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Biomedical subjects

V Mitz

Publications and source records attributed to V Mitz.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Ultrastructure of human normal and pathological reassembled collagen fibers].

It is possible, in vitro, to break down human skin then reassemble the collagen fibres of the dermis, essentially type I collagen. The authors have developed a biophysical process for the manufacture of type I autocollagen. They present the electron microscopic study of this collagen. These healthy collagen fibres are compared with the fibres obtained from radiation dermatitis skin and keloid scars. Major ultrastructural differences are demonstrated.

Cicatrix↗
PubMed1990

[Objective evaluation of the results of interventions for breast hypertrophy].

It would appear to be impossible to compare completely different techniques of mammaplasty performed in very different clinical situations. However, we thought it would be useful to approach the result of mammaplasties from a more "orthopaedic" point of view. Such an approach distinguishes populations of patients with different results and in whom the postoperative assessment must take into account the result obtained, the residual scars and the final breast shape. A formula has been developed after multiple attempts: [formula: see text] This formula expresses positive factors: the quantity of glandular tissue removed (in grams), the final appearance of the scars, the appearance of the overall shape of the two reconstructed breasts and the reappearance of ptosis measured from the edges of the breast below the inframammary sulcus (in the erect position). In this way, it is possible to express these positive factors by the multiplying the scores attributed to each of the factors. For example, a resection of 150 g will be scored as 1.5 and a resection of 1,200 g will be scored as 12, i.e. the weight in grams is simply divided by 100 to give the score for weight. The scar will be scored according to an individual scale of 1 to 5. The shape will also be scored according to an individual scale of 1 to 5. The division factors include the length of the inframammary scar (segment 3); this inframammary vertical line will be included directly in the calculation. In contrast, the length of the horizontal inframammary scar will be divided by 10.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Replantations and devascularization. VBS (Vessel-Bone-Skin) emergencies].

The reimplanting activity initiated by Professor Raymond Vilain at Boucicaut Hospital in 1972 allowed emphasizing that, in addition to the reimplantation of a completely severed segment, there existed a parallel activity including microsurgical steps, bone surgery and skin plasties, all of which were gathered under the term of VBS, or Vessels-Bone-Skin, emergencies. Other terms are used (stage 3 fracture with vascular involvement, stage 4 fracture) for the same ultra-emergent pathology, in which many diagnostic problems as to the significance and extent of ischemia are associated with therapeutic issues. The results of an operation performed by one surgeon possessing all the desirable skills and working in a specialist Center allowed demonstrating that the quality of the results was such as could be hoped for: an overall survival rate of about 60%, little second surgery, blood consumption lower than 10 bottles per patient in average. These data represent the major progress made in 15 years. However, the rescuing staff must still be made aware of the importance of diagnosing devascularization in a context of multiple injuries: a VBS emergency involves limbs in which bony continuity, and sometimes even a skin bridge, may still be preserved. The vascular problems cannot be solved without resorting to the microanastomosed flap techniques. Lastly, the staff in charge of this kind of problems must treat upper limbs as well as lower limbs. Utmost surgical strictness is essential to avoid the major complication of such surgery: not only local failure threatening the functional results, but also the vital risks inherent in the reimplantation of a large limb segment. Reimplantation of an autologous limb has largely demonstrated its superiority over prostheses, even the most sophisticated ones.

Arm↗
PubMed1990

[Isolated ulnar nerve lesions. Results and sequelae after treatment at a specialized unit: apropos of 40 cases].

77 patients with an isolated traumatic ulnar nerve lesion were operated on between 1972 and 1982. 40 patients with more than 18 months of follow-up were reviewed with a new clinical quoting. 37.5 p. cent of satisfactory results were achieved with nerve sutures done in emergency, 56.3 p. cent with secondary nerve grafting. Factors influencing the results were age, level of the lesion and use of the microscope. 80 p. cent of the patients recovered a protective sensibility, but only one third discrimination. Patients considered sensory deficit as little cumbersome. Wartenberg's sign was noticed in 60 p. cent of our patients and a claw hand in 46 p. cent. Power grip was only 70 p. cent of the contralateral hand due to poor interosseous muscle recovery. The main disability was an instable thumb metacarpophalangeal joint in 70 p. cent. Subterminal pinch grip was weak and was improved by the transfer of the flexor digitorum superficialis of the ring finger. Cold hypersensitivity was noticed in 73 p. cent of our patients, but its frequency diminished with sensory recovery. Motor deficiencies were the most important and required early tendon transfers in older patients.

