Arterial Embolism After Facial Fat Grafting: A Systematic Literature Review.

BACKGROUND: While autologous fat grafting of the face is considered a generally safe procedure, severe complications such as arterial embolism (AE) have been reported. OBJECTIVE: To summarize data on injection-related visual compromise, stroke, and death caused by arterial embolism after facial fat transplantation. MATERIALS AND METHODS: Plastic surgery societies were contacted for reports on AE after autologous facial fat injection. In addition, a systematic literature review was performed. Data extracted included study design, injection site/technique, symptoms, management, outcome, and etiology. RESULTS: 61 patients with a mean age of 33.56 ± 11.45 years were reported. Injections targeted the glabella or multiple facial regions (both n = 16/61, 26.2%) most commonly, followed by injections in the temples (n = 10/61, 16.4%) and the forehead (n = 9/61, 14.8%). The mean volume injected was 21.5 ± 21.5 ml. Visual symptoms were described most frequently (n = 24/58, 41.4%) followed by neurological symptoms (n = 20/58, 34.5%), or both (n = 13/58, 22.4%). Ophthalmic artery (OA, n = 26/60, 43.3%), anterior or middle cerebral artery (CA, n = 11/60, 18.3%) or both (n = 14/60, 23.3%) were most frequently occluded. Outcome analysis revealed permanent vision loss in all patients with OA occlusion (n = 26/26, 100%), neurological impairment in most patients with CA occlusion (n = 8/10, 80%), and vision loss in most patients suffering from both OA and CA occlusion (n = 7/11, 63.6%). Six patients died following embolisms. CONCLUSIONS: AE causes severe complications such as blindness, stroke, and death. Due to a lack of high-quality data, no evidence-based treatment algorithms exist. To increase patient safety, a database collecting cases and complications should be established. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Urinary Continence Recovery after Robotic Radical Prostatectomy without Anterior or Posterior Reconstruction: Experience from a Tertiary Referral Center.

BACKGROUND: The aim of our study is to evaluate the prevalence and predictive factors of short- (30 d) and mid-term continence in a contemporary cohort of patients treated with robotic-assisted laparoscopic prostatectomy (RALP) without any posterior or anterior reconstruction at our referral academic center. METHODS: Data from patients undergoing RALP between January 2017 and March 2021 were prospectively collected. RALP was performed by three highly experienced surgeons following the principles of the Montsouris technique, with a bladder-neck-sparing intent and maximal preservation of the membranous urethra (if oncologically safe) without any anterior/posterior reconstruction. (Self-assessed urinary incontinence (UI) was defined as the need of one or more pads per die (excluding the need for a safety pad/die. Univariable and multivariable logistic regression analysis was used to assess the independent predictors of early incontinence among routinely collected patient- and tumor-related variables). RESULTS: A total of 925 patients were included; of these, 353 underwent RALP (38.2%) without nerve-sparing intent. The median patient age and BMI were 68 years (IQR 63-72) and 26 (IQR 24.0-28.0), respectively. Overall, 159 patients (17.2%) reported early (30 d) incontinence. In multivariable analysis adjusting for patient- and tumor-related features, a non-nerve-sparing procedure (OR: 1.57 [95% CI: 1.03-2.59], p = 0.035) was independently associated with the risk of urinary incontinence in the short-term period, while the absence of cardiovascular diseases before surgery (OR: 0.46 [95% CI: 0.320.67], p ≤ 0.01) was a protective factor for this outcome. At a median follow-up of 17 months (IQR 10-24), 94.5% of patients reported to be continent. CONCLUSIONS: In experienced hands, most patients fully recover urinary continence after RALP at mid-term follow-up. On the contrary, the proportion of patients who reported early incontinence in our series was modest but not negligible. The implementation of surgical techniques advocating anterior and/or posterior fascial reconstruction might improve the early continence rate in candidates for RALP.

Inflammation in Urological Malignancies: The Silent Killer.

Several studies have investigated the role of inflammation in promoting tumorigenesis and cancer progression. Neoplastic as well as surrounding stromal and inflammatory cells engage in well-orchestrated reciprocal interactions to establish an inflammatory tumor microenvironment. The tumor-associated inflammatory tissue is highly plastic, capable of continuously modifying its phenotypic and functional characteristics. Accumulating evidence suggests that chronic inflammation plays a critical role in the development of urological cancers. Here, we review the origins of inflammation in urothelial, prostatic, renal, testicular, and penile cancers, focusing on the mechanisms that drive tumor initiation, growth, progression, and metastasis. We also discuss how tumor-associated inflammatory tissue may be a diagnostic marker of clinically significant tumor progression risk and the target for future anti-cancer therapies.

Adipose and lipoma stem cells: A donor-matched comparison.

