Biomedical subjects

L D Garland

Publications and source records attributed to L D Garland.

7 recordsLinked to original sources

PubMed1994

Squamous cell carcinoma arising from chronic osteomyelitis treated by Mohs micrographic surgery.

Squamous cell carcinoma is a rare, but well documented complication of chronic osteomyelitis. Many authors have recommended amputation as the treatment of choice for locally invasive disease. Presented is a patient with squamous cell carcinoma arising in the draining sinus tract of chronic osteomyelitis of the lower extremity that was treated successfully with Mohs micrographic surgery (MMS). After ten year follow-up he remains tumor free and continues to enjoy use of his leg. We propose MMS as a therapeutic option to amputation for control of locally invasive disease.

Adult↗

PubMed1993

Margin assessment of selected basal cell carcinomas utilizing laser Doppler velocimetry.

BACKGROUND: Basal cell carcinomas (BCC) have increased vasculature, therefore, blood flow within the tumor may be greater than normal surrounding skin. We attempted to detect the difference in blood flow between the tumor and uninvolved surrounding skin utilizing laser doppler velocimetry (LDV). METHODS: Ten patients with 14 BCC were studied. Using LDV, we calculated the size of the tumor based on margin assessment as predicted by the measured difference in blood flow and compared this size with the clinically predicted size and the size of the defect after Mohs micrographic surgery (MMS). RESULTS: Clinical evaluation of tumor size prior to MMS did not correlate with the size of the surgical defect after MMS; however, correlation was found between the predicted size of the tumor as determined by LDV and the defect after MMS. CONCLUSIONS: Tumor size of BCC as predicted by measured differences in blood flow using LDV correlated with the size of the surgical defect after MMS. This suggests that LDV was able to detect the difference in blood flow between the tumor and uninvolved surrounding skin.

Blood Flow Velocity↗

PubMed1992

The use of Mohs micrographic surgery for determination of residual tumor in incompletely excised basal cell carcinoma.

BACKGROUND: The presence of tumor involving surgical margins after excision of basal cell carcinoma (BCC) presents a therapeutic dilemma. Some authors advocate a conservative policy whereas others recommend immediate reexcision. OBJECTIVE: Our purpose was to evaluate residual tumor utilizing Mohs micrographic surgery (MMS) of those BCCs with margin involvement after primary excision. METHODS: We retrospectively reviewed 77 patients with 78 tumors who underwent MMS because of margin involvement after primary excision of BCC to detect the presence or absence of residual tumor. RESULTS: Residual tumor was found in 55% of the cases as defined by the need for two or more stages of MMS to achieve a tumor-free plane. CONCLUSION: We suggest reexcision of all BCCs that are found to have marginal involvement after primary excision because of the large percentage of cases found to have residual tumor.

Age Factors↗

PubMed1988

delta 5-3 beta-hydroxysteroid dehydrogenase activity in sebaceous glands of scalp in male-pattern baldness.

Sebaceous glands were isolated by manual dissection using a stereomicroscope from skin specimens of bald scalp of men with male-pattern baldness undergoing hair transplant or scalp reduction surgery and also from specimens taken from hairy and bald areas of scalp at autopsy of adult male victims of accidental death within 3 h post mortem. Homogenates of the isolated glands exhibited activities of delta 5-3 beta-hydroxysteroid dehydrogenase (3 beta HSD), 17 beta-hydroxysteroid dehydrogenase, and testosterone 5 alpha-reductase by the conversion of [3H]dehydroepiandrosterone (DHA) to 3H-delta 4-androstenedione (AD), [3H]testosterone, and [3H]dihydrotestosterone. Homogenates of glands from bald (B) scalp had greater 3 beta HSD activity than homogenates of glands from hairy (H) scalp. After differential centrifugation, 3 beta HSD activity was found mainly in the microsomal and 105,000 X g supernatant fractions. Specific activity of the enzyme based on protein mass was highest in the microsomal fraction; however, the total 3 beta HSD activity in the 105,000 X g supernatent of B glands was significantly (p less than .01) greater than that of H glands. 3 beta HSD activity in sebaceous glands isolated from autopsy specimens did not differ from that of glands isolated from surgical specimens in apparent Km (0.13-0.14 microM), pH optima (8.0), or coenzyme requirement for NAD. Since substantial 3 beta HSD activity was present in the cytosol, and cytosol of B glands showed increased 3 beta HSD activity, the increased conversion of DHA to AD may be a critical step for androgenic action and may be responsible for excessive androgenicity in male-pattern baldness.

3-Hydroxysteroid Dehydrogenases↗

PubMed1988

Oestrogen and progesterone receptors in lentigo maligna.

We have measured oestrogen and progesterone binding in specimens of histopathologically confirmed lentigo maligna (LM) lesions excised from five elderly white men, using a dextran-coated charcoal method. Oestrogen binding was observed in four of the five specimens, and progesterone binding in all five. Marginal normal skin showed only non-specific binding for oestrogen and progesterone. The presence of steroid hormone receptors in LM suggests the possibility that hormone responsiveness may be relevant in the transformation of a lentigo maligna into malignant melanoma.

Aged↗

PubMed1987

Syringoid eccrine carcinoma.

Syringoid eccrine carcinomas (SECs) are rare adnexal neoplasms that may display aggressive local recurrence and occasional metastases. This report describes three cases of SEC treated by Mohs micrographic surgery.

Adenocarcinoma↗

PubMed1985

Tumors of the nail.

Tumors of the nail unit are frequently difficult to diagnose in a timely fashion. This article reviews the principal benign and malignant conditions the clinician may expect to encounter and stresses differential diagnosis.

Adult↗