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1.
Artigo em Inglês | MEDLINE | ID: mdl-34735711

RESUMO

PURPOSE: Calcific aortic valve disease (CAVD), has been characterized as a cascade of cellular changes leading to leaflet thickening and valvular calcification. In diseased aortic valves, glycosaminoglycans (GAGs) normally found in the valve spongiosa migrate to the collagen I-rich fibrosa layer near calcified nodules. Current treatments for CAVD are limited to valve replacement or drugs tailored to other cardiovascular diseases. METHODS: Porcine aortic valve interstitial cells and porcine aortic valve endothelial cells were seeded into collagen I hydrogels of varying initial stiffness or initial stiffness-matched collagen I hydrogels containing the glycosaminoglycans chondroitin sulfate (CS), hyaluronic acid (HA), or dermatan sulfate (DS). Assays were performed after 2 weeks in culture to determine cell gene expression, protein expression, protein secretion, and calcification. Multiple regression analyses were performed to determine the importance of initial hydrogel stiffness, GAGs, and the presence of endothelial cells on calcification, both with and without osteogenic medium. RESULTS: High initial stiffness hydrogels and osteogenic medium promoted calcification, while for DS or HA the presence of endothelial cells prevented calcification. CS was found to increase the expression of pro-calcific genes, increase activated myofibroblast protein expression, induce the secretion of collagen I by activated interstitial cells, and increase calcified nodule formation. CONCLUSION: This study demonstrates a more complete model of aortic valve disease, including endothelial cells, interstitial cells, and a stiff and disease-like ECM. In vitro models of both healthy and diseased valves can be useful for understanding the mechanisms of CAVD pathogenesis and provide a model for testing novel therapeutics.

3.
J Cosmet Dermatol ; 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34535947

RESUMO

BACKGROUND: The aging face is characterized by skin laxity and volume loss. Attenuation of facial retaining ligaments significantly contributes to skin sagginess and soft tissue volume loss. AIMS: We designed a prospective cohort study to quantitatively assess the efficacy of hyaluronic acid (HA) with adjunct poly-L-lactic acid (PLLA) injections in strengthening the retaining ligaments. PATIENTS/METHODS: A total of 12 Asian women were treated with HA injections to the orbital, zygomatic, buccal-maxillary, and mandibular retaining ligaments with adjunct supraperiosteal and subdermal PLLA injections to the temporal region, midface, and lower face. Cephalometric measurements were done before treatment and 2, 4, 12, and 24 weeks post-procedurally. RESULTS: Eyebrow peak and tail angles increased 20.0° ± 3.8° to 21.0° ± 3.8° (p < 0.05) and -2.9° ± 4.2° to -1.3° ± 3.3° (p < 0.001) at week 12. Eyebrow-to-orbital-rim distance increased 1.9 ± 2.0 mm to 3.9 ± 1.5 mm (p < 0.001) at week 12. Eyebrow-to-upper-eyelid distance increased 11.6 ± 3.0 mm to 12.7 ± 3.2 mm (p < 0.001) at week 24. Eyebrow-peak-to-lateral-limbus distance decreased 6.1 ± 3.1 mm to 5.3 ± 2.4 mm (p < 0.05) at week 4. Tragus-oral-commissure length and lower-facial-contouring length decreased 281 ± 11 mm to 275 ± 10 mm (p < 0.01) and 297 ± 14 to 292 ± 11 mm (p < 0.05) at week 12, respectively. CONCLUSION: Hyaluronic acid injection for strengthening of facial retaining ligaments with adjunct PLLA is viable, safe, and effective in facial rejuvenation as supported by quantitative data.

