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Biomedical subjects

E Babin

Publications and source records attributed to E Babin.

At least 19 recordsLinked to original sources

[Otogenic cavernous sinus thrombophlebitis. A case report].

OBJECTIVES: Acquire knowledge concerning the diagnosis and treatment of otogenic cavernous sinus thrombophlebitis. PATIENT AND METHODS: We report a case of otogenic cavernous sinus thrombophlebitis (CST) in a 6-year-old boy. RESULTS: CST diagnosis was based on clinical signs (septic illness, ocular nerve palsy and chemosis), and neuro-imaging confirmed the diagnosis. Contrast-enhanced CT scan demonstrates different signs: (i) filling defect or heterogeneous enhancement of cavernous sinus, (ii) cavernous sinus enlargement with bulging of the lateral wall, (iii) intensive enhancement of lateral wall corresponding to enhancement of a collateral network replacing the thrombosed cavernous veins, (iiii) and sometimes indirect orbital signs (exophthalmus, densification of the retro-orbital fat, superior ophthalmic dilatation with partial or no enhancement in case of thrombosis extension). The bacteria most frequently found are Streptococci, Streptococcus pneumoniae, Staphylococcus aureus, Gram-negative rods and anaerobes combined. The therapeutic management of CST consists of intravenous administration of appropriate antibiotics combined radical mastoidectomy if medical therapy has failed. Anticoagulant therapy is controversial. CONCLUSION: Knowledge of early diagnosis of otogenic cavernous sinus is important because prior to the antibiotic era, CST was almost always fatal. Currently, therapeutic outcome is not always favorable due to high morbidity after aggressive treatment.

Cavernous Sinus Thrombosis↗

[Surgery for hyperthyroidism on 43 patients].

UNLABELLED: Treatment of hyperthyroidy uses surgery as well radioactive iodine and antithyroid agents. OBJECTIVES: The study analyses the modalities of hyperthyroidy surgery, describes its complications and the population undergoing surgical treatment. POPULATION AND METHODS: It is a retrospective study on 43 patients with hyperthyroidy treated by thyroidectomy from January first 1998 until 31 January 2002. RESULTS: The mean age is 48 years. The sex ratio showed a predominance of women (with 36 women and 7 men). The most frequent aetiology is Graves' disease and toxic multinodular goiter. Total thyroidectomy is applied to Graves' disease and toxic multinodular goiter while single toxic nodules are treated by loboisthmectomy. Surgery for hyperthyroidy have a low morbidity (1/43 haematoma, 0/43 hypoparathyoidy, 1/43 palsy of recurrent nerve). CONCLUSIONS: In this conditions, the hyperthyroidy surgery is fast, effective and does not need a heavy follow-up. Surgery seems to be a good alternative to antithyroid agents, which are constraining and often ineffective in the long term, and to radioactive iodine who leads to a long follow-up because of induced hypothyroidy.

Adult↗

[Bronchial foreign bodies in children].

BACKGROUND: Tracheobronchial aspiration of foreign bodies in children is a rare event that can be serious. We report a 10-year retrospective study of tracheobronchial foreign body aspiration in children. METHOD: This retrospective analysis involved 87 patients who underwent endoscopy at the ENT unit of the Caen University Hospital. RESULTS: Foreign bodies were found in 34 of the 87 patients. Average age was 3 years, with a male predominance. Peanuts were the most common foreign bodies observed (16/34). Most of the foreign bodies were removed via the right main bronchus (17/34). Clinical and radiological signs depended on delay to admission and were found to be normal in 15% and 37.5% of the cases respectively. Twenty-four children out of 34 had a positive history of foreign body inhalation. All foreign bodies were removed during the endoscopy procedure. CONCLUSION: This work underlines the much-debated function of chest x-ray, the need for a rigorous technically correct endoscopy procedure and the importance of close cooperation between the anesthesiologist and the endoscopist.

Bronchi↗

[Chondromas and low-grade chondrosarcomas of the larynx: a case report].

OBJECTIVE: We report a case of cricoid chondroma, underlining the difficulty in establishing a precise differential diagnosis between chondroma and low-grade chondrosarcoma of the larynx. MATERIAL AND METHODS: A 48-year-old woman developed inspiratory dyspnea. The final diagnosis was cricoid chondroma. We reviewed our case and data in the literature on these cartilaginous tumors. RESULTS: The patient was treated with conservative surgery. At 18 months follow-up, no recurrence has been detected. DISCUSSION: These tumors are rarely found in an ENT location and have similar histological features. According to many authors, the clinical course alone enables a distinction between chondroma and low-grade chondrosarcoma. Surgical treatment is indicated and provides good phonatory function in the vast majority of the cases.

