Laryngocele - A Case Report and Review of Literature

This is case report of 35-year old male patient presented with hoarseness and swelling on left side of neck. The swelling was noticed by the patient for 8 months. It has been diagnosed clinically and radiologically as a combined laryngocele. The laryngocele has been successfully excised using and combined approach i.e., external and endoscopic methods. This case has been reported for its rarity at this age.     

Real-time polymerase chain reaction quantification of specific butyrate-producing bacteria, Desulfovibrio and Enterococcus faecalis in the feces of patients with colorectal cancer

Background and Aim:  Bacterial metabolites produced in the bowel are potentially related to the genesis of colorectal cancer. Butyrate is protective against cancer, whereas hydrogen sulfide and oxygen free radicals can be toxic to the epithelium. The present study was designed to quantitate Eubacterium rectale , Faecalibacterium prausnitzii (both butyrate-producing bacteria), Desulfovibrio (sulfate-reducing bacteria), and Enterococcus faecalis (that produces extracellular superoxide) in the feces of patients with colorectal cancer.
Methods:  DNA was extracted from feces of 20 patients with colorectal cancer, nine patients with upper gastrointestinal cancer and 17 healthy volunteers. Real-time polymerase chain reaction using primers aimed at 16S rDNA was used to quantitate the above bacterial species or genus, and this was expressed relative to amplification of universal sequences conserved among all bacteria.
Results:  Levels of E. rectale and F. prausnitzii were decreased approximately fourfold ( P  = 0.0088 and 0.0028, respectively) in colorectal cancer patients compared to healthy control volunteers. Levels of Desulfovibrio were not significantly different between the three groups. E. faecalis populations were significantly higher in colorectal cancer patients compared to healthy volunteers ( P  = 0.0294).
Conclusions:  Butyrate producers were decreased and E. faecalis increased in the feces of colon cancer patients. These shifts in the colonic bacterial population could potentially lead to epithelial cell damage and increased turnover and may be a factor leading to colon cancer.     

A curricular initiative for internal medicine residents to enhance proficiency in internal jugular central venous line placement

OBJECTIVE: To determine the feasibility, efficacy, and outcomes of teaching Internal Jugular (IJ) central venous line placement (CVLP) to internal medicine residents in a hands-on training experience with adult patients. SUBJECTS AND METHODS: Data were obtained from 47 residents during their 3-year residency program through questionnaires and a proprietary system that tracks resident procedures. Twenty-five postgraduate year (PGY) 2 residents at the Mayo Clinic in Rochester, Minn, were assigned to IJ-CVLP training in the cardiac catheterization laboratory from January 2001 to June 2001. Their experience, analyzed immediately after training and at completion of residency, was compared with that of 22 PGY-2 residents in the same class who were not assigned to IJ-CVLP training. RESULTS: The median Likert scores of the residents' self-reported perception of independence in IJ-CVLP increased from 3.0 (mean +/- SD score, 2.8+/-1.4) before the intervention to 5.0 (4.4+/-0.9) after the intervention (P<.001, signed rank test). At graduation, trained residents had performed more IJ-CVLPs than the control residents (mean +/- SD, 17.8+/-8.4 vs 9.8+/-6.3, respectively; P<.001). Residents who received IJ-CVLP training, compared with those who did not, showed a significant increase in the mean percentage of IJ-CVLPs performed independently between PGY-1 (2.2%) and PGY-3 (31.2%) (P=.008). CONCLUSIONS: Training internal medicine residents to perform IJ-CVLP is feasible in the cardiac catheterization laboratory with supervision from an attending cardiologist. Trained residents performed significantly more IJ-CVLPs independently during their third year compared with their first year of training. We believe this initiative may be implemented successfully in graduate medical education curriculums.     

The influence of laminin-derived peptides conjugated to Lys-capped PLLA on neonatal mouse cerebellum C17.2 stem cells

Chemical guiding cues are being exploited to stimulate neuron adhesion and neurite outgrowth. In this study, an amino-functioned PLLA, lysine-capped PLLA [K-(CH₂)_n-PLLA (n = 2, 5, 8)], was synthesized with different length of linking spaces between lysine molecule and PLLA backbone. Drop-cast films were fabricated from K-(CH₂)_n-PLLA/PLLA blends (10/90, w/w) and amino groups were detected on the surfaces of the resultant films. More amine groups were detected on the surface and the hydrophilicity of the films was obviously improved by annealing the films in water. The representative atomic force microscopy (AFM) images indicated that incorporation of lysine-capped PLLA into PLLA matrix increased the roughness of the films and resulted in a phase separation with distinct two nano-domains which may correspond to the hydrophilic and hydrophobic domains. Furthermore, the laminin-derived peptides, CYIGSR (Cys-Tyr-Ile-Gly-Ser-Arg) and CSIKVAV (Cys-Ser-Ile-Lys-Val-Ala-Val), were jointly tethered to the amine groups of lysine-capped PLLA by a linking reagent sulfo-succinimidyl 4-(N-maleimidomethyl) cyclohexane-1-carboxylate (Sulfo-SMCC). The neonatal mouse cerebellum C17.2 stem cells were seeded on the peptides-grafted K-(CH₂)_n-PLLA/PLLA (n = 2, 5, 8) films and pure PLLA films were used as controls. Improved viability and longer neurites were obtained on the peptide-grafted films than PLLA film over the cultivation period, especially for K-(CH₂)₅-PLLA/PLLA, which had the highest peptide density of 0.28 ± 0.03 μg/cm². This study highlights the potential of using the lysine-cappeded PLLA with laminin-derived peptides for promoting nerve regeneration.     

Tubular nanofiber scaffolds for tissue engineered small-diameter vascular grafts

Quick establishment of a confluent and stable endothelial cells (ECs) layer in the lumen of vascular grafts is critical for long-term patency of small-diameter vascular grafts. The objective of the study was to fabricate tubular nanofiber scaffolds, incorporate ECs onto the lumen of the scaffolds, and establish an animal model to prove the basic concept of using the scaffolds as vascular grafts. Poly(L-lactic acid)-co-poly(epsilon-caprolactone) P(LLA-CL 70:30) tubular nanofiber scaffolds were fabricated by electrospinning onto a rotating mandrel. Collagen was coated onto the scaffolds after air plasma treatment. Structure and mechanical property of the scaffolds were studied by scanning electron microscopy and tensile stress measurement, respectively. Human coronary artery endothelial cells (HCAECs) were rotationally seeded onto the lumen of the scaffolds at the speed of 6 rpm for 4 h through a customized seeding device, followed with static culture. Results showed evenly distributed and well-spread HCAECs throughout the lumen of the scaffold from 1 day onward to 10 days after seeding. Further, HCAECs maintained phenotypic expression of PECAM-1. To prove the basic concept of using the scaffolds as vascular grafts, acellular tubular P(LLA-CL) nanofiber scaffolds (inner diameter 1 mm) were implanted into rabbits to replace the inferior superficial epigastric veins. Results showed the scaffolds sustained the surgical process, kept the structure integrity, and showed the patency for 7 weeks.