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The Immune System – stanfordchildrens.org

October 8th, 2019 6:43 am

What is the immune system?

The immune system protects your child's body from outside invaders. These include germs (such as bacteria, viruses, and fungi) andtoxins (chemicals made by microbes). The immune system is made up of different organs, cells, and proteins that work together.

There are 2 main parts of the immune system:

The innate immune system. You are born with this.

The adaptive immune system. You develop this when your body is exposed to microbes or chemicals released by microbes.

These 2 immune systems work together.

This is your child's rapid response system. It is the first to respond when it finds an invader. It is made up of the skin, the eye's cornea, and the mucous membrane that lines the respiratory, gastrointestinal, and genitourinary tracts. These all create physical barriers to help protect your child's body. They protect against harmful germs, parasites (such as worms), or cells (such as cancer). The innate immune system is inherited. It is active from the moment your child is born. When this system recognizes an invader, it goes into action right away. The cells of this immune system surround and cover the invader. The invader is killed inside the immune system cells (called phagocytes).

The acquired immune system, with help from the innate system, makes cells (antibodies) to protect your body from a specific invader. These antibodies are developed by cells called B lymphocytes after the body has been exposed to the invader. The antibodies stay in your child's body.It can take several days for antibodies to form. But after the first exposure, the immune system will recognize the invader and defend against it. The acquired immune system changes during your child's life. Immunizationstrain your child's immune system to make antibodies to protect him or her from harmful diseases.

The cells of both parts of the immune system are made in different organs of the body, including:

Adenoids. Two glands located at the back of the nasal passage.

Bone marrow. The soft, spongy tissue found in bone cavities.

Lymph nodes. Small organs shaped like beans, which are located all over the body and connect via the lymphatic vessels.

Lymphatic vessels. A network of channels all over the body that carries lymphocytes to the lymphoid organs and bloodstream.

Peyer's patches. Lymphoid tissue in the small intestine.

Spleen. A fist-sized organ located in the belly (abdominal) cavity.

Thymus. Two lobes that join in front of the windpipe (trachea) behind the breastbone.

Tonsils. Two oval masses in the back of the throat.

Antibiotics can be used to help your child's immune system fight infections by bacteria. But antibiotics dont work for infections caused by viruses. Antibiotics were developed to kill or disable certain bacteria. That means that an antibiotic that works for a skin infection may not work to cure diarrhea caused by bacteria. Using antibiotics for viral infections or using the wrong antibiotic to treat a bacterial infection can help bacteria become resistant to the antibiotic so it won't work as well in the future.It's important to take antibiotics as prescribed and for the right amount of time.If antibiotics are stopped early, the bacteria may develop a resistance to the antibiotics. Then the infection may come back again.

Most colds and acute bronchitis infections won't respond to antibiotics.You can help decrease the spread of more aggressive bacteria by not asking your childs healthcare provider for antibiotics in these cases.

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Triad Regenerative Medicine – Greensboro, NC

October 8th, 2019 6:43 am

The Future of Medicine is Here!

To help you return to the activities you love, our expert team at Triad Regenerative Medicine now offer Regenerative Cell Therapy procedures to help alleviate your pains without relying on complex surgical procedures or medication.

Of all bodily ailments, nothing is more painful and crippling than the persistent knee, hip or shoulder pain. Unfortunately, any damage to the ligaments, cartilage or bone by way of injury or disease (such as osteoarthritis), can cause severe pain and difficulty walking or partaking in your favorite activities. To help you return to the activities that you love, our expert team at Triad Regenerative Medicine now offer Regenerative Cell Therapy, based on a 21st-century therapeutic procedure to help alleviate your shoulder, hip, and knee pains without relying on complex surgical procedures or medication.

Regenerative Cell Therapy is one of the most effective treatments today that help the body to heal and regenerate tendon injuries, ligament damage, degenerative joint disease DJD and osteoarthritis. This procedure is non-invasive and harnesses your bodys natural healing potential to combat shoulder, hip and knee problems by the newly introduced cells stimulating existing healthy cells and tissues to operate at a higher level of function boosting the bodys repair mechanisms to aid in the healing process. The whole procedure takes approximately 30 minutes and has no known adverse side effects.

Regenerative Cell Therapy is one of the safest and most advanced approaches to treating a wide variety of injuries and diseases within the human body.

Patients recovering from injuries will rapidly improve exhibiting a greater mobility and less pain, compared to the lengthy and exhaustive period of post-surgical healing and rehabilitation.

Regenerative Cellular Medicine has opened the doors to medical advancements. We have only just begun to explore the amazing benefits. Praised notes of success thus far include the reduction or elimination of pain, increased strength and mobility, and quicker healing and recovery.

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How to change positive numbers to negative … – ExtendOffice

October 8th, 2019 6:42 am

How can you quickly change all positive numbers or values to negative in Excel? The following methods can guide you to quickly change all positive numbers to negative in Excel.

Change positive numbers to negative with Paste Special function

Change positive numbers to negative with VBA code

Change positive numbers to negative or vice versa with Kutools for Excel

Change or convert positive numbers to negatives and vice versa:

With Kutools for Excels Change Sign of Values utility, you can change the positive numbers to negative or vice versa, reverse the sign of numbers, fix trailing negative signs, and so on.

You can change positive numbers to negative with Paste Special function in Excel. Please do as follows.

1. Tap number -1 in a blank cell and copy it.

2. Highlight the range that you want to change, then right-click and choose Paste Special from the context menu to open the Paste Special dialog box. See screenshot:

3. Then select All option from the Paste, and Multiply from the Operation.

4. And then click OK, all of the positive numbers have been changed to negative numbers.

5. At last, you can delete the number -1 as you need.

Using VBA code, you can also change positive numbers to negative, but you must know how to use a VBA. Please do as the following steps:

1. Select the range that you want to change.

2. Click Developer >Visual Basic, a new Microsoft Visual Basic for applications window will be displayed, click Insert > Moduleand then copy and paste the following codes in the module:

3. Click button to run the code, a dialog is popped out for you to select a range that you want to convert the posItive values to negative. See screenshot:

4. Click Ok, then the positive values in the selected range is converted to negative at once.

You can also use Kutools for Excels Change Sign of Values tool to quickly change all positive numbers to negative.

If you have installed Kutools for Excel, you can change positive numbers to negative as follows:

1. Select the range you want to change.

2. Click Kutools > Content > Change Sign of Values, see screenshot:

3. And in the Change Sign of Values dialog box, select Change all positive values to negative option.

4. Then click OK or Apply. And all of the positive numbers have been converted to negative numbers.

Tips: To change or convert all the negative numbers to positive, please choose Change all negative values to positive in the dialog box as following screenshot shown:

Kutools for Excels Change Sign of Values can also fix trailing negative signs, change all negative values to positive and so on. For more detailed information about Change Sign of Values, please visit Change Sign of Values feature description.

Click to Download and free trial Kutools for Excel Now!

Related articles:

Change negative numbers to positive

Reverse signs of values in cells

Fix trailing negative signs in cells

Kutools for Excel Solves Most of Your Problems, and Increases Your Productivity by80%

Office Tab Brings Tabbed interface to Office, and Make Your Work Much Easier

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11 Abnormal Pap Smear Causes You Should Know – HPV Negative?

October 8th, 2019 6:42 am

Many diseases that women suffer from could have been properly managed if they were detected and diagnosed early with health screening tests that are recommended to undergo regularly.

These medical checks are meant to detect traces or symptoms of serious health issues such as cancer or HPV infections, with a Pap Smear test is one of such screening procedures.

A Pap smear, also known as the Papanicolaou test, is a quick and relatively painless test carried out to screen for cancer or precancer symptoms in the cervix. Women are compelled to undergo regular Pap smear tests when they visit the gynecologist.

The process of carrying out a Pap smear test involves getting some of the cells in the patients cervix, and examining them under a microscope to see if there are any abnormal cells in the sample. The discovery of abnormal cells is an indication that the patient might be prone to suffering from cervical cancer or precancerous indication of cervical dysplasia.

The recommended next steps after a Pap smear test will depend on the kind of abnormality and other relevant results discovered in the cells diagnosis:

When Pap screening test results show abnormal, it is understandable that your first immediate reaction is shocked and alarmed, as abnormal Pap smears results may indicate there is abnormal cells or infection known as dysplasia.

According to Australia Cancer Council, around 1 in 10 Pap smears show abnormal results, with Human Papillomavirus (HPV) is the most common cause of abnormal Pap smears.

Further evaluation would be required to determine if the HPV strains discovered are high-risk HPV type that have the tendency to cause cancer, or its low-risk HPV types that can cause warts.There are over 100 different types of HPV, with the high-risk HPV16 and HPV18 strains cause 70% of cervical cancers and precancerous cervical lesions.

The distortion of normal cells features in the cervix can occur when high-risk HPV strains find their way into the cervix to work against the skin cells and make them abnormal. This is a medical condition called cervical dysplasia.

The low-risk HPV virus that causes genital warts can cause abnormal results on a Pap smear, says MedlinePlus. If you have these symptoms, you may need a colposcopy or more frequent Pap smears.

Having abnormal Pap smear does not mean you have cancer.

While the common cause of abnormal Pap smear test results is the presence of HPV, this is not an indication that the patient is definitely infected by HPV and has cervical cancer, because there are also patients who have HPV-negative abnormal pap smear test results without any HPV detected.

Dr. Duncan Burkholder discusses abnormal pap smear and HPV in brief video below.

According to the American Pregnancy Association, WebMD, Queensland Government, Medscape, and SteadyHealth

Besides HPV, the other abnormal Pap smear causes include vaginal infections as well as some common sexually transmitted diseases (STD) that can cause cervix inflammation and lead to abnormal Pap test results:

>> You Can Test Trichomoniasis, Chlamydia and Gonorrhea at Home with OTC Test Kit

As revealed by OncoLink, when the results of a Pap smear tests indicate the presence of atypical squamous cells of undetermined significance (ASCUS):

HPV test is reported as either HPV positive or HPV negative:

By conducting the tests above, the physicians will have more convincing evidence to back up the Pap smear tests. They would also know if the patient is being affected by other gynecological issues.

The standard process before the commencement of treatment is to carry out a Colposcopy, a typical biopsy with comprehensive study of tissue samples from the patients cervix with a microscope.

