Distribution of internal thoracic artery perforators: A clincal anatomy study

There are various modifications of the transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap to reduce the morbidity of the donor site or to augment the vascularity of the flap. For microanastomosis of multiple pedicles, multiple recipient vessels or an intervening vein graft should be provided. In addition, alternative perforator‐based flaps used in breast reconstruction have small caliber pedicles. Therefore, small recipient vessels such as internal thoracic artery perforators are more suitable for appropriate microanastomosis. Therefore, it is important to acquaint the distribution and anatomical characteristics of internal thoracic artery perforators. We researched the perforators running in the intercostal spaces under the pectoralis major muscle to provide an overview of the anatomical distribution and characteristics of the perforators in patients who underwent immediate subpectoral implant‐based breast reconstructions. In our study, the major perforators (diameter > 1.5 mm) were easily found 2–7 cm medially between the third and fourth intercostal space and were sparse in the lateral area from the midline of the breast (usually 8–9 cm lateral to the midsternal line) and above the third rib. In each side of the breast, the average number of perforators greater than 1.5 mm was 1.6, and the average number of perforators between 1 mm and 1.5 mm in diameter was 3.2. Our results provide information about perforators in the anterior chest wall related to the breast area. Clin. Anat. 32:471–475, 2019. © 2018 Wiley Periodicals, Inc.     

Long-term efficacy and safety of aripiprazole in patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder: 26-week prospective study

Aims:  To date there have been no reports of long-term efficacy of aripiprazole in Asian populations. The aim of the present study was therefore to investigate the long-term efficacy, safety and tolerability of aripiprazole in a large number of patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder in Korea.
Methods:  This study was a prospective, multicenter, single-group, 26-week open study of patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder. A total of 300 Korean patients participated in the study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures included the PANSS positive and negative subscales, Clinical Global Impression–Severity of Illness (CGI-S). Tolerability and safety were assessed by monitoring the frequency and severity of treatment-emergent adverse events, extrapyramidal symptoms (EPS), vital signs, weight, and laboratory tests.
Results:  Aripiprazole produced rapid and significant improvements on all efficacy measures. As evidenced by PANSS total score, PANSS positive subscales and the CGI-S scores, first-episode drug-naïve patients demonstrated significantly greater efficacy relative to patients who had previously experienced one or more episodes of relapse. Aripiprazole was associated with significant decrease of serum prolactin level. The subjects showed mild weight gain.
Conclusion:  Aripiprazole is an effective antipsychotic in the long-term treatment of both positive and negative symptoms. This study extends the findings of previous long-term studies, and has found that there is no significant difference with regard to ethnicity in response to aripiprazole.     

Optimizing tissue clearing and imaging methods for human brain tissue

ObjectivesTo identify optimum sample conditions for human brains, we compared the clearing efficiency, antibody staining efficiency, and artifacts between fresh and cadaver samples.MethodsFresh and cadaver samples were cleared using X-CLARITY™. Clearing efficiency and artifact levels were calculated using ImageJ, and antibody staining efficiency was evaluated after confocal microscopy imaging. Three staining methods were compared: 4-day staining (4DS), 11-day staining (11DS), and 4-day staining with a commercial kit (4DS-C). The optimum staining method was then selected by evaluating staining time, depth, method complexity, contamination, and cost.ResultsFresh samples outperformed cadaver samples in terms of the time and quality of clearing, artifacts, and 4′,6-diamidino-2-phenylindole (DAPI) staining efficiency, but had a glial fibrillary acidic protein (GFAP) staining efficiency that was similar to that of cadaver samples. The penetration depth and DAPI staining improved in fresh samples as the incubation period lengthened. 4DS-C was the best method, with the deepest penetration. Human brain images containing blood vessels, cell nuclei, and astrocytes were visualized three-dimensionally. The chemical dye staining depth reached 800 µm and immunostaining depth exceeded 200 µm in 4 days.ConclusionsWe present optimized sample preparation and staining protocols for the visualization of three-dimensional macrostructure in the human brain.     

Effect of eccentric load cycling on microleakage of Class V flowable and packable composite resin restorations.

Class V composite restorations are subject to the stresses that induce non-carious cervical lesions. This study evaluated the effect of eccentric oblique load on microleakage of restorations. Class V cavities were randomly prepared on the buccal surfaces of 40 recently extracted premolars and restored with composite resin according to manufacturers' directions. Teeth were randomly assigned to one of four treatment groups with 10 teeth per group: (1) flowable resin (Revolution) without load cycling; (2) packable resin (Prodigy Condensable) without load cycling; (3) flowable resin with load cycling (200,000 cycles) and (4) packable resin with load cycling (200,000 cycles). All teeth were then immersed in 2% methylene blue solution for 24 hours after thermocycling (500 cycles). Dye penetration was measured (scores 0-3). The results indicated that adding load cycling significantly increased microleakage (p < 0.05). No significant differences in microleakage were observed for flowable resin vs packable resin. Gingival margins had significantly more microleakage (p < 0.05) than occlusal margins.     

