Identification of a myofibroblast differentiation program during neonatal lung development.

Alveologenesis is the final stage of lung development in which the internal surface area of the lung is increased to facilitate efficient gas exchange in the mature organism. The first phase of alveologenesis involves the formation of septal ridges (secondary septae) and the second phase involves thinning of the alveolar septa. Within secondary septa, mesenchymal cells include a transient population of alveolar myofibroblasts (MyoFBs) and a stable but poorly described population of lipid-rich cells that have been referred to as lipofibroblasts or matrix fibroblasts (MatFBs). Using a unique Fgf18CreER lineage trace mouse line, cell sorting, single-cell RNA sequencing and primary cell culture, we have identified multiple subtypes of mesenchymal cells in the neonatal lung, including an immature progenitor cell that gives rise to mature MyoFB. We also show that the endogenous and targeted ROSA26 locus serves as a sensitive reporter for MyoFB maturation. These studies identify a MyoFB differentiation program that is distinct from other mesenchymal cell types and increases the known repertoire of mesenchymal cell types in the neonatal lung.

The 3D Structural Architecture of the Human Hand Area Is Nontopographic.

The functional topography of the human primary somatosensory cortex hand area is a widely studied model system to understand sensory organization and plasticity. It is so far unclear whether the underlying 3D structural architecture also shows a topographic organization. We used 7 Tesla (7T) magnetic resonance imaging (MRI) data to quantify layer-specific myelin, iron, and mineralization in relation to population receptive field maps of individual finger representations in Brodman area 3b (BA 3b) of human S1 in female and male younger adults. This 3D description allowed us to identify a characteristic profile of layer-specific myelin and iron deposition in the BA 3b hand area, but revealed an absence of structural differences, an absence of low-myelin borders, and high similarity of 3D microstructure profiles between individual fingers. However, structural differences and borders were detected between the hand and face areas. We conclude that the 3D structural architecture of the human hand area is nontopographic, unlike in some monkey species, which suggests a high degree of flexibility for functional finger organization and a new perspective on human topographic plasticity.SIGNIFICANCE STATEMENT Using ultra-high-field MRI, we provide the first comprehensive in vivo description of the 3D structural architecture of the human BA 3b hand area in relation to functional population receptive field maps. High similarity of precise finger-specific 3D profiles, together with an absence of structural differences and an absence of low-myelin borders between individual fingers, reveals the 3D structural architecture of the human hand area to be nontopographic. This suggests reduced structural limitations to cortical plasticity and reorganization and allows for shared representational features across fingers.

Ultrasound Features of Nodular Hidradenoma: A Case Series of 27 Patients.

OBJECTIVE: The aim of this study was to systematically investigate the ultrasonographic features of nodular hidradenoma (NH). METHODS: A retrospective analysis was used to systematically summarize the ultrasonographic data of 27 patients diagnosed with NH by surgical pathology, including 13 eccrine nodular hidradenomas (ENH) and 14 apocrine nodular hidradenomas (ANH). RESULTS: All instances of NH presented as solitary, well-defined lesions that infiltrated the dermis and subcutaneous fat layer, characterized by a heterogeneous hypoechoic internal solid component on ultrasound imaging. Color Doppler ultrasound revealed blood flow signals of Grade 2 or higher within 74% (20/27) of the lesions. Solid + cystic (cystic >50%) NH (14/27, 51.4%) were typically large and predominantly had an oval shape (11/14, 78.5%). Their distinctive sonographic features included the presence of inner septa within the cystic area (8/14, 57.1%), "snow falling" sign (7/14, 50%), or "fluid-fluid level" sign (7/14, 50%). Solid + cystic (cystic ≤50%) NH exhibited a lobulated morphology in all instances (5/5, 100%). No inner septa, "snow falling" sign or "fluid-fluid level" sign was observed within the cystic regions. The solid NH (8/27, 29.7%) morphology predominantly featured lobulation (6 out of 8, 75%). Ultrasound analysis revealed distinct differences between ENH and ANH. ENH were more lobulated, while ANH were predominantly oval. ANH were mainly solid + cystic (cystic >50%), whereas ENH were mostly solid. Inner septa, "snow falling" sign, and "fluid-fluid level" sign frequencies were similar in both groups, correlating more with cystic-solid composition than pathological subtype. CONCLUSIONS: Ultrasonographic features of lobulated morphology and the presence of inner septa, "snow falling" sign or "fluid-fluid level" sign in the cystic region provide strong support for the diagnosis of NH.

