The widely used nerve transfer sources for elbow flexion in patients with upper brachial plexus avulsion (UBPA) include partial ulnar nerve, phrenic nerve and intercostal nerves. A retrospective review of 21 patients treated with phrenic and partial ulnar nerve transfers for elbow flexion after UBPA was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of anterior division of upper trunk; In the partial ulnar nerve transfer group, one fascicle of the ulnar nerve was transferred to the biceps branch.
Παρασκευή 8 Ιουνίου 2018
Comparative study of phrenic and partial ulnar nerve transfers for elbow flexion after upper brachial plexus avulsion–a retrospective clinical analysis
Concomitant Injuries Affect Prognosis in Patients with Central Slip Tear
Central slip tears often occur with concomitant hand injuries. However, the outcome of a central slip tear and the effect of concomitant injuries are rarely reported. We evaluated 67 fingers in 63 patients with central slip tears who underwent primary surgery in our hospital between April 2009 and June 2017. We performed multivariate analyses; on proximal interphalangeal joint active range of motion and existing extension lag greater than 10 degrees as dependent variables, and age, existence of concomitant fractures, skin defects, collateral ligament injuries, ruptured lateral bands, ruptured flexor tendons, or vascular injury in the injured finger as independent variables.
Ultra-High Frequency Ultrasound in planning capillary perforator flaps: preliminary experience.
The introduction of perforator flaps has revolutionized the modern reconstructive plastic surgery. The technical ability to dissect small vessels allowed to further expand the perforator flap concept to precise composite tissues harvest, known as chimerism.1 The latest evolution of perforator flap was represented by the introduction of superthin skin flaps which are based on very peripheral vascular structures.2 Although the thinning procedure was usually performed after traditional harvest of adipocutaneous perforator flap, recently, Hong JP introduced the concept of harvesting thin flap by using superficial fascia as dissection plane thus allowing to directly harvest thin flaps.
Incidence of heparin-induced thrombocytopenia in lower-extremity free flap reconstruction correlates with the overall surgical population
Lower extremity free flap reconstruction is a growing trend in the management of lower extremity wounds. Heparin induced thrombocytopenia (HIT) is a significant risk to free flap reconstruction. The purpose of this study was to investigate the incidence of heparin-induced thrombocytopenia in patients receiving lower-extremity free flap surgery.
‘The Silicone Siphon’ - A safe and simple method of removing silicone implant and content from the breast
Removal of leaking or ruptured breast implants,1,2 often presenting sub-clinically and sometimes diagnosed by MRI or USS,3,4 can present a technical challenge.
A technique to measure the tension across a wound in real time during wound closure
The optimal result after primary closure of a wound, if wound eversion and low tissue tension is maintained, is a flat inconspicuous and robust scar that heals in a timely fashion. If the tension applied during wound closure is too high and the sutures are too tight, blood supply to the site may be compromised resulting in wound breakdown. If the tension applied is too little, the subcutaneous tissues and dermal edges will not be opposed effectively, leading to poor scar formation.
Review of Donor Site Complications Among Different Intra-Abdominal Vascularized Lymph Node Free Flaps: Future Tendency of Application Based on Anatomical Considerations
Transfer of lymph node flap (LNF) has become popular in surgical management of lymphedema as a means of providing physiologic lymph drainage. A variety of donor site options have been reported, and their effects are still under investigation, but a consensus is to minimize the donor site complications. Among them, iatrogenic lymphedema is one of the least desirable complications. Therefore, the intra-abdominal options, theoretically free of iatrogenic lymphedema, is getting more accepted. We review the current options and discuss their precautions and indications.
Internal Mammary Usability as Recipient Vessels in DIEP Breast Reconstruction in the Setting of Previous Radiation
Autologous breast reconstruction has become the standard of care over the last several decades. The recipient vessel for these patients with microvascular reconstruction has classically been the thoracodorsal (TD) artery. This artery has a reliable anatomic location and is often easily dissected and preserved when exploring the axilla as part of the oncological procedure.1 Recent recommendations have supported the use of the Internal mammary (IM) vessels for free flap anastomosis. The IM vessel selection allows for better arterial inflow, medial breast mound placement, shorter pedicle length, and avoids axillary exploration with resulting scarring and lymphedema risk.
