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1. Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients

Author

Chatelet, Florian, Ferrand, François Régis, Atallah, Sarah, Thariat, Juliette, Mouawad, François, Fakhry, Nicolas, Malard, Olivier, Even, Caroline, de Monès, Erwan, Uro-Coste, Emmanuelle, Benzerdjeb, Nazim, Hans, Stéphane, Testelin, Sylvie, Mauvais, Olivier, Evrard, Diane, Bastit, Vianney, Salas, Sébastien, Espitalier, Florent, Classe, Marion, Digue, Laurence, Doré, Mélanie, Wong, Stéphanie, Dupin, Charles, Nguyen, France, Bettoni, Jeremie, Lapierre, Ariane, Colin, Emilien, Philouze, Pierre, Vergez, Sébastien, Baujat, Bertrand, Herman, Philippe, Verillaud, Benjamin, Constans, Jean-Marc, Coutte, Alexandre, Devauchelle, Bernard, Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de physique corpusculaire de Caen (LPCC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Faculté de Médecine Henri Warembourg - Université de Lille, Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hospices Civils de Lyon (HCL), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Réseau d’Expertise Français sur les Cancers ORL Rares - French Network of Rare Head and Neck Tumors (REFCOR), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Pellegrin, and CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin

Subjects
Salivary gland neoplasms, Cancer Research, Propensity score, Radiotherapy, Oncology, Acinar cell, Acinic cell carcinoma, Carcinoma, Neck dissection, Prognosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background: Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands.Patients and methods: Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS.Results: A total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3-T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16).Conclusions: These results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3-T4 status and/or intermediate/high histological grade.

Published
2023
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2. Use of an occlusal splint and intraoperative imaging with an intraoral approach in the management of mandibular subcondylar fractures

Author

Stéphanie Dakpé, J. Bettoni, J. Bouaoud, Bernard Devauchelle, M. Olivetto, Sylvie Testelin, Michel Lefranc, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Open treatment, [SDV]Life Sciences [q-bio], Mandibular fracture, Intraoperative cone-beam CT, Condyle, Occlusal Splints, Fracture Fixation, Internal, 03 medical and health sciences, Fixation (surgical), 0302 clinical medicine, stomatognathic system, Mandibular Fractures, Mandibular subcondylar fracture, Humans, Medicine, Orthodontics, Osteosynthesis, Dental occlusion, business.industry, Intraoral approach, Mandibular Condyle, Soft tissue, 030206 dentistry, medicine.disease, Open Fracture Reduction, Otorhinolaryngology, 030220 oncology & carcinogenesis, Condylar process fracture, Bite splint, Surgery, Oral Surgery, business
Abstract

International audience; Introduction: To evaluate the feasibility of safely managing subcondylar fractures using an original surgical procedure combining an intraoral approach, the use of a custom-made occlusal overlay splint, and intraoperative imaging.Materials and methods: Condylar fragment was freed from surrounding soft tissues, was laterally exposed to the ramus, and a miniplate was fixed in place for osteosynthesis. An overlay splint maintaining the dental occlusion was used to facilitate reduction and stabilization during fixation. Intraoperative monitoring by cone-beam computed tomography (CBCT) was performed before completing the fixation.Results: Between November 2018 and June 2019, 10 patients were treated using this procedure. The median length of the proximal condylar fragment was 29 mm (range 24-39 min). Five patients had an associated mandibular fracture. The median duration of the condylar fracture surgery was 54.5 min (range 38-79 min). All patients had satisfactory reduction and osteosynthesis with no complications.Conclusion: It is feasible to safely manage subcondylar fractures with this surgical procedure that could facilitate open reduction using intraoral approaches. Occlusal splints maintain downward pressure on the rami bilaterally and symmetrically, helping to anatomically reposition condylar process fractures. Intraoperative imaging is used to monitor this step.

Published
2020
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3. Automatic part segmentation of facial anatomies using geometric deep learning toward a computer-aided facial rehabilitation

Author

Duc-Phong Nguyen, Paul Berg, Bilel Debbabi, Tan-Nhu Nguyen, Vi-Do Tran, Ho-Quang Nguyen, Stéphanie Dakpé, Tien-Tuan Dao, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Observation de l’environnement par imagerie complexe (OBELIX), SIGNAL, IMAGE ET LANGAGE (IRISA-D6), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Ho Chi Minh City University of Technology and Education, Vietnam., Eastern International University, Ho Chi Minh city University of Technology and Education, Institute of Engineering and Technology, Thu Dau Mot University, Binh Duong, Vietnam, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Laboratoire de Mécanique, Multiphysique, Multiéchelle - UMR 9013 (LaMcube), and Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SPI]Engineering Sciences [physics], Artificial Intelligence, Control and Systems Engineering, [SDV]Life Sciences [q-bio], Electrical and Electronic Engineering
Abstract

International audience

Published
2023
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4. Intraosseous microdialysis for bone free flap monitoring in head and neck reconstructive surgery: A prospective pilot study

Author

J. Bettoni, Emilien Colin, Sylvie Testelin, Stéphanie Dakpé, Momar Diouf, Julien Davrou, Bernard Devauchelle, CHU Amiens-Picardie, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Adult, Male, medicine.medical_specialty, Reconstructive surgery, Microdialysis, Adolescent, Osteoradionecrosis, Bone Neoplasms, Pilot Projects, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Free flap, 030230 surgery, Free Tissue Flaps, Iliac crest, Facial Bones, Bone remodeling, Ilium, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pyruvic Acid, medicine, Humans, Lactic Acid, Prospective Studies, Aged, Clinical Article, business.industry, Soft tissue, Middle Aged, Plastic Surgery Procedures, medicine.disease, 3. Good health, Surgery, Catheter, Glucose, medicine.anatomical_structure, Fibula, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Clinical Articles, Female, business
Abstract

International audience; Background: Although some researchers have positioned microdialysis catheters in the soft tissue surrounding bone, the results did not accurately reflect bone metabolism. The present study's objective was to establish the feasibility of microdialysis with a catheter positioned directly in bone.Methods: Thirty‐four patients (19 males, 15 females; median age: 59) were included in a prospective, nonrandomized clinical trial in the Department of Maxillofacial Surgery at Amiens‐Picardie University Hospital (Amiens, France). Fibula or iliac crest free flaps were used in reconstructive head and neck surgery (for cancer, osteoradionecrosis, trauma, or ameloblastoma) and monitored with microdialysis catheters positioned in a hole drilled into the bone. Glucose, lactate, pyruvate, and glycerol concentrations were analyzed for 5 days.Results: All catheters were positioned successfully, and thrombosis did not occur during the monitoring. In two patients, an increase in the lactate concentration and a glucose level close to 0 were associated with signs of flap necrosis, with removal on Days 9 and 50. In viable flaps, the mean glucose level was 2.02 mmol/L, the mean lactate level was 8.36 mmol/L, and the mean lactate/pyruvate ratio was 53. Forty percent of the glucose values were below 1 mmol/L, and 50% of the lactate/pyruvate ratio values were above 50—suggesting a specific metabolic pattern because these values would be considered as alert values in soft tissue.Conclusion: Monitoring bone free flaps with intraosseous microdialysis is feasible. This technique specifically assesses bone viability, and further studies are now necessary to define the alert values in bone.

Published
2019
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5. Characterisazion of bifid, fibrous and fine zygomaticus muscles with ultrasound elastography

Author

Ternifi, R., Pouletaut, P., Charleux, F., Dakpé, Stéphanie, Testelin, Sylvie, Devauchelle, Bernard, Boussida, Salem, Constans, Jean-Marc, Bensamoun, S., Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), FEDER - Hauts de France RegionEquipex Figures, Société de Biomécanique, and Pouletaut, Philippe

Subjects
shear wave elastography, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, facial muscle, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, morphology, major zygomaticus, muscle elasticity, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2020

6. Development of MR Elastography method to characterize the elastic property of the sterno-cleido-mastoid (SCM) muscle

Author

Sabine F. Bensamoun, Redouane Ternifi, A. Hamaoui, Philippe Pouletaut, B. Devauchelle, Jean-Marc Constans, S. Boussida, C. Krzisch, Fabrice Charleux, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département d'oncologie, CHU Amiens, FEDER - Hauts de France RegionEquipex Figures, and Société de Biomécanique

Subjects
Magnetic Resonance Elastography, medicine.medical_specialty, Side effect, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, 0206 medical engineering, Biomedical Engineering, Bioengineering, 02 engineering and technology, Head and neck cancers, 03 medical and health sciences, 0302 clinical medicine, Fibrosis, medicine, Head and neck, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, business.industry, Muscle elasticity, 030229 sport sciences, General Medicine, sterno-cleido-mastoid muscle, muscle elasticity, Muscle stiffness, medicine.disease, 020601 biomedical engineering, 3. Good health, Computer Science Applications, Magnetic resonance elastography, Human-Computer Interaction, Radiation therapy, Radiology, Elastography, business
Abstract

Radiotherapy applied to head and neck cancers causes fibrosis that is a very frequent side effect of this treatment. Fibrosis provides an increase of muscle stiffness, responsible for an impairment...

