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Biomedical subjects

D Herman

Publications and source records attributed to D Herman.

At least 55 records · Page 3Linked to original sources

Different effects of nasal and bronchial glucocorticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis.

Disorders of the upper respiratory tract, particularly allergic rhinitis, are commonly associated with bronchial hyperresponsiveness. The latter may be due to postnasal drip or to mediator or chemotactic factors into the lower airways that either directly alter airway reactivity or cause airway inflammation. The aim of this study was to compare the effect of an identical dose of nasal or bronchial corticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis. Eleven patients were studied. All of them were judged atopic on the basis of positive skin tests to common allergens. During control, spirometry, flow-volume curves, and specific airway conductance (SGaw) were measured. Bronchial challenges were then performed with increasing concentrations of carbachol, and dose-response curves were constructed. The concentration of carbachol that decreased SGaw by 35% from baseline (PD35) was determined by interpolating from the dose-response curve. Control measurements were repeated at 1-wk intervals to ensure that PD35 was stable in all the patients. Then the patients received for 2 wk, in a double-blind randomized crossover fashion, a topical administration of either an aerosol of 400 micrograms of beclamethasone dipropionate (B) into the nose (100 micrograms four times per day) or into the bronchi. During each trial period, identical sprays of placebo were used, the latter being administered into the nose when B was administered into the bronchi and vice versa. Measurements were then performed after 2 wk of intranasal administration and after 2 wk of intrabronchial administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

[Mini-forum: rhinoplasty by external approach. Collumello-trans-alar approach of open rhinoplasty: advantages].

For several years, the authors have been using a columellar transalar incision through the medial crus along the nasal septum, reaching the vault and continued laterally by a transalar cartilaginous incision. The nasal tip is thus opened like a car-hood, leaving the alar cartilage attached to the skin and exposing the triangular cartilage and the nasal septum. This approach allows septoplasty to be performed with excellent exposure. The tip is easily revised backwards allowing anomalies to be viewed directly. The advantages of this external approach compared with the classical external Rethi's approach are multiple: simplicity and rapidity of the technique, excellent access to triangular cartilages and the triangular-septum junction; possibility of always going from an endonasal approach to an external one and excellent access to the tip. Moreover, there is no long term swelling of the tip. The indications of this external approach are asymmetry of the tip, excessive tip projection, saddle nose deformities and secondary rhinoplasties. No complication has been observed in a series of 32 patients with a follow-up of 6 to 48 months. There is no disturbance of the tip position and the skin scar is imperceptible.

Bone Transplantation↗

[Our experience of infectious risk in prosthetic breast surgery].

This retrospective clinical study was made to help determine the signs of infectious or healing problems in candidates for prosthetic breast surgery. It concerns 80 patients with 108 breast implants (44 breast reconstructions, 21 cases of hypoplasia, 8 breast asymmetric, 20 secondary procedures, 15 of them being changes of expansion implants by definitive implants). Thirty one infectious complications (28.7%) were noted. In 22 cases it consisted of a resolutive hyperthermia. Nine cases of local complications were noted, with four implant exposures (3%). Bacteriological samples were analyzed and were positive in four out of nine (Staphylococcus aureus). In 8 out of the 9 cases the initial procedure consisted in a breast reconstruction. All 8 patients underwent postoperative radiotherapy after the initial mastectomy (Patey). The implant type (implantable, pre-filled, expansion prosthesis), its location (retromuscular), the type of surgery (asymmetrical breast musculocutaneous or fasciocutaneous flap) don't seem to be responsible in the genesis of the complications. This retrospective study could not help determine which protocol of antistaphylococcal antibiotherapy suits lest. Infectious problems arose with or without antibiotics.

Adult↗

[Tumors of the parotid area. Apropos of 203 surgical explorations].

The authors present their clinical, radiological and histological conclusions, according to a retrospective personal study about 203 chirurgical explorations from the parotid gland. The pleomorphic adenoma and the cystadenoma are presented more precisely and basically their chirurgical indications; the other histological types met are only presented through several tables.

Adenolymphoma↗

Appendiceal mucoceles and pseudomyxoma peritonei.

Mucoceles of the appendix and associated pseudomyxoma peritonei are a heterogeneous group comprising various histopathologic lesions with differing prognoses. Between 1983 and 1990, we treated eight patients with appendiceal mucocele, three cystadenomas and five cystadenocarcinomas, three of which had accompanying pseudomyxoma peritonei. All patients were more than 50 years of age. Women outnumbered men by seven to one. Preoperative diagnosis was acute appendicitis or appendiceal abscess in all instances of mucocele unaccompanied by pseudomyxoma peritonei. Ultrasound of the abdomen, together with paracentesis, diagnosed pseudomyxoma peritonei in two of three patients. Elevated carcinoembryonic antigen levels were found in six of the eight patients and monitoring of this parameter was useful in the early detection of the two recurrences observed. The three patients with cystadenomas remain free of disease after appendectomy. Of the five patients treated for cystadenocarcinoma by right colectomy, two underwent reoperation after recurrence of disease. One patient died 41 months later of intestinal obstruction caused by pseudomyxoma peritonei. Pseudomyxoma peritonei significantly decreases survival of patients with appendiceal mucocele. In these patients, aggressive initial surgical management, repeated if need be, is indicated.

Aged↗

[Extensive cervical hematoma complicating multinodular goiter. Apropos of a case].

