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Biomedical subjects

G Ballon

Publications and source records attributed to G Ballon.

At least 19 recordsLinked to original sources
PubMed2005

[Anterolateral thigh flap. Retrospective study].

The anterolateral thigh flap is a cutaneous or fasciocutaneous perforator flap, extensively used in China, Japan, Taiwan (Demirkan et al., 2000; Kimata et al., 1997; Koshima et al., 1993; Luo et al., 1999) but infrequently in Europe, probably because of variations in origin and course of the cutaneous perforators rending its use apparently less reliable. This study is about 13 anterolateral thigh flaps performed between November 1, 1998, and December 30, 2002, on 13 patients, four women, nine men. Among these 13 flaps, 11 were free flaps, two were pedicled flaps. The surgical procedure was decided because of loss of soft tissue localised in: floor of the mouth (2 flaps), limb (9 flaps), inguinal-illiac region (2 flaps). The mean age of patients was 47.7 years (ext. 23 years and 69 years). The quality of the result was evaluated by the surgeon as good or very good, fair or bad. The function of the donor site was evaluated by questionnaire of the patient and physical examination of knee extension. Three free flaps were re-explored because of venous thrombosis, one of them necrosed. No functional impairment was found. The result was evaluated by the surgeon as good or very good in 11 cases, fair for one case, "bad" in the case were the flap was lost. The results of the reconstructive procedure using the anterolateral thigh flap are satisfying. This flap is reliable if the surgical technique is strictly applied.

Adult↗
PubMed2003

[Uterine liposarcoma invading abdominal wall and inguinal region. Immediate reconstruction using a pedicled anterolateral thigh flap].

The anterolateral thigh flap is a particular flap of the vastus lateralis musculocutaneous flap (perforator flap). This flap was used as a pedicled flap to reconstruct the abdominal wall and to cover the inguinal region following the resection of a voluminous tumor of the womb invading the abdominal wall, the femoral vessels and the skin. The flap included a large facial paddle nourishing a skin island and a little muscle paddle including the perforator vessel. This medially positioned facial paddle allowed to increase the area of useful flap. So it was possible to reconstruct a 10x15 cm abdominal wall defect, and to cover the vascular decking in inguinal region with this only flap. In spite of the harvesting of a small muscular paddle of vastus lateralis (with conservation of the motor nerve) the function of thigh extension has been preserved. Besides the subtlety described to increase the "solid" surface of the fragment, it seems that the anterolateral thigh flap is perfectly useful to cover defects of soft tissues in inguinal region after vascular surgery, indication which was not reported to our knowledge in spite of the high frequency of these losses defects.

Abdominal Wall↗
PubMed2002

[Anterolateral thigh free flap. Surgical technique].

The anterolateral thigh free flap is a cutaneous or fasciocutaneous flap vascularised by one or several perforating arteries arising from the descending branch of the lateral circonflex femoral artery. Venous drainage occurs via the perforators or a similar route to the deep femoral system or the femoral vein. This flap is commonly used in Asia (China, Japan) where for certain teams, it replaces the classical radial forearm flap or the rectus abdominis myocutaneous flap for the reconstruction of head and neck defects after tumor ablation. We briefly describe the anatomy and vascularization of this flap and present the harvesting technique as well as the properties of the flap.

China↗
PubMed2001

Telomerase activity and clinical progression in chronic lymphoproliferative disorders of B-cell lineage.

The activation of telomerase, which specifically occurs in neoplastic cells to avoid telomere attrition at each cell division, is a necessary event in tumorigenesis. The evidence that telomerase is also present in normal B cells at different levels according to their differentiation and activation state makes the study of telomerase activity in B cell tumors particularly interesting. This review summarizes data concerning telomerase activity in chronic lymphoproliferative disorders of B-cell lineage (B-CLD), making suggestions regarding B-cell development and B-cell tumor histogenesis. The role of telomerase activity as a potential prognostic marker, as well as a target of new antineoplastic strategies is discussed.

B-Lymphocytes↗
PubMed2000

Human immunodeficiency virus type 1 modulates telomerase activity in peripheral blood lymphocytes.

