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Biomedical subjects

C N Verheyden

Publications and source records attributed to C N Verheyden.

At least 19 recordsLinked to original sources
PubMed2005

The effects of public education on the incidence and presentation of cutaneous melanoma in Central Texas.

Despite intensive public education, the incidence of melanoma in Central Texas has remained relatively constant (from 175 per 100,000 during 1981-1990 to 190 per 100,000 during 1991-2000). Although other investigators have hypothesized that the slight increase in incidence results from increased detection and reporting of early-stage (thinner) tumors, we found the average thickness was 0.99 mm from 1981 through 1990 and 1.11 mm from 1990 through 2000 (P = .30). These data suggest that despite efforts at public education, the incidence of melanoma in Central Texas is not decreasing and people are not identifying their tumors at an earlier stage.

Early Diagnosis↗
PubMed1998

Nipple-sparing total mastectomy of large breasts: the role of tissue expansion.

Nipple-sparing total mastectomy remains an alternative for management of patients with high risk breast disease or patients with various types of symptomatic breast problems. In a patient with large breasts, however, achieving good cosmesis while still performing a thorough mastectomy remains a challenge. This report includes 10 patients who underwent unilateral nipple-sparing total mastectomy and 10 patients who underwent bilateral nipple-sparing total mastectomy. Tissue expansion was used as the reconstructive technique in this consecutive series done from 1985 through 1988. All expanders were placed in the submuscular position, and hyperbaric oxygen was used when intraoperative fluorescein administration identified marginally perfused areas. The average volume of breast tissue removed was 800 gm. The average permanent implant size was 767 cc. Complications included partial skin or nipple loss, infection, and problems related to the implants themselves. The complication rate, however, was not excessive, and results have been good as measured by cosmetic results, capsule grade, and lack of development of cancer in operated breasts. This reconstructive technique is recommended as an alternative in those patients undergoing nipple-sparing total mastectomy.

Adult↗
PubMed1996

Functional evaluation of gap vs. abutment repair of peripheral nerves in the rat.

Various expressions of nerve regeneration specificity (tissue, target, and end-organ) have been demonstrated histologically, but the influence of nerve regeneration specificity on functional outcome remains to be investigated. Specificity expression appears to be dependent, to some extent, on the distance between the proximal and distal nerve stumps. Regeneration specificity is inhibited by end-to-end alignment. This study examined the effect of gap distance repair on the return of rat hind-limb function, as measured by the sciatic function index (SFI). Sixty-four Sprague-Dawley rats were randomized into three groups: 0-mm gap (abutment), 2-mm gap, and 5-mm gap repair. The sciatic nerve was divided and secured in a Silastic conduit to maintain the gap length. The SFI was measured preoperatively and then at postoperative weeks 2, 4, 8, 12, 16, and 20. Results showed no significant difference in functional return between the abutment and the two gap groups at any time period (SFI at 20 weeks = -73.9, 0 mm; -73.5 2 mm; -75.2, 5mm; p = 0.90). This lack of difference in functional outcomes suggested an insignificant functional influence of regeneration specificity within single chamber conduits. The study also demonstrated that small gaps between nerve ends within a conduit yielded functional results equal to end-to-end repair of rat sciatic nerves.

Anastomosis, Surgical↗
PubMed1996

Implantable cardioverter-defibrillator: another device to cover.

The implantable cardioverter-defibrillator is a mechanical device developed to manage patients with life-threatening arrhythmias when pharmacologic control has failed or produced unacceptable side effects. It is a significant amount of foreign material with a generator pack (volume 113 to 145 cc, weight 197 to 235 gm) and two or three leads and patches that are inserted into or placed on the heart. Although it has worked very well in preventing premature death, there have been complications associated with the device itself. The most significant of these has been exposure and/or infection. We present three patients who have experienced this problem. Improved coverage has been accomplished by burying the implant beneath the rectus abdominis muscle in situations where skin and subcutaneous tissue alone have proved inadequate. By dividing one or two tendinous inscriptions and the anterior limb of the internal oblique fascia, a musculofascial pocket is created to contain the generator and lead wires. This provided satisfactory coverage in two of our three patients. The single failure resulted from external trauma to the abdominal wall.

Aged↗
PubMed1996

Treatment of the facial angiofibromas of tuberous sclerosis.

Tuberous sclerosis is an inherited syndrome with mental retardation, epilepsy, and acne rosacea being the classic triad of manifestations. The facial skin problems can present a cosmetic deformity or, as in the three patients presented here, can produce difficulties with hygiene and nasal breathing. Various approaches to treatment have been described over the last century, but no long-term results have been presented. Because of the full-thickness skin involvement, complete removal is not practical, and treatment should be directed toward acceptable long-term results with minimal surgical morbidity. Shaving and dermabrasion of the involved area produce very satisfactory results, but long-term follow-up of approximately 10 years reveals that there is a variable amount of recurrence and that subsequent treatment will be required.

Adult↗
PubMed1994

Implantable cardioverter defibrillator patch erosion presenting as hemoptysis.

