Search

We present the case of a 23-year-old woman who reported weakness in the left upper limb, decreased warmth, numbness in the fingers, pain in the clavicular region, and a severe cold sensation in the limb. A thermal imaging camera examination was performed for diagnostic purposes, which guided further diagnostic and therapeutic management towards arterial thoracic outlet syndrome (aTOS). Following surgery and rehabilitation procedures, significant remission of symptoms was achieved and the patient's condition improved. This is the first report on the diagnosis of aTOS using thermal imaging, paving the way for further clinical research into this effective, rapid, and radiation-free method of diagnostic imaging. Conclusion: Thermal imaging is one of the most effective, readily available, and patient-safe methods for diagnosing vascular disease associated with flow disruption. [ABSTRACT FROM AUTHOR]

Chronic immunosuppressive therapy is currently the only effective method to prevent acute rejection of a transplanted organ. Unfortunately, the expected effect of treatment brings a number of grave side effects, one of the most serious being cardiovascular complications. In our study, we wanted to investigate how treatment with commonly used immunosuppressive drugs affects the occurrence of programmed cardiac cell death. For this purpose, five groups of rats were treated with different triple immunosuppressive regimens. Cardiac tissue fragments were subjected to the TUNEL assay to visualize apoptotic cells. The expression of Bcl-2 protein, Bax protein, caspase 3 and caspase 9 was also assessed. This study indicates that all immunosuppressive protocols used chronically at therapeutic doses result in an increased percentage of cells undergoing apoptosis in rat heart tissue. The greatest changes were recorded in the TMG (rats treated with tacrolimus, mycophenolate mofetil and glucocorticosteroids) and CMG (rats treated with cyclosporin A, mycophenolate mofetil and glucocorticosteroids) groups. The TRG (rats treated with rapamycin, tacrolimus and glucocorticosteroids) group showed the lowest percentage of apoptotic cells. The internal apoptosis pathway was confirmed only in the TMG group; in the remaining groups, the results indicate programmed cell death via the receptor pathway. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is a condition caused by chronic compression of the median nerve. The diagnosis is made mainly on the basis of clinical image and confirmed with electrodiagnostic testing (electromyography and nerve conduction study); however, these methods do not always aid in reaching the diagnosis of CTS. Moreover, they are invasive examinations, unpleasant for the patient and have to be performed by a qualified physician.

Many factors contribute to successful nerve reconstruction. The correct technique of anastomosis is one of the key elements that determine the final result of a surgery. The aim of this study is to examine how useful an electromyography (EMG) can be as an objective intraoperative anastomosis assessment method.

Using different three-drug immunosuppressive treatment regimens in a rat model, we aimed to determine the effects of long-term therapy on metalloproteinase-2 and metalloproteinase-9 activity and the expression of their inhibitors, as well as to assess the morphology of the animals' cardiac tissue. Our results suggest that chronic use of immunosuppressive drugs disrupts the balance between the activity of MMPs and TIMPs. Depending on the type of drug regimen used, this leads to abnormalities in the cardiac structure, collagen fiber accumulation, or cardiomyocyte hypertrophy. The information obtained in the present study allows us to conclude that the chronic treatment of rats with the most common clinical immunosuppressive regimens may contribute to abnormalities in the myocardial structure and function. The results presented in this study may serve as a prelude to more in-depth analyses and additional research into the optimal selection of an immunosuppressive treatment with the lowest possible risk of cardiovascular complications for patients receiving organ transplants. [ABSTRACT FROM AUTHOR]