The effect of human immunodeficiency virus type 1 (HIV-1) on telomerase activity in peripheral blood lymphocytes (PBL) was examined. Telomerase is an enzyme that is involved in mechanisms that control cell life span and replicative potential. HIV-1 reduced telomerase activity in in vitro-infected PBL and impaired enzyme activation upon cell stimulation. Telomerase activity was significantly lower in PBL from 23 HIV-1-infected patients than in PBL from healthy donors and significantly increased during highly active antiretroviral therapy (HAART) in 10 patients who had both a virological and an immunological response and in 5 and 8 patients with a virological or an immunological response, respectively. Further analyses of fractionated cells revealed that telomerase activity increased mainly in CD4(+) lymphocytes. Overall, these findings demonstrate that HIV-1 infection down-modulates telomerase activity and suggest that both the HIV-1 decline and immunorestoration in response to HAART contribute to increased telomerase activity in CD4(+) lymphocytes.

Antiretroviral Therapy, Highly Active↗
PubMed1999

Telomerase activity in chronic lymphoproliferative disorders of B-cell lineage.

The progressive shortening of telomeres at each cell division is a key mechanism in controlling cell proliferative capacity. The activation of telomerase, a reverse transcriptase that extends telomere length, potentially leads to unlimited cell proliferation, and is believed to play a critical role in the neoplastic process. High levels of telomerase activity have been demonstrated in almost all solid tumours; however, little data is available concerning its expression in chronic B-cell neoplasms. By using a quantitative polymerase chain reaction-based method we quantified telomerase activity in normal B lymphocytes, and in various B-cell malignancies, including chronic lymphocytic leukaemia (CLL), mantle cell lymphoma (MCL) and hairy cell leukaemia (HCL). Compared to normal B cells, which expressed very low levels of telomerase activity, malignant cells from most of the patients showed a significant increase in telomerase activity, with highest values observed in HCL samples. Moreover, among the CLL and HCL cases, significantly higher levels of telomerase activity were found in patients with progressive disease at 1 year follow-up versus patients with stable disease. These data suggest that telomerase activity might correlate with disease progression.

Aged↗
PubMed1999

Serratus anterior free fascial flap for dorsal hand coverage.

Reconstruction of the dorsal surface of hand defects requires thin, pliable, well-vascularized tissue with a gliding surface for the extensor tendon course. Fasciocutaneous or fascial flaps are the two surgical options. Fascial flaps present the advantages of thinness and low donor site morbidity. The authors present 4 cases of serratus anterior free fascial flap (SAFFF) used to cover the dorsum of the hand. The SAFFF with skin graft has many advantages for a fascial flap: long, constant vascular pedicle; very thin, well-vascularized tissue; low donor site morbidity; and the possibility of simultaneous donor and recipient site dissection. Furthermore, it can be associated with other flaps of the subscapular system for complex reconstructions. Of the 4 observations described, 2 used associated flaps, 1 used the SAFFF with a latissimus dorsi flap, and 1 used a scapular bone flap with the SAFFF. One flap was lost due to an electrical lesion to the forearm vessels.

Adult↗
PubMed1999

[Serratus anterior muscle flap: indications and sequelae. 26 cases and review of the literature].

The authors report their experience of the use of the serratus anterior flap. Between 1992 and 1997, this flap was used for 14 head and neck and 11 limb and 1 intra-thoracic reconstructions. Twelve patients were examined for functional evaluation of the donor site. When only 2 or 3 slips are raised donor site morbidity is limited to moderate winging of the scapula with no functional disorders. Because of its thinness, and the length and diameter of the vascular pedicle, the serratus anterior flap is our favourite option for small wounds of the distal limb or composite and large defects in association with flaps of the subscapular system.

Adolescent↗
PubMed1999

[The facial artery-buccinator musculo-mucosal flap for reconstruction of the palate].

Since may 1999, 5 facial artery musculo-mucosal (FAMM) flaps have been used for mucosal reconstruction of the top of the mouth. The FAMM flap, first described by Pribaz in 1993 is a modification of the naso-labial cutaneous flap. The flap can be inferiorly based on the facial vessels (orthograde flow) or superiorly based (retrograde flow). It can easily reconstruct palate, alveolus and soft palate defects. The are of rotation has its pivot point inferiorly at the retromolar trigone, superiorly at the gingival labial sulcus. The FAMM flap has been used for 2 palatal fistula after facial blast injuries and 1 secondary cleft palate surgery. For the cleft palate surgery an Lefort 1 osteotomy with iliac crest graft was associated. All the flap but one survive with primary healing. One partial necrosis was noted but spontaneously healed secondarily. The FAMM flap is a reliable flap for mucosal reconstructions of the top of the mouth. The flap dissection is easy and the donor site morbidity is low.

Adolescent↗
PubMed1995

[The principle of Colson's flap applied to facial reconstruction].

