Search PubMed⌕ Search

Biomedical subjects

E Biemer

Publications and source records attributed to E Biemer.

At least 19 recordsLinked to original sources
PubMed1999

[Free microvascular rectus abdominis muscle flap for soft tissue reconstruction of the lower leg and foot: results and donor site defect].

The free rectus abdominis muscle flap is now a routine procedure for the reconstruction of soft tissue defects in the lower extremity. We present the follow-up of 21 out of 27 patients operated in our clinic between 1986 and 1994. The recipient leg always showed a stable soft-tissue coverage. Clinical or radiological signs of osteitis were not found. In many of the cases, where the transplantion was to the ankle region, the muscle bulk led to an alteration of the shape of the leg, without impairment of function. When harvested through a low transverse abdominal incision, the aesthetic results in the donor site are convincing. The functional donor site defect is negligible as long as only a segment of the muscle is used. Abdominal muscle tests showed good results when only a segment of the muscle was used. The patients reported no impairment in daily life. Abdominal wall weakness was present only when the entire muscle was harvested. There was one hernia after postoperative wound infection and secondary wound healing. In all other cases, the abdominal wall was stable. In the segmental use of the free rectus abdominis muscle flap, the good results obtained in our examination correlate to the high degree of patient satisfaction.

Adult↗
PubMed1998

Donor-site morbidity of the segmental rectus abdominis muscle flap.

The donor-site morbidity of the segmental rectus abdominis muscle flap was evaluated in 20 patients with an average follow-up time of 47 months. Our criteria were based on static and dynamic functional results including relaxation and hernia of the abdominal wall, aesthetic outcome and patient satisfaction. The dynamic functional tests of the abdominal wall showed good results corresponding to the reported minimal impairment of quality of life. There was one abdominal hernia after wound infection and secondary healing. There was no evidence of abdominal wall instability in any of the other patients. The aesthetic outcome was excellent when a transverse lower abdominal incision, asymmetrically elongated to the donor site, was used and moderate in the case of a paramedian vertical incision. Ninety-five per cent of the patients were completely satisfied or satisfied with the result at the donor site. In the segmental use of the free rectus abdominis flap a high degree of subjective patient satisfaction reflects the favourable outcome of our examinations. On the other hand there is a clinically significant functional donor-site defect of this flap. As this procedure is still widely used, and as its indication is closely linked to its absolute and relative donor-site defect, comparisons with the alternatives, e.g. the partial latissimus dorsi muscle flap, the extended gracilis muscle flap or the serratus anterior muscle flap will have to be made.

Abdominal Muscles↗
PubMed1998

[Information exchange via internet--possibilities, limits, future].

Today, the exchange of information in the Internet is dominated by the WWW and e-mail. Discussion groups like mailing lists and newsgroups also permit communication in groups. Information retrieval becomes a crucial challenge in using the Internet. In the field of medicine, three more aspects are of special importance: privacy, legal requirements, and the necessity of transferring large amounts of data. For these problems, today's Internet doesn't provide a sufficient solution yet. Future developments will not only improve the existing services, but also lead to fundamental changes in the transfer technologies: Safer data transfer is to be ensured by new encrypting software together with the planned transfer protocol IPv6. Introducing the new transfer mode ATM will lead to better and resource saving transmission. Computer, telephone and TV networks will grow together, resulting in convergence of media.

Forecasting↗
PubMed1997

Expression of CD44-v6-containing isoform on breast tissue adjacent to silicone breast implants.

Although a variety of studies exists, the silicone controversy is still going on. In the present study we investigated the expression of the activation markers CD44-v6, intracellular adhesion molecule 1 (ICAM-1), and HLA class II molecules on breast epithelia adjacent to a silicone gel-filled breast implants (SGBI). Using an indirect immunoperoxidase procedure 12 tissue samples from implant recipients were investigated and 6 tissue samples from patients with slight breast hyperplasia were used as controls. Expression of CD44-v6 was found on ductal epithelia in all specimens from implant recipients, HLA-DR was expressed in all specimens, HLA-DQ in 3 of 10, and ICAM-1 in 8 of 12. In contrast, neither CD44-v6 nor HLA-DQ nor ICAM-1 were expressed on ductal epithelia from patients with slight breast hyperplasia, and HLA-DR was only weakly expressed in 2 of 6 patients. These data show that CD44-v6 can be expressed by benign cells under certain conditions, which may indicate an abnormal state of activation in breast tissue adjacent to an SGBI.

