Biomedical subjects
Publications and source records attributed to R F Morgan.
Kienböck's disease has been a well-recognized disorder of the wrist since it was first described in 1910. It has not been reported to occur bilaterally. We have recently treated two men who presented with bilateral Kienböck's disease.
The microscopic anatomical localization of the sympathetic nerves within the peripheral nerves and their relationship to the end arteries in the hand has not been fully evaluated. A preliminary study is presented that outlines a method of microscopic identification of sympathetic nerves in the hand. Fresh human tissue consisting of median and ulnar nerves and their arterial supply were used in the study. Sections of these were taken at multiple levels in the forearm, wrist, and hand after the tissue was frozen. The sections were then immersed in a glyoxylic acid solution in order to excite catecholamine fluorescence. Dark-field fluorescence microscopy was then used to view the sections. Light microscopy was also used to examine adjacent sections from the same specimens. The sympathetics are more plentiful in the median nerve as compared to the ulnar nerve at the wrist. They are mostly located, in clusters, in the peripheral aspect of the nerve. Control material consisting of motor nerve, sympathetic chain, and adrenal gland was used to standardize the fluorescence. Histofluorescence was then used as a method to define the anatomy of the sympathetic nerves in the hand.
The effect of a levator retrodisplacement procedure upon conductive hearing loss in cleft palate patients was evaluated. Forty-two children with cleft palates, operated upon between 1970 and 1975, were included in the study. The results suggest that 73.5% of those in the levator retrodisplacement group achieved normal hearing, compared with 37.5% among those whose palatoplasties did not include levator retrodisplacement. The degree of hearing impairment in patients with levator retrodisplacement was mild (20 to 40 db) in contrast to that in patients without levator retrodisplacement, whose impairment was severe (40 to 60 db).
Reconstruction of extensive compound lower-extremity injuries may require the use of local flaps or free-tissue transfer. When either method alone is inadequate for reconstruction of two isolated defects on the same lower extremity, a combined approach may be utilized to reconstruct a functional lower extremity.
Postoperative lymphoceles and adventitious bursae are common occurrences. They are slow to resolve and often persist when traditional techniques of prolonged drainage, multiple aspirations, and local pressure are used. Tetracycline sclerotherapy provides a rational nonoperative alternative treatment that is simple and without major complications and provides a rapid resolution of persistent seromas. Based on our favorable limited experience we believe that this technique should be studied in patients with persistent seromas in a randomized prospective fashion.
The postoperative dressing is an integral part of an otoplasty. The dressing should fit securely, provide protection, and be comfortable for the patient to wear. Wrestling headgear can be used to fill these needs.
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The Indian art and science of total nasal reconstruction comprise the first chapter in the history of plastic surgery. Remarkably, centuries after their first use, the original Indian methods utilizing the cheek flap and median forehead flap for total rhinoplasty remain the basis for most reconstructive rhinoplastic procedures.
John Staige Davis was the first surgeon to devote his entire practice to plastic surgery and worked exclusively for its recognition as a specialty. He wrote the first American text on plastic surgery, published 78 papers on a wide range of subjects in plastic surgery, was the first to establish a formal training program in plastic surgery in 1924, and was the first Chairman of the American Board of Plastic Surgery.
This study was carried out to determine the perioperative mortality rate of patients over the age of 65 years who are undergoing major head and neck resections under general anesthesia. The total number of patients was 810 and the perioperative mortality rate (death within 30 days of operation) was 3.5 percent (29 of 810). This rate is relatively low when compared with the rate for patients undergoing similar procedures during the same period in the 35 to 65 years age group. Since 1975 reports of other types of surgery in the elderly have given perioperative mortality rates of from 4.8 to 26 percent. Previous studies of head and neck surgery in the elderly have given perioperative mortality rates of from 1.3 to 13.6 percent. Head and neck surgery in the elderly continues to be a safe procedure when compared with other types of surgery. As the portion of patients in the population over the age of 65 continues to increase, advanced age alone should not be a deterrent to performing aggressive surgical therapy for head and neck cancer.
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Cooling the amputated part and the partially amputated devascularized extremity is critical for a successful replantation attempt. Cooling devascularized or amputated tissue is the simplest and most effective method for preventing the detrimental effects of ischemia. Successful microsurgical revascularization begins with proper treatment in the local referring emergency room. Proper care and transportation of the patient and his devascularized or amputated extremity are essential.
The nasolabial skin flap has proved very useful in reconstruction of anterior intraoral defects after ablation for cancer. The technique allows immediate single-stage reconstruction with local tissue. Minimal functional or cosmetic deformity results at the donor site. Fifty-five consecutive patients who underwent anterior intraoral reconstruction with 68 nasolabial flaps were followed up for 1 to 10 years. Only two flaps were total failures. Three flaps had partial tissue loss. Successful reconstruction without complication was obtained with 93 percent of the flaps. Technical refinements and considerations in flap design are presented.
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Explore the source record for details and available documents.