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Biomedical subjects

W Lawson

Publications and source records attributed to W Lawson.

At least 145 records · Page 8Linked to original sources

Unusual and fatal complications of rhinoplasty.

Serious complications of cosmetic rhinoplasty are extremely rare. However, awareness of their existence is essential so that the surgeon can minimize the potential hazards of the procedure. This demands a careful preoperative examination, a meticulous intraoperative technique, and a careful postoperative monitoring of the patient. The complications of rhinoplasty have been classified into infectious, traumatic, hemorrhagic, systemic, and miscellaneous groups. The pertinent literature is reviewed, as well as cases of inclusion cyst formation, disturbance of eye closure, local activation of systemic disease, and fatalities from intracranial injury with brain laceration and pneumocephalus.

Adolescent↗

Giant-cell lesions of the facial bones.

Giant-cell lesions of the paranasal sinuses, including the giant-cell reparative granuloma, the brown tumor of hyperparathyroidism, the true giant-cell tumor, cherubism, and the aneurysmal bone cyst, are uncommon entities. Plain radiographic and computed-tomographic studies of these lesions are described and the differential diagnosis is discussed.

Adult↗

The role of conservative surgery in the management of inverted papilloma.

A group of 31 patients with inverted papilloma were treated at the Mount Sinai Medical Center. There were no multicentric cases, and one patient had an associated malignancy. A conservative procedure consisting of intranasal or transantral sphenoethmoidectomy was selectively performed in 8 patients with limited lesions. No recurrences were observed in this group after a mean follow-up of 2 years. Lateral rhinotomy with medial maxillectomy and en bloc resection of the ethmoid labyrinth was performed in 23 other patients. One recurrence appeared in this group, members of which were followed a mean of 3.8 years. Radiographic evaluation by multidirectional polytomography and CT scanning permits identification of a small group of patients who have limited lesions and may be candidates for conservative tumor excision.

Adolescent↗

An analysis of 133 pectoralis major myocutaneous flaps.

Our experience with 133 consecutive pectoralis major island myocutaneous flaps in 126 patients is reviewed. The incidence of complications has been relatively low. Among the 133 flaps used in the head and neck area, 11 flaps (8 percent) failed to accomplish the intended purpose and required secondary repair. The pectoralis major myocutaneous flap with its abundant tissue and excellent blood supply and anatomic proximity provide a simple, reliable, and versatile method of primary reconstruction of various head and neck defects.

Adult↗

Experience with immediate and delayed mandibular reconstruction.

The functional disability and cosmetic deformity after jaw and neck dissection can be very severe due to soft tissue and mandibular loss. Reconstruction of the mandible alone without soft tissue coverage can be complicated with prosthetic exposure, infection and, finally, rejection. We attempted to reconstruct the mandible at the time of tumor resection in a group of patients, using titanium mesh with marrow, rib, scapular spine, and clavicle. We used myocutaneous flaps in order to obtain intraoral coverage of the mandibular grafts. In a second group of patients, delayed reconstruction of the jaw was performed 6 months to 2 years after tumor resection. Titanium mesh prostheses were used for reconstruction of the mandible in conjunction with myocutaneous flaps for soft tissue augmentation. Osteomyocutaneous flaps were also used. The results and complications in 54 patients are presented.

Bone Transplantation↗

Breast carcinoma metastasizing to the cervical esophagus.

Tumor metastasis to the esophagus is rare. While breast carcinoma metastasizing to the thoracic esophagus has been described, there are no reported cases of spread to the cervical esophagus. Two patients, having had mastectomy for breast carcinoma several years previously, presented with cervical esophageal obstruction secondary to metastatic disease. Tumor resection with cervical esophageal reconstruction is advocated for palliation. The details of the history, diagnosis and surgical technique are presented.

Adult↗

Proficiency in testing for hepatitis B surface antigen: experience with Ausria II.

