Embedding systems biology approaches in drug discovery, which see

Embedding systems biology approaches in drug discovery, which seek to investigate underlying molecular mechanisms of potential drug targets in a network context, will reduce attrition rates by earlier target validation and the introduction of novel targets into the currently stagnant market. Systems biology approaches also have the potential to assist in the design of multidrug treatments and repositioning of existing drugs, while stratifying patients to give a greater personalization of medical treatment. (C) 2013 Wiley Periodicals, Inc.”
“The study investigates the influence of low-level laser therapy (LLLT) on bone healing in the femur

of osteopenic and normal rats with titanium implants. Ovariectomy and control selleck chemicals group were randomly Oligomycin A inhibitor submitted to LLLT, which was applied by gallium-aluminum-arsenium (GaAlAs) laser at the surgical site before and after placing the implant, for seven times. Histomorphometric and statistical analysis were performed. Most irradiated groups showed higher values than the nonirradiated groups. The GaAlAs infrared diode laser may improve the osseointegration process in osteopenic and normal

bone, particularly based on its effects in the initial phase of bone formation.”
“OBJECTIVE: Alternatives to surgical therapy are needed for the treatment of high-grade cervical intraepithelial neoplasia (CIN 2-3). We aimed to estimate the efficacy of a treatment with imiquimod, a topical immune-response modulator, in patients with CIN 2-3.

MATERIALS AND METHODS: Fifty-nine patients with untreated CIN 2-3 were randomly allocated to a 16-week treatment with self-applied vaginal suppositories containing either imiquimod or placebo. The main outcome was efficacy, defined as histologic regression to CIN 1 or less after treatment. Secondary outcomes were complete histologic remission, human papillomavirus (HPV) clearance, and tolerability. Assuming

selleck products a two-sided 5% significance level and a power of 80%, a sample size of 24 patients per group was calculated to detect a 35% absolute increase in CIN 2-3 regression.

RESULTS: Histologic regression was observed in 73% of patients in the imiquimod group compared with 39% in the placebo group (P=.009). Complete histologic remission was higher in the imiquimod group (47%) compared with the placebo group (14%) (P=.008). At baseline, all patients tested positive for high-risk HPV. Human papillomavirus clearance rates were increased in the imiquimod group (60%) compared with the placebo group (14%) (P<.001). In patients with HPV-16 infection, complete remission rates were 47% in the imiquimod group compared with 0% in the placebo group (P=.003). Microinvasive cancer was observed in three of 59 (5% [1-14%]) patients, all within the placebo group. Topical imiquimod treatment was well tolerated, and no high-grade side effects were observed.

CONCLUSION: Topical imiquimod is an efficacious and feasible treatment for patients with CIN 2-3.

However, more effective manipulation conditions should be develop

However, more effective manipulation conditions should be developed for somatic cell nuclear transfer (SCNT) studies using human abnormally fertilized zygotes as recipients. The present study found that the use of cytochalasin B was not necessary for, and even harmful to, the enucleation

of human zygotes. This study also decreased the DNA methylation levels in reconstructed embryos using a DNA methyltransferase inhibitor, 5-aza-2′-deoxycytidine (5-aza-dC), in an attempt to correct the abnormalities in DNA methylation that might play an important role in the failure of embryo development. After 5-aza-dC treatment and nuclear transfer (NT-Aza group), 32.7% of reconstructed embryos developed to the 8-cell stage, which is a much higher percentage than that of the nuclear transfer only (NT) group (11.1%). The DNA methylation level in the NT-Aza group was significantly lower than Selisistat that of the NT group, as determined by 5-methylcytosine immunodetection. Based on the present results, this study recommends performing the enucleation procedure without cytochalasin B treatment and using 5-aza-dC in the culture LY2090314 order of reconstructed

embryos in human SCNT studies. RBM Online (c) 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“Background: Use of high concentrations of glucose for peritoneal dialysis (PD) may produce unfavorable results. Our previous study showed that high initial glucose load is associated with poor PD technique survival.

Objective: This retrospective cohort study at a medical center in Taiwan aimed to understand the factors associated with high glucose load in long-term PD patients.

