bluuebunny/crossref_metadata_2025 huggingface dataset:
Adipose-Derived Stem Cells and Vascularized Lymph Node Transfers Successfully Treat Mouse Hindlimb Secondary Lymphedema by Early Reconnection of the Lymphatic System and Lymphangiogenesis
Authors: Hayashida Kenji , Yoshida Shuhei , Yoshimoto Hiroshi , Fujioka Masaki , Saijo Hiroto , Migita Kiyoshi , Kumaya Misato , Akita Sadanori
Published: February 2017

Background:

Secondary lymphedema is often observed in postmalignancy treatment of the breast and the gynecologic organs, but effective therapies have not been established in chronic cases even with advanced physiologic operations. Currently, reconstructive surgery with novel approaches has been attempted.

Methods:

The hindlimbs of 10-week-old male C57BL/6J mice, after 30-Gy x-irradiation, surgical lymph node dissection, and 5-mm gap creation, were divided into four groups, with vascularized lymph node transfer abdominal flap and 1.0 × 104 adipose-derived stem cells. Lymphatic flow assessment, a water-displacement plethysmometer paw volumetry test, tissue quantification of lymphatic vessels, and functional analysis of lymphatic vessels and nodes were performed.

Results:

Photodynamic Eye images, using indocyanine green fluorescence, demonstrated immediate staining in subiliac lymph nodes, and linear pattern imaging of the proximal region was observed with the combined treatment of adipose-derived stem cells and vascularized lymph node transfer. Both percentage improvement and percentage deterioration with the combined treatment of adipose-derived stem cells and vascularized lymph node transfer were significantly better than with other treatments (p < 0.05). The numbers of lymphatic vessels with LYVE-1 immunoreactivity significantly increased in mice treated with adipose-derived stem cells (p < 0.05), and B16 melanoma cells were metastasized in groups treated with vascularized lymph node transfers by day 28.

Conclusions:

Adipose-derived stem cells increase the number of lymphatic vessels and vascularized lymph node transfers induce the lymphatic flow drainage to the circulatory system. Combined adipose-derived stem cell and vascularized lymph node transfer treatment in secondary lymphedema may effectively decrease edema volume and restore lymphatic function by lymphangiogenesis and the lymphatic-to-venous circulation route.
Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial
Authors: Hidalgo David A. , Weinstein Andrew L.
Published: February 2017

Background:

The purpose of this randomized controlled trial was to determine whether anatomical implants are aesthetically superior to round implants in breast augmentation.

Methods:

Seventy-five patients undergoing primary breast augmentation had a round silicone implant of optimal volume, projection, and diameter placed in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other. After intraoperative photographs were taken, the anatomical device was replaced by a round implant to complete the procedure. A survey designed to measure breast aesthetics was administered to 10 plastic surgeon and 10 lay reviewers for blind evaluation of the 75 cases.

Results:

No observable difference in breast aesthetics between anatomical and round implants was reported by plastic surgeons in 43.6 percent or by lay individuals in 29.2 percent of cases. When a difference was perceived, neither plastic surgeons nor lay individuals preferred the anatomical side more often than the round side. Plastic surgeons judged the anatomical side superior in 51.1 percent of cases and the round side superior in 48.9 percent of cases (p = 0.496). Lay individuals judged the anatomical side superior in 46.7 percent of cases and the round side superior in 53.3 percent (p = 0.140). Plastic surgeons identified implant shape correctly in only 26.5 percent of cases.

Conclusions:

This study provides high-level evidence supporting no aesthetic superiority of anatomical over round implants. Given that anatomical implants have important and unique disadvantages, a lack of proven aesthetic superiority argues against their continued use in breast augmentation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, I.
Safety and Efficacy of Subfascial Calf Augmentation
Authors: Andjelkov Katarina , Sforza Marcos , Husein Rodwan , Atanasijevic Tatjana C. , Popovic Vesna M.
Published: February 2017

Background:

Calf augmentation surgery is one of the least popular procedures among plastic surgeons; in contrast, it is by far one of the most gratifying procedures among patients. In this article, the authors present a retrospective analysis of a surgeon’s extensive experience with calf implants.

Methods:

The authors retrospectively analyzed 134 patients having calf augmentation for cosmetic and reconstructive surgery in their practice from 2003 to 2015. All patients were divided into two groups: primary cases and patients who had previously been operated on and who were referred to our service as patients who had complications after calf augmentation surgery. The subfascial approach was the preferred approach by authors for all primary cases. The authors analyzed indications, complication rates, results, and pitfalls. Secondary cases were further divided into three groups according to the origin of the problem and some possible solutions.

Results:

Subfascial calf augmentation surgery is safe and easy to reproduce, with a short recovery period and a low complication rate (<1 percent). To achieve the best aesthetic results, surgeons should choose appropriate implants for each case. In secondary cases, fat grafting is a powerful tool and can be used alone or in combination with calf implants.

