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Biomedical subjects

J C Van der Meulen

Publications and source records attributed to J C Van der Meulen.

15 recordsLinked to original sources
PubMed1999

Symmetry and morbidity assessment of unilateral complete cleft lip nose corrected with or without primary nasal correction.

OBJECTIVE: Unilateral complete cleft lip patients treated with or without a primary nasal correction at the time of cleft lip repair were compared to evaluate the relevance of early surgical correction of the nose by using two assessments: nasal symmetry and morbidity. DESIGN, SETTING, PATIENTS: The no nasal correction group (NNC, n = 19) was operated by surgeon A using the Millard technique. The primary nasal correction group (PNC, n = 9) was operated by surgeon B combining the modified Millard technique with a columellar lift and alar mobilization. Symmetry was assessed on two sets of standardized photographs at 9 years of age using a computer-assisted analysis. Both cleft groups were compared with normal controls (NC, n = 20). The computer method included area and angular measurements. Morbidity was assessed by the number of procedures on the vermilion, the lip, and/ or nose for revisional surgery up to the age of 9 (NNC, n = 26; PNC, n = 12). RESULTS: No significant differences in symmetry were found between the NNC and PNC groups regarding the area and angular measurements. With regard to the area measurements, both cleft groups produced a significant asymmetry when compared to the NC group. Concerning the angular measurements, however, the NNC group differed significantly from the NC group, whereas such a difference could not be noted between the PNC group and NC group. With respect to morbidity, no revisional procedures were performed in the PNC group. The number of revisional procedures in the NNC group was 16 in 10 patients. CONCLUSION: Results are presented that favor, up to the age of 9 years, a primary nasal correction at the time of cleft lip repair.

Child↗
PubMed1994

[Scaphocephaly. Its clinical study and surgical treatment].

The authors report a clinical study in 51 patients with scaphocephaly. Since 1986 the mathematical patterns of projection geometry have been applied to the reshaping of the skull in the early surgical correction of scaphocephaly. The mathematical and geometric principles are discussed and the surgical technique utilized is illustrated. Results are presented. The authors, encouraged by the very satisfactory results obtained, suggested the application of the method for the reshaping of the skull in other craniofacial malformations.

Craniosynostoses↗
PubMed1993

The hand of the musician: the kinematics of the bidigital finger system with anatomical restrictions.

Tendons of the fingers are frequently interconnected by anatomic structures that limit the displacements of these tendons relative to each other. In this paper a bidigital finger system in which such interconnections between tendons are present is kinematically modelled. Using this model, an exhaustive description of the effects on finger movement of connections between the different tendons of the fingers is given. The study provides a context for the interpretation of typical difficulties of finger coordination in musicians, especially in pianists and string players.

Finger Joint↗
PubMed1993

Double-opposed Z plasty for upper eyelid entropion correction.

Recurrent cicatricial entropion of the upper eyelid creates a surgical problem. We present a 53-year-old patient with complicated postsurgical fibrotic and scarred upper eyelid entropion. Double-opposed Z-plasty incisions were used at the anterior approach. The outer Z incision included the skin and the orbicularis oculi muscle underneath, whereas the inner Z incisions included the tarsal plate and conjunctiva, in a mirror-image fashion. Two goals were achieved, i.e., release of the vertical traction vector of the conjunctiva and balance of forces between the anterior and posterior layers of the lid. Symptomatic and clinical improvement was observed, and there was no recurrence 2 years after surgery.

Entropion↗
PubMed1992

Biomechanics of the finger with anatomical restrictions--the significance for the exercising hand of the musician.

Exercise and teaching of musicians presupposes in the individual the constitutive ability to freely execute the finger movements required in the playing of the instrument. However, in the hand anatomical restrictions may exist that limit the mobility of the fingers and, thereby, the possibility to determine their movements voluntarily. In this article we investigate the kinematics of a monodigital system in which restrictions are present.

Biomechanical Phenomena↗
PubMed1992

Replantation of the radial side of the hand in the rhesus monkey: anatomical and functional aspects. A preliminary study to composite tissue allografting.

