The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suf... more The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma. Chemotherapy included 8 cycles of doxorubicin, vincristine, and cyclophosphamide, with alternating cycles of etoposide and ifosfamide. A year later, a second wide excision of the mass was performed, followed by bilaminate skin substitute and skin graft placement for reconstruction of the soft-tissue defect. After chemotherapy, a follow-up PET scan showed no signs of re-uptake in any soft tissue or skeletal structures. After 2 years, the patient remains in complete remission.
OBJECTIVE Microvascular free-tissue transfer (M-FTT) is a surgical technique for traumatic injuri... more OBJECTIVE Microvascular free-tissue transfer (M-FTT) is a surgical technique for traumatic injuries that allows tissue reconstruction based on donor tissue composition. The aim of this study is to describe the surgical experiences of M-FTT for reconstruction of complex soft tissue injuries in the lower extremities of a Hispanic population. METHODS This is a descriptive study of all M-FTT procedures performed by a single plastic surgeon from 2012 to 2016 at Puerto Rico Medical Center. Demographics, admission diagnosis, mechanism of trauma, type of free flap, co-morbidities, length of stay, donor site and complications were evaluated. RESULTS Eight patients who underwent single M-FTT procedures at lower extremity were enrolled in the study. The average age at time of surgical reconstruction was 36.9+13.2 years with six males and two females. The transfer procedures were performed using donor sites of six rectus abdominis flaps and 2 radial forearm flaps. Posterior tibial artery was us...
Transplantation of Composite Tissue Allografts, 2008
... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replaceme... more ... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replacement of a gangrenous and cancerous leg of a sleeping man with an amputated limb from a recently deceased Ethiopian Moor, conducted by the physician twins Saint Cosmos and Saint ...
The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suf... more The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma. Chemotherapy included 8 cycles of doxorubicin, vincristine, and cyclophosphamide, with alternating cycles of etoposide and ifosfamide. A year later, a second wide excision of the mass was performed, followed by bilaminate skin substitute and skin graft placement for reconstruction of the soft-tissue defect. After chemotherapy, a follow-up PET scan showed no signs of re-uptake in any soft tissue or skeletal structures. After 2 years, the pat...
Survival in breast cancer maybe more accurately predicted by a scoring system based on the biolog... more Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and diseas...
Surgical outcomes from a breast cancer-screening program of low-income women are similar to those... more Surgical outcomes from a breast cancer-screening program of low-income women are similar to those of other screening programs. Prospective cohort. Federally funded screening program. A total of 15730 women. A total of 23149 mammograms, 20396 with concomitant clinical breast examination, from January 1, 1997, through December 31, 2001. American College of Radiology scores; associated surgery consultations, biopsies, operations, and pathology results. Most (20868) of the 21296 mammograms assigned an American College of Radiology score were benign; only 428 (2%) were suspicious. Resulting from suspicious clinical breast examinations, the group with American College of Radiology scores of 1 to 3 accounted for 45%, 18%, and 10% of recommended surgical consultations, biopsies, and cancers detected, respectively. A rate of 12.3 cancers per 1000 women was found, greater than with other screening programs. Compliance with therapy was 97%. This screening program had a higher rate of advanced ...
Surgical outcomes from a breast cancer-screening program of low-income women are similar to those... more Surgical outcomes from a breast cancer-screening program of low-income women are similar to those of other screening programs. Prospective cohort. Federally funded screening program. A total of 15730 women. A total of 23149 mammograms, 20396 with concomitant clinical breast examination, from January 1, 1997, through December 31, 2001. American College of Radiology scores; associated surgery consultations, biopsies, operations, and pathology results. Most (20868) of the 21296 mammograms assigned an American College of Radiology score were benign; only 428 (2%) were suspicious. Resulting from suspicious clinical breast examinations, the group with American College of Radiology scores of 1 to 3 accounted for 45%, 18%, and 10% of recommended surgical consultations, biopsies, and cancers detected, respectively. A rate of 12.3 cancers per 1000 women was found, greater than with other screening programs. Compliance with therapy was 97%. This screening program had a higher rate of advanced cancers. Clinical breast examination was an important component, and compliance with surgical recommendations was excellent.
Transplantation of Composite Tissue Allografts, 2008
... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replaceme... more ... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replacement of a gangrenous and cancerous leg of a sleeping man with an amputated limb from a recently deceased Ethiopian Moor, conducted by the physician twins Saint Cosmos and Saint ...
