[Pyoderma gangrenosum: spontaneous healing after early diagnosis. Three cases and general review]. / Pyoderma gangrenosum : cicatrisation spontanée à la suite d'un diagnostic précoce. À propos de trois cas et revue générale.

INTRODUCTION: Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring and lead to significant sequelae. A rapid initial management avoids a dramatic evolution. PATIENTS AND METHODS: We report the case of three PG for patients followed for breast reconstruction after breast cancer. DISCUSSION: PG is a neutrophilic dermatosis that can occur after injuries of varying intensity. Its shape after surgery is a rare disease whose presentation loud and fast pace "infectious" contrasts with the absence of inflammatory lymphangitis or lymphadenopathy. Be aware of prescribing high doses of corticosteroids. CONCLUSION: These three cases illustrate the importance for early diagnosis and treatment of PG, who can allow spontaneous healing without complex surgery, always feared in this context.

Characterization and analyses of acid-extractable and leached trace elements in dental cements.

AIMS: Determination of the elemental constitution and investigation of the total and leachable arsenic, chromium and lead in Portland cement, pure tricalcium silicate, Biodentine, Bioaggregate and mineral trioxide aggregate (MTA) Angelus. METHODOLOGY: The chemical composition of Portland cement, MTA Angelus, tricalcium silicate cement, Biodentine and Bioaggregate was determined using X-ray fluorescence (XRF). Measurements of arsenic, lead and chromium were taken with inductively coupled plasma-mass spectrometry (ICP-MS), following acid digestion on the hydrated material and on leachates of cements soaked in Hank's balanced salt solution (HBSS). RESULTS: All the cements investigated had a similar oxide composition with the main oxide being calcium and silicon oxide. Both the Portland cement and MTA Angelus had an additional aluminium oxide. The dental cements included a radiopacifying material. All the materials tested had higher acid-extractable arsenic content than the level set by ISO 9917-1 (2007) and an acceptable level of lead. Regardless these high levels of trace elements present in the materials, the leaching in HBSS was minimal for all the dental material tested in contrast to the high levels displayed by Portland cement. CONCLUSIONS: Dental materials based on tricalcium silicate cement and MTA Angelus release minimal quantities of trace elements when in contact with simulated body fluids. The results of acid extraction could be affected by nonspecific matrix effects by the cement.

[Breast reconstruction using muscle sparing latissimus dorsi flap and fat grafting]. / Reconstruction mammaire par lambeau dorsal à prélèvement minimal (LDPM) et transfert graisseux.

INTRODUCTION: The aim of this study is to assess our results of autologous breast reconstruction using a combined muscle sparing latissimus dorsi flap (MSLD) and fat tissue transfer. METHODS: A prospective study was performed on 20 patients over a period of 1 year. Three objective criteria were analyzed: morphometric, surgical procedure and postoperative latissimus dorsi function. A subjective assessment was done using a 4-level scale for patients' and surgeons' satisfaction. RESULTS: Mean age of patients was of 45 ± 1.2 years. The average Body Mass Index (BMI) was 21.9 ± 2.2. The average weight of mastectomy specimen was 348.3 ± 135.6 g. The average duration of the surgical procedure was 149 ± 32.1 minutes. The average length of hospitalization was 4.5 ± 1.4 days. The average quantity of dorsal drainage during the hospitalization was 117.7 ± 41.5 cm(3), and a Visual Analog Scale (VAS) of pain of 2 ± 0.9 over 10. Patients from our series had 0.8 ± 0.9 dorsal punction per patient, with an average volume of seroma of 51.2 ± 70.8 cm(3). Fat grafting was used in every case with an average number of 1.2 ± 0.4 procedures per patient. The mean of injected volume was 250.1 ± 132.8 cm(3). No complications occurred in the postoperative period. There was no difference of latissimus dorsi functional assessment at 3 months and 1 year postoperative. CONCLUSION: Combined MSLD and fat transfer is a reliable and an efficient technique for autologous breast reconstruction. The donor site morbidity is low, the postoperative recovery is fast and functional integrity of latissimus dorsi muscle is preserved in all cases. This technique can be used in immediate or delayed autologous breast reconstruction, and is particularly useful for bilateral breast reconstruction.