Patients and Methods: We reviewed 90 newly started PD patients over 5 years. We determined glucose load by calculating annual glucose weight and dialysate

volume Sepantronium administered. Multiple linear regression analyses with time-dependent covariates were used to determine factors that influence the annual average dialysate glucose concentration.

Results: The study group included 47 men and 43 women with a mean age of 53.4 +/- 13.9 years. Technique survival rates were 91.0%, 84.1%, and 77.6% at the beginning of the second, third, and fourth year of PD therapy respectively. The presence of diabetes mellitus (DM), high body mass index (BMI), and low weekly renal Kt/V were significantly correlated with high average dialysate glucose concentration during the first, second, and third years. For patients undergoing PD for more than 3 years, residual renal function (RRF) deteriorated, and only DM significantly affected higher dialysate glucose concentration in the fourth year.

Conclusions: Patients with DM, high BMI, and low RRF were more likely to require a high glucose load for PD therapy, especially during the first 3 years. After those 3 years of PD, DM was the only significant factor in the need for higher glucose load.

Concentrations of sCD14 were measured in scrum samples using enzy

Concentrations of sCD14 were measured in scrum samples using enzyme-linked immunosorbent assay.

RESULTS: The genotype frequencies of C-159T polymorphism differed significantly between TB patients and controls (P BIIB057 = 0.006). The risk of TB was 2.3-fold greater in individuals with

the T-allele (CT + TT) in comparison to those without (OR 2.3, 95%CI 1.2-4.3, P = 0.006). Mean total sCD14 was significantly increased in the serum of patients with newly diagnosed pulmonary TB (mean +/- SD = 3177 +/- 751 ng/ml) compared to healthy controls (mean +/- SD = 2955 +/- 424 ng/ml, P < 0.004).

CONCLUSION: These data indicate that the C-159T polymorphism of the CD14 gene is associated with TB; serum sCD14 levels were higher in TB patients in a sample of the Iranian population.”
“Background: Enhanced cardiac matrix

metalloproteinase activity (MMPs) has been associated with ventricular remodeling and cardiac dysfunction. It is unknown whether MMPs contribute to systolic/diastolic dysfunction and compensatory remodeling in 2-kidney, 1-clip (2K1C) hypertensive rats. To test this hypothesis, we used 2K1C rats after 2 weeks of surgery treated or not with a nonspecific inhibitor of MMPs (doxycycline).

Methods and Results: We found that blood pressure and +/-dP/dt increased in 2K1C rats compared with sham groups, and these parameters were attenuated by doxycycline treatment (P < .05). Doxycycline also reversed cardiac hypertrophy observed in 2K1C rats (P < .05). Hypertensive rats showed Oligomycin A manufacturer increased MMP-2 levels in zymograms and in the tissue by immunofluorescence (P < .05) compared with sham groups. Increased total gelatinolytic activity was observed in untreated 2K1C rats when compared with sham groups (P < .05). Doxycycline decreased total gelatinolytic activity in 2K1C rats to control levels PND-1186 ic50 (P < .05).

Conclusion: An imbalance in gelatinolytic activity, with increased MMP-2 levels and activity underlies the development of morphological and functional alterations found in the compensatory hypertrophy observed in 2K1C

hearts. Because function and structure were restored by doxycycline, the inhibition of MMPs or their modulation may provide beneficial effects for therapeutic intervention in cardiac hypertrophy. (J Cardiac Fail 2010;16:599-608)”
“SETTING: Bovine tuberculosis (TB) is endemic in the cattle population in Nigeria. Livestock workers are at risk of Mycobacterium bovis infection and unaware of their health status.

OBJECTIVE: To determine the occurrence of pulmonary M. bovis infection among livestock workers.

DESIGN: A cross-sectional study of livestock traders was conducted for TB through screening of sputum samples using a simple random sampling method coupled with oral interview on the assumption of sub-clinical pulmonary TB infection. Specimens were cultured, and the isolates analysed using molecular typing techniques.

RESULTS: Overall, 10% (7/70) of the livestock traders had a positive culture indicative of M.

