Poul Fogh-Andersen

Malignant melanoma of the skin in children (0 to 14 years of age) in Denmark

A total of 63 cases of cutaneous malignant melanoma in children have been reported to the Danish Cancer Registry during the 40-year period from 1943-1982. In order to describe the true incidence of childhood melanoma in Denmark, a clinical and pathological evaluation was performed. Not surprisingly we found that childhood melanomas were gravely overdiagnosed in Denmark. Nine cases of childhood melanoma were identified in our material. Seven of these were aged 10 to 14 years. Two of the tumours had developed in congenital giant naevi. The crude incidence rate was estimated to be between 0.24 x 10(-6) and 0.32 x 10(-6). In Denmark this corresponds to one new case of childhood melanoma every 3 to 4 years.

Lip and nose morphology in patients with unilateral cleft lip and palate from four Scandinavian centers

Sixty patients with unilateral cleft lip and palate were compared for lip and nose appearance. All patients were photographed from an anteroposterior and a basal view at 7-10 years of age. The photographic registration method was tested for validity and accuracy. Although the four groups of 15 patients each were treated according to different protocols, many similarities were found with shorter lip heights at the cleft side and inclination of the rima oris. Asymmetry of nose and retropositioning at the cleft side naris were generally seen. Significantly straighter noses were demonstrated in the group treated with a two-stage lip nose operation combined with nose plugs, and the two groups where vomer flaps were used showed the greatest deviation of the nose.

Electrical oral burns in Danish children with special reference to prevention

68 children, most of them 1-3 years old, with electric burns of the mouth from slight cases to severe burns with extensive necroses were treated over a 30-year period. Principles of primary conservative treatment and secondary reconstructive surgery are mentioned. A Stein- Abbe flap procedure, single or double, has been the method-of-choice in severe defect of the lower lip. In the majority of the cases the accident was caused by a defective bakelite plug from the detachable cord of a popular electric vacuum cleaner of Danish origin. In 1968 a plea was made for a change of this kind of plug to a better type made of an unbreakable plastic material. As a prophylactic measure this intervention seems to have been very useful in so far as the number of these senseless accidents has decreased dramatically in Denmark during the last 15 years.

Cleft lip and palate, scoliosis, skeletal and cardiac malformations and other dysmorphic features in a child. Case report

A girl aged 3 1/2 years presented with cleft lip and palate, facial asymmetry, brachycephaly, persistent ductus arteriosus, vertebral defects, and progressive scoliosis. There was, however, no significant mental and growth retardation.

Fresh, frozen, or decalcified bone grafts: A study of early vascularization and mineralization of allogeneic and syngeneic bone grafts in rats

The incorporation of syngeneic and allogeneic bone grafts pretreated by freezing or demineralisation was studied in 10 rats. Fresh, decalcified, or frozen cancellous bone of syngeneic or allogeneic origin was transplanted to intramuscular pouches. Revascularisation was evaluated with radioactive microspheres; formation of new bone was assessed by incorporation of strontium, and resorption was assessed by measuring the reduction of graft weight. Three weeks after grafting, fresh syngeneic and allogeneic bone differed significantly in all three variables. Frozen syngeneic bone was revascularised significantly better than frozen allogeneic bone, but there was no difference in formation of new bone or resorption. There were no significant differences between syngeneic and allogeneic decalcified bone in any of the variables studied. We conclude that differences in incorporation between syngeneic and allogeneic bone grafts are reduced by pretreatment with deep-freezing or demineralisation. Both forms of pretreatment affect the incorporation of the grafts.

Speech results in CLP patients operated on with a von Langenbeck palatal closure

A speech evaluation of 203 CLP patients operated on at the Department of Plastic Surgery, Rikshospitalet, Oslo, during the period 1969-75 has been performed. All patients had the posterior palate closed using a modified von Langenbeck technique at an average age of 24.4 months. The speech evaluation, based on 4 clinical tests, was done at the age of 6 years by experienced speech pathologists. The results were considered good concerning articulation and nasality in 86.2% and 80.5%, respectively. Among the 36 patients with moderate or severe nasality, 28 had a pharyngoplasty performed. The final speech results were considered good in 97.3% of the whole sample.

Positive nitrogen balance in burn patients

Two case-histories of patients with full thickness burns covering 60 and 70% of their bodies are presented. In spite of the obligatory increase in the metabolic rate, both patients had a positive nitrogen balance from the very beginning, maintained exclusively by peroral nutrition.

Two major burn cases

Case histories of two patients admitted to the Burns Unit in 1976 and 1982, with very extensive and very deep burns, are described. The philosophy behind the usual treatment plan of the Unit and the unorthodox ideas that had to be devised in order to treat the 2 patients are described.

A ten-year retrospective study of sepsis in severely burned patients treated with or without silver sulfadiazinate

Three groups of extensive burn patients of the surgical intensive care unit (ICU) have been compared: Group I: twenty patients, who were treated locally without silver sulfadiazinate (1968-1970); Group II: the twenty first patients topically treated with silver sulfadiazinate (1970-1972); Group III: twenty similarly treated patients, with silver sulfadiazinate, six years later (1976-1977). The groups are statistically comparable. All bacteriological samples were computerized; the chi-square method was used for statistical analysis of the data. The main conclusions are: (A) Silver sulfadiazinate treatment reduced Pseudomonas aeruginosa and Proteus sepsis. No change in Coliform bacilli sepsis was observed. After six years, a rise in Klebsiella sepsis and Candida sepsis was noted. (B) A quantitative estimate of infections in each group was made by measuring the percentage of positive samples, taking into account the five above-mentioned strains. In the beginning, silver sulfadiazinate reduced quantitative sepsis, but this benefit decreased after six years; the same evolution was demonstrated for positive blood bacteriology; severe septicaemia showed a parallel pattern.

Early necrectomy in deep burns of aesthetically and functionally important areas

Deep burns of aesthetically and functionally important body areas in children may in their later growth and development have a decisive role. Of the total number (2743) of hospitalized children at the Burns Department of the Pediatric Surgery in Zagreb in the last ten years, deep burns of some aesthetically and functionally important body areas were separated and the results of the application of the early necrectomy and immediate grafting method, as recommended by Janzekovic, are analysed. It is concluded that the results, due to the strict and minute application of the method (considered are individual technically important details and solutions) are good in aesthetic and even more so in the functional sense. Very fast recovery of the functions as well as the fact that up till now no surgical corrections for functional disorders were necessary in analyzed areas, along with already known advantages of the early surgical treatment, undoubtfully speak for its application.