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Free tissue transfer

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https://www.readbyqxmd.com/read/28805282/autologous-breast-reconstruction-in-sickle-cell-trait-a-fine-line-between-success-failure
#1
Danny A Young-Afat, Marije J Hoornweg, Martine A van Huizum
Autologous breast reconstructions are increasingly being performed. While increased risks for flap loss after free tissue transfer (FTT) in sickle cell patients are known to most plastic surgeons, risks for patients with sickle cell trait (SCT) are less known. Unfortunately, recommendations to prevent complications after FTT in SCT are still scarce. We present additional and novel surgical measures that we took aiming to enhance probabilities for successful FTT in a SCT patient undergoing autologous breast reconstruction...
August 14, 2017: Breast Journal
https://www.readbyqxmd.com/read/28790159/functional-imaging-and-circulating-biomarkers-of-response-to-regorafenib-in-treatment-refractory-metastatic-colorectal-cancer-patients-in-a-prospective-phase-ii-study
#2
Khurum Khan, Mihaela Rata, David Cunningham, Dow-Mu Koh, Nina Tunariu, Jens C Hahne, George Vlachogiannis, Somaieh Hedayat, Silvia Marchetti, Andrea Lampis, Mahnaz Darvish Damavandi, Hazel Lote, Isma Rana, Anja Williams, Suzanne A Eccles, Elisa Fontana, David Collins, Zakaria Eltahir, Sheela Rao, David Watkins, Naureen Starling, Jan Thomas, Eleftheria Kalaitzaki, Nicos Fotiadis, Ruwaida Begum, Maria Bali, Massimo Rugge, Eleanor Temple, Matteo Fassan, Ian Chau, Chiara Braconi, Nicola Valeri
OBJECTIVE: Regorafenib demonstrated efficacy in patients with metastatic colorectal cancer (mCRC). Lack of predictive biomarkers, potential toxicities and cost-effectiveness concerns highlight the unmet need for better patient selection. DESIGN: Patients with RAS mutant mCRC with biopsiable metastases were enrolled in this phase II trial. Dynamic contrast-enhanced (DCE) MRI was acquired pretreatment and at day 15 post-treatment. Median values of volume transfer constant (K(trans)), enhancing fraction (EF) and their product KEF (summarised median values of K(trans)× EF) were generated...
August 8, 2017: Gut
https://www.readbyqxmd.com/read/28789661/reference-free-determination-of-tissue-absorption-coefficient-by-modulation-transfer-function-characterization-in-spatial-frequency-domain
#3
Weiting Chen, Huijuan Zhao, Tongxin Li, Panpan Yan, Kuanxin Zhao, Caixia Qi, Feng Gao
BACKGROUND: Spatial frequency domain (SFD) measurement allows rapid and non-contact wide-field imaging of the tissue optical properties, thus has become a potential tool for assessing physiological parameters and therapeutic responses during photodynamic therapy of skin diseases. The conventional SFD measurement requires a reference measurement within the same experimental scenario as that for a test one to calibrate mismatch between the real measurements and the model predictions. Due to the individual physical and geometrical differences among different tissues, organs and patients, an ideal reference measurement might be unavailable in clinical trials...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28770621/longitudinal-perioperative-pain-assessment-in-head-and-neck-cancer-surgery
#4
Marisa R Buchakjian, Andrew B Davis, Sebastian J Sciegienka, Nitin A Pagedar, Steven M Sperry
OBJECTIVE: To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. METHODS: Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks...
August 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28767176/sequential-chimeric-medial-femoral-condyle-and-anterolateral-thigh-flow-through-flaps-for-one-stage-reconstructions-of-composite-bone-and-soft-tissue-defects-report-of-three-cases
#5
Dominic Henn, Mohamed H Abouarab, Christoph Hirche, Jochen F Hernekamp, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#6
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28763157/a-unifying-mathematical-model-of-lipid-droplet-metabolism-reveals-key-molecular-players-in-the-development-of-hepatic-steatosis
#7
Christin Wallstab, Dimitra Eleftheriadou, Theresa Schulz, Georg Damm, Daniel Seehofer, Jürgen Borlak, Hermann-Georg Holzhütter, Nikolaus Berndt
The liver responds to elevated plasma concentrations of free fatty acids (FFAs) with an enhanced uptake of FFAs and their esterification to triacylglycerol (TAG). On the long term this may result in massive hepatic TAG accumulation called steatosis hepatitis. In hepatocytes, the poor water-soluble TAG is packed in specialized organelles: Lipid droplets (LDs) serving as transient cellular deposit and lipoproteins (LPs) transporting TAG and cholesterol esters to extra-hepatic tissues. The dynamics of these organelles is controlled by a variety of regulatory surface proteins (RSPs)...
