Search results for: tissue-engineered vascular graft

Authors: Andriy Fedorenko

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Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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Authors: B. V. Murlimanju

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Background: Scaphoid bone is commonly fractured among all the bones of the wrist. The fracture can damage the arteries and would cause avascular necrosis of the scaphoid. In this present study, the goal was to study the topography and number of nutrient foramina in the scaphoid bones of South Indian population. Methods: We studied 46 human scaphoid bones, among them 20 were left sided and 26 belonged to the right side. The scaphoid bones were available at the department of anatomy of our institution. The scaphoid bones were macroscopically observed for the topography and number of nutrient foramina. The data was collected, tabulated and analyzed. Results: The nutrient foramina were observed in all the scaphoid bones (100%). The locations of the foramina were over the non-articular surfaces in all these scaphoids. They were distributed over the palmar and dorsal surfaces. The foramina were found proximal as well as distal to the mid waist of the scaphoid bone. Their number ranged between 9 and 54 in each scaphoid bone. The number ranged between 2-24 over the palmar surface and 7-36 over the dorsal surface. They ranged between 2-24 proximal to the waist and 3-39 distal to the waist. Conclusion: The knowledge of arterial supply, topography of nutrient foramen and their number is essential to understand the concepts of avascular necrosis of scaphoid bone. It will be enlightening to understand the non-union of the fracture of waist of the scaphoid. The morphological data is required to the operating hand surgeon. We do believe that the present study has provided additional information about the topography and number of nutrient foramina of the human scaphoid bones.

Keywords: avascular necrosis, nutrient foramen, scaphoid, vascular

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Authors: Mahdieh Jajroudi

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Developing a pharmacokinetic model for the neuroendocrine tumors therapy agent 177Lu-DOTATATE in nude mice bearing AR42J rat pancreatic tumor to investigate and evaluate the behavior of the complex was the main purpose of this study. The utilization of compartmental analysis permits the mathematical differencing of tissues and organs to become acquainted with the concentration of activity in each fraction of interest. Biodistribution studies are onerous and troublesome to perform in humans, but such data can be obtained facilely in rodents. A physiologically based pharmacokinetic model for scaling up activity concentration in particular organs versus time was developed. The mathematical model exerts physiological parameters including organ volumes, blood flow rates, and vascular permabilities; the compartments (organs) are connected anatomically. This allows the use of scale-up techniques to forecast new complex distribution in humans' each organ. The concentration of the radiopharmaceutical in various organs was measured at different times. The temporal behavior of biodistribution of 177Lu labeled somatostatin analogues was modeled and drawn as function of time. Conclusion: The variation of pharmaceutical concentration in all organs is characterized with summation of six to nine exponential terms and it approximates our experimental data with precision better than 1%.

Keywords: biodistribution modeling, compartmental analysis, 177Lu labeled somatostatin analogues, neuroendocrine tumors

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Authors: B. V. Murlimanju, P. J. Jiji, Latha V. Prabhu, Mangala M. Pai

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Background: The scaphoid is the most commonly fractured bone of the wrist. The fracture may disrupt the vessels and end up as the avascular necrosis of the bone. The objective of the present study was to investigate the morphology and number of the nutrient foramina in the cadaveric dried scaphoid bones of the Indian population. Methods: The present study included 46 scaphoid bones (26 right sided and 20 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the scaphoid bones. The foramina were observed both proximal and distal to the mid waist of the scaphoid bone. The foramen ranged between 9 and 54 in each scaphoid bone. The foramina over the palmar surface ranged between, 2-24 in number. The foramina over the dorsal surface ranged between, 7-36 in number. The foramina proximal to the waist ranged between 2 and 24 in number and distal to the waist ranged between 3 and 39. Conclusion: We believe that the present study has provided additional data about the nutrient foramina of the scaphoid bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the avascular necrosis of the proximal scaphoid and non-union of the fracture at the waist of the scaphoid.

