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Biomedical subjects

Hildegunde Piza-Katzer

Publications and source records attributed to Hildegunde Piza-Katzer.

At least 19 recordsLinked to original sources
PubMed2006

Surgery for foreign body reactions due to injectable fillers.

BACKGROUND: An increasing number of soft tissue fillers have been introduced to the beauty market and these filler substances are widely used as non-toxic, non-immunogenic and relatively harmless injectable alternatives to surgical rejuvenation. Generally, facial fillers are injectable - or surgically insertable - products that are used to fill up the volume loss in the aging face. Depending on bioavailability, chemical composition and degradation, fillers can be classified as temporary or permanent, organic or inorganic and autologous or heterologous. OBJECTIVE: A plethora of new products has swamped the beauty market since face rejuvenation has become socially acceptable as well as affordable to a wider population, but adverse reactions cannot be excluded. We present 4 patients with complications after injection of facial fillers [including Artecoll(polymethylmethacrylate microspheres), Restylane (hyaluronic acid), DermaLive (hyaluronic acid plus acrylic hydrogel particles) and Newfill (polylactic acid)] and surgical correction. RESULTS: Surgical intervention led to good aesthetic and functional results after multiple unsuccessful conservative therapies. CONCLUSION: We recommend that only physicians familiar with the injection techniques and the biological and chemical characteristics of the various injectable products should perform such interventions. Especially permanent fillers should be used with utmost reticence in cosmetic surgery and we would recommend their application only in reconstructive procedures. Additionally, documentation and reporting of all adverse effects must be mandatory.

Acrylates↗
PubMed2005

Gene therapy with adenovirus-mediated VEGF enhances skin flap prefabrication.

We investigated the feasibility in rats of enhancing skin-flap prefabrication with subdermal injections of adenovirus-encoding vascular endothelial growth factor (Ad-VEGF). The left saphenous vascular pedicle was used as a source for vascular induction. A peninsular abdominal flap (8 x 8 cm) was elevated as distally based, keeping the epigastric vessels intact on both sides. After the vascular pedicle was tacked underneath the abdominal flap, 34 rats were randomly divided into three groups according to treatment protocol. The implantation site around the pedicle was injected with Ad-VEGF in group I (n = 10), with adenovirus-encoding green fluorescent protein (Ad-GFP) in control group I (n = 14), and with saline in control group II (n = 10). All injections were given subdermally at four points around the implanted vessel by an individual blinded to the treatment protocol. The peninsular flap was sutured in its place, and 4 weeks later, an abdominal island flap based solely on the implanted vessels was elevated. The prefabricated island flap was sutured back, and flap viability was evaluated on day 7. Skin specimens were stained with hematoxylin and eosin for histological evaluation. In two rats from each group, microangiography was performed to visualize the vascularity of the prefabricated flaps. There was a significant increase in survival of prefabricated flaps in the Ad-VEGF group compared to the control groups: Ad-VEGF, 88.9 +/- 6.1% vs. Ad-GFP, 65.6 +/- 9.4% (P < 0.05) and saline, 56.0 +/- 3.4% (P < 0.05). Sections from four prefabricated flaps treated with Ad-GFP revealed multiple sites of shiny deposits of green fluorescent protein around the area of local administration 1 day and 3 weeks after gene therapy. Histological examination done under high-power magnification (x400) with a light microscope revealed increased vascularity and mild inflammation surrounding the implanted vessel in all groups. However, we were unable to demonstrate any significant quantitative difference with respect to vascularity and inflammatory infiltrates in prefabricated flaps treated with Ad-VEGF compared with controls. Microangiographic studies showed increased vascularity around the implanted pedicle, which was similar in all groups. However, vascularization was distributed in a larger area in the prefabricated flaps treated with Ad-VEGF. In this study, the authors demonstrated that adenovirus-mediated VEGF gene therapy increased the survival of prefabricated flaps, suggesting that it may allow prefabrication of larger flaps and have the potential to reduce the time required for flap maturation.

Adenoviridae↗
PubMed2005

Sciatic nerve enlargement in the Klippel-Trenaunay-Weber syndrome.

The case of a 35-year-old woman with Klippel-Trenaunay-Weber syndrome (KTWS) showing clinical symptoms of a peroneal nerve lesion is presented. An immense nerve enlargement along most of the sciatic, peroneal and tibial nerve was found to be due to a lipoma arising from the epi- and perineurium. Treatment consisted of extensive microsurgical neurolysis and excision of the tumor resulting in decompression of the affected nerves. Although rare, a perineural lipoma should be kept in mind in patients with KTWS showing neurological abnormalities.

