• Double paddle free fibular flap for reconstruction of the composite facial tumour in patient with Fanconi's anaemia.

      Alkaabi, Malaka; Regan, Padraic J; Kelly, Jack; Mc Cann, Patrick J; Ismael, Thamir S (2009-11)
    • The human POLH gene is not mutated, and is expressed in a cohort of patients with basal or squamous cell carcinoma of the skin.

      Flanagan, Annabelle M; Rafferty, Gerard; O'Neill, Anne; Rynne, Leonie; Kelly, Jack; McCann, Jack; Carty, Michael P; Department of Biochemistry, National University of Ireland, Galway, Ireland. (2007-04)
      Skin cancer, the most common cancer in the general population, is strongly associated with exposure to the ultraviolet component of sunlight. To investigate the relationship between DNA damage processing and skin tumour development, we determined the POLH status of a cohort of skin cancer patients. The human POLH gene encodes DNA polymerase eta (poleta), which normally carries out accurate translesion synthesis past the major UV-induced photoproduct, the dithymine cyclobutane dimer. In the absence of active poleta in xeroderma pigmentosum variant (XPV) patients, mutations accumulate at sites of UV-induced DNA damage, providing the initiating step in skin carcinogenesis. Forty patients diagnosed with skin cancer were genotyped for polymorphisms in the POLH protein-coding sequence, using glycosylase-mediated polymorphism detection (GMPD) and direct DNA sequencing of POLH PCR products derived from white blood cell genomic DNA. All individuals carried the wild-type POLH sequence. No POLH mutations were identified in genomic DNA from skin tumours derived from 15 of these patients. As determined by RT-PCR, POLH mRNA was expressed in all normal and skin tumour tissue examined. Poleta protein was also detectable by Western blotting, in two matched normal and skin tumour extracts. An alternatively spliced form of POLH mRNA, lacking exon 2, was more readily detected in skin tissue than in white blood cells from the same patient. Real-time PCR was used to quantify POLH expression in matched normal and skin tumour-derived mRNA from a series of patients diagnosed with either basal or squamous cell carcinoma. Compared to matched normal skin tissue from the same patient, 1 of 7 SCC, and 4 of 10 BCC tumours examined showed at least a 2-fold reduction in POLH expression, while 1 of 7 SCC, and 3 of 10 BCC tumours showed at least a 2-fold increase in POLH expression. Differences in gene expression, rather than sequence changes may be the main mechanism by which POLH status varies between normal and skin tumours in the population under investigation. Knowledge of the POLH status in skin tumours could contribute to an understanding of the role of this gene in the development of the most common cancer in the general population.
    • Maxillofacial osseous reconstruction using the angular branch of the thoracodorsal vessels.

      Dolderer, Jürgen H; Kelly, Jack L; McCombe, David; Burt, Jamie; Pfau, Matthias; Morrison, Wayne A; Department of Plastic, Hand and Reconstructive Surgery, BG-Trauma-Center, Eberhard-Karls-University Tuebingen, Tuebingen, Germany. drdolderer@hotmail.com (Thieme Publications, 2010-09)
      Mandibular and maxillary resections can produce complex three-dimensional defects requiring skeletal, soft tissue, and epithelial reconstruction. The subscapular vascular axis offers a source of skin, bone, and muscle on a single pedicle for microvascular flap transfer. We reviewed four cases where the subscapular vascular pedicle was used as a source of tissue for complex facial reconstructions in maxillofacial defects. Reconstruction of these complex defects was performed with a latissimus dorsi muscle or myocutaneous flap in combination with the lateral border of the scapula, harvested on the angular branch of the thoracodorsal vessels. There were three cases of maxillectomy and one case of partial mandibulectomy for malignant tumors. In each case, the angular branch of the thoracodorsal artery supplied 6 to 8 cm of the lateral border of the scapula and a latissimus dorsi myocutaneous flap was used for soft tissue reconstruction. Follow-up ranged from 9 months to 3 years and in all cases there was successful bony union. Shoulder movement was normal. This series encourages the further use of subscapular axis flaps as flexible sources of combined myocutaneous and osseous flaps on a single vascular pedicle in cases of complex maxillofacial reconstruction.
    • Surgery for oesophageal cancer at Galway University Hospital 1993-2008.

      Chang, K H; McAnena, O J; Smith, M J; Salman, R R; Khan, M F; Lowe, D; Department of Surgery, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland. kahhoong_chang@yahoo.co.uk (2010-12)
      Surgical volume and outcome remain controversial in the management of oesophageal cancer.