Biomedical subjects

G Freilinger

Publications and source records attributed to G Freilinger.

At least 19 recordsLinked to original sources

PubMed1995

[Results of various reconstructive methods after subcutaneous mastectomy and objective evaluation of tissue fibrosis with a new measurement procedure].

Of 35 patients undergoing subcutaneous mastectomy performed within the last 15 years, 25 were evaluated for follow-up studies. Reconstruction had been achieved either using silicone implants or autologous tissue formed from the resulting dermal-fat pedicles. The patients were interviewed for subjective results. In addition, firmness of the breast according to the classification of Baker was investigated. The compressibility of the breast was electronically measured, employing a new compression device. In 13 patients, the breast was distorted after reconstruction with implants. The deformity did not correlate with submuscular or subcutaneous placement of the implants. The aesthetic results after dermal-fat pedicle techniques were superior to reconstruction with silicone implants. Compressibility to 32% of breast diameter was defined to be a border value between a soft and firmer breast, correlating with clinical conditions between Baker 2 and Baker 3.

Adult↗

PubMed1995

[Which changes occur in nerve grafts harvested with a nerve stripper? Morphological studies].

A histological and morphometric study was undertaken in order to evaluate the alterations in sural nerves harvested for nerve grafting using a nerve stripper. In 19 nerves biopsies were taken from the proximal and/or the distal end of the stripped nerve graft. Cross sections were examined for alterations of the perineurium and the myelin sheaths. In four nerves alterations within the perineurium were found, which affected 37% of the endoneural cross-sectional area on the average. In all specimens, the perineurial sheath was seen to be intact. The results of the present study suggest that harvesting of a nerve graft using a stripper does not cause major injuries to the graft and therefore successful neurotization of the graft should not be impaired.

Humans↗

PubMed1994

[The long-term changes after the implantation of silicone breast prostheses].

In a prospective study 60 patients with unilateral or bilateral mammary implants underwent mammography and sonography. Location, form and structure of the implants were evaluated. Additionally capsular fibrosis and its influence on the imaging quality of parenchyma was scored. We found increasing implant deformities and increasing density of the implants with increasing postoperative interval. There was poor statistically significant correlation between the thickness of the periprosthetic capsular and the postoperative interval in prepectoral implants (r = 0.555, p < 0.01); in case of subpectoral implants there was no such correlation. In 88% of the cases imaging quality was scored as adequate by two independent observers, with additional views in all cases. We conclude that sufficient imaging quality for the assessment of parenchyma and of potential implants complications may be obtained by the combination of mammography and sonography.

Adult↗

PubMed1993

Clinical application of motorsensory differentiated nerve repair.

Since 1979 acetylcholinesterase has been used in clinical practice for motor sensory differentiation. It was first used for median and ulnar nerve injuries at the wrist. Recently the application was extended to secondary nerve repair, including plexus reconstruction. The aim of this study was to present, for the first time, clinical results of motor sensory differentiated median and ulnar nerve repair and to show the advantage of this method in secondary repair. We compared a group of nine patients with motor sensory differentiated median and ulnar nerve repair with a group of 13 patients without motor sensory differentiation. Sensibility testing, strength measurements, and anatomical examinations were performed. The hand function was expressed in percentage values. Compound muscle action potentials and sensory antidromic conduction velocities were measured electroneurographically. Sensibility recovery was significantly better after motor sensory differentiated median nerve repair (P < 0.05). In secondary nerve repair acetylcholinesterase was used additionally for evaluating the level of resection of the proximal stump. The time required for perioperative histochemical differentiation has now been reduced to 2 hr.

Acetylcholinesterase↗

PubMed1993

Peripheral nerve repair in the hand with and without motor sensory differentiation.

To investigate the value of motor sensory differentiated nerve repair, we examined a group of 9 patients with motor sensory differentiated nerve repair and a group of 13 patients without motor sensory differentiated nerve repair. The clinical and electroneurographic findings were compared. For the clinical examination, Millesi's scoring system was used. The hand function after motor sensory differentiated median nerve repair was 72% +/- 16% compared with 57% +/- 14% without motor sensory differentiation. The hand function after motor sensory differentiated median and ulnar nerve repair was 53% +/- 12% compared with 43% +/- 24% without motor sensory differentiation. After ulnar nerve repair the achieved values for hand function were high even without motor sensory differentiation. Our results indicate that intraoperative motor sensory differentiation of injured nerves is helpful to reestablish particularly the sensory function in median nerve injuries.

Action Potentials↗

PubMed1993

[Minimizing scar expansion using the B technique in form correction of the breast].