The results of the Colposcopy will determine the treatment process that should be started. At this stage, the level of abnormality of the cells would have been ascertained.

Treatment processes aim at eliminating the abnormal cells:

In video below, Dr. Stephen Buckley and Dr. discussed abnormal Pap smear treatment and steps to take following an abnormal Pap smear results depend on severity of cell changes.

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Chelsea Eye Ophthalmology, PLLC – LASIK Surgeon & LASIK …

October 8th, 2019 6:41 am

The renowned surgical director of our practice, Christopher T. Coad, MD, FACS has gathered a team of highly gifted staff to create a boutique practice in New York City that brings a comprehensive approach to patients vision, LASIK and cosmetic needs. Our state-of-the-artfacility boasts an art gallery in the reception area, a comfortable relaxed environment suggestive of a spa and an in-office surgical suite. Our doctors train other physicians and are often featured in the press.

Dr. Coad specializes in the most advanced vision correction procedures including LASIK, PRK, Visian ICL, premium intraocular lens implants, and no-stitch cataract surgery. He has been performing laser vision correction since its approval by the FDA in the early 1990s. Dr. Coad has been named a Top Doctor in Ophthalmology by Castle Connolly Medical.

Competitive prices, extended office hours, participation in most health care plans, and interest-free financing have helped us gain the trust of over 60,000 patients.

Giving Back to the CommunityWeve been serving our community for two decades and donate to organizations such as amfAR, Callen Lorde, ESPA, glaad, HRC, and The Little Baby Face Foundation. We have special programs to treat patients in financial need who suffer from HIV related lipodystrophy and are setting up a foundation to help treat victims of bullying and spousal abuse in the LGBT community. Our waiting room also serves as an art gallery to exhibit the work of local artists and fund charities. To find out more about the ways we support art and our community, visit us on Facebook.

Chelsea Eye Ophthalmology is downtown Manhattans leading eye care andlaser visioncenter. Founded in 1989, the facility expanded 10 years later to its present location in the heart of Chelsea's gallery district in NYC.

Dr. Coad specializes in the most advanced vision correction procedures includingLASIK,PRK,Visian ICL,premium intraocular lens implants, andno-stitch cataract surgery. He has been performing laser vision correction since its approval by the FDA in the early 1990s.

Dr. Jason Cheung, works closely with Dr. Coadto provide comprehensive eye care includingcontact lens servicesand treatments formedical eye conditions.

Competitive prices, extended office hours, participation in mosthealth care plans, andinterest-free financinghave helped us gain the trust of over 60,000 patients.

Giving Back to the CommunityWeve been serving our community for two decades and donate to organizations such as amfAR, Callen Lorde, ESPA, glaad, HRC, and The Little Baby Face Foundation. We have special programs to treat patients in financial need who suffer from HIV related lipodystrophy and are setting up a foundation to help treat victims of bullying and spousal abuse in the LGBT community. Our waiting room also serves as anart galleryto exhibit the work of local artists and fund charities. To find out more about the ways we support art and our community,visit us on Facebook.

"Im so happy I chose Dr. Coad as my physician for LASIK. I have been his patient for many years and we both felt the time was right for me to have the surgery." - Tracie Max Sachs, 5x World CupChampion Speed Skier, LASIK Patient

"I have had no problems, I see perfectly and I wish I had done this years agoDr. Coad is the best!!" - Mario Cantone, Actor, LASIK Patient

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American Journal of Preventive Medicine – Elsevier

October 7th, 2019 3:44 am

The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.

Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.

For information on the American College of Preventive Medicine (ACPM) and the Association for Prevention Teaching and Research (APTR), visit their web sites at the following URLs:http://www.acpm.org/ andhttp://www.aptrweb.org

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Genetic Counseling Program – medicine.umich.edu

October 7th, 2019 3:42 am

The University of Michigan Genetic Counseling Programis one of the most well established programs in the country and exemplifies our long history of innovation in clinical service and education in genetics and genomics. Michigan graduates emerge as extremely well rounded genetic counselors, who are ready to meet the current challenges in clinical genomic medicine and are able to help guide the evolving practice of genetic counseling and genomic medicine.

The vision of the University of Michigan Genetic Counseling Program is to train genetic counselors that are able to meet the current challenges and to help shape the future of genetic counseling and genomic medicine.

Our mission is to provide an individualized, integrated and supportive graduate training environment comprised of:

Most importantly, our graduate training program is responsive to the interests and unique needs of individual students.

For more information about the U-M Genetic Counseling Program see our2020 Program Prospectus.You can also join us at either of our 'Open House' events:

Introduction to the UMGCP-WebinarOctober 2, 2019; 4-5:30 pm

Introduction to the UMGCP-Open House in Ann ArborOctober 18, 2019; 3-5 pm

Click the above links for details about the event and information on how to RSVP!

Contact us at UMGenetics@umich.edu.

The University of Michigan Masters in Genetic Counseling program is accredited by the Accreditation Council for Genetic Counseling (ACGC), located at 4400 College Blvd., Ste. 220, Overland Park, KS 66211, web addresswww.gceducation.org. ACGC can be reached by phone at 913.222.8668.

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Genetic and Genomic Medicine – nationwidechildrens.org

October 7th, 2019 3:42 am

Services We Offer

Services we offer include:

Learn More About Our Services

A genetics consult starts with a phone call from a genetic counseling assistant. The assistant will gather information about the reason for the visit, obtain a detailed history of any problems in the family (which is called a pedigree) and possibly request medical records from other providers or hospitals. Sometimes, the assistant may need sensitive information. During this first contact, if you do not want to come for a full visit or have concerns about sharing sensitive information, please let us know.

The first appointment will take about two hours.If the person who is referred is a child, they MUST come to the visit. Plan to arrive at least 30 minutes before your appointment time to allow ample time to get registered, complete forms and have measurements taken (height, weight, blood pressure).

You will meet with several healthcare providers at this visit. This will include a genetic counselor, a genetic nurse practitioner or genetics physician, and possibly a metabolic dietician.

A consult with genetics is more than having genetic testing. It includes a full assessment that consists of taking a detailed history, reviewing outside medical records and performing a complete exam. We will discuss possible conditions, provide genetic counseling and review what may be needed to establish a diagnosis. A decision about whether testing is required, and what kind of tests should be performed, will be discussed at the first visit.

In most cases, testing will not be done at that time. If testing is recommended, we will work with your insurance to get prior authorization and let you know when to return for testing.

A return visit with the nurse practitioner, geneticist or genetic counselor is often needed when test results are available. Our team will go over what the results mean and discuss any next steps. Genetic counseling will be provided at every step to ensure you understand what the results mean for the patient and the family. Finally, any needed additional tests will be ordered, and a care plan with specific treatments, if available, will be made.

Clinical services are supported partly by the Ohio Department of Health as a Regional Genetics Center of the State of Ohio, Region IV.

Kim L. McBride, MD, MS, is Division Chief of Genetic and Genomic Medicine at Nationwide Children's Hospital.

Dennis W. Bartholomew, MD, is Section Chief of Genetic and Genomic Medicine and Director of the Biochemical Genetics Laboratory in the Department of Laboratory Medicine at Nationwide Childrens Hospital and a Clinical Professor of Pediatrics at The Ohio State University College of Medicine.

Genetics ClinicTower Building, 4th Floor, Suite D700 Children's DriveColumbus, OH 43205(614) 722-3535FAX (614) 722-3546Metabolic ClinicTower Building, 4th Floor, Suite D700 Childrens DriveColumbus, OH 43205(614) 722-3543FAX (614) 722-3546Dublin Genetics ClinicDublin Medical Office Building5665 Venture DriveDublin, OH 43017(614) 722-3535FAX (614) 722-3546Tuesdays all day

Westerville Genetics ClinicClose To Home Center on N. Cleveland AvenueWesterville, OH 43082(614) 722-3535FAX (614) 722-3546Mondays 12:30 pm 5:00pm

Athens Outreach278 W. Union StreetAthens, OH 45701To schedule, call: (614) 592-4431FAX (614) 594-9929Held bimonthly on a Wednesday

Marietta OutreachMarietta City Health Department304 Putnam StreetMarietta, OH 45750To schedule, call: (740) 373-0611FAX (740) 376-2008Held bimonthly on a Wednesday

Waverly OutreachPike County General Health District14050 US23 NWaverly, Ohio 45690To schedule, call: (614) 722-3535Fax referral to: (614) 722-3546Office Phone: (740) 947-7721Office Fax (740) 947-1109Held bimonthly on a Wednesday

Zanesville OutreachMuskingham Valley Health Care719 Adair AvenueZanesville, Ohio 43701To schedule, call: (614) 722-3535Fax referral to: (614) 722-3546Held bimonthly on a Wednesday

22q CenterNationwide Childrens Hospital700 Childrens DriveColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 962-6373

Complex Epilepsy Clinic (Epilepsy Center)Nationwide Childrens Hospital700 Childrens DriveColumbus, OH 43205(614) 722-6200FAX (614) 722-4000

Cleft Lip and Palate CenterNationwide Childrens Hospital700 Children's DriveSuite T5EColumbus, Ohio 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 962-6366Tues. 12:30 pm 5 pm

Cystic Fibrosis ClinicOutpatient Care Center, 5th Floor555 S. 18th StreetColumbus, OH 43205Phone: (614) 722-4766Fax: (614) 722-4755Tues PM, Wed PM, and Thurs PM

Down Syndrome Clinic (Developmental and Behavioral Pediatrics)Nationwide Childrens Hospital700 Childrens DriveColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 722-4050

Muscular Dystrophy Association(MDA)/Spinal Muscular Atrophy (SMA) ClinicOutpatient Care Center, 1st Floor555 S. 18th StreetColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 722-2203Wednesdays

Myelomeningocele Clinic (Developmental and Behavioral Pediatrics)Nationwide Childrens Hospital700 Childrens DriveColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 722-4050Friday AM

Prader-Willi Syndrome Clinic (Endocrinology)Outpatient Care Center, 5th Floor555 S. 18th StreetColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 722-44252nd Friday of the month

Williams Syndrome Clinic (Developmental and Behavioral Pediatrics)Nationwide Childrens Hospital700 Childrens DriveColumbus, OH 43205(614) 722-6200FAX (614) 722-4000Office phone (614) 722-40502nd Tuesday of the month

The mission of the Center for Gene Therapy is to investigate and employ the use of gene- and cell-based therapeutics for prevention and treatment of human diseases.

