Localization of neuroglobin in the brain of R6/2 mouse model of Huntington's disease.

Neuroglobin (Ngb) is expressed in the central and peripheral nervous system, cerebrospinal fluid, retina, and endocrine tissues where it is involved in binding O2 and other gasotransmitters. Several studies have highlighted its endogenous neuroprotective function. Huntington's disease (HD), a dominant hereditary disease, is characterized by the gradual loss of neurons in discrete areas of the central nervous system. We analyzed the expression of Ngb in the brain tissue of a mouse model of HD, in order to define the role of Ngb with respect to individual cell type vulnerability in HD and to gender and age of mice. Our results showed different expressions of Ngb among neurons of a specific region and between different brain regions. We evidenced a decreased intensity of Ngb at 13 weeks of age, compared to 7 weeks of age. The double immunofluorescence and fluorescence resonance energy transfer (FRET) experiments showed that the co-localization between Ngb and huntingtin at the subcellular level was not close enough to account for a direct interaction. We also observed a different expression of Ngb in the striatum, depending on the sex and age of animals. These findings provide the first experimental evidence for an adaptive response of Ngb in HD, suggesting that Ngb may exert neuroprotective effects in HD beyond its role in reducing sensitivity to oxidative stress.

Expanded tubed flap in scalp reconstruction: a modern option in an old technique.

Reconstruction of extensive scalp defects represents a difficult problem for the plastic surgeon. In this case report, a successful result was obtained by stretching a dorsal tubed flap with an inflatable balloon placed between the tube and the underlying donor site. This modified tissue expansion has permitted us to transfer an adequate amount of tissue and resurface an extensive area hardly reached by other reparative methods.

The temporalis osteomuscular flap versus the free calvarial bone graft. An experimental study in the growing rabbit.

The authors have conducted an experimental study on the evolution of temporalis osteomuscular flaps compared with calvarial free bone grafts in young rabbits. The evaluation of the results has been performed with macroscopic, radiological and histological investigations in an early and late postoperative phase. This study has confirmed that the bone flaps remain viable and are characterized by a normal evolution. There is no evidence of anomaly of craniofacial growth nor asymmetry when compared with the contralateral side. On the other hand, the free bone grafts show the typical signs of necrosis and resorption. Some asymmetries are produced in comparison with the contralateral side, these being particularly evident in the two-months samples, while the overall craniofacial growth is not seriously impaired. This experimental study confirms the reliability of the temporalis osteomuscular flap in facial reconstruction.

Considerations on 100 cases of free microsurgical flaps in the reconstruction of the soft tissues of the lower limb.

The authors evaluate the results for 100 cases of severe loss of substance of the lower limb treated by microvascular free flaps at the Division of Plastic Surgery, Bellaria Hospital in Bologna, between 1994 and 2001. The cases involved recent traumatic loss of substance in 48 cases, post-traumatic defects such as osteomyelitis, ulcers, unstable scarring, sequelae of burns in 40, and neoplasms in 12. Muscular flaps were used in 89 cases, skin flaps in 9, a flap of the omentum in 1; the latissumus dorsi flap was that most frequently used (50 cases). A total of 87 cases had favorable results, while in 13 cases there was failure of the flap. Based on the results obtained, and experience, current indications and causes of failure are discussed.

Use of the trans-abdominal rectus abdominis flap in sacrum surgery.

The authors describe the method used to reconstruct the posterior wall of the pelvis using a flap taken from the rectus abdominis muscle after resection of the sacrum to treat neoplasm.

[Free-flap fibula for the reconstruction of composite mandibular defects]. / Il lembo libero microvascolare di perone nella ricostruzione di difetti mandibolari complessi.

The advent of microsurgery has revolutionized the reconstruction of composite tissue defects of the mandibular region. Well-vascularized bone and soft-tissues can be used to repair any kind of oromandibular defects and many of the morphological and functional goals of mandibular reconstruction can now be achieved. The ideal flap should provide a vascularized bone of sufficient length and height, easily shaped to match the original mandible with a thin, abundant soft-tissue component. The donor site morbidity should be minimal and a two-team approach possible. Different flaps have been used for mandibular reconstruction including fibula, iliac crest, radius and scapula. According to us, fibula free-flap satisfies many of these requirements and is the flap of choice in most cases of difficult mandibular reconstruction. 8 fibula free flaps were used in 6 cases of primary and 2 cases of secondary reconstructions. The defects were secondary to resections of oral cancers in 4 cases and of osteosarcomas in 4 cases. The mandibular defects were between 8 and 16 cm in length. Multiple osteotomies were used to shape the bone and miniplates were utilized for rigid fixation of the osteotomized bone and of the remaining mandible. An important soft-tissue defect was present in 6 cases requiring a skin paddle for oral lining. In 6 cases there was a complete survive of the flaps with very satisfactory results and good mandibular contour. There was one flap failure for a venous thrombosis and in one case the flap was removed after 8 days for complications independent of the microvascular technique. Donor site morbidity was minimal with no significant gait disturbance. In conclusion, the advantages of microvascular surgery and the reliability of fibula free-flap make it an attractive and versatile option in one-stage reconstruction of composite tissue defects in the mandibular region.

