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1.
Adv Skin Wound Care ; 37(7): 354-359, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38595155

RESUMEN

OBJECTIVE: To evaluate the strengths of various surgical knot techniques, including square knot, surgeon's knot, granny knot, and random knot with the same three throws. METHODS: The authors tested each of the four knot techniques using four different gauges of nylon (polyamide [Ethicon]): 4-0, 5-0, 6-0, and 7-0. Each knot type was tested 20 times per nylon gauge, for a total of 320 knots tested. The authors used a static pull machine to measure elongation at yield and maximal force to break. RESULTS: A comparison of elongation at yield revealed that the surgeon's knot was superior to the square knot, granny knot, and random knots across all gauges of nylons. Further, a comparison of maximal force to break revealed that the surgeon's knot was superior to the square knot, granny knot, and random knots when using 4-0, 5-0, and 6-0 nylon but not when using 7-0 nylon. CONCLUSIONS: The surgeon's knot was the strongest, and random knot was the weakest when the authors used nylon 4-0, 5-0, and 6-0. While handling fine suture materials such as 7-0 nylon, knot failure appears to be unrelated to the knot technique used. This study provides not only fundamental guidance for tying surgical knots using nylon, but also a rational basis for an adequately strong knot choice in various fields of surgery.


Asunto(s)
Ensayo de Materiales , Nylons , Técnicas de Sutura , Suturas , Humanos , Ensayo de Materiales/métodos , Resistencia a la Tracción
2.
Appl Microbiol Biotechnol ; 107(18): 5569-5593, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37450018

RESUMEN

Antibiotic resistance is a growing concern that is affecting public health globally. The search for alternative antimicrobial agents has become increasingly important. Antimicrobial peptides (AMPs) produced by Bacillus spp. have emerged as a promising alternative to antibiotics, due to their broad-spectrum antimicrobial activity against resistant pathogens. In this review, we provide an overview of Bacillus-derived AMPs, including their classification into ribosomal (bacteriocins) and non-ribosomal peptides (lipopeptides and polyketides). Additionally, we delve into the molecular mechanisms of AMP production and describe the key biosynthetic gene clusters involved. Despite their potential, the low yield of AMPs produced under normal laboratory conditions remains a challenge to large-scale production. This review thus concludes with a comprehensive summary of recent studies aimed at enhancing the productivity of Bacillus-derived AMPs. In addition to medium optimization and genetic manipulation, various molecular strategies have been explored to increase the production of recombinant antimicrobial peptides (AMPs). These include the selection of appropriate expression systems, the engineering of expression promoters, and metabolic engineering. Bacillus-derived AMPs offer great potential as alternative antimicrobial agents, and this review provides valuable insights on the strategies to enhance their production yield, which may have significant implications for combating antibiotic resistance. KEY POINTS: • Bacillus-derived AMP is a potential alternative therapy for resistant pathogens • Bacillus produces two main classes of AMPs: ribosomal and non-ribosomal peptides • AMP yield can be enhanced using culture optimization and molecular approaches.


Asunto(s)
Antiinfecciosos , Bacillus , Bacillus/genética , Bacillus/metabolismo , Péptidos Catiónicos Antimicrobianos/genética , Péptidos Catiónicos Antimicrobianos/farmacología , Péptidos Antimicrobianos , Antiinfecciosos/farmacología , Antiinfecciosos/metabolismo , Antibacterianos/farmacología
3.
Biochem Biophys Res Commun ; 545: 150-156, 2021 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-33550096

