Gender representation in editorial boards of international general surgery journals.

BACKGROUND: Despite women constituting over half of new doctors, gender disparity remains an issue. Surgery has shown particularly slow progress towards gender parity. This study aimed to quantify gender representation within editorial boards of the highest ranking international general surgery journals. METHODS: Surgical journals were collated using two indices: SCImago Journal Rank (SJR) and Journal Impact Factor (JIF). Non-general surgery journals were excluded. Journals were contacted, requesting gender editorial team demographics. Editorial board data were collected via journal websites on 28 November 2019. RESULTS: The top 25 general surgery journals according to SJR and JIF ranking methods were determined, identifying 28 unique journals. Editorial board data were publicly available for 27 of these 28 surgical journals, and were examined. Women accounted for 20.2 per cent (568 of 2816) of total editorial board positions. Women constituted 11 per cent (4 of 36) of editor-in-chief positions, 32 per cent (29 of 92) of deputy editors, and 19.1 per cent (369 of 1935) of general editorial board positions. CONCLUSION: The findings demonstrate gender disparity within editorial boards of the most prominent general surgery journals.

A comparison of collagen and PTFE patch repair in a rabbit model of congenital diaphragmatic hernia.

The use of prosthetic material in severe cases of congenital diaphragmatic hernia is complicated by infection, bowel adhesion, and patch dehiscence. We hypothesized that a bioprosthetic collagen patch would reduce these complications and be remodeled into autogenous tissue over a short period of time. Thirty-two New Zealand White rabbits had two 2 x 2-cm left diaphragmatic defects created. One of these defects was repaired with a collagen bioprosthetic patch (n = 20) and the other with a polytetrafluoroethylene (PTFE) patch (n = 20). Members of a control group (n = 12) had their defects closed primarily. The animals were then placed in either a 6- or 12-week survival cohort. At necrosectomy the repairs were assessed histologically, graded for adhesion formation, and tensiometrically tested. The PTFE patch was noted to have a significantly higher average adhesion grade than the collagen patch. The tensile strength of the two repair methods was statistically equivalent at both time intervals. On histologic examination the collagen patches were surrounded by an increased number of macrophages and fibroblasts. The PTFE patch exhibited no neovascularization or fibroblast deposition at the periphery, but had a much greater surrounding inflammatory response. Thus, there was evidence of early remodeling of the collagen with no increase in the amount of adhesions or loss of strength when compared to the PTFE, while the PTFE patches exhibited a more severe grade of adhesions.

Early prenatal diagnosis of choledochal cyst.

Unrecognized biliary tract obstruction due to choledochal cysts or biliary atresia can result in significant morbidity and mortality. Diagnosis in utero of choledochal cyst allows prompt postnatal diagnostic evaluation and appropriate surgical therapy to be instituted early in life. This may minimize the potential complications of cholangitis, cirrhosis, and liver failure in infants with choledochal cysts.

Effect of fetal serum on fibroblast pericellular matrix formation.

Hyaluronic acid (HA)-dependent pericellular matrices (PCM) play a role in embryonic differentiation of mesodermal cells. Fetal fibroblasts have significantly larger PCMs than postnatal fibroblasts. To determine if this property is intrinsic to fetal fibroblasts or induced by factors in the fetal environment, we studied the effect of fetal bovine serum (FBS) of varying gestational age on human fetal, newborn, and adult fibroblast PCM formation. Cultured human fetal, newborn, and adult fibroblasts were plated in triplicate at a density of 1 x 10(5) cells and incubated in medium alone, medium containing 10% pooled FBS, or FBS from the first, second, or third trimesters. The cells were photographed and morphometric analysis of PCM was performed by the erythrocyte exclusion technique. PCM size was expressed as a ratio of the maximal width of the cell matrix to the maximal width of the cell. The unpaired Student's t test was used for statistical analysis. The earlier the gestational age of FBS used, the larger the PCM observed in fetal and newborn fibroblasts. The PCM of fetal fibroblasts was significantly larger (P < 0.001) than that of newborn and adult fibroblasts at each gestational age of FBS tested (fetal >> newborn > adult). Medium containing pooled FBS caused a significant (P < 0.001) increase in PCM size in all cell lines compared with serum-free medium. There are both intrinsic and extrinsic factors which affect PCM size. These factors which affect HA-dependent PCM size may contribute to a permissive microenvironment for cell migration, proliferation, and development which may be important for scarless fetal wound repair.

Hyaluronic acid-dependent pericellular matrices in fetal fibroblasts: implication for scar-free wound repair.

Fetal fibroblasts are intrinsically different from postnatal fibroblasts. We studied the differences in expression, size, and assembly of pericellular matrices in human fetal and postnatal fibroblasts, as well as the effect of fetal fibroblast-conditioned media as a source of migration stimulating factor on pericellular matrix formation. Fibroblasts in their fifth to fifteenth passages were cultured for 24 hours before analysis. Streptomyces hyaluronidase (0.1 U/ml), monoclonal mouse anti-human CD-44std, or anti-human CD-4 antibodies were added and incubated for 1 hour (at 4 degrees and 37 degrees C) before analysis of the pericellular matrices with the use of a particle exclusion technique. The pericellular matrix/cell body ratio of fetal fibroblasts was significantly larger than that of newborn (p < 0.002) and adult (p < 0.001) fibroblasts. Hyaluronidase disrupted the pericellular matrices in all three cell lines. Assembly of the pericellular matrices was blocked by anti-human CD-44std antibody but not by anti-human CD-4 antibody at both 4 degrees and 37 degrees C. Incubation of fibroblast cell lines in fetal fibroblast-conditioned media did not increase pericellular matrix/cell body ratio but did increase the percentage of fibroblasts expressing a detectable pericellular matrix in adult (p < 0.01), newborn (p < 0.001), and fetal (p < 0.005) fibroblasts. We conclude that fibroblasts produce hyaluronic acid-dependent pericellular matrices which require interaction with a hyaluronic acid-binding protein for assembly. Large pericellular matrices are one intrinsic factor characterizing a unique fetal fibroblast phenotype.