Avoiding free nipple grafts during reduction mammaplasty in patients with gigantomastia.

Excessive breast hypertrophy or gigantomastia (>2000 g excision of tissue per breast) has traditionally been approached with breast amputation and free nipple grafting during reduction mammaplasty procedures. Disadvantages of free nipple grafts include loss of sensation, poor projection, uneven nipple-areolar complex pigmentation, and loss of lactation. We report our experiences utilizing the inferior pedicle technique of reduction mammaplasty with successful preservation of the nipple-areola complex for patients with gigantomastia.

Splenic artery embolization in the management of an acute immune thrombocytopenic purpura-related intracranial hemorrhage.

Although relatively rare, intracranial hemorrhage remains the most common cause of immune thrombocytopenic purpura-related mortality [Medeiros D. Current controversies in the management of idiopathic thrombocytopenic purpura during childhood. Pediatr Clin North Am .

Factors associated with local recurrence of mammographically detected ductal carcinoma in situ in patients given breast-conserving therapy.

Background: The authors reviewed their institution's experience treating patients with mammographically detected ductal carcinoma in situ (DCIS) of the breast with breast-conserving therapy (BCT) to determine 10-year rates of local control and survival and to identify factors associated with local recurrence.

Methods: From January 1980 to December 1993, 132 breasts in 130 patients were treated with BCT for mammographically detected DCIS at William Beaumont Hospital, Royal Oak, Michigan. All patients underwent an excisional biopsy, and 64% were reexcised.

The effect of radiation on an ambulatory chemotherapy infusion pump.

Background: Ambulatory infusion pumps are used to deliver concurrent chemotherapy with pelvic radiation therapy for patients with rectal carcinoma. The pump is worn around the waist and may be exposed to direct as well as scattered radiation, possibly leading to a complete malfunction, requiring a new pump, and/or changes in the pump timing, with clinically significant reductions in chemotherapy administration.

Methods: Two new ambulatory chemotherapy pumps were irradiated using a 6-megavolt linear accelerator.

Cancerization of lobules and atypical ductal hyperplasia adjacent to ductal carcinoma in situ of the breast.

Recurrent carcinoma develops in approximately 10% of patients with ductal carcinoma in situ (DCIS) of the breast treated with local excision and radiation therapy. Cancerization of lobules (COL) and atypical ductal hyperplasia (ADH)frequently occur at the edge of DCIS. We postulated that recurrent carcinoma is associated with ADH or COL near the DCIS excision margin, and the amount of DCIS left in the breast may be too large for eradication by radiation therapy.

The role of regional nodal irradiation in the management of patients with early-stage breast cancer treated with breast-conserving therapy.

Purpose: To determine the incidence of regional nodal failure (RNF) and indications for regional nodal irradiation (RNI) in patients with Stage I and II breast cancer treated with breast-conserving therapy (BCT).

Methods And Materials: Four hundred fifty-six patients with Stage I/II breast cancer were treated with BCT at William Beaumont Hospital. All patients underwent excisional biopsy and 288 (63%) were reexcised.

Ductal carcinoma in situ detected in the mammographic era: an analysis of clinical, pathologic, and treatment-related factors affecting outcome with breast-conserving therapy.

Purpose: We reviewed our institution's experience treating predominantly mammographically detected ductal carcinoma in situ (DCIS) with breast-conserving therapy (BCT) to determine if any clinical, pathologic, or treatment-related factors affected outcome.

Methods And Materials: From January 2, 1980 to January 6, 1992, 107 breasts in 105 patients were treated with BCT at William Beaumont Hospital, Royal Oak, MI. All patients underwent at least an excisional biopsy and 70 patients (65%) were reexcised.

Surgical aspects of autonomic dysreflexia.

Autonomic dysreflexia (AD) is a characteristic syndrome that occurs in spinal cord injury (SCI) patients with lesions above the sympathetic outflow at T6 and rarely in those with lesions below T10. Symptoms are initiated by noxious stimuli below the level of injury which result in massive sympathetic discharges from the isolated cord. These produce what may be called a sympathetic storm manifest by severe life threatening hypertension.

Long-term outcome with interstitial brachytherapy in the management of patients with early-stage breast cancer treated with breast-conserving therapy.

Purpose: We reviewed our institution's experience with interstitial implant boosts to determine their long-term impact on local control and cosmetic results.

Methods And Materials: Between January 1, 1980 and December 31, 1987, 390 women with 400 cases of Stage I and II breast cancer were managed with breast-conserving therapy (BCT) at William Beaumont Hospital. All patients were treated with an excisional biopsy and 253 (63%) underwent reexcision.

Excellent functional outcome in patients with squamous cell carcinoma of the base of tongue treated with external irradiation and interstitial iodine 125 boost.

Background: Local control, functional outcome, and complications in patients with carcinoma of the base of tongue (BOT) were analyzed to assess the impact of interstitial implant boost with I-125 seeds.

Methods: Between December 1986 and May 1995, 16 patients with squamous cell carcinoma of the BOT received treatment at the William Beaumont Hospital and 4 received treatment at the Northern Virginia Cancer Center. The primary tumor classification for this group consisted of T1/T2-11 patients, T3/T4-9 patients.

Cat carotid body: oxygen consumption and other parameters.

Cats were anesthetized with pentobarbital, pump ventilated with air, and given heparin, and the carotid body (CB) was vascularly isolated except for the supplying artery. The CB could be normally blood perfused, or alternatively, perfused with Locke's solution; flow of either could be stopped suddenly. Sinus nerve discharge was measured.

Rare metastasis of primary bronchogenic carcinoma to sigmoid colon: report of a case.

The authors present a case of a rare metastasis of bronchogenic carcinoma to sigmoid colon. Carcinoma of the lung usually spreads locally to adjacent mediastinum or paratracheal lymph nodes via the lymphatics. When tumor invades the pulmonary vein, distal metastases are most often to brain, suprarenal glands, or bones.