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Biomedical subjects

S N Snow

Publications and source records attributed to S N Snow.

At least 19 recordsLinked to original sources
PubMed1992

Mucinous eccrine carcinoma of the eyelid.

BACKGROUND: Mucinous eccrine carcinoma (MEC) is a rare malignant tumor that typically arises in the periorbital area. METHODS: The authors report the 73rd case of primary MEC of the skin. This patient's clinicopathologic findings and the world literature are reviewed. RESULTS: Patient ages range from 8-84 years (median, 63 years). The male-to-female ratio was approximately 2:1. The racial distribution was 67% white, 32% black, and 4% Asian. Primary MEC originates in the head and neck region in approximately 75% of patients. The most common location was the periorbital area (40% or 29 of 73 patients). The local recurrence rate after conventional surgery was: eyelid, 34%; scalp, 36%; and face, 33%. CONCLUSIONS: Primary MEC is often a slow-growing tumor that may recur after traditional surgical excision. Recurrent eyelid MEC tends to be locally destructive with a regional metastatic rate of 3.5% (1 of 29). The regional metastatic rate for all sites was 11%, and the distant metastatic rate was 3%.

Adenocarcinoma, Mucinous↗
PubMed1992

Failure to detect human papillomavirus DNA in extramammary Paget's disease.

Ten genital skin specimens, biopsy proven to be Paget's disease, were examined by human papillomavirus (HPV) in situ hydridization in an effort to detect DNA of HPV types 6, 11, 16, 18, 31, 33, and 35. All ten specimens showed no evidence of DNA of these HPV types. Extra-mammary Paget's disease is probably not a result of infection with HPV types 6, 11, 16, 18, 31, 33, or 35.

DNA, Viral↗
PubMed1992

Eccrine porocarcinoma of the face.

Eccrine porocarcinoma is a rare tumor of the skin. We report a case on the chin that was successfully treated with Mohs surgery. In our review of the world's literature 105 cases were compiled. The tumor most often occurs in the elderly and affects men more frequently than women. It may develop from a preexisting benign poroma and may also appear as a verrucous or nodular, ulcerative growth. Approximately 50% of the tumors occur on the lower extremities; the leg is the most common site. Microscopically the tumor demonstrates both intraepidermal and dermal invasion and is capable of forming satellite lesions and in-transit metastases when lymphatic vessels are invaded. The local recurrence and regional metastatic rates are both approximately 20%. Distant metastasis occurs in 12% of cases. The mortality rate is more than 65% when regional nodes are involved.

Adenoma, Sweat Gland↗
PubMed1992

Running vertical mattress suturing technique.

The running vertical mattress suturing technique is a quick and simple method of providing skin edge eversion that is equivalent to the simple vertical mattress technique. The running stitch is relatively easy to master and provides excellent apposition of wound edges.

Dermatologic Surgical Procedures↗
PubMed1992

Rapid atraumatic nail plate removal using the cordless cautery unit.

This article describes the use of a handy, battery-powered, thermocautery unit to cut through the nail plate when performing dermatologic surgery involving nail tissue. Thermocauterization of keratin is a simple, atraumatic method of removing portions of the nail plate, so that the underlying soft tissue may be biopsied or treated. The units are inexpensive and safe to operate.

Adult↗
PubMed1992

Mohs micrographic surgery for penile tumors.

The advantages of the total microscopic control of excision that is provided by Mohs micrographic surgery often justify consideration of this modality in neoplasms of the penis. The excision in successive layers with complete microscopic scanning of the entire underside of each horizontally cut layer assures eradication of the silent outgrowths that often extend well beyond the clinically visible and palpable borders of the cancer. With elimination of all ramifications, the excisions are abruptly stopped, and removal of a substantial surgical margin of normal tissue is obviated. Other advantages are the absence of need for general anesthesia and the fact that most patients remain ambulatory.

Adult↗
PubMed1991

Metastatic basal cell carcinoma: report of twelve cases with a review of the literature.

Metastatic basal cell carcinoma was found in 12 patients at the University of Wisconsin Mohs Surgery Clinic during the period 1936 to 1989. All patients were white men. The time of onset of the primary tumor ranged from childhood to 71 years. Eleven patients had previous treatment for basal cell carcinoma; two patients had received x-ray radiation to the face for teenage acne. The locations of the primary basal cell carcinomas were the face (n = 10), back (n = 1), and arm (n = 1). The primary tumors ranged from 3.6 x 3.0 to 20.0 x 7.0 cm. The interval from onset to the first sign of metastases ranged from 7 to 34 years. In all cases, the primary tumor was histologically identical to the metastatic lesion. Perineural extension of the basal cell carcinoma in the primary lesion was found in five cases. Regional lymph nodes were the most frequent site of metastasis. Treatment consisted of a combination of surgery, radiation, and chemotherapy. Only two patients survived more than 5 years after surgical treatment. One patient has survived 25 years and is still alive.