Is there a relationship between sphenoid sinus pneumatization and carotid canal-intersinus septa connection?

OBJECTIVES: We investigated the relationship between sphenoid sinus (SS) pneumatization types, carotid canal types and carotid canal-intersinus septa connection. METHODS: The paranasal sinus computed tomography (PNSCT) images of 274 patients (141 males and 133 females) were evaluated retrospectively. SS pneumatization, SS intersinus septation, SS intersinus septa deviation, carotid canal classification, carotid canal dehiscence, carotid canal-intersinus septa connection and presence of Onodi cells were evaluated. RESULTS: In presellar and sellar SS, type 1 carotid canal was detected. However, type 3 carotid canal was detected more in postsellar SS. On the left side, in 26.4% of the postsellar SS, carotid canal dehiscence was detected. On the right side, carotid canal-intersinus septa connection was detected in 55.8% of the postsellar SS and 35.1% of the sellar SS. On the left side, it was detected 58.3% of the postsellar SS and 30.9% of the sellar SS. In postsellar type SS pneumatized cases, right caroid canal-intersinus septa connection increased by 5.4 fold and left carotid canal-intersinus septa connection increased by 7.3 fold compared to presellar type SS pneumatization. In 2≥ intersinus septa group, left carotid canal-intersinus septa connection increased 5.0 fold compared to 'no septa' group. CONCLUSION: In this study, we evaluated SS pneumatization types and their relation with carotid canal types and carotid canal-intersinus septa connections. Type 3 carotid canal (protrudation to SS wall) was detected more in postsellar SS. In these cases, surgeons should be very careful during surgery to avoid damage to the internal carotid artery (ICA).

Prevalence and Features of Maxillary Sinus Septa in Patients with Cleft Lip and Palate: Cone Beam Computed Tomography Imaging Technique.

OBJECTIVE: The development of the maxillary sinus is different in patients with cleft lip and palate (CLP) compared to non-CLP individuals. To investigate the prevalence and features of maxillary sinus septa (MSS) in patients with CLP in comparison with the non-CLP population. DESIGN: Retrospective study. INTERVENTION: Cone beam computed tomography (CBCT) evaluation. SETTING: CLP center in Shiraz faculty of dentistry, Iran. PATIENTS: A total 306 sinuses (88 cleft and 218 noncleft) on 153 images (CLP group: n = 66; control group: n = 87) were examined to determine the prevalence of septa and characterize them. MAIN OUTCOME MEASURES: Sinus septa were characterized according to height, orientation, angle, origin, and location. The chi-square test, Mann-Whitney U test, and Fisher's exact test were used for statistical analysis. RESULTS: The prevalence of septa was 28.9% and 32.1% in the CLP and control groups, respectively. No significant difference was found between the study groups in terms of prevalence, location, and orientation of MSS. The average height and angle of septa were significantly higher in the control group compared to the CLP group. Inferior origin was significantly more prevalent in the control group than in the CLP group (P = .004). CONCLUSION: There was no difference in the prevalence of MSS between patients with CLP and non-CLP individuals. However, certain features of the septa were different in patients with CLP.

Incidence of maxillary sinus septa in the saudi population.

