Suture Area Research Articles

Palatal expansion and relapse in rats: A histologic and immunohistochemical study

Rapid palatal expansion is an effective intervention for correcting transverse maxillary deficiency in growing patients. However, relapse after treatment is often observed, and the mechanisms of tissue remodeling during expansion and relapse remain unclear. This study aimed to gain insight into such a mechanism. A total of 24 5-week-old male Wistar rats were randomly divided into either the expansion or sham device (control) group. Each rat underwent 7days of expansion and 7days of relapse. The width of the dental arch, palatal bone, and suture, as well as the angle of the teeth, were measured. Tissue remodeling in the midpalatal suture was examined using microcomputed tomography and histologic and immunohistochemical analyses. The mechanical expansion force caused an increase in arch width, which relapsed after the removal of force. Bilateral tilting of the teeth and midpalatal suture expansion contributed to the widening of the maxillary arch, and only the relapse of the palatal bone width was observed. Histochemical staining showed that suture tissue remodeling was activated by mechanical force in the expansion group and reverted to the level of the control group after relapse. Immunohistochemistry staining revealed that the expression of cathepsin K, osteocalcin, and collagen type I was higher in the expansion group than that in the control group on day 7; however, the difference dissipated by day14. The expansion force stimulated osteogenic activity in the midpalatal suture area. After removal of the expansion force, tissue remodeling went back to the normal level.

The oldest fossil darkling beetle of the genus Neomida Latreille, 1829 (Coleoptera: Tenebrionidae) from Eocene Baltic amber examined with X-ray microtomography.

Based on a single well-preserved specimen from Eocene Baltic amber, a new tenebrionid beetle Neomida groehni Nabozhenko et Bukejs sp. nov. (Diaperinae: Diaperini) is described and illustrated using phase-contrast X-ray microtomography. This oldest representative of the genus differs from all known extant and extinct congeners by the dorsally very weakly convex pronotum with undulate lateral margins (while other Neomida have a pronotum that is strongly convex along its transverse axis, with evenly rounded lateral margins); distinct, right posterior angles of pronotum; and elevated sutural area of the elytra.

The effect of mesenchymal stem cells in improving the uterus scar condition after several exposure methods

Background & Aim Aim To study the tissue effect after various methods of scar recovery on the uterus and the activity of MSCs at the damaged area Methods, Results & Conclusion Female rats of the Wistar line, weighing 220-240 g were observed. Animals for the experiment were selected due to the two-horned uterus. Model sharp trauma to the unchanged uterine muscle, sutured with a continuously synthetic absorbable thread. A total of 30 animals were operated. In the 1st group (n=15), the suture on the left uterine horn was treated with argon plasma coagulation. In the 2nd group (n=15), after suturing the left uterine horn, direct intramuscular injection of allogeneic MSCs isolated in rats of the same line (a dose of 500*103 cells in 1mL of 0.9% saline) was injected along the suture area. In both groups suture on the right horn of the uterus was not additionally affected and served as check (n=30). On the 30th day after operation, the rats were euthanized and serial sections of uterine tissues were prepared for further immunohistochemical studies. The distribution of autologous MSCs in the operated uterine horns of rats was evaluated by immunohistochemistry. Slices were deparaffinized and rehydrated according to a standard protocol with anti-CD105 and CD44 antibodies conjugated to FITC and phycoerythrin, respectively. Images were analyzed using an Axioscope epifluorescence microscope and confocal microscope. In the 1st group an even distribution of MSCs was observed mainly in the subendothelial layer of the endometrial villi and myometrium. A slight accumulation of MSCs was observed in the scar region (10-15 cells in the field of view). In the 2nd group (with MSCs) the accumulation of cells in the region of the scar was 25-28 cells in the field of view. Moreover, in the studied horn, an increased concentration of MSCs was also observed in areas adjacent to the scar (at a distance of 300-500 microns). In the check horns of both groups no such accumulation was recorded (5-8 cells and 4-9 cells in the field of view). After the injection of MSCs in the scar region, the increased concentration and tissue effect of MSCs persists for at least one month, which may be an example of microchemerization. The data obtained also suggest the migration of part of the cells from the scar region to the adjacent areas. The positive effect of the MSCs directly introduced at the damaged area is associated not only with the active tissue factors and cytokines secreted by them, but also with the differentiation of stem cells into myocytes To study the tissue effect after various methods of scar recovery on the uterus and the activity of MSCs at the damaged area Female rats of the Wistar line, weighing 220-240 g were observed. Animals for the experiment were selected due to the two-horned uterus.

