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Biomedical subjects

R Deraemaecker

Publications and source records attributed to R Deraemaecker.

At least 37 records · Page 2Linked to original sources
PubMed1997

Immunoreactive alpha-melanotropin as an autocrine effector in human melanoma cells.

Melanotropin is a peptide having several functions, including the stimulation of melanogenesis and the modulation of proliferation of melanocytes and melanoma cells. It acts through binding to high-affinity receptors of the melanocortin-1 subtype, exclusively expressed in cells of the melanocytic lineage. Elevated levels of immunoreactive alpha-melanotropin were previously reported in melanoma cell lines, tumours and plasma from patients with melanoma. Here, we show that this high ectopic production of melanotropin is restricted to melanoma and non-pituitary tumours with the same neuroectodermic origin. The occurrence of a melanotropin-specific autocrine loop was further investigated in human melanoma cells. Immunoreactive alpha-melanotropin was spontaneously released from a melanoma cell line (HBL) expressing melanotropin receptors on the cell surface. This release was significantly increased in the presence of melanotropin-related peptides such as corticotropin-(4-10)-peptide and beta-melanotropin, competing for binding to the melanotropin receptor and was directly correlated to the displacement potential of these peptides. Both spontaneous and induced releases of immunoreactive alpha-melanotropin could be blocked at low temperatures, suggesting the involvement of intracellular protein movement in the release mechanism. The release of immunoreactive alpha-melanotropin was not significant in melanoma cells expressing very low levels of melanotropin receptors (IGR3) or in non-melanoma cells (SCC1). However, upon expression of the melanocortin-1 receptor cDNA into IGR3 cells, spontaneous and competition-induced releases of immunoreactive alpha-melanotropin were both increased and also blocked at low temperatures. This observation further underlines a role for the melanotropin receptor in the release of immunoreactive alpha-melanotropin. These experiments indicate that an autocrine loop between the melanocortin-1 receptor and immunoreactive alpha-melanotropin may be functional in human melanoma cells.

Adult↗
PubMed1997

Pilomatrix carcinoma.

A 43-year-old man presented with a tumour of the medial part of the right eyebrow. A biopsy was performed and histological examination revealed a malignant transformation of a 'calcifying epithelioma of Malherbe'. A secondary wide excision was performed. Clinical and pathological findings of this extremely rare tumour are reviewed. Factors influencing the prognosis are proposed, based on a compilation of the literature.

Adult↗
PubMed1997

Dermatofibrosarcoma protuberans of the upper lip: an overview and a case report.

Dermatofibrosarcoma protuberans is a slow-growing but locally aggressive malignant neoplasm of the skin. The preferential locations are on the trunk and proximal extremities but it can occur in the head and neck region in about 15% of the cases. This is a report of such a case and a review of the literature of head and neck cases attempting to analyse the profile of patients and surgical prognosis factors. The recurrence rate is important (20% to 55%) and dependent on the free tissue margins. Those margins are at least 3 cm in all directions; this is difficult to assess in the head and neck region because of both functional and cosmetic aspects. Distant metastases are rare but related to a long recurrence history. This behaviour gives the impression that prognosis is poorer for dermatofibrosarcoma in the head and neck than within other locations.

Aged↗
PubMed1995

Aggressive basal cell carcinoma of head and neck areas.

Among skin cancers, basal cell carcinoma (BCC) is considered as a relatively indolent disease. Sometimes, these carcinomas have an unusual clinical behaviour, with extreme aggressiveness. Based on reports of eight cases of aggressive BCC of the head and neck areas, and after a review of the literature, we define three criteria of aggressiveness: (1) initial diameter greater than 1 cm, (2) more than two recurrences despite all tentative conclusions of adequate treatment, or (3) extension into any extracutaneous structure.

Adult↗
PubMed1993

Wound dressing in major head and neck cancer surgery: a prospective randomized study of gauze dressing vs sterile vaseline ointment.