The Center for Cardiovascular Research conducts innovative research leading to improved therapies and outcomes for pediatric cardiovascular diseases and promotes cardiovascular health in adults.

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Integrative Medicine – Highland Oaks – wakehealth.edu

October 7th, 2019 3:42 am

This chart is a list of the most common health insurance plans we accept. This list is subject to change. Please check your individual plan to confirm their participation and the coverage allowed.

Due to the different physician groups and hospitals within the Wake Forest Baptist system, physician services and hospital services are billed separately. Please remember that health insurance coverage varies, so some services may not be covered.

If you dont see your plan or you have questions, please call our Customer Service Center at 877-938-7497. We will do our best to work with you and your plan.

WFUHS - Wake Forest University Health Sciences (professional services)NCBH - North Carolina Baptist HospitalLMC - Lexington Medical CenterCHC - Cornerstone HealthcareWilkes - Wilkes Regional Medical CenterHPR- High Point RegionalN/A - Not applicable to services provided at facility and/or CHCNC -Not Contracted, very low to no volume for facility and/or CHC

AETNA (PPO & HMO): Accepted at all locations

AETNA MEDICARE:Accepted at all locations

AETNA WHOLE HEALTH:Accepted at all locations

BCBSNC (PPO & HMO):Accepted at all locations

BLUE MEDICARE:Accepted at all locations

BLUE VALUE:Accepted at all locations

CAROLINA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

CIGNA: Accepted at all locations

CIGNA BEHAVIORAL HEALTH: Accepted at NCBH and High Point (not applicable to services provided at Davie, LMC, CHC and Wilkes)

CIGNA HEALTHSPRING MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC and CHC (not applicable to services provided at Wilkes and High Point)

CIGNA LIFESOURCE (TRANSPLANTS): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

COVENTRY/WELLPATH:Accepted at all locations

CRESCENT PPO (ASHEVILLE): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

DIRECT NET: Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

FIRST HEALTH (COVENTRY):Accepted at all locations

FIRSTCAROLINACARE (PINEHURST, NC): Accepted at NCBH (not contracted, very low to no volume for WFUHS, Davie, LMC, CHC, Wilkes and High Point)

GATEWAY HEALTH ALLIANCE (VIRGINIA):Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

GOLDEN RULE INS (UNITED):Accepted at all locations

HEALTHGRAM (formerly PRIMARY PHYSICIAN CARE): Accepted at WFUHS, NCBH and LMC (not contracted, very low to no volume for Davie, CHC, Wilkes and High Point)

HEALTHTEAM ADVANTAGE:Accepted at all locations

HUMANA CHOICECARE:Accepted at all locations

HUMANA MEDICARE ADVANTAGE:Accepted at all locations

LIBERTY ADVANTAGE (MEDICARE ADVANTAGE): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

MAGELLAN (BEHAVIORAL HEALTH): Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

MEDCOST:Accepted at all locations

MEDCOST ULTRA: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not applicable at CHC)

OPTUMHEALTH (TRANSPLANTS - APPLICABLE TO NCBH/WFUHS ONLY): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

PREFERRED CARE OF VA INC:Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

SOUTHERN HEALTH SVCS (COVENTRY-PPO ONLY): Accepted at WFUHS, NCBH, Davie and CHC (not contracted, very low to no volume for LMC, Wilkes and High Point)

TWIN COUNTY (VIRGINIA):Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

UNITED BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH, CHC and High Point (not applicable to services provided at Davie, LMC and Wilkes)

UNITED BEHAVIORAL HEALTH INTENSIVE OUTPATIENT PROGRAM (WFUHS ONLY): Accepted at WFUHS (not applicable for services provided at NCBH, Davie, LMC, CHC, Wilkes and High Point)

UNITED HEALTHCARE:Accepted at all locations

UNITED HEALTHCARE MEDICARE:Accepted at all locations

WELLPATH (COVENTRY):Accepted at all locations

BEECHSTREET PPONATIONAL PROVIDER NETWORK/MEDICAL RESOURCESPHCS/MULTIPLAN

CHC ONLY - contracts specific to support CHC

AETNA BEHAVIORAL HEALTHCIGNA BEHAVIORAL HEALTH (limited providers)THN-TRIAD HEALTH NETWORK MA Plans only (Humana Medicare and Healthteam Advantage)TRICARE

Key

WFUHS - Wake Forest University Health Sciences (professional services)NCBH - North Carolina Baptist HospitalLMC - Lexington Medical CenterCHC - Cornerstone HealthcareWilkes - Wilkes Regional Medical CenterHPR- High Point RegionalN/A- Not applicable to services provided at facility and/or CHCNC- Not Contracted, very low to no volume for facility and/or CHC

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Ophthalmology | Children’s National

October 7th, 2019 3:41 am

Your child's ability to see the world depends on healthy eyes. At Children's National Health System, our pediatric ophthalmologists are experts at diagnosing and treating complex eye problems, congenital disorders and rare eye conditions, such as strabismus, childhood cataract and glaucoma. We offer comprehensive care for patients of all ages, from newborns to young adults.

Not all eye doctors are the same. Eye conditions that threaten your child's sight, such as retinopathy of prematurity, require the expertise of a well-trained and experienced pediatric ophthalmologist.

Our team includes board-certified ophthalmologists with advanced fellowship training who specialize in pediatric care. Our pediatric ophthalmologists are trained to recognize and manage eye diseases and disorders in children whose vision is still developing.

Features of our ophthalmology program include:

Every year, our ophthalmology team treats thousands of children and adults with strabismus or misalignment of the eyes. That high volume allows us to develop expertise, not only in the common problems such as crossing (esotropia) and wandering (exotropia) of the eyes, but also in the most complex cases, such as:

Each type of strabismus requires a different approach, and so does every patient. We use the results of a comprehensive eye exam and orthoptics evaluation to develop a personalized treatment specific to your child's age and diagnosis.

Surgery may be the best treatment option for some patients, with or without eyeglasses or patching. We take into account factors such as the type and severity of the strabismus and your child's age when making a recommendation. We will sit down and discuss the potential risks and benefits of surgery with you, so you can make the most informed choice. We schedule most evaluations and surgery on an outpatient basis.

We emphasize a multidisciplinary approach to care. That means, our program includes a team of experts specialized in all aspects of eye care so we can provide the most comprehensive care possible.

Learn more:

At Children's National, we use the most advanced equipment and techniques for accurate diagnostic tests and screenings. A comprehensive eye evaluation takes about two hours. Your ophthalmologist may order one or several of the following tests:

For more information or to schedule an appointment, please call 202-476-3015.

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Ophthalmology | Children's National

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Ophthalmology – lahey.org

October 7th, 2019 3:41 am

Lahey Hospital & Medical Centers Department of Ophthalmology serves the needs of patients by providing comprehensive medical care. We seek to foster an environment of high caliber professionalism in order to exceed our patients expectations.

A team of more than 70 medical professionals provides a full range of eye care. Nearly 20 ophthalmology and optometry specialists work in proximity to each other, allowing interchange of talent. Examination rooms are adjacent to the operating suite to facilitate care.

In addition to providing routine eye examinations, staff diagnose and treat all aspects of eye disease in adolescents, adults and seniors. These include cataracts, glaucoma, cornea and external disease, laser vision correction, trauma, low vision, retinal and vitreous disease, oculoplastics and neuro-ophthalmology.

Patient undergoing an eye exam.The Department of Ophthalmology provides comprehensive eye care and complete medical and surgical treatment. The foundation of the department is an experienced, highly motivated staff whose mission has multiple goals:

Dr. Edward Connolly, who joined Lahey in 1969, and Dr. Joseph Bowlds, who joined in 1972, founded Ophthalmology Services at the then Lahey Clinic. The department was initially located on Commonwealth Avenue in Boston. Over the next 14 years, optometrists and ophthalmologists were hired.

By 1994, when the department was located in Burlington, it consisted of six full-time ophthalmologists, one part-time ophthalmologist, and five full-time optometrists. Today, the departments unique multidisciplinary approach to patient care involving the collaboration of ophthalmology and optometry specialists with different areas of expertise allows for cross-fertilization of talent, producing the very best in comprehensive patient care.

The Eye Institute, a dynamic eye care center housed within the Department of Ophthalmology, was conceived in the summer of 1994 as part of the re-engineering of the ophthalmology program, led by F. Denton Wertz III, MD, then the chair of the department. After opening at Lahey Medical Center, Peabody the Institutes comprehensive approach to vision care and medical and surgical diseases of the eyes made it popular with patients. In addition to providing state-of-the-art diagnostic capabilities in all areas of vision care, it is situated adjacent to the operating suite, facilitating the very best in care.

Ophthalmology services are also available through Lahey at its Arlington site, located at the former Symmes Hospital. In addition, a program providing subspecialized ophthalmology care for patients in Bermuda is currently under development.

