Upper eyelid angiolipoma associated friction in the glide zone.

A 74-year-old man was examined for a mass in the left upper eyelid. It was inconspicuous in inspection. There was no visual restriction, however a feeling of friction on the superior orbit during lid movement. Through eyelid crease lid incision, a solitary lesion appeared in the preaponeurotic space that orginated from the upper tarsal plate. Excisional biopsy revealed adipose proliferation with patch form vessels. This case represents the second reported angiolipoma of the eyelid in English literature.

Correction of congenital cleft earlobe with front and back flaps.

Congenital auricular deformities may be either deformational or malformational. Malformational anomalies present with a skin or cartilage shortage. Two cases with congenital cleft earlobe were presented. A new surgical technique using a two-layered repair with front and back flaps were introduced. She waited to begin wearing earrings until six months after the surgery to prevent possible scar contracture. The patients were followed up for a period ranging from 3 to 14 months. The earlobe volume deficiency was replaced, and acceptable scar maturation was obtained.

Simple Correction of the Congenital Cleft Earlobe.

The appearance of the ear is an important component of the facial characteristics. Lower auricular malformations are less frequent than total or upper auricular malformations. The patients are affected unilaterally in general. Cleft earlobe is frequently encountered among earlobe anomalies. The presented case may be classified as longitudinal type according to Kitayama (Jpn J Plast Reconstr Surg 11:663-670, 1980). Many of the correction methods may lead to patient discomfort due to possible conspicuous scar. The patient was a 5 year old girl. In the presented case, a simple method has been performed. Satisfactory outcome is achieved. As a simple method applying longitudinal division and rotation procedure does not have marginal excision. Furthermore there is no additional incision outside the cleft margin. Local flap and graft are not applied. Conservative approach was maintained with respect to scar occurrence. This method is not favourable in the case of acquired split earlobe deformities due to the wide cleft surface. Postoperative 3rd-month appearance demonstrated adequate correction.

Hemostatic efficacy of a traditional medicinal plant extract (Ankaferd Blood Stopper) in bleeding control.

The aim of this study is to assess the in vivo hemostatic effect of Ankaferd Blood Stopper (ABS) on rats using a tail bleeding model. Wistar rats were randomized into 4 groups of 9 each: group 1, control, no pretreatment, irrigated with saline; group 2, no pretreatment, irrigated with ABS; group 3, control, heparin pretreatment, irrigated with saline; and group 4, heparin pretreatment, irrigated with ABS. To control bleeding, compressive dressings were placed after instilling 1 mL of either ABS or saline to the bleeding area. Without heparin pretreatment, ABS shortened hemostasis time by 1.57 minutes and reduced the amount of bleeding by 0.85 g. With heparin pretreatment, ABS shortened hemostasis time by 3.29 minutes and reduced the amount of bleeding by 1.32 g. The ABS was more effective than saline irrigation for treating tail tip bleeding in rats, with or without heparin pretreatment, while also using a compressive dressing.

Treatment of large xanthelasma palpebrarums with full-thickness skin grafts obtained by blepharoplasty.

PURPOSE: The treatment of large xanthelasma palpebrarum cases in patients whose lesions could not be closed primarily is reported. All lesions were repaired with full-thickness skin grafts obtained by blepharoplasty of the same upper eyelid. Patient satisfaction, complications, and recurrence rates were investigated. METHODS: Sixteen patients were treated between 2007 and 2012. Bilateral upper eyelids were involved in all patients. Twenty-six large xanthelasma palpebrarum lesions were treated using this method. All lesions were located in the medial canthus of the upper eyelid. RESULTS: The patients were followed up for 6 months to 5 years (mean 3 years). No patients developed complications or required revision surgery. All patients had normally positioned upper eyelids and were satisfied with the aesthetic outcome. Two patients had mild hyperpigmentation at the graft site. CONCLUSIONS: The results of this study suggest that large xanthelasma palpebrarum defects that are not primarily closed after excision should be repaired with full-thickness skin grafts harvested from the lateral aspect of the same upper eyelid. Moreover, good patient satisfaction can be achieved when blepharoplasty of the upper eyelid is performed concurrently in patients who are middle-aged or older.

Intraareolar polythelia: a rare anomaly.

