Plant cell walls: source of carbohydrate-based signals in plant-pathogen interactions.

Plant cell walls are essential elements for disease resistance that pathogens need to overcome to colonise the host. Certain pathogens secrete a large battery of enzymes to hydrolyse plant cell wall polysaccharides, which leads to the release of carbohydrate-based molecules (glycans) that are perceived by plant pattern recognition receptors and activate pattern-triggered immunity and disease resistance. These released glycans are used by colonizing microorganisms as carbon source, chemoattractants to locate entry points at plant surface, and as signals triggering gene expression reprogramming. The release of wall glycans and their perception by plants and microorganisms determines plant-microbial interaction outcome. Here, we summarise and discuss the most recent advances in these less explored aspects of plant-microbe interaction.

Linear ß-1,2-glucans trigger immune hallmarks and enhance disease resistance in plants.

Immune responses in plants are triggered by molecular patterns or elicitors, recognized by plant pattern recognition receptors. Such molecular patterns are consequence of host-pathogen interactions and the response cascade activated after their perception is known as pattern-triggered immunity (PTI). Glucans have emerged as key players in PTI, but the ability of certain glucans to stimulate defensive responses in plants remains understudied. This work focused on identifying novel glucan oligosaccharides as molecular patterns. The ability of various microorganism-derived glucans to prompt PTI responses was tested, revealing that specific microbial-derived molecules, such as short linear ß-1,2-glucans, trigger this response in plants by increasing the production of reactive oxygen species (ROS), MAP kinase phosphorylation, and differential expression of defence-related genes in Arabidopsis thaliana. Pretreatments with ß-1,2-glucan trisaccharide (B2G3) improved Arabidopsis defence against bacterial and fungal infections in a hypersusceptible genotype. The knowledge generated was then transferred to the monocotyledonous model species maize and wheat, confirming that these plants also respond to ß-1,2-glucans, with increased ROS production and improved protection against fungal infections following B2G3 pretreatments. In summary, as with other ß-glucans, plants perceive ß-1,2-glucans as warning signals and stimulate defence responses against phytopathogens.

Leucine rich repeat-malectin receptor kinases IGP1/CORK1, IGP3 and IGP4 are required for arabidopsis immune responses triggered by ß-1,4-D-Xylo-oligosaccharides from plant cell walls.

Pattern-Triggered Immunity (PTI) in plants is activated upon recognition by Pattern Recognition Receptors (PRRs) of Damage- and Microbe-Associated Molecular Patterns (DAMPs and MAMPs) from plants or microorganisms, respectively. An increasing number of identified DAMPs/MAMPs are carbohydrates from plant cell walls and microbial extracellular layers, which are perceived by plant PRRs, such as LysM and Leucine Rich Repeat-Malectin (LRR-MAL) receptor kinases (RKs). LysM-RKs (e.g. CERK1, LYK4 and LYK5) are needed for recognition of fungal MAMP chitohexaose (ß-1,4-D-(GlcNAc)6, CHI6), whereas IGP1/CORK1, IGP3 and IGP4 LRR-MAL RKs are required for perception of ß-glucans, like cellotriose (ß-1,4-D-(Glc)3, CEL3) and mixed-linked glucans. We have explored the diversity of carbohydrates perceived by Arabidopsis thaliana seedlings by determining PTI responses upon treatment with different oligosaccharides and polysaccharides. These analyses revealed that plant oligosaccharides from xylans [ß-1,4-D-(xylose)4 (XYL4)], glucuronoxylans and α-1,4-glucans, and polysaccharides from plants and seaweeds activate PTI. Cross-elicitation experiments of XYL4 with other glycans showed that the mechanism of recognition of XYL4 and the DAMP 33-α-L-arabinofuranosyl-xylotetraose (XA3XX) shares some features with that of CEL3 but differs from that of CHI6. Notably, XYL4 and XA3XX perception is impaired in igp1/cork1, igp3 and igp4 mutants, and almost not affected in cerk1 lyk4 lyk5 triple mutant. XYL4 perception is conserved in different plant species since XYL4 pre-treatment triggers enhanced disease resistance in tomato to Pseudomonas syringae pv tomato DC3000 and PTI responses in wheat. These results expand the number of glycans triggering plant immunity and support IGP1/CORK1, IGP3 and IGP4 relevance in Arabidopsis thaliana glycans perception and PTI activation. Significance Statement: The characterization of plant immune mechanisms involved in the perception of carbohydrate-based structures recognized as DAMPs/MAMPs is needed to further understand plant disease resistance modulation. We show here that IGP1/CORK1, IGP3 and IGP4 LRR-MAL RKs are required for the perception of carbohydrate-based DAMPs ß-1,4-D-(xylose)4 (XYL4) and 33-α-L-arabinofuranosyl-xylotetraose (XA3XX), further expanding the function of these LRR-MAL RKs in plant glycan perception and immune activation.

