Stephen R. Colen, M.D., D.D.S.

Poland's syndrome and carcinoma of the breast: a case report
Katz SC; Hazen A; Colen SR; Roses DF
2001 Jan-Feb;7(1):56-59, Breast journal
Poland's syndrome is a rare congenital anomaly that may include mammary hypoplasia and has been described in association with various malignancies. We report the case of a 42-year-old woman with unilateral Poland's syndrome who developed carcinoma in the hypoplastic breast. A review of the literature reveals no previous report of carcinoma of the hypoplastic breast with Poland's syndrome
— id: 20671, year: 2001, vol: 7, page: 56, stat: Journal Article,

Scalp injuries
Colen SR
Head injury New York : McGraw-Hill Health Professions, 2000,
— id: 3569, year: 2000, vol: , page: 397, stat: Chapter,

In vivo expression of the insulin-like growth factor-I (IGF-I) receptor in congenital pigmented nevi
Hodak, E; Gottlieb, AB; Colen, S; Anzilotti, M; Krueger, JG
1996 FEB ;23(1):19-24, Journal of cutaneous pathology
Growth of normal melanocytes, nevus cells and primary melanoma cells is enhanced by insulin/insulin-like growth factor-I (IGF-I) in vitro. It has been shown that a melanoma cell line possesses the IGF-I receptor which plays a role in activation of the chemotactic response. Little is known about the in vivo expression of the IGF-I receptor and its role in melanocytic lesions. In an immunohistochemical study, we investigated the expression of IGF-I receptor in frozen sections of congenital pigmented nevi from 10 patients (ages 8 months to 4 yrs) using the monoclonal antibody alpha IR(3), which specifically recognizes the extracellular alpha subunit of the IGF-I receptor. The proliferative activity of the nevus cells was examined by staining with Ki67 monoclonal antibody (reactive with all actively cycling cells). IGF-I receptor was found to be widely expressed by the cell surface of the nevus cells. Membrane staining was occasionally stronger in the superficial portion of the congenital pigmented nevi. In contrast, Ki67-positive cells were only sparsely scattered throughout the nevi with some tendency to localization to the superficial portion. This study indicates that in vivo the IGF-I receptor is widely expressed by congenital pigmented nevus cells. As opposed to keratinocytes, in which IGF-I receptor expression defines the proliferation pool of the normal and disordered epidermis, the IGF-I receptor is expressed by all nevus cells, irrespective of their proliferative status. Further studies are needed to assess whether the IGF-I receptor expression can serve as a marker for increased risk for development of malignancy in various types of benign melanocytic lesions. (C) Munksgaard 1996
— id: 53050, year: 1996, vol: 23, page: 19, stat: Journal Article,

Salvage of traumatic below-knee amputation stumps utilizing the filet of foot free flap: critical evaluation of six cases
Kasabian AK; Glat PM; Eidelman Y; Colen S; Longaker MT; Attinger C; Shaw W
1995 Oct;96(5):1145-1153, Plastic & reconstructive surgery
Over a 12-year period between 1979 and 1991, 27 patients were operated on at the New York University Medical Center for salvage of below-knee amputation stumps utilizing free flaps. Six different donor sites were used. In 6 patients, the amputated foot was the donor site for a free flap to cover the tibial stump. There were 3 males and 3 females in this group. Five of the patients underwent immediate filet of foot reconstructions, while 1 patient had a reconstruction performed 69 days after injury, electively, when it was determined that below-knee amputation was the best option. All foot flaps survived and ultimately provided the major soft-tissue coverage for the below-knee amputation stump. The length of hospitalization ranged from 24 to 118 days. The time required from foot filet procedure to ambulation was 2, 4, 6, 7, 9, and 12 months in the 6 patients. Five of the 6 patients have resumed work or school after their injury. Foot flaps were based on the posterior tibial artery, anterior tibial artery, or both vessels. Nerve anastomosis of the posterior tibial nerve was performed in 5 patients. In 1 patient it was possible to maintain the continuity of the posterior tibial nerve. Five of the 6 patients were tested over a year after the flap, and all have good cold, pressure, and vibration sensation. Two of the 5 patients have heat sensation, and all 5 patients have at least protective pressure sensation. All the patients ambulate well with a below-knee prosthesis
— id: 56766, year: 1995, vol: 96, page: 1145, stat: Journal Article,

