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Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

tance, althdugh this high degree of penetrance is rare.89 Peters and others emphasised good nutritional habits and complete avoidance of precipitant causes as the greatest priority in treating acute intermittent porphyria.'9 In that context it is unsettling to read in van Gogh's letters the recurring theme that sickness, or something less than full health, is compatible with or even encourages ...

We report the case of a three-year-old girl who complained from dysphagia and post-prandial vomiting since she was 6 months old. Several diagnostic work-ups were performed for her problem. Upper GI endoscopy was normal but barium swallow revealed an external pressure effect over upper part of the esophagus (figure 1) and the CT angiography of thoracic aorta showed that this external pressure ef...

Neuroblastoma is the third most common malignancy of childhood, after leukemia and brain tumors. Only 2% of all neuroblastoma occur in the brain. Primary cerebellar neuroblastoma is an specific subset of Primitive Neuroectodermal Tumors (PNET). Meduloblastoma is a relatively common and well-established entity, consisting of primitive and multipotential cells that may exhibit some evidence of ne...