Published
2020
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7. Management of nasopharyngeal teratomas associated with cleft palate

Author

P. Guerreschi, Hervé Benateau, C. Diakité, S. Dakpé, Alexis Veyssière, P. Galinier, Biotechnologie des tissus conjonctifs et cutanés / Biology of Connective and Cutaneous Tissues (BioConnecT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Institut pour la Recherche sur le Cancer de Lille (U837 INSERM - IRCL), and Institut pour la recherche sur le cancer de Lille [Lille] (IRCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche Jean-Pierre AUBERT - Neurosciences et Cancer -JPArc [Lille]

Subjects
Male, Pediatrics, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Prenatal diagnosis, Velopalatin cleft, Acute respiratory distress, Ultrasonography, Prenatal, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 10. No inequality, Pathological, Retrospective Studies, Respiratory Distress Syndrome, business.industry, Mortality rate, Infant, Newborn, Teratoma, Nasopharyngeal Neoplasms, Retrospective cohort study, 030206 dentistry, University hospital, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Cleft Palate, Respiratory distress at birth, Treatment Outcome, Otorhinolaryngology, 030220 oncology & carcinogenesis, Operative time, Female, Surgery, Teratomas, Oral Surgery, Tomography, X-Ray Computed, business
Abstract

International audience; Nasopharyngeal teratomas are rare tumours, responsible for a high birth mortality rate from acute respiratory distress. Palatine localization can lead to an embryopathogenic mechanical obstacle responsible for a cleft palate. The aim of this study was to update current knowledge concerning the management of this rare pathological association.We conducted a multicentre, retrospective study by case analysis. The inclusion criteria were patients of any age under care for a nasopharyngeal teratoma associated with a velopalatine cleft. The diagnosis of the teratoma was confirmed by histological analysis.Seven cases were included in the study: three cases from the University Hospital of Lille, one from the University Hospital of Caen, one from of the University Hospital of Toulouse, and two from of the University Hospital of Amiens. Approximately 30% of patients experienced acute respiratory distress at birth, necessitating oro- or nasotracheal intubation. The surgical excision was performed in the first 5 months of life for all patients and in a single operative time for 70%. There was no recurrence.Therapeutic management of nasopharyngeal teratomas associated with cleft palate at birth is multidisciplinary and is based on surgical excision. In the absence of other associated pathologies, the prognosis is favourable.

Published
2019
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8. Reduction of morbidity of the revascularization surgery in the management of mandibular osteoradionecrosis by basilar edge preservation

Author

Jérôme Duisit, M. Olivetto, Bernard Devauchelle, J. Bettoni, Stéphanie Dakpé, J. Bouaoud, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Cliniques Universitaires Saint-Luc [Bruxelles], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), UCL - SSS/IREC/MORF - Pôle de Morphologie, and UCL - (SLuc) Service de chirurgie plastique

Subjects
Revascularization surgery, Male, Reconstructive surgery, medicine.medical_specialty, Osteoradionecrosis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Free flap, Mandible, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030223 otorhinolaryngology, Reduction (orthopedic surgery), Retrospective Studies, Osteosynthesis, business.industry, 030206 dentistry, Middle Aged, Plastic Surgery Procedures, medicine.disease, Surgery, Management, Mandibulectomy, Otorhinolaryngology, Female, Oral Surgery, Morbidity, business, Complication, Switzerland
Abstract

Introduction The chronic complications of bone free-flap revascularization surgery are mainly characterized by skin fistulization of the osteosynthesis material, which sometimes leads to reactivation of the osteoradionecrotic phenomenon. The objective of the study is to evaluate the benefit of mandibular basilar edge preservation in bone reconstructive surgery in irradiated areas performed for the treatment of advanced mandibular osteoradionecrosis. Materials and methods A retrospective monocentric study conducted between 2003 and 2018 including all patients undergoing revascularization surgery for the treatment of advanced osteoradionecrotic lesion with respect to the basilar margin was conducted. Results Eight patients (7 males and 1 female, aged 50 to 63 years) who had a marginal mandibulectomy with reconstruction by bone free flap or composite free flap were included. The stability of the reconstruction (junction native mandible/bone free flap) was achieved on average by using 1.75 [range 0–4] mini plates (Medartis® Modus 2.0, Medartis AG, Basel, Switzerland). During the follow-up (30 ± 13 months) no chronic complication related to a dissociation of the osteosynthesis material or a reactivation of the osteoradionecrotic phenomenon were identified. Conclusions Despite the limited number of patients, it seems that the increase in the friction surface between the free flap and the native mandibular bone, linked to the preservation of the basilar edge, improves the primary stability of the reconstruction. This reduction in mechanical stress on osteosynthesis materials limits its use and reduces the rate of chronic complications of bone flap revascularization surgery in irradiated areas.

Published
2020
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9. An asymptomatic palatal tumor

Author

M. Olivetto, J. Bettoni, J. Bouaoud, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
medicine.medical_specialty, Palatal Neoplasms, business.industry, MEDLINE, Asymptomatic, Surgical Flaps, Surgery, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Otorhinolaryngology, 030220 oncology & carcinogenesis, medicine, Humans, Oral Surgery, medicine.symptom, 030223 otorhinolaryngology, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience

Published
2020
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10. Should a neck dissection be performed on patients with cN0 adenoid cystic carcinoma? A REFCOR propensity score matching study

Author

Sylvain Morinière, Christian Righini, Sarah Atallah, Franck Jegoux, Nicolas Fakhry, Esteban Brenet, Bertrand Baujat, Pierre Philouze, Haitham Mirghani, Patrice Gallet, Antoine Moya-Plana, Benjamin Verillaud, Ludovic de Gabory, Philippe Schultz, Vianney Bastit, Gilles Poissonnet, Chloé Bertolus, Nicolas Bon-Mardion, Olivier Malard, Sébastien Vergez, Jérémie Bettoni, Xavier Dufour, Olivier Mauvais, Maria Lesnik, Diane Evrard, Pierre Ransy, Julian Biau, Service d'ORL pédiatrique et Chirurgie Cervico-faciale [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), ORL et Chirurgie cervico-faciale pédiatrique - [Hôpitaux Timone et Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liege, Belgium, Institut de mécanique des fluides de Toulouse (IMFT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d’Otorhino-laryngologie et de chirurgie cervicofaciale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [APHP], Service d'ORL et de Chirurgie cervico-faciale - Hôpital Lyon-Sud, INSERM Unit 708 Hôpital La Salpêtrière, Université Pierre et Marie Curie-Paris, Biomatériaux et Bioingénierie (BB), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et nanosciences d'Alsace, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Université de Strasbourg (UNISTRA), Service ORL et chirurgie cervico-faciale [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), INSERM U823, équipe 5 (cibles diagnostiques ou thérapeutiques et vectorisation de drogues dans le cancer du poumon), Service d'ORL et de chirurgie cervicale, CHU Grenoble-CHU Grenoble-Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-UF cancérologie biologique et biothérapie, CHU Grenoble, LPP - Laboratoire de Phonétique et Phonologie - UMR 7018 (LPP), Université Sorbonne Nouvelle - Paris 3-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche sur le Handicap Ventilatoire (GRHV), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT), CHU Tenon [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-Université Joseph Fourier - Grenoble 1 (UJF)-UF cancérologie biologique et biothérapie, Université de Strasbourg (UNISTRA)-Matériaux et nanosciences d'Alsace (FMNGE), and Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, 0301 basic medicine, Cancer Research, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Gastroenterology, 0302 clinical medicine, Prospective Studies, Prospective cohort study, Lymph node, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Prophylactic Surgical Procedures, Middle Aged, Prognosis, Salivary Gland Neoplasms, Carcinoma, Adenoid Cystic, Treatment Outcome, medicine.anatomical_structure, Oncology, Head and Neck Neoplasms, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, France, Adult, medicine.medical_specialty, Adolescent, Adenoid cystic carcinoma, Matched-Pair Analysis, Neck dissection, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Propensity Score, Survival analysis, Aged, Neoplasm Staging, Salivary gland cancer, business.industry, medicine.disease, Survival Analysis, REFCOR, Confidence interval, 030104 developmental biology, Propensity score matching, Surgery, Lymph Nodes, business
Abstract

Background Patterns of nodal involvement in adenoid cystic carcinoma (ACC) of the head and neck have not been sufficiently assessed to guide a decision of prophylactic neck dissection (ND). The objective of this study is to analyse the influence of ND on event-free survival (EFS) for patients with cN0 ACC. Patients and methods A multicentre prospective study was conducted between 2009 and 2018. Patients presenting cN0 non-metastatic ACC on any site, and who received surgery on the tumour, were included. EFS was the main judgement criterion. A comparative survival analysis between the groups that received a ND versus those that did not was performed, using a propensity score. Analyses were carried out using the R software. Results Between 2009 and 2018, 322 patients with cN0 ACC were included, out of which 58% were female. The average age was 53 years. Tumours were in minor salivary glands in 58% of cases, and 52% had T3/T4 stages. ND was performed on 46% of patients. Out of them, seven had histological lymph node invasion, out of which six had tumour infiltration in the mucosa of oral cavity. After propensity score, the median EFS for N0 patients with ND was 72 months (95% Confidence Interval (CI) [48–81]), compared to 73 months (95% CI [52–85]) for patients without ND (HR = 1.33; 95% CI [0.82–2.16]; p = 0.2). Conclusion ND of cN0 patients does not provide any benefit on EFS, which suggests that its application on such patients is not necessary.

