Search results for: retinal prosthesis

Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

Procedia PDF Downloads 49

Authors: Kemal Polat

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In this paper, three feature weighting methods have been used to improve the classification performance of diabetic retinopathy (DR). To classify the diabetic retinopathy, features extracted from the output of several retinal image processing algorithms, such as image-level, lesion-specific and anatomical components, have been used and fed them into the classifier algorithms. The dataset used in this study has been taken from University of California, Irvine (UCI) machine learning repository. Feature weighting methods including the fuzzy c-means clustering based feature weighting, subtractive clustering based feature weighting, and Gaussian mixture clustering based feature weighting, have been used and compered with each other in the classification of DR. After feature weighting, five different classifier algorithms comprising multi-layer perceptron (MLP), k- nearest neighbor (k-NN), decision tree, support vector machine (SVM), and Naïve Bayes have been used. The hybrid method based on combination of subtractive clustering based feature weighting and decision tree classifier has been obtained the classification accuracy of 100% in the screening of DR. These results have demonstrated that the proposed hybrid scheme is very promising in the medical data set classification.

Keywords: machine learning, data weighting, classification, data mining

Procedia PDF Downloads 301

Authors: Riffat Iqbal, Sidra Ihsan, Andleeb Batool, Maryam Mukhtar

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Glaucoma is a gathering of optic neuropathies described by dynamic degeneration of retinal ganglionic cells. It is clinically and innately heterogenous illness containing a couple of particular forms each with various causes and severities. Primary open-angle glaucoma (POAG) is the most generally perceived kind of glaucoma. This study investigated the genetic association of single nucleotide polymorphisms (SNPs; rs10483727 and rs33912345) at the SIX1/SIX6 locus with primary open-angle glaucoma (POAG) in the Pakistani population. The SIX6 gene plays an important role in ocular development and has been associated with morphology of the optic nerve. A total of 100 patients clinically diagnosed with glaucoma and 100 control individuals of age over 40 were enrolled in the study. Genomic DNA was extracted by organic extraction method. The SNP genotyping was done by (i) PCR based restriction fragment length polymorphism (RFLP) and sequencing method. Significant genetic associations were observed for rs10483727 (risk allele T) and rs33912345 (risk allele C) with POAG. Hence, it was concluded that Six6 gene is genetically associated with pathogenesis of Glaucoma in Pakistan.

Keywords: genotyping, Pakistani population, primary open-angle glaucoma, SIX6 gene

Procedia PDF Downloads 149

Authors: P. S. Jagadeesh Kumar, Yang Yung, Mingmin Pan, Xianpei Li, Wenli Hu

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Glaucoma is impelled by optic nerve mutilation habitually represented as cupping and visual field injury frequently with an arcuate pattern of mid-peripheral loss, subordinate to retinal ganglion cell damage and death. Glaucoma is the second foremost cause of blindness and the chief cause of permanent blindness worldwide. Consequently, all-embracing study into the analysis and empathy of glaucoma is happening to escort deep learning based neural network intrusions to deliberate this substantial optic neuropathy. This paper advances an ophthalmic hashing based supervision of glaucoma and corneal disorders preeminent on deep graphical model. Ophthalmic hashing is a newly proposed method extending the efficacy of visual hash-coding to predict glaucoma corneal disorder matching, which is the faster than the existing methods. Deep graphical model is proficient of learning interior explications of corneal disorders in satisfactory time to solve hard combinatoric incongruities using deep Boltzmann machines.

Keywords: corneal disorders, deep Boltzmann machines, deep graphical model, glaucoma, neural networks, ophthalmic hashing

Procedia PDF Downloads 215

Authors: Asiri Wijesinghe, N. D. Kodikara, Damitha Sandaruwan

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The Diabetic Retinopathy (DR) is a rapidly growing interrogation around the world which can be annotated by abortive metabolism of glucose that causes long-term infection in human retina. This is one of the preliminary reason of visual impairment and blindness of adults. Information on retinal pathological mutation can be recognized using ocular fundus images. In this research, we are mainly focused on resurrecting an automated diagnosis system to detect DR anomalies such as severity level classification of DR patient (Non-proliferative Diabetic Retinopathy approach) and vessel tortuosity measurement of untwisted vessels to assessment of vessel anomalies (Proliferative Diabetic Retinopathy approach). Severity classification method is obtained better results according to the precision, recall, F-measure and accuracy (exceeds 94%) in all formats of cross validation. In ROC (Receiver Operating Characteristic) curves also visualized the higher AUC (Area Under Curve) percentage (exceeds 95%). User level evaluation of severity capturing is obtained higher accuracy (85%) result and fairly better values for each evaluation measurements. Untwisted vessel detection for tortuosity measurement also carried out the good results with respect to the sensitivity (85%), specificity (89%) and accuracy (87%).

