Tissue Manipulation Research Articles

Proper Circumferential Sizing of Penile Implants

ABSTRACT Introduction The Introduction: of narrow inflatable cylinders allows high volume implanters to correctly size patients despite anatomic limitations. Clinical manifestations of circumferential oversizing include pain associated with the inability to fully inflate the implant, noncompliance of cycling regiment, and isolated persistent phallic pain despite a deflated implant. Oversizing patients may negatively impact patient satisfaction and recovery efficacy which may ultimately lead to unnecessary surgical revision. Herein, we describe our experience with the role of narrow cylinders to address a common intraoperative occurrence of decreased corporal circumference using a decision tree to assist and alert the implanting surgeon on appropriate use of narrow cylinders. Objective Our goal is to establish a specific guideline for the proper circumferential sizing of penile implants, utilizing narrow based cylinders. Methods From May 2018- May 2021, 1,158 patients underwent penile implantation from two high volume surgeons. Data were collected prospectively. A total of 201 cases were identified in which narrow cylinders were required. Operative notes were reviewed for the cause of narrowing, method of corporal dilation, and decision to use narrow cylinders. We employed the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Visual Analog Scale (VAS) for Pain. Using a previously presented algorithm (Figure 1) by the authors for proper circumferential sizing, a cutoff of 12mm corporal dilation was established. If any resistance was met when passing the 12mm dilator, narrow cylinders were subsequently placed. We compared the VAS and EDITS scores for patients who underwent narrow base cylinder placement both prior to and after the strict implementation of the aforementioned algorithm. Results Prior to 2018, the use of narrow cylinders among these two high volume surgeons was <1%. Since the strict adoption of the algorithm, the use of narrow cylinders increased to 18%. Causes for corporal narrowing were congenital narrowing, fibrosis/scarring, revision surgery, Peyronie's plaques, and history of penile trauma. After implementation of the algorithm, we demonstrate a significant increase in narrow based cylinder placement usage, without the expense of reduced EDITS scores as well as reducing patient reported VAS scores. POD #1 VAS pain scores for the post-algorithm cohort, and pre-algorithm cohort demonstrated a mean of 1.9 (median 2, range 0-7), vs 3.9 (median 4, range 0-8), respectively. POD #10, scores for phallus-specific pain for the post-adoption algorithm cohort and pre-adoption algorithm cohort, demonstrated a mean of 0.25 (median 0, range 0-2) and 0.53 (median 0, range 0-3), respectively. Patient satisfaction scores for the post-adoption algorithm cohort and pre-adoption algorithm cohort were similar with mean EDITS scores of 93.2 on a 100-point scale (median 88.6, range 79.5-100) vs 94.5 (median 90.3, range 81-100), respectively. Conclusions In order to avoid corporal circumferential oversizing, we encourage the adoption of the aforementioned algorithm. Properly sized cylinders prevent increased operative times, reduce tissue manipulation, and may prevent unnecessary revision surgery. As a result of adhering to this algorithm, we believe we have been able to properly adjust for a narrow corporal body, thus decreasing VAS pain scores while maintaining penile implant patient satisfaction and efficacy. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific

Astrocytes and Microglia Exhibit Cell-Specific Ca2+ Signaling Dynamics in the Murine Spinal Cord.

