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Biomedical subjects

E K Manders

Publications and source records attributed to E K Manders.

At least 73 records · Page 4Linked to original sources
PubMed1987

Uvulopalatopharyngoplasty as a treatment of obstructive sleep apnea precipitated by uvular prolapse.

Two patients are discussed in whom obstructive sleep apnea was precipitated by uvular prolapse into the larynx and successfully treated by uvulopalatopharyngoplasty. Although tracheostomy has been the definitive treatment for obstructive sleep apnea, uvulopalatopharyngoplasty has also been used as an alternative surgical procedure. However, indications for its successful use have not been clearly defined. Our experience illustrates that the surgical approach to obstructive sleep apnea is dependent on a thorough diagnostic evaluation that includes a sleep history, head and neck examination, hypnopolygraphic recording and, if indicated, nocturnal fiberoptic endoscopy.

Endoscopy↗
PubMed1987

The effect of age and hair colour on human hairbulb tyrosinase activity.

We studied tyrosinase activity from human hairbulbs from 51 subjects, aged 5-72 years. We used anagen hairbulbs and grouped the subjects according to hair colour. We did not observe an age-dependent fall in hairbulb tyrosinase activity. We observed considerable inter-individual variation in activity, with a range of 8-342 pmol DOPA formed/three hairbulbs/30 min. The mean tyrosinase activity from red hairbulbs was significantly higher than the mean for the other hair colours. White hairbulbs did not express tyrosinase activity, and specific antibodies to tyrosinase were used to establish that tyrosinase antigen was absent from white hairbulbs.

Adolescent↗
PubMed1987

Scalp expansion for male pattern baldness.

Male pattern baldness may be effectively eliminated in most patients through the use of soft-tissue expansion. Expansion affords larger temporo-parieto-occipital flaps with a more easily closed donor defect. Differential expanders are used to eliminate hippocratic male pattern baldness through a massive scalp reduction and simultaneous reconstruction of an anterior hairline.

Alopecia↗
PubMed1987

Elongation of peripheral nerve and viscera containing smooth muscle.

Peripheral nerve, ureter, and small bowel will all elongate over a soft-tissue expander. Elongation of peripheral nerve serves as an effective alternative to nerve grafting both in selected clinical cases and in experimental settings. While canine ureter functions well with little morphologic change following elongation, the rabbit small bowel morphology and function are significantly altered after elongation through expansion.

Animals↗
PubMed1987

Cutaneous myiasis.

Although cutaneous myiasis remains uncommon in North America, any traveler to the tropics may return with this ailment. A history of travel to a tropical country, a persistent pruritic lesion resembling a boil but having a dark central punctum with seropurulent or serosanguineous drainage, and complaints of a crawling sensation in the area of the lesion should lead the physician to consider myiasis. Treatment is directed at prompt removal of the fly maggot by incision and extraction.

Adolescent↗
PubMed1986

Reconstruction by expansion in the patient with cancer of the head and neck.

Soft-tissue expansion has undergone wide application in reconstructive surgery. The technique has been used about the head and neck, for breast reconstruction, and for reconstruction in the extremities. Scalp reconstruction, total nasal reconstruction, and the movement of flaps of bearded skin using soft-tissue expansion offer selected patients improved results as compared with what could be achieved by using other methods.

Female↗
PubMed1986

Elimination of lymphangioma circumscriptum by suction-assisted lipectomy.

Lymphangioma circumscriptum presents as cutaneous vesicles or skin tags that drain lymphatic fluid. Deep, sequestered lymphatic cisterns encircled by smooth muscle are thought to be the cause of the skin manifestations, and selective resection of the deep cisterns, not the involved overlying skin, has been suggested as the treatment of choice. We report a successful treatment of lymphangioma circumscriptum using suction-assisted lipectomy to obliterate the deep lymphatic cisterns and their vertical channels communicating to the skin.

Adult↗
PubMed1986

Labeled leukocyte scans for detection of retained polyurethane foam.

Complete removal of an infected polyurethane-covered breast prosthesis is difficult, and retained tissue-embedded foam can form a nidus for persistent infection. Scanning the chest wall after administration of indium-111 oxine-labeled autogenous leukocytes will locate areas of infection around retained fragments of foam, thereby facilitating their removal and allowing eventual successful reconstruction. This technique may deserve wider application for locating infected foreign bodies in a variety of patient problems.

Adult↗
PubMed1984

Sleep apnea precipitated by pharyngeal surgery in a patient with myotonic dystrophy.

