Primary Anterior Cruciate Ligament Reconstruction. How Do We Do It?

Anterior cruciate ligament (ACL) tears are frequently seen in current practice mostly affecting the young, active subjects, and usually require ligament reconstruction in order to restore normal knee kinematics. As worldwide interest in anatomic reconstruction grew over the last decade, we have also refined our technique in order to restore the anatomical function as near to the normal as possible. This anatomical restoration concept is believed to prevent the onset of osteoarthritis, which the non-anatomic reconstructions fail to attain. The knowledge gained from the ACL anatomy, function and kinematics has helped in developing the current anatomic methods of reconstruction, which take into account patient anatomy, the rupture pattern, as well as the comorbidities. We present our approach to anatomical single- and double-bundle ACL reconstruction.

Epithelial papillary angioepithelioma pada rongga sinus maksila wanita dewasa muda

Latar belakang: Epithelial Papillary Angioepithelioma (EPA) yang dikenal juga sebagai tumor Dabska adalah suatu tumor vaskular yang jarang terjadi pada rongga hidung dan sinus paranasalis. Tindakan bedah, radioterapi dan kemoterapi serta kombinasi ketiganya adalah pengobatan utama untuk tumor ganas sinonasal. Tujuan: Memberikan informasi mengenai diagnosis dan penatalaksanaan tumor Dabska. Kasus: Kasus langka ini ditemukan pada wanita usia 16 tahun dengan massa tumor pada rongga hidung dan sinus paranasal yang berekstensi hingga rongga mulut. Pemeriksaan histopatologi didapatkan sel tumor endothelial yang menunjukkan pola pertumbuhan papiler. Pemeriksaan imunohistokimiaCD34 positif. Penatalaksanaan: Radioterapi preoperasi 10 kali untuk mengurangi massa tumor yang progresif kemudian dilakukan maksilektomi infrastruktur dilanjutkan radioterapi postoperasi. Dilakukan juga pemasangan protesa palatum bars postoperasi dan protesa palatomaksilaris 3 bulan pasca operasi. Evaluasi pasca operasi tampak perbaikan, tidak didapatkan infeksi maupun tanda-tanda kekambuhan,dan secara anatomi fungsi kembali seperti semula. Kesimpulan: Diagnosis dan penatalaksanaan yang cepat dan tepat dapat meningkatkan prognosis pada tumor DabskaKata kunci: Tumor Dabska, maksilektomi infrastruktur, radioterapi, tumor sinonasal, protesa ABSTRACTBackground: Epithelial papillary angioepithelioma (EPA), also known as Dabska tumor, is a very rare vascular neoplasm in the sinonasal. Surgery, radiotherapy and chemotherapy, and the combination of those three are the primary treatment for malignant sinonasal tumors. Purpose: To inform about the diagnostic and treatment of Dabska tumor. Case: We present an exceptionally rare case of EPA of the sinonasal in a 16 year old female. A well defined, reddish tumor existed at the sinonasal that extended to oral cavity. Microscopic examination revealed the endothelioid tumor cells showing a papillary growth pattern with positive imunohistchemistry of CD34. Management: Ten consecutive radiotherapies was performed preoperatively and then continued with progressive infrastructure maxillectomy andreconstructions of the maxilla, followed by postoperative radiotherapies. Postoperative management also include the mounting bars palate prosthesis and palatomaxillary prosthesis 3-month after the operation. Postoperative evaluation showed improvement, there was no sign of any infection or recurrence, and the anatomical function returned to normal. Conclusion: Prompt diagnosis and the rightmanagement could improve the prognosis in Dabska tumors.Keywords: Dabska tumor, infrastructure maxillectomy, radiotherapy, sinonasal neoplasm, prosthesis

Sternalis Muscle: An Unexpected Finding during Mastectomy

Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. It is regularly observed in lower animal but infrequently in humans. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. Although less is known about its origin and innervations, knowledge about this muscle can have many clinical implications. A case of unilateral sternalis muscle detected during mastectomy, in a female with carcinoma of the right breast, is being reported with a brief review of the literature and highlighting its clinical significance.

Terapia della calcolosi delle vie urinarie: Ancora tema controverso? Interrogativi

The authors report some cases of urinary calculosis mistakenly treated in monotherapy with ESWL. They indicate the limits of this technique as well as the necessity of starting auxiliary and/or alternative methods. In the authors’ opinion the indispensable preliminary parameter is the careful evaluation of the functional possibilities of the involved area, also taking into account that if anatomical function is partially or totally compromised, traditional surgery undoubtedly still plays a leading role.

Silica deposition and ultrastructure in the cell wall of Equisetum arvense : the importance of cell wall structures and flow control in biosilicification?

Scanning and transmission electron microscopy have been used in the investigation of the surface micromorphology and ultrastructure of silicas extracted from different regions of the horsetail Equisetum arvense . The surface micromorphology was found to be very complex and varied with the anatomical region of the plant. Principally fibrillar, globular and sheet-like ultrastructural motifs of silica were observed, their proportions and detailed structure also varying with the anatomical region studied. The physiocochemical mechanisms by which these structural motifs arise are discussed in relation to the surface micromorphologies observed and to their anatomical function.