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Biomedical subjects

S Roman

Publications and source records attributed to S Roman.

At least 19 recordsLinked to original sources
PubMed2003

[Pediatric cochlear implants].

Indications for cochlear implants have been widened since 1995. Most implant candidates are children with severe congenital deafness. The cochlear implant must be inserted as early as possible for these children in order to optimize development of perception and language. A cochlear implant can also be discussed in certain particular cases for children with associated diseases, malformation of the inner ear, or severe deafness. The educational project must be realistic and take into account the future difficulties as well as an established set of criteria for successful language acquisition.

Acoustic Impedance Tests↗
PubMed2003

[Choanal atresia: therapeutic management and results].

OBJECTIVES: To assess and compare long term results after surgical correction (transnasal or transplatine approaches) of unilateral or bilateral choanal atresia, in children with or without associated anomalies. PATIENTS: During a 13-year period, 58 children were included in this retrospective study. Seventy-five choanas were operated on (41 unilateral and 17 bilateral). The transpalatine approach was performed in 41 children (56 choanas) while the transnasal approach was performed in 17 patients (19 choanas). Associated anomalies were reported in 28 children and corresponded to CHARGE association in 13 cases. RESULTS: With a mean follow-up of 7 years, perfect choanal permeability was reported in 90% of children operated on through a transpalatine approach and in 76% of children with a transnasal approach. A complementary therapeutic procedure was required in 54% of transpalatine approaches and 46% of transnasal approaches to yield these results. Postoperative choanal permeability was obtained in 93% of children without an associated anomaly and in 77% of those with associated anomalies, such as in 88% of unilateral atresias and 80% of bilateral ones. CONCLUSION: Initial success rate after surgery is similar for all surgical procedure insofar as nearly half choanas required a complementary therapeutic procedure. The endonasal procedure using the microdebrider appears hopeful and the KTP laser is interesting in fibrous residual stenosis. Associated anomalies are factors which lower general prognosis while inducing a higher surgical failure rate.

Abnormalities, Multiple↗
PubMed2002

Interaction of a new potent anticholinesterasic compound (+/-)huprine X with muscarinic receptors in rat brain.

The interaction of rac-12-amine-3-clor-6,7,10,11-tetrahydro-9-ethyl-7-11-methanecyclo-octane[b]quinoline ((+/-)huprine X) with M(1) and M(2) receptors has been studied in rat brain. Specific binding of [(3)H]pirenzepine or [(3)H]quinuclinidylbenzylate to hippocampus preparations was inhibited by (+/-)huprine X. This drug displayed a greater affinity for M(1) (K(i)=0.338+/-0.41 microM) than M(2) (K(i)=4.66+/-0.32 microM) receptors. In functional studies, (+/-)huprine X (1 microM) increased the release of [(3)H]dopamine in cortical synaptosomes, and this effect was partially reverted by atropine and mecamylamine, suggesting an agonistic effect on both M(1) and nicotinic receptors. The inhibitory effect of (+/-)huprine X (10 microM) on [(3)H]acetylcholine release and the subsequent reversion by atropine suggests that the drug also has an agonist effect on M(2) receptors. The present results demonstrate that this acetylcholinesterase inhibitor has an ample cholinergic profile, which suggests a potential source of interest of (+/-)huprine X in Alzheimer's disease therapy.

Acetylcholine↗
PubMed2002

Minimally invasive parathyroid surgery.

The standard bilateral neck exploration in primary hyperparathyroidism (HPTH) has been challenged in the recent years by the general trend toward less invasive surgery. The development of more reliable preoperative imaging techniques such as Sestamibi scanning and high definition ultrasonography coupled with improvements in intraoperative rapid assays of intact parathyroid hormone have allowed unilateral explorations in most patients with primary HPTH. This article reviews the currently available preoperative parathyroid localization studies as well as the currently used minimally invasive parathyroidectomy (MIP) techniques, such as open approaches, radioguided surgery and endoscopic procedures. While some techniques are more popular than others, careful selection of patients with primary HPTH has resulted in comparable cure rates to the standard bilateral parathyroid exploration.

Biomarkers↗
PubMed2002

[Contribution of intravitreal infracyanine green to macular hole and epimacular membrane surgery: preliminary study].