A patient was seen for evaluation of excessive daytime sleepiness, which was exacerbated following complications secondary to surgical reconstruction of the pharynx for a submucous cleft palate. She underwent recordings in the sleep laboratory and was found to have sleep apnea. Also, a thorough clinical and laboratory assessment established the diagnosis of myotonic dystrophy. Following tracheostomy, both the patient's sleep apnea and daytime hypersomnia were eliminated. Our case demonstrates that surgical procedures involving the upper airway should be approached with considerable caution in patients with myotonic dystrophy and only after the presence of associated sleep apnea has been carefully excluded. An original finding is the suggestion of a decrease in the number of T-cell lymphocytes in a patient with myotonic dystrophy.

Adult↗
PubMed1984

Skin expansion to eliminate large scalp defects.

In three children aged 3 to 8 years with large scalp defects temporary expanders of silicone elastomer were inserted under the scalp above the pericranium and under the galea through an incision at the junction of the defect and the normal scalp. Over the following six to eight weeks, the expanders were inflated weekly or semiweekly with injections of saline. During expansion, hair growth continued. When the scalp flap expansion was completed, the scalp margin was advanced. Two of the 3 patients required additional expansion, so a deflated expander was left under the scalp. The entire defect was covered in each case. This technique has wide application for a variety of reconstructive problems.

Child↗
PubMed1984

The permanence of otoplasty in the rabbit ear: a comparison of techniques.

Otoplasty should restructure the cartilage framework of the ear with permanent results. Major techniques include the placement of permanent sutures, with or without concomitant cartilage scoring, and cartilage abrasion alone. Our study evaluates the durability of the results of each method. Fifteen New Zealand white rabbits were divided into two groups. In 10 rabbits, the posterior surface of the right ear cartilage was abraded, and the ear was folded forward and secured with nylon stitches. A similar procedure was performed on the left ear, omitting the cartilage abrasion. In 4 rabbits, both ears were abraded transversely on the posterior cartilaginous surface and no sutures were placed. In 1 rabbit only the posterior skin was undermined on both ears. For one week dressings maintained a right-angle fold at the operative site. Rabbit ears reshaped with abrasion only failed to maintain the desired conformation. Ears with suture and abrasion did not maintain the full 90-degree angle created at surgery, although they did not fully straighten. Ears reshaped with suture alone maintained a folded angle close to the original right angle. Three months after operation the sutures within the cartilage were removed to approximate the clinical situation of late suture disruption from trauma to the operated ear and the shape was assessed.

Animals↗
PubMed1984

Soft-tissue expansion: concepts and complications.

Soft-tissue expansion complements existing reconstructive techniques and provides new vistas for the plastic surgeon. The technique finds use for overcoming a shortage of tissue, for obtaining skin with special desirable qualities, for creation of flaps otherwise not possible because of the resultant donor site or limited vascularity, for creation of flaps with functioning muscle and overlying soft tissue, and for minimizing flap donor-site problems. Careful planning should include patient counseling, optimum incision placement, and time for a leisurely, complete expansion. The surgery can often be performed under local anesthesia and expansion is tolerated well. Patients should be counseled that the incidence of major complications in an unselected series is 1 in 4 patients. Major complications, however, typically result in a delay in reconstruction and not tissue loss.

Adult↗
PubMed1984

Alopecia reduction by scalp expansion.

Areas of alopecia may be eliminated by scalp expanders. This is accomplished by subgaleal placement of soft tissue expanders under normal scalp adjacent to defect. Subsequent inflation and advancement of the expanded scalp resurfaces the defect with an excellent aesthetic result.

Alopecia↗
PubMed1984

Spontaneous occurrence of synergistic bacterial gangrene following external pelvic irradiation.

A case of spontaneous synergistic bacterial gangrene occurring after external pelvic irradiation is presented in a 25-year-old woman with invasive cervical cancer. Treatment consisted of aggressive antibiotic therapy and extensive excision and debridement followed by split-thickness skin grafting. Both recovery and cosmetic results were satisfactory. The pathophysiology, predisposing factors, and treatment modalities are presented.

Anti-Bacterial Agents↗
PubMed1983

Mitomycin C extravasation injuries.

Mitomycin C extravasation produces a chronic painful ulceration similar to that of adriamycin. Pain marks the extravasation of this chemotherapeutic agent when it occurs. A complaint of pain during mitomycin administration should prompt immediate cessation of infusion and regular frequent follow-up. Ulceration may not appear for one to two weeks after initial injury. Wide local excision with subsequent split thickness skin grafting is recommended.

Female↗