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The Japanese Dental Science Review Aug 2018Maxillofacial osteosynthetic surgeries require stable fixation for uneventful boney healing and optimal remodeling. Although conventional titanium plates and screws for... (Review)
Review
Maxillofacial osteosynthetic surgeries require stable fixation for uneventful boney healing and optimal remodeling. Although conventional titanium plates and screws for osteofixation are considered the gold standard for rigid fixation in maxillofacial surgeries, bioresorbable implants of plates and screw systems are commonly used for various maxillofacial osteosynthetic surgeries such as orthognathic surgery, maxillofacial fractures, and reconstructive surgery. Titanium plates are limited by their palpability, mutagenic effects, and interference with imaging, which may lead to the need for subsequent removal; the use of a biologically resorbable osteofixation system could potentially address these limitations. However, several problems remain including fundamental issues involving decreased mechanical strength and stability, slow biodegradation, complex procedures, and the available bioresorbable implant materials. Major advances in bioresorbable plate systems have been made with the use of bioactive/resorbable osteoconductive materials and an accelerator of bioresorption, such as polyglycolic acid. This report presents an overview of currently available resorbable implant materials and their applications, with a focus on recent innovative advances and new developments in this field.
PubMed: 30128060
DOI: 10.1016/j.jdsr.2018.03.003 -
The Hastings Center Report Sep 2019Dan Callahan never tired of probing the fundamental ethical question that Socrates asked, "How should we live?" The investigation animated him. He asked, Can we, for a...
Dan Callahan never tired of probing the fundamental ethical question that Socrates asked, "How should we live?" The investigation animated him. He asked, Can we, for a moment, set aside our preoccupation with better health and a longer life and think together about what we want those things for ? Can we explore what a good life consists in? It turned out there was no better alibi for asking that fundamental question than taking up the seemingly more manageable ones that were arising in the context of emerging medicine, science, and technology. When one asked about who should be born, or how we should die, or how we should prioritize investments in the myriad institutions that help to promote human well-being, the question concerning what we mean by a good life was always and palpably present.
Topics: Attitude to Health; Delivery of Health Care; Ethical Theory; Humans; Life Style; Personality; Quality of Life; Sense of Coherence
PubMed: 31581333
DOI: 10.1002/hast.1044 -
The Journal of the American College of... Apr 2009Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage.... (Review)
Review
Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings.
PubMed: 24527114
DOI: 10.1016/j.jcws.2009.01.002 -
Clinics in Plastic Surgery Oct 2015Patients presenting for correction of breast and chest wall asymmetries may have undergone numerous thoracic procedures in early childhood and may have suffered profound... (Review)
Review
Patients presenting for correction of breast and chest wall asymmetries may have undergone numerous thoracic procedures in early childhood and may have suffered profound psychosocial effects. Complex congenital syndromes as well as mild breast asymmetries should be carefully documented using objective measurements, photography, and 3-dimensional simulations when available. Shaped highly cohesive breast implants offer plastic surgeons more possibilities and precision by fine-tuning the gel distribution and specific volumes required to correct the hypoplastic elements. Long-lasting correction of asymmetry can be obtained when patients are not oversized, and care is taken to avoid visibility, palpability, and malposition problems.
Topics: Breast; Breast Diseases; Breast Implantation; Breast Implants; Female; Humans; Mammaplasty; Musculoskeletal Abnormalities; Thoracic Wall
PubMed: 26408441
DOI: 10.1016/j.cps.2015.06.009 -
American Journal of Surgery May 2003Each year thousands of women present to general surgeons with palpable breast masses, some of which are clinically ambiguous and the majority of which are benign. In...
BACKGROUND
Each year thousands of women present to general surgeons with palpable breast masses, some of which are clinically ambiguous and the majority of which are benign. In addition, surgeons are frequently faced with the question of whether to biopsy those palpable abnormalities in the setting of normal radiographic studies. One might propose that such lesions could be safely observed rather than immediately biopsied. If these lesions were not biopsied, how many cancers would escape detection? To address this issue, a population of patients with known, palpable breast cancer was retrospectively examined to determine the frequency of normal or benign findings on both mammography and ultrasonography.
METHODS
Between January 1998 and December 2001, 351 women with breast carcinoma presented initially with palpable tumors. The medical records of these remaining 351 cases were retrospectively reviewed to examine the radiographic characteristics of the palpable carcinomas.
RESULTS
Of the 351 cases in the study group, 13 (3.7%) patients with palpable breast cancers had mammogram and sonogram examinations that were both normal, benign, or nonspecific in appearance.
CONCLUSIONS
The results of this study indicate that nearly 4% of women with breast cancer who present with palpable lumps will have normal or benign findings on both mammography and ultrasonography. These data support prior studies of similar false negative rates and may provide some reassurance to surgeons and patients regarding clinical breast lumps, as the decision of whether to biopsy still rests in the surgeon's hands. However, inappropriate reliance on these tests for an evaluation of a palpable abnormality will result in a number of missed tumors.
Topics: Biopsy; Breast Neoplasms; False Negative Reactions; Female; Humans; Mammography; Palpation; Predictive Value of Tests; Retrospective Studies; Ultrasonography, Mammary
PubMed: 12727559
DOI: 10.1016/s0002-9610(03)00042-4 -
Ultrasound in Medicine & Biology Oct 2017We examined the feasibility of ultrasound diagnosis of insulin-derived localized amyloidosis (IDLA). In addition to ultrasound detectability and findings, the insulin...
