1/40. Annular vasculitis in association with sarcoidosis.We report a case of cutaneous vasculitis with annular features in association with sarcoidosis. A 36-year-old woman presented with fever, polyarthralgias, erythema nodosum, bilateral hilar lymphadenopathy, and induration of a long-standing scar on the face. In addition, she developed annular, erythematous, and purpuric patches over her thighs and buttocks that were histologically characterized by a small vessel leukocytoclastic vasculitis. The presence of circulating immune complexes in the early stages of sarcoidosis might be related to the occurrence of the vascular damage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/40. Protean manifestations of lipoid proteinosis in a 16-year-old boy.We report a 16-year-old Japanese male with lipoid proteinosis showing various skin manifestations. The patient was born to nonconsanguineous parents and none of his relatives was similarly affected. The patient suffered from a hoarse voice and refractory temporal epilepsy from early childhood. Computed tomography scanning of the brain showed bilateral calcification in the temporal lobes, a characteristic feature of lipoid proteinosis. On physical examination, various skin manifestations, including papules and haemorrhagic blisters, acne-like scars at sites of minor trauma or friction, and beads of small papules along the free margins of the eyelids were noted. A skin biopsy showed deposits of homogeneous hyaline-like material, positive on periodic acid-Schiff staining, throughout the dermis, particularly around small blood vessels. It is noteworthy that a range of characteristic skin lesions can be present in a patient with lipoid proteinosis even with mild systemic involvement.- - - - - - - - - - ranking = 3.4097314290818keywords = blood vessel, vessel (Clic here for more details about this article) |
3/40. Preperitoneal lipoleiomyoma of the abdominal wall in a postmenopausal woman.OBJECTIVE: Extrauterine leiomyomas are rare events. These tumors may be easily misdiagnosed as ovarian tumors at the clinical investigation. We present the first case of an otherwise healthy postmenopausal woman, hysterectomized 20 years ago, who developed a preperitoneal lipoleimoyoma in the 30-year-old scar of a Pfannenstiel incision. The patient received continuous hormone replacement therapy (HRT) for 5 years with 1.25 mg conjugated estrogen and 5 mg medrogeston per day. methods: In sections of the tumor, immunohistochemical reactions with antibodies against actin, desmin, vimentin, estrogen and progesterone receptors and factor viii related antigen was performed. RESULTS: Histologic findings revealed cellular fascicles of spindle-shaped smooth muscle cells in a whorled arrangement. Mitotic figures were absent. Central degenerative changes and focal edema were observed. Between muscle fascicles, a significant amount of fat cells (20% of tumor volume) was visible. Leiomyocytes showed immunohistochemicaly positive reactions with actin, desmin, vimentin, and steroid hormone receptors. Based on these findings, the tumor was diagnosed as lipoleiomyoma. CONCLUSIONS: Origin of the tumor of smooth muscle cells of vessels located in the abdominal wall and development under influence of oral steroids seems most probable. HRT appears to promote the development of extrauterine leiomyomas in postmenopausal women.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/40. The sandwich temporoparietal free fascial flap for tendon gliding.Microsurgical transfer of the superficial and deep temporal fascia based on the superficial temporal vessels has been documented. This article analyzes the functional recovery when each layer of this facial flap is placed on either side of reconstructed or repaired tendons, to recreate a gliding environment. This fascial flap also provided a thin, pliable vascular cover in selected defects of the extremities.Six patients (four male and two female) with tendon loss and skin scarring of the hand (three dorsum, one palmar, and one distal forearm) and posttraumatic scarring of the ankle with tendoachilles shortening (one patient) underwent this procedure. No flap loss was witnessed. Good overall functional recovery and tendon excursion were observed. Complication of partial graft loss was observed in two patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/40. Ultrastructure of keloid: an unusual incident involving lepromatous leprosy.A patient with lepromatous leprosy developed keloids on the dorsum of both arms in response to ulcerations due to acute erythema nodosum leprosum reactions. Electron microscopic examination of the keloidal dermis showed a morphology indicative of increased production of normal collagen fibrils. The greatest cellular changes from normal were in fibroblasts which were enlarged due to increased amounts of rough endoplasmic reticulum and extensive Golgi complexes. Nuclear folds were also evident in these fibroblasts. Some cells, considered to be fibroblasts, were filled with cytoplasmic filaments and contained bizarre shaped nuclei. mast cells, blood vessels and nerve processes were also present.- - - - - - - - - - ranking = 3.4097314290818keywords = blood vessel, vessel (Clic here for more details about this article) |