RESUMEN

The hypoxia-inducible factor (HIF-1α) functions as a master regulator of oxygen homeostasis. Oxygen-dependent hydroxylation of HIF-1α is tightly regulated by prolyl hydroxylase domain containing proteins (PHD1, PHD2, and PHD3). The prolyl hydroxylation facilitates the recruitment of the von Hippel-Lindau (VHL) protein, leading to ubiquitination and degradation of HIF-1α by the proteasomes. Besides prolyl hydroxylation, phosphorylation of HIF-1α is another central post-translational modification, which regulates its stability under hypoxic conditions as well as normoxic conditions. By use of LC/MS/MS-based analysis, we were able to identify a specific serine residue (Ser451) of HIF-1α phosphorylated under hypoxic conditions. Using plasmids expressing wild type (WT), non-phosphorylatable mutant HIF-1α (S451A), and phosphomimetic mutant HIF-1α (S451E), we demonstrated that the phosphorylation at Ser451 is important in maintaining the HIF-1α protein stability. Notably, phosphorylation at S451 interrupts the interaction of HIF-1α with PHD and pVHL. A phosphomimetic construct of HIF-1α at Ser451 (S451E) is significantly more stable than WT HIF-1α under normoxic conditions. Cells transfected with unphosphorylatable HIF-1α exhibited significantly lower HIF-1 transcriptional activity than WT cells and markedly reduced tumor cell migration. Further, tumors derived from the phosphomimetic mutant cells grew faster, whereas the tumors derived from non-phosphorylatable mutant cells grew slower than the control tumors, suggesting that the phosphorylation of HIF-1α at the Ser451 site is critical to promote tumor growth in vivo. Taken together, our data suggest an alternative mechanism responsible for the regulation of HIF-1α stability.


Asunto(s)
Subunidad alfa del Factor 1 Inducible por Hipoxia/química , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Sustitución de Aminoácidos , Materiales Biomiméticos/química , Materiales Biomiméticos/metabolismo , Hipoxia de la Célula , Células HCT116 , Células HEK293 , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Modelos Biológicos , Mutagénesis Sitio-Dirigida , Peptidilprolil Isomerasa de Interacción con NIMA/metabolismo , Fosforilación , Prolil Hidroxilasas/química , Prolil Hidroxilasas/metabolismo , Dominios y Motivos de Interacción de Proteínas , Procesamiento Proteico-Postraduccional , Estabilidad Proteica , Serina/química , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/química , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/metabolismo
4.
Ann Plast Surg ; 80(6): 644-647, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29553977

RESUMEN

BACKGROUND: Muscle flap is a valuable option in soft tissue reconstruction. Denervated skeletal muscle is known to undergo degeneration. However, information regarding histological and genetic changes in muscle free flap without reinnervation over long-term follow-up remains unclear. METHODS: We collected flap muscles obtained during secondary exploration surgery after more than 15 years of previous muscle free flap without reinnervation. Compared with normal muscle and fat, histomorphometric and gene expression analysis of flap muscle were performed. RESULTS: During the study period, we collected 5 samples of previous muscle free flap. The mean ± SD postoperative duration after free flap was 18.6 ± 4.0 years. All flap muscles were replaced with adipose tissue based on gross and histological findings. In flap muscle, the expression of gene related to muscle-specific MYH2 gene was downregulated, whereas the expression of genes related to adipose, fibroadipogenic progenitor, and blood vessel was upregulated compared with that of normal muscle. Vascular density and pattern were also similar to those in normal fat. CONCLUSIONS: We demonstrated that muscle free flap without reinnervation eventually converts into adipose tissue regardless of spontaneous reinnervation during muscle regeneration. The long-term findings of the present study will be valuable for muscle flap selection and prognosis.


Asunto(s)
Desnervación , Músculo Esquelético/inervación , Músculo Esquelético/trasplante , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Biomarcadores/análisis , Técnica del Anticuerpo Fluorescente , Perfilación de la Expresión Génica , Humanos , Reoperación , Estudios Retrospectivos , Colgajos Quirúrgicos/inervación , Resultado del Tratamiento
5.
Mol Cell Proteomics ; 13(5): 1219-30, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24615062

