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Biomedical subjects

L C Argenta

Publications and source records attributed to L C Argenta.

At least 73 records · Page 4Linked to original sources

Quantitative analysis of the thickness of human skin and subcutaneous tissue following controlled expansion with a silicone implant.

Histologic quantitation of the thickness of human tissues that were expanded using silicone expanders showed that the epidermis underwent significant thickening after 5 weeks to 5 months of expansion. The dermis and subcutaneous tissue, on the other hand, were significantly thinner after expansion. Capsules were formed in all 19 patients. The capsule was significantly thickest after 2 to 2.5 months of expansion. Expanded tissues 2 years after cessation of expansion had the same thickness as control tissues and had no remnant fibrous capsule.

Adolescent↗

The temporal island scalp flap for management of facial burn scars.

Facial burn scars are difficult to conceal and often preclude an aesthetic rehabilitation of the patient. Multistaged scalp and neck flaps have been described to provide hair-bearing skin to resurface burn scars in men. We have been resurfacing the upper lip and cheek in a one-stage procedure using a temporal artery island scalp flap. The temporoparietal fascia has been well described in recent years, and the understanding of this anatomy has facilitated the use of the island scalp flap for more distal transfers.

Adult↗

Endothelial cell crystalloids in newborn human foreskin.

This study describes the presence of crystalline inclusions in the endothelial cells of foreskins. They were found in 9 normal full-term newborn infants, without maternal medication or complication during pregnancy and delivery. These cytoplasmic crystalloids occurred in 10% of endothelial cells of small blood vessels. The diameter of the inclusions ranged from 0.3 to 1.5 micron and they appeared as round, oval, hexagonal or irregular polygonal in shape. These inclusions were surrounded by a triple membrane and their contents demonstrated granular, homogeneous and crystalloid-like material with a regular periodicity of dense and less dense layers measuring about 20-25 nm. Similar crystalloids in the endothelial cells were observed in the normal upper lip skin of a 6-week-old girl, although they were present in much smaller numbers than in foreskin. No endothelial inclusions were found in normal skin taken from 11 body areas in 29 patients aged 2.5 to 56 years. The nature and function of these cytoplasmic crystalloids are unknown.

Adolescent↗

Tissue expansion.

Controlled tissue expansion began as a concept based on primitive ideas and observations. Its application to breast reconstruction has played a major role in the tissue and psychologic rejuvenation following surgery for breast carcinoma. During the last several years, controlled expansion of tissue has been applied to many other anatomic sites treating many difficult reconstructive and excisional surgeries which heretofore were either impossible or required several stages to accomplish. As experience has grown, the use of tissue expansion has become safer and has been applied to many excisional and reconstructive efforts. The future use of tissue expansion is extremely bright and limited only by the creativity of the surgeon familiar with the technique. In the future, under study is controlled expansion of bone, of nerves, and of other body parts that may prove to be valuable in the surgeon's armamentarium. The dermatologic surgeon should become familiar with the concept and practice of tissue expansion, whether or not it is used in his or her practice. By being familiar with what the reconstructive surgeon can do with tissue expansion, the dermatologist can treat entities perhaps not otherwise treated in the past. For the dermatologist experienced in cutaneous surgery, tissue expansion can be added to his armamentarium in the treatment of male pattern baldness, some local flaps, congenital nevi and larger excisions requiring serial excision in the past as well as tattoos.

Humans↗

Heterotopic brain presenting as a lip lesion.

Heterotopic brain tissue in the upper lip of a newborn child is presented and discussed. This rare developmental anomaly is usually present at birth and may simulate hemangioma. Before any surgical procedure can be performed, thorough radiographic and neurosurgical examination is essential to rule out eventual communication of the tumor with intracranial space.

Brain↗

Giant cerebriform intradermal nevus.

Giant cerebriform intradermal nevus (GCIN) is a form of cutis verticis gyrata and may be associated with a number of systemic diseases. Clinically it manifests itself as a scalp deformity resembling the surface of the brain with cerebriform morphologic characteristics. Degeneration into malignant melanoma has been reported. We herein report 3 cases of GCIN successfully treated by surgical extirpation and scalp flap reconstruction.

Adult↗

Microcystic adnexal carcinoma: an unpredictable aggressive neoplasm.

Microcystic adnexal carcinoma is a rare, locally aggressive cutaneous neoplasm that has been recently recognized as a distinct entity. Typically it appears as a papular, flesh-colored mass on the face of women patients. Because of its benign appearance, it is often present for months or years before diagnosis. Histologically, there is a paucity of mitotic figures and other criteria usually associated with aggressive lesions. In this article we discuss 3 cases of microcystic adnexal carcinoma, each presenting as a small, localized lesion but all requiring extensive surgical extirpation with margin control using the Mohs tissue resection technique.

Aged↗

Scalp expansion in the treatment of male pattern baldness.

