Remembering Dr. Kernohan: "She enjoyed helping people".
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History, 20th Century↗
Biomedical subjects
B Yaffe
Publications and source records attributed to B Yaffe.
The abortion issue in Newfoundland: a province divided.
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Abortion Applicants↗
The role of three dimension computerized imaging in hand surgery.
Three-dimensional computerized imaging is a new modality of radiological imaging. This new technique transforms the two-dimensional slices of bi-plane CT into a three-dimensional picture by a computer's monitor adjusted to the system. This system enables the physician to rotate the angle of viewing of the desired region to any desired angle. Moreover, this system can delete certain features of different densities from the picture, such as silicone implants, thus improving visualization. Our preliminary results using this technique are presented. The advantages, pitfalls, and suggested future applications of this new technique in hand surgery are discussed.
Adolescent↗
Villonodular synovitis of the shoulder in the elderly.
Villonodular synovitis of the shoulder developed in two elderly patients. Huge soft tissue mass, marked joint effusion, and radiographs demonstrating severe osteoarthritic changes characterized these patients. Localized shoulder muscle atrophy accounts for residual painfree limitation of active shoulder motion following synovectomy of the shoulder joint.
Aged↗
Factitious lymphedema of the hand: a diagnostic challenge.
A case of factitious lymphedema of the hand is presented. Attention is drawn to this entity and its differential diagnosis. Delayed detection in our case resulted in prolonged and costly hospitalization with some loss of hand function. Treatment should be left to those skilled in psychotherapy.
Adult↗
Rupture of extensor digitorum communis after distal ulnar styloidectomy.
Attrition ruptures of tendons in the hand, other than those caused by rheumatoid arthritis, are rare. We report a case in which high styloidectomy of the distal ulna caused the rupture of the extensor digitorum communis tendon to the long finger. This complication can be avoided by resection of the smallest segment of the distal ulna that is compatible with relief of the problem. Soft tissue closure over the resected end of the ulna should also be carried out.
Adult↗
Successful replantation of a totally avulsed scalp.
A case of successful replantation of a totally avulsed scalp in a 19-year-old woman is presented. Although severely traumatized, about 90 percent of the surface of the replanted scalp survived. Only one artery (left superficial temporal) and four veins were anastomosed, sufficient enough to revascularize the entire scalp.
Adult↗
Peripheral nerve injection injury: an experimental pilot study of treatment modalities.
The accidental injection of various drugs into peripheral nerves has serious medical complications and medicolegal implications. The most neurotoxic substances of II agents tested in a previous study were penicillin G, diazepam, and chlorpromazine. The appropriate management of such an injury has not been well-established. In an attempt to define the proper treatment in accidental peripheral nerve injection, an experimental study was carried out, in which 70 sciatic nerves of rats were injected intrafascicularly with penicillin G and treated by neurolysis, neurolysis and Celestone irrigation (betamethasone, a synthetic glucocorticoid), and neurolysis and saline irrigation. The degree of damage was evaluated histologically after two weeks. Statistical analysis of the results showed that neurolysis performed at 24 hours after the injury lessened the damage to the peripheral nerve. No additional improvement was found when, in addition to neurolysis, the nerves were irrigated with Celestone or saline solutions.
Animals↗
Complications of liquid nitrogen cryosurgery for verrucae over bony prominences.
Liquid nitrogen cryosurgery is the most frequently used surgical treatment for verrucae. Its success rate is high and complications are rare. However, liquid nitrogen should be used with great care over bony prominences where skin and subcutaneous tissues are thin. We present 3 patients in whom the treatment of simple warts over bony prominences by liquid nitrogen resulted in full-thickness loss of skin. In 2 of them, extensor tendons of fingers were exposed and had to be covered with flaps. We conclude that expertise of the physician is of paramount importance in preventing similar complications in cryosurgery of verrucae.
Adult↗
Complication with the elastic tubed net bandage.
A case is presented in which inappropriate application of extensible tubed net bandage to a finger caused local skin necrosis. Only one comparable complication of this dressing material has been reported previously.
Bandages↗
Effect of cigarette smoking on experimental microvascular anastomoses.
