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Recent developments in the field of regenerative surgeries and medical applications have led to a renewed interest in adipose tissue-enriched mesenchymal stem cell scaffolds. Various advantages declared for the decellularized adipose matrix (DAM) have caused its extensive use in the transfer of stem cells or growth factors for soft tissue regeneration induction. Meanwhile, the long-term application of detergents toward DAM regeneration has been assumed as a risky obstacle in this era. Herein, a rapid, mechanical protocol was developed to prepare DAM (M-DAM) without chemicals/enzymes and was comprehensively compared with the ordinary DAM (traditional chemical method). Accordingly, this method could effectively hinder oils and cells, sustain the structural and biological elements, and contain a superior level of collagen content. In addition, more protein numbers, as well as higher basement membrane elements, glycoproteins, and extracellular matrix-related proteins were detected in the regenerated M-DAM. Also, superior adipogenesis and angiogenesis proteins were distinguished. The noncytotoxicity of the M-DAM was also approved, and a natural ecological niche was observed for the proliferation and differentiation of stem cells, confirming its great potential for vascularization and adipogenesis in vivo. The suggested technique could effectively prepare the modified DAM in variant constructions of tablets, powders, emulsions, hydrogels, and different three-dimensional-printed structures. Hence, this rapid, mechanical process can produce bioactive DAM, which has the potential to be widely used in various research fields of regenerative medicine.
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Adipogenia , Alicerces Teciduais , Humanos , Alicerces Teciduais/química , Matriz Extracelular/metabolismo , Tecido Adiposo , Diferenciação Celular , Obesidade/metabolismo , Engenharia Tecidual/métodosRESUMO
BACKGROUND: Breast reduction surgery has witnessed significant advancements in recent years; however, it continues to pose challenges for both surgeons and patients when dealing with cases involving excessive breast volume and severe breast ptosis. This study aimed to assess the aesthetic outcomes and the impact on the quality of life, as measured by the BREAST-Q questionnaire, in patients with gigantomastia and severe breast ptosis who underwent reduction mammaplasty using the superomedial-based pedicle technique. METHODS: We present a retrospective series comprising 84 patients who underwent reduction mammoplasty utilizing the superomedial pedicle technique. The surgical resections exceeded 1 kg per breast, with a mean resection weight of 1506.58 g (right breast) and 1500.32 g (left breast). The preoperative mean suprasternal notch to nipple distance measured 40.50 cm (right breast) and 40.38 cm (left breast). Postoperatively, the patients were followed up for a minimum of 6 months. Both preoperative and postoperative BREAST-Q surveys were administered to the participants, and scores were analyzed using descriptive statistics. RESULTS: Complications were observed in 3 patients (3.57%), characterized by partial loss of the areola, which resolved spontaneously over time. Additionally, 2 cases of hematoma and 2 instances of minor delayed wound healing were reported. All patients expressed satisfaction with their aesthetic outcomes, as they achieved a natural breast shape and minimal scarring, along with symptomatic relief. CONCLUSIONS: The superomedial pedicle reduction mammaplasty technique has demonstrated its ability to produce satisfactory aesthetic outcomes and long-term benefits in patients with excessively large breasts. Careful patient selection and postoperative management are vital for achieving optimal results. Further investigations involving larger sample sizes and longer follow-up periods are warranted to validate our findings. LEVEL OF EVIDENCE: IV.