4.
J Allergy Clin Immunol ; 148(5): 1324-1331.e12, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34536416

RESUMO

BACKGROUND: Asthma is a heterogeneous disease. Clinical blood parameters differ by race/ethnicity and are used to distinguish asthma subtypes and inform therapies. Differences in subtypes may explain population-specific trends in asthma outcomes. However, these differences in racial/ethnic minority pediatric populations are unclear. OBJECTIVE: We investigated the association of blood parameters and asthma subtypes with asthma outcomes and examined population-specific eligibility for biologic therapies in minority pediatric populations. METHODS: Using data from 2 asthma case-control studies of pediatric minority populations, we performed case-control (N = 3738) and case-only (N = 2743) logistic regressions to quantify the association of blood parameters and asthma subtypes with asthma outcomes. Heterogeneity of these associations was tested using an interaction term between race/ethnicity and each exposure. Differences in therapeutic eligibility were investigated using chi-square tests. RESULTS: Race/ethnicity modified the association between total IgE and asthma exacerbations. Elevated IgE level was associated with worse asthma outcomes in Puerto Ricans. Allergic asthma was associated with worse outcomes in Mexican Americans, whereas eosinophilic asthma was associated with worse outcomes in Puerto Ricans. A lower proportion of Puerto Ricans met dosing criteria for allergic asthma-directed biologic therapy than other groups. A higher proportion of Puerto Ricans qualified for eosinophilic asthma-directed biologic therapy than African Americans. CONCLUSIONS: We found population-specific associations between blood parameters and asthma subtypes with asthma outcomes. Our findings suggest that eligibility for asthma biologic therapies differs across pediatric racial/ethnic populations. These findings call for more studies in diverse populations for equitable treatment of minority patients with asthma.

5.
J Med Chem ; 64(17): 13004-13024, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34423975

RESUMO

Wee1 inhibition has received great attention in the past decade as a promising therapy for cancer treatment. Therefore, a potent and selective Wee1 inhibitor is highly desirable. Our efforts to make safer and more efficacious Wee1 inhibitors led to the discovery of compound 16, a highly selective Wee1 inhibitor with balanced potency, ADME, and pharmacokinetic properties. The chiral ethyl moiety of compound 16 provided an unexpected improvement of Wee1 potency. Compound 16, known as ZN-c3, showed excellent in vivo efficacy and is currently being evaluated in phase 2 clinical trials.

6.
J Hum Genet ; 64(10): 1033-1040, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31388112

RESUMO

Prior studies in predominantly European (Caucasian) populations have discovered common genetic variants (single nucleotide polymorphisms, SNPs) associated with leukocyte telomere length (LTL), but whether these same variants affect LTL in non-Caucasian populations are largely unknown. We investigated whether six genetic variants previously associated with LTL (TERC (rs10936599), TERT (rs2736100), NAF1 (7675998), OBFC1 (rs9420907), ZNF208 (rs8105767), and RTEL1 (rs755017)) are correlated with telomere length (TL) in peripheral blood mononuclear cells (PBMCs) in a cohort of Africans living with and without HIV and undergoing evaluation for tuberculosis (TB). We found OBFC1 and the genetic sum score of the effect alleles across all six loci to be associated with shorter TL (adjusted for age, gender, HIV status, and smoking pack-years (p < 0.02 for both OBFC1 and the genetic sum score). In an analysis stratified by HIV status, the genetic sum score is associated with LTL in both groups with and without HIV. On the contrary, a stratified analysis according to TB status revealed that in the TB-positive subgroup, the genetic sum score is not associated with LTL, whereas the relationship remains in the TB-negative subgroup. The different impacts of HIV and TB on the association between the genetic sum score and LTL indicate different modes of modification and suggest that the results found in this cohort with HIV and TB participants may not be applied to the African general population. Future studies need to carefully consider these confounding factors.


Assuntos
Infecções por HIV/genética , Proteínas de Ligação a Telômeros/genética , Telômero/genética , Tuberculose/genética , Adulto , África , Alelos , Estudos de Coortes , DNA Helicases/genética , Demografia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Leucócitos/metabolismo , Masculino , Polimorfismo de Nucleotídeo Único , RNA/genética , Ribonucleoproteínas/genética , Telomerase/genética
7.
Biomicrofluidics ; 13(2): 024103, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30867887

RESUMO

The failure to clear amyloid-Beta from an aging brain leads to its accumulation within the walls of arteries and potentially to Alzheimer's disease. However, the clearance mechanism through the intramural periarterial pathway is not well understood. We previously proposed a hydrodynamic reverse transport model for the cerebral arterial basement membrane pathway. In our model, solute transport results from fluidic forcing driven by the superposition of forward and reverse propagating boundary waves. The aim of this study is to experimentally validate this hydrodynamic reverse transport mechanism in a microfluidic device where reverse transport in a rectangular conduit is driven by applying waveforms along its boundaries. Our results support our theory that while the superimposed boundary waves propagate in the forward direction, a reverse flow in the rectangular conduit can be induced by boundary wave reflections. We quantified the fluid transport velocity and direction under various boundary conditions and analyzed numerical simulations that support our experimental findings. We identified a set of boundary wave parameters that achieved reverse transport, which could be responsible for intramural periarterial drainage of cerebral metabolic waste.