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Vision Loss, Sudden – Eye Disorders – Merck Manuals …

October 7th, 2019 3:40 am

Sudden loss of vision without eye pain

Blindness in one eye lasting minutes to hours

Ultrasonography of the carotid arteries

Echocardiogram (ultrasound of the heart)

Continuous monitoring of heart rhythm

Almost instantaneous, complete loss of vision in one eye

In people with risk factors for atherosclerosis (such as high blood pressure, abnormal blood lipids, or cigarette smoking)

Measurement of ESR (a blood test), C-reactive protein, and platelets

In people with risk factors for this disorder (such as diabetes, high blood pressure, a tendency for blood to clot excessively, or sickle cell disease)

Vitreous hemorrhage (bleeding into the vitreous humorthe jellylike substance that fills the back of the eyeball)

In people who have had specks, strings, or cobwebs in their field of vision (floaters) or who have risk factors for vitreous hemorrhage (such as diabetes, a tear in the retina, sickle cell disease, or an eye injury)

Usually loss of the entire field of vision (not in just one or more spots)

Examination by an ophthalmologist

Sometimes ultrasonography of the retina

Sometimes headache, pain while combing the hair, or pain in the jaw or tongue when chewing

Sometimes aches and stiffness in the large muscles of the arms or legs (polymyalgia rheumatica)

Measurement of ESR, C-reactive protein, and platelets

Biopsy of the temporal artery

In people with risk factors for this disorder (such as diabetes or high blood pressure) or in people who have had an episode of very low blood pressure, which sometimes causes fainting

Measurement of ESR, C-reactive protein, and platelets

Sometimes biopsy of temporal artery

Sometimes carotid artery Doppler (ultrasound of the neck veins) and echocardiogram (ultrasound of the heart)

Macular hemorrhage (bleeding around the maculathe most sensitive part of the retina) resulting from age-related macular degeneration

Usually in people known to have age-related macular degeneration or in people with risk factors for blood vessel disorders (such as high blood pressure, cigarette smoking, or abnormal blood lipids)

Ocular migraine (migraines that affect vision)

Shimmering, irregular spots that drift slowly across the field of vision of one eye for about 10 to 20 minutes

Sometimes blurring of central vision (what a person is looking at directly)

Sometimes a headache after the disturbances in vision

Often in young people or in people known to have migraines

Sudden, spontaneous flashes of light that can look like lightning, spots, or stars (photopsias) that occur repeatedly

Loss of vision that affects one area, usually what is seen out of the corners of the eye (peripheral vision)

Loss of vision that spreads across the field of vision like a curtain

Sometimes in people with risk factors for detachment of the retina (such as a recent eye injury, recent eye surgery, or severe nearsightedness)

Usually loss of the same parts of the field of vision in both eyes

In people with risk factors for these disorders (such as high blood pressure, atherosclerosis, diabetes, abnormal blood lipids, and cigarette smoking)

Sometimes slurred speech, impaired eye movements, muscle weakness, and/or difficulty walking

Ultrasonography of the carotid arteries

Echocardiogram (ultrasound of the heart)

Continuous monitoring of heart rhythm

Sudden loss of vision with eye pain

Severe eye ache and redness

Headache, nausea, vomiting, and sensitivity to light

Disturbances in vision such as seeing halos around lights

Measurement of pressure inside the eye (tonometry)

Examination of eye's drainage channels with a special lens (gonioscopy), done by an ophthalmologist

Often a grayish patch on the cornea that later becomes an open, painful sore

Eye ache or a foreign object (body) sensation

Sometimes in people who have an infection after an eye injury or who have slept with their contact lenses in

Culture of a sample taken from the ulcer, done by an ophthalmologist

Optic neuritis (inflammation of the optic nerve), which can be related to multiple sclerosis

Usually mild pain that may worsen when the eyes are moved

Partial or complete loss of vision

Eyelids and corneas that appear normal

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Board of Veterinary Medicine

October 7th, 2019 3:40 am

This process is used for the Boards that are administered in the Business Standards Division.The various Programs administered in the Division use a similar process.

Frequently Asked Questions about Complaint Process

IMPORTANT

When filing or responding to a complaint, be as thorough as possible. You may attach additional documents to the complaint form to ensure that all pertinent information has been included. The Screening Panel meeting is NOT a hearing, but is a time for the panel to consider the complaint and response. Attendance is your choice. If you attend the panel may ask additional questions. Please notify this office prior to the meeting if you plan to attend.

After acomplainthas been filed against a licensed individual...

The Compliance Office will send a letter of acknowledgment to the person who filed the complaint (Complainant), and a letter requesting a response (with a copy of the complaint) to the licensee against whom the complaint was filed.

The Licensee may submit a written response addressing the complaint to the Compliance Office. The process continues whether or not a response is submitted. The Complainant is not entitled to a copy of the response.

The Compliance Office will notify the Licensee and Complainant regarding the date and time of any meeting during which the case will be discussed.

Complaints remain confidential unless aNotice of Proposed Board Actionis issued, which is a public document along with all subsequent legal filings.

MEETINGSClosed Meeting-During a Closed Meeting only the Licensee, the Complainant, and/or attorneys for either can be in attendance. Minutes of Closed Meetings are not public documents.

Open Meeting-A public meeting which anyone can attend. The minutes of Open meetings are public documents and made available online via the specific Boards webpage.(Adjudication Panel meetings are usuallyopen.)

Individuals may attend a meeting in person or by telephone. Please notify this office prior to the meeting if you plan to attend the meeting.

Screening Panel:A committee comprised of members of the Board. The Screening Panels function is to determine the preliminary action(s) to take on a complaint. Possible preliminary actions include dismissal, investigation, or a finding of Reasonable Cause.

The complaint and response (if any) are submitted to the Screening Panel members.The Screening Panel meeting isnota hearing, but rather a committee meeting to review and discuss the complaint and response to determine if disciplinary action is warranted.

DISMISSAL

If the Screening Panel dismisses a complaint, the complaint can be dismissedwithorwithout prejudice(see definitions below).

Dismissal With Prejudice-The complaint is dismissed and cannot be considered by the Screening Panel in the future.

Dismissal Without Prejudice-The complaint is dismissed but may be considered by the Screening Panel in the future if there are ever allegations of a similar nature.

INVESTIGATION

Only a member of the Screening Panel can request an investigation of a complaint. If an investigation is requested by the Screening Panel, the case is assigned to an investigator who may request an interview with the Licensee, the Complainant, and/or other individuals. Upon completion of the investigation, a written report is submitted to the Screening Panel, which will then determine if there isReasonable Causeto proceed with disciplinary action.

Reasonable Cause-A finding by the Screening Panel that evidence exists that a violation of statutes and rules has occurred which warrants proceeding with disciplinary action.

IfReasonable Causeis found, the Department Counsel issues aNotice of Proposed Board Action(Notice) to the Licensee. Once a Notice is issued, it is public information. A proposedStipulationmay be included with the Notice.

Notice-A legal document from the Departments Legal Counsel which sets forth the Departments factual assertions, the statutes or rules relied upon, and advising the licensee of the right to a hearing.

Stipulation- A tentative agreement for settlement of the case. A Stipulation is not finalized until approved by the Adjudication Panel.

The Licensee may either sign theStipulationor contest the proposed action by requesting an administrativeHearing(a legal process before a Hearing Examiner). If the Licensee wishes to request a hearing, written request must be received within twenty (20) days from receipt of the Notice. Failure to either sign a Stipulation or request a hearing within twenty (20) days may result in the issuing of a Final Order of Default against the licensee.

Default- the licensees acceptance of the disciplinary action demonstrated by failing to participate in the process

ADJUDICATION PANEL

Adjudication Panel-A committee comprised of members of the Board who areNOTon the Screening Panel. The Adjudication Panel determines the final outcome of a case.

The Adjudication Panel reviews the record to determine appropriate sanctions. A Final Order is issued by the Adjudication Panel, completing the complaint process.

COMPLAINT PROCESS FLOW

Current license status and information regarding disciplinary action(s) againsta licensee can be accessed online at:https://ebiz.mt.gov/pol/

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Genetic Medicine | List of High Impact Articles | PPts …

October 5th, 2019 6:47 pm

Genetic medicine is the integration and application of genomic technologies allows biomedical researchers and clinicians to collect data from large study population and to understand disease and genetic bases of drug response. It includes genome structure, functional genomics, epigenomics, genome scale population genomics, systems analysis, pharmacogenomics and proteomics. The Division of Genetic Medicine provides an academic environment enabling researchers to explore new relationships between disease susceptibility and human genetics. The Division of Genetic Medicine was established to host both research and clinical research programs focused on the genetic basis of health and disease. Equipped with state-of-the-art research tools and facilities, our faculty members are advancing knowledge of the common genetic determinants of cancer, congenital neuropathies, and heart disease.

Related Journals of Genetic Medicine

Cellular & Molecular Medicine, Translational Biomedicine, Biochemistry & Molecular Biology Journal, Cellular & Molecular Medicine, Electronic Journal of Biology, Molecular Enzymology and Drug Targets, Journal of Applied Genetics, Journal of Medical Genetics, Genetics in Medicine, Journal of Anti-Aging Medicine, Reproductive Medicine and Biology, Romanian journal of internal medicine

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Microscope Imaging Station. Stem Cells: Cells with potential.

October 5th, 2019 6:46 pm

These heart cells were grown from mouse stem cells.

Stem cells have captured the public's attention because of their potential to revolutionize ourtreatment of many debilitating diseases and injuries. Using stem cells, we may someday be able to repair spinal cord injuries or replace diseased organs, although such therapeutic treatments are probably a long way off. The study of stem cells is relatively newthey were discovered in 1976, and human embryonic stem cells finally isolated in 1998so scientists still have much to learn about them.

Right now, researchers are still learning how to generate and grow stem cells. But simply knowing how to culture the cells in the lab isnt enough. Scientists also need to understand and control how stem cells differentiate to become specific cell types. If researchers can decode the signals that govern differentiation, they may be able to take charge of the process, directing a culture of cells to become a specific cell typeheart, neuron, skin, liver, or whatever kind is needed.

Cultivation of stem cells from days-old embryos

Progress....and hurdles

Treatments for a few particular diseases have emerged as exciting possibilities on the forefront of stem cell research. Parkinsons results from the death of a specific type cell in the brain. Scientists have succeeded in easing the condition in rats by injecting them with embryonic stem cells that then turned into the missing neurons. Researchers hope to develop a similar treatment for diabetes, which is caused by the destruction of insulin-producing cells in the pancreas.

Though there has been progress in developing new stem cell-based therapies, researchers caution that many hurdles remain. For example, its unclear whether implanted stem cells can, after differentiating, revert to their previous state and then cause cancer. Another problem involves our natural immune response to foreign cells in the body. Patients currently receiving stem cell treatments, such as bone marrow transplants, must take drugs to prevent their immune system from attacking the newly introduced cells. Scientists may be able to address this problem by creating banks of embryonic stem cells, each of which is slightly different genetically. The cells best suited to a patients genetic makeup would then be used to grow new cells for transplantation, in hopes that this would lessen the immune response.

Embryonic stem cells can be grown in culture dishes. A pinkish solution provides the sugars and other compounds the cells need to grow.

