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Can Lateral Thoracic Artery Preservation Improve Results in Large PMMC Flaps? - Our Experience of 61 Cases from Northern India. 保留胸外侧动脉能否改善大型 PMMC 皮瓣的效果?- 印度北部 61 例病例的经验。
IF 0.6 0 RELIGION Pub Date : 2024-02-01 Epub Date: 2023-08-04 DOI: 10.1007/s12070-023-04123-3
Pranav Mohan Singhal, Pinakin Patel, Kama Kishor Lakhera, Agil Babu, Aishwarya Chatterjee, Suresh Singh, Bhoopendra Singh Gora, Naina Kumar Agarwal

Introduction: Pectoralis major myo-cutaneous (PMMC) flap continues to be a widely used tool to reconstruct oral cavity defects. But an unreliable and unstable vascular supply can lead to complications like flap loss, Oro-cutaneous fistula and wound dehiscence. Preservation of the lateral thoracic artery (LTA) has been suggested to improve the vascularity of the skin paddle. The present study aspires to compare the complications and flap related outcomes after preserving or sacrificing the LTA while reconstructing oral cavity defects with bi-folded PMMC flap. Materials and Methods: Retrospective analysis of the data of 61 male patients who were reconstructed with bi-folded PMMC flaps between January 2022 and September 2022 was done. 36 patients were reconstructed using a PMMC flap where the LTA was sacrificed, whereas in 25 patients the LTA was preserved. Data was analyzed in terms of patient factors and flap related complications. Results: The overall complication rate including major/minor complications was 44.26% with flap detachment at 22.95% being the commonest complication observed. 13.11% patients developed an Oro-cutaneous fistula and partial and complete flap loss were seen in 9.83% and 4.91% respectively. LTA preservation was significantly associated with only decreased flap detachment rates (p value < 0.05). No significant association was noticed between other flap related complications and LTA preservation. Conclusion: Reconstructing larger defects with a PMMC flap where the LTA is preserved can help improve the vascularity of the flap and decrease various major/minor flap related complications.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-04123-3.

简介:胸大肌肌皮瓣(PMMC)一直是重建口腔缺损的广泛应用工具。但不可靠和不稳定的血管供应会导致皮瓣脱落、口腔瘘和伤口裂开等并发症。有人建议保留侧胸动脉(LTA)来改善皮瓣的血管供应。本研究旨在比较使用双折PMMC皮瓣重建口腔缺损时保留或牺牲LTA后的并发症和皮瓣相关结果。材料与方法:对2022年1月至2022年9月期间使用双折叠PMMC瓣重建的61名男性患者的数据进行了回顾性分析。36例患者使用PMMC皮瓣进行了重建,其中牺牲了LTA,而25例患者保留了LTA。对患者因素和皮瓣相关并发症进行了数据分析。结果:包括主要/次要并发症在内的总体并发症发生率为 44.26%,其中最常见的并发症是皮瓣脱落,占 22.95%。13.11%的患者出现口-皮瘘,9.83%和4.91%的患者出现皮瓣部分和完全脱落。保留 LTA 与皮瓣脱落率下降有明显关系(P 值 结论):用保留LTA的PMMC皮瓣重建较大的缺损有助于改善皮瓣的血管性,减少各种主要/次要皮瓣相关并发症:在线版本包含补充材料,可在 10.1007/s12070-023-04123-3。
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引用次数: 0
A word about . . . violence in a pluralistic age: Constraints and opportunities for Christians 关于……多元时代的暴力:基督徒的约束与机会
0 RELIGION Pub Date : 2023-10-17 DOI: 10.1177/00346373231203871
Caleb O. Oladipo
The challenges presented by the current global culture of violence are baffling. Humanity faces these unprecedented challenges that have origins in sacred texts containing violent events. “Spiritualizing” these events is not the solution to dealing with the problems they present. Christians should be prepared to doubt the texts that promote violence as a part of faithfulness to God. This article suggests the opposite of faith is not only doubt, but also fear. Christians demonstrate a cheap relationship with sacred texts when they fail to challenge traditional interpretations. A more mature approach is to embrace alternative, if unfamiliar, interpretations of sacred texts rather than hold on to orthodoxy that is beloved but unloving. Christians should see the texts that seem to justify violence or encourage war as a message requiring humanity to struggle against such violence to transform the world around them nonviolently. The Church of the twenty-first century has optimal opportunity for building harmonious relationships with people of other faiths, which will require a multifaceted approach to understanding God in a pluralistic age.