Keywords: avascular necrosis, nutrient, scaphoid, vascular

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Authors: D. Leibman, D. Wolf, A. Gal-On

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Viral diseases of tomato crops result in heavy yield losses and may even jeopardize the production of these crops. Classical tomato breeding for disease resistance against Tomato yellow leaf curl virus (TYLCV), leads to partial resistance associated with a number of recessive genes. To author’s best knowledge Pepino mosaic virus (PepMV) genetic resistance is not yet available. The generation of viral resistance by means of genetic engineering was reported and implemented for many crops, including tomato. Transgenic resistance against viruses is based, in most cases, on Post Transcriptional Gene Silencing (PTGS), an endogenous mechanism which destroys the virus genome. In this work, we developed immunity against PepMV and TYLCV in a tomato based on a PTGS mechanism. Tomato plants were transformed with a hairpin-construct-expressed transgene-derived double-strand-RNA (tr-dsRNA). In the case of PepMV, the binary construct harbored three consecutive fragments of the replicase gene from three different PepMV strains (Italian, Spanish and American), to provide resistance against a range of virus strains. In the case of TYLCV, the binary vector included three consecutive fragments of the IR, V2 and C2 viral genes constructed in a hairpin configuration. Selected transgenic lines (T0) showed a high accumulation of transgene siRNA of 21-24 bases, and T1 transgenic lines showed complete immunity to PepMV and TYLCV. Graft inoculation displayed immunity of the transgenic scion against PepMV and TYLCV. The study presents the engineering of resistance in tomato against two serious diseases, which will help in the production of high-quality tomato. However, unfortunately, these resistant plants have not been implemented due to public ignorance and opposition against breeding by genetic engineering.

Keywords: PepMV, PTGS, TYLCV, tr-dsRNA

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Authors: Luksanaporn Krungkraipetch

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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).

Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation

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Authors: Taha Kadir Yesin, Hanyu Liu, Zhangfan Ding, Amit Singh, Qi Tian, Yuheng Zhang, Biswajyoti Borah, Junyu Chen, Anjali P. Kusumbe

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The skeletal structure and bone marrow endothelium collectively form a critical functional unit essential for bone development, health, and aging. At the core of osteogenesis and bone formation lies the dynamic process of angiogenesis. In this study, we reveal a potent endogenous anabolic NCAM1-14.3.3. ζδ-derived- Peptide interaction, which stimulates bone angiogenesis and osteogenesis during homeostasis, aging, and age-related bone diseases. Employing high-resolution imaging and inducible cell-specific mouse genetics, our results elucidate the pivotal role of the NCAM1-14.3.3.ζδ-derived-Peptide interaction in driving the expansion of Clec14a+ angiogenic endothelial cells. Notably, Clec14a+ endothelial cells express key osteogenic factors. The NCAM1-14.3.3.ζδ-derived-Peptide interaction in osteoblasts drives osteoblast differentiation, ultimately contributing to the genesis of bone. Moreover, the NCAM1-14.3.3.ζδ-derived-Peptide interaction leads to a reduction in bone resorption. In age-associated vascular and bone loss diseases, stimulating the NCAM1-14.3.3.ζδ-derived-Peptide interaction not only promotes angiogenesis but also reverses bone loss. Consequently, harnessing the endogenous anabolic potential of the NCAM1-14.3.3.ζδ-derived-Peptide interaction emerges as a promising therapeutic modality for managing age-related bone diseases.

Keywords: endothelial cell, NCAM1, Clec14a, 14.3.3.ζδ

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Authors: Afzaal Bashir, Sunaina Afzaal

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Background: Facial contour deformities associated with pigmentary changes are of major concern for plastic surgeons, both being important and difficult in treating such issues. No definite ideal treatment option is available to simultaneously address both the contour defect as well as related pigmentation. Objectives: The aim of the current study is to compare the long-term effects of conventional adipose tissue grafting and ex-vivo expanded Mesenchymal Stem Cells enriched adipose tissue grafting for the treatment of contour deformities with pigmentary changes on the face. Material and Methods: In this study, eighty (80) patients with contour deformities of the face with hyperpigmentation were recruited after informed consent. Two techniques i.e., conventional fat grafting (C-FG) and fat grafts enriched with expanded adipose stem cells (FG-ASCs), were used to address the pigmentation. Both techniques were explained to patients, and enrolled patients were divided into two groups i.e., C-FG and FG-ASCS, per patients’ choice and satisfaction. Patients of the FG-ASCs group were treated with fat grafts enriched with expanded adipose stem cells, while patients of the C-FGs group were treated with conventional fat grafting. Patients were followed for 12 months, and improvement in face pigmentation was assessed clinically as well as measured objectively. Patient satisfaction was also documented as highly satisfied, satisfied, and unsatisfied. Results: Mean age of patients was 24.42(±4.49), and 66 patients were females. The forehead was involved in 61.20% of cases, the cheek in 21.20% of cases, the chin in 11.20% of cases, and the nose in 6.20% of cases. In the GF-ASCs group, the integrated color density (ICD) was decreased (1.08×10⁶ ±4.64×10⁵) as compared to the C-FG group (2.80×10⁵±1.69×10⁵). Patients treated with fat grafts enriched with expanded adipose stem cells were significantly more satisfied as compared to patients treated with conventional fat grafting only. Conclusion: Mesenchymal stem cell-enriched autologous fat grafting is a preferred option for improving the contour deformities related to increased pigmentation of face skin.

