Solar-Light-Driven Photocatalytic Oxidative Coupling of Phenol Derivatives over Bismuth-Based Porous Metal Halide Perovskites.

The selective oxidative coupling of phenol derivatives, involving carbon-carbon (C-C) and carbon-oxygen (C-O) bond formation, has emerged as a critical approach in the synthesis of natural products. However, achieving precise control over the selectivity in coupling reactions of unsubstituted phenols utilizing solar light as the driving force remains a big challenge. In this study, we report a series of porous Cs3Bi2X9 (X=Cl, Br, I) photocatalysts with tailored band gaps and compositions engineered for efficient solar-light-driven oxidative phenol coupling. Notably, p-Cs3Bi2Br9 exhibited about 73 % selectivity for C-C coupling, displaying a high formation rate of 47.3 µmol gcat -1 h-1 under solar radiation. Furthermore, this approach enables control of the site-selectivity for phenol derivatives on Cs3Bi2X9, enhancing C-C coupling. The distinctive porous structure and appropriate band-edge positions of Cs3Bi2Br9 facilitated efficient charge separation, and surface interaction/activation of phenolic hydroxyl groups, resulting in the kinetically preferred formation of C-C over C-O bond. Mechanistic insights into the reaction pathway, supported by comprehensive control experiments, unveiled the crucial role of interfacial charge transfers and Lewis acid Bi sites in stabilizing phenolic intermediates, thereby directing the regioselectivity of diradical couplings and resulting in the formation of unsymmetrical biphenols.

Effects of preoperative education using virtual reality on preoperative anxiety and information desire: a randomized clinical trial.

This study aimed to investigate the effect of preoperative education using virtual reality (VR) on preoperative anxiety and information desire. The participants were randomly assigned to the VR group and control group. The VR group received preoperative education using VR content describing preoperative and postoperative processes and their management, and the control group received preoperative education with traditional verbal education. Preoperative anxiety and information desire were measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Additionally, patient satisfaction was investigated. Preoperative anxiety (APAIS-A) and information desire (APAIS-I) scores were statistically significantly different between the VR group and the control group (p < 0.001). Patient satisfaction was not statistically significant (p = 0.147). Preoperative education using VR effectively reduced preoperative anxiety and information desire.Trial registration CRIS, KCT0007489. Registered 30 June 2022. http://cris.nih.go.kr/cris/ .

In Vivo Efficacy of an Injectable Human Acellular Dermal Matrix.

BACKGROUND: Human acellular dermal matrix (hADM) has found applications in a variety of settings, particularly in breast surgery. The most common hADM is a sheet. Recently, an injectable hADM has been introduced; we compared the biocompatibility and long-term structural integrity of, an injectable hADM and a sheet-type hADM in mice. METHODS: An injectable hADM (experimental group) and a sheet-type hADM (control group) were implanted into sub-panniculus pockets on the backs of 50 mice. The animals were sacrificed 2, 4, 8, 12, or 24 weeks later and the hADMs and surrounding tissues were recovered and stained for histopathological analyses. The microscopic endpoints included the thickness of the hADM and capsule around the hADM, and the extents of fibroblast proliferation and neovascularization. RESULTS: No animal developed a complication or infection. The capsule was significantly thinner in the experimental than the control group. There were no significant differences between groups in the hADM thickness. Microscopically, the fibroblast density inside the hADM was significantly higher in the experimental group. The fibroblasts inside of the hADM lay significantly deeper in the experimental group. Similarly, the experimental group exhibited significantly deeper microvessels inside the hADM. CONCLUSIONS: The injectable hADM had a thinner capsule thickness (more biocompatible), than the sheet-type hADM. It maintained its thickness as well as the sheet-type hADM and had a more fibroblast proliferation and neovascularization. This means the tissue incorporation and long-term structural integrity of the injectable hADM may be as good as or better than that of the sheet-type hADM. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Eribulin Mesylate Improves Cisplatin-Induced Cytotoxicity of Triple-Negative Breast Cancer by Extracellular Signal-Regulated Kinase 1/2 Activation.

