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1.
Cell Surf ; 11: 100124, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38600908

ABSTRACT

Pattern-Triggered Immunity (PTI) in plants is activated upon recognition by Pattern Recognition Receptors (PRRs) of Damage- and Microbe-Associated Molecular Patterns (DAMPs and MAMPs) from plants or microorganisms, respectively. An increasing number of identified DAMPs/MAMPs are carbohydrates from plant cell walls and microbial extracellular layers, which are perceived by plant PRRs, such as LysM and Leucine Rich Repeat-Malectin (LRR-MAL) receptor kinases (RKs). LysM-RKs (e.g. CERK1, LYK4 and LYK5) are needed for recognition of fungal MAMP chitohexaose (ß-1,4-D-(GlcNAc)6, CHI6), whereas IGP1/CORK1, IGP3 and IGP4 LRR-MAL RKs are required for perception of ß-glucans, like cellotriose (ß-1,4-D-(Glc)3, CEL3) and mixed-linked glucans. We have explored the diversity of carbohydrates perceived by Arabidopsis thaliana seedlings by determining PTI responses upon treatment with different oligosaccharides and polysaccharides. These analyses revealed that plant oligosaccharides from xylans [ß-1,4-D-(xylose)4 (XYL4)], glucuronoxylans and α-1,4-glucans, and polysaccharides from plants and seaweeds activate PTI. Cross-elicitation experiments of XYL4 with other glycans showed that the mechanism of recognition of XYL4 and the DAMP 33-α-L-arabinofuranosyl-xylotetraose (XA3XX) shares some features with that of CEL3 but differs from that of CHI6. Notably, XYL4 and XA3XX perception is impaired in igp1/cork1, igp3 and igp4 mutants, and almost not affected in cerk1 lyk4 lyk5 triple mutant. XYL4 perception is conserved in different plant species since XYL4 pre-treatment triggers enhanced disease resistance in tomato to Pseudomonas syringae pv tomato DC3000 and PTI responses in wheat. These results expand the number of glycans triggering plant immunity and support IGP1/CORK1, IGP3 and IGP4 relevance in Arabidopsis thaliana glycans perception and PTI activation. Significance Statement: The characterization of plant immune mechanisms involved in the perception of carbohydrate-based structures recognized as DAMPs/MAMPs is needed to further understand plant disease resistance modulation. We show here that IGP1/CORK1, IGP3 and IGP4 LRR-MAL RKs are required for the perception of carbohydrate-based DAMPs ß-1,4-D-(xylose)4 (XYL4) and 33-α-L-arabinofuranosyl-xylotetraose (XA3XX), further expanding the function of these LRR-MAL RKs in plant glycan perception and immune activation.

2.
Mol Plant Microbe Interact ; 37(5): 432-444, 2024 May.
Article in English | MEDLINE | ID: mdl-38265007

ABSTRACT

Zymoseptoria tritici, the causal agent of Septoria tritici blotch, is one of Europe's most damaging wheat pathogens, causing significant economic losses. Genetic resistance is a common strategy to control the disease, Stb6 being a resistance gene used for more than 100 years in Europe. This study investigates the molecular mechanisms underlying Stb6-mediated resistance. Utilizing confocal microscopy imaging, we determined that Z. tritici epiphytic hyphae mainly accumulate the corresponding avirulence factor AvrStb6 in close proximity to stomata. Consequently, the progression of AvrStb6-expressing avirulent strains is hampered during penetration. The fungal growth inhibition co-occurs with a transcriptional reprogramming in wheat characterized by an induction of immune responses, genes involved in stomatal regulation, and cell wall-related genes. Overall, we shed light on the gene-for-gene resistance mechanisms in the wheat-Z. tritici pathosystem at the cytological and transcriptomic level, and our results highlight that stomatal penetration is a critical process for pathogenicity and resistance. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.


