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Chronic recurrent parotitis (CRP) is a rare affliction of unknown cause characterized by recurrent episodes of unilateral or bilateral nonobstructive and nonsuppurative inflammation of the parotid glands. Management of CRP is not standardized, and attempts at treatment often fail. We report a case of a 29-year-old female patient with CRP for 13 years, with recurrent acute episodes, complicated with a collection and cutaneous fistula, refractory to repeated courses of corticosteroids and antibiotics. Injections of botulinum toxin in the parotid gland and maintenance treatment with oral colchicine lead to a rapid and sustained improvement. Local botulinum toxin injections associated with colchicine might represent a safe and noninvasive treatment of CRP. The possible beneficial effect of colchicine could be an argument for auto-inflammatory participation in the pathogenesis of CRP. more...

Over the last few years, historical populations originating essentially from necropolises and being used as reference have been studied from a standpoint of biodynamical and architectural methodology of the cranium and the face and their relations to occlusion. The same analytic parameters have been used on Homo Sapiens from Algeria, in respect thereof the humans from Mechta-Afalou. As to the cranio-facial set, it is no longer the cranial morphological description for a given progressive period that prevails, but rather the individual growth rhythm in a progressive population, taking into account its developmental anomalies and pathologies. The dentitions that are an integral part of the cranio-facial architecture are then correlated to the whole harmonic or disharmonic cranium/face on one hand and, on the other hand, to the vertebral column when this latter is more or less well preserved. This anatomical reading is based on architectural parameters of biodynamic morphogenesis through medical imaging such as paralleling technique or scanning. Paralleling technique was systematically used and an analysis done on all the archeological crania from the Afalou Bou Rhummel site (Bedjaia, Algeria) with a temporomandibular joint or calvaria. Their study allows to point to certain periods the cranio-facial architectural chart as well as the occlusal balance or disbalance and for the latter, if appropriate, to find the cause. All in all, the biodynamic and occlusal analysis of hominids from Algeria not only allows us to discover their cranio-facial architecture, but also contributes to a better understanding of the occlusion in contemporary Algerians. The latter have been the subject for a few years of an architectural and occlusal analysis in comparison to contemporary Saharan and Sub Saharan populations. more...

Introduction. Les lithiases salivaires representent une pathologie benigne des glandes salivaires. Historiquement, seuls les traitements chirurgicaux etaient utilises pour leurs prises en charge (ablation de la glande par voie transcutanee ou dissection des canaux excreteurs par voie endobuccale a la recherche des lithiases). Cette chirurgie n’est pas sans risque pour les structures avoisinantes (nerf facial ou nerf lingual essentiellement). Depuis vingt ans, le developpement de l’endoscopie avec l’instrumentation endocanalaire et de la lithotripsie extracorporelle (LEC) a permis une nouvelle alternative a la chirurgie conventionnelle. Materiel et methodes. Nous avons pris en charge par ces techniques 3 436 patients a l’Institut d’Explorations Fonctionnelles et d’Endoscopie des Glandes Salivaires (IEFGS) a Paris entre decembre 1988 et aout 2010. Ils ont beneficie d’un traitement par LEC dans 1 571 cas et/ou par sialendoscopie dans 1 865 cas. Ces deux techniques ont toujours ete realisees en ambulatoire, sans recours a l’anesthesie generale, tant chez les adultes que chez les enfants. Resultats. L’endoscopie a permis d’extraire les calculs avec succes chez 96,4 % des patients (1 402 sur 1 455). Elle a aussi ete utilisee pour le diagnostic voire le traitement d’autres pathologies comme les infections chroniques et les stenoses canalaires. La LEC a, quant a elle, permis de fragmenter 100 % des lithiases en six seances en moyenne, 67,2 % totalement et 32,8 % partiellement. 92 % des patients ont vu une disparition totale de leur symptomatologie retentive, qu’il persiste ou non des fragments residuels a l’echographie. Aucune complication majeure n’a ete a deplorer.Discussion. La reussite des procedures endoscopiques tient principalement en la selection des bonnes indications (lithiase de taille inferieure a 4 mm, canal de calibre suffisant et permeable, calcul non enclave). La LEC a pu etre effectuee sur toutes les lithiases avec une bonne efficacite. Les inconvenients principaux restent la longueur du traitement et la difficulte du reperage echographique qui rend la procedure operateur-dependant. Conclusion. Le traitement des lithiases salivaires ne doit plus aujourd’hui faire appel au seul traitement chirurgical, mais doit prendre en compte les nouvelles techniques d’endoscopie et de LEC. Ces deux techniques sont particulierement interessantes et efficaces a condition d’en respecter les indications, affinees au fur et a mesure de leur developpement et de notre experience. more...