This review focuses on the role of metalloproteinases in the pathogenesis of myocardial injury in various disease entities. It reveals how the expression and serum levels of metalloproteinases and their inhibitors change in many disease states. At the same time, the study offers a review of the impact of immunosuppressive treatment on this relationship. Modern immunosuppressive treatment is based mainly on the use of calcineurin inhibitors, including cyclosporine A and tacrolimus. The use of these drugs may carry a number of side effects, specifically to the cardiovascular system. The scale and degree of long-term influence on the organism remains unclear, but a significant risk of complications for transplant recipients who take immunosuppressive drugs as part of their daily treatment is to be expected. Therefore, the knowledge on this subject should be expanded and the negative effects of post-transplant therapy minimized. Immunosuppressive therapy plays an important role in the expression and activation of tissue metalloproteinases and their specific inhibitors, which leads to many tissue changes. The presented study is a collection of research results on the effects of calcineurin inhibitors on the heart, with particular emphasis placed on the participation of MMP-2 and MMP-9. It is also an analysis of the effects of specific heart diseases on myocardial remodeling through inductive or inhibitory effects on matrix metalloproteinases and their inhibitors. [ABSTRACT FROM AUTHOR]

Thyroid neoplasms (tumors) are the most common pathology of the endocrine system that requires surgery, and in most cases changes are benign. The surgical treatment of thyroid neoplasms consists in total, subtotal, or one lobe excision. Our study aimed to assess the concentration of vitamin D and its metabolites in patients before thyroidectomy. The study included 167 patients with thyroid pathology. Before the thyroidectomy procedure calcidiol (25-OHD), calcitriol (1,25-(OH)2D), and vitamin D binding protein (VDBP), as well as basic biochemical parameters, were measured using an enzyme-linked immunosorbent assay kit. Data analysis showed that the cohort of patients has a significant 25-OHD deficiency and proper concentration of 1,25-(OH)2D. Before the surgery, more than 80% of patients have extreme vitamin D deficiency (<10 ng/mL), and only 4% of the study group has proper 25-OHD concentration. Patients undergoing thyroidectomy are exposed to many complications, including calcium reduction. Our research has shown that patients prior to surgery have a marked vitamin D deficiency, an indicator that may affect their subsequent convalescence and prognosis. The results suggest that determination of vitamin D levels prior to thyroidectomy may be useful for potential consideration of supplementation when vitamin D deficiency is marked and needs to be incorporated into the good clinical management of these patients. [ABSTRACT FROM AUTHOR]

Abstract Background It has been suggested that action of complement cascade [CC]-derived anaphylatoxins/molecules may represent a missing link between obesity and metabolic disorders. However, to date, the direct biochemical/immunomodulatory composition of the human AT environment remains poorly understood. In this study, we examined plasma and AT (subcutaneous and visceral/omental) levels of selected CC-derived anaphylatoxins/molecules, and adipsin as well as verified their associations with immune and stem cells chemoattractant - stromal-derived factor-1 (SDF-1). Methods A total of 70 (35 subcutaneous and 35 omental) AT samples were obtained from patients undergoing elective surgery. Plasma and AT-derived interstitial fluid levels of C3a, C5a, C5b-9/membrane attack complex (MAC), complement factor D (adipsin) were measured using ELISA. Results AT levels of all examined substances were significantly lower than the corresponding levels in the plasma (in all cases P Conclusions Our study demonstrated for the first time that significantly reduced levels of complement-derived molecules were present in human AT than in the peripheral blood, and that these factors are associated with the metabolic status of examined individuals. Moreover, in human AT, various associations between complement-derived molecules and SDF-1 levels exist.

The evaluation of skin penetration of active substances from topical preparations is a pre-clinical requirement in the pharmaceutical industry. While in vitro preparations of human or animal skin are frequently used the development of artificial lipophilic and hydrophilic membranes with similar properties to human or animal skin needs to be developed. This preliminary study compared the in vitro permeation of niacinamide (vitamin B3), which is used as a model drug, across artificial hydrophilic and lipophilic membranes with in vitro penetration across human skin. The experiments were carried out in Franz diffusion cells. Artificial membranes were filter paper impregnated with either collodium (hydrophilic), stearic acid, cetyl alcohol or cetyl alcohol + cholesterol (lipophilic). Hydrogel and emulsion containing 0.5% of niacinamide were applied to membranes for up to 4 hours. Acidic and neutral (pH 5.4 and 7.4) acceptor fluid samples were taken after 0.5, 1, 2 and 4 hours. Niacinamide permeated hydrophilic better than lipophilic membranes. There were no significant differences between the cumulated amounts of niacinamide that penetrated artificial lipophilic membranes consisting of stearic acid, cetyl alcohol and cholesterol as compared with human skin in vitro. Also, hydrogel and emulsion gave similar results. In conclusion, these artificial membranes seem to be a promising alternative to human or animal skin. [ABSTRACT FROM AUTHOR]

