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In a specific biosensing application, a nanoplasmonic sensor chip has been tested by an experimental setup based on an aluminum holder and two plastic optical fibers used to illuminate and collect the transmitted light. The studied plasmonic probe is based on gold nanograting, realized on the top of a Poly(methyl methacrylate) (PMMA) chip. The PMMA substrate could be considered as a transparent substrate and, in such a way, it has been already used in previous work. Alternatively, here it is regarded as a slab waveguide. In particular, we have deposited upon the slab surface, covered with a nanograting, a synthetic receptor specific for bovine serum albumin (BSA), to test the proposed biosensing approach. Exploiting this different experimental configuration, we have determined how the orientation of the nanostripes forming the grating pattern, with respect to the direction of the input light (longitudinal or orthogonal), influences the biosensing performances. For example, the best limit of detection (LOD) in the BSA detection that has been obtained is equal to 23 pM. Specifically, the longitudinal configuration is characterized by two observable plasmonic phenomena, each sensitive to a different BSA concentration range, ranging from pM to µM. This aspect plays a key role in several biochemical sensing applications, where a wide working range is required.

Purpose: Factors such as body masses and humour are known to influence human posture. Abdominoplasty, which causes a sudden change in body masses, significantly improves body image and self-esteem. The aim of this study was to assess postural changes after abdominoplasty by studding the position and orientation through space of the body and the centre of pressure., Methods: Patients affected by excess abdominal skin and/or significant abdominal muscular anterior wall laxity due to undergo an abdominoplasty were enrolled. Posture was evaluated both before and for 1 year after surgery by quantifying the centres of mass, using the Fastrak™ system, and the centre of pressure, using stabilometry. The Wilcoxon signed-rank sum test was used to compare changes., Results: Forty-six patients were enrolled. A retro-positioning of the pelvis with a compensatory advancement of the head and shoulders, confirmed by the baropodometric analysis, was evident in the early post-operative period. The biomechanical system subsequently stabilized, achieving a state of equilibrium 1 year after surgery., Conclusions: We believe that the change in posture following abdominoplasty is a consequence of both surgery (changes in body masses) and psychological factors that influence posture. Indeed, redundant abdominal skin and abdominal muscular anterior wall weakness are often associated with kyphosis since patients try to hide what they consider to be a source of embarrassment. The discovery of a new body image eliminates dissatisfaction, reduces anxiety and increases self-esteem, which provide psychological and physical benefits that improve the quality of life.

Background: Numerous factors such as the equilibrium of body masses and psychological status influence human posture. Breast reduction, on the one hand, produces a sudden change in this equilibrium, and on the other hand, it can modify the psychological status, significantly improving body image and self-esteem. This study aimed to assess postural changes after breast reduction by studying the position and orientation in space of the body and center of pressure., Methods: The study enrolled 52 patients with breast hypertrophy scheduled to undergo breast reduction. Posture was evaluated before surgery and during the first year after surgery by quantifying the centers of mass using the Fastrak system and the center of pressure using stabilometry. The Wilcoxon signed-rank sum test was used to detect any changes., Results: Retropositioning of the upper part of the body, confirmed by baropodometric analysis, was observed in the early postoperative period. The biomechanical system subsequently stabilized, reaching equilibrium 1 year after surgery., Conclusions: The authors believe that postural changes after breast reduction are due to changes in body mass as well as to the effects of physical and psychological factors on posture. Indeed, breast hypertrophy often is associated with kyphosis as patients try to hide what they consider to be a source of embarrassment. A new breast eliminates previous dissatisfaction with body image, reduces anxiety, and increases self-esteem. Improvements in body image and reduced weight in the anterior part of the body help to correct this postural disorder., Level of Evidence Ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Pyoderma gangrenosum (PG) is a chronic skin disease with an incidence of 3-10 per million, and it is often associated with underlying systemic disease. A case of PG of the left leg successfully treated with local debridement and advanced and compression dressings, without systemic treatment is reported. Progression and healing of the ulcer was incredibly rapid. The treatment of PG usually consists of systemic administration of corticosteroids. But wherever the administration of systemic immunosuppressive therapy is impractical, a topical treatment can be used. This type of treatment does not represent a mere palliative, but could be significant for healing, as in the case of our patient.

