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Results for “Mucocutaneous plane”

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12 recordsLinked to original sources

PubMed2026

Bipolar circumcision with mucocutaneous plane separation: A safe, precise, blood-sparing, dressing-free approach.

Conventional circumcision techniques may result in bleeding, limited control of the mucosal collar, and the need for dressings. We describe a modified bipolar technique enabling near-bloodless dissection with precise mucosal trimming. Following bipolar division of the preputial skin, the inner mucosa is separated using two forceps and retracted proximally, creating a protective plane for safe skin adjustment. The mucosal collar is trimmed with scissors. The wound is closed with sutures and 2-octyl cyanoacrylate, avoiding dressings. This technique has been performed in 55 consecutive cases (median age: 2 years and 2 months; range: 0 days-17 years and 5 months) with no reported complications over a median follow-up of 2 years and 7 months (range: 3 months-4 years and 1 month).

Humans↗

PubMed1978

Surgical approaches to abnormalities of the nasal valve.

A systematic surgical approach to nasal valve abnormalities depends on adequate and precise exposure of the abnormality to be corrected and is facilitated by the use of magnification. Small anatomic disturbances in the region of the nasal valve can produce significant airway obstruction by narrowing the nasal valve angle. Normally, this angle between the caudal end of the upper lateral cartilage and the nasal septum is from 10 to 15 degree. In all patients with nasal airway obstruction, a meticulous clinical evaluation of the nasal valve is required. Nasal valve abnormalities can produce symptoms due to an already increased collapsibility of the nasal valve; therefore surgical intervention is directed toward reconstruction of normal anatomic relationships, usually by widening the nasal valve angle and preventing either extreme of rigidity or collapsibility. Appropriate and delicate handling of the intercartilaginous aponeurosis between the upper lateral (roof) cartilage and the lower lateral (lobular or alar) cartilage with prevention of excessive scar tissue formation usually can be achieved by dissection on the upper lateral cartilage. The surgical plane is beneath the overlying musculature and neurovascular layers. By preserving the mucocutaneous lining and by accurate suturing of incisions, primary wound healing is facilitated. Clinical experience suggest that the application of these concepts benefits patients by preventing or treating abnormalities of the nasal valve. Eventually, longterm results with preoperative and postoperative physiologic testing (rhinomanometry), coupled with critical clinical re-evaluation, should allow adoption, rejection, or, more likely, modification of the principles offered by this contribution.

Airway Obstruction↗

PubMed1979

The dynamic Abbe flap.

A modification of the Abbe flap procedure is presented in which muscle-to-muscle union of the orbicularis muscle is obtained prior to inset of the flap. The technique consists in splitting the lip at the midline followed by dissection of the orbicularis muscle on each side from its abnormal position. The muscle is then rotated downward and sutured, restoring the oral sphincter. The flap is outlined on the lower lip and elevated. Following closure of the donor site, the Abbe flap is split in the coronal plane at the level of the muscle; this division is carried up to the mucocutaneous border, and the flap placed like a sandwich around the repaired muscle and sutured. The flap is usually divided in 14 to 16 days. The results have been good, with improved lip movement in 12 patients during animation.

Adolescent↗

PubMedDate not supplied

Principles and techniques in the use of convexity.

Expected outcomes for a correctly fitted ostomy prosthetic device include sustained, predictable wearing time, protection of the stoma from injury, and maintenance of peristomal skin integrity. To accomplish this, the pouching system must be properly sized and maintain continuous contact with the peristomal skin. Continuous contact is achieved when the faceplate provides a mirror image of the topography of the peristomal plane. Varying degrees of support and convexity of the faceplate are used to fit the unique characteristics of the patient's peristomal plane and stoma. Support can be absent, soft or firm. Convexity is some degree of outward curving of the faceplate. Characteristics of the stoma (i.e., flush, retracted, loop), peristomal plane (i.e., creases, hernia, scarring) and abdomen (i.e., flaccid, soft, or firm) may indicate the need for convexity. Potential problems include mucocutaneous separation, ischemia, laceration, erythema, ecchymosis, and pain if convexity is used inappropriately. Alternatives to convexity include the use of an ostomy belt or surgery. Ongoing, intermittent assessment of the prosthetic is essential to evaluate that the convexity and support have achieved the expected outcomes.

