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Biomedical subjects

B van der Lei

Publications and source records attributed to B van der Lei.

At least 19 recordsLinked to original sources
PubMed2004

[Successful breastfeeding after reduction mammaplasty].

OBJECTIVE: To determine if it is possible to successfully breastfeed after reduction mammaplasty with intact continuity between papilla and glandular tissue. DESIGN: Retrospective by use of a written questionnaire. METHOD: Between 1986 and 2000, 994 women under the age of 35 underwent a reduction mammaplasty at the Medical Centre in Leeuwarden, The Netherlands. They were all sent a questionnaire of which 585 were completed correctly and returned. RESULTS: Of the 585 women, 215 had had one or more children and 90 had started breastfeeding, 57 of whom were successful (63%). In non-operated women this figure is 69%. The advice to try to breastfeed was associated with a higher percentage of success than the advice not to try--78% and 42% respectively. CONCLUSION: It appears to be justified to encourage women who have had a breast reduction to attempt to breastfeed after the birth of a child.

Adult↗
PubMed2002

[Recognition of malignant skin tumors of the head and neck].

Skin cancer is the most common malignancy in man. The sun-exposed surfaces of the head and neck are the areas most frequently involved. Since skin cancers in most instances are easily recognized, they may be diagnosed at an early stage. The dentist may play a role in the early detection of skin cancers of the head and neck.

Dentists↗
PubMed2001

Long-term results of arthrodesis of the carpometacarpal joint of the thumb.

We reviewed 48 arthrodeses of the carpometacarpal joint of the thumb in 39 patients being treated for osteoarthritis. The mean follow-up period was 90 months (range 14 months-17 years). In 28 (58%) hands pain relief was excellent and in 6 (12%) good. Morbility was significantly reduced (p < 0.002). Mean key pinch (52.9 N) and grip strength (219.5 N) were comparable with the unoperated hand (51.0 and 239.1 N, respectively). Hand function was near normal. In 29 hands an additional operation was needed to remove the osteosynthesis material; 14 hands failed to unite. Osteoarthritis of the scaphotrapezial joint increased significantly faster in the operated hands than in the unoperated ones (p < 0.0001). A soft tissue procedure (such as flexor carpi radialis interposition arthroplasty) is advised instead of arthrodesis, because of the large number of reoperations, based on non-union and removal of the osteosynthesis material. From a survey of published papers we conclude that arthrodesis of the carpometacarpal joint of the thumb can best be done by stapling and bone grafting.

Adult↗
PubMed1999

Closure of radial forearm free flap donor site with local full-thickness skin graft.

A triangular shaped full-thickness skin graft harvested adjacent to the donor site of the radial forearm flap, as originally described by Liang et al, has successfully been used in seven consecutive patients for coverage of the donor site of the radial forearm free flap. In all patients this resulted in a robust coverage with no late wound breakdown and an aesthetic appearance far superior to split-thickness skin-graft coverage. We recommend this technique which is feasible in the majority of cases and reduces both donor site and graft site morbidity of the radial forearm flap.

Bandages↗
PubMed1998

[Plastic surgery treatment of a nose tip amputation in an Eleven-Cities marathon skater].

A 41-year-old male participant of the 200 km Eleven Cities ice skating marathon in 1997 lost a large part of his nose tip as a result of hitting a bridge. Avascular replantation of the amputated nose tip combined with ice water cooling for three days did not result in revascularisation. Subsequently the entire nose tip was reconstructed by means of a paramedian forehead flap. This reconstruction was performed in three stages and had a good aesthetic result.

Adult↗
PubMed1997

Bilateral osteoarthritis of the trapeziometacarpal joint treated by bilateral tendon interposition arthroplasty.

Twenty-four flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for bilateral trapeziometacarpal osteoarthritis were reviewed. Pain was reduced in all cases. Function was improved in all right hands and in 92% of the left hands. FCR tendon interposition arthroplasty for bilateral trapeziometacarpal osteoarthritis yields satisfactory long-term results on both sides.

Adult↗
PubMed1997

Osteosarcoma of the sternum.

Primary malignant sternal tumours are very rare. The most common malignant sternal tumour is a chondrosarcoma. Until now, controversies in the management of malignant sternal tumours were mainly caused by limited clinical experience. However, treatment of malignant sternal tumours should not differ from that of chest wall malignancies. In this paper a 74-year-old man with a kyphoscoliosis and an osteosarcoma of the sternum is described who received combined treatment modalities, consisting of surgical resection and reconstruction with a myocutaneous flap, followed by external beam radiotherapy. This treatment strategy is discussed.

Aged↗
PubMed1996

Poly(DL-lactide-epsilon-caprolactone) nerve guides perform better than autologous nerve grafts.

