Gluteoperinealis muscle: a surgically important variation

xlomafota13 shared this article with you from Inoreader Gluteoperinealis muscle: a surgically important variation Via radiol anat Surg Radiol Anat. 2021 May 16. doi: 10.1007/s00276-021-02766-x. Online ahead of print. ABSTRACT BACKGROUND: Anatomical variations are common in gluteal region. This report presents two cases of gluteoperinealis muscles detected during radiological imaging. CASE PRESENTATION: Our study was conducted on two patients. This report describes an accessory muscle detected in the gluteal region on MRI examination of a patient who admitted to our clinic after a firearm injury a nd a second patient examined with CT imaging who had signs of pelvic infection. In the first case, this accessory muscle originated bilaterally from the fascia of the gluteus maximus throughout its posteromedial side and was attached to the perineal body. In the second case, it extended forward from the fascia of the gluteus maximus muscle and inserted to the cavernous body of penis on the left side and to the perineal body on the right. In the literature, this accessory muscle has been described as the gluteoperinealis muscle being a rare variation. CONCLUSION: Considering the origin and insertion of the muscle, this variation may be important during the surgical operations of the gluteal and perineal regions. PMID:33993323 | DOI:10.1007/s00276-021-02766-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ossiculoplasties: about 30 cases and literature review

xlomafota13 shared this article with you from Inoreader Ossiculoplasties: about 30 cases and literature review Via Laryngologie Pan Afr Med J. 2021 Feb 18;38:187. doi: 10.11604/pamj.2021.38.187.27449. eCollection 2021. ABSTRACT The purpose of this study was to evaluate the functional outcomes of ossiculoplasties. We conducted a retrospective study, in the department of ear, nose and throat (ENT) and congestive cardiac failure (CCF) at the University Hospital Mohammed VI, in Oujda, from October 2018 to March 2020. Out of 45 patients with secondary otitis, 30 had gone ossiculoplasty using endoscopic transmeatal approach. These patients were enrolled in the study. The average age of patients was 31.8 years, with a F/M sex ratio of 1.5. The examination of the eardrum showed type A otitis (18 cases) type B otitis (5 cases), type C otitis (3 cases) and type D otitis (4 cases), according to Austin classification; 70% of patients who had undergone surgery had hearing loss between 30 and 40 dB and 30% of patients had hearing loss of ≥40 dB. Type II ossiculoplasty was perform ed in 26 cases, using tragal cartilage in 18 cases. Autologous incus interposition graft and placement of titanium PORP were performed in 4 cases each, whereas ossiculoplasty type III was performed in 4 cases, with placement of titanium TORP. Type II ossiculoplasty group had a hearing gain of ≥20 dB (all cases), whereas type III ossiculoplasty group had a hearing gain of ≥1 dB (1 case). Success rate was 90%. The analysis of these results shows that the overall outcome is slightly worse in patients undergoing type III ossiculoplasty than in those undergoing type II ossiculoplasty. However, comparative studies between the placement of prostheses and autografts or between different types of materials have only shown minor differences reported by the same author or the same team. Many authors highlighted that the preservation of the handle of malleus could provide better functional results. PMID:33995793 | PMC:PMC8106790 | DOI:10.11604/pamj.2021.38.187.27449 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular mechanisms of radioactive iodine refractoriness in differentiated thyroid cancer: Impaired sodium iodide symporter (NIS) expression owing to altered signaling pathway activity and intracellular localization of NIS

xlomafota13 shared this article with you from Inoreader Molecular mechanisms of radioactive iodine refractoriness in differentiated thyroid cancer: Impaired sodium iodide symporter (NIS) expression owing to altered signaling pathway activity and intracellular localization of NIS Via radioactive iodine Theranostics. 2021 Apr 15;11(13):6251-6277. doi: 10.7150/thno.57689. eCollection 2021. ABSTRACT The advanced, metastatic differentiated thyroid cancers (DTCs) have a poor prognosis mainly owing to radioactive iodine (RAI) refractoriness caused by decreased expression of sodium iodide symporter (NIS), diminished targeting of NIS to the cell membrane, or both, thereby decreasing the efficacy of RAI therapy. Genetic aberrations (such as BRAF, RAS, and RET/PTC rearrangeme nts) have been reported to be prominently responsible for the onset, progression, and dedifferentiation of DTCs, mainly through the activation of mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT signaling pathways. Eventually, these alterations result in a lack of NIS and disabling of RAI uptake, leading to the development of resistance to RAI therapy. Over the past decade, promising approaches with various targets have been reported to restore NIS expression and RAI uptake in preclinical studies. In this review, we summarized comprehensive molecular mechanisms underlying the dedifferentiation in RAI-refractory DTCs and reviews strategies for restoring RAI avidity by tackling the mechanisms. PMID:33995657 | PMC:PMC8120202 | DOI:10.7150/thno.57689 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Utility of autologous fibrin glue in the donor site of free abdominal flap for breast reconstruction: A randomized controlled study

