Reconstruction of postexcisional defects for periocular giant carcinoma

Clinic of Plastic and Reconstructive Microsurgery, St. Spiridon Emergency Hospital, Iasi, Romania, Grigore T. Popa University of Medicine and Pharmacy, Iasi, RomaniaIntroduction. The giant basal cell carcinoma is a rare skin malignity, representing only 1% of the basal cell carcinomas. The giant type is defined as the lesion which exceeds 5 cm in diameter. The disease is reported generally in persons in their seventh decade of life, patients with various other pathologies. The excisions within oncological limit lead to large soft tissue defects which, if localized at the periocular region, become a real challenge for the surgeon that has to choose a surgical technique for the reconstruction. Aim of the study. To show some technical solutions to cover soft tissue defects from the periocular level left after excision for giant carcinomas and their results. Materials and methods. The study includes 9 patients, 8 male and one woman, age between 60 to 85 years, with a history of carcinomatous lesions in evolution from 7 to 12 years. All the lesions have dimensions between 5 and 7.5 cm, located in four cases in the external angle of the right eye,two at the upper eyelid and the external angle of the left eye, and, in one case, in theglabellar region with extension at both eyes. In all of the 8 cases the intervention consisted in complete excision (with oncological limit restriction) and covering with regional flaps (in 3 cases Mustarde flap, in 3 cases association of frontal flaps and in 3 cases genian advancement flap, from witch, one anchored in the zygomatic bone). All the reconstructive surgical interventions were performed in one operatory time, only in two cases it was necessary the reintervention after three months for the sectioning of the conjunctival flap (for the eyeprotection). In all 8 cases the nodular form of the basal cell carcinoma was observed. Results. The immediate postoperative evolution was good, without flap vascularisation problems. Long term evolution was good, with full reintegration of the flaps and a pleasant esthetic result. No recurrences were registered 18 months after the intervention. Conclusions. The giant basal cell carcinoma, a rare form of disease, is most often diagnosed at advanced ages. On the face, excision determines the presence of large soft tissue defect. Sometimes the reconstruction represented a real challenge for the surgeon

MANAGEMENTUL HIPERTENSIUNII ARTERIALE LA ADULTII CU DIABET ZAHARAT SI BOALA CRONICA DE RINICHI

Blood pressure (BP) level is a major determinant of cardiovascular morbidity and mortality in individuals with diabetes mellitus. Hypertension and diabetes mellitus are the most common causes of end stage renal disease. Blood pressure goals in patients with diabetic kidney disease areNivelul tensiunii arteriale este un determinant major pentru morbiditatea si mortalitatea cardiovasculara la indivizii cu diabet zaharat. Hipertensiunea si diabetul zaharat sunt cele mai frecvente cauze de boala renala in stadiul final.Tinta valorii tensiunii arteriale la pacientii diabetici cu boala renala est

CORELATIONS BETWEEN THE CLINICAL AND MORFOLOGICAL ASPECTS AND THE MOLECULAR MARKERS IN THE MALIGNANT TRANSFORMATION OF THE ORAL LEUKOPLAKIAS

The leukoplakia injuries represent the most frequent premalignant oral injuries. Their clinical and histopathological features are not always significant for the malignant transformation and, implicitly, for their diagnosis. The important progress achieved in the last three decades for the understanding of the cellular and molecular mechanisms of the leukoplakia lesions have not managed to significantly reduce the prevalence of the oral squamouscellular carcinomas. Therefore, it is necessary the identification and the characterization of the molecular markers which, together with the clinical and morphological aspects, can improve the management of these lesions

IgG,kappa monoclonal gammopathy of unknown significance with AL amyloidosis simulating giant cell arteritis

Monoclonal gammopathies complicated by AL amyloidosis can mimic giant cell arteritis (GCA). We hereby present the case of a 63 year old woman in whom symptoms consistent with GCA were the first manifestations of a monoclonal gammopathy of unknown significance (MGUS) associated with amyloidosis. A 63 year old woman was admitted for temporal headache, maseterine claudication, neck and shoulder stiffness. She was recently diagnosed with carpal tunnel syndrome. On physical examination she had prominent temporal arteries, macroglosia and orthostatic hypotension. Muscular strength was normal. She had high ESR and CRP; in this clinical context, GCA was suspected. A gamma spike on serum protein electrophoresis raised the suspicion of monoclonal gammopathy (MG). Immunoelectrophoresis revealed monoclonal bands for IgG and kappa chains. Massive deposits of amyloid and no inflammation were found on temporal artery biopsy. Multiple myeloma and lymphoma were ruled out. A diagnosis of AL amyloidosis complicating MGUS was formulated. She did well on therapy with bortezomib, cyclophosphamide and dexamethasone. Cases published in medical literature reveal amyloidosis mimicking GCA in the setting of established MGUS. As far as we know, this is the first case of MGUS with IgG and kappa chains in which a GCA-like picture induced by amyloidosis was present from the very onset