BACKGROUND: The variability in the maxillary sinus anatomy makes dental implant planning challenging. One of the anatomical landmarks that could affect the decision for implant placement around the maxillary sinus is the sinus septa. This study aimed to retrospectively determine the prevalence, anatomical distribution, and morphology of the maxillary sinus septa. MATERIALS AND METHODS: This study included 309 CBCT images that were analyzed to determine the prevalence, height, location, and orientation of the maxillary sinus septa. Descriptive statistics, Mann‒Whitney U tests, and Kruskal‒Wallis tests were used for data analysis. RESULTS: A total of 618 maxillary sinuses were analyzed. Maxillary septa were present in 30% (n = 188) of the sinuses and in approximately 45% of the analyzed images. The mean height of the septa was 5.09 mm. The presence of bilateral septa was evident in 49 subjects (35.25%). Female subjects were significantly more likely to have only one septum (n = 67, 53.6%, p < 0.05). CONCLUSION: The presence of septa is very common, found in one-third to approximately half of the evaluated cases, which warrants careful examination before any surgical interventions to avoid possible complications.

Cone-beam computed tomographic analysis of maxillary sinus septa among Yemeni population: a cross-sectional study.

BACKGROUND: Maxillary sinus septa increase perforation risk of Schneiderian membrane during the sinus floor elevation (SFE). Cone Beam Computed Tomography (CBCT) allows for a more precise assessment of the septal position; thus, preoperative CBCT analysis is substantial to avoid possible complications. This study aims to investigate the 3D characteristics of the maxillary sinus septa based on CBCT images. To our knowledge, no study reported the CBCT-based investigation for the sinus septa among Yemeni population. MATERIALS AND METHODS: This is a retrospective cross-sectional analysis of 880 sinus CBCT images 440 patients. The septa prevalence, locations, orientations, morphology, and associated factors were analyzed. The effect of age, gender, and dental status on the sinus septa and the relationship between sinus membrane pathology and sinus septa were also analyzed. Anatomage (Invivo version 6) was used for CBCT images analysis. Descriptive and analytical statistics were performed, and a P-value < 0.05 was significantly considered. RESULTS: The maxillary sinus septa were found among 63.9% of patients and 47% of sinuses. The average septa height was 5.2 mm. 15.7% of patients had septa in the right maxilla, 18% in the left, and 30.2% in both. Gender, age, and dental condition had no influence on the presence of septa, and septa presence did not influence sinus membrane pathology. Many septa originated from the floor (54.5%), located in the middle (43%), with coronal orientation (66%) and complete configuration (58.2%). CONCLUSION: Based on our findings, the septa prevalence, locations, orientations, and morphology were significant and equivalent to the highest recorded in the literature yet. Thus, when sinus floor elevation is planned, CBCT imaging of the maxillary sinus is recommended for safe dental implantation.

Myogenesis of Siboglinum fiordicum sheds light on body regionalisation in beard worms (Siboglinidae, Annelida).

BACKGROUND: Many annelids, including well-studied species such as Platynereis, show similar structured segments along their body axis (homonomous segmentation). However, numerous annelid species diverge from this pattern and exhibit specialised segments or body regions (heteronomous segmentation). Recent phylogenomic studies and paleontological findings suggest that a heteronomous body architecture may represent an ancestral condition in Annelida. To better understand the segmentation within heteronomous species we describe the myogenesis and mesodermal delineation of segments in Siboglinum fiordicum during development. RESULTS: Employing confocal and transmission electron microscopy we show that the somatic longitudinal musculature consists of four separate strands, among which ventrolateral one is the most prominent and is proposed to drive the search movements of the head of the late metatrochophore. The somatic circular musculature lies inside the longitudinal musculature and is predominantly developed at the anterior end of the competent larva to support the burrowing behaviour. Our application of transmission electron microscopy allows us to describe the developmental order of the non-muscular septa. The first septum to form is supported by thick bundles of longitudinal muscles and separates the body into an anterior and a posterior region. The second group of septa to develop further divides the posterior body region (opisthosoma) and is supported by developing circular muscles. At the late larval stage, a septum reinforced by circular muscles divides the anterior body region into a forepart and a trunk segment. The remaining septa and their circular muscles form one by one at the very posterior end of the opisthosoma. CONCLUSIONS: The heteronomous Siboglinum lacks the strict anterior to posterior sequence of segment formation as it is found in the most studied annelid species. Instead, the first septum divides the body into two body regions before segments are laid down in first the posterior opisthosoma and then in the anterior body, respectively. Similar patterns of segment formation are described for the heteronomous chaetopterid Chaetopterus variopedatus and serpulid Hydroides elegans and may represent an adaptation of these annelids to the settlement and transition to the sedentarian-tubiculous mode of life.

