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H Piza-Katzer

Publications and source records attributed to H Piza-Katzer.

At least 73 records · Page 4Linked to original sources
PubMed1999

The nerve of Henle: an anatomic and immunohistochemical study.

The topography of the nerve of Henle was reviewed. Fifty-two human cadaveric upper extremities were studied. In 30 (58%) the nerve was well defined; in 22 (42%) its origin from the ulnar nerve was unidentifiable. The palmar cutaneous branch of the ulnar nerve separated from the ulnar nerve 5 to 11 cm distal to the medial epicondyle of the humerus to divide into its terminal branches in the distal forearm. Four patterns were detected: ulnar, radioulnar, vessel-related, and radial. These shared a consistent vascular branch, which sent 2 branches to the ulnar artery just proximal to the distal ulnar tunnel. Using a tyrosine hydroxylase antibody-based immunohistochemistry technique the nerve was shown to carry sympathetic fibers. Motor fibers were ruled out with Karnovsky's stain, which was used in combination with the tyrosine hydroxylase method in 10 specimens.

Adult↗
PubMed1998

[Case report of segmental neurofibromatosis of the 3rd finger ray].

We report on a 36-year-old woman suffering from a segmental neurofibromatosis solely confined to the third finger. Microscopically, the tumor showed mesenchymal tissue containing myxoid material with features of the nerve sheath--myxoid neurofibroma. The tumor was characterized by the peculiar tendency to grow in a multifocal pattern involving the distribution of every nerve of one finger, by an extreme proneness to local recurrences as well as by a concomitant bone defect.

Adult↗
PubMed1997

[Surgical therapy of pronounced gout tophi in both hands. Case report].

We report an 80-year-old male patient who had been suffering from gouty arthritis for the last seven years, both hands being deformed by multiple tophaceous deposits within soft tissue and bone. Immediate surgical therapy became inevitable when a ruptured tophus led to a severe infection of the right index finger. We describe the surgical procedure as well as the pathological findings and the clinical course.

Aged↗
PubMed1997

[Compression syndrome of the superficial fibular nerve. Case report].

The case of a female patient complaining of dysaesthesia and paraesthesia on the dorsum of her right foot and digits which failed to respond to conservative treatment is presented. 10 cm above the lateral malleolus, a muscle bulge of 2 cm was detected. Hoffmann-Tinel's sign was positive at this site. The diagnosis of nerve entrapment was confirmed by a conduction velocity block. Through an incision centered over the muscle bulge, the superficial fibular nerve was identified. It was found to be compressed by fascia. Fascial release and epineuriotomy resulted in complete recovery. Entrapment of the sensory superficial fibular nerve in the patient is thought to have been caused by prolonged work-related kneeling and squatting over many years.

Adult↗
PubMed1997

[Is transposition of the ulnar nerve in ulnar nerve sulcus syndrome really indicated?].

Anterior transposition of the ulnar nerve in cubital tunnel syndrome requires ligation of the segmental epineural vessels over 8 to 10 cm in order to free up and mobilize the nerve along its new course. As a result, the blood supply of ulnar nerves already compromised by entrapment is likely to be harmed even more. For the past three years we chose to perform simple decompression of the nerve with or without external/internal neurolysis on 33 patients (34 arms). After a follow-up time of six months to three years (mean 12 months), the outcome was evaluated by complete examination of hand function and by electrophysiologic studies. Four patients were excluded from the analysis due to short follow-up times. Four underwent decompression for mild entrapment symptoms, six for moderate symptoms, and 19 for severe symptoms. The functional outcome was rated as excellent in 26.7% (eight patients) and as good in 33.3% (ten patients). In group 3 (severe entrapment symptoms), seven patients (23.3%) showed moderate results and in four patients (13.3%) the outcome was poor. Considering that most of our patients had severe entrapment with advanced muscle atrophy, the overall outcome of decompression was satisfactory.

Adolescent↗
PubMed1997

[Significance of double crush in carpal tunnel syndrome].

From June 1992 to October 1995, 224 patients were operated on carpal tunnel syndrome. We treated 71 male and 153 female patients. During our investigations, we found that one third of the patients suffered from a double crush syndrome. 84% of the patients suffered from one or more predisposing accompanying diseases. In most of them (42%) we found rheumatic diseases, 19% diabetes mellitus, 8% hyperuricaemia, and 6% hypothyreosis. In 33%, we observed a very short history and a bilateral carpal tunnel syndrome. According to the preoperative tests, four different groups of patients regarding electrophysiological parameters and the graduation of thenar atrophy were differentiated. The fourth group was composed of patients with double crush syndrome, who continued to complain of considerable pain despite surgery, the operated hand remaining both weak and awkward in its movements. Inspired by the prospective study by Dellon (1992) and our results, we will perform a retrospective analysis of the longterm effect of carpal tunnel release in diabetic neuropathy.

