PubMed Health⌕ Search

Biomedical subjects

H Holmström

Publications and source records attributed to H Holmström.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Gastroenteritis in children. Peroral rehydration, intravenous fluid therapy and nutrition].

In pediatrics, oral rehydration treatment is increasingly used in the management of gastroenteritis, and based on third world experiences, it is becoming used also in hospitals in western countries. In this paper, the advantages, limitations and practical use of oral rehydration treatment are discussed. Clinical examination of dehydrated children is described, and guidelines are given for intravenous fluid treatment. Furthermore, the article reviews modern research on the nutritional management of gastroenteritis. The incidence of secondary lactose intolerance has been dramatically reduced in recent decades, and this necessitates some changes in our traditional nutritional therapy. Rest of the bowels, and removal of lactose from the diet are seldom justified.

Administration, Oral↗
PubMed1994

Midface prognathism in maxillonasal dysplasia (Binder's syndrome) determined by a theoretical midface ratio.

A theoretical midface ratio was determined from midface lengths and heights in straight lateral radiographs. Using regression analyses, the ratio was tested on 90 adults who did not have an aberrant anatomy of the maxilla. A linear relationship was found between the theoretical midface ratio and sella-nasion-point A (SNA), and the correlation was high (adjusted R2 = 82.7%). Limit values were determined using the theoretical midface ratio for the classifications of retrognathia, orthognathia, and prognathia. Conditional probabilities were estimated for classifications according to SNA for every classification by the theoretical midface ratio. Eighty percent of the subjects were identically classified by SNA and the theoretical midface ratio, and no subjects were placed differently in the extreme groups of retrognathia and prognathia. The theoretical midface ratio was then used to estimate the degree of prognathism in 35 adults with maxillonasal dysplasia. Less than half of the subjects had maxillary retrognathia, and the majority had an orthognathic or even prognathic maxilla. This is an indication that individualization of treatment objectives, including the consideration of mandibular setback operations to correct incisor crossbites, is equally important in maxillonasal dysplasia and in normal anatomy.

Adolescent↗
PubMed1993

The use of preformed HTR polymer implants for chin augmentation. A preliminary report.

Ten patients with microgenia had their chins augmented with HTR polymer implants. The implants were inserted intraorally and fixed rigidly with a titanium screw. The postoperative course was uneventful except in one patient who had wound dehiscence and was resutured. This patient and all the others were clinically and radiographically stable at one year follow up.

Adult↗
PubMed1991

Two stage correction of the constricted ear. Case report.

A 3-year-old girl presented with a constricted ear (Tanzer type 2B) on the right. This was repaired in two stages: the helix was opened up and then, when she was 17 years old, the helical fold was reconstructed under local anaesthesia with a bipedicled tube flap from behind the ear. The cosmetic result was good, and the two ears were symmetrical.

Adolescent↗
PubMed1990

Reduction mammaplasty with a sliding nipple technique.

Ninety-four consecutive patients (19 who underwent mastopexy, and 75 who underwent reduction mammaplasty) were reviewed. They had all been operated on using a sliding manoeuvre for transfer of the nipple-areola complex on its underlying parenchyma, which has been in use for reduction mammaplasty in our unit since 1978. This makes it possible to slide the nipple-areola complex on the glandular tissue by making incisions in the de-epithelialised dermal zone on both sides of the areola, and leaving a dermal bridge above. The technique increases the mobility of the nipple-areola complex without jeopardising the blood supply, and is a combination of horizontal and superior pedicle techniques. The patients had been followed up for three to six months, except for five who had been followed up for five to six years. Minor early complications occurred in two patients. The sliding nipple technique is applicable to most types of mammary ptosis and hypertrophy, except those with a sclerotic and stiff parenchyma.

Adolescent↗
PubMed1989

Capsular contracture after breast reconstruction with the lateral thoracodorsal flap.

Early postoperative manipulation of breast implants in patients who underwent breast reconstruction utilizing a lateral thoracodorsal flap is described. This manipulation did not reduce the rate of firm capsular contracture after the reconstruction with the flap, but only postponed its development. Open capsulotomies, however, yielded stationary soft breasts to a statistically significant extent. The patient's acceptance of the reconstructed breast as a natural part of her own body was high. It was not influenced by the occurrence of firm capsular contracture.

Adult↗
PubMed1988

The step technique for the reconstruction of lower lip defects after cancer resection. A follow-up study of 165 cases.

One hundred and sixty-five patients with localized cancer of the lower lip were excised and reconstructed over a 25-year period using Bengt Johanson's step technique. Eight-eight percent of the tumors were less than 2 cm in size and 65% were of high histopathological differentiation. Fifty-six percent were reconstructed with bilateral step flaps. Nine local recurrences appeared in 5 patients, none of whom died of lip cancer. Eight patients later developed regional metastases and 3 of these patients died of lip cancer. The 5-year survival rate was 98%. The step technique is recommended for reconstruction of lip defects of up to 2/3 of the lower lip and may, in larger resections, be combined with either a fan flap or an Estlander flap. The outstanding functional results are due to the use of adjacent tissue for the reconstruction which preserves the normal arrangement of muscles, vessels and nerves.

Adult↗
PubMed1988

Surgical approach in severe cases of maxillonasal dysplasia (Binder's syndrome).

Binder's syndrome or maxillonasal dysplasia is a malformation characterized by an extremely flat and retruded nose. Severe cases of the syndrome do also have a retrognatic maxilla often combined with an open bite deformity which demands a combined surgical solution with both maxillary osteotomy and secondary nose correction. The two-stage surgical procedure in the advanced cases of maxillonasal dysplasia has in our opinion been preferable to a Le Fort II osteotomy. Two cases with severe Binder's syndrome where the two-stage procedure has been performed will be presented and the surgical approach discussed.

