Arterial fasciocutaneous vascular territories of the lower leg

The purpose of this study was to analyze the fasciocutaneous arterial circulation of the lower extremity to provide a quantitative guide to design reliable fasciocutaneous flaps. Thirty-one fresh cadaver limbs were studied using the techniques of dissection of latex injected specimens, selective ink injections, and barium latex radiographs. Fasciocutaneous perforator locations were recorded according to fascial septum of origin and distance relative to bony landmarks between the knee and the ankle. Selective ink injections of the trifurcation vessels identified four anterior tibial, three peroneal, and three posterior tibial fasciocutaneous territories. Although perforator site locations were randomly distributed along the trifurcation vessel within any vascular territory, the separate cutaneous regions that make up the fasciocutaneous territories occur in predictable locations with a measurable standard deviation. The transverse section radiographs confirmed the transverse dimensions of the vascular territories. Additionally, the summation of any two vascular territories calculated from the anatomical data conforms to the clinically observed 2.5:1 to 3:1 length-to-width ratios for fasciocutaneous flap viability as reported by Ponten and by Barclay et al. This study provides a quantitative anatomical framework using primary fasciocutaneous vascular territories to design potentially reliable fasciocutaneous flaps in the lower extremity.     

Aphthosis of the oral cavity: therapeutic prospectives

After analysing of recurrent aphthous stomatitis the clinical and morphological aspects, the authors consider various therapeutic possibilities. They underline the relationship between therapy and clinical aspects of the pathology.     

Arterial vascular anomalies of the retina

The incidence of nonaneurysmal congenital anomalies of the retinal arteries was determined by ophthalmoscopic examination of the eyes of 2,100 consecutive healthy individuals whose ages ranged from 6 to 68 years. Unusual anomalies were triple branching, anomalous course, arteriolar-arterial crossing, unusual tortuosity, prepapillary loops, aberrant macular arteries, unusual supply of the optic disc, presumed total ciliary arterial supply of the retina, anomalous relationship with the central retinal vein at the optic disc, and pseudoaneurysm of a major retinal artery. Cilioretinal arteries are the commonest of the congenital vascular anomalies of the retina.     

Arterial vascular remodeling: the endothelial cell''s central role

As a measurement of the level of anxiety in psychiatric outpatients with anxiety, we determined the saliva level of free 3-methoxy-4-hydroxyphenyleglycol (MHPG) using gas chromatography- mass spectrometry and scored the levels of anxiety with the Hamilton Anxiety Scale (HAS) in patients, before and after drug treatment with alprazolam for 1 week. The saliva level of free-MHPG at first visit to hospital was significantly higher than that of control individuals and disease control individuals and was reduced by alprazolam treatment for 1 week. There was no correlation between MHPG level and the HAS score at the first hospital visit. The MHPG levels after treatment correlated with the HAS scores. The reduction of the anxiety level as scored by the HAS correlated with the reduction of MHPG level. These results indicate that the free saliva MHPG level may be a useful indicator for assessing not only the level of anxiety, but also the response to drug treatment for anxiety in these patients.     

Dermoid cysts of the oral cavity

The authors describe ethiology, clinical picture, diagnosis and treatment of the dermoid cyst of oral cavity floor. They show the advantages after using ultrasonography and computer tomography in treatment of these cysts.     

Coaggregation of oral lactobacilli with streptococci from the oral cavity

The ability of oral lactobacilli to coaggregate with streptococci and actinomycetes was investigated. Of the 7 species of lactobacilli studied, only two were capable of coaggregation and the coaggregation was restricted to streptococci. Lactobacillus salivarius strains (2/4) coaggregated with Streptococcus salivarius, Streptococcus gordonii, Streptococcus crista and tufted Streptococcus sanguis II strains. Lactobacillus fermentum (2/3) coaggregated with S. gordonii and S. sanguis. The coaggregation between L. salivarius and S. salivarius, S. gordonii or tufted S. sanguis II strains was mediated by a protein on the surface of the lactobacilli and was not inhibited by lactose. The coaggregation between L. fermentum and the streptococci was mediated by protein on the surface of the streptococci and was inhibited by lactose.     

