Complications of aesthetic medicine procedures: five case studies.

The paper presents the cases of five patients who developed complications after aesthetic medicine procedures. Four of the cases involved women who reported to the Department of Forensic Medicine, Medical University of Lodz, for a description and legal qualification of bodily injuries suffered as a result of aesthetic medicine procedures, whereas one was related to the assessment of accuracy of medical management at the request of the prosecutor handling the case. The reported cases concerned acid exfoliation treatments, photoepilation and cryotherapy. The authors attempt to discuss the most common complications that may occur after aesthetic medicine procedures, and measures to avoid them.

Suicidal asphyxiation by using helium - two case reports.

Helium is one of inert gases causing physical asphyxiation, whose excess content in the breathing atmosphere reduces the partial pressure of oxygen and may be fatal after short-term exposure. When breathing a mixture of an inert gas (helium, nitrogen, argon) with a small amount of oxygen, with the possibility of exhaling carbon dioxide, no warning signs characteristic of suffocation are perceived by the subject. Freedom from discomfort and pain, effectiveness, rapid effect and relatively easy availability of required accessories have resulted in the use of inert gases for suicidal purposes. The paper reports two cases of suicide committed by using a special kit consisting of the so-called "suicide bag" (or "exit bag") filled with helium supplied through a plastic tube. In both cases, examination of the sites where the corpses were found and analysis of collected material allowed to establish that before their death the subjects had searched the Internet for instructions on how to commit suicide using helium. Due to the advanced putrefaction process, the autopsies failed to determine the causes of their death unequivocally. However, the circumstances surrounding the deaths suggested rapid asphyxiation as a result of oxygen deficiency in the breathing mixture. Since in cases of the type discussed here the cause of death cannot generally be established by autopsy, knowledge of the circumstances of disclosure of the corpse, as well as examination of the cadaver and the death scene is of utmost importance.

Chylothorax as a rare complication of acute pancreatitis in a 25-year-old woman after cesarean section.

The paper presents the case of a 25-year-old woman who underwent cesarean section for gynecological indications in the 37(th) week of her second pregnancy. The perioperative course was uncomplicated, but one day later the general condition of the patient suddenly deteriorated: she developed respiratory disorders requiring intubation and treatment in an intensive care unit. On the 6(th) day after the surgery, the patient was diagnosed with acute pancreatitis. Appropriate conservative treatment was instituted, resulting in a gradual improvement of her condition. On the 13(th) postoperative day, a cardiac arrest in asystole occurred, with no response to the undertaken resuscitation procedures. An autopsy performed in the Department of Forensic Medicine in Lódz revealed, among other findings, acute pancreatitis with enzymatic necrosis of the adipose tissue, a significant accumulation of lymph in both pleural cavities, and pulmonary atelectasis. As demonstrated by the analysis of the case, chylothorax had most probably developed in the course of acute pancreatitis which was a complication of the cesarean section. Consequently, the prosecutor opened an investigation into the case under Article 155 of the Polish Penal Code to assess the appropriateness of medical management. The medico-legal opinion was issued by experts from outside the Department of Forensic Medicine in Lódz. In their view, the medical management of the patient was correct.

Long-term functional success and patient-reported outcomes after female one-stage buccal mucosal graft urethroplasty.

INTRODUCTION AND OBJECTIVES: Female urethral strictures are a rare condition that significantly impacts patients' quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center. PATIENTS AND METHODS: We conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009-2023. We assessed objective (retreatment-free survival, ΔQmax) and subjective outcomes (validated patient-reported outcomes). RESULTS: Of 12 women, 83% and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25% and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2 cm. At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate (ΔQmax) was 10 ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction. CONCLUSIONS: Buccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.

X-ray structure of the GCN4 leucine zipper, a two-stranded, parallel coiled coil.

The x-ray crystal structure of a peptide corresponding to the leucine zipper of the yeast transcriptional activator GCN4 has been determined at 1.8 angstrom resolution. The peptide forms a parallel, two-stranded coiled coil of alpha helices packed as in the "knobs-into-holes" model proposed by Crick in 1953. Contacts between the helices include ion pairs and an extensive hydrophobic interface that contains a distinctive hydrogen bond. The conserved leucines, like the residues in the alternate hydrophobic repeat, make side-to-side interactions (as in a handshake) in every other layer of the dimer interface. The crystal structure of the GCN4 leucine zipper suggests a key role for the leucine repeat, but also shows how other features of the coiled coil contribute to dimer formation.

Rapid targeting of nuclear proteins to the cytoplasm.

