Biomechanical Comparison of Glutaraldehyde-Crosslinked Gelatin Fibrinogen Electrospun Scaffolds to Porcine Coronary Arteries.

Cardiovascular disease (CVD) is the leading cause of death for Americans. As coronary artery bypass graft surgery (CABG) remains a mainstay of therapy for CVD and native vein grafts are limited by issues of supply and lifespan, an effective readily available tissue-engineered vascular graft (TEVG) for use in CABG would provide drastic improvements in patient care. Biomechanical mismatch between vascular grafts and native vasculature has been shown to be the major cause of graft failure, and therefore, there is need for compliance-matched biocompatible TEVGs for clinical implantation. The current study investigates the biaxial mechanical characterization of acellular electrospun glutaraldehyde (GLUT) vapor-crosslinked gelatin/fibrinogen cylindrical constructs, using a custom-made microbiaxial optomechanical device (MOD). Constructs crosslinked for 2, 8, and 24 hrs are compared to mechanically characterized porcine left anterior descending coronary (LADC) artery. The mechanical response data were used for constitutive modeling using a modified Fung strain energy equation. The results showed that constructs crosslinked for 2 and 8 hrs exhibited circumferential and axial tangential moduli (ATM) similar to that of the LADC. Furthermore, the 8-hrs experimental group was the only one to compliance-match the LADC, with compliance values of 0.0006±0.00018 mm Hg-1 and 0.00071±0.00027 mm Hg-1, respectively. The results of this study show the feasibility of meeting mechanical specifications expected of native arteries through manipulating GLUT vapor crosslinking time. The comprehensive mechanical characterization of cylindrical biopolymer constructs in this study is an important first step to successfully develop a biopolymer compliance-matched TEVG.

Exodeviation compensated for by dragged macula: pseudo-exodeviation.

Dragged macula is a manifestation of several ophthalmic conditions. We present a 25-years-old male with dragged macula in the right eye, good vision in both eyes, and pseudo-exodeviation of 45 prism diopter without diplopia. We tried to correlate between the degree of pseudo-deviation and the distant of the fovea from its expected original position.

Modulating smooth muscle cell response by the release of TGFß2 from tubular scaffolds for vascular tissue engineering.

Tissue engineering has gained considerable attention in the development of small diameter tissue engineered vascular grafts (TEVGs) for treating coronary heart disease. A properly designed acellular and biodegradable TEVG must encourage the infiltration and growth of vascular smooth muscle cells (SMCs). Our group has previously shown that increasing levels of TGFß2 can differentially modulate SMC migration and proliferation. In this study, tubular electrospun scaffolds loaded with TGFß2 were fabricated using various ratios of gelatin/polycaprolactone (PCL), resulting in scaffolds with porous nano-woven architecture suitable for tissue ingrowth. Scaffold morphology, degradation rate, TGß2 release kinetics, and bioactivity were assessed. TGFß2 was successfully integrated into the electrospun biomaterial that resulted in a differential release profile depending on the gelatin/PCL ratio over the course of 42 days. Higher TGFß2 elution was obtained in scaffolds with higher gelatin content, which may be related to the biodegradation of gelatin in culture media. The biological activity of the released TGFß2 was evaluated by its ability to affect SMC proliferation as a function of its concentration. SMCs seeded on TGFß2-loaded scaffolds also showed higher densities and infiltration after 5 days in culture as compared to scaffolds without TGFß2. Our results demonstrate that the ratio of synthetic and natural polymers in electrospun blends can be used to tune the release of TGFß2. This method can be used to intelligently modulate the SMC response in gelatin/PCL scaffolds making the TGFß2-loaded conduits attractive for cardiovascular tissue engineering applications.

General anesthesia for cataract surgery: Experience at King Fahd Hospital of the University, Al-Khobar.

Although cataract surgery is increasingly being performed under local anesthesia in many centers, general anesthesia is preferred for cataract surgery at the King Fahd Hospital of the University (KFHU), Al-Khobar. Ninety two patients who had cataract extraction under general anesthesia at KFHU between October 1988 and April 1990 are presented. Of these, 57 patients (61.9%), had pre-existing medical ailments (mainly cardiovascular and metabolic). Perianesthetic problems (dysrhythmia, hypotension), were encountered in ten patients (10.8%). All responded to treatment. Surgical conditions were ideal. There was no mortality. It would appear that modern general anesthesia, with appropriate monitoring, can effectively be applied to planned cataract surgery, with good results, provided the patients are in optimal physical health.