Factors influencing oral cavity status during high-dose antineoplastic therapy: a secondary data analysis

A case of multiple bile duct hamartomas (von Meyenburg complex) of the liver accompanied by exudative and in part necrotizing pancreatitis is presented. Magnetic resonance imaging (fat suppressed, T2-weighted images with prolonged echo time) could exclude diffuse tumor infiltration of the liver, which had not been possible with CT, sonography, or ERCP. To our knowledge, no comparable case has been reported.     

Epidemiology of oral cavity tumors

In this study we aimed at evaluating the modifications in the pharmacokinetic profile of cyclosporin A (CyA) after conversion from standard formulation (CyA-ST) to a new formulation (CyA-NF, Sandimmun Neoral) in patients with rheumatoid arthritis (RA). It was an open, crossover study that involved 15 RA patients who were on stabilized treatment with CyA-ST. The patient continued receiving CyA-ST (mean dose of 3.0 +/- 0.7 mg/kg per day) for 3 weeks and then converted 1:1 to CyA-NF for a further 3 weeks. CyA pharmacokinetics were established on day 1 (CyA-ST evaluation) and +21 (CyA-NF evaluation). The results showed that the bioavailability of CyA-NF was greater than that of CyA-ST (AUC tau, bss: 3335 +/- 1300 vs 2667 +/- 1155 ng.h/ml, P = 0.0073; AUC tau, bss ratio 1.26 +/- 0.40 vs 1.0 as reference, P < 0.05), with higher and earlier peak blood concentrations (Cmax: 677 +/- 256 vs 475 +/- 213 ng/ml, P = 0.0329; tmax: 1.5 +/- 0.7 vs 2.6 +/- 1.6 h, P = 0.0720). The pharmacokinetic profile of CyA-NF showed greater between-patient reproducibility (lower CV% for all of the considered parameters). In conclusion, when using CyA-NF instead of CyA-ST, greater and more constant exposure to CyA should be expected.     

Primary extranodal non-Hodgkin lymphoma of the oral cavity. An analysis of 34 cases

A case of macroglossia and resulting apertognathia because of primary amyloidosis in a 65-year-old man with multiple myeloma is described. In addition, a retrospective study of the oral manifestations of primary amyloidosis and multiple myeloma in the last 15 years is reported.     

Use of the laser in the oral cavity

Literature on head and neck oncology continues to support the use of lasers in surgery of malignant and premalignant lesions of the oral cavity. This article explores the indications, techniques, results, and complications of laser use for surgery involving these lesions. Highlighted is the carbon dioxide laser, which is well suited for transoral resections of premalignant lesions and early carcinomas in the oral cavity. In this study the local control, the 5-year survival rates, and the postoperative function with the carbon dioxide laser are at least comparable with those obtained using other surgical methods. The neodymium:yttrium-aluminum-garnet laser, which has specific advantages in the treatment of large vascular malformations of the oral cavity because of its unique characteristics, is also discussed.     

Bone harvesting from the oral cavity]

BACKGROUND AND METHODS: We examined the effect on health perceptions of a diagnostic workup in 172 patients with suspected multiple sclerosis (MS) using two questionnaires (Mishel, Rand Medical Outcome Study) and three visual analogue scales measuring distress. Patients were categorized into "MS," "not MS," or "still uncertain" groups. RESULTS: Patients with a definitive diagnosis reported a significant decrease in uncertainty (analysis of variance [ANOVA] P = .0004). The Medical Outcome Study showed a slightly worsened perceived current health status (ANOVA P = .02) and future health outlook (ANOVA P = .001) in the MS group compared with the other two groups. Distress over physical symptoms decreased in all three groups and anxiety was more likely to decrease than increase even in those with MS. Prognostic uncertainty distress decreased in the not MS group and still uncertain groups, whereas it remained unchanged in the MS group (P = .9156). CONCLUSION: Significant and generally beneficial changes in patient health perceptions are seen associated with a neurologic workup in suspected MS, irrespective of the final diagnosis.