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Biomedical subjects

D Goga

Publications and source records attributed to D Goga.

At least 73 records · Page 4Linked to original sources
PubMed1990

The temporomandibular joint in rheumatoid arthritis. Correlations between clinical and computed tomography features.

Clinical and computed tomography (CT) examination of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Each examination was scored. In the group with RA 61.2% had physical signs in the stomatognathic system compared to 42.3% in a control group (NS); 88.4% of the group with RA had erosive or cystic lesions of the TMJ compared to 57.6% of control subjects (p less than 0.05). The clinical dysfunction score did not correlate with the CT TMJ score in RA. It correlated with the number of slow acting antirheumatic drugs used, the rheumatoid factor titer and radiographic scores of the hands and cervical spine. In agreement with others, we believe that the only specific CT lesions of RA are erosions and cysts of the mandibular condyle, that there is no correlation between clinical and CT findings of TMJ in RA, and that the intensity of destructive lesions of TMJ on CT in RA is well correlated with the severity of the disease.

Arthritis, Rheumatoid↗
PubMed1990

[Cicatricial pemphigoid disclosed by superficial desquamative gingivitis. Clinical and immuno-electron microscopic study of a case].

Six months before consulting, a 71-year old man developed buccal and genital erosions which gradually became worse. Physical examination showed signs of superficial desquamative gingivitis, wide erosions on the bony palate, erythemato-erosive balanoposthitis and 7 bullae or skin erosions on the upper part of the back. At histopathological examination of a cutaneous bulla there was dermoepidermal cleavage and an inflammatory infiltrate without eosinophils. At direct immunofluorescence, linear deposits of IgG and C3 were present along the basement membrane. A search for anti-skin autoantibodies was negative at indirect immunofluorescence but positive at immunoblotting (240 Kd band). The cicatricial pemphigoid was treated with dapsone alone in doses of 100 mg/day. Treatment was continued for 6 months, resulting in complete cure of the mucosal and cutaneous lesions. An immunoelectromicroscopic study, performed according to the technique described by Prost et al., on a fragment of skin from around the bullae, showed deposits of granular IgG in the lamina lucida and the lamina densa and deposits of C3 in the lamina densa. This case of cicatricial pemphigoid exhibited 3 features which are not usually found in bullous pemphigoid. Clinically, the buccal lesions were located on the gums and on the hard palate, i.e. where the mucosa adheres to the underlying bone through the periosteum. This location is habitual in cicatricial pemphigoid and differs from that of the bullous pemphigoid lesions which affect the free mucosa lining the cheeks and the soft palate. Treatment with dapsone was dramatically successful in our patient whose lesions disappeared in 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Condylar fractures and involvement of the trigeminal nerve].

Although fractures of the condylar neck belong to the most frequent injuries of the jaws, and various nerves are found in close proximity to the temporomandibular joints, only little mention is made in the literature of the neurological complications. An unusual case of V2 and V3 nerve injury is presented. The literature is reviewed and the mechanism of the nerve injuries are discussed, 21 cases are reported.

Child↗
PubMed1990

[Results of radiotherapy of carcinomas of the tonsillar area. Study of 137 cases].

In our center, carcinomas of the tonsillar region are most often treated by radiotherapy. The aim of this retrospective study was to assess the therapeutical results obtained for such tumors over a period of ten years. From 1976 to 1986, 137 patients with carcinoma of the tonsillar area were exclusively treated by radiotherapy. The mean age of the patients was 54.3 years. 120 male and 17 female patients were included in the study. 63% of the patients had T3 or T4 tumors, while 53% had N2 or N3 adenopathies at enrollment (1979 TNM classification). All the patients had transcutaneous irradiation done either exclusively (121 cases) or in combination with curietherapy (16 cases). 61 patients had induction chemotherapy. Local control of the tumor was obtained in 59% of patients (79/137), and attained 92%, 71%, 58% and 16% for the T1, T2, T3 and T4 groups, respectively. The 5 year survival rate was 34%. 12 patients developed distal metastases. 9 patients developed another type of cancer. Elements of prognosis were tumor size and nodal status. Age, sex and histological differentiation were not determinant prognostic factors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Tomographic aspects of the temporomandibular joint (TMJ). Comparative study of 30 subjects with rheumatoid arthritis and 30 normal subjects].

