326 research outputs found
Ventralight ST and Sorbafix versus Physiomesh and Securestrap in a porcine model
BACKGROUND AND OBJECTIVES: The objective of this study was to compare mesh contracture, adhesion characteristics, tissue ingrowth, and histologic response of Ventralight ST/SorbaFix (C.R. Bard/Davol, Warwick, RI, USA) with Physiomesh/Securestrap (Ethicon, Somerville, NJ, USA) in a porcine model of laparoscopic ventral hernia repair. METHODS: Standard laparoscopic technique was used to bilaterally implant meshes in 10 female Yorkshire swine. Each animal received either two Ventralight ST meshes (oval shaped, 10.2 Ă— 15.2 cm) or two Physiomesh meshes (oval shaped 10 Ă— 15 cm), one on either side of the midline. The meshes were fixated to the intact peritoneum with either SorbaFix (for animals receiving Ventralight ST) or Securestrap (for animals receiving Physiomesh). There were 5 animals in each group, yielding 10 of each mesh-fixation combination. Mesh contracture, adhesion characteristics, tissue ingrowth, and histologic response were evaluated after 14 days by image analysis, mechanical testing, and histologic staining (hematoxylin-eosin, Masson trichrome, picrosirius red, and von Willebrand factor). RESULTS: Ventralight ST/SorbaFix and Physiomesh/Securestrap exhibited a similar percentage of mesh contracture, percentage of adhesion coverage, adhesion tenacity, collagen deposition, and levels of necrosis (P > .05 in all cases). However, Ventralight ST/SorbaFix exhibited significantly less inflammation (P = .0001), fibrosis (P = .0017), hemorrhage (P = .0001), and angiogenesis (P = .0032) and significantly greater strength of tissue ingrowth (P = .0003) than Physiomesh/Securestrap after the 14-day implantation period. CONCLUSIONS: Ventralight ST/SorbaFix exhibited more favorable strength of tissue ingrowth and histologic response and similar mesh contracture and adhesion characteristics compared with Physiomesh/Securestrap over a short-term 14-day implantation period in a preclinical porcine model
Reinforced Tissue Matrix to Strengthen the Abdominal Wall Following Reversal of Temporary Ostomies or to Treat Incisional Hernias
BACKGROUND: Abdominal wall deficiencies or weakness are a common complication of temporary ostomies, and incisional hernias frequently develop after colostomy or ileostomy takedown. The use of synthetic meshes to reinforce the abdominal wall has reduced hernia occurrence. Biologic meshes have also been used to enhance healing, particularly in contaminated conditions. Reinforced tissue matrices (RTMs), which include a biologic scaffold of native extracellular matrix and a synthetic component for added strength/durability, are designed to take advantage of aspects of both synthetic and biologic materials. To date, RTMs have not been reported to reinforce the abdominal wall following stoma reversal.
AIM: To evaluate the effectiveness of using an RTM to reinforce the abdominal wall at stoma takedown sites.
METHODS: Twenty-eight patients were selected with a parastomal and/or incisional hernia who had received a temporary ileostomy or colostomy for fecal diversion after rectal cancer treatment or trauma. Following hernia repair and proximal stoma closure, RTM (OviTex
RESULTS: The observational study cohort included 16 male and 12 female patients with average age of 58.5 years ± 16.3 years and average body mass index of 26.2 kg/m
CONCLUSION: RTMs were used successfully to treat parastomal and incisional hernias at ileostomy reversal, with no hernia recurrences and favorable outcomes after 1-month and 1-year
Identification of Arabidopsis thaliana phloem RNAs provides a search criterion for phloem-based transcripts hidden in complex data sets of micro array experiments
Phloem-mobile signals play a major role in plant nutrition, development and communication. In the latter
context, phloem-mobile RNAs have been associated with signalling between plant tissues. In this study, we
focused on the identification of transcripts in the shoot phloem of the model plant Arabidopsis thaliana. To
isolate transcripts expressed in phloem parenchyma cells and in companion cell–sieve element complexes, we
used laser microdissection coupled to laser pressure catapulting (LMPC). Mobile transcripts in sieve elements
were isolated from leaf phloem exudates. After optimization of sampling and fixation, RNA of high quality was
isolated from both sources. The modifications to the RNA amplification procedure described here were well
suited to production of RNA of sufficient yield and quality for microarray experiments. Microarrays hybridized
with LMPC-derived phloem tissue or phloem sap RNA allowed differentiation between phloem-expressed and
mobile transcript species. Using this set of phloem transcripts and comparing them with microarrays derived
from databases of light, hormone and nutrient treatment experiments, we identified phloem-derived RNAs as
mobile, potential long-distance signals. Our dataset thus provides a search criterion for phloem-based signals
hidden in the complex datasets of microarray experiments. The availability of these comprehensive phloem
transcript profiles will facilitate reverse-genetic studies and forward-genetic screens for phloem and longdistance
RNA signalling mutants
Combustion Chamber Fatigue Life Analysis for Reusable Liquid Rocket Engines (LREs)
To increase liquid rocket engines (LREs) lifetime capability and allow for reusability applications, the efficient evaluation of the most critical subcomponents' remaining useful life plays a vital role. Regeneratively cooled combustion chamber (CC) wall must withstand extremely high loads emerging from a massive temperature gradient between the hot gas and the low temperature of the coolant. The combined loading and unloading operations, together with high temperature and rate dependent inelastic strain, significantly lessen the combustion chamber inner liner life. Within the presented research, the post-processing model was developed for low cycle fatigue (LCF) evaluation of the reusable LRE’s combustion chamber walls. The proposed damage accumulation model is based on the amalgamation of Bonora-Gentile-Pirondi (2004) and Dufailly-Lemaitre (1995) methods, and it incorporates ductile and brittle damage components which are embedded in the post-processing method. Moreover, the required numerical calculation time is further decreased on account of the proposed routine which allows for analysis of only two initial numerically acquired FE cycles. The obtained results based on the developed method combined with coupled thermal-structural quasi 2D Finite Element Analysis (FEA) of the nozzle throat cross-section, were confirmed to be in good agreement with the validation data acquired from the M51 thermo-mechanical laboratory site at DLR Lampoldshausen. The proposed model can be successfully applied for a quick evaluation of the remaining useful life of the CC wall for various rocket engine architectures
Fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for soft tissue repair and reconstruction: A scoping review
BackgroundPoly-4-hydroxybutyrate (P4HB) is a fully resorbable, biologically-produced polymer with a strength and flexibility comparable to permanent synthetic polymers. The objective was to identify/summarize all peer-reviewed publications involving P4HB mesh.MethodsA scoping review was conducted within PubMed and included articles published through October 2022.ResultsA total of n = 79 studies were identified (n = 12 in vitro/bench; n = 14 preclinical; n = 6 commentaries; n = 50 clinical). Of the clinical studies, n = 40 reported results applicable to hernia and n = 10 to plastic/reconstructive surgery and involved patients of all Centers for Disease Control (CDC) wound classes and Ventral Hernia Working Group (VHWG) grades.ConclusionP4HB mesh provides long-term hernia repair strength and exhibits promising clinical outcomes beyond its resorption period. Future studies should include randomized controlled trials comparing P4HB to other biomaterials, as well as optimal patient selection, operative technique, long-term outcomes, minimization of potential mesh-related complications, and potential contraindications/complications for P4HB in hernia/abdominal wall reconstruction
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Argonne National Laboratory Reports
This report presents two detailed computerized operating procedures developed to assist and control the shearing and dissolution of irradiated fuel rods. The procedures were employed in the destructive analysis of end-of-life fuel rods from the Light Water Breeder Reactor (LWBR) that was designed by the Westinghouse Electric Corporation Bettis Atomic Power Laboratory. Seventeen entire fuel rods from the end-of-life core of the LWBR were sheared into 169 precisely characterized segments, and more than 150 of these segments were dissolved during execution of the LWBR Proof-of-Breeding (LWBR-POB) Analytical Support Project at Argonne National Laboratory. The procedures illustrate our approaches to process monitoring, data reduction, and quality assurance during the LWBR-POB work
Patient-reported outcome measures for cancer caregivers: a systematic review
Purpose
Informal caregivers provide invaluable help and support to people with cancer. As treatments extend survival and the potential burdens on carers increase, there is a need to assess the impact of the role. This systematic review identified instruments that measure the impact of caregiving, evaluated their psychometric performance specifically in cancer and appraised the content.
Methods
A 2-stage search strategy was employed to: 1. identify instruments that measure the impact of caregiving, 2. run individual searches on each measure to identify publications evaluating psychometric performance in the target population. Searches were conducted in Medline, Embase, CINAHL and Psychinfo and restricted to English for instrument used and article language. Psychometric performance was evaluated for content and construct validity, internal consistency, test-retest reliability, precision, responsiveness and acceptability. Individual scale items were extracted and systematically categorised into conceptual domains.
Results
10 papers were included reporting on the psychometric properties of 8 measures. Although construct validity and internal consistency were most frequently evaluated, no study comprehensively evaluated all relevant properties. Few studies met our inclusion criteria so it was not possible to consider the psychometric performance of the measures across a group of studies. Content analysis resulted in 16 domains with 5 overarching themes: lifestyle disruption; wellbeing; health of the caregiver; managing the situation and relationships.
Conclusions
Few measures of caregiver impact have been subject to psychometric evaluation in cancer caregivers. Those that have do not capture well changes in roles and responsibilities within the family and career, indicating the need for a new instrument
META Score: An International Consensus Scoring System on Mesh-Tissue Adhesions
Background: Currently, the lack of consensus on postoperative mesh-tissue adhesion scoring leads to incomparable scientific results. The aim of this study was to develop an adhesion score recognized by experts in the field of hernia surgery. Methods: Authors of three or more previously published articles on both mesh-tissue adhesion scores and postoperative adhesions were marked as experts. They were queried on seven items using a modified Delphi method. The items concerned the utility of adhesion scoring models, the appropriateness of macroscopic and microscopic variables, the range and use of composite scores or subscores, adhesion-related complications and follow-up length. This study comprised two questionnaire-based rounds and one consensus meeting. Results: The first round was completed by 23 experts (82%), the second round by 18 experts (64%). Of those 18 experts, ten were able to participate in the final consensus meeting and all approved the final proposal. From a total of 158 items, consensus was reached on 90 items. The amount of mesh surface covered with adhesions, tenacity and thickness of adhesions and organ involvement was concluded to be a minimal set of variables to be communicated separately in each future study on mesh adhesions. Conclusion: The MEsh Tissue Adhesion scoring system is the first consensus-based scoring system with a wide backing of renowned experts and can be used to assess mesh-related adhesions. By including this minimal set of variables in future research interstudy comparability and objectivity can be increased and eventually linked to clinically relevant outcomes
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