Reverse Facial-submental Artery Island Flap with Reinnervation of the Anterior Belly of the Digastric Muscle

Reconstruction of the upper lateral lip subunit is challenging, and use of several classical local flaps have been previously reported. However, these methods have drawbacks such as visible scarring, anatomic distortion, and functional disability. To obtain satisfactory results, preservation of perioral function is important. We report a case of functional upper lip reconstruction after tumor resection using a reverse facial-submental artery island flap with a reinnervated anterior belly of the digastric muscle (ABDM) without sacrificing the perioral structure. A 73-year-old man presented with basal cell carcinoma on the left upper lip which was widely excised, including the orbicularis oris muscle. The remaining 4 cm × 3.5 cm defect was reconstructed using a reverse facial-submental artery island flap with ipsilateral ABDM. The motor nerve of the ABDM was sutured with the stump of the buccal branch of the ipsilateral facial nerve. The postoperative course was uneventful, and good functional and esthetic recovery were observed at 12-month follow-up. This procedure may be an alternative option for reconstruction of lateral upper lip defects

Comparison of Protein Profiles of Gingival Crevicular Fluids Collected from Incisors, Canines, and Molars

Many studies have shown that gingival crevicular fluid （GCF） reflects the inflammatory state of local periodontal tissues. GCF has been collected from several types of teeth in previous studies. However, there is no report that characterizes GCF by the type of tooth. In the present study, the protein profiles of GCF from different sites were comprehensively compared with each other. GCF was sampled from six healthy adult men （21-31 years old） with healthy periodontal tissues. Three separate GCF samples were collected at the maxillary central incisor, canine, and first molar of each individual. The protein profiles of GCF were analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis and liquid chromatogram-tandem mass spectrometry （LC-MS/MS）. The band patterns on the sodium dodecyl sulfate polyacrylamide gel electrophoresis from the set of three GCF samples from each individual were similar, regardless of the type of tooth. The proteins contained in each band were identified by LC-MS/MS analysis, and they were found to be the same among the three GCF samples. A comprehensive and quantitative analysis of proteins in the GCF samples was performed by LC-MS/MS using isobaric tag labeling. In total, 86 proteins were identified in GCF. A small number of proteins were increased or decreased in GCF from the first molars compared with the other types of teeth in one or two individuals. However, overall, no proteins were found to exhibit a reproducibly different composition in any of the individuals. These analyses show that the protein profiles of GCF in healthy periodontal tissues are similar, regardless of the type of tooth

Chibby cooperates with 14-3-3 to regulate β-catenin subcellular distribution and signaling activity

β-Catenin functions in both cell–cell adhesion and as a transcriptional coactivator in the canonical Wnt pathway. Nuclear accumulation of β-catenin is the hallmark of active Wnt signaling and is frequently observed in human cancers. Although β-catenin shuttles in and out of the nucleus, the molecular mechanisms underlying its translocation remain poorly understood. Chibby (Cby) is an evolutionarily conserved molecule that inhibits β-catenin–mediated transcriptional activation. Here, we identified 14-3-3ε and 14-3-3ζ as Cby-binding partners using affinity purification/mass spectrometry. 14-3-3 proteins specifically recognize serine 20 within the 14-3-3–binding motif of Cby when phosphorylated by Akt kinase. Notably, 14-3-3 binding results in sequestration of Cby into the cytoplasm. Moreover, Cby and 14-3-3 form a stable tripartite complex with β-catenin, causing β-catenin to partition into the cytoplasm. Our results therefore suggest a novel paradigm through which Cby acts in concert with 14-3-3 proteins to facilitate nuclear export of β-catenin, thereby antagonizing β-catenin signaling

CFTR and Wnt/beta-catenin signaling in lung development

<p>Abstract</p> <p>Background</p> <p>Cystic fibrosis transmembrane conductance regulator (CFTR) was shown previously to modify stretch induced differentiation in the lung. The mechanism for CFTR modulation of lung development was examined by <it>in utero </it>gene transfer of either a sense or antisense construct to alter CFTR expression levels.</p> <p>The BAT-gal transgenic reporter mouse line, expressing β-galactosidase under a canonical Wnt/β-catenin-responsive promoter, was used to assess the relative roles of CFTR, Wnt, and parathyroid hormone-related peptide (PTHrP) in lung organogenesis. Adenoviruses containing full-length CFTR, a short anti-sense CFTR gene fragment, or a reporter gene as control were used in an intra-amniotic gene therapy procedure to transiently modify CFTR expression in the fetal lung.</p> <p>Results</p> <p>A direct correlation between CFTR expression levels and PTHrP levels was found. An inverse correlation between CFTR and Wnt signaling activities was demonstrated.</p> <p>Conclusion</p> <p>These data are consistent with CFTR participating in the mechanicosensory process essential to regulate Wnt/β-Catenin signaling required for lung organogenesis.</p

Post mortem activation of human blood fibrinolytic enzyme in sudden and natural deaths

