Long-term pollution by chlordecone of tropical volcanic soils in the French West Indies: a simple leaching model accounts for current residue.

Chlordecone was applied between 1972 and 1993 in banana fields of the French West Indies. This resulted in long-term pollution of soils and contamination of waters, aquatic biota, and crops. To assess pollution level and duration according to soil type, WISORCH, a leaching model based on first-order desorption kinetics, was developed and run. Its input parameters are soil organic carbon content (SOC) and SOC/water partitioning coefficient (K(oc)). It accounts for current chlordecone soil contents and drainage water concentrations. The model was valid for andosol, which indicates that neither physico-chemical nor microbial degradation occurred. Dilution by previous deep tillages makes soil scrapping unrealistic. Lixiviation appeared the main way to reduce pollution. Besides the SOC and rainfall increases, K(oc) increased from nitisol to ferralsol and then andosol while lixiviation efficiency decreased. Consequently, pollution is bound to last for several decades for nitisol, centuries for ferralsol, and half a millennium for andosol.

[Malignant fibrous histiocytoma of the maxillary sinus. Clinical and therapeutic aspects]. / Histiocytome fibreux malin du sinus maxillaire. Aspects cliniques et thérapeutiques.

Malignant fibrous histiocytomas, or MFH, have been individualized only since the last two decades. These sarcomas which usually develop from soft tissues are no longer considered rare, except in some of their facial sinus localizations. Two chapters will be particularly developed: the paramount significance of anatomopathological investigations owing to the difficulty in establishing the diagnosis, since MFHs may be mistaken for benign processes; the treatment which is, generally speaking, the same as for bone sarcomas.

[Development of treatments and results of mandibular fractures from 1950 to 1978 at the University Center Hospital in Lyon]. / Evolution des traitements et des résultats des fractures mandibulaires entre 1950 et 1978 au CHU de Lyon.

Over the period extending from 1950 to 1978, the treatment of mandibular fractures at the CHU of Lyon followed a dual evolutionary course. On the one hand, fractures of the dental part of the bone were treated more and more often surgically via the endobuccal approach, by osteosynthesis using miniature screwed plates. On the other hand, fractures of the region of the condyle benefited from mechanotherapy according to professor Delaire's technique. These therapeutical trends have led to frank improvement in the outcome of these patients, both from the functional and esthetical points of view.

[Clinical and therapeutic aspects of maxillofacial lesions of Paget's disease]. / Aspects cliniques et thérapeutiques des atteintes maxillo-faciales de la maladie de Paget.

Histopathology of mandibular swellings in two women aged 68 and 73 years respectively provided a diagnosis of Paget's disease. The complementary biological tests (phosphorus-calcium metabolism, alkaline phosphatase, hydroxyprolinuria) performed showed the increase in bone metabolism, while imaging techniques (conventional radiography, scintigraphy, CT scan) demonstrated numerous subclinical bony foci. Treatment of the facial deformity, if desirable esthetically or functionally necessary (alveolitis, osteitis) can only be surgical. If there is biological bone hypermetabolism, medical (diphosphonate, calcitonin) can be discussed with the rheumatologists. Evolutive risks are represented by rare sarcomatous transformations, osteomyelitis on Paget and monstrous deformities of the face, as in one of the patients reported who had refused all treatment over 37 years.

[Cosmetic and functional diagnosis in vertical dysmorphisms of the face]. / Les diagnostics cosmétique et fonctionnel dans les dysmorphoses verticales de la face.

If it is accepted that 68 p. 100 of patients consulting for maxillofacial malformations do so for cosmetic reasons then the facial deformity must be taken into account in a similar manner to the maxillodental dysmorphism. A morphological cosmetic diagnosis must therefore be combined with a skeletal functional diagnosis. Just as teleradiographic techniques (Tweed-Sassouni-Delaire) contribute to the differention of the various types of vertical dysmorphism, photographic analysis procedures (Fomon-Broadbent and Mathews-Baud) are necessary for the study of anterior vertical abnormalities. A global diagnosis (functional and cosmetic) requires evaluation of results of these different examination techniques evaluation of establish the choice of operation responding to the wishes of the patient while respecting the occlusal criteria ensuring durability of results.

