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Biomedical subjects

J Fissette

Publications and source records attributed to J Fissette.

At least 19 recordsLinked to original sources

Thyrolingual trunk arising from the common carotid artery: a case report.

During a cadaver dissection in the anatomy department of the University of Liege, Belgium, an anatomic variation of the superior thyroid and lingual arteries was observed on the right side in a 68-year-old woman. Both arteries arose from a common trunk located 30 mm beneath the carotid bifurcation. After a 5.2 mm course, the thyrolingual trunk divided into superior thyroid and lingual arteries which followed an unusual course towards their respective organs. Knowledge of this anomaly is important for those who are involved with neck surgery and anatomy.

Aged↗

Bilateral case of superficial ulnar artery originating from axillary artery.

During the dissection of an 86-year-old male human cadaver, superficial ulnar arteries were found in both upper limbs. These arteries branched from the axillary arteries. In the left arm, the artery crossed ventral to the medial root of the median nerve before running towards the medial part of the arm. The persistence of the median artery was noted. In the right arm, the ulnar artery had a common origin with the subscapular artery. It crossed anterior to the lateral root of the median nerve and then, in the arm, ran alongside the anterolateral aspect of the median nerve, near the biceps brachii muscle, which was supplied by this superficial ulnar artery. Then the artery crossed the median nerve and the brachial artery. The embryology, incidence and clinical relevance of this anatomical variation are discussed. So this was a rare case where the ulnar arteries originated from the axillary artery on both sides, but then followed different courses in the arm and, on the right side, the superficial ulnar artery partly supplied the biceps brachii muscle.

Aged↗

[Adipofascial flaps of the frontal-internal part of the leg: an alternative to free flaps for the repair of skin loss from the knee to the ankle. Report of a clinical experience with 17 cases].

Leg coverage remains a difficult challenge for plastic surgeon, especially in certain areas. Although treatment of osteomyelitis is well established, coverage of bone, tendinous or hardware exposure remain controversial. In these selected cases, adiposofascial pedicled flaps should constitute a interesting solution. The multiples vascular supplies to the adiposofascial tissue of the medial side of the leg constitute de basis of this flap family. These condition allows an extreme adaptability to a wide range of defect with maximal satisfaction.

Dermatologic Surgical Procedures↗

[Management of hemangiomas and vascular malformations].

Vascular anomalies can be classified as hemangiomas or vascular malformations. Hemangiomas are benign neoplasms, frequently diagnosed in infancy. The vast majority of these anomalies are totally harmless and spontaneously regress, although they often worry the parents because of esthetic reasons. Only a few (1/4), however, are endangering and will require therapy. Vascular malformations are rather vessel abnormalities which, unlike hemangiomas, persist. They require a thorough evaluation and most will benefit from an intervention. The recent development of informative imaging techniques (ultrasonography, Dopplerflow imaging and magnetic resonance) has permitted significant advances in the etiology and therapy of these vascular anomalies. All too often, these patients shuffle from physician-to-physician seeking help. Thus the authors recommend a multidisciplinary approach. This team should include a plastic surgeon, a radiologist and a paediatrician.

Arteriovenous Malformations↗

Is fractal geometry useful in medicine and biomedical sciences?

Fractal geometry has become very useful in the understanding of many phenomena in various fields such as astrophysics, economy or agriculture and recently in medicine. After a brief intuitive introduction to the basis of fractal geometry, the clue is made about the correlation between Df and the complexity or the irregularity of a structure. However, fractal analysis must be applied with certain caution in natural objects such as bio-medical ones. The cardio-vascular system remains one of the most important fields of application of these kinds of approach. Spectral analysis of the R-R interval, morphology of the distal coronary arteries constitute two examples. Other very interesting applications are founded in bacteriology, medical imaging or ophthalmology. In our institution, we apply fractal analysis in order to quantitate angiogenesis and other vascular processes.

