Optimal cosmetic autogenous reconstruction with modified radical mastectomy.
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Biomedical subjects
Publications and source records attributed to J Sampliner.
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Reconstruction of the breast after modified radical mastectomy can be safely and adequately performed in the subcutaneous plane. Placement of a subcutaneous tissue expander (as either an immediate or a delayed procedure), rapid expansion over a 3- to 4-month period, capsulotomy, and placement of a polyurethane-coated implant have led to satisfactory results over a 6-year period. Breast reconstruction methods are well documented; however, the utilization of expanded subcutaneous chest wall skin has not been reported heretofore.
We have reexamined the subcutaneous route of reconstruction of the breast following mastectomy. For either delayed or immediate reconstruction of the breast, we have used a subcutaneously placed Radovan tissue expander, followed by expansion of the skin flap, then capsulotomy and insertion of the polyurethane-coated implant. The results of these procedures are presented after follow-up periods ranging from one and one-half to three years, with more than satisfactory results.
An intraluminal duodenal diverticulum is an uncommon congenital abnormality that may produce intermittent ostruction. The true pathogenesis of this lesion is still disputed, but it probably results from ballooning of a congenital web or diaphragm with prolonged peristalsis. An intraluminal "wind sock"-like structure filed with barium and surrounded by a radiolucent halo is the classic and diagnostic radiologic appearance. An association with trisomy 21 is made.
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