From a prospective study, two populations are compared: 30 Healthy subjects with 30 subjects suffering from rheumatoid arthritis. Two conclusions are statistically significant: --The temporo-mandibular joint is affected like the other joints in the rheumatoid arthritis, --the lesions are often bilateral. Two radiographic aspects, are most often observed: the erosion and the lacuna.

Arthritis, Rheumatoid↗
PubMed1989

[Facial injuries caused by firearms. Practical approach in emergencies].

Firearm injuries to the face are often a disconcerting clinical problem for the non specialized surgeon. The aim of this article is to de-mystify this emergency situation, which is common in Maxillo-facial units, and requires rigorous management and respect of well established general surgical principles. The authors subsequently review the need for secondary repair by a maxillo-facial and plastic surgeon.

Emergencies↗
PubMed1989

[Radiotherapy of carcinoma of the oropharynx. Results of 10 years' experience at the University Hospital Center, Tours].

In our centre, the vast majority of patients with oropharyngeal tumours are treated by irradiation. Over a period of 10 years, between 1976 and 1986 we treated 305 patients with squamous carcinomas of the oropharynx. The mean age was 58.2 years. There were 24 women and 281 men. 59% of the patients had advanced tumours, classified as T3 or T4, 54% of the patients showed the presence of adenopathy at the first examination. All patients received radiation therapy. 69 patients had surgical treatment of the tumour or glands. 21 patients had implant therapy (most often combined with transcutaneous irradiation). 165 patients had induction chemotherapy. Local tumour control was obtained in 124 patients (41%), i.e. 82, 56, 31 and 4% for T1, T2, T3 and T4 respectively. The 5 years survival rate of the overall population was 28%. The principle causes of failure were local progression for T3 and T4 tumours and metastases and second cancers in patients with T1 or T2 tumours. The prognostic factors were gland involvement and general health. The site of the tumour, sex and histological type were not prognostic factors. Induction chemotherapy did not improve the results of treatment.

Carcinoma↗
PubMed1988

Surgical treatment of Graves' disease.

Seven men and 81 women were operated on for Graves' disease. Their median age was 33 years. Eleven patients underwent a bilateral subtotal lobectomy; 77 patients underwent a complete lobectomy with contralateral partial lobectomy. Forty-seven patients were treated before 1981. In these patients, the weight of the thyroid remnant was estimated empirically between 5 and 12 g. In the 41 patients treated since 1981, the remnant weight was estimated at 5 g by comparative weighing. There were no postoperative deaths. Functional results were established in 83 patients with an average follow-up of 50 months (range 12 to 156 months), with control of vocal cord mobility demonstrated by indirect laryngoscopy in 66 patients. Hormonal determinations were carried out in 74 patients. There were no cases of permanent hypoparathyroidism. Three patients (4.5 percent) had unilateral vocal cord dysfunction. Twelve patients (14.5 percent) had clinical and biologic hypothyroidism, which occurred within 1 year postoperatively in 11 cases. Seven patients (8.3 percent) had latent hypothyroidism only discovered by hormonal determinations. Fifteen patients (17.8 percent) had recurrent hyperthyroidism, 6 of whom were diagnosed by hormonal determinations. The actuarial recurrence rate increased progressively up to the sixth postoperative year. The only predictive factor for recurrence was the type of operation. Patients who underwent a bilateral subtotal lobectomy had more recurrences than patients who underwent a complete lobectomy with partial contralateral lobectomy (p less than 0.01). These results suggest that patients should be followed closely for many years and should undergo hormonal determinations regularly, as some recurrences can occur 5 years or more after operation with very few symptoms.

Adolescent↗
PubMed1988

[Carcinoma of the soft palate and uvula. An analysis of the results and the reasons for failures. A study of 76 cases].

