Stability of proximal femoral grafts in canine hip arthroplasty

In a canine model, the fixation stability of a prosthesis and proximal bone graft composite were measured relative to the distal femur. One group had the prosthesis graft composite cemented into the distal femur. The second group had the prosthesis graft composite press fit into the distal femur for biologic ingrowth. Displacements of the proximal femoral grafts relative to the host bone in each group were measured after ex vivo (acute with graft) implantation and 4 months after implantation. A third group with no osteotomy (acute intact) simulated perfect graft to host bone union. Relative displacements representing 6 degrees freedom (translation and rotation) were calculated from the displacement values measured by 9 eddy current transducers. Measurements of displacement were used to test the hypothesis that distal press fit fixation equals distal cement fixation at 4 months after implantation. In all cases the measured translations and rotations of the graft to implant construct were small and of a magnitude that should encourage bone ingrowth (< 0.05 mm and < 0.1 degree, respectively). The stability of the press fit group at 4 months was not significantly different from the cemented group in axial and transverse displacement during axial and transverse loading, respectively. There was no difference in stabilities at 4 months between distal press fit and cemented fixation in hip replacements requiring a proximal femoral graft.     

Influence of hypertonic saline solution infusion on defibrillation efficacy

BACKGROUND: Transplantation of lung allografts from the same donor into 2 recipients ("twinning") provides an opportunity to study recipient and donor factors that influence early allograft function. METHODS: Twenty-seven pairs of recipients were identified and evaluated using multivariate logistic regression analysis (p < 0.05). Four measures of early graft function were analyzed: alveolar-arterial gradient in the operating room, first alveolar-arterial gradient in the intensive care unit, alveolar-arterial gradient at 24 hours, and days of mechanical ventilation. RESULTS: Analysis of the pooled data without regard to pairing showed that alveolar-arterial gradient in the operating room was influenced by donor age, length of donor hospitalization, recipient mean pulmonary artery (PA) pressure at unclamping, and transplantation of a left lung. The alveolar-arterial gradient in the intensive care unit was correlated with donor age, donor cause of death, and mean PA pressure on arrival in that unit. Only mean PA pressure remained significant at 24 hours. Days of mechanical ventilation was determined by mean PA pressure on arrival in the intensive care unit, drop in mean PA pressure during operation, and diagnosis of the recipient. In the paired analysis, receiving a left lung, recipient diagnosis (pulmonary hypertension worse than others), and need of cardiopulmonary bypass were significantly associated with immediate graft dysfunction, although these influences did not persist beyond the immediate postoperative period. Donor arterial oxygen tension and time of ischemia were not significant predictors in any analysis. CONCLUSIONS: Immediate allograft function was associated with donor-related characteristics initially, but these lost importance over the ensuing 24 hours. Recipient PA pressure was an immediate and persisting influence. In the analysis of differences in function between the members of each pair, transplantation of the left lung, recipient diagnosis, and cardiopulmonary bypass were identified, but their influence did not persist beyond the first 6 hours.     

Secretome from Human Mesenchymal Stem Cells-Derived Endothelial Cells Promotes Wound Healing in a Type-2 Diabetes Mouse Model

