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Tidsskrift For Den Norske Laegeforening... May 2023We describe a successful composite graft of a 4.5 cm piece of an amputated tongue, performed without microvascular technique.
BACKGROUND
We describe a successful composite graft of a 4.5 cm piece of an amputated tongue, performed without microvascular technique.
CASE PRESENTATION
A young adult fell off his bicycle, resulting in a traumatic amputation of part of his tongue, approximately 4.5 cm from the tip. Microvascular expertise was not available but the otolaryngologist on duty was advised to proceed with non-vascular composite graft surgery. Postoperatively the tongue was ischaemic. Marginal blood flow was assessed with ultrasound and pulse oximetry, and surgical reamputation was deferred. Several treatments were initiated to facilitate tongue revitalisation and circulation, including hyperbaric oxygen. Five months postoperatively, the patient was able to protrude his tongue to his teeth, had no problems swallowing, had improved pronunciation, and had regained some sensibility and taste.
INTERPRETATION
We strongly recommend microvascular surgery reimplantation when such competency is available, but in locations without this option we have demonstrated that a non-vascular approach with a composite graft can be attempted as a last resort.
Topics: Young Adult; Humans; Tongue; Amputation, Traumatic
PubMed: 37158513
DOI: 10.4045/tidsskr.22.0234 -
Structure (London, England : 1993) Oct 2019Vinculin and its splice isoform metavinculin play key roles in regulating cellular morphology, motility, and force transduction. Vinculin is distinct from metavinculin...
Vinculin and its splice isoform metavinculin play key roles in regulating cellular morphology, motility, and force transduction. Vinculin is distinct from metavinculin in its ability to bundle filamentous actin (F-actin). To elucidate the molecular basis for these differences, we employed computational and experimental approaches. Results from these analyses suggest that the C terminus of both vinculin and metavinculin form stable interactions with the F-actin surface. However, the metavinculin tail (MVt) domain contains a 68 amino acid insert, with helix 1 (H1) sequestered into a globular subdomain, which protrudes from the F-actin surface and prevents actin bundling by sterically occluding actin filaments. Consistent with our model, deletion and selective point mutations within the MVt H1 disrupt this protruding structure, and facilitate actin bundling similar to vinculin tail (Vt) domain.
Topics: Actins; Alternative Splicing; Animals; Binding Sites; Cryoelectron Microscopy; Models, Molecular; Mutation; Protein Binding; Protein Domains; Protein Structure, Secondary; Vinculin
PubMed: 31422909
DOI: 10.1016/j.str.2019.07.013 -
Journal of Biosciences 2020Primary cilia are non-motile, microtubule-based, antennae-like organelle that protrude out from the cell surface and perform sensory function or transduce physiological... (Review)
Review
Primary cilia are non-motile, microtubule-based, antennae-like organelle that protrude out from the cell surface and perform sensory function or transduce physiological signals in majority of the vertebrate cells. Cilia are assembled on basal bodies that are transformed centrioles. The assembly-disassembly of primary cilia may pose an additional measure on regulating cell cycle in vertebrate cells. While primary cilia are commonly found in differentiated or quiescent cells that are not cycling, disassembly of primary cilia may promote re-entry of these cells into the mitotic cycle, and support proliferation. Many cancer tissues or cancer-derived cells exhibit loss of primary cilia. However, primary cilia may also promote tumorigenesis in some contexts through growth-promoting signalling. This review will shed light on recent advancements of temporal coordination of ciliary disassembly and cell cycle progression, with a focus on how cilia loss may support tumorigenesis in various epithelial cancers.
Topics: Animals; Carcinogenesis; Cell Differentiation; Cell Proliferation; Centrioles; Cilia; Humans; Microtubules; Mitosis; Neoplasms; Signal Transduction
PubMed: 33051411
DOI: No ID Found -
Royal Society Open Science Jan 2023Brazilian sex-role reversed cave insects (genus ) have a striking structure called the gynosome (or female penis), which deeply penetrates male vagina-like genitalia...
Brazilian sex-role reversed cave insects (genus ) have a striking structure called the gynosome (or female penis), which deeply penetrates male vagina-like genitalia during copulation to receive nutritious semen. However, the protruding and retracting mechanisms of the female penis, including their evolutionary origin, are poorly understood. By using micro-computed tomography (µCT), we compared the genital morphology and musculature between species with a gynosome and others lacking this structure. As a result, we discovered two groups of muscles related to the protrusion and retraction of gynosomes. These muscles were also observed in species with non-protrusible prepenis. This suggests that evolution of these muscles preceded the acquisition of the protruding function of the gynosome, originally having a putative stimulatory function to receive nutritious semen. This intermediate stage probably allowed for the reversal of genital functions.
PubMed: 36686554
DOI: 10.1098/rsos.220471 -
The Cornell Veterinarian Jan 1978Anencephaly occurred in four calves and was characterized by cranioschisis, absence of the diencephalon with the cerebral hemispheres and rostral midbrain, various forms...
