Thesis (M.D.) -- Dept. of Surgery, University of Adelaide, 1981. / Typescript (photocopy).

Typescript (photocopy) / 163 leaves, [8] leaves of plates : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--Dept. of Surgery, University of Adelaide, 1981

EINLEITUNG: Neben der potentiellen Heilung können systematische Lymphadenektomien der Axilla und Leiste erhebliche Komplikationen, wie die Ausbildung von Lymphozelen und Lymphfisteln, nach sich ziehen. METHODEN: Es wurden alle Patienten erfasst, bei denen im Zeitraum zwischen 3/2002 und 12/2008 in der Abteilung der Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie der Bayerischen Julius-Maximilians-Universität Würzburg eine systematische Lymphknotendissektion der Axilla oder Leiste erhielten. Nach Sichtung der OP-Bücher wurden die jeweiligen Verläufe anhand der Aktenlage analysiert. ERGEBNISSE: 146 Patienten wurden lymphadenektomiert, davon 69 axillär und 77 inguinal. Mit 93,1 % stellte die Hauptindikation für diese Operationen das maligne Melanom der Haut dar. Während die 30-Tage-Mortalität 0 % betrug, entwickelten 83 von 146 Patienten (56,8 %) eine Lymphfistel, 58 Patienten (39,7 %) eine Lymphozele. Die Entstehungsrate von Lymphfisteln und/oder Lymphozelen war nach inguinaler Lymphadenektomie mit 80,5 % signifikant höher als nach axillärer mit 62,3%. In der weiterführenden Statistik konnte festgestellt werden, dass sich mit Hilfe von ROC-Kurven Patienten mit und ohne Lymphfistel über die postoperative Drainagemenge trennen lassen. Die Rezidivraten für die Rotlicht-, Röntgenreizbestrahlung, sowie die operative Revision lagen bei 76,4 %, 22,4 % und 16,7 %. SCHLUSSFOLGERUNG: Trotz der niedrigen Mortalität waren Lymphadenektomien der Axilla und Leiste mit erheblicher Morbidität behaftet. Die Inzidenz lymphatischer Komplikationen war auch im Literaturvergleich hoch. Inguinale Dissektionen zogen statistisch signifikant mehr Lymphfisteln und Lymphozelen nach sich. ROC-Kurven können für einen frühzeitigen Therapiebeginn sowie Drainagezug herangezogen werden. Die Therapie der Lymphfisteln/Lymphozelen ist bislang nicht standardisiert. Eine alleinige Rotlichttherapie war zur Behandlung nicht erfolgreich, für die Röntgenreizbestrahlung und operative Revision konnten jedoch gute Behandlungsergebnisse erzielt werden. / INTRODUCTION: Aside from the potential healing systematic axillary and groin dissections can entail considerable complications like the formation of lymphatic fistulas and lymphoceles. METHODS: Included were all patients, who received systematic axillary or groin lymph node dissection in the Department of General, Visceral, Vascular and Pediatric Surgery at University Hospital in Würzburg from February 2002 until December 2008. The courses of disease were analyzed on the medical records. RESULTS: A total of 146 lymphadenectomies were performed. 69 patients had axillary and 77 patients had groin dissection. 93.1% of the patients suffered from malignant melanoma of the skin, which therefore was the main indication for surgery. While no patient died in the first 30 postoperative days, 83 von 146 patients (56.8%) developed lymphatic fistulas, 58 patients (39.7%) suffered from lymphoceles. Lymphatic complication rate was significantly increased in patients who underwent inguinal lymphadenectomy (80.5%) compared with the axillary group (62.3%). Further statistical analysis showed that with the aid of ROC curves early separation of patients with and without lymphatic fistulas by postoperative drainage volume is possible. Recurrence rates for red light therapy, low dose radiation und operative treatment were 76.4%, 22.4 % and 16.7 % respectively. CONCLUSION: Despite the low mortality rate lymphadenectomies of the axilla and groin were afflicted with considerable morbidity. When compared to previous published studies incidence of lymphatic complications was high. Groin dissection was followed by statistically significant higher rate of lymphatic fistulas and lymphoceles. ROC curves can be used for initiating early treatment and drainage removal. Treatment of lymphatic complications lacks standardization. For the most part red light therapy alone was not successful in treating lymphatic fistulas or lymphoceles but in contrast low dose radiotherapy and surgical wound exploration reached good treatment results.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Deodorants are cosmetic products that are consumed by people regularly and globally. In this thesis, the opportunities to develop a deodorant for the Swedish cosmetics brand IDUN Minerals AB is investigated. The deodorant market in Swedish pharmacies, deodorant formulation and deodorant packaging are studied. Furthermore, controversial ingredients, such as synthetic aluminum compounds, are explored. The scientific aspects of using synthetic aluminum compounds, which are used as antiperspirant in deodorants, are investigated. There is a general fear that they may increasethe risk of developing breast cancer. However, after a full review of exciting scientific evidence, it is clear that there is currently no study that can prove or disprove the suspicions. The use of aluminum-based antiperspirants therefore continues to be a controversial topic. The conclusion of this thesis is that there is a market opening for IDUN Minerals, especially since they aim for a synthetic aluminum-free, unperfumed and preservative-free deodorant. Furthermore, it is concluded that a Nordic Swan Ecolabel would make their product uniquein its product category. Lastly, it is determined that traditional plastic packaging is more accessible and possesses many favorable properties, but that bioplastics should be further researched. / Deodoranter är kosmetiska produkter som dagligen används av människor världen över. I denna rapport undersöks möjligheterna att implementera en deodorant i det svenska kosmetikföretaget IDUN Minerals AB:s produktsortiment. I rapporten kartläggs deodorantsortimentet på svenska apotek, samtidigt som deodoranters innehåll och paketering undersökts. Vidare granskas kontroversiella ingredienser, såsom syntetiska aluminiumföreningar. Syntetiska aluminiumföreningar, vilka används som antiperspiranter i deodoranter, misstänks öka risken för bröstcancer hos människor. Efter en fullständig genomgång av befintliga studier kan det dock fastställas att det inte finns någon studie som kan bevisa eller motbevisa misstankarna. Användningen av aluminiumbaserade antiperspiranter fortsätter därför att vara ett kontroversiellt ämne. Slutsatsen av denna rapport är att det finns en marknadsöppning för IDUN Minerals, särskilt eftersom företaget strävar mot en deodorant utan syntetiska aluminumsalter, parfym eller konserveringsmedel. Dessutom kan slutsatsen dras att en eventuell Svanen-märkning skulle göra deodoranten unik i sin produktkategori. Slutligen har det fastställts att traditionella plastförpackningar är mer tillgängliga och att de erbjuder fördelaktiga egenskaper, men att bioplaster fortfarande bör undersökas ytterligare.

