Microfluidic synthesis of retinoic acid-loaded nanoparticles for neural differentiation of trabecular meshwork mesenchymal stem cell

OBJECTIVES

This study aimed to fabricate the PCL-nanoparticles (NPs) loaded retinoic acid (RA) using the microfluidic system for successful cellular uptake and induction of neuronal differentiation of trabecular meshwork mesenchymal stem cells (TMMSCs).

METHODS

A microfluidic system used to synthesize RA-loaded NPs, DLS, FTIR, TEM, and UV-spectroscopy was recruited to characterize and study the release of RA. Also, the toxicity, cellular uptake, and neuronal differential of TMMSCs have been assessed.

RESULTS

According to the obtained results, the spherical NPs (117.6±0.35 nm, ‒19.4±5.3) and RA-loaded NPs (121.6±0.75 nm, ‒23.6±1.3) were synthesized successfully by microfluidic system. 7.8±2.04 % of RA was loaded in NPs, and 25 % was released in the first four hours. Thus, the NPs have been successfully internalized into the stem cells, leading to a significant increase in neural genes and protein (β Tubulin III and Map-2) expression.

CONCLUSION

Our study's harvested results have represented valid data for practical use of microfluidic systems in the term of NPs loaded RA synthesis and its successful function to cellular internalization and euronal differentiation of TMMSCs (Tab. 2, Fig. 10, Ref. 46).

The effects of aromatherapy on patients undergoing coronary angiography: A systematic review of clinical trials

As a diagnostic and therapeutic technique for coronary artery disease, angiography is usually associated with some disorders and complications such as fear, pain, discomfort, limited mobility, and anxiety. The present study is a systematic review determining the effects of aromatherapy with different plants in patients undergoing angiography. This review was conducted according to the 06-PRISMA guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility (SyRF) database. The English databases were Google Scholar, PubMed, Scopus, Web of Science, EBSCO, and ScienceDirect to search articles regarding the effects of aromatherapy with different plants in patients experiencing angiography without a date limitation. The searched keywords in this study were "aromatherapy", "angiography", "coronary artery disease", "anxiety", "stress", and "cardiovascular diseases". Out of 1835 papers, 20 papers up to 2021, met the inclusion criteria for discussion in this systematic review with the data extracted. Most studies were intended to evaluate the effect of aromatherapy on patients’ anxiety with coronary artery bypass graft surgery (11 papers, 55.0%). The most widely used essential oil belonged to the lavender essential oil (13 papers, 65.0%). The results of the current review confirmed that aromatherapy management with lavender, damask rose, orange, and peppermint is able to significantly decrease anxiety, pain, nausea and vomiting, sleep quality, hemodynamic indices, blood pressure, etc. in patients with coronary angiography. However, more investigation is required to confirm the precise mechanisms and side effects of the alternative treatment.

Effects of ADJUVANT Ketamine on Induction of Anesthesia for the Cesarean Section

BACKGROUND

The cesarean section has shown an increasing trend within the past few years. The use of appropriate and effective anesthesia for the procedure is important, not only to reduce the incidence of maternal and fetal morbidities but also to reduce the incidence of intraoperative consciousness. The aim of this study is to evaluate the intraoperative and postoperative effects of adjuvant ketamine, when used in combination with general anesthesia.

METHODS

The study was conducted on the patients referred to Asali hospital for the cesarean section. 100 patients were assigned into two groups. Patients in Group A received thiopental (4 mg / kg) as an anesthetic agent for the surgery, whereas those in group B received thiopental along with 0.5 mg/kg of intravenous ketamine. The effects of ketamine, such as depth of anesthesia, intraoperative and postoperative awareness, vomiting and hallucination were recorded in the questionnaire and data were statistically analyzed using SPSS v25.

RESULTS

Of 100 patients in group A, 10 of them were not deeply unconscious. 40 patients in group A and 25 in group B had intraoperative awareness. Depth of anesthesia was significantly associated with the use of ketamine (p = 0.0017) 1 patient in group A and 3 in group B had vomiting and 1 patient in group B was presented with the hallucinations. These parameters were not significantly associated with the dose of ketamine (p = 0.5).

CONCLUSION

Overall use of ketamine is associated with better sedation and no significant side effects, with low doses of ketamine, were seen in our study. Comparative studies using other analgesics, with larger sample size, are therefore recommended.

