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Uterine Healing after Therapeutic Intrauterine Administration of TachoSil (Hemostatic Fleece) in Cesarean Section with Postpartum Hemorrhage Caused by Placenta Previa  [PDF]
Katrine Fuglsang,Margit Dueholm,Estrid St?hr-Hansen,Lone Kjeld Petersen
Journal of Pregnancy , 2012, DOI: 10.1155/2012/635683
Abstract: Background. Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa. Methods. Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing. Results. Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects. Conclusion. TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility. 1. Introduction The incidence of postpartum hysterectomy varies from 0.2 to 1.74/1000 deliveries. The most common indication for postpartum hysterectomy is abnormally adherent placenta (59%), 41% of which are due to placenta previa [1]. Delivery of patients with placenta previa is associated with the risk of excessive bleeding. Hysterectomy is a lifesaving procedure in the treatment of excessive bleeding due to placenta previa, but it deprives the woman of her ability for further reproduction [2]. In patients with placenta previa, traditionally methods, such as uterotonics, for reducing the blood loss [3] may be insufficient probably because of less muscular activity in the lower uterine segment [4]. Other methods are needed as alternatives to hysterectomy. Application of TachoSil in the peritoneal cavity is a well-documented treatment, and studies show that the fleece is absorbed [5, 6]. Intrauterine treatment with TachoSil is a new technique with obvious short-term benefits to the patients, but its potential effects on uterine heeling are unknown, and insufficient healing and adhesions could impair the menstrual flow and decrease the ability to achieve future pregnancy. Moreover, the resorption of TachoSil in the uterine
Extramedullary Hematopoiesis in the Uterine Cervix Associated with Tissue Repair  [PDF]
Suchanan Hanamornroongruang,Chanon Neungton,Malee Warnnissorn
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/626130
Abstract: Extramedullary hematopoiesis (EMH) is the presence of hematopoietic precursors outside the bone marrow. This condition is usually associated with hematologic disorders. Although EMH can be found in almost every site in the body, female genital tract involvement is rare. The authors report EMH in the uterine cervix from a 64-year-old patient following cervical biopsy due to abnormal cervical cytology. Neither neoplasm nor hematologic disorder was detected before the diagnosis and after 1 year of follow up. To the best of our knowledge, this is the first reported case of EMH involving the uterine cervix which showed an association with tissue repair. 1. Introduction Extramedullary hematopoiesis (EMH) is the presence of hematopoietic precursors outside the medullary space of the bone marrow. Although this condition is physiologic in fetus, occurrence after birth usually associates with abnormal conditions, especially hematologic disorders. Common sites for pathologic EMH are the liver and spleen which are also normal sites for physiologic EMH in fetal life. Although EMH can be found in almost every site in the body, uterine involvement is rare. Thirty three cases of uterine EMH have been reported in the literature [1–8]. Only 4 cases showed cervical involvement [2, 5, 8], one was associated with myelofibrosis [5], and one was associated with chronic myeloid leukemia [8] whilst the remaining 2 cases showed no association with a significant hematologic disorder [2]. The authors reported a case of EMH involving the uterine cervix in association with tissue repair. 2. Case Presentation A 64-year-old Thai female was referred to a gynecologist due to abnormal cervical cytology. Colposcopy and cervical biopsy were performed but no specific lesion was detected. Loop electrosurgical excision procedure (LEEP) for diagnosis was performed 2 weeks after biopsy. Microscopic examination of cervical tissue revealed clusters of erythroids and few megakaryocytes embedded in granulation tissue consistent with previous biopsy site (Figures 1(a)–1(c)). The erythroid precursors were confirmed by glycophorin C (Figure 1(d)). Figure 1: Microscopic appearance of the uterine cervix showed granulation tissue at squamocolumnar junction consistent with previous biopsy site (a). Clusters of erythroid precursors (b) and a megakaryocyte ((c), arrow) embedded in granulation tissue. The erythroid precursors were highlighted by glycophorin C (d). Complete blood count of the patient was within normal limits (hemoglobin 13?g/dL, hematocrit 39.9%, red blood cell count 4.63 × 106/uL, MCV 86?fl,
Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia
George S. Karagiannis,Mihalis Pelekanis,Panayiotis Loukopoulos,Haris N. Ververidis,Eleni Kaldrymidou
Case Reports in Veterinary Medicine , 2011, DOI: 10.1155/2011/901874
Abstract: An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomyosis, and cystic endometrial hyperplasia. Interestingly, such combination was never encountered before in dogs. Although uterine leiomyoma is quite usual in the reproductive system of female dogs, this case resembled relevant cases of human uterine adenomyomas in morphology, and thus it was offered a similar tentative diagnosis.
