1/9. Detection of Epstein-Barr virus dna in a patient with Kimura's disease.An 80-year-old man, with a past medical history of senile dementia, presented with a 6-month history of a solitary, gradually enlarging tumor, located on his chin. A squamous cell carcinoma had been surgically excised 30 years previously in the same location. physical examination revealed an erythematous, well-defined plaque of 3 cm in diameter, located on the chin (Fig. 1). The submandibular lymph nodes were enlarged. Squamous cell carcinoma and primary cutaneous lymphoma were considered. Relevant laboratory findings were as follows: white blood cell count, 5.600/microL; eosinophils, 1000/microL; gammaglobulin, 2.4 g/dL; lactate dehydrogenase, 343 IU/L; and immunoglobulin g (IgG) antibodies to Epstein-Barr virus (EBV) positive (at 1 : 128 serum dilution), with negative IgM. skin and lymph node biopsies were performed. Histopathologic study of the cutaneous specimen revealed a heavy lymphoid infiltrate with numerous lymphoid follicles, with prominent germinal centers involving the subcutaneous fat as well as the deep dermis and muscular fascia. Some germinal centers showed folliculolysis. The lymphoid follicles were surrounded by fibrous tissue. The interfollicular infiltrate was rich in plasma cells and eosinophils that formed scattered eosinophilic microabscesses. Thin-walled vessels were numerous and prominent, but with no epithelioid or vacuolated endothelial cells (Fig. 2). Histopathology of a lymph node biopsy specimen showed reactive lymphoid follicle hyperplasia, with prominent eosinophilic infiltrates in both follicular and interfollicular areas. Eosinophilic deposits and polykaryocytes of Warthin-Finkeldey type were seen in the germinal centers. The paracortical area showed vascular proliferation. polymerase chain reaction (PCR) for the detection of specific sequences of EBV from routinely processed paraffin-embedded material was carried out under the conditions and with the same set of primers as described previously in detail (Tenorio A, Echevarria JE, Casas E et al. J Virol methods 1993; 44: 261-269). dna samples were confirmed to be amplifiable with PCR primers specific for a conserved region of the human beta-globin gene. Every sample was tested at least twice for EBV dna and beta-globin gene. One sample from one skin lesion of the patient, with confirmed diagnosis of Kimura's disease, and 10 samples from normal skin biopsies retrospectively collected from other patients in archival files of our department were tested. Only the patient's specimen tested positive to EBV. The amplified product of EBV was analyzed using dna sequencing and confirmed the results obtained. The patient received radiotherapy at doses of 35 Gy. Nevertheless, the tumor enlarged to reach twofold its original size 1 month later. Due to the physical status of the patient, no further treatments were considered, but the disease remained stable over the following 3 years.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Reconstruction of total lower lip, labial commissure and palatomaxillary defect with composite island cheek flap.Functional and cosmetic restoration of total lower lip, labial commissure, and palatomaxillary defects can be achieved by using multiform flaps. The possibility of reconstruction of these areas with composite island cheek flap is presented. The flap was used in three patients who were surgically treated between 1993 and 1998. In one female patient, total lower lip and chin defect was restored with a small contralateral platysma muscle cutaneous flap. The functional and cosmetic result was achieved with composite island cheek flap. In the other two cases, reconstruction was performed without another flap. Composite island cheek flap is supplied with bloody by the facial artery and vein, and contains mucous membrane, muscle and skin of the cheek. In two cases, the flap was formed by the anterior part of the buccal muscle, and in the case with the reconstruction of labial commissure, the greater and lesser zygomatic muscles with levator muscle of the angle of mouth were used. By freeing the blood vessels from the surrounding structures, isolation and transsection of minor vessel branches allowed straightening of the tortuous main vessels. With this technique, excellent functional and satisfactory cosmetic results were achieved in a single act, with minimal morbidity for labial commissure, and total lower lip or palatomaxillary defect reconstruction.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
