Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction

Elevation of the skin along with its deep fascia vascular network is a recent facility for flap design. The longitudinal trapezius fasciocutaneous flap was first introduced in 1996; at that time it did not receive much attention, although it has many significant benefits compared with other available procedures.Sixteen trapezius fasciocutaneous flaps were elevated in 15 patients for reconstruction of severe scarring of the neck and midface. All flaps were based on the deep branch of the transverse cervical artery and included the overlying fascia of the trapezius muscle. Delaying was applied for very long flaps. Two flaps developed minimal distal necrosis (10 cm below the muscle border). The results indicate that an extra-long back fascia flap based on the descending branch of the transverse cervical artery could be formed, which would be long enough to reconstruct the entire neck and safely transfer it to the midface.The vertical trapezius fasciocutaneous flap, with its abundant tissue, excellent blood supply, anatomic proximity, wide arc of rotation, and hidden donor site scar, provides a simple and reliable method for primary reconstruction of various midface and neck defects. Copyright © 2008 by Lippincott Williams & Wilkins

Extended vertical trapezius fasciocutaneous flap (back flap) in face and neck burn scar reconstruction

Elevation of the skin along with its deep fascia vascular network is a recent facility for flap design. The longitudinal trapezius fasciocutaneous flap was first introduced in 1996; at that time it did not receive much attention, although it has many significant benefits compared with other available procedures.Sixteen trapezius fasciocutaneous flaps were elevated in 15 patients for reconstruction of severe scarring of the neck and midface. All flaps were based on the deep branch of the transverse cervical artery and included the overlying fascia of the trapezius muscle. Delaying was applied for very long flaps. Two flaps developed minimal distal necrosis (10 cm below the muscle border). The results indicate that an extra-long back fascia flap based on the descending branch of the transverse cervical artery could be formed, which would be long enough to reconstruct the entire neck and safely transfer it to the midface.The vertical trapezius fasciocutaneous flap, with its abundant tissue, excellent blood supply, anatomic proximity, wide arc of rotation, and hidden donor site scar, provides a simple and reliable method for primary reconstruction of various midface and neck defects. Copyright © 2008 by Lippincott Williams & Wilkins

Long-term clinical outcomes of radical prostatectomy versus watchful waiting in localized prostate cancer patients: A systematic review and meta-analysis

Background: The present study aimed to compare the long-term clinical and functional outcomes of patients with clinically localized prostate cancer treated with radical prostatectomy compared to the watchful waiting. Methods: PubMed, Cochrane Central Register of Controlled Trials and reference lists of relevant marker studies were scrutinized from inception to Jan 2018. Two reviewers conducted data abstraction and quality assessment of included trials independently. Quality of included studies were assessed by using Cochrane checklist. Inverse-variance and Mantel-Haenszel estimates under random effects model were used to pool results as relative risks with 95 confidence interval. Heterogeneity was assessed by using I 2 . Results: Three randomized controlled trials with 1568 participants were included. Compared to watchful waiting, radical prostatectomy had no significant effect on all-cause mortality at 12-year follow-up. However, radical prostatectomy had significant effect on reducing prostate-cause mortality at 12-year follow-up. We found significant lower prostate-cause mortality in patients with PSA>10 and GS�7 scores who had undergone radical prostatectomy compared with patients in watchful waiting group. In addition, younger patients undergoing surgery developed lower distant metastases rate compared to another approach. Watchful waiting had a significant effect on erectile and urinary incontinence during 2 years. Conclusion: There was no significant difference between radical prostatectomy and watchful waiting on all-cause mortality. However, the radical prostatectomy was associated with statistically lower prostate-cause mortality and metastases rates. Compared with older men, younger men experienced better clinical outcomes. Moreover, watchful waiting had better effect on reducing erectile dysfunction and urinary incontinence among patients during 2 years compared to radical prostatectomy. © 2019, Iranian Journal of Public Health. All rights reserved

The Nrf1 CNC-bZIP Protein Is Regulated by the Proteasome and Activated by Hypoxia

BACKGROUND: Nrf1 (nuclear factor-erythroid 2 p45 subunit-related factor 1) is a transcription factor mediating cellular responses to xenobiotic and pro-oxidant stress. Nrf1 regulates the transcription of many stress-related genes through the electrophile response elements (EpREs) located in their promoter regions. Despite its potential importance in human health, the mechanisms controlling Nrf1 have not been addressed fully. PRINCIPAL FINDINGS: We found that proteasomal inhibitors MG-132 and clasto-lactacystin-β-lactone stabilized the protein expression of full-length Nrf1 in both COS7 and WFF2002 cells. Concomitantly, proteasomal inhibition decreased the expression of a smaller, N-terminal Nrf1 fragment, with an approximate molecular weight of 23 kDa. The EpRE-luciferase reporter assays revealed that proteasomal inhibition markedly inhibited the Nrf1 transactivational activity. These results support earlier hypotheses that the 26 S proteasome processes Nrf1 into its active form by removing its inhibitory N-terminal domain anchoring Nrf1 to the endoplasmic reticulum. Immunoprecipitation demonstrated that Nrf1 is ubiquitinated and that proteasomal inhibition increased the degree of Nrf1 ubiquitination. Furthermore, Nrf1 protein had a half-life of approximately 5 hours in COS7 cells. In contrast, hypoxia (1% O(2)) significantly increased the luciferase reporter activity of exogenous Nrf1 protein, while decreasing the protein expression of p65, a shorter form of Nrf1, known to act as a repressor of EpRE-controlled gene expression. Finally, the protein phosphatase inhibitor okadaic acid activated Nrf1 reporter activity, while the latter was repressed by the PKC inhibitor staurosporine. CONCLUSIONS: Collectively, our data suggests that Nrf1 is controlled by several post-translational mechanisms, including ubiquitination, proteolytic processing and proteasomal-mediated degradation as well as by its phosphorylation status

Preventing plagiarism in academic literature, lessons learned from European union member states

Background and Objectives: Plagiarism is the most prevalent type of scientific misconduct, and various rules and strategies have been proposed to combat it in different countries. A review of other countrieschr('39') experiences in this area contributes to good policymaking. The present study was conducted to introduce preventive interventions of plagiarism in the leading countries. Methods: The present study was a qualitative review study of applied practices. In this study, preventive interventions of scientific plagiarism in the 27 European ::::::::union:::::::: countries were studied due to the appropriate coherence and structural similarity at national, organizational, and individual levels. The national-level interventions were analyzed using the content analysis method in mentioned countries. Results: The results of analyzing the national-level interventions were categorized into eight main themes, including reaching a national agreement on examples of scientific plagiarism and misconduct; policy development; monitoring and supervision; financial support development; development of databanks and software; compiling educational programs for faculty members and students; dissemination and use of successful experiences; and eventually establishment of laws related to scientific misconduct, plagiarism, and punishments activities. Conclusion: Using preventive interventions at a national level proves the commitment and determination of policymakers to control and prevent plagiarism. Proper use of preventive interventions at a national level strengthens the controlling and preventive infrastructures of this issue at the organizational level, and enhances moral commitment and professional skills among the countrychr('39')s researchers