1,721,010 research outputs found
Surgical management of the glomus tumors of the fingers: a single center experience
No full text"INTRODUCTION:. Glomus tumors are rare neoplasms arising from the subcutaneous glomus apparatus. They account for 1 - 5% of the soft tissue tumors of the upper extremity, occurring in most cases in the nail bed. The typical clinical presentation includes paroxysmal pain and hypersensitivity to cold which limit the use of the affected hand causing practical, professional and often emotional discomfort for the patient.. MATERIALS AND METHODS:. Four patients with finger glomus tumor were treated in our institution in the last 30 years. Three patients had a right hand tumor (1st, 3rd and 4th finger) and one patient a left hand tumor (2nd finger). Three tumors were placed in the nail bed and one in the finger tip. In all cases duplex ultrasonography was employed preoperatively and during surgery to ensure complete resection of the tumor. All patients underwent surgical excision of the tumor with local block anesthesia.. RESULTS:. Intense point pain and hypersensitivity to cold was observed in all cases (100%). Two out of 4 patients (50%) presented an irradiation of the pain at the ipsilateral arm and shoulder. Surgical procedure was performed successfully in all cases, with total excision of the tumor and no intraoperative or postoperative complications. No recurrences occurred.. CONCLUSIONS:. Diagnosis of glomus tumors of the fingers is generally easy when manifested with the classical clinical picture and duplex ultrasonography is employed. Complete surgical excision is curative, providing immediate relief of symptoms and improvement of eventual professional or psychological discomfort.
Randomized prospective study on the efficacy of a new revitalizing filler composed of hyaluronic acid (Wipeline)
No full textAim: The aim of the study was to test the efficacy of a new revitalizing filler (Wipeline) formed by a buffer physiological solution of hyaluronic acid (HA). Methods: A prospective study was performed on 100 patients (aging between 40 and 70 years), with clear signs of premature facial aging. Patients were randomly assigned to two groups, one treated with a HA concentration of 1.6%, the other with a concentration of 2% in the tested product. The treatment protocol consisted of three sessions with a four weeks intervals between them. Visual Analogue Scale (VAS) and digital photos were used to evaluate results after 1, 3, 6 and 12 months from treatment end. Results: An improvement of turgidity, elasticity and luminosity of the skin and a reduction of folds and wrinkles of the treated areas were observed in both groups. The higher concentrated solution of HA had a more prolonged effect and a greater filling effect. Products were well tolerated and no adverse reactions observed. Conclusion: The efficacy of Wipeline has been clinically supported. This revitalizing filler succeeded in increasing skin elasticity and tone by dermal hydration. The procedure is simple and little invasive. It represents a good treatment option to restore vitality and turgidity of skin presenting the signs of aging
Multimodality approach to malignant pleural mesothelioma. A case report
No full textINTRODUCTION: We report a case of diffuse malignant pleural mesothelioma (DMPM) in a 68-years-old male patient who was admitted for right sited pleural effusion. The patient was treated by multimodality approach consisting in surgical treatment with Extrapleural Pleuropneumonectomy followed by chemotherapy with Cisplatin and Pemetrexed. He had a disease free period of one year and survived for 31 months.
CASE REPORT: The patient was admitted to our Institute for a right sited pleural effusion diagnosed on chest X ray. Anamnesis revealed professional asbestos exposure and the patient presented dyspnea, dry cough, right sited chest pain, low fever and loss of weight. As thoracentesis and CT scan did not reveal pathological findings except of the effusion, we performed videothoracoscopy. Several grey nodular lesions involving the costal, diaphragmatic and mediastinic parietal pleural sheets were found. Histological examination of the specimens extracted revealed the presence of epithelial malignant pleural mesothelioma with sarcomatoid areas. Further examinations staged the lesion as Butchart I. Extrapleural pleuropneumonectomy was performed followed by a chemiotherapic treatment with Cisplatin and Pemetrexed. The patient underwent a follow up program with CT scan every four months. The disease free period was of about one year and the patient died after 31 months from diagnosis for septic complications related to chronic effusion.