Conclusions:

There are several groups of patients seeking calf augmentation surgery (e.g., bodybuilders, women, those with reconstructive problems). Therefore, treatment should be planned individually. The development of a new implant is necessary and should be based on detailed anatomical findings and in accordance with surgical techniques. The process is intriguing and rewarding.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, V.
The Importance of the Anterior Septal Angle in the Open Dorsal Approach to Rhinoplasty
Authors: Rohrich Rod J. , Dauwe Phillip B. , Pulikkottil Benson J. , Pezeshk Ronnie A.
Published: February 2017

Functional and aesthetic manipulation of the nose relies on a detailed understanding of nasal anatomy and a meticulous dissection. Maneuvers are performed in four regions of the nose: nasal tip, dorsum, posterior septum, and caudal septum. Positioned at the cornerstone of these regions, the anterior septal angle acts as a point of reference, especially in secondary rhinoplasty. Identification of the anterior septal angle early in the nasal dissection aids in reliable exposure, either wide or limited, and facilitates desired maneuvers. In addition, alteration of the position of the anterior septal angle can affect nasal tip projection, especially in cases such as the tension tip deformity. The authors emphasize the importance of the anterior septal angle in their simplified methodology for the open dorsal approach in rhinoplasty.
The Effect of Antiseptics on Adipose-Derived Stem Cells
Authors: Kim Bong-Sung , Ott Veronica , Boecker Arne Hendrick , Stromps Jan-Philipp , Paul Nora Emilie , Alharbi Ziyad , Cakmak Ercan , Bernhagen Jürgen , Bucala Richard , Pallua Norbert
Published: February 2017

Background:

Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of five different antiseptics on adipose-derived stem cells were evaluated.

Methods:

Human adipose-derived stem cells were harvested from healthy donors. Adipose-derived stem cell viability was measured after treatment with different concentrations of antiseptics over 5 days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of adipose-derived stem cells was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected.

Results:

Octenisept and Betaisodona significantly reduced cell proliferation and differentiation and led to considerable adipose-derived stem cell necrosis. Octenisept decreased stem cell viability at the lowest concentrations tested, and all stem cell markers were down-regulated by Octeniseptr and Betaisodona. Lavasept and Prontosan both led to reduced stem cell viability, proliferation, and differentiation, and increased apoptosis/necrosis, although the effects were less pronounced compared with Octenisept and Betaisodona. Adipose-derived stem cells survived treatment with mafenide acetate even at high concentrations, and mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression.

Conclusions:

Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue because of its low adipose-derived stem cell toxicity. Lavasept and Prontosan are possible alternatives to mafenide acetate. Octenisept and Betaisodona, by contrast, may be used only in highly diluted solutions.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, V.
The Double Opposing Z-Plasty Plus or Minus Buccal Flap Approach for Repair of Cleft Palate: A Review of 505 Consecutive Cases
Authors: Mann Robert J. , Martin Matthew D. , Eichhorn Mitchell G. , Neaman Keith C. , Sierzant Charles G. , Polley John W. , Girotto John A.
Published: February 2017

Background:

Standard methods of cleft palate repair rely on existing palatal tissue to achieve closure. These procedures often require relaxing incisions, causing scars and growth restriction, and may result in insufficient palatal length and suboptimal positioning of the velar musculature. The Furlow double opposing Z-plasty improves palatal length and repositions the velar musculature; however, relaxing incisions may still be needed. The addition of buccal flaps to the Furlow repair obviates the need for relaxing incisions and allows the Furlow repair to be used in wide clefts.

Methods:

A retrospective review was performed on 505 patients; all patients were treated with the double opposing Z-plasty plus or minus buccal flap approach. Outcomes included nasal resonance, secondary speech surgery, and postoperative complications. A comparison was made between patients treated with double opposing Z-plasty alone and those treated with double opposing Z-plasty plus buccal flaps.

Results:

The average nasal resonance score was 1.38 and was equivalent in both the double opposing Z-plasty alone and with buccal flap groups, despite significantly more wide clefts in the buccal flap group (56 percent versus 8 percent). The secondary surgery rate for velopharyngeal insufficiency was 6.6 percent and the fistula rate was 6.1 percent. The large fistula rate (>2 mm) was 2.7 percent.

Conclusions:

The double opposing Z-plasty plus or minus buccal flap approach is a useful alternative to standard palate repairs. Speech outcomes were excellent, even in wider clefts, and postoperative complications were minimal. Buccal flaps allow the benefits of the Furlow repair to be applied to any size cleft, without the need for relaxing incisions.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Principles of Cleft Lip Repair: Conventions, Commonalities, and Controversies
Authors: Marcus Jeffrey R. , Allori Alexander C. , Santiago Pedro E.
Published: February 2017

Learning Objectives:

After reading this article, the participant should be able to: 1. Understand the principles of contemporary methods for repair of unilateral and bilateral cleft lip. 2. Understand the design elements of a poor repair that predispose to a suboptimal outcome.

