Advantage of vacuum assisted closure on healing of wound associated with omentoplasty after abdominoperineal excision: a case report

<p>Abstract</p> <p>Background</p> <p>Primary closure of the perineum with drainage after abdominoperineal excision of the rectum for carcinoma, is widely accepted. However hematoma, perineal abscess and re-operation are significantly more frequent after primary closure than after packing of the perineal cavity. Those complications are frequently related to the patients' clinical antecedent (i.e radiotherapy, diabetes, smoking).</p> <p>Case presentation</p> <p>In the present report, vacuum assisted drainage was used after abdominoperineal excision for carcinoma in the very first step due to intraoperative gross septic contamination during tumor resection. The first case: A 57-years old man with a 30-years history of peri-anal Crohn's disease, the adenocarcinoma of the lowest part of the rectum and Crohn colitis with multiple area of severe dysplasia required panproctocolectomy with a perineal resection. The VAC system was used during 12 days (changed every 3 days). We observed complete healing 18 days after surgery. The second case: A 51-year-old man, with AIDS. An abdominoperineal resection was performed for recurrence epidermoid anal cancer. The patient was discharged at day 25 and complete healing was achieved 30 days later after surgery.</p> <p>Conclusion</p> <p>The satisfactory results showed in the present report appear to be favored by association of omentoplasty and VAC system. Those findings led us to favor VAC system in the case of pelvic exenteration associated with high risk of infection.</p

Towards a multi-layer architecture for multi-modal rendering of expressive actions

International audienceExpressive content has multiple facets that can be conveyed by music, gesture, actions. Different application scenarios can require different metaphors for expressiveness control. In order to meet the requirements for flexible representation, we propose a multi-layer architecture structured into three main levels of abstraction. At the top (user level) there is a semantic description, which is adapted to specific user requirements and conceptualization. At the other end are low-level features that describe parameters strictly related to the rendering model. In between these two extremes, we propose an intermediate layer that provides a description shared by the various high-level representations on one side, and that can be instantiated to the various low-level rendering models on the other side. In order to provide a common representation of different expressive semantics and different modalities, we propose a physically-inspired description specifically suited for expressive actions

Therapeutic Anticoagulant Does not Modify Thromboses Rate Vein after Venous Reconstruction Following Pancreaticoduodenectomy

Recommendations for anticoagulation following major venous reconstruction for pancreatic adenocarcinoma (PA) are not clearly established. The aim of our study was to find out the relation between postoperative anticoagulant treatment and thrombosis rate after portal venous resection. Materials and methods. Between 1986 and 2006, twenty seven portal vein resections were performed associated with pancreaticoduodenectomies (n = 27) (PD).We defined four types of venous resection: type I was performed 1 cm above the confluent of the superior mesenteric vein (SMV) (n = 12); type II lateral resection and venorrhaphy at the level of the confluent SMV (n = 12); type III (n = 1) resulted from a primary end-to-end anastomosis above confluent and PTFE graph was used for reconstruction for type IV (n = 2). Curative anticoagulant treatment was always indicated after type IV (n = 2) resection, and after resection of type II when the length of venous resection was longer than ≥2 cm. Results. Venous thrombosis rate reached: 0%, 41%, and 100% for type I, II, IV resections, respectively. Among them four patients received curative anticoagulant treatment. Conclusion. After a portal vein resection was achieved in the course of a PD, curative postoperative anticoagulation does not prevent efficiently the onset of thrombosis

A GWAS in Latin Americans identifies novel face shape loci, implicating VPS13B and a Denisovan introgressed region in facial variation

To characterize the genetic basis of facial features in Latin Americans, we performed a genome-wide association study (GWAS) of more than 6000 individuals using 59 landmark-based measurements from two-dimensional profile photographs and ~9,000,000 genotyped or imputed single-nucleotide polymorphisms. We detected significant association of 32 traits with at least 1 (and up to 6) of 32 different genomic regions, more than doubling the number of robustly associated face morphology loci reported until now (from 11 to 23). These GWAS hits are strongly enriched in regulatory sequences active specifically during craniofacial development. The associated region in 1p12 includes a tract of archaic adaptive introgression, with a Denisovan haplotype common in Native Americans affecting particularly lip thickness. Among the nine previously unidentified face morphology loci we identified is the VPS13B gene region, and we show that variants in this region also affect midfacial morphology in mice