Keywords: hyperpigmentation, color density, enriched adipose tissue graft, fat grafting, contour deformities, Image J

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Authors: M. Wisnu Pamungkas, Patrianef Darwis

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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.

Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty

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Authors: Shackira Am, Jos T. Puthur

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The phytostabilization potential of a halophyte Acanthus ilicifolius L. has been evaluated with special attention to the nutritional as well as anatomical adaptations developed by the plant. Distribution of essential elements influenced by the excess Zn²⁺ ions in the root tissue was studied by FEG-SEM EDX microanalysis. Significant variations were observed in the uptake and allocation of mineral elements like Mg, P, K, S, Na, Si and Al in the root of A. ilicifolius. The increase in S is in correlation with the increased synthesis of glutathione which might be involved in the biosynthesis of phytochelatins. This in turn might be aiding the plant to tolerate the adverse environmental conditions by stabilizing the excess Zn in the root tissue itself. Moreover it is revealed that most of the Zn were accumulated towards the central region near the vascular tissue. Treatment with ZnSO₄ in A. ilicifolius caused significant increase in the number of glandular trichomes on the adaxial leaf surface as compared to the leaves of control plants. In addition to this, A. ilicifolius when treated with ZnSO₄, exhibited a deeply stained layer of cells immediate to the endodermis, forming more or less a ring like structure around the xylem vessels. Phloem cells in these plants were crushed/reduced in numbers. There were no such deeply stained cells forming a ring around the xylem vessels in the control plants. These adaptive responses make the plant a suitable candidate for the phytostabilization of Zn. In addition the nutritional adjustment of the plant equips them for a better survival under increased concentration of Zn²⁺.

Keywords: Acanthus ilicifolius, mineral elements, phytostabilization, zinc

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Authors: Mehmet Ali Kisaçam, P. Sema Temizer Ozan, Ayşe Doğan, Gonca Ozan, F. Sarper Türker

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Cardiovascular disease which is one of the most common health problems worldwide has crucial importance because of its’ morbidity and mortality rates. Nitric oxide synthase and arginase use L-arginine as a substrate and produce nitric oxide (NO), citrulline and urea, ornithine respectively. Endothelial dysfunction is characterized by reduced bioavailability of vasodilator and anti-inflammatory molecule NO. The purpose of the study to assess endothelial function via arginase activity and NO levels in patients undergoing coronary artery bypass grafting (CABG) surgery. The study was conducted on 26 patients (14 male, 12 female) undergoing CABG surgery. Blood samples were collected from the subjects before surgery, after the termination and after 24 hours of the surgery. Arginase activity and NO levels measured in collected samples spectrophotometrically. Arginase activity decreased significantly in subjects after the termination of the surgery compared to before surgery data. 24 hours after the surgery there wasn’t any significance in arginase activity as it compared to before surgery and after the termination of the surgery. On the other hand, NO levels increased significantly in the subject after the termination of the surgery. However there was no significant increase in NO levels after 24 hours of the surgery, but there was an insignificant increase compared to before surgery data. The results indicate that after the termination of the surgery vascular and endothelial function improved and after 24 hours of the surgery arginase activity and NO levels returned to normal.

