Tissue Implants Research Articles

Synthesis and investigation on microstructural, mechanical features of mesoporous hardystonite/reduced graphene oxide nanocomposite for medical applications.

The use of hardystonite (Ca2ZnSi2O7, HT)-based composites could be one the main strategies to improve mechanical properties closing to natural bone. However, there are a few reports in this regard. Recent findings indicate that graphene is a promising biocompatible additive in ceramic-based composite. Here, we propose a simple approach for the synthesis of porous nano- and microstructured hardystonite/reduced graphene oxide (HT/RGO) composite using a sol-gel method followed by ultrasonic and hydrothermal processes. Integrating GO to the pure HT increased the bending strength and toughness values about 27.59% and 34.33%, respectively. It also allowed the increment of compressive strength and compressive modulus by about 8.18% and 86%, respectively, and improvement in the fracture toughness about 11.8 times compared to pure HT. The formation of HT/RGO nanocomposites with different RGO weight percentages ranging from 0 to 5.0 has been investigated by scanning electron microscopy (SEM) and X-ray diffraction and the efficient incorporation of GO nanosheets into HT nanocomposite as well as the mesoporous structural properties were also confirmed by Raman, FTIR and BET analyses. The cell viability of HT/RGO composite scaffolds was assayed by methyl thiazole tetrazolium (MTT) test in vitro. In this regard, the alkaline phosphatase (ALP) activity and the proliferation rate of mouse osteoblastic cells (MC3T3-E1) on the HT/1wt. % RGO composite scaffold enhanced in comparison with the pure HT ceramic. The adhesion of osteoblastic cells on the 1% wt. HT/RGO scaffold was interesting as well. In addition, the effect of 1% wt. HT/RGO extract on the proliferation of osteoblast human G-292 cells was successfully evaluated and remarkable observations were obtained. All together it can be said that the proposed bioceramic hardystonite/reduced graphene oxide composites can be a promising candidate for designing hard tissue implants.

Review of Immediate and Delayed Dental Implant Placement in Modern Dentistry

This literature review contains the overview and comparison of three research articles regarding immediate implants and delayed implants in modern dentistry. With the rise of immediate implants, there are so many factors involved when they are placed during surgery as well as the overall efficiency of the implants. Studies from the three articles are reviewed thoroughly regarding the two main types of implant procedures. Research has shown that immediate implants have various benefits such as shorter treatment time and psychological benefit to the patient. For delayed implants, studies have proven that these implants contain a higher success rate with fewer post-operant complaints. There are many benefits and downsides to each of the options, and this review explores immediate and delayed dental implants while comparing them to one another in modern dental surgeries. The main results of the research was the immediate implants can be more useful and efficient that delayed implants when used properly in dental surgeries and also being well planned ahead of time. Though delayed implants have a higher success rate than immediate implants in tissue, immediate implants get the job done faster and can be a better option when it is well placed.

Long-Term Outcomes of Parathyroid Autografts in Primary Hyperparathyroidism.

Autologous implantation of parathyroid tissue is frequently utilized after parathyroidectomy in patients with heritable forms of primary hyperparathyroidism (PHPT). Data on long-term functional outcome of these grafts is sparse. To investigate long-term outcomes of parathyroid autografts. Retrospective study of patients with PHPT who underwent parathyroid autografts from 1991 to 2020. We identified 115 patients with PHPT who underwent 135 parathyroid autografts. Median follow-up duration since graft was 10 (4-20) years. Of the 111 grafts with known functional outcome, 54 (49%) were fully functional, 13 (12%) partially functional, and 44 (40%) nonfunctional at last follow-up. Age at time of graft, thymectomy prior to autograft, graft type (delayed vs immediate), or duration of cryopreservation did not predict functional outcome. There were 45 (83%) post-graft PHPT recurrences among 54 fully functional grafts at a median duration of 8 (4-15) years after grafting. Surgery was performed in 42/45 recurrences, but cure was attained in 18/42 (43%) only. Twelve of 18 (67%) recurrences were graft-related while remaining 6 (33%) had a neck or mediastinal source. Median time to recurrence was 16 (11-25) years in neck or mediastinal source vs 7 (2-13) years in graft-related recurrences. Median parathyroid hormone (PTH) gradient was significantly higher at 23 (20-27) in graft-related recurrence vs 1.3 (1.2-2.5) in neck or mediastinal source (P = .03). Post-graft recurrence of PHPT occurs frequently within the first decade after graft and is challenging to localize. Time to recurrence after graft is significantly shorter and PTH gradient higher for graft-related recurrence. Clinical Trial Number: NCT04969926.

