Search PubMed⌕ Search

Biomedical subjects

J Van Geertruyden

Publications and source records attributed to J Van Geertruyden.

At least 19 recordsLinked to original sources
PubMed2002

[The plastic surgery department].

Plastic surgery associates reconstructive and aesthetic surgery, as these are complementary and cannot be dissociated. Modern techniques in reconstructive surgery include grafts and flap transfers. Our team does 4500 consultations and 750 operations per year, out of which a large proportion of complex reconstructions. In order to treat very various diseases, strong collaborations exist with several units such as orthopaedics, ENT, maxillofacial surgery, neurosurgery, ophthal-mology, gynaecology, and dermatology.

Belgium↗
PubMed2001

Munchausen syndrome.

Munchausen syndrome is a rare condition in which the patient repeatedly seeks medical care for factitious illnesses. With this self-inflicted disease, the patients characteristically travel from one hospital to another, feigning acute, usually spectacular illnesses. The patients willingly submit themselves to extensive as well as invasive diagnostic and therapeutic procedures. Munchausen syndrome is a psychiatric disorder that requires psychiatric treatment. Reconstructive surgical procedures may be required to correct the acquired deformities. The difficulty in Munchausen syndrome lies essentially in early recognition of the psychiatric syndrome. Two exceptional cases are reported, and diagnosis and treatment are presented in the light of the current literature.

Adult↗
PubMed2001

Nondetection of sentinel lymph node with lymphoscintigraphy as a result of massive malignant invasion shown by positron emission tomography.

PURPOSE: The authors report the complementary roles of lymphoscintigraphy in sentinel node mapping and F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in a massively invaded sentinel node. MATERIALS AND METHODS: A 49-year-old woman was referred to the authors' institution after the resection of a malignant melanoma (Clark IV, Breslow 5.25) of the right buttock. No evidence of regional or distant organ metastases was observed on bone scintigraphy or thoracoabdominal or cerebral computed tomographs. Preoperative lymphoscintigraphy showed drainage around a circular structure, without any node detected. F-18 FDG PET imaging detected an area of focal, markedly hypermetabolic activity at the same location. RESULTS: The focal, markedly hypermetabolic activity detected by F-18 FDG PET corresponded to a massively invaded sentinel node not shown by lymphoscintigraphy but found and removed at the time of surgery. Radical regional lymphadenectomy showed only one small additional lymph node micrometastasis detected after immunohistochemical staining for S-100 protein and HMB45 antigen. CONCLUSIONS: This case emphasizes the complementary roles of lymphoscintigraphy sentinel node mapping and F-18 FDG PET. Indeed, a massively invaded sentinel node may be detected by PET but missed by lymphoscintigraphy.

Female↗
PubMed1999

Sentinel lymph node mapping in the management of high risk malignant melanoma.

In patients with malignant melanoma, the selective biopsy of the first draining lymph node, so-called the sentinel lymph node, allows to identify, with a low morbidity, the patients with nodal metastasis that require radical lymphadenectomy and adjuvant systemic chemotherapy. Herein, we report our initial experience in sentinel lymph node biopsy in 16 patients with malignant melanoma. The sentinel lymph node was localised using preoperative lymphoscintigraphy and injection of dye blue. Intraoperatively, the dissection was guided with a gamma probe and by the recognition of the blue nodes. In the 16 cases the sentinel lymph node was localised. In 50% of the cases, multiple sentinel nodes were demonstrated at lymphoscintigraphy and found during surgery. A limited postoperative morbidity was observed in three cases. Three patients presented nodal metastasis and underwent further radical lymphadenectomy. We conclude that sentinel lymph node mapping is a feasible and reproductive procedure. The preoperative lymphoscintigraphy is essential to identify multiple sentinel nodes and guide surgical dissection. The impact of this approach on the overall survival of patients with high-risk melanoma has still to be demonstrated in studies with a long follow-up.

Adult↗
PubMed1998

Apocrine hidrocystoma of the finger.

