Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer

Treatment of isoniazid-resistant pulmonary tuberculosis

<p>Abstract</p> <p>Background</p> <p>Although resistance to isoniazid (INH) is the most common form of drug resistance seen among <it>Mycobacterium tuberculosis </it>isolates, there have been few studies on the efficacy and optimal duration of treatment for patients with INH-resistant tuberculosis (TB).</p> <p>Methods</p> <p>We evaluated retrospectively the treatment outcomes of 39 patients who were treated for INH-resistant pulmonary TB. The treatment regimens consisted of a 12-month regimen of rifampin (RIF) and ethambutol (EMB), with pyrazinamide (PZA) given during the first 2 months (2HREZ/10RE) (<it>n </it>= 21), a 9-month regimen of RIF and EMB with PZA during the first 2 months (2HREZ/7RE) (<it>n </it>= 5), and a 6-month regimen of RIF, EMB, and PZA (2HREZ/4REZ) (<it>n </it>= 13). After drug susceptibility testing confirmed the INH-resistance of the isolated <it>M. tuberculosis </it>strains, INH was discontinued for all the patients.</p> <p>Results</p> <p>Among the 39 patients, treatment was successfully completed by 36 patients (92%). However, treatment failure occurred, and acquired resistance to other first-line drugs, such as RIF, developed in three patients (8%). Cavitary and bilateral extensive lesions were commonly found in the chest radiographs of the patients who exhibited treatment failure.</p> <p>Conclusion</p> <p>These findings underline the seriousness of concerns regarding treatment failure and the development of multidrug-resistant TB in patients with INH-resistant TB following treatment with recommended regimens.</p

Drug Resistance Rates of Mycobacterium tuberculosis at a Private Referral Center in Korea

The goals of this study were to identify first-line drug resistance in new and previously treated tuberculosis (TB) cases and to determine risk factors for multidrug-resistant TB (MDR-TB) at a private referral center in Korea. All patients with culture-confirmed pulmonary TB over a 2-yr period between July 2002 and June 2004 were prospectively included in this study. In total, 637 patients were included; 512 (80.4%) were new cases, and 125 (19.6%) were previously treated cases. Resistance to at least one first-line drug was identified in 11.7% of new cases and 41.6% of previously treated cases. MDR-TB was detected in 3.9% of new cases and 27.2% of previously treated cases. The proportion of extensively drug-resistant TB among MDR-TB patients was 16.7% (9/54). Factors associated with MDR-TB included age under 45 yr, previous TB treatment, and the presence of cavitation on chest radiography. Rates of first-line drug resistance are high, particularly in previously treated patients, in the private sector in Korea. This underscores the need for an improved control program, coupled with early diagnosis of MDR-TB, to reduce the spread and development of resistance

Additional file 1 of CRISPR base editing-mediated correction of a tau mutation rescues cognitive decline in a mouse model of tauopathy

Additional file 1: Fig. S1. Adenine base editing frequencies induced by NG-ABE8e. Fig. S2. Intracranial delivery of tsAAV-NG-ABE8e into the hippocampus of PS19 mice. Fig. S3. RNA trans-splicing AAV encoding NG-ABE8e for targeted adenine base editing. Fig. S4. Genome-wide specificity of NG-ABE8e. Fig. S5. Representative image of immunoblot using anti-tau antibody between different lysis fractions. Fig. S6. Tau protein levels in soluble fraction of hippocampus. Fig. S7. Representative images and quantification of phospho-tau (AT8) staining of the mouse hippocampus. Fig. S8. The level of MAPT gene expression and gliosis. Fig. S9. Results from the Probe test of Morris water maze. Table S1. The sgRNA target sequences in this study. Table S2. List of primers used for targeted deep sequencing. Table S3. Potential off-target sites of NG-ABE8e targeted to MAPT or Rosa26 identified by Cas-OFFinder. Table S4. Information of antibodies used in this study. Materials and Methods

A Senolytic-Eluting Coronary Stent for the Prevention of In-Stent Restenosis

The vast majority of drug-eluting stents (DES) elute either sirolimus or one of its analogues. While limus drugs stymie vascular smooth muscle cell (VSMC) proliferation to prevent instent restenosis, their antiproliferative nature is indiscriminate and limits healing of the endothelium in stented vessels, increasing the risk of late-stent thrombosis. Oxidative stress, which is associated with vascular injury from stent implantation, can induce VSMCs to undergo senescence, and senescent VSMCs can produce proinflammatory cytokines capable of inducing proliferation of neighboring nonsenescent VSMCs. We explored the potential of senolytic therapy, which involves the selective elimination of senescent cells, in the form of a senolytic-eluting stent (SES) for interventional cardiology. Oxidative stress was modeled in vitro by exposing VSMCs to H2O2, and H2O2-mediated senescence was evaluated by cytochemical staining of senescence-associated beta galactosidase activity and qRT-PCR. Quiescent VSMCs were then treated with the conditioned medium (CM) of H2O2-treated VSMCs. Proliferative effects of CM were analyzed by staining for proliferating cell nuclear antigen. Senolytic effects of the firstgeneration senolytic ABT263 were observed in vitro, and the effects of ABT263 on endothelial cells were also investigated through an in vitro re-endothelialization assay. SESs were prepared by dip coating. Iliofemoral arteries of hypercholesteremic rabbits were implanted with SES, everolimus-eluting stents (EESs), or bare-metal stents (BMSs), and the area of stenosis was measured 4 weeks post-implantation using optical coherence tomography. We found that a portion of H2O2-treated VSMCs underwent senescence, and that CM of H2O2-treated senescent VSMCs triggered the proliferation of quiescent VSMCs. ABT263 reverted H2O2-mediated senescence and the proliferative capacity of senescent VSMC CM. Unlike everolimus, ABT263 did not affect endothelial cell migration and/or proliferation. SES, but not EES, significantly reduced stenosis area in vivo compared with bare-metal stents (BMSs). This study shows the potential of SES as an alternative to current forms of DES.N

New Bipolar Host Materials for Realizing Blue Phosphorescent Organic Light-Emitting Diodes with High Efficiency at 1000 cd/m²

New host molecules such as 9-(6-(9<i>H</i>-carbazol-9-yl)­pyridin-3-yl)-6-(9<i>H</i>-carbazol-9-yl)-9<i>H</i>-pyrido­[2,3-<i>b</i>]­indole (pPCB2CZ) and 9-(6-(9<i>H</i>-carbazol-9-yl)­pyridin-2-yl)-6-(9<i>H</i>-carbazol-9-yl)-9<i>H</i>-pyrido­[2,3-<i>b</i>]­indole (mPCB2CZ) were designed and synthesized for blue phosphorescent organic light-emitting diodes (PhOLEDs). The glass transition temperatures of two host molecules were measured higher than 120 °C, and the identical triplet energies were determined to be 2.92 eV for both molecules. The bis­(3,5-difluoro-2-(2-pyridyl)­phenyl-(2-carboxypyridyl)­iridium­(III) (FIrpic)-doped mPCB2CZ-based PhOLED exhibited practically useful driving voltage of 4.8 V in a simple organic three layer device configuration which has a smaller number of interfaces in conventional multilayer PhOLEDs. Also, the high quantum efficiency of 23.7% is reported at the practically useful brightness value of 1000 cd/m²