bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching facial fracture repair: A novel method of surgical skills training using three-dimensional biomodels
Authors: D'souza Neil , Mainprize James , Edwards Glenn , Binhammer Paul , Antonyshyn Oleh
Published: March 2018

Background

The facial fracture biomodel is a three-dimensional physical prototype of an actual facial fracture. The biomodel can be used as a novel teaching tool to facilitate technical skills training in fracture reduction and fixation, but more importantly, can help develop diagnostic and management competence.

Objective

To introduce the ‘facial fracture biomodel’ as a teaching aid, and to provide preliminary evidence of its effectiveness in teaching residents the principles of panfacial fracture repair.

Method

Computer three-dimensional image processing and rapid prototyping were used to generate an accurate physical model of a panfacial fracture, mounted in a silicon ‘soft tissue’ base. Senior plastic surgery residents in their third, fourth and fifth years of training across Canada were invited to participate in a workshop using this biomodel to simulate panfacial fracture repair. A short didactic presentation outlining the ‘patient's’ clinical and radiological findings, and key principles of fracture repair, was given by a consultant plastic surgeon before the exercise. The residents completed a pre- and postbiomodel questionnaire soliciting information regarding background, diagnosis and management, and feedback.

Result

A total of 29 residents completed both pre- and postbiomodel questionnaires. Statistically significant results were found in the following areas: diagnosis of all fracture patterns (P=8.2×10−7 [t test]), choice of incisions for adequate exposure (P=0.04 [t test]) and identifying sequence of repair (P=0.019 [x2 test]). Subjective evaluation of workshop effectiveness revealed a statistically significant increase in ‘comfort level’ only among third year trainees. Overall, positive feedback was reported among all participants.

Conclusions

Biomodelling is a promising ancillary teaching aid that can assist in teaching residents technical skills, as well as how to assess and plan surgical repair.
Arteriovenous fistulas for microvascular head and neck reconstruction
Authors: Moubayed Sami P , Giot Jean-Philippe , Odobescu Andrei , Guertin Louis , Harris Patrick G , Danino Michel Alain
Published: March 2018

Background

In head and neck cancer patients, multiple surgeries and radiation can leave the neck depleted of recipient vessels appropriate for microvascular reconstruction. The creation of temporary arteriovenous fistulas using venous interposition for subsequent microvascular reconstruction has rarely been reported in the head and neck. The authors report the largest series of temporary arteriovenous loops for head and neck reconstruction in vessel-depleted necks.

Methods

The authors performed a case series of major head and neck reconstructions using temporary arteriovenous fistulas with a saphenous vein graft. A subclavian surgical approach was used. All reconstructions were performed at least two weeks after the creation of the initial fistula.

Results

The authors have performed nine reconstructive cases for malignancy using five different free flaps. The subclavian and transerve cervical arteries were used, and the subclavian, internal jugular and cephalic veins were used for microanastomosis. Two cases of flap hematoma and one case of venous pedicle compression were recorded. No cases of flap failure were reported.

Conclusions

Reconstruction using temporary arteriovenous fistulas is a reliable technique that can be used in the vessel-depleted neck, with excellent outcomes in experienced hands.
Botulinum toxin for the prevention and healing of wound scars: A systematic review of the literature
Authors: Prodromidou Anastasia , Frountzas Maximos , Vlachos Dimitrios-Efthymios G , Vlachos Georgios D , Bakoyiannis Ioannis , Perrea Despina , Pergialiotis Vasilios
Published: March 2018

Background

Botulinum toxin injections have been investigated for the treatment or prevention of hypertrophic scars in several clinical studies. However, its clinical effectiveness has not yet been established.

Objective

To examine all available evidence that support the use of botulinum toxin injections for the treatment or prevention of hypertrophic scars in current clinical practice.

Methods

A systematic review searching the MEDLINE (1966 to 2014), Scopus (2004 to 2014), Popline (1974 to 2014), ClinicalTrials.gov (2008 to 2014) and Cochrane Central Register of Controlled Trials (CENTRAL) (1999 to 2014) databases together with reference lists from included studies was conducted.

Results

Te n studies (255 patients) were included. Of these, 123 patients were injected with botulinum toxin type A, nine patients were offered botulinum toxin type B and the remaining 123 patients represented the control groups. Significantly improved cosmetic outcomes were observed among certain studies using the visual analogue scale (experimental group: median score 8.25 [range 6 to 10]) versus control group: median score 6.38 [range 2 to 9]; P<0.001) and the Stony Brook Scar Evaluation Scale (experimental group score: 6.7 versus control group score: 4.17; P<0.001) assessments. However, the methodological heterogeneity of the included studies, the lack of control group in the majority of them, the use of subjective scales of measurement and the frequent use of patient self-assessment precluded unbiased results.

Conclusions

Current evidence does not support the usage of botulinum toxin. Future randomized controlled trials are needed in the field to reach firm conclusions regarding its place in current clinical practice.
Ischemic bowel as a late sequela of abdominal compartment syndrome secondary to severe burn injury
Authors: Sun Ken , Hancock Betty Jean , Logsetty Sarvesh
Published: March 2018

Abdominal compartment syndrome (ACS) is a known complication of the large-volume resuscitation that burn patients receive. Bowel ischemia has been theorized to occur in ACS but has yet to be described in the literature. The authors report an occurrence of late bowel obstruction related to ACS-associated bowel ischemia in a burn patient.