Stability and dynamics of the fractured zygomaticomaxillary complex fixed using non-resorbable and resorbable 2- and 3-point miniplates, under physiological and maximal occlusal loads: a finite element analysis

Background: Given that zygoma fractures are the second most common facial trauma, knowledge of their treatments is of clinical value. Among these are fixation methods, which despite their importance are neglected in many aspects. Objectives: Therefore, for the first time in the literature, the present finite element analysis evaluated displacements and dynamics of the zygoma fixed using four 2- and 3-point resorbable and four non-resorbable plates under normal and maximal mastication loads. Methods: A maxillofacial CT scan of a man with linear fractures without severe displacements was used to model the zygoma and its adjacent bones. Seven combinations of resorbable and seven combinations of non-resorbable mini-plates 2mm thick were fixed on the zygoma (orbital rim, zygomaticomaxillary buttress [ZMB], and frontozygomatic [FZ]) using 6mm miniscrews. ZMB was fixed using an L-shaped 4-hole plate. The infraorbital rim was fixed with a curved 5-hole miniplate. The FZ suture area was fixed with a 4-hole miniplate. The model underwent 150N and 750N loads. Minimum and maximum displacements, rotational displacements, stresses, and strains of the zygoma models were calculated. Results: Non-resorbable fixation methods can yield much smaller stresses, strains, and displacements compared to resorbable fixations. Also the parameters were much smaller under the 150N load compared to the 750N load. The worst results belonged to the fixation of Rim and ZMB and the best results belonged to the fixation of ZMB-Rim, and especially FZ-ZMB, Rim-FZ, and FZ-ZMB-Rim. Conclusions: In patients with heavy masticatory forces, it is not recommended to use resorbable platesZygomatic fractures are the second most common facial injury, knowledge of their management is important. However, fixations methods, which are of importance are variable.

Botkin Hospital Transplant Program: 100 solid organ transplantations

Objective : to evaluate the first results of the Botkin Hospital transplant program. Materials and methods . From June 2018 to October 2019, 100 solid organ transplants were performed at the Botkin City Clinical Hospital. Out of the 100 transplantations, 72 were kidney transplants (average age of recipients was 45.65 ± 11.35 years, HLA match averaged 2.09 ± 1.03) and 28 were liver transplants (average age of recipients was 50.14 ± 7.62 years, average MELD was 17.78 ± 3.28 (14–34). Results . After transplantation, there was no 30-day mortality. Postoperative complications following kidney transplantation were established in 11 patients (15.2%). In 3 patients (4.3%) – suppuration of postoperative wound, in 2 patients (2.8%) – hematomas in the area of the postoperative suture during hemodialysis, in 5 patients (6.9%) – retroperitoneal lymphocele, in 1 patient (1.4%) – urosepsis. There were 4 cases (5.5%) of acute rejection, 3 cases (4.2%) of humoral rejection, and 1 case (1.3%) of cellular rejection. Early postoperative complications following liver transplantation were detected in 2 patients (7.2%). In one patient – hematoma under the right lobe of the liver on the 1st day after surgery, the diaphragm was the source of bleeding, in one patient – ascites leakage through postoperative sutures, which required relaparotomy. In 2 patients (7.2%), postoperative complications were found in the separated postoperative period. In one case, of choledochocholedochal anastomotic stricture – stricture stenting was performed with coated nitinol stent. In another case, acute adhesive intestinal obstruction, which required laparotomy, adhesiolysis. Conclusion . Implementation of the transplantation program in multidisciplinary hospitals can boost transplant care in a district and improve the treatment results of patients with terminal organ damage.

HFSE and REE Geochemistry and Nd-Sr-Os Systematics of Peridotites in the Subcontinental Lithospheric Mantle of the Siberian Craton and Central Asian Fold Belt Junction Area: Data on Mantle Xenoliths

