Search PubMed⌕ Search

Biomedical subjects

M Spira

Publications and source records attributed to M Spira.

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

Neurofibromatosis.

Neurofibromatosis (NF) is an inherited disorder characterized by the development of a wide variety of clinical manifestations, including characteristic "freckle-like" pigmentations (cafe au lait spots) that develop in infancy, followed by skin tumors that may vary widely in size, number, and distribution. In addition to skin tumors, bone, neurologic, and endocrine abnormalities are common. NF is recognized in eight different types, with clinical heterogeneity being the hallmark of this disease. Malignant degeneration of the tumor to neurofibrosarcoma is rare. Early diagnosis, genetic counseling, treatment of symptoms, and appropriate surgery are the tools available for management of NF patients. Surgical procedures generally involve judicious subtotal resection, combined with reconstructive efforts aimed at functional improvement and cosmesis.

Adult↗
PubMed1987

Skin morphology and function.

Proper understanding of the cause, nature, and treatment of diseases affecting the skin requires an intimate knowledge of the anatomy and physiology of normal as well as pathologic skin. This article thus lays the groundwork for the discussions of specific pathologic conditions that follow in this issue.

Adipose Tissue↗
PubMed1986

Management of soft tissue injuries.

The author presents a brief discussion of the causes, extent, and prevention of primarily automobile-related soft tissue maxillofacial injuries. This is followed by a practical approach to their management. Personal preferences relative to armamentarium and techniques that have withstood the test of time are given, together with several maxims useful in the treatment of soft tissue trauma. Personal bias and philosophy born of years of experience in the treatment of such injuries are freely given.

Anesthesia, Local↗
PubMed1986

Long-term stability of Teflon orbital implants.

Teflon orbital floor implants have become controversial owing to reports of implant-related complications. To determine the actual incidence of Teflon implant-related complications and factors associated with complications, we conducted a long-term follow-up study of 77 selected patients. We obtained data on 35 implants in 31 patients with a mean follow-up period of 16 years, representing an experience of 528 patient-implant years. The short-term complication rate (within 1 month of surgery) was 3.9 percent. The long-term complication rate was 2.8 percent. Concomitant antral packing and implantation of Teflon sheet were associated with a markedly higher risk of implant pocket infection. There was no case of implant migration with proper fixation. Facial growth was normal in three children in the series. We conclude that Teflon sheet is well-tolerated in the orbit in the long term. The low complication rate can be further reduced with proper fixation of the implant and avoidance of antral packing at the time of implantation.

Adult↗
PubMed1986

Melanoma of the head and neck. Update and perspective.

The diagnosis and appropriate treatment of melanoma remains a controversial subject. A review of the literature as well as evaluation of our experience allows for a better understanding of this challenging problem and the development of some up-to-date guidelines in the treatment of this disease.

Biopsy↗
PubMed1985

Mons pubis as a donor site for split-thickness skin grafts.

It is extremely important that a donor graft site be selected with attention to the type of graft needed as well as the specific patient's needs and lifestyle. While it is inevitable that any donor site heals with altered pigmentation and texture, we feel that by using a combination of several time-honored techniques in this well-concealed donor site, we have achieved long-term aesthetic results of the transfer of skin grafts from a hair-bearing area.

Female↗
PubMed1984

Enhancement of skin-flap survival using nitroglycerin ointment.

Rat and pig skin flaps were used to investigate the effects of topical nitroglycerin ointment on flap survival. Significant increase in flap survival was detected and correlated well with plasma nitroglycerin levels measured during the treatment regimen. The drug was applied 1 hour preoperatively in both models. Recent experimental clinical investigations on the use of pharmacologics for treating failing flaps were reviewed, including the possible mechanism of action of nitroglycerin. Characteristics of an ideal pharmacologic agent for use in the treatment of failing flaps were delineated. Further investigation is warranted to determine the effects of nitroglycerin ointment on various other flaps, including musculocutaneous and free flaps, as well as timing of these applications. All these variables could best be studied in the pig with confirmation of other researchers prior to advocating clinical usage. Until then, the ideal pharmacologic agent for prevention of skin-flap necrosis remains unknown.

Administration, Topical↗
PubMed1983

Critical comparison of transcutaneous PO2 and tissue pH as indices of perfusion.

