bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chondro-Keratoprosthesis: An Alternative to OOKP?
Authors: Hoffart Louis , Guyot Laurent 
Published: April 2017

Purpose To evaluate the use of cartilage as a potential graft material toward osteo-odontal tissue replacement in keratoprosthesis surgery. Methods We describe a modification of the osteo-odonto-keratoprosthesis surgery that involves the use of autologous auricular conchal cartilage graft (ACCG). In stage 1a, a full-thickness cheek mucosa graft was performed over the ocular surface. In stage 1b, ACCG was harvested via a retroauricular approach. An optical polymethyl-methacrylate cylinder was embedded into a double-layered fragment of cartilage and secured by cyanoacrylate glue. The graft is then placed in a infraorbital pocket. Stage 2, performed after 3 months, involved retrieval of the complex and implantation after reflection of the mucosal flap, corneal trephination, iris and lens removal and anterior vitrectomy. Results We report two cases of chondro-keratoprosthesis (CKPRO) who underwent surgery with up to 15 months of follow-up. Preoperatively, vision was limited to light perception (LP) in both cases. On patient 1, CKPRO was performed in the right eye and the postoperative visual acuity stay limited to LP related to preoperative retinal lesions. On patient 2, CKPRO was performed in the left eye and the vision was improved to 20/100 J6. No postoperative complications such as extrusion, epithelial downgrowth, retrocorneal membrane or endophtalmia were observed. Conclusions ACCG could be an interesting alternative to replace osteo-odontal graft in keratoprosthesis surgery. However, further comprehensive studies with larger sample size and longer follow-up are required. However longer follow-up and a higher number of patient are required to report postoperative complications incidence, survival and functional outcomes.
Povidone-Iodine 3-Minute Exposure Time is Viable in Preparation for Cataract Surgery
Authors: Nguyen Chu L. , Oh Lawrence J. , Wong Eugene , Francis Ian C. 
Published: April 2017

Purpose Povidone-iodine (PI) is widely used to reduce the preoperative conjunctival bacterial load. This study aimed to evaluate the employment of PI 10% in an attempt to sterilize the ocular surface prior to cataract surgery, and to show that PI could be left in contact for 3 minutes. The viability of this exposure time in clinical practice, associated adverse events, and visual outcomes were documented. Methods In this prospective cohort study, phacoemulsification cataract surgery was performed in 604 patients by a single surgeon. Preoperative preparation was undertaken with PI 10%, applied to the cornea, conjunctival sac, eyelids, and periorbital skin with sterile cotton gauze. Povidone-iodine was then flushed onto the ocular surface. Operating room staff timed the precise duration of exposure. After the 3-minute preparation, the lids were thoroughly dried with fresh dry gauze. Results The median PI exposure time was 3.17 minutes, with an interquartile range of 0.25. All cases were followed up postoperatively at 1 day, 1 week, and 1 month. There were no complications attributable to PI. Visual outcomes were satisfactory. Conclusions Implementation of a preoperative prophylaxis protocol that used PI 10% with a 3-minute exposure time can be performed in clinical practice. The 3-minute exposure time had no adverse sequelae.
Reading Ability and Quality of Life in Stargardt Disease
Authors: Murro Vittoria , Sodi Andrea , Giacomelli Giovanni , Mucciolo Dario P. , Pennino Monica , Virgili Gianni , Rizzo Stanislao 
Published: April 2017

