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Biomedical subjects

J-P A Nicolai

Publications and source records attributed to J-P A Nicolai.

9 recordsLinked to original sources
PubMed2006

Architecture of European plastic surgery.

The architecture of European Plastic Surgery was published in 1996 [Nicolai JPA, Scuderi N. Plastic surgical Europe in an organogram. Eur J Plast Surg 1996; 19: 253-256.] It is the objective of this paper to update information of that article. Continuing medical education (CME), science, training, examination, quality assurance and relations with the European Commission and Parliament all are aspects covered by the organisations to be discussed.

Education, Medical, Continuing↗
PubMed2006

Functional dominance of finger flexion over extension, expressed in left parietal activation.

Sensory stimuli may elicit a widely distributed parietal-premotor circuitry underlying task-related movements such as grasping. These stimuli include the visual presentation of an object to be grasped, as well as the observation of grasping performed by others. In this study, we used functional Magnetic Resonance Imaging (fMRI) to test whether the performance of simple finger flexion, contrasted to extension, might similarly activate higher-order circuitry associated with grasping. Statistical Parametric Mapping (SPM) showed that flexion, compared to extension, was related with significant activation of the left posterior parietal cortex and posterior insula, bilaterally. This pattern supported our hypothesis that simple finger flexion has a specific relation with circuitry involved in preparing manual tasks. Although the two motor conditions showed major overlap in the primary motor cortex, increased flexion-related activation at the precentral motor-premotor junction further supported its association with higher-order motor control.

Adult↗
PubMed2005

[Hyperextension trauma of the finger].

In 2 patients, a man aged 30 and a woman aged 31, a hyperextension trauma of the proximal interphalangeal joint of the right index finger and the left middle finger respectively was diagnosed. The man underwent surgery for volar plate rupture in the acute phase. The woman presented 7 weeks after the trauma with a chronic flexion contracture; she had an avulsion fracture of the second phalanx and was treated conservatively with splints and exercise therapy. The hyperextension trauma of the proximal interphalangeal joint of a finger is one of the most frequently occurring hand traumas. In the more severe cases, there can be substantial damage to the structures ofthe joint capsule, such as a volar plate rupture. In the acute phase, a ruptured volar plate results in pain and dorsal dislocation. In the long term however, two significant late complications can arise: the chronic post-traumatic hyperextension deformity and the flexion contracture. These complications are difficult to treat, but can be prevented by adequate initial treatment. The diagnosis of volar plate rupture is essential to this and can be formulated after a carefully conducted history taking and physical examination usually with simple radiological studies ofthe affected digit. Treatment of a volar plate rupture can be either conservative or surgical and is directed at regaining finger function and preventing complications. For the treatment to be successful, intensive physiotherapy during follow-up is essential.

Adult↗
PubMed2004

[Interplast in India. Review of 14 years].

Interplast teams conducted two-week (or less) camps in India over a 14 year period. The majority of the teams were mixed and consisted of German and Dutch plastic surgeons and nurses. In five different villages and cities, 1015 patients were operated: 41% concerned cleft lip and palate and 32% post-burn contractures. The work is rewarding and is considered by some the best holiday imaginable. The teams intend to continue their project in the future.

Attitude of Health Personnel↗
PubMed2004

Breast cancer and the role of breast size as a contributory factor.

Several studies have been published on the incidence of breast cancer following augmentation mammaplasty, with very different conclusions. A lower incidence of breast cancer than expected was found in a study conducted by Deapen and Brody in women who had undergone augmentation surgery, and an anticarcinogenic effect of silicone implants has been suggested. Before accepting this conclusion it is important to study the relationship between breast size and the risk of developing breast cancer. It can be assumed that on average, women who have their breasts enlarged have smaller breasts, originally, than other women. Therefore, it seemed possible that breast size might be the predominant factor, and not the silicone implant. To test the hypothesis that women with breast cancer have statistically larger breasts than women who are not found to have breast cancer, a questionnaire was sent to each of 232 women who had undergone surgery for breast cancer; 146 of these questionnaires were returned. Body mass index (BMI) and breast size were compared against the corresponding values in a population-based control group. The results showed no statistical difference between the two groups in BMI or breast size. These findings seem to support the hypothesis that silicone breast implants have some kind of anticarcinogenic effect.

Adolescent↗
PubMed2004

A hyaluronan-based nerve guide: in vitro cytotoxicity, subcutaneous tissue reactions, and degradation in the rat.

We investigated possible cytotoxic effects, biocompatibility, and degradation of a hyaluronan-based conduit for peripheral nerve repair. We subjected the conduits to an in vitro fibroblast cytotoxicity test and concluded that the conduits were not cytotoxic. Subsequently, we implanted the conduits subcutaneously in rats, in order to investigate tissue reactions and biodegradation. Initially, a fibrin matrix was formed around the material, while the surroundings were relatively quiet. Macrophages (MØ) migrated to the conduits and formed giant cells next to the material after 5 days. The maximum presence of MØ was found after 3-6 weeks. The appearance of MHC class II cells showed a similar pattern. Highest numbers of giants reached a maximum after 6-12 weeks. Angiogenesis was started in the surroundings of the hyaluronan-based conduit within a few days. Massive ingrowth of blood vessels into the biomaterial was found after 6 weeks as well as cellular ingrowth into the lumen of the tube. At that time the tubular structure of the conduit was lost and loose biomaterial fibers were observed. The results show that a hyaluronan-based conduit is not cytotoxic and shows good biocompatibility. Such a conduit may be suitable as a guide in peripheral nerve repair.

Adjuvants, Immunologic↗
PubMed2003

Cerebral reorganisation of human hand movement following dynamic immobilisation.

Surgical treatment of a flexor tendon lesion of the hand is followed by a 6-week period of dynamic immobilisation. This is achieved by the elastic strings of a Kleinert splint, enabling only passive and no active flexor movements. After such immobilisation, the appearance of a temporary clumsy hand indicates decreased efficiency of cerebral motor control. Using PET we identified the recruitment of contralateral parietal and cingulate activations specifically related to the suboptimal character of these hand movements. After 6-8 weeks, normalised movement was related with contralateral putamen activation. Activations of the sensorimotor cortex and cerebellum were present during both scanning sessions. Changes in the pattern of cerebral activations reflect functional reorganisation. The shift from cortical to striatal involvement, observed in the group of four patients, generates the concept of unlearned movements being relearned.

Cerebellum↗
PubMed2003

The CE mark.

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Breast Implants↗