In vitro antibacterial and cytotoxicity assay of multilayered polyelectrolyte-functionalized stainless steel

Infection of implanted materials by bacteria constitutes one of the most serious complications following prosthetic and implant surgery. In the present study, a new strategy for confering stainless steel with antibacterial property via the alternate deposition of quaternized polyethylenimine (PEI) or quaternized polyethylenimine-silver complex and poly(acrylic acid) (PAA) was investigated. The success of the deposition of the polyelectrolyte multilayers (PEM) and its chemical nature was investigated by static water contact angle and X-ray photoelectron spectroscopy (XPS), respectively. The antibacterial activity was assessed using Escherichia coli (E. coli, a gram-negative bacterium) and Staphylococcus aureus (S. aureus, a gram-positive bacterium). The inhibition of E. coli and S aureus growth on the surface of functionalized films was clearly shown using the LIVE/DEAD Baclight bacterial viability kits and fluorescence microscopy. The cytotoxicity of the PEM to mammalian cells, evaluated by the MTT assay, was shown to be minimal and long-term antibacterial efficacy can be maintained. These results indicate new possibilities for the use of such easily built and functionalized architectures for the functionalization of surfaces of implanted medical devices.     

Hormones,sex, and asthma

Objective

To summarize the current literature on the sex disparity in asthma and the role of sex hormone signaling in allergic and neutrophilic airway inflammation.

Effect of Peritoneal Dialysis Modality on the 1-Year Rate of Decline of Residual Renal Function

Purpose

The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort.

Materials and Methods

We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation.

Results

The RRF at 1 year after PD initiation was 1.98±2.20 mL/min/1.73 m² in CCPD patients and 3.63±3.67 mL/min/1.73 m² in NIPD patients, which were moderately lower than 4.23±3.51 mL/min/1.73 m² in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (β=-31.50; 95% CI, -63.61 to 0.62; p=0.052).

Conclusion

Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities.     

Hypoxia-responsive polymeric nanoparticles for tumor-targeted drug delivery

Hypoxia is a condition found in various intractable diseases. Here, we report self-assembled nanoparticles which can selectively release the hydrophobic agents under hypoxic conditions. For the preparation of hypoxia-responsive nanoparticles (HR-NPs), a hydrophobically modified 2-nitroimidazole derivative was conjugated to the backbone of the carboxymethyl dextran (CM-Dex). Doxorubicin (DOX), a model drug, was effectively encapsulated into the HR-NPs. The HR-NPs released DOX in a sustained manner under the normoxic condition (physiological condition), whereas the drug release rate remarkably increased under the hypoxic condition. From in vitro cytotoxicity tests, it was found the DOX-loaded HR-NPs showed higher toxicity to hypoxic cells than to normoxic cells. Microscopic observation showed that the HR-NPs could effectively deliver DOX into SCC7 cells under hypoxic conditions. In vivo biodistribution study demonstrated that HR-NPs were selectively accumulated at the hypoxic tumor tissues. As consequence, drug-loaded HR-NPs exhibited high anti-tumor activity in vivo. Overall, the HR-NPs might have a potential as nanocarriers for drug delivery to treat hypoxia-associated diseases.     

Screening for Head,Neck, and Shoulder Pathology in Patients with Upper Extremity Signs and Symptoms

Narrative ReviewConditions of the head, neck, thorax, and shoulder may occur simultaneously with arm pathology or produce symptoms perceived by the patient to originate in the elbow, wrist, or hand. Identification of the tissue disorder and associated impairments, followed by matching the rehabilitative intervention to address these issues, leads to optimal outcomes. With this goal in mind, the hand therapist needs to recognize clinical findings that signal potentially serious medical conditions of the brain, cervical region, chest, or shoulder. Additionally, less serious but potentially debilitating, musculoskeletal or neurogenic pain from proximal sources must also be differentiated from somatic pain originating in the elbow, wrist, or hand so that the clinician can decide to further examine and intervene or refer to an appropriate health care provider. This article describes clinical findings that suggest the presence of serious medical pathology in the head, neck, or thorax and presents a screening algorithm to assist in discriminating pain derived from local structures in the distal arm from referred pain originating in the more proximal regions of the shoulder, thorax, neck, or brain.Level of Evidence5.     

Tracheobronchography and angiocardiography of paediatric cardiac patients with airway disorders

OBJECTIVE: We report our experience in combining tracheobronchography and angiocardiography in the assessment of a selected cohort of paediatric cardiac patients with problematic airway disorders. METHODOLOGY: The clinical records of 11 patients who underwent 17 studies at a median age of 5.5 months (range 3 months to 10.8 years) were reviewed. Tracheobronchography and angiocardiography were performed under general anaesthesia using a non-ionic contrast agent. The findings were compared with those of flexible bronchoscopy and magnetic resonance imaging (MRI). RESULTS: Seven patients had cardiac lesions associated with vascular anomalies potentially compressing the airway, while four had no identifiable aberrant or enlarged vessels. All examinations but one were performed without complications. Tracheobronchography demonstrated extrinsic vascular compression with secondary airway malacia in three (27%), intrinsic tracheobronchial stenosis in five (45%), and airway malacia in three patients (27%). Precise measurement of the airway calibre and real-time fluoroscopic monitoring facilitated transcatheter tracheobronchial interventions (six balloon dilations, three stent implantations) in four patients. In conjunction with angiocardiography, cine-tracheobronchography provided detailed information on the spatial relationship between vascular and airway structures in all patients; allowed dynamic assessment of airway malacia; and facilitated preoperative planning in six patients. In contrast, bronchoscopy failed to differentiate malacia from extrinsic compression in four patients (36%), while MRI, performed in six patients, was unsatisfactory in one due to a motion artefact and failed to diagnose airway malacia and extrinsic compression in three patients. CONCLUSIONS: Tracheobronchography is relatively safe in paediatric cardiac patients. Combined tracheobronchography and angiocardiography, a less operator-dependent imaging modality compared to bronchoscopy and MRI, delineated the airway and vascular anatomy in detail; facilitated preoperative planning; and permitted transcatheter tracheo-bronchial interventions. The dynamic capability of tracheobronchography supplements that of flexible bronchoscopy and MRI in the diagnosis of airway malacia.     

First-trimester fetal limb biometry in Chinese population

OBJECTIVES: To establish reference ranges for fetal limb biometry obtained by transabdominal ultrasound examination at 12-14 weeks of gestation in Chinese women. METHODS: A total of 1489 normal singleton fetuses between 12(+0) and 14(+6) weeks of gestation were examined transabdominally by two experienced observers. The gestation was ascertained by measurement of fetal crown-rump length (CRL) or biparietal diameter (BPD) and head circumference (HC). The lengths of the humerus and femur were prospectively worked out. RESULTS: Gestation-specific reference ranges for limb measurements were calculated. The femur length (FL) (mean +/- SD) was 9.15 +/- 1.44 mm at 12-12(+6) weeks, 11.45 +/- 1.35 mm at 13-13(+6) weeks, and 13.64 +/- 1.60 mm at 14-14(+6) weeks; the corresponding humerus length (HL) (mean +/- SD) was 9.63 +/- 1.44 mm, 12.01 +/- 1.41 mm, 14.29 +/- 1.48 mm, respectively. CONCLUSIONS: There was a general increase in fetal limb biometry with gestation. Fetal limb length can be an early marker of early growth restriction as well as fetal skeletal dysplasia among women in the local population.