Mean Percentage Of Area Research Articles

Two Stage Sinus Lifting Using Nanohydroxyapatite Particles Versus Deproteinized Bovine Bone: Randomized Clinical Trial.

Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation. Twenty-four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy-apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively. Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (p > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (p > 0.05). The two-stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended. ClinicalTrials.gov identifier: NCT03184857.

Dipeptidyl peptidase IV inhibitors reduce hepatic fibrosis and lipid accumulation in rat intestinal failure-associated liver disease models.

This study aimed to investigate the effectiveness of dipeptidyl peptidase IV inhibitors (DPP4-I) against liver damage, especially fibrosis and lipid accumulation, in a rat intestinal failure-associated liver disease (IFALD) model. SD rats were divided into two groups: the Control (n = 7; normal saline + IFALD model) and DPP4-I (n = 7; DPP4-I + IFALD model; short bowel syndrome (SBS) + total parenteral nutrition) groups. All rats were euthanized 21days postoperatively to obtain tissue samples. Liver fibrosis was evaluated by Sirius Red and α-SMA staining. Liver damage was assessed using the steatosis, activity, and fibrosis score. Inflammation cytokines were examined by ELISA. The survival rate was comparatively different, being 87.5% in the DPP4-I group and 70.0% in the Control group. Two rats of the Control group showed progressive liver fibrosis in the periportal area with fibrous streaks. Further, the mean area percentage of α-SMA immune-positive cells was significantly lower in the DPP4-I group than in the Control group. TGF-β levels were significantly lower in the DPP4-I group than in the Control group. DPP4-I administration reduced liver fibrosis in IFALD, possibly by inhibiting DPP4-I-induced adipogenesis and suppressing TGF-β. These results may contribute to elucidating the mechanism of IFALD.

A multicentre clinical trial evaluating the outcomes of two application regimens of a unique keratin-based graft in the treatment of Wagner grade one non-healing diabetic foot ulcers.

Diabetic foot complications that lead to lower extremity amputations pose a significant challenge to the entire global health system. In this multicentre clinical trial, 26 patients with chronic Wagner one diabetic foot ulcers (DFUs) were treated with a unique human keratin matrix graft applied either weekly or bi-weekly, in addition to standard of care. The hypothesis was that bi-weekly application would be similar to weekly application. The primary endpoint was complete wound closure by 12 weeks, and secondary endpoints included healing time, percent area reduction and weekly changes in peripheral neuropathy, pain and quality of life. In the intent-to-treat population, 77% (10/13) of DFUs treated with bi-weekly application healed compared with 69% (9/13) treated with weekly application. The mean time to heal within 12 weeks in the bi-weekly group was 61 days and in the weekly group was 54 days. The mean percent area reduction at 12 weeks was 94.7% in the bi-weekly group compared with 84.8% in the weekly group. The number of grafts used in the bi-weekly group was 3.9 compared with 6.2 in the weekly group. The results of this trial confirm our hypothesis that whether bi-weekly or weekly application of the unique keratin matrix graft is used to treat nonhealing indolent DFUs, there is a high rate of complete healing. Based on these results, future studies should be conducted that further investigate the use of this novel human keratin matrix graft for the treatment of chronic DFUs.

Treatment of bacterially contaminated lower extremity ulcers with a fatty acid-containing wound matrix: a case series.

The aim was to evaluate the effectiveness of a marine omega fatty acid-containing multimodal wound matrix (MWM) in reducing bacterial contamination and supporting wound area reduction (WAR) in patients with hard-to-heal wounds of varying aetiologies. A prospective, single-site, pilot case series of patients with hard-to-heal wounds. All wounds were considered non-healing prior to inclusion as they had failed to achieve at least 50% WAR after at least four weeks of standard of care (SoC) treatments. Patients were seen once weekly for wound assessments, matrix application and dressing changes. Baseline and weekly fluorescence images, standard wound images and wound measurements were obtained. A total of three patients, two with venous leg ulcers (VLUs) and one with a diabetic foot ulcer (DFU) were enrolled in this pilot study. The mean baseline wound age prior to study enrolment was 24 weeks, with a mean baseline wound size of 8.61cm2. The two VLUs went on to complete closure. The DFU displayed a total WAR of 53% by six weeks, when the patient was lost to follow-up due to a geographical relocation. The mean percentage area reduction of all wounds combined was 82% upon study completion. The use of MWM proved to be effective and safe in this patient cohort. The wounds included in this case series failed to enter a healing trajectory with SoC wound therapies. The MWM supported wound closure and reduced bacterial loads in this patient cohort.

