摘要:

&NA;The molecular basis of enhanced ischemic tissue survival in flaps preconditioned by surgical delay is poorly understood. Because elevated expression of so‐called heat shock or stress proteins has been shown to protect tissues/organs against ischemic injury, the authors examined whether the levels of the most highly induced stress protein—hsp72—were elevated in delayed muscle flaps using a rat muscle flap model. Bilateral latissimus dorsi muscle flaps based on the thoracodorsal vessels were elevated in 16 male Sprague‐Dawley rats. For each animal, one side was selected randomly to undergo preconditioning by surgical delay for a 7‐day period prior to elevation. Delay was accomplished by preserving the thoracodorsal pedicle and a single large distal intercostal perforating vessel. After bilateral flap elevation, latissimus dorsi tissue was harvested from proximal, central, and distal flap segments 0, 1, 3, and 7 days postoperatively (N = 4 for each group), and was analyzed for the expression of hsp72 via Western blot analysis. At the time of harvest, flap viability was assessed by staining with nitroblue tetrazolium. Flap perfusion was measured prior to muscle elevation and harvest using laser Doppler flowmetry. The results demonstrate that delayed muscle flaps had significantly greater total perfusion (p< 0.05) and survival (p< 0.03) 1, 3, and 7 days after elevation compared with the acutely elevated control tissue. Western blot analysis revealed that tissues harvested from the delayed flaps expressed substantially higher levels of hsp72 compared with the acutely elevated control samples. Segmental analysis also revealed a proximal > middle > distal expression of hsp72 in the delayed flaps (p< 0.05). Flap preconditioning by surgical delay increases the expression of hsp72. Moreover, regional differences in hsp72 gene expression are associated with differences in perfusion and survival of delayed muscle flaps. These results indicate that hsp72 may play a substantial role in mediating the delay phenomenon.Fan LK, Wang C, Hansen W, Welch WJ, Lee C. Hsp72 induction: a potential molecular mediator of the delay phenomenon. Ann Plast Surg 2000;44: 65‐71

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Lymphangiosarcoma (LAS) is an aggressive, malignant vascular tumor following long‐lasting chronic lymphedema. Patients with LAS demonstrate a history of breast cancer treated by radical mastectomy in the majority of patients. In the 1960s the incidence of LAS in patients with a 5‐year survival after radical mastectomy varied from 0.07 to 0.45%. Today, due to changes in the operative techniques of breast cancer, less chronic lymphedema is seen with only a scant number of LAS patients. The etiology of this enigmatic tumor is not yet completely understood. Histologically, LAS arises from vascular endotheliocytes, and all vascular sarcomas originating in the setting of a chronic lymphedema are categorized as LAS. There is no standard treatment of LAS. The treatment options include radical ablative surgery, radiation therapy, and chemotherapy. The prognosis of LAS is poor; long‐term survival is the exception. Only early recognition and radical surgery offer a chance of cure.Heitmann C, Ingianni G. Stewart‐Treves syndrome: lymphangiosarcoma following mastectomy. Ann Plast Surg 2000;44:72‐75

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;A rare case of congenital midline sinus of the upper lip is presented. The patient had recurrent cellulitis with swelling at the base of the medial crus of the right lower lateral cartilage. Excision was performed using the intraoral approach. Theories concerning the etiology of the midline sinus of the upper lip are discussed.Al‐Qattan MM. Congenital midline sinus of the upper lip. Ann Plast Surg 2000;44:76‐78

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;A 36‐year‐old man sustained a thrombosis of the radial artery at the wrist while performing bench presses. Surgical exploration six weeks later demonstrated a 7‐cm segmental thrombosis that was successfully bypassed with a reversed vein graft. The patient returned to full work duty without symptoms.Isenberg JS. Spontaneous exercise‐induced thrombosis of the radial artery: a case report and literature review. Ann Plast Surg 2000;44:79‐81

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Keratoacanthoma is a common, benign cutaneous neoplasm that displays rapid growth on sun‐exposed skin. Keratoacanthomas usually involute spontaneously after several months but rarely progress to squamous cell carcinoma. Because this is a benign, self‐limited lesion of exposed skin, effective treatment should emphasize patient comfort and cosmetic results in addition to effectiveness. The authors present 2 patients with keratoacanthomas treated with topical 5‐fluorouracil. Both patients had complete resolution of their lesions within 8 weeks. The cosmetic result was superb in both patients. Patient satisfaction with this therapy was excellent. Treatment can be instituted based on a clinical diagnosis; no diagnostic biopsy is necessary. Most keratoacanthomas respond to topical 5‐fluorouracil therapy within 3 weeks, whereas squamous cell carcinomas respond poorly. Any lesion that shows a poor response after 3 weeks of therapy or that does not resolve within 8 weeks should undergo prompt excisional biopsy for definitive diagnosis and treatment. Topical 5‐fluorouracil is an effective, convenient, relatively inexpensive treatment for keratoacanthoma that produces excellent cosmetic results. It should be added to the therapeutic armamentarium of all physicians who treat keratoacanthoma.Gray RJ, Meland NB. Topical 5‐fluorouracil as primary therapy for keratoacanthoma. Ann Plast Surg 2000;44:82‐85

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;A case of basal carcinoma metastatic to the spine is presented. A review of the literature revealed 14 similar cases.Kogan L, Ariely D, Pizov G, Wexler MR. Metastatic spinal basal cell carcinoma: a case report and literature review. Ann Plast Surg 2000;44: 86‐88

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;The relevance of psychological issues in cosmetic surgery has been well established in the literature. Early articles considered psychopathology to be prevalent in the plastic surgery population, whereas more recent views consider the typical cosmetic surgery candidate to be more psychologically stable. Despite these changes, the potential for psychopathology continues to be recognized. Consequently, screening for psychopathology during the preoperative interview has remained essential. To facilitate a working knowledge of psychological issues that may be useful in preoperative screening, this article reviews the current literature on the psychology of plastic surgery. In addition to discussing the psychological impact of cosmetic surgery, patient's motivations and expectations for surgery are discussed in the context of self‐image. After reviewing potential types of psychopathology, various preoperative screening techniques are discussed.Hasan JS. Psychological issues in cosmetic surgery: a functional overview. Ann Plast Surg 2000;44:89‐96

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Plastic surgeons are often confronted with psychiatric patients seeking aesthetic surgery. It is imperative for surgeons to recognize underlying psychiatric illnesses and to acknowledge their influence over patient motives and judgment. It is the goal of this paper to present the defining characteristics of the major psychiatric disorders as illustrated in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, in a manner that will allow plastic surgeons to incorporate and utilize this information in daily practice. It is the authors' hope that this paper will assist plastic surgeons in ultimately preventing patient dissatisfaction within the population of patients with psychiatric disorders.Mowlavi A, Lille S, Andrews K, Yashar S, Schoeller T, Weschelberger G, Anderson R. Psychiatric patients who desire aesthetic surgery: identifying the problem patient. Ann Plast Surg 2000;44:97‐106

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:2000

数据来源: OVID