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Biomedical subjects

P Gehanno

Publications and source records attributed to P Gehanno.

At least 127 records · Page 7Linked to original sources
PubMed1985

[Cervical adenopathies in relation to AIDS. Course of histological aspects. Diagnostic and prognostic value].

Histopathologic appearances of lymph nodes during acquired immune deficiency syndrome (AIDS) and related conditions are analyzed, with emphasis on the diagnostic and prognostic value of cervical gland biopsy at the lymphadenopathic stage. Details are given of the characteristics of the follicular hyperplasia of the lymph nodes (type I), which appears to be the initial lesion and is possibly regressive, and emphasis placed on the poor prognostic significance of the hyperplasia simulating a Castleman syndrome and of the forms simulating an angioimmunoblastic lymphadenopathy (type II). Findings suggest that the appearance, in a still hyperplastic lymph nodes, of foci of pseudo-angioimmunoblastic homogenization, of fibroedema with lymphoid depletion or conjunctival vascular proliferation may be the initial sign of a course towards the glandular atrophy (type III) or Kaposi's sarcoma which are the attribute of confirmed AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[ORL manifestations reported in AIDS. Apropos of 54 cases].

A review of 54 cases of AIDS established the ORL manifestations of this constantly fatal disease. Simple infections such as sinusitis, otitis and tonsillitis were frequent and quite typical, but buccopharyngeal herpes and particularly buccopharyngo-esophageal candidosis were widespread affections. The onset of candidosis in a subject at risk is a valid diagnostic factor for AIDS. A buccopharyngeal Kaposi tumor is specific and is usually associated with lesions in other, particularly cutaneous localizations. Marked emphasis is placed on the role of specialists in the detection of this disease, currently increasing at a high rate. In the USA, where AIDS is very prevalent and doctors very clearly informed, 40% of cases are detected from cervicofacial manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Serous otitis and necrotizing angiitis].

Three cases are reported of necrotizing angiitis of otologic origin (one polyarteritis nodosa and two wegener's disease). Data in the published literature are reviewed and necrotizing angiitis classified. Two features resulting from this review are emphasized. Firstly, form the pathogenic point of view the fact that specific lesions were detected in the ear in one of these patients means that this localization may be a possible visceral manifestation, as are rhinologic and pulmonary lesions. Otologic sites may be an isolated, or in association, further type of pathogenic mechanism. From the practical point of view, any unexpected serous otitis in adults should suggest the need for an erythrocyte sedimentation test, very high values requiring investigation of etiology. This will avoid unnecessary medical and surgical treatments and the institution of immunosuppressant therapy active against all visceral lesions and the only effective means of treating the otitis. Early treatment could avoid the catastrophic prognosis observed short-term in the 3 cases reported.

Adult↗
PubMed1984

[Survival of bone after osteomuscular transposition. Histological study in man and an experimental model].

Most bone cells in homografts fail to survive, and several months are required before live bone tissue structures develop in the graft. Various attempts have been made to preserve or re-establish homograft vascularization. One method involves the use of free bone transfer with revascularization of the supply artery or the total periosteal network, this enabling the majority of the bone cells to survive. Another procedure uses osteomuscular transplants in which the muscle acts as a pedicle for the transplanted bone segment, but whether bone elements in these flaps remain viable is a very debatable point. Experimental and clinical studies were conducted to evaluate, histologically, the viability of bone after osteomuscular transplantation. Fluorescence examination of bone sections from 40 osteomuscular flaps in the rat demonstrated bone formation on the external cortical surface but marked diminution of endosteal moulding in other zones. Examination of bone biopsies from 10 patients treated by mandibular reconstitution using an osteomuscular flap provided data comparable with those obtained during the experimental study. These findings demonstrate that osteomuscular transplantation is responsible for endosteal ischemia, preventing survival of cells other than those lying most externally to the cortex.

Animals↗
PubMed1984

[Musculocutaneous flaps in cervicofacial oncology surgery. Experience in 145 cases].

The use of myocutaneous flaps in reconstructive surgery after cancer resection for T3-T4 tumors of the head and neck is reported in 145 clinical cases. In this series, flap viability, proved to be as high as 96%. The use of myocutaneous flaps extends far beyond the limits of tumor resection, improves functional and cosmetic results and permits to operate safely on irradiated patients. This study shows that healing in irradiated patients tends to be comparable to that in non irradiated patients. Survival's conditions, especially the relief of pain are consistently improved, still when no tumor control can be achieved. Most recurrences occurs within a year following surgery, most frequently after salvage surgery.

Cicatrix↗
PubMed1983

[Mandibular reconstruction by composite musculocutaneous flap in glossopelvimandibular excisions].

Results of 14 mandibular reconstruction by a composite muscular flap of the pectoralis major and trapezium muscles during widespread glossopelvimandibular excisions are described. The technique employed is outlined, emphasis being placed on the need to observe strict precautions during removal and application of the bone component, to avoid accidental avulsion during reconstruction which could compromise the musculoperiosteal vascularization of the graft. Results are sufficiently encouraging for this type of reconstructive surgery to be proposed in all cases where mandibular repair is necessary after interruption of continuity.

Glossectomy↗
PubMed1982

[Esophageal perforation during tracheal intubation. Report on 6 cases. (author's transl)].

Perforation of the esophagus and hypopharynx followed tracheal intubation for general anesthesia or during intensive care in 6 patients. Circumstances favorable to the production of these lesions, and diagnostic features enabling early diagnosis are discussed. Simple surgical procedures and intensive postoperative care resulted in recovery in 5 of the 6 cases.