Drainage↗

PubMed2003

Pathophysiology and prevention of loop stomal prolapse in the transverse colon.

We investigated both pathogenesis and prevention of loop transverse stomal prolapse. Seven patients with reducible prolapsed stoma were studied under fluoroscopy after staining the prolapsed stoma and the colon by barium medium while prolapsing or reducing the stoma with or without the stomal wall pressed on to the abdominal wall of fascial plane. All prolapses occurred in the distal limbs of the loop stoma with the distal transverse colons redundant. The prolapse started around the mucocutaneous suture with the stoma inflated and the colon in it depressed and proceeded in accordance with an addition of abdominal pressure, but did not occur by pressing of the stomal wall. Prolapse of transverse loop stoma occurs when redundant colon invades the stoma with an abdominal pressure. Stomal prolapse might be prevented by fixation of the colon to the fascia.

Aged↗

PubMed1997

Palpebral conjunctival transient amplifying cells originate at the mucocutaneous junction and their progeny migrate toward the fornix.

PURPOSE: The conjunctival epithelium performs an important role in the homeostasis and integrity of the eye. These cells need to be replaced in order to protect the integrity of the ocular surface. Epithelial cells are replaced from slow cycling stem cells which in turn produce transient amplifying cells that undergo further divisions before becoming mature conjunctival epithelial cells. The natural history of the bulbar palpebral conjunctival cells has not been previously described. METHODS: A single injection of bromodeoxyuridine (brdU), a thymidine analogue, was administered intraperitoneally to adult rabbits at a concentration of 50 mg/kg body weight. The rabbits were sacrificed at 1, 3, 5, and 7 days following the injections. The orbital contents including the eyelids were exenerated en bloc, frozen in a manner that maintained the orientation and continuity between the eyelids and globe and sectioned in a parasagittal plane. The tissue was stained immunohistochemically to detect brdU labeled conjunctival epithelial cells. The brdU-positive epithelial cells were counted in a series of 0.4 mm zones starting at the mucocutaneous junction of the eyelid and progressing through the fornix and bulbar conjunctiva. Rabbit eyelids and human eyelid surgical specimens were stained for cyclin D1, a marker for cells that are in the G1 phase of the cell cycle. RESULTS: In both the upper and lower eyelids, the peak number of brdU labeled cells/0.4 mm zone was located at progressively greater distances from the mucocutaneous junction in the animals sacrificed at 1, 3 and 5 days respectively, and gone by 7 days. A focus of brdU-labeled conjunctival cells remained within 1-2 mm of the mucocutaneous junction at all post-injection intervals. Foci of cyclin 1-positive cells were found almost exclusively near the mucocutaneous junction, but not in the fornix. CONCLUSIONS: The mucocutaneous junction of the conjunctival epithelium is a source of actively dividing transient amplifying cells that migrate toward the fornix at a rate of about 1.7 mm/day as replacement conjunctiva so that at least some conjunctival epithelial stem cells must be located near the mucocutaneous junction. The presence of cyclin D1 staining cells at the mucocutaneous junction supports this view. These results are not necessarily at variance with previous studies, but they do diminish the relative importance assigned the forniceal region in palpabral conjunctival homeostasis. Moreover, the mucocutaneous junction might provide a therapeutically significant source of replacement conjunctival cells. The transit time of conjunctival epithelial cells is about 6 days.

Animals↗

PubMed1999

Mucocutaneous junction as the major source of replacement palpebral conjunctival epithelial cells.

