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Background Adult acquired buried penis syndrome may be associated with an inability to void, sexual dysfunction, and recurrent infection. Previously published classification systems rely on intraoperative findings, such as penile skin quality. Objectives The purpose of this study was to evaluate outcomes after adult acquired buried penis repair and to develop a classification system based on preoperative assessment. Methods The authors reviewed data from patients who underwent buried penis reconstruction at a single institution. Patient history and physical examination guided the development of a classification system for surgical planning. Results Of the 27 patients included, the mean age was 56 ± 15 years and mean body mass index was 49 ± 14 kg/m2. Patients were classified into 4 groups based on examination findings: (I) buried penis due to skin deficiency, iatrogenic scarring, and/or diseased penile skin (n = 3); (II) excess abdominal skin and fat (n = 6); (III) excess skin and fat with diseased penile skin (n = 16); and (IV) type III plus severe scrotal edema (n = 2). Surgical treatment (eg, excision and grafting, mons suspension, panniculectomy, translocation of testes, and/or scrotectomy) was tailored based on classification. Complications included wound breakdown (n = 3), cellulitis (n = 4), and hematoma (n = 1). Nearly all patients (96%) reported early satisfaction and improvement in their symptoms postoperatively. Conclusions Classifying patients with buried penis according to preoperative examination findings may guide surgical decision-making and preoperative counseling and allow for optimized aesthetics to enhance self-esteem and sexual well-being. Level of Evidence: 4

Mammalian skin impacts metabolic efficiency system-wide, controlling the rate of heat loss and consequent heat production. Here we compare the unique fat depots associated with mouse and human skin, to determine whether they have corresponding function and regulation. For human, we assay a skin-associated fat (SAF) body-wide depot to distinguish it from the subcutaneous fat pads characteristic of abdomen and upper limbs. We show that the thickness of SAF is not related to general adiposity; it is much thicker (1.6-fold) in women than men, and highly subject-specific. We used molecular and cellular assays of β-adrenergic induced lipolysis and found that dermal white adipose tissue (dWAT) in mice is resistant to lipolysis; in contrast, the body-wide human SAF depot becomes lipolytic, generating heat in response to β-adrenergic stimulation. In mice challenged to make more heat to maintain body temperature (either environmentally or genetically), there is a compensatory increase in thickness of dWAT: A corresponding β-adrenergic stimulation of human skin adipose (in vivo or in explant) depletes adipocyte lipid content. We summarize the regulation of skin-associated adipocytes by age, sex, and adiposity, for both species. We conclude that the body-wide dWAT depot of mice shows unique regulation that enables it to be deployed for heat preservation; combined with the actively lipolytic subcutaneous mammary fat pads they enable thermal defense. The adipose tissue that covers human subjects produces heat directly, providing an alternative to the brown adipose tissues.KEY POINTS SUMMARYSeveral distinct strategies produce and conserve heat to maintain body temperature of mammals, each associated with unique physiologies, with consequence for wellness and disease susceptibilityHighly regulated properties of skin offset the total requirement for heat productionWe hypothesize that the adipose component of skin is primarily responsible for modulating heat flux; here we evaluate the relative regulation of adipose depots in mouse and human, to test their recruitment to heat production and conservationWe found that insulating mouse dermal white adipose tissue accumulates in response to environmentally- and genetically-induced cool stress; this layer is one of two adipose depots closely apposed to mouse skin, where the subcutaneous mammary gland fat pads are actively recruited to heat productionIn contrast, the body-wide adipose depot associated with human skin produces heat directly, potentially creating an alternative to the centrally regulated brown adipose tissue

Background Few studies have examined the impact of abdominoplasty on chronic back pain. Objectives The aim of this study was to test our hypothesis that patients undergoing abdominoplasty with anterior abdominal wall plication will show significant improvements in back pain and physical function compared with those without plication. Methods We utilized Current Procedural Terminology (CPT) codes to identify patients who underwent abdominoplasty with the senior author over a 10-year period. The Oswestry Disability Index (ODI) and the RAND 36-Item Short-Form Health Survey (SF-36) were administered. All patients indicating preoperative back pain were reviewed. Results Of 338 patients, 143 surveys (42.3%) were returned; 51 patients (35.7%; n = 28 aesthetic, n = 23 massive weight loss) reported preoperative back pain on the ODI. Paired t tests compared overall and strata-specific changes in ODI and SF-36 pre- and postsurgery. Multivariable linear regression models were fitted to model relations between scores and plication, adjusting for presurgery scores and patient variables. There were significant improvements in overall patient cohort in ODI (–15.14), SF-36 physical function (19.92), and pain (17.42) (P Conclusions Abdominoplasty with and without anterior abdominal wall plication significantly improves ODI and SF-36 scores relating to physical function and pain, in both aesthetic and massive weight loss patients. Outcomes did not differ based on plication status. All patients with preoperative back pain showed improvement regardless of operation performed, suggesting that abdominoplasty with or without abdominal wall plication improves chronic back pain in this patient population. Level of Evidence: 4

