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Biomedical subjects

A L Moss

Publications and source records attributed to A L Moss.

At least 73 records · Page 4Linked to original sources
PubMed1987

Congenital "giant" naevus: a preliminary report of a new surgical approach.

A new approach to the treatment of congenital "giant" naevi is described, using a curette in the first few weeks of life. This attempts to minimise the disadvantages of established methods of treatment. The technique is relatively atraumatic as there appears to be a natural cleavage plane within the dermis removing the pigmentation. Ten patients have been treated with this procedure with a follow-up of 3 months to 5 years; 3 patients have produced poor and unsatisfactory curettings, which has resulted in return of pigmentation. One case developed hypertrophic scarring following a wound infection and delayed healing. The other 6 cases have encouraging appearances although the hairs in some lesions remain. It is too early to say if malignant potential has been removed but perhaps it has been reduced by decreasing the total number of melanocytes and naevus cells.

Curettage↗
PubMed1987

The sanctity of the upper lid in lower eyelid reconstruction questioned. A modification of a lid sharing procedure with a long-term follow-up.

Sharing techniques using the upper eyelid to reconstruct the lower one have been criticised for causing distortion of the normal upper lid leading to corneal exposure and possible visual disturbance, and for creating second-rate lids. A modification of previously described tarsoconjunctival flap techniques is described which minimises the known complications of earlier methods. A flap of conjunctiva alone is mobilised from the upper eyelid and covered with a full thickness skin graft. A second minor procedure to divide the flap from its donor site is necessary 2 weeks later. Forty-three patients over a 25-year period have undergone total lower eyelid reconstruction with this modified technique and are reviewed with some illustrative cases. Total or subtotal lower eyelid reconstruction is most commonly performed following tumour resection and only occasionally to correct congenital or traumatic defects. The surgical techniques available still cause controversy (Byrd, 1983). An upper lid sharing technique has been criticised for possibly causing a shortened or distorted normal lid (Mustardé, 1981). A modification of this method is described which has been used for over 25 years and has reduced the morbidity of the procedure, leading to acceptable cosmetic and functional long-term results.

Adult↗
PubMed1987

Hynes pharyngoplasty revisited.

The treatment of velopharyngeal incompetence remains unsatisfactory because the causes are many, as are the variations in anatomic and physiologic defects. Therefore, full assessment and investigation are essential in tailoring the surgery to the defect. A modified Hynes pharyngoplasty has been used in 40 patients, aged 4 to 52, over a 4-year period for velopharyngeal incompetence of varying etiologic causes. Speech was assessed before and at least 6 months after pharyngoplasty. At the same time, radiologic and, when possible, nasendoscopic investigations were undertaken. Thirty-eight patients had no or variable nasal escape (variable defined as achieving intermittent closure), whereas 33 had normal or slight hyponasal resonance. There was only one complication, an asymptomatic dehiscence of the "bucket handle" flap from the posterior wall. Thirteen patients had an assortment of side effects, none requiring surgical treatment. We believe that patients who are suitable for the described sphincter pharyngoplasty are those with slight or moderate nasal escape having a mobile palate with an anteroposterior gap of 5 mm or less.

Adolescent↗
PubMed1986

Surgical treatment of painful lichen planus of the hand and foot.

Lichen planus of the hands and feet, although uncommon, can be very disabling with painful hypertrophic areas or ulcers, mainly of palmar and plantar surfaces. These lesions may not respond to conventional medical treatment. A case of surgical treatment with excision and split skin grafting of ulcerative lichen planus of the soles, with a fourteen year follow up, is reported. Only three other reported cases with a longer review period could be found. A second patient is described in which excision and grafting of painful, hypertrophic, ulcerative lichen planus of the hands achieved a satisfactory long term outcome. No other examples could be found in the English literature. It is suggested that surgical treatment should be considered more often and sooner in painful lichen planus of the hands and feet.

Female↗
PubMed1986

Cutaneous malignant melanoma in the young.

Cutaneous malignant melanoma in children and adolescents is rare. Of over 1600 patients documented in the Melanoma Registry at Frenchay Hospital from 1967 onwards, only 29 cases are recorded who were 21 years of age or younger. Of these, four patients were pre-pubertal (13 years or less) and none arose from a congenital "giant" naevus. Fifteen patients developed metastases, 10 of whom showed spread of tumour within 30 months of initial presentation. Eight of these patients with metastatic disease died, with a maximum survival of 61 months. Only seven patients, five of whom have metastatic disease, survive more than 10 years after first presentation; nine patients, one of whom has secondaries, survive for 5 years or less.

Adolescent↗
PubMed1985

Lengthening of a short traumatic femoral stump.

