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Biomedical subjects

D A Janssen

Publications and source records attributed to D A Janssen.

8 recordsLinked to original sources
PubMed1998

The extended submental island lip flap: an alternative for esophageal repair.

An esophagocutaneous fistula after total laryngectomy in a radiated field is rare. A 62-year-old man, with a history of T2N0 M0 laryngeal carcinoma, was treated with radiation therapy. He subsequently developed recurrent disease and underwent total laryngectomy. A complication of his total laryngectomy was a high esophagocutaneous fistula. The patient had no evidence of other disease. A functional repair was achieved by extending the submandibular arterial flap to incorporate the central third of the lower lip as a mucosomyocutaneous flap. This extension of the submandibular artery flap may preclude the need for jejunal free tissue transfer in some patients with esophagocutaneous fistula.

Carcinoma, Squamous Cell↗
PubMed1995

Early free-flap debulking: avoiding the second donor site.

The advantages of this technique in large, shallow defects are: 1. The flap can be monitored clinically during the critical postoperative period. 2. The aesthetic result is much better than that of the bulky myocutaneous flap. 3. No second donor site for the split-thickness skin graft is required.

Adult↗
PubMed1994

Cryptococcal infection of a prosthetic dialysis fistula.

Fungal infections of prosthetic dialysis fistulae are rare. We report the first case of infection of a polytetrafluoroethylene dialysis access graft with the yeast Cryptococcus neoformans. Therapy with antifungal agents alone failed to cure the infection and significant improvement was observed only when all prosthetic material was surgically removed. This case emphasizes the potential for fungal infection of prosthetic dialysis fistulae and the importance of removal of intravascular foreign material in conjunction with antifungal therapy for treatment of fungal prosthetic graft infections.

Aged↗
PubMed1993

Detection and characterization of mupirocin resistance in Staphylococcus aureus.

Fourteen mupirocin-resistant Staphylococcus aureus strains were isolated over 18 months; 12 exhibited low-level resistance, while two showed high-level resistance. Highly mupirocin-resistant strains contained a large plasmid which transferred mupirocin resistance to other S. aureus strains and to Staphylococcus epidermidis. This plasmid and pAM899-1, a self-transferable gentamicin resistance plasmid, have molecular and biologic similarities.

Conjugation, Genetic↗
PubMed1993

Angioedema presenting as chronic gastrointestinal symptoms.

Gastrointestinal complaints may be the presenting feature of patients with acquired or hereditary angioedema. We describe two patients with episodic nausea, abdominal pain, and cramping secondary to C1 inhibitor deficiency. In one patient, an acquired deficiency arose as a paraneoplastic syndrome with abdominal complaints preceding the diagnosis of an occult lymphoma. The second patient presented at age 61 with abdominal complaints secondary to a hereditary deficiency of C1 inhibitor. The patients' symptoms were due to gastrointestinal angioedema, resulting from episodic unregulated complement activation. The biochemical mechanism of this unusual syndrome and its diagnostic importance are discussed. A C1 inhibitor deficiency should be considered in patients with unexplained abdominal symptoms suggestive of intestinal pseudo-obstruction.

Abdominal Pain↗