RESUMEN
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.
Asunto(s)
Extremidades/lesiones , Medicina Militar , Guerra , Cicatrización de Heridas , Heridas por Arma de Fuego , Europa (Continente) , Historia del Siglo XX , Humanos , Estados UnidosRESUMEN
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. Neural factors may be responsible for the progressive development of multi-centric lesions within a restricted region of skin (field effect). We recommend investigation of neurogenic influences in human melanoma, particularly with regard to the role of nerve growth factor.
Asunto(s)
Melanoma/patología , Femenino , Humanos , Lentigo/patología , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Factores de Crecimiento Nervioso/fisiología , Luz SolarRESUMEN
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. The differential diagnosis of sebaceous and clear cell lesions of salivary glands is discussed.
Asunto(s)
Carcinoma Basocelular/patología , Neoplasias de la Parótida/patología , Glándulas Sebáceas/patología , Ameloblastoma/diagnóstico , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Parótida/diagnóstico , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Sebáceas/diagnósticoRESUMEN
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.
Asunto(s)
Prótesis Articulares , Articulación Temporomandibular/cirugía , Adolescente , Adulto , Anquilosis/etiología , Anquilosis/cirugía , Artritis/cirugía , Infecciones Bacterianas/prevención & control , Niño , Preescolar , Dicloxacilina/uso terapéutico , Humanos , Masculino , Mandíbula/anomalías , Complicaciones Posoperatorias/cirugía , Radiografía , Infecciones Estafilocócicas/complicaciones , Articulación Temporomandibular/anomalías , Articulación Temporomandibular/diagnóstico por imagenRESUMEN
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. The concept of supplying normal tissue with normal vascularity to the involved area is advocated.
Asunto(s)
Malformaciones Arteriovenosas/terapia , Cabeza/irrigación sanguínea , Cuello/irrigación sanguínea , Adulto , Angiografía , Malformaciones Arteriovenosas/diagnóstico por imagen , Malformaciones Arteriovenosas/cirugía , Niño , Preescolar , Embolización Terapéutica , Humanos , Procedimientos Quirúrgicos Operativos/efectos adversosRESUMEN
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. However, an overcorrection may be necessary if there is much redundant skin. Discretion may indicate the need for a secondary procedure. Lateral wall valving is unusual-but it may occur in the long, high, thin nose (where a suggestion of this action may be observed preoperatively). Maintenance of continuous cartilage along the alar rim, at the time of alar cartilage resection, appears to be important in prevention of postoperative valvular obstruction in these few patients.