- Pulmonary Delivery of Nanocomposite Microparticles (NCMPs) incorporating miR-146a for Treatment of COPD. [Journal Article]
- IJInt J Pharm 2019 Jul 15; :118524
- The treatment and management of COPD by inhalation to the lungs has emerged as an attractive alternative route to oral dosing due to higher concentrations of the drug being administered to site of ac…
The treatment and management of COPD by inhalation to the lungs has emerged as an attractive alternative route to oral dosing due to higher concentrations of the drug being administered to site of action. In this study, Nanocomposite Microparticles (NCMPs) of microRNA (miR-146a) containing PGA-co-PDL nanoparticles (NPs) for dry powder inhalation were formulated using L-leucine and mannitol. The spray-drying (Buchi B290) process was optimised and used to incorporate NPs into NCMPs using mix of L-leucine and mannitol excipients in different ratios (F1; 100:0 % w/w, F2; 75:25 % w/w, F3; 50:50 % w/w, F4; 25:75 % w/w, F5; 0:100 % w/w) to investigate yield %, moisture content, aerosolisation performance and miR-146a biological activity. The optimum condition was performed at feed rate 0.5 mL/min, aspirator rate 28 m3/h, atomizing air flow rate 480 L/h, and inlet drying temperature 70 °C which produced highest yield percentage and closest recovered NPs size to original prior spray-drying. The optimum formulation (F4) had a high yield (86.0±15.01 %), recovered NPs size after spray-drying 409.7±10.05 nm (initial NPs size 244.8±4.40 nm) and low moisture content (2.02±0.03 %). The aerosolisation performance showed high Fine Particle Fraction (FPF) 51.33±2.9 %, Emitted Dose (ED) of 81.81±3.0 %, and the mass median aerodynamic diameter (MMAD) was ≤ 5 µm suggesting a deposition in the respirable region of the lungs. The biological activity of miR-146a was preserved after spray-drying process and miR-146a loaded NCMPs produced target genes IRAK1 and TRAF6 silencing. These results indicate the optimal process parameters for the preparation of NCMPs of miR-146a-containing PGA-co-PDL NPs suitable for inhalation in the treatment and management of COPD.
- Diagnosing Kikuchi's Disease on fine needle aspiration biopsy. [Journal Article]
- CCytopathology 2019 Jul 14
- CONCLUSIONS: In summary, FNA biopsy is a fast, reliable, and relatively inexpensive diagnosis tool for KD. CB preparation is an important adjunct method for the diagnosis of KD.
- Bone Grafting in Total Wrist Arthrodesis With Large Bone Defects Using the Reamer-Irrigator-Aspirator: A Case Study of 2 Patients. [Journal Article]
- JHJ Hand Surg Am 2019; 44(7):620.e1-620.e7
- Total wrist arthrodesis, fusion of the carpus to the radius, is a well-established and commonly performed procedure for the management of pancarpal degenerative arthritis, trauma, and other severe di…
Total wrist arthrodesis, fusion of the carpus to the radius, is a well-established and commonly performed procedure for the management of pancarpal degenerative arthritis, trauma, and other severe diseases of the wrist. A well-known complication of this is radiocarpal nonunion, with a rate of 4.4%. Commonly, bone grafting is done at the time of the surgery using local bone, iliac crest bone graft, or cancellous allograft bone. The Synthes Reamer-Irrigator-Aspirator (RIA) is a flexible reamer originally designed as a single-pass intramedullary reamer that can be used in reaming of long bone fractures prior to insertion of an intramedullary nail. Recently, its use has been expanding to the harvesting of bone graft. We present a case study of 2 patients who had total wrist arthrodesis after severe trauma to the wrist resulting in severe bone loss, in whom we used an RIA to obtain bone graft, and both patients went on to union. The first patient is a 17-year-old male who sustained a blast injury from a firework resulting in a mangling injury to the wrist with soft tissue and severe bone loss of his carpus. After being treated with multiple debridements with an external fixator, he was definitively treated with a wrist fusion with RIA bone graft. He went on to osseous union by his 4-month follow-up. Our second patient is a 53-year-old woman who sustained a gunshot wound to the wrist resulting in massive bone loss of the distal radius. After being initially treated with multiple debridements and external fixation, she was treated with a wrist fusion with RIA bone graft and went on to osseous fusion by her 3-month follow-up. Neither patient had complications from the RIA procedure.
- Endarterectomy Using the Lateral Approach with an Ultrasonic Surgical Aspirator Device for Heavily Calcified Peripheral Arterial Occlusive Disease. [Journal Article]
- AVAnn Vasc Dis 2019 Jun 25; 12(2):216-221
- CONCLUSIONS: We address the technical difficulty in treating highly calcified lesions that could not be dealt with conventional endarterectomy. Our new method is one of the options for revascularization of heavily calcified lesions.
