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Fascia
Kinds of Fascia Selected AbstractsAutologous Transplantation of Fascia into the Vocal Fold: Long-Term Result of Type-1 Transplantation and the Future,THE LARYNGOSCOPE, Issue S108 2005Koichi Tsunoda MD Abstract Objectives: Since 1997, we have performed the autologous transplantation of fascia into the vocal fold (ATFV) procedure on cases of sulcus vocalis. In what follows, we report the long-term results of our new surgical approach and discuss the role of these transplantations. We also review and report some complications that can be caused by ATFV. Finally, we discuss the ATFV technique as a contribution to the phonosurgery of the future. Study Design: Prospective study. Methods: We were able to obtain long-term results from 10 volunteer cases (2 female and 8 male, age: 15,71, mean 46.5 years old) who could be followed up for at least 3 years after transplantation. All were cases of pathologic sulcus vocalis. We measured maximum phonation time (MPT) and carried out pre- and postsurgical clinical observation and laryngeal stroboscopy in all cases. These measurements and observations were made before the ATFV and at 6 months, 1 year, 2 years, and 3 years after surgery. Results: In stroboscopic observation 1 year after the ATFV, satisfactory glottal closure and excellent mucosal wave were observed for all cases, and there was no case with hyperadduction of the false vocal folds. MPT measures remained at an improved level 2 years and 3 years after the transplantations. Paired-sample t tests showed that the improvement relative to preATFV levels was significant for all postsurgical measurements up to 3 years. Conclusions: We conclude that ATFV is a successful surgical procedure for sulcus vocalis and scarred vocal folds. Other phonosurgical clinical applications may also be envisioned. [source] Fascia Augmentation of the Vocal Fold: Graft Yield in the Canine and Preliminary Clinical Experience,THE LARYNGOSCOPE, Issue 5 2001Sanford G. Duke MD Abstract Introduction Glottal insufficiency resulting from vocal fold bowing, hypomobility, or scar is frequently treated by injection augmentation. Injection augmentation with fat, collagen, gel foam, polytef, and recently, fascia lata has been previously reported. Variable graft yield and poor host-tissue tolerance have motivated the continued search for an ideal graft substance. Study Design A prospective trial of autologous fascia augmentation of the vocal cord in the human and in an animal model. Methods Autologous fascia injection augmentation (AFIA) was evaluated in 8 canines and 40 patients at our institution between 1998 and 2000. The animal study compared graft yield from AFIA with autologous fat yield. The outcome measure was graft yield calculated from histological examination of larynges 12 weeks after injection augmentation. Clinical trial outcome measures included symptom surveys, acoustical voice analyses, and subjective voice assessments. Mean follow-up was 9 months. Results In the canine larynx, the mean graft yield for AFIA was 33% (range, 5%,84%) compared with autologous lipoinjection (47%; range, 7%,96%;P = .57). Subjective improvement in vocal quality was reported by 95% of patients (38 of 40) after AFIA. Preoperative and postoperative voice analysis data were obtained from 26 patients. Subjective voice rating demonstrated a significant improvement after AFIA (P <.0001). Acoustical parameters of jitter, shimmer, noise-to-harmonic ratio, phonatory range, and degree unvoiced improved significantly (P <.05) in all patients after fascia augmentation. Conclusions Based on the animal study, we concluded that graft yields are excellent but variable for AFIA. The result is similar in variability and overall yield to autologous lipoinjection. Subjective and objective analyses of voice outcomes after AFIA are universally improved. Fascia appears to be an excellent alternative to lipoinjection in properly selected cases of glottic insufficiency. [source] Novel Face-Lift Suspension Suture and Inserting Instrument: Use of Large Anchors Knotted into a Suture with Attached Needle and Inserting Device Allowing for Single Entry Point Placement of Suspension Suture.DERMATOLOGIC SURGERY, Issue 3 2006Preliminary Report of 20 Cases with 6- to 12-Month Follow-Up BACKGROUND Various suspension suture techniques exist to elevate the mid-face, jowls, and neck. OBJECTIVE To assess safety and efficacy of a new suspension suture and inserting instrument with both standard and minimal incision (no-skin-excision) face-lifts. METHODS A new type of multianchor suspension suture assembled from commercially available 2-0 absorbable monofilament material, with 5 to 9 equally spaced knots through which are secured 7 to 9 mm bits of 0 thickness similar suture material, and an attached straightened needle, was used to elevate and suspend facial tissues to temporal or mastoid fascia. The suspension sutures are placed in the deep subcutaneous tissues, just above the superficial musculo aponeurotic system (SMAS), by use of a novel, blunt instrument, which does not require a second, distal exit point. The suspension suture distal end floats free. The proximal needle end is sutured to fascia. The suture was used on 20 patients. Fourteen of them underwent pure, "no-skin-excision," suspension lifts. Six had suspension suture elevation of the mid-face in conjunction with relatively conservative open lifts. Nine- to 12-month results were evaluated. RESULTS With open face-lifts, 9- to 12-month results are excellent with significant persistence of the correction initially achieved. Resulting scars remained fine line. There were no complications. With pure suspension lifts, initial results were impressive. By 6 months, correction started to fade. By 12 months 100% of initial correction for jowls, and 80 to 100% for mid-face, appeared lost. Recovery time was 2 to 4 days. There were no significant complications. CONCLUSION Large multianchor, absorbable monofilament sutures can safely and effectively enhance results of conservative