Fruit evolution in Hydrophyllaceae.

PREMISE: Fruit type and morphology are tightly connected with angiosperm diversification. In Boraginales, the first-branching families, including Hydrophyllaceae, have one- to many-seeded capsules, whereas most of the remaining families have four-seeded indehiscent fruits. This fact argues for many-seeded capsules as the ancestral condition. However, little is known about the evolution of fruit dehiscence and seed number. The present study investigated the gynoecium and fruit development and morphology and the evolution of seed-numbers in Hydrophyllaceae. METHODS: Gynoecium and fruit development and morphology were studied using scanning electron microscopy and x-ray microcomputed tomography. Ancestral character state reconstruction of seed number was performed using a broadly sampled phylogeny of Boraginales (ndhF and ITS) with an emphasis on Hydrophyllaceae. RESULTS: Our ontogenetic studies not only demonstrate parallel developmental trajectories across Hydrophyllaceae, but also a striking diversity regarding the internal organization of the gynoecium. Ovule number appears to determine ovary structure. Many-seeded capsules are retrieved as the ancestral state of Hydrophyllaceae. At least seven transitions to fruits with (one to) four seeds and four reversals (i.e., from four- to many-seeded fruits) were reconstructed in Hydrophyllaceae. CONCLUSIONS: Several shifts in seed number from "many" to "four" and back to "many" have taken place in capsular-fruited Hydrophyllaceae, a strikingly high number considering that seed number is virtually conserved across the rest of the order. The groups with a conserved seed number of four are characterized by indehiscent schizocarps or drupes and by seeds that are integrated into mericarps. This functional integration probably acts as an evolutionary constraint to shifts in seed number.

Alveologenesis: What Governs Secondary Septa Formation.

The simplification of alveoli leads to various lung pathologies such as bronchopulmonary dysplasia and emphysema. Deep insight into the process of emergence of the secondary septa during development and regeneration after pneumonectomy, and into the contribution of the drivers of alveologenesis and neo-alveolarization is required in an efficient search for therapeutic approaches. In this review, we describe the formation of the gas exchange units of the lung as a multifactorial process, which includes changes in the actomyosin cytoskeleton of alveocytes and myofibroblasts, elastogenesis, retinoic acid signaling, and the contribution of alveolar mesenchymal cells in secondary septation. Knowledge of the mechanistic context of alveologenesis remains incomplete. The characterization of the mechanisms that govern the emergence and depletion of αSMA will allow for an understanding of how the niche of fibroblasts is changing. Taking into account the intense studies that have been performed on the pool of lung mesenchymal cells, we present data on the typing of interstitial fibroblasts and their role in the formation and maintenance of alveoli. On the whole, when identifying cell subpopulations in lung mesenchyme, one has to consider the developmental context, the changing cellular functions, and the lability of gene signatures.

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis.

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

[Topography of maxillary sinus septa according to cone beam computed tomography data]. / Topografiya sept verkhnechelyustnoi pazukhi po dannym konusno-luchevoi komp'yuternoi tomografii.

The aim of the study was to establish the location, orientation and height of the maxillary sinus primary septa. The data of 100 cone-beam computed tomography scans of patients with a mean age of 37.6±15.4 years from dental outpatient hospitals of Minsk, Belarus taken from 2012 to 2019 were analyzed. The prevalence of sinus septa was 45.6% for sinuses and 37.2% for patients. As a rule, septa were symmetric bilaterally. The heights of septa varied from 2-3 mm to 8-14 mm in the majority of cases. Orientation of septa was coronal in 94.7%, sagittal in 3.9%, and horizontal in 1.4% of cases. The location of the septa must be considered when planning for dental implants. In addition, septa in the upper and posterior regions of the maxillary sinus may interfere with mucociliary clearance.