The authors describe the evaluation and management of unilateral and bilateral cleft lip (with or without cleft alveolus and with or without cleft palate). Each deformity is presented in a “principles-based” manner. For unilateral cleft lip, the authors discuss common modifications of rotation-advancement and Fisher’s anatomical subunit approach. In expert hands, both techniques can give excellent results. For bilateral cleft lip, Mulliken’s method is presented. Methods for synchronous correction of the cleft lip nasal deformity are also discussed.
Facial Feminization Surgery: Simultaneous Hair Transplant during Forehead Reconstruction
Authors: Capitán Luis , Simon Daniel , Meyer Teresa , Alcaide Antonio , Wells Alan , Bailón Carlos , Bellinga Raúl J. , Tenório Thiago , Capitán-Cañadas Fermín
Published: February 2017

Background:

Reconstruction of the frontonaso-orbital complex is one of the best-described and most commonly used procedures in the field of facial feminization surgery. To a large extent, this complex determines the facial expression and plays a key role in the visual identification of facial gender. After the forehead, the hairline pattern is the second most important feature of gender identification within the upper third of the face. The combined evaluation of these two features should be a basic premise of facial feminization surgery.

Methods:

The authors present a new surgical sequence developed by their group in which reconstruction of the frontonaso-orbital complex and redefinition of the hairline by means of an autologous hair transplant are carried out during the same operation: forehead reconstruction and simultaneous hair transplantation.

Results:

Sixty-five male-to-female transgender patients treated with forehead reconstruction and simultaneous hair transplantation are presented along with the surgical technique, sequence used, and the results obtained. A classification method for hairlines in male-to-female transgender patients is proposed based on the observation of 492 patients. A modified temporoparietooccipital coronal (posterior coronal) approach is also described.

Conclusion:

The forehead reconstruction and simultaneous hair transplant technique makes it possible to address the entire upper third of the face in a single facial feminization operation.
Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System
Authors: Daniali Lily N. , Rezzadeh Kameron , Shell Cheryl , Trovato Matthew , Ha Richard , Byrd H. Steve
Published: February 2017

Background:

A single practice’s treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings.

Methods:

A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients.

Results:

One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions.

Conclusion:

The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
The Drivers of Academic Success in Cleft and Craniofacial Centers: A 10-Year Analysis of over 2000 Publications
Authors: Plana Natalie M. , Massie Jonathan P. , Stern Marleigh J. , Alperovich Michael , Runyan Christopher M. , Staffenberg David A. , Koniaris Leonidas G. , Grayson Barry H. , Diaz-Siso J. Rodrigo , Flores Roberto L.
Published: February 2017

Background:

Cleft and craniofacial centers require significant investment by medical institutions, yet variables contributing to their academic productivity remain unknown. This study characterizes the elements associated with high academic productivity in these centers.

Methods:

The authors analyzed cleft and craniofacial centers accredited by the American Cleft Palate-Craniofacial Association. Variables such as university affiliation; resident training; number of plastic surgery, oral-maxillofacial, and dental faculty; and investment in a craniofacial surgery, craniofacial orthodontics fellowship program, or both, were obtained. Craniofacial and cleft-related research published between July of 2005 and June of 2015 was identified. A stepwise multivariable linear regression analysis was performed to measure outcomes of total publications, summative impact factor, basic science publications, total journals, and National Institutes of Health funding.

Results:

One hundred sixty centers were identified, comprising 920 active faculty, 34 craniofacial surgery fellowships, and eight craniofacial orthodontic fellowships; 2356 articles were published in 191 journals. Variables most positively associated with a high number of publications were craniofacial surgery and craniofacial orthodontics fellowships (β = 0.608), craniofacial surgery fellowships (β = 0.231), number of plastic surgery faculty (β = 0.213), and university affiliation (β = 0.165). Variables most positively associated with high a number of journals were craniofacial surgery and craniofacial orthodontics fellowships (β = 0.550), university affiliation (β = 0.251), number of plastic surgery faculty (β = 0.230), and craniofacial surgery fellowship (β = 0.218). Variables most positively associated with a high summative impact factor were craniofacial surgery and craniofacial orthodontics fellowships (β = 0.648), craniofacial surgery fellowship (β = 0.208), number of plastic surgery faculty (β = 0.207), and university affiliation (β = 0.116). Variables most positively associated with basic science publications were craniofacial surgery and craniofacial orthodontics fellowships (β = 0.676) and craniofacial surgery fellowship (β = 0.208). The only variable associated with National Institutes of Health funding was craniofacial surgery and craniofacial orthodontics fellowship (β = 0.332).

Conclusion:

Participation in both craniofacial surgery and orthodontics fellowships demonstrates the strongest association with academic success; craniofacial surgery fellowship, university affiliation, and number of surgeons are also predictive.
Torsed and Nontorsed Inguinal Undescended Testis: Comparison of Computed Tomography Findings
Authors: Klang Eyal , Kanaan Nadin , Soudack Michalle , Kleinbaum Yeruham , Heiman Zehava , Raskin Steve , Amitai Marianne Michal
Published: February 2017

Objective

The aim of this study was to compare the computed tomography imaging features of a torsed inguinal testis with nontorsed inguinal testes.

