Hemangiomas of the lips: treatment with magnesium seeds.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
O Staindl
Publications and source records attributed to O Staindl.
[Angioarchitecture of keloids. A scanning electron microscopy study of a corrosion specimen].
Three keloids harvested during surgery were prepared for histology and scanning electron microscopy (SEM) of vascular corrosion casts. One well-filled keloid (12 cm x 7 cm) was examined by SEM. This specimen revealed a conspicuous increase in subepidermal venous vessels as well as prominent luminal bulging of the endothelial lining in arterial and venous vessels, shown by prominent surface imprint patterns on cast vessels. There were no tapered or compressed vessels. Blind ending vessels identified by cast morphology as vascular sprouts indicated keloid angiogenesis. The increase in (venous) vessels correlated very closely with the hyperaemic state of the keloid.
Adult↗
Treatment of hemangiomas of the face with magnesium seeds.
Various conservative and surgical procedures are available for the management of aggressive hemangiomas in infancy and childhood. One of them is magnesium seeding, a treatment modality developed more than 90 years ago but neglected for a long time. The technique consists of implanting 0.5- to 1-mm-thick wires of 99.8% pure magnesium into the tumor mass. During repeated courses oxidation of the metal results in fibrosis and cicatricial transformation of the tumor. Indications, technique and results are discussed.
Adult↗
[Ivory as a nose implant performed by Jacques Joseph. Late results after more than 40 years].
A report is represented on late results of saddle-nose corrections in three patients who, more than 40 years ago, underwent surgery performed by Jacques Joseph in Berlin using an ivory chip. One patient showed a very good permanent result, while the two others had implant loss, which, in one case, was due to trauma. The case reports offer an opportunity to recall a few biographical data on Jacques Joseph and on his use of ivory as an implant material.
Aged↗
[Clinical aspects and therapy of hemangioma].
Vascular malformations of the skin, such as angiomatous naevi (haemangiomas) are discussed in the present paper. Haemangiomas can be differentiated by histology into "capillary" and "cavernous" types. Therapy should be very conservative because about 95% of all haemangiomas in childhood tend to involute spontaneously. Active treatment is necessary for complications, such as bleeding or ulceration, the Kasabach-Merritt syndrome, or tumours at special sites such as the eyelid, lips etc. Conservative treatment includes steroids and embolisation by fibrin. Surgery includes the largely forgotten magnesium seed treatment first described 90 years ago; 99.8% pure magnesium foil and wires 0.5 and 1.0 mm thick were implanted into nine haemangiomas. Fibrosis and tumour regression were observed in seven cases: two further cases are still under treatment.
Capillaries↗
[Failures and complications following otoplasty].
Success of failure of otoplasties can be assured by individual aesthetic and objective evaluation. Objective complications after correction of prominent ears are discussed in the present paper: Complications following wrong operation techniques. Early complications such as haematoma, infection, fistuli and granuloma, allergic reactions, ulceration and asymmetry of the ears. Late complications such as reprotrusion, "telephoneear", cut edges, keloids, overcorrection and finally the so called "catastrophicear". Causes, prevention and therapy of these complications are presented.
Child↗
[Indications for free transplants for scar correction in the area of the head and neck].
Three different operating techniques can be used for scar-correction: Linear Revision-techniques as simple excisions, W-plasties, broken-line-technique. Regional flaps as Z-plasty, VY-plasty, rhomboid flaps. Both are suitable for correcting the size and direction of scars. They are mainly used for cosmetically (e. g. relatively) indicated corrections. Free grafts. A scar causing functional disability usually represents an absolute indication for surgery, such as scarring defects, shrinking scars, keloids as well as the scar carcinoma. Typical indications for scar correction using free grafts in the head and neck area are discussed in the present paper. Different methods of choice are full skin grafts, split skin grafts, composite grafts and free transplants using microvascular anastomosis. This techniques do not normally achieve a satisfactory result from a cosmetic point of view but only the functional rehabilitation of the patient.
Adult↗
The angioarchitecture of the Lewis lung carcinoma in laboratory mice (a light microscopic and scanning electron microscopic study).
53 Lewis lung carcinomas implanted subcutaneously into C57BL/6-mice were examined. The animals were killed at various stages of tumor growth (TG) and prepared for histology and for scanning electron microscopy (critical-point-dried tissue; vascular corrosion casts). Prior to casting animals were rinsed using different perfusion pressures. Casting was done by manual injection of the resin, whereby different influx-rates were applied resulting in low, medium and high pressure preparations. We discern 3 phases of tumor angiogenesis (TA) occurring during 4 stages of TG among which vasodilation establishes the first reaction of the host vascular system to a growing tumor implant. During this stage 1 of TG, tumor nidation, nearby sinusoidal dilated host capillaries form globular outgrowings (phase 1 of TA). Subsequently radially arranged sprouts, which preferentially arise from venous host vessels, grow into the centre of the implant (phase 2 of TA). Stage 2 of TG, early tumor growth, is characterized by necrosis of the central tumor tissue and the development of a central avascular cavity. Thus the tumor vascular system is organized like a hollow sphere with a central cavity and a peripheral vascular "envelope" with large vessels embracing the tumor and centrifugally growing vascular sprouts, which arise from the venous part of the vascular "envelope" and invade the surrounding host tissue (phase 3 of TA). During stage 3 of TG, late tumor growth, many vessels of the basket-like vascular "envelope" obliterate. In stage 4 of TG, prefinal phase, the peripheral vascular density decreases continuously. Thus vascular sprouting and proliferation of viable tumor cells is confined to basal regions of the tumor.
