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The Use of Arteriovenous Bundle Interposition Grafts in Microsurgical Reconstruction: A Systematic Review of the Literature

  • Kareh, Aurora M.;Tadisina, Kashyap Komarraju;Chun, Magnus;Kaswan, Sumesh;Xu, Kyle Y.
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.543-548
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    • 2022
  • Microvascular reconstruction frequently requires anastomosis outside of the zone of injury for successful reconstruction. Multiple options exist for pedicle lengthening including vein grafts, arteriovenous loops, and arteriovenous bundle interposition grafts. The authors performed a systematic review of arteriovenous bundle interposition grafts to elucidate indications and outcomes of arteriovenous grafts in microvascular reconstruction. A systematic review of the literature was performed using targeted keywords. Data extraction was performed by two independent authors, and descriptive statistics were used to analyze pooled data. Forty-four patients underwent pedicle lengthening with an arteriovenous graft from the descending branch of the lateral circumflex femoral artery. Most common indications for flap reconstruction were malignancy (n = 12), trauma (n = 7), and diabetic ulceration (n = 4). The most commonly used free flap was the anterolateral thigh flap (n = 18). There were five complications, with one resulting in flap loss. Arteriovenous bundle interposition grafts are a viable option for pedicle lengthening when free flap distant anastomosis is required. The descending branch of the lateral circumflex femoral artery may be used for a variety of defects and can be used in conjunction with fasciocutaneous, osteocutaneous, muscle, and chimeric free flaps.

Cytotoxicity Effects of Mouse IgG Produced against Three Nanoliposomal Human DR5 Receptor Epitopes on Breast Cancer Cells

  • Amirijavid, Shaghayegh;Entezari, Maliheh;Movafagh, Abolfazl;Hashemi, Mehrdad;Mosavi-Jarahi, Alireza;Dehghani, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.257-261
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    • 2016
  • Cancer causes cells to avoid death while being the second cause of death in the world itself. Damaged cells in the absence of apoptosis will increasingly amplify their inefficient genome. Of the two main apoptosis inducing pathways in cells, the first has p53 protein as the main initiating factor in the cascade. According to research results this protein s mutated in 50% of cancers and sointerest has cooncentrated on the second pathway that features death receptors. Among these receptors TRAIL1/DR5 is especially expressed in cancer cells. So targeting such receptors can initiate the apoptotic cascade in cells. Interestingly by substitution of activating ligands with antibodies as agonists, we could efficiently turn on the apoptosis pathway. First of all, three small peptides from the DR5 protein extracellular domain were synthesized and injected with two different kind of adjuvants (Fround and liposomal encapsulation) separately into mice at 15 day intervals. As a result, liposomal peptides induced the immune system more efficient than Frounds adjuvant and at the end point the antibodies which were obtained from liposomal peptide injection induced much more effective death. Liposomal formol could be used as an adjuvant in immunization utilizing small peptides. They carry, protect and deliver peptides very efficiently. In addition, small peptides of a certain size from the extracellular domain of DR5 proteins not only can induce immune system but also produce antibodies playing a remarkable anti-cancer roles against breast cancer cells (MCF-7).

Evaluating Performance of Telecommunication Branch : Application of DEA with Non-Discretionary Factor (통신지사의 성과평가 : 비재량 요인을 포함한 DEA 적용)

  • Kwon, Sun-Man;Han, Chang Hee
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.40 no.4
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    • pp.21-28
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    • 2017
  • Improving efficiency of the telecommunication is crucial to the development and growth of Korean economy. Recently, it has become important with the huge development of information technology and its greater potential for extensive impact on the rest of the economy. Hence, it is useful to determine the factors that help enhance efficiency in telecommunication and consider them in improving the evaluation model. This study applies DEA (data envelopment analysis) to evaluate the relative efficiency of 51 branches of a Korean telecommunication company. Using the super-efficiency approach, we tested outliers which may affect the results and ranked the efficient branches. A method of deriving key variables applied to business operation is proposed to identify the key performance indicators for evaluation that takes environmental (non-discretionary) factors into account. We used the extended CCR model proposed by Banker and Morey to investigate the influence of non-discretionary factor. The information provided by the model (slacks, weights) and the sensitivity analysis shows that the most important indicator that affects the branch performance is operating cost. The results of sensitivity analysis show that average efficient score decreases from 0.972 (base case) to 0.863 for CASE2-COST. The average score of the data proves the priority of operating cost over other indicators. The effect of environmental (non-discretionary) variable was found to be significant. The population effect was positive and improved overall efficiency by 0.91% on average. Non-discretionary factor plays a meaningful role explaining the performance of branches. The performance optimization report can help a manager of an inefficient branch to develop branch strategies. Managers can identify the top-performing units, study best practices and adopt the strategy to the organization.

