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Biomedical subjects

A L Shapiro

Publications and source records attributed to A L Shapiro.

At least 19 recordsLinked to original sources
PubMed2001

Growth induced magnetic and chemical anisotropy in CoPt3 alloy films.

We report the results of polarized Co EXAFS experiments on a series of CoPt3 films grown by molecular beam epitaxy on (100) MgO singe crystal substrates over a range of temperatures from 473 K to 1073 K. These samples exhibit substantial perpendicular magnetic anisotropy that is strongly dependent on the substrate growth temperature Tg. We measure a preference for in-plane Co-Co pairs that is correlated with the magnetic properties.

Journal Article↗
PubMed1996

Effects of intraoperative tissue expansion and skin flaps on wound closing tensions.

OBJECTIVE: To evaluate the effect on wound closing tension of acute tissue expansion combined with development of a rectangular flap compared with simple undermining with rectangular flap development. DESIGN: Wound closing tensions of 30 acutely expanded skin sites and 30 matched undermined sites were compared after development of rectangular flaps. Analysis of covariance was used to determine statistical significance. SUBJECTS: Ten domestic piglets. RESULTS: When mean values of wound closing tension for the expanded rectangular flap were compared with those of the undermined rectangular flap a significant difference was found at the intermediate points along the curve for tension vs length of skin stretch. CONCLUSION: For small lesions, acute tissue expansion in conjunction with the use of a rectangular flap results in decreased wound closing tensions when compared with simple undermining with the use of a flap.

Animals↗
PubMed1995

Long-term nasal mucosal tissue expansion use in repair of large nasoseptal perforations.

Reperforation rates of large, surgically closed nasoseptal perforations remain unacceptably high (30% to 70%). With the advent of newer surgical techniques, including external decortication rhinoplasty and midface degloving, excellent exposure of the intranasal anatomy is afforded. The limiting factor of these approaches is the deficiency of local intranasal mucosal lining, which is used to close large septal perforations. The paucity of nasal mucosal lining results in excessive tension on the perforation closure suture line that leads to distal flap ischemia, anastomosis breakdown and, ultimately, reperforation of the septum. Alternatively, using intraoral mucosal flaps of sufficient length and width to close large perforations results in significant and unacceptable donor-site morbidity. We present our technique of harvesting additional local endonasal mucosa using long-term soft-tissue expanders. Long-term nasal mucosal expansion was used in the closure of large septal perforations in five patients. Complications included one case of expander exposure and the morbidity of prefacial expander injections. Total closure of all five septal perforations was documented at the 1-year postsurgical visit. Histologic and electron-microscopic examinations of the expanded nasal floor mucosa are presented.

Collagen↗
PubMed1994

Otoplasty using the postauricular skin flap technique.

OBJECTIVE: To evaluate the efficacy of the postauricular skin flap technique in otoplasty. DESIGN: We conducted a case series study of 25 patients who underwent bilateral otoplasty for prominent ears over a 4-year period. Follow-up ranged from 6 months to 4 years. SETTING: Academic tertiary care referral center. PATIENTS: Twenty-five patients with congenitally prominent bilateral ears, aged 5 to 38 years of age. INTERVENTION: Cartilage-sparing otoplasties were performed with access using the postauricular skin flap technique. The specifics of cartilage correction were determined by the surgeon based on the patients' anatomic deformity. OUTCOME MEASURE: Clinically noted aesthetic results, complications, and patient satisfaction. RESULTS: No complications, such as hypertrophic scarring, keloid formation, scar migration, ear deformity, or obliteration of the postauricular sulcus, were noted. Patient satisfaction with the procedure was generally high. CONCLUSION: We conclude that the postauricular skin flap approach to otoplasty is safe, provides excellent exposure, is amenable to most cartilage surgical techniques, and is a valuable addition to otoplasty techniques.

Adolescent↗
PubMed1994

Outer table graft in middle fossa surgery.

We describe a surgical technique in which the middle fossa craniotomy ordinarily used for facial nerve decompression and related surgery is extended superiorly to allow the harvest of a split-thickness calvarial graft. This graft allows the tegmen defect in middle fossa surgery to be repaired without shortening the original craniotomy plate. Avoiding the usual temporoparietal depression after middle cranial fossa surgery is both a structural and cosmetic benefit for the patient.

Adult↗
PubMed1992

Aesthetic reconstruction of the platyrrhine nose.

