Biomedical subjects

A Cordova

Publications and source records attributed to A Cordova.

At least 19 recordsLinked to original sources

PubMed2006

Further application of the bilobed flap: the split bilobed flap for reconstruction of composite posterior auricular and mastoid defects.

In this article a modified bilobed flap from mastoid and lateral neck skin for reconstruction of complex defects of the posteromedial surface of the auricle and mastoid skin, with the preservation of the retroauricular sulcus, is described. Reconstruction of the postero-medial auricular surface has almost never been a concern for reconstructive surgeons. It is in fact a shaded area with little aesthetic relevance and direct closure, skin grafting and even secondary healing are used for skin cancer defects repair. Also mastoid skin defects can be repaired with simple techniques such as skin grafts or transposition flaps from the remaining mastoid skin or from the neck. On the other hand, cancers involving the postero-medial auricular surface, the retroauricular sulcus and the mastoid skin require wide and deep resections that involve the posterior auricular muscles and reach the perichondral and periosteal surfaces. Direct closure with undermining, if feasible, will obliterate the retroauricular sulcus causing asymmetry with the contralateral ear and, if defects are cephalad will impair the possibility of wearing spectacles, thus leaving functional and aesthetic impairment. Transposition flaps from the remaining mastoid skin, due to the lack of skin laxity, are not feasible because the donor site cannot be closed. Two patients, both affected by basal cell carcinoma involving the posteromedial auricular surface and the mastoid skin have been treated with this flap. In both cases the use of the modified bilobed flap described in this article allowed preservation of the retroauricular sulcus and closure of the donor site. Scars were hidden along minimal tension lines and the possibility of wearing spectacles along with sensitivity all over the reconstructed area were maintained.

Aged↗

PubMed2005

Dupuytren's contracture: an update of biomolecular aspects and therapeutic perspectives.

The so-called fibrogenic cytokines, able to induce the growth of fibroblasts and their differentiation into myofibroblasts and to stimulate their production of extracellular matrix, are involved in the genesis of Dupuytren's contracture. Although many studies have been made of biomolecular aspects of palmar fibromatosis, practical applications from them are still far from imminent because of the real difficulty of blocking their action in vivo, even in a chronic, progressive lesion such as Dupuytren's disease. Consequently, surgical excision of the palmar fascia still remains the treatment of choice.

Dupuytren Contracture↗

PubMed2005

Surgical treatment of pharyngostomes in irradiated patients. Our experience with musculocutaneous pectoralis major flap and hyperbaric oxygen therapy.

CONCLUSION: Our experience confirms that pectoralis major flap is the first-choice technique for repairing recurrent hypopharyngeal fistulae in previously irradiated patients in whom microsurgical techniques are not indicated, and that hyperbaric oxygen therapy helps to solve this complex pathology. OBJECTIVES: A pharyngostome is a complication encountered when performing surgical operations on pharyngolaryngeal structures. The authors present their experience of treating recurrent complex pharyngostomes in previously irradiated patients in poor physical health. These patients need a simple, safe reconstruction with a low incidence of postoperative complications. MATERIAL AND METHODS: A pedicled pectoralis major flap was used for reconstruction: the skin side of the flap was used to restore the continuity of the pharyngeal mucosa, while the muscle was used to reconstruct the intermediate layer. The skin layer was completed by means of a free skin graft. In all cases, surgical treatment was combined with hyperbaric oxygen therapy before and after the operation. RESULTS: A total of 10 patients, all of whom had previously undergone surgery and radiotherapy, had recurring or pluri-recurring pharyngostomes. All patients (8 males, 2 females; age range 52-80 years) had previously been affected by carcinoma of the pharyngolaryngeal region. All underwent major local Ablation together with radical neck dissection and radiotherapy. In all cases there was mucosa on the posterior wall; a musculocutaneous pectoralis major flap was used in all cases for reconstruction.

Aged↗

PubMed2003

The supra-auricular arterial network: anatomical bases for the use of superior pedicle retro-auricular skin flaps.

