The usefulness of a free thinned deep inferior epigastric artery perforator flap and measurement of the vascular pedicle length: A thin flap with a long pedicle

xlomafota13 shared this article with you from Inoreader The usefulness of a free thinned deep inferior epigastric artery perforator flap and measurement of the vascular pedicle length: A thin flap with a long pedicle Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 7:S1748-6815(21)00654-9. doi: 10.1016/j.bjps.2021.11.105. Online ahead of print. ABSTRACT BACKGROUND: The thinned deep inferior epigastric perforator (DIEP) flap branching from the main trunk to the superolateral direction may be useful because of its long vascular pedicle. DIEP flap is used as an axial-pattern adipose flap. The vascular pedicle length of the thinned DIEP flap was investigated using originally developed software. The clinical application of the thinned DIEP flap was verified in a case series. METHODS: In 40 patients with enhanced computed tomography (CT) data, the vascular pedicle length of the longest thinned DIEP flap was simulated using the software. A free thinned DIEP flap was used in 10 clinical cases of facial or breast reconstruction. RESULTS: In all simulated cases, the vascular pedicle of the DIEP branching to the superolateral direction was the longest, and the vascular pedicle could be lengthened up to 34.8% by dissecting the vessels on the fascia as a vascular pedicle. In all the clinical cases, the reconstruction of a complex form defect or reconstruction requiring a long vascular pedicle could be achieved in one stage without any perioperative complications. The intraclass correlation coefficient between simulated pedicle length and dissected pedicle length was 0.99. CONCLUSION: Thinned DIEP flaps with long vascular pedicles could be elevated safely. Multiple adipose or muscle flaps could be combined without complications. The length of the winding vascular pedicle could be measured using imaging data using the software first developed in the present study. This software would be useful in the planning of a thinned DIEP flap and other free flaps. PMID:34973933 | DOI:10.1016/j.bjps.2021.11.105 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Breast reconstruction using the profunda artery perforator (PAP) flap: Technical refinements and evolution, outcomes, and patient satisfaction based on 116 consecutive flaps

xlomafota13 shared this article with you from Inoreader Breast reconstruction using the profunda artery perforator (PAP) flap: Technical refinements and evolution, outcomes, and patient satisfaction based on 116 consecutive flaps Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00635-5. doi: 10.1016/j.bjps.2021.11.085. Online ahead of print. ABSTRACT INTRODUCTION: When a deep inferior epigastric artery flap is not suitable, the profunda artery perforator (PAP) flap can be a good alternative for autologous breast reconstruction. Popularity of the PAP flap is expanding, but it is still only slowly being adopted worldwide. We report our experience with 116 consecutive PAP flaps showing refinements and evolution of the technique towards improvement in outcomes and patients' satisfaction. METHODS: We prospectively collected data from consecutive PAP flap breast reconstructions performed from 2016 to 2019. Patients' demographics, pre-, intra-, postoperative data, and revision procedures were analyzed. The BREAST-Q and a specific questionnaire investigating outcomes at the donor site were completed preoperatively and 12 months postoperatively. RESUL TS: One-hundred and sixteen PAP flaps were performed in 86 patients, 64 unilateral and 22 bilateral breast reconstructions. Mean body mass index was 24.72 kg/m2 (range 18.9-29.2) and mean flap weight was 251.30 g (range 152-455 g). Complications included donor site hematoma (1.7%), seroma (2.6%), fat necrosis (1.7%), and wound dehiscence (2.6%). No arterial/venous thrombosis nor flap losses were recorded. Patients reported high satisfaction in all BREAST-Q domains, with mean postoperative scores being higher than preoperative ones, suggesting a positive effect in quality of life and satisfaction. Scores were significant in the satisfaction with breast domain (p = 0.0016). CONCLUSIONS: Breast reconstruction with PAP flap yields a high success, low complications, and excellent cosmetic outcomes in the breast and donor sites. It improves patients' satisfaction and quality of life; hence, it can be considered an excellent option for autologous breast reconstruction. PMID:34975000 | DOI:10.1016/j.bjps.2021.11.085 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oncocytic Papillary Thyroid Carcinoma and Oncocytic Poorly Differentiated Thyroid Carcinoma: Clinical Features, Uptake, and Response to Radioactive Iodine Therapy, and Outcome

