Days Of Excision Research Articles

Methodological optimisation of thymocyte isolation and cryopreservation of human thymus samples

Premature lymphocytes develop into non-autoreactive, mature naïve CD4+ or CD8+ T cells in the thymus before entering the circulation. However, in-depth characterization of human thymocyte development remains challenging due to limited availability of human thymus samples and the fragile nature of thymocyte populations. Thymocytes often do not survive cryopreservation and thawing procedures, especially the fragile CD4+CD8+ double positive population. It is generally recommended to use fresh human thymus tissue on the day of excision to avoid any biases in thymocyte composition. This hampers the possibility to perform multiple experiments on the same thymus sample. To establish how the thymocyte viability and composition can be maintained, we compared two thymocyte isolation methods used for human and/or mice thymi, three cryopreservation methods in combination with our most gentle thawing technique. Based on our findings we established that fresh human thymi remain viable in cold storage for up to two days post-surgery without compromising thymocyte composition. Thymocytes can be cryopreserved if required, although the CD4+CD8+ double positive populations may be reduced. Our study provides thoroughly optimized methods to study human thymocyte development over a considerable time-frame post-surgery.

Timing of HPV vaccination as adjuvant treatment of CIN2+ recurrence in women undergoing surgical excision: a meta-analysis and meta-regression

ObjectiveThe main aim was to determine the overall vaccine effectiveness (VE) against recurrent cervical intraepithelial neoplasia grade 2 or worse (CIN2+) including specific VE associated with timing of human papillomavirus...

Excision in girls: Life-threatening acute complications in girls within 7 days of excision: Experience of the Pediatric Department of the University Hospital Gabriel Toure in Bamako, Mali

The practice of excision in girls poses a significant risk to their health. The objective of this study was to determine the immediate acute complications associated with this practice. Patients and methodsThis was a retrospective descriptive study over a period of 15 months including all girls aged 0–15 years hospitalized for acute complications related to excision within 7 days of the practice in the pediatric department of the University Hospital Gabriel Toure. ResultsWe collected 17 patient files. The median consultation time was 43 h. The main reason for consultation was post-excision bleeding in 76.4% of the cases. Pallor associated with respiratory distress was found in almost all cases. On admission, four girls (23.5%) were comatose and five girls (29.4%) showed signs of shock. The reasons for hospitalization were hemorrhage associated with post-excisional sepsis (52.9%), complicated shock anemia (23.5%), and severe post-excision anemia (23.5%). The average hemoglobin level was 5.5 g/dL; there was severe anemia in 94.1% of the girls (Hb <7g/dl). All the girls received blood transfusions with red blood cell concentrate. The other treatments received were local care (100%), administration of analgesics (100%), antibiotic therapy (82.4%), and oxygen therapy (41.2%). The outcome was unfavorable in two patients (11.8% deaths). ConclusionThis study shows the seriousness of the immediate complications associated with the practice of excision.

Basal cell carcinoma: what new can be learned about the most common human cancer? A cross-sectional prospective study of 180 cases in a single centre.

IntroductionBasal cell carcinoma (BCC) is the most common cancer in humans, but the reporting of patients with BCC is still not complete. There are a limited number of analyses in the literature on BCC epidemiology.AimTo study the epidemiological as well as clinical aspects of BCC by analysing a single centre’s experience in the Lower Silesia region of Poland.Material and methodsWe investigated 180 patients with BCC treated in the Unit of Dermatosurgery, Department of Dermatology, Venereology, and Allergology of Wroclaw Medical University between September 2017 and December 2019.ResultsThe mean age of patients with BCC was 70.5 ±11.9 years. The most frequently diagnosed type of BCC was nodular type, at 72% of all patients. BCC occurred most commonly on the face and neck area, at 132 (73.3%), without a statistical difference between males and females. The vast majority of cancers were located on the nose. There was a personal history of skin cancer in 29% of our patients. In 127 (70.6%) subjects, the diameter of the BCC on the day of excision was less than 2 cm.ConclusionsThe clinical characteristics of our cohort of BCC patients has some similarities with that reported from central Poland and other European countries. However, we found an increase in the incidence of BCC among females.