Comparison between Wrapping Dice Cartilage with Temporal Fascia and Wrapping in Alloderm for Dorsal Nasal Augmentation

BACKGROUND

Dorsal augmentation of the nose for aesthetic and reconstructive purposes is an important issue in rhinoplasty surgery. This study aimed to compare the two methods of dice cartilage wrapping for dorsal augmentation of the nose including temporalis fascia and alloderm.

METHODS

In a clinical trial study, 50 patients who needed to augment the nasal dorsum, were enrolled and randomly allocated to two equal groups. In the first group, diced cartilage graft of the patient was wrapped in temporalis fascia and in the second group, a thin sheet of alloderm was used for this purpose. After one year follow up, satisfaction of patients and the expert panel were compared in two groups. Also mean increase in dorsal height was measured and compared in two groups.

RESULTS

The mean increase of dorsal nasal height one year after surgery in the alloderm and temporalis fascia was 3.13±0.49 and 3.42±0.33, respectively and in the fascia group was significantly higher (p=0.02). The mean of patients’ satisfaction in the two groups of alloderm and temporal fascia groups was 7.48±0.92 and 8.04±0.89, respectively (p=0.03). The mean satisfaction of expert panel in the two methods was 7.56±0.81 and 7.7±0.63, respectively (p=0.5).

CONCLUSION

The use of temporal fascia for covering the diced cartilage in augmentation of nasal dorsum had better results than the alloderm. Patients satisfaction and mean dorsal height was higher in temporal fascia group.

The Effect of Hirodoid Cream on Ecchymosis and Edema around Eyes after Rhinoplasty

BACKGROUND

Several methods have been used to decrease the periorbital edema and ecchymosis after rhinoplasty. In this study, we evaluated the efficacy of hirudoid and dexamethasone in reduction of the periorbital edema and ecchymosis.

METHODS

Sixty patients who underwent primary rhinoplasty were randomly divided into 3 groups. Group H received hirudoid cream, 3 times per day for 5 days from postoperative-day (POD). Group D received 10 mg of dexamethasone IV, immediately before surgery; and group C (control) received neither dexamethasone nor hirudoid. Two surgeons who were unaware of administered medications rated the severity of edema and intensity of ecchymosis, on 2^nd, 5^th, and 7^th POD.

RESULTS

On 2^nd POD, the edema in group D was significantly lower than groups H and C; but there was no significant difference in severity and intensity of ecchymosis between 3 groups. On 7^th POD, the intensity of ecchymosis was significantly lower in group H in comparison to group C. When the difference between 2^nd and 7^th POD was evaluated, the resolution of severity of edema and intensity of ecchymosis was significantly better in group H (p<0.001).

CONCLUSION

Hirudoid was shown to be effective in reducing edema and ecchymosis after rhinoplasty. The use of dexamethasone was effective in prevention of periorbital edema at early postoperative days, but it was not effective on resolution of ecchymosis.

Intraluminal bezoar caused obstruction and pancreatitis: A case report

Acute pancreatitis from bezoar-induced obstruction is rare. We present an uncommon case report of a man with manifestations of Rapunzel syndrome with no known history of mental disorders. Surgical removal of the bezoar through gastrostomy and enterotomy in the absence of a psychiatric undertone will undoubtedly prevent a relapse.

TRAIL-expressing recombinant Lactococcus lactis induces apoptosis in human colon adenocarcinoma SW480 and HCT116 cells

AIMS

We investigated the ability of Lactococcus lactis, a species generally regarded as safe, to express tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) protein. The expressed protein was either cell wall anchored or secreted, and it was assessed whether this could induce apoptosis in human colon adenocarcinoma cell lines SW480 and HCT116.

METHODS AND RESULTS

Constructs were designed to produce either secreted or cell wall-anchored forms of human TRAIL cloned into pNZ7021 expression vector. The expression by L. lactis was confirmed by Western blotting and immunofluorescence. Induction of cell death was evaluated by coculturing transformants producing either form of TRAIL protein with the two cell lines followed by MTT assay. Gene expression of apoptosis genes, Bax and Bcl2, was assessed by qPCR. The viability of SW480 and HCT116 cells treated with recombinant L. lactis was significantly reduced. A significant change was observed in the ratio of Bax/Bcl2 expression in HCT116 cells only following treatment with the supernatant of recombinant L. lactis containing secreted TRAIL.

