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Broccoli (Brassica oleracea L. var. capitata L.) leaf waxes were labelled with [2-14C]acetate and examined during synthesis and deposition using microautoradiography. Waxes were viewed with light microscopy and scanning electron microscopy (SEM), including cryo-SEM. In microautoradiography, silver grains resulting from radioactive decay of labelled waxes seemed to be distributed randomly throughout the cuticle. This random distribution supports the hypothesis of diffusion or complex anastomosing pores as the mechanism of epicuticular wax deposition. The hypothesis of wax-depositing pores running perpendicular to the leaf surface is not supported. [ABSTRACT FROM AUTHOR]

Primary tumoral calcinosis is a rare and benign condition characterized by calcium salt deposition in periarticular soft tissues. It typically presents as a firm, rubbery mass that arises around large joints. While an estimated 250 cases have been described since its discovery, very few cases have been identified in the hand. We present a case of multiple calcified masses in the hand, one of which required meticulous dissection from a digital neurovascular bundle, and our technique for surgical excision. We present this case to lower the threshold for clinical suspicion of tumoral calcinosis for patients who present with a soft tissue mass in the hand. Furthermore, we recommend prompt surgical excision due to low success rates of alternative treatment options and to prevent potential neurovasculature or tendon injury., (Published by Elsevier B.V. on behalf of Society for Indian Hand Surgery and Micro Surgeons.)

Background: The current practice of assessing wounds is highly dependent on visual examination and clinical judgment; these methods are highly subjective and leave great room for error. Objective measures of wound severity and healing are necessary tools that have been lacking in clinical practice. Long-wave infrared thermography (LWIT) has diverse applications that can be optimized to help detect and monitor wounds., Methods: This work is a retrospective case series of pertinent patients encountered by the authors in clinical practice., Results: Nine cases were ultimately selected to best represent the multitude of benefits that can be seen with the utilization of LWIT devices., Conclusions: Through this case series, we show the many advantages of LWIT devices. This technology is safe, noninvasive, and user friendly and, most importantly, gives objective, instant, and repeatable measurements., Competing Interests: Disclosures: The authors disclose no financial or other conflicts of interest.

Although radiation therapy remains an integral component in cancer treatment, the sequela of tissue damage can result in long-term morbidity and mortality for patients. This article aimed to perform a comprehensive review of the current literature for both nonsurgical and surgical management strategies for radiation-induced injuries., Methods: A literature search was performed on PubMed to review the current described management and treatment options for radiation-induced injuries. Patient demographics, medical diagnoses, complications, strategies of management care, and outcomes were reviewed., Results: The most commonly described management options and reconstructive techniques of radiation wounds were analyzed and reported., Conclusions: Consideration of current techniques and outcomes in the management of radiation-induced wounds demonstrates that impaired wound healing remains a major problem. This literature review provides a detailed overview of the most frequently used therapies with recommendations for surgeons., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Autologous fat grafting (AFG) has been used in reconstructive plastic surgery for over a century. Although it has obvious benefits to the aesthetic appearance of many reconstructive surgeries, less appreciated advantages of fat grafting have also been shown in potential pain reduction. This can be seen across the board from head to toe with examples ranging from facial nerve injury to pedal atrophy and foot ulcers. The purpose of this literature review is to evaluate the efficacy of AFG for pain relief in various indications and serve as a reference for clinicians to gain insight on potentially beneficial therapies for their patients., Methods: A broad literature review was performed to analyze the various uses of AFG for pain management by various indications including postmastectomy pain syndrome, scar pain, neuromas, chronic wounds and many more. The PubMed, Science Direct and Scopus online databases were searched using keywords such as "autologous fat grafting," "reconstruction," "pain," and "therapy.", Results: At this point, there is decent evidence to support AFG's role in pain resolution in postmastectomy pain syndrome, neuropathic scar pain, and pedal injury. There is also ample low-level evidence for pain efficacy in autoimmune diseases, neuromas, vulvar lichen sclerosis, burns, and radiation-induced wounds., Conclusions: While there is a clear lack of higher-level evidence based studies conducted on AFG for all indications, the existing literature shows a definite trend of reconstructive efficacy and pain management that can be clearly appreciated. With the increasing popularity of this procedure for reconstruction, higher-level studies are beginning to take place pertaining to AFG's efficacy not only in reconstruction, but pain management as well., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

