The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.

Enhanced Transdermal Delivery of Pranoprofen Using a Thermo-Reversible Hydrogel Loaded with Lipid Nanocarriers for the Treatment of Local Inflammation

A biocompatible topical thermo-reversible hydrogel containing Pranoprofen (PF)-loaded nanostructured lipid carriers (NLCs) was studied as an innovative strategy for the topical treatment of skin inflammatory diseases. The PF-NLCs-F127 hydrogel was characterized physiochemically and short-time stability tests were carried out over 60 days. In vitro release and ex vivo human skin permeation studies were carried out in Franz diffusion cells. In addition, a cytotoxicity assay was studied using the HaCat cell line and in vivo tolerance study was performed in humans by evaluating the biomechanical properties. The anti-inflammatory effect of the PF-NLCs-F127 was evaluated in adult male Sprague Daw-ley® rats using a model of inflammation induced by the topical application of xylol for 1 h. The developed PF-NLCs-F127 exhibited a heterogeneous structure with spherical PF-NLCs in the hydrogel. Furthermore, a thermo-reversible behaviour was determined with a gelling temperature of 32.5 °C, being close to human cutaneous temperature and thus favouring the retention of PF. Furthermore, in the ex vivo study, the amount of PF retained and detected in human skin was high and no systemic effects were observed. The hydrogel was found to be non-cytotoxic, showing cell viability of around 95%. The PF-NLCs-F127 is shown to be well tolerated and no signs of irritancy or alterations of the skin’s biophysical properties were detected. The topical application of PF-NLCs-F127 hydrogel was shown to be efficient in an inflammatory animal model, preventing the loss of stratum corneum and reducing the presence of leukocyte infiltration. The results from this study confirm that the developed hydrogel is a suitable drug delivery carrier for the transdermal delivery of PF, improving its dermal retention, opening the possibility of using it as a promising candidate and safer alternative to topical treatment for local skin inflammation and indicating that it could be useful in the clinical environment.

Surgical Treatment of Ruptured Infectious Femoral Pseudoaneurysms Caused By Intravenous Drug Abuse: A Nonemergent (Postponed) Operation Pattern May Be a Possible Alternative

Objective: To evaluate the possibility of surgical treatment of ruptured infectious femoral pseudoaneurysms caused by intravenous drug abuse in a nonemergent operation pattern, with retrospective analysis of clinical data and experience at a single center.Methods: Clinical data of 85 consecutive patients presenting with groin area active or recent hemorrhage due to a ruptured infectious femoral artery pseudoaneurysm related to drug abuse who were treated in the First Hospital of Changsha, China, from July 2008 to June 2020 were collected and analyzed.Results: A total of 74.1% of patients presented with active hemorrhage, and 36.5% presented with significant hypotension at admission. The average interval between arrival and operation was 34.7±4.7 hours. Vital physiological parameters and overall situation improved significantly after sufficient preoperative preparation. Satisfactory hemostasis can be achieved by bandage compression or local skin suture. No case was transferred to urgent operation due to severe bleeding, and 1 postoperative death case was observed in the cohort. The main operative- and postoperative-related indicators were satisfactory and close to those in the emergent operation pattern.Conclusion: While emergent or urgent operation is the mainstream surgical treatment for ruptured infectious femoral pseudoaneurysms, nonemergent (postponed) operation with sufficient preoperative preparation might also be an acceptable and comparable choice in some cases.

Numerical Study of Variable Viscosity and Thermal Conductivity on Natural Convection Flow along a Vertical Flat Plate with Pressure Work and Heat Conduction

A heated vertical flat plate in the presence of heat generation is an extremely significant technological issue, and many academics have studied this sort of problem. A vertical plate submerged in a fluid with varying viscosity will be used in this research to investigate the effects of variable viscosity and thermal conductivity on heat generation free convection flow. The boundary layer equations in this section are two-dimensional, laminar, and unstable. The fundamental governing equations are turned into non-dimensional governing equations by using the necessary variables. Using the Crank-Nicolson implicit finite-difference technique, these equations are solved numerically. Viscosity and thermal conductivity are temperature-dependent properties of a viscous, incompressible fluid. Variations in the study's numerous parameters will reveal and compare the velocities, temperatures, local skin friction, and local heat transfer co-efficient profiles. There will be a comparison between the current numerical data and previously reported data findings. Besides that, we'll compare our current work numbers to those of past released publications. Graphs and tables will be used to display the findings for a variety of key physical characteristics.

Flow Analysis of Hybridized Nanomaterial Liquid Flow in the Existence of Multiple Slips and Hall Current Effect over a Slendering Stretching Surface

Carbon nanotubes (CNTs) are favored materials in the manufacture of electrochemical devices because of their mechanical and chemical stability, good thermal and electrical conductivities, physiochemical consistency, and featherweight. With such intriguing carbon nanotubes properties in mind, the current research aims to investigate the flow of hybridized nano liquid containing MWCNTs (multi-wall carbon nanotubes) and SWCNTs (single-wall carbon nanotubes) across a slendering surface in the presence of a gyrotactic-microorganism. The temperature and solutal energy equation are modified with the impact of the modified Fourier and Fick’s law, binary chemical reaction, viscous dissipation, and joule heating. The slip conditions are imposed on the surface boundaries. The flow equations are converted into ODEs by applying similarity variables. The bvp4c approach is applied to tackle the coupled and extremely nonlinear boundary value problem. The outputs are compared with the PCM (Parametric continuation method) to ensure that the results are accurate. The influence of involved characteristics on energy distribution, velocity profiles, concentration, and microorganism field are presented graphically. It is noted that the stronger values of the wall thickness parameter and the Hartmann number produce a retardation effect; as a result, the fluid velocity declines for MWCNT and SWCNT hybrid nano liquid. Furthermore, the transport of the mass and heat rate improves with a higher amount of both the hybrid and simple nanofluids. The amount of local skin friction and the motile density of microorganisms are discussed and tabulated. Furthermore, the findings are validated by comparing them to the published literature, which is a notable feature of the present results. In this aspect, venerable stability has been accomplished.

