Combining intraoperative ICG lymphography with NIR vein visualization can aid supermicrosurgeons in identifying lymphatic vessels and superficial venules to guide LVA incision placement. This guided approach significantly improves successful creation of LVAs when compared to the blind (anatomic) approach. In addition, the absence of linear ICG lymphographic patterns does not prevent formation of successful LVAs.

The authors present a novel synthetic vascular model for microanastomosis training. This model is suitable for trainees with intermediate level of microsurgical skills, and useful as a bridging model between simple suturing exercise and in vivo rat vessel anastomosis during pre-clinical training. It is an easy model to construct, using widely available materials. It simulates arterial anastomosis well, and enables direct observation and feedback of the anastomosis quality. This model is non-commercialized, cost effective, and is readily accessible. This model allows the trainee to grow their microsurgical skills ethically, systematically and confidently.

Diabetes control in the studied population could be too strict, and consequently, hypoglycemia in these patients could play a role in the major decline of cognitive function. Therefore, avoiding treatments that could lead to hypoglycemia in these patients could be very important. The aim of the treatment of diabetes in elderly patients is focused on stabilization, prevention of acute complications, and improving the quality of life.

HbA1c levels decreased with increasing Hb levels, independent of age, sex, BMI, FPG, and smoking and alcohol habits in Japanese men and women without diabetes or anemia. There was an interaction between sex and hemoglobin in the effects on HbA1c. The interpretation of HbA1c values should be cautious in the screening of glucose intolerance.

A 29-year-old male suffered from total loss of function of his left shoulder and upper limb after a traffic accident while riding a motorcycle. He was treated by a brachial plexus specialist at another hospital and managed surgically under the impression of total root avulsion.

The communication among international microsurgeons have switched from one direction (from paper, textbook) to multiway interactions through the internet. The authors believe the online platform will play an immensely important role in the learning and development in the field of microsurgery.

The high incidence of brain metastasis and the comparison of metastatic and non-metastatic phenotypes indicate an active crosstalk of brain metastatic breast cancers with the BBB. Certain miRNAs and serpins are regulatory molecules in defining the metastatic potential of breast cancers. Targeting these factors that favor the metastatic microenvironment may provide future therapeutic interventions for the brain metastasis of breast cancers.

The author concerns that long-term application of biologics will destroy the natural balance, and argues to rethink about small molecules that can restore immune homeostasis, thereby naturally correcting overproduced proinflammatory cytokines, as a strategy of new drug development against psoriasis and other autoimmune disorders.

The authors reviewed the MDCT images to show the number of lymph nodes superior to the saphenofemoral junction. In this study, on average, 3.67 nodes existed. However, there were 4 percent of cases with no countable nodes. This result indicates that appropriate preoperative screening is needed for this procedure.

Pedicled anterolateral thigh flap is a versatile option for reconstruction of complex soft tissue defects in varied anatomical regions. Its wide arc of rotation and less donor site morbidity are its added advantages.