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Mama , Hipertrofia , Mamoplastia , Humanos , Mamoplastia/métodos , Feminino , Estudos Retrospectivos , Adulto , Hipertrofia/cirurgia , Mama/cirurgia , Mama/anormalidades , Pessoa de Meia-Idade , Cicatriz/etiologia , Cicatriz/cirurgia , Cicatriz/prevenção & controle , Estética , Retalhos Cirúrgicos , Qualidade de Vida , Resultado do Tratamento , Satisfação do PacienteRESUMO
BACKGROUND: Vertical mammoplasty techniques have been widely used for breast reduction. The authors present the combination of superior pedicle vertical mammoplasty with liposuction in different regions in the treatment of severe breast hypertrophy in obese patients. We also propose some innovative methods in terms of surgical approach, breast parenchymal anatomy pattern and liposuction. METHODS: A retrospective study of 50 female patients with severe hypertrophic breasts and obesity who underwent breast reduction in our department from February 2019 to February 2022 was performed. Pre- and postoperative photographs, breast parenchyma distribution and postoperative patient satisfaction were recorded. RESULTS: Fifty patients underwent breast reduction. Through clinical examination, patient photo evaluation and satisfaction survey results. Good breast shape and projection, full upper pole of the breast, and high satisfaction results were obtained. There were no serious complications. CONCLUSION: This technique is acceptable and reproducible. It is suitable for patients with varying degrees of breast hypertrophy, especially those with severe hypertrophic breasts and obesity. There are fewer associated complications and a lower rate of re-repair. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: Gynecomastia is a progressive disease characterized by enlarged breasts, affecting a significant proportion of men. Persistent gynecomastia negatively affects the psychological and emotional development of patients; therefore, surgical intervention is required. In this article, we describe a surgical technique, where liposuction through an axillary incision is used in combination with a single small periareolar incision, to obtain the most minimal scars in the treatment of gynecomastia. METHODS: Between June 2021 and June 2023, 125 patients with different Simon grades of gynecomastia were enrolled. The patients' basic conditions and operation processes were recorded. Following surgery, a score was assigned according to the five main aesthetic aspects of the surgical procedure. RESULTS: In total, 125 patients with gynecomastia were treated with a pre-axillary fold incision combined with a small areolar incision. There were 17 cases of Simon grade I, 46 grade IIA, 42 grade IIB, and 20 grade III. The average operation time was 45.8 min, the average liposuction volume was 250.5 mL, the average glandular tissue volume was 50.5 g, intraoperative blood loss ranged from 15 to 60 mL, and the average hospital stay was 3.2 days. Regarding the postoperative aesthetic effect, doctors scored > 4 points, and the patient satisfaction score was > 7.5, which fully affirmed the aesthetic effect of this method. CONCLUSIONS: Treatment of gynecomastia through an anterior axillary fold incision combined with a small areolar incision is safe and feasible, involving a simple procedure, short operation time, and few complications. Its efficacy and cosmetic effects could lead to its use as a primary surgical method to treat gynecomastia. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: The superomedial pedicle reduction mammoplasty has gained popularity and is an important alternative approach for reduction mammoplasty, while the inferior pedicle reduction mammaplasty remains by far the most performed as it is considered to provide the best vascularization to the nipple-areola complex, allowing safe removal of large amount of redundant tissue. The authors conducted the first systematic review and meta-analysis in an attempt to declare the differences of the superomedial pedicle versus the inferior pedicle reduction technique by comparing the postoperative complications. METHODS: PubMed, MEDLINE, and Cochrane Library for clinical studies were queried from inception to January 1, 2024. Review Manager Version 5.4 was used for this meta-analysis. A random effects model was applied to OR, and 95%CI were determined using the Mantel-Haenszel method. The I2 test was used to assess heterogeneity, and the Newcastle-Ottawa scale was used to assess the risk of bias in the nonrandomized studies. RESULTS: Twelve observational comparative studies were included. The superomedial pedicle technique had a statistically lower rate of overall complications (OR 0.59, 95% CI 0.47-0.75; p < 0.0001) and delayed wound healing (OR 0.46, 95% CI 0.33-0.64; p < 0.00001) than the inferior pedicle technique. No significant differences in wound dehiscence, infection, seroma, hematoma, skin necrosis, fat necrosis, NAC necrosis, nipple sensation decrease or loss, asymmetry, hypertrophic scarring, and reoperation were noted. CONCLUSIONS: Both two techniques are equally safe and reliable, while the superomedial pedicle technique resulted in a statistically lower rate of overall complications and delayed wound healing. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: Skin incision scars are cosmetically displeasing; the effects of current treatments are limited, and new methods to reduce scar formation need to be found. OBJECTIVE: We sought to determine whether immediate postoperative injection of stromal vascular fraction gel (SVF-gel) could reduce scar formation at skin incision sites. METHODS: A prospective, randomized, double-blind, self-controlled trial was conducted in patients who underwent breast reduction. SVF-gel was intradermally injected into the surgical incision on one randomly selected side, with the other side receiving saline as a control. At the 6-month follow-up, the incision scars were evaluated using the Vancouver scar scale (VSS) and visual analog scale (VAS). Antera 3D camera was used for objective evaluation. RESULTS: The VSS score and VAS score were significantly different between the SVF-gel-treated side (3.80 ± 1.37, 3.37±1.25) and the control side (5.25 ± 1.18, 4.94 ± 1.28). Moreover, the SVF-gel-treated side showed statistically significant improvements in scar appearance, based on evidences from Antera 3D camera. LIMITATIONS: This was a single-center, single-race, and single-gender study. Furthermore, the results were available only for the 6-month interim follow-up period. CONCLUSION: Postoperative immediate SVF-gel injection in surgical incisions can reduce scar formation, and exert a preventive effect on scars. LEVEL OF EVIDENCE I: Evidence obtained from at least one properly designed randomized controlled trial. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Cicatriz , Géis , Mamoplastia , Humanos , Método Duplo-Cego , Cicatriz/prevenção & controle , Cicatriz/etiologia , Feminino , Estudos Prospectivos , Adulto , Mamoplastia/métodos , Resultado do Tratamento , Pessoa de Meia-Idade , Injeções Intradérmicas , Fatores de Tempo , Seguimentos , Estética , Cicatrização/fisiologiaRESUMO
BACKGROUND: Autologous adipose tissue often experiences ischemia and hypoxia after transplantation, leading to low retention rates and unstable operative impacts due to necrotic absorption. Platelet-rich plasma (PRP) can enhance fat regeneration and increase the fat retention rate after transplantation. However, the quick release of growth factors (GFs) in PRP decreases therapeutic efficiency. This study aimed to achieve a slow release of PRP to promote fat retention. METHODS: We prepared a dual-network hydrogel (DN gel) based on FDA-approved PRP and sodium alginate (SA) through a simple "one-step" activation process. In vivo study, adipose tissue with saline (control group), SA gel (SA gel group), PRP gel (PRP gel group), and DN gel (DN gel group) was injected subcutaneously into the dorsum of nude mice. At 4 and 12 weeks after injection, tissues were assessed for volume and weight. Hematoxylin and eosin staining (HE) and immunofluorescence staining were performed for histological assessment. RESULTS: DN gel exhibits long-lasting growth factor effects, surpassing conventional clinical PRP gel regarding vascularization potential. In fat transplantation experiments, DN gel demonstrated improved vascularization of transplanted fat and increased retention rates, showing promise for clinical applications. CONCLUSIONS: DN gel-assisted lipofilling can significantly improve the retention rate and quality of transplanted fat. DN gel-assisted lipofilling, which is considered convenient, is a promising technique to improve neovascularization and fat survival. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Tecido Adiposo , Plasma Rico em Plaquetas , Animais , Camundongos , Camundongos Nus , Tecido Adiposo/transplante , InjeçõesRESUMO
Molecules with fast-acting antidepressant effects have potentials to become new antidepressants. Here we report the fast-acting (1hr) antidepressant effects of ketamine (10 mg/kg, i.p.) in chronic adreno-cortico-tropic-hormone (ACTH)-induced and chronic unpredictable mild stress (CUMS)-induced depression mouse models. These behavioral anti-depressant effects are associated with normalized expression of glutamate transporter-1(GLT-1), glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF) and eukaryotic elongation factor 2 phosphorylation (p-eEF2) in the prelimbic prefrontal cortex (PrL-PFC). Excitatory neurons in PrL also showed reduced ambient glutamate responses to synaptic stimulation, and reduced ambient NMDA receptor responses after ketamine injection. Interestingly, ketamine induced biochemical and electrophysiological changes still occurred with GLT-1 knockdown in PrL, suggesting that elevated GLT-1 level is not required for ketamine to exert its antidepressant effect. At the same time, ketamine did not elevate GLT-1 level in the isolated astrocytes, suggesting distinct contributions from neurons and astrocytes to ketamine-induced changes.