Background and Objectives; Triple-negative breast cancer (TNBC) is associated with poor patient prognosis because of its multiple molecular features. Thus, more effective treatment for TNBC is urgently needed. This study determined the possible involvement of ERK1/2 activation in cisplatin-induced cytotoxicity in TNBC by providing additional eribulin treatment. Materials and Methods; We investigated cell viability and apoptosis caused by eribulin, cisplatin, or co-treatment in HCC38, MDA-MB-231, and SKBR3 human breast cancer cells. Results; Cisplatin significantly lowered cell viability and caused high apoptotic cell death in all breast cancer cell lines. The viability of TNBC cells was significantly lower in the group co-treated with cisplatin and eribulin than in the cisplatin-only treatment group. Additional eribulin treatment significantly enhanced PARP cleavage and caspase-3 activity in cisplatin-treated TNBC cells. Moreover, cisplatin treatment activated ERK1/2 in all breast cancer cell lines. The cisplatin and eribulin combination synergistically activated ERK1/2 in TNBC cells compared with the cisplatin-only treatment. Administration of the ERK1/2 inhibitor PD98059 increased the viability of TNBC cells treated with cisplatin plus eribulin. Conclusions; Eribulin could synergize the cytotoxic and apoptotic activities of cisplatin and increase ERK1/2 activation, thus enhancing anti-cancer effects against TNBC cells.

Unraveling the Function of Metal-Amorphous Support Interactions in Single-Atom Electrocatalytic Hydrogen Evolution.

Amorphization of the support in single-atom catalysts is a less researched concept for promoting catalytic kinetics through modulating the metal-support interaction (MSI). We modeled single-atom ruthenium (RuSAs ) supported on amorphous cobalt/nickel (oxy)hydroxide (Ru-a-CoNi) to explore the favorable MSI between RuSAs and the amorphous skeleton for the alkaline hydrogen evolution reaction (HER). Differing from the usual crystal counterpart (Ru-c-CoNi), the electrons on RuSAs are facilitated to exchange among local configurations (Ru-O-Co/Ni) of Ru-a-CoNi since the flexibly amorphous configuration induces the possible d-d electron transfer and medium-to-long range p-π orbital coupling, further intensifying the MSI. This embodies Ru-a-CoNi with enhanced water dissociation, alleviated oxophilicity, and rapid hydrogen migration, which results in superior durability and HER activity of Ru-a-CoNi, wherein only 15 mV can deliver 10 mA cm-2 , significantly lower than the 58 mV required by Ru-c-CoNi.

Unveiling the Protonation Kinetics-Dependent Selectivity in Nitrogen Electroreduction: Achieving 75.05 % Selectivity.

While higher selectivity of nitrogen reduction reaction (NRR) to ammonia (NH3 ) is always achieved in alkali, the selectivity dependence on nitrogen (N2 ) protonation and mechanisms therein are unrevealed. Herein, we profile how the NRR selectivity theoretically relies upon the first protonation that is collectively regulated by proton (H) abundance and adsorption-desorption, along with intermediate-*NNH formation. By incorporating electronic metal modulators (M=Co, Ni, Cu, Zn) in nitrogenase-imitated model-iron polysulfide (FeSx), a series of FeMSx catalysts with tailorable protonation kinetics are obtained. The key intermediates behaviors traced by in situ FT-IR and Raman spectroscopy and operando electrochemical impedance spectroscopy demonstrate the strong protonation kinetics-dependent selectivity that mathematically follows a log-linear Bradley curve. Strikingly, FeCuSx exhibits a record-high selectivity of 75.05 % at -0.1 V (vs. RHE) for NH3 production in 0.1 M KOH electrolyte.

Binder-free TiO2 hydrophilic film covalently coated by microwave treatment.