An expanded study of long-pulsed 1064 nm Nd:YAG laser treatment of basal cell carcinoma.

Basal cell carcinoma (BCC) is an indolent form of skin cancer that is rarely life threatening, but can cause significant cosmetic and functional morbidity. Surgical treatments often result in disfiguring scars, while topical therapies frequently result in recurrence. The need for a more effective nonsurgical alternative has led to the investigation of laser treatment of BCC. We have previously conducted a pilot study which showed 100% histologic clearance at high fluences. Treatments were well tolerated with no significant adverse events. The objective of this larger study was to confirm preliminary results that the 1064 nm Nd:YAG laser is a safe and effective method for treating non-facial BCC. This is an IRB-approved, prospective, multi-center study evaluating the safety and efficacy of the 1064 nm Nd:YAG laser for the treatment of BCC on the trunk and extremities. Thirty-three subjects seeking treatment for biopsy-proven BCC that did not meet the criteria for Mohs surgery were recruited. Subjects on current anticoagulation therapy, or with a history of immunosuppression were excluded. Subjects received one treatment with the 1064 nm Nd:YAG laser as follows: 5-6 mm spot, fluence of 125-140 J/cm2 and a pulse duration of 7-10 ms. Standard excision with 5 mm clinical margins was performed at 30 days after laser treatment to evaluate clinical and histologic clearance of BCC. Standardized photographs and adverse assessments were taken at the baseline visit, immediately after laser treatment and on the day of excision. Thirty-one subjects completed the study. BCC tumors had a 90% (28 of 31 BCC tumors) histologic clearance rate after one treatment with the long-pulsed 1064 nm Nd:YAG laser. Treatments were generally well tolerated without any anesthesia. Immediate side effects included edema and erythema. At 1-month follow-up, some patients had residual crusting. No significant adverse events occurred. The 1064 nm long-pulsed Nd:YAG laser is an alternative for treating non-facial BCC for those that are poor surgical candidates. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.

Alcoholic versus aqueous chlorhexidine for skin antisepsis: the AVALANCHE trial.

Preoperative skin antisepsis is routine practice. We compared alcoholic chlorhexidine with aqueous chlorhexidine for skin antisepsis to prevent surgical site infection after minor skin excisions in general practice. We conducted this prospective, multicentre, randomized controlled trial in 4 private general practices in North Queensland, Australia, from October 2015 to August 2016. Consecutive adult patients presenting for minor skin excisions were randomly assigned to undergo preoperative skin antisepsis with 0.5% chlorhexidine in 70% ethanol (intervention) or 0.5% chlorhexidine aqueous solution (control). Our primary outcome was surgical site infection within 30 days of excision. We also measured the incidence of adverse reactions. A total of 916 patients were included in the study: 454 underwent antisepsis with alcoholic chlorhexidine and 462 with aqueous chlorhexidine. Of these, 909 completed follow-up. In the intention-to-treat analysis of cases available at follow-up, there was no significant difference in the incidence of surgical site infection between the alcoholic chlorhexidine arm (5.8%, 95% confidence interval [CI] 3.6% to 7.9%) and the aqueous chlorhexidine arm (6.8%, 95% CI 4.5% to 9.1%). The attributable risk reduction was 0.010 (95% CI -0.021 to 0.042), the relative risk was 0.85 (95% CI 0.51 to 1.41), and the number needed to treat to benefit was 100. Per protocol and sensitivity analyses produced similar results. The incidence of adverse reactions was low, with no difference between groups (p = 0.6). There was no significant difference in efficacy between alcoholic and aqueous chlorhexidine for the prevention of surgical site infection after minor skin excisions in general practice. Trial registration: https://www.anzctr.org.au, no. ACTRN12615001045505.