Keywords: fundus image, exudates, microaneurisms, hemorrhages, tortuosity, diabetic retinopathy, optic disc, fovea

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Authors: A. Zarenezhad, A. Esfandiari, E. Zarenezhad, M. Mardkhoshnood

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The aim of this study was to investigate the ultra-structure of the photoreceptor layer of male rats under the effect of methanol intoxication and protective effect of silymarin against the methanol toxicity. Fifteen adult male rats were divided into three groups: Control group, Experimental group I (received 4g/kg methanol by intraperitoneal injection for five days), Experimental group II (received 4 g/kg methanol by intraperitoneal injection for five days and received 250 mg/kg silymarin orally for three months). At the end of the experiment, the eyes were removed; retina was separated near the optic disc and studied by transmission electron microscope. Results showed that the retina in the experimental group I exhibited loss of outer segments and disorganization in inner segment. Increased extra cellular space, disappearance of outer limiting membrane and pyknotic nuclei were seen in this group. But normal outer segment, organized inner segment and normal outer limiting membrane were obvious after treatment with silymarin in experimental group II. These findings show that methanol causes damage in the photoreceptor layer of the rat retina and silymarin can protect the damage to retina against the methanol intoxication.

Keywords: ultra-structure, photoreceptor layer, methanol intoxication, silymarin, rat

Procedia PDF Downloads 261

Authors: Ceren Kaya, Okan Erkaymaz, Orhan Ayar, Mahmut Özer

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Diabetes Mellitus (Diabetes) is a disease based on insulin hormone disorders and causes high blood glucose. Clinical findings determine that diabetes can be diagnosed by electrophysiological signals obtained from the vital organs. 'Diabetic Retinopathy' is one of the most common eye diseases resulting on diabetes and it is the leading cause of vision loss due to structural alteration of the retinal layer vessels. In this study, features of horizontal and vertical Video-Oculography (VOG) signals have been used to classify non-proliferative and proliferative diabetic retinopathy disease. Twenty-five features are acquired by using discrete wavelet transform with VOG signals which are taken from 21 subjects. Two models, based on multi-layer perceptron and radial basis function, are recommended in the diagnosis of Diabetic Retinopathy. The proposed models also can detect level of the disease. We show comparative classification performance of the proposed models. Our results show that proposed the RBF model (100%) results in better classification performance than the MLP model (94%).

Keywords: diabetic retinopathy, discrete wavelet transform, multi-layer perceptron, radial basis function, video-oculography (VOG)

Procedia PDF Downloads 231

Authors: R. W. Walker, J. M. Lynch, K. Anderson, R. G. Middleton

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Hip and knee arthritis are two of the commonest conditions that result in elective orthopaedic outpatient referral. At clinic appointments advice given regarding lifestyle modifications or treatment options may not be fully understood by patients. The majority of patients now use the internet to research their condition and use this to inform their decision about treatments. This study assessed the quality of patient information regarding hip and knee arthritis. To assess the quality of patient information regarding knee and hip arthritis available on the internet. Two internet searches were carried out one month apart using the search terms “knee arthritis” and “hip arthritis” on Google, a search engine that accounts for over 90% or internet searches in the UK. Sites were evaluated using the DISCERN instrument, a validated tool for measuring the quality of consumer health information. The first 50 results for each search were analysed by two different observers and discrepancies in scores were reviewed by both observers together and a score was agreed upon. In total 200 search result websites were assessed, of which 84 fulfilled the inclusion criteria. 53% (n=44) were funded directly by commercial healthcare businesses and of these, 70% (n=31) were funded by a surgeon/hospital promoting end-user purchase of surgical intervention. Overall 35% (n=29) websites were “for-profit” information websites where funding was from advertising revenues from pharmaceutical and prosthesis companies. 81% (n=67) offered information about surgical treatments however only 43% (n=36) mentioned the risk of complications of surgery. 67% (n=56) did not have any reference to sources for the information they detailed and 57% (n=47) had no apparent date for the production of the information they offered. Overall 17% (n=14) of websites were judged as being of high quality, with 29% (n=24) being of moderate quality and 54% (n=45) being of low quality. The quality of health information regarding hip and knee arthritis on the internet is highly variable and the majority of websites assessed were of poor quality. A preponderance of websites were funded by a commercial surgical service offering athroplasty at consumer cost, with a further third being funded indirectly via advertising revenues from commercial businesses. The vast majority of websites only mentioned surgery as a treatment and nearly half of all websites did not mention the risks or complications of surgical intervention at all. This has implications for the consent process. As such, Clinicians should be aware of the heterogeneous nature of patient information on the internet and be prepared to advise their patients about good quality websites where further reliable information can be sought.