With the incidence of breast cancer, breast cancer survival rates, and prophylactic mastectomies all increasing, efforts to optimize breast reconstruction and improve quality of life are becoming increasingly important. Nerve coaptation has been investigated for its potential to remedy the clinical and psychosocial deficits in newly reconstructed breasts. The purpose of this review is to gauge the efficacy of nerve coaptation during breast reconstruction in creating worthwhile benefits in both objective and subjective dimensions of sensation., Methods: A Prospero registered systematic review was conducted. Databases including PubMed, SCOPUS, and ScienceDirect were screened using search terms "innervation," "breast reconstruction," and "neurotization" and relevant inclusion criteria., Results: Twenty-three studies were found that met parameters for inclusion. We identified studies that assessed DIEP-based reconstruction (7), TRAM-based reconstruction (9), implant-based reconstruction (2), and five studies that looked at a variety of reconstructive modalities. Monofilament testing was the most common modality used to assess sensation, while pain, temperature, and pressure thresholds were assessed more infrequently. Various tools were used to measure psychosocial impacts, including the BREAST-Q. While the methods for evaluation of both aspects of sensation were heterogenous, there was a trend towards improved outcomes with neurotization., Conclusions: The results of this review show promising improvements in clinical and psychosocial outcomes in innervated breasts compared to non-innervated breasts. However, the heterogeneity of studies in the literature indicates that more multi-center studies with standardized methodology including the BREAST-Q, sensory testing and complication analysis are needed to adequately demonstrate the value of neurotization in breast reconstruction., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Background: Hip disarticulation (HD) is a radical lower extremity amputation performed by carefully transecting all muscles and nerves surrounding the hip joint and separating the leg at the joint capsule. It is considered a last resort to be used as a life-preserving measure under emergent circumstances due to high rates of morbidity and mortality., Methods: This case series presents 4 patients who underwent HD. The procedure was performed due to various indications including necrotizing fasciitis, gangrene, stump necrosis from previous above-the-knee amputation, and septic joint secondary to chronic osteomyelitis, 3 of which were planned and 1 was emergent., Results: The procedure was performed successfully in all 4 patients. Furthermore, all patients were eventually discharged to home or to a long-term care facility for wound care or rehabilitation., Conclusions: Overall, HD should be reserved as a life-saving treatment for various indications including infections that fail other modalities, limb ischemia, trauma, and malignancy. Ideally, this procedure would be planned and performed on proper candidates; however, HD should still be a consideration in the emergent setting regardless of most optimal patients due to its life-saving potential., (© 2022, HMP Global. All rights reserved. Reproduction in whole or in part prohibited. Content may not be reproduced in any form without written permission. Rights, Permission, Reprint, and Translation information is available at www.hmpglobal.com.)