8.
Biomicrofluidics ; 11(4): 044104, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28798857

RESUMO

Tumor development is influenced by stromal cells in aspects including invasion, growth, angiogenesis, and metastasis. Activated fibroblasts are one group of stromal cells involved in cancer metastasis, and one source of activated fibroblasts is endothelial to mesenchymal transformation (EndMT). EndMT begins when the endothelial cells delaminate from the cell monolayer, lose cell-cell contacts, lose endothelial markers such as vascular endothelial-cadherin (VE-cadherin), gain mesenchymal markers like alpha-smooth muscle actin (α-SMA), and acquire mesenchymal cell-like properties. A three-dimensional (3D) culture microfluidic device was developed for investigating the role of steady low shear stress (1 dyne/cm2) and altered extracellular matrix (ECM) composition and stiffness on EndMT. Shear stresses resulting from fluid flow within tumor tissue are relevant to both cancer metastasis and treatment effectiveness. Low and oscillatory shear stress rates have been shown to enhance the invasion of metastatic cancer cells through specific changes in actin and tubulin remodeling. The 3D ECM within the device was composed of type I collagen and glycosaminoglycans (GAGs), hyaluronic acid and chondroitin sulfate. An increase in collagen and GAGs has been observed in the solid tumor microenvironment and has been correlated with poor prognosis in many different cancer types. In this study, it was found that ECM composition and low shear stress upregulated EndMT, including upregulation of mesenchymal-like markers (α-SMA and Snail) and downregulated endothelial marker protein and gene expression (VE-cadherin). Furthermore, this novel model was utilized to investigate the role of EndMT in breast cancer cell proliferation and migration. Cancer cell spheroids were embedded within the 3D ECM of the microfluidic device. The results using this device show for the first time that the breast cancer spheroid size is dependent on shear stress and that the cancer cell migration rate, distance, and proliferation are induced by EndMT-derived activated fibroblasts. This model can be used to explore new therapeutics in a tumor microenvironment.

9.
J Biomed Mater Res A ; 105(10): 2729-2741, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28589644

RESUMO

Alterations in shear stress, mechanical deformation, extracellular matrix (ECM) composition and exposure to inflammatory conditions are known to cause endothelial to mesenchymal transformation (EndMT). This change in endothelial phenotype has only recently been linked to adult pathologies such as cancer progression, organ fibrosis, and calcific aortic valve disease; and its function in adult physiology, especially in response to tissue mechanics, has not been rigorously investigated. EndMT is a response to mechanical and biochemical signals that results in the remodeling of underlying tissues. In diseased aortic valves, glycosaminoglycans (GAGs) are present in the collagen-rich valve fibrosa, and are deposited near calcified nodules. In this study, in vitro models of early and late-stage valve disease were developed by incorporating the GAGs chondroitin sulfate (CS), hyaluronic acid, and dermatan sulfate into 3D collagen hydrogels with or without exposure to TGF-ß1 to simulate EndMT in response to microenvironmental changes. High levels of CS induced the highest rate of EndMT and led to the most collagen I and GAG production by mesenchymally transformed cells, which indicates a cell phenotype most likely to promote fibrotic disease. Mesenchymal transformation due to altered ECM was found to depend on cell-ECM bond strength and extracellular signal-regulated protein kinases 1/2 signaling. Determining the environmental conditions that induce and promote EndMT, and the subsequent behavior of mesenchymally transformed cells, will advance understanding on the role of endothelial cells in tissue regeneration or disease progression. © 2017 Wiley Periodicals Inc. J Biomed Mater Res Part A: 105A: 2729-2741, 2017.


