Suspension Technique Research Articles

Thread Lifting of the Jawline: A Pilot Study for Quantitative Evaluation.

Introduction:The facial aging process produces changes that are characteristic of the superficial and deep fat framework and skin layers. Subdermal suspension with threads enables the sagging tissues to be lifted by means of a minimally invasive, closed procedure without surgical dissection. This observational study has been carried out on the basis of standardized tridimensional photographic analysis and measurement, aimed at determining objective, repetitive, and reliable evaluation of the soft tissue suspension technique.Materials and Methods:Eight participants were enrolled in this pilot study presenting with mild to moderate ptosis of the jawline tissues. Patient photographs were taken before (t0), immediately after threads implantation (t1), and at the following visit (t2). Each image captured before thread insertion was registered by the software and surface linear lengths in between the mentioned points were calculated.Results:The result showed an overall average improvement in the “tragus-to-marionette distance” (C-A) and the “tragus-to-jowl distance” after a mean follow-up time of 8.16 months (t0-t2). All analyzed parameters improved significantly (P < 0.05) at t1 and at t2 with respect to t0.Conclusions:This pilot study suggest that facial tissue suspension by means of poli-lactic/poli-caprolactone threads is safe and effective in treating skin flaws that affect mild-to-moderate ptosis of the jawline up to 8 months.

Comparative Evaluation of Efficacy of Non-cultured Epidermal Cell Suspension and Epidermal Curettage in Stable Vitiligo.

Context:Vitiligo is a common primary acquired pigmentary disorder due to loss of epidermal functioning melanocytes. Many surgical techniques have evolved over the years for its treatment and the need of a cost-effective modality has always been put forward.Aim:The aim of the study was to compare the efficacy of non-cultured epidermal cell suspension with that of epidermal curettage in repigmentation of stable vitiligo.Settings and Design:It was a prospective randomized non-controlled study.Subjects and Methods:Forty lesions were selected in patients of stable, recalcitrant vitiligo belonging to different age-groups and genders. After histopathological confirmation, the patients were taken up for surgery after obtaining written consent and were divided into two groups for two different procedures, that is, non-cultured epidermal cell suspension (Group A) and epidermal curettage (Group B). Follow-up was carried out at 2, 4, 8, and 12 weeks of procedure to assess the repigmentation achieved.Statistical Analysis:Statistical Package for Social Sciences (SPSS) software, version 21.0, was used.Results:At the end of the study, >50% repigmentation was achieved in 95% (19 of 20) lesions of Group A and 85% (17 of 20) lesions in Group B, whereas >75% repigmentation was achieved in 60% (12 of 20) in both Groups A and B. The color matching with surrounding skin and yield of graft was better in epidermal cell suspension technique than that in epidermal curettage. The difference was not statistically significant.Conclusion:Though both the surgical techniques of melanocyte transplantation are effective in achieving uniform pigmentation, epidermal curettage has an extra edge of being simpler and more cost-effective.

Key Steps in Retzius-Sparing Robot-Assisted Radical Prostatectomy with a Novel Technique for Suspension of Parietal Peritoneum

Abstract Introduction: Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has been associated with better functional outcomes when compared with conventional RARP.1–3 Nonetheless, it is...

Simplified abductor pollicis longus suspension interposition arthroplasty for thumb carpometacarpal joint osteoarthritis

PurposeThe primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose of the present study was to introduce a variation of the abductor pollicis longus (APL) suspension arthroplasty using a single looping of a radial slip from the APL tendon around the flexor carpi radialis (FCR) tendon combined with RegJoint™ interposition and to determine its efficacy in the treatment of thumb CMC joint osteoarthritis.MethodsBetween 2015 and 2017, 21 patients were included. The average age was 60.8 years (range 48–79). The mean follow-up was 27.7 months (range 8–50). Evaluation included pain, radial and palmar abduction, tip pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score.ResultsPain averaged 0.3 (range 0–4) at rest and 1.4 (range 0–4) on exertion. The radial and palmar abduction were 97% and 99% compared to the contralateral side. The tip pinch and grip strength were 4.1 kg (range 3–6.5) and 22 kg (range 13.3–40), respectively. The DASH score accounted for 18.5 (range 0.8–41.7).ConclusionThe modified APL suspension interposition arthroplasty was an efficient and simplified option for the treatment of thumb CMC joint osteoarthritis, with results comparable or better than other published procedures. The APL suspension technique was easy to perform avoiding difficult bone tunneling and incision of the FCR tendon. The RegJoint™ interposition as spacer prevented impingement of the first metacarpal base on the second metacarpal base or the trapezoid bone.

