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Biomedical subjects

S Ariyan

Publications and source records attributed to S Ariyan.

At least 19 recordsLinked to original sources
PubMed2026

Anatomical location defines distinct molecular subtypes of mucosal melanoma.

BACKGROUND: Mucosal melanoma (MM) is a rare and aggressive melanoma subtype that is understudied. The relationships between anatomical location, genomic alterations, stage at presentation, and survival remain incompletely characterized. METHODS: We carried out a retrospective single tertiary center study of 105 patients with histologically confirmed MM diagnosed between 1996 and 2025. Clinical and genomic data were analyzed to evaluate associations between anatomical location, mutational profile, stage at presentation, and survival outcomes, including melanoma-specific mortality. RESULTS: Lower-body tumors arising in the anus or genital areas were enriched for KIT and splicing factor 3 subunit B1 alterations, whereas NRAS mutations were distributed across anatomical regions. Among the two most common mutated genes, NRAS-mutant tumors were more likely than KIT-mutant tumors to present with metastatic disease [53% versus 19%; P = 0.046, odds ratio (OR) 4.7, 95% confidence interval (CI) 1.15-19.41]. Lower-body tumors were associated with worse overall survival (OS) than upper-body tumors (median 2.81 versus 8.40 years; OR = 0.05) and with higher melanoma-specific mortality. In multivariable analyses, upper-body location remained independently associated with improved OS (hazard ratio 0.14, 95% CI 0.05-0.36, P < 0.001). CONCLUSIONS: Anatomical location of MMs and genomic alterations define biologically and clinically distinct subtypes.

KIT mutation↗
PubMed1992

Comparison of 180-degree and 360-degree skeletal muscle nerve cuff electrodes.

Use of skeletal muscle for cardiac augmentation is a promising technique for treatment of end-stage cardiac failure. An electrode woven through the latissimus dorsi that recruits nearby nerve fibers is commonly used to pace skeletal muscles both in clinical practice and in the laboratory. A proximally placed nerve cuff electrode offers potential advantages in improved recruitment of muscle fibers and low threshold for stimulation. We tested the effectiveness of a nerve cuff electrode passed directly about the proximal thoracodorsal nerve. Our report looks at the efficacy of nerve cuff electrode stimulation and compares electrical and histologic characteristics of a 180-degree wrap of the thoracodorsal nerve to a 360-degree wrap in dogs over 3 months. Threshold voltage at the commonly used pulse width of 200 microseconds was typically in the range of 400 to 600 mV for each electrode after 3 months. Statistical analysis revealed no significant difference (p < 0.05) in threshold voltage or current between the 180-degree and 360-degree nerve cuff electrode either at acute evaluation or after 3 months. Even contraction of latissimus dorsi was achieved with all implants. Adenosine triphosphatase staining revealed 100% conversion of type II to type I fibers in all stimulated muscles. Histologic examination of the thoracodorsal nerve and latissimus dorsi muscle revealed no abnormalities grossly or by light microscopy. Thus, a carefully applied nerve cuff electrode is an atraumatic, effective method for skeletal muscle stimulation. The 180-degree and 360-degree nerve cuff configurations are equally effective.

Adenosine Triphosphatases↗
PubMed1992

The impact of stress on the clinical presentation of melanoma.

The impact of major life events on the clinical presentation of melanoma was determined in a retrospective case-control analysis. There was a significantly higher occurrence of divorce or marital separation and a significantly higher occurrence of bankruptcy or unemployment in the 5 years prior to the clinical presentation of 56 melanoma patients relative to an age- and sex-matched control group of 56 general surgical patients (p less than 0.01). There was also a higher occurrence of death of a spouse or immediate family member, although this difference was not statistically significant. Overall, 26 (46 percent) of the melanoma patients had major life crises in the 5 years prior to clinical presentation, and this was highly significant (p less than 0.01). We believe that major life stress has an impact on the clinical presentation of melanoma. Potential reasons for this difference are reviewed.

Adult↗
PubMed1989

Scanning electron microscopy and gel electrophoresis of vascularized periosteal autografts.

This study was devised to investigate the morphologic and biochemical sequence of events occurring during early periosteal osteogenesis in vascularized periosteal flaps. A pleuroperiosteal flap based on the intercostal vessels was developed and rotated onto the chest wall in 12 adult dogs. Animals were sacrificed at intervals between 7 and 60 days, and the flaps were removed with the underlying muscular bed. Specimens were studied by tetracycline uptake, gel electrophoresis, light microscopy, and the scanning electron microscope. Osteoprogenitor cells were seen as early as 7 days after transfer. Collagen fiber deposition was vigorous and noted in all specimens with rapid mineralization by 9 to 15 days. There was no structural or vascular interaction between the flaps and the recipient muscular bed. Gel electrophoresis confirmed the presence of type I and III collagen, with an increase in type I collagen over time. The pattern of collagen deposition and the final bony architecture resembled that of woven bone.

