Heterotopic Implantation of Decellularized Pulmonary Artery Homografts In A Rodent Model: Technique Description and Preliminary Report

Purpose: Despite a substantial amount of literature on tissue-guided regeneration, decellularization process, repopulation time points and stem cell turnover, more in-depth study on the argument is required. Currently, there are plenty of reports involving large animals, as well as clinical studies facing cardiac repair with decellularized homografts, but no exhaustive rodent models are described. The purpose of this study was to develop such a model in rats; preliminary results are also herein reported. Material and Methods: Fresh or decellularized pulmonary homografts from wild type rats were implanted in the abdominal aorta of green fluorescent protein positive rats. Three experimental groups were build up: sham, fresh homograft recipients and decellularized homograft recipients. The homograft decellularization process was performed with three cycles of detergent-enzymatic treatment protocol. Surgical technique of pulmonary homograft implantation and postoperative ultrasonographic evaluation were also reported; gross, histology and immunohistochemistry analysis on unimplanted and postoperative homografts were also carried out. Results: The median total recipient operating time was 148 minutes, with a surgical success rate of 82%. The decellularization protocol resulted effective and showed a complete decellularization with intact extracellular matrix. At 15 days from surgery, the implanted decellularized pulmonary homografts exhibited cell repopulation in the outer media wall and partial endothelial lining in absence of rejection. Conclusions: Our technique is a feasible and reproducible model that can be fundamental for building a valid study for further exploitation on the field. Even in a short-term follow up, the decellularized pulmonary homografts showed autologous repopulation in absence of rejection.     

Fragile X syndrome: An overview and update of the FMR1 gene

Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and the leading form of the monogenic cause of autism. Fragile X mental retardation type 1 (FMR1) gene premutation is the first single‐gene cause of primary ovarian failure (Fragile X‐associated primary ovarian insufficiency [FXPOI]) and one of the most common causes of ataxia (fragile X‐associated tremor/ataxia syndrome [FXTAS]), multiple additional phenotypes such as fibromyalgia, hypothyroidism, migraine headaches, sleep disturbances, sleep apnea, restless legs syndrome, central pain syndrome, neuropathy and neuropsychiatric alterations has been described. Clinical involvement in men and women carrying the FMR1 premutation currently constitutes a real health problem in the society that should be taken into account. It is important to highlight that while in FXS there is a loss‐of‐function of the FMR1 gene, in premutation associated disorders there is a gain of FMR1 mRNA function. To date, the tremendous progress achieved in the understanding of the pathophysiology of FXS, has led to the development of several targeted therapies aimed at preventing or improving the neurological manifestations of the disease. This review is an update of the diseases associated with the FMR1 gene.     

Versatile,Reusable, and Inexpensive Ultrasound Phantom Procedural Trainers

We have constructed simple and inexpensive models for ultrasound‐guided procedural training using synthetic ballistic gelatin. These models are durable, leak resistant, and able to be shaped to fit a variety of simulation scenarios to teach procedures. They provide realistic tactile and sonographic training for our learners in a safe, idealized setting.     

First-trimester septated cystic hygroma and cavum velum interpositum cyst

First-trimester septated cystic hygroma, frequently noted during general obstetric first-trimester screening, is strongly associated with fetal aneuploidy and structural anomalies and is considered an ominous finding. We present the case of a fetus with a first-trimester septated cystic hygroma and cavum velum interpositum cyst.     