Abordaje global del paciente con pie diabético: Una revisión / Global approach to the patient with diabetic foot: A review

RESUMEN El artículo de revisión destaca la importancia de la planta del pie en la deambulación y su adaptación a las necesidades humanas. Se enfoca en el pie diabético (PD), definido por signos, síntomas o úlceras en el pie debido a complicaciones crónicas de la diabetes. El PD afecta a alrededor del 25% de los pacientes con diabetes mellitus (DM), con úlceras que pueden derivar en infecciones graves y riesgo de amputación. El manejo del PD es complejo y requiere un enfoque multidisciplinar. Este artículo propone un "Sistema de Evaluación y Tratamiento del Pie Diabético", aplicable en diversos entornos clínicos, que clasifica las úlceras según su profundidad e infección y ofrece guías claras para su tratamiento. Se discuten también la epidemiología de la neuropatía diabética (ND), destacando su alta prevalencia y morbilidad, y la necesidad de un diagnóstico y tratamiento adecuados. Se analiza en detalle la neuropatía de Charcot, una complicación severa del PD, incluyendo sus causas y métodos diagnósticos. Además, se enfatiza la importancia del enfoque multidisciplinar en el tratamiento de las úlceras del PD para reducir amputaciones y mejorar la calidad de vida de los pacientes. También se abordan las infecciones del PD y la antibioticoterapia, recomendando el uso de antibióticos adecuados según la gravedad de la infección y la realización de cultivos microbiológicos precisos. Finalmente, se presenta una visión global del manejo del PD, destacando la importancia de un enfoque multidisciplinar y proponiendo un sistema de evaluación y tratamiento eficaz que puede ser implementado en diversos contextos clínicos.

ABSTRACT The review article highlights the importance of the sole of the foot in ambulation and its adaptation to human needs. It focuses on diabetic foot (DF), defined by signs, symptoms, or ulcers on the foot due to chronic complications of diabetes. DF affects approximately 25 % of patients with diabetes mellitus (DM), with ulcers that can lead to severe infections and risk of amputation. Managing DF is complex and requires a multidisciplinary approach. This article proposes a "Diabetic Foot Evaluation and Treatment System," applicable in various clinical settings, which classifies ulcers according to their depth and infection and provides clear treatment guidelines. The epidemiology of diabetic neuropathy (DN) is also discussed, highlighting its high prevalence and morbidity, and the need for adequate diagnosis and treatment. The article provides a detailed analysis of Charcot neuropathy, a severe complication of DF, including its causes and diagnostic methods. Furthermore, the importance of a multidisciplinary approach in the treatment of DF ulcers is emphasized to reduce amputations and improve patients' quality of life. DF infections and antibiotic therapy are also addressed, recommending the use of appropriate antibiotics according to the severity of the infection and the performance of precise microbiological cultures. Finally, a comprehensive view of DF management is presented, highlighting the importance of a multidisciplinary approach and proposing an effective evaluation and treatment system that can be implemented in various clinical contexts.

The Zymoseptoria tritici Avirulence Factor AvrStb6 Accumulates in Hyphae Close to Stomata and Triggers a Wheat Defense Response Hindering Fungal Penetration.