Lymphoma was one of the first cancers curable by radiotherapy and/or chemotherapy. However the increased risk of second malignancies in lymphoma survivors appeared to be the price of success of modern treatment modalities. In particular, breast cancer has been a major concern among women irradiated for lymphoma at a young age. There are several reports of breast cancer after Hodgkin's lymphoma, but few after non-Hodgkin's lymphoma. Owing to the particularity of this condition and the difficulties in its diagnosis and treatment, we wish to report the case of ductal infiltrant carcinoma of the breast in a young woman survived to a non-Hodgkin's lymphoma. Women who are survivors of pediatric lymphoma have a significantly increased risk of subsequent breast cancer compared with the general population and are at a high risk of developing bilateral disease within a short interval. Several studies have shown that the relative risk for secondary breast cancer becomes significantly increased between 5 and 9 years and rises dramatically between 15 and 19 years after lymphoma treatment. Screening programs to detect breast cancer should be initiated early after Hodgkin's and non-Hodgkin's lymphomas. Screening have to include breast self examinations every month, clinical breast examinations every 6 months, and mammography every 2-3 years. The patients should start breast self-examination at puberty. In these high-risk patients, "aggressive" biopsy is appropriate for suspicious lesions.

Introduction: Incisional hernias can be treated with laparoscopic and laparotomic surgery. Laparoscopic surgery can be made without the use of mesh when performing component separation technique. This technique allows to limit the adverse effects to foreign body and promotes a tension-free closure. We studied intravescical pressure changes during intervention in order to quantify intrabdominal pressure., Material and Methods: A prospective, non-controlled study (cohort study), was made on thirty patients, treated to repair incisional hernia. Standard panniculectomies and component separation technique were performed in all patients. A standard Foley catheter was inserted in to the bladder in order to measure pressure modification in the peri-/postoperative phases. Statistical significance of modifications of pressure values was evaluated with the Wilcoxon's sum rank test., Results: Bladder pressure increased after hernia repair and skin closure and decreased in the first day after surgery, but without returning to the original values, and these modifications were statistically significant., Discussion: We study intravescical pressure changes as an indirect measurement of intrabdominal pressure. Intrabdominal pressure cut-off for the rise of complications is 20 mmHg. This technique allows to maintain pressure under dangerous limits and to limits complications.

Introduction: patients with body dysmorphic disorder often go to the plastic surgeon to correct what they consider a physical deformity or defect, although their appearance falls within normal aesthetic standards. The aim of our study was to evaluate the real need for aesthetic treatments in such patients., Patients and Methods: we included patients who practised an intense sport activity and believed they had body deformities ascribable to their sport activity. We evaluated whether the deformities described by the patients were real or exaggerated. The patients who did have a deformity underwent surgery to correct it; their level of satisfaction was evaluated at a 6-month follow-up examination. The patients with subjective deformities underwent a psychiatric examination., Results: we enrolled 51 patients who practised an intense sport activity and reported body deformities. Forty-one of these patients were found to have a body deformity upon examination and underwent surgery. Surgery was considered to be unnecessary in the remaining 10 patients. Thirty-two of the 41 patients who did undergo were highly satisfied with the outcome., Discussion: the plastic surgeon often sees patients with minor body deformities that do not require treatment but are a major cause of psychological disorders. A thorough psychiatric examination is necessary in such patients to rule out psychiatric diseases. The plastic surgeon should make every effort to identify patients with subjective body dysmorphic disorder to avoid the negative consequences due to the patient's insatisfaction for the outcome of surgery.

Elastofibroma is a benign, poorly circumscribed, tumor-like condition involving, in the vast majority of cases, the subscapular region of elderly individuals, though isolated cases have been seen in the deltoid muscle, infraolecranon area, hip, thigh and stomach. It is characterized by accumulated abnormal elastic fibres and is generally regarded as a reactive process, an unusual fibroblastic pseudotumor. Multiple elastofibromas have been reported to occur in the scapula and olecranon and in the scapula and ischium, whereas literature reports of multiple elastofibromas in the same patient are rare. The case of concomitant, asynchronous double elastofibroma in the same patient is described. A 69-year-old woman presented with right subscapular and left olecranon swelling associated with pain and a clicking sensation during certain arm movements. Some months later the patient developed asymptomatic left subscapular and right olecranon swelling. All the lesions, which were subsequently diagnosed as elastofibromas, were removed.

Desmoid tumor of the breast is a rare fibroblastic disease, a slow-growing and histologically benign lesion that accounts for 0.2% of all breast tumors. It can arise either primarily from the breast parenchyma or, by secondary invasion, from the muscolo-aponeurotic layer of the pectoral muscles. These tumors do not metastatize, have no capsule but do have the propensity to aggressively invade local tissues and organs. It has been suggested that these tumours are associated with surgical and non-surgical tissue trauma, certain hormones and genetic susceptibility. We describe two cases of breast desmoid tumor after breast augmentation. A 52-year-old caucasian woman and 38-year-old caucasian woman presented for a breast implant change. During surgery an inelastic, soft, capsulated mass, arising from the periprosthetic capsula in the area of pectoralis major muscle was found. The mass was removed en bloc together with a portion of the periprosthetic capsula, the resection including a portion of the pectoralis major muscle fascia in both cases. The results of this histological examination suggested an extra-abdominal desmoid tumor. To date both the local and the general conditions of the two patients are good, with no signs of recurrence of the lesion.