Introduction: The constantly rising number of skin malignancies and increasing cancer awareness encourage more people to visit outpatient clinics in order to have various skin lesions removed. Despite the fact that scarring is a physiological response to any excision procedure, minimizing the size of it is a goal of every good practitioner. Therefore the question arises whether different techniques used to remove skin lesions may impact the formation and quality of skin scars. Aim: To perform an evaluation of skin scars formed by laser and surgical incisions and their influence on lymphatic outflow in rats. Material and methods: Five male rats were used. Using methylene blue, the migration of dye through lymphatic channels of the lower extremity was measured. Afterwards, transverse incisions were made distally using laser and a surgical blade. Wounds were left to heal by secondary intention. After 4 weeks dye migration assessment was repeated and tissue samples were obtained for microscopic evaluation. Results: Wounds after surgical incisions healed entirely. Wounds after laser treatment had not healed, with a visible area of granulation tissue and hair loss. Significantly worse dye migration was observed in rat extremities after laser therapy than after surgical incision (p = 0.007). Conclusions: The results of the study show that the size of the scar can depend on the incision technique used. Larger scars after laser therapy limit the lymphatic flow of the skin, which may have an adverse effect on mapping sentinel lymph nodes. However, this hypothesis requires further research. [ABSTRACT FROM AUTHOR]

Introduction: Tissue perfusion disorders can be present in various diseases and progress in the form of arterial ischemia or venous stasis with accompanying local changes in temperature. Aim: To use of thermography in the diagnostics of early periods of tissue perfusion disorders before the clinical symptoms occur. Material and methods: Thirty-two male rats were used. After anesthesia the skin on lower limbs was shaved and femoral vessels of both sides were exposed. In 10 rats the left femoral artery was ligated, in 12 rats the left femoral vein was ligated and in the 10 remaining rats both left femoral vessels were ligated. Thermography of the limbs was performed before the vessels were ligated and after a period of 24 h. The pictures were taken every 5 s during 3 min. Before the measurement, the tissues were cooled down for 20 s with a 5°C water compress. The rate of temperature return to the limbs was evaluated. Results: Statistically significant differences were observed after the 24-hour period on the thigh after the ligation of the vein, and on the shank and the foot after ligation of the artery. After the ligature of both vessels, statistically significant differences occurred immediately after their ligature within the thigh and shank and after 24 h on the foot. Conclusions: The results show that cameras with an accuracy of0.05°C can be used to detect tissue perfusion disorders. The special diagnostic value is the ability to detect perfusion disorders before clinical symptoms occur. [ABSTRACT FROM AUTHOR]

Introduction: Methods allowing one to locate the position of a cutaneous perforator do not allow one to determine the boundaries of the vascularized skin. In clinical practice this causes complications in the form of marginal necrosis of the flap. Aim: To examine the usefulness of thermography to assess the extent of vascularization of the skin and subcutaneous tissue by a single perforator. Material and methods: Thirty-one male rats were used. Using dynamic thermography the perforators on the abdominal skin were located. Afterwards the flap was prepared on a randomly chosen perforator. After 24 h the extent of vascularization of the skin by a single perforator was examined. Results: In 22.5% of cases the number of perforators marked in the thermography was equal to the number of perforators marked intraoperatively, in 64.5% it was lower and in 13% higher. The use of thermography has shown that basing the flap vascularization on the perforator with low efficiency resulted in statistically more frequent occurrence of ischemia and partial necrosis of the flap (p = 0.024). Partial necrosis of the flap occurred in 12 of 31 cases, always in the area in which during the preoperative thermography no perforators were found. The areas of necrosis occurred irrespectively of the distance from the supplying vessel. Conclusions: When designing the shape of the flap, the distribution of all perforators must be considered. The perforators need to be included in the area of prepared tissues because their location indicates the area with a more efficient network of vessels. [ABSTRACT FROM AUTHOR]

