BIOE 402. Medical Technology Assessment. 2 or 3 hours. Bioentrepreneur course. Assessment of medical technology in the context of commercialization. Objectives, competition, market share, funding, pricing, manufacturing, growth, and intellectual property; many issues unique to biomedical products. Course Information: 2 undergraduate hours. 3 graduate hours. Prerequisite(s): Junior standing or above and consent of the instructor.

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羟氨苄青霉素引起大疱性类天疱疮样疹

Applications of nanotechnology for treatment, diagnosis, monitoring, and control of biological systems has recently been referred to as "nanomedicine" by the National Institutes of Health. Research into the rational delivery and targeting of pharmaceutical, therapeutic, and diagnostic agents is at the forefront of projects in nanomedicine. These involve the identification of precise targets (cells and receptors) related to specific clinical conditions and choice of the appropriate nanocarriers to achieve the required responses while minimizing the side effects. Mononuclear phagocytes, dendritic cells, endothelial cells, and cancers (tumor cells, as well as tumor neovasculature) are key targets. Today, nanotechnology and nanoscience approaches to particle design and formulation are beginning to expand the market for many drugs and are forming the basis for a highly profitable niche within the industry, but some predicted benefits are hyped. This article will highlight rational approaches in design and surface engineering of nanoscale vehicles and entities for site-specific drug delivery and medical imaging after parenteral administration. Potential pitfalls or side effects associated with nanoparticles are also discussed.

https://www.cpe.vt.edu/globaltechseminars/downloads/nanomedicine_applications.pdf

Nanomedicine: current status and future prospects

Guidelines and Expert Consensus documents aim to present management and recommendations based on all of the relevant evidence on a particular subject in order to help physicians to select the best possible management strategies for the individual patient, suffering from a specific condition, taking into account not only the impact on outcome, but also the risk benefit ratio of a particular diagnostic or therapeutic procedure. The ESC recommendations for guidelines production can be found on the ESC website†.

In brief, the ESC appoints experts in the field to carry out a comprehensive and critical evaluation of the use of diagnostic and therapeutic procedures and to assess the risk–benefit ratio of the therapies recommended for management and/or prevention of a given condition. The strength of evidence for or against particular procedures or treatments is weighed according to predefined scales for grading recommendations and levels of evidence, as outlined below. Once the document has been finalized and approved by all the experts involved in the Task Force, it is submitted to outside specialists for review. If necessary, the document is revised once more to be finally approved by the Committee for Practice Guidelines and selected members of the Board of the ESC.

The ESC Committee for Practice Guidelines ( CPG ) supervises and coordinates the preparation of new Guidelines and Expert Consensus Documents produced by Task Forces, expert groups, or consensus panels. The chosen experts in these writing panels are asked to provide disclosure statements of all relationships they may have, which might be perceived as real or potential conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. The Committee is also responsible for the endorsement of these Guidelines and Expert Consensus Documents or statements.

 
| Classes of recommendations |
|:-------------------------- | ------------------------------------------------------------------------------------------------------------------------ |
| Class I | Evidence and/or general agreement that a given diagnostic procedure/treatment is beneficial, useful, and effective |
| Class II | Conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the treatment or procedure |
|  Class IIa | Weight of evidence/opinion is in favour of usefulness/efficacy |
|  Class IIb | Usefulness/efficacy is less well established by evidence/opinion |
| Class III | Evidence or general agreement that the treatment or procedure is not useful/effective and, in some cases, may be harmful |

Diabetes and cardiovascular diseases (CVD) often appear …

/pdf/guidelines-on-diabetes-pre-diabetes-and-cardiovascular-4j63bs7fb2.pdf

Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD).

https://www.cell.com/cell/pdf/S0092-8674(13)01546-8.pdf

What We Talk About When We Talk About Fat

F irst described in 1964, 1 yellow nail syndrome is a clinical presentation that continues to elude clinicians and lymphatic investigators. The condition has a perplexing relationship to respiratory disease and is a cause of both morbidity and accelerated mortality. The genetic substrate of this condition, at times familial or congenital, remains unresolved. Of interest to the readers of Lymphatic Research and Biology is the fact that yellow nail syndrome has an unquestioned relationship to the presentation of primary lymphedema, yet the question remains: Is lymphatic dysfunction responsible for all of the seemingly disparate components of the clinical presentation of this syndrome? In the current issue of the journal, Cousins et al. have addressed this question in a case-control investigation of yellow nail syndrome. The investigators performed four-limb qualitative and quantitative lymphoscintigraphy in affected individuals and in healthy, age-matched controls. The results suggest that yellow nail syndrome is, indeed, associated with a generalized lymphatic phenotype: The presence of the syndrome correlates with both upper and lower limb lymphatic dysfunction confirmed by this imaging modality. Furthermore, quantitative analysis of tracer uptake confirms a significant reduction in the affected individuals. Taken together, these findings strongly support the lymphatic substrate of this perplexing clinical presentation. The next mystery to solve is the nature of the lymphatic abnormality and its relationship to the extra-lymphatic manifestations of yellow nail syndrome.

