Treatment of atheromatous renal artery in-stent restenosis in 51 patients.

OBJECTIVE: To evaluate our treatment of renal artery in-stent restenosis. PATIENTS AND METHODS: Monocentric retrospective study of 53 cases of restenosis and two occlusions in 51 patients detected via systematic follow-up with imaging (72.5%) and/or deterioration of kidney function (5.9%) and/or blood pressure failure (54.9%), 15.7 months (5-121) after implantation, giving rise to 49 recalibrations via a balloon and five additional stentings. Analysis of the technical results, the effects on blood pressure and kidney function after repeated revascularizations. RESULTS: Secondary permeability of 38 arteries (63.2%) after 12.4 months (3-64) with 14 second restenoses; 33.3% after redilation with a balloon, 60% after renewed stenting, more common in smokers (P=0.02), in case of peripheral arterial disease (P=0.02), ostial location (P=0.049) and kidney function impairment at the time of diagnosis of the restenosis (P=0.012). After 12.7 months (3-64) post-revascularization, kidney function was improved in 30% of patients and stabilised in 50% of patients. Treatment of second restenoses: one failure (7.1%), nine dilations with a balloon, three cutting balloon, one second stent. Treatment of third restenoses: 71.4% treated with a balloon (2), cutting balloon (2) or coated stent (DES) (1); then permeability at a later point in time: 50%. CONCLUSION: The treatment of repeated restenoses with conventional techniques is of imperfect efficacy, and currently remains un-codified.

[Congenital absence of the patella: two cases reported]. / Absence congenitale de rotules: à propos de deux cas.

OBJECTIVES: To remind a rare disease, To emphasize the importance of patellar agenesis because it's a calling sign, To insist on the necessity to know child bony growth. MATERIALS AND METHODS: We reported observations of two negro-african children's, one female and one male, who were both 7-years-old. They were referred for troubles of the walk, knee pains for the male, and for the female frequent falls and hypotonia. We have noted previous history of second degree familial consanguinity and paternal grandfather's ungueal anomalies for the female. RESULTS: For the female, examination showed ligamentary hyperlaxity, anterior flattening and lateral dimple of the knee, so varied skeletal defects. Skeletal radiographies displayed absence of the patella, "console like" aspect of the superior tibial metaphysis. At the male, examination is normal. Standard radiographies showed semilunar opacities and tomodensitometry showed presence of a tissular formation who looks like the patella. Aplasia of the patellar apparatus is evocated for the female, even though for the male, the diagnosis of hypoplasia seems more probable. CONCLUSION: Absence of patella is rare. It can be transient and patellar nucleus appears lately. It can be permanent and in this case, it is isolated whether associated with other osseous malformations. Interest of such observations is in its rarity and its functional impact related to the biomechanical importance of the patella.

[Commissural agenesis associated with inter hemispheric cyst]. / Agénesie commisurale associée a un kyste inter hemisphérique.

The Objectives of this study were to Report a rare malformation and to try to understand the embryological origin of such lesion. We reported the case of an eight-month-old female infant, without any particular past medical history, who was refered for seizures and vomiting. The examination revealed normal anthropometric constants, a soft painless and renitent tumefaction of the vertex and a psychomotor delay. Skull x-ray showed a parietal lacuna opposite to an opacity. Ultrasound scan showed an encephalocystocele communicating with dilated ventricles. CT x-ray revealed a single ventricle with an important back and upper extension, which evokes a cystic formation of the centre line. The existence of this cystic formation suppose an agenesis of diencephalic and telencephalic structures notably commissural. Interest of such observation is in its rarity, its complexity, the possibility of its antenatal diagnosis and in the etiopathogenic discussions that she gives rise to.

[Growing skull fracture with cerebral and ventricular hernia after brain trauma]. / Fracture evolutive avec hernie cérébrale et ventriculaire post-traumatique.

Authors report the case of 3 years old boy. He represented a severe head injury with dura mater damage and skull fracture. He has been operated and few years later, he present a vault tumefaction. CT scan show a very large bone defect, a cerebral and ventricular hernia. Mecanism and causal factors are discussed.

[Arachnoid cyst with orbital meningocele: a case report]. / Kyste arachnoidien avec meningocele orbitaire: à propos d'un cas.