The spinal cord is the main pathway connecting brain and peripheral nervous system. Its functionality relies on the orchestrated activity of both neurons and glial cells. To date, most advancement in understanding the spinal cord inner mechanisms has been made either by in vivo exposure of its dorsal surface through laminectomy or by acute ex vivo slice preparation, likely affecting spinal cord physiology in virtue of the necessary extensive manipulation of the spinal cord tissue. This is especially true of cells immediately responding to alterations of the surrounding environment, such as microglia and astrocytes, reacting within seconds or minutes and for up to several days after the original insult. Ca2+ signaling is considered one of the most immediate, versatile, and yet elusive cellular responses of glia. Here, we induced the cell-specific expression of the genetically encoded Ca2+ indicator GCaMP3 to evaluate spontaneous intracellular Ca2+ signaling in astrocytes and microglia. Ca2+ signals were then characterized in acute ex vivo (both gray and white matter) as well as in chronic in vivo (white matter) preparations using MSparkles, a MATLAB-based software for automatic detection and analysis of fluorescence events. As a result, we were able to segregate distinct astroglial and microglial Ca2+ signaling patterns along with method-specific Ca2+ signaling alterations, which must be taken into consideration in the reliable evaluation of any result obtained in physiological as well as pathological conditions. Our study revealed a high degree of Ca2+ signaling diversity in glial cells of the murine spinal cord, thus adding to the current knowledge of the astonishing glial heterogeneity and cell-specific Ca2+ dynamics in non-neuronal networks.

Application of anatomically contoured intramedullary interlocking nailing for fixation of femoral diaphyseal fractures in dogs

The study was conducted on 10 client-owned dogs of either sex presented for fixation of femoral diaphyseal fractures. After thorough clinical, orthopaedic and radiographic examinations, the patients were subjected to application of specially-designed anatomically contoured intramedullary interlocking nailing (ACIILN) for fixation of fractures. All the fractures were closed and involved mid (n=9) to slightly distal (n=1) diaphysis. The diameter of used ACIILN ranged from 5–7 mm and the length from 11–15 cm. All the ACIILN were applied in static fashion with at least 2 screws each in both proximal and distal fracture fragments. The duration of surgery for application of ACIILN ranged from 35–75 min. The technique was found to be moderately difficult with extent of tissue manipulation in the category of low to moderate. Pain and inflammation decreased gradually in all the cases in an anticipated manner.With gradual improvement in weight-bearing capability, the limb function was restored in all cases quiet fast in the postoperative period. More amount of the callus formed over medial and caudal surfaces indicating less amount of stability at these surfaces. Anatomically contoured intramedullary interlocking nailing technique provided clinically viable fracture fixation technique resulting into early limb function.

Re-creating reality: validation of fresh frozen full cadaver airway training with videolaryngoscopy and bougie FIRST strategy

BackgroundTracheal intubation is the gold standard in emergency airway management. One way of measuring intubation quality is first pass success rate (FPSR). Mastery of tracheal intubation and maintenance of the skill is challenging for non-anesthesiologists. A combination of individual measures can increase FPSR. Videolaryngoscopy is an important tool augmenting laryngeal visualization. Bougie-first strategy can further improve FPSR in difficult airways. Standardized positioning maneuvers and manipulation of the soft tissues can enhance laryngeal visualization. Fresh frozen cadavers (FFC) are superior models compared to commercially manufactured manikins. By purposefully manipulating FFCs, it is possible to mimic the pre-hospital intubation conditions of helicopter emergency medical service (HEMS).MethodsTwenty-four trauma surgeons (12 per Group, NOVICES: no pre-hospital experience, HEMS: HEMS physicians) completed an airway training course using FFCs. The FFCs were modified to match airway characteristics of 60 prospectively documented intubations by HEMS physicians prior to the study (BASELINE). In four scenarios the local HEMS airway standard (1: unaided direct laryngoscopy (DL), OLD) was compared to two scenarios with modifications of the intubation technique (2: augmented DL (bougie and patient positioning), 3: augmented videolaryngoscopy (aVL)) and a control scenario (4: VL and bougie, positioning by participant, CONTROL). FPSR, POGO score, Cormack and Lehane grade and duration of intubation were recorded. No participant had anesthesiological qualifications or experience in VL.ResultsThe comparison between CONTROL and BASELINE revealed a significant increase of FPSR and achieved C&L grade for HEMS group (FPSR 100%, absolute difference 23%, p ≤ .001). The use of videolaryngoscopy, bougie, and the application of positioning techniques required significantly more time in the CONTROL scenario (HEMS group: mean 34.0 s (IQR 28.3–47.5), absolute difference to BASELINE: 13.0 s, p = .045). The groups differed significantly in the median number of real-life intubations performed in any setting (NOVICES n = 5 (IQR 0–18.75), HEMS n = 68 (IQR 37.25–99.75)). In the control scenario no significant differences were found between both groups. The airway characteristics of the FFC showed no significant differences compared to BASELINE.ConclusionAirway characteristics of a pre-hospital patient reference group cared for by HEMS were successfully reproduced in a fresh frozen cadaver model. In this setting, a combination of evidence based airway management techniques results in high FPSR and POGO rates of non-anesthesiological trained users. Comparable results (FPSR, POGO, duration of intubation) were achieved regardless of previous provider experience. The BOAH concept can therefore be used in the early stages of airway training and for skill maintenance.

