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Biomedical subjects

H I Friedman

Publications and source records attributed to H I Friedman.

At least 19 recordsLinked to original sources
PubMed1992

Craniofacial screening profile: quick screening for congenital malformations.

The correct identification of syndromes and other congenital malformations at an early age is critical for the child, family and care providers. Most specialists who conduct large screenings of young children are not adequately trained to recognize signs and symptoms that should lead to appropriate referral to the clinical geneticist and/or diagnostic team. A systematic approach for recognizing important signs is presented here; a Craniofacial Screening Profile. Following a brief training program, the Profile was validated by 39 speech-language pathologists in screening 3,539 kindergarten and first grade children. The results were excellent (specificity was 99.6%), demonstrating that with limited training, specialists can effectively screen for important signs and symptoms of a major group of syndromes and other congenital malformations.

Child↗
PubMed1992

The tarsal pillar technique for narrowing and maintenance of the interpalpebral fissure.

We describe a tarsorrhaphy technique whereby an ipsilateral upper-eyelid tarsal pillar is sutured to a corresponding lower-eyelid recipient site. This technique allows maintenance of a narrowed interpalpebral fissure indefinitely, yet is easy to reverse without incurring lid-margin damage. Additionally, the procedure can be adjusted postoperatively to either narrow or widen the initial surgical result. We report our combined surgical experience in 35 consecutive procedures using this technique to treat eyes with exposure-related keratopathy of varied etiology, including facial nerve palsies, combined facial nerve palsy and trigeminal neuropathy with an anesthetic cornea, Graves' disease, congenital craniofacial anomalies, and severe keratitis sicca syndrome. The procedure was successful in improving exposure keratopathy symptoms in all 35 cases. Complications, reflecting the authors' learning curve with this new procedure, included intermarginal pyogenic granulomas, stretching of the tarsal pillar, minor lower-eyelid-margin eversion, and tarsal pillar dehiscence.

Adolescent↗
PubMed1992

Augmentation of the failed pharyngeal flap.

Pharyngeal flaps are frequently used with good results to eliminate hypernasality and/or nasal escape. In a small percentage of patients, however, cicatricial contracture of the flap occurs to such a degree that velopharyngeal incompetence returns. The authors have devised a method of augmenting the scarred flap with small, superiorly based flaps lateral and adjacent to the original flap. Four cases are presented in which speech analysis was conducted prior to the procedure and then for 9 to 24 months postoperatively. The postoperative speech results are all within normal limits.

Child↗
PubMed1991

Symbolic representation of cleft lip and palate.

Since the introduction of symbolic representations of cleft lip and palate anomalies in 1964, they have served the clinician as a quick and easy method of recording these disorders. This paper reviews the evolution of the schematic classification systems and evaluates them. It then presents a new scheme that synthesizes what the authors feel are the most advanced of the existing symbolic representations. This proposed new symbolic representation scheme also specifically provides for ratings of severity (including the documentation of microforms) and facilitates computerized data storage and analysis.

Cleft Lip↗
PubMed1990

Evaluation of porous polyethylene for external ear reconstruction.

Autogenous rib cartilage and silicone rubber are materials currently used for ear reconstruction. Increased morbidity and operative time with rib cartilage grafts and a high rate of extrusion with silicone implants render them less than ideal for reconstruction of the human ear. The purpose of the current investigation is to determine the efficacy of porous polyethylene as an alternative synthetic material for ear reconstruction. Porous polyethylene and silicone rubber discs of equal sizes in two thicknesses were implanted in lieu of the cartilage in the external ear of eight baboons. Histological evaluation of the sites after nine weeks revealed excellent anchorage of the thin porous polyethylene implants (1.5 mm) in the surrounding tissues. Silicone rubber implants, however, were encapsulated in a thickened granulation tissue capsule. When thicker implants (3.0 mm) were used, exposure or extrusion occurred in all cases. Porous polyethylene implants demonstrated only partial exposure; half of the silicone rubber implants were extruded; and the other two silicone rubber implants were almost completely extruded. Porous polyethylene was thus better incorporated into the soft tissues than silicone rubber as long as the overlying soft tissues were not stressed by an oversized implant or inadequate soft tissue coverage.

Animals↗
PubMed1990

Audiologic management of bilateral external auditory canal atresia with the bone conducting implantable hearing device.

The hearing impairment associated with congenital external auditory canal atresia has been managed with early bone conduction hearing aid placement and surgical reconstruction in selected patients. However, many patients do not wear a bone conduction hearing aid because of physical or social considerations and surgical reconstruction of the external auditory canal and middle ear may be difficult or contraindicated. This report details the use of implantable bone conducting hearing devices in five children with bilateral external auditory canal atresia. Each patient had bilateral conductive hearing impairment with normal bone conduction thresholds. Four of the five patients had associated craniofacial anomalies including three cases of microtia. The average preoperative sound field speech reception threshold improved from 63 dB to 13 dB with the implant. Patients experienced a definite preference for the implanted hearing device over the bone conduction hearing aid.

Adolescent↗
PubMed1986

Antimicrobial treatment of minor soft tissue lacerations: a critical review.

This article is a collective review of all the prospective clinical studies that assessed the therapeutic value of antibiotics in minor soft tissue lacerations. This review critically evaluates each study that tests the hypothesis that antibiotic treatment reduces the incidence of infection. Even though the design of each of the studies was scientifically inadequate, important factors were identified that influenced the incidence of infection. On the basis of this collective review as well as other studies, indications for antibiotic therapy of minor soft tissue lacerations have been identified. Future clinical studies must be designed to test more precisely the validity of these recommendations.

Adult↗
PubMed1985

Prognostic and therapeutic use of microstaging of cutaneous squamous cell carcinoma of the trunk and extremities.

