Migration of Long Standing Fish Bone to Subcutaneous Tissues of the Neck: An Unusual Presentation.

Fish bone is one of the most common foreign bodies encountered in the upper aerodigestive tract region. Owing to its trivial size, smooth surface, and sharp ends, it has a great propensity to migrate in the neck and adjoining structures. Long standing migrated foreign bodies can cause devastating complications like neck abscess and injuries to the major blood vessels. Herein, we report a rare case of long-standing fish bone, which migrated to the subcutaneous tissues of the neck. The foreign body bypassed all the vital structures and was observed as a projection in the skin of the patient’s neck. A careful history and a detailed clinico-radiographic investigation helped to locate the bone and aided in its successful removal.

Fibrogenesis and epithelial coating of skin wounds in rats treated with angico extract (Anadenanthera colubrina var. cebil)

PURPOSE: To evaluate the effects of angico bark extract (Anadenanthera colubrina var. cebil) in the healing process of the skin of rats. METHODS: Twenty adult male rats were divided into four groups of five animals each, according to the respective postoperative days, as follow: G4, G7, G14 and G21. Each group received two incisions on skin and subcutaneous tissue in the right and left antimere of the thoracic region, separated by a distance of 2 cm. The right lesion was treated daily with saline and the left with the angico alcoholic extract (5%). At the end of each experimental period, the animals were euthanized and fragments of the wound area with the edges were removed, fixed in 10% formaldehyde solution and processed for paraffin embedding. Histological sections (5 μm of thickness) were stained with hematoxylin and eosin (HE), Gomori trichromic and picrosisirus red for morphological and morphometric analyses. Statistical analysis was done by ANOVA and Tukey-Kramer test (p<0.05). RESULTS: Morphological analysis showed larger fibroblasts and a higher concentration of collagen fibers in skyn wounds treated with the angico extract. Morphometric analysis demonstrated a significant increase in the number of fibroblasts at 7th and collagen in 7th and 14th days (p<0.01) in wounds treated with the angico extract. CONCLUSION: The angico alcoholic extract (Anadenanthera colubrina var. cebil) induces the acceleration of wound healing in skin wounds of rats. .

Tratamento das áreas cruentas de perna com retalhos locais / Treatment of open wounds of the leg by using local flaps

INTRODUÇÃO: Até os anos 70, a reparação de perdas de substância na perna representava, quase sempre, um problema de solução muito difícil ou, até, insolúvel. Atualmente, embora ainda constitua um campo para os mais experientes, as áreas cruentas na perna já contam com várias técnicas confiáveis e algumas relativamente simples para sua reparação. Este trabalho visa equacionar condutas reparadoras de feridas de perna, utilizando tecidos locais. MÉTODO: Estudo retrospectivo pela análise de casos de reconstrução de perna com retalhos locais realizados pelos autores. Foram incluídos os retalhos dermoadiposos, fasciocutâneos, fasciossubcutâneos e musculares. RESULTADOS: Foram operados 70 pacientes que possuíam áreas cruentas na perna, em consequência de fratura de tíbia, osteomielite, perda tecidual isquêmica, úlcera crônica e tumoração de pele. Os resultados foram avaliados segundo etiologia, tipo de procedimento cirúrgico e complicações. CONCLUSÕES: A opção do tratamento de áreas cruentas de membros inferiores com retalhos locais é bastante válida. A escolha do retalho vai depender de condições locais da perna e da região anatômica afetada. No terço superior da perna, utilizamos retalhos fasciocutâneos baseados na rede vascular do joelho ou retalho de gastrocnêmio. Já no médio, os principais retalhos foram o solear e o fasciossubcutâneo de panturrilha. E, por fim, no inferior, o principal retalho usado foi o fasciossubcutâneo de panturrilha.

INTRODUCTION: Until the 70s, repairing loss of tissue in the leg was almost always difficult, or even impossible. Currently, only the most experienced surgeons are able to repair open wounds of the leg. Nevertheless, several reliable and simple techniques are currently available. This work aimed to evaluate repair techniques for leg wounds by using local tissues. METHOD: The authors performed a retrospective study of cases of leg reconstruction using local flaps. Dermoadipose, fasciocutaneous, fasciosubcutaneous, and muscle flaps were used. RESULTS: Seventy patients who had open areas in the leg due to tibial fractures, osteomyelitis, ischemic tissue loss, chronic ulcer, or skin tumor underwent surgery. Results were evaluated according to etiology, type of surgical procedure, and complications. CONCLUSIONS: The option of treating open wounds of the lower limbs by using local flaps is very valid. Selection of the flap type depended on local conditions in the leg, and the anatomical region affected. In the upper third of the leg, we used fasciocutaneous flaps, based on the vascular network of the knee, or gastrocnemius flaps. In the middle third of the leg, we used the soleus muscle as the primary flap, and fasciosubcutaneous flaps in the calf region. In the lower third of the leg, a fasciosubcutaneous flap of the calf was primarily used.

