Transcriptome of the Atlantic halibut (Hippoglossus hippoglossus).

Although the Atlantic halibut (Hippoglossus hippoglossus) is an important commercial species, there is still a deficit with regard to the number of transcripts in the databases, which can be accessed and exploited for targeted candidate gene and pathway studies. In this study, the RNAs from head, skin and GI tract from different developmental stages were sequenced to generate 22,272 contigs of 500 base pairs or greater as a molecular resource for this species.

Comparative analysis of a teleost skeleton transcriptome provides insight into its regulation.

An articulated endoskeleton that is calcified is a unifying innovation of the vertebrates, however the molecular basis of the structural divergence between terrestrial and aquatic vertebrates, such as teleost fish, has not been determined. In the present study long-read next generation sequencing (NGS, Roche 454 platform) was used to characterize acellular perichondral bone (vertebrae) and chondroid bone (gill arch) in the gilthead sea bream (Sparus auratus). A total of 15.97 and 14.53Mb were produced, respectively from vertebrae and gill arch cDNA libraries and yielded 32,374 and 28,371 contigs (consensus sequences) respectively. 10,455 contigs from vertebrae and 10,625 contigs from gill arches were annotated with gene ontology terms. Comparative analysis of the global transcriptome revealed 4249 unique transcripts in vertebrae, 4201 unique transcripts in the gill arches and 3700 common transcripts. Several core gene networks were conserved between the gilthead sea bream and mammalian skeleton. Transcripts for putative endocrine factors were identified in acellular gilthead sea bream bone suggesting that in common with mammalian bone it can act as an endocrine tissue. The acellular bone of the vertebra, in contrast to current opinion based on histological analysis, was responsive to a short fast and significant (p<0.05) down-regulation of several transcripts identified by NGS, osteonectin, osteocalcin, cathepsin K and IGFI occurred. In gill arches fasting caused a significant (p<0.05) down-regulation of osteocalcin and up-regulation of MMP9.

Sympathetically mediated pain after reduction mammoplasty: an unusual complication.

We present a case report of a patient who developed an unusual bilateral breast pain syndrome after a reduction mammoplasty. Her symptoms and physical examination findings resolved after four stellate ganglion blocks, of which two on each side were performed over a period of 2 weeks. The case serves to alert clinicians to the possibility of a patient developing a sympathetically mediated pain syndrome after reduction mammoplasty.

Lobular carcinoma in situ in a 15-year-old girl: a case report and review of the literature.

Lobular carcinoma in situ is a clinically occult lesion associated with subsequent development of invasive breast cancer in up to one-third of patients. Lobular carcinoma in situ may be viewed as a marker lesion indicating an increased risk for development of subsequent invasive disease in either breast. Regardless of patient age or diagnosis, excised breast tissue merits thorough pathologic examination. If lobular carcinoma in situ is identified, a thorough search for areas of invasion is warranted. Treatment options are based on the associated risk of invasive carcinoma. Thorough counseling of patients regarding risks and benefits of surgical and nonsurgical treatment options is essential, with marked emphasis on the need for continued lifelong surveillance of unexcised breast tissue.

The safety and efficacy of extensive abdominal panniculectomy at the time of pelvic surgery.

Nine massively obese patients underwent excision of a large abdominal panniculus in conjunction with pelvic surgery. The most frequent indication for surgery was endometrial cancer. The charts of the patients were reviewed with careful attention to the outcome of the operation and the postoperative course. Comparison was made to previously reported data. The patients ranged in age from 48 to 72 years (mean 56). Weight range was 216 to 325 pounds (mean 261) and averaged more than twice ideal body weight. The weight of the resected abdominal wall was 3900 to 11,000 grams (mean 6247). Hospital stay ranged from 6 to 18 days (mean 8.2). Postoperative complications were chiefly those associated with the dead space created by the large resection without flap undermining (seromas in 2 and wound infections in 3). Four patients required prolonged wound drainage as outpatients. The average length of time to complete wound healing was 40.3 days (range 10 to 65). There were no dehiscences, pulmonary emboli, or operative mortalities. No patients required reoperation. Our study demonstrates that it is possible to safely combine plastic and gynecologic surgery without significantly increasing operative time, blood loss, postoperative complications, or hospital stay.

The effects of nicotinamide and hyperbaric oxygen on skin flap survival.

