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Biomedical subjects

G F Funk

Publications and source records attributed to G F Funk.

45 records · Page 3Linked to original sources
PubMed1993

Osseointegrated implants: a comparative study of bone thickness in four vascularized bone flaps.

Primary and secondary reconstruction of mandibular continuity defects with vascularized bone is currently the standard of care at many institutions. The most commonly utilized donor sites for such bone flaps include the scapula, iliac crest, fibula, and radius. Recently, interest has grown in the placement of osseointegrated implants into these flaps to facilitate functional dental rehabilitation. There are no studies comparing the bone available from each of these flaps into which osseointegrated implants can be placed. In this cadaver study, the dimensions of bone available for implant placement from the iliac crest, scapula, fibula, and radius osseous flaps were measured. The iliac crest and fibula flaps had bone dimensions consistently adequate for implant placement. Bone available for the safe placement of implants into the scapula flap was found in the majority of specimens. The radius flap group had the highest number of specimens that were inadequate for implant placement. The majority of the specimens with bone inadequate for implantation were from females. Clinical implications of this study regarding flap selection are discussed.

Aged↗
PubMed1991

Management of complicated fractures involving the orbits and nasoethmoid complex in young children.

This article presents some ideas and techniques for surgical reduction of complicated orbit and nasoethmoid complex fractures in young children. Operative techniques for surgical exposure and fracture reduction and fixation have evolved from standard facial incisions and wire fixation to complete exposure of the cranium and orbits via a bicoronal scalp flap, application of rigid plating techniques, and use of cranial bone grafts when necessary. This evolution of surgical techniques has been accompanied by an overall improvement in cosmetic and functional results.

Adolescent↗
PubMed1988

Rigid internal fixation for fractures involving tooth-bearing maxillary segments.

Fracture dislocations of the middle third of the face usually involve a complex combination of the three types of fractures initially described by LeFort. Treatment of these injuries requires a six- to eight-week period of intermaxillary fixation, unless rigid internal fixation devices (plates and screws) are used to stabilize the fractures. However, rigid fixation carries the risk of producing a malunion and serious malocclusion if not performed correctly. A review of 22 patients with complex LeFort fractures treated with rigid fixation revealed that the only absolute contraindication to its use is difficulty in interdigitating the maxillary and mandibular teeth in a passive fashion at the time of fracture reduction. Rigid internal fixation should therefore be considered as an alternative treatment for most fractures of the middle third of the face.

Fracture Fixation, Internal↗
PubMed1982

Resonance-enhanced Raman identification of a ternary chemical intermediate during the equine liver alcohol dehydrogenase reduction of p-(dimethylamino)benzaldehyde.

The nature of the binding of aromatic aldehyde and aromatic alcohol substrates to the catalytic zinc of equine liver alcohol dehydrogenase has been studied by using resonance-enhanced Raman spectroscopy. When an excess of both enzyme and coenzyme to substrate is used, a stable ternary chemical intermediate is formed between liver alcohol dehydrogenase and the reduced coenzyme, nicotinamide adenine dinucleotide, and the aldehyde, p-(dimethylamino)benzaldehyde, in the pH range 8.5-0.6. Resonance-enhanced Raman spectra clearly show that this same intermediate is formed between the excess enzyme, oxidized coenzyme, and the corresponding alcohol, p-(dimethylamino)benzyl alcohol. Thus, in the presence of excess enzyme and coenzyme, this specific ternary complex is a stable intermediate for both forward and reverse reactions. As a model for this enzyme-substrate intermediate, a complex between the aldehyde and Zn2+ in diethyl ether was made which showed a resonance-enhanced Raman spectrum essentially identical with that of the enzyme-coenzyme-substrate intermediate and completely different from that of the substrate. Most striking in this spectrum is the total absence of the carbonyl vibration which indicates that the C = O no longer exists in either the enzyme-substrate-coenzyme intermediate or the model complex, most probably due to the presence of a zinc-oxygen bond. The assignments are aided by 18O isotopic substitution in the substrate. The Raman spectra of crystals of the ternary complex and the dynamics of the complex are also discussed.

Alcohol Dehydrogenase↗
PubMedDate not supplied

Reversible visual loss due to impacted lateral orbital wall fractures.

Impaction of the sharp medial edge of the orbital plate of the greater sphenoid wing into the orbital apex is a unique type of lateral orbital wall fracture that can produce a potentially reversible optic neuropathy. Two patients in whom the lateral or temporal approach to the orbit was used to reduce this type of fracture will be presented. In both patients, improvement in vision appeared to be related to removal of a bone fragment compressing the optic nerve in the orbital apex.

Adult↗
PubMedDate not supplied

Anomalies of forearm vascular anatomy encountered during elevation of the radial forearm flap.

BACKGROUND: The radial forearm flap has gained considerable popularity over the past 10 years. With the increasing number of forearm flaps being used in head and neck reconstruction, it is likely that anomalous forearm vascular anatomy will be encountered by more head and neck surgeons performing this procedure. METHODS: We reviewed our experience with 52 forearm flaps; four different anomalies of forearm vascular anatomy were encountered in four patients. In this article we present each of our cases and discuss the incidence, preoperative diagnosis, and recommended management of these and the more common forearm vascular anomalies. RESULTS: The anomalies encountered in our series include: one case of distal takeoff of the radial artery deep to the pronator teres muscle, two cases of a superficial dorsal antebrachial artery, one case of bilateral hypoplastic ulnar arteries, and one case of high takeoff of the radial artery. CONCLUSIONS: There are a number of anomalies of forearm vascular anatomy of clinical significance to the surgeon performing these procedures. Most of these anomalies can be identified with a careful preoperative examination. Surgeons performing this procedure should be familiar not only with the normal vascular anatomy of the forearm flap, but also with the more common anatomic variants. Failure to recognize or appropriately manage these anomalies of forearm vascular anatomy may result in a compromised surgical outcome.

Adolescent↗
PubMedDate not supplied

Liver function studies in the assessment of head and neck cancer patients.

BACKGROUND: Serum liver function tests (LFTs) are used in the initial evaluation of patients with head and neck squamous cell carcinoma (SCC) to evaluate hepatic function and to screen for liver metastases. METHODS: One hundred forty patients initially seen with SCC between 1988 and 1991 were followed for a minimum of 2 years to determine the significance of abnormal LFTs at presentation. RESULTS: Abnormal values were found in 69 patients (49%), including elevated alkaline phosphatase in 37 (26%) and lactic dehydrogenase in 25 (18%). Abnormal values were most commonly attributed to alcohol-related liver disease. No liver metastases were identified at initial screening. LFTs were normal at presentation in all three patients subsequently identified with liver metastases during follow-up. CONCLUSIONS: Abnormal LFTs are commonly encountered but are of little value in identifying patients with liver metastases during initial assessment. Modest elevation of LFTs should not necessitate costly and time-consuming investigation to exclude hepatic metastasis.

Adult↗