For the last two years, the B-technique has been used in mammaplasty to minimise the extent of scars, if the expected resection weight is 700 g or less. 33 patients were operated by means of this technique. Scar formation and areola sensation were examined and compared with 188 patients operated by the techniques of McKissock, Strömbeck or Pitanguy. 19 of those patients and 3 patients, who had been operated on by the B-technique, developed hypertrophic scars. The widths of the scars was significantly smaller after operation by the B-technique, than by other techniques. After operation by the B-technique, the areola sensation was unchanged in 67% compared to 46% after operation by above mentioned and other techniques. In cases, where the expected resection weight does not exceed 700 g, the B-technique is superior to other techniques, because the medial scars can be avoided.

Adolescent↗

PubMed1993

Surgical treatment of developmental asymmetry of the breast. Long term results.

To evaluate our operative techniques for the treatment of breast asymmetry, 30 patients were interviewed and examined three to 16 years after correction of developmental asymmetry. Breast symmetry was assessed by linear measurements and by subjective evaluation. The most satisfactory long term results were found in the patients who had undergone bilateral reduction mammaplasty or unilateral reduction mammaplasty combined with a contralateral mastopexy. In some cases longer lasting symmetry could be achieved by operating on both breasts using similar techniques. Long term results were not significantly better in those patients who had been operated after reaching the age of 18 years, compared with those of patients operated on at the age of 17 years or younger. To avoid psychological consequences therefore it is not always justifiable to delay operation until the breasts have matured.

Adolescent↗

PubMed1993

Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve repair in the hand.

In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 years after surgery, and at that time clinical and electroneurographic examinations were performed to evaluate the techniques. Clinical examination showed that four patients had regained on average 71.9% of hand function after median nerve repair, one patient had regained 83.6% of hand function after ulnar nerve repair, four patients had regained on average 53.3% of hand function after median and ulnar nerve repair, and two patients had regained on average 43.5% of hand function after median and partial ulnar nerve repair. The contribution of the ulnar nerve to reinnervation of the thenar muscles was 68.5%, whereas the median nerve did not contribute to reinnervation of the hypothenar muscles. Distal latencies for the median nerve showed a delay of 36% of the upper limit of normal value, and those for the ulnar nerve revealed a delay of 21.5%. This study demonstrated that sensory/motor-differentiated nerve repair of the median and ulnar nerves is possible and can be proven electroneurographically.

Adult↗

PubMed1993

[Long-term results of the Wilhelm denervation operation in epicondylitis humeri radialis (tennis elbow)].

Fourteen patients with epicondylitis humeri radialis, resistant to conservative therapy were surgically treated according to Wilhelm's procedure at the II. Department of Plastic Surgery, University of Vienna. The mean follow-up period was 7.6 years (1 to 14 years). This study demonstrates a marked improvement of the symptoms after operative treatment, hence it follows that Wilhelm's procedure can be recommended in patients resistant to conservative therapy.

Adult↗

PubMed1993

[Blepharoplasty with special reference to correction of xanthelasma].

Tissues in the periorbital region commonly change due to aging. We examined 31 patients for scar formation and symmetry after blepharoplasty and looked for symptoms of keratoconjunctivitis sicca by means of the Schirmer's I test. In eight patients the operation was done because of xanthelasma formation. Visible scars remained in the upper eyelid if the incision was placed too far medially or too far laterally beyond the lateral orbital rim or too close to the lid margin. In the lower eyelid, the scar is unsightly when near the lid margin. Since in all patients visible scars were left after correction of xanthelasma, the CO2 laser was used in four patients in addition to the surgical procedure in order to avoid extension of scars.

Adolescent↗

PubMed1991

Transfer of the temporal muscle for lagophthalmos according to Gillies.

For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos.

Eyelid Diseases↗

PubMed1991

Transfer of the temporal muscle for lagophthalmos according to Gillies.

Aged↗

PubMed1990

Histochemical mapping and fiber size analysis of mimic muscles.

Fourteen functionally relevant mimic muscles of nine human bodies were analyzed with respect to their muscle fiber sizes and their histochemical fiber type composition. In cryostat sections stained for actomyosin ATPase, type 1 and type 2 fibers were evaluated separately by means of computer-assisted image analysis. The fiber diameters varied between 20.24 and 41.45 microns. According to the proportions of the fiber types, the mimic muscles could be classified into three groups: (1) phasic muscles, with 14 to 15 percent type 1 fibers, (2) intermediate muscles, with 28 to 37 percent type 1 fibers, and (3) tonic muscles, containing 41 to 67 percent type 1 fibers. It is concluded that one has to consider this diversity of mimic muscles when planning the surgical reconstruction of facial paralysis.

