Electrospun microporous gelatin–polycaprolactone blend tubular scaffold as a potential vascular biomaterial

The work reported involved the fabrication of an electrospun tubular conduit of a gelatin and polycaprolactone (PCL) blend as an adventitia‐equivalent construct. Gelatin was included as the matrix for increased biocompatibility with the addition of PCL for durability. This is contrary to most of the literature available for biomaterials based on blends of gelatin and PCL where PCL is the major matrix. The work includes the assiduous selection of key electrospinning parameters to obtain smooth bead‐free fibres with a narrow distribution of pore size and fibre diameter. Few reports elucidate the optimization of all electrospinning parameters to fabricate tubular conduits with a focus on obtaining homogeneous pores and fibres. This stepwise investigation would be unique for the fabrication of gelatin–PCL electrospun tubular constructs. The fabricated microfibrous gelatin–PCL constructs had pores of size ca 50–100 μm reportedly conducive for cell infiltration. The measured value of surface roughness of 57.99 ± 17.4 nm is reported to be favourable for protein adhesion and cell adhesion. The elastic modulus was observed to be similar to that of the tunica adventitia of the native artery. Preliminary in vitro and in vivo biocompatibility tests suggest safe applicability as a biomaterial. Minimal cytotoxicity was observed using MTT assay. Subcutaneous implantation of the scaffold demonstrated acute inflammation which decreased by day 15. The findings of this study could enable the fabrication of smooth bead‐free microfibrous gelatin–PCL tubular construct as viable biomaterial which can be included in a bilayer or a trilayer scaffold for vascular tissue engineering. © 2019 Society of Chemical Industry     

Development of LTCC micro-hotplate with PTC temperature sensor for gas-sensing applications

Low temperature co-fired ceramic (LTCC) micro-hotplates show wide applications in gas sensors and micro-fluidic devices. It is easily structured in three-dimensional structures. This paper presents the low power consumption micro-hotplates which were developed with PTC (positive temperature coefficient) temperature sensor and inter-digitated electrodes. The paper presents two different structures for micro-hotplate with platinum as a heating element. The PTC temperature sensor using two different materials viz. PdAg and platinum paste are developed with micro-hotplates. The simulation has been achieved through COMSOL for LTCC and alumina micro-hotplates. The temperature variation with power consumption has been measured for the developed LTCC micro-hotplates. The change in resistance of PTC temperature sensors was measured with micro-hotplate temperature. The aim of this study was to place a temperature sensor with the gas sensor module to measure and control the temperature of micro-hotplate. A SnO₂ sensing layer is coated on LTCC micro-hotplate using screen printing and characterized for the sensing of carbon monoxide gas (CO). This study will be beneficial for designing hotplates based on LTCC technology with low power consumption and better stability of temperature for gas-sensing applications.     

The association of gonorrhoea and syphilis with premature birth and low birthweight

The indications and results of single and double lung transplantation are described on the basis of 66 operations performed by the authors and on the background of the world literature. Lung transplantation is considered a new and promising therapeutic mode for treating patients with end-stage pulmonary failure related to fibrosis, emphysema, infective conditions, and pulmonary hypertension yielding satisfactory early results. The long-term prognosis of patients undergoing lung transplantation, like that of any other organ transfer, remains guarded.     

Clinical chemistry of common apolipoprotein E isoforms

Apolipoprotein E plays a central role in clearance of lipoprotein remnants by serving as a ligand for low-density lipoprotein and apolipoprotein E receptors. Three common alleles (apolipoprotein E(2), E(3) and E(4)) give rise to six phenotypes. Apolipoprotein E(3) is the ancestral form. Common apolipoprotein E isoforms derive from nucleotide substitutions in codons 112 and 158. Resulting cysteine-arginine substitutions cause differences in: affinities for low-density lipoprotein and apolipoprotein E receptors, low-density lipoprotein receptor activities, distribution of apolipoprotein E among lipoproteins, low-density lipoprotein formation rate, and cholesterol absorption. Accompanying changes in triglycerides, cholesterol and low-density lipoprotein may promote atherosclerosis development. Over 90% of patients with familial dysbetalipoproteinaemia have apolipoprotein E(2)/E(2). Apolipoprotein E(4) may promote atherosclerosis by its low-density lipoprotein raising effect. Establishment of apolipoprotein E isoforms may be important for patients with diabetes mellitus and several non-atherosclerotic diseases. Apolipoprotein E phenotyping exploits differences in isoelectric points. Isoelectric focusing uses gels that contain pH 4-7 ampholytes and urea. Serum is directly applied, or prepurified by delipidation, lipoprotein precipitation or dialysation. Isoelectric focusing is followed by immunofixation/protein staining. Another approach is electro- or diffusion blotting, followed by protein staining or immunological detection with anti-apolipoprotein E antibodies and an enzyme-conjugated second antibody. Apolipoprotein E genotyping demonstrates underlying point mutations. Analyses of polymerase chain reaction products are done by allele-specific oligonucleotide probes, restriction fragment length polymorphism, single-stranded conformational polymorphism, the primer-guided nucleotide incorporation assay, or denaturating gradient gel electrophoresis. Detection with primers that either or not initiate amplification is performed with the amplification refractory mutation system. Disparities between phenotyping and genotyping may derive from isoelectric focusing methods that do not adequately separate apolipoprotein E posttranslational variants, storage artifacts or faint isoelectric focusing bands.     