Arterioles↗
The vascular pattern of basal cell tumors: light microscopy and scanning electron microscopic study on vascular corrosion casts.
Light microscopy of hematoxylin-eosin stained tissue sections and scanning electron microscopy (SEM) of vascular corrosion casts were used to study the blood vascular system of human basal cell tumors. Concerning the gross angioarchitecture there is a very close correlation between the histological appearance and the findings obtained from vascular corrosion casts, when evaluated in a SEM. The tumor cell beds are enveloped by basket-like capillary plexus. The tumors are traversed over long distances by superficially running, teleangiectatic, but flattened capillaries. These compressed vessels are squeezed between tumor cell cords and epidermis. In vascular corrosion casts of human basal cell tumors the vascular system exhibits three different features. Blind-ending vascular casts; Four different causes for blind-ending cast structures are pointed out and discussed. Incomplete filling of the vascular system; compression of tumor vessels; new proliferating capillary sprouts; broken cast endings. Variations in vessel caliber and extravasation of the injection resin. Most of the variation in vessel calibers are thought to be caused by dilation of the weakened endothelial walls, but some of them presumably represent new projecting vascular swellings. Circumscribed leakage of the injected resin could be attributed to regions of advanced connective tissue degeneration and endothelial lysis. Flattened cast structures; The addition of tissues during tumor growth results in an increase of tissue pressure. Thus many tumor vessels get displaced, compressed, and flattened and vascular occlusions will occur. However, it must be stressed that much caution is needed in assessing the nature of the vascular cast structures of basal cell tumors.
Basal Cell Carcinoma↗
[Echinococcosis of the orbit].
A 5 year old girl with an echinococcuscyst in the right orbit is reported. The final diagnosis was made by removal of the cyst. A second cyst was found in the liver. The epidemiology, clinical and diagnostic problems of echinococcosis are reviewed. Radical surgery is still the only reliable treatment. For inoperable cases chemotherapy with Mebendazol seems promising. Many problems of chemotherapy remain to be solved and Mebendazol therapy is still in an experimental stage.
Child, Preschool↗
[Diagnosis and operative treatment of nevi and hemangiomas in the area of the head and neck].
This paper is divided into four sections. In the first section we attempted to emphasise for the plastic surgeon some practical aspects of clinical diagnosis of moles. Taking into account the pathologic and dermatologic nomenclature we classified moles (naevi) as a) melanocytic naevi, b) vascular naevi, c) epithelial naevi. The second section deals with the indication for surgical treatment. Distinction is made between relative and absolute indications. We considered the cosmetic reason only as a relative indication for surgery. On the other hand we based the absolute indication on three reasons: a) Psychosocial aspects observed in patients with moles on the face. b) Risk of malignancy: there is a high risk of melanoma associated with congenital melanocytic naevi, dysplastic naevi and blue naevi; carcinomas can develop to a sebaceous naevus; basaliomas have been described in linear verrucous epidermal naevus (Schimmelpennig-Feuerstein-Mims Syndrome). c) Complications associated with location and/or the size of a mole: amblyopia results if a haemangioma on eyelid remains untreated. Kasabach-Merrit-Syndrome develops in children with large haemangiomas. In the third section we explain our reasons for not performing incisional biopsies on pigmented skin lesions and we also describe basic surgical techniques such as simple excision with primary wound closure according to RSTL, regional flaps and free grafts (full thickness graft, split thickness graft, mesh graft, composite graft). The fourth section is a short review of special techniques in the treatment of haemangiomas: electrocoagulation, cryosurgery, magnesium seeds, systemic corticosteroids, sclerosing methods and radiotherapy.
Diagnosis, Differential↗
[Plastic surgery in the ENT area in childhood].
Three different indications for plastic and reconstructive ENT-surgery in children are discussed: Malformations, comprising deformities such as prominent ears and complications (keloids) after their correction, Bonnevie -Ullrich's syndrome etc., Injuries, such as dog-bite lesions of the face with different concepts for reconstructive techniques, and tumour surgery based e.g. on the example of pigmented naevi and haemangiomas.
Bites and Stings↗
[Scars and scar revision].
