Production of gelatin fibrous mats using different nanofiber production methods for medical applications and comparison of their properties.

In the literature, there are studies on medical applications using different nanofiber production methods with natural polymers. However, each system has different fiber-forming capabilities. For this reason, in this study, we investigated the production of nanofibers from a biodegradable natural polymer, gelatin, using four separate nanofiber production methods, namely electrospinning (ES), electroblowing (EB), solution blowing (SB), and centrifugal spinning (CS). Our aim was to determine the most suitable fibrous web structure for medical applications and contribute to science in this respect. It was observed that the thinnest fibers (386 nm) and the heaviest mats (15.975 g m-2) were produced by the SB method as a result of using 10 wt.% gelatin solution with a total of 10 mL. With the ES and EB methods, tighter fabric structures were obtained than with the others due to the presence of electric fields. In the CS method, more and bead-free fibers were produced due to the increase in viscosity with a 12.5 wt.% gelatin solution. Moreover, with the concentration of 12.5 wt.%, the fiber diameters of SB and CS samples increased about 2-fold.

Aerosol Filtration Performance of Solution Blown PA6 Webs with Bimodal Fiber Distribution.

A bimodal web, where both nanofibers and microfibers are present and distributed randomly across the same web, can deliver high filter efficiency and low pressure drop at the same time since in such a web, filter efficiency is high thanks to small pores created by the presence of nanofibers and the interfiber space created by the presence of microfibers, which is large enough for air to flow through with little resistance. In this work, a bimodal polyamide 6 (PA6) filter web was fabricated via a modified solution blowing (m-SB) technique that produced nanofibers and microfibers simultaneously. Scanning electron microscope (SEM) images of the webs were used to analyze the fiber morphology. Additionally, air permeability, solidity, porosity, filtration performance, and tensile strength of the samples were measured. The bimodal filter web consisted of nanofibers and microfibers with average diameters of 81.5 ± 127 nm and 1.6 ± 0.458 µm, respectively. Its filter efficiency, pressure drop at 95 L min-1, and tensile strength were 98.891%, 168 Pa, and 0.1 MPa, respectively. Its quality factor (QF) and tensile strength were 0.0268 Pa-1 and 0.1 MPa, respectively. When compared with commercially available filters, the bimodal web produced had superior filter performance, constituting a suitable alternative for air filter applications.

Evaluation of sexual function in women with labia minora hypertrophy: A preliminary study.

OBJECTIVE: To compare the sexual functions in women with labia minora hypertrophy and age-matched healthy controls. MATERIAL AND METHOD: 43 patients with labia minora hypertrophy and 30 age-matched healthy controls were enrolled in the present study. The sexual functions of the women were evaluated by using the index of female sexual function (IFSF). RESULTS: Mean ages of the patients and controls were 30.06±7.11 and 31.34±4.12 (p=0.41), respectively. Mean total IFSF scores of the patients and controls were 24.18±3.24 and 27.53±4.43 (p<0.05), respectively. The subscale scores of IFSF-lubrication, orgasm, satisfaction and pain in the patient group were significantly lower than in the control group (respectively, p<0.001, p<0.05, p<0.001 and p<0.05). There was no statistically significant difference between IFSF-arousal scores of the patient and control groups (p=0.30). The mean IFSF-desire scores of the patient group was higher than the controls (p<0.001). Labia minora hypertrophy was significantly associated with female sexual dysfunction (odds ratio [OR]=14.97, 95% confidence interval [Cl]=[3.66-61.21], p<0.001). CONCLUSION: This study suggests that patients with labia minora hypertrophy have poorer lubrication, satisfaction, pain, and orgasm scores on the IFSF scale compared to age-matched healthy controls.

Evaluation of sexual function in women with labia minora hypertrophy: a preliminary study / Evaluación de la función sexual en las mujeres con hipertrofia en los labios vaginales menores: un estudio preliminar

Objective. To compare the sexual functions in women with labia minora hypertrophy and age-matched healthy controls. Material and method. 43 patients with labia minora hypertrophy and 30 age-matched healthy controls were enrolled in the present study. The sexual functions of the women were evaluated by using the index of female sexual function (IFSF). Results. Mean ages of the patients and controls were 30.06±7.11 and 31.34±4.12 (p=0.41), respectively. Mean total IFSF scores of the patients and controls were 24.18±3.24 and 27.53±4.43 (p<0.05), respectively. The subscale scores of IFSF-lubrication, orgasm, satisfaction and pain in the patient group were significantly lower than in the control group (respectively, p<0.001, p<0.05, p<0.001 and p<0.05). There was no statistically significant difference between IFSF-arousal scores of the patient and control groups (p=0.30). The mean IFSF-desire scores of the patient group was higher than the controls (p<0.001). Labia minora hypertrophy was significantly associated with female sexual dysfunction (odds ratio [OR]=14.97, 95% confidence interval [Cl]=[3.66-61.21], p<0.001). Conclusion. This study suggests that patients with labia minora hypertrophy have poorer lubrication, satisfaction, pain, and orgasm scores on the IFSF scale compared to age-matched healthy controls

