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Biomedical subjects

F Becker

Publications and source records attributed to F Becker.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Nasal reconstruction in the elderly patient. The case for not letting age determine method.

OBJECTIVES: To review a series of nasal reconstructive procedures in elderly patients, and to discuss management issues related to reconstructing nasal defects in patients 80 years and older. DESIGN: Retrospective review identifying patients 80 years and older undergoing significant nasal reconstructive surgery. SETTING: University and private practice settings. PATIENTS: Patients 80 years and older requiring significant nasal reconstructive surgery, with nasal defect large enough to require a forehead flap for skin resurfacing. Patients whose defects were allowed to granulate or who had skin grafts were excluded. INTERVENTION: Nasal reconstructive surgery using advanced surgical techniques such as forehead flaps and cartilage grafts. MAIN OUTCOME MEASURES: Complications related to surgery or use of anesthesia and whether patients believed the effort and resources required to complete the nasal reconstruction were worth it. RESULTS: Fifteen patients 80 years and older underwent nasal reconstructive surgery using forehead flaps. In addition, 5 patients had intranasal mucosal grafts and 6 had cartilage grafts. There were no instances of anesthetic or perioperative morbidity or mortality. In addition, all flaps completely survived, and results were judged as good to excellent. CONCLUSIONS: Actuarial evidence shows that a 90-year-old American woman has a 40% chance of living to be 95 years old. Presently, with the improved level of functioning of octogenarians and nonagenarians, we are also concerned with their facial appearance, and want to use the optimum reconstructive technique. The decision of what type of reconstructive surgery to perform should not be based simply on a patient's age but must also take into account the patient's mental status and wishes, and medical condition. Our evidence supports the concept that, in the appropriately chosen patient 80 years and older, forehead flaps and cartilage grafting can be performed without significant morbidity.

Aged↗
PubMedDate not supplied

Angiotensin-converting enzyme inhibitory activity of SCH 31846, a new non-sulfhydryl inhibitor.

SCH 31846, 1-(N-[1(S)-(ethoxycarbonyl)-3-phenylpropyl]-(S)-alanyl)-cis, syn-octahydro-(H-indole-2-S)-carboxylic acid; CI-907; PD 109, 763-2, is a new non-sulfhydryl-containing, angiotensin-converting enzyme (ACE) inhibitor. The present investigation describes its ACE inhibitory properties and compares them to those of MK 421. The diacid of SCH 31846 inhibited rabbit pulmonary ACE with an IC50 of 2.2 nM (MK 421 diacid 2.5 nM). The drug behaved as a competitive and specific inhibitor in vitro. SCH 31846 and its diacid effectively inhibited pressor actions of intravenous injection of angiotensin I (AI) in anesthetized rats. ID50 values were 27 and 11 micrograms/kg for SCH 31846 and SCH 31846 diacid, respectively (MK 421 and MK 421 diacid 57 and 15 micrograms/kg, respectively). Oral administration of SCH 31846 (0.03-1 mg/kg) inhibited pressor actions of AI in conscious rats with a duration of over 16 h at 0.3 and 1 mg/kg. SCH 31846 was 2.2 times as potent as MK 421 in this regard. The diacid of SCH 31846 was considerably less potent than the ester, implying poor oral absorption of the former. Effective ACE inhibition, as judged by attenuation of pressor actions of AI, was noted in dogs after both intravenous and oral administrations of SCH 31846. Onset of action was more rapid than that of MK 421. Intravenous administration of SCH 31846 inhibited the renal vascular actions of intrarenal injection of AI, indicating effective blockade of the renal enzyme. Intracerebroventricular administration of SCH 31846 diacid blocked pressor responses to intracerebroventricular AI, whereas oral administration of SCH 31846 (10 mg/kg) did not, implying that SCH 31846 inhibits brain ACE but does not gain access to the cerebral enzyme when administered orally. These data indicate that SCH 31846 is a potent and specific non-sulfhydryl ACE inhibitor. As such, it should be useful in the treatment of hypertension and heart failure.

Administration, Oral↗
PubMedDate not supplied

[What complementary examinations to demand in chronic venous insufficiency?].

