117,331 research outputs found
Malignant Glomus Tumor of the Leg Developed in the Context of a Superficial Typical Glomus Tumor.
No full textTitle: Necrotizing Fasciitis: classification, diagnosis and management
No full textNecrotizing fasciitis (NF), a life-threatening rare infection of the soft tissues, is a medical and surgical emergency. It is characterized by subtle, rapid onset of spreading inflammation and necrosis starting from the fascia, muscles, and subcutaneous fat, with subsequent necrosis of the overlying skin. Once suspected, immediate and extensive radical debridement of necrotic tissues is mandatory. Appropriate antibiotics and intensive general support avoid massive systemic diffusion of the infective process and are the key for successful treatment. However, early diagnosis is missed or delayed in 85% to 100% of cases in large published series: because of the lack of specific clinical features in the initial stage of the disease, it is often underestimated or confused with cellulitis or abscess. Mortality rates are still high and have shown no tendency to decrease in the last 100 years. Unfortunately, the prevalence of the disease is such that physicians rarely become sufficiently confident with NF to be able to proceed with rapid diagnosis and management. This review covers the literature published in MEDLINE in the period 1970 to December 31, 2010. Particular attention is
given to the clinical and laboratory elements to be considered for diagnosis. A wide variety of diagnostic tools have been described to facilitate and hasten the diagnosis of NF, but the most important tool for early diagnosis still remains a high index of clinical suspicion
Trattamento delle radiodermiti della spalla: tecniche tradizionali versus chirurgia rigenerativa
No full textPreliminary report of in vitro reconstruction of a vascularised tendon-like structure: a novel application for adipose derived stem cells (ADSCs)
No full textIntroduction. A greater supply of tendinous tissue can be obtained through tissue engineering technology with increasing application of adult stem cells. It is well known that adipose derived stem cells (ADSCs), found in abundance in adipose tissue, have the same differentiating capacity as mesenchymal stem cells (MSCs) yet have the advantage of being easily isolated. In the present study, we combined the great facility of ADSCs to differentiate with the application of an external mechanical stimulus to successfully create an in vitro reconstructed tendon like structure with a microcapillary network.
Materials and methods. Hyalonect® meshes were used as scaffold. Human ADSCs were seeded onto the biomaterials, and the cell/scaffold constructs were cultured under mechanical stress for up to 15 days. Human tenocytes were used in the same conditions as control. Performance were assessed by histology, immunochemistry, ultrastructure, and biomolecular analysis. Results. ADSCs seeded onto Hyalonect® adhered and differentiated along the entire surface of the biomaterial and began to infiltrate within its structure. Subsequently, endothelial cells migrated, forming capillary in the new extracellular matrix.
Conclusions. This technique allowed for the creation of a vascularized tendon equivalent that could easily be detached from the bioreactor, thus facilitating its implant at the lesion site. These results highlight biological performance of biodegradable hyaluronic acid-based (HYAFF-11) scaffolds, which were shown to be suitable for deposition of the autologous extracellular matrix critical for ADSCs differentiation
Temporary coverage of a forehead defect following tumor resection with a hyaluronic acid biological dressing: a case report.
No full textCoverage of large skin defects, especially following tumor resection and in patients who are not good candidates for procedures requiring general anesthesia, may require a staged procedure. The use of dermal substitutes to cover the defect until autologous grafting can be performed has been described. Hyaluronic acid biological dressings (HABD) also have been used for the temporary coverage of partial- to full-thickness posttraumatic or postsurgical wounds. An 82-year-old man with cardiopathy presented with an 8 cm x 4 cm ulcerated squamous cell carcinoma on his forehead. Following surgical removal under local anesthesia, the 12 cm x 8 cm defect was covered with HABD, which was removed immediately before the scheduled surgical closure (21 days later). At that time, well-vascularized granulation tissue completely covered the bone and an autologous skin graft was applied. Punch biopsy results obtained 4 weeks after surgery showed dressing remnants in the dermis and confirmed the graft was totally integrated with the surrounding tissues; there was no evidence of hypertrophy or excessive scarring. In this patient, the staged procedure provided an excellent alternative to a complex surgical procedure. Use of the biological dressing required only a weekly wound and dressing assessment and the cosmetic result was good without evidence of a recurrence at the 2-year follow-up. Studies to ascertain the efficacy and effectiveness of this dressing for the temporary coverage of soft tissue defects are needed
Negative pressure therapy potential enhancement with a biointeractive hyaluronan acid scaffold interface: case report.
No full textCase Repor
Histological 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
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe 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
Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature
No full textBackground:. Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures. Leeching is one the most efficient methods to relieve venous congestion. It has been used as an alternative venous outflow in case of severe impairment of the physiologic one.
Methods:. We present a case of successful rescue of a congested reattached ear by leeching after subtotal avulsion, along with a review of the literature on cases of avulsed auricle reconstruction salvaged by hirudotherapy. Data were collected and analyzed to identify a best regimen to deal with venous congestion.
Results:. More than 130 cases of avulsed auricle savage are described in the literature, in a fourth of which leech therapy was used in the management of venous congestion.
Discussion:. In case of both venous outflow deficit or absence, leeches are a potentially successful option to correct the congestion while new veins reestablish normal physiology. The need for anticoagulant/antiaggregant therapy, antibiotics, and often blood transfusion are the main pitfalls of leeching.
Conclusion:. Leeches can be considered a salvage method for ear replantation and reattachment in those cases that lack venous outflow in the presence of valid arterial inflow
- …