Chondroma↗

[Utility and limitations of speech audiometry testing in the detection of occupational noise-induced hearing loss: a comparative study in two groups in the hospital setting].

OBJECTIVE: The objective of this study is the evaluation of the calculation of 100% intelligibility threshold and noise resistance index as a monitoring test in populations exposed to noise in their work environment. METHOD: This is a retrospective exposed-unexposed study as the exposure to the risk factors took place before the survey. The exposed subjects were chosen in principle on sonometric criteria and the unexposed subjects among employees whom we believe were not exposed. The exploration method included history taking, clinical examination, free field audiometry and speech audiometry with background noise. RESULTS: The exposed population has a 100% intelligibility threshold on average equal to 29.69 dB, significantly higher than in the unexposed population where it is calculated at 25.30 dB (p = 0.07). The noise resistance index varies with age (p = 0.04). CONCLUSION: Our study shows the existence of a significant hearing difference between two populations with different noise exposure. It demonstrates a relationship between a hearing loss risk factor such as noise and the occurrence of the "professional hearing loss" disorder. The calculation of the 100% intelligibility index and the noise resistance index advantageously complements tonal audiometry. These procedures provide a better approach to the social impact of hearing loss but were not useful in the detection of hearing loss.

Adult↗

[Intracranial complications of acute mastoiditis].

We report a case of extradural abscess after acute mastoiditis in an 8-years-old boy. The clinic diagnostic of an intracranial complication is difficult. The most common present symptoms are fever, otalgia and otorrhea but are not specific. Neurologic symptoms are suggestive signs of an intracranial complication. We believe that, in acute mastoiditis performance of a CT scan of the brain and temporal bones with intravenous contrast, contribues to the diagnostic of intracranial complication. The diagnostic of thrombosis sinus sigmoid is evoked with slight contrast enhanced sinus sigmoid and failure to opacify. The characterisation of an epidural empyema is a hypodense epidural collection in a contrast-enhanced CT scan. The most common isolated organism are Streptococcus Pneumoniae, Staphylococcus aureus and Pseudomonas aeuginosa. The therapeutic management includes combination of intraveinous antibiotics, mastoidectomy and surgery of the intracranial complication.

Acute Disease↗

[Parathyroid cysts].

Two cases of parathyroid cysts are described. One cyst was symptomatic, the other was discovered while performing thyroidectomy. In both cases, the cysts were non-functional. There have been reports of functional cysts occurring in a lesser proportion and causing primary hyperthyroidism. These benign cysts are rare (300 cases reported in the literature). Surgery is the treatment of choice in most cases.

Adult↗

[Life after total laryngectomy].

This work relates the observation conducted in our outpatient clinic with fourteen patients who underwent a total laryngectomy due to a laryngeal and hypo pharyngeal cancer. The aims of our study were to analyse identity transformations and sociability modifications for these patients. It confirmed the social inequalities when a cancer occurs. Total laryngectomy upset or staggers the patients by impairing their appearance. Relations with other people are limited to the dearest because the tracheostomy and the deprivation of the original voice are regarded as disability that excludes them from the society. The physicians should be aware of the profound psychologic trouble and social changes attached to laryngeal cancer surgery to allow optimal care for the patients.

Adult↗

Facial nerve: vascular-related anatomy at the stylomastoid foramen.

We dissected 30 facial nerves in fresh cadavers after arterial casting with red latex to provide specific information about the arterial-related anatomy of the trunk of the facial nerve from the stylomastoid foramen to its bifurcation. We found that a wide anatomic variability does exist. The trunk of the facial nerve was in proximity to the stylomastoid artery, which originated from the posterior auricular artery in 70% of the specimens (21/30), from the occipital artery in 20% (6/30), and directly from the external carotid artery in 10% (3/30). The stylomastoid artery passed medially to the trunk of the facial nerve in 63 of the specimens (19/30) and laterally in 37% (11/30). Among these 11 specimens, 8 were large-caliber stylomastoid arteries. During parotid surgery, the main trunk of the facial nerve may be difficult to identify, because a large-caliber stylomastoid artery can mask it. Therefore, it is important to dissect this artery with caution.

Facial Nerve↗

[Head and neck desmoid tumor in children: a case report and review of the literature].

We report a case of desmoid tumor in the submandibular region in an 18-month-old girl. Head and neck desmoid tumors are uncommon in children and diagnosis is a difficult task because the tumors are often classified as different types of fibromatosis. This histologically benign affection is characterized by local expansion or destruction and tends to recur. Pathology gives the positive diagnosis, showing fibroblastic monoclonal proliferation between the cellular center and the collagen periphery. Electron microscopy evidences an abundant collagen network enclosing a polymorphous cellular proliferation. Immunohistochemistry defines vimentin and actin positive desmoid tumors. Surgery is usually the therapeutic choice. Chemotherapy and radiotherapy may be used in conjunction with surgery in situations of recurrence or unsatisfactory surgical margin. There is a risk of recurrence which can be detected with regular follow-up examinations.

