Biomedical subjects

V L Young

Publications and source records attributed to V L Young.

At least 55 records · Page 3Linked to original sources

PubMed1993

Age-related differences in measures of upper extremity impairment.

BACKGROUND: Upper extremity cumulative trauma disorders (CTDs) are among the most prevalent and costly occupational injuries. These disorders include nerve compression syndromes, tenosynovitis, epicondylitis, tendinitis, and arthritis. These have been related in the past to repetitive use of the upper extremity. The expected increase in the age of the American work force and the assumption that older workers are more susceptible to the disorders prompted this investigation of the relationship of age to signs and symptoms of upper extremity impairment. METHODS: A battery measuring seven objective signs and four reported symptoms of upper extremity cumulative trauma disorders was administered to two stratified random samples of workers. One group (n = 157) processed cooked poultry and the second group (n = 118) performed data entry at VDT terminals. Workers were separated into three age groups (younger: 20-35 years, middle-aged: 36-50 years, and older: 51-71 years). RESULTS: A series of analyses of variance were computed to determine whether the older workers were more impaired. No significant age differences were found for sign, symptom, or total scores in either sample, and no significant Age x Gender interaction was present. Older workers were more impaired for vibratory sensation, cutaneous pressure, and motor latency. CONCLUSIONS: The results support the hiring of older workers for general tasks in the workplace without significant worry of increased susceptibility to CTDs.

Adolescent↗

PubMed1993

Quantitative three-dimensional assessment of face-lift with an optical facial surface scanner.

Three-dimensional computed tomographic scan images of facial deformities provide information that has been useful in planning and evaluating therapy. However, the benefits of computed tomographic imaging in cosmetic plastic surgery are often insufficient to justify exposing the patient to radiation. This report describes application of an optical, noncontact, three-dimensional surface digitizer with subsecond scanning time for 360-degree examination of the human head. The resultant three-dimensional surface data are suitable for computer graphics display and manipulation, and for noncontact skin surface measurement. The scanner provides accurate and complete coverage of complex facial surfaces. This system was applied to digitization of the human head in the planning and evaluation of facial plastic surgery. The results indicate that the resulting image is accurate enough to detect subtle dimensional changes resulting from surgery, including postoperative edema and surface changes due to face-lift. This type of scanning can assist in a number of tasks performed by plastic surgeons, including collecting anthropomorphic measurements, preoperative and postoperative assessment, volume monitoring, customizing of implants, and interactive planning.

Algorithms↗

PubMed1993

The relative radiolucencies of breast implant filler materials.

Breast implants in current use utilize silicone gel for filler material. One substantial drawback of silicone gel is its radiodensity, resulting in the obscuration of breast tissue on mammography. The relative radiolucencies of silicone gel, saline, breast tissue equivalent, triglycerides (peanut oil), and polyvinylpyrrolidone (Bio-Oncotic gel) were determined by using standard mammographic equipment. Visibility through these materials was compared by using a standard breast phantom as background. The x-ray dosage necessary to create each mammographic image was measured. Peanut oil provided the clearest image of the phantom artifacts, required the least radiation exposure, and was approximately four times more radiolucent than the saline or Bio-Oncotic gel and about 45 times more radiolucent than silicone gel. As improved implant filler materials are being sought, triglycerides maintain superior radiographic properties.

Air↗

PubMed1993

Hand infections.

The hand is a commonly injured part of the body that frequently becomes infected. Improperly treated hand infections can lead to severe disability including stiffness, contracture, and amputation. This article describes the current concepts of diagnosis and treatment of common hand infections.

Anti-Bacterial Agents↗

PubMed1993

Giant lipomas of the hand and forearm.

Giant lipomas of the upper extremity are infrequently reported. They can alter function by restricting motion or producing compressive neuropathies. This report of four cases of giant lipoma in the hand and forearm illustrates these functional losses. The role of MRI and CT in preoperative evaluation of these lesions is discussed and a report of an anterior interosseous syndrome caused by a giant lipoma is presented.

Adult↗

PubMed1993

How safe are silicone breast implants?

The Food and Drug Administration's recent decision to limit the use of silicone gel breast implants was surrounded by a great deal of misleading information in the popular press. This article outlines the most relevant information available in the literature on the most often raised safety issues, including the carcinogenicity of silicone, speculation on a possible connection between silicone and autoimmune disease, the significance of gel bleed, and the effect of implants on mammography. In this attempt to better educate primary care physicians, we explain what is known about silicone gel breast implants so physicians can more wisely counsel their patients, who may be needlessly frightened by inaccuracies they have heard.

Female↗

PubMed1993

Indications for prophylactic mastectomy.

This article reviews the current state of knowledge regarding factors which put women at highest risk for developing breast cancer and identifies that population we consider as potential candidates for prophylactic mastectomy. Specifically, we focus on the concept of cumulative predisposition and the relative risk assigned to more significant factors that increase a woman's chances of developing breast cancer: family history, proliferative breast histology, and previous cancer in one breast. In addition to outlining the results of reconstruction, the article also examines the controversy surrounding the issue of whether any mastectomy can be truly prophylactic. We conclude with advice to physicians who must counsel women concerned about their breast cancer risk so they can help their patients make fully informed choices.