Assuntos
Estenose da Valva Aórtica/patologia , Valva Aórtica/patologia , Calcinose/patologia , Colágeno/metabolismo , Células Endoteliais/patologia , Transição Epitelial-Mesenquimal , Glicosaminoglicanos/metabolismo , Células-Tronco Mesenquimais/patologia , Adulto , Animais , Valva Aórtica/citologia , Valva Aórtica/metabolismo , Estenose da Valva Aórtica/metabolismo , Materiais Biocompatíveis/metabolismo , Calcinose/metabolismo , Células Cultivadas , Módulo de Elasticidade , Células Endoteliais/citologia , Matriz Extracelular/metabolismo , Humanos , Hidrogéis/metabolismo , Células-Tronco Mesenquimais/citologia , Suínos , Fator de Crescimento Transformador beta1/metabolismo
10.
J Cosmet Dermatol ; 16(1): 132-143, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27987257

RESUMO

BACKGROUND: Physicians face the challenge of individualizing aesthetic treatments in order to match the aesthetic needs of patients with their expectations. OBJECTIVE: To review issues underlying patient satisfaction with minimally invasive aesthetic treatment and to present a patient-centric assessment tool (the Global Ranking Scale [GRS]) designed to set higher standards for patient consultation and treatment experience; ensure a comprehensive patient-centric aesthetic consultation process; and raise patient satisfaction with facial rejuvenation treatment. METHODS: A review of the design and content of the GRS and its use as part of the wider Galderma Harmony Program. Results of a small survey of clinicians who have switched to the GRS, and case studies of patients who have used the tool, are also presented. RESULTS: The GRS is used in ~500 clinics around the world. In a small survey, physicians who have used the GRS report that it has changed the way that patients are assessed and treated. While no patient survey was conducted, anecdotal evidence suggests that patients are satisfied with the GRS procedure and the outcomes of treatment. CONCLUSIONS: The GRS is a new patient assessment tool that is designed as a guide for clinicians to help ensure consistency in the quality of patient assessment and consultation in their clinics offering minimally invasive facial cosmetic procedures. Qualitative research suggests that it gives patients a better chance to achieve results aligned with their needs resulting in a higher level of satisfaction with aesthetic treatments, but this needs to be confirmed in a formal patient survey.


Assuntos
Técnicas Cosméticas , Educação de Pacientes como Assunto/normas , Participação do Paciente , Satisfação do Paciente , Relações Médico-Paciente , Envelhecimento da Pele , Adulto , Comunicação , Face , Feminino , Humanos , Pessoa de Meia-Idade , Rejuvenescimento , Pigmentação da Pele , Inquéritos e Questionários
11.
Plast Reconstr Surg ; 136(5): 940-956, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26505699

RESUMO

BACKGROUND: Although the use of filling agents for soft-tissue augmentation has increased worldwide, most consensus statements do not distinguish between ethnic populations. There are, however, significant differences between Caucasian and Asian faces, reflecting not only cultural disparities, but also distinctive treatment goals. Unlike aesthetic patients in the West, who usually seek to improve the signs of aging, Asian patients are younger and request a broader range of indications. METHODS: Members of the Asia-Pacific Consensus group-comprising specialists from the fields of dermatology, plastic surgery, anatomy, and clinical epidemiology-convened to develop consensus recommendations for Asians based on their own experience using cohesive polydensified matrix, hyaluronic acid, and calcium hydroxylapatite fillers. RESULTS: The Asian face demonstrates differences in facial structure and cosmetic ideals. Improving the forward projection of the "T zone" (i.e., forehead, nose, cheeks, and chin) forms the basis of a safe and effective panfacial approach to the Asian face. Successful augmentation may be achieved with both (1) high- and low-viscosity cohesive polydensified matrix/hyaluronic acid and (2) calcium hydroxylapatite for most indications, although some constraints apply. CONCLUSION: The Asia-Pacific Consensus recommendations are the first developed specifically for the use of fillers in Asian populations. CLINCIAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Técnicas Cosméticas , Preenchedores Dérmicos/administração & dosagem , Durapatita/farmacologia , Ácido Hialurônico/farmacologia , Guias de Prática Clínica como Assunto , Consenso , Características Culturais , Estética , Face , Feminino , Humanos , Injeções Subcutâneas , Masculino , Resultado do Tratamento
12.
Hum Factors ; 56(6): 1021-35, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25277014

