Buschke-Lowenstein tumor: Use of dermal matrix for reconstruction of genital area

none8noBuschke-Lowenstein tumor (BLT) is a rare giant condyloma acuminatum of the anogenital region, first described by Buschke and Lowenstein as a potential malignant condyloma acuminatum. A 64-year-old Moroccan man was referred to our dermatology department with a 10-year-history of a growing mass in the genital region. A diagnosis of giant condyloma acuminatum was made based on clinical and histopathological features. We opted for a two-stage surgical procedure. The first stage consisted in tumor removal with clinically safe margins and positioning of an Integra® Matrix Wound Dressing. After 3 weeks the silicone top layer was removed and a thin split-thickness skin graft was applied.At the 1 year follow-up, the patient still presented an adequate reconstruction of the area and an acceptable cosmesis, without any complication or signs of recurrences.noneCondorelli A.G.; Ferrari B.; Francomano M.; Rocco B.; Sighinolfi M.C.; Giacomelli L.; Pignatti M.; Magnoni C.Condorelli A.G.; Ferrari B.; Francomano M.; Rocco B.; Sighinolfi M.C.; Giacomelli L.; Pignatti M.; Magnoni C

First cases of combined full robotic partial nephrectomy and colorectal resections: Results and new perspectives

Background: Nowadays the robotic platform is widespread in general surgery, urology, and gynecology. Combined surgery may represent an alternative to sequential procedures and it allows the treatment, at the same time, of coexisting lesions; in this perspective, full-robotic multiorgan surgery is starting to gain interest from surgeons worldwide. Methods: Between April and June 2019, two patients presenting with synchronous colorectal and kidney cancers underwent, respectively, full-robotic right colectomy with right partial nephrectomy and anterior rectal resection with left partial nephrectomy. Surgeries were performed by both the general surgery and urology team. Results: No intraoperative complications were registered and the postoperative course was uneventful in both cases. Conclusions: Combined multiple organ surgery with full robotic technique is safe and offers oncological adequate results. A multi-team surgical pre-planning is mandatory to reduce invasiveness and operative time. To the best of our knowledge, these are the first reports of full robotic partial nephrectomy combined with colorectal procedures

Use of Neem oil and Hypericum perforatum for treatment of calcinosis-related skin ulcers in systemic sclerosis

Objective: This study evaluated Neem oil and Hypericum perforatum (Holoil®) for treatment of scleroderma skin ulcers related to calcinosis (SU-calc). Procedure: We retrospectively analyzed 21 consecutive systemic sclerosis (SSc) patients with a total of 33 SU-calcs treated daily with Holoil® cream compared with a control group of 20 patients with 26 SU-calcs. Holoil® was directly applied to skin lesions, while the control group received only standard medication. Results: Application of Holoil® either resulted in crushing and complete resolution of calcium deposits or facilitated sharp excision of calcinosis during wound care sessions in 27/33 cases (81.8%). Complete healing of SU-calc occurred in 15/33 (45%) of cases within a time period of 40.1 ± 16.3 (mean ± SD) days, while 18/33 (55%) of lesions improved in terms of size, erythema, fibrin and calcium deposits. Patients reported a reduction of pain (mean numeric rating scale 7.3 ± 1.9 at baseline versus 2.9 ± 1.4 at follow-up) The control group had longer healing times and a higher percentage of infections. Conclusions: The efficacy of local treatment with neem oil and Hypericum perforatum suggest that Holoil® could be a promising tool in the management of SSc SU-calc

HHV-6A infection and systemic sclerosis: Clues of a possible association

Systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy, excessive extracellular matrix deposition, and fibrosis of the skin and internal organs. Several infectious agents, including human herpesvirus-6 (HHV-6), have been suggested as possible triggering factors, but a direct association is still missing. We characterized 26 SSc patients for the presence of HHV-6 in tissues and blood, the anti-HHV-6 response, HLA-G plasma levels, and KIR typing. Given the prominent role of endothelial cells (EC) in SSc pathogenesis, along with HHV-6 tropism for EC, we also investigated the expression of pro-fibrosis factors in HHV-6 infected EC. Results showed the presence of HHV-6A in skin biopsies, and an increased virus load was associated with disease severity and poor natural killer (NK) response against the virus, particularly in subjects exhibiting a KIR2 phenotype. HLA-G plasma levels were significantly higher in HHV- 6A/B-KIR2 positive SSc patients and in vitro HHV-6A infection-induced pro-fibrosis factors expression in EC, supporting its role in the development of the fibrosing process. Our data suggest an association between virus infection/reactivation and disease, opening the way to future studies to understand the mechanisms by which HHV-6A might contribute to the multifactorial pathogenesis of SSc

Analytical Concentrations of Some Elements in Seeds and Crude Extracts from Aesculus hippocastanum, by ICP-OES Technique

The metal content in some samples of horse chestnut seeds (Aesculus hippocastanum) was monitored over time (years 2016, 2017, 2018, 2019) considering the two most common and representative Mediterranean varieties: the pure species (AHP, which gives white flowers) and a hybrid one (AHH, which gives pink flowers). The selected elemental composition of the samples was determined by applying the ICP-OES technique. Several samples obtained from different preliminary treatments of the peeled seeds were examined, such as: i) floury samples (wild type) mineralized with the wet method; ii) the ashes of both AHP and AHH varieties; iii) the fraction of total inorganic soluble salts (TISS). Furthermore, the hydroalcoholic crude extracts (as a tincture) were obtained according to the official Pharmacopoeia methods, and the relevant results were compared with those of a commercial sample, an herbal product - food supplement of similar characteristics. The main characteristics of this research work underline that the two botanical varieties give different distinctive characters, due to the Fe content (80.05 vs 1.42 mg / 100 g d.s., for AHP and AHH - wild type flour samples, respectively), along with K, Ca, Mn, Ni and Cu, which are more abundant in the AHP samples. Furthermore, the PCA analysis was applied to the experimental dataset in order to classify and discriminate the samples, in relation to their similar botanical origin, but different for the color of the bloom. These results can be useful for the traceability of raw materials potentially intended for the production of auxiliary systems of pharmacological interest.The metal content in some samples of horse chestnut seeds (Aesculus hippocastanum) was monitored over time (years 2016–2019) considering the two most common and representative Mediterranean varieties: the pure species (AHP, which gives white flowers) and a hybrid one (AHH, which gives pink flowers). The selected elemental composition of the samples was determined by applying the Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) technique. Several samples obtained from different preliminary treatments of the peeled seeds were examined, such as: (i) floury samples (wild-type) mineralized with the wet method; (ii) the ashes of both AHP and AHH varieties; (iii) the fraction of total inorganic soluble salts (TISS). Furthermore, the hydroalcoholic crude extracts (as a tincture) were obtained according to the official Pharmacopoeia methods, and the relevant results were compared with those of a commercial sample, an herbal product-food supplement of similar characteristics. The main characteristics of this research work underline that the two botanical varieties give different distinctive characters, due to the Fe content (80.05 vs. 1.42 mg/100 g d.s., for AHP and AHH wild-type flour samples, respectively), along with K, Ca, Mn, Ni and Cu, which are more abundant in the AHP samples. Furthermore, the Principal Component Analysis (PCA) was applied to the experimental dataset in order to classify and discriminate the samples, in relation to their similar botanical origin, but different for the color of the bloom. These results can be useful for the traceability of raw materials potentially intended for the production of auxiliary systems of pharmacological interest