Adolescent↗

PubMed1992

Decreased wound contraction with fibrin glue--treated skin grafts.

Skin grafts can be used effectively to inhibit wound contraction. A critical element of this inhibition is the adherence of the graft to the wound bed. Fibrin glue has been shown to increase the adherence of skin grafts to wound beds. We therefore devised an experiment to determine the effect of fibrin glue on skin graft inhibition of wound contraction. Two 2.5 x 2.5-cm full-thickness defects were created on the dorsa of 15 Sprague-Dawley rats. Thirty partial-thickness grafts were harvested from isogeneric donor animals using a brown dermatome. Prior to grafting, one full-thickness defect, each animal received 0.2 mL of fibrin glue (Immuno AG, Vienna, Austria). The adjacent wound served as the control and received 0.2 mL of normal saline. Grafts were applied, sutured, and protected with an occlusive dressing. The size of graft sites treated with fibrin glue or normal saline was determined at the time of graft application and thereafter at 3-day intervals for 21 days using standardized photographic techniques. The percentage of change from initial wound size at each point was recorded for each group. Graft sites treated with fibrin glue contracted less than the controls from the ninth postgraft day to the completion of the study. The mechanism by which fibrin glue inhibits wound contraction may be related to increased adherence of grafts to the underlying wound bed. As an adjunct in skin grafting, fibrin glue may offer certain advantages that are not achieved by suturing alone.

Animals↗

PubMed1992

Upper extremity impairment in workers performing repetitive tasks.

A series of subjective and objective measures were chosen to determine impairment of upper extremity function in 157 workers performing repetitive tasks. Workers were asked to respond to questions regarding their perception of the presence or absence of numbness, pain, weakness, or swelling in their upper extremities. Objective tests consisted of the measurement of grip strength, pinch strength, Semmes-Weinstein monofilament sensory responses, vibrometer responses, neurometer measurement, and the presence or absence of Tinel's or Phalen's signs. These measures were considered collectively to estimate the overall levels of impairment of each individual. Overall findings show that 55 percent of workers examined had impairment scores of 2 or more and 75 percent had scores of 1 or more. Significant differences were found in impairment ratings between job types. Those jobs requiring the highest repetition with the least rest per cycle had the highest impairment ratings. Workers that rotated jobs had impairment scores significantly less (p less than 0.005) than the average of workers performing single-task jobs. We conclude that cumulative trauma disorders are more prevalent than originally believed and that the disorder is best examined from an overall functional impairment perspective.

Adult↗

PubMed1992

Grip strength before and after carpal tunnel decompression.

We prospectively studied preoperative and postoperative grip and pinch strength in 21 patients having 30 consecutive median nerve decompressions for carpal tunnel syndrome. All procedures were done by one surgeon. Each hand operated on served as its own control and was studied by the same therapist preoperatively and at monthly intervals for 6 months after the procedure. An initial decline in both grip and pinch strength was noted in most hands during the first postoperative month. Eighty percent or more grip strength was regained in 65% of the hands at 2 months and in 81% at 3 or more months. In those hands (65%) that regained at least 100% of their preoperative grip strength at 3 or more months, there was an average increase in maximal grip of 56%, as compared with an average decrease of 20% in the remaining hands (35%).

Adult↗

PubMed1992

Screening mammography in 350 women with breast implants: prevalence and findings of implant complications.

OBJECTIVE: A series of screening mammograms in asymptomatic women with breast implants was reviewed to determine the prevalence of clinically silent sequelae of breast augmentation and to analyze the mammographic findings. MATERIALS AND METHODS: The screening mammograms of 350 consecutive women with implants were reviewed retrospectively by experienced mammographers. Any women who reported problems had a diagnostic examination and therefore were not included in our sample. Mammographic features of sequelae specific to implantation such as development of a fibrous capsule, periprosthetic calcification, implant herniation, and silicone leaks were tabulated. Additionally, modified compression (push-back) views, when obtained, were evaluated for their usefulness. RESULTS: Fibrous encapsulation of breast implants was seen in 257 (73%) of 350 women. Periprosthetic calcification was seen in 90 (26%), and 60 women (17%) had implant herniations. Sixteen women (5%) had implant failure as evidenced by silicone leak. Two of these women had bilateral implant failures. Surgical confirmation was attainable in only five of 16 women. Analysis of modified compression views demonstrated an overall improvement in visualization of breast tissue with this technique. Although the sample size is small, there was a significant increase in the amount of breast tissue seen with push-back views in women with submuscular implants. CONCLUSION: Our analysis revealed a wide range of mammographic findings in this group of asymptomatic women with breast augmentation. Especially worrisome is the 5% prevalence of unsuspected silicone extravasation. Additionally, we have demonstrated the usefulness of push-back views in this screening group, especially in women with submuscular implants.

Breast Diseases↗

PubMed1992

Breast reconstruction in women treated with radiation therapy for breast cancer: cosmesis, complications, and tumor control.