ANATOMICAL STUDY OF THE INFRAPATELLAR BRANCH OF THE SAPHENOUS NERVE USING ULTRASONOGRAPHY

International audienceIntroduction: The purpose of this study was to determine whether ultrasonography allows precise assessment of the course and relations of the infrapatellar branch of the saphenous nerve. Methods: This work, initially undertaken in 5 cadavers, was followed by high-resolution ultrasonographic study in 10 healthy volunteers. The location and relations of the infrapatellar branch of the saphenous nerve to the adjacent anatomical structures were analyzed. The course of the nerve was classified according to its relation to the sartorius muscle as posterior or penetrating. Results: The infrapatellar branch of the saphenous nerve could be identified consistently along the majority of its course by ultrasonography. Useful landmarks for the detection of the nerve could be defined. Some anatomical variations were noted. Conclusions: The infrapatellar branch of the saphenous nerve can be depicted by ultrasonography. Precise mapping of its anatomical course may have significant clinical applications. Muscle Nerve 44: 50-54, 201

Anatomical study of the infrapatellar branch of the saphenous nerve using ultrasonography.

peer reviewed[en] INTRODUCTION: The purpose of this study was to determine whether ultrasonography allows precise assessment of the course and relations of the infrapatellar branch of the saphenous nerve. METHODS: This work, initially undertaken in 5 cadavers, was followed by high-resolution ultrasonographic study in 10 healthy volunteers. The location and relations of the infrapatellar branch of the saphenous nerve to the adjacent anatomical structures were analyzed. The course of the nerve was classified according to its relation to the sartorius muscle as posterior or penetrating. RESULTS: The infrapatellar branch of the saphenous nerve could be identified consistently along the majority of its course by ultrasonography. Useful landmarks for the detection of the nerve could be defined. Some anatomical variations were noted. CONCLUSIONS: The infrapatellar branch of the saphenous nerve can be depicted by ultrasonography. Precise mapping of its anatomical course may have significant clinical applications

Livre de musique pour l'orgue

Modern notation. --- Biographical sketch (p.vii-xvii) by A. Pirro

A new lateral approach to the parasacral sciatic nerve block: an anatomical study

International audienceSciatic nerve block is a commonly used technique for providing anesthesia and analgesia to the lower extremity. At the parasacral level, the nerve block is classically performed via a posterior approach in lateral decubitus position causing patient's discomfort. Therefore, we aimed to conduct an anatomical study describing a new lateral approach to the parasacral sciatic nerve in supine position. The skin entry point was located on the vertical line through the greater trochanter (GT) at the midpoint between the anterior superior iliac spine (ASIS) level and the GT. The angle to the skin was 10A degrees dorsally oriented. According to these palpable anatomical landmarks, the parasacral lateral approach was simulated bilaterally in four cadavers in supine position. Anatomical dissection allowed assessment of the needle tip position with regard to the sciatic nerve. Then, to refine the anatomical description of this new lateral approach, 40 pelvic computer tomography (CT) examinations were retrospectively selected and post-processed to bilaterally simulate the needle route to the sciatic nerve. The skin-nerve distance, the optimal angle to the skin, and the sciatic nerve anteroposterior diameter at parasacral and ischial tuberosity levels, respectively were recorded by two independent readers. Cadaver dissection showed that the needle tip was placed in the vicinity of the sciatic nerve in 8/8 cases. Then, CT-simulated lateral approach demonstrated a mean skin-nerve distance of 128 mm (81-173), and a 12A degrees dorsally oriented (5-22) optimal angle to the skin. The sciatic nerve anteroposterior diameter was 10 mm (7-15) at the parasacral level, and 7 mm (5-10) more caudally at the ischial tuberosity level. No significant intra- or inter-observer variability was observed. This study describes a new lateral approach to the parasacral sciatic nerve block in supine position. These anatomical results should be confirmed by further clinical studies

Livre de musique (1685)

xxi, 217 p., facsim., 34 cm. Commentary in French by Andre Pirro and Alex. Guilmant

L'évaluation automatique des déplacements et des déformations des organes pelviens est faisable et reproductible.

National audienceno abstrac