[Case No. 4. Ossifying fibroma of the ethmoid].
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Adult↗
Biomedical subjects
P Yapo
Publications and source records attributed to P Yapo.
[Case No. 5. Bilharziasis of the brain stem].
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Adult↗
[Case No. 6. Primary abscess of the right psoas-iliac compartment caused by Proteus mirabilis in a female patient with NF1].
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Aged↗
[Value of perineal sonography for diagnosing anterior urethral stenosis].
OBJECTIVES: To determine the value of perineal sonography in the diagnosis of urethral stenosis and evaluation of surrounding fibrosis. Materials and methods. Fifty-eight healthy subjects underwent urethral sonography. Thirty-two patients with suspected urethral stenosis underwent sonography after retrograde distension of the urethra using normal saline and retrograde urethrogram and voiding cystourethrogram. RESULTS: The mean diameters of the healthy urethra varied from 11 to 15 mm. The mean thickness of normal periurethral tIssue was between 2 and 4mm. Sonography detected 34 stenoses (97.4%). The length of the stenosis was significantly longer at sonography compared to retrograde urethrogram and voiding cystourethrogram. No significant difference was found between both techniques when measuring urethral diameter. In all cases, the thickness of periurethral tIssues was greater at the stenotic level than at a normal level, irrespective of the involved segment. There was no correlation between the thickness of periurethral tIssues and the degree of stenosis. CONCLUSION: Urethral sonography is a method that permits diagnosis of urethral stenosis and evaluation of periurethral fibrosis. It may replace retrograde urethrogram and voiding cystourethrogram in the diagnosis of post infectious stenosis.
Adult↗
[Deep cerebral venous thrombosis].
Deep cerebral venous system thrombosis is uncommon and is usually encountered in children, generally in the neonatal period. In adults, this pathology is even more exceptional. We report two cases in adults. Deep cerebral venous system thrombosis mainly affects women taking oral contraception. The most common clinical pattern combines headaches and confusion. A comatose state is rather exceptional. This pathology, formerly considered to have poor prognosis, has benefited from diagnostic and therapeutic progress. Favorable outcome has been achieved in several recent cases, as one of ours, without after-effects. Diagnosis, often suggested by the CT-scan, is based on MRI associated with MRA. Thrombus formation is easily diagnosed by MRI at the subacute stage, but far less easily at the acute and chronic stages as the low signal is identical to the normal flow void. MRA, in phase contrast or time of flight sequences, is highly interesting at the acute phase. In case of doubt, an angiography can be applied. Therapy is based on heparin. The contribution of local infusion of thrombolytic agents, recently used with success, remains to be determined.
Adult↗
[MRI and computer-assisted tomography in Kufs disease. Apropos of a familial form].
Kufs disease is the adult form of ceroid neurolipofuscinosis, and an uncommon cause of degenerative nervous system disease affecting young adults. We present here 4 cases of family form revealed by a demential syndrome. In all 4 patients MRI showed diffuse cortical atrophy predominant in the parietal regions. In 3 of these 4 patients MRI also exhibited a low signal in T2-weighted sequences on the putamens. There was no abnormality of the white matter. Diagnosis was made by cerebral biopsy in one case and by rectal biopsy in all other cases. Although the MRI images are not specific, they must be used when the diagnosis of Kufs disease is suspected in young patients with demential syndrome.
Adult↗
[Primary intramedullary melanoma. Apropos of a case].
Primary melanoma is a rare spinal tumour first reported by Hirschberg in 1906. Since then, only 34 cases have been reported. When present here a new case of primary intramedullary thoracic melanoma developed in a 64-year old male patient. MRI showed a paramagnetic signal with reactive cysts. Macroscopy and histology confirmed the diagnosis. Spinal cord melanoma is presumed to be primary when no other melanoma is found outside the CNS. The tumour is often located in the middle or lower thoracic cord, may be intra- or extra-medullary and leptomeningeal or extradural. It frequently progresses slowly. MRI is the essential examination as it demonstrates a lesion with paramagnetic properties. Its image is not specific and may correspond to other pigmented tumours (meningeal melanocytoma, melanotic schwannoma), to a lipoma or to a vascular or tumoral haemorrhagic lesion. Treatment is uncertain, but surgery is frequently associated with radiation. Postoperative follow-up aims at detecting a local regrowth of the tumour or leptomeningeal dissemination which affects the prognosis.
Diagnosis, Differential↗
[Use of a stimulated echo sequence in the MRI study of the brain and spine].
