The Helsinki approach to face transplantation

Aim

We herein describe the establishment of the Helsinki Vascularized Composite Allotransplantation (VCA) program and its execution in the first two face transplant cases.

Syndrompatienten im Rahmen der kieferorthopädischen Frühbehandlung von Säuglingen mit Lippen-Kiefer-Gaumen-Spalten

Zusammenfassung Die kieferorthopädische Säuglingsbehandlung widmet sich schwerpunktmäßig Neugeborenen mit orofazialen Spaltbildungen und Kindern mit Syndromen, vornehmlichDown-Syndrom. Über 100 Dysmorphiesyndrome können mit Spaltbildungen einhergehen.An klinischen Beispielen (Robin-Syndrom,Stickler-Syndrom) wird die Problematik der Syndromdiagnostik umrissen und an einem Fall (orofaziodigitales Syndrom) der Beitrag des in der Spaltfrührehabilitation tätigen Kieferorthopäden zur Syndromidentifikation aufgezeigt.

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Summary The orthodontist's early orthopaedic treatment of the newborn focuses on cleft palate infants and children withDowns syndrome. In more than 100 malformation syndromes, orofacial clefting occurs. The problem of syndrome diagnosis is discussed by way of clinical examples (Robin-syndrome,Stickler-syndrome).A case of oro-facial digital syndrome serves to demonstrate the orthodontists contribution to syndromic diagnosis in early cleft rehabilitation.

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Résumé Le traitement orthodontique précoce de nourrissons se voue dans le plus grand nombre des cas aux nouveaunés atteints de malformations orofaciales et aux enfants souffrant de syndromes, surtout du syndrome deDown (mongolisme). La formation de fentes peut être accompagnée de plus de 100 syndromes de malformations.La problématique du diagnostic de syndromes (séquence deRobin et syndrome deStickler) est esquissée à titre d'exemples cliniques et l'apport que l'orthodontiste s'occupant de la rééducation précoce de fentes labiomaxillaires peut faire à l'indentification de syndromes est mis en évidence à propos d'un cas spécifique (syndrome oro-facio-digital).

     

Catheter Ablation of Chronic Atrial Fibrillation with Noncontact Mapping:

SEIDL, K., et al .: Catheter Ablation of Chronic Atrial Fibrillation with Noncontact Mapping: Are Continuous Linear Lesions Associated with Ablation Success? Catheter-based, right and left atrial compartmentalization procedure was evaluated using a noncontact mapping (NCM) system. Its usefulness to identify and close discontinuities in linear lesions in both atria was evaluated. The impact of linear lesion continuity on ablation success of chronic AF was also investigated. Nineteen patients with symptomatic, drug refractory chronic AF were studied. Right atrial ablation with three predefined lines was attempted in all patients. In 18 patients, left atrial ablation was performed with four linear lesions. During a follow-up of 12 ± 3 months , 6 of 19 patients remained in sinus rhythm (SR) without antiarrhythmic agents (AAs). In addition, four patients were maintained in SR with AA. Thirteen of 14 patients with gaps identified during off-line analysis had recurrence of AF. Only one patient with a gap was free of recurrence without AAs. In the remaining five patients without recurrence of AF, no gap was observed during off-line analysis. In all four patients who were free of AF with additional treatment of AAs, two gaps had been identified. In the remaining nine patients with chronic AF recurrence, a mean of 4.9 gaps were identified. Excluding the initial learning period (first five patients) the success rate increased to 43% (6/14 patients) without and to 71% (10/14 patients) with AA. NCM identifies discontinuities in lines of ablation. Successful ablation of chronic AF is associated with continuity of linear lesions and good clinical technique demands a vigilant search for and closure of every gap. (PACE 2003; 26[Pt. I]:534–543)