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Transtorno Depressivo , Ketamina , Animais , Antidepressivos/uso terapêutico , Astrócitos/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Depressão/induzido quimicamente , Depressão/tratamento farmacológico , Depressão/metabolismo , Transtorno Depressivo/tratamento farmacológico , Ketamina/farmacologia , CamundongosRESUMO
AIM: Widespread clinical application of vascularized composite allotransplantation (VCA) has been limited by the need for lifelong systemic immunosuppression to prevent rejection. Our goal was to develop a site-specific immunosuppressive strategy that promotes VCA allograft survival and minimizes the risk of systemic side effects. METHODS: Tacrolimus loaded polycaprolactone (TAC-PCL) disks were prepared and tested for their efficacy in sustaining VCA allograft survival via site-specific immunosuppression. Brown Norway-to-Lewis rat hind limb transplantations were performed; animals received one TAC disk either in the transplanted (DTx) or in the contralateral non-transplanted (DnonTx) limbs. In another group, animals received DTx and lymphadenectomy on Tx side. Blood and allograft levels of TAC were measured using LC-MS/MS. Systemic toxicity was evaluated. RESULTS: Animals that received DTx achieved long-term allograft survival (> 200 days) without signs of metabolic and infectious complications. In these animals, TAC blood levels were low but stable between 2 to 5 ng/mL for nearly 100 days. High concentrations of TAC were achieved in the allografts and the draining lymph nodes (DLN). Animals that underwent lymphadenectomy rejected their allograft by 175 days. Animals that received DnonTx rejected their allografts by day 70. CONCLUSION: Controlled delivery of TAC directly within the allograft (with a single TAC disk) effectively inhibits rejection and prolongs VCA allograft survival, while mitigating the complications of systemic immunosuppression. There was a survival benefit of delivering TAC within the allograft as compared to a remote site. We believe this approach of local drug delivery has significant implications for drug administration in transplantation.
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Aloenxertos Compostos , Tacrolimo , Aloenxertos , Animais , Cromatografia Líquida , Sobrevivência de Enxerto , Terapia de Imunossupressão , Imunossupressores/farmacologia , Ratos , Ratos Endogâmicos BN , Ratos Endogâmicos Lew , Tacrolimo/farmacologia , Espectrometria de Massas em TandemRESUMO
Sustainable utilization has been becoming the core idea of concentrated seawater disposal, which makes the harvest of salinity gradient power based on reverse electrodialysis (RED) become one of the important ways. As the important factors affecting RED performance, different flow orientations along the membrane and solution temperature have been studied in the previous researches. However, there are still some details that need to be clarified. In this study, the inflow mode was further detailed investigated. The results showed that after eliminating the interference of bubbles in the counter-current, the co-current was still better than the counter-current; when the solution of HCC (high concentration compartment) and LCC (low concentration compartment) was circulated for 3 h, the concentration of concentrated seawater discharge liquid was reduced by 6.93%, which was conducive to reducing the negative impact on the marine ecological environment. Meanwhile, the response of salinity gradient power generation to temperature difference was that high temperature had a positive effect on power density, and the order was both the HCC and LCC (0.44 W m-2) > LCC (0.42 W m-2) > HCC (0.39 W m-2). Although the RED performance was more sensitive to the temperature rise of LCC, the positive temperature difference between HCC and LCC is a more practical advantage because the temperature of concentrated seawater in HCC is usually high. These new observations could provide supports for the industrial development of RED in generating electricity economically and reducing the negative environmental impact of concentrated seawater.
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Energia Renovável , Salinidade , Água do Mar , Ecossistema , Eletricidade , TemperaturaRESUMO
High-resolution satellite images (HRSIs) obtained from onboard satellite linear array cameras suffer from geometric disturbance in the presence of attitude jitter. Therefore, detection and compensation of satellite attitude jitter are crucial to reduce the geopositioning error and to improve the geometric accuracy of HRSIs. In this work, a generative adversarial network (GAN) architecture is proposed to automatically learn and correct the deformed scene features from a single remote sensing image. In the proposed GAN, a convolutional neural network (CNN) is designed to discriminate the inputs, and another CNN is used to generate so-called fake inputs. To explore the usefulness and effectiveness of a GAN for jitter detection, the proposed GANs are trained on part of the PatternNet dataset and tested on three popular remote sensing datasets, along with a deformed Yaogan-26 satellite image. Several experiments show that the proposed model provides competitive results. The proposed GAN reveals the enormous potential of GAN-based methods for the analysis of attitude jitter from remote sensing images.