Patient-reported outcome measurement in upper blepharoplasty; how to measure what the patient sees
Blepharochalasis is very common and affects not only appearance but also visual function. Upper blepharoplasty is therefore the most frequently performed facial cosmetic procedure worldwide. It is generally seen as a small procedure with good patient acceptance and postoperative satisfaction. Research concerning the outcome of this procedure in terms of satisfaction and quality of life is lacking, as well as a recommendation on which assessment tools to use in this patient group.
SELECTIVE NON-OPERATIVE MANAGEMENT FOR PENETRATING EXTREMITY TRAUMA– A PARADIGM SHIFT IN MANAGEMENT?
Selective non-operative management (SNOM) has been proposed as a safe and adequate strategy for penetrating extremity trauma (PET) management. This may reduce unwarranted surgical exploration and enhance cost-effectiveness. Our experience at a UK major trauma centre advocates SNOM-PET as a viable and safe strategy for selected patients. A PET management algorithm is proposed.
Clinical features affecting the patient-based outcome after minimal medial epicondylectomy for cubital tunnel syndrome.
Little information is currently available to analyze unsatisfactory surgical outcomes for cubital tunnel syndrome (CuTS). The aim of this study was to analyze the clinical features influencing patient-reported outcomes of minimal medial epicondylectomy for CuTS.
Total Lower Lip Reconstruction with Free Forearm Flap Suspended on Adams Wires
After a total lower lip resection, the radial forearm free flap (RFFF) may be used for lip reconstruction [1]. However, the flap retraction occurs in some patients and causes oral incompetence that could be prevented by improved suspension of the flap.
Historical Review of Dakin's Solution Applications
Dakin's solution and the Carrel-Dakin method were developed and integrated into clinical practice in the early 20th century, which were found to aid in effective wound healing and infection. This historical review briefly outlines highlights with respect to the history of infection management, wartime amputation, and wound treatment dating back to Galen through the early 20th century. This paper extensively reviews and discusses the historic use of Dakin's solution, which was developed almost a century ago, in both wartime settings and in the civilian sector as well.
Quality of life and Shoulder Function after Latissimus Dorsi Breast Reconstruction
Breast reconstruction using a latissimus dorsi flap impacts one of the principal muscles of the shoulder. There is therefore concern that this procedure could impair shoulder function. The primary objective of this study was to study the effect of breast reconstruction using the latissimus dorsi flap on patient reported shoulder function and quality of life, compared to women who underwent total mastectomy without reconstruction.
“Efficacy of autologous fat transfer for the correction of contour deformities in the breast: a systematic review and meta-analysis”
Autologous fat transfer (AFT), also known as fat grafting or lipofilling, has already become part of clinical practice for treating contour deformities of the breast, even though evidence regarding its efficacy is still lacking. This is the first meta-analysis on the subject, aimed to facilitate intuitive interpretation of the available data by clinicians, guideline committees and policy makers.
Inferiorly Based Lotus Petal Flap & Laser Therapy in Difficult Pilonidal Sinus Management
To assess the efficacy of the lotus petal flap in difficult pilonidal sinus management
Chances and limitations of a low-priced mobile 3-D scanner for breast imaging in comparison to an established 3-D photogrammetric system
In search of new possibilities in 3-D surface imaging, several non-medical scanning systems have been assessed for their implementation in Plastic Surgery. The aim of this study was to compare a new affordable 3-D imaging consumer product in comparison to an established medical 3-D imaging system for objective 3-D breast imaging.
Lympahtico venous anastomosis and resection for genital acquired lymphangiectasia (GAL)
The purpose of this paper is to report on the relationship between lymphoscintigraphic findings and the operative results of lymphatico-venous anastomosis (LVA) and resection of genital acquired lymphangiectasia (GAL). Seventeen GAL patients who underwent lymphoscintigraphy between April 2012 and June 2016 were included in this retrospective study. LVA and GAL resections were performed for 14 patients. The GALs were resected in a spindle shape to the full thickness of the genital skin and the wounds were closed primarily.