Zymoseptoria tritici, the causal agent of Septoria tritici blotch, is one of Europe's most damaging wheat pathogens, causing significant economic losses. Genetic resistance is a common strategy to control the disease, Stb6 being a resistance gene used for more than 100 years in Europe. This study investigates the molecular mechanisms underlying Stb6-mediated resistance. Utilizing confocal microscopy imaging, we determined that Z. tritici epiphytic hyphae mainly accumulate the corresponding avirulence factor AvrStb6 in close proximity to stomata. Consequently, the progression of AvrStb6-expressing avirulent strains is hampered during penetration. The fungal growth inhibition co-occurs with a transcriptional reprogramming in wheat characterized by an induction of immune responses, genes involved in stomatal regulation, and cell wall-related genes. Overall, we shed light on the gene-for-gene resistance mechanisms in the wheat-Z. tritici pathosystem at the cytological and transcriptomic level, and our results highlight that stomatal penetration is a critical process for pathogenicity and resistance. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach.

Objective: Transoral robotic surgery (TORS) has evolved since its 2009 US Food and Drug Administration approval for use in local stage T1-T2 oropharyngeal carcinoma. The ability to resect increasingly larger and more complex lesions has led to the need to introduce reconstructive techniques through this route, avoiding the classic transmandibular or pull-through approach. Few studies have compared the safety, efficacy, and advantages of TORS versus classic open approaches in oropharyngeal salvage surgery with reconstruction using microanastomosed flaps. Here we retrospectively compare our center's experience with the open approach and TORS and describe the technical variations used. Methods: Between 2013 and 2021, 30 stage III-IV oropharyngeal cancer patients underwent salvage surgery with reconstruction in our center. From 2013 to 2017, 15 patients underwent surgery with the classic open approach, and from 2018 to 2021, an additional 15 patients underwent TORS. We have compared surgical outcomes, post-surgical results, and survival in the two groups. Results: Patient characteristics were similar in the two groups. TORS was associated with shorter surgical time (p < .001), fewer complications (p = .01), shorter hospital stay (p < .001), and lower feeding tube requirements (p = .003). No significant differences were observed between the two groups in the free margin rate or survival. Conclusion: Oropharyngeal salvage surgery with TORS with free flap reconstruction reduced associated morbidity compared to the open approach in a patient cohort with poor prognosis. Level of Evidence: 4.

Optimización del protocolo postoperatorio en reconstrucción microquirúrgica mamaria con colgajo abdominal DIEP y MS-TRAM / Optimization of the postoperative protocol of the microsurgical breast reconstruction with DIEP and MS-TRAM flaps

Introducción y objetivo: El manejo del dolor es esencial en el postoperatorio inmediato de los colgajos microquirúrgicos para reconstrucción de mama: Presentamos un estudio de optimización del manejo postoperatorio basado en la introducción de un catéter de bupivacaína subfascial abdominal y la movilización precoz de las pacientes. Material y método: Incluimos los colgajos DIEP y MS-TRAM libres para reconstrucción mamaria llevados a cabo en nuestro Servicio de enero 2013 a diciembre 2019, divididos en 2 grupos según el protocolo de manejo postoperatorio empleado, estándar o de rápida recuperación, para comparar su efectividad. Resultados: Analizamos un total de 186 pacientes: 68 en el grupo estándar y 118 en el grupo de rápida recuperación. La estancia hospitalaria, la necesidad de mórficos de rescate y los vómitos durante el postoperatorio inmediato disminuyeron de forma estadísticamente significativa en el grupo de rápida recuperación (p = 0.013, p = 0.001 y p = 0.012, respectivamente). El inicio de la deambulación fue más precoz en el grupo de rápida recuperación, también de forma estadísticamente significativa (p = 0.01). No objetivamos más complicaciones abdominales asociadas al cambio del protocolo. Conclusiones: En nuestra experiencia, el protocolo de rápida recuperación permite optimizar el manejo del dolor postoperatorio, iniciar una deambulación más temprana y reducir la estancia hospitalaria en la reconstrucción microquirúrgica mamaria con colgajo abdominal. Nivel de evidencia científica 4c Terapéutico.(AU)

