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D S Wijnberg

Publications and source records attributed to D S Wijnberg.

6 recordsLinked to original sources

Pulsed dye laser treatment, a review of indications and outcome based on published trials.

INTRODUCTION: Pulsed dye laser (PDL) treatment is based on the principle of selective photothermolysis and is widely considered to be the treatment of choice for a variety of cutaneous vascular lesions. OBJECTIVE: To review the indications and outcome of PDL treatment and summarise new developments. METHOD: A literature-based study has been conducted entailing the review of publications over the period January 1993-December 2003 using the databases Medline and Cochrane CENTRAL. RESULTS: The PDL was found to be effective in port wine stain, facial telangiectasia, leg telangiectasia <0.5 mm, scars, hypertrophic scars and ulcerated haemangioma. DISCUSSION: Essential characteristics of lesions suitable for PDL treatment are discussed and guidelines are presented for future research.

Cicatrix↗

[Initial Groningen experiences with dynamic cardiomyoplasty].

Four patients, one woman and three men aged 48, 62, 49, en 54 years respectively, were subjected to cardiomyoplasty because of medically refractory heart failure secondary to ischaemic or idiopathic dilating cardiomyopathy. The operation and the training period were uncomplicated. In one patient symptoms of heart failure did not improve; the other patients experienced substantial relief of symptoms. However, all three died suddenly within one year after the operation, probably due to ventricular arrhythmias. Cardiomyoplasty may deserve a place in the treatment of heart failure, provided sudden death can be better prevented. Possibly, treatment with an implantable cardioverter-defibrillator might be useful.

Cardiomyoplasty↗

Innervated rectus abdominis myofascial flap for dynamic cardiomyoplasty.

This study examined the rectus abdominis myofascial flap as an innervated flap for dynamic cardiomyoplastic purposes. It is common to use the latissimus dorsi to wrap or patch around or in the heart, but there is a need for more innervated skeletal muscle for a variety of reasons. The rectus abdominis musculature often is used for reconstructions and its vascular reliability is well known. The segmental build-up of the rectus abdominis myofascial flap, its direct proximity to the heart, and the superb quality of the anterior fascia allow for more extensive cardiomyoplastic use than with the latissimus dorsi alone. This article describes an anthropometric cadaver study in which the methods of mobilizing the rectus abdominis myofascial flap for cardiac purposes are shown.

Abdominal Muscles↗

The rectus abdominis cardiomyoplastic procedure: preliminary results.

The rectus abdominis myofascial flap (RAMF) was investigated as a viable alternative to the latissimus dorsi flap for dynamic cardiomyoplasty. In human and animal cadaver experiments and live sheep, it was possible to use the RAMF for innervated intrathoracic use. The RAMF was stimulated by a specially designed cardiomyostimulator (Medtronic Inc., Maastricht, The Netherlands). The flap might be promising as an addition to the currently available dynamic cardiomyoplastic techniques.

Abdominal Muscles↗

Patency of arm vein grafts used in aorto-coronary bypass surgery.

Arm veins have been used in myocardial revascularisation procedures as a last resort bypass conduit because of their associated low patency. Nevertheless, leg veins and mammary arteries, which are the most commonly used, are sometimes not sufficient, leaving little choice as to the bypass conduit. To assess the properties of arm veins in bypass surgery, we compared a group of 28 patients that underwent an arm vein graft coronary bypass procedure with a matched group of patients in which leg veins were used. In 28 patients, 40 arm vein grafts with 77 distal anastomoses were used (mean 1.9 +/- 0.9; range 1-5). A cerebrovascular accident was the cause of the sole death (2%) during the study period. The mean follow-up was 4.6 years (Standard deviation, SD: 1.5 years). More antianginal medication was used in the arm vein group (P = 0.017). Additionally, the percentage of the expected maximal frequency during exercise testing was lower in the arm vein group as compared to the leg vein group. Digital subtraction angiography showed that the patency of the arm vein bypass grafts was 47% (70% confidence limits, CL: 32%-62%) while the patency of the leg vein grafts was 77% (CL: 64%-87%), which was statistically significant (P = 0.051). Comparison of these figures with the few published reports on arm veins used as coronary bypass grafts reveals similar results. We conclude that the arm vein as a coronary bypass graft is only to be used when mammary arteries and leg veins are not available.

Arm↗