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Search Results: 1 - 10 of 139942 matches for " Loren K. Spencer "
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Ankle Arthroscopy, Lateral Ligament Repair and Peroneal Tendon Reefing for Chronic Lateral Ankle Instability: The Triad vs Arthroscopy with Ligament Repair  [PDF]
John J. Anderson, Loren K. Spencer, Zflan Fowler
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.69058
Abstract: Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its modifications. An ankle arthroscopy is an adjuvant procedure to address any intra-articular pathology. We review our results of two study groups. The first group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and excision of low lying peroneal muscle belly with tightening of the inferior peroneal retinaculum. The triad technique was performed on 97 patients and results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure. The patients were contacted at a mean follow-up time of 30 months for postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were also asked to report incidence of ankle sprain recurrence. The average postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89 for the arthroscopic debridement and Brostrom-Gould group. The average overall satisfaction was 98% in the triad group and 91% in the scope and Brostrom group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the Brostrom-Gould with scope group. Each group had a similar incidence of wound healing complications. Peroneal tendon and retinacular pathology contributes to continued ankle instability and pain. We believe that the triad procedure is superior to the Brostrom-Gould procedure.
Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review
John J. Anderson,Kelly J. Wallin,Loren Spencer
Diabetic Foot & Ankle , 2012, DOI: 10.3402/dfa.v3i0.10204
Abstract: We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean healing time for those without complications was 4.9 weeks (3 to 10 weeks). Overall complication rate was 2.8%. Patients with a STSG take of less than 95% had a mean healing time of 7.9 weeks compared to 4.8 weeks for those with a STSG take of 100% (p<0.001). The use of autologous STSG for treatment of non-healing diabetic foot and leg wounds is a viable method for soft tissue closure and may present a low complication rate and a satisfactory rate of healing.
A comparison of diabetic smokers and non-smokers who undergo lower extremity amputation: a retrospective review of 112 patients
J. Joseph Anderson,Joshua Boone,Myron Hansen,Loren Spencer
Diabetic Foot & Ankle , 2012, DOI: 10.3402/dfa.v3i0.19178
Abstract: Background : A diabetic foot or lower extremity amputation may be exacerbated by or related to the smoking habits and history of the patient. Patients and methods : Of the 112 diabetic patients in this retrospective study, 46 were non-smokers and 66 were smokers. The smokers were further categorized into patients who: 1) did not cease smoking; 2) ceased in the immediate post-operative period but resumed within 3 months; and 3) ceased up to and at the 3-month post-operative period. The patients were also divided by their amputation level of forefoot, midfoot/rearfoot, and proximal leg. Results : Smoking diabetic patients underwent more amputations, as well as more proximal amputations than those who did not smoke. The higher amount of smoking in pack years followed an increasing trend of more proximal amputations as well. Conclusion : Neither the amputation level nor the amputation itself was enough motivation for the patients to participate in smoking cessation.
Use of Early Goal-Directed Therapy in the Emergency Department before and after the Sepsis Trilogy  [PDF]
Loren K. Reed, Benton R. Hunter, Tyler M. Stepsis
Open Journal of Emergency Medicine (OJEM) , 2016, DOI: 10.4236/ojem.2016.42005
Abstract: The management of sepsis evolved recently with the publication of three large trials (referred to as the sepsis trilogy) investigating the efficacy of early goal-directed therapy (EGDT). Our goal was to determine if the publication of these trials has influenced the use of EGDT when caring for patients with severe sepsis and septic shock in the emergency department (ED). In February 2014, we surveyed a sample of board-certified emergency medicine physicians regarding their use of EGDT in the ED. A follow-up survey was sent after the publication of the sepsis trilogy. Data was analyzed using 95% confidence intervals to determine if there was a change in the use of EGDT following the publication of the above trials. Subgroup analyses were also performed with regard to academic affiliation and emergency department volume. Surveys were sent to 308 and 350 physicians in the pre-and post-publication periods, respectively. Overall, ED use of EGDT did not change with publication of the sepsis trilogy, 48.7% (CI 39.3% - 58.2%) before and 50.5% (CI 40.6% - 60.3%) after. Subgroup analysis revealed that academic-affiliated EDs significantly decreased EGDT use following the sepsis trilogy while nonacademic departments significantly increased EGDT use. Use of EGDT was significantly greater in community departments versus academic departments following the publication of the sepsis trilogy. There was no change overall in the use of EGDT protocols when caring for patients with severe sepsis and septic shock, but subgroup analyses revealed that academic departments decreased their use of EGDT while community departments increased use of EGDT. This may be due to varying rates of uptake of the medical literature between academic and community healthcare systems.