An apocrine hidrocystoma occurring on the finger of a 55-year-old man is reported. The lesion presented as a solitary, painless cystic nodule on the dorsal aspect of the middle phalanx of the index finger. Apocrine hidrocystoma is a benign tumour developed from apocrine sweat glands, but the location of the lesion was, however, not consistent with reported locations of apocrine glands in the adult.

Apocrine Glands↗
PubMed1998

Free-flap evolution after hyperthermic regional chemotherapy in the isolated limb for malignant melanoma.

Two patients presenting with a stage I melanoma of the sole of the foot (Clark's level IV, Breslow's 2.8 mm, and Clark's level IV, Breslow's 3.2 mm) underwent a 3-cm tumor free-margin skin resection, followed by microanastomosed muscle flap reconstruction (serratus anterior and latissimus dorsi). Immediately after primary wound healing, an elective inguino-iliac lymph-node dissection, followed by hyperthermic isolated regional chemotherapy with Melphalan, was carried out. Only moderate swelling of both free flaps was observed after these procedures, and this resolved rapidly. The patients returned to ambulation after 2 weeks. No other side effects of the hyperthermic isolated regional chemotherapy were observed in the previously microanastomosed flaps.

Antineoplastic Agents, Alkylating↗
PubMed1998

Lipoma of the toe.

Lipoma is a common benign soft tissue tumor. It may arise in any location, but most frequently it is located on the trunk, chest, upper thigh, upper arm, and shoulder. Reports of a lipoma in the foot exist, but the occurrence of the tumor in this location is very rare. Lipomas of the toe have only been reported in children, some imitating or having associated gigantism. We present a benign lipoma occurring on the plantar aspect of the second toe in an adult.

Child↗
PubMed1997

Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: a possible manifestation of methotrexate hypersensitivity.

Large haemorrhagic and necrotic cutaneous lesions developed after two low dose (5 mg) methotrexate injections in a patient suffering from long standing rheumatoid arthritis. Differential clinical diagnosis included factitia dermatitis, infectious processes, pyoderma gangrenosum, rheumatoid neutrophilic dermatitis, necrotizing arteritis and vasculitis. Histological and direct immunofluorescent examinations of skin biopsies supported the diagnosis of leucocytoclastic vasculitis. We discuss the respective roles of methotrexate and rheumatoid arthritis in the outbreak of leucocytoclastic vasculitis. Hypersensitivity is strongly suspected.

Antirheumatic Agents↗
PubMed1996

Glomus tumours of the hand. A retrospective study of 51 cases.

The authors report a series of 51 patients with glomus tumours in the hand. The duration of symptoms before treatment averaged 10 years. No one site or finger was more commonly involved. Objective features were limited to a blue discoloration in 29%, a pulp nodule or a nail deformity in 33%. An osseous defect was seen on plain X-ray films in 36%. Diagnosis depended on clinical suspicion in 90%. Careful dissection and complete excision of the tumour almost always offer permanent relief. A direct transungual approach was used in the subungual tumours with only one cosmetic problem. Recurrence of symptoms occurred in only two cases after a pain-free interval of 2 years.

Adult↗
PubMed1996

[Post-gastroplasty plastic surgery].

Gastric volume modification by surgery (gastroplasty, gastric banding ...) is intended to improve health in patients presenting morbid obesity. However, consecutive cutaneous sequellae are always ungrateful and often particularly disabling. The treatment of these sequellae often necessitates plastic surgery correction. We present a series of 21 patients whose cutaneous sequellae secondary to gastroplasty were operated on after a mean loss of 42% of body mass index. Sixty-three anatomical sites were treated in 27 operative sessions without any general complication. The number of operative sessions was limited using a simultaneous multiple surgical team approach, which is particularly adapted to this type of patients. The local complications (11 cases) were minor (delays of healing, hematoma, seroma, abscess). Even though the final aesthetic appearance depended greatly on the preoperative situation, all the patients were satisfied with the results obtained.

Abdomen↗
PubMed1993

[Treatment of tissue defects of the posterior aspect of the elbow].

Coverage of soft tissue defects of the posterior region of the elbow can be a difficult problem. The different techniques described are reviewed, focusing on the lateral arm flap of Maruyama. Ten cadaver studies were performed to confirm the reliability of this flap, a first choice for the authors. It was used successfully in 5 clinical cases.