Isolation and long-term culture of human hair-follicle melanocytes
Tobin DJ; Colen SR; Bystryn JC
1995 Jan;104(1):86-89, Journal of investigative dermatology
We report a method to establish long-term cultures of melanocytes derived from human hair follicles. Normal human scalp was transected 1 mm below the epidermis, and hair follicles in the remaining dermis were isolated by collagenase treatment. Hair-follicle cell suspensions were prepared by trypsin/ethylenediamine tetraacetic acid treatment and cultured in a mixture of Eagle's minimum essential medium (supplemented with 12-O-tetradecanoyl-phorbol-13-acetate and cholera toxin) and keratinocyte serum-free medium. After contaminating fibroblasts and keratinocytes were removed, cells with two distinct morphologies remained. These included large, dendritic and deeply pigmented cells, which did not proliferate and which disappeared by the third passage, and small bipolar cells, which initially were unpigmented, proliferated very rapidly, and became pigmented after the addition of 3-isobutyl-1-methylxanthine to the culture medium. Both cell types were melanocytes as confirmed by electron microscopy and by staining with antibodies to S-100, GD3, and melanosomal antigens. The availability of cultured hair-follicle melanocytes wil facilitate investigations of the role of these cells in normal and abnormal hair biology
— id: 6765, year: 1995, vol: 104, page: 86, stat: Journal Article,

Microvascular free-flap salvage of the diabetic foot: a 5-year experience
Karp NS; Kasabian AK; Siebert JW; Eidelman Y; Colen S
1994 Nov;94(6):834-840, Plastic & reconstructive surgery
This study reviews 21 microvascular free flaps to the diabetic foot in 19 patients over a 65-month period. All flaps were either to the plantar surface of the foot or to cover exposed Achilles tendon. Twenty of the flaps survived. The operations required a long, costly hospitalization with frequent recipient- and donor-site complications. All patients eventually ambulated on their flaps. Five patients came to proximal amputation from 6 to 37 months after surgery. Only one amputation was for flap breakdown
— id: 12869, year: 1994, vol: 94, page: 834, stat: Journal Article,

Dysplastic and congenital nevi
Casson P; Colen S
1993 Jan;20(1):105-111, Clinics in plastic surgery
The dysplastic nevus, both the sporadic and familial type, has a significant association with melanoma of the skin. The congenital nevus, which ranges in size from less than 1 cm to a giant hairy nevus, are treated primarily for aesthetic reasons and, in the giant variety, are also treated as a prophylaxis against the possibility of malignant change
— id: 13301, year: 1993, vol: 20, page: 105, stat: Journal Article,

Various methods of breast reconstruction after mastectomy: an economic comparison
Elkowitz A; Colen S; Slavin S; Seibert J; Weinstein M; Shaw W
1993 Jul;92(1):77-83, Plastic & reconstructive surgery
This study is an economic comparison of various methods of breast reconstruction after mastectomy. The hospital bills of 287 patients undergoing breast reconstruction at three institutions from June of 1988 to March of 1991 were analyzed. The procedures examined included mastectomy, implant and tissue-expander reconstruction, and TRAM and latissimus pedicle flaps, as well as free TRAM and free gluteal flaps. These procedures were subdivided into those which were performed at the time of mastectomy and those performed at a later admission. In addition, auxiliary procedures (i.e., revision, nipple reconstruction, tissue-expander exchange, and contralateral mastopexy/reduction) also were examined. Where appropriate, these procedures were subdivided into those performed under general or local anesthesia and by inpatient or outpatient status. Data from the three institutions were converted to N.Y.U. Medical Center costs for standardization. A table is presented that summarizes the costs of each individual procedure with all the pertinent variations. In addition, a unique and novel method of analyzing the data was developed. This paper describes a menu system whereby other data regarding morbidity, mortality, and revision rates may be superimposed. With this information, the final cost of reconstruction can be extrapolated and the various methods of reconstruction can be compared. This method can be applied to almost any complex series of multiple procedures. The most salient points elucidated by this study are as follows: The savings generated by performing immediate reconstruction varies between $5092 (p < 0.05) for free gluteal flaps and $10,616 (p < 0.05) for pedicled TRAM flaps.(ABSTRACT TRUNCATED AT 250 WORDS)
— id: 13108, year: 1993, vol: 92, page: 77, stat: Journal Article,

