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Biomedical subjects

K W Marck

Publications and source records attributed to K W Marck.

At least 19 recordsLinked to original sources
PubMed2003

Cancrum oris and noma: some etymological and historical remarks.

Necrotising ulcerative stomatitis is used in the International Statistical Classification of the WHO for orofacial gangrene in children, that is known in medical literature as cancrum oris or noma. The many historical synonyms for this disease together with other historical data indicate that orofacial gangrene in children was a common affection in Europe in previous centuries. The etymological and historical backgrounds of the names "noma" and "cancrum oris" indicate that "cancrum oris" is based on the incorrect use of the Latin term "cancer oris" and maybe on tradition, for which reasons the use of "noma" as medical term for necrotising ulcerative stomatitis should be preferred.

Child↗
PubMed2002

[Some similarities between the work of M.C. Escher and plastic surgery].

At first sight there would appear to be no similarities between the work of the Dutch graphic artist M.C. Escher and plastic surgery. M.C. Escher was a gifted graphic artist who produced a large collection of work. Most of his fame is due to the works that play with symmetry, space and infinity and leave the viewer astounded. However, how Escher came to produce these works is less well known. A theory which he developed himself formed the basis of the regular plane division. It later became apparent that this theory almost completely agreed with the mathematics of plane division. Two movements (isometries) defined in mathematics, translation and rotation, are equivalent to two techniques for transferring local skin in plastic surgery, namely, advancement and transposition. Escher's performance on the plane of a sheet of paper and a plastic surgeon's performance on the plane of the skin, therefore have a similar mathematical background. Escher has visualised these mathematical rules in an unusual and artistic manner, whereas plastic surgeons apply these rules in the grace of an elastic and healing nature.

Art↗
PubMed2001

[Noma: Dutch history of a nearly forgotten disease].

Noma is an orofacial gangrene that may develop in malnourished and debilitated children. It was once a common disorder in the Netherlands. The medical history of noma has some important Dutch contributions. In 1595, Carel Baten was the first to describe noma as a clinical entity and in 1680, Cornelis van de Voorde coined the name 'noma' for this orofacial gangrene, thereby replacing the term 'water cancer' which was then in common usage. One of the first facial reconstruction operations on a noma patient was performed by Leendert Stelwagen in 1779. Noma gradually disappeared in the Netherlands during the second half of the nineteenth century due to an improved nutritional status amongst the poorest in society. Yet in other parts of the world approximately 110,000 children a year still die from this disorder, which has been largely forgotten in the Western world.

Child↗
PubMed2001

[Low 5-year recurrence rate after surgical excision of 126 basal cell carcinomas with frozen section analysis upon indication].

OBJECTIVE: To determine the recurrence rate of basal cell carcinoma (BCC) after surgical excision. DESIGN: Retrospective. METHOD: The records of all 139 patients treated for BCC at the Department of Plastic Surgery and Hand Surgery, Leeuwarden Medical Centre, Leeuwarden, the Netherlands, in 1992 were reviewed. This was done by examining case histories and additional information was obtained from dermatologists, general practitioners, patients and the Dutch National Automated Pathological-Anatomical Archive. One hundred and twenty-six BCCs were investigated in 108 patients: 51 men and 57 women, with a mean age of 66 years (range: 24-92). Of these BCCs, 114 had not been previously treated and 12 were a relapse. Freeze section analysis was carried out during the excision if a sprouting or deep growth was suspected and if a tight excision or reconstruction with transposed or rotated piece was desired. RESULTS: The mean follow-up was 59 months (range: 5-86). Sixty-one BCCs on which frozen section analysis was performed were excised completely. In 65 BCCs which were excised without frozen section analysis, a second operation was necessary on 11 occasions to obtain histologically free margins. In both groups a tumour recurred on one occasion (2/126; 1.6%). CONCLUSION: Surgical treatment of BCC aimed at free histological margins, results in a recurrence rate of 1.6%.

Adult↗
PubMed2001

[Noma: 'the face of poverty'].

Noma (cancrum oris, water cancer) is an orofacial gangrene that may develop in malnutritioned children debilitated by concomitant diseases as measles. It has been hypothesized that the gangrene originates from acute necrotizing gingivitis, common in malnourished children in developing countries. In previous centuries noma was common in the Western world. The affection disappeared when economical progress permitted the poorest to feed their children sufficiently. The yearly incidence of noma in the world is estimated as 140,000. The mortality is +/- 90%. The facial deformities of those who survive noma are generally serious. Beside facial mutilations, oral functions are hampered (trismus, oral incontinence, impaired speech). Both prevention (improved feeding, measles vaccination) as the treatment of those who contract and survive noma are a challenge for the 'global village' of the modern world.

