Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm

BACKGROUND: A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release. METHODS: Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months. RESULTS: A total of 24 females and 48 males were included in this study. The mean age of the patients was 33.7±15.6 years. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusion: Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.

Antimicrobial activity for excretion and secretion of the greenbottle fly larvae lucilia sericata [meigen] [diptera: calliphoridae]

Sterile larval excretion/secretion [ES] exhibited antibacterial activity against some species of bacteria. They were shown to inhibit the growth of Gram-positive bacteria Staphylococcus aureus and Bacillus subtilis Gram-negative bacteria Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae and Fungi Geotricum candidum and Aspergillus fumigatus thus exhibited limited inhibitory effect towards Gram-positive bacteria Streptococcus pyogenes and Staphylococcus epidermidis and Gram-negative Proteous vulgaris and Fungi Syncephalastrum racemosum, Candida albicans, that effect was slowed down when challenged with secretion on a solid media but no zone of complete inhibition was detected. Growth inhibiting activity was determined in liquid growth media using the Gram-positive, Gram-negative bacterial and fungal strains as indicator organisms

vascularization of symphysis pubis in the albino RAT

Little attention has been paid to study the vascular nutritional pathways to the symphysis pubis. Knowledge regarding the nutrient sources and degree of vascularisation of the fibrocartilaginous structures especially the articular discs of symphysis pubis in virgins and during late period of pregnancy is fundamental for physiotherapists and physicians for clinical decision making. This work was undertaken to describe the vascular nutritional pathway to the symphysis pubis in rats using light microscopy and immunohistochemistry and to describe the structural transformation observed in the symphysis pubis during the intrapartum period. 20 rats [8 males and 12 females] 80 - 100 days of age were used in this study. The symphysis pubis was excised and specimens were prepared for light microscopy and immunohistochemistry. The interpubic disc has two distinct portions: an inner bearing portion made up of cartilage and a peripheral portion made up of dense connective tissue. Blood vessels that supply the medial extremity of each pubic bone, penetrate the muscle attachments and the articular tissue to supply the pubic ligaments and the fibrous rim of the interpubic disc. The subchondral bone also share in giving blood supply to the symphysis pubis as it shows several marrow contacts linking the marrow space of the pubic bones with the interpubic disc. Histological examination revealed more intense factor VIII staining in the joint in intrapartum specimens indicating more angiogenesis. The lengthening of the articular gap is seen in intrapartum specimens. The symphyseal gap changes morphologically in intrapartum specimens as a result of pregnancy. Its width increased and it assumed the structure of a ligament. Mononuclear cellular infiltration was demonstrated in the interpubic tissue around parturition. As a result of delivery, traumatic changes occur leading to progressive loosening of the symphysis pubis and production of cartilaginous nodules. Changes in the symphysis pubis noticed as an effect of pregnancy are increased vascularity, increased deposition of collagen, mononuclear cellular infiltration and formation of cartilaginous nodules. These results are of interest to physiotherapists and physicians. Knowledge regarding the degree of vascularisation of the symphysis pubis in virgins and during late period of pregnancy is fundamental for clinical decision making. A clear understanding of the changes that occur in the symphysis pubis at term would be of great benefit to the diagnosis and management of any pathophysiological condition that may happen at parturition

Serum and urinary B2-microglobulin in patients with rheumatoid arthritis

Serum and urinary beta-2 microglobulin [beta-2 m], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], and total lymphocytic count [TLC] were determined in 32 patients with classic seropositive rheumatoid arthritis [RA] and 20 healthy control subjects matched for age and sex. Patients with RA had significant increase in the levels of serum beta-2 m, CRP, ESR, and TLC, but they had nonsignificant increase in the levels of urinary beta-2 m. A positive significant correlation was found between the increased levels of serum beta-2 m and CRP [P <0.001], ESR [P <0.001] and TLC [P <0.05] but no correlation was found with levels of urinary beta-2 m [P >0.05]. The increased levels of serum beta-2 m in patients with RA could be attributed to the high turnover in the lymphocytic pool. According, serum beta-2 m could become part of the routine biochemical assessment of patients with RA with more relevance to the disease process than the acute phase proteins CRP and ESR