Circulating Tumor Cells and the Non-Touch Isolation Technique in Surgery for Non-Small-Cell Lung Cancer.

Simple SummaryOur review discusses findings for the non-touch isolation technique in surgery, especially in surgery for non-small-cell lung cancer. This technique aims to prevent the release of circulating tumor cells (CTCs) from the tumor nest to the bloodstream during surgery, but its efficacy has not been clearly verified. We have summarized the history of CTC detection, relevance of CTCs to clinical practice, and evidence regarding this technique for lung cancer surgery.Circulating tumor cells (CTCs) are dislodged from the primary tumor into the bloodstream, travel within the bloodstream to distant organs, and finally extravasate and proliferate as epithelial metastatic deposits. The relationship between the existence of CTCs and tumor prognosis has been demonstrated by many researchers. In surgery for malignancies, the surgical manipulation of tumors and tissues around the tumor may lead to the release of CTCs into the bloodstream. The non-touch isolation technique (NTIT) has been advocated to prevent the release of CTCs during surgery. The concept of NTIT is the prevention of intraoperative increment of CTCs from the primary tumor by the early blockade of outflow vessels, and ‘pulmonary vein (PV)-first lobectomy’ during surgery for non-small-cell lung cancer (NSCLC) corresponds to this technique. The concept of PV-first lobectomy is well known among thoracic surgeons, but evidence of its efficacy for preventing the increase of intra- and postoperative CTCs and for improving postoperative prognosis is still uncertain. Our study summarizes evidence regarding the relationship between NTIT and CTCs in NSCLC and suggests the need for further research on CTCs and CTC-detecting modalities.

Robotic and 3D laparoscopic radical nephroureterectomy with en bloc specimen excision (kidney, ureter, bladder cuff excision and extended lymphadenectomy) - Case report.

Introduction and importanceUpper tract urothelial carcinoma (UTUC) is a highly systemic aggressive disease with a tendency of rapid lymph node invasion and metastasis presenting poor oncologic outcomes. Ureteral localization of tumors leads to hydronephrosis and early invasion of the muscle wall, being categorized as high risk tumors.Case presentationA 70 years old female was diagnosed with lower left ureteral urothelial tumor associated with hydronephrosis and paraaortic and iliac enlarged lymph nodes. The disease was stratified as high risk upper tract urothelial carcinoma. Treatment consisted in en bloc radical nephroureterectomy, bladder cuff excision and wide lymph node dissection using a combined robotic and 3D laparoscopic approach.Clinical discussionSurgical challenges are surpassed by the use of minimal invasive approaches that offer precise dissection and tissue manipulation with a fast postoperative recovery and early adjuvant oncologic treatment. Comprehensive and complete lymph node dissection along with precise bladder cuff excision offers improved staging, possibly impacting disease prognosis.ConclusionEn bloc minimal invasive radical nephroureterectomy, bladder cuff excision and wide lymph node dissection offer improved surgery time and lymph node dissection, better management of distal ureteral and bladder cuff excision, watertight cystorrhaphy and optimal disease staging. The experience of the main surgeon with 3D laparoscopy was used in the hereby case to optimize operatory time for the renal step of the surgery. The gentle and precise movements of the Da Vinci robot allowed an accurate en bloc dissection (pN2, N4+/15) with implications in staging and possibly also in oncologic outcomes.

