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Biomedical subjects

Bernard Bertrand

Publications and source records attributed to Bernard Bertrand.

14 recordsLinked to original sources
PubMed2006

Olfactory function assessed with orthonasal and retronasal testing, olfactory bulb volume, and chemosensory event-related potentials.

OBJECTIVE: To investigate whether differences in olfactory function between healthy individuals and patients with olfactory loss could be detected by various diagnostic tests. DESIGN: Psychophysical testing of orthonasal and retronasal olfactory functions, magnetic resonance imaging of olfactory bulb (OB) volume, and chemosensory event-related potential (ERP) measurement performed between January 1, 2005, and October 31, 2005. SETTING: Academic tertiary referral medical center. PATIENTS: Eleven healthy individuals with normal olfactory function (NL) and 11 patients with nasal polyposis (NP), 11 with posttraumatic olfactory loss (PT), and 11 with postinfectious olfactory loss (PI) were included in this study. MAIN OUTCOME MEASURES: Orthonasal and retronasal olfactory test results, magnetic resonance imaging-based OB volume, and ERPs to both olfactory and intranasal trigeminal stimulation. RESULTS: Orthonasal and retronasal testing revealed that NL individuals had higher scores than patients with NP, PT, or PI. Retronasal scores were higher in NP patients compared with PT and PI patients. The OB volumes were higher in NL individuals compared with NP, PT, and PI patients. The OB volumes in PT patients were significantly lower than those from NP and PI patients. Olfactory ERPs were different between NL individuals and NP, PT, and PI patients, and trigeminal ERPs were significantly different when comparing NL individuals with NP patients. For the entire cohort, a significant correlation was found between orthonasal testing and OB volume, between retronasal testing and OB volume, and between both orthonasal and retronasal testing and olfactory ERP amplitudes. Olfactory ERPs were recorded in the 11 NL individuals and in 3 NP, 3 PT, and 4 PI patients, defined as responders. Orthonasal and retronasal test scores, OB volume, and olfactory ERPs were significantly larger in responders compared with nonresponders. CONCLUSIONS: Significant differences in various tests that evaluate olfactory function were detectable in a cohort of NL individuals and NP, PT, and PI patients. This finding suggests that these diagnostic tools provide information in terms of the clinical assessment of olfactory function. Future studies will investigate their combined use in terms of the prognosis of olfactory function in patients with olfactory loss.

Action Potentials↗
PubMed2006

Olfactory function and olfactory bulb volume in patients with postinfectious olfactory loss.

OBJECTIVE: The study aimed to investigate whether the degree of postinfectious olfactory loss is reflected in volume of the olfactory bulb (OB). STUDY DESIGN: Retrospective study of 26 patients with postinfectious olfactory loss. MATERIALS AND METHODS: Olfactory function was assessed with the "Sniffin' Sticks" test kit, and the magnetic resonance imaging study focused on OB volume and the olfactory sulcus. RESULTS: The study revealed that 1) OB volume varies with regard to olfactory function, 2) OB volume decreases with duration of olfactory loss, and 3) patients with parosmia had smaller OB volumes than patients who did not report such smell distortions, although their overall olfactory function was not significantly different from each other. CONCLUSION: The study emphasizes that OB volume is a gauge of olfactory function.

Adult↗
PubMed2006

Retronasal and orthonasal olfactory function in relation to olfactory bulb volume in patients with posttraumatic loss of smell.

