The free fasciocutaneous infragluteal (FCI) flap: Outcome and patient satisfaction after 142 breast reconstructions.

Background: The free fasciocutaneous infragluteal flap (FCI) is relatively rarely used for autologous breast reconstruction; however, it is a good option for thin patients. The outcome of 142 FCI flaps for breast reconstruction is presented here.

Materials And Methods: Between January 2008 and December 2013, 142 patients underwent unilateral breast reconstruction with the FCI flap.

Pathophysiology and modern treatment of ulcer disease.

This is an overview of the pathophysiological abnormalities of gastroduodenal (GD) ulcers [duodenal ulcer (DU), gastric ulcer (GU) and Dragstedt ulcers (combined DU and GD)], as well as the effects of the different treatments (surgical, medicinal and physiological) described since the introduction of stomach resections. The intention is to demonstrate whether the peptic ulcer diseases are a homogeneous entity with a characteristic pathophysiology or whether they represent the final expression of many heterogeneous causes including impairment of upper gastrointestinal motility. The review also asks whether DU and GU have a common or different pathogenesis and whether ulcers in the stomach might be predominantly due to impaired mucosal resistance and the DU to gastric hypersecretion.

[Vacuum-assisted closure therapy. Current status and basic research].

The gap between the broad clinical use of vacuum-assisted closure therapy (VT) and knowledge of the physiological mechanisms leading to its effectiveness is great. The value of the technique and its future development are dependent on research into these mechanisms. A meta-analysis evaluating the results of basic research on the effectiveness of VT was carried out based on peer reviewed publications.

[Vacuum-assisted closure therapy and wound coverage in soft tissue injury. Clinical use].

This study presents the results of a meta-analysis based on the literature dealing with the clinical applications of vacuum-assisted closure (VAC) in the areas of chronic wounds, acute posttraumatic wounds, compartment syndromes, or injuries of the upper extremities. The studies were analysed for validity, significance of conclusion with respect to success rate, publications, and economic efficacy. The data show that with VAC a very valuable technique has been added to an integrated therapeutic concept of soft tissue reconstruction.

[Functional and aesthetic refinements of free flap coverage at the dorsum of the hand and distal forearm].

Introduction: Free coverage of exposed functional structures of the hand and distal forearm can be achieved using a variety of free flaps. However, there is a lack of data in the literature which tissue components are best used for defect coverage of this specific area regarding aspects such as tendon gliding and tissue elasticity. The purpose of this retrospective study was to compare and to evaluate the functional and aesthetical results using free cutaneous, fascial and muscle flaps.

Long-term results of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-Wrist) and scapholunate advanced collapse (SLAC-Wrist).

Unlabelled: Outcome evaluation of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist).

Purpose: Scaphoid nonunion or scapholunate ligament instability results in carpal collapse and subsequent arthrosis. These conditions, termed SLAC-wrist and SNAC-wrist, are the most common patterns of arthrosis in the wrist.

Current status of genetic modulation of growth factors in wound repair.

Growth factors are members of a large functional group of polypeptide regulatory molecules secreted by different cells. They are important players in orchestrating all stages of wound healing exerting their influence through autocrine and paracrine fashions within sites of injury and repair. They are mitogen, chemotactic, they regulate cell-cell interactions and influence synthesis and composition of extracellular matrix components.

The influence of neural signal transduction on EEC gene expression under consideration of chromatin, following myenteric ablation (review).

Significant numerical and spatial changes in 5-HT i.r. cells, CCK i.

Influence of the intramural innervation on the morphogenesis of the enteroendocrine cells and the genetic construct involved (review).

The influence of intramural intestinal innervation on the morphogenesis of the mucosa and in particular of the enteroendocrine cells (EECs) has been studied on male Wistar rats with morphometric, autoradiographic and immuno-histochemical methods in the duodenum, proximal and distal jejunum and ilium before and after myenteric ablation with benzalkonium chloride (BAC). Twenty-one days after denervation alterations were observed in the mucosal structure with thickening of the mucosa, increase in the proliferation rate and with changes in numerical and spatial distribution of D-cells, I-cells, N-cells, glucagon and glicentin i.r.

Different endogenous opioid effects on delta- and mu-receptor subtypes in antral and duodenal motility of conscious dogs.

To evaluate the role of endogenous opioids in regulation of upper gastrointestinal motility in unanesthetized dogs and to differentiate the actions on mu- and delta-opioid receptors, seven strain gauges and five platinum electrodes were chronically implanted at the serosa along the antrum and duodenum and connected to a plug in the neck of the dog. Signals were processed by a Hellige AC amplifier, a rectilinear recorder, and a data aquisition system. A motility index (MI) was calculated and together with the electrical data a contractile activity percentage (CAP) was determined for consecutive 30 min periods.

Changes in muscularis externa of rat small intestine after myenteric ablation with benzalkonium chloride: electron microscopic and morphometric study.

The influence of the intrinsic innervation on the muscularis externa of the rat small intestine was studied by chemical ablation of the myenteric plexus with benzalkonium chloride (BAC). The resulting severe hypertrophy (cell hypertrophy of 96-133% and hyperplasia) differs from working hypertrophy by the distribution and degree of muscle thickening and by characteristics of the extracellular matrix: narrowing of muscle interspaces of 43%; lack of increased collagen; changes in the ratio of interstitial cells of Cajal (ICCs) to fibroblasts from 1.6:1 to 0.

Effect of 17-norleucine-VIP on gastroduodenal motility relative to serum VIP concentration and blockade of NOS.