Purpose To study the reading performance of patients with Stargardt disease (STGD) and the relationship between clinical vision measurements and vision-related quality of life (VRQOL). Methods We studied both eyes of 16 patients with STGD. Each patient was examined for best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS]), reading ability (MNREAD and REX charts), contrast sensitivity (Pelli-Robson charts), fixation study (MP1 microperimeter), and VRQOL (25-item National Eye Institute Visual Function Questionnaire [NEI VFQ-25]). The correlation pattern among these variables was examined and an exploratory factor analysis was used to investigate dimensionality of both visual function and VRQOL. Results Mean ETDRS visual acuity was about 20/160 (0.9 logMAR). All studied psychophysical measures were highly or moderately correlated with MNREAD reading speed (p<0.05 level). A similar correlation was found between psychophysical measures and VRQOL, which was higher for MNREAD measures of acuity (r = -0.75) and speed (r = 0.74). Accordingly, exploratory factor analysis suggested that a single latent dimension explained most of the variance of vision psychophysical measures as well as of VRQOL. Conclusions We propose that reading ability should be assessed in patients with STGD, since we found that both MNREAD reading speed and visual acuity are strong determinants of quality of life. The observed relation between reading ability and VRQOL in STGD suggests that in these patients appropriate low vision rehabilitation can improve both reading performance and consequently VRQOL. Finally, our data support the use of reading speed and visual acuity as important outcome measures for monitoring STGD progression.
Factors Influencing Intravitreal Bevacizumab and Triamcinolone Treatment in Patients with Diabetic Macular Edema
Authors: Kim Tai K. , Shin Hye Y. , Kim Su Y. , Lee Young C. , Lee Mee Y. 
Published: April 2017

Purpose To evaluate factors associated with response to intravitreal bevacizumab (IVB) and intravitreal triamcinolone acetonide (IVTA) in diabetic macular edema (DME). Methods Ninety-one eyes of 88 patients diagnosed with DME were enrolled in this retrospective chart review. Group 1 included eyes that showed good response to IVB. Group 2 included eyes that did not respond to IVB but responded to IVTA. Group 3 included eyes that responded to neither. Clinical factors, HbA1c, and optical coherence tomography (OCT) findings including patterns of macular edema were compared among the 3 groups. Results A total of 44, 27, and 20 eyes were included in groups 1, 2, and 3, respectively. HbA1c was higher in group 3 than in the other groups. Proportion of full (combination of all patterns) type edema was higher in group 3 than in the other 2 groups. In group 1, the proportion of sponge-like diffuse retinal thickening type was higher and cystoid macular edema type was lower than in the other groups. Conclusions The degree of diabetic control and morphologic subtypes with OCT should be considered to better predict the prognosis after treatment in DME.
Epiretinal membrane negative staining and double peeling in a single block with Brilliant Blue G
Authors: Martins David , Neves Pedro 
Published: April 2017

Purpose: To describe a surgical technique for combined peeling of epiretinal and internal limiting membranes. Methods: The authors present their procedure of choice for epiretinal membrane surgery: negative staining effect using Brilliant Blue G and single block removal of the epiretinal and internal limiting membranes in a single step. Results: A total of 26 eyes were operated with the described technique. In all cases, the peeling was performed successfully and with no complications. Minimum postoperative follow-up was 12 months. There were no recurrences of epiretinal membranes. Conclusions: The ideal surgical approach for epiretinal membranes should attempt to reduce mechanical trauma, light exposure, and dye toxicity.
An Experimental-Numerical Investigation on the Effects of Macroporous Scaffold Geometry on Cell Culture Parameters
Authors: Eghbali Hadis , Nava Michele M. , Leonardi Gabriella , Mohebbi-Kalhori Davod , Sebastiano Roberto , Samimi Abdolreza , Raimondi Manuela T. 
Published: April 2017

Introduction Perfused bioreactors have been demonstrated to be effective in the delivery of nutrients and in the removal of waste products to and from the interior of cell-populated three-dimensional scaffolds. In this paper, a perfused bioreactor hosting a macroporous scaffold provided with a channel is used to investigate transport phenomena and culture parameters on cell growth. Methods MG63 human osteosarcoma cells were seeded on macroporous poly(ε-caprolactone) scaffolds provided with a channel. The scaffolds were cultured in a perfused bioreactor and in static conditions for 5 days. Cell viability and growth were assessed while the concentration of oxygen, glucose and lactate were measured. An in silico, multiphysics, numerical model was set up to study the fluid dynamics and the mass transport of the nutrients in the perfused bioreactor hosting different scaffold geometries. Results The experimental and numerical results indicated that the specific cell metabolic activity in scaffolds cultured under perfusion was 30% greater than scaffolds cultured under static conditions. In addition, the scaffold provided with a channel enabled the shear stress to be controlled, the initial seeding density to be retained, and adequate mass transport and waste removal. Conclusions We show that the macroporous scaffold provided with a channel cultured in a macroscale bioreactor can be a robust reference experimental model system to systematically investigate and assess crucial culture parameters. We also show that such an experimental model system can be employed as a simplified “representative unit” to improve the performance of both perfused culture systems and hollow, fiber-integrated scaffolds for large-scale tissue engineering.
Yap, Taz and Areg Expression in Eighth Cranial Nerve Schwannoma
Authors: Martini Alessandro , Marioni Gino , Zanoletti Elisabetta , Cappellesso Rocco , Stramare Roberto , Fasanaro Elena , Faccioli Chiara , Giacomelli Luciano , Denaro Luca , D'Avella Domenico , Mazzoni Antonio , Fassina Ambrogio 
Published: April 2017

