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Biomedical subjects

A E Wulc

Publications and source records attributed to A E Wulc.

At least 19 recordsLinked to original sources
PubMed1992

The use of a contained breathing apparatus to isolate the operator and assistant for aerosolizing procedures including dermabrasion and laser surgery.

Dermabrasion and carbon dioxide laser surgery aerosolize patient blood and tissue particles. The operating physician and assistants may therefore have intimate inhalational and mucous membrane contact with patients' body fluids. Herein is described the use of an isolated ventilation system to protect physicians and assistants from blood and tissue products aerosolized during the course of dermabrasion and carbon dioxide laser surgery.

Aerosols↗
PubMed1992

Vector-running subcuticular sutures in high-tension and high-mobility areas.

Routine cuticular sutures pierce the epidermis, and if left in place long enough, will noticeably scarify, a process called "tracking." Alternatively, the running subcuticular suture has the advantage of minimizing suture tracking, especially following a prolonged usage, because it does not pierce the epidermis along most of its course. A "hybrid" modification of these two sutures, described herein, allows for prolonged tight closure under high tension in high-movement areas, avoidance of tracking, and rapidity of placement. This innovation is called the vector-running subcuticular suture.

Dermatologic Surgical Procedures↗
PubMed1992

Haemangiopericytoma of the orbit.

Orbital haemangiopericytomas are ideally managed by complete surgical excision in the first instance. This is frequently not achieved, because difficulty in making the diagnosis preoperatively results in incisional biopsy and the highly vascular nature of the tumour makes complete excision difficult. A series of 12 patients with orbital haemangiopericytoma seen over a 23-year period is presented. The following combination of clinical and radiological features is suggestive of haemangiopericytoma. 1. Painless non-axial proptosis with downward displacement of the globe. 2. Intermittent upper lid swelling. 3. A soft, superiorly located mass with poorly defined borders, especially with a blue hue. 4. A superiorly located, rounded or elongated extraconal mass on CT, isodense with brain, with smooth, well-defined borders and moderate to marked enhancement with the injection of intravenous contrast medium. 5. Significant blush in all three phases of carotid angiography, without prominent arteriovenous shunting. Once haemangiopericytoma is suspected, complete surgical excision is recommended.

Adult↗
PubMed1992

A new method for preabrasion graft site suturing. The superficial linear restraining stitch.

Since the introduction of wire brush dermabrasion in the 1940s, many ancillary procedures have been developed including preabrasion scar elevation and punch grafting of deep scars. Unfortunately, unsutured punch grafts tend to cobblestone or rise-up in an unsightly manner. Traditional suturing methods appear to decrease this tendency but are time consuming and tedious. Herein is described a new method for suturing preabrasion punch grafts that is extremely rapid, efficacious, and easy for the patient to remove if desired.

Cicatrix↗
PubMed1992

Oculoplastic surgery. An overview.

BACKGROUND. The interface between the subspecialties of dermatologic surgery and oculoplastic surgery is broad. However, there are many commonly seen oculoplastic conditions that are not foremost in the mind of the dermatologic surgeon. OBJECTIVES. Common oculoplastic problems are detailed in this article and should provide the reader with a basis for understanding the wide spectrum of oculoplastic problems encountered in practice.

Eyelid Diseases↗
PubMed1992

Simultaneous lateral, anterior, and posterior (SLAP) lower-lid blepharoplasty.

We report a hybrid of procedures for correcting the aging lower eyelid--transconjunctival blepharoplasty, skin blepharoplasty, and skin-muscle blepharoplasty--that maximizes the strengths of these procedures while minimizing their shortcomings. Our procedure, a simultaneous lateral, anterior, and posterior blepharoplasty, simultaneously attacks the lateral canthal angle, the anterior lamella, and the posterior lamella of the eyelid.

Adult↗
PubMed1991

Asymptomatic orbital cavernous hemangiomas.

Computed tomographic (CT) scanning and magnetic resonance imaging (MRI) are commonly performed to evaluate neurologic symptoms. Rarely are asymptomatic orbital tumors discovered, creating uncertainty about their management. Eleven patients are presented who were referred for asymptomatic orbital tumors discovered on either CT scanning or MRI performed for unrelated symptoms of headache, vertigo, peripheral numbness, seizures, stroke, or hallucinations. The asymptomatic orbital tumors were diagnosed clinically and radiologically as cavernous hemangiomas. All the patients were followed clinically and neuroradiologically for an average of 37 months (range, 8 to 120 months). None of the tumors enlarged during this time. The authors conclude that patients who have asymptomatic cavernous hemangiomas, discovered by coincidence during neuroimaging, that bear no relation to the indication for obtaining the CT scan or MRI, can be safely followed by observation as an alternative to surgical excision.