Lipomas are slow growing benign fat tumors that develop in soft tissues of the mesoderm. Thus, the specific (dys-)function of mesenchymal stem cells (MSCs) has been suggested in the development of lipomas, but details of the tumor pathogenesis remain unclear. Existing studies comparing stem cells from native adipose (adipose stem cells [ASCs]) and lipomatous tissues (LSCs) have reported contradicting findings. However, harvesting ASCs and LSCs from different individuals might have influenced proper comparison. Therefore, we aimed to characterize donor-matched ASCs and LSCs to investigate metabolic activity, proliferation, capability for tri-linear differentiation (chondrogenesis, adipogenesis, osteogenesis), and the secretome of mature adipocytes and lipomacytes. Both stem cell types did not differ in metabolic activity, but ASCs demonstrated stronger proliferation than LSCs. While there was no difference in proteoglycan accumulation during chondrogenic differentiation, adipogenesis was higher in ASCs, with more lipid vacuole formation. Conversely, LSCs showed increased osteogenesis by higher calcium deposition. Lipomacytes showed stronger secretory activity and released higher levels of certain adipokines. Our findings indicated that LSCs possessed important characteristics of MSCs, including ASCs. However, LSCs' low proliferation and adipogenic differentiation behavior did not appear to account for enhanced tissue proliferation, but the secretome of lipomacytes could contribute to lipomatous neoplasm.

Gender and Advanced Urothelial Cancer: Outcome, Efficacy and Toxicity following Chemotherapy.

Background and Objectives: The incidence of urothelial cancer in males is higher than in females; however, females have a higher risk of recurrence and progression. The aim of our study was to report the effect of gender on the oncological outcome in advanced urothelial cancer. Materials and Methods: In our retrospective study, all patients had undergone primary surgical treatment for urothelial cancer and were affected by stage IV disease at the time of chemotherapy. Response to therapy and toxicity were evaluated. Subgroups were analyzed for tumour presentation, first- and second-line treatment response, progression-free survival (PFS) and overall survival (OS). Results. Seventy-five patients, 18 (24%) females and 57 (76%) males, were considered. Investigation into the distribution of individual characteristics according to gender revealed a significant difference only for smoking, with a prevalence of smokers in women (p = 0.029). At the end of follow-up, OS was higher in females (27.5% vs. 17.4%; p = 0.047). Smoking did not significantly influence OS (p = 0.055), while univariate Cox regression analysis confirmed that males had a higher risk of death (HR = 2.28, 95% CI 0.99-129 5.25), with borderline statistical significance (p = 0.053). Men showed higher PFS than women both after first-line (p = 0.051) and second-line chemotherapy (p = 0.018), with a lower risk of progression (HR = 0.29, 95% CI 0.10-0.86; p = 0.026). No differences were found between genders with regard to toxicity. Conclusions. In our series, PFS rates following first- and second-line therapies for advanced urothelial carcinoma confirmed that females have a greater risk of progression than males.

Low Metal Loading (Au, Ag, Pt, Pd) Photo-Catalysts Supported on TiO2 for Renewable Processes.

Photo-catalysts based on titanium dioxide, and modified with highly dispersed metallic nanoparticles of Au, Ag, Pd and Pt, either mono- or bi-metallic, have been analyzed by multiple characterization techniques, including XRD, XPS, SEM, EDX, UV-Vis and N2 adsorption/desorption. Mono-metallic photo-catalysts were prepared by wet impregnation, while bi-metallic photocatalysts were obtained via deposition-precipitation (DP). The relationship between the physico-chemical properties and the catalyst's behavior for various photo-synthetic processes, such as carbon dioxide photo-reduction to liquid products and glucose photo-reforming to hydrogen have been investigated. Among the tested materials, the catalysts containing platinum alone (i.e., 0.1 mol% Pt/TiO2) or bi-metallic gold-containing materials (e.g., 1 wt% (AuxAgy)/TiO2 and 1 wt% (AuxPtz)/TiO2) showed the highest activity, presenting the best results in terms of productivity and conversion for both applications. The textural, structural and morphological properties of the different samples being very similar, the main parameters to improve performance were function of the metal as electron sink, together with optoelectronic properties. The high activity in both applications was related to the low band gap, that allows harvesting more energy from a polychromatic light source with respect to the bare TiO2. Overall, high selectivity and productivity were achieved with respect to most literature data.

Effect of Metal Cocatalysts and Operating Conditions on the Product Distribution and the Productivity of the CO2 Photoreduction.

