Genome-wide phylogeography reveals cryptic speciation in the circumglobal planktonic calcifier Limacina bulimoides.

Little is known about when and how planktonic species arise and persist in the open ocean without apparent dispersal barriers. Pteropods are planktonic snails with thin shells susceptible to dissolution that are used as bio-indicators of ocean acidification. However, distinct evolutionary units respond to acidification differently, and defining species boundaries is therefore crucial for predicting the impact of changing ocean conditions. In this global population genomic study of the shelled pteropod Limacina bulimoides, we combined genetic (759,000 single nucleotide polymorphisms) and morphometric data from 161 individuals, revealing three major genetic lineages (FST = 0.29-0.41): an "Atlantic lineage" sampled across the Atlantic, an "Indo-Pacific lineage" sampled in the North Pacific and Indian Ocean, and a "Pacific lineage" sampled in the North and South Pacific. A time-calibrated phylogeny suggests that the lineages diverged about 1 million years ago, with estimated effective population size remaining high (~10 million) throughout Pleistocene glacial cycles. We do not observe any signatures of recent hybridization, even in areas of sympatry in the North Pacific. While the lineages are reproductively isolated, they are morphologically cryptic, with overlapping shell shape and shell colour distributions. Despite showing that the circumglobal L. bulimoides consists of multiple species with smaller ranges than initially thought, we found that these pteropods still possess high levels of genetic variability. Our study adds to the growing evidence that speciation is often overlooked in the open ocean, and suggests the presence of distinct biological species within many other currently defined circumglobal planktonic species.

Hyperspectral analysis for perioperative perfusion monitoring-a clinical feasibility study on free and pedicled flaps.

OBJECTIVES: In reconstructive surgery, flap monitoring is crucial for early identification of perfusion problems. Using hyperspectral imaging (HSI), this clinical study aimed to develop a non-invasive, objective approach for perfusion monitoring of free and pedicled flaps. MATERIAL AND METHODS: HSI of 22 free (FF) and 8 pedicled flaps (PF) in 30 patients was recorded over time. Parameters assessed were tissue oxygenation/superficial perfusion (0-1 mm) (StO2 (0-100%)), near-infrared perfusion/deep perfusion (0-4 mm) (NIR (0-100)), distribution of haemoglobin (THI (0-100)), and water (TWI (0-100)). Measurements up to 72 h were correlated to clinical assessment. RESULTS: Directly after flap inset, mean StO2 was significantly higher in FF (70.3 ± 13.6%) compared with PF 56.2 ± 14.2% (p = 0.05), whereas NIR, THI, and TWI were similar (NIR_p = 0.82, THI_p = 0.97, TWI_p = 0.27). After 24 h, StO2, NIR, THI, and TWI did not differ between FF and PF. After 48 h, StO2, NIR, and TWI did not differ between FF and PF whereas THI was significantly increased in FF compared with PF(p = 0.001). In three FF, perfusion decreased clinically and in HSI, 36(1), 40(2), 5(3), and 61(3) h after flap inset which was followed by prompt intervention. CONCLUSIONS: StO2 < 40%, NIR < 25/100, and THI < 40/100 indicated arterial occlusion, whereas venous problems revealed an increase of THI. In comparison with FF, perfusion parameters of PF were decreased after flap transfer but remained similar to FF later on. CLINICAL RELEVANCE: HSI provides objective and non-invasive perfusion monitoring after flap transplantation in accordance to the clinical situation. With HSI, signs of deterioration can be detected hours before clinical diagnosis.

The influence of geranylgeraniol on microvessel sprouting after bisphosphonate substitution in an in vitro 3D-angiogenesis assay.

