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At least 127 records · Page 7Linked to original sources
PubMed2005

Use of an artificial dermis (Integra) for the reconstruction of extensive burn scars in children. About 22 grafts.

We used an artificial dermis (Integra) for the reconstruction of extensive burn scars in children. Integra was initially developed for the primary coverage of acute burns, but several authors report good experiences with Integra for reconstructive surgery. We present a group of 10 children who underwent Integra grafting at 22 different operational sites. Five children received several grafts with Integra. On average, 260 cm(2) per session were grafted. We compared the surface of Integra on the day of grafting and then again on the evaluation day to measure the secondary retraction of the grafts. Complications (infection of Integra, failure of the epidermal graft) were observed in 5 cases. At the final evaluation, 20 grafts were visible. The surface of the Integra graft represented less than 50% of the initial surface in 7 cases, 51-75% in 5 cases and more than 76% in 8 cases. The disadvantages of Integra in reconstructive surgery are that two operative procedures are necessary and the recurrence of contraction seems to be more significant than with full thickness auto grafts. However, Integra has many advantages: the immediate availability of large quantities, the simplicity and reliability of the technique, the pliability and the cosmetic aspect of the resulting coverage. In light of these preliminary results, Integra appears to offer a new alternative for the reconstruction of extensive burn scars in children.

Biocompatible Materials↗
PubMed2004

Thoracodorsal artery perforator (TAP) flap reconstruction of a soft-tissue defect of the knee following below-knee amputation.

Soft-tissue coverage of lower extremity defects with thin, sensate, mobile, and durable soft tissue is challenging. Reconstructive options are further limited in the setting of a below-knee amputation. The authors present the first report of an innervated thoracodorsal artery perforator (TAP) flap for coverage of an anterior knee soft-tissue defect in a patient with bilateral below-knee amputations following disseminated meningococcemia. The soft-tissue defect measured 11 x 17 cm2 centered over the patella, and the TAP flap provided adequate pedicle length, with optimal soft-tissue thickness and pliability with the potential for innervation and minimal donor-site morbidity. Six months postoperatively, the patient is ambulating well with prostheses fitted over her well-healed, stable, knee coverage.

Adult↗
PubMed1984

Replacement of mitral valve chordae with autologous pericardium in dogs.

Glutaraldehyde-tanned autogenous pericardium was compared with untreated autogenous pericardium as a tissue for replacement of anterior chordae tendinae of the mitral valve. Tanned autogenous pericardial chordae have a marked fibrous reaction at their healing ends but retain central pliability. Untreated autogenous pericardial chordae become uniformly fibrosed and stiff. Both retain their length, heal well to the papillary muscle and cusp, and are considered as potentially useful chordal substitutes in the right circumstances. Some of the response of the host to implanted tanned xenograft tissue must be related to the consequences of tanning rather than a reaction to foreign tissue.

Animals↗
PubMed1986

[Gastrointestinal amyloidosis as a differential diagnostic problem].

The diagnostic radiologist may have problems with the differential diagnosis of gastrointestinal amyloidosis combined with only uncharacteristic clinical symptoms. In the stomach upper gastrointestinal series show in most cases stenosing submucosal masses in the gastric antrum with diminished peristalsis and pliability. Sonography reveals a circular thickening of the gastric antrum wall. Only a synopsis of radiologic changes, the patients's history, laboratory tests and biopsies render a clue to the correct diagnosis. In the small bowel segmental or total intestinal dilatation with sonographically demonstrable thickening of the bowel wall and diminished motility, prolonged transit and eventually obstruction or paralytic ileus can be demonstrated. In patients with simultaneous plasmocytoma the radiologist has to take a gastrointestinal involvement by concurrent amyloidosis into account.

Aged↗
PubMed1996

Other flaps for head and neck use: temporoparietal fascial free flap, lateral arm free flap, omental free flap.

Advances in microvascular surgery have led to the development of new donor sites for head and neck reconstruction. The superficial temporoparietal, lateral arm, and omental free flaps represent three flaps with primarily soft tissue uses. Their reliable blood supply and pliability make them well suited for a variety of head and neck defects. The superficial temporoparietal and lateral arm free flaps may be used as osteocutaneous flaps, but more rarely is this the case. Minimal donor site morbidity is an advantage with the superficial temporoparietal and lateral arm flaps. The morbidity of a laparotomy must be weighed against the advantage gained by employing the omental free flap in cases of soft tissue reconstruction.