Background Although the diagnosis and treatment of eighth cranial nerve (VIII CN) schwannoma (acoustic neuroma) has improved over the years, no factors capable of predicting tumor growth have been identified as yet. This study is a preliminary investigation of the expression in sporadic VIII CN schwannomas of Yes-associated protein (YAP), transcriptional coactivator with PDZ-binding motif (TAZ), and amphiregulin (AREG), a direct target gene of YAP and TAZ. The expression of YAP, TAZ and AREG was correlated with the volumetric dimensions of tumors on contrast-enhanced magnetic resonance imaging (ceMRI). Methods YAP, TAZ and AREG expression was assessed immunohistochemically in surgical specimens of 36 consecutive sporadic VIII CN schwannomas. 3D reconstructions of the tumors and their corresponding volumes in cm3 were obtained from measurements on ceMRI images using the OsiriX® software. Results We found a significant direct correlation between TAZ expression and VIII CN schwannoma volumes on latest preoperative ceMRI (p<0.0003). Mean TAZ expression was also significantly higher in VIII CN schwannomas with a volume ≥2.1 cm3 than in those with a volume <2.1 cm3 (p<0.0018). No significant correlations emerged for YAP or AREG expression and VIII CN schwannoma volume. Conclusions The immunohistochemical expression of TAZ (but not YAP or AREG) correlated significantly with schwannoma volume measured on ceMRI. Further investigations are needed to identify the biological factors influencing tumor proliferation (ideally secreted proteins like AREG) that might be detected using non-invasive approaches (i.e., blood samples).
Healing Response of Rat pulp Treated with an Injectable Keratin Hydrogel
Authors: Ajay Sharma Lavanya , Love Robert M. , Ali Mohammad A. , Sharma Ajay , Macari Soraia , Avadhani Avadhoot , Dias George J. 
Published: April 2017

Background Keratin has shown promising outcomes as a biomaterial due to its inherent bioactivity, biocompatibility and regenerative effects. The effect of keratin on repair and regeneration of dental tissues has never been studied before. Current therapies to treat pulp tissues involve its replacement with inert, synthetic materials that do not have a proper biological function, leading to failure and tooth loss. This study aimed to develop a biocompatible keratin hydrogel (KH) suitable for pulp therapies. Methods Keratins extracted from sheep wool were isolated, quantified and reconstituted to form KH. Different concentrations of keratin gel suitable for dental application were characterized by rheological analysis. The optimized gel based on flow characteristics was studied further for microstructure including porosity, percentage swelling ratio and contact angle measurements, using analytical tools such as scanning electron microscopy (SEM), micro-computed tomography and goniometer. To assess both biocompatibility and pulpal response, KH was implanted into rat upper molar teeth following partial pulpotomy. After 28 days, the tissue sections were analyzed by histological and immunohistochemical methods to identify dentin matrix protein 1 (DMP-1) formation and compared with control (Ca(OH)2-treated) teeth. Results The results of the study demonstrated a viscous and injectable, porous, dimensionally stable, hydrophilic and biocompatible gel that allowed pulp healing to occur by a reparative response, with widespread DMP-1 expression. Conclusions The findings of this study indicate that keratins can be developed as a biomaterial source for alternate biological treatment options for pulp therapies.
Surfactant-Assisted Synthesis of Polyvinylpyrrolidone-hydroxyapatite Composites as a Bone Filler
Authors: Langroudi Masoumeh Meskinfam , Saravani Masoud Giahi , Nouri Azita 
Published: April 2017