English

BACKGROUND Surgical removal of the lower impacted third molar is the most classic procedure performed in oral surgery. This procedure is often linked with hard and soft tissue manipulation leading to activation of acute-phase inflammatory response. This has led to the development of serum inflammatory biomarkers which has given the advantage of reducing the prolonged use of prophylactic antibiotics and an analgesic. The purpose of this study was to determine the analgesic and antiinflammatory effects of two NSAIDs in patients undergoing third molar surgery and assess the serum CRP levels preoperatively and postoperatively. METHODS Our study was carried out on twenty (20) healthy volunteering young adults who reported to the Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College & Hospital, Chennai, for the surgical removal of impacted mandibular third molars. Patients were enrolled in two groups. Each group was subjected to the withdrawal of a venous blood sample of 2 ml preoperatively, immediately 1 hr after the surgery and on the third postoperative day. A turbidimetric test was done for CRP level on all these samples and the results were analyzed. RESULTS An investigation was performed to find the association of gender, age, difficulty index, duration of surgery and pain scores by using a biochemical marker – C - reactive protein. The ibuprofen group showed increased postoperative 72 hr CRP levels and diclofenac group showed decreased postoperative 72 hr CRP levels in comparison to initially measured preoperative CRP levels regardless of an increase or decrease in the duration of the surgery. CONCLUSIONS Thus, it can be concluded that a non-steroidal anti-inflammatory drug like diclofenac is a better analgesic and anti-inflammatory drug than ibuprofen in controlling the pain perception and inflammation responses based on inflammatory biomarker–C-reactive protein levels. An inflammatory biomarker like CRP is a reliable and potent indicator of various inflammatory responses. KEY WORDS NSAIDS, CRP, Molar, Analgesics.

Bacteremia after Orthodontic Miniscrew Insertion.

Objectives: Use of miniscrews has become very common in orthodontic treatment of patients. Following tissue manipulation during miniscrew placement, bacteremia may occur, which is important in patients susceptible to infective endocarditis. This study aimed to investigate the possibility of bacteremia following orthodontic miniscrew placement. Materials and Methods: The present quasi-experimental study was conducted on 30 orthodontic patients, including 11 males (36.7%) and 19 females (63.3%) with a mean age of 23.67±4.87 years, who required miniscrew placement in their treatment plan. Two blood samples were taken from the patients for aerobic and anaerobic cultures right before and 30-60 seconds after miniscrew placement. To investigate the presence of bacteremia, the blood samples were incubated in an automated blood culture machine for five days. The standard biological methods were used for the positive sample(s) to identify the type of bacteria. Data analysis was performed using the McNemar test. Results: The blood samples of 29 patients were negative for the bacteria before and after miniscrew placement. Blood sample of one patient was positive for aerobic and anaerobic bacteria after miniscrew placement. However, bacteremia was negative in the initial (preplacement) blood samples for both aerobes and anaerobes. Conclusion: Miniscrew placement in orthodontic patients was not associated with bacteremia.

TGF-1 biomarker level evaluation on fracture healing in a murine model with a bone defect after stromal vascular fraction application.

