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Stanley J Miller

Publications and source records attributed to Stanley J Miller.

7 recordsLinked to original sources
PubMed2006

"Running pleated" suture technique opposes wound edges of unequal lengths.

BACKGROUND: Cutaneous advancement flaps, such as the T-plasty or H-plasty, are commonly used in order to relocate standing cones away from critical structures. In this process, what would have been the tips of a standard elliptical closure are displaced laterally as Burrow's triangles. This method creates additional terminal incision lines, perpendicular to the force vector of the flap. OBJECTIVE: To describe a suture technique commonly employed in our practice that eliminates the need for such Burrow's triangles, hence minimizing suture lines and enhancing cosmesis. MATERIALS AND METHODS: Through the described "running pleated" suture technique, excess tissue created by flap advancement is distributed equally along the entire length of the incision. RESULTS: All patients did well postoperatively with excellent wound healing and superior cosmetic outcomes. CONCLUSION: The "running pleated" suture technique obviates the need for large, laterally displaced Burrow's triangles that are normally created during the construction of flaps such as the T-plasty and H-plasty and can be a powerful tool in the armamentarium of any dermatologic surgeon.

Cicatrix↗
PubMed2005

Interpreting epithelial cancer biology in the context of stem cells: tumor properties and therapeutic implications.

Over 90% of all human neoplasia is derived from epithelia. Significant progress has been made in the identification of stem cells of many epithelia. In general, epithelial stem cells lack differentiation markers, have superior in vivo and in vitro proliferative potential, form clusters in association with a specialized mesenchymal environment (the 'niche'), are located in well-protected and nourished sites, and are slow-cycling and thus can be experimentally identified as 'label-retaining cells'. Stem cells may divide symmetrically giving rise to two identical stem cell progeny. Any stem cells in the niche, which defines the size of the stem cell pool, may be randomly expelled from the niche due to population pressure (the stochastic model). Alternatively, a stem cell may divide asymmetrically yielding one stem cell and one non-stem cell that is destined to exit from the stem cell niche (asymmetric division model). Stem cells separated from their niche lose their stemness, although such a loss may be reversible, becoming 'transit-amplifying cells' that are rapidly proliferating but have a more limited proliferative potential, and can give rise to terminally differentiated cells. The identification of the stem cell subpopulation in a normal epithelium leads to a better understanding of many previously enigmatic properties of an epithelium including the preferential sites of carcinoma formation, as exemplified by the almost exclusive association of corneal epithelial carcinoma with the limbus, the corneal epithelial stem cell zone. Being long-term residents in an epithelium, stem cells are uniquely susceptible to the accumulation of multiple, oncogenic changes giving rise to tumors. The application of the stem cell concept can explain many important carcinoma features including the clonal origin and heterogeneity of tumors, the occasional formation of tumors from the transit amplifying cells or progenitor cells, the formation of precancerous 'patches' and 'fields', the mesenchymal influence on carcinoma formation and behavior, and the plasticity of tumor cells. While the concept of cancer stem cells is extremely useful and it is generally assumed that such cells are derived from normal stem cells, more work is needed to identify and characterize epithelial cancer stem cells, to address their precise relationship with normal stem cells, to study their markers and their proliferative and differentiation properties and to design new therapies that can overcome their unusual resistance to chemotherapy and other conventional tumor modalities.

Animals↗
PubMed2003

The crescentic advancement flap revisited.

BACKGROUND: When closing surgical defects, optimal aesthetic results are obtained when cosmetic units are preserved and, whenever possible, when scars are placed in naturally occurring creases and folds. This is particularly challenging in the perialar region, where surgical defects can encompass more than one cosmetic subunit. OBJECTIVE: To examine the reconstructive options and to demonstrate that the crescentic advancement flap for closures of defects in the perialar area is a superior alternative. METHODS: This is a review of surgical approaches, a historical examination of perialar repairs, and an illustrative case. RESULTS: A patient with a perialar defect was reconstructed using the crescentic advancement flap with excellent postoperative results. CONCLUSION: When compared with the other options, whenever feasible, the crescentic advancement flap, which has evolved over the years, remains a superior option for defects in the perialar location.

Humans↗