xlomafota13 shared this article with you from Inoreader Oncocytic Papillary Thyroid Carcinoma and Oncocytic Poorly Differentiated Thyroid Carcinoma: Clinical Features, Uptake, and Response to Radioactive Iodine Therapy, and Outcome Via radioactive iodine Front Endocrinol (Lausanne). 2021 Dec 16;12:795184. doi: 10.3389/fendo.2021.795184. eCollection 2021. ABSTRACT OBJECTIVE: The main objective of this study was to review the clinicopathologic characteristics and outcome of patients with oncocytic papillary thyroid carcinoma (PTC) and oncocytic poorly differentiated thyroid carcinoma (PDTC). The secondary objective was to evaluate the prevalence and outcomes of RAI use in this population. METHODS: Patients with oncocytic PTC an d PDTC who were treated at a quaternary cancer centre between 2002 and 2017 were retrospectively identified from an institutional database. All patients had an expert pathology review to ensure consistent reporting and definition. The cumulative incidence function was used to analyse locoregional failure (LRF) and distant metastasis (DM) rates. Univariable analysis (UVA) was used to assess clinical predictors of outcome. RESULTS: In total, 263 patients were included (PTC [n=218], PDTC [n=45]) with a median follow up of 4.4 years (range: 0 = 26.7 years). Patients with oncocytic PTC had a 5/10-year incidence of LRF and DM, respectively, of 2.7%/5.6% and 3.4%/4.5%. On UVA, there was an increased risk of DM in PTC tumors with widely invasive growth (HR 17.1; p<0.001), extra-thyroidal extension (HR 24.95; p<0.001), angioinvasion (HR 32.58; p=0.002), focal dedifferentiation (HR 19.57, p<0.001), and focal hobnail cell change (HR 8.67, p=0.042). There was additionally an incr eased risk of DM seen in male PTC patients (HR 5.5, p=0.03).The use of RAI was more common in patients with larger tumors, angioinvasion, and widely invasive disease. RAI was also used in the management of DM and 43% of patients with oncocytic PTC had RAI-avid metastatic disease. Patients with oncocytic PDTC had a higher rate of 5/10-year incidence of LRF and DM (21.4%/45.4%; 11.4%/40.4%, respectively). Patients with extra-thyroidal extension had an increased risk of DM (HR 5.52, p=0.023) as did those with angioinvasion. Of the patients with oncocytic PDTC who received RAI for the treatment of DM, 40% had RAI-avid disease. CONCLUSION: We present a large homogenous cohort of patients with oncocytic PTC and PDTC, with consistent pathologic reporting and definition. Patients with oncocytic PTC have excellent clinical outcomes and similar risk factors for recurrence as their non-oncocytic counterparts (angioinvasion, large tumor size, extra-thyroidal extension, and focal dediffere ntiation). Compared with oncocytic PTCs, the adverse biology of oncocytic PDTCs is supported with increased frequency of DM and lower uptake of RAI. PMID:34975765 | PMC:PMC8716491 | DOI:10.3389/fendo.2021.795184 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autologous rib cartilage as implanted stiffener of phalloplasty: comparing three different methods

