Melanoma of the ear: results of a cartilage-sparing approach to resection.

Melanoma of the ear is often treated by composite resection of the skin and cartilage and, occasionally, by total auriculectomy. This review analyzes the oncologic, functional, and esthetic results of cartilage-sparing wide local excision for melanoma of the ear. This retrospective study reviewed patients with ear melanoma treated between 1997 and 2002.

The role of lymphatic mapping and sentinel lymph node biopsy in the staging and treatment of melanoma.

The incidence of malignant melanoma is increasing at an alarming rate, doubling in women and growing by more 300% in men during the past 25 years. The importance of diagnosing nodal metastatic disease, with the ability to detect smaller and smaller volumes of tumor in the sentinel lymph nodes (SLNs) biopsied using immunohistochemical staining, has impacted the accurate staging and stratification of melanoma patients. The role that elective lymph node dissection now plays in staging the melanoma patient and determining subsequent treatment has been greatly diminished in favor of less morbid and less invasive techniques that have a higher degree of accuracy in detecting occult nodal disease.

Electrically stimulated rectus abdominis muscle flap to achieve enterostomal continence: development of a functional canine model.

Background: Dynamic myoplasty has many clinical applications and has proven to be a versatile surgical procedure with great promise. This procedure has been used to achieve fecal/urinary continence, as in the dynamic graciloplasty, and to augment cardiac ventricular function, as is commonly seen with dynamic latissimus cardiomyoplasty. In the present study, the authors describe a functional innovative island flap sphincter created from the rectus abdominis muscle in a large-animal model to provide stomal continence for future clinical studies.

The acute and delayed effects of hydrostatic dilation on rat femoral arteries.

The technique of intraoperative vessel dilation is sometimes used to facilitate microvascular anastomosis and prevent vasospasm. Although this technique is not new, its application has not gained widespread acceptance mainly due to concerns raised about potential damage to the vessels acutely and during the postoperative period, leading to decreased vessel patency. The goal of this study was to determine the acute and delayed histologic effects of hydrostatic dilation on rat femoral arteries and to compare the response of dilated arteries to vasodilating and vasoconstricting agents.

Lymphadenectomy prior to rat hind limb allotransplantation prevents graft-versus-host disease in chimeric hosts.

In previous rat studies, the use of mixed allogeneic chimerism (MAC) to induce host tolerance to hind limb allografts has resulted in severe graft-versus-host disease (GVHD). The purpose of this study was to determine if immunocompetent cells in bone marrow (BM) and/or lymph nodes (LNs) of transplanted limbs were responsible for inducing GVHD in mixed chimeric hosts. [ACI-->Wistar Furth] chimeric rats received ACI hind limbs that were non-irradiated, irradiated (1050 cGy) or lymphadenectomized.

Incidence of nonlocalization of sentinel lymph nodes using preoperative lymphoscintigraphy in 74 consecutive head and neck melanoma and Merkel cell carcinoma patients.

Introduction: Lymphatic drainage pathways in the head and neck region are more variable than in any other location of the body. Occasionally, head and neck lymphoscintograms fail to identify a definitive lymphatic drainage pattern, making preoperative and intraoperative identification of sentinel nodes very difficult. The purpose of this study was to determine the incidence of nonlocalization on lymphoscintigraphy of sentinel nodes in patients with head and neck cutaneous malignancies.

Sentinel lymph node biopsy for head and neck melanomas.

Background: Sentinel lymph node (SLN) biopsy for head and neck (H&N) melanomas may be more technically challenging compared with other locations because of complex lymphatic drainage patterns. This analysis was performed to compare the results of SLN biopsy for H&N, truncal, and extremity melanomas.

Methods: The Sunbelt Melanoma Trial includes patients aged 18 to 70 with melanomas > or = 1.

Preconditioning of latissimus dorsi muscle flaps with monophosphoryl lipid a.

The use of dynamic myoplasty to restore function to failing organs is an exciting new application of skeletal muscle flaps. A complication of large flap elevation that can compromise flap function is ischemia-induced necrosis; one approach to minimizing this is to pretreat tissues with ischemic preconditioning. The purpose of this study was to determine whether systemic administration of monophosphoryl lipid A, a drug known to mimic late-phase ischemic preconditioning in the heart, could reduce ischemia-induced necrosis in latissimus dorsi muscle flaps.

Analysis of fiber type transformation and histology in chronic electrically stimulated canine rectus abdominis muscle island-flap stomal sphincters.

Dynamic skeletal muscle flaps are designed to perform a specific functional task through contraction and relaxation of their muscle fibers. The most commonly used dynamic skeletal flaps today are for cardiomyoplasty and anal or urinary myoplasty. Low-frequency chronic stimulation of these flaps enables them to use their intrinsic energy stores in a more efficient manner through aerobic metabolic pathways for increased endurance and improved work capacity.

Successful treatment of 19 consecutive groin lymphoceles with the assistance of intraoperative lymphatic mapping.

Postoperative groin lymphoceles that fail to resolve spontaneously or with interventional therapy present a formidable problem that is associated with a high degree of morbidity. Numerous interventional methods and operative techniques have been described to treat these fluid collections, yet recurrence rates remain high. The use of lymphatic mapping has gained widespread use in the treatment of cutaneous malignancies and breast cancer and has been proven effective in delineating the course of lymphatic channels.

Intraoperative lymphatic mapping to treat groin lymphorrhea complicating an elective medial thigh lift.

Groin lymphoceles and lymphorrhea are a rare complication of medial thigh lift procedures. The author describes a case in which a very thin patient developed groin lymphorrhea after an uncomplicated medial thigh lift procedure. Initial treatment interventions, including edema control and the placement of a drain with surgical exploration, failed to control the lymphatic leak.