Next: Looking forward

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Neural Stem Cells – Stemcell Technologies

October 5th, 2019 6:46 pm

The Central Nervous System

The mature mammalian central nervous system (CNS) is composed of three major differentiated cell types: neurons, astrocytes and oligodendrocytes. Neurons transmit information through action potentials and neurotransmitters to other neurons, muscle cells or gland cells. Astrocytes and oligodendrocytes, collectively called glial cells, play important roles of their own, in addition to providing a critical support role for optimal neuronal functioning and survival. During mammalian embryogenesis, CNS development begins with the induction of the neuroectoderm, which forms the neural plate and then folds to give rise to the neural tube. Within these neural structures there exists a complex and heterogeneous population of neuroepithelial progenitor cells (NEPs), the earliest neural stem cell type to form.1,2 As CNS development proceeds, NEPs give rise to temporally and spatially distinct neural stem/progenitor populations. During the early stage of neural development, NEPs undergo symmetric divisions to expand neural stem cell (NSC) pools. In the later stage of neural development, NSCs switch to asymmetric division cycles and give rise to lineage-restricted progenitors. Intermediate neuronal progenitor cells are formed first, and these subsequently differentiate to generate to neurons. Following this neurogenic phase, NSCs undergo asymmetric divisions to produce glial-restricted progenitors, which generate astrocytes and oligodendrocytes. The later stage of CNS development involves a period of axonal pruning and neuronal apoptosis, which fine tunes the circuitry of the CNS. A previously long-held dogma maintained that neurogenesis in the adult mammalian CNS was complete, rendering it incapable of mitotic divisions to generate new neurons, and therefore lacking in the ability to repair damaged tissue caused by diseases (e.g. Parkinsons disease, multiple sclerosis) or injuries (e.g. spinal cord and brain ischemic injuries). However, there is now strong evidence that multipotent NSCs do exist, albeit only in specialized microenvironments, in the mature mammalian CNS. This discovery has fuelled a new era of research into understanding the tremendous potential that these cells hold for treatment of CNS diseases and injuries.

Neurobiologists routinely use various terms interchangeably to describe undifferentiated cells of the CNS. The most commonly used terms are stem cell, precursor cell and progenitor cell. The inappropriate use of these terms to identify undifferentiated cells in the CNS has led to confusion and misunderstandings in the field of NSC and neural progenitor cell research. However, these different types of undifferentiated cells in the CNS technically possess different characteristics and fates. For clarity, the terminology used here is:

Neural Stem Cell (NSCs): Multipotent cells which are able to self-renew and proliferate without limit, to produce progeny cells which terminally differentiate into neurons, astrocytes and oligodendrocytes. The non-stem cell progeny of NSCs are referred to as neural progenitor cells.

Neural Progenitor Cell: Neural progenitor cells have the capacity to proliferate and differentiate into more than one cell type. Neural progenitor cells can therefore be unipotent, bipotent or multipotent. A distinguishing feature of a neural progenitor cell is that, unlike a stem cell, it has a limited proliferative ability and does not exhibit self-renewal.

Neural Precursor Cells (NPCs): As used here, this refers to a mixed population of cells consisting of all undifferentiated progeny of neural stem cells, therefore including both neural progenitor cells and neural stem cells. The term neural precursor cells is commonly used to collectively describe the mixed population of NSCs and neural progenitor cells derived from embryonic stem cells and induced pluripotent stem cells.

Prior to 1992, numerous reports demonstrated evidence of neurogenesis and limited in vitro proliferation of neural progenitor cells isolated from embryonic tissue in the presence of growth factors.3-5 While several sub-populations of neural progenitor cells had been identified in the adult CNS, researchers were unable to demonstrate convincingly the characteristic features of a stem cell, namely self-renewal, extended proliferative capacity and retention of multi-lineage potential. In vivo studies supported the notion that proliferation occurred early in life, whereas the adultCNS was mitotically inactive, and unable to generate new cells following injury. Notable exceptions included several studies in the 1960s that clearly identified a region of the adult brain that exhibited proliferation (the forebrain subependyma)6 but this was believed to be species-specific and was not thought to exist in all mammals. In the early 1990s, cells that responded to specific growth factors and exhibited stem cell features in vitro were isolated from the embryonic and adult CNS.7-8 With these studies, Reynolds and Weiss demonstrated that a rare population of cells in the adult CNS exhibited the defining characteristics of a stem cell: self-renewal, capacity to produce a large number of progeny and multilineage potential. The location of stem cells in the adult brain was later identified to be within the striatum,9 and researchers began to show that cells isolated from this region, and the dorsolateral region of the lateral ventricle of the adult brain, were capable of differentiating into both neurons and glia.10

During mammalian CNS development, neural precursor cells arising from the neural tube produce pools of multipotent and more restricted neural progenitor cells, which then proliferate, migrate and further differentiate into neurons and glial cells. During embryogenesis, neural precursor cells are derived from the neuroectoderm and can first be detected during neural plate and neural tube formation. As the embryo develops, neural stem cells can be identified in nearly all regions of the embryonic mouse, rat and human CNS, including the septum, cortex, thalamus, ventral mesencephalon and spinal cord. NSCs isolated from these regions have a distinct spatial identity and differentiation potential. In contrast to the developing nervous system, where NSCs are fairly ubiquitous, cells with neural stem cell characteristics are localized primarily to two key regions of the mature CNS: the subventricular zone (SVZ), lining the lateral ventricles of the forebrain, and the subgranular layer of thedentate gyrus of the hippocampal formation (described later).11 In the adult mouse brain, the SVZ contains a heterogeneous population of proliferating cells. However, it is believed that the type B cells (activated GFAP+/PAX6+ astrocytes or astrogliallike NSCs) are the cells that exhibit stem cell properties, and these cells may be derived directly from radial glial cells, the predominant neural precursor population in the early developing brain. NPCs in this niche are relatively quiescent under normal physiological conditions, but can be induced to proliferate and to repopulate the SVZ following irradiation.10 SVZ NSCs maintain neurogenesis throughout adult life through the production of fast-dividing transit amplifying progenitors (TAPs or C cells), which then differentiate and give rise to neuroblasts. TAPs and neuroblasts migrate through the rostral migratory stream (RMS) and further differentiate into new interneurons in the olfactory bulb. This ongoing neurogenesis, which is supported by the NSCs in the SVZ, is essential for maintenance of the olfactory system, providing a source of new neurons for the olfactory bulb of rodents and the association cortex of non-human primates.12 Although the RMS in the adult human brain has been elusive, a similar migration of neuroblasts through the RMS has also been observed.13 Neurogenesis also persists in the subgranular zone of the hippocampus, a region important for learning and memory, where it leads to the production of new granule cells. Lineage tracing studies have mapped the neural progenitor cells to the dorsal region of the hippocampus, in a collapsed ventricle within the dentate gyrus.10 Studies have demonstrated that neurogenic cells from the subgranular layer may have a more limited proliferative potential than the SVZ NSCs and are more likely to be progenitor cells than true stem cells.14 Recent evidence also suggests that neurogenesis plays a different role in the hippocampus than in the olfactory bulb. Whereas the SVZ NSCs play a maintenance role, it is thought that hippocampal neurogenesis serves to increase the number of new neurons and contributes to hippocampal growth throughout adult life.12 Neural progenitor cells have also been identified in the spinal cord central canal ventricular zone and pial boundary15-16, and it is possible that additional regional progenitor populations will be identified in the future.

In vitro methodologies designed to isolate, expand and functionally characterize NSC populations have revolutionized our understanding of neural stem cell biology, and increased our knowledge of the genetic and epigenetic regulation of NSCs.17 Over the past several decades, a number of culture systems have been developed that attempt to recapitulate the distinct in vivo developmental stages of the nervous system, enabling theisolation and expansion of different NPC populations at different stages of development. Here, we outline the commonly used culture systems for generating NPCs from pluripotent stem cells (PSCs), and for isolating and expanding NSCs from the early embryonic, postnatal and adult CNS.

Neural induction and differentiation of pluripotent stem cells: Early NPCs can be derived from mouse and human PSCs, which include embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), using appropriate neural induction conditions at the first stage of differentiation. While these neural differentiation protocols vary widely, a prominent feature in popular embryoid body-based protocols is the generation of neural rosettes, morphologically identifiable structures containing NPCs, which are believed to represent the neural tube. The NPCs present in the neural rosette structures are then isolated, and can be propagated to allow NPC expansion, while maintaining the potential to generate neurons and glial cells. More recently, studies have shown that neural induction of PSCs can also be achieved in a monolayer culture system, wherein human ESCs and iPSCs are plated onto a defined matrix, and exposed to inductive factors.18 A combination of specific cytokines or small molecules, believed to mimic the developmental cues for spatiotemporal patterning in the developing brain during embryogenesis, can be added to cultures at the neural induction stage to promote regionalization of NPCs. These patterned NPCs can then be differentiated into mature cell types with phenotypes representative of different regions of the brain.19-24 New protocols have been developed to generate cerebral organoids from PSC-derived neural progenitor cells. Cerebral organoids recapitulate features of human brain development, including the formation of discrete brain regions featuring characteristic laminar cellular organization.25

Neurosphere culture: The neurosphere culture system has been widely used since its development as a method to identify NSCs.26-29 A specific region of the CNS is microdissected, mechanically or enzymatically dissociated, and plated in adefined serum-free medium in the presence of a mitogenic factor, such as epidermal growth factor (EGF) and/or basic fibroblast growth factor (bFGF). In the neurosphere culture system, NSCs, as well as neural progenitor cells, begin to proliferate in response to these mitogens, forming small clusters of cells after 2 - 3 days. The clusters continue to grow in size, and by day 3 - 5, the majority of clusters detach from the culture surface and begin to grow in suspension. By approximately day seven, depending on the cell source, the cell clusters, called neurospheres, typically measure 100 - 200 m in diameter and are composed of approximately 10,000 - 100,000 cells. At this point, the neurospheres should be passaged to prevent the cell clusters from growing too large, which can lead to necrosis as a result of a lack of oxygen and nutrient exchange at the neurosphere center. To passage the cultures, neurospheres are individually, or as a population, mechanically or enzymatically dissociated into a single cell suspension and replated under the same conditions as the primary culture. NSCs and neural progenitor cells again begin to proliferate to form new cell clusters that are ready to be passaged approximately 5 - 7 days later. By repeating the above procedures for multiple passages, NSCs present in the culture will self-renew and produce a large number of progeny, resulting in a relatively consistent increase in total cell number over time. Neurospheres derived from embryonic mouse CNS tissue treated in this manner can be passaged for up to 10 weeks with no loss in their proliferative ability, resulting in a greater than 100- fold increase in total cell number. NSCs and neural progenitors can be induced to differentiate by removing the mitogens and plating either intact neurospheres or dissociated cells on an adhesive substrate, in the presence of a low serum-containing medium. After several days, virtually all of the NSCs and progeny will differentiate into the three main neural cell types found in the CNS: neurons, astrocytes and oligodendrocytes. While the culture medium, growth factor requirements and culture protocols may vary, the neurosphere culture system has been successfully used to isolate NSCs and progenitors from different regions of the embryonic and adult CNS of many species including mouse, rat and human.

