ABSTRACT
BACKGROUND: Necrosis of random pattern flaps caused by inadequate blood flow, especially in the distal part of the flap is one of the biggest challenges in reconstructive surgery. Various agents have been used to prevent flap ischemia. In this study, we used omeprazole, which is a potent inhibitor of gastric acidity to increase flap viability. METHODS: In this study, 35 Wistar-Albino type rats which were divided into 5 equal groups were used. Random-pattern dorsal skin flaps were raised in all groups at seventh day of the study. Group 1 was accepted as control group, and the rats in this group was only given distilled water intraperitoneally for 14 days. Group 2 and group 3 received 10 and 40 mg/kg omeprazole daily for 14 days, respectively. Group 4 and group 5 were given distilled water for the first 7 days and then after the operations they received 10 and 40 mg/kg omeprazole daily for 7 days, respectively. Survival rates of the flaps were examined seventh day after elevation of the flaps by digital imaging and scintigraphy. After assessment of the amount of necrosis, number of vascular structures were counted histopathologically. RESULTS: Percentage of flap necrosis was found to be less in all omeprazole received groups. On digital imaging, percentages of flap necrosis in the study groups were statistically significantly lower than that of the control group (P < 0.001), but there was no significant difference between the study groups (P > 0.05).In the histopathologic specimens, it was detected that the mean number of vessels in proximal (a) and distal (c) portions of the flap in the study groups showed a significant increase when compared with the control group (P < 0.01 for groups 2, 4 and 5, and P < 0.05 for group 3). CONCLUSIONS: In conclusion, possible clinical usage of medications increasing gastrin during flap surgeries can be thought as a positive contributor. In this sense, this study showed that parenteral administration of omeprazole in skin flap surgery increases flap viability possibly by increasing gastrin levels.
Subject(s)
Graft Survival/drug effects , Omeprazole/pharmacology , Surgical Flaps/blood supply , Animals , Female , Image Interpretation, Computer-Assisted , Necrosis/diagnostic imaging , Necrosis/prevention & control , Omeprazole/administration & dosage , Postoperative Complications/diagnostic imaging , Postoperative Complications/prevention & control , Rats , Rats, Wistar , Skin TransplantationABSTRACT
Neurofibromatosis or von Recklinghausen's disease is the most common inherited syndrome predisposing to neoplasia. Carcinosarcoma is a rare malignant mixed tumor of the lung. Association of carcinosarcoma of lung with Neurofibromatosis-1 is not common. A 57-year-old man presented with history of fever, cough, hemoptysis, breathlessness, weight loss, chest pain. Multiple cutaneous neurofibromas and café au lait spots were revealed by physical examination. A homogeneous opacity was found in the right middle and right upper zone on posterior-anterior chest radiography. A 8x8x7 cm mass that had irregular borders in right upper posterior and apical segment was seen on contrast enhanced chest computed tomography. On bronchoscopy, the lumen of right upper apical segment was obstructed with vegetating tumoral lesion. The biopsy taken from this region was diagnosed as carcinosarcoma by histopathological and immunohistochemical examination.A rare case with carcinosarcoma of the lung and Neurofibromatosis-1 was reported.
Subject(s)
Carcinosarcoma/pathology , Lung Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Neurofibromatosis 1/pathology , Humans , Male , Middle AgedABSTRACT
Angioleiomyoma (vascular leiomyoma or angiomyoma) is a rare, benign smooth muscle tumor that originates in the tunica media of blood vessels. These tumors may be found anywhere in the body. They usually occur in the lower extremity. Auricular angioleiomyoma is very rare, and only a few cases have been reported. We describe here a 38-year-old male patient with angioleiomyoma on the left auricular helix.
Subject(s)
Angiomyoma/pathology , Ear Neoplasms/pathology , Adult , Angiomyoma/surgery , Biopsy , Ear Neoplasms/surgery , Humans , Immunohistochemistry , MaleABSTRACT
Polymastia is a term that is used to describe the presence of more than two breasts in human beings. It is synonymous with supernumerary or accessory breast tissue. In the ectopic breast tissue any disease can develop that affects the normal breast, including fibroadenoma. We reported a case of fibroadenoma of the axilla in a 23-year-old woman. Differential diagnosis of an axillary mass should also include fibroadenoma in an ectopic breast tissue.