Hyperbaric oxygen has been established as an acceptable treatment for the chronic healing wound. Nicotinamide has been shown to be angiogenic and accelerate the physiologic process following wounding. Therefore both nicotinamide and hyperbaric oxygen were evaluated to enhance flap survival in an island pedicle skin flap model. These two treatment modalities were evaluated alone and in combination to assess if there is an addictive effect to enhance flap survival. Forty Sprague-Dawley male rats (weight 300-350 grams) were treated for 14 days preoperatively 1 day post-operatively with either 400 mg of nicotinamide i.p. or saline i.p. On day 14, a 7 X 7 cm island pedicle skin flap was elevated ligating the left inferior epigastric neurovascular pedicle and were sutured in their normal position. Twenty animals then underwent hyperbaric oxygen treatments. Forty-eight hours post-operatively animals were re-anesthetized and were given a single injection of fluorescein (25 mg/kg) via the tail vein. The % survival of the flap and SEM of the groups are as follows: Saline 45.67 +/- 31.14, nicotinamide 85.30 +/- 9.24, saline-hyperbaric oxygen 76.70 +/- 9.42 and nicotinamide-hyperbaric oxygen 90.86 +/- 3.94 with statistical significance of p less than 0.01. Nicotinamide appears to be another acceptable therapeutic modality in the management of the acceleration of wound healing.

Nicotinamide enhances skin flap survival.

The effects of nicotinamide in an abdominal island pedicle skin flap were examined. A 7 x 7 cm island pedicle skin flap ligating the left inferior neurovascular pedicle was created on 50 male Sprague Dawley rats (250-275 grams) that were divided into five groups. Animals received either 0.6 cc of saline or doses of nicotinamide for 16 days (14 days preoperatively and 2 days postoperatively): 25 mg b.i.d., 50 mg b.i.d., 100 mg b.i.d. or 200 mg b.i.d. Forty-eight hours postoperatively each animal received 25 mg of Fluorescein via the tail vein. The area of necrosis was visualized and quantified and is presented as % survival. A one factor Fisher PLSD test was performed with a statistical significance of p less than 0.05 with the results as follows: saline 58.8%, 25 mg 68.6%, 50 mg 82%, 100 mg 80.8%, and 200 mg 86%. From this data it would appear that the angiogenic factor nicotinamide may increase random flap survival.

Is topical application of epinephrine at skin graft donor sites during halothane anesthesia safe?

Topical epinephrine is useful in controlling the bleeding of skin graft donor sites. However, the use of exogenous epinephrine during halothane anesthetization increases the risk of cardiac arrhythmias. This study shows that there is no significant increase in plasma epinephrine levels after topical administration of up to 80 cc of 1:500,000 epinephrine, suggesting that the use of this dose in conjunction with halothane anesthesia is safe.

The treatment of intraarterial pentazocine injection injuries with intraarterial reserpine.

From 1979 to 1983, 14 patients were treated at the University of Maryland Hospital for injuries sustained as a result of the injection of crushed pentazocine tablets partially dissolved in water into the arterial system of the upper extremity. Eight patients received intraarterial reserpine within 15 hours of the injury and had no functional or tissue loss. Six patients either received no treatment or were given the reserpine more than 15 hours after the injury; they sustained notable functional or tissue loss. The results of this review would indicate that there may be a role for the use of intraarterial reserpine in the treatment of impending tissue loss from intraarterial drug injections.

Hemangioma of the masseter muscle: a case report and review of the literature.

The case of a patient with a hemangioma of the masseter muscle is presented. The treatment in this case was superficial parotidectomy and resection of the hemangioma. A review of the literature reveals that the masseter muscle is a fairly uncommon location for hemangiomas. Among the cases reported the diagnosis was rarely made preoperatively. Most authors recommended that superficial parotidectomy be done as part of the surgical excision.

The combined use of the latissimus dorsi musculocutaneous free flap and split-rib grafts for cranial vault reconstruction.

The patient described in this article had a large skull defect under the scalp which had been irradiated during treatment of a malignant brain tumor. The patient desired reconstruction of her defect. To provide good soft-tissue coverage for the bony reconstruction, a free latissimus dorsi musculocutaneous flap was used. The bony defect was partially reconstructed with split-rib grafts. The two parts of the reconstruction were combined into one operation, since it was felt that the well-vascularized muscle would ensure viability of the bone grafts.

Use of the pharyngeal flap in the treatment of congenital velopharyngeal incompetence.

Seventy-four patients were referred to the senior author because of presumed velopharyngeal incompetence without cleft palate. As a result of an extensive preoperative evaluation that included assessment of articulation patterns, nasal emission, oronasal resonance, and general speech intelligibility, 57 of the 74 patients were selected for a pharyngeal flap procedure. In 54 of the 57 patients (95 percent), the operation corrected inappropriate nasal emission and hypernasality and improved intraoral air pressure to allow normal speech production.

Congenital hemangioendothelioma of the hand--case report.

This is a case report of a congenital hemangioendothelioma-a rare vascular tumor of the hand. The literature concerning hemangioendothelioma has numerous conflicting statements as to histologic definition, malignant potential, and optimal treatment. A newborn found to have a hemangiomatous type of lesion on the index finger of the right hand was operated upon at 7 days of age. An intraoperative brachial arteriogram identified the radial digital artery as the major arterial supply to the lesion. The operating microscope allowed precise dissection and preservation of the digital nerves and the flexor and extensor tendons. The defect was covered with a full-thickness skin graft providing optimal follow-up for local recurrence.