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At least 307 records · Page 17Linked to original sources
PubMed1984

[Treatment of megaureter in children by Cohen's operation combined with ureteral reconstruction. 81 reconstructed and reimplanted ureters].

From January 1973 to June 1983, 69 children have been operated on: remodeling of a primary mega-ureter and reimplantation of the tailored ureter with the Cohen technique. 81 ureters have been treated this way. 68 children have been followed and the results of this operation are evaluated on 80 ureters. There are 65 satisfactory results, 5 mediocre and 10 bad (5 stenosis, 5 reflux); another operation has been done for these cases: 3 nephrectomy, 7 conservative treatments have been successful.

Child, Preschool↗
PubMed1995

[Reconstruction of muscle glycogen phosphorylase b from an apoenzyme and pyridoxal-5'-phosphate and its analogs. Interaction of apophosphorylase and the reconstructed enzyme with specific ligands].

Sedimentation methods were used to study the effects of modification of the pyridoxal-5'-phosphate (PLP) molecule at the 5th position on the affinity of reconstituted muscle glycogen phosphorylase b for the substrate (glycogen) and the allosteric inhibitor (FMN) as well as on the enzyme capacity to association induced by AMP. Reconstituted phosphorylase b was obtained with PLP analogs containing at the 5th position -CH2-CH2-COOH (analog I), trans-CH=CH-COOH (analog II) or -C identical to COOH (analog III) residues. Reconstitution of phosphorylase b is accompanied by the recovery of the enzyme quaternary structure. Phosphorylase b reconstituted with PLP or analogs I, II and III is not distinguished practically from the native enzyme in its affinity for glycogen. Substitution of the native coenzyme in the phosphorylase molecule with any tested PLP analog leads to lower enzyme affinity for FMN. Microscopic dissociation constants of the FMN-enzyme complexes increase in the following order: enzyme.I < enzyme.II < enzyme.III. Phosphorylase b reconstituted with analogs I, II and III differs substantially from the native enzyme in its capacity to association in the presence of 1 mM AMP: the reconstituted enzyme is represented practically by only the tetrameric form.

Adenosine Monophosphate↗
PubMed1997

[3-dimensional reconstruction of the superficial facial contour using opto-electronic recording for control of reconstructive soft tissue interventions].

We present a method of scanning the facial surface optoelectronically by means of the coded light approach. Using 20 plaster models of patients who had undergone plastic surgery of the face, we investigated the indications and possible limitations of this registration method. Using a 3D scanner developed by Duwe, we found that this method is limited in posterior areas. Further hardware and software improvements will permit volumetric control. The advantages of this new technology lie in planning, follow-up and in improved patient instruction for plastic surgery.

Equipment Design↗
PubMed1998

[Reconstructive hand surgery after cervical spinal injury: a new method increases the possibilities to reconstruct important functions].

The sarcomere is the basic unit of force generation in skeletal muscle. Since muscle force generation is highly dependent on sarcomere length, it is important to know the normal range of sarcomere length if informed decisions are to be made regarding surgical procedures affecting muscle length, such as tendon transfer or lengthening. The article reports intraoperative sarcomere length measurement with a laser diffraction technique. Sarcomere length as a function of joint angle was monitored during various tendon transfers performed to restore lost finger, thumb, wrist, forearm and elbow function in tetraplegics. The intraoperative measurements were essentially the same as those obtained in cadaveric muscle sarcomere models. Muscle fiber length, torque and tendon length are the most important structural determinants of the operating range and torque profile of each motor, while the relation between passive tension and active force is the most critical factor in making surgical decisions.

Arm↗
PubMed2002

Nipple-areola reconstruction: satisfaction and clinical determinants.

After performing a chart review, the authors identified 120 patients who underwent breast cancer-related reconstruction. All charts were evaluated with regard to breast mound reconstruction type, nipple-areola reconstruction type, the interval between breast mound and nipple-areola reconstruction, the number of procedures needed to achieve nipple-areola reconstruction, patient history of radiation therapy, and complications. A questionnaire was then developed and mailed to all of the patients who underwent both breast mound and nipple/areola reconstruction (n = 105) to evaluate their level of satisfaction. Of the 43 patients who returned the questionnaire, 41 completed all portions correctly. The questionnaire evaluated patient satisfaction with breast mound reconstruction; patient satisfaction with nipple-areola reconstruction; what the patient disliked most about the nipple-areola reconstruction; and whether or not the patient would choose to have breast reconstruction again. Several parameters were then tested statistically against the reported patient satisfaction.A review of all patients who underwent breast reconstruction revealed that their breast mound reconstructions were done using either a TRAM flap (59 percent), a latissimus dorsi flap and an implant (19 percent), an expander followed by an implant (9 percent), an implant only (4 percent), or other means (9 percent). The nipple-areola was reconstructed in these patients with either a star flap (36 percent), nipple sharing (10 percent), a keyhole flap (9 percent), a skate flap (9 percent), an S-flap (8 percent), a full-thickness skin graft (6 percent), or by another means (22 percent). The number of procedures needed to achieve nipple-areola reconstruction was either one (in 66 percent of the patients), two (in 32 percent of the patients), or three or more (2 percent of the patients). Eleven percent of the patients experienced the complication of nipple necrosis. Satisfaction with breast mound reconstruction was reported by 81 percent of patients to be excellent/good, by 14 percent of patients to be fair, and by 5 percent of patients to be poor. Reported satisfaction with nipple-areola reconstruction was excellent/good for 64 percent of patients, fair for 22 percent of patients, and poor for 14 percent of patients. The factors patients disliked most about their nipple-areola reconstruction were, in descending order, lack of projection, color match, shape, size, texture, and position. Statistical analysis of the data revealed inferior patient satisfaction when there was a longer interval between breast mound and nipple areola reconstruction (p = 0.003). No significant difference was observed in nipple/areola reconstruction satisfaction ratings when compared with breast mound reconstruction type (p = 0.46), nipple-areola reconstruction type (p = 0.98), and history of radiation therapy (p = 0.23). There was also no significant difference when breast mound reconstruction was compared with technique (p = 0.51) and history of radiation therapy (p = 0.079). Overall, there was a greater satisfaction with breast mound reconstruction than with nipple-areola reconstruction (p = 0.0001).