The authors present an anatomical study on vascularization of the retro-auricular skin, focusing on the origin, distribution and anastomoses of the superior auricular artery. This artery is used as the pedicle of a retro-auricular flap to repair defects in the upper third of the auricle and in the temporal region. The study was carried out on 13 fresh cadavers, with a total of 25 auricles. The common carotid artery had previously been injected with dyed latex. The superior auricular artery was found in all specimens. It had constant course and caliber, mean axial length 2.4 cm, mean caliber 0.8 mm. This artery connected the superficial temporal artery, or its parietal branch, and the posterior auricular artery network. This branch proved a reliable vascular pedicle for the mobilization of retro-auricular flaps. The results of this study are presented together with preliminary clinical results obtained using an antero-superior retro-auricular flap, never previously described, to reconstruct the superior third of the auricle and the temporal region.

Arteries↗

PubMed2003

An innervated retroauricular skin flap for total earlobule reconstruction.

In this article, the authors describe a technique for total earlobule reconstruction in a patient who underwent earlobule excision for basal cell carcinoma. The reconstruction was by means of an innervated retroauricular skin flap, folded double. The flap presented preserved skin sensitivity over all the reconstructed area, which is compromised by those techniques using a cranially or medially based flap which lead to the reconstruction of an insensible earlobule. This is a very important aspect of this technique, especially for those who wear pendant earrings, since a non-sensitive lobule would be more vulnerable to traumas causing laceration. In addition, it allows a good aesthetic result without evident donor site scars. Further investigation is needed to decide if this method is suitable for other types of total earlobule loss (e.g. congenital, traumatic), or not.

Ear Neoplasms↗

PubMed2002

[External oblique muscle-cutaneous flap use of the in the reconstruction of large chest wall defects after mastectomy].

The use of an external oblique muscle-cutaneous flap in the reconstruction of large chest wall defects after mastectomy is described. The flap is drown as a V-Y advancement-rotation flap, laterally based, on the ipsilateral abdominal wall. The flap extends from the posterior axillary line to the linea alba, vascular supply is provided by the musculo-cutaneous perforating arteries of the intercostal vessels. Mobilization starts medially including the anterior rectus sheath, décollement continues between the external and the internal oblique muscles as far as the posterior axillary line. The abdominal wall, after flap mobilization, is reinforced by the plication of the internal oblique sheath. The flap was used in 13 patients with major anterior chest-wall defects after mastectomy. In one patient a marginal skin necrosis of about 2 cm was observed. The flap described differs from other external oblique flaps already described in several technical innovations that allow to obtain better functional and esthetic results.

Abdominal Muscles↗

PubMed2001

Effect of Lepidium meyenii (maca) roots on spermatogenesis of male rats.

AIM: To determine the effect of oral administration of an aqueous extract from the roots of Lepidium meyenii (maca) on spermatogenesis in adult male rats. METHODS: Male rats received an aqueous extract of the root (66.7 mg in one mL) twice a day for 14 consecutive days. RESULTS: Treatment with Lepidium meyenii resulted in an increase in the weights of testis and epididymis but not the seminal vesicle weight. The length and frequency of stages IX-XIV seminiferous tubules, where mitosis occurred, were increased and stages I-VI were reduced in rats treated with Lepidium meyenii. CONCLUSION: The Lepidium meyenii root invigorates spermatogenesis in male rats by acting on its initial stages (IX-XIV).

Administration, Oral↗

PubMed2001

Lepidium meyenii (Maca) improved semen parameters in adult men.

AIM: The present study was designed to determine the effect of a 4-month oral treatment with tablets of Lepidium meyenii (Maca) on seminal analysis in nine adult normal men aged 24-44 years old. METHODS: Nine men received tablets of Maca (1500 or 3000 mg/day) for 4 months. Seminal analysis was performed according to guidelines of the World Health Organization (WHO). Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), testosterone (T) and estradiol (E2) were measured before and after treatment. RESULTS: Treatment with Maca resulted in increased seminal volume, sperm count per ejaculum, motile sperm count, and sperm motility. Serum hormone levels were not modified with Maca treatment. Increase of sperm count was not related to dose of Maca. CONCLUSION: Maca improved sperm production and sperm motility by mechanisms not related to LH, FSH, PRL, T and E2.