Polythelia, the presence of supernumerary nipples or nipple-areola complexes, is the most common anomaly of the pediatric breast. Although polythelia is common, intraareolar polythelia (nipple dichotomy) is an extremely rare congenital malformation. Surgical treatment is performed as a prophylaxis against breast cancer which has a higher prevalence in polythelia or polymastia. We describe a case of a young woman with polythelia in the right breast. The patient was a 25-year-old young woman who had two nipples by birth on the areola of the right breast. An abdominal ultrasound examination showed no urorenal malformations. Surgery was performed with elliptical excision under local anesthesia. A management of such cases with polythelia or polymastia was discussed in the view of recent literature.

Hemostatic efficacy of folkloric medicinal plant extract in a rat skin bleeding model.

OBJECTIVE: To assess the in vivo hemostatic effect of a folkloric medicinal plant extract. SUBJECTS AND METHODS: Wistar rats were randomized into four groups of seven. Group 1, a control group, received no pretreatment and was irrigated with saline. Group 2 received no pretreatment and was irrigated with the plant extract. Group 3, a control group, received pretreatment with heparin and was irrigated with saline. Group 4 received pretreatment with heparin and was irrigated with the plant extract. A standardized skin-bleeding model was created using full-thickness skin defects on the Wistar rats' dorsal skin. To control bleeding, compressive dressings were placed after inserting 1 mL of the plant extract or saline into the bleeding area. Hemostasis time and amount of nasal bleeding were measured in all groups to compare the treatments without and with the plant extract. RESULTS: Without heparin pretreatment, the folkloric medicinal plant extract shortened the hemostasis time by 1.29 minute and reduced the amount of bleeding by 0.63 g. With heparin pretreatment, the plant extract shortened the hemostasis time by 2.29 minutes and reduced the amount of bleeding by 0.70 g. CONCLUSION: The medicinal plant extract irrigation was more effective than saline irrigation for treating hemorrhagic skin defects in animals using a compressive dressing with or without heparin pretreatment.

Primary hydatid cyst: an unusual cause of a mass in the supraclavicular region of the neck.

UNLABELLED: Hydatid disease, also known as echinococcosis or hydatidosis, is an infectious disease caused by the cestode Echinococcus. Echinococcus granulosus is the most common Echinococcus species affecting human beings. It may affect any organ and tissue in the body, in particular the liver and lung. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% 5% of all echinococcal infections in endemic areas, and is almost always secondary to the hepatic or pulmonary disease. Even in regions where echinococcosis is endemic, hydatidosis of cervicofacial region is extremely rare. Herein, we present exceptionally rare case with an unusual localization of primary hydatid cyst in the left supraclavicular region of the neck. KEYWORDS: Hydatid cyst; Supraclavicular region; Neck; Unusual localization.

Use of expanded reverse sural artery flap in lower extremity reconstruction.

Coverage of defects of the distal third portion of the leg and foot remains a challenge for surgeons. The difficulty results from the limited mobility and availability of the overlying skin, the weight-bearing requirements, and the relatively poor circulation of the skin. From January 2008 to December 2009, 10 patients had defects of the foot and ankle covered using the 2-stage expanded reverse sural flap. Of these 10 patients, 6 had at least 1 risk factor for compromised wound healing, such as diabetes mellitus, peripheral arterial disease, venous insufficiency, tobacco smoking, or age older than 40 years. Flap necrosis was observed in only 1 patient (10%). Venous congestion was noted in 2 patients (20%) by the third postoperative day, 1 of whom responded to postural elevation of the extremity and 1 to medicinal leech therapy. Although it is a 2-stage procedure that requires wound dressing during the expansion, we strongly suggest the use of the expanded reverse sural flap for defects too large to be primarily closed, especially in patients older than 40 years with risk factors such as diabetes mellitus, peripheral arterial disease, or venous insufficiency.

The efficacy of Ankaferd Blood Stopper in heparin-induced hemostatic abnormality in a rat epistaxis model.