The CO2 photoreduction is a promising way to convert one of the most abundant greenhouse gases to valuable chemicals. The photoreduction in the liquid phase is limited by the low solubility of CO2 in water, but this point is overcome here by using an innovative photoreactor, which allows one to work up to pressures of 20 bar, improving the overall productivity. The photoreduction was performed in the presence of Na2SO3 and using in primis commercial titanium dioxide (P25) and a set of titania catalysts functionalized by surface deposition of either monometallic or bimetallic cocatalysts. The gaseous products were hydrogen and traces of CO, while, in the liquid phase, formic acid/formate, formaldehyde and methanol were quantitatively detected. The pH was observed to shift the products distribution. A neutral environment led mainly to hydrogen and methanol, while, at pH 14, formate was the most abundant compound. The trend for monometallic cocatalysts showed enhanced productivity when using noble metals (i.e., gold and platinum). In order to limit the cost of the catalytic material, bimetallic cocatalysts were explored, adding titania with Au+Ag or Au+Pt. This may open to the possibility of performing the reaction with a smaller amount of the most expensive metals. In the end, we have expressed some conclusions on the cost of the photocatalysts here employed, to support the overall feasibility assessment of the process.

A review of advances in multifunctional XTiO3 perovskite-type oxides as piezo-photocatalysts for environmental remediation and energy production.

Over more than three decades, the field of engineering of photocatalytic materials with unique properties and enhanced performance has received a huge attention. In this regard, different classes of materials were fabricated and used for different photocatalytic applications. Among these materials, recently multifunctional XTiO3 perovskites have drawn outstanding interest towards environmental remediation and energy conversion thanks to their unique structural, optical, physiochemical, electrical and thermal characteristics. XTiO3 perovskites are able to initiate different surface catalytic reactions. Under ultrasonic vibration or heating, XTiO3 perovskites can induce piezo-catalytic reactions due to the titling of their conduction and valence bands, resulting in the formation of separated charge carriers in the medium. In addition, under light irradiation, XTiO3 perovskites are considered as a new class of photocatalysts for environmental and energy related applications. Herein, we addressed the recent advances on variously synthesized, doped and formulated XTiO3 perovskite-type oxides showing piezo- and/or photocatalytic exploitation in environmental remediation and energy conversion. The control of structural crystallite size and phase, conductivity, morphology, oxygen vacancy control, doping agents and ratio has a significant role on the photocatalytic and piezocatalytic activities. The different piezo or/and photocatalytic processes mechanistic pathways towards varying applications were discussed. The current challenges facing these materials and future trends were addressed at the end of the review.

Flame Pyrolysis Synthesis of Mixed Oxides for Glycerol Steam Reforming.

Flame spray pyrolysis was used to produce nanosized Ni-based catalysts starting from different mixed oxides. LaNiO3 and CeNiO3 were used as base materials and the formulation was varied by mixing them or incorporating variable amounts of ZrO2 or SrO during the synthesis. The catalysts were tested for the steam reforming of glycerol. One of the key problems for this application is the resistance to deactivation by sintering and coking, which may be increased by (1) improving Ni dispersion through the production of a Ni-La or Ni-Ce mixed oxide precursor, and then reduced; (2) using an oxide as ZrO2, which established a strong interaction with Ni and possesses high thermal resistance; (3) decreasing the surface acidity of ZrO2 through a basic promoter/support, such as La2O3; and (4) adding a promoter/support with very high oxygen mobility such as CeO2. A further key feature is the use of a high temperature synthesis, such as flame spray pyrolysis, to improve the overall thermal resistance of the oxides. These strategies proved effective to obtain active and stable catalysts at least for 20 h on stream with very limited coke formation.

Synthesis of [Pt12(CO)20(dppm)2]2- and [Pt18(CO)30(dppm)3]2- Heteroleptic Chini-type Platinum Clusters by the Oxidative Oligomerization of [Pt6(CO)12(dppm)]2.

The reactions of [Pt6(CO)12]2- with CH(PPh2)2 (dppm), CH2═C(PPh2)2 (P^P), and Fe(C5H4PPh2)2 (dppf) proceed via nonredox substitution and result in the heteroleptic Chini-type clusters [Pt6(CO)10(dppm)]2-, [Pt6(CO)10(P^P)]2-, and [Pt6(CO)10(dppf)]2-, respectively. Conversely, the reactions of [Pt6(CO)12]2- with Ph2P(CH2)4PPh2 (dppb) and Ph2PC≡CPPh2 (dppa) can be described as redox fragmentation that afford the neutral complexes Pt(dppb)2, Pt2(CO)2(dppa)3, and Pt8(CO)6(PPh2)2(C≡CPPh2)2(dppa)2. The oxidation of [Pt6(CO)10(dppm)]2- results in its oligomerization to yield the larger heteroleptic Chini-type clusters [Pt12(CO)20(dppm)2]2-, [Pt18(CO)30(dppm)3]2-, and [Pt24(CO)40(dppm)4]2- (for the latter there is only IR spectroscopic evidence). All the clusters were characterized by means of IR and 31P NMR spectroscopies and electrospray ionization mass spectrometry. Moreover, the crystal structures of [NEt4]2[Pt6(CO)10(dppm)]·CH3CN, [NEt4]2[Pt12(CO)20(dppm)2]·2CH3CN·2dmf, [NEt4]2[Pt12(CO)20(dppm)2]·4dmf, [NEt4]2[Pt6(CO)10(dppf)]·2CH3CN, Pt2(CO)2(dppa)3·0.5CH3CN, Pt8(CO)6(PPh2)2(C≡CPPh2)2(dppa)2·2thf, and Pt(dppb)2 were determined by single-crystal diffraction (dmf = dimethylformamide; thf = tetrahydrofuran).

