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Biomedical subjects

F Firmin

Publications and source records attributed to F Firmin.

At least 19 recordsLinked to original sources
PubMed2002

[Indications for curietherapy of the prostate using permanent implants].

In the last decade, brachytherapy emerged as a particularly appealing new way ot treating localized prostate cancer. Recently published 10-12 years biochemical control results appear to be superimposable to the best percentages achieved by surgery or conformal radiotherapy, with a small percentage of complications. This applied to severely patients. Only patients with T1/T2, PSA < 10 ng/mL, and Gleason score < 7 should be proposed such a treatment. The potential benefit of exploring patients with a endorectal coil MRI is being evaluated. The number of positive biopsies is also a parameter which should probably be considered in the therapeutic choice. Moreover, a prostate volume > 60 g, hip mobility limitations, a urinary obstructive syndrome and previous transurethral resection lead to difficulties in technical implantation and therefore must be taken into account when discussing brachytherapy. In conclusion, for adequately selected patients, brachytherapy offers a particularly applied alternative to surgery and external radiotherapy, with satisfactory long term biochemical control rates and limited complications.

Adenocarcinoma↗
PubMed2001

[Auricular reconstruction in cases of microtia. Principles, methods and classification].

In the correction of microtia, whether it be isolated or associated to other facial anomalies, the same principles are followed: sculpture of a framework from autologous rib cartilage to reproduce the contours of an ear and coverage of the framework with the cutaneous remnants. The sculpting of the cartilaginous framework requires sufficient training which through experience becomes the most routine surgical step of the reconstruction. Regarding the cutaneous step, it is different, because the microtia may appear in multiple forms. Numerous clinical classifications have already been published. The new classification which has been proposed, enables a better understanding of the cutaneous step of microtia correction. It is a surgical classification. Three different types of skin plasties (type 1, 2 and 3) allow for the treatment of all microtia. Thus, a surgical proposal can be advocated as early as the clinical examination regarding the appropriate utilization of the cutaneous remnants.

Cartilage↗
PubMed2001

[Microtia in cases of oto-mandibular dysplasia].

The technique of reconstruction of a microtia, observed in cases of otomandibular dysplasia, does not differ in its principle from that of an isolated microtia. The technical approach depends primarily on the aspect of the auricular remnants whose forms are multiple and are in no way etiologically specific. However, when associated with other malformations of otomandibular dysplasia, the microtia presents some particularities and its correction must be integrated in the global treatment of hemifacial anomalies.

Adolescent↗
PubMed1998

Ear reconstruction in cases of typical microtia. Personal experience based on 352 microtic ear corrections.

The aim of this paper is to report my experience of 352 ear reconstructions to correct microtia with Brent's technique (n = 184) and Nagata's technique (n = 144). The remaining 24 were atypical presentations reconstructed in a one-stage procedure. Brent's technique is a safe, step-by-step, four-stage reconstruction and Nagata's technique involves only two stages. Nagata's innovations include transposing the lobule of the auricle during the first stage, carving a framework that includes the tragus, and constructing the posterior wall of the concha during the second stage. Cases of typical microtia have been selected to illustrate the advantages and pitfalls of both techniques.

Adolescent↗
PubMed1998

Use of the subgaleal fascia to construct the auditory canal in microtia associated with aural atresia. A preliminary report.

In this paper we introduce the use of a subgaleal flap to construct the auditory canal in cases of microtia associated with aural atresia. The anatomy, the vascularisation, and the nomenclature of the different planes that constitute the temporal region are wellknown. The subgaleal fascia, also referred to as the loose areolar fascia has been until now the less surgically exploited of these planes. Nevertheless, it has a structure and a vascularisation that enables it to be dissected and used surgically. The subgaleal flap used to line the neoauditory canal drilled into the bone provides a vascular bed that greatly improves the quality of the skin graft and supports the tympanoplasty. The procedure is done while the ear is being raised, which constitutes the second stage of the two-stage ear reconstruction. This new approach has been used on 22 ears. A preliminary analysis of the results shows that construction of the auditory canal has been improved.

Adolescent↗
PubMed1997

[Reconstruction of the pinna in cases of microtia].

Pessimism about the results of surgical reconstruction of the pinna in cases of microtia is unjustified. Currently there are two techniques available which give excellent results if conditions are favourable: these are the techniques of Brent and of Nagata. This article describes both of these techniques, whose common principle is the use of autologous costal cartilage sculptured to give the contour of a normal ear, and the areas where they are different. The author has carried out 154 reconstructions using the Brent technique and 92 using the Nagata technique, and gives a critical analysis of the results obtained by these two methods.

Child↗
PubMed1997

[Pseudosarcoma of the bladder. Apropos of a case of inflammatory tumor of the bladder].

The authors report a case of benign pseudosarcoma of the bladder and emphasize the endoscopic features of the tumour, which were highly suggestive of malignancy, leading to the decision to perform cystectomy. The diagnosis was corrected by endoscopic resection and histology. Treatment usually consists of partial cystectomy, but can sometimes be limited to one or several endoscopic resections.

Adult↗
PubMed1996

[Value of tissue expansion in total reconstruction of the external ear].

By recalling the imperatives of auricular reconstruction, the author analyses the indications for tissue expansion in this area. This expansion can be performed preoperatively or intraoperatively, directly on the ear, indirectly, away from the ear. In the light of his experience, illustrated by three clinical cases, the author considers preoperative indirect expansion to be the most useful, by placing the expander underneath the scalp.

Adult↗
PubMed1995

[Secondary reconstruction of the external ear destroyed by burns. Indications and techniques. Apropos of 30 clinical cases].

Reconstruction of an ear destroyed by burns raises several difficulties related to the presence of associated lesions. The essential element determining the indication for reconstruction is the possibility to cover a three dimensional cartilaginous graft with skin. Depending on the local condition of the skin, retroauricular skin, a temporal fascia flap or preliminary expansion may be indicated. Reconstruction should be performed when the chances of obtaining a good result are sufficient in a motivated patient. If these conditions are not satisfied, prosthesis should be proposed.

Burns↗
PubMed1995

[Intestinal perforations in percutaneous surgery of the kidney].

Using 9 personal surveys and 11 cases found in the literature, the authors analyse the etiologies of this iatrogenic accident, the often secondary modalities of the diagnosis and the benign nature of the fistula which usually heals spontaneously.

Colonic Diseases↗
PubMed1995

[Vesico-intestinal fistulas].

The authors report the various locations (ileal, appendicular, colic, rectal and through Meckel diverticulum) of the fistulas between the bladder and the digestive tract and specify the mainly inflammatory etiologies and specifically those due to the Crohn disease or those caused by tumors aggravated by irradiation and repeated surgery.

Adult↗
PubMed1995

[Uro-intestinal fistulas of cancerous origin].

Malignant entero-vesical fistulas are uncommon. Colonic malignancy is the main cause although fistula are present in just 1%. Pneumaturia and fecaluria are pathognomonic for entero-vesico-fistula and are present in half of cases. By combining the results of cystoscopy, barium enema and urine culture, fistula can be identified in almost all the cases. Escherichia coli, Streptococcus faecalis and Proteus mirabilis are very often isolated from the urine cultures. The management of entero-vesical-fistula depends of the etiology. The treatment requires in most of the case resection of the diseased bowel with partial cystectomy and primary anastomosis. But sometimes, is necessary to perform a diverting colostomy and urinary diversion.

Aged↗