Concepts of Sliding and Lifting Tissue Movement in Flap Reconstruction

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94457/1/j.1524-4725.2000.09172.x.pd

An Interdisciplinary Approach to the Management of Basal Cell Carcinoma of the Head and Neck

At the University of Michigan the dermatologic surgeon works closely with the head and neck surgeon in resecting extensive cutaneous malignancies that could benefit from the combined skills of both surgical specialists. Mohs surgery offers complete microscopic controlled resection of the cutaneous portion of skin cancers. Tumors extending deeply from the skin into underlying bone and soft tissue are resected with the assistance of the head and neck surgeon familiar with the anatomy and trained in the protection of the vital structures of the head and neck. It is evident that patients with large or aggressive basal cell carcinomas will best be served when this interdisciplinary approach has become commonplace.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72612/1/j.1524-4725.1987.tb00917.x.pd

Families of Graphs with W_r({G},q) Functions That Are Nonanalytic at 1/q=0

Denoting $P(G,q)$ as the chromatic polynomial for coloring an $n$-vertex graph $G$ with $q$ colors, and considering the limiting function $W(\{G\},q) = \lim_{n \to \infty}P(G,q)^{1/n}$, a fundamental question in graph theory is the following: is $W_r(\{G\},q) = q^{-1}W(\{G\},q)$ analytic or not at the origin of the $1/q$ plane? (where the complex generalization of $q$ is assumed). This question is also relevant in statistical mechanics because $W(\{G\},q)=\exp(S_0/k_B)$, where $S_0$ is the ground state entropy of the $q$-state Potts antiferromagnet on the lattice graph $\{G\}$, and the analyticity of $W_r(\{G\},q)$ at $1/q=0$ is necessary for the large-$q$ series expansions of $W_r(\{G\},q)$. Although $W_r$ is analytic at $1/q=0$ for many $\{G\}$, there are some $\{G\}$ for which it is not; for these, $W_r$ has no large-$q$ series expansion. It is important to understand the reason for this nonanalyticity. Here we give a general condition that determines whether or not a particular $W_r(\{G\},q)$ is analytic at $1/q=0$ and explains the nonanalyticity where it occurs. We also construct infinite families of graphs with $W_r$ functions that are non-analytic at $1/q=0$ and investigate the properties of these functions. Our results are consistent with the conjecture that a sufficient condition for $W_r(\{G\},q)$ to be analytic at $1/q=0$ is that $\{G\}$ is a regular lattice graph $\Lambda$. (This is known not to be a necessary condition).Comment: 22 pages, Revtex, 4 encapsulated postscript figures, to appear in Phys. Rev.

Ground State Entropy of Potts Antiferromagnets: Bounds, Series, and Monte Carlo Measurements

We report several results concerning $W(\Lambda,q)=\exp(S_0/k_B)$, the exponent of the ground state entropy of the Potts antiferromagnet on a lattice $\Lambda$. First, we improve our previous rigorous lower bound on $W(hc,q)$ for the honeycomb (hc) lattice and find that it is extremely accurate; it agrees to the first eleven terms with the large-$q$ series for $W(hc,q)$. Second, we investigate the heteropolygonal Archimedean $4 \cdot 8^2$ lattice, derive a rigorous lower bound, on $W(4 \cdot 8^2,q)$, and calculate the large-$q$ series for this function to $O(y^{12})$ where $y=1/(q-1)$. Remarkably, these agree exactly to all thirteen terms calculated. We also report Monte Carlo measurements, and find that these are very close to our lower bound and series. Third, we study the effect of non-nearest-neighbor couplings, focusing on the square lattice with next-nearest-neighbor bonds.Comment: 13 pages, Latex, to appear in Phys. Rev.

High-dose cisplatin in advanced head and neck cancer

In 22 patients with advanced squamous cell carcinoma of the head and neck we evaluated the efficacy and toxicity of 200 mg/m 2 cisplatin administered in 3% NaCl with vigorous hydration. Six patients had previously untreated stage IV disease and 16 patients had recurrent disease, including eight with prior chemotherapy including low-dose cisplatin and carboplatin. Cisplatin was administered as a brief infusion, either 40 mg/m 2 /day × 5 or 50mg/m 2 /day × 4, every 28 days. Objective responses were observed in 16 of 22 (73%) patients, including 5 of 6 (83%) previously untreated patients and 11 of 16 (69%) patients with recurrent disease. This included two comoplete responses, one confirmed pathologically. Fifty-seven courses of drug were administered and toxicity was monitored with serial creatinine clearance determinations, audiograms, and sensorimotor exams. Neuropathy and ototoxicity were dose-limiting and led to the stopping of treatment in 12 of the 16 responders after one to four courses (median three courses). Only two responding patients continued treatment until disease progression occurred at 3 and 4 months after achieving maximum response. Acute, transient nephrotoxicity occurred in four patients; two were retreated. Moderate myelosuppression occurred in all patients but was not treatment-limiting. For most patients the maximally tolerated number of courses was three. The median survival time was 33.5 weeks for recurrent disease patients, 108 weeks for newly diagnosed patients. This regimen is not recommended for the palliation of recurrent disease. However, the very high response rate suggests that high-dose cisplatin may have a useful role in induction or adjuvant chemotherapy regimens.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46916/1/280_2004_Article_BF00254569.pd