The Potential Role of Bone Marrow Mesenchymal Stem Cells Derived Exosomes on Experimentally Induced Osteoarthritis of Knee Joint in Male Albino Rats. Histological and Immunohistochemical Study

Abstract Introduction Osteoarthritis (OA) is the most common joint disorder worldwide characterized by progressive loss of articular cartilage. This study was conducted to evaluate the role of bone marrow mesenchymal stem cells (BMSCs) derived Exosomes as a promising therapy for treating osteoarthritis. Aim of the Work to study the healing potential of BMSCs derived exosomes on experimentally induced knee osteoarthritis. Materials and Methods Forty adult male albino rats, weighing 200-250 gm, were used in this study, five rats used as a source of BM-MSCs derived exosomes. The other thirty-five rats were randomly divided into three main groups Group I: The control group (20 rats) in which rats were subdivided into four subgroups. Subgroups IA and IB were sacrificed 2 and 6 weeks after the beginning of the experiment. Subgroup IC left for 2 weeks then were received intra-articular injection of 0.1ml Phosphate buffer saline (PBS) in right knee joint once weekly for 4 weeks Subgroup ID: left for 2 weeks then given intra-articular injection of purified exosome concentrate in the right knee joint once weekly for 4 weeks then the animals were sacrificed Group II:(15 rats) in which OA was induced by intra-articular injection of 2% formaldehyde solution in the right knee joints. The rats of group II were subdivided into two subgroups. Subgroups IIA and IIB were sacrificed 2 and 6 weeks after induction of OA respectively. Group III (5 rats), Osteoarthritis induced, as in group II and animals left for 2 weeks then treated by intra-articular injection of purified exosome concentrate in right knee joint once weekly for 4 weeks. The right joints from all groups were collected, decalcified and processed for histological studies. Morphometric and statistical measurements were done. Results Histological examination of the right knee joints of OA group (subgroups IIA and IIB) showed surface erosions, decrease cartilage thickness, chondrocytes with pyknotic nuclei and areas of chondrocytes loss with longitudinal clefts reaching the deep zone. Synovial membrane of group II showed increased thickness of the intima, mononuclear cellular infiltration with abundant collagen fibres deposition and dilated congested blood vessels in subintima, apparent increase in the number of iNOS positive intimal synovial cells. Meanwhile, group III showed smooth articular surface, with multiple colonies of chondrocytes and multiple cell nests, significant increase in the mean area percentage of PCNA positive chondrocytes in animals of group Ш when compared to all the other groups. Conclusion BMSCs derived exosomes improved OA induced damage of articular cartilage and synovial membrane. Therefore, it offers a cell-free treatment of OA and joint damage.

Does Fibromyalgia Affect the Structure of the Dentate Gyrus?

Abstract Background The hippocampus is considered an important component of the limbic system of the brain. It is involved in memory and functional diversities. The term hippocampus typically refers to the dentate gyrus and the hippocampus proper, the cornu ammonis (CA). Fibromyalgia is known to cause memory and cognitive function impairment and is characterized by causing chronic widespread muscular pain. Aim of the Work The aim of this work was to study the possible structural and morphometric changes in rats’ hippocampal dentate gyrus induced by repeated intramuscular injections of acidic saline in the left gastrocnemius and to compare it with the control. Material and Methods Fifty-four adult female albino Swiss rats were divided into three equal groups (18 rats each): control group (I), natural saline group (II) and acidic saline group (III). Group I received no medication, group II received two i.m. injections of 100 μl saline (pH 7.4) into the left gastrocnemius muscle at day 0 and 5 respectively under sedation with halothane (2-4%), while group III received two i.m. injections of 100 μl saline (pH 4) into the left gastrocnemius muscle at day 0 and 5 respectively under sedation with halothane (2-4%). Rats of each group were further subdivided into 3 subgroups (a, b, c) 6 rats each. Rats were sacrificed by decapitation at day 7, 14, 21 from the start of experiment and their brains were excised. Results Histological examination of H&E-stained sections of groups I and II showed no difference and were both considered control groups. The dentate region was formed of three laminae: the molecular, granular and polymorphic. The granular cell layer is the principal layer separating the molecular and polymorphic layers and was formed of aggregation of granular cells. They were rounded to oval with large vesicular nuclei and .prominent nucleoli The examination of the H&E-stained sections of rats’ dentate gyrus granular cells (DG) appeared darkly stained with pyknotic nuclei I group III as compared to the control. Glial cells slightly increased especially among molecular and polymorphic layers. Neurofibrillary tangles and vacuolations started to appear in silver-stained sections. The neurodegenerative findings started to be more notable in subgroup (b) then became more prevalent in subgroup(c) together with the appearance of clear areas among the sub granular zone. Morphometric studies detected non-significant difference in mean area percentage of astrocytes between group I and group II subgroups. The statistical analysis demonstrated high significant difference in mean area percentage of astrocytes between control groups and acidic saline groups. Evident gliosis was confirmed in group IIIc when the astrocytes percentage areas become very highly significantly increased compared to groups I and II. Conclusion In conclusion, repeated acidic saline injection induced dentate gyrus alterations obvious but minimal at week 1 and become intense at week 3 after the first injection. This effect ended with neuronal death and gliosis.

