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Biomedical subjects

J Hochberg

Publications and source records attributed to J Hochberg.

43 records · Page 3Linked to original sources

Saving the frontal branch during a low fronto-orbital approach.

This report describes the anatomy of the frontal branch of the seventh nerve and a technique for assuring its preservation when doing a low frontal approach. By dissecting under both layers of the temporal fascia, rapid and safe access to the inferior fronto-orbital region may be achieved. This technique is recommended for exposure of a bony lesion in the fronto-orbital region and when performing an osteoplastic pterional craniotomy.

Child↗

A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release.

A prospective randomized study was performed comparing the efficacy of controlled cold therapy (CCT) with the efficacy of ice therapy in the postoperative treatment of 72 patients with carpal tunnel syndrome. Immediately after surgery, patients applied either a temperature-controlled cooling blanket (CCT) or a standard ice pack over their surgical dressings. Pain was assessed by visual analog scale and swelling by wrist circumference preoperatively, immediately after surgery, and on postoperative day 3. Patients kept log books of daily treatment times. Narcotic use (of Vicodin ES) was determined by pill count at day 3 and by daily log book recordings. Patients who used CCT showed significantly greater reduction in pain, edema (wrist circumference), and narcotic use at postoperative day 3 than did those using ice therapy. This study indicates that after carpal tunnel surgery, the use of CCT, compared with traditional ice therapy, provides patients with greater comfort and lessens the need for narcotics.

Adult↗

Development and evaluation of an in vivo mouse model for studying myocutaneous flap microcirculation and viability before and after suturing or stapling.

A model was developed in albino hairless mice to study microcirculation and viability of dorsal distally based myocutaneous flaps. The efficacy of this model was tested in 120 mice by evaluating the effects of excessive crimping and tension attributed to Proximate or Signet staples or to simple or mattress nylon sutures. Microhemodynamics were assessed using computer-assisted intravital videomicroscopic and electro-optical methods. Volumetric rates of blood flow were calculated within terminal arterioles from measurements of internal diameter and mean centerline cellular velocity. The viability was determined on day 5 by measuring the areas of necrosis (mm2) along the cut edges of these flaps. In 80 mice, flaps were elevated and examined at 0 h and then again at 24 or 48 h. There were 40 mice in each of these disturbed groups. In a third group of 40 mice, flaps were raised at 0 h without videomicroscopic examination at 0, 24, or 48 h (undisturbed group). All flaps were stapled or sutured to the original donor site with one of the four methods of closure. The results of this study indicate that sutures produce the highest incidence of necrosis at 5 days when compared to staples in the undisturbed groups of mice. However, no significant differences in necrosis were observed when flaps were disturbed at 48 h despite videomicroscopic evidence of depressed blood flow along their cut edges. In contrast, results at 24 h were equivocal and statistically not significant. These data suggest that the phenomenon of delay and/or flap recirculation following removal and reapproximation of sutures or staples drastically improves perfusion and viability of disturbed flaps.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Diagnosing and treating congenital melanocytic nevus simulating malignant melanoma.

Many cases reported as malignant melanomas arising in benign congenital melanocytic nevi in the neonatal period have not shown evidence of metastases after several years of follow-up. These lesions were probably pathologically misdiagnosed, thus creating a controversy regarding the precise incidence. This article describes the case of an infant with a giant melanocytic nevus simulating malignant melanoma to illustrate the proper criteria for diagnosis of this condition so extensive and unnecessary therapy procedures can be avoided.

Diagnosis, Differential↗

Granuloma of the lacrimal sac.

This article describes a rare case of granuloma of the lacrimal sac, which was treated with dacryocistorhinostomy and glabellar flap. In addition, the possible etiologic factors, the differential diagnosis and reconstructive techniques indicated in such cases are described.

Adult↗