Breast↗
PubMed1997

[Neovascularization of pre-formed tissue flaps in relation to arteriovenous blood flow of the implanted vascular pedicle. Experimental study in the rabbit].

In 45 Chinchilla-Bastard rabbits, a skeletonised arterio-venous pedicle was implanted on the subsurface of a 15 x 8 cm abdominal skinflap to create a neovascularised axial prefabricated flap. In order to evaluate the potency of neovascularisation in relation to the blood flow of the pedicle, we compared minimal blood flow by distal ligation (model 1) with maximal blood flow by distal microvascular arteriovenous shunt anastomoses (model 2) of the implanted vascular pedicle. The results show that 8 and 12 days after pedicle implantation, tissue flap perfusion in model 2 is significantly earlier and better in comparison to model 1.

Anastomosis, Surgical↗
PubMed1996

Temporary ectopic implantation for salvage of amputated digits.

Temporary ectopic implantation for salvage of amputated parts is a fascinating idea. The first successful case, to our knowledge, of preserving digits by means of temporary ectopic implantation to the contralateral forearm is presented and this treatment concept is discussed. The indication for temporary ectopic implantation is an amputation injury with associated extensive soft tissue damage in which immediate replantation with either adequate shortening or preservation of length does not seem feasible, although the amputated part itself is uninjured and should therefore be salvaged. The groin, axilla and lower arm are compared as possible recipient sites for ectopic implantation. Early replantation of the ectopic implanted parts will provide superior functional results although replantation may be technically more demanding. The function of a replanted extremity after ectopic implantation will probably always be inferior to a comparable, immediately replanted extremity.

Adult↗
PubMed1996

Increase of immunologically relevant parameters in correlation with Baker classification in breast implant recipients.

A variety of studies have suggested a possible immune reaction to silicone implants, although an increased frequency of rheumatic disorders among implant recipients could not be established. Several immunologically relevant humoral parameters were investigated in 239 breast implant recipients. The following parameters were determined: immunoglobulin G and M, complement C3 and C4, rheumatoid factor, C-reactive protein, antinuclear antibodies, antimitochondrial antibodies, and antithyroglobulin and antimicrosomal antibodies of the thyroid gland. Levels of complement C3 were elevated in 42.5% of the patients. No difference could be observed between silicone gel-filled and saline-filled implant recipients. Complement C4 was increased in 21.3% of the patients and a parallel relationship was observed between elevated C4 and C3 levels (p < 0.0015). In 28% of the patients, the antithyroglobulin titer was elevated > 200 U/ml. No difference was found between silicone gel-filled and saline-filled implant recipients. Elevation of antimicrosomal antibodies existed in 14.3% of the patients and was correlated significantly with antithyroglobulin antibodies (p < 0.0347). In accordance with the classification developed by Baker, we observed a significant correlation between capsule fibrosis types Baker I and II, and elevated C3 values (p < 0.0004) in silicone gel-filled but not in saline-filled implant recipients. Additionally, a correlation was found between increased antithyroglobulin titers (< 200 U/ml) and capsule fibrosis types Baker I and II (p < 0.0001) in this group. In the study presented here, an increase of several humoral parameters could be demonstrated in breast implant recipients, although we failed to correlate these findings with any clinical symptoms.

Adult↗
PubMed1996

Insulin-like growth factor binding protein 2 is differentially expressed in leukaemic B- and T-cell lines.

Production of insulin-like growth factor binding protein (IGFBP)-2 and accumulation of IGFBP-2 mRNA was determined in six leukaemic T-, B- or promyelocytic cell lines. Cell growth was compared in serum free medium M-3 and in medium M-9 containing 5% FCS. In both media, high amounts of IGFBP-2 as measured by radioimmunoassay were detectable in culture supernatant of T-cell lines and promyelocytic HL-60 cells, whereas only small amounts of IGFBP-2 were secreted by the B-cell lines. Production of IGFBP-2 in M-9 was approximately 20-fold higher (up to 195 ng ml-1) than in M-3, partially reflecting higher proliferation. However, quantitative reverse transcriptase polymerase chain reaction analysis revealed that, independent of the culture medium 10(6) T-cells contained between 30 and 48 units IGFBP-2 mRNA relative to the glycerol aldehyde phosphate dehydrogenase control gene, but B-cells contained less than 1 unit. Since IGF-II is known to be a major regulator of IGFBP-2, its influence on IGFBP-2 expression has to be investigated.

Base Sequence↗
PubMed1996

[Endoscopic forehead lift].

