Craniofacial coverage using the latissimus dorsi myocutaneous island flap.

The latissimus dorsi myocutaneous island flap adds a new dimension to head and neck reconstruction. With it, massive defects of the neck, face, and cranium can be covered in a single-stage procedure.

Reconstruction of the breast following mastectomy.

The experience with 300 reconstructions after mastectomy over a ten year period is reported. The whole reconstruction was performed in one stage, including latissimus dorsi flap, volume replacement by a double lumen prosthesis and nipple-areola reconstruction. In 50% of the cases adjustment of the opposite breast has been necessary to achieve symmetry.

Vascular considerations in the use of a latissimus dorsi myocutaneous flap after a mastectomy with an axillary dissection.

Is an intact thoracodorsal vascular pedicle necessary for clinical rotation of a latissimus dorsi myocutaneous flap? Our laboratory and clinical experiences indicate that it is not necessary. These are described herein.

Distal digital nerve grafts: clinical and anatomical studies.

An anatomical study of the terminal branches of the digital nerves of thumb and finger indicated a constant trifurcation at the level of the distal interphalangeal joint. Twelve microscopic interfascicular nerve grafts were done in 11 patients who had nerve division at this level with insensitive fingertips. All patients exhibited improved sensibility.

Reduction mammaplasty: a technique to achieve the conical breast.

Conceptualization of the problem in reduction of the large breast is defined. A technique for reduction mammaplasty is presented based on: (1) the Wise-type pattern, (2) wide undermining of skin flaps with definitive sculpting of the breast parenchyma, and (3) utilization of hypotensive anesthesia. A series of 63 patients is presented in which this technique was utilized.

Gracilis myocutaneous flap in reconstruction of the vulva and female perineum.

For the past 2 decades there has been a definite trend among pelvic surgeons to immediately reconstruct the large defects created by deforming radical cancer surgery in the female pelvis and perineum. Extensive en bloc removal of more tissue has enhanced the probabilities of increased 5-year survival. At the same time, however, the quality of life following radical surgery has been of great concern to both patient and surgeon.

Multiple digital glomus tumors.

In 28 patients with glomus tumors of the digits, 21 were relieved of symptoms by excision of a solitary tumor. Seven other patients had multiple tumors, four of which were the cause of recurrent symptoms. Three patients had multiple tumors--five in one patient, four in another, and two in a third, which had been found at the time of the first operation.

Aneurysms after microvascular anastomoses. Incidence and pathogenesis in experimental animals.

This study has demonstrated that aneurysms occur in about 50 percent of the rat femoral arteries subjected to microvascular anastomosis. These aneurysms are consistent histologically--being characterized by medial necrosis, loss of elastic lamellae, and subintimal hyperplasia. Mechanical trauma is implicated as a factor in their pathogenesis, though further study in necessary to define the exact etiology.

Management of compound injuries of the lower extremity.

The reconstructive surgeon experienced in the use of rotated or free muscle and myocutaneous flaps, skilled in microvascular surgery, and interested in lower extremity trauma, may favorably alter the course of management of these historically difficult problems. It can be of great advantage to the patient if this surgeon is involved in the primary evaluation, so that all initial therapy can be performed with the future reconstructive goals in mind.

Primary selective deficiency of immunoglobulin M.

Selective deficiency of IgM as a primary disorder is seldom encountered1--3, and the syndrome remains ill-defined4. It is generally accepted that for a diagnosis to be made, the serum IgM level should be consistently below 2 SD of normal, no other immunodeficiencies are present, and it is not secondary to other disease processes4. This report of an additional case may provide further insight into this rare disease.

Herpes simplex encephalitis: treatment with adenine arabinoside and cytosine arabinoside.

A series of three infants with herpes simplex encephalitis is reported, together with details of treatment with adenine arabinoside and cytosine arabinoside. The former appears to be the most effective treatment available. A more aggressive approach is urged in the diagnosis and treatment of this serious infantile disorder.

Urinary content of 3',5'-adenosine monophosphate (cAMP) and creatinine in full-term and premature infants.

Cyclic 3',5'-monophosphate (c-AMP) and creatinine were measured in full-term and premature infants. In normals, values for c-AMP were highest on days 1 and 2 (1.3-1.

Experimental delayed union of the dog tibia and its use in assessing the effect of an electrical bone growth stimulator.

A technique has been described for the consistent production of delayed bone healing of the tibia in an animal model. A controlled double blind trial, where independent observors did not know the coding of the stimulators and did not collaborate with each other, has evaluated the use of a direct current bone growth stimulator in such an animal model. The conclusion of the experiment is that this commercially available direct current stimulator does produce a significant acceleration of bone healing at 4 weeks in the experimental model used.

Electrical bone-growth stimulation in an experimental model of delayed union.

An experimental model has been devised for the consistent production of delayed bone healing of the tibia in adult dogs. A double-blind trial, with bias eliminated, was used to evaluate the use of a commercially available direct-current bone-growth stimulator with this model. The stimulator produced a statistically significant acceleration of bone healing at four weeks in the experimental model.

High resolution proton magnetic resonance spectral characteristics of water, lipid, and protein signals from three mouse cell populations.

The high resolution proton magnetic resonance spectral properties of three C57BL/6J mouse cell populations (EL4 ascites tumor cells, normal spleen leukocytes, and normal erythrocytes) were investigated. Packed cell pellets were investigated at 100 MHz and 13.56 MHz.

Substrate dependence of cell migration from explanted neural tubes in vitro.

Embryonic chick neural tubes containing neural crest cells were cultured in vitro on tissue culture plastic and collagen. Two parameters, the time of onset of cell migration from the neural tube and the rate of movement of the cell front away from the neural tube explant, were determined. On collagen, cell migration consistently began after four to six h in vitro, about five h prior to the onset of cell migration on tissue culture plastic.

The effects of 3-hydrazine-6[N,N-bis(2-hydroxyethyl)-amino]-pyridazine dihydrochloride (L6150) on the general and cardiac haemodynamics of the intact dog.

1. The effects of 3-hydrazine-6[N,N-bis(2-hydroxyethyl)amino]-pyridazine dihydrochloride (L6150) were studied in intact anaesthetized dogs. 2.