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Biomedical subjects

Y Robert

Publications and source records attributed to Y Robert.

At least 19 recordsLinked to original sources
PubMed1992

Lateral differences indicate future glaucoma.

Since eye pairs are anatomically and pathologically asymmetrical, we attempted to determine whether the transition from ocular hypertension to glaucoma might be typified by lateral differences in either intraocular pressure (IOP), papillary excavation, or visual field. Such lateral differences were sought in a retrospective study of the medical records of 47 patients exhibiting ocular hypertension, of whom 25 remained hypertensives and 22 developed glaucoma during the period considered. Although all visual field indices in the latter group had remained within the normal range, the same side consistently yielded significantly worse results in mean sensitivity, and the absolute value for the lateral difference in these individuals was significantly higher than that found for the patients who did not develop glaucoma. Future glaucoma is manifested when the mean sensitivity remains worse in one eye.

Adult↗
PubMed1992

Protracted ruthenium treatment of recurrent pterygium.

By combining excision with 106ruthenium irradiation in 17 patients previously operated on for persistently recurrent pterygium, we have devised an effective therapy that produces virtually no side effects and further prevents events recurrence. The ruthenium applicator shell was left in place for 2-3 h, yielding a total dosage of 2000 cGy. Only 2 of 17 patients suffered even slight recurrences, and 2 more had either motility disturbance or corneal haze. Through application of the internationally accepted total dosage of 2000 cGy, but at a relatively low dose rate, which especially protects the tissue responsible for proper healing, strong support is provided for the principle of protracted irradiation in recurrent (and possibly even primary) pterygium, permitting milder treatment and fewer recurrences.

Adult↗
PubMed1992

[Autoregulation in the choroid].

The cerebral perfusion is continuously and highly sensitively dependent on arterial pCO2. Does the ocular perfusion behave in a similar manner? To answer this question, the authors measured the following parameters before and after the inhalation of 10% CO2: a) the increase of capillary pCO2, using a transcutaneous sensor, and b) the redness (pallor) of the retinal tissue, an expression of its hemoglobin content, was measured at two retinal locations with the Ocular Photometer (OPM). Initial results from young test-volunteers and patients with documented carotis stenoses show that the choroid is able to maintain constant its blood-volume even under changing loads.

Adult↗
PubMed1992

[Discrete media clouding and its effect of contrast transfer coefficients, the pattern ERG and contrast sensitivity].

As a model for our study we selected 11 pseudophacic patients with secondary cataracts who experienced good postoperative visual acuity after extracapsular cataract extraction. Besides best visual acuity and contrast sensitivity Pattern-ERG (PERG) and Contrast-Transfer-Ratio (CTR) were measured before and after YAG-Kapsulotomy was performed. Visual acuity and contrast sensitivity increased in all patients after treatment, whereas CTR increased in eight patients. PERG was measured in five patients, in two cases its amplitudes were higher, the other measurements revealed unchanged or lower amplitudes. Our model shows that in addition to the usual psychophysic tests, with CTR and PERG there are objective methods available to measure discrete opacities of the visual system.

Cataract↗
PubMed1992

Carbohydrate moieties of myelin-associated glycoprotein, major glycoprotein of the peripheral nervous system myelin and other myelin glycoproteins potentially involved in cell adhesion.

The myelin-associated glycoprotein (MAG) and the major glycoprotein of the peripheral nervous system myelin (P0) are two members of the family of cell adhesion molecules (CAMs). A role in cell adhesion of the carbohydrate moiety of these molecules has been attributed to the presence of N-glycans bearing the HNK-1 carbohydrate epitope. On the other hand, it has been suggested that these glycoproteins could be ligands of an endogenous mannose-binding lectin present in myelin, the cerebellar soluble lectin (CSL). In order to further document the heterogeneity of the glycans of these two CAMs, we have used several probes: an anti-carbohydrate antibody of the HNK-1 type, called Elec-39, the plant lectin concanavalin A (ConA), and the endogenous lectin CSL involved in myelin compaction. This study shows that CSL binds to a small proportion of the polypeptide chains of MAG found in adult CNS of rats and man and the polypeptide chains of P0 molecules from adult human and rat sciatic nerve. For MAG from adult rat brain, the binding of CSL is restricted to glycans of polypeptide chains which could be separated from the others according to their solubility properties. These MAG molecular entities react also with the Elec-39 antibody and with ConA. These results confirm that P0 and MAG are heterogeneous in their carbohydrate moieties.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Anatomy of the auditory tube: CT scan and MRI aspect].