The axilla is a major source of human body odour from which the characteristic musky, urinous or acidic odours emanate, and are predominantly due to bacterial metabolism of the protein-rich fluid secreted by the apocrine and sebaceous glands located in this area (Senol and Fireman, 1999). Clothing has been implicated in contributing to body odour intensity, possibly even increasing the intensity (Dravnieks, et al., 1968; Shelley, et al., 1953) by the transfer of secretions, skin debris and bacteria from the body to the fabric substrate. Despite much anecdotal evidence indicating that some fibres and fabrics are better at limiting odour intensity than others, there appears to be no published research confirming this. The purpose of this study therefore, was to determine whether fabrics varying in fibre content (cotton, wool, polyester) and fabric knit structure (interlock, single jersey, 1x1 rib) differed in the extent to which they retained and emanated axillary odour following wear, and whether the intensity of odour was linked to the number of bacteria transferred to the fabrics. A procedure for collecting odour on fabrics was developed as was a method for evaluating odour through use of a sensory panel. Total aerobic bacteria and aerobic coryneform bacteria extracted from the fabrics were counted to determine if an association between bacterial counts and fabrics existed. Sensory analysis recognises the unique capability of humans as odour-detecting instruments whereas, instrumental analysis has the potential to offer information on the concentration and identification of axillary compounds, which a human assessor cannot. To investigate a new method for detecting axillary odour on apparel fabrics, proton transfer reaction mass spectrometry (PTR-MS) was used to analyse volatiles emitted from fabrics differing in fibre type. After removal of garments from the human body, axillary odour can be detected on fabrics, with the intensity of odour being strongly influenced by the fibre type from which the fabrics had been made. Polyester fabrics emanated odour of high intensity, cotton that of mid-low odour intensity, and wool fabrics were low odour. Fabric structural properties such as thickness, mass per unit area and openness of knit structure also had an effect on odour intensity. However, as the principal factor influencing odour intensity was fibre, only fabrics characterised by a high intensity (i.e. polyester) were influenced by structural properties. Differences in odour intensity among fabrics were not necessarily related to bacterial numbers, and no �inherent antimicrobial� properties were evident for any of the fabrics. Bacterial populations persisted in all fabrics up to 28 days. A decline in numbers was apparent for high-odour polyester fabrics, while numbers in low-odour wool fabrics remained relatively stable. PTR-MS detected compounds likely to be short-chain carboxylic acids which increased in the headspace above the polyester fabrics after 7 days. However, this increase was not evident for either the wool or cotton fabrics. Therefore, bacterial numbers per se cannot be a predictor of the odour intensity emanating from fabrics at least on the basis of these fabrics and fibres. The intensity of axillary odour emanating from fabrics was found inversely related to fibre hygroscopicity. Keywords:fibre content, fabric structure, axillary odour, sensory analysis, bacteria, corynebacteria, instrumental analysis, PTR-MS

