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Biomedical subjects

S Ariyan

Publications and source records attributed to S Ariyan.

At least 109 records · Page 6Linked to original sources
PubMed1979

One-stage reconstruction for defects of the mouth using a sternomastoid myocutaneous flap.

The sternomastoid muscle has 3 blood supplies: the occipital artery superiorly, the superior thyroid artery in the middle, and the thyrocervical trunk below. We report the use of a myocutaneous flap consisting of a "paddle" of skin on the end of a pedicle of sternomastoid muscle--with the latter based either on its superior or inferior blood supply. Fourteen such flaps have been used successfully in 13 consecutive patients for one-stage reconstructions of defects of the oral cavity and oropharynx. Although there was partial epithelial loss of the skin "paddle" in 7 cases, in each case the surviving dermis became resurfaced with epithelium.

Aged↗
PubMed1979

Infections following surgery for head and neck cancer.

Cancer of the head and neck area disturbs the balance between the bacterial organisms of the area and the host-defense mechanisms. The very nature of treatment of this cancer predisposes patients to infection. An awareness of the multiplicity of factors that lead to these complications and the understanding of the various defense mechanisms of the host provide the basis for a rational approach to the successful treatment of these patients.

Age Factors↗
PubMed1978

Wound contraction and fibrocontractive disorders.

A most important contribution to the understanding of wound healing has been the identification of the myofibroblast. These cells contract like smooth muscle cells and have been identified in a variety of chronic and open wounds. The myofibroblasts have been reported as the causative factor resulting in the wound contraction. This report demonstrates the presence of the myofibroblasts in breast capsule contraction, as well as in Peyronie's disease. The presence of the myofibroblast in Peyronie's disease and Dupuytren's contracture suggests that the myofibroblast may be the causal factor behind the association of these two disorders. The evidence suggests that a spectrum of fibrocontractive disorders exists that has the myofibroblast as the common denominator. Some evidence is presented that permits the speculation that the myofibroblast may be a transformation of the local fibroblast to a smooth muscle cell in response to forces applied to the tissue.

Animals↗
PubMed1978

A simplified technique for correction of the cleft lip nasal deformity.

The cleft lip nasal deformity is a result of imbalance of the structures caused by a collapsed alar cartilage, a widened nostril floor, and a lowered nasal orifice. This deformity can be corrected most readily by repositioning and supporting the collapsed alar cartilage of the cleft side. A technique has been developed to achieve this by releasing the ala from the nasolabial fold, elevating and supporting the alar cartilage, and repositioning the alar rim on its new deepithelialized base. One- to two-year follow-up of seven patients who underwent such repair has demonstrated satisfactory correction of the deformity.

Cleft Lip↗
PubMed1978

The anterior chest approach for obtaining free osteocutaneous rib grafts.

Fresh cadaver dissections indicated that the anterior chest approach for obtaining a free osteocutaneous rib graft, based on the anterior intercostal vessels, would be feasible. Following this, a mandibular defect in radiated tissue was successfully repaired in one stage by a free osteocutaneous graft with microvascular anastomoses. A 22-cm segment of rib, with overlying muscle and skin measuring 10 X 30 cm, was transferred. Follow-up, with selective arteriography at 6 months, confirmed the belief that the periosteal blood supply alone could support the rib segment. The anterior chest approach, to obtain a free osteocutaneous rib graft, is easier, faster, and safer than the posterior approach.

Angiography↗
PubMed1977

A simple stereotactic method to isolate and remove foreign bodies.

For the past several years, a simple technique using an image intensifier has been employed to isolate and remove foreign bodies from the extremities. Five consecutive cases were recorded to demonstrate its accuracy and simplicity. After the foreign body was identified by an x-ray film, the wound was infiltrated with local anesthesia and the foreign body was "located" by two venipuncture needles placed with the aid of an image intensifier. A small incision was then made between the needles to locate the foreign body at their tips. In this manner, foreign bodies have been consistently removed successfully in the emergency room in a relatively short period of time.

Adolescent↗
PubMed1977

Modifications in the treatment of the multiple injury patient.

When burns complicate the management of an otherwise severely injured patient, modifications in treatment must be undertaken for both problems. The unique situation of this type of patient often requires the use of multiple therapeutic interventions which may differ from the usual. The use of controlled hypotension and aggressive surgical burn management was successful in allowing the postponement of vascular surgery in a young male patient with a traumatic aortic disruption and extensive burns resulting from a 60-foot fall and severe thermal burns.