A binder-free attachment method for TiO2 on a substrate has been sought to retain high active photocatalysis. Here, we report a binder-free covalent coating of phase-selectively disordered TiO2 on a hydroxylated silicon oxide (SiO2) substrate through rapid microwave treatment. We found that Ti-O-Si and Ti-O-Ti bonds were formed through a condensation reaction between the hydroxyl groups of the disordered TiO2 and Si substrate, and the disordered TiO2 nanoparticles themselves, respectively. This covalent coating approach can steadily hold the active photocatalytic materials on the substrates and provide long-term stability. The binder-free disordered TiO2 coating film can have a thickness (above 38 µm) with high surface integrity with a strong adhesion force (15.2 N) against the SiO2 substrate, which leads to the production of a rigid and stable TiO2 film. This microwave treated TiO2 coating film showed significant volatile organic compounds degradation abilities under visible light irradiation. The microwave coated selectively reduced TiO2 realized around 75% acetaldehyde degradation within 12 h and almost 90% toluene degradation after 9 h, also retains stable photodegradation performance during the cycling test. Thus, the microwave coating approach allowed the preparation of the binder-free TiO2 film as a scalable and cost-effective method to manufacture the TiO2 film that shows an excellent coating quality and strengthens the application as a photocatalyst under severe conditions.

Osteogenic Effect of Inducible Nitric Oxide Synthase (iNOS)-Loaded Mineralized Nanoparticles on Embryonic Stem Cells.

BACKGROUND/AIMS: This study investigated the effect of inducible nitric oxide synthase-loaded mineralized nanoparticles (iNOS-MNPs) on the osteogenic differentiation of mouse embryonic stem cells (ESCs). METHODS: We prepared iNOS-MNPs using an anionic block copolymer template-mediated calcium carbonate (CaCO3) mineralization process in the presence of iNOS. iNOS-MNPs were spherical and had a narrow size distribution. iNOS was stably loaded within MNPs without denaturation. In order to confirm the successful introduction of iNOS-MNPs into the cytosol of ESCs, intracellular levels of nitric oxide (NO) was determined with a fluorometric analysis. A NO effector molecule, cyclic guanosine 3',5' monophosphate (cGMP) was also quantified with a competitive enzyme immunoassay. Cell viability in response to iNOS-MNP treatment was determined using the cell counting kit-8 (CCK-8) assay. Alkaline phosphatase (ALP) activity assay, intracellular calcium quantification assay, and Alizarin red S staining for matrix mineralization were performed to investigate osteogenic differentiation of ESCs. The protein levels of Runt-related transcription factor 2 (RUNX2), osteocalcin (OCN), and osterix (OSX) as osteogenic-related factors were also assessed by immunofluorescence staining and Western blot analysis. The complex pathways associated with iNOS-MNP-derived osteogenic differentiation of ESCs were evaluated by network-based analysis. RESULTS: Cells with iNOS-MNPs displayed a significant increase in NO and cGMP concentration compared with the control group. When cells were exposed to iNOS-MNPs, there were no adverse effects on cell viability. Importantly, iNOS-MNP uptake promoted the osteogenic differentiation of ESCs. Using transcriptome profiling, we obtained 1,836 differentially-induced genes and performed functional enrichment analysis with ClueGO and KEGG. These analyses identified significantly enriched and interconnected molecular pathways such as protein kinase activity, estrogen receptor activity, bone morphogenetic protein (BMP) receptor binding, ligand-gated ion channel activity, and phosphatidylinositol 3-phosphate binding. CONCLUSION: These findings suggest that iNOS-MNPs can induce osteogenic differentiation in ESCs by integrating complex signaling pathways.

Whole-Genome Sequencing and Genomic Analysis of a Virulent Bacteriophage Infecting Bacillus cereus.