Adult↗

PubMed2000

Thallium-201 scintigraphy is not predictive of late cardiac complications in patients with Hodgkin's disease treated with mediastinal radiation.

PURPOSE: To assess whether abnormalities depicted by Thallium-201 scintigraphy can predict the occurrence of late cardiac complications in patients with Hodgkin's disease treated with mantle field radiation therapy. METHODS AND MATERIALS: Thallium scintigraphy was performed in 49 patients at a median of 75 months after initial treatment (range 28-208 months). Initial treatment consisted in chemotherapy, given to two-thirds of the patients and mantle field radiation, delivered to all patients, using a 25-MV linear accelerator. Myocardial perfusion defects were observed in 78% of patients on thallium scintigraphy. These patients had their cardiac status reassessed at a median follow-up of 13.5 years after treatment. RESULTS: Forty-two patients were assessable, as data on the cardiac status were missing in 7 patients. The majority of patients received at least 40 Gy, and 75% of them were treated with one field per day. The median follow-up of patients is 13.5 years (range 9-24.5). Eleven cardiac complications were observed in 9 patients (coronary artery disease [n = 2], conduction-system abnormalities [n = 3], valvular defects [n = 5], and congestive heart disease [n = 1]). The median 15-year actuarial incidence of cardiac complications was 21% (95% confidence interval of 9-40%). The positive and negative predictive value of thallium scintigraphy was 19% and 77%, respectively. The univariate analysis showed that the extent of left ventricle exposure to irradiation was an adverse prognostic factor, and chemotherapy administered before mantle field irradiation was of borderline significance. CONCLUSION: Thallium scintigraphy is not predictive of late cardiac complications. The extent of left ventricle exposure to radiation and possibly chemotherapy given before radiation treatment are adverse prognostic factors.

Adolescent↗

PubMed2000

Innervated island flaps in morphofunctional vulvar reconstruction.

In this article, the authors present their own experience in vulvar reconstruction following vulvectomy using two different innervated island flaps according to the size and site of the defect. Island-flap mobilization is possible thanks to the rich blood supply of the perineal region. The methods described are a "V-Y amplified sliding flap from the pubis" and a "fasciocutaneous island flap" raised from one or both gluteal folds. The V-Y amplified sliding flap from the pubis is indicated when the defect is symmetric and located anteriorly. This flap is harvested from the pubis and vascularized by the deep arterial network of the pubis. Sensory innervation is provided by branches of the ileo-inguinal nerve. The fasciocutaneous island flap, raised from one or both gluteal folds, can be used following hemivulvectomy or radical vulvectomy, respectively, to cover posteriorly located defects. Vascularization is provided by the musculocutaneous perforating branches of the pudendal artery, whereas sensory innervation is maintained through the perineal branches of the pudendal nerve. Twenty-two patients have undergone reconstructive surgery of the vulvar region from 1989 to date. On 14 patients, a V-Y amplified sliding flap was used; on 7 patients, reconstruction was carried out by island flaps raised from the gluteal fold. Both techniques are compatible with inguino-femoral lymphadenectomy, and they allow for a correct morphofunctional reconstruction and provide good local sensibility. The final result is aesthetically satisfactory, as all final scars are hidden in natural folds.

Adult↗

PubMed1999

A new extended external oblique musculocutaneous flap for reconstruction of large chest-wall defects.

A new extended external oblique musculocutaneous flap utilized in the reconstruction of chest-wall defects is described. The flap is drawn as a V-Y rotation flap on the ipsilateral abdominal wall. It is laterally based, and its pedicle coincides with the five lowest costal insertions of the external oblique. The flap extends above the transiliac line, from the posterior axillary line to the linea alba, and includes the dynamic territory of the external oblique muscle. Vascular supply is provided by the musculocutaneous perforating arteries of the intercostal vessels and their subcutaneous branches. The flap is raised medially and includes the anterior sheath of the rectus. Undermining continues between the external and the internal oblique muscles as far as the posterior axillary line. The donor site on the abdominal wall is reinforced by the plication of the internal oblique sheath. This flap was used in 13 patients with major anterior chest-wall excisional defects. The mean chest-wall defect was about 390 cm2. Marginal necrosis with distal skin loss was observed in one patient. All other flaps healed without complications. The extended external oblique musculocutaneous flap differs from other external oblique flaps already described in several aspects that allow it to obtain better functional and aesthetic results.

