[Cacchi-Ricci disease. Apropos of 3 cases].
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Biomedical subjects
Publications and source records attributed to M Robert.
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Aneurysmal bone cysts (ABC) are locally aggressive bony tumors which rarely occur in the head and neck. Only 3 cases have been reported in the larynx previously, 1 involving the cricoid cartilage. A patient is presented who developed subglottic stenosis with airway compromise due to an ABC arising from the cricoid cartilage. The literature on bony tumors of the laryngeal cartilages was reviewed and the clinical and pathologic findings in this case highlighted.
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This study was undertaken to evaluate the frequency, severity, and reversibility of stent-induced pancreatic ductal and parenchymal changes in the normal dog pancreas. Six adult mongrel dogs underwent duodenotomy and placement of 5F polyethylene pancreatic duct stents into the main pancreatic duct. After 8 weeks of stenting, the animals were randomly assigned to one of three groups: group I (n = 2), sacrifice; group II (n = 2), stent removal followed by sacrifice after an 8-week recovery period; group III (n = 2), the stent was exchanged and kept in place for an additional 8 weeks. In group III at 16 weeks the stent was removed, and the animals were allowed to recover for 8 weeks before sacrifice. Pancreatograms were obtained at each operation and were normal before stent placement. Gross and histologic evaluation was performed at the time of sacrifice. All stented animals developed radiographic, gross, and histologic abnormalities. Pancreatograms showed duct dilation in the stented region associated with a short stenosis at the mid to upstream segment of the stent. Group III animals had more advanced radiographic changes than group I and II animals. The radiographic findings were associated with gross evidence of fibrosis, which increased proportionately with the length of the stenting period. Group III animals developed moderate to severe pancreas atrophy. Histologic changes of obstructive pancreatitis were present in most experimental dogs. The results of this study suggest that pancreatic stenting may cause permanent damage in the normal dog pancreas. The cause of the damage appears to be related to stent occlusion, perhaps exacerbated by local stent-induced trauma.
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Many studies have found that people with tic disorder show more difficulty when inhibiting an automated than a controlled response. Furthermore, although normal motor threshold and excitability are present, but reduced or impaired, motor inhibition seems manifest in patients with tic. In order to localize this inhibition impairment in tic disorder the present study examine two response-locked ERPs: the Bereitschaft (preparation BP) and the motor potentials (MP). The simple tic group showed faster BP latency and smaller amplitude than control and complex tic group and did not show a corresponding change in values with practice or with automated or controlled condition. The MP amplitudes revealed that whereas both controls and complex tic disorder showed a decrease in amplitude during control condition for both blocks, simple tic showed larger amplitude. Our ERP results are in agreement with RT results of a previous study. The explanation could lie with modulation in motor excitation inhibition circuits and seems worse in simple tics where the movements are more automatic and nonvoluntary.
BACKGROUND: The development of newer-generation lithotripters has reduced the pain associated with SWL, but many patients still require some form of sedation. We prospectively compared the analgesic requirements for kidney and upper ureteral treatments. Predictive factors for pain during piezoelectric SWL were also studied. PATIENTS AND METHODS: A total of 102 consecutive patients without any previous experience of SWL were treated for renal (N = 70) or upper ureteral (N = 32) calculi using the EDAP LT02 lithotripter. The stones' largest diameter ranged from 4 to 30 mm (mean 9 mm). Patients were given an oral dose of 60 mg of dextropropoxyphene hydrochloride and 800 mg of paracetamol associated with 100 mg of ketoprofene per rectum 30 minutes before treatment. The SWL session was begun at low intensity and increased to the maximal range of energy as rapidly as could be tolerated by the patient. The amount of pain during treatment was recorded according to a visual analogue scale (VAS). Further analgesia using intravenous alfentanil was given as required by the severity of the pain. Visual analog pain scores, additional sedation requirements, and success rates after one session were analyzed. RESULTS: The VAS scores and intravenous sedation requirements were significantly lower for patients with upper ureteral stones than for those with renal calculi (P < 0.01). The stone-free rates after one session were, respectively, 90% and 73% (P < 0.05). On the other hand, SWL tolerance was significantly lower for women presenting with renal stones (P < 0.05). CONCLUSION: Piezoelectric SWL without intravenous sedation is suitable for the treatment of upper ureteral calculi. However, such an approach is less efficient in the management of kidney stones, especially for female patients.
Twenty-five cases of fractures of the proximal tibial metaphysis in children are reported. They are divided into three groups: torus fractures, greenstick fractures, and complete fractures. Genu valgum appeared in 12 cases of complete or greenstick fractures. Eleven deformities deteriorated progressively in the year following trauma. Three of these were spontaneously compensated for by growth at the inferior epiphyseal plate. Four corrective osteotomies were performed in the series, but this procedure is not recommended because of the significant risk of recurrence and the possibility of compartment syndrome, even with associated fibular osteotomy. A persistent valgus deformity can be corrected during puberty, if necessary, by a medial tibial epiphysiodesis.
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The study compared controlled and automatic processing in 17 people diagnosed with chronic tic disorder (CTD), 20 with habit disorder (HT), and 30 screened controls. Using a countermanding paradigm, time to initiate a response (GO-time) was compared with time taken to inhibit a response (STOP-time) under automated and controlled response conditions. The signals were 2 sets of traffic-light-like computer displays with ready, go, and stop lights. The automated response was a repetitive series of taps and the controlled response was a morse code pattern of taps. There were no group differences in GO time under any conditions. The control group but not the HD or CTD groups showed a significant practice effect over time. The CTD group was significantly slower to STOP the automated than the controlled response. The results suggest that the CTD group had specifically, greater difficulty inhibiting automated than controlled actions.
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