The massive hemorrhagic accidents of multinodular goiter are very rare, implicating the vital prognosis through an airway obstruction by tracheal compression. To illustrate this situation, the authors present an original case with a large cervico-thoracic hematoma without any respiratory's difficulties. The serious evolutive potential of that situation in spite the unworrying aspect of the patient, bring them to operate in delayed emergency.

Aged↗

[Post-traumatic aneurysm of the internal carotid artery].

The authors present a typical case of a traumatic internal carotid aneurysm rupture appearing 40 years after a blunt head trauma and surgically treated with success. The etiopathogenic and clinical aspects are reviewed and the important place of the angiography in diagnostic and therapeutical strategy is discussed.

Aged↗

Downloading from MEDLINE: a comparison of personal database software.

The compatibility of downloaded MEDLINE references with software packages designed for maintenance of personal bibliographic databases is considered. The nine packages reviewed enable one to import batches of records downloaded from one or more presentations of the MEDLINE database, online or CD-ROM; and enable the user to re-format records into the various styles required by journal editors. Some basic features of the packages are tabulated, and details of record-importing facilities are described. Details of suppliers and prices are given.

Catalogs, Commercial as Topic↗

Protective effect of theophylline on bronchial hyperresponsiveness in patients with allergic rhinitis.

Disorders of the upper respiratory tract, particularly allergic rhinitis are commonly associated with bronchial hyperresponsiveness. The latter may be responsible for chronic cough, a common symptom in patients with allergic rhinitis, which, as previously shown, can be the sole presenting manifestation of bronchial hyperresponsiveness. Theophylline is widely used in patients with asthma for its bronchodilator effect, whereas its action on bronchial reactivity is controversial. The aim of this study was to determine the effect of theophylline administration on bronchial hyperresponsiveness in patients with allergic rhinitis complaining of chronic cough. Fourteen patients were studied. All of them were judged atopic on the basis of positive skin tests to common allergens. During control, spirometry, flow-volume curves and specific airway conductance (SGaw) were measured. Bronchial challenges were then performed with increasing concentrations of carbachol, and dose-response curves were constructed. The concentration of carbachol, which decreased SGaw by 35% from baseline (PD35) was determined by interpolating from the dose-response curve. After control measurements patients received in a randomized, double-blind crossover fashion either theophylline 10 mg/kg/day orally or placebo for 30 days. Measurements were then redone. After a washout period of 8 days the measurements were repeated, and patients received theophylline or placebo for a second period of 30 days. Measurements were again performed at the end of this last study period. During control all patients had normal baseline lung function data and showed marked bronchial hyperresponsiveness, PD35 amounting to 26 +/- 7 micrograms of carbachol (normal value greater than 160 micrograms). No significant changes in PD35 were noted after placebo and washout when compared with control values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[External injuries of the larynx. Our experience apropos of 55 cases].

Reporting 55 cases of laryngeal trauma, the authors detail the etiologies and the lesions observed and expose their trauma management. Endoscopic results are basic in the evaluation of the gravity of the trauma. Radiological investigations, especially C.T. scan, take the second place. The use of endolaryngeal stent in the surgical treatment is as limited as possible. A precise lesional staging and a great rigour in the operative management can only guarantee the recovery of normal vocal and respiratory functions.

Adolescent↗

[Exostosis of the external auditory canal: clinical and therapeutic aspects].

Based on the study of 25 cases, the authors recall the frequency and pathogeny of these lesions, specifying the surgical technique and presenting their results. The risks of this surgery lie in the ever possible impairment of the facial nerve and labyrinthization on treble frequencies (2 cases). The incidents are tympanic perforation (1 case) and the opening of the temporomandibular joint. It is not always possible to preserve the skin of the external auditory canal. It can be reconstructed by a free (3 cases) or pedicle (3 cases) graft of more simply in case of small loss of substance by a temporal fascia graft.

Adolescent↗

[Rhabdomyosarcoma of the nasopharynx occurring with immunosuppressive treatment with cyclosporin A. Apropos of a case].

The authors report the case of a 15 year old adolescent who presents a rhabdomyosarcoma of the rhinopharynx. This young patient underwent 23 months before a kidney transplantation and was since under immunosuppressing treatment including corticoids, azathioprine and cyclosporin A. The characteristics of this tumor make it probably induced by the therapeutic based on cyclosporin.

Adolescent↗

[ORL metastases of Grawitz's tumors].

Renal cell carcinoma (Grawitz's tumor), may metastasize to the head and neck region at different stages of its evolution. The authors present four cases illustrating the difficulties of the preoperative and histopathological diagnosis. The data on otolaryngological localisations are reviewed.

Aged↗

Comparison of conidial and mycelial allergens of Alternaria alternata.

Alternaria allergens, separated by SDS polyacrylamide gel electrophoresis and transferred onto a nitrocellulose membrane, were identified using sera from Alternaria-allergic patients. 30 Alternaria components of spore and mycelium, ranging in molecular weight from more than 150 to 12 kD, bound IgE antibodies. 15 were detected by more than 25% of the sera and only 4 (85, 56, 42, 31 kD) by more than 50% of the sera. Among these four major allergens, the 56-kD component was present mostly in the spore extract, the 85- and 42-kD fractions in the mycelium extract and the 31-kD in both extracts. The 31-kD component showed the highest IgE binding and the highest frequency of binding (95% with mycelium extract and 79% with spore extract). It was composed of two subunits.

Allergens↗