Characterisation of “flushable” and “non-flushable” commercial wet wipes using microRaman, FTIR spectroscopy and fluorescence microscopy: to flush or not to flush
Abstract
The introduction to the market of wet wipes, advertised and labelled as "flushable", has been the subject of controversy due to their perceived potential to block sewer systems as observed with other non-woven cloths such as traditional non-flushable wipes. Non-woven cloths that enter wastewater systems can find their way into the aquatic environment via wastewater effluents and it has been suggested that the breakdown of these fabrics can release materials such as microplastics into the environment. Worldwide research has revealed the alarming number of aquatic organisms affected by the presence of plastic debris in the aquatic environment harbouring a potential risk to humans through the introduction of microplastics into the food chains. However, the actual material composition of flushable wipes, their fate and impacts in the aquatic environment have not yet been scientifically studied. This paper investigates the fibre composition of flushable and non-flushable wipes, specifically with regard to synthetic polymer material, using Fourier transform infrared (FTIR) and microRaman spectroscopy along with fluorescence microscopy. The study demonstrated the presence of polyester (polyethylene terephthalate, (PET)), high-density polyethylene (HDPE) and polyethylene/vinyl acetate (PEVA/EVA) in some flushable wipes and PET in all non-flushable. Other polymers such us polypropylene (PP), low-density polyethylene (LDPE), expanded polystyrene (EPS) and polyurethane (PU) were also identified as potential components in the flushable material. Hence, commercially available wet wipes labelled as flushable could also be considered as a possible source of microplastic fibres in the wastewater streams and, if not retained, in the environment.
Seasonal variation and source analysis of persistent organic pollutants in the atmosphere over the western Tibetan Plateau
Abstract
Over the past few decades, the Tibetan Plateau (TP) region has become gradually contaminated by persistent organic pollutants (POPs). The picture regarding POPs is clear in the central and southern parts of the TP; however, few observational campaigns have focused on the western TP. To clarify the concentrations, seasonal trends and source regions of POPs in the western TP, a first study of POPs in Muztagh Ata (westerly region) and a long-term (5 years) monitoring program in Ngari (transect region influenced by both the Indian monsoon and westerly climate) were conducted. Except for hexachlorobenzene (HCB) and polychlorinated biphenyls (PCBs), relatively low POP levels were observed in the western TP. In Muztagh Ata, dichlorodiphenyltrichloroethanes (DDTs) showed higher concentrations in winter and lower ones in summer, whereas at Ngari, higher DDTs and hexachlorocyclohexanes (HCHs) concentrations were observed in summer as compared with winter. Source diagnosis indicated that Xinjiang and central Asia were the main source regions for POPs in Muztagh Ata and that westerly winds play a key role in transporting POPs from central Asia. No correlation was found between the height of the atmospheric boundary layer and the concentrations of POPs over the TP.
Occurrence of tumors among gastropods Plicopurpura pansa (Gastropoda: Neogastropoda) in the Port of Manzanillo, Mexico
Abstract
In order to evaluate the health of Plicopurpura pansa, a species considered vulnerable, a population of this gastropod living in proximity to the port of greatest cargo movement in Mexico was monitored seasonally during 1 year. Morphometric characteristics and sexual proportion were recorded. A macroscopic analysis was carried out to detect malformations and imposex; a histological analysis was performed to evaluate disseminated and gonadal neoplasias; the presence/absence in soft tissues of butyltin species (BTs) as possible contamination agents was also estimated. A total of 508 P. pansa specimens were collected. The largest specimens were obtained in winter. The coefficients of determination inside the port were low (R2 = 0.453). In general, there was a greater proportion of females than males throughout the year. Distinctive foot malformations (tumors) were recorded, but without signs of imposex. The histological examination confirmed the presence of disseminated neoplasias in the foot and gonads of P. pansa in the Port of Manzanillo. The comparative analysis of the morphological and histological features of the studied gastropod population allowed us to recognize impact patterns in relation to proximity to the port. There were high concentrations of monobutyltin (MBT) and greater abundance of tumors in heavier specimens; this was associated with port proximity zones. P. pansa could therefore serve as a sensitive bioindicator of environmental health in marine systems.
Lycopene reduces in utero bisphenol A exposure-induced mortality, benefits hormones, and development of reproductive organs in offspring mice
Abstract
This study was conducted to investigate the protective effect of lycopene on reproductive toxicity induced by in utero exposure to bisphenol A (BPA) in offspring mice. Pregnant mice in the BPA model group were given orally 500 mg/kg/day BPA from pregnant day (PD)8 to PD14. Mice of lycopene group were gavaged with 20 mg/kg/day lycopene from PD1 to PD7 and then given 500 mg/kg/day BPA from PD8 to PD14. Results showed that lycopene reduced the elevated mortality in offspring mice of the mother exposed to BPA. BPA lowered the levels of testosterone, luteinizing hormone, and follicle-stimulating hormone while lycopene treatment increased the levels significantly. BPA elevated estradiol while lycopene lowered estradiol in the offspring. BPA caused testicular damage as shown by less Leydig cells and ovarian injury as shown by less corpus granules in adult offspring, while lycopene decreased the damages. Maternal exposure to BPA increased Bax and decreased Bcl-2 in testicular and ovary tissues in the offspring mice. Lycopene decreased Bax in testis and ovary and increased Bcl-2 in ovary tissues in the offspring mice. These findings suggest lycopene has protective effects on in utero BPA exposure-induced reproductive toxicity in offspring mice.
