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Biomedical subjects

G Moulin

Publications and source records attributed to G Moulin.

At least 91 records · Page 5Linked to original sources
PubMed1994

Protrusion of the optic nerve into the ethmoid and sphenoid sinus: prospective study of 150 CT studies.

Damage to the optic nerve is a serious complication of intranasal sinus surgery. Protrusion of the optic canal into the sphenoid sinus is a major risk factor. In this prospective study of 150 CT studies, we found this anatomical variation in 8% of cases. It was consistently associated with pneumatisation of the ipsilateral anterior or clinoid process. Protrusion of the optic nerve into the posterior ethmoid cells was never observed. CT is a useful part of the preoperative investigation of patients undergoing intranasal sinus surgery. Axial and coronal images obtained or by direct acquisition by reconstructions are necessary to show the position of the optic nerve.

Adult↗
PubMed1994

Extended operation for lung cancer invading the superior vena cava.

Between 1981 and 1991, 845 patients were operated on for right lung cancer. Among them, 50 (6%) had a tumor invading the superior vena cava (SVC). Fifteen patients (14 men and 1 woman, mean age: 58 years) underwent radical resection with concomitant vascular reconstruction. Two patients presented with a superior vena caval syndrome. The SVC was invaded by direct extension from the tumor (n = 11) or by paratracheal nodal involvement (n = 4). The patients required pneumonectomy (n = 13) or upper lobectomy (n = 2), with lateral (n = 11) or circumferential resection (n = 4) of the SVC. The venous pathway was repaired by direct suture (n = 9), prosthetic patch (n = 2) or polytetrafluoroethylene (PTFE) graft (n = 4). Tumor resection was considered macroscopically complete in 12 patients (80%). One patient died postoperatively (7%) and non-fatal complications occurred in 3 (20%). Early patency of the four grafts was assessed by phlebography. In the late course, pulmonary embolism occurred in two patients and extended superior vena caval thrombosis in one; the overall clinical patency rate was 75.7% at 1 and 5 years. Two patients (13.3%) experienced mediastinal recurrence; the overall survival rates at 1 year, 2 years and 5 years were, respectively, 46.7%, 32% and 24% (median: 8.5 months). We conclude that extended resection for lung cancer invading the SVC, when feasible, is justified given the effective control of the primary tumor thereby provided, with an acceptable operative risk.

Adenocarcinoma↗
PubMed1994

Tantalum-Dacron coknit stent for endovascular treatment of aortic aneurysms: a preliminary experimental study.

PURPOSE: The purpose of this study was to evaluate the efficiency of intraluminal tantalum-Dacron coknit stents for the treatment of artificial aortic aneurysms in minipigs. METHODS: Replacement of the infrarenal abdominal aorta with Dacron artificial aneurysm graft was performed in eight minipigs. After 2 weeks, balloon-expandable coknit stents were inserted through the femoral artery to the site of the artificial aneurysm in seven minipigs. One animal was kept as a control. Coknit stent/artificial aneurysm complexes were explanted at various intervals from 24 hours to 12 weeks and underwent gross examination, followed by scanning electron and light microscopy studies. RESULTS: Aortography performed at the time of stent placement displayed immediate exclusion of the aneurysm in every case. In follow-up studies, all coknit stents remained patent until the time of explant. Scanning electron microscopy studies revealed apparent endothelialization of the entire coknit stent lumen at and after 6 weeks. CONCLUSION: Tantalum-Dacron coknit stents are efficient in the treatment of artificially created aneurysms in minipigs and facilitate the creation of an endothelialized new vascular wall. Clinical application of this coknit stent can be considered but necessitates retaining the same stent structure in diameters greater than 20 mm and the development of a suitable delivery system.

Animals↗
PubMed1994

Difference in the height of the right and left ethmoidal roofs: a possible risk factor for ethmoidal surgery. Prospective study of 150 CT scans.

A prospective study of 150 CT scans showed that the right ethmoidal roof was lower than the left in 8.6 per cent of cases. The reverse situation, i.e. the right higher than the left, was observed in only 1.2 per cent of cases. This finding could account for the higher reported incidence of endocranial complications associated with right ethmoidectomy. Coronal CT scans allowing comparison of the right and left ethmoidal roofs should always be made before undertaking intranasal ethmoidectomy.

