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Biomedical subjects

R Peynegre

Publications and source records attributed to R Peynegre.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Comparative frequencies of the beats of nasal and bronchial ciliary cells. Study in 10 adults without respiratory pathology].

The frequencies of nasal and bronchial ciliated cell beats were compared in 10 adult subjects (mean age 56 years) with E.N.T. tumoral pathology but no recent respiratory disease. Ciliated cells were collected by simultaneous nasal curettage and bronchial brushing carried out under general anaesthesia during endoscopic evaluation of the tumors. The frequency of beats was measured by the stroboscopic method at room temperature (18 degrees-25 degrees C) at least 3 hours after cell collection. A significant (p less than 0.05) difference was found between nasal (8.89 +/- 0.84 Hz) and bronchial (9.6 +/- 1.03 Hz) beats. A study of nasal ciliated cell beats therefore provides a first assessment of ciliary function which is of interest in patients with recurrent respiratory diseases. It is a simple procedure that can easily be performed prior to more complex investigations, such as study of the bronchial ciliated cell beats or ultrastructural study of the cilia.

Aged↗
PubMed1987

[Critical study and role of partial vertical reconstructive laryngectomies with epiglottoplasty by the Tucker method. Apropos of 18 cases].

Two groups could be distinguished in a series of 18 patients with glottic lesions: one with pure glottic tumors (12 cases) and the other with tumors extending beyond the glottic region (6 cases). All patients but one were operated upon by first intention for epidermoid carcinoma, but also for associated pronounced dysplasia. The so-called Tucker technique was used with slight modifications (less extensive resection of thyroid cartilage, conservation of the two arytenoid cartilages). The postoperative course was satisfactory with decanulation and ablation on the 13th day, and a mean hospital stay of 22 days. Two postoperative deaths due to vascular complications occurred and one patient developed a swinging epiglottis after 2 years. The remaining 16 patients are all alive, including 8 after less than 3 years. Analogous results were noted in an analysis of a total of 93 case-reports from 5 different series of patients. This method provides an elegant and satisfactory repair of pure cordal surgery, but adds nothing from the oncologic point of view since other better adapted and currently well defined operations have to be envisaged for lesions extending beyond this region.

Adult↗
PubMed1987

[Severe nasosinus aspergillosis in immunosuppressed patients. Apropos of 3 cases].

Nasosinusal lesions due to Aspergillus rarely occur during immunosuppressive chemotherapy, but are extremely grave, and often fatal due to the extensive necrotizing mucoperiostitis of facial bones provoked under these conditions. Three cases are reported, with recovery in one case only, after exenteration of orbit and denudation of dura mater in orbital roof.

Adolescent↗
PubMed1985

[Incidence of ciliary beats in nasal cells obtained from smears. Study of 40 patients of whom 28 were children with respiratory pathology].

Disturbance of ciliary function are considered as a significant factor in the outcome of chronic respiratory afflictions. Thanks to a simple method of stroboscopic lighting, the ciliary beat frequency was studied on 40 nasal mucus smears obtained by swabbing in 28 children and 12 adults with chronic respiratory failure or recurrent disease. The 28 children were divided into three groups: group A (n = 10), pulmonary disease (broncho-pneumonia); group B (n = 3), Kartagener syndrome; group C (n = 15) pure otorhinolaryngological (ORL) disease (rhino-opharyngitis, sinusitis, otitis). Twelve adults with chronic ORL pathology (vaso-motor rhinitis) made up group D. A cytological control was carried out on each smear and showed the presence of ciliated cells in 92.5% of samples. In three group B cases (Kartagener's syndrome) no ciliary movement was observed. The results in groups A (9.3 +/- 1.46 Hz) and C (8.98 +/- 2.23 Hz) show that the level of respiratory infection (pulmonary or ORL) did not influence the ciliary beat frequency (p greater than 0.05). On the other hand, there was a significant difference (p less than 0.001) between the beat frequency in the group of children in group A (9.3 +/- 1.46 Hz) and C (8.98 +/- 2.23 Hz) and those of adults in group D (11.32 +/- 1.89 Hz). Two hypotheses might explain these facts: The existence of a differing physiological response in children and adults. Different mechanisms during chronic ORL infections in adults (vasomotor phenomena) and in the child (bacterial infection). The average frequencies measured were comparable to those previously published in human respiratory cilia using other methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1984

[Initial polychemotherapy in the treatment of cancers of the head and neck. The efficacy and tolerance of 2 nonrandomized combinations in 48 patients].