Copyright of Polimery is the property of Industrial Chemistry Research Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper aimed to evaluate the effect of vehicle and chemical modifications of the structure of active compounds on the skin permeation and accumulation of ibuprofen [IBU]. In vitro permeation experiments were performed using human abdominal skin and Strat-M™ membrane. The HPLC method was used for quantitative determinations. The formulations tested were hydrogels containing IBU and its derivatives and commercial gel with ibuprofen. The results obtained indicate that Celugel® had an enhancing effect on the skin penetration of IBU. The average cumulative mass of [IBU] after 24 h permeation test from Celugel® formulation through human skin was over 3 times higher than for the commercial product. Three ibuprofen derivatives containing [ValOiPr][IBU], [ValOPr][IBU], and [ValOBu][IBU] cation were evaluated as chemical penetration enhancers. The cumulative mass after 24 h of penetration was 790.526 ± 41.426, 682.201 ± 29.910, and 684.538 ± 5.599 μg IBU cm−2, respectively, compared to the formulation containing unmodified IBU-429.672 ± 60.151 μg IBU cm−2. This study demonstrates the perspective of the transdermal hydrogel vehicle in conjunction with the modification of the drug as a potential faster drug delivery system. [ABSTRACT FROM AUTHOR]

Thyroid diseases are common conditions that have a negative impact on the health of all populations. The literature sheds light on the differences in the composition of the intestinal microbiota in patients suffering from thyroid diseases compared to healthy individuals. The microbiome affects the proper functioning of the thyroid gland, and the existence of the gut–thyroid axis is discussed in the context of both thyroid diseases and intestinal dysbiosis. The purpose of this review is to describe associations between the microbiome and its metabolites and thyroid dysfunction. We try to explain the role of the microbiome in the metabolism of thyroid hormones and the impact of thyroid autoimmune diseases. In addition, we raise issues related to the influence of bacterial metabolites, such as short-chain fatty acids or secondary bile acids, in the functioning of the thyroid gland. Last but not least, we explored the interactions between the gut microbiota and therapeutics and supplements typically administered to patients with thyroid diseases. [ABSTRACT FROM AUTHOR]

Increased triacylglycerols' (TAG) synthesis, insulin resistance, and prolonged liver lipid storage might lead to the development of non-alcoholic fatty liver disease (NAFLD). Global prevalence of NAFLD has been estimated to be around 25%, with gradual elevation of this ratio along with the increased content of adipose tissue in a body. The initial stages of NAFLD may be reversible, but the exposition to pathological factors should be limited. As dietary factors greatly influence various disease development, scientists try to find dietary components, helping to alleviate the steatosis. These components include n-3 polyunsaturated (PUFA) fatty acids, especially eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA). This review focused on the role of resolvins, protectins and merensins in NAFLD. [ABSTRACT FROM AUTHOR]

Epilobium angustifolium L. is a popular and well-known medicinal plant. In this study, an attempt to evaluate the possibility of using this plant in preparations for the care and treatment of skin diseases was made. The antioxidant, antiaging and anti-inflammatory properties of ethanolic extracts from Epilobium angustifolium (FEE) were assessed. Qualitative and quantitative evaluation of extracts chemically composition was performed by gas chromatography with mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC). The total polyphenol content (TPC) of biologically active compounds, such as the total content of polyphenols (TPC), flavonoids (TFC), and assimilation pigments, as well as selected phenolic acids, was assessed. FEE was evaluated for their anti-inflammatory and antiaging properties, achieving 68% inhibition of lipoxygenase activity, 60% of collagenase and 49% of elastase. FEE also showed high antioxidant activity, reaching to 87% of free radical scavenging using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 59% using 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS). Additionally, in vitro penetration studies were performed using two vehicles, i.e., a hydrogel and an emulsion containing FEE. These studies showed that the active ingredients contained in FEE penetrate through human skin and accumulate in it. The obtained results indicate that E. angustifolium may be an interesting plant material to be applied as a component of cosmetic and dermatological preparations with antiaging and anti-inflammatory properties. [ABSTRACT FROM AUTHOR]