Biology↗

[How I treat...decubitus ulcers surgically].

Although pressure sores occur frequently during the evolution of paraplegic patients, they can present in patients confined to bed or in casts. Ischiatic, sacral and trochanteric sores are the most frequent. For stade III & IV lesions surgical excision followed by a coverage with healty tissue remain the only right principle. Usually, flap transfert meats these requirements. However, the selection of the surgical procedure and the post-op care are the main factors for a successful treatment.

Debridement↗

[Breast implants: state of the controversy].

The controversy that occurred during the 1990 years concerning the breast implants has revealed several new problems, related to comfort surgery. Considering that this surgery has developed considerably, we found useful to outline the difficulties and the drifts that appeared with the breast implants. They were present at all levels: patients, implant factories, judges and lawyers, media, certified laboratories. An increased vigilance was found to be necessary in order to provide the safety and the quality of this type of surgery.

Breast Implants↗

Video-microsurgery: a new tool in microsurgery.

Endoscopic surgery is slowly becoming an increasing part of plastic surgical practice. Besides its most obvious advantages, related to small incisions, the endoscope provides excellent magnification of the operative field. We thus decided to investigate the possibility of using the endoscope as an alternative to the operative microscope for performing microsurgical procedures. Before starting a clinical investigation, digital artery, nerve, vein microsutures, and neck dissections were performed in fresh human cadavers. Magnification, working distance, depth of focus, diameter and temperature of the operative field, and resolution were measured using either the operating microscope or the endoscope. Working conditions were compared. The advantages of the endoscope as compared to the microscope were: less bulk, sterility, mobility, versatility and cost-effectiveness. The disadvantages were: short working distance, inferior resolution and two-dimensional images. Overall, the endoscope was found to be an interesting alternative to the operating microscope. We are now using the endoscope routinely in the clinical arena, and we believe that it has a great potential and a promising future as a microsurgical tool.

Endoscopes↗

Microsurgical repair of Stensen's duct using an interposition vein graft.

Facial wounds are frequently associated with bone fractures and multiple trauma; however, disruption of the parotid gland or Stensen's duct is rare and is often associated with facial nerve palsy. Lesions are often undiagnosed on first assessment of the multiple trauma patient. If microsurgical repair of Stensen's duct provides good functional results, ignoring such lesions often leads to later complications such as fistulae and sialocoeles. Although simple ligation of Stensen's duct has been reported to give satisfactory results, the authors prefer a more anatomic reconstruction of this structure whenever possible. A case of Stensen's duct microsurgical repair using a vein graft are reported.

Adult↗

Recurrent pleomorphic solitary angiomyxoma of the face.

The historical background of solitary and multiple myxoid tumors of the dermis is accompanied by a confusing conglomeration of names. We report a case whose histologic features do not fit exactly with previous classifications. It appeared as a solitary angiomyxoma of the face containing stellate pleomorphic cells and exhibiting a locally infiltrative behavior with tendency for recurrences over more than 25 years. This recurrent pleomorphic solitary angiomyxoma appears to be distinct from cutaneous myxomas that exhibit a very low local recurrence rate and from malignant tumors with myxoid deposits. The treatment consisted of a wide surgical excision.

Humans↗

[Aesthetic surgery update].

Aesthetic surgery has its origin in plastic surgery. It has considerably developed to such a point that the number of procedures performed at the present time is well over the reconstructive procedures. After having emphasized the importance of patient's motivation and the high level of specific technical training of the plastic surgeon, the most common procedures are illustrated. Their major advantages and pitfalls are outlined.

Blepharoplasty↗

Hypnosedation: a valuable alternative to traditional anaesthetic techniques.