Effect of preoperative supplementation with alpha-tocopherol and ascorbic acid on myocardial injury in patients undergoing cardiac operations

Augmentation of antioxidant defenses may help protect tissues against ischemia-reperfusion injury associated with operations involving cardiopulmonary bypass. In this study we examined the effect of pretreating patients with alpha-tocopherol (vitamin E) and ascorbic acid (vitamin C) or placebo on injury to the myocardium. Seventy-six subjects undergoing elective coronary artery bypass grafting participated in a prospective, double-blind, placebo-controlled randomized trial, receiving either placebo or both 750 IU dl-alpha-tocopherol per day for 7 to 10 days and 1 gm ascorbic acid 12 hours before the operation. Plasma alpha-tocopherol concentrations, raised fourfold by supplementation, fell by 70% after the operation in the supplemented group and to negligible levels in the placebo group. There were no significant differences between the groups with respect to release of creatine kinase MB isoenzyme over 72 hours, nor in the reduction of the myocardial perfusion defect determined by thallium 201 uptake. Electrocardiography provided no evidence of a benefit from antioxidant supplementation. Thus the supplementation regimen prevented the depletion of the primary lipid soluble antioxidant in plasma, but provided no measurable reduction in myocardial injury after the operation.     

Risk factors for a medically inappropriate admission to a Department of Internal Medicine

OBJECTIVE: To identify patient- and admission-related risk factors for a medically inappropriate admission to a department of internal medicine. METHODS: Cross-sectional study of a systematic sample of 500 admissions to the department of internal medicine of an urban teaching hospital. The appropriateness of each admission and reasons for inappropriate admissions were assessed using the Appropriateness Evaluation Protocol. Risk factors included the time (day of week and holidays) and manner (through emergency department or direct admission) of admission, patient age and sex, health status of patient and spouse, living arrangements, formal home care services, and informal support from family or friends. RESULTS: Overall, 76 (15.2%) hospital admissions were rated as medically inappropriate by the Appropriateness Evaluation Protocol. In multivariate analysis, the likelihood of an inappropriate admission was increased by better physical functioning of the patient (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.1 [for 1 SD in Physical Functioning scores]), lower mental health status of the patient's spouse (OR, 2.6; 95% CI, 1.3-5.6), receipt of informal help from family or friends (OR, 3.3; 95% CI, 1.5-7.2), and hospitalization by one's physician (OR, 3.6; 95% CI, 1.7-7.5). Receiving formal adult home care was not associated with inappropriateness of hospitalization. CONCLUSIONS: Inappropriate admissions to internal medicine wards are determined by a mix of factors, including the patient's health and social environment. In addition, the private practitioners' discretionary ability to hospitalize their patients directly may also favor medically inappropriate admissions.     

Guidelines for the diagnosis and outpatient management of diabetic peripheral neuropathy

AIMS: This series analyses the results of conservative surgery for large lower pole breast cancers by lumpectomy associated with a bilateral remodelling mammoplasty, in order to avoid residual deformities. METHODS: This retrospective study concerns 50 patients with a lower pole breast cancer treated between 1986 and 1996 by lumpectomy, mammoplasty and irradiation. The contralateral breast was immediately made symmetrical in all cases. The mean tumour size was 32.5 mm. RESULTS: The mean weight of the lumpectomy specimen was 270 g. Resection margins were tumour-free in 90% of cases. The main complication observed was delayed healing, thus postponing post-operative treatment in 6.5% of cases. The median follow-up was 48 months. The 5-year actuarial ipsilateral local recurrence rate was 7% and 5-year actuarial metastasis-free and overall survival rates were 81 and 97%, respectively. Cosmesis was satisfactory in 85% of patients. We observed better results when radiotherapy was performed after rather than prior to surgery (92 vs. 67%: NS). CONCLUSIONS: Performing a bilateral mammoplasty at the time of initial surgery for large breast cancers situated in the lower quadrants of the breast facilitates larger lumpectomies with good cosmetic results.     

磷钨酸乙醇染色法在嗜铬颗粒电镜X射线显微分析中的应用

通过比较常规透射电镜制样法、快速冷冻固定－冷冻超薄切片法及磷钨酸乙醇（EPTA）染色法在嗜铬颗粒透射电镜X射线显微分析中的应用，发现磷钨酸乙醇染色法能使嗜铬颗粒电子着色，从而较好地显示嗜铬颗粒的超微结构。同时磷钨酸乙醇染色法也以在一定程度上原位保留生物样品中元素，可以应用于检测样品元素含量的变化或比较样品元素含量的组间差别，提示磷钨酸乙醇染色法是一种可应用于透射电镜X射线显微分析的经济简便的生物样品制备方法。