Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Fever ; Histoplasma ; Histoplasmosis ; diagnosis ; drug therapy ; microbiology ; pathology ; Humans ; Jaundice ; Male ; Middle Aged

Recently, regenerative medicine utilizing tissue manufacturing has been a creative topic of study, offering promise for resolving the gap between insufficient organ supply and transplantation needs. Moreover, 3D generation of functional organs is seen as the main hope to resolve these issues that will be a major advancement in the field over the next generation. Organ printing is the 3D construction of functional cellular tissue that can replace organs made by additive biofabrication with computational technology. Its advantages offer rapid prototyping (RP) methods for fabricating cells and adjunctive biomaterials layer by layer for manufacturing 3D tissue structures. There is growing interest in applying stem cell research to bio-printing. Recently several bio-printing methods have been developed that accumulate organized 3D structures of living cells by inkjet, extrusion, and laser based printing systems. By printing spatially organized gradients of biomolecules as an extracellular matrix, direct stem cell seeding can then be engineered to differentiate into different lineages forming multiple subpopulations that closely approximate the desired organ. Pliable implementation patches can Stem cells for tissue regeneration can be arranged or deposited onto pliable implementation patches with the purpose of generating functional tissue structures. In this review, current research and advancement of RP-based bio-printing methods to construct synthetic living organs will be discussed. Furthermore, recent accomplishments in bioprinting methods for stem cell study and upcoming endeavors relevant to tissue bioengineering, regenerative medicine and wound healing will be examined.
Biocompatible Materials ; Bioengineering ; Bioprinting ; Extracellular Matrix ; Hope ; Imaging, Three-Dimensional ; Organ Transplantation* ; Regeneration ; Regenerative Medicine ; Stem Cell Research ; Stem Cells ; Tissue Engineering ; Transplants* ; Wound Healing

Biopsy, Fine-Needle ; methods ; Bronchi ; diagnostic imaging ; pathology ; Endosonography ; methods ; Humans ; Lung Neoplasms ; pathology ; Lymph Nodes ; pathology ; Neoplasm Staging

Autoimmune encephalitis (AIE) is a type of immunoreactive encephalitic disorder and is recognized as the most prevalent noninfectious encephalitis. Nevertheless, the rarity of definitive AIE diagnosis through biopsy or autopsy represents a significant hurdle to understanding and managing the disease. In this article, we present the pathological findings of AIE and review the literature based on a distinct case of AIE presenting as CD8+ T-lymphocyte predominant encephalitis. We describe the clinical progression, diagnostic imaging, laboratory data, and autopsy findings of an 80-year-old deceased male patient. The patient was diagnosed with pulmonary tuberculosis 6 months before death and received appropriate medications. A week before admission to the hospital, the patient manifested symptoms such as a tendency to sleep, decreased appetite, and confusion.Although the patient temporally improved with medication including correction of hyponatremia, the patient progressed rapidly and died in 6 weeks. The brain tissue revealed lymphocytic infiltration in the gray and white matter, leptomeninges, and perivascular infiltration with a predominance of CD8+ T lymphocytes, suggesting a case of AIE. There was no detectable evidence of viral infection or underlying neoplasm. The autopsy revealed that this patient also had Alzheimer’s disease, atherosclerosis, arteriolosclerosis, and aging-related tau astrogliopathy. This report emphasizes the pivotal role of pathological examination in the diagnosis of AIE, especially when serological autoantibody testing is not available or when a patient is suspected of having multiple diseases.