当前全球暴力文化带来的挑战令人困惑。人类面临着这些前所未有的挑战,这些挑战源于包含暴力事件的神圣文本。“精神化”这些事件并不能解决它们所呈现的问题。基督徒应该准备好怀疑那些宣扬暴力是对上帝忠诚的一部分的经文。这篇文章表明,信仰的对立面不仅是怀疑,还有恐惧。当基督徒无法挑战传统的解释时,他们就会表现出与神圣文本的廉价关系。一个更成熟的方法是接受另一种,如果不熟悉的,对神圣文本的解释,而不是坚持被爱但没有爱的正统。基督徒应该把那些似乎为暴力辩护或鼓励战争的经文视为一种信息,要求人类与这种暴力作斗争,以非暴力方式改变他们周围的世界。二十一世纪的教会有最佳的机会与其他信仰的人建立和谐的关系,这需要在一个多元化的时代用多方面的方法来理解上帝。
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引用次数: 0
“Put your sword back into its sheath”: A Johannine approach to nonviolent resistance “把你的剑放回鞘里”:非暴力抵抗的约翰式方法
0 RELIGION Pub Date : 2023-10-17 DOI: 10.1177/00346373231201522
Andrew J. Byers
The Gospel of John challenges the use of violence in both the exercise of power and in resistance to power. This article identifies how power is used in John, discusses who uses it, and examines how power is complicated or inhibited within the narrative. God and the Logos are introduced in the Prologue as the Gospel’s most powerful figures, yet their power is resisted. The Jewish leaders (often co-identified with “the Jews”) hold sociocultural power, though it is limited by Rome. The Empire looms in the background until the passion narrative, in which Roman power is relativized to the power of the empire of God. Cosmic evil co-opts Rome and the Jewish leaders and serves as the most dominant force arrayed against Jesus in the Fourth Gospel, even if constrained. Jesus’s power is superior, yet he exercises self-restraint. The article then explores the resistance practices to dominant power by the Jewish leadership, Peter, then Jesus, focusing on the arrest and (quasi-)trial in John 18. While “the Jews” resort to violence by colluding with Rome, Peter assaults with a sword then denies Jesus. Although greater in power than the arresting party and judicial authorities, Jesus responds to threats with nonviolence, undermining an imperial imagination sustained by ideologies of violence and death.
约翰福音对暴力的使用提出了挑战,无论是在行使权力还是抵抗权力的时候。本文确定了约翰是如何使用权力的,讨论了谁使用权力,并研究了权力在叙述中是如何复杂或被抑制的。上帝和逻各斯在序言中被介绍为福音中最强大的人物,然而他们的力量受到了抵制。犹太领袖(通常被认为是“犹太人”)拥有社会文化权力,尽管它受到罗马的限制。帝国一直隐现在背景中,直到激情叙事,在激情叙事中,罗马的权力相对于上帝帝国的权力。宇宙邪恶拉拢了罗马和犹太领袖,成为第四福音中反对耶稣的最主要力量,即使受到限制。耶稣的能力是超然的,但他是自我克制的。然后,文章探讨了犹太人领袖彼得和耶稣对统治权力的抵抗实践,重点关注约翰福音18章中的逮捕和(准)审判。当“犹太人”与罗马勾结,诉诸暴力时,彼得用剑攻击,然后否认耶稣。虽然比逮捕的政党和司法当局更有权力,耶稣以非暴力回应威胁,破坏了由暴力和死亡意识形态支撑的帝国想象。
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引用次数: 0
After the pain: A sermon on John 20:19–20 痛苦之后:约翰福音20:19-20的讲道
0 RELIGION Pub Date : 2023-09-29 DOI: 10.1177/00346373231198177
Latonya Latrice Agard
In the Gospel of John, readers encounter a community of believers who gather behind locked doors even after they have heard Jesus is alive. What can one make of their actions? Why are they not rejoicing, spreading the good news? Something is amiss. Jesus is alive, but the disciples are terrified and appear uncertain about what to do next. Using a trauma-informed hermeneutic, I interpret the actions, words, and apparent mood of the disciples in John 20: 19–20 as symptoms of post-traumatic stress disorder (PTSD). Jesus’s visible scars testify to his pain and prove that the person in the room is the same person who hung on the cross. In a similar vein, the scars, visible and invisible, of trauma survivors tell stories of unimaginable horror. Many people who survive traumatic events manage to integrate their experiences without prolonged injury to their mental health. For others, however, this is not the case. Fragmentation, not integration, characterizes their post-trauma narratives. Is there any escape for those who live in this prison? For John, the answer, the healing, is in the Risen One. Ultimately, Jesus’s scars speak life and bring hope to a community haunted by loss.
