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Study on the optical property and biocompatibility of a tissue engineering cornea

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International Journal of Ophthalmology(English edition) 2012年第1期5卷 45-49页

作者： Yukiko Nakahara Dwight Xuan Department of medical Engineering Faculty of Health ScienceJunshin Gakuen UniversityChikushioka1-1-1Fukuoka 815-8510Japan brooke army medical center 3851 Roger Brooke Drive Fort Sam Houston TX 78234 USA

AIM: To study the optical property and biocompatibility of a tissue engineering cornea. METHODS: The cross-linker of N- (3-Dimethylaminoropyl)-N'ethylcarbodiimide hydrochloride (EDC)/ N-Hydroxysuccinimide (NHS) was mixed with Type I collagen at 10% (weight/volume). The final solution was molded to the shape of a corneal contact lens. The collagen concentrations of 10%, 12.5%, 15%, 17.5% and 20% artificial corneas were tested by UV/vis-spectroscopy for their transparency compared with normal rat cornea. 10-0 sutures were knotted on the edges of substitute to measure the corneal buttons's mechanical properties. Normal rat corneal tissue primary culture on the collagen scaffold was observed in 4 weeks. Histopathologic examinations were performed after 4 weeks of in vitro culturing. RESULTS: The collagen scaffold appearance was similar to that of soft contact lens. With the increase of collagen concentration, the transparency of artificial corneal buttons was diminished, but the toughness of the scaffold was enhanced. The scaffold transparency in the 10% concentration collagen group resembled normal rat cornea. To knot and embed the scaffold under the microscope, 20% concentration collagen group was more effective during implantation than lower concentrations of collagen group. In the first 3 weeks, corneal cell proliferation was highly active. The shapes of cells that grew on the substitute had no significant difference when compared with the cells before they were moved to the scaffold. However, on the fortieth day, most cells detached from the scaffold and died. Histopathologic examination of the primary culture scaffold revealed well grown corneal cells tightly attached to the scaffold in the former culturing. CONCLUSION: Collagen scaffold can be molded to the shape of soft contact corneal lens with NHS/EDC. The biological stability and biocompatibility of collagen from animal species may be used as material in preparing to engineer artificial corneal scaffold.

关键词： tissue engineering collagen cross-linking scaffold primary culture in vitro optical property biocompatibility

A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members

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Military medical Research 2020年第2期7卷 140-150页

作者： Kimberly S.Peacock Erika Stoerkel Salvatore Libretto Weimin Zhang Alice Inman Michael Schlicher John D.Cowsar Jr David Eddie Joan Walter University of Texas Health San Antonio 7703 Floyd Curl DriveSan AntonioTX78229USA TLI Foundation 1750 Tysons BoulevardMcLeanVirginia22102USA Henry M.Jackson Foundation 6720A Rockledge DriveBethesdaMD20817USA BD Life Sciences 1 Becton DriveFranklin LakesNJ07417USA brooke army medical center 3551 Roger Brooke DriveFort Sam HoustonTX78234USA Madigan army medical center 9040A Jackson AveJoint Base Lewis-McChordWA98431USA MedPost Urgent Care center 513 Cibolo Valley DriveCiboloTX78108USA Massachusetts General Hospital Harvard Medical School151 Merrimac St.6th FloorBostonMA02114USA H&S Ventures Samueli Integrative Health Program1800 Diagonal RoadSuite 617AlexandriaVA22314USA

Background:The present investigation tested the efficacy of the Tennant Biomodulator,a novel pain management intervention that uses biofeedback-modulated electrical stimulation,to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service *** Tennant Biomodulator used on its most basic setting was compared to two commonly used,non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation(TENS)—in a comparative efficacy,randomized,open-label ***:Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the brooke army medical center in Texas,USA,randomly assigned to receive six,weekly sessions of either Tennant Biomodulator treatment,traditional Chinese acupuncture,or TENS,in addition to usual *** was conducted between May 2010 to September *** measures were collected at intake,before and after each treatment session,and at a 1-month ***-to-treat analyses were used throughout,with mixed models used to investigate main effects of group,time,and group×time interactions with consideration given to quadratic *** measured included ratings of chronic pain,pain-related functional disability,and symptoms of post-traumatic stress disorder(PTSD)and ***:On average,regardless of their treatment group,participants exhibited a 16%reduction in pain measured by the brooke army medical center’s Clinic Pain Log[F(1,335)=55.7,P<0.0001]and an 11%reduction in pain-related disability measured by the Million Visual Analog Scale[MVAS:F(1,84)=28.3,P<0.0001]from baseline to the end of treatment,but no one treatment performed better than the other,and the reductions in pain and pain-related disability were largely lost by 1-month *** of PTSD and depression did not change significantly as a function of time or ***:Findings build on previ