Localization of nonpalpable masses in patients with breast implants
Mitnick JS; Vazquez MF; Colen SR; Plesser K; Roses DF
1993 Sep;31(3):238-240, Annals of plastic surgery
Nonpalpable nodules in patients with breast implants may represent silicone granulomas, fibrocystic mastopathy, or cancer. We describe a modified technique for needle localization which facilitates the surgical excision of these nodules while minimizing the possibility of rupture
— id: 56564, year: 1993, vol: 31, page: 238, stat: Journal Article,

Distinction between postsurgical changes and carcinoma by means of stereotaxic fine-needle aspiration biopsy after reduction mammaplasty
Mitnick JS; Vazquez MF; Plesser KP; Pressman PI; Harris MN; Colen SR; Roses DF
1993 Aug;188(2):457-462, Radiology
Stereotaxic fine-needle aspiration biopsy (SFNAB) was performed to evaluate suspicious mammographic findings (31 stellate lesions, 20 regions of grouped calcifications, two nodules, and one area of prominent trabecular markings) in 54 patients who had undergone reduction mammaplasty. SFNAB findings were correlated with findings in histologic specimens whenever possible; the cytologic samples were classified as malignant, atypical, or benign. In 22 lesions, the abnormalities on mammograms were considered highly suspicious for malignancy. In the 32 others, the degree of suspicion was lower, but these lesions had a change in appearance since acquisition of the first postoperative mammogram. SFNAB enabled diagnosis of adenocarcinoma in five women. Patients who have undergone mastectomy with reconstruction of one breast and mammaplasty in the other are at higher risk for development of contralateral breast cancer, as are all patients who have had such cancer. SFNAB is reliable for evaluation of suspicious mammographic abnormalities that develop after mammaplasty and findings that change after acquisition of the first postoperative mammogram
— id: 6460, year: 1993, vol: 188, page: 457, stat: Journal Article,

"Ductogram" associated with extravasation of silicone from a breast implant
Mitnick JS; Vazquez MF; Plesser K; Colen SR
1992 Nov;159(5):1126-1127, American journal of roentgenology
— id: 63011, year: 1992, vol: 159, page: 1126, stat: Journal Article,

Stereotactic localization for fine needle aspiration biopsy in patients with augmentation prostheses
Mitnick JS; Vazquez MF; Roses DF; Harris MN; Colen SR; Colen HS
1992 Jul;29(1):31-35, Annals of plastic surgery
Fifteen patients with augmentation mammoplasties had mammography demonstrating nonpalpable breast lesions. Of the 15 patients, three (20%) had adenocarcinoma confirmed by open biopsy and histopathology. All patients underwent stereotactic localization for fine needle aspiration biopsy. Four of the 15 patients had benign cysts (26%). None of the cysts could be diagnosed by ultrasound. The remaining eight patients had mammary dysplasia of a proliferative or nonproliferative type of fibroadenoma. These benign entities were followed with interval mammography demonstrating no change. The data suggest that fine needle aspiration biopsy is an effective technique to assess nonpalpable breast lesions in patients who have had augmentation mammoplasties
— id: 13553, year: 1992, vol: 29, page: 31, stat: Journal Article,