Adult↗
PubMed1977

Identification of squamous cell carcinoma of the head and neck by tissue culture and immunological testing.

We outline the techniques used to successfully grow squamous cell carcinoma in tissue culture, and to test the cellular immunity of the patient by lymphocyte cytotoxicity studies. Lymphocytes cultured with malignant squamous cells killed from 40 to 60 percent of the tumor cells during 48 hours of incubation. These same lymphocytes did not show any killing potential against cultured melanoma cells or against cultured fibroblasts. This demonstrates an immune response that is tumor-antigen specific. There was no evidence of any serum-blocking factor, because the killing potential of these lymphocytes was not significantly altered by the addition of the patients' sera. The implications and potential for early diagnosis made possible by these techniques are discussed.

Adult↗
PubMed1977

The palmar approach for the visualization and release of the carpal tunnel. An analysis of 429 cases.

A review of 429 cases of carpal tunnel syndrome in 329 patients confirms the prevalence of this entity among disorders of the hand. Three symptoms are almost diagnostic--daytime numbness, nighttime pain, and morning stiffness of the fingers. The diagnosis is confirmed by findings on physical examination. A relatively simple technique is presented for the exposure and release of the median nerve, using a longitudinal incision in the palm and stopping short of the wrist skin. Limiting the incision to the palmar skin results in an inconspicuous scar, while still providing adequate exposure for a complete anatomical release. An epineural neurolysis of the median nerve was performed in each case, resulting in improvement in the symptoms in all but 4 of these 429 patients.

Adolescent↗
PubMed1977

Mesenteric and peripheral vascular ischemia secondary to ergotism.

At the present time ergotism is due primarily to excessive use or abuse of ergot preparations for migraine headaches. The diagnosis may be made with the evidence of vascular ischemia in the presence of a history of migraines and its treatment with this drug. The therapy for the vasospasm is directed chiefly at the discontinuation of the ergot preparation, with further treatment aimed at the relief of symptoms or prevention of complications. A case is presented of lower extremity ischemia with impending gangrene of both feet in a patient with a history of chronic schizophrenia. Arteriograms revealed symmetrical vasospasm in the lower extremities as well as spasm of the superior mesenteric artery and its intestinal branches. This is believed to be the first documented case of mesenteric vasospasm due to ergotism. Treatment was instituted with low molecular weight dextran, tolazoline, and reserpine with rapid and complete resolution. Caution is advised in the use of ergot preparations in neuropsychiatric disorders.

Adult↗
PubMed1976

Further hazards of heparin therapy in vascular surgery.

Three consecutive patients were treated with heparin sodium administered intravenously for phlebitis and pulmonary embolism following abdominal aortic surgery. After the institution of heparin, hemorrhage in these patients occurred from the suture line 14 days, 18 days, and 31 days after surgery, respectively. the diagnosis was correctly made and control of the bleeding was achieved in each case. The first two patients required exploratory surgery and the third patient was treated successfully without surgical intervention. We propose that the integrity of the clot at the suture line is in dynamic balance. There is a continuous lysis and resorption of old thrombus and replacement with new clot formation until the suture line is sealed by regeneration of the new "intima". If the blood is anticoagulated by heparin, this balance is disrupted and hemorrhage may result.

Aged↗
PubMed1976

In defense of the open wound.

In a case of bilateral five-finger Dupuytren contracture, one hand was treated by open excision of the contracutred fascia and shortened skin with application of skin graft. The opposite hand was treated by the "open-palm" technique for comparison. There was no observable difference in the ranges of motion at the end of the two months following surgery. The open-palm technique continues to be simple alternative for the advanced cases requiring extensive excision of the palmar fascia leaving wide gaps in the palmar skin.

Dupuytren Contracture↗
PubMed1976

Hidradenitis suppurativa of the groin, treated by excision and spontaneous healing.

A simplified approach to the surgical treatment of hidradenitis supprativa of the groin and perineum is presented. All tissue is excised down to the fascia, and the wound is allowed to granulate and epithelialize spontaneously. The advantage of the procedure are (1) a simple surgical technique, (2) easier postoperative care, (3) full and early ambulation, (4) no donor sites, (5) no losses of skin grafts, (6) early discharge from the hospital, and (7) early return to work.

Humans↗