Radioguided occult lesion localization (ROLL) versus wire‐guided lumpectomy for non‐palpable breast lesions: A randomized prospective evaluation

It is important to optimize the localization technique for non-palpable breast lesions. One hundred consecutive women with non-palpable breast lesions were randomized to radioguided occult lesion localization (ROLL) or wire localization (WL). For ROLL technique (99m)Tc-labeled particles of human serum albumin were injected under breast-imaging control. Localization of the lesion was done in the operating room with the aid of a gamma-probe. All lesions were identified in an X-ray control of the surgical specimen. Categorical variables were analyzed with the Chi-square method. Significance was considered at P < 0.05. All procedures were performed on the same day of excision, on ambulatory basis. Both techniques resulted in 100% retrieval of the lesions. Localization time was reduced with ROLL (P < 0.001). Clear margins were achieved in 88.9% ROLLs and 62.5% WLs (P < 0.05) reducing the requirement of re-excision. There were significant differences in the subjective ease of the procedures in favor of ROLL technique as rated by surgeons and radiologists. ROLL technique is as effective as WL for excision of non-palpable breast lesions, reduce localization time and probably the incidence of pathologically involved margins of excision. ROLL appears to improve the learning curve for surgical residents and cosmesis. ROLL is an attractive alternative to WL.

An assessment of the aquaculture potential of the tropical sponges Rhopaloeides odorabile and Coscinoderma sp.

Sponge aquaculture offers the opportunity to provide a sustainable supply of bath and industrial sponges and mitigate the environmental effects of over-harvesting. The potential to develop sponge aquaculture is diverse given the variety of sponge species. However, amenability to culture and the selection of appropriate culture methods are species specific and need to be determined to provide the platform for commercial success. In this study the survival (in situ and ex situ), growth rates (in situ), and recovery processes (ex situ) were measured for explants of two sponge aquaculture candidates, Rhopaloeides odorabile Thompson et al. and Coscinoderma sp. [Phylum Porifera: Order Dictyoceratida: Family Spongiidae], cultured in the Palm Islands Group of the central Great Barrier Reef. Sponge survival was dependent on the species, experiment duration, and method of culture. For both species the highest mortality occurred within days of excision of sponge material from parent stock, and mortalities were negligible after 78 days. After 78 days, R. odorabile had highest survival ex situ (75%) and lowest in situ (60%). In contrast, Coscinoderma sp. had the lowest survival ex situ (30%) and highest in situ (90%). The total growth of R. odorabile (146.0 ± 40.3%) and Coscinoderma sp. (195.9 ± 39.8%) was not significantly different over the 21 month experimental period, but was highly variable between explants from the same individual. Both species demonstrated initial size dependent growth rates with smaller explants growing fastest over the first 78 days. Explant recovery rates were rapid for both species with a protective layer of collagen forming over the surface within 24 h. This layer was replaced by pinacoderm between 3 and 41 days after excision as the subsurface tissue reorganised to recreate a functional surface for each species, including redevelopment of the aquiferous system within 41 days for R. odorabile. R. odorabile and Coscinoderma sp. both show potential for commercial aquaculture, however, further research is required to reduce initial mortality rates and the high variability in growth rates between explants.

(441) Evaluation of Three Grafting Methods for Propagating Soursop (Annona muricata L.) in the Dry Tropic Region of Mexico

Soursop (Annonamuricata L.) is reproduced by seeds from `Criollo' cultivars in Mexico. The replication of desirable agronomic traits is difficult when selected plants are from sexual reproduction. The heterogeneity of plants is observed as taller trees, irregular fresh fruit yield, variable fruit quality, different insect pests, disease susceptibilities, and lower number of plants per hectare. There is an extended time period for recovering investments and commericialization problems due to fruit quality and price. Vegetative propagation is an alternative for reducing the heterogeneity of soursop trees. Three grafting methods were evaluated for propagating soursop in the dry tropic region of Colima, Mexico: 1) splice side graft; 2) wedge graft; and 3) bud graft. The experiment was carried out on the Tecoman Campus of the Universidad de Colima. Rootstocks were from 8-month-old healthy plants, 1-m tall and 1-cm diameter, obtained from `Criollo' seedlings, and the scions were obtained from a healthy 10-year-old `Sin Fibra' donor tree. This donor tree was selected for its excellent agronomic traits and fruit yield. Vigorous and terminal scions were used, disinfected with fungicide, and used the same day of excision. The experiment was distributed under a completely randomized design. Splice side grafting had 67% success after 60 days, while wedge grafting and bud grafting had 0% success.