A total of 207 patients were randomized in a prospective comparative study of standard gauze dressing vs sterile vaseline ointment. 179 patients were evaluable. All patients received antimicrobial prophylaxis. The two groups (86 standard and 93 vaseline) were comparable as far as age (mean, 57 yr; range, 21-84), genders (155 males/24 females), weight (mean, 66 kg; range, 40-69), type of surgery, previous or concomitant anticancer treatment. Severity of surgery was identical, as was the severity of cancer, in the two groups. Wound infection within 20 days of surgery occurred in 31.2% (29/93) of the vaseline group and 24.4% (21/86) in the standard group (NSS). Bacteremia occurred in three patients from the vaseline group and in four patients from the standard group. Bronchopneumonia occurred in 10 patients from the vaseline group and 14 patients in the standard group. The spectrum of microorganisms recovered was similar in the two groups. The need for antimicrobial treatment (empiric or for documented infections) within 20 days after surgery was 34.4% (32/93) in the vaseline group and 36.0% (31/86) in the standard group. The median delay to infection (range in days) in the vaseline group was 9 (5-15) for wound and 6 (1-12) for bronchopneumonia. For the standard group the corresponding delays were 8 (4-15) and 7 (2-19). Vaseline dressing was not associated with an increased risk of infection as compared to the standard gauze dressing.

Adult↗
PubMed1992

Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin.

A total of 99 patients with head and neck cancer who were to undergo surgery were randomized in a prospective comparative study of sulbactam-ampicillin (1:2 ratio; four doses of 3 g of ampicillin and 1.5 g of sulbactam intravenously [i.v.] every 6 h) versus clindamycin (four doses of 600 mg i.v. every 6 h)-amikacin (two doses of 500 mg i.v. every 12 h) as prophylaxis starting at the induction of anesthesia. The two groups of evaluable patients (43 in the clindamycin-amikacin treatment group and 42 in the sulbactam-ampicillin treatment group) were comparable as far as age (mean, 57 years; range, 21 to 84 years), sex ratio (71 males, 28 females), weight (mean, 66 kg; range, 40 to 69 kg), indication for surgery (first surgery, 48 patients; recurrence, 37 patients), previous anticancer treatment (surgery, radiation therapy, chemotherapy), type of surgery, and stage of cancer. The overall infection rate (wound, bacteremia, and bronchopneumonia) within 20 days after surgery was 20 patients in each group. Wound infections occurred in 14 (33%) sulbactam-ampicillin-treated patients and 9 (21%) clindamycin-amikacin-treated patients (P = 0.19; not significant). The rates of bacteremia were 2 and 4%, respectively. The rates of bronchopneumonia were 14.3 and 23.2%, respectively (P was not significant). Most infections were polymicrobial, but strict anaerobes were recovered only from patients who received sulbactam-ampicillin. Antimicrobial treatment was required within 20 days after surgery for 42% of the sulbactam-ampicillin-treated patients and 44% of the clindamycin-amikacin-treated patients. By comparison with previous studies, we observed a decreased efficacy of antimicrobial prophylaxis in patients with head and neck cancer undergoing surgery because of the increased proportion of patients who were at very high risk for infection (extensive excision and plastic reconstruction in patients with recurrent stage III and IV cancers) and because of the longer duration of surgery.

Adult↗
PubMed1991

Wide vertical hemipharyngolaryngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap: preliminary results.

We propose a new technique of wide vertical hemipharyngolaryngectomy which combines resection of laterally localized extended pharyngolaryngeal tumors with immediate microsurgical reconstruction using a radial forearm free flap, including the tendon of the palmaris longus. It eliminates the limitations of resections, which are usually performed to avoid closure difficulties of the resulting defect. In addition, the new technique avoids the use of tumor-neighboring structures for closure, fulfilling the oncological principles of surgery performed in this region. Our preliminary results show good restored deglutition and phonation. Postoperative irradiation does not seem to affect these results.

Forearm↗
PubMed1989

Vertical hemipharyngolaryngectomy: reconstruction with the radial forearm free flap.

A considerable body of literature defines techniques to restore glottic function after partial laryngectomy. The authors of this paper describe a new original technique for glottic and hypopharyngeal reconstruction after vertical hemipharyngolaryngectomy. Using a radial forearm free flap including the tendon of the palmaris longus and a sensitive branch of the radial nerve, they were able to reconstruct the missing vocal cord and a pyriform fossa. This procedure permits an extended resection without the usual phonatory or swallowing inconveniences. There is no contraindication for postoperative radiotherapy. The technique and preliminary functional results are reported.

