Removal Of Tissue Research Articles

Insights into Cancer Cell Imaging Probes Based on Chalcone Scaffolds: Theoretical and Experimental Perspectives.

The research article details the synthesis of chalcone-chromone-based scaffolds via multicomponent reactions. These compounds were characterized using conventional spectroscopic methods, including NMR (1H and 13C), FT-IR, and HR-MS. Among the synthesized scaffolds, AZBNPy stood out, exhibiting exceptional DNA and protein targeting capabilities with superior binding parameters. Molecular docking studies indicated that AZBNPy has potential as a potent anticancer agent and a probe for cancer cell imaging. The findings showed that AZBNPy effectively inhibited cell proliferation and induced cell death by targeting HER-2, PARP-2, and HFR in MCF-7 cells. Additionally, in vitro fluorescence imaging studies confirmed AZBNPy's specificity for cancer cell receptors, displaying strong fluorescence in human breast cancer tissues. The clinical application of AZBNPy as an optical imaging agent holds significant promise in aiding surgeons with the precise identification and removal of cancerous tissues, potentially improving patient outcomes and survival rates.

Innovative Approaches in Fistula-In-Ano Management: Evaluating the Role of Fistula Brush - A Case Study

Introduction: Fistula in ano is one of the most common anorectal diseases. The prevalence is greater in men than women, with the rate of 12.3 cases per 100,000 and 5.6 cases per 100,000, respectively. In Ayurvedic Science Ksharasutra ligation is one of the most popular treatment modality for Bhagandara. Ksharasutra is indeed a well-known treatment in Ayurveda, particularly for managing conditions like pilonidal sinus and anal fistulas. However, it does have some limitations. Hence, an innovative technique is adopted by introducing a new Yantra i.e., Fistula brush in the field of Shalya Tantra for minimizing the unit cutting time in fistulous tract. Methodology: The fistulous tract was curetted using the fistula brush in 4-5 strokes followed by primary threading with barbour thread. Follow up thread change was done after curetting the tract using fistula brush until the tract was cut through. (under local anaesthesia). Result: The intervention results indicated a marked improvement in both subjective and objective parameters, demonstrating the intervention's effectiveness in enhancing patient outcomes. Discussion: The treatment of anal fistula through curettage of the tract using a fistula brush has been demonstrated to be a cost-effective and accessible method. This technique facilitates the removal of unhealthy granulation tissue while ensuring adequate drainage with the use of a drainage seton, thereby promoting the formation of healthy granulation tissue. Ultimately, this process encourages fibrosis of the tract and minimizes the risk of sphincter damage. Mechanical debridement plays a pivotal role throughout the stages of wound healing by promoting a clean, healthy wound environment. By alleviating symptoms associated with each stage - such as pain, burning sensation, discharge and local tenderness - it ultimately enhances the healing process and improves patient comfort.

Trabecular metal collars in endoprosthetic replacements: do they osseointegrate?

Limb salvage surgery (LSS) is the primary treatment option for primary bone malignancy. It involves the removal of bone and tissue, followed by reconstruction with endoprosthetic replacements (EPRs) to prevent amputation. Trabecular metal (TM) collars have been developed to encourage bone ingrowth (osseointegration (OI)) into EPRs. The primary aim of this study was to assess whether OI occurs when TM collars are used in EPRs for tumour. A total of 124 patients from July 2010 to August 2021 who underwent an EPR for tumour under the West of Scotland orthopaedic oncology team were identified. Overall, 81 patients (65%) met the inclusion criteria, and two consultants independently analyzed radiographs at three and 12 months, as well as the last radiograph, using a modified version of the Stanford Radiological Assessment System. OI of the TM collar occurred in approximately 65% of patients at last radiograph. The percentage of patients with OI at three months (65.4%) reflected the 12-month (65%) and long-term (64.4%) follow-up. The median amount of OI across all radiographs was one at all three timepoints, with only five cases (11.1%) showing OI in all four zones at last radiograph. Radiolucency at the bone:collar junction was present in 23 cases (28.4%) at three months, but only four (6.7%) showed progression of this at 12 months. The interobserver reliability was found to be highly reliable in all parameters (p < 0.001). OI occurs in approximately 65% of TM collars, and is similar at three months, 12 months, and last radiograph. The extent of OI at the bone:collar junction was found to have decreased at longer-term follow-up. Furthermore, radiolucency at the bone-collar impact junction does occur in some patients but only a low number will show radiolucency progression at longer-term follow-up.