Arachnoïd cysts are rare. 1% of cranial neoformation. We report the case of a six years old boy who presented an arachnoid cyst impressive by its compressive phenomena. Present complaint are macrocrania and right orbitary tumor. Tomodensitometry reveal a huge liquid collection which starts from the right cerebellopontine angle to the frontal region and invading the orbital cavity. In addition we have a thalamic fusion Its congenital origin is obvious. The associated malformations seem to be related to an anomaly of the centre line. This case point out the primum movens of malformations which are often complex and whose antenatal diagnosis is rare in our countries

Esthetique bucco-dentaire en milieu traditionnel au Senegal

La forte composante psycho-sociale de l'esthetique de maniere generale a stimule la recherche dans les habitudes socio-culturelles de la sous-region et la motivation esthetique des patients en dentisterie cosmetique. L'esthetique dentaire en milieu traditionnel au Senegal s'exprime a travers des habitudes culturelles et des artifices artisanaux. Cette esthetique exprime aussi le besoin d'embellissement et/ou de procedes magico-religieux. 70 a 80 pour cent de la population est rurale et reste fidele a ses traditions; ses coutumes et ses croyances (canons de beaute; pratiques initiatiques et artifices artisanaux). L'initiation constitue une exigence du groupe; une identification ethnique ou de hierarchie sociale dont l'individu a du mal a se liberer; leurs incidences biologiques et sanitaires sont souvent nefastes et parfois funestes. Le mode de vie citadin elimine de plus en plus la folklorisation de ces pratiques culturelles pour privilegier le confort et l'aseptie. L'odontologiste dispose de la dentisterie cosmetique; avec ses regles esthetiques occidentales; pour repondre aux besoins esthetiques du milieu. En l'informant et le sensibilisant; les praticiens contribueront a atteindre l'un des objectifs de la profession; l'esthetique

Aspects cliniques des parodontites juveniles rencontrees a l'Institut d'Odontologie et de Stomatologie de Dakar

Les parodontites sont des maladies inflammatoires caracterisees par une atteinte de l'os alveolaire; pouvant cependant apparaitre chez les adolescents et jeunes adultes avant l'age de 35 ans

[Clinical use of the Sonic Air MM 1500 and the Meca Sonic 1400 in canal preparation in endodontics]. / De l'utilisation clinique du Sonic Air MM 1500 et du Mecasonic 1400 dans la préparation canalaire en endodontie.

INTRODUCTION: The preparation for canalisation has remained manual for a long time, technically constrictive and lasting for a long time. The application of ultrasound in Endontony allows us to tackle more calmly the canal course of the teath. The aim of this work is to make a qualitative comparison of the endosonic technique and the manual technique with reference to cases treated in the Dentisterie Opératoire clinic in Dakar. MATERIAL AND METHOD: 40 teeth of a complex canal anatomy and or in the posterior position in the buccal cavity were submitted to either a manual canalisation preparation or endosconic followed by monconic canal filling with a paste: 3 inc oxyde eugenol and iodoform. OPERATING FORMULA: Preparatory X rays: Allow us to evaluate the length of the work or the operating length after catheterisation: LO--length PRO, APEX RADIO-IMM LO--operating length PRO - occlusive point of reference The parietal support technique: The "synergetic" effect of ultrasonic oscillations of cavitation and of micro-acoustic currents associated with the action of the irrigation solution allow us to obtain canal incision. INSTRUMENTS: the pneumatic Sonic Air MM 1500; the Meca Sonic MMR 1400 coupled to a standard ISO motor; SHAPERS and Meca Shapers. Activated by shaper or Méca Shaper. Classic monoconic canal filling: Wadding paste + zinc oxyde paste-iodoform eugenol. X rays for orthocentric monitoring. RESULTS--DISCUSSION: In 60% of the cases treated, the patients presented with a complete dentition. The third inferior molar was in almost all the cases, the cause of the patient seeking a dental consultation. By endosonic treatment-conservation of teeth which would otherwise have been destined for extraction; biopulectomy or instituted pulpectomy for cases of desdodontite, endosconic amplication and canal sealing after the cooling of the inflammation. Duration of treatment: 2 sessions for gangrenous cases or desmodondite and one session for biopulpectomy or pulpectomy, with 4 sessions in 10% of the cases. Operation times: Saving of time of 40-50%. If a second session was necessary, 15-20 minutes was sufficient. Incidents or accidents during or after the operation: breakage of instruments, post-operative inflammatory reaction. CONCLUSION: better distribution of the irrigation solution, lessening of the risk of infection, better quality of the state of the canal surface, reduction in operating time, precision and reliability, conservation of teeth which would otherwise have been extracted, as many of the elements which encourages the appreciation of ultrasound in endodonty.