Current advances of nanocellulose application in biomedical field

Nanocellulose (NC) is a natural fiber that can be extracted in fibrils or crystals form from different natural sources, including plants, bacteria, and algae. In recent years, nanocellulose has emerged as a sustainable biomaterial for various medicinal applications including drug delivery systems, wound healing, tissue engineering, and antimicrobial treatment due to its biocompatibility, low cytotoxicity, and exceptional water holding capacity for cell immobilization. Many antimicrobial products can be produced due to the chemical functionality of nanocellulose, such disposable antibacterial smart masks for healthcare use. This article discusses comprehensively three types of nanocellulose: cellulose nanocrystals (CNC), cellulose nanofibrils (CNF), and bacterial nanocellulose (BNC) in view of their structural and functional properties, extraction methods, and the distinctive biomedical applications based on the recently published work. On top of that, the biosafety profile and the future perspectives of nanocellulose-based biomaterials have been further discussed in this review.

Immune Biomarkers for Diagnosis and Treatment Monitoring of Tuberculosis: Current Developments and Future Prospects

Tuberculosis (TB) treatment monitoring is paramount to clinical decision-making and the host biomarkers appears to play a significant role. The currently available diagnostic technology for TB detection is inadequate. Although GeneXpert detects total DNA present in the sample regardless live or dead bacilli present in clinical samples, all the commercial tests available thus far have low sensitivity. Humoral responses against Mycobacterium tuberculosis (Mtb) antigens are generally low, which precludes the use of serological tests for TB diagnosis, prognosis, and treatment monitoring. Mtb-specific CD4⁺ T cells correlate with Mtb antigen/bacilli burden and hence might serve as good biomarkers for monitoring treatment progress. Omics-based techniques are capable of providing a more holistic picture for disease mechanisms and are more accurate in predicting TB disease outcomes. The current review aims to discuss some of the recent advances on TB biomarkers, particularly host biomarkers that have the potential to diagnose and differentiate active TB and LTBI as well as their use in disease prognosis and treatment monitoring.

Mutagenicity evaluation of Anastatica hierochuntica L. aqueous extract in vitro and in vivo

Anastatica hierochuntica L. ( A. hierochuntica), a folk medicinal plant, was evaluated for mutagenic potential via in vitro and in vivo assays. The in vitro assay was conducted according to modified Ames test, while the in vivo study was performed according to Organisation for Economic Co-operation and Development guideline for mammalian erythrocyte micronucleus assay. Four groups ( n= 5 males and 5 females per group) Sprague Dawley rats were randomly chosen as the negative control, positive control (received a single intramuscular injection of cyclophosphamide 50 mg/kg), 1000 and, 2000 mg/kg A. hierochuntica aqueous extracts. All groups except the positive control were treated orally for three days. Findings of the in vitro assay showed mutagenic potential of AHAE at 0.04 and 0.2 mg/ml. However, no mutagenic effect was demonstrated in the in vivo study up to 2000 mg/kg. No significant reduction in the polychromatic and normochromatic erythrocytes ratio was noted in any of the groups. Meanwhile, high micronucleated polychromatic erythrocytes frequency was seen in cyclophosphamide-treated group only. These findings could perhaps be due to insufficient dosage of A. hierochuntica aqueous extracts to cause genetic damage on the bone marrow target cells. Further acute and chronic in vivo toxicity studies may be required to draw pertinent conclusion on the safety aspect of A. hierochuntica aqueous extracts consumption. Impact statement In this paper, we report on the mutagenicity evaluation of Anastatica hierochuntica aqueous extract. This is a significant research in view of the popularity of this herb consumption by the people across the globe despite of limited scientific evidence on its toxicity potential. This study is intended to encourage more extensive related research in order to provide sufficient evidence and guidance for determining its safe dosage.

Over-expression of Runx1 transcription factor impairs the development of thymocytes from the double-negative to double-positive stages

Runx1 transcription factor is highly expressed at a CD4/CD8-double-negative (DN) stage of thymocyte development but is down-regulated when cells proceed to the double-positive (DP) stage. In the present study, we examined whether the down-regulation of Runx1 is necessary for thymocyte differentiation from the DN to DP stage. When Runx1 was artificially over-expressed in thymocytes by Lck-driven Cre, the DN3 population was unaffected, as exemplified by proper pre-T-cell receptor expression, whereas the DN4 population was perturbed as shown by the decrease in the CD27(hi) sub-fraction. In parallel, the growth rate of DN4 cells was reduced by half, as measured by bromodeoxyuridine incorporation. These events impaired the transition of DN4 cells to the DP stage, resulting in the drastic reduction of the number of DP thymocytes. The Runx1 gene has two promoters, a proximal and a distal promoter; and, in thymocytes, endogenous Runx1 was mainly transcribed from the distal promoter. Interestingly, only distal, but not proximal, Runx1 over-expression exhibited an inhibitory effect on thymocyte differentiation, suggesting that the distal Runx1 protein may fulfil a unique function. Our collective results indicate that production of the distal Runx1 protein must be adequately down-regulated for thymocytes to transit from the DN to the DP stage, a critical step in the massive expansion of the T-cell lineage.