A four-year-old previously well girl sustained 70% total body surface area burns with inhalation injury. The areas injured were the anterior neck, circumferential torso from neck to waist, left arm, left thigh and two-thirds of her right thigh. Fluid resuscitation was initially administered using the modified Parkland formula. Her transfer to the regional burn unit from a local hospital was complicated by early septic shock from a line infection, which increased her resuscitation fluid requirements. Infection ultimately led to multiple instances of ACS. Intervention with percutaneous drainage led to immediate improvement; however, the episodes of ACS resulted in a late small bowel obstruction secondary to stricture, requiring a laparotomy and bowel resection.
Adverse outcomes following hand surgery in patients with rheumatoid arthritis
Authors: Menchaca-Tapia Victor M , Rodríguez Elizabeth M , Contreras-Yáñez Irazú , Iglesias-Morales Martin , Pascual-Ramos Virginia
Published: March 2018

Background

Up to 70% of patients with long-standing rheumatoid arthritis (RA) may present with rheumatic hand disease and benefit from hand surgical procedures (HSPs).

Objective

Through retrospective review, the present study aimed to report HSPs in RA patients at a tertiary care centre to identify patient adverse outcomes (AOs) and their predictors.

Methods

From 1989 to 2013, 96 patients who underwent ≥1 HSP(s) were identified from two local registries; their clinical records were independently reviewed by two trained physicians (surgeon and clinical) who used a standardized format. AOs were defined by consensus; data abstracter agreement was found in 90% of cases. Descriptive statistics were used in addition to Kaplan-Meier curves to determine the time to each AO, while logistic regression models were used to determine predictors of AOs.

Results

At first HSP, 89.6% of patients were female, had a mean (± SD) age of 49.1±12 years, a disease duration of 12.2±7.2 years, 93.6% were positive for rheumatoid factor and 24% were receiving intensive treatment. A total of 130 HSPs were performed: the most frequent interventions were arthrodesis (25.4%), resection of the ulnar head (15.4%) and tenorrhaphy (14.6%). During follow-up, 33 AOs were reported in 27 (28.1%) patients, 87% of which occurred after the first HSP. The most frequent AO subsets were impaired wound healing (18.2%) and exposed pin (15.2%). Longer disease duration at first HSP (OR 3.07 [95% CI 1.04 to 9.08]; P=0.04) and intensive treatment (OR 1.08 [95% CI 1.002 to 1.156]; P=0.045) were predictors of AOs. The optimal disease duration cut-off to predict AOs was 20.1 years.

Conclusion

Early referral of long-standing RA patients for hand surgery, along with less aggressive treatment, favoured improved surgical outcomes.
A modified mini-incisional technique for double-eyelid blepharoplasty
Authors: Hu Xiaogen , Ma Haihuan , Xue Zhiqiang , Qi Huijie , Chen Bo , Zhou Yang , Huang Wengang
Published: March 2018

Background

Double-eyelid blepharoplasty is one of the most popular cosmetic surgeries in Asia.

Objective

To introduce a modified mini-incisional technique to form a double eyelid.

Methods

A total of 372 patients (325 women, 47 men) were involved in the study between July 2008 and August 2014. Their age ranged from 16 to 34 years, with a mean age of 24 years. All patients underwent the modified mini-incisional upper blepharoplasty. In the technique, four 2 mm incisions were made along the designed fold. The orbicularis muscle overlying the levator aponeurosis was removed. The removal of the lateral fat pad was completed accordingly. The medial fat pad was also removed if necessary. Suture was used to fix the skin to pretarsal fascia along the double-eyelid line. The double-eyelid crease was formed after the operation.

Results

The follow-up period was three to 12 months (mean nine months). Most of the double eyelids were natural. During the follow-up period, 92% (342 of 372) patients were satisfied with the blepharoplasty. The most common complications were swelling within first week after the operation, which subsided spontaneously. Asymmetries occurred in 17 patients; six patients had multiple eyelids and seven patients experienced shifting of the fold. These were corrected six months after the operation. Disappearance of the fold was not observed. The scars of the stab incision became invisible after one full year of recovery. No other severe complications were found.

Conclusion

The four mini-incisional blepharoplasty technique was successful for the formation of a natural-appearing and long-lasting double eyelid. Except for individuals with obvious skin redundancy, patients with a single eyelid are suitable candidates for the technique.
Late postoperative massive bleeding in septorhinoplasty: A prospective study
Authors: Ors Safvet , Ozkose Mehmet
Published: March 2018

Background

There are various complications that can occur in septorhinoplasty, most of which are related to postoperative failure to achieve the desired aesthetic result. However, there are also many other complications, including postoperative bleeding, which is one of the most common nonaesthetic-related complications.

Objective

The present study was a prospective analysis involving a total of 750 septorhinoplasty patients, and included individuals who experienced massive bleeding after postoperative day 8.