xlomafota13 shared this article with you from Inoreader Autologous rib cartilage as implanted stiffener of phalloplasty: comparing three different methods Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 7:S1748-6815(21)00658-6. doi: 10.1016/j.bjps.2021.11.111. Online ahead of print. ABSTRACT BACKGROUND: Maintaining the length, rigidity, and appearance of a reconstructed phallus in the long term has been challenging for phalloplasty and may depend on choosing the optimal implanted stiffener. The aim of this study was to determine the best type of stiffener for a reconstructed phallus regarding aesthetic and functional parameters. METHODS: From 1987 to 2018, 376 individuals underwent phalloplasty at a single institution of which 81 met the following inclusion criteria: biological male gender, age between 18 and 60 years, radial forearm flap for tube-within-a-tube phalloplasty with rib cartilage and secondary glans sculpting and unimpaired urination preoperatively. Those were divided into three groups with regard to different types of autologous rib cartilage stiffener. A group with a cartila ge strip, T-shaped cartilage, and mushroom-shaped cartilage group were evaluated regarding preserved length and aesthetic features of the phallus during a minimum period of 12 months. The rib cartilage length in the phallus was 10.5 cm in all groups. RESULTS: The length of the phallus was 10.8 ± 0.5 cm in the cartilage strip group, 11.3 ± 0.3 cm in the T-shaped cartilage group and 11.3 ± 0.3 cm in the mushroom-shaped cartilage group at 1-year postoperatively. The aesthetic appearance score of mushroom-shaped cartilage group was 1.67 ± 0.48, significantly higher than the cartilage strip group (1.38 ± 0.50, p = 0.03) at 1 year after surgery. CONCLUSIONS: The mushroom-shaped autologous rib cartilage group showed superior length preservation and aesthetic appearance and appeared as the best type of stiffener for one-phase phalloplasty. PMID:34975003 | DOI:10.1016/j.bjps.2021.11.111 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of hsa_circ_0066966 in proliferation and migration of hepatitis B virus-related liver cancer cells

xlomafota13 shared this article with you from Inoreader Role of hsa_circ_0066966 in proliferation and migration of hepatitis B virus-related liver cancer cells Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):87. doi: 10.3892/etm.2021.11010. Epub 2021 Nov 25. ABSTRACT A large proportion of liver cancer cases is caused by hepatitis B virus (HBV) infection. In recent years, an increasing number of reports have indicated that circular RNAs (circRNAs) exert regulatory effects in cancer development, whereas the role of circRNAs in HBV-positive liver cancer requires further investigation. In the present study, abnormally expressed circRNAs were identified in HBV-positive liver cancer cells through microarray analysis. A total of 1,493 differentially expressed circRNAs [absolute fold-change (FC) ≥2] in HBV-positive liver cancer cells were detected, of which 171 were upregulated and 1,322 were downregulated. Subsequently, Gene Ontology enrichment analysis indicated that the genes of dysregulated circRNAs were mainly involved in regulating Sertoli cell differentiation and development, as well as telomeric DNA binding. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that most of these genes were enriched in cancer-related signaling pathways, including the MAPK and Hippo signaling pathways. Next, the expression levels of the top-10 dysregulated circRNAs were verified in HBV-positive liver cancer cells through reverse transcription-quantitative PCR. Among them, hsa_circ_0066966 had the highest absolute Log2FC value and was abnormally increased in HBV-positive liver cancer cells. Functional experiments further verified that knockdown of hsa_circ_0066966 had a significant inhibitory effect on the proliferation and migration of HBV-positive liver cancer cells. By contrast, overexpression of hsa_circ_0066966 in HBV-negative liver cancer cells resulted in the opposite effect. In conclusion, in the present study, comprehensive circRNA profiling in HBV-positive liver cancer cells indicated that hsa_circ_0066966 may regulate the progression of HBV-positive liver cancer. PM ID:34976133 | PMC:PMC8674973 | DOI:10.3892/etm.2021.11010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of patella resurfacing on functional outcome and revision rate in primary total knee arthroplasty (Review)