Keywords: hip osteoarthritis, informed consent, knee osteoarthritis, patient information

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Authors: Venkat Garigapati

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Cell-based therapies are limited due to underlying host immune system activity. Microencapsulation of living cells to overcome this issue has some serious drawbacks, such as limitations of nutrient and oxygen diffusion, which pose a threat to the function and longevity of cells. The conformal coating could overcome the issues which are generally involved in traditional microencapsulation. Some of the theoretical advantages of conformal coating include superior nutrient and oxygen supply to cells, prolonged lifespan, improved drug-secreting cell functionality and an opportunity to load high cell doses in small volumes. Despite several advantages to the conformal coating, there are no suitable methods available to apply to living cells. The ultra-thin conformal coating was achieved utilizing click-reactive methacryloyloxyethyl phosphorylcholine (MPC) polymers, which are capable of specifically reacting one polymer to another at neutral pH in the aqueous isotonic system at the desired temperature suitable for living cells without the need of deleterious initiators. ARPE-19 (Adult Retinal Pigment Epithelial cell line-19) cell-spheroids and rat pancreatic islets were used in the formulation studies. The in vitro studies of coated ARPE-19 cell-spheroids and rat islets indicate that the coat was intact; cells were viable and functioning. The in vitro study results revealed that the conformal coating technology seems promising and in vivo studies are being planned.

Keywords: cells, hydrogel, conformal coating, microencapsulation, insulin

Procedia PDF Downloads 68

Authors: Rueyhung Weng, Chia-En Huang, Jung-Chi-Liao

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The transition zone (TZ) serves as a diffusion barrier to regulate the ins and outs of the proteins recruited to the primary cilia. TCTN2 is one of the TZ proteins and its mutation causes Joubert syndrome, a serious multi-organ disease. Despite its important medical relevance, the functions of TCTN2 remain elusive. Here we created a TCTN2 gene deleted retinal pigment epithelial cells (RPE1) using CRISPR/Cas9-based genome editing technique and used this knockout line to reveal roles of TCTN2. TCTN2 knockout RPE1 cells displayed a significantly reduced ciliogenesis or a shortened primary cilium length in the cilium-remaining population. Intraflagellar transport protein IFT88 aberrantly accumulated at the tip of TCTN2 deficient cells. Guanine nucleotide exchange factor Arl13B was mostly absent from the ciliary compartment, with a small population localizing at the ciliary tip. The deficient TZ was corroborated with the mislocalization of two other TZ proteins TMEM67 and MKS1. In addition, TCTN2 deficiency induced TZ impairment led to the suppression of Sonic hedgehog signaling in response to Smoothened (Smo) agonist. Together, depletion of TCTN2 destabilizes other TZ proteins and considerably alters the localization of key transport and signaling-associated proteins, including IFT88, Arl13B, and Smo.

Keywords: CRISPR/Cas9, primary cilia, Sonic hedgehog signaling, transition zone

Procedia PDF Downloads 313

Authors: Miriam Borchardt, Agata M. Ritter, Macaliston G. da Silva, Mauricio N. de Carvalho, Giancarlo M. Pereira

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This paper aims to analyze the barriers faced by social enterprises and based on that to propose a social business model framework that helps them to leverage their businesses and the social value delivered. A business model for social enterprises should amplify the value perception including social value for the beneficiaries while generating enough profit to escalate the business. Most of the social value beneficiaries are people from the base of the economic pyramid (BOP) or the ones that have specific needs. Because of this, products and services should be affordable to consumers while solving social needs of the beneficiaries. Developing products and services with social value require tie relationship among the social enterprises and universities, public institutions, accelerators, and investors. Despite being focused on social value and contributing to the beneficiaries’ quality of life as well as contributing to the governments that cannot properly guarantee public services and infrastructure to the BOP, many barriers are faced by the social enterprises to escalate their businesses. This is a work in process and five micro- and small-sized social enterprises in Brazil have been studied: (i) one has developed a kit for cervical uterine cancer detection to allow the BOP women to collect their own material and deliver to a laboratory for U$1,00; (ii) other has developed special products without lactose and it is about 70% cheaper than the traditional brands in the market; (iii) the third has developed prosthesis and orthosis to surplus needs that health public system have not done efficiently; (iv) the fourth has produced and commercialized menstrual panties aiming to reduce the consumption of dischargeable ones while saving money to the consumers; (v) the fifth develops and commercializes clothes from fabric wastes in a partnership with BOP artisans. The preliminary results indicate that the main barriers are related to the public system to recognize these products as public money that could be saved if they bought products from these enterprises instead of the multinational pharmaceutical companies, to the traditional distribution system (e.g. pharmacies) that avoid these products because of the low or non-existing profit, to the difficulty buying raw material in small quantities, to leverage investment by the investors, to cultural barriers and taboos. Interesting strategies to reduce the costs have been observed: some enterprises have focused on simplifying products, others have invested in partnerships with local producers and have developed their machines focusing on process efficiency to leverage investment by the investors.