Treatment of external root resorption with Biodentine in a tooth with a periodontal pocket: a case report with 2-year follow-up

External root resorption is characterized by the loss of mineral tissues in the dental root. This condition is difficult to diagnose, and if not identified early, it can lead to tooth extraction. The treatment consists of surgical access, removal of granulation tissues, and sealing the area with a biological material. Objective: This article reports on the treatment of ERR in the middle third of the root, associated with an 8 mm periodontal pocket using Biodentine, with a two-year follow-up. Case report: A 57-year-old woman attended complaining of discomfort in the palate. After a thorough medical history, clinical, radiographic, and tomographic evaluation, the final diagnosis was External Root Resorption. Concerned about preserving the tooth, it was suggested to fill the resorption with Biodentine and regular follow-ups. The patient agreed, and a tissue flap was raised in the palatal region, followed by sealing of the perforation with Biodentine and suturing. After 7 days, the sutures were removed, and during the six-month and two-year follow-ups, the tooth exhibited no mobility, good periodontal health, and maintained its function. Conclusion: The case demonstrated a reduction in the periodontal pocket (from 8 mm to 4 mm), maintenance of the tooth, and the effectiveness of Biodentine in treating ERR, even when exposed to the oral cavity.

Exploring the Impact of Access Cavity Designs on Canal Orifice Localization and Debris Presence: A Scoping Review.

One of the primary objectives in endodontics is to achieve thorough cleaning and disinfection of the root canal system during an endodontic procedure. This aims to reduce microbial contamination and prevent the development of endodontic lesions. To attain this goal, it is imperative to establish access to the endodontic space that allows for the complete removal of pulp tissue and the accurate identification of canal orifices while preserving the anatomical integrity of the root floor and pulp chamber as much as possible. In this scoping review, we aim to explore aspects related to the identification of canal orifices and the presence of pulp debris and residues during endodontic treatment. Specifically, we aim to assess whether and to what extent the design of the access cavity impacts these factors. The scoping review was conducted and prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA Extension for Scoping Reviews [PRISMA-ScR]). The search yielded a total of 3697 bibliographic sources. After eliminating duplicates and applying eligibility criteria, only 10 studies were included. In conclusion, our review, conducted following PRISMA guidelines, includes 10 studies and suggests a potential trend: conservative techniques may generate more debris, whereas guided techniques exhibit superior precision in locating canal openings.

A Study on the Carbon Dioxide Laser

Abstract: One of the first gas lasers to be created was the carbon-dioxide laser (CO2 laser). One of the most practical kinds of lasers, it was created in 1964 by Bell Labs' Kumar Patel [22]. The most powerful continuous-wave lasers on the market right now are carbon-dioxide lasers. Additionally, they are quite efficient; the output power to pump power ratio can reach 20%. The primary wavelength bands of the infrared light beam produced by the CO2 laser are 9.6 and 10.6 micrometers (μm). [22] In order to improve its performance, a carbon dioxide laser uses carbon dioxide as its main gain medium. Nitrogen (N2), helium (He), and occasionally hydrogen (H2), water vapor, oxygen, or xenon (Xe) are added. This laser works by energizing the gas mixture to produce laser light by promoting the emission of radiation by an electrical gas discharge. In carbon dioxide lasers, the electrical gas discharge can be powered by radio frequency (RF), direct current (DC), or alternating current (AC). The wavelength of the light emitted by these lasers is 10.6 micrometers. In dermatology, they are frequently used for operations like wrinkle reduction, scar removal, and sun damage treatment. Furthermore, for accurate cutting and tissue removal, carbon dioxide lasers are employed as surgical instruments in specialties such as neurosurgery and gynecology.[24]