A Histological Study of the Effects of Administration and Withdrawal of Anabolic Androgenic Steroid (Nandrolone Decanoate) on the Hippocampus and the Prefrontal Cortex in Adult Male Albino Rats

Abstract Background The PFC and the hippocampus are parts of the limbic systems and have a major role in emotion regulation, memory and learning. Anabolic androgenic steroids (AASs) are large groups of synthetic derivatives of testosterone, prescribed for the treatment of male hypogonadism. Common abuse of AASs has spread among the general population and Aim of the Work The aim of the current work was to study the effects of AASs on the PFC and the hippocampus histologically and statistically and to evaluate the reversibility of these effects in these regions after AASs withdrawal. Material and Methods 24 adult male albino rats (3 – 6) months old (weighing 200-225 gm) were used in the current study and divided into 3 groups; according to the procedure and treatment type: control group (I) (12 rats) and AASs treated group (II) (6 rats) and Withdrawal group (III) (6 rats). Fixation for the brain using bouin solution was done first in situ followed by its removal and transfer to a glass bottle containing bouin solution for 24 hours to ensure complete fixation. The PFC and the hippocampi were obtained through parasagittal section. Specimens were processed for preparation of paraffin blocks then stained with H&E stain and immunohistochemically stained for GFAP antibody. Image analysis &morphometry were performed on stained sections for; number of surviving pyramidal neurons and the mean area percentage of GFAP staining. Results On examination of H&E-stained sections of control groups, the PFC was formed of the six- layers, the molecular layer, outer granular layer, outer pyramidal layer, inner granular layer, inner pyramidal layer and the multiform layer. The Hippocampus was formed of two components: the dentate gyrus (DG), the hippocampus proper (Cornu Ammonis, with its four regions: CA1, CA2, CA3 and CA4). The cells forming the hippocampus proper were arranged in three layers; the molecular, the pyramidal and the polymorphic layers. In immunohistochemically stained section, the present work showed minimal apparent immune-reaction in the cytoplasm and processes of astrocytes in the PFC and CA1 region of the hippocampus in the control group. On examination of H&E-stained sections of the AASs treated groups, signs of neuronal damage were observed. The inner pyramidal layer of the PFC and the pyramidal layer of CA1 region of the hippocampus revealed abnormal shrunken pyramidal cells having deeply stained nuclei, peri-cellular spaces and flame like appearance with pointed end. Moreover, these layers demonstrated also normal pyramidal cells showing also large rounded open vesicular nuclei and prominent nucleoli. Immunohistochemically stained sections of the treated group in both regions showed apparent extensive brownish immunostaining of the astrocytes with ramifying processes along the layer. Examination of H&E-stained sections of the withdrawal group revealed the inner pyramidal layer of the PFC and the pyramidal layer of CA1 region of the hippocampus showing normal pyramidal cells having large rounded open vesicular nuclei, prominent nucleoli and apical dendrites. It also showed dark irregular cells having deeply stained nuclei, peri- cellular spaces and flame like appearance with pointed end. Immunohistochemically stained section of the treated group in both regions showed apparent minimal brownish immunostaining of the astrocytes. Conclusion Results of the present experimental study demonstrated that AASs (in the form of ND) administration affecting the PFC and the hippocampus resulted in several histopathological and morphometric harmful effects which regressed to a lesser extent through its withdrawal after 2 weeks.