Published
2020
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11. Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France

Author

A. Moya-Plana, A. Aupérin, R. Obongo, A. Baglin, F.R. Ferrand, B. Baujat, N. Saroul, O. Casiraghi, S. Vergez, P. Herman, F. Janot, J. Thariat, B. Vérillaud, L. de Gabory, S. Albert, G. Andry, E. Babin, C. Bach, J.-M. Badet, C. Badoual, A.C. Baglin, A. Banal, B. Barry, E. Baudin, R.J. Bensadoun, C. Bertolus, J.-P. Bessède, D. Blanchard, C. Borel, A. Bozorg-Grayeli, R. Breheret, P. Breton, L. Brugel, G. Calais, E. Cassagnau, L. Castillo, P. Ceruse, F. Chabolle, D. Chevalier, J.C. Chobaut, O. Choussy, A. Cosmidis, A. Coste, V. Costes, L. Crampette, V. Darrouzet, P. Demez, P. Dessi, B. Devauchelle, L. Digue, G. Dolivet, F. Dubrulle, S. Duflo, X. Dufour, C. Even, S. Faivre, N. Fakhry, C. Ferron, F. Floret, R. Garrel, L. Geoffrois, L. Gilain, A. Giovanni, A. Girod, B. Guerrier, S. Hans, P. Hofman, M. Housset, R. Jankowski, F. Jegoux, M. Juliéron, M.-C. Kaminsky, F. Kolb, J. Lacau St Guily, L. Laccoureye, B. Lallemant, P. Lang, E. Lartigau, J.-P. Lavieille, M. Lefevre, X. Leroy, O. Malard, F. Massip, O. Mauvais, J.-C. Merol, J. Michel, T. Mom, S. Morinière, E. de Monès, G. Moulin, G. Noel, G. Poissonnet, J.-M. Prades, D. de Raucourt, E. Reyt, C. Righini, Y. Marie Robin, F. Rolland, B. Ruhin, N. Sarroul, P. Schultz, E. Serrano, O. Sterkers, V. Strunski, A. Sudaka, M. Tassart, S. Testelin, A. Timochenko, B. Toussaint, E. Uro Coste, G. Valette, T. Van den Abbeele, A. Varoquaux, F. Veillon, M. Wassef, Institut Gustave Roussy (IGR), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Laboratorium für Physikalische Chemie (ETH-LPC), Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich] (ETH Zürich), French Rare Head and Neck Cancer Expert Network (REFCOR), Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), French Rare Head and Neck Cancer Expert Network. (REFCOR), Laboratoire d'études spatiales et d'instrumentation en astrophysique (LESIA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Service d'ORL et de Chirurgie Cervico-Faciale (PARIS - BICHAT - ORL et CCF), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Service d’ORL et de chirurgie cervico-faciale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Paul Strauss de Lutte contre le Cancer (Strasbourg), Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Chambre Régionale d'Agriculture des Pays de la Loire, Service de chirurgie, Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service d’Otorhinolaryngologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Service d'ORL, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine gériatrique, CHU de Saint-Etienne, Université Paris 13 (UP13), Hôpital Pellegrin, Service d'ORL et chirurgie cervico-faciale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'ORL et Chirurgie Cervico-Facial, Hôpital de la Timone [CHU - APHM] (TIMONE), Fluides, automatique, systèmes thermiques (FAST), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Géomatériaux (DGCB-LGM), École Nationale des Travaux Publics de l'État (ENTPE)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie des réseaux sensorimoteurs (NRS (U7060)), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Centre méditérannéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), University of St Andrews [Scotland], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Centre hospitalier universitaire de Nantes (CHU Nantes), Statistique en grande dimension pour la génomique, Département PEGASE [LBBE] (PEGASE), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Institut d'Electronique du Solide et des Systèmes (InESS), Centre National de la Recherche Scientifique (CNRS), Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UNIV-RENNES), Service de chirurgie oncologique cervico-faciale [centre Antoine Lacassagne, Nice], Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA)-UNICANCER-Université Côte d'Azur (UCA), Department of Otolaryngology and Head and Neck Surgery, University Hospital of Grenoble, BP 217, 38043, Grenoble Cedex 09, France, Université Joseph Fourier - Grenoble 1 (UJF), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), CRLCC René Gauducheau, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Réhabilitation Chirurgicale mini-Invasive et Robotisée de l'Audition, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de cristallographie et sciences des matériaux (CRISMAT), École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC), Department of Head and Neck Surgery, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'oto-rhino-laryngologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Biomécanique et génie biomédical (BIM), Réseau d’Expertise Français sur les Cancers ORL Rares - French Network of Rare Head and Neck Tumors (REFCOR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...] (GICC EA 7501), Université de Tours (UT), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Université de Lille-UNICANCER, Université de Rennes (UR), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Les Hôpitaux Universitaires de Strasbourg (HUS), Service Chirurgie maxillo-faciale et plastique de la face [CHU Toulouse], Pôle Céphalique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Tours-Centre National de la Recherche Scientifique (CNRS), and Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, Multivariate analysis, medicine.medical_treatment, 0302 clinical medicine, Paranasal Sinuses, Medicine, Prospective Studies, Stage (cooking), Head and neck, Lymph node, Melanoma, Aged, 80 and over, Mucosal melanoma, Middle Aged, Prognosis, Progression-Free Survival, 3. Good health, Tumor Burden, Survival Rate, medicine.anatomical_structure, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Mouth Neoplasms, France, Algorithms, Paranasal Sinus Neoplasms, Adult, medicine.medical_specialty, Nose Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Young Adult, Internal medicine, Humans, Sinonasal, Aged, Neoplasm Staging, Radiotherapy, business.industry, Head and neck cancer, Mouth Mucosa, medicine.disease, Otorhinolaryngologic Surgical Procedures, Oral cavity, Radiation therapy, Nasal Mucosa, 030104 developmental biology, Oral Cavity Mucosal Melanoma, Radiotherapy, Adjuvant, business
Abstract

International audience; BACKGROUND:Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established.MATERIAL & METHODS:Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed.RESULTS:In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10-4), although, as in SNMM, it was not a significant prognostic predictor.CONCLUSION:Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.

Published
2019
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12. Muscle entrapment in Orbito-zygomatico-maxillary complex fracture Author names and affiliations

Author

Bouaoud, Jebrane, Olivetto, Matthieu, Bettoni, Jérémie, Devauchelle, Bernard, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Muscle entrapment, Orbito-zygomatic fracture, Ophthalmologic injury, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience

Published
2019
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13. Development of a new MR Elastography protocol to measure the functional properties of facial muscles

Author

Redouane Ternifi, Sabine F. Bensamoun, B. Devauchelle, Philippe Pouletaut, Fabrice Charleux, S. Testelin, Jean-Marc Constans, Stéphanie Dakpé, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Centre d'Imagerie Médicale Avancée (CIMA), CIMA, FEDER - Hauts de France RegionEquipex Figures, and société de Biomecanique

Subjects
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, 0206 medical engineering, Biomedical Engineering, Bioengineering, 02 engineering and technology, Palpation, 03 medical and health sciences, 0302 clinical medicine, zygomatic major, medicine, ComputingMilieux_MISCELLANEOUS, Facial expression, medicine.diagnostic_test, business.industry, fungi, Magnetic Resonance Elastography, food and beverages, 030229 sport sciences, General Medicine, Anatomy, 020601 biomedical engineering, Computer Science Applications, Magnetic resonance elastography, Human-Computer Interaction, Facial muscles, medicine.anatomical_structure, muscle tissue elasticity, Elastography, business
Abstract

The face expression is animated by the movements of the muscles, which can be altered during pathology. Assessment of facial muscle deficits is subjective (palpation), dependent operator, and is cu...

Published
2019
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14. Fraser syndrome: review of the literature illustrated by a historical adult case

Author

Sylvie Testelin, J. Bettoni, Stéphanie Dakpé, J. Bouaoud, M. Olivetto, Bernard Devauchelle, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de médecine Pitié Salpétrière, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Cryptophthalmos, Adult, Pediatrics, medicine.medical_specialty, Prenatal diagnosis, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, Abnormalities, Multiple, Syndactyly, Family history, Renal agenesis, Fraser syndrome, business.industry, Eyelids, 030206 dentistry, Rare conditions Genetic, medicine.disease, 3. Good health, Otorhinolaryngology, autosomal recessive 2, 030220 oncology & carcinogenesis, Mutation, Etiology, FRAS1, Surgery, Female, Oral Surgery, business, cryptophthalmos, Fraser Syndrome, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Fraser syndrome (cryptophthalmos-syndactyly syndrome) is a rare autosomal recessive malformation disorder. The first description of the syndrome was reported by George Fraser in 1962. Diagnosis is based on the major and minor criteria established by van Haelst et al. in 2007. Unilateral or bilateral cryptophthalmos, syndactyly, unilateral renal agenesis, and genital anomalies are the most frequent anomalies. Several maxillofacial, oro-dental, ear-nose-throat, hormonal, and anorectal disorders are reported. Cardiac malformations and musculoskeletal anomalies are uncommon. The syndrome is related to mutations in three different genes (FRAS1, FREM2, and GRIP1) resulting in failure of the apoptosis program and disruption of the epithelial-mesenchymal interactions during embryonic development. Prenatal diagnosis is based on the detection of renal agenesis and laryngeal atresia, together with a family history. Most foetuses with severe anomalies are terminated or are stillborn. All patients or pregnancies with a diagnosis of Fraser syndrome should be referred to expert centres. A collaborative approach including anaesthetists, ENT specialists, maxillofacial surgeons, and geneticists is necessary for the management of this syndrome. In vivo and in vitro research models are available to better understand the underlying aetiology.