A critical laboratory evaluation of transcutaneous PO2 monitoring and tissue pH monitoring in lower abdominal island flaps based on the superficial inferior epigastric vessels in rabbits revealed that transcutaneous PO2 values correlate poorly with tissue survival under circumstances of decreased arterial inflow. The inability of the transcutaneous PO2 monitor to accurately predict viability of the flaps in this study is attributed to physiologic changes in the microcirculation and not to instrument error. Tissue pH was, in all instances, a reliable index of the perfusion status of the flaps.

Abdomen↗
PubMed1983

Vascular augmentation of skin and musculocutaneous flaps.

In a series of rats, pigs, and dogs, a method for ligating an expendable vessel and placing it under a skin flap or using the vessel to create a new pedicle (neovascular pedicle) for a musculocutaneous flap by the process of neovascularization is demonstrated. No ischemic stimulus is necessary to induce this process of transmural neovascularization.

Animals↗
PubMed1983

The totem pole rib graft reconstruction of the nose.

The totem pole rib bone graft for nasal reconstruction is presented as an effective way to prepare the donor bone for the correction of saddle-nose deformity. The article's title emanates from the fact that when the sculpturing of the rib is completed it has the appearance of a totem pole before the separate parts are disarticulated for insertion into the nose. The use of this technique permits an accurate, detailed sculpturing of the component parts of the subsequent reconstruction, permitting correction of each feature of the saddle-nose deformity. If these bony segments were dissected or sculptured separately, the smallness of each part would make it very difficult to carve the precise definition needed for a reconstruction that would give structural support and at the same time afford an aesthetically pleasing result. The rationale of the technique and representative cases are presented.

Adult↗
PubMed1983

Lining the superiorly based pharyngeal flap.

Developing a mucosal flap to line the nasal surface of a superiorly based pharyngeal flap can present technical difficulties, particularly in the scarred and immobile soft palate. Employing the technique described, the forward attachment of the pharyngeal flap to the nasal surface is made through a long, horizontal incision high in the soft palate. The dissection of the nasal lining is started at this point and carried posteriorly to provide a single broad mucosal flap, hinged near the margin of the velum, and turned backward to line the raw area of the pharyngeal flap. This minor variation in technique has made the operative procedure easier to perform, resulting in fewer complications.

Cleft Palate↗
PubMed1983

The conchal flap: an adjunct in otoplasty.

When the protruding ear is caused in whole or in part by an enlarged or abnormally angulated concha, the conchal set-back is a recognized technique in corrective surgery. The authors describe a modification of this procedure in which a posterior flap of cartilage, based laterally adjacent to the antihelix, is elevated and sutured to the mastoid process. The maneuver serves to bring the concha closer to the scalp and thus reduces the protrusion. The residual deformity in the conchal bowl, resulting from the development of this cartilage flap, is negligible. The authors stress the need for correct analysis of the original deformity and usually employ this maneuver in conjunction with a suture technique for creating or accentuating a poorly defined antihelix.

Adolescent↗
PubMed1983

Recognition and treatment of recurrent basal cell carcinoma.

The recognition and treatment of recurrent basal cell cancer presents a diagnostic as well as a therapeutic problem. While recurrences are often masked by previous surgical efforts, there are definite clinical features that warrant suspicion and subsequent biopsy. Adequate therapy can come only with accurate recognition and aggressive treatment using microscopical control.

Basal Cell Carcinoma↗
PubMed1983

Secondary island composite flap: an experimental study in ear reconstruction.

An experimental study is presented which demonstrates that a large composite graft of cartilage and skin can survive with an overlying skin flap. The grafts were transferred without loss of configuration when the composite tissue was placed on a bed of vascular tissue. The presence of a skin flap over the graft appears to assist in providing an environment conducive to survival while neovascularization is occurring. This is the first stage in developing a technique of ear reconstruction in which the overlying skin is not used and the cartilage will retain its shape with subsequent transfer.

Animals↗
PubMed1983

Ultraviolet light and hyperpigmentation in healing wounds.

The concept of permanent hyperpigmentation in wounds following ultraviolet light exposure during the postoperative period has found a place in plastic surgical literature but has not been documented. This study evaluates the effect of ultraviolet light on healing wounds in paraplegics. It failed to confirm permanent alteration in pigmentation response to ultraviolet exposure and suggests that other factors are of greater importance in the development of hyperpigmentation in the healing wound.

Humans↗