Adult↗
PubMed1994

Effect of heavy smoking on nasal resistance.

Smoking is a part of our sociocultural environment. Its medical consequences are probably still underestimated. In this prospective clinical study, we explored the relationship between heavy smoking and nasal resistance. Anterior rhinomanometry was performed in 26 smokers and 26 non-smokers. Each group contained 13 men and 13 women. Analysis of variance of nasal resistance measurements using age and weight as covariables showed no significant difference between sexes. In contrast, a highly significant increase was noted between smokers and non-smokers. Age and weight had no influence on these results. Rhinomanometry proved to be an excellent method of detection for these modifications. Similar studies on the effects of passive smoking and of atmospheric and occupational pollutants should follow in the near future.

Adult↗
PubMed1994

[Perianal basal cell carcinoma. Apropos of 2 cases].

INTRODUCTION: Two cases of perianal basal cell carcinoma were reported. Less than 100 cases have been so far described. OBSERVATIONS: The first case was a pigmented tumour, in the second an erosive erythematous plaque somewhat similar to Paget's disease. COMMENTS: Basal cell carcinoma of the anal margin is about 15-fold less common than squamous cell carcinoma. The tumour is often ulcerated, sometimes infiltrative but metastasis never occurs. Histopathological findings are often close to what is observed in cloacogenic carcinoma. Surgical resection of the lesion is the best treatment but electrontherapy permitted lesion healing in one of our cases.

Aged↗
PubMed1994

[Tufted folliculitis of the scalp].

INTRODUCTION: Tufted hair folliculitis is a localized scarring bacterial folliculitis due to Staphylococcus aureus. We present two cases. OBSERVATIONS: Both patients were in their thirties. The first had had an inflammatory sclerous lesion of the vertex for three years, and the second an alopecial scarring lesion. Clinically there were tufts of hair within or around the lesions. Staphylococcus aureus was found in biopsy samples which showed hairs or composed follicles. Prolonged treatment with oral antibiotics led to progressive limitation of the lesions. DISCUSSION: Tufted hair folliculitis is a characteristic folliculitis of the scalp showing scar formation and the presence of Staphylococcus aureus. The review of the literature raises the question of the role of local immunity and the nature of the hair tufts: primary anomaly or secondary to Staphylococcus infection? The therapeutic attitude is not well defined but prolonged treatment with oral antibiotics can stabilize the lesions.

Adult↗
PubMed1994

[A case of unilateral elastosis with cysts and comedones. Favre-Racouchot syndrome].

INTRODUCTION: Cutaneous elastosis with cysts and comedones (Favre-Racouchot) is one of the oldest known manifestations of helioderma. Both sides of the face are usually involved symmetrically. CASE REPORT: We observed a 65-year-old woman with extremely severe Favre-Racouchot disease localized exclusively on the left side of the face. The diagnosis of elastosis with cysts and comedones was confirmed histologically. This elastosis with cysts and comedones was associated with spasms of the hemiface treated with injections of botulinic toxin. This association was fortuitous and we retained actinic irradiation as the causal agent in this woman who had worked for 15 years in the same room. The elastosis occurred on the side of the face which had been continuously exposed at the same orientation to the window. COMMENTS: This original observation is similar to cases where facial exposure to artificial light or sunlight is asymmetrical, leading to a higher incidence of lesions on one side of the face: colloid milium, actinic keratosis, Dubreuilh melanoma (malignant lentigo) or simple helioderma. The asymmetrical nature of the actinic lesions is often related to automobile driving. This case was particular since it demonstrated that Favre-Racouchot elastosis with cysts and comedones is due to actinic irradiation and not to skin aging.

Acne Vulgaris↗
PubMed1994

[Indications for imagery in dysfunctional temporomandibular pathology].

Cranio-mandibular disorders include muscular and articular signs. Articular pathology is the only one that need to be structurally studied. Paraclinic indications are based upon physical examination. Bone structure can be explored with tomography or CT scan and intra-articular structures can be explored with M.R.I. or arthrography. Two pathologies have then been found with an excessive frequency, disc displacements and juvenile osteoarthrosis.

Cartilage, Articular↗
PubMed1994

Right-sided aortic arch: surgical treatment of an aneurysm arising from a Kommerell's diverticulum and extending to the descending thoracic aorta with an aberrant left subclavian artery.