Keywords: base of the pyramid, business model, social business, social business model, social enterprises

Procedia PDF Downloads 75

Authors: Hyvee Gean Cabuso, Arvin Taruc, Danielle Villanueva, Channela Anais Hipolito, Jia Bianca Alfonso

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Introduction: Denture adhesive aids to provide additional retention, support and comfort for patients with loose dentures, as well as for patients who seek to achieve optimal denture adhesion. But due to its growing popularity, arising oral health issues should be considered, including its possible impact that may alter the microbiological condition of the denture. Changes as such may further resolve to denture-related oral diseases that can affect the day-to-day lives of patients. Purpose: The study aims to assess and compare the microbiological status of dentures without adhesives versus dentures when adhesives were applied. The study also intends to identify the presence of specific microorganisms, their colony concentration and their possible effects on the oral microflora. This study also aims to educate subjects by introducing an alternative denture cleaning method as well as denture and oral health care. Methodology: Edentulous subjects age 50-80 years old, both physically and medically fit, were selected to participate. Before obtaining samples for the study, the alternative cleaning method was introduced by demonstrating a step-by-step cleaning process. Samples were obtained by swabbing the intaglio surface of their upper and lower prosthesis. These swabs were placed in a thioglycollate broth, which served as a transport and enrichment medium. The swabs were then processed through bacterial culture. The colony-forming units (CFUs) were calculated on MacConkey Agar Plate (MAP) and Blood Agar Plate (BAP) in order to identify and assess the microbiological status, including species identification and microbial counting. Result: Upon evaluation and analysis of collected data, the microbiological assessment of the upper dentures with adhesives showed little to no difference compared to dentures without adhesives, but for the lower dentures, (P=0.005), which is less than α = 0.05; therefore, the researchers reject (Ho) and that there is a significant difference between the mean ranks of the lower denture without adhesive to those with, implying that there is a significant decrease in the bacterial count. Conclusion: These results findings may implicate the possibility that the addition of denture adhesives may contribute to the significant decrease of microbial colonization on the dentures.

Keywords: denture, denture adhesive, denture-related, microbiological assessment

Procedia PDF Downloads 105

Authors: Murat Durucu

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Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

Procedia PDF Downloads 259

Authors: Bawa Yusuf Muhammad, Musa Abubakar Kana, Aminatu Abdulrahman, Kerry Goetz

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Background: Inherited eye diseases are disorders that affect globally, 1 in 1000 people. The six main world populations have created databases containing information on eye genotypes. Aim: The aim of the scoping review was to mine and present the available information to date on the genetics of inherited eye diseases within the African continent. Method: Literature Search Strategy was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and Google Scholar searched for articles on inherited eye diseases from inception to 20th June 2022. Both Original and review articles that report on inherited, genetic or developmental/congenital eye diseases within the African Continent were included in the research. Results: A total of 1162 citations were obtained, but only 37 articles were reviewed based on the inclusion and exclusion criteria. The highest output of publications on inherited eye diseases comes from South Africa and Tunisia (about 43%), followed by Morocco and Egypt (27%), then Sub-Saharan Africa and North Africa (13.50%), while the remaining articles (16.5%) originated from Nigeria, Ghana, Mauritania Cameroon, Zimbabwe and combined article between Zimbabwe and Cameroon. Glaucoma and inherited retinal disorders represent the most studied diseases, followed by Albinism and congenital cataracts, respectively. Conclusion: Despite the growing research from Tunisia, Morocco, Egypt and South Africa, Sub-Saharan Africa remains almost a virgin region to explore the genetics of eye diseases.

Keywords: inherited eye diseases, Africa, scoping review, longitudinal eye study

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Authors: Jimmy Jiun-Ming Su, Yuan-Min Lin

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Bioprinting has been applied to produce 3D cellular constructs for tissue engineering. Microextrusion printing is the most common used method. However, printing low viscosity bioink is a challenge for this method. Herein, we developed a new 3D printing system to fabricate cell-laden hydrogels via a DLP-based projector. The bioprinter is assembled from affordable equipment including a stepper motor, screw, LED-based DLP projector, open source computer hardware and software. The system can use low viscosity and photo-polymerized bioink to fabricate 3D tissue mimics in a layer-by-layer manner. In this study, we used gelatin methylacrylate (GelMA) as bioink for stem cell encapsulation. In order to reinforce the printed construct, surface modified hydroxyapatite has been added in the bioink. We demonstrated the silanization of hydroxyapatite could improve the crosslinking between the interface of hydroxyapatite and GelMA. The results showed that the incorporation of silanized hydroxyapatite into the bioink had an enhancing effect on the mechanical properties of printed hydrogel, in addition, the hydrogel had low cytotoxicity and promoted the differentiation of embedded human bone marrow stem cells (hBMSCs) and retinal pigment epithelium (RPE) cells. Moreover, this bioprinting system has the ability to generate microchannels inside the engineered tissues to facilitate diffusion of nutrients. We believe this 3D bioprinting system has potential to fabricate various tissues for clinical applications and regenerative medicine in the future.

