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Biomedical subjects

G K Frykman

Publications and source records attributed to G K Frykman.

29 records · Page 2Linked to original sources
PubMed1983

The psycho-flexed hand.

Five mentally disturbed patients had flexion contractures of the middle, ring, and little fingers of one or both hands. All gave a history of psychiatric illness manifested by depression. Since no organic etiology for the contractures was found, the authors name this condition the "psycho-flexed hand." Four of the five patients were middle-aged women who suffered long-term depression, hypochondriasis, and/or schizophrenia. The patients' severely contracted fingers often macerated the palm. Manipulation under anesthesia and splinting only temporarily relieved the contractures. Multiple complications occurred following splinting and hand therapy, as well as surgery. Therefore, caution is urged when attempting surgical correction before resolving the mental illness.

Aged↗
PubMed1981

Neurolysis.

A proposal for classification of neurolysis and standardization of descriptive terms of neurolysis is made based on the anatomy of the peripheral nerves, particularly the connective tissue layers, the epineurium, the perineurium, and the endoneurium. The techniques of neurolysis are explained. Our animal studies demonstrate that following saline neurolysis, epineurectomy, or interfascicular neurolysis, fibrosis usually occurs in the epineurial layer, regardless of the method of neurolysis used. These findings indicate that neurolysis should be considered only if the scarring in or about the nerve is worse than would be produced by the neurolysis procedure itself. The results of neurolysis for those lesions that have remained in continuity and have failed to recover after an appropriate interval of observation seem to indicate that the procedure is worthwhile in this situation. After review of the literature, we conclude that there is no clinical or experimental series that would give clear guidelines for neurolysis following a repair of loss of continuity of the nerve trunk. With new techniques of nerve stimulation and intraoperative recording, perhaps interfascicular neurolysis will become a more valuable surgical procedure.

Animals↗
PubMed1981

Rehabilitation of peripheral nerve injuries.

Rehabilitation of the patient with a peripheral nerve injury requires knowledge, understanding, and cooperation between the patient, the physician, and the therapist. Careful documentation of the patient's status prior to beginning rehabilitation and periodic follow-up assessments are of utmost importance. We have presented a detailed scheme for initial and follow-up evaluation. Prevention of unnecessary stiffness, swelling, and contractures is emphasized. Education of the patient to prevent the individual from doing further damage to the anesthetic area is important. Proper splinting techniques, from the postoperative splint and cast to splints that prevent deformities as well as overcome established contractures and improve function, will aid in the patient's recovery. Desensitization is an important aspect of sensory recovery, and sensory reeducation will aid in recovery of sensibility. Early tendon transfers are found to be particularly advantageous for high radial and median nerve palsies to gain functional recovery earlier and to allow the patient to become brace-free sooner.

Edema↗
PubMed1980

Winging of the scapula as a complication of first rib resection: a report of six cases.

Long thoracic nerve injury occurred in 6 patients as a complication of first rib resection by the transaxillary route for relief of thoracic outlet syndrome. In a review of 38 patients following 48 first rib resections, this is the second most frequent complication. This complication has rarely been reported in the literature. In 4 patients the long thoracic nerve palsy was transient, and complete recovery of serratus anterior function occurred within 6 months. In one patient, complete recovery followed repair of the long thoracic nerve.

Female↗
PubMed1979

Automated nerve fiber counting using an array processor in a multi-minicomputer system.

It has been suggested that recovery of motor and sensory function in the site distal to a peripheral nerve lesion should be improved if the nerve bundles (fasciculi) are matched and individually sutured. Three parameters are proposed to provide quantitative data: the count of the nerve fibers that regenerate, the number of functional regenerated nerve fibers, and a measurement of end organ reinnervation. A thin cross section of a transected and repaired sciatic nerve of a mongrel cat is fixed, stained, photographed, and digitized through a microscope 6 months following nerve repair. The data arrays are then subjected to four basic processing routines: edge enhancing, thresholding, template matching, and peak detection. Finally, the peaks are counted and provide an estimate of the number of nerve fibers in the nerve under study. Comparing counts of nerve fibers proximal and distal to the transection site of the nerve provide data on the proportion of regeneration present at various times. The content of this paper is, to a large extent, describing the implementation of the needed image-processing algorithms for automated counting on the Multi-MiniComputer System (MMCS). Optimal use of the AP-120B array processor and the pipeline processing provided by using the Eclipse 200s and the Nova 3 make a marked improvement in overall throughput.

