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Biomedical subjects

J Angelats

Publications and source records attributed to J Angelats.

12 recordsLinked to original sources
PubMed1996

A full nasal skin rotation flap for closure of soft-tissue defects in the lower one-third of the nose.

Large soft-tissue defects in the lower one-third of the nose challenge the reconstructive surgeon both technically and aesthetically. Many procedures have been described previously that close the wound with varying degrees of color and texture match. We present a modified nasal rotation flap that closes large soft-tissue defects of the lower one-third of the nose in a single stage with minimal donor-site morbidity and a pleasing aesthetic result.

Aged↗
PubMed1996

Sonographic signs of breast implant rupture.

OBJECTIVE: This study evaluated sonography as a screening test for breast implant rupture and developed diagnostic criteria for implant rupture. SUBJECTS AND METHODS: Women contemplating implant removal were evaluated prospectively with sonography. Implants were classified as normal, indeterminate, or ruptured. Individual sonographic signs were analyzed for their statistic association with implant rupture. To measure the degree of interobserver variation, static images were evaluated by two different observers. RESULTS: Of 236 implants evaluated, surgical confirmation was available in 78, 22 of which were ruptured and 56, intact. Echogenic noise, multiple discontinuous parallel linear echoes, and echodense aggregates in the implant lumen were statistically associated with rupture. Based on sonographic findings, we classified 34 implants as intact (at surgery: 31 intact, 3 ruptured). We classified 19 as ruptured (at surgery: 11 ruptured, 8 intact). Of the 25 implants we classified as indeterminate, 17 were intact and 8 were ruptured at surgery. Therefore, sonography had a positive predictive value of 58%, a negative predictive value of 91%, a sensitivity of 50%, and a specificity of 55%. Receiver operating characteristic analysis suggests a learning curve effect and no significant interobserver variation. CONCLUSIONS: A normal sonographic result is highly predictive of an intact implant. Thus, sonography is useful in evaluating symptomatic women or women concerned about implant rupture. An indeterminate sonographic result suggests the need for further testing.

Adult↗
PubMed1994

Functional outcome following traumatic upper limb amputation and prosthetic limb fitting.

Nineteen consecutive patients underwent traumatic upper limb amputation for nonreconstructible or replantible upper limb injury at a Level I trauma center over a 9-year-period. Eleven amputations were at the transradial level, five were transhumeral, and three were shoulder disarticulation. Eighteen patients underwent prosthetic limb fitting. Fifteen of the 18 initially underwent preparatory prosthetic limb fitting within 30 days following amputation with a body-powered, cable-driven prosthesis. Seventeen of the 18 achieved sufficient proficiency with their prostheses to allow them to return to work. Of these, 15 maintained daily functional prosthetic use of at least 8 hours daily at a followup examination of 12 to 110 months. Use of prosthetic limb following traumatic upper limb amputation carries a high probability for functional rehabilitation if limb fitting and prosthetic training are instituted as soon as the residual limb can tolerate the prosthetic socket as opposed to waiting for the residual limb to "mature".

Adolescent↗
PubMed1990

Management of burns of the hands in children.

Burns of the hand occur in children when the infant or toddler suffers a scald burn or a contact burn to the palm of the hand. Older children frequently suffer burns from experimenting with matches or gasoline. Although burns of the hand in children are not always as deep as in adults, optimal treatment involves the correct acute management, with skin grafting and proper splinting and physical therapy playing a large role, as well as long-term follow-up due to the excessive scar tissue that may form and the continued growth of the child's hand. The psychosocial needs of the burned child, including an understanding of the nature of child abuse and/or neglect, are also important.

Burns↗
PubMed1985

Upper and lower lip reconstruction using the step technique.

The step technique for lip reconstruction is a simple, flexible, one-stage operation that allows reconstruction of full-thickness defects spanning up to two-thirds of the lower lip and, in our experience, one-half of the upper lip without violating the opposite lip or using distant advancement flaps. Twelve patients, ranging in age from 24 to 86 years, underwent full-thickness lip excisions for squamous cell and deeply invading basal cell carcinomas. Reconstruction was achieved by advancing the remaining lateral lip elements to close the defects in a stepwise fashion without violating the remaining orbicularis oris muscle. All patients had a symmetrical, mobile, oral sphincter with intact commissures, adequate buccal sulcus, no symptomatic microstomia, and normal sensation at the completion of the procedure. There have been no recurrences in a nine-month to four-year follow-up, and satisfactory aesthetic results were achieved.