Tissue expansion has been extremely valuable in the treatment of traumatic scalp defects. We have recently used expansion techniques in the treatment of male pattern baldness. Expansion has been used in conjunction with scalp-reduction procedures and pedicled hair-bearing flaps. Flaps have been designed as Juri flaps, and in one patient, a new posteriorly based flap was used. This design gives the advantage of a more natural-appearing hairline and forward-growing hair. The major advantage of tissue expansion in the treatment of male pattern baldness is that it generates new hair-bearing scalp. The increase in vascularity which occurs during expansion allows for large, safe, and predictable flaps. Donor sites are also relatively easily closed. The disadvantages of expansion include the need for two or more surgical procedures and multiple office visits. There is also some discomfort following expansion and a cosmetic defect as the expanders become larger. Complications include infection, exposure or extrusion, deflation, and hair loss. Tissue expansion combined with scalp reduction and pedicled hair-bearing flaps have proved to be a valuable technique in the treatment of male pattern baldness with a high degree of patient satisfaction.

Adult↗

Histopathology of human expanded tissue.

In this article the authors summarize statistical data from 19 patients obtained during quantitative analysis of the thickness of expanded skin and soft tissues utilizing silicone expander procedures. Histopathologic and ultrastructural changes that take place in individual levels of expanded tissues are also illustrated.

Connective Tissue↗

Rapid expansion: experimental and clinical experience.

One of the drawbacks of clinical expansion is delay of the final reconstruction and patient inconvenience. The authors have explored the physiologic response to rapid expansion in an animal model and present initial clinical experiences with three patients.

Adolescent↗

Expanded myocutaneous flaps: their clinical use.

In particularly large defects the best available flap may not provide sufficient tissue for satisfactory correction. Pre-expansion of an overlying musculocutaneous flap allows transposition of a larger flap to reconstruct such defects. The authors present their experience in four patients to illustrate the efficacy of this modality in select patients.

Adult↗

Burn management: the role of tissue expansion.

Tissue expansion has facilitated reconstruction in selected burn patients. For the past 5 years the authors have used this modality in 45 patients, reconstructing the head and neck, trunk, and extremities.

Breast↗

Utility of lymphoscintigraphy in directing surgical therapy for melanomas of the head, neck, and upper thorax.

Lymphoscintigraphy with technetium99m antimony sulfur colloid or technetium99m human serum albumin helped direct the surgical management of 24 patients who had melanomas of the head, neck, and upper thorax. Eighteen (75%) patients had documented lymphatic flow to other than a single adjacent predictable lymph nodal group. Nineteen patients underwent lymphadenectomy. Availability of the scan altered surgical management in nine patients (47%) who required resection of nodes in addition to resection of adjacent nodes. The discovery of metastatic disease in one patient was clearly attributable to lymphoscintigraphy. This demonstrates the unpredictable lymphatic anatomy of this region and suggests that preoperative lymphoscintigraphy may be useful in directing the surgical management of cutaneous melanomas in which lymph node dissection is planned.

Adult↗

Tissue expansion in craniofacial surgery.

Craniofacial surgery has evolved through an era of refinement and finesse, both in techniques and in results. Tissue expansion offers an opportunity to improve the quantity and quality of tissue available for these procedures. It may also be of benefit in long-term molding of the craniofacial skeleton during growth of the child, obviating the need for multiple revisions. This adjunct to craniofacial surgery is being performed with minimal complications and results in improved appearance for the patient.

Adolescent↗

Total reconstruction of aplasia cutis congenita involving scalp, skull, and dura.

A case of total reconstruction of skull and scalp in a patient with a large defect from aplasia cutis congenita is reported. Tissue expansion was successfully employed on two occasions: first to construct a well-vascularized space to sustain multiple rib grafts for cranial reconstruction and then to develop adequate quantities of scalp and forehead for total coverage.

Child↗

Simulated metastatic carcinoma after breast reconstruction.

In two patients who had undergone mastectomies and reconstruction for breast carcinoma, suspicious lesions were noted on chest roentgenograms. Subsequent studies revealed the lesions to be shadows from the reconstructed nipples. The most frequently employed techniques for nipple reconstruction involve the grouping and overlapping of multiple local flaps which results in a round radiodensity on a roentgenogram. Patients with suspicious roentgenographic lesions after breast reconstruction should have oblique films taken to localize the lesion.

Breast Neoplasms↗

Heating pad burns in anesthetic skin.

Patients requiring reconstruction by muscle or musculocutaneous flaps often have an associated area of skin anesthesia. This skin is susceptible to trauma because of its insensibility. This study reports 3 cases in which patients sustained deep partial-thickness burns of anesthetic skin following flap reconstruction. All burns healed by reepithelialization. Following flap reconstruction, patients should be warned regarding the use of heating pads. Burns of this type represent a preventable complication of flap reconstruction.

Aged↗