Intraprocedural Use of the Novel Protrieve Sheath Removes Embolus During Mechanical Thrombectomy of a Complex Iliocaval Deep Vein Thrombosis.

Extension of proximal deep vein thrombosis (DVT) into the inferior vena cava (IVC) complicates treatment with mechanical thrombectomy, as the presence of IVC thrombus increases embolization risks. In the case of a 39-year-old man with left-sided iliocaval DVT, the novel Protrieve sheath (Inari Medical, Irvine, California) was intraprocedurally placed in the IVC to ensure such complications would not outweigh the benefits of intervention. During successful thrombectomy, the sheath's wall-apposing funnel trapped and removed procedural embolus from the IVC, with no complications occurring.

Tree Stand-Related Injuries in Nonadmitted and Admitted Patients at a Level 2 Trauma Center in Michigan: 2015-2019.

Introduction: Tree stand-related injuries (TSRI) are more common than firearm-related injuries in hunters. Most previous studies on the topic used trauma databases that only include admitted patients. This study characterizes injury patterns found in nonadmitted and admitted TSRI patients presenting to a level 2 Michigan trauma center.

Oleosin L improves oil packaging in leaves.

Plant oil production has been increasing continuously in the past decade. There has been significant investment in the production of high biomass plants with elevated oil content. We recently showed that the expression of WRI1 and DGAT1 genes increase oil content by up to 15% in leaf dry weight tissue.

The need for perforator treatment after VenaSeal and ClosureFast endovenous saphenous vein closure in CEAP 6 patients.

Objective: The authors have previously demonstrated that VenaSeal (Medtronic, Inc, Minneapolis, Minn) adhesive, compared with radiofrequency ablation (RFA, ClosureFast; Medtronic, Inc), in treatment of refluxing saphenous veins in CEAP 6 limbs, results in shorter healing times of venous ulcers. The authors hypothesize that the longer treated length possible with VenaSeal's nonthermal modality may affect the number of critical refluxing perforators contributing to the nonhealing wound. This follow-up study compares the need for follow-up treatment of perforator veins after saphenous vein treatment with either radiofrequency ablation (ClosureFast RFA) or adhesive closure (VenaSeal).

Delayed referral of venous ulcers increases resource usage.

Objective: Venous insufficiency is often not readily recognized as a contributing etiology to nonhealing wounds by nonvascular surgery specialists, potentially delaying appropriate treatment to achieve wound healing and increasing healthcare costs. The objective of the present study was to understand the time and resources used before the definitive treatment of venous ulcers.

Methods: A single-institution retrospective medical record review of C6 patients undergoing radiofrequency saphenous and perforator vein ablation from May 2016 to January 2018 identified 56 patients with 67 diseased limbs.

Optimization of factors for the prevention of spinal cord ischemia in thoracic endovascular aortic repair.

Objectives: Spinal cord ischemia following thoracic endovascular aortic repair (TEVAR) is a devastating complication. This study seeks to demonstrate how a standardized protocol to prevent spinal cord ischemia affects incidence in patients undergoing TEVAR.

Methods: Using CPT codes 33880 and 33881, all TEVAR procedures performed at a single tertiary care center from January 2017 to December 2018 were examined.

A comparison of cyanoacrylate glue and radiofrequency ablation techniques in the treatment of superficial venous reflux in CEAP 6 patients.

Objective: Venous leg ulcers (CEAP [clinical, etiologic, anatomic, pathophysiologic] class 6) represent the most severe form of chronic venous insufficiency. As closure techniques for superficial venous reflux evolve, direct outcome comparisons of treatments are integral, because many studies have already demonstrated that early endovenous intervention improves wound healing. The present study compared the rates of venous wound healing between two techniques of superficial vein closure: ClosureFast radiofrequency ablation (RFA) and adhesive closure (VenaSeal; both Medtronic, Inc, Minneapolis, Minn).

Limb Salvage Rates and Functional Outcomes Using a Longitudinal Slit Arteriotomy End-to-Side Anastomosis for Limb-Threatening Defects in a High-Risk Patient Population.

Background: Limb salvage techniques using free tissue transfer in patients with chronic wounds caused by longstanding osteomyelitis, diabetes, and peripheral vascular disease are technically challenging. The longitudinal slit arteriotomy end-to-side anastomosis is the authors' preferred technique because it is the least invasive arteriotomy and is especially important for diseased recipient arteries. The authors reviewed highly comorbid patients who underwent free tissue transfer with this technique to understand the success rates, overall outcomes, and long-term limb salvage rates.

Spontaneous Resolution of Gravid Uterine Incarceration With Spinal Anesthesia: A Case Report.

Incarceration of the gravid uterus may pose significant risks to both maternal and fetal health. Anesthetic management for these patients is variable, and the ideal anesthetic technique is unknown. The patient presented to the labor and delivery unit with pelvic pain and urinary retention in the setting of a gravid incarcerated uterus.

A Multidisciplinary Approach to Restore an Unconventional Crown Removal of Traumatized Permanent Central Incisors.

A 13-year-old female presented with traumatized maxillary central incisors that had been endodontically treated. Five years later, at a different dental office, she had the clinical crowns removed, leaving subgingival margins. From the patient's history and our initial assessment, it seemed as if the teeth had been fractured and luxated but not avulsed.

A reconfigured Kennedy pathway which promotes efficient accumulation of medium-chain fatty acids in leaf oils.

Medium-chain fatty acids (MCFA, C6-14 fatty acids) are an ideal feedstock for biodiesel and broader oleochemicals. In recent decades, several studies have used transgenic engineering to produce MCFA in seeds oils, although these modifications result in unbalance membrane lipid profiles that impair oil yields and agronomic performance. Given the ability to engineer nonseed organs to produce oils, we have previously demonstrated that MCFA profiles can be produced in leaves, but this also results in unbalanced membrane lipid profiles and undesirable chlorosis and cell death.

Thioesterase overexpression in Nicotiana benthamiana leaf increases the fatty acid flux into triacylgycerol.

Increasing the oil content of leafy biomass is emerging as a sustainable source of vegetable oil to meet global demand. Transient gene expression in leaf provides a reproducible platform to study the effect of transgenes on lipid biosynthesis. We first generated a transgenic Nicotiana benthamiana line containing high levels of triacylglycerol in the leaf tissue (31.

Metabolic engineering of medium-chain fatty acid biosynthesis in Nicotiana benthamiana plant leaf lipids.

Various research groups are investigating the production of oil in non-seed biomass such as leaves. Recently, high levels of oil accumulation have been achieved in plant biomass using a combination of biotechnological approaches which also resulted in significant changes to the fatty acid composition of the leaf oil. In this study, we were interested to determine whether medium-chain fatty acids (MCFA) could be accumulated in leaf oil.

New molluscan larval form: brooding and development in a hydrothermal vent gastropod, Ifremeria nautilei (Provannidae).

Despite extreme differences between some shallow and deep-sea habitats, the developmental modes and larval forms of deep-sea animals are typically similar to those of their shallow-water relatives. Here we report one of the first documented exceptions to this general rule. The hydrothermal vent snail Ifremeria nautilei displays two novel life-history traits: (1) an unusual uniformly ciliated larva that we here name Warén's larva, and (2) internal brood protection in a modified metapodial pedal gland.