Surgical Treatment of Advanced Lymphatic Filariasis of Lower Extremity Combining Vascularized Lymph Node Transfer and Excisional Procedures.

Lymphatic filariasis (LF) in advanced stage is a clinically challenging disability resulting in poor quality of life. In advanced stage of filariasis, medical management is seldom effective and few surgical procedures are beneficial. In this study, we assessed clinical efficacy of a surgical technique combining vascularized lymph node transfer (VLNT) and serial excision for patients affected by advanced LF.

Hedgehog Pathway Inhibitors and Their Utility in Basal Cell Carcinoma: A Comprehensive Review of Current Evidence.

Basal cell carcinoma (BCC) is the most commonly diagnosed malignancy in humans, and as such it poses a significant healthcare burden. The majority of BCC cases are amenable to cure by surgical extirpation. However, until recently there have been no good treatment options for a significant minority of advanced BCC cases, including locally advanced BCC and metastatic BCC.

Submillimeter Diameter Poly(Vinyl Alcohol) Vascular Graft Patency in Rabbit Model.

Microvascular surgery is becoming a prevalent surgical practice. Replantation, hand reconstruction, orthopedic, and free tissue transfer procedures all rely on microvascular surgery for the repair of venous and arterial defects at the millimeter and submillimeter levels. Often, a vascular graft is required for the procedure as a means to bridge the gap between native arteries.

The laparoscopic right gastroepiploic lymph node flap transfer for upper and lower limb lymphedema: Technique and outcomes.

Background: Lymph node flap transfer popularity for treatment of extremity lymphedema is increasing quickly. Multiple flap donor sites were described in search of the optimal one. We describe the technique and outcomes of a laparoscopically harvested right gastroepiploic lymph node flap for treatment of extremity lymphedema.

Free lymph node flap transfer and laser-assisted liposuction: a combined technique for the treatment of moderate upper limb lymphedema.

Upper limb lymphedema following breast cancer surgery is a challenging problem for the surgeon. Lymphatico-venous or lymphatico-lymphatic anastomoses have been used to restore the continuity of the lymphatic system, offering a degree of improvement. Long-term review indicates that lumen obliteration and occlusion at the anastomosis level commonly occurs with time as a result of elevated venous pressure.

End-to-patch anastomosis for microvascular transfer of free flaps with small pedicle.

Background: Although perforator-to-perforator anastomosis in supermicrosurgery may be used in transferring free flaps with small vessels, it is still difficult in certain situations that include potentially infected wounds. Moreover, it is limited to smaller flaps. Anastomosis of large vessels is still safer for transfer of a large flap for most surgeons.

Sling suspension using the anterior third of the temporalis muscle extended with tendon graft to correct oral incontinence after free flap reconstruction in cases of a major defect of the lower lip muscle.

Background: Oral incontinence is a common complication after free flap reconstruction after ablation of oral cancers. The postoperative incontinence was corrected with strong suspension to the temporalis muscle in cases of major or total defect of lower lip muscles.

Methods: Eight patients with oral cancer with previous skin flaps for reconstruction of the lower lip had incontinence because of major or total loss of the lower lip muscle.

Reconstruction after orbital exenteration using gracilis muscle free flap.

Background: Orbital exenteration (OE) is a disfiguring procedure, which typically includes the removal of the entire eyeball including the globe, extraocular muscles, and periorbital soft tissues after malignancies excision or trauma. Several methods of orbital reconstruction have been attempted with varying success. In this report, we analyze results of the use of gracilis muscle free flap for reconstruction of OE defects and its feasibility for prosthetic rehabilitation.

Maxillary artery injury associated with subcondylar mandible fractures: a novel treatment algorithm.

Mandible fractures commonly occur in patients who have sustained blunt facial trauma, and the subcondylar region is the most frequently fractured due to its intrinsic biomechanical weakness. The maxillary artery lies in close relation to the medial cortex of the subcondyle and is vulnerable to injury by the sharp edges of the fracture fragments during the initial trauma or during operative fracture reduction. Maxillary artery injuries and subcondylar fractures may be an underdiagnosed phenomenon.

Infraorbital nerve schwannoma presenting as an upper lip mass in an adolescent boy.

Background: Schwannomas of the head and neck are uncommon tumors that arise from the nerve sheath and may afflict peripheral, autonomic, or cranial nerves. It is important to consider the possible differential diagnoses of a nasolabial lump in a child because its appropriate treatment varies widely.

Methods: The authors describe a case of a 12-year-old boy who presented with a 2.

Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm.

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.

The kidney dish as a template for titanium mesh contouring in supraorbital rim fractures: a simple and effective method.

The supraorbital rims are an integral part of facial esthetics and fractures to this region can result in obvious cosmetic deformities. When there is significant bone loss, using titanium mesh is an effective method of reconstructing the supraorbital rim. Conventional methods of contouring the rim include polyurethane skull models, customized implants, and free-form intraoperative bending of the mesh.

Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome.

Background: Tumors arising from the esophagogastric junction (OGJ) are increasing in incidence in the west, but data from Asian populations are conflicting. Singapore has a mixed-Asian population with an international lifestyle. This study was designed to examine the changing trends in incidence of gastric cardia cancer (type III) within this population and to compare the clinicopathological characteristics and outcome of these tumors with gastric tumors.

Distance health services under the general agreement on trade in services.

This Article discusses the state of distance health with respect to the General Agreement on Trade in Services (GATS). After examining the various aspects of telemedicine and its place in international trade, the author looks at the structure and functioning of GATS and how telemedicine is regulated under this agreement. The author argues that the potential for telemedicine under this agreement has yet to be fulfilled and suggests a number of ways to realize its potential.