Background and objective: Pain management is essential during the immediate postoperative period of microsurgical flaps for breast reconstruction. The aim of this study is to assess the effectiveness of a postoperative management protocol based on the use of an abdominal bupivacaine catheter and the early mobilization of patients. Methods: Patients underwent free DIEP and MS-TRAM flaps for breast reconstruction in our Service from January 2013 to December 2019 were included and divided into 2 groups according to the postoperative management protocol used, standard versus fast-track, to compare its effectiveness. Results: A total of 186 patients were included: 68 standard group, 118 fast-track group. The length of hospital stays, the intravenous opiate use and vomiting during the immediate postoperative period, were reduced in the fast-track group, and the results were statistically significant (p = 0.013, p =0.001 and p = 0.012, respectively). The initiation of ambulation was earlier in the fast-track group (p = 0.01). No differences in abdominal complications were found between both protocols. Conclusions: In our experience, the fast-track protocol allows to optimize the management of postoperative pain, to initiate an earlier ambulation and to reduce the length of the hospital stay in breast microsurgical reconstruction with abdominal fap. Level of evidence 4c Terapeutic.(AU)

A genetic approach reveals different modes of action of prefoldins.

The prefoldin complex (PFDc) was identified in humans as a co-chaperone of the cytosolic chaperonin T-COMPLEX PROTEIN RING COMPLEX (TRiC)/CHAPERONIN CONTAINING TCP-1 (CCT). PFDc is conserved in eukaryotes and is composed of subunits PFD1-6, and PFDc-TRiC/CCT folds actin and tubulins. PFDs also participate in a wide range of cellular processes, both in the cytoplasm and in the nucleus, and their malfunction causes developmental alterations and disease in animals and altered growth and environmental responses in yeast and plants. Genetic analyses in yeast indicate that not all of their functions require the canonical complex. The lack of systematic genetic analyses in plants and animals, however, makes it difficult to discern whether PFDs participate in a process as the canonical complex or in alternative configurations, which is necessary to understand their mode of action. To tackle this question, and on the premise that the canonical complex cannot be formed if one subunit is missing, we generated an Arabidopsis (Arabidopsis thaliana) mutant deficient in the six PFDs and compared various growth and environmental responses with those of the individual mutants. In this way, we demonstrate that the PFDc is required for seed germination, to delay flowering, or to respond to high salt stress or low temperature, whereas at least two PFDs redundantly attenuate the response to osmotic stress. A coexpression analysis of differentially expressed genes in the sextuple mutant identified several transcription factors, including ABA INSENSITIVE 5 (ABI5) and PHYTOCHROME-INTERACTING FACTOR 4, acting downstream of PFDs. Furthermore, the transcriptomic analysis allowed assigning additional roles for PFDs, for instance, in response to higher temperature.

Prefoldins contribute to maintaining the levels of the spliceosome LSM2-8 complex through Hsp90 in Arabidopsis.

Although originally identified as the components of the complex aiding the cytosolic chaperonin CCT in the folding of actins and tubulins in the cytosol, prefoldins (PFDs) are emerging as novel regulators influencing gene expression in the nucleus. Work conducted mainly in yeast and animals showed that PFDs act as transcriptional regulators and participate in the nuclear proteostasis. To investigate new functions of PFDs, we performed a co-expression analysis in Arabidopsis thaliana. Results revealed co-expression between PFD and the Sm-like (LSM) genes, which encode the LSM2-8 spliceosome core complex, in this model organism. Here, we show that PFDs interact with and are required to maintain adequate levels of the LSM2-8 complex. Our data indicate that levels of the LSM8 protein, which defines and confers the functional specificity of the complex, are reduced in pfd mutants and in response to the Hsp90 inhibitor geldanamycin. We provide biochemical evidence showing that LSM8 is a client of Hsp90 and that PFD4 mediates the interaction between both proteins. Consistent with our results and with the role of the LSM2-8 complex in splicing through the stabilization of the U6 snRNA, pfd mutants showed reduced levels of this snRNA and altered pre-mRNA splicing patterns.

Pneumoendoscopic single port approach to breast cancer. How we do it?

Endoscopic procedures have not become the gold standard in breast surgery. In order to improve today's outcomes we have developed a pilot study in the Breast Pathology Unit of Hospital Germans Trias i Pujol. A surgical procedure was performed creating a pneumoendoscopic cavity by using a Single Incision Laparoscopic Surgery (Single port) approach with a follow up of four years. Four patients underwent pneumoendoscopic single-port breast surgery receiving skin-sparing quadrantectomy and axillary surgery requiring lymphadenectomy in all of them. All patients had immediate reconstruction with a Latisimus Dorsi flap. No perioperative complications appeared. Mean operative time was 290 min (range 240-315 min) and mean hospital stay was 3,2 days. Surgical margins of all cases were pathologically negative and all patients were disease free after four years of monitoring. All patients were satisfied with the cosmetic outcome in the immediate postoperative and during the follow up. Although all innovative techniques generate hesitation on their beginnings and are liable to improve, we believe that pneumoendoscopic single-port breast surgery can be suitable for breast cancer, offering better cosmetic outcomes with oncological safety.

When to assess the DIEP flap perfusion by intraoperative indocyanine green angiography in breast reconstruction?

BACKGROUND: Although the indocyanine green angiography (ICGA) has been used for years in the assessment of Deep Inferior Epigastric Perforator (DIEP) perfusion, it has not yet been established when it should be performed during the surgery. The aim of this study is to evaluate whether it is better to perform the test on the donor or recipient sites. METHODS: Intraoperative perfusion of 46 DIEP flaps was assessed twice, on the donor and recipient sites. Differences between both ischemic areas of each flap were statistically analyzed. In addition, perforator location and risk factors were evaluated in order to assess whether they are associated with changes in the perfusion of the flap between both sites. RESULTS: Differences between ischemic areas on the donor and recipient sites were statistically significant (p = 0.012). However, in most cases (82.6%) the ischemic area was the same on both sites, and the final flap design only changed in two cases (4.3%) because of the ICGA findings on the recipient site. Besides, performing the ICGA on the donor site facilitated the identification of the best perfused areas, allowed a better planning of its placement into the recipient site, and also can be useful to choose the best perforator. Bilateral DIEP flap, lateral location of the perforator and tobacco use had a statistically significant association with lower probability to increase the perfusion area between both sites. CONCLUSIONS: several advantages have been found in performing the ICGA on the donor site to assess the perfusion of the DIEP flap.

Manejo y reconstruccion microquirúrgica de extremidad inferior distal con colgajo SCIP libre / Management and microsurgical reconstruction of distal lower limb with SCIP free flap

Introducción y objetivo. En los últimos años han surgido nuevas técnicas de reconstrucción mediante supermicrocirugía con buenos resultados estéticos y funcionales, como el colgajo libre SCIP (Superficial Circumflex Iliac Artery Perforator), que permite realizar anastomosis a perforantes pudiendo conservar así los vasos principales de la extremidad. El objetivo de este estudio es presentar nuestra experiencia en la reconstrucción de extremidad inferior distal con SCIP libre y su manejo perioperatorio. Material y método. Nuestro estudio incluye 17 pacientes en los que llevamos a cabo reconstrucción mediante SCIP libre de extremidad inferior distal (pierna y pie) entre 2015 y 2017. Realizamos angioTAC preoperatorio para planificar la cirugía y valorar la necesidad de optimización vascular. Resultados. Preferentemente hicimos anastomosis término-terminales a perforantes de la zona receptora. No fueron necesarias revisiones microquirúgicas inmediatas. La complicación postoperatoria más frecuente fue la congestión venosa (29.4%). En todos los pacientes se logró la conservación de la extremidad y se mantuvo la capacidad de deambulación. Conclusiones. el SCIP libre es una buena opción microquirúrgica para la reconstrucción de extremidad inferior distal, tanto estética como funcionalmente, ya que presenta escasas complicaciones y puede evitar la amputación. En base a nuestra experiencia inicial, recomendamos realizar angioTAC y valoración preoperatoria de optimización de la vascularización regional, cambios posturales, 2 anastomosis venosas siempre que sea posible y un manejo multidisciplinario