Clinical efficacy study of the IBS® (Intergrated Bigatti Shaver) Tissue Removal Device in the treatment of endometrial polyps

BackgroundThe IBS® Tissue Removal Device, as a new technology, currently lacks a systematic evaluation of its effectiveness in treating endometrial polyps. Furthermore, the exact cause of polyps recurrence is not yet clear. The purpose of this article is to compare the efficacy of the IBS® Tissue Removal Device with hysteroscopic cold knife resection for the treatment of endometrial polyps and analyze the recurrence factors of endometrial polyps.Methods202 patients with endometrial polyps who were admitted to Changzhou Maternal and Child Health Care Hospital from January 2019 to December 2022 were included in the retrospective studies. Based on the surgical technique, these patients were categorized into two groups: the IBS group (n = 100) and the cold knife group (n = 102). Following surgery, both groups underwent a year of follow-up. Data from the perioperative period (operation time, intraoperative blood loss, intraoperative rehydration, intraoperative complications, length of hospital stay), follow-up data (postoperative endometrial thickness, postoperative vaginal bleeding time, complication rate, menstrual recovery time, pregnancy rate, and recurrence rate) and general clinical data (age, BMI(Body mass index, BMI), number of pregnancies or miscarriages, number of hysteroscopic operations, preoperative white blood cells, fasting blood glucose, polyp diameter) were compared between the two groups.ResultsThe recurrence rate of the IBS group was 6% (6/100), which was lower than that of the cold knife group (14.7% (15/102), and the difference was statistically significant (P < 0.05). The operation time, intraoperative blood loss, and postoperative vaginal bleeding time in the IBS group were significantly lower than those in the cold knife group (P < 0.05), and the multivariate analysis of polyp recurrence showed that polyp diameter was closely related to postoperative recurrence (P < 0.05). The preoperative white blood cells and blood sugar levels have no association with the diameter of polyps. (P > 0.05). There was also no significant difference between IBS group and cold knife group in intraoperative rehydration, intraoperative complications and postoperative hospital stay, intermenstrual bleeding, recovery of menstruation and endometrial thickness and postoperative pregnancy between the IBS group and the cold knife group (P > 0.05).ConclusionThe IBS® Tissue Removal Device can reduce the recurrence rate of endometrial polyps after surgery, improve the perioperative indexes, and reduce the postoperative vaginal bleeding time, which is better than that of hysteroscopic cold knife resection.

Management of Deep Caries Lesions: A Study among Dentists in the Private Sector of Casablanca, Morocco.

To find out which management methods are preferred by dentists in the private sector of Casablanca for a deep carious lesion or a pulp exposure during carious tissue removal in adult patients. A questionnaire consisting of 25 questions was sent to 300 randomly sampled dentists in Casablanca. Only specialists in conservative dentistry and endodontics and general practitioners were included. There were three clinical scenarios allowing to approach the therapy recommended by each practitioner according to the proposed pulp diagnosis, these three different scenarios were based on preoperative symptomatology: Healthy pulp, reversible pulpitis, and irreversible pulpitis. Data entry and analysis were carried out using Epi7 and the results were statistically analyzed. The survey was answered by 214 dentists,145 women and 69 men. Approximately 74.3% of the respondents always establish a pulp diagnosis before carious tissue removal. Approximately 56.54% use partial carious tissue removal techniques. During pulp exposure, 79.25% of the practitioners opted, respectively, for a direct pulp capping (DPC) in the case of healthy pulp and 46.7% in the case of reversible pulpitis, while no practitioner chose DPC in the case of irreversible pulpitis. In addition, 3.31, 27.83, and 4.23% opted for pulpotomy in cases of healthy pulp, reversible and irreversible pulpitis, respectively. Glass ionomer cement (GIC) and calcium hydroxide (CH) are the materials of choice for dentists in cases of partial caries removal. In the case of DPC, dentists use CH and Biodentine™ in particular. Partial carious tissue removal techniques are not adopted by the majority of dentists. When faced with irreversible pulpitis, most dentists (93.33%) go directly to endodontic treatment in the case of deep carious lesion without pulp exposure. While 204 dentists (95.33%) preferred root canal treatment (RCT) too in the case of deep carious lesion with pulp exposure. The use of bioactive materials should be encouraged in the management of deep caries lesions and pulp exposure, Biodentine™ and MTA were chosen by 96 of the practitioners. Traditionally, the treatment of deep caries has been destructive, with removal of all carious dentin; however, the promotion of biologically based minimally invasive treatment strategies has been recommended to selectively (partially) remove caries and reduce the risk of pulp exposure. How to cite this article: Laslami K, Kharroubi SE, Moudrif M, et al. Management of Deep Caries Lesions: A Study among Dentists in the Private Sector of Casablanca, Morocco. J Contemp Dent Pract 2024;25(8):751-757.

Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs.

To determine the prevalence of incidentally found pulmonary bullae and blebs (PBBs) in a population of dogs undergoing thoracic computed tomography (CT) for reasons other than presence of pneumothorax and to determine the prevalence of subsequent spontaneous pneumothorax (SP) development. Retrospective study. A total of 30 dogs. A total of 2221 CT studies of the sample population were retrospectively assessed for the presence of incidental PBBs between April 2013 and April 2019. Inclusion criteria were complete thoracic CT studies from dogs obtained from the hospital database. Exclusion criteria were concurrent presence of a pneumothorax or severe pulmonary disease preventing assessment for PBBs, an air-filled space related to a pathological process, for example, neoplasm, incomplete CT studies, or no available follow-up. Long term outcome was evaluated using a questionnaire to determine the occurrence of SP post CT examination. Incidental PBBs were identified in 30 out of 2178 (1.4%) CT studies that met the inclusion criteria. None of the dogs subsequently developed clinical evidence of SP (median follow-up time 1255 days, range: 147 to 2363 days). One dog died suddenly of unknown cause and as no post-mortem was performed SP could not be ruled out. There was a low prevalence of incidentally found PBBs in dogs. None of the dogs followed over a long period subsequently developed SP. Based on this study, prophylactic removal of lung tissue containing incidentally found PPBs is not justified.

Injectable and adhesive MgO2-potentiated hydrogel with sequential tumor synergistic therapy and osteogenesis for challenging postsurgical osteosarcoma treatment

The clinical treatment of osteosarcoma faces great challenges of residual tumor cells leading to tumor recurrence and irregular bone defects difficult to repair after surgery removal of the primary tumor tissue. We developed an injectable and in-situ cross-linkable hydrogel (named MOG hydrogel) using MgO2 nanoparticles and dopamine-conjugated gelatin as main components. MgO2 was rationally designed as a multifunctional active ingredient to mediate in situ gelation, tumor therapy, and bone repair sequentially. The 10MOG (with 10 mg/mL MgO2 content) showed excellent gel stability, injectability, shape adaptability, tissue adhesion, and rapid hemostatic ability. Importantly, 10MOG exhibited ideal sequential H2O2 and Mg2+ release property. The released H2O2 synergized with photothermal therapy for enhanced tumor recurrence suppression, and the sustainable Mg2+ release efficiently promoted bone regeneration. The MOG hydrogel, possessing excellent on-demand antitumor and osteogenic capabilities in vitro and in vivo, exhibited tremendous potential in the clinical application for challenging postsurgical osteosarcoma treatment.

MALTectomy and psoriasis risk in women: A prospective study in the French E3N prospective cohort.

