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Biomedical subjects

G B Stark

Publications and source records attributed to G B Stark.

At least 73 records · Page 4Linked to original sources
PubMed1994

Phenol burns and intoxications.

Phenol burns and intoxications are life-threatening injuries. Roughly 50 per cent of all reported cases have a fatal outcome. Only a small number of cases have been reported with high serum concentrations after phenol burns who survived. In our own experience a patient with 20.5 per cent total body surface area deep partial skin thickness phenol burns and serum concentrations of 17,400 micrograms/litre survived after immediate and repeated treatment of the scalds with polyethylene glycol (PEG) and silver sulphadiazine. A literature review of experiences with phenol intoxications reveals the advantages of PEG application. Questions on the need for enforced diuresis and haemodialysis as well as the initial treatment procedures are discussed. Advantages of different solutions for local therapy are reported.

Accidents, Occupational↗
PubMed1994

[Treatment of perianal burns with submerged skin particles].

Perianal burn wounds often cannot be cured by conventional split-thickness skin grafting procedures. This is due to the mechanical stress and the enormous bacterial colonization. Transplantation of small skin pieces, submerged into the granulation tissue, is able to produce small epithelial islands within 2 weeks. These enlarge continuously and produce complete epithelialisation in the further course. Own results with 7 burn patients prove that this technique is suitable to epithelialize gluteal and perianal problem wounds with comparatively little expenditure.

Adolescent↗
PubMed1994

[Preoperative prevention of infection with cefuroxime in hand surgery emergencies. Efficacy, control of concentration, follow-up].

Clinical efficacy and drug safety of Cefuroxime for preoperative prophylaxis of wound infection was investigated in 20 cases of acute open hand injuries. Ten minutes before filling of the tourniquet, Cefuroxime was given. Tissue and serum levels of ten patients were determined 10 and 70 minutes later. Levels far above the minimum inhibitory concentrations of possible pathogenic bacteria were obtained. No serious infection occurred. Wound complications not related to infection occurred in 15%.

Adolescent↗
PubMed1994

[Single dose prevention with cefuroxime in plastic surgery. Control of serum level, efficacy and tolerance].

Clinical efficacy and drug safety of single-shot prophylaxis with Cefuroxime was investigated in a series of 50 elective plastic surgical operations. Serum and tissue concentrations at one hour after application were determined in ten patients undergoing breast reduction. Levels far above the minimum inhibitory concentrations for possible pathogenic bacteria were obtained. No infection occurred. Wound complications not related to wound infection occurred in 12%.

Adolescent↗
PubMed1994

Prosthetic vascular graft infection--defect covering with delayed vertical rectus abdominis muscular flap (VRAM) and rectus femoris flap.

Prosthetic vascular graft infection is associated with high rates of morbidity and mortality. When infections lead to an open exposure of vascular prosthesis special techniques may be necessary to cover tissue defects in regions with often very poor circulation/perfusion conditions. Even when there are large tissue defects associated with vascular prosthetic graft infections and exposure of prosthesis local cure can be achieved after radical debridement and defect coverage through transposition of myocutaneous flaps. The cases of two patients with open exposure of prosthesis in the groin who had been successfully treated by delayed vertical rectus abdominis muscular flap (VRAM) or rectus femoris rotation are presented. The contralateral VRAM myocutaneous flap is an excellent alternative if local measures fail to close large groin defects with exposed prosthesis. In addition the delayed flap rotation offers a greater safety in conditioning the vascularity of the flap.

Amputation Stumps↗
PubMed1993

[The expanded ileal pouch as a reservoir in continence preserving proctocolectomy. An experimental study on the pig].

Silicone balloons were inserted into bypassed segments of terminal ileum of five mini-pigs. The balloons were expanded over a period of 3 months, thereby creating pouches with a mean volume of 700 cm3 (a 9.5-fold increase). Functional proctocolectomy was performed and the bypassed segment was than placed in continuity with its terminal end at the previous site of the anus, thus creating a neorectum. One year later, the three pigs were still alive. They were continent and stool frequency was 2-3 times a day. The final mean volume of the pouch was still 360 cm3, corresponding to a 5.7-fold increase. At the end of the experiment significant hypertrophy of the bowel wall thickness was observed compared to the controls. The rectal X-ray contrast study demonstrated a new rectal reservoir without fistula or stenosis.

Animals↗
PubMed1992

Tissue suction of the male and female breast.

Liposuction has been used either alone or combined with resection for the correction of male and female breast deformities. The majority of the 32 patients in our study were treated for gynecomastia (69%). Other indications were Madelung's disease, gender dysphoria, asymmetry, hypertrophy, postburn and postreconstruction deformities. In 54% of the gynecomastia cases, suction alone gave a satisfactory result. In all but one male patient suction permitted us to avoid incisions other than periareolar incisions. Thirteen aspirates from gynecomastias and three glands resected secondarily after suction were examined histologically. All aspirates included glandular tissue. We conclude that breast tissue is accessible to the suction cannula, and that this is a valuable tool for correcting gynecomastia and for use in many aesthetic procedures on female patients.

Adolescent↗
PubMed1992

Use of the biceps femoris following failed inferior gluteal flap transfer. Case report.

