Ron Azaria - Academia.edu (original) (raw)

Papers by Ron Azaria

Research paper thumbnail of Reconstruction of Nonhelical Auricular Defects with Local Flaps

Dermatologic Surgery, Apr 1, 2008

The integrity of each of the components of the auricle is important for its overall aesthetic app... more The integrity of each of the components of the auricle is important for its overall aesthetic appearance. Cartilage-exposing nonhelical defects that are too large to be closed primarily without distorting the auricle may be reconstructed with local flaps. The objective was to present our experience with the reconstruction of nonhelical medium-sized defects using a variety of simple, one-stage local flaps. Eighteen patients who underwent reconstruction of nonhelical auricular defects with local flaps at our center from 2003 to 2006. Defect size ranged from about 10 to 20 mm. Various methods were used for reconstruction as follows: conchal defect (n=11)--pull-through postauricular flap or cutaneous rotation flap from the concha itself; triangular fossa defect (n=3)--transposition-rotation flap from the concha or cutaneous periauricular pull-through flap via the root of the helix; antihelical defect (n=2)--V-Y advancement flap from the skin of the antihelix; and tragus defect (n=2)--periauricular cutaneous flap. All flaps survived. Transient congestion was noted in four patients. The aesthetic results were good, with no auricular deformation. It is important that reconstructive surgeons be familiar with a variety of basic flaps for reconstruction of nonhelical defects. An algorithm for nonhelical flap reconstruction is suggested.

Research paper thumbnail of Morphometry of the Adult Human Earlobe: A Study of 547 Subjects and Clinical Application

Plastic and Reconstructive Surgery, 2003

The purpose of this study was to define the factors that influence earlobe length and to establis... more The purpose of this study was to define the factors that influence earlobe length and to establish a standard for adult earlobe length by sex and age. The study sample consisted of 547 adult subjects older than 20 years of age. A randomized, prospective design was used. Patients with malignancies, previous surgery or trauma to the earlobe, or congenital earlobe anomalies were excluded. The following variables were studied: sex; age; ethnic origin; skin complexion; height, weight, and body mass index; and piercing. Pearson's correlation, analysis of variance, t test, and multiple regression analysis were used for the statistical analysis. There were 383 women (70 percent) and 164 men (30 percent) aged 20 to 80 years. The average length of the left earlobe was 1.97 cm (SD, 0.42 cm), and that of the right earlobe, 2.01 cm (SD, 0.42 cm) (p < 0.0001). A post hoc test revealed a statistically significant difference among the three age groups (20 to 40 years, 40 to 60 years, and >60 years) in both men and women. Pendulous earlobes were significantly longer and less symmetrical than nonpendulous ones by t test. In men, nonpierced left earlobes were longer than pierced lobes; in women, there was no significant difference between pierced and nonpierced ears. Pearson's correlation tests for weight, height, and body mass index showed that only weight had a significant effect on earlobe length, and only in women. Analysis of variance for ethnic origin and skin color revealed a longer left earlobe in Ashkenazi and Sephardic Jews compared with Ethiopian, Asian, and American Jews and Arabs and a short earlobe in blacks compared with dark and fair-skinned people. On multiple regression analysis, sex and age were the only factors that contributed to earlobe length. A table of average earlobe length by age was formulated on the basis of the authors' findings. These data, together with the knowledge that earlobe length changes little in women over 40, that earlobes are not symmetrical, and that right and left nonpendulous earlobes are symmetrical in individual patients and shorter than pendulous earlobes, can assist the plastic surgeon in deciding on the proper time for loboplasty. The preferable technique is creating a nonpendulous earlobe to minimize the chances of further elongation with time.

