No abstract available.
Rectal Neoplasms*

The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

No abstract available.
Snake Bites* ; Snakes*

Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

No abstract available.
Humans ; Stomach Neoplasms* ; Young Adult*

No abstract available.
Duodenal Ulcer* ; Vagotomy*

Adenoma of the nipple is a benign tumor of the lactiferous ducts of the nipple which frequently causes erosion of the surface. It can clinically mmic Paget's disease and histologically be misdiagnosed as a well-differentiated adenocarcinoma. A 20-year-old woman developed an erythematous oozing patch on the right nipple two years ago, which subsequently developed iiito verrucous surfaccd papules. A biopsy specimen of the lesion showed focal acanthosis of the epidermis. The tumor was composed of fairly well-circumscribed, glandlike structures within the nipple stroma. Ductlike struciures, papillary areas, solid nests of cells and cysts lined by squarnous epithelium, could be seen, Two cell types lining the ducts were recognized; inner columnar cells and peripherally located cuboidal cells. Although simple excision of the adenoma is the treatment of choice, our case was treated successfully by electrucoagulation.
Adenocarcinoma ; Adenoma* ; Biopsy ; Epidermis ; Epithelium ; Female ; Humans ; Nipples* ; Young Adult

No abstract available.
Thumb*

No abstract available.
Head*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap