New trends in breast reconstructive surgery: "Florentine Lily" reductive mastoplasty.

BACKGROUND: To describe a mammoplasty technique that we called "Florentine Lily" because of the shape of the pre-operative drawings similarity with the symbol lily Florentine. METHODS: In a group of 190 women who underwent reductive mammoplasty, 23 women affected by severe enlarged breasts were selected. Main selection requirements were: 18-30 cm rising of the Areola-Nipple Complex (NAC). RESULTS: to obtain a functional and cosmetic result; preservation of mammary gland function; vitality of the areola-nipple complex and its sensitivity. We describe the case of 35 years old woman affected by severe enlargement of the breast and no pathologies. CONCLUSION: We didn't observe necrosis of the skin flaps and NAC in any case. In one case (rising of Nipple-Areola Complex >25 cm) NAC showed NAC 2 days post-surgery, which spontaneously resolved. Minor complications (edema and ematoma) developed in 20 cases. No infections were observed.

Traumas of the middle skull base with TMJ involvement. Case report.

The authors report their experience with temporomandibular joint (TMJ) traumas involving breakage of the roof of the glenoid cavity, an infrequent event that occurs in those cases in which, as a result of the condylar neck not fracturing, the traumatic energy is transmitted to the middle skull base. As the literature contains no valid series for establishing standardized protocols for the treatment of these fractures, we propose our own orthopedic-functional approach. The patient observed by us had suffered a cranio-facial trauma and presented the classical symptoms and signs of TMJ traumas and complete bilateral Bell paralysis. He was subjected to a CAT scan and then to 2-stage treatment consisting of functional rest with liquid diet followed by physiotherapy. An almost total recovery in TMJ function was observed after 1 month. At 1-year follow-up the facial paralysis had resolved completely. On the basis of our experience, breakages of the glenoid cavity can be compared, in terms of treatment procedure, to intracapsular fractures of the TMJ with surgery confined to cases of ankylosis sequelae. To avoid the onset of ankylosis careful control of clinical, functional and radiological follow-up is required.

[Preliminary study of the pathogenetic mechanisms of pulmonary hypertension due to hypoxia. the role of histamine]. / Studio preliminare sui meccanismi patogenetici dell'ipertensione polmonare da ipossia. Il ruolo dell'istamina.

It has long been supposed that histamine plays an intemediary rôle in pulmonary hypertension due to hypoxia, though no firm evidence has been collected. Lung and aortic pressure and the blood histamine content in the aorta, pulmonary artery, vena cava inferior, and suprahepatic veins were therefore measured in anaesthetised dogs breathing ambient air, and after 5' administration of a gas mixture containing 8% O2. Lung pressure rose significantly and aortic pressure changed only slightly. Histamine values, however, rose significantly in the pulmonary artery and were unchanged in the aorta after the hypoxic stimulus. In addition, concentrations were higher in the vena cava and unchanged in the suprahepatic veins. These results indicate that histamine is released from skeletal muscle and electively taken up by lung tissue during hypoxia. Its rôle is certainly important, but further elucidation must await the performance of other studies using drugs that selectively block its release from the muscle district.

Effect of a combined nutraceutical containing Orthosiphon stamineus effect on blood pressure and metabolic syndrome components in hypertensive dyslipidaemic patients: a randomized clinical trial.

Effect of a nutraceutical containing Ortosiphon stamineus leaf extract on blood pressure and metabolic syndrome components in hypertensive dyslipidaemic patients treated with calcium-channel blockers, or angiotensin converting enzyme inhibitors: a randomized clinical trial.

Alternative techniques in reconstructive surgery: bone-anchored extraoral implants for burn cases.

BACKGROUND: The authors present their experience with the use of extraoral implants for reconstruction of the ear area after burns. The first step of the protocol includes positioning of implants in the mastoid process. The second step, after 3 to 4 months, is to realize the auricle prosthesis and apply it. Extraoral, bone-integrated implants offer low surgical risks and few postsurgical complications, leading to optimal aesthetic results, mainly in the ear area. Compared with traditional surgery techniques, the aesthetic results are better, with less surgery, possibly only two surgery sessions. Adhesive prostheses can be placed without the usual local irritation, and a more correct positioning can be obtained. METHODS: For this study, two female patients, treated from December 2001 to January 2005, were selected to receive auricle epitheses. In the authors' experience, 79% of case reporting describes the creation of this epithesis type. The patient age has a range of 26 years. The two study patients initially had the same diagnosis: burns of the auricle-temporal region. RESULTS: In all cases, a good aesthetic result was obtained. CONCLUSION: The authors believe that bone-anchored implants for the treatment of auricle burns is a valid and brilliant technique that complements traditional reconstructive procedures. The advantages are the low incidence of long-term complications and the possibility of obtaining excellent aesthetic lasting results even for very complicated cases that would not have been solved in the past.