Static suspension technique with alloplastic suture material for facial reanimation in facial palsy

Introduction: Facial paralysis is an unsatisfactory pathology to treat, and the results of neural reconstruction are unsatisfactory and over the last few decades several techniques static and dynamics, have been performed to improve facial asymmetry and functionality alter suffering facial paralysis. Methods: we presenting a case report to evaluate the benefits of a new form of facial suspension, with prolene sutures traction technique. We performed on a patient with partial facial palsy. Results: six months after surgery, patient have improved facial asymmetry, mastication and speech production which have led to a higher self-esteem and major social interaction. Conclusions: static facial suspension with prolene sutures is a better alternative to dynamic techniques in patients who don’t want or can’t undergo more complex surgeries. Keywords: Facial palsy, Facial nerve, Static suspension, Re-animation.

Ocorrência de fungos na água e areia de praias urbanas

RESUMO: As praias da cidade de Maceió, conhecidas mundialmente por suas belezas naturais, atraem turistas de todo o mundo. Entretanto, dejetos orgânicos são lançados diretamente nas areias e águas, favorecendo a proliferação fúngica. O objetivo deste estudo foi investigar a ocorrência de fungos na água e areia de duas praias da região metropolitana de Maceió - Alagoas, identificandoa presença de agentes patogênicos e potencialmente patogênicos para o homem.Foram coletadas 20 amostras de água do mar e 20 amostras de areia, em pontos escolhidos aleatoriamente, no período da manhã, durante a maré baixa. De cada amostra da água, retirou-se 1 mL que foi cultivado em placas de Petri contendo Ágar Sabouraud Dextrose (ASD) acrescido de cloranfenicol. Para o isolamento de fungos da areia, utilizou-se a técnica de suspensão de solo. A identificação dos fungos foi realizada por meio da associação dos aspectos macroscópicos e microscópicas da cultura, utilizando-se microcultivo. Como resultados, foram obtidas310 Unidades Formadoras de Colônias (UFC) nas duas praias, das quais 290 UFC (94%) pertenciam a fungos filamentosos e 20 UFC (6%) a leveduriformes. A maior ocorrência de fungos foi registrada nas amostras de areia (163 UFC) em comparação com a água (147UFC). Observou-se uma maior prevalência de Aspergillussp. (20,1%), seguido por Mycelia sterilia (13,4%) e Bipolaris sp. (12,2%). Uma ampla variedade de fungos desencadeadores de infecções e processos alérgicos foram identificados, evidenciando a necessidade de monitoramento contínuo e a implantação de uma política educacional ambiental.&#x0D; PALAVRAS-CHAVE: Saneamento de praias, Micoses, Contaminação ambiental.

Identificação de fungos queratinofílicos obtidos do solo de recintos de mamíferos selvagens

RESUMO: O solo é o principal ambiente de ocorrência da maioria dos fungos e tem grande importância para suas atividades biológicas. Este habitat abriga especialmente fungos queratinofílicos, que fazem parte de um grupo de microrganismos capazes de produzir enzimas que degradam a queratina, destacando-se os dermatófitos, agentes de micoses em humanos e animais, sendo alguns responsáveis por infecções oportunistas. Com base no exposto, este estudo teve por objetivo detectar a ocorrência de fungos queratinofílicos em solo de recintos que abrigam mamíferos selvagens. Para isso, foram coletadas 395 amostras de solo do Parque Estadual de Dois Irmãos (PEDI), localizado na cidade de Recife - PE. As amostras foram processadas pela técnica de suspensão do solo e cultivadas em placas de Petri contendo Ágar Sabouraud Dextrose acrescido de cloranfenicol. A identificação dos fungos filamentosos foi realizada através de microcultivo em lâmina, baseando-se na observação de características macro e micromorfológicas das colônias. Como resultados, foram obtidas 233 Unidades Formadoras de Colônias (UFC), das quais 85 (36,5%) eram provenientes do solo que abrigava mamíferos da ordem Carnivora, seguido por 84 UFC (36%) em solo de mamíferos da ordem Primates. Em relação aos fungos identificados, observou-se uma maior ocorrência de Microsporum gypseum com 123 UFC (52,8%), seguido por Chrysosporium sp. com 28 UFC (12,0%) e Fusarium sp. com 10 UFC (4,30%). Animais que vivem em recintos contaminados podem ser portadores assintomáticos de muitas doenças fúngicas, atuando na transmissão para outros animais e seres humanos. Como forma preventiva, salienta-se melhoria nas condições higiênicas e de manejo.&#x0D; PALAVRAS-CHAVE: fungos, dermatófitos, micoses, animais selvagens.

