Bifurcation or periphery: Where should aberrant arteries in pulmonary sequestration be divided?

Introduction: Whether aberrant arteries in pulmonary sequestration should be divided at the bifurcation or at the periphery remains a subject of debate (Kodama et al., 2016). Due to the risk of postoperative aneurysm formation followed by fetal bleeding (Rubin et al.

Changes in Skin Paddle Morphology after Autologous Breast Reconstruction.

Background: Immediate autologous breast reconstruction (IABR) can provide favorable aesthetic outcomes after skin-sparing mastectomy. However, it is known that the morphology of the reconstructed breast changes over time. Therefore, it is necessary to be able to predict the likely amount of change preoperatively to reconstruct a symmetrical breast.

Dorsal Hand Reconstruction with Web Contracture Release Using Free Superficial Inferior Epigastric Artery Flap.

We present a case in which reconstruction of the dorsum of the hand and finger web space was carried out concurrently with the insertion of a superficial inferior epigastric artery flap into the interdigital spaces. This approach was taken to prevent the potential development of subsequent web space contracture. The patient, a 57-year-old woman, presented with a necrotizing soft tissue infection on the dorsum of her left hand, resulting in a full-thickness skin defect extending from the metacarpophalangeal joint to the wrist, with exposure of the extensor tendons.

Endothelial cell-specific LAT1 ablation normalizes tumor vasculature.

Some endothelial cells in the tumor vasculature express a system L amino acid transporter, LAT1. To elucidate the role of LAT1 in tumor-related endothelial cells, tumor cells were injected into endothelial cell-specific LAT1 conditional knockout mice (Slc7a5flox/flox; Cdh5-Cre-ERT2), and we found that the shape of the tumor vasculature was normalized and the size and numbers of lung metastasis was reduced. TNF-α-induced expression of VCAM1 and E-selectin at the surface of HUVEC, both of which are responsible for enhanced monocyte attachment and premetastatic niche formation, was reduced in the presence of LAT1 inhibitor, nanvuranlat.

Prognostic significance of ground-glass areas within tumours in non-small-cell lung cancer.

Objectives: To validate or refute the hypothesis that non-small-cell lung cancers (NSCLC) with ground-glass areas (GGA+) within the tumour on high-resolution computed tomography are associated with a more favourable prognosis than those without GGA (GGA-).

Methods: We analysed data from a multicentre observational cohort study in Japan including 5005 patients with completely resected pathological stage I NSCLC, who were excluded from the Japan Clinical Oncology Group (JCOG) 0707 trial on oral adjuvant treatment during the enrolment period. The patients' medical and pathological records were assessed retrospectively by physicians and re-staged according to the 8th tumour, node, metastasis edition.

Small Bowel Obstruction Caused by Migration of Fractured Metal Stent in Patients with Malignant Gastric Outlet Obstruction: A Report of Two Cases and Review of the Literature.

Gastroduodenal stenting (GDS) is a less invasive alternative to gastrojejunostomy for the management of malignant gastric outlet obstruction (mGOO). GDS is a minimally invasive treatment with good technical and clinical success, and severe complications that require surgical intervention are rare. Stent fracture is an uncommon complication associated with GDS; however, migration of the fractured distal segment can result in small bowel obstruction.

Pulmonary interstitial glycogenosis in Birt-Hogg-Dubé syndrome-associated lung cysts: A new insight into the pathogenesis?

Multiple lung cysts are one of the major features of Birt-Hogg-Dubé syndrome (BHD), but little is known about their nature and pathogenesis. We report a case of a woman diagnosed with BHD lung cysts who exhibited pulmonary interstitial glycogenosis (PIG), a mesenchymal abnormality hitherto undescribed in this disease, in specimens resected at 14 and 29 years of age. Histopathologically, oval to spindle clear cells were seen in the subepithelial interstitial tissue of septal structures and the walls of the cysts.

Minimal Scar Autologous Breast Reconstruction with Skin-sparing Mastectomy.

Unlabelled: A skin paddle severely impairs the appearance of the reconstructed breast. We have established a new technique called "minimal scar autologous breast reconstruction" involving delayed nipple reconstruction using a local flap designed on the skin paddle and simultaneous resection of the residual skin paddle.

Methods: We analyzed 20 patients with unilateral breast cancer who underwent skin-sparing mastectomy followed by immediate breast reconstruction using a free flap (deep inferior epigastric perforator flap in 13 patients and profunda artery perforator flap in seven).

The bioengineering of perfusable endocrine tissue with anastomosable blood vessels.

Organ transplantation is a definitive treatment for endocrine disorders, but donor shortages limit the use of this technique. The development of regenerative therapies would revolutionize the treatment of endocrine disorders. As is the case for harvested organs, the ideal bioengineered graft would comprise vascularized endocrine tissue, contain blood vessels that could be anastomosed to host vessels, have stable blood flow, and be suitable for transplantation into various sites.

Endothelial tissue remodeling induced by intraluminal pressure enhances paracellular solute transport.

The endothelial layers of the microvasculature regulate the transport of solutes to the surrounding tissues. It remains unclear how this barrier function is affected by blood flow-induced intraluminal pressure. Using a 3D microvessel model, we compare the transport of macromolecules through endothelial tissues at mechanical rest or with intraluminal pressure, and correlate these data with electron microscopy of endothelial junctions.

