RESUMO
The Fujimori gate flap has been known and used for reconstruction of defects resulting from oncologic surgery. In this case report, we describe how this flap was utilized in reconstructing the upper lip of a patient who experienced an electrical burn injury resulting in 70% tissue loss of the upper lip with exposed alveolar bone. A 22-year-old man presented to our institution with near total full-thickness burn over the upper lip, deep partial thickness burns over left upper lid, and superficial partial thickness burns over both malar areas, anterior chest, and both legs. He underwent full-thickness skin grafting of the left upper lid and upper cutaneous lip. After 3 weeks, a unilateral gate flap was performed. The flap was elevated with care to preserve the right angular artery and the Stensen's duct. The flap was rotated 90 degrees medially and was sutured to the contralateral orbicularis oris, gingivobuccal mucosa, and to the rest of the upper cutaneous lip. The patient was followed up at 6 months and 1 year postoperatively. The flap was able to restore oral competence and enabled the patient to speak and chew with no difficulty. Patients suffering from high-voltage electrical burns, especially involving the mouth, present a challenging case for surgeons for reconstruction. Here, the goals of the reconstruction are to restore oral competence and ability to articulate, and still provide good appearance. A feasible and aesthetically acceptable flap providing good functional outcome is provided by the use of the unilateral Fujimori gate flap among patients suffering from high-voltage electrical burns of the oral cavity.
RESUMO
BACKGROUND: Entamoeba histolytica is an important etiologic agent of diarrhea. Globally, it is estimated to infect 40 to 50 million people and cause 40,000 to 100,000 deaths per year. Metronidazole is effective but can cause adverse reactions in certain individuals. In search of alternatives, traditional medicinal plants are being studied. Several plants in Family Simaroubaceae have shown anti-amoebic activity. Quassia amara, a member of this family has not been tested.OBJECTIVE: To determine the effect of Q. amara crude extract on Entamoeba histolytica in vitro.METHODS: Initial testing of 104 µg/ml ethanolic bark extract was performed. Counts were made after 72 hours. Three trials in triplicates were performed.Nine (9) dilutions of extract were then tested (18.8 to 5,00 µg/ml). Test tubes were checked for viable amoeba after 24-hour and 72-hour incubation. Minimum inhibitory concentrations (MIC) were determined for the two incubation periods. At least two trials in triplicates for each dilution were performed. metronidazole served as positive control.RESULTS: At 104 µg/ml incubated for 72 hours, no viable amoeba was obtained and counted. The MIC after 24 hours was 5,000 µg/ml, while the MIC at 72 hours was 37.5 µg/ml.CONCLUSION: Q. amara crude extract has inhibitory effects on E. histolycain vitro.