xlomafota13 shared this article with you from Inoreader Utility of autologous fibrin glue in the donor site of free abdominal flap for breast reconstruction: A randomized controlled study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00180-7. doi: 10.1016/j.bjps.2021.03.073. Online ahead of print. ABSTRACT BACKGROUND: Seroma formation at the donor site is a common complication of breast reconstruction using free abdominal flap. In this study, we assessed the benefits of use of autologous fibrin glue (AFG) at the donor site. METHODS: This randomized controlled study compared AFG group (n = 61) with commercial fibrin glue (CFG) group (n = 79). Owing to the high volume of AFG (10 mL), AFG group received fibrin glue at both the anastomosis and the donor sites, whereas CFG group received fibrin glue only at the anastomosis site. Operative protocols and the criteria for postoperative drain removal were identical in both groups. Patient characteristics and abdominal discharge were compared between the two groups. RESULTS: Since anemia was a contraindication for use of AFG, preoperative Hb in CFG group wa s significantly lower than that in AFG group; other factors were comparable in the two groups. The mean total abdominal drain volumes on first postoperative day (POD1) and POD2 was (AFG vs. CFG) 130.9 vs. 169.4 mL (P < 0.001) and 131.0 vs. 162.8 mL (P = 0.03), respectively. On POD3, there was no significant difference in this respect (116.2 vs. 128.4 mL, P = 0.19). The mean time for removal of all abdominal drains was significantly lower in AFG group (7.4 vs. 8.4 days; P = 0.01). CONCLUSIONS: AFG reduced the discharge at the donor site of free abdominal flap, especially in the early postoperative period. AFG helped to reduce the abdominal drainage period. PMID:33992561 | DOI:10.1016/j.bjps.2021.03.073 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lower extremity postaxial polydactyly: Current literature status and future avenues

xlomafota13 shared this article with you from Inoreader Lower extremity postaxial polydactyly: Current literature status and future avenues Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00198-4. doi: 10.1016/j.bjps.2021.03.094. Online ahead of print. ABSTRACT BACKGROUND: Despite lower extremity polydactyly (LEP) representing the most common congenital foot anomaly with functional and psychosocial implications, the literature is devoid of comprehensive, synthesizing reviews. The purpose of the current review is to identify an evidence-based approach to guide clinical management and shed light on reported functional and esthetic outcomes for postaxial polydactyly. METHODS: A scoping systematic review of primary clinical studies was performed. Baseline patient characteristics, diagnostic, and surgical approaches were recorded. Main outcomes included immediate postoperative pain, infections, callouses, scar cosmesis, residual deformities, and difficulty with shoe-wear or mobility. A qualitative synthesis of outcomes was performed, and a therapeutic algorithm w as developed. RESULTS: Nine primary studies were identified representing 375 cases of LEP; mean age was 28.8 months (range: 20-40.6 months), and mean follow-up: 42.7 months (range: 1 month-41 years). Ray dominance and the presence of syndactyly were identified as the most important factors for surgical planning; age at surgery was insignificant. A lateral incision approach was used in 78% of cases. Postoperative callouses occurred in 22.1% of cases, infections in 2.5%, and intermittent pain in 11.9%. Significant issues with shoe-wear or mobilization and esthetic residual deformities were reported for 0.78% and 41.2% of cases, respectively. The incidence of residual valgus was 10.6%. CONCLUSION: LEP is most commonly managed with excision of the non-dominant ray and carries excellent long-term functional outcomes, as presented herein. Numerous techniques are discussed to minimize the risk of esthetic sequalae, although the presence of residual valgus remains a concern. A t herapeutic algorithm is proposed for the optimal management of LEP. PMID:33992559 | DOI:10.1016/j.bjps.2021.03.094 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstructive and restorative cues improve public perception on the value of plastic and reconstructive surgeries

