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Friedrich G.,Medical University of Graz | Dikkers F.G.,University of Groningen | Arens C.,Otto Von Guericke University of Magdeburg | Remacle M.,Leuven University Hospital of Mont Godinne | And 6 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2013

Scarring of the vocal folds leads to a deterioration of the highly complex micro-structure with consecutively impaired vibratory pattern and glottic insufficiency. The resulting dysphonia is predominantly characterized by a reduced vocal capacity. Despite the considerable progress in understanding of the underlying pathophysiology, the treatment of scarred vocal folds is still an unresolved chapter in laryngology and phonosurgery. Essential for a successful treatment is an individual, multi-dimensional concept that comprises the whole armamentarium of surgical and non-surgical (i.p. voice therapy) modalities. An ideal approach would be to soften the scar, because the reduced pliability and consequently the increased vibratory rigidity impede the easiness of vibration. The chosen phonosurgical method is determined by the main clinical feature: Medialization techniques for the treatment of glottic gap, or epithelium freeing techniques for improvement of vibration characteristics often combined with injection augmentation or implantation. In severe cases, buccal mucosa grafting can be an option. New developments, include treatment with anxiolytic lasers, laser technology with ultrafine excision/ablation properties avoiding coagulation (Picosecond infrared laser, PIRL), or techniques of tissue engineering. However, despite the promising results by in vitro experiments, animal studies and first clinical trials, the step into clinical routine application has yet to be taken. © 2013 Springer-Verlag Berlin Heidelberg. Source

Goudet P.,Center Hospitalier University | Goudet P.,University of Burgundy | Murat A.,University of Nantes | Binquet C.,French Institute of Health and Medical Research | And 12 more authors.
World Journal of Surgery | Year: 2010

Background: The natural history of multiple endocrine neoplasia type 1 (MEN1) is known through single-institution or single-family studies. We aimed to analyze the risk factors and causes of death in a large cohort of MEN1 patients. Methods: Overall, 758 symptomatic MEN1 patients were identified through the GTE network (Groupe d'étude des Tumeurs Endocrines), which involves French and Belgian genetics laboratories responsible for MEN1 diagnosis and 80 clinical reference centers. The causes of death were analyzed. A frailty model, including time-dependent variables, was used to assess the impact of each clinical lesion, except for hyperparathyroidism, on survival. Results: The median follow-up was 6.3 years. Female gender, family history of MEN1, and recent diagnosis were associated with a lower risk of death. Compared with nonaffected patients, those with thymic tumors (hazard ratio [HR] = 4.64, 95% CI = 1.73-12.41), glucagonomas-vipomas-somatostatinomas (HR = 4.29, 95% CI = 1.54-11.93), nonfunctioning pancreatic tumors (HR = 3.43, 95% CI = 1.71-6.88), and gastrinoma (HR = 1.89, 95% CI = 1.09-3.25) had a higher risk of death after adjustment for age, gender, and diagnosis period. The increased risk of death among patients with adrenal tumors was not significant, but three patients died from aggressive adrenal tumors. Pituitary tumors, insulinomas, and bronchial tumors did not increase the risk of death. The proportion of MEN1-related deaths decreased from 76.8 to 71.4% after 1990. Conclusions: The prognosis of MEN1 disease has improved since 1980. Thymic tumors and duodenopancreatic tumors, including nonsecreting pancreatic tumors, increased the risk of death. Rare but aggressive adrenal tumors may also cause death. Most deaths were related to MEN1. New recommendations on abdominal and thoracic imaging are required. © 2009 Société Internationale de Chirurgie. Source

Alliez A.,Aix - Marseille University | Gay A.-M.,Aix - Marseille University | Prost C.,Center Hospitalier University La Timone | Legre R.,Aix - Marseille University
Annales de Chirurgie Plastique et Esthetique | Year: 2013

The persistent sciatic artery is a rare cause of painful buttock mass with L5-S1radicular signs. A 56-year-old man presents a right painful buttock mass with L5-S1radicular symptoms for 3years. The surgical exploration found a pulsatile vascular mass like a persistent sciatic artery aneurysm. This vascular pathology is a misunderstood embryogenesis anomaly. The treatment aims to avoid serious complications. This pathology must be known from plastic surgeon. © 2013 Elsevier Masson SAS. Source

Hascoet S.,Toulouse University Hospital Center | Fraisse A.,Center Hospitalier University La Timone | Elbaz M.,Toulouse University Hospital Center
Catheterization and Cardiovascular Interventions | Year: 2013

Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a deflectable catheter delivery system in a patient with a PFO, recurrent stroke, and an inferior vena cava filter. Copyright © 2013 Wiley Periodicals, Inc. Source

Jean Vague (1911-2003) was an outstanding medical scientist living in Marseilles, France. He has deeply influenced the researches on obesity during the last decades. He firstly described the two morphotypes associated with obesity ( android/abdominal , and gynoid/gluteal ). He had the judicious intuition that metabolic and cardiovascular complications of obesity were only linked to the android/abdominal phenotype. Therefore, he must be considered as the founding father of the metabolic syndrome. © 2015-Elsevier Masson SAS-Tous droits reserves. Source

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