Adherent monolayer culture: Alternatively, cells obtained from CNS tissues can be cultured as adherent cultures in a defined, serum-free medium supplemented with EGF and/or bFGF, in the presence of a substrate such as poly-L-ornithine, laminin, or fibronectin. When plated under these conditions, the neural stem and progenitor cells will attach to the substrate-coated cultureware, as opposed to each other, forming an adherent monolayer of cells, instead of neurospheres. The reported success of expanding NSCs in long-term adherent monolayer cultures is variable and may be due to differences in the substrates, serum-free media andgrowth factors used.17 Recently, protocols that have incorporated laminin as the substrate, along with an appropriate serum-free culture medium containing both EGF and bFGF have been able to support long-term cultures of neural precursors from mouse and human CNS tissues.30-32 These adherent cells proliferate and become confluent over the course of 5 - 10 days. To passage the cultures, cells are detached from the surface by enzymatic treatment and replated under the same conditions as the primary culture. It has been reported that NSCs cultured under adherent monolayer conditions undergo symmetric divisions in long-term culture.30,33 Similar to the neurosphere culture system, adherently cultured cells can be passaged multiple times and induced to differentiate into neurons, astrocytes and oligodendrocytes upon mitogen removal and exposure to a low serum-containing medium.

Several studies have suggested that culturing CNS cells in neurosphere cultures does not efficiently maintain NSCs and produces a heterogeneous cell population, whereas culturing cells under serum-free adherent culture conditions does maintain NSCs.17 While these reports did not directly compare neurosphere and adherent monolayer culture methods using the same medium, growth factors or extracellular matrix to evaluate NSC numbers, proliferation and differentiation potential, they emphasize that culture systems can influence the in vitro functional properties of NSCs and neural progenitors. It is important that in vitro methodologies for NSC research are designed with this caveat in mind, and with a clear understanding of what the methodologies are purported to measure.34-35

Immunomagnetic or immunofluorescent cell isolation strategies using antibodies directed against cell surface markers present on stem cells, progenitors and mature CNS cells have been applied to the study of NSCs. Similar to stem cells in other systems, the phenotype of CNS stem cells has not been completely determined. Expression, or lack of expression, of CD34, CD133 and CD45 antigens has been used as a strategy for the preliminary characterization of potential CNS stem cell subsets. A distinct subset of human fetal CNS cells with the phenotype CD133+ 5E12+ CD34- CD45- CD24-/lo has the ability to form neurospheres in culture, initiate secondary neurosphere formation, and differentiate into neurons and astrocytes.36 Using a similar approach, fluorescence-activated cell sorting (FACS)- based isolation of nestin+ PNA- CD24- cells from the adult mouse periventricular region enabled significant enrichment of NSCs(80% frequency in sorted population, representing a 100-fold increase from the unsorted population).37 However, the purity of the enriched NSC population was found to be lower when this strategy was reevaluated using the more rigorous Neural Colony-Forming Cell (NCFC) assay.38-39 NSC subsets detected at different stages of CNS development have been shown to express markers such as nestin, GFAP, CD15, Sox2, Musashi, CD133, EGFR, Pax6, FABP7 (BLBP) and GLAST40-45. However, none of these markers are uniquely expressed by NSCs; many are also expressed by neural progenitor cells and other nonneural cell types. Studies have demonstrated that stem cells in a variety of tissues, including bone marrow, skeletal muscle and fetal liver can be identified by their ability to efflux fluorescent dyes such as Hoechst 33342. Such a population, called the side population, or SP (based on its profile on a flow cytometer), has also been identified in both mouse primary CNS cells and cultured neurospheres.46 Other non-immunological methods have been used to identify populations of cells from normal and tumorigenic CNS tissues, based on some of the in vitro properties of stem cells, including FABP7 expression and high aldehyde dehydrogenase (ALDH) enzyme activity. ALDH-bright cells from embryonic rat and mouse CNS have been isolated and shown to have the ability to generate neurospheres, neurons, astrocytes and oligodendrocytes in vitro, as well as neurons in vivo, when transplanted into the adult mouse cerebral cortex.47-50 NeuroFluor CDr3 is a membrane-permeable fluorescent probe that binds to FABP7 and can be used to detect and isolate viable neural progenitor cells from multiple species.42-43

Multipotent neural stem-like cells, known as brain tumor stem cells (BTSCs) or cancer stem cells (CSCs), have been identified and isolated from different grades (low and high) and types of brain cancers, including gliomas and medulloblastomas.51-52 Similar to NSCs, these BTSCs exhibit self-renewal, high proliferative capacity and multi-lineage differentiation potential in vitro. They also initiate tumors that phenocopy the parent tumor in immunocompromised mice.53 No unique marker of BTSCs has been identified but recent work suggests that tumors contain a heterogenous population of cells with a subset of cells expressing the putative NSC marker CD133.53 CD133+ cells purified from primary tumor samples formed primary tumors, when injected into primary immunocompromised mice, and secondary tumors upon serial transplantation into secondary recipient mice.53 However, CD133 is also expressed by differentiated cells in different tissues and CD133- BTSCs can also initiate tumors in immunocompromised mice.54-55 Therefore, it remains to bedetermined if CD133 alone, or in combination with other markers, can be used to discriminate between tumor initiating cells and non-tumor initiating cells in different grades and types of brain tumors. Recently, FABP7 has gained traction as a CNS-specific marker of NSCs and BTSCs.42-43, 57

Both the neurosphere and adherent monolayer culture methods have been applied to the study of BTSCs. When culturing normal NSCs, the mitogen(s) EGF (and/or bFGF) are required to maintain NSC proliferation. However, there is some indication that these mitogens are not required when culturing BTSCs.57 Interestingly, the neurosphere assay may be a clinically relevant functional readout for the study of BTSCs, with emerging evidence suggesting that renewable neurosphere formation is a significant predictor of increased risk of patient death and rapid tumor progression in cultured human glioma samples.58-60 Furthermore, the adherent monolayer culture has been shown to enable pure populations of glioma-derived BTSCs to be expanded in vitro.61

Research in the field of NSC biology has made a significant leap forward over the past ~30 years. Contrary to the beliefs of the past century, the adult mammalian brain retains a small number of true NSCs located in specific CNS regions. The identification of CNS-resident NSCs and the discovery that adult somatic cells from mouse and human can be reprogrammed to a pluripotent state,62-68 and then directed to differentiate into neural cell types, has opened the door to new therapeutic avenues aimed at replacing lost or damaged CNS cells. This may include transplantation of neural progenitors derived from fetal or adult CNS tissue, or pluripotent stem cells. Recent research has shown that adult somatic cells can be directly reprogrammed to specific cell fates, such as neurons, using appropriate transcriptional factors, bypassing the need for an induced pluripotent stem cell intermediate.69 Astroglia from the early postnatal cerebracortex can be reprogrammed in vitro to neurons capable of action potential firing, by the forced expression of a single transcription factor, such as Pax6 or the pro-neural transcription factor neurogenin-2 (Neurog2).70 To develop cell therapies to treat CNS injuries and diseases, a greater understanding of the cellular and molecular properties of neural stem and progenitor cells is required. To facilitate this important research, STEMCELL Technologies has developed NeuroCult proliferation and differentiation kits for human, mouse and rat, including xenofree NeuroCult-XF. The NeuroCult NCFC Assay provides a simple and more accurate assay to enumerate NSCs compared to the neurosphere assay. These tools for NSC research are complemented by the NeuroCult SM Neuronal Culture Kits, specialized serum-free medium formulations for culturing primary neurons. Together, these reagents help to advance neuroscience research and assist in its transition from the experimental to the therapeutic phase.

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Stem cells: The secret to change | Science News for Students

October 5th, 2019 6:46 pm

Inside your body, red blood cells are constantly on the move. They deliver oxygen to every tissue in every part of your body. These blood cells also cart away waste. So their work is crucial to your survival. But all that squeezing through tiny vessels is tough on red blood cells. Thats why they last only about four months.

Where do their replacements come from? Stem cells.

These are a very special family of cells. When most other cells divide, the daughter cells look and act exactly like their parents. For example, a skin cell cant make anything but another skin cell. The same is true for cells in the intestine or liver.

Not stem cells. Stem cells can become many different types. That is how an embryo grows from a single fertilized egg into a fetus with trillions of specialized cells. They need to specialize to make up tissues that function very differently, including those in the brain, skin, muscle and other organs. Later in life, stem cells also can replace worn-out or damaged cells including red blood cells.

The remarkable abilities of stem cells make them very exciting to scientists. One day, experts hope to use stem cells to repair or replace many different kinds of tissues, whether injured in accidents or damaged by diseases. Such stem cell therapy would allow the body to heal itself. Scientists have found a way to put specialized cells to work repairing damage, too. Together, these cell-based therapies might one day make permanent disabilities a thing of the past.

One unusual type of stem cell offers special promise for such therapeutic uses. For the recent development of this cell type, Shinya Yamanaka shared the 2012 Nobel Prize in medicine.

Meet the family

Blood stem cells live inside your bones, in what is called marrow. There, they divide over and over. Some of the new cells remain stem cells. Others form red blood cells. Still others morph into any of the five types of white blood cells that will fight infections. Although blood stem cells can become any one of these specialized blood cells, they cannot become muscle, nerve or other types of cells. They are too specialized to do that.

Another type of stem cell is more generalized. These can mature into any type of cell in the body. Such stem cells are called pluripotent (PLU ree PO tint). The word means having many possibilities. And its not hard to understand why these cells have captured the imaginations of many scientists.

Until recently, all pluripotent cells came from embryos. Thats why scientists called them embryonic stem cells. After an egg is fertilized, it divides in two. These two cells split again, to become four cells, and so on. In the first few days of this embryos development, each of its cells is identical to all the others. Yet each cell has the potential to develop into any specialized cell type.