xlomafota13 shared this article with you from Inoreader Effect of patella resurfacing on functional outcome and revision rate in primary total knee arthroplasty (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):104. doi: 10.3892/etm.2021.11027. Epub 2021 Dec 1. ABSTRACT Anterior knee pain, as well as patellofemoral disorders, after total knee arthroplasty are important reasons for revision in total knee arthroplasty. Current prosthesis designs include patellar components for patella replacement, and together with improved rational design of the prosthesis and advancement in knee alignment these appear to reduce the incidence of anterior knee pain following total knee replacement, even if the etiology of anterior knee pain remains unclear. However, new complications related to patella resurfacing emerge with this approach. At present, there are three strategies involving patella replacement in total knee arthroplasty: There are surgeons who always replace the patella, others who never resurface the patella and a third group of surgeons who usually do not resurface the patella but replace the patella in particular s ituations. There are arguments to support each of these viewpoints regarding patella resurfacing but no strong arguments to favor any of them. Finally, the decision to resurface the patella or not should be based on the practice, training and experience of individual surgeons. The aim of this review was to analyze the results of different strategies for patella resurfacing in terms of functional outcome and revision rate following primary total knee arthroplasty. PMID:34976146 | PMC:PMC8674976 | DOI:10.3892/etm.2021.11027 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

lncRNA HOTAIR mediates OGD/R-induced cell injury and angiogenesis in a EZH2-dependent manner

xlomafota13 shared this article with you from Inoreader lncRNA HOTAIR mediates OGD/R-induced cell injury and angiogenesis in a EZH2-dependent manner Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):99. doi: 10.3892/etm.2021.11022. Epub 2021 Dec 1. ABSTRACT Long non-coding RNAs (lncRNA) serve an important role in neonatal hypoxic-ischemic encephalopathy (HIE) have been reported to regulate the activity of HIE-associated proteins. The present study aimed to elucidate the role of Hox transcript antisense intergenic RNA (HOTAIR) in oxygen-glucose deprivation/reperfusion (OGD/R)-induced injury in human brain microvascular endothelial cells (hBMVECs). The levels of HOTAIR were evaluated in the serum of neonatal patients with HIE, and the effects of HOTAIR were evaluated using in vitro assays, such as reverse transcription-quantitative PCR to detect lncRNA and mRNA levels and western blot analysis to determine protein levels. Moreover, RNA immunoprecipitation assays were used to evaluate the association between HOTAIR and enhancer of zeste homolog 2 (EZH2), Cell Counting Kit-8 was used to detect cell viability, an endothelial monolayer cell permeability assay was used to analyze cell viability, TUNEL staining was used to detect the levels of apoptosis, a Transwell assay was used to evaluate cell invasion and a tube formation assay was used to analyze tube formation ability. In addition, the effects of HOTAIR and EZH2 on cell apoptosis and the invasive and tube formation abilities of hBMVECs were investigated using TUNEL, Transwell and tube formation assays, respectively. The results showed that the expression levels of HOTAIR were markedly increased both in neonatal HIE patients and in the OGD/R injury in vitro model. HOTAIR knockdown reduced hBMVEC viability, enhanced cell permeability and apoptosis, in addition to decreasing the expression levels of tight junction-related proteins, such as zonula occludens-1, occluden, Claudin5 and vascular endothelial-cadherin. However, EZH2 overexpression reversed the effects of HOTAIR silencing on hBMVECs. Additionally, HOTAIR knockd own enhanced the migratory and tube formation abilities of OGD/R-induced hBMVECs, which were also reversed by EZH2 overexpression. Overall, the present study revealed an association between the HOTAIR/EZH2 axis and brain microvascular endothelial cell injury and angiogenesis, which provides a novel insight into the molecular mechanism underlying stroke or the development of new pharmacotherapies. PMID:34976141 | PMC:PMC8674968 | DOI:10.3892/etm.2021.11022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suicidality and COVID-19: Suicidal ideation, suicidal behaviors and completed suicides amidst the COVID-19 pandemic (Review)