Same-Day Mastectomy and Immediate Prosthetic Breast Reconstruction: A 12-Year National Database Analysis and Early Postoperative Outcomes.

Coronavirus disease of 2019 and rising health care costs have incentivized shorter hospital stays after mastectomies with immediate prosthetic reconstruction. The purpose of this study was to compare postoperative outcomes following same-day and non-same-day mastectomy with immediate prosthetic reconstruction. A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2007 to 2019 was performed. Patients who underwent mastectomies and immediate reconstruction with tissue expanders or implants were selected and grouped based on length of stay. Univariate analysis and multivariate regression were performed to compare 30-day postoperative outcomes between length-of-stay groups. A total of 45,451 patients were included: 1508 had same-day surgery (SDS) and 43,942 were admitted for 1 or more night (non-SDS). There was no significant difference in overall 30-day postoperative complications between SDS and non-SDS following immediate prosthetic reconstruction. SDS was not a predictor of complications (OR, 1.1; P = 0.346), whereas tissue expander reconstruction decreased odds of morbidity compared with direct-to-implant reconstruction (OR, 0.77; P < 0.001). Among patients who had SDS, smoking was significantly associated with early complications on multivariate analysis (OR, 1.85; P = 0.010). This study provides an up-to-date assessment of the safety of mastectomies with immediate prosthetic breast reconstruction that captures recent advancements. Postoperative complication rates are similar between same-day discharge and at least 1-night stay, suggesting that same-day procedures may be safe for appropriately selected patients. Therapeutic, III.

Designing Ti Alloy for Hard Tissue Implants: A Machine Learning Approach

Designing Ti Alloy for Hard Tissue Implants: A Machine Learning Approach

Impact of Magneto-Deformation Effect in Ferrogels on the Echogenicity of Magnetic Composites

Basically, this study was carried out in the context of the development of ferrogel-based biocompatible soft tissue implants, in particular, for the needs of regenerative medicine and replacement therapy. The magneto-deformation effect (MDE) of ferrogels (FGs) and the possibility of its visualization with the use of medical ultrasound were in the focus of this work. The aim of this investigation was addressed to search a possible relationship between the extent of MDE and the intensity of the reflected echo signal at the gel/water interface and in the gel interior. Cylindrical FGs [Formula: see text][Formula: see text]mm in diameter and [Formula: see text][Formula: see text]mm in height based on polyacrylamide (PAAm) with interpenetrating physical network of natural polysaccharide (Guar) filled with 200–300[Formula: see text]nm Fe3O4 magnetic microparticles (MPs) with weight fraction of 12% or 23% were investigated. MDE was studied using an ultrasonic medical device Sonoline Adara (Siemens, Germany), and estimated by the relative compression of FGs after application the constant gradient magnetic field (MF) up to 500 Oe by an electromagnet. Viscoelastic and acoustic properties of FGs in the absence of the application of an MF were determined as well. It was found that an increase of the weight fraction of MPs in FGs resulted in the significant increase of the ferrogel’s density, the elastic storage modulus, the loss modulus, the acoustic impedance, the reflection coefficient and some decrease of the ultrasonic velocity in FGs. At a given MPs concentration, the MDE in FGs was increased according to a quadratic law with the gradual increase of MF strength. The growth of MDE in FGs accompanies by an increase in the intensity of the reflected echo signal both from the gel/water interface and from the interior of the FGs. The obtained results are discussed from the viewpoint of the effects of MPs on the interaction of an ultrasonic wave with the structure of FGs in the course of MF application.

The Partner Perspective on Autologous and Implant-Based Breast Reconstruction.