PURPOSE: The conjunctival epithelium performs an important role in the homeostasis and integrity of the eye. To protect the integrity of the ocular surface, these cells must be replaced from locally concentrated or randomly distributed foci of stem cells. These slow-cycling stem cells produce transient amplifying cells that undergo further divisions before becoming mature conjunctival epithelial cells. In the current study, the source of palpebral conjunctival cells was determined. METHODS: Adult rabbits were injected intraperitoneally with bromodeoxyuridine (BrdU) at a dose of 50 mg/kg body weight and killed after 1, 3, 5, and 7 days and 2 months. The orbital contents and eyelids were exenterated en bloc, frozen to maintain the orientation between the eyelids and globe, and sectioned in a parasagittal plane. Random midglobe sections were stained for the presence of proliferating cell nuclear antigen (PCNA). Additional sections were immunostained to detect BrdU-labeled conjunctival epithelial cells. BrdU-positive cells were counted in a series of 0.4-mm zones from the mucocutaneous junction of the eyelid, through the fornix and bulbar conjunctiva. A second set of rabbits received daily injections of BrdU for 2 or 4 weeks followed by a 2-month BrdU-free period before death and processing. RESULTS: In all eyelid sections examined, there was a focus of PCNA-positive cells in the mucocutaneous junction and a few scattered PCNA-positive cells along the length of the palpebral conjunctiva toward the fornix. In both the upper and lower eyelids, the peak concentration of BrdU-labeled cells/0.4-mm zone was located at progressively greater distances from the mucocutaneous junction in the animals killed at 1, 3, and 5 days respectively and was unidentifiable by 7 days. A focus of BrdU-labeled conjunctival cells remained within 1 to 2 mm of the mucocutaneous junction at all postinjection intervals. These were always found within one cell height of the basement membrane in the basal layer of the epithelium. In the long-term studies, BrdU-labeled nuclei were retained at the mucocutaneous junction. CONCLUSIONS: The mucocutaneous junction of the conjunctival epithelium is a source of actively dividing transient amplifying cells that migrate toward the fornix at a rate of approximately 1.7 mm/d with a transit time of approximately 6 days. Long-term retention of label at the mucocutaneous junction indicates that slow-cycling stem cells are present at this location. It appears that most palpebral conjunctival epithelial stem cells are located near the mucocutaneous junction. These results are not necessarily at variance with previous studies, but they diminish the relative importance of the forniceal region in palpebral conjunctival homeostasis. The mucocutaneous junction may provide a therapeutically significant source of replacement conjunctival cells.

Animals↗

PubMed1984

Systematic visualization of coronary arteries by two-dimensional echocardiography in children and infants: evaluation in Kawasaki's disease and coronary arteriovenous fistulas.

We describe in our report a systematic approach for visualizing in detail coronary artery anatomy by two-dimensional echocardiography (2DE). The approach provides longitudinal and transverse images of the proximal coronaries, as well as transverse images of the anterior descending and right coronary artery tree. The method is delineated by showing certain cases of Kawasaki's disease (MCLS) and coronary arterial fistula. Using these multiple echo planes, the diagnostic accuracy was improved for both right and left coronary arteries.

Adolescent↗

PubMed2003

An unusual form of primary systemic amyloidosis: amyloid elastosis: report of a case treated by haematopoietic cell transplantation.

Amyloid elastosis is a rare variant of primary systemic amyloidosis characterized by amyloid deposited around elastic fibres. Only two cases, with pseudoxanthoma elasticum-like features and fatal outcome, have been reported. A 56-year-old woman presented with polyneuropathy and a diffuse plane xanthoma-like eruption. Light and electron microscopy studies revealed deposits of amyloid L encasing either normal-looking or short, fragmented elastic fibres in the dermis in a pattern characteristic of amyloid elastosis. The patient had medullary plasmocytosis with lambda light chain restricted expression and underwent autologous stem cell transplantation, which resulted in progressive regression of mucocutaneous signs and stabilization of the polyneuropathy. Our case extends the spectrum of clinical and histopathological presentations of amyloid elastosis. Haematopoietic cell transplantation might improve outcome in patients with multisystem disease.

Amyloidosis↗

PubMed1996

Suspected drug eruption in seven dogs during administration of flucytosine.

7 of 8 dogs receiving combination drug therapy consisting of flucytosine together with amphotericin B and/or a triazole for cryptococcosis or aspergillosis developed cutaneous or mucocutaneous eruptions during the course of treatment. Lesions resolved in all cases following discontinuation of flucytosine despite continued administration of other antifungals, suggesting the eruption was referable primarily to the flucytosine component of therapy. Lesions developed 13 to 41 days (median 20 days) after commencing flucytosine (105 to 188 mg/kg/day divided and given every 8 h; median dose rate 150 mg/kg/day). The cumulative dose of flucytosine given prior to the first signs of the drug eruption ranged from 1.7 to 6.8 g/kg (median 2.3 g/kg). The eruptions consisted of depigmentation, followed by ulceration, exudation and crust formation. The scrotum was affected in all 4 male dogs, the nasal plane in 6 of 7 cases, while the lips, vulva, external ear canal and integument were involved in a smaller number of cases. There was considerable variation in the severity of lesions, with changes being most marked when flucytosine was continued for several days after lesions first appeared. Some dogs experienced malaise and inappetence in association with the suspected drug eruption. Healing took a variable period, typically in excess of 2 weeks after discontinuing flucytosine, with up to 2 months being required for total resolution of the lesions. All lesions resolved eventually without scarring or permanent loss of pigment.

