Berfu Babuccu

Complications of Minor Cutaneous Surgery in Patients Under Anticoagulant Treatment

Anticoagulant use is common in the elderly population. The role of these medications in the postoperative period is not well defined. We designed a prospective study to evaluate the incidence of postoperative complications in patients taking aspirin and warfarin. A prospective study was performed on 102 patients undergoing minor cutaneous plastic surgery. The number of subjects using regular aspirin, warfarin, and that of the patients with no anticoagulant medication were 37, 21, and 44, respectively. Complications were defined as minor, moderate, or major based on predetermined criteries. Of patients taking warfarin, 57% had some complication, significantly more than complications in the control group. The number of major complications in the warfarin group was significantly higher than those of the control and aspirin groups (p = 0.02). Also, the total number of complications in the warfarin group was significantly higher than the control group, but there was no significant difference between aspirin and control groups (p > 0.05). Cutaneous surgery in patients who receive warfarin is associated with a risk of major complication, but this risk does not exist in the patients receiving chronic aspirin treatment.

Morphology of the Gluteal Region in the Female Population 5 to 83 Years of Age

This study evaluated the development of gluteal region morphology in the female population 5 to 83 years of age. For the study, 132 female subjects were placed into four groups: prepubertal (ages 5 to 8 years; n = 10), pubertal (ages 9 to 14 years; n = 38) postpubertal (ages 15 to 41 years; n = 34), and menopausal–postmenopausal (older than 42 years; n = 29). The age, weight, and height of the subjects were routinely recorded, and body mass index was estimated. In addition, 11 measurements were performed on the gluteal region. The data were analyzed by Pearson and Spearmen correlation analyses using SSPS 11.0 for Windows. In the prepubertal group, the intergluteal sulcus and infragluteal sulci did not actively change. Weight gain was the major factor influencing the shape of the gluteal region, whereas age had no effect. In the puberty group, the gluteal region expanded in all directions. During this period, it was difficult to determine any specific relation between measurements because of significant correlation involving all parameters. However, it should be mentioned that among the four groups, only in pubertal group did age significantly affect the shape of the gluteal region. In other three groups, weight seemed to be a major determinant. In the pospubertal and menopausal–postmenopausal groups, the buttocks sagged with weight gain, contrary to the belief that this happens with aging. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus.Although the gluteal shape is open to the effects of demographic factors such as ethnicity, feeding habits, and lifestyle, according to these findings, it might be advised that in the assessment of the gluteal region morphology, it would be better to consider its dynamic nature. Reshaping its only one part, which can be devastating unless the whole gluteal region and upper limb are addressed.

The effect of the Botulinum toxin-A on craniofacial development: an experimental study.

In this study, we developed a novel experimental model to evaluate muscular action on bone formation and remodeling by the help of Botulinum toxin-A (BTX).Forty-nine 15-day-old male Wistar rats were put into 4 groups randomly. Group 1 was the control group. BTX 0.4 IU (0.05 mL) was injected into the right masseter muscle in group 2 and into right temporalis muscle in group 3. The same volume of sterile saline was given into the both above-mentioned muscles in group 4. At the end of the fourth month, all animals were killed. Histology and weight of the masseter and temporalis muscles were studied. Thirty different osteometric measurements were also taken from skulls.Significant atrophy in BTX injected muscles was observed in groups 2 and 3. In group 4 (saline injection), only few osteometric measurements were significantly reduced, indicating the effect of the injection itself. Both groups 2 and 3 have apparent decrease in nasal bone, premaxilla, maxilla, and zygomatic dimensions on the injected side. When masseter group was compared with control and saline groups, no significant difference was found in skull base dimensions and mandibular length. In contrast, temporal group has also shown significant decrease in skull base dimensions.Our conclusions are as follows: (1) With this model, it is possible to study muscular action on bone formation and modeling without any surgical intervention, that is, by avoiding surgical artifacts, such as scar and contracture; (2) denervation of the skeletal muscles with BTX during the growing phase does effect bone development in a negative way; (3) pediatric use of the BTX deserves reevaluation under the light of these findings.

Malignant solitary cylindroma of the scalp

Cylindroma is a rare tumor which originates from skin appendages and occurs predominantly on the scalp and face. It is considered to be benign, but malignant transformation has been reported. It has two distinct clinical presentations, solitary and multiple. A review of the literature revealed that the majority of malignant cylindromas occur among multiple type cylindromas. Only 36 malignant cylindromas have been reported, and only 9 were of the solitary type. A case with a solitary type of cylindroma exhibiting malignant transformation of the scalp is presented.