Methods

Computed tomography scans of patients with undescended testes were retrospectively collected (2011–2016). Imaging features of nontorsed undescended testis were compared with a case of an inguinal torsed testis. Observations included location of the undescended testis, size (length × width) and texture of each testis, peritesticular findings, position of testicular vessels, and enhancement patterns.

Results

Twelve nontorsed inguinal undescended testes were compared with 1 torsed undescended testicle. Torsed testis was larger than nontorsed (44 × 27 mm vs 32.9 ± 6.1 × 22.9 ± 4.9 mm), surrounded by fat stranding and fluid, with heterogeneous texture, enhancement of its outer layers, and an upward kink of its vessels.

Conclusions

Because torsed undescended testis can mimic a groin abscess and because torsion is a medical emergency, radiologists should be aware of this entity and its distinguishing imaging features. Color Doppler examination can ascertain absence/reduction of blood flow.
Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary Hypertension Etiologies
Authors: Siegel Yoel , Bleicher Drew , Gordon Michael Kurt , Fertel Debra
Published: February 2017

Objective

Pulmonary hypertension (PH) is caused by etiologies that differ in pathophysiology. Patients with undiagnosed PH may have a computed tomography pulmonary angiography (CTPA) scan during workup. Static measurements on computed tomography correlate with PH; however, dynamic parameters have received less attention. We studied the correlation between CTPA dynamic parameters and PH and assessed whether these parameters differ among PH etiologies. We also propose a method for PH screening.

Methods

Patients who underwent right-heart catheterization and CTPA within 45 days of each other were included. Charts were reviewed for presence and etiology of PH. The time it took to reach the CTPA trigger threshold during bolus tracking (TT) was recorded and compared with pulmonary pressure measured on pulmonary artery catheterization. The correlation between TT values and pulmonary pressure was studied, as well as the sensitivity and specificity of TT for PH.

Results

Twenty-seven patients with 28 examinations were included. A significant correlation was found between pulmonary pressure and TT, as well as TT and right ventricular decreased function, P < 0.01. Left heart failure showed the longest TT among PH subgroups and significantly longer TT in patients with both PH and right ventricular decreased function. Time to trigger demonstrated a sensitivity range of 75% to 92% and specificity between 56% and 88% for pulmonary pressure of 40 mm Hg or greater.

Conclusions

Dynamic parameters of flow measured on CTPA significantly correlate with pulmonary pressure and can potentially help screen for PH. Left heart failure seems to have the greatest impact on TT among patients with PH.
Comparison of the Timing of Hepatic Arterial Phase and Image Quality Using Test-Bolus and Bolus-Tracking Techniques in Gadolinium–Ethoxybenzyl–Diethylenetriamine Pentaacetic Acid–Enhanced Hepatic Dynamic Magnetic Resonance Imaging
Authors: Iyama Yuji , Nakaura Takeshi , Yokoyama Koichi , Kidoh Masafumi , Utsunomiya Daisuke , Oda Seitaro , Namimoto Tomohiro , Yamashita Yasuyuki
Published: February 2017

Objectives

The aim of this study was to compare the image quality, the degree of artifacts and the percentage of timing of the optimal hepatic arterial phase (HAP) between test-bolus and bolus-tracking methods on gadolinium–ethoxybenzyl–diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI).

Methods

In this prospective study, 60 patients who underwent 3-dimensional dynamic Gd-EOB-DTPA–enhanced hepatic 3-T MRI were enrolled in this study. We randomly assigned the 30 patients to the bolus-tracking method, and another 30 patients to the test-bolus method. Signal-to-noise ratios of the liver and spleen in HAP were compared in the 2 groups. Two radiologists independently assessed the ratio of optimal timing of HAP and the degree of ringing and motion artifacts of the 2 protocols.

Results

The signal-to-noise ratios of the liver (24.0 [SD, 6.4] vs 20.4 [SD, 4.0]) and spleen (30.0 [SD, 13.3] vs 23.6 [SD, 9.9]) were significantly higher in the test-bolus protocol than in the bolus-tracking protocol. The ratio of optimal timing was also significantly higher with the test-bolus protocol than with the bolus-tracking protocol (76.7% vs 40.0%). The degree of ringing and motion artifacts of test-bolus protocol was significantly lower than that of the bolus-tracking protocol (P < 0.01).

Conclusions

The test-bolus protocol in dynamic 3-T MRI can yield better qualitative image quality and more optimal timing of HAP images, while reducing the degree of artifacts compared with the bolus-tracking protocol.
Correlation Between Bile Reflux Gastritis and Biliary Excreted Contrast Media in the Stomach
Authors: Hyun Jong Jin , Yeom Suk Keu , Shim Euddeum , Cha Jaehyung , Choi Inyoung , Lee Seung Hwa , Chung Hwan Hoon , Cha Sang Hoon , Lee Chang Hee
Published: February 2017

Objective

This study aimed to evaluate the relationship between biliary excreted contrast media in the stomach and the presence of bile reflux gastritis.