When the human embryo reaches three to five days old, its cells start to realize their potential. They specialize. Some will develop into muscle cells or bone cells. Others will form lung cells or maybe the cells lining the stomach. Once cells specialize, their many possibilities suddenly become limited.

By birth, almost all of a babys cells will have specialized. Each cell type will have its own distinctive shape and function. For example, muscle cells will be long and able to contract, or shorten. Red blood cells will be small and plate-shaped, so they can slip through blood vessels with ease.

Hidden among all of these specialized cells are pockets of adult stem cells. (Yes, even newborns have adult stem cells.) Unlike embryonic stem cells, adult stem cells cannot transform into any and every cell type. However, adult stem cells can replace several different types of specialized cells as they wear out. One type of adult stem cell is found in your marrow, making new blood cells. More types are found in other tissues, including the brain, heart and gut.

Among naturally occurring stem cells, the embryonic type is the most useful. Adult stem cells just arent as flexible. The adult type also is relatively rare and can be difficult to separate from the tissues in which it is found. Although more versatile, embryonic stem cells are both difficult to obtain and controversial. Thats because harvesting them requires destroying an embryo.

Fortunately, recent discoveries in stem cell research now offer scientists a third and potentially better option.

The search for answers

In 2006, Shinya Yamanaka discovered that specialized cells like those in skin could be converted back into stem cells. Working at Kyoto University in Japan, this doctor and scientist induced or persuaded mature cells to become stem cells. He did this by inserting a specific set of genes into the cells. After several weeks, the cells behaved just like embryonic cells. His new type of stem cells are called induced pluripotent stem cells, or iP stem cells (and sometimes iPS cells).

Yamanakas discovery represented a huge leap forward. The iP stem cells offer several advantages over both embryonic and adult stem cells. First, iP stem cells are able to become any cell type, just as embryonic stem cells can. Second, they can be made from any starting cell type. That means they are easy to obtain. Third, in the future, doctors would be able to treat patients with stem cells created from their own tissues. Such cells would perfectly match the others, genetically. That means the patients immune system (including all of its white blood cells) would not attack the introduced cells. (The body often mounts a life-threatening attack against transplanted organs that come from other people because they dont offer such a perfect match. To the body, they seem foreign and a potentially dangerous invader.)

Scientists the world over learned of the technique developed by Yamanaka (who now works at the Gladstone Institutes which is affiliated with the University of California, San Francisco). Many of these researchers adopted Yamanakas procedure to create their own induced pluripotent stem cells. For the first time, researchers had a tool that could allow them to make stem cells from people with rare genetic diseases. This helps scientists learn what makes certain cell types die. Experts can also expose small batches of these diseased cells to different medicines. This allows them to test literally thousands of drugs to find out which works best.

And in the future, many experts hope induced stem cells will be used to replace adult stem cells and the cells of tissues that are damaged or dying.

Therapies take patients and patience

Among those experts is Anne Cherry, a graduate student at Harvard University. Cherry is using induced stem cells to learn more about a very rare genetic disease called Pearson syndrome. A syndrome is a group of symptoms that occur together. One symptom of Pearson syndrome is that stem cells in bone marrow cannot make normal red blood cells. This condition typically leads to an early death.

Cherry has begun to study why these stem cells fail.

She started by taking skin cells from a girl with the disease. She placed the cells in a test tube and added genes to turn them into stem cells. Over several weeks, the cells began to make proteins for which the inserted genes had provided instructions. Proteins do most of the work inside cells. These proteins turned off the genes that made the cells act like skin cells. Before long, the proteins turned on the genes to make these cells behave like embryonic stem cells.

After about three months, Cherry had a big batch of the new induced stem cells. Those cells now live in Petri dishes in her lab, where they are kept at body temperature (37 Celsius, or 98.6 Fahrenheit). The scientist is now trying to coax the induced stem cells into becoming blood cells. After that, Cherry wants to find out how Pearson syndrome kills them.

Meanwhile, the patient who donated the skin cells remains unable to make blood cells on her own. So doctors must give her regular transfusions of blood from a donor. Though life-saving, transfusions come with risks, particularly for someone with a serious disease.

Cherry hopes to one day turn the girls induced stem cells into healthy new blood stem cells and then return them to the girls body. Doing so could eliminate the need for further transfusions. And since the cells would be the girls own, there would be no risk of her immune system reacting to them as though they were foreign.

Sight for sore eyes

At University of Nebraska Medical Center in Omaha, Iqbal Ahmad is working on using stem cells to restore sight to the blind. A neuroscientist someone who studies the brain and nervous system Ahmad has been focusing on people who lost sight when nerve cells in the eyes retina died from a disease called glaucoma (glaw KOH muh).

Located inside the back of the eye, the retina converts incoming light into electrical signals that are then sent to the brain. Ahmad is studying how to replace dead retina cells with new ones formed from induced pluripotent stem cells.

The neuroscientist starts by removing adult stem cells from the cornea, or the clear tissue that covers the front of the eye. These stem cells normally replace cells lost through the wear and tear of blinking. They cannot become nerve cells at least not on their own. Ahmad, however, can transform these cells into iP stem cells. Then, with prodding, he turns them into nerve cells.

To make the transformation, Ahmad places the cornea cells on one side of a Petri dish. He then places embryonic stem cells on the other side. A meshlike membrane separates the two types of cells so they cant mix. But even though they cant touch, they do communicate.

Cells constantly send out chemical signals to which other cells respond. When the embryonic stem cells speak, the eye cells listen. Their chemical messages persuade the eye cells to turn off the genes that tell them to be cornea cells. Over time, the eye cells become stem cells that can give rise to different types of cells, including nerve cells.

When Ahmads team implanted the nerve cells into the eyes of laboratory mice and rats, they migrated to the retina. There, they began replacing the nerve cells that had died from glaucoma. One day, the same procedure may restore vision to people who have lost their sight.

Another approach

In using a bodys own cells to repair injury or to treat disease, stem cells arent always the answer. Although stem cells offer tremendous advances in regenerating lost tissue, some medical treatments may work better without them. Thats thanks to the chemical communication going on between all cells all of the time. In some situations, highly specialized cells can act as a conductor, directing other cells to change their tune.

In 2008, while working at the University of Cambridge in England, veterinary neurologist Nick Jeffery began a project that used cells taken from the back of the nose. But Jeffery and his team were not out to create stem cells. Instead, the scientists used those nasal cells to repair damaged connections in the spinal cord.

The spinal cord is basically a rope of nerve cells that ferry signals to and from the brain and other parts of the body. Injuring the spinal cord can lead to paralysis, or the loss of sensation and the inability to move muscles.

Like Ahmad, some researchers are using stem cells to replace damaged nerve cells. But Jeffery, now at Iowa State University in Ames, doesnt think such techniques are always necessary to aid recovery from spinal injuries. Stem cell transplantation, points out Jefferys colleague, neuroscientist Robin Franklin, is to replace a missing cell type. In a spinal injury, the nerve cells arent missing. Theyre just cut off.

Nerve cells contain long, wirelike projections called axons that relay signals to the next cell. When the spine is injured, these axons can become severed, or cut. Damaging an axon is like snipping a wire the signal stops flowing. So the Cambridge scientists set out to see if they could restore those signals.

Jeffery and his fellow scientists work with dogs that have experienced spinal injuries. Such problems are common in some breeds, including dachshunds. The team first surgically removed cells from the dogs sinuses or the hollow spaces in the skull behind the nose. These are not stem cells. These particular cells instead encourage nerve cells in the nose to grow new axons. These cells help the pooches maintain their healthy sense of smell.

The scientists grew these sinus cells in the lab until they had reproduced to large numbers. Then the researchers injected the cells into the spinal cords of two out of every three doggy patients. Each treated dog received an injection of its own cells. The other dogs got an injection of only the liquid broth used to feed the growing cells.

Over several months, the dogs owners repeatedly brought their pets back to the lab for testing on a treadmill. This allowed the scientists to evaluate how well the animals coordinated their front and hind feet while walking. Dogs that had received the nasal cells steadily improved over time. Dogs that received only the liquid did not.

This treatment did not result in a perfect cure. Nerve cells did reconnect several portions of the spinal cord. But nerve cells that once linked to the brain remained disconnected. Still, these dog data indicate that nasal cells can aid in recovering from a spinal cord injury.

Such new developments in cellular research suggest that even more remarkable medical advancements may be just a few years away. Yamanaka, Cherry, Ahmad, Jeffery, Franklin and many other scientists are steadily unlocking secrets to cellular change. And while you cant teach an old dog new tricks, scientists are finding out that the same just isnt true of cells anymore.

cornea The clear covering over the front of the eye.

embryo A vertebrate, or animal with a backbone, in its early stages of development.

gene A section of DNA that carries the genetic instructions for making a protein. Proteins do most of the work in cells.

glaucoma An eye disease that damages nerve cells carrying signals to the brain.

immune cell White blood cell that helps protect the body against germs.

molecule A collection of atoms.

neuron (or nerve cell) The basic working unit of the nervous system. These cells relay nerve signals.

neuroscientist A researcher who studies neurons and the nervous system.

paralysis Loss of feeling in some part of the body and an inability to move that part.

retina The light-sensitive lining at the back of the eye. It converts light into electrical impulses that relay information to the brain.

sinus An opening in the bone of the skull connected to the nostrils.

spinal cord The ropelike collection of neurons that connect the brain with nerves throughout the body.

tissue A large collection of related, similar cells that together work as a unit to perform a particular function in living organisms. Different organs of the human body, for instance, often are made from many different types of tissues. And brain tissue will be very different from bone or heart tissue.

transfusion The process of transferring blood into one person that had been collected from another.

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Stem cells: The secret to change | Science News for Students

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An Overview of Stem Cell Research | The Center for …

October 5th, 2019 6:46 pm

Post Date: 04/2005, Updated 08/2009Author: CBHD Research Staff

In November of 1998, scientists reported that they had successfully isolated and cultured human embryonic stem cellsa feat which had eluded researchers for almost two decades. This announcement kicked off an intense and unrelenting debate between those who approve of embryonic stem cell research and those who are opposed to it. Some of the most prominent advocates of the research are scientists and patients who believe that embryonic stem cell research will lead to the development of treatments and cures for some of humanitys most pernicious afflictions (such as Alzheimers disease, Parkinsons disease, heart disease, and diabetes). Among the most vocal opponents of the research are those who share the desire to heal, but who object to the pursuit of healing via unethical means. CBHDs view is that because human embryonic stem cell research necessitates the destruction of human embryos, such research is unethicalregardless of its alleged benefits. Ethical alternatives for achieving those benefits should be actively pursued, and have demonstrated a number of promising preclinical and clincial results without the ethical concers present with embryonic stem cells.

