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Biomedical subjects

J Holle

Publications and source records attributed to J Holle.

At least 19 recordsLinked to original sources
PubMed2002

Pharmacokinetics and bioavailability of trimethoprim-sulfamethoxazole in alpacas.

The pharmacokinetics and bioavailability of trimethoprim-sulfamethoxazole (TMP-SMX) were studied in six healthy male-castrate alpacas (Lama pacos) after intravenous (i.v.) or oral (p.o.) drug administration of 15 mg/kg TMP-SMX using a crossover design with a 2-week washout period. After 90 days one group (n = 3) was given a p.o. dose of 30 mg/kg TMP-SMX and the other group (n = 3) was given a p.o. dose of 60 mg/kg TMP-SMX. After i.v. administration of 15 mg/kg of TMP-SMX the mean initial plasma concentration (C0) was 10.75 +/- 2.12 microg/mL for trimethoprim (TMP) and 158.3 +/- 189.3 microg/mL for sulfamethoxazole (SMX). Elimination half-lives were 0.74 +/- 0.1 h for TMP and 2.2 +/- 0.6 h for SMX. The mean residence times were 1.45 +/- 0.72 h for TMP and 2.8 +/- 0.6 h for SMX. The areas under the respective concentration vs. time curves (AUC) were 2.49 +/- 1.62 microg h/mL for TMP and 124 +/- 60 microg h/mL for SMX. Total clearance (Clt) for TMP was 21.63 +/- 9.85 and 1.90 +/- 0.77 mL/min kg for SMX. The volume of distribution at steady state was 2.32 +/- 1.15 L/kg for TMP and 0.35 +/- 0.09 L/kg for SMX. After intragastric administration of 15, 30 and 60 mg/kg the peak concentration (Cmax) of SMX were 1.9 +/- 0.8, 2.6 +/- 0.4 and 2.8 +/- 0.7 microg/mL, respectively. The AUC was 9.1 +/- 5, 25.9 +/- 3.3 and 39.1 +/- 4.1 microg h/mL, respectively. Based upon these AUC values and correcting for dose, the respective bioavailabilities were 7.7, 10.5 and 7.94%. Trimethoprim was not detected in plasma after intragastric administration. These data demonstrate that therapeutic concentrations of TMP-SMX are not achieved after p.o. administration to alpacas.

Administration, Oral↗
PubMed2001

Serum immunoglobulin G concentrations in calves fed fresh and frozen colostrum.

OBJECTIVE: To determine whether serum IgG concentrations in neonatal calves are adversely affected by short-term frozen storage of colostrum. DESIGN: Prospective study. SAMPLE POPULATION: Experiment 1 consisted of 10 pairs of Holstein calves (n = 20) fed matched aliquots of either fresh (n = 10) or frozen and thawed (10) colostrum. In experiment 2, 26 Holstein calves were fed either fresh (n = 13) or frozen and thawed (n = 13) colostrum. PROCEDURE: Experiment 1 consisted of calves resulting from observed parturitions; calves were randomly assigned to treatment groups (fresh or frozen and thawed colostrum) in pairs. Calves were fed 4 L aliquots of colostrum via oroesophageal intubation at 3 hours of age. Serum IgG concentrations at 2 days of age were compared between the 2 groups by use of a paired t-test. Experiment 2 consisted of calves resulting from observed parturitions; calves were randomly assigned to treatment groups (fresh or frozen and thawed colostrum). Calves were fed 4 L aliquots of colostrum via oroesophageal intubation at 3 hours of age. Regression analysis was used to determine whether calf serum IgG concentration was a function of colostral IgG concentration and colostrum storage group. RESULTS: Significant differences were not observed between the 2 groups in experiment 1. No significant relationship was observed between colostrum storage group and serum IgG concentration in experiment 2. The model that best predicted serum IgG concentrations accounted for 20% of the variability in serum IgG concentration. CONCLUSION AND CLINICAL RELEVANCE: Frozen colostrum is an adequate source of IgG for calves.