A case is reported in which a severe open injury of the thigh eventually required amputation of the lower limb. Lengthening of the short proximal femoral stump was achieved by turning over a flap comprising bone and soft tissue, with sensation, from the ipsilateral leg.

Adult↗
PubMed1985

Lymphangiosarcoma of the hand arising in a pre-existing non-irradiated lymphangioma.

Lymphangioma is an uncommon lesion which is widely believed not to undergo malignant change. Lymphangiosarcoma is even rarer and most of the cases reported in the literature were encountered in the setting of chronic lymphoedema, although occasional cases have been reported in irradiated lymphangiomata. This brief communication describes a case of multifocal lymphangiosarcoma arising in a non-irradiated, long standing lymphangioma of the hand. To our knowledge no similar case has been reported previously in the English literature, which is briefly reviewed.

Adipose Tissue↗
PubMed1985

Effects of lysosomal inhibitors on 125I-insulin and 125I-asialofetuin degradation by the isolated, perfused rat liver and isolated rat hepatocytes.

To further evaluate the role of the lysosomal system in insulin degradation, we have compared the effects of inhibitors of lysosomal function on the degradation of 125I-insulin with 125I-asialofetuin, a lysosomally targeted molecule, by the intact, perfused rat liver and the isolated rat hepatocyte. The inhibitors employed were chloroquine (125 microM), NH4Cl (10 mM), and leupeptin (50 micrograms/ml). In the intact, perfused liver the observed inhibition of 125I-asialofetuin degradation at 30 min was as follows: chloroquine, 38%; NH4Cl, 32%; and leupeptin, 86%. Chloroquine also inhibited 125I-insulin degradation in the intact, perfused liver (29%), but NH4Cl and leupeptin had no effect. Using the isolated hepatocyte, the observed values for inhibition of 125I-asialofetuin at 60 min were: chloroquine, 85%; NH4Cl, 76%; and leupeptin, 81%. Chloroquine produced a 28% inhibition of 125I-insulin degradation, while NH4Cl and leupeptin had no effect. Chloroquine and NH4Cl decreased cell-associated radioactivity when isolated hepatocytes were incubated with 125I-asialofetuin (leupeptin had no effect), whereas chloroquine caused a 107% increase in cell-associated radioactivity when 125I-insulin was added to the incubation media (NH4Cl and leupeptin had no effect). These results indicate that the effects of chloroquine on insulin degradation are an extralysosomal action and that lysosomes appear not to be involved in the physiologic degradation of the insulin molecule.

Ammonium Chloride↗
PubMed1984

Metastatic malignant melanoma in muscle.

A case is reported in which metastatic melanoma had extensively infiltrated the sartorius muscle which had been used earlier to cover the femoral vessels at the time of an inguinal node dissection. The patient also had a swelling in the ipsilateral popliteal fossa that was thought to be a metastasis from the primary malignant melanoma of the foot: however, on exploration, this mass was found to be a Baker's cyst.

Adolescent↗
PubMed1984

Malignant melanoma in Maoris and Polynesians in New Zealand.

In 1896, Matas was the first to comment on the relative infrequency of malignant melanoma in negroes and this observation has been repeated for all pigmented races (McGovern, 1977a) A review of malignant melanoma in Maoris and Polynesians in New Zealand was performed to see if the above statement was true with respect to the pigmented people of a country with the second highest incidence of the disease in the world (Little et al., 1980).

Adult↗
PubMed1984

Lower limb salvage using an extended free radial forearm flap.

A case is reported of an unusual double injury, in which a lower limb salvage procedure employed a free radial forearm flap from an amputated upper limb. The use of amputated parts for salvage procedures is well documented but none has previously involved a free forearm flap. This clinical case shows that the entire forearm and hand skin can be adequately perfused on the radial artery along with the superficial palmar arch.

Adolescent↗
PubMed1984

Free vascularized fibular graft to reconstruct early a traumatic humeral defect.

A case is reported in which a free, vascularized fibular graft was used to reconstruct early a traumatic 16-cm defect in a humerus. A description of a cast-brace used postoperatively is included. A brief review is presented of the literature with respect to the use of free vascularized fibular graft for defects in the upper extremity.

Adult↗
PubMed1984

Secondary carcinoma simulating a pulp infection.

Pulp infections are second in frequency to paronychia among infections of the hand (Hamilton Bailey, 1977) Metastatic carcinoma involving the fingers, however, is very rare (Norman and Leventhal, 1966; Martin and Dove, 1983; Schulz and Kearns, 1983). A case is reported to illustrate that a secondary carcinoma from a lung primary can present itself as a pulp infection, with a poor prognosis.

Bacterial Infections↗