Sensitivity Evaluation of Two Human Breast Cancer Cell Lines to Tamoxifen through Apoptosis Induction  [PDF]
Spencer Keene, Charles Azuelos, Shyamal K. Majumdar
Open Journal of Apoptosis (OJApo) , 2014, DOI: 10.4236/ojapo.2014.34008
Abstract: Tamoxifen citrate (TAM) has been used to treat breast cancer in women for many years. The com-parative effects of TAM in inducing apoptosis were evaluated in estrogen receptor-positive (ER- positive MCF-7) and estrogen receptor-negative (ER-negative MDA-MB-231) human breast cancer cell lines in vitro in order to determine if these two cell lines differ in their sensitivity to TAM. Mi-tochondrial membrane permeability potential disruption was assessed in both cell lines by a lip-ophilic cationic dye (DePsipher assay, Trevigen, Inc.) utilizing fluorescence microscopy. Using this specific fluorochrome, we were able to associate mitochondrial membrane disruption to early, mid-, and late apoptotic cells. TAM induced cell death via apoptosis in both ER-positive and ER- negative cells, however, apoptosis induction was more pronounced in ER-positive MCF-7 compared to ER-negative MDA-MB-231 breast cancer cells. These findings may have some therapeutic use in the treatment of estrogen dependent and estrogen independent breast cancer.
Lean Revolution and the Human Resource Aspects
Ifechukwude K. Dibia,Spencer Onuh
Lecture Notes in Engineering and Computer Science , 2010,
Lean Culturerization: A Long Term Philosophy for Full Optimization of the Human Resource
Ifechukwude K. Dibia,Spencer Onuh
Lecture Notes in Engineering and Computer Science , 2010,
Characterization of the Rac guanine nucleotide exchange factor P-Rex1 in platelets
Joseph E Aslan, Alex M Spencer, Cassandra P Loren, Jiaqing Pang, Heidi C Welch, Daniel L Greenberg, Owen JT McCarty
Journal of Molecular Signaling , 2011, DOI: 10.1186/1750-2187-6-11
Abstract: Here, we demonstrate that Rac1 captures the Rac guanine nucleotide exchange factor P-Rex1 from platelet lysates. Western blotting experiments confirmed that P-Rex1 is expressed in platelets and associated with Rac1. To investigate the functional role of platelet P-Rex1, platelets from P-Rex1-/--deficient mice were treated with platelet agonists or exposed to platelet activating surfaces of fibrinogen, collagen and thrombin. Platelets from P-Rex1-/- mice responded to platelet agonists and activating surfaces similarly to wild type platelets.These findings suggest that P-Rex1 is not required for Rac1-mediated platelet activation and that the GEF activities of P-Rex1 may be more specific to GPCR chemokine receptor mediated processes in immune cells and tumor cells.Upon exposure to agonist signals of vascular injury, platelets spread out on sites of vessel damage to form thrombotic plugs [1,2]. During this process, platelets undergo an ordered series of shape changes that are determined by a spatial reorganization of the actin cytoskeleton [3]. These geometric changes that occur in the activated platelet are regulated by many of the same proteins that confer motility and regulate the cytoskeleton in nucleated cells, namely the Rho family of GTPases, including Cdc42, Rac1, and RhoA [4]. Accordingly, conditional knock-out mice models deficient in Rac1 do not undergo normal platelet spreading or aggregation and form a weak primary platelet plug over a site of vascular injury [5]. Similarly, constitutive deactivation of RhoA in platelets results in reduced platelet adhesion and an unstable thrombus [6].Rho family GTPases are regulated in a cyclical manner by different classes of Rho-GTPase binding proteins. When platelets are stimulated to form a plug over the site of vascular injury, guanine nucleotide exchange factors (GEFs) such as Vav1 bind the Rac1 GTPase in its GDP conjugated form and catalyze a nucleotide exchange reaction to form Rac1-GTP [7]. Rac1-GTP is then able