RESUMEN

Actinomycetes undergo a dramatic reorganization of metabolic and cellular machinery during a brief period of growth arrest ("metabolic switch") preceding mycelia differentiation and the onset of secondary metabolite biosynthesis. This study explores the role of phosphorylation in coordinating the metabolic switch in the industrial actinomycete Saccharopolyspora erythraea. A total of 109 phosphopeptides from 88 proteins were detected across a 150-h fermentation using open-profile two-dimensional LC-MS proteomics and TiO(2) enrichment. Quantitative analysis of the phosphopeptides and their unphosphorylated cognates was possible for 20 pairs that also displayed constant total protein expression. Enzymes from central carbon metabolism such as putative acetyl-coenzyme A carboxylase, isocitrate lyase, and 2-oxoglutarate dehydrogenase changed dramatically in the degree of phosphorylation during the stationary phase, suggesting metabolic rearrangement for the reutilization of substrates and the production of polyketide precursors. In addition, an enzyme involved in cellular response to environmental stress, trypsin-like serine protease (SACE_6340/NC_009142_6216), decreased in phosphorylation during the growth arrest stage. More important, enzymes related to the regulation of protein synthesis underwent rapid phosphorylation changes during this stage. Whereas the degree of phosphorylation of ribonuclease Rne/Rng (SACE_1406/NC_009142_1388) increased during the metabolic switch, that of two ribosomal proteins, S6 (SACE_7351/NC_009142_7233) and S32 (SACE_6101/NC_009142_5981), dramatically decreased during this stage of the fermentation, supporting the hypothesis that ribosome subpopulations differentially regulate translation before and after the metabolic switch. Overall, we show the great potential of phosphoproteomic studies to explain microbial physiology and specifically provide evidence of dynamic protein phosphorylation events across the developmental cycle of actinomycetes.


Asunto(s)
Proteínas Bacterianas/metabolismo , Regulación Bacteriana de la Expresión Génica , Proteoma/análisis , Saccharopolyspora/crecimiento & desarrollo , Fermentación , Espectrometría de Masas , Fosfopéptidos/metabolismo , Fosforilación , Proteómica/métodos , Saccharopolyspora/metabolismo
6.
Appl Microbiol Biotechnol ; 98(21): 9033-44, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25125039

RESUMEN

Sugarcane is the most efficient large-scale crop capable of supplying sufficient carbon substrate, in the form of sucrose, needed during fermentative feedstock production. However, sucrose metabolism in Escherichia coli is not well understood because the two most common strains, E. coli K-12 and B, do not grow on sucrose. Here, using a sucrose utilizing strain, E. coli W, we undertake an in-depth comparison of sucrose and glucose metabolism including growth kinetics, metabolite profiling, microarray-based transcriptome analysis, labelling-based proteomic analysis and (13)C-fluxomics. While E. coli W grew comparably well on sucrose and glucose integration of the omics, datasets showed that during growth on each carbon source, metabolism was distinct. The metabolism was generally derepressed on sucrose, and significant flux rearrangements were observed in central carbon metabolism. These included a reduction in the flux of the oxidative pentose phosphate pathway branch, an increase in the tricarboxylic acid cycle flux and a reduction in the glyoxylate shunt flux due to the dephosphorylation of isocitrate dehydrogenase. But unlike growth on other sugars that induce cAMP-dependent Crp regulation, the phosphoenol-pyruvate-glyoxylate cycle was not active on sucrose. Lower acetate accumulation was also observed in sucrose compared to glucose cultures. This was linked to induction of the acetate catabolic genes actP and acs and independent of the glyoxylic shunt. Overall, the cells stayed highly oxidative. In summary, sucrose metabolism was fast, efficient and led to low acetate accumulation making it an ideal carbon source for industrial fermentation with E. coli W.