Objetivo. Comparar las funciones sexuales en mujeres con hipertrofia de labios menores y un grupo control. Material y método. En el presente estudio se incluyeron 43 pacientes con hipertrofia de labios menores y 30 controles sanos de la misma edad. Las funciones sexuales de las mujeres fueron evaluadas utilizando el Índice de Función Sexual Femenina (IFSF). Resultados. La edad promedio de las pacientes y controles fueron 30,06±7,11 y 31,34±4,12 (p=0,41), respectivamente. La puntuación total media del IFSF de las pacientes y controles fueron 24,18±3,24 y 27,53±4,43 (p<0,05), respectivamente. Las puntuaciones de la subescala de lentificación, orgasmo, satisfacción y dolor en el grupo estudio fueron significativamente menores que en el grupo control (p<0,001, p<0,05, p<0,001 y p<0,05). No hubo diferencias estadísticamente significativas entre las puntuaciones de excitación del IFSF de las pacientes y los grupos control (p=0,30). El promedio de las puntuaciones del deseo del IFSF del grupo de pacientes fue mayor que en el grupo control (p<0,001). La hipertrofia de labios menores se asoció significativamente con disfunción sexual femenina (odds ratio [OR]=14,97; intervalo de confianza [lC] del 95%=[3,66-61,21]; p<0,001). Conclusión. Este estudio sugiere que las pacientes con hipertrofia de labios menores tienen peor puntuación en cuanto a lubricación, satisfacción, dolor y orgasmo en la escala del IFSF en comparación con el grupo control

Giant lipoma extending into two thigh canals: A case report.

Giant lipomas, although rare, represent a real diagnostic and therapeutic challenge. We report an unusual giant lipoma of the thigh extending into two thigh canals and it's diagnostic and therapeutic processes.

Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

BACKGROUND: The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. PATIENTS AND METHODS: First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). RESULTS: There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P < 0.001). The average external bleeding period was 7.2 days. The mean hospital stay was 12.4 ± 1.5 days for group 1, which was significantly longer when compared with group 2 (5.2 ± 0.5 days, P < 0.001). CONCLUSIONS: Although palmar vein anastomosis did not show a statistically significant effect on relieving venous congestion, it reduced the rate and the severity of venous congestion. Also, replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

Invasive squamous cell carcinoma originating from a giant penile condyloma.

In this case study, we present an unusual case with squamous cell carcinoma originating from a giant condyloma acuminata completely surrounding the penis. A 57-year-old circumcised heterosexual male patient presented with a penile lesion existing for 20 years. Incisional biopsy revealed acanthosis of the squamous epithelium. The patient was operated on under spinal anaesthesia. The lesion was resected circumferentially with macroscopic clearance, resulting in complete degloving of the penile shaft. Neurovascular bundles were preserved. The penile skin was constructed with a split thickness skin graft. Histopathological analysis of the lesion revealed an invasive and well-differentiated squamous cell carcinoma arising on a condyloma, and the surgical margins were free from tumour. The patient was staged as G2 T1 N0 M0 and was followed for one year. He did not have any erectile dysfunction and could engage in intercourse. Pelvic tomographic and physical examination findings did not reveal any episode of recurrence or metastasis. When encountering patients with giant condyloma acuminata, it should not be forgotten that it may be accompanied by squamous cell carcinoma. In addition, tissue excision should be as extensive as possible while keeping in mind the importance of the function. This is the first case of a penile-degloving surgery for giant penile condyloma, supporting conservative and preserving penile surgery for such tumours.

Sexual function and hormone profile in young adult men with idiopathic gynecomastia: Comparison with healthy controls.