[Role of microvascular free flaps in the treatment of amputation stumps]. / Ruolo dei lembi liberi microvascolari nel trattamento dei monconi di amputazione degli arti.

The authors report the importance of plastic surgery in rehabilitation of the amputated stump. After having referred the tight dependence between amputated stump and prosthesis, they underline the importance of a trophic and painless stump characterized by a satisfactory "useful length". They report two cases in which these priorities have been satisfied by using latissimus dorsi free flap. The authors believe that better rehabilitative results can be achieved by applying the most recent techniques utilized in plastic surgery and particularly microvascular free flaps.

[Current therapeutic trends in the oto-mandibular syndrome]. / Attuali orientamenti terapeutici nella sindrome oto-mandibolare.

The authors describe the characteristics of oto-mandibular syndrome (hemifacial microsomia), underlining that the knowledge of the craniofacial growth and the analysis of the deformities are necessary for a correct surgical approach. The skeletal abnormalities, and in particular the mandibular deformity, are the first step of treatment, which is begun more and more often before the age of six to minimize the skeletal distortion and to decrease the psychological problems of the child. Nevertheless, several surgical procedures are generally required up to the age of 12-16 to obtain a good symmetry. The reconstruction of the ear is deferred, whenever possible, until the mandibular and zygomatic osseous framework have been established to avoid a location in an unfavorable site. The earliest age of repair is six years. Early correction of macrostomia is needed in order to obtain a functioning and symmetric oral sphincter. The possible deficiency of soft tissues does not always require surgery and is the last step of treatment of hemifacial microsomia.

Tumours of the skin adnexa: a case series with focus on multiple segmental forms.

OBJECTIVE: Skin adnexal tumours (SAT) as a whole are rare tumours, and most of our current knowledge on SAT is from single case reports or small series focused on single histotypes. The purpose of this paper is to review a series of benign and malignant SAT diagnosed in a 20-year period. METHODS: All consecutive cases of SAT diagnosed between January 1992 and Dicember 2011 were retrieved. All slides were reviewed and diagnosed according to currently accepted criteria. RESULTS: 281 consecutive cases of SAT were found. The majority of cases (94.3%) were benign, the most frequent histotypes were eccrine spiradenoma, hidrocystoma, eccrine poroma, syringoma, sebaceous adenoma and trichofolliculoma. Benign SAT affected adult males more frequently (M/F = 153/112) (mean age 59 years). Recurrences were rare (2/265). Three cases of multiple segmental spiroadenoma were observed. Malignant SAT consituted only 5.7% of all cases comprising sebaceous carcinoma, extramammary Paget disease and apocrine carcinoma. There was a slight female predilection (M/F = 7/9) (mean age 72 years), although patients were older than those affected by benign SAT. All neoplasms were small and no recurrences were recorded. CONCLUSION: SAT are rare and most frequently benign. Correct diagnosis and complete surgical removal are important.

Sexual dimorphism in the squirrel monkey, Saimiri sciureus (Linnaeus, 1758) and Saimiri ustus (I. Geoffroy, 1844) (Primates, Cebidae).

Causes and implications of sexual dimorphism have been studied in several different primates using a variety of morphological characters such as body weight, canine length, coat color and ornamentation. Here we describe a peculiar coat color characteristic in the squirrel monkey that is present only in adult females over five years old and which increases with age. Neither males nor young animals manifest this phenomenon, which is characterized by a spot of black hairs located anteriorly to the external ear (pinna). This characteristic could be used to discriminate adult females of Saimiri sciureus in the wild without the need of capture techniques.

Agnathia and associated malformations in a male rhesus monkey.

BACKGROUND: Agnathia is a rare malformation characterized by the absence of the mandible. METHODS: A male rhesus monkey with malformations was found dead and studied by internal examination, radiographs and histopathology. RESULTS: A case of a rare first branchial arch anomaly with agenesis of the mandible and tongue is presented. The animal also had visceral deformities. However, ears were normal in shape and only slightly low in position. The craniofacial malformations may reflect incomplete separation of the first branchial arch into its maxillary and mandibular processes. CONCLUSIONS: The association between the craniofacial and other corporal anomalies is unclear.

[Hyperbaric oxygenation: physical and physiological premises, clinical uses, review of the literature]. / L'ossigenoterapia iperbarica (OTI): premesse fisiche e fisiologiche, applicazioni cliniche, revisione della letteratura.

The physic and physiologic principles regarding the mechanism of hyperbaric oxygen are referred. On the basis of the literature, the possible clinical applications of hyperbaric oxygen therapy in plastic surgery are reported. The Authors underline the usefulness of this method in traumatic lesions of the legs, in gaseous gangrene, in ulcers of different etiology, in X-rays lesions, in burns and in improving the viability of cutaneous flaps.

[Dog bite wounds: characteristics and therapeutic principles]. / Le ferite da morsi di cane: particolarità e principi terapeutici.

