Arteriovenous fistula complicating an inferior gluteal artery perforator flap donor site.

We report the case of a 59-year-old woman who developed an arteriovenous fistula in her right buttock following a right inferior gluteal artery perforator flap for breast reconstruction.

A ten-year experience of multiple flaps in head and neck surgery: how successful are they?

Ablative surgery in the head and neck often results in defects that require free flap reconstruction. With improved ablation/reconstructive and adjuvant techniques, improved survival has led to an increase in the number of patients undergoing multiple free flap reconstruction. We retrospectively analyzed a single institution's 10-year experience (August 1993 to August 2003) in free flap reconstruction for malignant tumors of the head and neck.

The glottis and subglottis: an otolaryngologist's perspective.

The complexity of the glottic and subglottic region in terms of anatomy and function make this region challenging in evaluation and treatment. A thorough understanding of the complex anatomy is necessary for the management of patients who have dysphonia, vocal fold paralysis, glottic or subglottic stenosis, or complications, which may present after prolonged intubation or surgical interventions in the upper airway and the thorax.

Interactions of GABA A receptor activation and light on period mRNA expression in the suprachiasmatic nucleus.

Activation of gamma-aminobutyric acid (GABA) A receptors in the suprachiasmatic nucleus (SCN) resets the circadian clock during the day and inhibits the ability of light to reset the clock at night. Light in turn acts during the day to inhibit the phase-resetting effects of GABA. Some evidence suggests that Period mRNA changes in the SCN are responsible for these interactions between light and GABA.

Free tissue transfer and deep vein thrombosis.

Reconstruction of the post-oncologic defect of the lower limb frequently requires free tissue transfer and these often extensive bone and soft tissue resections can occasionally be compounded by the presence of a deep venous thrombosis (DVT). We describe two patients in whom free tissue transfer was attempted, following extensive resection of a sarcoma in the thigh. Both patients had been diagnosed with DVT prior to surgery and received therapeutic low molecular weight heparin preoperatively.

Bisphosphonates and avascular necrosis of the mandible: case report and review of the literature.

Background: Avascular necrosis of the mandible or maxilla is being recognized with increasing frequency in patients who are being treated with bisphosphonates for metastatic cancers.

Methods And Results: A patient who was treated for avascular necrosis following treatment with bisphosphonates for multiple myeloma is presented.

Conclusion: Prophylactic and preventative measures should be instituted prior to commencing treatment with bisphosphonates to minimize the risk of developing avascular necrosis.

Fasciocutaneous free flaps in pharyngolaryngo-oesophageal reconstruction: a critical review of the literature.

Fasciocutaneous (FC) free flaps are gaining widespread popularity for the reconstruction of head and neck defects. The radial forearm free flap and the anterolateral thigh flap are now widely used for pharyngolaryngo-oesophageal (PLO) reconstruction. In many units these flaps are used in preference to enteric free flap reconstructions.

Boundary-specific cost functions for quantitative airway analysis.

Computed tomography (CT) images of the lungs provide high resolution views of the airways. Quantitative measurements such as lumen diameter and wall thickness help diagnose and localize airway diseases, assist in surgical planning, and determine progress of treatment. Automated quantitative analysis of such images is needed due to the number of airways per patient.

Central neural and endocrine mechanisms of non-exercise activity thermogenesis and their potential impact on obesity.

The rise in obesity is associated with a decline in the amount of physical activity in which people engage. The energy expended through everyday non-exercise activity, called non-exercise activity thermogenesis (NEAT), has a considerable potential impact on energy balance and weight gain. Comparatively little attention has been paid to the central mechanisms of energy expenditure and how decreases in NEAT might contribute to obesity.

Comparison of anterolateral thigh and radial forearm free flap donor site morbidity.

This study evaluated patient-reported outcome of the donor site in patients following head and neck cancer reconstruction. Patients who had undergone cancer reconstruction using either an anterolateral thigh or a radial forearm free flap and who were at least 6 months postsurgery were included and contacted by telephone. There were 37 patients (mean age 61 years, standard deviation 16 years) with 18 anterolateral thigh flaps and 19 radial forearm flaps.

Comparison of reconstructive procedures in primary versus secondary mandibular reconstruction.

Background: Few reports have compared reconstructive outcomes of primary versus secondary mandibular reconstruction.

Methods: A retrospective chart review was performed on 149 patients following primary (n = 110) and secondary reconstruction (n = 39).

Results: There was no statistically significant difference in patient demographics between the 2 groups.

Sensitivity of the hypothalamic paraventricular nucleus to the locomotor-activating effects of neuromedin U in obesity.

Obesity is associated with a decrease in energy expenditure relative to energy intake. The decrease in physical activity associated with obesity in several species, including humans, contributes to decreased energy expenditure. Several hormones and neuropeptides that affect appetite also modulate physical activity, including neuromedin U (NMU), a peptide found in the gut and brain.

Workers' compensation, return to work, and patient satisfaction after carpal tunnel decompression.

In the study reported here, we assessed satisfaction and return to work in workers' compensation (WC) patients after carpal tunnel decompression. Eighty of the 362 patients who underwent surgery met the study criteria; 42 of the 80 were found for follow-up; 40 of the 42 participated in the telephone questionnaire; 15 (38%) of the 40 received WC; and 39 (98%) of the 40 returned to work. Mean age of the 40 respondents was 47 years, and mean follow-up was 29 months.