We also determined that Delta Sigma(m) is lower in cultured when

We also determined that Delta Sigma(m) is lower in cultured when compared to non-cultured porcine

early blastocysts. Sv(in,m) was higher in immature oocytes than mature oocytes and remained constant BI-D1870 datasheet up to the 4- to 8-cell embryo stage. It increased significantly at morula and early blastocyst stages. No differences in Sv(in,m) were found between developmentally matched non-cultured and cultured embryos. These results indicate that the inner mitochondrial membrane potential and surface density change significantly during pre-implantation porcine development in relation to metabolic alterations of the embryo. It is possible that modification of Delta Sigma(m) by manipulating culture conditions may improve the performance THZ1 of embryos

that develop in vitro.”
“Context: For decades and in many countries, the issue of compensation for victims of medical injuries has led to lively debates. In 2002, a law set up a new model for compensation in France – based on the creation of a “”no fault”" compensation scheme and of an out-of-court settlement mechanism. This is one of the most recent models to have been adopted in European countries. This article analyses the choices made by the law and discusses the key figures of its ten years of implementation.

Methods: We conducted (1) a study of debates regarding compensation for victims of medical injuries in France; (2) a comparative analysis of the different models of compensation which had already been adopted in different countries; (3) a study of primary sources provided by the bodies in charge of the French new out-of-court settlement mechanism; and (4) a statistical analysis of the exhaustive list of 18,258 claims filed between

selleck chemicals 2003 and 2009.

Results: The article highlights the context which led to the adoption of the 2002 law on the quality of care and patients’ rights. It analyses, from a comparative standpoint, the specificities of the new compensation model set up by the law. It shows how the opportunities for victims of medical injuries to be compensated had improved in France. Finally, we discuss the limits of the new model and what the next step might be to improve access to compensation for victims of medical injuries. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Study aim: Adherence to Advanced Trauma Life Support (ATLS) protocol has been associated with improved management of injured patients. The objective of this study is to determine factors associated with delayed and omitted ATLS primary and secondary survey tasks at a level 1 pediatric trauma center.

Methods: Video recorded resuscitations of 237 injured patients < 18 years old obtained over a four month period at our hospital were evaluated to assess completeness and timeliness of essential tasks in the primary and secondary survey of ATLS. Multivariate analyses were performed to identify features associated with decreased ATLS performance.

The assessment focused

on five air pollutants (i e , PM10

The assessment focused

on five air pollutants (i.e., PM10, benzene, toluene, nonane and naphthalene) and six food pesticides (i.e., acetamiprid, carbendazim, chlorpyrifos, diazinon, imidacloprid and permethrin). Exposure predictions showed that PMIG, benzene and naphthalene exposure frequently exceeded the standards, and SP600125 that the indoor environment contributed more than the outdoor environment. Effect predictions showed that mixture and interaction effects were generally limited. However, model calculations indicated potential synergistic effects between naphthalene and benzene and between chlorpyrifos, diazinon and toluene. PM10 dominated the health impact expressed in Disability Adjusted Life Years (DALYs). We conclude that measures to reduce the health impact of environmental pollution should focus on the improvement of indoor air quality and the reduction of PM10 emissions. Cumulative risk assessment can be improved by (1) the development of person-oriented exposure models that can simulate the cumulative exposure history of individuals, (2) a better mechanistic understanding of the effects of cumulative stressors, and (3) the development selleck chemicals llc of instruments to prioritize stressors for inclusion in cumulative risk assessments. (C) 2011 Elsevier