Semantic Labeling of Nonspeech Audio Clips  [cached]
Xiaojuan Ma,Christiane Fellbaum,Perry Cook
EURASIP Journal on Audio, Speech, and Music Processing , 2010, DOI: 10.1155/2010/404860
Abstract: Human communication about entities and events is primarily linguistic in nature. While visual representations of information are shown to be highly effective as well, relatively little is known about the communicative power of auditory nonlinguistic representations. We created a collection of short nonlinguistic auditory clips encoding familiar human activities, objects, animals, natural phenomena, machinery, and social scenes. We presented these sounds to a broad spectrum of anonymous human workers using Amazon Mechanical Turk and collected verbal sound labels. We analyzed the human labels in terms of their lexical and semantic properties to ascertain that the audio clips do evoke the information suggested by their pre-defined captions. We then measured the agreement with the semantically compatible labels for each sound clip. Finally, we examined which kinds of entities and events, when captured by nonlinguistic acoustic clips, appear to be well-suited to elicit information for communication, and which ones are less discriminable. Our work is set against the broader goal of creating resources that facilitate communication for people with some types of language loss. Furthermore, our data should prove useful for future research in machine analysis/synthesis of audio, such as computational auditory scene analysis, and annotating/querying large collections of sound effects.
The role of cellular coupling in the spontaneous generation of electrical activity in uterine tissue  [PDF]
Jinshan Xu,Shakti N. Menon,Rajeev Singh,Nicolas B. Garnier,Sitabhra Sinha,Alain Pumir
Quantitative Biology , 2014, DOI: 10.1371/journal.pone.0118443
Abstract: The spontaneous emergence of contraction-inducing electrical activity in the uterus at the beginning of labor remains poorly understood, partly due to the seemingly contradictory observation that isolated uterine cells are not spontaneously active. It is known, however, that the expression of gap junctions increases dramatically in the approach to parturition, which results in a significant increase in inter-cellular electrical coupling. In this paper, we build upon previous studies of the activity of electrically excitable smooth muscle cells (myocytes) and investigate the mechanism through which the coupling of these cells to electrically passive cells results in the generation of spontaneous activity in the uterus. Using a recently developed, realistic model of uterine muscle cell dynamics, we investigate a system consisting of a myocyte coupled to passive cells. We then extend our analysis to a simple two-dimensional lattice model of the tissue, with each myocyte being coupled to its neighbors, as well as to a random number of passive cells. We observe that different dynamical regimes can be observed over a range of gap junction conductances: at low coupling strength, the activity is confined to cell clusters, while the activity for high coupling may spread across the entire tissue. Additionally, we find that the system supports the spontaneous generation of spiral wave activity. Our results are both qualitatively and quantitatively consistent with observations from in vitro experiments. In particular, we demonstrate that an increase in inter-cellular electrical coupling, for realistic parameter values, strongly facilitates the appearance of spontaneous action potentials that may eventually lead to parturition.
Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model
Ozer Kandemir, Mustafa Buyukates, Nilufer Kandemir, Erol Aktunc, Aylin Gul, Sanser Gul, S Akin Turan
Journal of Cardiothoracic Surgery , 2010, DOI: 10.1186/1749-8090-5-110
Abstract: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required.Impaired tissue integrity and uncontrollable hemorrhage are important causes of morbidity and mortality, especially in the presence of coagulopathies [1]. Various hemostatic agents have been developed to achieve sufficient hemostasis [2,3]. In cardiovascular surgery, bleeding from anastomosis sites is usually controlled with pressure o
Simplified hemostatic technique during laparoscopic partial nephrectomy
Tsivian, Alexander;Tsivian, Matvey;Benjamin, Shalva;Sidi, Ami A.;
International braz j urol , 2012, DOI: 10.1590/S1677-55382012000100012
Abstract: introduction: laparoscopic partial nephrectomy (lpn) has gained popularity in recent years, although it remains a challenging procedure. herein we describe our technique of renal defect closure using sutures as the sole means of hemostasis during lpn. surgical technique: the kidney is approached transperitoneally in a standard fashion. after the renal artery is clamped and the tumor has been excised, the defect is closed in two separate knot-free suture layers. the deep layer suture is continuous and involves deep parenchyma including the collecting system, if opened. the superficial layer suture approximates the margins of the defect using absorbable clips on one parenchymal edge only. no bolsters, glues or other additional hemostatic agents are used. results: at present this technique was applied in 34 patients. tumor size ranged from 17-85 mm. median warm ischemia time was 23 min (range 12-45) and estimated blood loss 55 ml (30-1000). there were no intraoperative complications or conversions to open surgery. no urine leaks or postoperative bleedings were observed. conclusions: this simplified technique appears reliable and quick, and therefore may be attractive for many urologic surgeons. furthermore, the avoidance of routine use of additional hemostatic maneuvers may provide an economical advantage to this approach with no compromise of the surgical outcome.
Amount of cells of diffuse lymphoid tissue of uterine tube in women of different age groups
S.V. Shadlinskaya
Saratov Journal of Medical Scientific Research , 2010,
Abstract: The aim of the investigation was to study the amount of lymphoid cells of diffuse lymphoid tissue of uterine tube in women of different age. The transverse sections of one-third of each part of uterine tube from 116 women (from newborn to senile age) were studied. The sections were colored by gematoksilin-eosin, by van Gizon, by Brashe, azur-2-eosine, by Qrimelius. The amount of lymphoid cells of diffuse lymphoid tissue of uterine tube increased till the age of 16-20 and remained at high level further on till the age of 35. The quantity of lymphoid cells of diffuse lymphoid tissue of uterine tube changed according to the age and localization throughout the organ. The presence of diffused lymphoid tissue of uterine tube depended on the state of reproductive function of female organism. In the phase of desquamation there was minimal quantity of lymphoid tissue and in the phase of secretion there was maximal quantity of lymphoid tissue
基于有限元模型的经阴道分娩产妇子宫瘢痕处最大应力分析
Analysis on the maximum stress of uterine scar during delivery based on finite element model
 [PDF]

王贤达,,,马新刚,董瑞春,孟颜颜
- , 2018, DOI: 10.13705/j.issn.1671-6825.2018.03.133
Abstract: 目的:基于有限元模型分析分娩时产妇子宫瘢痕处的应力情况,用以判断分娩方式。方法:通过查阅文献资料建立子宫的三维简化模型,在有限元软件ANSYS workbench中设置子宫前壁上、下段和子宫瘢痕厚度以及宫内压力,计算子宫瘢痕处的应力,判断经阴道分娩子宫破裂的风险。结果与结论:通过ANSYS workbench得到了分娩时子宫应力分布图,最大应力位于子宫瘢痕处。固定子宫前壁上段厚度为10.0 mm,当子宫前壁下段和子宫瘢痕厚度从1.0 mm逐渐增至6.0 mm时,子宫瘢痕处受到的最大应力逐渐减小。当子宫瘢痕厚度小于3.0 mm时,经阴道分娩时子宫瘢痕处的最大应力大于此处的抗拉强度,此时不建议顺产。固定子宫瘢痕厚度为3.0 mm,当子宫前壁上段厚度在4.5~10.0 mm时选择顺产比较安全; 子宫瘢痕处应力随着子宫前壁上段厚度的增加先减小后增大,当子宫前壁上段厚度达7.0 mm时瘢痕处的应力达到最小值。