OBJECTIVES: Recent studies focused on angiogenesis in the pathophysiology of bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) and identified geranylgeraniol (GGOH) as a feasible option for BP-ONJ therapy. This study investigated the influence of GGOH on microvessel sprouting after BP-incubation in vitro. MATERIALS AND METHODS: Ten experimental set-ups were randomly designed in an in vitro 3D-angiogenesis assay. Two groups included HUVEC cell spheroids with and without (±) GGOH substitution as controls and eight groups pairwise contained either clodronate or the nitrogen-containing bisphosphonates (N-BP) ibandronate, pamidronate, and zoledronate ± GGOH. The size of the cell spheroids including the outbranching sprouts (SpS) as well as the density (SpD) and length of the sprouts (SpL) were analyzed by a grid system after 0, 24, 48, and 72 h. RESULTS: For controls and NN-BP clodronate, no significant differences at any tested parameter and any point of measurement could be detected within the experimental set-ups ± GGOH (p each ≥0.05). For N-BP ibandronate, the experimental set-ups +GGOH showed a significantly increased SpS, SpD, and SpL after 48 and 72 h (p each ≤0.002) compared to the experimental set-ups -GGOH. For N-BPs pamidronate and zoledronate, the experimental set-ups + GGOH demonstrated a significantly increased SpS, SpD, and SpL after 24, 48, and 72 h (p each ≤0.001) compared to the experimental set-ups -GGOH. CONCLUSIONS: The strong negative influence of N-BPs on microvessel sprouting could be significantly reversed by GGOH. CLINICAL RELEVANCE: Since supportive therapeutic options for BP-ONJ are lacking, GGOH might be a promising substitute for BP-ONJ prevention and therapy.

Performance of different osteosynthesis materials in microvascular fibula free flap reconstruction.

Fibular free flap (FFF) is the main reconstructive choice for large mandibular defects. Recent improvements have been made regarding planning and surgical procedure, but choice of osteosynthesis material (OSM) for segment-fixation remains controversial. A retrospective cohort study obtained clinical and radiological data from FFF-patients. Data were screened for OSM, surgical procedure and complications as OSM fractures, loosening, exposure, or insufficient osseous consolidation. Eighty patients with FFF were included. Planning was CAD/CAM (n=29), Recon Guide (n=26) or without planning (n=25). OSM was 2.0mm-miniplates in standard (n=26), preformed (n=6), CAD/CAM (n=14) or ReconGuide (n=23) variation and 2.3mm-reconstruction-plates in standard (n=5) or CAD/CAM (n=6) variation. Complications were observed in 21 cases, fractures occurred 10 times overall, but with low rates for preformed (n=1), ReconGuide (n=3) and none for CAD/CAM. Analysis detected significant correlations between used OSM and plate exposure (p = 0.000), but none regarding fracture (p = 0.275), loosening (p = 0.714) or insufficient osseous consolidation (p = 0.208). No correlations were observed between complications and OSM (p = 0.609) or diagnosis (p = 0.716). Fixation of FFF segments for reconstruction is possible with various OSM providing good clinical outcome. No significant differences were detected regarding prevention of complications by any osteosynthesis material (miniplate vs. macroplate). Although no differences were detected, miniplate usage is advocated whenever clinically reasonable, due to easier reintervention possibilities and reduced implanted foreign material. Nevertheless, decision for ideal OSM must remain patient-specific and cannot be generalised.

[Digitalization and use of artificial intelligence in microvascular reconstructive facial surgery]. / Digitalisierung und Ansätze künstlicher Intelligenz in der mikrovaskulär-rekonstruktiven Gesichtschirurgie.

BACKGROUND: When using digitalization and artificial intelligence (AI), large amounts of data (big data) are produced, which can be processed by computers and used in the field of microvascular-reconstructive craniomaxillofacial surgery (CMFS). OBJECTIVE: The aim of this article is to summarize current applications of digitalized medicine and AI in microvascular reconstructive CMFS. MATERIAL AND METHODS: Review of frequent applications of digital medicine for microvascular CMFS reconstruction, focusing on digital planning, navigation, robotics and potential applications with AI. RESULTS: The broadest utilization of medical digitalization is in the virtual planning of microvascular transplants, individualized implants and template-guided reconstruction. Navigation is commonly used for ablative tumor surgery but less frequently in reconstructions. Robotics are mainly employed in the transoral approach for tumor surgery of the hypopharynx, whereas the use of AI is still limited even if possible applications would be automated virtual planning and monitoring systems. CONCLUSION: The use of digitalized methods and AI are adjuncts to microvascular reconstruction. Automatization approaches and simplification of technologies will provide such applications to a broader clientele in the future; however, in CMFS, robotic-assisted resections and automated flap monitoring are not yet the standard of care.

Pteropods are excellent recorders of surface temperature and carbonate ion concentration.