Background Different methods have been used to prepare bone-like composites from inorganic nanoparticles embedded in polymeric matrixes to obtain the properties and structures required for bone fillers. Methods Bone-like nano-hydroxyapatite (nHA) was synthesized using a biomimetic method, with polyvinylpyrrolidone (PVP) as template and sodium dodecyl sulfate (SDS) as surfactant. Results The results demonstrated the formation of HA composites and showed that polymer and surfactant as the polymer capsule can be properly used to control the size, shape, morphology and dispersion of HA crystals. All of the samples were bioactive due to their ability to form carbonate apatite and grow HA on their surface. The MTT assay showed that the samples were biocompatible. Conclusions Based on bioactivity and biocompatibility evaluations, the prepared composites can be considered as good candidates for bone filler applications.
The incidence and risk factors of coronary steal after ipsilateral AVF in patients with a coronary artery bypass graft
Authors: Ahn Sanghyun , Han Ahram , Kim Song-Yi , Choi Chanjoong , Min Sang-il , Ha Jongwon , Hwang Ho Young , Kim Ki-Bong , Min Seung-Kee 
Published: April 2017

Objective Ipsilateral arteriovenous fistula (AVF) may cause symptoms of coronary steal in patients who had undergone coronary artery bypass graft (CABG) using internal thoracic artery. The purpose of this study was to evaluate the adverse effects of ipsilateral AVF to CABG, including the incidence of coronary steal, and to analyze the risk factors for coronary steal. Methods Between 2000 and 2013, a total of 25 patients undergoing hemodialysis via upper extremity AVF, ipsilateral to the preexisting CABG, were reviewed retrospectively. Clinical assessment related to coronary steal, echocardiography before AVF, and coronary angiography after symptoms were assessed. The definition of coronary steal was the new development of one or more of the following symptoms within 12 weeks after AVF creation: chest pain, chest discomfort, and dyspnea. Results Three patients were clinically diagnosed as coronary steal. Left ventricular ejection fraction (LVEF) was statistically lower in coronary steal group compared to no-steal group (41.7% vs. 50.9%; p = 0.036). Patients with coronary steal were older at the age of CABG surgery and showed a higher incidence of regional wall motion abnormality. Conclusions Coronary steal after ipsilateral AVF creation in patients with CABG using in situ internal thoracic artery (ITA) developed in 12%, which can be related to low LVEF. In patients with CABG requiring AVF for hemodialysis, the ipsilateral fistula to the grafted ITA should be carefully selected and performed.
Transulnar approach as an alternative to transradial approach in non-coronary intervention: safety, feasibility and technical factors
Authors: Zybulewski Adam , Edwards Martin , Kim Edward , Nowakowski Francis S. , Patel Rahul , Tabori Nora , Lookstein Robert , Fischman Aaron 
Published: April 2017

Purpose Transulnar access (TUA) has been shown to be an effective alternative to transradial access (TRA) for coronary intervention. This study evaluates the safety and efficacy of TUA in patients undergoing visceral interventions in the setting of contraindication to TRA. Materials and Methods Patients who underwent visceral interventions via ulnar approach were included in the study. Outcome variables include technical success, access site and bleeding complications. Results From May 2014 to September 2016, TUA was attempted 17 times in 14 patients (mean age: 60 years; range: 27 to 81 years) for whom TRA was planned for visceral intervention, but contraindicated. Contraindication to TRA included Barbeau D waveform (n = 3), radial artery diameter <2 mm (n = 8), known radial loop (n = 2), high takeoff of the radial artery (n = 2), prior radial artery occlusion (RAO) (n = 1), and radiocephalic arteriovenous fistula (n = 1). Interventions included selective internal radiation therapy (SIRT) (n = 4), SIRT mapping (n = 2), chemoembolization (n = 6), renal embolization (n = 1) and bland liver embolization (n = 4). Technical success was achieved in 94.1% (16/17 cases) with the single failure attributed to an inability to cannulate the target vessel due to vessel tortuosity, requiring ipsilateral femoral crossover. There were no major access site or bleeding complications. Minor adverse events include two access site hematomas, which were successfully treated with conservative management. Conclusions TUA for visceral interventions is a safe and effective alternative to femoral approach when TRA is contraindicated.
Arteriovenous access banding revisited
Authors: Teixeira Gabriela , Almeida Paulo , Sousa Clemente N. , Teles Paulo , De Sousa Paulo , Loureiro Luís , Teixeira Sérgio , Rego Duarte , Almeida Rui , Norton de Matos António 
Published: April 2017

