Three-dimensional facial hard tissue symmetry in a healthy Caucasian population group: a systematic review

Clinical Oral Investigations - The aim of this study was to quantify the symmetry of the facial hard tissue structures using three-dimensional radiographic imaging modalities in a normal Caucasian...     

Aqueous leaching of lithium from simulated pyrometallurgical slag by sodium sulfate roasting

In the pyrometallurgical treatment for spent lithium-ion batteries (LIBs), lithium is generally present in slag with Al, Ca and Si and is hard to be further treated. In this study, lithium was recovered from a simulated pyrometallurgical slag (pyro-slag) via sodium roasting and water leaching. The thermodynamic process for the reactions between slag and additives such as NaCl, NaNO₃ and Na₂SO₄ were simulated during roasting by the HSC software, where Na₂SO₄ possessed stronger chemical reactivity. The optimal conditions for roasting were experimentally determined to be 800 °C for 60 min and an Na₂SO₄/Li molar ratio of 3 : 1, followed by water leaching at 70 °C for 80 min using a liquid-to-solid (L/S) mass ratio of 30 : 1. This yielded a maximum of 93.62% lithium recovery. The mechanism by which insoluble lithium in slag was transformed into soluble lithium by salt roasting was proposed using the analysis of XRD and EDS spectra, in which ion exchange occurred between Na⁺ and Li⁺ at a certain temperature.

An effective method for the recovery of lithium from the slag formed by treating spent lithium-ion batteries.     

Reducing length of stay with the direct oral anti-coagulants in low and intermediate risk pulmonary embolism: a single center experience

Journal of Thrombosis and Thrombolysis - Direct oral anti-coagulants (DOACs) reduce hospital length-of-stay (LOS) in patients with acute pulmonary embolism (PE) in clinical trials. There is a...     

Inferiorly based thigh flap for reconstruction of defects around the knee joint

Background:

Soft-tissue defects around the knees are common in injured limbs and in the same injury the leg is often involved and the thigh is spared. Furthermore due to pliable and relatively lax skin, we have used inferiorly based thigh flap to reconstruct defects around knee joint.

Aims and Objectives:

The aim of this study is to evaluate the use of inferiorly based thigh flap to cover soft-tissue defects over the proximal one-third of the leg, patellar region, knee, and lower thigh.

Materials and Methods:

This study was conducted during the period between October 2011 and February 2013. Inferiorly based anteromedial thigh fasciocutaneous flap was performed on 12 patients and inferiorly based anterolateral thigh fasciocutaneous flap on four patients. The sites of the soft-tissue defects included patellar regions, infrapatellar region, upper one-third of leg, lower thigh, and over the knee joint.

Results:

Patients were evaluated post-operatively in terms of viability of flap, the matching of the flap with the recipient site, and donor site morbidity. All the flaps survived well except one which developed distal marginal flap loss, one in which wound dehiscence was noticed, and two in which mild venous congestion was observed. Venous congestion in two patients subsided on its own within 3 days. One patient with wound dehiscence achieved complete healing by secondary intention. Patient who developed distal flap loss required debridement and skin grafting. No appreciable donor site morbidity was encountered. Skin colour and texture of the flap matched well with the recipient site.

Conclusions:

The inferiorly based thigh flap is a reliable flap to cover the defect over proximal one-third of the leg, patellar region, knee, and lower thigh.KEY WORDS: Defect around the knee joint, inferiorly based thigh flap, perforator based flap     

Distally based posterior tibial artery perforator flap for coverage of defects around the ankle,heel and lower third of leg

Introduction

Reconstruction of distal leg region remained a difficult task. Free flaps had long been considered as a gold standard for these regions. However, due to various limitations of the free flap, a local fasciocutaneous flap could be considered as a good alternative. In this study, the use of a distally based posterior tibial artery perforator flap had been evaluated in the coverage of defects around the ankle, heel, and lower third of a leg. The study also outlined the donor-site morbidity and the technical details of the surgical procedure.

Methods

In this prospective study, a total of 42 patients with distal lower leg defects were included. The defects were located on the lower third of the leg (n?=?23), ankle (n?=?11), and heel (n?=?8). Reconstruction was performed using distally pedicled posterior tibial artery perforator flaps. Patients were evaluated in terms of viability of the flap, functional gain, and donor-site morbidity. The technical details of the operative procedure have also been outlined.

Results

All the flaps survived well, with the exception of one patient, who experienced complete flap loss. Minor complications were, however, noted in four other patients: One patient developed superficial epidermolysis; one developed postoperative venous congestion, which subsided within 3 days by conservative means, and in two patients, partial loss of the skin graft occurred at the donor site but healed completely with dressing and antibiotics. The patients were followed up for an average period of 6 months, ranging from 1 to 13 months. Donor-site morbidity was minimal.

Conclusions

It was concluded that the distally based pedicled posterior tibial artery perforator flap was a reliable, easy, less time-consuming, and versatile procedure for covering the defects around the ankle, heel, and lower third a leg. Level of Evidence: Level IV, therapeutic study     

Rate-dependent aberrancy and cardiac resynchronization therapy

Left bundle branch block (LBBB) can result in significant dyssynchrony in left ventricular (LV) contraction, ultimately leading to cardiac remodeling. LBBB can be rate dependent and may appear with LV systolic dysfunction. Cardiac resynchronization therapy (CRT) has been demonstrated to improve hemodynamics as well as clinical symptoms in patients with LBBB. We describe the case of a 57-year-old man who underwent CRT implantation due to exertional dyspnea, rate-dependent LBBB, and impaired left LV systolic function.