This case study examines a common agricultural cooperative structure in the United States, namely that of a business which both sells farm supplies to its members and also markets, to others, the agricultural products of its members. The case concerns whether the United Agricultural Cooperative should sell the cooperative’s agronomy supply division. This division sells fertilizer, chemicals and seed. It also provides related services. The cooperative has received an acquisition inquiry from rapidly expanding agricultural retailer, Pinnacle Agricultural Holdings, LLC. The case allows readers to examine both detailed financial information as well as the cooperative’s political environment. The case ends with readers being asked to recommend a decision; namely should the cooperative sell the agronomy division or should it be kept? Professors can read the authors’ teaching note to learn recommended classroom teaching strategies and also to learn the actual decision which was made by this cooperative.

Bouma has recently been appointed to the National Milk Producers Federation's (NMPF) Board of Directors. "When my local cooperative appointed me to the NMPF board I was humbled. Now I have a lot of getting ready to do." Members of the NMPF board are also members of the Cooperatives Working Together (CWT) Committee. The committee is in charge of the CWT program, a major industry-funded effort to manage the U.S. milk supply by reducing herd numbers and subsidizing the export of dairy products. Courtney Phillips has just started her second summer internship at the Bouma Dairy Farm. She has been given the assignment of providing key information to help Mr. Bouma get ready for his role on the CWT Committee. "Courtney may like to work outside, but she is a 4.0 student in agribusiness. Through her research this summer, I can gain an understanding of both the background issues and the current operations of CWT. As a member of the board, Fd like to determine the effectiveness of CWT and also how it might be improved."

Extracellular functions of the endoplasmic reticulum chaperone protein calreticulin (CRT) are emerging. Here we show novel roles for exogenous CRT in both cutaneous wound healing and diverse processes associated with repair. Compared with platelet-derived growth factor-BB-treated controls, topical application of CRT to porcine excisional wounds enhanced the rate of wound re-epithelialization. In both normal and steroid-impaired pigs, CRT increased granulation tissue formation. Immunohistochemical analyses of the wounds 5 and 10 days after injury revealed marked up-regulation of transforming growth factor-beta3 (a key regulator of wound healing), a threefold increase in macrophage influx, and an increase in the cellular proliferation of basal keratinocytes of the new epidermis and of cells of the neodermis. In vitro studies confirmed that CRT induced a greater than twofold increase in the cellular proliferation of primary human keratinocytes, fibroblasts, and microvascular endothelial cells (with 100 pg/ml, 100 ng/ml, and 1.0 pg/ml, respectively). Moreover, using a scratch plate assay, CRT maximally induced the cellular migration of keratinocytes and fibroblasts (with 10 pg/ml and 1 ng/ml, respectively). In addition, CRT induced concentration-dependent migration of keratinocytes, fibroblasts macrophages, and monocytes in chamber assays. These in vitro bioactivities provide mechanistic support for the positive biological effects of CRT observed on both the epidermis and dermis of wounds in vivo, underscoring a significant role for CRT in the repair of cutaneous wounds.

A study of undergraduates at Texas A&M University, Purdue University, and the University of Florida reveals that students viewing grades as a contributor to career success tend to be more academically motivated. Several measures of academic motivation are examined by means of general linear and also nonlinear models. Electronic entertainment, socializing, and time spent working are all negatively associated with academic motivation. Greater academic motivation exists among females. To the extent that additional work is needed for the support of increased tuition costs, students have the potential to be less academically motivated. Copyright 2006, Oxford University Press.

A survey of agribusiness firms identifies characteristics associated with above average starting salary offers in the allied fields of agribusiness, agricultural economics, business, and economics. A complementary survey is made of students at Texas A&M University and University of Georgia. Results show that firms value work experience and leadership experience more than students do, whereas students value raising grade point average and interview preparation more than do firms. Students seeking a firm's maximum starting salary offer will need to enhance academic performance with substantial work experience and leadership experience. Copyright 2002, Oxford University Press.

