RESUMEN
There is no consensus on the use of prophylactic antibiotics in plastic surgery to prevent postoperative infection. This study was performed to investigate whether the use of prophylactic antibiotics has an effect on postoperative infection rate. A total of 500 patients were classified into 3 groups based on their diagnosis. Approximately half of the cases received amoxicilin/clavulanate combination the other half had no antibiotics. Wound infection was observed in the post operative period. According to our clinical findings, antibiotic prophylaxis is not necessary in plastic surgery in all patients. We did not find significant difference between the antibiotic prophylaxis and placebo group.
Asunto(s)
Profilaxis Antibiótica , Procedimientos de Cirugía Plástica , Cirugía Plástica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
Severe intraabdominal sepsis sometimes recquires very aggressive surgery with repeated surgical revisions of abdominal cavity. This often leads to large ventral hernia. The authors present one of the possibilities of surgical management of the hernia using fascia lata graft. This method is easy to perform and cost effective because of autologous material, which is most ideal from the point of biological view.
Asunto(s)
Fascia Lata/trasplante , Hernia Ventral/cirugía , Pared Abdominal/cirugía , Adolescente , Humanos , Masculino , Complicaciones Posoperatorias , ReoperaciónRESUMEN
Cleft lip and cleft palate are problems of great importance. The majority of cleft lips and palate are caused by the misdevelopment of mesoderm in facial region in second and third week of gestation. The main goal of the study was to evaluate the epidemiology of cleft lip and palate in East Slovakia and influence of environmental agents on the development of cleft lip and palate. The data were collected from epidemiological study performed by investigators among the population born with cleft anomaly in the period 1985-2000. Our conclusions concerning type of cleft and possible genetic and environmental influences were correlated to the literature. All of our results are pretty close to results published in literature.
Asunto(s)
Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Niño , Labio Leporino/etiología , Fisura del Paladar/etiología , Femenino , Humanos , Masculino , Eslovaquia/epidemiologíaRESUMEN
Authors describe 6 cases (3 women, 3 men) affected by Apert syndrome (acrocephalosyndactyly). Clinical material has been documented since 1953. They concentrate on the description of individual clinical cases on the basis of objective and radiograph examination of patients. They describe surgical procedure of syndactyly between the thumb and 2nd-5th digits on both hands. Prior to 1998 they started with separation of digits at the age of 3-5 years. After 1998 they began with it as early as at the age of 3-6 months. For the reconstruction of lateral aspects of separated digits and for the creation of inter-digital space they use "zig-zag" incision and for covering the resulting skin defects they use skin transplants. During separation of 2nd-4th digits they extirpate all phalanges of 3rd digit and they leave metacarpal III in situ by which they create a three-digit hand with a relatively good functional result.
Asunto(s)
Acrocefalosindactilia/complicaciones , Dedos/anomalías , Sindactilia/cirugía , Acrocefalosindactilia/cirugía , Adulto , Niño , Preescolar , Femenino , Dedos/cirugía , Humanos , Lactante , Masculino , Sindactilia/complicacionesRESUMEN
The authors describe their experience with Lemperle's method of reduction mammoplasty. It is based on the procedure of Wise and Strombeck and involves resection of the lower quadrants. We used this operation in seventy patients of the age between seventeen and 55 years during last five years. Six of our cases (8.6%) were classified as gigantomasty, four of them (5.7%) as hypertrophy with asymmetry and sixty patients (85.7%) were classified as hypertrophy with ptosis. As to the postoperative complications, two patients (2.8%) developed partial necrosis of the areola with dehiscence of the vertical suture and one patient (1.4%) partial dehiscence of the vertical suture. The resected tissue volumes were between 4,500 g and 400 g. The patients were very pleased with the result of the operation.
Asunto(s)
Mamoplastia/métodos , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana EdadRESUMEN
In the course of 16 years at the authors department 46 children with congenital malformation of the diaphragm were operated. This group comprised 12 children (26%) where the first symptoms developed only after the neonatal period. Most frequently the symptoms were repeated respiratory infections (in 9 children), and gastrointestinal complaints in 4 children. The children were operated electively: in 8 patients a left-sided Bochdalek hernia (1x with a sac) was involved, 3 children had a hiatus hernia and one child a Morgagni hernia. After surgery no early or late complications were recorded. In the discussion the authors deal with inborn diaphragmatic hernia with a late manifestation which is mainly a diagnostic problem. Therefore, based on their own experience and consistent with data in the literature, the authors recommend careful aimed examination of children with chronic non-specific respiratory or gastrointestinal complaints.