OBJECTIVES: To compare sexual function and hormone profile in male patients with gynecomastia with matched controls. MATERIALS-METHODS: Forty-seven male subjects with gynecomastia and thirty healthy controls were enrolled in this study. Serum free T3, free T4, TSH, FSH, prolactin, estradiol, total testosterone, free testosterone, DHEA-SO4, LH and total PSA were measured in the patients and controls. Sexual function of the patients and controls were evaluated using International Index of Erectile Function (IIEF). The hormone values and IIEF scores of the patients were statistically compared with the controls'. RESULTS: The mean of age, body mass index, right and left testicular volume in the patient and control group were similar. The mean FSH and free T3 values of the patients were significantly lower than the controls (p = 0.007 and p = 0.03, respectively). The mean of the other hormone values in the both groups were found to be statistically similar (p > 0.05). The mean ±SD of total IIEF scores in the patient and control group were 60.14 ± 8.78 and 65.24 ± 5.52, respectively (p = 0.007). Although the mean IIEF-erectile function, orgasmic function and intercourse satisfaction scores in the patient group were significantly lower than the control group (p < 0.001, p = 0.004 and p = 0.001, respectively), the mean IIEF-desire score of the patients was significantly higher than the controls (p = 0.002). CONCLUSION: We found that the hormone profiles (except FSH and free T3) of the patients with gynecomastia were similar with the controls. However, gynecomastia adversely affected male sexual function.

Increasing topical anesthetic efficacy with microneedle application.

INTRODUCTION: Since topical anesthetics alone seldom provide adequate analgesia for laser resurfacing procedures, injectable forms of anesthesia are often required. However, their application is uncomfortable for the patient. In this study, it is investigated whether microneedle application would enhance the efficacy of topical anesthetics. METHODS: Forty-seven patients participated in the study. Topical anesthetic agent EMLA was applied to the whole face of the patients. Microneedle treatment was applied to one side of the face with a roller-type device. Whole-face carbon dioxide laser resurfacing therapy was carried out then. The pain that patients experienced was assessed by using visual analog scale (VAS) method. VAS scores of two sides of the face were compared by using Wilcoxon signed-rank test. RESULTS: The mean of VAS score of the microneedle treated side was 2.1 ± 1.1 while that of the untreated side was 5.9 ± 0.9 and this difference was statistically significant (Wilcoxon signed-rank test, the Z-value is - 5.9683 and the p-value is < 0.001). SUMMARY: This study revealed that microneedle application, with a roller-type device, is a safe and easy procedure in providing sufficient anesthesia for facial laser resurfacing without the need for supplementary nerve blocks or injections.

Effect of Reduction Mammaplasty on Sexual Activity.

AIM: This study aimed to evaluate the effects of reduction mammaplasty operation on sexual functions of the patients with macromastia and of their partners. MATERIALS AND METHODS: Thirty-nine patients with macromastia and their partners were assessed for their sexual function before and 6 months after reduction mammaplasty. Sexual function of the women and their partners were evaluated using the Index of Female Sexual Function (IFSF) and the International Index of Erectile Function (IIEF), respectively. Controls (n = 33) were chosen from healthy hospital staff and their partners. Preoperative and postoperative scores were statistically compared with the controls' scores by using Student t test. Also, preoperative and postoperative scores were compared by using paired t test. RESULTS: The mean of age and body mass index of the women and their partners in the patient and control group were similar (P = 0.07). Before the operation, the mean of IFSF scores in the patient and control group were 22.75 (3.45) and 27.28 (5.05), respectively (P < 0.001). After the operation, the mean of IFSF scores in the patient group increased significantly to 27.67 (P < 0.001). The postoperative scores of all IFSF subscales except lubrication subscale were higher than the preoperative scores. Although there was no significant difference between preoperative and postoperative IIEF-total scores, postoperative IIEF-erectile function and IIEF-intercourse satisfaction scores were significantly reduced (P < 0.05). CONCLUSIONS: We found that macromastia adversely affected female sexual function but reduction mammaplasty eliminated this adverse effect. We also found that the partners' erectile function and intercourse satisfaction reduced after the operation. This reduction may be due to psychological effects.

Lateral thoracic artery perforator-based flap: a new experimental model.

BACKGROUND: The aim of this study was to describe a new experimental perforator-based flap in rats, supplied by lateral thoracic artery perforator. METHODS: Through out the study, two control and two experimental groups were created consisting of six rats in each group. In the first control group (group 1), mid-axillary line and the fourth intercostal space intersection were used as the center of the flap. A 3 × 2 cm flap was designed and elevated above the cutaneous maximus muscle by transecting all connections with the muscle. In the second control group (group 2), the flap was extended caudally, and 3 × 6 cm flap was designed. Then, the flap was elevated in the same manner as it was described for group 1. In the first experimental group (group 3) 3 × 2 cm flap and in the second experimental group (group 4) 3 × 6 cm flap were designed like control groups. The flaps were islanded on a single musculocutan perforator arising from lateral thoracic artery. The surviving skin paddle areas were calculated on postoperative day 7. RESULTS: The flap viability was calculated 0% for control groups (groups 1 and 2), 100% for the first experimental group (group 3), between 33.3% and 37.7% for the second experimental group (group 4; mean ± standard deviation, 34.76% ± 1.92%). CONCLUSIONS: This new lateral thoracic artery perforator-based flap has a constant anatomy and reliable survival pattern. Also, easy harvesting and the possibility of designing two flaps per animal make this new flap an appealing model for pathophysiological or pharmacologic researches.

