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Skin AND anatomy

Zhenglin Chi, Peng Yang, Dajiang Song, Zan Li, Liang Tang, Weiyang Gao, Yonghuan Song, Tingang Chu
INTRODUCTION: To investigate the results of resurfacing completely degloved digits using bilobed innervated radial artery superficial palmar branch (RASPB) perforator flap in a spiral fashion. METHODS: A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The flap-raising procedure was performed using four fresh cadaver specimen...
October 21, 2016: Surgical and Radiologic Anatomy: SRA
Paulo Esteves Pinto Faria, Abrahão Cavalcante Gomes de Souza Carvalho, Bárbara Masalskas, Letícia Chihara, Eduardo Sant'Ana, Osvaldo Magro Filho
One of the most impressive soft tissue injuries is the facial degloving, normally associated with industrial machines and traffic accidents. This injury is characterized by the separation of the skin and cartilage from the bones, compromising the soft tissues correlated in the trauma area, nerves, and blood vessels. A 28-year-old patient, male, was referred to Araçatuba's Santa Casa Hospital, after a motorcycle accident, hitting his face on the sidewalk. The patient was conscious, oriented, denying fainting and unconsciousness during the accident, and complaining of pain in the nasal region of the face...
October 2016: Journal of Craniofacial Surgery
Bowen Gao, Qingxiong Yu, Feng Xie, Lingling Sheng, Xiyuan Mao, Qingfeng Li, Hainan Zhu
BACKGROUND: Conventional reconstructive methods fail to achieve satisfactory results in total eyelid defect cases. Vascularized composite tissue allotransplantation might provide both good appearance and function for these patients. The structure of the eyelid is exceptional because it simultaneously consists of skin, connective tissue, the striated muscle, fiber structure, aponeuroses, and mucosa. Thus, before clinical application of eyelid allotransplantation, more experiments are needed to clarify the impact of ischemia, immunal suppressive agents, and deinnervation effects on these sophisticated structures...
October 13, 2016: Ophthalmic Plastic and Reconstructive Surgery
Kamol Wattanakrai, Nattawut Chiemchaisri, Penpun Wattanakrai
BACKGROUND: Blepharoplasty is a common aesthetic surgery performed worldwide. In Asians, too high eyelid folds after blepharoplasty cause an unsatisfactory aesthetic outcome that is difficult to correct. In this article, the authors propose surgical techniques to correct the high eyelid fold after blepharoplasty. METHODS: During a 4-year period, 213 secondary blepharoplasties were performed to correct high folds. Postoperative results were reviewed, graded, and analyzed...
October 14, 2016: Aesthetic Plastic Surgery
Antonio Carlos Abramo, Thiago Paoliello Alves Do Amaral, Bruno Pierotti Lessio, Germano Andrighetto De Lima
BACKGROUND: The purpose of this study is to establish a relationship between the skin lines on the upper third of the face in cadavers, which represent the muscle activity in life and the skin lines achieved by voluntary contraction of the forehead, glabellar, and orbital muscles in patients. METHODS: Anatomical dissection of fresh cadavers was performed in 20 fresh cadavers, 11 females and 9 males, with ages ranging from 53 to 77 years. Subcutaneous dissection identified the muscle shape and the continuity of the fibers of the eyebrow elevator and depress muscles...
October 14, 2016: Aesthetic Plastic Surgery
Elena Esra Foditsch, Reinhold Zimmermann
PURPOSE: The aim of this study was to develop a controlled approach for sacral neuromodulation (SNM) to improve both nerve targeting and tined lead placement, for which a new computed tomography (CT)-guided implantation technique was analyzed in minipigs. MATERIALS AND METHODS: This study included five female, adult Göttingen minipigs. In deep sedoanalgesia, the minipigs were placed in an extended prone position. Commercially available SNM materials were used (needle, introduction sheath, and quadripolar tined lead electrode)...