The role of microvascular free flaps in salvaging below-knee amputation stumps: a review of 22 cases
Kasabian AK; Colen SR; Shaw WW; Pachter HL
1991 Apr;31(4):495-500, Journal of trauma
Twenty-two cases of traumatic below-knee amputation stumps with inadequate soft-tissue coverage salvaged with microvascular free flaps were reviewed retrospectively. All patients would have required an above-knee amputation for prosthesis fitting had microvascular free flaps not bee utilized. A total of 24 flaps were used in 22 patients; parascapular 11 (46%), foot filet six (25%), latissimus dorsi four (17%), lateral thigh, tensor fascia lata, and groin one (4%). Free flaps were performed immediately after injury in five (21%) cases, within the first week in two (8%), between 1 and 3 months in 12 (50%), and after 3 months in five (21%). Fifty per cent of the patients had significant other injuries. The patients had a total of 107 operations (mean, 4.9) related to their injury: 33 (mean, 1.5) of those operations were after the free flap, 27 (25%) of which were either performed because of a complication of the free flap or for revision of the free flap. Complications included partial necrosis in five (21%), neuroma in three (13%), hematoma in two (8%), donor site complication in two (8%), thrombosis requiring reoperation in one (4%), and flap failure in one (4%). Patient followup ranged from 12 to 116 months. All patients maintained a functional below-knee prosthetic level. The mean time to ambulation was 5.75 months, and was not significantly affected by flap complications. Most patients employed before their injury were employed after their injury. Despite a protracted course in these severe injured trauma patients, a functional below-knee amputation level was preserved in all cases utilizing microvascular free flaps
— id: 14074, year: 1991, vol: 31, page: 495, stat: Journal Article,

Carcinoid tumor of skin: report of a possible primary case
Bart RS; Kamino H; Waisman J; Lindner A; Colen S
1990 Feb;22(2 Pt 2):366-370, Journal of the American Academy of Dermatology
A case of a possible primary carcinoid tumor of the skin in a 40-year-old man is presented. The neoplasm was diagnosed as consistent with carcinoid tumor on the basis of conventional light microscopy, immunohistochemical studies, and electron microscopy. Workup revealed no evidence of carcinoid tumor elsewhere. Metastases to the skin from internal carcinoid tumors are uncommon, but presumed primary carcinoid tumors that arise in the skin are extremely rare; only three cases have been found in the English-language literature
— id: 16467, year: 1990, vol: 22, page: 366, stat: Journal Article,

Calcifications of the breast after reduction mammoplasty
Mitnick JS; Roses DF; Harris MN; Colen SR
1990 Nov;171(5):409-412, Surgery, gynecology & obstetrics
Mammograms of 152 patients after mammoplasty were studied and 37 patients were noted to have calcifications. The pattern of these calcifications was studied to determine if specific characteristics could be identified. The calcifications were found to occur within the skin of the breast, mainly at a periareolar location. The ability to identify these benign calcifications further aids in reliably monitoring patients by mammography after reduction mammoplasty
— id: 14291, year: 1990, vol: 171, page: 409, stat: Journal Article,

60 CONSECUTIVE BREAST RECONSTRUCTIONS WITH THE INFLATABLE EXPANDER - A CRITICAL-APPRAISAL
Slavin, SA; Colen, SR
1990 Nov;86(5):910-919, Plastic & reconstructive surgery
— id: 31832, year: 1990, vol: 86, page: 910, stat: Journal Article,

SELECTIVE MICROVASCULAR PROCEDURES IN OCULOPLASTIC SURGERY
COLEN, SR
1988 APR ;15(2):283-287, Clinics in plastic surgery
— id: 41852, year: 1988, vol: 15, page: 283, stat: Journal Article,

Reconstruction of a large chest wall defect with a musculocutaneous free flap using anterolateral thigh musculature
Press BH; Colen SR; Boyd A; Golomb F
1988 Mar;20(3):238-241, Annals of plastic surgery
Reconstruction of a large postmastectomy irradiated chest wall defect was accomplished with a large musculocutaneous free flap of anterolateral thigh musculature and skin. The vascular anatomy of the donor area allows a very substantial flap and skin island to be transferred, leaving a well-tolerated donor defect
— id: 11178, year: 1988, vol: 20, page: 238, stat: Journal Article,

FREE FLAPS TO PRESERVE BELOW-KNEE AMPUTATION STUMPS - LONG-TERM EVALUATION - DISCUSSION
Colen, SR
1987 Jun;79(6):878-878, Plastic & reconstructive surgery
— id: 31165, year: 1987, vol: 79, page: 878, stat: Journal Article,