Human embryonic stem cells are the cells from which all 200+ kinds of tissue in the human body originate. Typically, they are derived from human embryosoften those from fertility clinics who are left over from assisted reproduction attempts (e.g., in vitro fertilization). When stem cells are obtained from living human embryos, the harvesting of such cells necessitates destruction of the embryos.

Adult stem cells (also referred to as non-embryonic stem cells) are present in adults, children, infants, placentas, umbilical cords, and cadavers. Obtaining stem cells from these sources does not result in certain harm to a human being.

Fetal stem cell research may ethically resemble either adult or embryonic stem cell research and must be evaluated accordingly. If fetal stem cells are obtained from miscarried or stillborn fetuses, or if it is possible to remove them from fetuses still alive in the womb without harming the fetuses, then no harm is done to the donor and such fetal stem cell research is ethical. However, if the abortion of fetuses is the means by which fetal stem cells are obtained, then an unethical means (the killing of human beings) is involved. Since umbilical cords are detached from infants at birth, umbilical cord blood is an ethical source of stem cells.

Yes. In contrast to research on embryonic stem cells, non-embryonic stem cell research has already resulted in numerous instances of actual clinical benefit to patients. For example, patients suffering from a whole host of afflictionsincluding (but not limited to) Parkinsons disease, autoimmune diseases, stroke, anemia, cancer, immunodeficiency, corneal damage, blood and liver diseases, heart attack, and diabeteshave experienced improved function following administration of therapies derived from adult or umbilical cord blood stem cells. The long-held belief that non-embryonic stem cells are less able to differentiate into multiple cell types or be sustained in the laboratory over an extended period of timerendering them less medically-promising than embryonic stem cellshas been repeatedly challenged by experimental results that have suggested otherwise. (For updates on experimental results, access http://www.stemcellresearch.org.)

Though embryonic stem cells have been purported as holding great medical promise, reports of actual clinical success have been few. Instead, scientists conducting research on embryonic stem cells have encountered significant obstaclesincluding tumor formation, unstable gene expression, and an inability to stimulate the cells to form the desired type of tissue. It may indeed be telling that some biotechnology companies have chosen not to invest financially in embryonic stem cell research and some scientists have elected to focus their research exclusively on non-embryonic stem cell research.

Another potential obstacle encountered by researchers engaging in embryonic stem cell research is the possibility that embryonic stem cells would not be immunologically compatible with patients and would therefore be rejected, much like a non-compatible kidney would be rejected. A proposed solution to this problem is to create an embryonic clone of a patient and subsequently destroy the clone in order to harvest his or her stem cells. Cloning for this purpose has been termed therapeutic cloningdespite the fact that the subject of the researchthe cloneis not healed but killed.

Underlying the passages of Scripture that refer to the unborn (Job 31:15; Ps. 139:13-16; Lk. 1:35-45) is the assumption that they are human beings who are created, known, and uniquely valued by God. Genesis 9:6 warns us against killing our fellow human beings, who are created in the very image of God (Gen. 1:26-27). Furthermore, human embryonic lifeas well as all of creationexists primarily for Gods own pleasure and purpose, not ours (Col. 1:16).

Many proponents of human embryonic stem cell research argue that it is actually wrong to protect the lives of a few unborn human beings if doing so will delay treatment for a much larger number of people who suffer from fatal or debilitating diseases. However, we are not free to pursue gain (financial, health-related, or otherwise) through immoral or unethical means such as the taking of innocent life (Deut. 27:25). The history of medical experimentation is filled with horrific examples of evil done in the name of science. We must not sacrifice one class of human beings (the embryonic) to benefit another (those suffering from serious illness). Scripture resoundingly rejects the temptation to do evil that good may result (Rom. 3:8).

No forms of stem cell research or cloning are prohibited by federal law, though some states have passed partial bans. Private funds can support any practice that is legal, whereas federal funds cannot be used for research on embryonic stem cell lines unless they meet the guidelines set forth by the National Institutes of Health in July 2009. For the latest developments you can stay informed via CBHD's newsblogwww.bioethics.com and thecoalition site http://www.stemcellresearch.org.

Editor's Note: This piece was originally published by Linda K. Bevington, MA, by CBHD in April 2005 under the title "Stem Cell Research and 'Therapeutic' Cloning: A Christian Analysis." The piece was subsequently revised and updated by CBHD research staff in August 2009.

Posted 4/2005, Updated 8/2009

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Dr. Neil Riordan, Cell Therapy Expert – RMI Clinic | Stem …

October 5th, 2019 6:46 pm

Neil Riordan, PA, PhD is one of the early pioneers and experts in applied stem cell research. Dr. Riordan founded publicly traded company Medistem Laboratories (later Medistem Inc.) which was acquired by Intrexon in 2013.

He is the founder and chairman of Medistem Panama, Inc., a leading stem cell laboratory and research facility located in the Technology Park of the prestigious City of Knowledge in Panama City, Panama. Medistem Panama (est. 2007) is at the forefront of research on the effects of adult stem cells on the course of several chronic diseases and conditions. The stem cell laboratory at Medistem Panama is fully licensed by the Ministry of Health of Panama.

Human umbilical cord tissue-derived mesenchymal stem cells (hUCT-MSCs) that were isolated and grown at Medistem Panama to create master cell banks are currently being used in the United States. These cells serve as the starting material for cellular products used in MSC clinical trials for two Duchennes muscular dystrophy patients under US FDAs designation of Investigational New Drug (IND) for single patient compassionate use. (IND 16026 DMD Single Patient) These trials are the first in the United States to use hUCT-MSCs. Translational Biosciences, a fully-owned subsidiary of Medistem Panama is currently conducting phase I/II clinical trials for multiple sclerosis, autism and rheumatoid arthritis.

Dr. Riordan is founder, chairman and chief science officer of the Stem Cell Institute in Panama, which specializes in the treatment of human diseases and conditions with adult stem cells, primarily human umbilical cord tissue-derived mesenchymal stem cells. Established in 2007, Stem Cell Institute is one of the oldest, most well-known and well-respected stem cell therapy clinics in the world.

He is co-founder and chief science officer of the Riordan Medical Institute (RMI). Located in the Dallas-Fort Worth area city of Southlake, Texas, RMI specializes in the treatment of orthopedic conditions with autologous bone marrow-derived stem cells combined with amniotic tissue products developed by Dr. Riordan.

He is also the founder of Aidan Products, which provides health care professionals with quality nutraceuticals. Dr. Riordans team developed the product Stem-Kine, the only nutritional supplement that is clinically proven to increase the amount of circulating stem cells in the body for an extended period of time. Stem-Kine is currently sold in 35 countries.

Dr. Riordan has published more than 70 scientific articles in international peer-reviewed journals. In the stem cell arena, his colleagues and he have published more than 20 articles on multiple sclerosis, spinal cord injury, heart failure, rheumatoid arthritis, Duchenne muscular dystrophy, autism, and Charcot-Marie-Tooth syndrome. In 2007, Dr. Riordans research team was the first to discover and document the existence of mesenchymal-like stem cells in menstrual blood. For this discovery, his team was honored with the Medical Article of the Year Award from Biomed Central. Other notable journals in which Dr. Riordan has published articles include the British Journal of Cancer, Cellular Immunology, Journal of Immunotherapy, and Translational Medicine.

In addition to his scientific journal publications, Dr. Riordan has authored two books about mesenchymal stem cell therapy: Stem Cell Therapy: A Rising Tide: How Stem Cells Are Disrupting Medicine and Transforming Lives and MSC (Mesenchymal Stem Cells): Clinical Evidence Leading Medicines Next Frontier. Dr. Riordan has also written two scientific book chapters on the use of non-controversial stem cells from placenta and umbilical cord.

Dr. Riordan is an established inventor. He is the inventor or co-inventor on more than 25 patent families, including 11 issued patents. His team collaborates with a number of universities and institutions, including National Institutes of Health, Indiana University, University of California, San Diego, University of Utah, University of Western Ontario, and University of Nebraska.

He has made a number of novel discoveries in the field of cancer research since the mid-1990s when he collaborated with his father, Dr. Hugh Riordan, on the effects of high-dose intravenous vitamin C on cancer cells and the tumor microenvironment. This pioneering study on vitamin Cs preferential toxicity to cancer cells notably led to a 1997 patent for the treatment of cancer with vitamin C. In 2010, Dr. Riordan was granted an additional patent for a new cellular vaccine for cancer patients.

Neil Riordan, PA, PhD earned his Bachelor of Science at Wichita State University and graduated summa cum laude. He received his Masters degree at the University of Nebraska Medical Center. Dr. Riordan completed his education by earning a Ph.D. in Health Sciences at Medical University of the Americas.

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Human Mesenchymal Stem Cells (hMSC) | PromoCell

October 5th, 2019 6:46 pm

Mesenchymal Stem Cells (MSC), also termed Mesenchymal Stromal Cells, are multipotent cells that can differentiate into a variety of cell types and have the capacity for self renewal. MSC have been shown to differentiate in vitro or in vivo into adipocytes, chondrocytes, osteoblasts, myocytes, neurons, hepatocytes, and pancreatic islet cells. Optimized PromoCell media are available to support both the growth of MSC and their differentiation into several different lineages. Recent experiments suggest that differentiation capabilities into diverse cell types vary between MSC of different origin.

PromoCell hMSC are harvested from normal human adipose tissue,bone marrow, andumbilical cord matrix (Whartons jelly) of individual donors.

The cells are tested for their ability to differentiate in vitro into adipocytes, chondrocytes, and osteoblasts. OurhMSC show a verified marker expression profile that complies with ISCT* recommendations, providing well characterized cells.

*ISCT (International Society for Cellular Therapy) Cytotherapy (2006) Vol. 8, No. 4, 315-317

NEW: Our hMSC are now also available from HLA-typed donors.

Available formats:

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Human Mesenchymal Stem Cells (hMSC) | PromoCell

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