Heavy Metals Induce Lipid Peroxidation and Affect Antioxidants in Wheat Leaves

The possible role of Zn and Cr as catalytic inducers of free radicals in wheat leaves was investigated. Treatment of excess heavy metals decreased the chlorophyll and carotenoid content in wheat leaves with the increase in time of excision. A sharp increase in proline accumulation was marked with the increase in metal concentration. Total peroxide content and lipid peroxidation measured as malondialdehyde content showed uniform increase under metal treatment in excised leaves. At almost all concentrations, catalase, guaiacol peroxidase and superoxide dismutase activities decreased with a minor increase in the earlier days of excision. Though glutathione content decreased ascorbate content showed significant increase in wheat leaves under heavy metal treatment.

Involvement of rooting factors and free IAA in the rootability of citrus species stem cuttings

Two-year-old trees of cultivar ‘Rangpur’ lime (Citrus limonia Osb.) and of cultivar ‘Oroblanco’, a triploid pummelo-grapefruit hybrid (Citrus grandis Osb. × Citrus paradisi Macf.), which had not reached flowering stage, were grown under greenhouse conditions. Cuttings from the last vigorous vegetative flush were taken from each species for rooting experiments. Callus formation and percentage of rooting were determined after 19 and 36 days. Endogenous indole-3-acetic acid (IAA) content and avocado rooting promoter (ARP)-like activity were determined in leaves and bark (cortex) of the lower end of the cutting on day of excision and 19 days later. Rooting of the easy-to-root ‘Rangpur’ lime reached 77% after 19 days and 100% after 36 days. At those times the difficult-to-root ‘Oroblanco’ did not root at all or reached 12% rooting, respectively. At Day 19 the level of free IAA in the bark of ‘Rangpur’ lime was 3.5 times higher than that at Day 0, and 3.6 times higher than in the ‘Oroblanco’ bark on the same day. ARP was found in both species at excision day and after 19 days using gas-chromatography analysis. The ARP activity on the day of excision was only slightly higher in the leaves and bark of ‘Rangpur’ lime than in ‘Oroblanco’, but after 19 days ARP-like activity rose approximately 45% in the basal bark of ‘Rangpur’ lime with no such increase in its leaves or in the leaves and bark of ‘Oroblanco’. The differences in IAA level and ARP-like activity in the two citrus cultivars appear to be correlated with their ease of rooting, but it is not possible to tell whether the increase in IAA and ARP over the rooting period is the cause or result of root initiation.

Modification of the volumetric growth responses and steady-state hypoxic fractions of xenografted DLD-2 human colon carcinomas by administration of basic fibroblast growth factor or suramin.

We studied the growth characteristics and hypoxic fractions of DLD-2 human colon tumours xenografted into male nude mice either in the unperturbed state or after i.p. injection (q.i.d. x 7) of basic fibroblast growth factor (0.25 mg kg-1) or suramin (50 mg kg-1). Hypoxic fractions were measured by clonogenic excision assay 1 day after administration b FGF or suramin was stopped. As compared to controls, the growth of tumours in b FGF treated mice was increased by a factor of 1.5 as indicated by the relative volumes of tumours on the day of excision. Similarly, suramin decreased the growth of DLD-2 tumours by a factor of 1.6. The percentage of hypoxic cells in control neoplasms was 42.9% (95% confidence limits 34.2-52.1%). In mice that received basic fibroblast growth factor injections, hypoxic fractions decreased to 19.1% (95% confidence limits 13.5-26.9%). In contrast, in mice treated with suramin, the percentage of hypoxic cells increased to 74.0% (95% confidence limits 65.3-83.9%). These data indicate that the biology of solid tumours can be significantly modified by alteration of growth factor status.

