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Biomedical subjects

K O Wustrack

Publications and source records attributed to K O Wustrack.

9 recordsLinked to original sources
PubMed1979

Surgical management of silicone mastitis.

The results of the operative treatment of 22 cases of silicone mastitis are presented. Moderate involvement can usually be managed successfully by local excision of the masses, or by a subcutaneous mastectomy with later reconstruction. Patients with severe skin infiltration and/or pectoral muscle involvement are prone to complications, however, and we now believe an aggressive approach--such as a complete mastectomy with nipple banking and excision of the infiltrated muscle, might be best. This would allow the later reconstruction to proceed in relatively uninvolved tissue, and prevent the problems of recurrent inflammation from placing bag-gel prostheses in a residual bed of silicone-infiltrated tissue.

Adult↗
PubMed1978

Pyoderma gangrenosum: recognition and management.

Pyoderma gangrenosum, a progressive necrotizing and ulcerative disease of the skin, presents serious problems in diagnosis and management to physicians not familar with the entity. The clinical basis of the diagnosis is outlined, and the possible etiological mechanisms are reviewed. Treatment is primarily nonsurgical, relying on oral administration of corticosteroids and conservative local care of the ulcers.

Diagnosis, Differential↗
PubMed1977

Microvascular anastomosis using a blood product sealant-adhesive.

In this experimental model, we have shown that a four suture repair with a biologic sealant adhesive significantly reduces hemorrhage and reduces operative time, while allowing a flap survival comparable to that obtained with standard techniques in rats undergoing a microvascular anastomosis. In heparinized rats undergoing the same procedure, the sealant adhesive significantly decreases hemorrhage and increases flap survival. Of significance is the fact that the platelet-fibrinogen-thrombin adhesive is biodegradable and does not induce a tissue reaction. We believe that this physiologic adhesive may become a useful adjunct in digital reimplantation. It appears to reduce operative time and heparin-induced bleeding.

Animals↗
PubMed1975

Immunological enhancement of skin allografts in the rat. Role of vascular and lymphatic reconstitution.

Four skin graft models are created which vary in the rates of lymphatic and vascular reconstitution. Rat allografts (Brown Norway or (L times BN)F1 hybrid) transplanted to Lewis recipients by conventional (immediate lymphatic, delayed vascular), surgical anastomosis (immediate lymphatic, immediate vascular) or isolated anastomosis (delayed lymphatic, immediate vascular) techniques have similar mean survival times (7.8 days). Grafts placed on an isolated recipient pedicle (delayed lymphatic, delayed vascular) double the mean survival time to 15.6 days. Treatment with alloimmune serum, able to indefinitely prolong survival of similarly mismatched renal grafts, prolongs only isolated anastomosed grafts. In contrast, cyclophosphamide treatment prolongs survival of all groups. These results suggest, first, that both vascular and lymphatic routes of sensitization are equally effective and, second, that immunological enhancement requires either prompt vascular continuity or a persistent lack of lymphatic reconstitution.

Angiography↗
PubMedDate not supplied

Pyrogen reactions associated with the infusion of normal serum albumin (human).

In November, 1974, eight patients in three hospitals had pyrogen reactions associated with the infusion of 25% Normal Serum Albumin from the same lot. The reactions were recognized because the same physician or nurse observed several patients having recurrent reactions or because a single patient receiving several vials had consecutive reactions. The remaining albumin in three vials associated with reactions had apparent endotoxin concentrations of 4, 16, and 32 ng/ml and that 22 vials from recalled supplies had a median concentration of 4 ng/ml (range: 2 to 64) as determined by the Limulus amebocyte lysate test, but the lot again passed the rabbit pyrogen test. In a prospective study to determine the efficacy of the Limulus test in quality control, patients had their temperatures taken hourly during albumin infusions and the remaining fluid was tested by the Limulus assay. The albumin in 443 of the 662 vials infused (65%) gave a positive test and 311 of these vials (45%) had apparent endotoxin concentrations of 4 to 64 ng/ml, but no patient had a reaction. Because of the limitations of both the rabbit pyrogen and Limulus test, the detection of some pyrogenic lots continues to depend on hospital surveillance and reporting os suspect reactions.

Adult↗