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Biomedical subjects

O Lapid

Publications and source records attributed to O Lapid.

14 recordsLinked to original sources

Meningomyelocele reconstruction with bilobed flaps.

A new method for the repair of meningomyeloceles is described. After neurosurgical repair and closure of the placode, the soft-tissue deficit is closed using a bilobed flap. The flap is based superiorly and laterally to the area to be covered. The first lobe crosses the midline above the defect, and the second lobe goes up the midline perpendicular to the first lobe. Once in place, the flap provides a tension-free repair; no suture lines overlie the cord closure.

Female↗

Congenital epulis.

Epulis is a rare tumor of the newborn, also known as granular cell tumor of the newborn or Neumann's tumor. This tumor arises from the mucosa of the gingiva, most commonly from the anterior part of the maxillary alveolar ridge, and is typically seen as a mass protruding out of the newborn child's mouth, which may interfere with respiration or feeding. Epulis is seen only in the newborn and is a different entity from other granular cell tumors. The tumor has a marked female preponderance of 8:1. The recommended treatment is prompt surgical resection. Recurrences of the tumor and damage to future dentition have not been reported, suggesting that radical excision is not warranted. A newborn female with such a mass is described. The tumor was resected using a carbon dioxide laser; the postoperative course was uneventful. On histologic examination, it was composed of diffuse sheets and clusters of polygonal cells containing small round to oval nuclei and abundant coarsely granular cytoplasm. The tumor cells stained positive for vimentin, and negative for S100-protein, actin, desmin, laminin, keratin, estrogen, and progesterone receptors. Electron microscopic examination showed granular cells containing heterogeneous electron-dense granules, lysosomes, and cytoplasmic lipid droplets. The clinical and microscopic features of such tumors are reviewed.

Female↗

An improved design for vacuum tube drains.

Mini vacuum drains can be helpful in reconstructive surgery. The drains may be assembled using a scalp needle and a vacuum tube. The addition of the adapter that is used with the vacuum tubes for blood sampling improves the ease of use and practicality of these drains and increases their safety.

Equipment Design↗

Subungual amelanotic melanoma.

We describe a 76-year-old white male with subungual amelanotic melanoma. The lack of pigmentation of the lesion may cause misdiagnosis and aggravate its poor prognosis.

Aged↗

Sigmoid colon carcinoma metastatic to the myometrium.

Metastases to the uterus from extragenital cancers are significantly rarer than metastases to the ovaries. Of the approximately 200 cases of metastases to the uterus from extragenital cancers that have been reported in the literature, more than half are cases of metastases from breast carcinoma and only 16 are cases of metastases from colorectal carcinoma. A case of isolated metastases restricted to the myometrium of the right uterine comu from sigmoid colon carcinoma, without involvement of the ovaries, is described. The patient who six months previously had surgery for sigmoid colon carcinoma presented with right lower abdominal pain and a palpable mass in the region of the right uterine cornu. The diagnosis of isolated metastases restricted to the myometrium of the right uterine cornu was confirmed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. This case illustrates that a growing uterine mass in a patient with a history of primary extragenital cancer, regardless of whether abnormal uterine bleeding is present or absent, should alert the physician to consider the possibility of uterine metastases.

Abdominal Pain↗

Airway obstruction by Ascaris, roundworm in a burned child.

Ascaris lumbricoides, roundworm, is a Nematode parasite infecting about 1 billion people worldwide. We report the case of a ten-year-old Bedouin girl hospitalized with burns to 45% of her body surface area, including the face. The patient was intubated upon admission and mechanically ventilated. Four days later she was extubated but required reintubation 15 min later for severe hypoxemia. Laryngoscopy disclosed an unidentified tube which obstructed the opening of the larynx. The 'tube' was removed by Magill forceps. The object was identified as a 35 cm long Ascaris roundworm. Once the worm was removed the patients' respiratory condition dramatically improved. We review the main features of Ascaris infection and some similar cases of airway obstruction caused by this worm.

Airway Obstruction↗

The ping-pong ball microphone: facilitating speech for a patient with hand burns and a tracheostomy.

Patients who have sustained thermal injuries may require tracheostomies as a result of facial burns; these operations may also be required after prolonged intubation for smoke inhalation injury or respiratory failure. For a patient with a temporary tracheostomy, speech may be achieved by occluding the opening of the tracheostomy cannula with the tip of a finger, thereby directing airflow through the vocal cords and allowing phonation to be produced. However, some patients who also have hand burns may not be able to cover the opening of the tube because of the injuries to their fingers and the bulky dressings covering them. A simple tracheal occluder can be made out of a ping-pong ball and a syringe casing. The device presented in this article allows for the restoration of speech in the types of patients described above, and it promotes purposeful movement of their upper extremities.

Burns↗

CO2-laser in the removal of a plexiform neurofibroma from the eyelid.

We present a child with neurofibromatosis type I (NF-I) who underwent excision of a large upper lid neurofibroma using a CO2-laser. Plexiform neurofibromas are notorious for their bleeding tendency and the inability to achieve complete surgical excision. The CO2-laser is an adjunct to achieving better hemostasis and delineation of the tissue in the absence of natural tissue planes caused by the tumor's diffuse mode of growth. Using the CO2-laser achieves better cosmesis, while reducing operation time and limiting complications.

Child↗