Keywords: bioprinting, cell encapsulation, digital light processing, GelMA hydrogel

Procedia PDF Downloads 149

Authors: Mohammadreza Aghasadeghi, Mojtaba Hamidi-Fard, Seyed Amir Sadeghi, Ashkan Noorbakhsh

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Introduction: HIV is known as one of the most important pathogens and mortality in all human societies, but unfortunately, no definitive cure has been found for it. Due to its weakened immune system, this virus causes a variety of primary and secondary opportunistic infections. Cytomegalovirus (CMV) is one of the most relevant opportunistic viruses seen in HIV-positive people that cause various infections in HIV-positive people. This virus causes various infections in HIV-positive people, such as retinal infection (CMVR), gastrointestinal infections, diarrhea, severe weight loss, and cerebrospinal fluid problems. These various infections make it important to evaluate the prevalence of CMV in HIV-positive people to diagnose it quickly and in a timely manner. This infection in HIV-positive people reduces life expectancy and causes serious harm to patients. However, a simple test in HIV-positive people can prevent the virus from progressing. Material and Methods: In this study, we collected 200 blood samples (including 147 men and 53 women) from HIV-positive individuals and examined the frequency of CMV-DNA in these cases by real-time PCR method. In the next step, the data was analyzed by SPSS software, and then we obtained the relationship between age, sex, and the frequency of CMV in HIV-positive individuals. Results: The total frequency of CMV DNA was about 59%, which is a relatively high prevalence due to the age range of the subjects. The frequency in men was 61.2% and 52.8% in women. This frequency was also higher in males than females. We also observed more frequency in two age groups of 16 to 30 years and 31 to 45 years. Discussion: Due to the high prevalence of CMV in HIV-positive individuals and causing serious problems in this group of people, this study was shown that both the patients and the community should pay more attention to this issue. Ministry of Health, as a stakeholder organization, can make CMV DNA testing mandatory as soon as a person is HIV positive.

Keywords: CMV, HIV, AIDS, real-time PCR, SPSS

Procedia PDF Downloads 185

Authors: Sudip Mondal, Biswanath Mondal, Sudit S. Mukhopadhyay, Apurba Dey

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Bioactive materials improve devices for a long lifespan but have mechanical limitations. Mechanical characterization is one of the very important characteristics to evaluate the life span and functionality of the scaffold material. After implantation of scaffold material the primary stage rejection of scaffold occurs due to non biocompatible effect of host body system. The second major problems occur due to the effect of mechanical failure. The mechanical and biocompatibility failure of the scaffold materials can be overcome by the prior evaluation of the scaffold materials. In this study chemically treated Labeo rohita scale is used for synthesizing hydroxyapatite (HAp) biomaterial. Thermo-gravimetric and differential thermal analysis (TG-DTA) is carried out to ensure thermal stability. The chemical composition and bond structures of wet ball-milled calcined HAp powder is characterized by Fourier Transform Infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), Energy Dispersive X-ray (EDX) analysis. Fish scale derived apatite materials consists of nano-sized particles with Ca/P ratio of 1.71. The biocompatibility through cytotoxicity evaluation and MTT assay are carried out in MG63 osteoblast cell lines. In the cell attachment study, the cells are tightly attached with HAp scaffolds developed in the laboratory. The result clearly suggests that HAp material synthesized in this study do not have any cytotoxic effect, as well as it has a natural binding affinity for mammalian cell lines. The synthesized HAp powder further successfully used to develop porous scaffold material with suitable mechanical property of ~0.8GPa compressive stress, ~1.10 GPa a hardness and ~ 30-35% porosity which is acceptable for implantation in trauma region for animal model. The histological analysis also supports the bio-affinity of processed HAp biomaterials in Wistar rat model for investigating the contact reaction and stability at the artificial or natural prosthesis interface for biomedical function. This study suggests the natural sourced fish scale-derived HAp material could be used as a suitable alternative biomaterial for tissue engineering application in near future.

Keywords: biomaterials, hydroxyapatite, scaffold, mechanical property, tissue engineering

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Authors: Christolyn Raj, Lewis Levitz

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Introduction: Two cases of late presentation ( > five years ) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentations(s): Case 1 is an 83-year-old female who has been stable on Ibrutinib (Imbruvica ®) for chronic lymphocytic leukemia (CLL). She presented with bilateral blurred vision from severe cystoid macula edema seven years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with Ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema six years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last five years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of the chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.