Objectifs : les lithiases salivaires representent une pathologie benigne des glandes salivaires. Les traitements par sialo-endoscopie et lithotripsie intra ou extra-corporelle ont ete developpes dans le monde comme alternative a la chirurgie. Notre objectif de depart a ete de mettre au point des traitements non chirurgicaux afin de reduire au minimum la morbidite de cette pathologie. Dans cette etude, nous analysons une grande serie clinique afin de determiner le succes de ces nouvelles techniques mais aussi de developper des protocoles de traitement en fonction des pathologies. But de l’etude : etudier retrospectivement 1973 glandes salivaires presentant une pathologie et traitees non chirurgicalement. Methodes : traitement des lithiases salivaires utilisant soit l’endoscopie avec instrumentation endocanalaire, soit la lithotripsie intracanalaire par laser, soit la lithotripsie par ondes de chocs electromagnetiques sur 1973 glandes lithiasiques entre 1988 et 2004. Au total, 1205 endoscopies ont ete pratiquees sur des glandes pathologiques et 768 lithotripsies extracorporelles ont ete realisees. Resultats : l’endoscopie a permis d’eliminer 96% des lithiases examinees. La lithotripsie, quant a elle, a detruit completement 63 % des lithiases dont 35 % de cas ont ete totalement evacues, soit de facon spontanee soit en utilisant l’endoscopie. Il n’y a jamais eu de complications majeures au niveau des nerfs facial ou lingual, aucun dommage dentaire n’a ete releve. Un patient au debut de l’etude sur l’endoscopie a du subir une intervention chirurgicale par blocage de la sonde a panier miniaturisee dans le bassinet de la glande. Les effets secondaires comme les infections, douleurs, oedemes ou petechies ont ete traites simplement sans consequence pour les glandes salivaires. 4 % des endoscopies et 2 % des lithotripsies ont cependant en dernier recours necessite l’ablation chirurgicale des glandes. Conclusions : le traitement des lithiases salivaires ne doit plus aujourd’hui faire appel au seul traitement chirurgical, mais doit prendre en compte les nouvelles techniques d’endoscopie et la lithotripsie extra-corporelle. Ces deux nouvelles techniques sont particulierement interessantes pour les calculs situes dans les canaux salivaires et les bassinets des glandes. Cette etude demontre l’efficacite des nouveaux traitements. more...

BACKGROUND Facial lipoatrophy has been observed to occur in a variety of patient populations, with inherited or acquired disease, or even in aging patients as a natural progression of tissue change over time. There is currently no framework from which physicians of all medical specialties can communally discuss the manifestations, diagnoses, and management of facial lipoatrophy. OBJECTIVE The aim of this assembly was to derive a definition of facial lipoatrophy capable of being applied to all patient populations and develop an accompanying grading system. RESULTS The final consensus of the Facial Lipoatrophy Panel encompasses both aging and disease states: "Loss of facial fat due to aging, trauma or disease, manifested by flattening or indentation of normally convex contours." The proposed grading scale includes five gradations (Grades 1-5; 5 being the most severe), and the face is assessed according to three criteria: contour, bony prominence, and visibility of musculature. CONCLUSION Categorizing the presentation of facial lipoatrophy is subjective and qualitative, and will need to be validated with objective measures. Furthermore, during the assembly, several topics were exposed that warrant further research, including the physiology of volume loss, age and lipoatrophy, and human immunodeficiency virus and lipoatrophy. more...

BACKGROUND Interest in facial lipoatrophy (LA) has recently intensified; this phenomenon is linked to the rise in the number of people adversely affected by the condition as a side effect of antiretroviral treatment for HIV, combined with the growing number of cosmetic products that claim to be able to correct the appearance of LA. Despite growing awareness of the problem, there is at present no standard and accepted technique with which to assess the severity of LA. OBJECTIVE This review explores facial LA, the use of ultrasound in the evaluation of facial LA, its advantages and disadvantages, and will place the technique in the context of other means of assessing regional skin and fat thickness. METHOD Review of literature published on PubMed. RESULTS Ultrasound, as with any technique used to assess facial LA, is associated with distinct advantages and disadvantages. CONCLUSIONS Studies that use a number of different techniques to evaluate changes in dermal thickness provide the greatest insight into both perceived and actual changes in facial LA. Further investigation into the use of these techniques is warranted, along with a formal consensus of facial LA grades. more...

During the last decade, minimally invasive and nonsurgical techniques of diagnosing and treating salivary gland duct stones have rapidly evolved. Physicians have developed alternative treatments beyond the sole use of invasive conventional surgery. Techniques and equipment have been specifically developed to deal with ductal lithiasis. Salivary duct endoscopy, endoscopic instrumentation, and intra- or extracorporeal lithotripsy have proven themselves to be efficacious in most cases involving ductal stones. Current algorithms for treatment combine conventional surgical, minimally invasive, and nonsurgical strategies to produce the least invasive and best-tolerated outcomes for each individual patient. more...