Mantle xenoliths were found in alkaline basalts of Tokinsky Stanovik (TSt) in the Dzhugdzhur-Stanovoy superterrane (DS) and Vitim plateau (VP) in the Barguzin–Vitim superterrane (BV) (Stanovoy suture area) at junction of the Central Asian Orogenic Belt (CAOB) and the Siberian craton (SC). Xenoliths from TSt basalts are represented by spinel lherzolites, harzburgites, wehrlites; while VP basalts frequently contain spinel–garnet and garnet peridotites lherzolites, and pyroxenites. Xenoliths in kimberlites of the Siberian craton are mainly represented by garnet-bearing lherzolites with abundant eclogite xenoliths (age of 2.7–3.1 Ga), which were not found in mantle of superterranes. The Re-Os determinations point to the Early Archean age of peridotites and eclogites from mantle beneath the Siberian craton. The major and trace (rare-earth and high-filed strength) elements and Nd-Sr-Os composition were analyzed in the peridotites (predominant rocks) of lithospheric mantle at junction of the Central Asian Orogenic Belt and Siberian Craton. The degree of rock depletion in CaO and Al2O3 and enrichment in MgO relative to the primitive mantle in the peridotites of the Dzhugdzhur–Stanovoy superterrane is close to that of the Siberian craton. The peridotites of the Barguzin–Vitim superterrane are characterized by much lower degree of depletion and have mainly a primitive composition. Mantle melting degree reaches up to 45–50% in the Siberian Craton and Dzhugdzhur-Stanovoy superterrane, and is less than 25% in the Barguzin–Vitim terrane. The mantle peridotites of the craton as compared to those of adjacent superterranes are enriched in Ba, Rb, Th, Nb, and Ta and depleted in Y and REE from Sm to Lu. However, all studied peridotites are characterized by mainly superchondritic values of Nb/Ta (>17.4), Zr/Hf (>36.1), Nb/Y (>0.158), and Zr/Y (>2.474). The Nb/Y ratio is predominantly >1.0 in SC peridotites and 0.115 but usually lower than 0.1296 (primitive upper mantle value) in the peridotites of the Dzhugdzhur–Stanovoy and Barguzin–Vitim superterranes. Thus, the geochemical and isotopic composition of peridotites indicates different compositions and types of mantle beneath the Siberian craton and adjacent superterranes of the Central Asian Orogenic Belt in the Early Archean, prior to the formation of 2.7–3.1 Ga eclogites in the cratonic mantle.

Laparoscopic treatment of giant circumferential leiomyoma of the distal esophagus

Introduction: Leiomyomas are rare esophagus tumors, with 0.4-1% incidence of all esophagus tumors. Only 5% grow to the point of being called giant tumors, measuring more than 10cm. Symptoms usually begin on tumors bigger than 5cm. Objective: Reporting a new therapeutic course of action to giant leiomyomas of distal esophagus. Case Report: VCA, female, 38 years old, presented retrosternal oppression for 4 months. Having realized a computed tomography on another service which demonstrated a mass suggestive of leiomyoma. On the endoscopy exam, performed for heartburn complaint and mild dysphagia, was determined a hiatal hernia of 2cm and mild gastritis. Patient submitted to complete excision of tumor without mucosal lesion and reconstruction of the external muscular wall, by the video laparoscopic method. Hiatoplasty and partial esophagogastrofundoplication were associated. The anatomic pathological examination confirmed leiomyoma, with 10x5x2cm. Patient evolved clinically without the appearance of the heartburn or dysphagia. With contrast examination of the esophagus after 6 months and endoscopy and tomography the following 4 years, all normal. The classic treatment of giant leiomyomas, includes thoracotomy with esophagectomy. Considering that in 80% of the cases it is found in the middle and lower thirds of the esophagus, the videolaparoscopic approach by transhiatal route becomes possible. The reconstruction of the external muscular layer is important to prevent a possible prolapse of the mucosa. Also, the realization of the fundoplication in addition to avoiding the gastroesophageal reflux, allows the suture area of the esophageal muscular wall to be covered, increasing the safety in the treatment. In services with experience in the surgical treatment of diseases of the gastric esophagus transition through the videolaparoscopic method, it is possible to perform with adequate safety the surgical treatment of the tumor lesions of the distal esophagus. The method provides greater postoperative comfort and prompt clinical surgical recovery.

Finite Element Analysis of Air Gun Impact on Post-Keratoplasty Eye.

PurposeDue to the mechanical vulnerability of eyes that have undergone penetrating keratoplasty (PKP), it is clinically important to evaluate the possibility of corneal wound dehiscence by blunt impact. We have previously developed a simulation model resembling a human eye based on information obtained from cadaver eyes and applied three-dimensional finite element analysis (FEA) to determine the physical and mechanical response to an air gun impact at various velocities on the post-PKP eye.MethodsSimulations in a human eye model were performed with a computer using a FEA program created by Nihon, ESI Group. The air gun pellet was set to impact the eye at three-different velocities in straight or 12° up-gaze positions with the addition of variation in keratoplasty suture strength of 30%, 50% and 100% of normal corneal strength.ResultsFurthermore to little damage in the case of 100% strength, in cases of lower strength in a straight-gaze position, wound rupture seemed to occur in the early phase (0.04–0.06 ms) of impact at low velocities, while regional break was observed at 0.14 ms after an impact at high velocity (75 m/s). In contrast, wound damage was observed in the lower quadrant of the suture zone and sclera in 12° up-gaze cases. Wound damage was observed 0.08 ms after an impact threatening corneoscleral laceration, and the involved area being larger in middle impact velocity (60 m/s) simulations than in lower impact velocity simulations, and larger damaged area was observed in high impact velocity cases and leading to corneoscleral laceration.ConclusionThese results suggest that the eye is most susceptible to corneal damage around the suture area especially with a straight-gaze impact by an air gun, and that special precautionary measures should be considered in patients who undergo PKP. FEA using a human eyeball model might be a useful method to analyze and predict the mechanical features of eyes that undergo keratoplasty.