Partner involvement in the decision-making process concerning breast reconstruction (BR) after a breast cancer diagnosis may be very supportive for the patient. So far, no study evaluates partner satisfaction with the outcome after BR and the relationship to patient satisfaction. The aim of this study was to assess and compare partner satisfaction of BR with autologous tissue (ABR) and prosthetic implants (IBR), respectively, and compare it to patient-reported outcomes. All patients undergoing ABR and IBR between January 2014 and December 2020 were asked to participate with their partners. Patient and partner satisfaction with breast reconstruction, overall outcome as well as patient's perceived and self-reported psychosocial well-being were evaluated using the Breast-Q and a modified partner questionnaire, respectively. Fifty-three couples participated (IBR: n=30, ABR: n = 23). Patient and partner satisfaction with breast (r = 0.552), outcome (r = 0.465) as well as patient's perceived and self-report psychosocial well-being (r = 0.495) were highly correlated with partners scoring significantly higher (p<0.001). In terms of partner satisfaction, both reconstructive procedures achieved satisfactory results. ABR scored higher in terms of softness of breast and how natural the breast feels to touch whereas IBR was rated superior evaluating the breast size. Both reconstructive procedures achieve satisfactory results in terms partner satisfaction whereas patient's psychosocial well-being was highly overestimated by their partners. Hence, partner inclusion in the regular psycho-oncological support might further sensitize them of the high psychological burden of a breast cancer diagnosis and therefore stabilize patients private support system. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Peritoneal immune microenvironment of endometriosis: Role and therapeutic perspectives.

Endometriosis, an estrogen-dependent chronic inflammatory disease characterized by the growth of endometrium-like tissues outside the uterine cavity, affects 10% of reproductive-age women. Although the pathogenesis of endometriosis is uncertain, it is widely accepted that retrograde menstruation results in ectopic endometrial tissue implantation. Given that not all women with retrograde menstruation develop endometriosis, immune factors have been hypothesized to affect the pathogenesis of endometriosis. In this review, we demonstrate that the peritoneal immune microenvironment, including innate immunity and adaptive immunity, plays a central role in the pathogenesis of endometriosis. Current evidence supports the fact that immune cells, such as macrophages, natural killer (NK) cells, dendritic cells (DCs), neutrophils, T cells, and B cells, as well as cytokines and inflammatory mediators, contribute to the vascularization and fibrogenesis of endometriotic lesions, accelerating the implantation and development of ectopic endometrial lesions. Endocrine system dysfunction influences the immune microenvironment through overexpressed estrogen and progesterone resistance. In light of the limitations of hormonal therapy, we describe the prospects for potential diagnostic biomarkers and nonhormonal therapy based on the regulation of the immune microenvironment. Further studies are warranted to explore the available diagnostic biomarkers and immunological therapeutic strategies for endometriosis.

Biopolymeric Coatings for Local Release of Therapeutics from Biomedical Implants.

The deployment of structures that enable localized release of bioactive molecules can result in more efficacious treatment of disease and better integration of implantable bionic devices. The strategic design of a biopolymeric coating can be used to engineer the optimal release profile depending on the task at hand. As illustrative examples, here advances in delivery of drugs from bone, brain, ocular, and cardiovascular implants are reviewed. These areas are focused to highlight that both hard and soft tissue implants can benefit from controlled localized delivery. The composition of biopolymers used to achieve appropriate delivery to the selected tissue types, and their corresponding outcomes are brought to the fore. To conclude, key factors in designing drug-loaded biopolymeric coatings for biomedical implants are highlighted.