CONCLUSION

Recombinant L. lactis producing TRAIL protein can induce apoptosis in human colon adenocarcinoma cell lines SW480 and HCT116.

SIGNIFICANCE AND IMPACT OF THE STUDY

The use of recombinant probiotics that produce anticancer compounds is a promising option for combating cancer cells.

A comparison study of insertion of spreader graft in the convex side in patients with deviated nose undergoing open septorhinoplasty

Background: Correction of a crooked or deviated nose is a major challenge for rhinoplasty surgeons. In the present study we proposed to compare the aesthetic and functional results of unilateral grafting using spreader grafts on the convex side of the nasal deviation with those used on the concave side. Methods: In this study, the technique and aesthetic and functional outcomes of the correction of crooked noses with spreader graft placement at either convex or concave side of the nasal deviation are presented. Results: Unilateral spreader graft was used in 66 patients with C-type deviated nose. At the discretion of the rhinoplasty surgeon, the spreader graft was placed in the convex side of the nasal deviation in 33 patients (group A) and in the concave side of the nasal deviation in the remaining 33 patients (group B). During an average following-up period of 18 months (ranged from 8 to 36 months), there were no complications, infection, or graft extrusions. Functional evaluation was performed using a visual analog scale before and 4 months after surgery. Patients were asked to score their nasal breathing on a scale from 0 to 10. In group A (convex group), the mean preoperative score was 6.32+/-1.02 (ranging from 2 to 8), and the mean postoperative score was 2.03+/-1.01 (ranging from 0 to 4). In group B (concave group), the mean preoperative score was 6.76+/-1.10 (ranging from 2 to 8), and the mean postoperative score was 3.67+/-1.80 (ranging from 2 to 7). Patients with spreader graft at the convex side showed higher increase in angle measurements as compared to the patients with spreader graft in the concave side. Moreover, patients with spreader graft at the convex side were more likely to have excellent or good surgical outcomes (according to the degree of correction in the angle of deviation) as compared to patients with spreader graft in the concave side. Conclusion: The use of the spreader graft is a safe and effective method for correction of crooked noses. We showed that speeder graft at the convex side of C-type nose deformity provided better aesthetic and functional results as compared to the placement of the speeder graft in the concave side of the nasal deformity.    

Investigating cell blood counter and abdominal radiography accuracy in diagnosis of acute suppurative appendicitis among patients under surgery

Background: Acute appendicitis is the most common surgical emergencies; while unusual symptoms have a differential diagnosis. This study aimed to determine the diagnostic accuracy of CBC and abdominal X-ray in acute suppurative appendicitis. Methods: This cross-sectional study was performed on 198 patients. For all patients, complete blood count and abdominal X-ray were recorded. The pathological report after surgery was the gold standard for diagnosis. Then indicators of the validity of tests CBC, X-ray and neutrophil to lymphocyte ratio, consisted of positive predictive value (PPV) and negative predictive value (NPV), sensitivity, specificity, were analyzed. Results: Out of patients, 133 of patients were male (67.2%), and 65 (32.8%) were female with mean age of 29.13 years. Acute appendicitis confirmed in 77.8% of pathological study, and 17.7% was the normal appendix. Leukocytosis, NLR and abdominal X-ray tests, each have a sensitivity of 89.5%, 78.5% and 100%, specificity of 31.4%, 31.4% and 31.8%, PPV 85.8%, 84.2% and 53.9%, NPV 39.2%, 23.9% and 100%, respectively. There was a significant relationship between appendicitis and WBC> 10.000 and abdominal radiography findings. Conclusion: Due to the sensitivity of performing CBC and leukocytosis and NLR is at an acceptable level, especially with a relatively high positive predictive value, could be concluded that the positivity of these tests for confirming the diagnosis in suspected cases might be helpful and can help to strengthen the clinical diagnosis. Our results in relation to the x-ray of the abdomen suggest its usefulness in the diagnosis of appendicitis.  

Contralateral medial pectoral nerve transfer with free gracilis muscle transfer in old brachial plexus palsy

BACKGROUND

There is a very small chance of success for nerve reconstruction in patients with old total brachial plexus palsy who visit after 2 y or suffer from flail upper extremity after the failure of previous operations.