Adult↗
PubMed2004

Professional satisfaction of women in surgery: results of a national study.

HYPOTHESIS: Individual, group, and organizational factors influence the professional satisfaction of women surgeons in Austria. DESIGN: Survey on professional and private issues sent out by mail in 2000 and 2001. SETTING: Women surgeons working in hospitals and/or in private practices and those who were retired or on maternity leave. PARTICIPANTS: All 351 Austrian women surgeons of all core surgical specialties (general, trauma, pediatric, plastic, thoracic, and cardiovascular), certified or in training, were addressed. MAIN OUTCOME MEASURES: Proportional odds regression models were used to correlate professional satisfaction with objectively measurable prognostic factors such as age, surgical subspecialty, status of training, type of hospital, location of work (federal states vs the capital), status of activity (active vs on maternity leave), profession of private partner, number of children, and subjectively assessed prognostic factors such as operative volume and departmental organization. RESULTS: The response rate was 58.7% (206/351). One hundred eighty-seven surgeons-active or on maternity leave-were included in the analysis. Higher satisfaction was reported by active surgeons in subspecialties, certified surgeons, comparatively younger and older surgeons, surgeons working in hospitals outside the capital, and surgeons with a physician as a partner. When entering subjectively assessed variables into the model, the quality of departmental organization and operative volume (P<.001), as well as the status of activity (P<.001), had the strongest effect. CONCLUSIONS: Women surgeons' professional satisfaction highly depends on departmental organization and status of activity. Inadequate leadership, low operative volume, and being on maternity leave have a negative effect on job satisfaction. Private factors seem to be of little influence. Optimal departmental organization would help women to reconcile their professional and their private lives.

Adult↗
PubMed2004

Secondary end-to-end repair of extensive facial nerve defects: surgical technique and postoperative functional results.

BACKGROUND: Repair of the transected facial nerve is imperative for restoration of muscle function, including the ability to produce appropriate facial expressions. Injury might involve the main trunk and its several branches. Restoration of function presupposes meticulous repair of all injured nerve branches. METHODS: Here we report three cases of secondary tension-free end-to-end coaptation of a transected trunk and branches of the facial nerve by removal of the superficial part of the parotid gland. RESULTS: Facial tone and symmetry at rest and motion were achieved. In two patients, a slight residual synkinesis is observed under stress. CONCLUSIONS: Direct end-to-end coaptation of the facial nerve and its branches by the technique described should be considered before deciding on grafts or rerouting procedures to deal with gaps of up to 15 mm. This technique is not recommended in the presence of infection and nerve defects. Intensive postoperative physiotherapy is required for optimal results.

Adolescent↗
PubMed2004

Free anteromedial thigh flap: clinical application and review of literature.

The anteromedial thigh (AMT) flap is reviewed in terms of its vascular anatomy and previous clinical reports in the literature. Our own series of 5 patients treated with this flap for defects in the head and neck region and lower extremity is presented. Although several authors controversially discussed vasculature, we constantly found the pedicle as an emerging septocutaneous perforator at a point where the medial border of the rectus femoris muscle is crossed by the sartorius muscle. In all 5 patients, the AMT flap provided stable coverage with no flap loss. Based on our findings, we conclude that the anteromedial thigh flap offers all the advantages of fasciocutaneous flaps. Therefore, we recommend this flap as an alternative for defects requiring coverages of thin to moderate skin thickness. However, it should be remembered that variations in vascular anatomy are possible.

Aged↗
PubMed2004

Adenovirus-mediated transforming growth factor-beta ameliorates ischemic necrosis of epigastric skin flaps in a rat model.