2016: Research and Reports in Urology
V Peppa, E P Pappas, P Karaiskos, T Major, C Polgár, P Papagiannis
PURPOSE: To investigate the clinical significance of introducing model based dose calculation algorithms (MBDCAs) as an alternative to TG-43 in (192)Ir interstitial breast brachytherapy. MATERIALS AND METHODS: A 57 patient cohort was used in a retrospective comparison between TG-43 based dosimetry data exported from a treatment planning system and Monte Carlo (MC) dosimetry performed using MCNP v. 6.1 with plan and anatomy information in DICOM-RT format. Comparison was performed for the target, ipsilateral lung, heart, skin, breast and ribs, using dose distributions, dose-volume histograms (DVH) and plan quality indices clinically used for plan evaluation, as well as radiobiological parameters...
October 5, 2016: Physica Medica: PM
Clara Ferreira, Daniel Johnson, Karl Rasmussen, Clinton Leinweber, Salahuddin Ahmad, Jae Won Jung
PURPOSE: To develop a novel conformal superficial brachytherapy (CSBT) device as a treatment option for the patient-specific radiation therapy of conditions including superficial lesions, postsurgical positive margins, Dupuytren's contractures, keloid scars, and complex anatomic sites (eyelids, nose, ears, etc.). METHODS AND MATERIALS: A preliminary CSBT device prototype was designed, built, and tested using readily available radioactive seeds. Iodine-125 ((125)I) seeds were independently guided to the treatment surface to conform to the target...
October 3, 2016: Brachytherapy
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
R Hoerster, M Schlaak, K R Koch, M Ortmann, C Mauch, L M Heindl
Merkel cell carcinoma of the eyelid is an aggressive, highly malignant tumor of the skin. Totaling approximately 0.5 % of all tumors of the eyelid, it constitutes a relatively small group of lid tumors. Nevertheless Merkel cell carcinoma is of significance to the ophthalmologist. Because of its clinical presentation it can be easily confused as a chalazion, a hordeolum or the lesser aggressive basal cell carcinoma. This often leads to delayed treatment. In this article we describe clinical aspects, which aim to help the ophthalmologist suspect Merkel cell carcinoma earlier...
September 20, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Yeon Soo Yeom, Zhao Jun Wang, Thang Tat Nguyen, Han Sung Kim, Chansoo Choi, Min Cheol Han, Chan Hyeong Kim, Jai Ki Lee, Beom Sun Chung, Maria Zankl, Nina Petoussi-Henss, Wesley E Bolch, Choonsik Lee
The reference adult computational phantoms of the international commission on radiological protection (ICRP) described in Publication 110 are voxel-type computational phantoms based on whole-body computed tomography (CT) images of adult male and female patients. The voxel resolutions of these phantoms are in the order of a few millimeters and smaller tissues such as the eye lens, the skin, and the walls of some organs cannot be properly defined in the phantoms, resulting in limitations in dose coefficient calculations for weakly penetrating radiations...
October 7, 2016: Physics in Medicine and Biology
Yue Fen Toh, Su Mei Yew, Chai Ling Chan, Shiang Ling Na, Kok Wei Lee, Chee-Choong Hoh, Wai-Yan Yee, Kee Peng Ng, Chee Sian Kuan
Pyrenochaeta unguis-hominis is a rare human pathogen that causes infection in human skin and nail. P. unguis-hominis has received little attention, and thus, the basic biology and pathogenicity of this fungus is not fully understood. In this study, we performed in-depth analysis of the P. unguis-hominis UM 256 genome that was isolated from the skin scraping of a dermatitis patient. The isolate was identified to species level using a comprehensive multilocus phylogenetic analysis of the genus Pyrenochaeta. The assembled UM 256 genome has a size of 35...
2016: PloS One
D Alastair Taylor
BACKGROUND: The elucidation of the superficial fascial system (SFS) by Lockwood in 1991 has been the cornerstone of our understanding of abdominal excisional dynamics for the last 25 years. The SFS can be used for closure and, appropriately mobilized, for tension transmission in abdominoplasty, and lower body lifts. The pattern of SFS adhesion to muscle fascia and the zones of adhesion was also described but there are inconsistencies between the description and clinical experience. OBJECTIVES: This study was performed to better describe the pattern of subcutaneous tissue adhesion to the trunk...