Adolescent↗
PubMed1989

[Functional treatment of closed boutonnière deformity using a dorsal digito-palmar dynamic extension splint].

We advise dynamic extensor splintage put on as early as possible within the first 6 weeks after the diagnosis of boutonniere deformity. This splintage runs from the dorsal aspect of the hand to the DIP joint which is left free to flex actively. This apparatus is left on for at least six weeks post injury. Sixteen patients have been treated in this way. Seven of them were monitored carefully. Only one had a bad result with DIP flexion still preserved. The others averaged a mean extension loss of 23 degrees, and no loss of extension in DIP joints. Active flexion both in PIP and DIP was perfectly preserved. The functional treatment without surgery seems to be a good technique in management of fresh rupture of the extensor mechanism in PIP joints.

Equipment Design↗
PubMed1986

Current face lifting procedure: an attempt at evaluation.

There are many techniques currently available for face lifting. The individual choice should be made based upon solid knowledge of anatomy and physiology as well as upon knowledge of long-term results in operated patients. In the absence of scientific information regarding deterioration of skin and muscle tension after operation, the only valid basis for judgement is a combination of the surgeon's assessment and the patient's degree of satisfaction 10 years after the operation. The latter is often impossible to obtain. The recently proposed deep undermining of the superficial musculoaponeurotic system (SMAS) seems both excessive and potentially dangerous. An evaluation of 30 consecutive patients would seem to indicate that a segmental approach, along with tightening of the platysmal and genioparotid layers of the SMAS, gives good immediate results and may be responsible for longer-lasting results.

Evaluation Studies as Topic↗
PubMed1986

The fasciocutaneous flap as an alternative solution in difficult reconstructive problems.

Fasciocutaneous flaps are available anywhere in the body, literally from head to foot. Some hair-bearing flaps, the parasternal flap, and some forearm and lower extremity flaps may be useful for coverage of soft tissue defects when a relatively simple one-stage procedure is preferred. The fasciocutaneous flaps described here are long and narrow, with a length to width ratio of up to 5:1. Although these flaps are not the ultimate solution to all reconstructive problems, they are especially useful in the treatment of burn scar contractures and chronic ulcerations such as those that result from the extravasation caused by chemotherapeutic agents. Of particular importance is the fact that the use of these flaps does not preclude the use of other flaps later, should this be necessary. Specific indications for these flaps must always be kept in mind in relation to other reconstructive alternatives.

Adolescent↗
PubMed1986

Risk and consequence of infection at the site of microsurgical repair: an experimental model.

The consequences of postoperative infection at the site of microsurgical repair were studied. The experiment used 60 Wistar rats which were divided into 3 groups of 20 each. The femoral artery, vein, and nerve were transected unilaterally and repaired using microsurgical techniques. Staphylococcus aureus was then inoculated into the wound of group 1. Beta-hemolytic Streptococcus was inoculated into the wound of group 2. Group 3 rats served as controls. Clinical, anatomical, bacteriological and histopathological examinations were performed on postoperative days 8 and 30. Wounds in which S. aureus was inoculated demonstrated a significant tendency toward vascular thrombosis with extensive tissue destruction. In the majority of these cases, the necrosis caused by the primary infection engendered an associated, opportunistic infection. Streptococcal inoculations in group 2 demonstrated less severe changes than in group 1. These changes were characterized by injury of the vascular structures themselves with a significant tendency for thickening of the arterial wall, perivascular inflammation, and hematoma formation at the site of the repair. This model allows demonstration of the enzymatic and toxic consequences of bacterial infection in a postoperative site characterized by cellular destruction and interstitial edema surrounding foreign bodies represented by sutures.

Animals↗
PubMed1986

Second toe to thumb transfer with extensor digitorum brevis opponensplasty.

A second toe to hand transfer is described for thumb reconstruction which includes the extensor digitorum brevis as a simultaneous opponensplasty. This procedure was effective in a young man injured in a bomb explosion that completely destroyed the first ray. The second toe was dissected in continuity with the extensor digitorum brevis muscle, its nerve was anastomosed to the motor branch of the median nerve. Thus a one-stage operation allowed a complete reconstruction of the first ray proximally to the trapezium. Recovery at 2 years is good, and the muscle transfer can be demonstrated to work.

Adolescent↗