Detection accuracy of maxillary sinus floor septa in panoramic radiographs using CBCT as gold standard: a multi-observer receiver operating characteristic (ROC) study.

OBJECTIVES: To investigate diagnostic accuracy of panoramic radiography in detecting maxillary sinus floor septa by means of a multi-observer receiver operating characteristic (ROC) analysis and a standardized protocol for reporting (STARD protocol; Clin Chem 49(1):1-6, 2003). MATERIAL AND METHODS: From our database, 25 cone beam computed tomographies (CBCTs) were selected with one maxillary sinus floor septum (height ≥ 2.5 mm). For the same patient, a recent panoramic radiograph (PAN) had to be available in the database. As controls, 28 CBCTs plus corresponding PANs without evidence of a sinus septum were selected. Using the CBCTs as ground truth, 17 observers from our dental school on a five-point confidence scale rated both sinuses in all 53 PANs with respect to presence/absence of a sinus septum. Areas beneath ROC curves (Az-values), sensitivity/specificity (SNT/SPF), positive/negative predictive values (PPV, NPV), and positive/negative likelihood ratios (LR+, LR-) were computed for each observer and pooled over all observers. Inter-rater reproducibility was assessed by means of the intraclass coefficient (ICC) using a two-way random effects model. RESULTS: A pooled Az-value of 0.839 was observed (SNT 84.6%, SPF 73.5%). PPV ranged between 0.492 and 0.824 (median 0.627) and NPV between 0.838 and 0.976 (median 0.917). A median LR+ of 3.567 was computed (LR- median 0.193). Inter-rater reliability revealed an ICC of 0.55 (95% confidence interval 0.48 to 0.62). CONCLUSIONS: Our results indicate that PAN is a moderately accurate method for sinus elevation planning for the purpose of septum detection. Ruling out a septum by PAN seems to work more accurately than ruling in. CLINICAL RELEVANCE: For the purpose of maxillary sinus floor septa detection, panoramic radiography can be relatively safely advocated, particularly for judgment of a septum-free sinus.

The effects of posterior alveolar bone height on the height of maxillary sinus septa.

PURPOSE: The purpose of this study was to evaluate whether posterior alveolar bone height affects maxillary sinus septa (MSS) height in dentate and edentulous patients, as determined by cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This retrospective analysis enrolled 166 patients (91 men and 75 women) with a mean age of 43.12 ± 15.26 years (range 18-74 years), who had at least one MSS on CBCT images. MSS were categorized into three regions: anterior, middle, and posterior. Patients were categorized as complete or partial posterior edentulous or fully posterior dentate. The maximum vertical diameter of the sinus septa and alveolar bone height was analyzed in sagittal CBCT sections; P < 0.05 was regarded as statistically significant. RESULTS: We found 210 MSS among the patients in this study. Of the 166 patients, 36 had bilateral septa and 4 had three septa. The septa were mainly located in the middle region in the dentate (n = 70; 33.3%) and edentulous (n = 59; 28.1%) patients. The mean septal height was significantly higher in men than in women (P = 0.024). In dentate patients, the mean MSS height was similar among the three regions. In edentulous patients, the anterior mean MSS height (4.96 ± 2.77 mm) was lower than that of the other two regions. There was no statistically significant association between septa and alveolar bone height in any anatomic region, in either group (r = 0.022; P = 0.748). CONCLUSIONS: These results suggest that MSS height is not influenced by alveolar bone height.

Alcohol Contributes to Attraction of Heliothis (= Chloridea) virescens Males to Females.

