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Biomedical subjects

R Caron

Publications and source records attributed to R Caron.

14 recordsLinked to original sources

Mast cell involvement in fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is a catastrophic genetic disorder of progressive heterotopic ossification associated with dysregulated production of bone morphogenetic protein 4 (BMP4), a potent osteogenic morphogen. Postnatal heterotopic ossification in FOP is often heralded by hectic episodes of severe post-traumatic connective tissue swelling and intramuscular edema, followed by an intense and highly angiogenic fibroproliferative mass. The abrupt appearance, intense size, and rapid intrafascial spread of the edematous preosseous fibroproliferative lesions implicate a dysregulated wound response mechanism and suggest that cells and mediators involved in inflammation and tissue repair may be conscripted in the growth and progression of FOP lesions. The central and coordinate role of inflammatory mast cells and their mediators in tissue edema, wound repair, fibrogenesis, angiogenesis, and tumor invasion prompted us to investigate the potential involvement of mast cells in the pathology of FOP lesions. We show that inflammatory mast cells are present at every stage of the development of FOP lesions and are most pronounced at the highly vascular fibroproliferative stage. Mast cell density at the periphery of FOP lesional tissue is 40- to 150-fold greater than in normal control skeletal muscle or in uninvolved skeletal muscle from FOP patients and 10- to 40-fold greater than in any other inflammatory myopathy examined. These findings document mobilization and activation of inflammatory mast cells in the pathology of FOP lesions and provide a novel and previously unrecognized target for pharmacologic intervention in this extremely disabling disease.

Cell Count↗

[Percutaneous drainage of abdominal abscess. A clinical case and issues of operative ultrasonography in urology].

Percutaneous drainage of intrabdominal abscesses currently is a well established technique. The use of ultrasound, ever more frequently utilized in urology department, made urologists autonomous in ultrasound diagnosis and operative stage. We report on a patient admitted to emergency department in whom acute prostatitis was diagnosed. Urological consultation was obtained. The ultrasound examination performed, permitted to reveal the real syntomatology origin and to make an evaluation about the possible application of ultrasound in diagnosis and treatment of abdominal abscesses. This was also an occasion to re-examine some not urological ultrasound cases and their treatment. We believe that, also for the urologists, morphological knowledge of most frequent abdominal pathologies, visible by ultrasound, is useful to avoid diagnostic mistakes and useless and hazardous treatments. In our experience we confirm that percutaneous and non invasive techniques, if well utilized, have a good cost/benefit ratio. The percutaneous treatment is also useful to convert an urgent surgical operation into a well established and programmed one.

Abdominal Abscess↗

[Clear cell renal carcinoma metastatic to the thyroid. A case report].

A case of clear cell renal carcinoma metastatic to the thyroid 5 years after surgical removal of the primary tumor is presented. The differential diagnosis related to cyto-histologic findings, the uncommon occurrence and the unpredictable behaviour of clear cell renal carcinoma are discussed.

Adenocarcinoma, Clear Cell↗

Infant sensitivity to deviations in dynamic facial-vocal displays: the role of eye regard.

Do young infants appreciate the intentionality of adult interactors? In view of recent speculation that infants are innately sensitive to eye direction and that communicative intent is conveyed in part by attentional cues, the reactions of 3- and 5-month infants were compared to video episodes of normally responsive women who either appeared or did not appear to make eye contact. Across three experiments, lack of eye contact was achieved by either averting the eyes (E), averting the head and eyes (H&E), closing the eyes (ECL), or averting the head alone (H). Three-month-olds smiled less at H&E, H, and ECL, but not at E, relative to frontal faces, indicating sensitivity to head but not to eye orientation. By contrast, 5-month-olds smiled less at H&E, E, and ECL, but not at H, indicating sensitivity to both head and eye orientation. The implications of the data for mentalist views of infant social behavior are discussed.

Adult↗

[Aneurysm of the iliac artery].

The authors consider isolated iliac artery aneurysms. While the incidence of isolated iliac lesion is, as literature reports, quite low, it rises up to 20% when associated with aortic lesions. The clinical findings are often characterized by effects of compression on the intrapelvic structures, by neurological symptoms and decreased venous flow. Diagnosis is based on ecography, CT and angiography for the definition of side and extension of the aneurysmatic lesion. From the technical point of view, the surgical approach is based on the dimensions of aneurysm and its mono- or bilateral extension. The most common approach in case of bilateral aneurysms or aorto-iliac lesions is transperitoneal, while it's limited to extraperitoneal way, when isolated iliac lesion. If the aneurysm involves the hypogastric artery, mostly when bilateral, the risk of bowel ischemic complications becomes more significative.

Aged↗

[Bilateral thrombosis of a femoral pseudoaneurysm].

One case has been described of acute thrombosis of bilateral femoral anastomotic pseudoaneurysm. The clinical finding of bilateral acute ischemia of the lower limbs required urgent surgical treatment. The operative technique consisted of excision of anastomotic aneurysms and replacement by a new segment of prosthesis with an end-to-end anastomosis to the deep femoral artery. Pathogenesis of the pseudoaneurysms at the femoral anastomosis generally recognized numerous factors such as mechanical, graft or suture defects, hypertension, wound complications. Recognition of femoral anastomotic aneurysms is usually simple, when a pulsative mass is noted. In such a case (reported) of thrombosis of bilateral femoral pseudoaneurysms, preoperative diagnosis was more difficult. Anastomotic aneurysms of little size that occur later after original intervention require observation by echography and angiodinography. When rapid enlargement arises, urgent surgical treatment is required, before rupture or thrombosis. The surgical intervention consists of excision of the anastomotic aneurysm and replacement by a new segment of prosthesis between the prosthesis and the common or deep femoral artery. If the reconstruction at the level of femoral artery is not possible, the anastomosis is performed more distally, at the level of popliteal artery. The results are affected by the degree of urgency of surgery, with significant difference in favour of the patients Who underwent elective procedures.

Anastomosis, Surgical↗

[Emergency surgery in patients over eighty].

The authors describe a series of 139 over-eighty patients (M = 53, F = 86), who underwent emergency surgery between 1-1-1987 and 30-6-1993. They consider diagnosis, copathology, type of surgical procedures, postoperative complications and final results. In this series they study 73 large bowel obstruction and 48 peritonitis. They notice important copathologies in 78% of patients, in particular cardiovascular diseases. They performed 74 mayor surgical procedures with 48% of postoperative complications and exitus in 24% of cases, due overall to exacerbation of coexisting diseases. The authors underline the direct between mortality rate and number of copathologies, and analyze the basic rules to follow in surgical indications and during the postoperative period.

Age Factors↗

[Prognostic value of postoperative determination of CEA in carcinoma of the large intestine].

The C.E.A. level was routinely determined in the follow up of 133 patients who underwent surgery because of colorectal cancer. Preoperative levels of C.E.A. appear to be related to Dukes staging of the disease. Postoperative values of the marker were higher than normal in 36 patients, 91% of whom had recurrences; normal postoperative values were observed in 90 patients and only 21% of these eventually showed recurrences.

Carcinoembryonic Antigen↗

[Perforated colonic diverticulitis. Surgical technique].

Emergency surgery is required for performed colonic diverticulitis. Surgical indications are not uniform in literature. In the experience of the authors the operations have been performed in the case of peritonitis subsequent to the perforation or in the case of failure of the conservative treatment. Twenty-four patients underwent surgical intervention because of diffuse (17 cases) or localized peritonitis (7 cases). Exitus were related to cardiovascular complications in patients over seventy. Postoperative results are related to the age, the general conditions of the patient and to the intraoperative finding, of localized or generalized peritonitis. Operations may be divided into two groups: conservative procedures or primary resections. In the first one it is possible to suture the colonic wall without resection; in the second one the intraoperative finding or the extensive necrotic lesions indicates colonic resection or exteriorization. The surgical treatment adopted is correlated both to the age and cardiorespiratory conditions and to the other associated diseases.

Adult↗

[Colorectal pathology: an analysis and comparison between patients of different ages].

The increasing incidence of large bowel diseases observed in the last years is age-related. The authors have analyzed 366 patients who underwent surgery for colorectal pathology, divided in two groups (> or < 65 years) considering sex, diagnosis, type of clinical presentation, incidence and type of associated pathology, and post-operative complications. The analysis of the series revealed that type of clinical presentation, surgical patterns, post-operative infections were the same in the two groups, as reported in the literature. The substantial differences were only due to the different incidence of colo-rectal pathology, associated pathology and cardiovascular complications, factors that become characteristic of the elderly patients.

Age Factors↗