Suiza Foods has rapidly grown to become the largest company in the U.S. fluid milk industry. This teaching case is designed to familiarize students with the challenges which confront Suiza in its quest for further growth and, in turn, high profitability. Interviews with top executives describe the history of Suiza as well as the rationale behind Suiza’s strategies. Information is presented on both economic and financial trends so as to allow the student to assess Suiza’s past, present and future performance.

Various authors have advocated the use of enhanced communication between cattle producers and their customers, be they first handlers, processors, retailers, or the final consumer, to help address microbial food-safety concerns (see, e.g., Buchanan, Acuff, and Halbrook). Further, as producers adopt riskmanagement strategies for veterinary drug residues and microbial pathogen contents in and on animals presented for slaughter, it is essential that these farm-level food-safety gains not be eroded downstream. The greater initial control of microbial contamination preslaughter fits neatly into the recent stageand sector-specific HACCP-based (Hazard Analysis and Critical Control Point) regulatory regimes (e.g., USDA). Indeed, without evidence of such practices, producers risk the rejection of whole lots or herds upon delivery, due to food-safety concerns arising from processor's HACCP-based systems. Combined, these elements demonstrate the importance of a close dialogue between slaughter-processing plants and their customers and suppliers on all issues that can impact food safety. Key factors at the slaughter-processing stage(s) include: comingling of animals prior to slaughter, lot size and identification on the slaughter floor, animal-to-carcass and carcass-to-cut traceability, as well as general plant hygiene, sanitation, and foodsafety activities. This article assesses the economic implications of changes in these stages, suggesting potential hurdles to the development of farm-to-table food-safety systems. Demand for Traceback

This teaching case enables students to examine basic forces transforming the structure of the dairy industry. A New Mexico family farm faces challenges associated with its large milk production volume. In an environment of rapid but uncertain change, questions regarding future management structure and investment priorities must be answered. The dairy examined is considered representative of the modern dairies of Netherlands lineage operating throughout the southwestern United States. This case does not represent an actual farm, but is a composite of realistic design.

An analysis is provided of the general value added challenge faced by farmers, cooperatives, economic development boards, and others. The VEST model is developed by which publicly traded equities (stocks) can be used directly by farmers as an alternative to traditional value added investment strategies. Numeric VEST Coefficients are developed to serve as investment guidelines for farmers seeking the benefits of value added in the grains, red meat, and poultry sectors. © 1997 John Wiley & Sons, Inc.

Food-away-from-home (FAFH) accounts for an increasingly large component of consumers' food expenditures. The concept of examining both food and non-food suppliers to the FAFH market is introduced as a vehicle to expand student awareness and career choice. Pizza is examined as an industry case study for this agribusiness teaching purpose. © 1997 John Wiley & Sons, Inc.

Hypertrophic scarring is characterized by disordered collagen fibrils. In order to determine whether this is, in part, a result of changes in the population of proteoglycans that are thought to be involved in regulation of collagen fibril formation, we have compared PGs from post-burn normal and hypertrophic scar tissue, as well as from human dermis and epidermis. Efforts to separate the two major iduronic acid-containing proteoglycans, decorin [PG(IdoA)-II] and biglycan [PG(IdoA)-I], for quantitation were not successful. The different N-terminal sequences of these two iduronic acid-containing proteoglycans PG(IdoA-I and -II were utilized to estimate the relative amounts in the above PG(IdoA) preparations. Normal scar, dermis and epidermis were all found to contain primarily decorin with low (< 10%) levels of biglycan relative to decorin. In contrast, iduronic acid-containing proteoglycans from hypertrophic scar were found to be approximately 30% biglycan [PG(IdoA)-I]. This may be a proximal cause of altered collagen fibrils, or may result in alterations in the sequestration of growth factors, which then results in changes in collagen that effect the appearance of the scar. 1966 Elsevier Science Ltd.

The ability of fetal skin wounds to heal without scar formation is remarkable. The mechanisms that endow the fetus with this unique healing ability remain unknown. We have developed an in vitro explant model using fetal sheep skin to investigate fetal wound healing. This model eliminates the complex systemic mechanisms that modulate in vivo wound healing. We demonstrated that using an enriched medium, midgestation fetal sheep skin explants following wounding reepithelialized within 4 days. By 7 days after wounding the confluent epidermis was thicker, but the dermal wound remained open. This model demonstrates that it is possible to achieve conditions in culture that maintain tissue viability and support reepithelialization. This model may allow us to resolve some of the individual components that participate in the process of scarless fetal skin healing.

