Development of prototype bandage lapper for constant tension bandaging required for effective medical-clinical treatments

Application of the bandaging materials is a skilled task and required considerable practice to perform it correctly. The variation in bandaging pressure is introduced due to different tensions applied by different persons during lapping. So, a handy mechanical bandage lapper is developed. This helps in keeping lapping tension uniform and adjustable irrespective of the bandager. Its proficiency is checked by bandaging two persons with different fore-arm circumferential measures. Bandaging is done at three different limb positions with and without the use of bandage lapper up to three layers by the same bandager. Three different lapping tensions viz; 0.40 kgf, 0.45 kgf and 0.50 kgf are set up for bandage lapper to study their impact on bandage pressure. Pneumatic bandage pressure mapper is developed for the measurement of bandage pressure. Seven trials separated by different time intervals are conducted for each variable. This has prevented record of consistency of bandage pressure measure by chance.Crepe bandage, normally employed for the management of Oedema in clinical treatment is used throughout the study. Higher coefficient of variations up to 15% in pressure values are found when bandaging done without the lapper. However, identical pressure, coefficient of variation less than 0.3% for all except 0.8% for bandaging done at 0.45 kgf for second person at position 1, is mapped when bandaging done with the lapper by the same bandager.     

Vα24-invariant NKT cells mediate antitumor activity via killing of tumor-associated macrophages

Tumor infiltration with Vα24-invariant NKT cells (NKTs) associates with favorable outcome in neuroblastoma and other cancers. Although NKTs can be directly cytotoxic against CD1d⁺ cells, the majority of human tumors are CD1d^–. Therefore, the role of NKTs in cancer remains largely unknown. Here, we demonstrate that CD68⁺ tumor-associated monocytes/macrophages (TAMs) represented the majority of CD1d-expressing cells in primary human neuroblastomas. TAMs stimulated neuroblastoma growth in human cell lines and their xenografts in NOD/SCID mice via IL-6 production. Indeed, TAMs produced IL-6 in primary tumors and in the BM of patients with metastatic neuroblastoma. Gene expression analysis using TaqMan low-density arrays of 129 primary human neuroblastomas without MYCN amplification revealed that high-level expression of TAM-specific genes (CD14, CD16, IL6, IL6R, and TGFB1) was associated with poor 5-year event-free survival. While NKTs were not cytotoxic against neuroblastoma cells, they effectively killed monocytes pulsed with tumor cell lysate. The killing of monocytes was CD1d restricted because it was inhibited by a CD1d-specific mAb. Cotransfer of human monocytes and NKTs to tumor-bearing NOD/SCID mice decreased monocyte number at the tumor site and suppressed tumor growth compared with mice transferred with monocytes alone. Thus, killing of TAMs reveals what we believe to be a novel mechanism of NKT antitumor activity that relates to the disease outcome.     

Solitary plasmocytoma of frontal bone presenting as an asymptomatic forehead lump

Solitary plasmocytoma of bone is a rare type of plasma cell tumor. We present a case of a solitary extramedullary plasmacytoma of the frontal bone presenting as an asymptomatic forehead lump with clinically benign characteristics. This case highlights the need for a high index of suspicion when dealing with enlarging subcutaneous lumps of the forehead and scalp. The significance of this lies in the appropriate sequencing of investigations and the implementation of the necessary treatment regimen.     

Kinematic assessment of hip movement when retrieving an object from the floor

Background  

Activities that require extreme hip movement can dislocate hip implants in the early post operative phase. One such activity is retrieving an object from the floor. The aim of this study was to assess hip movement using four different techniques to accomplish this task. This assessment would identify the techniques least likely to cause a hip dislocation.     

Use of a hybrid-abdominal wound simulated patient in the ACS/ASE medical student simulation skills curriculum

Objective

We incorporated a hybrid-abdominal wound simulation to teach/assess the acquisition of three essential clinical skills in the ACS/ASE Medical Student Simulation-based Surgical Skills Curriculum.

Kinetic modeling of selenium metabolism in nonpregnant ewes

The kinetics of selenium metabolism in three nonpregnant ewes were studied by the intravenous injection of 75Se-sodium selenite and measurement of radioactivity responses in blood, tissues and excreta. Stable selenium measurements were also made to determine selenium intake, excretion in feces and urine, and mass of selenium in tissues. Immediately following tracer injection, there was a rapid disappearance of radioactivity from plasma reflecting the uptake of the element by the liver and blood cells. The decrease in plasma radioactivity ceased abruptly by 30-45 min, and was followed by an increase to a peak by 3-4 h and a more gradual biphasic decline thereafter. A kinetic model of selenium metabolism in the whole animal was constructed employing the SAAM/CONSAM computer program. The multiphasic response of plasma radioactivity during a physiological steady state was explained on the basis of rapid hepatic uptake of selenium and its subsequent reappearance in the circulation in protein-bound form followed by further metabolism and excretion of the element. The model provides reference parameter values for 75Se-sodium selenite kinetics in selenium-replete, mature nonpregnant ewes for comparison with the kinetics in animals whose selenium status may be altered.