Ltd. All rights reserved.”
“Platelets play a crucial role in hemostasis; activating and aggregating to arrest bleeding following vascular injury. Platelet activation is a complex and dynamic process, involving the co-ordination of numerous receptors to initiate shape change and aggregation. Under pathological conditions, alterations in the normal platelet response can favor a prothrombotic state and increase the risk of acute coronary syndromes (ACS). Receptor stimulation and the tyrosine phosphorylation of key signaling molecules Trichostatin A price underpin platelet activation in both hemostasis and cardiovascular disease. A lack of nucleus and low mRNA levels

makes protein function the primary focus of platelet research. Advancements in proteomic technologies now allow for comprehensive analysis of the platelet proteome and its associated post-translational modifications. In this review, recent applications of proteomics in platelet signaling studies are discussed with particular focus on the elucidation of novel phosphorylation events following receptor activation.”
“Concentrations, composition and interrelationships of selenium and metallic elements (Ag, Ba, Cd, Co, Cr, Cs, Cu, Ga, Mn, Mo, Pb, Rb,Sb, Sr, Tl, V and Zn) have been examined in muscle and organ meats of Red Deer hunted in Poland. The analytical data obtained were also discussed in terms of Se supplementation and deficit to Deer as well as the benefits and risk to humans associated with the essential and toxic metals intake resulting from consumption of Deer meat and products.

A less known feature of tau is its existence as a non-microtubule

A less known feature of tau is its existence as a non-microtubule associated protein. Here we review the interactions of tau with other proteins, some of which interact with the microtubule binding repeat region of tau. The tau interactions with Fyn and with Pin1 have attracted the most attention and both interactions have been thought to have a role in Alzheimer’s disease. The fact A-1331852 order that tau has unknown cellular functions is further evidenced by its involvement in cell cycle activated neurodegeneration. One possible route for additional investigations stems from the presence of tau in non-neuronal cells where its characteristics have been largely unknown, although there has

been a correlation between tau levels and the response of some cancer cells to microtubule-targeting chemotherapy drugs. Our studies of prostate cancer cells indicate see more that these cells can provide a system with phosphorylated adult tau for functional studies. In fact, structural similarities exist between Alzheimer’s disease tau and prostate cancer cell tau, raising the possibility that new tau functions uncovered in prostate cancer cells will have relevance to Alzheimer’s disease.”
“Background: Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking.

Methods:

Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview

on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months.

Results: Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; selleck chemical 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.08-10.00), smoking methamphetamine (aOR 1.65, 95% CI 1.05-2.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.18-3.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.15-3.96).

Conclusions: Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk. (C) 2010 International Society for Infectious Diseases.


“Objective:


“Objective: CUDC-907 solubility dmso The SF-36 Health Survey (SF-36) is a general instrument used to assess health-related quality of life (HRQL). The purpose of this study is to describe self-reported information on health and the quality of life among cancer outpatients during chemotherapy treatment and to compare it with the baseline sample drawn from the general Spanish population.

Methods: A randomised sample of 583 cancer outpatients completed the questionnaire. Using a cross-sectional analysis of the SF-36 data, standardised scores were used to compare patients with comparative

Spanish baseline data. Other health-related concerns (gender, age, site of cancer) were also analysed.

Results: The patients showed acceptable levels on HRQL and no significant differences were found between the oncology patients compared with the general population for any of the SF-36 domains. The older patients had scores significantly lower in physical functioning (p < 0.01) and physical role

(p<0.05). The results identified lower HRQL ratings among women compared with men on all the scales except general health. In relation to the location of the cancer, patients with genitourinary tumours scored statistically lower (P<0.05) on bodily pain in the SF-36 domain compared with patients with gastrointestinal tumours.

Conclusions: Although more studies are needed, the SF-36 allows us to describe the HRQL of cancer outpatients during chemotherapy treatment compared with the general population. Copyright (C) 2009 John

Wiley & Sons, Ltd.”
“Objective: HD203 is a biosimilar of etanercept, a fusion protein of the ligand-binding portion of the human tumor necrosis factor Selleck Mizoribine receptor Il linked to the Fe portion of human immunoglobulin G1. Since HD203 is under clinical development, this study was conducted to compare the pharmacokinetics of HD203 with Enbrel (R), the first marketed etanercept.

