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OBJECTIVE: To compare The anatomy lesson of Dr Nicolaes Tulp by Rembrandt (1632) with the findings during dissection of the forearm of a cadaver. DESIGN: Descriptive. METHOD: The left forearm of a 41-year-old white male cadaver was dissected, photographs being taken at every stage of dissection. The anatomical structures in the original painting and during dissection were described and compared. At dissection, several structures were displaced in an attempt to reproduce the anatomical structures as shown in the painting. RESULTS: Dissection revealed four anatomical differences in comparison with Rembrandt's painting: (a) the muscle belly seen at the proximal ulnar side of the forearm in the painting was not seen on dissection; section of the insertion of the M. flexor carpi radialis and transposition of this muscle to the location of the muscle belly created the possibility of lifting up the M. flexor digitorum superficialis and reproducing the muscle belly; (b) in the painting, Tulp lifted only the M. flexor digitorum superficialis, but the amount of muscle tissue found in the forceps was increased in the painting compared with the dissection; (c) the positions of the bellies of the M. flexor digitorum superficialis to the index finger and 5th digit and to the 3rd and 4th digits were found to be reversed; (d) the longitudinal white structure situated in the ulnar part of the 5th digit in the painting was not found on dissection. This may have been an anatomical variant of the ulnar nerve. CONCLUSION: The anatomical characteristics of the painting could not be reproduced by dissection of the forearm of a cadaver.

Phimosis preputii kan behandeld worden zonder een circumcisie te verrichten. - De meest voorkomende en effectiefste behandeling is de lokale applicatie van corticosteroïdcrème. - Mocht dit onvoldoende effect hebben, dan kan met 2 Z-plastieken de vernauwde ring worden onderbroken, voldoende om de glans pijnloos te ontbloten. Er wordt hierbij geen huid verwijderd. De ingreep kan poliklinisch, onder regionale anesthesie worden uitgevoerd. - Wanneer er een indicatie tot reconstructie van het preputium bestaat, kan dit plaatsvinden met een naar distaal omgeklapte lap van penisschachthuid, gecombineerd met de toepassing van vrije huidtransplantaten.

The standard technique for bridging a peripheral nerve defect is an autologous nerve graft if the nerve ends cannot be sutured. Recent evidence indicates that an alternative procedure - application of a degradable nerve guide - may be feasible. Currently the use of such a degradable nerve guide for the recovery of peripheral nerve defects in the hand is being tested in a multicenter trial. Conventional suturing as well as autologous nerve grafting are accepted methods in the control group within the protocol of the multicenter study. In the first two patients to receive the implant, a 28-year-old man and a 50-year-old woman with tendon and nerve injury due to glass cuts, the operation was technically successful. Functional nerve recovery will be assessed in due course.