Surgical Management of Chronic Morel-Lavallée Lesion with Minimal Cosmetic Scarring: A Case Report.

Introduction: Morel-Lavallée lesion (MLL) is a closed degloving injury that occurs after traumatic damage to soft tissue, leading to the formation of an encapsulated serosanguinous collection of fluid. Although some MLLs resolve spontaneously, chronic MLLs present with a significant risk of infection and may impede patients' quality of life. Chronic lesions require surgical intervention to evacuate and debride the hematoma, often resulting in severe cosmetic damage postoperatively. Case Report: We documented a large 19.4 cm × 4.2 cm × 15.10 cm MLL on the right lateral hip that presented a significant impediment to the patient's daily functions. After the failure of conservative management, the patient was treated surgically through a minimal incision debridement procedure, utilizing a wound drain and vacuum-assisted compressional dressing upon closure. Excellent 1-year post-operative outcomes were achieved with no recurrence of the lesion and limited cosmetic evidence of the MLL. Conclusion: This case highlights the value of a limited incisional debridement procedure for the management of a chronic Morel-Lavellée lesion. When using this technique, surgeons can effectively treat these lesions with promising short-term outcomes and minimal wound scarring.

Left Ventricular Twist and Untwist in Patients Undergoing Elective Percutaneous Coronary Intervention.

BACKGROUND: Left ventricular (LV) twist and untwist plays important roles in physiological adaptation and development of clinically relevant cardiac diseases. AIMS: To assess LV twist and untwist in patients undergoing elective percutaneous coronary intervention (PCI) by two-dimensional (2D) speckle tracking echocardiography (STE). SUBJECTS AND METHODS: Fifty patients who had stable angina pectoris and/or abnormal result from noninvasive stress tests were enrolled after undergoing elective PCI. Conventional and 2D STE were performed before elective PCI and after 3 months. RESULTS: There was no significant systolic improvement in conventional echocardiography. However, there was a significant diastolic improvement after elective PCI as higher E, E/A, e` and lower E/e` (P < 0.034, <0.042, 0.015, and 0.033, respectively). In addition, there was a statistically significant improvement of STE-derived systolic parameters as regard higher global longitudinal strain, peak twist, and torsion (P value 0.009, 0.009, and < 0.001, respectively). Furthermore, there was significant improvement of STE-derived diastolic parameters as higher peak untwist, recoil, and lower time to peak untwist (P value 0.013, 0.001, and 0.004, respectively). CONCLUSIONS: LV and untwist parameters were improved before most of conventional echocardiographic parameters in postrevascularization of stable coronary artery disease.

Hematological effect of benzene exposure with emphasis of muconic acid as a biomarker.

Human exposure to benzene in work environment is a global occupational health problem. It is established that benzene requires to be metabolized to induce its effects. Benzene has been associated with various hematotoxins and carcinogens. The aim of this study was to investigate the effect of benzene on complete blood picture, with emphasis of trans, trans-muconic acid (t,t-MA) as a biomarker of benzene in urine, considering the influence of cigarette smoke. A total of 81 workers (61 males and 20 females) have been occupationally exposed to benzene. In addition, 83 workers (55males and 28 females) were also recruited as a control group. Complete blood picture was analyzed and urinary t,t-MA was determined by liquid chromatography. In addition, creatinine in the urine samples was determined. Levels of blood elements (white blood cells, red blood cells and platelets) were decreased among exposed workers compared with the controls. The urinary level of t,t-MA/creatinine of the exposed workers was elevated especially in the smoking group compared to the controls. This study recommends that complete blood picture and t,t-MA are helpful biomarker tests that should be done to detect the early effects of benzene exposure.

Genotoxic effect of occupational exposure to cadmium.

Many studies proved the genotoxic effect of cadmium (Cd) exposure and highlighted the importance of the cytogenetic studies as a sensitive and effective means for early detection of Cd-induced mutagenicity. The relationship between occupational exposure to Cd and increased risk of cancer, particularly lung cancer, has been explored in number of epidemiological studies. The aim of this study is to assess the role of chromosomal abnormalities and sister chromatid exchange as sensitive indicators for the genotoxicity of occupational exposure to Cd. Cytogenetic studies was done for 40 workers (27 smokers and 13 non-smokers) exposed to Cd dust and fumes with 40 control subjects (28 smokers and 12 non-smokers) not exposed to Cd before. Both exposed and control groups were similar in age and other sociodemographic factors. Clinical examination, laboratory investigation including urinary and blood Cd, cytogenic analysis for detection of chromosomal aberrations and sister chromatid exchange and environmental study of the work places were done. Statistical analysis of cytogenetic studies revealed the presence of significant elevation of chromosomal aberrations and sister chromatid exchanges of the exposed group. Urinary and blood Cd of the exposed group were significantly higher than that of the control group. These abnormalities were not significantly affected with age, duration of exposure, smoking habits, blood and urinary Cd. In conclusion, the study adds more proof that Cd exposure has a genotoxic effect and highlighted the importance of using cytogenetic studies as a sensitive and effective means for early detection of Cd-induced mutagenicity.