[Complex breast reconstruction after severe chest trauma by firearm]. / Reconstruction complexe de la région mammaire après traumatisme thoracique grave par arme à feu.

This case report is of a 47-year-old woman who suffered a ballistic chest trauma with severe left hemothorax and heart wound. She was treated in emergency for the collapse by heart surgery. Then the coverage for her soft thorax tissue loss was done by an ipsilateral musculocutaneous latissimus dorsi pedicled flap. The patient was subsequently addressed to our team for a repair, especially for reconstruction of the left breast. Initially, rehabilitation of aesthetics units breast was achieved through the realization of an abdominal advancement flap, and breast volume was restored by several sessions of lipomodeling. The surgical alternatives were very limited for this post-traumatic complex breast reconstruction. Due to ballistic trauma, no reliable recipient vessels allowed a microsurgical solution, and the ipsilateral latissimus dorsi was used for the coverage. In conclusion, the restoration of the aesthetics units with lipomodeling has achieved a very good result in this extreme thoracomammary region repair.

[Breast rupture: presentation, diagnosis and treatment of two cases]. / Fracture du sein : présentation, diagnostic et prise en charge chirurgicale de deux cas.

INTRODUCTION: Breast rupture is an uncommon event that has become more frequent from the 1980s, with the generalisation of the seat belt, so that we can now speak of seat belt related injuries. The trauma is often forgotten and leaves a fibrous band in the breast as only mark. In this way, the breast can be deformed by the scar as much as the retraction is important. The clinical presentation can mime that of a breast cancer, so it is really important to do an echography and a mammography of the lesion. If some dilemma remains, IRM or core biopsy can be helpful. PATIENTS AND METHODS: We report two cases of breast rupture. A breast cancer has been excluded with echography and mammography. We performed a reduction mammoplasty, with inverted T scars, conserving a posterior glandular flap. We will present the observations in the article. DISCUSSION: A breast trauma often leads to haematomas, necrosis of fat and lipid cyst formation. Typically, these lesions are located in regard to the passage of the seat belt on the thorax. The surgical treatment should correct an oblique deformation. It is important to excise all the fibrous tissue and to reharmonize the glandular content. Moreover, in the accidentally discovered forms, one should take in mind the vascular damage determined by the lesions and be able to recognise its presentation before the operation. CONCLUSIONS: Breast rupture is a rare situation that should be known. The treatment is simple and consists in excising the fibrous tissue and replacing it with a well-vascularised tissue. The posterior glandular flap is a helpful tool in these situations.

[Lateral Intercostal Artery Perforator (LICAP) flap for lateral breast defect reconstruction]. / Reconstruction par lambeau perforant de l'artère intercostale latérale (LICAP) d'une séquelle sévère de traitement conservateur du cancer du sein.

Lateral breast defect after partial mastectomy is a difficult challenge. Pedicled perforator flap is a new indication for breast surgery. Perforator flaps and fat tissue transplant are new concepts in this kind of reconstruction. Lateral intercostal artery perforator (LICAP) flap has been used for a lot of indications. It can be used for lateral breast defect reconstruction. This flap provides several advantages: minimal donor site morbidity, advantages in flap shaping, better aesthetic results and higher patient satisfaction. The aim of this paper is to present indications of LICAP flap. We discuss its advantages and its limits in lateral breast reconstruction after partial mastectomy. LICAP flap provides a new solution instead of conventional flaps.

[Muscle-sparing latissimus dorsi flap. Vascular anatomy and indications in breast reconstruction]. / Le lambeau de grand dorsal avec conservation du muscle. Etude anatomique et indications en reconstruction mammaire.

