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Biomedical subjects

Berish Strauch

Publications and source records attributed to Berish Strauch.

14 recordsLinked to original sources
PubMed2006

Pulsed magnetic field therapy increases tensile strength in a rat Achilles' tendon repair model.

PURPOSE: To examine the effect of pulsing electromagnetic fields on the biomechanic strength of rat Achilles' tendons at 3 weeks after transection and repair. METHODS: This noninvasive modality was tested in a prospective, randomized, double-blinded, placebo-controlled study to evaluate the effect of a specific noninvasive radiofrequency pulsed electromagnetic field signal on tendon tensile strength at 21 days post transection in a rat model. RESULTS: In the animals receiving PMF exposure, an increase in tensile strength of up to 69% was noted at the repair site of the rat Achilles' tendon at 3 weeks after transection and repair compared with nonstimulated control animals. CONCLUSIONS: The application of electromagnetic fields, configured to enhance Ca(2+) binding in the growth factor cascades involved in tissue healing, achieved a marked increase of tensile strength at the repair site in this animal model. If similar effects occur in humans, rehabilitation could begin earlier and the risk of developing adhesions or rupturing the tendon in the early postoperative period could be reduced.

Achilles Tendon↗
PubMed2006

Limited myocardial muscle necrosis model allowing for evaluation of angiogenic treatment modalities.

The currently accepted model for creating infarcted cardiac tissue in a rat model involves ligation of the left anterior descending artery (LAD), either proximally or at the bifurcation level. This procedure requires significant technical expertise and, even in skilled hands, commonly results in a 30% to 60% animal mortality. The authors propose a new model for creating a limited area of myocardial muscle necrosis that can be effectively studied. It involves a distal electrocautery occlusion of the LAD terminal branches and coagulation of the surrounding muscle. The model is consistently reproducible and decreases the morbidity of the study animals. It provides a cardiac muscle necrosis model not dependent on survival, while allowing study of the post injured state of the muscle and surrounding scar. This allows researchers to evaluate neovascularization and healing of the scar and peri-necrotic muscle, to assess improving blood flow with treatment by techniques designed to improve and stimulate angiogenesis, and to measure the outcome of stem-cell transplants for potential clinical use.

Animals↗
PubMed2006

Mid-body contouring in the post-bariatric surgery patient.

BACKGROUND: Obesity has become an increasingly important health care problem. It is estimated that almost 20 percent of the adult U.S. population is obese, including approximately 5 percent of the population considered morbidly obese. Recent advances in bariatric surgery have improved the safety and efficacy of weight-loss operations. As a consequence of the above factors, there has been a 150 percent increase in the number of gastric bypass and vertical banding gastroplasty procedures performed over the past 3 years. Post-bariatric surgery care has become an integral part in the care of these patients, with plastic surgeons playing an important role. METHODS: The senior author (B.S.) has developed unique variations of the circumferential and near-circumferential abdominoplasty operations to fulfill the needs of these patients. Seventy-five consecutive mid-body lift procedures have been performed over the past 5 years. The basic operation involves circumferential incisions, anterior flap undermining, and simultaneous flap thinning, without resorting to the need for an anterior midline incision. RESULTS: A dramatic improvement in appearance results from the anterior resection and the lateral thigh and buttock lifts that this procedure affords. More recently, the lower back roll has been removed as well. A cohesive operative sequence that includes optimized patient preparation and positioning, tailoring of flaps for improved contour with avoidance of unnecessary midline scars, a strong superficial fascial system closure, and coordination with the entire operating room team has been developed. CONCLUSION: The procedure is associated with a low complication rate, a dramatically shortened operative time, and high patient satisfaction.

Abdomen↗
PubMed2005

Superolateral pedicle for breast surgery: an operation for all reasons.

