Immediate traumatic thumb loss reconstruction: case reports.

In the article we present and evaluate our successful immediate attempts of traumatic thumb loss reconstruction in the last fourteen years: early passive stump elongation, immediate pollicization and replantation. Our experience confirms the known fact that in spite of unfavorable oblique transarticular thumb amputation with interphalangeal joint destruction, considerable bone shortening and interphalangeal joint fusion, successful replantation offered us better cosmetic and partially functional outcome than the one we have obtained ealier with other methods of immediate thumb reconstruction.

Dermatofibrosarcoma protuberans: our experience after ten years of patient's surgical follow-up.

Dermatofibrosarcoma protuberans has a high rate of recurrence, presumably as a consequence of persistent residual tumour. This is probably the main reason why repeated surgical treatment is frequently required. In the article we present our experience of surgical treatment of such malignancy on the neck and shoulder in the elder male after ten years follow-up period. The case is interesting because we started with aggressive treatment relatively late in the unfavourable, fully-developed stage of the disease, with multiple satellite nodules spreading and signs of partial myxoid degeneration of the largest tumour mass itself. Despite initial wide excision, five local recurrences--fortunately without regional or distant metastases--were observed during the first eight years. The recurrences appeared mostly in the region of greatest tumour degeneration and infiltration and where the excision margins were less than 2 cm apart from the visible tumour mass. A sufficiently wide excision, long-term follow-up and good co-operation between surgeon and experienced pathologist are crucial for the strategy of treatment and the prognosis of this unusual malignancy.

Dorsal finger joint soft tissue loss: two case reports.

This article brings our experience, standpoints and management guidelines for early reconstruction of traumatic soft tissue loss on the dorsal aspect of the finger joints, with the aim of preserving acceptable late functional ability of the hand. Two interesting and unusual cases of reconstruction are presented.

An alternative video footprint analysis to assess functional loss following injury to the rat sciatic nerve.

The rat sciatic nerve is a well-established animal model for the study of recovery from peripheral nerve injuries. Footprint analysis is the most widely used non-invasive method of measuring functional recovery after injury in this model. We describe a new, alternative video analysis of standing (or static footprint video analysis) to assess functional loss following injury to the rat sciatic nerve, while the animal is standing or at periodic rest on a flat transparent surface. We found that this alternative video analysis is technically easier to perform than the corresponding footprint video analysis while walking, but still preserves all advantages of video versus conventional ink track method: i.e. few non-measurable footprints, better repeatability, high accuracy and more precise quantification of the degree of functional loss after sciatic nerve injury in the rat.

Cardiogenic shock following a single therapeutic oral dose of verapamil.

Cardiogenic shock and apnoea appeared in a 78-year-old woman with a history of biventricular heart failure, following ingestion of a single 80 mg verapamil tablet. She was resuscitated with artificial ventilation, dobutamine, norepinephrine and calcium gluconate. Toxicological analysis revealed unexpectedly high plasma verapamil concentration, which was attributed to the patient's liver failure. In patients with advanced heart failure a single oral therapeutic dose of verapamil may have a severe toxic effect.

Video analysis of standing--an alternative footprint analysis to assess functional loss following injury to the rat sciatic nerve.

The rat sciatic nerve is a well-established animal model for the study of recovery from peripheral nerve injuries. Footprint analysis is the most widely used non-invasive method of measuring functional recovery after injury in this model. We describe a new alternative video analysis of standing (or static footprint video analysis) to assess functional loss following injury to the rat sciatic nerve, during animal standing or periodic rest on a flat transparent surface. We found good correlation between video recording during standing and dynamic ink track footprint parameter measurements for both 1-5 and injured 2-4 toe spreads only. Reproducibility for these three parameters was also better using the video method. Uninjured 2-4 toe spread by video showed a poor correlation and similar reproducibility as compared with ink. However, both print length parameters measured by video had poorer correlation and greater variability, particularly the print length factor (PLF) was weakly correlated with that determined by ink. Contribution of the footprint factors on the estimated functional loss has also changed in conditions during standing. It was most prominent for the 1-5 toe spread factor (TSF), near marginal for the 2-4 or intermediary toe spread factor (ITF), and weak, statistically insignificant for the PLF. Thus, the introduction of a new functional loss index, or so-called static sciatic index (SSI), and its estimating formula was mandatory. Moreover, using a simple ratio of injured/uninjured 1-5 video toe spread as a substitute for the SSI, we could achieve considerable simplification of the method without any significant loss of accuracy. Our video analysis of standing is technically easier to perform than the corresponding footprint video analysis during walking, but still preserves all advantages of video versus conventional ink track method, i.e. there are few non-measurable footprints, better repeatability, high accuracy and more precise quantification of the degree of functional loss after sciatic nerve injury in the rat.

[Organization of experimental microsurgery research at the General Hospital in Maribor--principles and personal experience]. / Organizacija eksperimentalne mikrokirurske djelatnosti u Opcoj bolnici Maribor--principi i nasa iskustva.

In this report, the authors discuss the organization of experimental microsurgical activities from the standpoint of their own experience. Their opinion is that elementary microsurgical technique and routine could be obtained only in the experimental laboratory. Each institution dealing with microsurgery should organize such a functional unit. The importance of an experimental laboratory is not only for education, but also for basic microsurgical research. To attain adequate results, specially in nonclinical institutions, it is necessary to follow consequently clearly defined principles of organization and provide adequate conditions. The competence of such a concept is illustrated with the results of the authors' own researches during 1987. They completed 44 microvascular anastomoses in rats, on vessels of approximately 1 mm in diameter and obtained initial and early patency rates of 88.6 and 93.2% respectively. These patency rates could be sufficient for the safe clinical application of the microvascular technique.

[Use of the composite tendo-aponeuro-capsular autotransplant in the early repair of injuries of the metacarpophalangeal (MCP) joint--case report]. / Uporaba sestavljenega tendo-aponevro-kapsularnega avtotransplantata v zgodnji oskrbi poskodovanega metakarpofalangealnega (MCP) sklepa--prikaz primera.

A case report of a mutilating injury of the hand is presented illustrating the use of a composite tendo-aponeuro-capsular autograft during primary reconstruction, with the aim to preserve the functional ability of the injured MCP joint. Some conditions necessary for such reconstruction are also mentioned.