Aged↗

PubMed1998

Platysma muscle cutaneous flap for large defects of the lower lip and mental region.

Based on the experience acquired using the depressor anguli oris flap for lateral lower lip reconstruction, the authors in this paper present their own technique to reconstruct large deficits of the lower lateral lip, involving the commissure and the mental region, by means of a platysma muscle cutaneous flap with a triangular skin island. The flap is oriented in the mandibular cheek region. The skin and the platysma muscle fibers, which run vertically, are incised and turned 90 degrees, so the edges of the platysma fibers are sutured to the edge of the residual orbicularis. The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa. The motor nerve and the vascular pedicle are preserved during the mobilization. The authors have treated six cases without relevant complication. A thorough knowledge of the anatomy of the region is mandatory; the surgical work must be precise and takes a long time, but results are highly satisfactory.

Aged↗

PubMed1997

Compartmental shifts of calcium and magnesium as a result of swimming and swimming training in rats.

To describe accurately the mineral changes (Ca and Mg) provoked by swimming, the aims of this study were to analyze those tissues that, with regard to their mineral content, can better classify individuals performing both swimming until exhaustion and swimming as training and to know the shifts of these minerals between different tissues after a single session of swimming until exhaustion and after training. Wistar rats were distributed into 12 groups, six male and six female (N = 10): 1) control rest group (CR); 2) trained rest group (TR); 3) control exercise group (CE); 4) trained exercise group (TE); 5) control recovery group (CER) and 6) trained recovery group (TER). The most informative tissues of Ca and Mg compartmental shifts during exercise have been determined. Discriminant analysis selected heart Ca, muscle Ca and bone Ca, bone Mg, erythrocyte Mg, and serum Mg as the most significant variables. The animals were classified by means of two canonical axes: the first one relates to training situation and sex, and the second one shows the special characteristics of trained male rats. Another independent discriminant analysis applied to male and female groups separately showed that the first canonical axis (control/trained) is basically defined by heart Ca, bone Ca, and erythrocyte Mg (male), and by heart Ca, bone Ca, and bone Mg (female), while the second axis, related to the exercise situations, is defined by the serum Mg levels in both sexes. We think that discriminant analysis is a statistical method capable of explaining physiological processes and classifying individuals performing exercises of different length. It suggests that the homeostasis of Ca and Mg is somewhat different for males and females. Serum magnesium must be considered to distinguish exercise situations. The analysis of these tissues could inform us about the mineral status of the rats and then we could correct possible deficiencies in our research. In this work we have only found different mineral redistributions among tissues. The trained animals have a better mineral recovery capacity than the untrained ones. Training has a different physiological repercussion in male and female rats on the basis of their respective maximal swimming times after training and their mineral behavior.

Animals↗

PubMed1997

Psychosocial factors associated with complementary treatment use in fibromyalgia.

OBJECTIVE: To examine the frequency and predictors of reported complementary treatment use in a sample of 111 subjects with fibromyalgia (FM). The perspective was adopted that complementary treatment use represents a form of medical help-seeking that may be subject to a variety of biological, social, and psychological influences. METHODS: Patients with FM were recruited from community and university based clinics and support groups throughout the greater San Diego, California, area. Patients participated in a comprehensive evaluation of their pain, psychological functioning, and disability prior to their potential involvement in a clinical trial designed to help them copy with their condition. They were also administered a rheumatological evaluation to verify their FM and a 20 item questionnaire to assess their use of complementary treatment strategies specifically for coping with FM. RESULTS: Ninety-eight percent of the sample reported the use of at least one strategy over the preceding 6 months. Exercise, bed rest, vitamins, heat treatment, and spirituality/praying were the most frequently used strategies by subjects on a daily basis. Multiple regression analysis revealed that lower age, higher pain, and higher disability were uniquely associated with higher complementary treatment use. The Pain Rating Index, a measure of the subjective severity of pain from the McGill Pain Questionnaire, proved highly significant in explaining the relationship between pain and questionnaire scores. Pain coping strategies and quality of social support did not predict complementary treatment use. CONCLUSION: The findings suggest that poor clinical status is a major predictor of complementary treatment use in FM. However, longitudinal research is recommended to clarify the relationship between clinical status and help-seeking patterns in patients with FM over time.