Subject(s)
Ascomycota , Fungal Proteins , Hyphae , Plant Diseases , Plant Stomata , Triticum , Triticum/microbiology , Triticum/genetics , Ascomycota/pathogenicity , Ascomycota/physiology , Ascomycota/genetics , Plant Stomata/microbiology , Plant Diseases/microbiology , Plant Diseases/immunology , Fungal Proteins/genetics , Fungal Proteins/metabolism , Gene Expression Regulation, Plant , Disease Resistance/genetics , Virulence , Host-Pathogen Interactions , Plant Proteins/genetics , Plant Proteins/metabolism , Virulence Factors/metabolism , Virulence Factors/genetics
3.
Laryngoscope Investig Otolaryngol ; 8(6): 1564-1570, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38130254

ABSTRACT

Objective: Transoral robotic surgery (TORS) has evolved since its 2009 US Food and Drug Administration approval for use in local stage T1-T2 oropharyngeal carcinoma. The ability to resect increasingly larger and more complex lesions has led to the need to introduce reconstructive techniques through this route, avoiding the classic transmandibular or pull-through approach. Few studies have compared the safety, efficacy, and advantages of TORS versus classic open approaches in oropharyngeal salvage surgery with reconstruction using microanastomosed flaps. Here we retrospectively compare our center's experience with the open approach and TORS and describe the technical variations used. Methods: Between 2013 and 2021, 30 stage III-IV oropharyngeal cancer patients underwent salvage surgery with reconstruction in our center. From 2013 to 2017, 15 patients underwent surgery with the classic open approach, and from 2018 to 2021, an additional 15 patients underwent TORS. We have compared surgical outcomes, post-surgical results, and survival in the two groups. Results: Patient characteristics were similar in the two groups. TORS was associated with shorter surgical time (p < .001), fewer complications (p = .01), shorter hospital stay (p < .001), and lower feeding tube requirements (p = .003). No significant differences were observed between the two groups in the free margin rate or survival. Conclusion: Oropharyngeal salvage surgery with TORS with free flap reconstruction reduced associated morbidity compared to the open approach in a patient cohort with poor prognosis. Level of Evidence: 4.

4.
Cir. plást. ibero-latinoam ; 49(3): 231-236, Juli-Sep. 2023. tab, ilus
Article in Spanish | IBECS | ID: ibc-227156

ABSTRACT

Introducción y objetivo: El manejo del dolor es esencial en el postoperatorio inmediato de los colgajos microquirúrgicos para reconstrucción de mama: Presentamos un estudio de optimización del manejo postoperatorio basado en la introducción de un catéter de bupivacaína subfascial abdominal y la movilización precoz de las pacientes. Material y método: Incluimos los colgajos DIEP y MS-TRAM libres para reconstrucción mamaria llevados a cabo en nuestro Servicio de enero 2013 a diciembre 2019, divididos en 2 grupos según el protocolo de manejo postoperatorio empleado, estándar o de rápida recuperación, para comparar su efectividad. Resultados: Analizamos un total de 186 pacientes: 68 en el grupo estándar y 118 en el grupo de rápida recuperación. La estancia hospitalaria, la necesidad de mórficos de rescate y los vómitos durante el postoperatorio inmediato disminuyeron de forma estadísticamente significativa en el grupo de rápida recuperación (p = 0.013, p = 0.001 y p = 0.012, respectivamente). El inicio de la deambulación fue más precoz en el grupo de rápida recuperación, también de forma estadísticamente significativa (p = 0.01). No objetivamos más complicaciones abdominales asociadas al cambio del protocolo. Conclusiones: En nuestra experiencia, el protocolo de rápida recuperación permite optimizar el manejo del dolor postoperatorio, iniciar una deambulación más temprana y reducir la estancia hospitalaria en la reconstrucción microquirúrgica mamaria con colgajo abdominal. Nivel de evidencia científica 4c Terapéutico.(AU)