FUNDAMENTAL PRINCIPLES OF MICROGEL SYNTHESIS BY INVERSE EMULSION METHOD

Microgels represent a unique class of compounds that combine the properties of such classes of compounds as colloids, macromolecules and surfactants in a unique way. Microgels are widely used for wastewater treatment, as drug delivery systems, for drying biodiesel, in tissue regeneration and implantation, in chromatography, etc. At this point, such methods of microgel synthesis as the precipitation method, suspension polymerisation and the emulsion method have been developed, which have become traditional in the synthesis of microgels. This publication reviews the inverse emulsion method for microgel synthesis based on polyacrylamide and its derivatives. This method was chosen due to a number of advantages, such as a high degree of monomer conversion, the ability to control the granulometric composition of gel particles during synthesis, a simplified drying procedure for the finished product, etc. The article describes the synthesis features that affect the size and shape of microgels, describes the main factors to consider when planning an inverse emulsion synthesis; shows the difference between macroemulsion, nanoemulsion and microemulsion. The article also presents some aspects of the synthesis of microgel based on acrylamide and its derivatives: the main free-radical initiators are listed; monomers that affect microgel properties are described. This review may be of interest to specialists who are just starting research in this field. Based on this publication, the reader will be able to plan and conduct an experiment on the synthesis of polyacrylamide-based microgels by the inverse emulsion method. For citation: Burin D.A., Rozhkova Yu.A., Kazantsev A.L. Fundamental principles of microgel synthesis by inverse emulsion method. ChemChemTech [Izv. Vyssh. Uchebn. Zaved. Khim. Khim. Tekhnol.]. 2023. V. 66. N 3. P. 6-17. DOI: 10.6060/ivkkt.20236603.6732.

Engineered tissue vascularization and engraftment depends on host model

Developing vascular networks that integrate with the host circulation and support cells engrafted within engineered tissues remains a key challenge in tissue engineering. Most previous work in this field has focused on developing new methods to build human vascular networks within engineered tissues prior to their implant in vivo, with substantively less attention paid to the role of the host in tissue vascularization and engraftment. Here, we assessed the role that different host animal models and anatomic implant locations play in vascularization and cardiomyocyte survival within engineered tissues. We found major differences in the formation of graft-derived blood vessels and survival of cardiomyocytes after implantation of identical tissues in immunodeficient athymic nude mice versus rats. Athymic mice supported robust guided vascularization of human microvessels carrying host blood but relatively sparse cardiac grafts within engineered tissues, regardless of implant site. Conversely, athymic rats produced substantive inflammatory changes that degraded grafts (abdomen) or disrupted vascular patterning (heart). Despite disrupted vascular patterning, athymic rats supported > 3-fold larger human cardiomyocyte grafts compared to athymic mice. This work demonstrates the critical importance of the host for vascularization and engraftment of engineered tissues, which has broad translational implications across regenerative medicine.

Partial Decellularization as a Method to Improve the Biocompatibility of Heart Tissue Implants.

Increasing the biocompatibility of some biological implants through tissue engineering is important for regenerative medicine, which recently has a rapid development dynamic. In this study we used tree different washing protocols, respectively with Sodium Lauryl Sulfate (SLS), with Sodium Deoxycholate (SD), and with saline (Sa) to achieve partial decellularization of 2-3mm thick cross-sections through Wistar rat hearts. Pieces of the heart tissue were either histologically analyzed to evaluate the decellularization processes or implanted for 5 days on 9-day-old chick embryo chorioallantoic membrane (CAM) and then histologically analyzed to evaluate CAM-implant interactions. Histological analysis of SLS or SD washed tissues showed different microscopic features of the decellularization processes, SLS-washing leading to the formation of a completely decellularized ECM layer at the periphery of the heart tissue. Both detergents induced changes in the spatial arrangement of collagen fibers of the heart tissue. Histological analysis of the CAM implants shoved that the peripheral zone with complete decellularization induced by SLS increased the biocompatibility of heart tissue implants by favoring neovascularization and cell migration. These results suggested that the biocompatibility of the heart tissue implant can be modulated by the appropriate use of a SLS-based decellularization protocol.

Recent Advancements in Polyurethane-based Tissue Engineering.

In tissue engineering, polyurethane-based implants have gained significant traction because of their high compatibility and inertness. The implants therefore show fewer side effects and lasts longer. Also, the mechanical properties can be tuned and morphed into a particular shape, owing to which polyurethanes show immense versatility. In the last 3 years, scientists have devised methods to enhance the strength of and induce dynamic properties in polyurethanes, and these developments offer an immense opportunity to use them in tissue engineering. The focus of this review is on applications of polyurethane implants for biomedical application with detailed analysis of hard tissue implants like bone tissues and soft tissues like cartilage, muscles, skeletal tissues, and blood vessels. The synthetic routes for the preparation of scaffolds have been discussed to gain a better understanding of the issues that arise regarding toxicity. The focus here is also on concerns regarding the biocompatibility of the implants, given that the precursors and byproducts are poisonous.