The diagnosis of chronic venous insufficiency (CVI) is first of all a clinical diagnosis. Subsequent investigations are useful to elucidate the underlying abnormalities in the venous system and to quantify their severity. Continuous wave doppler ultrasound is the basis test. Duplex scanning is useful for the study of popliteal and tibial veins reflux. The others non invasive techniques aim to investigate patients with severe CVI. But it seems necessary to be very careful with the methodologies used with these tests, and there is a need for a test of the whole calf venous pump function. Venographic studies are performed only if it is necessary to complete the non invasive tests data, before surgical treatment of a postthrombotic syndrome or of congenital deep venous reflux, or when a rare form of CVI is suspected. Venography remains the better test for the study of the anatomy of the venous system, but it is no longer the gold standard for the investigation of CVI.

Chronic Disease↗
PubMedDate not supplied

[Valves and valve pockets of the thoracic duct: sites of stagnation of neoplastic cells].

The thoracic duct was excised and histologically examined in 53 patients who died due to cancer. 11 specimens showed intraluminal cancer cells without signs of tumor migration through the duct wall. The malignant cells were either unattached in the lumen, caught within the valve pocket or had invaded the valve tissue. These findings add to the importance of lymphotropic cytotoxic agents.

Autopsy↗
PubMedDate not supplied

Exploration of arterial function with noninvasive technics. Results in chronic arterial occlusive disease of the lower limbs according to Leriche and Fontaine classification.

On a continuous series of 1000 lower limbs, the Author correlates the by Leriche and Fontaine described stages in arterial occlusive disease of lower limbs, with parameters given by a set of functional vasculary tests: Doppler, tetrapolar rheography, digital plethysmography, transcutaneous measure of PO2 (Tc PO2). The ankle systolic pressure index is a good method to value the importance of arterial occlusion, but it reflects not so well the clinical severity of ischemia. The degradation of the digital plethysmography pulsated signal and of the Tc PO2, is proportional to the ischemia degree with a very good specificity in stages III and IV. The reography indexes, the quantification of leg arteries (Doppler), the digital plethysmography, show that the major opposition between stage II and stage III - IV is the quality of peripheral vascular bed. It appears that the notion of leg arteries outflow must be completed with a notion of compensation in distally and of global peripheral vascular bed (leg arteries--arteriolary system--microcirculation). The set of the used methods allows only to retain two different groups: the first one gathering asymptomatic or responsible of an effort ischemia lesions (corresponding to stage I and II), the other gathering responsible of permanent ischemia, which impends gangrene (corresponding to stages III and IV). In the presence of rest pain or trophic disorder, the joined data of digital plethysmography and of Tc PO2, are more discriminating than the single impression and allow to discover some false stages III and IV.

Arterial Occlusive Diseases↗
PubMedDate not supplied

[Value of vascular function tests in complicated venous pathology].

The authors define their approach to vascular function tests (VFT) and the situations in which they may be useful in the diagnosis of complicated, associated or secondary venous disease. They present various pathological cases (superficial phlebitis, swollen leg, calf pain, deep venous obstruction syndrome, intermittent claudication, subacute ischaemia, trophic disorders). In general, VFT are able to: demonstrate the haemodynamic signs of venous stasis, recognise and analyse the various forms of diabetic angiopathy and quantify the degree of ischaemia in the presence of PVD associated with venous symptoms. VFT are particularly useful when the problems to be studied have been carefully defined by means of a thorough clinical examination.

Diabetic Angiopathies↗
PubMedDate not supplied

[Surgery in postphlebitic disease. Apropos of 157 surgical interventions].

Surgery occupies only a restricted position in post-phlebitic illness. The authors analyse 157 surgical operations carried out on 138 patients between 1969 and 1983. A detailed report is always given pre-operatively as a matter of course by Functional examination and phlebography, in order to locate the predominant physiopathological disorder or disorders: superficial venous deficiency--reflux via the perforators--the obliteration syndrome or devalvulation syndrome of the deep venous system. After a short listing of the surgical methods, the results of these different operations are analysed. They are hard to assess. Where there is a relapsing ulcer, surgery of the perforators produces 70 percent good results. The therapeutic indications are discussed, finally, on the basis of recently published series and the authors' experience.

Femoral Vein↗