Animal Feed↗
PubMed2001

[Treatment of chronic osteomyelitis of the tarsal bones with free muscle flaps].

Although the value of free muscle flaps in the treatment of chronic osteomyelitis of the lower leg is well documented, only few reports deal with the use of free muscle flaps for treatment of osteomyelitis of the tarsal bones. Four patients with chronic osteomyelitis of the tarsal bones (in three patients several bones were involved) were treated using the following regimen: radical debridement, coverage with a free muscle flap, and systemic antibiotic therapy. In two patients, infection recurred following primary transplantation of the muscle flap. In one of these patients, recurrence was controlled by repeating the same regimen. In the other patient, debridement was repeated and the calcaneus was transposed to obliterate the resultant bone cavity. At follow-up (mean 19 months following last surgical procedure), all four patients showed no evidence of infection and were fully weight-bearing. Chronic osteomyelitis of tarsal bones can be successfully treated by radical debridement and coverage with muscle flaps, even in advanced stages of the disease. The clinical and anatomical peculiarities of this region, however, have to be taken into consideration.

Adolescent↗
PubMed2001

Evaluation of total vs. regional blood perfusion with a laser Doppler imaging system in the rat epigastric flap.

Monitoring systems to measure flap survival are either invasive, touch the surface of the tissue, or have problems in reproducibility. The authors sought to determine the efficacy of a laser Doppler imaging (LDI) system to measure perfusion in a myocutaneous flap, by producing a two-dimensional picture of the flap without touching the surface. They compared total flap perfusion with perfusion in selected areas of interest after flap surgery. The perfusion in the left groin of Sprague-Dawley rats was measured before and after surface rubbing, skin injury, and during different lighting conditions. The perfusion of the epigastric flap before and over a period of 60 min after elevation was measured, and values were compared to pre-surgical values and to sham-operated animals. They determined the differences between single and running-suture techniques after flap surgery, as well as between venous and/or arterial occlusion. Surface rubbing, skin injury, and light influenced the LDI image. After flap elevation, total flap perfusion remained stable, while the distal area (area 8, n = 7) of the flap showed a statistically significant decrease in perfusion (71 +/- 5.9 vs. 92 +/- 9.5 percent perfusion units--PU; p < .05). The proximal areas (1 to 3, n = 7) of the flap had a higher perfusion at 60 min after flap surgery, compared with sham-operated (n = 8) animals (118 +/- 12.5 vs. 97 +/- 10.4 percent PU; p < .05). The running-suture technique was followed by decreased perfusion on the peripheral side of the flap, compared with the single-suture technique (73.7 +/- 9.2 vs. 99.2 +/- 4.9 percent PU; n = 2). The LDI was able to visualize venous and/or arterial occlusion after flap surgery. Under standardized circumstances (light, temperature), the LDI was efficient in measuring regional flap circulation experimentally. While total flap perfusion after flap surgery remained stable, perfusion in the distal flap decreased significantly.

Animals↗
PubMed2001

The dermis-prelaminated scapula flap for reconstructions of the hard palate and the alveolar ridge: a clinical and histologic evaluation.

Ideal reconstructions of complex defects in the midface require the restitution not only of bone and soft tissue, but also of a thin and durable lining of the oral cavity. So far, split-thickness skin grafts, intestinal grafts, and in vitro cultured mucosal grafts have been used for the reconstruction of the oral lining. The use of skin as a substitute for oral mucosa is controversial because contraction, hair growth, maceration, and dysplastic changes can occur. This clinical and histologic study was performed to evaluate the suitability of dermis as a substitute for oral lining. Twelve complex defects of the midface were reconstructed with dermis-prelaminated scapula flaps. A bony flap from the lateral border of the scapula was prepared, and osseointegrated implants were placed. The bone flap was then prelaminated with dermis and covered with a Gore-Tex membrane to prevent adhesions. The composite flap was transferred to the midface 2 to 3 months later. The oral lining of the flap was evaluated clinically and histologically at 2, 4, and 6 weeks and at 3 to 41 months after the reconstruction. In all patients, the reconstructed bone was covered with a thin and lubricated surface without hair growth. None of the patients showed any signs of maceration. Histologically, these findings corresponded to a keratinized stratified squamous epithelium with highly developed connective-tissue papillae. These features closely resemble those of the normal mucosa of the hard palate and the gingiva. Thus, dermis prelamination is an effective method for reconstructing the mucosa of the alveolar ridge and the hard palate.