The axilla is a major source of human body odour from which the characteristic musky, urinous or acidic odours emanate, and are predominantly due to bacterial metabolism of the protein-rich fluid secreted by the apocrine and sebaceous glands located in this area (Senol and Fireman, 1999). Clothing has been implicated in contributing to body odour intensity, possibly even increasing the intensity (Dravnieks, et al., 1968; Shelley, et al., 1953) by the transfer of secretions, skin debris and bacteria from the body to the fabric substrate. Despite much anecdotal evidence indicating that some fibres and fabrics are better at limiting odour intensity than others, there appears to be no published research confirming this. The purpose of this study therefore, was to determine whether fabrics varying in fibre content (cotton, wool, polyester) and fabric knit structure (interlock, single jersey, 1x1 rib) differed in the extent to which they retained and emanated axillary odour following wear, and whether the intensity of odour was linked to the number of bacteria transferred to the fabrics. A procedure for collecting odour on fabrics was developed as was a method for evaluating odour through use of a sensory panel. Total aerobic bacteria and aerobic coryneform bacteria extracted from the fabrics were counted to determine if an association between bacterial counts and fabrics existed. Sensory analysis recognises the unique capability of humans as odour-detecting instruments whereas, instrumental analysis has the potential to offer information on the concentration and identification of axillary compounds, which a human assessor cannot. To investigate a new method for detecting axillary odour on apparel fabrics, proton transfer reaction mass spectrometry (PTR-MS) was used to analyse volatiles emitted from fabrics differing in fibre type. After removal of garments from the human body, axillary odour can be detected on fabrics, with the intensity of odour being strongly influenced by the fibre type from which the fabrics had been made. Polyester fabrics emanated odour of high intensity, cotton that of mid-low odour intensity, and wool fabrics were low odour. Fabric structural properties such as thickness, mass per unit area and openness of knit structure also had an effect on odour intensity. However, as the principal factor influencing odour intensity was fibre, only fabrics characterised by a high intensity (i.e. polyester) were influenced by structural properties. Differences in odour intensity among fabrics were not necessarily related to bacterial numbers, and no �inherent antimicrobial� properties were evident for any of the fabrics. Bacterial populations persisted in all fabrics up to 28 days. A decline in numbers was apparent for high-odour polyester fabrics, while numbers in low-odour wool fabrics remained relatively stable. PTR-MS detected compounds likely to be short-chain carboxylic acids which increased in the headspace above the polyester fabrics after 7 days. However, this increase was not evident for either the wool or cotton fabrics. Therefore, bacterial numbers per se cannot be a predictor of the odour intensity emanating from fabrics at least on the basis of these fabrics and fibres. The intensity of axillary odour emanating from fabrics was found inversely related to fibre hygroscopicity. Keywords:fibre content, fabric structure, axillary odour, sensory analysis, bacteria, corynebacteria, instrumental analysis, PTR-MS

Having detailed anatomical knowledge when performing surgeries, is crucial to ensure a successful outcome. This is especially true when undertaking relatively new procedures. Even though nerve transfers and nerve grafts have been performed on the different parts of the brachial plexus for some time, nerve transfer and grafting procedures involving the axillary and radial nerves using a newly proposed axillary approach has not yet been fully studied. This study provides some enlightenment to the anatomy surrounding the axillary approach, with special regard to the axillary and radial nerves and their branches. The axillae of 51 (26 female and 25 male) formalin fixed cadavers were bilaterally dissected using a simulation of the axillary approach, which has been described to gain access to the brachial plexus in a clinical setting. Following which, various distances between easily identifiable anatomical landmarks and relevant neurovascular structures were measured, and observations regarding the relationship of these structures to the landmarks were recorded. This study found that the axillary nerve and its anterior and posterior divisions, as well as the radial nerve with its nerve to the long head of triceps brachii muscle could be easily identified however, their proximal parts were situated fairly deep and therefore were difficult to expose. Methods such as the musculo-arterial triangle described by Bertelli et al., which was designed to aid in identification on localization of the axillary nerve was also assessed; it was found to be relatively successful, however more consistent landmarks might be considered. In conclusion this study found that the axillary approach may serve as a reliable and safe method to reach the axillary and radial nerves, as well as their branches, allowing for adequate exposure when considering a nerve transfer or graft. / Dissertation (MSc)--University of Pretoria, 2019. / Anatomy / MSc / Unrestricted