Research paper thumbnail of Anterior Conchal Reconstruction Using a Posteroauricular Pull-Through Transpositional Flap

Plastic and Reconstructive Surgery, 2004

Research paper thumbnail of Removing Highly Cohesive Silicone Gel after Breast Implant Rupture: An In Vitro Study

Plastic and Reconstructive Surgery, 2010

Research paper thumbnail of Use of reflectance spectrophotometry to predict the response of port wine stains to pulsed dye laser

Lasers in Medical Science, 2014

Reflectance spectroscopy can be used to quantitate subtle differences in color. We applied a port... more Reflectance spectroscopy can be used to quantitate subtle differences in color. We applied a portable reflectance spectrometer to determine its utility in the evaluation of pulsed dye laser treatment of port wine stains (PWS) and in prediction of clinical outcome, in a prospective study. Forty-eight patients with PWS underwent one to nine pulsed dye laser treatments. Patient age and skin color as well as PWS surface area, anatomic location, and color were recorded. Pretreatment spectrophotometric measurements were performed. The subjective clinical results of treatment and the quantitative spectrophotometry results were evaluated by two independent teams, and the findings were correlated. The impact of the clinical characteristics on the response to treatment was assessed as well. Patients with excellent to good clinical results of laser treatments had pretreatment spectrophotometric measurements which differed by more than 10%, whereas patients with fair to poor results had spectrophotometric measurements with a difference of of less than 10%. The correlation between the spectrophotometric results and the clinical outcome was 73% (p < 0.01). The impact of the other clinical variables on outcome agreed with the findings in the literature. Spectrophotometry has a higher correlation with clinical outcome and a better predictive value than other nonmeasurable, nonquantitative, dependent variables.

Research paper thumbnail of Basal cell carcinoma arising over facial port wine stain: a single-centre experience

Journal of the European Academy of Dermatology and Venereology, 2006

Background A growing number of reports point to a possible connection between basal cell carcinom... more Background A growing number of reports point to a possible connection between basal cell carcinoma (BCC) and port wine stain (PWS). Researchers suggest that either the elevated temperature induced by the increased dermal vasculature or an oncogenic factor produced by the ectatic vessels makes the overlying epidermis more susceptible to ultraviolet or ionizing radiation. Objective To check the prevalence of BCC in patients with PWS at a large national vascular amomalies centre. Methods The study group included 68 patients, 44 women and 24 men, with facial PWSs. Detailed data were collected on background features, past treatments and past exposure to radiation, and a comprehensive physical examination was performed. Biopsy samples were taken from suspect lesions for histological study. Results Four patients (5.9%) were found to have histologically proven BCC, 3 nodular and one multifocal. All had been exposed to radiation during childhood. Treatment consisted of excision; there was one recurrence. Conclusion Although the co-occurrence of BCC and PWS is probably related to radiation treatment in childhood, these findings should alert physicians to regularly examine PWSs for cancerous changes, especially in patients at risk.

Research paper thumbnail of Endometrial Cancers in Postmenopausal Breast Cancer Patients with Tamoxifen Treatment

International Journal of Gynecological Pathology, 1999

To evaluate possible predicting factors for endometrial cancer in postmenopausal breast cancer pa... more To evaluate possible predicting factors for endometrial cancer in postmenopausal breast cancer patients with tamoxifen treatment, we compared various clinical features between 12 postmenopausal breast cancer tamoxifen-treated patients with endometrial cancer and a control group of 261 otherwise similar patients without this endometrial pathology. These comparisons were based on a long-term prospective follow-up. Several clinical factors such as longer duration of breast disease, older patient age, lower frequency of chemotherapy administration, and higher frequency of postmenopausal bleeding were found among the tamoxifen-treated patients with endometrial cancers, and were significantly different when compared to the control group. Only eight (66.7%) had postmenopausal bleeding, and a preoperative diagnosis of endometrial cancer was made in only six (50.0%). When considering postmenopausal bleeding as a marker for endometrial cancer in the study patients, sensitivity was 67% and specificity was 98%.

