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Malignant Glomus Tumor of the Leg Developed in the Context of a Superficial Typical Glomus Tumor.
No full textHistological study of the deep fasciae of the limbs.
No full textThe aim of this study is to analyse the deep fasciae of limbs in order to evaluate the collagen and elastic fibre arrangement and the types of innervation. Histological and immunohistochemical stains were performed in 72 specimens. The deep fascia of the limbs is a sheath presenting a mean thickness of 1mm, formed by two to three layers of parallel collagen fibre bundles. In the adjacent layers, they show different orientations. Each layer is separated from the adjacent one by loose connective tissue, permitting the sliding of the collagen layers. Nerve fibres were found in all specimens, while muscular fibres were evidenced only in one specimen. The described structure permits the fasciae of the limbs to have a strong resistance to traction, even when exercised in different directions. The capacity of the different collagen layers to glide one on the other could be altered in cases of overuse syndrome, trauma, or surgery
Cutaneous manifestations of Scedosporium apiospermum in an immunosuppressed patient
No full textScedosporium apiospermum is a ubiquitous fungus of the soil and polluted water responsible for cutaneous and disseminated infection. It is identified as the common cause of mycetoma after trauma in immunocompetent patient and it is recognized as one of the medically important opportunistic fungi causing life-threatening infections in immunosuppressed patients. Cutaneous involvement lacks pathognomonic features that would make an early diagnosis possible. Presentations range from erythematous lesions, abscesses, nodules with purulent discharge to skin plaques, nodules, scaly, crusted surface, granulomatous lesions without signs of infection. A case of deep cutaneous mycosis mimicking a skin cancer is described. The patient was initially treated for an immunosuppressive therapy-related neoplasm. Afterwards the correct histopathological diagnosis was performed, and the patient underwent the proper long-term antifungal treatment. The review of 38 cases collected from the literature underlines the variability of clinical presentations of cutaneous Scedosporium apiospermum. Healthcare providers awareness of clinical aspects and presentation of Scedosporium apiospermum infections and the knowledge of the best treatment options would prevent treatment delay and can be life-saving in immunocompromised patients. The association of early surgical debridement and specific long-term antifungal therapy (based on intraoperative microbiological specimens) offers the best chance of healing, avoiding the risk of dissemination or local recurrence
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Temperamental and personality traits in obese/overweight patients who refer to Plastic Surgery: a Padua Pilot study.
No full textBackground: literature evidenced correlation between psychiatric disorders and overweight/obese (BMI>25) conditions, management and treatment. There are involved psychiatric diseases and temperamental traits. Our study, born from collaboration between Psychiatric and Plastic Surgery Clinic of Padua University, wants to detect psychiatric disorders, temperamental traits and body image perception in overweight-obese patients who seek surgical liposuction or abdominoplastic. Methods: we studied (March 2008 -June 2011), 28 consecutive patients who refer for surgical enhancement (age 18-60 ys) with BMI<34.9 at the recruitment. Exclusion criteria are: organic disorders or drugs that could interfere with obesity; cognitive deficit and psychosis. 30 patients refused psychiatric evaluation. This clinical population has been compared to a control group (N=25) from general population. Psychiatric evaluation was based on clinical information, Mini-International Neuropsychiatric Interview, Beck Depression Inventory, Yale Brown Scale, Paykel Life Events Scale, NEO Five Factory Inventory, Tridimensional Personality Questionnaire, Body Shape Questionnaire.
Results: case group evidenced higher scores in lifetime depression and BSQ scores with a moderate/mild concern with body shapes; focus on personality traits, TPQ revealed higher score in subscale dependence/independence and significant higher presence at YBS for obsessive-compulsive characteristics; NEO-FFI Openness to experience is higher in control.
Conclusions: It’s unmistakable that affective sphere is relevant but also obsessive-compulsive and temperamental traits and negative body shape perception. These aspects are implicated in treatments adhesion and clinical outcome. Possibility to individuate patients who present those characteristics is an instrument to avoid early post-treatment relapse and give the possibility to refer to psychiatric care before and after surgery
Autologous injectable dermis: a clinical and histological study.
Get PDFBACKGROUND:
: No perfect solution yet exists for dermal fillers. The authors hypothesized that autologous dermis can be processed in an operator-friendly manner and adopted in selected patients as a filler, following the principle of replacing "like with like."