Results

The incidence of bleeding was 2% among all patients. One percent of cases with bleeding occurred between postoperative days 8 and 14. None of the patients exhibited an abnormality in preoperative or postoperative coagulation tests. Mean blood loss was approximately 1 unit. In all patients, clots in the nose were cleaned, bleeding was subsequently controlled by placement of a polyvinyl alcohol sponge tampon soaked in adrenalin and tranexamic acid, and intravenous administration of 250 mg tranexamic acid in isotonic saline solution. This treatment was sufficient for all cases. None of the patients expereinced recurrent bleeding nor did they require a blood transfusion.

Conclusion

Late bleeding in septorhinoplasty is rare. It may be prevented by completely filling the nasal cavity so that there is no dead space between the septal mucosal membranes and the drainage opening. If bleeding occurs, it can be treated by placement of a tampon soaked in adrenalin and tranexamic acid plus intravenous administration of 250 mg tranexamic acid.
Techniques to refine the upper outer breast aesthetic subunit in alloplastic breast reconstruction: The lateral capsular flap
Authors: Degeorge Brent R , Campbell Christopher A
Published: March 2018

Background

Lateral displacement of breast implants and axillary fullness are common causes of patient dissatisfaction and reoperation following prosthetic breast reconstruction. Suture plication of the capsule and acellular dermal matrix slings have been described to address lateral implant malposition, but with unacceptably high rates of recurrence and additional cost, respectively.

Objective

To describe a novel technique using a lateral capsular flap to provide durable correction of implant malposition and, at the same time, redefinition of the lateral breast border, thereby restoring balance to the breast aesthetic subunits.

Methods

Sixteen patients presented with lateral malposition of tissue expanders or breast implants during staged implant-based breast reconstruction, four of whom had additional unwanted axillary soft tissue fullness. An anteriorly based lateral capsular flap was performed for each breast to reconstruct the lateral border of the breast, return the implant to its appropriate position and address axillary fullness when indicated.

Results

Lateral capsular flaps were performed for 16 patients (20 breasts) resulting in durable medial repositioning of the implant for a minimum of six months follow-up (range six to 60 months). Eight patients presented after implant placement with subsequent malposition while the remainder presented after tissue expander placement alone. For the eight patients with axillary fullness, elevation of the capsular flap allowed access to axillary contents for excision (four cases) or incorporation of axillary fat into the flap to prevent lateral implant palpability. No major complications, infectious complications or wound healing complications were reported. All patients showed satisfactory results, and reported high cosmetic and functional satisfaction with the appearance of their reconstructed breasts and axillary comfort.

Conclusions

In the authors' experience, the lateral capsular flap represents a simple, safe and reliable technique to correct breast implant lateral malposition, reconstruct the lateral breast border, and address unwanted axillary fullness in primary or revision implant-based breast reconstruction with improved cosmetic appearance and balance of the breast.
Evaluation of a new tension relief system for securing wound closure: a single-centre, Chinese cohort study
Authors: Huahui Zhang , Dan Xue , Hongfei Jiang , Hang Hu , Chunmao Han , Haitao Ren , Jianxin Yu , Zhiping Tao
Published: March 2018

Background

Wounds that have been closed under excessive tension, and skin defects that cannot be closed primarily, pose a daily challenge for the reconstructive surgeon.

Objective

To evaluate a new tension relief system (TRS) device for skin stretching and secure wound closure.

Methods

From September 2013 to March 2014, a consecutive series of 41 Chinese patients with 43 wounds were enrolled for application of 50 cycles of TRS therapy. TRS was used for two main clinical applications: closure of a variety of surgical/traumatic wounds; and securing wound closure after high-tension suture closure. Basic information and details regarding this therapy and its complications were recorded. Follow-up visits were conducted three to six months after wound closure.

Results

Mean residual wound width decreased approximately 20% every two days during cycles of TRS therapy. Infection was the most common complication (five cases). Other complications included dehiscence (two cases) and pressure ulcer (one case). At the six-month follow-up visit, (21 wounds in 20 patients), both the extent of healing and the scar were acceptable.

Discussion

There are no absolute contraindications to TRS therapy. The authors have formulated instructions for the prevention and treatment of the most common complications.

Conclusions

The results demonstrate that TRS therapy is a simple, effective method for primary closure of difficult wounds, and large skin and soft-tissue defects. Larger randomized studies are required to further evaluate of the effectiveness, indications, complications and cost effectiveness of this innovative TRS therapy.
Airway Management in Pierre Robin Sequence: The Vancouver Classification
Authors: Li Wai-Yee , Poon Alana , Courtemanche Douglas , Verchere Cynthia , Robertson Sandra , Bucevska Marija , Malic Claudia , Arneja Jugpal S.
Published: March 2018

Background:

Pierre Robin sequence (PRS) is a triad of micrognathia, glossoptosis, and respiratory distress. There is no standard clinical classification used in the management of neonatal airway in patients with PRS. The goal of our study was to review the presentation and management of patients with PRS and formulate a clinical grading system and treatment algorithm.