OBJECTIVE: The aims of this study were to evaluate olfactory function with orthonasal and retronasal testing in patients with posttraumatic olfactory loss and to investigate the relation between residual olfactory function and olfactory bulb (OB) volume. METHOD: A retrospective study of 25 patients with posttraumatic olfactory loss was performed. Orthonasal olfactory function was assessed with the Sniffin' Sticks test kit; retronasal olfactory function was assessed with intraorally applied odors. Magnetic resonance imaging was used to determine OB volume and cortical damage in the frontal and temporal areas. RESULTS: The main outcomes of the present study were the demonstration of a correlation between olfactory function and OB volume, which was more pronounced for retronasal than for orthonasal olfactory function; retronasal olfactory function was most affected in the patients with the most extensive cerebral damage and was least compromised in patients without such damage; OB volumes were smaller in patients with parosmia compared with those without; and the presence of parosmia was clearly associated with the presence of cerebral damage. CONCLUSION: The data confirm that OB volume is an indicator of olfactory function but, interestingly, in this study, it is largely determined by retronasal olfactory sensitivity. In addition, these results emphasize the role of higher cortical centers in olfactory function, and especially in parosmia, which may, at least in some cases, be related to lesions in the fronto-orbital and anterior temporal cortices. It would be of interest to investigate OB volume further in relation to the prognosis of the disorder.

Adult↗
PubMed2005

Respiratory cycle as time basis: an improved method for averaging olfactory neural events.

In the mammalian olfactory system, neural activity appears largely modulated by respiration. Accurate analysis of respiratory synchronized activity is precluded by the variability of the respiratory frequency from trial to trial. Thus, the use of respiratory cycle as the time basis for measuring cell responses was developed about 20 years ago. Nevertheless, averaging oscillatory component of the activity remains a challenge due to their rhythmic features. In this paper, we present a new respiratory monitoring setup based on the measurement of micropressure changes induced by nasal airflow in front of the nostril. Improvements provided by this new monitoring setup allows automatic processing of respiratory signals in order to extract each respiratory period (expiration and inspiration). The time component of these periods, which can differ from trial to trial, is converted into a phase component defined as [-pi, 0] and [0, pi] for inspiration and expiration, respectively. As opposed to time representation, the phase representation is common to all trials. Thus, this phase representation of the respiratory cycle is used as a normalized time basis permitting to collect results in a standardized data format across different animals and providing new tools to average oscillatory components of the activity.

Animals↗
PubMed2005

Comparison of synchrotron radiation angiography with conventional angiography for the diagnosis of in-stent restenosis after percutaneous transluminal coronary angioplasty.

AIMS: Synchrotron radiation angiography (SRA) is a novel tool for minimally invasive coronary artery imaging. The method uses subtraction of two images produced at energies bracketing the iodine K-edge after intravenous infusion of iodinated contrast agent. We investigated the accuracy of SRA for detecting in-stent restenosis (ISR). METHODS AND RESULTS: We recruited 57 men, 4-6 months after successful PTCA. We visualized the right coronary artery (RCA) in 27 patients with 36 stented segments [12 segments with ISR>50% by quantitative coronary angiography (QCA)], and the left anterior descending artery (LAD) in 30 patients with 37 stented segments (10 ISR). SRA and QCA were performed within 2 days of each other. Two experienced observers unaware of QCA data evaluated the SRA results. Image quality was good or excellent in most patients. Global sensitivity was 64%, specificity was 95%, and positive and negative predictive values were approximately 85%. Inter-observer kappa concordance coefficient was 0.86. False negatives involved short eccentric lesions and superimposed segments, most frequently of the LAD. False positives occurred in intermediate stenoses slightly overestimated by SRA. CONCLUSION: In men, this minimally invasive approach, using small radiation doses, detects significant ISR in the RCA, but the LAD poses difficulties because of superimposition with others structures.

Adult↗
PubMed2005

Quantitative analysis of synchrotron radiation intravenous angiographic images.

A medical research protocol on clinical intravenous coronary angiography has been completed at the European Synchrotron Radiation Facility (ESRF) biomedical beamline. The aim was to investigate the accuracy of intravenous coronary angiography based on the K-edge digital subtraction technique for the detection of in-stent restenosis. For each patient, diagnosis has been performed on the synchrotron radiation images and monitored with the conventional selective coronary angiography method taken as the golden standard. In this paper, the methods of image processing and the results of the quantitative analysis are described. Image processing includes beam harmonic contamination correction, spatial deconvolution and the extraction of a 'contrast' and a 'tissue' image from each couple of radiograms simultaneously acquired at energies bracketing the K-edge of iodine. Quantitative analysis includes the estimation of the vessel diameter, the calculation of the absolute iodine concentration profiles along the coronary arteries and the stenosis degree measurement.