Epilobium angustifolium L. is applied as an antiseptic agent in the treatment of skin diseases. However, there is a lack of information on human skin penetration of active ingredients with antioxidative potential. It seems crucial because bacterial infections of skin and subcutaneous tissue are common and partly depend on oxidative stress. Therefore, we evaluated in vitro human skin penetration of fireweed ethanol-water extracts (FEEs) by determining antioxidant activity of these extracts before and after penetration study using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and Folin–Ciocalteu methods. Microbiological tests of extracts were done. The qualitative and quantitative evaluation was performed using gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC-UV) methods. The in vitro human skin penetration using the Franz diffusion chamber was assessed. The high antioxidant activity of FEEs was found. Gallic acid (GA), chlorogenic acid (ChA), 3,4-dihydroxybenzoic acid (3,4-DHB), 4-hydroxybenzoic acid (4-HB), and caffeic acid (CA) were identified in the extracts. The antibacterial activities were found against Serratia lutea, S. marcescens, Bacillus subtilis, B. pseudomycoides, and B. thuringiensis and next Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, Pseudomonas aeruginosa, and P. fluorescens strains. In vitro penetration studies showed the penetration of some phenolic acids and their accumulation in the skin. Our results confirm the importance of skin penetration studies to guarantee the efficacy of formulations containing E. angustifolium extracts. [ABSTRACT FROM AUTHOR]

Introduction: Most ischemic strokes develop as a result of atherosclerosis, in which inflammation plays a key role. The synthesis cascade of proinflammatory mediators participates in the process induced in the vascular endothelium and platelets. Resolvins are anti-inflammatory mediators originating from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which may improve the prognosis related to atherosclerosis by inhibiting the production of proinflammatory cytokines, limiting neutrophil migration, or positively influencing phagocytosis. Although clinical trials with resolvin in humans after stroke have not been realized, they may soon find application. Aim: The aim of the study was to review the available literature on the scope of the possibilities of the prevention and treatment of stroke with the use of resolvins, EPA and DHA derivatives. Materials and methods: The review features articles published until 31 January 2020. The search for adequate literature was conducted using the keywords: stroke and resolvins. Over 150 articles were found. Studies not written in English, letters to the editor, conference abstracts, and duplicate information were excluded. Results: In several studies using the animal model, the supplementation of resolvin D2 decreased brain damage caused by myocardial infarction, and it reversed the neurological dysfunction of the brain. A decrease in the concentration of proinflammatory cytokines, such as TNF-α, Il-6, and Il-1β, was also observed, as well as a decrease in the scope of brain damage. In the context of stroke in animals, the treatment with resolvin D2 (RvD2) (injection) has a better effect than supplementation with DHA. Conclusions: Resolvins are characterised by strong anti-inflammatory properties. Resolvins improve prognosis and decrease the risk of developing cardiovascular disease, consequently lowering the risk of stroke, and may find application in the treatment of stroke. [ABSTRACT FROM AUTHOR]

Background: Delay in the diagnosis and treatment of bone tumors continues to be a common problem. Prolonged diagnosis can significantly reduce the chances of successful treatment of the disease. Accordingly, the aim of this study was to assess the delay in the diagnosis of primary bone tumors, identify the most common symptoms and analyze the course of the diagnostic and therapeutic path., Material and Methods: Thirty-two (K=18; M=14) patients treated surgically for primary bone tumors were included in the retrospective study. Patient records were analyzed. Delay in diagnosis was defined as the time from the onset of symptoms to the initial diagnosis and referral to an orthopedic oncology center., Results: The median delay in diagnosis was 7 (3-12) months. For tumors located in the pelvis, the delay was 10 months, compared to 5 months for the upper limb and 7 months for the lower limb (p=0.2312). The delay was 6 months In patients with osteosarcoma, and 8 months in chondrosarcoma patients (p=0.1786). At the first office visit, an x-ray was ordered in 19 cases (59.4%), of whom 9 patients (47.4%) were referred on to the oncology center. The most common symptoms were pain in the affected area (90.6%), limited mobility (28.1%) and pathological fracture (25%). After admission to an orthopedic department, a biopsy was performed after 5.5 (3-8.2) days. The histology results were ready after another 14 (8-18) days, and surgical treatment was performed after 95 (76-100) days., Conclusions: 1. Although patients show typical symptoms of bone tumors, only a small proportion are referred directly to an oncology center. After a primary bone tumor is suspected, further diagnostic and therapeutic activities proceed efficiently, in accordance with the current guidelines.

