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Biomedical subjects

R Besson

Publications and source records attributed to R Besson.

At least 19 recordsLinked to original sources

Classification of modified starches by fourier transform infrared spectroscopy using support vector machines.

The aim of this study was to compare the performance of different supervised discrimination methods based on IR data for the classification of starches according to the type of chemical modification undergone. The goal of the supervised classification methods is to develop classification rules. Representative samples of each group (known beforehand) were available, from which the relevant characteristics (chemical modification) were known. On the basis of a training data set, classification rules are determined, which can then be applied to classify new (unknown) samples.

Spectroscopy, Fourier Transform Infrared↗

[Cow's milk protein allergy after neonatal intestinal surgery].

UNLABELLED: Cases of cow's milk protein allergy have been occasionally reported after neonatal intestinal surgery. AIM OF THE STUDY: To measure the prevalence of cow's milk protein allergy (CMPA) following neonatal intestinal surgery. PATIENTS AND METHODS: The files of all children who underwent intestinal surgery in the neonatal period over a four-year-period were reviewed. The diagnosis of CMPA was made on the association of one or several symptoms suggesting food allergy after the introduction of cow's milk protein in the diet, the disappearance of the symptoms after exclusion of cow's milk protein from the diet and their reappearance after reintroduction of cow's milk protein. RESULTS: During the study period, 251 neonates underwent an intestinal surgery. Among them, 11 babies (4.3%) developed CMPA. None of them had a medical history of family atopy. Moreover, while 5 children were fed with a diet containing cow's milk protein before surgery: none of them presented initially with symptoms suggesting CMPA before intestinal surgery. Small intestine suffering was observed during operation in seven of 11 patients. No specific neonatal digestive disease or malformation was associated with CMPA. The signs revealing CMPA were primarily digestive : diarrhoea (N =3), vomiting (N =4), abdominal distension (N =2), colic or anorexia (N =2). Casein specific immunoglobulin E were present in nine of ten cases, alpha lactalbumin and/or beta lactoglobulin specific immunoglobulin E were present in six of ten cases. Prick test were performed in three children and were positive. CONCLUSION: The high prevalence of CMPA among these patients with no risk factors of allergy raises the question of the role of neonatal intestinal surgery in developing food allergy. These data should be confirmed by prospective case-control studies. They underline the interest to evoke the diagnosis of CMPA when digestive symptoms occur after milk protein introduction in children undergoing neonatal intestinal surgery. Breast feeding or milk protein hydrolysate formula should be used for refeeding these patients.

Digestive System Surgical Procedures↗

Successful management of severe chylothorax with argon plasma fulguration and fibrin glue in a premature infant.

Post-traumatic neonatal chylothorax is a rare entity. Management includes medical and surgical treatment. We describe here a newborn who developed a severe chylothorax after repair of an oesophageal atresia. The chylothorax was treated successfully by a combination of argon beam coagulation of the mediastinum and fibrin glue application. However, the patient developed complete thrombosis of the left femoral vein with clot extension to the inferior vena cava which resolved after infusion of recombinant tissue plasminogen activator (rt-PA). The use of argon plasma coagulation and mediastinal fibrin glue application for treating postoperative chylothorax appears to be attractive and is easy to perform even in small premature infants and may replace a more extensive surgical procedure. However, the coagulation profile should be monitored and special care should be taken to prevent vascular thrombosis after surgery.

Argon↗

Photography in dermatology: comparison between slides and digital imaging.

BACKGROUND: Clinical photography is an essential tool for any medical speciality, such as dermatology, wherein accurate records are required of pre, intra and postoperative findings, plus quick access to these records for comparison and evaluation purposes. Clinical photography is important not only to the surgeon, but also to the patient, so that a realistic objective assessment of improvement may be made. Conventional emulsion film-based prints from negatives and positive colour transparencies revolutionised clinical records when they first appeared. Now the appearance and rapid development of digital photography is bringing about yet another revolution. AIM: To compare conventional with digital photography from the standpoints of cost-effectiveness, ease of archiving and ease of retrieval. The quality of the imaging was not dealt with. METHODS: A professional clinical photographer took images using: Nikon F3 (conventional emulsion based photography); FotoFinder Derma (digital photography). RESULTS: Although traditional emulsion-based photographs are quicker to take, digital imaging provides an almost immediately available image and is much swifter to use for classification, later retrieval and comparison between serial images. CONCLUSIONS: Despite the initial expense of acquiring digital equipment compared with traditional photographic apparatus, when examined over a five-year period, both formats cost approximately the same. Digital photography offers advantages in ease of archiving and storage, savings in time and space, extremely quick retrieval and very easy comparison of images. Digital photography is very much the way of the future in dermatological clinical imaging.