Before loco regional treatment for head and neck cancer forty eight patients received one or the other of the following combined chemotherapy regimens: Regimen A (28 patients): high dosage methotrexate, bleomycin, cis-platin; regimen B (20 patients): common dosage methotrexate, bleomycin, hydroxyurea, vincristin. The effectiveness of regimen A seemed better than that of regimen B (46% responses versus 20%). This assessment must be accepted with caution, since, although the organization of treatment was strictly similar in the two groups, the study was not randomized, and there were noticeable differences between the two groups. Regimen B was associated with no toxicity. Regimen A was responsible for two fatalities. These two cases were linked to high dosage methotrexate. However, a combined chemotherapy regimen of type A with the high dosage methotrexate replaced by intermediate dosage methotrexate, seems feasible to us. Loco regional treatment was not impaired by initial chemotherapy with either regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Surgical treatment of naso-sinus tumors invading the anterior region of the base of the skull. Problems encountered during exploration, and repair of bone and dura mater].

Current limitations for surgical excision and solutions to problems of bone and dura mater repair of nasosinusal tumors invading the anterior region of the base of skull are discussed in relation to 14 cases. None of these patients had been operated upon by first intention using the upper approach Exploration of the median part of the anterior region is limited posteriorly by the posterior border of the jugum and the base of the anterior clinoid processes. Pre-operative discovery of invasion of the dura mater is a contraindication for surgery. Posterior and dural extension of the tumor is evaluated by combined CT Scan and tomography, but these examinations do not always confirm the absence of dura mater involvement before surgery. A double approach should be used when doubt as to invasion of the base exists. Dura mater repair involves suturing, a free periosteal flap, and a pediculated cranial periosteum flap anteriorly on the fronto-orbital region. Reconstruction of the base requires the use of the periosteal flap, alone or associated with bone grafts depending on the size and location of the bone breach. Short and long term postoperative complications were nor observed.

Bone Transplantation↗
PubMed1984

[Relations of sinusitis and primary glomerulonephritis].

Certain types of glomerulonephritis develop typically as the result of focal infection, and may recover following effective treatment of the infective focus at cause. Apart from the classical immunity mechanism consisting of the formation of immune complexes with the bacterial antigen, a major role for environmental allergens must also be evoked, as well as the probable existence of different immunity mechanisms at the origin of certain types of GN (mainly mesangial GN with IgA deposits and lipoid nephrosis). Invasion of the pulmonary allergen through a rhinosinusal route is responsible for a rhinosinusitis demonstrating a typical clinical features and course. Progression of the rhinosinusitis runs parallel with that of the GN. The course of the GN may be improved after treatment of the sinusitis and the allergic disposition. Ten particularly significant case-reports of GN associated with rhinosinusitis are studied from various aspects.

Adrenal Cortex Hormones↗
PubMed1984

[Use of the pectoralis major myocutaneous flap in transmaxillary buccopharyngectomy].

Pectoralis major musculocutaneous flaps were used for reconstruction after transmaxillary buccopharyngectomy to treat 22 patients with large oropharyngeal tumors. Short and medium term results are discussed. Large excisions such as these raise many functional problems, even though the use of a musculocutaneous flap for reconstruction is a valid procedure from the anatomical point of view. The cancer prognosis must still be reserved as follow up is still limited for these cases.

Carcinoma, Squamous Cell↗
PubMed1984

[Use of pectoralis major myocutaneous flaps in cervicofacial surgery. Our experience with 46 cases].

Musculocutaneous flaps from pectoralis major were used during cervico-facial surgery for repair after cancer operations in 46 patients. Use of this technique in surgical practice is discussed as a function of the site of cancer, and results described in relation to the viability of the flap and the outcome. Removal of the flap is simple and possible by a one-stage operation, and the method provides functional improvement for these patients.

Adult↗
PubMed1984

[Influence of the stimulation frequency on the morphology of auditory evoked potentials in multiple sclerosis].