Background and objective: Pain management is essential during the immediate postoperative period of microsurgical flaps for breast reconstruction. The aim of this study is to assess the effectiveness of a postoperative management protocol based on the use of an abdominal bupivacaine catheter and the early mobilization of patients. Methods: Patients underwent free DIEP and MS-TRAM flaps for breast reconstruction in our Service from January 2013 to December 2019 were included and divided into 2 groups according to the postoperative management protocol used, standard versus fast-track, to compare its effectiveness. Results: A total of 186 patients were included: 68 standard group, 118 fast-track group. The length of hospital stays, the intravenous opiate use and vomiting during the immediate postoperative period, were reduced in the fast-track group, and the results were statistically significant (p = 0.013, p =0.001 and p = 0.012, respectively). The initiation of ambulation was earlier in the fast-track group (p = 0.01). No differences in abdominal complications were found between both protocols. Conclusions: In our experience, the fast-track protocol allows to optimize the management of postoperative pain, to initiate an earlier ambulation and to reduce the length of the hospital stay in breast microsurgical reconstruction with abdominal fap. Level of evidence 4c Terapeutic.(AU)


Subject(s)
Humans , Female , Breast/surgery , Mammaplasty , Guidelines as Topic , Postoperative Care , Pain Management , Length of Stay , Surgery, Plastic , Postoperative Period , Retrospective Studies , Spain , Pain , Breast Neoplasms/surgery , Mastectomy
5.
Plant Physiol ; 187(3): 1534-1550, 2021 11 03.
Article in English | MEDLINE | ID: mdl-34618031

ABSTRACT

The prefoldin complex (PFDc) was identified in humans as a co-chaperone of the cytosolic chaperonin T-COMPLEX PROTEIN RING COMPLEX (TRiC)/CHAPERONIN CONTAINING TCP-1 (CCT). PFDc is conserved in eukaryotes and is composed of subunits PFD1-6, and PFDc-TRiC/CCT folds actin and tubulins. PFDs also participate in a wide range of cellular processes, both in the cytoplasm and in the nucleus, and their malfunction causes developmental alterations and disease in animals and altered growth and environmental responses in yeast and plants. Genetic analyses in yeast indicate that not all of their functions require the canonical complex. The lack of systematic genetic analyses in plants and animals, however, makes it difficult to discern whether PFDs participate in a process as the canonical complex or in alternative configurations, which is necessary to understand their mode of action. To tackle this question, and on the premise that the canonical complex cannot be formed if one subunit is missing, we generated an Arabidopsis (Arabidopsis thaliana) mutant deficient in the six PFDs and compared various growth and environmental responses with those of the individual mutants. In this way, we demonstrate that the PFDc is required for seed germination, to delay flowering, or to respond to high salt stress or low temperature, whereas at least two PFDs redundantly attenuate the response to osmotic stress. A coexpression analysis of differentially expressed genes in the sextuple mutant identified several transcription factors, including ABA INSENSITIVE 5 (ABI5) and PHYTOCHROME-INTERACTING FACTOR 4, acting downstream of PFDs. Furthermore, the transcriptomic analysis allowed assigning additional roles for PFDs, for instance, in response to higher temperature.


Subject(s)
Arabidopsis Proteins/genetics , Arabidopsis/genetics , Molecular Chaperones/genetics , Transcription Factors/genetics , Arabidopsis/metabolism , Arabidopsis Proteins/metabolism , Molecular Chaperones/metabolism , Transcription Factors/metabolism
7.
Nucleic Acids Res ; 48(11): 6280-6293, 2020 06 19.
Article in English | MEDLINE | ID: mdl-32396196

ABSTRACT

Although originally identified as the components of the complex aiding the cytosolic chaperonin CCT in the folding of actins and tubulins in the cytosol, prefoldins (PFDs) are emerging as novel regulators influencing gene expression in the nucleus. Work conducted mainly in yeast and animals showed that PFDs act as transcriptional regulators and participate in the nuclear proteostasis. To investigate new functions of PFDs, we performed a co-expression analysis in Arabidopsis thaliana. Results revealed co-expression between PFD and the Sm-like (LSM) genes, which encode the LSM2-8 spliceosome core complex, in this model organism. Here, we show that PFDs interact with and are required to maintain adequate levels of the LSM2-8 complex. Our data indicate that levels of the LSM8 protein, which defines and confers the functional specificity of the complex, are reduced in pfd mutants and in response to the Hsp90 inhibitor geldanamycin. We provide biochemical evidence showing that LSM8 is a client of Hsp90 and that PFD4 mediates the interaction between both proteins. Consistent with our results and with the role of the LSM2-8 complex in splicing through the stabilization of the U6 snRNA, pfd mutants showed reduced levels of this snRNA and altered pre-mRNA splicing patterns.