BACKGROUND: The evolution of procedures for reduction of breast volume and improvement of breast shape has been ongoing, based on the rich blood supply that has allowed a plethora of pedicle types. With particular consideration of the primary pattern of sensory innervation to the nipple-areola complex previously described, the authors have used the superolateral dermoparenchymal pedicle as a basis for surgery on a variety of presenting breast shapes. METHODS: This has been proven to be a versatile and effective technique for a wide array of breast morphologies with differing patterns of skin excision. The operative technique involves superior rotation of a superolaterally based dermoparenchymal pedicle, resulting in a "periwinkle" effect that provides desirable superior pole fullness and increased projection to the breast. RESULTS: More than 1500 breast procedures have been performed by the senior author (Strauch) during the past 15 years using the superolateral pedicle. Experience has demonstrated that the operation is safe, with total nipple-areola complex loss observed in only four cases. Long-term follow-up to 15 years has shown that the results are maintained well with time. CONCLUSIONS: The superolateral dermoparenchymal pedicle has fulfilled the goals of successful breast surgery. It is a safe and effective technique that has provided long-lasting results for patients. The design of the procedure can be adapted to a variety of skin excision patterns and breast morphologies.

Breast↗
PubMed2005

Sural nerve harvest: anatomy and technique.

A minimally-invasive technique of sural nerve harvesting using an initial blunt tip harvesting device, combined with a recessed sharp cutting mechanism for final severance of the nerve, has been developed. Important surgical landmarks have been established, based on a review of the anatomy of the sural nerve. Harvesting is begun through a small incision at the level of the lateral malleolus, thereby identifying the nerve and inserting the nerve-harvesting device. An additional small incision, if needed, is placed at the junction of the middle and distal thirds of the lower leg, a landmark at which an anastomosis between the medial and lateral sural cutaneous nerves is seen in at least 74 percent of patients. When this anastomosis is palpated, the lateral sural cutaneous nerve is visualized and divided, and the dissection of the medial sural cutaneous nerve proceeds in a proximal direction. At the distal end below the popliteal fossa, the cutting mechanism is safely deployed, transecting the nerve. This combination of a limited incision approach with the blunt harvester and sharp, protected division provides 30 to 35 cm of sural nerve graft in the great majority of patients, while reducing the complications often associated with open techniques and minimally-invasive techniques that rely on sharp or blunt instrumentation.

Humans↗
PubMed2005

Palmar arch revascularization for arterial occlusion of the distal upper extremity.

During a period of nine years, 10 patients, ages 42 to 66 years (55 +/- 7, mean +/- SD) underwent upper extremity bypass for ischemic changes to the hand not responsive to conservative management. Patients were referred from the vascular department at the authors' institution. Preoperative angiograms were performed and attempts at angioplasty or intravenous attempts to dissolve clots were carried out (with tissue plasminogen activator-tPA) when appropriate. Patients with persistent upper extremity ischemia and an obvious occlusion with reconstitution in the hand were candidates for upper extremity bypass to the palmar arch. All patients had upper extremity bypasses performed with reverse saphenous vein grafts. The proximal anastomoses (end-to-side) were performed by either the vascular or plastic surgery team, while all distal anastomoses (end-to-side) were performed by plastic surgery team microscopic magnification to the deep or superficial palmar arch. Postoperative follow-up ranged from 3 months to 3 years. The bypass graft to the hand resulted in improved pain and resolution of tissue ischemia in all cases. Patients with preoperative ulcers were completely healed by 3 months. The results are in accordance with previous studies demonstrating that improved blood flow afforded by the procedure can improve the healing of recalcitrant ulcers and mitigate the symptoms of ischemic changes. In addition, end-to-side anastomosis to the palmar arch offers significant advantages, in that the continuity of the arch is maintained with all possible outflow vessels, and the problems associated with size discrepancy in the anastomosed vessels are eliminated.

Adult↗
PubMed2004

True aneurysms of the digital artery: case report.

True aneurysms of the digital arteries are extremely rare; a search of the literature in English yielded only 12 cases. An idiopathic true aneurysm of the radial digital artery of the small finger is described, with its clinical presentation and corresponding arteriogram. Microsurgical repair with an interposition vein graft was performed to re-establish the vascular anatomy. To our knowledge this is the first such reconstruction reported.

Adult↗
PubMed2004

Treatment of human immunodeficiency virus-associated lipodystrophy with dermafat graft transfer to the malar area.