OBJECTIVE: Infants with a weak immune system are prone to infection with Bacillus cereus, which is commonly found in natural environments. With the aim of achieving better control of this pathogenic bacterium, in the present study we characterized a new bacteriophage, ΦBC01. METHODS: Bacteriophage particles were analyzed by transmission electron microscopy. Factors influencing adsorption were identified in a double-layer plaque assay. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was conducted to determine the size of major structural proteins. The complete genome of the phage was analyzed. RESULTS: Bacteriophage particles (105.3 ± 3.1 nm icosahedral head and 208.8 ± 3.6 nm contractile tail) were identified as Myoviridae. ΦBC01 was found to have host specificity to B. cereus. Major structural proteins of ΦBC01 showed 2 well-pronounced bands of 99 and 56 kDa. The 158,385-bp genome sequence of ΦBC01 was determined: 56 of the 239 open reading frames were annotated, indicating involvement in bacteriophage DNA manipulation, cell lysis, packaging, virion structure, and other functions. CONCLUSION: Because of characterization and genotyping of a new bacteriophage from soil samples containing earthworms, this study provides a baseline for the development of alternatives to antibiotics.

Antitumorigenic Effects of ZAKß, an Alternative Splicing Isoform of ZAK.

Sterile alpha motif (SAM)- and leucine-zipper-containing kinase (ZAK) plays a role in the regulation of cell cycle progression and oncogenic transformation. The ZAK gene generates two transcript variants, ZAKα and ZAKß, through alternative splicing. In this study, we identified that ZAKα proteins were upregulated in tumor tissues, whereas ZAKß proteins were mostly expressed in corresponding normal tissues. The ectopically expressed ZAKß proteins in cancer cells inhibited cancer cell proliferation as well as anchorage-independent growth. The ZAKß:ZAKα protein ratio played a role in the regulation of the cyclic adenosine monophosphate (cAMP) signaling pathway, whereas high ZAKß protein levels led to the activation of cAMP response element binding protein 1 (CREB1) and exerted antitumor properties. Overexpression of ZAKß or CREB1 cDNAs in cancer cells inhibited anchorage-independent growth and also reduced the levels of cyclooxygenase 2 (Cox2) and ß-catenin proteins. Cancer cells treated with doxorubicin (Doxo) resulted in the switching from the expression of ZAKα to ZAKß and also inhibited cancer cell growth in soft agar, demonstrating that pharmacological drugs could be used to manipulate endogenous reprogramming splicing events and resulting in the activation of endogenous antitumorigenic properties. We showed that the two ZAK transcript variants, ZAKα and ZAKß, had opposite biological functions in the regulation of tumor cell proliferation in that ZAKß had powerful antitumor properties and that ZAKα could promote tumor growth.

In vivo 4-1BB deficiency in myeloid cells enhances peripheral T cell proliferation by increasing IL-15.

4-1BB signals are considered positive regulators of T cell responses against viruses and tumors, but recent studies suggest that they have more complex roles in modulating T cell responses. Although dual roles of 4-1BB signaling in T cell responses have been suggested, the underlying mechanisms are still not fully understood. In this study, we tested whether 4-1BB expression affected T cell responses differently when expressed in myeloid versus lymphoid cells in vivo. By assessing the proliferation of 4-1BB(+/+) and 4-1BB(-/-) T cells in lymphocyte-deficient RAG2(-/-) and RAG2(-/-)4-1BB(-/-) mice, we were able to compare the effects on T cell responses of 4-1BB expression on myeloid versus T cells. Surprisingly, adoptively transferred T cells were more responsive in tumor-bearing RAG2(-/-)4-1BB(-/-) mice than in RAG2(-/-) mice, and this enhanced T cell proliferation was further enhanced if the T cells were 4-1BB deficient. Dendritic cells (DCs) rather than NK or tissue cells were the myeloid lineage cells primarily responsible for the enhanced T cell proliferation. However, individual 4-1BB(-/-) DCs were less effective in T cell priming in vivo than 4-1BB(+/+) DCs; instead, more DCs in the secondary lymphoid organs of RAG2(-/-)4-1BB(-/-) mice appeared to induce the enhanced T cell proliferation by producing and transpresenting more IL-15. Therefore, we conclude that in vivo 4-1BB signaling of myeloid cells negatively regulates peripheral T cell responses by limiting the differentiation of DCs and their accumulation in secondary lymphoid organs.