Recurrence of mature cystic teratoma with gliomatosis

Gliomatosis is characterised by the implantation of mature glial tissue on the surface of the peritoneum, with glial nodules 1–10 mm in size. We report a rare case of gliomatosis peritonei associated with a recurrent mature teratoma. A 27-year-old female patient presented with a large abdominal mass after 6 months of caesarean section with a history of mature teratoma resection. Ultrasound and MRI both suggested mature ovarian teratoma. A laparotomy was performed to remove the tumour. During the operation, a large ovarian tumour was noted with a haemorrhagic mass in the peritoneum.

Dissolvable Calcium Alginate Microfibers Produced via Immersed Microfluidic Spinning

Fabrication of micro- and nanofibers are critical for a wide range of applications from microelectronics to biotechnology. Alginate microfibers with diameters of tens to hundreds of microns play an important role in tissue engineering and fibers of these diameters are impossible to fabricate via electrospinning and can only be produced via fluidic spinning. Typically, microfluidic spinning based on photopolymerization produces fibers that are not easily dissolvable, while fluidic spinning with chemical cross-linking employs complex setups of microfabricated chips or coaxial needles, aimed at precise control of the fiber diameter; however, fluidic spinning introduces significant cost and complexity to the microfluidic setup. We demonstrate immersed microfluidic spinning where a calcium alginate microfiber is produced via displacement of alginate solution through a single needle that is immersed in a cross-linking bath of calcium chloride solution. The resulting diameter of the fiber is characterized and the fiber diameter and topology of the deposited fiber is related to the concentration of the alginate solution (2 wt%, 4 wt%, and 6 wt%), needle gauge (30 g, 25 g, and 20 g), and the volumetric flow rate of the alginate solution (1 mL/min, 2 mL/min, and 2.7 mL/min). The resulting fiber diameter is smaller than the internal diameter of the needle and this dependence is explained by the continuity of the flow and increased rate of fall of the liquid jet upon its issuing from the needle. The fiber diameter (demonstrated diameter of fibers range from 100 microns to 1 mm) depends weakly on the volumetric flow rate and depends strongly on the needle diameter. It also seems that for a smaller needle size, a greater concentration of alginate results in smaller diameter fibers and that this trend is not evident as the needle diameter is increased. In terms of topology of the deposited fiber, the higher wt% alginate fiber produces larger loops, while smaller wt% alginate solution yields a denser topology of the overlaid fiber loops. These fibers can be dissolved in DMEM/EDTA/DSC solution in 20-30 min (depending on the fiber diameter), leaving behind the hollow channels in the hydrogel matrix. We believe that the demonstrated simple setup of the immersed microfluidic spinning of the calcium alginate microfibers will be useful for creating tissue constructs, including the vascularized tissue implants.

Differential Angiogenic Induction Impacts Nasal Polyp Tissue Growth.

In chronic rhinosinusitis with nasal polyps, inflammatory edema drives tissue remodeling favoring anomalous growth of the nasal mucosa, but a proangiogenic contribution of nasal polyp in support of tissue growth is still controversial. The chorioallantoic membrane of chicken embryo model was employed to address the potentiality of nasal tissue fragments to modulate angiogenesis. Fifty-seven fertilized eggs were implanted with polyp or healthy nasal mucosa tissue or were kept as non-implanted controls. The embryos' size, length, and development stage, and chorioallantoic membrane vasculature morphology were evaluated after 48h. Quantitative computer vision techniques applied to digital chorioallantoic membrane images automatically calculated the branching index as the ratio between the areas of the convex polygon surrounding the vascular tree and the vessels' area. Ethics approval and consent to participate: the study was approved by the Human Research Ethics Committee of the Federal University of São Paulo (CAAE number: 80763117.1.0000.5505) and by the Animal Research Ethics Committee of University of São Paulo (nº CEUA 602-2019). Mucosal, but not polyp tissue implants, hampered embryo development and induced underdeveloped chorioallantoic membranes with anastomosed, interrupted, and regressive vessels. Vessels' areas and branching indexes were higher among the chorioallantoic membranes with polyp implants and controls than among those with healthy mucosa implants. Nasal polyp presents differential angiogenic induction that impacts tissue growth.

