Biological, Functional And Radiographic Evaluation Of Autologous Chondrocyte Implantation
Funder
National Health and Medical Research Council
Funding Amount
$307,400.00
Summary
We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radio ....We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radiographic changes in the patellofemoral joint that occur as a result of ACI, using high resolution magnetic resonance imaging (MRI) to quantify the regeneration of hyaline articular cartilage; 3. Using the new technique of confocal arthroscopy, we will compare the histologic appearances of the ACI graft and its interface with adjacent articular cartilage; 4. Evaluate patient, surgical and explant chondrocyte characteristics in relation to functional, radiographic and biological outcomes. With respect to the matrix-induced autologous chondrocyte implantation (MACI) technique, we wish to clarify the clinical practice as a definitive treatment for articular cartilage defects. This will be the first randomised, controlled clinical trial of the MACI technique compared to that used by other groups. A positive clinical outcome from this trial will help promote the three cornerstones of this procedure – successful cell culture, efficient surgical procedures, and complimentary postoperative rehabilitation. Furthermore, this research will: a) Enhance the expansion of the MACI technique; b) Encourage development of endoscopic techniques of implantation using a combination of – • Preoperative defect registration with MRI • pre-cut custom patches, implanted with • Computer-assisted navigation techniques: c) Increase the potential to cater for a larger number of patients requiring articular cartilage repair; d) Confirm the long-term durability of regenerated cartilage in the 4th year and beyond; e) Add further commercial value by demonstrating MACI may prevent the onset of osteoarthritis.Read moreRead less
A Motion Correction Technique For Accurate PET/CT Brain Imaging In Paediatric And Dementia Patients
Funder
National Health and Medical Research Council
Funding Amount
$190,450.00
Summary
PET-CT imaging is a vital tool in the diagnosis and management of patients with brain disorders including dementia, epilepsy and cancer. However images are often distorted by patient motion, particularly in demented and paediatric patients. The CI has recently developed a motion tracking and correction method to derive images nearly free of motion effects. This aim of this project is to evaluate its impact on image quality in a variety of patients referred for PET- CT brain investigations.
Control Of Refractive Error Through Ionically Driven Fluid Movements
Funder
National Health and Medical Research Council
Funding Amount
$208,600.00
Summary
Myopia affects about half the world's population with recent studies suggesting epidemic proportions among some Asian schoolchildren though we are not seeing this in Australia. Costs associated with detection, monitoring and optical correction of low and high myopia are huge. High myopes (15% with > 6D) also have a greatly increased risk of blindness between the ages of 30 and 50 years due to secondary disorders associated with impaired fluid balance (retinal and choroidal oedema, macula oede ....Myopia affects about half the world's population with recent studies suggesting epidemic proportions among some Asian schoolchildren though we are not seeing this in Australia. Costs associated with detection, monitoring and optical correction of low and high myopia are huge. High myopes (15% with > 6D) also have a greatly increased risk of blindness between the ages of 30 and 50 years due to secondary disorders associated with impaired fluid balance (retinal and choroidal oedema, macula oedema, retinal detachment and glaucoma). Currently there is no accepted pharmaceutical treatment for myopia though our studies in chick have provided the theoretical rationale and experimental data for a potential therapy and patent. This patent is now at the PCT stage and attests that changes in the abundance of the ions of the subretinal space control fluid movements across the retina to choroid and can be modulated therapeutically by diuretics to control fluid flow and hence axial growth and myopia. This application aims to take our current knowledge about fluid control in myopic chick into a mammalian model prior to preclinical trials in monkey. We anticipate it will take 1 year to establish the feasibility of diuretic control of experimentally induced myopic refractive errors in guinea pigs and the best drug and best the dosage range. These studies will contribute to the scientific understanding and bring the proposed pharmaceutical therapy for myopia in adults and children to a point of full commercialization. We believe that the results found in chick will have significance for early and late-onset myopia in humans as it is highly likely that the same mechanisms of ocular growth regulation operate throughout life.Read moreRead less
A Novel One-step Approach In The Early Diagnosis Of Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$102,150.00
Summary
In order to avoid the invasiveness and imprecision of current prostate cancer detection, this programme is directed to developing a non-invasive and repeatable, accurate approach. This research project is designed to optimise retrieval of prostate cells from ejaculate and to compare two methods for profiling selected genetic changes to diagnose prostate cancer. The refinement of techniques, outlined in the application, is essential before proceeding to a clinical trial.
Novel Nanoparticle Composites For Molecular Probes In Diagnostic Imaging
Funder
National Health and Medical Research Council
Funding Amount
$170,716.00
Summary
Isotope labelled protein probes, eg. antibodies, are a valuable imaging tool in investigating patient disease. Their biological specificity is their great strength, however, detection sensitivity often limits their use. A novel nanoparticle developed at ANU can increase this signal by a million-fold in comparison with conventional methods of labelling. This approach suits a range of probes and will accommodate many of the isotopes already used in patient diagnostics and therapy.