RESUMO

OBJECTIVE: We investigated whether intelligent advanced warnings of the end of green traffic signals help drivers negotiate the dilemma zone (DZ) at signalized intersections and sought to identify behavioral mechanisms for any warning-related benefits. BACKGROUND: Prior research suggested that warnings of end of green can increase slowing and stopping frequency given the DZ, but drivers may sometimes respond to warnings by speeding up. METHOD: In two simulator studies, we compared six types of roadway or in-vehicle warnings with a no-warning control condition. Using multilevel modeling, we tested mediation models of the behavioral mechanisms underlying the effects of warnings. RESULTS: In both studies, warnings led to more stopping at DZ intersections and milder decelerations when stopping compared with no warning. Drivers' predominant response to warnings was anticipatory slowing on approaching the intersection, not speeding up. The increased stopping with warning was mediated by increased slowing. In Study I, anticipatory slowing given warnings generalized to green-light intersections where no warning was given. In Study 2, we found that lane-specific warnings (e.g., LED lights embedded in each lane) sometimes led to fewer unsafe emergency stops than did non-lane-specific roadside warnings. CONCLUSION: End-of-green warnings led to safer behavior in the DZ and on the early approach to intersections. The main mechanism for the benefits of warnings was drivers' increased anticipatory slowing on approaching an intersection. Lane-specific warnings may have some benefits over roadside warnings. APPLICATION: Applications include performance models of how drivers use end-of-green warnings, control algorithms and warning displays for intelligent intersections, and statistical methodology in human factors research.


Assuntos
Prevenção de Acidentes/instrumentação , Acidentes de Trânsito/prevenção & controle , Condução de Veículo/psicologia , Comportamento de Escolha , Interface Usuário-Computador , Adulto , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipamentos de Proteção , Tempo de Reação , Adulto Jovem
13.
Dermatol Surg ; 39(3 Pt 2): 493-509, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23458294

RESUMO

BACKGROUND: The U.S. Food and Drug Administration has approved four distinct formulations of botulinum toxin (BoNT) serotypes A and B (BoNTA and BoNTB) for medical use. These four products are indicated for many medical applications, but the three BoNTA formulations are the most widely used worldwide and are the only products approved for aesthetic use. The latest approval of a BoNTA with no complexing proteins (incobotulinumtoxinA) necessitates a review and discussion of differences between available formulations and the effect that these differences may have on clinical practice. OBJECTIVES: To review the history, science, safety information, and current and emerging applications of BoNT in clinical and cosmetic practice and to compare commercially available BoNTA formulations. METHODS AND MATERIALS: Publications, clinical trials, and author experience were used as a basis for an up-to-date review of BoNT and its use in human medicine. The similarities and differences between formulations are presented, and diffusion, spread, equivalency ratios, stability, and storage are discussed. RESULTS: Each commercial formulation has unique characteristics that may influence its use in aesthetic medicine. Familiarity with the similarities and differences between products will aid physicians in making patient care decisions. CONCLUSION: New formulations, emerging uses, and continued research into the science and uses of BoNTA will lead to increasingly refined therapeutic approaches and applications. Continued education is important for physicians to optimize use of the agent according to the most current evidence and approaches.


Assuntos
Toxinas Botulínicas/uso terapêutico , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/efeitos adversos , Toxinas Botulínicas Tipo A/uso terapêutico , Química Farmacêutica , Técnicas Cosméticas , Humanos
14.
Cytometry A ; 79(10): 866-73, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21744493

RESUMO

Leukemia is the most common pediatric cancer and leading cause of cancer related deaths in children. Improvements in the assessment of leukemic cells have the potential to influence not only the diagnosis of leukemia, but also the risk assessment of patients during the course of the treatment, both of which are important for improving the cure rate for this disease. In this study, we report on the design and performance of a confocal laser based system built to collect backscattered light over a range of 26° at 405, 488, and 633 nm to discriminate leukemic cells from normal red blood cells (RBC) and white blood cells (WBC). The design of the system is based on the spectral differences observed from spectroscopy measurements with a similar system designed with a white light source. Significant differences are observed in the intensity and wavelength dependence of leukemic cells from normal RBC and WBC. Specifically, the distinct light scattering of RBC is due to hemoglobin absorption, allowing for its discrimination from leukemic cells, mononuclear, and polymorphonuclear WBC particularly at certain wavelengths. Meanwhile, the high scattering intensities of polymorphonuclear WBC reflect the intracellular complexity of these cells in comparison to the leukemic or normal lymphocytes. Additionally, the detected light scattering spectra for leukemic cells are consistently steeper in comparison to normal WBC, which we attributed to differences in the fractal organization of intracellular scatterers. Based on our findings, the system has potential applications in the detection and quantification of leukemic cells in blood either in vivo or in vitro, using microfluidic-based systems, for disease monitoring.