Published
2019
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15. Chronic Rejection in Human Vascularized Composite Allotransplantation (Hand and Face Recipients)

Author

Olivier Thaunat, Sylvie Testelin, Lionel Badet, J. Kanitakis, Jean-Michel Dubernard, Bernard Devauchelle, Emmanuel Morelon, Aram Gazarian, Palmina Petruzzo, Clinique Dermatologique, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Clinique du Parc, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), and Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie]

Subjects
Graft Rejection, Vascularized Composite Allotransplantation, Transplantation, medicine.medical_specialty, Graft acceptance, business.industry, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Immunosuppression, 030230 surgery, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Vascular narrowing, Atrophy, Deep tissue, Chronic Disease, medicine, Humans, 030211 gastroenterology & hepatology, Composite tissue, business, Immune mechanisms
Abstract

International audience; Vascularized composite tissue allografts (VCA) have become a viable option to restore severely damaged parts of the body that cannot be repaired with conventional surgical techniques. Acute rejection develops frequently in the early postgraft period both in human and experimental VCA, but the possibility of human VCA to undergo chronic rejection (CR) remained initially unknown. The experience gained over the years shows that, similar to solid organ transplants (SOT), human VCA can also develop CR. Chronic rejection is clinically mostly apparent on the skin and targets preferentially skin and deep vessels, leading, as in SOT, to graft vasculopathy and often to graft loss. Dermal sclerosis and adnexal atrophy are additional features of CR. The pathogenetic immune mechanisms involved (cell-mediated versus humoral) remain incompletely known. The changes of CR can be detected with skin and deep tissue biopsies. Modern in vivo imaging tools can detect vascular narrowing and have the advantage of being noninvasive. However, the diagnosis and treatment of CR remain challenging, as several important questions remain to be answered: a more accurate definition of CR in VCA is needed to establish criteria allowing an accurate and early diagnosis. The pathogenetic mechanisms of CR need to be better understood to allow more efficacious treatment. Favoring/triggering factors of CR need to be better known so that they can be avoided. As in SOT, there is a need for efficient tolerance-inducing protocols that will favor graft acceptance and (ideally) circumvent the necessity of lifelong immunosuppression.

Published
2016
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16. Développement d’un nouveau protocole en élastographie IRM pour mesurer les propriétés fonctionnelles des muscles du visage

Author

Redouane Ternifi, Philippe Pouletaut, Stéphanie Dakpé, Sylvie Testelin, Bernard Devauchelle, Fabrice Charleux, Jean-Marc Constans, Sabine Bensamoun, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Contrat Etat-Région, Société française de résonance magnétique en biologie et médecine, and Pouletaut, Philippe

Subjects
[SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], [SDV.OT] Life Sciences [q-bio]/Other [q-bio.OT], [INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV]Life Sciences [q-bio], Human face modeling, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], Muscle Skeletal, [SDV] Life Sciences [q-bio], [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, [SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], Magnetic resonance imaging MRI, Elastography
Abstract

National audience; Objectifs: L'évaluation des déficits des muscles de la face est subjective (palpation), opérateur dépendant, et est actuellement estimée avec des échelles cliniques [1]. Il est donc urgent de quantifier les propriétés fonctionnelles des muscles du visage pour aider à évaluer les traitements (chirurgical, injection ou rééducatif) destinés aux patients atteints de paralysie faciale. L'élastographie par résonance magnétique (ERM) a été développée pour évaluer le comportement mécanique individuel des muscles sain [2] et pathologique (Duchenne) [3] de la cuisse. L'objectif de ce projet est de développer pour la première fois l'ERM pour un muscle fin (zygomatique majeur: ZM) impliquant des verrous technologiques. Matériels et Méthodes : Trois volontaires sains ont effectué un test ERM sur une IRM 1,5T (GE Signa HDx). Différents stimulateurs pneumatiques ont été développés pour générer un déplacement d'ondes, à une fréquence de 90Hz, au sein du ZM. Celui-ci est placé sur l'os du ZM en direction de la commissure et une antenne tête (16 canaux) est utilisée. Les images anatomiques axiales sont obtenues avec une séquence T1 et les images phases mesurées avec les paramètres suivants : matrice 256x256, deux gradients de sensibilisation au mouvement de polarité opposée dans la direction Z, TR/TE: 55,5/19,1 ms, un angle de bascule de 25°, un champ de vue de 18cm, 4 offsets et une épaisseur de coupe de 1,5mm. Des filtres (directionnel, Butterworth) ont été appliqués, en considérant le muscle comme linéaire élastique, homogène et incompressible. Un module de cisaillement (µ) est localement mesuré [2]. Résultats : Le déplacement des ondes de cisaillement a été observé dans le tissu adipeux, le ZM et d'autres muscles du visage. La propagation obtenue est imparfaite car elle n'est pas localisée uniquement au sein du ZM. Des équipements (stimulateur, etc…) seront développés afin d'améliorer l'acquisition des images phases. La mesure du module de cisaillement pour un groupe musculaire (µ=2,45 ± 0,32 kPa) montre la faisabilité de cette étude. Conclusion : L'originalité de cette étude est de mettre au point le premier protocole ERM pour des muscles d'épaisseur faible (

Published
2019

17. Technical note on the harvest of periosteal forearm composite free flaps in the treatment of early mandibular osteoradionecrotic injury

Author

Bernard Devauchelle, J. Bettoni, M. Olivetto, J. Bouaoud, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Revascularization surgery, medicine.medical_specialty, Forearm periosteal free flap, Osteoradionecrosis, Free flap, Iliac crest, Free Tissue Flaps, 03 medical and health sciences, 0302 clinical medicine, Forearm, MESH: Osteoradionecrosis, medicine, Humans, 43 Osteoradionecrosis, MESH: Mandibular Injuries, 030223 otorhinolaryngology, MESH: Humans, Medical treatment, business.industry, Technical note, 030206 dentistry, Plastic Surgery Procedures, medicine.disease, Mandibular Injuries, Periosteal free flap, Management, Surgery, medicine.anatomical_structure, Hypocellularity, Otorhinolaryngology, MESH: Forearm, MESH: Free Tissue Flaps, MESH: Reconstructive Surgical Procedures, Oral Surgery, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Periosteal radial forearm free flaps allow functional and curative treatment of osteoradionecrotic jaw lesions. The flap responds physiologically to hypoxia, hypocellularity, and hypovascularity, which are characteristic results of osteoradionecrotic injury. Here, we propose a reproducible, simple, and safe method for harvesting a forearm free flap, allowing us to obtain a periosteal composite free flap. Our technique offers potential early management of osteoradionecrotic lesions resistant to medical treatment. Furthermore, the forearm periosteal composite free flap offers the advantage of a long vascular pedicle which is ideally suited for necks which have been submitted to irradiation or multiple operations. Thusly, vascular anastomosis can be performed at a distance from the irradiated areas. Compared to other periosteal free flaps, such as those harvested from the iliac crest or the internal femoral condyle, the presence of a skin paddle facilitates clinical flap monitoring, optimizes the restoration of bone sealing, and facilitates the treatment of scarring.

Published
2019
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18. A three-gene expression signature associated with positive surgical margins in tongue squamous cell carcinomas: Predicting surgical resectability from tumour biology?

Author

Antoine Galmiche, Zuzana Saidak, Louise Galmiche, Cyril Page, Stéphanie Dakpé, J. Bouaoud, Caroline Pascual, Florian Clatot, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Stomatologie et Chirurgie Maxillo-facial [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pathologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CCSD, Accord Elsevier, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Larynx, Male, Cancer Research, Pathology, medicine.medical_specialty, Cell, [SDV.CAN]Life Sciences [q-bio]/Cancer, Transcriptome, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Tongue, Gene expression, medicine, Tumor Microenvironment, Humans, 030223 otorhinolaryngology, business.industry, Surgical margins, The Cancer Genome Atlas (TCGA), Margins of Excision, Head and neck squamous cell carcinoma, Middle Aged, medicine.disease, Omics, Head and neck squamous-cell carcinoma, 3. Good health, Tongue tumours, Tongue Neoplasms, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, Oral Surgery, Positive Surgical Margin, business
Abstract

International audience; Objectives: Achieving complete tumour resection is one of the main goals of surgery for head and neck squamous cell carcinoma (HNSCC) tumours. Whether biological characteristics of tumours contribute to the surgical resectability and the presence of positive surgical margins (SM) after resection of HNSCC is unclear. We aimed to address this issue.Materials and methods: We used data from The Cancer Genome Atlas (TCGA) to relate the SM status of 356 HNSCC tumours covering five major primary locations (tongue, larynx, tonsils, floor of mouth and buccal mucosa) with data from multiple omics approaches (transcriptomic, genomic and proteomic analyses).Results: We identified three differentially expressed genes whose expression was significantly associated with the presence of positive SM in tongue tumours (n = 144). The three genes (CCDC66, ZRANB2 and VCPKMT) displayed significantly higher mRNA levels in tongue tumours with positive SM compared to tumours with negative SM. The corresponding gene expression signature identified tongue tumours with a positive SM with high sensitivity and specificity (85% and 76%, respectively, Area Under the Curve (AUC) = 0.84). Tongue tumours with this signature were characterised by a high grade, elevated proliferation levels and a tumour stroma with fewer fibroblasts and endothelial cells.Conclusion: Positive SM were found to be strikingly associated with tumour biology in tongue tumours. These findings offer interesting perspectives for biomarker identification and precision surgery in these tumours.

Published
2019
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19. Contribution of flow MRI in the therapeutic management of middle face high flow arteriovenous malformation: A case report

Author

J. Bettoni, Sylvie Testelin, Anne-Virginie Salsac, Bernard Devauchelle, Jérôme Duisit, Jean-Marc Constans, Gwenaël Pagé, Olivier Balédent, C. Chivot, Stéphanie Dakpé, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Biomécanique et Bioingénierie (BMBI), and Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, medicine.medical_specialty, Hemodynamics, Contrast Media, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Radiosurgery, Arteriovenous Malformations, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Stage (cooking), [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], 030223 otorhinolaryngology, Therapeutic strategy, medicine.diagnostic_test, business.industry, Angiography, Arteriovenous malformation, Magnetic resonance imaging, 030206 dentistry, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Otorhinolaryngology, Flow (mathematics), Surgery, Radiology, Doppler ultrasound, Oral Surgery, High flow, business
Abstract

International audience; Backround: The radiosurgical management of high flow arteriovenous malformations (HFAVM) in the "destructive" stage requires a precise hemodynamic and anatomical assessment.Patient and methods/case report: We report the case of a 32 years-old patient with a large ulcerated face HFAVM, on which Doppler ultrasound was impossible to perform. We show that, by combining 3D PCA and 2D CINE PC-MRI sequences, magnetic resonance imaging is capable to provide a complete morphometric and velocimetric mapping of the nidus and feeding arteries of the HFAVM.Conclusion: Although Doppler ultrasound is the reference examination in the HFAVM, Flow MRI without contrast agent provides an advantageous alternative to assess vascular pathologies and choose the therapeutic strategy. (C) 2018 Elsevier Masson SAS. All rights reserved.