We describe in this paper how the STEAM sequence can be an efficient tool to obtain images free of flow artifacts in anatomical situation where the spin echo failed. The simplest way to eliminate flow artifacts is to exploit the dephasing induced by motion in magnetic field gradients and to reduce to zero the signal from moving tissues. This can be achieve by increasing the time elapsed between the spin excitation and the signal observed. Because of T2 relaxation, such an increase results in a signal decrease when the spin echo sequence is used. The STEAM sequence has the unique property that the time elapsed between observation and excitation can be increased without change in T2 value and so allows a good suppression of signals from the moving spins with short TE. Our results demonstrate that, although the stimulated echo intensity is only half that of a spin echo taken at the same read out time, the advantages of STEAM imaging can compensate for this partial loss in signal to noise in some particular clinical situations. The influence of mixing time on contrast has been evaluated using thoracic spine imaging and it has been shown that contrast between spine and CSF can be significantly improved (+ 60%) when TM is increased (from 17 ms to 50 ms). In the same time, the contrast between spine and fat issue decreases (40%). This last effect facilitates the adjustment of contrast window. Suppression of motion artifacts has first been evaluated with thoracic spine imaging, using a whole body coil. Suppression of artifacts was better than that obtained with a flow compensated spin echo sequence, especially in the case of kyphotic patients when a presaturation band was inefficient. In a second step suppression of motion artifacts has been evaluated from posterior fossa examination after injection of a paramagnetic contrast agent. The images obtained with the stimulated echo sequence show a dramatic reduction of signal from blood in the lateral sinus, and therefore an increase of quality by elimination of motion artifacts.
Adipose Tissue↗
[Treatment of Buruli's ulcers by excision-graft].
Buruli's ulcer is a real disease of public health. In Ivory Coast, 50 patients were treated from February 1987 to August 1991. It realizes a real destruction of skin and subcutaneous tissues. The germ is Mycobacterium ulcerans. The preferential localisation is the limbs in children of 14 years old. Large ulcer with polycyclic margin are treated by extended excision and thin skin grafts. But deformities persist after the surgical treatment. Hospitalisation is long and drugs are expensive.
Adolescent↗
[Ileo-sigmoid knot. 16 cases].
A retrospective study of 16 cases of ileo sigmoid knot, treated at Treichville Hospital in Abidjan Côte-d'Ivoire, is reported by the authors between 1970 and 1989. This pathology is not so seldom and concerned 14 men and 2 women from 14 years old to 61 years old with an average of 42 years. The more precise description of the physiopathology of this occlusion allows to classify this pathology as an independent entity from the other types of volvulus. The physiopathologic knowledge described allow a more precise diagnostic approach and a better codified therapeutic attitude.
Adolescent↗
[Pheochromocytoma in black Africa. Report of 9 cases].
Pheochromocytoma exists in black African countries with the same frequency observed in other places. The characteristics of our series of nine patients are the followings: an average age of 19, 6 years old, a sex-ratio of 1, 25, a paroxysmal high blood pressure for six patients, no MEN neither malignant tumors, the measures of V.M.A. done positively eight times, a retropneumoperitoneum scan, seven arteriographies, three echographies which were consistently positive, one death post surgery by collapsus consecutive to tumor excision, only one contralateral recurrence and positive followings in all other cases.
Adrenal Gland Neoplasms↗
[Sequela of hand burns in children: 32 cases followed and treated in the Plastic Surgery and Reconstruction department of the University Hospital Center of Treichville, Abidjan].
An investigation on the effects of hand burns has been undertaken about 32 children admitted in the plastic surgery outpatients Department. Accident occurs among the lower class population and heat is the major factor pointed out. The most frequent effects are hand palmar contracture. The surgical treatment completed with the functional re-education has given very good results in 79% cases. However the cheloid contractures are the most difficult to cure. Indeed the authors insist or the prevention and the creation of a center of burned patients and a plastic surgery Service to take care of patients whose life prognostic is optimistic.
Adolescent↗
[Skin expansion in plastic surgery. (University Hospital Center of Treichville-Abidjan)].
The skin expansion by inflatable prosthesis is a recent method to resolve insufficient tissue a short series of 7 cases. But the authors think that despite these inconveniences this technique needs to be largely diffused and used judiciously.
Adolescent↗
[Dupuytren's contracture: review of the literature. Case report of a black African].
In one case of Dupuytren's contracture the authors make an important literature review. The affection is rare with the black man but frequent in caucasian population. Its origin is therefore european. They point out alcoholism and microtrauma due to the patient's antecedents and job.
Black or African American↗
[Intra-keloid excision and deferred corticoid infiltration in the treatment of keloids. University Hospital Center of Treichville-Abidjan].
On a series of 38 keloid surgery patients the authors noted a strong female predominance and the frequency of ear lobule keloid. After some rather unsuccessful excision-suture of the keloid they recommend the intra- keloid excision to be followed by a late corticoid infiltration but deferred until the 15th day. The results obtained were encouraging but some researches have to be made with regard to the etiology of this affection which might probably resolve the therapeutic problem.
Adolescent↗
[Semilunar dislocations. A report of 8 cases. (Orthopedic service-University Hospital Center of Treichville-Abidjan)].
The authors have underlined in a study made on 8 observations that the lunate dislocation is scar. All their patients were men under 40 years old. Industrial injury was the most dominant cause. Using WITVOET and ALLIEU's classification, they noticed a predominance of perilunar and posterior dislocations (7/8 cases). Perilunar anterior dislocations and isolated scaphoid carpal dislocation have not been encountered. The treatment which has been orthopaedic or surgical has given moderate results: Good results = 4; Average result = 1; Bad results = 2; Non seen to again = 1 The authors think that a precocious diagnosis and an orthopaedic treatment in the forms detected early and surgical treatment in ancient forms are the only guarantee of a good functional result avoiding dread diseases such as carpal instability, radiocarpal arthrosis.
Adult↗