Calreticulin (CRT), an intracellular chaperone protein crucial for the proper folding and transport of proteins through the endoplasmic reticulum, has more recent acclaim as a critical regulator of extracellular functions, particularly in mediating cellular migration and as a requirement for phagocytosis of apoptotic cells. Consistent with these functions, we show that the topical application of CRT has profound effects on the process of wound healing by causing a dose-dependent increase in epithelial migration and granulation tissue formation in both murine and porcine normal and impaired animal models of skin injury. These effects of CRT are substantiated, in vitro, as we show that CRT strongly induces cell migration/wound closure of human keratinocytes and fibroblasts, using a wound/scratch plate assay, and stimulates cellular proliferation of human keratinocytes, fibroblasts, and vascular endothelial cells, providing mechanistic insight into how CRT functions in repair. Similarly, in both animal models, the histology of the wounds show marked proliferation of basal keratinocytes and dermal fibroblasts, dense cellularity of the dermis with notably increased numbers of macrophages and well-organized collagen fibril deposition. Thus, CRT profoundly affects the wound healing process by recruiting cells essential for repair into the wound, stimulating cell growth, and increasing extracellular matrix production.

Detailed information on firm level food safety costs is reported. Survey data for small and very small meat processors are modeled. Economies of scale in implementing Hazard Analysis Critical Control Point (HACCP) systems are investigated. Results indicate that even after controlling for scale, very small plants incur higher compliance costs. Diseconomies of scope are assessed using the probability and number of products discontinued due to HACCP. Such “partial exit” is positively related to the current range of items produced and the need for facility modification. However, no evidence is found for higher levels of partial exit in very small plants.

The small firms examined produce meats in the State of Texas and emphasize such products as sausage, jerky, brisket, and fresh meats. The authors test hypotheses with the intent to identify operational factors associated with firm financial success. A quartile model and an econometric model are both used for this purpose. Results generally suggest important factors for firms to be profitable include product selection, pricing strategies, special equipment, and location.

Proteoglycans (PGs) were extracted from human hypertrophic and normal scar tissues from two different stages of maturation after burn injury, under dissociative conditions (4 M guanidinium chloride containing proteinase inhibitors). The extracts were fractionated by ion-exchange chromatography, followed by ethanol precipitation, to give PG-containing iduronic acid (PG IdoA ). The size of the PG IdoA decreased with the maturation of scars. Glycosaminoglycan (GAG) chains from PG IdoA were released by alkaline borohydride treatment, and their M r values were evaluated by polyacrylamide gel electrophoresis. The M r values for PG IdoA protein cores of the hypertrophic scars (5 + years and 2–5 years) and normal scar (5 + years and 2–5 years) were 22.6, 25, 19 and 21 KDa, respectively. The iduronic acid content of PG IdoA from both types of scar increased in their maturation phase. The M r , values of PG IdoA decreased with maturation. PG IdoA carried the sulfate group mainly attached at C-4 of the 2-amino-2-deoxy- d -galactose residue. The NH 2 -terminal amino acid sequences of all the PG IdoA were similar to those of normal human skin or bone PG II (decorin) (i.e., Asp-Glu-Ala-B-Gly-Ile-Gly-Pro-Glu-Val-Pro-Asp-Asp-Arg).

Hyaluronan has long been associated with the remodelling extracellular matrix. Such remodelling occurs in development, growth and wound healing. This role has been thought to be related to the physical structure and chemical composition of the pure glycosaminoglycan chain. We question this proposition and present evidence which suggests that proteins associated with hyaluronan may be more critical determinants of tissue remodelling.

Preparing students to transition from the classroom to the workplace is a matter of considerable importance. The author draws upon eleven years of experience as the vice president of a farmer-owned marketing cooperative and upon two years experience in the classroom to design a classroom teaching technique which is similar in nature to the agribusiness work environment. Methods of classroom implementation and grading are discussed.

An estimated $21 million was lost nationwide from grain elevator bankruptcies between 1974 and 1979. Ninety percent of this loss was absorbed by farmers. The remaining 10% was spread between bankers and other grain companies (Carr et al.). Hence, an important area for economic research is how elevator bankruptcy can be predicted and in turn prevented. An early warning model for grain elevator bankruptcy could alert licensing agencies and creditors to which elevators have a high probability of failure. The U.S. General Accounting Office (p. 15) recommended that the U.S. Department of Agriculture (USDA) Agricultural Marketing Service (AMS) develop such a system. Likewise, many states are trying to improve their regulatory efforts. This preliminary work can provide a first step in that direction.