The aim of this study was to compare the speed and quality of nerve regeneration after reconstruction using a biodegradable nerve guide or an autologous nerve graft. We evaluated nerve regeneration using light microscopy, transmission electron microscopy and morphometric analysis. Nerve regeneration across a short nerve gap, after reconstruction using a biodegradable nerve guide, is faster and qualitatively better, when compared with nerve reconstruction using an autologous nerve graft. Therefore, we conclude that in the case of a short nerve gap (1 cm), reconstruction should be carried out using a biodegradable nerve guide constructed of a copolymer of DL-lactide and epsilon-caprolactone.

Analysis of Variance↗
PubMed1996

Carpometacarpal arthritis of the thumb.

Forty-five flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for the treatment of carpometacarpal osteoarthritis were reviewed. The average follow-up period was 103 months (range, 22-213 months). Pain was reduced in 42 (93%) of the cases. Mobility was equal to that of the unoperated side. Key pinch and grip strengths compared to the unoperated thumb measured 86% and 90%, respectively. The mean distance between the scaphoid and the base of the first metacarpal bone was 7 mm (range, 2-12 mm). Function was improved in 39 (87%) of the cases, and in 42 (93%) of the cases the overall results were satisfactory. The results of this study show that FCR tendon interposition arthroplasty gives satisfactory long-term results.

Arthritis, Rheumatoid↗
PubMed1996

The 3M precise microvascular anastomotic system for implanting PTFE microvenous prostheses into the rat femoral vein.

Successful implantations of PTFE microvenous prostheses with 3M precise anastomosis systems were presented. Twelve PTFE prostheses (Gore-Tex;I.D.1.0 mm) were implanted into rat femoral veins by means of 3M precise technique to evaluated the patency rate. In the control group, PTFE prostheses (n = 12) were implanted by means of end-to-end technique. In the experimental group, patency of the PTFE prostheses was evaluated at 3 (n = 6) and 6 (n = 6) weeks after implantation by means of macroscopic inspection and scanning electron microscopy. All prostheses except one were patent at the time of removal (patency rate 91.7 percent). All the microvenous prostheses were completely covered by an endothelial layer at 3 and 6 weeks after implantation, and no stenosis was observed at the anastomotic sites. In the control group, all prostheses except one were found to be occluded 3 weeks after implantation. These results demonstrate the value of the 3M precise technique when implanting PTFE microvenous prostheses.

Anastomosis, Surgical↗
PubMed1995

Biological performance of a degradable poly(lactic acid-epsilon-caprolactone) nerve guide: influence of tube dimensions.

One of the ways to reconstruct a nerve defect is to use a biodegradable nerve guide. The aim of this study was to establish a nerve guide constructed of an amorphous copolymer of lactic acid-caprolactone. A pilot study was set up to elucidate the effect of the tube dimensions on nerve regeneration. Four types of nerve guides, with internal diameters ranging from 1.12-1.23 mm and wall thicknesses ranging from 0.34-0.68, were tested for this purpose. We evaluated the biodegradation, foreign body reaction and nerve regeneration by light microscopy, after three different implantation times (1, 2, and 3 months). After 2 months, we observed that all types of nerve guides had changed from a transparent to an opaque and swollen state, and that they had lost their strength. The foreign body reaction was characterized by the presence of giant cells and fibroblasts surrounding the degrading nerve guide. From this pilot study, we conclude that nerve guide type 1, with an internal diameter of 1.23 mm and a wall thickness of 0.34 mm, can ensure nerve regeneration in the case of a 1-cm gap in the sciatic nerve of the rat. Nerve guides types 3 and 4, with relatively small lumens, show nerve compression due to a more pronounced swelling of the degrading tube.

Animals↗
PubMed1995

Influence of luminal pore size on the patency rate and endothelialization of polymeric microvenous prostheses.

In microvenous prosthetic surgery a continuous search for better patency rates is necessary to enable a clinical application. In this search for better patencies, modifications in the wall structure are being made. Directions found in the literature suggest that pore size plays an important role in achieving better patencies. Thus far, no study has been conducted to evaluate the influence of pore size on the patency rate of polyurethane microvenous prostheses. Since polyurethane is known to yield good patency rates, we conducted this study in which we compared different luminal pore sizes with regard to patency. Pore size varied from 0.6 to 20 microns in microvenous polyurethane-based prostheses (length 5-6 mm, internal diameter 1 mm). The results showed a favorable patency rate in the pore sizes larger than 5.0 microns (patency 75%) when compared to pore sizes smaller than 2.0 microns (patency 50%). This study demonstrates that microvenous polyurethane-based prostheses with a luminal pore size larger than 5.0 microns may yield better patency rates than prostheses with a luminal pore size smaller than 5.0 microns. Further studies are currently being performed to elucidate the very reasons for this effect.

Animals↗