Animals↗
PubMed1978

Peripheral nerve hamartoma with macrodactyly in the hand: Report of three cases and review of the literature.

Two patients with hamartomas of the median nerve and one with hamartoma of the ulnar nerve associated with macrodactyly are described. Nineteen similar cases of this association have been found in the literature. There is evidence that these two conditions are part of a localized regional growth disturbance. This type of macrodactyly should be differentiated from neurofibromatosis.

Adult↗
PubMed1976

Peripheral nerve injuries in children.

Recovery after peripheral nerve injuries in children is more complete than in adults and is inversely related to the age of the patient. The prognosis for the return of sensation following laceration of the median, ulnar, or digital nerve depends upon recovery of two point discrimination (in millimeters approximately equal to the child's age) at the time of nerve repair. The better results in children probably reflect the greater adaptability of the immature central nervous system to the nerve injury. Operative exploration of an open wound when there is a potential for nerve injury in an uncooperative child is the only sure way of determining the status of the nerves. Primary repair of cleanly divided nerves in tidy wounds is advocated if it can be done competently. Secondary repair is indicated for avulsion injuries, gunshot wounds, crush injuries, and human or animal bites. Delicate, atraumatic technique and accurate repair of the divided nerve are stressed. The more exacting technique of funicular repair may yield better results. Interfascicular cable grafting is a new and useful alternative to extensive mobilization in closing nerve gaps. Nonoperative treatment of nerve injuries associated with closed fractures is advocated unless there are no signs of nerve regeneration in two to three months. Obstetrical brachial plexus injuries of the upper plexus carry a better prognosis than lower plexus or total plexus injury. Early range of motion exercises to prevent contractures are stressed. Maximal recovery takes place within two years. The acute nerve compression syndrome should be considered an emergency and may require surgical decompression if it is severe and if rapid return of function does not occur following reduction of the fracture.

Adolescent↗
PubMed1974

Saving amputated digits. Current status of replantation of fingers and hands.

Since the advent of microsurgery in the 1960's it has become possible to sucessfully repair vessels as small as 0.5 mm in diameter, which makes the replantation of totally severed digits possible. Some centers have reported 50 to 60 percent survival of completely severed digits and up to 100 percent survival of amputated hands and of partially amputed but otherwise non-viable digits that were reattached. In view of this success, severed members should be considered as potentially replantable.THE RECOMMENDED INDICATIONS FOR REPLANTATION ARE: (1) multiple digital amputations at or proximal to the proximal interphalangeal joint; (2) amputation of the thumb; (3) amputation of the wrist or hand; (4) partially attached digits that are non-viable without reattachment.The surviving replanted digits give functional improvement to the hand and prove cosmetically acceptable.

Amputation, Traumatic↗
PubMedDate not supplied

The quest for better recovery from peripheral nerve injury: current status of nerve regeneration research.

The author reviews relevant nerve regeneration research in the past half-century to give the reader familiarity with the background of current research efforts. Recent research has been aided by newer knowledge of the biology of nerve regeneration. Early efforts to improve nerve regeneration centered on improvements in technical or surgical repairs, with only modest gains. Although current technical improvements with lasers or fibrin glue to repair nerves may show promise, the approach of deMedinaceli et al. combines several new ideas with some improvement experimentally. With the discovery of nerve growth factors and a host of newer nerve growth promoting factors, the biochemical arena has explored. Special tubes to repair nerves enable easy manipulation of the environment to study the effects of various factors on nerve regeneration. Silastic and bioresorbable tubes show the most promise to enhance nerve regeneration by tubulization. Because of the explosion of knowledge and high levels of activity of research, it is apparent that further improvements of nerve regeneration are on the horizon.

Axons↗