5 resultados para 250702 Gravedad ( terrestre) y prospección gravimetrica
Resumo:
Upper eyelid tumours, particularly basal cell carcinomas, are relatively frequent. Surgical ablation of these lesions creates defects of variable complexity. Although several options are available for lower eyelid reconstruction, fewer surgical alternatives exist for upper eyelid reconstruction. Large defects of this region are usually reconstructed with two-step procedures. In 1997, Okada et al. described a horizontal V-Y myotarsocutaneous advancement flap for reconstruction of a large upper eyelid defect in a single operative time. However, no further studies were published regarding the use of this particular flap in upper eyelid reconstruction. In addition, this flap is not described in most plastic surgery textbooks. The authors report here their experience of 16 cases of horizontal V-Y myotarsocutaneous advancement flaps used to reconstruct full-thickness defects of the upper eyelid after tumour excision. The tumour histological types were as follows: 12 basal cell carcinomas, 2 cases of squamous cell carcinomas, 1 case of sebaceous cell carcinoma and 1 of malignant melanoma. This technique allowed closure of defects of up to 60% of the eyelid width. None of the flaps suffered necrosis. The mean operative time was 30 min. No additional procedures were necessary as good functional and cosmetic results were achieved in all cases. No recurrences were noted. In this series, the horizontal V-Y myotarsocutaneous advancement flap proved to be a technically simple, reliable and expeditious option for reconstruction of full-thickness upper eyelid defects (as wide as 60% of the eyelid width) in a single operative procedure. In the future this technique may become the preferential option for such defects.
Resumo:
O sndroma de Turner (TS) tem sido descrito em associao com diversas anomalias dos cromossomas sexuais. Embora a maioria dos individuos com TS no apresentem evidncia citogentica de sequncias do cromossoma Y, diferentes autores consideram que algumas doentes com TS podem possuir uma linha celular minoritria contendo material do cromossoma Y, que no detectada pela anlise citogentica convencional. A identificao de moisacismos minoritrios ou subrepresentados contendo o cromossoma Y de importncia fundamental em termos clnicos devido ao risco aumentado que estas doentes possuem para desenvolvimento de gonadoblastoma. No presente estudo procedeu-se anlise citogentica convencional de linfcitos de sangue perifrico obtidos de 22 doentes com TS. Destas doentes, doze possuam cariotipo 45,X, em sete foram detectados mosaicos com ou sem anomalias estruturais do cromossoma X e nas restantes trs foram identificados os seguintes cariotipos: 46,X,i (X)(q10); 46,X,+mar/47,X,idic(Y),+mar e 45,X/46,X,+r. Os estudos moleculares foram realizados em DNA genmico obtido a partir de linfcitos de sangue perifrico e de clulas de mucosa bucal, dois tecidos que derivam de folhetos embrionrios diferentes, respectivamente, mesoderme e ectoderme. A pesquisa de moisacismos minoritrios envolvendo o cromossoma Y foi efectuada por PCR simples e PCR nested para os seguintes loci especficos do cromossoma Y: SRY (sex determining region Y), TSPY (testis specific protein Y encoded), DYZ3 (locus centromrico) e DAZ1 (deleted in azoospermia). O uso de STSs localizados nos braos curto e longo do cromossoma Y permitiu a caracterizao de um idic (Y)e de um cromossoma em anel, detectados em duas das doentes estudadas. A eleveda sensibilidade da PCR nested (1 clila masculina/125 000 clulas femininas) permitiu excluir a presena de moisacismos minoritrios do Y em 20 das 22 doentes com TS. Na doente com um idic(Y) a anlise por PCR simples foi posistiva para todos os loci estudados com excepo da regio heterocromtica. Este resultado permitiu identificar o ponto de quebra no brao longo entre sY158 e sY159, tendo-se confirmado por hibridao in situ de fluorescncia (FISH), a duplicao da eurocromatina do brao longo, centrmero e brao curto do cromossoma Y. A caracterizao do cromossoma em anel, detectado num das doentes com TS s foi possvel por FISH e por PCR. Neste cromossoma, derivado de Y, foi detectada, no brao curto, a deleco da regio pseudoautossmica 1 (PARY1)e, no brao longo, a deleco dos intervalos 6 e 7. Contudo, o referido cromossoma foi positivo para os loci SRY, RPS4Y, AMGY, TSPY localizados no brao curto, DYZ3 (centrmero) e, sY85, DFFRY, GY6, sY87, sY113, sY119, sY122, sY126 e RBMY1 localizados no brao longo do cromossoma Y. Este estudo permitiu, assim, excluir a presena de moisacismos minoritrios do cromossoma Y em dois tecidos obtidos de 20 doentes com TS, e caracterizar por FISH e anlise molecular, um idic(Y) e um cromossoma em anel, em que a natureza deste ltimo no tinha sido identificada por anlise citogentica convencional. O risco elevado de desenvolvimento de gonadoblastoma nos indivduos com TS que possuem sequncias do cromossoma Y justifica a aplicao de FISH e PCR para a caracterizao de cromossomas marcadores e a utilizao de PCR nested para a deteco de moisacismos minoritrios do Y sempre que o material deste cromossoma no seja detectado pela anlise citogentica convencional em doentes com cariotipo 45,X e/ou virilizao.
Resumo:
The classical Roux en Y Gastric Bypass (RYGBP) is still the standard technique between all the ones being used nowadays. The One anastomosis gastric bypass (OAGBP), is an evolution of the Minigastic bypass described by Robert Rutledge in 2001, is a well known and progressively frequent but still controversial technique. In our group, after an experience of 10 years using the RYGBP as a salvage surgery after failed gastric banding, in 132 cases, we decided to adopt the OAGBP as our preferential bariatric technique also in this situation. The theoretical main reasons for that shift are related to the increased safety, maximized weight loss, long term weight loss maintenance and reversibility of the operation. Method: Retrospectively we evaluated data of the surgical management of revisional cases for conversion, after failed or complicated gastric bands to gastric bypass. We selected the last 40 cases of each technique since May 2010. Results: All cases were performed by laparoscopy without any conversion. In both groups the conversion has been performed in one single step (17 cases, 42,5%). Data showed lower morbidity with OAGBP (2,5% against 7,5%) and better weight loss in theOAGBP cohort after a median follow up of 16months (67%against 55%) in patients revised after gastric band failure or complications. None had statistic significance (p>0,1) by the chi-square contingency table analysis.Conclusion: It seems to there is a difference in favour of OAGBP for conversion of complicated gastric bands. In this study we didnt found statistic significance probably because of the short numbers. Prospective and more powerful studies are necessary to evaluate the benefit of the studied procedure.