Anencephaly occurred in four calves and was characterized by cranioschisis, absence of the diencephalon with the cerebral hemispheres and rostral midbrain, various forms of eye defects, and relatively normal development of caudal brain stem, cerebellum and spinal cord. Amorphous dysplastic vestiges of the cerebral tissue protruded into the cranial defects. Morphologic features varied but were essentially similar. The cerebellum was absent in one case. Anencephaly in calves at least those we observed and defined in this study is localized defect confined to the brain, eye and skull. No spinal defect was observed in the calves.
Topics: Anencephaly; Animals; Brain; Cattle; Cattle Diseases
PubMed: 618715
DOI: No ID Found -
Evidence-based Complementary and... 2022Tongue diagnosis is a convenient and noninvasive clinical practice of traditional Chinese medicine (TCM), having existed for thousands of years. Prickle, as an essential...
Tongue diagnosis is a convenient and noninvasive clinical practice of traditional Chinese medicine (TCM), having existed for thousands of years. Prickle, as an essential indicator in TCM, appears as a large number of red thorns protruding from the tongue. The term "prickly tongue" has been used to describe the flow of qi and blood in TCM and assess the conditions of disease as well as the health status of subhealthy people. Different location and density of prickles indicate different symptoms. As proved by modern medical research, the prickles originate in the fungiform papillae, which are enlarged and protrude to form spikes like awn. Prickle recognition, however, is subjective, burdensome, and susceptible to external factors. To solve this issue, an end-to-end prickle detection workflow based on deep learning is proposed. First, raw tongue images are fed into the Swin Transformer to remove interference information. Then, segmented tongues are partitioned into four areas: root, center, tip, and margin. We manually labeled the prickles on 224 tongue images with the assistance of an OpenCV spot detector. After training on the labeled dataset, the super-resolutionfaster-RCNN extracts advanced tongue features and predicts the bounding box of each single prickle. We show the synergy of deep learning and TCM by achieving a 92.42% recall, which is 2.52% higher than the previous work. This work provides a quantitative perspective for symptoms and disease diagnosis according to tongue characteristics. Furthermore, it is convenient to transfer this portable model to detect petechiae or tooth-marks on tongue images.
PubMed: 36185091
DOI: 10.1155/2022/5899975 -
Clinical and Translational... Dec 2020In contrast to most colorectal carcinomas arising from pedunculated or sessile protruded adenomas, submucosal-invasive (pT1) colorectal carcinoma exhibiting a depressed... (Observational Study)
Observational Study
INTRODUCTION
In contrast to most colorectal carcinomas arising from pedunculated or sessile protruded adenomas, submucosal-invasive (pT1) colorectal carcinoma exhibiting a depressed surface (hereinafter, "depressed colorectal carcinoma," identified by means of high-definition endoscopy) is considered to be derived from depressed precursors. We hypothesized that depressed colorectal neoplasms have unique clinicopathological features different that are different from those of protruded and flat colorectal neoplasms.
METHODS
We classified 27,129 colorectal neoplasms (909 pT1 carcinomas and 26,220 adenomas) resected between 2001 and 2017 into depressed (211 carcinomas and 109 adenomas), flat (304 carcinomas and 11,246 adenomas), and protruded subtypes (394 carcinomas and 14,865 adenomas) and compared their clinicopathological features. As exploratory analyses of pT1 carcinomas, we conducted whole-exome sequencing for 19 depressed and 8 protruded subtypes and RNA sequencing for 8 depressed and 8 protruded subtypes.
RESULTS
pT1 carcinomas were more common in depressed lesions (66%) than in protruded (2.6%) and flat lesions (2.6%) (P < 0.001). Compared with nondepressed pT1 carcinomas, depressed pT1 carcinomas were positively correlated with lymphovascular invasion, tumor budding, and massive submucosal invasion and inversely correlated with the presence of an adenoma component (all P < 0.001). Depressed adenomas were more likely to contain high-grade dysplasia than nondepressed adenomas (49% vs 11%, P < 0.001). A KRAS mutation was observed only in one of the 19 depressed pT1 carcinomas. Relative to protruded carcinomas, depressed carcinomas generally exhibited higher expression of genes related to angiogenesis and epithelial-mesenchymal transition.
DISCUSSION
Depressed colorectal neoplasms may harbor a unique combination of malignant histopathological phenotypes and molecular features.
Topics: Adenoma; Aged; Biomarkers, Tumor; Carcinoma; Colon; Colonoscopy; Colorectal Neoplasms; DNA Mutational Analysis; Diagnosis, Differential; Epithelial-Mesenchymal Transition; Female; Gene Expression Regulation, Neoplastic; Humans; Intestinal Mucosa; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Proto-Oncogene Proteins p21(ras); RNA-Seq; Exome Sequencing
PubMed: 33512809
DOI: 10.14309/ctg.0000000000000269 -
Imaging Science in Dentistry Mar 2022This study evaluated the distance from the posterior root apices to the maxillary sinus floor (MSF) and the frequency of roots touching or protruding through the MSF...