Before human hand transplantation can even be considered, an appropriate research model must be studied in a non-human primate. The first ray of the hand, augmented with a radial forearm flap, was chosen as a functional composite tissue graft. Four technically successful replantation of the radial unit have been carried out. One monkey died on the first post-operative day due to cardiac arrythmia. Normal wound healing occurred in the other three animals. In three monkeys, functional sensory and motor recovery was almost complete. The monkeys were able to pick up small particles of food with the index finger and thumb. It is suggested that this model could be used for allogeneic composite tissue transplantation in a non-human primate.

Animals↗
PubMed1988

The radial forearm flap.

The radial forearm flap or 'Chinese' flap, originally used as a fasciocutaneous flap based on the radial artery, is extremely versatile and can be employed as free vascularized or island flap with or without skin, vascularized nerve, tendons or bone. The radial forearm flap was performed in 21 patients (16 free and 5 as a distally based island flap) for head and neck as well as for hand and foot reconstruction. All flaps survived. Indications and complications are discussed.

Adolescent↗
PubMed1984

Hypertelorism and the median cleft face syndrome. An embryological analysis.

A microscopical study of the early and late development of the face was performed in 77 human embryos and fetuses. After the transformation of both nasal placodes, via nasal grooves, into the nasal tubes the ectoderm of the face is closed superficially and the early development of the face (less than or equal to 17 mm crown-rump length (C-RL)) is terminated. Between the nasal tubes the internasal groove is present. Furthermore these embryos show physiologically a flat nose and hypertelorism. During the late development (greater than or equal to 17 mm C-RL) of the face the internasal groove disappears due to the outgrowth and differentiation of the nasal septum in the frontocaudal direction. Simultaneously (17-27 mm C-RL) the distance between the eyes decreases relatively, because of a relative lag in transverse growth. The differentiation of the facial mesenchyme into bone centres starts in the same period. From this embryological point of view the major anomalies of the median cleft face syndrome (hypertelorism--orbital as well as interorbital--and cranium bifidum occultum, median cleft nose, median cleft prolabium and median cleft premaxilla), can be classified as secondary or late, i.e., differentiation, defects.

Bone Diseases, Developmental↗
PubMed1983

Cerebro-craniofacial and craniofacial malformations: an embryological analysis.

A macro- and/or microscopical study on the normal and abnormal development of the forebrain with the eyes, nose, and cranium, was performed in 139 mouse embryos, 120 normal and 19 abnormal human embryos and fetuses, and in about 2,300 human skulls. The results suggest that from the embryological point of view, a distinction should be made between facial defects involving the brain and/or the neural elements of the eyes, i.e., the cerebro-craniofacial dysplasias, and malformations of the face and cranium only, called the craniofacial dysplasias. Both groups can be subdivided into early or primary defects (in embryos less than or equal to 17 mm C-RL) and late or secondary defects (in embryos greater than or equal to 17 mm C-RL). Almost all of the primary defects can be considered to originate from disorders occurring during the transformation of the brain and face. The secondary defects concern defective differentiation of neurectoderm and of the mesenchyme into bone centers, cartilage, and muscles. All of the defects in question can be explained by insufficient cell proliferation, degeneration, and/or differentiation. New terminology is proposed.

Animals↗
PubMed1982

The management of orbitofacial neurofibromatosis.

Neurofibromatosis is a rare inherited disease that may present as facial hamartoma or as a more generalized disease with subcutaneous tumors, skin pigmentation in the form of café-au-lait patches, and multiple pedunculated neurofibromas on a narrow skin base. The generalized form of the disease is named after von Recklinghausen, who described its main features in 1882. In this paper, we restrict ourselves to a discussion of the craniofacial manifestation of the disorder and also report our experience in treating 2 patients with orbitofacial neurofibromatosis at the Rambam Medical Center in Haifa.

Child, Preschool↗
PubMed1982

Pathology and treatment of nasoschizis.

A craniofacial malformation is caused by a developmental arrest that results in focal fetal dysplasia. The severity, location, and number of these dysplasias make a wide spectrum of abnormalities possible. In this spectrum nasal dysplasia and, more particularly, the malformations characterized by a cleft in the lateral part of the nose play a prominent role, but in past years they have received only scant attention. In Tessier's classification this nasoschizis is the Number 1 cleft. We present here our observation in 2 patients with nasoschizis and the procedure used to correct it. Both patients were operated on at the Rambam Medical Center in Haifa, Israel.

Cleft Lip↗