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Biomedical subjects

B Hirshowitz

Publications and source records attributed to B Hirshowitz.

At least 91 records · Page 5Linked to original sources

The two-stage face lift.

Skin under tension with "creep", i.e. stretch. This probably accounts for the fact that by far the commonest postoperative complaint of face-lift patients is of inadequate lift. Creep occurs within a few hours of the operation but is at first masked by postoperative oedema. At the second stage half as much or more skin as was excised on the first occasion may be re-excised. The conservative face-lift incision which spares the sideburns is the most conventient for the 2-stage operation.

Face↗

Effect of an egg-rich diet on plasma lipids and proteins in severely burned patients.

Eight severely burned young patients were maintained on an oral hyperalimentation regimen of about 7,000 calories--including 314 proteins, 600 g carbohydrates and 336 g fats, containing greater than 8 g cholesterol--based mainly on a daily ingestion of 35 eggs. Serum cholesterol and protein, and plasma lipoprotein levels were measured during period of 30 days on the diet. The mean serum cholesterol level prior to the egg-rich diet was low [108 +/- 42 (SD) mg/dl] and it remained within the normal range during the study. The initial mean serum total protein level of 4.1 +/- 0.5 (SD) rose to 6.5 +/- 0.7 g/dl by the 19th day and stayed high throughout the remainder of the study. Plasma lipoprotein levels, assessed by nephelometry and reported as concentrations of large, medium and small particles, were not increased. It is assumed that the high demand for energy during recovery from burns prevented abnormal rises in plasma lipid levels on fat-rich diet.

Adult↗

Correction of poor speech due to a low pharyngeal flap attachment by a V-Y advancement procedure.

Four post cleft palate patients with persistent hypernasality resulting from low superiorly based pharyngeal flap attachments were operated on using a V-Y Advancement procedure. In each patient, the tethering effect of the flap on the soft palate was overcome. Gratifying correction of hypernasality was achieved and articulation ability considerably improved. Long-term follow-up results are not yet available as our experience with this procedure extends over a period of only two years in all.

Child↗

Proximal and distal releasing incisions for the treatment of flexion contracture of the popliteal region.

Proximal and distal releasing incisions and skin grafting have been found to be useful as an alternative procedure to the standard transverse incision for dealing with flexion contractures of the popliteal region. In this region important structures underlying the deep fascia may readily be exposed when the deep fascia itself is involved in the scar process and is cut across during the release. Chronic ulcer formation in the centre of hypertrophic scar contracture is a fairly frequent accompanying feature. Proximal and distal release incisions help solve the problem by providing protection for the deep vessels, nerves and tendons, without jeopardising the take of a skin graft.

Adult↗

Repeated superiorly based pharyngeal flap operation for persistent velopharyngeal incompetence.

A secondary pharyngeal flap procedure, superimposed, on the primary flap, is described after having successfully improved the speech of the three patients on whom it has been used. The raising of a secondary flap is made possible by the fact that minimal scarring occurs from previous pharyngeal flap surgery and also because of the presence of a muscle layer. The combination of factors leading to further reduction in the size of the velopharyngeal lumen is discussed. This operation offers some measure of hope for the not insignificant number of patients who have been left with poor speech after pharyngeal flap surgery and supports the recent work of Cosman and Falk (2).

Adult↗

Some physical properties of the Haifa occlusive dressing for burns.

In order to evaluate some of the physical properties of the Haifa Occlusive Dressing, which is in use in our Department, temperature, moisture and the transfer of gases were measured. The Haifa Occlusive Dressing does not significantly raise the temperature of the covered burn, nor does it hinder the diffusion of gases, even when wet. Measurements taken from a patient suffering from a deep second degree burn showed that the amount of secretion over a 9-h period was 270 cm3 and the rate of secretion/unit area was 0.0125 cm/h.

Absorption↗

35 eggs per day in the treatment of severe burns.

A regime involving the dietary management of 8 severely burned patients has been described, the main feature of this diet being the high egg intake. The eggs were given in a variety of forms without any untoward effects and without any distaste being developed. No pathological levels of serum lipoproteins or cholesterol were attained. Serum proteins from an initial low level reached normal values within a relatively short time. It is felt that a high egg diet is a valuable and safe addition in the management of severely burned patients.

Adult↗