Cutaneous squamous cell carcinomas (SCC) arising in actinically damaged skin, unassociated with chronic inflammation or injury, are generally regarded as nonaggressive lesions. These tumors occasionally recur or metastasize, however, as do de novo SCC. The authors reviewed 63 patients with cutaneous SCC of the trunk or extremities, excluding lesions that developed in known high risk settings, in order to explore the potential of histologic microstaging as a prognostic indicator. Fifty-four patients (86%) were free of recurrence following primary surgical therapy. Nine patients (14%) had either local recurrence or metastases; five of these (8% of the entire series) died of their tumors. Tumor behavior correlated best with the level of dermal invasion and the vertical tumor thickness. All tumors that recurred were 4 mm or more thick and involved the deep half of the dermis or deeper structures. All tumors that proved fatal were at least 10 mm in maximum thickness, and the four lethal lesions that could be evaluated for level of invasion extended into subcutaneous tissue or deeper structures. The thickness and level of invasion of cutaneous SCC appear to represent important prognostic factors and may be relevant indicators for wide field resection and/or elective lymph node dissection.

Adult↗
PubMed1979

The ultrastructural changes of prostate adenocarcinoma following external beam radiation therapy.

Ultrastructural studies were done to determine the effects of radiation therapy on prostatic adenocarcinoma. Twenty patients were included in the study: 6 with benign hyperplasia, 4 with untreated adenocarcinoma and 10 with adenocarcinoma who had received radiation therapy. Benign and malignant ultrastructural characteristics were established. On the basis of these characteristics 6 of the 10 radiated prostates were believed to have tumor cells present after therapy. Of the remaining 4 patients 3 had ultrastructural changes suggesting radiation effects and a possibly altered malignant potential.

Adenocarcinoma↗
PubMed1979

Primary herpetic gingivostomatitis accompanying lesions on fingers: report of case.

A case is presented of primary herpetic gingivostomatitis with herpes simplex virus infection involving the right thumb and little finger of an 18-year-old white man. The lesions all started at the same time. The disease was allowed to run its course except for symptomatic treatment. The diagnosis was made both from clinical signs and laboratory isolation of the virus.

Adolescent↗
PubMed1978

Alterations in intestinal structure, fat absorption and body weight after intestinal bypass for morbid obesity.

Eleven patients underwent jejunoileal bypass for morbid obesity. Serial intestinal biopsies were obtained prior to, and at timed intervals following, operation in both fasted and fat-fed states. Villus height increased asymptotically, reaching a plateau one year after operation, with an increase of 80 per cent in mean villus length. The postbypass body weight reached a plateau at 63.9 per cent of initial body weight and correlated linearly with villus height following an asymptotic curvilinear course. The time required to attain 90 per cent of total body weight loss was 15.9 months. A study of intestinal fat absorption at both the light microscopic and ultrastructural levels showed that the enlarged villi are lined along the entire villus by functionally mature epithelium capable of transporting lipid. Villus hypertrophy is an important mechanism in the plateauing of weight loss after jejunoileal bypass for morbid obesity.

Body Weight↗
PubMed1978

Morphologic effects following massive exchange transfusions with a stroma-free hemoglobin solution. I. Liver.

Hepatic morphology was studied in rats that were exchange transfused with either a stroma-free hemoglobin solution (SFHS) or with various asanguineous resuscitative fluids. The animals under-went 75 per cent blood volume replacement and tissues were collected and fixed at timed intervals after the exchange transfusion. In addition, blood volumes were determined, using chromium labeled red blood cells, in both albumin and SFHS-treated rats at varying time periods after exchange transfusion. One hour following exchange transfusion, livers of animals infused with asanguineous fluids demonstrated marked centrolobular hepatocellular vacuolization and mitochondrial shape alterations consistent with the effects of hypoxia. SFHS appeared to protect the liver from these early abnormalities. However, at later time intervals livers of albumin-treated animals appeared normal, whereas those of SFHS-transfused rats exhibited centrolobular necrosis. Blood volume was reduced approximately 10 per cent during the first 18 hours after exchange transfusion with albumin, while SFHS-treated rats experienced a 42 per cent blood volume decrement in only 6 hours. Blood volumes were near normal in all animals by 48 hours. These findings suggest that SFHS protects the liver from hypoxia immediately after exchange transfusion, presumably by its ability to transport and release oxygen. However, the eventual disappearance of hemoglobin from the intravascular space is associated with a marked reduction in blood volume which is accompanied by hepatic ischemia and centrolobular necrosis.

Animals↗
PubMed1977

Alterations in the endoplasmic reticulum and Golgi complex of intestinal epithelial cells during fat absorption and after termination of this process: a morphological and morphometric study.

Earlier investigations of intestinal fat-absorption have stressed the importance of continued protein synthesis to provide membranes which are utilized for the intracellular transport of resynthesized lipid. The resulting membranes, when incorporated into the endoplasmic reticulum (ER) and Golgi complex, serve as vehicles for the movement of fat within the cell and for its release to the extracellular space. In the current study, attention was focused on the morphological changes in the ER and Golgi complex both during fat absorption and at successive time intervals after fat-absorption termination. Morphological interpretations were confirmed by morphometric analysis. This investigation supports the interpretation that during fat absorption, membrane synthesis by the rough endoplasmic reticulum (RER) is insufficient to accomodate membrane utilization and intraconversion, resulting in a decrease of both ER and Golgi complex components. However, following fat-absorption termination, and cell is able to replace previously depleted components of the ER and Golgi complex and regain the full membrane complement of the fasted state. Replenishment of cellular membranes is postulated as resulting from a continued synthesis of new membranes by the RER which eventually exceeds membrane utilized during lipid transport.

Animals↗