Arm↗
PubMed2003

Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue.

OBJECTIVE: Numerous patients in Taiwan with tongue carcinoma require tongue reconstruction. We compared the abilities of 2 methods of tongue reconstruction to reserve tongue function. STUDY DESIGN AND SETTING: Sixty patients underwent resection of the tumors and reconstruction with a pectoralis major flap or a radial forearm flap. The Chinese articulation test was used to evaluate the place and manner of error production, and a questionnaire on dietary habits was used to evaluate deglutition 6 months to 10 years after reconstruction. RESULTS: Patients with the free flap had more intelligible speech. The questionnaire study showed no significant difference between the 2 groups in swallowing rating. Motility caused by flap pliability increased speech intelligibility more than it did on swallowing function. CONCLUSION: Our experience in a few selected patients shows that the functional outcome of tongue surgery is related to the reconstruction methods used (for speech) and to the extent of tongue resection (for swallowing).

Deglutition↗
PubMed2001

Comparison of measured astigmatic retinoscopies from different lid specula.

PURPOSE: We wanted to study the effects of different lid specula on retinoscopy readings in the pediatric population. METHODS: We prospectively enrolled 29 patients from the Eye Clinic at The Children's Hospital of Denver who were being examined under anesthesia and met the inclusion criteria for the study. Any patient with ocular pathology that could affect the pliability of the sclera of both eyes was excluded. Patients with preexisting lid abnormalities or adnexal masses were also excluded. Cycloplegic retinoscopies were performed under anesthesia with the Barraquer wire and the Lancaster solid-blade specula. The amounts and the axes of the astigmatism were tabulated and statistically analyzed with the paired t test. RESULTS: A statistically significant difference occurred in the retinoscopies obtained from the 2 lid specula. The Barraquer lid speculum seemed to induce the least amount of astigmatism (P =.0001). CONCLUSIONS: There was a statistically significant difference in the amount of astigmatism found with each lid speculum. The choice of lid speculum in performing retinoscopies on the pediatric population can influence the final refraction and may have implications for visual outcome.

Adolescent↗
PubMedDate not supplied

Sperm extracted and cryopreserved from testes several hours after death results in pregnancy following frozen embryo transfer: case report.

A 38-year-old male died suddenly on his honeymoon. Sperm was extracted from his testes 3 h following his death and cryopreserved. His wife had in vitro fertilization (IVF) and the eggs were inseminated by intracytoplasmic sperm injection (ICSI). None of the sperm were motile. Selection was based on softness and pliability. There were 4 embryos formed that cleaved, but only 2 were transferred on the retrieval cycle. The wife failed to conceive, but then had a second transfer of the 2 cryopreserved embryos. She achieved a chemical pregnancy with the beta-human chorionic gonadotropin level attaining a maximum level of 107 mIU/mL (rising from 19 mIU/mL). Though this retrieval cycle did not result in a successful pregnancy the achievement of a clinical pregnancy following frozen embryo transfer at least provides cautious optimism for other cases with similar conditions.

Adult↗
PubMedDate not supplied

Encountering violence and aggression in mental health nursing: a phenomenological study of tacit caring knowledge.

Violence is a growing psychosocial problem in the health care working environment. Literature shows that nurses are physically assaulted, threatened, and verbally abused more often than other professionals. However, some nurses are able to relate to clients in a way that produces positive resolution. This study explored the phenomenon of positive encounters with aggressive and violent clients. Guided by a phenomenological method, data were analyzed within a lifeworld perspective. The essential meaning of the phenomenon of caregivers' experiences of encountering violent clients is described as an "embodied moment," which is explicated by seven themes of meaning, "respecting one's fear and respecting the client," "touch," "dialogue," "situated knowledge," "stability," "mutual regard," and "pliability." The authors discuss the meaning of the outcome and propose both theory and praxis-oriented activities toward decreasing aggression and violence in health care.

Aggression↗
PubMed2004

Amyloid formation: an emulation of matrix protein assembly?

