Metabolite Variations in the Hippocampus and Corpus Callosum of Patients with Mild Cognitive Impairment Using Magnetic Resonance Spectroscopy with Three-Dimensional Chemical Shift Images.

This study compared the metabolites in the brain regions of hippocampus and corpus callosum between patients with mild cognitive impairment (MCI) and healthy controls using no-radiation and high-sensitivity magnetic resonance spectroscopy (MRS) with three-dimensional chemical shift images (3D-CSI). Twenty volunteers (seven patients with MCI and 13 healthy controls) aged 50-71 years were recruited for this prospective study. MRS with 3D-CSI images of a variety of metabolites was collected from the hippocampus and corpus callosum.

Anesthetics and human epidermal growth factor incorporated into anti-adhesive nanofibers provide sustained pain relief and promote healing of surgical wounds.

This study exploited sheath-core-structured lidocaine/human EGF (hEGF)-loaded anti-adhesive poly[(d,l)-lactide-co-glycolide] (PLGA) nanofibrous films for surgical wounds via a co-axial electrospinning technique. After spinning, the properties of the co-axially spun membranes were characterized by scanning electron microscopy, laser-scanning confocal microscopy, Fourier Transform Infrared spectrometry, water contact angle measurements, and tensile tests. Furthermore, a HPLC analysis and an ELISA evaluated the in vitro and in vivo release curves of lidocaine and hEGF from the films.

Trend and survival outcome in Taiwan cervical cancer patients: A population-based study.

Cervical cancer is one of the most common cancers in Taiwan. The aim of this study was to estimate the incidence of cervical cancer in Taiwan, the relationship between cervical cancer and previous co-morbidities, and the long-term trend of cervical cancer mortality differences in the rest of the world.This study was based on the data of cervical cancer in the National Health Insurance Research Database from 1997 to 2013, and estimated the annual prevalence and incidence of cervical cancer.

Targeted concurrent and sequential delivery of chemotherapeutic and antiangiogenic agents to the brain by using drug-loaded nanofibrous membranes.

Glioblastoma is the most frequent and devastating primary brain tumor. Surgery followed by radiotherapy with concomitant and adjuvant chemotherapy is the standard of care for patients with glioblastoma. Chemotherapy is ineffective, because of the low therapeutic levels of pharmaceuticals in tumor tissues and the well-known tumor-cell resistance to chemotherapy.

Advanced interstitial chemotherapy for treating malignant glioma.

Glioblastoma multiforme (GBM) is the most prevalent primary neoplasm of the brain. Moreover, the prognosis of patients with GBM has been poor, with almost uniform progressive neurological impairment and rapid death. Despite the availability of multimodal treatments through surgery, focal radiation, and chemotherapy, no major progress has been reported until recently.

Sustained relief of pain from osteosynthesis surgery of rib fracture by using biodegradable lidocaine-eluting nanofibrous membranes.

Various effective methods are available for perioperative pain control in osteosynthesis surgery, but they are seldom applied intraoperatively. The aim of this study was to evaluate a biodegradable poly([d,l]-lactide-co-glycolide) (PLGA)/lidocaine nanofibrous membrane for perioperative pain control in rib fracture surgery. Scanning electron microscopy showed high porosity of the membrane, and an ex vivo high-performance liquid chromatography study revealed an excellent release profile for both burst and controlled release of lidocaine within 30days.

The Effects of Volume-Controlled and Pressure-Controlled Ventilation on Lung Mechanics, Oxidative Stress, and Recovery in Gynecologic Laparoscopic Surgery.

Study Objective: To compare ventilation variables, changes in oxidative stress, and the quality of recovery in 2 different ventilation strategies (volume-controlled ventilation [VCV] and pressure-controlled ventilation [PCV]) during gynecologic laparoscopic surgery.

Design: A prospective randomized controlled trial (Canadian Task Force classification I).

Setting: One university teaching hospital in Taiwan.

A comparison of parecoxib and thoracic epidural analgesia for postoperative analgesia following Nuss procedure.