Methods: A double-blind, randomized, single-dose, two-period, two-sequence, crossover study was conducted in 37 healthy volunteers. In each period, 25 mg/mL of reconstituted lyophilized reference (Enbrel (R)) or test product (HD203) was administered subcutaneously, either the reference product followed by the test product, or vice versa. Serial blood samples for pharmacokinetic analysis were taken for 480 hours after dosing, and serum concentrations of the products were LB-100 price determined using a commercial enzyme-linked immunosorbent assay. The geometric mean ratios with 90% confidence intervals for the maximum concentration (C-max) and the area under the concentration-time curve from time 0 to the last measurable time point (AUC(0-t)) were estimated.

Results: A total of 35 subjects completed the study; serious adverse events were not observed. The mean serum concentration-time profiles of the two products were similar. The C-max and AUC(0-t) values of the reference product (mean +/- standard deviation) were 1.25 +/- 0.45 mg/L and 283.15 +/- 98.


“Purpose: To quantify the accumulation, progression, and d


“Purpose: To quantify the accumulation, progression, and distribution of fat separately in and around the supraspinatus muscle from

the onset of tendon detachment and to validate computed tomography (CT) for quantification of fat content by using volumetry and histomorphometry as reference standards.

Materials and Methods: Institutional animal care committee approval was obtained. The supraspinatus tendon of 30 adult female rabbits (3.0 kg) was detached. Rabbits were sacrificed in groups of 10 after 4, 8, and 12 weeks. Fifteen rabbits that did not undergo surgery served as control subjects. Fat accumulations in and around the proximal, middle, and distal supraspinatus muscle were quantified, volumetrically and histologically, and were compared with extramuscular presence and intramuscular attenuation at CT. Weight, volume, histologic findings, and CT

determinations of fat were compared Baf-A1 mouse by using one-way PARP inhibition analysis of variance. The Pearson test was used to correlate intramuscular fat accumulation with CT observations.

Results: Four weeks after tendon detachment significant extraand intramuscular fat had accumulated (both P < .05) and progressed during 12 weeks, with accumulation of extramuscular fat being three times greater than that of intramuscular fat (both P < .05). An increasing proximal-to-distal gradient existed for both extra- and intramuscular accumulation (both P < .05). CT depicted the onset, progression, and gradient of extra-

and intramuscular fat accumulation (all P < .05). CT attenuation correlated strongly with histologic findings (P < .05).

Conclusion: Fat accumulated early, along an increasing proximal-to-distal buy LEE011 gradient, and progressed with time after supraspinatus tendon detachment. CT proved to be a valid tool for monitoring the onset, progression, and gradient separately for extra- and intramuscular fat accumulation. (C) RSNA, 2010″
“The spatial structure of a microwave plasma torch driven by an azimuthally symmetric surface wave operating in a N-2-Ar mixture at atmospheric pressure is investigated. A two-dimensional (2D) self-consistent theoretical model is developed to investigate the entire spatial structure of the source, including the discharge zone, sustained by the field of the surface TM00 mode, and the postdischarge plasma. Maxwell’s equations, the rate balance equations for the most important excited species-vibrationally and electronically excited states, ions and nitrogen atoms N(S-4)-and the Boltzmann equation for electrons are consistently solved. Model calculations of the 2D spatial distributions of species of interest such as charged particles (electrons and positive ions), N-2(X 1 Sigma(+)(g), u) vibrationally excited molecules, N-2(A (3)Sigma(+)(u)) metastable molecules, and N(S-4) ground state atoms are presented and discussed. (C) 2011 American Institute of Physics. [doi:10.1063/1.


“QUESTIONS UNDER STUDY / PRINCIPLES: Weight is important i


“QUESTIONS UNDER STUDY / PRINCIPLES: Weight is important information in the emergency department (ED). Weight loss leads to an increase of mortality and is suggestive of morbidity. Correct weight is important for dosing of drugs to avoid toxicity and lack of effectiveness. Objective body weight measurement is often not possible in the emergency department. Especially in elderly ED patients, acute disease might have an impact on weight reporting. The objective of this study was to determine whether body weight reported by elderly patients presenting to the ED with nonspecific symptoms is accurate.

METHODS: In 233 patients, measured weight

was detected within patients’ medical record and was compared to reported weight at presentation in the ED.