Efficacy of Different Doses of Quercetin against Chemically Induced Oral Squamous Cell Carcinoma in Hamsters

Abstract Background: The use of Caspase-3 to evaluate the chemopreventive effect of quercetin on experimentally induced squamous cell carcinoma was applied in the current study. Materials and Methods: Five groups of Syrian male hamsters were employed in the study. Group I (negative control): 5 animals do not receive any treatment. Group II: 5 animals receiving (quercetin only at a concentration of 150 mg/kg). Group III (dimethylbenz(a)anthracene [DMBA]-treated group for 14 weeks): 10 animals were coated with 0.5% DMBA. Group IV (DMBA + quercetin 150 mg/kg): 15 animals receiving quercetin of a concentration (150 mg/kg) every day through a gavage tube along with painting the hamster buccal pouch with DMBA (0.5%) three times per week for 14 weeks. Group V (DMBA + quercetin 50 mg/kg): 15 animals receiving quercetin of concentration (50 mg/kg) every day through a gavage tube along with painting the hamster buccal pouch with DMBA (0.5%) for 14 weeks at three times each week. Results: Group III showed the lowest mean area percent (10.23), whereas Group V revealed the highest mean area percent value (23.64). All groups showed a statistically significant difference among them. Conclusion: Quercetin showed apoptotic potential validated by Caspase-3, so it may be a valuable chemopreventive agent antagonizing DMBA-induced carcinogenesis in animal models.

LATERAL TRANSLIGAMENTOUS APPROACH TO THE TALAR DOME

IntroductionAnatomic reduction of talar body fractures is critical in restoring congruency to the talocrural joint. Previous studies have indicated a maximum of 25% talar body exposure without malleolar osteotomy. The aim of this study was to investigate the percentage talar body exposure when using the lateral transligamentous approach.MethodsThe lateral transligamentous approach to the talus was undertaken in 10 fresh frozen cadaveric specimens by surgeons inexperienced in the approach, following demonstration of the technique. An incision was made on the anterolateral aspect of the ankle augmented by the removal of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) from their fibular insertions. A bone lever was then placed behind the lateral aspect of the talus and levered forward with the foot in equinus and inversion.The talus was disarticulated and high resolution images were taken of the talar dome surface. The images were overlain with a reproducible nine-grid division. Accessibility to each zone within the grid with a perpendicular surgical blade was documented. ImageJ software was used to calculate the surface area exposed with each approach.ResultsThe mean percentage area of talar dome available through the transligamentous approach was 77.3 % (95% confidence interval 73.3, 81.3). In all specimens the complete lateral talar process was accessible, along with the lateral and dorsomedial aspect of the talar neck. This approach gives complete access to Zones 1,2, 3,5 & 6 with partial access to Zones 4,8 & 9.ConclusionThe lateral transligamentous approach to the talus provides significantly greater access to the talar dome as compared to standard approaches. The residual surface area that is inaccessible with this approach is predominantly within Zone 4 and Zone 7, the posteromedial corner.

Efficacy of photobiomodulation using diode laser 650 nm combined with nano-cellulose and nano-amorphous calcium phosphate in bone healing of rabbit tibial defects assessed by H&E staining and computed tomography.

The purpose of the current study was to evaluate the effect of Diode LLLT 650 nm, TEMPO oxidized Nano-fibrillated cellulose mixed with Nano-Amorphous calcium phosphate, and their combination on bone healing in rabbit tibia using H&E staining and computed tomography. Eighteen adult male New Zealand rabbits were selected, two circular bone defects were created in each tibia, resulting in four bony defects in each rabbit, representing the four tested groups; group A (negative control), group B (filled with mineralized nano-cellulose), group C (combination), group D (laser). Animals were euthanized after two weeks and one month, defects were assessed by CT for bone density, then histological samples were examined by H&E stain. In both evaluation periods, group D recorded the greatest mean area percent of new bone formation and bone density, followed by group A, while group C recorded the lowest value. Groups A and D showed full closure of the defects, while groups B and C showed partial defect closure with retained bone graft material. H&E and CT showed that Laser group had the best results of defects healing, bone density and new bone formation, followed by the negative control group. Diode laser 650nm photobiomodulation significantly improved bone defects healing. Mineralized nano-cellulose experimental bone substitute material showed a delayed effect in bone healing and graft material resorption. The combination of LLLT with the graft material had no positive outcome on bone defect healing.

Efficacy of acellular fish skin graft in the management of chronic ulcer: a systematic review and meta-analysis.