Pteropods are among the first responders to ocean acidification and warming, but have not yet been widely explored as carriers of marine paleoenvironmental signals. In order to characterize the stable isotopic composition of aragonitic pteropod shells and their variation in response to climate change parameters, such as seawater temperature, pteropod shells (Heliconoides inflatus) were collected along a latitudinal transect in the Atlantic Ocean (31° N to 38° S). Comparison of shell oxygen isotopic composition to depth changes in the calculated aragonite equilibrium oxygen isotope values implies shallow calcification depths for H. inflatus (75 m). This species is therefore a good potential proxy carrier for past variations in surface ocean properties. Furthermore, we identified pteropod shells to be excellent recorders of climate change, as carbonate ion concentration and temperature in the upper water column have dominant influences on pteropod shell carbon and oxygen isotopic composition. These results, in combination with a broad distribution and high abundance, make the pteropod species studied here, H. inflatus, a promising new proxy carrier in paleoceanography.

Osseous plasma cell neoplasm of the mandible for initial diagnosis of multiple myeloma: case report and literature review.

PURPOSE: Plasmocytoma of the bone represents a variance of plasma cell neoplasms, which often gives hint for systemic affection. A case of a mandibular tumor as first manifestation of multiple myeloma (MM) is presented and discussed with the literature. MATERIALS AND METHODS: A 76-year old female with pain and swelling of the right lower jaw was assigned to the hospital. Radiograph showed a lytic tumor at the mandibular condyle and histological analysis gave evidence of a plasma cell tumor with positivity to CD138. In further examinations, elevated immunoglobulin levels in serum and osseous plasma cell infiltration unveiled MM. PubMed-database was searched by "multiple myeloma primary lesion jaw", "multiple myeloma primary manifestation mandible" and "multiple myeloma mandibular lesion" within the last 30 years. RESULTS: Together with the current case, 11 reports including 13 patients were found describing mandibular plasmocytoma as first sign for MM. Mean age was 59 years with slight female preference. Initial symptoms were mostly swelling episodes with or without pain. The main radiological presentation was a uni- or multilocular radiolucency. After a mean follow up time of 29 months (stated in 8 cases; standard deviation 50, min: 1, max: 151), 3/8 patients died and in 5/8 cases, signs of progress were seen. CONCLUSION: In rare cases, occurrence of plasmocytoma of the mandible is first sign for MM and should always lead to further investigations regarding systemic disease. Simple examinations such as panoramic X-rays can lead to early detection of MM and thereby better prognosis by earlier treatment.

Concentration and composition of the lipoprotein classes in human umbilical cord serum.

The concentration and composition of the lipoprotein density classes d less than 1.006 (VLDL), d = 1.006 - 1.064 (LDL), and d = 1.064 - 1.21 (HDL) of human umbilical cord serum were investigated by means of preparative ultracentrifugation. The concentrations of all the density classes, in particular that of the VLDL, are lower than in adults; the values correspond to 8.1 (VLDL), 59.2 (LDL), and 77.4 (HDL) mg/100 ml. About 15% of the total cholesterol and roughly 40% of the total lipid phosphorus did not float at the highest density of 1.21. The composition of the LDL and the HDL was principally in agreement with the pattern obtained in adults. The VLDL of the cord serum, however, showed a lower amount of triglycerides (45%) and a higher content of proteins (22%) than the VLDL from serum of adults. In cord serum only 25% of the total triglycerides are associated with the VLDL fraction, while more than 50% of the triglycerides circulate as a constituent of the LDL.

The effect of intrauterinely injected lymphocytes prepared from sensitized or non-sensitized guinea-pigs on the ultrastructure of rat fetal membranes (visceral yolk sac).

The susceptibility of rat fetal membranes (visceral yolk sac) to cell-mediated immunity was studied electron microscopically at day 19 of pregnancy. For this purpose guinea-pigs were sensitized to rat placental antigens and the activated lymphocytes were injected intrauterinely. Simultaneously, the effect of lymphocytes from non-sensitized guinea-pigs was examined on the rat yolk sac. Lymphocytes from sensitized guinea-pigs revealed a clear cytotoxic effect on the visceral yolk sac, but the degree of cell destruction showed marked differences from one epithelial cell to the other. Furthermore, the yolk sac regionally displayed great differences in the intensity of immune cytolysis...