Purpose: Technetium 99 m (99 m Tc) labeled scan is often done to localize bleeding to facilitate treatment. No level 1 or 2 data supports this approach. The aim of this study was to determine the correlation between s...Purpose: Technetium 99 m (99 m Tc) labeled scan is often done to localize bleeding to facilitate treatment. No level 1 or 2 data supports this approach. The aim of this study was to determine the correlation between site of bleeding by nuclear scan and findings at surgery, angiogram or colonoscopy. Methods: Records of patients admitted to Cooper University Hospital from January 2001-December 2005 with LGIB who had 99mTc scan were analyzed. Results: 164 of 170 patients were eligible to be evaluated. There were 45 positive (27.5%) and 119 negative scans (72.5%). 21 of 45 patients with positive scans had angiography. 7 patients (33.3%) had positive and 14 (66.6%) negative angiograms. In 6 patients (85.7%) with (+) angiograms, there was correlation on the area of bleed as seen on the 99 m Tc scan (p = 0.125). 20 patients, in the positive scan group, required surgery. In 15 (75%) the findings at surgery correlated with the scan result (p = 0.04). 31 patients (68.8%) with positive scan had colonoscopy. There was correlation in 27 patients (87.0%) (p < 0.001). The patients with (+) scan received a total of 372 (8.2 per patient) transfusions of packed red blood cells (PRBC) compared to 333 (2.7 per patients) transfusions in patients with (–) scans. Surgeons documented in 7 patients that the result of scan influenced surgery. Patients with (+) and (–) scans had similar rates of colonoscopy (73.35% vs 76.4%), hospital length of stay (14.3 vs 12.10 days), while mortality rate was (8.8% vs 6.72%) respectively, Conclusion: 99 m Tc scan has low yield in the evaluation of LGIB. However when positive, they tend to correlate with findings at angiogram, surgery and colonoscopy.展开更多
Tissue engineering of the annulus fibrosus(AF)is currently being investigated as a treatment for intervertebral disc degeneration,a condition frequently associated with low back pain.The objective of this work was to ...Tissue engineering of the annulus fibrosus(AF)is currently being investigated as a treatment for intervertebral disc degeneration,a condition frequently associated with low back pain.The objective of this work was to use 3D printing to generate a novel scaffold for AF repair that mimics the structural and biomechanical properties of the native tissue.Multi-layer scaffolds were fabricated by depositing polycaprolactone struts in opposing angular orientations,replicating the angle-ply arrangement of the native AF tissue.Scaffolds were printed with varied strut diameter and spacing.The constructs were characterized morphologically and by static and dynamic mechanical analyses.Scaffold surfaces were etched with unidirectional grooves and the influence on bovine AF cell metabolic activity,alignment,morphology and protein expression was studied in vitro.Overall,the axial compressive and circumferential tensile properties of the scaffolds were found to be in a similar range to the native AF tissue.Confocal microscopy images indicated that cells were able to attach and spread on the smooth polycaprolactone scaffolds,but the surface texture induced cellular alignment and proliferation.Furthermore,immunofluorescence analysis demonstrated the aligned deposition of collagen type I,aggrecan and the AF-specific protein marker tenomodulin on the etched scaffolds.Overall,results demonstrated the potential for using the scaffolds as a template for AF regeneration.展开更多
文摘Purpose: Technetium 99 m (99 m Tc) labeled scan is often done to localize bleeding to facilitate treatment. No level 1 or 2 data supports this approach. The aim of this study was to determine the correlation between site of bleeding by nuclear scan and findings at surgery, angiogram or colonoscopy. Methods: Records of patients admitted to Cooper University Hospital from January 2001-December 2005 with LGIB who had 99mTc scan were analyzed. Results: 164 of 170 patients were eligible to be evaluated. There were 45 positive (27.5%) and 119 negative scans (72.5%). 21 of 45 patients with positive scans had angiography. 7 patients (33.3%) had positive and 14 (66.6%) negative angiograms. In 6 patients (85.7%) with (+) angiograms, there was correlation on the area of bleed as seen on the 99 m Tc scan (p = 0.125). 20 patients, in the positive scan group, required surgery. In 15 (75%) the findings at surgery correlated with the scan result (p = 0.04). 31 patients (68.8%) with positive scan had colonoscopy. There was correlation in 27 patients (87.0%) (p < 0.001). The patients with (+) scan received a total of 372 (8.2 per patient) transfusions of packed red blood cells (PRBC) compared to 333 (2.7 per patients) transfusions in patients with (–) scans. Surgeons documented in 7 patients that the result of scan influenced surgery. Patients with (+) and (–) scans had similar rates of colonoscopy (73.35% vs 76.4%), hospital length of stay (14.3 vs 12.10 days), while mortality rate was (8.8% vs 6.72%) respectively, Conclusion: 99 m Tc scan has low yield in the evaluation of LGIB. However when positive, they tend to correlate with findings at angiogram, surgery and colonoscopy.
文摘Tissue engineering of the annulus fibrosus(AF)is currently being investigated as a treatment for intervertebral disc degeneration,a condition frequently associated with low back pain.The objective of this work was to use 3D printing to generate a novel scaffold for AF repair that mimics the structural and biomechanical properties of the native tissue.Multi-layer scaffolds were fabricated by depositing polycaprolactone struts in opposing angular orientations,replicating the angle-ply arrangement of the native AF tissue.Scaffolds were printed with varied strut diameter and spacing.The constructs were characterized morphologically and by static and dynamic mechanical analyses.Scaffold surfaces were etched with unidirectional grooves and the influence on bovine AF cell metabolic activity,alignment,morphology and protein expression was studied in vitro.Overall,the axial compressive and circumferential tensile properties of the scaffolds were found to be in a similar range to the native AF tissue.Confocal microscopy images indicated that cells were able to attach and spread on the smooth polycaprolactone scaffolds,but the surface texture induced cellular alignment and proliferation.Furthermore,immunofluorescence analysis demonstrated the aligned deposition of collagen type I,aggrecan and the AF-specific protein marker tenomodulin on the etched scaffolds.Overall,results demonstrated the potential for using the scaffolds as a template for AF regeneration.