Female-emitted volatile sex pheromones in most moths are composed of biosynthetically related blends of fatty acid derivatives, such as aldehydes, acetate esters and alcohols. In many moths, as in the noctuid Heliothis (Chloridea) virescens, the pheromone gland contains alcohols (e.g., (Z)-11-hexadecen-1-ol, hereafter Z11-16:OH) that may serve dual functions as pheromone components as well as precursors of other pheromone components. The relative importance of Z11-16:OH to male attraction in H. virescens has been controversial. It occurs in the pheromone gland in relatively large amounts, but several studies could neither detect Z11-16:OH in gland emissions nor attribute any conspecific behavioral function to it in flight- tunnel assays. Trapping assays in the field, however, have more consistently documented that the addition of Z11-16:OH increased trap catch. Using a short section of thick film megabore column, in combination with derivatization and GC-CI-SIM-MS, we determined that Z11-16:OH is emitted from the sex pheromone gland during calling. Field trapping studies demonstrated that trap catch increased when Z11-16:OH was added to a 2-component minimal blend and to a 6-component blend. Behavioral observations in the field confirmed that more males responded to a pheromone blend that contained a low blend ratio of Z11-16:OH, but ≥5% Z11-16:OH depressed both male behavior and trap catch. We conclude that Z11-16:OH should be considered a component of the sex pheromone of H. virescens females.

Body Topography Parcellates Human Sensory and Motor Cortex.

The cytoarchitectonic map as proposed by Brodmann currently dominates models of human sensorimotor cortical structure, function, and plasticity. According to this model, primary motor cortex, area 4, and primary somatosensory cortex, area 3b, are homogenous areas, with the major division lying between the two. Accumulating empirical and theoretical evidence, however, has begun to question the validity of the Brodmann map for various cortical areas. Here, we combined in vivo cortical myelin mapping with functional connectivity analyses and topographic mapping techniques to reassess the validity of the Brodmann map in human primary sensorimotor cortex. We provide empirical evidence that area 4 and area 3b are not homogenous, but are subdivided into distinct cortical fields, each representing a major body part (the hand and the face). Myelin reductions at the hand-face borders are cortical layer-specific, and coincide with intrinsic functional connectivity borders as defined using large-scale resting state analyses. Our data extend the Brodmann model in human sensorimotor cortex and suggest that body parts are an important organizing principle, similar to the distinction between sensory and motor processing.

Accuracy of Hysteroscopic Metroplasty With the Combination of Presurgical 3-Dimensional Ultrasonography and a Novel Graduated Intrauterine Palpator: A Randomized Controlled Trial.

UNLABELLED: STUDY OBJECTIVE: To assess whether the use of a novel graduated intrauterine palpator can improve the accuracy of hysteroscopic metroplasty, introducing objective intraoperative criteria. DESIGN: A prospective randomized study (Canadian Task Force I, evidence obtained from a properly design, randomized, controlled trial). SETTING: University Federico II hysteroscopic clinic. PATIENTS: Ninety women with a uterine septum diagnosed during office hysteroscopy and 3-dimesional transvaginal ultrasound (3D-TVS) were randomized into 2 groups: group T (metroplasty with intrauterine palpator) (n = 45) and group C (metroplasty without intrauterine palpator) (n = 45). INTERVENTIONS: Outpatient hysteroscopic metroplasty under conscious sedation using a 5-mm hysteroscope and miniaturized 5F instruments including a bipolar electrode for the removal of three quarters of the septum, blunt scissors to refine the base of the septum, and an intrauterine palpator to measure the portion of the removed septum (only group T). 3D-TVS and second-look hysteroscopy were used to identify the number of optimal (residual septum <5 mm), suboptimal (residual septum 5-10 mm), and incomplete resections (residual septum >10 mm). In group T, metroplasty was stopped when the intrauterine palpator showed that the resected septum corresponded to presurgical ultrasonographic measurements in order to obtain a fundal notch of 1.0 cm. In group C, metroplasty was interrupted once the tubal ostia were clearly visible on the same line and/or hemorrhage from small myometrial vessels of the fundus was observed. MEASUREMENTS AND MAIN RESULTS: No differences were observed in baseline characteristics between the 2 groups. The proportion of patients with complete septum resection was significantly higher in group T (71.5% vs 41%, χ(2): p = .006; relative risk: 1.684; 95% confidence interval, 1.116-2.506). Suboptimal resection was achieved in 13 cases (28.5%) in group T and 14 cases (20%) in group C, whereas incomplete resection was observed in only 12 patients in group C (27%). CONCLUSION: Presurgical evaluation with 3D-TVS together with the use of a graduate intrauterine palpator improves the accuracy of hysteroscopic metroplasty, allowing complete removal of a uterine septum in 1 surgical step.