Animals↗
PubMed1989

Cutaneous angiosarcoma of the face and scalp.

Cutaneous angiosarcoma is an infrequent but aggressive neoplasm involving the skin of the face and scalp. Unfamiliarity with the clinical manifestations of cutaneous angiosarcoma frequently leads to misdiagnosis and delay in treatment. Complete surgical resection requires the performance of preoperative staging biopsies to determine the true extent of the neoplasm. Intraoperative frozen section analysis to determine the adequacy of the surgical resection is unreliable due to the high false-negative rate. All patients should receive a full course of postoperative radiation.

Aged↗
PubMed1987

A suspensory jacket permitting long-term sitting in paraplegic patients.

A thoracic suspensory jacket has been used in four patients with recurring ischial pressure sores to transfer the site of skin pressure from the insensate ischial area to the sensory area over the rib cage. This modality is not an alternative to surgery, but rather an adjunct to prevent an early recurrence after an ischial pressure sore has been repaired with a proper surgical procedure.

Adult↗
PubMed1986

Radical neck dissection.

This article discusses how the spread of tumor occurs and reviews surgical treatment, including classic and functional radical neck dissection, as well as complications.

Face↗
PubMed1986

Free radial forearm flap versatility for the head and neck and lower extremity.

Microsurgical techniques have developed numerous territories suitable for free tissue transfer. However, the demand for thin cutaneous resurfacing limits the choice of flaps available to the reconstructive microsurgeon. The radial forearm flap is a thin, axial, fasciocutaneous flap, offering pliable cutaneous resurfacing, with or without sensation. We have used 15 flaps to reconstruct defects in the head and neck and lower extremity resulting from burns, blunt and avulsive trauma, radiation necrosis, and tumor ablation. Two flaps (15 percent) developed venous congestion and were salvaged by reoperation. One retrograde flap (7.5 percent) developed partial necrosis from arterial insufficiency. Neural re-innervation was successful in two out of three patients in whom it was attempted. Two patients (15 percent) sustained minor donor site skin graft loss that healed secondarily. In our series of predominantly older patients the donor sites have been relatively inconspicuous at one year follow-up. A functional restoration was achieved in all patients.

Adult↗
PubMed1986

Single-stage repair of complex scalp and cranial defects with the free radial forearm flap.

The free radial forearm flap provides a reliable single-stage method to cover difficult scalp and forehead defects where other local methods are unsuitable. Six patients have been successfully reconstructed utilizing seven free radial forearm flaps. A description of our surgical technique along with illustrative cases demonstrate the indications and advantages of this flap. Cranial soft-tissue deficits are primarily cutaneous; therefore, a more predictable reconstruction can be obtained utilizing a cutaneous flap with similar characteristics. Restoration of bony defects should be considered separately utilizing autogenous bone and/or alloplastic materials and not merely obliterated with a bulky soft-tissue flap. Therefore, if the local factors of a cranial wound require the utilization of a distant tissue transfer, we prefer the thin coverage of a well-vascularized free fasciocutaneous radial forearm flap over two-stage distant pedicle flaps or skin-grafted free flaps.

Aged↗
PubMed1986

Effects of local heat on blood flow in infected and normal hands.

Changes in response to heat in the dermal, subcutaneous, and muscle blood flow in the hands of 10 patients with hand infections were studied using 133Xe and recording of clearance data. A further 15 normal hands were studied in a similar manner. The application of topical heat to normal hands resulted in a decrease in the dermal blood flow (p less than 0.001), an increase in the subcutaneous blood flow (p less than 0.05), and perhaps an increase in the intramuscular flow (p less than 0.1). This suggests that surface heat promotes a shunting of the blood from the skin to deeper tissue layers. In infected hands, the blood flow was found to be significantly increased threefold in the intradermal circulation (p less than 0.01) and eightfold in the subcutaneous circulation (p less than 0.03) when compared to controls. In contrast to normal hands, in the infected hands, the blood flow decreased in all three compartments by 50 percent following application of heat. The blood flow of the normal hand in patients with infection did not respond to heat in the normal pattern. We conclude that the application of local heat to normal tissues results in shunting of blood flow from superficial tissues such as dermis to deeper ones such as subcutaneous fat and muscle. In infected tissues, the blood flow was found to be much higher than normal; however, the traditional belief in the improvement in blood flow by the application of heat was not confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1986

Replantation of a totally amputated ear by means of a platysma musculocutaneous "sandwich" flap.