Optical imaging is the only technique that allows to record the activity of a neuronal population at the mesoscopic scale. A large region of the cortex (10–20 mm diameter) is directly imaged with a CCD camera while the animal performs a behavioral task, producing spatio-temporal data with an unprecedented combination of spatial and temporal resolutions (respectively, tens of micrometers and milliseconds). However, researchers who have developed and used this technique have relied on heterogeneous software and methods to analyze their data. In this paper, we introduce Vobi One, a software package entirely dedicated to the processing of functional optical imaging data. It has been designed to facilitate the processing of data and the comparison of different analysis methods. Moreover, it should help bring good analysis practices to the community because it relies on a database and a standard format for data handling and it provides tools that allow producing reproducible research. Vobi One is an extension of the BrainVISA software platform, entirely written with the Python programming language, open source and freely available for download at https://trac.int.univ-amu.fr/vobi_one. more...

An automated surveillance method that uses multiple image processing can detect, analyze, and track movements to identify emergency situations.

In this paper, an iterative tracking algorithm based on a non-linear JTC (Joint Transform Correlator) architecture and enhanced by a digital image processing method is proposed and validated. This algorithm is based on the computation of a correlation plane where the reference image is updated at each frame. For that purpose, we use the JTC technique in real time to track a patient (target image) in a room fitted with a video camera. The correlation plane is used to localize the target image in the current video frame (frame i). Then, the reference image to be exploited in the next frame (frame i +1) is updated according to the previous one (frame i). In an effort to validate our algorithm, our work is divided into two parts: (i) a large study based on different sequences with several situations and different JTC parameters is achieved in order to quantify their effects on the tracking performances (decimation, non-linearity coefficient, size of the correlation plane, size of the region of interest...). (ii) the tracking algorithm is integrated into an application of elderly fall detection. The first reference image is a face detected by means of Haar descriptors, and then localized into the new video image thanks to our tracking method. In order to avoid a bad update of the reference frame, a method based on a comparison of image intensity histograms is proposed and integrated in our algorithm. This step ensures a robust tracking of the reference frame. This article focuses on face tracking step optimisation and evalutation. A supplementary step of fall detection, based on vertical acceleration and position, will be added and studied in further work. more...

Introduction. Les lithiases salivaires representent une pathologie benigne des glandes salivaires. Historiquement, seuls les traitements chirurgicaux etaient utilises pour leurs prises en charge (ablation de la glande par voie transcutanee ou dissection des canaux excreteurs par voie endobuccale a la recherche des lithiases). Cette chirurgie n’est pas sans risque pour les structures avoisinantes (nerf facial ou nerf lingual essentiellement). Depuis vingt ans, le developpement de l’endoscopie avec l’instrumentation endocanalaire et de la lithotripsie extracorporelle (LEC) a permis une nouvelle alternative a la chirurgie conventionnelle.Materiel et methodes. Nous avons pris en charge par ces techniques 3 436 patients a l’Institut d’Explorations Fonctionnelles et d’Endoscopie des Glandes Salivaires (IEFGS) a Paris entre decembre 1988 et aout 2010. Ils ont beneficie d’un traitement par LEC dans 1 571 cas et/ou par sialendoscopie dans 1 865 cas. Ces deux techniques ont toujours ete realisees en ambulatoire, sans recours a l’anesthesie generale, tant chez les adultes que chez les enfants.Resultats. L’endoscopie a permis d’extraire les calculs avec succes chez 96,4 % des patients (1 402 sur 1 455). Elle a aussi ete utilisee pour le diagnostic voire le traitement d’autres pathologies comme les infections chroniques et les stenoses canalaires. La LEC a, quant a elle, permis de fragmenter 100 % des lithiases en six seances en moyenne, 67,2 % totalement et 32,8 % partiellement. 92 % des patients ont vu une disparition totale de leur symptomatologie retentive, qu’il persiste ou non des fragments residuels a l’echographie. Aucune complication majeure n’a ete a deplorer.Discussion. La reussite des procedures endoscopiques tient principalement en la selection des bonnes indications (lithiase de taille inferieure a 4 mm, canal de calibre suffisant et permeable, calcul non enclave). La LEC a pu etre effectuee sur toutes les lithiases avec une bonne efficacite. Les inconvenients principaux restent la longueur du traitement et la difficulte du reperage echographique qui rend la procedure operateur-dependant.Conclusion. Le traitement des lithiases salivaires ne doit plus aujourd’hui faire appel au seul traitement chirurgical, mais doit prendre en compte les nouvelles techniques d’endoscopie et de LEC. Ces deux techniques sont particulierement interessantes et efficaces a condition d’en respecter les indications, affinees au fur et a mesure de leur developpement et de notre experience. more...