Keywords: macula edema, oral kinase inhibitors, retinal toxicity, pseudo-phakia

Procedia PDF Downloads 62

Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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Authors: Hilal Keklicek, Fatih Erbahceci, Elif Kirdi, Ali Yalcin, Semra Topuz, Ozlem Ulger, Gul Sener

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Objectives and Goals: The stride-to-stride fluctuations in gait is a determinant of qualified locomotion as known as gait variability. Gait variability is an important predictive factor of fall risk and useful for monitoring the effects of therapeutic interventions and rehabilitation. Comparison of gait variability in individuals with trans-tibial lower limb loss and trans femoral lower limb loss was the aim of the study. Methods: Ten individuals with traumatic unilateral trans femoral limb loss(TF), 12 individuals with traumatic transtibial lower limb loss(TT) and 12 healthy individuals(HI) were the participants of the study. All participants were evaluated with treadmill. Gait characteristics including mean step length, step length variability, ambulation index, time on each foot of participants were evaluated with treadmill. Participants were walked at their preferred speed for six minutes. Data from 4th minutes to 6th minutes were selected for statistical analyses to eliminate learning effect. Results: There were differences between the groups in intact limb step length variation, time on each foot, ambulation index and mean age (p < .05) according to the Kruskal Wallis Test. Pairwise analyses showed that there were differences between the TT and TF in residual limb variation (p=.041), time on intact foot (p=.024), time on prosthetic foot(p=.024), ambulation index(p = .003) in favor of TT group. There were differences between the TT and HI group in intact limb variation (p = .002), time on intact foot (p<.001), time on prosthetic foot (p < .001), ambulation index result (p < .001) in favor of HI group. There were differences between the TF and HI group in intact limb variation (p = .001), time on intact foot (p=.01) ambulation index result (p < .001) in favor of HI group. There was difference between the groups in mean age result from HI group were younger (p < .05).There were similarity between the groups in step lengths (p>.05) and time of prosthesis using in individuals with lower limb loss (p > .05). Conclusions: The pilot study provided basic data about gait stability in individuals with traumatic lower limb loss. Results of the study showed that to evaluate the gait differences between in different amputation level, long-range gait analyses methods may be useful to get more valuable information. On the other hand, similarity in step length may be resulted from effective prosthetic using or effective gait rehabilitation, in conclusion, all participants with lower limb loss were already trained. The differences between the TT and HI; TF and HI may be resulted from the age related features, therefore, age matched population in HI were recommended future studies. Increasing the number of participants and comparison of age-matched groups also recommended to generalize these result.

Keywords: lower limb loss, amputee, gait variability, gait analyses

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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Authors: Faris Tarlochan, Siva Mahesh Tangutooru

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Lateral Geniculate Nucleus (LGN) is the relay center in the visual pathway as it receives most of the input information from retinal ganglion cells (RGC) and sends to visual cortex. Low threshold calcium currents (IT) at the membrane are the unique indicator to characterize this firing functionality of the LGN neurons gained by the RGC input. According to the LGN functional requirements such as functional mapping of RGC to LGN, the morphologies of the LGN neurons were developed. During the neurological disorders like glaucoma, the mapping between RGC and LGN is disconnected and hence stimulating LGN electrically using deep brain electrodes can restore the functionalities of LGN. A computational model was developed for simulating the LGN neurons with three predominant morphologies, each representing different functional mapping of RGC to LGN. The firings of action potentials at LGN neuron due to IT were characterized by varying the stimulation parameters, morphological parameters and orientation. A wide range of stimulation parameters (stimulus amplitude, duration and frequency) represents the various strengths of the electrical stimulation with different morphological parameters (soma size, dendrites size and structure). The orientation (0-1800) of LGN neuron with respect to the stimulating electrode represents the angle at which the extracellular deep brain stimulation towards LGN neuron is performed. A reduced dendrite structure was used in the model using Bush–Sejnowski algorithm to decrease the computational time while conserving its input resistance and total surface area. The major finding is that an input potential of 0.4 V is required to produce the action potential in the LGN neuron which is placed at 100 µm distance from the electrode. From this study, it can be concluded that the neuroprostheses under design would need to consider the capability of inducing at least 0.4V to produce action potentials in LGN.

Keywords: Lateral Geniculate Nucleus, visual cortex, finite element, glaucoma, neuroprostheses

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Authors: Hadeel Seraj, Mohammed Khoshhal, Mustafa Alhamoud, Hassan Alhashim, Anas Alsaif, Amro Abukhashabah

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Central serous chorioretinopathy (CSCR) is an idiopathic retinal disease characterized by localized serous detachment of the neurosensory retina at the macula. To date, there is no high-quality evidence of recent updates on treating acute CSCR, focusing on photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF). Hence, this review aims to systematically review the latest treatment strategies for acute CSCR. Methodology: The following electronic databases were used for a comprehensive and systematic literature review: MEDLINE, EMBASE, and Cochrane. In addition, we analyzed studies comparing PDT with placebo, anti-VEGF with placebo, or PDT with anti-VEGF in treating acute CSC eyes with no previous intervention. Results: Seven studies were included, with a total of 292 eyes. The overall positive results were significantly higher among patients who received PDT compared to control groups (OR = 7.96, 95% CI, 3.02 to 20.95, p < 0.001). The proportions of positive results were 81.0% and 97.1% among patients who received anti-VEGF and PDT, respectively, with no statistically significant differences between the groups. In addition, there were no significant differences between anti-VEGF and control groups. In contrast, PDT was significantly associated with lower recurrence odds than the control groups (OR = 0.12, 95% CI, 0.04 to 0.39, p = 0.042). Conclusion: According to our findings, PDT showed higher positive results than Anti-VEGF in acute CSCR. In addition, PDT was significantly associated with a lower recurrence rate than the control group. However, the analysis needs to be confirmed and updated by large-scale, well-designed RCTs.