INTERACTION BETWEEN DENTO-MAXILLOFACIAL ANOMALIES AND GENERAL-SOMATIC HUMAN CONDITION (LITERATURE REVIEW)

The main task of modern orthodontics is to create a balanced and morphologically stable occlusion in harmony with facial aesthetics and functional adaptation. Over the last decade, there has been a clear trend towards an increase in the prevalence of malocclusion, which reaches 80% according to current scientific literature and sometimes it exceeds this percentage. Researchers note a constant and statistically significant correlation between the permanent occlusion pathology and the state of somatic health in adolescence. On the other hand, the interdisciplinary approach is one of the most urgent tasks of modern orthodontics and a constant object of searching for new methods of diagnosis and treatment.
 The aim of the study is to investigate the relationship between dento-facial anomalies and somatic pathology.
 Materials and methods. Literary sources were reviewed on the relationship of malocclusion with the general diseases and the obtained data were analysed.
 Discussion. The human body is a biological system consisting of interconnected and subordinate elements. The peculiarities of their structure and relations are subordinated to their functioning as part of a single integral mechanism. Most authors note the existence of a direct interconnection between the general somatic pathology and anomalies of the dento-facial system. When analysing the literature data, several major groups of diseases that have the greatest impact on the development of the dento-facial system are clearly distinguished: diseases of the ENT organs, the gastrointestinal tract, endocrine and musculoskeletal systems. At present the scientists have substantiated the concept of commonality of factors that shape both dental status and state of somatic health. An increase in the frequency of dento-facial anomalies and deformations in 1,6-2,3 times is noted in disorder of the musculoskeletal system. In this category of children, deep incisor occlusion, distal occlusion and neutral occlusion with anomalies of individual teeth predominate. In children with scoliosis, 72.9-84.3% of cases are diagnosed with dento-facial anomalies and deformations. The position of the jaws has an effect on the spatial orientation of the head and this in turn affects the position of other structures of the body. Some researchers point to the “anterior” position of the head of patients with dysfunction of the temporomandibular joints associated with the shortening of the extensors of the sternocleidomastoid muscles. Research showed that in 89,3% of cases, children with bronchial asthma have dento-facial anomalies. Adolescence is one of the critical periods of human life, since it is precisely in adolescence that the neuroendocrine system begins to function, and sex hormones which affect the development of many body systems and the formation of reproductive health are produced. Under the action of steroid hormones, an active development of the musculoskeletal system occurs, which is manifested by the acceleration of total body growth and dento-maxillofacial growth. Insufficient secretion of estrogen leads to impaired bone mineralization and may cause abnormalities in the maxillofacial area. Impaired growth and development of the dento-facial system was detected in case of juvenile rheumatoid arthritis. In juvenile idiopathic arthritis, one third of the patients were examined. The skeletal pathology of the Angle I class, as well as impaired functional state of the TMJ were diagnosed. Thyroid hormone and thyroxin stimulates growth in the sphenoid-occipital synchondrosis, nasal cartilage and the growth of the upper jaw in the area of bone sutures, thereby determining of the size and position of the upper jaw. As a result of a decrease in thyroxin level, there is a delay in craniofacial growth, disproportional development, retroposition of the upper jaw and decrease in the length of the mandible.
 Thus, the correlation of malocclusion in children and adolescents with common diseases arise. Therefore, the diagnosis, tactics of treatment and prevention of dental anomalies and deformities should be considered in the context of the integrity of the unformed organism of the child, the interdependence of the form and functions of its organs and systems.

