Primary dermal melanoma in a patient with a history of multiple malignancies: a case report with molecular characterization

Introduction: Primary dermal melanoma (PDM) is a recently described clinical entity accounting for less than 1% of all melanomas. Histologically, it is located in the dermis or subcutaneous tissue, and it shows no connections with the overlying epidermis. The differential diagnosis is principally made along with that of metastatic cutaneous melanoma. Case Report: A 72-year-old Caucasian woman with a history of multiple cancers (metachro-nous bilateral breast cancer, meningioma, clear cell renal cell carcinoma, uterine fibromatosis and intestinal adenomatous polyposis), came to our attention with a nodular lesion on her back. After removal of the lesion, the histology report indicated malignant PDM or metastatic malignant melanoma. The clinical and instrumental evaluation of the patient did not reveal any other primary tumour, suggesting the primitive nature of the lesion. The absence of an epithelial component argued for a histological diagnosis of PDM. Subsequently, the patient underwent a wide surgical excision with sentinel node biopsy, which was positive for metastatic melanoma. Finally, the mutational status was studied in the main genes that regulate proliferation, apoptosis and cellular senescence. No pathogenetic mutations in CDKN2A, BRAF, NRAS, KRAS, cKIT, TP53 and PTEN genes were observed. This suggests that alternative pathways and low-frequency alterations may be involved. Conclusions: The differential diagnosis between PDM and isolated metastatic melanoma depends on the negativity of imaging studies and clinical findings for other primary lesions. This distinction is important because 5-year survival rates in such cases are higher than in metastatic cases (80– 100 vs. 5–20%, respectively)

Safe and Effective Augmentation Mastopexy with Tumescent Local Anesthesia: A Decade of Experience

Background: Tumescent local anesthesia (TLA) is widely used in esthetic surgery due to its ability to reduce complications, eliminate the need for general anesthesia, provide effective pain control, and shorten hospitalization times. Methods: This study evaluates the use of TLA in 80 patients who underwent augmentation mastopexy between 2010 and 2022. A tumescent solution containing 500 mg lidocaine, 672 mg sodium bicarbonate, and 1 mg epinephrine in 1000 mL of saline was infiltrated, with an average of 300 mL per breast. The surgical technique involved creating a subpectoral pocket for textured round implants (250–400 cc), followed by careful hemostasis. Results: No patients required conversion to general anesthesia, and there were no signs of toxicity or major complications. Minor complications included wound dehiscence (6.2%), hematoma (2.5%), and capsular contracture (2.5%). Pain management satisfaction at 3 months post-surgery was rated as “outstanding” by 12.5% of patients, “excellent” by 67.5%, and “good” by 20%. The longest follow-up was 6 years, with no implant ruptures except one (1.2%). Conclusions: While the study did not include a control group or statistical analysis, the findings suggest that TLA is a safe and effective alternative to general anesthesia for augmentation mastopexy, providing excellent pain control and a low rate of complications. © 2024 by the authors

Osservazioni sul nevo sebaceo di Jadassohn

Scopo del lavoro è illustrare la clinica, l'istologia e l'innovativa terapia ricostruttiva mediante skin expander del nevo di Jadassoh

RF-powered UHF-RFID analog sensors platform

An RF powered UHF-RFID passive sensors platform was realized using discrete components and printed antennas designed to resonate at 868 MHz, used both for energy harvesting and data transmission. The tests demonstrate the possibility for the system to operate autonomously within the reading range of a standard RFID reader, that acts both as the RF power source and the receiver of the data stored in the tag user memory. The microcontroller can be interfaced on the same substrate with a sensor made of polymeric materials, sensible to physical parameters or chemical agents. RF-powered UHF-RFID analog sensors platform (PDF Download Available). Available from: http://www.researchgate.net/publication/279193365_RF-powered_UHF-RFID_analog_sensors_platform [accessed Sep 14, 2015]

