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Biomedical subjects

S C Adler

Publications and source records attributed to S C Adler.

9 recordsLinked to original sources
PubMed2001

Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years.

Solitary rectal ulcer syndrome (SRUS) is an infrequent pathology often associated with pelvic floor disorders. The aim of this retrospective study was to review the long-term results of a surgical series of SRUS. Between 1988 and 1998, 13 patients were operated on for SRUS. Seven patients had associated internal rectal prolapse (58%), two had associated total rectal prolapse (15%), and two had associated mucosal prolapse (15%). We performed simple resection of the SRUS in one case (8%), a stoma as primary operation in one (8%), three rectopexies according to Orr-Loygue (23%), and eight Delorme's operations as modified by Berman (62%). Mean follow-up was 57 months (range 15-112). Simple resection of the solitary rectal ulcer syndrome did not improve symptoms. Colostomy permitted relief of symptoms and healing of the SRUS. Two of the three rectopexies achieved good results, and the third patient relapsed at the 6th postoperative month. A secondary modified Delorme's operation permitted relief of symptoms and healing of the SRUS. Five of the eight patients (62.5%) who received modified Delorme's operations had improved at a follow-up of 46 months. We conclude that, considering the high failure rate after surgery, operations should be performed only in patients with total rectal prolapse or intractable symptoms not amenable to behavioral therapy. Delorme's operation and abdominal rectopexy help in about 60% of cases.

Adult↗
PubMed1995

Innominate artery compression of the trachea: diagnosis and treatment by anterior suspension. A 25-year experience.

Suspension of the innominate artery to the sternum has been a widely accepted therapy for the relief of tracheal compression. Recently, reimplantation of the innominate artery has been advocated as a superior operative procedure. While generally successful, arterial transfer carries the risk of early bleeding and stroke, and the potential for late stenosis at the anastomotic site. Between 1969 and 1994, 25 infants and children at our institution received diagnoses of innominate artery compression and were treated by anterior suspension. All presented with stridor and one third had a history of suspected or proven apnea. Twenty-four children had excellent results, while 1 required resuspension after stridor returned. There were no major complications. Our series strongly supports the belief that anterior suspension of the innominate artery is a successful and reliable operation with minimal morbidity and mortality. More complex procedures are rarely indicated.

Apnea↗
PubMed1992

Thin bipolar leads: a solution to problems with coaxial bipolar designs.

A new type of bipolar lead has been designed to be thinner and more reliable than the standard coaxial design. The new lead has passed numerous bench tests to ensure its reliability. Improved fatigue performance was shown during comparisons between the new type of coil (bifilar DFT [drawn filled tube]) and previous standard coils (trifilar MP35N). During the initial animal studies no reliability concerns were raised and stable electrode thresholds were measured. If success in the test process of this lead continues, a bipolar lead may soon be marketed with a size and reliability comparable to unipolar leads.

Animals↗
PubMedDate not supplied

Evaluation of past and present hair replacement techniques. Aesthetic improvement, effectiveness, postoperative pain, and complications.

OBJECTIVE: To evaluate and compare past and present hair replacement techniques of standard grafts, minigrafts, micrografts, scalp reduction, scalp flaps, strip harvesting, and punch harvesting procedures with regard to aesthetic improvement, effectiveness, postoperative pain, and complications. DESIGN: Three hundred surveys were mailed randomly to patients who had undergone hair replacement over the last 3 decades. The questionnaire asked patients to rate the level of postoperative results and complications in several comparison groups with regard to the following factors: itching, pain, swelling, scarring, bleeding, altered sensation, poor growth, color and texture, infection, hairline, and natural appearance. Each factor was rated by the patients on a scale of 0 to 3 (0, none [best]; 1, minimal; 2, moderate; and 3, worst [severe]). SETTING: Private facial plastic surgery practice. METHODS: A hypothesis about each set of survey questions was formed based on general trends in patient responses, also known as the null hypothesis; chi 2 tests were conducted for each of the survey questions to determine the statistical trend with a certain level of confidence. The weighted arithmetic mean of the expected response was used for the varying number of patients responding to each question. Using the chi 2 test, the formulated hypotheses can be accepted or rejected based on the observed and expected responses. RESULTS: Between 1981-1990 and 1991-1996, there was a reduction of 38 percentage points in the number of standard graft procedures performed, an increase of 31 percentage points in the number of minigraft procedures, and an increase of 48 percentage points in the number of micrograft procedures. The complication rate was 31% lower for minigraft procedures compared with standard graft procedures and 29% lower for micrograft procedures compared with minigraft procedures. The complication rate was 59% lower for strip harvesting procedures compared with punch harvesting procedures. CONCLUSIONS: Newer hair replacement techniques have improved aesthetic results, with lower morbidity and complication rates. These improvements are responsible for the increase in the level of satisfaction of patients undergoing hair replacement surgery today.

Adult↗