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Biomedical subjects

Y Ramon

Publications and source records attributed to Y Ramon.

At least 37 records · Page 2Linked to original sources

Treatment of necrobiosis lipoidica diabeticorum by hyperbaric oxygen.

Necrobiosis lipoidica diabeticorum is a chronic cutaneous complication of diabetes mellitus with microangiopathy as an important pathophysiologic factor. Because of the known success of hyperbaric oxygen in the treatment of chronic non-healing wounds, we used this mode of therapy to treat a diabetic patient with ulcerated necrobiosis lipoidica of 7 years' duration, refractory to medical and surgical treatment. The patient received daily sessions of hyperbaric oxygen therapy. There was considerable improvement during the course of the treatment, with complete closure of all the ulcerations after 98 sessions. The success of this treatment emphasizes the role of hypoxia in the pathogenesis of the lesion. This simple and safe treatment method may be a good solution for patients with chronic nonhealing necrobiosis lipoidica which fails to respond to other therapeutic approaches.

Adult

[Immediate breast reconstruction with tissue expander].

The technique of immediate breast reconstruction, using the tissue expander and replacing it with a permanent silicone prosthesis, has been applied with increasing frequency during the past several years. We chose this technique for immediate breast reconstruction because of its simplicity, rapidity when combined with mastectomy, and good esthetic results. We have performed 29 immediate breast reconstructions in the past 1.5 years in patients ranging from 22 to 72 years (mean 47). The insertion of the tissue expander added only 20-30 minutes of operating time for the mastectomy, and did not prolong hospitalization. Before we began to replace the expander with a permanent silicone prosthesis there were complications in 4 patients (14%). These included development of a seroma in 3, 1 of which became infected 40 days after insertion of the tissue expander, and capsular contraction in a patient who had previously had radiotherapy to her breast. The case with the infection was the only failure and the expander had to be removed. Immediate reconstruction of the breast is easily performed and can be of tremendous psychological benefit to mastectomy patients. Chemotherapy or radiotherapy are not contraindications to this type of reconstruction.

Adult

Kaposi's sarcoma in immunosuppression. Possibly the result of a dual viral infection.

Kaposi's sarcoma of the gingiva and skin developed in an HIV-negative renal transplant patient while he was receiving cyclosporine therapy. The Kaposi's sarcoma developed shortly after the patient had an acute infection with cytomegalovirus (CMV). Electron microscopy of the tumor's established cell line showed two types of virus-like particles. CMV DNA was identifiable in the cell line whereas infectious CMV could be isolated only after repeated passages (only after 3 months of culture). The other virus could not be identified, but did not appear to be either HIV or papilloma virus. The patient's tumor regressed after the discontinuation of cyclosporine therapy and the recovery from the acute CMV infection.

Adult

The management of exposed cardiac pacemaker pulse generator and electrode using restricted local surgical interventions; subcapsular relocation and vertical-to-horizontal bow transposition techniques.

This paper describes an approach to the treatment of exposed pacemaker generator and electrode. Local infection is controlled by the administration of systemic antibiotics and topical antibacterial solutions. Because the generator and lead are enveloped by an inert synthetic coating, it is possible to eradicate an infection without their removal if it is due to a weak opportunist pathogen fully sensitive to antibiotics. Thereafter, subcapsular relocation of the exposed generator or vertical-to-horizontal transposition of the exteriorised lead is carried out. These surgical interventions are designed to overcome the vertical force which tends to cause the extrusion of the pacing hardware.

Aged

Reconstruction of the maxilla with bone grafts supported by the buccal fat pad.

In the usual reconstruction of maxillary contour, the grafts are usually exposed to the antral or nasal cavities. This leads to postponed remodelling and a higher rate of resorption and sequestration. To avoid exposure of the grafts, the buccal fat pad is rotated into the maxillary sinus and lined to the bone grafts. The vascularized buccal fat pad not only contributes to a better integration of the bone grafts but also enables the restoration of normal physiologic function of the maxillary sinus.

Adipose Tissue

Mandibular condylosis and apertognathia as presenting symptoms in progressive systemic sclerosis (scleroderma). Pattern of mandibular bony lesions and atrophy of masticatory muscles in PSS, presumably caused by affected muscular arteries.