Aim:To assess the way of delivery according to the maximum stress of uterine scar based on finite element model.Methods:Through consulting the literature, a three-dimensional simplified model of the uterus was established. The thicknesses of the upper uterine segment, lower uterine segment and the uterine scar, as well as the intrauterine pressure were set, and the force at the scar was obtained and the risk of uterine rupture during vaginal trial production was assessed.Results and Conclusion:The stress distribution of the uterus was calculated by ANSYS workbench, and the maximum stress was located at the uterine scar. When the thickness of the upper uterine segment was set as 10.0 mm,the stress at the uterine scar decreased with the increase of the thicknesses(1.0-6.0 mm)of the lower uterine segment and the uterine scar; when the thickness of the uterine scar was less than 3.0 mm, the maximum stress at the uterine scar was greater than the strength of the uterine scar muscle, and vaginal delivery was no recommended. When the thickness of the uterine scar was set as 3.0 mm, the thickness of the upper uterine segment was at the range of 4.5-10.0 mm, vaginal delivery is relatively safe. The stress at the uterine scar decreases first and then increases with the increase in the thickness of the upper uterine scar. The stress at the uterine scar is the lowest when the thickness of the upper uterine segment is 7.0 mm
Finite Element Method (FEM), Mechanobiology and Biomimetic Scaffolds in Bone Tissue Engineering
A. Boccaccio, A. Ballini, C. Pappalettere, D. Tullo, S. Cantore, A. Desiate
International Journal of Biological Sciences , 2011,
Abstract: Techniques of bone reconstructive surgery are largely based on conventional, non-cell-based therapies that rely on the use of durable materials from outside the patient's body. In contrast to conventional materials, bone tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences towards the development of biological substitutes that restore, maintain, or improve bone tissue function. Bone tissue engineering has led to great expectations for clinical surgery or various diseases that cannot be solved with traditional devices. For example, critical-sized defects in bone, whether induced by primary tumor resection, trauma, or selective surgery have in many cases presented insurmountable challenges to the current gold standard treatment for bone repair. The primary purpose of bone tissue engineering is to apply engineering principles to incite and promote the natural healing process of bone which does not occur in critical-sized defects. The total market for bone tissue regeneration and repair was valued at $1.1 billion in 2007 and is projected to increase to nearly $1.6 billion by 2014. Usually, temporary biomimetic scaffolds are utilized for accommodating cell growth and bone tissue genesis. The scaffold has to promote biological processes such as the production of extra-cellular matrix and vascularisation, furthermore the scaffold has to withstand the mechanical loads acting on it and to transfer them to the natural tissues located in the vicinity. The design of a scaffold for the guided regeneration of a bony tissue requires a multidisciplinary approach. Finite element method and mechanobiology can be used in an integrated approach to find the optimal parameters governing bone scaffold performance. In this paper, a review of the studies that through a combined use of finite element method and mechano-regulation algorithms described the possible patterns of tissue differentiation in biomimetic scaffolds for bone tissue engineering is given. Firstly, the generalities of the finite element method of structural analysis are outlined; second, the issues related to the generation of a finite element model of a given anatomical site or of a bone scaffold are discussed; thirdly, the principles on which mechanobiology is based, the principal theories as well as the main applications of mechano-regulation models in bone tissue engineering are described; finally, the limitations of the mechanobiological models and the future perspectives are indicated.
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