Assuntos
Microscopia Confocal/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Células Precursoras de Linfócitos B/patologia , Análise Espectral/métodos , Adolescente , Linhagem Celular , Criança , Contagem de Eritrócitos , Eritrócitos/citologia , Citometria de Fluxo/métodos , Humanos , Contagem de Leucócitos , Leucócitos/citologia , Luz , Linfócitos/citologia , Microfluídica/instrumentação , Microfluídica/métodos , Microscopia Confocal/instrumentação , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Espalhamento de Radiação , Sensibilidade e Especificidade , Análise Espectral/instrumentação
15.
Cytometry A ; 79(10): 874-83, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21638765

RESUMO

The prognostic value of assessing minimal residual disease (MRD) in leukemia has been established with advancements in flow cytometry and PCR. Nonetheless, these techniques are limited by high equipment costs, complex, and costly cell processing and the need for highly trained personnel. Here, we demonstrate the potential of exploiting differences in the relative intensities of backscattered light at three wavelengths to detect the presence of leukemic cells in samples containing varying mixtures of white blood cells (WBCs) and leukemic cells flowing through microfluidic channels. Using 405, 488, and 633 nm illumination, we identify distinct light scattering intensity distributions for Nalm-6 leukemic cells, normal mononuclear (PBMC) and polymorphonuclear (PMN) white blood cells and red blood cells. We exploit these differences to develop cell classification algorithms, whose performance is evaluated based on simultaneous acquisition of light scattering and fluorescence flow cytometry data. When this algorithm is used prospectively for the analysis of samples consisting of mixtures of PBMCs and leukemic cells, we achieve an average specificity and sensitivity of leukemic cell detection of 99.6 and 45.2%, respectively. When we consider samples that include leukemic cells along with PMNs and PBMCs, which can be acquired using a simple red blood cell lysis step following venipuncture, the specificity and sensitivity of the approach decreases to 91.6 and 39.5%, respectively. On the basis of the performance of these algorithms, we estimate that 42 or 71 µL of blood would be adequate to confirm the presence of leukemia at an 80% power level in samples containing 0.01% leukemia to either PBMCs or PBMCs and PMNs, respectively. Therefore, light scattering-based flow cytometry in a microfluidic platform could provide a low cost, highly portable, minimally invasive approach for detection and monitoring of leukemic patients. This could offer significant improvements especially for pediatric patients and for patients in developing countries.


Assuntos
Citometria de Fluxo/métodos , Microfluídica , Microscopia Confocal/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Células Precursoras de Linfócitos B/patologia , Análise Espectral/métodos , Adolescente , Algoritmos , Linhagem Celular , Criança , Contagem de Eritrócitos , Eritrócitos/citologia , Citometria de Fluxo/instrumentação , Humanos , Contagem de Leucócitos , Leucócitos/citologia , Leucócitos Mononucleares/citologia , Luz , Microfluídica/instrumentação , Microfluídica/métodos , Microscopia Confocal/instrumentação , Neutrófilos/citologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Espalhamento de Radiação , Sensibilidade e Especificidade , Análise Espectral/instrumentação
16.
J Cataract Refract Surg ; 37(2): 335-40, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21241918