The auditory tube is a bony and cartilaginous canal which connects the middle ear to the nasopharynx. The bony portion (protympanum), explored by computed tomography, is cone shaped, with a posterior base. The main relations are: the intrapetrous carotid, the tensor tympani muscle, the middle cerebral fossa and temporo-mandibular joint. The fibrocartilaginous portion is explored by computed tomography and mainly by magnetic resonance. The fibrocartilaginous tube is posteromedial; its upper margin is curled outward to form the roof of the cartilaginous tube. Anterioly and Laterally, the auditory tube is closed by a fibrous membrane extending along the inferior surface of the auditory tube to form its floor. The auditory tube is in contact with two main muscle: the tensor veli palatini anterolateral and the levator veli palatini posterolateral and inferior. They are bounded by fascia: the intrapharyngeal fascia is medial, the pharyngo basilar fascia (salpingopharyngeal fascia of Trölstch, is between the tensor and levator veli palatini muscles; the fascia of Weber Liel is lateral to the tensor veli palatini. The auditory tube and its muscles form the lateral wall of the rhinopharynx and prevent the extension of a pathologic process to the para pharyngeal and infratemporal spaces.

Eustachian Tube↗
PubMed1992

[Quality of sedation and neurologic evaluation following surgery of the posterior cranial fossa: the importance of propofol].

Following cerebral posterior fossa surgery, 23 patients were admitted in Intensive Care Unit for postoperative mechanical ventilation. Mean age was 45 +/- 16 years. Mean duration of surgical procedure was 09 h 20 min +/- 04 h 45 min. Heart rate, blood pressure, coma Glasgow scale, pupil reaction, respiratory pattern were recorded throughout the study. Following recovery from anaesthesia sedation was initiated by an intravenous bolus injection of propofol 2 mg.kg-1 followed by a continuous infusion starting at 1 mg.kg-1.h-1. The infusion rate was adjusted thereafter to ensure that the patient was sedated (Glasgow coma scale less than or equal to 6), unable to react to tracheal suction, well adapted to mechanical ventilation with a cardiovascular stability. Mean duration of sedation was 27 h 45 min +/- 04 h 45 min. Mean infusion rate of 3.81 mg.kg-1.h-1 allowed good sedation in 22 patients. There were no clinical changes in arterial pressure and heart rate. Propofol infusion was stopped transiently to assess neurologic status at 18 h +/- 02 h 45, 33 h 45 +/- 08 h 15, 49 h 10 +/- 16 h 50 after sedation onset. During these interruptions, the speed of recovery was assessed and arterial blood samples taken simultaneously. When the infusion was discontinued, adequate recovery was obtained in 48 +/- 26 min for 17 patients of 23, 64 +/- 58 min for 7 of 12, 70 +/- 65 min for 3 of 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Polycystic ovarian disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis.

OBJECTIVE: We evaluated the superiority of vaginal ultrasonography (US) on the abdominal US for the diagnosis of polycystic ovarian disease (PCOD). DESIGN: The US pattern of ovaries was prospectively investigated by abdominal US and, whenever possible, by vaginal US. SETTING: Primary care, institutional. PATIENTS: One hundred forty-four women in whom PCOD was suspected on endocrine grounds and 62 other patients presenting with primary hyperprolactinemia (n = 23) or hypothalamic anovulation (n = 39). MAIN OUTCOME MEASURE: Vaginal US allowed a better analysis of the ovarian stroma. RESULTS: The external ovarian features of PCOD were observed by both routes in less than one third of the 144 patients with PCOD. The internal ovarian features of PCOD were much more frequently observed by vaginal US than by abdominal US (polycystic pattern: 66.7% versus 38.1%, P less than 0.05; increased ovarian stroma: 57.1% versus 4.8%, P less than 0.001). In the 62 patients without PCOD, US features of PCOD were observed in less than 10% of them, except for the uterine width/ovarian length ratio less than 1 and the polycystic pattern (abdominal US: 17% and 34%; vaginal US: 11% and 50%, respectively). CONCLUSIONS: An increased ovarian stroma seems to be the most sensitive and specific US sign of PCOD, providing that it can be investigated by vaginal US.

Abdomen↗
PubMed1991

[Is there an ideal surgical time for retinitis pigmentosa patients with cataract?].

According to the literature, a fully developed cataract should be removed generally when the macula is intact. However, patients with a slowly progressing retinal disease find themselves in a particularly difficult situation. In this clinical, retrospective study, 24 retinitis-pigmentosa (RP) patients after cataract surgery were asked whether they recommend cataract surgery early or late in the course of the development of the retinal disease. A correlation was found between the answers to this question and the time elapsed between each patient's own operation and his interview. Three preference groups resulted through statistical evaluation: 1) those who recommend an early operation (n = 8), 2) those who recommend a late operation (n = 8), and 3) those who were undecided (n = 8). All patients had been operated at the same time following the RP onset and cataract diagnosis. Those patients who preferred a late operation had been questioned in this regard considerably later after their own operation than those who preferred an early operation. In other words, the preference for an early or late operation depended on how much prior to the questioning the patient's own operation had been conducted. The RP patient, quite disease conscious, has an exact conception of the ideal time of cataract operation in RP patients in general, but this does not always coincide with the opinion of his physician. It is considerably more necessary to consider the individual situation of the RP-patient than that of normal cataract patients.