xlomafota13 shared this article with you from Inoreader Suicidality and COVID-19: Suicidal ideation, suicidal behaviors and completed suicides amidst the COVID-19 pandemic (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):107. doi: 10.3892/etm.2021.11030. Epub 2021 Dec 2. ABSTRACT Since the outbreak of the coronavirus 2019 (COVID-19) pandemic, there has been widespread concern that social isolation, financial stress, depression, limited or variable access to health care services and other pandemic-related stressors may contribute to an increase in suicidal behaviors. In patients who have recovered from COVID-19, an increased risk of developing suicidal behaviors may be noted, while post-COVID syndrome comprises another potential risk factor contributing to increased suicidal behaviors. Despite the initial alarming predictions for an increase in suicide rates due to the COVID-19 pandemic, the majority of published studies to date suggest that experienced difficulties and distress do not inevitably translate into an increased number of suicide-related deaths, at least not in the short-term. Nevertheless, the long-term mental h ealth effects of the COVID-19 pandemic have yet to be unfolded and are likely to remain for a long period of time. Suicide prevention and measures aiming at promoting well-being and mitigating the effects of COVID-19 on mental health, particularly among vulnerable groups, should thus be a priority for healthcare professionals and policymakers amidst the evolving COVID-19 pandemic. PMID:34976149 | PMC:PMC8674972 | DOI:10.3892/etm.2021.11030 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Research advances in Dieulafoy's disease of the bronchus (Review)

xlomafota13 shared this article with you from Inoreader Research advances in Dieulafoy's disease of the bronchus (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):100. doi: 10.3892/etm.2021.11023. Epub 2021 Dec 1. ABSTRACT Dieulafoy's disease is characterized by abnormal submucosal arteries and results in acute luminal hemorrhage. Dieulafoy's lesions can also be found in the submucosa of the bronchus. Due to its low incidence rate and non-specific clinical symptoms, Dieulafoy's disease is easy to overlook, but can lead to massive bleeding and high rates of mortality. Therefore, improvements in the understanding of the disease are necessary. The awareness of the disease and associated diagnostic and treatment techniques have continued to improve, and thus, an increasing number of cases of Dieulafoy's disease of the bronchus have been reported. In the present review, 74 cases of Dieulafoy's disease are summarized. New technologies such as endobronchial ultrasound, narrow-band imaging, angiography and argon plasma treatment have been found to be increasingly applied to diagnose and treat Dieulafoy's disease of the bronchus. Therefore, the primary focus of this systematic review is to highlight advances in the diagnosis and treatment of bronchial Dieulafoy's disease. PMID:34976142 | PMC:PMC8674951 | DOI:10.3892/etm.2021.11023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High Mobility Group Box-1 Protein and Interleukin 33 Expression in Allergic Rhinitis

xlomafota13 shared this article with you from Inoreader High Mobility Group Box-1 Protein and Interleukin 33 Expression in Allergic Rhinitis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Background: Allergic rhinitis (AR) is characterized by an inflammatory reaction. High mobility group box 1 (HMGB1) protein and interleukin (IL)-33 are damage-associated molecular pattern molecules and have many characteristics similar to pro-inflammatory cytokines. However, the role of IL-33 and HMGB1 in AR remains unclear. The aim of this study is to explore the role of HMGB1 and IL-33 in AR. Methods: Twenty patients with AR (AR group) and 10 normal controls (normal group) were enrolled in this study. HMGB1 and IL-33 expression were analyzed by immunohistochemistry in epithelial cells of the inferior turbinate mucosa samples. Then, the human nasal mucosa epithelial cells (HNECs) were cultured in vitro, and the house dust mite allergen (Derp1) was used to stimulate the cells. Quantitative real-time PCR and ELISA assay were performed to detect HMGB1 and IL-33 expression in HNECs. Results: The expression of HMGB1 and IL-33 in the nasal mu cosa was higher in the AR group than in the normal group, with a statistically significant difference (p #x3c; 0.05). In HNECs of AR, the expression of both HMGB1 and IL-33 in stimulated groups was higher than that in non-stimulated groups. The differences were statistically significant (p #x3c; 0.05). In addition, they increased gradually with the prolonging time and the concentration of the added Derp1. Conclusions: The expression of HMGB1 and IL-33 were both increased in AR. HMGB1 and IL-33 may have a close relationship in AR. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.