Asunto(s)
Hernias Diafragmáticas Congénitas , Preescolar , Hernia Diafragmática/diagnóstico , Hernia Diafragmática/cirugía , Humanos , Lactante , Recién NacidoRESUMEN
The presence of a Ca2+-blockable monovalent cation current is demonstrated in isolated ectodermal cells of the chick embryo using the whole-cell patch-clamp method. In the absence of any stimulation, the whole-cell current is time independent and rectifies outwardly at membrane potentials higher than +40 mV. The outward current is neither carried by Cl- channels nor by K+ channels. Application of a Ca2+-free solution containing 1 mmol/l ethylenediaminetetraacetic acid (EDTA) elicits a large inward current and increases the outward current. The inward current can be carried by extracellular Li+, Na+, K+ and Cs+, but not N-methyl-D-glucamine. The Ca2+-blockable monovalent cation channel discriminates very poorly among these cations. The estimated number of channels per cell is around 2000. Extracellular protons block the inward Na+ current in the absence of extracellular Ca2+. The apparent negative logarithm of the dissociation constant for proton (pKH) at -100 mV is 5.8. Among 12 potential channel modulators, including verapamil and nifedipine, only quinine decreases the current. Quinine blocks this current with a dissociation constant, Kd, equal to 0.18 mmol/l, independent of the membrane potential. This study demonstrates the presence of a whole-cell Ca2+-blockable monovalent cation current in dissociated chick ectodermal cells with permeation properties similar to those observed at the single-channel level. Contrary to studies made of other tissues, we did not observe any blocking effect of verapamil and nifedipine on the Ca2+-blockable monovalent cation current.
Asunto(s)
Bloqueadores de los Canales de Calcio/farmacología , Canales de Calcio/fisiología , Animales , Calcio/farmacología , Calcio/fisiología , Canales de Calcio/efectos de los fármacos , Permeabilidad de la Membrana Celular/efectos de los fármacos , Embrión de Pollo , Ectodermo/citología , Glutamatos/farmacología , Hidróxidos/farmacología , Nifedipino/farmacología , Protones , Quinina/farmacología , Verapamilo/farmacologíaRESUMEN
Some epithelial nonselective cation channels although in an open conformation are impermeable because they are blocked by extracellular Ca2+ ions. Such a channel is present in the apical membrane of the ectodermal cells of the chick gastrula. This single-channel study shows that protonation of a site located inside the pore of this embryonic channel reduces the Ca2+ block thus allowing Na+ to pass. The apparent pK for Ca2+ at -50 mV shifts from 5.7 at pH 7.4 to 3.5 at pH 4.5. Unexpectedly, the change in Ca2+ affinity does not originate from a destabilization of the binding but comes from a large reduction of the association rate.
Asunto(s)
Bloqueadores de los Canales de Calcio/farmacología , Calcio/farmacología , Canales Iónicos/efectos de los fármacos , Canales Iónicos/metabolismo , Animales , Calcio/metabolismo , Embrión de Pollo , Medios de Cultivo , Espacio Extracelular/metabolismo , Concentración de Iones de Hidrógeno , Cinética , Sodio/metabolismoRESUMEN
A Ca(2+)-blockable monovalent cation channel is present in the apical membrane of the ectoderm of the gastrulating chick embryo. We used the patch clamp technique to study several single-channel permeation properties of this channel. In symmetrical conditions without Ca2+, the Na+ current carried by the channel rectifies inwardly. The channel has an apparent dissociation constant for extracellular Na+ of 115 mM at 0 mV and a low density of negative surface charge (-0.03 e/nm2) at its extracellular entrance. The minimal pore diameter is approximately 5.8 A, as calculated from the relative permeabilities of 10 small organic cations. Extracellular application of six large organic cations decreased the inward Na+ current in a voltage-dependent manner, which strongly suggests an intrachannel block. The presence of at least two ion binding sites inside the pore is inferred from the Na+ dependence of the block by the organic cations. This hypothesis is strengthened by the fact that the extracellular Ca2+ block is also modified by the Na+ concentration. In particular, the rise of the unblocking rate with increased Na+ concentrations clearly suggests the presence of an interaction between Ca2+ and Na+ inside the channel. A low probability of double occupancy at physiological ionic conditions is implied from the absence of an anomalous mole fraction effect with mixtures of extracellular Li+ and K+. Finally, the absence of inward current at very strong hyperpolarizations and in the presence of 10 mM extracellular Ca2+ demonstrates the absence of significant Ca2+ current through this channel. It is argued that this embryonic epithelial Ca(2+)-blockable monovalent cation channel is related to both L-type Ca2+ channel and cyclic nucleotide-gated channels.