Metagenomic study of the viruses of African straw-coloured fruit bats: detection of a chiropteran poxvirus and isolation of a novel adenovirus

Viral emergence as a result of zoonotic transmission constitutes a continuous public health threat. Emerging viruses such as SARS coronavirus, hantaviruses and henipaviruses have wildlife reservoirs. Characterising the viruses of candidate reservoir species in geographical hot spots for viral emergence is a sensible approach to develop tools to predict, prevent, or contain emergence events. Here, we explore the viruses of Eidolon helvum, an Old World fruit bat species widely distributed in Africa that lives in close proximity to humans. We identified a great abundance and diversity of novel herpes and papillomaviruses, described the isolation of a novel adenovirus, and detected, for the first time, sequences of a chiropteran poxvirus closely related with Molluscum contagiosum. In sum, E. helvum display a wide variety of mammalian viruses, some of them genetically similar to known human pathogens, highlighting the possibility of zoonotic transmission

Asymptotic Limits and Zeros of Chromatic Polynomials and Ground State Entropy of Potts Antiferromagnets

We study the asymptotic limiting function $W({G},q) = \lim_{n \to \infty}P(G,q)^{1/n}$, where $P(G,q)$ is the chromatic polynomial for a graph $G$ with $n$ vertices. We first discuss a subtlety in the definition of $W({G},q)$ resulting from the fact that at certain special points $q_s$, the following limits do not commute: $\lim_{n \to \infty} \lim_{q \to q_s} P(G,q)^{1/n} \ne \lim_{q \to q_s} \lim_{n \to \infty} P(G,q)^{1/n}$. We then present exact calculations of $W({G},q)$ and determine the corresponding analytic structure in the complex $q$ plane for a number of families of graphs ${G}$, including circuits, wheels, biwheels, bipyramids, and (cyclic and twisted) ladders. We study the zeros of the corresponding chromatic polynomials and prove a theorem that for certain families of graphs, all but a finite number of the zeros lie exactly on a unit circle, whose position depends on the family. Using the connection of $P(G,q)$ with the zero-temperature Potts antiferromagnet, we derive a theorem concerning the maximal finite real point of non-analyticity in $W({G},q)$, denoted $q_c$ and apply this theorem to deduce that $q_c(sq)=3$ and $q_c(hc) = (3+\sqrt{5})/2$ for the square and honeycomb lattices. Finally, numerical calculations of $W(hc,q)$ and $W(sq,q)$ are presented and compared with series expansions and bounds.Comment: 33 pages, Latex, 5 postscript figures, published version; includes further comments on large-q serie

Serial studies of autologous antibody reactivity to squamous cell carcinoma of the head and neck

In previous studies we evaluated the incidence and specificity of autologous antibody reactivity against squamous cell carcinoma of the head and neck (SCCHN). We were able to demonstrate that autologous antibody reactivity is present in native sera but was usually of too low a titer to allow further analysis. Dissociation of immune complexes by acidification and ultrafiltration of serum augmented autologous antibody reactivity in nine out of nine autologous systems tested. Native antibody and antibody derived from immune complexes produced by the host and reactive with autologous tumor cells may be directed against physiologically relevant antigens. Therefore, correlations of antibody titers with clinical course may provide insight into the nature of the host response to cancer. In the present analysis, serological studies of six patients with SCCHN were performed with serum samples obtained over many months. Results of serial serological assays were correlated to tumor progression and clinical course. Fluctuations in autologous antibody reactivity were noted over time. In four cases, rises in autologous antibody titers preceded the clinical diagnosis of recurrence by several months. Drops in autologous antibody reactivity were noted in two cases following surgery or radiation therapy. In two cases of long-term survivors, no correlation between antibody reactivity and clinical course was noted. Specificity analysis of the six autologous systems demonstrated reactivity against autologous and allogeneic SCCHN as well as melanoma cell lines. These sera did not react with glioma, neuroblastoma, renal cell, breast, bladder and colon carcinoma cell lines nor with fetal calf serum, pooled lymphocytes, red blood cells and platelets. Autologous serial serological studies may provide a means by which to evaluate the host/tumor relationship in patients with SCCHN.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46858/1/262_2005_Article_BF01741554.pd

Clinical consensus statement: Diagnosis and management of nasal valve compromise

OBJECTIVE: To create a clinical consensus statement to address ambiguities and disparities in the diagnosis and management of nasal valve compromise (NVC). SUBJECTS AND METHODS: An updated systematic review of the literature was conducted. In addition, a Modified Delphi Method was used to refine expert opinion and facilitate a consensus position. RESULTS: After two rounds of surveys and conference calls, 36 items reached consensus, six items reached near consensus, and 10 items reached no consensus. The categories that had the greatest percentage of consensus or near consensus items were as follows: definition, history and physical examination, outcome measures, and management. Conversely, the categories with greater percentage of no consensus items were adjunctive tests and coding. CONCLUSION: The consensus panel agreed that NVC is a distinct clinical entity that is best evaluated with history and physical examination findings. Endoscopy and photography are useful but not routinely indicated, whereas radiographic studies are not useful in evaluating NVC. Other objective nasal outcome measures may not be useful or accepted for NVC. Nasal steroid medication is not useful for treatment of NVC in the absence of rhinitis, and mechanical treatments may be useful in selected patients. Surgical treatment is the primary mode of treatment of NVC, but bill coding remains ambiguous and confusing