[Dobutamine speckle tracking imaging for evaluation of microvascular dysfunction in a patient with exertion dyspnea]. / Dysfonction microcirulatoire coronaire et 2D strain à la dobutamine chez un patient dyspnéique.

Microcirculatory dysfunction despite the absence of angiographically obvious significant coronary artery disease may potentially generate symptomatic myocardial ischemia; comprehensive assessment both noninvasive and invasive could prove to be of critical interest. We report the case of a 54-year old patient referred for an exertion dyspnea that proved to be caused by both micro and microvascular dysfunction. We present key elements for diagnosis, functional evaluation and management and demonstrate the potential role of speckle tracking imaging in that setting.

[A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases]. / Variante des lambeaux en îlot pour couverture d'escarres: le lambeau en hachette. A propos de 31 cas.

The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.

[Cutaneous extension of parotid carcinoma]. / Extension à la peau d'un carcinome parotidien.

INTRODUCTION: Telangiectatic cutaneous metastases are mostly associated with breast carcinomas. We report a case which was developed from a parotid tumour. CASE REPORT: A 63-year-old patient presented an erythematous, telangiectatic, rounded, cutaneous lesion of the cheek developed over a parotid tumour. Metastatic lymph nodes were observed in the drainage area of the tumour. Cutaneous histology revealed the presence of neoplastic cells in dermal vessels. After its surgical excision, histology of the parotid tumour showed an undifferentiated adenocarcinoma. Cutaneous lesions disappeared with chemotherapy. CONCLUSION: Two similar cases of inflammatory and telangiectatic cutaneous metastases associated with parotid carcinomas were reported previously. This metastatic localization to the skin could be due to special anatomic conditions and perhaps to the similarity of some surface antigens between skin vessels and parotid carcinoma cells.

[Cutaneous dehiscences during tissue expansion: use of surgical adhesive plastic film]. / Déhiscences cutanées en cours d'expansion: utilisation d'un film plastique chirurgical adhésif.

Cutaneous expansion, especially in the lower limb, is sometimes complicated by the development of partial dehiscence of the surgical scar or a small area of necrosis over an angle of the prosthesis. The expander implant can be salvaged by closing the dehiscence with surgical adhesive film which allows continuation of expansion while preventing herniation of the prosthesis.