Alterações bioquímicas e anátomo-histopatológicas causadas pelo veneno do escorpião Tityus fasciolatus em camundongos / Biochemical and anatomo-histopathogical alterations caused by Tityus fasciolatus scorpion venom in mice

O objetivo desta pesquisa foi estudar as alterações causadas pelo veneno de Tityus fasciolatus, uma espécie de escorpião encontrada no Brasil Central, sobre os tecidos, utilizando-se camundongos Swiss CF1, machos, com peso entre 18 e 20g como modelo experimental. Numa primeira parte do experimento, foi determinada a DL50 do veneno de T. fasciolatus, administrado por via subcutânea e foram avaliadas as alterações anátomo-histopatológicas dos animais que vieram a óbito. Numa segunda parte, foram estudados os efeitos de 24µg de veneno de T. fasciolatus sobre a bioquímica sanguínea, 1h, 8h e 24h após a inoculação por via subcutânea do veneno. A DL50 do veneno de T. fasciolatus para o camundongo foi de 59,65µg. Os achados macroscópicos encontrados foram áreas de hemorragia pulmonar (petéquias e equimoses) difusamente distribuídas pela superfície dos pulmões. Os corações apresentavam uma área de coloração mais clara, em formato de cunha no ápice, sugerindo área de infarto. Na microscopia observou-se hemorragia intersticial e presença de leucócitos nas paredes dos alvéolos; leve a moderada congestão dos vasos sanguíneos do epicárdio, miocárdio e endocárido e discreto infiltrado inflamatório linfo-histiocitário no endocárdio e miocárdio. Os animais da segunda parte, inoculados com 24µg de veneno de T. fasciolatus, não apresentaram alterações significativas nos valores de creatina quinase (CK), isoenzima CK-MB, aspartato aminotransferase (AST), lactato desidrogenase (LDH), amilase e glicose. Concluiu-se que o veneno de T. fasciolatus possui uma menor toxicidade quando comparada com o veneno de T. serrulatus e na dose de 24µg não alterou o perfil bioquímico sanguíneo em camundongos.

The aim of this study was to investigate the action of the venom the species Tityus fasciolatus scorpion, found in the Central of Brazil on the tissue using CF1 Swiss mice, male, (18-20kg) as experimental model. In the first part of the experiment, the LD50 of T. fasciolatus was determined by sub-cutaneous and evaluated the anatomo-pathological changes of the animals who died . In a second part, we studied the effects of 24ìg of venom of T. fasciolatus in the blood biochemistry, 1h, 8h and 24h after inoculation of the venom. The LD50 of the venom of T. fasciolatus for mice was 59.65 µg. The macroscopic findings were found with areas of pulmonary haemorrhage (petechiae and ecchymosis), diffusely distributed on the surface of the lungs. The hearts had a clearer field of colour in the wedge at the apex, suggesting infarcted area. Microscopy was observed in interstitial haemorrhage and presence of leukocytes in the alveolar walls, light to moderate congestion of the blood vessels of the epicardium, myocardium and endocardium and discrete hystiocitary lymphohistiocytic inflammatory infiltrate in the myocardium and endocardium. The second part of the animals inoculated with 24ìg of venom of T. fasciolatus showed no significant changes in the levels of creatine kinase (CK), CK-MB isoenzyme, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), amylase and glucose. It was concluded that the venom of T. fasciolatus has a lower toxicity when compared with the venom of T. serrulatus and the dose of 24ìg did not alter the blood biochemical profile in mice.

Morel-Lavallee lesion. Results of surgical drainage with the use of synthetic glue

To evaluate the results of surgical drainage and use of synthetic glue in Morel-Lavallee lesions. We treated 7 Morel-Lavallee lesions in Ankara Bayindir Hospital, Ankara, Turkey between April 2003 and June 2004. These lesions developed in 5 male patients due to crush under a vehicle or a traffic accident. The mean age was 32.8 years; range 16-55. All lesions were localized in thigh. One patient had surgery due to acetabulum fracture and one had an urological operation for urethral rupture. All patients were operated 6-48 hours after the injury. After surgical drainage, soft tissues were attached with the use of synthetic glue and compressive bandage was applied. We defined healing as the loss of fluctuation and elicitation of the normal mobility of the injured skin on manual examination. The mean follow-up was 11.6 months [range 8-20 months]. One patient was operated for acetabulum fracture and had a bilateral Morel-Lavallee lesion 2 days after the operation. This patient was reoperated for drainage. All lesions were healed with a mean of 5 weeks [range 3-8 weeks]. No infection, necrosis or recurrences were detected during the follow-up. Results of the treatment with the use of synthetic glue and surgical drainage in Morel-Lavallee lesion are satisfactory with early healing time without recurrence