MATERIALS AND METHODS

For these individuals, the surgeon has to find a recipient motor nerve to perform free gracilis muscle transplantation. In this study, contralateral medial pectoral nerve from the intact side was transferred to the damaged side as a recipient nerve. Then, in the second operation, approximately 15 mo later, the free gracilis muscle transfer was performed. The gracilis muscle was removed and transferred to provide elbow and finger flexion.

RESULTS

In a retrospective study (over 10 y), we reviewed 68 patients for whom this method had been performed. After 1 y, the results were investigated using the Medical Research Council grading system. Five patients did not participate in the study, and the muscle underwent necrosis in two patients. M3 and M4 muscle power was regained in 26 (42.6%) and 21 (34.4%) patients, respectively.

CONCLUSIONS

Contralateral pectoral nerve transfer followed by free muscle transplantation can be a good option for patients with old total brachial plexus palsy.

Magnesium Sulfate Mediates Morphine Administration Reduction in Varicocelectomy Surgery

AIMS

Varicocelectomy is the most common operation carried out by doctors for male infertility treatment. The aim of varicocele treatment is to hinder the refluxing venous drainage to the testis, retaining arterial inflow, and lymphatic drainage. A lot of pain is generated after this surgery, and the use of opium should be reduced to nearest minimum, as all drugs are toxins. Thus the aim of the present study is to facilitate morphine usage reduction after varicocelectomy surgery.

MATERIAL AND METHODS

One-hundred (100) patients who were varicocelectomy candidate were randomized into two groups: experimental group contain 50 patients and control group contain 50 patients as well. In experimental group, 2 mL magnesium sulfate in 2 mL normal saline was injected into patient immediately after surgery. The control group received only 4 mL normal saline. Morphine dosage administered, and severity of pain monitoring was accessed and recorded with a visual analogue scale (VAS).

RESULT

Result indicated that administration of morphine dosage in the test group 0.21 ± 0.64 mg was significantly lower as compared to the control group 0.75 ± 1.30 mg during the first 24-hour after surgery (p = 0.01). Average VAS scores in the experimental and control groups in the first 4-hour interval were 0.91 ± 1.30 and 2.9 ± 2.50 (p = 0.02) respectively. We observed a significant difference in the VAS score for pain severity and the dosages of morphine administered.

CONCLUSIONS

The experimental group with magnesium sulfate in its drug formulation showed better pain control compared to the control group which received only normal saline, whose pain manifested after every few hours. This can be used for the formulation of opium for this surgery in a large scale.

Effect of magnesium sulfate on morphine activity retention to control pain after herniorrhaphy

Aim: This research was carried out to compare magnesium sulfate (MgSO4) with isotonic saline in terms of pain control after herniorrhaphy. Patients & methods: A randomized double-blind study, in which the patients were blind to all. A total of 100 patients who were candidates of herniorrhaphy were randomized into two groups: experimental and control (50 patients in each). Anesthesia was induced with 20% of 4 cc of morphine. The experimental and control group received postoperative 20% of 2 cc MgSO4 in 2 cc of isotonic saline and 4 cc of isotonic saline, respectively. Result: The administration of postoperative morphine in control group 0.79 ± 1.48 mg was significantly higher to the experimental group 0.17 ± 0.63 mg during the first 24 h (p = 0.01). Conclusion: MgSO4 increased the potency of morphine thereby reducing the amount of postoperative pain killer needed.

Novel Mutation in Exon 1 of the BMP15 Gene and its Association with Reproduction Traits in Sheep

The BMP15 gene is a growth factor and a member of the transforming growth factor β (TGFβ) superfamily, specifically expressed in oocytes. In the present study, polymorphism of BMP15 gene exon 1 was studied using single strand conformational polymorphism (SSCP) and direct DNA sequencing methods in 170 Mehraban and Lori sheep ewes. A 231-bp fragment in BMP15 exon 1 was amplified by PCR reactions. Two genotypes (GG and AG) with a new point mutation at position 121 bp of the studied fragment (c.379G>A in reference GenBank number AF236078.1 sequence), deducing an amino acid exchange in the codified amino acid sequence (p.Glu41Lys) were identified in the studied populations. The AG and GG frequencies were 74.4% and 25.6% in Mehraban and 44.7% and 55.3% in Lori sheep, respectively. Frequencies of the A and G alleles were 37.2% and 62.8% in Mehraban and 22.4% and 77.6% in Lori sheep, respectively. Two different secondary structures of protein were predicted for encoded precursor protein. The genotypes GG and AG did not have any significant association with the studied reproductive traits, but the AA genotype is likely to have a lethal or sterility effect.