Not required for Clinical Vignette.

The effect of transdermal vehicle (Pentravan ® ) on skin permeability was examined for unmodified ibuprofen (IBU) and ion pairs of ibuprofen with new L-valine alkyl esters [ValOR][IBU]. The percutaneous permeation across the human skin and transdermal diffusion test model (Strat-M ® membranes) of ibuprofen and its structural modification were measured and compared using Franz diffusion cells. For comparison, the penetration of ibuprofen from a commercial product was also investigated. The cumulative amount of drug permeated through human skin at the end of the 24 h study was highest for ibuprofen derivatives containing propyl (C3), isopropyl (C3), ethyl (C2), and butyl (C4) esters. For Strat-M ® , the best results were obtained with the alkyl chain length of the ester from C2 to C5. The permeation profiles and parameters were appointed, such as steady-state flux, lag time, and permeability coefficient. It has been shown that L-valine alkyl ester ibuprofenates, with the propyl, butyl, and amyl chain, exhibit a higher permeation rate than ibuprofen. The diffusion parameters of analyzed drugs through human skin and Strat-M ® were similar and with good correlation. The resulting Pentravan-based creams with ibuprofen in the form of an ionic pair represent a potential alternative to other forms of the drug-containing analgesics administered transdermally. Furthermore, the Strat-M ® membranes can be used to assess the permeation of transdermal preparations containing anti-inflammatory drugs.

Introduction: The constantly rising number of skin malignancies and increasing cancer awareness encourage more people to visit outpatient clinics in order to have various skin lesions removed. Despite the fact that scarring is a physiological response to any excision procedure, minimizing the size of it is a goal of every good practitioner. Therefore the question arises whether different techniques used to remove skin lesions may impact the formation and quality of skin scars., Aim: To perform an evaluation of skin scars formed by laser and surgical incisions and their influence on lymphatic outflow in rats., Material and Methods: Five male rats were used. Using methylene blue, the migration of dye through lymphatic channels of the lower extremity was measured. Afterwards, transverse incisions were made distally using laser and a surgical blade. Wounds were left to heal by secondary intention. After 4 weeks dye migration assessment was repeated and tissue samples were obtained for microscopic evaluation., Results: Wounds after surgical incisions healed entirely. Wounds after laser treatment had not healed, with a visible area of granulation tissue and hair loss. Significantly worse dye migration was observed in rat extremities after laser therapy than after surgical incision ( p = 0.007)., Conclusions: The results of the study show that the size of the scar can depend on the incision technique used. Larger scars after laser therapy limit the lymphatic flow of the skin, which may have an adverse effect on mapping sentinel lymph nodes. However, this hypothesis requires further research., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia Sp. z o. o.)

Introduction: Methods allowing one to locate the position of a cutaneous perforator do not allow one to determine the boundaries of the vascularized skin. In clinical practice this causes complications in the form of marginal necrosis of the flap., Aim: To examine the usefulness of thermography to assess the extent of vascularization of the skin and subcutaneous tissue by a single perforator., Material and Methods: Thirty-one male rats were used. Using dynamic thermography the perforators on the abdominal skin were located. Afterwards the flap was prepared on a randomly chosen perforator. After 24 h the extent of vascularization of the skin by a single perforator was examined., Results: In 22.5% of cases the number of perforators marked in the thermography was equal to the number of perforators marked intraoperatively, in 64.5% it was lower and in 13% higher. The use of thermography has shown that basing the flap vascularization on the perforator with low efficiency resulted in statistically more frequent occurrence of ischemia and partial necrosis of the flap (p = 0.024). Partial necrosis of the flap occurred in 12 of 31 cases, always in the area in which during the preoperative thermography no perforators were found. The areas of necrosis occurred irrespectively of the distance from the supplying vessel., Conclusions: When designing the shape of the flap, the distribution of all perforators must be considered. The perforators need to be included in the area of prepared tissues because their location indicates the area with a more efficient network of vessels.

