[Use of pedicled cutaneous groin flaps in distal reconstruction of the upper extremity]. / Zastosowanie uszypulowanego skórno-tluszczowego plata pachwinowego w rekonstrukcjach obwodowej czesci konczyny górnej.

In the years 1981-1997 at the Department of Plastic Surgery Medical Centre for Postsgraduate Education in Warsaw 116 patients were treated surgically using groin flaps and 97 patients using a pedicled cutaneous groin flap. This paper reports the results of the later technique. Reconstructions were performed in 10 female patients aged 18-58 (mean age 37.5 years) and 87 male patients aged 15-67 (mean age 33.8 years). The tissue defects or acquired deformations were caused by: crush injuries (26 cases), scalping injuries (23 cases), rugged injuries (18 cases), avulsion trauma (15 cases), explosion injuries (8 cases) and electric burns (7 cases). Flap size depended upon extent of the tissue defect and the from flaps were 7-26 cm long and 4-12 cm wide. Flap area ranged from 35 to 260 square centimetres. Emergency procedures were performed in 59 patients (61%). Secondary reconstructions were carried out in 38 cases (39%). Operative technique was based on the rules described by McGregor and Jackson. The donor site was sutured primarily tubulizing its basis--as in tube flap. The flap pedicle was cut off during a one stage procedure in 41 patients 21-30 days (mean 23 days) after surgery or during a two-stage procedure in 56 cases. The two-stage procedure consisted of an incision of part of the pedicle after 15-45 days post-op (mean 21 days) followed by a complete dissection after a few days (mean 4 days). In 44 cases the flap required modelling i.e. excision of excessives kin and/or thinning of subcutaneous tissue. The flap healed in 96 patients (99%). Complications at different stages of the treatment were observed in 40 patients (41%). In 3 cases wound ischemia was observed because of too tight suturing. Removal of skin sutures lead to normalization of blood supply. In 7 patients cyanotic skin of the distal part with no significant consequences was observed. In 27 patients (28%) necrosis of the marginal tissues surrounding the operation wound after cutting of the pedicle was noted. Besides supported necrectomy a conservative treatment was also applied by putting dressings soaked with antiseptics and 0.5% neomycine solution on a daily basis. This prolonged treatment by further several weeks. No significant complications were observed at the donor site.

[Rhabdomyosarcoma of the middle ear in childhood]. / Rhabdomyosarcoma ucha srodkowego u dzieci.

The authors have described a case of a 2.5-year-old boy who suffered from rhabdomyosarcoma of the middle ear. The clinical course, differential histopathology diagnosis and dynamic growth of the tumor have also been presented. In spite of combined therapy--surgery and chemotherapy--prognosis in rhabdomyosarcoma of the middle ear in childhood is poor.

Congenital temporomandibular joint ankylosis--a case report.

A case of congenital temporomandibular joint (TMJ) ankylosis which caused facial disfigurement, significant reduction in mouth opening, difficulties in feeding and breathing, and general interference with physical and mental development is presented. The wide range of manifestations exceed the typical picture of TMJ ankylosis and resemble a syndrome rather than an isolated defect of the TMJ.

[Analysis of menstrual cycle irregularities in adolescents]. / Analiza zaburzen miesiaczkowania u mlodocianych.

The analysis covered 1615 teenagers, patients of Child's & Adolescents Gynaecology Clinic in Lódz in the years 1980-1990. 338 of them had troubles in the menstrual cycle. Majority of them (55.6%) claimed about algomenorrhoea, 17.6% had oligomenorrhoea and 10.5% had hypermenorrhoea. The examined teenagers were normally developed both in respect of age and gender. Age of menarche is relatively a little lower in Lódz, i.e. 12.4 years of age.

An objective evaluation of retrocochlear function by means of CNT (Cochlear Nerve Tester).

Indications for hearing implants in profoundly deaf patients have been presented. Auditory pathway status was evaluated by application of electric stimulation of cochlear nerve. The electric stimulus originated from Cochlear Nerve Tester. Obtained sound sensations might be revealed on ABR pattern.

[Syndrome of double uterus with occluded vagina, lack of kidney and ovarian dermoid cyst on the same side]. / Zespól podwójnej macicy z niedrozna jedna pochwa, brakiem nerki i torbiela skórzasta jajnika po tej samej stronie.

The developmental anomalies of the reproductive system are frequently accompanied by urinary system anomalies. Among the development anomalies of the urogenital system, the syndrome of double uterus with occluded one vagina and lack of kidney on the same side is very rarely encountered and, in view of this, little known. This anomaly may be frequently accompanied by other developmental anomalies. The authors presented such a case. Thanks to the theoretical knowledge its diagnosis and adequate management were facilitated.