Methods

Consecutive 111 patients who underwent both gadoxetic acid–enhanced magnetic resonance cholangiography (gadoxetic MRC) and gastric endoscopy were included in this study. We performed a review of the gadoxetic-MRC image sets acquired 60 minutes after intravenous injection of contrast media and endoscopic images. We recorded amount of contrast media in the stomach. The sensitivity, specificity, and accuracy of duodenogastric bile reflux diagnosis were evaluated for the gadoxetic MRC. Statistical analysis was performed using the Fisher exact test and the linear-by-linear association test.

Results

Among the 111 patients, 39 had 60-minute delayed images showing the presence of contrast media in the stomach. Of these 39 patients, 13 had bile reflux gastritis and 5 showed bile in the stomach without evidence of erythematous gastritis. Of the 72 patients who did not show contrast media in the stomach, none had bile reflux gastritis and 2 patients showed bile staining in the stomach without evidence of erythematous gastritis. Bile reflux gastritis was significantly more frequent in patients with contrast media in the stomach on gadoxetic MRC than in those without. Patients with high-grade extension of contrast media in the stomach had significantly frequent bile reflux gastritis than did those with low-grade extension.

Conclusion

Biliary excreted contrast media in the stomach on 60-minute delayed gadoxetic MRC has a correlation with the presence of bile reflux gastritis on endoscopic examination.
Measurement of Myocardial Extracellular Volume Fraction From Iodine Density Images Using Single-Source, Dual-Energy Computed Tomography: A Feasibility Study
Authors: Ohta Yasutoshi , Kitao Shinichiro , Watanabe Tomomi , Mukai Natsuko , Kishimoto Junichi , Yamamoto Kazuhiro , Ogawa Toshihide
Published: February 2017

Objective

The aims of this study were to develop and validate an iodine density method for the quantification of myocardial extracellular volume (ECV) fraction using single-source, dual-energy computed tomography.

Methods

Extracellular volume measurements were carried out in 40 subjects (20 patients with heart failure, 20 control subjects) using single-source, dual-energy computed tomography. Subtraction-derived ECVs (subECVs) were computed by subtracting precontrast from delayed images. Iodine density-derived ECVs (iECVs) were calculated from iodine density images obtained from delayed images. Iodine density-derived ECVs were compared with reference subECVs.

Results

A strong correlation (r = 0.896, P < 0.0001) and a small bias (−0.06%) were determined between subECV and iECV with high interobserver concordances (0.915 and 0.906, respectively). Extracellular volume measurements in patients with heart failure were higher in both subECV and iECV compared with control subjects (34.6% [SD, 5.0%] vs 29.5% [SD, 3.6%], P = 0.001, for subECV; 34.9% [SD, 4.5%] vs 29.2% [SD, 2.6%], P < 0.0001, for iECV).

Conclusions

Extracellular volume analysis using iodine density is a useful tool for the noninvasive quantification of ECV in myocardial diseases.
Diaphragmatic Hernia After Living-Donor Right Hepatectomy: An Important Late Donor Complication
Authors: Oh Ji-Won , Oh Soon Nam , Jung Seung Eun , Byun Jae Young
Published: February 2017

Objective

This study was performed to evaluate the incidence and clinical outcome of diaphragmatic hernia after living-donor right hepatectomy.

Methods

Three hundred thirty-six patients (202 men, 134 women; mean age, 37.6 years) who underwent abdominal computed tomography (CT) after right donor hepatectomy were enrolled in this study. The CT images and the electronic medical records were reviewed. We evaluated the associations between diaphragmatic hernia and patient characteristics.

Results

Diaphragmatic hernia developed in 9 (2.7%) of 336 patients at a median time interval of 173 days (range, 98–488 days) after hepatectomy. In all 6 patients with available follow-up CT images, diaphragmatic hernia increased in size. Three patients presented with abdominal pain and underwent diaphragmatic repair. Diaphragmatic hernia was associated with older age but not with body mass index or sex.

Conclusions

Clinicians and radiologists should not overlook the possibility of diaphragmatic hernia after living-donor right hepatectomy, especially in old liver donors.
Comparison of 270 Versus 320 mg I/mL of Iodixanol in 1 Image Assessment of Both Renal Arteries and Veins With Dual-Energy Spectral CT Imaging in Late Arterial Phase and Their Influence on Renal Function
Authors: Zhou Kefeng , He Jian , Qu Feng , Fan Haijian , Ma Yi , Shi Tingting , Zhou Zhengyang , Zhu Bin
Published: February 2017

Objective

The objective of this study was to compare the image quality of renal arteries and veins with dual-energy spectral computed tomography (CT) imaging in late arterial phase using 270 and 320 mg I/mL of iodixanol and their influence on renal function.

Methods

A total of 1062 patients underwent renal CT angiography with 270 or 320 mg I/mL of iodixanol with dual-energy spectral CT imaging in late arterial phase. Image quality and their influence on renal function were compared.

Results

There were no significant differences of CT value, signal-to-noise ratio, contrast-to-noise ratio, and subjective score of renal vessels between 2 groups (all P > 0.05). The incidence of contrast-induced nephropathy in patients with abnormal renal function using 320 mg I/mL of iodixanol was significantly higher than using 270 mg I/mL of iodixanol (P = 0.043).

