The History of Plastic Surgery in Israel.

Today, plastic surgery is a well-known profession with highly respected surgeons from institutions all over the world. Over the last several decades numerous clinical and technological advances have been made, thanks to the dedication and hard work of these outstanding professionals; however, things were not always this way. At the turn of the 20 th century, Israel had yet to be introduced to the field of plastic surgery. However, this all changed with the War of Independence. Humanitarian aid by the prominent South African surgeon, Jack Penn, laid the foundation for the founding fathers of plastic surgery in Israel to establish a strong legacy of producing world-renowned surgeons and innovators. Through this paper, we hope to provide a brief overview of the history of plastic surgery in Israel and what transpired to give us the state of surgical practice we have today.

[REVIEW OF COMMON PATHOGENS IN THE BONE AND BLOOD CULTURES AND ANTIBIOTIC TREATMENT IN PATIENTS WITH STERNAL OSTEOMYELITIS].

AIMS: This study concentrates on microbiological data collection of deep sternal wounds to delineate early and correct antibiotic therapy. BACKGROUND: Deep sternal wound infection, mediastinitis and sternal osteomyelitis are devastating and life-threatening complications of median-sternotomy incisions after cardiac surgical procedures. The incidence of surgical wound infection in sternotomies should be similar to that in any clean surgical procedure (i.e. approximately 2%). Nonetheless, the infection rates are higher among heart disease patients, due to the fact that these patients are burdened with a high number of risk factors in comparison with the general population. RESULTS: In line with other publications, the most commonly cultured organism from deep sternal wound and blood cultures was found to be Staphylococcus. In comparison, the most commonly cultured Gram-negative organisms were Pseudomonas and all gram-negative organisms combined together represented approximately 50% of all cultures. Three dominant organisms were isolated from wound and blood cultures: Staphylococcus, Pseudomonas and Acinetobacter. We found that 40% of blood cultures were identical to prior wound cultures, in comparison to 30% of bone cultures. Furthermore, 20% of the organisms isolated from the wound and 13% of the organisms isolated from the bone later on cross over to involve the blood. CONCLUSIONS: Empiric antibiotic regimen should be broad spectrum and cover both gram-positive as well as gramnegative organisms. We demonstrate that antibiotic regimen during sepsis may rely partially on preliminary wound cultures. Furthermore, antibiotic treatment for a relatively short period of two weeks is adequate, alongside thorough surgical revision with debridement of all foreign bodies, and reconstruction with vascularized soft tissue flap (pectoral major).

Monoclonal origin of anatomically distinct basal cell carcinomas.

Basal cell carcinoma (BCC) is the most common skin tumor in Caucasians. Loss of heterozygosity (LOH) of chromosome 9 (9q22.3) is common in BCCs, and indirectly implies their monoclonal origin. Although BCCs are considered monoclonal tumors, the clonal origin of anatomically distinct tumors in the same patient was rarely investigated. Forty-one anatomically distinct BCCs from 15 female patients were genotyped for LOH at chromosome 9q22.3, and the inactivation pattern of X-chromosome using the androgen receptor polymorphic site. Overall, 11 women with 30 tumors were heterozygous (informative) with either one of the two 9q markers or the androgen receptor polymorphism. LOH of 9q was detected in 20 tumors from seven patients, and in all tumors derived from the same patient, the same allele was lost. An identical X-chromosome inactivation pattern was noted in all four tumors taken from one patient, and in another informative patient, one tumor demonstrated LOH and the other retained it. In five tumors from two patients, there was no evidence of monoclonality using either technique. We conclude that the majority of anatomically distinct BCCs are monoclonal neoplasms and may represent expansion of the same clone.