Lipid membranes composed of an iminodiacetic acid functionalized lipid, DSIDA, in a POPC matrix exhibited switchable properties via Cu(2+) recognition to rapidly assemble microdomains that act as high affinity sites for His-tagged proteins. The microdomains demonstrated an order of magnitude enhanced affinity for the proteins compared to homogeneously functionalized POPC membranes with Ni(2+)-NTA DOGS or Cu(2+)-DOIDA, while a rapid release and restoration of the original membrane was accomplished with micromolar concentrations of EDTA.

Telemedicine in the U.S. military has provided valuable dermatology support to providers in remote locations by delivering appropriate and timely consultation for military service members and coalition partners. In addition to avoiding unnecessary medical evacuations, the program facilitated appropriate evacuations that may otherwise have been delayed.

To study the efficacy of vagus nerve stimulation (VNS) therapy as an adjunctive treatment for intractable epilepsy in patients under 12 years of age, we analyzed 2-year postimplant data of 35 consecutive patients. Of the 35 patients, 18 (51.4%) at 6 months, 18 (51.4%) at 12 months, and 21 (60.1%) at 24 months showed ≥50% reduction in seizure frequency (responders). Although incremental seizure freedom was noted, no patient remained seizure-free throughout the 3 study periods. Partial response (≥50% seizure reduction in 2 or less study periods) was seen in 8 (22.9%) patients. Twelve patients (34.3%) were nonresponders. Out of 29 patients with primary generalized epilepsy, 20 (68.9%) and, out of 6 patients with focal epilepsy, 3 (50%) had ≥50% seizure control in at least one study period. No major complications or side effects requiring discontinuation of VNS therapy were encountered. We conclude that (1) patients with intractable primary generalized epilepsy respond better to VNS therapy, (2) cumulative effect of neuromodulation with improving responder rate to seizure freedom with continuation of VNS therapy is noted, and (3) VNS therapy is safe and is well tolerated in children receiving implant under 12 years of age.

No abstract

To establish efficacy of vagus nerve stimulation (VNS) therapy in the treatment of intractable epilepsy, we compared outcome data from the baseline period to the maintenance period (7 to 24 months post-implant) by calculating the mean seizure frequency at 6-month intervals (7 to 12 months-first study period, 13 to 18 monthssecond study period, and 19 to 24 months-third study period), in 39 consecutive patients on unchanged antiepilepsy drug (AED) regimen for 24 months following the VNS implant. Of the 39 patients24 (61.5%) at first study period, 25 (64.1 %) at second study period and 25 (64.1 %) at third study period were responders (≥50% reduction in seizures). Twenty one (53.9 %) patients were responders in all three study periods. Incremental seizure control was seen in 15 of these 21 patients. Although 3 (7.7%), 4 (10.3 %) and 8 (20.5%) patients had a total (100%) seizure control at first, second and third study periods respectively, no patient remained seizure-free through all 3 study periods. Seven (17.9%) patients were partial responders (≥ 50% seizure reduction in two or less study periods). Eleven patients (28.2%) were non-responders (< 50% seizure reduction in all 3 study periods). Twenty three patients (59%) had partial epilepsy with and without secondarily generalization and 16 patients (41%) had primary generalized epilepsy. Eleven (47.8%) of the 23 patients with partial epilepsy and 10 (62.5%) of the 16 patients with generalized epilepsy were responders in all three study periods. We conclude that: 1) More than 60 % of patients on unchanged AED regimen continued to be responders at 24 months following the VNS implant. 2) A trend towards increasing responder rate with increasing duration of VNS therapy was observed.3) No major complications or side effects requiring discontinuation of VNS therapy were noted.