Three-dimensional reconstruction of hip and groin region by division and rotation of skin paddle using oblique rectus abdominis musculocutaneous flap after squamous cell carcinoma resection.

Reconstructing extensive defects in the hip and groin region is challenging. Although the technique of wrapping the flaps is often chosen, achieving effective coverage of defects is difficult because of the tissue bulge in the center, and a skin graft is frequently required. We herein report a case of successful hip "corner" reconstruction using a pedicled oblique rectus abdominis musculocutaneous flap with division and rotation of the skin paddles after squamous cell carcinoma resection. The patient had a history of immunosuppressive treatment, radiation therapy, and surgeries on the ipsilateral thigh. Our technique minimized the sacrifice of the flap donor site, achieved primary closure, and resulted in a favorably shaped reconstruction with respect to three-dimensional morphology. The patient's postoperative quality of life was ultimately improved.

Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms.

Introduction: Leucine-rich alpha-2-glycoprotein (LRG) is a potential biomarker for disease activity and reflects mucosal healing in patients with ulcerative colitis (UC). However, only a few studies have described a detailed sensitivity analysis of LRG in predicting mucosal healing in patients. This study aimed to evaluate the association between LRG and the endoscopic activity of UC and its predictability for mucosal healing and explore the utility and clinical application of LRG. Methods: The diagnostic accuracy of biomarkers, including LRG, in predicting the endoscopic activity of UC was evaluated. All consecutive patients who underwent total colonoscopy between April 2021 and September 2022 were included. The Mayo endoscopic subscore (MES) was used for assessing endoscopic activity. Furthermore, endoscopic remission was defined as an MES of ≤1. Clinical activity was evaluated based on stool frequency and bloody stool. Receiver operating characteristic curve analysis and binary logistic regression were performed to assess the diagnostic accuracy of the biomarkers. We evaluated LRG trends and treatment response in patients with MES ≥2 who underwent induction therapy. Results: This study comprised 214 patients. The proportions of endoscopically and clinically active patients were 33.6% and 49.1%, respectively. LRG had an area under the curve (AUC) of 0.856, with a higher diagnostic accuracy than other biomarkers, such as C-reactive protein, leukocyte, neutrophil, platelet, and albumin. The cutoff value for LRG was 15.6 µg/mL (sensitivity, 72.2%; specificity, 86.6%). Using the MES, patients with higher scores had higher LRG levels than those with lower scores. The cutoff value, AUC, sensitivity, and specificity varied with a higher AUC for left-sided colitis and pancolitis than for proctitis. Logistic regression analysis showed that LRG was an independent predictor of endoscopic remission using multivariate analysis, even with the factor of clinical activity. The change ratio of LRG pre- and post-treatment was statistically significant in the higher LRG group. Conclusion: LRG reflected endoscopic activity independently, regardless of clinical symptoms. An LRG below the cutoff value could indicate a significantly low probability of endoscopic activity in asymptomatic patients, and follow-up endoscopy (not for cancer screening) may be unnecessary. Furthermore, a higher LRG level might be more useful as an indicator of treatment efficacy.

Effect of High Hydrostatic Pressure Treatment Combined with Alkaline Electrolyzed Water on the Injury and Growth Characteristics of Bacterial Spores.

The characteristics of growth and injury of Bacillus subtilis spores whose heat resistance was reduced by the treatment of high hydrostatic pressure processing (HPP) combined with/without alkaline electrolyzed water (AlEW) were investigated. The delay in the lag phase of growth curve observed when used in combination with AlEW, especially at 50 MPa or less, and was prolonged by about 4 to 6 hours. However, the effects of temperature and time during treatment on the lag phase were not significantly different between solo-HPP and in combination with AlEW. The injury characteristics of the treated bacterial spores were evaluated by using antibiotics (penicillin G, rifampicin and chloramphenicol) supplemented trypticase soy broth. In the chloramphenicol supplemented TSB, although the lag phase of bacterial spores treated by HPP with AlEW was not prolonged as compared with the normal-TSB, the decrease in growth rate during logarithmic phase and increase in maximum growth amount were observed. This result could suggest due to a damage by combined treatment of HPP with AlEW such as the inhibition of protein synthesis. Furthermore, the combined treatment with AlEW increased the catalase activity by 1.45, 1.63 and 4.25 times at 30, 80 and 100 MPa, respectively, as compared with solo-HPP, therefore the combined treatment could cause high oxidative stress on bacterial spores.