PURPOSE
This study evaluated the distance from the posterior root apices to the maxillary sinus floor (MSF) and the frequency of roots touching or protruding through the MSF using cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
This study included 100 subjects divided into different vertical and anteroposterior skeletal growth patterns. On CBCT images, the distance from the posterior root apices to MSF was measured and the frequency of roots touching or protruding through the MSF was evaluated using NNT software (version 5.3.0.0; ImageWorks, Elmsford, NY, USA).
RESULTS
No statistically significant differences were found in the distance from the posterior root apices to the MSF among vertical skeletal groups (>0.05). The palatal roots of the first molar and the palatal, mesio-buccal and disto-buccal roots of the second molars had significantly less distance from MSF in skeletal class II than in class III (<0.05). The high-angle group had the highest frequencies of roots touching or protruding into the maxillary sinus (49.8%); the lowest proportion of these roots was found in skeletal class III (28.3%) and the highest proportion in class II (50.3%). Males had shorter distances from the posterior root apices to the MSF and higher frequencies of roots protruding through or touching the MSF than females.
CONCLUSION
Anteroposterior skeletal growth patterns and sex affected the distances from the maxillary posterior roots to the MSF. The frequency of roots protruding into or touching the sinus was affected by both vertical and anteroposterior skeletal groups and sex. These findings have implications for dental practice.
PubMed: 35387101
DOI: 10.5624/isd.20210145 -
Annals of the Royal College of Surgeons... Apr 2020A fibrovascular polyp is a rare benign pseudotumour of the oesophagus and hypopharynx. Although patients usually present with dysphagia, aspiration related mortality may...
A fibrovascular polyp is a rare benign pseudotumour of the oesophagus and hypopharynx. Although patients usually present with dysphagia, aspiration related mortality may occur. If the tumour is too large and/or located in the proximal oesophagus, it may protrude from the mouth. The general approach to treatment is complete reconstruction with cervicotomy. We present our experience of a giant oesophageal fibrovascular polyp that was protruding from the mouth and treated with endoscopic resection. A 55-year-old man was admitted to our outpatient clinic complaining of a mass protruding from his mouth when he coughed. Endoscopy and bronchoscopy both revealed a 15-18cm long polypoid mass originating from the proximal oesophagus (at the level of the hypopharynx). Complete resection was performed via endoscopy.
Topics: Esophageal Neoplasms; Esophagoscopy; Esophagus; Humans; Male; Middle Aged; Polyps; Treatment Outcome; Tumor Burden
PubMed: 31964152
DOI: 10.1308/rcsann.2020.0008 -
Pain Research & Management 2019Percutaneous epidural neuroplasty (PEN) is an effective and safe procedure for herniated lumbar disc (HLD). Although PEN has an advantage of adhesiolysis, this procedure... (Clinical Trial)
Clinical Trial
Percutaneous epidural neuroplasty (PEN) is an effective and safe procedure for herniated lumbar disc (HLD). Although PEN has an advantage of adhesiolysis, this procedure cannot decompress the protruded disc. Recently, trans-sacral epiduroscopic laser decompression (SELD) for HLD has been introduced as a promising alternative methodology. This study evaluated the clinical efficacy and safety of SELD compared to PEN, as well as the change in protruded disc volume after SELD through pre- and postoperative magnetic resonance imaging (MRI), in patients with HLD. Thirty consecutive patients underwent SELD (SELD group), and 45 patients underwent PEN (PEN group). The Visual Analog Scale (VAS) for leg pain; Oswestry Disability Index (ODI); 12-Item Short-Form Health Survey (SF-12); preoperative and postoperative 4-, 12-, and 24-week Macnab criteria; and preoperative and 24-week postoperative lumbar spinal MRIs after SELD were obtained. There was no significant difference in age, sex, duration of symptoms, and the distributions of disc level between the two groups (all > 0.05). Between the SELD and PEN groups, preoperative VAS, ODI, and SF-12 scores had no significant differences. However, the VAS, ODI, and SF-12 scores improved significantly after the procedures by postoperative week 24 in each group (all < 0.05). Furthermore, improvements of VAS, ODI, SF-12, and success rate of Macnab criteria in the SELD group were better than those in the PEN group (all < 0.05). The protruded disc volume after SELD decreased significantly (=0.034). All clinical and functional outcomes of patients undergoing SELD and PEN for HLD improved following the procedures. Notably, SELD was superior to PEN regarding the degree of improvement in clinical and functional outcomes. Therefore, we suggest that SELD can be used as an effective alternative to PEN to provide improved clinical and functional outcomes in patients with HLD.
Topics: Adult; Aged; Decompression, Surgical; Female; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Laser Therapy; Magnetic Resonance Imaging; Male; Middle Aged; Minimally Invasive Surgical Procedures; Neuroendoscopy; Sacrum; Treatment Outcome; Visual Analog Scale
PubMed: 30755783
DOI: 10.1155/2019/2893460