Inhibition of Curcumin on ZAKα Activity Resultant in Apoptosis and Anchorage-Independent Growth in Cancer Cells.

Curcumin, a popular yellow pigment of the dietary spice turmeric, has been reported to inhibit cell growth and to induce apoptosis in a wide variety of cancer cells. Although numerous studies have investigated anticancer effects of curcumin, the precise molecular mechanism of action remains unidentified. Whereas curcumin mediates cell survival and apoptosis through mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) signaling cascades, its impact on the upstream regulation of MAPK is unclear. The leucine-zipper and sterile-α motif kinase alpha (ZAKα), a mitogen-activated protein kinase kinase kinase (MAP3K), activates the c-Jun N-terminal kinase (JNK) and NF-κB pathway. This paper investigated the prospective involvement of ZAKα in curcumin-induced effects on cancer cells. Our results suggest that the antitumor activity of curcumin is mediated via a mechanism involving inhibition of ZAKα activity.

Exploring the Effects of the Photochromic Response and Crystallization on the Local Structure of Noncrystalline Niobium Oxide.

Niobium oxide (Nb2O5) is a versatile semiconductor material with photochromic properties. This study investigates the local structure of noncrystalline, short-range-ordered niobium oxide synthesized via a sol-gel method. X-ray atomic pair distribution function analysis unravels the structural arrangements within the noncrystalline materials at a local scale. In the following, in situ scattering and diffraction experiments elucidate the heat-induced structure transformation of the amorphous material into crystalline TT-Nb2O5 at 550 °C. In addition, the effect of photocatalytic conditions on the structure of the material was investigated by exposing the short-range-ordered and crystalline materials to ultraviolet light, resulting in a reversible color change from white to dark brown or blue. This photochromic response is due to the reversible elongation of the nearest Nb-O neighbors, as shown by local structure analysis based on in situ PDF analyses. Optical band gap calculations based on the ultraviolet-visible spectra collected for both the short-range-ordered and crystalline materials show that the band gap values reduced for the darkened materials return to their initial state after bleaching. Furthermore, electron energy loss spectroscopy reveals the reduction of Nb5+ to Nb4+ centers as a persistent effect. The study establishes a correlation between the band gap and the structure of niobium oxide, providing insights into the structure-performance relation at the atomic level.

Improvement in Biocompatibility and Biointegration of Human Acellular Dermal Matrix through Vacuum Plasma Surface Treatment.

Efforts are ongoing to enhance the functionality of human acellular dermal matrices (hADMs), which are extensively utilized in reconstructive surgeries. Among these efforts, plasma treatments, particularly vacuum plasma treatments, have recently emerged in the medical field. This study aims to investigate the efficacy of a vacuum plasma treatment in enhancing the biocompatibility and biointegration of hADMs. Utilizing a plasma activator (ACTILINK reborn, Plasmapp Co., Ltd., Daejeon, Republic of Korea), hADMs were treated and evaluated through in vitro and in vivo analyses. Hydrophilicity changes were gauged by the blood absorption times, while SEM imaging was used to analyze physical surface deformation. Protein adsorption was measured with fluorescently labeled bovine serum albumin and fibronectin. For the in vivo study, mice were implanted with plasma-treated and untreated hADMs, and the post-implantation effects were analyzed through histological and immunofluorescence microscopy. The plasma-treated hADMs demonstrated a significantly enhanced hydrophilicity compared to the untreated samples. SEM imaging confirmed the maintenance of the microroughness after the treatment. The treated hADMs showed a significant reduction in fibronectin adsorption, a critical factor for cellular adhesion. In vivo, the plasma-treated hADMs exhibited reduced capsule formation and enhanced fibroblast infiltration, indicating improved biocompatibility and integration. These findings highlight the potential of a plasma treatment to enhance the performance of hADMs in clinical settings, offering a promising avenue for improving reconstructive surgery outcomes.