BACKGROUND: The transcription factor NF-ATc plays a key role in the activation of many early immune response genes and is regulated by subcellular localization. NF-ATc translocates from the cytoplasm to the nucleus in response to a rise in intracellular calcium, and immediately returns to the cytoplasm when intracellular calcium levels fall. The rapid nuclear exit of NF-ATc is thought to be one mechanism by which cells distinguish between sustained and transient calcium signals. RESULTS: To study the nuclear export of NF-ATc, we have developed a general, non-invasive assay for the identification and study of nuclear export signals (NESs). The NES is defined by its ability to translocate a protein from the nucleus to the cytoplasm when the two are tethered by a membrane-permeable ligand. This procedure has allowed us to identify a NES within NF-ATc that functions in concert with a glycogen synthase kinase-regulated process to direct the rapid nuclear exit of NF-ATc. CONCLUSIONS: The rapid nuclear export of NF-ATc via its NES and a glycogen synthase kinase-regulated event may be an important mechanism for insulating cells from transient spikes in intracellular calcium which might otherwise lead to inappropriate activation. The assay we have developed allows the rapid identification of NESs and can be used as a general method for the inducible cytoplasmic export of nuclear proteins.

Cancer Moonshot Data and Technology Team: Enabling a National Learning Healthcare System for Cancer to Unleash the Power of Data.

The Cancer Moonshot emphasizes the need to learn from the experiences of cancer patients to positively impact their outcomes, experiences, and qualities of life. To realize this vision, there has been a concerted effort to identify the fundamental building blocks required to establish a National Learning Healthcare System for Cancer, such that relevant data on all cancer patients is accessible, shareable, and contributing to the current state of knowledge of cancer care and outcomes.

p38 MAP kinase mediates stress-induced leukotriene synthesis in a human B-lymphocyte cell line.

5-Lipoxygenase (5-LO), which catalyzes the first two steps in leukotriene biosynthesis, is a target for pharmacological treatment of inflammatory disorders. Previous studies have shown that B-lymphocytes express 5-LO. Here we demonstrate that several stimuli of cell stress such as osmotic shock (sorbitol, NaCl), oxidative stress (hydrogen peroxide, diamide), chemical stress sodium arsenite, and inflammatory cytokines enhanced cellular 5-LO activity in a B cell line (BL41-E95-A), when added simultaneously with ionophore plus arachidonate. It is interesting that sorbitol alone was sufficient for 5-LO product formation in the presence of exogenous arachidonic acid. These stimuli also activated p38 mitogen-activated protein (MAP) kinase and downstream MAP kinase-activated protein kinases in BL41-E95-A cells, which could phosphorylate 5-LO or heat shock protein 27 in vitro. The p38 MAP kinase inhibitor SB203580 abolished stress-induced leukotriene synthesis in B cells, without inhibition of 5-LO catalytic activity in cell-free systems. Our results indicate that p38 MAP kinase activation by cell stress is required for efficient leukotriene synthesis in B-lymphocytes.

A technique for the immunohistochemical localization of prostaglandin E.

Prostaglandin E (PGE) has been localized via the unlabeled antibody technique in freeze-dried and ethanol-fixed cryostat sections. Discrete perivascular and stromal localization was present in the uterus prepared by the method presented, but not in classically fixed specimens. Absorption of the anti-PGE by addition of free PGE was ineffective; whereas, removal of PGE-reactive antibodies from the anti-serum was effectively accomplished with an Affigel-101-PGE immunoadsorbant column.

Tc-99m-labeled red blood cells for the measurement of red cell mass in newborn infants: concise communication.

In vitro and in vivo investigations were performed to examine the binding of Tc-99m to neonatal red blood cells (RBC). Labeling efficiency was about 90%, and unbound Tc-99m less than 3% after one washing, in premature and full-term newborns and in children. Thus presence of high percentages of fetal hemoglobin (Hb F) did not influence the labeling of RBCs with Tc-99m. RBCs of 11 newborns were hemolysed and the distribution of Tc-99m on RBC components was analyzed. Although Hb F percentage averaged (60.0 +/- 8.1)% (s.d.), only (11.9 +/- 3.7)% of Tc-99m was bound by Hb F, whereas (45.0 +/- 6.1)% was associated with Hb A. RBC membranes bound (13.7 +/- 4.3)% and (29.3 +/- 4.0)% were found unbound in hemolysates. These results indicate that Tc-99m preferentially binds to beta chains. In vivo equilibration of Tc-99m RBCs and of albumin labeled with Evans blue was investigated in five newborn infants. Tc-99m RBCs were stable in each case during the first hour after injection. Elution of Tc-99m from RBCs was (3.4 +/- 1.5)% per hour. Body-to-venous hematocrit ratio averaged 0.86 +/- 0.03.

Isolation and culture of bovine intracranial arterial endothelial cells.

We report a simple explant technique to isolate and propagate endothelial cells from bovine cerebral arteries. The endothelial nature of the cells was confirmed by the presence of Factor VIII/von Willebrand antigen, the ability to phagocytize low-density lipoprotein, and the ability to be induced to express E-selectin. The lack of expression of the CD11c antigen and the absence of smooth muscle alpha-actin immunofluorescence suggested that the cultures were not contaminated with macrophages or smooth muscle cells, respectively. This technique yields pure cerebral arterial endothelial cell cultures, which will be of value for in vitro investigation of cerebrovascular physiology and disease processes.

Deciphering Medicaid data: issues and needs.

