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Biomedical subjects

J M Nachbar

Publications and source records attributed to J M Nachbar.

8 recordsLinked to original sources
PubMed1993

Steam press burns of the hand.

Steam presses pose an occupational hazard to workers in the dry cleaning industry. Three patients with thermal burns to the hand from steam press accidents were recently treated at this institution. Each patient sustained deep second and third degree burns to the dorsum of the hand. Two patients required split-thickness skin grafts and have retained full range of motion and returned to full employment. One patient sustained destruction of extensor tendons and required a groin flap for coverage. Late tendon reconstruction will be necessary. Investigation revealed that older steam press models do not have an emergency release lever in case of accidental closure on a worker's hand. Although newer models are equipped with a thigh-activated emergency release lever, a contact burn remains likely if the press closes on the operator's hands. Some of the newest models have an attached safety bar that prevents the press from closing on the operator's hands. It is recommended that older models either be modified with the attachment of a safety bar or replaced entirely.

Accidents, Occupational↗
PubMed1991

Validation of quantification of breast implant capsule surface area and volume using magnetic resonance imaging.

Capsular contracture has been among the most frequent and frustrating complications of augmentation and reconstructive mammoplasty with silicone breast implants. Experimental evaluation of methods designed to modify the capsule has been limited by the lack of an effective method for quantification of contracture. It has been suggested that measurement of capsule surface area would be the most direct way to quantify capsular contracture. A method using magnetic resonance imaging for calculation of implant surface area is demonstrated; validation of this method using silicone phantoms with geometrically known surface areas is presented. The surface areas of two implants were also measured in a human subject; this represents the first reported measurement of an implant capsule surface area in vivo. Calculation of surface area according to the tiling method appears to be valid, whereas the circumference method consistently underestimates capsule surface area. Although clinical correlation has not been proved, it is hoped that further experimental studies of capsular contracture will incorporate this quantitative method.

Breast↗
PubMed1991

A new method of methyl methacrylate fixation in skull reconstruction.

Fifty-two methyl methacrylate cranioplasties were performed in 47 patients over a 5-year period. The indications for the original craniectomy fell into four categories. Nine patients had a craniectomy for tumor, 32 for trauma, 5 for infection, and 1 for aneurysm. A new approach, which eliminates the need for suture or wire fixation and which facilitates intraoperative calvarial contouring, is presented. An excellent cosmetic result is the norm with this technique.

Adolescent↗
PubMed1990

A computerized approach to injury description.

The study of trauma has been handicapped from its inception by the absence of a single coherent method of cataloging injuries. The AIS and ICD-9 systems have failed to fill this void because they lack the precision necessary to describe surgically treated injuries. We conceived a simple system of injury description in which injuries are rapidly encoded using a microcomputer in sufficient detail to distinguish among millions of different injuries. This system is easily searched by a microcomputer and allows for the automatic assignment of AIS, ISS, and CPT codes. In this system a patient is described by a 'paragraph' consisting of any number of identically patterned 'sentences,' each describing one of the patient's injuries. Each 'sentence' is composed of a string of six 'words' from controlled vocabularies and has the following structure: "Body region, Organ, Anatomic region, Injury, Physiology, Treatment." Defining the vocabulary allowed for each 'word' in a 'sentence' is complex because the allowed vocabulary is dependent upon the preceding 'words' in a 'sentence,' but in practice a microcomputer simply provides short lists of acceptable choices at each step of injury description, and records the user's selections. Additionally, the microcomputer assigns AIS, ISS, and CPT codes appropriate to the injury description sentence. The ease of data entry, the fineness of detail captured, the automation of code assignment, and the accuracy of database searching for specific injuries, classes of injuries, or combinations of injuries, we believe will give this approach widespread application in academic trauma centers where an accurate and accessible trauma database is important.

Humans↗