Tissue regeneration is often impaired in patients with metabolic disorders such as diabetes mellitus and obesity, exhibiting reduced wound repair and limited regeneration capacity. We and others have demonstrated that wound healing under normal metabolic conditions is potentiated by the secretome of human endothelial cell-differentiated mesenchymal stem cells (hMSC-EC). However, it is unknown whether this effect is sustained under hyperglycemic conditions. In this study, the wound healing effect of secretomes from undifferentiated human mesenchymal stem cells (hMSC) and hMSC-EC in a type-2 diabetes mouse model was analyzed. hMSC were isolated from human Wharton’s jelly and differentiated into hMSC-EC. hMSC and hMSC-EC secretomes were analyzed and their wound healing capacity in C57Bl/6J mice fed with control (CD) or high fat diet (HFD) was evaluated. Our results showed that hMSC-EC secretome enhanced endothelial cell proliferation and wound healing in vivo when compared with hMSC secretome. Five soluble proteins (angiopoietin-1, angiopoietin-2, Factor de crecimiento fibroblástico, Matrix metallopeptidase 9, and Vascular Endothelial Growth Factor) were enriched in hMSC-EC secretome in comparison to hMSC secretome. Thus, the five recombinant proteins were mixed, and their pro-healing property was evaluated in vitro and in vivo. Functional analysis demonstrated that a cocktail of these proteins enhanced the wound healing process similar to hMSC-EC secretome in HFD mice. Overall, our results show that hMSC-EC secretome or a combination of specific proteins enriched in the hMSC-EC secretome enhanced wound healing process under hyperglycemic conditions.     

Propagation of diffuse light in a turbid medium with multiple spherical inhomogeneities

We develop a fast and accurate solver for the forward problem of diffusion tomography in the case of several spherical inhomogeneities. The approach allows one to take into account multiple scattering of diffuse waves between different inhomogeneities. Theoretical results are illustrated with numerical examples; excellent numerical convergence and efficiency are demonstrated. The method is generalized for the case of additional planar diffuse-nondiffuse interfaces and is therefore applicable to the half-space and slab imaging geometries.     

Inverse problem in optical diffusion tomography. IV. Nonlinear inversion formulas

We continue our study of the inverse scattering problem for diffuse light. In contrast to our earlier work, in which we considered the linear inverse problem, we now consider the nonlinear problem. We obtain a solution to this problem in the form of a functional series expansion. The first term in this expansion is the pseudoinverse of the linearized forward-scattering operator and leads to the linear inversion formulas that we have reported previously. The higher-order terms represent nonlinear corrections to this result. We illustrate our results with computer simulations in model systems.     

Geometrical renormalization approach to calculating optical properties of fractal carbonaceous soot

We develop a theoretical approach to calculating optical properties of carbonaceous soot in the long-wavelength limit. Our method is based on geometrical renormalization of clusters; it avoids both the inaccuracy of the dipole approximation in its pure form and the numerical complexity of rigorous direct methods of solving the EM boundary problem. The results are verified by comparison with the experimental measurements for specific extinction of diesel soot in the spectral region from 0.488 microm to 0.857 cm that were performed by Bruce et al. [Appl. Opt. 30, 1537 (1991)]. The theory leads to analytical expressions that are applicable to different soots, with various geometrical properties and optical constants. We show that the functional form of the long-wavelength asymptote of the specific extinction can depend critically on a parameter characterizing the sample geometry, and we identify the critical value of this parameter.     

Web accessibility for people with disabilities: an introduction forWeb developers

The article presents an overview of the topic of Web access for people with disabilities. First, we describe the four basic disabilities and explain the benefits of making sites accessible, as well as the reasons that more sites are not accessible. We review the relevant laws regarding Web access, and then discuss efforts being made by vendors and professional organizations, especially Microsoft and the World Wide Web Consortium, to encourage accessibility. Finally, we describe major resources that Web developers might consult to assist them in making their sites accessible to people with disabilities     

Medical liability in the treatment of intensive care unit patients

Critical care medicine was practiced informally during several years, specially during war periods. Nowadays it is, however, a fundamental part of health systems in which patients attain care facilities of increasing complexity in a cost effective manner, according to their needs. The importance of this discipline in Chile, during its 30 years of development, has progressively increased and at the present time, intensive care units represent up to 30% of the total number of beds in some hospitals. Even though these units require great budgets and many resources, their place and the role of physicians who work in them has not been recognized adequately by the national medical community. The present document presents the official position of the Chilean Society of Intensive Medicine on the general objectives of this discipline. It indicates the scope of action of the specialty and the role of intensive care physicians, their relationship with other specialties, their duties and responsibilities with their patients.