Reconstruction of mandibular and floor of mouth defects using the trapezius osteomyocutaneous flap
Dufresne, C; Cutting, C; Valauri, F; Klein, M; Colen, S; McCarthy, J G
1987 May;79(5):687-696, Plastic & reconstructive surgery
The trapezius osteomyocutaneous island flap has evolved in postablative head and neck reconstruction as a versatile and hardy local flap which can provide intraoral lining, well-vascularized bone, and muscle bulk for the reconstruction of a complex defect. This investigative study examines the anatomy of 20 osteomyocutaneous flaps in 10 fresh cadavers and in 8 clinical patients. In our series, 80 percent (type I) of the major vascular pedicle arose from the thyrocervical trunk. In 20 percent (type II), the major pedicle arose separately from the subclavian artery. The regions perfused by the vascular trunk were further examined with microopaque and Prussian blue injections through the transverse cervical artery. Consistent areas of cutaneous staining as well as bony staining were noted over the shoulder, arm, and back and into the scapula itself. Experience with eight clinical applications of this osteomyocutaneous flap resulted in successful healing with an excellent aesthetic and functional result. Long-term follow-up was maintained on the patients for up to 36 months. Panorex radiographs and biopsies of the grafted bone were obtained on several patients. These disclosed evidence of bony remodeling and viable bone tissue. Tetracycline labeling also revealed evidence of active bony turnover
— id: 99055, year: 1987, vol: 79, page: 687, stat: Journal Article,

Review of the morbidity of 300 free-flap donor sites
Colen, S R; Shaw, W W; McCarthy, J G
1986 Jun;77(6):948-953, Plastic & reconstructive surgery
Donor-site morbidity in 300 consecutive free flaps was reviewed to identify their etiologies and potentially prevent their recurrence in future cases. An overall morbidity rate of 20 percent was seen in this series. Secondary surgical procedures specific for donor-site problems were required in 7.7 percent of patients. Major complications occurred in 2.3 percent of the donor sites. From this review it is apparent that major donor-site morbidity is uncommon and most donor-site problems could probably have been avoided. Our recommendations are as follows: closure of the donor site to avoid excessive tension must be carefully planned preoperatively, donor-site anatomy and flap elevation techniques must be precisely understood, surgical retractors must be carefully placed to avoid injury to nearby structures, the donor site should be closed immediately following pedicle division, thus minimizing wound exposures, and complete surgical hemostasis is mandatory
— id: 99057, year: 1986, vol: 77, page: 948, stat: Journal Article,

Dynamic computer tomography determining the patency of buried free flaps
Fischer, J C; Parker, P M; Shaw, W W; Colen, S R
1986 ;7(4):190-192, Microsurgery
Numerous methods exist for monitoring the patency of cutaneous free flaps. Monitoring the patency of microvascular anastomosis in buried free flaps are limited. The present case report is of a 39-year-old female with Rhomberg's disease who underwent an abdominus rectus muscle free flap to correct the contour deformity of the right face. Dynamic CT scan was performed on the sixth postoperative day. Plots of the rate of change of density of the free flap were compared to an adjacent muscle of the face. Dynamic CT scanning provides a high degree of resolution of the free flap, the ability to examine the entire free flap, and the ability to determine the patency of buried free flap
— id: 133262, year: 1986, vol: 7, page: 190, stat: Journal Article,

PELVIC FLOOR RECONSTRUCTION USING THE RECTUS ABDOMINIS MUSCLE FLAP
GIAMPAPA, V; KELLER, A; SHAW, WW; COLEN, SR
1984 ;13(1):56-59, Annals of plastic surgery
— id: 41075, year: 1984, vol: 13, page: 56, stat: Journal Article,

Microvascular flap reconstruction of the head and neck. An overview
Colen, S R; Baker, D C; Shaw, W W
1983 Jan;10(1):73-83, Clinics in plastic surgery
— id: 117558, year: 1983, vol: 10, page: 73, stat: Journal Article,

SALVAGE REPLANTATION
Colen, SR; Romita, MC; Godfrey, NV; Shaw, WW
1983 ;10(1):125-131, Clinics in plastic surgery
— id: 30669, year: 1983, vol: 10, page: 125, stat: Journal Article,

CHANGING INDICATIONS FOR LOWER-EXTREMITY AMPUTATIONS FOR TRAUMA
SHAW, WW; COLEN, SR; GODFREY, NV; ROMITA, MC
1983 ;23(7):663-663, Journal of trauma, injury, infection, & critical care
— id: 40657, year: 1983, vol: 23, page: 663, stat: Journal Article,