Dog bite wounds are a common problem and children are the age group at highest risk. Wounds are often multiple and generally involve the face or the limbs. Injuries include punctures, crushes, lacerations and avulsions of flaps. The well-know prevalence of facial injuries can pose some difficult reconstructive problems. Infections are not rare even in well-treated cases. The Authors report the last ten cases which they have treated and on the basis of their experience and of the literature suggest guidelines for effective treatment. A prophylactic antibiotic therapy and tetanus immunization are the basis of rational medical therapy. Wounds should be immediately sutured after careful debridement and through irrigation, unless they are heavily contaminated or located on the hand.

[Current trends and indications in post-mastectomy breast reconstruction]. / Attuali orientamenti ed indicazioni nelle ricostruzioni mammarie post mastectomia.

Breast reconstruction should not be limited to the requiring patients, but should represent, in selected cases with favourable prognosis, an integrative and complementary procedure of the treatment. On the basis of the most important prognostic factors, the authors propose an oncologic-reconstructive protocol and consider how many patients in the Ospedale Maggiore of Parma in a sample year could be candidate for routine breast reconstruction. Finally the main surgical techniques employed in breast reconstruction are reviewed.

[Use of aztreonam in the perioperative prevention in burned patients]. / L'impiego dell'aztreonam nella profilassi perioperatoria del paziente ustionato.

The perioperative short-term prophylaxis is often used in burned patients. The basic of an adequate choice of the antibiotics is the knowledge of the kind of bacteria present in the burned areas. Because of the quality and the diversity of the bacteria, it is generally necessary to use an antibiotic combination chosen on the basis of the latest antibiogram. The Authors refer their experience of 15 cases treated with combination of aztreonam-oxacillin (10 cases) and aztreonam-tobramycin (5 cases) chosen on the basis of the latest antibiograms performed some days before surgery. The antibiotics were administered intravenously 1 hour before surgery. Three subsequent administrations every 8 hours followed. The microbiological and clinical results were positive. No systemic septic complication was reported and a global take of the skin graft was observed.

[Hyperkeratosis follicularis et parafollicularis in cutem penetrans (Kyrle's disease). Description of a case]. / Ipercheratosis follicularis et parafollicularis in cutem penetrans (Malattia di Kyrle). Descrizione di un caso.

A case of hyperkeratosis follicularis et parafollicularis in cutem penetrans Kyrle's disease in a 41-year-old woman is described. It was a recurrence of a lesion surgically removed and originally diagnosed as invasive squamous cell carcinoma. Kyrle's disease is a rare dermatosis and should not be confused with neoplastic conditions i.e. squamous cell carcinoma. Pathologists should be aware of such conditions in order to avoid misdiagnosis, which can imply over treatment for the patient.

Breast feeding, bottle feeding, and non-nutritive sucking; effects on occlusion in deciduous dentition.

AIMS: To assess the effect of the type of feeding and non-nutritive sucking activity on occlusion in deciduous dentition. METHODS: Retrospective study of 1130 preschool children (3-5 years of age) who had detailed infant feeding and non-nutritive sucking activity history collected by a structured questionnaire. They all had an oral examination by a dentist, blinded to different variables evaluated. RESULTS: Non-nutritive sucking activity has a substantial effect on altered occlusion, while the effect of bottle feeding is less marked. The type of feeding did not have an effect on open bite, which was associated (89% of children with open bite) with non-nutritive sucking. Posterior cross-bite was more frequent in bottle fed children and in those with non-nutritive sucking activity. The percentage of cross-bite was lower in breast fed children with non-nutritive sucking activity (5%) than in bottle fed children with non-nutritive sucking activity (13%). CONCLUSIONS: Data show that non-nutritive sucking activity rather than the type of feeding in the first months of life is the main risk factor for development of altered occlusion and open bite in deciduous dentition. Children with non-nutritive sucking activity and being bottle fed had more than double the risk of posterior cross-bite. Breast feeding seems to have a protective effect on development of posterior cross-bite in deciduous dentition.

Tissue expansion in the leg: limits and complications in trauma pathology.

Subcutaneous tissue expansion in the treatment of skin loss was first introduced by Neuman (1957) and subsequently developed by Radovan (1982) as a means of increasing the amount of tissue available for reconstruction. It takes advantage of the elasticity of the skin and its ability to expand when submitted to traction, thereby increasing its surface area. This is achieved by the temporary subcutaneous insertion of prostheses which are gradually expanded with physiological saline injected percutaneously through a valve. Once the required increase in skin surface has been achieved, the prosthesis is removed. Indications and modalities for the use of expanders in the head and neck (Argenta et al., 1983; Manders et al., 1984) and the breast (Radovan, 1982; Argenta et al., 1983) are now well established, but severe skin loss in the distal part of the leg, particularly if due to trauma and accompanied by exposure of the neural structure, may create serious problems of reconstruction. We therefore found it useful to apply this new technique in this situation, having previously adopted it in other parts of the body and obtained good results which would have been difficult to achieve with traditional techniques.