Background and objetive. New reconstruction techniques have been described for last years with good aesthetic and functional results, such as the free SCIP flap (Superficial Circumflex Iliac Artery Perforator). Supermicrosurgery allows anastomoses to perforator vessels and therefore the main vessels of the limb can be preserved. The aim of this study is to present our experience in the reconstruction of the distal lower extremity with free SCIP and its perioperative management. Methods. From 2015 to 2017, 17 patients who underwent a reconstruction of the distal lower extremity (leg and foot) by free SCIP flap were included. Preoperative CT-angiography was performed for the surgical planning and to assess the need for angioplasty. Results. End-to-end anastomoses were made to perforator vessels of the recipient area. No immediate microsurgical revisions were needed. The most frequent postoperative complication was venous congestion (29.4%). Limb salvage was achieved in all patients and walk ability was preserved. Conclusions. The free SCIP flap is a good microsurgical option for the reconstruction of the distal lower extremity, both aesthetically and functionally, presents few complications and an avoid amputation. Based on our initial experience, we recommend performing a CT-angiography and a preoperative assessment of regional vascularization optimization, postural changes, 2 venous anastomoses whenever possible and multidisciplinary management

Emerging Roles of LSM Complexes in Posttranscriptional Regulation of Plant Response to Abiotic Stress.

It has long been assumed that the wide reprogramming of gene expression that modulates plant response to unfavorable environmental conditions is mainly controlled at the transcriptional level. A growing body of evidence, however, indicates that posttranscriptional regulatory mechanisms also play a relevant role in this control. Thus, the LSMs, a family of proteins involved in mRNA metabolism highly conserved in eukaryotes, have emerged as prominent regulators of plant tolerance to abiotic stress. Arabidopsis contains two main LSM ring-shaped heteroheptameric complexes, LSM1-7 and LSM2-8, with different subcellular localization and function. The LSM1-7 ring is part of the cytoplasmic decapping complex that regulates mRNA stability. On the other hand, the LSM2-8 complex accumulates in the nucleus to ensure appropriate levels of U6 snRNA and, therefore, correct pre-mRNA splicing. Recent studies reported unexpected results that led to a fundamental change in the assumed consideration that LSM complexes are mere components of the mRNA decapping and splicing cellular machineries. Indeed, these data have demonstrated that LSM1-7 and LSM2-8 rings operate in Arabidopsis by selecting specific RNA targets, depending on the environmental conditions. This specificity allows them to actively imposing particular gene expression patterns that fine-tune plant responses to abiotic stresses. In this review, we will summarize current and past knowledge on the role of LSM rings in modulating plant physiology, with special focus on their function in abiotic stress responses.

Intraoperative Indocyanine Green Angiography for Fat Necrosis Reduction in the Deep Inferior Epigastric Perforator (DIEP) Flap.