Subject(s)
Arabidopsis Proteins/metabolism , Arabidopsis/metabolism , HSP90 Heat-Shock Proteins/metabolism , Molecular Chaperones/metabolism , Multiprotein Complexes/metabolism , RNA-Binding Proteins/metabolism , Spliceosomes/metabolism , Arabidopsis/genetics , Gene Expression Regulation, Plant , Multiprotein Complexes/chemistry , Mutation , Protein Binding , RNA Splicing , Spliceosomes/chemistry
9.
Surg Oncol ; 32: 41-45, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31733585

ABSTRACT

Endoscopic procedures have not become the gold standard in breast surgery. In order to improve today's outcomes we have developed a pilot study in the Breast Pathology Unit of Hospital Germans Trias i Pujol. A surgical procedure was performed creating a pneumoendoscopic cavity by using a Single Incision Laparoscopic Surgery (Single port) approach with a follow up of four years. Four patients underwent pneumoendoscopic single-port breast surgery receiving skin-sparing quadrantectomy and axillary surgery requiring lymphadenectomy in all of them. All patients had immediate reconstruction with a Latisimus Dorsi flap. No perioperative complications appeared. Mean operative time was 290 min (range 240-315 min) and mean hospital stay was 3,2 days. Surgical margins of all cases were pathologically negative and all patients were disease free after four years of monitoring. All patients were satisfied with the cosmetic outcome in the immediate postoperative and during the follow up. Although all innovative techniques generate hesitation on their beginnings and are liable to improve, we believe that pneumoendoscopic single-port breast surgery can be suitable for breast cancer, offering better cosmetic outcomes with oncological safety.


Subject(s)
Breast Neoplasms/surgery , Endoscopy/methods , Mastectomy, Segmental/methods , Organ Sparing Treatments/methods , Breast Neoplasms/pathology , Endoscopy/instrumentation , Female , Follow-Up Studies , Humans , Middle Aged , Pilot Projects , Prognosis
10.
Breast ; 47: 102-108, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31404745

ABSTRACT

BACKGROUND: Although the indocyanine green angiography (ICGA) has been used for years in the assessment of Deep Inferior Epigastric Perforator (DIEP) perfusion, it has not yet been established when it should be performed during the surgery. The aim of this study is to evaluate whether it is better to perform the test on the donor or recipient sites. METHODS: Intraoperative perfusion of 46 DIEP flaps was assessed twice, on the donor and recipient sites. Differences between both ischemic areas of each flap were statistically analyzed. In addition, perforator location and risk factors were evaluated in order to assess whether they are associated with changes in the perfusion of the flap between both sites. RESULTS: Differences between ischemic areas on the donor and recipient sites were statistically significant (p = 0.012). However, in most cases (82.6%) the ischemic area was the same on both sites, and the final flap design only changed in two cases (4.3%) because of the ICGA findings on the recipient site. Besides, performing the ICGA on the donor site facilitated the identification of the best perfused areas, allowed a better planning of its placement into the recipient site, and also can be useful to choose the best perforator. Bilateral DIEP flap, lateral location of the perforator and tobacco use had a statistically significant association with lower probability to increase the perfusion area between both sites. CONCLUSIONS: several advantages have been found in performing the ICGA on the donor site to assess the perfusion of the DIEP flap.


