[Value of Hoffman's reflex in the investigation of lumbo-sacral radicular injuries of intervertebral disk origin].
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Biomedical subjects
Publications and source records attributed to F Resche.
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Maxillonasal dysostosis, described by Binder in 1962, is probably more common than one would think from the small number of cases that have been published (fewer than 40). We have seen 37 cases of this syndrome over a period of 8 years. Diagnosis of the syndrome is easy because of its characteristic anomalies of the upper lip and nose: smallness of the nose, a groove under the columella, a "half-moon" appearance of the nasal apertures, absence of the nasal spine, and projection of the chin. In addition, we have observed several associated abnormalities: convergent strabismus (2 cases), mongolism (1 case), labiomaxillopalatine cleft (1 case), and, of particular note, numerous abnormalities of the cervical spine, frequently associated with mandibular prognathism. In view of the frequency of the latter abnormalities. Binder syndrome might well be called a "nasomaxillovertebral syndrome."
Craniospinal and cervicospinal malformations were found in 15 (53.5%) of 28 cases of maxillonasal dysostosis (Binder syndrome) in which a complete radiographic analysis could be done. These anomalies have not been reported previously. Analysis of the anomalies suggested a common induction factor, or, at least, a simultaneity in the development of the maxillonasal and vertebral dysplasias that characterize Binder syndrome. The following procedures are recommended: (1) examination of the cranial and cervical spine in all subjects with symptoms of Binder syndrome, and (2) regular examination of patients with spinal malformations, so that any neurologic damage may be detected early.
Treatment of maxillonasal dysostosis (Binder syndrome) varies according to the age of the patient. In the newborn, respiratory and alimentary problems resulting from the anomaly may necessitate the insertion of endonasal and gastric tubes. In children, occlusal problems and orofacial dysfunctions caused by maxillonasal dysostosis should be treated as soon as possible with an orthodontic mask. Once a patient reaches adulthood, surgery may be performed. If orthodontic treatment has been successful and there is normal occlusion, the surgery may consist simply of placing the muscles of the nose and upper lip in normal; anatomic position. If occlusion is abnormal, osteotomy may be performed.
This study was carried out to evaluate the effect of new anti-inflammatory drugs in the treatment of brain edema in new models. Experimental brain edema was induced in rats by stereotaxic injection of phospholipase A2 into one hemisphere. Concentrations of intravenously injected gadolinium-DOTA in the lesioned hemisphere were three times as high as in normal rat hemisphere. Edema was reduced by treatment with anti-inflammatory drugs such as dexamethasone (P < 0.01) or an experimental benzamide drug (P < 0.02). Magnetic resonance imaging (MRI) was then used to evaluate edema reduction after administration of contrast medium. We observed weighted scans for control lesioned rats, a reduction of signal intensity after dexamethasone and no significant regression after the benzamide drug. For purposes of experimental brain edema research in rats, the MRI technique facilitates detection and evaluation of the anti-inflammatory activity of molecules crossing the blood-brain barrier.
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Authors describe the fine structure of the border zone of a cerebellar hemangioblastoma. This electron microscopie study corroborates all the previous optic microscopic results concerning absence of a well delimited bound between hemangioblastoma and bordering cerebellar tissue. Different stages of peculiar cellular degeneration are found, and an attempt for interpretation is given. However these morphologic changes are insufficient to allow further explanation about the histogenesis of hemangioblastomas, which remains unknown.
In current practice, arteriograpy is already acknowledged, at the present time, as a method of primary importance which cannot be dispensed withfor diagnosis, prognosis and treatment. By opposition, considering pathology of the peripheric nerves, arteriography is often overlooked before chirurgical exploration though it affords the same advantages as in the remaining fields of pathology. Technically our preference goes to selective angiography by direct puncture of humeral or femoral artery. Arteriography will permit:-Visualisation of the location of the tumor close to the major vessels;-Evidence of the exact site of the efferent and afferent pedicles;-Discovery of other localisation. Mostly arteriography helps preoperatively to histological diagnosis. It must be recalled that benign neurinomas often assume a misleading aspect on the tumorography with stagnation of the contrast medium which might suggest malignancy. These benign tumors have three peculiar features: 1. Arteries are observed to stretch out around the lesion but never to narrow. 2. There is no explosive vascularisation ; hypervascularisation appears progressively, is located on the periphery of the lesion, and occupies but a part of the whole area. 3. Veins are not invaded but pushed apart and duly appear in normal timing. This peculiar aspect is quite the opposite of what can be observed in malignant tumors, which are, by far, less frequent.
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A progressive facial paralysis in a child of 14 years allowed the diagnosis of a hamartoma to be made. The discovery of such a benign lesion should always be followed by a search for other lesions elsewhere, i.e. to see if there is not a phacomatosis. Persistent sciatic pains which this child now has lead one to fear a second lesion, compressing a nerve root or trunk of the sciatic nerve. There is a strong possibility that this tumor of the auditory canal is only the first manifestation of a neurocristopathy.
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