Aged↗
PubMed1982

[Cellulitis of the neck due to anaerobic germs: report of 10 cases (author's transl)].

Cellulitis of the neck in 10 patients was found to be due to anaerobic germ infections of either dental or tonsillar origins or following surgery. The lesion was diffuse in 8 cases, unilateral in two, and associated with signs of severe toxic infection in 9 cases. Early clinical crepitation was detected in 4 patients. The extremely poor prognosis related to the onset of infective shock and pleuropulmonary and mediastind complications, treatment including intensive care and anti-anaerobic germ antibiotic therapy. The place of surgical treatment is discussed, operative intervention being necessary when there are signs of poor general tolerance, not only in the presence of gas gangrene, but also when a diffuse cellulitis exists without signs of crepitation or the presence of fluid.

Anaerobiosis↗
PubMed1982

[Pneumococcal meningitis and ENT infections. Review of 100 cases (author's transl)].

One hundred cases of pneumococcal meningitis admitted to the Intensive Care Unit of the Infectious Diseases Department of the Hôpital Claude-Bernard, France are reviewed, and the course of this serious affection in this series described. Mortality was 38 p. cent as against that reported by INSERM of 45 p. cent. The original lesion was an ENT infection in 50 p. cent of cases, raising the problem of the need for early surgical intervention, on an otological focus which may appear minimal on otoscopic examination, when the meningitis does not respond to antibiotics.

Adolescent↗
PubMed1982

[Musculocutaneous flaps of pectoralis major. Anatomical and technical aspects, results, and literature review (author's transl)].

After a review of reports in the published literature on the employ of musculocutaneous flaps of pectoralis major, and a brief historical outline, the techniques employed, indications, advantages, and results obtained are discussed. Surgery for cancer, particularly in the buccopharyngeal region, could be partly transformed by this excellent reparative procedure because of the wide surgical scope it allows, and the spectacular functional results obtained.

Aged↗
PubMed1982

[Recovery total glossectomy with immediate reconstruction by means of a musculocutaneous flap : functional results and perspectives (author's transl)].

A surgical procedure is proposed for treating recurrent or non-sterile cancer of the tongue whenever satisfactory excision of the tumor can be accomplished. The technique involves a recovery total glossectomy associated, as shown to be necessary following its application in 3 cases, with a transmaxillary buccopharyngectomy. This operation has become valid following the use of musculocutaneous flaps, which enable reconstruction of the tongue with good quality functional results.

Glossectomy↗
PubMed1982

[Mandibular reconstruction employing a costomyocutaneous flap of pectoralis major. Anatomical and technical aspects and viability of graft (author's transl)].

Costomyocutaneous flaps of pectoralis major were employed for reconstruction of the mandible. The various unconventional procedures for mandibular reconstruction reported in the published literature are reviewed, a critical analysis conducted of the different tests of viability of the graft employed, anatomical and technical aspects discussed, and results presented. This flap is suggested as being an excellent method for reconstruction after interrupted pelvimandibulectomy or mandibulectomy involving the skin.

Graft Survival↗
PubMed1982

[Meningo-encephalic complications of sinusitis. 29 cases ].

On the basis of 29 cases of meningo-cephalic complications of sinusitis, the authors evaluate the following ; the type of sinusitis responsible, emphasising the fact that in contrast to classical concept maxillary sinusitis was responsible equally as often as frontal sinusitis. Amongst abcesses, the predominant cause is the streptococcus. Cases of meningitis are dominated by the pneumococcus, which cases obviously the gravest bacteriological aetiology. Finally, amongst the 3 cases of thrombophlebitis reported, there were two blood cultures positive for staphylococci. In the light of these bacteriological data, the authors emphasise the need for appropriate antibiotic therapy in acute and chronic sinusitis.

Adolescent↗
PubMed1982

[Bacteria seen in acute otitis media in children hospitalised for infectious diseases].

The authors draw the following conclusion on the basis of 85 cases of children hospitalised for infectious diseases : -amongst childhood infectious diseases, measles between the ages of 7 and 14 is most commonly associated with complications in the form of otitis (50 as against 19 other diseases). -Staphylococcus aureus was the dominant organism in measles otitis, but in addition to a particular affinity of this organism for measles, it is also necessary to bear in mind contamination by hospital flora, amongst which staphylococci are especially representative, in view of the late development of the otitis and the multiresistance of staphylococci isolated after the 4th day of admission. -Bacteria seen in other exanthematous fevers were more varied but if there is not rapid cure of the otitis, the generally sensitive flora is replaced by a multiresistant hospital flora, once again dominated by staphylococcus aureus and Gram negative bacilli. - The role played by such flora was seen to occur particularly on the 4th day of hospitalization, implying a twofold increase in the period of hospitalisation when compared with cases where paracentesis was performed before this time.

Acute Disease↗
PubMed1981

Inhibition of experimental esophageal lye strictures by penicillamine.

We describe a new experimental model for the study of caustic stenosis of the esophagus in the rat. Sixty-five Wistar rats were given a standard esophageal lye burn. Animals were divided into two groups: (1) a control group and (2) a treatment group that received penicillamine from the day after the esophageal lye burn. Stenosis developed in only two of the 23 treated rats. Our conclusion is that penicillamine-induced lathyrism inhibits the onset of stenosis in the rat. Double-blind controlled studies of the effect of penicillamine in the prevention of corrosive strictures of the esophagus in man seem warranted.

Animals↗