Indications for the endoscopic frontal lift are the same as for the conventional open procedure: (a) ptosis of the eyebrow; (b) laxation of the frontal skin; (c) frowning of the glabella in the frontal area. While the conventional open procedure requires a coronal incision from ear to ear, the endoscopic procedure requires only four to six 1-cm incisions in the hair area. From there we lift the frontal skin subperiosteally up to the orbital rim where we incise the periosteum. Here the corrugator and procerus muscle are incised and the necessary portion of frontal skin can be elevated. Technical details, as well as the instruments needed are described in over 30 procedures.

Adult↗
PubMed1995

Revascularisation versus reconstruction of degloving injuries of the heel: case report.

The anatomy of heel vascularization implies that there is a high risk of necrosis if degloved soft tissue is only sutured back to its former position. Two patients who had sustained similar degloving injuries of the heel are presented. One of them was treated by primary revascularization and the other by secondary reconstruction with a dorsalis pedis flap. The postoperative outcome was investigated to show the value of the salvage operation. Dynamic pressure distribution gait analysis was performed barefoot and in the shoe to investigate postoperative weightbearing on the reconstructed areas. In contrast to the heel reconstruction with the dorsalis pedis flap, the revascularized original heel was stable without development of soft tissue lesions. The salvaged original heel tissue enabled a physiologic pressure distribution beneath the heel and a more physiological rollover process of the foot, comparable to the contralateral foot. In degloving injuries of the heel, revascularization of the soft tissue should be considered whenever possible.

Adolescent↗
PubMed1995

[Donor site morbidity in free rectus abdominis muscle flaps].

To evaluate donor-site morbidity, we used a questionnaire, which was answered by 196 patients. 152 patients underwent a medical examination. The follow-up ranged from six month to ten years. The results of this retrospective study are presented. In 16,8%, we found hernia of the abdominal wall at the donor-site and relaxation was noticed in 32% of the cases. Painful symptoms of different degrees were reported by 50% of the patients.

Adult↗
PubMed1994

[Degloving injuries of the soft tissues of the heel. An indication for microvascular revascularization!].

The sole of the foot has a unique soft tissue structure which allows weightbearing. There is no adequate reconstructive method for soft tissue defects of the weightbearing sole. Soft tissue reconstructions in this area frequently develop stress lesions. After degloving injuries of the heel, the unique vascularisation of the sole may lead to ischemia and consecutive soft tissue necrosis. Revascularisation of degloved heel pads e.g. by reconstruction of the medial calcaneal branch of the posterior tibial artery is recommended as a salvage procedure. In the primary treatment of extremity injuries with severe soft tissue damage a plastic surgeon should be involved.

Adult↗
PubMed1994

[Second toe transplantation in loss of a long finger. Indications--planning--technique].

Transplantation of the second toe is a routinely employed method in reconstructive hand surgery. Most often it is used for thumb or midhand amputations. Following partial amputations of digits distal to the MP-joints, toe transplantations are less frequently employed. However, function as well as cosmesis of the hand after partial amputation of digits can considerably be improved by toe transplantation. The length of the reconstructed finger is a most important aspect of operative planning which has influence on operative technique as well as functional and aesthetic results. A smooth junction at the base of the transplanted toe should be maintained. This can be achieved by adequate soft-tissue reduction and exclusion of the metatarsophalangeal joint. Anastomoses of the subcutaneous venous and plantar as well as dorsal arterial vascular systems are recommended.

Amputation, Traumatic↗
PubMed1993

Treatment of post-replantation retardation of bone growth by callus distraction. A report of two cases.

Hand and forearm replantation in children may lead to premature closure of the distal radial or ulnar growth-plates. Following successful replantation, bone growth may be retarded, resulting in a length discrepancy between the radius and ulna with secondary deviation of the replanted hand. We present two cases in which callus distraction was employed to correct a length discrepancy. The relative merits of the various treatment options are discussed.

Amputation, Traumatic↗
PubMed1992

[Experimental study using porous, vascularizable polytetrafluoroethylene in preformed free flaps].

Following radical tumor resections or severe trauma, particularly in the head and neck region, cartilage or bone grafts serve as frame work in defect reconstruction. As an alternative, porous plastic material was used for preformed free flaps in an experimental study with 28 New Zealand rabbits. Due to ingrowth of fibrous tissue and capillaries, it was possible to obtain prefabricated flaps consisting of vascularized porous plastic, a thin layer of fatty gliding tissue and full thickness skin graft. The blood supply of all three layers of the transplant was confirmed by microangiography, Tc 99 m labeled red blood cells and histological examination.

Aluminum Oxide↗