August 1, 2017: FEBS Journal
https://www.readbyqxmd.com/read/28761809/evaluating-single-point-quantitative-magnetization-transfer-in-the-cervical-spinal-cord-application-to-multiple-sclerosis
#8
Alex K Smith, Samantha By, Bailey D Lyttle, Richard D Dortch, Bailey A Box, Lydia J Mckeithan, Saakshi Thukral, Francesca Bagnato, Siddharama Pawate, Seth A Smith
Spinal cord (SC) damage is linked to clinical deficits in patients with multiple sclerosis (MS), however, conventional MRI methods are not specific to the underlying macromolecular tissue changes that may precede overt lesion detection. Single-point quantitative magnetization transfer (qMT) is a method that can provide high-resolution indices sensitive to underlying macromolecular composition in a clinically feasible scan time by reducing the number of MT-weighted acquisitions and utilizing a two-pool model constrained by empirically determined constants...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28759109/probing-the-phosphatidylinositol-3-kinase-mammalian-target-of-rapamycin-pathway-in-gliomas-a-phase-2-study-of-everolimus-for-recurrent-adult-low-grade-gliomas
#9
Michael Wahl, Susan M Chang, Joanna J Phillips, Annette M Molinaro, Joseph F Costello, Tali Mazor, Sanda Alexandrescu, Janine M Lupo, Sarah J Nelson, Mitchel Berger, Michael Prados, Jennie W Taylor, Nicholas Butowski, Jennifer L Clarke, Daphne Haas-Kogan
BACKGROUND: Activation of the phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is common in patients with low-grade gliomas (LGGs), but agents that inhibit this pathway, including mTOR inhibitors, have not been studied in this population. METHODS: Fifty-eight patients with pathologic evidence of recurrence after they had initially been diagnosed with World Health Organization (WHO) grade II gliomas were enrolled into a prospective phase 2 clinical trial and received daily everolimus (RAD001) for 1 year or until progression...
July 31, 2017: Cancer
https://www.readbyqxmd.com/read/28755704/it-takes-two-one-resects-one-reconstructs
#10
REVIEW
Shabnam Ghazizadeh, Edward C Kuan, Jon Mallen-St Clair, Elliot Abemayor, Quang Luu, Vishad Nabili, Maie A St John
Care of patients with advanced head and neck cancer is a multidisciplinary effort through all phases of care. Head and neck cancer surgery involves balancing oncologic control, functional preservation, and aesthetics. Given the advances in free tissue reconstruction, the majority of defects can be reconstructed using free tissue transfer flaps. A 2-team approach allows for early, continual communication and meticulous operative planning. Operations can be combined into a single effort. This approach maximizes efficiency and enables multidisciplinary collaboration for comprehensive surgical treatment...
August 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28753417/ex-vivo-determined-experimental-correction-factor-for-the-ultrasonic-source-term-in-the-bioheat-equation
#11
Guillermo A Cortela, Wagner C A Pereira, Carlos A Negreira
The objective of this work is to propose an effective absorption coefficient (αeffec) as an empirical correction factor in the source term of the bioheat equation. The temperature rise in biological tissue due to ultrasound insonification is produced by energy absorption. Usually, the ultrasonic absorption coefficient (αA) is used as a source term in the bioheat equation to quantify the temperature rise, and the effect of scattering is disregarded. The coefficient αeffec includes the scattering contribution as an additional absorption term and should allow us to make a better estimation of the thermal dose (TD), which is important for clinical applications...
July 19, 2017: Ultrasonics
https://www.readbyqxmd.com/read/28753219/the-retrograde-transverse-cervical-artery-as-a-recipient-vessel-for-free-tissue-transfer-in-complex-head-and-neck-reconstruction-with-a-vessel-depleted-neck
#12
Pedro Ciudad, Mouchammed Agko, Oscar J Manrique, Shivprasad Date, Kidakorn Kiranantawat, Wei Ling Chang, Fabio Nicoli, Federico Lo Torto, Michele Maruccia, Georgios Orfaniotis, Hung-Chi Chen
BACKGROUND: Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746290/the-associations-of-hospital-volume-surgeon-volume-and-surgeon-experience-with-complications-and-30-day-rehospitalization-after-free-tissue-transfer-a-national-population-study
#13
Elham Mahmoudi, Yiwen Lu, Shu-Chen Chang, Chia-Yu Lin, Yi-Chun Wang, Chee Jen Chang, Ming-Huei Cheng, Kevin C Chung
BACKGROUND: Greater provider volume is associated with better outcomes. There is, however, a paucity of evidence on volume-outcome associations for surgical complications and 30-day all-cause rehospitalization after free tissue transfer or free flap surgery. Surgical complications and frequent rehospitalization are important quality indicators that substantially hinder appropriate health care spending. The authors hypothesized that increased provider volume and surgeon experience are associated with lower complication and hospital readmission rates...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28744952/effects-of-free-radical-initiators-on-polyethylene-glycol-dimethacrylate-hydrogel-properties-and-biocompatibility
#14
Thomas S Wilems, Xi Lu, Yuki Kurosu, Zara Kahn, Hyun Ju Lim, Laura A Smith Callahan
Many studies have utilized Irgacure 2959 photopolymerized poly(ethylene glycol) (PEG) hydrogels for tissue engineering application development. Due to the limited penetration of ultraviolet light through tissue, Irgacure 2959 polymerized hydrogels are not suitable for use in tissues where material injection is desirable, such as the spinal cord. To address this, several free radical initiators (thermal initiator VA044, ammonium persulfate/TEMED reduction-oxidation reaction, and Fenton chemistry) are evaluated for their effects on the material and mechanical properties of PEG hydrogels compared to Irgacure 2959...
