Abdominal closure with different oblique planes in island TRAM flaps: a method for achieving a better scar and contour of the donor site

Background An autologous abdominal flap can provide an aesthetically pleasing breast with a natural feel. However, contracted scars and hourglass contour deformities at the abdominal donor site can sometimes occur. These complications can reduce patient satisfaction and quality of life. Therefore, we performed different oblique plane closure of the abdominal donor site and evaluated the aesthetic scores in comparison with the conventional vertical single plane closure. Methods The procedures begin with a beveled incision down to the fascia level during transverse rectus abdominis muscle flap elevation. At the time of donor site closure, Scarpa’s fascia and the subcutaneous layers are sutured while being pulled downward. Sixty patients were divided into two groups: group A (single vertical plane closure) and group B (different oblique plane closure). Abdominal scars were scored by five reviewers using the scar scale. Results There were no significant differences in scores for vascularization, dog-ear presence, and umbilical shape of the scar between the two groups. However, group B showed marked improvements in flatness, contracture, and thickness of the scar surface. Notably, the different oblique plane closure in group B achieved much higher scores for the abdominal contour than group A. Conclusions The vertical single plane suture of the abdominal donor site may result in depressive contracture with poor cosmetic outcomes. The different oblique plane closure technique markedly improved the appearance of scars on the abdomen. This technique is likely to enhance patient satisfaction with both the breast and abdominal outcomes of breast reconstruction using an abdominal flap

Full-length genomic analysis of korean porcine sapelovirus strains.

Porcine sapelovirus (PSV), a species of the genus Sapelovirus within the family Picornaviridae, is associated with diarrhea, pneumonia, severe neurological disorders, and reproductive failure in pigs. However, the structural features of the complete PSV genome remain largely unknown. To analyze the structural features of PSV genomes, the full-length nucleotide sequences of three Korean PSV strains were determined and analyzed using bioinformatic techniques in comparison with other known PSV strains. The Korean PSV genomes ranged from 7,542 to 7,566 nucleotides excluding the 3' poly(A) tail, and showed the typical picornavirus genome organization; 5'untranslated region (UTR)-L-VP4-VP2-VP3-VP1-2A-2B-2C-3A-3B-3C-3D-3'UTR. Three distinct cis-active RNA elements, the internal ribosome entry site (IRES) in the 5'UTR, a cis-replication element (CRE) in the 2C coding region and 3'UTR were identified and their structures were predicted. Interestingly, the structural features of the CRE and 3'UTR were different between PSV strains. The availability of these first complete genome sequences for PSV strains will facilitate future investigations of the molecular pathogenesis and evolutionary characteristics of PSV

Association between red blood cell storage duration and clinical outcome in patients undergoing off-pump coronary artery bypass surgery: a retrospective study

Background: Prolonged storage of red blood cells (RBCs) leads to fundamental changes in both the RBCs and the storage media. We retrospectively evaluated the relationship between the RBC age and in-hospital and long-term postoperative outcomes in patients undergoing off-pump coronary artery bypass. Methods: The electronic medical records of 1,072 OPCAB patients were reviewed and information on the transfused RBCs and clinical data were collected. The effects of RBCs age (mean age, oldest age of transfused RBCs, any RBCs older than 14 days) on various in-hospital postoperative complications and long-term major adverse cardiovascular and cerebral events over a mean follow-up of 31 months were investigated. Correlations between RBCs age and duration of intubation, intensive care unit, or hospital stay, and base excess at the first postoperative morning were also analyzed. Results: After adjusting for confounders, there was no relationship between the RBCs age and in-hospital and long-term clinical outcomes except for postoperative wound complications. A significant linear trend was observed between the oldest age quartiles of transfused RBCs and the postoperative wound complications (quartile 1 vs. 2, 3 and 4: OR, 8.92, 12.01 and 13.79, respectively; P for trend = 0.009). The oldest transfused RBCs showed significant relationships with a first postoperative day negative base excess (P = 0.021), postoperative wound complications (P = 0.001), and length of hospital stay (P = 0.008). Conclusions: In patients undergoing off-pump coronary artery bypass, the oldest age of transfused RBCs were associated with a postoperative negative base excess, increased wound complications, and a longer hospital stay, but not with the other in-hospital or long-term outcomes.Peer Reviewe

