Streptobacillary rat-bite fever: a pediatric problem.

A case of streptobacillary rat-bite fever in an 11-year-old boy from rural North Carolina is described. The child's clinical course was unique in that he developed a subglottic mass and bilateral parotid swelling. He responded initially to tetracycline but relapsed after therapy. Cure was ultimately achieved with a three-week course of penicillin. A review of the literature concerning this unusual clinical entity is presented.

[Myasthenia gravis and elderly persons. A case study]. / Myasthénie et personnes âgées. A partir d'une observation.

INTRODUCTION: Myasthenia gravis is an uncommon autoimmune disease which affects all ages. There are late-onset occurrences whose diagnosis is not considered often enough in geriatrics. EXEGESIS: We report a case of late-onset myasthenia gravis with a 78-year-old woman who was multi-pathologic and hospitalized for a diplopia check-up and recurrent falls. These stress the difficulty of suggesting myasthenia gravis in geriatrics due to the number of differential diagnoses that can mislead the physician. For the elderly subject, the diagnostic methodology is close to that of the younger subject. The search for related diseases must be systematic. CONCLUSION: Late-onset myasthenia gravis must remain a diagnosis present in the mind of the physician because of the significant improvement of the functional prognosis after the start of the treatment. The majority of subjects will recover a normal life.

[Current techniques of pharyngo-velar reconstruction after excision for cancer]. / Les techniques actuelles de reconstruction pharyngovélaire après exérèse carcinologique.

Carcinological surgery of the pharyngo-velar region poses delicate problems of reconstruction in exereses exceeding the midline. To avoid false alimentary pathways through the nose and phonatory problems (open rhinolalia), we propose the use, with or without the combination of a muscular cutaneous flap, of a free antecubital flap or of a latter is apparently fully satisfactory on the functional plane with the additional advantage of not leaving any aesthetic sequellae.

[The value of cellulo-adenectomy in the treatment of pharyngolaryngeal cancers without clinical adenopathy]. / Intérêt de la cellulo-adénectomie dans le traitement des cancers pharyngo-laryngés sans adénopathie clinique.

The term cellulo-adenectomy involves dissection of all the neck jugulo-carotid lymph nodes below the digastric muscle and above the omo-hyoid muscle. From the study of 133 cases treated by primary surgery, it can be said that this technique is essentially diagnosis to verify the actual integrity of the jugulo-carotid lymph trunk in patients who are clinically NO and who present a lymphophile ENT tumour. Such a technique necessitates a macroscopic lymph examination with an extemporaneous anatomical and pathological examination. Subsequent therapy depends on the result; for N+ patients, further surgery and/or irradiation, irrespective of the site; for a confirmed N- patient, additional therapy depending on the site of the tumour. Our experience has shown that this approach is safe and enables the treatment of the lymph glands to be better adapted to the reality of the neoplastic invasion.

Learning and generalization with Minimerror, a temperature-dependent learning algorithm.

We study the numerical performances of Minimerror, a recently introduced learning algorithm for the perceptron that has analytically been shown to be optimal both on learning linearly and nonlinearly separable functions. We present its implementation on learning linearly separable boolean functions. Numerical results are in excellent agreement with the theoretical predictions.

Anatomical and surgical particularities of cholesteatomas in children.

In children, cholesteatoma is closely related to dysfunction of the eustachian tube and evolves inside a malleable temporal bone. The importance of auditory and speech functions in such patients has caused us to use a very particular clinical philosophy. At the present time we have studied 154 cases of cholesteatomas in children under 15 years old. The following three points have been shown: the pathogenesis of a cholesteatoma can be of the primary type, secondary (due to an unfavorable extension of retraction pocket or to squamous cell migration) or even be iatrogenic; anatomical and clinical findings (with X-ray studies) predicate the treatment used; surgical treatment frequently requires a "second-look" operation.