Methods:

A 10-year retrospective review of all neonates diagnosed with PRS was performed after obtaining institutional ethics approval. Patients were identified using our cleft lip and palate program database. Inclusion criteria were 2 of the following 3 clinical features—glossoptosis, retrognathia, or airway obstruction. We collected demographic data, clinical information (coexisting airway morbidity, maxillary-mandibular discrepancy, type of intervention used, complications, and outcomes (feeding, length of stay, and airway status) during the first year of life.

Results:

Sixty-three patients met our inclusion criteria. Of these, 55 (87%) had cleft palate and 17 (27%) were syndromic. Forty-eight (76%) patients were managed by prone positioning. Of the 15 surgically managed patients, the initial procedure was floor of mouth release in 7, mandibular distraction osteogenesis (MDO) in 4, and tongue-lip adhesion in 4. Five patients with coexisting airway morbidity needed a second surgery; 2 had MDO and 3 tracheostomies (one patient was later decannulated). Seven (47%) of the surgically managed patients required a gastrostomy tube.

Conclusion:

At present, there is no consensus on neonatal airway management in infants with PRS. From our review of 63 patients with PRS, we hereby propose a simple 4-point classification system and treatment algorithm, based on clinical features.
Comparing the Use of 3D Photogrammetry and Computed Tomography in Assessing the Severity of Single-Suture Nonsyndromic Craniosynostosis
Authors: Ho Olivia A. , Saber Nikoo , Stephens Derek , Clausen April , Drake James , Forrest Christopher , Phillips John
Published: March 2018

Purpose:

Single-suture nonsyndromic craniosynostosis is diagnosed using clinical assessment and computed tomography (CT). With increasing awareness of the associated risks of radiation exposure, the use of CT is particularly concerning in patients with craniosynostosis since they are exposed at a younger age and more frequently than the average child. Three-dimensional (3D) photogrammetry is advantageous—it involves no radiation, is conveniently obtainable within clinic, and does not require general anaesthesia. This study aims to assess how 3D photogrammetry compares to CT in the assessment of craniosynostosis severity, to quantify surgical outcomes, and analyze the validity of 3D photogrammetry in craniosynostosis.

Methods:

Computed tomography images and 3D photographs of patients who underwent craniosynostosis surgery were assessed and aligned to best fit. The intervening area between the CT and 3D photogrammetry curves at the supraorbital bar (bandeau) level in axial view was calculated. Statistical analysis was performed using Student t test. Ninety-five percent confidence intervals were determined and equivalence margins were applied.

Results:

In total, 41 pairs of CTs and 3D photographs were analyzed. The 95% confidence interval was 198.16 to 264.18 mm2 and the mean was 231.17 mm2. When comparisons were made in the same bandeau region omitting the temporalis muscle, the 95% confidence interval was 108.94 to 147.38 mm2, and the mean was 128.16 mm2. Although statistically significant difference between the modalities was found, they can be attributable to the dampening effect of soft tissue.

Conclusion:

Within certain error margins, 3D photogrammetry is comparable to CT in assessing the severity of single-suture nonsyndromic craniosynostosis. However, a dampening effect can be attributable to the soft tissue. Three-dimensional photogrammetry may be more applicable for severe cases of craniosynostosis but not milder deformity. It may also be beneficial for assessing the overall appearance and aesthetics but not for determining underlying bony severity.
Aesthetic Refinements in Forehead Flap Reconstruction of the Asian Nose
Authors: Hsiao Yen-Chang , Chang Chun-Shin , Zelken Jonathan
Published: March 2018

Background:

Traditional paramedian forehead flap reconstruction exploits the aesthetic subunit principle. Refinements and outcomes of forehead flap nasal reconstruction largely reflect Western experience. Differences in ethnic Asian anatomy and wound healing may foster suboptimal outcomes. We modified methods to address Asian features by extending subunit and flap boundaries, minimizing flap thinning, and overbuilding the nasal framework to combat contraction and suboptimal scarring.

Methods:

Between November 2010 and September 2015, 40 Asians were treated for nasal reconstruction with a modified forehead flap technique. Average age of 26 men and 14 women was 50.2 years (range: 10-87 years). Oncologic, traumatic, congenital, and infectious defects involving 1 (37%) or more (63%) subunits were reconstructed. Modifications to the classic forehead flap were extension of involved subunits and flap, conservative flap thinning, and framework overbuilding.

Results:

Patients were followed for 20 months (range: 16 months to 4 years 8 months). Nasal lining was reconstructed with hinge-over lining flaps, forehead flaps, free flaps, or regional flaps. Cartilage was reconstructed in 44 (88%) patients with autologous septum or ear in 33 (75%) cases. Costal cartilage was needed in 11 (25%) cases. In 48 (96%) cases, the ipsilateral forehead was used. There were 5 (10%) wound infections, 2 (4%) dehisced wounds, and 2 (4%) occurrences of distal flap necrosis. Nasal aesthetic results were 72.6% good, 23.3% fair, and 4% poor. Donor site aesthetic results were 74% good and 26% fair. Three case reports are included.

