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Biomedical subjects

D C Baker

Publications and source records attributed to D C Baker.

At least 109 records · Page 6Linked to original sources
PubMed1981

Immediate reconstruction of full-thickness chest wall defects.

Twenty-one patients had full-thickness chest wall defects reconstructed at the New York University Medical Center in the last ten years. Marlex mesh provided chest wall stability in 5 patients. In 9 patients with radiation ulcers Marlex mesh was not required; a severe fibrotic reaction had obliterated the pleural space and prevented paradoxical motion. Partial sternal resections did not require Marlex stabilization, while a total sternectomy resulted in marked ventilatory insufficiency in a patient who would have benefited from the use of a stabilizing material. Random pattern flaps were used initially; more recently, axial pattern, myocutaneous, and myocutaneous free flaps were employed. Necrosis developed in 4 (36%) of the 11 patients with random pattern flaps, but was not seen with the newer flap techniques. Myocutaneous free flaps provided uncomplicated coverage of and stability to three large, potentially contaminated defects. It seems that with the currently available flap techniques and the methods of chest wall stabilization, immediate repair of all full-thickness chest wall defects is possible.

Adult↗
PubMed1981

Reconstruction of defects following Mohs' surgery.

Repairs of surgically produced wounds require fore-thoughts and planning individualized for particular patients and particular original conditions. Nowhere is this more important than in patients treated by Mohs' methods for cutaneous cancers. Indications for early and late repair and methodology by a variety of grafts and flaps are explored and illustrated.

Facial Neoplasms↗
PubMed1981

Clinicopathologic evaluation N-acetylcysteine therapy in acetaminophen toxicosis in the cat.

Acute acetaminophen (ACM) toxicosis was induced in cats and the therapeutic benefit of N-acetylcysteine (NAC) was demonstrated. Groups of 4 adult cats were treated as follows: group A-given ACM only; group B- given ACM and then treated with NAC, starting at 0 hour; group C-given ACM and then treated with NAC, starting at 4 hours; and group D-treated with NAC only. Acetaminophen was given as a single oral dose or 143 mg/kg, and the NAC regimen consisted of 4 oral doses (200 mg/kg, given 3 times and 100 mg/kg, given once) with 2 hours between doses. Group A cats developed increased methemoglobin concentration, depletion of erythrocyte reduced glutathione, and increased Heinz body formation. Group B cats also developed methemoglobinemia, depletion of glutathione, and increased Heinz body formation, but the magnitude of these changes was significantly less (P less than 0.05) than in group A. In group C, the findings were similar to group A through 4 hours, but thereafter, significant hematologic improvement was noted. The level of Heinz bodies in group C was intermediate between the values for groups A and B. In group D cats, no significant changes from base line were noted. Evidence of hepatotoxicity was not seen in any group as based on daily determinations of plasma alanine aminotransferase and sorbitol dehydrogenase activities.

Acetaminophen↗
PubMed1980

Microvascular free dermis-fat flaps for reconstruction after ablative head and neck surgery.

Reconstruction of the head and neck region following radical parotidectomy with or without mandibulectomy may be a difficult procedure. Facial skin is usually preserved, but the underlying soft-tissue structures and bone are deficient. The challenge is to augment the facial defect while the overlying skin is preserved with a high success rate, minimal time, one operative stage, and reduced secondary deformity to the patient. In certain instances, a microvascular free flap is ideal. We have used a de-epithelialized microvascular free groin flap successfully to reconstruct large parotid-mandibular defects in nine patients. A small bridge of epithelium is left to relieve tension from edema and to monitor the flap postoperatively. The high success rate, minimal complications, and acceptable donor site defect make the microvascular free dermis-fat flap an ideal choice for this type of reconstruction.

Adolescent↗
PubMed1979

Thread augmentation.

A review of thread augmentation has added helpful points to the technique and given an opportunity to assess the long-range results. It is obvious at this stage that there is no panacea for the wrinkling process. Each technique has advantages and disadvantages. The simplicity and low complication rate of thread augmentation supports this appeal. It is reasonable to state that the full application of the concept of this type of augmentation has not as yet been realized with this ongoing principle. This technique has been found of value when used as a single procedure or in combination with blepharoplasty or rhytidectomy.

Biocompatible Materials↗
PubMed1979

Management of the eye socket in cancer of the paranasal sinuses.

There are several basic techniques for obtaining acceptable closure of the orbital defect following exenteration. The approach to reconstructing a socket in the method chosen should be the one that gives the best cosmetic result while not compromising the surgical excision and the possibility of cure. Few surgeons have attempted to correct the deformity of orbital exenteration so that an artificial eye can be worn. We have found that approximately 20% of those patients undergoing radical ablation of the orbit quality for simultaneous reconstruction of the eye socket. The technique of a cheek-eyelid-conjunctiva flap allows for immediate reconsturction of the eye socket and the fitting of a prosthesis.

Eye, Artificial↗
PubMed1979

Prodrugs of 9-(beta-D-arabinofuranosyl)adenine 2. Synthesis and evaluation of a number of 2',3'- and 3',5'-di-O-acyl derivatives.