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BACKGROUND: Improving the retention rate of transplanted fat is, currently, of great concern. Partial immobilization, angiogenesis, and adipose tissue-derived stem cells, all proven to be influenced by botulinum toxin A (BTX-A), are significant in fat graft retention. OBJECTIVES: The authors sought to determine the impact of BTX-A on fat grafts. METHODS: Our study included 12 Sprague Dawley rats and each rat's hind limbs were randomly designated as the BTX-A side and control side. We injected 0.2 mL of BTX-A-treated fat into the quadriceps femoris and subcutaneous space of the BTX-A sides. This was also done for the control sides but with untreated fat. We performed electroneuromyography of recipient muscles at 1 week post-operation. The rats were euthanized at 12 weeks post-operation and we observed the fat retention rate, the fat's histologic characteristics, and the density of vessels and mature adipocytes. RESULTS: The amplitudes of electroneuromyography were smaller for the BTX-A sides than the control sides. For intramuscularly injected fat, the BTX-A sides had better retention rates and histologic characteristics and a higher density of vessels and mature adipocytes than the control sides. For subcutaneously injected fat, the BTX-A sides had better histologic characteristics and a higher density of vessels and mature adipocytes than the control sides, but the retention rates were not significantly different between the 2 sides. CONCLUSIONS: Injecting BTX-A-treated fat grafts can immobilize the surrounding muscles. BTX-A can improve the density of vessels and mature adipocytes, histologic characteristics of fat grafts, and retention rate of fat grafts transplanted into muscles.
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Tecido Adiposo/transplante , Toxinas Botulínicas Tipo A/administração & dosagem , Sobrevivência de Enxerto/efeitos dos fármacos , Adipócitos/citologia , Tecido Adiposo/citologia , Animais , Eletromiografia , Feminino , Membro Posterior , Injeções Intramusculares , Injeções Subcutâneas , Ratos , Ratos Sprague-DawleyRESUMO
BACKGROUND: Improvement in the retention rate of transplanted fat is currently a topic of interest. The retention of transplanted fat relies heavily on the reestablishment of blood supply and the function of the adipose-derived stem cells (ADSCs), which may both be impeded by mechanical force. However, the effect of mechanical force on the retention of adipose implants remains unclear. OBJECTIVES: This study aimed to evaluate the effectiveness of immobilization on fat retention rate. METHODS: Immobilization was carried out by denervation of the hind limb of rats to reduce the mechanical force. Sprague-Dawley (SD) rats were used, and the two hind limbs were assigned at random to the immobilization side and the control side. On average, 0.4 mL of fat was injected into the bilateral muscle and subcutaneous space of the hind limb, and 6 rats were sacrificed at each time point. The outcome measures included the retention rate, the histologic evaluation, and the density of new vessels and proliferative ADSCs. RESULTS: For the muscle fat, the retention rate improved, and more proliferative ADSCs and new vessels were found in the immobilization group. The histologic evaluation between the two sides was of no statistical significance. For the fat in the subcutaneous space, no statistical difference was observed in all the outcome measures between the two sides. CONCLUSIONS: Regional immobilization of the recipient site by denervation can improve the retention of the fat graft in muscles owing to improved density of the new vessels and proliferative ADSCs.