Laparoscopic treatment of giant circumferential leiomyoma of the distal esophagus

Introduction: Leiomyomas are rare esophagus tumors, with 0.4-1% incidence of all esophagus tumors, being more frequent in medium and distal portions1. Only 5% grow to the point of being called giant tumors, measuring more than 10cm2. Symptoms usually begin on tumors equal to or bigger than 5cm. Objectives: The following case objectifies reporting a new therapeutic course of action to giant leiomyomas of distal esophagus. Case Report: VCA, female, 38 years old, presented retrosternal oppression for 4 months. Having realized a computed tomography (CT) on another service 5 days ago which demonstrated a tumor injury on the distal esophagus and suggestive of leiomyoma. Patient was submitted through endoscopy exam 4 months ago, for complaint of heartburn and mild dysphagia. It was determined a hiatal hernia of 2cm and mild gastritis. Patient was submitted to complete excision of tumor without mucosal lesion and reconstruction of the external muscular wall, by the video laparoscopic method. Hiatoplasty and partial esophagogastrogemorplication were associated. The anatomic pathological examination confirmed the leiomyoma, with 10x5x2cm. Patient evolved clinically in the long term without the appearance of the heartburn or dysphagia. The patient underwent contrast examination of the esophagus after 6 months and endoscopy and tomography for the following 4 years, all normal. The classic treatment of giant leiomyomas larger than 10cm, includes thoracotomy with esophagectomy. Considering that in 80% of the cases it is found in the middle and lower thirds of the esophagus, the videolaparoscopic approach by transhiatal route becomes possible3. The reconstruction of the external muscular layer is important to prevent a possible prolapse of the mucosa1. Also, the realization of the fundoplication in addition to avoiding the gastroesophageal reflux, allows the suture area of the esophageal muscular wall to be covered, increasing the safety in the treatment4. In services with experience in the surgical treatment of diseases of the gastric esophagus transition through the videolaparoscopic method, it is possible to perform with adequate safety the surgical treatment of the tumor lesions of the distal esophagus. The method provides the patient with greater postoperative comfort and prompt clinical surgical recovery.

348 Endoscopic Management of a Recalcitrant Anastomotic Bile Leak After Pancreaticoduodenectomy

INTRODUCTION: A 64-year-old female with past history of pylorus-preserving pancreaticoduodenectomy for pancreatic adenocarcinoma presented for endoscopic management of anastomotic bile leak and suspected stricture at the hepaticojejunostomy which persisted despite surgical and percutaneous intervention. CASE DESCRIPTION/METHODS: At the time of her surgery she was noted to have bile leakage from the new hepaticojejunostomy anastomosis, which was managed with intraoperative revision of the anastomosis and placement of a T-tube. On follow up after her surgery, she continued to have bilious drainage from her drains and was referred to interventional radiology for percutaneous transhepatic cholangiography. Cholangiogram demonstrated a significant leak from the anastomosis into a new subhepatic fluid collection. A percutaneous drainage catheter was placed. On subsequent catheter change, it was also noted that the biliary catheter was actually placed into a fluid collection adjacent to the small bowel and not across the hepaticojejunostomy. Internalization of the biliary catheter was unsuccessful as no flow of contrast from the bile duct to the jejunal limb could be identified. Her course was also complicated by episodes of cholangitis. To manage the persistent anastomotic leak, ERCP was performed. An adult colonoscope was advanced to the hepaticojejunostomy, which appeared widely patent. Contrast injection through the existing external percutaneous drain in the right hepatic duct confirmed complete distal occlusion of the duct without any contrast passage into the jejunum. Careful exam of anastomosis revealed sutures located superior to the hepaticojejunostomy. A 0.018 inch hydrophilic wire was advanced anterograde alongside the external drain under fluoroscopic guidance. This was unable to be passed into the small bowel but advancement of the wire resulted in a bulge in the mucosa seen endoscopically in the area of sutures, confirming the diagnosis of inadvertent surgical closure of right system. To gain access to the right biliary system, a choleodochojejunostomy was created using a needle knife in the area of the bulge created by the antegrade passage of wire through percutaneous tract. This allowed a 10 mm by 4 cm fully covered metal biliary stent to be deployed into the right hepatic duct across the newly created hepaticojejunostomy. DISCUSSION: In this case, we describe the endoscopic diagnosis and treatment of an iatrogenic biliary stricture leading to persistent anastomotic leak after pancreaticoduodectomy. Watch the video: http://bit.ly/2Z1kewv

Effect of rapid maxillary expansion on the morphology of spheno-occipital synchondrosis in rats : Amicro-CT study.

