Surgical repair of an anterior tibialis muscle hernia with Mersilene mesh.

The most frequent muscle hernia of the lower extremities is the anterior tibialis muscle hernia. A number of surgical procedures are available for the treatment of symptomatic anterior tibialis muscle hernias. However, in case of a large fascial defect, their use may be unfeasible or inconvenient. Moreover, current surgical procedures are prone to the risk of an anterior tibial compartment syndrome. The use of a synthetic patch could provide an alternative, particularly for large defects. In this paper we report the repair of a large, symptomatic, long-standing anterior tibialis muscle hernia with polyester mesh (Mersilene) fixed to the edges of the defect (muscular fascia and tibial periosteum). This simple procedure provided excellent functional results and a good cosmetic appearance without complications and sequelae.

Use of the bilobed flap for coverage of exposed structures on the fingers.

An original surgical procedure for the repair of soft tissue defects localized on the dorsal aspect of the proximal phalanx of the fingers is described. A patient was seen with a posttraumatic soft tissue loss corresponding to the dorsal aspect of the second metacarpophalangeal joint and the adjacent proximal half of the proximal phalanx of the index finger with extensor tendon exposure. The repair of the defect using a local flap taken from the second web space and the dorsum of the proximal phalanx of the long finger provided excellent coverage with early movement and a good functional result.

Ruptured abdominal aortic aneurysm. Analysis of 50 procedures.

The authors report their experience in the management of 50 patients operated on for ruptured abdominal aortic aneurysms. The importance of an early surgical indication will be discussed. A didactically written chart will be presented to simplify and allow early diagnosis. The results will be analysed as to onset of rupture, quantity of transfused blood and shock condition of the patient.

Alanine and aspartate aminotransferase serum levels in burned patients: a long-term study.

Increased alanine and aspartate aminotransferase (ALT and AST) serum levels are usually considered expressions of cellular necrosis, especially in hepatocytes. They represent cellular damage due to burn which, according to many authors, becomes normal before discharge of patients. We studied 43 consecutive burned patients, both during and after recovery, from a minimum of 120 to a maximum of 640 days, and an average of 18.62 blood samples were taken from each patient. Hepatitis A and B markers were tested. Results showed a 67.44% increase in aminotransferases in patients during recovery and a 25.58% increase after discharge. No neopositivity was observed for hepatitis A and B markers. We therefore conclude that the increase of enzymes during recovery expresses a toxic-infective phase and this increase, contrary to what was believed, does not always drop to normal values at time of discharge. Instead, after discharge, higher values can be a manifestation of a Non-A Non-B hepatitis.

Aminotransferase changes in burned patients.

The time course of serum transaminases (alanine aminotransferase and aspartate aminotransferase) has been followed in 30 selected consecutive patients presenting burn sizes ranging from 10% to 95% of the total body surface (mean 43.13) and a survival index from 0.99 to 0.00 (mean 0.59). The results show that in all the patients both transaminases change in parallel, increasing in 18 patients (60%). In nearly all patients both enzymes increase during the second week after injury and aspartate aminotransferase increases later than alanine aminotransferase. The higher transaminase levels are noted in moderately ill patients. No clear correlation between the overall increase of transaminases and the extent of burned surface area has been found. We conclude that functional liver alterations mostly contribute to the increase of serum transaminases in burns.

Na+-dependent, electroneutral L-ascorbate transport across brush border membrane vesicles from guinea pig small intestine.

In brush border vesicles from guinea pig small intestine L-ascorbate transport is Na+-dependent and electroneutral (in the presence of Na+, as shown by its lack of response to either positive or negative delta psi across the membrane). L-Ascorbate transporter has the kinetic characteristics of a mobile carrier (Km for L-ascorbate, 0.3 mM). D-Isoascorbate (erythorbate) seems to be another, but poorer, substrate of the same transporter. L-Ascorbate transport is subjected to heterologous inhibition by D-glucose.