RESULTS: The median age of the observed population was 74 years (IQR 72, 86). Comparison between estimated Belnacasan price and measured weight showed a good agreement between the two measures (Pearson’s correlation coefficient r = 0.94). The mean difference between estimated and measured weight was small (+0.1 kg) selleck chemical whereas the range of the estimation error was between -10.9 and

11.1 kg. Age had no influence on the accuracy to predict the measured weight. Also, the correlation did not differ in patients with and without acute morbidity or between men and women.

CONCLUSIONS: Neither old age nor acute disease status impaired the strong correlation of reported and measured

GSK2118436 price weight. Therefore, self reported weight can be used as approximation for real body weight in elderly ED patients presenting with non-specific complaints.”
“Prominent in the sky, but not visible to humans, is a pattern of polarized skylight formed around both the Sun and the Moon. Dung beetles are, at present, the only animal group known to use the much dimmer polarization pattern formed around the Moon as a compass cue for maintaining travel direction. However, the Moon is not visible every night and the intensity of the celestial polarization pattern gradually declines as the Moon wanes. Therefore, for nocturnal orientation on all moonlit nights, the absolute sensitivity of the dung beetle’s polarization detector may limit the precision of this behaviour. To test this, we studied the straight-line foraging behaviour of the nocturnal ball-rolling dung beetle Scarabaeus satyrus to establish when the Moon is too dim-and the polarization pattern too weak-to provide a reliable cue for orientation. Our results show that celestial orientation is as accurate during crescent Moon as it is during full Moon. Moreover, this orientation accuracy is equal to that measured for diurnal species that orient under the 100 million times brighter polarization pattern formed around the Sun. This indicates that, in nocturnal species, the sensitivity of the optical polarization compass can be greatly increased without any loss of precision.

During the post implant period, recent studies have shown an impr

During the post implant period, recent studies have shown an improvement of parental behavior as well as the development of the child in the domains of shared attention, problem

solving, symbolic play and social functioning. In addition, during this stage the relationships between parents and children are more effective, and all parental figures are positively motivated towards appropriate behaviors. Hence the effects of CI are no longer limited to the implanted child, but now entail the entire family. In fact, the parents judge the quality of their lives on the basis of how successful they perceive the results obtained by having their child undergo a CI. Consequently, they regulate PI3K inhibitor their behavior and attitudes influencing the child’s development. Parents themselves maintain that specialized psychological support is fundamental during

all stages connected to CI and more generally to the overall development of their child.”
“Photodynamic therapy (PDT) has been demonstrated to be an effective minimally invasive treatment modality for early esophageal cancer. However, the molecular action in esophageal cancer during PDT is hardly known. EGFR has been known to downregulate in various cancer cells during PDT. In this study, we investigated click here the effects of Photofrin-mediated PDT on cell death and expression of EGFR in CE48T/VGH (CE48T) esophageal squamous cell carcinoma cells. We found that the photosensitizer Photofrin in the absence of light exposure can downregulate the expression of EGFR at both transcription and translation levels. Higher concentrations of Photofrin results in cytotoxicity whereas lower doses of Photofrin inhibit EGFR expression under dark control without inducing significant cell death. This Photofrin-associated inhibition of EGFR was repeated in lung cancer, cervical cancer, and glioblastoma cells. Another

esophageal squamous cell carcinoma cell line PF-4708671 in vivo CE81T/VGH (CE81T) was found to be resistant to Photofrin-induced inhibition of EGFR as well as to Photofrin-mediated dark toxicity compared with CE48T. The resistance to the cytotoxicity in CE81T cells became insignificant when the Photofrin-treated cells were further irradiated by red light (Photofrin-PDT). We suggest Photofrin modulates the expression of EGFR in cancer cells. However, efficient cell death still requires the combination of Photofrin and light irradiation in esophageal squamous cell carcinoma cells.”
“Purpose: This study aims to compare orbital volume obtained by helical tomography and rapid prototyping.

Methods: The study sample was composed of 6 helical tomography scans. Eleven healthy orbits were identified to have their volumes measured. The volumetric analysis with the helical tomography utilized the same protocol developed by the Plastic Surgery Unit of the Federal University of Parana.