Conclusions

The renal arteries and veins can be fully assessed in late arterial phase with 270 mg I/mL of iodixanol using dual-energy spectral CT scan with better preserved renal function.
Flexibility to contingency changes distinguishes habitual and goal-directed strategies in humans
Authors: Lee Julie J. , Keramati Mehdi
Published: February 2017

Decision-making in the real world presents the challenge of requiring flexible yet prompt behavior, a balance that has been characterized in terms of a trade-off between a slower, prospective goal-directed model-based (MB) strategy and a fast, retrospective habitual model-free (MF) strategy. Theory predicts that flexibility to changes in both reward values and transition contingencies can determine the relative influence of the two systems in reinforcement learning, but few studies have manipulated the latter. Therefore, we developed a novel two-level contingency change task in which transition contingencies between states change every few trials; MB and MF control predict different responses following these contingency changes, allowing their relative influence to be inferred. Additionally, we manipulated the rate of contingency changes in order to determine whether contingency change volatility would play a role in shifting subjects between a MB and MF strategy. We found that human subjects employed a hybrid MB/MF strategy on the task, corroborating the parallel contribution of MB and MF systems in reinforcement learning. Further, subjects did not remain at one level of MB/MF behavior but rather displayed a shift towards more MB behavior over the first two blocks that was not attributable to the rate of contingency changes but rather to the extent of training. We demonstrate that flexibility to contingency changes can distinguish MB and MF strategies, with human subjects utilizing a hybrid strategy that shifts towards more MB behavior over blocks, consequently corresponding to a higher payoff.

Author Summary

To make good decisions, we must learn to associate actions with their true outcomes. Flexibility to changes in action/outcome relationships, therefore, is essential for optimal decision-making. For example, actions can lead to outcomes that change in value – one day, your favorite food is poorly made and thus less pleasant. Alternatively, changes can occur in terms of contingencies – ordering a dish of one kind and instead receiving another. How we respond to such changes is indicative of our decision-making strategy; habitual learners will continue to choose their favorite food even if the quality has gone down, whereas goal-directed learners will soon learn it is better to choose another dish. A popular paradigm probes the effect of value changes on decision making, but the effect of contingency changes is still unexplored. Therefore, we developed a novel task to study the latter. We find that humans used a mixed habitual/goal-directed strategy in which they became more goal-directed over the course of the task, and also earned more rewards with increasing goal-directed behavior. This shows that flexibility to contingency changes is adaptive for learning from rewards, and indicates that flexibility to contingency changes can reveal which decision-making strategy is used.
Poly(A)-ClickSeq: click-chemistry for next-generation 3´-end sequencing without RNA enrichment or fragmentation
Authors: Routh Andrew , Ji Ping , Jaworski Elizabeth , Xia Zheng , Li Wei , Wagner Eric J.
Published: February 2017

The recent emergence of alternative polyadenylation (APA) as an engine driving transcriptomic diversity has stimulated the development of sequencing methodologies designed to assess genome-wide polyadenylation events. The goal of these approaches is to enrich, partition, capture, and ultimately sequence poly(A) site junctions. However, these methods often require poly(A) enrichment, 3´ linker ligation steps, and RNA fragmentation, which can necessitate higher levels of starting RNA, increase experimental error, and potentially introduce bias. We recently reported a click-chemistry based method for generating RNAseq libraries called “ClickSeq”. Here, we adapt this method to direct the cDNA synthesis specifically toward the 3´ UTR/poly(A) tail junction of cellular RNA. With this novel approach, we demonstrate sensitive and specific enrichment for poly(A) site junctions without the need for complex sample preparation, fragmentation or purification. Poly(A)-ClickSeq (PAC-seq) is therefore a simple procedure that generates high-quality RNA-seq poly(A) libraries. As a proof-of-principle, we utilized PAC-seq to explore the poly(A) landscape of both human and Drosophila cells in culture and observed outstanding overlap with existing poly(A) databases and also identified previously unannotated poly(A) sites. Moreover, we utilize PAC-seq to quantify and analyze APA events regulated by CFIm25 illustrating how this technology can be harnessed to identify alternatively polyadenylated RNA.
Oxygen consumption rate inGasterosteus aculeatus-Schistocephalus solidussystem from a non-migratory naturally infected population
Authors: Andrea Tarallo , Giuseppe D’Onofrio , Claudio Agnisola
Published: February 2017

The three spine sticklebackGasterosteus aculeatusis a specific obligatory intermediate host for the cestode wormSchistocephalus solidus. This system is commonly used to investigate the host-parasite interaction in fishes. Despite the interesting attempts which have been made to quantify the impact of the parasite over the respiration rate of the host fish, none of the previous reports took in consideration that stickleback is diversified in different ecotypes according to its ability to made reproductive migration, from and to the sea. Here the oxygen consumption rate in specimens of three-spine stickleback collected from a non-migratory population was quantified with the aim to test if theS. solidusinfection drives a change in the oxygen consumption level of the host fish. The results showed that the infected fishes have a higher rate of oxygen consumption compared with the uninfected one. The differences were due to a direct effect of the parasite, not merely to its contribution to the whole oxygen consumption rate. The data were compared with previous reports, showing that the non-migratory population was characterized by a different level of oxygen consumption rate. The differences were interpreted in terms of divergence in physiological adaptations which had to be appeared in different populations.
Controlling cell shape on hydrogels using lift-off patterning
Authors: Moeller Jens , Denisin Aleksandra K. , Sim Joo Yong , Wilson Robin E. , Ribeiro Alexandre J.S. , Pruitt Beth L.
Published: February 2017

