Platysma myocutaneous flap: caveats reexamined.
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Arteries↗
Biomedical subjects
J S May
Publications and source records attributed to J S May.
Temporal bone: three-dimensional CT. Part II. Pathologic alterations.
Three-dimensional (3D) surface renderings were obtained from routine axial computed tomographic (CT) images in 15 patients with a variety of complex temporal bone abnormalities. The 3D CT reformations served as an adjunct to conventional sectional CT examination. While no diagnosis was substantially changed because of the 3D CT images, they did provide a more global perspective in cases of large tumors and fractures and at the postmastoidectomy site. Three-dimensional CT surface reformations are now practical and may be potentially useful for visualizing temporal bone lesions characterized by complex destructive change.
Adolescent↗
Temporal bone: three-dimensional CT. Part I. Normal anatomy, techniques, and limitations.
Three-dimensional (3D) surface renderings of the temporal bone were created from routine axial computed tomographic (CT) images in 15 subjects and in cadaver specimens. The displayed anatomy was correlated with these specimens, as well as with images from the routine study. Six sets of viewing angles were derived for optimal display of surgically important surface landmarks, such as the suprameatal triangle and supramastoid crest. The 3D CT images were found to be of excellent quality and permitted a global view of the temporal bone surface anatomy. Bone depletion artifacts ("pseudoforamina") posed a potentially serious problem in evaluating the tegmen and wall of the sigmoid sulcus, being present in eight of 20 cases. Three-dimensional CT may be a useful adjunct to routine temporal bone imaging.
Humans↗
Expression and function of HLA-A2.1 in transgenic mice.
We have derived a number of transgenic mouse lines which express the human major histocompatibility complex class I gene HLA-A2.1. Two lines carry the complete human HLA-A2.1, the others bear a recombinant gene in which the HLA-A2.1 coding regions are fused to the H-2Kb promoter. Analysis of transgenic spleen cells by immunofluorescence demonstrates that these mouse cells express HLA-A2.1 on their surface in association with mouse beta 2-microglobulin (beta 2m), confirming that HLA-A2 does not require human beta 2m to be expressed at the cell surface. The cells contain more HLA mRNA than endogenous H-2 class I mRNA. There is also a large pool of non-beta 2m-associated HLA heavy chain inside the cell. In contrast the amount of HLA:beta 2m complex is low. Thus, in transgenic mice HLA-A2 seems to compete poorly with H-2 heavy chains for mouse beta 2m. The HLA-A2.1 transgenic mice do not produce influenza-virus-specific cytotoxic T cells (CTL) restricted to the HLA transgene, at least in sufficient numbers to be measured in a direct bulk CTL assay. The dominance of H-2-restricted clones may be the result of quantitative rather than qualitative factors. However, HLA-A2.1 transgenic spleen cells are effective in stimulating an allogeneic CTL response in normal mice. This response is not H-2 restricted. Cold target inhibition studies show that there are at least two populations of CTL, one of which is specific for HLA-A2.1 on mouse cells. This result suggests that at least some allo-CTL are directed against major histocompatibility complex plus "self-peptide".
Animals↗
Postoperative hypertension associated with radical neck dissection.
The incidence of hypertension following radical neck dissection was examined in 94 consecutive patients. Nine patients (9.6%) had postoperative blood pressure readings of 200/100 mm Hg or higher (n = 4) or of more than 40 mm Hg systolic and more than 20 mm Hg diastolic above preoperative levels (n = 5); ten patients (10.6%) had blood pressure readings of more than 40 mm Hg systolic or more than 20 mm Hg diastolic above preoperative levels. These elevations usually occurred in the first two postoperative hours and lasted approximately nine hours. Six patients required interventional therapy (intravenous nitroglycerin or sodium nitroprusside). No cardiac or central nervous system sequelae resulted, but two patients had postoperative hemorrhage and flap elevation by hematoma attributed to the hypertension. Carotid sinus denervation during radical neck dissection may be the cause of the reflex hypertension once general anesthesia-induced vasodilation has ended. Stripping of tumor from the carotid artery or placement of dermis grafts directly on the artery do not appear to influence postoperative development of hypertension.
Carotid Arteries↗
Frey's syndrome: treatment with topical glycopyrrolate.
Gustatory sweating and flushing of the facial skin, or Frey's syndrome, is fairly common after parotidectomy. The most likely mechanism is aberrant reinnervation of the sweat glands of the face by the severed parotid parasympathetic nerve fibers. A survey of 61 patients having undergone parotidectomy yielded 29 (47.5%) with gustatory sweating. Twenty-three percent (14 patients) considered the symptoms severe. In a double-blind study, five of those 14 patients were alternately treated with topically applied placebo and with glycopyrrolate (an anticholinergic agent) as 0.5% lotion, 2% lotion, and 2% cream. All five patients showed some improvement with the test preparations, but had longer lasting and more effective lessening of symptoms with the 2% glycopyrrolate preparations. There were no adverse side effects. We therefore believe that the topical application of a 2% glycopyrrolate preparation is a safe and effective treatment for severe gustatory sweating following parotidectomy.
Administration, Topical↗