Minimal Clinically Important Differences for Measures of Treatment Efficacy in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Publication date: Available online 8 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Whan B. Kim, Brandon Worley, James Holmes, Elizabeth J. Phillips, Jennifer Beecker, Jennifer Beecker
Platelet rich plasma with microneedling and trichloroacetic acid peel for treatment of striae distensae
Publication date: Available online 8 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Abhijeet Kumar Jha, Sidharth Sonthalia, Deepak Jakhar
The dependency analysis between energy consumption, sanitation, forest area, financial development, and greenhouse gas: a continent-wise comparison of lower middle-income countries
Abstract
This study explored the long-run association among greenhouse gases (GHGs), financial development, forest area, improved sanitation, renewable energy, urbanization, and trade in 24 lower middle-income countries from Asia, Europe, Africa, and America (South and North) by using panel data from 1990 to 2015. Granger causality was tested by Toda and Yamamoto approach. The bi-directional causality was established among urbanization and GHGs (Asia), financial development and forest (Asia), energy use and renewable energy (Asia), renewable energy and forest (Asia), improved sanitation and forest (Asia, Africa, America), urbanization and forest (Asia), and improved sanitation and financial development (Europe). The GHG emission also shows one-way causality is running from financial development to GHG (America), energy to GHG (Asia), renewable energy to GHG (America), forest area to GHG (America), trade openness to GHG (Africa), urbanization to GHG (Europe), GHG to financial development (Europe), GHG to energy use (Europe, Africa, and America), and GHG to trade openness (Asia). On the basis of fully modified ordinary least square and generalized method of moment, the reciprocal relationship of GHGs was observed due to financial development in Asia and Africa; renewable energy in all panels; forest area in Asia, Europe, and America; improved sanitation in Asia, Africa, and America; trade openness in Africa; and urbanization in Europe and America. Policymakers should concentrate on these variables for the reduction in GHGs. The annual convergence towards long-run equilibrium was 50.5, 31.9, and 20.9% for America, Asia, and Africa, respectively.
Occurrence and ecological risk assessment of 22 emerging contaminants in the Jilin Songhua River (Northeast China)
Abstract
Rivers may receive pharmaceuticals, personal care products, and environment estrogens, which are emerging concerns, from various sources. Understanding the fate of these emerging contaminants (ECs) from the sources to their receiving river is important for assessing their ecosystem risk. Here, the occurrence, seasonal variation, spatial distribution, and ecological risk of 22 ECs in water and sediments from the Jilin Songhua River, as well as in the effluents from the riverside Jilin wastewater treatment plant (WWTP) were investigated. Results indicated that estriol with the highest median concentration of 21.5 ng L−1 in the river water and with the highest median concentration of 481.5 ng g−1 in the sediments, and methylparaben with the highest concentration of 29.6 ± 2.9 ng L−1 in the WWTP effluents were the predominant contaminants. The total concentration of ECs in the river water in the dry season was about 1.5 times higher than that in the wet season. The concentrations of these ECs close to the contaminated tributary and the WWTP were relatively high. Risk assessment showed that the maximum risk quotient value of estrone was 1.07 in the river water and estriol was 2.10 in the effluents. In addition, erythromycin posed generally medium risk in the river water and WWTP effluents. It should be paid attention to the prior control of the three contaminants in the river region.