Reconstruction of facial skin defects after cancer surgery or trauma with conventional flaps can give a poor cosmetic result when a thick flap is used to replace thin skin. The thickness of the flap can be a disadvantage to replacing a thin skin. Defatting the flap can resolve these situations, using the principle of Colson's flap. This operative procedure is safe, and improves the cosmetic results. The authors report a series of 21 full-thickness skin defects located at the junction of two or three regional units. The defects were repaired with total or partial undermining flap (frontal, nasoiabial, cheek flaps). The viability of these reconstructions was perfect and the cosmetic results fairly esthetic in comparison with conventional flaps.

Basal Cell Carcinoma↗
PubMed1995

[Cervicofacial involvement of primary cutaneous neuroendocrine carcinomas or Merkel cell tumors: therapeutic considerations].

Seven cases of primary skin neuroendocrine carcinoma or Merkel cell tumours with cervico-facial localization are reported. The poor prognosis of these tumours is essentially due to the potential for local recurrence and the frequency of locoregional and visceral metastasis. Surgical treatment is required but rarely sufficient to control the disease. Complementary radiotherapy, when performed early, can reduce the rate of locoregional recurrence. Lymph node resection is important to determine prognosis but has not been proven to improve outcome. In addition, parotid metastasis appears to result from blood stream dissemination and has a very poor prognosis. Exclusive radiotherapy may be discussed in such cases.

Adult↗
PubMed1993

[Forum on tissue expansion. Breast reconstruction by expansion in a young woman with sequelae of thoracic amniotic disease. Apropos of a case].

Amniotic disease or congenital skin sulci disease is a clinical entity covering a broad spectrum of malformations, usually involving the limbs, skull and face. This malformation is exceptional in the thorax. The authors report the case of a 22 year old woman with sequelae of thoracic amniotic disease, consisting of unilateral mammary aplasia, atrophy of the pectoralis major and latissimus dorsi muscles and deformity of the homolateral thoracic skeleton. They describe the breast reconstruction performed by tissue expansion in this patient.

Adult↗
PubMed1991

[Covering of ischial pressure sores using a fasciocutaneous flap from the posterior surface of thigh (modified Griffith method) after mattressing with the biceps femoris. Apropos of 11 cases].

The ischial region is the commonest site for pressure sores in paraplegics capable of sitting. The choice of treatment must be guided by two imperatives: the need for a thick tissue cover (mattressing) and perfect trophicity, the risk of recurrence which always remains possible. The association of a modified Griffith fasciocutaneous flap from the posterior surface of the thigh and a hamstring muscle flap (preferably biceps femoris) providing mattressing of the ischial region, appears to satisfy these imperatives. The other repair procedures are discussed in order to ensure the best management of the paraplegic patient's cutaneous capital, due to the continual risk of a new pressure sore or a recurrence of the ischial pressure sore.

Adult↗
PubMed1991

[Treatment of loss of substance of the ankle or heel in adults. Apropos of a series of 88 cases].

Cover of ankle and heel defects is always a difficult problem for the plastic surgeon. This complexity is due to the poor blood supply and the limited amount of surrounding soft tissue, as well as the high incidence of adjacent lesions. Apart from pressure sores in bedridden patients, skin defects in active patients, which require reconstruction to a state as close as possible to the premorbid state, are relatively rare. A plastic surgery unit is faced with this problem four or five times a year, on average. This low incidence means that each patient constitutes a particular case. There are no series in the international literature sufficiently large to establish any statistically valid data. The authors analyse a series of 88 cases of ankle or heel defects treated between 1982 and 1989 in the plastic surgery unit of CHU de Tours. They report their experience of the techniques used and define the indications in relation to the nature of the structures exposed and the weight-bearing or non-weight-bearing nature of the defect to be covered.

Adult↗
PubMed1990

[Presuture: back-up technique in plastic surgery. Review of 18 cases].

The recent technique of "presuturing" has been used in 18 cases of skin lesions in which primary wound closure after resection would not have been possible without undermining. This method, which takes a few more minutes, on the day before the operation, allows an easier surgical closure after resection. Our case reports concern melanomas, giant nevi, Bowen's disease and tattoos measuring 6 to 84 cm2. Some sites respond better than others to presuturing. The cosmetic gain for the patient confirms the surgical gain of this method.

Adolescent↗
PubMed1990

[Inner canthus--anatomical junction. A surgical entity].

The medial canthus is a surgical entity. The anatomical features are defined from a dissection of eight orbital regions. The pathways of carcinological invasion and the anatomical barriers are considered. The conclusions are discussed in the light of the data reported in the literature.

Dissection↗