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Karthick Balasubramanian - One of the best experts on this subject based on the ideXlab platform.
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two new species of achnanthidium kutzing bacillariophyceae from kolli hills eastern ghats india
Fottea, 2017Co-Authors: Karthick Balasubramanian, Jonathan C Taylor, Paul B HamiltonAbstract:Two new freshwater species of Achnanthidium Kutzing are described from Eastern Ghats Mountain range of Peninsular India based on light and scanning electron microscopy observations. Achnanthidium initium sp. nov. belongs to the group of Achnanthidium taxa that have terminal raphe fissures curved to opposite sides of the valve. This taxon is characterized by distinctive fascia, raphe endings extending to the valve margin, lineate distal raphe endings and 2-5 linear Areola per striae. Achnanthidium linannulum sp. nov. belongs to the group of Achnanthidium taxa with terminal raphe fissures curved to the same side of the valve. This species is characterized by the presence of occluded Areolae near the margin, striae orientation and the weakly bent internal distal ends of the raphe. These new species are known only from their type locality, oligotrophic Masilla Waterfalls from Kolli Hills, Eastern Ghats.
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Two new species of Achnanthidium Kützing (Bacillariophyceae) from Kolli Hills, Eastern Ghats, India
Fottea, 2017Co-Authors: Karthick Balasubramanian, Taylor, Jonathan C., Hamilton, Paul B.Abstract:Two new freshwater species of Achnanthidium Kützing are described from Eastern Ghats Mountain range of Peninsular India based on light and scanning electron microscopy observations. Achnanthidium initium sp. nov. belongs to the group of Achnanthidium taxa that have terminal raphe fissures curved to opposite sides of the valve. This taxon is characterized by distinctive fascia, raphe endings extending to the valve margin, lineate distal raphe endings and 2–5 linear Areola per striae. Achnanthidium linannulum sp. nov. belongs to the group of Achnanthidium taxa with terminal raphe fissures curved to the same side of the valve. This species is characterized by the presence of occluded Areolae near the margin, striae orientation and the weakly bent internal distal ends of the raphe. These new species are known only from their type locality, oligotrophic Masilla Waterfalls from Kolli Hills, Eastern Ghats.South African National Research Foundation (NRF
Paul B Hamilton - One of the best experts on this subject based on the ideXlab platform.
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two new species of achnanthidium kutzing bacillariophyceae from kolli hills eastern ghats india
Fottea, 2017Co-Authors: Karthick Balasubramanian, Jonathan C Taylor, Paul B HamiltonAbstract:Two new freshwater species of Achnanthidium Kutzing are described from Eastern Ghats Mountain range of Peninsular India based on light and scanning electron microscopy observations. Achnanthidium initium sp. nov. belongs to the group of Achnanthidium taxa that have terminal raphe fissures curved to opposite sides of the valve. This taxon is characterized by distinctive fascia, raphe endings extending to the valve margin, lineate distal raphe endings and 2-5 linear Areola per striae. Achnanthidium linannulum sp. nov. belongs to the group of Achnanthidium taxa with terminal raphe fissures curved to the same side of the valve. This species is characterized by the presence of occluded Areolae near the margin, striae orientation and the weakly bent internal distal ends of the raphe. These new species are known only from their type locality, oligotrophic Masilla Waterfalls from Kolli Hills, Eastern Ghats.
Jean Yves Petit - One of the best experts on this subject based on the ideXlab platform.
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free nipple graft technique to correct nipple and Areola malposition after breast procedures
Plastic and reconstructive surgery. Global open, 2013Co-Authors: Mario Rietjens, Francesca De Lorenzi, Manconi Andrea, Prakasit Chirappapha, Stefano Martella, Benedetta Barbieri, Alessandra Gottardi, Lomeo Giuseppe, Alaa Hamza, Jean Yves PetitAbstract:Summary:Secondary correction of nipple Areola complex (NAC) malposition represents a major concern after breast reconstructive procedures. It is frequently requested by patients complaining about asymmetric Areolas impairing the whole reconstructive procedure and asking for improved cosmetic outcome
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nipple sparing mastectomy can we predict the factors predisposing to necrosis
Ejso, 2012Co-Authors: Patrick Maisonneuve, Jean Yves Petit, Z K Algaithy, Varut Lohsiriwat, Piercarlo Rey, N Baros, H Lai, P MulasAbstract:Abstract Background Nipple sparing mastectomy (NSM) is an accepted surgical approach in selected breast cancer and prophylactic mastectomy, nevertheless post-mastectomy skin necrosis is one of the frequent complications. This study aimed to analyze the factors that may lead to skin necrosis after NSM. Patients and methods From May 2010 to July 2010, we prospectively registered 50 consecutive NSM from 45 patients. There were 40 mastectomies for cancer, and 10 prophylactic mastectomies. The various patient’s and surgical factors were registered during pre-, intra- and postoperative period. Results No total necrosis of the nipple Areola complex (NAC) was observed. There were thirteen cases with partial necrosis (26.0%) of the Areola or the adjacent skin. All these necrosis were partial both for the surface and the thickness. Surgical debridement was performed in 9 (18.0%) cases. The significant risk factors are smoking, young age, type of incision and NAC involvement with Areola flap thickness less than 5 mm. Conclusion NSM should be done with high caution in smokers. Young patients, periAreolar incision and superior circumAreolar incision have also a higher risk of necrosis. We recommend keeping Areolar flap thickness more than 5 mm in Areola region.