Infections in breast implants: a review with a focus on developing Countries

The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extended-spectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution

SEM low vacuum study of fat transfer Coleman’s technique: effect of centrifugation and sedimentation on adipocyte morphology

Introduction. The concept of beauty has always been important for man, if we think that cosmetics existed in ancient times and the body care had a crucial role. Among various techniques to repair physical defects exist lipofilling, that is an explant of fat tissue from a part of body and the implant in other areas; however, autologous fat graft is not very simple and often it causes damages to the cells. The procedure used is Coleman’s technique and, in literature, we find many variations of this method to overcome its limitations such as reabsorption of the implanted cells, formation of oil cysts and fibrous tissue. Today, there are some works that study what kind of modifications we can find utilizing Coleman’s technique but no one of these analyses with SEM the alterations that may suffer the fat. Therefore, our work is to evaluate changes induced by this procedure and to validate SEM for analyses of the tissue explanted. Materials and Methods. From 10 clinical surgeries of lipofilling we used: a) fragments of adipose tissue taken with Coleman’s technique. These fragments were divided in: untreated specimen, sedimented specimen for 15 minutes and centrifuged specimen at 1500 rpm for 3 minutes. Purpose of sedimentation and centrifugation was to remove blood and tryglicerides released by adipocytes during explants; b) a biopsy specimen of adipose tissue taken from the site of graft, as a control. Each fat graft specimen was freshly washed in PBS, fixed in glutaraldehyde and osmium tetroxide and observed at SEM FEI Quanta 200 in low vacuum. Results. The technique of lipofilling we studied causes different types of damage on the adipocytes during liposuction. The modifications we observed compared to control are: presence of oily surface veil, above all detectable in sedimented specimens and in centrifuged specimens; a reduction of the numbers of adipose cells up to 50% and an augmentation of damages to cell membrane about in 20% of adipocytes of centrifuged fragments. There aren’t differences of diameter of the cells after sedimentation and centrifugation. In the three observed specimens about a 90% of adipose cells with a normal structure without changements of volume and a 10-20% of altered cells was found. Conclusions. We can say that adipose tissue during fat graft has some modifications mainly due to the technique utilized. It justifies the higher engraftment of sedimented specimens compared to those centrifuged. We can say also that SEM in low vacuum can be easily applied to study new methods of lipofilling to improve Coleman’s technique

Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: A Time and Cost Analysis

Background- Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure. Methods- Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat. Results- In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system. Conclusion- Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively

T cell activation induces CuZn Superoxide Dismutase (SOD)-1) intracellular re-localization, production and secretion

Reactive Oxygen Species (ROS) behave as second messengers in signal transduction for a series of receptor/ligand interactions. A major regulatory role is played by hydrogen peroxide (H2O2), more stable and able to freely diffuse through cell membranes. CuZn Superoxide dismutase (SOD)-1 is a cytosolic enzyme involved in scavenging oxygen radicals to H2O2 and molecular oxygen, thus representing a major cytosolic source of peroxides. Previous studies suggested that superoxide anion and H2O2 generation are involved in T Cell Receptor (TCR)-dependent signaling. Here, we describe that antigen-dependent activation of human T lymphocytes significantly increased extracellular SOD-1 levels in lymphocyte cultures. This effect was accompanied by the synthesis of SOD-1-specific mRNA and by the induction of microvesicle SOD-1 secretion. It is of note that SOD-1 increased its concentration specifically in T cell population, while no significant changes were observed in the “non T” cell counterpart. Moreover, confocal microscopy showed that antigen-dependent activation was able to modify SOD-1 intracellular localization in T cells. Indeed, was observed a clear SOD-1 recruitment by TCR clusters. The ROS scavenger N-acetylcysteine (NAC) inhibited this phenomenon. Further studies are needed to define whether SOD-1-dependent superoxide/peroxide balance is relevant for regulation of T cell activation, as well as in the functional cross talk between immune effectors