µMAPPS: a novel phasor approach to second harmonic analysis for in vitro-in vivo investigation of collagen microstructure.

Second Harmonic Generation (SHG) is a label-free imaging method used to monitor collagen organization in tissues. Due to its sensitivity to the incident polarization, it provides microstructural information otherwise unreachable by other intensity based imaging methods. We develop and test a Microscopic Multiparametric Analysis by Phasor projection of Polarization-dependent SHG (µMAPPS) that maps the features of the collagen architecture in tissues at the micrometer scale. µMAPPS retrieves pixel-by-pixel the collagen fibrils anisotropy and orientation by operating directly on two coupled phasor spaces, avoiding direct fitting of the polarization dependent SHG signal. We apply µMAPPS to fixed tissue sections and to the study of the collagen microscopic organization in tumors ex-vivo and in-vivo. We develop a clustering algorithm to automatically group pixels with similar microstructural features. µMAPPS can perform fast analyses of tissues and opens to future applications for in-situ diagnosis of pathologies and diseases that could assist histo-pathological evaluation.

Temporal myofascial flap in reconstructive surgery of the oral cavity.

AIM: The temporal myofascial flap is a simple, rapid and reliable surgical method for immediate reconstruction of facial defects: indications in the light of modern anatomical knowledge and personal experience, with the accent on achieving an appropriate access route without damaging the facial nerve. METHODS: Our series covers the period from January 1999 to December 2004, during which time myofascial flaps of temporal muscle were used for immediate reconstruction in 20 surgical oncological cases involving the face and neck. RESULTS: Postoperative progress was regular; no lesions of the facial nerve were observed, nor any cases of flap necrosis, including partial. Epithelialisation could already be observed as early as 15 days postsurgery without skin grafting being employed. CONCLUSIONS: Application of a Medpor prosthesis eliminates the only negative outcome from the aesthetic standpoint, related to harvesting the muscle from the fossa.

Treatment of lower lip cancer: an experience of 48 cases.

The article reports results obtained in 48 cases of lower lip cancer. Tumor classified as T1 or T2, requiring a resection up to 60% of the lower lip, were treated with the stair-case technique. Nine patients were treated with the bilateral symmetrical stair-case technique since their lesions were located medially, while 23 were treated with the bilateral method using two asymmetrical flaps because their lesions were in paramedian position but larger than 2 cm. Ten patients required a unilateral flap. The cases classified as T3, in which the lesion required resection of more than 60% of the lip, were treated with the Bernard-Freeman-Fries technique.

[Synovial chondromatosis of the temporomandibular joint]. / Condromatosi sinoviale dell'articolazione temporo-mandibolare.

Synovial chondromatosis is an uncommon monoarticular proliferative disease of the synovium characterized by loose bodies developed in the synovial membrane. The literature is reviewed and two cases of synovial chondromatosis of the temporomandibular joint characterized by swelling, pain and limitation of mandibular movement are reported. Radiographic evidence of loose bodies may or may not be present. Computed tomography (CT) or magnetic resonance (MR) might be helpful in the diagnosis of synovial chondromatosis. The treatment of choice of synovial chondromatosis is surgical and the loose bodies should be removed by arthrotomy with examination of the joint cavity. In our patients, no recurrence had occurred according to other authors' experience.

Radical retropubic prostatectomy: limited benefit of autologous blood donation.

PURPOSE: We determine whether autologous blood donation significantly decreases the need for homologous transfusions after radical prostatectomy. MATERIALS AND METHODS: The effects of estimated blood loss and autologous donation on the rate of homologous transfusions were analyzed in 3 groups of 100 consecutive patients treated between 1983 and 1992. RESULTS: Overall, donors were less likely than nondonors to receive homologous blood. As median estimated blood loss decreased from 1,200 to 800 cc from groups 1 to 3 (p < 0.05), the incidence of nondonors requiring homologous blood decreased from 62 to 11% and that of autologous units transfused decreased from 96 to 19%. CONCLUSIONS: With decreasing blood loss, safe but stringent criteria for transfusion and improved safety of the blood supply, autologous donation is an inefficient method to lower the slight risk of complications following homologous transfusion during radical prostatectomy.