We examined the feasibility of ultrasound diagnosis of insulin-derived localized amyloidosis (IDLA). In addition to ultrasound detectability and findings, the insulin absorption rate, insulin dosage and hemoglobin A1c (HbA1c) levels before and after shifting the insulin injection site were investigated for 22 cases of IDLA. The detectability of IDLA on ultrasound was 100%; 59.1% was palpable lumps and 40.9% was not palpable. The palpable type had lower echo intensity and were harder than the non-palpable type. Blood flow decreased in IDLA, especially in the palpable type. IDLA, especially the palpable type, had a low insulin absorption rate. HbA1c level and insulin dosage decreased after shifting the injection site. The palpable type had more insulin reduction than the non-palpable type. Characteristic ultrasound images of IDLA were acquired. As the non-palpable type could be identified by ultrasound, its diagnosis encourages changing the insulin injection site; hence, ultrasound diagnosis of IDLA can enhance insulin treatment.
Topics: Amyloidosis; Blood Glucose; Diabetes Mellitus; Feasibility Studies; Glycated Hemoglobin; Humans; Insulin; Prospective Studies; Retrospective Studies; Subcutaneous Tissue; Ultrasonography
PubMed: 28754497
DOI: 10.1016/j.ultrasmedbio.2017.06.011 -
BJU International Jan 2004To compare the clinical and morphological features of impalpable and palpable cryptorchid testes, as there is debate about how much effort is appropriate to bring an... (Comparative Study)
Comparative Study
OBJECTIVE
To compare the clinical and morphological features of impalpable and palpable cryptorchid testes, as there is debate about how much effort is appropriate to bring an impalpable undescended testicle into the scrotum.
PATIENTS AND METHODS
We reviewed retrospectively 189 cases of undescended testicles in 168 patients who were explored surgically by one surgeon between August 1997 and September 2000. Operative findings of palpability, testicular size and location were collected. The mean tubular diameter (MTD), tubular fertility index (TFI) and mean number of germ cells per tubule (MGCT) were calculated using immunohistochemistry for CD-99, a Sertoli-cell marker, to classify germ cells more accurately.
RESULTS
Sixty-three testes (33%) were impalpable; the median age at the time of surgical exploration was 23 months for both groups. The mean (sd) testicular volume for the impalpable and palpable groups were 0.83 (0.38) and 1.22 (0.54) mL, respectively. Using fitted curves of size vs age, impalpable testes were smaller than palpable testes at all ages, with the difference nearly statistically significant (P < 0.06). The MTD, TFI and MGCT decreased with age in both groups, with no statistically significant differences between the groups. A sub-analysis of abdominal and extra-abdominal testes confirmed no significant differences.
CONCLUSION
Impalpable testes are smaller at the time of exploration than palpable cryptorchid testes. However, histological factors predict that impalpable testes have a significant chance of future fertility and therefore orchidopexy is appropriate. CD-99 immunohistochemistry makes objective morphological information easier to obtain.
Topics: 12E7 Antigen; Antigens, CD; Biopsy; Cell Adhesion Molecules; Child; Child, Preschool; Cryptorchidism; Humans; Immunohistochemistry; Infant; Male; Palpation; Retrospective Studies; Testis
PubMed: 14678384
DOI: 10.1111/j.1464-410x.2004.04571.x -
ACS Synthetic Biology Jan 2024CRISPR-Cas9 and Cre recombinase, two tools extensively used for genome interrogation, have catalyzed key breakthroughs in our understanding of complex biological... (Review)
Review
CRISPR-Cas9 and Cre recombinase, two tools extensively used for genome interrogation, have catalyzed key breakthroughs in our understanding of complex biological processes and diseases. However, the immense complexity of biological systems and off-target effects hinder clinical applications, necessitating the development of platforms to control gene editing over spatial and temporal dimensions. Among the strategies developed for inducible control, light is particularly attractive as it is noninvasive and affords high spatiotemporal resolution. The principles for optical control of Cas9 and Cre recombinase are broadly similar and involve photocaged enzymes and small molecules, engineered split- and single-chain constructs, light-induced expression, and delivery by light-responsive nanocarriers. Few systems enable spatiotemporal control with a high dynamic range without loss of wild-type editing efficiencies. Such systems posit the promise of light-activatable systems in the clinic. While the prospect of clinical applications is palpably exciting, optimization and extensive preclinical validation are warranted. Judicious integration of optically activated CRISPR and Cre, tailored for the desired application, may help to bridge the "bench-to-bedside" gap in therapeutic gene editing.
Topics: Gene Editing; CRISPR-Cas Systems; Integrases
PubMed: 38134336
DOI: 10.1021/acssynbio.3c00596 -
Advances in Dermatology 1994Diseases associated with purpura range from the most common and trivial of human afflictions to some of the most devastating and rapidly fatal syndromes known. In order... (Review)
Review
Diseases associated with purpura range from the most common and trivial of human afflictions to some of the most devastating and rapidly fatal syndromes known. In order to sort the simple from the sinister, it is necessary to use not only the history and general physical examination, but also various morphologic components of the purpuric lesions themselves to suggest likely pathophysiologies of hemorrhage. Findings such as erythema, livedo reticularis, size of hemorrhage, presence or absence of palpability, symmetry or retiform patterning of lesions, and presence and extent of necrosis or eschar formation all can serve as clues to the likely etiologies of hemorrhage. Effective communication about purpuric syndromes requires information regarding the likely age of lesions described clinically or histologically and a precise description of the individual elements of the lesion. Such communication would be enhanced by eliminating the ambiguity inherent in the current usage of many of the terms employed to describe such lesions. This paper presents one possible approach to better use of the information that the morphology of purpuric lesions can provide.
Topics: Diagnosis, Differential; Erythema; Hemorrhage; Humans; Purpura; Vasculitis
PubMed: 8060741
DOI: No ID Found -
CytoJournal 2016In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing... (Review)
Review
In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist.
PubMed: 27651820
DOI: 10.4103/1742-6413.189637