The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suf... more The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma. Chemotherapy included 8 cycles of doxorubicin, vincristine, and cyclophosphamide, with alternating cycles of etoposide and ifosfamide. A year later, a second wide excision of the mass was performed, followed by bilaminate skin substitute and skin graft placement for reconstruction of the soft-tissue defect. After chemotherapy, a follow-up PET scan showed no signs of re-uptake in any soft tissue or skeletal structures. After 2 years, the patient remains in complete remission.
OBJECTIVE Microvascular free-tissue transfer (M-FTT) is a surgical technique for traumatic injuri... more OBJECTIVE Microvascular free-tissue transfer (M-FTT) is a surgical technique for traumatic injuries that allows tissue reconstruction based on donor tissue composition. The aim of this study is to describe the surgical experiences of M-FTT for reconstruction of complex soft tissue injuries in the lower extremities of a Hispanic population. METHODS This is a descriptive study of all M-FTT procedures performed by a single plastic surgeon from 2012 to 2016 at Puerto Rico Medical Center. Demographics, admission diagnosis, mechanism of trauma, type of free flap, co-morbidities, length of stay, donor site and complications were evaluated. RESULTS Eight patients who underwent single M-FTT procedures at lower extremity were enrolled in the study. The average age at time of surgical reconstruction was 36.9+13.2 years with six males and two females. The transfer procedures were performed using donor sites of six rectus abdominis flaps and 2 radial forearm flaps. Posterior tibial artery was us...
Transplantation of Composite Tissue Allografts, 2008
... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replaceme... more ... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replacement of a gangrenous and cancerous leg of a sleeping man with an amputated limb from a recently deceased Ethiopian Moor, conducted by the physician twins Saint Cosmos and Saint ...
The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suf... more The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma. Chemotherapy included 8 cycles of doxorubicin, vincristine, and cyclophosphamide, with alternating cycles of etoposide and ifosfamide. A year later, a second wide excision of the mass was performed, followed by bilaminate skin substitute and skin graft placement for reconstruction of the soft-tissue defect. After chemotherapy, a follow-up PET scan showed no signs of re-uptake in any soft tissue or skeletal structures. After 2 years, the pat...
Survival in breast cancer maybe more accurately predicted by a scoring system based on the biolog... more Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and diseas...
Surgical outcomes from a breast cancer-screening program of low-income women are similar to those... more Surgical outcomes from a breast cancer-screening program of low-income women are similar to those of other screening programs. Prospective cohort. Federally funded screening program. A total of 15730 women. A total of 23149 mammograms, 20396 with concomitant clinical breast examination, from January 1, 1997, through December 31, 2001. American College of Radiology scores; associated surgery consultations, biopsies, operations, and pathology results. Most (20868) of the 21296 mammograms assigned an American College of Radiology score were benign; only 428 (2%) were suspicious. Resulting from suspicious clinical breast examinations, the group with American College of Radiology scores of 1 to 3 accounted for 45%, 18%, and 10% of recommended surgical consultations, biopsies, and cancers detected, respectively. A rate of 12.3 cancers per 1000 women was found, greater than with other screening programs. Compliance with therapy was 97%. This screening program had a higher rate of advanced ...
Surgical outcomes from a breast cancer-screening program of low-income women are similar to those... more Surgical outcomes from a breast cancer-screening program of low-income women are similar to those of other screening programs. Prospective cohort. Federally funded screening program. A total of 15730 women. A total of 23149 mammograms, 20396 with concomitant clinical breast examination, from January 1, 1997, through December 31, 2001. American College of Radiology scores; associated surgery consultations, biopsies, operations, and pathology results. Most (20868) of the 21296 mammograms assigned an American College of Radiology score were benign; only 428 (2%) were suspicious. Resulting from suspicious clinical breast examinations, the group with American College of Radiology scores of 1 to 3 accounted for 45%, 18%, and 10% of recommended surgical consultations, biopsies, and cancers detected, respectively. A rate of 12.3 cancers per 1000 women was found, greater than with other screening programs. Compliance with therapy was 97%. This screening program had a higher rate of advanced cancers. Clinical breast examination was an important component, and compliance with surgical recommendations was excellent.
Transplantation of Composite Tissue Allografts, 2008
... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replaceme... more ... Milton B. Armstrong, Ricardo Jimenez-Lee, and Eddie Manning ... was inspired by the replacement of a gangrenous and cancerous leg of a sleeping man with an amputated limb from a recently deceased Ethiopian Moor, conducted by the physician twins Saint Cosmos and Saint ...
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