- Cerebellar mutism syndrome: current approaches to minimize risk for CMS. [Journal Article]
- CNChilds Nerv Syst 2019 Jul 05
- CONCLUSIONS: In an effort to reduce the incidence and severity of CMS in our population, our institution adopted surgical practices that minimize tissue trauma and mitigate postoperative edema. This included the use of a telovelar over a transvermian approach to obviate the need for vermian incision, avoidance of the CUSA, and minimization of heavy retraction during surgery. This was successful in reducing the incidence of CMS from 39% in our medulloblastoma patients to 10.8%. The development of CMS after posterior fossa surgery appears to be a "two-hit" phenomenon requiring a combination of existing predisposition, surgical injury, and postoperative exacerbation. Therefore, it is critical to identify the factors involved at each stage and investigate treatments to target them appropriately.
- Endoscopic Inside-Out Mastoidectomy with the Ultrasonic Bone Aspirator. [Journal Article]
- OOOTO Open 2019 Jan-Mar; 3(1):2473974X18821923
- We report our experience using the ultrasonic bone aspirator (UBA) for transcanal endoscopic "inside out" mastoidectomy. The UBA has irrigation, suction, and nonrotatory ultrasonic bone-removing tech…
We report our experience using the ultrasonic bone aspirator (UBA) for transcanal endoscopic "inside out" mastoidectomy. The UBA has irrigation, suction, and nonrotatory ultrasonic bone-removing technology in 1 handpiece, which makes it appropriate for bone removal during this procedure. The results of our study show that this technique is safe and effective for patients with cholesteatoma in a small sclerotic mastoid. We also discuss the nuances associated with using the UBA during endoscopic ear surgery.
- Suction dissector device for sinus membrane elevation. [Journal Article]
- IJInt J Oral Maxillofac Surg 2019 Jun 20
- The maxillary sinus floor augmentation technique requires lifting of the sinus membrane with a series of curved elevators. Lifting of the sinus membrane can be difficult due to the presence of bleedi…
The maxillary sinus floor augmentation technique requires lifting of the sinus membrane with a series of curved elevators. Lifting of the sinus membrane can be difficult due to the presence of bleeding, requiring the alternate use of curved elevators and the aspirator. This technical note presents a new surgical device, a suction dissector specifically designed for sinus membrane elevation. The suction dissector has a curvature similar to that of the curved dissector commonly used for lifting of the sinus membrane and contains an internal channel that allows the aspiration of liquid.
- Experience and outcomes in living donor liver procurement using the water jet scalpel. [Journal Article]
- JHJ Hepatobiliary Pancreat Sci 2019 Jun 18
- CONCLUSIONS: Living donor liver procurement using WJS contributes to shortening of parenchymal transection time while maintaining the same level of safety as when using CUSA.
- Ultrasonic annular debridement in minimally invasive aortic valve replacement. [Journal Article]
- GTGen Thorac Cardiovasc Surg 2019 Jun 15
- Here, we demonstrate the details of annular decalcification using an ultrasonic aspirator in minimally invasive aortic valve replacement for aortic stenosis. In our debridement procedure, the aortic …
Here, we demonstrate the details of annular decalcification using an ultrasonic aspirator in minimally invasive aortic valve replacement for aortic stenosis. In our debridement procedure, the aortic valve leaflets are excised with enough valve tissue left, not just at the annulus. The invisible annulus is exposed by traction of the remnant valve tissue, and the annular calcifications are scraped off using an ultrasonic aspirator. After an annular decalcification, the remnant valve tissue was completely resected using long scissors. No cases of in-hospital mortality, annular injury, stroke, or paravalvular leakage were found. In conclusion, ultrasonic aspirator allowed safe and secure annular debridement and could be a useful tool during minimally invasive aortic valve replacement.
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- Retrosigmoid Transtentorial Resection of a Petroclival Meningioma: 2-Dimensional Operative Video. [Journal Article]
- ONOper Neurosurg (Hagerstown) 2019 Jun 04
- In this video, we aimed to demonstrate retrosigmoid-transtentorial resection of a 4.5 × 4 × 4.5 cm3 left-sided petroclival meningioma compressing the brainstem in a 62-yr-old male who presented with …
In this video, we aimed to demonstrate retrosigmoid-transtentorial resection of a 4.5 × 4 × 4.5 cm3 left-sided petroclival meningioma compressing the brainstem in a 62-yr-old male who presented with decreased hearing on the left and imbalance. The patient was placed in park-bench position and a left-sided suboccipital craniotomy was performed. The mass was severely compressing the brainstem as well as the cranial nerves V, VI, VII, and VIII while IV was encased by the tumor. The circumferential dissection of the tumor was facilitated while the surgical corridor and exposure were enlarged by incising the tentorium. Uneventfully, the meningioma was resected in piecemeal fashion as it was not coming out easily with the ultrasonic aspirator. All relevant cranial nerves and adjacent vascular structures were protected. Early postoperative CT scan demonstrated changes due to the surgery and resolution of the compression on the brainstem. The patient made excellent recovery and he was discharged home on postoperative day 4 safely. Petroclival meningiomas are one of the most challenging tumors for neurosurgeons due to their close proximity to the vascular structures, cranial nerves as well as the brainstem. The retrosigmoid approach provides a direct route during microsurgical resection of these tumors. By incising the tentorium, the corridor can be widened while addressing the supratentorial portion of the tumor with relative ease.