Research paper thumbnail of Malignant Endometrial Polyps in Postmenopausal Breast Cancer Tamoxifen-Treated Patients

Gynecologic Oncology, 1999

Endometrial polyps are the most common endometrial pathology described in association with postme... more Endometrial polyps are the most common endometrial pathology described in association with postmenopausal tamoxifen exposure. It is generally accepted that the occurrence of malignancy in endometrial polyps among healthy women is up to 0.5%. However, no one has yet described the incidence of this malignant transformation among postmenopausal breast cancer tamoxifen-treated patients. Objective. The aim of this study was to study the exact rate of malignant changes in endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients. We reviewed the pathological results and medical records of all postmenopausal breast cancer patients in whom endometrial polyps were recovered following at least 6 months of tamoxifen treatment in our institute. We also looked for the rate of malignant changes in polyps recovered from all healthy postmenopausal controls with endometrial polyps in our institute during the period of the study. Two (3.0%) of 67 endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients revealed malignant features. None of the clinical variables tested, including risk factors for endometrial cancer, was significantly different between the groups. In the controls only 5 (0.48%) of 1034 polyps were malignant. Up to 3.0% of endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients may show malignant changes. This rate is higher than that found in our controls as well as that reported in the general female population.

Research paper thumbnail of Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

Gynecologic and Obstetric Investigation, 1999

Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal ... more Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal breast cancer patients with tamoxifen treatment (group I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared. This comparison was performed in order to assess whether endometrial pathologies are more frequently diagnosed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological findings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium was significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001). All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 and 11. 5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15. 0 and 0.4%, respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various endometrial histological findings and of overall positive endometrial histological findings were significantly higher in specimens collected by hysterectomy than in specimens obtained by hysteroscopy.

Research paper thumbnail of Reconstruction of Nonhelical Auricular Defects with Local Flaps

Dermatologic Surgery, 2008

The integrity of each of the components of the auricle is important for its overall aesthetic app... more The integrity of each of the components of the auricle is important for its overall aesthetic appearance. Cartilage-exposing nonhelical defects that are too large to be closed primarily without distorting the auricle may be reconstructed with local flaps. The objective was to present our experience with the reconstruction of nonhelical medium-sized defects using a variety of simple, one-stage local flaps. Eighteen patients who underwent reconstruction of nonhelical auricular defects with local flaps at our center from 2003 to 2006. Defect size ranged from about 10 to 20 mm. Various methods were used for reconstruction as follows: conchal defect (n=11)--pull-through postauricular flap or cutaneous rotation flap from the concha itself; triangular fossa defect (n=3)--transposition-rotation flap from the concha or cutaneous periauricular pull-through flap via the root of the helix; antihelical defect (n=2)--V-Y advancement flap from the skin of the antihelix; and tragus defect (n=2)--periauricular cutaneous flap. All flaps survived. Transient congestion was noted in four patients. The aesthetic results were good, with no auricular deformation. It is important that reconstructive surgeons be familiar with a variety of basic flaps for reconstruction of nonhelical defects. An algorithm for nonhelical flap reconstruction is suggested.

Research paper thumbnail of Tragus Reconstruction after Tumor Excision with Preauricular Folded Flap

Dermatologic Surgery, 2007

Research paper thumbnail of Treatment of Angiokeratoma of Fordyce with Pulsed Dye Laser

Dermatologic Surgery, 2006

BACKGROUND Angiokeratomas of Fordyce are typically asymptomatic vascular lesions characterized by... more BACKGROUND Angiokeratomas of Fordyce are typically asymptomatic vascular lesions characterized by blue-to-red papules with a scale surface, most often located on the scrotum. Although considered benign, the lesions may bleed, either spontaneously or secondary to rupture, leading to patient anxiety and social embarrassment.

Research paper thumbnail of Risk factors of endometrial polyps resected from postmenopausal patients with breast carcinoma treated with tamoxifen

Cancer, 2001

Endometrial polyps are the most common endometrial pathology described in association with postme... more Endometrial polyps are the most common endometrial pathology described in association with postmenopausal tamoxifen exposure. Up to 3% of these polyps may show malignant changes. However, to the authors' knowledge no one has described any risk factor for the development of this pathology in postmenopausal patients with breast carcinoma treated with tamoxifen. OBJECTIVE. The objective of this study was to evaluate whether risk factors can be identified for the development of endometrial polyps in postmenopausal patients with breast carcinoma treated with tamoxifen. The authors reviewed the medical records of 54 postmenopausal patients with breast carcinoma in whom endometrial polyps were resected by hysteroscopy after at least 6 months of tamoxifen treatment (Group I). Demographic characteristics, health habits, risk factors for endometrial carcinoma, and clinical factors related to the primary breast disease were examined. The results were compared with those obtained from 210 similar patients in whom hysteroscopy did not reveal any endometrial pathology (Group II). Age at menopause was significantly older, duration of breast disease was significantly longer, and body weight was significantly heavier among Group I patients compared with Group II patients (P = 0.0162, P = 0.0026, and P = 0.0364, respectively). Endometrial thickness, measured by transvaginal ultrasonography, was significantly thicker in Group I patients (16.3 +/- 7.2 mm) compared with that detected in Group II patients (11.8 +/- 6.3; P = 0.0001). Various factors, such as older age at menopause, longer duration of breast disease, heavier weight, and thicker endometrium may contribute to the prediction of increased risk of development of endometrial polyps in postmenopausal patients with breast carcinoma treated with tamoxifen.

Research paper thumbnail of Significance of secondary ultrasonographic endometrial thickening in postmenopausal tamoxifen-treated women

Cancer, 2002

BACKGROUND. Ultrasonography has a limited value in endometrial assessment for identification of e... more BACKGROUND. Ultrasonography has a limited value in endometrial assessment for identification of endometrial pathologies in postmenopausal tamoxifen-treated patients.

Research paper thumbnail of Ultrasonographic measurement of endometrial changes following discontinuation of tamoxifen treatment in postmenopausal breast cancer patients

BJOG: An International Journal of Obstetrics and Gynaecology, 2000

Objective To assess whether there is a decrease in endometrial thickness following discontinuatio... more Objective To assess whether there is a decrease in endometrial thickness following discontinuation of Design Prospective study.

Research paper thumbnail of Nasolabial Hinge Flap with Simultaneous Cartilage Graft in Nasal Alar and Tip Reconstruction

Dermatologic Surgery, 2007

Research paper thumbnail of Reconstruction of Nonhelical Auricular Defects with Local Flaps

Dermatologic Surgery, Apr 1, 2008

The integrity of each of the components of the auricle is important for its overall aesthetic app... more The integrity of each of the components of the auricle is important for its overall aesthetic appearance. Cartilage-exposing nonhelical defects that are too large to be closed primarily without distorting the auricle may be reconstructed with local flaps. The objective was to present our experience with the reconstruction of nonhelical medium-sized defects using a variety of simple, one-stage local flaps. Eighteen patients who underwent reconstruction of nonhelical auricular defects with local flaps at our center from 2003 to 2006. Defect size ranged from about 10 to 20 mm. Various methods were used for reconstruction as follows: conchal defect (n=11)--pull-through postauricular flap or cutaneous rotation flap from the concha itself; triangular fossa defect (n=3)--transposition-rotation flap from the concha or cutaneous periauricular pull-through flap via the root of the helix; antihelical defect (n=2)--V-Y advancement flap from the skin of the antihelix; and tragus defect (n=2)--periauricular cutaneous flap. All flaps survived. Transient congestion was noted in four patients. The aesthetic results were good, with no auricular deformation. It is important that reconstructive surgeons be familiar with a variety of basic flaps for reconstruction of nonhelical defects. An algorithm for nonhelical flap reconstruction is suggested.

Research paper thumbnail of Morphometry of the Adult Human Earlobe: A Study of 547 Subjects and Clinical Application

