Multiple ligation of the proximal greater saphenous vein in the CHIVA treatment of primary varicose veins

Saphenous femoral disconnection is the key point of most surgical techniques in the treatment of primary varicose vein surgery. The aim of this study is to compare and analyze different techniques for conservative saphenousfemoral ligation or disconnection. These techniques can be to perform mini invasive open surgery and are suitable for implementation of the conservative hemodynamic correction of venous insufficiency (CHIVA) method. The aim was to present the follow-up by retrospective analysis of three different ligation-disconnection techniques of the proximal great saphenous vein (GSV) according to the CHIVA method at the GSV end, i.e. between the very end of the GSV and the first arch tributary, according to the CHIVA method. The first thecnique consisted of a surgical division (crossotomy). The other two consisted of triple superposed ligation with No. 2 non-absorbable braided coated suture without division labeled TSFL (triple saphenous flush ligation) and No. 0 polypropylenene ligation TPL (triple polypropylene ligation). The difference between TSFL and TPL was in the thickness and type of material of the thread, though both were non-absorbable. The follow up of 56 TPL procedures, 61 crossotomy procedures, and 82 TSFL procedures was analysed. The follow-up consisted of checking the sapheno-femoral junction occlusion with Duplex color ultra sound. The incidence rates of neovascularization (new vessels in the ligation or surgical disconnection site with saphenous-femoral reflux during the Valsalva maneuver) were: 4.9% for the crossotomy group, 6.1% for the TSFL group and 37.5% for the TPL group. The data analysed show satisfactory results with both crossotomy and TSFL. Crossotomy has proven to be an effective technique for performing saphenous-femoral disconnection, but TSFL could also be a reliable, safe and low-cost varicose mini-invasive surgery in outpatients. TPL appeared to be less reliable

Anti-infective effects of sugar-vaseline mixture on leg ulcers

Fifty patients affected of resistant leg ulcers where treated exclusively with a vaseline-glucose mixture in combination with an etiologic treatment. Neither additional topical, systemic anti-infective drugs nor surgical debridement were applied. The dressing turnover rate was 6-7 days. A first bacteriological sampling was followed by a second one (40 days mean), which showed 100% sterilized ulcers. A complete scaring was achieved in 46 (92%) on average of 109 days of apply. This efficient, low cost, painless and quick treatment could proposed as a first line option

Dynamics of Membrane Potential Variation and Gene Expression Induced by <em>Spodoptera littoralis</em>, <em>Myzus persicae</em>, and <em>Pseudomonas syringae</em> in Arabidopsis

<div><h3>Background</h3><p>Biotic stress induced by various herbivores and pathogens invokes plant responses involving different defense mechanisms. However, we do not know whether different biotic stresses share a common response or which signaling pathways are involved in responses to different biotic stresses. We investigated the common and specific responses of <em>Arabidopsis thaliana</em> to three biotic stress agents: <em>Spodoptera littoralis</em>, <em>Myzus persicae</em>, and the pathogen <em>Pseudomonas syringae</em>.</p> <h3>Methodology/Principal Findings</h3><p>We used electrophysiology to determine the plasma membrane potential (V_m) and we performed a gene microarray transcriptome analysis on Arabidopsis upon either herbivory or bacterial infection. V_m depolarization was induced by insect attack; however, the response was much more rapid to <em>S. littoralis</em> (30 min −2 h) than to <em>M. persicae</em> (4–6 h). <em>M. persicae</em> differentially regulated almost 10-fold more genes than by <em>S. littoralis</em> with an opposite regulation. <em>M. persicae</em> modulated genes involved in flavonoid, fatty acid, hormone, drug transport and chitin metabolism. <em>S. littoralis</em> regulated responses to heat, transcription and ion transport. The latest Vm depolarization (16 h) was found for <em>P. syringae</em>. The pathogen regulated responses to salicylate, jasmonate and to microorganisms. Despite this late response, the number of genes differentially regulated by <em>P. syringae</em> was closer to those regulated by <em>S. littoralis</em> than by <em>M. persicae</em>.</p> <h3>Conclusions/Significance</h3><p>Arabidopsis plasma membranes respond with a V_m depolarization at times depending on the nature of biotic attack which allow setting a time point for comparative genome-wide analysis. A clear relationship between V_m depolarization and gene expression was found. At V_m depolarization timing, <em>M. persicae</em> regulates a wider array of Arabidopsis genes with a clear and distinct regulation than <em>S. littoralis</em>. An almost completely opposite regulation was observed between the aphid and the pathogen, with the former suppressing and the latter activating Arabidopsis defense responses.</p> </div

GO analysis of Arabidopsis genes regulated by <i>Myzus persicae</i> herbivory.

<p>Red color indicates up-regulation, green color indicates down-regulation.</p

Plasma transmembrane potential (V_m) depolarization measured in Arabidopsis mesophyll leaves at different times upon herbivory by <i>Spodoptera littoralis</i> and <i>Myzus persicae</i> and infection by <i>Pseudomonas syringae</i>.

<p>Chewing herbivore induces a fast V_m depolarization that lasts about 4–6 h from feeding, whereas phloem feeding induces a V_m depolarization that occurs after about 6 h from feeding. Infection by <i>P. syringae</i> causes a V_m depolarization about 16 h after infection. No matter the biotic stress the level of the highest V_m depolarization shows the same value (statistical significance P>0.05). For each time point at least 50 measurements were performed. The timing of V_m depolarization depends on biotic damage. Bars represent standard error, different letters indicate significant (P<0.05) differences.</p

Cluster analysis of commonly regulated genes in Arabidopsis fed by the herbivores <i>Myzus persicae</i> and <i>Spodoptera littoralis</i> and infected by <i>Pseudomonas syringae</i>.

<p><i>M. persicae</i> shows a lower statistical linkage with <i>S. littoralis</i> and <i>P. syringae</i>, which are linked together.</p

GO analysis of Arabidopsis genes regulated by <i>Pseudomonas syringae</i> infection.

<p>Red color indicates up-regulation, green color indicates down-regulation.</p

GO analysis of Arabidopsis commonly expressed genes upon <i>Pseudomonas syringae</i> (<i>PS</i>) infection and <i>Spodoptera littoralis</i> (<i>SL</i>) herbivory.

<p>Red color indicates up-regulation, green color indicates down-regulation.</p

<i>Arabidopsis thaliana</i> genes commonly expressed at the time of Vm depolarization upon <i>Spodoptera littoralis</i> (2 h) and <i>Myzus persicae</i> (5 h) herbivory and <i>Pseudomonas syringae</i> (16 h) infection.

<p>Values are expressed as fold change with respect to controls (P<0.05). AGI, Arabidopsis Genome Initiative gene index.</p