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May 2019 DOI 10.14302/issn.2641-5518.jcci-19-2816
Menon P VarunCorresponding author
Assistant Professor, Department of Oral and Maxillofacial Surgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
Basal cell carcinoma (BCC) is the most common type of skin cancer, which arises from the basal layer of the epithelium. It is a slow growing tumor and has a low metastatic potential, it accounts for 70–80% of all cutaneous malignancies in the head face and neck region .Defects near nasal tip and ala of the nose are one of the most difficult site to cover in a single stage, bilobed flap is reported to be used very effectively to close the defect in these areas. This article reports a case of basal cell carcinoma involving the ala of the nose which was excised and the reconstruction was done using bilobed flap.
Dec 2015 DOI 10.14302/issn.2473-1005.jdoi-15-742
Fortes Ferreira CimaraCorresponding author
Assistant Professor, Department of Prosthodontics, UTHSC, Memphis, TN, USA.
This case report details reconstruction of a severely atrophic pre‑maxilla using rhBMP‑2 and a titanium mesh framework. Surgical technique, graft outcomes, and implant rehabilitation are described, with notes on indications and complications.
Mar 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3756
Boulila MoncefCorresponding author
Professor, Université de Sfax- Institut de l’Olivier- B.P. 14, 4061 Sousse Ibn Khaldoun, Tunisia.
In contributing to the initiative to address the COVID-19 pandemic and in order to enhance the knowledge on driving forces shaping the evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (isolated from Tunisian patients), a comparison in relation to other coronaviruses infecting humans (SARS-CoV-1, MERS-CoV, HCoV/229E, HCoV/NL63, HCoV/OC43, and HCoV/HKU1) as well as animals (SARS-CoVs in tiger, bats, civet, pangolin, bovine, and MERS-CoV in dromedary/camel), was conducted. In-depth analysis was carried out involving 115 sequences of spike glycoprotein-coding gene extracted from the international databases. Phylogeny inference allowed the reconstruction of a bifurcating tree where four distinct groups were delineated and at the same time, three animal accessions (SARS-CoV-2/tiger, MERS-CoV/camel, and SARS-CoV/bovine) shifted from the animal group and integrated the human coronaviruses clades. Nonetheless, in the presence of reticulate events such as recombination, networks described better the phylogenetic relationships rather than the classic dendrogram. Thus, networks were produced and identified four clusters containing sharply demarcated subgroups (eight subdivisions). Except networked phylogenies of SARS-CoV-1, SARS-CoV-2, and HCoV/HKU1, all the others showed edges and boxes illustrating the occurrence of incompatibilities related to the sequences of spike glycoprotein-coding gene. Thereby and consolidating this result, three methods (RDP package, GARD, and RECCO) were used to detect breakpoints in aligned sequences. Except the clades SARS-CoV-1 and SARS-CoV-2, all the remaining phylogenetic subdivisions were subject to recombination. Furthermore, the screening of selection pressure in all studied sequences by various statistics-based models of the HyPhy package, showed that, similarly, the lineages belonging to the clades SARS-CoV-1 and SARS-CoV-2 were not under selection. In contrast, all members of the remaining clades underwent, to different extents, adaptive selection as well as purifying selection.
Dec 2020 DOI 10.14302/issn.2641-5518.jcci-20-3636
El Guindi WaelCorresponding author
Department of Obstetrics and Gynecology, Franck Joly Hospital, Saint-Laurent-du-Maroni, France
Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.