Adult↗
PubMed1984

Sural nerve neurocutaneous cross-foot flap.

Managing heel ulcers has proved frustrating because of the tendency for recurrence despite satisfactory use of grafts and flaps. This predisposition for continual breakdown is invariably associated with the loss of sensation. A neurocutaneous cross-foot flap was used to provide coverage and sensation to a heel after a degloving injury. Initially a full-thickness skin graft was used but resulted in a chronic, infected ulcer. Local tissue was not available for coverage. The neurocutaneous flap was based over the distribution of the sural nerve of the opposite foot. After proper delay, the flap was transferred. When the pedicle was divided, the sural nerve was anastomosed to the sural nerve in the recipient leg. This procedure has provided adequate padding and good sensation to the heel, preventing recurrence in this very active patient.

Child↗
PubMed1984

Prolactin, corticotropin, and gonadotropin concentrations following thermal injury in adults.

The concentration of serum prolactin (PRL), plasma corticotropin (ACTH), serum follicle stimulating (FSH), and luteinizing (LH) hormones were measured in 28 adult burned patients (25 males and three females). Morning and night determinations were performed for each hormone. Serum PRL was elevated in males up to the fourth week after the thermal injury. Plasma ACTH increased significantly on the second day postburn and returned gradually to normal on the fifth; serum FSH and LH increased on day 1, then decreased significantly on day 2 and remained low for about 2 weeks. In females, while PRL increased significantly, the gonadotropins were slightly elevated and the ACTH remained within normal limits for the 3 days during which it was possible to study these patients. In all subjects the circadian rhythm of the four measured hormones showed significant variations from the normal pattern.

Adolescent↗
PubMed1981

Latissimus dorsi myocutaneous flap in Poland syndrome.

We present a new approach to the old problem of congenital chest wall malformation--an approach that is anatomically reliable, physiologically sound, and cosmetically pleasing. The procedure used the patient's own tissues, thus avoiding the problem associated with the use of a foreign body, such as a silicone mammary implant. In addition, no loss of muscle mass is seen due to the retention of the normal neurovascular supply to the latissimus dorsi muscle.

Adolescent↗
PubMed1975

Surgical treatment of hidradenitis suppurativa of the axilla.

We review our surgical experience with hidradenitis suppurativa of the axilla at Cook County Hospital during the years 1963 to 1972. The operation for this entity described by Pollock et al has (1) reduced the length of hospitalization, (2) increased the rate of primary healing and reduced the period of secondary healing, (3) allowed a great amount of tissue to be excised, (4) permitted both axillae to be operated on at once (without incapacitating the patient), (5) avoided the need for skin grafting, and (6) has had less morbidity for those patients in whom primary healing is not achieved. We believe the method reported by Pollock et al is now the treatment of choice for this disease.

Axilla↗
PubMedDate not supplied

Angiotensin-1-converting enzyme activity as index of pulmonary damage in thermal injury with or without smoke inhalation.

Serum angiotensin-converting enzyme (ACE) activity, plasma renin activity (PRA), and serum aldosterone levels were measured up to four weeks in a population of adults exposed to thermal injury, with or without concomitant exposure to smoke inhalation. In 10 patients, plasma levels of angiotensin-2 and ACE activity in bronchial lavage were also evaluated. Patients with severe burn injury had a significant decline of serum ACE activity while the concentrations of aldosterone and PRA were markedly elevated. Smoke inhalation seemed to counterbalance the decline of serum ACE activity, and, in the last group of patients, ACE concentrations were higher than those recorded in patients suffering only from cutaneous burn. The ACE activity was evidenced in bronchial lavage of patients exposed to smoke inhalation with the highest values present in the first day after the injury. The same patients had also very elevated levels of plasma angiotensin 2. In conclusion, serum ACE activity decreases in burn patients according to the severity of the cutaneous burn; smoke inhalation influences serum levels of the enzyme with concentration values opposite to the low ones present in cutaneous burn. Finally, the enzyme activity has an independent pattern from that of the other components of the renin angiotensin aldosterone system. The evaluation of ACE activity may be a marker of pulmonary damage in smoke inhalation.

Adolescent↗