The wounds failing to heal through a timely and orderly standard of care (SOC) treatment are considered as chronic wounds, which add significant burden to healthcare systems around the world. SOC treatment has been commonly applied for management of chronic wounds, but SOC alone may not be adequate to heal all ulcers effectively. Fish skin graft (FSG) is a xenogenic skin substitute which could be used for accelerating skin healing. The current study was performed with the view of evaluating the effectiveness of FSG as an adjuvant treatment of SOC for chronic ulcer treatment. Two authors independently searched the following electronic databases: PubMed, Embase, and CENTRAL, using keywords including "diabetic foot ulcer," "fish skin graft," and "wound healing." Clinical studies that evaluated the clinical outcomes of FSG in treatment of chronic ulcers were included in this meta-analysis. Random- or fixed-effect modeled meta-analyses were performed according to the heterogeneity test result (i.e., I2), to analyze the clinical outcome of FSG. A total of 8 studies were included in qualitative synthesis and meta-analysis, with 145 patients treated by SOC and 245 patients treated by SOC plus FSG. There was no significant difference between two groups for time to healing (MD = 1.99, 95% CI: -3.70~7.67, p = 0.493). The complete healing rate was significantly higher in FSG group compared with SOC alone (OR = 3.44, 95% CI: 2.03~5.82, p < 0.001***). Mean percentage area reduction (PAR) was reported in six studies, with a range of 71.6~97.3%. However, many of these studies did not report the value of standard deviation (SD), so we could not pool the data. No significantly different ulcer recurrence rate (RR = 0.60, 95% CI: 0.07~5.27, p = 0.645) and severe adverse events (SAEs) risk (RR = 1.67, 95% CI: 0.42~6.61, p = 0.467) were found between two groups. The application of FSG treatment for patients with chronic ulcers that do not respond well to SOC management could significantly increase the complete healing rate compared with SOC alone, without increased recurrence rate and SAEs risk.

Remote assessment and monitoring with advanced wound therapy to optimise clinical outcomes, access and resources.

Patients in rural communities may have limited access to wound care; however, this may be mitigated by using a shared care approach. This study assessed the impact of a remote assessment and monitoring tool in combination with adjunctive continuous topical oxygen therapy (cTOT) in patients with diabetes and hard-to-heal wounds. Patients with hard-to-heal wounds (defined as no visible improvement in the previous four weeks) were enrolled to this 12-week pilot study to validate a shared care approach using an Advanced Digital Wound Care Platform-telehealth (ADWCPt) system (eKare Inc., US) coupled with cTOT. Patient and wound assessments were reviewed by the clinician either remotely, via telehealth calls, or at the clinic, and the number of face-to-face clinic visits was recorded. Patient health status scores were captured before and after the study, along with feedback on usability of the remote platform and cTOT device. The wounds in all eight patients studied reduced in size over 12 weeks (mean percentage area reduction 92.0%), and two wounds were completely re-epithelialised. Another wound almost healed (99.2% wound area reduction). Clinical interactions consisted of self-assessments (n=80, 50.0%), video assessments with the clinician (n=27, 16.9%), and face-to-face interactions in clinic (n=53, 33.1%). Operational efficiencies encompassed a 54.0% increase in the number of clinical interactions, whereas clinical time was reduced by 25.8%. Health status scores improved across all eight patients and feedback on the shared approach and cTOT device was favourable. A shared care model with ADWCPt coupled with an innovative cTOT device saved time and resources, improving patient access and engagement, along with a marked improvement in the wound healing trajectory.

Effect of pyometra on vascularity alterations, oxidative stress, histopathology and inflammatory molecules in feline

This study aimed to investigate blood flow, hemodynamical features by Doppler ultrasound, the oxidative stress biomarkers from serum samples, and histopathology from uterine tissue, in healthy queens and queens with pyometra. Twenty queens were categorized into two groups, according to signs, history, and ultrasound findings, as pyometra and control healthy queens. Doppler ultrasonography, total antioxidant capacity (TAC), malondialdehyde (MDA), albumin, bacteriological isolation, histopathology, and immunohistochemistry of tumor necrosis factor-alpha (TNF-α) and nuclear factor kappa B (NF-κB) P65 were performed. Uterine diameter and thickness increased significantly in the pyometra group compared to control. Uterine peak velocity and flow rate were significantly higher in the control group. The pyometra group showed a significant decrease in albumin, TAC, and a significant increase in MDA. Fibrosis and mononuclear inflammatory cell infiltration were seen in the pyometra samples. The mean area percentage of TNF-α expression in the uteri of the pyometra group was higher. The expression of NF-κB P65 in the uteri in the pyometra group was significantly higher. Doppler ultrasonography can provide valuable information for diagnosing pyometra in queens by elevating the uterine thickness with reducing blood flow rate. Oxidative stress, TNF-α, and NF-κB expression alterations varied between pyometra and control groups.