lifts, with remarkable elevation of the mid-face not achievable with simple SMAS flaps. These suspension sutures can easily and safely achieve impressive, though relatively short-term results, with a minimal incision, "no-skin-excision" technique. [source] Inguinal rupture with herniation of the urinary bladder through the scrotal fascia in a Shetland pony foalEQUINE VETERINARY EDUCATION, Issue 1 2010M. Cousty Summary Herniation of the urinary bladder in the inguinal region has not previously been described in the horse. A case of inguinal rupture with herniation of the bladder through the scrotal fascia in a 3-month-old Shetland pony, diagnosed by external palpation, urinary catheterisation and external ultrasonographic examination is reported. Surgical management of the case was by dissection of the scrotal fascia, partial cystectomy and unilateral castration. During the period of hospitalisation the only complication was a slight seroma, which resolved spontaneously. Follow-up after 6 months did not reveal any abnormality. [source] Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2008Yur-Ren Kuo MD Abstract Background. Extensive composite defects involving the lip and cheek present difficult reconstructive challenges. This study presents a technique using anterolateral thigh (ALT) flaps with vascularized fascia for large complex oral sphincter defect reconstruction. Methods. Fifteen patients who had undergone oral cancer ablation were enrolled in the study. The average area of intraoral lining and cheek,lip skin defects was 96.9 cm2. Upper-lip defects ranged 0% to 60%, and lower-lip defects ranged 20% to 80%. Skin and intraoral lining defects were replaced by an ALT fasciacutaneous flap. The vascularized fascia of the flap was used to provide lip suspension. Results. Flap survival was 100%. All but 1 patient had good static suspension. Nine patients had adequate oral competence without drooling, but 6 had occasional oral incontinence. All patients achieved an acceptable appearance. Conclusions. For extensive cheek,lip composite defects, ALT flap together with vascularized fascia has proven to be a useful option for functional reconstruction. © 2008 Wiley Periodicals, Inc. Head Neck 2008 [source] Cervical spondylodiscitis: A rare complication after phonatory prosthesis insertionHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2006Andrea Bolzoni MD Abstract Background. Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported. Methods. We report a case of cervical spondylodiscitis, occurring in a 67-year-old woman submitted to phonatory prosthesis insertion. After 1 month, she complained of severe cervicalgia associated with fever. Spondylodiscitis involving C6, C7, and the intervening vertebral disk with medullary compression was detected by means of imaging studies. Results. A right cervicotomy with drainage of necrotic tissue was performed, and a deepithelialized fasciocutaneous deltopectoral flap was interposed between the neopharynx-esophagus and the prevertebral fascia to protect the neurovascular axis. MR performed 1 month later showed a complete resolution of the infectious process. Conclusions. Severe neck pain after tracheoesophageal puncture should alert the physician about the possibility of a cervical spondylodiscitis. MR is the most useful imaging technique for preoperative and postoperative evaluation. When neurologic symptoms are detected, surgical exploration of the neck is mandatory. © 2005 Wiley Periodicals, Inc. Head Neck28: XXX,XXX, 2005 [source] Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral spaceHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2005Wendy C. Hsu MD Abstract Background. The purpose of this study was to determine the preoperative accuracy of preservation of the retropharyngeal fat plane on magnetic resonance (MR) images in predicting the absence of fixation or extension of head and neck carcinomas to the prevertebral space. Methods. The MR images of 75 patients with T3 or T4 primary pharyngeal or laryngeal cancers seen over a 5-year period and treated at our Head and Neck Cancer Center were retrospectively reviewed. The MR images were independently and blindly evaluated by two head and neck radiologists for preservation of the retropharyngeal fat plane between the tumor and prevertebral musculature. In cases in which the fat was preserved, the prevertebral muscle complex was assessed for the presence of T2 hyperintensity and enhancement. All patients underwent panendoscopy, surgery, or both. Results. Forty of 75 patients had preservation of the retropharyngeal fat plane between the tumor and the prevertebral compartment on T1-weighted images. In all 40 cases, the prevertebral muscles had a normal appearance on T2-weighted and enhanced MR images. Intraoperative assessment revealed absence of fixation of tumor to the prevertebral fascia in 39 of 40 cases, and these tumors were resectable. Conclusion. In patients with advanced head and neck carcinomas, preservation of the fat between the tumor and the prevertebral musculature on unenhanced T1-weighted images reliably predicts absence of prevertebral space fixation. © 2004 Wiley Periodicals, Inc. Head Neck27: 95,100, 2005 [source] Laparoscopic cholecystectomy in the grossly obese: 4 years experience and review of literatureHPB, Issue 4 2002M Hussien Background Conventional abdominal surgery in grossly obese patients is associated with an increased rate of postoperative complications; thus, laparoscopic surgery may be preferred in these patients. Patients and methods A prospective analysis was performed of 20 grossly obese patients who underwent laparoscopic cholecystectomy between April 1996 and April 2000 for symptomatic non-complicated gallstone disease. Results Technical problems at operation included difficulty with induction of pneumoperitoneum and introduction of the most lateral subcostal port, retraction of the gallbladder fundus, the need for longer instruments and the closure of the fascia. Laparoscopic cholecystectomy was successfully completed in 19 patients, but one patient