Accuracy and availability of automated urine output monitoring in the operating room using a smart scale.

PURPOSE: Urine output (UO) is an important intraoperative parameter that is not yet electronically monitored. We compared an automatic urinometer (AU) based on a smart scale with a manual urinometer (MU). PATIENTS AND METHODS: This prospective study investigated the hourly UO of 35 preoperative patients with an indwelling urinary catheter using AU, MU, and cylinder measurements. Data were analyzed using the Bland-Altman method. A questionnaire related to the use of the AU was completed by medical staff (n=25). RESULTS: Compared to the cylinder measurements, the differences in measurements by the AU and the MU were -6.31 â€‹± â€‹15.03 â€‹mL/h (p=0.018) and 20.26 â€‹± â€‹26.81 â€‹mL/h (p=0.001), respectively. The r values for the comparison of cylinder measurements with AU and MU values were 0.985 (p<0.001) and 0.968 (p<0.001), respectively. Bland-Altman analyses showed that cylinder measurements had better agreement with the AU measurements than with the MU measurements. Also, the medical staff reported that the use of the AU was easier to learn than the use of the MU (p<0.001). CONCLUSIONS: Compared to the MU values, AU values were noninferior; they had significantly less bias and temporal deviation. Additionally, the medical staff reported that the use of the AU was easier to learn than the use of the MU.

The relative isoform expression levels of isocitrate dehydrogenase in breast cancer: IDH2 is a potential target in MDA-MB-231 cells.

PURPOSE: The isocitrate dehydrogenase (IDH) family plays an essential role in metabolism and energy production. The relative expression levels of IDH isoforms (IDH1, IDH2, and IDH3) have prognostic significance in several malignancies, including breast carcinoma. However, the IDH isozyme expression levels in different cancer stages and types have not been determined in breast carcinoma tissues. METHODS: We analyzed the messenger RNA (mRNA) and protein levels of IDH (IDH1, IDH2, and IDH3A) and α-ketoglutarate (α-KG) in 59 breast carcinoma tissues. RESULTS: The mRNA level of IDH2 was significantly increased at stages 2 and 3 in triple-negative and (ER-/PR-/HER+) breast cancers. However, the elevated α-KG level was only observed in stages 2 and 3, with no differences in the various breast carcinoma types. Western blotting analysis showed that IDH2 protein expression increased in the patient tissues and cell lines. An in vitro study showed IDH2 downregulation in the triple-negative breast cancer cell line MDA-MB-231 that inhibited cell proliferation and migration and induced cell cycle arrest in the G0/G1 phase. CONCLUSION: These findings suggest that different from IDH1 and IDH3, IDH2 is more highly expressed in stages 2 and 3 breast cancer tissues, especially in triple-negative breast cancer. IDH2 potentially serves as a target to detect unknown mechanisms in breast cancer.

Efficient Nitrate Conversion to Ammonia on f-Block Single-Atom/Metal Oxide Heterostructure via Local Electron-Deficiency Modulation.

Exploring single-atom catalysts (SACs) for the nitrate reduction reaction (NO3-; NitRR) to value-added ammonia (NH3) offers a sustainable alternative to both the Haber-Bosch process and NO3--rich wastewater treatment. However, due to the insufficient electron deficiency and unfavorable electronic structure of SACs, resulting in poor NO3--adsorption, sluggish proton (H*) transfer kinetics, and preferred hydrogen evolution, their NO3--to-NH3 selectivity and yield rate are far from satisfactory. Herein, a systematic theoretical prediction reveals that the local electron deficiency of an f-block Gd single atom (GdSA) can be significantly regulated upon coordination with oxygen-defect-rich NiO (GdSA-D-NiO400) support. Thus, facilitating stronger NO3- adsorption via strong Gd5d-O2p orbital coupling and further improving the protonation kinetics of adsorption intermediates by rapid H* capture from water dissociation catalyzed by the adjacent oxygen vacancy site along with suppressed H* dimerization synergistically boosts the NH3 selectivity/yield rate. Motivated by DFT prediction, we delicately stabilized electron-deficient (strongly electrophilic) GdSA on D-NiO400 (∼84% strong electrophilic sites), which exhibited excellent alkaline NitRR activity (NH3 Faradaic efficiency ∼97% and yield rate ∼628 µg/(mgcat h)) along with superior structural stability, as revealed by in situ Raman spectroscopy, significantly outperforming weakly electrophilic Gd nanoparticles, defect-free GdSA-P-NiO400, and reported state-of-the-art catalysts.

