Biomedical subjects
Publications and source records attributed to J G Hoehn.
Subungual exostosis in the digit is an uncommon benign tumor. Only 21 (10%) of 203 cases reported in the literature occurred in the hand. We present a recent case, detailing diagnosis, pathologic findings, and management.
Ninety-two of 220 plastic surgeons submitted information from 600 women (the last 15 to 20 reduction mammaplasties by each surgeon) regarding height, weight, and amount of breast tissue removed. In a second survey to estimate percentages of women who sought reduction mammaplasties for purely cosmetic reasons, for mixed reasons, and for purely medical reasons, 132 of the same 220 surgeons responded. All women whose removed breast weight was less than the 5th percentile sought the procedure for purely cosmetic reasons, and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. Those women whose removed breast tissue weight was between the 5th and the 22nd percentiles had mixed reasons for requesting the procedure.
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We have presented the management of a case of benign lipoblastomatosis in the face. Knowledge of this rare condition will enable the surgeon to make intelligent intraoperative decisions when confronted with similar findings.
Although lipomas of the hand are frequently encountered, a massive tumor involving one-half of the palm and extending into the fourth finger has been reported only once before. The case history of a 45-year-old male who underwent surgical removal of such a massive palmar lipoma is presented. Lipomas of the hand are discussed and the literature summarized. Details of the surgical evaluation and management of a massive lipoma of the hand are presented to assist other surgeons in handling similar cases.
Prevailing theories on the causation of choanal atresia are presented, with emphasis on some of the embryologic and anatomic abnormalities that are consistently found. The teleologic significance of nose breathing has been emphasized. This neonatal characteristic leads to a tongue-palate seal that can be rapidly fatal. Treatment of these patients has been divided into two phases. Phase I deals with immediate establishment of an airway, and phase II deals with the definitive surgical management in these patients. Our preference is for the transpalatine approach. Representative cases highlight our technique. A wire-reinforced double-barreled Elastomer stent has been developed and is described. Successful use in five patients is reported.
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A new method of management of pure degloving injuries has been presented. Return of the distally based flap to its bed without longitudinal tension, use of a temporary biological dressing to protect exposed structures, and early, delayed repair of the residual defect are suggested. The improved survival of the flap and earlier rehabilitation of the patient have been gratifying.
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Fibrous xanthomas of the digital tendon sheath system are a common benign tumour. The varying recurrence rates cited in the literature have usually been attributed to inadequate surgical excision. However, Boyes (1964) has suggested "seeding" as a possible mechanism to explain persistence of the tumour. Our case of multiple fibrous xanthomas at different levels in a single digital sheath system is presented as an example of "seeding" along the tendon sheath.
Rhinophyma is classically a benign tumor of unknown etiology and pathogenesis. Once fully developed, it requires surgical treatment; its management has invited controversy for more than a century. We favor electrosurgical sculpturing, removal of the burned tissue by abrasion, treatment of the entire nasal cover as a unit, and the utilization of biological dressings to promote reepithelization. The cosmetic results have been gratifying.
Basal cell adenoma of the parotid gland is infrequently seen and rarely documented in the American literature. A case history is presented to emphasize its occurrence in older men and to discuss its pathological appearance. A review of the literature shows that superficial conservative parotidectomy is the treatment of choice because the lesion is considered benign.
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We have used dacryoscintigraphy to study the efficiency of the lacrimal system following the repair of a divided lower canaliculus in 4 children. This test has been reliable in evaluating lacrimal function and suggests that a canaliculus can be repaired and splinted satisfactorily. Our experience with dacryoscintigraphy confirms that it is a safe comfortable, and reliable method for studying the patency of the lacrimal drainage system.
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