Cigarette smoking has been shown to cause cutaneous vasoconstriction, a decrease in digital blood flow, impaired wound healing, and it was implicated as a cause of failure of microvascular anastomoses in replanted digits. The subject of the following study was to assess the effect of cigarette smoking on experimental microvascular anastomoses. Twenty Sprague-Dawley male rats weighting 200 to 250 grams were divided into groups of ten. Both the experimental and the control groups were acclimatized to a Maddox/ORNL rat smoke inhalation exposure system for six days prior to operation. At this time they were anesthetized and bilateral femoral artery end to end anastomoses were performed by two surgeons, using standard microsurgical techniques. After a recovery period of 24 hours, both groups were started on a smoking/sham-smoking regime for 12 to 13 days. After this time they were anesthetized again, the femoral artery anastomoses were checked for patency in vivo and excised for histological evaluation. Five cm3 of blood was drawn from each animal to be analyzed for the presence of nicotine and its metabolites, and the rats were sacrificed. All the anastomoses in both groups were patent at the time of exploration and no histological difference could be demonstrated between the two groups. The radioimmunoassay of nicotine and cotinine showed large amounts in the smokers, and none in the nonsmokers.
Animals↗
The effect of a simple preservation method on immediate and late patency rates of autogenous microvenous grafts.
The subject of this study was assessing in vivo a simple short-term preservation method of autogenous microvenous grafts. Forty-five autogenous vein grafts in rats were divided into groups of five and preserved in lactated Ringer's solution at 4 degrees C for 0, 1, 2, 3, 5, 8, 10, 12, and 14 days. After a designated preservation period, the veins were implanted as autografts into defects created in the animal's femoral arteries, while a small portion of each vein was processed for histologic examination. The patency was assessed immediately, at 1 week, and at 5 to 6 weeks following grafting, at which time the patent grafts were biopsied. Preserving the grafts for up to 2 days had no effect on their patency rate, which remained 100 percent, and no histologic changes were noted in the veins preserved for this period. However, longer preservation resulted in gradual necrotic changes in the veins, which were reflected in lower patencies of the grafts. The histology of the preserved veins and of the patent vein grafts 5 to 6 weeks following grafting is discussed. The model developed in this study can be used as a benchmark for further preservation studies using more sophisticated methods.
Animals↗
Measuring surgical decision-making with hypothetical cases.
Hypothetical clinical cases were used to investigate surgical decision-making in relation to surgical rates across Ontario. Six procedures were studied (cholecystectomy, colectomy, inguinal herniorrhaphy, hysterectomy, cesarean section and tonsillectomy-adenoidectomy), and substantial differences of opinion regarding the choice of surgical or nonsurgical treatment were recorded. The decision to operate, however, was not made more frequently in Ontario counties with high operative rates, and none of the demographic variables studied were correlated with the decision to operate. Other variables that might have affected operative rates were not taken into account. There were also differences of opinion in referral decisions, but generally internists and pediatricians were less likely to refer the hypothetical cases to surgeons than were family physicians.
Cesarean Section↗
Impending Volkmann's contracture in a newborn.
A newborn presented with severe necrosis of the volar aspect of the forearm and impending Volkmann's contracture. This is the youngest such patient reported in the literature. We suspect prolonged intrauterine pressure from an amniotic band. Such bands are known to cause constricting rings, syndactyly, and congenital amputations. If our assumption is correct, this case is unique.
Amniotic Band Syndrome↗
True sagittal CT scanning of the elbow.
OBJECTIVE: A new method to obtain true sagittal CT scans of the elbow joint is described. MATERIALS AND METHODS: The patient is placed prone on the CT table with the arm around and under the table. RESULTS: True sagittal images of the elbow joints and all the articulating surfaces were easily obtained in a standard and reproducible manner. CONCLUSION: For CT scanning of the elbow, true sagittal scanning is superior to axial views and is readily obtained by the described method.
Elbow↗
Survey of infection control procedures at manicure and pedicure establishments in North York.
OBJECTIVE: To describe infection control practices used by technicians doing manicures and pedicures in an urban setting in Ontario. METHODS: A random sample of 120 establishments was selected from a sampling frame. A survey was designed and administered to technicians through face-to-face interviews. RESULTS: Technicians in 72 establishments were interviewed, representing a 60% response rate. Twenty-nine (40%) of these technicians indicated that they had been immunized against hepatitis B. Technicians re-used almost all instruments even if this was not the intent of the manufacturer. Isopropyl alcohol was the most commonly used disinfectant. Many technicians did not wear gloves while performing procedures. Most did not follow universal precautions when asked how they would react to incidental cuts on either the client or themselves. CONCLUSION: There is a need for the development of infection control protocols for manicure and pedicure establishments since the potential for transmission of infectious diseases does exist.
Beauty Culture↗