Adult↗
PubMed1997

[Late functional outcome after reconstruction of the upper aerodigestive tract with free transplanted microvascular anastomosed jejunum].

Since 1983, 90 autologous jejunal transplantations for reconstruction of the upper digestive tract have been performed in 89 patients (9 females, 80 males, average age 56.3 years). 73 patients were operated primarily, in 16 patients a recurrent tumor had been treated. One patient received a second jejunal graft after necrosis. In these heterogenous patients, the primary tumor was located in the hypopharynx 48 times, in the larynx 21 times, in the oropharynx 19 times and twice in the oral cavity. There was nearly always tumor stage III or IV without distant metastases. Following locoregional tumor resection, speech restoration was achieved 35 times by a siphon-like tube, and the upper digestive tract was reconstructed using a patch 18 times and by a tube 28 times. A combination of tube or patch with a siphon-like tube was employed 9 times. In only two of 16 patients with recurrent tumor, speech reconstruction was performed, in the other 14, the upper digestive tract was reconstructed. In those patients, in whom speech reconstruction (by siphon tube or by combination with tube/patch) was intended, this was achieved in 81.5%. Successful functional reconstruction of the upper digestive tract (by patch, tube, combination) could be achieved in about 60% of these patients.

Adenocarcinoma↗
PubMed1996

Modifications of the paraspinous muscle flap: anatomy and clinical application.

Soft-tissue defects of the back, particularly involving the paravertebral tissues, are generally covered with myocutaneous, muscle, or fasciocutaneous flaps. The case of a 64-year-old man with a paravertebral malignant fibrous histiocytoma is reported. To ensure adequately radical margins, the ipsilateral trapezius and latissimus dorsi muscles as well as the costal periosteum and the spinous processes were resected between T9 and T12. The resulting defect was covered with a pedicled latissimus dorsi flap and an island flap of the paravertebral muscles. Prompted by this case, we studied the blood supply of the paravertebral muscles in 10 cadavers. The vasculature was visualized after flushing with colored latex and microsurgical dissection. Another 4 specimens were subjected to angiography and tomography. In the majority of cases (8 of 10), three perforators emerging from the intercostal arteries were identified. These were found to communicate in a longitudinal and vertical direction. Before piercing the fascia, they ramified in three layers matching the layers of the paravertebral muscles. Since the intercostal arteries were shown to communicate through anastomoses of adequate caliber, the paravertebral muscles appear to be useful candidates for proximally or distally pedicled transposition or island flaps.

Aged↗
PubMed1996

[Complications of endoscopic carpal tunnel operations].

This report is about four female patients admitted to our hospital because of pain, dysaesthesia and paraesthesia following endoscopic release of the carpal tunnel, who underwent revisional surgery. Intraoperatively, we found a partial lesion of the median nerve in two cases and an incomplete release of the ligament in the remaining two cases. The complete decompression and epineurotomy of the median nerve and a nerve graft in two patients resulted in clinical improvement.

Aged↗
PubMed1995

[Compartment syndrome. Frequently missed, with severe sequelae].

Experience and late results in patients with a compartment syndrome which was either missed or diagnosed too late are reported. In the case of 14 patients we were consulted after a delay of 24 h, in another three patients 48 h after the causative event. At that time the diseased extremity was severely swollen, blistered and extremely painful. Ten patients presented with loss of sensitivity; in eight the peripheral pulses were not palpable. CPK was elevated in nine patients (up to 30,000); in six patients CPK was not determined. Causative factors included vascular occlusion (n = 6), paravenous infusions or injections (n = 4), compression in heroin or alcohol abusers (n = 4) and infections secondary to i.m. injections, sepsis or snake bites (n = 4). One patient developed a compartment syndrome after the closure of a muscular hernia. The late results were sobering: eight limbs had to be amputated, another 13 showed muscle necrosis necessitating necrosectomy, and both transitory and persistent median, ulnar, radial and peroneal nerve damage was observed. Our experience shows that dermatofasciotomy should be done on a more generous scale, because it obviously prevents sequelae and because the late complications following inadequately treated compartment syndromes are grave.

Adolescent↗
PubMed1995

Quantification of functional deficits associated with rectus abdominis muscle flaps.