Journal Article↗

Comprehensive ab initio thermodynamic treatment of impurities in ordered alloys: application to boron in B2 Fe-Al.

A rigorous description of impurities in nearly stoichiometric ordered systems, relying on independent-point-defect thermodynamics and density-functional-theory ab initio calculations, is presented and applied to the study of the equilibrium point defect structure of Fe-Al-B alloys in the B2 composition domain (x(Al) approximately 50 at. %, x(B) approximately 0), including the influences of (i) magnetism and (ii) the local density approximation (LDA) or generalized gradient approximation (GGA) exchange-correlation functionals. Whatever the alloy composition, B substitutes for Al, except in the nonmagnetic GGA scheme predicting a switch towards interstitial occupancy for sufficient Al contents.

Journal Article↗

Incontinence and constipation after low anorectal malformations in a boy.

BACKGROUND: Low anorectal malformations are considered to be a benign type of anorectal malformations. Their treatment is simple in the neonatal period and gives good results as far continence is concerned. METHODS: We studied a group of 55 boys with low anorectal malformations which had been surgically treated between the 1st January 1975 and the 31st December 1992. We studied the initial treatment and the associated anomalies, 5 patients have died. 27 were seen for an interview and a clinical examination. Extra investigations (anorectal manometry or electromyography of external sphincter) were only offered to consenting patients with an ongoing problem. RESULTS: 3 to 20 years had passed since their operations. Associated anomalies had been found in 11 children. The initial treatment was a perineal procedure in 20 cases and a colostomy in 8 cases. Dilatations were carried out on 11 children. Faecal and urinary continence had been acquired before 30 months of age. 13 children (48%) had problems of soiling and/or chronic constipation. There was no difference between these children and the 14 continent ones regarding the type of malformation, the initial treatment and the follow-up. Anorectal manometry (performed on 9 cases) showed 4 anorectal dyssynergies. It was normal in 3 cases. The Recto Anal Inhibitory Reflex was always present. CONCLUSION: Problems of continence are not rare in the evolution of low anorectal malformations. We suggest therefore a long-term clinical follow-up for those children, with one anorectal manometry control being performed after continence is acquired.

Anal Canal↗

Incidence of urinary tract infection in neonates with antenatally diagnosed ureteroceles.

PURPOSE: To evaluate the incidence of neonatal urinary tract infection (UTI) in the presence of a ureterocele. PATIENTS AND METHODS: Fifteen successive patients with antenatally detected ureteroceles were reviewed between 1991 and 1996. Sixteen ureteroceles were treated (in one patient they were bilateral). Seven ureteroceles were intravesical, and nine were ectopic. Fourteen patients had a duplex upper tract associated with a ureterocele. One patient had one duplex upper tract and one simple upper tract, both associated with a ureterocele. RESULTS: Of the fifteen neonates with a ureterocele, eight already had a UTI on admission. Of these, three had had prophylactic antibiotics. Of the eight infected patients, seven were symptomatic (three with septicaemia). CONCLUSION: If diagnosed antenatally, obstruction has to be relieved as early as possible during the first week of life as antibiotic prophylaxis alone is not sufficient to avoid UTI in these patients. The authors point out the high frequency of UTI in patients with ureterocele.

Female↗

Treatment of small-bowel obstruction by laparoscopy in children multicentric study. GECI. Groupe d'Etude en Coeliochirurgie Infantile.

In May 1996, the team working on infantile laparoscopy (GECI) carried out a retrospective study (using questionnaires) to analyse the use of laparoscopy in child postoperative obstructions (involving bands or adhesions). Of the 86 laparoscopic attempts, 66 could have been performed without conversion. Technical difficulties were responsible for the majority of the conversions performed on children aged 3 years younger than the average age in this study (10 years old). Digestive perforation accounts for a fifth of conversions, the perforations either occurring when the operational trocars were introduced (3 cases), or during viscerolysis (2 cases). For 5 children the treatment failed at an early stage (in the month following the operation). Relapses occurred in 3 children, usually at a later date (between 6 months and 3 years). Laparoscopic treatment of bowel obstruction should always be attempted, for as the results of the study show, morbidity is low and mortality is nil and the postoperative phase is quick and painless.