3/9. glomus tumor: a rare location in the upper lip.glomus tumor is a benign neoplasm composed of glomocytes and vessels in varying proportions. It appears as a single painful nodule typically found in the dermis and the subcutaneous tissue of the extremities. A rare appearance of the tumor in the upper lip is presented. Differential diagnosis (along with clinical, microscopic, and immunohistochemical findings) is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Proximal forearm flap based on a septocutaneous vessel from the radial artery.BACKGROUND: The radial forearm flap has been a workhorse flap for soft-tissue or coverage reconstruction in the head and neck area. Although it has several major advantages, it requires sacrifice of the radial artery. In this article, the authors present their modification of harvesting a forearm flap based on a large septocutaneous branch of the radial artery in the proximal forearm with or without sacrificing the main radial artery. They name it the proximal radial forearm flap. methods: From September of 2003 to March of 2004, a total of 14 free proximal radial forearm flaps were used for head and neck reconstruction in 12 patients. There was one female patient and 11 male patients. Their ages ranged from 32 to 85 years. The skin flap size ranged from 2.0 x 6.0 cm to 4.5 x 18 cm. RESULTS: All free proximal radial forearm flap reconstructions had immediate success. There were one delayed flap loss caused by wound infection and one death attributable to advanced medical disease. Six flaps were harvested with preservation of the radial artery trunk. Six of the eight radial arteries that were killed during flap harvest were repaired with a short segment (3 to 4 cm) of vein graft. The average diameter and length of the septocutaneous vessel of the proximal radial forearm flap was 0.73 mm and 3.3 cm, respectively. Two flaps were harvested in conjunction with the conventional free radial forearm flaps. Nine donor sites were closed primarily and five donor sites required skin grafts. CONCLUSIONS: The proximal radial forearm flap can be used successfully in head and neck reconstruction with the advantages of moving the donor site to the proximal forearm for better scar concealment and possible preservation of the radial artery trunk. The disadvantages of this flap are short pedicle length and small pedicle diameter when the radial artery is to be preserved.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
5/9. The CO2 laser in surgery of vascular tumors of the oral cavity in children.The three cases of children treated for excision of oral hemangiomas presented here illustrate the advantages of using the CO2 laser rather than a scalpel in surgery for vascular lesions of the oral cavity. This laser has the ability to coagulate, vaporize, or cut; its main advantage, however, is its ability to seal blood vessels during surgery. Satisfactory healing in infants and children makes the CO2 laser the preferred method for performing vascular surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/9. angiomyoma of the upper lip: report of a case with electron microscopic and immunohistochemical observation.Immunohistochemical and electron microscopic observations of a vascular leiomyoma of the upper lip are presented. Tumour cells were positive for desmin, vimentin and neuron specific enolase but not for S-100 protein. factor viii was detected in the endothelium of blood vessels. Ultramicroscopically, the spindle-shaped tumour cells had elongated nuclei and cytoplasm containing abundant myofilaments and pinocytotic vesicles. Emphasis is placed on the fact that an immunohistochemical approach using appropriate antibodies can be used in identifying this tumour.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/9. angiography in the evaluation of cryosurgery efficiency in the treatment of a haemangioma of the face. A case report.The authors present the use of carotid angiography for the diagnosis of maxillofacial cavernous haemangiomata. Radiological investigation of vessels permits the identification of the exact site and range of pathological change but also the evaluation of the mechanism of tissue healing following cryogenic treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Superselective embolization and surgery of noninvoluting hemangiomas and A-V malformations.Eight patients with severe arteriovenous malformations of the head and neck region have been treated by superselective embolization utilizing Ivalon and surgery. Six of those patients underwent surgical resection of the malformation following embolization with apparent lack of recurrence of the vascular tumor. The approach of superselective embolization is different because it is an attempt to occlude the malformation from the inside out, that is, occluding the smallest vessels first, and utilizes the increased vascular demand of the tumor. The increased blood flow to the malformation is seen to change, since new vessels dilate instantly following occlusion of major feeders. The malformations fill from the ipsilateral side first, but frequently from the contralateral vessels as well. The futility of surgical ligation of large incoming filling vessels is pointed out. Complications other than what may occur with any transfemoral arteriogram included skin slough, particularly when the "glue" was utilized to an excess of extracranial sites.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
9/9. Cryogen spray cooling for spatially selective photocoagulation of hemangiomas: a new methodology with preliminary clinical reports.Spatially selective photocoagulation of subsurface-targeted blood vessels by repetitive application of a short cryogen spurt during continuous Nd:YAG laser irradiation has been demonstrated in two human cases. This procedure may be effective for the treatment of thick hemangiomas that require photocoagulation of subsurface blood vessels while protecting the epidermis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |