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Biomedical subjects

A Gentine

Publications and source records attributed to A Gentine.

At least 19 recordsLinked to original sources

Pseudorandom rotational stimuli of the vestibulo-ocular reflex in humans: normal values of the transfer function.

Pseudorandom binary rotatory stimulation is used to study the vestibulo-ocular reflex (VeOR) frequency response (from 0.01 to 0.64 Hz). Fifty-two normal subjects volunteered for this test. The transfer function's gain and phase, and the corresponding coherence function between slow phase eye velocity and head velocity were computed. According to the linearity hypothesis, the results match the sinusoidal stimulation studies. In both cases, the variability of the gain was higher than that of the phase shift. Identification of some parameters of the VeOR's mathematical model were performed, using the experimental results.

Adult↗

[Caseous sinusitis. Clinical, x-ray computed, surgical, histopathological, biological, biochemical and myco-bacteriological aspects. Apropos of 33 cases].

We analyse the most important clinical, CT, surgical, histopathological, biological, biochemical, mycological and bacteriological features of caseous sinusitis, i.e. chronic, poorly symptomatic sinusitis which are resistant to usual treatment. CT shows an opacity of the maxillary sinus with often a hyperdense foreign body (dental overfilling) but no valid predictive criteria for fungal etiology. The endoscopic or surgical procedures point out a caseous mass often called fungal mass or aspergilloma. The biochemical composition of this mass (water, proteins, lipids) is similar to that of tissues surrounding the sinus. The calcium value is variable and shows no correlation with CT imaging. The qualitative and quantitative analysis of the metals (zinc, lead, silver, copper, iron) is of relevance for exogenic origin (dental overfilling). The fungal etiology is inconstant (20 cases) after the mycological investigations. We discuss the nosologic and diagnostic features of caseous sinusitis, fungal or not, and which are often or too often called aspergillosis sinusitis.

Adult↗

[Rotatory impulse test does not replace caloric tests].

We sought to determine whether the rotatory impulsional test was capable of exploring the canalar function with sufficient precision to replace the caloric test, as it has been recently affirmed. We first compared the observed preponderance from this test with that measured during a sinusoidal (20 and 4 s) test. We observed that, in the case of a significant preponderance for a given test, there was complete redondance with the preponderance observed with any other test. The rotatory impulsional test does not present any specific advantage compared to other kinetic test as far as the observation of the preponderance phenomenon. We then compared the preponderance with the results of the caloric tests and came to the following conclusions i) the absence of preponderance does not allow us to predict the absence of vestibular deficit, due to the fact that 37% of the deficits were compensated for including acoustic neuroma; ii) the presence of a preponderance does not allow a priori to say whether it is of vestibular, cervical, or central origin and systematic caloric tests shows that almost one fourth of preponderance observed is not associated with unilateral weakness iii) supposing that a clinical argument allow us to conclude as to the probable vestibular origin of a vestibular preponderance, the direction of this preponderance does not allow us to determine which side is involved. In fact, if the undercompensated deficits are 3 times more frequent than overcompensated deficits, the proportion of preponderance not linked to a significant deficit indicates that the probability of encountering a preponderance related to a specific undercompensated deficit is approximately 50%. We thus did not find in the rotatory impulsional test any specific advantage allowing us to predict the laterality of a vestibular lesion.

Caloric Tests↗

Siblings with congenital renal tubular acidosis and nerve deafness.

Two siblings (a boy and a girl) had congenital renal tubular acidosis (RTA) with nephrocalcinosis. Hearing loss due to nerve deafness was diagnosed at 13 1/2 and 9 years of age, respectively. The parents, who are second cousins, are healthy. They have another boy who is unaffected. This is in accordance with an autosomal recessive gene. The association of RTA and deafness was first noted by Royer in 1967, and so far some 50 cases have been described. The literature is reviewed.

Acidosis, Renal Tubular↗

[Hypothyroidism following radiosurgical treatment of cancers of the hypopharynx].