Nerve Conduction Study of Lateral Dorsal Cutaneous Branch of Sural Nerve (비복신경 외측분지의 신경전도검사)

  • Kim, Sung-Je;Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.5 no.2
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    • pp.192-196
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    • 2003
  • The Lateral dorsal cutaneous branch of sural nerve (LDCB) is a terminal sensory branch of lower extremities. It can be injured frequently in peripheral nerves. However, the normal data of each component of nerve conduction study (NCS) of were not studied at this time. The Nerve Conduction Study of LDCB adults were assessed for amplitude, area, duration and nerve conduction velocity (NCV) in normal fifty. We also evaluated how age, sex and dexterity affect the various components of NCS. The Mean amplitude of LDCB was $9.45{\pm}1.93{\mu}V$, area was $4.05{\pm}0.55{\mu}V/s$, duration was $1.50{\pm}0.13s$, and NCV was $37.9{\pm}3.09m/s$, respectively. The amplitude of right was $10.1{\mu}V$ in men, $8.65{\mu}V$ in women. The area of right was $3.83{\mu}V/s$ in less than 40 years and $4.24{\mu}V/s$ in older than 40 years. The areas of left was $3.86{\mu}V/s$ in less than 40 years and $4.30{\mu}V/s$ in older than 40 years. The NCV was 39.0 m/s in less than 40 years and 36.7 m/s in older than 40 years. All of above differences were statistically significant. There were no statistically significant differences between right and left NCS. Normal data of LDCB could be applicable in peripheral neuropathy or nerve injury.

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Distally Based Anterolateral thigh Pedicled Flap in the Reconstruction of Defect Around Knee (역혈류성 전외측대퇴 혈관경피판을 이용한 무릎 주위 결손의 재건)

  • Park, Sang-Soon;Shim, Jeong-Su
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.769-774
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    • 2010
  • Purpose: As the soft tissue defect around the knee is difficult to reconstruct, local flap or free flap is used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee. We report successful reconstruction of defect around knee by this method. Methods: Four patients with skin & soft tissue defect around knee have been treated for reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and in order to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, a more careful ligation was done starting from 10 cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts. Results: Not all patients suffered from flap necrosis. In case of the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but it disappeared the following day. All three patients had no occurences of additional complications. Conclusion: Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. The distally based anterolateral thigh pedicled flap used by the authors is a very useful way of reconstructing the area around knee.

Liver Dysfunction and Oxidative Stress in Streptozotocin-Induced Diabetic Rats: Protective Role of Artemisia Turanica

  • Yazdi, Hassan Bgheri;Hojati, Vida;Shiravi, Abdolhossein;Hosseinian, Sara;Vaezi, Gholamhassan;Hadjzadeh, Mousa-Al-Reza
    • Journal of Pharmacopuncture
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    • v.22 no.2
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    • pp.109-114
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    • 2019
  • Objectives: Oxidative stress plays a central role in diabetes-induced complications. In the present study, the protevtive effect of Artemisia turanica (A. turanica) was evaluated against diabetes-induced liver oxidative stress and dysfunction. Methods: Fifty male Wistar rats were randomly divided into five groups: control, diabetic, diabetic + metformin, diabetic + A. turanica extract, and diabetic + A. turanica extract + metformin. Experimental diabetes was induced by a single-dose (55 mg/kg, intraperitoneally (ip)) injection of streptozotocin (STZ). Metformin (300 mg/kg) and A. turanica extract (70 mg/kg) were orally administrated three days after STZ injection for four weeks. The levels of malondialdehyde (MDA), total thiol content and superoxide dismutase (SOD) and catalase activities were measured in the liver tissue. Serum glucose concentration, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were also determined. Results: In the diabetic group, serum glucose concentration, serum AST and ALT activities and liver MDA level were significantly higher while tissue total thiol content as well as catalase and SOD activities were lower, compared to the control group. Serum glucose in diabetic rats treated with metformin + A. turanica extract showed a significant decrease compared with the diabetic group. In all the A. turanica extract and metformin treated groups, serum ALT, tissue MDA level, total thiol content and SOD activity significantly improved compared with the diabetic rats. However, treatment of the diabetic rats only with metformin could not significantly change the activities of catalase and AST compared with the diabetic group. Conclusion: These findings suggested that A. turanica extract had a therapeutic effect on liver dysfuncyion and oxidative stress induced by diabetes, that may be probably due to its antioxidant and antiinflammatory effects.