Apertognathia (open bite) is usually a developmental deformity of the jaws and the dentoalveolar segments in childhood and adolescence. The sudden insidious appearance of an open anterior bite in adult life is extremely rare and may be due to pathologic condylar fractures (with displacement) or to bilateral condylosis. To the best of our knowledge, only five cases of bilateral mandibular condylosis in progressive systemic sclerosis (PSS) have been reported in the literature, and the present article deals with the sixth known case. In the 22-year-old woman presented in this article the mandibular manifestations were the very early symptoms of PSS, which had a very rapid fatal course. A review of the literature is presented, and attention is called to the serious significance of sudden apertognathia. PSS is a chronic generalized disease of the small arterial vessels and the mesenchyme tissues of unknown origin. The musculoskeletal system is often involved, and the disease may affect the mandible, causing bony erosions, osteolysis, and atrophy of the masticatory muscles. It is believed that these bony lesions are of ischemic origin. The lesions, which are usually bilateral, occur only in the condyles, the coronoid processes, and the gonial angles. The main arterial blood supply to the mandible and to the major part of the ascending ramus originates from the inferior alveolar artery. The blood supply of the condyles, the coronoid processes, and the gonial angles originates in small muscular arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Indirect cervical lymphoscintigraphy in healthy subjects via submucosal cheek injections.

A new method of cervical lymphoscintigraphy is presented. It was performed on 16 healthy individuals via bilateral submucosal cheek injections with 99mTc-rhenium-sulfide-colloid. The ipsilateral uptake by the lymphatics on each side of the neck was consistently demonstrated in 15 subjects and allowed a comparative evaluation of the cervical lymphatic chains, including the submental, submandibular, jugulo-digastric and jugulo-omohyoid. The transverse cervical chain was demonstrated in 10 of 16 subjects. The method is simple, reliable and capable of clearly visualizing the lymphatic drainage of the oral cavity.

Adult

Idiopathic submandibular abscesses in children.

Idiopathic submandibular abscesses are often observed in young children and the report concerns 31 children treated over a period of 3 years. Their origin is unknown. As all these abscesses were lymph node abscesses in the submandibular region, it is assumed that they are due to minor oral and nasal cavity traumatic lesions secondarily infected. Antibiotic treatment and surgical drainage resulted in quick resolution and recurrences were never observed.

Abscess

Accidental displacement of impacted maxillary third molars.

3 cases of accidental displacement of maxillary impacted 3rd molars are presented. 2 were displaced into the maxillary sinus and 1 into the infratemporal fossa. The difficulties in locating these displaced teeth are described and demonstrated on a dry skull model. The mode of treatment is discussed.

Adult

Gingival hyperplasia caused by nifedipine--a preliminary report.

We observed marked gingival hyperplasia, similar clinically and histologically to the hyperplasia caused by 5:5 sodium diphenylhydantoin (Dilantin) during the last 18 months in five patients treated by nifedipine. Histologically, marked epithelial hyperplasia-acanthosis, with moderate inflammatory reaction in the lamina propria, was observed in all the biopsy specimens. Evidence points to a strong relationship between the gingival hyperplasia and the administration of nifedipine.

Aged

Melanotic neuroectodermal tumor of infancy (pigmented melanoameloblastoma).

The paper describes a large pigmented maxillary tumor in a 46-day-old infant. The histological examination showed the tumor to be a melanotic neuroectodermal tumor of infancy (MNTI). No raised urinary levels of vanilmandelic acid could be shown. The tumor was surgically removed and during a 5 1/2-year follow-up period there was no clinical evidence of recurrence. The origin, behavior and treatment of these rare tumors are discussed.

Female

Chondrosarcoma of the maxilla: report of case.

Chondrosarcomas of the jaws are rare tumors; an additional case in the maxilla is described. The literature that discusses the pathogenesis of the tumor, its biological behavior, and the preferred treatment is reviewed. The histologic differentiation between chondrosarcoma and benign cartilagenous tumors is discussed.

Adult

A large mandibular tumor with a distinct radiological "sun-ray effect" as the primary manifestation of multiple myeloma.

The significant feature of the reported case was that of a sinister-looking mandibular tumor highly suggestive of a metastatic lesion or of osteogenic sarcoma. A biopsy specimen and results of a thorough medical work-up showed the lesion to be multiple myeloma. The myeloma cells apparently have the capability to stimulate osteoblastic activity and new bone formation. This capability should be kept in mind when making the differential diagnosis of osteoblastic bony lesions of the jaws.

Aged