In a series of 224 patients treated between 1980 and 1992 for hypopharyngeal carcinoma by surgery and post postoperative radiotherapy we found an overall 54% incidence of elevated TSH levels. Decreased FT4 levels were associated in about one-third of the patients. When thyroidectomy was performed, 71% of the patients developed thyroid dysfunction. Most TSH abnormalities (45%) occurred within two years of treatment. Nevertheless, long-term followup is indicated since those complications may be delayed. Hormonal replacement therapy is recommended for patients with elevated TSH.

Adult↗

[Mucormycosis-actinomycosis and caseous dental sinusitis associated with sinusal foreign body].

The authors report an uncommon case of caseous dental sinusitis with infection or superinfection by mocorales and actinomycetes. The patient was healthy, without diabetes mellitus, but was treated for lymphoma 18 years before. This observation leads to a discussion of nosologic, diagnostic and therapeutic features of caseous sinusitis, dental or not, fungal or not, which are often or too often called aspergillosis sinusitis. The recovery of the patient was complete after surgery, amphotericin B and hyperbaric oxygen.

Actinomycosis, Cervicofacial↗

[Cavernous hemangioma of the geniculate ganglion. Value of otoneurosurgical collaboration].

A patient with a progressive peripheral facial paralyses should be considered to have a tumor involved the facial nerve until proved otherwise. Haemangiomas of the temporal bone are uncommon and the present study discusses pathology, clinical presentation and therapeutic management of a tumor located at the geniculate ganglion. Complete surgical removal by the middle fossa approach is the treatment of choice with adequate margins and preservation of adjacent structures when it is oncologically possible. The surgeon must be familiar with all aspects of facial nerve repair.

Adult↗

[Crista ampullaris mechanics and possibilities of regulation of the semi-circular canal].

A software using a finite element method is used to study the deformation of a bidimensional model of the human cupular diaphragm and the distribution of angular shearing of the hairs of the sensory cells located on the crista ampularis. This study shows that the hairs on the top of the crista are more sensitive to the pressure difference across the cupula due to angular acceleration of the head and those located on the sides of the crista are sensitive to the variation of the inflation pressure of the ampulla. This spatial discrimination of sensibility of the hair cells to the two types of mechanical solicitations leads us to consider the SCC as regulated sensor.

Biomechanical Phenomena↗

[Tonometric monitoring of the viability of free transplants of the jejunum and the stomach after total circulary pharyngolaryngectomy].

A prospective study concerning the tonometric viability supervision of 9 digestive free autografts after total pharyngolaryngectomy was conducted. This technic is based on the Henderson and Hasselbalch's equation which calculates the intramucosal pH (pHi) in the graft using a tonometric catheter. When the pHi is under 7.10, there is a graft ischemia. This invasive technique seems to be sensitive and specific provided that minimally rigorous measurement procedures are used. Late graft necrosis is the major limitation of the technique.

Adult↗

[Thyroid metastases of Grawitz tumors: apropos of a case].

Secondary localisations of malignant tumors to the ENT areas are rare. One case of renal adenocarcinoma metastasis to the thyroid has been followed in our department. After a quick recall of the clinical story, we will try to point out the epidemiological and physiopathological specificities of this localisation and to emphasize its therapeutic difficulties.

Carcinoma, Renal Cell↗

[Cholesteatoma in children. Apropos of 110 cases].

This retrospective study of 110 middle ear cholesteatomas, concerning children up to 15 years old which have been treated between 1982 and 1992 in the ENT department of the university hospital of Strasbourg, analyzes the particularities of this disease and the therapeutic strategy adopted. The evolution of middle ear cholesteatoma is more rapid in childhood than in adulthood, due to greater growth potential of tissue in childhood, persistence of Eustachian tube dysfunction and aggressive extension in middle ear. The surgical removal is said to be difficult with numerous postoperative recurrences. Closed technique tympanoplasty was used for 47 cholesteatomas (43%), with a postoperative recurrence rate of 54%. An open technique was used for 63% cholesteatomas (57%), with a recurrence rate of 29%. The postoperative follow up has to be continued as long as possible, whatever the technique used may be.

