The Development of Polylactic Acid/Multi-Wall Carbon Nanotubes/Polyethylene Glycol Scaffolds for Bone Tissue Regeneration Application.

Composite electrospun fibers were fabricated to develop drug loaded scaffolds to promote bone tissue regeneration. Multi-wall carbon nanotubes (MWCNTs) were incorporated to polylactic acid (PLA) to strengthen electrospun nanofibers. To modulate drug release behavior, different ratios of hydrophilic polyethylene glycol (PEG) were added to composite fibers. Glass transition temperature (Tg) can be reduced by the incorporated PEG to enhance the ductility of the nanofibers. The SEM images and the MTT results demonstrated that composite fibers are suitable scaffolds for cell adhesion and proliferation. Dexamethasone (DEX), an osteogenic inducer, was loaded to PLA/MWCNT/PEG fibers. The surface element analysis performed by XPS showed that fluorine of DEX in pristine PLA fibers was much higher than those of the MWCNT-containing fibers, suggesting that the pristine PLA fibers mainly load DEX on their surfaces, whereas MWCNTs can adsorb DEX with evenly distribution in nanofibers. Drug release experiments demonstrated that the release profiles of DEX were manipulated by the ratio of PEG, and that the more PEG in the nanofibers, the faster DEX was released. When rat bone marrow stromal cells (rBMSCs) were seeded on these nanofibers, the Alizarin Red S staining and calcium quantification results demonstrated that loaded DEX were released to promote osteogenic differentiation of rBMSCs and facilitate mineralized tissue formation. These results indicated that the DEX-loaded PLA/MWCNT/PEG nanofibers not only enhanced mechanical strength, but also promoted osteogenesis of stem cells via the continuous release of DEX. The nanofibers should be a potential scaffold for bone tissue engineering application.

A Case of Left Duplex Kidney with Hydronephrosis Mimicking a Left Renal Cyst in a 29-Year-Old Woman.

BACKGROUND Duplex kidney, also known as duplex renal collecting system, consists of 2 ureters arising from a single kidney and is a common congenital anomaly. The condition is usually an asymptomatic normal variant. However, abnormal anatomic variants such as hydronephrosis, vesicoureteral reflux (VUR), and ureterocele are sometimes observed in a patient with a duplicated kidney. These abnormal variants usually lead to diagnostic challenges. Here, we report a case of congenital left duplex kidney with hydronephrosis that presented as an isolated left renal cyst in a 29-year-old woman. CASE REPORT We present the case of a 29-year-old woman who had left-side abdominal pain and fever for 1 day. Left-side flank throbbing pain was also noted. Laboratory investigations showed leukocytosis, pyuria and bacteriuria. Renal ultrasound revealed a huge hypoechoic mass around the left kidney, which was suspected to be a huge renal cyst or renal abscess. Under the impression of acute pyelonephritis with abscess formation, the patient was admitted for antibiotic treatment. The following abdominal computed tomography (CT) revealed a left duplex kidney with severe hydronephrosis and hydroureter. A percutaneous nephrostomy was then performed. Next, following a discussion with the patient, she underwent a robot-assisted left heminephrectomy. CONCLUSIONS A duplex kidney and collecting system should be considered when chronic urologic problems occur. This report shows that because duplex kidney is a relatively common congenital abnormality, it should be considered in the differential diagnosis in young patients who present with renal cyst. This case also shows that patients can be managed effectively using robot-assisted heminephrectomy.

Benign Neoplasm of Kidney: Angiomyolipoma.

Angiomyolipoma is one of the renal benign neoplasms. The most of the angiomyolipomas are asymptomatic and found incidentally with ultrasound. They are more prevalent in patients with tuberous sclerosis. It is very important to make differential diagnosis from other renal neoplasm such as renal cell carcinoma. Growth rate is higher among pregnant women suggest that the hormones may play a role in the stimulation of angiomyolipoma. The most common serious presentation is rupture and hemorrhage, and sometimes it can lead to shock. Adequate diagnosis, treatment, and follow-up are very important in the face of renal angiomyolipoma.

Improved emotional stability in experienced meditators with concentrative meditation based on electroencephalography and heart rate variability.

OBJECTIVE: To determine whether emotional stability distinguishes how experienced and novice meditators react to visual stimuli. DESIGN: PARTICIPANTS practiced concentrative meditation and then responded to visual stimuli while continuing to meditate. PARTICIPANTS: Ten experienced and 10 novice meditators responded to sequences of visual stimuli after concentrative meditation. RESULTS: As predicted, both groups had increased parasympathetic activities during concentrative meditation. Experienced meditators had increased low-frequency electroencephalography (EEG) rhythms in response to visual stimulation, whereas novices had increased high-frequency EEG rhythms. Correlational analyses revealed that novice meditators changed from a meditative state to a nonrelaxed state when the visual stimuli were presented, whereas experienced meditators maintained the meditative state. CONCLUSION: The study provides evidence that regular concentrative meditation can improve emotional stability and that recording physiologic responses to visual stimuli can be a good method for identifying the effects of long-term concentrative meditation practice.

Increased risk of mortality among haemodialysis patients with or without prior stroke: a nationwide population-based study in Taiwan.

BACKGROUND & OBJECTIVES: Patients with prior stroke (PS) undergoing chronic dialysis are at a high risk of mortality. However, little is known about the cumulative risk and survival rate of dialysis patients with long-term follow up. The aim of this study was to assess risks for mortality between patients with and without PS undergoing chronic haemodialysis (HD). METHODS: The Taiwan National Health Insurance Research Database (NHRI-NHIRD-99182) was used and all adult patients (≥18 yr) with end stage renal disease (ESRD) who started maintenance HD between January 1, 1999, and December 31, 1999, were selected. The patients were followed from the first reported date of HD to the date of death, end of dialysis or December 31, 2008. A Cox's proportional hazard model was applied to identify the risk factors for all-cause mortality. RESULTS: Among 5672 HD patients, 650 patients (11.5%) had PS. A higher proportion of stroke history at baseline was found in men (52.8%) and those aged ≥ 55 yr (80.9%). After adjusting for age, sex and other covariates, the patients with PS were found to have a 36 per cent increased risk of mortality compared to those without PS (HR 1.36, 95% CI: 1.22-1.52). The cumulative survival rates among HD patients without PS were 96.0 per cent at the first year, 68.4 per cent at the fifth year, and 46.7 per cent at the ninth year, and 92.9, 47.3 and 23.6 per cent, respectively, in those with PS (log-rank: P<0.001). INTERPRETATION & CONCLUSIONS: Our findings showed that PS was an important predictor for all-cause mortality and poor outcome in patients undergoing chronic HD.