Reconstruction of a Submandibular Soft Tissue Defect with a Temporoparietal Fasciocutaneous Flap - A Case Report.

Rationale: Reconstruction of soft tissue defects in the facial region have always been challenging. Appropriate selection of flaps will result in minimal morbidity and restore the tissue form without compromising function. Patient Concerns: During reconstruction in the facial region, patients desire to have minimal visible scar and functions of the jaw bone. Diagnosis: The article discusses a case of right space infection with soft tissue loss in the submandibular region. Treatment: The fascial spaces were explored and the odontogenic foci of infection were removed. The soft tissue defect in the submandibular region was resurfaced using the temporoparietal fasciocutaneous flap. Outcomes: The flap was well settled, and facial contours were maintained with reasonable facial symmetry. Take-away Lessons: Surgical skill in the management of soft tissue defects in the fascial region demands sound knowledge of the facial region, selection of the flap and meticulous execution of the surgical plan.

Use of an ultrasound imaging device within the applicator to evaluate placement and support treatment planning for breast brachytherapy and intraoperative radiation therapy.

PURPOSE: We evaluated the use of ultrasound imaging within a brachytherapy applicator as a method for applicator positioning, evaluation, and treatment planning in a series of in vitro, cadaver, and human studies. METHODS AND MATERIALS: We evaluated the performance of a prototype system comprising a small ultrasound imaging catheter inserted within the lumen of a balloon brachytherapy catheter. We tested the device in an ultrasound phantom, in human breast tissue, and in an endoscopic ultrasound catheter in cadaveric breast tissue. We evaluated the visualization of adjacent tissue to consider future development of a similar system for use in brachytherapy and intraoperative radiation therapy. RESULTS: Based on the ultrasound images obtained in an ultrasound phantom, cadaveric breast, and human participants, we observed that an ultrasound imaging catheter placed within the lumen of a brachytherapy applicator can effectively image adjacent tissue, ribs, and air voids, with appropriate quality to support clinical use. We observed high correlation in clinically useful information detected on ultrasound and comparative CT, with ultrasound spatial resolution near 1 mm (spatially variant). CONCLUSIONS: The findings from our pilot work suggest that real-time ultrasound imaging, operated from within the applicator, is a promising technique for image guidance and treatment planning during brachytherapy and intraoperative radiation therapy. Further expansion of this technology for clinical use will require development of a cohesive system of components to suit specific clinical applications.

The antithrombotic and antimicrobial properties of PEG-protected silver nanoparticle coated surfaces.

Cardiovascular implant-associated complications such as infection and thrombosis may be reduced by modification of device surfaces using antimicrobial and antithrombotic agents. Silver nanoparticles (SNPs) are well accepted for its broad-spectrum antimicrobial effect. A recent report suggested its antiplatelet effect also. So the hypothesis of this study is that polyethylene glycol (PEG) protected SNPs can be incorporated with biomaterials to attain dual properties; and by adjusting an optimum concentration, its cytotoxicity to tissues and cells can be prevented. To prove this, detailed study of PEG-SNP was done at three levels: (i) direct inhibitory effect on platelet activation, aggregation and biochemical pathways when PEG-SNP is added into platelet suspension; (ii) inhibition of platelet adhesion to PEG-SNP incorporated biological matrix and polymer scaffold and (iii) non-cytotoxic behavior of immobilized PEG-SNP in fibrin matrix. Inhibitory effects demonstrated are on: platelet function by aggregometry, exposure of activation and apoptosis markers by flow cytometry, biochemical pathway by malondealdehyde (MDA) estimation and protein phosphorylation by Western blot. Reduced platelet adhesion onto PEG-SNP incorporated scaffold is shown using scanning electron microscopy (SEM). Non-toxic behavior of endothelial cells (EC) and smooth muscle cells (SMC) grown on PEG-SNP-fibrin disc is shown by fluorescence microscopy and cell phenotype stability by real-time polymerase chain reaction (PCR).

Transition flow through an ultra-thin nanosieve.

The fabrication and gas flow characterization of an ultra-thin inorganic nanosieve structured by interference lithography and a bond-micromachining approach are reported. The nanosieve has been observed to exhibit transition gas flow behaviour around atmospheric pressure and ambient temperature. The small lip thickness (45 nm) of the nanopores with respect to their diameter (120 nm) helps in understanding pure transition flow by minimizing interactions between the molecule and inner pore wall. Due to the absence of these collisions, the transition flux is the superimposition of viscous and molecular fluxes without the need for higher-order slip correction. The nanosieve shows a flow selectivity of 3.1 between helium and argon at 20 mbar.

Normal-incidence grating couplers in Ge-Si.

We report a normal-incidence grating coupler that is monolithically integrated with a Ge(x)Si(1-x) rib waveguide. The design, fabrication, and testing procedures are described for a 0.33-microm-period grating coupler integrated with a Ge(0.04)Si(0.96) waveguide. Also, a theoretical analysis based on coupler-mode theory has been carried out to predict the coupling efficiency and its dependence on the angle of incidence of light. For normal incidence the measured efficiency of 6.5% was found to be in good agreement with the theoretical prediction of 6.9%. The measured FWHM of the acceptance angle about the normal was 5 degrees , compared with the theoretical prediction of 3 degrees .