Progress attained in the search for the primary healing of gunshot wounds of the extremities in the ETO in World War II.

Every war offers the opportunity to improve wound healing, applying proved techniques developed since the last conflict. The medical and surgical contributions of World War II, blood transfusions, antibiotics, immunizations and reconstructive procedures, to name a few, allowed wounds to be closed earlier.

Sequential histologic study of evolving lentigo maligna melanoma.

Malignant melanoma has been thought to evolve from junctional proliferation of atypical melanocytes, through a stage characterized by large junctional nests, into an invasive an ultimately metastasizing neoplasm. Sequential histologic study of a case of lentigo maligna melanoma suggested that the tumor progressed by development of more aggressive lesions in adjacent skin, rather than by evolution of preexisting lower-grade lesions. The higher grade of the later-developing lesions may result from greater exposure to carcinogens, perhaps by virtue of greater solar exposure prior to onset.

Sebaceous differentiation in adenoid cystic carcinoma of the parotid gland.

The first reported case of sebaceous differentiation in adenoid cystic carcinoma is presented. The tumor arose in the superficial lobe of the left parotid gland of a 48-year-old white man, had a predominantly solid histologic pattern, and manifested focal sebaceous differentiation in each of three recurrences over a two-year period. Review of the medical literature suggests that sebaceous differentiation is a normal property of some salivary ducts and may be found in any type of salivary gland neoplasm which has a ductal component.

Total prosthetic replacement of the temporomandibular joint.

Twenty-seven patients have been operated on for total replacement of the temporomandibular joint because of ankylosis due to trauma, arthritis, neoplasm, infection, or pain. One prosthesis had to be taken out because of gross infection due to Staphylococcus albus, 2 more were removed for pain and dislocation of the prosthesis, and 1 was removed because of erosion through the skin. The remaining 23 had no complications.

Congenital arteriovenous malformation of the head and neck.

A discussion of congenital arteriovenous malformation of the head and neck based on five patients followed from three to twenty years is presented. Definition of the lesion and its progression as followed by angiography is described. The poor response to surgery is ascribed to the ischemic nature of the area of involvement.

Valvular obstruction of the nasal airway.

Valvular nasal obstruction may occur in the postoperative rhinoplasty patient. One may anticipate a dropping of the tip, from residual redundant or inelastic skin, in some older patients with long noses. Measures to correct (or avoid) this may be undertaken at the time of the primary rhinoplasty.