xlomafota13 shared this article with you from Inoreader Reconstructive and restorative cues improve public perception on the value of plastic and reconstructive surgeries Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 22:S1748-6815(21)00175-3. doi: 10.1016/j.bjps.2021.02.012. Online ahead of print. ABSTRACT BACKGROUND: Persistent public misconceptions of plastic and reconstructive surgery (PRS), ambiguity between cosmetic versus reconstructive surgical procedures, and subjective interpretation of aesthetics can result in undervaluing of the field. Our study analyzes how patient context (cosmetic or reconstructive/restorative cues) affect public perception of outcomes and value of surgery. METHODS: We distributed Qualtrics™ surveys to laypersons via Amazon Mechanical Turk. Demographics were self-reported. The survey presented a series of pre- and post-operative photographs of PRS surgeries alongside either a cosmetic or reconstructive/restorative cue, followed by questions on values of procedure. Survey responses were analyzed using two-tailed Student's t tests and chi square analyses, univariate and mu ltivariate analysis, and linear regression. RESULTS: Of the 459 respondents, the mean age was 38.5 ± 12.1 years, and was 50.5% (232) male. The majority of respondents classified breast reconstruction as a cosmetic surgery (243, 66.8%), and was rated more attractive (p < 0.0005), higher impact on self-esteem (p < 0.001), and to be covered by health insurance (p < 0.0001) compared to breast augmentation. Reconstructive cued breast and facial procedures were viewed more favorably; the exception was gynecomastia reduction. Reconstructive classification had significant positive correlation with support for insurance coverage (R2 = 0.8268) and willingness to pursue (R2 = 0.5328). CONCLUSIONS: This study revealed more public support for reconstructive/restorative cued PRS cases over cosmetic cued PRS cases, and persistent misconceptions of breast reconstruction as a cosmetic procedure. Reconstructive or restorative cues can be used to educate the public and address skewed perceptions on the roles and value of PRS. PMID:33992560 | DOI:10.1016/j.bjps.2021.02.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of postoperative recurrence rates between levator aponeurosis advancement and external Müller's muscle tucking for acquired blepharoptosis

xlomafota13 shared this article with you from Inoreader Comparison of postoperative recurrence rates between levator aponeurosis advancement and external Müller's muscle tucking for acquired blepharoptosis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 24:S1748-6815(21)00190-X. doi: 10.1016/j.bjps.2021.03.086. Online ahead of print. ABSTRACT Treatment options for acquired blepharoptosis include levator resection, levator aponeurosis advancement (LAA), Müller's muscle-conjunctival resection (MMCR), and frontalis suspension. Previously, we reported a technique called external Müller's muscle tucking (EMMT) using the Müller's muscle as a power source. In this study, we compare LAA with EMMT and evaluate the recurrence and reoperation rates. LAA was performed on 96 eyelids in 51 patients. The average follow-up period was 12.2 months, recurrence occurred in four eyelids (4.2%) of three patients, and reoperation was required in one eyelid of one patient (2.0%). EMMT was performed on 94 eyelids in 51 patients, the mean follow-up period was 10.5 months, recurrence occurred in 14 eyelids (15%) of 10 patients, and reoperation was required in three eye lids of two patients (3.9%). A comparison of LAA and EMMT recurrence showed that EMMT was associated with a significantly higher recurrence rate (P = 0.0021). The causes of EMMT recurrence included thinning and fatty degeneration of Müller's muscles, necrosis of ligated Müller's muscles, and less postoperative scar formation. There was no correlation between EMMT recurrence and the severity of the blepharoptosis. PMID:33994326 | DOI:10.1016/j.bjps.2021.03.086 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Water jet-assisted lipoaspiration and Sepax cell separation system for the isolation of adipose stem cells with high adipogenic potential