Preparative field flow fractionation for complex environmental samples: online detection by inductively coupled plasma mass spectrometry and offline detection by gas chromatography with flame ionization

Asymmetric flow field flow fractionation (AF4) in particular online with elemental detection via inductively coupled plasma mass spectrometry (ICP-MS) has been developed as powerful and flexible separation technique for suspensions of nano- and micro-particles covering a broad range of applications including environmental water samples and soil extracts. However, for challenging applications, such as particulate phosphorus determination in non-contaminated water samples at levels close to the limit of detection the throughput of the analytical field flow fractionation (FFF) is not sufficient. The same holds true for more specific identification and quantification of black carbon (BC) which needs a subsequent complex multi-step analysis using the well-established benzene polycarboxylic acids (BPCA) method.To overcome these limitations, the performance of a commercially available preparative AF4 channel, which has rarely been applied, yet, was investigated in this study. Using the example of an extract from charcoal spiked soil, method development for the preparative channel was performed and the results from six replicate fractionations with multi-element online detection by ICP-MS were compared to the results from the analytical channel for the same extracts. A similar fractionation pattern was achieved and the quantitative results agreed well for most of the particulate fractions (ratio 1.7 with standard deviation (SD) 0.2 for fraction 1, ratio 0.81 with SD 0.14 for fraction 2 and ratio 1.1 with SD 0.2 for fraction 3). Relative standard deviations were in the range of 9% to 18% for the preparative channel and between 3% and 17% for the analytical channel. Transferability of the separation parameters between both channels is discussed as well as the operational challenges of the preparative channel. As proof of principle, preparative fractionation of an extract from charcoal spiked soil was performed with fraction collection and subsequent quantification of BC via the BPCA method including derivatization, cation exchange pre-cleaning and finally gas chromatographic separation and quantification via flame ionization detection. The results indicated the majority of detected BC in the often so-called dissolved fraction was bound to nanoparticles (48%) and colloids (27%). Only 25% was detected in the cross flow (truly dissolved fraction). This successful example opens new possibilities for hyphenation of FFF separation with multiple detection techniques for improved characterization of particulate matter in challenging applications.

Colposuspensión latero-abdominal laparoscópica: descripción, ventajas y resultados preliminares

IntroductionThere are currently various fixation or suspension techniques for pelvic organ prolapse (POP) surgery. Laparoscopic colposacropexy is considered the gold standard. We present the surgical steps of the laparoscopic latero-abdominal colposuspension (LACS) technique and the preliminary results obtained. Material and methodsPatients with anterior and/or apical compartment symptomatic POP undergoing LACS are included. The Baden-Walker scale, the Overactive Bladder Questionnaire-Short Form (OAB-q SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Patient Global Impression of Improvement (PGI-I) scale were used to assess the degree of prolapse, urinary filling and sexual symptoms and the level of satisfaction before and after surgery, respectively. Conventional laparoscopic material and a polyvinylidene fluoride (PVDF) mesh were used. ResultsEighteen patients were included with a minimum follow-up time of 6months. The mean surgical time was 70.3±23.8min. Anatomic correction of prolapse was seen in all cases. Only one recurrence was detected. High levels of patient satisfaction were achieved. ConclusionLACS allowed the anatomical reconstruction of the pelvic floor and proved to be a minimally invasive, fast, effective, safe and reproducible technique. More series are needed to evaluate its role against laparoscopic colposacropexy.

New Pigmentation After Medical Treatment Suggests Increased Efficacy of Dermabrasion and Noncultured Epidermal Cell Suspension Techniques in Stable Vitiligo.

Stable vitiligo has been treated by dermabrasion and noncultured epidermal cell suspension (NCES) effectively. However, not all patches respond well. To investigate the efficacy of new pigmentation after medical treatment in the therapy of stable vitiligo. Medical records were retrospectively reviewed from October 2016 to March 2019, and 134 patients with stable vitiligo after medical therapy were further treated with NCES. They were divided into 2 groups: 70 patients in Group 1 had new pigmentation, whereas 64 patients in Group 2 did not. Repigmentation and satisfaction of patients and third-party assessors were evaluated at 3 and 6 months postoperatively. Repigmentation was scored as excellent (≥76%), good (51%-75%), fair (26%-50%), or poor (≤25%). Repigmentation of the 2 groups at 6 months postoperatively was excellent in 82.9% versus 23.4%, good in 10.0% versus 15.6%, fair in 7.1% versus 13.0%, and poor in 0% versus 48.4%, respectively. A positive correlation between satisfaction and repigmentation was found. New pigmentation after medical treatment suggests increased efficacy of NCES in treating stable vitiligo.

