Notes

Automatic Self-Regulation along with Creased Hydrogels and also Plasmonic Nanoparticle Lattices.
Remote acute subdural hematoma following a decompressive craniotomy or craniectomy is a rare phenomenon. Only few cases of postoperative contralateral acute subdural hematomas have been reported in the literature review till date. This case report details a case of a 32-year-old hypertensive male who presented with severe headache, multiple episodes of vomiting, slurring of speech, nystagmus and ataxic gait for one day. Computed tomography (CT) scan of head revealed a right sided cerebellar hemorrhage with effacement of fourth ventricle and upstream hydrocephalus. A right suboccipital craniectomy and hematoma evacuation were performed. A repeat CT scan of head was done at six hours post surgery; which revealed a contralateral (left-sided) subdural hematoma involving the fronto-parieto-temporal region. The patient improved following conservative management. Contralateral acute subdural hematoma following evacuation of hematoma is a rare, but a potentially life-threatening complication; therefore, we should try to detect such contralateral hematoma and prevent clinical deterioration. Copyright © 2020, Pradhan et al.Background Apical periodontitis is caused by bacteria present in the root canal space. The removal of the infection is crucial to obtain healing. Canal irrigation is among one of the most important steps in eliminating bacteria. Sodium hypochlorite (NaOCl) is still the preferred irrigant due to its disinfecting and pulpal dissolution abilities. Heating NaOCl improves those abilities. However, the ability of intracanal heated NaOCl to kill bacteria has not yet been evaluated. Objectives This study compared the disinfecting ability of different irrigation regimens using NaOCl with and without sonic and ultrasonic agitation, and with and without intracanal heating of NaOCl. Methods The canals of extracted mandibular premolars were prepared, sterilized and infected with E. faecalis for 28 days. The canals were then assigned to eight groups of 10 teeth depending on the NaOCl irrigation protocol. Group CONV conventional irrigation with syringe and needle; Group END NaOCl sonic agitation with EndoActivator; Group EDof NaOCl. Conclusions Intracanal heating of NaOCl has the potential to be used as an adjunct to root canal irrigation in order to increase bacterial reduction in comparison to the conventional irrigation techniques involving sonic or ultrasonic agitation. Agitation of NaOCl followed by intracanal warming of the solution seems to be very promising in eliminating bacteria from infected root canals. Copyright © 2020, Yared et al.Introduction Latissimus Dorsi (LD) myocutaneous flap is a workhorse flap for various large reconstructions. Variants described to increase its volume are referred to as extended LD flaps. The extended fleur-de-lis LD is one of these variants. We report the clinical outcomes using a modified extended fleur-de-lis LD flap for complex multi-directional soft and bone tissue defects. Methods Between 2010 and 2017, 29 patients underwent the modified extended fleur-de-lis LD flaps, whose sizes were between 120 cm2 and 442 cm2. The mean age was 47.55 ± 9.07 years. Locations of the defects included head and neck (nine cases), upper extremity (six cases), lower extremity (nine cases) and chest wall regions (five cases). Results Of the 29 extended fleur-de-lis LD flaps, 11 were pedicled and 18 were free flaps. A total of 10 flaps were osteomyocutaneous and 19 were myocutaneous. The mean vertical size of the harvested skin paddle was 30.72 ± 4.57 cm (range 20-38), and the mean horizontal size of the skin paddle was 8.69 ± 0.80 (range 7-10) cm, with the mean maximum horizontal extensions of the flaps being 16.03 ± 1.18 (range 14-18) cm. KC7F2 The flap survival rates were 100%. One flap had distal partial loss (less than 5%). Donor site complications included seroma (1) and numbness (1), both of which were managed conservatively. The average follow-up time was 23.97 ± 7.19 months. Conclusion The presented modified extended fleur-de-lis LD myocutaneous/osteomyocutaneous flap for reconstruction of multi-directional complex soft tissue and bone defects is a good and reliable option, with low donor site morbidity. Copyright © 2020, Ciudad et al.Objective The optimal treatment for a craniopharyngioma has been controversial. Complete resection is ideal, but it has been difficult to obtain total resection in many cases because of intimate proximity to critical structures such as the optic pathway, hypothalamus, and pituitary gland. A growing number of studies have demonstrated the utility of radiosurgery in controlling residual or recurrent craniopharyngioma. However, most of them are small series. The aim of this multi-institutional study was to clarify the efficacy and safety of Gamma Knife (Elekta, Stockholm, Sweden) surgery for patients with a craniopharyngioma. Methods This was a multi-institutional retrospective study by 16 medical centers of the Japan Leksell Gamma Knife Society. Data on patients with craniopharyngiomas treated with Gamma Knife Surgery (GKS) between 1991 and 2013 were obtained from individual institutional review board-approved databases at each center. A total of 242 patients with craniopharyngioma were included in this study. The mean age of the patients was 41 (range, 3 to 86) years. The median follow-up time was 61.4 months (range, 3 to 180 months). The mean radiosurgery target volume was 3.1 ml (range, 0.03-22.3 ml), and the mean marginal dose was 11.4 Gy (range, 8-20.4 Gy). Results Two-hundred twenty patients were alive at the time of the last follow-up visit. The three-, five-, and 10-year overall survival rates after GKS were 95.4%, 92.5%, and 82.0%, respectively. The three-, five-, and 10-year progression-free survival rates after GKS were 73.1%, 62.2%, and 42.6% respectively. The rate of radiation-induced complications was 6.2%. Conclusion GKS is effective for controlling the tumor growth of craniopharyngiomas with an acceptable complication rate. Copyright © 2020, Tsugawa et al.Background Genetic pathways involved with flower color and shape are thought to play an important role in the development of flowers associated with different pollination syndromes, such as those associated with bee, butterfly, or hummingbird pollination. Because pollination syndromes are complex traits that are orchestrated by multiple genes and pathways, the gene regulatory networks have not been explored. Gene co-expression networks provide a systems level approach to identify important contributors to floral diversification. Methods RNA-sequencing was used to assay gene expression across two stages of flower development (an early bud and an intermediate stage) in 10 species of Achimenes (Gesneriaceae). Two stage-specific co-expression networks were created from 9,503 orthologs and analyzed to identify module hubs and the network periphery. Module association with bee, butterfly, and hummingbird pollination syndromes was tested using phylogenetic mixed models. The relationship between network connectivity and evolutionary rates (d N/d S) was tested using linear models.
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