Periodontal disease is inflammatory pathological conditions in the gingiva and dental support structures that usually results in extracellular matrix and connective tissue destruction. During periodontitis, inflammatory cells facilitate collagen and connective tissue loss, affects the number and activity of fibroblasts and its production of local collagen networks. Aim of this study was to evaluate collagen density and accumulation of collagen producing fibroblast and macrophages in affected tissue of periodontal disease. Histological and immunohistochemical analyzes were performed on paraffin embedded tissue sections of gingival biopsies, obtained from 30 patients with diagnosis of periodontal disease and 10 healthy donors. Tissue sections of gingival of patients with periodontal disease had significantly decreased collagen volume density and visible fragmentation and lysis of the collagen fibers, decreased number of fibroblasts, accompanied with increased accumulation of macrophages. Presented data implicate that macrophages accumulation may be the cause of enzyme mediated collagen destruction
Introduction. Whether it is a classic version of the flap or its modification, the Limberg flap is an appropriate solution for covering small and medium-sized defects, as well as for covering largesized defects where certain localizations are concerned. It represents a local, transposition flap that has proven to be a safe option. Methods. The defect coverage was achieved by marking a defect that was in the form of an equilateral rhombus by means of extending a shorter diagonal by the length of its side and drawing a parallel with the defect side, which created four different flaps. We included 50 patients surgically treated at the Varis Clinic for Plastic and Reconstructive Surgery in Belgrade and the University Hospital in Foca for the period 2018-2020. In all patients, we used the Limberg flap as a method for defect reconstruction. Case presentations. The sample was comprised of up to 50 patients, with an average respondent age of 60.3 years. According to etiology, the most common changes in the skin belonged to Basal cell carcinoma (58%), Squamous cell carcinoma (24%) and melanoma (8%), with the most common predilection sites associated with the face in 22 patients and with the lumbosacral region in 8 patients. A well-planned Limberg flap caused minor complications in terms of mild marginal infection in one patient, and mild marginal infection as an early complication and a stretched scar as a late complication in one patient as well. Other complications in the sample were not recorded. Conclusion. To obtain the best possible functional and esthetic result with minimal disruption of the region, respecting the anatomy and the basic principles in plastic surgery, the Limberg flap is an excellent solution for the reconstruction of defects of different sizes.
<p><strong>Introduction.</strong> The hypothenar&rsquo;s skin is nourished by perforant cutaneous branches which pass across muscle, fascia and palmar aponeurosis. The aim of this work was determination of anatomic characteristics of vascular cutaneous territory of hypotenars as the basis for raising the flaps for the purpose of reconstruction of the defects on the hand. <strong>Methods.</strong> Micro morphological and morphometric researches have been done on 30 hands of cadavers of both sexes without pathological changes on the blood vessels of the hand. We selectively injected 10% dissolved douche gelatin in two colors into blood vessels of 10 hands . By injecting metyl-metacrylate into the arterial system of 20 hands and by corrosion in 40% solution KOH, we got plastic castings of the arterial network that we have used as the basis for all measures and space analyses in our research. <strong>Results.</strong> The trunk of the ulnar artery gives 3-6 cutaneous branches, average 4.1+/- 1.07, and their diameter was about 0.40 to 0.85 mm. Ulnar palmar digital artery of the little finger gives 5 to 9 cutaneous branches, average 7.6. Their diameter was from 0.35 to 0.70 mm. Superficial branch of deep palmar branch of the ulnar artery gives sprigs that vascularize the hypotenar&rsquo;s skin, and they reach the skin through abductor digiti minimi muscle and flexor digiti minimi brevis muscle. That one gives from 2 to5 perforators for the skin of approximately half of the hypotenars, on average 3.70. Their diameter was from 0.25 to 0.70 mm. Cutaneous branches of the superficial palmar arch were reaching either through palmar aponeurosis or by its ulnar border in order to vascularize the radial border of the hypotenar eminence. <strong>Conclusion.</strong> Hypotenar&rsquo;s skin is nourished by perforant cutaneous of ulnar artery trunk branches, ulnar palmar digital artery of the little finger, deep palmar branch of the ulnar artery and superficial palmar arch. Cutaneous branches of these arteries establish anasthomosises at all levels.</p>
Uvod. Tireoglosalna cista predstavlja najčešću kongenitalnu anomalijuvrata i javlja se kod oko 7% ukupne populacije. Nastaje kaoposljedica izostanka obliteracije ductus thyreoglossus-a za vrijemetireoidne migracije tokom embrionalnog razvoja. Najčešće se dijagnostikujeu prvoj deceniji života, a dijagnoza se postavlja kliničkimpregledom, ehosonografijom, multislajsnom kompjuterizovanomtomografijom (MSCT) i/ili magnetnom rezonancom (MRI) glave ivrata, finom iglenom aspiracijom (FNA) i citološkom analizom punktata.Terapija je hirurška, operacijom po Sistrunk-u.Prikaz bolesnika. Četrdesetogodišnji pacijent je hospitalizovan radidijagnostike i liječenja tumora podvilične i podbradne regije i usnešupljine, sa dislokacijom jezika, otežanim gutanjem, i govorom. Pacijentje u ranom djetinjstvu uočio potkožnu izraslinu ispod bradekoja je postepeno rasla. Kliničkim pregledom vidi se potkožna tumorskamasa koja zahvata submentalnu i obje submandibularneregije predominantno lijevo uz intraoralnu prezentaciju submukoznogtumora koja u potpunosti ispunjava orofarinks i dislocirajezik udesno. MSCT poda usta i vrata ukazuje na nepravilno ovalnitumor veličine 120 x 95 x 90 mm, koji gornjim polom doseže dotvrdog nepca, zauzima usnu šupljinu te se spušta anterolateralnoi više lijevo u regiju vrata do hioidne kosti, udesno dislocirajući jezik,jednjak i strukture farinksa i larinksa. Citološka analiza sadržajaciste dobijenog FNA pokazuje da sadržaj odgovara tireoglosalnojcisti. U uslovima opšte nazotrahealne anestezije uradi se operacijapo Sistrunk-u sa odstranjenjem cističnog tumora i srednjeg dijelahioidne kosti uz repozicioniranje jezika. Postoperativni tok protekaouredno. Funkcije govora i gutanja u potpunosti rehabilitovane.Patohistološki nalaz je potvrdio da se radi o tireoglosalnoj cisti.Zaključak. Tireoglosalne ciste su najčešće kongenitalne anomalijevrata i uspješno se liječe operativnim zahvatom sa zadovoljavajućimishodom, niskom stopom komplikacija i malim procentom recidiva.
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