Algorithms↗
PubMed2005

Taste disorders after tonsillectomy: case report and literature review.

The authors describe a case of dysgeusia that occurred during the recovery period after a tonsillectomy. The cause was thought to be a lesion to the lingual branch of the glossopharyngeal nerve because of the location of the symptoms at the posterior region of the buccal cavity and because of the raised electrogustometric thresholds in the posterior region of one half of the tongue. Clarification of this type of case was made by a review of the literature from 1966 to June 2004, carried out with the aid of Medline. From a medicolegal standpoint, it is important to inform the patient of the risk of dysgeusia after tonsillectomy, especially if that patient has a profession in which taste plays an essential role.

Adult↗
PubMed2005

Endoscopic and microscopic paraseptal transsphenoidal approach to the sella turcica.

OBJECTIVES: To establish the feasibility of the paraseptal approach to the sella and to demonstrate the superiority of the endoscopic over the microscopic vision during pituitary surgery. STUDY DESIGN: Prospective monocentric study. METHODS: Nine consecutive patients with a pituitary tumour were operated since November 2002. The surgical procedure consisted of a paraseptal approach of the sella with use of a rigid endoscope. Pre- and postoperative (3 months after surgery) symptoms, Magnetic Resonance Imaging (MRI) findings, endocrine and ophthalmic assessment, and intraoperative findings were recorded. RESULTS: One patient presented a CSF leak with a successful peroperative repair. Regarding symptom resolution, headache disappeared during the early postoperative period in case of pituitary apoplexy. All cases of preoperative hemianopsia and diplopia but one improved significantly. Two patients recovered preoperative deficient hormonal functions and six patients did not require substitution therapy any more. No nasal packing was needed except in one case. Considering the healing course, the mucosa repair inside the sphenoid sinus was quicker with Surgicel removal at week 4. Postoperative MRI demonstrated a residual parasellar nodule in 3 out of 6 cases of macroadenoma. Only one required radiation therapy. These results are commented through comparison with the transseptal approach and with surgery exclusively using the microscope. CONCLUSIONS: The paraseptal transsphenoidal approach to the sella turcica using the telescope is at least as effective as the conventional transseptal approach using the operating microscope only. It provides a wide access to the pituitary fossa and an optimal vision of the critical areas. The absence of postoperative nasal packing improves significantly the comfort of the patient during the first postoperative hours.

Endoscopy↗
PubMed2004

Solid cast-forming actinomycotic canaliculitis: case report.

Solid-cast forming actinomycotic canaliculitis is an uncommon cause of unilateral chronic red eye resistant to conventional topical medical therapy. The authors report the history of a 62-year old woman who was complaining of mucopurulent discharge from the right lower canaliculus for a period of 12 months. Culture yielded a few colonies of Actinomyces. Magnetic resonance imaging showed a dilation of the right lower canaliculus. The signal was hypointense and heterogeneous on both T1 and T2 weighted sequences. Surgery enabled removal of several solid yellowish casts and resulted in resolution of the disease. Histopathologic examination confirmed the presence of dense, basophilic conglomerates of filamentous organisms. Because rhinologists have more and more opportunities to perform surgery of the lachrymal pathway they need to be informed about this clinical entity.

Actinomycosis↗
PubMed2003

Perceptual, affective, and cognitive judgments of odors: pleasantness and handedness effects.

The present study sought to examine the differential processing of pleasant, neutral, and unpleasant odors. The effects of the nostril stimulated (left or right) and the type of judgment (perceptual, affective, or cognitive) performed on the olfactory stimuli were also studied. To this end, 64 subjects were asked to smell pleasant, neutral, and unpleasant odors under four conditions (detection, intensity, pleasantness, and familiarity tasks). The participants were to perform these tasks as quickly as possible, while response times were recorded. The results showed that (i) unpleasant odors were assessed more rapidly than neutral or pleasant odors, and that this was specifically true (ii) during right nostril stimulation, and (iii) during pleasantness assessment, suggesting possible differential cerebral hemisphere involvement, with a right-side advantage for processing of unpleasant affect in olfaction. A handedness effect on familiarity judgment is also discussed.

