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free tissue transfers

Alastair Henry, James A McCaul
INTRODUCTION: Complex hard and soft tissue defects produced as a result of ablative resection of head and neck malignancy can represent a reconstructive challenge, especially when patients are medically compromised. PRESENTATION OF CASE: We present the case of 72-year-old women presenting with an oral squamous cell carcinoma of the right floor of mouth invading the right mandible. Surgical management of the disease required ablative surgery with complex free tissue transfer reconstruction to provide restoration of form and function...
October 12, 2016: International Journal of Surgery Case Reports
Martina F Callaghan, Siawoosh Mohammadi, Nikolaus Weiskopf
Quantitative MRI (qMRI) provides standardized measures of specific physical parameters that are sensitive to the underlying tissue microstructure and are a first step towards achieving maps of biologically relevant metrics through in vivo histology using MRI. Recently proposed models have described the interdependence of qMRI parameters. Combining such models with the concept of image synthesis points towards a novel approach to synthetic qMRI, in which maps of fundamentally different physical properties are constructed through the use of biophysical models...
October 18, 2016: NMR in Biomedicine
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Shuting Xu, Aurélie Ducroux, Aparna Ponnurangam, Gabrielle Vieyres, Sergej Franz, Mathias Müsken, Thomas Zillinger, Angelina Malassa, Ellen Ewald, Veit Hornung, Winfried Barchet, Susanne Häussler, Thomas Pietschmann, Christine Goffinet
Upon sensing cytoplasmic retroviral DNA in infected cells, cyclic GMP-AMP (cGAMP) synthase (cGAS) produces the cyclic dinucleotide cGAMP, which activates STING to trigger a type I interferon (IFN) response. We find that membrane fusion-inducing contact between donor cells expressing the HIV envelope (Env) and primary macrophages endogenously expressing the HIV receptor CD4 and coreceptor enable intercellular transfer of cGAMP. This cGAMP exchange results in STING-dependent antiviral IFN responses in target macrophages and protection from HIV infection...
October 12, 2016: Cell Host & Microbe
Jordan J Allensworth, Scott H Troob, Tyler S Weaver, Javier D Gonzalez, Daniel Petrisor, Mark K Wax
OBJECTIVE: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. The purpose of this study was to examine surgical outcomes and survival in patients undergoing free flap transfer following invasive fungal sinusitis. STUDY DESIGN: Retrospective case series...
October 12, 2016: Laryngoscope
Varinder Singh, Aditi Kahol, Inder Pal Singh, Isha Saraf, Richa Shri
ETHNOPHARMACOLOGICAL RELEVANCE: Ocimum species are traditionally used for the treatment of anxiety, nerve pain, convulsions and a variety of neurodegenerative disorders. The present study was undertaken to evaluate the anti-amnesic effect of O. basilicum L., O. sanctum L. and O. gratissimum L. extracts using in-vitro and in-vivo models. MATERIALS AND METHODS: In-vitro acetylcholinesterase (AChE) inhibitory and antioxidant activities of hydro-methanol extracts of plants were evaluated using Ellman and DPPH and FRAP assays, respectively...
October 7, 2016: Journal of Ethnopharmacology
Christopher P Jackman, Aaron L Carlson, Nenad Bursac
Engineered cardiac tissues hold promise for cell therapy and drug development, but exhibit inadequate function and maturity. In this study, we sought to significantly improve the function and maturation of rat and human engineered cardiac tissues. We developed dynamic, free-floating culture conditions for engineering "cardiobundles", 3-dimensional cylindrical tissues made from neonatal rat cardiomyocytes or human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) embedded in fibrin-based hydrogel. Compared to static culture, 2-week dynamic culture of neonatal rat cardiobundles significantly increased expression of sarcomeric proteins, cardiomyocyte size (∼2...
September 30, 2016: Biomaterials
Harriet Kiwanuka, Mario A Aycart, David F Gitlin, Elaine Devine, Bridget J Perry, Thet-Su Win, Ericka M Bueno, Muayyad Alhefzi, Nicco Krezdorn, Bohdan Pomahac
BACKGROUND: Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Tiago Teixeira, Tarik Hafyane, Nikola Stikov, Cansu Akdeniz, Andreas Greiser, Matthias G Friedrich
BACKGROUND: T1 mapping based on cardiovascular magnetic resonance (CMR) is a novel approach using the magnetic relaxation T1 time as a quantitative marker for myocardial tissue composition. Various T1 mapping sequences are being used, with different strengths and weaknesses. Data comparing different sequences head to head however are sparse. METHODS: We compared three T1 mapping sequences, ShMOLLI, MOLLI and SASHA in phantoms and in a mid-ventricular slice of 40 healthy individuals (mean age 59 ± 7 years, 45 % male) with low (68 %) or moderate cardiovascular risk...
October 4, 2016: Journal of Cardiovascular Magnetic Resonance
Alvin C Kwok, Jayant P Agarwal
PURPOSE: We sought to use the NSQIP database to determine the national rate and predictors of free flap failure based upon flap sites and flap types. METHODS: Free flaps were identified using the 2005-2010 NSQIP database. We examined overall flap failure rates as well as failure rates based upon flap sites (head and neck, extremities, trunk, and breast) and flap types (muscle, fascial, skin, bone, and bowel flaps). Univariate and multivariate analyses were used to determine predictors of flap failure...
