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Biomedical subjects

D J Hodgkinson

Publications and source records attributed to D J Hodgkinson.

At least 37 records · Page 2Linked to original sources
PubMed1983

Muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction.

Four cases of forearm defects requiring reconstruction are presented to demonstrate the usefulness of muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction. The forearm is divided into four zones--cubitoolecranon, proximal and middle one-third, distal one-third, and wrist--for purposes of discussing the scope of these different flaps. Muscle flaps are useful for defects in all zones except the distal forearm, where fasciocutaneous flaps are available; however, the superficial forearm muscles and tendons should be included to prevent interference with fascial blood supply.

Adult↗
PubMed1982

Scrotal reconstruction for giant inguinal hernias.

A case of inguinal hernia with massive scrotal enlargement is presented. Walking and voiding had become extremely difficult for the patient; only one testicle could be palpated, and the penis could not be delivered from the scrotal mass. Surgical reduction of the massive hernia was accomplished. The right testis with its spermatic cord had to be sacrificed; the left one was normal, although the cord was elongated. The main bulk of the enlarged scrotum was excised, and a neoscrotum was created from perineal skin; orchiopexy on the left was carried out. Healing has been uneventful.

Aged↗
PubMed1980

Newer applications of the cross-leg flap.

Five recent examples of the cross-leg flap are presented. Its applications and design have been altered and its versatility widened by using muscle. In all cases the use of a Hoffmann apparatus facilitated not only fixation of the flap but also patient comfort, since ropes attached to side-arm rods can be put over pulleys and weights attached to take the strain off potential pressure points. The technetium scan was helpful in determining when flap division should be done. Flaps were rarely in place more than three weeks before division: often, especially in children, division is possible by two weeks. By clamping the flap with a soft clamp and giving an intravenous bolus of fluorescein, circulation can be ascertained unequivocally. Cross-leg flaps remain a useful and highly reliable tool for the reconstruction of difficult wounds of the lower limb.

Adult↗
PubMed1980

Extensor digitorum turn-down muscle flap.

When the extensor digitorum longus--a multisegmentally vascular-supplied muscle--is rotated distally, its origin can be used for covering defects in the lower one-third of the leg. We have used this technique successfully in four consecutive patients, and it has resulted in osteomyelitic cavity obliteration in three and a stable skin coverage in all four.

Adolescent↗
PubMed1980

Extra-adrenal intrathoracic functioning paraganglioma (pheochromocytoma) in childhood.

Extra-adrenal pheochromocytomas are more common in children (30%) than in adults (10%). Of the extra-adrenal sites, the intrathoracic site is the most rare. A 15-year-old boy had a pheochromocytoma successfully removed from the left paraspinal region of his chest. Four years before removal, he had radiation therapy of 3,500 rads to the tumor because of its apparent nonresectability. After therapy, there was transient clinical and biochemical improvement. Preoperative angiography and computed tomography helped define the anatomy of the tumor vessels and the relationship to the thoracic aorta of the tumor. These studies also aided in discounting any other site for the pheochromocytoma, either adrenal or extramedullary. A slow-growing pulmonary metastatic lesion was subsequently identified and successfully excised.

Adrenal Gland Neoplasms↗
PubMed1979

Cutaneous angiosarcoma of the head and neck.

Between 1920 and 1970, 13 patients (7 men and 6 women) with cutaneous angiosarcomas of the head or neck were treated at the Mayo Clinic; the mean age of the patients was 66 years. Three clinical patterns were noted: a superficial spreading type, a nodular type, and an ulcerating type. There were no predisposing benign lesions; however, in one patient, angiosarcoma developed in an area of previously irradiated skin. Three modes of therapy were used: surgery alone, radiation alone, and surgery with postoperative irradiation. Of the 13 patients, 2 survived more than 5 years and 2 were alive within 1 year of therapy. Because cervical lymph node spread is common, lymph node clearance is recommended for patients with lateralized lesion or with palpable lymphadenopathy at presentation.

Aged↗
PubMed1978

Pancreatic cystadenoma. A clinicopathologic study of 45 cases.

Forty-five patients with pancreatic cystadenoma were treated surgically at the Mayo Clinic between 1939 and 1975. Each lesion was classified as mucous or serous. The most frequent lesion site was the tail of the pancreas. The typical patient was a middle-aged woman with upper abdominal pain and a palpable mass on initial examination. Total extirpation of the cystadenoma was the treatment of choice; internal drainage or external drainage of these cysts should not be done. Occasionally, the nearness of the tumors to the mesenteric vessels precluded excision. The mucous type had malignant potential whereas the serous does not. None of the cystadenomas subsequently underwent malignant degeneration. Because of the slow-growing characteristics of the tumor, undue operative risks should not be taken.

Adult↗
PubMed1978

Keratocysts of the jaw. Clinicopathologic study of 79 patients.

A study of 79 patients with keratocysts of the jaws revealed that 72% of the cysts were in the mandible, predominantly in the ramus. The most common symptom was a painful swelling in the jaw. Enucleation was used in 69.2% of the cases. The recurrence rate was 39%. Total removal of the lining of the keratocyst is essential to prevent recurrence.

Adolescent↗
PubMed1978

A clinicopathologic study of 21 cases of pancreatic cystadenocarcinoma.

Cystadenocarcinomas are rare tumors of the pancreas. They are half as common as their benign counterpart--the cystadenoma. A review of 21 cases, including eight reported since 1963, revealed that most patients presented with upper abdominal pain and a large palpable upper abdominal mass. All patients had evidence of malignant degeneration occurring in a mucous cystadenoma. None had evidence of a serious cystadenoma. Grading revealed a predominance of low-grade tumors: 20 of the 21 lesions were grade 1 or 2. Cystadenocarcinomas were slightly more frequent in the head of the pancreas. Four patients had metastasis. Complete excision by distal or total pancreatectomy or Whipple pancreaticoduodenectomy is recommended. The five year survival after complete excision is 68%, and for patients with grade 1 lesions, and five year survival is 64%.

Adult↗
PubMed1978

Chemical burns and skin preparation solutions.

Skin preparation burns associated with chemical agents are uncommon. They occur most frequently in those patients placed in the lithotomy position undergoing gynecologic operations, the burn being on the buttocks, and in those undergoing orthopedic operations, the burn being on the extremities and under a tourniquet. Thimerosal has been the most common agent to be implicated. The basic mechanism involves irritation coupled with maceration and pressure--conditions that can cause an acute pressure sore and superficial skin loss. To prevent these burns from occurring, the skin must not be abraded excessively before the final skin preparation solution is applied; the agent should not be allowed to pool and become trapped under the tourniquet or the torso of the patient, and the agent should be allowed to dry before the patient is draped. In our experience, the agent that has been the most effective and the least irritating to the skin during the time it has been used is povidone-iodine.

Adolescent↗