Anaglyph of Retinal Stem Cells And Developing Axons: Selective Volume Enhancement In Microscopy Images

Retinal stem cell culture has become a powerful research tool, but it requires reliable methods to obtain high‐quality images of living and fixed cells. This study describes a procedure for using phase contrast microscopy to obtain three‐dimensional (3‐D) images for the study of living cells by photographing a living cell in a culture dish from bottom to top, as well as a procedure to increase the quality of scanning electron micrographs and laser confocal images. The procedure may also be used to photograph clusters of neural stem cells, and retinal explants with vigorous axonal growth. In the case of scanning electron microscopy and laser confocal images, a Gaussian procedure is applied to the original images. The methodology allows for the creation of anaglyphs and video reconstructions, and provides high‐quality images for characterizing living cells or tissues, fixed cells or tissues, or organs observed with scanning electron and laser confocal microscopy. Its greatest advantage is that it is easy to obtain good results without expensive equipment. The procedure is fast, precise, simple, and offers a strategic tool for obtaining 3‐D reconstructions of cells and axons suitable for easily determining the orientation and polarity of a specimen. It also enables video reconstructions to be created, even of specimens parallel to the plastic base of a tissue culture dish, It is also helpful for studying the distribution and organization of living cells in a culture, as it provides the same powerful information as optical tomography, which most confocal microscopes cannot do on sterile living cells. Anat Rec, 297:770–780, 2014. © 2014 Wiley Periodicals, Inc.     

Conservative management of cholestasis with and without fever in acute biliary pancreatitis

The presence of cholestasis in both mild and severe forms of acute biliary pancreatitis(ABP)does not justify,of itself,early endoscopic retrograde cholangiography(ERC)or endoscopic sphincterotomy(ES).Clinical support treatment of acute pancreatitis for one to two weeks is usually accompanied by regression of pancreatic edema,of cholestasis and by stone migration to the duodenum in 60%-88%of cases.On the other hand,in cases with both cholestasis and fever,a condition usually characterized as ABP associated with cholangitis,early ES is normally indicated.However,in daily clinical practice,it is practically impossible to guarantee the coexistence of cholangitis and mild or severe acute pancreatitis.Pain,fever and cholestasis,as well as mental confusion and hypotension,may be attributed to inflammatory and necrotic events related to ABP. Under these circumstances,evaluation of the bile duct by endo-ultrasonography(EUS)or magnetic resonance cholangiography(MRC)before performing ERC and ES seems reasonable.Thus,it is necessary to assess the effects of the association between early and opportune access to the treatment of local and systemic inflammatory/infectious effects of ABP with cholestasis and fever, and to characterize the possible scenarios and the subsequent approaches to the common bile duct,directed by less invasive examinations such as MRC or EUS.     

Long‐Term Evaluation of Periodontal Parameters and Implant Outcomes in Periodontally Compromised Patients: A Systematic Review

Background : The aim of this systematic review is to evaluate the long‐term outcomes of patients with periodontitis submitted to periodontal therapy/maintenance and implant placement. Methods: Studies reporting clinical and/or long‐term implant outcomes from partially edentulous patients with periodontitis who were treated and followed periodontal maintenance for ≥5 years were considered eligible for the review. Screening of the articles, data extraction, and quality assessment were conducted independently and in duplicate. Results: Search of MEDLINE, EMBASE, and CENTRAL databases resulted in 959 papers, and of them 931 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only 10 studies met inclusion criteria. Most of the included studies (77.8%) presented a medium/high methodologic quality. The results demonstrated that patients with a diagnosis of periodontitis had satisfactory implant outcomes. Implant survival was high (92.1%) within studies reporting 10 years of follow‐up. Parameters related to probing depth, clinical attachment level, and bone loss around teeth increased the occurrence of peri‐implantitis and implant loss. Non‐attendance to periodontal maintenance and smoking habits were also associated with less favorable implant outcomes. Conclusions: This systematic review confirmed that implant therapy can be successfully used in patients with a diagnosis of periodontitis who underwent proper therapy and regular periodontal maintenance. Residual pockets, non‐attendance to the periodontal maintenance program, and smoking were considered to be negative factors for the long‐term implant outcomes.     