None of studies are available on the predictive ability of white matter lesions (WMLs) among patent foramen ovale (PFO), atherosclerotic cerebral small vessel disease (aCSVD) and cerebral venous thrombosis (CVT). Herein, we aimed to uncover the difference of the WML patterns among the three disease entities in a real-world setting to provide clinical references for predicting probable WML etiologies. We retrospectively reviewed data from consecutive patients with imaging-confirmed PFO, aCSVD, or CVT enrolled from 2014 through 2020. WMLs presented on fluid-attenuated inversion recovery (FLAIR) maps were compared among the three groups based on visual evaluation, Fazekas and modified Scheltens scales. Propensity score matching (PSM) was implemented to correct age and hypertension differences among groups. A total of 401 patients were entered into final analysis, including PFO (n = 112, 46.5 ± 12.8 years), aCSVD (n = 177, 61.6 ± 11.8 years) and CVT (n = 112, 37.4 ± 11.4 years) groups. In this study, WMLs occurred in all of the involved patients in the three groups (100%), which were independent to age, symptom onset and disease durations. On visual evaluation, PFO-WMLs were multiple spots distributed asymmetrically around bilateral subcortex and peri-ventricles. aCSVD-WMLs were dots or sheets distributed symmetrically in subcortex and peri-ventricles, and often coexisted with lacunar infarctions. CVT-WMLs were cloud-like around bilateral peri-ventricles, and enabled to attenuate after recanalization. Fazekas and modified Scheltens scores of PFO-WML vs. aCSVD-WML were significantly different even after being matched by 1:2 PSM (all p < 0.05), meaning that the WML burden in aCSVD was considerably heavier than that in PFO. WML patterns induced by PFO, aCSVD and CVT were obviously different, and were therefore of great clinical significance to preliminarily predict and differentiate the three diseases entities., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Keloids are skin lesions of abnormal and excessive scar proliferation that have no agreed upon gold standard of therapy. Extensive research in this area has shown that both intralesional triamcinolone and verapamil are effective in their treatment., Methods: A review of these two treatment modalities was conducted via an extensive search of existing literature published in PubMed, Scopus Libraries, and Science Direct databases using keywords "keloid," "verapamil," "triamcinolone," "intralesional," "treatment," and "corticosteroid" published between 1996 and 2021. From these included studies, clinical trials that directly compared the effects of intralesional triamcinolone and verapamil from 2008 to 2021 were included in a meta-analysis. Lastly, the minimal current research pertaining to a potential future direction of their combination was described., Results: Over 30 publications were included in this literature review to describe the current state of keloid treatment and outline the advantages and disadvantages of intralesional triamcinolone and verapamil. Eight of these studies were included in the meta-analysis which had varying results. In all studies, greater improvement was seen in the triamcinolone acetonide group compared with the verapamil group. However, these improved results were associated with a higher rate of adverse effects., Conclusions: When comparing the modalities of triamcinolone acetonide and verapamil for keloid treatment, triamcinolone acetonide shows more significant and rapid improvement compared with verapamil; however, there are also increased adverse effects. Minimal combination studies of these treatments have shown that perhaps using them together can augment their mechanisms without the unwanted side effects., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Objective: This study aimed to develop and validate a novel index to predict SAP for AIS patients who underwent endovascular treatment. Methods: A study was conducted in an advanced comprehensive stroke center from January 2013 to December 2019 aiming to develop and validate a novel index to predict SAP for AIS patients who underwent endovascular treatment. This cohort consisted of a total of 407 consecutively registered AIS patients who underwent endovascular therapy, which was divided into derivation and validation cohorts. Multiple blood parameters as well as demographic features, vascular risk factors, and clinical features were carefully evaluated in the derivation cohort. The independent predictors were obtained using multivariable logistic regression. The scoring system was generated based on the β-coefficients of each independent risk factor. Results: Ultimately, a novel predictive model: the SDL index (stroke history, dysphagia, lymphocyte count < 1.00 × 10 3 /μL) was developed. The SDL index showed good discrimination both in the derivation cohort (AUROC: 0.739, 95% confidence interval, 0.678-0.801) and the validation cohort (AUROC: 0.783, 95% confidence interval, 0.707-0.859). The SDL index was well-calibrated (Hosmer-Lemeshow test) in the derivation cohort ( P = 0.389) and the validation cohort ( P = 0.692). We therefore divided our population into low (SDL index = 0), medium (SDL index = 1), and high (SDL index ≥ 2) risk groups for SAP. The SDL index showed good discrimination when compared with two existing SAP prediction models. Conclusions: The SDL index is a novel feasible tool to predict SAP risk in acute ischemic stroke patients post endovascular treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhang, Zhao, Wu, Wu, Hou, Klomparens, Ding, Li, Chen, Duan, Zhang, Chang and Ji.)

The purpose of this minireview is to outline the updates made on the association of Alzheimer's disease (AD) and brain injury. A review of the literature on this subject was conducted that included various aspects such as age of onset, severity of head trauma, and genetic influences. The results of this mini-review were that consistent associations of AD risk are seen when the severity of head trauma increases, the lag time decreases and when genetic links are present. Brain injury and AD have a complicated relationship that requires further studies to be fully understood., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Brain Circulation.)

Agarose, agar, and gelatin were initially compared as encapsulation media for 3 structurally diverse particulate specimens: bacteria, yeast, and mitochondria. Agarose proved superior to both gelatin and agar for ease of handling and overall image quality (minimum background). All sample types exhibited high quality fixation and structural detail with no heat damage from the agarose medium. Based on this finding, we further characterized agarose encapsulation as affected by post-fixation, en bloc staining and resin type. Osmium tetroxide post-fixation, followed by en bloc uranyl acetate staining, could be performed without an increase in the electron density of the encapsulation medium. Agarose proved successful as an encapsulation medium regardless of the resin type or preparation protocol, thus providing flexibility in experimental design and excellent results over a range of variables.

