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Biomedical subjects

T Menovsky

Publications and source records attributed to T Menovsky.

41 records · Page 3Linked to original sources
PubMed1995

Laser(-assisted) nerve repair. A review.

Over the last decade low power laser irradiation has been used to repair nerves by photothermal welding. Nineteen animal and clinical experimental studies of laser tissue welding of nerves are reviewed. Possible mechanisms of tissue welding are presented, together with the benefits, limitations, and possible future implications of several techniques used in laser nerve repair. The consensus of these studies is that nerve welding has some advantages over standard suture repair. These advantages include less neuroma- und scar formation and shorter repair time. The major disadvantage of laser nerve repair is the initial inferior tensile strength. In the future, use of dyes or proteins could enhance the welding process by reinforcing the union strength, thus may improve the results of this promising technique.

Animals↗
PubMed1994

[Reliability of registration of multi-trauma patients].

OBJECTIVE: Evaluation of the reliability of diagnostic codification by the Medical Codification Department (MCD) as a method of national hospital identification of multiple injury patients and description of epidemiology and mortality among the multiple injury group studied. DESIGN: Prospective/retrospective and descriptive. SETTING: Free University Hospital, Amsterdam. METHOD: The injuries of 207 severely injured patients presented at the Accident and Emergency department during the year 1992, were coded as an Injury Severity Score (ISS). Those having an ISS > or = 18 were reviewed on cause and outcome of the injury. The diagnose for codification (International Classification of Diseases-9 Clinical Modification) of the MCD, from which an Abbreviated Injury Score (AIS) and the ISS can be calculated, was evaluated. RESULTS: 24 out of the 207 severely injured patients were transferred to other hospitals after stabilisation because of lack of room. Of the remaining 183 patients 124 had an ISS > or = 18.44 (35%) patients died during their stay in hospital. 21 (48%) of them died within 2 hours. 28 (64%) multiple injury patients died during the first 24 hours after admission. Neurological damage was the main cause of death (59%), followed by exsanguination (30%). A traffic accident was the cause of the injuries in 61% and a fall or jump in 27%. The mean ISS of these patients was 29 and the maximum score was 66. Head and neck injuries were present in 80% of the patients. The codification of brain damage by the MCD resulted in several mistakes. Brain damage in multiple injury cases results in a high AIS. Since the ISS is calculated by multiplication of AIS values, small differences in AIS create considerable variations in ISS. CONCLUSION: Multiple injury patients need fast and adequate help because of the high mortality, especially in the first 24 hours. The diagnostic codification of the MCD was found not reliable enough to be used for a hospital identification and registration of multiple injury patients.

Abbreviated Injury Scale↗
PubMed1994

CO2 laser nerve welding: optimal laser parameters and the use of solders in vitro.

To improve the welding strength, an in vitro study was performed to investigate the bonding strength of CO2 laser nerve welding (LNW), with and without the use of human albumin solution, dried albumin solution, egg white, fibrinogen solution, fibrin glue, and red blood cells as a solder. Fifteen different combinations of laser power (50, 100, and 150 mW) and pulse duration (0.1 to 3 s) were used with a spot size of 320 microns. The results have been compared to suture, fibrin glue, and laser-assisted nerve repair (LANR). The strongest welds (associated with whitening and caramelization of tissue) were produced at 100 mW with pulses of 1.0 s and at 50 mW with pulses of 3 s. The use of a dried albumin solution as a solder at 100 mW with pulses of 1 s increased the bonding strength 9-fold as compared to LNW (bonding strength 21.0 +/- 8.6 g and 2.4 +/- 0.9 g, respectively). However, positioning the nerves between cottons soaked in saline for 20 minutes resulted in a decrease of the bonding strength (9.8 +/- 4.5 g). The use of a 20% albumin solution and egg white, both at 50 mW with pulses of 3 s, resulted in a bonding strength of, respectively, 5.7 +/- 2.1 g and 7.7 +/- 2.4 g. Other solders did not increase the bonding strength in comparison to LNW. The substantial increase in bonding strength for some solders suggests that it is worthwhile to investigate the dehiscence rate and nerve regeneration of solder enhanced LNW in an in vivo study.

Anastomosis, Surgical↗
PubMed1994

Light propagation in the brain depends on nerve fiber orientation.

In this study, the penetration of red laser light (632.8 nm) in fresh bovine brain was measured parallel, oblique, and perpendicular to the axis of white matter tracts. The measurements were performed in eight samples with an isotropic light source and detector and were obtained by advancing the detector tip toward the light source in the tissue. A statistically significant difference in the effective attenuation coefficient of the light (mueff) was found between the parallel and perpendicular directions, 0.47 +/- 0.06 mm -1 and 0.63 +/- 0.13 mm-1, respectively (P = 0.005). The measurements taken at an angle of 45 degrees in the same sample resulted in an intermediate mueff of 0.58 +/- 0.09 mm-1. These results suggest a preferential guidance of light along the axis of the white matter tracts of the brain.

Animals↗