Adult↗
PubMed1991

The pathogenesis of canalicular laceration.

Canalicular lacerations are seen commonly in ophthalmic practice, but the pathogenesis of canalicular lacerations has not been explored. The authors retrospectively reviewed 25 cases of canalicular laceration seen at their institutions. Only 4 patients (16%) had injuries attributable to direct trauma; the remaining 21 patients (84%) had diffuse trauma or trauma to the eyelid remote from the canaliculus. The authors postulate that, in many of their cases, canalicular "lacerations" resulted from indirect trauma, where the eyelid was ruptured when it was stretched acutely to the point of avulsion. Two experimental models were derived to test this hypothesis. The results suggest that the canalicular portion of the eyelid is a particularly vulnerable location, and that injuries morphologically similar to canalicular "lacerations" occur predictably if the eyelid is traumatized indirectly or diffusely to the point of rupture.

Adolescent↗
PubMed1991

Bell's palsy in Moebius syndrome.

We report a case of unilateral transient and reversible facial paresis, which was superimposed on a congenital bifacial palsy in a young adult with Moebius syndrome. Our case illustrates the potential for two conditions, both affecting the facial nerve and both of unknown etiology, to be juxtaposed in a single individual. Worsening of facial palsy in the Moebius syndrome may not signify progressive disease.

Abnormalities, Multiple↗
PubMed1991

Refinements of the tarsal strip procedure.

We present several refinements in technique that simplify the tarsal strip procedure and enhance its results. Among these refinements are: electrosurgical deepithelialization of conjunctiva and lid margin, use of a V-shaped needle, direct needle passage about the lateral orbital tubercle, and the parallel placement of a buried absorbable suture to unite the upper and lower lid margins and to maintain a long-lasting sharp canthal angle. We have used these maneuvers in 45 patients with few complications; patient acceptance has been high. Also, we have found that using these maneuvers is helpful in teaching the procedure to residents.

Ectropion↗
PubMed1990

Rhinocerebral mucormycosis: management and survival after carotid occlusion.

Rhinocerebral mucormycosis is a rare but often fatal fungal infection. We present 2 patients with mucormycosis complicated by internal carotid artery thrombosis. Magnetic resonance imaging was superior to computed tomography in localizing the pathological process. Subtotal resection of devitalized tissue and intravenous amphotericin B therapy resulted in a successful outcome for both patients. Prompt recognition of this disorder by using modern diagnostic and therapeutic modalities promises to improve survival rates.

Adult↗
PubMed1990

Lateral wall advancement in orbital decompression.

Treatment of dysthyroid orbitopathy can be enhanced with a modified craniofacial approach using a lateral wall osteotomy, and anterolateral advancement and osteosynthesis in conjunction with medial and inferior wall orbital decompression. The technique of lateral wall advancement is described, and the results are discussed. While the authors advocate orbital decompression for dysthyroid optic neuropathy, advancement of the lateral orbital wall can easily be performed as an adjunct to the two- or three-wall decompression procedure. Advancement appears to increase the overall decompressive effect by providing a potential space where lateral expansion can occur and by enlarging the bony orbital volume. It also appears to lessen lid retraction and facilitates (and in some cases, obviates) the need for further lid retraction surgery.

Female↗
PubMed1990

Suture tensor.

The suture tensor is a simple stainless steel device that pulls the ends of a running subcuticular suture in opposite directions, maintaining the desired closure. The benefits of the use of this device may include minimization of train-track and excisional scarification (via the enhanced maintenance of "tenting"), time savings, and flexibility and durability for the sporting or physically active patient.

Dermatologic Surgical Procedures↗
PubMed1990

Evaluation of the lacrimal apparatus with digital subtraction macrodacryocystography.

Patients who suffer from epiphora can benefit from reconstructive surgery in many cases of obstructive and nonobstructive lesions of the lacrimal apparatus. We describe our technique of digital subtraction macrodacryocystography (DSM) and discuss its efficacy in the evaluation of various abnormalities involving the lacrimal drainage pathway. A variety of pathologic conditions of the lacrimal apparatus are portrayed. DSM is an accurate, easy to perform, but relatively unrecognized method of anatomic localization of obstructive lesions within the lacrimal drainage system.

Dacryocystitis↗
PubMed1990

Conjugal temporal arteritis.

We report the simultaneous occurrence of biopsy-proven temporal arteritis in husband and wife. Serologic and viral studies were negative, including viral culture of the wife's temporal artery. The concurrent incidence of giant cell arteritis in a married couple would suggest a common exogenous exposure.

Aged↗