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nipple sparing mastectomy risk of nipple Areolar recurrences in a series of 579 cases
Breast Cancer Research and Treatment, 2009Co-Authors: Jean Yves Petit, F. De Lorenzi, Mario Rietjens, Stefano Martella, Umberto Veronesi, Nicole Rotmensz, Edoardo Botteri, C Garusi, Riccardo Bosco, Andrea ManconiAbstract:BACKGROUND: When the conservative treatment is not recommended, Nipple Sparing Mastectomy (NSM) is proposed more and more frequently for the surgical treatment of breast cancer. The risk of local recurrence behind the nipple Areolar complex (NAC) is the main limiting factor of the NSM procedure. To minimize such risk, we proposed in 2002 a intraoperative radiotherapy of the preserved NAC. PATIENTS AND METHODS: From March 2002 to November 2006, 579 cases (in 570 patients) of NSM were performed for carcinoma. The median follow up time was 19 months (Range: 1-60). The subcutaneous mastectomy was performed through an incision removing a portion of the skin overlying the tumour. An extemporaneous histological examination was performed on the retroAreolar glandular tissue. If the histology was positive the patient was not considered eligible. Then an intraoperative radiotherapy with electrons (ELIOT) of 16 Gy in one shot was delivered on the NAC area. An immediate breast reconstruction was done using implants in most cases and in several cases a musculocutaneous flaps, usually in large breast. The number of local recurrences was recorded and the correlation between their occurrence and the clinical and histological criteria were analysed using the Gray test statistical method in a competing framework. RESULTS: In 516 cases the negative retroAreolar frozen section biopsy was confirmed by the final histology, while in 63 cases, the final histology showed foci of carcinoma. Seven out of these 63 cases underwent a secondary NAC removal. In the 56 cases which preserved Areolas we did not observe any local recurrence after 19 months follow up. The probability of retro Areola positive histology increases with the tumour size. and was not related to the nodal status. The rate of local relapses was 0.9% per year. We didn't find any significant difference in the local relapse rate according to different patient's and tumour's features. Most relapses were located close to the tumour bed but never in the NAC area. CONCLUSION: Our study confirms that the local recurrence rate in the NSM completed with local radiotherapy on the NAC is not higher than the usual rate observed in the literature and the preservation of the NAC does not increase the risk. The absence of local recurrence in the region where a portion of glandular tissue has been purposely preserved is a good argument in favour of ELIOT.
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nipple sparing mastectomy with nipple Areola intraoperative radiotherapy one thousand and one cases of a five years experience at the european institute of oncology of milan eio
Breast Cancer Research and Treatment, 2009Co-Authors: Jean Yves Petit, Paolo Veronesi, Stefano Martella, Umberto Veronesi, Roberto Orecchia, Florence Didier, Giuseppe Viale, A Luini, Viviana Galimberti, R BedolisAbstract:In order to reduce mutilation, nipple-Areola complex (NAC) conservation can be proposed for the treatment of breast cancer when mastectomy is indicated. To reduce the risk of retro Areolar recurrence, a novel radiosurgical treatment combining subcutaneous mastectomy with intraoperative radiotherapy (ELIOT) is proposed. One thousand and one nipple sparing mastectomies (NSM) were performed from March 2002 to November 2007 at the European institute of oncology (EIO), for invasive carcinoma in 82% of the patients and in situ carcinoma in 18%. Clinical complications, aesthetic results, oncological and psychological results were recorded. A comparison was performed between the 800 patients who received ELIOT and the 201 who underwent delayed one-shot radiotherapy on the days following the operation. The median follow up time was 20 months (range 1–69) for a follow up performed in 83% of the patients. The NAC necrosed totally in 35 cases (3.5%) and partially in 55 (5.5%) and was removed in 50 (5%). Twenty infections (2%) were observed and 43 (4.3%) prostheses removed. The median rate of the patients for global cosmetic result on a scale ranging from 0 (worst) to 10 (excellent) was 8. Evaluation by the surgeon in charge of the follow-up gave a similar result. Only 15% of the patients reported a partial sensitivity of the NAC. Of the fourteen (1.4%) local recurrences, ten occurred close to the tumour site, all far from the NAC corresponding to the field of radiation. No recurrences were observed in the NAC. In a group of patients characterized by a very close free margin under the Areola, no local recurrence was observed. Overall, 36 cases of metastases and 4 deaths were observed. No significant outcome difference was observed between the 800 patients receiving intraoperative radiotherapy (ELIOT) and the 201 patients receiving delayed irradiation.