Published
2019
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20. First Evaluation of Zygomaticus Major Muscle Elastic Properties Using a US Elastography Technique

Author

Bernard Devauchelle, Stéphanie Dakpé, Sabine F. Bensamoun, Philippe Pouletaut, Jean-Marc Constans, Sylvie Testelin, Fabrice Charleux, Redouane Ternifi, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Centre d'Imagerie Médicale Avancée (CIMA), CIMA, Service de Radiologie [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), and Hauts-de-France Region and CPER Santé.

Subjects
0301 basic medicine, Materials science, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Palpation, 03 medical and health sciences, 0302 clinical medicine, medicine, Elasticity (economics), ComputingMilieux_MISCELLANEOUS, [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], Zygomaticus major muscle, medicine.diagnostic_test, business.industry, Ultrasound, Echogenicity, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], 030206 dentistry, medicine.disease, Facial paralysis, Facial muscles, 030104 developmental biology, medicine.anatomical_structure, Elastography, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Biomedical engineering
Abstract

Facial expressions are linked to movements of muscles, which can be altered by pathological diseases. Assessment of facial muscle deficits is subjective (palpation) and operator-dependent, and these deficits are currently estimated with clinical scales. Thus, the quantification of facial muscle elastic properties is a key for the clinical adaption and evaluation of treatments for facial paralysis. We herein present a novel application of shear wave elastography (SWE) based on an ultrasound protocol to assess the morphological (thickness and texture) and elastic (Young’s modulus) properties of the zygomaticus major (ZM) muscle. Fifteen healthy volunteers underwent SWE tests, and the ultrasound acquisitions were obtained using a new linear transducer (SLH20-6, spatial resolution: 38 μm) and compared to those obtained using an SL10-2 probe (spatial resolution: 50 μm). The probe position was placed along the muscle fiber orientation. A semi-automatic method was developed to quantify the ZM muscle elasticity, and the repeatability was analyzed at one-week intervals. The mean elasticity for the two probes was about 15 kPa. The SLH20-6 probe yielded a higher mean elasticity (approximately 6 kPa) and less homogeneous echogenicity than the SL10-2 probe. Two distinct groups of texture profiles as a function of the transducer were obtained. This study will provide some guidance for clinical practices and will allow the construction of a reference database that could be used to evaluate treatments and develop numerical models of facial expression.

Published
2019
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21. Clinicopathological Findings of Chronic Rejection in a Face Grafted Patient

Author

Fanny Buron, Emmanuel Morelon, Jean Baptiste Pialat, Palmina Petruzzo, Sylvie Testelin, Lionel Badet, Olivier Thaunat, Bernard Devauchelle, Jean Kanitakis, Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Département de Dermatologie [CH Lyon-Sud, Pierre-Bénite], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Service de Radiologie, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Graft Rejection, Male, Pathology, medicine.medical_specialty, Erythema, Biopsy, medicine.medical_treatment, Asymptomatic, Vascularized Composite Allotransplantation, medicine, Humans, Hypopigmentation, Transplantation, Facial Transplantation, business.industry, Graft Survival, Immunosuppression, Allografts, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Tacrolimus, 3. Good health, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Chronic Disease, [SDV.IMM]Life Sciences [q-bio]/Immunology, medicine.symptom, business, Immunosuppressive Agents
Abstract

International audience; BACKGROUND: Skin chronic rejection (CR) in vascularized composite allotransplantation has not been included in the Banff classification yet. We report a face-transplant patient who developed cutaneous clinicopathologic changes suggestive of CR. METHODS: The recipient was a 27-year-old man with severe disfigurement of the lower face due to a pyrotechnic explosion. He received a facial allograft, including mandible, cheeks, lips, and chin, in November 2009. Immunosuppression included antithymocyte globulins and bone-marrow infusion then steroids, tacrolimus, and mycophenolate mofetil. RESULTS: During the first posttransplant year the acute rejection episodes were characterized by reversible oedema and erythema of the graft. Subsequently, the patient developed primary asymptomatic Epstein-Barr virus (EBV) infection, followed by EBV+ B-cell lymphoma and hepatic EBV-associated posttransplant smooth muscle tumors; therefore, the immunosuppressive treatment was greatly reduced. Since the second posttransplant year, the allografted facial skin became progressively sclerotic and presented pigmented macules on a background of hypopigmentation and teleangiectasias, resulting in a poikilodermatous aspect. Skin biopsies showed epidermal atrophy, basal cell vacuolization, and diffuse dermal sclerosis in the absence of significant dermal cell infiltration. The dermal capillaries showed thickened walls and narrowed lumina, whereas the large vessels did not show significant alterations. Neither donor-specific antibodies nor vascular Cd4 deposits were detected.A dysfunction of the graft functions occurred. It was evidenced by a decrease in mouth opening and modification of some phonemes although lip closure was still possible allowing food intake. CONCLUSIONS: This is the first report suggestive of CR in a face allotransplantation after immunosuppression minimization.

Published
2015
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22. What are the predictive factors of caecal perforation in patients with obstructing distal colon cancer?

Author

François Mauvais, Brice Robert, Jean-Marc Regimbeau, N. Siembida, François Browet, Charles Sabbagh, C. Chivot, Thierry Yzet, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Système membranaires, photobiologie, stress et détoxication (SMPSD), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Laboratoire Bioénergétique Membranaire et Stress (LBMS), Département Biochimie, Biophysique et Biologie Structurale (B3S), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), and Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie]

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], animal diseases, medicine.medical_treatment, Perforation (oil well), Computed tomography, 030230 surgery, General status, digestive system, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Laparotomy, medicine, Ascitic Fluid, Cecal Diseases, Humans, In patient, Pneumatosis Cystoides Intestinalis, Aged, Aged, 80 and over, Univariate analysis, medicine.diagnostic_test, business.industry, digestive, oral, and skin physiology, food and beverages, Cancer, Organ Size, Middle Aged, bacterial infections and mycoses, medicine.disease, ROC Curve, Intestinal Perforation, 030220 oncology & carcinogenesis, Colonic Neoplasms, Female, Distal colon, business, Tomography, X-Ray Computed, Intestinal Obstruction
Abstract

International audience; AimIn the presence of large bowel obstruction, the choice of treatment is determined by the patient's general status, the tumour characteristics and the perceived risk of caecal perforation. This study was designed to evaluate the predictive factors of impending caecal perforation, and also investigated the use of caecal volumetry. MethodFrom January 2011 to June 2016, patients with obstructive distal colon cancer undergoing emergency laparotomy, for whom a pretreatment CT scan was available, were included in this retrospective, case-control, two-centre study. Two patient groups were defined: patients with and without impending caecal perforation. The primary end-point of the study was a determination of predictive factors for caecal perforation. ResultsA total of 72 patients (45 men, 62.5%) were included. Univariate analysis revealed that the presence of pericaecal fluid (P9cm (P=0.002) and a caecal diameter at the ileocaecal junction >7.5cm (P=0.001) were associated with impending caecal perforation. In multivariate analysis, only caecal volume >400cm(3) (P=0.001) was correlated with the risk of impending caecal perforation. ConclusionCaecal volumetry is an easy and useful tool to predict impending caecal perforation in patients with large bowel obstruction.

Published
2017
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23. Applications cliniques de l’IRM de flux en chirurgie cervico-faciale

Author

Bettoni, Jérémie, Pagé, Gwenael, Salsac, Anne-Virginie, Paasche, Agnès, Testelin, Sylvie, Constans, Jean-Marc, Balédent, Olivier, Devauchelle, Bernard, Dakpé, Stéphanie, Université de Picardie Jules Verne (UPJV), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Départment de Neuroradiologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, and Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)

Subjects
[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2017

24. Management of somatic pain induced by head and neck cancer treatment: Pain following radiation therapy and chemotherapy. Guidelines of the French Otorhinolaryngology Head and Neck Surgery Society (SFORL)

Author

Sylvain Morinière, M Navez, D. Blanchard, C Dreyer, S. Albert, C Perrichon, C Couturaud, P Calmels, M Bollet, F Espitalier, S Testelin, M Binczak, Laboratoire de Physiologie de l'Exercice EA4338 (LPE), Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Laboratorium für Physikalische Chemie (ETH-LPC), Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich] (ETH Zürich), Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Mucositis, medicine.medical_specialty, Osteoradionecrosis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Nociceptive Pain, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Humans, Pain Management, Medicine, ComputingMilieux_MISCELLANEOUS, Chemotherapy, Radiotherapy, business.industry, General surgery, Head and neck cancer, Evidence-based medicine, medicine.disease, 3. Good health, Surgery, Neuropathy, Radiation therapy, Otorhinolaryngology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Radiodermatitis, business, 030217 neurology & neurosurgery
Abstract

Objectives The authors present the section of the guidelines of the French Otorhinolaryngology Head and Neck Surgery Society (SFORL) for the management of somatic pain induced by head and neck cancer treatment concerning management of pain following radiation therapy and chemotherapy. Methods A multidisciplinary work group was entrusted with a literature review. Guidelines were drawn up based on the articles retrieved and the group members’ experience. They were read over by an editorial group independent of the work group. A coordination meeting drew up the final version. Guidelines were graded A, B or C or as expert opinion in decreasing order of level of evidence. Results Particular care should be given to detection and early adapted treatment of pain induced by radiation therapy and/or chemotherapy, to improve quality of life in head and neck cancer patients.