Adult↗

PubMed1996

Anatomic basis for the dorsal radial flap of the thumb: clinical applications.

The pattern of the dorsal arterial supply of the thumb was studied by the dissection of 25 thumbs of fresh cadavers. A constant vascular axis was found, originating at the radial a. and communicating at the level of the middle third of the proximal phalanx with the arterial palmar circuit. The constant presence of this vascular axis and its connection with the palmar circuit permits the mobilisation of a dorsal metacarpal skin flap, with a distal pedicle and a reversed flow, that can be used for covering dorsal and palmar losses of substance in the thumb.

Cadaver↗

PubMed1995

Upper eyelid reconstruction with mucosa-lined bipedicled myocutaneous flaps.

We present a method for morphodynamic reconstruction of the upper eyelid for large full thickness defects. The main features of this single-stage operation are: reconstruction of the conjunctiva by free mucosal graft from the oral cavity; mobilisation of a bipedicled myocutaneous flap from the preseptal (or orbital) portion of the lid, anchoring of the levator to this flap and transposition of a temporofrontal flap to reconstruct the donor site of the bipedicled flap. This method is simpler and above all less invasive than other techniques used at present and at the same time allows for a good functional and aesthetic reconstruction.

Aged↗

PubMed1995

Behaviour of zinc in physical exercise: a special reference to immunity and fatigue.

The variations in plasma zinc levels is dependent which follows intensivity of exercise. It is clear that there are short-term effects of exercise on zinc metabolism. It has also been shown that a high level of constant exercise can have long-term effects on zinc metabolism. It has been reported that runners have lower plasma zinc levels than controls. Long term endurance training has been shown to significantly decrease resting serum zinc levels in both male and female athletes compared to sedentary controls. Severe zinc deficiency can affect muscle function. One consequence of low serum zinc levels could be a reduction in muscle zinc concentrations. Since zinc is required for the activity of several enzymes in energy metabolism it could be predicted that low muscle zinc levels would result in a reduction in endurance capacity. Zinc may also be acting directly at membrane level; changes in extracellular zinc levels have been reported to influence twitch-tension relationship in muscle. Some investigators have associated acute and exhaustive exercise with decreased immune function. The mechanisms by which physical stress modulates immune competence are complex, involving both immune and neuroendocrine messengers. Muscular fatigue is of critical importance and as such it has been the subject matter of numerous investigators. Although many factors have been identified, a clear cause remains elusive. Factors discussed include: energy supply, the accumulation of metabolites, eccentric work, immune dysfunctions, etc. Recently we have demonstrated that daily high and maintained physical training over a prolonged period of time (7 mo) provokes marked modifications in the immune system of elite sportsmen accompanied by a psychological and biochemical stress level.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

Correction of constricted ear.

We present a case of moderate constricted ear corrected using a modified Tanzer's technique for the helical deformity and lengthening the lower third of the pinna with a cutaneous transposition flap from the retroauricular area. The operation begins with a rapid intraoperative expansion of the retroauricular skin. Then an incision is made on the posteromedial ear aspect and the ear is degloved using a subperichondral plane. The upper pole of the cartilage is expanded and rearranged by an anteriorly pedicled helical flap and a cartilaginous graft is taken from the constricted part of the concha. The lower third of the pinna is lengthened by a cutaneous transposition flap from the retroauricular area. Thus, the ear is lengthened and the skin that otherwise tends to maintain its "constricted" form relapses. A second surgical stage is performed, under local anesthesia, to cut the pedicle of the retroauricular transposition flap. This method consents an adequate correction of the shape and an effective expansion, of about 1 cm, in the length of the pinna.

Adult↗