Collagen-GAG Scaffolds Grafted Onto Myocardial Infarcts in a Rat Model:A Delivery Vehicle for Mesenchymal Stem Cells

1 IntroductionThe objective of the present study was to investigate the response of rat myocardial scar tissue to type I collagen-glycosaminoglycan (GAG) tissue engineering scaffolds, and to assess the feasibility of using a collagen-GAG scaffold as a delivery vehicle for bone marrow-derived mesenchymal stem cells. The benefits of employing the collagen-GAG scaffold for this application include the following:(1) the large surface area of the three-dimensional sponge-like material allows for the delivery of ...     

Soil Nutrient-Vegetation Relationships in the Eden Area,N.S.W. II. Vegetation-Soil Associations

A soil survey in the forests of the Eden area, N.S.W., included the recording of the tree species present at each plot, and based on these data eight main vegetation types were classified. These vegetation associations have been assessed in relation to soil nutrient levels, elevations and topographical features. Elevation and soil fertility were the two main measured parameters which appeared to determine the association distribution but other factors, such as aspect and slope were important on specific sites. It has been concluded that the forest mosaics of this area can be related to readily measurable soil and environmental parameters but that further detailed studies beyond this general survey are required for verification.     

BDDrFVIII (Moroctocog alfa [AF‐CC]) for surgical haemostasis in patients with haemophilia A: results of a pivotal study

Summary. Moroctocog alfa (AF‐CC) (Xyntha?, BDDrFVIII) is manufactured by a process designed to enhance the theoretical viral safety profile relative to ReFacto^®, its predecessor, and to provide alignment with clinical monitoring by the one‐stage clotting assay. To evaluate the efficacy and safety of B‐domain‐deleted recombinant factor VIII (BDDrFVIII) was given as bolus injection (BI) or continuous infusion (CI) in haemophilia patients undergoing major surgery. BDDrFVIII was administered by BI or CI per investigator discretion peri‐operatively for at least 6 days. Thirty patients enrolled and were treated with at least one dose of BDDrFVIII. Twenty‐five patients were evaluable for efficacy. Outcomes were favourable against a background of multiple major surgical procedures. All haemostatic efficacy ratings were ‘excellent’ or ‘good’. End‐of‐surgery haemostasis ratings, the primary efficacy endpoint, were excellent for 72% (18/25) and good for 28% (7/25) of patients. Haemostasis ratings following the initial postoperative period were excellent for 92% (23/25) and good for 8% (2/25) of patients. Intra‐operative blood loss was rated as normal in all patients. Thirteen patients had postoperative blood loss; in 10, this was rated as normal. A low frequency of transfusion was reported in both the intra‐operative and postoperative settings. Adverse events (AEs) were consistent with surgery; three were considered related to BDDrFVIII. One patient had a related AE of postoperative haemorrhage. A clinically silent low‐titre inhibitor was detected in one patient, and one patient had a false‐positive inhibitor titre. This study demonstrates that BDDrFVIII is safe and efficacious for surgical prophylaxis in haemophilia A patients undergoing major surgery.     

NONBLADDER RELATED SYMPTOMS IN PATIENTS WITH INTERSTITIAL CYSTITIS

PURPOSE: Clinical experience and epidemiological studies suggest that patients with interstitial cystitis have multiple nonbladder related symptoms. However, to our knowledge this finding has not been tested with a validated questionnaire and matched controls. With the University of Wisconsin scale, we compare the scores for patients with interstitial cystitis to those for control subjects. This validated questionnaire includes 7 bladder and 18 reference symptoms not related to the bladder. MATERIALS AND METHODS: A total of 35 female patients with interstitial cystitis and 35 age matched female controls completed the University of Wisconsin questionnaire. RESULTS: For the 7 bladder symptoms the difference between interstitial cystitis and control groups was extremely significant (p = 0.0001). Patients with interstitial cystitis had higher scores than controls for 2 reference symptoms, including other pelvic discomfort, backache, dizziness, chest pain, aches in joints, abdominal cramps, nausea, heart pounding and headache (p <0.01). However, they did not have higher scores for blind spots and/or blurred vision, numbness and/or tingling in fingers or toes, swollen ankles, feeling of suffocation, sore throat, cough, flu, nasal congestion and ringing in ears. The majority of patients with interstitial cystitis had a 0 score for all but 2 of the reference symptoms. CONCLUSIONS: Patients with interstitial cystitis had increased scores for 9 reference symptoms but did not indiscriminately report high scores for generalized complaints. This result suggests that in some cases of interstitial cystitis the pathophysiology may affect other organ systems besides the bladder. Alternatively, some of these symptoms may result from changes in sleep pattern or other factors associated with interstitial cystitis.     

