Applause-induced ulnar artery thrombosis: a case report.
A case is described involving ulnar artery thrombosis attributed to vigorous applause. This is a previously unrecognized cause of ulnar artery thrombosis.
Adult↗
Biomedical subjects
G H Croll
Publications and source records attributed to G H Croll.
The use of demineralized bone powder in an onlay graft model.
Demineralized bone powder has been shown previously to successfully induce bone formation. The purpose of this study was to use demineralized bone powder in an onlay graft situation using implantable molds. Demineralized bone powder was placed within a mold and rigidly attached to the frontal bones of 30 New Zealand White rabbits by screw fixation. Periosteum was not closed over the mold. A control group had the mold placed without demineralized bone powder used. After 12 weeks of growth, the animals were sacrificed and the frontal bone was analyzed for bone growth using standardized histology and fluorescent microscopy. One hundred percent of the animals (30 of 30) that received demineralized bone powder underwent bone growth in the precise shape of the mold (p < 0.001). There was no new bone development in the control group (n = 8). Placement of larger molds duplicated these results (n = 20) with a 650 percent increase in frontal bone thickness within 12 weeks after placement of demineralized bone powder. This model mimics onlay bone grafting, and perhaps this technique may replace onlay grafting or alloplastic implantation in certain circumstances, avoiding the extra morbidity and donor-site defects associated with bone grafting.
Animals↗
Free fibular transfer in a growing individual (long-term results).
We present a case report of a 4-year-old in whom the distal fibula and epiphyseal plate had been traumatically destroyed. A free vascularized epiphyseal transfer using the ipsilateral proximal fibula was performed which provided good bony stability at the ankle, as well as excellent long-term growth characteristics. We demonstrate immediate postoperative results, as well as long-term (5 years) follow-up.
Bone Transplantation↗
An intraoperative stent for McIndoe vaginal construction.
We report an inexpensive, easy-to-apply vaginal stent for use in McIndoe vaginal reconstruction using Surgi-Stuf inserted in a sterile condom. This material's easy compressibility and good "memory" facilitate good apposition for the skin grafts while being easily placed into the depth of the new vaginal pocket.
Congenital Abnormalities↗
Computer-generated slide graphics: an exciting advancement or a problem?
Computer-generated slide graphics have significantly altered the face of audiovisual presentations. However, it remains to be determined if dramatic effects enhance presentation clarity and increase information retrieval. This study compared color combination and print type graphics. Ninety medical students were shown a 29-minute, 45-slide presentation addressing aspects of plastic surgery. Each slide represented one of 15 color combinations and one of 3 fonts. The students studied each slide for 10 seconds and then in 25 seconds recorded all information they could recall. Statistical analysis (using ANOVA) revealed a significant difference in information retrieval among slides and a significant interaction between color and font. The "best" was orange block print on a raspberry background. The "worst" was yellow cursive print on a black background. This study demonstrated that (1) color influences information gleaned from a slide presentation and (2) font type simplicity may result in improved retention.
Audiovisual Aids↗
Application of maxillofacial miniplating and microplating systems to the hand.
During the past several years, a profound change in our approach to bone stabilization in the hand has occurred. Today, standard management of almost any fracture requiring open reduction as well as most arthrodeses and osteotomies will incorporate rigid fixation employing one of the maxillofacial systems. Many of the early concerns, such as increased complexity of the procedure, the need for extensive periosteal stripping, bulkiness of the plates (with potential palpation, tenderness, and the impingement on tendon and joint motion), and the anticipated frequent need for removal, have been allayed. Thinner plates, the smallest screws from the miniplating systems, and the introduction of the microplating systems (Luhr and Synthes) have obviated much of the anticipated difficulty with tendon gliding and have made the necessity for subsequent plate removal a rarity in our practice. The use of these systems allows much earlier mobilization postoperatively, reducing the incidence of joint stiffness and tendon adhesion. This paper discusses our series of 143 patients (average follow-up time over 18 months) and the application of miniplating and microplating systems for a variety of fractures, osteotomies, and arthrodeses in the hand.
Adolescent↗
Nipple reconstruction using the "inchworm" flap.
A new method of nipple reconstruction called the "inchworm" flap is described. The name comes from the manipulation method used to position the flap for nipple projection. Experience with over 50 patients and including 58 breasts has been reviewed. There was adequate followup for 36 breasts in which overall maintenance of projection was 78% for this technique. When used after submuscular expansion for breast reconstruction, maintenance of projection reached 89%. The technique of flap manipulation is described in detail. This flap appears to be a reliable method for obtaining moderate nipple projection, particularly in the submuscular expansion breast reconstruction cases. It is not recommended for use in TRAM flap cases.
Female↗
Follicular carcinoma with clear cell change arising in lingual thyroid.
A case of follicular carcinoma arising in the lingual thyroid of a 23-year-old woman is added to the 22 previous reports. The embryology and the clinical and pathologic differential diagnoses are discussed. Histologic criteria useful in diagnosing follicular malignancy in this area include local and vascular invasiveness, hypercellularity, mitotic activity, and necrosis. The use of the immunohistochemical marker thyroglobulin and electron microscopy are described for the first time and confirm a thyroid follicular cell origin.
Adenocarcinoma↗
A comparison of irrigation solutions for microanastomoses.
A comparative study of irrigating solutions that contained various clot-active substances and/or vasodilating substances was done using a crush injury model of the rat's femoral artery. A routine microanastomosis was done with one of seven irrigation solutions employed in the study. The patency rate of lactated Ringer's solution (10%) (the control solution) was compared with solutions of heparin (35%) urokinase (50%), phentolamine (35%) tissue plasminogen activator (tPA) (15%), a combination of urokinase, heparin, and phentolamine (55%), and a combination of tPA, heparin, and phentolamine (42.5%). Statistically significant improvement in patency rates were obtained with heparin (p less than 0.0005), phentolamine (p less than 0.03), urokinase (p less than 0.001), the tPA, heparin and phentolamine combination (p less than 0.001), and the urokinase, heparin, and phentolamine combination (p less than 0.0001). There seems to be a benefit with the addition of either vasoactive agents or clot-active agents to the microvascular irrigating solution during construction of a compromised microanastomosis.
Anastomosis, Surgical↗
A critical look at capsule contracture in subglandular versus subpectoral mammary augmentation.
A critical comparison of the contracture rate in subglandular versus subpectoral augmentations was done in a personal series (senior author's) of 100 consecutive augmentation patients, 50 with subglandular augmentation and 50 with subpectoral augmentation. The average followup for the series was 27 months. Baker's classification of capsule contracture was utilized. Overall contracture rate in the subglandular group was 58% (29 of 50 patients) while in the subpectoral group it was 22% (11 of 50 patients), p less than 0.0002. Considering only the more severe contractures (Baker III & IV), the subglandular patients had 48% (24/50) while the subpectoral patients had 14% (7/50), p less than 0.0002. Comparing the more severe contractures in individual breasts, the subglandular group had 41% and the subpectoral group had 8%, p less than 0.0001. We conclude that in this personal series of patients, subpectoral placement of the prosthesis has significantly reduced but not eliminated the occurrence of capsule contracture without sacrificing a normal breast appearance.
Adult↗