Relationship between mechanical load and surface erosion degradation of a shape memory elastomer poly(glycerol-dodecanoate) for soft tissue implant.

Poly(glycerol-dodecanoate) (PGD) has aroused increasing attention in biomedical engineering for its degradability, shape memory and rubber-like mechanical properties, giving it potential to fabricate intelligent implants for soft tissues. Adjustable degradation is important for biodegradable implants and is affected by various factors. The mechanical load has been shown to play an important role in regulating polymer degradation in vivo. An in-depth investigation of PGD degradation under mechanical load is essential for adjusting its degradation behavior after implantation, further guiding to regulate degradation behavior of soft tissue implants made by PGD. In vitro degradation of PGD under different compressive and tensile load has proceeded in this study and describes the relationships by empirical equations. Based on the equations, a continuum damage model is designed to simulate surface erosion degradation of PGD under stress through finite element analysis, which provides a protocol for PGD implants with different geometric structures at varied mechanical conditions and provides solutions for predicting in vivo degradation processes, stress distribution during degradation and optimization of the loaded drug release.

The pedicled gracilis muscle combined with the fascia lata: a preliminary clinical study of a new biomimetic dynamic phalloplasty method.

Phalloplasty is a challenging procedure in the field of repair and reconstruction. Traditional skin flap methods with prostheses or autologous tissue implantation are still common; however, with this method the reconstructed phallus is static and has a high risk of complications. We aimed to use novel methods for phalloplasty to mimic the normal structure of the phallus while maintaining the patient's ability to obtain sufficient hardness and subjective controllability. The neophallus comprised the bilateral pedicled neurovascular gracilis muscle, which provided neophallus volitional control; the pedicled fascia lata, which mimicked the tunica albuginea; the pedicled anterolateral thigh flap, which was used to reconstruct the neourethra and neoglans; and the thin split-thickness skin grafted on the surface of the fascia lata. The urethral anastomosis was performed simultaneously. The appearance and function of the neophallus, as well as patient satisfaction, were evaluated postoperatively. The biomimetic dynamic phalloplasty using the bilateral pedicled gracilis muscle combined with the fascia lata was successfully performed in 4 patients. During follow-up at 10-21months after the procedure, all 4 patients could complete sexual intercourse and were satisfied with the appearance and self-controllability of the neophallus. The size of the neophallus stabilized within 6months. The tactile, deep touch sensation, and pain sensations of the neophallus partially recovered. All of the patients could stand to urinate. We used the gracilis muscle combined with the fascia lata to mimic the basic structure of the corpus cavernosum and tunica albuginea and successfully reconstructed the biomimetic dynamic neophallus. This is to our knowledge the first report of biomimetic dynamic phalloplasty using the bilateral pedicled gracilis muscle combined with the fascia lata to mimic the complex structure of the phallus and enable the achievement of erection. However, due to the small number of patients included in this study, the data have no statistical significance. More cases are needed to obtain conclusive data and examine the long-term clinical effects of this procedure. Using novel methods for phalloplasty, we successfully maintained the patient's ability to obtain sufficient hardness and subjective controllability without the use of implants, and the preliminary clinical results are encouraging.

Laparoscopic Approach for the Management of Ectopic Pregnancy in a District Level Hospital, Cox's Bazar