Adolescent↗
PubMed1987

Prognosis for localized cutaneous melanoma treated with wide excision only, with special reference to development of regional node metastases.

A consecutive series of 564 patients with localized (Stage I) melanoma treated by wide excision only were followed for at least 5 years. The median tumor thickness was 1.50 mm, and 30% were ulcerated. The female/male ratio was 54/46. The overall survival rates were 80% at 5 years and 73% at 10 years. The survival rates were statistically significantly better for females, even when tumor thickness and ulceration were taken into consideration. Twenty percent developed regional node metastases after an average remission period of 13 months. The actuarial survival rates after node dissection were 32% at 5 years and 27% at 10 years. A subgroup with an exceptionally poor prognosis and a high rate of regional node dissemination was looked for. Only 26% of the intermediate thickness group (1.50-3.99 mm, Breslow) developed nodal metastasis, whereas patients with thick lesions (greater than 4 mm) had a metastasis rate of 43%. Patients with thick lesions may therefore benefit more from elective node dissection than patients with lesions of intermediate thickness. Patient characteristics, e.g., sex and tumor characteristics (ulceration), may prove to be of importance in a prospective trial on elective node dissection.

Female↗
PubMed1987

The Abbe island flap for the correction of whistle deformity.

An Abbe flap with the skin removed was used in four cases of whistle deformity after bilateral clefts. The Abbe flaps were converted into island flaps by incising the mucosa all around the pedicle. The results obtained were considered to be superior to those obtained by using neighbouring tissues from the upper lip as more bulk was supplied as well as a perfect lining for the reconstruction of the tubercle of the upper lip vermilion. The balance between the lips was improved. The technique is recommended for patients with severe shortage of vermilion in the midline.

Adolescent↗
PubMed1986

The lateral thoracodorsal flap in breast reconstruction.

A fasciocutaneous transposition flap, the lateral thoracodorsal flap, has been used in 114 cases of breast reconstruction. This flap is raised from the lateral and dorsal aspects of the thoracic wall at the level of the submammary crease, and the size may be varied from 12 to 22 cm in length and 6 to 12 cm in width. The lateral thoracodorsal flap is used with an implant and forms the lateral part of the reconstructed breast. A natural ptotic breast shape is achieved in a single-stage procedure. Complications such as partial necrosis and infection have occurred in 3.5 and 2.5 percent of cases, respectively. The procedure is simple and has at our unit largely replaced the use of the latissimus dorsi musculocutaneous flap in extensive postmastectomy defects. In less disfiguring defects, the lateral thoracodorsal flap has taken the place of direct implantation because the reconstructed breast obtains a more pleasing shape by augmentation of the lower lateral pole.

Adult↗
PubMed1986

Clinical and pathologic features of maxillonasal dysplasia (Binder's syndrome): significance of the prenasal fossa on etiology.

Clinical and pathologic anatomic parameters were studied in 50 patients with maxillonasal dysplasia (Binder's syndrome). The skeletal deformity causing the flat and low-set nose was in typical patients a palpable depression in the anterior nasal floor (fossa prenasalis) and a localized maxillary hypoplasia in the alar base region. Class III malocclusion was found in 54 percent. In 6 percent of the patients a slope (sulcus prenasalis) was found instead of a fossa in the anterior nasal floor, and in one patient a rudimentary fossa was found. Concomitant malformations were noted in 18 percent, and a hereditary connection was seen in 16 percent. The etiology is discussed in relation to the development of the premaxilla and the appearance of a secondary external trabecular network of bone in the canine region. An inhibition of the latter ossification center would explain the localized hypoplasia in the floor and walls of the piriform aperture in maxillonasal dysplasia.

Abnormalities, Multiple↗
PubMed1986

Absent latissimus dorsi muscle and anhidrotic axilla in Poland's syndrome. Case report.

The case of an 18-year-old female with absence of the right breast, sternocostal part of the major pectoral muscle and total absence of the minor pectoral muscle and the latissimus dorsi muscle, is presented. She also had decreased sweating capacity and absence of terminal hairs in the central part of her right axilla. Histological examination of skin specimens from this area of the axilla demonstrated hypoplasia of the apocrine sweat glands, but normal eccrine sweat glands, indicating an apocrine dependent axillary sweating function. The breast was constructed using a direct subcutaneous prosthesis implant, giving a final result that was good in regard to shape and softness. This provides grounds for reconsidering the use of the latissimus dorsi muscle flap in breast constructions in Poland's syndrome.

Adolescent↗
PubMed1986

The Abbe flap converted to an island flap.

A modification of the Abbe flap is described. The pedicle is cut all around the vermilion leaving only a muscle cuff with the nutrient labial vessels. This increases the flexibility of the Abbe flap without reducing its viability. The division of the pedicle is a simplified procedure. The technique has been used on ten patients.

Adolescent↗
PubMed1986

Anterior levator resection in congenital genuine blepharoptosis. A follow-up of 55 operated eyelids.

Fifty-five eyelids operated on for congenital blepharoptosis over a 10-year period were followed up, with a mean observation time of seven years. Ptosis was on the right side in 12 patients, the left side in 20, and bilateral in 12. Ptosis was regarded as being slight in 32 eyelids, moderate in 10 and severe in 14. The operative procedure was resection of the levator muscle and its aponeurosis through an anterior approach. Fifty-five percent of the patients with slight ptosis were improved, with the eyelid having a normal position. All the patients with moderate ptosis were improved--half to a normal eyelid position, and half with a residual slight ptosis. All but one patient with severe ptosis were improved, and half of these to a normal eyelid position. It is concluded that this operation can be used for all types of congenital ptosis, and especially in severe cases, where it produces better results than e.g. the frontalis sling procedure.

Adolescent↗