Our clinical experiences in lower eyelid reconstruction

Objective: Different treatment principles have been applied in the reconstruction of partial or full layer defects of the lower eyelid. The use of the most similar tissue for eyelid reconstruction is important for both functional and esthetic results. This study aims to investigate the reconstruction methods performed in lower eyelid defects and to evaluate their esthetic and functional results. Patients and Methods: In this study, patients who underwent reconstructive surgery from 2012 to 2016 in our clinic were investigated. Cases of primary repairs after skin tumors located in the lower eyelids were excluded from the study. The sociodemographic characteristics of patients, the type and location of the tumor, defect size after surgery, anterior and posterior lamellar defects, and reconstruction methods used were retrospectively reviewed. Results: Thirty-seven patients were included in the study. Fifteen were male and 22 were female. There was only anterior lamellar defect in 29 patients and full-thickness lower eyelid defect in 8 patients. Anterior flaps used in lamellar defects were identified as glabellar flap, Limberg flap, advancement, transposition flap, nasolabial flap, forehead flap, and cheek flap. Chondromucosal graft, palatal mucosal graft, and buccal mucosal graft were used for repairing posterior lamellar defects. Conclusion: Separate reconstruction of the posterior and anterior lamellae is important to provide good functional and esthetic results in lower eyelid reconstruction. Depending on the size of the defect, using a single local flap or a combined flap with posterior lamella repair provides highly acceptable results

Measurement of epidermis, dermis, and total skin thicknesses from six different body regions with a new ethical histometric technique

Introduction: Although it is important to know the normal values of dermis, epidermis, or total skin thicknesses (ST) for some drugs and vaccine research, skin-related clinical investigations, and skin transfer operations used in plastic surgery, it would not be ethical to take new biopsies from healthy volunteers to measure their ST. This study aims to describe a new ethical histometric technique for the measurement of skin layers and to determine the mean ST of some major body regions in the people living in our region. Materials and Methods: A total of 180 skin samples from six major body regions of 90 males and 90 females were enrolled in the study. The measurements were performed histometrically from appropriate skin samples obtained from the pathology archive. The samples were classified according to the six different parts of the body (scalp, abdomen, back, dorsum of foot, dorsum of hand, and the breast). Results: The mean epidermal thickness ranged from 76.9 ± 26.2 to 267.4 ± 120.6 μm. The thickest epidermis was found in the dorsum of foot in women (267.4 ± 120.6 μm) while the thinnest was found in the breast in women (76.9 ± 26.2 μm). The mean dermal thickness ranged from 2115 ± 946.4 to 5888 ± 2422.3 μm. The thickest dermis was found in the breast in men (5888 ± 2422.3 μm), while the thinnest dermis was found in the dorsum of hand in women (2115 ± 946.4 μm). Conclusions: Human ST varies according to ethnic origin. It was determined that the dermis and epidermis of Anatolian people are thicker than that of the previously reported other ethnic groups. The skin pathology archive can be used to create maps of the body's skin structure

Direct Immunofluorescence (Dif) Microscopy In Cutanous Small Vessel Vasculitis: A Single Institution Experiences