Asunto(s)
Acetatos/metabolismo , Escherichia coli/metabolismo , Sacarosa/metabolismo , Carbono/metabolismo , Escherichia coli/crecimiento & desarrollo , Perfilación de la Expresión Génica , Glucosa/metabolismo , Análisis de Flujos Metabólicos , Metaboloma , Oxidación-Reducción , Proteoma/análisis
7.
Trauma Case Rep ; 51: 100994, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38572423

RESUMEN

Posterior interosseous nerve (PIN) injury is uncommon due to its anatomically deep location. We report a neglected, rare case of PIN injury presenting the loss of extension of thumb, index, and small fingers with weakness of thumb abduction in a 49-year-old male patient. The patient sustained a penetrating injury to his right forearm caused by a kitchen knife that was repaired primarily through an emergency surgery under general anesthesia. During the regular follow-up on the 52nd postoperative day, the patient presented 20° of extension lags in the right thumb and index finger and 30° in the small finger. Wrist extension was intact, and there was no sensory deficit. We explored the wound and traced the PIN completely, identifying a club-shaped neuroma formation at the proximal cut end of the PIN. Delayed nerve repair was performed with a double-strip cable graft. Hand surgeons should be aware of the probable PIN injury in certain situations of forearm-penetrating injury and perform proper preoperative physical examination to rule out neurovascular deficits. Careful exploration and immediate repair of severe PIN are mandatory, even in emergency situations.

8.
Case Reports Plast Surg Hand Surg ; 11(1): 2351130, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38751547

RESUMEN

Carpal tunnel syndrome is the most common entrapment neuropathy in the upper extremity. Palmaris longus, flexor digitorum superficialis, and lumbricals have infrequently been reported as causes of nerve compression. During routine Korean cadaver dissection, we incidentally identified an anatomic variant of first lumbrical muscle within the carpal tunnel in both wrists. The aberrant musculature originated from the radial side of the second FDS muscle at distal forearm level, running separately across the wrist beneath the flexor retinaculum. The dissected anomalous muscle was identified as an additional muscle belly of the first lumbrical muscle. Compression of the median nerve at the wrist might rarely be caused by the presence of such a tendon or muscle anomaly found in this study. Surgeons should be aware of possible anatomic variations in the carpal tunnel, and be prepared to modify their surgical plan accordingly.

9.
Microorganisms ; 11(4)2023 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-37110354

RESUMEN

The number and variety of protein post-translational modifications (PTMs) found and characterized in bacteria over the past ten years have increased dramatically. Compared to eukaryotic proteins, most post-translational protein changes in bacteria affect relatively few proteins because the majority of modified proteins exhibit substoichiometric modification levels, which makes structural and functional analyses challenging. In addition, the number of modified enzymes in bacterial species differs widely, and degrees of proteome modification depend on environmental conditions. Nevertheless, evidence suggests that protein PTMs play essential roles in various cellular processes, including nitrogen metabolism, protein synthesis and turnover, the cell cycle, dormancy, spore germination, sporulation, persistence, and virulence. Additional investigations on protein post-translational changes will undoubtedly close knowledge gaps in bacterial physiology and create new means of treating infectious diseases. Here, we describe the role of the post-translation phosphorylation of major bacterial proteins and review the progress of research on phosphorylated proteins depending on bacterial species.

10.
World J Clin Cases ; 11(27): 6646-6652, 2023 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-37900234

RESUMEN

BACKGROUND: Orthopedic surgeries after device implantation are susceptible to infections and may require device removal in the worst cases. For this reason, many efforts are being made to control infections after spinal surgery; however, the number of infection cases is increasing owing to the increasing number of elderly citizens. CASE SUMMARY: A 75-year-old male with a chronic spinal defect due to previous spine surgery underwent reconstruction using a perforator-based island flap. After bursectomy and confirmation that there was no connection with the deep tissue, reconstruction was performed. However, wound disruption occurred with abscess formation on postoperative day 29, which led to an imaging workup revealing delayed deep tissue infection. CONCLUSION: Infection is one of the most common causes of surgical wound dehiscence and is associated with devastating results if not controlled promptly and definitively. Surgeons should always suspect delayed infections when reconstructing chronic soft tissue defects.