Acquired immunodeficiency syndrome, a death sentence two decades ago, has been transformed into a chronic disease with a life expectancy of many years, due to the advent of highly active antiretroviral therapy. Despite virologic success, nearly 50 percent of patients on highly active antiretroviral therapy develop lipodystrophy with central and visceral fat accumulation and/or facial and limb fat atrophy. The changes are referred to as the human immunodeficiency virus lipodystrophy syndrome. The authors describe a series of five patients with antiretroviral therapy-induced lipodystrophy of the face who benefited from surgical correction of their typical stigmatizing malar atrophy. Dermafat grafts were transferred from the abdominal wall to malar pockets through a transoral approach. The aesthetic results were dramatic and stable, lasting the duration of the 1- to 2-year follow-up period.

Adipose Tissue↗
PubMed2004

A technique of brachioplasty.

Various techniques for the management of upper extremity contour deformities have been suggested since aesthetic brachioplasty was first described. Such deformities are commonplace with aging, after normal weight loss, and especially after massive weight loss such as is seen following bariatric surgery. Despite the multiplicity of procedures described for the correction of these deformities, there are still problems associated with current brachioplasty techniques, including incorrectly placed incisions, widened hypertrophic scars, and postoperative contour deformities. In addition, postoperative skin laxity and ptosis in the axillary region are frequently encountered in the more extreme deformities. The authors present their technique for upper extremity brachioplasty. This technique is suitable for patients with severe brachial ptosis and skin laxity, with relatively little lipomatous tissue, which may extend from the olecranon to the chest wall. The described surgical approach provides excellent overall extremity contour with favorable scars while simultaneously addressing axillary contour deformities.

Arm↗
PubMed2004

Pulsed magnetic fields applied to a transferred arterial loop support the rat groin composite flap.

Pulsed magnetic fields have been shown to stimulate neovascularization in the authors' laboratory. The rat groin composite flap was used to create a prospective randomized trial to test the effectiveness of these pulsed magnetic fields. The skin paddle to this flap is highly consistent, and the authors proposed using the flap to study how pulsed magnetic fields affect composite flap survival when the dominant vessel to the flap is divided and flap survival becomes dependent on a transferred vessel loop. Forty-three rats had the tail artery microsurgically anastomosed to the femoral artery and placed between the groin musculature and the abdominal skin. Pulsed magnetic energy of 1 gauss was applied for 8 (n = 14) or 12 (n = 8) weeks to the experimental groups. Control groups were treated in a comparable manner for 8 (n = 16) or 12 (n = 5) weeks. After the 8 or 12 weeks, all groups had an 8 x 4-cm skin flap raised, and the superficial epigastric artery, the main feeding vessel, was ligated. After 5 days, the total area of the flap and the area of necrosis were traced onto velum paper for each rat. The percent survival was calculated per rat, and a mean survival percentage was calculated per group. The experimental animals treated with pulsed magnetic fields for 8 weeks had statistically significant improved flap survival over the control animals. The study provides evidence that pulsed magnetic energy stimulates angiogenesis and suggests a possible use of this modality to create island vascular flaps in otherwise random vascular territories.

Animals↗
PubMed2003

Reconstruction with irradiated homograft costal cartilage.

The authors present their experience with 51 patients who underwent 55 reconstructive and cosmetic operative procedures with irradiated homograft costal cartilage, who were studied between August of 1988 and June of 2001. The procedures included 52 rhinoplasties and three penile implantations among a total of 130 grafts. Follow-up ranged from 7 months to 12 years. There were two immediate graft exposure complications. Late complications included displacement of the graft in two patients, fracture of the graft in one patient, and partial resorption in one patient at 6 months postoperatively. The experience is described and the literature is reviewed.

Adolescent↗
PubMed2002

Correction of lateral brow ptosis: a nonendoscopic subgaleal approach.

The authors present their experience with a relatively uncomplicated, rapid technique for elevation of the lateral eyebrow and a simultaneous correction of eyelid hooding that is secondary to the descent of the eyebrow. The procedure is designed for all patients requiring lateral brow elevation, either separately or in combination with other procedures. The authors describe and illustrate their technique.

Eyebrows↗