Giriş: Küçük damar kutanöz vaskülitlerinde (KKV) direkt immunfloresanmikroskopide (DİF) immun depolanmalar (özellikleIgG, IgM, IgA ve Kompleman C3) gözlenebilir. Dünya literatüründeçeşitli pozitiflik oranları bildiren çalışmalar mevcuttur. Çalışmamızdakliniğimize ait KKV’lerinin DİF mikroskopi sonuçlarını sunmayıamaçladık. Gereç ve yöntem: Vaskülit ön tanısı ile biopsi ve DİF tetkikiyapılan, histopatolojik olarak KKV’i mevcut olan toplam 121olgu retrospektif olarak çalışmaya dahil edildi. Olgular klinik verilerive Chapel Hill Consensus Conference vaskülit sınıflaması gözönündebulundurularak toplam 6 gruba ayrıldı. Bazal membran ya da perivasküler(PV) alanda en az bir depolanma ‘DİF pozitif’ olarak kabuledildi. Tüm olgularda DİF IgG, IgM, IgA ve Compleman C3 depolanmalarınındağılımları, oranları ve gruplarda en az bir immun depozitinbulunma durumu belirlendi. Lökositoklazis bulunduran ya daeozinofil bulunduranlar ayrı grup yapılarak diğerleri ile immun depolanmalaraçısından istatistiksel olarak karşılaştırıldı. Bulgular: Tümolgularda DİF pozitifliği %58.7 (n:71/121) idi. Lökositoklastik vaskülitolgularının %50.9’unda (n:28/55), nonspesifik KV olgularının%67.4’ünde (n:31/46), ürtikeryal vaskülit olgularının %44.4(n:4/9)’ünde, livedoid vaskülit olgularının %75 (n:3/4)’inde, henochschonlein purpurası (HSP) olgularının (n:5/5) %100’ünde DİF pozitifti.2 vaskülopati olgusunda depolanma yoktu. Lökositoklazis veeozinofil mevcudiyeti ile immun depolanmalar arasında herhangi birilişki yoktu. En fazla biriken depozit C3 iken, HSP olgularında IgAdepolanma oranı %100’dü. Sonuç: KKV’lerinde gözardı edilemeyecekyüksek DİF pozitiflik oranları (özellikle C3) tespit edildi. HSPolgularında DİF ile IgA depozit tespiti tanı için oldukça önemlidir.KKV’lerde DİF tetkikinin, klinik ve histopatolojik incelemeye ekolarak uygulanması faydalı olabilir.Background: İmmun deposits (especiallyIgG, IgM, IgA and Compleman C3) can be observedunder direct immunofluorescence microscopy(DIF) in many patients with cutaneoussmall vessel vasculitis (CSV). There are somestudies reporting various positivity rates in theliterature. İn this study, we aimed to present theresults of DIF microscopy of CSV cases in ourınstitute. Materyal and Methods: A total of 121patients with CSV were included retrospectivelyin this study. All the cases have skin biopsyfor DIF and histopathological examinationand clinical data. A total of 6 groups were formedconsidering the clinical data of the casesand the Chapel Hill Consensus Conference vasculitisclassification. The accumulation of atleast one of the immun deposits (IgG, IgM, IgAve C3) in basal membrane or perivascular (PV)field was assessed as ‘DIF positive’. The relationshipbetween the presence of eosinophil andleucocytoclasia and the accumulation of immundeposits was investigated statistically. Results:DIF was positive in 58.7% (n:71/121) cases.DIF was positive in 50.9% (n: 28/55) of leukocytoclasticvasculitis cases, 67.4% (n: 31/46)of nonspecific CV cases, 44.4% (n: 4/9) of urticarialvasculitis cases and 75% of livedoid vasculitiscases (n: 3/4), 100% (n: 5/5) of henochschonlein purpura (HSP) cases. There was notany accumulation in vasculopathy cases (n:2).There was not any relationship statisticallybetween the presence of eosinophil and leucocytoclasiaand the accumulation of immundeposits. The highest immun accumulation wasC3 and the rate of IgA accumulation in HSPwas 100%. Conclusion: In CSVs, high DIF positivityrates (especially C3) were determined.The determination of IgA deposits with DIF isvery important for diagnosis of HSP. Performingof DIF in addition to clinical and histopathologicexamination may be useful in CSVs

Cerebrolysin Alleviating Effect on Glutamate-Mediated Neuroinflammation Via Glutamate Transporters and Oxidative Stress

Glutamate, one of the most important excitatory neurotransmitters, acts as a signal transducer in peripheral tissues and endocrine cells. Excessive glutamate secretion has been shown to cause excitotoxicity and neurodegenerative disease. Cerebrolysin is a mixture of enzymatically treated peptides derived from pig brain including neurotrophic factors, like brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), and ciliary neurotrophic factor (CNTF). The present study investigated the protective effects of cerebrolysin on glutamate transporters (EAAT 1, EAAT 2) and cytokines (IL-1 beta and IL-10) activity in glutamate-mediated neurotoxicity. Primary cortex neuron culture was exposed to glutamate and successively treated with various cerebrolysin concentrations for 24 and 48 h. Our data showed that cerebrolysin primarily protects neurons by decreasing glutamate concentration in the synaptic cleft. In addition, Cerebrolysin can decrease oxidative stress and neuron cell damage by increasing antioxidant activity and decreasing inflammation cytokine levels