Aim Bone defect is a challenge even for experienced orthopaedic surgeons and it is a significant cause of morbidity in patients and a source of high economic burden in health care. A severe bone defect is a condition whereby the bone tissue cannot undergo natural healing despite surgical stabilization and requires further surgical intervention. Stromal vascular fraction (SVF) is a heterogeneous cell population derived from adipose tissue that results from minimal manipulation of the adipose tissue itself. TGF is essential in maintaining and expanding mesenchymal stem cells or progenitors of osteoblasts. Furthermore, TGF-β signalling also triggers osteoprogenitor cell proliferation, early differentiation, and maintenance of osteoblasts in the bone healing process. The aim of this study was to determine the effect of administering SVF on bone defects' healing process assessed based on the TGF- β1. Methods This was an animal study involving twelve Wistar strain Rattus norvegicus. They were divided into three groups: negative group (normal rats), positive group (rats with bone defect without SVF application), and SVF group (rats with bone defect with SVF application). After 30 days, the rats were sacrificed, the TGF- β1 biomarker was evaluated (quantified using ELISA). Results TGF- β1 biomarker expressions were higher in the group with SVF application than in the group without SVF application. All comparisons of the SVF group and positive control group showed significant differences (p=0,000), respectively. Conclusion Giving SVF application could aid the healing process in a murine model with bone defect, marked by an increased level of TGF- β1.

Contraction Control of Aligned Myofiber Sheet Tissue by Parallel Oriented Induced Pluripotent Stem Cell-Derived Neurons.

Fabrication and application of engineered complex tissues composed of different types of cells is a crucial milestone in the next phase of tissue engineering. The delicate organization structure of each tissue component and its physiological connections enable all the functions in the human body. In this study, cell sheet-based engineering allowed us to fabricate a complex myofiber sheet tissue using motor neurons derived from human-induced pluripotent stem cells. In contrast with previous studies of other groups, a myofiber sheet with a biomimetic aligned structure was produced from human myoblasts using a striped-patterned thermoresponsive dish, which enabled manipulation of the sheet tissue by simply lowering the culture temperature. The myofiber sheet was transferred onto a gel that promotes functional maturation of human myofibers, resulting in production of contractile human muscle tissue. Just by seeding motor neurons onto the sheet tissue, all the neurons physically contacted to the aligned myofibers, and autonomously elongated in parallel to the myofiber orientation. In addition, the neurite outgrowth was enlarged by coculturing on the myofiber sheet. The presence of the neurons enhanced clustering of myofiber acetylcholine receptors (AChRs), typically found at the neuromuscular junctions (NMJs). Consequently, contraction behaviors of the myofiber sheet were regulated by neuronal signal transduction through NMJs. Muscle contraction was induced when the motor neurons were stimulated by glutamic acid, and effectively blocked by administration of d-tubocurarine as an antagonistic inhibitor for the AChR. The fibrin-based gel was useful as a culture environment for tissue maturation and as a favorable substrate for unobstructed contractions. Our neuron-muscle sheet tissue will be scalable by simply enlarging the micropatterned substrate and manipulable three dimensionally; fabrication of a thick tissue and a bundle-like structured tissue will be possible just by layering multiple sheets or rolling up the sheet. Simplified control over self-orientation of neurite elongation will be advantageous for fabrication of such a large and complex tissue. Therefore, our methodology, established in this study, will be instrumental in future applications of regenerative medicine for locomotion apparatus. Impact Statement A complex tissue containing skeletal myofibers and induced pluripotent stem cell-derived motor neurons was fabricated from human cells based on the cell sheet engineering technology. A micropatterned thermoresponsive culture dish and a fibrin-based gel substrate enabled production of aligned, and functionally matured myofiber sheet tissue. The motor neurons were autonomously oriented simply by seeding on the aligned myofiber sheet tissue. Induction and inhibition of the muscle contraction were effectively controlled by neuronal signal transduction. Considering the potential scalability and manipulability of the neuron-muscle sheet tissue, our methodology will contribute to future applications of regenerative medicine for locomotion apparatus.

Methodology and Neuromarkers for Cetaceans' Brains.