The involvement of mucosa associated lymphoid tissues (MALT) in the development of an autoimmune response in the skin is unclear and unstudied. In this study we sought to assess the relationship between removal of MALT tissues (MALTectomy) and the risk of development of psoriasis (overall or moderate-to-severe). We conducted a prospective observational study based on E3N, a French cohort composed of 98 995 women born between 1925 and 1950 and insured by the health insurance of the national education system (MGEN). The study population included the 90 119 women that completed the 1990 baseline questionnaire with available information on MALTectomy and a valid incident diagnostic date for psoriasis. During the 1990-2018 follow-up period 2 433 incident cases of psoriasis were identified through self-reports while during the period for which drug reimbursement data were available from the MGEN database (2004-2018), 120 cases of moderate-to-severe psoriasis were identified. Hazard ratios (HR) and their 95% confidence intervals were estimated by Cox proportional hazards models and adjusted for known or putative psoriasis risk factors. Appendectomy was associated with an increased risk of psoriasis both in the univariate [HR: 1.17 (95% CI: 1.08-1.27)] and multivariable models [HR: 1.14 (95% CI: 1.05-1.24)]. A suggestive association with appendectomy was observed for moderate-to-severe psoriasis risk [univariate HR: 1.40 (95%CI: 0.97-2.02); multivariable HR: 1.36 (95%CI: 0.94-1.96)]. No association was observed between tonsillectomy or adenoidectomy both for overall and moderate-to-severe psoriasis. The observed association between appendectomy and risk of psoriasis warrants further investigations as they may help to elucidate the disease etiology and improve risk prediction.

Observation on the efficacy and safety of Holmium laser enucleation of the prostate (HoLEP) with preservation of the urethral mucosa from the bladder neck to the tip of the prostate for the treatment of benign prostatic hyperplasia.

This study investigates the efficacy and safety of transurethral prostate laser resection (HoLEP) with preservation of the urethral mucosa from the bladder neck to the tip of the prostate for the treatment of benign prostatic hyperplasia (BPH). A retrospective study was conducted on 208 patients with BPH treated at our hospital. In the control group, the urethral mucosa from the bladder neck to the tip of the prostate was not retained during surgery to ensure maximum removal of possible diseased tissue. The urethral mucosa was preserved in the observation group, which was finely separated to avoid injury, in order to protect urinary control function to the greatest extent and reduce postoperative complications. The surgical-related indicators, urinary function, sexual function, quality of life (QOL), and occurrence of postoperative complications were compared between the 2 groups of patients. After the procedure, both groups of patients experienced an increase in maximum flow rate and a decrease in residual urine volume (P < .05). The observation group showed a higher immediate postoperative urinary continence rate of 98.23% compared to 85.26% in the control group (P < .05). After the procedure, both groups of patients exhibited a significant increase in International index of erectile function-5 scores (P < .05). The retrograde ejaculation rates were compared between the 2 groups of patients before the procedure (P > .05). After the procedure, the occurrence rate of retrograde ejaculation decreased in both groups of patients, with the observation group being lower than the control group (P < .05). The International prostate symptom score (IPSS) scores and QOL scores were compared between the 2 groups of patients before and after the procedure (P > .05). After the procedure, both groups of patients showed a decrease in IPSS scores and QOL scores compared to before the procedure (P < .05). The occurrence of complications such as urethral injury, urinary incontinence, urinary retention, and postoperative bleeding was compared between the 2 groups of patients (P > .05). The efficacy and safety of performing HoLEP treatment for BPH patients with preservation of the urethral mucosa from the bladder neck to the tip of the prostate are comparable to those without preservation. However, it can improve immediate urinary continence rate and reduce retrograde ejaculation rate.

A rapid and simple micro-assay to assess catalase activity in individual mosquito tissues

Oxidative stress generated as a normal byproduct of aerobic metabolism is minimized by the enzyme catalase (CAT; EC 1.11.1.6), which reduces hydrogen peroxide to molecular oxygen and water. In various mosquitoes, hydrogen peroxide and/or CAT activity have been implicated in oxidative responses to viral and protozoal pathogens as well as in ovarian maturation and insecticide resistance. We combined features of various CAT assays to develop a simple micro-assay that enables comparison of enzyme activities in individual mosquito tissues on a microscope slide. Activity recovered in the supernatant of mosquito whole body homogenates was inhibited by the CAT-specific inhibitor 3-amino-1,2,4-triazole. Activity was higher in blood-fed mosquitoes, consistent with exogenous enzyme in vertebrate blood. Triton X-100 improved evaluation of dissected organs, and accurate comparisons required careful removal of extraneous tissues. In unfed mosquitoes baseline CAT activity was lower in ovaries than in midgut or fatbody, but increased as oocytes matured after a blood meal, and was detectable in a single mature egg. CAT has unusual kinetics and can be difficult to assay directly. Our observations provide a simple approach for direct evaluation of CAT activity independent of changes in transcript levels and results of RNAi-based interference.