A total amputation of an ear from an automobile accident was salvaged by suturing the fragments of the skeletonized auricular cartilage and reattaching it to its original position "sandwiched" in a platysma musculocutaneous flap. The anterior portion of this flap was subsequently removed to apply a skin graft to the thin platysma muscle left over the convolutions of the auricular cartilage. This technique represents the application of the principle of bringing blood supply to avascular tissue in order to salvage it.

Adult↗
PubMed1986

Costochondritis: pathogenesis, diagnosis, and management considerations.

The management of costochondritis of the chest wall is reviewed and four illustrative cases presented. Adequate debridement is the single most important factor to ensure eradication of this disease. Well-vascularized tissue coverage reduces ischemic factors, resists secondary infection by contamination, and promotes rapid healing. The pectoralis major, latissimus dorsi, and rectus abdominis muscle flaps are the primary choices for pedicle-flap coverage. Antibiotic coverage was not extended beyond 3 weeks in these cases, and no recurrences have been noted over a 1- to 3-year follow-up.

Actinomycosis↗
PubMed1985

Intraoperative adjuvant radiotherapy for advanced cancers of the head and neck. Preliminary report.

We have reported the early local control and survival results of treatment of recurrent or metastatic head and neck tumors with intraoperative brachytherapy. All six patients were locally free of disease after curative surgery and intraoperative brachytherapy for 4 months to 1 year, whereas two of eight patients were alive at last follow-up at 7 and 8 months with some complications after palliative surgery and intraoperative brachytherapy. We advocate such a technique not only in hopelessly advanced tumors but also in less advanced tumors, as well as a definitively integrated plan of management. Doses of iodine-125 of up to 15,000 rads are safe and well tolerated, even in the presence of a past history of radiotherapy.

Brachytherapy↗
PubMed1985

Management of giant cystic hygromas in infants.

Giant cystic lymphangioma is a rare lesion that presents major therapeutic challenges. Four infants presented in the first weeks of life with diffuse cysts in the neck. The tongue was involved in three, the mediastinum in one, and the pharynx and supraglottic larynx in two. These lesions are characterized by hundreds of cysts that infiltrate in and around muscles, nerves, and vessels. Complete excision is not possible without damaging the normal structures. All four infants initially had partial removal with unroofing and drainage of the remaining cysts and temporary tracheostomy to protect the airway. One infant died from a thrombosed sagittal sinus. She had severe venous congestion of the head and neck postoperatively which may have been caused by an overzealous attempt to remove all of the cysts. The other three have required nine additional operations for removal of recurrent neck cysts (one operation), removal of mediastinal cysts (one operation), partial glossectomy (three operations), and laser excision of lymphangiomas of the pharynx and supraglottic larynx (four operations). Two patients have required partial glossectomy which should be performed early to protect the airway, to allow normal speech development, and to prevent malocclusion and prognathism from constant pressure of the tongue against the teeth. Removal of wedges of tissue from each side and from the center of the dorsum of the tongue reduces bulk with minimal risk to the lingual arteries and nerves. Recurrent tongue enlargement is common and can be treated by repeated partial glossectomy. Lymphangiomatosis of the pharynx and supraglottic larynx is difficult to treat. The carbon dioxide laser allows very precise excision of individual cysts with minimal drainage to adjacent mucosa, but in our limited experience it has not prevented recurrence. Despite the extensive nature of these lesions, the impossibility of complete excision, and the need for multiple operations, the long-term results in the three surviving patients have been satisfactory. Asymmetry of the neck and face due to lymphedema tends to improve with time. All three children have an acceptable appearance and normal speech for their ages.

Female↗
PubMed1985

Burn wound excision and local flap closure.

Eleven circumscribed, full-thickness burns were treated in 9 patients with immediate excision and primary closure of the defect or by using a variety of local random cutaneous and musculocutaneous flaps. The burns were located on the face, trunk, and extremities. In 2 patients this technique was used in the management of smaller burns on one surface of the body, thus facilitating skin grafting of larger wounds on the opposite surface. The cutaneous flaps utilized included advancement flaps, V-Y flaps, Moberg flaps, and S-plasties. The timing of the excision and closure varied from 2 hours to 2 weeks following thermal injury, with no postoperative wound infections. In selected cases primary excision of deep burns and closure by use of local tissue approach ideal treatment. With certainty of the depth of destruction, this procedure should be carried out regardless of locality when technically and anatomically feasible.

Adolescent↗