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As reconstructive needs often extend past the soft tissue alone, a plastic surgeon must also be well versed in the methods of bony reconstruction. Understanding of the basic science of fracture healing and the biochemical mechanisms of the different bone grafts, bone substitutes, and orthobiologics is essential to selecting among the many different options available to the modern plastic surgeon. This review provides a broad overview of these different options and the specific applications for plastic surgeons based on anatomic location.

The nonprofit sector is a vibrant, dynamic, and expanding portion of the United States' economy. Its growth over the past two decades has opened up many avenues for entrepreneurs wishing to create corporations that are community- and need-driven, particularly in the health services industry. The fertility of this sector has not been maximized by physicians in particular due to the tortuous path of nonprofit incorporation and accreditation. This article focuses on reviewing the structure of nonprofits and streamlining the establishment process.

With the rapid rise of personalized genomic sequencing and clustered regularly interspaced short palindromic repeat (CRISPR) technology, previous gaps in gene therapy are beginning to be bridged, paving the way for increasing clinical applicability. This article aims to provide an overview of the fundamentals of gene therapy and discuss future potential interventions relevant to plastic surgeons. These interventions include enhancing tissue regeneration and healing, as well as modifying disease processes in congenital anomalies. Though clinical applications are still on the horizon, a deeper understanding of these new advances will help plastic surgeons understand the current landscape of gene therapy and stay abreast of future opportunities.

Today, cell phone technology is an integral part of everyday life and its use is not only restricted to voice conversations but also conveying news, high resolution pictures and internet. However, these advances in technology are accompanied by progressive boost in the intensity and frequency of the emitted electromagnetic waves without consideration of their health consequences. Our bodies act as parasitic antennas that receive these waves and convert them into electric and magnetic fields. While thermal effects at the present level of cell phone radiation are negligible, most of the biological interactions are attributed to non-thermal effects. Male reproductive system is highly compartmentalized and sensitive biological system that requires the integration of intrinsic and extrinsic factors to properly function. The generated electrical currents may alter the hormonal milieu and testicular microenvironment, necessary for sperm production. Additionally, sperm are electrically active cells and their exposure to cell phone electromagnetic waves and currents may affect their motility, morphology and even their count. Leaky plasma membranes, calcium depletion and oxidative stress are the postulated cellular mechanisms mediating the harmful effects of cell phones radiation on sperm and male fertility potentials. Evidences for such impacts come from designed animal and in vitro studies which may be different from in vivo human exposure. Nevertheless, the important advice is to apply strict regulations on further increase in the power density of the emitted cell phone radiation and to conduct in vivo human research to study its negative effects on fertility.

Infertility affects approximately a quarter of all couples. Of these cases, roughly half are due to male factors. However, more than 50% of the causes of male factor infertility are still obscure. Contemporary Andrology includes a thorough analysis of the sperm looking at the cellular and subcellular imperfections which may have an adverse effect on fertility. Defects in DNA and chromatin structure are examples of such analysis. The structure of spermatozoa DNA is very unique, highly specialized in order to control time-appropriate maturation of the zygote. Damage to sperm DNA may occur as a result of intrinsic factors such as limited defenses against oxidative stress, ageing and varicocele, or as a result of extrinsic determinants such as medications and environmental factors. This damage thereby may have negative effects on ART procedures, and could lead to failure of fertilization. Sperm DNA damage significantly contributes to the growing number of infertility cases, and should be a part of a modern andrology lab.

Beta defensins (BDs) are cationic peptides with antimicrobial activity that defend epithelial surfaces including the skin, gastrointestinal, and respiratory tracts. However, BD expression and function in the urinary tract are incompletely characterized. The purpose of this study was to describe Beta Defensin-1 (BD-1) expression in the lower urinary tract, regulation by cystitis, and antimicrobial activity toward uropathogenic Escherichia coli (UPEC) in vivo. Human DEFB1 and orthologous mouse Defb1 mRNA are detectable in bladder and ureter homogenates, and human BD-1 protein localizes to the urothelium. To determine the relevance of BD-1 to lower urinary tract defense in vivo, we evaluated clearance of UPEC by Defb1 knockout (Defb1(-/-)) mice. At 6, 18, and 48 hours following transurethral UPEC inoculation, no significant differences were observed in bacterial burden in bladders or kidneys of Defb1(-/-) and wild type C57BL/6 mice. In wild type mice, bladder Defb1 mRNA levels decreased as early as two hours post-infection and reached a nadir by six hours. RT-PCR profiling of BDs identified expression of Defb3 and Defb14 mRNA in murine bladder and ureter, which encode for mBD-3 and mBD-14 protein, respectively. MBD-14 protein expression was observed in bladder urothelium following UPEC infection, and both mBD-3 and mBD-14 displayed dose-dependent bactericidal activity toward UPEC in vitro. Thus, whereas mBD-1 deficiency does not alter bladder UPEC burden in vivo, we have identified mBD-3 and mBD-14 as potential mediators of mucosal immunity in the lower urinary tract.

The physician and andrologist must turn to semen characteristics to decipher what are the causative agents behind male infertility. WHO standard protocol requires analysis of sperm concentration, motility, and morphology. However, recent evidence implies that such parameters are not enough to fully depict the basis for male infertility and suggests that the effects of sperm DNA damage on infertility be considered. With the increasing ease of artificial reproduction, factors effecting embryo viability and offspring health related to the quality of sperm used and associated integrity of DNA must be strictly analyzed. Male gametes with damaged DNA can transmit genetic defects, lead to pregnancy loss, infant mortality, birth defects, and genetic diseases in the offspring. Furthermore, studies report that more than 80% of the structural de novo chromosome aberrations are of paternal origin. This chapter will begin by reviewing the process of spermatozoal chromatin organization and DNA packaging. Next, DNA damage and the factors causing this damage shall be considered. Subsequently, recognition and detection of this DNA damage will be reviewed followed finally by the effects of this damage and clinical applications encompassing treatment options involving antioxidants.

Cell phones have become a vital part of everyday life. However, the health risks associated with their usage are often overlooked. Recently, evidence from several studies supports a growing claim that cell phone usage may have a detrimental effect on sperm parameters leading to decreased male fertility. Nonetheless, other studies showed no conclusive link between male infertility and cell phone usage. The ambiguity of such results is attributed to the lack of a centralized assay for measuring inflicted damage caused by cell phones. Study design, ethics, and reproducibility are all aspects which must be standardized before any conclusions can be made.