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Biomedical subjects

A Cazenave

Publications and source records attributed to A Cazenave.

10 recordsLinked to original sources

Mammographic pattern due to residual Lipiodol after galactography.

The purpose of this pictorial essay is to describe the different mammographic aspects of residual Lipiodol ultra fluid (LUF) after galactography, and to define some specific patterns, because it may in some cases mimic microcalcifications and give diagnostic problems. The mammograms of 14 patients, aged 32-63 years, presenting LUF residues related to previous galactography, were analyzed retrospectively. In 12 cases the diagnosis was easy because the patients presented a typical pattern on mammography and came with their initial galactography. In 2 cases the diagnosis was more difficult because the patients did not remember the previous injection and the progressive resorption mimicked perfectly intraductal calcification. Benign duct ectasia with inflammatory reaction to foreign bodies were found in 3 cases in which surgery was performed. Lipiodol ultra fluid is no longer used for galactography, but it may persist in breast ducts or cysts for years and seems to still be used in some countries. There are in most cases specific signs enabling the diagnosis.

Adult↗

[Reconstruction of the anterior cruciate ligament with artificial ligament (Ligastic). Clinical results in 72 patients].

INTRODUCTION: The purpose of the study was to evaluate the anatomical and functional results of Anterior Cruciate Ligament reconstruction with the synthetic ligament Ligastic. MATERIAL AND METHODS: 72 patients have been reviewed clinically and radiologically and their functional abilities have been evaluated with Lysholm and Arpege score. 46 have been operated for recent ruptures (group A) and 26 for chronic ACL tears (group B). Follow up was 2 to 4,5 years. RESULTS: The results showed in group A a Lachman test > 3 mm in 57 per cent cases, a positive pivot shift in 29 per cent and ruptures of the ligament in 22 per cent. In group B, the Lachman test was > 3 mm in 47 per cent of the cases the pivot shift was positive in 54 per cent and the rupture of the ligament occurred in 35 per cent. The functional evaluation showed that only one third was stable but painful, and one third was unstable and painful. DISCUSSION: As many authors, we found an increase of bad anatomical and functional results with time. The ligament can't be considered as a scaffold for ingrowth tissue. Two thirds of the patients had painful knees at effort. CONCLUSION: The high percentage of ruptures of the ligament, and the non satisfactory functional results led us not to recommend the ACL reconstruction with a Ligastic implant.

Adolescent↗

[Recent ruptures of the anterior cruciate ligament. Suture technique on a reinforcement ligament. Results of a 5 years' experience].

225 patients with acute rupture of the anterior cruciate ligament were operated upon with a knitted polyester synthetic ligament (Ligastic) reinforced by a suture of the anterior cruciate ligament remnant. Five technical points must respected during the implantation of the ligament: isometry, direction of the femoral and tibial tunnels, absence of abrasion of the ligament in the notch, tensioning of the synthetic ligament equal to the natural cruciate ligament, careful suture of the remnants of the ruptured anterior cruciate around the synthetic ligament replacement. The functional results, according to the rating system of ARPEGE, demonstrated 8.6 on the stability scale, 8.1 for pain, 8.7 for mobility; 87 per cent of the competitors were able to return to their sport at the same level. There were no cases of acute synovitis. The patients were separated into three groups for evaluation: Group I--More than three years follow-up. Group II--More than two years follow-up. Group III--Less than two years follow-up. An anterior drawer test of less than 5 mm was observed in 85 per cent of Group I, 88 per cent of Group II, and 87 per cent of Group III. A negative jerk test was noted in 92 per cent of Group I, 95 per cent of Group II and 95 per cent of Group III. These differences were not statistically significant. On follow-up, a Lachman test of less than 5 mm was found respectively in 37 per cent, 70 per cent and 79 per cent; this difference was statistically significant. The relatively mediocre results of the Lachman test in Group I led us to follow a more precise isometric method. Postoperative cases were reexamined and demonstrated that the artificial ligament had become covered with an oriented fibrous tissue. The long-term outlook also depended on a successful restoration of proprioception in the repaired remnant of the anterior cruciate.

Adult↗

[Reconstruction of the anterior cruciate ligament. Determination of the pre- and peroperative femoral isometric point].

This study attempted to determine the femoral isometric site by a simple, reliable and easily reproducible technique for the reconstruction of a torn anterior cruciate ligament (A.C.L.). Anatomoradiological studies showed that the posterior border of the lateral condyle corresponded with the third of a circle and that the center of this circle was named the "isometric point" (F). The variations of the intra-articular length of a ligament between the point F and the center of the A.C.L. tibial attachment did not exceed 2 mm. A radiological study on 50 normal patients knees X-Rayed at 0 degree and 90 degrees of flexion showed a length dependence of 1.5 mm in 84% and 2 mm maximum in 98%. Twenty patients with acute or chronic A.C.L. rupture were operated on; the isometric point F was determined by superimposing a template of circles on the posterior border of the condyle. An original guide allowed to drill a bony tunnel with a pin emerging at the exact previous point F. A per-operative X-Ray studied the good reliability of this guide. The measurements of the variations of length of the ligament between 0 degree and 110 degrees of flexion varied less than 5% in 18 patients, which confirms the good isometry of the reconstruction. On the basis of these data, we propose to improve the implantation of autogenous or synthetic ligament in A.C.L. reconstruction by the use of a pre-operative determination of the isometric femoral point and the use of a guide able to drill easily a bony tunnel at this exact pre-determined point.

Anterior Cruciate Ligament↗

[Post-traumatic hemarthrosis of the knee and arthroscopy. Review of 161 cases].

In a prospective study, 161 traumatic hemarthrosis of the knee had clinical, radiological and arthroscopic examination. The anatomical lesions were diagnosed clinically and radiologically in 78%, but was incomplete every other time. Arthroscopy allowed us to confirm, to complete or to do the exact diagnosis in 98%. Anatomical lesions were never benign: ligaments ruptures (65%), patella dislocations (20.5%), chondral lesions (41%), meniscal lesions (31%). The main interest of arthroscopy is to precise associated lesions and thus, to use these data for a rational treatment program. Most often, the treatment has been performed by arthroscopic techniques, avoiding arthrotomy and shortening post operative rehabilitation. No complication due to arthroscopy has been noted. This study confirms: (1) that a traumatic hemarthrosis indicates a serious knee injury, and (2) the important contribution of arthroscopy for diagnosis and treatment of these traumatic knees.

Adult↗

[Malignant angular cheilitis].

A case of chronic angular cheilitis is reported. Candida albicans was isolated repeatedly and the process developed into epitheliomatous carcinoma. The etiopathogenic role of Candida albicans and possible mechanism of action are discussed.

Aged↗