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Biomedical subjects

O Richard

Publications and source records attributed to O Richard.

At least 37 records · Page 2Linked to original sources
PubMed2004

[Hard palate mucosal graft for posterior lamella repair].

Several techniques have been proposed for posterior lamella repair. The ideal gaft should be easy and safe to harvest, be lined by mucosa and be rigid enough to support the lower lid against retraction. Hard palate mucosal grafts meet these criteria. The surgical procedure is done under local or general anaesthesia and a graft up to a 40 x 20 mm can be harvested. Paramedian and subperiostal harvest is recommended, local complications are less frequent (bleeding and sensory lesions) and the hard palate mucosa is of better quality at this site (thinner graft with fewer salivary glands but rigid enough due to the periostal layer). Donor site complications such as local bleeding can be reduced by meticulous surgical technique and local postoperative care such as compression using a mouthguard. The main indications for hard palate mucosal graft are lower eyelid reconstruction and management of lower eyelid retraction.

Eyelids↗
PubMed2003

Role of laparoscopy in vaginal malformation.

BACKGROUND: The aim of this study was to assess the role of laparoscopy in the management of vaginal malformations in children, a subject not often discussed in the literature. METHODS: Between 1980 and 2002, we treated 22 children for vaginal malformations. Two main patient populations were distinguished: younger children with asymptomatic hymenal imperforation and hydrocolpos, and adolescents with hematocolpos. A third of the malformations were identified on systematic clinic examination, a third on the basis of abdominal pain, and a third due to various other symptoms. Nine of the girls had associated malformations of the uterus, external genital organs, or urinary tract. Eight patients underwent laparoscopy, either to look for endometriosis in cases of hematocolpos, to make an accurate determination of malformations in cases where clinical and paraclinical methods failed, or to manage an abnormality. RESULTS: Eleven laparoscopic procedures were performed in eight patients. Three diagnostic laparoscopies enabled us to determine the exact nature of the malformations. One newborn underwent two laparoscopic procedures to treat peritoneal fibrous bands that had caused repeated episodes of obstruction. Six patients underwent exploratory laparoscopy to look for endometriosis, but none was found. CONCLUSION: Laparoscopy is not applied systematically in the management of any malformation, but it can be useful when complementary exams fail to make an accurate diagnosis of the anomaly or for the management of the rare complication of adhesions and bands. When used to search for endometriosis, MRI detects ~50% of lesions, but laparoscopy is certainly still appropriate for that purpose. However, the optimal timing of the procedure still needs to be established.

Abnormalities, Multiple↗
PubMed2003

Discomallear and malleomandibular ligaments: anatomical study and clinical applications.

Phylogenesis, ontogenesis and anatomy show the existence of two discomallear and malleomandibular ligaments, arising from the first branchial arch and uniting the middle ear with the temporomandibular joint and to the mandible. The intra-articular discomallear ligament is the involuted tendon of the lateral pterygoid muscle on the primitive quadrato-articular joint. The malleomandibular ligament is the fibrous remnant of Meckel's cartilage. In the physiology of the temporomandibular joint, the discomallear ligament alone limits the anterior movement of the disc. Its stretching accompanies disco-condylar disunity, hyperlaxity and temporomandibular dislocation. The malleomandibular ligament, wrongly limited to its sphenomandibular part in classic anatomy, has no physiological role. However, it can be responsible for the dislocation of the ear ossicle chain after disarticulation or temporomandibular trauma. These two ligaments do not play any role in otological manifestations in dysfunction of the manducatory apparatus.

Humans↗
PubMed2003

[The association of polyarteritis nodosa and familial Mediterranean fever].

INTRODUCTION: Some necrotizing vasculitis may be associated with familial Mediterranean fever (FMF). We report a new case of polyarteritis nodosa (PAN) that preceded the diagnosis of FMF. OBSERVATION: A young woman of Turkish origin had a long childhood history of inflammatory arthralgia and myalgia, leading to the provisional diagnosis of chronic juvenile arthritis, then, after a confirmative muscle biopsy, to the diagnosis of PAN, whose outcome remained benign. At the age of 19, she was diagnosed as having FMF on clinical and genetic grounds, and colchicine led to the regression of most symptoms. DISCUSSION: As with Henoch-Schönlein's purpura, PAN seems significantly associated with FMF. Its characteristics are a younger age at onset, more frequent peri-renal hematoma, overlap between classical PAN and micropolyangeitis, and overall better prognosis. In its muscular form, PAN is difficult to distinguish from protracted febrile myalgia, a recently described manifestation of FMF, in which pathological findings are poorly documented.