RESUMO

PURPOSE: To evaluate whether laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) achieve effective targeted correction and the extent of post-treatment corneal haze after corneal transplantation. SETTING: Nonhospital surgical facility, Calgary, Alberta, Canada. DESIGN: Evidence-based manuscript. METHODS: This study evaluated visual acuity, refractive error correction, and potential complications after LASEK or PRK to eliminate refractive error differences after penetrating keratoplasty in adults. A Nidek EC-5000 or Technolas 217 excimer laser was used in all treatments. RESULTS: At last follow-up (mean 20.50 months post laser), the mean spherical equivalent (SE) decreased from -2.71 diopters (D) ± 4.17 (SD) to -0.54 ± 3.28 D in the LASEK group and from -4.87 ± 3.90 D to -1.82 ± 3.34 D in the PRK group. The mean preoperative uncorrected distance visual acuity (UDVA) was 1.63 ± 0.53 and 1.45 ± 0.64, respectively, and the mean postoperative UDVA, 0.83 ± 0.54 and 0.90 ± 0.55, respectively. The improvement in SE and UDVA was statistically significant in both groups (P < .01). The mean haze (0 to 3 scale) at the last follow-up was 0.46 ± 0.708 in the LASEK group and 0.58 ± 0.776 in the PRK group. CONCLUSIONS: The UDVA improved and refractive errors were effectively reduced after LASEK or PRK in eyes with previous PKP. There was no significant difference in the change in SE, UDVA, or corrected distance visual acuity between LASEK and PRK. Some patients had evidence of corneal haze, although the difference between the groups was not significant.


Assuntos
Astigmatismo/etiologia , Astigmatismo/cirurgia , Ceratectomia Subepitelial Assistida por Laser , Ceratoplastia Penetrante/efeitos adversos , Miopia/etiologia , Miopia/cirurgia , Ceratectomia Fotorrefrativa , Adulto , Idoso , Astigmatismo/fisiopatologia , Opacidade da Córnea/etiologia , Feminino , Seguimentos , Humanos , Ceratectomia Subepitelial Assistida por Laser/efeitos adversos , Masculino , Pessoa de Meia-Idade , Miopia/fisiopatologia , Ceratectomia Fotorrefrativa/efeitos adversos , Estudos Retrospectivos , Acuidade Visual
17.
J Cataract Refract Surg ; 36(2): 260-7, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20152607

RESUMO

PURPOSE: To assess the refractive, visual acuity, and binocular results of laser-assisted subepithelial keratectomy (LASEK) in children with bilateral hyperopia or hyperopic anisometropic amblyopia. SETTING: Nonhospital surgical facility and hospital clinic, Calgary, Alberta, Canada. METHODS: This retrospective review comprised children with bilateral hyperopia or hyperopic anisometropic amblyopia who had LASEK. Refractive status, visual acuity, and binocular vision were assessed and recorded 2 months and 1 year postoperatively. RESULTS: The mean spherical equivalent (SE) in all 72 hyperopic eyes (47 patients) was +3.42 diopters (D) (range 0.00 to +12.50 D) preoperatively and +0.59 D (range -1.25 to +2.00 D) 1 year postoperatively. After LASIK, 41.7% of eyes had improved corrected distance visual acuity (CDVA). No patient had reduced CDVA or loss of fusional ability; there was a 25.0% improvement in stereopsis at 1 year. The mean anisometropic difference in the hyperopic anisometropic amblyopia subgroup (18 eyes, 10 patients) was 4.39 D (range +1.75 to +7.75 D) preoperatively and +0.51 D (range 0 to +0.875 D) at 1 year. One year postoperatively, 83% of anisometropic eyes were within +/-1.00 D of the fellow eye and 94.0% were within +/-3.00 D. Postoperatively, 64.7% of eyes had improved CDVA with no reduced CDVA or loss of fusional ability; there was a 22% improvement in stereopsis at 1 year. CONCLUSION: Laser-assisted subepithelial keratectomy improved visual acuity in pediatric hyperopia with or without associated hyperopic anisometropic amblyopia.


Assuntos
Ambliopia/cirurgia , Hiperopia/cirurgia , Ceratectomia Subepitelial Assistida por Laser/métodos , Adolescente , Ambliopia/fisiopatologia , Criança , Pré-Escolar , Percepção de Profundidade/fisiologia , Feminino , Seguimentos , Lateralidade Funcional , Humanos , Hiperopia/fisiopatologia , Lactente , Masculino , Estudos Prospectivos , Refração Ocular/fisiologia , Estudos Retrospectivos , Resultado do Tratamento , Visão Binocular/fisiologia , Acuidade Visual/fisiologia
18.
Aesthetic Plast Surg ; 34(1): 88-95, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19924470