Subject(s)
Breast Neoplasms/surgery , Epigastric Arteries/transplantation , Indocyanine Green , Mammaplasty/methods , Perforator Flap/blood supply , Adult , Angiography/methods , Breast Neoplasms/pathology , Cohort Studies , Female , Follow-Up Studies , Graft Rejection , Graft Survival , Humans , Intraoperative Care/methods , Mastectomy/methods , Middle Aged , Myocutaneous Flap/blood supply , Myocutaneous Flap/transplantation , Perforator Flap/transplantation , Prospective Studies , Risk Assessment , Spain
11.
Cir. plást. ibero-latinoam ; 45(2): 189-195, abr.-jun. 2019. ilus, tab
Article in Spanish | IBECS | ID: ibc-184227

ABSTRACT

Introducción y objetivo. En los últimos años han surgido nuevas técnicas de reconstrucción mediante supermicrocirugía con buenos resultados estéticos y funcionales, como el colgajo libre SCIP (Superficial Circumflex Iliac Artery Perforator), que permite realizar anastomosis a perforantes pudiendo conservar así los vasos principales de la extremidad. El objetivo de este estudio es presentar nuestra experiencia en la reconstrucción de extremidad inferior distal con SCIP libre y su manejo perioperatorio. Material y método. Nuestro estudio incluye 17 pacientes en los que llevamos a cabo reconstrucción mediante SCIP libre de extremidad inferior distal (pierna y pie) entre 2015 y 2017. Realizamos angioTAC preoperatorio para planificar la cirugía y valorar la necesidad de optimización vascular. Resultados. Preferentemente hicimos anastomosis término-terminales a perforantes de la zona receptora. No fueron necesarias revisiones microquirúgicas inmediatas. La complicación postoperatoria más frecuente fue la congestión venosa (29.4%). En todos los pacientes se logró la conservación de la extremidad y se mantuvo la capacidad de deambulación. Conclusiones. el SCIP libre es una buena opción microquirúrgica para la reconstrucción de extremidad inferior distal, tanto estética como funcionalmente, ya que presenta escasas complicaciones y puede evitar la amputación. En base a nuestra experiencia inicial, recomendamos realizar angioTAC y valoración preoperatoria de optimización de la vascularización regional, cambios posturales, 2 anastomosis venosas siempre que sea posible y un manejo multidisciplinario


Background and objetive. New reconstruction techniques have been described for last years with good aesthetic and functional results, such as the free SCIP flap (Superficial Circumflex Iliac Artery Perforator). Supermicrosurgery allows anastomoses to perforator vessels and therefore the main vessels of the limb can be preserved. The aim of this study is to present our experience in the reconstruction of the distal lower extremity with free SCIP and its perioperative management. Methods. From 2015 to 2017, 17 patients who underwent a reconstruction of the distal lower extremity (leg and foot) by free SCIP flap were included. Preoperative CT-angiography was performed for the surgical planning and to assess the need for angioplasty. Results. End-to-end anastomoses were made to perforator vessels of the recipient area. No immediate microsurgical revisions were needed. The most frequent postoperative complication was venous congestion (29.4%). Limb salvage was achieved in all patients and walk ability was preserved. Conclusions. The free SCIP flap is a good microsurgical option for the reconstruction of the distal lower extremity, both aesthetically and functionally, presents few complications and an avoid amputation. Based on our initial experience, we recommend performing a CT-angiography and a preoperative assessment of regional vascularization optimization, postural changes, 2 venous anastomoses whenever possible and multidisciplinary management


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Free Tissue Flaps/surgery , Perforator Flap/surgery , Lower Extremity/injuries , Lower Extremity/surgery , Microsurgery , Anastomosis, Surgical/methods , Postoperative Complications , Leg/surgery , Plastic Surgery Procedures , Edema/complications
12.
Front Plant Sci ; 10: 167, 2019.
Article in English | MEDLINE | ID: mdl-30873189

