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Biomedical subjects

B Pertuiset

Publications and source records attributed to B Pertuiset.

At least 37 records · Page 2Linked to original sources
PubMed1986

Aneurysm of the circle of Willis. Comparison between computed tomography and angiography.

The authors report their experience in 13 patients with unruptured non-giant aneurysms diagnosed at computed tomography (CT), who were without clinical deficits but who complained of chronic headache or cranial nerve palsy and had other members in their families with a cerebral vascular malformation. Screening with contrast-enhanced CT is discussed with respect to certain social groups. Surgical management before rupture of aneurysms could be envisaged in view of the bad prognosis when rupture has occurred.

Cerebral Angiography↗
PubMed1985

Operability of intracranial meningiomas. Personal series of 353 cases.

The senior author's experience has been reviewed in 353 operated meningiomas; so called "malignant meningiomas" have been discarded. The whole series has been split into two groups: the first (A) includes 273 cases operated before the CT era, the second (B) consists of 80 cases the operability of which was based mainly on the CT. In addition, during the time elapsed to constitute the second series surgery has been refused to 15 patients which were considered for CT and clinical reasons as surgically incurable when one wants to reduce the risk of mortality and morbidity. Therefore, we have reviewed in series B indisputable, questionable and incurable cases with respect to operability in the present condition of our technical possibilities including arterial hypotension, the operative microscope and the CUSA. Considering localization, we have made technical observations with respect to the principles on which operations have been based since 1958 when general anaesthesia became available in La Pitié. Among the patients of the whole series, 14 were admitted for a recurrence. The time interval between surgery and readmission has been given as well as the primary location of the meningiomas. The mortality rate has been 26 out of 353 (7%), and the main causes have been reviewed especially in series B. With regard to series B, we have been able to get in touch with 53 patients out of 80; 90% of them returned to work or family without sequelae. Intracranial meningiomas remain the most curable tumours, nevertheless some of them must be considered incurable like in meningiomatosis or when the dural attachment is extensive. For those cases surgery is not the final answer and we must accept the fact that in the future other kinds of treatment will develop.

Adult↗
PubMed1985

The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography.

The authors report a series of 56 cases of craniocerebral lesions secondary to missile injuries studied by means of CT scan. CT scans demonstrate the track of the missile, destruction of deep cerebral parenchyma, dissection of the white matter (intracerebral air) and reactive oedema. The prognostic incidence of CT is discussed. The CT scan helps to choose the best therapeutic management with respect to each particular case.

Adolescent↗
PubMed1985

Stem cell studies of human malignant brain tumors. Part 2: Proliferation kinetics of brain-tumor cells in vitro in early-passage cultures.

The proliferation kinetics were studied in early-passage cultures of cells from 13 human malignant brain tumors and two specimens of normal brain under conditions similar to those used in clonogenic cell-survival studies. Autoradiography was performed in all but four cases to estimate the fraction of cells actively replicating deoxyribonucleic acid (DNA), the approximate cell cycle time, and the effect of low-dose tritiated thymidine on cell proliferation. The mean tumor cell doubling time (TD) was 53 hours for five glioblastomas, 46 hours for two ependymomas, and 83 hours for two medulloblastomas. A gliosarcoma grew fastest (TD = 22 hours) in culture and a pilocytic astrocytoma grew slowest (TD = 144 hours). The approximate cell cycle time ranged from 1 to 2.5 days for all tumors tested. This suggests that chemotherapeutic agents that predominantly kill proliferating cells should be administered in vitro for at least 2 to 2.5 days to achieve maximum cell kill. The approximate growth fraction ranged from 0.65 to 0.96 for all tumors except for the two medulloblastomas and the pilocytic astrocytoma, which had growth fractions of 0.34 and 0.35, respectively. Most laboratories investigating the chemosensitivity of primary or early-passage human tumor cells require that 40% to 70% of cells be killed to consider a drug active in vitro. The results of this study suggest that the cell-cycle-specific agents cannot achieve a high enough cell kill to be considered active for some tumors that grow slowly in culture. An estimate of the in vitro growth rate is necessary to reliably interpret cell-survival results with such agents. Tritiated thymidine appeared to slow cell proliferation in some of the cultures, presumably as a result of radiation-induced DNA damage caused by tritium that had been incorporated into DNA. The degree to which cell growth ws slowed in individual tumors correlated with the patient's clinical response to radiation therapy and postoperative survival time.

Brain Neoplasms↗
PubMed1985

[Instantaneous measurement of blood flow velocity in internal carotid arteries by pulsed Doppler in cerebral arteriovenous malformations].

Hemodynamics (systolic rate: VS and diastolic rate: VD) of internal carotid artery blood flow was determined by pulsed Doppler combined with ultrasound scans to measure instantaneous flow rate in 8 patients with cerebral arteriovenous malformations. Values obtained were compared with those in 10 healthy volunteers. Measurement of the diastolic fraction a = (formula: see text) appears to be a valid method for assessing severity of this malformation and the importance of its output. Repeated tests in one patients operated upon by several stages demonstrated the importance of a blood shunt after ablation of lesions.

Adult↗
PubMed1984

Traumatic, spontaneous and postoperative CSF rhinorrhea.