Conclusion:

We report favourable results of forehead flap nasal reconstruction using refinements tailored to ethnic Asians.
Ivy Loop Wiring: A Useful Form of Endotracheal Tube Stabilization in Burn Patients
Authors: Curran Matthew W. T. , Tredget Edward E.
Published: March 2018

The stabilization of endotracheal tubes in the burn population presents many problems. Access to the face for dressings, debridements, and the use of topical antimicrobials prevent adequate stabilization of the endotracheal tube with commonly used methods. Conventional methods have an increased risk of shifting, which can lead to injury to the friable burned tissue or unplanned extubation. To prevent these complications, alternative methods using the dentition to stabilize the endotracheal tube have been described. Here, we present our technique of using Ivy loops to secure the endotracheal tube. It is a simple method with low complications that provides a strong stabilization of the tube while giving access to the face.
Treatment of Constriction Bands of Limbs by Fat Injection: An Additional Modality
Authors: Daya Mahendra
Published: March 2018

Background:

Constriction bands in the majority of cases presents as a contour deformity. The gold standard of treatment is a single-stage constriction ring excision and serial Z-plasty. The expense is unsightly scarring. We present case reports of deformity correction by serial fat injections

Methods and Participants:

Three case studies of children in whom this modality was used in limbs to correct the deformity are presented.

Results:

Two participants showed a good correction of the deformity and in a single-case treatment failed requiring excision and serial Z-plasty for correction.

Conclusion:

Fat injection in combination with Khouri’s technique of aponeurotomies is an attractive modality of managing superficial constriction bands of limbs.
How Well Are We Doing at Teaching Critical Appraisal Skills to Our Residents? A Needs Assessment of Plastic Surgery Journal Club
Authors: Hryciw Nicole , Knox Aaron , Arneja Jugpal S.
Published: March 2018

Objective:

To perform a needs assessment of journal club in plastic surgery residency programs. Specifically, this study focused on potential gaps in journal club associated with teaching and assessing critical appraisal of the literature, an important component of medical education and practice.

Methods:

This is a qualitative study that utilized an online survey tool to collect information about the characteristics of journal club in plastic surgery residency programs in both Canada and the United States. Both program directors and residents were surveyed.

Results:

When presented with a range of objectives, both program director and resident responses identified that teaching critical appraisal skills was often the main goal of journal club in their program (67.1%). Most trainees perceived that journal club was at least somewhat effective in improving their critical appraisal skills. Despite this perception, many residents felt that they had minimal to no experience in critical appraisal of the literature upon entry into their respective residency programs (46.2%), and only 29.2% indicated that they received formal instruction regarding critical appraisal. Three-quarters of residents indicated that there was no tool provided to aid them in their analysis of the literature. Finally, most residents also responded that they were not assessed objectively with regard to their performance.

Conclusions:

Although residents in our study perceive journal club to at least somewhat improve their critical appraisal skills, evidence in the literature has been controversial. It cannot be assumed that residents are learning the skills they need by simply attending and reading the articles associated with journal club. Future study should focus on the best way to meet these objectives.
Balancing the Need for Clinical Photography With Patient Privacy Issues: The Search for a Secure SmartPhone Application to Take and Store Clinical Photographs
Authors: Dumestre Danielle O. , Fraulin Frankie O. G.
Published: March 2018

Background:

Physicians are increasingly using smartphones to take clinical photographs. This study evaluates a smartphone application for clinical photography that prioritizes and facilitates patient security.

Methods:

Ethics approval was obtained to trial a smartphone clinical photography application, PicSafe Medi. Calgary plastic surgeons and residents used the application to obtain informed consent and photograph patients. Surveys gauging the application’s usability, consent process, and photograph storage/sharing were then sent to surgeons and patients.

Results:

Over a 6-month trial period, 15 plastic surgeons and residents used the application to photograph 86 patients. Over half of the patients (57%) completed the survey. The majority of patients (96%) were satisfied with the application’s consent process, and all felt their photographs were secure. The majority (93%) of surgeons/residents completed the survey. The application was felt to overcome issues with current photography practices: inadequate consent and storage of photographs (100%), risk to patient confidentiality (92%), and unsecure photograph sharing (93%). Barriers to regular use of the application included need for cellphone service/Internet (54%), sanitary concerns due to the need for patients to sign directly on the phone (46%), inability to obtain proactive/retroactive consent (85%), and difficulty viewing photographs (80%). The majority of surgeons (85%) believe a smartphone application would be suitable for clinical patient photography, but due to its limitations, only 23% would use the trialed application.

Conclusions:

A smartphone clinical photography application addresses the patient confidentiality risks of current photography methods; however, limitations of the trialed application prevent its broad implementation.
Textural and mineral-chemistry constraints on columbite-group minerals in the Penouta deposit: evidence from magmatic and fluid-related processes
Authors: Alfonso P. , Hamid S. A. , Garcia-Valles M. , Llorens T. , López Moro F. J. , Tomasa O. , Calvo D. , Guasch E. , Anticoi H. , Oliva J. , Parcerisa D. , García Polonio F.
Published: March 2018

The Penouta Sn-Ta deposit, in the northwest of Spain, is a greisenized granitic cupola where Ta minerals occur mainly as disseminations in a leucogranite body intruded in Precambrian–Lower Cambrian gneisses and mica-schists. This leucogranite is a medium- to fine-grained inequigranular rock consisting mainly of quartz, albite, K-feldspar and muscovite. Accessory minerals are mainly of spessartine, zircon, cassiterite, Nb-Ta oxides, monazite, xenotime, native bismuth and pyrite. The alteration processes were mainly albitization, muscovitization and kaolinitization.

