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Biomedical subjects

D Bremond-Gignac

Publications and source records attributed to D Bremond-Gignac.

11 recordsLinked to original sources

Anatomical histological and mesoscopic study of the adipose tissue of the orbit.

Our study aimed to define the organization of the orbital adipose tissue, which is constituted from white adipose tissue. Six orbital samples were taken by dissection from fresh cadavers. After fixation and paraffin-embedding, the blocks were sectioned in the three spatial planes (two in the frontal, two in the sagittal, two in the horizontal). Semi-serial sections of 7 microm were then stained with hematein, eosin, safran or Masson trichrome green. We noticed strong areas of adhesion with orbital bones located at the lacrimal gland, the orbital trochlea and the inferior orbital fissure. Our mesoscopic and histological results allowed the description of two types of orbital adipose tissue corresponding to morpho-functional topographic variations. One was constituted of thick conjunctival septa with small adipocytes near muscles and the lacrimal gland. This was a supporting tissue that gave the points of rotation. The other was constituted of thin conjunctival septa with larger adipocytes near the optic nerve, allowing its movements in the orbit. These morphological differences appeared to be correlated with the mechanical role of these two areas. The dense appearance could correspond to the functional trochlea of rectus muscles described. In contrast we did not observe the systematic radial and concentric conjunctival meshwork classically described. This study underlines the specificity of orbital adipose tissue, which could be useful for a better understanding of its normal and pathological partition and its involvement in ocular motility.

Adipose Tissue↗

[CHARGE syndrome].

Explore the source record for details and available documents.

Abnormalities, Multiple↗

[Histologic and anatomic correlation of the infraorbital region].

The infra-orbital area has not been well studied although it represents an interesting area in plastic surgery because of its implication in malarplasty reduction or transplantation for facial tissue repair. This work comprises an anatomic dissection layer by layer and a histologic study describing the various structures of this area. It was performed on 10 heads taken from cadavers (mean age 70 years old). The anatomic and histologic study found four layers: a subcutaneous fat layer, a muscular layer, a deep fat layer and a deep muscular layer. The superficial fat layer constitutes the convexity of the cheek and can be removed in plastic surgery reduction or reconstituted after atrophy following nasolabial musculo cutaneous flaps.

Aged↗

Endoscopic technique for suturing posterior chamber intraocular lenses.

A challenge of the sutured posterior chamber intraocular lens (IOL) technique is to perform blind actions behind the iris. To avoid imprecise transscleral sutures and complications, we use an endoscopic procedure with 2 goals: to control the entry site of the needle penetration and of the haptic location. The endoscopic technique allows retroiris control during transscleral suturing and iridociliary IOL implantation. It is a safe, precise method that avoids the risks of blind procedures behind the iris.

Cataract Extraction↗

Vertigo is an underestimated symptom of ocular disorders: dizzy children do not always need MRI.

Vertigo, instability, dizziness, or equilibrium disorders are not usually considered as consequences of ophthalmologic problems. We present data indicating that ocular disorders can be responsible for these symptoms in children. In a population of 523 pediatric patients with vertigo or disequilibrium and referred for vestibular testing in our otolaryngology department during a 5-year period, 27 children presented with normal vestibular and somatic neurologic examinations but with ophthalmologic disorders (vergence insufficiency or latent strabismus with binocular vision in 70% and anisometropia in 41%). These patients represented 24% of all vergence insufficiencies detected and 4% of all orthoptic examinations performed in the pediatric ophthalmology department. These ocular abnormalities were considered to be the initial cause of the problems. In two thirds of these patients the symptoms were completely resolved by simple ophthalmologic treatment. No other additional tests, such as magnetic resonance imaging, were required. Therefore we propose that every child complaining of vertigo or dizziness but with normal clinical somatic neurologic and vestibular examinations should have a complete ophthalmologic examination before additional, more costly, investigations. This should lead to better screening and more appropriate care of ocular disorders in children and avoid unnecessary magnetic resonance imaging.

Child↗

Skin tests and cutaneous anergy in children with ocular allergy.

PURPOSE: To evaluate skin tests with clinical ocular allergy and to compare cutaneous hypersensitivity and seasonal allergic conjunctivitis in children. CASE-REPORT: A 10-year-old girl presented a typical seasonal allergic conjunctivitis, never treated and the onset occurred one year before. She was skin tested for the allergy. Complete blood tests were also performed. An ocular treatment was given: olopatadine over 45 days. RESULTS: She showed a complete cutaneous anergy including histamine and codeine controls. Radioallergosorbent tests (RAST) found numerous great positivity to different allergens. Within 30 days under ocular treatment, she recovered completely from symptoms and clinical signs. CONCLUSION: Clinical typical seasonal ocular allergy in children with cutaneous anergy should be explored further or at least treated. Cutaneous hypersensitivity should be evaluated more precisely with a larger study comparing results in general allergy and in ocular allergy where the anergy seems to be more frequent.