Cetacean brain sampling may be an arduous task due to the difficulty of collecting and histologically preparing such rare and large specimens. Thus, one of the main challenges of working with cetaceans’ brains is to establish a valid methodology for an optimal manipulation and fixation of the brain tissue, which allows the samples to be viable for neuroanatomical and neuropathological studies. With this in view, we validated a methodology in order to preserve the quality of such large brains (neuroanatomy/neuropathology) and at the same time to obtain fresh brain samples for toxicological, virological, and microbiological analysis (neuropathology). A fixation protocol adapted to brains, of equal or even three times the size of human brains, was studied and tested. Finally, we investigated the usefulness of a panel of 20 antibodies (neuromarkers) associated with the normal structure and function of the brain, pathogens, age-related, and/or functional variations. The sampling protocol and some of the 20 neuromarkers have been thought to explore neurodegenerative diseases in these long-lived animals. To conclude, many of the typical measures used to evaluate neuropathological changes do not tell us if meaningful cellular changes have occurred. Having a wide panel of antibodies and histochemical techniques available allows for delving into the specific behavior of the neuronal population of the brain nuclei and to get a “fingerprint” of their real status.

Longitudinal Intravital Microscopy Using a Mammary Imaging Window with Replaceable Lid

The branched structure of the mammary gland is highly dynamic and undergoes several phases of growth and remodeling after birth. Intravital microscopy in combination with skin flap surgery or implantation of imaging windows has been used to study the dynamics of the healthy mammary gland at different developmental stages. Most mammary imaging technologies are limited to a time frame of hours to days, whereas the majority of mammary gland remodeling processes occur in time frames of days to weeks. To study mammary gland remodeling, methods that allow optical access to the tissue of interest for extended time frames are required. Here, an improved version of the titanium mammary imaging window with a replaceable lid (R.MIW) is described that allows high-resolution imaging of the mammary gland with a cellular resolution for up to several weeks. Importantly, the R.MIW provides tissue access over the entire duration of the intravital imaging experiment and could therefore be used for local tissue manipulation, labeling, drug administration, or image-guided microdissection. Taken together, the R.MIW enables high-resolution characterization of the cellular dynamics during mammary gland development, homeostasis, and disease.

Longitudinal Intravital Microscopy Using a Mammary Imaging Window with Replaceable Lid.

The branched structure of the mammary gland is highly dynamic and undergoes several phases of growth and remodeling after birth. Intravital microscopy in combination with skin flap surgery or implantation of imaging windows has been used to study the dynamics of the healthy mammary gland at different developmental stages. Most mammary imaging technologies are limited to a time frame of hours to days, whereas the majority of mammary gland remodeling processes occur in time frames of days to weeks. To study mammary gland remodeling, methods that allow optical access to the tissue of interest for extended time frames are required. Here, an improved version of the titanium mammary imaging window with a replaceable lid (R.MIW) is described that allows high-resolution imaging of the mammary gland with a cellular resolution for up to several weeks. Importantly, the R.MIW provides tissue access over the entire duration of the intravital imaging experiment and could therefore be used for local tissue manipulation, labeling, drug administration, or image-guided microdissection. Taken together, the R.MIW enables high-resolution characterization of the cellular dynamics during mammary gland development, homeostasis, and disease.

Treatment of Multiple Adjacent Class I and Class II Gingival Recessions by Modified Microsurgical Tunnel Technique and Modified Coronally Advanced Flap Using Connective Tissue Graft: A Randomized Mono-center Clinical Trial.