AP-1-Targeting Anti-Inflammatory Activity of the Methanolic Extract of Persicaria chinensis

In traditional Chinese medicine, Persicaria chinensis L. has been prescribed to cure numerous inflammatory disorders. We previously analyzed the bioactivity of the methanol extract of this plant (Pc-ME) against LPS-induced NO and PGE2 in RAW264.7 macrophages and found that it prevented HCl/EtOH-induced gastric ulcers in mice. The purpose of the current study was to explore the molecular mechanism by which Pc-ME inhibits activator protein- (AP-) 1 activation pathway and mediates its hepatoprotective activity. To investigate the putative therapeutic properties of Pc-ME against AP-1-mediated inflammation and hepatotoxicity, lipopolysaccharide- (LPS-) stimulated RAW264.7 and U937 cells, a monocyte-like human cell line, and an LPS/D-galactosamine- (D-GalN-) induced acute hepatitis mouse model were employed. The expression of LPS-induced proinflammatory cytokines including interleukin- (IL-) 1β, IL-6, and tumor necrosis factor-α (TNF-α) was significantly diminished by Pc-ME. Moreover, Pc-ME reduced AP-1 activation and mitogen-activated protein kinase (MAPK) phosphorylation in both LPS-stimulated RAW264.7 cells and differentiated U937 cells. Additionally, we highlighted the hepatoprotective and curative effects of Pc-ME pretreated orally in a mouse model of LPS/D-GalN-intoxicated acute liver injury by demonstrating the significant reduction in elevated serum AST and ALT levels and histological damage. Therefore, these results strongly suggest that Pc-ME could function as an antihepatitis remedy suppressing MAPK/AP-1-mediated inflammatory events

Porcine Sapelovirus Uses α2,3-Linked Sialic Acid on GD1a Ganglioside as a Receptor.

UNLABELLED: The receptor(s) for porcine sapelovirus (PSV), which causes diarrhea, pneumonia, polioencephalomyelitis, and reproductive disorders in pigs, remains largely unknown. Given the precedent for other picornaviruses which use terminal sialic acids (SAs) as receptors, we examined the role of SAs in PSV binding and infection. Using a variety of approaches, including treating cells with a carbohydrate-destroying chemical (NaIO4), mono- or oligosaccharides (N-acetylneuraminic acid, galactose, and 6'-sialyllactose), linkage-specific sialidases (neuraminidase and sialidase S), lectins (Maakia amurensislectin andSambucus nigralectin), proteases (trypsin and chymotrypsin), and glucosylceramide synthase inhibitors (dl-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol and phospholipase C), we demonstrated that PSV could recognize α2,3-linked SA on glycolipids as a receptor. On the other hand, PSVs had no binding affinity for synthetic histo-blood group antigens (HBGAs), suggesting that PSVs could not use HBGAs as receptors. Depletion of cell surface glycolipids followed by reconstitution studies indicated that GD1a ganglioside, but not other gangliosides, could restore PSV binding and infection, further confirming α2,3-linked SA on GD1a as a PSV receptor. Our results could provide significant information on the understanding of the life cycle of sapelovirus and other picornaviruses. For the broader community in the area of pathogens and pathogenesis, these findings and insights could contribute to the development of affordable, useful, and efficient drugs for anti-sapelovirus therapy. IMPORTANCE: The porcine sapelovirus (PSV) is known to cause enteritis, pneumonia, polioencephalomyelitis, and reproductive disorders in pigs. However, the receptor(s) that the PSV utilizes to enter host cells remains largely unknown. Using a variety of approaches, we showed that α2,3-linked terminal sialic acid (SA) on the cell surface GD1a ganglioside could be used for PSV binding and infection as a receptor. On the other hand, histo-blood group antigens also present in the cell surface carbohydrates could not be utilized as PSV receptors for binding and infection. These findings should contribute to the understanding of the sapelovirus life cycle and to the development of affordable, useful and efficient drugs for anti-sapelovirus therapy.This study was supported by Wellcome Trust (097997/Z/11/Z) and a grant from Basic Science Research Program through the National Research Foundation of Korea (NRF). This study was also supported by Bio-industry Technology Development Program through the Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries (iPET) funded by the Ministry of Agriculture, Food and Rural Affairs, and Chonnam National University (2013). IG is a Wellcome Senior Fellow supported by the Wellcome Trust (097997/Z/11/Z).This is the final version of the article. It first appeared from the American Society for Microbiology via http://dx.doi.org/10.1128/JVI.02449-1

