The temporoparietal galea flap.

The temporoparietal galea flap has been rediscovered as a useful tissue transfer technique. It is the only single-layered fascial flap that can be transposed into the craniofacial and head and neck region on its vascular pedicle. In the 1990s, it was used extensively in the surgical reconstruction of a wide variety of defects in the craniomaxillofacial area, ranging from scalp and auricle defects to nasal and maxillo-orbital repair to all types of intraoral and even mandibular and pharyngeal reconstructions.

Locally acquired hepatitis E in the Netherlands: associated with the consumption of raw pig meat?

We here present 2 patients who developed hepatitis E, without having been abroad or in contact with anyone who did, indicating locally acquired hepatitis E. We point out that the consumption of raw pig meat could be of relevance in HEV-associated hepatitides in the Netherlands.

Does a minimally invasive approach affect positioning of components in unicompartmental knee arthroplasty? Early results with survivorship analysis.

Fifty unicompartmental knee arthroplasties (UKAs) were performed through a minimally invasive approach and were reviewed with an average follow-up of 3.7 years. This technique leads to reduced access to surgical landmarks.

Ross procedure: medium-term results.

Introduction: The Ross procedure is a safe alternative option for aortic valve replacement in selected patients. Here we present the medium-term results of our experience with this procedure.

Methods: Between December 1998 and January 2004, 21 patients (16 male, 5 female, mean age 42 years) underwent aortic valve replacement using the Ross operation.

Endovascular treatment of a ureteroiliac fistula associated with ureteral double J-stenting and an aortic-bifemoral stent graft for an inflammatory abdominal aortic aneurysm.

We report an unusual case of a ureteroiliac fistula due to prolonged ureteral stenting for hydronephrosis combined with an aortic-bifemoral stent graft in an inflammatory abdominal aortic aneurysm (AAA), treated with an endovascular stent graft. In a 77-year-old man ureteral J-stents were placed for bilateral hydronephrosis due to retroperitoneal fibrosis caused by an inflammatory AAA. The aneurysm was treated with an endovascular aortic-bifemoral stent graft.

The facio-audio-symphalangism syndrome in a four generation family with a nonsense mutation in the NOG-gene.

We report a four generation family with features of the facio-audio-symphalangism syndrome. This condition is characterized by proximal symphalangism, conductive hearing loss due to stapes fixation and a distinctive facies. A novel nonsense mutation in the NOG gene on chromosome 17q22 was identified in the patients.

Left atrial volumes, function and work before and after mitral valve repair in chronic mitral regurgitation.

Background And Aim Of The Study: Despite the effect of mitral valve repair in left ventricular (LV) function having been extensively studied, investigations of left atrial (LA) performance indices are minimal. This prospective study was undertaken to analyze LA volumes, function and work in patients with chronic mitral valve regurgitation (MR) who underwent mitral valve repair; the analyses were conducted both before and six months after surgery.

Methods: Twenty patients (15 males, five females; mean age 51.

Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey's syndrome.

Purpose: The purpose of this retrospective study was to evaluate the incidence of Frey's syndrome after parotid gland surgery with elevation of a skin flap versus the interposition of musculoaponeurotic tissue between the skin and the facial nerve.

Materials And Methods: The standard skin flap was used in 122 patients (1981 to 1989), whereas interposition of temporoparietal galea or superficial musculoaponeurotic system was performed in 146 consecutive patients (1989 to 1998).

Results: The incidence of Frey's syndrome was reduced from 33% to 4% with the use of a musculoaponeurotic layer, and the mean duration of postoperative facial nerve paresis decreased from 3 months to 6 weeks.

A paravenous approach for the saphenous nerve block.

Background And Objectives: This study assesses a paravenous approach for saphenous nerve block at approximately the level of the tibial tuberosity, and compares it with the conventional technique of blind subcutaneous infiltration between the tibial tuberosity and the gastrocnemius muscle.

Methods: In dissections of 5 cadavers, the saphenous nerve was found very close to the saphenous vein bilaterally. Subsequently, in 20 volunteers, a bilateral saphenous nerve block was performed with 5 mL mepivacaine on each side.

Limy bile and laparoscopic cholecystectomy.

Objective: To determine incidence of 'limy bile' in patients undergoing laparoscopic cholecystectomy; to analyze patient characteristics and preoperative imaging modalities in these patients and evaluate surgical treatment.