BACKGROUND: Fat necrosis is a frequent complication (up to 62.5%) of microsurgical breast reconstruction using the deep inferior epigastric perforator (DIEP) flap. This could have important clinical and psychological repercussions, deteriorating the results and increasing reconstruction costs. OBJECTIVES: The aim of this study was to demonstrate the intraoperative use of indocyanine green angiography (ICGA) to reduce fat necrosis in DIEP flap. METHODS: Sixty-one patients who underwent unilateral DIEP flap procedures for breast reconstruction after oncological mastectomy were included (24 cases with intraoperative use of ICGA during surgery, 37 cases in the control group). The follow-up period was 1 year after surgery. The association between the use of ICGA and the incidence of fat necrosis in the first postoperative year, differences in fat necrosis grade (I-V), differences in fat necrosis requiring reoperation, quality of life, and patient satisfaction were analyzed. RESULTS: The incidence of fat necrosis was reduced from 59.5% (control group) to 29% (ICG-group) (P = 0.021) (relative risk = 0.49 [95% CI, 0.25-0.97]). The major difference was in grade II (27% vs 2.7%, P = 0.038). The number of second surgeries for fat necrosis treatment was also reduced (45.9% vs 20.8%, P = 0.046). The ICG group had higher scores on the BREAST-Q. CONCLUSIONS: Intraoperative ICGA is a useful technique for reconstructive microsurgery that might improve patient satisfaction and reduce the incidence of fat necrosis by half as well as reduce its grade, especially in small fat necrosis cases; consequently, ICGA could reduce the number of secondary surgeries for treatment of fat necrosis.

Environment-dependent regulation of spliceosome activity by the LSM2-8 complex in Arabidopsis.

Spliceosome activity is tightly regulated to ensure adequate splicing in response to internal and external cues. It has been suggested that core components of the spliceosome, such as the snRNPs, would participate in the control of its activity. The experimental indications supporting this proposition, however, remain scarce, and the operating mechanisms poorly understood. Here, we present genetic and molecular evidence demonstrating that the LSM2-8 complex, the protein moiety of the U6 snRNP, regulates the spliceosome activity in Arabidopsis, and that this regulation is controlled by the environmental conditions. Our results show that the complex ensures the efficiency and accuracy of constitutive and alternative splicing of selected pre-mRNAs, depending on the conditions. Moreover, miss-splicing of most targeted pre-mRNAs leads to the generation of nonsense mediated decay signatures, indicating that the LSM2-8 complex also guarantees adequate levels of the corresponding functional transcripts. Interestingly, the selective role of the complex has relevant physiological implications since it is required for adequate plant adaptation to abiotic stresses. These findings unveil an unanticipated function for the LSM2-8 complex that represents a new layer of posttranscriptional regulation in response to external stimuli in eukaryotes.

Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application.

BACKGROUND: Although the use of lateral intercostal artery perforator (ICAP) flaps for immediate breast reconstruction has been widely described, data on the use of the anterior ICAP (AICAP) flaps for this indication are limited. In this context, we describe the results of anatomical study and our clinical experience with AICAP flaps for breast reconstruction. METHODS: In this study, the location and characteristics of the AICAPs were dissected in 12 female adult formalin-preserved hemitrunks and two fresh-frozen cadavers. Fourteen patients (mean BMI 23) underwent partial breast resection for a quadrant breast cancer followed by breast reconstruction with an intercostal perforator flap. The mean resection size was 6 × 5 × 5.5 cm (range 3-8 × 3.5-7 × 4-8 cm).The main outcome measures were pre-operative and postradiotherapy health-related quality of life assessed with the BREAST-Q reconstruction survey. RESULTS: According to anatomical study, at least one perforator was found in each third of hemitrunks dissected. The mean of perforator size was in diameter 0.42 ± 0.05 mm and in length 3.1 ± 0.36 cm. In clinical outcomes, the mean of flap size was 16 × 5 × 3 cm (range 14-19 × 3-8 × 2-5 cm). The mean surgical time was 120 min (range 109-125 min). Only one partial flap failure was detected. No postoperative changes in breast size were observed, although soft tissue changes were observed in four patients after radiotherapy. The mean BREAST-Q scores changes were 0 in satisfaction with the breast, 5 in satisfaction with outcome, 0 in psychosocial well-being, 6.15 in sexual well being, and 34.69 in physical well-being. CONCLUSIONS: Based on this anatomical and clinical study, we found AICAP flap has a consistent vascularization with good perforators. And moreover, it is suitable for partial breast reconstruction (quadrantectomy) and does not appear to negatively impact patient satisfaction.