Keywords: arginase, bypass, cordiopulmonary, nitric oxide

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Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: Chia-Yen Lee, Hao-Jen Wang, Jhih-Hao Lai

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In recent years, infrared (IR) imaging has been considered as a potential tool to assess the efficacy of chemotherapy and early detection of breast cancer. Regions of tumor growth with high metabolic rate and angiogenesis phenomenon lead to the high temperatures. Observation of differences between the heat maps in long term is useful to help assess the growth of breast cancer cells and detect breast cancer earlier, wherein the multi-time infrared image alignment technology is a necessary step. Representative feature points detection and matching are essential steps toward the good performance of image registration and quantitative analysis. However, there is no clear boundary on the infrared images and the subject's posture are different for each shot. It cannot adhesive markers on a body surface for a very long period, and it is hard to find anatomic fiducial markers on a body surface. In other words, it’s difficult to detect and match features in an IR sequence images. In this study, automated feature detection and matching algorithms with two type of automatic feature points (i.e., vascular branch points and modified Harris corner) are developed respectively. The preliminary results show that the proposed method could identify the representative feature points on the IR breast images successfully of 98% accuracy and the matching results of 93% accuracy.

Keywords: Harris corner, infrared image, feature detection, registration, matching

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Authors: O. Casasayas, M. Vigo, R. Navarro, P. Ragazzi, P. Alvarez, A. Perez-Bellmunt

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Introduction: The blood flow restriction training (BFR) is a method of muscle training that allows increasing the stress of muscle tissue to enhance the muscle cross-section and strength. This type of training has clear benefits in the rehabilitation field since it can improve muscle strength using low mechanical loads. The aim of this study is to know in which knee pathologies BFR has been used, what methodology was used and what were the obtained results. Study design: We performed a systematic literature search using strategies for the concepts of “blood flow restriction OR blood flow restriction training AND knee” in Medline. Articles were screened by authors and included if they used the blood flow restriction training in pathology of the knee. Results: The pathology more frequently treated by BFR was knee osteoarthritis and the variables most analyzed were strength and pain. The vascular occlusion used was 80% in the major part of studies. The groups of BFR obtained an increase of strength with less pain but not always the results are statistically significant. The evidence levels are poor in the high number of studies because in some cases there is not a control group or the evaluators were not blinded. Conclusion: The use of BFR is useful to improve muscle strength in knee pathology since it does not increase the pain, but more studies are needed to see (comprehend) if this type of treatment obtains better results than a conventional therapy. No studies have been found that compare the different occlusion effects in both the strength improvement and the pain reduction. Neither studies that analyse the effects of BFR on the muscle contractile parameters have been found.

Keywords: blood flow restriction training, knee, arthroscopy knee, physical therapy

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Authors: I-Yun Cheng, Min-Yu Chiang, Shwu-Jen Chang, San-Yuan Chen

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Osteoarthritis (OA) is among the most challenging joint diseases, and as far as we know, there is currently no exact and effective cure for it because it has low self-repair ability due to lack of blood vessels and low cell density in articular cartilage. So far, there have been several methods developed to treat cartilage disorder. The most common method is to treat the high molecular weight of hyaluronic acid (HA) injection, but it will degrade after a period of time, so the patients need to inject HA repeatedly. In recent years, self-healing hydrogel has drawn considerable attention because it can recover its initial mechanical properties after damaged and further increase the lifetime of the hydrogel. Here, we aim to develop a self-healable composite hydrogel combined with magnetic microspheres to trigger glutathione(GSH) release for promoting cartilage repair. We use HA-cyclodextrin (CD) as host polymer and poly(acrylic acid)-ferrocene (pAA-Fc) as guest polymer to form the self-healable HA-pAA hydrogel by host and guest interaction where various graft amount of pAA-Fc (pAA:Fc= 1:2, 1:1.5, 1:1, 2:1, 4:1) was conducted to develop different mechanical strength hydrogel. The rheology analysis showed that the 4:1 of pAA-Fc has higher mechanical strength than other formulations. On the other hand, iron oxide nanoparticle, poly(lactic-co-glycolic acid) (PLGA) and polyethyleneimine (PEI) were used to synthesize porous magnetic microspheres via double emulsification water-in-oil-in-water (W/O/W) to increase GSH loading which acted as a reductant to control the hydrogel crosslink density and promote hydrogel self-healing. The results show that the porous magnetic microspheres can be loaded with 70% of GSH and sustained release about 50% of GSH after 24 hours. More importantly, the HA-pAA composite hydrogel can self-heal rapidly within 24 hours when suffering external force destruction by releasing GSH from the magnetic microspheres. Therefore, the developed the HA-pAA composite hydrogel combined with GSH-loaded magnetic microspheres can be in-vivo guided to damaged OA surface for inducing the cartilage repair by controlling the crosslinking of self-healing hydrogel via GSH release.