Background: The purpose of this study was to compare the results of thoracic epidural analgesia (TEA) and parecoxib in controlling postoperative pain after the Nuss procedure.

Methods: Between August 2005 and July 2014, 120 adolescents and adults underwent Nuss procedures and received either TEA or parecoxib for postoperative pain control. Demographic data, preoperative preparation times, visual analog scale (VAS) pain scores from postoperative day 1 to day 5, medical costs of pain control, days to Foley catheter removal, days to being able to sit up, days to being able to walk, days of hospital stay, nausea/vomiting scores, and complications related to pain control were compared.

Concurrent delivery of carmustine, irinotecan, and cisplatin to the cerebral cavity using biodegradable nanofibers: In vitro and in vivo studies.

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor, and the prognosis of patients afflicted with GBM has been dismal, exhibiting progressive neurologic impairment and imminent death. Even with the most active regimens currently available, chemotherapy achieves only modest improvement in the overall survival. New chemotherapeutic agents and novel approaches to therapy are required for improving clinical outcomes.

Sustained Release of Lidocaine from Solvent-Free Biodegradable Poly[(d,l)-Lactide-co-Glycolide] (PLGA): and Study.

Local anesthetics are commonly used for pain relief by regional nerve blocking. In this study, we fabricated solvent-free biodegradable pellets to extend the duration of lidocaine release without any significant local or systemic toxicity levels. To manufacture the pellets, poly[(d,l)-lactide-co-glycolide] (PLGA) was first pre-mixed with lidocaine powder into different ratios.

Adsorption of silver ions on polypyrrole embedded electrospun nanofibrous polyethersulfone membranes.

In this study we developed polypyrrole embedded electrospun nanofibrous polyethersulfone nanofibrous membranes for the removal of silver ions. Polypyrrole and polyethersulfone dissolved in N-methyl-2-pyrrolidone (NMP) were electrospun into nanofibrous membranes via an electrospinning process. The morphology of as-spun polypyrrole/polyethersulfone nanofibers was examined by scanning electron microscopy.

Fabrication of balloon-expandable self-lock drug-eluting polycaprolactone stents using micro-injection molding and spray coating techniques.

The purpose of this report was to develop novel balloon-expandable self-lock drug-eluting poly(ε-caprolactone) stents. To fabricate the biodegradable stents, polycaprolactone (PCL) components were first fabricated by a lab-scale micro-injection molded machine. They were then assembled and hot-spot welded into mesh-like stents of 3 and 5 mm in diameters.

Solvent-free biodegradable scleral plugs providing sustained release of vancomycin, amikacin, and dexamethasone--an in vivo study.

Delivering effective drugs at sufficiently high concentrations to the area of infection is a standard treatment for infectious disease, such as endophthalmitis. This is currently done by empirical trans pars plana intravitreal injection of both antibiotics directed against gram-positive and gram-negative microorganisms and steroids. However, injections by needles repeatedly may increase the risks of intraocular infection and hemorrhage, as well as retinal detachment.

In vitro elution of vancomycin/amikacin/steroid from solvent-free biodegradable scleral plugs.

The purpose of this report was to develop solvent-free biodegradable scleral plugs for vancomycin, amikacin and dexamethasone delivery for endophthalmitis treatment. To fabricate a biodegradable plug, polylactide-polyglycolide copolymers were pre-mixed with the drugs. The mixture was then compression molded and sintered to form a scleral plug of 1.

Mitigation of direct neurotoxic effects of lidocaine and amitriptyline by inhibition of p38 mitogen-activated protein kinase in vitro and in vivo.

Background: Local anesthetic-induced direct neurotoxicity (paresthesia, failure to regain normal sensory and motor function) is a potentially devastating complication of regional anesthesia. Local anesthetics activate the p38 mitogen-activated protein kinase (MAPK) system, which is involved in apoptotic cell death. The authors therefore investigated in vitro (cultured primary sensory neurons) and in vivo (sciatic nerve block model) the potential neuroprotective effect of the p38 MAPK inhibitor SB203580 administered together with a clinical (lidocaine) or investigational (amitriptyline) local anesthetic.