ABSTRACTBackground:Complete and uneventful recession coverage should be the aim of gingival recession treatment. Systematic reviews have said that coronally advanced flap with connective tissue graft (CTG) is the gold standard for gingival recession treatment. Minimally invasive procedures with optical magnification allow minimal tissue manipulation and precise adaptation of wound edges helping in faster and uneventful healing, thus bringing about a satisfactory clinical and patient outcome. Thus, the following study compares the clinical- and patient-related outcomes of modified microsurgical tunnel technique (MMTT) and modified coronally advanced flap (MCAF) using CTG in the coverage of multiple adjacent Miller’s class I and II gingival recessions.Materials and Methods:Gingival recession patients were selected and were assigned randomly to either MMTT+CTG or MCAF+CTG. Clinical parameters were evaluated at 1, 3, and 6 months. Patient’s satisfaction level was assessed by measuring root coverage esthetic score, hypersensitivity, and morbidity. The statistical analysis was performed using commercially available software SPSS version 14. Descriptive statistics were expressed as mean±standard deviation for each parameter. Intragroup comparison was done by using the paired T-test. Intergroup comparison was done using the independent Student’s T-test. The significance level was set at P = 0.05.Results:MMTT+CTG showed a statistically significant greater clinical- and patient-related outcome.Conclusion:MMTT+CTG, being a closed procedure, preserves the blood supply, helps in faster healing, and does not compromise the esthetics. All these lead to decreased morbidity and increased patient satisfaction which makes MMTT a superior technique than the conventional procedure in gingival recession treatment.

Experimental Study Comparing Release in Stretch Position, Myokinetic Releases, and MFR to Increase Muscle Extensibility

Background Effective maintenance of the bodyrsquos flexibility offers better mobility allowing full range of motion and reduces the risk of injury from muscle restriction. Musclersquos fixation in shortened position causes a decrease in the number of sarcomeres. Since muscle is a mutable tissue the shortening is reversible. The treatment for this is stretching. Many studies concluded that there is no effective technique that individually stretches Tensor Fascia Latae TFL or pectoralis minor. Soft tissue manipulation techniques can be used to treat the shortening of these muscles. This study aimed to determine which among the three techniques i.e stretch position myokinetic active release and myofascial release was better to gain the optimal muscle length.Methods The study included 30 participants with tensor fascia latae tightness and 30 participants with pectoralis minor tightness. Pre-treatment length was tested and then the participants were split into three groups. Each group consisted of 10 participants with pectoralis minor muscle tightness and 10 participants with tensor fascia latae muscle tightness. For subjects in Group 1 Myokinetic active release therapy was given. For group 2 muscle release in stretched position was done and for group 3 the conventional myofascial release was given. After the treatment post-treatment length was tested. Pre-and post-treatment length was analyzed using paired t-test for within the group and ANOVA for between the groups.Results The results of the study proved that all the treatment techniques were effective on both the muscles. The results of all the groups showed a statistically significant value of lt0.05. But on comparing the groups the result was non-significant.Conclusion The results demonstrated that all the three techniques were equally effective.

Patient-Derived Explant Cultures of Normal and Tumor Human Breast Tissue.

Tissue culture has evolved considerably over the last few years, including cell culture in three dimensions, organoids, cocultures of different cell types and the use of diverse types of matrices in an attempt to mimic conditions that more closely resemble those found in the original tissue or organ. In this chapter, we describe how patient-derived breast tissue can be cultured on sponges for several days, maintaining their original architecture and with the capacity to respond to treatments. This protocol facilitates the study of the tissue responses without the need for extensive tissue manipulation, cell digestion or use of a biomaterial as scaffold, while maintaining the stroma and extracellular matrix organization. This method has the potential to improve preclinical testing by contributing to provide more accurate data reflecting cell-cell and cell-matrix interactions, tumor microenvironment, drug effects or stem cell function in normal- and pathophysiology of the breast.

Evaluating the efficacy of a minimally invasive root coverage procedure with platelet rich fibrin using the gum drop technique

Gingival recession is manifested as an apical displacement of the gingival tissues, leading to root surface exposure. They may cause root hypersensitivity, root caries, and pose esthetic concerns to patients when left untreated. Various surgical treatment modalities are being practised to treat these mucogingival defects. The innovations and the advances in the surgical techniques has led to the development of surgeries that could be done with minimal tissue manipulation and trauma improving the healing and overall clinical parameters. In the current study a novel, minimally invasive surgical approach called the Gum Drop Technique, which utilises both A-PRF membrane and i-PRF as the regenerative biomaterials for recession defects in the maxillary anterior region has been described.