Adolescent↗
PubMed2001

The prefabricated scapula flap consists of syngeneic bone, connective tissue, and a self-assembled epithelial coating.

The reconstruction of maxillary defects is a challenge in plastic surgery. The so-called prefabricated scapula flap consists of syngeneic bone covered with syngeneic dermis and is used to reconstruct maxillary defects. After placing these flaps into the oral cavity, they are reepithelialized within a short time period, raising the question of the cellular origin of the "neomucosa." We therefore obtained sequential biopsy samples of the prefabricated flap and of the flap after being placed into the oral cavity and analyzed the keratin expression profile of epithelial cells. We expected that after placing the prefabricated flap into the oral cavity, keratinocytes from adnexal structures of the dermal component of the graft would migrate onto the surface and reepithelialize the flap. Unexpectedly, reepithelialization occurred earlier. The flap had acquired a mucosa-like epithelium at the interface between the Gore-Tex coating and the dermis while still being positioned within the scapular region. The keratin expression profile of this epithelium was very similar to that of mucosal epithelium. Thus, the prefabricated scapula flap not only consisted of bone covered with connective tissue, but was also covered with epithelial cells derived from adnexal structures of the dermal graft. This seems to be the reason for the rapid restoration of an intact mucosa and the excellent outcome achieved with this surgical technique.

Adult↗
PubMed2000

[A comparison of long-term outcome of 6 techniques of breast reduction].

In a retrospective study we examined 192 patients who underwent breast reduction between 1973 and 1993 to compare the long-term results of six various reduction mammaplasty techniques. We investigated patient's satisfaction, the relief of preoperative symptoms as well as the possibility of lactation. The sensitivity of the areola was measured with Semmes-Weinstein monofilaments and the breast contour, the scar formation, and the complication rate were evaluated. 89% of our patients were very satisfied with the cosmetic result. Breast-feeding was possible after all techniques except for free-nipple grafting. The sensitivity of the areola was found to be more decreased after using a superior pedicle technique. Breast ptosis was obtained in 30% of our patients and correlated significantly with postoperative weight loss. Breast ptosis was less frequent after using an inferior pedicle technique. Length and width of the scar, as well as the complication rate correlated with the resection weight.

Adolescent↗
PubMed2000

[Soft tissue tumors with difficult to distinguish boundaries. From myxoma to myxofibrosarcoma: a case report].

Myxofibrosarcoma is a slow-growing subcutaneous tumor found in the older patient. Because of its deceptive macroscopic and histologic appearance, it is often misinterpreted as a benign lesion. We report a case of this tumor in a young woman recurring five times before the final diagnosis was made. Since recurrence may lead to tumor progression and increases the risk of metastasis, accurate diagnosis and radical removal of the lesion are extremely important. Eight benign and malignant myxoid tumors that have to be considered as differential diagnosis are reviewed.

Adult↗
PubMed2000

The sensitivity of the nipple-areola complex: an anatomic study.