The effects of gabapentin on severity of post spinal anesthesia headache

Spinal anesthesia is a common anesthesia method and post dural puncture headache (PDPH) is one of its most common adverse effects. Gabapentin is a popular anticonvulsant drug that has been used as an oral nonopioid analgesic in recent years. In this placebo-controlled double-blind study, 120 patients were randomized in two equal groups (Placebo or gabapentin). The patients in the gabapentin group received gabapentin 300 mg orally one hour before the surgery and then every 12 hours for the first 24 hours after the surgery while the placebo group received placebos in the same way. Severity of headache and postoperative pain assessed by verbal rating score for pain (VRSP), morphine consumption, nausea, vomiting, somnolence, pruritus, dizziness in the first 48 hours, hypertension, hypotension, bradycardia and tachycardia in the first 24 hours after the surgery were recorded. In first 48 hour after surgery the mean of severity of headache in the gabapentin group was 0.20±0.05, and in the placebo group it was 0.93±0.01. The mean of postoperative pain in the gabapentin group was2.25±0.793, and in the placebo group it was3.77±0.813. In the first 24 hours post operative the mean of morphine consumptions were 0.20±0.030 and 0.32±0.0 30 mg in gabapentin and placebo groups. No significant differences were found between the two groups regarding incidence rate of the adverse effects. In this study, administration of gabapentin decreased the incidence and severity of post spinal anesthesia headache, postoperative pain and morphine consumption, without any significant differences in serious adverse effects.

Fine-Needle Aspiration, Touch Imprint, and Crush Preparation Cytology for Diagnosing Thyroid Malignancies in Thyroid Nodules

Several methods are used to evaluate the thyroid nodules. The aim of this study was to determine the sensitivity, specificity, false positive and negative rates, positive predictive value (PPV), and negative predictive value (NPV) of touch imprint, crush preparation, and fine-needle aspiration (FNA) methods. This cross-sectional study was done in Shohada-ye Ashayer University Hospital in Khorramabad. All the patients who underwent thyroid surgery due to thyroid nodules in this hospital between March and September 2011 were evaluated. The thyroid nodules of all the patients were evaluated by touch imprint, crush preparation, FNA, and permanent pathology methods. Finally, the results of the first three methods were compared with the result of permanent pathology method. The mean age of 104 patients who underwent thyroid surgery was 42.6 ± 11.9 years old. Based on permanent pathology, touch imprint, crush preparation, and FNA methods, 15.3, 6.25, 6.25, and 4.4 % of thyroid nodules were malignant, respectively. Sensitivity, specificity, false positive rate, false negative rate, PPV, and NPV of FNA biopsy were 62.5, 100, 0, 37.5, 100, and 95.3 %, respectively. Also, sensitivity, specificity, false positive rate, false negative rate, PPV, and NPV of touch imprint and crush preparation were equal and were 80, 100, 0, 20, 100, and 96.7 %, respectively. Using touch imprint and crush preparation in evaluation of thyroid nodules for rapid evaluation of these nodules in operating rooms seems to be logical, and it can prevent further surgeries.

Comparative analysis of mesenchymal stromal cells from murine bone marrow and amniotic fluid

BACKGROUND

Murine mesenchymal stromal cells (mMSC) are a good model for pre-clinical investigations, and alternative sources of mMSC are subject to intensive experiments. In the present study, we obtained mMSCs from amniotic fluid (AF) and compared their characteristics with mMSCs from bone marrow (BM).

METHODS

NMRI mice, 4-6 weeks old, were killed and AF and BM cells collected from those in the second week of pregnancy. MSC were achieved by adhesion to cell culture plastic. Isolated cells were assessed for clonogenic capacity, some surface markers (epitopes) and differentiation potential.

RESULTS

We achieved AF mMSC more readily than BM mMSC. Differences concerning colony assay and some surface markers of mMSC derived from these two source cells were observed. Most strikingly, AF mMSC showed no adipogenic differentiation capacity, in contrast with BM mMSC.

DISCUSSION

Our results show that mMSC from AF are an appropriate source for pre-clinical investigation. Furthermore, mMSC from different sources of mice vary in clonogenic capacity, surface markers and differentiation potential.