Hamilton, Paul B. - One of the best experts on this subject based on the ideXlab platform.
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Two new species of Achnanthidium Kützing (Bacillariophyceae) from Kolli Hills, Eastern Ghats, India
Fottea, 2017Co-Authors: Karthick Balasubramanian, Taylor, Jonathan C., Hamilton, Paul B.Abstract:Two new freshwater species of Achnanthidium Kützing are described from Eastern Ghats Mountain range of Peninsular India based on light and scanning electron microscopy observations. Achnanthidium initium sp. nov. belongs to the group of Achnanthidium taxa that have terminal raphe fissures curved to opposite sides of the valve. This taxon is characterized by distinctive fascia, raphe endings extending to the valve margin, lineate distal raphe endings and 2–5 linear Areola per striae. Achnanthidium linannulum sp. nov. belongs to the group of Achnanthidium taxa with terminal raphe fissures curved to the same side of the valve. This species is characterized by the presence of occluded Areolae near the margin, striae orientation and the weakly bent internal distal ends of the raphe. These new species are known only from their type locality, oligotrophic Masilla Waterfalls from Kolli Hills, Eastern Ghats.South African National Research Foundation (NRF
D'andrea F. - One of the best experts on this subject based on the ideXlab platform.
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The oval technique for nipple-Areolar complex reconstruction
KOREAN SOC PLASTIC & RECONSTRUCTIVE SURGERY, 2019Co-Authors: Vozza A., Larocca F., Ferraro G., Nicoletti G.f., D'andrea F.Abstract:Background Nipple-Areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, pigmentation, and permanent projection, and although many technical descriptions of NAC reconstruction exist in the medical literature, there is no gold standard technique. The technique devised by the authors is very versatile, with excellent results, and it enables 1-step reconstruction with optimal results in terms of shape and nipple projection. Methods Our technique consists of a combination of modified local flaps and a full-thickness skin graft. Patients were observed for 18 months to estimate the amount of retraction. This procedure was performed in 40 patients, four of them bilaterally. The duration of the follow- up was 30 months. Complications occurred in 10% of patients, and included infections (5%), ischemia (2.5%), and hematoma (2.5%). Results No cases of total nipple necrosis were reported. The NAC shape remained optimal in all cases, with a very small reduction of the vertical and horizontal diameters of the Areola, which maintained its designed round shape well, and negligible retraction in the diameter and projection of the nipple. Conclusions The oval technique represents a major step forward, involving a combination of existing techniques, such as the C-V flap and the cutaneous graft, to achieve excellent results regarding Areola shape and nipple projection, significantly reducing the cases of nipple ischemia. These results were substantially obtained through subcutaneous equatorial sutures, skin grafting, and flattening of the apexes of the flap.Background Nipple-Areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, pigmentation, and permanent projection, and although many technical descriptions of NAC reconstruction exist in the medical literature, there is no gold standard technique. The technique devised by the authors is very versatile, with excellent results, and it enables 1-step reconstruction with optimal results in terms of shape and nipple projection.Methods Our technique consists of a combina-tion of modified local flaps and a full-thickness skin graft. Patients were observed for 18 months to estimate the amount of retraction. This procedure was performed in 40 patients, four of them bilaterally. The duration of the follow-up was 30 months. Complications oc-curred in 10% of patients, and included infections (5%), ischemia (2.5%), and hematoma (2.5%).Results No cases of total nipple necrosis were reported. The NAC shape remained optimal in all cases, with a very small reduction of the vertical and horizontal diameters of the Areola, which maintained its designed round shape well, and negligible retraction in the diameter and projection of the nipple.Conclusions The oval technique represents a major step forward, involving a combination of existing techniques, such as the C-V flap and the cutaneous graft, to achieve excellent results regarding Areola shape and nipple projection, significantly reducing the cases of nipple ischemia. These results were substantially obtained through subcutaneous equatori-al sutures, skin grafting, and flattening of the apexes of the flap