Archerdelacruz5164
The use of cryopreserved allogenic vascular graft in reconstructive microsurgery has rarely been reported. Here, we report a case of lower extremity reconstruction using cryopreserved hepatic artery as the vein conduit. Postoperative flap perfusion was uneventful with satisfactory wound healing, and graft patency was observed on follow-up color Doppler. Thus, cryopreserved allogenic vascular graft could be a source of vascular conduit in microsurgery.Castleman disease (CD) is a rare clinical entity characterized by enlarged lymph nodes. It may affect a single lymph node (unicentric) or multiple lymph nodes in the body (multicentric). However, it is exceptionally uncommon for unicentric Castleman disease (UCD) to present in the mesentery. Herein, we report a case of 38-year-old female complaining of polymenorrhea and abdominal discomfort for 4 months. Her past medical history was unremarkable; however, she has started smoking recently. The physical examination and radiography indicated a large, well-defined mass in the right hypochondrium. Eventually, the patient underwent laparotomy and the mass was excised totally. The Pathologic study confirmed the diagnosis as mesenteric CD, hyaline-vascular type. After 5 months of follow-up, the patient showed no evidence of recurrence. In conclusion, this case underscores the importance of taking mesenteric CD into consideration in each patient who presents with solid abdominal mass or ambiguous abdominal discomfort.The penile and scrotal skin are often resected after vulvar necrotizing fasciitis, so functional and aesthetic vulvar reconstruction is extremely challenging. With widespread and deepened infections, urethral fistulas can develop, forcing penis and scrotal amputations. In cases complicated with a urethral fistula, the wound cannot be treated by simple skin graft surgery, and complicated flap surgery is required. We verified that urethral functional reconstruction using a pedicled thigh flap is a useful technique for managing urethral cutaneous fistulas that develop after necrotizing fasciitis.Bilateral sagittal split osteotomy (BSSO) of the mandible according to Obwegeser/Dal Pont is considered to be gold standard in orthognathic surgery. Frequently reported complications of BSSO are injuries of the mandibular nerve resulting in paresthesia/anesthesia as well as inadequate mandibular bone fracturing ('bad split'). High oblique sagittal osteotomy (HOSO) was introduced to overcome these complications. We present an innovative HOSO modification using patient-specific 3D-printed cutting guides positioned on the outside of the ascending mandibular ramus and fixed in the incisura semilunaris, precisely marking the optimal height and angle of the osteotomy. Advantages are a decreased operation time due to the simplicity of this less invasive procedure, a potentially reduced frequency of mandibular nerve damage and bad splits as well as a lower bleeding risk.Giant inguinal hernias are defined as inguinal hernias that extend below the midpoint of the inner thigh when the patient is in the standing position or an anteroposterior diameter of at least 30 cm or a laterolateral diameter of ~50 cm with non-reducibility for >10 years. This article presents a 39-year-old male with a five-year history of a giant left inguinal hernia that was treated with left inguinal hernia repair with mesh, orchiectomy, complicated scrotoplasty, intraoperative ultrasound and aspiration of 3.9 L of fluid from the hernia sac. Surgical repair of giant inguinal hernias can be challenging and is associated with a variety of complications. Various modalities have been described to assist in hernia reduction including debulking, or, as in this case, aspiration of the hernia sac and a preperitoneal incision. Although the Lichtenstein tension free repair is commonly used, no standard approach has been accepted.Endometriosis is classically defined as 'the presence of endometrial glands and stroma outside of the uterine cavity and musculature'. Although it most commonly occurs in the pelvis, various extrapelvic locations have been reported in the literature. There seems to be a strong association between abdominal wall endometriomas and previous surgical scars. In female patients presenting with a cyclically painful abdominal wall mass, a high index of suspicion for endometrioma must be maintained, especially in the setting of previous gynecologic surgery. Although there may be a role for medical management of symptoms, the most definitive treatment of an abdominal wall endometrioma appears to be wide local excision with negative margins. This paper presents a 39-year-old female with an extensive gynecologic surgical history presenting with a 6 × 6 cm cyclically tender abdominal wall endometrioma treated with wide local excision.[This corrects the article DOI 10.1177/2042098616646726.].After short-term, acute-care hospitalization for stroke, patients may be discharged home or other facilities for continued medical or rehabilitative management. The site of postacute care affects overall mortality and functional outcomes. Determining discharge disposition is a complex decision by the healthcare team. Early prediction of discharge destination can optimize poststroke care and improve outcomes. Previous attempts to predict discharge disposition outcome after stroke have limited clinical validations. In this study, readmission status was used as a measure of the clinical significance and effectiveness of a discharge disposition prediction. Low readmission rates indicate proper and thorough care with appropriate discharge disposition. We used Medicare beneficiary data taken from a subset of base claims in the years of 2014 and 2015 in our analyses. A predictive tool was created to determine discharge disposition based on risk scores derived from the coefficients of multivariable logistic regressiog these readmissions.There has long been interest in both the tonic and phasic release of scent across a wide