Published
2014
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25. Multicenter prospective micro-costing study evaluating mandibular free-flap reconstruction

Author

Jocelyn Gal, Yann Château, Renaud Schiappa, Morbize Julieron, Marie-Helene Orlanducci, Emmanuel Chamorey, Bernard Devauchelle, Olivier Dassonville, Jérôme Sarini, Jacques Yachouh, Gilles Poissonnet, Yann Mallet, Marie-Yolande Louis, Alexandre Bozec, Gilles Dolivet, Emile Reyt, Pierre Breton, Service d'ORL, Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA)-UNICANCER-Université Côte d'Azur (UCA), UNICANCER-Université Côte d'Azur (UCA), Service d'ORL et de chirurgie cervicale, CHU Grenoble, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Claudius Regaud, Université de Lorraine (UL), CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), and Université de Lille-UNICANCER

Subjects
Adult, Male, Reoperation, medicine.medical_specialty, Adolescent, Hospital bed, Total cost, [SDV]Life Sciences [q-bio], Young Adult, 03 medical and health sciences, 0302 clinical medicine, Mandibular reconstruction, medicine, Cost analysis, Humans, Hospital Costs, 030223 otorhinolaryngology, Intensive care medicine, Prospective cohort study, health care economics and organizations, Aged, business.industry, General Medicine, Middle Aged, Multicenter study, 3. Good health, Hospitalization, Otorhinolaryngology, Free tissue flaps, 030220 oncology & carcinogenesis, Micro costing, Emergency medicine, Free flap reconstruction, Female, France, Neurosurgery, business, Prospective studies
Abstract

International audience; Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers' time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009€ (5151-119,604€), the most expensive item being the duration of hospital bed occupation, representing 30-90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly.

Published
2017
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26. Caractérisation clinique et génétique d’une nouvelle dysplasie ectodermique en mosaïque

Author

Odile Boute, J.-B. Rivière, C. Gondry, Laurence Faivre, Pierre Vabres, S.S. Kholmanskikh, M. E. Ross, B. Devauchelle, B. Demeer, J. St-Onge, David Geneviève, William B. Dobyns, Laurent Guibaud, Julien Thevenon, G. Captier, G. Bernard, E. Carmi, Paul Kuentz, Yannis Duffourd, Alain Bron, Jean-Benoît Courcet, A. Lafon, V. Carmignac, Arthur Sorlin, Didier Bessis, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), FHU TRANSLAD (CHU de Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Weill Cornell Medicine, CHU Amiens-Picardie, McGill University = Université McGill [Montréal, Canada], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre Hospitalier Universitaire de Lille (CHU de Lille), Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Seattle Children’s Research Institute, Equipe GAD (LNC - U1231), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Dermatologie (CHU de Dijon), Centre de génétique - Centre de référence des maladies rares, anomalies du développement et syndromes malformatifs (CHU de Dijon), Department of Neurology and Feil Family Brain and Mind Research Institute [New-York] (BMRI), Weill Medical College of Cornell University [New York], Center for neurogenetics [Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York], Unité de génétique médicale et oncogénétique [CHU Amiens Picardie], McGill University Health Center [Montreal] (MUHC), Génétique biologique histologie [CHRU de Besançon], Département de dermatologie [CHU de Montpellier], Service de Génétique clinique, Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Ophtalmologie (CHU de Dijon), Département Chirurgie Pédiatrique [CHRU Montpellier], Pôle Femme Mère Enfant [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de dermatologie [CHU d'Amiens-Picardie], Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], Département de génétique médicale, maladies rares et médecine personnalisée [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Radiologie [Amiens], Service d’imagerie pédiatrique et fœtale [Hôpital Femme Mère Enfant - HCL], Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service Chirurgie Maxillo-Faciale - Stomatologie - Chirurgie Plastique Réparatrice et Esthétique - Chirurgie de la main (CHU de Dijon), Center for Integrative Brain Research, University of Washington [Seattle], Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), FHU TRANSLAD, Department of Neurology and Feil Family Brain and Mind Research Institute [New-York] ( BMRI ), The Research Institute of the McGill University Health Centre [Montréal, QC, Canada], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Centre Hospitalier Universitaire de Montpellier ( CHU Montpellier ), Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Département de chirurgie infantile [CHRU de Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Département de génétique médicale, maladies rares et médecine personnalisée [CHRU de Montpellier], Hôpital Femme Mère Enfant [CHU - HCL] ( HFME ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), University of Washington [Seattle]-Seattle Children's Research Institute, and McGill University

Subjects
hypomélanose d'ito, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, mosaïcisme, dysplasie ectodermique, Hypomélanose d’Ito, Dermatology, [ SDV.GEN.GH ] Life Sciences [q-bio]/Genetics/Human genetics, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 3. Good health
Abstract

National audience; Introduction L’hypomélanose d’Ito est définie par l’association d’une hypopigmentation qui suit les lignes de Blaschko et de manifestations principalement neurologiques. Les autres atteintes associées sont variables. Elle peut être associée à diverses anomalies chromosomiques en mosaïque ou à des mutations MTOR lorsqu’elle s’associe à une hémimégalencéphalie. Nous rapportons un nouveau syndrome clinique avec hypomélanose d’Ito et atteinte neuroectodermique en lien avec des mutations postzygotiques de RHOA . Matériel et méthodes Dans le cadre de la cohorte Mosaic Unknown Skin Traits And Related Disorders (MUSTARD), nous avons étudié 5 patients par séquençage haut débit de l’exome complet ou ciblé, sur peau atteinte et dans le sang. Observations Les 5 patients, non apparentés, présentaient tous une hypopigmentation ou une hypotrichose linéaire, associée à une atteinte faciale bilatérale ou unilatérale (hypoplasie malaire, élargissement de la pyramide nasale), malformations dentaires avec dysplasie de l’émail, doigts et orteils courts, atteinte oculaire avec choroïdose myopique. L’IRM réalisée chez 3 patients a montré une leucoencéphalopathie asymptomatique avec hypersignal de la substance blanche et dilatation des espaces de Virchow. Résultats Chez les deux premiers patients, le séquençage de l’exome en profondeur (144X à 228X) sur peau atteinte a identifié une même mutation en mosaïque p.Glu47Lys du gène RHOA , confirmée par séquençage ciblé (taux allélique : 33,5 % et 23,1 %), absente du sang. Cette mutation a également été identifiée par séquençage ciblé chez deux des autres patients ayant un phénotype similaire. Le cinquième patient était porteur d’une autre mutation postzygotique de RHOA , Pro71Ser, identifiée par séquençage de l’exome. La transfection de plasmides porteurs de ces mutations de RHOA dans des cellules NIH 3T3 en culture a montré une diminution de l’étalement cellulaire, de la formation de fibre de stress, et de la phosphorylation des effecteurs de RhoA , MYPT1 et MLC2, suggérant un effet dominant-négatif de ces mutations. Discussion Nous avons identifié une affection neuroectodermique jamais décrite à notre connaissance, causée par des mutations en mosaïque de RHOA , qui code la protéine RhoA , une petite GTPase de la superfamille Ras, impliquée dans le chimiotactisme, le guidage axonal, et le contrôle du cycle cellulaire. En plus des anomalies fonctionnelles mises en évidence, la forte conservation de la séquence de RHOA au cours de l’évolution est en faveur du caractère pathogène des mutations identifiées. Conclusion Cette dysplasie ectodermique en mosaïque liée à RHOA s’ajoute aux syndromes causés par des mutations létales, pour lesquelles la survie embryonnaire n’est possible que par mosaïcisme. Il s’agit d’une de premières caractérisations moléculaires d’un mosaïcisme pigmentaire, qui souligne l’importance de RHOA dans le développement cutané.

Published
2017
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27. PARTIAL GRAFT LOSS OF A FACIAL TRANSPLANT AFTER DONOR SPECIFIC ANTIBODIES DEVELOPMENT

Author

Morelon, Emmanuel, Petruzzo, Palmina, Kanitakis, Jean, Dakpé, Stéphanie, Thaunat, Olivier, Dubois, Valerie, Choukroun, Gabriel, Testelin, Sylvie, Dubernard, Jean-Michel, Badet, Lionel, Devauchelle, Bernard, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Clinique Dermatologique, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, HLA Department, EFS Rhone-Alpes, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), and Département de transplantation et d'immunologie clinique [Hôpital Edouard Herriot, HCL]

Subjects
[SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2017

28. Brain functional modeling, what do we measure with fMRI data?

Author

Bernard Devauchelle, Patrick Berquin, G. De Marco, Laboratoire Interdisciplinaire en Neurosciences, Physiologie et psychologie (LINP2), Université Paris Nanterre (UPN), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Groupe de Recherche sur l'Analyse Multimodale de la Fonction Cérébrale - UMR INSERM_S 1105 (GRAMFC), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur le Sport et le Mouvement (CeRSM), and Service de neuropédiatrie

Subjects
Time Factors, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Computer science, Models, Neurological, Network, Analyse du Mouvement en Biomécanique Physiologie et Imagerie, Functional modeling, Measure (mathematics), Structural equation modeling, [SHS]Humanities and Social Sciences, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neural Pathways, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Bold fmri, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Causal model, Brain Mapping, DCM, Communication, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, General Neuroscience, fMRI, Brain, Pattern recognition, General Medicine, Magnetic Resonance Imaging, Independent component analysis, Oxygen, Cerebrovascular Circulation, SEM, Artificial intelligence, business, 030217 neurology & neurosurgery, Model
Abstract

International audience; The description of specific circuits in networks should allow a more realistic definition of dynamic functioning of the central nervous system which underlies various brain functions. After introducing the programmed and acquired networks and recalling the concepts of functional and effective connectivity, we presented biophysical and physiological aspects of the BOLD signal. Then, we briefly presented a few data-driven and hypothesis-driven methods; in particular we described structural equation modeling (SEM), a hypothesis-driven approach used to explore circuits within networks and model spatially and anatomically interconnected regions. We compared the SEM method with an alternative hypothesis-driven method, dynamic causal modeling (DCM). Finally, we presented independent components analysis (ICA), an exploratory data-driven approach which could be used to complete the directed brain interactivity studies. ICA combined with SEM/DCM may allow extension of the statistical and explanatory power of fMRI data.