Juvenile recurrent parotitis (JRP) can be a debilitating illness in children. Knowing how to recognize and diagnose it for early treatment avoids recurrences that could lead to significant destruction of the glandular parenchyma. This article discusses the various therapeutic modalities proposed in the literature (medical treatment or sialendoscopy) and describes the authors' treatment of choice of combining antibiotics and iodinated oil sialography. more...

Ultrasound investigation of the major salivary glands has been routinely used for the past 25 years. Ultrasound provides an immediate diagnosis in acute or chronic inflammatory salivary diseases and can visualize sialolithiasis as small as 0.4 mm. Ultrasound is also an important imaging modality for salivary gland tumors, guiding fine needle aspiration (FNA) for cytological diagnosis. It is particularly sensitive in detecting suspicious lymph nodes in the neck and helps to guide FNA. Ultrasound is a first-line tool for diagnosis of salivary pathology. It is simple to use, noninvasive, and well tolerated, even in children. more...

Objective: To evaluate the application of minimally invasive techniques in the management of salivary stones. Background: The incidence of salivary calculi is 60 cases/million/year, with most stones situated in the mid or proximal duct. The current treatment of these stones is adenectomy. This paper reports the results of minimally invasive methods of stone removal that avoid gland excision. Methods: Observational study of 5,528 consecutive patients treated by lithotripsy, endoscopy, basket retrieval, and /or surgery in five centers from 1990 to 2004 inclusive. A total of 567cases were excluded, leaving 4,691 patients (parotid n = 1,165, submandibular n = 3,526) for analysis. Results: Salivary calculi were eliminated in 3,775/4,691 (80.5%) of cases and partly cleared in 782/4,691 (16.7%). Salivary glands were removed in 134/4,691 (2.9%) of patients with symptoms in whom treatment failed. Conclusions: Minimally invasive techniques move treatment of salivary calculi to an outpatient or a day case setting. They are reliable ways of both retrieving stones and eliminating symptoms, and mean that the gland rarely has to be removed. Laryngoscope, 2009 more...

Background In the absence of currently available therapy to manage facial lipoatrophy, strategies used to compensate for facial fat loss warrant clinical evaluation. Methods The goal of this open-label, single-arm, pilot study was to evaluate the efficacy and safety of facial injections of poly-L-lactic acid (PLA) (New-Fill) in HIV-infected patients with severe facial lipoatrophy. Patients received four sets of injection at day 0 and then every 2 weeks for 6 weeks. Patients were evaluated by clinical examination, facial ultrasonography, and photography at screening and at weeks 6, 24, 48, 72, and 96. Results Fifty patients were enrolled. At entry, the median facial fat thickness was equal to zero (range, 0.0-2.1 mm). The median total cutaneous thickness (TCT) increased significantly from baseline : +5.1 mm (range, 2.2-8.6 mm) at week 6, +6.4 mm (range, 3.1-9.1 mm) at week 24, +7.2 mm (range, 4.2-9.6 mm) at week 48, +7.2 mm (range, 3.5-9.6 mm) at week 72 and +6.8 mm (range, 3.9-10.1 mm) at week 96 (P 10 mm was observed in 19% at week 6, 41% at week 24, 61% at week 48, 52% at week 72 and 43% at week 96. In 22 (44%) patients, palpable but non-visible subcutaneous micronodules were observed with a spontaneous resolution in six patients at week 96. Conclusion The benefit of PLA for the correction of the facial lipoatrophy in HIV-infected patients was clearly demonstrated, with an evident aesthetic and quality of life improvement. The efficacy, safety profile, and the simplicity of the injection schedule of PLA make this filling material a potentially attractive treatment. more...

International audience; We consider a new approach for enhancing the discrimination performance of the VanderLugt correlator. Instead of trying to optimize the correlation filter, or propose a new decision correlation peak detection criterion, we propose herein to denoise the correlation plane before applying the peak-to-correlation energy (PCE) criterion. For that purpose, we use a linear functional model to express a given correlation plane as a linear combination of the correlation peak, noise, and residual components. The correlation peak is modeled using an orthonormalized function and the singular value decomposition method. A set of training correlation planes is then selected to create the correlation noise components. Finally, an optimized correlation plane is reconstructed while discarding the noise components. Independently of the filter correlation used, this technique denoises the correlation plane by lowering the correlation noise magnitude in case of true correlation and decreases the false alarm rate when the target image does not belong to the desired class. Test results are presented, using a composite filter and a face recognition application, to verify the effectiveness of the proposed technique. more...