Efficacy of lidocaine or bupivacaine combined with ephedrine in rat sciatic nerve block.

Background And Objectives: The adrenergic drug ephedrine inhibits Na(+) current in cultured cells expressing Na(+) channels and provides dose-dependent reversible rat sciatic nerve blockade. The dosage required for peripheral nerve blockade in humans would cause unacceptable cardiovascular side effects. We therefore hypothesized that either lidocaine or bupivacaine would show synergy with ephedrine in a rat sciatic nerve block model, allowing a dose reduction and limiting side effects while improving efficacy.

Ephedrine blocks rat sciatic nerve in vivo and sodium channels in vitro.

Background: The sympathomimetic drug ephedrine has been used intrathecally as the sole local anesthetic for labor and delivery. Because ephedrine may be a useful adjuvant to local anesthetics, the authors investigated the local anesthetic properties of ephedrine in a rat sciatic nerve block model and the underlying mechanism in cultured cells stably expressing Na channels.

Methods: After approval of the animal protocol, the sciatic nerves of anesthetized rats were exposed by lateral incision of the thighs, 0.

Profound hypoxemia during major abdominal surgery in a small infant with tetralogy of Fallot.

We report a protracted hypoxic event during Soave's endorectal pull-through for Hirschsprung's disease in a 2-month-old male infant with tetralogy of Fallot. After the bowel loops were delivered out of the abdominal cavity, profound hypoxemia occurred which persisted for about 120 min. The hypoxemia was completely resolved after the intestine was reduced back into the peritoneal cavity.

Intubation conditions with low dose rocuronium under sevoflurane induction for children.

Background: During short surgical procedures and when there is a need to avoid the use of anticholinesterase at the end of surgery, the use of a smaller intubation dose of neuromuscular blocking drug is preferred. The aim of this study was to evaluate tracheal intubation conditions using smaller doses of rocuronium for children under sevoflurane induction.

Methods: Eighty American Society of Anesthesiologists classification physical status I or II children were enrolled.

Caudal epidural block for minor gynecologic procedures in outpatient surgery.

Background: Caudal epidural block (CEB) has become increasingly important for pediatric analgesia in recent years. However, data regarding CEB in adult ambulatory surgery are scarce. The aim of this study was to verify whether CEB could be applied as a simple, safe and economic method of anesthesia for adult patients undergoing minor gynecologic procedures (MGP).

Epidural anesthesia does not increase the incidences of urinary retention and hesitancy in micturition after ambulatory hemorrhoidectomy.

Background: This randomized, prospective study was designed to evaluate the role of various anesthesias in postoperative urinary retention and hesitancy in micturition in patients receiving hemorrhoidectomy on ambulatory basis.

Methods: In a randomized order, 128 ambulatory patients, ASA physical status I or II, were divided into two groups to receive hemorrhoidectomy under epidural or local anesthesia. In all patients, the intraoperative intravenous fluid given was limited to 200 ml +/- 2 ml/kg/h of Ringer's lactate solution.

Simultaneous determination of unbound ropivacaine in rat blood and brain using microdialysis.

To investigate the pharmacokinetics of ropivacaine in rat blood and brain, a sensitive HPLC method and microdialysis were developed for the simultaneous determination of unbound ropivacaine in rat blood and brain. Adult, male Sprague-Dawley rats (290-350 g) were anesthetized with sodium pentobarbital (50 mg/kg, i.p.

Impact of race in lung cancer: analysis of temporal trends from a surveillance, epidemiology, and end results database.

Study Objectives: We analyzed data from a community-based cancer database over a 26-year period in order to characterize clinicopathologic differences between black and white patients with lung cancer, and to identify relevant temporal trends in incidence and survival.

Design, Setting, And Patients: Data on demographics, stage, histology, and survival were obtained on all black and white patients with primary bronchogenic carcinoma registered in the community-based metropolitan Detroit Surveillance, Epidemiology, and End Results database from 1973 to 1998.

Results: Of 48,318 eligible patients, 23% were black.