Published
2009
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29. Chronic rejection in vascularized composite allotransplantation

Author

Morelon, Emmanuel, Petruzzo, Palmina, Kanitakis, Jean, Gazarian, Aram, Testelin, Sylvie, Devauchelle, Bernard, Thaunat, Olivier, Buron, Fanny, Dubois, Valerie, Badet, Lionel, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Clinique Dermatologique, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Clinique du Parc, CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], HLA Department, and EFS Rhone-Alpes

Subjects
[SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2016

30. Modélisation personnalisée de l'activation du grand zygomatique via l'IRM. Application à la simulation de la mimique faciale

Author

Tho, Marie-Christine Ho Ba, Dakpé, Stéphanie, Dao, Tien-Tuan, Devauchelle, Bernard, Rachik, Mohamed, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Roberval (Roberval), Université de Technologie de Compiègne (UTC), CSMA, and Legrand, Mathias

Subjects
mimique faciale, modélisation du muscle squelettique, [PHYS.MECA]Physics [physics]/Mechanics [physics], [PHYS.MECA] Physics [physics]/Mechanics [physics]
Abstract

International audience; Trois positions (l'étirement des commissures « Sourire », la protrusion labiale sur le son « POU » et « O ») décrivant des mouvements spécifiques de la face lors de la mimique faciale ont été acquises via l'IRM permettant la modélisation personnalisée du comportement mécanique du grand zygomatique, zygomaticus major GZ (un des muscles peauciers). Une loi de comportement (LDC) isotrope transverse, hyperélastique, incompressible permettant de décrire les comportements passifs et actifs du muscle a été utilisée. Les résultats de simulations ont été comparés qualitativement puis quantitativement aux images IRM traitées. Les déplacements moyens obtenus via l'IRM du GZ sont de 4±2mm, 4,5±1,4mm et 6±3mm pour les positions « Sourire », « POU » et « O » respectivement. Les déplacements moyens obtenus via les simulations numériques du GZ sont de 1,9±0,8mm, 2±1mm et 2,8±1,1mm pour les positions « Sourire », « POU » et « O » respectivement. Sur le plan quantitatif, les déplacements obtenus numériquement sont sous estimés d'environ d'un facteur 2, sur le plan qualitatif le meilleur résultat est obtenu avec la position « Sourire ». On notera seule la contribution d'un muscle a été étudiée et que la contraction de ce muscle est en grande partie responsable de l'expression du « Sourire ». Cette étude préliminaire a permis la mise en place d'une méthodologie de modélisation personnalisée permettant une confrontation entre les données expérimentales et simulées. La prochaine étape consistera à réaliser le modèle complet avec les autres muscles, et les tissus environnants les muscles, à prendre en considération les conditions aux limites du modèle, puis à effectuer l'identification des propriétés mécaniques du GZ in vivo.

Published
2013

31. Haptic systems for training sensorimotor skills: A use case in surgery

Author

Pascal Delcampe, Sylvain Bouchigny, Cédric D'Hauthuille, Farid Taha, Florian Gosselin, Christine Megard, Département Intelligence Ambiante et Systèmes Interactifs (DIASI), Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, CHU Rouen, Normandie Université (NU), Département de Stomatologie et chirurgie maxillo-faciale [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), SKILLS Integrated Project (IST-FP6 #035005, http://www.skills-ip.eu) funded by the European Commission., and Laboratoire d'Intégration des Systèmes et des Technologies (LIST)

Subjects
medicine.medical_specialty, Computer science, General Mathematics, media_common.quotation_subject, Context (language use), 02 engineering and technology, Virtual reality, computer.software_genre, Sensorimotor skills, Task (project management), 03 medical and health sciences, [SPI]Engineering Sciences [physics], 0302 clinical medicine, Perception, 0202 electrical engineering, electronic engineering, information engineering, medicine, ComputingMilieux_MISCELLANEOUS, Haptic technology, media_common, Multimedia, 020207 software engineering, Computer Science Applications, Surgery, Action (philosophy), Control and Systems Engineering, 030220 oncology & carcinogenesis, computer, Software, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Learning and training sensorimotor tasks typically involve different phases. Usually, the trainee has first to understand the task. He can read books, listen to explanations, look at videos or observe other people. Then he has to perform the task, either on his own or under the supervision of a mentor, to build his own perception action loops. With time and practice, he will progress towards expertise, more efficiently if he receives an appropriate feedback. This common approach has however a limited applicability for safety-critical tasks and for partially blindfolded activities heavily relying on haptics, both commonly found in surgery. Safety issues prevent initial trials and errors and require good performance on the first trial just from explanations and observation, exactly what is missing for blindfolded activities and difficult for complex movements with force accuracy requirements. Haptic systems and virtual reality (VR) technologies allow reproducing such situations, yet without risks for the patient, and offer new opportunities for training. The trainee can learn the task on a multimodal console until he has reached a sufficient proficiency level before moving to the operating room (OR). In this paper, we present how this approach was applied in the context of maxillofacial surgery (MFS). A novel training platform offering high fidelity haptic interactions was specified, developed and evaluated. The first results tend to prove its efficiency in qualifying expertise and training people.

Published
2013
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32. Principle of Structural Equation Modeling for Exploring Functional Interactivity within a Putative Network of Interconnected Brain Areas

Author

Sylvie Testelin, Giovanni de Marco, Christophe Destrieux, Bernard Devauchelle, Damien de Marco, Pierre Vrignaud, Patrick Berquin, Université de Picardie Jules Verne (UPJV), Université Paris Nanterre (UPN), Service de neuroradiologie [Tours], Service de neuropédiatrie, CHU Amiens-Picardie, De Marco, Giovanni, Processus cognitifs et conduites interactives, Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], Neurosciences fonctionnelles et pathologies (NFP), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Computer science, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Models, Neurological, Biomedical Engineering, Biophysics, Integration, Network, Machine learning, computer.software_genre, Brain mapping, 050105 experimental psychology, Structural equation modeling, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, Functional neuroimaging, Neural Pathways, Image Processing, Computer-Assisted, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, 0501 psychology and cognitive sciences, Radiology, Nuclear Medicine and imaging, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Effective connectivity, Brain Mapping, Models, Statistical, Artificial neural network, Functional integration (neurobiology), business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, 05 social sciences, [SCCO.NEUR] Cognitive science/Neuroscience, Covariance, Magnetic Resonance Imaging, Field (geography), SEM, Artificial intelligence, [SHS] Humanities and Social Sciences, business, Artifacts, computer, 030217 neurology & neurosurgery, Algorithms, Model
Abstract

International audience; Functional neuroimaging first allowed researchers to describe the functional segregation of regionally activated areas during a variety of experimental tasks. More recently, functional integration studies have described how these functionally specialized areas, interact within a highly distributed neural network. When applied to the field of neurosciences, structural equation modeling (SEM) uses theoretical and/or empirical hypotheses to estimate the effects of an experimental task within a putative network. SEM represents a linear technique for multivariate analysis of neuroimaging data and has been developed to simultaneously examine ratios of multiple causality in an experimental design; the method attempts to explain a covariance structure within an anatomical constrained model. This method, when combined with the concept of effective connectivity, can provide information on the strength and direction of the functional interactions that take place between identified brain regions of a putative network.

Published
2009
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33. Intérêt clinique de l’IRMf et des méthodes d’exploration fonctionnelle de l’activité et de l’interactivité cérébrales: considérations physiques et neurophysiologiques

Author

de Marco, Giovanni, Menuel, C., Guillevin, R., Vallée, J., Lehmann, P., Fall, S., Quaglino, V., Bourdin, B., Devauchelle, B., Chiras, J., Laboratoire d'Imagerie Fonctionnelle (LIF), Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR14-IFR49-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Interdisciplinaire en Neurosciences, Physiologie et psychologie (LINP2), Université Paris Nanterre (UPN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Nord [CHU - APHM], Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, and Department of Neuroradiololy, Hôpital Pitié-Salpêtrière, Paris

Subjects
Brain plasticity, Plasticité cérébrale, [SCCO.NEUR]Cognitive science/Neuroscience, Neurodegenerative diseases, Maturation, Connectivité effective, Maladies neurodégénératives, Effective connectivity, IRM fonctionnelle, Functional MRI, BOLD, [SHS]Humanities and Social Sciences
Abstract

International audience; After having provided a brief reminder of the principle of the blood oxygen level-dependent (BOLD) contrast effect, the physiological bases of brain activity and the concepts of functional integration and effective connectivity, we describe the most recent approaches, which permit to explore brain activity and putative networks of interconnected active areas in order to examine the normal brain physiology and its dysfunctions. We present various methods and studies of brain activity analysis clinically applicable, and we detail the concepts of functional and effective connectivity, which allow to study the cerebral plasticity which occurs at the child's during the maturation (e.g., dyslexia), at the adult during the ageing (e.g., Alzheimer disease), or still in schizophrenia or Parkinson disease. The study of specific circuits in networks has to allow defining in a more realistic way the dynamic of the central nervous system, which underlies various cerebral functions, both in physiological and pathological conditions. This connectivity approach should improve the diagnostic and facilitate the development of new therapeutic strategies.; Après un bref rappel sur les bases physiologiques et physiques du signal blood oxygen level-dependent (BOLD), nous décrivons les récentes approches d’exploration fonctionnelle de l’activité et de l’interactivité cérébrales mesurées en IRMf, permettant d’appréhender le fonctionnement cérébral normal et ses dysfonctionnements. Nous présentons différentes méthodes d’analyse de l’interactivité cérébrale applicables en clinique et nous détaillons les concepts de connectivité fonctionnelle et effective qui permettent d’étudier la plasticité cérébrale qui se produit chez l’enfant au cours de la maturation (ex. dyslexie), chez l’adulte au cours du vieillissement (ex. démence de type Alzheimer) ou encore dans le cas de la schizophrénie ou de la maladie de Parkinson. L’étude de circuits spécifiques en réseaux doit permettre de cerner de façon plus réaliste le fonctionnement dynamique du système nerveux central qui sous-tend de nombreuses fonctions, tant dans des conditions physiologiques normales que pathologiques, et donc d’améliorer le diagnostique et la prise en charge des pathologies neurologiques.