Pathogenesis of Korean SapelovirusA in piglets and chicks.

Sapelovirus A (SV-A), formerly known as porcine sapelovirus as a member of a new genus Sapelovirus, is known to cause enteritis, pneumonia, polioencephalomyelitis and reproductive disorders in pigs. We have recently identified α2,3-linked sialic acid on GD1a ganglioside as a functional SV-A receptor rich in the cells of pigs and chickens. However, the role of GD1a in viral pathogenesis remains elusive. Here, we demonstrated that a Korean SV-A strain could induce diarrhoea and intestinal pathology in piglets but not in chicks. Moreover, this Korean SV-A strain had mild extra-intestinal tropisms appearing as mild, non-suppurative myelitis, encephalitis and pneumonia in piglets, but not in chicks. By real-time reverse transcription (RT) PCR, higher viral RNA levels were detected in faecal samples than in sera or extra-intestinal organs from virus-inoculated piglets. Immunohistochemistry confirmed that high viral antigens were detected in the epithelial cells of intestines from virus-inoculated piglets but not from chicks. This Korean SV-A strain could bind the cultured cell lines originated from various species, but replication occurred only in cells of porcine origin. These data indicated that this Korean SV-A strain could replicate and induce pathology in piglets but not in chicks, suggesting that additional porcine-specific factors are required for virus entry and replication. In addition, this Korean SV-A strain is enteropathogenic, but could spread to the bloodstream from the gut and disseminate to extra-intestinal organs and tissues. These results will contribute to our understanding of SV-A pathogenesis so that efficient anti-sapelovirus drugs and vaccines could be developed in the future.This study was supported by a grant (2014R1A2A2A01004292) of the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning, Bio-industry Technology Development Program (315021-04) through the Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries (iPET) funded by the Ministry of Agriculture, Food and Rural Affairs, and Korea Basic Science Institute grant (C33730), Republic of Korea. IG is a Wellcome Senior Fellow supported by the Wellcome Trust (097997/Z/11/Z). Chonnam National University provided funding to Mun-Il Kang (2012). The Mab against SV-A capsid protein was received as a generous gift from Dr. M. Dauber (Friedrich-Loeffler Institute, Germany).This is the accepted version of the article. The final version is available from the Microbiology Society via http://dx.doi.org/10.1099/jgv.0.00057

Pore Size Distribution Analysis of Mesoporous TiO2 Spheres by H-1 Nuclear Magnetic Resonance (NMR) Cryoporometry