关键词： Tennant biomodulator Acupuncture Transcutaneous electrical nerve stimulation Chronic pain Military service members

糖蛋白Ⅱb/Ⅲa抑制剂相关性血小板减少症:临床预测指标及其对预后的影响

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世界核心医学期刊文摘（心脏病学分册） 2005年第3期1卷 23-24页

作者： George B.J. Eckart R.E. Shry E.A. Simpson D.E. 高登峰 Department of Internal Medicine Brooke Army Medical Center 3851 Roger Brooke Drive San Antonio TX 78234-6200 United States Dr.

Glycoprotein Ⅱb/Ⅲa inhibitors are used as an adjunct to antiplatelet therapy in percutaneous coronary intervention to reduce postprocedural enzyme elevations. Previous studies have shown a risk for thrombocytopenia that is associated with these agents. We sought to evaluate the incidence and outcomes of glycoprotein Ⅲb/Ⅲa inhibitor-associated thrombocytopenia in an unselected series of patients undergoing percutaneous coronary intervention. We reviewed 984 interventions performed on 908 subjects over a specific time period. Glycoprotein Ⅲb/Ⅳa inhibitors were used in 58.8%of cases. Their use increased from 38 to 82%during the study period(p 0.05). The occurrence of thrombocytopenia was not associated with increased in-hospitalmortality, 1-yearmortality,myocardial infarction or revascularization, but was associated with a hospital stay twice as long as in those patients without thrombocytopenia(5.6±11.3 vs. 2.1±2.2 days, p< 0.001). Of the 5.4%of patients who developed thrombocytopenia, only 2 patients(7.1%) required platelet or blood cell transfusion.

关键词：临床预测介入治疗前血小板年死亡率酶活性

Current devices,outcomes,and pain management considerations in penile implant surgery:an updated review of the literature

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Asian Journal of Andrology 2024年第4期26卷 335-343页

作者： Nirupama Ancha Maya Eldin Tarah Woodle Sofia Gereta Krishna Hariprasad Imani Butler E Charles Osterberg III Department of Surgery and Perioperative Care University of Texas at Austin Dell Medical SchoolAustinTX 78712USA Department of Urology Brooke Army Medical CenterSan AntonioTX 78234USA Department of Molecular Biosciences The University of Texas at AustinAustinTX 78712USA.

Penile prosthesis surgery is a definitive treatment for erectile dysfunction(ED).The two categories of penile prosthesis are endorsed by professional guidelines,inflatable penile prosthesis(IPP)and malleable penile prosthesis(MPP).Each modality of penile prosthesis offers distinct advantages and incorporates specific design features,allowing for personalized device selection that aligns with individual needs and *** the overall complication rate of penile implant surgery remains low,surgeons should maintain a high index of suspicion for complications in the perioperative time *** analgesic regimens including nerve blocks and narcotic-free pathways should be administered to manage perioperative ***,the high patient satisfaction after penile prosthesis surgery underscores the success of this ED treatment option.

关键词： erectile dysfunction penile implant penile prosthesis

Validation of the age-adjusted shock index for pediatric casualties in Iraq and Afghanistan

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Military medical Research 2021年第1期8卷 17-24页

作者： Camaren M.Cuenca Matthew A.Borgman Michael D.April Andrew D.Fisher Steven G.Schauer JUS army Institute of Surgical Research 3698 Chambers PassJBSA Fort Sam HoustonSan AntonioTX 78234-7767USA brooke army medical center JBSA Fort Sam HoustonSan AntonioTXUSA Uniformed Services University of the Heath Sciences BethesdaMDUSA Texas army National Guard AustinTXUSA Department of Surgery UNM School of MedicineAlbuquerqueNMUSA 59th medical Wing JBSA LacklandSan AntonioTXUSA

