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Biomedical subjects

S de Fontaine

Publications and source records attributed to S de Fontaine.

16 recordsLinked to original sources
PubMed2002

[The plastic surgery department].

Plastic surgery associates reconstructive and aesthetic surgery, as these are complementary and cannot be dissociated. Modern techniques in reconstructive surgery include grafts and flap transfers. Our team does 4500 consultations and 750 operations per year, out of which a large proportion of complex reconstructions. In order to treat very various diseases, strong collaborations exist with several units such as orthopaedics, ENT, maxillofacial surgery, neurosurgery, ophthal-mology, gynaecology, and dermatology.

Belgium↗
PubMed2001

Munchausen syndrome.

Munchausen syndrome is a rare condition in which the patient repeatedly seeks medical care for factitious illnesses. With this self-inflicted disease, the patients characteristically travel from one hospital to another, feigning acute, usually spectacular illnesses. The patients willingly submit themselves to extensive as well as invasive diagnostic and therapeutic procedures. Munchausen syndrome is a psychiatric disorder that requires psychiatric treatment. Reconstructive surgical procedures may be required to correct the acquired deformities. The difficulty in Munchausen syndrome lies essentially in early recognition of the psychiatric syndrome. Two exceptional cases are reported, and diagnosis and treatment are presented in the light of the current literature.

Adult↗
PubMed1999

Circumferential torsoplasty.

Abdominoplasty procedures are often unsatisfactory in correcting body deformities remaining after massive weight loss. Lateral flanks, hip rolls and buttock ptosis need also to be addressed surgically. To achieve a more noticeable improvement in body contour, a circumferential torsoplasty procedure was performed in 30 patients during the years 1993-1997. Twenty of them had had a gastroplasty procedure before with a mean weight loss of 49.5 kg. Mean operative time was 210 min (range 150-420 min). The total resection weight ranged from 2 to 8.96 kg (mean 4.3 kg). Mean operative blood loss was 635 ml (range 300-1900 min). The mean hospital stay was 12 days. Minor complications occurred in four patients and major complications in one. Both patients and surgeons considered the outcome very satisfactory.

Abdomen↗
PubMed1998

Traumatic spinal accessory nerve palsy.

Spinal accessory nerve sections due to a purely traumatic origin are very rare. The authors report a case in which a total section of the spinal accessory nerve was observed after a glass-penetrating injury. The primary lesion was undiagnosed, and only late physical examination revealed a scapula alata with a deficiency in shoulder protrusion and elevation. Surgical exploration with direct suturing of the nerve was performed 2 months after the initial trauma; full restoration of muscle function was obtained 12 months after the surgical procedure. Pain, the dominant preoperative feature, totally disappeared after restoration of shoulder function. Although infrequent, spinal accessory nerve lesions must always be excluded in cases of penetrating injuries in the posterior triangle of the neck. Emphasis is placed on diagnosis and treatment of this condition.

Accessory Nerve↗
PubMed1998

Free-flap evolution after hyperthermic regional chemotherapy in the isolated limb for malignant melanoma.

Two patients presenting with a stage I melanoma of the sole of the foot (Clark's level IV, Breslow's 2.8 mm, and Clark's level IV, Breslow's 3.2 mm) underwent a 3-cm tumor free-margin skin resection, followed by microanastomosed muscle flap reconstruction (serratus anterior and latissimus dorsi). Immediately after primary wound healing, an elective inguino-iliac lymph-node dissection, followed by hyperthermic isolated regional chemotherapy with Melphalan, was carried out. Only moderate swelling of both free flaps was observed after these procedures, and this resolved rapidly. The patients returned to ambulation after 2 weeks. No other side effects of the hyperthermic isolated regional chemotherapy were observed in the previously microanastomosed flaps.

Antineoplastic Agents, Alkylating↗
PubMed1998

Lipoma of the toe.

Lipoma is a common benign soft tissue tumor. It may arise in any location, but most frequently it is located on the trunk, chest, upper thigh, upper arm, and shoulder. Reports of a lipoma in the foot exist, but the occurrence of the tumor in this location is very rare. Lipomas of the toe have only been reported in children, some imitating or having associated gigantism. We present a benign lipoma occurring on the plantar aspect of the second toe in an adult.

Child↗
PubMed1997

Verrucous carcinoma or epithelioma cuniculatum plantare.

Verrucous carcinoma is a rare form of squamous cell carcinoma. It behaves as a slow-growing, locally aggressive and rarely metastasizing tumour. Three clinical cases are presented, with emphasis on clinical presentation, pathological diagnosis and therapeutic approach. The pathogenesis of verrucous carcinoma, including chronic inflammation and human papillomavirus, is also discussed.