Plastic and Reconstructive Surgery, 2003

The purpose of this study was to define the factors that influence earlobe length and to establis... more The purpose of this study was to define the factors that influence earlobe length and to establish a standard for adult earlobe length by sex and age. The study sample consisted of 547 adult subjects older than 20 years of age. A randomized, prospective design was used. Patients with malignancies, previous surgery or trauma to the earlobe, or congenital earlobe anomalies were excluded. The following variables were studied: sex; age; ethnic origin; skin complexion; height, weight, and body mass index; and piercing. Pearson's correlation, analysis of variance, t test, and multiple regression analysis were used for the statistical analysis. There were 383 women (70 percent) and 164 men (30 percent) aged 20 to 80 years. The average length of the left earlobe was 1.97 cm (SD, 0.42 cm), and that of the right earlobe, 2.01 cm (SD, 0.42 cm) (p < 0.0001). A post hoc test revealed a statistically significant difference among the three age groups (20 to 40 years, 40 to 60 years, and >60 years) in both men and women. Pendulous earlobes were significantly longer and less symmetrical than nonpendulous ones by t test. In men, nonpierced left earlobes were longer than pierced lobes; in women, there was no significant difference between pierced and nonpierced ears. Pearson's correlation tests for weight, height, and body mass index showed that only weight had a significant effect on earlobe length, and only in women. Analysis of variance for ethnic origin and skin color revealed a longer left earlobe in Ashkenazi and Sephardic Jews compared with Ethiopian, Asian, and American Jews and Arabs and a short earlobe in blacks compared with dark and fair-skinned people. On multiple regression analysis, sex and age were the only factors that contributed to earlobe length. A table of average earlobe length by age was formulated on the basis of the authors' findings. These data, together with the knowledge that earlobe length changes little in women over 40, that earlobes are not symmetrical, and that right and left nonpendulous earlobes are symmetrical in individual patients and shorter than pendulous earlobes, can assist the plastic surgeon in deciding on the proper time for loboplasty. The preferable technique is creating a nonpendulous earlobe to minimize the chances of further elongation with time.

Research paper thumbnail of Anterior Conchal Reconstruction Using a Posteroauricular Pull-Through Transpositional Flap

Plastic and Reconstructive Surgery, 2004

Research paper thumbnail of Removing Highly Cohesive Silicone Gel after Breast Implant Rupture: An In Vitro Study

Plastic and Reconstructive Surgery, 2010

Research paper thumbnail of Use of reflectance spectrophotometry to predict the response of port wine stains to pulsed dye laser

Lasers in Medical Science, 2014

Reflectance spectroscopy can be used to quantitate subtle differences in color. We applied a port... more Reflectance spectroscopy can be used to quantitate subtle differences in color. We applied a portable reflectance spectrometer to determine its utility in the evaluation of pulsed dye laser treatment of port wine stains (PWS) and in prediction of clinical outcome, in a prospective study. Forty-eight patients with PWS underwent one to nine pulsed dye laser treatments. Patient age and skin color as well as PWS surface area, anatomic location, and color were recorded. Pretreatment spectrophotometric measurements were performed. The subjective clinical results of treatment and the quantitative spectrophotometry results were evaluated by two independent teams, and the findings were correlated. The impact of the clinical characteristics on the response to treatment was assessed as well. Patients with excellent to good clinical results of laser treatments had pretreatment spectrophotometric measurements which differed by more than 10%, whereas patients with fair to poor results had spectrophotometric measurements with a difference of of less than 10%. The correlation between the spectrophotometric results and the clinical outcome was 73% (p < 0.01). The impact of the other clinical variables on outcome agreed with the findings in the literature. Spectrophotometry has a higher correlation with clinical outcome and a better predictive value than other nonmeasurable, nonquantitative, dependent variables.

Research paper thumbnail of Basal cell carcinoma arising over facial port wine stain: a single-centre experience

Journal of the European Academy of Dermatology and Venereology, 2006

Background A growing number of reports point to a possible connection between basal cell carcinom... more Background A growing number of reports point to a possible connection between basal cell carcinoma (BCC) and port wine stain (PWS). Researchers suggest that either the elevated temperature induced by the increased dermal vasculature or an oncogenic factor produced by the ectatic vessels makes the overlying epidermis more susceptible to ultraviolet or ionizing radiation. Objective To check the prevalence of BCC in patients with PWS at a large national vascular amomalies centre. Methods The study group included 68 patients, 44 women and 24 men, with facial PWSs. Detailed data were collected on background features, past treatments and past exposure to radiation, and a comprehensive physical examination was performed. Biopsy samples were taken from suspect lesions for histological study. Results Four patients (5.9%) were found to have histologically proven BCC, 3 nodular and one multifocal. All had been exposed to radiation during childhood. Treatment consisted of excision; there was one recurrence. Conclusion Although the co-occurrence of BCC and PWS is probably related to radiation treatment in childhood, these findings should alert physicians to regularly examine PWSs for cancerous changes, especially in patients at risk.