VARIABILITY OF TRAITS OF GROWTH - IN VIVO AND IN VITRO - ON GREENHOUSE CARNATION

Several traits of growth on greenhouse carnation were analysed at seven varieties, growing both in vivo and in vitro. In vitro culture, proliferation and root formation were more intense in Pink Sol, Caribe and Tanga than in Pink Sim, Obor and Domingo cultivars. The highest intervarietal variability, under in vivo conditions, was recorded for the number of flowers per plant and number of petals per flower, while in vitro all analysed characters showed an extremely large span of variability values (s% = 26.5 - 109.1). The heritability in broad sense showed high values for the analysed characters, both in vivo (H2 = 0.548 - 0.992) and in vitro (H2 = 0.688 -0.953) conditions. There has been noted a tight positive and negative correlation among a lot of the traits of plants, both in vivo and in vitro. Correlations among the desirable traits can be used as selection indices, in carnation breeding

Chitosan-Based Bactericidal Interpenetrated Hydrogels

Bactericidal interpenetrated hydrogels have become a popular topic in recent years due to their unique properties, with potential applications in wound-healing devices [...

Urologic Cancer Molecular Biology

An adequate understanding of the molecular mechanisms of the most common urological cancers is necessary for a correct approach to diagnosis, precise treatment, but also for the follow-up of these patients. It is necessary to understand the molecular mechanisms underlying the carcinogenic processes, the molecular pathways involved in this process, and also to describe the biomarkers useful for diagnosis but also for predictability, treatment, and natural history. In addition, it would be useful to describe a list of useful molecules currently under investigation as possible biomarkers to improve the income of cancer patients

PERIODONTAL DISEASE AND COMPLICATIONS IN THE CONTEXT OF THE COVID-19 PANDEMIC. INACTIVATION OF PATHOGENS AT THE LEVEL OF A DENTAL OFFICE IN THE CONTEXT OF THE PANDEMIC. REVIEW.

When a disease is new to humans, only very few people are immune to it. In such cases, there is no vaccine and the result can be a rapid increase in the incidence of the disease. How dangerous or deadly that disease is – it all depends on the specific virus in question and the general state of health of each individual patient. If a disease does not only spread regionally but ends up affecting entire countries and continents, then experts speak of a pandemic. Periodontal disease is a bacterial infection that causes inflammation of the supporting tissues of the tooth. Experts say that there is a dangerous link between this and the COVID-19 infection, which leads to hospitalization or even admission to intensive care, periodontal disease can lead to complications of Covid-19. The association between coronavirus disease 2019 infection and periodontitis has also been investigated in the retrospective studies. In the current context we have solutions to eradicate already known pathogens, but new pathogens or changes to existing ones occur that require time and research to find a solution

EFFICIENCY OF DISINFECTION AND STERILIZATION IN DENTAL MEDICINE PRACTICE. REVIEW.

Medical devices that come into contact with sterile tissues or body fluids are considered critical items. In dentistry, conventional manual decontamination of medical device surfaces is used, and this requires a two-step procedure that includes rehydration of the surface followed by decontamination, for effective inactivation of bacteria and viruses on dry surfaces The most effective decontamination agents are ethanol in high concentration while sodium hypochlorite and hydrogen peroxide require a minimum concentration to be effective with little impact on human health. The bactericidal action of quaternaries has been attributed to inactivation of energy-producing enzymes, denaturation of essential cellular proteins, and disruption of the cell membrane. Sterilization destroys all microorganisms on the surface of an item or in a fluid to prevent the transmission of diseases associated with the use of that item Most medical and surgical devices used in medical facilities are made of materials that are heat stable and therefore undergo high temperature sterilization, primarily with steam

Expression of β-Defensin-1 and 2 in HPV-Induced Epithelial Lesions

α, β, θ defensins represent a family of small antimicrobial peptides expressed predominantly by a series of cells, including neutrophils, monocytes-macrophages and epithelial cells that are involved in defense mechanisms against viral infections. β-defensins are the most widespread in this family being encountered in oral, digestive, urogenital mucosa and cutaneous lesions. β-defensins directly inactivate certain viruses, including the human papillomavirus(HPV) suppressing viral replication by altering target cells. Considering these aspects, we investigated the immunohistochemical expression of β-defensin-1 and 2 in HPV-induced epithelial lesions. For this study, tumoral and normal mucosal tissue fragments were collected from 10 patients aged between 31-60years, with previously confirmed HPV infection, diagnosed clinically and histopathologically with cervical carcinoma. Patients did not receive any chemotherapy or radiotherapy before the biopsy procedure. The tissue fragments were processed by the standard immunohistochemistry technique using anti-β-defensin-1 and 2 antibodies(Bioss Antibodies). The samples examination revealed weak positive(+) membrane, cytoplasmic and nuclear IR for hβD-1 in basal layer of normal cervical mucosa and moderate positive(++) membrane and cytoplasmic IR in squamous epithelium. For dysplastic HPV-associated tissues we highlighted a nuclear moderate positive(++) IR.For hβD-2, IR in basal layer of the normal mucosa was lower(+) compared with dysplastic cells IR and showed a strong expression(+++) at membrane, cytoplasmic and nuclear level in koilocytes of patients with HPV-associated dysplasia. It was also observed a moderate positive (++) IR in basal layer of dysplastic cells of patients without HPV. The obtained results are in agreement with some literature data, which highlighted the fact that hβD-1 and hβD-2 are very important components of the molecular pattern in HPV-induced lesions