No abstract

As a first choice for treating pressure sores, we present our experiences with gluteal perforator flaps and a simplified surgical technique. Twenty-three gluteal perforator flaps were used in 20 patients (13 males, 7 females; aged, 8-68 years) with pressure sores. The pressure sores were sacral in 16 patients, ischial in 2, and trochanteric in 2 patients. During follow-up, recurrence in the same region did not occur. Our simplified operative technique includes finding a suitable perforator with a Doppler probe (it does not matter from which mother artery), outlining the flap, dissecting the perforator with just enough length, and transposing the flap to the defect. The gluteal region has numerous perforators, and there is no need to depend on strict anatomic landmarks to detect perforator vessels or to sacrifice main arteries, as has been the case when raising gluteal perforator flaps.

Lupin is a valuable ancient legume which contains high amount of protein, dietary fiber, oil, minerals and different functional components. Bitter lupin seeds cannot be consumed directly since its high toxic alkaloid content. Cooking and soaking are effective processes for removing these toxic substances and antinutrients as phytic acid, trypsin inhibitors and oligosaccharides. In this study, debittering process containing cooking and soaking up to 144 h was applied to lupin seeds. Raw lupin seeds had 3.3 % ash and 41.3 % protein content. Ash and protein content of debittered seeds changed between 2.1 and 2.5 %, 39.5 and 40.9 % respectively. After debittering process, significant (p < 0.05) decreases (between % 5.7 and 75.7) were observed in calcium, phosphorus, zinc, iron, magnesium and manganese contents of the lupin seeds. Phytic acid was removed from raw lupin seeds up to 71.4 % ratio by debittering processes, and soaking in distilled water at 55 °C and long soaking time (144 h) was found the most effective methods on phytic acid loss. While more lighter (L*) seeds were obtained with soaking in distilled water at 25 °C, soaking in 0.5 % NaHCO3 solution gave more yellowish (b*) seed properties compared to other soaking methods. Soaking in 0.5 % NaHCO3 solution at 144 h gave the most liked products in terms of sensorial evaluation.

Changes in the chemical constituents and nutritive quality of chickpea bulgur process, were studied in seeds that were soaked at different time (2, 8 and 12 h), different soaking water pH (pH 4, 6 and 8). Soaking in pH 8 soaking water and 12 h soaking time significantly (p < 0.05) reduced the ash content of chickpea bulgur samples. Compared to the raw material, the protein content and in-vitro protein digestibility increased, but starch, crude fiber, fat and energy values decreased and trypsin inhibitor activity was completely eliminated by bulgur process. As the soaking time increased, the phytic acid content also decreased. The highest total phenolic content was determinated with bulgur samples soaked in pH 4 soaking water. The P, Ca, and K values decreased with increasing soaking time. The HCl-extractability of P, Ca, Mg, Fe and K present in chickpea bulgur samples were significantly higher than the raw chickpea seeds.

The subareolar glandular pedicle is indicated for grades 1 and 2 gynecomastia. Circumareolar incision provides perfect exposure. The technique is reliable if the pedicle is dissected 2 mm wider than the areola and dissection under the pedicle is avoided. Postoperative circumareolar scarring is minimal and nipple-areola sensation is preserved in most cases. However, experience is needed to determine the pedicle girth because a wide pedicle leads to subareolar bulk, whereas a thin pedicle may cause partial areola necrosis.