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Biomedical subjects

M J Weinberg

Publications and source records attributed to M J Weinberg.

9 recordsLinked to original sources
PubMed1997

"Spare part" forearm free flaps harvested from the amputated limb for coverage of amputation stumps.

The use of "spare part" flaps from a non-replantable limb to cover amputation stumps in the upper extremity preserves limb length, provides durable coverage and sensation and will avoid additional donor site morbidity. We have studied the blood supply of the forearm based on the radial artery. The potential for harvesting different tissues is confirmed. In five clinical cases reliable primary soft tissue reconstruction was achieved, even in the presence of trauma.

Amputation Stumps↗
PubMed1995

Facial nerve palsy after mandibular fracture.

A 19-year-old man sustained a right parasymphyseal fracture and bilateral condylar neck fractures in a motor vehicle accident. The parasymphyseal fracture was treated by open reduction and internal fixation, and the subcondylar fractures were treated with closed reduction and maxillomandibular fixation. Three days postoperatively, a near-complete left facial nerve palsy developed. Facial nerve recovery was not full. The literature is reviewed, and possible mechanisms of this rare and devastating complication are discussed.

Adult↗
PubMed1994

Type 4 median nerve entrapment after elbow dislocation.

A rare case of median nerve entrapment after posterior elbow dislocation is reported. Nerve entrapment was both in the healed medial epicondyle fracture and within the elbow joint and we recommend placing this type of entrapment separately in an extended classification of median nerve entrapment following elbow dislocation.

Adolescent↗
PubMed1992

Reconstruction of avulsed scalp after go-cart injury.

Scalp avulsion is a rare injury that has significant physical and psychological consequences. It may require emergency replantation or late, challenging surgical reconstruction, or both. The authors describe two patients who had scalp avulsion. Each patient got long hair entangled in the uncovered engine of a go-cart. One underwent unsuccessful replantation without vascular repair; the other had a large segment of scalp successfully replanted with microvascular repair. Both patients required late reconstruction with tissue expansion. The final results were good. When feasible, microvascular replantation is the treatment of choice. If replantation is not possible, temporary cover by skin grafts followed by later reconstruction with tissue expansion can be effective.

Child↗
PubMed1991

Current status of pancreatectomy for persistent idiopathic neonatal hypoglycemia due to islet cell dysplasia.

A series of 18 children suffering from persistent idiopathic neonatal hypoglycemia (PINH) is reported. Medical and surgical managements are described in detail. All patients subjected to surgery had failed medical treatment. These patients were divided into two groups: 1) 85% pancreatectomy leaving the uncinate process in situ, and 2) 95% pancreatectomy leaving a small rim of pancreatic tissue along the duodenum and the common bile duct. The spleen was preserved in all cases. Two out of 5 children of group 1 required further resection of the pancreas for persistent hypoglycemia and were converted to 95% pancreatectomy. Since 1981 95% pancreatectomy was exclusively employed. Only one patient required insulin for 3 weeks postoperatively. Histopathology and immunohistochemistry revealed islet cell dysplasia and islet cell nuclear hypertrophy in the majority of cases, 35% of the patients had focal adenomatosis. Better control of hypoglycemia is achieved by primary 95% pancreatectomy and, thus, 95% pancreatectomy is recommended as the initial procedure in the treatment of PINH.

Female↗
PubMed1987

5-Fluorouracil infusions and fractionated doses of radiation: studies with a murine squamous cell carcinoma.

The present investigation describes the effects on a murine squamous cell tumor of combined treatment using radiation and 5-Fluorouracil (5FU), with emphasis on 5FU infusions. The tumor, SCC VII/To, was grown intramuscularly in the hind legs of C3H mice. Radiation was given locally with 100 kVp X rays either alone or in combination with 5FU by i.p. bolus injections or 4-14 day infusions using subcutaneously implanted mini-osmotic pumps. Studies with radiation alone indicated regrowth delay increased with total dose. This increase was less for fractionated than single doses. The effects of 5FU alone were compared using i.p. injections or 4, 7 or 14 day infusions. Tumor response to single i.p. bolus injections or 4 day infusions were not significantly different. Up to total drug doses of 200 mg/kg, 14 day infusions were least effective on regrowth delay, 4 day infusions were intermediate and 7 day infusions were most effective. Above total drug doses of 200 mg/kg, effects of 14 day infusions on regrowth delay increased rapidly. The LD50 for single i.p. bolus injections and 7 day infusions were similar, 230 and a total drug dose of 270 mg/kg, respectively. When a 7 day infusion of 5FU (133 mg/kg) was combined with increasing total radiation doses (1 or 5 fractions), the increase in regrowth delay was additive. Combining a fractionated dose of 5 Gy per day for 5 days (5/5 Gy) with increasing total drug doses of 5FU (single i.p. bolus injections or 4, 7 or 14 day infusions) resulted in regrowth delays that were dependent on the total dose of 5FU. Administering a 133 mg/kg dose of 5FU (via a single i.p. bolus injection or 7 day infusion) starting 2 days before, during, or immediately after 5/5 Gy gave the same regrowth delay, indicating no effect of drug sequencing. In conclusion, the above data indicate that (a) 5FU infusions (greater than 4 days) are more effective than 5FU injections on regrowth delay and (b) combinations of 5FU and radiation, produce an additive tumor response, which occurs independent of mode, schedule, and time of 5FU administration, and is dependent on 5FU total dose.

Animals↗
PubMed1986

Growth delay in a murine squamous cell tumor after local radiation and concurrent infusional 5-fluorouracil treatment.

In an effort to increase local control rates in a variety of human squamous cell carcinomas, infusional 5-Fluorouracil (5FU) has been combined with conventional fractionated radiation. The present work uses an experimental tumor system to examine the interactive effect of radiation and 5FU treatment. A transplantable murine tumor of squamous cell origin, SCC VII/SF, was grown in the legs of C3H mice. Leg diameter was measured and converted to tumor weight by an empirical calibration curve. Tumors of 0.3 g were treated by local irradiation with single or fractionated doses of 100 kVp X rays, alone, or in combination with a 7 day infusion of 5FU delivered by subcutaneously implanted mini-osmotic pumps. The tumor response was measured for single doses of 10-30 Gy and a fractionated dose of 5 Gy per day for 5 days. Studies done with single doses of radiation indicated delay and extent of tumor volume reduction, increased with dose. The effects of 5FU as a single agent were studied at infusion rates of 0.7, 1.3, or 2 mg/kg/hr for seven days. The LD50 for 5FU infusion was 1.3 mg/kg/hr. A single dose of 20 Gy or a fractionated dose of 5 Gy per day for 5 days was compared both in the presence and absence of 5FU at 0.7 mg/kg/hr. Results were consistent with the single dose radiation and infusional 5FU, interacting in a less than simply additive fashion, whereas, the 5FU-fractionated radiation interaction appears to be greater than simply additive. These results suggest that infusional 5FU may be enhancing the effects of fractionated radiation by inhibiting tumor cell repair and/or repopulation.

Animals↗