Adolescent↗

[Congenital cholesteatoma and associated ossicular malformations].

15 cases of congenital cholesteatoma surgically treated from 1982 to 1992 are presented. Clinical diagnosis criteria, pathology, localisations and extensions to the middle ear are analyzed. Ossicular malformations were associated in one third of the patients of this series. These ossicular malformations underscore the congenital origin of such cholesteatoma. A review of the literature and pathogenesis of congenital cholesteatoma is discussed.

Adolescent↗

[Thrombophlebitis of the lateral sinus. Apropos of a case].

About one case of septic sigmoid sinus thrombosis, the authors present various clinical and paraclinical elements of this rare pathology, whose entity are generally subtle for benign but also for serious forms. Although uncomplicated dural venous thrombosis carries an excellent prognosis with proper treatment, delay in diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. The modern literature is reviewed and the pathology, presentation and management of lateral sinus pathology is discussed.

Adolescent↗

[Uncommon caseous maxillary sinusitis of dental origin caused by Microsporum canis].

The authors report an uncommon case of maxillary sinusitis due to Microsporum canis. To their knowledge this is the first observation in which a zoophilic dermatophytic fungus which grows usually on keratin has been isolated in a dental maxillary sinusitis in human. This observation makes it possible to discuss nosologic and diagnostic features of dental caseous sinusitis and fungal sinusitis which are often or too often called aspergillosis sinusitis.

Aspergillosis↗

[Correlations between anatomy and x-ray computed tomography in cancers of the pharyngo-larynx. Apropos of a prospective study of 35 patients].

A prospective study has been conducted in 35 cases of pharyngolaryngeal's carcinoma, between december 1990 and june 1992 in the department of Head and Neck Surgery of Strasbourg. The authors compared, in a statistic analysis, Computed Tomography and histopathologic's correlations. The operative specimen were sectioned in the horizontal plane to correspond with the CT sections. 11 structures were studied more particularly. Results revealed an excellent sensibility for the study of the pre-epiglottic spaces (100%). Inversely, the study of the para glottic space is less good (69% of sensibility). We found that the CT Scan was of no value for the study of the thyroid cartilage, particularly for detection of subclinical lesions. Overall, this study allowed to confirm the value of the CT Scan in the investigation of pharyngolaryngeal tumors but its limits also.

Adult↗

[A new approach to the mechanism of vestibular response to caloric stimulation].

Barany's classical hydrodynamic theory has been called into question by the zero-gravity Spacelab experiments, and several new hypotheses are put forth to explain the vestibular response to caloric stimulation. We have developed a mathematic model based on the analysis of an experimental model of the semicircular canal, incorporating observations done with zero-gravity and with gravity. Two purely mechanical phenomena are involved: one one hand, the modification of the hydrostatic pressure on both sides of the cupula due to a temperature variation if the semicircular canal is not in the horizontal plane in normal gravity conditions; on the other hand, local changes in endolymph pressure and volume due to the mechanical and osmotic properties of the canal, which are independent from gravity and from the position of the canal. These mechanical processes, though not exclusive, are predominant and therefore sufficient to explain the caloric response of the vestibulum in all cases.

Caloric Tests↗

[Neuroendocrine giant-cell epithelioma. Description of a clinical case and review of the literature].

Neuroendocrine tumors are rare neoplasms of the larynx and hypopharynx. This tumors are divided in paragangliomas (usually benign, although malignant case have been reported), large cell neuroendocrine carcinoma, described in this case as a primary pharyngo-laryngeal locate, and small cell neuroendocrine carcinoma (characterized by early and diffuse metastatic disease, and best treated by radiotherapy and chemotherapy). Through the international literature, the authors reviewed the characteristics of the large cell neuroendocrine tumors and their management.

Aged↗

[Laryngeal sarcoidosis: apropos of a case].

The authors report an unusual case of laryngeal sarcoidosis. After having explained it, they describe the elements of diagnosis about this rarely isolated pathology, its complications and treatment as well.

Adrenal Cortex Hormones↗