Single-triangle versus Fox pentagon frontalis suspension for unilateral severe congenital ptosis correction

To compare the functional and cosmetic outcomes of two different frontalis sling techniques for correction of severe unilateral congenital ptosis: single triangle and Fox pentagon techniques using expanded polytetrafluoroethylene (ePTFE) suture. This randomized controlled trial included 60 eyes of 60 patients with severe unilateral simple congenital ptosis and poor levator function (≤4mm). Participants were randomly assigned for either single triangle or Fox pentagon frontalis suspension using ePTFE suture. Functional outcome measures were margin reflex distance (MRD1), palpebral fissure height (VFH), and lagophthalmos. Cosmetic outcome parameters (lid contour, lid crease, and height symmetry) were graded as 3 (excellent), 2 (good), or 1 (poor), with a minimum of 18months' follow-up. At final follow-up, there was a significant improvement in the MRD1 and VFH in both groups, with no statistical difference (P=0.9). Both groups showed comparative cosmetic results regarding lid height symmetry, crease, and contour. The patients in the single-triangle group showed more rapid recovery of postoperative edema and lagopthalmos with less visible forehead scarring. There were no serious ePTFE sling-related complications. In our study cohort, the single-triangle and Fox pentagon frontalis suspension techniques had similar outcomes with respect to MRD1 and VFH and comparable cosmetic results. However, the single-triangle technique avoids two forehead incisions and was associated with less postoperative edema, lagophthalmos, and scarring.

Design and vibration suppression performance of magnetic suspension dynamic vibration absorber

In this article, a magnetic suspension technique was introduced into the field of vibration absorption. Using the advantage of adjustable control parameters of a magnetic suspension system, a type of a magnetic suspension dynamic vibration absorber that can achieve broadband vibration suppression was designed. First, the theoretical model of a magnetic suspension dynamic vibration absorber was established. Then, the cantilever beam with sinusoidal excitation is seen as the main system of vibration suppression; combined with the fixed point theory (Seto K (2013) Dynamic Vibration Absorber and its Application. Mechanic Industry Press), the specific structure of the magnetic suspension dynamic vibration absorber was designed. Based on that, the simulation study of vibration suppression performance of the magnetic suspension dynamic vibration absorber was carried out. The results indicated that the vibration of the main system at the 1st modal frequency was reduced by 65.38% under the action of the magnetic suspension dynamic vibration absorber, compared with that without the action of the magnetic suspension dynamic vibration absorber. Furthermore, the vibration of the main system can be suppressed in the frequency band of [16 Hz, 32 Hz]. Finally, a vibration test rig of the magnetic suspension dynamic vibration absorber was built up for experimental study. And the results showed that the absorber can decrease the vibration of the main system by 43.03% at the 1st modal frequency compared with that without the action of magnetic suspension dynamic vibration absorber and had a certain suppression effect (decrease varies from 0 to 43.03%) on the vibration of the main system in the frequency band of [20 Hz, 32 Hz].

The nasal cantilever technique in children undergoing primary cleft lip surgery: novel concepts and review

BackgroundNasal deformity associated with cleft lip deformity is a challenging issue, encompassing controversies, theories, and a diversity of techniques. Historically, esthetic outcomes have ranged from being below expectations to barely acceptable.MethodBased on the concept that the nasal cartilaginous framework in clefts is similar to that of a collapsing pyramid, a novel suspension technique has been described. The entire cartilaginous structure is lifted from the infratip segment with a loop suture and is secured in a cantilever fashion onto the periosteum overlying the nasal bone. This part of the operation is performed in a semiclosed manner. The technique is applied during primary surgery in bilateral and unilateral nasal cleft lip deformities, with changes in the orientation of the cantilever loop suture. Studies conducted by Masters S. Tajima, H. McComb, H. Thomson, D. Fisher, and J. Mulliken, which are most relevant to this article, have been reviewed and discussed throughout.ResultsThe technique was first applied over 10 years ago. A case series of nine children whose parents consented to the developing technique is presented with follow-up ranging from months to years, along with technical descriptions and illustrative drawings. None of these cases had preoperative orthopedic correction, molding, or postoperative nostril splints. The esthetic outcome was optimal enough; none of the cases requested a secondary correction.ConclusionThe nasal cantilever technique is a novel concept in cleft nasal deformity, which can be used in conjunction with an appropriate lip technique, per the surgeon’s discretion. Other than a learning curve, we believe that it provides a solid correction by securing the cartilaginous structures after they have been mobilized to a stable base, the nasion.

Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

Background: Obstructive sleep apnea (OSA) is a common and challenging health problem, especially in adults, as it is the second most common disease related to sleep. Surgical treatment plays an important role in management of OSA. However, the optimal procedure is not yet determined. Aim of the work: To compare between modified hyoid bone suspension and midline glossectomy in management of OSA due to hypopharyngeal obstruction. Patients and Methods:40 patients with OSA due to hypopharyngeal obstruction were randomly assigned to either modified hyoid bone suspension (group A; 20 patients) or midline glossectomy (group B; 20 patients). All had been assessed by full history, clinical examination and Lab investigations and underwent pre-assigned surgical intervention. Indicators of OSA such as minimal oxygen saturation, Apnea hypopnea Index [AHI] and Epworth Sleepiness Scale [ESS] had been measured preoperatively and 6 months after surgery. Results: The studied groups were comparable as patient characteristics and preoperative data. However, hyoid suspension was associated with significant decrease of AHI [16.67±6.06 vs 20.72±4.41] and ESS [9.10±2.42 vs 11.20±2.33]. Also, minimal oxygen saturation improved significantly in group A than group B. The percentage of responders increased significantly in group A (75.0% vs 40.0% respectively). Conclusion: Modified hyoid suspension is superior than the midline glossectomy, as a safer and more effective procedure for treatment of OSA due to hypopharyngeal obstruction.

Vertical Mammaplasty with Retromammary En Bloc Breast Suspension.

In a vertical mammaplasty, various types of pedicles have been proposed for the nipple-areola transposition. The preparation of any type of nipple-areola flap necessitates disconnecting the nipple-areola from the breast gland, except for the pedicle bearing glandular part. These flap-dependent techniques not only impair the functions of the breast but also do not provide enough fullness to the upper pole. No specific nipple-areola flap preparation is made. Reduction is obtained by a transverse excision from the lowermost part of the breast gland. Apart from this, no cut into the gland is needed. Liposuction, wide skin elevation and extended retromammary dissection permit the en bloc suspension of the breast. The study enrolled a total of 85 patients with 170 breasts. Mastopexy or minor reduction less than 100gr was applied for 49 breasts; moderate reduction, 100-399gr, for 67 breasts; and a large reduction of more than 400gr for 54 breasts. No complete or incomplete nipple-areola necrosis was seen. The success rate for achieving upper pole fullness was compared between groups for reduction amount, age and body mass index (BMI). The functions of the breast organ are preserved in the en bloc suspension technique. In patients with dense breasts, a good upper pole fullness was achieved with a high success rate. Young patients and patients with a body mass index below 25 are suitable for this technique. However, the same success rate could not be achieved in elderly patients with fatty breasts. 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 .

Accuracy of spiked cell counting methods for designing a pre-clinical tumorigenicity study model

BackgroundEvaluations for the tumorigenicity of transplantation of stem cell products is mandatory for clinical application. It is of importance to establish a system to accurately quantify contaminated tumorigenic cells regardless of the format of stem cell product. In the present report, we aimed to examine the accuracy of the quantification of tumorigenic cell numbers with commonly used 2 methods, quantitative polymerase chain reaction (qPCR) and flow cytometry (FCM) using experimental models of stem cell products spiked with tumorigenic cells. MethodsHuman mesenchymal stem cells (hMSCs) and melanoma Mewo-Luc cells constitutively expressing luciferase were used. We stained Mewo-Luc cells with a cell linker then spiked onto hMSC suspensions and hMSC sheets. We validated the accuracy of 10-fold serial dilution technique for Mewo-Luc cell suspension using a Coulter counter. The samples spiked with Mewo-Luc cells were subjected to qPCR and FCM analyses, respectively for the quantification of Mewo-Luc cells. ResultsTen-fold serial dilutions of Mewo-Luc cells were performed accurately with small deviation. In samples spiked with or less than 100 cells in hMSC suspensions, and samples spiked with or less than 1,000 cells in hMSC sheets showed significantly higher cell numbers in calculations by FCM, respectively (suspensions; qPCR vs FCM: 100 cells: 59 ± 25 vs 232 ± 35 cells, p = 0.022/10 cells: 21 ± 7 vs 114 ± 27 cells, p = 0.030, sheets; qPCR vs FCM: 1,000 cells: 1723 ± 258 vs 5810 ± 878 cells, p = 0.012/100 cells: 110 ± 18 vs 973 ± 232 cells, p = 0.012/10 cells: 20 ± 6 vs 141 ± 36 cells, p = 0.030). ConclusionDifferences in accuracy between quantification methods should be considered in designing a tumorigenicity study model.