The decision to withdraw tube feeding

Physicians involved in the care of elderly patients are often faced with end-of-life decisions including withholding or withdrawal of tube feeding. More than 80% of deaths take place in the hospital or nursing home and the prolongation of life by medical technology has replaced natural processes. We believe the availability of life-sustaining medical technology including tube feeding does not make physicians ethically obligated to use it once it is known that health and function cannot be restored and the burdens outweight the benefits. Patients and their surrogate decision-makers have a right to refuse life-sustaining medical treatment they find burdensome. Tube feeding as a medical treatment, witholding of tube feeding as equivalent to withdrawal of tube feeding, the benefits versus the burdens of tube feeding, and the decision-making process involved in the withdrawal of medical treatment are considered Hawaii's statutes as they apply to decision-making and examples of cases to illustrate how these concepts are pertinent to patients whom we encounter in clinical practice are discussed.

Excimer laser photorefractive keratectomy for myopia: six-month follow-up

In this study, 108 eyes of 62 patients had photorefractive keratectomy (PRK) with a 193 nm excimer laser to correct myopia. The eyes were assigned to one of three groups: low, moderate, or high myopia. Six months after PRK, 88.9% of eyes in the low myopia group, 90.0% in the moderate myopia group, and 23.8% in the high myopia group achieved an uncorrected visual acuity of 20/40 or better. In the low myopia group, 88.9% were within +/- 1 diopter (D) of attempted correction, as were 70.0% in the moderate group and 18.8% in the high myopia group. There were no significant complications. We conclude that excimer laser PRK appears to be a safe and relatively accurate procedure to correct low to moderate myopia but not high myopia because of regression over time.

Quantitation of lipid in biological tissue by chemical shift magnetic resonance imaging

A method combining several previously used approaches is described for the rapid, accurate quantitation of the fat content of biological tissue based on chemical shift images (CSI) corrected for magnetic field inhomogeneity, and compensated for T1 and T2 effects. The gravimetrically determined lipid content of fatty tissues (pork fat, rabbit and human liver) that had been differentially depleted of lipid by chloroform extraction correlated well (r = 0.99) with the lipid image intensities of the respective tissues. This multi-point CSI method was used to quantitate lipid in fresh fatty human liver tissue (wet and dry) containing varying amounts of lipid. Plots of integrated lipid intensity versus tissue lipid content gave straight parallel lines for hydrated (r = 0.94) and dehydrated (r = 0.98) tissues, permitting determination of a proportionality constant for measuring absolute amounts of lipid present in a specific biological tissue. These results suggest the feasibility of using the method in vivo for absolute quantitation of lipid in tissues of agricultural (e.g. pork, beef) and medical (e.g. human liver) interest.

Nuclear magnetic resonance velocity spectra of pulsatile flow in a rigid tube

Velocity spectra can be derived from velocity-encoded nuclear magnetic resonance (NMR) images. Velocity spectra are histograms showing the amounts of fluid flowing at different velocities in the sensitive volume of the measurement. Velocity spectra may prove to be useful in characterizing the flow of blood in small vessels, for example, in detecting the presence of stenoses and in evaluating their severity. NMR velocity spectra acquired in vivo are sufficiently complicated that a model system was designed and tested to investigate the velocity spectra of pulsatile flow. This study measured the NMR velocity spectra of pulsatile flow in a rigid tube and compared them to velocity spectra derived from Doppler ultrasound measurements and to velocity spectra inferred from a theoretical model driven by the measured pressure difference function. The experimental results from each technique agree.

Magnetic resonance velocity measurements in small arteries. Comparison with Doppler ultrasonic measurements in the aortas of normal rabbits

RATIONALE AND OBJECTIVES

Magnetic resonance imaging (MRI) can be used to measure motion. This study compares MRI blood flow velocity measurements to Doppler ultrasound velocity measurements in an animal model.

MATERIALS AND METHODS

Blood flow in the abdominal aortas of nine normal rabbits was measured using 16-frame, velocity-resolved MRI and Doppler ultrasound. The MRI data were processed into velocity spectra to aid in their interpretation.

RESULTS

Maximum velocity measurements made by range-gated Doppler ultrasound were predicted by the maximum velocity values derived from MR velocity spectra with a slope of 0.861, an intercept of -2.78 cm/second, and an R-value of 0.935 in 70 measurements.

CONCLUSIONS

Despite the longer time required for the MR measurement, the MR velocity measurement may be useful in the assessment of deep vessels or those obscured by other structures, which are difficult to measure with ultrasound.

An electrocardiograph-respiration gating device for MR studies

A versatile gating device for magnetic resonance (MR) spectroscopy and imaging is presented. The device uses electrocardiograph (ECG) and respiration signals as input, applies appropriate signal conditioning, and generates control signals for ECG, respiration, or combined gating studies. In the combined ECG and respiration mode, in conjunction with a proper MR pulse program, one can acquire MR data gated by the ECG signal within a selected window of the respiration cycle, while maintaining a steady level of magnetization saturation during the remainder of the respiration cycle, by gating the radio-frequency excitation with the ECG while inhibiting data acquisition.

Invasive treatment for coronary artery disease in the elderly

The widespread availability of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty presents important treatment options for the older patient. The findings from a number of surgical series of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty are summarized. Certain trends are evident. Perioperative mortality, cardiovascular morbidity, and other complications, while declining, remain somewhat higher in elderly patients. However, the impact of age alone is slight. In both coronary artery bypass grafting and percutaneous transluminal coronary angioplasty, complications are more closely correlated with the presence of serious concomitant disease. Long-term survival and pain relief after coronary artery bypass grafting are excellent in older patients, and percutaneous transluminal coronary angioplasty may be the treatment of choice in some elderly patients with coronary artery disease. As in younger patients, prolongation of survival should not be the exclusive goal. Rather, a focus on quality of life and freedom from dependency should be seriously considered.