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Tecido Adiposo/transplante , Autoenxertos/fisiologia , Denervação , Células-Tronco Mesenquimais/fisiologia , Tecido Adiposo/citologia , Animais , Autoenxertos/irrigação sanguínea , Autoenxertos/citologia , Contorno Corporal/métodos , Proliferação de Células , Feminino , Membro Posterior/inervação , Membro Posterior/cirurgia , Injeções Intramusculares , Injeções Subcutâneas , Modelos Animais , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Neovascularização Fisiológica/fisiologia , Ratos , Ratos Sprague-Dawley , Nervo Isquiático/cirurgia , Transplante AutólogoRESUMO
BACKGROUND: Current knowledge about the blood supply of the nipple-areola complex (NAC) has largely been derived from studies on cadavers or persons with breasts of normal size. The aim of this study was to identify and classify the NAC blood supply by computed tomographic angiography (CTA) examination in female volunteers with breast hypertrophy. METHODS: CTA examination was performed on hypertrophic breasts of 23 female subjects. The main blood supplies were revealed through image data analyses. The dominant blood supply of the NAC and its vascular sources were identified and sorted. The detectable diameter threshold of blood vessels was set beyond 1.0 mm. RESULTS: A total of 61 dominant blood vessels were identified. The source arteries were traced as the internal thoracic artery (ITA, 50.8%), lateral thoracic artery (LTA, 27.8%), thoracoacromial artery (TA, 14.8%), brachial artery (BA, 3.3%), and axillary artery (AA, 3.3%), and the corresponding reproducibility of these source vessels was 31, 37, 9, 4.3, and 4.3%, in all breasts. The intercostal artery (IA) was not identified as a dominant NAC supplying vessel in any CTA scan image. Twenty-six breasts had only one dominant artery, whereas 17 breasts showed multiple dominant blood supplies. Three breasts showed no dominant blood vessels of the NAC, with diameters greater than the detectable threshold of 1.0 mm, and 52.2% of the breasts demonstrated anatomically symmetrical patterns of blood supply for the NAC. CONCLUSIONS: The ITA, LTA, and TA are likely to be the main vessel sources, whereas the IA is unlikely to be the dominant vessel for NAC perfusion, on the basis of the studied breasts. An asymmetrical pattern of bilateral breast blood supply was demonstrated in a considerable portion of the females with breast hypertrophy in this study. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Mama/anormalidades , Angiografia por Tomografia Computadorizada/métodos , Hipertrofia/diagnóstico por imagem , Hipertrofia/cirurgia , Mamoplastia/métodos , Mamilos/irrigação sanguínea , Artérias Torácicas/diagnóstico por imagem , Adolescente , Adulto , Artéria Axilar/diagnóstico por imagem , Índice de Massa Corporal , Artéria Braquial/diagnóstico por imagem , Mama/diagnóstico por imagem , Mama/cirurgia , China , Estudos de Coortes , Feminino , Seguimentos , Humanos , Artéria Torácica Interna/diagnóstico por imagem , Pessoa de Meia-Idade , Mamilos/diagnóstico por imagem , Mamilos/cirurgia , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Penile reconstruction or phalloplasty has always been one of the most challenging problems for plastic surgeons. In 1936, Bogoras performed the first phalloplasty by using traditional tubed pedicle flaps. Many other flaps and methods have been applied since, including lower abdominal flaps, pudendal-thigh flaps, parascapular flaps, paraumbilical flaps and, of course, radial forearm flaps. For each method, reports of both functional and esthetic successes abound. In this case, donor sites for phalloplasty were somewhat limited by the severe electric burn injury. After much consideration, we decided to preexpand the scapular flap and to use this for phalloplasty, with satisfactory outcome. Our case is a 31-year-old patient who sustained a 19% total burn surface area by electrical burn in August 2011. The burn area involved both forearms, abdominal region, both femoral regions, and perineum including genitalia loss. Most of the burn wounds were skin grafted shortly after the injury. Due to the nature of the burn, regular donor sites for penile reconstruction were unavailable. Before surgery, we went through a detailed plan for phalloplasty with the patient and his family. The patient consented to the 2-stage surgery for the penile reconstruction. The first stage was insertion of a 600-mL soft tissue expander in the scapular region. After 4 months of expansion, the second stage of free scapular flap transfer was performed in March 2012. RESULTS: The reconstruction was successful with good appearance and patient satisfaction, complicated by urethral fistula. Eight months later, the urinary fistula was repaired successfully. CONCLUSIONS: The free scapular flap proved to be an ideal solution to this patient's dilemma. The flap has adequate amount of tissue and a reliable blood supply. Its amenability to be expanded allows better donor-site primary closure. Tissue bulk resulted in adequate stiffness without artificial prosthesis for the phallus to be functional.