The treatment of carcinomas of the soft palate most often involves radiotherapy. In order to assess the value of irradiation, notably in the treatment of limited T1 or T2 tumours, a retrospective study was carried out of 76 case records suitable for analysis of patients treated in our hospital for this type of tumour between 1974 and 1987. There were 70 men and 6 women. The mean age was 54 years. Fifty-four patients had limited T1 or T2 tumours (including 40 without lymphadenopathy). Treatment methods varied but 48/76 were treated by radiotherapy only (transcutaneous irradiation and/or local interstitial implant). Local tumour control was obtained in 87% of patients with T1 tumours, in 77% with T2 and in 50% with T3 tumours. Lymph node control was obtained in 68% of patients. None of the patients initially classified NO showed any subsequent lymph node involvement. The actuarial five-year survival rate was 67% for T1, 38% for T2 and 22% for T3. Lymph node involvement was the only other prognostic factor. Fourteen patients developed distant metastases and 13% had at least one other tumour site. Radiotherapy as tumour treatment is thus felt to be the method most widely used apart from tumours strictly limited to the uvula, where surgery is preferred. Cervical lymph nodes are treated surgically when there is a palpable lymphadenopathy and by radiotherapy for N0 patients. Induction chemotherapy before radiotherapy is used in addition at stages T3 and T4.

Adult↗
PubMed1988

[Surgical correction of saddle nose. Apropos of 23 cases].

Choice of graft for repair of a saddle nose in 23 patients, usually late sequelae of nasal fracture, varied with degree of concavity : moderate anomalies usually by cartilaginous graft, major lesions by iliac bone graft. Postoperative course was always simple. The Rethi approach was used when a bone graft was necessary, with a minimum esthetic ransom, and a skin flap of V-Y advancement at the expense of the white labrum when there was insufficiency of columellar height. Although results were assessed as satisfactory by the patients, the difficulties in obtaining excellent results in this type of rhinoplasty are emphasized, imperfections being frequent : filling of nasofrontal angle, asymmetry of naries orifices and fixed nose appearance.

Adolescent↗
PubMed1987

[Induction chemotherapy of carcinomas of the oral cavity and oropharynx. Feasibility study, levels and factors of response to treatment. Apropos of 135 cases].

Induction chemotherapy is now frequently included in therapeutic protocol for carcinoma of oral cavity and oropharynx. Frequency of objective responses and predictive factors for favorable responses to therapy were evaluated in 135 patients. In 45% of cases an objective tumoral regression was noted (with 6% total regression). Combined CDDP-5 FU produced responses in 65% of cases, whereas the combinations of CDDP-BLM-VCR-MTX and of CDDP-BLM-VDS produced values of 35 and 41% respectively. Small tumors (T1, T2) regressed better during chemotherapy than extensive tumors (T3, T4) (16 and 34% respectively). The tumor implantation site was a predictive factor: tumors of the tonsillar region not extending to base of tongue regressed in 74% of cases as against 35% for lesions of base of tongue. In contrast, histologic type and degree of glandular involvement were not important predictive factors. These findings suggest that induction chemotherapy for carcinoma of oropharynx or oral cavity is feasible and that predictive factors of response to treatment are size and site of tumor and type of chemotherapy.

Adult↗
PubMed1987

[Use of coral implants in maxillofacial and otorhinolaryngologic surgery].

The coral, as bio-compatible implant, has been used in several indications: in Otology: for ossicular chain and external auditory canal reconstruction. In Maxillo-facial surgery: for orbital floor, maxillary sinus and jawbone reconstruction. The first results of this study are favorable but coral resorption might be prevent by a careful sealing of the implant deep under the surface layer.

Biocompatible Materials↗
PubMed1987

[Extensive mycoses of the face. Apropos of a case].

An 11 year old boy with medullary aplasia developed extensive mycosis of the face. This mucormycosis is a rare affection that appears in patients with predisposing disease (diabetes, blood disorders) and is easily diagnosed, if considered, from clinical features. Diagnosis is confirmed by histopathology, culture sometimes identifying the causative fungus. Despite the intrinsic serious course of this affection (facial necrosis, death) prognosis appears to be related essentially to the rapid control of the subjacent disease.

Anemia, Aplastic↗