The wide range of data bases that can be used for Medicaid analyses and research are reviewed in this article. The Health Care Financing Administration, State Medicaid agencies, and other groups have developed useful data bases and made them available to the public. Efforts could be made to obtain better quality national data, including annual reports on State participation, expenditures and program characteristics, and person-based data bases about medicaid clients and services. State-level analyses and research could be enhanced and disseminated more widely. More complex data collection and analysis efforts are an inevitable tradeoff for the flexibility of the Federal-State structure of Medicaid.

Microbiological quality of Queensland stockfeeds with special reference to salmonella.

One hundred Queensland stockfeeds were examined for their counts of total aerobic bacteria, coliforms, fungi and salmonellas. The total aerobic bacteria, coliform and fungal counts were significantly higher (P < 0.005) for mashes than for crumbles and pellets and salmonellas were isolated from significantly more (P < 0.005) mashes (64%) than pellets and crumbles (8%). Counts of less than 1 salmonella per 100 g were found in 36.4% of the 44 positive feeds. The remainder of the counts ranged from 1.2 per 100 g to greater than 147 salmonellas per 100 g feed.

Axosomatic synapses on granule cells are preserved in human non-infiltrating tumour or lesion-related and mesial temporal sclerotic epilepsy, but markedly reduced in tumour-infiltrated dentate gyrus with or without epilepsy.

Granule cells of the human hippocampal dentate gyrus were examined. In controls, granule cells displayed somatic spines and cell nuclei with small infoldings. In addition, the cytoplasm of human granule cells always displayed lipofuscin. Subsurface cisterns of endoplasmic reticulum were frequently observed in the human granule cells. Two types of axosomatic synapses were found; most frequently symmetric and less frequently asymmetric. Many of the axosomatic synapses were isolated by glial processes in tumour or lesion-related epileptic patients, but the ultrastructural characteristics of granule cells were not different from those of the control patients. Large bundles of reactive astroglial fibres appeared regularly in all layers of the dentate gyrus. In tumour infiltrated hippocampi, glial processes dominated the neuropil and the number of perisomatic synapses was markedly reduced. Reduction in the number of perisomatic synapses did not correlate with severity and duration of seizures but did correlate with the malignancy of the tumour. It is suggested that reduction of perisomatic inhibition may not be a characteristic of granule cells in the epileptic human dentate gyrus.

Element-resolved corrosion analysis of stainless-type glass-forming steels.

Ultrathin passive films effectively prevent the chemical attack of stainless steel grades in corrosive environments; their stability depends on the interplay between structure and chemistry of the constituents iron, chromium, and molybdenum (Fe-Cr-Mo). Carbon (C), and eventually boron (B), are also important constituents of steels, although in small quantities. In particular, nanoscale inhomogeneities along the surface can have an impact on material failure but are still poorly understood. Addressing a stainless-type glass-forming Fe50Cr15Mo14C15B6 alloy and using a combination of complementary high-resolution analytical techniques, we relate near-atomistic insights into increasingly inhomogeneous nanostructures with time- and element-resolved dissolution behavior. The progressive elemental partitioning on the nanoscale determines the degree of passivation. A detrimental transition from Cr-controlled passivity to Mo-controlled breakdown is dissected atom by atom, demonstrating the importance of nanoscale knowledge for understanding corrosion.

[Treatment of cerebral circulatory insufficiency. Double-blind study of the efficacy of a quinine-papaverine combination]. / Therapie der zerebralen Minderdurchblutung. Doppelblindstudie zur Wirkung einer Chinin-Papaverin-Kombination.

Four weeks of oral therapy with a combination of quinine and papaverine at a dose of 3 X 1 coated tablet per day cause a marked and--as compared with placebo--statistically highly significant increase (p less than 0.01) in cerebral blood flow of patients with a moderate impairment of the terminal vascular system of the brain. The combination of substances brings about a more pronounced improvement (p less than 0.05) in the cerebral blood flow than papaverine alone which itself is superior to placebo (p less than 0.05). The quinine contained in the combination evidently increases its efficacy. The results of platelet aggregation tests, performed simultaneously, suggest that rheological factors in the sense of an improvement of the flow properties of the blood might play a part in causing these effects. Clinical and neurological findings indicate a clear parallel with the results of the measurements of the cerebral blood flow, even though this was not statistically significant.

[Adrevil improves the peripheral blood flow. Results of a study using the 133-Xe muscle clearance method on lower limbs]. / Adrevil verbessert die periphere Durchblutung. Ergebnisse einer Studie mit der 133-Xe-Muskel-Clearance-Methods an den unteren Extremitäten.

The efficacy of Adrevil has been investigated in 35 patients suffering from arterial blood flow disorders in the lower limb. The patients were given a daily dose of 3 X 2 tablets over a period of 30 days. Changes in muscle perfusion were determined by means of the 133 Xenon muscle clearance. The perfusion volume was found to be increased by 8--12% depending on the severity of the clinical state before treatment. The effect of the drug was more pronounced in cases with severe pathological changes prior to treatment. No adverse reactions were observed.