required conversion to open operation. There were no anaesthetic difficulties. Two patients developed minor chest infections. The mean hospital stay was 2.9 days. Conclusion Laparoscopic cholecystectomy is feasible and can be recommended for symptomatic gallstone disease in grossly obese patients. [source] Necrotizing fasciitis: delay in diagnosis results in loss of limbINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2006Rajat Varma MD A 58-year-old man presented to the Emergency Room with a 1-day history of severe pain in the left lower extremity preceded by several days of redness and swelling. He denied any history of trauma. He also denied any systemic symptoms including fever and chills. His past medical history was significant for diabetes, hypertension, deep vein thrombosis, and Evans' syndrome, an autoimmune hemolytic anemia and thrombocytopenia, for which he was taking oral prednisone. Physical examination revealed a warm, tender, weeping, edematous, discolored left lower extremity. From the medial aspect of the ankle up to the calf, there was an indurated, dusky, violaceous plaque with focal areas of ulceration (Fig. 1). Figure 1. Grossly edematous lower extremity with well-demarcated, dusky, violaceous plaque with focal ulceration Laboratory data revealed a white blood cell count of 6.7 × 103/mm3[normal range, (4.5,10.8) × 103/mm3], hemoglobin of 11.5 g/dL (13.5,17.5 g/dL), and platelets of 119 × 103/mm3[(140,440) × 103/mm3]. Serum electrolytes were within normal limits. An ultrasound was negative for a deep vein thrombosis. After the initial evaluation, the Emergency Room physician consulted the orthopedic and dermatology services. Orthopedics did not detect compartment syndrome and did not pursue surgical intervention. Dermatology recommended a biopsy and urgent vascular surgery consultation to rule out embolic or thrombotic phenomena. Despite these recommendations, the patient was diagnosed with "cellulitis" and admitted to the medicine ward for intravenous nafcillin. Over the next 36 h, the "cellulitis" had advanced proximally to his inguinal region. His mental status also declined, and he showed signs of septic shock, including hypotension, tachycardia, and tachypnea. Vascular surgery was immediately consulted, and the patient underwent emergency surgical debridement. The diagnosis of necrotizing fasciitis was then made. Tissue pathology revealed full-thickness necrosis through the epidermis with subepidermal splitting. Dermal edema was also present with a diffuse neutrophilic infiltrate (Fig. 2). This infiltrate extended through the fat into the subcutaneous tissue and fascia. Tissue cultures sent at the time of surgery grew Escherichia coli. Initial blood cultures also came back positive for E. coli. Anaerobic cultures remained negative. Figure 2. Necrotic epidermis with subepidermal splitting. Marked dermal edema with mixed infiltrate and prominent neutrophils. Hematoxylin and eosin: original magnification, ×20 After surviving multiple additional debridements, the patient eventually required an above-the-knee amputation due to severe necrosis. [source] Laparoscopic management of urachal remnants in adulthoodINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2006TAKATSUGU OKEGAWA Background: The aim of this study was to investigate the outcome of laparoscopic excision of urachal remnants (LUR), and to compare the outcome with that of the traditional open excision of urachal remnants (OUR). Methods: Between February 2001 and December 2005, six patients with a mean age of 23.8 years who had a symptomatic urachal sinus underwent radical LUR. Using 12 mm and 5 mm ports, the caudal stump of the urachus was ligated with an absorbable clip and divided. The peritoneal and preperitoneal tissue between the medial umbilical ligaments was dissected free of the transversalis fascia. Dissection was carried out along the preperitoneal plane toward the umbilicus. The cephalic side of the lesion was ligated at the umbilicus with an endo-loop and divided. In addition, four patients who underwent a traditional OUR were included. Peri- and postoperative records were reviewed to assess morbidity, recovery, and outcome. Results: The operative duration was not significantly shorter for the LUR group than the OUR group, but there was generally a reduction in blood loss (mean 16.5 vs 68.3 mL), an earlier resumption of eating (mean 1.3 vs 2.5 days), and a shorter hospital stay (mean 5.3 vs 10.5 days). There were no intraoperative complications in either the LUR or the OUR group. Mean follow up was 5 (range 4,12) months. There were no postoperative complications. Conclusions: The results suggest that LUR can be safely and satisfactorily performed in adulthood. [source] An approach to the management of necrotising fasciitis in neonatesINTERNATIONAL WOUND JOURNAL, Issue 2 2005Soraya Zuloaga-Salcedo MD Abstract Necrotising fasciitis is a severe, life-threatening soft tissue infection. It produces an extensive cellulitis with severe involvement of subcutaneous tissue, fascia, muscle or both, resulting in necrosis of the tissue. All age groups, including neonates, can be affected. Patients with necrotising fasciitis present with more severe constitutional symptoms and have a poor outcome, unless aggressive antibiotic therapy and surgical debridement are instituted promptly. The debridement of necrotic tissue is imperative to control the infection, but results in deep wounds that require further treatment. In this study, the neonate was treated with alginate dressings and negative pressure therapy after resolution of cellulitis, with excellent results and no untoward events. [source] Diagnosis and Therapy of Localized SclerodermaJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2009Alexander Kreuter Abstract Localized scleroderma is a rare autoimmune disease with primary affection of the skin, and occasional involvement of the fat tissue, muscle, fascia, and bone. Depending on the clinical subtype, the spectrum of skin lesions ranges from singular plaque lesions to severe generalized or linear