PURPOSE: To evaluate the contribution of intravitreal infracyanine green to macular hole and epimacular membrane surgery. PATIENTS AND METHODS: Twenty-five consecutive patients were operated on for macular hole (seven cases) or epiretinal membrane (18 cases) using intravitreal infracyanine. In most cases, 25mg of infracyanine powder was diluted in 5ml of solvent, then in 5ml of BSS and used within 1 hour. The solution was injected at the end of the vitrectomy and aspirated after 1-2 minutes. The internal limiting membrane was removed in both diseases. All specimens were studied using confocal microscopy or an immunocytochemical preparation. RESULTS: In cases of macular hole, the internal limiting membrane was bright green colored. Opening and peeling were greatly facilitated. In cases of epiretinal membrane, staining was variable: the most frequent aspect was an uncolored central area similar to a geographic map surrounded by a green stained zone. Sometimes the coloration appeared as sparse spots on the posterior pole. Occasionally the staining was homogeneous as in the macular hole cases. After the removal of the membrane, a second injection made it possible to check for the persistence of the internal limiting membrane and proceed to its ablation when necessary. A good correlation was found between surgical and histopathological aspects. CONCLUSION: Intravitreal infracyanine green is very helpful for the removal of internal limiting membrane in macular holes and epiretinal membrane surgery.

Epiretinal Membrane↗
PubMed2001

Prognostic factors of sudden hearing loss in children.

OBJECTIVE: Sudden hearing loss in children under 15 years old is rare and its pathophysiology remains unclear. The aim of this retrospective study was to define prognostic factors of sudden hearing loss in children under 15 years old. METHODS: Among the patients referred to our institution during the period 1990-1999 for sudden hearing loss, 12 children were considered eligible for this study (mean age=9.5 years old). Patients were divided into three groups according to hearing recovery and seven putative prognostic factors were analyzed. RESULTS: Total hearing recovery (group I: 90-100%) occurred in 28.5% of cases, partial hearing recovery (group II: 11-89%) occurred in 28.5% of cases and absence of recovery (group III: 0-10%) was reported in 43% of cases. Factors such as age, sex, and bilaterality of hearing loss were not correlated with hearing recovery. CONCLUSIONS: Initial severe hearing loss, associated vertigo and 'downward' audiometric curve were three negative prognostic factors of hearing recovery. Tinnitus has only been reported in children with partial or total hearing recovery.

Adolescent↗
PubMed2001

Primary pediatric neuroblastic tumors of the neck.

Neuroblastic tumors are the third most common cause of solid tumors in early childhood. Cervical tumors account for only 5% of cases. In this report, we describe a series of four pediatric neuroblastic tumors of the neck. The histological diagnosis was ganglioneuroblastoma in three cases and neuroblastoma in one case. Presenting signs were solitary cervical mass in two cases and respiratory distress in association with Claude-Bernard Horner's syndrome in two cases. Mean age at presentation was 15 months. Cervical computed tomography scan and/or magnetic resonance imaging depicted calcifications within the tumor in 50% of cases and allowed accurate assessment of extension. Increased urine catecholamine levels were observed only in the patient with neuroblastoma. Scintigraphy with [131]iodine-methyliodobenzylguanidine demonstrated selective uptake by the tumor in two cases. Amplification of N-myc oncogene, a documented unfavorable prognostic sign, was not found in any case. Surgical treatment was performed in all patients. Neoadjuvant chemotherapy was performed in one case. All patients underwent regular surveillance. No evidence of recurrence has been observed with a mean follow-up period of 7 years.

Biopsy, Needle↗
PubMed2001

Primary cricotracheal resection in children: indications, technique and outcome.

OBJECTIVE: Treatment of subglottic stenosis has benefited greatly from development of grafting techniques such as larygontracheoplasty. Meanwhile, cricotracheal resection of the stenotic area and a major part of the cricoid cartilage have been shown to give excellent results in adults. PATIENTS AND METHODS: From June 1993 to June 2000, we performed cricotracheal resection, as the primary surgical procedure, for acquired (n=13), congenital (n=2) or mixed (n=l) subglottic stenosis in 16 pediatric patients comprising seven boys and nine girls. At the time of surgery, the mean weight was 16 kg and the mean age was 5 years. Degree of stenosis was classified as grade II in one case, grade III in 12, and grade IV in three. Eight patients underwent two-stage procedures with postoperative tracheostomy. A rolled reinforced silastic stent was placed for a mean period of 20 days and the tracheostomy tube was removed within a mean period of 44 days after stent removal. Eight patients underwent single-stage procedures. The Portex endotracheal tube was used for a mean period of 4 days. RESULTS: All patients underwent regular clinical and endoscopic postoperative examination. Mean follow-up was 38 months. No interference with laryngotracheal growth has been noted in any case, including the five with follow-ups longer than 5 years. CONCLUSIONS: The indications for laryngotracheoplasty and cricotracheal resection in children with subglottic stenosis are still unclear. Decisions must be made on a case-by-case basis. In this article the authors discuss decisional factors in terms of clinical findings, surgical techniques, potential complications, and outcome.