Purpose The aim of this study is to validate the current applicability of arteriovenous access banding in high flow access (HFA) and/or haemodialysis access-induced distal ischaemia (HAIDI). Methods This retrospective study was conducted at the GEV (Grupo de Estudos Vasculares) vascular access centre. The clinical records of consecutive patients undergoing banding for HAIDI and HFA symptoms, between June 2011 and January 2015, were reviewed until April 2015. All vascular access patients’ consultation records and surgical notes were reviewed. We analysed and compared patients’ age, gender, comorbidities, symptoms and intraoperative ultrasound control. We defined technical failure as recurrence of symptoms, requiring new banding. Excessive banding, access thrombosis, rupture and false aneurysm development were registered as complications. Primary clinical success was defined as improvement of symptoms or effective flow reduction after banding, with no need for reintervention. If one reintervention was necessary, we have defined it as secondary clinical success. Results Overall, 119 patients underwent banding: 64 (54%) with HAIDI and 55 (46%) with HFA. The HAIDI group was significantly older (65 ± 13 years compared with 56 ± 22 years, p = 0.001) and had significantly greater number of patients with diabetes (56% vs 24%, p = 0.004). Primary success was achieved in 85 patients (71.4%) and the secondary success rate was 84.9%. Older age (p = 0.016) and intraoperative ultrasound control (p = 0.012) were significantly associated with primary success. Conclusions Our results do not corroborate the high incidence of thrombosis previously reported as associated with AV access banding and suggest that ultrasound control is crucial for preventing technical failure. The procedure was effective on both compared groups.
Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients
Authors: Ronald James , Davis Bradley , Guevara Carlos J. , Pabon-Ramos Waleska M. , Smith Tony P. , Kim Charles Y. 
Published: April 2017

Purpose To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. Materials and Methods A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group). Results The 3-, 6-, and 12-month primary lesion patency for the in-stent PTS group was 73%, 57%, and 32%, respectively. The 3-, 6-, and 12-month primary patency for the in-stent PTA group was 70%, 38%, and 17% and for the native vein PTS group was 78%, 57%, and 26%, which were similar to the in-stent PTS group (p = 0.20 and 0.41, respectively). The 3-, 6-, and 12-month secondary access patency was 91%, 73%, and 65% for the in-stent PTS group. Sub-analysis of the in-stent PTS group revealed no difference in primary (p = 0.93) or secondary patency rates (p = 0.27) of bare metal stents (n = 23) compared with stent grafts (n = 12). Conclusions Stent deployment for central vein in-stent stenosis refractory to angioplasty was associated with reasonable patency rates, which were similar to in-stent PTA and native vein PTS.
Variation in use of technology among vascular access specialists: an analysis of the PICC1 survey
Authors: Chopra Vineet , Kuhn Latoya , Ratz David , Winter Suzanne , Carr Peter J. , Paje David , Krein Sarah L. 
Published: April 2017

Background While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings. Methods Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement. Individual and organizational-level characteristics between technology users versus non-users were assessed. Bivariable comparisons were made using Chi-squared or Fisher's exact tests; two-sided alpha with p<0.05 was considered statistically significant. Results Of the 2762 PICC inserters who accessed the survey, 1518 (55%) provided information regarding technology use. Technology users reported greater experience than non-technology users, with a higher percentage stating they had placed >1000 PICCs (55% vs. 45%, p<0.001). A significantly greater percentage of technology users also reported being certified in vascular access by an external agency than non-technology users (75% vs. 63%, p<0.001). Technology users were more often part of vascular access teams with ≥10 members compared to non-technology users (35% vs. 22%, p<0.001). Some practices also varied between the two groups: for example, use of certain securement devices and dressings differed between technology users and non-users (p<0.001). Conclusions Technology use by vascular access clinicians while placing PICCs is associated with clinician characteristics, work setting and practice factors. Understanding whether such differences influence clinical care or patient outcomes appears necessary.