Aged↗
PubMed1991

Rapid skin edge elevation using the OCT compound droplet technique to obtain horizontal microsections in Mohs micrographic surgery.

We describe a technique to quickly raise the skin edges when mounting flat tissue specimens on cryostat discs used in Mohs micrographic surgery. The technique consists of placing a drop of OCT compound on the superficial surface of the tissue before the specimen is mounted bottom-side-up on the cryostat object disc. When the Mohs tissue layer is transferred to the disc, the droplet spreads out underneath the tissue to support the bottom and to prevent the skin edges from dropping below the horizontal plane of the tissue. This technique assures that the skin edge and bottom surface of the tissue are on the same plane so that a complete section of the undersurface of the flat specimen is taken when the tissue is cut with the microtome. The technique is relatively simple to perform, requires no special instrumentation, and provides consistent microsections with complete skin edge.

Humans↗
PubMed1991

Cylindroma treated by Mohs micrographic surgery.

Cylindroma, a rare benign adnexal neoplasm, may occur in areas in which simple excision is either not possible or severely disfiguring. We present a case of cylindroma that was treated by Mohs micrographic surgery. Postsurgical evaluation of the tumor showed that the tumor had invaded a larger area than was initially suspected based on clinical examination alone.

Aged↗
PubMed1991

Malignant cylindroma of the scalp.

Malignant cylindroma may develop via malignant transformation of cylindroma in rare instances or may develop de novo in others. We present a case of malignant cylindroma located on the left parietal-occipital scalp that was treated twice by Mohs micrographic surgery in an attempt to excise the tumor completely and to minimize the excision of normal tissue. Our case is the sixteenth reported case of malignant cylindroma in the world literature.

Aged↗
PubMed1991

Excision of exposed cartilage for management of Mohs surgery defects of the ear.

Cartilage of the ear is often exposed during Mohs surgical procedures. Fenestration of the cartilage with a skin punch has been recommended to stimulate granulation tissue where the perichondrium has been destroyed. This article describes an alternative method--the excision of a window through the exposed cartilage, fully exposing the perichondrium on the other side of the cartilage. This promotes the rapid healing by second intention or provides a vascular bed for immediate skin grafting. Also, aggressive excision of nonviable cartilage helps prevent chondritis or perichondritis.

Ear Cartilage↗
PubMed1991

Power drills to fenestrate exposed bone to stimulate wound healing.

Power drills can be used to stimulate the formation of granulation tissue over exposed cortical bone. These tools allow for the rapid fenestration and selective abrasion of large areas of exposed bone; fenestration and abrasion create the multiple bleeding points essential for the production of granulation tissue. The granulation tissue thus produced is allowed to grow out through the holes to cover bone. This procedure can be performed in an outpatient setting, usually without the need for either local or general anesthesia; it is particularly useful for patients considered to be poor risks for general anesthesia. Healing by granulation tissue is a somewhat slow process, but it has a high success rate, causes few complications, and produces very good cosmetic results. Two cases illustrate the method of fenestration of exposed cranial bone to stimulate granulation tissue. Specific instructions describe the needed care of exposed bone.

Aged↗
PubMed1991

Managing common suturing problems.

The closure of surgical wounds can be improved by applying some basic techniques for suturing and for correcting suture errors. These techniques include 1) the locking stitch, 2) the pulley stitch for closing large gaping defects, and 3) a means of welding polyfilament synthetic polyamide suture and polypropylene suture.

Humans↗
PubMed1990

Mohs micrographic surgery fixed-tissue technique for melanoma of the nose.

Mohs micrographic surgery, fixed-tissue technique, for excision of nasal melanoma provides three important benefits: 1) assurance of eradication of the main mass along with its "silent" contiguous outgrowths, 2) safe management of non-contiguous satellites too small to be visible initially, and 3) safe sparing of maximal amounts of surrounding normal tissues. These benefits are achieved because all incisions are through chemically fixed (killed) tissue, eliminating the danger of disseminating the highly transplantable melanoma cells and permitting the excision of successive layers for microscopic scanning of their undersurfaces by the systematic use of frozen sections. The process is continued to the termination of each ramification. There is no need to remove a wide margin of normal tissue as is customary with conventional surgery. Clinically invisible satellites are not moved or disturbed and can be removed safely by the same method if they appear. The reliability of the method is manifested by the 62.5% 5-year cure in a series of 10 consecutive patients, all of whom had no local recurrence after micrographic surgery.

Female↗