Metastatic Melanoma in Sentinel Node-Negative Patients: The Ottawa Experience.

Background: Lymph node involvement is a major independent prognostic factor for survival in patients with malignant melanoma. Sentinel lymph node biopsy (SLNB) detection of microscopic nodal melanoma has been shown to improve both 5-year survival and 5-year disease-free survival.

Objective: To determine the rate of metastatic melanoma in SLNB-negative patients at long-term follow-up.

Canaries in the mineshaft: the dermatology workforce shortage in Eastern Ontario.

Background: The number of dermatology residency positions in Canada has not reflected the growing workforce shortage. Until 2005, all dermatology residents at the University of Ottawa were committed to return to their funding area at the completion of their training. This has left Eastern Ontario with a critical shortage of dermatologists.

Cutis marmorata telangiectatica congenita and neonatal lupus.

Cutis marmorata telangiectatica congenita is an uncommon congenital vascular anomaly that is characterized by persistent, reticulated, violaceous pigmentation. We describe a female infant with vascular lesions consistent with this entity who was born to a mother with previously diagnosed systemic lupus erythematosus. Antinuclear antibodies and anti-Ro/SSA antibodies were detected in both mother and infant, supporting a diagnosis of neonatal lupus.

The interaction between gabapentin and amitriptyline in the rat formalin test after systemic administration.

Unlabelled: We examined the effects of systemically administered gabapentin on flinching and biting/licking behaviors produced by 2.5% formalin in the rat, compared these with those of amitriptyline, and determined the effects of combinations of gabapentin with amitriptyline. Gabapentin produced a dose-related inhibition of Phase 2, but not Phase 1, flinching and biting/licking behaviors.

Peripheral amitriptyline suppresses formalin-induced Fos expression in the rat spinal cord.

Unlabelled: We examined the effects of systemically, spinally, and peripherally administered amitriptyline on formalin-induced Fos immunoreactivity in the lumbar spinal cord. Formalin (2.5%), injected subcutaneously into the rat hindpaw, increased Fos immunoreactivity in laminae I-II, III-IV, and V-VI of the dorsal L5 spinal cord.

Presidential address, 1995. Surgery 2000: a look back to the future.

The present demoralized state of Canadian surgery is due to a number of short-term influences. They include financial restraints, the desire of government agencies to off-load blame for unpopular decisions onto doctors and altered public expectations. The major long-term challenge will be a shortage of physicians and a severe shortage of general surgeons because of the superimposition of longer-term trends in medical demographics on short-term political reactions to a perceived oversupply of doctors.

Splenic vein thrombosis as a cause of variceal bleeding.

Splenic vein thrombosis as a cause of variceal bleeding is underdiagnosed. Newer, noninvasive techniques of diagnosis that have been introduced recently appear to be accurate. Isolated gastric varices in the presence of normal liver function and especially in the presence of pancreatic disease should prompt a search for splenic vein thrombosis.

Thoracic outlet compression.

In a review of his experience with thoracic outlet compression, the author attempts to define factors that will help select patients for operation. Fifty-three patients underwent 59 transaxillary resections of the first rib. In almost all cases the diagnosis was clinical, based mainly on the history.

Early gastric cancer.

Early gastric cancer confined to the mucosa or submucosa, similar to that described in the Japanese literature, exists in Newfoundland, on area of North America in which gastric cancer is four times more prevalent that on the rest of the continent. If untreated, this early gastric cancer will progress to advanced disease. The clinical presentation of 10 patients suffering from cancer confined to the mucosa and submucosa of the stomach is described.

Laceration of superior vena cava due to blunt trauma: successful surgical management.

Injuries of the superior vena cava are usually due to penetrating trauma. Injuries due to blunt trauma are rare. The diagnosis of superior vena caval injuries, which may be intrapericardial or extrapericardial, is usually made retrospectively.

Endoscopic diagnosis of intestinal metaplasia in Canada and Japan.

We carried out comparative studies on chronic atrophic gastritis with accompanying intestinal metaplasia using the methylene blue dye spraying, endoscopic technique on 167 Japanese and 77 Canadian outpatients free of gross stomach disease. In both population samples (Kyoto, Japan and St. John's, Newfoundland) with increasing subject age, the fundic-pyloric (F-P) border shifted cephalad indicating atrophy of the fundic mucosal glands.

Pyogenic psoas abscess secondary to infection of the lumbar disc space.

Two cases of staphylococcol psoas abscess are reported. These occurred many years after operations on lumbar discs, complicated by post-operative disc space infection. Clinical and radiological findings are reported.

Some aspects of wound healing research: a review.

Mammalian response to injury essentially is that of tissue repair and re-epithelialization. The most important component of repair tissue is collagen, and after injury collagen turnover is greatly increased. Collagen biosynthesis is initiated by nuclear DNA of fibroblasts; the steps in biosynthesis are complex but studies of collagen biosynthesis may eventually have clinical potential.