A novel method to prevent complications of nasal osteotomy: matress suture which traverses lateral walls and septum.

OBJECTIVES: This study aims to investigate long-term nasal wall stability and prevention of nasal osteotomy complications using thin osteotomes without a nasal splint. PATIENTS AND METHODS: Between March 2012 and August 2014, 16 male patients (mean age 24 years; range 18 to 42 years) who were admitted with the complaint of appearance of nose to our clinic and were diagnosed with nasal deformity were included in this study. Primary rhinoplasty was performed on 15 patients, while secondary rhinoplasty due to open roof deformity was applied in one patient. After hump resection, two holes were made cranially and caudally over the each nasal bone. The mattress suture was performed by passing these holes to stabilize the nasal bone in a desired position following osteotomy. With this technique, only adhesive tapes were applied postoperatively. No external nasal splint was used. RESULTS: The mean follow-up was nine (range, 7 to 13) months. None of the patients experienced open roof deformity, inverted V deformity, nasal bone collapses or wall irregularities. CONCLUSION: Our study results show that our technique is useful to reduce osteotomy complications and to reach the optimal cosmetic outcomes in rhinoplasty.

Assessment of sexual function in women with macromastia and their partners / / Evaluación de la función sexual en mujeres con macromastia y sus parejas

Objective. To investigate the sexual function in patients with macromastia and their partners. Materials and methods. 48 patients with macromastia and 30 healthy controls and their partners were enrolled in the study. The sexual function of the women and their partners was evaluated by using the Index of Female Sexual Function (IFSF) and International Index of Erectile Function (IIEF), respectively. Results. Mean ages of the patients and controls were respectively, 33.27 ± 5.24 and 32.06 ± 3.91 (p > 0.05). Mean IFSF scores of the patients and controls were 23.21 ± 3.16 and 27.33 ± 4.94 (p = 0.00), respectively. All of the subscale scores of IFSF in the patient group were significantly lower than in the control group. Mean IIEF scores of the patients’ and controls’ partners were 60.33 ± 11.46 and 65.25 ± 6.18 (p = 0.04), respectively. Conclusion. In this study, Macromastia was shown to affect sexual function of women and their partners adversely (AU)

Objetivo. Investigar la función sexual en pacientes con macromastia y en sus parejas. Material y método. 48 pacientes con macromastia y 30 controles sanos y sus parejas fueron inscritos en el estudio. La función sexual de las mujeres y sus parejas fueron evaluadas usando el Índice de Función Sexual Femenina (IFSF) y el Índice Internacional de Función Eréctil (IIEF), respectivamente. Resultados. La edad media de los pacientes y controles era de respectivamente 33,27 ± 5,24 y 32,06 ± 3,91 (p > 0,05). Las puntuaciones medias de los pacientes y los controles eran de respectivamente 23,21 ± 3,16 y 27,33 ± 4,94 (p = 0,00). Todas las puntuaciones en subescalas de IFSF en el grupo de los pacientes eran significativamente más bajas con respecto al grupo de control. La media de las puntuaciones del IIEF en las parejas de los pacientes y de los controles eran de respectivamente 60,33 ± 11,46 y 65,25 ± 6,18 (p = 0,04). Conclusiones. En este estudio, se demostró que la macromastia afecta la función sexual de las mujeres y sus parejas negativamente (AU)

Basosquamous carcinoma: is it an aggressive tumor?

Basosquamous carcinoma is a rare cutaneous tumour that is considered an aggressive type of basal cell carcinoma with an increased risk of recurrence and metastases. This impression has been perpetuated in the literature, despite limited scientific data and conflicting results of some authors. This present study was aimed to evaluate the clinical-pathological features of this tumour and follow-up of a series of basosquamous carcinoma. Basosquamous carcinoma patients who underwent surgical excision between January 2000 and February 2012 were analyzed retrospectively. Their medical files were reviewed and the corresponding routinely stained sections (with hematoxylin-eosin) were re-evaluated by two pathologists. Thirty-five patients with basosquamous carcinoma were operated on in this period. Most tumurs were located in the head and neck area (94%), and the mean age of the patients was 69.8 years. Margin involvements were seen in 11 patients (31.4%) and all of them underwent re-excision. There was only one local recurrence. There was neither regional lymph node nor distant metastasis in this series. The recurrence rate of basosquamous carcinoma is found as 4%, lower than that of most other similar studies. Further pathologic studies are needed to better classify basosquamous carcinoma and to increase consistency between the results of studies. Surgical excision and regular follow-up are considered as the treatment of choice.