Transmission electron microscopy (TEM) and energy dispersive X-ray microanalysis (EDS) were used to localize manganese from KMnO4, and bromine, as ultrastructural stains for lignin in an herbaceous plant. The Spookie cultivar of pumpkin is susceptible to infection by the fungus Colletotrichum lagenarium and served as a model system to compare the Br and KMnO4 techniques. Bromine was used in a fixation/staining procedure, and in separate experiments, KMnO4 was used as either a fixative or as a postsection stain. The technique for using bromine was modified from the woody plant procedure by adding a paraformaldehyde prefixation step. With the bromine procedure, cell walls were well-preserved, but the cytoplasm was heavily extracted. The KMnO4 procedures produced well-fixed cytoplasm, but with some staining artifacts. With all procedures, EDS dot mapping demonstrated lignin deposition in the cell walls specifically associated with sites of fungal infection. Lignin was also localized in secondary walls of tracheary elements, sites known to be highly lignified. The bromine procedure provided the most specific localization of lignin with a minimum of artifact. The specific applications of these stains provided data on the ultrastructural localization of lignin which contributed to the elucidation of its role in the interactions between pathogenic fungi in both their resistant and susceptible plant hosts.

Polyhydroxybutyrate (PHB), a high molecular weight polyester, is accumulated as a storage carbon in many species of bacteria and is a biodegradable thermoplastic. To produce PHB by genetic engineering in plants, genes from the bacterium Alcaligenes eutrophus that encoded the two enzymes required to convert acetoacetyl-coenzyme A to PHB were placed under transcriptional control of the cauliflower mosaic virus 35S promoter and introduced into Arabidopsis thaliana. Transgenic plant lines that contained both genes accumulated PHB as electron-lucent granules in the cytoplasm, nucleus, and vacuole; the size and appearance of these granules were similar to the PHB granules that accumulate in bacteria.

The ultrastructural characteristics of several growth matrices were examined using two cell types chosen for their distinct growth habits. Chinese hamster ovary cells and Balb-c 3T3 mouse fibroblasts were grown on flat substrates (glass, tissue culture plastic, Millipore filters) as well as spherical (glass, tissue culture plastic, cross-linked dextran) substrates. Cells were plated maintaining equal densities and growth surface area. Once the majority of the cells reached confluency, the cell's morphology on each matrix was examined using scanning electron microscopy. Digital analysis was performed on cell attachment area to compare the effect of each matrix on cell spreading. Variation in cell shape was dramatic between matrices, being most noticeable between a textured surface (filter, dextran bead) and that of a smooth (glass) surface. Even within smooth surfaces, some variation was observed. There was also an effect of matrix curvature on cell attachment area, the greatest being in the 3T3-c Balb cells, causing an overall decrease in the area of attachment between cell and matrix. The changes seen could also be related to the particular cell type used. Hamster ovary cells tended to be cylindrical and showed little effect between matrices, whereas the mouse fibroblasts, which are more flattened, showed the matrix effect to a greater degree. This study demonstrates the necessity of being aware of substrate-induced cell changes in tissue culture, where some variation in cell shape may be due to the surface on which the cells are grown as opposed to the experimental procedure.

We report a direct comparison of phosphate uptake by adnate and loosely attached microalgae in an intact biofilm matrix, with resolution at the level of individual cells. Track scanning electron microscope autoradiography enabled assay of [P]phosphate uptake from the overlying water by adnate algae left undisturbed on mature leaves of the macrophyte Potamogeton illinoensis or on artificial plant mimics. The epiphyte communities developed in either phosphate-poor or moderately phosphate-enriched water, and they were assayed on both natural and artificial plants. All adnate taxa examined from both natural and artificial plants in both habitats took up significantly less radiolabel when assayed beneath the overlying matrix than when they were exposed to the water upon removal of the overstory material. Track scanning electron microscope autoradiography and track light microscope autoradiography were intercalibrated to enable comparison of [P]phosphate uptake by adnate and loosely attached components of the epiphyte matrix. Loosely attached cells on substrata from both habitats took up significantly more radiolabel than did underlying adnate cells, indicating that access to phosphate supplies from the water depended on the position of microbial cells in the matrix. In this short-term assay, the adnate microalgae were relatively isolated from the water column nutrient source.

Electron microscopy has contributed a great deal to the field of mycology. Fungal ultrastructure has been, and continues to be, a key research element in the study of spore development and germination, host-pathogen interactions, nuclear behavior, and studies of subcellular organelles and organization linking structure and function. Since the earliest research in transmission electron microscopy in the 1950s, mycologists have kept pace with the developments in all areas of electron microscopy and have used them to great advantage in generating fine structural information on fungi. These recent developments include the use of scanning electron microscopy in the 1960s, X-ray microanalysis, cryopreservation and immunoelectron microscopy in the 1970s and 1980s. All of these techniques will continue to provide mycologists with the means to gain morphological and analytical data at the ultrastructural level.