Comparison of the effects of different local thresholding techniques on noise: A potential for optical coherence tomography image binarization

This study aims to investigate the different local thresholding methods on various regions of noise images, which could be used for image binarization of optical coherence tomography images. In the methods one hundred 8-bit images of noise, 1000x1000 pixel in size, is generated using ImageJ/FIJI program. Images processed with four different auto local threshold method in ImageJ/FIJI program as Niblack, mean, median and midgrey, to perform binarization. Twenty-five different region of interest, 100x100 pixel in size, from different region in an image analyzed for area percentage (AP) measurement. Normality tests were performed via Saphiro Wilk Normality test, and Student’s t test and one-way ANOVA were used to assess the continuous variables, and Bonferroni test for post hoc analysis, utilizing the IBM SPSS Statistics for the statistical analysis. In the results of this study mean AP for Niblack method was 42.08 ± 0.32%, for mean method was 50.00 ± 0.32%, for median method was 49.28 ± 0.16%, and for midgrey method was 49.63 ± 2.09%. One-way ANOVA analysis shows all the different subgroups of Niblack and mean, Niblack and median, Niblack and midgrey, mean and median, mean and midgrey, and median and midgrey measurements are significantly different from each other. In conclusion this study examined 100 noise images across 25 regions using four auto local threshold methods (Niblack, mean, median, and midgrey). Analyses indicated that Niblack having the lowest mean and there is significant difference between all the methods; researchers using auto local threshold methods in OCT image processing should select methods aligned with data properties, warranting further exploration of these methods’ impact on diverse OCT image, especially taking into account the effect of the noise.

Impact of Prepectoral vs. Subpectoral Tissue Expander Placement on Post-mastectomy Radiation Therapy Delivery: A Retrospective Cohort Study.

Implant-based reconstruction is the most common method of postmastectomy reconstruction. Many patients require postmastectomy radiation (PMRT). Tissue expanders (TEs), typically inserted as a first stage, have historically been placed subpectorally. More recently, prepectoral reconstruction has gained popularity, but its impact on PMRT is unknown. Prior studies focus on complication rates and aesthetic outcomes. This study examines whether there is a difference in radiation dosimetry among patients undergoing prepectoral versus subpectoral TE reconstruction. Electronic medical records and radiation plans of 50 patients (25 prepectoral, 25 subpectoral) who underwent mastectomy with immediate TE reconstruction at our institution or affiliate site were reviewed. Pectoralis major muscle and chest wall structures were contoured and mean percentage volumes of these structures receiving less than 95%, 100%, and more than 105% target radiation dose were calculated, as were heart and ipsilateral lung doses. Welch two sample t test, Fisher exact test, and Pearson chi-squared tests were performed. The groups had comparable patient and tumor characteristics and underwent similar ablative and reconstructive procedures and radiation dosimetry. Subpectoral patients had larger mean areas receiving less than 95% target dose ("cold spots"); prepectoral patients had larger mean areas receiving greater than 105% ("hot spots") and 100% target doses. There were no differences in chest wall, heart, and lung doses. Our results demonstrate an increased mean percentage area of pectoralis cold spots with subpectoral reconstruction and increased area of hot spots and 100% dose delivery to the pectoralis in prepectoral patients. Larger studies should analyze long-term effects of prepectoral reconstruction on radiation dosing and recurrence rates.

Immunostimulatory and anti-inflammatory impact of Fragaria ananassa methanol extract in a rat model of cadmium chloride-induced pulmonary toxicity.