Successful haploidentical transplantation with post-transplant cyclophosphamide for activated phosphoinositide 3-kinase δ syndrome
Publication date: Available online 8 June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Che Ry Hong, Sangmoon Lee, Kyung Taek Hong, Jung Yoon Choi, Hee Young Shin, Murim Choi, Hyoung Jin Kang
Timoma de estadio avanzado asociado a síndromes paraneoplásicos con buena respuesta a los corticosteroides orales y tacrolimus tópico
Publication date: Available online 7 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): S. Sánchez-Pérez, C. Monteagudo-Castro, J.M. Martín-Hernández, M.D. Ramón-Quiles
Descripción de los pacientes que reciben biológicos como primer tratamiento sistémico en el registro BIOBADADERM durante el periodo 2008-2016
Publication date: Available online 7 June 2018
Source:Actas Dermo-Sifiliográficas
Author(s): G. Carretero Hernández, C. Ferrándiz, R. Rivera Díaz, E. Daudén Tello, P. de la Cueva-Dobao, F.J. Gómez-García, E. Herrera-Ceballos, I. Belinchón Romero, J.L. López-Estebaranz, M. Alsina Gibert, J.L. Sánchez-Carazo, M. Ferrán Farrés, A. González Quesada, J.M. Carrascosa Carrillo, M. Llamas-Velasco, M.V. Mendiola Fernández, D. Ruiz Genao, C. Muñoz Santos, I. García-Doval, M.A. Descalzo
Introducción y objetivosLa utilización clínica habitual de los fármacos biológicos en el tratamiento de la psoriasis es en segunda línea, es decir, tras el uso previo de un fármaco clásico. Sin embargo, en casos particulares ?particularidades del paciente o criterio médico? se realiza la indicación en primera línea. No existen estudios sobre las características demográficas, clínicas y de seguridad de los pacientes que reciben fármaco biológico en primera línea. Como objetivo primario se pretende determinar dichas características de acuerdo con la iniciación de la terapia biológica en primera o segunda línea.Material y métodoSe realizó un estudio descriptivo, multicéntrico, de 181 pacientes que iniciaron tratamiento biológico como primer fármaco sistémico para control de su psoriasis moderada-grave, y que forman parte del Registro Español de Acontecimientos Adversos Asociados con Medicamentos Biológicos en Dermatología, entre enero de 2008 y noviembre de 2016.ResultadosLos pacientes de ambos grupos son muy similares, si bien se evidencia que el grupo que recibe el biológico en primera línea presenta una edad más avanzada, sin que se justifique por gravedad de la enfermedad (PASI) ni por el tiempo de evolución de esta desde el diagnóstico. En este grupo de pacientes es más frecuente la presencia de hipertensión, diabetes y hepatopatía. No hemos encontrado diferencias en motivos de suspensión ni seguridad entre ambos grupos.ConclusionesNo se han encontrado diferencias relevantes entre los 2 grupos, lo cual refuerza la seguridad de los fármacos biológicos en este contexto.Introduction and objectivesBiologic drugs are usually prescribed as second-line treatment for psoriasis, that is, after the patient has first been treated with a conventional psoriasis drug. There are, however, cases where, depending on the characteristics of the patient or the judgement of the physician, biologics may be chosen as first-line therapy. No studies to date have analyzed the demographics or clinical characteristics of patients in this setting or the safety profile of the agents used. The main aim of this study was to characterize these aspects of first-line biologic therapy and compare them to those observed for patients receiving biologics as second-line therapy.Material and methodWe conducted an observational study of 181 patients treated in various centers with a systemic biologic drug as first-line treatment for moderate to severe psoriasis between January 2008 and November 2016. All the patients were registered in the Spanish Registry of Adverse Events Associated with Biologic Drugs in Dermatology.ResultsThe characteristics of the first- and second-line groups were very similar, although the patients receiving a biologic as first-line treatment for their psoriasis were older. No differences were observed for disease severity (assessed using the PASI) or time to diagnosis. Hypertension, diabetes, and liver disease were all more common in the first-line group. There were no differences between the groups in terms of reasons for drug withdrawal or occurrence of adverse effects.ConclusionsNo major differences were found between patients with psoriasis receiving biologic drugs as first- or second-line therapy, a finding that provides further evidence of the safety of biologic therapy in patients with psoriasis.
Graphical abstract
Water content of limestones submitted to realistic wet deposition: a CIME2 chamber simulation
Abstract
An experimental chamber (CIME2) has been specially designed to simulate wet atmospheric deposition on limestones used in Paris cultural heritage. This instrument is a complementary tool to CIME, a previously developed chamber dedicated to the simulation of dry atmospheric deposition on monuments and artifacts. The aim of this paper is to describe CIME2 and characterize the wet deposits produced inside it. Mist (fog), drizzle, and rainfall are differentiated in order to document their ability to saturate the limestones most currently used in Paris monuments: The Saint-Maximin's limestone, the Liais of Saint-Maximin, and the Chauvigny's limestone are tested. The comparison between normalized and environmental petrophysical data shows that in the wet deposition simulations, limestones are not systematically water-saturated. Moreover, the realistic experimental conditions chosen favor a more rapid evaporation of the stone water. The quantification of the non-saturation state is a first step that has to be taken into account to improve the geochemical models used to predict the alteration.