ABSTRACT

It has long been assumed that the wide reprogramming of gene expression that modulates plant response to unfavorable environmental conditions is mainly controlled at the transcriptional level. A growing body of evidence, however, indicates that posttranscriptional regulatory mechanisms also play a relevant role in this control. Thus, the LSMs, a family of proteins involved in mRNA metabolism highly conserved in eukaryotes, have emerged as prominent regulators of plant tolerance to abiotic stress. Arabidopsis contains two main LSM ring-shaped heteroheptameric complexes, LSM1-7 and LSM2-8, with different subcellular localization and function. The LSM1-7 ring is part of the cytoplasmic decapping complex that regulates mRNA stability. On the other hand, the LSM2-8 complex accumulates in the nucleus to ensure appropriate levels of U6 snRNA and, therefore, correct pre-mRNA splicing. Recent studies reported unexpected results that led to a fundamental change in the assumed consideration that LSM complexes are mere components of the mRNA decapping and splicing cellular machineries. Indeed, these data have demonstrated that LSM1-7 and LSM2-8 rings operate in Arabidopsis by selecting specific RNA targets, depending on the environmental conditions. This specificity allows them to actively imposing particular gene expression patterns that fine-tune plant responses to abiotic stresses. In this review, we will summarize current and past knowledge on the role of LSM rings in modulating plant physiology, with special focus on their function in abiotic stress responses.

14.
Aesthet Surg J ; 39(4): NP45-NP54, 2019 03 14.
Article in English | MEDLINE | ID: mdl-30358820

ABSTRACT

BACKGROUND: Fat necrosis is a frequent complication (up to 62.5%) of microsurgical breast reconstruction using the deep inferior epigastric perforator (DIEP) flap. This could have important clinical and psychological repercussions, deteriorating the results and increasing reconstruction costs. OBJECTIVES: The aim of this study was to demonstrate the intraoperative use of indocyanine green angiography (ICGA) to reduce fat necrosis in DIEP flap. METHODS: Sixty-one patients who underwent unilateral DIEP flap procedures for breast reconstruction after oncological mastectomy were included (24 cases with intraoperative use of ICGA during surgery, 37 cases in the control group). The follow-up period was 1 year after surgery. The association between the use of ICGA and the incidence of fat necrosis in the first postoperative year, differences in fat necrosis grade (I-V), differences in fat necrosis requiring reoperation, quality of life, and patient satisfaction were analyzed. RESULTS: The incidence of fat necrosis was reduced from 59.5% (control group) to 29% (ICG-group) (P = 0.021) (relative risk = 0.49 [95% CI, 0.25-0.97]). The major difference was in grade II (27% vs 2.7%, P = 0.038). The number of second surgeries for fat necrosis treatment was also reduced (45.9% vs 20.8%, P = 0.046). The ICG group had higher scores on the BREAST-Q. CONCLUSIONS: Intraoperative ICGA is a useful technique for reconstructive microsurgery that might improve patient satisfaction and reduce the incidence of fat necrosis by half as well as reduce its grade, especially in small fat necrosis cases; consequently, ICGA could reduce the number of secondary surgeries for treatment of fat necrosis.


Subject(s)
Angiography/methods , Fat Necrosis/prevention & control , Indocyanine Green/administration & dosage , Mammaplasty/methods , Perforator Flap/blood supply , Adult , Aged , Breast Neoplasms/surgery , Fat Necrosis/etiology , Female , Follow-Up Studies , Humans , Mastectomy/methods , Middle Aged , Patient Satisfaction , Perforator Flap/pathology , Postoperative Complications/prevention & control , Quality of Life
16.
Nucleic Acids Res ; 45(12): 7416-7431, 2017 Jul 07.
Article in English | MEDLINE | ID: mdl-28482101

ABSTRACT

Spliceosome activity is tightly regulated to ensure adequate splicing in response to internal and external cues. It has been suggested that core components of the spliceosome, such as the snRNPs, would participate in the control of its activity. The experimental indications supporting this proposition, however, remain scarce, and the operating mechanisms poorly understood. Here, we present genetic and molecular evidence demonstrating that the LSM2-8 complex, the protein moiety of the U6 snRNP, regulates the spliceosome activity in Arabidopsis, and that this regulation is controlled by the environmental conditions. Our results show that the complex ensures the efficiency and accuracy of constitutive and alternative splicing of selected pre-mRNAs, depending on the conditions. Moreover, miss-splicing of most targeted pre-mRNAs leads to the generation of nonsense mediated decay signatures, indicating that the LSM2-8 complex also guarantees adequate levels of the corresponding functional transcripts. Interestingly, the selective role of the complex has relevant physiological implications since it is required for adequate plant adaptation to abiotic stresses. These findings unveil an unanticipated function for the LSM2-8 complex that represents a new layer of posttranscriptional regulation in response to external stimuli in eukaryotes.