A Specific Angiographic View of Left Coronary Artery Bifurcation in the Left Main Percutaneous Coronary Intervention Era

Objectives

We propose a right lateral (90–120° RAO) with 30° cranial angiographic view to expose the bifurcation of the left main coronary artery (LMCA) when previously used routine projections were inefficient at clearly showing this region.

Background

Little has been published in the medical literature regarding angiographic projections dedicated to special anatomies.

Methods

A total of 84 patients were subjected to the proposed projections. A reproducibility study, conducted with the participation of 2 independent observers, judged the effectiveness of the proposed projection. The Prevalence and Bias Adjusted Kappa (PABAK) index, with a 95% confidence interval (CI), was used to demonstrate the intensity of intra/inter‐observer agreement.

Results

The proposed projection was efficient in 79% of the angiograms, with agreement of 0.76 (0.6–0.9; P ≤ 0.001). The origins and the proximal segments of: the anterior descending coronary artery were exposed in 89% of the angiograms, agreement of 0.86 (0.7–1.0; P ≤ 0.001); the circumflex artery were exposed in 83% of the angiograms, with agreement of 0.72 (0.5–1.0; P ≤ 0.001); and the intermediate branch, when present, were exposed in 89% of the angiograms, agreement of 0.79 (0.6–1.0; P ≤ 0.001).

Conclusion

The right lateral (90–120° RAO) with 30° cranial projection is effective, safe, and reproducible. In special situations where routine projections fail, this proposed projection can reveal important details of the anatomy of the bifurcation of the LMCA during conventional coronary angiography or be the working projection during coronary angioplasty. (J Interven Cardiol 2016;29:293–299)

     

Is endovascular revascularisation worthwhile in diabetic patients with critical limb ischemia who also have end-stage renal disease?

To present the outcomes of endovascular treatment of diabetics patients with critical limb ischemia who have end-stage renal disease. Limb-salvage was achieved in 58.6% of the limbs during a mean follow-up period of 12.4 months. No major amputations were required on patients with rest pain or with grade 1 lesions.     

First description of Grapevine leafroll-associated virus 5 in Argentina and partial genome sequence

An accession of Vitis vinifera cv. Red Globe from Argentina, was found to be infected with Grapevine leafroll-associated virus-5 by ELISA. It was partially sequenced, and three ORFs, corresponding to HSP70h, HSP90h, and CP, were found. This isolate shares a high aminoacid identity with the previously reported sequence of the virus, and identities between 80% and 90% with previously reported GLRaV-9 and GLRaV-4 isolates. The analysis of the sequence supports the clustering together with GLRaV-4 and GLRV-9 inside the Ampelovirus genus.     

Web-based adaptive training simulator system for cardiac life support

OBJECTIVE: We introduce a web-based adaptive training simulator system to exercise cardiopulmonary resuscitation skills. Our purpose is to provide emergency physicians with an additional training tool for cardiac life support clinical cases, by integrating an adaptive learning environment with a web-based case simulator. METHODS AND MATERIALS: Adaptive systems reflect some features of the user in the user model and apply this model to adapt various visible aspects of the system to the user. Our system follows a stage-based learning model with several steps to personalize student learning. First, students learn the theory and content of life support and take computerized tests to evaluate their declarative knowledge of these areas. Second, they practice with clinical case examples and complete an exam at the appropriate level of difficulty to assess their practical knowledge. Finally, they train with additional clinical cases. RESULTS AND CONCLUSION: In order to evaluate the usefulness of the system, we used it in two traditional advanced life support courses at the Jaen Hospital in Spain, as an additional and complementary tool within the course. Results show that the use of adaptation techniques can improve student performance.