METHODS:
: The authors designed a prototype "cutting chamber" to morsel dermis into an injectable form. Autologous injectable dermis grafting was performed in 16 patients who underwent lip or labionasal fold correction concomitant with abdominoplasty or cesarean scar correction; patient dermis was used for the donor graft. Furthermore, injectable dermis grafting was performed in the subcutaneous tissue of three patients undergoing multistage reconstructive procedures for obesity. The grafts were harvested and examined histologically at 3, 7, and 12 months.
RESULTS:
: Dermis processing and injection proved feasible with limited effort. All 16 patients presented good volume maintenance by 12 months. Two reported transient palpable firmness for the first 6 months, which subsequently resolved. Histological examination of processed and injected dermis showed volume maintenance over time, effective revascularization of the mass, and structural reorganization with collagen bundles and nested fibroblasts reminiscent of reticular dermis. A transient inflammatory reaction was observed, consistent with the expected healing events.
CONCLUSIONS:
: Use of autologous dermis as a filler substance for both aesthetic and reconstructive procedures appears to be a feasible option. It could be advised for patients requiring filler correction who undergo concomitant procedures involving excision of potential donor dermis
Overweight/Obese Patients Referring to Plastic Surgery: Temperament and Personality Traits.
No full textBACKGROUND:
Correlations between psychiatric disorders and overweight/obesity are reported in the literature. However, temperament/personality traits have been less frequently studied even though the correlation with Axis-1 diseases is well defined. The present study aims to detect correlations between psychiatric disorders, temperament traits and body image perception in overweight and obese patients who seek surgical lipostructuring treatment.
METHODS:
Seventy overweight/obese patients (age 18-60 years, BMI 25-34.9 at recruitment) referring to the outpatient service for obesity-related lipodystrophism were enrolled in the period March 2008-March 2012. Psychiatric disorders, temperament traits, and body image perception were evaluated and compared with a control group (N = 33) from the general population sharing clinical/demographic features.
RESULTS:
Patients had higher scores in lifetime depression, with moderate/mild concern with body shape. Regarding personality traits, tests revealed higher scores on subscale RD4 (dependence/independence) in patients, whereas controls scored higher on the "openness to experience" NEO Five Factory Inventory sub-scale. Obese patients had a higher prevalence of obsessive characteristics.
CONCLUSIONS:
The affective sphere is an important feature in obese patients, as are obsessive traits, since negative body shape perception and temperament and personality characteristics appear to be involved in leading patients to seek surgical advice. These aspects should be involved in medical/surgical outcomes and compliance with treatment. The future possibility of identifying patients who show alterations in these traits or psychic characteristics may represent a possible instrument to avoid early post-treatment relapse and to implement the service offered to patients, with appropriate psychiatric care before and after surgery
Anatomicalmodification of the vascularization of anterior abdominal wall secondary to weight variation.
No full textComparison of Transverse Carpal Ligament and Flexor Retinaculum Terminology for the Wrist
No full textPURPOSE: To investigate the macroscopic anatomy and histological characteristics of the transverse carpal ligament and the flexor retinaculum of the wrist and to investigate their anatomical relationships and define appropriate terminology.
METHODS: The volar regions of the wrists of 30 unembalmed subjects were examined by dissection and by histological and immunohistochemical staining. In vivo magnetic resonance imaging studies were also carried out on 10 subjects.
RESULTS: The dissection study showed that the antebrachial fascia at the volar aspect of the wrist presents a reinforcement. From a histological point of view, it is composed of 3 layers of undulated collagen fiber bundles. Adjacent layers show different orientations of the collagen fibers. Many nerve fibers and Pacini and Ruffini corpuscles were found in all specimens. Under this fibrous plane is another fibrous structure, placed transversely between the ulnar-sided hamate and pisiform bones, and the radial-sided scaphoid and trapezium bones. The deeper fibrous structure shows completely different histological characteristics, having parallel, thicker collagen fiber bundles and few nerve fibers. Magnetic resonance images confirm the presence of 2 clearly distinguished fibrous structures in the wrist, the first in continuity with the antebrachial fascia and the second located in a deeper plane between the hamate and scaphoid.
CONCLUSIONS: Two different fibrous structures with different histological characteristics are present in the volar wrist: the more superficial one is in continuity with the antebrachial fascia and could be considered its reinforcement; the deeper one is composed of strong lamina, with histological features similar to those of a ligament. For these reasons, we suggest that the term transverse carpal ligament should be used to indicate the fibrous lamina connecting the hamate and pisiform to the scaphoid and trapezium and that the term flexor retinaculum of the wrist should be abandoned because it does not correspond to any specific, autonomous structure
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