Faculty Bibliography

This study was designed to evaluate pulse sequences and patient positioning for MR imaging of silicone breast implants in patients. One hundred forty-three patients (281 silicone implants) underwent imaging over a 21-month period. The combination of a T2-weighted fast spin echo technique (SE), T2-weighted fast SE with water suppression, and T1-weighted SE with fat suppression is recommended to reliably differentiate silicone from other breast tissues and to identify intracapsular and extracapsular ruptures or leaks. Seventy of the 143 patients underwent removal of their silicone implants. The sensitivity for detection of silicone implant rupture was 76%, with a specificity of 97%. Positioning the patient prone improved image quality

The real future of surgical lasers, and indeed of surgery itself, will depend on the integration of the surgeon into a system incorporating real-time tissue sensors, computer-directed robotic manipulation, and laser-tissue interactions that are customized to the clinical task. The human surgeon will operate as the central judgmental element in this mechanized and semiautomated laser surgical system. Only then will we really be able to make use of the subtle and varied laser-tissue effects now being discovered

Optimal management of thumb loss necessitates individual consideration of all options, including prosthetic fitting, in relation to the needs and circumstances of each patient. Increased availability and substantial technical improvements in hand prostheses are resulting in their more frequent utilization, alone or in conjunction with surgical reconstruction. It has been found, contrary to general recommendations, that digital prostheses do in fact follow the basic rule of upper limb prostheses: the more distal the amputation, the more benefit a prosthetic fitting will be as there is a corresponding increase in automatic control. The benefit of digital prosthetic fitting is most striking in activities such as playing the piano or typing. The success of prosthetic fitting depends greatly on the defining of realistic goals and on the prosthesis being developed to very high standards with efficient follow-up service arrangements

Complete, stable chest-wall reconstruction was accomplished in a single operative procedure, using a fasciocutaneous free forearm flap based on the brachial artery. This allowed coverage of an extensive chest-wall defect

One patient with a solitary plasmacytoma of the frontal bone was treated with complete surgical resection. To reconstruct the large calvarial defect, a split-thickness calvarial graft was harvested from the parietal area and secured in place with miniplates. Solitary plasmacytomas of the calvaria are not common. Clinical presentation, diagnostic criteria, therapeutic approaches, and prognosis are discussed

A technique for the construction of a frontal bar and a forehead plate as a single unit is described. This technique could be used in any procedure in which a frontal bandeau is advanced and the forehead needs to be remodeled. By using microscrew fixation, the bulkiness of miniplates and wires is eliminated