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Biomedical subjects

P Giesswein

Publications and source records attributed to P Giesswein.

5 recordsLinked to original sources
PubMed1994

Supercharged latissimus dorsi muscle flap for coverage of the problem wound in the lower back.

Described is the "supercharging" of a latissimus dorsi muscle flap for coverage of an irradiated nonhealing wound of the lumbar area of the back. Nonhealing wounds of the lower back pose difficult management problems. In the face of radiation therapy, infection, and the presence of foreign materials, they can have the potential for disastrous outcomes. Exposed bone and prosthetic materials in an irradiated bed were covered by turning a latissimus dorsi muscle flap over its lower paraspinous origin and anastomosing the thoracodorsal artery and vein to the ipsilateral superior gluteal vessels. Postoperatively, the patient's wound healed without incident, and the muscle flap and skin graft provided a stable and durable reconstruction. Subsequent duplex Doppler imaging demonstrated a significant inflow to the flap from the superior gluteal artery and vein anastomosed to the thoracodorsal artery and vein of the muscle.

Back↗
PubMed1991

The prevalence of hepatitis B surface antigen and antibody in home-reared individuals with Down syndrome.

We examined 180 noninstitutionalized persons with Down syndrome for the presence of both hepatitis B surface antigens and antibodies to hepatitis B surface antigen. Two of the 180 subjects with Down syndrome had a positive test. One patient was hepatitis B surface antigen positive and the other was found to have antibodies to hepatitis B surface antigen. Also, 2 of the 155 individuals in the comparison group tested positive for hepatitis B surface antigen. Thus, we did not observe an increased prevalence of hepatitis B surface antigen or antibody in the study group and there was no significant difference between the Down syndrome and comparison groups. This is in contrast to many studies that originated in residential facilities where an increased number of persons with Down syndrome were found to have hepatitis B surface antigenemia. The related public health concerns are discussed.

Adolescent↗
PubMed1991

Thyroid function in Down syndrome.

The thyroid function of 181 patients with Down syndrome was investigated. When compared with a control group of 163 children we found T4 and FT4 levels to be significantly lower and T3 and TSH levels to be significantly higher in the Down syndrome population. Of the 181 patients with Down syndrome, 29 (16%) showed evidence of either uncompensated or compensated hypothyroidism: 11 (6%) had both low T4 and high TSH levels, 14 (8%) had only high TSH values, and 4 (2%) had only low T4 values. One of the patients with Down syndrome had a significantly elevated T4 level. Studying different age groups, we observed a decline of the mean T4, FT4, T3, FT3, and TBG values with advancing age. T4, T3, and TSH blood levels obtained in 1988 were slightly but not significantly lower when compared with values from 1985. Because thyroid dysfunctions in patients with Down syndrome are more common than in the general population, periodic thyroid hormone function tests should be performed in persons with Down syndrome in particular as they advance in age. Thus, individuals with significantly abnormal results can be identified early before clinical symptoms become manifest. If patients with Down syndrome are found to have a thyroid hormone disorder, appropriate treatment should be forthcoming, which in turn will enhance their quality of life.

Adolescent↗