[Reconstruction of the floor of the mouth by arterialized dorsalis pedis flap].
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Biomedical subjects
Publications and source records attributed to N Ben-Hur.
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De Myer (1963) classified median-facial anomalies into two groups: 1. Median cleft lip with orbital hypotelorism 2. Median cleft lip with orbital hypertelorism. The first group is characterised by median-cleft lip, absence of premaxilla, nasal skeleton, and crista galli. In addition, there is a holoprosencephaly which may involve the whole forebrain or a smaller part of the brain. In this group, the children die within the first year or during childhood and always suffer from mental retardation. In this report, we present a 12-year-old child with an unusual form of median cleft lip with hypotelorism without brain deformity.
A case of chronic lymphedema of the hand and forearm following a fracture of the distal radius is reported. None of the classic causes of secondary lymphedema appeared to be the cause. A strong psychogenic component appeared to be the underlying mechanism. This rare phenomenon was thought to be self-induced and not genetic in nature.
Amniotic membrane dressings were tested in the treatment of 30 patients. Fifteen of them had burns, 5 had chronic varicose ulcers, and 10 had decubitus ulcers or other open infected wounds. No effort was made to separate the chorion from the amnion. Dressings were changed every 48 hours, and treatment was, in some cases, partially ambulatory. Good results were obtained in the treatment of 2nd- and 3rd-degree burns and of other open, infected wounds, both in the preparation of the patients for autografting and in consequent treatment.
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The dorsalis pedis flap used for immediate reconstruction in two patients after resection of cancers of the floor of the mouth. The procedure has much to recommend it in the immediate repair of such defects.
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A functional and simple surgical method for treating the respiratory distress of the neonate affected by Pierre Robin syndrome is described. The base of the tongue is placed in an anterior position via a buried wire suture tied around the body of the hyoid. The method proposed in this paper fulfills the following: 1. It is physiologic since the infant is able to suckle and maintain its nutrition by preserving the function of the mobile portion of the tongue for deglutition. 2. Maintenance of the "pushing" action of the tongue stimulates growth of the mandible. 3. The anchoring wire is not exposed in the oral cavity and the risk of tissue breakdown and infection is eliminated. 4. This technique utilizes the stronger fibrous portion of the mid-tongue rather than muscle which "gives" more readily under pressure. 5. The shortest distance from the base of the tongue to the mid-hyoid provides the best mechanical advantage. 6. The suture, if need be, may be tightened at subsequent periods of time. Under Ketamin (Ketalan) anesthesia the tip of the tongue was held in the forward position. An 18 gauge stainless steel wire was inserted via a large curved needle through the midline of the posterior-most portion at the base of the tongue. The needle was directed anteriorly and inferiorly to emerge below the mid point of the inferior border of the hyoid bone. The opposite end of the wire was then tunneled submucosally to the anterior portion of the base of the tongue at foramen caecum, and directed inferiorly to emerge above the superior border of the mid-portion of the hyoid bone. Through a small skin incision opposite the body of the hyoid bone, both free ends of the wire were tied under tension around the body of the hyoid while pulling the base of the tongue forward. The skin incision was closed with a single nylon suture. A prosthetic obturator was used to close the cleft palate. The outcome was satisfactory with no morbidity.
Amniotic bands which become involved with fetal parts, especially the extremities, are produced by rupture of the amnion during pregnancy with the consequent union of the extra-embryonic mesoderm in fibrous strings. An infant with the amniotic band syndrome, in whom an annular constriction of the left leg and right hand was found, is described. He was treated successfully by multiple Z-plasties and a plaster cast to correct the clubfoot. The oedema of the leg persisted for 5 weeks and then subsided completely. The role of amniotic abnormalities in the production of congenital malformations is reappraised. The microscopic and histological investigation of the placenta and membranes should accompany every case of fetal malformation in abortuses, stillbirths, and affected newborn.
The effect of orally administered salazopyrin on the prevention of experimentally induced peritoneal adhesions in albino rats was investigated. Comparison of the findings with those for untreated rats and rats given penicillin for sulfadiazine indicated that salazopyrin has a preventive effect on the development of peritoneal adhesions. This effect is dose dependent and does not seem to be due merely to the antibacterial effect of the drug.
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