Air Plasma Spray for First Aid  [PDF]
Spencer Kuo
Open Journal of Emergency Medicine (OJEM) , 2016, DOI: 10.4236/ojem.2016.43010
Abstract: Hemorrhage during trauma occurred in emergency situations is a significant challenge. It may be life threatening if it is not treated swiftly. A new device which can effectively stop bleeding to save life of injured person, especially in battlefield situations and accidents, is presented. A plasma generator is designed to generate a low temperature air plasma spray for treating wounds. The spectral spike at 777.4 nm in the emission spectrum of the plasma plume and the spatial distribution of this emission line’s spectral intensity indicate that abundant atomic oxygen is generated and sprays out of the generator by about 25 mm. Atomic oxygen carried by the plasma spray can quickly activate the cascading of coagulation processes and works as dry disinfectant to advance healing. Tests on blood droplets reveal the strong dependence of blood clotting on the amount of atomic oxygen applied in the plasma treatment, which is maneuvered by increasing the plasma treatment time or decreasing the exposure distance; in both approaches, the degree of blood clotting increases. Treated smeared blood samples show that an increase of the erythrocyte concentration and a drastic decrease of the platelet count are also correlated to the increase of atomic oxygen dose applied in the plasma treatment. The results reveal the mechanisms of air plasma blood coagulation and wound healing. As animal models, pigs were used in the tests of stopping wound bleeding from a cross cut in the ham area, from a hole in an ear’s saphenous vein, and from cuts to arteries in an ear and in a real leg, all stopped swiftly. Moreover, both artery cuts were secure to remove tourniquet; downgrade of tourniquet necessary wound in under 2 minutes was demonstrated. The healing progress of cross cut wounds was observed. The healing time was shortened to about half. This battery power plasma spray can be carried to or placed at anywhere available for first aid applications. It stops bleeding swiftly to save life, and also downgrades tourniquet necessary wound to extend the golden period of saving the remaining part below tourniquet.
On Hemostasis of Cold Atmospheric Air Plasma  [PDF]
Spencer Kuo
Open Journal of Emergency Medicine (OJEM) , 2018, DOI: 10.4236/ojem.2018.64012
Abstract: The efficacy and mechanism of a cold atmospheric-pressure air plasma (CAAP), which carries abundant atomic oxygen (OI), on blood coagulation are studied. The tests on sodium citrate mixed blood-droplet samples show that 1) The heat delivered by the CAAP has no impact on the observed clot formation, 2) Plasma effluent activates platelets to promote coagulation state and cascade, and 3) The degree of clotting increases with the OI flux delivered by the CAAP. The full clotting time is shortened from about 25 minutes of the natural clotting time to about 16 s of the CAAP treatment time. The tests on smeared blood samples show that the reduction of the platelet count and the increase of RBC count are proportional to the applied OI flux. In vivo tests, using swine as nimal model, swift hemostasis of large and deep cut wounds on the back by the CAAP treatment was demonstrated. A cut artery was sealed completely with 25 s treatment. The pressure applied by a finger on the cut artery could be removed immediately after the treatment and there was no re-bleed. Based on the in vitro test results and the animal model trials, CAAP coagulation mechanism is presented.
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