Aged↗
PubMed1996

Reduction mammaplasty combined with pectoralis major muscle flaps for median sternotomy wound closure.

Sternal wound infection can be a problem in patients who undergo coronary artery bypass graft surgery and is usually treated with local flaps. Severe macromastia can cause a large wound dehiscence by inferolateral tension on the skin sutures. Chest wall reconstruction can be achieved by combining muscle flap coverage with reduction mammaplasty. Two musculoglandulocutaneous flaps can be designed, using two superiorly based pectoralis muscle flaps vascularising the medial portion of the glandular breast tissue. The flaps are advanced medially to the sternectomy site and the breast reduction is then completed by adjusting the lateral breast pillar to the medial breast pillar. A case in which this technique was successfully used is reported.

Aged↗
PubMed1996

Glomus tumours of the hand. A retrospective study of 51 cases.

The authors report a series of 51 patients with glomus tumours in the hand. The duration of symptoms before treatment averaged 10 years. No one site or finger was more commonly involved. Objective features were limited to a blue discoloration in 29%, a pulp nodule or a nail deformity in 33%. An osseous defect was seen on plain X-ray films in 36%. Diagnosis depended on clinical suspicion in 90%. Careful dissection and complete excision of the tumour almost always offer permanent relief. A direct transungual approach was used in the subungual tumours with only one cosmetic problem. Recurrence of symptoms occurred in only two cases after a pain-free interval of 2 years.

Adult↗
PubMed1996

[Post-gastroplasty plastic surgery].

Gastric volume modification by surgery (gastroplasty, gastric banding ...) is intended to improve health in patients presenting morbid obesity. However, consecutive cutaneous sequellae are always ungrateful and often particularly disabling. The treatment of these sequellae often necessitates plastic surgery correction. We present a series of 21 patients whose cutaneous sequellae secondary to gastroplasty were operated on after a mean loss of 42% of body mass index. Sixty-three anatomical sites were treated in 27 operative sessions without any general complication. The number of operative sessions was limited using a simultaneous multiple surgical team approach, which is particularly adapted to this type of patients. The local complications (11 cases) were minor (delays of healing, hematoma, seroma, abscess). Even though the final aesthetic appearance depended greatly on the preoperative situation, all the patients were satisfied with the results obtained.

Abdomen↗
PubMed1994

Anomalous blood supply to the serratus anterior muscle flap.

The serratus anterior free muscle flap is useful in lower limb reconstruction, as it combines a moderate quantity of muscle with a long vascular pedicle. There are known vascular anatomical variations, for example the blood supply may come from the thoracodorsal pedicle, directly from the subscapular pedicle or from the axillary artery and vein. We present a case with a totally independent arterial supply to the flap from the first intercostal artery, while venous return from the flap went back as usual to the subscapular pedicle.

Foot↗
PubMed1993

Refinements in the axial frontonasal flap.

The frontonasal flap is a useful flap for medial and lateral tip defects of the nose. It can be used as a random rotation flap or as an axial flap. This paper describes modifications to the original designs of these flaps, with improvements in the final scar.

Cicatrix↗
PubMed1993

Human orf.

Human Orf is an uncommon viral disease acquired through contact with infected sheep and goats. We report five cases of human Orf acquired while preparing mutton. The clinical picture and the management of human Orf are presented. Awareness of the benign nature of the condition is important in preventing ill-advised therapy.

Adult↗
PubMed1987

Enhanced hepatic adenylate cyclase activity in rats with portacaval shunt.

Male Wistar rats were submitted to a portacaval anastomosis (PCA). Control rats were sham operated and pair fed. After 20 days, PCA led to a decrease in liver weight (-40%) and fasting blood glucose (-35%) and to an increase in fasting glucagonemia (+65%). The in vitro response of adenylate cyclase in hepatic membranes to GTP, Gpp(NH)p, fluoride, and forskolin (in the absence of GTP), and to glucagon (in the presence of GTP) was greater in PCA rats than in controls (by 30-54%) whereas the response to L-isoproterenol (in the presence of GTP) was only slightly increased (by 8%) and that to vasoactive intestinal peptide (in the presence of GTP) was similar in both groups of rats. The binding of [125I]glucagon and [125I]VIP to liver membranes did not differ in both groups of animals. It is concluded that the hepatic adenylate cyclase system from PCA rats responded better to stimuli involving efficiently the guanyl nucleotide stimulatory site Ns. This implies that the fasting hypoglycemia observed in these animals, in spite of the hyperglucagonemia, was due to either the refractoriness of a step distal to adenylate cyclase activation or to limited glucose production by an atrophic liver.

Adenylyl Cyclases↗