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Biomedical subjects

L Hakelius

Publications and source records attributed to L Hakelius.

At least 19 recordsLinked to original sources
PubMed1992

A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants.

The aim of this prospective, controlled clinical investigation was to find out if there is a difference in the capsular contracture rate between silicone implants with a smooth or textured surface as the only difference. Twenty-five women with bilateral mammary hypoplasia underwent mammary augmentation. All got a textured implant on one side and a smooth implant on the other. The implants were placed subglandularly. Follow-up examinations were done on six occasions. Three parameters were used for estimation of the tendency to capsular contracture: (1) the patient's opinion on differences in hardness of the breasts, (2) the investigator's classification of capsular contracture, and (3) applanation tonometry. At the end of the follow-up period, after 1 year, all parameters showed with no doubt that the breasts augmented with textured implants had a lower tendency to develop contracting capsules than the breasts augmented with smooth implants.

Adult↗
PubMed1991

Free autogenous muscle transplantation in children. Long-term results.

For more than 15 years we have been using free muscle transplantation in the treatment of anal incontinence in children. This method implies transposition of a striated muscle, usually the palmaris longus, two weeks after denervation, to the perirectal area as a U-sling around the rectum corresponding to the location of the so-called puborectalis muscle. We have now evaluated the long-term results in all 26 children operated on by this method. Before the operation all children were totally incontinent after a primary repair. At follow-up after an average of 11 years and 4 months, 60% of the cases were regarded as good, 16% as fair, 8% as improved and 16% as failures. In our opinion, free muscle transplantation offers a good chance of achieving acceptable continence in a majority of incontinent children.

Adolescent↗
PubMed1989

Origin and relationship between different cell types in malignant fibrous histiocytoma.

The derivation of histiocyte-like cells in malignant fibrous histiocytoma (MFH) has been a matter of debate. To shed light on this problem two cell lines from two subsequent recurrencies of MFH were established. The existence of two different cell populations, mainly fibroblast-like in the first cell line and mainly histiocyte-like in the second, was shown by light and electron microscopy, DNA measurements, and karyotype analysis. By detailed banding analysis and identification of several identical chromosomal marker types in the two cell lines, it was proven that they originally derived from the same single cell or single clone. Because the first cell line, with mainly fibroblast-like cells, was in the hypotriploid region and the second, with mainly histiocyte-like cells, was in the penta-hexaploid region, the data explained the appearance of histiocyte-like cells in MFH as a consequence of chromosomal progression.

Aged↗
PubMed1984

Cross-face nerve grafting followed by free muscle transplantation in young patients with long-standing facial paralysis. Reanimation of the cheek and the angle of the mouth.

For reanimation of the cheek in 8 young patients with long-standing facial palsy a method with cross-face nerve grafting followed by free muscle transplantation has been used. The sural nerve was used as nerve graft and placed in a subcutaneous tunnel across the face. In the normal cheek 3-4 fascicles of the nerve were anastomosed to facial nerve branches innervating muscles elevating the angle of the mouth. Four to 13 months later the extensor digitorum brevis muscle to the second toe or the palmaris longus was transplanted to the paralysed cheek. It was attached between the zygomatic arch and the angle of the mouth. The end of the nerve was sutured to the muscle after taking a biopsy. The follow-up period has been 7-30 months. At 7 months 6 patients had positive EMG, either on voluntary movement or on stimulation of the contralateral facial nerve. Three of them had also a slight movement in the cheek. Two patients are as yet only 7 months postoperative. In the remaining two cases, No. 2 and 4, there were no signs of reinnervation. At 18 months 4 out of 6 patients had a synchronous natural contraction in the cheek giving increased balance to the mouth. These patients had a positive EMG. In patients No. 2 and 4 there was neither innervation nor improvement. At 30 months there was additional improvement in two cases but as previously in patients No. 2 and 4 there was neither improvement nor signs of innervation of the muscle on the EMG. The other 4 patients have not reached this postoperative stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Malignant, locally recurring cystosarcoma phyllodes in an adolescent female. A case report.

A 16-year-old girl presented with a large and rapidly growing cystosarcoma phyllodes in her right breast. The excised tumour showed unequivocal malignant characteristics at light and electron microscopy and was oestrogen-receptor negative. After repeated early local recurrences, a subcutaneous mastectomy ultimately led to local tumour control and the patient is now disease free 5.5 years after diagnosis.

Adolescent↗
PubMed1984

Urinary incontinence in children: treatment with free autogenous muscle transplantation.

Free autogenous muscle transplantation has now been carried out in 13 patients with anal incontinence and 16 patients with urinary incontinence. In anal incontinence the results have been excellent; all patients were improved and 12 out of 13 reached an acceptable level of continence. In 10 patients with urinary incontinence the results were good, with increase of functional bladder capacity and abandonment of nappies during the day. Two patients were improved and 4 were failures. Cinematographic studies in both anal and urinary incontinence clearly demonstrated the muscular activity of the transplants and confirmed the existence of a reinnervation process. The longest postoperative observation time is now 7-years in the anal patients and 6 years in the urinary patients.

Adolescent↗
PubMed1983

Further experience of free muscle transplantation in children with urinary incontinence.