October 7, 2016: Microsurgery
Carina Muoth, Adrian Wichser, Marco Monopoli, Manuel Correia, Nicky Ehrlich, Katrin Loeschner, Audrey Gallud, Melanie Kucki, Liliane Diener, Pius Manser, Wolfram Jochum, Peter Wick, Tina Buerki-Thurnherr
There is increasing evidence that certain nanoparticles (NPs) can overcome the placental barrier, raising concerns on potential adverse effects on the growing fetus. But even in the absence of placental transfer, NPs may pose a risk to proper fetal development if they interfere with the viability and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking...
October 6, 2016: Nanoscale
Lisa E Ishii
Facial nerve paralysis, although uncommon in the pediatric population, occurs from several causes, including congenital deformities, infection, trauma, and neoplasms. Similar to the adult population, management of facial nerve disorders in children includes treatment for eye exposure, nasal obstruction/deviation, smile asymmetry, drooling, lack of labial function, and synkinesis. Free tissue transfer dynamic restoration is the preferred method for smile restoration in this population, with outcomes exceeding those of similar procedures in adults...
November 2016: Facial Plastic Surgery Clinics of North America
S Raja Sabapathy, David Elliot, Hari Venkatramani
With the available microsurgical techniques, salvage of the limb can almost always provide a useful upper limb, even in the most complex combined injuries. Having a low threshold for revascularization of doubtfully viable extremities and making full use of the current armamentarium of soft tissue cover techniques, including flow through free flaps, will salvage many limbs. Secondary procedures, including free functioning muscle transfers and toe transfers, further increase the possible functional outcome. Even in the most complex combined injuries, intelligent reconstruction will obtain better outcomes than the best available prosthesis, making the efforts of salvage worthwhile...
November 2016: Hand Clinics
Kyungjin Lee, Siyoung Roh, Dongchul Lee, Jinsoo Kim
The foremost goal of managing a mutilated hand is provision of adequate skin coverage. The most suitable method is free tissue transfer. The specific role of volar surface requires replacement tissue to have similar texture for aesthetically satisfactory and functionally acceptable outcomes. Hand surgeons must approach mutilating hand injuries with the recognition that no 2 injuries are ever the same. The injured hand must be evaluated on the individual demand and characteristics of hand use. Optimal function and aesthetic outcomes require appropriate selection of skin coverage...
November 2016: Hand Clinics
Emily Eva Holmes, Diane Goltz, Verena Sailer, Maria Jung, Sebastian Meller, Barbara Uhl, Jörn Dietrich, Magda Röhler, Jörg Ellinger, Glen Kristiansen, Dimo Dietrich
BACKGROUND: Molecular biomarkers that might help to distinguish between more aggressive and clinically insignificant prostate cancers (PCa) are still urgently needed. Aberrant DNA methylation as a common molecular alteration in PCa seems to be a promising source for such biomarkers. In this study, PITX3 DNA methylation (mPITX3) and its potential role as a prognostic biomarker were investigated. Furthermore, mPITX3 was analyzed in combination with the established PCa methylation biomarker PITX2 (mPITX2)...
2016: Clinical Epigenetics
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
Florian Dittmann, Heiko Tzschätzsch, Sebastian Hirsch, Eric Barnhill, Jürgen Braun, Ingolf Sack, Jing Guo
PURPOSE: To develop a compact magnetic resonance elastography (MRE) protocol for abdomen and to investigate the effect of water uptake on tissue stiffness in the liver, spleen, kidney, and pancreas. METHODS: Nine asymptomatic volunteers were investigated by MRE before and after 1 liter water uptake. Shear-wave excitation at four frequencies was transferred to the abdomen from anterior and posterior directions using pressurized air drivers. Tomographic representations of shear-wave speed were produced by analysis of multifrequency wave numbers in axial and coronal images acquired within four breath-holds or under free breathing, respectively...
October 3, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Richard J Albertini, Debra A Kaden
Formaldehyde (FA) is a mutagenic chemical - a property mitigated in vivo by rapid detoxification and limited tissue distribution following inhalation of the free agent. Endogenously produced FA is necessary for life and required for one-carbon transfer reactions; however, FA derived from external sources (exogenous FA), which may be in the form of methanol, may increase in vivo concentrations above naturally occurring physiological levels. Both endogenous and exogenous FA produce DNA monoadducts, DNA-DNA and DNA-protein cross-links (DDX and DPX) but, when exposed to exogenously-derived free FA, DNA monoadducts, DDX, and DPX are only produced at initial sites of contact...
August 11, 2016: Critical Reviews in Toxicology
Jennifer M Sabino, Julia Slater, Ian L Valerio
Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases...
September 1, 2016: Advances in Wound Care
Mario A Aycart, Muayyad Alhefzi, Maximilian Kueckelhaus, Nicco Krezdorn, Ericka M Bueno, Edward J Caterson, Julian J Pribaz, Bohdan Pomahac
BACKGROUND: Face transplantation has emerged as a viable option for certain patients in the treatment of devastating facial injuries. However, as with autologous free tissue transfer, the need for secondary revisions in face transplantation also exists. The authors' group has quantified the number of revision operations in their cohort and has assessed the rationale, safety, and outcomes of posttransplantation revisions. METHODS: A retrospective analysis of prospectively collected data of the authors' seven face transplants was performed from April of 2009 to July of 2015...
October 2016: Plastic and Reconstructive Surgery
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