BACKGROUND: Gene therapy has been recently introduced as a novel approach to treat ischemic tissues by using the angiogenic potential of certain growth factors. We investigated the effect of adenovirus-mediated gene therapy with transforming growth factor-beta (TGF-beta) delivered into the subdermal space to treat ischemically challenged epigastric skin flaps in a rat model. MATERIAL AND METHODS: A pilot study was conducted in a group of 5 animals pretreated with Ad-GFP and expression of green fluorescent protein in the skin flap sections was demonstrated under fluorescence microscopy at 2, 4, and 7 days after the treatment, indicating a successful transfection of the skin flaps following subdermal gene therapy. Next, 30 male Sprague Dawley rats were divided into 3 groups of 10 rats each. An epigastric skin flap model, based solely on the right inferior epigastric vessels, was used as the model in this study. Rats received subdermal injections of adenovirus encoding TGF-beta (Ad-TGF-beta) or green fluorescent protein (Ad-GFP) as treatment control. The third group (n = 10) received saline and served as a control group. A flap measuring 8 x 8 cm was outlined on the abdominal skin extending from the xiphoid process proximally and the pubic region distally, to the anterior axillary lines bilaterally. Just prior to flap elevation, the injections were given subdermally in the left upper corner of the flap. The flap was then sutured back to its bed. Flap viability was evaluated seven days after the initial operation. Digital images of the epigastric flaps were taken and areas of necrotic zones relative to total flap surface area were measured and expressed as percentages by using a software program. RESULTS: There was a significant increase in mean percent surviving area between the Ad-TGF-beta group and the two other control groups (P < 0.05). (Ad-TGF-beta: 90.3 +/- 4.0% versus Ad-GFP: 82.2 +/- 8.7% and saline group: 82.6 +/- 4.3%.) CONCLUSIONS: In this study, the authors were able to demonstrate that adenovirus-mediated gene therapy using TGF-beta ameliorated ischemic necrosis in an epigastric skin flap model, as confirmed by significant reduction in the necrotic zones of the flap. The results of this study raise the possibility of using adenovirus-mediated TGF-beta gene therapy to promote perfusion in random portion of skin flaps, especially in high-risk patients.

Adenoviridae↗
PubMed2004

Microsurgical repair of the sural nerve after nerve biopsy to avoid associated sensory morbidity: a preliminary report.

OBJECTIVE: The purpose of this article is to report our preliminary results regarding microsurgical repair of the sural nerve after nerve biopsy, in an attempt to reduce the well-described sensory morbidity and neuroma formation. METHODS: Three patients with a suspected diagnosis of peripheral neuropathy underwent sural nerve biopsies to establish definitive diagnoses. A 10-mm segment of the sural nerve was resected with local anesthesia. After harvesting of the specimen, the proximal and distal nerve stumps were carefully mobilized and united with epineural suture techniques, under a surgical microscope. Sensory evaluations (assessing the presence of hypesthesia/dysesthesia or pain) of the lateral aspect of the foot, in regions designated Areas 1, 2, and 3, were performed before and 6 and 12 months after the biopsies. A visual analog scale was used for pain estimation. RESULTS: The biopsy material was sufficient for histopathological examinations in all cases, leading to conclusive diagnoses (vasculitis in two cases and amyloidosis in one case). The early post-biopsy hypesthesia, which was present for 4 to 8 weeks, improved to preoperative levels as early as 6 months after the nerve repair. Sensory evaluations performed at 6- and 12-month follow-up times demonstrated that none of the patients complained of pain at the biopsy site or distally in the area innervated by the sural nerve. Ultrasonography performed at the 12-month follow-up examination revealed normal sural nerve morphological features, with no neuroma formation, comparable to findings for the contralateral site. CONCLUSION: Microsurgical repair of the sural nerve after biopsy can eliminate or reduce sensory disturbances such as paraesthesia, hypesthesia, and dysesthesia distal to the biopsy site, in the distribution of the sensory innervation of the sural nerve, and can prevent painful neuroma formation. To our knowledge, this article is the first in the literature to report on microsurgical repair of the sural nerve after nerve biopsy. Decreased side effects suggest that this technique can become a standard procedure after sural nerve biopsy, which is commonly required to establish the diagnosis of various diseases, such as peripheral nerve pathological conditions, vasculitis, and amyloidosis. More cases should be analyzed, however, to explore the usefulness of the technique and the reliability of sural nerve biopsy samples in attempts to obtain conclusive diagnoses.

Aged↗
PubMed2003

Carl Nicoladoni and his contributions to scoliosis.

Carl Nicoladoni (1847-1902) studied medicine in Vienna and became Privatdozent in surgery in 1876. He accepted a chair as a Professor of Surgery at the university clinics of Innsbruck (1881) and Graz (1895). Nicoladoni has made significant contributions in the progress of surgery and performed a variety of operations in several surgical disciplines. However, his principal contributions are in the field of orthopedic surgery, in particular his excellent and detailed studies on scoliosis, based on thorough anatomic and kinetic investigation. His commitment to the research of scoliosis resulted in three books and three bigger treatises, all of which were printed in German. His earliest book was printed in 1882 and was on the torsion of the scoliotic spine, Die Torsion der Skoliotischen Wirbelsäule. Three bigger treatises on scoliosis entitled Die Architektur der Sskoliotischen Wirbelsäule (The Architecture of the Scoliotic Spine, 1889), Die Architektur der Kindlichen Skoliose (The Architecture of Juvenile Scoliosis, 1894), and Die Skoliose des Lendensegmentes (The Scoliosis of Lumbar Segments, 1894) were published in an anthology called Denkschriften der Kaiserlichen Akademie der Wissenschaften, a series of publications from the imperial academy of science. Two versions of his epical work, Anatomie und Mechanismus der Skoliose (Anatomy and Mechanism of Scoliosis) were printed. A larger edition printed in 1904 was part of the Bibliotheca Medica, a monumental series of various clinical books published around the beginning of the past century. The second version, a shortened one, with the same title was included in an anthology called Deutsche Chirurgie (German Surgery) and published in 1909. The purpose of this historical article is to discuss Nicoladoni's achievements in the field of scoliosis based on a detailed analysis of his books.