Yellow Nail Syndrome: A Mystery, Partially Solved.

Secondary lower limb lymphedema (LLL) is commonly associated with surgical excision of inguinofemoral lymph nodes and/or radiation of the respective node-bearing areas. The condition of LLL presents as progressive swelling of one leg or both, most typically within the first 12 months after the treatment for cancer. Once it develops, it is typically unremitting and often progressive. The incidence of, and risk factors for, LLL will vary depending on cancer type and treatment regimen. LLL is one of the important survivorship issues reported after cancer treatment, aggravating financial difficulties and impacting on quality of life.


Secondary lower limb lymphedema (LLL) is commonly associated with surgical excision of inguinofemoral lymph nodes and/or radiation of the respective node-bearing areas.


The incidence of, and risk factors for, LLL vary depending on cancer type and treatment regimen.


The most common timing of the onset of LLL is within the first year following treatment.


LLL is the most frequent problem impacting quality of life after cancer treatment of the relevant neoplasms.

Lower Extremity Cancers

A Role for Ultrasonography in the Diagnostic Evaluation of Lymphedema.

Alzheimer's Disease: Can the Meningeal Lymphatics Provide the Answer?

The lymphatics are essential for the maintenance of tissue fluid homeostasis. Accordingly, lymphatic dysfunction contributes to lymphedema. In development, lymphangiogenesis often requires lymphatic endothelial cell (LEC) lineage specification from the venous ECs and subsequent LEC proliferation and migration, all of which are regulated by the VEGFC/VEGFR3 signaling. Cholesterol is essential for proper cell functions and organ development, yet the molecular mechanism by which cholesterol metabolism controls lymphangiogenesis is unknown. We show that the secreted protein, ApoA1 binding protein (AIBP), dictates lymphatic vessel formation by accelerating cholesterol efflux. Loss of Aibp2, the human paralog in zebrafish, impairs LEC progenitor specification and impedes lymphangiogenesis. Mechanistically, we found that caveolin-1 (CAV-1) suppresses VEGFR3 activation in LECs, and that AIBP-regulated cholesterol efflux disrupts lipid rafts/caveolae and reduces CAV-1 bioavailability, which abolishes the CAV-1 inhibition of VEGFR3 signaling, thereby augmenting VEGFR3 activation and increasing lymphangiogenesis. Enhancement of cholesterol efflux with ApoA1 overexpression or inhibition of cholesterol biosynthesis using atorvastatin restores proper lymphangiogenesis in Aibp2 mutant zebrafish. Loss of Cav-1 increases LEC progenitor specification in zebrafish, and rescues lymphangiogenesis in Aibp2-deficient animals. Recombinant AIBP supplement confers profound LEC fate commitment in the mouse embryonic stem cells (mESC) to LEC differentiation model. Furthermore, enhancement of AIBP-CAV-1-VEGFR3 signaling axis promotes VEGFC-engaged adult lymphangiogenesis in mice. Consistent with these data, AIBP expression is reduced in the epidermis of human lymphedematous skin. These studies identify that AIBP-mediated cholesterol efflux is a critical contributor for lymphangiogenesis. Our studies will provide a new therapeutic avenue for the treatment of lymphatic dysfunctions. One Sentence Summary Our studies identify that AIBP-CAV-1-VEGFR3 axis enhances VEGFC-elicited lymphangiogenesis, which will guide a new therapeutic strategy for the treatment of lymphatic dysfunctions.

/pdf/aibp-cav1-vegfr3-axis-dictates-lymphatic-cell-fate-and-it7fuaiuch.pdf

Stanley G. Rockson

Papers

Yellow Nail Syndrome: A Mystery, Partially Solved.

Lower Extremity Cancers

A Role for Ultrasonography in the Diagnostic Evaluation of Lymphedema.

Alzheimer's Disease: Can the Meningeal Lymphatics Provide the Answer?

AIBP-CAV1-VEGFR3 axis dictates lymphatic cell fate and controls lymphangiogenesis