CSF fistulas are a major complication of head injury but also occur spontaneously or symptomatically in connection with tumours of the skull base, empty sella syndrome, ethmoidal encephalomyelocele, intracranial hypertension or postoperatively in connection with operations on skull base tumours or ENT operations. Their main risk is the possibility of meningitis. The main clinical symptom is CSF leakage from the nose, but meningitis may be the first manifestation. Isotope cisternography and metrizamide CT cisternography are the most important methods for precise localization, sometimes also for verification of a suspected fistula. Most traumatic CSF fistulas of the frontal and ethmoidal region have to be treated operatively. The method of choice is the transfrontal approach and the closure of the fistula opening using a pedicled pericranial flap or fascia lata graft. Most sphenoidal fistulas have to be treated by packing the sphenoidal sinus with muscle. The treatment methods of the rare spontaneous and symptomatic CSF fistulas are also described. The results of operative treatment are satisfactory. About 6% recurrences, which as a rule can be cured by reoperation, and a mortality rate of about 1-3% seem to be an acceptable price for prevention of an otherwise unavoidable and oftenly deadly meningitis. Future efforts are necessary to improve the operative technique in order to reduce the incidence of anosmia. Our descriptions and advice are based not only on literature reports but also on our own experiences with a combined material of 237 cases operated on for rhinorrhea.

Adult↗
PubMed1984

Biochemical characterization of 17 beta-hydroxysteroid dehydrogenase in human meningioma.

17 beta-Hydroxysteroid dehydrogenase (E2-DH) activity was characterized on a semipurified microsomal preparation of human meningioma tissue (mean Km of 2 microM and Vmax of 500 pmol/mg protein/10 min) and then assayed in 49 meningioma specimens with high progesterone receptor and low estrogen receptor levels. Of these 49 tumors, 36% contained an E2-DH activity greater than 1,000 pmol/mg protein/10 min and similar to that of uterine myometrium. In this limited series of tumors, no correlation between E2-DH activity and progesterone receptor levels was noted.

17-Hydroxysteroid Dehydrogenases↗
PubMed1983

Mathematical model for hormonal therapy (vasopressin, corticoids) in cerebral collapse and malignant tumors of the brain (36 cases).

A mathematical model of the adrenal postpituitary system has been used in cases of brain disease in which endocrine disturbances play an aggravating role. A computer simulation has suggested a type of therapy adding vasopressin to corticoids; this association seems to elicit better results than corticoids alone. Posttraumatic disorders of the cerebral hydration, on one hand, and inoperable or recurrent tumors, on the other hand, take advantage of such a systemic, formalized approach.

Adrenal Cortex Hormones↗
PubMed1983

[96 cases of spontaneous medical cerebral hemorrhage. Diagnostic and therapeutic experience].

Prognosis in a homogeneous series of 96 cases of non-traumatic cerebral hemorrhage admitted to a neurosurgical department within 6 to 24 hours of onset was assessed by studying possible correlations between clinical condition (grade I: conscious; grade II: somnolent; grade III: comatose; grade IV: comatose with signs of brain stem involvement) and computed tomography findings (site, extension, size of hemorrhage; degree of edema and of mass effect; presence of hydrocephalus or ventricular hemorrhage). It was possible to distinguish effects due to destruction and/or compression of functional cerebral regions for a given clinical picture, and to apply these data to determine types of therapy and surveillance according to 3 time-periods. During the first 48 hours there was almost perfect agreement between the severity of the clinical picture and the degree of cerebral destruction (62,6 p. 100 of grade IV, 27,7 p. cent of grade III died). Only patients in grade III with temporal hemorrhage directly menacing the brain stem were operated upon. From the 3rd to the 7th day surveillance was based on clinical findings and computed tomography, repeated in principle on the 3rd and 7th days. Patients operated upon during this period were those in whom clinical signs and/or effects due to mass effect as seen on the CTscan were becoming worse. The third period, lasting from the 8th to the 21st day, was that during which the vital prognosis was generally no longer affected, and indications for surgery were functional in nature. The prognostic value of measurements of intracranial pressure is discussed.

Adult↗
PubMed1983

[Elements predicting respiratory complications after total excision of neurinomas of the 8th nerve. Consequences on the postoperative treatment (study of 12 cases)].

Pulmonary complications are observed after radical surgery of acoustic neurinomas. This study, performed on 12 patients was undertaken to appreciate central respiratory activity by measuring the respiratory response to CO2 before and after the operation and to find out whether they could be used to predict post-operative respiratory complications. The patients who developped pulmonary or bronchial infections had increased PaCO2 (45.1 +/- 3.0 mmHg--mean +/- S.D.) and decreased ventilatory response to CO2 (VE/PACO2: 0.65 +/- 0.37 1/min/mmHg) before the operation. After the operation, all these patients developped swallowing difficulties and a decreased vigilance; therefore we assumed that swallowing troubles and decrease of vigilance could be responsible for bronchopulmonary infection. Patients with a low respiratory response to CO2 have higher risk of developping pulmonary complications and can be detected before surgery by this non-invasive test and by the measure of PaCO2.

Arousal↗
PubMed1982

Progestin and oestrogen receptors in meningiomas. Biochemical characterization, clinical and pathological correlations in 42 cases.

Progestin receptors (PR) were evaluated in 40 intracranial and 2 spinal meningiomas. PR measured with radiolabelled R 5020 were found in 93% of cases (39/42). PR levels were significantly higher (p = 0.05) in females (mean: 5,720 fmol/gmT) than in males (mean: 3,120 fmol/gmT). Biochemical characterization of the R 5020 saturable binding sites showed that they were mainly cytosolic, had a high affinity constant (Kd approximately equal to 1 nM) and were progestin specific. Correlation with sex suggested some biological activity of PR in meningiomas. Oestrogen receptors (OR) were evaluated in 36 intracranial and 2 spinal meningiomas. OR measured with radiolabelled R 2858 were present in 79% of cases (30/38). OR mean levels were equal in females (mean: 285 fmol/gmT) and in males (mean: 330 fmol/gmT). The relevance of PR and possibly OR in the biology of meningiomas and of leptomeninges was suggested by the presence of receptors in a sample of normal leptomeninges.

Adult↗