Austria↗
PubMed2003

A case of familial popliteal pterygium syndrome: early surgical intervention for successful treatment.

A 2-year-old boy presented at our hospital with severe familial popliteal pterygium syndrome with extensive skin webbing from thigh to heel and severely reduced range of motion of the knee and ankle joints. For accomplishment of knee extension, the patient underwent surgery with resection of the fibrous bands, freeing of the sciatic nerve, Z-lengthening of the Achilles tendon and multiple Z-plasties. One year after surgery, the patient can put his heel on the ground and has almost complete range of motion in the knee and ankle joints.

Abnormalities, Multiple↗
PubMed2003

Review of the " Chirurgia" of Giovanni de Vigo: estimate of his position in the history of surgery.

Giovanni de Vigo, who was born in at Rapallo, Italy, lived in the early Renaissance period (1450-1525). In 1503, De Vigo became the personal surgeon to Pope Julius II. He wrote a surgical book, " Practica Copiosa in Arte Chirurgia," which was completed in 1514 and published in Latin. It was translated into English by Richard Traheron and printed by Edward Whytchurch in 1543. Vigo's " Chirurgia" consists of nine books ranging from a consideration of anatomy necessary for a surgeon, to sections on abscesses, wounds, ulcers, benign and malignant tumors, fractures and dislocations, pharmaceuticals, ointments and plasters, as well as sections on dentistry, exercise, diet, syphilis, among others. De Vigo introduces a novel approach for treating mandible dislocations and describes a trephine he invented, as well as a number of new instruments. Examination of his surgical piece demonstrates that he had a broad spectrum of knowledge in surgery based in part on the ancient Greek and Arabic medical literature but mainly on his personal experience. Giovanni de Vigo contributed significantly to the revival of medicine in the sixteenth century, and he can be considered as a bridge between Greek medicine of antiquity, Arabic medicine, and the Renaissance.

General Surgery↗
PubMed2003

Isolated compression of the pectoral nerve resulting in atrophy of the major pectoral muscle.

We report on two cases of isolated damage to a muscle branch of the lateral pectoral nerve. Diagnosis was established by the clinical presentation and electromyographic examination. In the few reported cases of such injuries, the cause was trauma to this region. However, in both of our patients, focal muscle atrophy gradually developed after initiation of training schedules to increase the cross-section of the major pectoral muscle; we therefore assume that compression injury to the nerve by repetitive muscle contractions may be of pathogenic relevance. Anatomical studies of this region showed that the nerve branches of the lateral pectoral nerve, having to pierce through a connective tissue septum that is thicker here by a few millimeters, may be subjected to additional risk of compression. Early recognition and treatment are vital to prevent associated morbidity of these rare but serious injuries.

Adult↗
PubMed2003

Unilateral blepharochalasis.

Unilateral blepharochalasis is an extremely rare disorder with an unknown etiology and pathogenesis. The authors present a 22-year old patient in whom a right-sided skin overhang of the upper eyelid caused visual field impairment. The condition was corrected by a standard blepharoplasty. The histological examination suggested a localised anomaly of the lymphatic system and an almost complete absence of elastic fibres as the causative agent.

Adult↗
PubMed2003

[Elephantiasis of the thoracic wall within the scope of von Recklinghausen neurofibromatosis, case report].

Neurofibromas are benign tumors arising from neuroectodermal tissues. They may occur as solitary lesions, or multiple, in which case they are referred to as neurofibromatosis, or von Recklinghausen's disease. We report about a 17-year-old patient with neurofibromatous elephantiasis located in the lateral aspect of the left hemithorax. CT showed massive chest wall infiltration and retroperitoneal tumor growth, but no abnormalities of the cranium. Our surgical treatment consisted of a two-stage, palliative tumor debulking and defect coverage with a splitthickness skin graft. The operative and postoperative course was uneventful.

Adolescent↗
PubMed2003

Gracilis muscle split into two free flaps.

A case is presented in which the gracilis muscle was transversely split into two free flaps for coverage of two separate defects in a patient with a multi-segment fracture of the metatarsal bones and the ankle joint.

Adult↗