A cdc2-like kinase phosphorylates histone H1 in the amitotic macronucleus of Tetrahymena.

Genetic and biochemical studies have shown that cdc2 protein kinase plays a pivotal role in a highly conserved mechanism controlling the entry of cells into mitosis. It is generally believed that one function of cdc2 kinase is to phosphorylate histone H1 which in turn promotes mitotic chromosome condensation. However, direct evidence linking H1 phosphorylation to mitotic chromatin condensation is limited and the exact cellular function(s) of H1 phosphorylation remains unclear. In this study, we show that mammalian cdc2 kinase phosphorylates H1 from the amitotic macronucleus of Tetrahymena with remarkable fidelity. Furthermore, we demonstrate that macronuclei from Tetrahymena contain a growth-associated H1 kinase activity which closely resembles cdc2 kinase from other eukaryotes. Using polyclonal antibodies raised against yeast p34cdc2, we have detected a 36 kd immunoactive polypeptide in macronuclei which binds to Suc1 (p13)-coated beads and closely follows H1 kinase activity. Since macronuclei divide without mitotic chromosome condensation, these data demonstrate that H1 phosphorylation by cdc2 kinase may be necessary, but is not sufficient to promote mitotic chromatin condensation. The fact that an activity which strongly resembles mammalian cdc2 kinase is active during cell growth in a nucleus which does not undergo mitosis and chromosome condensation suggests that other factors are needed for a true mitotic division to occur. These data also reinforce the notion that H1 phosphorylation has important functions outside mitosis both in Tetrahymena and in mammalian cells.

The pectoralis major myocutaneous flap. Experience in 100 consecutive cases.

The authors have made a study of 100 consecutive cases in whom a pectoralis major myocutaneous flap was employed for reconstruction after surgical ablation of advanced malignant tumours in the head and neck. The results obtained show that primary healing took place in 74% of cases with a relatively low incidence of complications. The authors therefore confirm the reliability of the pectoralis major myocutaneous flap, which, owing to its rich blood supply, offers the possibility of providing large cutaneous islands, and its proximity to the site of ablation provides a simple and reliable method which may be used in the majority of cases of immediate or delayed reconstruction of the cervico-maxillo-facial area.

[Osteomas of the paranasal sinuses: review of the literature and personal cases]. / Gli osteomi dei seni paranasali: revisione della letteratura e casistica personale.

The sinusal osteomas: a review of literature and personal cases. The osteoma is a osteogenetic benign tumour formed by a fully developed bone, characterized by a slow growth, which, as far as the maxillo-facial region is concerned, shows to be frequently located in the paranasal sinuses. The osteoma originates from one of the sinus walls and spreads into the sinus cavity itself producing symptoms related to a lesion space occupying. In the present report, taking into consideration 4 personal cases, some literature datas are examined concerning the epidemiology, clinical behaviour and especially the therapeutic implications to be adopted by the surgeon in the presence of sinusal osteoma.

Total glossectomy without laryngectomy.

When cancer of the tongue reaches a large size (T3, T4) it is almost impossible to treat it successfully with radiotherapy. The only therapeutic possibility in such cases is, therefore, total glossectomy. This may be effected without laryngectomy and with immediate reconstruction using musculo-cutaneous flaps. Such an operation allows total removal of the tumour and is followed by an acceptable though impaired functional result. Eight cases subjected to total glossectomy without laryngectomy are presented and aspects of ablative and reconstructive surgery are discussed. A report is made of postoperative complications and of functional rehabilitation: mastication is certainly impaired. However, swallowing is regained rapidly and phonation, although altered, is still comprehensible. An acceptable quality of life and good possibilities for a return to a working life result.

Temporary intranasal prosthesis for a surgical defect of septum and columella.

A temporary intranasal prosthesis for the treatment of a surgical defect of the septum and columella after resection for a neoplasm has been described. The prosthesis is applied as soon as possible after surgery, which will limit complications during healing. Silicone elastomer is used because its softness does not produce decubitus ulcer, and it will accurately fit the surgical defect. The prosthesis can be relined easily during the postoperative period.