BACKGROUND: The muscle-sparing latissimus dorsi flap pedicled on descending branch presents distinct advantages in breast reconstruction, specially when there is a transversely oriented skin paddle, including reduced donor site morbidity, sparing muscle function and greater freedom of orientation of the skin paddle. This study reports the anatomical basis, surgical technique, advantages and complications of this technique. Four clinical cases illustrate surgical indications in breast reconstructive surgery. METHODS: An anatomical cadaveric study underwent to University of Texas Southwestern Medical Center, Dallas. The goal was performed to determine the location of the bifurcation of the thoracodorsal artery and the course of its descending branch compare to the anterior side of latissimus dorsi muscle. Four clinical cases illustrated indications of muscle-sparing latissimus dorsi flap pedicled on descending branch in breast reconstruction. These cases showed advantages and complications of the technique, and impact on donor site. RESULTS: Fifteen descending branch muscle-sparing latissimus dorsi flaps were harvested. All flaps had a bifurcation of the thoracodorsal artery. The average was located at 5,1cm from posterior axillary side (from 2,1 to 7,5 cm) and average of 2,2 cm from the anterior side of latissimus dorsi muscle (from 1,3 to 3,1cm). To 5, 10 and 15 cm from posterior axillary side, the descending branch was located at respectively an average of 2,0 cm (from 1,4 to 2,5), 2,4 cm (from 1,3 to 3,3), and 2,9 cm (from 2,0 to 3,8) behind the anterior side of latissimus dorsi muscle. The average length of descending branch was measured at 15,2 cm (from 13,2 to 19,0). None clinical cases paddle suffering was observed. Donor site morbidity was less than classical or extended adipomuscular technique. Latissimus dorsi muscle function is spared. CONCLUSIONS: The muscle-sparing latissimus dorsi flap, pedicled on descending branch, is versatile and reproducible. It results in minimal functional deficit of the donor site, absence of seroma, large freedom of orientation of the skin paddle, low rate of flap complications, and a cosmetically acceptable scar. There are a lot of indications in breast reconstruction.

Phase transition between single crystals of two thermotropic cubic phases from a mixture of 3,5-didodecyloxybenzoic acid and C18-ANBC.

A reversible phase transition between two different thermotropic cubic phases is observed in a mixture of two carboxylic acids. Such a transition was characterised by single-crystal X-ray diffraction and direct optical microscopy; an image of a facetted droplet just at the transition between the two phases is shown in the picture.

Effect of organic solvents in the on-line thermal lens spectrometric detection of chromium(III) and chromium(VI) after ion chromatographic separation.

The effect of methanol, acetone and acetonitrile on the sensitivity, selectivity and the detection limits (LODs) of the determination of chromium species by ion chromatography was investigated. A collinear dual-beam thermal lens spectrometer was used for the direct detection of chromium complexes [pre-column derivatized Cr(III)-pyridine-2,6-dicarboxylic acid, and post-column derivatized Cr(VI)-1,5-diphenylcarbazide] following the ion chromatographic separation on a Dionex HPIC-CS5A solvent compatible column. Different amounts of organic solvents were added directly to the eluent (up to 30%) and to the post-column reagent (up to 60%) to improve the thermooptical properties of the solvents. Consequently, the sensitivity of the technique was increased by a factor of 2-3 and LODs of 0.1 and 10 microg dm(-3) were achieved for Cr(VI) and Cr(III), respectively, when the eluent reaching the detector contained 30% of acetonitrile. The addition of organic solvents also resulted in significant changes in retention times, which improved the Cr(III)/Cr(VI) separation.

Original magnetic alignment of a nematic phase containing single-walled nanotubes.

Dispersions of single-walled carbon nanotubes in a 4-pentyl-4'-cyano-biphenyl nematic liquid crystal matrix are studied by X-ray scattering. For some mixtures, the addition of nanotubes strongly modifies the properties of the matrix: under a magnetic field, the nematic director is aligned perpendicular to the field, whereas it is parallel to it for pure 4-pentyl-4'-cyano-biphenyl. This original modification of liquid crystal alignment by the addition of nanotubes raises new questions about nanotubes and liquid crystal interactions.

Wet mineralization of organic matrices in glassy carbon vessels in a pressure-bomb system for trace element analysis.

