RESUMO
IgG4-related disease is an immune-mediated fibro-inflammatory disease, characterised by distinct pathological features. An increasing number of clinical phenotypes are described, from single-organ disease to a multisystem disorder, which can present to a variety of different specialities. Recognition is key; its protean manifestations can mimic other inflammatory diseases, infection and malignancy. Here, we present three cases to highlight the importance of being familiar with this condition in its various forms.
Assuntos
Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Pneumopatias/complicações , Pneumopatias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Tosse/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/imunologia , Redução de Peso/imunologiaRESUMO
This report describes a care bundles implementation project for COPD undertaken during 2013 in England and Wales. High-level data were collected on outcomes of care for 11â 748 patients admitted with an acute exacerbation of COPD (AECOPD). Patient-level data on processes and outcomes of care were collected on 3272 COPD admissions, among which 1174 bundles were delivered. Analysis demonstrated a statistically significant reduction in mortality and length of hospital stay from some bundle elements. Outcomes, including bundle completion rates, were better when specialist respiratory review occurred. The results support wider use of care bundles for AECOPD.
Assuntos
Hospitalização , Pacotes de Assistência ao Paciente , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Padrão de Cuidado , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , País de GalesRESUMO
This communication describes our work in electrical, topological, and chemical micromodification of surfaces to modulate cellular form and function. We have addressed the surface physico-chemico-mechano properties of cell culture substrates that play a role in modulating cellular behavior. Single factorial model systems have been built using techniques adapted from microlithography. The tools and techniques of microfabrication, if harnessed and used correctly, can be enabling in elucidating the underlying principles and fundamental forces driving the cell-substrate interface. Additionally, the long-term practical applications of microfabrication in medicine and biomaterial/tissue engineering lie in enabling "communication" with living cells/tissues at the cellular and subcellular levels.
Assuntos
Materiais Biocompatíveis , Técnicas de Cultura de Células/instrumentação , Modelos Biológicos , Animais , Biomarcadores/análise , Adesão Celular , Técnicas de Cultura de Células/métodos , Citoesqueleto , Humanos , Camundongos , Monócitos/citologia , Polímeros , Silicones , Estresse Mecânico , Propriedades de SuperfícieRESUMO
Two photolithographic methods are described for the formation of patterned single or multiple DNA species on SiO2 substrates. In the first approach, substrates are treated with a photochemically labile organosilane monolayer film. Irradiation of these surfaces with patterned deep UV (193 nm) light results in patterned chemically reactive groups which are then reacted with heterobifunctional crosslinking molecules. Covalent attachment of modified synthetic DNA oligomers to the crosslinker results in stable DNA patterns. Alternatively, a photoresist is spin-coated over a silane film which had been previously modified with the heterobifunctional crosslinker. Upon patterned irradiation and subsequent development, the underlying crosslinker-modified layer is revealed, and is then reacted with a chemically modified DNA. Feature dimensions to 1 micron are observed when a single fluorescent DNA is attached to the surface. By performing sequential exposures, we have successfully immobilized two distinguishable DNA oligomers on a single surface. Synthetic DNA immobilized in this manner retains the ability to hybridize to its complementary strand, suggesting that these approaches may find utility in the development of miniaturized DNA-based biosensors.
Assuntos
DNA/química , Oligodesoxirribonucleotídeos/química , Silanos/química , Técnicas Biossensoriais , Biotecnologia , Reagentes de Ligações Cruzadas , Lasers , Hibridização de Ácido Nucleico , Compostos de Sulfidrila/química , Propriedades de Superfície , Raios UltravioletaRESUMO
A new method is described for producing biomedically relevant polymers with precisely defined micron scale surface texture in the x, y, and z planes. Patterned Si templates were fabricated using photolithography to create a relief pattern in photoresist with lateral dimensions as small as 1 micron. Electroless Ni was selectively deposited in the trenches of the patterned substrate. The Ni served as a resilient mask for transferring the patterns onto the Si substrate to depths of up to 8.5 microns by anisotropic reactive ion etching with a fluorine-based plasma. The 3-dimensional (3-D) textured silicon substrates were used as robust, reusable molds for pattern transfer onto poly (dimethyl siloxane), low density poly (ethylene), poly (L-lactide), and poly (glycolide) by either casting or injection molding. The fidelity of the pattern transfer from the silicon substrates to the polymers was 90 to 95% in all three planes for all polymers for more than 60 transfers from a single wafer, as determined by scanning electron microscopy and atomic force microscopy. Further, the 3-D textured polymers were selectively modified to coat proteins either in the trenches or on the mesas by capillary modification or selective coating techniques. These selectively patterned 3-D polymer substrates may be useful for a variety of biomaterial applications.