Published
2008
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34. Multiplex PCR Targeting tpi (Triose Phosphate Isomerase), tcdA (Toxin A), and tcdB (Toxin B) Genes for Toxigenic Culture of Clostridium difficile

Author

Marie-Andre Mattrat, Ludovic Lemée, Karine Maillard, Jean-Louis Pons, Anne Dhalluin, Sabrina Testelin, Jean-François Lemeland, Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Unité de Recherche Risques Microbiens (U2RM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], and CHU Amiens-Picardie

Subjects
Microbiology (medical), Bacterial Toxins, Clostridium difficile toxin A, Clostridium difficile toxin B, Enterotoxin, medicine.disease_cause, Polymerase Chain Reaction, law.invention, Microbiology, Enterotoxins, Feces, 03 medical and health sciences, Bacterial Proteins, law, Multiplex polymerase chain reaction, medicine, Animals, Humans, Clostridiaceae, Enterocolitis, Pseudomembranous, Polymerase chain reaction, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, 0303 health sciences, biology, Clostridioides difficile, 030306 microbiology, Toxin, Bacteriology, Clostridium difficile, biology.organism_classification, Molecular biology, Culture Media, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Triose-Phosphate Isomerase
Abstract

A multiplex PCR toxigenic culture approach was designed for simultaneous identification and toxigenic type characterization of Clostridium difficile isolates. Three pairs of primers were designed for the amplification of (i) a species-specific internal fragment of the tpi (triose phosphate isomerase) gene, (ii) an internal fragment of the tcdB (toxin B) gene, and (iii) an internal fragment of the tcdA (toxin A) gene allowing distinction between toxin A-positive, toxin B-positive (A+B+) strains and toxin A-negative, toxin B-positive (A−B+) variant strains. The reliability of the multiplex PCR was established by using a panel of 72 C. difficile strains including A+B+, A−B−, and A−B+ toxigenic types and 11 other Clostridium species type strains. The multiplex PCR assay was then included in a toxigenic culture approach for the detection, identification, and toxigenic type characterization of C. difficile in 1,343 consecutive human and animal stool samples. Overall, 111 (15.4%) of 721 human samples were positive for C. difficile ; 67 (60.4%) of these samples contained A+B+ toxigenic isolates, and none of them contained A−B+ variant strains. Fifty (8%) of 622 animal samples contained C. difficile strains, which were toxigenic in 27 (54%) cases, including 1 A−B+ variant isolate. Eighty of the 721 human stool samples (37 positive and 43 negative for C. difficile culture) were comparatively tested by Premier Toxins A&B (Meridian Bioscience) and Triage C. difficile Panel (Biosite) immunoassays, the results of which were found concordant with toxigenic culture for 82.5 and 92.5% of the samples, respectively. The multiplex PCR toxigenic culture scheme described here allows combined diagnosis and toxigenic type characterization for human and animal C. difficile intestinal infections.

Published
2004
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35. Outcomes 18 Months after the First Human Partial Face Transplantation

Author

Farid Taha, Esther Carmi, Giovanni Di Marco, Mauricette Michallet, Palmina Petruzzo, Danielle Bachmann, Jean-Michel Dubernard, Assia El Jaafari, Benoît Lengelé, Pascal Giraux, Jean-Luc Beziat, Lionel Badet, Emmanuel Morelon, Stéphanie Dakpé, Sophie Cremades, Nathalie Parquet, Jean Kanitakis, Bernard Devauchelle, Cédric D'Hauthuille, C. Moure, Angela Sirigu, Gabriel Burloux, Xavier Martin, Olivier Hequet, Sylvie Testelin, Nicole Lefrançois, Camille Francès, Department of Transplantation Surgery, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Service de Chirurgie Maxillofaciale de l'Hôpital de la Croix-Rousse, Hospices Civils de Lyon (HCL), Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Department of Dermatology, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Institut des Sciences Cognitives (ISC), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University Jean Monnet, EFS Rhône-Alpes, EFS, Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hématologie [Hôpital Edouard Herriot - HCL], Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Adult, Graft Rejection, medicine.medical_specialty, Face transplant, Esthetics, [SDV]Life Sciences [q-bio], medicine.medical_treatment, T-Lymphocytes, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Vascularized Composite Allotransplantation, 03 medical and health sciences, 0302 clinical medicine, Prednisone, medicine, Humans, Facial Injuries, ComputingMilieux_MISCELLANEOUS, Facial Transplantation, business.industry, Histocompatibility Testing, Immunosuppression, General Medicine, Recovery of Function, Plastic Surgery Procedures, Tacrolimus, 3. Good health, Surgery, Transplantation, surgical procedures, operative, Photochemotherapy, 030220 oncology & carcinogenesis, Sirolimus, Face, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Immunosuppressive Agents, medicine.drug, Follow-Up Studies
Abstract

Background: We performed the first human partial face allograft on November 27, 2005. Here we report outcomes up to 18 months after transplantation. Methods: The postsurgical induction immunosuppression protocol included thymoglobulins combined with tacrolimus, mycophenolate mofetil, and prednisone. Donor hematopoietic stem cells were infused on postoperative days 4 and 11. Sequential biopsy specimens were taken from a sentinel skin graft, the facial skin, and the oral mucosa. Functional progress was assessed by tests of sensory and motor function performed monthly. Psychological support was provided before and after transplantation. Results: Sensitivity to light touch, as assessed with the use of static monofilaments, and sensitivity to heat and cold had returned to normal at 6 months after transplantation. Motor recovery was slower, and labial contact allowing complete mouth closure was achieved at 10 months. Psychological acceptance of the graft progressed as function improved. Rejection episodes occurred on days 18 and 214 after transplantation and were reversed. A decrease in inulin clearance led to a change in immunosuppressive regimen from tacrolimus to sirolimus at 14 months. Extracorporeal photochemotherapy was introduced at 10 months to prevent recurrence of rejection. There have been no subsequent rejection episodes. At 18 months, the patient is satisfied with the aesthetic result. Conclusions: In this patient who underwent the first partial face transplantation, the functional and aesthetic results 18 months after transplantation are satisfactory.

36. Propriétés élastiques du muscle zygomatique en utilisant la technique d'élastographie par ultrasons

Author

Redouane Ternifi, Philippe Pouletaut, Adrien Heintz, Stéphanie Dakpé, Sylvie Testelin, Bernard Devauchelle, Fabrice Charleux, Jean-Marc Constans, Sabine Bensamoun, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Centre d'Imagerie Médicale Avancée (CIMA), CIMA, Service de Radiologie [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Institut Faire Face, and Pouletaut, Philippe

Subjects
[SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.OT] Life Sciences [q-bio]/Other [q-bio.OT], [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing
Abstract

International audience; L'expression du visage (mimique faciale) est animée par les mouvements des muscles peauciers (grand zygomatique, orbiculaires des lèvres, muscle abaisseur de l'angle de la bouche, etc…). Elle peut être altérée lors d'une paralysie faciale centrale ou le plus souvent périphérique qui peut être 1) a frigore (ou paralysie de Bell), la plus fréquente des paralysies faciales périphériques, 2) traumatique c'est-à-dire une lésion du nerf lors d'un accident, ou 3) due à une toute autre cause (tumorale, virale, ...). L'évaluation des déficits musculaires faciaux est subjective (palpation, vidéoscopie, etc …) et cette approche qualitative est insuffisante pour planifier les traitements, évaluer leur efficacité et suivre en rééducation fonctionnelle la récupération des patients traités. Ainsi, l'objectif principal de cette étude est d'utiliser notre savoir-faire en élastographie par résonance magnétique pour développer un protocole expérimental en imagerie ultrasonore (échographie) pour évaluer les propriétés fonctionnelles du zygomatique. Huit volontaires sains (4 femmes, 4 hommes, âge moyen : 25,3 ± 5,7 ans) sans lésion musculaire faciale ont été recrutés. Un test d'élastographie par ultrasons a été fait avec un échographe (Aixplorer) dont la spécificité est d'utiliser le mode d'imagerie breveté d'élastographie ShearWave (SWE) qui permet de cartographier et de quantifier en temps réel l'élasticité des tissus (kPa), indicateur important de modification tissulaire. Deux sondes échographiques (SLH20-6 : résolution 38 µm et SL10-2 : résolution 50 µm) ont été utilisées pour analyser le muscle à différentes profondeurs

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