DISCUSSION: Single treatments do not demonstrate an acceptable efficacy on the treatment of DMPM. Multimodality therapy provides good survival improvement and acceptable quality of life for the patients
Neuro-ocular cutaneous syndrome: a case report
No full text: Neuro-ocular cutaneous syndrome is a rare and little-known illness. It affects the ocular apparatus, the nervous system and the skin. The disease causes pathologies such as phacomatosis, which is a generic term used to describe small cutaneous neoformations, as well as other ectodermal organ malformations (ocular apparatus and central nervous system). The symptoms of this disease are ocular, neurological and dermatological and can include: corneal opacity, papillary coloboma, optical atrophy, epibulbar dermoids, corectopia, palpebral coloboma, frontoparietal alopecia, epilepsy, psychomotor delay, pedunculated skin growths, a yellowing of the frontal area, milled papules, milled patches of skin, cutaneous spotting, familial angioma and hemiplegia. Due to the complexity of this disease, it is imperative that specialists (including ophthalmologists, neurologists, dermatologists, plastic surgeons, pediatricians and genetics) examine a great number of families affected by this rare pathology in a precise, accurate and ongoing manner. The clinical case of a 15 year-old patient (who was diagnosed at 10 months old) affected by the neuro-ocular cutaneous syndrome will be discussed below
Use of the reverse flow island sural flap in the replacement of tissue loss involving the distal third of the leg, ankle and heel
No full text: The events leading to a tissue loss in the lower limbs are varied. The aetiology can be traumatic, infective, neoplastic, iatrogenic, vascular or systemic. Five patients with lesions involving the distal third of the lower limb, the ankle and the heel, traumatic in origin, presented at our service within the Faculty of Plastic and Reconstructive Surgery, University Hospital "La Sapienza" in Rome. In such patients, the surgical approach involved the repair of tissue loss through the use of the neurocutaneous distally based sural artery flap. The use of the reverse flow island sural flap, compared to other therapeutic options, is advantageous from varying points of view: ease in taking the sample, limited morbidity of the donator site, less time required for the surgical procedure. Regarding the flap, safety and simplicity of execution were implemented in accordance with our experience, dissecting a wide adipo-fascial peduncle. Post-operative precautions were implemented in order to avoid compression of the transposed flap and of the peduncle. The healing in these patients was satisfactory
Use of the reverse flow island sural flap in the replacement of tissue loss involving the distal third of the leg, ankle and heel
No full textThe events leading to a tissue loss in the lower limbs are varied. The aetiology can be traumatic, infective, neoplastic, iatrogenic, vascular or systemic. Five patients with lesions involving the distal third of the lower limb, the ankle and the heel, traumatic in origin, presented at our service within the Faculty of Plastic and Reconstructive Surgery, University Hospital "La Sapienza" in Rome. In such patients, the surgical approach involved the repair of tissue loss through the use of the neurocutaneous distally based sural artery flap. The use of the reverse flow island sural flap, compared to other therapeutic options, is advantageous from varying points of view: ease in taking the sample, limited morbidity of the donator site, less time required for the surgical procedure. Regarding the flap, safety and simplicity of execution were implemented in accordance with our experience, dissecting a wide adipo-fascial peduncle. Post-operative precautions were implemented in order to avoid compression of the transposed flap and of the peduncle. The healing in these patients was satisfactory
Free fibular flap with periosteal excess for mandibular reconstruction.
No full textBackground In microvascular transfer of fibular osteocutaneous flap for mandible reconstruction after cancer ablation, good bone union is necessary to allow timely radiation therapy after surgery. As the area of bone contact between fibula and the original mandible at the edge of the mandibular defect is small, a periosteal excess at both ends of the fibula covering the bone junction can be used to increase the chance of bone union. The purpose of this study is to investigate whether a periosteal excess surrounding both ends of the fibula flap can provide better blood supply and, therefore, ensure bone union and wound healing at 6 weeks after surgery and before radiation therapy initiation. Patients and methods The transfer of fibular osteocutaneous flap with periosteal excess was only applied to reconstruct segmental mandibular defects. As a consequence, only cases in which osteotomy of fibula was not performed were included in this study. A total of 34 fibular flaps without osteotomies were performed between 2000 and 2008; 17 with and 17 without the periosteal excess. The bone union was evaluated in terms of osseous callus formation using X-rays and CT three-dimensional images at 6 weeks after surgery, and results were assessed by three independent radiologists. Results There was a significant difference between reconstructions with and without the periosteal excess in terms of bone union (P = 0.022). With reference to postoperative complications, the group reconstructed without periosteal excess presented a higher number of complications, mainly consisting of partial and total flap necrosis, respectively six (35.29%) and two (11.76%) cases. In the group reconstructed with periosteal excess, no loss of the skin island has occurred. A significant difference was observed in terms of partial flap necrosis (P = 0.024), while the other complications did not reveal a statistically significant difference (P > 0.05). Conclusions The use of a periosteal excess at both ends of the fibula flap provides better blood supply and is, therefore, able to ensure good bone healing and skin paddle survival regardless of the radiotherapy
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