Keywords: articular cartilage, magnetic microsphere, osteoarthritis, self-healing hydrogel

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Authors: Yahaya Tajudeen, Joy Okpuzor, Tolu Ajayi

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The cell-rebuilding efficacy of four food plants eating as vegetables and spices in Nigeria was assessed in the lungs of wild rats (Rattus rattus) living in a polluted environment. The plants are roselle (Hibiscus sabdarrifa), moringa (Moringa oleifera), ginger (Zingiber officinale) and ugwu (Telfairia occidentalis). Sixty rats were caught from the vicinity of a cement factory in Sagamu, Southwestern-Nigeria and grouped into 6. The control group was administered distilled water, while the test groups were given ethanolic extracts of roselle, moringa, ginger, ugwu and the mixture of the extracts for 180 days. The histopathology of the rats was conducted before and at the end of 180 days extracts administration. Before administering the extracts, the lungs of the rats showed vascular congestion, severe fibrosis and congested alveolus; all which were also observed in the lungs of control rats at the end of the treatment. However, the lungs of rats that were treated with the extracts of the plants showed moderate, mild or no histological damage compared to the control rats. The extract of the mixture of the plants performed best, followed by ginger, ugwu and roselle, respectively. These findings suggest that the food plants contain phytonutrients and phytochemicals, which repaired damaged cells and tissues in the exposed rats. Consequently, the plants could play a role in ameliorating health effects of environmental pollution.

Keywords: food plants, wild rats, lung, histopathology, fibrosis, cell-rebuilding

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Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

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Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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Authors: Vinay Kumar Theendra

Abstract:

The main objective of the study is to evaluate the effectiveness of hesperidin in the treatment of breast cancer and causing less (or) no bone marrow depression which is the major side effect of the present anticancer drugs treating breast cancer, also to evaluate the mechanisms through which these compounds are exerting their effect. Breast cancer is induced by administering N-methyl N-Nitrosourea (MNU) at a dose of 50mg/kg body weight. Upon the termination of the experiment, the animals were sacrificed by the method of cervical dislocation. The animals were dissected along the ventral midline and were grossly examined for the presence of tumors. Then the tumours were removed along with the stroma. Vascular endothelial growth factor (VEGF) levels were estimated by using ELISA method. The first occurrence of palpable tumors was eight weeks after carcinogen treatment and the final tumour incidence was 100% in the MNU alone and topical treated rats. Whereas in rats of other treatment groups there is decreased tumour incidence which might be due to their antitumour activity. Hesperidin therapy inhibited angiogenesis which can be evident from the significant reduction in serum as well as tumour VEGF concentrations in comparison to the untreated mammary carcinoma bearing rats. Hesperidin is promising agents that exert direct antitumor and also antiangiogenic, antiproliferative and anti-inflammatory activities. Even though the potency is little lesser than standard drug vincristine, it has been proved to be safe without effecting haematological count.

Keywords: hesperidin, VEGF, COX 2, N-methyl N-nitrosourea

Procedia PDF Downloads 117

Authors: Tsung-yin Lin, Yi-yu Lee, Ching-hua Hung

Abstract:

Snoring, the lay term for obstructive breathing during sleep, is one of the most prevalent of obnoxious human habits. Loud snoring usually makes others feel noisy and uncomfortable. Snoring also influences the sleep quality of snorers’ bed partners, because of the noise they do not get to sleep easily. Snoring causes the reduce of sleep quality leading to several medical problems, such as excessive daytime sleepiness, high blood pressure, increased risk for cardiovascular disease and cerebral vascular accident, and etc. There are many non-prescription devices offered for sale on the market, but very limited data are available to support a beneficial effect of these devices on snoring and use in treating obstructive sleep apnea (OSA). Mandibular advancement devices (MADs), also termed as the Mandibular reposition devices (MRDs) are removable devices which are worn at night during sleep. Most devices require dental impression, bite registration, and fabrication by a dental laboratory. Those devices are fixed to upper and lower teeth and are adjusted to advance the mandible. The amount of protrusion is adjusted to meet the therapeutic requirements, comfort, and tolerance. Many devices have a fixed degree of advancement. Some are adjustable in a limited degree. This study focuses on the stress analysis of Mandibular Advancement Devices (MADs), which are considered as a standard treatment of snoring that promoted by American Academy of Sleep Medicine (AASM). This paper proposes a new MAD design, and the finite element analysis (FEA) is introduced to precede the stress simulation for this MAD.

Keywords: finite element analysis, mandibular advancement devices, mechanical stress, snoring

Procedia PDF Downloads 340

Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

Abstract:

Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

Procedia PDF Downloads 325

Authors: Loubna Safar, Lama Youssef, Majd Aljamali

Abstract:

Age-related macular degeneration (AMD) is one of the leading causes of blindness worldwide. Complement factor H polymorphism (Y402H) is thought to play a potential role in the predisposition to AMD and response of patients with exudative AMD to treatment with anti-Vascular Endothelial Growth Factor (anti-VEGF). This study aimed to investigate the frequency of Y402H among Syrians, its impact on their susceptibility to AMD, and the hypothesized role of Y402H in patients' response to intravitreal anti-VEGF (i.e.,, bevacizumab). Our case-control study encompassed unrelated 54 AMD cases and 44 controls. Genotyping was determined by standard sequencing of PCR products. Frequency was compared between patients and controls, and correlation between genotype and response to treatment was assessed in 20 patients with wet AMD who received a therapeutic course of three intravitreal bevacizumab injections (once monthly). Our results revealed a significantly higher prevalence of the risk allele C among AMD cases (51.9%) in comparison with controls (37.5%) (P= 0.04, OR= 1.386, CI= 0.999- 1.923). Patients with the TT genotype (no risk allele) exhibited a significantly better primary response rate, reached 87.5% compared to only 41.7% in patients carrying the risk allele C (TC + CC), (P= 0.04, OR= 9.8, CI=0.899- 106.84). The findings of this study prove the importance of investigating Y402H polymorphism as a prognostic marker for predicting response to bevacizumab in AMD patients.

Keywords: age-related macular degeneration, bevacizumab, complement factor H gene, polymorphism, Y402H

Procedia PDF Downloads 134

Authors: Renato André S. Silva, Nana L. F. Sampaio, Carlos J. G. Cruz, Bruno Vianna, Flávio O. Pires

Abstract:

multiple stage bicycle races require high physiological loads from professional cyclists. Such demands can lead to immunosuppression and health problems. However, in this type of competition, little is known about its physiological effects on amateur athletes, who generally receive less medical support. Thus, this study analyzes the hematological effects of a multiple stage bicycle race on amateur cyclists. Seven Brazilian national amateur cyclists (34 ± 4.21 years) underwent a laboratory test to evaluate VO2Max (69.89 ± 7.43 ml⋅kg-1⋅min-1). Six days later, these volunteers raced in the Tour of Goiás, participating in five races in four days (435 km) of competition. Arterial blood samples were collected one day before and one day after the competition. The Kolmogorov-Smirnov tests were used to evaluate the data distribution and Wilcoxon to compare the two moments (p <0.05) of data collection. The results show: Red cells ↓ 7.8% (5.1 ± 0.28 vs 4.7 ± 0.37 106 / mm 3, p = 0.01); Hemoglobin ↓ 7.9% (15.1 ± 0.31 vs 13.9 ± 0.27 g / dL, p = 0.01); Leukocytes ↑ 9.5% (4946 ± 553 versus 5416 ± 1075 / mm 3, p = 0.17); Platelets ↓ 7.0% (200.2 ± 51.5 vs 186.1 ± 39.5 / mm 3, p = 0.01); LDH ↑ 11% (164.4 ± 28.5 vs 182.5 ± 20.5 U / L, p = 0.17); CK ↑ 13.5% (290.7 ± 206.1 vs 330.1 ± 90.5 U / L, p = 0.39); CK-MB ↑ 2% (15.7 ± 3.9 vs. 20.1 ± 2.9 U / L, p = 0.06); Cortizol ↓ 13.5% (12.1 ± 2.4 vs 9.9 ± 1.9 μg / dL, p = 0.01); Total testosterone ↓ 7% (453.6 ± 120.1 vs 421.7 ± 74.3 ng / dL, p = 0.12); IGF-1 ↓ 15.1% (213.8 ± 18.8 vs 181.5 ± 34.7 ng / mL, p = 0.04). This means that there was significant reductions in O2 allocation / transport capacities, vascular injury disruption, and a fortuitous reduction of muscle skeletal anabolism along with maintenance and / or slight elevation of immune function, glucose and lipid energy and myocardial damage. Therefore, the results suggest that no abnormal health effect was identified among the athletes after participating in the Tour de Goiás.