11.
World J Clin Cases ; 11(17): 4079-4083, 2023 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-37388779

RESUMEN

BACKGROUND: Hemophilia, an uncommon yet consequential hereditary bleeding disorder, manifests as two clinically indistinguishable forms that hinder the normal functioning of the coagulation cascade. This impairment renders individuals more susceptible to excessive bleeding during significant surgical interventions. Moreover, individuals with severe hemophilia frequently encounter recurring hemarthrosis, resulting in progressive joint destruction and, subsequently, the need for hip and knee replacement surgeries. CASE SUMMARY: The patient was a 53-year-old man with hemophilia A as the underlying disease and had self-injected factor VIII twice weekly for several decades. He had undergone ankle fusion surgery for recurrent hemarthrosis at the Department of Orthopedic Surgery 1 mo prior and was referred to our department because of skin necrosis after a hematoma at the surgical site. An anterolateral thigh perforator free flap was created after three cycles of factor VIII administration in addition to the concomitant administration of tranexamic acid (TXA) (Transamin 250 mg cap, 1 cap tid, q8h). After the operation, from postoperative days (PODs) 1-5, the factor VIII dose and interval were maintained, and q12h administration was tapered to q24h administration after POD 6. Because the patient's flap was stable 12 d after the operation, factor VIII administration was tapered to twice a week. At 6 mo follow-up, the patient recovered well without any complications. CONCLUSION: To the best of our knowledge, there are very few reports of successful free flaps in patients with hemophilia, and none have been reported in patients with hemophilia A. Moreover, there are several reports on the efficacy of TXA in free flaps in general patients; however, there are no case reports of combining factor VIII and TXA in patients with hemophilia. Therefore, we report this case to contribute to future academic research.

12.
Medicine (Baltimore) ; 102(36): e35097, 2023 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-37682134

RESUMEN

RATIONALE: Reconstruction of wound complications in patients with advanced cancer with distant metastases is challenging for plastic surgeons. This may be due to the cancer patients' hypercoagulability and potential intolerance to general anesthesia. This article aimed to discuss the risk of free-flap reconstruction in such cases. PATIENT CONCERNS: The patient was a 58-year-old female with advanced non-small cell lung cancer and brain metastasis. The patient underwent brain radiotherapy and chemotherapy through the Ommaya Reservoir. DIAGNOSES: A year ago, she underwent several local flap closures for recurrent wound healing failure due to wound complications, including infection, wound dehiscence, and subsequent device removal. INTERVENTIONS: A radial forearm free flap was created under general anesthesia. The patient was discharged in the third postoperative week since the flap remained stable. OUTCOMES: At follow-up a month thereafter, the patient exhibited signs of recovery without any complications even while continuing her chemotherapeutic regimen. LESSONS: Free flap placement is not an absolute contraindication in cancer patients with distant metastases. Nevertheless, it is associated with clinical challenges and operator hesitancy. This is a case of a successful free flap in a cancer patient with hypercoagulability and suspected floating tumor cells. Postoperative management, in this case, is appropriate.


Asunto(s)
Neoplasias Encefálicas , Carcinoma de Pulmón de Células no Pequeñas , Colgajos Tisulares Libres , Neoplasias Pulmonares , Humanos , Femenino , Persona de Mediana Edad , Neoplasias Pulmonares/cirugía , Cuero Cabelludo/cirugía , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Neoplasias Encefálicas/cirugía
13.
World J Clin Cases ; 11(31): 7684-7689, 2023 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-38078123