Adult↗
PubMed2003

Comparison between direct clinical and digital photogrammetric measurements in patients with 22q11 microdeletion.

Thanks to recent advances in imaging and computing technology, photoanthropometry has become an increasingly helpful adjunct to obtain objective clinical evidence of morphologic abnormalities in patients with dysmorphic syndromes. The aim of this study was to evaluate measurements made using a new two-dimensional digital photogrammetry technique by comparison with direct clinical measurements. A total of 14 patients with 22q11 microdeletion were included in this study. There were seven females and seven males between 5 and 38 years of age. Sixteen direct clinical measurements were performed using a graduated anthropometric sliding caliper and angle meter. Photogrammetric measurements were made on digital photographs using a commercially available software package. After calibration to one in situ reference on frontal and profile views, photogrammetric measurements were compared to a total of 14 direct clinical measurements made in the same patients. Findings showed that photogrammetric measurements calibrated to an in situ reference were reliable especially on profile views. No statistical difference was found between 10 of the 14 measurements (P> 0.05) including eight of the nine measurements on profile views and two of the five measurements on frontal views. This study indicates that digital photogrammetry is a useful tool but there is still no reliable standard photographic measurement technique.

Adolescent↗
PubMed2002

[Look and nasal ventilation].

Ophthalmic manifestations of nasal obstruction can involve palpebral, orbital and ophthalmic disturbances. They can be the consequence of: directly with the nasal obstruction because the orbital cavity drains partly in the nasal fossae: rings, lipoptosis, blepharochalasis, fat protrusions, aggravation of exophthalmy in Grave's disease, enophthalmia. Oral breathing: there are modifications in the shape of the palpebral fissure ("round eye") by stretching of the facial mask and modifications of the orbital rims ("sad eye") due to lack of naso-sinusal expansion, often associated to malocclusion, there is a biomechanical correlation between the dental occlusion and the orbital area because of the presence of the maxillary sinus. Every occlusal disorder have an influence on projections of the supra and infraorbital rims.

Adult↗
PubMed2002

Osteomalacia cured by surgery.

Oncogenic osteomalacia is an uncommon syndrome characterized by bone pain, proximal muscle weakness, hypophosphatemia, hyperphosphaturia, and a low concentration of 1,25-dihydroxyvitamin D. This syndrome is induced by a tumor, usually benign, of mesenchymal origin and resolves after its excision. We report a case of an oncogenic osteomalacia caused by a small mesenchymal tumor of the tendon sheath of the foot, a localized form of tenosynovial giant cell tumor.

Journal Article↗
PubMed2002

[Nasal injuries during labor and in early childhood. Etiopathogenesis, consequences and therapeutic options].

Childhood and perinatal nasal traumatisms involve an anterior septal deviation or an anterior septal lysis. These complications induce a soft nasal tip. Nasal obstruction et oral ventilation are responsible for the development of facial and occlusal sequelae. A better knowledge of anatomy and physiopathology of nasal traumatisms is needed for an earlier treatment.

Birth Injuries↗
PubMed2002

[Craniofacial anthropometric patterns in genetic facial dysmorphism: methodology and applications].

Craniofacial anthropometric has become an important tool in medical genetics. The method is simple, non-invasive, reliable, and inexpensive. To provide reliable measurements, the method must be conducted with a precise procedure by a trained physician. Anthropometric determination of craniofacial morphology is helpful in identifying and describing syndromes associated with classical techniques. Additional studies may involve new approaches to facial morphogenesis.

Adult↗
PubMed2002

[Ophthalmic manifestations of masticulatory system dysfunctions].

Temporomandibular joint dysfunctions may involve ophthalmic symptoms such as orbital pain, asthenopia, or anisocoria. These ophthalmic manifestations may be the first signs or the complications of masticatory system dysfunctions. Treatment of these ophthalmic symptoms begins with treatment of the temporomandibular joint dysfunctions.