Subject(s)
Alternative Splicing , Arabidopsis Proteins/genetics , Arabidopsis/genetics , RNA Precursors/genetics , RNA, Small Nuclear/genetics , RNA-Binding Proteins/genetics , Spliceosomes/chemistry , Adaptation, Physiological/genetics , Arabidopsis/drug effects , Arabidopsis/metabolism , Arabidopsis Proteins/metabolism , Cold Temperature , Gene Expression Regulation, Plant , Nonsense Mediated mRNA Decay , Protein Isoforms/genetics , Protein Isoforms/metabolism , RNA Precursors/metabolism , RNA Stability , RNA, Small Nuclear/metabolism , RNA-Binding Proteins/metabolism , Sodium Chloride/pharmacology , Spliceosomes/drug effects , Spliceosomes/metabolism , Stress, Physiological
17.
Microsurgery ; 37(6): 603-610, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28370199

ABSTRACT

BACKGROUND: Although the use of lateral intercostal artery perforator (ICAP) flaps for immediate breast reconstruction has been widely described, data on the use of the anterior ICAP (AICAP) flaps for this indication are limited. In this context, we describe the results of anatomical study and our clinical experience with AICAP flaps for breast reconstruction. METHODS: In this study, the location and characteristics of the AICAPs were dissected in 12 female adult formalin-preserved hemitrunks and two fresh-frozen cadavers. Fourteen patients (mean BMI 23) underwent partial breast resection for a quadrant breast cancer followed by breast reconstruction with an intercostal perforator flap. The mean resection size was 6 × 5 × 5.5 cm (range 3-8 × 3.5-7 × 4-8 cm).The main outcome measures were pre-operative and postradiotherapy health-related quality of life assessed with the BREAST-Q reconstruction survey. RESULTS: According to anatomical study, at least one perforator was found in each third of hemitrunks dissected. The mean of perforator size was in diameter 0.42 ± 0.05 mm and in length 3.1 ± 0.36 cm. In clinical outcomes, the mean of flap size was 16 × 5 × 3 cm (range 14-19 × 3-8 × 2-5 cm). The mean surgical time was 120 min (range 109-125 min). Only one partial flap failure was detected. No postoperative changes in breast size were observed, although soft tissue changes were observed in four patients after radiotherapy. The mean BREAST-Q scores changes were 0 in satisfaction with the breast, 5 in satisfaction with outcome, 0 in psychosocial well-being, 6.15 in sexual well being, and 34.69 in physical well-being. CONCLUSIONS: Based on this anatomical and clinical study, we found AICAP flap has a consistent vascularization with good perforators. And moreover, it is suitable for partial breast reconstruction (quadrantectomy) and does not appear to negatively impact patient satisfaction.


Subject(s)
Breast Neoplasms/surgery , Breast/surgery , Mammaplasty/methods , Mammary Arteries/transplantation , Perforator Flap/blood supply , Aged , Breast/anatomy & histology , Breast Neoplasms/pathology , Cadaver , Dissection , Esthetics , Female , Follow-Up Studies , Graft Survival , Humans , Mastectomy/methods , Middle Aged , Perforator Flap/transplantation , Transplantation, Autologous , Wound Healing/physiology
18.
Plast Reconstr Surg ; 139(3): 613e-619e, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28234821