Adult↗
PubMed1993

[Reoperations in parathyroid surgery].

In a continuous series of 439 parathyroidectomies for primary or secondary hyperparathyroidism, 36 cases were reoperations. The initial operation had been a prior parathyroid exploration (PTx) in 17 cases, a thyroidectomy (Tx) in 17 cases, both operations in two cases. The incidence of parathyroid glands discovered at exploration was lower in both types of reoperations (67% after Tx, 72% after PTx) than in patients who were explored for the first time (94%). Anatomical variations and parathyroid pathologies were comparable in patients reoperated after Tx and in those explored for the first time. In patients reoperated after PTx, anatomical abnormalities (46% of glands in ectopic locations, 12% of supernumeray glands) and multiglandular pathologies (56% of hyperplasias) were much more frequently encountered. Long term results were satisfactory in patients explored for the first time (98% cures) and in reoperations after Tx (94% cures), but were less favourable in reoperations after PTx (78% cures).

Adult↗
PubMed1993

Total parathyroidectomy and presternal subcutaneous implantation of parathyroid tissue for renal hyperparathyroidism.

When hyperparathyroidism recurs in patients previously treated by total parathyroidectomy and intramuscular parathyroid autotransplantation, excision of the graft is not always technically easy and it is often necessary to resect the portion of the muscle containing the implants. During November 1986, we began a program to test the feasibility of presternal subcutaneous autotransplantation of parathyroid tissue. We hoped this technique would make removal of the grafts simpler. Thirty-six patients with renal hyperparathyroidism (RHPT) received subcutaneous parathyroid implants. Persistent or recurrent hyperparathyroidism was observed in three patients during the follow-up period. The presence of active parathyroid tissue was demonstrated after some time in all the patients. The parathyroid implants were easily excised in three instances (one persistent RHPT and two recurrences). Microscopic examination of the resected specimens did not show any sign of malignant transformation. We conclude that presternal subcutaneous implantation of parathyroid tissue after total parathyroidectomy is a quick, safe and efficient surgical procedure in the treatment of RHPT.

Adult↗
PubMed1992

Hypocalcemia after thyroidectomy.

Serum calcium, sodium, potassium, chloride, magnesium, phosphorus, osmolarity, total protein, albumin, parathyroid hormone, and calcitonin values were systematically surveyed in 135 patients who underwent thyroidectomy and in 104 control surgical patients. A transient and moderate hypocalcemia developed after operation in thyroidectomized and control patients. Concentrations of other electrolytes, osmolarity, proteins, and albumin followed the same pattern of evolution. After thyroidectomy, the degree and duration of hypocalcemia increased with the extent of thyroid resection. A profound hypocalcemia (less than 2.0 mmol/L) and a marked reduction of the parathyroid hormone concentration (below normal) were present in 12% and 8% of cases after subtotal thyroidectomy and in 22% after total thyroidectomy. Calcitonin values did not increase after thyroidectomy. A slight correlation was observed between the preoperative serum alkaline phosphatase level and the minimal postoperative serum calcium level. It is concluded that post-thyroidectomy hypocalcemia is a multifactorial phenomenon. It is due, at least in part, to hemodilution. A temporary parathyroid insufficiency after subtotal and total thyroidectomy, and an avidity of the skeleton for calcium in hyperthyroid patients, may aggravate the hypocalcemia.

Adolescent↗
PubMed1992

[Persistent and recurrent hyperparathyroidism following parathyroidectomy].

In a series of 416 parathyroidectomies for primary or secondary hyperparathyroidism, 19 were reoperations for persistence (17 cases) on recurrence (2 cases) of the disease. (1) Preoperative localisation studies were useless in half of the cases. (2) In re-explorations, 72% only of parathyroid glands were discovered, 46% of them in ectopic locations. In reoperations for primary hyperparathyroidism, 56% of cases had more than one pathological gland. (3) Long term results have been less satisfactory after re-explorations than after the first operations.

Adult↗