Notes

Progression of Dermatitis Herpetiformis within Long-term Back plate Psoriasis.
The results demonstrated that APT ameliorated learning and memory impairment in scopolamine-induced mice. Correspondingly, APT significantly increased ACh and ChAT levels in the hippocampus and prefrontal cortex of scopolamine-induced mice. Additionally, treatment with APT significantly increased BDNF and IL-10 levels, and decreased IL-1β and AChE levels in the same mice. Furthermore, APT significantly increased SOD activity and GSH content, and decreased MDA levels in brain tissue. These results indicated that APT may ameliorate learning and memory impairment by regulating cholinergic activity, promoting BDNF and inhibiting neuroinflammation and oxidative stress.
The debate over the surgical strategy optimization in colorectal cancer patients with liver metastases (mCRC) has been ongoing in the last 20 years. However, parenchyma sparing surgery (PPS) in cases of hard to reach liver cites (HTRLC) remain to be controversial.

A prospective analysis of 185 mCRC patients performed who were devided in two groups depending by predominant liver cite localization. Peripherally localized metastases (PLM) (n=107) (S2, S3, S6, S7, Spiegel lobe and subcapsular area 1-2cm below the liver surface). Group 2 included those with metastases localized in HTRLC (n=78) - metastatic lesions of the "right venous core", portal and caval hilum, paracaval part of S1, "deep" parenchyma cites of S5, S8 and S4.

In 26 (33,3%) and 32 (29,9%) patients of HTRLC and PLM, respectively, performed one liver re-resection (0,62). In HTRLC group 2 and more re-resection were performed in 7 (8,9%) cases while in PLM in 11 (10,3%), p=0,76. Postoperative major morbidity was 24,4%, 21,8% (p=0,15) and mortality 8,9%, 4,6% for HTRLC and PLM groups, respectively. R1v principles were implemented in 24 (30,7%) cases with centrally located metastases and in only 6 cases (5.6%) with peripheral localized metastases (p=0,001). Cumulative 3-year disease-free survival (DSF) for PLM and HTRLC groups was 63% and 41% (p=0,008). DFS for R1v (n=24) and R0 (54) cochorts in HTRLC group was 33% and 43%, respeсtively (p=0,44).

Principles of the PPS tactic provides an adequate removal of metastatic lesions in hard to reach liver cites allowing to maintain organ functions and increases the feasibility of the repeated liver resections in case of the initial disease progression.
Principles of the PPS tactic provides an adequate removal of metastatic lesions in hard to reach liver cites allowing to maintain organ functions and increases the feasibility of the repeated liver resections in case of the initial disease progression.We describe a case of a 30-year-old man who complained intermitted pain in right abdominal flank; a large cavernoumatos hemangioma - up to 6 cm in size - was revealed in the fifth hepatic segment using Ultrasonography and MRI (Magnetic Resonance Imaging). find more Indications for treatment - based on imaging features and clinical data - are briefly discussed in our report, providing also a review of existing literature.
Intussusception in pediatric cases are predominantly idiopathic, while intussusception in adult cases are predominantly associated with a lesion. The differential diagnosis for the lesion includes Meckel's diverticulum, lipoma, adenoma, and metastatic disease.

We report a case of intussusception in which the lead point was the site of a jejunorrhaphy for a jejunal perforation secondary to blunt abdominal trauma. The intussusception presented as a postoperative bowel obstruction requiring a re-laparotomy and a segmental bowel resection. The postoperative course after the re-laparotomy was unremarkable.

Postoperative intussusception with a bowel anastomosis acting as the lead point is a rare but described complication of anastomotic procedures. Our report is the first in the trauma literature to describe an intussusception led by a jejunorrhaphy rather than a circumferential suture or stapled anastomosis. While rare, this complication is a critical constituent in the differential diagnosis of bowel obstruction after laparotomy for trauma. Currently, no standardized technique or prophylactic maneuver exists to prevent intussusception after an intestinal repair.
Postoperative intussusception with a bowel anastomosis acting as the lead point is a rare but described complication of anastomotic procedures. Our report is the first in the trauma literature to describe an intussusception led by a jejunorrhaphy rather than a circumferential suture or stapled anastomosis. While rare, this complication is a critical constituent in the differential diagnosis of bowel obstruction after laparotomy for trauma. Currently, no standardized technique or prophylactic maneuver exists to prevent intussusception after an intestinal repair.
Myelomeningocele (MMC) is the most common neural tube defect that can occur due to neural tube's failure to fuse properly during embryonic life. To prevent this, keystone island flap can be used for closure of large MMCs.

A new-born girl born as a product of 36 weeks of gestation had a weight of 3.020 kg and had multiple congenital anomalies including hydrocephalus, thoracolumbar myelomeningocele at the level of (T10-L4) and an atrial septal defect. Preoperative evaluation showed a head circumference of 42 cm (n mean 34.4±2SD), no lower limbs movements and a thoracolumbar soft tissue defect around 4×8 cm with exposed neuronal tissue and prominent thoracic kyphosis, and no obvious urogenital or limbs anomalies. The large thoracolumbar myelomeningocele was treated at KFSHRC with a Keystone Design Perforator Island Flap (KDPIF) to reconstruct the soft tissue defect following the neurosurgical reconstruction.

The keystone flaps were deemed as viable as all wounds were healed without any complications, such as flap necrosis, dehiscence, leakage of cerebrospinal fluid, or infection. The technique described in the case report offers a simple and effective method of wound closure in situations that would, otherwise, have required complex flap closure.

This flap can be an effective method for reconstruction of large thoracolumbar MMC defects that might improve outcome and minimize complications. It also ensures good watertight closure with minimal wound tension and breakdown.
This flap can be an effective method for reconstruction of large thoracolumbar MMC defects that might improve outcome and minimize complications. It also ensures good watertight closure with minimal wound tension and breakdown.
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