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Pharmacodynamics of amikacin in vitro and in mouse thigh and lung infections.

A variety of in-vitro and animal studies were performed to define the pharmacodynamic characteristics of amikacin against Gram-negative bacilli and to determine the impact of the dosing regimen on therapeutic efficacy. Mice with impaired renal function were included in these studies to more closely simulate in animals the pharmacokinetics of amikacin observed in humans. Amikacin exhibited concentration-dependent killing and produced prolonged postantibiotic effects both in vitro and in vivo. In mice with renal impairment, the efficacy of once-daily dosing of amikacin was similar to or greater than that observed with 6- and 12-hour dosing regimens. The antibacterial activity of amikacin in these mice correlated best with the AUC and peak serum concentration. The time course of antimicrobial activity demonstrated in these studies for amikacin against Gram-negative bacilli would support once-daily dosing in humans.

Amikacin↗

Extended myofascial thigh flaps for repair of large full-thickness abdominal wall defects.

The large, full-thickness abdominal wall defect encompassing the upper and lower quadrants can test the surgeon's ingenuity in providing definitive repair. Two cases are reported of this type of abdominal wall defect closed in one stage using an extended tensor fascia lata myofasciocutaneous flap and an extended rectus femoris myofascial flap, respectively. In addition, a fresh cadaver dye injection study demonstrates the extensive circulatory pattern of these flaps.

Abdominal Muscles↗

Lipoplasty of the abdomen and lateral thighs.

Liposuction, today, has become a routine technique for plastic surgeons and is frequently also used by nonspecialists. To obtain the best results, it is necessary to follow more rigorous standards of patient selection with a technique that is safely performed in the best possible way. The patients' expectations must be realistic and carefully considered. I try to demonstrate with illustrations that, by respecting these norms, the preoperative objectives set by the surgeon and the patient can be regularly reached.

Abdomen↗

Cutaneous pseudolymphoma: an unusual presentation of a deep subcutaneous thigh mass.

Cutaneous pseudolymphoma is considered to be a benign (reactive) cutaneous lymphoid infiltrate; the term designates reactive diseases of the skin that histologically mimic cutaneous lymphoma. We report a case in which a 63-year-old female presented with a 5-month history of a progressive skin eruption and an enlarging subcutaneous mass following a presumed insect bite. Excisional biopsy showed this to be a pseudolymphoma extending from the dermis into the subcutaneous tissue. A number of pathological features that distinguish pseudolymphoma from cutaneous lymphoma, including histology, immunophenotype, and immunogenotype, are reviewed. The case herein challenges previous beliefs that pseudolymphoma is confined to cutaneous involvement and indicates that the process can involve deeper tissues. The final criterion for distinguishing benign from reactive processes is biological behavior. Since the depth of invasion in cutaneous pseudolymphoma has not previously been appreciated, the patient will need to be carefully examined periodically until the biological behavior of the process has been determined.

Female↗