Feb 2020 DOI 10.14302/issn.2768-0207.jbr-20-3194
Mohammed AL-Namnam NisreenCorresponding author
Departmet of Oral Biology and Biomedical sciences, Faculty of Dentistry, MAHSA University, 42610 Bandar Saujana Putra, Malaysia
Rhinosinusitis is one of widely spread diseases in the region and the role of the anatomical variations in its pathogenesis remains unresolved. A retrospective study using CBCT scan was employed to locate and measure the diameter of 320 primary maxillary ostium (PMO) (n = 160 subjects) among the Malay and Chinese populations (Mongoloid race) in Malaysia. Image analysis was performed using the i-CAT Vision Software, employing the multiplanar reconstruction window in which axial, coronal and sagittal planes were visualized in 0.3 mm intervals. The mean diameter of the PMO was significantly larger in the Chinese than the Malay. Females had larger size than the male and bilateral asymmetry was noticed, where the right side PMO was larger than the left side (p < 0.05). In addition, PMO opened more in the posterior third position of the hiatus semilunaris (61.9%) than anterior and middle third. The PMO showed a statistically significant posteriorly placed position in the Chinese than the Malays and this was more evident in the right side PMO (p < 0.01). In conclusion, the PMO commonly opens in the posterior third of the hiatus semilunaris and its diameter is significantly greater in the Chinese female with evidence of bilateral asymmetry. Awareness the anatomical variation of the Ostium diameter and location among the Malay and Chinese populations potentially has important clinical effects during surgical procedures.
Feb 2019
P Dargan DallanCorresponding author
Mersey Regional Burns and Plastic Surgery Centre, Whiston Hospital, Warrington Road, Prescot, Merseyside, L35 5DR, United Kingdom
Background: Chest wall deformities may be managed with skeletal manipulation, which risks life-threatening complications. Custom-made prostheses are a less invasive surgical option, manufactured from silicone elastomer using 3D computed tomographic reconstruction and 3D-printed thoracic models. Methods: All patients undergoing custom-made implants between January 2010 and March 2017 were identified from the prosthetic department records. A retrospective review of the clinical records was performed. Mean follow up period was 1.8 years. A comparison was made with our earlier results from 1995 to 2009. Results: Twenty-six patients underwent insertion of custom-made implants for chest wall deformity. Pectus excavatum was present in 50% (n=13), and Poland syndrome 42% (n=11). All 11 female patients underwent 3D reconstruction and 3D printed models, and 3 of 15 males. Four underwent simultaneous bilateral breast augmentation, and three had staged breast augmentation. Seroma occurred in 27% (n=7), and hypertrophic scar in 12% (n=3). The reoperation rate was 23% (n=6), including autologous fat graft in two patients. Surgical suction drains were used in 42% (n=11) patients, of whom 36% (n=4) developed seroma, compared with 17% (n=2) of those without drains (p=0.08). Conclusions: Custom-made prostheses are an effective and safe option for patients with chest wall deformities. The majority have a short postoperative inpatient stay (81%) and are satisfied with the outcome (77%). Seroma was the commonest complication (27%), and drains did not reduce seroma risk. Single dose intravenous antibiotic prophylaxis is adequate. A minority of patients opt for further aesthetic procedures.
Jul 2016 DOI 10.14302/issn.2471-7061.jcrc-14-575
V. Roig JoséCorresponding author
Consorcio Hospital General Universitario de Valencia, Department of General and Digestive Surgery.
Aim: To analyze the factors involved in and the results of stoma reversal after an emergency Hartmann's operation. Methods: A multicenter retrospective study from the Valencian Society of Surgery of patients who had undergone an emergent Hartmann’s operation from 2004 to 2008. An analysis of the reversal rate and related factors, delay, and morbidity of reconstruction was performed. Results: Three hundred sixty-two patients were studied. The most frequent initial diagnosis was colorectal cancer, followed by complicated acute diverticulitis; the primary surgical indication was acute peritonitis. After a median follow-up of 52 months, 151 patients (41.7%) underwent surgery to reverse the stoma at a median of 10 months after initial surgery. Diagnosis of diverticulitis or trauma, peritonitis as the surgical indication, and non-advanced tumors were associated with reversal. Multivariate analysis showed that only age and tumor stage were predictive of reversal. Postoperative complications occurred in 44% of the cases, and wound infection was the most common. There were 9 (6%) anastomotic leaks. Thirteen patients (8.6%) retained a permanent or temporary stoma after the attempted reconstruction. Conclusion: Hartmann’s reversal after emergency surgery is performed in less than half of all such patients and has significant morbidity.