subtypes which may lead to movement restrictions and permanent disability. This German S1-guideline proposes a classification of localized scleroderma that, considering the extent and depth of fibrosis, distinguishes limited, generalized, linear, and deep forms of localized scleroderma, together with its associated subtypes. The guideline includes a description of the pathogenesis, of differential diagnoses, and particular aspects of juvenile localized scleroderma, as well as recommendations for histopathologic, serologic, and biometric diagnostic procedures. Based on studies of topical and systemic treatments as well as phototherapy for localized scleroderma published in international literature, a treatment algorithm was developed which takes account of the different subtypes and the extent of disease. [source] Deficiency of the ,-Subunit of the Stimulatory G Protein and Severe Extraskeletal Ossification,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 11 2000Mark C. Eddy Abstract Progressive osseous heteroplasia (POH) is a rare disorder characterized by dermal ossification beginning in infancy followed by increasing and extensive bone formation in deep muscle and fascia. We describe two unrelated girls with typical clinical, radiographic, and histological features of POH who also have findings of another uncommon heritable disorder, Albright hereditary osteodystrophy (AHO). One patient has mild brachydactyly but no endocrinopathy, whereas the other manifests brachydactyly, obesity, and target tissue resistance to thyrotropin and parathyroid hormone (PTH). Levels of the ,-subunit of the G protein (Gs,) were reduced in erythrocyte membranes from both girls and a nonsense mutation (Q12X) in exon 1 of the GNAS1 gene was identified in genomic DNA from the mildly affected patient. Features of POH and AHO in two individuals suggest that these conditions share a similar molecular basis and pathogenesis and that isolated severe extraskeletal ossification may be another manifestation of Gs, deficiency. [source] Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidanceJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2006Wen-Chung Tsai MD Abstract Purpose To compare the effectiveness of sonographically guided and palpation-guided steroid injection for the treatment of proximal plantar fasciitis. Patients and Methods Twenty-five consecutive patients with unilateral proximal plantar fasciitis were recruited and randomly divided into a sonographically guided group (n = 12) and palpation-guided group (n = 13). Proximal plantar fascia was assessed with a 5- to 12-MHz linear-array transducer. Pain intensity was quantified using a "tenderness threshold" (TT) and a visual analog scale (VAS). Injection of 7 mg (1 ml) of betamethasone and 0.5 ml of 1% lidocaine into the inflamed proximal plantar fascia was performed under the guidance of sonography or palpation. Patients were evaluated clinically and sonographically before injection and at 2 weeks, 2 months, and 1 year after injection. VAS- and TT-measured pain intensity, thickness, and echogenicity of the proximal plantar fascia, as well as the recurrence of heel pain, were assessed. Results Both VAS- and TT-measured levels of pain improved significantly after steroid injection in both groups (p < 0.001). Also, the thickness decreased significantly after injection (p < 0.01 in the palpation-guided group; p < 0.001 in the sonographically guided group). The number of patients with hypoechogenicity at the proximal plantar fascia decreased after steroid injection in both groups (p < 0.01 for both groups). The recurrence rate of plantar fasciitis in patients of the palpation-guided group (6/13) was significantly higher than that of the sonographically guided group (1/12) (p < 0.05). Conclusions Steroid injection can be an effective way to treat plantar fasciitis, and injection under sonographic guidance is associated with lower recurrence of heel pain. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound34:12,16, 2006 [source] Plantar fibromatosis: Most common sonographic appearance and variationsJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2001Deepak G. Bedi MD Abstract Purpose The aim of this study was to describe the most common sonographic appearances of plantar fibromatosis, thus enabling sonographic diagnosis of this benign, focally invasive fibrous neoplasm. Methods The medical records, pathologic reports, and sonographic reports and images of 22 patients with palpable plantar masses were reviewed retrospectively. The sonographic findings were used to characterize those masses with respect to location, shape, size, and echogenicity. Sixteen patients were included in this study because of the proximity of their lesions to the plantar fascia; 6 patients were excluded because their lesions were metatarsophalangeal bursae or ganglia. Results The 20 feet examined in the 16 patients studied contained 43 distinct lesions, all located on the surface of the plantar fascia. Thirty-seven (86%) of the 43 were 20 mm long or less. Thirty-seven (86%) of the 43 lesions were elongated; the remaining 6 (14%) were round or oval. Twenty-five (68%) of the 37 elongated lesions had tapered ends, and the other 12 (32%) had rounded ends. Thirty-one (72%) of the 43 lesions were hypoechoic; 25 (81%) of these 31 measured as long as 10 mm. Ten (83%) of the 12 lesions that had mixed echogenicity were longer than 10 mm. Conclusions The lesions of plantar fibromatosis were characteristically located on the surface of the plantar fascia, sagittally elongated, most often less than 20 mm long, fusiform, and hypoechoic. Lesions longer than 10 mm often exhibited mixed echogenicity. The superficial location and appearance should strongly suggest plantar fibromatosis, although careful examination is required to exclude other possibilities, such as sarcoma. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:499,505, 2001. [source] Proximal-type epithelioid sarcoma: case report and result of comparative genomic hybridizationJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2004Mi-Woo Lee Background:, Epithelioid sarcoma is a rare mesenchymal neoplasm. Recently, a more aggressive, so-called ,proximal type' epithelioid sarcoma has been described. Clinical case:, A 40-year-old-woman presented with 5 × 4 cm, erythematous, indurated, non-movable, painful mass on the pubic area. Histopathology demonstrated diffuse tumor-cell infiltration into the subcutaneous and fascia, which was consisted of prominent epithelioid cells and scattered rhabdoid cells. A multinodular growth pattern or granulomatous appearance with central necrosis was not observed. The tumor cells showed positive reactions for vimentin, cytokeratin (AE1/AE3), and CD34. Despite the surgery, left inguinal mass with lymphadenopathy occurred one month later. We also carried out comparative genomic hybridization (CGH) with tumor cells. CGH revealed chromosomal gain of 5q32-qter, 12q24-qter, and 22q. Conclusion:, We report a case of proximal-type of epithelioid sarcoma, which showed the chromosomal gains of 5q32-qter, 12q24-qter, and 22q by CGH. [source] Accuracy of MRI for predicting the circumferential resection margin, mesorectal fascia invasion, and tumor response to neoadjuvant chemoradiotherapy for locally advanced rectal cancerJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Seung Ho Kim MD Abstract Purpose To evaluate the diagnostic accuracy of MRI for predicting the circumferential resection margin (CRM), mesorectal fascia (MRF) invasion, and the tumor response to neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer. Materials and Methods Sixty-five consecutive patients with locally advanced rectal cancer (,T3 or lymph node-positive) who underwent neoadjuvant CRT and subsequent surgery were enrolled in this retrospective study. Two blinded radiologists independently reviewed both the pre- and post-CRT rectal MR images and measured the post-CRT CRM; they recorded their confidence level with respect to the MRF invasion and tumor response using a 5-point scale. The diagnostic accuracy of each reviewer was calculated using receiver operating characteristic curve (ROC) analysis. Results The measured CRM was not significantly different from the reference standard (mean difference, ,1.4 mm; 95% limits of agreement, ,8.3,5.4 mm; interclass correlation coefficient, 0.82). The diagnostic accuracy (Az) for determining MRF invasion was 0.890 for reviewer 1 (95% confidence interval [CI], 0.788,0.954) and 0.829 for reviewer 2 (95% CI, 0.715,0.911). The Az for predicting complete or near-complete regression was 0.791 for reviewer 1 (95% CI, 0.672,0.882) and 0.735 for reviewer 2 (95% CI, 0.611,0.837). Conclusion MRI provides accurate information regarding the CRM of locally advanced rectal cancer after neoadjuvant CRT; it also shows relatively high accuracy for predicting MRF invasion and moderate accuracy for assessing tumor response. J. Magn. Reson. Imaging 2009;29:1093,1101. © 2009 Wiley-Liss, Inc. [source] SEAWEED ABUNDANCE AND DIVERSITY IN HIGH ENERGY AND LOW ENERGY AREAS AT PORT ARANSAS, TEXAS JETTIESJOURNAL OF PHYCOLOGY, Issue 3 2001Article first published online: 24 SEP 200 Agan, J. C. & Lehman, R. L. Department of Physical and Life Sciences, Texas A&M University-Corpus Christi 6300 Ocean Dr., Corpus Christi, TX 78412 USA Benthic algal sampling from high and low energy zones at a selected site on the south jetty at Port Aransas, Texas was completed between April 1999 and February 2000. Species composition and seasonal periodicity in relation to temperature and salinity fluctuations were determined. Dominant plants throughout the year included Bryocladia cuspidata, Bryocladia thyrsigera, Gelidium pusillum, Centroceras clavulatum, Ulva fasciata, and Padina gymnospora. The Rhodophyta dominated species coverage, along with biomass accumulation, although Chlorophyta species accrued the greatest biomass on the high energy side in April and June sampling. Chlorophyta are important to benthic coverage and biomass in the shallowest of waters, despite being fewer in species richness. Phaeophyta species including Petalonia fascia, Hincksia mitchelliae, and Ectocarpus siliculosus were found only during the cooler months. Padina gymnospora was the one exception as it was collected year-round. Results indicate that a greater Rhodophyta abundance was found on the channel side (low energy), where as, the surf side (high energy) contained a greater Chlorophyta abundance. Phaeophyta abundance for both high and low energy sites were comparable possibly due to the greater depth of water in which they are located. Little variance occurred in average biomass accumulation throughout the year. Highest biomass was in August (216.613g dry weight) with lowest occurring in April (107.4205g dry weight). [source] SEAWEED ABUNDANCE AND DIVERSITY IN HIGH ENERGY AND LOW ENERGY AREAS AT PORT ARANSAS, TEXAS JETTIESJOURNAL OF PHYCOLOGY, Issue 2001Article first published online: 9 OCT 200 Agan, J. C. & Lehman, R. L. Department of Physical and Life Sciences, Texas A&M University-Corpus Christi 6300 Ocean Dr., Corpus Christi, TX 78412 USA Benthic algal sampling from high and low energy zones at a selected site on the south jetty at Port Aransas, Texas was completed between April 1999 and February 2000. Species composition and seasonal periodicity in relation to temperature and salinity fluctuations were determined. Dominant plants throughout the year included Bryocladia cuspidata, Bryocladia thyrsigera, Gelidium pusillum, Centroceras clavulatum, Ulva fasciata, and Padina gymnospora. The Rhodophyta dominated species coverage, along with biomass accumulation, although Chlorophyta species accrued the greatest biomass on the high energy side in April and June sampling. Chlorophyta are important to benthic coverage and biomass in the shallowest of waters, despite being fewer in species richness. Phaeophyta species including Petalonia fascia, Hincksia mitchelliae, and Ectocarpus siliculosus were found only during the cooler months. Padina gymnospora was the one exception as it was collected year-round. Results indicate that a greater Rhodophyta