RESUMEN

BACKGROUND: Forehead osteoma is a commonly encountered benign facial bone tumor. Endoscopic excision of benign forehead masses is widely performed. Here, we report a rare case of recurrent forehead osteoma that disseminated after a previous osteoma excision. CASE SUMMARY: A 54-year-old female patient had previously undergone endoscopic removal of a single forehead osteoma at 30 years of age. However, she had a recurrent osteoma around the same site and underwent another endoscopic resection at 40 years of age. During her first visit to our outpatient clinic, she presented with a cobblestone-like irregular surface on the forehead and a 3D facial bone computed tomography scan revealed a widely ragged surface of the inoculated osteoma on the outer table of the frontal bone. Under general anesthesia, we performed a radical complete excision of the disseminated osteoma through a bicoronal incision using an osteotome, chisel, mallet, and rasping. We hypothesized that the recurrence may have been caused by the inoculation of residual osteoma remnants from the previous procedure. Craniofacial surgeons should be cautious when removing osteoma particles, particularly when using an endoscopic approach. CONCLUSION: To prevent recurrence, it is essential to conduct additional meticulous burring and a thorough inspection of the surface after copious irrigation.

14.
World J Clin Cases ; 11(30): 7492-7496, 2023 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-37969458

RESUMEN

BACKGROUND: Gout is a common type of inflammatory arthritis caused by the deposition of monosodium urate crystals in the joints and surrounding tissues. It typically appears with abrupt and intense pain, redness, and swelling in the affected joint. It frequently targets the lower extremities, such as the big toe. However, rarely, gout can manifest in atypical locations, including the hands, leading to an uncommon presentation known as gouty tenosynovitis. However, it can result in significant morbidity owing to the potential for severe complications, such as myonecrosis and compartment syndrome. CASE SUMMARY: An 82-year-old male patient with a history of hypertension, cerebral infarction, Parkinson's disease, and recurrent gout attacks sought medical attention because of progressive pain and swelling in the right hand. Imaging findings revealed forearm swelling, raising concerns of possible tenosynovitis, bursitis, septic arthritis, and compartment syndrome. A fasciotomy was performed to decompress the patient's hands and forearms. The procedure revealed diffuse tenosynovitis, tophi with a pus-like discharge surrounding the carpal tunnel, and involvement of the flexor and extensor tendon sheaths. However, microbiological investigations, including Gram staining, acid-fast bacilli, tuberculosis, and non-tuberculous mycobacteria, yielded negative results. The patient was ultimately diagnosed with a severe gouty attack with compartment syndrome and myonecrosis. Septic arthritis and infectious flexor tenosynovitis were ruled out. Serial debridement and inflammation control were initiated, followed by staged closure with a skin graft. CONCLUSION: Septic-like complications can occur in the absence of infection in severe gout attacks with pus-like discharges due to compartment syndrome and myonecrosis. Cultures can be used to differentiate between gouty attacks, septic arthritis, and infectious tenosynovitis. Involvement of the flexor and extensor muscles, as in this case, is rare. This study contributes to the literature by reporting a rare case of successful fasciotomy and serial debridement in an elderly patient with multiple comorbidities.

15.
Front Surg ; 10: 1268555, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38026493

RESUMEN

Introduction: Deep sternal wound infection (DSWI) is a serious complication that may occur after median sternotomy, with potentially devastating consequences. By reporting our case and analyzing the existing literature, this article aimed to provide a thorough understanding of the role of negative-pressure wound therapy (NPWT) and the importance of flap choice in managing DSWI accompanied by severe heart injury and high hemodynamic risk. Case description: A 60-year-old woman with severe aortic stenosis, aortic valve regurgitation, and heart failure underwent redo sternotomy, which resulted in an intraoperative right ventricle injury. She required extracorporeal membrane oxygenation support because of low blood pressure and subsequently developed complications, including surgical site hematoma, wound dehiscence, and fat necrosis. She was referred for wound closure, where a significant 10 × 20-cm soft tissue defect in the anterior chest wall was observed. A pedicled vertical rectus abdominis myocutaneous flap addressed the soft tissue defect. The wound showed remarkable improvement at the 8-month follow-up visit. Conclusions: DSWI management is a complex and multifaceted challenge. NPWT, when combined with appropriate surgical strategies, including wound debridement and flap selection, may promote successful wound healing. This case report highlights the successful management of a complex DSWI using a multidisciplinary approach, including debridement, appropriate antibiotic therapy, and free-flap reconstruction, which resulted in favorable outcomes.