Immediate extended latissimus dorsi flap reconstruction after skin-sparing mastectomy for breast cancer associated with paraffinoma: report of a case.

Paraffin oil injection into the breast, which had been used for breast augmentation in the past, can cause various complications. Complete removal of paraffinoma lesions with immediate breast reconstruction using autogenous tissue is a very satisfactory treatment option. However, diffuse random distribution of paraffin oil through the subdermal layer makes it impossible to remove all of the lesions with overlying skin without resulting in a shortage of available skin and poor cosmesis. We herein report the case of a patient with breast cancer associated with paraffinoma, treated with skinsparing mastectomy and axillary node dissection with immediate extended latissimus dorsi flap reconstruction, resulting in good cosmetic outcome, and showing no complications during the wound-healing process.

Implant Delivery Technique for Prepectoral Reconstruction after Endoscopic-assisted Nipple-sparing Mastectomy.

Prepectoral breast reconstruction through a small axillary incision during endoscopic-assisted nipple-sparing mastectomy or robotic nipple-sparing mastectomy is difficult. Cases involving implants covered with an acellular dermal matrix (ADM) are particularly difficult. Therefore, a new delivery technique for ADM-covered implants is needed. The ADM pocket for complete coverage of the implant is made with double-crossed ADMs. The pocket end is open and sutured at the funnel entry. After insetting the ADM pocket at the mastectomy site through an axillary incision, the implant is delivered from a funnel to the ADM pocket by squeezing. Prepectoral breast reconstruction with the new delivery technique for implants covered with ADM pockets proved easy and safe. Our new implant delivery technique could be a good option for prepectoral breast reconstruction after minimal breast surgery.

Large-Scale Production of Cronobacter sakazakii Bacteriophage Φ CS01 in Bioreactors via a Two-Stage Self-Cycling Process.

Cronobacter sakazakii is an opportunistic pathogenic bacterium found in powdered infant formula and is fatal to neonates. Antibiotic resistance has emerged owing to overuse of antibiotics. Therefore, demand for high-yield bacteriophages as an alternative to antibiotics has increased. Accordingly, we developed a modified mass-production method for bacteriophages by introducing a two-stage self-cycling (TSSC) process, which yielded high-concentration bacteriophage solutions by replenishing the nutritional medium at the beginning of each process, without additional challenge. pH of the culture medium was monitored in real-time during C. sakazakii growth and bacteriophage CS01 propagation, and the changes in various parameters were assessed. The pH of the culture medium dropped to 5.8 when the host bacteria reached the early log phase (OD540 = 0.3). After challenge, it decreased to 4.65 and then recovered to 4.94; therefore, we set the optimum pH to challenge the phage at 5.8 and that to harvest the phage at 4.94. We then compared phage production during the TSSC process in jar-type bioreactors and the batch culture process in shaker flasks. In the same volume of LB medium, the concentration of the phage titer solution obtained with the TSSC process was 24 times higher than that obtained with the batch culture process. Moreover, we stably obtained high concentrations of bacteriophage solutions for three cycles with the TSSC process. Overall, this modified TSSC process could simplify large-scale production of bacteriophage CS01 and reduce the unit cost of phage titer solution. These results could contribute to curing infants infected with antibiotic-resistant C. sakazakii.