在《约翰福音》中,读者会遇到一群信徒,即使他们听说耶稣还活着,也会聚集在锁着的门后。人们能从他们的行为中得出什么结论?为什么他们不高兴,不传播好消息呢?有点不对劲。耶稣还活着,但门徒们很害怕,似乎不知道下一步该怎么做。使用创伤信息解释学,我将约翰福音20:19 - 20中门徒的行为、言语和明显的情绪解释为创伤后应激障碍(PTSD)的症状。耶稣可见的伤疤证明了他的痛苦,并证明房间里的人就是被钉在十字架上的那个人。同样,创伤幸存者身上可见或不可见的伤疤讲述了难以想象的恐怖故事。许多在创伤事件中幸存下来的人设法将他们的经历整合起来,而不会对他们的精神健康造成长期伤害。然而,对其他人来说,情况并非如此。他们创伤后叙事的特点是支离破碎,而不是融合。住在这个监狱里的人还有逃脱的办法吗?对约翰来说,答案,治愈,就在复活者身上。最终,耶稣的伤疤诉说着生命,给这个被丧亲之痛困扰的社区带来了希望。
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引用次数: 0
The significance of the wounds of Jesus in the Fourth Gospel 第四部福音书中耶稣伤口的意义
0 RELIGION Pub Date : 2023-09-29 DOI: 10.1177/00346373231196609
Dorothy A. Lee
In the resurrection narratives of John 20–21, the wounds of the risen Jesus serve a number of important functions. They work as markers of revelation, enabling disciples to recognize the identity of the crucified one in the risen one. They are symbols of colonialism and imperialism, creating solidarity between Jesus and the victims of such abuse and suffering. They are cultic symbols of sacrifice and purification, linked to the Johannine motif of Jesus as the Temple and sacrificial Lamb of God whose death on the cross effects cleansing, taking away the world’s sin. The wounds are also figures of new life and peace, forged ironically through violence and death, signs of triumph and glory. The wounds of the Johannine Jesus thus spell the end of what they embody: suffering and its healing, violence and its peaceful resolution, death and its defeat.
在约翰福音20-21章的复活叙述中,复活的耶稣的伤口有很多重要的作用。他们作为启示的标记,使门徒能够认出被钉十字架的人在复活的人身上的身份。它们是殖民主义和帝国主义的象征,在耶稣和这种虐待和痛苦的受害者之间建立了团结。它们是祭祀和净化的崇拜象征,与约翰的主题有关,耶稣是上帝的圣殿和牺牲的羔羊,他在十字架上的死亡起到了净化的作用,带走了世界的罪恶。这些伤口也是新生命与和平的象征,具有讽刺意味的是,它们是通过暴力和死亡锻造而成的,是胜利与荣耀的标志。因此,约翰·耶稣的伤口意味着它们所代表的一切的结束:痛苦与治愈、暴力与和平解决、死亡与失败。
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引用次数: 0
Jesus and violence during Tabernacles: Wit, mercy, and accountability in John 7–8 住棚会期间的耶稣和暴力:约翰福音7-8章的智慧、怜悯和责任
0 RELIGION Pub Date : 2023-09-29 DOI: 10.1177/00346373231200557
Sherri Brown
John 7–8 narrates Jesus’s dialogues with his opponents and the crowds during the annual Jewish festival of Tabernacles. Through this sensory backdrop, Jesus makes exceptional claims both for himself and for how God’s people should respond (e.g., 8:12). Across John’s narration of Jesus’s public ministry, Jesus challenges mainstream closedness by opening covenantal relationship with God to all those who can respond accordingly to what God as Father is doing in this world through Jesus who is Christ and Son. Such confrontation peaks in John 7–8 through a particularly violent interaction between Jesus’s radical acceptance and the resulting discontent in those who prefer the status quo. At the heart of this conflagration, the intrusive encounter between Jesus and the woman ensnared by the Pharisees (7:53–8:11) models a call for mercy and unity in community amid conflict. Despite the textual instability of its foundation, this passage must be given its due as an alternative of mercy to the violence that surrounds it in the final form of John’s Gospel. The presence of this passage in John’s canonical narrative presents a powerful antidote to the chaotic violence that surrounds it.