16.
Hand (N Y) ; 18(2): 272-281, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-34253087

RESUMEN

BACKGROUND: Reverse-flow posterior interosseous artery (rPIA) flap is an excellent tool for restoration of defects in the hand and upper extremity, sparing the main arteries to the hand. Its reliability has been well established. MATERIALS AND METHODS: Fifty-one cases of rPIA flap involving 49 patients were retrospectively reviewed. The inclusion criteria were age, sex, etiology, size and location of the defect, flap size, number of perforators included, pedicle length, flap inset, donor site coverage, complications, and ancillary procedures. RESULTS: This study included 44 men and 5 women, ranging in age between 10 and 73 years. The subjects had soft tissue defects of the hand and upper extremity mainly due to traumatic injuries, including scar contractures of the first web space in 18 cases, thumb amputations in 6 cases, and congenital defects in 1 case. Among the 51 rPIA flap elevations, 3 cases involved flap failure due to the absence of proper pedicle. A fasciocutaneous pattern was observed in 45 cases and a myocutaneous pattern in 3 cases. In 5 cases of unplantable thumb amputations, the rPIA flap was performed for arterial inflow to the secondary toe-to-thumb transfer. Venous congestion of varying degrees was noted in 7 cases involving partial necrosis in 2 cases. During the mean 17 months of follow-up, patients were generally satisfied with the final outcomes. CONCLUSION: The rPIA flap can be used not only for soft tissue coverage of the hand and upper extremity but also as a recipient arterial pedicle for a secondary toe-to thumb transfer.


Asunto(s)
Colgajos Quirúrgicos , Arteria Cubital , Masculino , Humanos , Femenino , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Reproducibilidad de los Resultados , Colgajos Quirúrgicos/irrigación sanguínea , Dedos del Pie/trasplante
17.
World J Clin Cases ; 11(1): 143-149, 2023 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-36687191

RESUMEN

BACKGROUND: Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence. They require immediate and appropriate management before they progress to an irreversible condition. Although negative pressure wound therapy (NPWT) can prevent wound progression by increasing microcirculation, the inappropriate application of NPWT on complication-threatened transferred and replanted tissues can induce an adverse effect. CASE SUMMARY: A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap. While applying a heating pad directly to the flap site, she sustained a deep second to third-degree contact burn over 30% of the transferred flap on postoperative 7 d. As the necrotic changes had progressed, we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d. After 4 d of NPWT application, the exposed fatty tissues of the flap changed to dry and brown-colored necrotic tissues. Upon further debridement, we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery. CONCLUSION: Although NPWT has been shown to be successful for treating various wound types, the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.

18.
Braz J Microbiol ; 54(3): 2011-2026, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36973583

RESUMEN

In Antarctica, human activities have been reported to be the major cause of the accumulation of heavy metal contaminants. A comprehensive bibliometric analysis of publications on heavy metal contamination in Antarctica from year 2000 to 2020 was performed to obtain an overview of the current landscape in this line of research. A total of 106 documents were obtained from Scopus, the largest citation database. Extracted data were analysed, and VOSviewer software was used to visualise trends. The result showed an increase in publications and citations in the past 20 years indicating the rising interest on heavy metal contamination in the Antarctic region. Based on the analysis of keywords, the publications largely discuss various types of heavy metals found in the Antarctic water and sediment. The analysis on subject areas detects multiple disciplines involved, wherein the environmental science was well-represented. The top countries and authors producing the most publication in this field were from Australia, China, Brazil and Chile. Numerous efforts have been exercised to investigate heavy metal pollution and its mitigation approaches in the region in the past decades. This paper not only is relevant for scholars to understand the development status and trends in this field but also offers clear insights on the future direction of Antarctic heavy metal contamination and remediation research.