The case of a 44-year-old black man who presented with severe dysphagia, cough and chest pain caused by a 12-cm aneurysm developing from a Kommerell's diverticulum at the origin of an aberrant retro-oesophageal left subclavian artery is reported. The aortic arch and descending thoracic aorta were right sided. Diagnosis was established before operation by computed tomography, magnetic resonance imaging and arteriography. The aneurysm extended a considerable distance down the descending aorta and therefore the risk of postoperative paraplegia was considered to be high. Accordingly selective arteriography was performed to locate the Adamkievicz's artery which arose only 2 cm below the end of the aneurysm. Resection grafting of the aneurysm including the upper third of the descending aorta via right thoractomy was performed. The patient made an uneventful recovery and was discharged 20 days later. This case appears to be the first successful operation for this pathology.

Adult↗
PubMed1994

[Intra-arterial thrombolysis using rt-PA for the treatment of occluded infra-inguinal bypasses].

From July 1990 to July 1993, we performed 41 percutaneous intra-arterial thrombolysis procedures for the treatment of obstructed infra-inguinal bypass grafts in 32 patients. There were 27 men and five women with a mean age of 63 +/- 17 years (range 21 to 83 years). The symptoms of occlusion were intermittent claudication in three cases, rest pain in 12 cases, severe ischemia without sensitive-motor loss in 26 cases. Bypasses were achieved using a prosthesis in 18 cases (43.9%), a saphenous vein in 10 cases (24.4%), an arterial allograft in nine cases (21.9%), and a composite prosthesis-vein graft in four cases (9.8%) (table I). The distal anastomosis of the bypass graft was located on the popliteal artery in 26 cases (63.4%) and a crural artery in 15 cases (36.6%). The mean duration of the occlusion was 4.9 +/- 3.4 days (range 1 to 15 days). The percutaneous approach was through the contralateral common femoral artery in 26 cases (63.4%), through the ipsilateral common femoral artery in seven cases (17.1%), through the left humeral artery in eight cases (19.5%). In all cases the thrombolytic agent was the recombinant tissue-type plasminogen activator (rt-PA). Each procedure began with the injection of a five milligram bolus of rt-PA into or onto the thrombus followed by infusion of rt-PA into the thrombus at a dose of 0.05 mg/kg/h. Intravenous heparin was simultaneously administered. Serum fibrinogen, prothrombin time, and partial thromboplastin time (PTT) were measured every three hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Dehiscence of the lamina papyracea of the ethmoid bone: CT findings.

PURPOSE: To describe the CT findings characterizing dehiscence of the lamina papyracea. METHODS: Axial and coronal CT scanning of the paranasal sinuses was performed on 783 patients. RESULTS: Dehiscence of the lamina papyracea was noted incidentally in six patients. In all cases dehiscence was characterized by protrusion of orbital fat through a gap in the anterior ethmoid. The posterior limit of the dehiscence was always the basal lamella. The anterior limit varied. CONCLUSION: CT scans are often taken to detect polyps or assess chronic sinusitis. Awareness of dehiscence of the lamina papyracea is important to avoid misdiagnosis as infectious or tumoral process and possible injury of the orbit during endoscopic surgery.

Congenital Abnormalities↗
PubMed1994

Pharmacokinetics and tissue residues of spiramycin in cattle after intramuscular administration of multiple doses.

Pharmacokinetic variables of spiramycin and its distribution in muscle, liver, kidney, and injection sites were studied in 18 mixed-sex 1-year-old calves to assess drug withdrawal time after 2 IM administrations of 100,000 IU of spiramycin/kg of body weight at 48-hour intervals. Presence of a compound, other than spiramycin I (ie, neospiramycin), was observed in tissues used for withdrawal time determination. High concentrations observed at the injection sites decreased slowly to maximal residue limit with half-life of 109.5 hours for neospiramycin and 77.5 hours for spiramycin. At 14 days, neospiramycin concentrations were higher in kidney than in liver and half-life was different between these 2 tissues. Two methods of withdrawal time determination were used and the part of the samples without residue detected, in the calculation, was discussed. Withdrawal time of 35 days can be proposed on the basis of average daily intake determined for spiramycin, with concentration at injection sites representing 10% of the whole muscle concentration.

Animals↗