To evaluate the deficits in trunk flexion due to partial or complete unilateral rectus abdominis muscle flap transfer in reconstructive surgery, 27 patients (11 females, 16 males) with rectus abdominis muscle flap transfer dating back at least 3 years, clinically healthy at the time of testing, and 22 controls (10 females and 12 males), comparable in age and body mass index, were compared. For clinical assessment of power of the straight and oblique abdominal muscles, Janda's test of muscle function was used, and torque (in N.m) of isometric trunk flexion at 0, 5, 10, 20, and 30 degrees was determined with the TEF Modular Component, an auxiliary unit of the Cybex 6000. Results were analyzed for males and females separately. Relative torque (N.m/kg) of operated male and female patients was significantly lower (p < 0.05) as compared with controls. Differences were more pronounced in males than in females. Clinically, there were no significant between-group differences in the power of the straight and oblique abdominal muscles. In conclusion, trunk flexion deficits following rectus abdominis muscle flap transfer can be compensated for satisfactorily in most cases, supporting the use of this muscle in reconstructive surgery, if patients are selected carefully.

Abdominal Muscles↗
PubMed1995

[Branchiogenic anomalies (with special reference to severe and complicated outcome)].

Lateral cervical fistulae are usually described as examples for inborn branchiogenic anomalies. They result from evolutionary disorders of the first and second branchiogenic arch. Four patients were seen with cervical fistulae, three of those having a recurrence after surgical treatment. After a short review of the evolution and the topographic anatomy of such cysts and ducts, four patients are presented with all the details regarding their partially very complicated history.

Adult↗
PubMed1995

[Experiences in the treatment of far advanced primary breast cancers, extensive tumor recurrences and radiation damage (reflections on on the value of surgical therapy)].

Ulcerating primary breast cancer, local recurrence with extension to the thoracic wall and skin and ulceration after radiation therapy, sometimes with malignant degeneration, call for interdisciplinary evaluation and treatment. For the benefit of the patient an effective cooperation of the involved specialties seems desirable at an early stage of management. We performed breast tumor resection and immediate coverage of the defect in 25 patients (median age 54 years). In choosing the reconstruction procedure great attention was paid to short hospitalization and the possibility of commencing cytostatic or radiation therapy as soon as possible. We are able in all cases to resect the open and partly infected, ulcerated and bleeding tumors and to close the defects completely by means of various flaps. Among the many flaps at our disposal to reconstruct the thoracic well defects, we prefer the cranial based, ipsi- or contralateral extended rectus abdominis flap.

Aged↗
PubMed1995

Videoradiography of free jejunal grafts for rehabilitation of speech in laryngectomized patients.

In laryngectomized patients a tracheo-esophageal artificial fistula can be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographic examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspiration. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time during the examination, this was a sign of aspiration hazard. To avoid aspiration, the vertex of the speech siphon should be higher than the level of the hypopharyngeal anastomosis.

Anastomosis, Surgical↗
PubMed1995

[Functional deficits following transfer of rectus abdominis muscle].

Functional deficits after raising of a rectus abdominis muscle flap in reconstructive surgery were evaluated retrospectively in 27 patients (11 female, 16 male) and compared to 22 healthy control individuals. To test the torque of trunk flexion, the Cybex 6000 (TEF modular component) was used and subjects tested in a defined position allowing isolated sagittal flexion. For the rectus and oblique abdominal muscles, the Janda muscle function test was applied. For comparison of patients and controls, the Man and Whitney test was applied, and subgroup analyses were performed for men and women, respectively. The peak torque (relative to bodyweight) was significantly lower in patients as compared to controls, the differences being greater in men than in women, whereas clinical examination did not reveal a significant difference between either group. After autologous transplantation of the rectus abdominis muscle flap, compensation is obviously restricted to a certain degree, although the remaining deficit does not seem to represent a handicap in normal life. Thus the use of rectus abdominis muscle flaps in reconstructive surgery may be beneficial for the patient, provided the indication is precise and long-term control is possible.

Adult↗
PubMed1994

Reconstructive surgery after hemilaryngectomy for recurrent thyroid cancer using a free jejunal patch-graft.

This case report describes the third recurrence of a poorly differentiated follicular thyroid carcinoma that led to destruction of the thyroid cartilage. Curative surgery required hemilaryngectomy. Because of three previous operations (including neck dissection) and repeated external radiation, the typical laryngoplastic procedures and muscle flaps were not applicable. We therefore employed a stretched jejunal patch to cover the defect so that the neoglottic slit rendered respiration and phonation possible. Thus this approach resulted in functional reconstruction and obviated the need for a tracheostoma. We conclude that the use of a jejunal transplant represents a viable alternative to local reconstruction, particularly in cases complicated by previous surgery and external radiation.

Adenocarcinoma, Follicular↗