With the purpose to elucidate the cause and difference of blood fluidity in sudden death and natural one, we have observed the fibrinolysis of the blood in medico-legal and pathological autopsies by means of Fibrin Plate Method, a routine method devised in our laboratory. As the result it has been found that in the blood serum of sudden death and in some of natural deaths from tumors, leukemias, etc., the decrease in fibrinolytic activity is equivalent to the amount of proactivator that combined with the SK-like substance liberated into blood. On the other hand, in the blood of most of natural deaths, and in that bled from vessels and stored in body cavities, no natural fibrinolysis is observable and the same fibrinolytic activity with SK as normal one is demonstrated. Thus it is concluded that the cause of blood fluidity in sudden death is due to the fibrinolysis.</p

Subcutaneous endoscopically assisted ligation using miniport for the treatment of girls with inguinal hernia

Background This report describes the first miniport method using  subcutaneous endoscopically assisted ligation (SEAL) for the treatment of girls with inguinal hernia. To validate its safety and efficacy, the  authors evaluated their early experiences.Methods Between April 2014 and December 2014, 19 SEALs using miniport were performed on 14 patients at the Fukaya Red-Cross Hospital, Saitama, Japan. Their mean age was 6 years (range, 11–128 months). This technique was performed using two ports (a 5mm port placed using the open technique and an additional 2mm miniport). A 5mm laparoscope was inserted via the umbilicus. The miniport was introduced percutaneously in the inguinal region under laparoscopic guidance and manipulated around the medial or lateral   hemicircumference of the internal ring extraperitoneally to place a purse-string around the internal ring. The hernia sac and patent processus vaginalis were closed at the level of the internal inguinal ring   extraperitoneally with circuit suturing using the 2mm miniport. Only the umbilical fascia was closed with an absorbable suture. No skin sutures were applied. We collected data regarding operative time, complications,and recurrence. Results The mean operative time was 20 ±6 min (unilateral, n =9) or 42± 8 min (bilateral, n= 5). The mean follow-up period was 12.8 ± 2.5 (range, 9–19) months. No intraoperative complications associated with theprocedure occurred and no hernial recurrences have been identified so far.Conclusion SEAL using miniport proved to be a successful operative procedure compared with other  laparoscopic percutaneous extraperitoneal closure procedures and produced excellent cosmetic results. SEAL using miniport for the treatment of girls with inguinal hernias appears to be safe, effective, and reliable.Keywords: inguinal hernia, miniport, SEA

A simple calculation for the preoperative estimation of transverse rectus abdominis myocutaneous free flap volume in 2-stage breast reconstruction using a tissue expander

Background Flap volume is an important factor for obtaining satisfactory symmetry in breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) free flap. We aimed to develop an easy and simple method to estimate flap volume. Methods We performed a preoperative estimation of the TRAM flap volume in five patients with breast cancer who underwent 2-stage breast reconstruction following an immediate tissue expander operation after a simple mastectomy. We measured the height and width of each flap zone using a ruler and measured the tissue thickness by ultrasound. The volume of each zone, approximated as a triangular or square prism, was then calculated. The zone volumes were summed to obtain the total calculated volume of the TRAM flap. We then determined the width of zone II, so that the calculated flap volume was equal to the required flap volume (1.2×1.05×the weight of the resected mastectomy tissue). The TRAM flap was transferred vertically so that zone III was located on the upper side, and zone II was trimmed in the sitting position after vascular anastomosis. We compared the estimated flap width of zone II (=X) with the actual flap width of zone II. Results X was similar to the actual measured width. Accurate volume replacement with the TRAM flap resulted in good symmetry in all cases. Conclusions The volume of a free TRAM flap can be straightforwardly estimated preoperatively using the method presented here, with ultrasound, ruler, and simple calculations, and this technique may help reduced the time required for precise flap tailoring

Interplay of Fli-I and FLAP1 for regulation of β-catenin dependent transcription

β-catenin mediates Wnt/wingless signaling and transcriptional activation by lymphocyte enhancer binding factor 1/T cell factor (LEF1/TCF) proteins with the assistance of multiple coregulators, including positive cofactors like p300/CBP and negative cofactors like HDACs. We previously demonstrated that a developmentally essential protein, Flightless-I (Fli-I), serves as a coactivator for nuclear receptor-mediated transcription. To further understand the action mechanism of Fli-I, we investigated the functional roles of Fli-I and Fli-I leucine rich repeat associated protein 1 (FLAP1) in transcriptional activation by β-catenin and LEF1/TCF. β-catenin-dependent transcription was activated by exogenous FLAP1 but inhibited by Fli-I. Reduction of endogenous FLAP1 levels compromised transcriptional activation by LEF1/TCF, β-catenin and the p160 coactivator GRIP1. FLAP1 interacted directly with β-catenin, GRIP1 and p300 and enhanced their activity. Furthermore, FLAP1 was strongly synergistic with p300 in supporting transcriptional activation by β-catenin and LEF1/TCF, but Fli-I disrupted the synergy of FLAP1 with p300 and β-catenin. Thus the opposing effects of Fli-I and FLAP1 may be a key regulatory mechanism for β-catenin and LEF1/TCF-mediated transcription and thus for Wnt signaling, and some mutations of Fli-I may result in developmental defects, such as the flightless phenotype of Drosophila, by causing dysregulation of the Wnt/β-catenin pathway