Keywords: cycling, health effects, cycling stages races, haematology

Procedia PDF Downloads 178

Authors: S. Abbasi, M. R. Hadian, M. Abdolvahab, M. Jalili, S. H. Jalaei

Abstract:

Background: Rehabilitation treatments have significant role in reducing the disabilities of Cerebro Vascular Accident (CVA). Due to great role of upper limb in the function of individuals particularly in Activity of Daily Living and the effect of stability of shoulder girdle on hand function, the aim of this study was to study the effects of Progressive Resistive Exercise on shoulder extensor and abductor muscles isometric strengths in adult hemiplegic. Methods: 17 adult hemiplegics patients (50-70 yrs., mean 60/52, SD7/22); with RT side dominancy and 6 months after stroke, participated in this study. All procedures were approved by ethical committee of TUMS and written consents were also taken. Patients were familiarized with the procedure and shoulder extensor and abductor muscles isometric strengths were measured by dynamometer. Results: according to result to our study, shoulder extensor and abductor muscles isometric strengths showed Significant differences between mean scores of pre and post intervention (P<0/05). Progressive Resistive Exercise improved 34% shoulder extensor muscles isometric strength and 27% shoulder abductor muscle isometric strength. Conclusion: Results of our research showed that progressive resistive exercise approach is a useful method for increasing the isometric strength of shoulder extensor and abductor muscles. Therefore, it might be concluded that improvement of strength of shoulder muscles could result in stability in shoulder girdle and consequently might effect on hand function in hemiplegic patients.

Keywords: shoulder extensor muscles isometric strength, shoulder abductor muscles isometric strength, hemiplegic, physical therapy

Procedia PDF Downloads 300

Authors: Souheila Zemmouchi

Abstract:

Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

Procedia PDF Downloads 138

Authors: A. Elmajdoub, A. El-Mahmoudy

Abstract:

The present study was designed to investigate the neurotransmitters that mediate the excitatory response of the circular muscle of final branches of mesenteric artery in bovine calves. Mesentery was dissected and the iliac branches were separated and used. The final mesenteric branches of diameter 400 micrometers and less responded strongly to norepinephrine and moderately to ATP. However, the mesenteric branches of wider diameters were gradually less responsive to norepinephrine and those of diameter 700 micrometers were exclusively nonresponsive. These arteries were strongly responsive to ATP (100 µM). Norepinephrine response was sensitive to phentolamine (3 µM) and prazosin (5 µM) indicating that it is mediated by α1 receptor; while ATP response was sensitive to suramin (200 µM), PPADS (50 µM), but not to cibacron blue (100 µM) indicating that it is mediated via P2X receptor. Further confirmatory experiments were performed including application of α1 and P2X receptor specific agonists which are methoxamine and α,β-methylene ATP. Methoxamine (1 µM) showed effects similar to norepinephrine in final branches and was without effect in wider branches. α,β-methylene ATP (1 µM), exhibited more pronounced effects on both wide and narrow branches but in parallel manner to that of ATP. Agonists for α2 and P2Y receptors as clonidine (10 µM) and 2-meThio ATP (10 µM), respectively, were without effect indicating that involvement of these receptors is unlikely. The neuropeptide-Y (200 nM) did not have any effects on either the narrow or the wide rings. Conclusion: These data may imply that in the most peripheral mesenteric arteries a strong vasopressor power represented by norepinephrine and ATP integration is needed for maintaining peripheral resistance; on the other hand a mild vasopressor power mediated only by ATP is enough to maintain the vascular tone in the relatively central mesenteric branches.