Eye Diseases↗
PubMed2001

[Mayer-Rokitansky-Kuster-Hauser syndrome: associated pathologies].

UNLABELLED: MRKH syndrome (Mullerian structures agenesis in woman) is often associated with other anomalies: kidney and bone anomalies, deafness, ovarian tumors. Functional ovarian anomalies have not been previously reported. CASE REPORTS: Five new cases of MRKH syndrome are reported. They were associated with deafness in two cases, with kidney anomaly in three cases, vertebral anomalies in one case, and four suffered from obesity and ovarian dysfunction (ovarian polycystics syndrome, advanced puberty, androgenic excess). All of them had ovarian ectopy, which was responsible for false ultrasonographic diagnosis. CONCLUSION: An MRKH syndrome diagnosis implicates a search for other anomalies. Ovarian functional trouble should not let MRKH syndrome remain unrecognized.

Abnormalities, Multiple↗
PubMed2001

"Axial split osteotomy" of free fibular flaps for mandible reconstruction: preliminary results.

Vascularized free flaps are now considered the most appropriate choice for mandible reconstruction because they offer excellent cosmetic and functional results. Various techniques have been proposed. Free fibular flaps have numerous advantages in terms of versatility and contouring. Shaping can be achieved by wedge osteotomy with excellent results. However, this technique leads to bone loss and may be difficult in the later stages of the procedure. The purpose of this report is to describe a simple and safe flap-shaping method involving axial split osteotomy.

Bone Transplantation↗
PubMed2001

[Infectious complications of mandibular osteotomy].

BACKGROUND: Infection is a rare complication after orthognathic surgery. A rate of 1% to 15% has been reported in the literature. We reviewed our experience. MATERIAL AND METHODS: We reviewed retrospectively 60 mandibular osteotomies performed between 1998 and 1999. There were 41 women and 19 men, mean age 24 years. All were given antibiotic therapy using cefamandol 1500 mg preoperatively then 750 mg every 6 hours peroperatively and cefixime 400 mg/d postoperatively for 7 days. Patients were followed for at least 6 months after surgery. RESULTS: There were 10 infections (16% of the cases) involving a hematoma in 2 cases, adenitis in 1, osteitis on a cortical fragment in 2 and osteitis on implanted material in 5. DISCUSSION: We defined infection following orthognathic surgery as a collection or purulent fistula with either a high polynuclear count in the discharge fluid or a positive culture. Both soft tissue (for example infection of a perimandibular hematoma) or bone infections were equally considered. We found two types of risk factors: patient-related or procedure-related. Patient-related factors included smoking, paradontal status, and dental hygiene. The main procedure-related factor was duration of surgery. Measures of prevention include extraction of the wisdom teeth, interruption of smoking, preoperative scaling and careful dental care, rigorous operative technique, antibiotic therapy.

Adolescent↗
PubMed2001

[Complications of genioplasty].

Genioplasty is one of the safest interventions in orthognathic surgery. We reviewed a series of 200 cases of genioplasty with or without other osteotomies and found 6 complications. We compared our findings with the rare data reported in the literature. We were able to distinguish: peroperative complications: atypical osteotomy, hemorrhage, soft tissue damage, injury to the mental nerve; postoperative complications: neurosensory deficits, hematoma, infection, secondary displacement, bone necrosis, mental ptosis, defective ossification, dental lesions, paradontal lesions, irregular mandibular contours. We present a discussion on means of prevention and treatment of these complications following genioplasty.

Blood Loss, Surgical↗
PubMed2000

Microstructure of Cu(x)Mo6S8 Chevrel phase thin films on R-plane sapphire

Cu(x)Mo6S8 Chevrel phase thin films epitaxially grown on R-plane sapphire substrates have been studied using field emission scanning electron microscopy (FE-SEM) and high-resolution transmission electron microscopy (HREM). For samples grown in optimal conditions, the SEM images evidence oriented grains of about 100 nm average size; the HREM images of cross-section samples allow to deduce the local epitaxial relations between the substrates and films. HREM also evidences two grain families, previously deduced from X-ray and reflection high-energy electron diffraction studies. No defects have been observed in the films; a higher molybdenum content in the films results in Mo-precipitation at the film-substrate interface.

Journal Article↗