Cadmium is an extremely dangerous heavy metal that can lead to disastrous consequences in all organisms. Several natural remedies reduce the toxicities of experimentally generated metals in animals. Strawberry Fragaria ananassa contains several bioactive compounds that may mitigate heavy-metal toxicity. The study aim was to evaluate the ability of a strawberry fruit methanol extract (SE) to reduce Cd toxicity and to identify and quantify the active constituents of SE. Forty Wistar rats were classified into four groups: the control group- 1 ml saline IP; SE group- 100 mg of SE/kg rats orally; cadmium (Cd) group-2 mg CdCl2/kg body weight/IP daily; and treated group- SE given 1 hour before Cd administration. Administration of Cd induced several histopathological and immunohistochemical alterations in lung sections. Biochemical analysis of lung homogenates and mRNA levels of antioxidants and inflammatory cytokines indicated significant changes to the risk profile. SE administration significantly decreased the oxidative stress, inflammation, tissue damage, the mean area percentage of collagen fibers, and positive immuno-expressions of TNF-α and NF-κB induced by CdCl2. Moreover, the MDA, TNF-α, GM-CSF, and IL-1β levels in Cd-exposed rat lung tissue were significantly lower in the SE-treated group than in the Cd-group. SE significantly augmented lung GSH, SOD, HO-1, GPx-2, and Nrf2 levels in Cd-exposed rats. SE mitigated Cd-caused oxidative stress and lung inflammation. Therefore, regularly consuming a strawberry-rich diet could benefit general health and help prevent and treat diseases.

Syndesmosis Evaluation Under WBCT: 3rd Base to Get a Cut-Off Point to Diagnosis

Category: Sports; Arthroscopy Introduction/Purpose: Evaluation of syndesmal injury remains challenging for Foot &amp; Ankle Surgeons. As objective data to provide an accurate preoperative diagnosis of syndesmal instability is lacking, arthroscopy has remained the Gold Standard. However, the costs and risks associated with surgery make arthroscopy challenging to indicate in all cases. Therefore, significant interest exists in determining objective criteria to safely indicate surgery. Comparative WBCT is a valuable tool, allowing a precise evaluation of the healthy and injured joints. Specifically, the difference in the syndesmal area correlates with diastasis at the inferior tibiofibular joint, while the cut value for diagnostic instability remains undetermined. Objective: To compare the difference in syndesmal area between healthy patients and patients with syndesmal sprains under WBCT. Methods: IRB approval was obtained for a retrospective case-control study. Patients with suspected syndesmal injuries from April 2019 to August 2022 were included in the case group. Patients with chronic ankle instability, age over 55 years, or surgery of the inferior limb were excluded. The control group was obtained from a previous study of comparative WBCT of the ankle joint, obtained for reasons different than trauma or instability. All patients were evaluated under WBCT by a fellowship-trained MSK radiologist. After evaluating the syndesmal area at 1 cm from the ankle joint line in an axial WBCT slice, the percentage difference from the injured to the healthy side was recorded. Demographic data were obtained from the patient chart. For those patients undergoing surgical stabilization, the operative note was examined. Statistical evaluation was performed by an independent statistician using SPSSv27 using the ANOVA test. Results: Thirty-nine patients were recruited for the study group, and a control group of 25 patients with healthy ankles was obtained. Demographics data for both groups were comparable Arthroscopy was indicated in 7/39 patients (17,9%), which confirmed diagnosis and warranted stabilization of the joint. The mean percentage area difference of the confirmed injured syndesmosis was 15,14% (IC 4,89-25,39), suspected injured syndesmosis was 9,25% (IC 3,11-15,39), and the healthy syndesmosis was 1,54 (IC 1,08-2,01). Statistically significant differences were obtained for healthy, operated, and non-operated patients with a p=0,021. Conclusion: A comparative WBCT scan and the percentage difference in the syndesmal area between the healthy, confirmed, and suspected syndesmal injury demonstrated a handy diagnostic tool. Although the limitations of this study, our results suggest that a 15% difference in the syndesmal area between healthy and injured sides might be used as the cut-off point to indicate diagnostic arthroscopy.

The impact of intracervical hyaluronidase enzyme on cervical histomorphology in successfully detorted uterine torsion affected buffaloes

The present study evaluated the impact of intracervical hyaluronidase enzyme on cervical histomorphology in successfully detorted uterine torsion affected buffaloes. These animals were either subjected to routine post-detorsion treatment (n=10) or in addition to routine treatment, hyaluronidase enzyme (10,000 IU; 2.5 ml at each of 3, 6, 9, 12 o’clock position of cervix) was administered intracervically immediately post-detorsion (n=10), followed by repeated administration at 6 h interval (0, 6, 12, 18 h) till complete cervical dilatation or till 24 h after detorsion. The pre-treatment cervical biopsy samples were collected immediately after detorsion and post-treatment samples were collected at complete cervical dilatation which happened within 24 h after detorsion in all the cases. Following histomorphology, the quantification of collagen fibers as mean percentage area occupied collagen out of total tissue area in pre-treatment cervical biopsy samples of all the buffaloes was revealed as 21.0±5.7. During post-treatment period, at the time of complete cervical dilatation, this value exhibited a decrease in control (9.1±2.2; P&gt;0.05) as well as hyaluronidase group (5.8±2.1; P&lt;0.05). In summary, collagen fiber dispersion in cervical tissue of successfully detorted uterine torsion affected buffaloes suggested their role in cervical dilatation, whereby, intracervical hyaluronidase was able to enhance the cervical tissue collagen dispersion.