According to Clodius the scar is the surgeon's best advertisement. However, the development and formation of a scar does not always depend solely on surgical technique. The type and site of traumatic wounds, disordered wound healing and a keloid tendency are all factors which may lead to an unsatisfactory scar, requiring later revision. The basic principles of scar correction and various operative techniques are described in the present paper: 1. Linear operation techniques: Scar excision, W-plasty, VY-plasty, Broken line technique. 2. Regional flaps: Z-plasty, rhomboid flap. 3. Free grafts. Finally the basic principles of dermabrasion are presented. In addition the problem of keloid-formation, its prophylaxis and therapy are discussed.
Adult↗
[Therapy of saddle nose].
Three types of saddle-nose deformities can be distinguished: 1. the pseudo-saddle nose, 2. the slight saddle nose, 3. the extensive saddle nose. The pseudo-saddle nose may show a depression of the cartilaginous dorsum due to a hump, frequently accompanied by widening of the bony bridge and a prominent nasal tip. Satisfactory correction of this type of deformity can often be obtained by resecting the pseudohump, narrowing the nasal bridge by osteotomy and shortening by excision of cartilage from the caudal border of the septum and from the alar region. Slight and extensive saddle noses are based on the less of the cartilaginous and/or the bony framework of the nose. In such cases reconstruction of the framework of the nose using suitable implants is required. We must differentiate between three types of implants: 1. synthetic material, 2. bone grafts, 3. cartilage grafts. Costal cartilage grafts are preferred by the author for implantation. Possible complications of cartilage grafts, such as resorption and a tendency to torsion, as well as their prevention, are discussed.
Bone Transplantation↗
[Vascularization of the cervical trachea and its clinical relevance. A scanning electron microscopy study on corrosion casts].
The angioarchitecture of the cervical trachea of the rat as a model was studied using scanning electron microscopy of vascular corrosion casts. Four different types of vascular pattern are described. 1. Supplying and draining vessels of the first order (Superior and inferior thyroid arteries, and inferior thyroid veins) situated within the peritracheal tissue at the lateral sides of the trachea. 2. The vessels arising from them, which have a horizontal course and lie within the intercartilaginous membrane (vessels of the second order). 3. The vessels of the third order branching from those of the second order, perforating the intercartilaginous membrane and again running vertically within the tracheal mucosa. 4. Vessels of the fourth order forming the capillary plexus of the tracheal mucosa, consisting of irregular (pars fibrocartilaginea) or rectangular (pars membranacea) meshes. The clinical relevance of the vascular patterns of the trachea is discussed in respect to ischemic tracheal lesions.
Animals↗
[Reconstruction of defects in the area of the dorsum of the nose and the naso-canthal angle].
Reconstruction of defects in the area of the naso-canthal angle is described. There are four possibilities of a defective closure: 1.) primary wound closure 2.) regional flaps 3.) distant flaps 4.) free transplants. For clinical application the regional flaps are most frequently used, and hence they are discussed in detail. These flaps can be prepared from the regions of the nose, forehead, and cheek; combined methods are also possible. The techniques of distant flaps are not described, since they form the subject of a separate paper. Free transplants are used in exceptional cases only, in which we prefer the composite grafts. Several graphical representations and clinical illustrations are added.
Adult↗
[Fibrin glue in dermatosurgery (author's transl)].
Highly concentrated human fibrinogen as a biological tissue-adhesive-system was successful in a variety of clinical applications during the last years. The adhesive-technique imitates the second phase of blood-coagulation, i.e. the transformation of fibrinogen to fibrin by addition of a thrombin solution. The advantages of fibrin glue in operative dermatology are based on the possibility of flat tissue adhesion as well as the local sealing of small and medium size vessels. Three groups of indications are reported: 1. Local blood-coagulation, demonstrated in our surgical management of rhinophyma. 2. The flat tissue adhesion without surgical suture, mainly used in fixation of skin transplants. 3. In cases of extended regional flap-transpositions or tissue transplantation using microvascular anastomoses a combined suture-and adhesive-technique is described.
Adult↗
[Angioarchitecture of the retroauricular skin in humans. Scanning electron microscope studies of corrosion casts].
The angioarchitecture of the skin of the retroauricular area of a 25-year-old and a 55-year-old man was studied by scanning electron microscopy of vascular corrosion casts. Special attention was paid to the arrangement of the capillary bed of the stratum papillare corii. There is an average of 40 capillary loops per mm2. The diameters of the ascending loops of the capillaries range between 12.3 and 15.3 microns, of the descending ones between 19.0 and 22.9 microns, the length of the capillary loops is between 326 and 407 microns. The range of confidence is 95 percent. Three different patterns of arteriovenous anastomoses were found within the papillary and partly in the subpapillary capillary bed. The results showed no difference between the vascular beds of the two men. The scanning electron microscopy of vascular corrosion casts and its significance in the normal and pathological vascular bed is discussed.
Adult↗