Overlapping lockup lymphaticovenous anastomosis: A useful addition to supermicrosurgery.

BACKGROUND: Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. This surgical procedure connects the superficial lymphatic vessels to nearby veins to establish lymphatic-venous pathways. One of the most common challenges encountered by lymphatic surgeons when performing LVA is a mismatch in the sizes of the veins and lymphatic vessels, with the effectiveness limited by technical constraints. We conducted a pilot study to evaluate the feasibility of an overlapping lockup anastomosis (OLA) LVA technique to address these problems. METHODS: In this study, we present a novel OLA technique for LVA that addresses the challenges with conventional techniques. The OLA technique was used in 10 lymphedema patients between September 2022 and March 2023 to compare OLA and end-to-end anastomosis. The time required for anastomosis, method of anastomosis, patency rates, and lymphedema volume were evaluated in this study. RESULTS: Of 123 LVAs, 44 were performed using the OLA technique in 10 patients, with indocyanine green lymphangiography revealing unobstructed drainage. A single case of slight fluid leakage occurred, which was resolved by reinforcing the sutures. The average anastomosis time for OLA and the end-to-end technique was 5.55 minutes and 12.1 minutes, respectively. The wounds of the patients healed without infection, and the subjective limb circumference decreased. CONCLUSIONS: The OLA technique could serve as a valuable addition to the current LVA technique, especially for cases with a mismatch in the sizes of the lymphatic vessels and veins. This technique has the potential to promote the broader application of LVA in the treatment and prevention of lymphedema.

Isolation and characterization of novel Fusobacterium nucleatum bacteriophages.

Fusobacterium nucleatum is a strictly anaerobic, Gram-negative bacterial species that is a member of the commensal flora in the oral cavity and gut. Recent studies suggested that the increase of abundance is associated with the development of various diseases, among which colorectal cancer is of the biggest concerns. Phage therapy is regarded as a potential approach to control the number of F. nucleatum, which may contribute to the prevention and treatment of related diseases. In this study, we isolated five isolates of bacteriophage targeting F. nucleatum. The morphological, biological, genomic and functional characteristics of five bacteriophages were investigated. Transmission electron microscopy revealed that JD-Fnp1 ~ JD-Fnp5 are all myoviruses. The size of the JD-Fnp1 ~ JD-Fnp5 genomes was 180,066 bp (JD-Fnp1), 41,329 bp (JD-Fnp2), 38,962 bp (JD-Fnp3), 180,231 bp (JD-Fnp4), and 41,353 bp (JD-Fnp5) respectively. The biological features including pH and heat stability, host range, growth characteristics of JD-Fnp1 ~ JD-Fnp5 displayed different patterns. Among them, JD-Fnp4 is considered to have the greatest clinical application value. The identification and characterization of JD-Fnp1 ~ JD-Fnp5 provides a basis for subsequent therapeutic strategy exploration of F. nucleatum-related diseases.

Stress-induced deformation of the coating on large lightweight freeform optics.

Large aperture, lightweight optics are frequently utilized in modern optical systems. However, despite the use of advanced techniques for developing their materials, fabrication, and mechanical structure, the coatings placed on the substrates induce slight lattice mismatches and increase the thin film stress on polished surfaces. This significantly distorts nano-accuracy optical surfaces, especially on lightweight freeform surfaces. In this study, we construct a finite element model (FEM) and a ray tracing model to estimate the impact of the stress-induced deformation of the coating on a 1.5m class lightweight silicon carbine (SiC) mirror with a freeform surface. Our simulation results are within 10% deviation from the experimental results, and the deformation texture map matches these results as well. We discuss several possible strategies to overcome stress-induced deformation, including fabrication pre-compensation, lightweight structure redesign, and an inverse print-through effect.

Equivalent thin-plate method for stressed mirror polishing of an off-axis aspheric silicon carbide lightweight mirror.

No physical model of stressed mirror polishing, based on the small deflection and deformation of elastic thin plates, has been applied in processing lightweight mirrors. We propose an equivalent thin-plate method for the stressed loading of lightweight mirrors for the first time. Stressed loading and polishing of an aspheric lightweight mirror are simulated using the small-deflection deformation theory of an elastic thin plate. We simulate off-axis aspheric silicon carbide (SiC) lightweight mirrors with three different structures, determining the corresponding equivalent thickness plate in a lightweight structure with a nearly uniform surface density distribution and isotropic bending properties. We then establish a residual removal model of a stressed polishing surface, design the stressed loading equipment, and propose an iterative method for stressed polishing of an off-axis aspheric SiC lightweight mirror. The results demonstrate that it is feasible to choose a lightweight structure that performs full-aperture stressed polishing on off-axis aspheric lightweight mirrors consisting of SiC or other materials.

Comprehensive study of the rapid stressed mirror polishing method for off-axis aspheric SiC thin-plate mirrors.

In this study, the stressed mirror polishing technique is used to perform off-axis aspheric silicon carbide (SiC) mirror full-aperture polishing for the first time. Mechanical and optical parameter analysis methods have been proposed. A medium-diameter off-axis aspheric SiC thin-plate mirror is used as a scaling model for an optical system mirror. A full diameter polishing simulation was completed, and a conceptual design for stress loading equipment is presented. An initial aspheric surface method for stressed mirror polishing of an off-axis aspheric SiC thin-plate mirror, providing a reference for rapid stress mirror polishing of SiC mirrors, is also proposed.

Distribution model of the surface roughness in magnetorheological jet polishing.

Magnetorheological jet polishing (MJP) plays an important role in polishing complex cavities and special optical elements with high precision. However, the roughness distribution function that describes the variation with polishing time of the roughness value of every area in the polishing area has not been studied deeply. In this paper, the influence of the roughness distribution on the removal function of MJP in optics (with a roughness of less than 10 nm) and its evolution model in the spatial and time domains are studied. With the increase of polishing time, the surface roughness of the central area linearly increases, forming surface defects, such as pits. The roughness of the polishing area exhibits a limited growth trend. Verification experiments are carried out on BK7 glass. The results of the roughness distribution on the removal function prove the correctness of the model. The model laid a foundation; therefore, it has important guidance and reference value for the application to the whole aperture polishing.

[Clinical application of reverse radial hypothenar flap for finger soft tissue defect].

OBJECTIVE: To investigate the therapeutic effect of reverse radial hypothenar flap for finger soft tissue defect. METHODS: From Mar. 2006 to Mar. 2010, 13 cases (14 fingers) with finger soft tissue defects were treated with reverse radial hypothenar flaps pedicled with ulnar palmar digital artery of little finger. The defects were 1.9 cm x 1.5 cm -4.0 cm x 2.0 cm in size. The flap size ranged from 1.5 cm x 2.0 cm to 4.0 cm x 2.0 cm. RESULTS: All the flaps survived completely with primary healing both in donor and recipient area. 12 cases (13 fingers) were followed up for 1-3 years. The flaps color was similar to the unaffected fingers. Cicatricial contracture happened in one case due to contracture of palmar fascia. The two-point discrimination distance on flap was 3.2-5.3mm. The active and passive movement of finger joints was evaluated as excellent in 12 fingers, good in one finger. There was no complaint about the feeling at the donor site. Two months after operation, all patients could go back to work. CONCLUSIONS: The reverse radial hypothenar flap is very suitable for finger soft tissue defect with less morbidity to donor site.