Biomedical subjects

D M Rothkopf

Publications and source records attributed to D M Rothkopf.

23 records · Page 2Linked to original sources

PubMed1990

Surgical management of ulnar artery aneurysms.

In a ten-year review (1978 to 1988), ten ulnar artery aneurysms in nine male patients were studied. Blunt trauma led to 70%, penetrating trauma to 20%, and 10% had no history of trauma. Three cases were seen as asymptomatic palmar masses with brief antecedent histories of 4 weeks or less. Seven patients with aneurysms had persistent vascular hand symptoms for 6 weeks or longer. All seven symptomatic lesions proved to be sources of emboli. Diagnostic arteriography was done in all cases. Intraoperative digital plethysmography aided in operative decisions regarding the necessity for microvascular reconstruction. Five aneurysms were resected with end-to-end ulnar artery microvascular repairs, four resected without repair, and a single case treated with long-term anticoagulants. Follow-up, averaging 40 months, showed uniform improvement in vascular symptoms, with no loss of jeopardized tissues. Ulnar artery aneurysms, well studied preoperatively and intraoperatively, can be treated successfully with selective microvascular reconstruction.

Adolescent↗

PubMed1989

Elective cross-hand transfer: a case report with a five-year follow-up.

The elective free microvascular cross-hand transfer of the right hand to the left distal carpus was successfully performed in a 35-year old professional photographer. Traumatic loss of the left hand with preservation of a useful thumb and concomitant right upper extremity injury leaving the right hand with an amputated thumb, but paralyzed and insensate from a brachial plexus palsy 5 years before transfer, set the stage for such a reconstruction. Multiple immediate tendon transfers and primary nerve grafting provided for finger flexion and extension plus functional sensibility in this first reported case of an elective cross-hand microvascular transfer. Five years follow-up demonstrates useful and powerful flexion, and functional extension of digits in the reconstructed left hand and right upper extremity function has been improved with a below-elbow prosthesis.

Adult↗

PubMed1989

Salvage of a failing microvascular free muscle flap by direct continuous intravascular infusion of heparin: a case report.

A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound. The free muscle flap failed from a venous thrombosis that was recognized 12 hours postoperatively, and reexploration revealed extensive venous thrombosis throughout the lower leg. The flap was salvaged by direct catheter administration of heparin into the vena comitans of the gracilis artery, which bathed the newly repaired venous anastomosis with an anticoagulating dose of heparin without systemic elevation of the patient's PTT. Ultimate full flap survival and wound healing ensued.

Adult↗

PubMed1987

Management of cutaneous melanomas of the female breast.

Primary melanomas of the skin of the breast are uncommon lesions. Fifty-four patients were surgically treated for this lesion during a 13-year period, accounting for 3.8 percent of a total of 1431 patients with cutaneous melanoma. Nineteen patients were female and 35 were male. Most recently, in patients with high-risk lesions, such as those exhibiting an aggressive vertical growth phase or a Clark level IV or V, attempts at curative resection have utilized wide and deep excision to the level of the pectoralis fascia with axillary lymph node dissection in selected cases. Reconstruction of the significant breast deficit in five female patients utilized the latissimus dorsi myocutaneous flap. This technique results in an improved aesthetic appearance when compared to primary closure or skin grafting. Donor-site morbidity is minimal. Long-term cancer surveillance is not impeded, and all five patients expressed satisfaction with the reconstruction. Four of the five female patients are currently alive with no evidence of disease at a mean follow-up of 55 months after definitive therapy.

Adolescent↗

PubMed1983

Augmentation of surviving flap area by intraarterial vasodilators administered through implantable pumps.

Using the implantable Infusaid Model 300 pump, several vasodilators (prostaglandin E1, isoxsuprine, bradykinin, trimethaphan, and reserpine) were infused intraarterially into an abdominal island flap in the rabbit. All produced a large increase in flap surviving area over saline controls at forty-eight hours, measuring as high as a 2.8-fold increase in random portions of the flap with prostaglandin E1. The agents possessed differing modes of action but had the common property of vasodilatation. The results raise questions concerning the possible physiological role of endogenous prostaglandins in the surgical delay phenomenon. The Infusaid pump was a valuable tool in the study and was well tolerated by the animals.

Alprostadil↗