Ehlers Danlos syndrome type I with novel dental features.

The clinical, radiographic and histologic findings are described in two cases of Ehlers Danlos Syndrome Type I with novel dental features. Defective dentinogenesis principally affecting the mandibular incisors result in aplasia or hypoplasia of root development predisposing to localized periodontal disease. A striking radiographic appearance with a bulbous enlargement of the roots together with pulp stones is seen in other teeth. 'Giant channels' and vascular inclusions resembling 'intermediate cementum' are prominent within this area. No evidence of Type III procollagen or collagen was detected with indirect immunofluorescence. It is suggested that an inherited collagen abnormality in a component common to dentin, skin, ligament and tendon probably explains both EDS I and the dentin dysplasia.

[An objective evaluation of retrocochlear structures in the auditory pathway by means of CNT (cochlear nerve tester)]. / Obiektywna ocena sprawnosci pozaslimakowych struktur drogi sluchowej za pomoca CNT (Cochlear Nerve Tester).

Indications for hearing implants in profoundly deaf patients have been presented. Auditory pathway status was evaluated by application of electrical stimulation of cochlear nerve. The electrical stimulus originated from Cochlear Nerve Tester. Obtained sound sensations might be revealed on ABR pattern.

[What do we know about Ludwig van Beethoven's deafness?]. / Co wiemy o gluchocie Ludwiga van Beethovena.

The authors described some details from the life of Beethoven, emphasizing his problem linked with his progressive deafness. The etiology of the deafness is not known. The authors discussed their own hypothesis of "music language".

[Incidence of Trichomonas vaginalis infection among girls from the Lódz population in the last 25-year period]. / Ekstensywnosc zarazenia rzesistkiem pochwowym dziewczat z populacji lódzkiej w ostatnim 25-leciu.

19,024 girls (aged: from 0 to 18) attending the Pediatric Gynaecology Outpatient Department and the Center for Treatment of Parasitic and Mycotic Diseases were examined. The diagnosis of infection with T. vaginalis was based on preparations using various methods and cultures on specific media, from vaginal content and urine. It was found that the frequency of T. vaginalis invasions in girls had lessened 2-6 times in different groups from 1960 till 1985 and the higher percent of T. vaginalis in girls over 10 years old had been observed than in younger ones. There exists the statistically significant correlation (P less than less than 0.02) between T. vaginalis invasions in girls and other persons from their environment (families).

[Analysis of the relations between selected symptoms of inflammation of the genital and urinary organs and invasion of Trichomonas vaginalis]. / Analiza zbieznosci miedzy wybranymi objawami zapalenia narzadów plciowych i moczowych u dziewczat a inwazja Trichomonas vaginalis.

Data concerning 604 girls up 18 year old were analysed. On the basis clinical symptoms and results of culture of various biological materials on selected media--the monofocal Trichomonas infection concerning the most often vulva and vagina, rarely urethra or other regions of urinary organ as well as the multifocal Trichomonas infection, particularly complicated by mycosis were proved. It was found the convergence statistically significant (P less than or equal to 0.5) of the invasion of T. vaginalis with some symptoms of inflammation of genital and urinary organs; the highest values of Pearson-Bravais coefficient was obtained in Trichomonas infection of genital organs and vaginal discharges, pain of vulva and vagina, the picture of colpitis maculosa, but in the multifocal one also with itching and pain in urethra and dysuria. T. vaginalis without symptoms occurred very seldom in the girls.

A Polish variant of isolated dentinogenesis imperfecta with a generalised connective tissue defect.

A case is described of four generations of a Polish family with characteristic features of dentinogenesis imperfecta, who also presented with a variety of generalised connective tissue features, suggestive of a structural gene mutation causing abnormalities in connective tissues other than dentine.

[Horizontal osteotomy of the mandibular body with transfer of the inferior dental nerve]. / Ostéotomie horizontale du corps de la mandibule avec transfert du nerf dentaire inférieur.

In a patient with developmental facial asymmetry resulting from unilateral mandibular hyperplasia, irregular height of the mandibular body was strongly manifested on the affected side. Since a large portion of the inferior border of the mandible predicted to be cut off contained almost the whole of the lower alveolar nerve, transfer of the latter was employed. The nerve was surgically isolated along its course, and secured by being lifted while horizontal osteotomy of the mandibular body was performed. The nerve was accommodated in new groove created at a safe distance from the roots of the lower teeth. Postoperative healing was uneventful, but feeling in the region of lower lip was decreased during a few days immediately after surgery. The patient reexamined 18 months later demonstrated satisfactory esthetic and functional result with preserved feeling in the region supplied by the lower alveolar nerve.