Polyacrylamide gels functionalized with extracellular matrix proteins are commonly used as cell culture platforms to evaluate the combined effects of extracellular matrix composition, cell geometry and substrate rigidity on cell physiology. For this purpose, protein transfer onto the surface of polyacrylamide hydrogels must result in geometrically well-resolved micropatterns with homogeneous protein distribution. Yet the outcomes of micropatterning methods have not been pairwise evaluated against these criteria. We report a high-fidelity photoresist lift-off patterning method to pattern ECM proteins on polyacrylamide hydrogels ranging from 5 to 25 kPa. We directly compare the protein transfer efficiency and pattern geometrical accuracy of this protocol to the widely used microcontact printing method. Lift-off patterning achieves higher protein transfer efficiency, increases pattern accuracy, increases pattern yield, and reduces variability of these factors within arrays of patterns as it bypasses the drying and transfer steps of microcontact printing. We demonstrate that lift-off patterned hydrogels successfully control cell size and shape and enable long-term imaging of actin intracellular structure and lamellipodia dynamics when we culture epithelial cells on these substrates.
RNA Stores Tau Reversibly in Complex Coacervates
Authors: Zhang Xuemei , Lin Yanxian , Eschmann Neil A. , Zhou Hongjun , Rauch Jennifer , Hernandez Israel , Guzman Elmer , Kosik Kenneth S. , Han Songi
Published: February 2017

Non-membrane-bound organelles that behave like liquid droplets are widespread among eukaryotic cells. Their dysregulation appears to be a critical step in several neurodegenerative conditions. Here we report that tau protein, the primary constituent of Alzheimer neurofibrillary tangles, can form liquid droplets and therefore has the necessary biophysical properties to undergo liquid-liquid phase separation (LLPS) in cells. Consonant with the factors that induce LLPS, tau is an intrinsically disordered protein that complexes with RNA to form droplets. Uniquely, the pool of RNAs to which tau binds in living cells are tRNAs. This phase state of tau is held in an approximately 1:1 charge balance across the protein and the nucleic acid constituents, and can thus be maximal at different RNA:tau mass ratios depending on the biopolymer constituents involved. This feature is characteristic of complex coacervation. We furthermore show that the LLPS process is directly and sensitively tuned by salt concentration and temperature, implying it is modulated by both electrostatic interactions between the involved protein and nucleic acid constituents, as well as net changes in entropy. Despite the high protein concentration within the complex coacervate phase, tau is locally freely tumbling and capable of diffusing through the droplet interior. In fact, tau in the condensed phase state does not reveal any immediate changes in local protein packing, local conformations and local protein dynamics from that of tau in the dilute solution state. In contrast, the population of aggregation-prone tau as induced by the complexation with heparin is accompanied by large changes in local tau conformations and irreversible aggregation. However, prolonged residency within the droplet state eventually results in the emergence of detectable β-sheet structures according to thioflavin-T assay. These findings suggest that the droplet state can incubate tau and pre-dispose the protein toward the formation of insoluble fibrils.
Accumulation of sensory evidence is impaired in Parkinson’s disease with visual hallucinations
Authors: O’Callaghan Claire , Hall Julie M. , Tomassini Alessandro , Muller Alana J. , Walpola Ishan C. , Moustafa Ahmed A. , Shine James M. , Lewis Simon J. G.
Published: February 2017

Models of hallucinations across disorders emphasise an imbalance between sensory input and top-down influences over perception. However, the psychological and mechanistic correlates of this imbalance remain underspecified. Visual hallucinations in Parkinson’s disease (PD) are associated with impairments in lower level visual processes and attention, accompanied by over activity and connectivity in higher-order association brain networks. PD therefore provides an attractive framework to explore the relative contributions of bottom-up versus top-down disturbances in hallucinations. Here, we characterised sensory processing in PD patients with and without visual hallucinations, and in healthy controls, by fitting a hierarchical drift diffusion model (hDDM) to an attentional task. The hDDM uses Bayesian estimates to decompose reaction time and response output into parameters reflecting drift rates of evidence accumulation, decision thresholds and non-decision time. We observed slower drift rates in PD patients with hallucinations, which were insensitive to changes in task demand. In contrast, wider decision boundaries and shorter non-decision times relative to controls were found in PD regardless of hallucinator status. Inefficient and less flexible sensory evidence accumulation emerge as unique features of PD hallucinators. We integrate these results with current models of hallucinations, suggesting that slow and inefficient sensory input in PD is less informative, and may therefore be down-weighted leading to an over reliance on top-down influences. Our findings provide a novel computational framework to better specify the impairments in dynamic sensory processing that are a risk factor for visual hallucinations.
MRIQC: Advancing the Automatic Prediction of Image Quality in MRI from Unseen Sites
Authors: Esteban Oscar , Birman Daniel , Schaer Marie , Koyejo Oluwasanmi O. , Poldrack Russell A. , Gorgolewski Krzysztof J.
Published: February 2017