Although preservation of the sensitivity of the nipple and areola is an important goal in breast surgery, only scant and contradictory information about the course and distribution of the supplying nerves is found in the literature. The existing controversy might be due to the difficulty in dissecting the thin nerves and to frequent anatomic variations that bias the results if only a small number of cadavers are dissected. We dissected 28 female cadavers and found that the nipple and areola were always innervated by the lateral and anterior cutaneous branches of the 3rd, 4th, and 5th intercostal nerves. The most constant innervation pattern was by the 4th lateral cutaneous branch (79 percent) and by the 3rd and 4th anterior cutaneous branches (57 percent). The anterior cutaneous branches took a superficial course within the subcutaneous tissue and terminated at the medial areolar border in all dissected breasts. The lateral cutaneous branches took a deep course within the pectoral fascia and reached the nipple from its posterior surface in 93 percent of the dissected breasts. In 7 percent of the dissected breasts, the lateral cutaneous branches took a superficial course within the subcutaneous fat and reached the nipple from the lateral side. These findings suggest that the nerves innervating the nipple and areola are best protected if resections at the base of the breast and skin incisions at the medial areolar border are avoided.

Female↗
PubMed2000

In-plane coronary arterial motion velocity: measurement with electron-beam CT.

PURPOSE: To determine the speed of and changes in the speed of coronary arterial movement during the cardiac cycle with electron-beam computed tomography (CT). MATERIALS AND METHODS: With electron-beam CT, 20 consecutive cross-sectional images were acquired at the mid right coronary artery (with 50-msec acquisition time, 8-msec intersection delay, 7-mm section thickness, and intravenous administration of 40 mL of contrast agent) in 25 patients. On the basis of the displacement of the left anterior descending, left circumflex, and right coronary arterial cross sections from image to image, movement velocity in the transverse imaging plane was calculated and was correlated with the simultaneously recorded electrocardiogram. RESULTS: The velocity of in-plane coronary arterial motion varied considerably during the cardiac cycle. Peaks were caused by ventricular systole and diastole and by atrial contraction. The mean velocity was 46.6 mm/sec +/- 12. 5 (SD). The mean velocity of right coronary arterial movement (69.5 mm/sec +/- 22.5) was significantly faster than that of the left anterior descending (22.4 mm/sec +/- 4.1) or the left circumflex coronary artery (48.4 mm/sec +/- 15.0). The lowest mean velocity (27. 9 mm/sec) was at 48% of the cardiac cycle. CONCLUSION: The lowest velocity of coronary arterial movement, which displays considerable temporal variation, was at 48% of the cardiac cycle.

Aged↗
PubMed1999

External oblique abdominal muscle: a new look on its blood supply and innervation.

Numerous reports have discussed the use of the external oblique abdominal muscle as a pedicled or a free flap for defect coverage. A detailed description of the supplying vessels and nerves is a prerequisite for successful tissue transfer but so far is not available in the literature. A study of the arteries and nerves supplying the external oblique abdominal muscle was carried out in 42 cadavers after injection of a mixture of latex and bariumsulfate. In seven fresh cadavers the motor branches were identified with the Karnovsky technique. Three different groups of arteries were identified as the nurturing vessels. The cranial part of the muscle is supplied by two branches of the intercostal arteries. While the lateral branches run on the outer surface of the muscle together with the nerves, the anterior branches enter the muscle from its inner surface. The caudal part of the muscle derives its main blood supply from one or two branches of the deep circumflex iliac artery (94.7%) or the iliolumbar artery (5.3%). The external oblique abdominal muscle is innervated by motor branches of the lateral cutaneous branches of the anterior spinal nerves in a segmental pattern. With the exception of the subcostal nerve the motor branches enter the outer surface of the muscle digitation arising from the rib above. The results show that the cranial half of the external oblique abdominal muscle has a strictly segmental blood and nerve supply while the caudal half of the muscle derives its main blood supply from one artery but still shows a segmental innervation.

Abdominal Muscles↗
PubMed1998

Revascularized composite grafts with inserted implants for reconstructing the maxilla--improved flap design and flap prefabrication.

We present a new technique including prefabrication of a revascularized composite scapular flap that will fit a maxillary defect exactly. The method is based on careful preoperative planning using three-dimensional reconstructions of data obtained from computed tomograms and stereolithographic models. A pedicled scapular flap with a split skin graft envelope that has endosteal implants already inserted is prepared and covered by a polytetrafluoroethylene (PTFE, Goretex) membrane. After 3-4 months these prefabricated grafts are harvested, inserted into the maxillary defects, and reanastomosed to the facial vessels. Two to three weeks later, after mucosal healing, a prosthesis can be fitted on the endosteal implants. Histological evaluation of the flap shows vital bone reactions and attachment of the split skin graft.

