Gracilis myocutaneous flap for perineal defect reconstruction after left hemivulvectomy for locally invasive vulvar cancer – A case report and a literature review

Performing radical surgery for locally advanced vulvar cancer is usually associated with the occurrence of large perineal defects. In order to provide a better healing process of the perineal wound, different reconstructive techniques have been proposed. We present the case of a 63-year-old female patient diagnosed with locally advanced vulvar cancer for which a left hemivulvectomy with bilateral inguinal lymph node dissection was performed. After completion of the resection phase, the reconstruction with gracilis myocutaneous flap was performed. The patient developed a non-union of the flap. However, it slowly healed without any surgical re-intervention. Gracilis myocutaneous flap seems to be an effective and feasible method of perineal reconstruction after extended perineal resection for gynecological malignancies, including vulvar cancer. The method appears effective even in pre-irradiated patients with larger perineal wounds resulting after total pelvic exenteration for locally advanced gynecological malignancies

John Donoghue, Fire under the Ashes: An Atlantic History of the English Revolution. Maggi M. Morehouse and Zoe Trodd, eds. Civil War America: A Social and Cultural History.

John Donoghue’s excellent book is transatlantic history at its best: The author gives a gripping account of the political, economic, social, and religious dimensions of the English Revolution in virtually all parts of the English Atlantic world between c. 1619 and 1661. Donoghue, associate professor of history at Loyola University in Chicago, takes us on a journey from Old to New England, various Caribbean archipelagos, West Africa, and back again. Building on transatlantic studies of the rev..

Multi-class region growing algorithm

An automated region growing algorithm has been adapted for multi-class segmentation. The algorithm does not need initial parameters. It automatically finds a start region which is required by each of the region growing processes performed during multi-class segmentation. A new method for finding start region is proposed. The multi-class region growing algorithm was tested on CT and MRI scans

The 40 kA dumping system for the ISR beams

It has been necessary to build a fast and reliable system which can dump the beam whenever safety monitors indicate a hardware fault or a beam loss. The beam in each ISR is dumped by means of four fast pulsed magnets deflecting the particles vertically onto an absorber block situated in the same long straight section. The 0.75 Omega , 40 kA pulse generator now energizing the four fast pulsed magnets is described with special attention to the principles and technological solutions which were adopted in order to achieve the necessary reliability of the system for each type of operation, and particularly during long colliding beam experiments. (7 refs)