Assuntos
Materiais Biocompatíveis/química , Materiais Biocompatíveis/síntese química , Silício , Dimetilpolisiloxanos , Desenho de Fármacos , Microscopia Eletrônica de Varredura , Poliésteres , Polietilenos , Ácido Poliglicólico , Silicones , Propriedades de SuperfícieRESUMO
A process for producing patterned metal deposits on fluoropolymeric substrates is described. A metal ion-chelating organosilane is chemisorbed by self-assembly onto a fluoropolymer surface after radio-frequency glow discharge plasma surface hydroxylation. Positional modulation of the surface hydrophobicity is illustrated by wetting. The silane covalently binds an aqueous palladium catalyst and subsequent electroless deposition yields homogeneous or patterned metal deposits that exhibit excellent adhesion to the fluoropolymer.
RESUMO
Proteins were attached in defined geometric patterns on a surface. A prerequisite to making a pattern of proteins is generation of surfaces resistant to nonspecific protein adsorption. This was accomplished via oxidation of the thiol terminus of an organosilane self-assembled monolayer film by deep ultraviolet (DUV) irradiation. The resultant surface exhibited marked resistance to protein adsorption. Using a mask to protect regions of the silanized surface from irradiation, proteins were selectively adsorbed or attached via covalent linkage at locations protected from the DUV light. Antibodies immobilized in patterns using this procedure retained their antigen-binding capability. Thus chemistry and DUV lithography were combined to create patterns of active biomolecules which could be used in the microfabrication of electronic devices and biosensors.
Assuntos
Técnicas Biossensoriais , Proteínas , Adsorção , Animais , Eletrônica Médica , Imunoglobulina G , Fotoquímica , Proteínas/química , Silanos , Propriedades de Superfície , Raios UltravioletaRESUMO
Deep ultraviolet (UV) irradiation is shown to modify organosilane self-assembled monolayer (SAM) films by a photocleavage mechanism, which renders the surface amenable to further SAM modification. Patterned UV exposure creates alternating regions of intact SAM film and hydrophilic, reactive sites. The exposed regions can undergo a second chemisorption reaction to produce an assembly of SAMs in the same molecular plane with similar substrate attachment chemistry. The UV-patterned films are used as a template for selective buildup of fluorophores, metals, and biological cells.
Assuntos
Axônios/efeitos da radiação , Raios Ultravioleta , Axônios/fisiologia , Adesão Celular/efeitos da radiação , Linhagem Celular , Sobrevivência Celular/efeitos da radiação , Humanos , Neuroblastoma , FotoquímicaRESUMO
A procedure for covalent immobilization of functional proteins on silica substrates was developed using thiol-terminal silanes and heterobifunctional cross-linkers. Using this procedure, a high density of functional antibodies was bound to glass cover slips and silica fibers. The amount of anti-IgG antibody immobilized was determined to be in the range of 0.66 to 0.96 ng/mm2 using radiolabeled antibody. The relative amount of IgG antigen bound by the immobilized antibody (0.37 to 0.55 mol antigen/mol antibody) was three to five times greater than other investigators have reported. In addition, the amount of protein nonspecifically adsorbed to the antibody-coated surface was further reduced by the addition of blocking agents so that nonspecific adsorption of protein antigens represented only 2-6% of the total antigen binding. With this low background, IgG antigen binding could be measured at levels as low as 150 fmol when an antigen concentration of 3 pmol/ml was applied. The process for antibody immobilization is straightforward, easy to perform, and adaptable for modifying mass quantities of biosensor components.
Assuntos
Anticorpos , Reagentes de Ligações Cruzadas , Reações Antígeno-Anticorpo , Dióxido de Silício , Compostos de SulfidrilaRESUMO
We have reviewed 21 cases with the clinical diagnosis of Post Traumatic Syringomyelia (P.T.S.). Fifteen of these cases had proven syrinx formation on Contrast Computed Tomography (C.C.T.) and the other 6 had obviously abnormal cords. A much earlier onset of P.T.C.M. was found in complete spinal injuries than in incomplete ones. We have discussed the technique of contrast computed tomography used at this hospital, its value in the diagnosis of this condition and its ability to define actual spinal cord structure. Most cases (91%) benefitted from surgery and several had marked sensory improvement, which previously has been described as unusual. Syringo-cisternal shunting, a new technique for the drainage of cervical and upper thoracic syrinxes is described. A theory is proposed to explain why, in some patients with classical presentations of P.T.S., no syrinx was found on C.C.T., although abnormal cords were found in all cases. It is felt that these abnormal areas of spinal cord are responsible for the presenting symptomatology and may be precursors of syrinxes.