Patient outcome after common peroneal nerve decompression.

Object: This study examines common peroneal nerve decompression and its effect on nerve function.

Methods: Fifty-one peroneal nerve decompressions were retrospectively reviewed. All patients were evaluated preoperatively and postoperatively for motor and sensory function of the peroneal nerve as well as for pain.

Reconstruction of lateral skull base defects after tumor ablation.

Neoplasms located in the lateral skull base region present a challenge for evaluation and management due to their difficult anatomic location and the complex reconstruction that is required following extensive tumor resection. Repair following tumor ablation requires a watertight dural seal, obliteration of the dead space, and coverage with vascularized soft tissue. Advances in radiologic imaging, diagnostic pathology, and surgical techniques and a multidisciplinary team for tumor ablation and reconstruction have significantly improved the treatment of these patients, minimized the occurrence of postoperative complications, and maximized patient outcome and quality of life.

Knee arthroplasty in the young patient: survival in a community registry.

Unlabelled: Operative options for the younger patient with an arthritic knee remain controversial. We prospectively followed 1047 patients 55 years old or younger who underwent knee arthroplasty in a community joint registry over a 14-year period. Patients were implanted with 1047 joints of three predominant designs by 48 surgeons in four hospitals associated with a community joint registry.

The enzyme CD38 (a NAD glycohydrolase, EC 3.2.2.5) is necessary for the development of diet-induced obesity.

Obesity is one of the major health problems of our times. Elucidating the signaling mechanisms by which high-fat caloric diet induces obesity is critical for the understanding of this condition and for the development of therapeutic strategies for its treatment. Here, we demonstrate a novel role for protein CD38 as a regulator of body weight during a high-fat diet.

Evaluation of sun protection behaviour in patients following excision of a skin lesion.

The present prospective study evaluated sun exposure and sun protection behaviours in patients diagnosed with a precancerous or cancerous skin lesion. Following signed informed consent, patients were given a questionnaire regarding sun protection and sun exposure behaviour. There were 50 patients (27 men, 23 women) with a mean age of 59 years.

Complete spontaneous regression in Merkel cell carcinoma.

Merkel cell carcinoma is a rare, aggressive, cutaneous malignancy of the elderly with a generally poor prognosis. Like all skin cancers, its incidence is rising. A few reports of spontaneous regression have been published.

Supplementation of Avizyme 1502 to corn-soybean meal-wheat diets fed to turkey tom poults: the first fifty-six days of age.

A study was designed to determine the effects of enzyme supplementation on poults fed commercially based diets that included corn, soybean meal, and ground wheat with meat and bone meal (0 to 21 d) or Pro-Pak (22 to 56 d). Day-old turkey poults (n = 3,850) were divided into 35 pens and fed 1 of 5 dietary treatments for 56 d. Treatments were a positive control, a negative control (corn matrix adjustment of 140 kcal), and negative control diets supplemented with Avizyme 1502 at 250, 500, or 750 g/tonne.

Tracking the physical aging of poly(ethylene oxide): a technical note.

Physical aging of 2 types of PEO could be tracked by the combination of PALS, DSC, and SEM methods. After storing the samples at 40°C±2°C and 75%±5% RH, a decrease in the o-Ps lifetime values and an increase in the melting enthalpies as a function of storage time indicated a reorientation of the polymer chains. The limitations of monitoring enthalpy relaxation confirm the importance of methods that track volume relaxation, such as PALS.

The internal mammary artery perforator flap: an anatomical study and a case report.

The anatomic basis for the internal artery mammary perforator (IMAP) flap is described in this cadaveric study, together with a clinical case report. The IMAP flap is based on a single or double perforator of the internal mammary artery that is included in the pedicle for added length. It provides a very useful source of local tissue with skin of good texture and color for head and neck reconstruction and, being muscle free, is thin.

Galectin-3 stimulates preadipocyte proliferation and is up-regulated in growing adipose tissue.

Objective: Some cytokines and mediators of inflammation can alter adiposity through their effects on adipocyte number. To probe the molecular basis of obesity, this study determined whether galectin-3 was present in adipose tissue and investigated its effects on fat cell number.

Research Methods And Procedures: In the first study, obesity-prone C57BL/6J mice were fed with high-fat (58%) diet.

Light and GABA)(A) receptor activation alter period mRNA levels in the SCN of diurnal Nile grass rats.

We examined Period (Per) mRNA rhythms in the suprachiasmatic nucleus (SCN) of a diurnal rodent and assessed how phase-shifting stimuli acutely affect SCN Per mRNA using semiquantitative in situ hybridization. First, Per1 and Per2 varied rhythmically in the SCN over the course of one circadian cycle in constant darkness: Per1 mRNA was highest in the early to mid-subjective day, while Per2 mRNA levels peaked in the late subjective day. Second, acute light exposure in the early subjective night significantly increased both Per1 and Per2 mRNA.

The effect of dietary protein level and total sulfur amino acid:lysine ratio on egg production parameters and egg yield in Hy-Line W-98 hens.

A 3 x 3 treatment arrangement varying in dietary protein and TSAA:Lys was used to evaluate the effect of low-protein diets fed to Hy-Line W-98 laying hens. Phase I was 20 to 43 wk of age with 18.9, 17.