Amphotericin B↗

PubMed2006

[Imaging procedures in rheumatology: imaging in vasculitis].

In small vessel vasculitides, imaging studies aid in determining disease extent and activity, localization for biopsy, and for disease monitoring. They do not directly delineate the vasculitic lesion. Imaging studies focus on the upper and lower respiratory tract. Cranial magnetic resonance imaging (MRI) shows upper respiratory and retrobulbar granuloma in Wegener's granulomatosis. Furthermore, MRI depicts both mastoiditis and mucosal inflammation of the ear, nose, and throat. It is sensitive but not specific for the detection of cerebral vasculitis. Computed tomography (CT) reliably detects osseous facial lesions. Chest radiography in two planes remains the standard method of investigation for the lower respiratory tract. High-resolution CT aids in detecting further interstitial pathologies. Medium-sized vasculitides frequently occur with aneurysms. The classification criteria for polyarteritis nodosa involve the angiographic detection of visceral aneurysms. Patients with Kawasaki disease may develop coronary aneurysms that may be described by echocardiography or angiography according to diagnostic criteria. In large-vessel vasculitides such as temporal arteritis (giant cell arteritis) and Takayasu arteritis, MRI, MR-angiography, CT, CT-angiography, and duplex sonography delineate characteristic homogenous wall thickening with or without stenoses in the aorta and other arteries. There is a high correlation with angiography and positron emission tomography. Duplex sonography of the temporal arteries has a high sensitivity and specificity for the diagnosis. Data on temporal artery MRI in giant cell arteritis have recently been published.

Aneurysm↗

PubMed1983

[Visualization of peripheral left coronary aneurysms in Kawasaki disease by subcostal two-dimensional echocardiography].

Our previous study provided a new two-dimensional echocardiographic technique for detecting peripheral "right" coronary artery aneurysms in Kawasaki disease using a subcostal approach. In the present paper, we presented an additional study for detecting peripheral "left" coronary artery aneurysms. Because the left anterior descending artery runs along the anterior interventricular sulcus and the left circumflex artery around the mitral valve ring, both coronary regions are difficult to search by a conventional method. Then coronary aneurysms of these regions were searched using the subcostal approach in this study. First, the sector beam was directed toward the heart on a plane parallel to a line between the patient's shoulders which allowed simultaneous visualization of four chambers (P1). The area around the mitral valve ring in this plane was examined for coronary aneurysms of the peripheral left circumflex artery. Secondary, the beam section was positioned parallel to the line cutting both the long axes of the sternum and spinal column which allowed visualization of the right ventricular outflow tract, pulmonary valves, interventricular septum, mitral valves and left atrium (P2). Thirdly, the sector plane was angled to the left (P3), and still more to the left (P4) until the left atrium just disappeared. By scanning from P2 to P4, the area around the mitral valve ring was examined for coronary aneurysms of the peripheral left circumflex artery. By scanning from P4 to the cardiac apex (P5), the anterior interventricular sulcus was searched for coronary aneurysms of the peripheral left anterior descending artery. Of 143 patients with Kawasaki disease, aged two months to 8 years, 7 peripheral left coronary aneurysms were visualized in five patients. These were three aneurysms in the left circumflex artery at the origin of the obtuse marginal artery, two aneurysms in segment 13, and two aneurysms in the left anterior descending artery at the origin of the second diagonal branch. These echocardiographic features coincided well in size, shape and anatomic location with angiographic appearances. In one patient whose echocardiogram in sector P2 showed a small echo-free space (2 X 2 mm) at the area around the mitral valve ring, the angiographic study showed the intact left circumflex artery, suggesting that there was a limitation to distinguish a very small coronary aneurysm from a normal one. There was no false negative diagnosis. These results showed that this new echocardiographic technique is useful for detecting peripheral left coronary aneurysms in patients with Kawasaki disease.

Aneurysm↗