Baranauskas, Gytis

Tiesioginį tarpląstelinį ryšį tarp ląstelių formuoja plyšinės jungtys (PJ). PJ – tai iš koneksinų (Cx) baltymų sudaryti specializuoti tarpląsteliniai kanalai, kurie koordinuoja ir reguliuoja daugelį ląstelės fiziologinių procesų. PJ sudarytos iš dviejų puskanalių, dar vadinamų koneksonais. Kiekvieną puskanalį sudaro šeši transmembraniniai baltymai – koneksinai. Kiekvienas puskanalis turi įtampai jautrius greituosius ir lėtuosius vartus, tačiau tik lėtieji vartai, dar vadinami cheminiais vartais, yra reguliuojami, viduląsteliniu pH, viduląsteliniu Ca2+ ir Mg2+, fosforilinimu bei cheminėmis medžiagomis. Disertaciniame darbe tirta muskato eterinio aliejaus ir jo sudedamųjų dalių įtaka Cx43 PJ kanalų biofizikinėms savybėms. Rezultatai parodė, kad muskato eterinis aliejus ir trys jo sudedamosios dalys (sabinenas, α-pinenas ir α-kopaenas) greitai ir grįžtamai slopina endogeninio Cx43 PJ kanalo laidumą, veikdamas PJ lėtuosius vartus. Naujų PJ moduliatorių paieškai, sukūrėme QSAR ir 3D-QSAR modelius (kiekybiniai aktyvumo priklausomybės nuo struktūros modeliai), kurių pagalba nustatėme ir eksperimentiškai patvirtinome, kad d-limonenas veikia kaip Cx43 PJ inhibitorius. Taip pat, pirmą kartą pademonstravome, kad α-pineno ir sevoflurano potencija priklauso nuo Cx43 fosforilinimo, kuris veikia teigiamos alosterinės kooperacijos būdu. Mūsų rezultatai rodo, kad CaMKII, aPKC, CDK ir iš dalies Pyk2 baltymų kinazės gali moduliuoti Cx43 PJ blokatoriaus α-pineno potenciją.

In visual cortex principal cells, the pyramidal neurons, can activate inhibitory interneurons that in turn control the visual response gain of other pyramidal neurons via suppression of visual responses. By employing optogenetic stimulation we show that both pyramidal and interneuron stimulation reduces receptive field (RF) area and increases signal-to-noise ratio (SNR) for such visual responses. We also show that such an increase in SNR increases information about visual stimuli that is encoded by action potentials. Since all sensory inputs will activate pyramidal neurons, it is concluded that any activation of visual cortex, be due to sensory inputs or state of wakefulness may enhance visual information processing. Since inhibitory neuron function is affected in brain injury and several brain disorders, these results may help to better understand the pathogenesis of brain dysfunction.

Background: Autologous fat grafting is widely used in plastic and reconstructive surgery. Liposuction methods play a key role in surgeons' work efficiency, adipocyte viability, graft survival, and outcomes. We investigated the effect of four liposuction methods on adipocyte viability, debris, and surgeons' work efficiency by measuring the active energy expenditure and changes in heart rate. Methods: Human lipoaspirate was harvested from patients' removed abdominal flaps using four different liposuction methods, and we counted calories per aspirated volume and surgeons' heart rate. Adipocytes were separated from the lipoaspirate immediately by digestion with 0.1% type I collagenase. After digestion, parts of the cells and debris were measured. Adipocytes were plated in an adipocyte maintenance medium containing Alamar blue reagent. The adipocyte metabolic activity was measured using a spectrophotometer. Results: After evaluating the active energy expenditure and changes in surgeons' heart rate, the ultrasonic-assisted liposuction (UAL) method was determined to be the most ergonomic liposuction device for surgeons. In addition, adipocyte viability was higher in the UAL group than in the other groups, and debris was the lowest in the power-assisted liposuction 1 group (PAL1). Conclusions: Adipocyte viability is crucial for improving fat grafting outcomes. This study revealed that the viability of adipocytes is best preserved using the UAL and PAL1 liposuction methods. The UAL and PAL1 methods caused the least damage to the cells. The UAL method yielded the best results for surgeons' work efficiency.

This paper describes a randomized, controlled, parallel-group, single-center clinical trial designed to compare non surgical treatment methods of deep partial thickness skin burns of the hand. All patients were scanned with the Laser Doppler Imaging device to determine the depth of the burn wound. Viable keratinocytes sites were determined according to the established Perfusion Units (PU) measurement system. The trial enrolled 87 patients with hand burn wounds in the section of 260-600PU. Hand burn patients were divided into the following four groups: treated with hydrocolloid dressings; treated with mechanical debridement of monofilament polyester fibers pad and then applying silver sulfadiazine; treated with gauze dressings containing enzymatic collagenase preparation. The fourth group of patients was treated with silver sulfadiazine and gauze dressings. This group was considered as the control group. The wound healing status was assessed after 3, 7, 14 and 21 days. Burn scars and injured extremity function were assessed after six months according to the Vancouver Scar Scale and Disabilities of the Arm, Shoulder and Hand Outcome Measure. The fastest epithelialization of hand burn wounds was observed in the patients group treated with hydrocolloid dressings (15, 7 days, p<0,05). The patients of this group also had less scars and a better hand function.

Breast augmentation with implants is one of the most commonly performed plastic surgery procedures. The goal of the operation is to increase the size, shape or fullness of the breast. It is accomplished by placing silicone, saline or alternative composite breast implants under the chest muscles, fascia or the mammary gland. This type of operation is no exception concerning the occurrence of complications. The most common early complications include an infectious process, a seroma, and a hematoma, and the late ones are capsular contracture, reoperation, implant removal, breast asymmetry, and rupture or deflation of the implant. The authors present a case of subacute arterial bleeding after simultaneous mastopexy and breast augmentation with silicone implants in a 27-year-old woman. The patient complained of worsening swelling and soreness in the right breast. The patient denied having had any traumas. Ultrasonography indicated 2.5 cm heterogeneous fluid sections around the implant. Therefore, revision surgery was performed, and a hematoma of 650 mL was removed. Hemorrhaging from a branch of an internal mammary artery was found. After the revision, the implant was returned to the lodge. The postoperative period was uneventful. This case report presents a description of a subacute hematoma after simultaneous mastopexy and breast augmentation with silicone implants, which is an extremely rare complication in esthetic surgery.

Breast augmentation with implants is one of the most commonly performed plastic surgery procedures. The goal of the operation is to increase the size, shape or fullness of the breast. It is accomplished by placing silicone, saline or alternative composite breast implants under the chest muscles, fascia or the mammary gland. This type of operation is no exception concerning the occurrence of complications. The most common early complications include an infectious process, a seroma, and a hematoma, and the late ones are capsular contracture, reoperation, implant removal, breast asymmetry, and rupture or deflation of the implant. The authors present a case of subacute arterial bleeding after simultaneous mastopexy and breast augmentation with silicone implants in a 27-year-old woman. The patient complained of worsening swelling and soreness in the right breast. The patient denied having had any traumas. Ultrasonography indicated 2.5 cm heterogeneous fluid sections around the implant. Therefore, revision surgery was performed, and a hematoma of 650 mL was removed. Hemorrhaging from a branch of an internal mammary artery was found. After the revision, the implant was returned to the lodge. The postoperative period was uneventful. This case report presents a description of a subacute hematoma after simultaneous mastopexy and breast augmentation with silicone implants, which is an extremely rare complication in esthetic surgery.