Mesoporous TiO2, spheres with various pore sizes were prepared by varying the calcination temperature in the range of 300-700 degrees C. Increasing, calcination temperature was found to increase the crystal size, decrease the surface area, and increase the pore size. The morphologies of mesoporous TiO2 spheres consist of well-defined spherical shapes of monodisperse sizes near 0.8 mu m. To determine the pore size distributions (PSDs) of these mesoporous TiO2 spheres, Ill nuclear magnetic resonance (NMR) cryoporometry and Barrett-Joyner-Halenda (BJH) analysis were conducted. NMR cryoporometry is based on the theory of the melting point depression (MPD) of probe molecule confined within a pore. which is dependent on the pore diameter. MPD was determined by analyzing the variation of the NMR spin echo intensity with temperature. From the resulting spin echo intensity versus temperature (l-T) curves, it was found that the maximum MPD of a probe molecule confined within the pores of mesoporous TiO2 decreases with increasing calcination temperature; that is, the pore size increases with increasing calcination temperature. Because mesoporous TiO2 spheres consist of aggregates of nanocrystallite TiO2 and mesopores located at intercrystallites. in increase in the calcination temperature induces an increase in the crystallite size and, thus, in the pore size because the small pores collapse and die large pores increase in size. We also confirmed by BJH analysis that the pore size of mesoporous TiO2 increases with increasing calcination temperature. This trend is hi agreement with our H-1 NMR cryoporometry results. Overall, these findings indicate that NMR cryoporometry is a very effective method for determining the PSDs of mesoporous TiO2 spheres

Rhabdomyolysis after the free fibular flap operation for mandibular reconstruction: a case report

Abstract Background Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxilla-mandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. Case presentation In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. Conclusions Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis

Effectiveness of Collagen Membrane in the Treatment of Schneiderian Membrane Perforation

Schneiderian membrane perforation (SMP) is the most common complication encountered during sinus lift procedures. SMPs should be managed to prevent loss of the valuable bone graft and bone substitute materials. A fast-resorbing collagen membrane (CM) is a soft, white, pliable, and nonfriable sponge used in dental surgery. The purpose of this study was to evaluate the clinical outcomes of SMP repair using CMs when an SMP had occurred during a sinus lifting procedure. The patients were divided into three groups according to the size of the SMPs during the sinus lift procedure. (A) Group 1: there was no perforation of the Schneiderian membrane but the membrane was weakened (or thinned) and repaired using CMs. (B) Group 2: the SMP was small to medium in size (< 10 mm) and repaired using CMs and fibrin adhesive (FA). (C) Group 3: the SMP was large in size (> 10 mm) and repaired using a collagen plug. The negative control group consisted of patients who did not have any SMP (Control) and these patients were randomly selected. Orthopantomographic X-rays taken before surgery, 2–3 days following surgery, and over 6 months after surgery (follow-up) were used to evaluate the acquired bone height according to groups. Bone heights were measured from the crestal bone at the planned implant placement sites. Clinical outcomes, including implant success and complications according to repair method, were also investigated. There was no significant difference in bone heights between the groups with the exception of group 3. The overall implant survival rate was 100% for implants placed in sinuses with frank SMPs or weakened sinus membranes. The CM is applicable for small-to-moderate perforations or sinus membranes which have been weakened or thinned during sinus lift procedures

Performance Comparison of CdTe:Na, CdTe:As, and CdTe:P Single Crystals for Solar Cell Applications

We compared thermal stability, open-circuit voltage, short-circuit current, and fill factor values of single-crystal Cadmium telluride (CdTe) grown using the vertical Bridgman (VB) technique and doped with group V elements (phosphorus and arsenic), and group Ⅰ element (sodium), followed by an annealing process. The sodium-doped CdTe maintained a hole density of 1016 cm−3 or higher; after annealing for a long time, this decreased to 1015 cm−3 or less. The arsenic-doped CdTe maintained a hole density of approximately 1016 cm−3 even after the annealing process; however its bulk minority carrier lifetime decreased by approximately 10%. The phosphorus-doped CdTe maintained its properties after the annealing process, ultimately achieving a hole density of ~1016 cm−3 and a minority carrier lifetime of ~40 ns. The characteristics of a single-crystal solar cell were evaluated using a solar cell device that contained single-crystal CdTe with various dopants. The sodium-doped sample exhibited poor interfacial properties, and its performance decreased rapidly during annealing. The samples doped with group V elements exhibited stable characteristics even during long-term annealing. We concluded, therefore, that group V elements dopants are more suitable for CdTe single-crystal-based solar cell applications involving thermal stress conditions, such as space missions or extreme fabrication temperature environments