Africa↗
PubMed2000

[Transposition of the tendon of M. tibialis posterior an effective treatment of drop foot; retrospective study with follow-up in 12 patients].

OBJECTIVE: To evaluate the results of transposition of the tendon of the M. tibialis posterior in patients with a drop foot. DESIGN: Descriptive, retrospective and follow-up investigation. METHODS: Surgical treatment was carried out in 12 patients with a drop foot (9 women and 3 men, with an average age of 37 years) in the period 1986-1998. The aetiology of the drop foot was a traumatic or iatrogenic lesion of the peroneal nerve or sciatic nerve in 9 patients and in 3 patients spina bifida occulta, leprosy and a herniation of a lumbar disc respectively. None of the patients had important comorbidity. Treatment consisted of lengthening the Achilles tendon according to Huckstep, transposition of the tibial posterior tendon in two tails to the dorsomedial and dorsolateral side of the foot, and six weeks of immobilisation in plaster of Paris. RESULTS: The postoperative period was without complications. The treatment improved the heel-toe steppage gait in all patients. None of the 10 patients who had used an orthosis preoperatively still used it at the time of the follow up. Fifty per cent of the patients acquired a dorsiflexion of the foot of more than 0 degree. The results were in accordance with those in the literature. CONCLUSION: Transposition of the tibial posterior tendon is a worthwhile alternative for those patients with a drop foot (and without important comorbidity) who cannot walk satisfactorily with an ankle-foot orthosis.

Adolescent↗
PubMed1999

Histoplasmosis of the wrist.

We present a case of synovitis of the wrist due to histoplasmosis, diagnosed only after extensive surgery and culturing. Treatment with amphotericin B in combination with radical surgery was effective in curing the disease. This manifestation was probably an exacerbation of a latent chronic infection with Histoplasma capsulatum, although it was unclear why the exacerbation occurred. Synovitis resistant to treatment should be assessed with great care, especially in view of the growing number of immunocompromised patients. Close collaboration between surgeon, rheumatologist, pathologist and microbiologist is paramount in such cases.

Aged↗
PubMed1999

Surgical treatment of noma.

In the acute stage of noma the role of surgery is a minor one: wound care and, very occasionally, treatment of haemorrhage. However in patients who survive noma, and develop a mutilated and disabled face (trismus, leakage of saliva, impaired speech), reconstructive surgery may improve their fate significantly. Because of economic and educational reasons reconstructive surgery in noma patients should be performed preferably in their own country. Treatment consists of excision of all scar tissue, correction of the trismus and closure of the tissue defects with local, pedicled or free flaps. Because of the large variety of tissue defects and the many surgical options, systematization and subsequently standardization of the reconstructive surgical approach to patients with the sequelae of noma is needed.

Cicatrix↗
PubMed1998

[Plastic surgery treatment of a nose tip amputation in an Eleven-Cities marathon skater].

A 41-year-old male participant of the 200 km Eleven Cities ice skating marathon in 1997 lost a large part of his nose tip as a result of hitting a bridge. Avascular replantation of the amputated nose tip combined with ice water cooling for three days did not result in revascularisation. Subsequently the entire nose tip was reconstructed by means of a paramedian forehead flap. This reconstruction was performed in three stages and had a good aesthetic result.

Adult↗
PubMed1996

Internal mammary artery and vein supercharge in TRAM flap breast reconstruction.

To improve the blood supply of the pedicled flap we have performed an additional microvascular augmentation to this type of breast reconstruction procedure since 1991. The ipsilateral deep inferior epigastric pedicle is anastomosed to the internal mammary artery and vein (IMAV supercharge). In 19 of 20 patients this technique proved to be feasible. For the venous anastomoses the 3M microvascular anastomosis system facilitated the procedure. In one patient the venous anastomosis failed due to the small calibre of two internal mammary veins. In a majority of the cases rapid improvement of flap perfusion could be observed as the direct result of the supercharging. The IMAV supercharged flap is quite comparable with the free flap as regards to the operative procedure. Disadvantages are a slightly more extensive dissection and less freedom in positioning the flap due to the presence of the superior muscular pedicle. The main advantage is that the supercharge procedure minimises the risk of total flap loss. Further technical improvement may be obtained by the use of a contralateral vascular pedicle dissected with muscle-sparing techniques.

Anastomosis, Surgical↗