Adult↗

PubMed1989

[Reconstruction of deformities of the external ear].

Microtia is a rare malformation. Reconstruction of microtia is not a routine operation because of its rarity of occurrence and the complex deformity. In this paper the indication for surgical treatment, technique, results and complications are discussed. Two different operation methods were used in our patients. A multiple-stage and a single-stage reconstruction procedure. We used autogenous rib cartilage. Five of the seven treated patients came to the follow-up examination. Reconstruction was performed 2 years ago in two cases and between 4 and 12 years ago in three cases. Our patients were content with the result in so far as they would be prepared to undergo treatment again. Carefully built rib framework is an essential prerequisite for a successful postoperative result. Microtia represents a greater psychological problem than a cosmetically imperfect result after reconstruction.

Adolescent↗

PubMed1989

[Late results following surgical correction of syndactyly and symbrachydactyly].

Growth and the type of surgical treatment of the hand play an important role in the results of surgery in children. 29 patients have been operated on because of syndactyly and symbrachydactyly and were controlled. The following parameters were assessed: kind of incision and skin graft, functional results, x-ray to examine the skeleton and the depth of the commissure, colour of the skin graft and use of the hand. After operation of syndactyly all patients were able to use their hands normally, although full extend of flexion and extension was achieved only in 20 of 22 hands. In 5 divided pairs of fingers there was recurrence of syndactyly. In all cases except one, a split thickness skin graft has been used. After operative treatment of symbrachydactyly and complex syndactyly, full extent of flexion was achieved in 13 of 19 hands, in 6 hands the range of flexion was incomplete because of skeleton abnormalities. Recurrence occurred in 9 divided pairs of fingers; in 7 cases, a split thickness skin graft had been used. Despite this, all patients were able to use their hands normally. The use of split thickness skin grafts resulted in a 60% recurrence rate, whereas the use of full thickness skin graft led merely to 7.5% recurrence rate. Our results show the advantage of the full thickness skin graft. As a consequence, full thickness skin graft should be used in all cases. Furthermore, the operation should be performed at an early age, if fingers of unequal length have to be separated. Zig-zag incision should be used in all cases.

Child↗

PubMed1989

[Hemodynamic and clinical studies following injury of the arteries of the forearm].

Forearm arterial injury usually does not lead to acute ischemia, but a functional deficit may develop. We tried to evaluate the need for two patent forearm arteries using rheological, Doppler sonographical and clinical parameters. Twenty-seven patients were examined after arterial and/or nerve injury in the forearm as well as six patients in whom a forearm flap was harvested. In seventeen patients both arteries were patent after primary reconstruction. Nine patients showed only one patent artery, while in the six patients with a forearm flap the radial artery was reconstructed in only one case. We found a decreased skin temperature in cases with artery and nerve injury. If both structures were reconstructed, the difference was not significant. The pressure of the finger collateral arteries and of the forearm arteries as well as the rheological investigation did not show any difference. The two-point discrimination, reflecting the nerve regeneration, was not affected, if one or two arteries had been reconstructed. Pain following exercise rarely occurred if both arteries of the forearm were patent. Because of the positive effect on skin temperature and of the reduced pain following exercise, reconstruction of both forearm arteries should be considered. Furthermore, the possibility of a subsequent arterial injury has to be taken into account.

Adolescent↗

PubMed1987

Surgical anatomy of the mimic muscle system and the facial nerve: importance for reconstructive and aesthetic surgery.

Mimic muscles are arranged in four layers regarding their origins, and these four layers should be considered when muscle tissue is added or lifted. All mimic muscles are built up by parallel fibers. Mean values of length, width, and thickness of the three lip elevators have been determined. These data might be of importance when dealing with this muscle system, which appears rather different from all other muscles in the human. The individual muscles receive their innervating facial nerve branches from their deeper surface when they belong to the superficial (first, second, or third) layer and from outside when they lie in the deepest (fourth) layer. Nerve branches communicate at least four times before innervating their respective muscles.

Aged↗

PubMed1987

[Clinical and electroneurographic results following surgery of carpal tunnel syndrome].

The surgical treatment of carpal tunnel syndrome is successful in most cases. Sometimes, however, it is not possible to reach a satisfying result. In order to find out the reasons for failure, we examined 80 surgically treated patients. Clinical and electroneurographical parameters were observed. We could show, that the time of intervention and the age of the patient are responsible for the results. The skin incision has to be planned carefully in order to avoid transection of the palmar cutaneous nerve. In cases of systemic diseases the patient has to be informed preoperatively about the possibility of incomplete recovery.

Carpal Tunnel Syndrome↗