Background: Pediatric casualties account for a notable proportion of encounters in the deployed setting based on the humanitarian medical care mission. Previously published data demonstrates that an age-adjust shock index may be a useful tool in predicting massive transfusion and death in children. We seek to determine if those previous findings are applicable to the deployed, combat trauma ***: We queried the Department of Defense Trauma Registry(DODTR) for all pediatric subjects admitted to US and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. This was a secondary analysis of casualties seeking to validate previously published data using the shock index, pediatric age adjusted. We then used previously published thresholds to determine patients outcome for validation by age grouping, 1–3 years(1.2), 4–6 years(1.2), 7–12 years(1.0), 13–17 years(0.9).Results: From January 2007 through January 2016 there were 3439 pediatric casualties of which 3145 had a documented heart rate and systolic pressure. Of those 502(16.0%) underwent massive transfusion and 226(7.2%) died prior to hospital discharge. Receiver operating characteristic(ROC) thresholds were inconsistent across age groups ranging from 1.0 to 1.9 with generally limited area under the curve(AUC) values for both massive transfusion and death prediction characteristics. Using the previously defined thresholds for validation, we reported sensitivity and specificity for the massive transfusion by age-group: 1–3(0.73, 0.35), 4–6(0.63, 0.60), 7–12(0.80, 0.57), 13–17(0.77, 0.62). For death, 1–3(0.75, 0.34), 4–6(0.66–0.59), 7–12(0.64, 0.52), 13–17(0.70, 0.57). However, negative predictive values(NPV) were generally high with all greater than ***: Within the combat setting, the age-adjusted pediatric shock index had moderate sensitivity and relatively poor specificity for predicting massive transfusion and death. Better scoring systems are needed to p

关键词： Pediatric Massive Transfusion Shock Index Age

Self-reported dietary supplement use in deployed United States service members pre-deployment *** deployment,Afghanistan,2013-2014

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Military medical Research 2018年第3期5卷 207-215页

作者： Shawn M.Varney Patrick C.Ng Crystal A.Perez Allyson A.Arana Edwin R.Austin Rosemarie G.Ramos Vikhyat S.Bebartas University of Texas Health Science center San Antonio 7709Floyd Curl DrSan AntonioTX 78229USA San Antonio Military medical center 3551Roger Brooke DriveSan AntonioTX 78234USA Rocky Mountain Poison and Drug center Denver Health and Hospital AuthorityDenverCOUSA U.S.army Institute of Surgical Research USAF En Route Care Research Center3698Chambers Pass STE BJBSA Ft Sam HoustonSan AntonioTX 78234USA Department of Emergency Medicine University of Colorado School of Medicine13001E 17th PlaceAuroraCO 80045USA

Background: Dietary supplement use(protein/amino acids, weight-loss supplements, performance enhancers) is common among U.S. military members. Reported dietary supplement use in deployed troops is limited and is of concern in settings where troops are exposed to high ambient temperatures, increased physical demands, and dehydration. Our objective was to describe dietary supplement use and adverse events(AEs) among deployed U.S. service members compared with their pre-deployment ***: We conducted an institutional review board(IRB) approved, descriptive study in Afghanistan using a written questionnaire and collected demographic information, dietary supplement use before and during deployment, AEs associated with supplement use, and physical workout routines. Participants were U.S. military personnel of all branches of service deployed to Afghanistan. They were recruited in high-traffic areas in the combat theater. We analyzed the data with descriptive statistics. Paired t-test/Wilcoxon signed-rank test was conducted to examine the before/during deployment changes for continuous data, and Mc Nemar's chi-square test was conducted for categorical data. We constructed separate logistic regression models to determine the best predictors of increases or decreases in dietary supplement use, with demographic information, reasons for using supplements, and education requested/received as covariates in each model. All statistical tests were two-sided at a significance level of 5%(Parmy or Air Force. The participants were more likely to work out daily or more than once a day during deployment. Thirty-five percent of the participants reported no supplement use before or during deployment. The remaining 65% of participants reported increased use and increased frequency of use of supplements(e.g., daily) during deployment compared with predeployment. Additionally, more pe

关键词： Military Dietary supplement Workout Exercise Adverse events

Endoscopic ultrasound-guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

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Portal Hypertension & Cirrhosis 2024年第2期3卷 67-74页

作者： Jerome C.Edelson Scott F.D.Edelson John G.Quiles Cyrus V.Edelson Eric M.Montminy Christian L.Horn John P.Magulick Don C.Rockey Department of Gastroenterology and Hepatology Brooke Army Medical CenterFort Sam HoustonTexasUSA Department of Medicine Uniformed Services University of the Health SciencesBethesdaMarylandUSA Department of Medicine Brooke Army Medical CenterFort Sam HoustonTexasUSA John H.Stroger Jr.Hospital of Cook County ChicagoIllinoisUSA Digestive Disease Research center Medical University of South CarolinaCharlestonSouth CarolinaUSA