Cutaneous Effects of Cryogen Spray Cooling on In Vivo Human Skin

BACKGROUND: Despite widespread clinical use of cryogen spray cooling (CSC) in conjunction with laser dermatologic surgery, in vivo cutaneous effects have not been systematically evaluated. OBJECTIVE: The authors characterize the in vivo cutaneous effects for Fitzpatrick skin types I through VI after CSC exposures of varying spurt durations and spurt delivery patterns (single vs. multiple spurts). MATERIALS AND METHODS: Twenty-seven normal human subjects were exposed to single cryogen spurts from 10 to 80 milliseconds, and multiple spurt patterns consisting of two 20-millisecond spurts, four 10-millisecond spurts, and eight 5-millisecond spurts. Subjects were evaluated by clinical observation and photography at 1 hour, 1 day, and 1, 4, 8, and 12 weeks after CSC exposure. RESULTS: Acute erythema and urticaria (1-24 hours) were noted in 14 of 27 and 3 of 27 subjects, respectively. Transient hyperpigmentation occurred in 4 of 27 subjects (skin types III-VI) but resolved spontaneously without medical intervention in all subjects by 8 weeks. No permanent skin changes were noted in any subjects. Skin reactions were more common with longer single-spurt durations (50 milliseconds or greater) and multiple spurt patterns. CONCLUSION: Acute erythema, urticaria, and, less commonly, transient hyperpigmentation were observed after CSC exposure. Permanent skin injury was not observed and is unlikely.     

Palpitations Occur Frequently Following Radiofrequency Catheter Ablation for Supraventricular Tachycardia, But Do Not Predict Pathway Recurrence

Radiofrequency ablation of extranodal pathways is an effective treatment for supraventricular tachycardia, but late recurrences of pathway conduction do occur. To determine if recurrence of palpitations following ablation predicts pathway recurrence, we interviewed 77 patients who were at Jeast 4 weeks status-post successful ablation of an accessory pathway (43 overt, 11 concealed)or a slow pathway (23)for AV nodal reentrant tachycardia. Palpitations were reported by 45 (58%)patients postablation, and 28 (36%)patients reported palpitations lasting ≥10 seconds and/or felt their symptoms represented recurrent tachycardia (major palpitations). Repeat electrophysiological testing was performed 3 months postablation in 53 patients, including 34 patients with palpitations (22 with major symptoms). Eight (10%)patients had recurrent pathway conduction demonstrated on repeat testing: two had no symptoms prior to restudy and six had major symptoms. One patient had major symptoms, but was found to have inducible atrial tachycardia and not pathway recurrence on restudy. Thus, 15 (68%)of 22 patients with major symptoms who were restud-ied had no pathway recurrence or inducible arrhythmia to explain their symptoms. Of the 24 patients not restudied, none has had documented recurrent tachycardia or overt pathway conduction by electrocardiogram over a mean follow-up of 335 ± 138 (range 132–616)days. Thus, palpitations, including palpitations reminiscent of preablation symptoms, are common following radiofrequency ablation and often do not predict pathway recurrence. Repeat electrophysiological testing is frequently required to document long-term success of radiofrequency ablation for supraventricular tachycardia in patients with recurrence of major symptoms.