Eight hepatitis B surface antigen (HBsAg) proficiency panels were tested using a radioimmunoassay (RIA) test kit during 1978 and 1979 by routine processing laboratories within the 57 American Red Cross Blood Services Regions. The test results were analyzed and it was found that lot-to-lot variability in the reagents may result in a measurable loss of sensitivity of the test leading to an increased error rate. On the basis of these studies, it is recommended that the positive to negative (P/N) ratio for validation of the test be raised to at least 25.

Analysis of Variance↗

Panel discussion: the management of advanced laryngotracheal stenosis. Staged tracheal reconstruction.

A staged method of repair of extended tracheal and combined laryngotracheal stenosis is presented. This entails creation of a trough by exteriorization of the involved segments, implantation of an alloplastic material adjacent to it, and the subsequent hinged rotation of the embedded implant over the trough to create a semi-rigid anterior wall to the airway. The development, indications, technique and complications of this method of tracheal reconstruction are discussed.

Humans↗

Clinical-pathological determinants in prognosis of fibrous histiocytomas of head and neck.

Review of the literature reveals 76 cases of fibrous histiocytoma of the deep structures of the head and neck. To this we have added 11 of our own cases, and analyzed the total group to determine clinical and histological features of a high risk population. Age, sex, presence of pain, location of tumor, size of tumor, and local invasion appear to be important clinical criteria. Bizarre giant cells, numerous and atypical mitoses, necrosis, and inflammation appear to be important histologic features. The treatment of choice is wide local excision. Chemotherapy appears to produce tumor regression.

Adult↗

The lower trapezius island myocutaneous flap.

The lower trapezius myocutaneous island flap is described. The reliability and uniform thickness of this flap make it ideal for reconstruction of facial skin defects or for subcutaneous augmentation of the face.

Aged↗

The neuroendocrine nature of the glomus cells: an experimental, ultrastructural, and histochemical tissue culture study.

Although the carotid body is an established chemoreceptor, there is considerable evidence also for its possessing a secretory function. While adrenergic neuroendocrine cells of neuroectodermal derviation exist in the central and autonomic nervous systems, the exact histogenesis of the mammalian carotid body is unsettled. The normal human carotid body and glomus jugulare tumor have been grown in tissue culture and their constituent cells have been observed to transform from epithelial to neuronoid appearing cells with extensive dendritic processes. This conversion has been further enhanced by the addition of nerve growth factor, a polypeptide specific for neural tissue. Electron microscopy confirmed that these culus cell. Histofluorescence revealed that these in vitro cells continued to synthesize and store biogenic monoamines in culture. Comparison of the morphologic, ultrastructural and histochemical features of the glomus cell with established neuroendocrine cells (central nervous system neurons, sympathetic ganglia cells, chromaffin cells) shows striking similarities. On the basis of these findings it is concluded that the glomus cell is a modified neuron of neural crest origin. The embryology, electron microscopy and histochemistry of the carotid body and related glomera and their tumors are reviewed.

Carotid Body↗

Patient survival factors in paranasal sinus mucormycosis.

Analysis of 170 cases of paranasal sinus mucormycosis collected from the literature and 9 cases of our own revealed a 50% mortality for this disease. When analyzed according to decade, survival has increased to 70% in the cases reported from 1970-1979. There were no significant differences between the survivors and the fatalities when evaluated according to age, sex, laterality, or radiographic findings. There was a markedly poorer prognosis for those patients with hemiplegia, facial necrosis, and nasal deformity. The underlying disease was an important determinant of survival: 75% of patients with no systemic disease, 60% of diabetics, and 20% of patients with other disorders survived. Surgical debridement or radical resection and the use of amphotericin B significantly increased survival. Their combination further enhanced survival, especially in the diabetic.

Adolescent↗

Double-sliding genioplasty for correction of severe micrognathia.

Profile correction of cosmetically deforming micrognathia in patients with functional occlusion may be attained by the foreshifting of multple horizontal oblique osteotomy segments of the anterior mandible. We discuss the development, limitations, advantages, preoperative evaluation, and surgical technique of this method.

Adult↗