Abstract 4137145: Aortic Stenosis in Pregnancy: A Multidisciplinary Team Approach

Introduction: The hemodynamic adaptations that occur during pregnancy can have significant effects on patients with aortic stenosis (AS). These changes can lead to structural changes identified on echocardiogram even during uncomplicated pregnancies. While some cases can be managed with medical therapy and activity modification, others may require valve intervention in the gestational period. Case: A 29-year-old female with history of congenital bicuspid aortic valve, G1P0 presented at 42+2 weeks of pregnancy and was admitted to cardiac intensive care unit for continuous hemodynamic monitoring via use of arterial line. Her prior aortic valve disease was treated by valve repair with valvotomy, removal of tissue from pseudo raphe, removal of calcified scar tissue from both commissures, and a mitral valve repair for closure of an iatrogenic tear in her anterior leaflet. She followed closely with maternal fetal medicine and cardiology but became symptomatic at week 28 with lightheadedness, shortness of breath and decreased exercise tolerance (NYHA Class II). By week 33 she noticed lower extremity edema. Despite recommendations for planned delivery, she opted to wait until full term for delivery. Surveillance echoes revealed rising velocities yet stable valve area by planimetry. She ultimately underwent an uncomplicated Cesarean delivery of baby boy in week 42. At 6 months post partum she had successful transcatheter aortic valve replacement. Discussion: As the severity of valvular disease worsens there is a higher risk of complications during pregnancy. In our case, aortic valve velocities were elevated due to the expected hemodynamic changes of pregnancy. Thus, echocardiography monitoring should be used to assess the left ventricle’s ability to tolerate and compensate for these changes, while intervening based on symptoms and NYHA classification. We highlight the importance of multidisciplinary collaboration for safe and successful delivery in patients with AS.

Evidence-Informed Nursing Clinical Practices for Wound Debridement.

Debridement, a mainstay of nursing clinical practice, refers to the removal of dead or unhealthy tissue from a wound to facilitate healing. Debridement is one component of the concept of wound bed preparation that has long guided the approach to wound management. The ability of a wound to heal must be determined prior to the initiation of any method of debridement. In areas where high-quality, comparative studies on the relative benefits of different debridement modalities are lacking, nurses should adopt an evidence-informed approach to care. To do this, nurses must understand the importance of following a comprehensive, holistic approach when treating chronic wounds. Nurses should have knowledge of inflammation and infection control and of the fundamentals of moisture management, recognize the need for debridement in healable wounds, and be familiar with different debridement options. This article provides nurses with a wound management framework, an overview of wound debridement options based on the potential for wound healing, and scope of practice considerations for developing a plan of care. A composite case is presented to illustrate the critical considerations in wound care.