Research paper thumbnail of Endometrial Cancers in Postmenopausal Breast Cancer Patients with Tamoxifen Treatment

International Journal of Gynecological Pathology, 1999

To evaluate possible predicting factors for endometrial cancer in postmenopausal breast cancer pa... more To evaluate possible predicting factors for endometrial cancer in postmenopausal breast cancer patients with tamoxifen treatment, we compared various clinical features between 12 postmenopausal breast cancer tamoxifen-treated patients with endometrial cancer and a control group of 261 otherwise similar patients without this endometrial pathology. These comparisons were based on a long-term prospective follow-up. Several clinical factors such as longer duration of breast disease, older patient age, lower frequency of chemotherapy administration, and higher frequency of postmenopausal bleeding were found among the tamoxifen-treated patients with endometrial cancers, and were significantly different when compared to the control group. Only eight (66.7%) had postmenopausal bleeding, and a preoperative diagnosis of endometrial cancer was made in only six (50.0%). When considering postmenopausal bleeding as a marker for endometrial cancer in the study patients, sensitivity was 67% and specificity was 98%.

Research paper thumbnail of Malignant Endometrial Polyps in Postmenopausal Breast Cancer Tamoxifen-Treated Patients

Gynecologic Oncology, 1999

Endometrial polyps are the most common endometrial pathology described in association with postme... more Endometrial polyps are the most common endometrial pathology described in association with postmenopausal tamoxifen exposure. It is generally accepted that the occurrence of malignancy in endometrial polyps among healthy women is up to 0.5%. However, no one has yet described the incidence of this malignant transformation among postmenopausal breast cancer tamoxifen-treated patients. Objective. The aim of this study was to study the exact rate of malignant changes in endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients. We reviewed the pathological results and medical records of all postmenopausal breast cancer patients in whom endometrial polyps were recovered following at least 6 months of tamoxifen treatment in our institute. We also looked for the rate of malignant changes in polyps recovered from all healthy postmenopausal controls with endometrial polyps in our institute during the period of the study. Two (3.0%) of 67 endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients revealed malignant features. None of the clinical variables tested, including risk factors for endometrial cancer, was significantly different between the groups. In the controls only 5 (0.48%) of 1034 polyps were malignant. Up to 3.0% of endometrial polyps recovered from postmenopausal breast cancer tamoxifen-treated patients may show malignant changes. This rate is higher than that found in our controls as well as that reported in the general female population.

Research paper thumbnail of Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

Gynecologic and Obstetric Investigation, 1999

Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal ... more Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal breast cancer patients with tamoxifen treatment (group I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared. This comparison was performed in order to assess whether endometrial pathologies are more frequently diagnosed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological findings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium was significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001). All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 and 11. 5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15. 0 and 0.4%, respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various endometrial histological findings and of overall positive endometrial histological findings were significantly higher in specimens collected by hysterectomy than in specimens obtained by hysteroscopy.

Research paper thumbnail of Reconstruction of Nonhelical Auricular Defects with Local Flaps