range of entertainment settings. While the presentation of semantically congruent scent has often been used in order to enhance people's immersion in a particular context, other generally less successful attempts have involved the pulsed presentation of a range of scents tied to specific events/scenes. Scents have even been released in the context of the casino to encourage the guests to linger for longer (and spend more), at least according to the results of one controversial study. In this narrative review, I want to take a closer look at the use of scent in a range of both physical and digital environments, highlighting the successes (as in the case of scented theme park rides) and frequent failures (as, seemingly, in the context of scent-enabled video games). While digitally inducing meaningful olfactory sensations is likely to remain a pipe dream for the foreseeable future, the digital control of scent release/delivery provides some limited opportunities to enhance the multisensory experience of entertainment. That said, it remains uncertain whether the general public will necessarily perceive the benefit, and hence be willing to pay for the privilege.Automated image-based plant identification has experienced rapid development and has been already used in research and nature management. However, there is a need for extensive studies on how accurately automatic plant identification works and which characteristics of observations and study species influence the results. We investigated the accuracy of the Flora Incognita application, a research-based tool for automated plant image identification. Our study was conducted in Estonia, Northern Europe. Photos originated from the Estonian national curated biodiversity observations database, originally without the intention to use them for automated identification (1496 photos, 542 species) were examined. Flora Incognita was also directly tested in field conditions in various habitats, taking images of plant organs as guided by the application (998 observations, 1703 photos, 280 species). Identification accuracy was compared among species characteristics plant family, growth forms and life forms, habitat type and guide further improvements of this application and automated plant identification in general.Restoration of dryland ecosystems is often limited by low seedling establishment and survival. Defoliation caused by insects and small mammals could be an overlooked cause of seedling mortality. In the sagebrush steppe, we examined the effect of seedling defoliation on the survival of perennial grasses commonly used as restoration materials. Under field conditions, seedlings of three perennial bunchgrass species (non-native Agropyron cristatum, and native grasses Poa secunda and Pseudoroegneria spicata) were defoliated at two intensities (30 % and 70 % leaf length removal) and frequencies (one or two clippings) and compared to a non-defoliated control. Following emergence the first year, clippings occurred at the two-leaf stage; a second clipping occurred 1 month later for repeated defoliation treatments. We monitored seedling survival and tillering for 2 years. We expected higher defoliation intensity and frequency to reduce survival for all species, but only a few treatments reduced Po. secunda survival. 6-Aminonicotinamide Conversely, larger-statured Triticeae (wheatgrasses) benefited from some defoliation treatments. In both years, A. cristatum survival increased with repeated defoliation at both intensities. Defoliation did not affect Ps. spicata survival in the first year, but a single defoliation in the second year resulted in increased survival. In both A. cristatum and Ps. spicata, higher-intensity defoliation reduced the boost to survival resulting from defoliation frequency. Seedlings with more tillers had greater survival probabilities, but tiller number was unaffected by defoliation. Further research may elucidate mechanisms seedlings use to compensate for or benefit from defoliation. In the meantime, managers should aim to select defoliation-tolerant species if they anticipate herbivory will be problematic for restoration sites.
Previous studies reported that melatonin exerts its effect on mesenchymal stem cell (MSC) survival and differentiation into osteogenic and adipogenic lineage. In the current study we aimed to explore the effect of melatonin on osteoporosis and relevant mechanisms.
Real-time qualitative polymerase chain reaction (RT-qPCR) and Western blot analysis were conducted to determine expression of
, and osteoblast differentiation-related genes in ovariectomy (OVX)-induced osteoporosis mice and the isolated bone marrow MSCs (BMSCs). Pre-conditioning with melatonin (1 μmol/l, 10 μmol/l and 100 μmol/l) was carried out in OVX mice BMSCs. Bone microstructure was analyzed using micro-computed tomography and the contents of alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase 5b (TRAP5b) were detected by enzyme-linked immunosorbent assay in serum. BMSC proliferation was measured by cell-counting kit (CCK)-8 assay. Alizarin red S (ARS) staining and ALP activity assay were performed to assess BMSC mineralization and calcification. The activity of the
/β-catenin pathway was evaluated by dual-luciferase reporter assay.
Melatonin prevented bone loss in OVX mice. Melatonin increased ALP expression and reduced TRAP5b expression.
and β-catenin were downregulated, while
was upregulated in the femur of OVX mice. Melatonin elevated
expression and then stimulated BMSC proliferation and osteogenic differentiation. Additionally,
diminished the expression of
, resulting in activated
/β-catenin pathway both
and
. Furthermore, melatonin was shown to ameliorate osteoporosis in OVX mice
the
/
/
/β-catenin axis.
Melatonin could potentially enhance osteogenic differentiation of BMSCs and retard bone loss through the
/
/
/β-catenin axis.
Melatonin could potentially enhance osteogenic differentiation of BMSCs and retard bone loss through the HGF/PTEN/Wnt/β-catenin axis.