Keywords: ATP, calves, mesenteric artery, norepinephrine

Procedia PDF Downloads 285

Authors: Victoria I. Michailova, Denitsa B. Momekova, Hristiana A. Velichkova, Evgeni H. Ivanov

Abstract:

The aim of this work is to design and develop thermo-responsive nanosized drug delivery systems based on poly(N-isopropylacrylamide)-g-poly(ethylene oxide) (PNIPAM-g-PEO) double hydrophilic graft copolymers. The PNIPAM-g-PEO copolymers are able to self-assemble in water into nanoparticles above the LCST of the thermo-responsive PNIPAM backbone and to disassemble and rapidly release the entrapped drugs upon cooling. However, their drug delivery applications are often hindered by their low loading capacity as the drugs to be encapsulated do not dissolve in water. In order to overcome this limitation, here we applied a low-temperature procedure with ethanol as an alternative route to the formation and loading a model hydrophobic drug, Indomethacin (IMC), into PNIPAM-g-PEO nanoparticles. The rationale for this approach was that ethanol dissolves both IMC and the copolymer and its mixing with water may induce micellization of PNIPAM-g-PEO at temperatures lower than the LCST. The influence of the volume fraction of ethanol and the temperature on the aggregation characteristics of PNIPAM-g-PEO copolymers (2.7 mol% PEO) was investigated by means of DLS, TEM and rheological dynamic oscillatory tests. The studies showed rich phase behavior at T < LCST, incl. the formation of highly solvated 500-1000 nm complex structures, 30-70 nm micelles and polymersomes as well as giant polymersomes, as the fraction of added ethanol increased. We believe that the PNIPAM-g-PEO self-assembly is favored due to the different solvation of its constituting blocks in ethanol-water mixtures. The incorporation of IMC led to alteration of the physicochemical and morphological characteristics of the blank nanoparticles. In this case, only monodisperse polymersomes and micelles were observed in the solutions with an average diameter less than 65 nm and substantial drug loading (DLC ~117 – 146 wt%). Indomethacin release from the nanoparticles was responsive to temperature changes, being much faster at a temperature of 42oC compared to that of 37oC under otherwise the same conditions. The results obtained suggest that these PNIPAM-g-PEO nanoparticles could be potential in mild hyper-thermic delivery of nonsteroidal anti-inflammatory drugs.

Keywords: drug delivery, nanoparticles, poly(N-isopropylacryl amide)-g-poly(ethylene oxide), thermo-responsive

Procedia PDF Downloads 259

Authors: Karissa Graham, Andrew Campbell-Lloyd

Abstract:

The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.

Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap

Procedia PDF Downloads 108

Authors: Gabi N. Nehme

Abstract:

Below-knee amputees commonly experience asymmetrical gait patterns. It is generally believed that ischemia is related to the formation of pressure sores due to uneven distribution of forces. Micro-vascular responses can reveal local malnutrition. Changes in local skin blood supply under various external loading conditions have been studied for a number of years. Radionuclide clearance, photo-plethysmography, trans-cutaneous oxygen tension along with other studies showed that the blood supply would be influenced by the epidermal forces, and the rate and the amount of blood supply would decrease with increased epidermal loads being shear forces or normal forces. Several cases of socket designs were investigated using Finite Element Model (FEM) and Design of Experiment (DOE) to increase flexibility and minimize the pressure at the limb/socket interface using ultra high molecular weight polyethylene (UHMWPE) and polyamide 6 (PA6) or Duraform. The pressure reliefs at designated areas where reducing thickness is involved are seen to be critical in determination of amputees’ comfort and are very important to clinical applications. Implementing a hole between the Patellar Tendon (PT) and Distal Tibia (DT) would decrease stiffness and increase prosthesis range of motion where flexibility is needed. In addition, displacement and prosthetic energy storage increased without compromising mechanical efficiency and prosthetic design integrity.

Keywords: patellar tendon, distal tibia, prosthetic socket relief areas, hole implementation

Procedia PDF Downloads 389