The Effect of Green Coffee Supplementation on Lipid Profile, Glycemic Indices, Inflammatory Biomarkers and Anthropometric Indices in Iranian Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial

  • Mehrnoush Meshkani;Ahmad Saedisomeolia;Mirsaeed Yekaninejad;Seyed Ahmad Mousavi;Azam Ildarabadi;Marzieh Vahid-Dastjerdi
    • Clinical Nutrition Research
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    • v.11 no.4
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    • pp.241-254
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    • 2022
  • Polycystic ovary syndrome (PCOS) is a heterogeneous clinical syndrome. Recent studies examine different strategies to modulate its related complications. Chlorogenic acid, as a bioactive component of green coffee (GC), is known to have great health benefits. The present study aimed to determine the effect of GC on lipid profile, glycemic indices, and inflammatory biomarkers. Forty-four PCOS patients were enrolled in this randomized clinical trial of whom 34 have completed the study protocol. The intervention group (n = 17) received 400 mg of GC supplements, while the placebo group (n = 17) received the same amount of starch for six weeks. Then, glycemic indices, lipid profiles, and inflammatory parameters were measured. After the intervention period, no significant difference was shown in fasting blood sugar, insulin level, Homeostasis model assessment of insulin resistance index, low-density lipoprotein, high-density lipoprotein, Interleukin 6 or 10 between supplementation and placebo groups. However, cholesterol and triglyceride serum levels decreased significantly in the intervention group (p < 0.05). This research confirmed that GC supplements might improve some lipid profiles in women with PCOS. However, more detailed studies with larger sample sizes are required to prove the effectiveness of this supplement.

Separate and Joint Associations of Shift Work and Sleep Quality with Lipids

  • Charles, Luenda E.;Gu, Ja K.;Tinney-Zara, Cathy A.;Fekedulegn, Desta;Ma, Claudia C.;Baughman, Penelope;Hartley, Tara A.;Andrew, Michael E.;Violanti, John M.;Burchfiel, Cecil M.
    • Safety and Health at Work
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    • v.7 no.2
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    • pp.111-119
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    • 2016
  • Background: Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women). Methods: Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; low-density lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, ${\leq}5$; intermediate, 6-8; poor, ${\geq}9$) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work + sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance. Results: Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and race-adjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers ${\geq}40$ years old, those reporting poor sleep quality had a significantly higher mean level of TC ($202.9{\pm}3.7mg/dL$) compared with those reporting good sleep quality ($190.6{\pm}4.0mg/dL$) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014). Conclusion: Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.

Influence of Work Characteristics on the Association Between Police Stress and Sleep Quality

  • Ma, Claudia C.;Hartley, Tara A.;Sarkisian, Khachatur;Fekedulegn, Desta;Mnatsakanova, Anna;Owens, Sherry;Gu, Ja Kook;Tinney-Zara, Cathy;Violanti, John M.;Andrew, Michael E.
    • Safety and Health at Work
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    • v.10 no.1
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    • pp.30-38
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    • 2019
  • Background: Police officers' stress perception, frequency of stressful events (stressors), and police work characteristics may contribute to poor sleep quality through different mechanisms. Methods: We investigated associations of stress severity (measured by stress rating score) and frequency of stressors with sleep quality and examined the influence of police work characteristics including workload, police rank, prior military experience, and shift work on the associations. Participants were 356 police officers (256 men and 100 women) enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress Study from 2004 to 2009. A mean stress rating score and mean frequency of stressors occurring in the past month were computed for each participant from the Spielberger Police Stress Survey data. Sleep quality was assessed using the global score derived from the Pittsburgh Sleep Quality Index survey. Linear associations of the stress rating score and frequency of stressors with sleep quality (Pittsburgh Sleep Quality Index global score) were tested. Age, sex, race/ethnicity, and smoking status were selected as potential confounders. Results: The stress rating score was positively and independently associated with poor sleep quality (${\beta}=0.17$, p = 0.002). Only workload significantly modified this association (${\beta}=0.23$, p = 0.001 for high workload group; p-interaction = 0.109). The frequency of stressors was positively and independently associated with poor sleep quality (${\beta}=0.13$, p = 0.025). Only police rank significantly modified the association (${\beta}=0.007$, p = 0.004 for detectives/other executives; p-interaction = 0.076). Conclusion: Both police officers' perception of stress severity and the frequency of stressors are associated with poor sleep quality. Stress coping or sleep promotion regimens may be more beneficial among police officers reporting high workloads.