约翰福音7-8章叙述了耶稣在一年一度的犹太人住棚节期间与他的对手和人群的对话。通过这个感官背景,耶稣对自己和神的子民应该如何回应做出了特别的要求(例如8:12)。在约翰对耶稣公开事工的叙述中,耶稣挑战了主流的封闭性,向所有能够回应上帝作为父亲通过耶稣作为基督和儿子在这个世界上所做的事情的人开放了与上帝的盟约关系。这种对抗在约翰福音7-8章中达到顶峰,在耶稣的激进接受和那些喜欢现状的人的不满之间发生了特别激烈的互动。在这场大火的核心,耶稣和被法利赛人诱捕的女人之间的侵入性相遇(7:53-8:11)是在冲突中呼吁怜悯和团结的典范。尽管它的文本基础不稳定,但这段经文必须被给予应有的地位,作为一种仁慈的选择,而不是在约翰福音的最终形式中围绕着它的暴力。这段经文出现在约翰的经典叙事中,为围绕着它的混乱暴力提供了一剂强有力的解药。
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引用次数: 0
A big, big house(hold): John 14:1–7 as a response to Roman imperial violence 大房子:约翰福音14:1-7是对罗马帝国暴力的回应
0 RELIGION Pub Date : 2023-09-29 DOI: 10.1177/00346373231195387
Arthur M. Wright
In antiquity, the entire Roman Empire itself was imagined as a household, with its inhabitants obedient children to their symbolic father, the emperor. The language and the literary context of John 14:1–7 suggest significant interplay with this way of conceptualizing the empire. The Fourth Gospel imitates imperial structures with its household imagery, in which God takes the place of “Father” and believers as “children.” The community of believers is thus imagined as an alternative household to Caesar’s empire, one with its own unique values and priorities. In this article, I suggest that Johannine believers are engaged in imperial negotiation by imagining themselves as an alternative household living under threat of imperial violence. Whereas traditional interpretations of John 14 that equate “my Father’s house” with “heaven” suggest an escapist strategy, in which believers will one day be whisked safely out of their imperial context, this interpretation suggests a more nuanced strategy of negotiating imperial power from within. The divine response to the threat of imperial violence is to establish a beloved household of God.
在古代,整个罗马帝国本身被想象成一个家庭,其中的居民对他们象征性的父亲——皇帝——忠心耿耿。约翰福音14章1到7节的语言和文学背景表明,这与帝国概念化的方式有重要的相互作用。第四部福音书以家庭形象模仿了帝国的结构,其中上帝代替了“父亲”,信徒则是“孩子”。因此,信徒群体被想象成凯撒帝国的另一个家庭,有自己独特的价值观和优先事项。在这篇文章中,我认为约翰的信徒通过把自己想象成一个生活在帝国暴力威胁下的另类家庭来参与帝国谈判。传统的对约翰福音14章的解释将“我父的家”等同于“天堂”,这暗示了一种逃避现实的策略,即信徒有一天会被安全地从他们的帝国背景中解脱出来,而这种解释暗示了一种更微妙的策略,即从内部与帝国权力进行谈判。神对帝国暴力威胁的回应是建立一个神所爱的家。
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引用次数: 0
“It is advantageous for you that one man should die for the people and not that the whole nation should perish” (John 11:50): A reassessment of Caiaphas’s argument from expediency “一个人替百姓死,免得全国灭亡,这对你们是有益的”(约翰福音11:50):重新评估该亚法的论点
0 RELIGION Pub Date : 2023-09-27 DOI: 10.1177/00346373231195634
Lidija Novakovic
In this article, I examine the declaration, “It is advantageous for you that one man should die for the people and not that the whole nation should perish” (John 11:50), which the high priest Caiaphas makes at the Sanhedrin’s deliberations about the necessity of Jesus’s execution. I argue that despite the narrator’s appreciative comment that Caiaphas “did not say this on his own, but, because he was high priest that year, he prophesied that Jesus was about to die for the nation, and not for the nation only, but that he may also gather into one the scattered children of God” (John 11:51–52), the evangelist does not endorse the argument from expediency that Caiaphas advocates. Jesus’s death in John is beneficial for others not because the reasoning “one for many” is morally justifiable but because Jesus freely lays down his life. This redefinition of the redemptive significance of Jesus’s death on the cross also implies the futility of violence because the execution of Jesus did not bring about the non-violent end that Caiaphas hoped for. After all, the Romans did come and destroy the city of Jerusalem and its temple. Thus, the death of Jesus in the Fourth Gospel is beneficial for all God’s people, but this act is not the result of the verdict of the Jewish leaders to put Jesus to death but of Jesus’s own decision to give his life for others.
