Biocompatibility and Adhesion Formation of Different Endoloop Ligatures in Securing the Base of the Appendix

Background and Objectives:

The common technique used in securing the base of the appendix is Endoloop ligature (Ethicon, Somerville, NJ, USA). Vicryl (polyglactin 910) (Ethicon) and polydioxanone (PDS) (Ethicon) Endoloop ligatures can be used. There are potential benefits of the use of PDS Plus (Ethicon) Endoloop ligature. However, the use of different materials may vary in terms of inflammation, foreign-body reaction, rate of infection in the surgical area, or rate of adhesion formation. An ideal suture would induce minimal inflammatory response and adhesion formation.

Methods:

Ninety rats were randomized into 3 groups: group I, in which appendectomy was performed with Vicryl ligature; group II, in which appendectomy was performed with PDS ligature; and group III, in which appendectomy was performed with PDS Plus ligature. The animals were killed on the seventh, 28th, and 60th days after surgery. The secured stump was used for histopathologic and immunohistochemistry analysis, as well as evaluation of the formation of adhesions.

Results:

Mild and moderate inflammation was more frequent in the PDS and PDS Plus groups than in the Vicryl group on the seventh postoperative day. There were no significant differences in the degree of inflammation on the 28th and 60th postoperative days. The lowest degree of postoperative adhesions was observed in the PDS group.

Conclusion:

Milder postoperative inflammatory changes and a lower degree of postoperative adhesions were seen in the PDS ligature group, suggesting that this could be the standard Endoloop used to secure the base of the appendix.     

A case of nonvalvular endocarditis with biventricular apical infected thrombi

We report what appears to be the first case of biopsy-proven nonvalvular endocarditis with biventricular apical infected thrombi. A 47-year-old man presented with hypoxic respiratory failure from a multilobar pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). Transthoracic echocardiography and cardiac magnetic resonance imaging revealed biventricular apical masses suggestive of nonvalvular endocarditis with infected thrombi. Given concern for ongoing septic embolization to the lungs and brain despite appropriate antimicrobial therapy, the masses were surgically resected. Culture and histopathology confirmed MRSA-positive infected thrombi. In this case report, we highlight the differential diagnosis of apical masses and the role of multimodality imaging.     

Biomaterial and stem cell‐based strategies for skeletal muscle regeneration

Adult skeletal muscle can regenerate effectively after mild physical or chemical insult. Muscle trauma or disease can overwhelm this innate capacity for regeneration and result in heightened inflammation and fibrotic tissue deposition resulting in loss of structure and function. Recent studies have focused on biomaterial and stem cell‐based therapies to promote skeletal muscle regeneration following injury and disease. Many stem cell populations besides satellite cells are implicated in muscle regeneration. These stem cells include but are not limited to mesenchymal stem cells, adipose‐derived stem cells, hematopoietic stem cells, pericytes, fibroadipogenic progenitors, side population cells, and CD133⁺ stem cells. However, several challenges associated with their isolation, availability, delivery, survival, engraftment, and differentiation have been reported in recent studies. While acellular scaffolds offer a relatively safe and potentially off‐the‐shelf solution to cell‐based therapies, they are often unable to stimulate host cell migration and activity to a level that would result in clinically meaningful regeneration of traumatized muscle. Combining stem cells and biomaterials may offer a viable therapeutic strategy that may overcome the limitations associated with these therapies when they are used in isolation. In this article, we review the stem cell populations that can stimulate muscle regeneration in vitro and in vivo. We also discuss the regenerative potential of combination therapies that utilize both stem cell and biomaterials for the treatment of skeletal muscle injury and disease. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1246–1262, 2019.     

Comparative study between Pap smear cytology and FTIR spectroscopy: a new tool for screening for cervical cancer

Aims: To evaluate Fourier transform infrared (FTIR) spectroscopy as new tool for screening of cervical cancer in comparison with cervical cytology. Methods: A total of 800 cervical scrapings were taken by cytobrush and placed in ThinPrep medium. The samples were dried over infrared transparent matrix. Beams of infrared light were directed at the dried samples at frequency of 4000 to 400 cm(-1). The absorption data were produced using a Spectrum BX II FTIR spectrometer. Data were compared with the reference absorption data of known samples using FTIR spectroscopy software. FTIR spectroscopy was compared with cytology (gold standard). Results: FTIR spectroscopy could differentiate normal from abnormal cervical cells in the samples examined. The sensitivity was 85%, specificity 91%, positive predictive value 19.5% and negative predictive value of 99.5%. Conclusion: This study suggests that FTIR spectroscopy could be used as an alternative method for screening for cervical cancer.     

Polymerase chain reaction assay and bacterial meningitis surveillance in remote areas, Niger

To compensate for the lack of laboratories in remote areas, the national reference laboratory for meningitis in Niger used polymerase chain reaction (PCR) to enhance the surveillance of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. PCR effectively documented the wide geographic spread of N. meningitidis serogroup W135.     

Rhinogrid™: Precision Instrument in Rhinoplasty

Rhinoplasty is a surgery where the result depends on precision in assessment, shaping and placing grafts. The grafts should be accurately measured with the help of precise measuring instruments. There is a need of instruments which allow precise slicing, measuring and re-sizing of the grafts. Other than depending on multiple instruments for slicing and measuring, we need a single instrument with multiple functions. We have developed a simple tool for measurements in Rhinoplasty incorporating both measurement grid and costal cartilage slicer into one device.     

Left ventricular non-Hodgkin lymphoma visualized on contrast echocardiography

We present a case of AIDS-related Burkitt's type cardiac lymphoma in a middle-aged woman with Epstein-Barr virus infection and profound immunodeficiency. The original features of our case include left ventricular location, female sex, and the use of contrast echocardiography to help establish the diagnosis.