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Queimaduras por Corrente Elétrica/cirurgia , Retalhos de Tecido Biológico , Pênis/lesões , Pênis/cirurgia , Expansão de Tecido , Adulto , Humanos , Escala de Gravidade do Ferimento , Masculino , Procedimentos de Cirurgia Plástica/métodosRESUMO
OBJECTIVE: To study the protective effects of N-acetylcysteine (NAC) against oxidative injury in the brain tissue of mice induced by decabromodiphenyl ether (PBDE-209) and the expression of mitogen activated protein kinase (MAPK)-related proteins in the hippocampus. METHODS: Twenty-one male BALB/c mice were randomly divided into three groups with seven mice in each group: solvent control group, PBDE-209 group with gavage of 500 mg/kg PBDE-209, and PBDE-209 +NAC group which received intraperitoneal injection of 100 mg/kg NAC 0.5 h before exposure to PBDE-209. Mice were sacrificed 6 weeks after exposure. Malondialdehyde (MDA) level, superoxide dismutase (SOD) activity, and glutathione (GSH) level in the cerebral cortex, hippocampus, cerebellum, and striatum, as well as the protein expression of extracellular signal-regulated kinase (ERK), phosphorylated ERK (p-ERK), p38 MAPK (p38), and phosphorylated p38 (p-p38) in the hippocampus, were determined by Western blot. RESULTS: Compared with the hippocampal and cerebellar levels of MDA in control group [(4.91±1.60) and (2.42±1.41) nmol/mg pro] and PBDE-209+NAC group [(6.16±1.03) and (2.83±0.85) nmol/mg pro], the MDA levels in PBDE-209 group [(12.12±6.39) and (4.24±1.15) nmol/mg pro] were significantly increased (P < 0.05). The striatum MDA level in PBDE-209 group [(12.92±4.30) nmol/mg pro] was significantly increased as compared with that of the control group [(4.05±2.23) nmol/mg pro] (P < 0.05). The hippocampal SOD activity of PBDE-209 group [(59.29±37.09) U/mg pro] was reduced significantly as compared with those of the control group [(93.28±21.75) U/mg pro] and PBDE-209+NAC group [(98.92±21.54) U/mgpro] (P < 0.05). The GSH levels in the cerebral cortex, striatum, and cerebellum in PBDE-209 group [(40.98±13.19), (24.46±11.30), and (3.55±1.55) mg GSH/g pro] were significantly reduced as compared with those of the control group [(75.79±26.51), (44.52±13.15) and (8.01±3.23) mg GSH/g pro] and the PBDE-209+NAC group [(89.86±28.39), (39.01±9.05) and (10.34±2.58) mg GSH/g pro] (P < 0.05). Western blot results showed that the ratios of p-p38/p38 and p-ERK/ERK in the hippocampus were significantly higher in the PBDE-209 group than in the control group and PBDE-209+NAC group (P < 0.05). CONCLUSION: Antioxidant NAC has a protective effect against PBDE-209-induced brain injury in mice to some extent, and reduces the expression of MAPK-related proteins.
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Acetilcisteína/farmacologia , Antioxidantes/farmacologia , Encéfalo/efeitos dos fármacos , Animais , Antioxidantes/metabolismo , Encéfalo/metabolismo , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Glutationa/metabolismo , Éteres Difenil Halogenados/toxicidade , Hipocampo/metabolismo , Masculino , Malondialdeído/metabolismo , Camundongos Endogâmicos BALB C , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Oxirredução , Fosforilação , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
Source-free domain adaptation has developed rapidly in recent years, where the well-trained source model is adapted to the target domain instead of the source data, offering the potential for privacy concerns and intellectual property protection. However, a number of feature alignment techniques in prior domain adaptation methods are not feasible in this challenging problem setting. Thereby, we resort to probing inherent domain-invariant feature learning and propose a curriculum-style self-training approach for source-free domain adaptive semantic segmentation. In particular, we introduce a curriculum-style entropy minimization method to explore the implicit knowledge from the source model, which fits the trained source model to the target data using certain information from easy-to-hard predictions. We then train the segmentation network by the proposed complementary curriculum-style self-training, which utilizes the negative and positive pseudo labels following the curriculum-learning manner. Although negative pseudo-labels with high uncertainty cannot be identified with the correct labels, they can definitely indicate absent classes. Moreover, we employ an information propagation scheme to further reduce the intra-domain discrepancy within the target domain, which could act as a standard post-processing method for the domain adaptation field. Furthermore, we extend the proposed method to a more challenging black-box source model scenario where only the source model's predictions are available. Extensive experiments validate that our method yields state-of-the-art performance on source-free semantic segmentation tasks for both synthetic-to-real and adverse conditions datasets. The code and corresponding trained models are released at https://github.com/yxiwang/ATP.
