Fifteen new species of Penicillium.

We introduce 15 new species of Penicillium isolated from a diverse range of locations, including Canada, Costa Rica, Germany, Italy, New Zealand, Tanzania, USA and the Dry Valleys of Antarctica, from a variety of habitats, including leaf surfaces in tropical rain forests, soil eaten by chimpanzees, infrabuccal pockets of carpenter ants, intestinal contents of caterpillars and soil. The new species are classified in sections Aspergilloides (1), Canescentia (2), Charlesia (1), Exilicaulis (3), Lanata-Divaricata (7) and Stolkia (1). Each is characterised and described using classical morphology, LC-MS based extrolite analyses and multigene phylogenies based on ITS, BenA and CaM.

Aplasia Cutis Congenita of the Scalp, Composite Type: The Criticality and Inseparability of Neurosurgical and Plastic Surgical Management.

Background/aims: The object of this report is to review the management of patients having the composite type of aplasia cutis congenita in the context of the relevant literature on this condition.

Methods: Clinical records, neuroimaging and photographic documentation of identified cases of composite type aplasia cutis congenita, with a comprehensive review of the literature, are the material basis of this report.

Results: Two neonates with composite type aplasia cutis congenita are described as examples of this disorder, and their management, including complications, is discussed.

Syndromic craniosynostosis, fibroblast growth factor receptor 2 (FGFR2) mutations, and sacrococcygeal eversion presenting as human tails.

Introduction: There have been 23 previously published cases of patients with syndromic craniosynostosis and human tails. In many of these, the tail was composed of prominent coccygeal and sacral vertebrae, curved in a retroverted instead of in the normal anterograde fashion. This has been termed sacrococcygeal eversion.

Fat redistribution following suction lipectomy: defense of body fat and patterns of restoration.

No randomized studies in humans have examined whether fat returns after removal or where it returns. We undertook a prospective, randomized-controlled trial of suction lipectomy in nonobese women to determine if adipose tissue (AT) is defended and if so, the anatomic pattern of redistribution. Healthy women with disproportionate AT depots (lower abdomen, hips, or thighs) were enrolled.

Cranial vault expansion by distraction osteogenesis.

Object: The object of this report is to present a conceptual and technical approach for expanding the cranial vault, by distraction osteogenesis, in patients with craniocephalic disproportion secondary to pancraniosynostosis and in patients with complex syndromic craniofaciosynostoses undergoing operations for aesthetic improvement.

Methods: The clinical characteristics, techniques used, outcome and complications for all patients who underwent cranial vault expansions with distraction osteogenesis in Children's Hospital of Denver were reviewed.

Results: Twenty-six cranial vault expansions were done in 24 patients.

Expansion cranioplasty with jackscrew distracters for craniosynostosis and intracranial hypertension in transplanted osteopetrosis.

Background: An 11-month-old boy with autosomal recessive infantile osteopetrosis presented, 7 months after bone marrow transplantation, with normal ventricular size and life-threatening intracranial hypertension due to pansynostosis.

Methods: The cranial vault was expanded by using jackscrew distracters to upwardly advance the upper part of the calvarium.

Results: The procedure achieved a 15-mm upward expansion of the cranial vault over a 15-day period, and the volume of the cranial vault was increased by 139 ml.

Through-and-through gunshot wounds to the foot: the "Fearless Fosdick" injury.

Through-and-through gunshot wounds of the foot present the unique problem of needing to fill a defect while at the same time providing coverage of the dorsum and plantar surface of the foot. A series of 5 patients from 2 institutions is presented. These patients all sustained gunshot wounds that penetrated the forefoot, leaving a rim of uninjured soft tissue and bone around the periphery.

Upper limb salvage with microvascular bone transfer for major long-bone segmental tumor resections.