Mechanical and electrical activity in the antrum, pylorus, and duodenum was evaluated in the conscious dog, instrumented with seven strain gauges and five platinum electrodes. 17-Norleucine-vasoactive intestinal peptide (17-N-Leu-VIP) or 17-N-Leu-VIP plus NG-nitro-L-arginine methyl ester (L-NAME) was injected intra-arterially close to the pylorus to identify influences of nitric oxide (NO) on effects of VIP. VIP concentration was measured by radioimmunoassay in serum samples collected from the cubital and portal veins before and up to 2 h after VIP injection.

Intrinsic corporoantropyloric coordination of motility and gastric emptying.

This study examined changes in gastric motility after interruption of the intramural nervous circuitry from the proximal portion of the stomach to the antrum by a circumferential gastric myotomy. Seven extraluminal strain gauge force transducers and five platinum electrodes were implanted along the antropyloroduodenal region, and gastric emptying was studied by X-ray after a 280-g solid meat meal mixed with barium. The motility index increased aboral to the myotomy by 106 and 69% in the distal antrum and pylorus, respectively, in the first postprandial 30-60 min because of the loss of an inhibitory neural influence from the proximal part of the stomach.

Histologic, immunohistochemical and morphometric study of the mucosa of the total gastric antrum in patients with carcinoma of the stomach.

Examination of gastrin-immunoreactive G-cells, somatostatin-immunoreactive D-cells, enterochromaffin cells and 5-hydroxytryptamine-immunoreactive (5-HT-immunoreactive) cells of the completely mapped histologic antrum (70 to 100 tissue blocks) was done in 20 normal stomachs of persons between 17 and 94 years of age (from forensic autopsy). Results were compared with those of nine patients between 48 and 76 years of age with total gastrectomy for carcinoma of the proximal part of the stomach. Cell counts and morphometric examinations were performed.

Innervation of pylorus in control of motility and gastric emptying.

The motility index (MI) and contractile frequency were determined for the gastric antrum, pylorus, and duodenum during digestive and interdigestive states in eight dogs before and after resection of the ramus pyloricus nervi vagi (NR) and after selective proximal vagotomy (SPV) subsequent to NR. Neither NR nor subsequent SPV altered the migrating motor complex in the interdigestive state. In the digestive state, NR decreased the MI in the antrum, pylorus, and duodenum.

Effects of erythromycin in the dog upper gastrointestinal tract.

The effects of erythromycin on motor and electrical behavior of the antrum, pylorus, and duodenum were determined in chronically instrumented, awake dogs. Erythromycin infusion resulted in an abrupt, powerful increase in motility. The motility index increased 18-fold in the antrum, 15-fold in the pylorus, and 8-fold in the duodenum.

Changes in the structure and regeneration mode of the rat small intestinal mucosa following benzalkonium chloride treatment.

Tritiated thymidine was administered IP to rats that had been exposed to benzalkonium chloride in the duodenum, jejunum, and ileum, resulting in neuronal ablation. Epithelial cell proliferation and migration were studied 21 and 7 days after treatment. Significant hyperplasia and hypertrophy of the villi and crypts was seen from day 7 on.

Myoelectric activity of small intestine after chemical ablation of myenteric neurons.

Ablation of the myenteric plexus was performed by serosal application of 0.062% benzalkonium chloride (BAC) in the duodenum, proximal and distal jejunum, and ileum. The thickness of muscle layers and the number and sizes of ganglia and neurons of the myenteric plexus were evaluated before and 21-28 days after treatment.

Effects of superior mesenteric and coeliac ganglionectomy on peptide-producing cells of the small intestinal mucosa in the Hanford mini pig. II. Immunohistochemical study.

Superior mesenteric and coeliac ganglionectomy was performed in 5 Hanford mini pigs and cholecystokinin (CCK)-immunoreactive I-cells, neurotensin (NT)-immunoreactive N-cells, glucagon (Glu)-immunoreactive L-cells, glicentin (Glic)-immunoreactive L-cells and somatostatin (Som)-immunoreactive D-cells were quantitatively evaluated in the duodenum, the upper, middle and lower jejunum and the ileum before, 3 weeks and 6 months after ganglionectomy. Three additional animals served as controls. After ganglionectomy, I-cell numbers increase by 110% in the upper jejunum and duodenum; N-cells increase by 86% in the lower jejunum.

Effects of superior mesenteric and coeliac ganglionectomy on the small intestinal mucosa in the Hanford mini pig. I. Histological and enzyme-histochemical study.

The effects of total superior mesenteric and coeliac ganglionectomy on the thickness of the mucosa, the cell composition of the epithelium and the enzyme activity of the absorptive cells was studied in 10 Hanford mini pigs 3 weeks and 6 months after ganglionectomy. The mucosal thickness increased after ganglionectomy by 10-33% (P less than 0.02) mainly due to increase in the villus height.

Recurrence of peptic ulcer after selective proximal vagotomy and pyloroplasty in relation to changes in clinical signs and symptoms between 1969 and 1983.

Only those patients who were examined endoscopically were evaluated. Concomitant examinations, such as biopsy, histologic studies, roentgenograms, scintiscanning, acid secretion, serum gastrin and review of the operative reports, were done. Duodenal ulcers (1,219) and gastric ulcers (421) were examined preoperatively.

[Relations between general pathology and clinical medicine].

After two preliminary remarks concerning the kind of approach in modern scientific research and the relations which exist between structure and life the author at first deals with the present state of the general and special pathology as well as the modern clinical medicine. Following this the change is discussed, which is outlined in the correlations between clinical medicine and pathology, and possibilities for a repeated closer cooperation are investigated.