Biomedical subjects
Publications and source records attributed to A A Quaba.
Two modifications to the classic design of the rhomboid flap are described. Firstly, no attempt is made to engineer a rhomboid defect and, secondly, the flap is made smaller than the defect to be reconstructed. The advantages of these modifications are discussed and their application in 175 reconstructions is reported.
While the association between large congenital nevocellular nevi and malignant melanoma has been established beyond reasonable doubt, its magnitude is the subject of wide controversy. In this study an attempt is made to estimate the risk of malignant transformation during the first 15 years of life in a sample of 39 congenital nevocellular nevi occupying a mean of 17 percent of the total body surface area collected from plastic surgical centers in England and Wales. During the period of observation, which totaled 337 years, two patients developed and died of metastatic malignant melanoma. A melanoma risk of 8.52 percent during the first 15 years of life is calculated. Although a high risk of melanoma must weigh heavily in favor of early prophylactic excision, the management of large congenital nevocellular nevi is considered to be too complicated to permit the invariable adoption of a wholesale excisional policy.
There is recent evidence that circulating opioid peptides, or 'endorphins', act as chemical messengers responsible for the induction of the complex cardiovascular changes leading to hypotension in septicaemic shock. The pilot study of an investigation of opioid peptides in septicaemia in burned patients is presented. Serial measurements of plasma beta-endorphin and metenkephalin were performed throughout the recovery of six patients with large burns (20-70 per cent BSA). Our preliminary findings concur with previous evidence that opioid peptides may play a role in the hypotension of septicaemic shock.
This report describes treatment combining Ultrapulse CO(2) laser and Q-switched frequency-doubled neodymium:yttrium-aluminum-garnet (Nd-YAG) laser for a number of congenital nevocellular naevi (CNN). The Ultrapulse CO(2) laser removes the superficial component, which contains most of the color, preserving the integrity of the reticular dermis. At a later stage, any residual color is targeted using the Nd-YAG laser. To date, a total of 10 histologically proven CNNs have been treated at the Laser Suite. The median age of the patients was 18 years (range, 13-24 years). All the patients were white females. The patients accepted for treatment had relatively small lesions (mean surface area, 352 mm(2); range, 50-1,092 mm(2)), but the lesions were either cosmetically sensitive or located in an anatomically critical area in which excision could result in a scar that would be unpredictable. The median follow-up period was 24 months. The overall results have been satisfactory, with reduction of color and no significant scarring. The minor textural and pigmentary changes were acceptable to the patients.
The development of aberrant pigmentation represents an unwelcome complication to an otherwise successful split skin graft resulting in a loss of colour match and, so it follows, of cosmesis. We present two cases where lasers have been successful in the treatment of this problem.