Adult↗
PubMed2003

Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring.

OBJECTIVES: We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring. METHOD: Forty-nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser-assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome. Each patient's evaluation encompassed postoperative pharyngeal pain (as measured by a 5-point visual analogue scale) and use of narcotic drugs in the early postoperative period as well as a subjective evaluation of late postoperative complaints. A surgeon's examination was performed to report postoperative complications in the oropharynx. RESULTS: Postoperative pharyngeal pain was less important in the RFTVR group than in the UPPP and LAUP groups. Mean scores at days 3, 7, 16 were as follows: 4.2, 4.0, and 2.4, respectively, for UPPP; 4.6, 3.8, and 1.6 for LAUP; and 2.4, 2.0, and 0.7 for RFTVR. Mean duration of pain with a score greater than 2 was calculated as follows: UPPP, 21.3 days; LAUP, 15.1 days; and RFTVR, 6.1 days. Mean duration of narcotic drug use for the patients who needed this medication was 10.1 days for UPPP, 7.2 days for LAUP, and 1.3 for RFTVR. Postoperative side effects (trouble with smell and taste, pharyngeal dryness, globus sensation, voice change, and pharyngonasal reflux) were more present in the UPPP and LAUP groups than in the RFTVR group. Surgeon's assessment for postoperative complications reported more wound infection, dehiscence, and posterior pillar narrowing in the UPPP and LAUP groups than in the RFTVR group. CONCLUSION: RFTVR is a safer and less painful procedure than UPPP and LAUP for the treatment of primary snoring. Postoperative discomfort after LAUP and after UPPP appears to be very similar.

Adult↗
PubMed2000

Medical costs of intravascular ultrasound optimization of stent deployment. Results of the multicenter randomized 'REStenosis after Intravascular ultrasound STenting' (RESIST) study.

OBJECTIVE: Intravascular ultrasound (IVUS) can be used to optimize the deployment of stents. The aim of this study was to assess the acute and long-term medical costs of the use of IVUS through the results of the 'REStenosis after Intravascular ultrasound STenting' (RESIST) study. METHODS: One hundred and fifty-five patients were randomized to routine stent deployment with (n = 79) versus without (n = 76) IVUS guidance, with clinical follow-up over 18 months. The medical costs (hospitalization plus procedural costs) were calculated using a cost accounting system at the time of stent implantation and for all repeat lesion revascularizations. (At the time of writing the exchange rate was 1 Euro = 1 US dollar.) RESULTS: Because of the cost of IVUS catheters and the need for more balloons, acute procedural costs were 18% higher in the group with IVUS guidance (2934 +/- 670 Euros vs 2481 +/- 911 Euros). Clinical events (death, myocardial infarction, unstable angina or lesion revascularization) occurred in 28/76 (37%) in the group without IVUS, versus 20/79 (25%) (OR = 1.7; 95%CI = [0.82; 3.63]) in the group with IVUS. There was a higher number of revascularization procedures in the control group (31 in the control group vs 20 in the IVUS group). The cumulative medical costs at 18 months were only slightly higher in the IVUS group (4535 +/- 2020 Euros vs 4679 +/- 1471 Euros in the IVUS group), as the higher acute costs in the group with IVUS guidance were partially offset by the lower cost for revascularization procedures. Sensitivity analysis using variations of the unit costs as well as variations in the number of revascularization procedures and length of hospital stay showed that the overcost remained in a range between 1% and 7.6%. CONCLUSIONS: Over 18 months of followup, despite higher acute costs, IVUS optimization of stent deployment did not considerably increase the medical costs.

Journal Article↗