A rare giant placental chorioangioma with favorable outcome: A case report and review of the literature

We describe a rare giant placental chorioangioma in a patient who had a favorable outcome with close prenatal surveillance in a 28‐year‐old primigravida who was referred to our clinic for ultrasound evaluation of a suspected placental mass at 23 weeks' gestation. A detailed ultrasound scan revealed a well‐circumscribed, echogenic lesion measuring 11.0 × 10.3 × 7.3 cm and protruding into the amniotic cavity. A diagnosis of placental chorioangioma was made and intensive prenatal surveillance was scheduled. A small‐for‐gestational age (2,325 g) but normal female neonate was delivered at 37 weeks by cesarean section and discharged from hospital on the second day of the delivery. A giant chorioangioma may not cause any adverse effect to the fetus and may not require any medication or invasive intervention. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :254–256, 2015     

Characteristics of COVID-19 infection clusters occurring among workers in several Asia-Pacific countries

The types of workplaces and occupations with coronavirus 2019 (COVID-19) clusters vary between countries and periods. We aimed to characterize major occupational groups with mass outbreaks of COVID-19 infections in several Asia-Pacific countries. Data on the major occupations or workplaces reporting COVID-19 cases in workplaces from January 2020 to July 2021 was collected from industrial hygiene professionals in nine countries. The proportion of workers accounted for 39.1 to 56.6% of the population in each country. The number of workers covered in the national statistics varies among nations based on their definition of a worker. None of the countries examined here have systematically collected occupational data on COVID-19 illnesses and deaths classified by type of industry, occupation, or job. Most countries experienced COVID-19 clusters among health and social care workers (HSCW) in hospitals or long-term care facilities. The types of occupations or workplaces with virus clusters in some participating countries included prisons, call centers, workplaces employing immigrants, garment facilities, grocery stores, and the military, which differed among countries, except for a few common occupations such as HSCW and those populated by immigrants. Further study is necessary in order to seek ways to control infection risks, including revisions to industrial-health-related laws.     

Expansions and contractions of the FMR1 CGG repeat in 5,508 transmissions of normal,intermediate, and premutation alleles

Instability of the FMR1 repeat, commonly observed in transmissions of premutation alleles (55–200 repeats), is influenced by the size of the repeat, its internal structure and the sex of the transmitting parent. We assessed these three factors in unstable transmissions of 14/3,335 normal (~5 to 44 repeats), 54/293 intermediate (45–54 repeats), and 1561/1,880 premutation alleles. While most unstable transmissions led to expansions, contractions to smaller repeats were observed in all size classes. For normal alleles, instability was more frequent in paternal transmissions and in alleles with long 3′ uninterrupted repeat lengths. For premutation alleles, contractions also occurred more often in paternal than maternal transmissions and the frequency of paternal contractions increased linearly with repeat size. All paternal premutation allele contractions were transmitted as premutation alleles, but maternal premutation allele contractions were transmitted as premutation, intermediate, or normal alleles. The eight losses of AGG interruptions in the FMR1 repeat occurred exclusively in contractions of maternal premutation alleles. We propose a refined model of FMR1 repeat progression from normal to premutation size and suggest that most normal alleles without AGG interruptions are derived from contractions of maternal premutation alleles.     

Posttransfusion equilibration of hematocrit in hemodynamically stable neonates.

OBJECTIVE: To determine whether hematocrit obtained 15 mins after blood transfusion in hemodynamically stable neonates is significantly different from that obtained after 6 hrs. We hypothesized that the hematocrit stabilizes within the first 15 mins that follow a 3-hr blood transfusion in preterm infants. DESIGN: We prospectively studied 24 consecutive infants who received blood transfusion. Hematocrit was measured immediately before the transfusion and 15 mins and 6 hrs after the transfusion of 10 mL/kg body weight of sedimented red blood cells administered over 3 hrs. Hematocrit was measured by centrifugation of a capillary. RESULTS: There was a significant increase in hematocrit from pretransfusion values both at 15 mins and 6 hrs. The increase in hematocrit from the pretransfusion value was identical (11%) at both 15 mins and 6 hrs. CONCLUSION: The hematocrit obtained 15 mins after the end of a 3-hr blood transfusion in hemodynamically stable, anemic infants is indistinguishable from that obtained after 6 hrs in the same infants. Thus, if the increase of hematocrit is deemed insufficient at 15 mins after the transfusion, it is possible to complete the transfusion without exposing the patient to an additional donor.