xlomafota13 shared this article with you from Inoreader Water jet-assisted lipoaspiration and Sepax cell separation system for the isolation of adipose stem cells with high adipogenic potential Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 29:S1748-6815(21)00115-7. doi: 10.1016/j.bjps.2021.03.025. Online ahead of print. ABSTRACT INTRODUCTION: Water jet-assisted liposuction has gained popularity due to favourable fat grafting outcomes. In this study, we compared stem cells obtained from fat isolated with manual or the water jet-assisted procedure. METHODS: Liposuction of abdominal fat was performed using the two methods on each donor (n = 10). Aspirate samples were collagenase digested and the isolated cells seeded in vitro prior to proliferation, adipogenic differentiation and angiogenic activity analyses. RESULTS: Cells from either procedure proliferated at similar rates and exhibited a similar colony-forming ability. The cells expressed stem cell markers CD73, CD90 and CD105. In the water jet cell preparations, there were higher numbers of cells expressing CD146. Robust adipogenic differentiation was observed in cultu res expanded from both manual and water jet lipoaspirates. Gene analysis showed higher expression of the adipocyte markers aP2 and GLUT4 in the adipocyte-differentiated water jet cell preparations, and ELISA indicated increased secretion of adiponectin from these cells. Both cell groups expressed vasculogenic factors and the water jet cells promoted the highest levels of in vitro angiogenesis. Given these positive results, we further characterised the water jet cells when prepared using an automated closed cell processing unit, the Sepax-2 system (Cytiva). The growth and stem cell properties of the Sepax-processed cells were similar to the standard centrifugation protocol, but there was evidence for greater adipogenic differentiation in the Sepax-processed cells. CONCLUSIONS: Water jet lipoaspirates yield cells with high adipogenic potential and angiogenic activity, which may be beneficial for use in cell-assisted lipotransfers. PMID:33994109 | DOI:10.1016/j.bjps.2021.03.025 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Considering the view from the inside of the maxillary sinus in Le Fort II osteotomy

xlomafota13 shared this article with you from Inoreader Considering the view from the inside of the maxillary sinus in Le Fort II osteotomy Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 28:S1748-6815(21)00236-9. doi: 10.1016/j.bjps.2021.03.129. Online ahead of print. NO ABSTRACT PMID:33994110 | DOI:10.1016/j.bjps.2021.03.129 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Oral Neurovascular Hamartoma of the Hard Palate: A Clinicopathologic Report

xlomafota13 shared this article with you from Inoreader Pediatric Oral Neurovascular Hamartoma of the Hard Palate: A Clinicopathologic Report Via ear nose throat Ear Nose Throat J. 2021 May 17:1455613211014302. doi: 10.1177/01455613211014302. Online ahead of print. ABSTRACT We hereby present the first-reported pediatric case of a hard palate neurovascular hamartoma in a male newborn, in which the diagnosis was established following an initial nondiagnostic biopsy, extensive radiological investigations, and eventual wide local excision. These benign lesions can easily be mistaken for malignant diagnoses, leading to increased parental and child anxiety as well as avoidable diagnostic and therapeutic interventions. PMID:33993743 | DOI:10.1177/01455613211014302 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Tympanic Membrane Perforation With and Without Calcification of Anterior Mallear Ligament Under Transcanal Endoscopic Type I Tympanoplasty

xlomafota13 shared this article with you from Inoreader Comparison of Tympanic Membrane Perforation With and Without Calcification of Anterior Mallear Ligament Under Transcanal Endoscopic Type I Tympanoplasty Via ear nose throat Ear Nose Throat J. 2021 May 16:1455613211010092. doi: 10.1177/01455613211010092. Online ahead of print. ABSTRACT OBJECTIVES: Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of TMP with and without AML calcification have rarely been reported. The aim of the current study is to compare the hearing outcomes of TMP with and without calcificatio n of AML under transcanal endoscopic type I tympanoplasty. METHODS: Records of 67 patients diagnosed with CSOM and receiving transcanal endoscopic type I tympanoplasty were divided into the AML calcification group (Cal group, n = 31) and the non-AML calcification group (non-Cal group, n = 36). The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed. RESULTS: Preoperatively, the Cal group had higher mean air-bone gap (ABG; P = .022), and ABGs at 250 Hz (P = .017) and 500 Hz (P = .008) compared with the non-Cal groups. The Cal group showed higher improvements of ABGs at 250 Hz (P = .039) and 500 Hz (P = .021) compared with the non-Cal groups postoperatively. CONCLUSIONS: The TMP with AML calcification leads to higher ABGs at low frequencies. The hearing o utcomes are similar for TMP both with and without AML calcification after surgery. Our results suggest that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for TMP with AML calcification, if the lesion can be detected and completely eliminated. PMID:33993754 | DOI:10.1177/01455613211010092 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.