Child↗

Congenital pyloric stenosis: a modified umbilical incision for pyloromyotomy

Thirty-two patients underwent a pyloromyotomy via an umbilical incision; in 11 a modified umbilical approach was used to facilitate delivery of the pyloric mass. Incisions are made in the skin fold of the upper half of the umbilicus and at the midline, joining the two at the top. The skin incision is closed by upper umbilical translocation with a very good cosmetic result. This incision allows easy access to the pylorus and provides more convenient exposure. The absence of traction on the retractors avoids tissue ischemia, which leads to wound abscess development.

Journal Article↗

Congenital pyloric stenosis: a modified umbilical incision for pyloromyotomy.

Thirty-two patients underwent a pyloromyotomy via an umbilical incision; in 11 a modified umbilical approach was used to facilitate delivery of the pyloric mass. Incisions are made in the skin fold of the upper half of the umbilicus and at the midline, joining the two at the top. The skin incision is closed by upper umbilical translocation with a very good cosmetic result. This incision allows easy access to the pylorus and provides more convenient exposure. The absence of traction on the retractors avoids tissue ischemia, which leads to wound abscess development.

Female↗

[Obstruction: a rare complication of congenital giant blue nevus].

BACKGROUND: The blue nevus is an acquired or congenital dermal melanosis, usually small in size. It is sometimes giant and responsible for complications. CASE REPORT: A newborn had a large infiltrated blue news located on buttocks, lombosacral and perianal areas. He was admitted at the age of 3 weeks for an intestinal obstruction which was due to an impassable anal stenosis secondary to the infiltrated nevus. The tumor was excised twice, completed by plastic surgery at the age of 10 months. CONCLUSIONS: This rare congenital giant blue nevus was responsible for an unreported intestinal obstruction. The risk of malignant transformation was another reason for complete excision.

Anal Canal↗

Peritoneal pseudocyst--ventriculo-peritoneal shunt complications.

Pseudocyst formation is a rare complication of ventriculo-peritoneal shunt, occurring in only 22 cases of 1300 shunts from 1968 to 1992. The most common presentation is that of abdominal signs rather than neurological or infectious signs. The diagnosis is easy with ultrasonography. The difficulty is to evocate the cyst and to correlate symptoms and cyst. Treatment of the cyst was by aspiration (21 cases) and excision in 7 cases. The therapeutic choice is made according to the ultrasound findings. When the cyst was infected, an external ventricular shunt was used temporary, but this type of shunt must be avoided where possible. Three patients died.

Child↗

Use of Ethibloc in the treatment of cystic and venous angiomas in children. 19 cases.

The authors report the use of Ethibloc in the treatment of cystic lymphangiomas and venous angiomas in 19 children. This embolizing product is injected by puncture in situ. Ten cystic lymphangiomas were treated, including 7 of the cervico-facial region. Of these ten, 8 were embolized initially using Ethibloc, and 2 after surgery. The diagnosis was always confirmed by echography and in some cases also by scanner. Six were completely cured and 2 had partial but satisfactory results requiring further injections. The final 2 cases when Ethibloc was administered after surgery, gave very disappointing results as the residual lesion was microcystic and thus difficult to access for the Ethibloc injection. The 9 venous angiomas involved various regions, including 5 facial lesions. These angiomas required a more extensive blood-clotting and radiologic assessment: standard radiography to detect the clot, Doppler echography and M.R.I. precisely clarifying the exact extension in depth. For 6 patients the cure was complete, for 2 others the results were good. Finally, in 1 case Ethibloc embolization was carried out prior to surgery, allowing definitive cure. In all, this technique resulted in a complete cure in 2/3 of the cases and its simplicity makes it a seemingly interesting alternative to surgery.

Adolescent↗

Traumatic chylous ascites: conservative management.

Traumatic chylous ascites is very rare. In the majority of cases, the diagnosis is made by laparotomy. The case of a 5-year-old girl with traumatic chylous ascites is presented. The authors give their experience in nonoperative management.

Child Abuse↗

Reconstruction of the perineal body after recurrence of a recto-perineal fistula in an intermediate type of anorectal malformation in a young woman.

The appearance of a recto-perineal fistula post-operatively in an intermediate type of anorectal malformation is rare. It always gives rise to incontinence. However, the closure of this fistula is particularly difficult since recurrence is frequent. The following case report concerns a patient who after several unsuccessful attempts to close the fistula, had a local rotation flap which permitted good healing and a beneficial effect on continence thanks to a good reconstruction of the perineal body.

Adult↗