在这篇文章中,我考察了大祭司该亚法在公会讨论处死耶稣的必要性时所说的一句话:“一人替百姓死,免得全国灭亡,这对你们是有益的”(约翰福音11:50)。我认为,尽管叙述者赞赏地评论说,该亚法“不是凭自己说的,而是因为他是那年的大祭司,所以他预言耶稣将要为国家而死,而且不仅为国家而死,而且要把上帝分散的儿女都聚集为一”(约翰福音11:51-52),但传道者并没有赞同该亚法主张的出于权谋的论点。在约翰福音中,耶稣的死对其他人有益,不是因为“一人为众人”的推理在道德上是正当的,而是因为耶稣自由地献出了自己的生命。这种对耶稣死在十字架上的救赎意义的重新定义也暗示了暴力的无效,因为耶稣的处决并没有带来该亚法所希望的非暴力结局。毕竟,罗马人确实来摧毁了耶路撒冷城和它的圣殿。因此,在第四部福音书中,耶稣的死对所有上帝的子民都是有益的,但这一行为并不是犹太领袖决定处死耶稣的结果,而是耶稣自己决定为他人献出生命的结果。
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引用次数: 0
Revelation through violence? Jesus in the Temple in John 2:13–22 暴力启示?约翰福音2:13-22,耶稣在圣殿里
0 RELIGION Pub Date : 2023-09-27 DOI: 10.1177/00346373231199503
Alicia D. Myers
John’s version of Jesus’s temple entrance is remarkable for its depiction of Jesus wielding a whip and driving out animals and people from the precincts. Focusing on the violence of Jesus’s “righteous anger,” some interpreters have used John 2:13–22 to justify violence in God’s name throughout history. Others push back against such readings by mitigating or ignoring the violence of Jesus’s actions. This article seeks to find a middle ground by focusing on ancient understandings of what happens when holiness is profaned. Using 2 Maccabees as a comparison, I argue John 2:13–22 presents Jesus’s arrival in the temple as a clash caused by holiness breaking out. This presentation emphasizes Jesus’s identity as God’s glory made flesh and plays into ancient audience expectations in 2:13–17. In 2:18–22, however, Jesus undercuts these assumptions by predicting his own death and resurrection. Rather than endorsing violence, then, John 2:13–22 is better understood as a type of bait and switch, in which the narrative emphasizes Jesus’s identity, the problem he faces in the world, and the surprising way God responds. Instead of spreading violence, Jesus receives it upon his own body, thus revealing God’s inviolability that results in life for those who will receive it.
约翰对耶稣进入圣殿的描述非常引人注目,因为它描绘了耶稣挥舞着鞭子,把动物和人赶出圣殿。关注耶稣“公义的愤怒”的暴力,一些解经家用约翰福音2:13-22来证明历史上以神的名义使用暴力是正当的。另一些人则通过减轻或忽视耶稣行为的暴力来反驳这种解读。本文试图通过关注古代对神圣被亵渎时会发生什么的理解,找到一个中间立场。用马加比书作比较,我认为约翰福音2章13 - 22节把耶稣进入圣殿描绘成一场因圣洁爆发而引起的冲突。这个陈述强调耶稣的身份是神的荣耀成肉身,并在2:13-17中迎合了古代观众的期望。然而,在2:18-22,耶稣通过预言他自己的死亡和复活削弱了这些假设。因此,约翰福音2:13-22与其说是支持暴力,不如把它理解为一种诱饵和诱饵,其中的叙述强调了耶稣的身份,他在世界上面临的问题,以及上帝令人惊讶的回应方式。耶稣没有传播暴力,而是在自己的身体上接受暴力,从而揭示了上帝的不可侵犯性,从而为那些接受暴力的人带来了生命。
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引用次数: 0
Editorial introduction: Violence and responses to violence in the Gospel of John 编辑导言:约翰福音中的暴力和对暴力的回应
0 RELIGION Pub Date : 2023-09-22 DOI: 10.1177/00346373231200558
Alicia D. Myers
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引用次数: 0
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