This leucogranite is peraluminous and P-poor, with 0.03–0.07 wt.% P2O5, 900–1500 ppm Rb, 30–65 ppm Cs, 120–533 ppm Li, 80–140 ppm Ta, 51–81 ppm Nb and up to 569 ppm of Sn.

Mineralogical characterization of Nb-Ta oxide minerals was determined by X-ray diffraction, scanning electron microscopy, electron microprobe analysis and mineral liberation analysis. Mn-rich members of the columbite-group minerals (CGM) are the most common Ta-bearing phases, but microlite, wodginite, tapiolite and Ta-rich cassiterite occur also. CGM crystals are commonly zoned concentrically, with a Nb-rich core surrounded by a Ta-rich rim, with a sharp boundary between them. Convoluted zoning occurs also. Dissolution textures resulting from the corrosion of columbite and tantalite rims, in particular, are common. The Mn/(Mn + Fe) ratio varies between 0.33 and 0.97 and the Ta/(Ta + Nb) ratio between 0.07 and 0.93. Wodginite and microlite formed as late replacements of CGM and occur associated with tantalite and cassiterite. Subhedral to anhedral cassiterite crystals, usually up to 200 μm across, occur in two generations: the earlier one is Nb,Ta-poor whereas in the later generation, the Ta content can reach >9 wt.% of Ta2O5and 1.7 wt.% of Nb. The presence of a fluid phase in the apical zone of the granite, probably related to the separation of a fluid/vapour of the melt, could explain the sponge-like textures, the Ta enrichment associated with these textures, the occurrence of Ta-enriched mineral phases (microlite and wodginite) and their common interstitial character.
Stable lines and clones of long-term proliferating normal, genetically unmodified murine common lymphoid progenitors
Authors: Kawano Yohei , Petkau Georg , Stehle Christina , Durek Pawel , Heinz Gitta Anne , Tanimoto Kousuke , Karasuyama Hajime , Mashreghi Mir-Farzin , Romagnani Chiara , Melchers Fritz
Published: March 2018

Key Points

We have established a novel culture system for long-term proliferating murine lymphoid progenitors without any genetic manipulation. The cultured lymphoid progenitors can differentiate to lymphoid and myeloid lineages in vitro and in vivo.
Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection
Authors: Dobler Claudia C. , Bosnic-Anticevich Sinthia , Armour Carol L.
Published: March 2018

The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice.

20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically.

The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk–benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances.

In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.
The cross-tissue metabolic response of abalone (Haliotis midae) to functional hypoxia
Authors: Venter Leonie , Loots Du Toit , Mienie Lodewyk J. , Jansen van Rensburg Peet J. , Mason Shayne , Vosloo Andre , Lindeque Jeremie Z.
Published: March 2018

Functional hypoxia is a stress condition caused by the abalone itself as a result of increased muscle activity, which generally necessitates the employment of anaerobic metabolism if the activity is sustained for prolonged periods. With that being said, abalone are highly reliant on anaerobic metabolism to provide partial compensation for energy production during oxygen-deprived episodes. However, current knowledge on the holistic metabolic response for energy metabolism during functional hypoxia, and the contribution of different metabolic pathways and various abalone tissues towards the overall accumulation of anaerobic end-products in abalone are scarce. Metabolomics analysis of adductor muscle, foot muscle, left gill, right gill, haemolymph and epipodial tissue samples indicated that South African abalone (Haliotis midae) subjected to functional hypoxia utilises predominantly anaerobic metabolism, and depends on all of the main metabolite classes (proteins, carbohydrates and lipids) for energy supply. Functional hypoxia caused increased levels of anaerobic end-products: lactate, alanopine, tauropine, succinate and alanine. Also, elevation in arginine levels was detected, confirming that abalone use phosphoarginine to generate energy during functional hypoxia. Different tissues showed varied metabolic responses to hypoxia, with functional hypoxia showing excessive changes in the adductor muscle and gills. From this metabolomics investigation, it becomes evident that abalone are metabolically able to produce sufficient amounts of energy when functional hypoxia is experienced. Also, tissue interplay enables the adjustment of H. midae energy requirements as their metabolism shifts from aerobic to anaerobic respiration during functional hypoxia.

This article has an associated First Person interview with the first author of the paper.
Intrinsic curvature in wool fibres is determined by the relative length of orthocortical and paracortical cells
Authors: Harland Duane P. , Vernon James A. , Woods Joy L. , Nagase Shinobu , Itou Takashi , Koike Kenzo , Scobie David A. , Grosvenor Anita J. , Dyer Jolon M. , Clerens Stefan
Published: March 2018

Hair curvature underpins structural diversity and function in mammalian coats, but what causes curl in keratin hair fibres? To obtain structural data to determine one aspect of this question, we used confocal microscopy to provide in situ measurements of the two cell types that make up the cortex of merino wool fibres, which was chosen as a well-characterised model system representative of narrow diameter hairs, such as underhairs. We measured orthocortical and paracortical cross-sectional areas, and cortical cell lengths, within individual fibre snippets of defined uniplanar curvature. This allowed a direct test of two long-standing theories of the mechanism of curvature in hairs. We found evidence contradicting the theory that curvature results from there being more cells on the side of the fibre closest to the outside, or convex edge, of curvature. In all cases, the orthocortical cells close to the outside of curvature were longer than paracortical cells close to the inside of the curvature, which supports the theory that curvature is underpinned by differences in cell type length. However, the latter theory also implies that, for all fibres, curvature should correlate with the proportions of orthocortical and paracortical cells, and we found no evidence for this. In merino wool, it appears that the absolute length of cells of each type and proportion of cells varies from fibre to fibre, and only the difference between the length of the two cell types is important. Implications for curvature in higher diameter hairs, such as guard hairs and those on the human scalp, are discussed.
Acute Effect of Noradrenergic Modulation on Motor Output Adjustment in Men
Authors: KLASS MALGORZATA , ROELANDS BART , MEEUSEN ROMAIN , DUCHATEAU JACQUES
Published: March 2018

Purpose

To determine the role of noradrenergic modulation in the control of motor output, we compared the acute effect of reboxetine (REB), a noradrenaline reuptake inhibitor, to a placebo (PLA) on knee extensors motor performance and cortical and spinal excitability.

Methods

Eleven young men took part in two randomized experiments during which they received either 8 mg of REB or a PLA. The torque produced during a maximal voluntary contraction (MVC) and its variability (i.e., coefficient of variation) during submaximal contractions ranging from 5% to 50% MVC were measured. Paired electrical (PES) and transcranial magnetic stimulation (TMS) were used to assess changes in voluntary activation during MVC, and corticospinal (motor-evoked potential (MEP)) and spinal excitability (Hoffmann (H) reflex) during contraction at 20% MVC.

Results

MVC torque and torque steadiness increased respectively by 9.5% and 24% on average in REB compared with PLA condition (P < 0.001). Voluntary activation tested by TMS and PES was greater (~3%; P < 0.05) in REB than PLA condition. The increase in voluntary activation in REB condition was significantly correlated with subjects’ initial voluntary activation level when tested by TMS (r = −0.62; P = 0.048) and PES (r = −0.86; P < 0.01). The maximal amplitudes of H reflex and MEP and the slope of their recruitment curves were enhanced by REB (P < 0.05). The ratio between the TMS-induced EMG silent period and the corresponding MEP (silent period/MEP) was reduced in REB condition (P < 0.01).

Conclusions

The present findings indicate that voluntary activation and accuracy in force control can be increased by an enhanced level of noradrenaline concentration. This improvement in motor performance is accompanied by changes located at both cortical and spinal levels.
A concise history of Salmonella spp. nomenclature
Authors: EVANGELOPOULOU GD , BOURRIEL A , SPYROU V
Published: March 2018

The history of typing strains of the genus Salmonella is a matter, perhaps, causing anxiety to those choosing to do research with this microorganism. The nomenclature and taxonomy of microorganisms of great Public Health importance, such as Salmonella, are causing proliferation of opinions and information representing various "schools of thought". They produce a difficult to manage bulk of scientific information, eventually deterring inexperienced newcomers in this field of research. In overcoming this confusing proliferation of information, international bodies, having the responsibility of summarizing and officializing available knowledge, publish regularly "landmark decisions" on nomenclature and taxonomy. The present concise review of the history of Salmonella nomenclature aims in guiding the inexperienced researchers studying salmonellosis in animals and man toward the sources of accurate information.
Applications of ultrasonography in ruminants (I): A Review.
Authors: LAZARIDIS LJ , KIOSSIS EA
Published: March 2018

