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Biomedical subjects

E Vitte

Publications and source records attributed to E Vitte.

17 recordsLinked to original sources

Anatomic and radiologic bases of surgery of the thoracic aorta.

Lesions of the thoracic aorta create problems related to their site and relations with the main aortic branches. The aim of surgery must be to treat the lesion while ensuring perfusion of the tissues excluded by clamping during the operation. Anatomic study of the aortic lesions is based on imaging. Angiography is still often the basic examination though it shows only the lumen and course of the aorta. However, CT and MRI visualise the aortic wall and especially the relations of the aorta to the mediastinal structures. A comparison of anatomic and imaging studies was made on 10 fresh subjects coming from the anatomy department of the Saints-Pères and from the school of surgery of Fer à Moulin. Sections were made every 3 to 5 mm in 3 planes (sagittal, coronal and axial) after CT localisation of the plane of section. This anatomic study was correlated with CT and MR images made on healthy volunteers. The choice of surgical management of a lesion of the thoracic aorta is based on preoperative anatomic assessment by imaging applied not only to the aorta but also to its branches and the territory supplied.

Aorta, Thoracic

[Vestibular studies: current status, prospects].

Equilibrium is based on gaze stabilization. Clinical examinations currently test, individually the three components involved in equilibrium: vestibular, visual and proprioception. New investigations are being developed to test equilibrium dynamic conditions. After briefly reviewing vestibular physiology, under the authors discuss the various tests of vestibular function and equilibrium.

Eye Movements

Head stabilization during various locomotor tasks in humans. II. Patients with bilateral peripheral vestibular deficits.

This experiment, which extends a previous investigation (Pozzo et al. 1990), was undertaken to examine how head position is controlled during natural locomotor tasks in both normal subjects (N) and patients with bilateral vestibular deficits (V). 10 normals and 7 patients were asked to perform 4 locomotor tasks: free walking (W), walking in place (WIP), running in place (R) and hopping (H). Head and body movements were recorded with a video system which allowed a computed 3 dimensional reconstruction of selected points in the sagittal plane. In order to determine the respective contribution of visual and vestibular cues in the control of head angular position, the 2 groups of subjects were tested in the light and in darkness. In darkness, the amplitude and velocity of head rotation decreased for N subjects; these parameters increased for V subjects, especially during R and H. In darkness, compared to the light condition, the mean position of a line placed on the Frankfort plane (about 20-30 degrees below the horizontal semi-circular canal plane) was tilted downward in all conditions of movement, except during H, for N subjects. In contrast, this flexion of the head was not systematic in V subjects: the Frankfort plane could be located above or below earth horizontal. In V subjects, head rotation was not found to be compensatory for head translation and the power spectrum analysis shows that head angular displacements in the sagittal plane contain mainly low frequencies (about 0.3-0.8 Hz). The respective contribution of visual and vestibular cues in the control of the orientation and the stabilization of the head in space is discussed.

Adult

The commissuro-mamillary plane in MRI of the brain (preliminary communication).

MRI sections of the brain in the coronal plane through the line joining the anterior commissure and the mamillary bodies display the constituent parts of the basal forebrain. The visualisation of the septal nuclei and the anterior columns of the fornix show the importance of this plane in the study of behaviour disorders and amnesic syndromes.

Corpus Striatum

The thoracic esophagus: sectional anatomy and radiosurgical applications.

The relationships of a tumor of the thoracic esophagus to the adjacent mediastinal structures are currently studied by means of computed tomography (CT), magnetic resonance imaging (MRI) and, more recently, by echoendoscopy. However, the assessment of axial mediastinal CT and of MRI in the coronal and sagittal planes calls for some degree of experience. To further this training a sectional anatomy is proposed in correlation with imaging of the thoracic esophagus and the posterior mediastinum. Ten fresh subjects whose vascular networks had been previously injected with colored resin were sectioned along the three planes of space after positioning under CT monitoring. The axial sections were compared with the CT images made with a GE 9800 Quick scanner. Three frontal and sagittal sections were compared with the MRI images made with a GE Signa apparatus using a high magnetic field. The relations of the esophagus were studied at three levels: the supra-azygo-aortic segment, where it is related to the left subclavian artery; the inter-azygo-aortic segment, where access to the esophagus is barred on the left by the aortic arch and on the right by the arch of the azygos vein, section of which provides ample access; and the sub-azygo-aortic segment, where the esophagus passes behind the left main bronchus and to the right of the descending aorta, two organs whose invasion contraindicates excision of a tumor of the esophagus but is difficult to assess by current thoracic imaging techniques. The esophagus then descends behind the left atrium; the investigation of the kinetics of the heart cavities by transesophageal echocardiography is an application of this anatomic relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophagus

Head stabilization during locomotion. Perturbations induced by vestibular disorders.