Child↗

[Functional visual explorations of Bardet-Biedl syndrome. A study of three cases].

Laurence-Moon syndrome, which is very rare, and Bardet-Biedl syndrome, which is more frequent are now well-recognized as two distinct entities in pediatric neurology. Bardet-Biedl syndrome includes a number of common clinical signs it shares with Laurence-Moon syndrome but also with other syndromes, particularly Alströme syndrome. These signs are retinitis pigmentosa, mental retardation, obesity, and hypogonadism. Ophthalmological and electrophysiological examinations are essential for confirmation and correct diagnosis of Bardet-Biedl syndrome. We present three case histories. Our third case illustrates the possibility of below normal yet discernable electroretinogram amplitudes which do not infirm the diagnosis of Bardet-Biedl syndrome.

Bardet-Biedl Syndrome↗

[Multifocal implants of 3 optic zones: optical performance and clinical functional results].

PURPOSE: Evaluation of multifocal IOL (three optical zones). METHODS: Twenty patients were implanted. Main outcome measures were: uncorrected and best corrected distance and near acuity, brigthness acuity test, contrast acuity with differents methods: Pelli-Robson Chart, Gradual System, and spatial visual integration (SVI). RESULTS: Uncorrected visual acuity was restored in 94% of cases. Contrast sensitivity was preserved with the Pelli-Robson chart test but a loss of contrast sensitivity was found with the multifocal IOL with the Gradual system and the SVI in comparison with monofocal IOL. CONCLUSION: Multifocal IOL (three optical zones) allows a good restoration of both near and far visual acuity but a decrease in contrast sensitivity was detected.

Adult↗

[Cytomegalovirus retinitis in children with AIDS acquired through materno-fetal transmission].

PURPOSE: To describe the clinical feature and the outcome of CMV retinitis in children with vertically transmitted HIV infection. RESULTS: Five case-reports of cytomegalovirus retinopathy are described. These children from eight month-old to seven and a half year-old (median age at diagnosis 52 months) had been perinatally contaminated by the human immuno-deficiency virus. The ophthalmic signs included only a red eye for one patient. The clinical signs were similar to the adult's retinopathy. At the opposite the differences were emphasized like the clinical onset with a delayed diagnosis. Mean follow-up since diagnosis is 8 months with 3 patients still alive. CONCLUSION: CMV retinitis in vertically transmitted AIDS can occur early in childhood and must be checked systematically in the patients with low CD 4 count because of the usual asymptomatic onset.

AIDS-Related Opportunistic Infections↗

Anatomic study of the lumbar region applied to multiplanar imaging techniques: importance and use of oblique vertical sections.

This anatomic study of the lumbar region (as defined by Rouvière [11]) applied to multiplanar imaging techniques was carried out both in the cadaver and in vivo. The cadaver study (5 cases) consisted of anatomic sections (transverse, sagittal, frontal and oblique) and computerised three-dimensional reconstructions after CT studies on subjects injected with colored and radio-opaque latex. The in vivo study (4 cases) used MRI sections and three-dimensional ultrasound sections coupled with the pulsed doppler. The spatially referenced oblique vertical sections revealed the structures from unusual aspects, situating them amidst the retroperitoneal area with the maximum of topographic landmarks. The transposition of these results (obtained by sectional anatomy of the retroperitoneal region) to the new techniques of multiplanar formatting after MRI, ultrasound or CT data acquisition should optimise the investigation of certain retroperitoneal structures by specifying the ideal planes of section for each organ, while diminishing certain artefacts specific to acquisitions in the traditional planes of section. Oblique vertical sections seem eminently suitable for ultrasound location of the suprarenal compartments, study of the renal pedicles and topographic retroperitoneal location. This oblique vertical visualisation constitutes a fundamental resource for the development of video-monitored surgical procedures as it corresponds exactly to the axes of the access routes in percutaneous surgery of the kidney and the adjacent anatomic structures.

Cadaver↗

[Review of ophthalmologic complications in hereditary bullous epidermolysis. Apropos of 40 cases].

INTRODUCTION: We assessed the frequency of ophthalmologic signs in inherited epidermolysis bullosa and evaluated follow-up. PATIENTS AND METHODS: Forty patients were studied retrospectively. Of the 40 patients, 38 had dystrophic and 2 had junctional epidermolysis bullosa. A complete ocular examination was performed in all cases and repeated if necessary (8 times). RESULTS: Ocular complications were found in 75% of the patients. Corneal anomalies associated or not with refractive anomalies were present. The best corrected visual acuity was less than 3/10 in 20% of the cases. Only 15% had lid modifications. DISCUSSION: In our series, 75% of the cases had ocular anomalies, similar to other series in the literature. Corneal problems dominated. CONCLUSION: Ocular lesions in inherited epidermolysis bullosa are often found and require initial ocular examination. Corneal lesions also need to be followed with optical correction to optimize functional prognosis.

Adolescent↗