Glassy carbon (Sigradur G(R)) is thermally stable up to 600 degrees under atmospheric conditions and has proved to be substantially resistant to many decomposition agents at temperatures up to 250 degrees . It can, therefore, substitute for PTFE vessels in a pressure-bomb device for the wet decomposition of organic and inorganic substances with, e.g., nitric, chloric or hydrofluoric acid or mixtures thereof, in the determination of trace elements. The mineralization can be carried out at temperatures up to 50 degrees higher than with PTFE vessels, which are limited to a maximum of 170 degrees . The higher decomposition temperature, which results in a higher oxidation potential, considerably shortens the decomposition time. On account of the lower content of impurities, particularly of Hg, Ag, Bi, Cd, Se, Te and Sb, the results are more accurate than those obtained with PTFE vessels, if these elements are to be determined in the ng/g range in the resulting solution.

Determination of aldehydes and ketones in air samples using cryotrapping sampling.

A cryotrapping sampling technique using glass traps cooled in liquid nitrogen for monitoring carbonyl compounds in air has been developed. Sampling was followed by derivatization by addition of acidified 2,4-dinitrophenyl hydrazine (DNPH) solution to the traps and an aliquot of the sample was analysed with a high performance liquid chromatograph system (HPLC), equipped with a diode array detector. The procedure was optimised concerning derivatization conditions and analytical parameters on formaldehyde, acetaldehyde, propanal, acetone, butanal and benzaldehyde. The technique was applied in monitoring their concentration in the urban atmosphere in Ljubljana.

Development and optimization of the drug release determination of iron from iron prolonged release tablets.

The aim of this research was to develop and optimize the drug release determination of iron from iron prolonged release tablets. First, solubility characteristics of ferrous sulfate in different aqueous media with a pH in the range of 1 to 8 were studied. According to the results obtained different physicochemical conditions that influence drug release of iron from iron prolonged release tablets were checked. Various aqueous media with a pH in the range of 1 to 7.4, different volumes of dissolution media, various rotation speeds of stirring elements, different dissolution apparatus (apparatus 1/basket apparatus and apparatus 2/paddle apparatus according to USP/Ph. Eur.) were verified. For evaluation of dissolved iron two different methods were checked: atomic absorption spectrometry and redox titration. Redox titration was proved to be a reproducible, discriminatory, selective and cost effective method for evaluation of dissolved iron from iron prolonged release tablets and can be applied in the quality control of solid dosage forms containing iron compounds.

[Continuous cultivation of hydrogen bacteria with multiple use of the medium]. / Nepreryvnoe kul'tivirovanie vodorodnykh bakterii s mnogokratnym ispol'zovaniem sredy

The possibility of continuous cultivation of hydrogen bacteria was studied in the conditions of recirculation of the medium. The hydrogen bacteria accumulated proteins, carbohydrates, lipids, organic and amino acids in the medium during its multiple reutilization, which however had no effect on the specific growth rate and the ability of the bactetia to oxidize molecular hydrogen.

Acute shift in immune response to microbial activators in very-low-birth-weight infants.

Investigation of lymphocyte activation in vitro to microbial pathogens was undertaken in very-low-birth-weight infants during the first 2 weeks of life. Twenty-three infants with birth weights less than 1500 g were studied on day 1. Normal adults (n = 23) and cord blood from seven full-term infants were used as controls. Longitudinal studies were also carried out on seven of the 23 infants 2 weeks following delivery. Results indicated that lymphocyte responses of very-low-birth-weight infants on day 1 of life were significantly greater than those of both adult controls and full-term infants, particularly to Haemophilus influenzae, Staphylococcus epidermidis and Staphylococcal protein A. In contrast, response to the T cell mitogen phytohaemagglutinin (PHA) was significantly less in very-low-birth-weight infants than in adult controls and full-term infants. The seven very-low-birth-weight infants studied showed a down-regulation of immune response in the 2 weeks following birth, such that responses on day 14 were significantly less than those on day 1 for the same activators. This shift in immune response appears to have important implications for the immune development and host defence in the post-natal period.

New investigation on the tetragonal liquid-crystalline phase or SmQ.

Chiral liquid crystals, for which twist and smectic order strongly compete, can exhibit complex architectures. This is the case of the SmQ phase which shows a high degree of 3D order (tetragonal or hexagonal) as well as a liquid signature. We have combined X-ray scattering and optical observations on a new compound exhibiting a SmQ phase to discriminate between the two models proposed by A.M. Levelut et al. (J. Phys. II 7, 981 (1997)) at the molecular level for the phase with the I4(1)22 space group.