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Biomedical subjects

O J Moy

Publications and source records attributed to O J Moy.

4 recordsLinked to original sources

Detection of migratory silicone pseudotumor with use of magnetic resonance imaging.

A patient with silicone gel breast implants, who experienced capsular contracture of the left breast that was treated by closed capsulotomy, sought medical attention because of numbness and pain in the left medial forearm and hand. Inflammatory masses subsequently developed in the left anterior axillary and antecubital regions. Magnetic resonance imaging revealed silicone pseudotumors, and mammography confirmed implant rupture and gel extrusion along fascial planes into the axillary region.

Arm

Common tumors.

Common tumors of the hand and upper extremity are, by definition, benign conditions. There is a predictable pattern of occurrence and presentation for many of these lesions. The practitioner should always bear in mind, however, that any tumor that appears anywhere in the body can appear in the hand and upper extremity. Moreover, several of the benign conditions can, in certain clinical settings, have a predilection for transformation or association with more aggressive conditions. We would emphasize that the approach to any tumor be carefully considered and include an appropriate differential diagnosis. Any suspicious lesion should be examined thoroughly, including first-order screening tests, history, physical examination, radiographic imaging, and laboratory evaluations followed by more detailed diagnostic imaging prior to surgery. Surgery should be approached as a biopsy, with the possibility of frozen section analysis, and the possibility of a two-staged operation for tumor removal with appropriate margins if necessary.

Bone Neoplasms

Reconstruction of traumatic or congenital amputation of the thumb by distraction-lengthening.

Reconstruction of the traumatically or congenitally amputated thumb presents a significant challenge. The individual needs of the patient must be matched with the armamentarium available to the surgeon. Metacarpal elongation via the distraction-lengthening technique, which uses local tissue without sacrificing any adjacent digits or toes, is a reliable means of increasing thumb length by 3 to 3.5 cm. The optimal situation for performing this procedure is the presence of an amputation in the perimetacarpophalangeal joint region. Although neo-osteogenesis has been shown to be useful in pediatric patients, bone grafting is recommended in those individuals aged 25 years and older with gaps of 3 cm or more. The patient must be carefully observed during the distraction period because of the potential problems that may arise from the use of an external fixation device.

Amputation, Traumatic

Fibrin seal adhesive versus nonabsorbable microsuture in peripheral nerve repair.

Although nonabsorbable microsuture is the material most often used in human peripheral nerve repair, it is capable of eliciting a foreign body reaction, impairing vascularity, and potentially disrupting axonal regeneration. Sutureless methods, including fibrin seal adhesive, may offer an alternative to traditional suture techniques. This study compared the efficacy of fibrin seal with nylon microsuture in tibial microneurorrhaphy on 28 adult New Zealand white rabbits (14 with 10-0 monofilament nylon suture and 14 with fibrin seal). Each rabbit was reexplored at 1, 6, 12, and 18 weeks. The criteria used to compare the two methods were operative time, clinical function, electrophysiologic measures, and histologic findings. Fibrin seal repairs required less time to execute (p less than 0.01) but were inferior in mean conduction amplitude (p less than 0.01) and with respect to histologic criteria. Fibrin seal also appeared less effective in maintaining nerve approximation. We do not believe that fibrin seal provides a superior alternative to nonabsorbable suture in primary nerve repair in this experimental model.

Animals