Introduction: An ectopic pregnancy occurs when a fertilized egg implants and grows outside of the uterine cavity. Ectopic pregnancy usually occurs as a result of delay or prevention in the passage of the blastocyst to the uterine cavity resulting in its premature implantation in the extrauterine tissues. It usually occurs in 2% of all pregnancies and is a major cause of maternal morbidity and mortality when misdiagnosed or left untreated and subsequent successful pregnancy is less than 50% of patients. About 95% of ectopic pregnancies originate in the tubes. Infrequently, it affects the ovary, the bicornuate uterus, and the cervix. The diagnosis of ectopic pregnancy has been performed using laparoscopy. Additionally, it is widely used for the surgical treatment of ectopic pregnancy. The benefit of laparoscopy for ectopic pregnancy over laparotomy is well-known. Laparoscopic surgery has been widely adopted and new technical innovations, procedures, and evidence-based knowledge are persistently emerging. The laparoscopic advantage over open surgery has also been confirmed in different fields. It is associated with shorter operative time, less intraoperative blood loss, reduce postoperative pain, less analgesic requirement, a shorter hospital stay, faster recovery, cost- effectiveness, and lower rate of postoperative complications. This study aimed to compare the outcome of laparoscopic management with laparotomy in the management of ectopic pregnancy. Methods: This was a prospective cross-sectional study that was carried out in a district level hospital at Cox's Bazar. This study was conducted from May 2020 to May 2022. A total of 59 subjects were selected for the study as per inclusion criteria. Result: Among 59 respondents, most of the subjects were of the 15-25 years age group which constituted 81.36%, followed by 13.56% of the 26-35 years age group, and the rest 5.08% were of &gt;35 years age group. Laparoscopy was done on 40 (67.20%) patients and laparotomy was done on 19 (32.80%) patients. Approximately, 25% of laparoscopy patients and 52% of laparotomy patients had prior surgery. Prior ectopic surgery was performed on around 8.47% of laparoscopy patients and 13.55% of laparotomy patients. Regarding the comparison of laparoscopy and laparotomy procedure, total blood loss was less (30-50ml) in laparoscopy and more (≥60ml) in the laparotomy procedure. Hospital stay was also less (1-2 days) in laparoscopy and more (≥3 days) in laparotomy, duration of operation was shorter (20-30min) in laparotomy and comparatively longer (30- 60 min) in laparoscopy. Previous surgery was done on 25% and 52.17% patients who underwent laparoscopy and laparotomy respectively. Previous ectopic pregnancy was diagnosed on 8.33% and 47.83% of laparoscopy and laparotomy patients respectively. Moreover, previous PID was found in 5.55% patients who underwent laparoscopy and none who underwent laparotomy. 2.77% of patients who underwent laparoscopy had a history endometriosis. Recovery to normal activity was early in laparoscopy and late in laparotomy. Moreover, 27 (67.5%) patients conceived among 40 who underwent laparoscopy, and 3 (15.78%) patients conceived among 19 who underwent laparotomy. Conclusion: The management of ectopic pregnancy with laparoscopy may be the most helpful operation with the highest possible level of safety and effectiveness. Laparoscopy has both a diagnostic &amp; therapeutic role in ectopic pregnancy. Laparoscopy is feasible and safer than laparotomy in surgical management of ectopic pregnancy.

Morphological and biochemical analysis of cells cultured on fibrous poly(ε-caprolactone) scaffolds with different degrees of fiber alignment produced by solution blow spinning.

Bioresorbable materials are compounds that decompose in physiological mediums both in vitro and in vivo and are used as an alternative to temporary implants in injured tissues. The aim of this study was to analyze the morphology and cytochemistry of cells grown on fibrous poly(ε-caprolactone) (PCL) scaffolds and to measure cell metabolism parameters by biochemical analysis of the conditioned culture medium from cells grown on the scaffolds. Fibrous PCL scaffolds were used under the following conditions: unaligned fibers (NA), fibers aligned at 150 rpm (A150), and fibers aligned at 300 rpm (A300). Vero cells were cultured on these scaffolds for 24 h, 48 h, and 72 h. Samples were analyzed by SEM, MicroCT, cytochemistry, and culture medium biochemistry. The results of the cytochemical analysis showed cells were confluent and well spread on the culture plate, while cells grown on the polymeric scaffold, exhibited an elongated morphology. In the biochemical analyses, no significant differences were observed in the expression of alkaline phosphatase or in the levels of cholesterol or total protein in the culture medium. The different materials do not seem to promote changes in the expression or metabolism of these molecules. Only glucose was markedly reduced in the culture medium of cells grown on either aligned or unaligned scaffolds for 48 h or 72 h. This finding indicates the intense energy requirements of cells grown on these scaffolds. PCL fibers showed a great capacity to support cell growth. These data reinforce the interpretation that cells grow satisfactorily on PCL scaffolds.