Buccal misoprostol during cesarean delivery reduced the need for additional uterotonic drugs to treat uterine atony. ClinicalTrials.gov:NCT01733329.

In cartilage tissue engineering, biphasic scaffolds (BSs) have been designed not only to influence the recapitulation of the osteochondral architecture but also to take advantage of the healing ability of bone, promoting the implant’s integration with the surrounding tissue and then bone restoration and cartilage regeneration. This study reports the development and characterization of a BS based on the assembly of a cartilage phase constituted by fibroin biofunctionalyzed with a bovine cartilage matrix, cellularized with differentiated autologous pre-chondrocytes and well attached to a bone phase (decellularized bovine bone) to promote cartilage regeneration in a model of joint damage in pigs. BSs were assembled by fibroin crystallization with methanol, and the mechanical features and histological architectures were evaluated. The scaffolds were cellularized and matured for 12 days, then implanted into an osteochondral defect in a porcine model (n = 4). Three treatments were applied per knee: Group I, monophasic cellular scaffold (single chondral phase); group II (BS), cellularized only in the chondral phase; and in order to study the influence of the cellularization of the bone phase, Group III was cellularized in chondral phases and a bone phase, with autologous osteoblasts being included. After 8 weeks of surgery, the integration and regeneration tissues were analyzed via a histology and immunohistochemistry evaluation. The mechanical assessment showed that the acellular BSs reached a Young’s modulus of 805.01 kPa, similar to native cartilage. In vitro biological studies revealed the chondroinductive ability of the BSs, evidenced by an increase in sulfated glycosaminoglycans and type II collagen, both secreted by the chondrocytes cultured on the scaffold during 28 days. No evidence of adverse or inflammatory reactions was observed in the in vivo trial; however, in Group I, the defects were not reconstructed. In Groups II and III, a good integration of the implant with the surrounding tissue was observed. Defects in group II were fulfilled via hyaline cartilage and normal bone. Group III defects showed fibrous repair tissue. In conclusion, our findings demonstrated the efficacy of a biphasic and bioactive scaffold based on silk fibroin and cellularized only in the chondral phase, which entwined chondroinductive features and a biomechanical capability with an appropriate integration with the surrounding tissue, representing a promising alternative for osteochondral tissue-engineering applications.

Knowledge of prenatal development of the maxillary sinus improves the perspective of the sinus surgeon and helps the understanding of postnatal anatomy, especially in children.

SUMMARY:Revascularization surgery should ensure morphological similarity between the coronary artery and the graft. This is an important factor for its duration and permeability. The aim of this study was to analyze the morphological characteristics and morphometrics of the coronary artery segments with greater occlusion. This was an observational, cross-sectional descriptive study that consisted of two phases. A macroscopic phase in which 11 cadaveric hearts were extracted and coronary dominance and length of the anterior interventricular artery (AIA), the right coronary artery (RCA) and the circumflex artery (CXA) were determined. In the microscopic phase a total of 77 segments of these arteries were obtained and the luminal diameter, wall thickness, and amount of elastic fibers and the presence and size of the atheroma were determined. Right coronary dominance was the most frequent. Total vessel length was 15.65±1.17 cm for the AIA, 12.67±2.02 cm for the RCA and 8.79±2.5 cm for the CXA. Diameters ranged from 2.3 mm in the proximal segments and between 1.1 mm to 1.8 mm in the distal segments. Wall thickness in the proximal segments was between 354 µm and 396 µm and in the distal segments it ranged from 120 µm to 305 µm. The amount of elastic fibers showed that they were muscular arteries. Atheromas were present in 35% in the CXA, and in 32.5% in the AIA and the RCA. The largest ones were found in the proximal segments. This study examined the morphology and morphometry of the segments of the coronary arteries that are more frequently occluded. It provides information on the most significant parameters to be considered for election of the vascular graft in myocardial revascularization surgery.