Persistence of picloram in soil with different vegetation managements
Abstract
Herbicides with long residual period may increase the risk of environmental contamination. Adequate management of forage can reduce the half-life of the picloram, one of the most herbicides used in weed control. This study aims to determine the half-life of picloram, using high-performance liquid chromatography in a cultivated soil with Brachiaria brizantha trimmed or not. Brachiaria brizantha was cultivated in 60 pots filled with samples of oxisol, and 30 others were kept uncultivated with this forage. This plant was cut off close to the ground, after 60 days of emergency on 30 vessels. Picloram was applied in all of the plots. Soil samples were collected at 2, 16, 30, 44, 58, 72, 86, 120, 150, and 180 days after the application of this herbicide. These samples were air-dried and stored at − 20 °C. Picloram was extracted by HPLC/UV-Vis detector. Half-life of this herbicide was calculated using kinetics models. The mere presence of roots in treatment with signalgrass cutoff did not reduce the concentrations of this herbicide, except when the emergence of new leaves occurred. The absence of B. brizantha cultivation in areas with application of picloram increases the risk of environmental contamination and successive crops due to the half-life of this herbicide. Brachiaria brizantha reduced half-life picloram and environmental risk in pastures. The validation method is suitable for determining picloram in low concentrations in soil.
Humic substances in Fluvisols of the Lower Vistula floodplain, North Poland
Abstract
The present study describes properties of humic substances of the Fluvisols (the Lower Vistula, Poland). Fluvisols under agricultural management (arable soil and grassland) were sampled from the surface horizon 50, 200, 600, and 900 m from the Vistula River. The content of carbon in the fractions of humic acids (CHAs), fulvic acids (CFAs), and humins (CHUMIN) as well as the content of dissolved organic carbon (DOC) were assayed. The organic matter of the soils that were sampled 200 m from the river demonstrated a lowest share of the humic acids (HAs) and fulvic acids (FAs). The percentage share of the hydrophilic fractions (HIL) in the HAs and, as a result the value of the HIL/ΣHOB ratio, increased with the distance from the riverbed. The HAs of the soils located further from the riverbed had a higher degree of humification compared to the HAs of the soils that were sampled 50 and 200 m away. Based on the research results, it was determined that the properties of HAs can be used to evaluate the effect of flood events, their location, and scope on the transformation of the organic matter in fluvial sediments.
Major Trauma Workload and Training Among UK Plastic Surgeons: A Survey of BAPRAS Members
Publication date: Available online 8 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Susan A. Hendrickson, Rob M.T. Staruch, Katie Young, Shehan Hettiaratchy
How to assess the volume of a DIEP flap using a free online calculator: the DIEP V (volume) method,,✰✰✰,✰✰✰✰
Publication date: Available online 8 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Sergio Razzano, Ryan Taylor, Schonauer Fabrizio, Andrea Figus
IntroductionAmong the few methods available, none is able to determine accurately the volume of a DIEP flap. Specimen weight is commonly used to assess the amount of flap needed to reconstruct a breast, but the density of breast is different from that of abdominal tissues; therefore, the volume should be used as a unique unit of measure. The purpose of this study was to provide a simple method to calculate the predicted volume of a DIEP flap in order to match the volume of the breast being reconstructed.Material and MethodWe hypothesised that the shape best resembling a DIEP flap was a truncated pyramid. Based on this shape, we tailored 30 DIEP flap models using the discarded tissue after unilateral DIEP flap breast reconstructions. The awaited volume (AV) of the models was calculated with a free online calculator measuring the length and height with a ruler, and width (fat thickness) with Ultrasound (US).The real volume (RV) of the models was calculated using water displacement method. AV and RV were compared and statistical analysis was performed.ResultsThe mean difference between the AV and the RV was not statistically significant with a mean estimation error of 6.75%. When the AVs were plotted against the RVs, the two data sets were highly statistically correlated (correlation coefficient (r) = 0.997).ConclusionsThe proposed tool can be a useful, precise, easy and accessible tool to improve the current DIEP flap size assessment improving outcomes for both surgeons and patients.
