Biomedical subjects

G M Beer

Publications and source records attributed to G M Beer.

24 records · Page 2Linked to original sources

PubMed1993

Importance of positive interaction in the initial meeting between plastic surgeons and patients: a survey.

The aesthetic plastic surgery patient represents a particularly sensitive and highly demanding client within the whole patient population. There is no doubt that a kind and understanding response to his problems and needs, which are often rather complex, contributes decisively to the establishment of a basis of confidence and it predominantly determines the further course of any interpersonal relationship with the surgeon. A kind response, i.e., positive interaction, signifies the complete acceptance of the patient, both verbally and nonverbally. The surgeon must be all ears to the requests and concerns and must attentively concern himself with all the patient's physical impairments that have grown into a problem. Positive interaction also means assessment and understanding of the patient's personality, including his self-image, his view of reality, and his present condition in order to choose correctly the suitable level of communication. Finally, positive interaction means the precise analysis of the patient's rational and irrational fears and his conceptions and expectations. There must be discussion of his wishes and the therapeutic and surgical possibilities in order to map out an acceptable path of treatment.

Attitude to Health↗

PubMed1983

[Necrotizing sialometaplasia (salivary gland infarct) of the submandibular gland. A case report].

Necrotizing sialometaplasia, being a rare, nonspecific reaction to ischaemic injury in salivary gland tissues of the head, is discussed in connection with a case of our own. In contrast to former reports concerning such lesions above all in minor salivary glands the following report concentrates on a case of necrotizing sialometaplasia in the submaxillary salivary gland of a 57-year old woman who noticed after exstirpation of a pleomorphic adenoma in the submaxillary gland a swelling that presented histologically as necrotizing sialometaplasia. Emphasis is placed on a detailed morphological knowledge of this innocuous, self-repairing process, since the extensive squamous cell metaplasia of minor excretory ducts as the essential finding could be easily misdiagnosed as a squamous cell carcinoma and, therefore deserves special consideration in differential diagnosis of salivary gland tumours.

Adenoma, Pleomorphic↗

PubMedDate not supplied

Endoscopic plastic surgery: the endoscopic evaluation of implants after breast augmentation.

There is an ongoing discussion about the possible connection of gel-filled silicone implants for breast augmentation and the development of connective tissue disease. In the absence of any proven link and irrespective of the difficulty to prove such a causality, these discussions lead to great concern for the hundreds of thousands of women who underwent breast augmentation with silicone gel implants. As a consequence there are voices that call for regular checks of the implants with regard to their integrity. All the external methods of judging an implant, including MRI, can--if at all--detect only marked lesions or ruptures. Direct visualization of the implant up to now has been the only safe method. Direct visualization can be carried out by reopening the previous incision or by endoscopic inspection. Endoscopic evaluation needs the dexterity of all endoscopic plastic surgery procedures, but with sufficient training and experience it is a very safe, quick, and highly compliant procedure for the patient and can be combined with endoscopic biopsies and other endoscopic operations such as capsulotomies.

Breast Implants↗

PubMedDate not supplied

Diagnosis of breast tumors after breast reduction.

We conducted a retrospective study to evaluate the diagnosability of breast tumors after breast reductions as this is a frequent surgical procedure. The data should shed light on the hypothesis that routine screening methods concerning the diagnosis of breast tumors prove more difficult after breast operations. All women who had undergone breast reduction at our department between January 1989 and December 1994 were examined. During this period we counted 166 patients; the majority of them (n = 144) had undergone a bilateral breast reduction and the rest of them (n = 22) a unilateral breast reduction for various reasons. After the operation, all patients were checked in standardized intervals. Those who developed any kind of breast mass (n = 6) were recorded and examined by ultrasound and mammography, and occasionally by an additional fine-needle biopsy. In case any doubt about the dignity had remained, an excisional biopsy was carried out. In none of our patients was it possible to get a precise diagnosis of an ill-defined mass with ultrasound. With mammography, some of the existing masses, which were really scars, mimicked different kinds of tumors, and once a carcinoma was initially interpreted as scar tissue with oil cysts. The diagnosis of breast masses after breast reductions with routinely used screening methods has proved to be more difficult as breast reductions lead to architectural alterations of the remaining breast parenchyma. Such alterations can and should be documented shortly after the operation so that later occurring tumors are distinguished more easily. Therefore, a basic mammography 3 months after each breast reduction has to be claimed in order to facilitate further breast tumor diagnosis.

Adult↗

PubMedDate not supplied

Closure of nasal defects after tumor excision with local flaps.

There is a myriad of proposals for nasal defect closure. One of the older concepts, the so-called topographical concept, adheres to the nasal subunit principle without taking into consideration textural details of the nasal skin such as thickness and mobility. In a newer concept, a morphological concept, the texture of the nasal skin is a basic consideration for defect closure. The morphological or textural concept demands defect closures only with local flaps of nearly identical texture located within the "unit" nose. In order to find out how the morphological concept influenced our operative design, we carried out a retrospective study from 1988 to 1995 checking the defect closure of all basal cell carcinoma on the nose. Of 598 basal cell carcinoma operated in the face, 141 were located on the nose. During the first years, free skin grafts and regional flaps dominated our operative design, in recent years the use of local flaps according to the criteria of the morphological concept increased significantly, leading not only to functional but also to more aesthetic results.

Adult↗

PubMedDate not supplied

Malignant tumors associated with nevus sebaceous: therapeutic consequences.

Nevus sebaceous has been considered a relatively infrequent and unimportant congenital hamartoma for plastic surgeons unless the lesions are so big that they require a demanding defect closure. As the dignity of such tumors is primarily benign and the malformed sebaceous glands are localized abnormally high in the dermis, the temptation is appealing not to excise these tumors any more but to eradicate them by laser beam therapy. Yet a nevus sebaceous not only affects sebaceous glands but includes various other malformations of the affected skin and its appendages. In addition, different malignant tumors may occur in nevus sebaceous, even in children and young adults. We encountered 4 such malignant tumors of 18 nevi sebaceous operated on from 1989 to 1997. All nevi had been unsuspicious macroscopically. In three patients, one of them only 15 years old, an associated basal cell carcinoma was found. In the fourth patient there was a mixture of three additional tumors, a cystadenoma, a keratoacanthoma, and a basal cell carcinoma, besides the sebaceous malformations. These findings have two consequences: first, to continue surgical treatment of nevus sebaceous instead of dermabrasion or dermablation and to have the specimen examined histologically and, second, to excise such tumors as early in childhood as possible.

Adolescent↗