Transvenous implantable cardioverter defibrillators are a type of implantable cardiac device. They are effective at reducing total and arrhythmic mortality in patients at risk of sudden cardiac death. Subcutaneous implantable cardioverter defibrillators (S-ICDs) are a new alternative that avoids the disadvantages of transvenous lead placement. In this case series, we report on the initial feasibility and safety of S-ICD implantation in Singapore.
Adult ; Death, Sudden, Cardiac ; prevention & control ; Defibrillators, Implantable ; statistics & numerical data ; Electrophysiology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Safety ; Prosthesis Implantation ; Singapore ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND: Neutrophils are considered to play critical roles in the development of acute respiratory distress syndrome. Histamine, which is distributed abundantly in lung tissue, increases the rolling of neutrophills via increase of P-selectin expression on the surface of endothelial cells and is known to have some interrelationships with IL-1, IL-8 and TNF-alpha. We studied to investigate the effect of the histamine on the acute lung injury of the rats induced by intratracheal insufflation of TNF-alpha which has less potency to cause lung injury compared to IL-1 in rats. METHODS: We intratracheally instilled saline or TNF(R&D, 500ng), IL-1(R&D, 50ng)or histamine of varius dose(1.1, 11 and 55 microg/kg) with and without TNF separately in Sprague-Dawley rats weighing 270-370 grams. We also intratracheally treated IL-l(50ng) along with histamine(55 microg/kg). In cases, there were synergistic effects induced by histamine on the parameters of TNF-induced acute lung injury, antihistainmes(Sigma, mepyramine as a H1 receptor blockade and ranitidine as a H2 receptor blockade, 10 mg/kg in each)were co-administered intravenously to the rats treated TNF along with histamine(1.1 microg/kg) intratracheally. Then after 5 h we measured lung lavage neutrophil numbers, lavage cytokine-induced neutrophil chemoatt- ractants(CINC), lung myeloperoxidase activity(MPO) and lung leak. We also intratracheally insufflated TNF with/without histamine(11 microg/kg), then after 24 h measured lung leak in rats. Statistical analyses were done by Kruskal-Wallis nonparametric ANOVA test with Dunn's multiple comparison test or by Mann-Whitney U test. RESULTS: We found that rats given TNF, histamine alone(11 and 55 microg/kg), and TNF with histamine(1.1, 11, and 55 microg/kg) intratracheally had increased (P<0.05) lung MPO activity compared with saline-treated control rats. TNF with histamine 11 microg/kg had increased MPO activity (P=0.0251) compared with TNF-treated rats. TNF and TNF with histamine(l.l, 11,, and 55 microg/kg) intratracheally had all increased (P<0.05) lung leak, lavage neutophil numbers and lavage CINC activities compared with saline. TNF with histamine 1.1 microg/kg had increased (P=0.0367) lavage neutrophil numbers compared with TNF treated rats. But there were no additive effect of histamine with TNF compared with TNF alone in acute lung leak on 5 h and 24 h in rats. Treatment of rats with the H1 and H2 antagonists resulted in inhibitions of lavage neutrophil accumulations and lavage CINC activity elevations elicited by co-treated histamine in TNF-induced acute lung injury intratracheally in rats. We also found that rats given IL-1 along with histamine intratracheally did not have increase in lung leak compared with IL-1 treated rats. CONCLUSION: Histamine administered intratracheally did not have synergistic effects on TNF-induced acute lung leak inspite of additive effects on increase in MPO activity and lavage neutrophil numbers in rats. These observations suggest that instilling histamine intratracheally would not play synergistic roles in neutrophil-mediated acute lung injury in rats.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Endothelial Cells ; Histamine* ; Insufflation ; Interleukin-1 ; Interleukin-8 ; Lung ; Lung Injury ; Neutrophils ; P-Selectin ; Peroxidase ; Pyrilamine ; Ranitidine ; Rats* ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha

Objective: To determine the association between Dialysis Malnutrition Score (DMS), hypoglycemia and quality of life among patients with Diabetes on Maintenance Hemodialysis (MHD). Methodology: Ninety-two diabetic patients on maintenance hemodialysis were assessed using a standardized data collection tool, Dialysis Malnutrition Score, WHOQoL-BREF questionnaire, anthropometric measurements and hourly blood sugar monitoring during the dialysis session. Association among DMS, hypoglycemia and quality of life were assessed along with other associated variables. Results: Based on the DMS, 62% of patients were malnourished. Those with malnutrition were significantly older (p=0.0006) and female (p=0.013). Only 6.5% of the participants developed hypoglycemia during dialysis. Those with poor nourishment in the DMS showed a significant trend of decrease in the quality of life (physical (p<0.001), psychological (p<0.001) and social (p=0.004) and is associated with the occurrence of hypoglycemia (p<0.001). Conclusion Malnutrition is prevalent in diabetic patients on MHD using DMS. A higher DMS score is highly correlated with increased risk of hypoglycemia and decreased quality of life hence detection of malnutrition is important to prevent further nutritional depletion, hypoglycemia and poor patient outcomes by implementing preventive measures such as nutritional counselling and psychosocial interventions.
Malnutrition ; Hypoglycemia ; Quality of Life ; Dialysis

INTRODUCTION: Singapore has one of the world's most rapidly ageing populations. Osteoporosis is associated with significant morbidity and mortality from hip fractures in the elderly. This pilot study aims to evaluate the knowledge, attitude and practice of osteoporosis among Singaporean women aged ≥ 65 years, and assess barriers to osteoporosis screening. METHODS: We conducted a cross-sectional survey of 99 English-speaking women aged ≥ 65 years at two SingHealth polyclinics by convenience sampling. The validated Osteoporosis Prevention and Awareness Tool was used to assess their knowledge about osteoporosis prevention and awareness and perceived barriers to osteoporosis screening. Osteoporosis health education was provided, and bone mineral density (BMD) screening was offered to all participants. RESULTS: The response rate was 91.6%. The majority of the participants (54.5%) had low knowledge of osteoporosis, and only 12.1% had high knowledge scores. Higher education levels were associated with higher knowledge scores (p = 0.018). Although participants with higher knowledge scores were more willing to undergo osteoporosis screening, these findings did not reach statistical significance (p = 0.067). The top reasons for declining BMD testing were misconceptions that lifestyle management is sufficient to prevent osteoporosis, poor awareness and knowledge of the disease, and the perceived high cost of BMD testing. CONCLUSION Interventions should focus on osteoporosis education and, eventually, BMD screening for less-educated patients. Health education should rectify common misconceptions of the disease, increase awareness of osteoporosis and improve screening rates.