Forearm↗
PubMed1989

Free and pedicled flaps for head and neck reconstruction in radically irradiated fields: 6 years' experience at the Jules Bordet Institute.

From 1982 to 1988, 127 flaps were performed after ablative surgery for head and neck squamous cell carcinoma: 86 pedicled pectoralis major island and 41 free flaps of different types. One hundred and four were evaluable for this retrospective study: 66 after definitive radiotherapy (6000-8000 cGy) and surgery for recurrent or persistent disease and 38 after elective surgery for Stage III and IV tumors without previous irradiation. Wound healing, hospital stay, survival rate and complications are compared between irradiated and nonirradiated areas. The indications, advantages and disadvantages of each type of flap are reviewed according to the main goals of our treatment: i.e. local disease control, restoration of function, cosmetic appearance and short hospital stay.

Adult↗
PubMed1988

Analysis of long-term results of 326 breast reconstructions.

It has been the experience of many surgeons that results following breast reconstruction change with time. To evaluate long-term results, the 350 breast reconstructions performed in the authors' department from January 1977 to April 1986 were reviewed. The results of the 326 cases in which there were sufficient data are presented here, and some late results are shown.

Breast↗
PubMed1986

Conservative treatment of 725 burned children hospitalized in 10 years.

Seven hundred and twenty-five children were hospitalized in the paediatric burn unit of Brugmann University Hospital during the past 10 years. The majority of the patients were under 5 years of age and presented with scalds on less than 10 per cent of the body surface area. As burn depth was difficult to assess on admission, a conservative form of treatment was performed including a daily bath containing chlorhexidine and silver sulphadiazine dressings. Contamination of the wounds was observed in 80 per cent of the larger than 20 per cent surface burns but only 18 cases (2.4 per cent) of the series needed administration of systemic antibiotics for repeated contamination. No lethal septicaemia was observed. Mean inpatient time ranged between 16 days for ungrafted patients to 69 days for over 20 per cent surface grafted patients. The lower iatrogenic risks (anaesthesia and donor site morbidity) seemed important enough to justify conservative treatment in children despite a slightly longer hospitalization time.

Administration, Topical↗
PubMed1985

[Selected reconstructive technics in the surgery of cancers of the face].

The technique of facial reconstruction used by the plastic team at the Cancer Center of the University of Brussels are presented. Free grafts are seldom performed because they often lead to disfigurement. An appropriate evaluation of the margins of resection is obtained during the operation by multiple frozen sections, and reconstruction is achieved by local flaps when possible. It is considered that a normal appearance is of extreme importance for old patients suffering from facial cancer, and that the aim of surgery is not only complete eradication of the lesion but also careful reconstruction of the removed structures by simple and safe procedures. The selected techniques are presented for each region of the face.

Aged↗
PubMed1983

Anthrax of the hand: case report.

A patient developed anthrax of his left long finger after an accidental injection with Bacillus anthracis. Early treatment with chemotherapy probably prevented the cultures from becoming positive. The patient recovered, and split-thickness skin grafting was needed for the finger wound.

Anthrax↗
PubMedDate not supplied

[Microsurgery and free flaps as indications for the reconstruction of the mouth and pharynx region following tumor resection].

This article describes the microsurgical approach of the head and neck team of the Bordet Institute. During a period of 2 1/2 years 35 free flaps, 71 Pectoralis Major and 9 local flaps were performed for oropharyngeal reconstruction. Different types of free flaps were used and analyzed: 15 latissimus dorsi myocutaneous, 8 radial forearm, 1 gastric, 3 jejunum, 2 crista iliaca osteocutaneous, 1 scapular osteomyocutaneous, 3 scapular osteo-muscular of a new type (discovered in our department), 1 serratus anterior muscular and 1 flap composed of 3 others (a latissimus myocutaneous, a serratus anterior and a scapular osteo-muscular flap). 60% of the microvascular anastomoses were performed in a previously heavily irradiated area and none failed. The indications of some of these flaps are discussed and summarized.

Bone Transplantation↗