Patient-reported quality-of-life outcomes of breast reduction evaluated with generic questionnaires and the breast reduction assessed severity scale.

BACKGROUND: The effects of breast reduction on quality of life (QOL) have been evaluated in patients with macromastia, but few investigators have performed condition-specific assessments. OBJECTIVES: The authors employed generic and condition-specific questionnaires to examine the QOL of patients with macromastia and determined the responsiveness of the Turkish version of Breast Reduction Assessed Severity Scale (BRASS). METHODS: This prospective cohort study included patients with breast hypertrophy who underwent breast reduction (n = 94). Patients completed the Turkish versions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), the BRASS, and the Rosenberg Self-Esteem Scale preoperatively and 4 months postoperatively. Differences in responses were evaluated by paired t-test and by comparing change effect sizes. Multiple regression analyses were performed to evaluate improvements in QOL in response to adjustments in baseline differences across patients. RESULTS: Preoperative and postoperative questionnaires were completed by 78 patients (83%). Significant postoperative improvements in self-esteem (Rosenberg Self-Esteem Scale; P < .001) and in all domains of the BRASS (P < .001) were noted. Mean preoperative scores for 5 of 8 domains in the SF-36 were lower than those of a normative population. Postoperatively, all 5 mean scores improved significantly, but the score for bodily pain remained less than that of a normative population. CONCLUSIONS: The results of this study indicate significant improvements in health-related QOL at 4 months after breast reduction in a population of patients with macromastia. The authors also demonstrate excellent responsiveness of the BRASS.

Tension adjusted multivectorial static suspension with plantaris tendon in facial paralysis.

Facial paralysis in the midface causes loss of cheek tonus, asymmetry at rest, and inability to smile. Static suspension is generally performed in patients who cannot tolerate time-consuming dynamic reanimation. Current methods for static slings are overly simplistic. A sling, which is generally fascia lata or palmaris tendon, is placed between the modiolus and the zygomatic arch or the temporalis fascia, with further extension to the midline of the upper end lower lips in 1 vector. Recently, sutures are placed in a multivectorial approach, but suture failure via breakage is the main problem. In this study, the long, thin, and powerful plantaris tendon was used and divided into 3 slips. Placement of these slips and their tension adjustment were revised to provide strong and long-lasting upper lip and the modiolus pull, along with creation of a well-defined nasolabial fold, and to create sufficient cheek tonus. The first slip was positioned at 35 to 45 degrees to the horizontal plane between the modiolus and the upper preauricular area, second slip at 55 to 60 degrees between the upper lip and the deep temporal fascia, and the third slip at 0 to 10 degrees between the lower lip and lower preauricular area with gradually decreasing tension from above to below in 9 patients. Upper 2 slings were also sutured to the dermis of the nasolabial fold to define it optimally. Results were assessed both objectively and subjectively. Symmetry at rest, sufficient cheek tightness to prevent drooling, and a well-defined fold were obtained.

A double-layered, stepped spreader graft for the deviated nose.

BACKGROUND: In deviated noses, a beveled hump resection is recommended to preserve the shorter nasal wall. Even with this precaution, in some patients, the shorter wall does not reach the planned dorsal level when the lateral wall is transposed toward the midline after the lateral osteotomy. METHOD: A double-layered, stepped spreader graft was used on the shorter wall side to construct symmetrical lateral nasal walls. The composite graft was constructed by fixing a smaller cartilage graft to the side of the dorsal border of a slightly larger than normal standard spreader graft. The smaller graft component adds height to the shorter lateral wall while the larger one functions as a usual spreader graft. RESULTS: Stepped spreader grafts were used in 4 primary and 2 secondary rhinoplasty cases. All compound grafts were harvested from the septal cartilage except for one of the secondary cases, in which auricular cartilage was used. Two patients received a usual spreader graft on the contralateral side. Postoperatively, none of the patients exhibited significant recurrent deviation, and acceptable symmetrical dorsal esthetic lines were obtained in all patients. CONCLUSION: This technique should be considered whenever the height of the lateral wall is shorter than desired after centralization of a deviated nose. Reconstruction of the shorter wall by adding height with a stepped spreader graft results in a more stable dorsum that resists relapse. Dorsal esthetic lines can also be reconstructed at the same time.