Keywords: central serous chorioretinopathy, Acute CSCR, photodynamic therapy, anti-vascular endothelial growth factor

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Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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Authors: Ashish Thakur

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This technical paper was written in view of focusing the biomaterials and its various applications in modern industries. Author tires to elaborate not only the medical, infect plenty of application in other industries. The scope of the research area covers the wide range of physical, biological and chemical sciences that underpin the design of biomaterials and the clinical disciplines in which they are used. A biomaterial is now defined as a substance that has been engineered to take a form which, alone or as part of a complex system, is used to direct, by control of interactions with components of living systems, the course of any therapeutic or diagnostic procedure. Biomaterials are invariably in contact with living tissues. Thus, interactions between the surface of a synthetic material and biological environment must be well understood. This paper reviews the benefits and challenges associated with surface modification of the metals in biomedical applications. The paper also elaborates how the surface characteristics of metallic biomaterials, such as surface chemistry, topography, surface charge, and wettability, influence the protein adsorption and subsequent cell behavior in terms of adhesion, proliferation, and differentiation at the biomaterial–tissue interface. The chapter also highlights various techniques required for surface modification and coating of metallic biomaterials, including physicochemical and biochemical surface treatments and calcium phosphate and oxide coatings. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. In addition to this, chapter introduces nanomedicine and the use of both natural and synthetic polymeric biomaterials, focuses on specific current polymeric nanomedicine applications and research, and concludes with the challenges of nanomedicine research. Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. Polymeric nanomaterial-based therapeutics plays a key role in the field of medicine in treatment areas such as drug delivery, tissue engineering, cancer, diabetes, and neurodegenerative diseases. Advantages in the use of polymers over other materials for nanomedicine include increased functionality, design flexibility, improved processability, and, in some cases, biocompatibility.

Keywords: nanomedicine, tissue, infections, biomaterials

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Authors: R. Pardo, P. Menendez, MA Gil-Olarte, S. Sanchez, E. García, R. Quintana, J. Martín

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Introduction : Within oncoplastic breast techniques there is increased interest in immediate partial breast reconstruction. The volume resected is greater than that of conventional conservative techniques. Central tumours of the breast have classically been treated with a mastectomy with regard to oncological safety and cosmetic secondary effects after wide central resection of the nipple and breast tissue beneath. Oncological results for central quadrantectomy have a recurrence level, disease- free period and survival identical to mastectomy. Grissoti flap is an oncoplastic surgical technique that allows the surgeon to perform a safe central quadrantectomy with excellent cosmetic results. Material and methods: The Grissoti flap is a glandular cutaneous advancement rotation flap that can fill the defect in the central portion of the excised breast. If the inferior border is affected by tumour and further surgery is decided upon at the Multidisciplinary Team Meeting, it will be necessary to perform a mastectomy. All patients with a Grisotti flap undergoing surgery since 2009 were reviewed obtaining the following data: age, hystopathological diagnosis, size, operating time, volume of tissue resected, postoperative admission time, re-excisions due to positive margins affected by tumour, wound dehiscence, complications and recurrence. Analysis and results of sentinel node biopsy were also obtained. Results: 12 patients underwent surgery between 2009-2015. The mean age was 54 years (34-67) . All had a preoperative diagnosis of ductal infiltrative carcinoma of less than 2 cm,. Diagnosis was made with Ultrasound, Mamography or both . Magnetic resonance was used in 5 cases. No patients had preoperative positive axilla after ultrasound exploration. Mean operating time was 104 minutes (84-130). Postoperative stay was 24 hours. Mean volume resected was 159 cc (70-286). In one patient the surgical border was affected by tumour and a further procedure with resection of the affected border was performed as ambulatory surgery. The sentinel node biopsy was positive for micrometastasis in only two cases. In one case lymphadenectomy was performed in 2009. In the other, treated in 2015, no lymphadenectomy was performed as the patient had a favourable histopathological prognosis and the multidisciplinary team meeting agreed that lymphadenectomy was not required. No recurrence has been diagnosed in any of the patients who underwent surgery and they are all disease free at present. Conclusions: Conservative surgery for retroareolar central tumours of the breast results in good local control of the disease with free surgical borders, including resection of the nipple areola complex and pectoral major muscle fascia. Reconstructive surgery with the inferior Grissoti flap adequately fills the defect after central quadrantectomy with creation of a new cutaneous disc where a new nipple areola complex is reconstructed with a local flap or micropigmentation. This avoids the need for contralateral symmetrization. Sentinel Node biopsy can be performed without added morbidity. When feasible, the Grissoti flap will avoid skin-sparing mastectomy for central breast tumours that will require the use of an expander, prosthesis or myocutaneous flap, with all the complications of a more complex operation.