Dermatologic Surgery, 2008

The integrity of each of the components of the auricle is important for its overall aesthetic app... more The integrity of each of the components of the auricle is important for its overall aesthetic appearance. Cartilage-exposing nonhelical defects that are too large to be closed primarily without distorting the auricle may be reconstructed with local flaps. The objective was to present our experience with the reconstruction of nonhelical medium-sized defects using a variety of simple, one-stage local flaps. Eighteen patients who underwent reconstruction of nonhelical auricular defects with local flaps at our center from 2003 to 2006. Defect size ranged from about 10 to 20 mm. Various methods were used for reconstruction as follows: conchal defect (n=11)--pull-through postauricular flap or cutaneous rotation flap from the concha itself; triangular fossa defect (n=3)--transposition-rotation flap from the concha or cutaneous periauricular pull-through flap via the root of the helix; antihelical defect (n=2)--V-Y advancement flap from the skin of the antihelix; and tragus defect (n=2)--periauricular cutaneous flap. All flaps survived. Transient congestion was noted in four patients. The aesthetic results were good, with no auricular deformation. It is important that reconstructive surgeons be familiar with a variety of basic flaps for reconstruction of nonhelical defects. An algorithm for nonhelical flap reconstruction is suggested.

Research paper thumbnail of Tragus Reconstruction after Tumor Excision with Preauricular Folded Flap

Dermatologic Surgery, 2007

Research paper thumbnail of Treatment of Angiokeratoma of Fordyce with Pulsed Dye Laser

Dermatologic Surgery, 2006

BACKGROUND Angiokeratomas of Fordyce are typically asymptomatic vascular lesions characterized by... more BACKGROUND Angiokeratomas of Fordyce are typically asymptomatic vascular lesions characterized by blue-to-red papules with a scale surface, most often located on the scrotum. Although considered benign, the lesions may bleed, either spontaneously or secondary to rupture, leading to patient anxiety and social embarrassment.

Research paper thumbnail of Risk factors of endometrial polyps resected from postmenopausal patients with breast carcinoma treated with tamoxifen

Cancer, 2001

Endometrial polyps are the most common endometrial pathology described in association with postme... more Endometrial polyps are the most common endometrial pathology described in association with postmenopausal tamoxifen exposure. Up to 3% of these polyps may show malignant changes. However, to the authors' knowledge no one has described any risk factor for the development of this pathology in postmenopausal patients with breast carcinoma treated with tamoxifen. OBJECTIVE. The objective of this study was to evaluate whether risk factors can be identified for the development of endometrial polyps in postmenopausal patients with breast carcinoma treated with tamoxifen. The authors reviewed the medical records of 54 postmenopausal patients with breast carcinoma in whom endometrial polyps were resected by hysteroscopy after at least 6 months of tamoxifen treatment (Group I). Demographic characteristics, health habits, risk factors for endometrial carcinoma, and clinical factors related to the primary breast disease were examined. The results were compared with those obtained from 210 similar patients in whom hysteroscopy did not reveal any endometrial pathology (Group II). Age at menopause was significantly older, duration of breast disease was significantly longer, and body weight was significantly heavier among Group I patients compared with Group II patients (P = 0.0162, P = 0.0026, and P = 0.0364, respectively). Endometrial thickness, measured by transvaginal ultrasonography, was significantly thicker in Group I patients (16.3 +/- 7.2 mm) compared with that detected in Group II patients (11.8 +/- 6.3; P = 0.0001). Various factors, such as older age at menopause, longer duration of breast disease, heavier weight, and thicker endometrium may contribute to the prediction of increased risk of development of endometrial polyps in postmenopausal patients with breast carcinoma treated with tamoxifen.

Research paper thumbnail of Significance of secondary ultrasonographic endometrial thickening in postmenopausal tamoxifen-treated women

Cancer, 2002

BACKGROUND. Ultrasonography has a limited value in endometrial assessment for identification of e... more BACKGROUND. Ultrasonography has a limited value in endometrial assessment for identification of endometrial pathologies in postmenopausal tamoxifen-treated patients.

Research paper thumbnail of Ultrasonographic measurement of endometrial changes following discontinuation of tamoxifen treatment in postmenopausal breast cancer patients

BJOG: An International Journal of Obstetrics and Gynaecology, 2000

Objective To assess whether there is a decrease in endometrial thickness following discontinuatio... more Objective To assess whether there is a decrease in endometrial thickness following discontinuation of Design Prospective study.

Research paper thumbnail of Nasolabial Hinge Flap with Simultaneous Cartilage Graft in Nasal Alar and Tip Reconstruction

Dermatologic Surgery, 2007