Although more than 20 different proteins are now associated with the amyloidoses, the fibrils share many properties. Despite disparity in primary and tertiary structures of the subunit proteins, assembled fibrils exhibit similar morphology, binding of Congo red, interaction with Thioflavine T, formation of complexes with serum amyloid P component, apolipoprotein E, several glycosaminoglycans, the receptor for advanced glycation endproducts and cross-recognition by some monoclonal antibodies. Thus, it is probable that the mechanism of amyloid generation involves a generic process that can be evoked by most, if not all, proteins under conditions that degrade the native conformation. As suggested by others, the beta-helix or beta-roll conformation may be the unifying element of fibril conformations. Several proteins that have evolved to form physiologically useful amyloid-like fibrils, as well as some proteins associated with pathological amyloidoses, exhibit sequence repeat patterns that may facilitate beta-roll or beta-helix formation. Threading analyses of 2 natural amyloid-forming proteins, curli and human Pmel 17, indicate compatibility of their primary structures with both beta sandwich and beta-helix conformations, suggesting a possible innate conformational pliability. In addition, these results may suggest that the misfolded form of some proteins that are associated with conformational disease may be the native conformation of other proteins to which they are linked by evolution. Finally, since many matrix and structural proteins are known to incorporate numerous tandem repeat sequence elements, we propose that the mechanism of fibril formation is fundamentally related to a general protein assembly process that is integral to the generation of cells and tissues.

Amino Acid Sequence↗
PubMed1991

Simplified pressure method for respirator fit testing.

A simplified pressure method has been developed for fit testing air-purifying respirators. In this method, the air-purifying cartridges are replaced by a pressure-sensing attachment and a valve. While wearers hold their breath, a small pump extracts air from the respirator cavity until a steady-state pressure is reached in 1 to 2 sec. The flow rate through the face seal leak is a unique function of this pressure, which is determined once for all respirators, regardless of the respirator's cavity volume or deformation because of pliability. The contaminant concentration inside the respirator depends on the degree of dilution by the flow through the cartridges. The cartridge flow varies among different brands and is measured once for each brand. The ratio of cartridge to leakflow is a measure of fit. This flow ratio has been measured on human subjects and has been compared to fit factors determined on the same subjects by means of photometric and particle count tests. The aerosol tests gave higher values of fit.

Humans↗
PubMed2003

Loss of keratin 6 (K6) proteins reveals a function for intermediate filaments during wound repair.

The ability to heal wounds is vital to all organisms. In mammalian tissues, alterations in intermediate filament (IF) gene expression represent an early reaction of cells surviving injury. We investigated the role of keratin IFs during the epithelialization of skin wounds using a keratin 6alpha and 6beta (K6alpha/K6beta)-null mouse model. In skin explant culture, null keratinocytes exhibit an enhanced epithelialization potential due to increased migration. The extent of the phenotype is strain dependent, and is accompanied by alterations in keratin IF and F-actin organization. However, in wounded skin in vivo, null keratinocytes rupture as they attempt to migrate under the blood clot. Fragility of the K6alpha/K6beta-null epidermis is confirmed when applying trauma to chemically treated skin. We propose that the alterations in IF gene expression after tissue injury foster a compromise between the need to display the cellular pliability necessary for timely migration and the requirement for resilience sufficient to withstand the rigors of a wound site.

Animals↗
PubMed2005

Innovative technique for ureteral stenting during retroperitoneal laparoscopic ureterolithotomy.

Large calculi in the upper and mid ureter are best managed by laparoscopic ureterolithotomy. Stenting after laparoscopic ureterolithotomy is difficult because of the curls and pliability of the double-J stent. To make the procedure easy, we have devised a double-J stent, closed at both ends, that is threaded on a guidewire, the length of which is 1 cm greater than the stent. The guidewire is passed from the sideholes in the stent, leaving 1 or 2 cm of the guidewire outside. This guidewire makes the stent taut so that it is easily negotiated up and down the ureter. After the stone has been extracted by incising the ureter, the straightened stent on the guidewire is passed in the retroperitoneal space through a 5-mm port. The stent is passed down the ureter into the bladder first and then up the ureter to the renal pelvis. The portion of the guidewire lying outside the stent is positioned at the site of ureterolithotomy. The guidewire is pulled out with a grasper after insertion of stent, and the two ends of the stent coil up in the bladder and the kidney. This innovative technique with the modified stent and guidewire has made stenting during laparoscopic ureterolithotomy easy and saves precious time.

Equipment Design↗
PubMed2006

Aged garlic extract improves blood pressure in spontaneously hypertensive rats more safely than raw garlic.