Assessment of Abdominal Ultrasound Guidance in Hysteroscopic Metroplasty.

STUDY OBJECTIVES: To compare the rates of re-intervention, and immediate and later complications associated with abdominal ultrasound-guided versus unguided hysteroscopic metroplasty in the surgical repair of European Society of Human Reproduction and Embryology/European Society for Gynecological Endoscopy class II intrauterine septa. DESIGN: We performed a large observational retrospective study (Canadian Task Force Classification II-2) in a selection of patients who underwent metroplasty in a tertiary university center between 2009 and 2013. PATIENTS: A total of 108 patients were included in the study. INTERVENTIONS: Patients were categorized as having abdominal ultrasound-guided metroplasty (n = 46) or unguided metroplasty (n = 62). MEASUREMENTS AND MAIN RESULTS: Data were collected with regard to medical and reproductive histories, diagnosis of septate uterus, surgical procedures, and complications. Using these data, the need for re-intervention and complication rates were compared between groups. Statistical analysis was performed using Fisher's exact test and Student's t-test. The characteristics of the 2 groups were comparable. A persistent septum of >10 mm, defined by 3-dimensional ultrasound hysterosonography, with a need for re-intervention, was found in 16 patients (39.0 %) in the unguided group versus 7 patients (18.4 %) in the ultrasound guidance group (p = .04). Risk of a persistent septum after resection (>10 mm) was reduced with ultrasound guidance (odds ratio = 0.35; 95% confidence interval 0.13-0.99). Two uterine perforations occurred in our series; both were in the unguided group. CONCLUSIONS: A systematic abdominal ultrasound-guided metroplasty by hysteroscopy seems to reduce the rates of re-intervention.

Histological Structure and Vascularity of Hysteroscopically Removed Uterine Septa in Patients With Primary Infertility and Patients With Recurrent Pregnancy Loss.

OBJECTIVE: To examine the histological structure and vascularity of uterine septa in patients with unexplained primary infertility and patients with recurrent pregnancy loss (RPL). DESIGN: Case-control study (Canadian Task Force classification II-2). SETTING: Kasr Al Aini Hospital, Cairo University, Egypt. PATIENTS AND INTERVENTIONS: A total of 41 patients with uterine septa presenting with either unexplained primary infertility or RPL underwent 3-dimensional (3D) and power Doppler (PD) ultrasound to calculate the septum volume, septal vascularization index (VI), and myometrial VI. Hysteroscopically removed septa were examined histologically for myometrial and fibrous tissue content. MEASUREMENTS AND MAIN RESULTS: Septal characteristics differed between the primary infertility group (24 patients) and the RPL group (17 patients). Mean septal VI was significantly higher in the RPL group compared with the infertility group (18.39% ± 7.57% vs 11.67% ± 4.56%; p = .003), as was septal myometrial area (20.74% ± 5.97% vs 13.57% ± 5.55%; p < .001). In both groups, septal VI was strongly correlated with myometrial VI and myometrial content, but not with fibrous tissue content. CONCLUSION: Uterine septa of patients with RPL are more vascularized and contain more muscular tissue compared with those of patients with primary unexplained infertility.

Automated High-Performance Analysis of Lung Morphometry.

Automation of lung morphometric analysis is an asset in the study of lung pathophysiology because it is an assurance of robustness, reproducibility, and rapidity. The novel automated morphometric approach presented here meets these criteria. This new method collects multiple parameters, allowing quantitative elucidation of the pathophysiology of the developing and mature lungs. The automated morphometric analysis is reliable and allows the analysis of a greater proportion of each lung together with a higher number of samples and superior reproducibility than manual analysis. The use of this method revealed that treatment with 80% oxygen and lung development presented an opposite effect on most of the analyzed parameters. In conclusion, this novel approach allowed the collection of new fundamental morphometric data on lung development and a deeper comprehension of the effect of hyperoxia.