Effect of IASTM vs. THERAGUN on Triceps Surae Active Range of Motion and Functional Movements in University Level Sprinters

Background: Sprinter is a person who runs very fast over a short distance in a race. In this study we determinethe effect of Instrument Assisted Soft Tissue Manipulation (IASTM) vs THERAGUN separately on triceps suraemuscle to check the Active Range of Motion and Functional Movement in sprinters of age group 18- 25 years.Methods: Study design: Experimental study (pre-test and post-test design). Sampling Technique: The subjectswere selected by Random Sampling. Source of Data: Universities of Patiala & Ludhiana Districts.Conclusion: The study examined the effect of IASTM and THERAGUN which shows significant changes in theActive Range of Motion & functional movement.

Effect of soft tissue manipulation of popliteus muscle on quadriceps muscle activity and torque production in athletes with anterior knee pain

Abstract Study aim: Popliteus is majorly associated with posterior knee pain; however, this muscle can also have an impact on anterior knee pain. The purpose of this study was to determine the effect of soft tissue manipulation of popliteus muscle on non-traumatic anterior knee pain in athletes; as the relationship between popliteus and Quadriceps muscle has not been studied/explored much. Materials and methods: In this experimental study, 15 subjects presenting with non-traumatic anterior knee pain were selected. Quadriceps muscle activity, torque production and knee pain were assessed. Followed by a single session of popliteus manipulation all the above parameters were re-assessed immediately and at 24 hours after intervention. Results: Significant reduction in pain (P < 0.005) at 24 hours was observed. There was a significant increase in muscle activity of Vastus Medialis (P < 0.05) and Vastus Lateralis (P < 0.005) immediately after the intervention but not after 24 hours. No significant change was found in the activity of Rectus femoris and Peak torque of Quadriceps immediately after the intervention and at 24 hours. Conclusion: Soft tissue manipulation decreased knee pain and improved muscle activity. Therefore, incorporating popliteus manipulation can be effective in treatment of anterior knee pain.

Comparison of Harvesting and Processing Technique for Adipose Tissue Graft: Evaluation of Cell Viability

Background: Clinical studies demonstrated the efficacy of therapies based on the autologous grafting of adult mesenchymal stem cells to accelerate the healing and regenerative processes of the skin and mesenchymal tissues; therefore, it is considered a valuable approach in the aesthetic rejuvenation treatment to give volumization and skin regeneration effects. Objective: The aim of the project consisted of the control of cell viability of adipose tissue (AT) harvested using the two types of cannulas having 0.8 mm and 1 mm side port holes. The results were compared with tissue harvested with a standard liposuction technique and processed with a standard procedure consisting of enzymatic digestion (collagenase). Methods: This study was performed on adipose tissues harvested from 7 patients (6 females and 1 male) with an average age of 48.5 years with 3 different techniques. We compared the cell vitality of every sample at T0 and T72. Results: Lipoaspirate tissue-derived by 0.8- and 1 mm cannula from all samples proved to be vital and possess viable cells. The average absorbance was similar immediately after plating (T0) and 72 hours after (T72) for the two cannulas, 0.8- and 1 mm cannula. The two systems proved to equally harvest vital tissue. An increase in cell viability was observed in all samples for each condition (0.8-, 1 mm and enzymatic digestion). Conclusion: This study proved that guided harvested adipose tissue with small cannulas with small side port holes yields a comparable amount of viable cells compared to adipose tissue harvested with a liposuction system and processed with enzymatic digestion (collagenase). This study confirms that the minimally invasive technique and minimal manipulation of the adipose tissue could yield a tissue with a good amount of viable cells. This micro fragmented adipose tissue is a promising source for regenerative treatments.