Introduction: Tissue perfusion disorders can be present in various diseases and progress in the form of arterial ischemia or venous stasis with accompanying local changes in temperature., Aim: To use of thermography in the diagnostics of early periods of tissue perfusion disorders before the clinical symptoms occur., Material and Methods: Thirty-two male rats were used. After anesthesia the skin on lower limbs was shaved and femoral vessels of both sides were exposed. In 10 rats the left femoral artery was ligated, in 12 rats the left femoral vein was ligated and in the 10 remaining rats both left femoral vessels were ligated. Thermography of the limbs was performed before the vessels were ligated and after a period of 24 h. The pictures were taken every 5 s during 3 min. Before the measurement, the tissues were cooled down for 20 s with a 5°C water compress. The rate of temperature return to the limbs was evaluated., Results: Statistically significant differences were observed after the 24-hour period on the thigh after the ligation of the vein, and on the shank and the foot after ligation of the artery. After the ligature of both vessels, statistically significant differences occurred immediately after their ligature within the thigh and shank and after 24 h on the foot., Conclusions: The results show that cameras with an accuracy of 0.05°C can be used to detect tissue perfusion disorders. The special diagnostic value is the ability to detect perfusion disorders before clinical symptoms occur.

"Heart-hand" syndrome is a broad category of diseases. The most common form is Holt-Oram syndrome (HOS) that occurs in approximately 1:100 000 live births. It is characterized by upper limb defects (carpal bone defects, triphalangeal thumbs, hypoplasia or absence of the thumb and the radial ray) and cardiac septal defects (atrial septal defects or ventricular septal defects). There are three main types of "heart-hand" syndromes. "Heart-hand" syndrome type I--HOS is characterised by atrial septal defect and thumb anomaly, type II (Tabatznik syndrome) by short distal phalanx of the thumb, upper limb abnormalities and cardiac arrhythmias, type III by cardiac conduction diseases and shortening of the middle phalanges. The aim of this report is to present a new case of the "heart-hand" syndrome in the family. This diagnosis was established on the base of clinical examination, radiological findings, and echocardiography. Our patient demonstrates congenital bilateral absence of a radial bone and thumbs, dextrocardia and patent foramen ovale.

This paper will discuss the biocompatibility and dynamic fatigue properties of polystyrene-b-polyisobutylene-b-polystyrene thermoplastic elastomer with 30 wt % polystyrene (SIBS30), an emerging FDA-approved biomaterial. SIBS30 is a very soft, transparent biomaterial resembling silicone rubber, with superior mechanical properties. Using the hysteresis method adopted for soft biomaterials, the dynamic fatigue properties of SIBS30 were found to be between those of polyurethane and silicone rubber, with fatigue life twice as long as that of silicone. Under single load testing (SLT, 1.25 MPa), SIBS30 displayed less than half the dynamic creep compared to silicone, both in air and in vitro (37 degrees C, simulated body fluid). Hemolysis and 30- and 180-day implantation studies revealed excellent biocompatibility of the new biomaterial. The results presented in this paper indicate that, in comparison with silicone rubber, SIBS30 has similar biocompatibility and superior dynamic fatigue properties.

During 1995-2002 in General and Hand Surgery Department 21 digits were reconstructed by toe to hand transplantation performed in 16 patients. There were 10 cases thumb was reconstruction with 4 great toe and 6 second toe transfers. Rest 11 fingers there were index, middle and ring were restored by II and III toe. Twelve osteosynthesis were performed by Kirschner wire and nine by bone peg. All fixations were sufficient stable to start early rehabilitation. In one case after Kirschner fixation occurred ostitis and malunion. This patient was cured by autovaccine. After bone peg we do not recorded any complication.