Hypnosis has become routine practice in our plastic and endocrine surgery services. Revivication of pleasant life experiences has served as the hypnotic substratum in a series of over 1650 patients since 1992. In retrospective studies, followed by randomised prospective studies, we have confirmed the usefulness of hypnosedation (hypnosis in combination with conscious IV sedation) and local anaesthesia as a valuable alternative to traditional anaesthetic techniques. The credibility of hypnotic techniques and their acceptance by the scientific community will depend on independently-confirmed and reproducible criteria of assessing the hypnotic state. Based on the clinical success of this technique, we were interested in confirming this phenomenon in healthy volunteers. The revivication of pleasant life experiences thus served as the cornerstone of a basic research program developed to objectify the neurophysiological attributes of the hypnotic state. We compared hypnosis to normal alertness with similar thought content. In our experience, the activation profile obtained during the hypnotic state was completely different from simple re-memoration of the same subject matter during normal alertness. This represents an objective and independent criteria by which to assess the hypnotic state.

Anesthesia, Local↗

[Lipoma, multiple lipomas and lipomatosis].

Lipomatous tumors are very frequent; simple lipoma is the most common variety. According to Enzinger, lipomatous tumors are classified into five different groups: simple lipomas, variant lipomas forms, heterotopic lipomas, infiltrating lipomas and lipomatosis, and finally hibernomas. Usually, lipomatous tumors are characterized by a slow, unpainful, growth. Classical treatment includes surgical resection. The clinical diagnosis is confirmed by histology. Liposucion can be a therapeutic option in certain cases.

Adipose Tissue↗

Necrotizing fasciitis: a life-threatening infection.

Necrotizing fasciitis is a rapidly progressing, synergistic bacterial infection of fascia with a reported average mortality of about 40%. Fournier's disease, necrotizing fasciitis of the genital sphere, is also included in this study. Seven patients were studied over a one-year period between May 1991 and October 1992. Most commonly, they were infected by perineal diseases, medical procedures and cutaneous ulcers. The local clinical signs are cellulitis, oedema, blisters, necrosis and crepitus; general septic symptoms may also be present. Associated chronic diseases were present in 4 patients. Three infections were polymicrobial. Control of this potentially lethal soft-tissue infection is based on early clinical diagnosis, timely, wide surgical debridements and appropriate antibiotic treatment. The overall mortality rate was 1 of 7 (14%). Death was due to persistent wound sepsis and systemic septic complications, but mainly to delay in surgical treatment. The presence of chronic debilitating diseases (diabetes, alcohol abuse, renal insufficiency, ...) contribute to increase rate of both local and systemic infection.

Adolescent↗

[Surgical anatomy of the nose. I].

Since a few years, more and more papers are published in the international literature about nasal anatomy, probably because of the growing popularity of the open rhinoplasty. So, new concepts, new anatomic entities have been established without equivalent in the French literature. The authors review the most recent notions of the surgical anatomy of the nose and propose a french terminology for several concepts developed in the international literature (e.g. supratip breakpoint). The surgical anatomy of the external nose is described.

Adult↗

[Surgical anatomy of the nose. II].

Over recent years, an increasing number of papers are published in the international literature about nasal anatomy, probably because of the growing popularity of open rhinoplasty. New concepts and new anatomical entities have been established without any equivalent in the French literature. This paper reviews the most recent concepts of surgical anatomy of the nose and proposes a French terminology for several concepts developed in the international literature (e.g. supratip breakpoint). In this second part, the surgical anatomy of the nasal cavities is analyzed together with a glossary including the main concepts, some of them unpublished in the French literature.

Cartilage↗

[Nasal obstruction. Physiology, etiology and review].

Nasal obstruction is a major epidemiologic medical problem. The cost of its medical and surgical treatment is considerable. The frequency of the symptoms and their usual benign course often lead the physician to pay little attention to them. Occasionally, life-threatening problems, such as Wegener's granulomatosis may first present as nasal obstruction. Frequently, nasal obstruction deteriorates the quality of life by causing serious discomfort and by altering with the sense of smell and taste.

Airway Resistance↗

[Breast implants].

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Autoimmune Diseases↗