A Kalman filter approach for denoising and deblurring 3-D microscopy images.

This paper proposes a new method for removing noise and blurring from 3D microscopy images. The main contribution is the definition of a space-variant generating model of a 3-D signal, which is capable to stochastically describe a wide class of 3-D images. Unlike other approaches, the space-variant structure allows the model to consider the information on edge locations, if available. A suitable description of the image acquisition process, including blurring and noise, is then associated to the model. A state-space realization is finally derived, which is amenable to the application of standard Kalman filter as an image restoration algorithm. The so obtained method is able to remove, at each spatial step, both blur and noise, via a linear minimum variance recursive one-shot procedure, which does not require the simultaneous processing of the whole image. Numerical results on synthetic and real microscopy images confirm the merit of the approach.

Expansion of intestinal CD4+CD25(high) Treg cells in patients with ankylosing spondylitis: a putative role for interleukin-10 in preventing intestinal Th17 response.

OBJECTIVE: Subclinical gut inflammation has been demonstrated in patients with ankylosing spondylitis (AS). This study was undertaken to determine the frequency of regulatory CD4+CD25(high) T cells (Treg cells) and to evaluate Treg cell-related cytokines (interleukin-2 [IL-2], transforming growth factor ß [TGFß], and IL-10) and transcription factors (FoxP3 and STAT-5) in the ileum of patients with AS. METHODS: Quantitative gene expression analysis, by reverse transcriptase-polymerase chain reaction, of Treg-related cytokines (IL-2, TGFß, and IL-10) and transcription factors (STAT-5 and FoxP3) was performed on ileal biopsy specimens from 18 patients with AS, 15 patients with active Crohn's disease (CD), and 15 healthy subjects. Tissue and circulating Treg cells were also analyzed by flow cytometry. RESULTS: A significant up-regulation of IL-2, TGFß, FoxP3, STAT-5, and IL-10 transcripts in the terminal ileum of AS patients displaying chronic ileal inflammation was observed. Flow cytometric analysis of Treg cells showed significant peripheral expansion in both patients with AS and chronic inflammation and patients with CD (mean ± SD 1.08 ± 0.4% and 1.05 ± 0.3%, respectively) as compared with healthy subjects (0.25 ± 0.12%) (P < 0.05). Interestingly, a 5-fold increase in the proportion of Treg cells was observed in the gut of patients with AS (5 ± 3%) as compared with healthy subjects (1.2 ± 0.4%) (P < 0.001), with 70-80% of these cells also producing IL-10. In vitro studies showed that blocking IL-10 was sufficient to induce Th17 polarization on lamina propria mononuclear cells isolated from AS patients. CONCLUSION: Our findings provide the first evidence that an active Treg cell response, mainly dominated by IL-10 production, occurs in the gut of AS patients and is probably responsible for the absence of a clear Th17 polarization in the ileum of AS patients.

Electrical injuries due to theft of copper.

This study shows that the theft of copper, mainly from electrical wires, is becoming a more frequent crime as the value of this metal rises. We have collected all the data from the Burn Centre of the Hospital of Palermo, Italy, from 1992 to 2007. Over the last two decades, we assisted to a dramatic increase of patients admitted to our hospital, reporting burn injuries while attempting to steal it in dangerous conditions. The circumstances of the injury, the clinical management of the case, and the long-term consequences are presented and discussed. We found that the electrical burn related to the theft of copper is often a life-threatening event because of the high-voltage electrical current passing through the patients. Patients, due to the type of activity, often requiring physical effort, were generally young and healthy. From a review of the literature on the subject, we have noticed that theft of copper is not reported as an important risk factor for electrical burns. Our report clearly shows that theft of copper-related electrical injury is becoming more frequent in the community and should be added as a "new" risk factor. The already high incidence reported here may actually be lower than the actual incidence because many patients tend not to come to the hospital because of the risk of being prosecuted by the police.