[Malignant centro-facial granuloma. Clinical contribution]. / Granuloma maligno centro-facciale. Contributo clinico.

The mid-face malignant granuloma represents an exceptionally rare disease. Its etiology is unknown and the prognosis is dismal. Characteristics pathological features are represented by granulomatous, ulcerative and lesions, with a destroying tendency. The AA., in reporting a recently observed case of the disease, stress the difficulties encountered in the diagnosis and analyze its clinical course typically showing relapsing episodes. Therapeutic strategies adopted in the various phases of the disease are discussed.

[Limitations in opening the mouth after temporal craniotomy. Observations on 3 clinical cases]. / Limitazioni dell'apertura della bocca dopo interventi di craniotomia temporale. Considerazioni su 3 casi clinici.

The authors describe 3 cases of mouth-opening limitations and dyskinesia of the remaining mandibular movements, of different degrees of severity, arisen following a cicatricial retraction of the temporal muscle, caused by neurosurgical accesses to the underlying encephalic regions. Having kept in mind the afflictions that could cause an analogous symptomatology, the authors stop to consider which is the most suitable kind of treatment (surgical or rehabilitative) in these specific cases. For both kinds of treatment, corresponding to the specific indications, they propose techniques confirmed by their personal experiences.

[Benign neoplasms of the soft tissues of the oral cavity]. / Le neoformazioni benigne dei tessuti molli del cavo orale.

The Authors, starting from a statistical study of Gennari et al., point out the frequency of the benign neoformations in the soft tissue of the oral cavity. They describe then the most frequently findable histological forms and the problems posed to the clinic and the surgeon by some histological forms such as the mixed tumours of the minor salivary glands and the fibropapillomatosis of the vestibular fornices. The Authors conclude stating that they not always are harmless neoformations and easily surgically excisable.

[Comparative study of pre and post-operative dynamic respiratory indices in subjects undergoing total laryngectomy]. / Studio comparativo degli indici respiratori dinamici pre e post-operatori in soggetti sottoposti a laringectomia totale.

A spirometric measurement was carried out on patients with cancer of the laryn before and after surgery for total laryngectomy at the Istituto Policattedra of the University of Parma ENT Clinic. Postoperative spirometry was performed by means of a Vitalograph apparatus with the mouthpiece positioned right over the tracheal opening. The parameters considered were the dynamic respiratory indices (CV/MEVS - MEVS/CV). Forty patients was mostly based on the fact that, prior to laringectomy, all of them had been subjected to a spirometric measurement for aneasthesiologic purposes. According to the results obtained, the patients can be divided into three groups. The first group consists of 10 subjects in whom no improvement was observed in their MEVS value, which in some instances had actually worsened. The second group is composed of 20 patients in whom the spirometric values remained more or less steady. The third group comprises 20 patients who showed a marked improvement of their respiratory indices. In some of the latter patients the values obtained were even better than those in the normal range. However, the overall average results are not statistically significant, except for an average 9% improvement of MEVS due, as expected, to a reduction of the dead space following total laryngectomy and a corresponding, though very slight, 4% improvement of the Tiffenau ratio.

[Biologic bases of musculo-cutaneous flaps most frequently used in cervico-maxillo-facial surgery]. / Basi biologiche dei lembi muscolo-cutanei di più frequente impiego in chirurgia cervico-maxillo-facciale.

An anatomical investigation on the vascular supply to "Pectoralis major", "Trapezius lateralis" and "Latissimus dorsi" muscolo-cutaneous flaps is presented. The AA. call particular attention to the vascular supply of the cutis going beyond the muscular borders. In this way we can determine the maximal width of the flap it is possible to achieve, without previous autonomization and without trophic problems.

[Fistulae and congenital cysts of dorsum of the nose. Report of a case (author's transl)]. / Fistole e cisti congenite del dorso del naso. Contributo clinico. Caso personale.

The Authors, after a brief review of the literature concerning the congenital fistulae and cysts of the nasal dorsum with special regard to the etiology, pathology, diagnosis and therapy, report a personal case of such fistulae in a 15 year old male. They stress importanct, for an accurate diagnosis, of radiography and fistulography and reccomend, radical surgery.