On the Use of Wearable Face and Neck Cooling Fans to Improve Occupant Thermal Comfort in Warm Indoor Environments

Face and neck cooling has been found effective in improving thermal comfort during exercise in the heat despite the fact that the surface area of human face and neck regions accounts for only 5.5% of the entire body. Presently very little documented research has been conducted to investigate cooling the face and neck only to improve indoor thermal comfort. In this study, two highly energy efficient wearable face and neck cooling fans were used to improve occupant thermal comfort in two warm indoor conditions (30 and 32 °C). Local skin temperatures and perceptual responses while using the two wearable cooling fans were examined and compared. Results showed that both cooling fans could significantly reduce local skin temperatures at the forehead, face and neck regions by up to 2.1 °C. Local thermal sensation votes at the face and neck were decreased by 0.82–1.21 scale unit at the two studied temperatures. Overall TSVs decreased by 1.03–1.14 and 1.34–1.66 scale units at 30 and 32 °C temperatures, respectively. Both cooling fans could raise the acceptable HVAC temperature setpoint to 32.0 °C, resulting in a 45.7% energy saving over the baseline HVAC setpoint of 24.5 °C. Furthermore, occupants are advised to use the free-control cooling mode when using those two types of wearable cooling fans to improve thermal comfort. Finally, despite some issues on dry eyes and dry lips associated with those wearable cooling fans, it is concluded that those two highly energy-efficient wearable cooling fans could greatly improve thermal comfort and save HVAC energy.

Sensory computations in the cuneate nucleus of macaques

Tactile nerve fibers fall into a few classes that can be readily distinguished based on their spatiotemporal response properties. Because nerve fibers reflect local skin deformations, they individually carry ambiguous signals about object features. In contrast, cortical neurons exhibit heterogeneous response properties that reflect computations applied to convergent input from multiple classes of afferents, which confer to them a selectivity for behaviorally relevant features of objects. The conventional view is that these complex response properties arise within the cortex itself, implying that sensory signals are not processed to any significant extent in the two intervening structures—the cuneate nucleus (CN) and the thalamus. To test this hypothesis, we recorded the responses evoked in the CN to a battery of stimuli that have been extensively used to characterize tactile coding in both the periphery and cortex, including skin indentations, vibrations, random dot patterns, and scanned edges. We found that CN responses are more similar to their cortical counterparts than they are to their inputs: CN neurons receive input from multiple classes of nerve fibers, they have spatially complex receptive fields, and they exhibit selectivity for object features. Contrary to consensus, then, the CN plays a key role in processing tactile information.

Questionnaire Survey of Possible Association of Allergic Diseases with Adverse Reactions to SARS-CoV-2 Vaccination

To protect against COVID-19, SARS-CoV-2 vaccines have been widely used. Besides anaphylaxis, some less severe adverse effects may occur at higher frequencies. It remains unclear whether present or past histories of allergic diseases exert effects on local and systemic reactions. We conducted a questionnaire survey among workers in our hospital. We analyzed the adverse effects occurring after the first and second doses of the Pfizer–BioNTech vaccine in 955 subjects. The presence or absence of local injection reactions and systemic reactions (headache, fatigability, fever, muscle pain, and joint pain) was questioned. The intensities of these reactions were graded on a scale of 0–4 (except fever) or 0–2 (fever). The allergic diseases that we focused on were bronchial asthma, atopic dermatitis, food allergy, pollinosis, and hand eczema. For the systemic reactions, fatigability after the first dose tended to be more severe in the bronchial asthma than in the non-allergic group. Headache, joint pain, and fever tended to be more severe in the food allergy than in the non-allergic group after the second dose. For the local skin reactions, atopic dermatitis subjects tended to show rather less severe local skin reactions after the second dose. The results contribute to the guidelines for the care of individuals with different allergy histories, so that they may safely receive their vaccine.

Interactions of host defense and hyper-keratinization in psoriasis

Objectives: To understand the crosstalk between the host and microbiota in psoriatic skin, using a systems biology approach based on transcriptomics and microbiome profiling. Methods: We collected the skin tissue biopsies and swabs in both lesion and non-lesion skin of 13 patients with psoriasis (PsO), 15 patients with psoriatic arthritis (PsA), and healthy skin from 12 patients with ankylosing spondylitis (AS). We performed transcriptome sequencing and metagenomics profiling on the local skin sites to study the similarities and differences in the molecular profiles between the three conditions, and the associations between the host defense and microbiota dynamic. Results: We found that lesion and non-lesional samples were remarkably different in terms of their transcriptome profiles. Functional annotation of differentially expressed genes (DEGs) showed a major enrichment in neutrophil activation. By using co-expression gene networks, we identified a gene module that was associated with local psoriasis severity at the site of biopsy. From this module, we extracted a "core" set of genes that were functionally involved in neutrophil activation, epidermal cell differentiation and response to bacteria. Skin microbiome analysis revealed that the abundance of Enhydrobacter, Micrococcus and Leptotrichia were significantly correlated with the "core network" of genes. Conclusions: We identified a core network that regulates inflammation and hyper-keratinization in psoriatic skin, and is associated with local disease severity and microbiome composition.