Patients And Methods: A retrospective analysis of 1800 laparoscopic cholecystectomies performed between March 1990 and March 1998 for symptomatic gallbladder disease.

Results: Five patients with limy bile (0.

Non-respiratory tuberculosis with Mycobacterium tuberculosis after penetrating lesions of the skin: five case histories.

Tuberculosis is primarily transmitted from person to person via the respiratory route. We describe five cases of patients who developed tuberculosis at the site of a skin injury: three after being treated repeatedly with local corticosteroids via intramuscular injections, and two who cut themselves accidentally with a knife. All cultures yielded normal-sensitive Mycobacterium tuberculosis, and all patients responded well to anti-tuberculosis treatment.

Constrictive pericarditis after coronary artery bypass surgery as a cause of unexplained dyspnea: a report of five cases.

Constrictive pericarditis after coronary artery bypass grafting (CABG) is rare and can present as unexplained dyspnea. We report five consecutive cases of post-CABG constrictive pericarditis seen within a period of 17 months at our institution. All patients presented with heart failure of unknown etiology within a period of 8-84 months after surgery.

Normal values of patellar and ankle tendon reflex latencies.

The clinical value of latency measurement of tendon reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon reflexes (ATR) were measured at rest and after facilitation in 102 normal controls.

Electromyographic evidence of delayed fatigue-induced sarcolemmal excitability impairment in McArdle's disease.

Loss of sarcolemmal excitability is an early sign of fatigue in exercising muscle. This can be determined from a decreasing muscle fibre conduction velocity (MFCV). Underlying causes are still unclear.

Tropical pyomyositis in a temperate climate: a case report.

Pyomyositis is an abscess-forming infection of large skeletal muscles, usually with Staphylococcus aureus. Although it is common in the tropics and relatively rare in temperate climates, imported cases due to growing global mobility may be expected to increase its incidence outside tropical regions. Early diagnosis and correct management are imperative in this potentially fatal disorder, and require a high degree of clinical suspicion.

Acute cardiorespiratory failure as presenting symptom of chronic lymphocytic leukemia.

A patient with acute cardiorespiratory failure caused by hyperleukocytosis due to chronic lymphocytic leukaemia (CLL) is described. Although acute pulmonary failure due to leukostasis is a known and often postmortem finding in patients with acute myelocytic leukaemia (AML) or chronic myelocytic leukaemia (CML) in blastic crises, it is rare in CLL.

Laparoscopic rectopexy: early results.

Five patients with complete rectal prolapse were operated by laparoscopic approach. Technical details are described. Preliminary results are excellent.

Myocardial infarction and post-traumatic stress disorder.

Studies concerning the development of a post-traumatic stress disorder related to severe illness are scarce. The confrontation with myocardial infarction may be a very stressful event. Twenty-three patients consecutively admitted for first myocardial infarction were studied.

Deafness, sensory neuropathy, and ovarian dysgenesis: a new syndrome or a broader spectrum of Perrault syndrome?

We report on 3 sibs (2 males and one female) with sensorineural deafness. The presence of ovarian dysgenesis in the girl suggested a diagnosis of Perrault syndrome. In addition our patients have a sensory polyneuropathy and amelogenesis imperfecta.

Colour flow imaging of the normal short saphenous vein.

Colour flow imaging was used to assess the functional anatomy of the short saphenous vein (SSV) system in 104 limbs of 52 healthy volunteers. Previous studies have shown that the majority of pathological SSVs join the popliteal vein (PV) at the level of the knee. This was not the case in nearly half of the healthy limbs in this study.

Dominant congenital benign spinal muscular atrophy.

The affected members of the family described in this article exhibit congenital nonprogressive atrophy and weakness of lower limb muscles in association with contractures. Clinical and laboratory findings support a dominant lower motor neuron disorder. DNA analysis excluded linkage of the disease with SMA markers on the long arm of chromosome 5.

Somatosensory evoked potentials after iohexol myelography.

Tibial nerve and S1 dermatome somatosensory evoked potentials (SSEPs) were recorded before and after iohexol lumbar myelography in order to evaluate possible neurotoxic effects of this contrast medium. No significant change in SSEP latencies nor amplitudes was noted after iohexol myelography, supporting the low neurotoxic profile of this contrast agent. Results were compared to those of a control group of patients before and after lumbar puncture (LP), without injection of contrast agent.