Although the internal cardioverter defibrillator has prevented many premature deaths from lethal ventricular arrhythmias, some complications have occurred with its use. We present a patient who developed a fistula between the left ventricle and a bronchus, caused by erosion of the ventricular patch. The patient's presenting symptom was hemoptysis. Physicians caring for patients with these devices should be aware of this potential problem.

Animals↗
PubMed1993

Autotomy and the sciatic functional index.

The rat sciatic nerve serves as a good model of nerve regeneration and, as such, is often used in investigations of nerve repair. After transection of the sciatic nerve, rodents frequently scratch and bite their anesthetic foot, resulting in amputation of one or more toes. This is termed autotomy or autophagy. When these rats are part of a study using the sciatic functional index (SFI), autotomy results in unusable data, since necessary foot landmarks have been removed. It would be helpful, therefore, to be familiar with the phenomenon of autotomy and to know which rats are least likely to mutilate themselves. In our experiment involving 64 rats in which the sciatic nerve was transected and repaired, we found that female Sprague-Dawley rats were significantly less likely to perform autotomy than males (33% vs. 65%, P = .04). In addition, we noted that two-thirds of the autotomies that occurred did so by postoperative week 4 and that tabasco sauce did not decrease this activity. We present our experience and a survey of the literature on autotomy and the SFI.

Animals↗
PubMed1988

Anatomical considerations in the repair of macrostomia.

Macrostomia is a deformity that occurs alone or in combination with other anomalies as a result of a failure of merging of the maxillary and mandibular processes of the first branchial arch. In an attempt to restore normal anatomy, a repair has been designed that includes provision of a lighter shade, rounded, nonrugated vermilion surface for the new oral commissure. The muscular ring is also reconstructed, and a Z-plasty is incorporated into the skin closure. In the patient described, an interesting band of fibrotic tissue was identified in the cleft, connecting the upper and lower orbicularis muscle bundles. Histologically, this tissue resembled scarred muscle fibers. A five-year follow-up is provided.

Branchial Region↗
PubMed1988

Combined plastic and gynecological surgical procedures.

The purpose of the present study was to determine the extent to which the planned combination of one of several major plastic and gynecological surgical procedures may alter patient morbidity and postoperative hospitalization when compared with similar procedures carried out separately. A review of 10 consecutive years of operative procedures produced 63 patients who underwent combined gynecological and plastic surgical procedures. Thirty-three of the combined-surgery patients could be suitably matched with 2 control patients each to compare complications and length of hospital stay. The requirement for transfusion was significantly greater (p = 0.01) in the combined-surgery versus the paired-control groups. No other complications, however, were increased in the combined-surgery patients. There was a significant reduction (p = 0.005) in hospital stay of 1.92 postoperative days for two groups of combined-surgery patients versus the control groups. In all combined-surgery patients, patient response was favorable. Recommendations on preoperative planning and intraoperative and postoperative management are discussed. There is a perception in the surgical community that combining procedures unacceptably increases morbidity. For the past 12 years plastic and gynecological surgeons in our institution have offered combined procedures to our patients, with positive results and favorable patient response. A search of recent medical literature demonstrated several references to the planned combination of plastic and gynecological or general surgical procedures [2, 4, 5]. However, the only study with matched control patients dealt exclusively with abdominoplasty in association with one of five major gynecological procedures.

Blood Transfusion↗
PubMed1986

An inexpensive wire passer.

The use of a drain trochar with a length of attached silicone drain is described for passing wires through the face into the mouth in fixation of complex facial fractures.

Bone Wires↗
PubMed1985

Management of chronic wounds in the elderly.

The elderly patient with a chronic wound displays many characteristics peculiar to the age group that must be considered by the treating physician. This article describes a variety of specific age-related influences on wound healing, and incorporates several illustrative case reports.

Aged↗
PubMed1984

Management of wounds in the diabetic foot.

Current management of wounds in the diabetic foot is detailed. A thorough initial clinical examination and non-invasive tests can give baseline values and provide valuable information about limb and foot circulation. The approach detailed involves limited amputation and preservation of as much of the weight-bearing surface as possible.

Amputation, Surgical↗
PubMed1983

The history of Dupuytren's contracture.

In 1833 Dupuytren described what he referred to as an "affectation" of the palmar aponeurosis. This disorder continues to bear his name a century and a half later despite the fact that Dupuytren was not the first to describe it. The author contemplates the contributions of Felix Platter, Henry Cline, and Sir Astley Cooper in the management of this "maladie."

Dupuytren Contracture↗
PubMed1980

Pitfalls and problems with subcutaneous mastectomy.

The most frequent problems after subcutaneous mastectomy involve capsule formation, inadequate resection of breast tissue, and a poor aesthetic result as a consequence of nipple-areolar ptosis. These problems can be largely avoided by the submuscular placement of implants and, in patients with moderate-to-severe ptosis, by performing concomitant mastopexy or skin tailoring. We believe that when properly performed for appropriate indications, subcutaneous mastectomy is a worthwhile procedure.

Adult↗