Tyrimo tikslas. Įvertinti chirurginio pragulų gydymo baigtis, bei įvairių veiksnių įtaką pooperaciniam pragulų atsinaujinimui. Tyrimo metodai. Atliktas retrospektyvusis vienmomentinis tyrimas, į kurį įtraukta 113 pacientų su 189 chirurginiu būdu gydytomis pragulomis. Įvairių veiksnių įtakai pooperaciniam pragulų atsinaujinimui vertinti atlikta dvireikšmė logistinė regresija. Rezultatai. Namie įgytos 159 (84,1 proc.), gydymo įstaigose – 30 (15,9 proc.) pragulų. Įprastai vartojantys specialias spaudimą mažinamąsias priemones pragulų atsinaujinimo profilaktikai (SPPP) teigė 60 pacientų (75,9 proc.). Iš pacientų, kuriems atliktos pragulų plastinės operacijos (N=160), atsinaujino net 41,9 proc. pragulų (N=67). Tyrimo duomenimis, nepriklausomi rizikos veiksniai pragulų atsinaujinimui po pragulų plastinių operacijų yra jaunesnis paciento amžius, pooperacinė pragulos infekcija, didesnis turimų pragulų skaičius ir SPPP nenaudojimas. Išvados. Viena didžiausių problemų po pragulų plastinių operacijų yra didelis atsinaujinimo dažnis, todėl svarbu vykdyti griežtesnę pacientų atranką chirurginiam gydymui ir koreguoti modifikuojamus pragulų atsikartojimą lemiančius veiksnius.

Introduction Surgical debridement of marginal deep dermal burns of the forearm and hand frequently is too aggressive to residual healthy skin. Additional operation is needed - split thickness skin grafting. Donor site complications should be taken in consideration, also transplanted skin rejection and ulceration. Therefore, clinical trials should be targeted to assess effectiveness of alternative debridement methods. Materials and Methods Our team performed a randomised, controlled, parallel-group clinical trial designed to compare enzymatic, mechanical, and autolytic debridement methods for the treatment of deep dermal burns of the forearm and hand. Laser Doppler Imaging (LDI) performed on the third day post-burn, was used to predict burn wound healing time. Patients who LDI predicted burn wound healing time of no more than three weeks, were included in the study. For the first (control) group received standard treatment - dressings with 1% silver sulphadiazine cream. The second patient group was treated with hydrocolloid dressings to promote autolytic debridement. The third patient group received a combination treatment - dressings with silver sulphadiazine and mechanical debridement using special single-use monofilament polyester fibre pads. The fourth group was treated with application of enzymatic dressings. The treatment period for each patient was 3 weeks, which was followed by assessment at 6 months to evaluate post-burn scars. Results There were 82 patients with deep dermal burns of the forearm and hand included in the trial, with a minimum of 20 patients in each treatment group The fastest burn wound healing was observed in the patient group treated with hydrocolloid dressings. Furthermore, the quality of scars according to the Vancouver Scare Scale (VSS) and return of function of the injured extremity according to Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) [...].

Aim: We aimed to analyze debridement methods efficacy for the treatment of patients with II stage pressure ulcers (PU). Method: Retrospective analysis of 60 patients’ case reports, treated for PU in single center, was performed. Group A (32 patients; PU stage II, covered with necrosis layer) underwent chemical debridement with moistened povidone iodine solution gauzes dressings. Group B (28 patients; PU stage II, covered with debris) was treated with hydrocolloid dressings to promote autolytic necrectomy. The study was performed between 2014 09 - 2016 09. We evaluated PU healing time and wounds’ clinical parameters (localization, size, persistence of necrosis, infection signs). Results / Discussion: There were 23 male patients and 9 female patients in chemical necrectomy group and 21 males and 7 females in other group respectively. 83 % of PU in both groups was home-acquired whereas 17 % evolved in previous health care facilities. 48 % of analyzed PU was in ischial region, 22 % sacral, 19 % trochanteric and 11 % heels. The mean diameter of PU was 3.2 cm. Groups were homogenous according to patients’ age, sex, wounds localization and size (p<0.05). In chemical debridement group the mean of healing time was 6.8 weeks and no presence of infection was mentioned. In hydrocolloid dressings group PU healed within 4 weeks. Two PU treated with hydrocolloids were excluded from study because of infection. Conclusion: Controlled autolytic necrectomy with the help of hydrocolloid dressings is the effective tool for the treatment of II stage PU in outpatient unit.