Keywords: Grisotti flap, oncoplastic surgery, central tumours, breast

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Authors: Md. Khayrul Bashar, Md. Saiful Islam, Kimiko Yamashita, Yano Midori

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Despite having some progress in human authentication, conventional biometrics (e.g., facial features, fingerprints, retinal scans, gait, voice patterns) are not robust against falsification because they are neither confidential nor secret to an individual. As a non-invasive tool, electrocardiogram (ECG) has recently shown a great potential in human recognition due to its unique rhythms characterizing the variability of human heart structures (chest geometry, sizes, and positions). Moreover, ECG has a real-time vitality characteristic that signifies the live signs, which ensure legitimate individual to be identified. However, the detection accuracy of the current ECG-based methods is not sufficient due to a high variability of the individual’s heartbeats at a different instance of time. These variations may occur due to muscle flexure, the change of mental or emotional states, and the change of sensor positions or long-term baseline shift during the recording of ECG signal. In this study, a new method is proposed for human identification, which is based on the extraction of the local roughness of ECG heartbeat signals. First ECG signal is preprocessed using a second order band-pass Butterworth filter having cut-off frequencies of 0.00025 and 0.04. A number of local binary patterns are then extracted by applying a moving neighborhood window along the ECG signal. At each instant of the ECG signal, the pattern is formed by comparing the ECG intensities at neighboring time points with the central intensity in the moving window. Then, binary weights are multiplied with the pattern to come up with the local roughness description of the signal. Finally, histograms are constructed that describe the heartbeat signals of individual subjects in the database. One advantage of the proposed feature is that it does not depend on the accuracy of detecting QRS complex, unlike the conventional methods. Supervised recognition methods are then designed using minimum distance to mean and Bayesian classifiers to identify authentic human subjects. An experiment with sixty (60) ECG signals from sixty adult subjects from National Metrology Institute of Germany (NMIG) - PTB database, showed that the proposed new method is promising compared to a conventional interval and amplitude feature-based method.

Keywords: human identification, ECG biometrics, local roughness patterns, supervised classification

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Authors: Yuanyuan Zhang, Yujuan Zheng, Giuseppina Barutello, Sumako Kameishi, Kungchun Chiu, Katharina Hennig, Martial Balland, Federica Cavallo, Lars Holmgren

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Angiogenesis describes that new blood vessels migrate from pre-existing ones to form 3D lumenized structure and remodeling. During directional migration toward the gradient of pro-angiogenic factors, the endothelial cells, especially the tip cells need filopodia to sense the environment and exert the pulling force. Of particular interest are the integrin proteins, which play an essential role in focal adhesion in the connection between migrating cells and extracellular matrix (ECM). Understanding how these biomechanical complexes orchestrate intrinsic and extrinsic forces is important for our understanding of the underlying mechanisms driving angiogenesis. We have previously identified Angiomotin (Amot), a member of Amot scaffold protein family, as a promoter for endothelial cell migration in vitro and zebrafish models. Hence, we established inducible endothelial-specific Amot knock-out mice to study normal retinal angiogenesis as well as tumor angiogenesis. We found that the migration ratio of the blood vessel network to the edge was significantly decreased in Amotec- retinas at postnatal day 6 (P6). While almost all the Amot defect tip cells lost migration advantages at P7. In consistence with the dramatic morphology defect of tip cells, there was a non-autonomous defect in astrocytes, as well as the disorganized fibronectin expression pattern correspondingly in migration front. Furthermore, the growth of transplanted LLC tumor was inhibited in Amot knockout mice due to fewer vasculature involved. By using MMTV-PyMT transgenic mouse model, there was a significantly longer period before tumors arised when Amot was specifically knocked out in blood vessels. In vitro evidence showed that Amot binded to beta-actin, Integrin beta 1 (ITGB1), Fibronectin, FAK, Vinculin, major focal adhesion molecules, and ITGB1 and stress fibers were distinctly induced by Amot transfection. Via traction force microscopy, the total energy (force indicater) was found significantly decreased in Amot knockdown cells. Taken together, we propose that Amot is a novel partner of the ITGB1/Fibronectin protein complex at focal adhesion and required for exerting force transition between endothelial cell and extracellular matrix.

Keywords: angiogenesis, angiomotin, endothelial cell migration, focal adhesion, integrin beta 1

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Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

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The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

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