July 26, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28743484/oxidative-stress-enhances-and-modulates-protein-s-nitrosation-in-smooth-muscle-cells-exposed-to-s-nitrosoglutathione
#15
E Belcastro, W Wu, I Fries-Raeth, A Corti, A Pompella, P Leroy, I Lartaud, C Gaucher
Among S-nitrosothiols showing reversible binding between NO and -SH group, S-nitrosoglutathione (GSNO) represents potential therapeutics to treat cardiovascular diseases (CVD) associated with reduced nitric oxide (NO) availability. It also induces S-nitrosation of proteins, responsible for the main endogenous storage form of NO. Although oxidative stress parallels CVD development, little is known on the ability of GSNO to restore NO supply and storage in vascular tissues under oxidative stress conditions. Aortic rat smooth muscle cells (SMC) were stressed in vitro with a free radical generator (2,2'-azobis(2-amidinopropane) dihydrochloride, AAPH)...
July 23, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/28739712/total-glossectomy-without-laryngectomy-for-advanced-squamous-cell-cancer-of-the-tongue-functional-and-oncological-results
#16
Maximilian Reiter, Ulrich Harréus
BACKGROUND/AIM: Total glossectomy without laryngectomy for large tongue carcinomas still remains controversial, as these defects may go along with dramatic effects on respiration, speech and swallowing. As a consequence, these procedures significantly impact quality of life. Therefore, larger case series are rare. Nevertheless, with the development of free tissue transfer, functional reconstruction has become increasingly popular and encouraging results are reported in the literature...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28739194/perforator-based-rectus-free-tissue-transfer-for-head-and-neck-reconstruction-new-reconstructive-advantages-from-an-old-friend
#17
Stephen Y Kang, Matthew E Spector, Douglas B Chepeha
OBJECTIVES: To demonstrate three reconstructive advantages of the perforator based rectus free tissue transfer: long pedicle, customizable adipose tissue, and volume reconstruction without muscle atrophy within a contained space. MATERIALS AND METHODS: Thirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. RESULTS: Transplant success was 93%. Mean pedicle length was 13.4cm...
July 21, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28738446/single-stage-versus-two-stage-arteriovenous-loop-microsurgical-reconstruction-a-meta-analysis-of-the-literature
#18
REVIEW
Rebecca Knackstedt, Rachel Aliotta, James Gatherwright, Risal Djohan, Brian Gastman, Graham Schwarz, Mark Hendrickson, Raffi Gurunluoglu
BACKGROUND: Arteriovenous (AV) loops can be utilized in a single- or two-stage approach in free flap reconstruction when proper vessels are not available. However, there exists no consensus on which method leads to superior microsurgical and patient outcomes. The purpose of this article was to review single- versus two-stage AV loops utilized in free flap reconstruction with a focus on complications and overall outcomes. METHODS: A systematic review of AV loops for autologous free tissue transfer was conducted...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28728324/the-chicken-thigh-adductor-profundus-free-muscle-flap-a-novel-validated-non-living-microsurgery-simulation-training-model
#19
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28727209/a-dual-flip-angle-3d-bssfp-magnetization-transfer-like-method-to-differentiate-between-recent-and-old-myocardial-infarction
#20
Philippe Germain, Soraya El Ghannudi, Aissam Labani, Mi Y Jeung, Afshin Gangi, Patrick Ohlmann, Catherine Roy
BACKGROUND: Magnetic resonance imaging (MRI) tissue signal is modulated by magnetization transfer (MT) phenomena, intrinsically induced by balanced steady-state free precession (bSSFP) imaging. PURPOSE: To investigate the possible value of such a MT-like bSSFP approach in two clinical settings involving focal myocardial lesions highligthed by late gadolinium enhancement (LGE+): edema induced by recent myocardial infarction (MI) and fibrotic scar related to chronic infarction...
July 20, 2017: Journal of Magnetic Resonance Imaging: JMRI
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