Introduction Axillary dissection has little diagnostic and therapeutic benefit in the node-positive breast cancer patients in whom axillary disease has been completely eradicated after neoadjuvant chemotherapy (ypN0). We sought to assess the efficacy of an algorithm used for the identification of the ypN0 patients consisting of intraoperative evaluation of sentinel and tattooed (initially positive) lymph nodes. Methods Included were T1 and T2 breast cancer patients with one to three positive axillary lymph nodes marked with carbon who were referred for neoadjuvant chemotherapy followed by a surgery. Axillary dissection was performed only in the patients with residual axillary disease after neoadjuvant chemotherapy on ultrasound or with metastases described in the sentinel or tattooed lymph nodes either intraoperatively or in the final histology. Results Out of 62 included initially node-positive patients, 15 (24%) were spared axillary dissection. The detection rate of tattooed lymph node after neoadjuvant chemotherapy was 81%. The ypN0 patients were identified with 91% sensitivity and 38% specificity using ultrasound and intraoperative assessment of both sentinel and tattooed lymph node according to the final histology. Discussion/Conclusion Lymph node marking with carbon dye is a useful and...

Desde a primeira descrição do retalho perfurante de artéria toracodorsal (TAP), sua indicação tem sido questionada por se tratar de um retalho de características semelhantes aos retalhos fasciocutâneos escapulares baseados na artéria circunflexa escapular, que são bem conhecidos e reprodutíveis. Este estudo visa comparar características anatômicas destes dois retalhos, distinguindo-os para uma melhor indicação. Adicionalmente o estudo visa estudar o posicionamento do pedículo perfurante do retalho TAP. Vinte e um pares de retalhos (TAP e escapular) foram dissecados simultaneamente em cadáveres frescos. Os músculos latíssimo do dorso e redondo maior foram seccionados e os dois retalhos foram retirados em peça única. O comprimento do pedículo, diâmetro externo da artéria e da veia, espessura da derme e espessura do tecido celular subcutâneo de ambos os retalhos foram avaliados e comparados de forma pareada. A localização dos pedículos dos retalhos foi avaliada em ambos os retalhos. Os dados obtidos foram analisados estatisticamente através do teste t de Student. O retalho TAP apresentou um pedículo com média de 16,95 cm de comprimento, sendo 50% maior que o do retalho escapular (p<0,05). A espessura média da derme foi 2,12 mm, sendo 42% mais fina do que a do retalho escapular; e a do tecido subcutâneo foi 1,37 cm, sendo 28% mais fina do que a do retalho escapular (p<0,05). O pedículo do retalho TAP apresentou artéria com diâmetro médio de 3,14 mm e veia com diâmetro médio de 3,03 mm, enquanto o pedículo do retalho escapular apresentou artéria com diâmetro médio de 3,33 mm e veia com diâmetro médio de 2,95mm, ambos sem diferenças estatísticas. Nas dissecções estudadas, todos os pedículos dos retalhos escapulares se localizavam no “espaço triangular". Já a localização dos pedículos perfurantes do retalho TAP não apresentou nenhum parâmetro constante. O estudo demonstrou que, apesar de se localizarem em sítios anatômicos adjacentes, o retalho TAP possui um pedículo mais longo e sua pele é mais fina do que o retalho escapular. Por outro lado, o posicionamento do pedículo do retalho escapular é constante, enquanto o pedículo perfurante do retalho TAP possui localização variável. / Indication of the thoracodorsal artery perforator (TAP) flap has been questioned because its characteristics are similar to those of scapular flaps based on the scapular circumflex artery. The scope of this study is to compare the anatomic features of these two flaps, differentiating them for a better indication. Twenty-one pairs of flaps (TAP and scapular) were dissected simultaneously in fresh cadavers. The length of the pedicles, thickness of the arteries and veins of the pedicles, and the thickness of the dermis and subcutaneous tissue of the flaps were assessed and compared. The position of the pedicles of both flaps was evaluated. The average length of the TAP flap pedicle was 16.95 cm, and it was 50% longer than the scapular flap (p<0.05). The mean thickness of the dermis was 2.12 mm and of the subcutaneous tissue 1.37 cm, respectively 42% and 28% thinner than the scapular flaps (p<0.05). No significant difference was evident between the thicknesses of the pedicles. The TAP arterial pedicle was 3.14 mm and the venous one 3.03 mm. The scapular flap demonstrated a 3.33 mm arterial pedicle and 2.95 mm for the venous one. The evaluation of the position of the pedicle of the scapular flap was constant; on the other hand, the perforator pedicle of the TAP flap did not show any constant anatomical parameter. The study revealed that although the TAP flap and the scapular flap lie in adjacent anatomical areas, the TAP flap has a longer pedicle and a thinner skin; their vascular pedicles have similar thickness; though the position of the thoracodorsal perforator pedicle is variable, when compared with the scapular flap.