Cataract Extraction↗
PubMed1991

[Granulocytic sarcoma. Apropos of a case].

The authors report a case of orbital granulocytic sarcoma complicating a case of acute myeloblastic leukaemia, which was investigated by CT and MRI. CT revealed a moderately contrast-enhanced orbital mass. The MR signal intensity was identical to that of grey matter on T1-weighted sequences and identical to that of white matter on T2-weighted sequences.

Humans↗
PubMed1991

[Normal imaging of facial sinuses].

The high spatial resolution of computed tomography allows visualisation of the fine structures of the facial skeleton and gives precise information about the anatomy of the nasal cavity, the paranasal sinuses and their relations with adjacent structures. A detailed knowledge of the normal anatomy, particularly of the nasal cavity and ethmoid, is very useful to provide to the surgeon with a precise pre operative surgical map, before transnasal endoscopic ethmoidectomy or management of paranasal sinuses tumors.

Humans↗
PubMed1990

[Cyclophotocoagulation with the Nd:YAG-laser].

Hopeless glaucoma cases fluctuate between excessive pressures and phthisis. Due to the underlying disease (neovascularization in the chamber angle, chronic inflammation, dysgenesis, aphakia) the customary surgical pressure-lowering operations often fail and medication is also useless. As a "last-ditch" measure, there remains only destruction of the ciliary body. In the Zurich eye department, noninvasive cyclophotocoagulation has been performed since 1987. The present paper reports on the first cases with long-term follow-up.

Adolescent↗
PubMed1990

[Esophageal mucoceles complicating double exclusion of the esophagus after ingestion of caustics].

A mucocele is rarely observed after esophageal exclusion for corrosive burns. It may represent a contra-indication to esophageal conservation in case of a total gastric resection for necrosis and perforation of the stomach. To evaluate this risk, 15 patients, operated between January 1970 and december 1988, were reviewed: they underwent total gastric resection with esophageal exclusion, followed by a secondary colon transplant between the cervical esophagus and the duodenum. A plain chest film was performed for 13 patients and a CT scan for 11 patients. Mean follow-up was 5.7 years (2 months - 17 years). Four patients died, one of them after resection of a compressive esophageal mucocele. Six mucoceles were detected on 13 chest films and 7 were described on 11 CT scans. On the whole, 8 mucoceles were diagnosed on 15 patients; one of them was complicated by tracheal compression. The formation of a secondary esophageal mucocele is a late sign of incomplete destruction of the esophageal wall. It is a frequent complication of esophageal exclusion performed after total gastrectomy for corrosive burns of the stomach. It must be detected on a chest film which shows the largest dilatations or on a CT scan, which is a better investigation. When the diameter of the mucocele is equal of superior to 50 mm, it can be compressive and must be treated by resection of internal diversion.

Adolescent↗
PubMed1990

[A superior vena cava syndrome of unusual etiology: compression syndrome of the innominate veins].

A 65-year-old hypertensive and atheromatous presented with "unilateral superior vena cava syndrome". Venography and computed tomography scan with hemodynamic studies demonstrated an intermittent compression of the left innominate vein by the supra-aortic trunks, mainly due to the left subclavian artery, during expiration. The late development of symptoms might be due to arterial atheroma coupled with a narrow superior mediastinum. The case described here is a thoracic equivalent of Cockett's syndrome and so can be called "innominate vein compression syndrome".

Aged↗
PubMed1990

[Correlation of diameters measured by x-ray computed tomography and intraparietal extension of squamous cell carcinoma of the thoracic esophagus. Apropos of 101 anatomoradiologic comparisons].

In order to assess the value of tomodensitometric classification of squamous cell carcinomas of the upper esophagus, which has been recently advocated, we compared the CT-measured diameters and the extent of intraparietal invasion in 101 tumors. According to selected criteria (superficial -T1- tumors: not apparent or less than 10 mm; tumors infiltrating incompletely the muscularis -T2- ; mass less than 10 to less than 20 mm in diameter; tumors extending beyond the muscularis -T3, T4- : diameter greater than or equal to 30 mm), 84/101 tumors were correctly assessed. The positive predictive value for T2 tumors was 73% in the 10 to less than 20 mm diameter range, and 71% for T3 and T4 tumors in the 20 to less than 30 diameter range. Starting from 30 mm, this value was 96% for T3 and T4 tumors. At the close of this study, it appeared that the classification criteria proposed did not have to be modified. CT-scanning is worth using jointly with ultrasonographic endoscopy (more performing when analysing small tumors) for pre-treatment classification of carcinomas of the upper esophagus, owing to the fact that the extent of wall infiltration is one of the elements which need be taken into account when planning therapy: direct surgery or, possibly, combined preoperative radio- and chemotherapy.

Carcinoma, Squamous Cell↗