Self-assembly of and charge transfer at N-docosyl-N′-methyl viologen on electrode surfaces

Self-assembled molecular films were formed on the electrode surfaces of glassy carbon (GC), platinum (Pt), gold, silver and indium–tin oxide in aqueous electrolyte solutions of N-docosyl-N′-methyl viologen (C₂₂VC₁). The temperature dependence of voltammetric responses showed a higher stability with higher surface coverage and with a Pt than a GC surface. Charge transfer reactions of the solution redox species of Ru(NH₃)₆³⁺ and Fe(CN)₆^4? at the irreversibly self-assembled C₂₂VC₁ ∣ GC interface were found to take place by an interplay of direct penetration of solution species through the self-assembled molecular layer of C₂₂VC₁ and of cross reaction between solution and surface bound redox agents.     

Expression of mitotic checkpoint proteins BUB1B and MAD2L1 in salivary duct carcinomas

J Oral Pathol Med (2010) 39 : 349–355 Objective: Defects in the mitotic checkpoint lead to aneuploidy and might facilitate tumorigenesis. However, the ploidy status in salivary duct carcinoma (SDC) has been reported to play limited role in prediction of prognosis. Thus, we need more reliable markers to reflect the rapid tumor progression in SDCs. We aimed here to investigate the expression of mitotic checkpoint proteins benzimidazole 1 homolog beta (BUB1B) and mitosis arrest‐deficient 2 like 1 (MAD2L1) in SDCs and to determine their possible role as surrogate prognostic markers. Methods: We analyzed the clinical courses, pathologic findings and immunohistochemical profiles of mitotic checkpoint proteins (BUB1B and MAD2L1) in 27 pathologically confirmed SDCs. The expression status of BUB1B and MAD2L1 was compared with clinicopathologic factors and other molecular markers, such as TGF‐beta, c‐erb‐B2, androgen receptor, vascular endothelial growth factor, and epidermal growth factor receptor, for prognostic significance. Results: High BUB1B expression was detected in 25.9% of subjects, and high MAD2L1 expression was in 55.6% of subjects. However, survival analysis revealed that mitotic checkpoint expression did not have prognostic significance in SDCs, nor did the other studied markers. Rather, the clinical variable of N classification at diagnosis (in N+ status, hazard ratio 5.19, 95% CI 1.26–21.32 for disease‐free survival and hazard ratio 7.18, 95% CI 1.09–46.99 for overall survival) was strongly associated with survival and prognosis based on the Cox proportional hazard model. Conclusions: Mitotic checkpoint proteins appeared to play a limited role in predicting prognosis in SDCs. Further study is required to elucidate the exact role of mitotic checkpoint proteins in SDCs.     

Differential effect of autoinducer 2 of Fusobacterium nucleatum on oral streptococci

Autoinducer 2 (AI-2) is a quorum sensing molecule and plays an important role in dental biofilm formation, mediating interspecies communication and virulence expression of oral bacteria. Fusobacterium nucleatum connects early colonizing commensals and late colonizing periodontopathogens. F. nucleatum AI-2 and quorum sensing inhibitors (QSIs) can manipulate dental biofilm formation. In this study, we evaluated the effect of F. nucleatum AI-2 and QSIs on biofilm formation of Streptococcus gordonii and Streptococcus oralis, which are initial colonizers in dental biofilm. F. nucleatum AI-2 significantly enhanced biofilm growth of S. gordonii and attachment of F. nucleatum to preformed S. gordonii biofilms. By contrast, F. nucleatum AI-2 reduced biofilm growth of S. oralis and attachment of F. nucleatum to preformed S. oralis biofilms. The QSIs, (5Z)-4-bromo-5-(bromomethylene)-2(5H)-furanone and d-ribose, reversed the stimulatory and inhibitory effects of AI-2 on S. gordonii and S. oralis, respectively. In addition, co-culture using a two-compartment system showed that secreted molecules of F. nucleatum had the same effect on biofilm growth of the streptococci as AI-2. Our results demonstrate that early colonizing bacteria can influence the accretion of F. nucleatum, a secondary colonizer, which ultimately influences the binding of periodontopathogens.