Spheno-occipital synchondrosis (SOS) plays asignificant role in the anterior growth of the midface. Orthopaedic forces acting during rapid maxillary expansion (RME) are transferred to the skull base and thus could alter the morphology of SOS. The aim of this study was to assess the influence of experimental RME on the rats' SOS by means of micro-computed tomography (micro-CT). In all, 40male 8‑week-old Wistar rats were enrolled into the study, among which 30 underwent experimental RME for 7, 14 and 21days by means of custom designed spring-coil expander. Specimens were scanned by micro-CT and median palatal suture area, maxillary skeletal base and SOS width were analysed. Experimental RME resulted in asignificant increase of the median palatal suture space and maxillary skeletal base which was particularly pronounced between day14 and 21 of expansion. SOS width increased significantly during the first 7days at the lowest point of the synchondrosis. However, the SOS width assessed at its highest point was temporarily even decreased between days 8 and 14 of therapy. Early SOS widening could be identified in the lowest part before median palatal suture opening. Similarly, narrowing of the SOS at its top was observed before the most significant median palatal suture expansion. Thus it can be hypothesized that changes within the SOS complex result from the transmission of the orthopaedic forces rather than from adisplacement of the maxillary halves.

Chronic wound assessment and infection detection method

BackgroundNumerous patients suffer from chronic wounds and wound infections nowadays. Until now, the care for wounds after surgery still remain a tedious and challenging work for the medical personnel and patients. As a result, with the help of the hand-held mobile devices, there is high demand for the development of a series of algorithms and related methods for wound infection early detection and wound self monitoring.MethodsThis research proposed an automated way to perform (1) wound image segmentation and (2) wound infection assessment after surgical operations. The first part describes an edge-based self-adaptive threshold detection image segmentation method to exclude nonwounded areas from the original images. The second part describes a wound infection assessment method based on machine learning approach. In this method, the extraction of feature points from the suture area and an optimal clustering method based on unimodal Rosin threshold algorithm that divides feature points into clusters are introduced. These clusters are then merged into several regions of interest (ROIs), each of which is regarded as a suture site. Notably, a support vector machine (SVM) can automatically interpret infections on these detected suture site.ResultsFor (1) wound image segmentation, boundary-based evaluation were applied on 100 images with gold standard set up by three physicians. Overall, it achieves 76.44% true positive rate and 89.04% accuracy value. For (2) wound infection assessment, the results from a retrospective study using confirmed wound pictures from three physicians for the following four symptoms are presented: (1) Swelling, (2) Granulation, (3) Infection, and (4) Tissue Necrosis. Through cross-validation of 134 wound images, for anomaly detection, our classifiers achieved 87.31% accuracy value; for symptom assessment, our classifiers achieved 83.58% accuracy value.ConclusionsThis augmentation mechanism has been demonstrated reliable enough to reduce the need for face-to-face diagnoses. To facilitate the use of this method and analytical framework, an automatic wound interpretation app and an accompanying website were developed.Trial registration201505164RIND, 201803108RSB.

Experimental justification of strengthening and morphological changes in colonic anastomosis

Objective. To study the morphological changes of tissues in the area of suture and additional materials, mechanical strength and bacteriological environment after the colonic anastomosis of the descending colon area in rats.Material and methods. In the course of the experimental study, morphological changes of tissues in the area of the colonic anastomosis of the descending colon in rats, mechanical strength and bacteriological environment on the 3rd, 7th, 14th, 21st and 30th day after the surgical intervention were determined. Two groups of animals were studied: the first one included the rats with a single-row suturing of colonic anastomosis, with the use of suture material “Vikryl 5.0”; for the animals of the second group, after a single-row suturing, a modern tissue adhesive "Catsyl" was additionally applied.Results. In the group of rats with a single-row suturing of the colonic anastomosis with the use of suture material “Vikryl 5.0” and with the additional use of the tissue adhesive “Katsyl”, according to bacteriological examination data on the 3rd day, the incidence of abdominal cavity infectioning was significantly lower in the number of Enterobacteriaceae Klebsiella pneumonia, Pseudomonaceae and Enterococcus faecalis in comparison with a group of animals without additional strengthening of anastomosis zone. According to the pneumopression data, in rats with an additional use of the tissue adhesive “Katsyl” the anastomosis strength on the 3rd, 7th, and 14th day after the fistulization was significantly higher than in the comparison group by 2.0, 1.3 and 2.3 times respectively (p <0.05).Conclusions. The use of tissue adhesive “Katsyl” reduces tissue infectioning in the anastomosis area, according to the bacteriological examination results, and also contributes to the strengthening of the anastomosis, according to the pneumopression data.

Sagittal suture maturation: Morphological reorganization, relation to aging, and reliability as an age-at-death indicator.