Neoplasias mamária e esplênica em cadela

Regarding mammary and splenic neoplasms in dogs, the surgical therapeutic approach is often the method of choice, given its curative potential and the possibility of subsequent histopathological analysis. In veterinary medicine, the incidence of mammary neoplasms is high, especially in unneutered female dogs. Breast carcinoma in situ, with its histological particularities and clinical behavior, requires a careful diagnosis and a precise therapeutic approach, carrying out additional tests such as cytopathology and ultrasound to adequately define the treatment. Surgical excision, associated with the evaluation of adjacent healthy breast tissue, is essential to ensure complete removal of neoplastic tissue, plus it is also indicated to perform ovariohysterectomy (OVH) together with mastectomy. Spleen tumors are similarly common in dogs, especially hemangiosarcoma, which is notable for its aggressiveness and high metastatic rate. Therefore, early diagnosis and precise interventions are essential for a good prognosis, with the affected organ being often removed in its entirety. Therefore, we report the case of a female Shih-Tzu dog, 7 years old and weighing 4kg, who presented, upon palpation, a nodule in the left M3 measuring &lt;1cm with absence of nodular secretion, change in color, itching local or galactorrhea. The patient was referred for regional mastectomy and OVH after cytological examination compatible with carcinoma and, in a pre-operative ultrasound examination, a singular hypoechoic nodular formation, discretely heterogeneous, vascularized on Doppler and in close contact with the splenic capsule was noted in the spleen in its medial parietal portion, measuring 0.96 cm in its longest axis. Thus, during intraoperative visual inspection after OVH and upon approval from the owner, it was decided to perform total splenectomy and, after histopathological examination, it was known that the organ was affected by hemangiosarcoma. The canine was discharged from the hospital a few hours after the end of the surgery, without the subsequent use of adjuvant therapies.

Lateralization of memory function in temporal lobe epilepsy using scene memory fMRI.

Functional magnetic resonance imaging (fMRI) offers an alternative to the traditional Wada test for presurgical language and memory lateralization that carries almost no risk. However, fMRI lateralization of episodic memory remains challenging because the hippocampus, which is fundamental to episodic memory, is smaller, more prone to susceptibility artifact, and harder to functionally modulate than language regions. We previously showed that a complex scene memory task can lateralize memory function in the mesial temporal lobe. Using data acquired from N = 45 patients with temporal lobe epilepsy acquired with an improved stimulus paradigm and high-resolution fMRI, we now demonstrate that memory activation can be successfully lateralized within hippocampus proper. PLAIN LANGUAGE SUMMARY: Epilepsy surgery can improve seizure control in patients with temporal lobe epilepsy (TLE) that cannot be controlled with medications also, but ablation or removal of temporal lobe brain tissue can also cause cognitive deficits. Functional MRI (fMRI) can noninvasively map brain activation and perform well in lateralizing and localizing language function, but localizing and lateralizing memory function is more challenging. Building upon prior work using complex scene encoding to map memory function, we demonstrate that the use of high-resolution fMRI along with an optimized task paradigm allows memory activation to be detected within the hippocampus. Because the hippocampus is both a common site of TLE and a key region underlying memory, this approach is expected to contribute to presurgical evaluation of TLE.

Efficacy Analysis of Anti-Tuberculosis Chemotherapy Combined with Arthroplasty or Joint Replacement for Tuberculous of the Elbow Joint: A Retrospective Study of 40 Patients.

Tuberculous arthritis of the elbow joint (TAEJ) is a relatively rare infectious bone and joint disease. Misdiagnosed owing to inconspicuous early symptoms, often the elbow joint has suffered serious damage at the time of treatment. This study retrospectively investigated the clinical manifestations, population characteristics, clinical diagnosis, surgical treatment, and functional recovery of elbow joint tuberculosis (TB). A retrospective study of 40 patients was conducted. These patients were diagnosed with tuberculous arthritis of the elbow from June 2007 to August 2021 and were diagnosed with TAEJ by fine-needle aspiration biopsy or biopsy of surgically excised lesions. All patients underwent surgery after taking regular anti-TB drugs and chemotherapy for 2 weeks. Visual analogue scale score, Mayo elbow performance score, and hospital for special surgery assessment scale score were used to evaluate postoperative functional recovery. Imaging tests were used to evaluate patients' postoperative recovery. Forty patients were followed up for an average of 12.5 ±0.5 months. Erythrocyte sedimentation rate and C-reactive protein values returned to normal after anti-TB drug chemotherapy combined with surgical removal of infected lesion tissue; only one patient relapsed 16 months after surgery. Tuberculous arthritis of the elbow joint should be diagnosed in an early stage based on clinical manifestations, laboratory tests, and histopathological examinations. Complete surgical removal of the lesions should be performed after chemotherapy with anti-TB drugs for 2 weeks. The corresponding operation should be selected according to the damage in the elbow joint.

