Biomedical subjects
Publications and source records attributed to A Bonafe.
The authors treated 38 cases with cervical disc prolapse and discoradicular pain by percutaneous chemonucleolysis. Material and procedure are described and the results of 31 cases with a follow-up between 3 and 52 months analysed. The global results were excellent. In detail the results are analysed according to symptomatology, aetiology, findings of discography and the dose of enzyme used.
SMS 201-995, a long-acting somatostatin analog, was given as the initial treatment to an acromegalic patient. SMS 201-995 (200 micrograms, sc, three times daily) reduced, but did not normalize, serum GH levels. Complete and prolonged control of GH secretion was obtained with a 600-micrograms daily continuous sc infusion (CSI), and the patient was treated in this way for 6 months. Rapid improvement of clinical signs and symptoms of acromegaly occurred, as did major tumor shrinkage. The other pituitary functions did not change. After 6 months, the daily SMS 201-995 dose was progressively reduced; GH secretion remained suppressed. After 12 months of treatment, GH secretion was controlled with a CSI of 100 micrograms SMS 201-995 daily, but not with two daily sc 100-micrograms injections. Further significant reduction in tumor size occurred. We conclude that CSI of SMS 201-995 resulted in constant GH normalization and marked clinical and morphological improvement. This form of treatment should be considered as an alternative to ablative treatment of acromegaly.
Precise delineation of vertebrobasilar ischemia by computed tomography (CT) appears difficult due to the numerous variations in distribution of the posterior fossa arterial supply. While pontine and upper brainstem infarctions can be readily demonstrated, medullary infarction remains beyond the scope of present CT scanners. CT findings in cases of basilar artery occlusion include bilateral pontine infarction or extensive brainstem ischemia, associated with cerebellar and posterior cerebral vascular damage. Demonstration of basilar artery occlusion using routine CT is only rarely achieved. In cerebellar ischemia, CT, in conjunction with clinical syndromes, helps in the recognition of the arterial territory involved. CT provides useful guidelines for the treatment of cerebellar stroke, leading to surgery in cases of massive cerebellar infarction.
Enzymatic dissolution of nucleus pulposus by percutaneous injection of a papain preparation is now used frequently to treat lumbosacral disc hernias responsible for resistant sciatica. Mechanisms of action and techniques are reviewed, and the importance of applying strict criteria for indications for use emphasized. The method should be reserved for nerve root sciatica resistant to medical treatment or physiotherapy, and it constitutes the last stage of conservative treatment. Exclusion criteria are mainly "excluded" disc lesions, major dysfunction or associated spinal vertebral canal stenosis. The optimal indication is represented by the subacute disc hernia in the young. This alternative to open surgery in no way compromises the results in case of failure. Results obtained in a personal series of 150 cases are analyzed comparatively with those reported in the literature.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Metrizamide is a new hydrosoluble contrast medium of an entirely original conception which for first time makes it possible to explore the whole cord and its spaces. The technique of latero-cervical puncture between C1 and C2 was used in 45 cases of cervical cord compression, cervico-brachial neuralgia or brachial plexus paralysis. This technique of myelography has proved to be simple and reliable. It has a number of advantages: it is far more rapid, less painful and offers good visualisation of the nerve roots as compared with air myelography; unlike myelography with iodine-based oils, it is not necessary to remove the contrast medium after the examination since Metrizamide is spontaneously resorbable. Tolerance in general is remarkably good.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pure motor hemiplegia (PMH) is a well defined syndrome usually caused by ischemic lesions of lacunar type located either in the internal capsule or in the pons. Angiography and isotope scanning are usually normal. CT scan reveals small deep infarcts and appears to be the most reliable investigative method. The CT scan findings are described of thirty patients with PMH of rapid onset (less than 36 hours). In 29 of the 30 cases a lesion was found which could explain the PMH. Small hemorrhages (2 cm in diameter) in the posterior limb of the internal capsule were noted in two cases. Ischemic lesions were found in 27 patients, 22 patients had a single lesion (20 capsular and 2 pontine), while 5 patients had 2 lesions (2 bi-capsular, 3 capsular and pontine). Three varieties of ischemic capsular lesions were observed. We found in 15 cases a capsulo-putamine-caudate infarct (type I); in 8 cases a capsulo-pallidal infarct (type II); and in 2 cases an anterior capsulo-caudate infarct (type III). Type I corresponded to the area of the lateral lenticulostriate branches of the middle cerebral artery. Type II involved the territory of the perforating branches of the anterior choroidal artery. We suggest that type III involves the territory of the internal lenticulostriate branches of the anterior cerebral artery. Lacunes are generally linked to arterial systemic hypertension. However, only 16 of 30 patients in this series were chronically hypertensive.
A prospective and comparative computed tomography (CT)/magnetic resonance imaging (MRI) study on 90 patients with endoscopically examined and histologically proven laryngeal malignancy is presented. Post-operative pathological and intra-radiological (CT vs. MRI) correlations are established. We conclude that MRI is the method of choice for staging laryngeal malignancies.
Explore the source record for details and available documents.