The sagittal suture (SS) is assumed to be an initial site for the commencement of cranial suture closure as well as the most frequent spot of isolated craniosynostosis. The present study aimed to inspect the reorganization of the SS at the microlevel to assess the relation between its closure and aging and to establish whether it could be used as a reliable indicator in age-at-death prediction. The SS was investigated in 68 dry contemporary adult male skulls of known age-at-death. An additional series of 20 skulls was used for verification. The skulls were scanned using a micro-computed tomography system. The SS closure degree was assessed along the three bone layers on cross-sectional tomograms by using a scoring scale. In the entirely open SS, the bone edges consist of compact bone and are widely separated. With SS maturation, the bone edges come into contact, and the remodeling process leads to a decrease in the sutural area and bone homogenization across all three layers. SS closure is an irregular process roughly related to aging, beginning in the early 20s, reaching its peak at about 30 years of age and abating in the late 40s. Although related to aging, SS closure is not a simple function of it. Rather, the underlying factors inducing and managing this process are multifaceted and complex. Although the etiology of SS maturation remains unclear, it is reasonable to use SS closure cautiously and only as a supportive method for age prediction.

Refractive shift after glaucoma surgery

Filtering glaucoma surgery can affect certain biometric features of the eye: it can change the axial length and anterior chamber depth, while redistribution of mechanical tensions in the fibrous tunic can alter the shape of the cornea. Among these changes that affect refraction, reshaping of corneal curvature is the principle one. Contrary to the expectations, and in contrast to changes associated with cataract surgery, glaucoma surgery led to decrease in vertical corneal radius (steepening) and development of the with-the-rule astigmatism. A number of studies helped reveal the features of corneal astigmatism that appears after glaucoma surgery: its power, duration, possibility of horizontal meridian flattening, influence of topical cytostatic drugs and drainage devices, etc. Potential reasons of astigmatism development were suggested: conjunctival incisions and sutures in the limbal area, quantity and strength of flap sutures, intraocular pressure level, shift of fistula edges, tissue contraction after cauterization, etc. The key role in pathogenesis of the refractive shift due to change of corneal curvature may belong to particularities of wound healing in the cornea and sclera: healing in sclera is similar to one of connective tissue - its ultrastructure undergoes aging process followed by change of rigidity. At the same time, the main reason for the development of corneal astigmatism after glaucoma surgery remains unclear.

Safe and easy technique for the laparoscopic application of Seprafilm® in gynecologic surgery.

Laparoscopic surgery is a minimally invasive surgery, and the rate of postoperative adhesions is low. Although Seprafilm® helps to reduce adhesions, its application in the abdominal cavity during laparoscopic surgery is difficult because of its material. Therefore, we propose an easy method for applying this adhesion barrier. The Seprafilm is cut into four equal pieces. The four pieces are stacked, firmly folded twice, and grasped with the forceps. The reducer sleeve is slid over the bundle of Seprafilm. The forceps with the reducer sleeve is inserted through a 12-mm trocar near the target area. The reducer sleeve is then slid down the forceps to uncover the Seprafilm. Finally, each piece of Seprafilm is applied over the suture area. In all cases, the Seprafilm was successfully applied to the intended target. There were no cases in which Seprafilm was incompletely applied or in which it could not be used because of moistening. The average application times of surgeon 1 and surgeon 2 were 4.8 min and 5.0 min, respectively; this difference was not significant. There were no postoperative complications in any case. It is safe and easy to use our simple technique to apply Seprafilm adhesion barrier laparoscopically. Further studies are warranted to prove Seprafilm's efficacy after such application.

Comparative effect of turmeric (Curcuma longa) and durba (Cynodon dactylon) on the healing of surgical wounds in cattle (Bos indicus)

Herbal preparations are used traditionally in wound management to promote wound healing process. In Bangladesh, there are limited researches on the use of herbal products to assist healing process. Therefore, this experiment was carried out to exploit turmeric (Curcuma longa) and durba (Cynodon dactylon) pastes in the treatment of surgical wounds in cattle and to study their healing effect on wound sutured with horizontal mattress using nylon. A total of 36 surgical wounds were made in six cattle. Tincture benzoin was used as control group. Follow-up information was recorded from day 0 to day 21 postoperatively. Some morphological characters such as swelling area of wound, elevation of sutured line from the skin surface, width of sutured area and contraction length per week were recorded to determine the healing process of the wounds. Bacteriological and histopathological studies were also performed. All wounds were closely monitored to observe any complications such as swelling, wound dehiscence, suture abscess, local infection and exudation etc. Results showed that Tr. Benzoin seal caused marked tissue reaction in wounds in comparison to turmeric and durba paste. Turmeric paste showed splendid results in the healing of the wounds produced in cattle. Durba paste also has wound healing activity but less effective than that of turmeric. This study could help veterinarians to consider herbal products especially turmeric for healing of wounds with minimum complications. Dissemination of these findings among the farmers may prevent skin degradation caused by the postoperative complications of the wound and thus improve the health status of livestock.Asian J. Med. Biol. Res. June 2018, 4(2): 164-171