[Macroglossia in apparently primary amyloidosis]. / Macroglossie au cours d'une amylose apparemment primitive.

The authors report a case of apparently primary amyloidosis in which macroglossia was the clinical presentation, confirmed by lingual biopsy. They take advantage of this case to review the therapeutic possibilities, though stating that from a stomatological standpoint there is virtually nothing available.

[Chronic maxillofacial suppuration due to unknown plant foreign bodies. Apropos of 2 cases with CT scanning]. / Suppurations maxillo-faciales chroniques par corps étrangers végétaux méconnus. A propos de 2 cas avec scanner.

Common features in two patients with chronic suppurative lesions of the maxillofacial region from vegetable foreign bodies were : foreign body origin of the accident ; chronic nature of the suppuration (7 and 23 months respectively) ; multiple operations by different surgical teams ; radiotransparency of the foreign bodies. Positive signs on CT scanning can confirm the diagnosis, but cannot exclude it when normal images are obtained. The number and localization of wood fragments may limit the value of the scan, and fistulography and xeroradiography may then provide confirmation of the diagnosis. Operative treatment may be difficult due to fragmentation of the wood into multiple pieces, a possible source of recurrence of infection.

[Malignant non-Hodgkin's lymphoma at a dental site. A case report]. / Lymphome malin non hodgkinien à point de départ stomatologique. Un cas.

The authors report on a case of non-Hodgkin type malignant lymphoma in which signs of the disease develop initially in the upper maxilla. The authors were able to observe the patient over a period of 3 years. They used this opportunity, as follows: -to grade the tumour according to the different classification schemata proposed for these tumours, -to attempt to assess the changes and progress in drug therapy for these conditions, while at all times keeping an open mind regarding the value of results obtained in this manner.

[Treatment of mandibular fractures in children. Our therapeutic approach (author's transl)]. / Traitement des fractures mandibulaires chez l'enfant. Notre attitude thérapeutique.

This is a study of 15 fractures of the mandible in children. We were able to make the following conclusions: --the usual causes of these fractures are road traffic accidents or accidents at play, --the fracture is usually single (7 cases) multiple (8 cases) and in 13 children out of 15 there was a fracture of the condyle. --the presence of the first dentition and dental germs posed special problems. The treatment is mainly orthopedic, and the fracture is maintained in place by metallic arches which may or may not be completed with a resin dropper. Condyle fractures are treated classically by functional mechanotherapy. The indications of osteosynthesis seem to be limited to cases of very unstable fractures or where these are comminutive. The treatment of sequelae requires techniques very similar to orthodontic apparatuses.

[Treatment of large mandibular cysts (author's transl)]. / Triatement des grands kystes de la mandibule.

Apart from certain particular types of lesions, the diagnosis of a histologically benign "large mandibular cyst" (paradental cyst, epidermal cyst, ameloblastoma...) should lead to an attempt at conservative treatment: this does not alter mandibular continuity and if possible, the inferior dental neurovascular pedicle, the soft tissues of the buccal lining, and the dental organs. It is finally the gross pathological findings and if necessary the results of an extemporaneous histological examination that will supply the information leading to the choice of the best type of treatment: marsupialization, enucleation, curettage, "pressure curettage", uninterrupting resection. This attitude requires prolonged postoperative radiological supervision and does not exclude the need for an interrupting resection in unfavourable cases at a later date.

[Hereditary enamel dysplasia. Therapeutic approach apropos of 2 cases]. / Dysplasie héréditaire de l'émail. Attitudes thérapeutiques à propos de 2 cas

Two cases of hereditary dysplasia in the same generation of a family are presented. The genetic line is suggestive of a dominant transmission. The therapeutic attitude in each case: --Orthodontic, endodontic and prosthetic rehabilitation in the 1st case. At the patient's strong urging, a total fixed denture was made, which made it possible to correct moderate protrusion of the incisors and to obtain the aesthetic result desired by the patient. This work was carried out in the Stomatological Clinic of Lyon, by students working for their specialty certificate in stomatology. --In the case of the younger sister, the presence of a markde skeletal open-bite and the refusal of any surgical solution led to the total extractions requested by the patient. A mobile denture was made by her own dentist. Thus complete assessment and knowledge of the patient's precise wishes make it possible to adopt the most desirable therapeutic approach in each case.