Suturing techniques

The act of suturing wounds on the skin has been done for thousands of years. Closing dead space, supporting and strengthening wounds until healing increases their tensile strength, approximating skin edges for an esthetically pleasing and functional result, and minimizing the risks of bleeding and infection remain the primary goals of suture techniques, even though suture materials and techniques have changed. A well-planned closure or flap may have its post-operative appearance jeopardized if the wrong suture technique is used or if the procedure is not performed well. On the other hand, poor surgical skills cannot entirely be made up for by careful suturing. Poor incision placement with respect to relaxed skin tension lines, excessive removal of tissue, or inadequate undermining may limit the surgeon’s options in wound closure and suture placement. Gentle handling of the tissue is also important to optimize wound healing. The choice of suture technique depends on the type and anatomic location of the wound, thickness of the skin, degree of tension, and desired cosmetic result. Proper placement of sutures enhances the precise approximation of the wound edges, which helps minimize and redistribute skin tension. Wound eversion is essential to maximize the likelihood of good epidermal approximation. Eversion is desirable to minimize the risk of scar depression secondary to tissue contraction during healing. Usually, inversion is not desirable, and it probably does not decrease the risk of hypertrophic scarring in an individual with a propensity for hypertrophic scars. To maximize the esthetic and functional outcomes, dead space must be removed, natural anatomic shapes must be restored, and stitch marks must be minimized. This page describes the methods for placing sutures for different kinds of stitches, goes over why certain suture techniques are better than others and goes over the benefits and drawbacks of each suture technique. For the best possible closure of a wound, multiple suture techniques are frequently required. After reading this article, the reader ought to comprehend the basic techniques for inserting each type of suture as well as how and why specific sutures are selected.

Embryofetoscopy followed by hysteroscopic evacuation of a first trimester missed abortion in a woman with septate uterus

To describe the technique of embryofetoscopy performed with 5Fr instruments with targeted evacuation of the gestational sac followed by a visual dilatation and curettage (D&C) using the hysteroscopic tissue removal system for the management of first trimester missed abortion in a patient with uterine septum. Video case-report. University tertiary-care hospital. A 32-year-old nulliparous (G3P0020) woman with septate uterus and a 7-week missed abortion. Written informed consent was obtained from the patient. Transvaginal pelvic ultrasound revealed a 7-week missed abortion. A 3D-ultrasound confirmed the presence of a partial uterine septum. Operative hysteroscopy under spinal anesthesia was performed using a vaginoscopic approach. A partial septum was observed, and a dysmorphic gestational sac was visualized in the left hemicavity.A small incision was made in the amniotic sac using a 5Fr-bipolar electrode allowing direct visualization of the embryo. The entire embryo was removed, and selective biopsies of the chorionic villi using the hysteroscopic "grasp biopsy" technique were obtained. The residual gestational sac was removed using a 6.25 mm tissue retrieval system. No cervical dilation was required.The patient was discharged on the same day of the procedure. No intraoperative bleeding was encountered. The overall operation time was 21 minutes. A postprocedure ultrasound confirmed the presence of an empty cavity. It was determined that further evaluation of the septum was needed before proceeding with hysteroscopic metroplasty. Step-by-step demonstration of the technique and some tips and tricks for bleeding management. Complete evacuation of the uterine cavity under direct visualization. Embryofetoscopy with miniaturized instruments allows selective targeting of trophoblastic and fetal tissues, avoiding the risk of maternal tissue contamination of the specimen. As reported in the literature, the visual D&C using tissue retrieval system could be a safe and innovative alternative for the treatment of early pregnancy loss. Compared with the use of hysteroscopic resection, tissue removal devices offer the advantage of not requiring cervical dilation and do not involve the use of electrosurgery, thus reducing damage to the uterine cavity. The combination of embryofetoscopy with visual D&C offers several advantages, especially in patients with congenital uterine anomalies, in which performing a blind D&C has a higher risk of complications.