Heval Selman Ozkan

A rare tumor: syringocystadenocarcinoma papilliferum.

Syringocystadenocarcinoma papilliferum (SCACP) is a rare form of adenocarcinoma of the skin. SCACP is a malignant form of syringocystadenoma papilliferum (SCAP). Occasionally, SCAP cases present as nodular or plaque-like lesions, but SCACP is rarely seen. It may develop from SCAP lesions or nevus sebaceous of Jadassohn. There have been 13 cases of SCACP reported in the literature. Here, we report and discuss the 14th case of SCACP occurring on the scalp of a 67-year-old man.

Isolated fibrous dysplasia of the zygomatic bone.

Fibrous dysplasia is a nonneoplastic, hamartomatous, developmental disease of the bone of obscure etiology. The disease is generally presented as a continuously growing, painless mass at late childhood. It is mostly seen in the maxilla and the mandible in facial skeleton. Involvement of the zygomatic bone is far rarer. Fibrous dysplasia of the zygomatic bone may cause orbital dystopia, diplopia, proptosis, loss of visual acuity, swelling, mass formation, or facial asymmetry. We present 2 cases of fibrous dysplasia with isolated zygomatic bone involvement.

Penile strangulation and necrosis due to condom catheter

Condom catheters are often used in the management of male urinary incontinence, and are considered to be safe. As condom catheters are placed on the male genitalia, sometimes adequate care is not taken after placement owing to poor medical care of debilitated patients and feelings of embarrassment and shame. Similarly, sometimes the correct size of penile sheath is not used. Strangulation of penis due to condom catheter is a rare condition; only few such cases have been reported in the literature. Proper application and routine care of condom catheters are important in preventing this devastating complication especially in a neurologically debilitated population. We present a case of penile necrosis due to condom catheter. We will also discuss proper catheter care and treatment of possible complications.

A Clinical Comparison of EMLA Cream and Ethyl Chloride Spray Application for Pain Relief of Forehead Botulinum Toxin Injection.

ObjectivesThis study aims to analyze the efficiency of EMLA cream and ethyl chloride spray application for pain alleviation before botulinum toxin injection. MethodsForty-five patients were divided into 3 treatment groups. Skin cooling with ethyl chloride spray (in group 1), topical anesthetic cream (EMLA) (in group 2), was used on the forehead area on one side previous to injection; the opposite side served as the control. In the third group (n = 15), cold was applied using ethyl chloride spray to one side, and to the other side topical anesthetic cream (EMLA) was applied. A visual analog scale was used for pain intensity. ResultsIn the first group, the average pain score was 3.20 ± 1.20 on the side where ethyl chloride spray was applied and 7.26 ± 1.94 on the control side (P < 0.05). It was 4.20 ± 1.37 on the side receiving EMLA and 7.66 ± 1.54 (P < 0.05) on the control side in the second group. In the third group, the average score was 6.80 ± 1.37 for the EMLA side and 2.93 ± 1.03 for the ethyl chloride sprayed side (P < 0.05). ConclusionsSkin cooling with ethyl chloride spray significantly decreases the pain associated during forehead botulinum toxin injections.

Results of transmasseteric anteroparotid approach for mandibular condylar fractures.

Management of condylar fractures has been the subject of much disagreement and debate. There is no general consensus for definitive treatment. Although there is a growing tendency for open reduction and internal fixation technique, risks and morbidity of the surgical procedure are still a point of concern for maxillofacial surgeons. To reduce potential complications and improve surgical exposure, the transmasseteric anteroparotid approach was introduced. Since 2008, we have operated on 6 patients (7 fractures) using this approach. The technique is easy to learn, provides adequate surgical exposure for open reduction internal fixation, and has few complication rates.

Primary hydatid disease of subcutaneous tissue in the leg

on symptomatic relief. The commonest treatment options for cutaneous mastocytosis are topical (emollients, topical glucocorticoids, calcineurin inhibitors), physical [psoralen UVA, UVA-1, laser (for telangiectasia eruptive perstans), surgery (for mastocytoma)] and systemic treatments (H1 and ⁄ or H2 antihistamines, glucocorticoids, low-dose aspirin, interferon-a, ciclosporin A). To date, PUVA and more recently UVA-1 irradiation have been considered the firstline treatments. The success of NB-UVB treatment in our patient group is probably due to a reduction of pro-inflammatory cytokines and ⁄ or to its action on the membranes and ⁄ or enzymes of the mastocytes. It is known that UVB reduces the release of histamine from mast cells but not from basophils. We consider that NB-UVB could be a useful alternative to PUVA treatment, with a lower risk of side-effects.