abundance was found on the channel side (low energy), where as, the surf side (high energy) contained a greater Chlorophyta abundance. Phaeophyta abundance for both high and low energy sites were comparable possibly due to the greater depth of water in which they are located. Little variance occurred in average biomass accumulation throughout the year. Highest biomass was in August (216.613g dry weight) with lowest occurring in April (107.4205g dry weight). [source] SPECIES COMPOSITION AND SEASONAL PERIODICITY OF MACROALGAL SPECIES IN CORPUS CHRISTI BAY, TEXASJOURNAL OF PHYCOLOGY, Issue 2000J.C. Agan Benthic algal sampling from selected sites along Corpus Christi Bay and from one site at the Port Aransas, Texas south jetty was completed between April 1999 and February, 2000. Species composition, seasonal periodicity, and fluctuations in temperature and salinity were determined. This is the first comprehensive study of benthic macroalgae conducted in Corpus Christi Bay, which is shallow, turbid, and lacks natural hard substrate. Man-made jetties are necessary for suitable floral attachment. Macroalgae are affected by changes in salinity as freshwater inflows are followed by periods of drought, which increase salinity. These effects are most notable where freshwater enters at the south end near Oso Bay and at the north end at Nueces Bay. Previous Texas algal collections described species of Enteromorpha, Ulva, Gelidium, and Gracilaria as the most dominant plants of the area. This supports the current study with the additions of Hypnea musciformis and Centroceras clavulatum. Dominant plants at the Port Aransas jetty include Ulva fasciata, Padina gymnospora, and Hypnea musciformis. The Rhodophyta including Gracilaria, Gelidium, and Centroceras clavulatum dominate the bay and do so throughout the year. Chlorophytes, although few in species richness, are important to benthic coverage and biomass. Phaeophyta are found predominantly at the Port Aransas jetty with Sargassum, Dictyota dichotoma, and Petalonia fascia being most abundant. A transition occurs in species composition as the water temperature changes seasonally. Hincksia, Ectocarpus, and Petalonia fascia are found only during the cooler months. [source] The parasympathetic supply to the distal colon,one marker for precisely locating the posterior dissection plane in the operation of TMEJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2010Bi Dong-song MD Abstract Background It is important for surgeons to locate the reliable surgical planes in the operation of total mesorectal excision (TME); we observe the parasympathetic nerve to the distal colon can be served as one of useful markers for precisely locating the posterior dissection plane in TME. Materials and Methods From October 2006 to January 2008, 26 patients underwent TME for rectal cancer. The dissections of the parasympathetic nerves to the distal colon were performed and the relationship of these nerves to the prehypogastric nerve fascia was observed. Results Some parasympathetic nerves ran upwards and lay anteromedial to the hypogastric nerves. In the avascular space between prehypogastric nerve fascia and the fascia propria of the rectum, the prehypogastric nerve fascia enveloped parasymphathetic nerve up to the fascia propria of rectum. Conclusions The parasympathetic nerve to the distal colon is evident between the fascia propria of the rectum and the prehypogastric nerve fascia. As the precise dissection plane of TME lay between the fascia propria of the rectum and the prehypogastric nerve fascia, these nerves could be served as useful marker for precisely locating the posterior dissection plane in TME. J. Surg. Oncol. 2010; 101:524,526. © 2010 Wiley-Liss, Inc. [source] Breast reconstruction using perforator flapsJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2006Jay W. Granzow MD Abstract Background Perforator flaps allow the transfer of the patient's own skin and fat in a reliable manner with minimal donor-site morbidity. The deep inferior epigastric artery (DIEP) and superficial inferior epigastric artery (SIEA) flaps transfer the same tissue from the abdomen to the chest for breast reconstruction as the TRAM flap without sacrificing the rectus muscle or fascia. Gluteal artery perforator (GAP) flaps allow transfer of tissue from the buttock, also with minimal donor-site morbidity. Indications Most women requiring tissue transfer to the chest for breast reconstruction or other reasons are candidates for perforator flaps. Absolute contraindications to perforator flap breast reconstruction include history of previous liposuction of the donor site or active smoking (within 1 month prior to surgery). Anatomy and Technique The DIEP flap is supplied by intramuscular perforators from the deep inferior epigastric artery and vein. The SIEA flap is based on the SIEA and vein, which arise from the common femoral artery and saphenous bulb. GAP flaps are based on perforators from either the superior or inferior gluteal artery. During flap harvest, these perforators are meticulously dissected free from the surrounding muscle which is spread in the direction of the muscle fibers and preserved intact. The pedicle is anastomosed to recipient vessels in the chest and the donor site is closed without the use of mesh or other materials. Conclusions Perforator flaps allow the safe and reliable transfer of abdominal tissue for breast reconstruction. J. Surg. Oncol. 