[Periodontal prosthesis planning].
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Biomedical subjects
Publications and source records attributed to M Perrier.
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From January 1976 to June 1986, 154 patients (75 men and 79 women) who were 75 years of age or older were admitted for the surgical treatment of a colonic cancer. The mean age was 80.7 years. Patients were divided into two groups: 66 patients, between 75 and 80 years of age, were in Group I; 88 patients, 80 years of age and older, were in Group II. One hundred and forty-three patients (93%) were operated on and a resection was carried out in 125 patients (87%). The overall post-operative mortality rate was 12% (Group I: 5%; Group II: 17%; p less than 0.02). The actuarial survival rate of patients operated on was 32 +/- 8% at 3 years and 26 +/- 8% at 5 years (Group I: 37%; Group II: 17%). In both groups the survival rate was closely related to the extent of the disease according to Dukes classification. These results suggest that in the 75-80 year group age alone should no longer be considered a major risk factor for immediate surgical outcome. In patients aged 80 and older, the results are worse but it is not advanced age per se which influences mortality, rather the physiologic status of the patient.
The somatosensory evoked potentials from median nerve were studied in a group of 127 normal adults aged from 19 to 79. The latencies of elbow, Erb's, cervical N11 and N13 as well as cortical N20 and P25 potentials were analyzed as a function of height and age. Two central conduction times, N20-N11 and N20-N13, were equally studied. The corresponding regression formulae were calculated and can be used to predict normative values of these parameters over a wide range of height and age. Standard error estimates are given for all parameters.
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In the present retrospective study, 79 percent of the patients were men with a median age of 65.5 years. Of 91 patients, 84 were surgically explored. Excision of the tumor was carried out in 57 patients (63 percent) and was curative in 28 cases and palliative in 29 cases. Curative resection included proximal gastrectomy in 5 patients and total gastrectomy in 23 patients, which was extended to the spleen and distal pancreas in 18 patients. Lymph node metastases were found in 67 percent of the patients treated by resection. According to the TNM classification, 18 percent of the patients undergoing resection had stage I tumor, 28 percent had stage II tumor, 40 percent had stage III tumor, and 14 percent had stage IV tumor. The postoperative mortality rate was 16 percent for the entire series, 21 percent for patients undergoing palliative resection, and only 4 percent for patients undergoing curative resection. Three patients had an obvious anastomotic leak, one of whom died. Median survival time was 5 months for patients who had exploration only, 6 months for patients who had palliative resection, and 36 months for patients who had potentially curative resection. The 5 year actuarial survival rate was 20 percent for patients having resection and 40 percent for patients having curative resection. Survival was closely related to tumor stage. These results indicate that total gastrectomy with complete abdominal lymph node dissection can give comparatively good long-term results when performed for cure. Nevertheless, only one of three patients in this series could have a potentially curative resection. The only way to increase the curative resection rate and to improve survival is to detect the cancer at an early stage.
Sensory peripheral neuropathy developed in 5 patients treated with almitrine dimesylate, 60-100 mg/day. Onset was insidious, beginning symmetrically in the legs with stocking sensory loss and loss of ankle-jerks. Cerebrospinal fluid protein levels were slightly increased and there was electrophysiological and histological evidence of distal axonopathy. The interval between the first dose of almitrine dimesylate and onset of symptoms ranged from 2 to 4 months in 4 patients. All patients had noted a recent weight loss of 4-15 kg which may have resulted in release of previously bound drug.
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Chronic haemorrhagic ascites in an infant is reported. After much hesitation without a definite diagnosis the first laparotomy was carried out and the estimation of amylase, lipase and proteolytic enzyme activities in the ascitic fluid suggested a pancreatic origin for the ascites. This was conformed at a second laparotomy when the condition was correted. This emphasises the importance of the estimation of pancreatic enzymes in unexplained ascites in children.
36 night sleep recordings were carried out on 15 patients suffering from myotonia dystrophica. 9 of these patients complained of diurnal hypersomnia. 10 patients had a disturbance of night sleep with a reduction of REM sleep sometimes associated with interruption of the recording with an increase in the light stages of sleep or alternatively with an increase of REM sleep with a reduction in the latency period of the first paradoxical sleep or with narcoleptic elements. 13 patients had abnormally early abolition of chin EMG activity, almost on falling asleep. 11 cases had pathological apnoeic episodes during sleep and in 9 of the 10 patients who underwent respiratory function studies there was a restrictive airways defect. In addition 9 had frank hypoxia without hypercapnia and 4 a right to left shunt. 3 clinically unaffected patients but with affected relatives were also investigated, 2 were found to have sleep disturbances 1 of which was associated with early abolition of tone.
The Sjögren-Gougerot syndrome represents a rare disease of the collagenous tissue characterized by the three symptoms Xerophtalmy, Xerostomy, polyarthritis. Women after the menopause are the most affected. Oral symptoms addup to diverse dermatological manifestations. The bilateral parotidic swelling and systemic complications accompany the disease, and the immunological disorder is coupled with hypergammaglobulinemia. Prognosis is very reserved and treatment delicate.
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