Aims:Portal hypertension(PH)is a complication of cirrhosis that leads to hepatic *** the portal pressure gradient(PPG)provides valuable information for disease assessment,staging,and *** this study,we aimed to report the utilization of endoscopic ultrasound(EUS)-guided PPG(EUS-PPG)measurements in a real-world ***:This retrospective analysis included patients at a tertiary care center who underwent EUS-PPG between February 2021 and May *** most common indication was to establish or exclude the diagnosis of cirrhosis,followed by an assessment of surgical risk in the setting of suspected *** demographic and clinical data were collected,and statistical analysis was performed using the Student's t ***:Eighteen patients underwent *** success was achieved in 17 of the 18 *** complications were *** mean scores of Child-Pugh,Model for End-Stage Liver Disease-Sodium,and Fibrosis-4 scores were 5.1±0.5,9.0±3.0,and 3.7±4.5,*** the 18 patients,two presented with esophageal varices and six with portal hypertensive *** mean PPG was 5.8±4.5 mmHg,and five patients exhibited clinically significant PH(CSPH).Of the 18 patients,15 underwent concurrent EUS-liver biopsy,which was 100%successful and provided diagnostic histology for all *** PPG data led to changes in the clinical management of 17 ***:EUS-PPG is safe and technically *** Child-Pugh score did not correlate well with the presence of CSPH;however,PPG measurements resulted in changes in the management of almost all *** studies correlating EUS-PPG with other assessments of liver diseases are required.

关键词： EUS portal hypertension portal pressure gradient

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使用“黄黑色药膏”自行治疗基底细胞癌

世界核心医学期刊文摘（皮肤病学分册） 2005年第12期1卷 16-16页

作者： Osswald S.S. Elston D.M. Farley M.F. 张莹 Dr. Department of Dermatology Brooke Army Medical Center 3851 Roger Brooke Dr Fort Sam Houston TX 78234 United States

Patients may seek “ alternative” or “ non- traditional” therapies for dermatologic problems, frequently in search of amiraculous cure. However, many of these medicaments contain unknown compounds with questionable benefit and a potential for significant harm. We describe a patient who developed a large ulceration on her nose after applying “ black and yellow salves” obtained from Mexico in an attempt to self- treat a basal cell carcinoma.

关键词：基底细胞癌巨大溃疡鼻部化学成分

The transcontinental variability of nonalcoholic fatty liver disease

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Hepatoma Research 2020年第10期6卷 75-87页

作者： Claudia P.Oliveira Angelo Paredes Mohammed Siddiqui Lawrence Serfaty Abhijit Chowdhury Jose Tadeu Stefano Denise Siqueira Vanni Sherry Boyett Arun J.Sanyal Department of Gastroenterology Faculdade de Medicina da Universidade de São PauloSão PauloSP 01000-000Brazil Laboratório de Gastroenterologia Clínica e Experimental(LIM-07)do Departamento de Gastroenterologia e Hepatologia do Hospital das Clínicas HCFMUSP da Faculdade de Medicina da Universidade de São Paulo São PauloSP 01000-000Brazil Internal Medicine Gastroenterology and Hepatology ServicesBrooke Army Medical CenterSan AntonioTX 78234USA Div.of Gastroenterology Hepatology and NutritionDept.of Internal MedicineVirginia Commonwealth University School of MedicineRichmondVA 23298-0341USA Viral and Metabolic Liver Unit Department of HepatologySaint-Antoine Hospital75012 ParisParis Department of Hepatology School of Digestive and Liver DiseaseInstitute of Post Graduate Medical Education&ResearchKolkata 700020India Disease Biology John C Martin Centre for Liver Research and Innovations SonarpurKolkata 7000150India

Aim:To compare the phenotype of lean versus overweight(OW)and obese(OB)subjects with non-alcoholic fatty liver disease(NAFLD)across multiple ***:A retrospective study of histologically defined subjects from a single center each in France(Fr),Brazil(Br),India(In)and United States(US)was ***:A total of 70 lean[body mass index(BMI)25 kg/m2,BMI29 kg/m2)(n=81:11:22:103).Lean French subjects had the lowest incidence of type 2 diabetes while those from Brazil(P<0.01)had the *** subjects had similar low-density lipoprotein-cholesterol,but higher high-density lipoprotein-cholesterol compared to obese subjects in all *** both lean and obese subjects,there were both insulin-sensitive and insulin-resistant *** French subjects were most insulin-sensitive while those from Brazil were mostly *** each weight category,subjects from India were more insulin-sensitive than those from other *** activity increased from lean to overweight to obese in France but was similar across weight categories in other ***:The phenotype of NAFLD in lean subjects varies by *** obese subjects with NAFLD are *** hypothesize that genetics and region-specific disease modifiers account for these differences.

关键词： Non-alcoholic fatty liver disease phenotype epidemiology demographics