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Biomedical subjects

H H Orenstein

Publications and source records attributed to H H Orenstein.

11 recordsLinked to original sources
PubMed2000

Restoration of elbow flexion after brachial plexus injury: the role of nerve and muscle transfers.

Brachial plexus trauma results in a variable loss of upper extremity function. The restoration of this function requires elbow flexion of adequate strength and range of motion. A proper evaluation of brachial plexus lesions is a prerequisite to any reconstructive procedure, and appropriate guidelines are presented. One option for restoring elbow flexion is a nerve transfer. The best results with this procedure are obtained in young patients treated within 6 months of injury. Another option is a free or pedicled muscle transfer, which should be considered in older patients or patients treated more than 6 months after an injury. Muscle transfers may also be used to augment the results of nerve transfer procedures. Choices and clinical results of donor nerves and muscle for transfer are discussed, and an algorithm for treatment is presented.

Accessory Nerve↗
PubMed1999

Mersilene suture as a vehicle for delivery of growth factors in tendon repair.

Extensive clinical and laboratory studies have demonstrated that growth factors accelerate and modulate the wound-healing process. The purpose of this experiment was to apply the principles of growth factor-enhanced wound healing to an in vitro rat tendon model. A method was developed for covalently binding a biologically active peptide to nonabsorbable braided polyester suture (Mersilene). Sutures were treated with various growth factors, which included epidermal growth factor, platelet-derived growth factor, and keratinocyte growth factor, and bovine serum albumin was the control. Spectrophotometric assessment was used to verify the peptide's activity. The suture was subsequently placed through individual harvested rat flexor tendons, which were arranged in standard tissue culture conditions. Markedly increased cellular proliferation along the suture was appreciated on the tendons treated with epidermal growth factor-bound suture. Platelet-derived growth factor was shown to have a lesser effect, whereas keratinocyte growth factor had no visible effect on cellular proliferation. This preliminary study describes a new technique of binding growth factors to suture. It also demonstrates that the presence of growth factors may help facilitate flexor tendon healing and allow early postoperative rehabilitation to decrease adhesion formation.

Animals↗
PubMed1996

The effect of a muscle wrap on nerve healing in a rat model.

Sixty Sprague-Dawley rats were studied to determine if peripheral nerve healing could be enhanced by translocation of an injured segment of sciatic nerve from an interfascial to an intramuscular environment. Group 1 (n = 12) were unoperated controls; Group 2 (n = 12) were sham-operated; Group 3 (n = 12) sustained an acute, double-crush injury to the sciatic nerve; and Group 4 (n = 12) sustained the same acute, double-crush injury as in Group 3, but the injured segment of nerve was transposed intramuscularly. All animals had sciatic function indices (SFI) computed at weekly intervals. At 2 weeks, Group 4 appeared to have improved gait function (SFI), compared to Group 3 (-39.7 vs. -56.4, p < 0.08). The experiment was repeated for Groups 3 and 4 using two groups of six additional rats each. The data were collected three times for each rat in the second experiment. No statistically significant differences in return of gait function or in nerve conduction evaluation could be demonstrated between the two study groups. From the results of this study, it appears that an intramuscular location does not enhance nerve recovery, compared to an interfascial location.

Animals↗
PubMed1996

Idiopathic midline granuloma--current classification and management controversies.

Midline granuloma is a mutilating process produced by a number of diseases that progressively destroy the nose, paranasal sinuses, and palate. Infectious, neoplastic, and idiopathic forms of this disease have been described. The specific diagnoses must be ascertained, as the treatment is different depending on the etiology of the disease. Radiation therapy is the treatment of choice for idiopathic midline destructive disease, while cytoxan is appropriate for Wegener's granulomatosis, polymorphic reticulosis, and primary nasal lymphomas. When the diagnosis is uncertain, the least-toxic therapy should be used. If the treatment is failing, an alternate therapy should be tried. This article reviews the history of idiopathic midline granuloma, describes the current classification of the disease, and discusses controversial issues demonstrated by two patient presentations.

Adult↗
PubMed1993

Soft tissue coverage for the upper extremity.

Soft tissue coverage of the upper extremity continues to be a challenging and evolving field. The expeditious and reliable methods of soft tissue coverage currently in use are discussed with reference to their shortcomings and advantages. For soft tissue coverage of fingertip injuries, open treatment or local flaps from the hand remain the mainstay of treatment. For dorsal and volar hand defects, distal axial flaps, such as the groin flap or microvascular tissue transfer, are utilized most commonly. For large defects proximal to the wrist, trunk axial pattern flaps, microvascular transfer, or the radial forearm flap have the greatest utility. Finally, technical points necessary for the success of some of the flaps are discussed.

Arm↗
PubMed1984

Granular cell myoblastoma of the extrahepatic biliary system.

We have reported our experience with two cases of granular cell myoblastoma, bringing the total number of cases to 29. Granular cell myoblastoma of the extrahepatic biliary system is a rare benign tumor that affects black women predominantly. Both black men in this study had multiple lesions involving the skin and biliary system. Surgery is necessary for tissue diagnosis and curative resection. Tumors involving the common bile duct or common hepatic duct require wide local excision and bilioenteric anastomosis. The cause is uncertain, but present data indicate a neuroectoderm origin.

Adult↗
PubMedDate not supplied

Müllerian adenosarcoma of the uterus: literature review, case report, and ultrastructural observations.

This is a report of a transmission and scanning electron microscopic examination of a müllerian adenosarcoma. The neoplasm had the characteristic pattern of benign neoplastic glands with focal squamous metaplasia and a sarcomatous stroma. Ultrastructurally, both mesenchymal and epithelial elements were identified. The mesenchymal components were ultrastructurally identical to those present in endometrial stromal sarcomas, including active collagen synthesis. The epithelial component resembled bening endometrial glands, and there was significant secretory activity as evidenced by prominent cytoplasmic glycogen collections.

Adenocarcinoma↗