Arteriovenous Shunt, Surgical↗
PubMed1998

The lumbrical muscle flap: anatomic study and clinical application.

This article describes the anatomy and clinical application of the lumbrical muscle flap. Anatomic and radiologic studies were performed in 20 fresh human cadaver hands injected with latex-lead-oxide solution. Only the 2 radial lumbrical muscles were found suitable for flap transposition. The vascular supply of the first and second lumbrical muscles is from branches originating in the superficial palmar arch and from the common palmar digital artery, respectively. The dominant branches invariably enter the muscle bellies at the junction of their proximal and middle thirds. Pedicled on these vessels, the lumbrical muscles can be transposed to reach the entire palm, up to the wrist flexion crease. The clinical use of the first and second lumbrical muscle flaps in 2 patients demonstrated the value of these flaps for coverage of the median nerve and its palmar branches.

Cadaver↗
PubMed1998

Sliding door technique for the repair of midline incisional hernias.

We describe a technique that enables the autologous repair of large midline incisional hernias by restoring the functional musculoaponeurotic support of the abdominal wall. Unlike other methods of hernia repair, the essential step of the sliding door technique is the complete release of the rectus abdominis muscles from the anterior and posterior layers of their sheaths. The released muscles are thus overlapped and sutured together without tension. Another step of the technique is the release of both rectus sheaths by incising the aponeuroses of the external oblique muscles. We report on the use of this technique in 10 patients with midline incisional hernias (mean size of the abdominal musculofascial defect 14 x 11 cm). The patients were examined 14 months to 5.5 years after hernia repair. Two postoperative complications occurred: one marginal skin necrosis and one subcutaneous seroma. Recurrences were not observed. Ultrasound examination showed that the rectus muscles maintained their overlapped position postoperatively. Clinical muscle testing indicated that the strength of the released rectus muscles provides functional support to the reconstructed anterior abdominal wall.

Abdominal Muscles↗
PubMed1998

Nerve and vessel supplying ligamentous suspension of the mammary gland.

Anatomical findings from 28 breast specimens of female corpses have shown a thin horizontal fibrous septum, originating from the pectoral fascia along the level of the fifth rib, heading toward the nipple. This fibrous septum lies in between a cranial and a caudal vascular network, and being mesentery-like, it is responsible for the supply of the nipple areola complex. The cranial vascular sheet is supplied by the thoracoacromial artery and a branch of the lateral thoracic artery, whereas the caudal sheet is supplied by perforating branches from anastomoses of intercostal arteries. The fibrous septum is also a guiding structure for the main supplying nerve of the nipple. At its borders the septum curves upward into a vertical medial and lateral ligament, which attach the breast to the sternum and the lateral edge of pectoralis minor. These ligaments also contain a regular nerve and vascular supply. In their total, the fibrous septum and its ligaments form a sling of dense connective tissue that acts as a brassiere-like suspensory system. These two structures, the fibrous sling and the vascular and nervous membranes attached to it, are consistent anatomical findings, which have not been described before. Their knowledge could be of value and relevance in clinical application.

Aged↗
PubMed1998

[Interdisciplinary status of plastic, esthetic and reconstructive surgery in Austria].

To evaluate the actual status of interdisciplinary treatment involving plastic surgery in Austria in 1993 and 1994, standardised questionnaires were sent to all Departments of Plastic Surgery and to 129--mainly surgically orientated--medical departments in Vienna. The survey revealed that more than 50 percent of interdisciplinary co-operation took place with the departments of traumatology, general surgery and dermatology. The demand for co-operation with plastic surgeons was especially felt in tumor surgery, peripheral nerve surgery and hand surgery. An additional demand for co-operation represented larger soft tissue defects and congenital anomalies.

Austria↗