Hydroxyzine, cimetidine and vitamin C in reducing skin flap necrosis in ischemia-reperfusion injury in rats. A comparative study.

PURPOSE: The purpose of the current experimental research was to investigate whether hydroxyzine can reduce the necrotic area in ischemia-reperfusion injury in epigastric rat skin flaps and to compare its role with cimetidine and vitamin C. METHODS: From a total of 77 ischemic rat skin flaps, 18 were treated with normal saline, 18 with vitamin C, 18 with cimetidine and 18 with hydroxyzine before reperfusion. Flap necrotic area, neutrophils and mast cells were measured on the 7th day. Analysis of variance for multiple comparisons and post hoc Dunnett's test were used for statistical analyses. RESULTS: The sham group of animals (n=5) showed 0% flap necrosis. The saline-treated group demonstrated 75±15.3% of necrosis. The vitamin C, cimetidine and hydroxyzine groups had 56.2 ± 24.4%, 25.8 ± 19.3%, and 33.6 ± 27.8% of flap necrosis, respectively. In addition, the number of neutrophils and mast cells were decreased in the pharmacologically treated groups compared with flaps perfused with normal saline (p<0.05). CONCLUSION: Our data suggest that administering hydroxyzine in rat epigastric skin flaps before reperfusion may attenuate necrosis, neutrophils and mast cell counts. The beneficial effect of cimetidine was the same as hydroxyzine's but the use of vitamin C was less effective.

Endometriosis mimicking soft tissue tumors: diagnosis and treatment.

The clinical manifestations, the radiologic appearance and the treatment of four women with extragenital endometriosis of the abdominal wall are presented. In two patients endometriosis was found adherent with the structures of the inguinal canal and in the other two the tumors infiltrated structures of the abdominal wall. Symptoms included cyclical pain and palpable subcutaneous masses fixed to the surrounding tissues. Computed tomography and magnetic resonance imaging failed to differentiate the lesions from other soft tissue tumors. Resection to healthy tissue margins is the treatment of choice, in order to avoid local recurrence.

Malignant schwannoma of the stomach in a patient with neurofibromatosis.

Malignant schwannoma of the stomach is a rare neurogenic tumor. We report a case in a man with neurofibromatosis, who developed liver metastasis 1 year after excision of the tumor and died a few months later despite aggressive chemotherapy.