The records of 55 patients who had breast cancer treated by mastectomy, irradiation, and breast reconstruction were reviewed for cosmetic outcome, complications, and tumor control. Median follow-up was 35 months. Local control rates were 95 percent in patients treated for high risk factors or breast conservation and 85 percent in patients treated for recurrent breast cancer. Acceptable cosmetic results were obtained in only 42 percent of patients. The incidence of complications was 55 percent. Transverse rectus abdominis muscle (TRAM) reconstructions gave superior cosmetic results compared with all other types of reconstructions. The timing of reconstruction in relation to mastectomy or radiation therapy did not significantly influence cosmetic outcome, although other factors suggest that delayed reconstruction may give better results. A majority of patients were satisfied with cosmetic outcome.

Abdominal Muscles↗

PubMed1992

Advances in total phalloplasty and urethroplasty with microvascular free flaps.

This article focuses on the lateral arm free flap as the option that comes closest to meeting the diverse aesthetic and functional goals of phalloplasty. The authors introduce a new technique for incorporating a prefabricated neourethra within the lateral arm to permit the coexistence of an erectile prosthesis alongside a fully vascularized urethra that extends to the distal tip. The unrecognized value of the radial forearm free flap for urethroplasty is also discussed and a case of reconstruction following urethral loss is presented. Also described is how the prefabricated urethra technique may be useful for repairing severe hypospadias defects.

Humans↗

PubMed1992

Diagnosis and management of ulnar nerve entrapment.

Ulnar nerve entrapment can be divided into compression at the elbow and the wrist. Etiologies range from direct trauma to metabolic derangements. Guidelines for diagnosis at each site have been presented. Surgical release at the elbow begin at the mid arm where the nerve passes from the anterior to the posterior compartment through the intermuscular septum and extends into the proximal forearm, where it dives down under the heads of the flexor carpi ulnaris. Surgical release at the wrist involves deroofing the canal of Guyon. The authors' preferred methods of release at each site are given along with a description of positive care.

Elbow↗

PubMed1992

Long-term effect of retrobulbar hematomas on the vision of cynomolgus monkeys.

Using the monkey model previously developed, we investigated the long-term effects of retrobulbar hematoma-induced retinal ischemia on functional vision and retinal histology. In this experimental model, ischemic periods of up to 120 minutes did not cause permanent visual deficits, as measured by flashed evoked visual potentials. Similarly, retinal histology showed no evidence of ischemic injury. From this we conclude that blindness after blepharoplasty is not due to retrobulbar hematomas alone and that additional predisposing factors are involved. The most likely additional factor is preexisting occult vascular ocular pathology.

Animals↗

PubMed1991

Biocompatibility of radiolucent breast implants.

Current implants for breast augmentation containing silicone gel, saline, or both are radiopaque on mammographic examination and can totally obscure microcalcifications and soft-tissue masses. The effect of these implants on the detection of early breast cancers in patients who have undergone augmentation mammaplasty remains unproven and controversial. Implants filled with medium-chain triglycerides (peanut oil) are radiolucent on mammographic examination and allow visualization of both soft-tissue masses and microcalcifications. To investigate the biocompatibility of radiolucent implants, 10 cc of sterile, nonpyrogenic peanut oil was injected subcutaneously into rats using silicone gel as a control. Twenty-one rabbits had two 125-cc silicone shell implants inserted on either side of the chest wall. The right-sided shell was filled with 125 cc of sterile saline, and the left-sided shell was filled with 125 cc of sterile, nonpyrogenic peanut oil. Results were determined by both histologic and radiographic examination. Rats injected with peanut oil equivalent to 7 percent of their body weight rapidly absorbed the freely injected oil without detriment. Histologic examination of the lungs, liver, kidneys, and tissues adjacent to the injection sites demonstrated no abnormalities. There was no evidence of allergic, toxic, inflammatory, or neoplastic response. Eighteen of 21 rabbits survived more than 3 months. Radiographs showed the oil-filled implants to be radiolucent, whereas the saline-filled controls obscured the surrounding soft and bony tissues. Histologic examination demonstrated a fibrous capsule surrounding both types of implants. Histologic examination of the lungs, liver, and kidneys showed no significant abnormalities. These and previous studies have shown peanut oil to be biocompatible when freely injected either intramuscularly or subcutaneously. This study demonstrates that a radiolucent, peanut oil-filled implant is biocompatible in animals and that further long-term studies for its use in humans are merited.

Animals↗

PubMed1991

Dupuytren's contracture.

Dupuytren's contracture is a disease of the palmar and digital fascia that results in a flexion deformity of the fingers. Although the first case was reported more than 350 years ago, many questions remain unanswered. With our present state of knowledge, treatment remains empiric and operative intervention is the only successful mode of treatment. Controversies continue over the type of procedure used, as well as its timing. In light of the high rate of recurrence of flexion contractures after apparently successful operations, current research is being directed toward identifying a biochemical or histologic marker to indicate the probability of recurrence.

Dupuytren Contracture↗

PubMed1991

Gynecomastia.

Gynecomastia is a serious cosmetic concern for many adolescent and adult males. In the majority of cases no pathologic cause for the problem can be found. The authors discuss the types of surgical treatment of gynecomastia.

Breast↗