Considering the high recurrence rate of pressure ulceration in paraplegic patients, flap procedures to reconstruct a defect should not be at the expense of another possible future flap. The posterior thigh fasciocutaneous flap is useful for the coverage of ischial and trochanteric pressure sores; the biceps femoris musculocutaneous flap is a useful choice for deep ischial defects. However, the cutaneous portions of these two flaps is nearly identical. The previous transfer of the biceps flap excludes the further use of the posterior thigh flap. In contrast, use of the posterior thigh flap still permits the employment of a biceps V-Y advancement flap. Even if the donor site of the previous posterior thigh flap must be skin-grafted, the graft will remain viable on its muscular bed and function as the cutaneous portion of the flap; thus stable coverage is provided, despite previous use of 'first line' flaps. We demonstrate how careful planning of the stages of flap procedures can allow the most economic use of donor areas in this difficult patient group.

Adult↗
PubMed1992

[Histomorphologic findings in human expanded tissue].

Forty biopsies from 22 patients undergoing tissue expansion were examined histologically. Expanded skin demonstrated a generally unconspicious morphology of the epidermis, dermis and subcutis. Adnexal organs of the skin were preserved. Mean epidermal thickness was increased to 710 +/- 240 microns compared to 624 +/- 215 microns in the controls. The tissue expanders were bordered by a richly vascularized connective tissue capsule with a very variable mean thickness of 795 +/- 712 microns. These histologic findings in human tissues support experimental evidence for a real increase in tissue by expansion.

Adolescent↗
PubMed1991

[Autologous corium-plasty in closure of muscle hernia. A case report].

The case involving a 33-year-old patient is presented who developed a muscle hernia through a fascia late defect subsequent to removal of internal fixation devices from the left femur. Because primary closure of the fascia could not be achieved, an autologous dermis graft harvested from the margin of the skin incision was used. A firm closure of the fascial gap was achieved and the patient has no complaints. Having used an autologous dermis graft, we were able to avoid an alloplastic substitute.

Adult↗
PubMed1990

The creation of a small bowel pouch by tissue expansion--an experimental study in pigs.

Tissue expanders (inflatable silicone balloons) were implanted into a bypassed ileum segment of seven pigs and consecutively filled over 8 to 12 weeks. The mean increase of the volume of the small bowel loops was 12 fold with a maximum of 22.8 times the original volume. The final volume 9 weeks after expander removal still presented an increase of 500%. Histologically there was an increase of the thickness of all layers of the bowel wall, especially in the tunica muscularis. The mucosa showed a value above normal in mean in vitro 14C-resorption capacity per surface area in the reintegrated bowel. Possible clinical applications of the augmentation of the gut by expansion as a rectum substitute after proctocolectomy, as a urinary bladder or stomach substitute, and for the treatment of short bowel syndrome are discussed.

Animals↗
PubMed1990

[May the internal iliac artery in the pelvic area be ligated in situ bilaterally for hemostasis? Indications and contraindications].

The bilateral ligation of the internal iliac arteries in situ is successful in preventing haemostasis and the treatment of potentially lethal haemorrhage. In spite of using a resorbable thread (catgut) for ligation a complete recanalization of this large artery could only be observed after nine months in an animal experiment. Clinically this ligation of the artery in situ without severance has not impaired erective potency in patients with an otherwise healthy vascular system. Since many patients did not show any disturbance prior to the vessel's recanalization the early established parallel circulation is sufficient to compensate for the perfusion deficit. A contraindication for the ligation is a previous major procedure, especially, in cases of irradiation or an occlusive vascular disease.

Adult↗
PubMed1990

[Upper gastrointestinal hemorrhage due to vena cava obstruction].

Occlusive disease of the inferior vena cava is rare. The experiences of diagnosis and uncommon complications of bleeding in a case of a now 21-year-old male are reported. Real-time ultrasound examination and cavography are very useful for diagnosis and planing of surgical intervention. Causes of complete occlusion of the VCI in early childhood are malignant tumours or an abdominal mass. Usually cava-azygos collaterals may enlarge sufficiently. Normally, vertebral pathways with sufficient circulation prevent oedema of the limbs, bilateral varicoceles and caput medusae of the abdominal wall. The vasa vasorum or intrahepatic pathways rarely contribute to the collateral circulation. In the present case, varicosities of the duodenum caused intestinal bleeding. Neither treatment by resection nor a shunt procedure may promise definite relief if collateral veins are bleeding diffusely. Stenosis and occlusion of VCI and small shot-like ulcers above the varicosities of the duodenum were the major observations found in the case under discussion.

Adult↗
PubMed1990

Intraluminal cyclosporine A reduces capsular thickness around silicone implants in rats.

One theory of the cause of connective tissue capsule formation around silicone mammary prostheses is based on an immunological interaction. In an in vitro pilot study, it is shown that intraluminal cyclosporine A, a potent T-lymphocyte-specific immunosuppressive agent, can diffuse slowly through the outer shell of a standard double-lumen silicone breast implant. Round silicone tissue expanders containing 50 mg of cyclosporine A were implanted subcutaneously in 10 rats. Ten animals served as controls. Evaluation was performed after three months. A significant decrease in collagen capsular thickness of 21.6 +/- 5.4 microns (mean +/- standard deviation was measured histomorphometrically in the treated group compared with 39.6 +/- 8.6 microns in the control group (p less than 0.001).

Animals↗
PubMed1990

[Angiography findings before and following transplantation of free myocutaneous flaps].

Prerequisite for successful split-skin flap transplants of myocutaneous flaps is the presence of adequate adjacent afferent and efferent vessels, thus making an arteriography of the receiving region mandatory during surgery preparation. In 20 or 29 patients in whom a split myocutaneous flap was transplanted to the lower leg, angiography revealed 22 pathological or other therapyrelevant findings. Besides the afferent vessels it is basically necessary to visualise the peripheral efferent pathways in order to prevent that vascular anastomosis to the split-skin flap obstructs the blood supply of the leg.

Adolescent↗