Blood flow of the areola and breast skin flaps during reduction mammaplasty as measured by laser Doppler flowmetry.

Blood flow changes during reduction mammaplasty were studied using laser Doppler flowmetry. Twenty-one patients (39 breasts) were entered into the study. Eight patients underwent a modified Skoog mammaplasty, 6 a central glandular pedicle mammaplasty, 2 an inferior pyramidal dermal flap mammaplasty, and 5 a glandular resection with free nipple grafts. Laser Doppler flowmetry was performed preoperatively, immediately postoperatively, 24 hours postoperatively, 48 hours postoperatively, and 2 weeks postoperatively. Laser Doppler flowmetry values (in milliliters per minute per 100 grams) measured at the areola declined by 23% (Skoog), 18% (central pedicle), and 21% (inferior pyramidal), in the immediate postoperative period. Values at 48 hours were 31% below baseline (Skoog), 14% below baseline (central pedicle), and 60% below baseline (inferior pyramidal). Values at 2 weeks postoperatively were 12% below baseline (Skoog), 2% above baseline (central pedicle), and 44% below baseline (inferior pyramidal). The free nipple grafts showed an 89% rise above baseline at 2 weeks. One patient's procedure was changed to a free nipple graft after a 92% Doppler flow reduction during a Skoog mammaplasty. The free nipple graft had the greatest blood flow. The central pedicle mammaplasty showed the least decline in areolar flow. The inferior pyramidal mammaplasty showed the greatest decline. Laser Doppler flowmetry is a clinically useful tool for monitoring intraoperative and postoperative nipple/areolar blood flow.     

Pigmented basal cell carcinoma and superficial spreading malignant melanoma: an unusual combination*

We report pigmented lesions in 2 white male patients, which were clinically diagnosed as superficial spreading malignant melanoma and histologically showed combined features of superficial spreading malignant melanoma in situ and pigmented basal cell carcinoma. The significance of this association is not known but is most likely very rare.     

Electron transfer reactions: from electrons to drugs

Electron transfer reactions have been at the heart of great advances in organic and inorganic chemistry and biology since the early work in 1954 by H. Taube (Nobel Chemistry Prize in 1983) and R. Marcus (Nobel Chemistry Prize in 1991). In organic chemistry, a new kind of chain substitution reaction with paramagnetic species was defined and identified as S(RN)1 (substitution, radial-nucleophilic, unimolecular). In our laboratory, choosing more or less complex molecules which possess electron-withdrawing groups and correctly disposed alkylation sites has enabled us to extend this concept to the heterocyclic (S(RN)1 HET) and quinonic (S(RN)1 QUI) series. These studies led us to prepare, under mild operating conditions, highly branched molecules hard to obtain via other pathways and which possess high pharmacological activity in various fields. We have discovered new reaction mechanisms such as LD-S(RN)1 (long-distance S(RN)1) E(RC)1 (elimination radical chain, unimolecular), bis-S(RN)1 and poly-S(RN)1. Moreover, we have developed a new technology using microwaves which increases the interest of electron transfer reactions in medicinal chemistry for drugs synthesis.