Breast Implants↗
PubMed2003

Breast reconstruction following mastectomy: current status in Australia.

BACKGROUND: Although breast reconstruction provides some advantages for women following mastectomy, few Australian breast cancer patients currently receive reconstruction. In Australia, the routine provision of breast reconstruction will require the development of specific health service delivery models. The present paper reports an analysis of the provision of breast reconstruction in eight sites in Australia. METHODS: A semi-structured telephone interview was conducted with 10 surgeons offering breast reconstruction as part of their practice, including nine breast or general surgeons and one plastic surgeon. RESULTS: Surgeons reported offering breast reconstruction to all women facing mastectomy; the proportion of women deciding to have breast reconstruction varied between sites with up to 50% of women having a reconstruction at some sites. Most sites offered three types of reconstruction. Two pathways emerged: either the breast surgeon performed the breast surgery in a team with the plastic surgeon who undertook the breast reconstruction or the breast surgeon provided both the breast surgery and the reconstruction. Considerable waiting times for breast reconstruction were reported in the public sector particularly for delayed reconstruction. Surgeons reported receiving training in breast reconstruction from plastic surgeons or from a breast surgery team that performed reconstructions; a number had been trained overseas. No audits of breast reconstruction were being undertaken. CONCLUSIONS: Breast reconstruction can be offered on a routine basis in Australia in both the private and public sectors. Women may be more readily able to access breast reconstruction when it is provided by a breast surgeon alone, but the range of reconstruction options may be more limited. If access to breast reconstruction is to be increased, there will be a need to: (i) develop effective models for the rural sector taking account of the lack of plastic surgeons; (ii) address waiting times for reconstruction surgery in the public sector; (iii) review costs to women in the private sector; (iv) develop a better understanding of women's views and how best to communicate about breast reconstruction; and (v) improve training in breast reconstruction.

Australia↗
PubMed2001

Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy.

Tumor pathologic features and the extent of nodal involvement dictate whether radiation therapy is given after mastectomy for breast cancer. It is generally well accepted that radiation negatively influences the outcome of implant-based breast reconstruction. However, the long-term effect of radiation therapy on the outcome of breast reconstruction with the free transverse rectus abdominis myocutaneous (TRAM) flap is still unclear. For patients who need postmastectomy radiation therapy, the optimal timing of TRAM flap reconstruction is controversial. This study compares the outcome of immediate and delayed free TRAM flap breast reconstruction in patients who received postmastectomy radiation therapy. All patients at The University of Texas M. D. Anderson Cancer Center who received postmastectomy radiation therapy and who also underwent free TRAM flap breast reconstruction between January of 1988 and December of 1998 were included in the study. Patients who received radiation therapy before delayed TRAM flap reconstruction were compared with patients who underwent immediate TRAM flap reconstruction before radiation therapy. Early and late complications were compared between the two groups. Early complications included vessel thrombosis, partial or total flap loss, mastectomy skin flap necrosis, and local wound-healing problems, whereas late complications included fat necrosis, volume loss, and flap contracture of free TRAM breast mounds. Late complications were evaluated at least 1 year after the completion of radiation therapy for patients who had delayed reconstruction and at least 1 year after reconstruction for patients who had immediate reconstruction. During the study period, 32 patients had immediate TRAM flap reconstruction before radiation therapy and 70 patients had radiation therapy before TRAM flap reconstruction. Mean follow-up times for the immediate reconstruction and delayed reconstruction groups were 3 and 5 years, respectively. The mean radiation dose was 50 Gy in the immediate reconstruction group and 51 Gy in the delayed reconstruction group. One complete flap loss occurred in the delayed reconstruction group, and no flap loss occurred in the immediate reconstruction group. The incidence of early complications did not differ significantly between the two groups. However, the incidence of late complications was significantly higher in the immediate reconstruction group than in the delayed reconstruction group (87.5 percent versus 8.6 percent; p = 0.000). Nine patients (28 percent) in the immediate reconstruction group required an additional flap to correct the distorted contour from flap shrinkage and severe flap contraction. These findings indicate that, in patients who are candidates for free TRAM flap breast reconstruction and need postmastectomy radiation therapy, reconstruction should be delayed until radiation therapy is complete.

Breast Neoplasms↗