September 13, 2016: Aesthetic Surgery Journal
Ramesha Papanna, Lovepreet K Mann, Saul Snowise, Yisel Morales, Sanjay P Prabhu, Scheffer C G Tseng, Raymond Grill, Stephen Fletcher, Kenneth J Moise
OBJECTIVES: The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. METHODS: Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation...
July 2016: American Journal of Perinatology Reports
Venkateswar R Surabhi, Christine O Menias, Ahmed M Amer, Mohamed Elshikh, Venkata S Katabathina, Amy K Hara, William C Baughman, Ania Kielar, Khaled M Elsayes, Cary L Siegel
Tumors and tumorlike conditions of the anus and perianal region originate from the anal canal and anal margin or result from direct extension of tumors from adjacent organs. The anatomy of the anal canal is complex, and its different histologic characteristics can lead to diverse pathologic conditions. The anal canal extends from the anorectal junction to the anal verge. The World Health Organization classification of anal canal tumors includes (a) anal intraepithelial neoplasia, the precursor of squamous cell carcinoma (SCC), and (b) invasive tumors...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tae-Hee Kim, Bel Seap, Soo Ah Kim, Gyeong-Eun Heo
Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement...
August 2016: Journal of Menopausal Medicine
Murat Ulutas, Suat Boyacı, Akın Akakın, Türker Kılıç, Kaya Aksoy
BACKGROUND: Tumors of the middle fossa or cavernous sinus (CS), or intraorbital tumors, can penetrate each other through the superior orbital fissure (SOF) or neighboring tissue. These complicated pathologies are often treated with highly invasive surgical procedures. In this article, we demonstrate surgical anatomic dissections of the CS, SOF, orbital apex (OA), and dura mater extending to the periorbita from the middle fossa, by performing an epidural dissection via a lateral orbitotomy approach, and discuss findings that may provide guidance during surgery in these regions...
November 2016: Acta Neurochirurgica
Jindou Jiang, Xuekun Wang, Rongrong Chen, Xueying Xia, Sai Sun, Kuikui Hu
AIM: To explore the efficacy of tear trough deformity treatment with the use of hyaluronic acid gel or autologous fat for soft tissue augmentation and fat repositioning via arcus marginalis release. MATERIAL AND METHODS: Seventy-eight patients with the tear trough were divided into three groups. Class I has tear trough without bulging orbital fat or excess of the lower eyelid skin. Class II is associated with mild to moderate orbital fat bulging, without excess of the lower eyelid skin...
August 2016: Postȩpy Dermatologii i Alergologii
Masashi Ono, Keisuke Takanari, Kazuhiro Toriyama, Shunjiro Yagi, Katsumi Ebisawa, Hisashi Sawamura, Miki Kambe, Kenta Murotani, Yuzuru Kamei
Background A successful free flap transfer is achieved, in part, by having a thorough understanding of vascular anatomy and blood flow dynamics. We previously reported that vascular resistance differs by type of free flap. To test the hypothesis that the difference reflects the proportion of tissue components within free flaps, we calculated blood flow and vascular resistance for free flaps in which we determined the volume of each tissue component. Methods Measurements and calculations were made for 40 free flap transfers performed at our hospital: 7 radial forearm flaps, 14 anterolateral thigh flaps, and 19 rectus abdominis myocutaneous flaps...
September 5, 2016: Journal of Reconstructive Microsurgery
Angela Gm O'Neill, Suneil Jain, Alan R Hounsell, Joe M O'Sullivan
Image guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogenous whole pelvic radiotherapy dose but these are not reliable when using reduced margins, dose escalation or hypo-fractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990's. They require surgical implantation and provide a surrogate for the position of the prostate gland...
September 2, 2016: British Journal of Radiology
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