Repairing peripheral nerve defects by vein grafts filled with adipose tissue derived stromal vascular fraction: an experimental study in rats

BACKGROUND There are many studies in the literature combining vein grafts with cell cultures, muscle, tendon, and nerve tissues, but none of them could replace isolated nerve grafts for nerve repair in clinical settings. There are studies in the literature indicating that adipose tissue derived stromal vascular fraction (SVF) enhances peripheral nerve healing. Considering these facts, an experimental study was performed in rats based on combining SVF with vein grafts for peripheral nerve defect repairs. METHODS The study included 30 rats which were divided in three groups. In the first stage, an 8 mm nerve defect was created in tibial nerve of each rat. In Group 1, the defect was reconstructed with nerve graft, in Group 2, the defect was reconstructed with vein graft, and in Group 3, the defect was reconstructed with vein graft filled with SVF solution. After 3 months, the second surgical stage was performed and nerve biopsies were taken. Tissue samples were observed histopathologically. RESULTS There were no statistically meaningful difference between nerve grafts, vein grafts and adipose tissue derived SVF- vein grafts combination groups considering myelin diameter and axonal diameter. Axon count was statistically superior in the nerve graft and study groups when compared to empty vein groups. CONCLUSION In conclusion, our results support the usage of stromal vascular fraction-vein graft combination for peripheral nerve defect repairs.

The Effect of Botox on the Implant Stabilization and Capsular Formation: An Experimental Study.

BackgroundBreast augmentation is one of the most common esthetic procedures with increasing frequency throughout the past years. The most demanding complications involving esthetic and reconstructive breast surgery are the malpositioning of the implant and capsular contracture. The etiology, prevention, and management remain to be fully explained. Botulinum toxin (BTX) administration has anti-inflammatory effects that can possibly decrease capsular contracture, and chemical denervation of the pectoral muscle theoretically may decrease incidence of malrotation. In our literature search, we found only 1 clinical study using BTX A for capsular contraction, and there were no experimental studies about the implant stabilization and capsular contracture. Therefore, we have studied the effect of BTX A on the prevention of breast implant malrotation and capsular contracture in a rabbit model. MethodsSixteen smooth-surfaced cohesive gel implants were implanted in 8 New Zealand white rabbits. The backs of the rabbits were divided into 2 groups. After skin incision, the exposed latissimus dorsi muscle was elevated, and a submuscular pocket was made. In the experimental group, Botox was injected in the muscle overlying the implant. In the control group, the implants were placed under the muscle, and saline was injected into the muscle. At the end of 3 months, the rabbits were imaged and evaluated by ultrasonography and x-ray to examine capsule formations and the movement of the implants. The animals were killed, and the implants with peri-implant capsule were excised. We evaluated collagen pattern and capsule thickness on ventral, lateral, and dorsal aspects. ResultsThe Botox group showed less infiltration of inflammatory cells at the third month (P < 0.05). Statistically significant differences in capsular thickness were observed on histopathological examination and ultrasonographic imaging. The capsule was thinner on all aspects and the collagen pattern had a more parallel alignment at low density in the experimental group compared with the control group. With x-ray, we observed an increased lateral movement of the implants in the control group. ConclusionsThe use of Botox effectively decreased implant movement and capsular formation at 12 weeks. More experimental and clinical studies will be required to determine whether this is a durable result that can be reproduced in humans.

A rare variant of scalp dermatofibrosarcoma protuberans: malignant fibrous histiocytomatous transformation

Dermatofibrosarcoma protuberans (DFSP) is a relatively uncommon, local aggressive tumor. Tumor metastasis is rare, and it has equal sex distribution. DFSP usually develops on the trunk and extremities. Scalp DFSP composes less than 5% of all cases. Local recurrence rates are high. Wide local excision and Mohs surgery are options for treatment. Fibrosarcomatous or malignant fibrous histiocytomatous transformation of DFSP are rare conditions. In this article, we described a case of a giant DFSP over the scalp containing malignant fibrous histiocytomatous transformation areas.

Using surgical drapes to facilitate pedicle deepithelialization in reduction mammoplasty

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