We studied the effects of two garlic sources on systolic blood pressure (SBP) using spontaneously hypertensive rats (SHRs). Beginning at 12 wk of age, male SHRs were fed diets containing either aged garlic extract (AGE) or raw garlic (RG) powder for 10 wk. Both AGE and RG reduced the increase of SBP compared with the control group from 4 wk after beginning the experimental diets. The effect of AGE was accompanied by a decrease of pulse pressure (PP), suggesting an improvement of the pliability of the artery, although RG did not affect PP. However, harmful effects were observed in the RG group, including a decrease in erythrocytes, an increase in reticulocytes, and generation of papilloma in the forestomach. These results suggest that AGE may safely improve several factors related to blood vessel physiology and circulatory disease.

Animal Feed↗
PubMed1984

Musculocutaneous flap or muscle flap and skin graft?

Six factors must be considered in choosing between muscle only and musculocutaneous flaps for reconstruction of defects: size, bulk, donor deformity, durability, pliability, and sensibility. The choice depends on the location and characteristics of the specific defect. Advantages and disadvantages of each flap in different circumstances are discussed, with emphasis on restoring form and function to the defect while preserving them at the donor site.

Female↗
PubMed1985

Objective measurement of hypertrophic burn scar: a preliminary study of tonometry and ultrasonography.

Many people are burned each year and subsequently develop hypertrophic burn scars. An objective means for quantitatively measuring scar characteristics would be useful in monitoring resolution of the individual patient's scars as well as in evaluating different treatment protocols. Two methods for quantitative measurement of hypertrophic scars were evaluated in 4 patients at 8 scar sites over a 2-month period. A specially designed tonometer, the cicatrometer, assesses scar firmness and pliability. It is shown to provide a simple noninvasive means for objectively evaluating the progress of scar maturation and therapy. High-resolution ultrasonic scanning is shown to provide an objective, quantitative measurement of hypertrophic scar thickness, which can be compared between patients. This allows for the design of controlled trials comparing different treatment protocols.

Burns↗
PubMed1995

Free temporoparietal fascia flap in reconstruction of the lower extremity.

Twenty-one patients with open wounds of the non-weight-bearing foot or the ankle underwent coverage with a free temporoparietal fascia flap and split-thickness skin graft. Our indications for this thin, well-vascularized flap included osteomyelitis and exposed tendon, bone, or fixation hardware. The pliability of the flap allowed superior restoration of natural anatomical contours. Only one flap was completely lost (95.2% overall success). There were four cases (20%) of partial flap loss, none of which required flap revision or a new flap. Four patients (19%) experienced transient donor-site alopecia, and one patient suffered transient palsy of the temporal branch of the facial nerve. One patient (4.7%) had an area of persistent scar alopecia in the temporal scalp after a donor-site hematoma that required revision under local anesthesia. Follow-up was available on 95% of the patients and averaged 20 months (range, 1-54 months). All patients resumed weight-bearing ambulation within 1 month from operation using unmodified footwear. The free TPF flap is a reliable coverage option, with long-term durability and minimal donor-site morbidity, for relatively superficial wounds of the distal lower extremity.

Adolescent↗
PubMed1975

A small arterial substitute: expanded microporous polytetrafluoroethylene: patency versus porosity.

Eighty-nine grafts of expanded microporous polytetrafluoroethylene (PTFE) with a diameter of 4 mm, were placed in the carotid and femoral arteries of dogs. The animals were sacrificed at varying intervals beginning three days after operation. Four animals remain alive with patent grafts 10 months post-operatively. Twenty-four of 89 grafts were occluded, an overall patency of 73%. Fibril length (pore size) of the graft material was varied from 4 to 110 microns. Average pore size ranged from 9 to 65 microns. Wall thickness varied from 0.3 to 0.75 mm. Density ranged from 0.24 to 0.35 g/ml. Tissue ingrowth, neointimization and patency rate as compared to pore size, wall-thickness and density of expanded PTFE were observed. Pore size is the primary determinant of tissue ingrowth, neointimization and patency. Of 51 grafts with an average pore size of 22 microns or less, there were 6 occlusions, an 88% patency rate. There were 38 grafts with an average pore size of 34 microns or greater. In these 38 grafts, 18 occlusions were observed, a 53% patency rate. Patent grafts demonstrated tissue ingrowth, capillary formation an a thin neointima. Using small pore grafts, patency rates of 90% can be anticipated in the dog. Expanded microporous PTFE with its ease of handling, strength and pliability may be the vascular prosthesis of choice in man.

Animals↗