RESUMO

The use of large-particle stabilized hyaluronic acid-based gel of nonanimal origin (NASHA™) for facial aesthetic procedures is widespread and increasing. A panel of experts with extensive clinical experience with NASHA based gel recently attended an advisory board meeting to develop guidelines for its use in volumetric tissue augmentation.Discussions included details of the blunt-cannula injection technique currently recommended for administration of large-particle NASHA-based gel. With the aim of optimizing patient comfort and control over administration of NASHA-based gel, the panel members explored an alternative,sharp-needle technique. In this article we describe the new technique in detail, together with practical recommendations and precautions. The technique has several advantages over blunt-cannula injection: improved patient comfort, lack of need for a skin incision, increased precision regarding the implant position, and improved control of injection volume. However, the sharp-needle technique requires a high level of skill and a good knowledge of facial anatomy.


Assuntos
Face/cirurgia , Ácido Hialurônico/análogos & derivados , Envelhecimento da Pele , Adulto , Técnicas Cosméticas , Dextranos/administração & dosagem , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Subcutâneas , Pessoa de Meia-Idade , Agulhas
19.
Appl Opt ; 48(13): 2595-9, 2009 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-19412220

RESUMO

We report on the design and construction of a confocal light scattering spectroscopic imaging system aimed ultimately to conduct depth-resolved characterization of biological tissues. The confocal sectioning ability of the system is demonstrated using a two-layer sample consisting of a 200 microm thick cancer cell layer on top of a scattering layer doped with a green absorber. The measurement results demonstrate that distinct light scattering signals can be isolated from each layer with an axial and a lateral resolution of 30 and 27 microm, respectively. Such a system is expected to have significant applications in the areas of tissue engineering and disease diagnostics and monitoring.


Assuntos
Aumento da Imagem/instrumentação , Leucemia/patologia , Leucemia/fisiopatologia , Microscopia Confocal/instrumentação , Nefelometria e Turbidimetria/instrumentação , Análise Espectral/instrumentação , Tomografia de Coerência Óptica/instrumentação , Linhagem Celular Tumoral , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Microscopia Confocal/métodos , Nefelometria e Turbidimetria/métodos , Análise Espectral/métodos , Tomografia de Coerência Óptica/métodos
20.
J Cataract Refract Surg ; 34(3): 411-6, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18299065

RESUMO

PURPOSE: To assess the long-term refractive, visual acuity, binocular vision, and quality-of-life outcomes of photorefractive keratectomy (PRK) and laser-assisted subepithelial keratectomy (LASEK) in children. SETTING: Non-hospital surgical facility with follow-up in a hospital clinical setting. METHODS: In this retrospective review, 56 eyes of 39 patients had PRK or LASEK under general anesthesia. Patients were examined preoperatively and postoperatively at 2 and 6 months and 1 year and then annually for a minimum of 3.5 years. Recorded variables included demographics, refractive error, best corrected visual acuity (BCVA), stereopsis, corneal haze, and quality of life. RESULTS: The mean age at surgery was 6.5 years (range 1.0 to 17.4 years). At the final postoperative examination (mean 5.15 years), the mean spherical equivalent was -1.73 diopters (D) in all patients, -3.20 D in PRK patients, and -1.37 D in LASEK patients. Refraction and corneal clarity were stable over the long term in all eyes. In 28 eyes that were measurable preoperatively, visual acuity improved by a mean of 1.6 lines (range 0 to 7 lines). Seven patients (18%) had measurable stereopsis before surgery and 19 (49%), after PRK or LASEK. No patient had reduced BCVA or loss of binocular fusion postoperatively. On a quality-of-life questionnaire, no family recorded negative opinions of the procedure or negative social or functional outcomes postoperatively. CONCLUSION: Photorefractive keratectomy and LASEK were effective and stable surgical alternative treatments in children with refractive errors who were unable to tolerate or who failed conventional methods of treatment.


Assuntos
Ceratectomia Subepitelial Assistida por Laser/métodos , Lasers de Excimer , Ceratectomia Fotorrefrativa/métodos , Visão Binocular/fisiologia , Acuidade Visual/fisiologia , Adolescente , Criança , Pré-Escolar , Percepção de Profundidade/fisiologia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Miopia/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
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