Objective assessment of effect of dome cut and suture on the correction of lower lateral cartilage malposition
Publication date: Available online 7 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Shahriar Hadadi Abyaneh, Ali Atri, Ali Ranjbari, Hojjat Molaei
Quantitative dynamic analysis of the nasolabial complex using 3D motion capture – a normative data set
Publication date: Available online 8 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): C.J. Lowney, T-C Hsung, D.O. Morris, B.S. Khambay
IntroductionSmile reanimation should be considered from a dynamic perspective. Any intervention should restore normality. To date no such normative dynamic data has been published.AimTo quantitatively analyse maximal smiles between a healthy group of Caucasian male and female adults using 3D motion capture (4D stereophotogrammetry).MethodUsing a 3D facial motion capture system 54 males and 54 female volunteers were imaged whilst performing a maximal smile. Eight nasolabial landmarks were digitised and tracked. Differences in displacement and speed of bilateral landmarks between males and females were analysed in each direction (x, y, z and Euclidian), from rest (T0), to median smile (T1) and maximal smile (T2), using paired t-tests and Wilcoxon-Signed Rank tests.ResultsIn males and females the displacement and speed of the left and right alar base landmarks were similar in the x and y directions but less in the z direction. For the philtrum, the displacement and speed of the bilateral landmarks were similar in the y and z directions, but less in the x direction. The left alar base and left philtrum moved significantly more in males. Left and right cheilion moved a similar amount in the x and y directions but more in the z direction. Labiale superius moved significantly more in the z direction, and labiale inferius moved significantly more in the y direction in males.In conclusion, this study has presented a novel normative data set of dynamic nasolabial complex movement for males and females during maximum smile. The data, as well as providing magnitudes of displacements of the nasolabial complex, also provides the speeds of movement.
Potentially toxic elements to maize in agricultural soils—microbial approach of rhizospheric and bulk soils and phytoaccumulation
Abstract
Maize fields near Mae Tao Creek in Pha Te Village, Tak Province, Thailand are contaminated with Zn, Cd, and Pb. This research studied the interaction between levels of the metals contaminating the soil and maize development, heavy metal accumulation in the seeds, and the soil bacterial community structure. Our field experiment was carried out in five plots with metal contents that gradually decreased from a high level near the creek to a lower level further into the land: Zn 380–4883 mg kg−1, Cd 6–85 mg kg−1, and Pb 34–154 mg kg−1. Cultivation and isolation on nutrient agar (NA) was utilized to study the culturable bacterial community, and polymerase chain reaction denaturing gradient gel electrophoresis (PCR-DGGE) was utilized for the unculturable bacterial communities. All statistical analyses clearly indicated that rainfall and irrigation were the main factors affecting total Zn concentration and bioavailable Zn, Cd, and Pb in the field. The variation in the contents of the heavy metals was weakly correlated with the culturable bacterial community indices (Shannon-Wiener, evenness and richness), but the contents resulted in a difference in the overall diversity of the bacteria in the soil. The richness, numbers of culturable rhizobacteria, and maize growth stage significantly affected the amount of Zn and Cd that accumulated in the roots. In addition, maize accumulated a high level of Zn in the seeds, while the low contents of Cd and Pb in the seeds were below our limit of detection. The results obtained could be informative for the management of maize cultivation in the area.
Combining micelle-clay sorption to solar photo-Fenton processes for domestic wastewater treatment
Abstract
A tertiary treatment of effluent from a biological domestic wastewater treatment plant was tested by combining filtration and solar photocatalysis. Adsorption was carried out by a sequence of two column filters, the first one filled with granular activated carbon (GAC) and the second one with granulated nano-composite of micelle-montmorillonite mixed with sand (20:100, w/w). The applied solar advanced oxidation process was homogeneous photo-Fenton photocatalysis using peroxymonosulfate (PMS) as oxidant agent. This combination of simple, robust, and low-cost technologies aimed to ensure water disinfection and emerging contaminants (ECs, mainly pharmaceuticals) removal. The filtration step showed good performances in removing dissolved organic matter and practically removing all bacteria such as Escherichia coli and Enterococcus faecalis from the secondary treated water. Solar advanced oxidation processes were efficient in elimination of trace levels of ECs. The final effluent presented an improved sanitary level with acceptable chemical and biological characteristics for irrigation.
