No abstract available.
Carcinoma, Squamous Cell* ; Maxillary Sinus* ; Nose* ; Papilloma, Inverted*

The deep inferior epigastric perforator (DIEP) flap has long been the gold standard for autologous breast reconstruction. Various factors that can disrupt abdominal wall vascular anatomy make dissection of the DIEP flap a technically demanding procedure. The mass effect from a huge uterine leiomyoma has not been previously reported as a factor influencing abdominal wall vascularity. The aim of this report was to describe the case of a patient with a huge uterine leiomyoma who underwent immediate free DIEP flap breast reconstruction without any major complications.
Abdominal Wall ; Breast* ; Female ; Free Tissue Flaps ; Humans ; Leiomyoma* ; Mammaplasty* ; Microsurgery ; Perforator Flap*

The deep inferior epigastric perforator (DIEP) flap has long been the gold standard for autologous breast reconstruction. Various factors that can disrupt abdominal wall vascular anatomy make dissection of the DIEP flap a technically demanding procedure. The mass effect from a huge uterine leiomyoma has not been previously reported as a factor influencing abdominal wall vascularity. The aim of this report was to describe the case of a patient with a huge uterine leiomyoma who underwent immediate free DIEP flap breast reconstruction without any major complications.
Abdominal Wall ; Breast* ; Female ; Free Tissue Flaps ; Humans ; Leiomyoma* ; Mammaplasty* ; Microsurgery ; Perforator Flap*

The reconstruction of the mandibulofacial defects is a difficult task when there are full-thickness cheek defects involving mandible, inner mucosa and outer skin. There are several reconstructive options for the coverage of large defects, but most of the methods are complicated, and time- and effort-consuming. We hereby present a case of fibula osteocutaneous flap based on a single peroneal artery perforator in the reconstruction of a three-dimensional mandibulofacial defects.
Arteries ; Cheek ; Fibula* ; Free Tissue Flaps ; Mandible ; Microsurgery ; Mucous Membrane ; Perforator Flap ; Skin

OBJECTIVE: The aim of this study was to provide normative data on the Literacy Independent Cognitive Assessment (LICA) and to explore the effects of age, education/literacy, and gender on the performance of this test. METHODS: Eight hundred and eighty-eight healthy elderly subjects, including 164 healthy illiterate subjects, participated in this study. None of the participants had serious medical, psychiatric, or neurological disorders including dementia. Bivariate linear regression analyses were performed to examine the effects of age, education/literacy, and sex on the score in each of the LICA cognitive tests. The normative scores for each age and education/literacy groups are presented. RESULTS: Bivariate linear regression analyses revealed that total score and all cognitive tests of the LICA were significantly influenced by both age and education/literacy. Younger and more-educated subjects outperformed older and illiterate or less-educated subjects, respectively, in all of the tests. The normative scores of LICA total score and subset score were presented according to age (60-64, 65-69, 70-74, 75-80, and > or =80 years) and educational levels (illiterate, and 0-3, 4-6, and > or =7 years of education). CONCLUSION: These results on demographic variables suggest that age and education should be taken into account when attempting to accurately interpret the results of the LICA cognitive subtests. These normative data will be useful for clinical interpretations of the LICA neuropsychological battery in illiterate and literate elderly Koreans. Similar normative studies and validations of the LICA involving different ethnic groups will help to enhance the dementia diagnosis of illiterate people of different ethnicities.
Aged* ; Dementia ; Diagnosis ; Education ; Ethnic Groups ; Humans ; Linear Models ; Nervous System Diseases

An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The O2 saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.
Aged, 80 and over ; Anti-Bacterial Agents ; Auscultation ; C-Reactive Protein ; Cardiomegaly ; Cough ; Dyspnea ; Echocardiography, Doppler, Color ; Edema ; Electrocardiography ; Female ; Fever ; Furosemide ; Heart ; Hematologic Tests ; Humans ; Hypertension ; Leukocytosis ; Lower Extremity ; Lung ; Mitral Valve Insufficiency* ; Pleural Effusion ; Pneumonia ; Pulmonary Edema* ; Radiography, Thoracic ; Respiration ; Respiratory Sounds ; Sputum ; Systolic Murmurs ; Tachycardia, Sinus

Infertility affects nearly 186 million people worldwide and the male partner is the cause in about half of the cases. Meta-regression data indicate an unexplained decline in sperm concentration and total sperm count over the last four decades, with an increasing prevalence of male infertility. This suggests an urgent need to implement further basic and clinical research in Andrology. Andrology developed as a branch of urology, gynecology, endocrinology, and, dermatology. The first scientific journal devoted to andrological sciences was founded in 1969. Since then, despite great advancements, andrology has encountered several obstacles in its growth. In fact, for cultural reasons, the male partner has often been neglected in the diagnostic and therapeutic workup of the infertile couple. Furthermore, the development of assisted reproductive techniques (ART) has driven a strong impression that this biotechnology can overcome all forms of infertility, with a common belief that having a spermatozoon from a male partner (a sort of sperm donor) is all that is needed to achieve pregnancy. However, clinical practice has shown that the quality of the male gamete is important for a successful ART outcome. Furthermore, the safety of ART has been questioned because of the high prevalence of comorbidities in the offspring of ART conceptions compared to spontaneous conceptions. These issues have paved the way for more research and a greater understanding of the mechanisms of spermatogenesis and male infertility. Consequently, numerous discoveries have been made in the field of andrology, ranging from genetics to several “omics” technologies, oxidative stress and sperm DNA fragmentation, the sixth edition of the WHO manual, artificial intelligence, management of azoospermia, fertility in cancers survivors, artificial testis, 3D printing, gene engineering, stem cells therapy for spermatogenesis, and reconstructive microsurgery and seminal microbiome. Nevertheless, as many cases of male infertility remain idiopathic, further studies are required to improve the clinical management of infertile males. A multidisciplinary strategy involving both clinicians and scientists in basic, translational, and clinical research is the core principle that will allow andrology to overcome its limits and reach further goals. This state-of-the-art article aims to present a historical review of andrology, and, particularly, male infertility, from its “Middle Ages” to its “Renaissance”, a golden age of andrology.