Actins↗

Alagille syndrome with cavernous carotid artery aneurysm.

We present a case of right sided blindness caused by a cavernous carotid artery aneurysm in a 17-year-old patient presenting with an Alagille syndrome. The diagnosis was made by magnetic resonance imaging and confirmed by angiography. This aneurysm was treated successfully with endovascular placement of detachable balloons. Cerebral vascular malformations are rarely reported in association with this syndrome. We discuss the clinical presentation, diagnosis, treatment and detection of this type of abnormality.

Adolescent↗

Supraselective embolization in intractable epistaxis: review of 45 cases.

Epistaxis is a common and in most cases benign event. Severe or recurrent epistaxis, however, can present therapeutic problems. Forty-five cases of supraselective embolization in intractable epistaxis are reported. The authors' success rate of 97%, similar to the success rates reported in the literature, confirms the effectiveness of this technique. Complications occurred in only 8% of the cases. One serious complication was neurologic. Percutaneous embolization is an effective option for managing intractable posterior nasal bleeding but is not recommended as an early form of treatment.

Adolescent↗

The recurrent laryngeal nerve: related vascular anatomy.

This study was based on 34 recurrent laryngeal nerve dissections after arterial casting with red-colored latex. The aim was to provide specific information about the perineural microvasculature. This study established the following points: 1. a great anatomic variability does exist; 2. the laryngeal nerve is usually in relation to the posterior branch of the inferior thyroid artery; and 3. this vascular branch is sometimes replaced with a vascular network. In all cases, this microvascularization must be preserved during thyroid surgery.

Cadaver↗

[Temporal fibrous dysplasia with labyrinthine involvement. Apropos of a case and review of the literature].

Craniofacial fibrous dysplasia manifests clinically with dysmorphic syndrome, ophtalmologic or otologic signs. We report a case of temporal polyostotic fibrous dysplasia with vertigo and sensorineural hearing loss. Sensorineural hearing loss, with no cholesteatoma associated, as described in our case is rarely described. We review the literature concerning main clinical, diagnostic and therapeutic aspects of this disease.

Aged↗

[A case of Kikuchi disease. Review of the literature].

We report a case of Kikuchi's disease in a young man. It is a rare entity, described for the first time in 1972. It manifests clinically with cervical adenopathy and fever, often associated with other non-specific clinical signs. Laboratory tests are often normal. The diagnosis is established on the basis of histologic of lymph node excisional biopsy. Kikuchi's disease is likely to be misinterpreted as malignant lymphoma or systemic lupus erythematosus. It generally needs no treatment because it runs a spontaneously benign course with complete resolution of the symptoms within 6 months. Secondary systemic lupus erythematosus may develop. For this reason, regular follow-up of patients is recommended. The etiopathogenesis of this disease is still unknown, perhaps due to an immunologic phenomenon. It could be a hyperimmune reaction induced by various antigenic agents (infectious, neoplasic), or an autoimmune process.

Adult↗

[Extemporaneous histologic examination of cutaneous carcinoma of the face].

One hundred thirty-eight skin cancers of the face were reviewed retrospectively in order to evaluate the extemporaneous histology examination. The results obtained were satisfactory and in agreement with those in the literature. This technique is perfectly adapted to cancers with a facial localization. In our opinion, the indication for extemporaneous examinations should be widened to all cases of epithelioma of the face.

Aged↗

Identification of a human delta opioid receptor: cloning and expression.

The delta opioid receptor is an important target for analgesic drug development. This report describes the identification of delta opioid receptor clones from human cDNA libraries and the preparation of a human delta receptor cDNA in the pcDNA3 expression vector for transfection studies. The cDNA encodes a 372 amino acid protein that has 93% amino acid identity to mouse and rat delta receptors. COS-7 cells transfected with this clone express over 1.0 pmol receptor/mg protein when measured by saturation binding with [3H]naltrindole. The delta receptor selective ligands NTB, BNTX, [4'-Cl-Phe4]DPDPE and [D-Ala2,Glu4]deltorphin all have Ki values under 10 nM while the affinities of the mu and kappa opioid receptor ligands CTAP and U-69593, respectively, are over 4.0 microM. Agonists show binding to multiple affinity states of the receptor consistent with the presence of G-protein coupled and uncoupled forms of the expressed receptor. The 8-fold higher affinity of NTB relative to BNTX suggests that the human delta receptor is of the delta 2 subtype.

Amino Acid Sequence↗