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Miami, FL, United States

Iobst C.,Miami Childrens Hospital
Operative Techniques in Orthopaedics | Year: 2011

The Taylor Spatial Frame (Smith & Nephew PLC, London, UK) is a circular external fixator that is able to correct multiplanar deformities simultaneously or sequentially. This makes the fixator an excellent tool for correcting pediatric limb deformities. This article highlights the common pediatric uses for the Taylor Spatial Frame, including Blount's disease, long bone trauma, lengthening, and joint contractures. Other issues specific to using the Taylor Spatial Frame in children, such as sizing, strut changes, dynamization, calculation of the length of correction, and postoperative management with be discussed as well. © 2011 Elsevier Inc.

Restrepo R.,Miami Childrens Hospital | Lee E.Y.,Harvard University
Orthopedic Clinics of North America | Year: 2012

Juvenile idiopathic arthritis is a broad term used to describe a series of chronic arthritis occurring in children younger than 16 years of age. Even though the cause is not fully understood, several clues regarding the pathogenesis have been found. Diagnosis of the different types of juvenile idiopathic arthritis is made clinically, and imaging plays a role in answering specific questions pertaining to disease classification, staging, and outcome of treatment options. © 2012 .

Ramachandran C.,Miami Childrens Hospital
Journal of complementary & integrative medicine | Year: 2012

We have investigated on the potentiation of etoposide (ETP) and temozolomide (TMZ) cytotoxicity in U-87MG glioblastoma and D283 medulloblastoma cell lines by curcumin (CUR) and turmeric force (TF), a nutraceutical formulation of turmeric, with the objective of assessing the potential for their adjuvant use in brain tumor chemotherapy. While U-87MG cell line was generally resistant to TMZ, IC50 values for CUR and TF were 37.33 and 30.75 μg/ml, respectively. TF is the only agent that demonstrated efficacy at the IC90 level. When CUR or TF was combined with ETP and TMZ, increased chemotherapeutic efficiency in the U-87MG cells was observed. TF is highly cytotoxic to D283 Med cell line compared to curcumin with an IC50 value of 1.55 ug/ml. Although both CUR and TF potentiated ETP and TMZ cytotoxicity, TF is more efficient than CUR in both U-87MG and D283 Med cell lines. Treatment of U-87MG cells with the triple combination of TMZ+ETP+TF induced a high percentage of apoptotic cells. Potential mechanisms that may explain evidence of synergy include down regulation of p10 and p53 mRNAs and increase in BAX/Bcl-2 mRNA ratio. These pre-clinical results suggest that TF may be useful as an adjuvant with ETP and TMZ for brain tumor chemotherapy.

Dick A.S.,Florida International University | Bernal B.,Miami Childrens Hospital | Tremblay P.,Laval University
Neuroscientist | Year: 2014

The field of the neurobiology of language is experiencing a paradigm shift in which the predominant Broca-Wernicke-Geschwind language model is being revised in favor of models that acknowledge that language is processed within a distributed cortical and subcortical system. While it is important to identify the brain regions that are part of this system, it is equally important to establish the anatomical connectivity supporting their functional interactions. The most promising framework moving forward is one in which language is processed via two interacting "streams" - a dorsal and ventral stream - anchored by long association fiber pathways, namely the superior longitudinal fasciculus/arcuate fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and two less well-established pathways, the middle longitudinal fasciculus and extreme capsule. In this article, we review the most up-to-date literature on the anatomical connectivity and function of these pathways. We also review and emphasize the importance of the often overlooked cortico-subcortical connectivity for speech via the "motor stream" and associated fiber systems, including a recently identified cortical association tract, the frontal aslant tract. These pathways anchor the distributed cortical and subcortical systems that implement speech and language in the human brain. © The Author(s) 2013.

Restrepo R.,Miami Childrens Hospital
Pediatric Radiology | Year: 2013

Vascular malformations and hemangiomas are common in children but remain a source of confusion during diagnosis, in part because of the lack of a uniform terminology. With the existing treatments for hemangiomas and vascular malformations, it is important to make the correct diagnosis initially to prevent adverse physical and emotional sequelae in not only the child but also the family. The diagnosis of vascular malformations is made primarily by the clinician and based on the physical exam. Imaging is carried out using predominantly ultrasound (US) and magnetic resonance imaging (MRI), which are complementary modalities. In most cases of vascular anomalies, US is the first line of imaging as it is readily available, less expensive, lacks ionizing radiation and does not require sedation. MRI is also of great help for further characterizing the lesions. Conventional arteriography is reserved for cases that require therapeutic intervention, more commonly for arteriovenous malformations. Radiographs usually play no role in diagnosing vascular anomalies in children. In this article, the author describes the terminology and types of hemangiomas and vascular malformations and their clinical, histological features, as well as the imaging approach and appearance. © 2012 Springer-Verlag Berlin Heidelberg.

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