PT038 - Fascial anastomosis suspension technique (FAST) during open retropubic radical prostatectomy: A novel method to improve early postoperative recovery of urinary continence

PT038 - Fascial anastomosis suspension technique (FAST) during open retropubic radical prostatectomy: A novel method to improve early postoperative recovery of urinary continence

Reconstruction totale de la lèvre inférieure : technique de suspension labiale par double haubanage nasogénien et revue de la littérature

Total lower lip defect is rare and its reconstruction difficult. The challenges are both aesthetic and functional. Suspension of the lower lip is essential for restoring oral competence. We report an original and simple technique of suspension by double nasolabial rigging. Two upper base orbitonasolabial flaps, extended over several centimeters below the lip commissures are raised. The epidermis is completely removed. Then, the flaps are tunneled under the skin and fixed to the reconstructed lower lip in order to provide it with effective suspension to the maxillary. In our experience, we used the nasolabial rigging associated with a total reconstruction of the lower lip for three patients. Lip continence is effective in the long term. The review of literature shows that the use of conventional locoregional flaps restores a good labial competence but is limited to subtotal lower lip defect. Distant pedicled flaps or free flaps made without suspension of the lower lip don't restore the labial competence. Several procedures to suspend the lower lip with strips of fascia lata or tendon of palmaris longus, associated or not with a free flap, seem to provide satisfactory oral competence. All these techniques are poorly standardized and technically difficult. The technique of the double nasolabial rigging that we describe seems to be an effective and interesting alternative by its simplicity, its reproducibility and its adaptability. It allows to obtain a perfectly fixed posterior plane, able to receive any reconstruction of the lower lip.

Diversity of Soil Filamentous Fungi Influenced by Marine Environment in São Luís, Maranhão, Brazil.

Introduction In recent decades, there has been an intensification of environmental problems, which are becoming increasingly critical and frequent due to population growth. Microorganisms, including soilborne fungi, play an essential role in maintaining and balancing the environment. One of the most impacted ecosystems in São Luís, Maranhão, Brazil, is the Jansen Lagoon State Park, an important tourist spot, which has suffered anthropogenic actions such as the dumping of household waste (sewage) in its body of water. As a consequence, these pollutants can accumulate in the adjacent soil, since the body of water is near this substrate. The objectives were to isolate and identify filamentous fungi from the soil of the Jansen Lagoon State Park. Methods Monthly soil samples were collected and later processed using the modified suspension technique according to Clark (1965). Results The isolated genera were Aspergillus, Penicillium, Trichoderma, Absidia, and Fusarium. Aspergillus is the fungal genus of greater dominance in the soil of the Jansen Lagoon State Park. Aspergillus niger was the dominant species (37%), followed by A. tamarii (21.6%). Conclusion The main isolated fungi from the Jansen Lagoon State Park were Aspergillus niger and Aspergillus tamrii. These fungi can be used as biological markers of pollution and as biodegraders and/or bioremediators to improve the area studied.

Video of uterovaginal procidentia repair incorporating a high extraperitoneal uterosacral vault suspension.

Women with high-grade uterovaginal prolapse have a higher incidence of levator injury, larger levator hiatal defects, and are at a greater risk of recurrent prolapse after pelvic organ prolapse (POP) surgery. RCOG guidelines have recommended prophylactic sacrospinous suspension at the time of vaginal hysterectomy, whenever there is a marked uterovaginal prolapse. The aim of the video is to describe our surgical approach at the time of surgery for advanced POP, and describe the technique for modified McCall high extraperitoneal vault suspension. We have modified the McCall culdoplasty by extending the dissection of the middle portion of the uterosacral/cardinal ligaments so that the sutures can be placed higher and more laterally extraperitoneally to re-support the vaginal cuff at the time of a vaginal hysterectomy. The video highlights the surgical technique used for apical support at the time of surgery for advanced POP. This video demonstrates our modified McCall technique for vault suspension at the time of vaginal surgery for advanced POP. This technique could be considered an alternative technique to other modes of apical support.