A series of 14 young, active patients who underwent vascularized bone graft reconstructions of large (9-15 cm) segmental skeletal defects of the upper extremity resulting from resection of a variety of bony tumors is presented. Eight defects involved the proximal humerus and required shoulder joint reconstruction, two were mid humeral and four involved the distal radius. Surgical techniques for both distal radius reconstruction with vascularized iliac crest and vascularized fibular head and glenohumeral reconstruction using the vascularized fibula are described.

Transcranial migration of microfixation plates and screws. Case report.

A case of transcranial, transdural migration of microplates and screws with damage to the subjacent cortex in an infant with craniosynostosis is described. The authors believe that plates and screws should be reserved for exceptional cases in which bony approximations are unstable or difficult to align by other means.

Trauma primes cells.

Trauma induces many dramatic and complex changes in host cellular response. This complexity arises from the constellation of signals induced by stress, infection, and injury. Cellular priming, defined as altered response to an agonist induced by an antecedent stimulus, appears to be operative after trauma.

WEB2170, a specific platelet-activating factor antagonist, attenuates neutrophil priming by human serum after clinical burn injury: the 1991 Moyer Award.

Primed neutrophils may contribute to endothelial and end-organ damage after burn injury because of increased endothelial adherence and enhanced toxic oxygen metabolite generation in response to a "second insult" such as bacterial sepsis. The purposes of this study were to determine: (1) whether serum from patients with thermal injury causes priming of the neutrophil NADPH:O2 oxidoreductase, (2) whether time after burn (early vs late) influences neutrophil priming, and (3) whether priming could be attenuated by a specific platelet-activating factor antagonist, WEB2170. Normal human neutrophils were incubated with 10% sera that was obtained from healthy adult controls (normal human sera) and with 10% sera from patients with greater than 30% total body surface area burns, which was collected early (early postburn sera) (i.

An unusual case of temporal encephalocele.

An unusual case of temporal encephalocele is presented in this report. A large temporal mass was detected prenatally by ultrasound and following delivery by caesarian section. It was determined to be a large temporal encephalocele with extensive invasion into the subtemporal, facial and cervical regions.

Healing characteristics of expanded autografts on wounds covered with homograft and Biobrane temporary wound dressing.

This study compared the healing characteristics of expanded autografts on wounds with interstices that were closed with cryopreserved cadaver homograft split-thickness skin and wounds with interstices that were closed with the synthetic skin substitute, Biobrane temporary wound dressing. Nine paired wounds in four patients with large burns were used in this study. When Biobrane temporary wound dressing adhered to a wound, epithelial migration did not proceed until it was removed.

Aeromonas hydrophila infection complicating digital replantation and revascularization.

Two cases of thumb replantation and one of finger revascularization complicated by Aeromonas hydrophila infection are reported. Two digits were lost because of infection in soft tissue and osteomyelitis. One thumb had extensive necrosis.

Management of associated soft-tissue injury.

Initially, soft-tissue injuries associated with vascular trauma require management according to the general surgical principles of wound care. Antimicrobial prophylaxis should be instituted. The mechanism and extent of injury must be determined, and debridement and irrigation should be completed in the operating room with the intent to preserve vital structures, decrease bacterial contamination, and render the wound free of devitalized tissue.

Surgical correction of the fat neck.

This is an up-to-date review of the state of the art in the treatment of the fat neck at the University of Miami School of Medicine, based on twenty-five years of experience including several thousand cases. The combination of submental lipectomy, platysma myectomy, facelift, submandibular lipectomy, platysma myotomy, and posterior muscle traction with suture fixation has consistently produced marked improvement in the fat neck. Under this regimen, when the patient returns in five to ten years for a second lift, it is rare that the neck requires more than the skin tightening that comes with a simple facelift.

Surgical implications of Behçet's disease.

Behcet's disease, though originally described as a triad of oral and genital aphthous ulcers and inflammatory ocular lesions, has had several new elements added to its description. The updated syndrome now includes gastrointestinal (GI) involvement as well as polyarthritis, neuritis, myocarditis, and glomerulonephritis. Of particular importance to the surgeon are the GI manifestations that include hemorrhage and perforation.