CLINICO-MORPHOLOGICAL FEATURES OF RE-CESAREAN SECTION

A high number of repeat cesarean sections increases a risk of excessive bleeding, uterine atony, hysterectomy.The aim of study was to evaluate the efficacy of medical and technical methods (argon plasma coagulation, tranexamic acid, carbetocin) to prevent complications following repeat cesarean section and to improve the myometrial wound healing, to establish morphological features of uterine scar tissue in case of using argon plasma coagulation of myometrium in the area of the suture during the previous operation.Materials and methods Prospective cohort study of 87 patients who had undergone repeat cesarean section. I group included 42 women who had repeat cesarean section using argon plasma coagulation. Ten minutes before the operation, 1,0 g of tranexamic acid was injected intravenously. 100 mcg carbetocin was administered intravenously after cutting the umbilical cord. ІІ group comprised 45 women who had traditional cesarean section using Stark’s technique and Joel-Cohen incision. Pathomorphological study of scarred lower uterine segment myometrium was performed. Immunohistochemical staining against CD3, CD34, CD68, vimentin, α-SMA was performed.Results are presented as Mean±SD.Results. Total operative time was significantly shorter in the І group (37,7±2,4 minutes) compared to ІІ (47,4±1,6 minutes) (р<0,05). Volume of blood loss in the І group was 476,7±37,4 ml, and in the ІІ — 549,7±35,7 ml (p<0.05). Patients of the І group needed analgesic for 18-24 hours, the ІІ group — 36-72 hours after operation. The width of the uterine cavity in group І was 9,7±0,39 mm, in group ІІ — 14,8±0,52 mm (р<0,05). One patient of group І and 9 patients of group ІІ had signs of uterine subinvolution. Length of hospital stay after surgery in group I was 4,7±0,12 days, in ІІ — 6,8±0,24 days. The ultrasound thickness of myometrium in group I and group II is an average of 8,72±0,54 mm and 6,75±0,69 mm, respectively. Pathomorphological data of scarred lower uterine segment myometrium showed that in group I regenerative processes have more favorable course, a tendency to restore the structure of myometrium, while in group II there were processes of disturbed regeneration with the replacement of smooth muscle tissue varying maturity of connective tissue, moderate inflammatory process.Conclusion. So, the use of tranexamic acid, carbetocin and argon plasma coagulation is effective in reducing perioperative blood loss, total operative time, dosage of uterotonic and analgesic medications and postoperative hospital stay in patients giving birth by repeat cesarean section. According to the pathomorphological study, argon plasma coagulation of myometrium in the area of suture increases the value of the reparative processes and promotes the formation of a morphologically complete scar, with the predominance of smooth muscle cells over connective tissue.

Involvement of calvarial stem cells in healing: A regional analysis of large cranial defects

Large craniofacial defects present a substantial clinical challenge that often requires the use of osteoconductive matrices and osteoinductive cues (i.e., bone morphogenetic proteins [BMP2]) to augment healing. While these methods have improved clinical outcomes, a better understanding of how the osteogenic fronts surrounding the defect, the underlying dura mater, and the cranial suture area contribute to healing may lead to more targeted therapies to enhance bone regeneration. We hypothesized that healing within a large bone defect will be precipitated from cells within the remaining or available suture mesenchyme abutting the edges of a murine critical sized defect. To investigate this hypothesis, 39 adult, wild-type mice were randomly arranged into groups (9 or 10 per group) by time (4 and 8 weeks) and treatment (control, acellular collagen sponge alone, or acellular collagen sponge loaded with a clinically relevant scaled dosage of BMP2). The skulls were then subjected to microcomputed tomography and histological analysis to assess bone regeneration in regions of interest within the defect area. A regional assessment of healing indicated that BMP2 drives greater healing than control and that healing emanates from the surgical margin, particularly from the margin associated with undisrupted suture mesenchyme. Though BMP2 treatment drove an increase in cell presence within the healing defect, there was no regional orientation of craniofacial stem cells or vascularity. Overall, these data reinforce that osteoconductive matrices in conjunction with osteoinductive peptides result in better healing of large calvarial defects. This healing is characterized as emanating from the surgical margin where there is an abundant supply of vasculature and progenitor cells.