6/40. Innovation and surgical techniques: endoscopic resection of cervical branchiogenic cysts.The recent advent of endoscopic procedures has compelled both plastic and neck and head surgeons to reconsider the conventional methods by which the excision of cervical congenital cystic is classically achieved.An endoscopic approach for excision of the cervical congenital cystic is described. This procedure is anatomically safe and can be made with minimal morbidity through a small transcervical incision.Both specific instruments and solid anatomical knowledge are necessary to perform a safe and efficient cystic endoscopic excision.The essential surgical steps are as follows: 1. Minimal incision placed in natural cervical wrinkle over the dome of the cyst; 2. Intracystic or extracystic dissection; 3. Identification and protection of the sternocleidomastoid muscle, spinal nerve, hypoglossi nerve, and posterior belly of digastric muscle; 4. Careful dissection of the posterior surface of the cyst, avoiding injury on the carotid vessels and internal jugular vein.Eight patients were operated on with this technique and they were very pleased with postoperative comfort and aesthetic results. Inconspicuous scars and no complications were registered.With advanced endoscopic instruments and the development of new surgical technique and surgeon experience, the endoscopic surgery can be the method of choice in cervical excision of branchiogenic cysts.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/40. An anatomical and clinical study of the dorsal intercostal cutaneous perforators, and application to free microvascular augmented subdermal vascular network (ma-SVN) flaps.We report a two-part anatomical and clinical study whose aim was to map the dominant dorsal intercostal cutaneous perforators (DICPs), which are useful for microvascular augmentation of flaps raised from the skin of the back called subdermal vascular network (SVN) flaps, and to test their reliability in the clinical setting. In the anatomical arm of the study, using preserved cadavers, we macroscopically confirmed the location of DICPs, and performed micro-angiography of the dorsal skin to find each dominant DICP. In the clinical arm of the study, we confirmed the location of the dominant DICP during microvascular augmented SVN flap transfer. Postoperatively, posteroanterior radiographs of the chest were taken to locate vessel clips used to ligate the DICPs. The combined study results showed that the dominant DICP is the sixth or seventh in most instances, but there are some anatomical variations. If no dominant DICP is found in the sixth or seventh spaces, at least one DICP that is of sufficient calibre for microvascular augmentation can usually be found in the general vicinity, such as the fifth, eighth or ninth spaces. The clinical application of microvascular augmented SVN flaps, both pedicled and free, is presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/40. The microvascular augmented subdermal vascular network (ma-SVN) flap: its variations and recent development in using intercostal perforators.In 1994 we reported the use of the microvascular augmented occipito-cervico-dorsal 'super-thin' flap for reconstruction of the cervical region in three cases. Since this preliminary report, we have performed a further 17 flaps, and the usefulness of the flap in the treatment of anterior cervical scar contractures in extensively burned patients has become apparent. Moreover, we have devised flaps with not only a narrow skin pedicle but also myocutaneous or island vascular pedicles. Various augmentation vessels, including myocutaneous perforators of the intercostal spaces in the back and chest, have also been used successfully. Here, we describe the microvascular augmented subdermal vascular network flaps that we have devised.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/40. Ill-defined choroidal neovascularization within ocular histoplasmosis scars.Seven patients with scars typical of ocular histoplasmosis syndrome presented with new symptoms of decreased vision or metamorphopsia. In each patient the symptoms corresponded to an atrophic or "punched-out" histoplasmosis scar in the macula. Clinically, a small amount of subretinal fluid overlying the scars and slight hyperfluorescence were seen on fluorescein angiography. These findings were due to a choroidal neovascular membrane growing within the margins of the atrophic scar. The membranes were difficult to diagnose because of the absence of hemorrhage, pigmentation, or growth of vessels beyond the margins of the scar. Clinicians should be aware that these patients may have early and growing choroidal neovascularization and may need to undergo photocoagulation or to be followed closely.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/40. Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization secondary to toxoplasmic chorioretinal scar.BACKGROUND: To assess the effect of photodynamic therapy in the treatment of subfoveal choroidal neovascularization consecutive to a toxoplasmic chorioretinal scar. history AND SIGNS: Three patients with a previous history of toxoplasmic chorioretinal scar noticed a decrease in visual acuity and metamorphopsia. Fundus examination and fluorescein angiography revealed the presence of subfoveal choroidal neovascularization at the edge of the toxoplasmic chorioretinal scar. THERAPY AND OUTCOME: The first patient, aged 78, was treated by photodynamic therapy followed by three subsequent treatments of feeder vessel by laser photocoagulation. visual acuity decreased during follow-up in the presence of recurrence of choroidal neovascularization and subretinal fibrosis. The second patient, a 20-year-old lady, was treated with three sessions of photodynamic therapy for a subfoveal choroidal neovascularization related to a toxoplasmic scar. visual acuity was stabilized on the last follow-up visit at 0.3. The third patient, aged 53, received four treatments with photodynamic therapy at an interval of 3 - 4 months. choroidal neovascularization was stabilized and the last visual acuity was 0.2. CONCLUSIONS: This preliminary report suggests that photodynamic therapy with verteporfine may be an effective therapeutic modality for subfoveal choroidal neovascularization related to a toxoplasmic chorioretinal scar. Further assessment is needed in order to confirm this preliminary findings.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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