Conservative Treatment of Scald Burns Is Superior to Early Excision

Early excision of deep burns has been advocated; however, it is difficult to clinically determine the depth of scald burns during the early postburn period. This prospective, randomized study was designed to determine whether early excision was superior to conservative treatment of scald injuries. Patients with scald injuries (which were not caused by grease) of clinically indeterminant depth were randomized to early (n = 12) or late (n = 12) excision; all patients with obvious superficial and full-thickness injuries were excluded. In the early excision group, all deep wounds were tangentially excised and grafted within 72 hours of admission, whereas in the late treatment group wounds were excised and grafted after 2 weeks had passed since injury. Area excised, postburn day of excision, percent graft take, operating-room time, blood replacement, incidence of infection, and length of hospital stay were compared. No patient experienced a significant wound infection or systemic sepsis. A significantly smaller area of excision was necessary for those patients who were treated with delayed surgery, and concomitant decreases in operating-room time and blood loss were observed. Notably, only one half of the patients who were randomized to the delayed excision group ultimately required surgical intervention to achieve wound closure. Graft take was comparable for both groups, as was length of hospital stay. Early clinical evaluation of scald injuries appears to be equivocal, and later evaluations reveal a less severe injury. Financial gains can be made when surgical excision of scald injuries is delayed until 2 weeks after injury because of a related reduction in hospital expenditures.

Immunological consequences of tumor excision: from active immunity to immunological memory.

Excision of the immunogenic Meth-A fibrosarcoma during generation by the host of concomitant antitumor immunity resulted in the appearance in sequence of two qualitatively distinct states of post-excision immunity. Immunity expressed on the day of excision was dependent on Ly-1-2+, cyclophosphamide-sensitive T cells, whereas immunity expressed 2 weeks later was dependent on cyclophosphamide-resistant T cells which can be functionally eliminated by either anti-Ly-1 or anti-Ly-2 monoclonal antibody and complement. The data suggest that antitumor immunity expressed shortly after tumor excision represents active concomitant immunity that is acquired by the host before excision is performed. In contrast, immunity expressed 2 weeks later is based on immunological memory.

Wound Excision to Fascia in Burn Patients

All charts of burn patients admitted to the US Army Institute of Surgical Research over a four-year period were reviewed to determine the efficacy of excision of the burn wound to fascia as a therapeutic modality. Of 1,013 burn patients, 72 underwent this procedure. The patients who had excisions had a mean total burn size of 52% of body surface area (BSA) and a mean third-degree burn of 33%. We correlated survival with burn size, associated injuries, day of excision, wound coverage, and sepsis. Survival in the group who had excisions (57%) did not differ substantially from that of the other patients (38%) when broken down by burn size. Careful selection of patients for this procedure and criteria for selection are stressed.

Rooting of chrysanthemum cuttings. Influence of irradiance during stock plant growth and of decapitation and disbudding of cuttings

Stock plants of Chrysanthemum morifolium Ramat. cultivar ‘Improved Mefo’ were grown in a controlled-environment room at different levels of irradiance (9, 23, 53 or 90 W m −2). After 3 weeks, cuttings were excised and rooted for 3 weeks at an irradiance of 16 W m −2. Cuttings from stock plants grown at the highest irradiance had the highest number of roots, while cuttings from the lowest irradiance had the lowest number of roots. The importance of the presence of shoot meristems for root formation was investigated through disbudding and decapitation at different times after the excision of the cuttings. Removing the buds on the day of excision had no effect on the number of roots formed, while the removal of the buds on day 2 to day 5 after excision had a promotive effect. Removal later than 7 days after excision had no effect at all. The results are discussed from the point of view that an interaction between nutritional and hormonal factors regulates the process of root formation.

Effect of Excision Duration on Spotted Alfalfa Aphid1 Resistance in Alfalfa Cuttings2

The effect of excision duration on resistance of alfalfa, Medicago saliva L., stem cuttings to Therioaphis maculata (Buckton) varied differently among 18 clones of diverse origin. The resistance of cuttings from I clone was not altered on leaves infested on the day of excision and on 2, 4, 6, and 9 days following excision. Total nymphal days on each treatment were similar to those on the attached leaf. Conversely, resistance of another clone was sharply reduced on leaves of plant parts excised and infested the same day. Recovery of resistance increased directly with duration of excision and was complete on plant parts excised 6 days prior to infestation. Rate of recovery of resistance varied among clones. The susceptibility of a susceptible clone was not altered by duration of excision. Leaves of detached plant parts from all clones were damaged more than corresponding attached leaves. However, the clone × treatment interaction was significant. Partial degradation of leaves did not affect the resistance of a highly resistant clone or the susceptibility of the susceptible clone.