Sixteen patients, 10 boys and 6 girls with severe urinary incontinence due to congenital malformations, were treated by free autogenous muscle transplantation. The mean follow-up period was 2.3 years. In 10 patients the results were good, implying increase in functional bladder capacity and abandoning of napkins during the day. Two patients were improved and 4 were failures. The earliest signs of improvement appeared 2 to 6 months after surgery. Most patients showed further improvement for at least 2 years post-operatively. Cine studies of micturition clearly showed activity of the transplant, most patients with good results being able to interrupt completely the urinary stream at will. Seven patients exhibited normal urinary flow post-operatively. In 5 patients the maximal urinary flow was around the lower normal limit, in two because of detrusor-sphincter dyssynergia. In boys, erection was unimpaired post-operatively. The prognosis seems to be better in girls than in boys, especially when comparing cases of epispadias. Patients with no sign of improvement during the first 6 months post-operatively had a poor prognosis. A relatively large bladder capacity before operation is advantageous, but not a prerequisite for continence, as bladder capacity can develop after transplantation. The ideal age for transplantation is 5 to 6 years.

Adolescent↗
PubMed1983

Freely transplanted peroneus longus muscle in the cat reinnervated by a single nerve: physiological properties.

Physiological properties (tetanic tension, single twitch, fatigability) of free autologous muscle transplants in cats were examined in vivo five months after transplantation. After 2 weeks denervation the peroneus longus muscle was placed isometrically in the abdomen with the omentum around the muscle and with the proximal end of a cut branch of the femoral nerve attached to the muscle. (In one case a sensory nerve was used.) Five months after transplantation the function of the muscle was controlled in vivo by nerve stimulation. In the case when a sensory nerve was connected to the muscle no contraction was obtained upon indirect or direct stimulation. All the other muscles contracted when the nerve was stimulated. The mean maximum tetanic tension was 16% of the mean for the control. The twitch-time was about the same as in the control muscle but the contraction time was longer and the half relaxation time shorter compared with the control. The transplanted muscles fatigued more slowly than the normal peroneus longus muscles. In spite of the unphysiological placement of the muscles in the abdomen where they have no natural function to fulfil, they became reinnervated and contracted as late as five months after transplantation.

Animals↗
PubMed1981

The effect of split skin allografts on wound epithelialization from autologous patch grafts. An experimental study in rabbits.

To compare the healing time of standardized wounds partly covered with autologous patch skin grafts, and wounds totally covered with a combination of allografts and autologous patch grafts 10 rabbits, each with two standardized wounds, were used. On each rabbit one wound was partially transplanted with 6 autologous patch grafts 9 mm in diameter. The patches covered 6% of the wound area. The second wound was covered with a rabbit skin allograft with six holes 7 mm in diameter. In these holes 6 autologous patch grafts, 9 mm in diameter were placed (intermingled transplantation of auto- and allografts). The average healing time for the ten wounds treated with autografts only was 39.8 days and for the wounds covered with auto- and allografts 21.6 days. This shows that the same amount of autologous skin epithelialized a wound area about 17 times larger than itself nearly twice as fast if the wound surface between the autografts was covered with allografts than if it was protected by a dressing only.

Animals↗
PubMed1979

Free autogenous muscle transplantation in 5 children with urinary incontinence.

Five children with urinary incontinence were operated with a new method involving free autogenous muscle transplantation. Before transplantation a skeletal muscle (extensor brevis of the foot) is denervated and, 2 weeks later, it is transplanted and placed as a U-sling around the urethra in close contact with normally innervated muscles, which act as reinnervation sources. All patients showed improvement of continence and increasing bladder capacity from about 2 months after transplantation. Postoperative cine-micturition studies clearly demonstrated the functional properties of the transplanted muscle and estimation of urinary flow rate showed no signs of infravesical obstruction.

Adolescent↗
PubMed1978

A new treatment of anal incontinence in children: free autogenous muscle transplantation.

A new method is presented for the treatment of anal incontinence in children, including free autogenous muscle transplantation. The primary step is denervation of a skeletal muscle, which 2 wk later is transplanted and placed as a U-sling around the rectum, imitating the position and function of the puborectalis muscle. The transplant is placed in close contact with innervated muscles, which act as reinnervation sources. The results in five consecutive patients are highly promising. An early sign of improvement is the occurrence of a sensation of rectal fullness. All the patients reached an acceptable degree of continence, including abandonment of the use of napkins, 4-12 mo after surgery.

Adolescent↗
PubMed1978

Free autogenous muscle transplantation in the treatment of urinary incontinence in children: background, surgical technique and preliminary results.

Urinary incontinence owing to epispadias or bladder exstrophy is a difficult therapeutic problem. To improve the results a new method, including free autogenous muscle transplantation, was developed. Before transplantation a skeletal muscle (extensor brevis of the foot) is denervated and, 2 weeks later, it is transplanted and placed as a U-sling around the urethra in close contact with normally innervated muscles, which act as reinnervation sources. Two patients showed improvement of continence and increasing bladder capacity from 6 weeks after transplantation. Postoperative cine-studies of micturition demonstrated clearly the functional properties of the transplanted muscle.

Bladder Exstrophy↗