2006;94:441,454. © 2006 Wiley-Liss, Inc. [source] Outcomes of re-excision after unplanned excisions of soft-tissue sarcomasJOURNAL OF SURGICAL ONCOLOGY, Issue 3 2005Mark W. Manoso MD Abstract Background and Objectives Unplanned excisions of soft-tissue sarcomas of the extremities occur commonly. Our goal was to evaluate the presence of residual disease, the treatment outcomes as they relate to local and distant recurrence and 5-year survival, and the limb functional outcomes in patients with unplanned sarcoma excision who were treated with re-excision and adjuvant therapy. Methods Between 1993 and 1999, 42 patients presented to our institution after unplanned excision of soft-tissue sarcomas. Of those 42 patients, 38 without gross residual disease or metastatic lesions formed the basis of this review. All 38 patients underwent revision wide excision; most (31) also received adjuvant therapy (radiation and/or chemotherapy). Clinical data were obtained from analysis of patient records and radiographic studies. Univariate analysis was performed with logistical regression, and multivariate analysis was performed with Cox modeling. Results The overall 5-year survival rate was 91.3% and the disease-free 5-year survival rate was 82.2%. Univariate analysis showed that stage-III disease (American Joint Committee on Cancer classification of soft-tissue sarcomas), lesions below the fascia, a histologic high-grade, and the development of organ metastasis were statistically significant factors for mortality. Stage-III disease also was significant for mortality on multivariate analysis. Only stage-III disease was significant for the development of local recurrence. Eighty-four percent of the patients had good to excellent functional outcomes. Conclusions Re-excision with adjuvant therapy proved to be a safe and effective method for treating the disease and preserving limb function. J. Surg. Oncol. 2005;91:153,158. © 2005 Wiley-Liss, Inc. [source] In vivo behaviour of long-circulating liposomes in blood vessels in hamster inflammation and septic shock models,use of intravital fluorescence microscopyLUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 2 2001Jean-Marie Devoisselle Abstract This study aimed to observe liposome uptake by leukocytes in vivo. The study was performed on skin by using a dorsal skin-fold chamber implanted in golden hamsters using intravital microscopy. 5 and 6-CF-encapsulated polyethylene glycolated liposomes were injected intravenously. The skin microcirculation was observed with an intravital Eclipse E800 Nikon microscope (using ×40, ×80 magnification) fitted with a Xenon light source and an epifluorescence assembly (excitation, 470,nm, FWHM 40,nm; emission, 540,nm, FWHM 40,nm). An ultra-high sensitivity videocamera mounted on the microscope projected the image onto a monitor, and the images (720,×,576 pixels) were recorded for playback analysis with a digital video cassette recorder. An acute inflammatory response was obtained by removing one complete layer of skin and the underlying fascia and avascular tissue on the opposing side of the flap corresponding to an area equivalent to the window aperture. Using this model and set-up, leukocyte rolling and adhesion were easily observed and the entry of PEGylated liposomes into hamster blood leukocytes was studied for a period of 6,h. PEGylated liposomes were clearly identified alone inside the blood flow and inside the leukocytes as soon as the inflammatory reaction appeared. This study shows for the first time that blood leukocytes in their natural milieu of whole blood are capable of interacting with, and taking up, liposomes. This observation is in accordance with previous in vitro studies. Copyright © 2001 John Wiley & Sons, Ltd. [source] Face resurfacing using a cervicothoracic skin flap prefabricated by lateral thigh fascial flap and tissue expanderMICROSURGERY, Issue 7 2009Ph.D., Qingfeng Li M.D. Background: Resurfacing of facial massive soft tissue defect is a formidable challenge because of the unique character of the region and the limitation of well-matched donor site. In this report, we introduce a technique for using the prefabricated cervicothoracic skin flap for facial resurfacing, in an attempt to meet the principle of flap selection in face reconstructive surgery for matching the color and texture, large dimension, and thinner thickness (MLT) of the recipient. Materials: Eleven patients with massive facial scars underwent resurfacing procedures with prefabricated cervicothoracic flaps. The vasculature of the lateral thigh fascial flap, including the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia, was used as the vascular carrier, and the pedicles of the fascial flap were anastomosed to either the superior thyroid or facial vessels in flap prefabrication. A tissue expander was placed beneath the fascial flap to enlarge the size and reduce the thickness of the flap. Results: The average size of the harvested fascia flap was 6.5 × 11.7 cm. After a mean interval of 21.5 weeks, the expanders were filled to a mean volume of 1,685 ml. The sizes of the prefabricated skin flaps ranged from 12 × 15 cm to 15 × 32 cm. The prefabricated skin flaps were then transferred to the recipient site as pedicled flaps for facial resurfacing. All facial soft tissue defects were successfully covered by the flaps. The donor sites were primarily closed and healed without complications. Although varied degrees of venous congestion were developed after flap transfers, the marginal necrosis only occurred in two cases. The results in follow-up showed most resurfaced faces restored natural contour and regained emotional expression. Conclusion: MLT is the principle for flap selection in resurfacing of the massive facial soft tissue defect. Our experience in this series of patients demonstrated that the prefabricated cervicothoracic skin flap could be a reliable alternative tool for resurfacing of massive facial soft tissue defects. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source] The thoracodorsal vascular tree-based combined fascial flapsMICROSURGERY, Issue 2 2009Meisei Takeishi M.D. In this study, combined fascial flaps pedicled on the thoracodorsal artery and vein were raised and used for thin coverage of dorsal surfaces of the fingers and the dorsum of hand and foot with favorable results. The combined fascial flaps consist of the serratus anterior fascia and the axillary fascia at the entrance of the latissimus dorsi. These flaps were used for reconstruction of the hand, fingers, or foot in nine patients. Reconstruction was performed for burn or burn scar contracture, after resection of malignant tumors, posttraumatic skin defects, and chronic regional pain syndrome. The sites of reconstruction were dorsal surfaces of fingers, dorsum of hand, wrist and palm, forearm, lower leg, and foot. The flaps were used in various configurations including two independent fascial flaps, two-lobed fascial flap with separate feeding vessels, and composite fascial and thoracodorsal artery perforator flap. The fascial and skin flaps survived in all nine patients, with favorable results both functionally and esthetically. Good coverage of soft tissue defects and good recovery of range of motion in resurfaced joints were achieved. There were no complications. The scars at the sites of harvest were not noticeable. The advantage of this method is that not only a single flap but flaps of a variety of configurations can be harvested for different purposes. The thoracodorsal vascular tree-based combined fascial flaps are useful for the reconstruction of soft tissue defects in the extremities. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source] Technique for determining when plantar heel pain can be neural in originMICROSURGERY, Issue 6 2008A. Lee Dellon M.D., Ph.D. The surgeon doing microsurgery will encounter problems related to the heel not only in terms of how to reinnervate the transferred tissue, but also in patients presenting with heel pain. While most heel pain is thought to be related to the plantar fascia arising from the calcaneus, conceptually heel pain can be of neural origin. The technique for documenting sensibility in the heel is described using the Pressure-Specified Sensory DeviceÔ. Knowledge of calcaneal nerve sensibility can determine whether there is sufficient sensation to prevent ulceration, whether there is a nerve entrapment that would benefit from neurolysis, or whether there is a neuroma that would benefit from resection. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source] Anatomic basis of perforator flaps of medial vastus muscleMICROSURGERY, Issue 1 2008Heping Zheng Ph.D. The purpose of this study was to elucidate anatomical features of perforating branch flaps based on the muscular branches of the medial vastus muscle and to seek a new, applicable technique that could be used in repairing soft tissue defects around human knees. In this study, the origin, the course, the branches, the distribution, and the distal anastomosis of the muscular branch of the medial vastus muscle were observed in 30 sides of adult cadaveric lower limb specimens with the adductor tubercle, the patella midpoint, and the inguinal ligament midpoint as the observation markers. The specimens had been perfused arterially with red gelatin before they were supplied. It was observed that the femoral artery gave constant muscular branches into the medial vastus muscle at the tip of the femoral triangle. The artery entered the muscle via the hilum and ran laterally downwards along the muscular bundle until it reached the lateral patella to anastomose with the arterial circle around the bone. Along its course, it also gave 1,3 (1/77%) musculocutaneous perforating branches (0.5,0.9 mm in diameter). It then extended vertically through the medial vastus muscle into the deep fascia and ran superficially to the overlying skin of the muscle. A flap based on the perforating branch of the medial vastus muscle could be harvested at a size of about 8.5 cm × 15.0 cm and might be transferred retrograde to repair the soft tissue defect around the knee. © 2007 Wiley-Liss, Inc. Microsurgery, 2008. [source] Free osteocutaneous lateral arm flap: Anatomy and clinical applicationsMICROSURGERY, Issue 2 2003Franz Haas M.D. For many surgeons, the potential to reconstruct skin, fascia, tendon, or bone in a single-stage procedure has made the lateral arm flap the technique of choice for reconstruction of complex defects. The aim of this study was to examine more closely how the humeral bone is supplied by the posterior collateral radial artery. To this end, we dissected 30 cadaver arms to determine the vascular relationship of the lateral arm flap to the humerus. The number of directly supplying vessels, and height to the lateral epicondyle of the humerus, were examined. The reconstructive potential of the osteocutaneous flap in different indications is analyzed in a series of five clinical cases. In all dissected extremities, we found one or two branches of the posterior collateral artery directly and constantly supplying the bone between 2,7 cm proximal to the lateral epicondyle. In five cases, combined defects, including bone, were successfully reconstructed with lateral arm flaps, including vascularized bone. © 2003 Wiley-Liss, Inc. MICROSURGERY 23:87,95 2003 [source] Lining the mouth floor with prelaminated fascio-mucosal free flaps: Clinical experienceMICROSURGERY, Issue 5 2002D.D.S., L. Chiarini M.D. Soft-tissue defects of the mouth floor need thin, foldable, and pliable tissues able to preserve local anatomy as well as chewing, phonation, and deglutition. The oral mucosa is made of a stratified, nonkeratinized, epithelium-secreting mucus, which lubricates the oral cavity and facilitates tongue movements. No flap exists that can reproduce the physiology of the oral mucosa better than the oral mucosa itself. Prefabrication of mucosal flaps may represent the best solution. Therefore, 10 consecutive cases of mouth floor cancer were treated with prelamination of the fascia antibrachialis with mucosal grafts obtained from the healthy cheek, and with subsequent transplantation 3 weeks later. A significant increase in mucosal graft surface was seen in all cases, with a mean size twice the original. All flaps healed uneventfully. Follow-up time ranged between 2,60 months (average, 26.6 months). Morphological and functional results were excellent. Tongue motility, speech intelligibility, and swallowing were reestablished in all treated cases. Mucosal prelamination of the forearm fascia is feasible and allows physiological reconstruction of oral cavity defects up to 6 × 4 cm. © 2002 Wiley Liss, Inc. MICROSURGERY 22:177,186 2002 [source] | |||||||||||||||||||||||||||||||||||||