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Training with more data has always been the most stable and effective way of improving performance in the deep learning era. The Open Images dataset, the largest object detection dataset, presents significant opportunities and challenges for general and sophisticated scenarios. However, its semi-automatic collection and labeling process, designed to manage the huge data scale, leads to label-related problems, including explicit or implicit multiple labels per object and highly imbalanced label distribution. In this work, we quantitatively analyze the major problems in large-scale object detection and provide a detailed yet comprehensive demonstration of our solutions. First, we design a concurrent softmax to handle the multi-label problems in object detection and propose a soft-balance sampling method with a hybrid training scheduler to address the label imbalance. This approach yields a notable improvement of 3.34 points, achieving the best single-model performance with a mAP of 60.90% on the public object detection test set of Open Images. Then, we introduce a well-designed ensemble mechanism that substantially enhances the performance of the single model, achieving an overall mAP of 67.17%, which is 4.29 points higher than the best result from the Open Images public test 2018. Our result is published on https://www.kaggle.com/c/open-images-2019-object-detection/leaderboard.
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Data association is at the core of many computer vision tasks, e.g., multiple object tracking, image matching, and point cloud registration. however, current data association solutions have some defects: they mostly ignore the intra-view context information; besides, they either train deep association models in an end-to-end way and hardly utilize the advantage of optimization-based assignment methods, or only use an off-the-shelf neural network to extract features. In this paper, we propose a general learnable graph matching method to address these issues. Especially, we model the intra-view relationships as an undirected graph. Then data association turns into a general graph matching problem between graphs. Furthermore, to make optimization end-to-end differentiable, we relax the original graph matching problem into continuous quadratic programming and then incorporate training into a deep graph neural network with KKT conditions and implicit function theorem. In MOT task, our method achieves state-of-the-art performance on several MOT datasets. For image matching, our method outperforms state-of-the-art methods on a popular indoor dataset, ScanNet. For point cloud registration, we also achieve competitive results.
RESUMO
Metabolic reprogramming is frequently accompanied by hepatocellular carcinoma (HCC) progression. Disrupted metabolites act as potential biomarkers and drug therapeutic targets for HCC. Peptide extract of scorpion venom (PESV) induces cytotoxic anti-proliferative effects and apoptosis in tumors. However, the action mechanisms of PESV remain unknown. This study aimed to explore the serum metabolic profiles of tumor-bearing mouse model. We generated an orthotopic HCC xenograft mouse model by implanting H22 cells into the left hepatic lobe of male C57BL/6 mice. After surgery, the mice were assigned to two groups randomly: PESV (PESV-treated 40 mg/kg daily, i.g.; n = 6) and control (treated with the solvent equally for 14 d, n = 6) groups. Based on an untargeted metabolomics approach using ultra-high-performance liquid chromatography/quadrupole time-of-flight mass spectrometry, differential metabolites were screened via univariate and multivariate data analyses. A total of 48 differential metabolites in negative ion mode and 63 in positive ion mode were identified in the serum samples. Furthermore, metabolic pathway analysis revealed that aminoacyl-tRNA biosynthesis, amino acid pathway, glutathione metabolism, protein transports, protein digestion and absorption, and cAMP signaling pathways play vital roles in PESV-induced inhibition of tumors. These findings highlight the distinct changes in the metabolic profiles of HCC-bearing mice after PESV treatment, suggesting the potential of the identified metabolic molecules as therapeutic targets for HCC.