Adolescent↗
PubMed2001

[Tracheomalacia and tracheal dyskinesias].

Tracheomalacia is characterized by an expiratory tracheal collapse. The revealing clinical features usually occur after a symptom-free period during the first year of life (during the first three months in 60% of cases): mainly stridor, wheezing, chronic cough, apnoeic attacks, and difficult breathing. Tracheoscopy allows the differentiation of primary tracheomalacia and tracheomalacia secondary to pressure on the trachea from the vascular ring or mediastinal tumour. Tracheomalacia is also frequently associated with oesophageal atresia. Surgical treatment is indicated in severe and secondary forms.

Apnea↗
PubMed2001

[Fifty-two cases of postoperative endophthalmitis treated with one protocol: anatomical and functional results].

PURPOSE: To evaluate our management of postoperative endophthalmitis and compare our protocol to the Endophthalmitis Vitrectomy Study's (EVS) recommended protocol. PATIENTS AND METHODS: This study comprises 52 patients with postoperative endophthalmitis treated with the same protocol in 1996 and 1997. Patients were given an intravitreal injection of antibiotics (vancomycin-amikacin) and steroids (dexamethasone), systemic antibiotics (pefloxacin-piperracillin), and systemic steroids in bolus. Vitrectomy was not systematic. So as not to delay the treatment, cultures were obtained only from an anterior chamber paracentesis. RESULTS: Visual acuity was measurable in 86.5% of the patients, with 20/100 in 63.4% and 20/40 in 44.2%. Our results are similar to those of the EVS even when initial visual acuity was Light Perception. CONCLUSION: Our protocol is simple and easy to perform in all ophthalmology centers. It is based on intravitreal injection, which must be performed as quickly as possible.

Adult↗
PubMed2001

[Posterior segment intraocular foreign bodies. Initial management].

Intraocular foreign bodies (IOFB) are a public health challenge because they are a major cause of poor vision in the young population. Initial management must be adapted to each case. The history analyzes the trauma circumstances and tries to determine the nature of the IOFB. The ocular examination must be complete. After a systemic antibiotic treatment has been prescribed, the patient is evaluated with plain radiography and a CT scan. The wound will be sutured as soon as possible. The IOFB will usually be removed later using vitrectomy. However, a pars plana magnet extraction can still be considered in some selected cases.

Eye Foreign Bodies↗
PubMed2001

[Neonatal screening of deafness: evoked otoacoustic emissions or acoustic distortion products?].

Transiently evoked otoacoustic emissions (TEOAE) allows an auditory screening in neonates above 30 dB and between 2 kHz to 4 kHz. Another type of otoacoustic emissions, the distortion product (DP) allows a similar screening and provides more specific frequency information over a broader frequency range, including frequencies below 2 kHz and above 4 kHz. The goal of this study was to determine 1) the interest of distortion product in comparison with TEOAE in a auditory screening program in neonates; 2) The predictive value of information extracted from otoacoustic emissions recordings, on frequential parameters of distortion product (DP). In this prospective study, TEOAE and DP were successively recorded in 20 neonates (34 ears) with risk of hearing impairment, using the ILO92 software and hardware. When TEOAs were no detectable (9/34), the DPs were no detectable neither (10/34). When TEOAs were detectable, the Dps carried more specific frequency information above 1 kHz in 52 to 80% of the patients. DP amplitudes have been quantitatively correlated with TEOA energy bands. Correlations between DP and TEOA have been objectivized for DP2.5 and DP4 with OE2, and for DP4 and DP6 with OE5. The correlation predictive value was above 85%. In conclusion, this study demonstrated that analysis of TEOA spectrums procures frequential information without requiring DP recordings.

Audiometry, Evoked Response↗