Asunto(s)
Contaminación Ambiental , Metales Pesados , Humanos , Regiones Antárticas , Contaminación Ambiental/análisis , Metales Pesados/análisis , China , Brasil
19.
J Hand Surg Asian Pac Vol ; 27(1): 163-170, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35037581

RESUMEN

Background: The anatomical structures in relation to the carpal tunnel release are the palmaris brevis muscle (PBM), transverse carpal ligament (TCL), and the recurrent motor branch of the median nerve (RMBMN). Our aim is to describe the gross morphology in the Korean population of the PBM, TCL, and RMBMN specifically looking for anomalies, and to determine the muscles encountered during a standard carpal tunnel release. Material and Methods: A total of 30 cadaveric hands were dissected. A longitudinal line drawn from the third web space to the midpoint of the distal wrist crease served as the reference line (RL). The PBM and TCL were classified according to its shape and location. The length, width, and thickness of the TCL were measured. The ratio of the lengths of PBM and TCL to RL was calculated. The course of the RMBMN was dissected specifically looking for anomalies. We also looked at the muscle fibers encountered during a standard carpal tunnel release to identify the muscle. Results: PBM was classified into three different types based on the shape. The average thickness of the PBM and TCL were 0.89 ± 0.16 mm and 1.43 ± 0.40 mm, respectively. The distal border of the TCL was thicker than the proximal border. The average ratio of the length of the PBM to the RL was 25.65 ± 8.62% and TCL to the RL was 24.00 ± 3.37%. The distribution of the RMBMN was classified into three different types. A few accessory branches of the RMBMN were also noted. And 36 muscle fibers were noted within the TCL in line with the RL. Conclusion: We clarified findings and added quantitative information about the anatomical structures surrounding carpal tunnel. A thorough knowledge of the anatomy and anomalies around the carpal tunnel is helpful for surgeons to ensure optimal surgical results.


Asunto(s)
Síndrome del Túnel Carpiano , Nervio Mediano , Síndrome del Túnel Carpiano/cirugía , Mano/anatomía & histología , Humanos , Ligamentos Articulares/cirugía , Nervio Mediano/anatomía & histología , Articulación de la Muñeca/anatomía & histología
20.
Foods ; 10(11)2021 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-34829082

RESUMEN

An Antarctic soil bacterial consortium (reference BS14) was confirmed to biodegrade canola oil, and kinetic studies on this biodegradation were carried out. The purpose of this study was to examine the ability of BS14 to produce biosurfactants during the biodegradation of canola oil. Secondary mathematical equations were chosen for kinetic analyses (Monod, Haldane, Teissier-Edwards, Aiba and Yano models). At the same time, biosurfactant production was confirmed through a preliminary screening test and further optimised using response surface methodology (RSM). Mathematical modelling demonstrated that the best-fitting model was the Haldane model for both waste (WCO) and pure canola oil (PCO) degradation. Kinetic parameters including the maximum degradation rate (µmax) and maximum concentration of substrate tolerated (Sm) were obtained. For WCO degradation these were 0.365 min-1 and 0.308%, respectively, while for PCO they were 0.307 min-1 and 0.591%, respectively. The results of all preliminary screenings for biosurfactants were positive. BS14 was able to produce biosurfactant concentrations of up to 13.44 and 14.06 mg/mL in the presence of WCO and PCO, respectively, after optimisation. The optimum values for each factor were determined using a three-dimensional contour plot generated in a central composite design, where a combination of 0.06% salinity, pH 7.30 and 1.55% initial substrate concentration led to the highest biosurfactant production when using WCO. Using PCO, the highest biosurfactant yield was obtained at 0.13% salinity, pH 7.30 and 1.25% initial substrate concentration. This study could help inform the development of large-scale bioremediation applications, not only for the degradation of canola oil but also of other hydrocarbons in the Antarctic by utilising the biosurfactants produced by BS14.

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