Can we use Cd-contaminated macrophytes for biogas production?
Abstract
Aside from the ability of plants to remove domestic-industrial wastewater contaminants from various types of water, macrophytes can also serve as an alternative source of energy. The goal of the present study was to test the viability of biogas production using aquatic macrophyte species—Eichhornia crassipes and Pistia stratiotes—contaminated with cadmium (Cd) after the phytoremediation process. The plants were transferred to a nutrient solution contaminated with 0.8 mg L−1of Cd. The experiment was set up in a 2 × 3 factorial scheme with the presence or absence of Cd and three phytoremediation times (20, 40, or 60 days) using P. stratiotes followed by an additional treatment consisting of P. stratiotes + E. crassipes for 20 days. The acute and chronic effects of bioassays with the microcrustacean Daphnia similis were used to evaluate the ability of the macrophytes to remove toxicity by phytoremediation. The viability test of biogas production after phytoremediation was evaluated using micro-biodigesters. According to the results, at least 60 days of phytoremediation are necessary to remove/remediate the Cd present in the contaminated solution. The metal did not influence the macrophytes' methanogenic activity, showing that these macrophytes can be used for biogas/methane production. The combination of Pistia stratiotes with Eichhornia crassipes is a good alternative to reduce phytoremediation time, but for 20 days of testing, the presence of Eichhornia crassipes reduces the biogas production/CH4. However, it is believed that if the digestion time is extended, this effect can be minimized. The phytoremediation time indicated that Pistia stratiotes must remain at least 60 days to remove/remediate the Cd present in the contaminated solution.
Arsenic-induced oxidative stress, cholinesterase activity in the brain of Swiss albino mice, and its amelioration by antioxidants Vitamin E and Coenzyme Q10
Abstract
Arsenic toxicity becomes one of the major public health issues in several countries. Chronic and acute exposure to arsenic has been reported to be toxic to various systems of the human body and also observed in controlled experimental studies. The study was conducted to evaluate the neurotoxic effect of arsenic in Swiss albino mice and its amelioration by Vitamin E, Coenzyme Q10 and their combination. Swiss albino mice were treated with arsenic of 136 ppm for 15 days. The daily dose is 1/3 of LD 50 (acute) reported dose of arsenic. Thereafter, the animals were maintained either on drinking water or treated with Vitamin E (50 mg/kg bwt), Coenzyme Q10 (10 mg/kg bwt), and their combination by i.p.daily for 15 days. After the treatment, animals were sacrificed. The weight of the brain was marginally lower (ns), in arsenic-treated group as compared to control and antioxidant-protected groups. The LPO (lipid peroxidation) level was higher in arsenic-treated group, and this elevation was checked to some extent by the selected antioxidants which were statistically significant in combination of antioxidant-protected group. A significant reduction was found in GSH (reduced glutathione) level in the brain of arsenic-treated mice whereas GSH level was considerably higher in antioxidant-protected groups. Further, total thiol and total protein level were lower in arsenic-treated group. However, total thiol was significantly higher in antioxidant-protected groups. CAT (catalase) activity was significantly lower while SOD (superoxide dismutase) activity was marginally lowered in arsenic-treated group, and it was slightly higher in antioxidant-protected groups. Further, reduction in AChE (acetylcholinesterase) and BChE (butyrylcholinesterase) and motor coordination activity were also observed in arsenic-treated groups. Whereas, a higher AChE, BChE, and motor coordination activity was observed in antioxidant-protected group. These data indicate a positive role of selected antioxidant against the toxicity of arsenic in the brain of mice.
The breast milk lead levels among Chinese population
Abstract
Breast milk is a potential source of infant and young children lead exposure, but national-level data on breast milk lead (BML) is unknown in China. To fill up this gap, we conducted a review by analyzing the articles enrolled through searching Wanfang MedOnline, CNKI, SinoMed, Pubmed, and Embase databases and relevant articles from 2000 through 2017. After screening and assessing process, 17 articles were included. The average concentrations of BML in these studies varied with regions (1.54–171.84 μg/L), and the BML level was dropping down in general. In conclusion, breast milk should still be encouraged to infant and young children in normal areas of China, and stopping breastfeeding should be considered prudently. Education for health workers and families on BML should be strengthened, and more surveys on BML should be conducted.
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
