0.5, 6, and 20 μg·kg−1 (groups 3A, 3B, and 3C, resp.). The sciatic nerve injury was assessed for nerve regeneration at 2 and 6 weeks. Results. There were no differences between groups 2 and 3 in their sciatic functional index (SFI) values or histological findings at 2 weeks postinjury. However, SFI differences were statistically significant at 6 weeks postinjury in group 3. The gross findings with H&E staining showed that the number of axons was higher in group 3 than in group 2. There was no histological difference according to the DXM concentration. Conclusion. The coincidental functional and histological assessment results of this study suggest that DXM for 6 weeks positively affects damaged peripheral nerves

Detection of SARS-associated Coronavirus in Throat Wash and Saliva in Early Diagnosis

Early detection of SARS-CoV in throat wash and saliva suggests that these specimens are ideal for SARS diagnosis

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

A comprehensive characterization of aggravated aging-related changes in T lymphocytes and monocytes in end-stage renal disease: The iESRD study

Background: Patients with end-stage renal disease (ESRD) exhibit a premature aging phenotype of the immune system. Nevertheless, the etiology and impact of these changes in ESRD patients remain unknown. Results: Compared to healthy individuals, ESRD patients exhibit accelerated immunosenescence in both T cell and monocyte compartments, characterized by a dramatic reduction in naïve CD4+ and CD8+ T cell numbers but increase in CD8+ TEMRA cell and proinflammatory monocyte numbers. Notably, within ESRD patients, aging-related immune changes positively correlated not only with increasing age but also with longer dialysis vintage. In multivariable-adjusted logistic regression models, the combination of high terminally differentiated CD8+ T cell level and high intermediate monocyte level, as a composite predictive immunophenotype, was independently associated with prevalent coronary artery disease as well as cardiovascular disease, after adjustment for age, sex, systemic inflammation and presence of diabetes. Levels of terminally differentiated CD8+ T cells also positively correlated with the level of uremic toxin p-cresyl sulfate. Conclusions: Aging-associated adaptive and innate immune changes are aggravated in ESRD and are associated with cardiovascular diseases. For the first time, our study demonstrates the potential link between immunosenescence in ESRD and duration of exposure to the uremic milieu

連續性bupivacaine脊椎麻醉失敗經驗的臨床研究

背景：連續性脊椎麻醉已被認為較單一注射劑量的脊椎麻醉具有注射劑量可調節性， 血液動力穩定性的優點。但對麻醉醫師極言，脊椎麻醉的失敗並不少見。在此，我們 報告在處理連續性脊椎麻醉失敗時的經驗及討論造成失敗的可能原因。方法：採回溯 性研究236位（皆大於65歲，ASA III）接受泌尿外科，骨科手術的病例。使用0.2% Bupivacaine做連續性脊椎麻醉，在20 mg Bupivacaine注射後30分鐘，若在皮節區T 10有針刺痛感(pin prick test)即認定為連續性脊椎麻醉失敗。隨即改以5 mL 1% Lidocaine注射。記錄Lidocaine的失敗率，感覺和運動阻斷的情形，以及失敗的病例 改以1% Lidocaine救援的成功率及所需要Lidocaine的平均劑量。結果：236位病例中 有11個病例被認定為Bupivacaine連續性脊椎麻醉失敗，失敗率為4.7%。在隨即改以5 mL 1% Lidocaine注射後，5分鐘內，有9個病例馬上產生溫度，感覺和運動阻斷的情 形。有2個病例，需要注射較多劑量的Lidocaine才可以達到相同的阻斷的情形。 Lidocaine救援成功率100%，所需要Lidocaine的平均劑量52±4.5mg。結論：在區域 性麻醉時失敗的原因包括技術不良、病人因素、藥品因素。本研究發現，造成連續性 脊椎麻醉失敗的原因中，局部麻醉藥本身的問題可能扮演著主要的角色。 Background: Continuous spinal anesthesia (CSA) has been considered to be better in temporal and dose flexibility, as well as hemodynamic stability than sigle dose spinal anesthesia. However, the failure of spinal anesthesia is not a rare experience for anesthesiologists. Here we present our experience in solving the problem and discuss the possible causes for the failure. Methods: 236 cases were studied retrospectively from January to December in 1996. All were over 65 years old, ASA III, scheduled for transurethral procedures or orthopedic operation. CSA was performed with 0 .2% bupivacaine. Failed CSA was confirmed by positive pin-prick test at T 10 dermatome(umbilicus) 30 minutes after 20 mg bupivacaine was injected. For failed cases, 5 mL 1% lidocaine was injected intrathecally for rescue. The failure rate, sensory and motor blockade, success rate by changing to lidocaine and its dosage were recorded. Results: Eleven of 236 cases (4.7 %) were considered spinal failure since the initial 20 mg bupivacaive could not provide adequate T10 anesthesia in 30 minutes. Addition of 5 mL 1% lidocaine produced a profound sensory and motor blockade in 9 cases, while further lidocaine injection was required in two cases. The success rate by rescuing lidocaine was 100% with an average lidocaine consumption by 52±4.5mg. Discussion: Factors contributed to failure spinal anesthesia including failure of technique, errors of judgment, maldistribution and failure of local anesthetic itself. However, we thought that change of pH value of local anesthetic in CSF may play a great part in these failed CSAs. Despite the reasons for failure, we demonstrate that failure of continuous spinal anesthesia by 0.2% bupivacaine can be readily resolved by 1% lidocaine.