ABSTRACT

BACKGROUND: Reconstruction of the anterior thorax is complex because of the presence of aesthetically important areas such as the breast, sternum, and upper abdomen. For this reason, a wide variety of pedicled perforator flaps have been described. The anterior intercostal perforator flap is one of these perforators flaps and is valuable for use in breast reconstruction surgery. METHODS: The location and characteristics of the anterior intercostal perforators were evaluated both anatomically and radiologically. The anatomical study was conducted in a set of 14 hemitrunk cadavers, and the radiologic study was performed retrospectively from a randomly selected set of images obtained from 30 female patients who underwent thoracic computed tomographic angiography for other health problems at the authors' institution during the year 2015. The findings were then compared. RESULTS: A total of 60 perforators in 14 hemitrunks were identified and mapped. Perforators were found in all hemithoraces. The lateral third donor location was the most reliable zone, containing larger and more numerous perforators compared with the other donor regions. According to the radiologic study, a total of 164 perforators in 30 computed tomographic angiographs were identified and mapped. Perforators were found in all thoraxes. CONCLUSIONS: The authors found that the intercostal perforator flap has a consistent vascularization. Computed tomographic angiography is less reliable than dissection in identifying the number of perforators. The authors' findings suggest that intercostal perforator flaps are reliable and consistent flaps for reconstruction of the upper trunk.


Subject(s)
Mammary Arteries/anatomy & histology , Mammary Arteries/diagnostic imaging , Perforator Flap/blood supply , Angiography/methods , Cadaver , Female , Humans , Plastic Surgery Procedures , Retrospective Studies , Thoracic Wall/surgery , Tomography, X-Ray Computed
19.
Microsurgery ; 36(5): 430-434, 2016 Jul.
Article in English | MEDLINE | ID: mdl-26991122

ABSTRACT

Owing to the limited blood supply in the midfoot, multiple arthrodesis attempts in midfood joints may result in severe osteonecrosis, leading to a difficult scenario for bone reconstruction. This article describes the use of fibula flaps (two free and one pedicled flap) to reconstruct bone defects in three cases of persistent nonunion in midfoot joints. Before admission, all patients (aged 32-56 years old) had undergone multiple arthrodesis attempts (range 3-4) aimed at treating joint diseases associated with flatfoot or Müller-Weiss syndrome. All inserted flaps were stable, and bone fusion was confirmed by X-ray examination at month 4. After the follow-up period (range 1-4 years), all patients showed normal, painless gait. No foot deformities or further complications were observed. Our report suggests that fibula flap transfer may be a good alternative for treating persistent nonunion in midfoot joints involving bone loss, and may prevent the osteonecrosis associated with limited blood supply. © 2016 Wiley Periodicals, Inc. Microsurgery 36:430-434, 2016.

20.
Plant Cell ; 28(2): 505-20, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26764377

ABSTRACT

In eukaryotes, the decapping machinery is highly conserved and plays an essential role in controlling mRNA stability, a key step in the regulation of gene expression. Yet, the role of mRNA decapping in shaping gene expression profiles in response to environmental cues and the operating molecular mechanisms are poorly understood. Here, we provide genetic and molecular evidence that a component of the decapping machinery, the LSM1-7 complex, plays a critical role in plant tolerance to abiotic stresses. Our results demonstrate that, depending on the stress, the complex from Arabidopsis thaliana interacts with different selected stress-inducible transcripts targeting them for decapping and subsequent degradation. This interaction ensures the correct turnover of the target transcripts and, consequently, the appropriate patterns of downstream stress-responsive gene expression that are required for plant adaptation. Remarkably, among the selected target transcripts of the LSM1-7 complex are those encoding NCED3 and NCED5, two key enzymes in abscisic acid (ABA) biosynthesis. We demonstrate that the complex modulates ABA levels in Arabidopsis exposed to cold and high salt by differentially controlling NCED3 and NCED5 mRNA turnover, which represents a new layer of regulation in ABA biosynthesis in response to abiotic stress. Our findings uncover an unanticipated functional plasticity of the mRNA decapping machinery to modulate the relationship between plants and their environment.


Subject(s)
Adaptation, Physiological , Arabidopsis Proteins/metabolism , Arabidopsis/genetics , Endoribonucleases/metabolism , Gene Expression Regulation, Plant , Models, Biological , Abscisic Acid/metabolism , Arabidopsis/physiology , Arabidopsis Proteins/genetics , Cold Temperature , Endoribonucleases/genetics , Genes, Reporter , Plant Growth Regulators/metabolism , Plants, Genetically Modified , RNA, Messenger/genetics , RNA, Messenger/metabolism , Sodium Chloride/metabolism , Stress, Physiological
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