Immediate breast reconstruction using latissimus dorsi and transverse rectus abdominus myocutaneous [TRAM] flaps

During a period of 12 months, ten women with stage II cancer breast underwent modified radical mastectomy and immediate breast reconstruction[IBR]. Six women had Latissimus Dorsi myocutaneous flaps while four patients had TRAM flaps. In the Latissimus Dorsi flap group, two patients were moderatly obese, two patients were mildly obese and 2 patients were of average body weight. While in the TRAM group, two patients were mildly obese and 2 patients were of average body weight. Operative time [Of the reconstruction only] in the Latissimus Dorsi group ranged from 1.5 to 2.5 hr. [mean 1.8 hr] and each patient received either one or two units of blood. While in the TRAM group, operative time [Of the reconstruction only] ranged from 2 to 3.5 hr. [mean 3.25 hr] and each patient received blood transfusion [range 2-4 units]. In patients of both groups there was no complete flap loss nor fat necrosis. Partial flap loss occured in 2 patients of the Latissiums Dorsi group as a small skin zone loss in the lateral edge, both of them was managed by debridement and repeated dressing. In patients of the TRAM group, partial flap loss in zone [IV] occured in 2 patients, both was managed by debridement and secondly sutures. Regarding donor site complications, seroma appeared in 2 patients of the Latissiums Dorsi group [managed by aspiration] but did not appear in the TRAM group. Wound dehiscence occured in 3 cases of Latissimus Dorsi group, but did not occur in the TRAM group. Haematoma developed in one patient of the TRAM group. Chemotherapy started after 3-4 weeks of operation regardless of the state of the wound. Patients were followed up for 6-12 months [mean 8 months]. All patients in both groups were satisfied and pleased with their reconstructed breasts. From this early experience it is concluded that: [A] Immediate breast reconstruction could be done for patients with cancer breast with excellent patient satisfaction and could be an attractive and encouraging factor for patients who are afraid of being devoid of their breasts to accept mastectomy. [B] Immediate breast reconstruction could be performed without delay in chemotherapy plan and without compromising the flap viability or management of complication. [C] The Latissium Dorsi flap is suitable for patients who refuse an abdominal scar or who are not candidates for a TRAM flap. [D] The TRAM flap is suitable for patients with relatively large breasts and those with average body weight or mild obesity

Bacterial disturbances implicated in naturally and experimentally infected fresh water fishes

Motile aeromonad organisms have been isolated in high incidence among examined fish species. A. hydrophila was recovered in an incidence of 6.4%, 4.8% and 6.4% from tilapia nilotica, clarias lazera and mugil species respectively. Other aeromonads were A. punctata, A. salmonicida and A. anaerogenes in an incidence extended between 0.00% up to 4.0%. A. salmonicida was the first to be recovered from fresh water fish. Ps. fluorescens, Citr. diversus, Citr. Freundii, capital later U enterocolitica, S. marcescens and Enterbacter species were the most bacterial pathogens isolated from different kinds of fish. Experimental studies on the pathogenicity of A. hydrophila, Ps. fluorescens and A. punctata in clarias species were discussed in details

Orthodontic treatment of cleft lip and palate

This study investigated the effect of orthodontic treatment for surgically repaired complete unilateral cleft lip and palate cases. Their average age at the beginning of treatment was 13.7 years. The effect of treatment was determined based upon the pre-treatment and post-treatment records especially the dental study casts and tracings from the lateral cephalometric radiographs.Nine arch dimensions on the dental casts were measured. There was significant increase in the maxillary arch width and depth, whereas the mandibular arch width showed significant increase in the intercanine and inter-first premolar widths only. The cross-bite was orthodontically corrected in all except one where the maxilla required surgical advancement The cephalometric analysis showed a great improvement in the axial inclination of the maxillary incisors and the interincisal angle. There was significant opening of the bite as evidenced by the increase in the mandibular plane angle. The soft tissue profile showed slight improvement, only the lower lip protrusion have been significantly reduced. Generally, the profile remained flattened than normal

Alexandria analysis: radiographic cephalometric standards for Egyptian adults

A radiographic cephalometric study was performed on a group of Egyptian University students. The subjects included 100 males and 100 females, between 18 and 25 years of age and with clinically acceptable occlusion and harmonious facial features. None of them had undergone orthodontic treatment. The object of this study is to establish craniofacial and soft tissue standards to be used by the clinicians on the Egyptian population. Twenty two angular measurements, thirteen linear measurements, and three ratios were established covering the most significant skeletal, dental and soft tissue parameters. The data obtained is presented in a convenient clinical table to assist orthodontists in diagnosis and treatment planning