The Rate-linked modifications observed in the Auditory Brainstem Responses (A.B.R.) in normal subjects are now well known. On the other hand they are a subject of controversy among groups studying multiple sclerosis (M.S.). 49 patients were observed in parallel studies in Milan and Creteil. The A.B.R. obtained for slow stimulus rates (11-21 Hz) were compared to fast ones (51 Hz). The A.B.R. were not significantly modified in 32% of the cases (deterioration: 21%, improvement: 11%). The variations don't seem to depend on the kind of curves involved. This phenomena can be explained by a frequency linked block of conduction of the pathological fibres, either partial or total. These data seem to be specific to demyelinating diseases. A research project is being conducted to study their specificity.

Adolescent↗
PubMed1984

[Ipsilateral masking of auditory evoked potentials: a method of studying multiple sclerosis].

20 normal subjects and 39 patients with multiple sclerosis were the control and the test groups. Auditory brainstem potentials to 60 dB nHL, 11/s clicks, were recorded under ipsilateral broad-band noise masking at S/N ratio of + 60 dB (unmasked condition), + 20 dB, + 10 dB and 0 dB. In the control group the ABP were absent only in 1 subject at S/N = 0 dB. In the group of 16/39 patients with definite multiple sclerosis, 11 had no ABP at S/N = 0 dB, 6 at S/N = + 10 dB and 5 at S/N = + 20 dB. The ABP waveform per se, in the same subjects, was abnormal in 7 and doubtful in 5. These results are discussed in terms of sensitivity, specificity and efficiency of the test to be applied. The best predictive value is achieved by combining a strict morphological criterion with the results of the ipsilateral masking. Moreover, the ipsilateral masking test positive findings are equally distributed in the group of patients with and without signs of neurological involvement of the brainstem.

Adolescent↗
PubMed1984

[Stroboscopic study of the respiratory mucosal ciliary beat frequency].

Abnormalities of the ciliary function have been found as an important factor in chronic respiratory diseases. For the study of the ciliary beat frequency, we developed a stroboscopic method using a stroboscopic illuminator ( Strobo Hertz) substituted to the normal light of an inverted optic microscope (Leitz). The ciliated cells obtained either by nasal scraping or tracheobronchial brushing were maintained in a culture medium (IP 199) at 37 degrees C. The ciliary beat frequency was measured at various times, at least one hour after the sampling. Nasal scraping, was performed with a curette in 17 children from 10 months to 16 years who complained of chronic respiratory diseases. Ciliated cells were obtained in 14 samples. In one of them 5 years old with a situs inversus, although the ciliated cells were numerous, the cilia appeared immotile. In the 13 others, the frequency was from 7 to 11.5 Hz with a mean of 10.8 Hz. These results were compared to those obtained by tracheobronchial brushings performed in 7 patients from 4 months to 46 years who underwent an endoscopic investigation. The ciliary frequency was 7 to 10 Hz with a mean of 8.5 Hz. The study of the ciliary beat frequency obtained by nasal scraping seems to be a reliable method for the detection of abnormal ciliary function. Nasal scraping is a non invasive method. Moreover, the stroboscopic method is a non expensive tool.

Adolescent↗
PubMed1981

[Surgical reconstruction of the sound conduction mechanism in congenital atresia of the ear (author's transl)].

125 congenital atresia of the ear have been operated from 1974 to 1980 in our O.L. department. Congenital atresia of the ear have a conductive type of 70 db which is stable. 45 had a lateral canal fenestration. 22 had an hearing improvement greater than 20 db. 45 had a tympanoplasty using a temporalis fascia graft and the ossicles when the malleo incus mass was mobile and had an adequate contact with the stapes. 25 out of these 45 cases had an hearing improvement greater than 20db. The other one had a tympanoplasty using tympano ossicular homograft with an hearing improvement greater than 20 db in 14 cases.

Child↗
PubMed1975

[Severe emergency epistaxis].

Selective ligature of the nutrient vessels of the nasal mucosa is an effective method of controlling massive epistaxis. Careful identification of the site of the haemorrhage is essential. One cause of immediate failure was an error in indication and another, lack of precision in locating a vascular tumour. With a short stay in hospital (the average is a week) we have achieved complete control over almost every very serious case of epistaxis we have been called upon to treat. Surgical sequelae have been minimal. In particular we found no mucosal vasomotor disorders such as those described in some operations involving the back of the pterygo-maxillary fossa.

Aged↗