Feb 2016 DOI 10.14302/issn.2575-7881.jdrr-15-849
BOULILA MoncefCorresponding author
Professor, Université de Sfax- Institut de l’Olivier- B.P. 14, 4061 Sousse Ibn Khaldoun, Tunisia.
Reverse Transcription Polymerase Chain Reaction (RT-PCR) using new designed primers pair for Heat Shock Protein70 homologue (HSP70h) of Olive leaf yellowing-associated virus revealed 667 amplified product of 10 olive accessions collected from various olive-growing regions in Tunisia. Amplicons were cloned and sequenced. The sequences were deposited in the international databases. Pairwise sequence comparisons among 10 Tunisian isolates along with a reference sequence (AJ440010) extracted from GenBank revealed a nucleotide identity of 86.06-99.40 and an amino acid similarity of 91.89-99.55. Sequence multiple alignments were searched for evidence of recombination using three methods, ie. Differences of Sums of Squares (DSS) implemented in TOPALi v2.5 software and Single Breakpoint (SBP) along with GARD, a genetic algorithm, both incorporated in HyPhy package. All used methods pointed out the presence of putative breaking points in partially sequenced HSP70h-coding gene. Since failing to account for recombination can mislead the phylogeny inference and can elevate the false positive error rate in positive selection assessment, the use of GARD resulted in the reconstruction of different phylogenies on the left as well as on the right sides of putative recombination breaking points, and the 11 accessions were distributed into at least three clusters compared to MEGA6 software which delineated only two clades. Nonetheless, by dividing the aligned sequences at breakpoints into separate sequence sets, MEGA6 delineated a clustering pattern different from the former two. As a result, recombination reshuffled the affiliation of the different accessions to the clusters. Analysis of selection pressures exerted on HSP70h encoded protein using different models (SLAC, IFEL, FEL, REL, PARRIS, FUBAR, MEME, GA Branch, and PRIME) taking into account recombination, and implemented in HyPhy package, revealed that it underwent predominantly purifying selection as confirmed by Tajima’s D, Fu and Li’s D and F tests, and SNAP algorithm. However, a few sites were also under positive selection as assessed by various models such as FEL, IFEL, REL, MEME, and PRIME.
Dec 2015 DOI 10.14302/issn.2471-7061.jcrc-15-661
Zoucas EvitaCorresponding author
Colorectal Section, Division of Surgery and Urology, Skane University Healthcare, SE-205 02 Malmö, Sweden.
Following multivisceral pelvic resections, the pelvis and perineum are often reconstructed using myocutaneous flaps. Abdominal wall defects after harvesting rectus abdominis flaps can be reinforced with mesh. Primary reconstruction using synthetic mesh was presently evaluated. Fifty-eight patients who underwent multivisceral pelvic resection and perineal reconstruction with a vertical rectus abdominis myocutaneous (VRAM) flap, January 2004 to February 2014, were retrospectively reviewed. The abdominal wall was reinforced in 26. Demographics, treatment procedures, surgical procedures, length of hospital and ICU stay, early and late morbidity at the recipient and donor sites were recorded. Patients with mesh reinforcement were significantly younger than those without. There were no further significant differences in patient demographics or treatment procedures between the two groups. In 31% of the patients with mesh, surgery was performed on two consecutive days, although total operating time did not differ significantly. Patients without mesh bled more. Surgery was associated with considerable morbidity, without significant differences in overall complication rate between the two groups. At the recipient site, wound infection/dehiscence was the most common early complication. The group with mesh had higher rate of total flap necrosis necessitating re-operation. At the donor site, wound infection /dehiscence, hernia, or bulge were recorded. Patients with mesh had lower rates of donor site morbidity. Perineal reconstruction with VRAM flap and primary abdominal wall reinforcement with mesh is feasible after multivisceral resection. Our study indicates that primary use of mesh can be applied in potentially contaminated surgical fields in oncologic patients without increasing morbidity and with improved long-term cosmetic results.