Quality control of MRI is essential for excluding problematic acquisitions and avoiding bias in subsequent image processing and analysis. Visual inspection is subjective and impractical for large scale datasets. Although automated quality assessments have been demonstrated on single-site datasets, it is unclear that solutions can generalize to unseen data acquired at new sites. Here, we introduce the MRI Quality Control tool (MRIQC), a tool for extracting quality measures and fitting a binary (accept/exclude) classifier. Our tool can be run both locally and as a free online service via the OpenNeuro.org portal. The classifier is trained on a publicly available, multi-site dataset (17 sites, N=1102). We perform model selection evaluating different normalization and feature exclusion approaches aimed at maximizing across-site generalization and estimate an accuracy of 76%±13% on new sites, using leave-one-site-out cross-validation. We confirm that result on a held-out dataset (2 sites, N=265) also obtaining a 76% accuracy. Even though the performance of the trained classifier is statistically above chance, we show that it is susceptible to site effects and unable to account for artifacts specific to new sites. MRIQC performs with high accuracy in intra-site prediction, but performance on unseen sites leaves space for improvement which might require more labeled data and new approaches to the between-site variability. Overcoming these limitations is crucial for a more objective quality assessment of neuroimaging data, and to enable the analysis of extremely large and multi-site samples.
Evolutionary dynamics of male reproductive genes in theDrosophila virilissubgroup
Authors: Ahmed-Braimah Yasir H. , Unckless Robert L. , Clark Andrew G.
Published: February 2017

Postcopulatory sexual selection (PCSS) is a potent evolutionary force that can drive rapid changes of reproductive genes within species, and thus has the potential to generate reproductive incompatibilities between species. Male seminal fluid proteins (SFPs) are major players in postmating interactions, and likely the main targets of PCSS in males. The virilis subgroup ofDrosophilaexhibits strong interspecific gametic incompatibilities, and can serve as a model to study the genetic basis of PCSS and gametic isolation. However, reproductive genes in this group have not been characterized. Here we use short-read RNA sequencing of male reproductive organs to examine the evolutionary dynamics of reproductive genes in members of the virilis subgroup:D. americana, D. lummei, D. novamexicana, andD. virilis.For each of the three male reproductive organs (accessory glands, ejaculatory bulb, and testes), we identify genes that show strong expression bias in a given tissue relative to the remaining tissues. We find that the majority of male reproductive transcripts are testes-biased, accounting for ~15% of all annotated genes. Ejaculatory bulb-biased transcripts largely code for lipid metabolic enzymes, and contain orthologs of theD. melanogasterejaculatory bulb protein, Peb-me, which is involved in mating-plug formation. In addition, we identify 71 candidate SFPs, and show that this set of genes has the highest rate of nonsynonymous codon substitution relative to testes- and ejaculatory bulb-biased genes. Furthermore, these SFPs are underrepresented on the X chromosome and are enriched for proteolytic enzymes, which is consistent with SFPs in other insect species. Surprisingly, we find 35D. melanogasterSFPs with conserved accessory gland expression in the virilis group, suggesting these genes may have conserved reproductive roles inDrosophila.Finally, we show that several of the SFPs that have the highest rate of nonsynonymous codon substitutions reside on the centromeric half of chromosome 2, which contributes to paternal gametic incompatibility between species. Our results suggest that SFPs are under strong selection in the virilis group, and likely play a major role in PCSS and/or gametic isolation.
A genome-wide interactome of DNA-associated proteins in the human liver
Authors: Ramaker Ryne C. , Savic Daniel , Hardigan Andrew A. , Newberry Kimberly , Cooper Gregory M. , Myers Richard M. , Cooper Sara J.
Published: February 2017

Large-scale efforts like the Encyclopedia of DNA Elements (ENCODE) Project have made tremendous progress in cataloging the genomic binding patterns of DNA-associated proteins (DAPs), such as transcription factors (TFs). However most chromatin immunoprecipitation-sequencing (ChIP-seq) analyses have focused on a few immortalized cell lines whose activities and physiology deviate in important ways from endogenous cells and tissues. Consequently, binding data from primary human tissue are essential to improving our understanding of in vivo gene regulation. Here we analyze ChIP-seq data for 20 DAPs assayed in two healthy human liver tissue samples, identifying more than 450,000 binding sites. We integrated binding data with transcriptome and phased whole genome data to investigate allelic DAP interactions and the impact of heterozygous sequence variation on the expression of neighboring genes. We find our tissue-based dataset demonstrates binding patterns more consistent with liver biology than cell lines, and describe uses of these data to better prioritize impactful non-coding variation. Collectively, our rich dataset offers novel insights into genome function in healthy liver tissue and provides a valuable research resource for assessing disease-related disruptions.