In the middle of 1960s ultrasonography entered the veterinary clinical practice of large animals, almost one decade after the introduction in medicine. First ultrasonography was used to approach problems of the ovine genital system. Overtime, new applications were developed and the use of ultrasonography in large animal medicine was intensified. In the everyday veterinary clinical practice B-mode ultrasonographic devices are mainly used, with simple or convex linear array probes, with a frequency of 3.0 MHz to 7.5 MHz, while sector probes are also used. The adequate knowledge of the anatomy of the region, the appropriate restraint of the animal and a previous good clinical examination are the main prerequisites to conduct an ultrasonographic examination. In ruminants ultrasonographic examination can be applied in mainy systems. In respiratory system ultrasonography is used to evaluate the general condition of the thoracic cavity, with main diagnosticai applications in pulmonary emphysema, bronchopneumonia and aspiration pneumonia. In cardiovascular system ultrasonography contributes efficiently to the examination of the heart and the vessels. Doppler devices offer the opportunity of better estimation of some blood parameters. In the last two decades the use of ultrasonography has been propagated widely to approach problems associated to the digestive system of the ruminants and to evaluate the general condition of their peritoneal cavity. Ultrasonography is a very useful diagnostic tool to evaluate traumatic reticuloperitonitis and distension of the cecum. In cattle ultrasonographic examination of some organs, such as liver, spleen and pancreas, offers an opportunity to estimate changes in their size, contour and their position in the abdomen comparatively to their adjacent organs. Changes in the normal echotexture image are in most cases a sign of pathological conditions. Ultrasonography is useful in calves for the estimation of the condition of their umbilicus. At their first week of life, contributes to confront better some conditions such as omphalophlebitis, omphaloarteritis and omphalolourachitis. In the ruminants' urinarysystem ultrasonography is used to approach cases of urolithiasis along to the deferent section, cases with rupture of the urinary tract or cases with the presence of a mass. Application of ultrasonography in the bovine's musculoskeletal system, which has been researched thoroughly at the last two decades, offers an opportunity to image in a better way the joints which are covered by huge muscles. The anatomical and tissue function can be estimated in real time and the general condition of the animal can be evaluated. New advantages of ultrasonography are being researched, with main purpose the use of this technology as much as possible. Ultrasonography is a very effective imaging means in the service of the clinical veterinarian, which offers him the opportunity to examine in real time the area he desires in ruminants, but it doesn't replace the clinical examination.
The effect of prolonged decalcification on the immunohistochemical staining of Leishmania infantum amastigotes in formalin-fixed, paraffin-embedded canine soft tissues (lymph nodes)
Authors: PAPADOGIANNAKIS E , KOUTINAS A , KONTOS V
Published: March 2018

The aim of this report was to present the preliminary results of the effect of prolonged decalcification on the immunohistochemical staining of Leishmania infantum in formalin-fixed, paraffin-embedded canine soft tissues. A heavily parasitized by Leishmania infantum amastigotes popliteal lymph node was used in this study. One half of a surgically excised lymphnode was processed according to a decalcification protocol (for 40 days), while the other half was processed without decalcification. Immunohistochemical staining for Leishmania infantum was then applied on both decalcified and non-decalcified lymph node sections. The amastigotes were stained and detected in non-decalcified sections, whereas a significant reduction of immunostainingwas observed in decalcified sections. It is likely that parasite antigens are altered by the decalcification procedure, probably as a result of the long lasting effect of decalcifying acids on both the amastigotes and the host cell cytoplasm. Consequently, it seems that immunohistochemical detection of Leishmania infantum amastigotes is significantly affected following prolonged tissue decalcification.
The effects of four protocols for the treatment of retained placenta on reproduction performance and milk yield in Holstein cows
Authors: MELLADO M. , SOLANO R. , VELIZ F. G. , DE SANTIAGO A. , GAYTAN L. , GARCIA J. E.
Published: March 2018

In a first study, 231 cows with retained placenta (RP) were assigned to four groups and their reproductive performance after treatment was studied. Group 1 received 2.0 mg/kg ceftiofur hydrochloride (CH), 10 mg estradiol cypionate (ECP) and 100 IU oxytocin for three consecutive days (CEO-3; n= 63). Group 2 received the same treatment for six consecutive days (CEO-6; n= 48). Group 3 was treated with CH and oxytocin for three consecutive days (CO-3; n= 68). Group 4 was subjected to the previous treatment for six consecutive days (CO-6; n=52). The control group (n= 62) did not present RP. Conception rates (CR) did not differ between treatments with values of 36.5, 25.0, 30.9, 30.8 and 33.9% for CEO-3, CEO-6, CO-3, CO-6 and control group, respectively. Services per pregnancy did not differ between groups (overall 3.6 ± 2.0; mean ± SD). In a second study, changes in milk production associated with RP were examined in cows receiving the CO-3 protocol. Data came from 360 cows with RP and 1623 served as controls. Mean 305-d milk yield was 283 ± 43 kg lower (P<0.05) in cows with RP compared to controls. It was concluded that either prolonged (6-d) or short (3-d) application of CH in combination with oxytocin and ECP were equally effective in preventing a reduction of the reproductive performance in cows suffering RP. Additionally, RP was associated with a 3% decrease in 305-d milk production.
Intra-abdominal Aspergillosis due to Aspergillus fumigatus in a Dog
Authors: KALOGIANNI L , SOUBASIS N , SARIDOMICHELAKIS M , VLEMMAS I , VELEGRAKI A , PAPAZOGLOU L , KRITSEPI-KONSTANTINOU M , RALLIS T
Published: March 2018

A 3 year-old, spayed female, mixed-breed dog presented with abdominal distension due to a large mass, detected during abdominal palpation and confirmed by abdominal imaging. Cytological examination of the mass was suggestive of pyogranulomatous inflammation. During exploratory laparotomy, extensive peritoneal adhesions and multifocal nodular lesions on the liver, spleen and omentum were revealed. One week later, the dog deteriorated and was euthanized. Numerous firm masses were observed in the liver, spleen, left kidney, stomach, small and large intestine during necropsy. The lungs, heart, and ocular structures were macroscopically normal. Histopathology results (surgery and necropsy) revealed fungal hyphae enclosed in the pyogranulomatous lesions. Polymerase chain reaction (PCR) products showed 100% homology with Aspergillus fumigatus and agar gel double diffusion was positive for IgG antibodies against the same fungus.