OBJECTIVE: To assess the in vivo hemostatic effect of Ankaferd Blood Stopper (ABS). STUDY DESIGN: An experimental study of an animal anterior epistaxis model. SETTING: A tertiary care university hospital. SUBJECTS AND METHODS: Wistar rats were randomized into 4 groups of 7 each: group 1, control, no pretreatment, irrigated with saline; group 2, no pretreatment, irrigated with ABS; group 3, control, heparin pretreatment, irrigated with saline; and group 4, heparin pretreatment, irrigated with ABS. In all groups, a standardized rat epistaxis model was obtained by cutting the anterior nasal septal mucosa. To control bleeding, compressive dressings were placed after instilling 1 mL of either ABS or saline to the bleeding area. The hemostasis time and amount of nasal bleeding were measured in all groups to compare the treatments without and with ABS. RESULTS: Without heparin pretreatment, ABS shortened the hemostasis time by 1.57 minutes (P = .003) and reduced the amount of the bleeding by 0.35 g (P = .006). With heparin pretreatment, ABS shortened the hemostasis time by 2.86 minutes and reduced the amount of the bleeding by 0.49 g (both P = .002). CONCLUSION: ABS irrigation was more effective than saline irrigation for treating anterior epistaxis hemostasis in animals using a compressive dressing with or without heparin pretreatment.

Nostril stenosis after undue power application of electric cauterization used in hypertrophy of inferior turbinate.

Nostril stenosis is an uncommon deformity with a variable aetiology. It may be either congenital or acquired. The causes of the acquired form includes trauma, infection and iatrogenic injury to the vestibular skin. Previous surgery including septoplasty and rhinoplasty, overzealous use of chemicals, laser, electrocauterization and traumatic placement of nasal packing to control epistaxis contribute significantly to the development of vestibular stenosis. Electrocauterization for inferior concha hypertrophy is a simple procedure and is frequently used in otolaryngeology-head and neck surgery. If enough attention is not paid during the operation, it may cause severe nasal obstruction and an aesthetic deformity which cannot be repaired easily. Various techniques have been described for repair of this stenotic segment but correction is difficult due to tendency of wound-contracture and recurrence. We present a case of a 58-year-old male patient complaining of nasal obstruction and an aesthetic deformity who had sought treatment for stenosis of the left nostril of 6 months duration. Previously, the patient had undergone septoplasty and electrocauterization for inferior turbinate hypertrophy.

Reconstruction of the defects in the middle of the nose with subcutaneous pedicled nasolabial island flap: report of two cases.

Two cases with basal cell carcinomas on the middle of the nose were treated by using subcutaneous pedicled nasolabial island flap. There were no partial or total flap losses in either case and neither of the cases had local recurrence during the follow-up period. The subcutaneous pedicled nasolabial flap should be considered to be an alternative to the paramedian forehead flap for the reconstruction of defects on the middle of the nose. In this article two cases in whom subcutaneous pedicled nasolabial island flap method was applied for the reconstruction of middle defects of the nose are presented in the light of the literature.

Lymphangiectasia of the vulva accompanying congenital lymphedema.

Lymphangiectasia is a benign condition with multiple dilated lymph vessels in the dermis. Vulvar localization is rare and mostly depends on disturbing the lymphatic flow. We present a patient with vulvar lesions and ipsilateral congenital lower extremity lymphedema. Surgical excision eliminated the lymphangiectasia and improved the appearance of the edematous vulva.

Giant rhinophyma in a bronchial asthma patient treated by excision and full thickness skin grafting.

A 72-year-old man presented with an unusually severe case of rhinophyma. The pedunculated mass was widely excised and a skin graft from the medial upper arm was applied. A very satisfactory cosmetic result was obtained.

[The management of snake envenomation: evaluation of twenty-one snake bite cases]. / Yilan zehirlenmelerinin tedavisi: yirmi bir olgunun incelenmesi.

BACKGROUND: Snake envenomation, its treatment and outcomes are presented in this study. METHODS: Twenty-one snake bite cases (10 males, 11 females; mean age 36.4; range 10 to 70 years) were followed up at our clinic during the summers of 2004 and 2005. Four of these patients were "dry bite". The remaining 17 cases were envenomated. RESULTS: Local and hematological disorders were detected in envenomated cases. Local skin necrosis developed in a case. Thrombocytopenia was seen in five of the cases. Seven units of whole blood were transfused in three patients. When the Zagreb antiserum which was produced against European snakes was used, better results achieved. The serum which was imported from Egypt was given to the patient in case of lacking of Zagreb serum was lacking. Clinical conditions were improved later with the "Egypt serum" although higher doses had been administered. CONCLUSION: Hematological disorders and local wound problems were more prominent with poisonous snake bite cases in our region. We conclude that these problems can be prevented by using antiserum treatment as early as possible.