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Biomedical subjects

M Hochman

Publications and source records attributed to M Hochman.

12 recordsLinked to original sources
PubMed1992

Relative effects of intraoperative tissue expansion and undermining on wound closing tensions.

Intraoperative tissue expansion is advocated as a technique to facilitate closure of soft-tissue wounds with less tension than if they were closed primarily without expansion or, presumably, simple undermining. Few objective studies have been done, however, to validate the technique. We specifically questioned the relative effects of intraoperative tissue expansion and undermining on wound closing tensions in an animal model. Our data showed statistically significant reduction in the force required to close a wound after acute intraoperative tissue expansion when compared with baseline. However, when the degree of undermining achieved by the expander was matched in an equivalent defect, no difference in the resultant wound closing tensions could be discerned between techniques. This study should be viewed as an initial effort to understand the role of intraoperative tissue expansion in reconstructive surgery.

Animals↗
PubMed1991

Thyroidectomy under local anesthesia.

Thyroidectomy for benign and malignant disease is most commonly performed with the patient under general anesthesia, although the literature is sprinkled with reports of series of operations performed using local anesthetic techniques. A retrospective review of 43 sequential thyroidectomies compares 21 performed using local anesthesia with 22 performed using general anesthesia. No significant difference was demonstrated in the incidence of major complications. All patients who required a second operation to remove the remaining hemithyroid after the final pathology reports were reviewed elected local anesthesia for their second procedure, attesting to patient satisfaction. Some hemithyroidectomies performed using local anesthesia were outpatient procedures. The indications, guidelines for patient selection, and operative technique of this effective alternative approach to thyroid surgery are presented.

Ambulatory Surgical Procedures↗
PubMed1991

The effect of hypertonic saline resuscitation on bacterial translocation after hemorrhagic shock in rats.

Translocation of enteric bacteria occurs in rats after hemorrhagic shock. A proposed mechanism involves intestinal mucosal injury by hypoperfusion. Recent work suggests that moderate hypovolemia causes gut arteriolar constriction, which is ameliorated by hypertonic saline resuscitation. Bacterial translocation should, therefore, be reduced when hypertonic saline (HS) is used as the resuscitative fluid. Seventy-eight Sprague-Dawley rats were anesthetized and subjected to 30 minutes of hemorrhagic shock (systolic blood pressure 30 to 50 mm Hg) through a modified Wigger's model. Resuscitation was performed with either shed blood (B), 3% HS + 1/2B (1:1), or with 7.5% HS + 1/2B (1:1). Spleen, liver, and mesenteric lymph nodes were sent for quantitative culture 24 hours later. Translocation occurred if enteric organisms were cultured from at least one organ. Statistical analysis used the Fisher exact test. Compared to autotransfusion, hemodilutional resuscitation from hemorrhagic shock with hypertonic saline resulted in a significant reduction in bacterial translocation (p values were 0.03 and 0.04 for 3% and 7.5% hypertonic saline, respectively). The reduction in translocation after hypertonic saline resuscitation may be the consequence of microcirculatory alterations preventing gut hypoperfusion.

Animals↗
PubMed1990

Severity of obstructive sleep apnea.

A four-level severity scale for obstructive sleep apnea is offered using four criteria: maximum oxygen desaturation, apnea/hyponea index, symptoms of excessive day-time sleepiness, and symptoms of related cardiac disease. Oxygen desaturation and the apnea/hyponea index for 175 patients, all having had uvulopalatopharyngoplasty surgery, showed 19% mild, 33% moderate, 17% moderately severe, and 31% severe obstructive sleep apnea. There was a very poor correlation between oxygen desaturations and number of obstructive events, which demands that both be used in any estimation of disease severity.

Humans↗
PubMed1978

Incompetent cervix in a hormone-exposed offspring.

Intensive interest has focused on DES-exposed men and women since the first reports on this in the early 1970s. We are presenting here what we feel is the first case of incompetent cervix in a DES-exposed female. It is hoped that this will stimulate further interest in the functional as well as anatomic problems which these individuals experience.

Adolescent↗
PubMed1976

Midtrimester pregnancy termination with prostaglandin E2 vaginal suppositories.

One hundred midtrimester pregnancies were randomly selected for elective termination with 20 mg prostaglandin E2 vaginal suppositories. The abortion rate was 93%. There were 66% complete abortions, 27% incomplete abortions and 7% failures. Mean insertion abortion time was 17 hours, 26 minutes. Average dosage was 82 mg. There were no mortalities but a high percentage of side effects, all of which were well tolerated. Two patients were admitted to other hospitals unfamiliar with termination technics, transfused and subjected to dilatations and curettages. There were no long-term sequelae.

Abortifacient Agents↗
PubMedDate not supplied

Conradi-Hunerman syndrome. Case report.

Conradi-Hunerman syndrome, a variant of chondrodysplasia punctata, rarely presents with primary manifestations relevant to the head and neck surgeon. Usually, the disease is evidenced by malformation of the extremities, cataracts, cutaneous lesions, and an unusual facies. We have followed a child with Conradi-Hunerman syndrome for 7 years whose primary manifestation of the disease is respiratory compromise secondary to calcification of the laryngotracheobronchial tree. In addition, he has a conductive hearing loss thought to be secondary to ossicular chain fixation.

Bronchial Diseases↗