Surgical Treatment of Ischial Ulcers Associated with Deposition of β2-Microglobulin in Two Cases of Dialysis-related Amyloidosis.

The accumulation of β2-microglobulin due to long-term hemodialysis is known as dialysis-related amyloidosis, a rare phenomenon that manifests as a subcutaneous mass. Subcutaneous β2-microglobulin amyloidomas are predominantly located on the buttocks. Owing to the load-bearing properties of this location and proximity to the anus, amyloidomas on the buttocks may be prone to pressure ulcers and infection.

Cardiac 18F‑FDG uptake and new‑onset rectal cancer.

The present study aimed to investigate the factors affecting the cardiac uptake of 18F-fluorodeoxyglucose (18F-FDG) during 18F-FDG positron emission tomography (PET) for new-onset rectal cancer and new-onset colon cancer (ascending, transverse, descending, sigmoid colon cancer) and to examine the association between the cardiac uptake of 18F-FDG and prognosis. The participants were diagnosed with new-onset rectal cancer and new-onset colon cancer (ascending, transverse, descending, sigmoid cancer) at the Iga City General Hospital (Iga, Japan) between January 1, 2013, and March 31, 2018, and underwent an 18F-FDG PET scan for pretreatment staging. The relationship between cardiac maximum standard uptake value (SUVmax), the presence/absence of distant metastasis and prognosis was examined.

Efficacy of the pedicle trapezius muscle flap for the multisurgical removal of pediatric posterior fossa anaplastic ependymoma.

Objective: Exceedingly refractory, pediatric anaplastic ependymoma in many cases requires multisurgical removal. The high risk of poor wound healing and CSF leakage especially at the posterior fossa make this tumor difficult to treat.

Case: A 9-year-old girl has had 4th ventricular anaplastic ependymoma since the age of 3.

Continuous local intravenous heparin infusion after re-exploration for venous congestion in free-flap breast reconstruction: A case series.

We demonstrated local intravenous heparin infusion to salvage flaps after re-exploration for postoperative venous congestion after free-flap breast reconstruction. All flaps were salvaged using local intravenous heparin infusion without major complications. Local intravenous heparin infusion is an effective and safe procedure.

Gemini Anastomosis for Dual Venous Anastomosis in Head and Neck Reconstruction.

Free tissue transfer has been frequently used in head and neck reconstruction. However, vascular problems still cause serious damage to patients when thromboses occur in microvascular anastomoses. In the Gemini anastomosis procedure, two flap pedicle veins are anastomosed adjacently to the internal jugular vein using the end-to-side anastomosis method.

Students' perception of problem-based learning at a Japanese medical school: an exploratory sequential mixed method.

Objectives: This study aimed to assess the perception of PBL among Japanese medical students.

Methods: Learning effects and challenges of PBL from the students' viewpoint were assessed with an exploratory sequential mixed method. Focus group discussions followed by thematic analysis were conducted with 27 students and residents.

Sensate Reverse Medial Plantar Flap for Reliable Forefoot Reconstruction with Flow-through Anterolateral Thigh Flap.

A reverse medial plantar flap is a major option for reconstructing the plantar forefoot. However, reconstruction of the distal forefoot stretches the vessels, causing tightness, and the skin graft to the donor site adds pressure to the vessel, precipitating venous congestion. We used a reverse medial plantar flap to reconstruct the lateral distal forefoot with a flow-through of the anterolateral thigh (ALT) flap for donor site coverage to maintain physiological and stable blood flow.

A neuroendocrine tumor within an anterior mediastinal mature teratoma: a case report.

Background: Mature teratomas are benign germ cell tumors. On rare occasions, they have been associated with somatic malignancies and are termed rare germ cell tumors with a somatic-type malignancy (GCTSM). Mature teratomas commonly comprise adenocarcinomas; only seven previous cases of mature teratomas with neuroendocrine tumors have been reported to date.

A trial to visualize perforators images from CTA with a tablet device: experience of operating on minipigs.

A reliable method for precise perforator mapping can be extremely valuable in perforator flap surgery. In this study, we attempted to map perforator location using 3-dimensional computed tomography angiography (CTA), a newly developed application, and a tablet device. Preliminary examinations to test the device were conducted in mini-pigs.

Functional analysis of mutant SLCO2A1 transporters found in patients with chronic enteropathy associated with SLCO2A1.

Background And Aim: Chronic enteropathy associated with the solute carrier organic anion transporter family member 2A1 (SLCO2A1), or CEAS, causes anemia and hypoalbuminemia in young people. Dysfunction of the SLCO2A1 transporter protein is thought to involve genetic mutation, but mutant proteins have not been functionally characterized. We examined the prostaglandin E (PGE ) transport ability of recombinant SLCO2A1 proteins containing 11 SLCO2A1 mutations found in CEAS patients.

Impact of COVID-19 pandemic on the care of severe burns in Japan: Repeated survey of specialized burn care facilities.

Background: The spread of coronavirus disease 2019 (COVID-19), which began in 2020, has had a major impact on healthcare systems. The spread of COVID-19 has been reported to have affected the readiness to treat patients with burns worldwide. However, the existing reports have evaluated burn care status within a limited time period during the pandemic, and no report clarifies the change in the impact of infection status on burn care from the beginning of the pandemic to the present.