A number of 2',3'- and 3',5'-di-O-acyl derivatives of 9-beta-D-arabinofuranosyladenine (1) were prepared and evaluated as antivirals. These compounds, designed as prodrugs of 1, offer a range of solubilities and lipophilicities, as well as a resistance to adenosine deaminase, that render some as being attractive as possibly useful antiviral agents. Of particular note is 9-(2,3-di-O-acetyl-beta-D-arabinofuranosyl)adenine that was found to be effective as a topical agent in a guinea pig model of genital herpes.

Animals↗
PubMed1979

Thread augmentation for facial rhytides.

Thread augmentation, a subsurface technique for correcting facial rhytides, is especially applicable to perioral wrinkles, melolabial furrows, and frown lines about the forehead. It is basically an augmentation technique which places a volume of well-tolerated, slowly absorbable or nonabsorbable sutures underneath the wrinkle. These threads produce augmentation by their volume and the mild local reaction of edema, lymphocytic infiltration, and fibrosis. This process gradually progresses to internal scar formation as the suture material is dissolved by slow hydrolysis in the presence of tissue fluid over a period of months; the nonabsorbable suture remains as a permanent implant. A high level of patient satisfaction with minimal complications has proved the value of this technique in over 100 cases.

Absorption↗
PubMed1979

Treatment of obstructing inferior turbinates with intranasal corticosteroids.

The most common cause of nasal obstruction is chronic enlargement of the inferior turbinate bones. The variety of medical and surgical treatments available for this condition bears testimony to their frequent ineffectiveness and the frustration of the physician or surgeon caring for these patients. Removal or destruction of the inferior turbinates has received strong criticism from rhinologists, although at present there is renewed interest in turbinectomy combined with rhinoplasty. A technique employing intranasal injections of long-acting corticosteroids has been used successfully for over twenty years in treating obstructing inferior turbinates secondary to allergic and vasomotor rhinitis. The indications, technique, and complications of this method are reviewed; the technique is presented as an alternative to destruction or resection of the inferior turbinates.

Adrenal Cortex Hormones↗
PubMed1979

Surgical approach to retromandibular parotid tumors.

Because of the anatomy of the deep lobe of the parotid and its restrictive boundaries, retromandibular tumors may be asymptomatic until reaching massive size. Removal by an intraoral approach may be not only disappointing but also disastrous, with disintegration of the tumor and generalized spillage in the wound. Our experience suggests that the best approach to any type of tumor in this region is through the upper lateral cervical tissues with consideration of a mandibular osteotomy if the tumor extends into the retropharynx or the nasopharynx. This review of 12 patients who required osteotomy describes a high success rate with minimal complications.

Adenoma, Pleomorphic↗
PubMed1979

Hypoglossal-facial nerve anastomosis for reinnervation of the paralyzed face.

The hypoglossal-facial nerve crossover is a valuable surgical procedure for the treatment of certain types of facial paralysis. It is most effective when used as an integral part of a primary ablative operation for the treatment of cancer in this region. In the treatment of long-standing facial paralysis, its application requires an intact peripheral facial nerve system and some functioning mimetic muscles with an obliterated proximal facial nerve segment. It is recognized that other procedures are available for repair in patients who meet essentially these same criteria. The disadvantages are minimal intraoral crippling, mass movements of the face and, in some instances, hypertonia of the face. The advantages are improved facial tone, protection of the eye, intentional facial movements controlled by the tongue, and movements associated with physiological functions of the tongue.

Adolescent↗
PubMed1979

Conservation of major leg arteries when used as recipient supply for a free flap.

The potential hazards of using proximal segments of leg arteries for end-to-end anastomosis to vessels in free flaps are examined, and alternatives are proposed. The convservation of the major tibial arteries seems highly desirable, to minimize any subsequent development of ischemic complications. Turning a free flap upside down moves the anastomosis to the distal part of the extremity, thus conserving most of the muscular branches of the recipient artery. Cutting the recipient artery distally and bending it back in recurrent fashion also allows for easy end-to-end anastomosis, with many technical advantages.

Adult↗
PubMed1979

Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls.

Injury to the facial nerve in rhytidectomy has been occurring in less than one percent of the cases, and a spontaneous return of function in more than 80 percent of these injuries has resulted within 6 months. With the introduction of the newer and more aggressive techniques of platysmal and subplatysmal flaps and SMAS dissections, the risk of injury to facial nerve branches is obviously increased. Though there has not yet been an increase in the facial nerve injuries reported, these techniques are still relatively recent additions to the face-lift operation-and usually they have been done by more experienced surgeons, taking more time and working under direct vision with a more careful dissection. More care is needed to prevent injuries. We discuss here the detailed anatomy of the muscular branches of the facial nerve, how to prevent injuries to them during rhytidectomy, and how to manage injuries when they do occur.

Face↗
PubMed1979

Regional muscle transposition for rehabilitation of the paralyzed face.

Masseter and temporalis muscle transpositions may be considered in cases of longstanding facial paralysis and in the congenital absence of the facial nerve or muscles. The basic advantage of this technique is the introduction of a large volume of living and dynamic muscle into the face. Additional advantages include simplicity, the support provided, enhancement of the possibility of myoneurotization, and no loss of other significant function. In many instances, facial movement improves for a period of approximately two years, and the long-range effect would suggest some degree of rehabilitation of the facial muscles. Our combined experience with over 100 muscle transpositions indicates the efficacy and success of this technique in selected patients.

Facial Muscles↗