Head kinematics was studied in 10 normal subjects (NS) and 7 patients (P) with bilateral vestibular deficit while they executed various locomotor tasks. The movement of the body was recorded with a video system which allowed a computer reconstruction of the motion of joint articulations and other selected points on the body in three dimensions. Analyses focus on head translation along the vertical axis and rotation in the sagittal plane. Two conditions were studied: free walking (W) and hopping (H). The subjects were tested in light and in darkness. In NS, while walking in darkness, mean head position was tilted downward. In contrast, this flexion was not systematic in P. Darkness did not significantly influence the amplitude and velocity of head angular displacement during W, but, during H the amplitude decreased by 37% for NS. During H in darkness, head stabilization decreased for P. These results suggest that head kinematics, during natural locomotor tasks, could be used to evaluate vestibular deficiencies.

Adult

The commissuro-mamillary plane in MRI of the brain (preliminary communication)

MRI sections of the brain in the coronal plane through the line joining the anterior commissure and the mamillary bodies display the constituent parts of the basal forebrain. The visualisation of the septal nuclei and the anterior columns of the fornix show the importance of this plane in the study of behaviour disorders and amnesic syndromes.

Brain

Radiological studies in trigeminal nerve pathology.

The authors have used CT scans and MRI to study pathology in anatomical and radiological correlations of brain slices. The CT scan was particularly useful for studying structures at the skull base, although at the level of the posterior fossa such scans could visualize only those tumors that were larger than 8 mm. even after injection. The CT scan was found to be the most useful examination before surgery for facial neuralgia. In contrast MRI gave a precise cisternal course of the trigeminal nerve and its relations with vascular structures.

Cranial Nerve Neoplasms

[Benign paroxysmal positional vertigo and provocative maneuvers].

Main features of the benign paroxysmal positional vertigo (B.P.P.V.) are: latency before the onset of vertigo, nystagmus of the rotatory type beating toward the lower ear, nystagmus tires out, nystagmus gets inverted when the head is brought back to orthostatism, nystagmus is reproducible as many times as the position is taken. B.P.P.V. is due to a deposit of heavy material on the cupula of the posterior semi circular canal. In this unusual condition, the cupula moves under the effect of gravity acceleration. The goal of the treatment is to free the cupula. The manoeuvre consists after determination of the position that elicits the vertigo to move the whole head and body together of the patient to a 180 degree opposite position in which the addition to the endolymph flow forces and weight forces of the material will unstick it from the cupula. The positive result of the manoeuvre is instantly proved by the arising of a rotatory nystagmus beating again toward the sick ear. In other words it is not the inversion of the primary nystagmus but a nystagmus beating the same direction. This is explained by the dynamic of the cupula: in the prime position the density modified cupula moves toward the canal. At the end of the manoeuvre when the velocity of the head is zero, the cupula has to support different forces. First the addition of the endolymph flow forces and the inertia of the heavy material makes the cupula move toward the ampulla. Secondly when the superficial tension forces are too high the heavy material unstick from the cupula and it goes back to its normal position. En this very moment the cupula moves toward the canal. The results are of more than 90% positive in one ore two sessions 4,2% of recurrence. The manoeuvre is unsuccessful in spontaneous nystagmus revealed by a position, in torsional nystagmus as in fistulas or in central position nystagmus.

Humans

Anatomical study of digital compression of the vertebral artery at its origin and at the suboccipital triangle.

Manual compression of the vertebral artery is used in routine clinical practice for diagnosis of positional hemodynamic vertebro-basilar insufficiency (VBI). The supraclavicular and suboccipital areas were carefully dissected in 20 cadavers. Anatomical variations observed on dissection were compared to angiographic data from 150 patients and data from the literature. Objective results of manual compression of the vertebral artery can be obtained by sonography. In patients with VBI, such compression induces signs of reversible cerebellar or brain stem ischemia, whereas no signs are observed in patients without VBI.

Cadaver

[Physiological and clinical recall on equilibrium disorders].

Static and dynamic equilibrium (posture and gait) is indispensable for a normal behavior in human. Its mechanisms are nearly the same in superior species and in man, but humans are the only ones to have acquired exclusively biped upright position and gait. Equilibrium is a sensory function involving 3 sub systems: visual, vestibular and sensori-motor (proprioceptive), controlled by cerebellum and cerebral structures. Information coming from those 3 sub systems must be concordant. In case of discordance, the patient is in a state of sensory conflict. This conflict can induce disequilibrium or true vertigo. After a recall on equilibrium, the authors report the results of an epidemiologic study upon 5298 patients suffering of balance disorders and treated by an alpha-blocker: nicergoline (30 mg/day during 6 months).

Humans