The platyrrhine nose is characterized by a hypoplastic nonprojected nasal tip, wide flaring alae, underdeveloped premaxilla, and lack of nasal dorsal support. Aesthetic nasal reconstruction is performed utilizing the external rhinoplasty technique. Precise placement of nasal augmentation grafts is facilitated by this technique. The harvesting and utilization of a large autogenous nasal fibrofatty graft for finesse dorsal contouring is described. Seventy-five patients underwent aesthetic reconstruction of the platyrrhine nose. Follow-up ranged from 2 to 7 years. No major complications, including extrusion or significant resorption of augmentation grafts, have been observed. Minor complications included notching of the transverse columella incision in 5% (4/75) of cases, observable suture tract marks along the alar closure incision in 4% (3/75) of cases, and alar incision granuloma in 1% (1/75). A modification of our technique, utilizing a two-layer tension-free closure of the columella and alar incisions, has alleviated these complications.

Asian People↗
PubMed1992

Head and neck lymphoma in patients with the acquired immune deficiency syndrome.

A marked increase has recently been noted in the incidence of lymphoma in patients with AIDS. These lymphomas are generally high-grade, of B-cell origin, and often involve extranodal sites. Reported here are twenty patients with AIDS in whom symptoms and physical findings developed related to the head and neck region as a result of lymphoma. The tumor was observed in a variety of sites, including the nasopharynx, orbit, submandibular triangle, anterior and posterior cervical triangles, supraclavicular fossa, and the hypopharynx. Sixteen tumors were large cell nonHodgkin's B-cell lymphomas, three were small cell nonHodgkin's B-cell lymphomas, and one was Hodgkin's disease, mixed cellularity. All were treated with combination chemotherapy. A high degree of suspicion for lymphoma is required in treating any patient with AIDS who has a rapidly enlarging mass in the head and neck. If needle aspiration is nondiagnostic, excisional biopsy should be performed after a complete head and neck evaluation. Although the development of lymphoma associated with AIDS portends a grave prognosis, prompt diagnosis will allow an improved chance of remission of the lymphoma.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Fine-needle aspiration of diffuse cervical lymphadenopathy in patients with acquired immunodeficiency syndrome.

Although diffuse cervical lymphadenopathy is one of the earliest and most common findings in patients with AIDS, the appropriate diagnostic approach in these patients has yet to be determined. Fine-needle aspiration (FNA) was performed on 26 patients with AIDS in order to evaluate the role of FNA in patients with diffuse cervical adenopathy. Specimens were sent for cytology, bacterial culture, fungal culture, and acid-fast smear and culture. Ten patients had positive findings, including toxoplasmosis, histoplasmosis, tuberculosis, atypical mycobacterium, and methicillin-resistant staphylococcal infection. All patients with either unilateral adenopathy or lymph nodes 3 cm or larger had positive aspirates. A statistically significant difference between patients with lymph nodes smaller than 2 cm and those with nodes larger than 2 cm was found. Fine-needle aspiration of a representative node in patients with AIDS may allow prompt diagnosis of diffuse lymphadenopathy. Rapid initiation of appropriate treatment can lead to symptomatic improvement. The need for excisional biopsy of involved lymph nodes may be obviated. Fine-needle aspiration is recommended as a diagnostic tool in selected patients with diffuse cervical lymphadenopathy and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Direct endolymphatic administration of antitubercular drugs in patients with inflammatory diseases of the urogenital organs].

Direct endolymphatic administration of broad-spectrum antibiotics was used in treatment of approximately 21 patients with complicated urogenital tuberculosis. The duration of the endolymphatic therapy ranged from 3 to 13 days. In the patients treated with endolymphatic administration of the antibiotics the effects were favourable. The use of the procedure were shown expedient because marked lesions in the urinary tracts, frequent chronic renal failure and the microbial flora resistance to the drugs lowered the efficacy of the treatment with the routine administration of the drugs. The drugs used i.e. klaforan and gentamicin were approved by the USSR Pharmacological Committee. The drugs were administered with dosator NDL-3 in original modification which provided continuous polycollector endolymphatic antibiotic therapy with simultaneous lavage of the lymphatic channel. It was shown expedient to use endolymphatic administration of antibiotics in treatment of complicated urogenital tuberculosis alone or in combination with the preoperative procedures.

Antitubercular Agents↗
PubMed1983

Successful management of severe paraquat poisoning.

A case of paraquat poisoning was successfully treated which would have been considered lethal according to a reported prognostic index. Main features in the treatment were removal of paraquat by gastric lavage, forced diuresis, hemodialysis, and charcoal hemoperfusion. Early ventilation with low FIo2 and with positive end-expiratory pressure (PEEP) were also utilized.

Charcoal↗