A Comparative Histological Study on the Role of Umbilical Cord Mesenchymal Stem Cells versus Their Conditioned Medium on the Pancreatic Beta Cells in Experimentally Induced Diabetes Mellitus in Albino Rat

Abstract Background Mesenchymal stem cells (MSCs) represent a promising population for supporting new clinical concepts in cellular therapy. Umbilical cord blood (UCB) has turned out to be an excellent alternative source of MSCs. This study had compared the role of human umbilical cord blood derived mesenchymal stem cells (UCB-MSCs) versus their conditioned medium (CM) alone on pancreatic beta cells in a rat model of Streptozotocin (STZ)-induced type I diabetes Mellitus. Material and Methods Forty adult male albino rats were divided randomly into 4 groups; Group I (control), Group II (STZ), rats received a single dose of intraperitoneal injection of 35 mg/kg of STZ dissolved in 1 ml sodium citrate buffer. Group III (STZ + UCB-MSCs) after rats had been confirmed to be diabetic they received single dose of 1 × 106 cells /ml of UCB-MSCs into tail vein, meanwhile Group IV (STZ+ CM) rats received 0.5 ml of CM that was injected intramuscularly once per week for 4 weeks. After 4 weeks the Pancreas from all groups were dissected and stained by Hematoxylin &amp; eosin stain and by immunohistochemical method using anti-insulin antibody to detect insulin granules in the Beta cells of the islets. Mean area percent of insulin positive reactions were measured and statistically analyzed. Results H&amp;E-stained section of group II (STZ) showed the nuclei of the islet cells small condensed and darkly stained while, the blood capillaries were congested in endocrine pancreas.Meanwhile, Group III (STZ + UCB-MSCs) restored nearly normal histological features. Sections of Group IV (STZ+CM) showed few cells of the islets sections of showed vacuolations and small darkly stained condensed nuclei. Studying the groups immunohistochemically, revealed decrease in insulin positive reactions in Group II (STZ) while an increase in insulin positive reactions noticed in group III (STZ +UCB-MSC) and group IV (STZ+CM) when compared to group II (STZ) with more increase in group III (STZ+UCB-MSC) than group IV (STZ+CM). Conclusion It can be considered that intravenous UCB-MSCs could be more effective than CM in treatment of STZ-induced type I diabetes in the pancreas.

The Potential Role of Mesenchymal Stem Cells Derived Exosomes on the Healing of Grade II Experimentally Induced Skeletal Muscle Injury in Adult Male Albino Rats. Histological Study

Abstract Background Musculoskeletal injuries are the most common cause of severe longterm pain and physical disability. However, there is still no efficient treatment that leads to prevention of muscle fibrosis. Cell-Free therapy using mesenchymal stem cells (MSCs) derived exosomes could provide a new promising therapy. Aim To study the potential role of MSCs-derived exosomes on the healing of experimentally induced grade II skeletal muscle injury in adult male albino rats. Materials and Methods Forty male albino Wister rats were used in this study. Five out of them were used for isolation of exosomes. The rest were randomly divided into three groups. Group I (Sham group), Group II (muscle injury group left for spontaneous healing), Group III (muscle injury treated with exosomes). Rats from each group were subdivided into two subgroups; subgroup “a and b” in which rats were sacrificed after ten days and twenty days, respectively. Muscle specimens were collected and prepared for proper histological techniques. Immuno-histochemical staining for detection of collagen type I and developmental myosin (MHCd) were also done. Morphometric study and statistical analysis were also performed. Results Granulation tissue and inflammatory cellular infiltration with significant increase in the mean area percentage of collagen fibers were noticed in subgroups of untreated muscle injury compared to the corresponding exosomes treated subgroups. This was confirmed by collagen type I immune histochemical reaction. Group III (treated with exosomes) showed better muscle regeneration and significant decrease in muscle fibrosis. Significant increase in immunohistochemical reaction of developmental myosin was noticed in exosomes treated subgroups compared to corresponding untreated muscle injury subgroups. Conclusions Exosomes enhance muscle regeneration after induced muscle injury. Exosomes also decreased muscle fibrosis and improve muscle healing.