Assessment Of Bilateral Oedema By Bioelectrical Impedance Analysis
Funder
National Health and Medical Research Council
Funding Amount
$180,000.00
Summary
Swelling of tissue due to fluid accumulation, known as oedema, is one of the earliest signs of diseases such as kidney failure, burn injury or lymphedema. All of these are not uncommon conditions. Lymphedema, for example, is a common sequela of radiotherapy or surgery in the treatment of malignancies such as breast, uterine, and prostatic carcinoma. It is reported to occur in up to 40% of patients depending on the type of surgery and whether or not the patient received radiotherapy. It is estima ....Swelling of tissue due to fluid accumulation, known as oedema, is one of the earliest signs of diseases such as kidney failure, burn injury or lymphedema. All of these are not uncommon conditions. Lymphedema, for example, is a common sequela of radiotherapy or surgery in the treatment of malignancies such as breast, uterine, and prostatic carcinoma. It is reported to occur in up to 40% of patients depending on the type of surgery and whether or not the patient received radiotherapy. It is estimated that at any time 100000 women are suffering from post- mastectomy lymphedema in Australia alone. Treatment of breast cancer alone therefore, given the incidence of the disease, produces a large at-risk population. Add to this other causes of oedema and the magnitude of the problem becomes clearly apparent. The presence of chronic oedema is often a disfiguring and disabling disorder, usually accompanied by pain, recurrent infection, reduced mobility and impaired function. In acute oedema the problem often resolves with recovery from the underlying pathology. In chronic oedema, progression may be arrested by early intervention including complex physical therapy (exercise regimen, compression bandaging, and massage) which is effective in reducing limb volume, in improving the quality of life, function and body image of patients. Although the assessment of oedema is clearly of clinical importance, relatively few objective and accurate techniques for its measurement exist. Research conducted over the past decade by the applicants has pioneered the Use of Bioelectrical Impedance Analysis for the assessment of lymphedema. This study aims to translate this basic research into clinical practice. Sensitivity and specificity studies will establish normative and threshold values for impedance measurements that can be used as presumptive indicators of oedema. User friendly technology and equipment suitable for clinical use will be developed which should improve treatment therapies.Read moreRead less
We will conduct a clinical trial of the effectiveness of a continuous auditory display of an anesthetized patient's respiratory status. Expired carbon dioxide monitoring has helped reduce respiratory incidents since its widespread introduction in the late 1980s, but a continuous auditory display of respiratory status may reduce incidents further. We will conduct a clinical trial with 10 anaesthetists of continuous auditory respiratory monitoring. Successful outcome may lead to commercial uptake.
Development And Clinical Evaluation Of A Depth Of Anaesthesia Monitor
Funder
National Health and Medical Research Council
Funding Amount
$424,785.00
Summary
Waking up during surgery (awareness under anaesthesia) is a frightening reality for some patients. Although uncommon (occurring in about 1 in 1000 operations), it remains one of the main concerns of patients before their surgery. Recent studies (including our own) have demonstrated that processed EEG monitoring using bispectral index (BIS) can markedly reduce the risk of awareness. Other EEG monitors are being developed, but each have weaknesses. As approximately two million Australians have a g ....Waking up during surgery (awareness under anaesthesia) is a frightening reality for some patients. Although uncommon (occurring in about 1 in 1000 operations), it remains one of the main concerns of patients before their surgery. Recent studies (including our own) have demonstrated that processed EEG monitoring using bispectral index (BIS) can markedly reduce the risk of awareness. Other EEG monitors are being developed, but each have weaknesses. As approximately two million Australians have a general anaesthetic each year, about 2000 will suffer an episode of awareness. More than 60 million people around the world have an anaesthetic, and so the problem is substantial. This suggests the potential benefits (health outcomes, commercial gains) are very great. In 2000 less than 5% of US hospitals used BIS monitoring; the current figure in the US is about 69% of the best-rated hospitals (US News and World Report) and 78% of teaching hospitals. A similar rapid growth is occurring in Australia and Europe. We are working with a successful Australian Company (Compumedics Ltd) to develop a better awareness monitor. We plan studies in groups of patients have surgery.Read moreRead less
A Novel Treatment For Ameliorating Retinal Vascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$366,685.00
Summary
Retinal vascular disease is a leading cause of blindness and is currently treated by laser photocoagulation surgery. Although successful, this treatment is associated with serious side effects. Recently, Ellex Pty has developed a novel laser called the 2RT laser that is likely to be effective without the accompanying side effects. This study will allow examine the effect of the 2RT laser in animal models of retinal vascular disease so as to complete preclinical development of this laser.