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Biomedical subjects

B Tomeno

Publications and source records attributed to B Tomeno.

At least 19 recordsLinked to original sources
PubMed1992

[Ewing's tumor].

Ewing's tumour is an undifferentiated round-cell sarcoma of children and adolescents arising from the skeleton. The translocation (11; 22) (q24; q12) is specific and could serve as a diagnostic marker. It has also enabled this tumour to be classified in the group of primary neuro-ectodermal tumours. Concerning treatment, intensive chemotherapy alternating with local therapy has improved the prognosis of localized Ewing's sarcoma of the limbs and, to a lesser degree, of the axial skeleton.

Bone Neoplasms↗
PubMed1992

[One stage revision of infected total hip replacements with replacement of bone loss by allografts. Study of 90 cases of which 46 used bone allografts].

We usually manage infected total hip replacements by a one stage revision. We have reviewed 90 cases operated on before 1988. Notable bone loss was frequently encountered and reconstructed using allografts. In all cases complete surgical debridement was performed and a cemented total hip replacement implanted. Bone allografts were used in 46 cases. Systemic antibiotics and antibiotic loaded cement were utilised. There were 17 failures (19%); one patient died soon after operation, there were 8 obvious infections (9%), 1 hip was thought to be infected although the prosthesis was not loose, and 7 femoral prostheses became loose of which 3 were due to mechanical failure and the remainder had no obvious explanation. Infection with staphylococcus aureus and pseudomonas had a statistical correlation with failure, but other factors including the preoperative status and the use of allografts did not appear to influence the result. Allograft femoral heads from the bone bank were found to be reliable for reconstruction of the acetabulum and small femoral defects. With major femoral bone loss we preferred massive irradiated cortical allografts. The quality of the bone reconstruction was probably the most important factor in the good functional results observed in 79% of cases. Effective surgical debridement and an appropriate antibiotic regime will allow a successful one stage revision procedure. The use of allografts gave a reliable reconstruction of the bone loss and was not associated with an increased rate of failure.

Acetabulum↗
PubMed1992

[Synovial sarcoma. A study of a series of 46 cases].

Synovial sarcoma is a rare malignant soft tissue tumor. The histological diagnosis remains sometimes difficult. The authors report 46 cases, treated in different hospitals in Paris. The medium survival rate of this group (which includes cases treated long ago) is of 30 per cent at 5 years. But only 24 per cent are disease free at this time. At the last follow up, the patients deceased after the fifth year included, the survival rate drops down to 12 per cent. Local recurrences and metastasis are analysed with reference to the different treatments applied. It seems that the association of polychimiotherapy and wide surgical excision might increase the survival rate, but this has to be confirmed in future. Radiotherapy is still a valuable treatment when excision is only limited, or when excision is impossible, due to localisation or extension of the tumor.

Adolescent↗
PubMed1992

[Ewing's sarcoma of bone in adults: an anatomic-clinical study of 30 cases].

The records of 30 adult patients with Ewing's sarcoma (ES) of bone treated between 1980 and 1990 at the Institut Curie were studied retrospectively; the diagnosis was reevaluated by histological and immunohistochemical analysis, using HNK and anti-neuron specific enolase (NSE) antibodies. The immunohistological analysis disclosed a significant staining of neoplastic cells in only few of our cases and is therefore of limited interest in the diagnosis of ES. Three groups of patients have been considered according to their clinical presentation: axial, peripheric and initial metastatic disease. The global prognosis is poor: the survival rate is 70% after a follow-up period of one year, and 23% after three years. The evolution was severe for patients with pelvic localization and/or initial metastatic disease. In contrast, five of six patients who are currently free of disease after a mean follow-up period of 42 months presented initial peripheric lesion. Four of these six patients were treated by a combination of surgical, chemical and radiation therapies.

Adolescent↗
PubMed1991

Femoral infarction following intraarterial chemotherapy for osteosarcoma of the leg: a possible pitfall in magnetic resonance imaging.

Bone infarction of the distal femur is reported in two patients with osteosarcoma of the leg (1 tibia, 1 fibula) treated by preoperative chemotherapy including intraarterial chemotherapy (IAC) by Cis-platinum. Both patients were examined by magnetic resonance imaging before chemotherapy and again prior to limb salvage surgery. The location of these lesions in the distal femur must suggest bone infarction especially if the tumor has decreased in size under treatment.

Adult↗
PubMed1991

Monobloc resection of the upper extremity of the leg for bone tumor with distal vascular reconstruction.

A patient with juxtacortical osteosarcoma of the upper extremity of the left tibia which encased the popliteal neurovascular bundle was treated by monobloc resection of the superior extremity of the tibia and the tibial nerve. The knee joint was replaced by a Guepar prosthetic knee. Arterial and venous continuity was reestablished by a double bypass using the contralateral greater saphenous vein. One year later the patient had good lower limb function and was free of local or general disease. This observation confirms that preservation of lower limb function is possible using reconstruction techniques of bone, nerves, and vessels in sarcoma of the musculoskeletal system.

Adult↗
PubMed1991

Histological patterns of bone and articular tissues after orthopaedic reconstructive surgery (artificial joint implants).

Revision surgery after failures of joint replacements leads to histological studies on joint and bone tissues close to the implanted material. Aspectic loosening is the main complication. The surgical pathologist has to identify wear debris (metal, polyethylene, polymethylmethacrylate, chiefly) which promotes a histiocytic granuloma. Some surgical procedures such as cup or resurfacing arthroplasties create a new articular surface and a bone remodeling or necrosis. Cemented joint prostheses show various membrane structures between bone and the cement mantle while there is an association of bone resorption and formation. Non-cemented, porous-coated joint prostheses induce little bone ingrowth, even in satisfactory clinical results. Mechanical factors are predominant in massive limb prostheses. For silicone elastomer implants or artificial ligaments, wear of material promotes many tissular reactions. Often used bone grafts show little creeping substitution process in case of homografts, even well-incorporated on X-rays. More retrieval specimen studies are necessary to delineate precise topographical histological lesions, including non-loosened joint implants.

Bone and Bones↗
PubMed1991

[Tumor prognostic factors in chondrosarcoma of the locomotor system. Apropos of 180 cases].

One hundred and seventy-eight patients suffering from 180 chondrosarcomas have been treated by the orthopaedic department of Cochin Hospital. Actuarial survival in these patients was 67 per cent after five years, 62 per cent after 10 years and 59 per cent after 15 years. The two main bases for survival prognosis were: --the histoprognostic grade in O'Neal and Ackerman's classification (survival after 5 years: 83 per cent for grade 1, 75 per cent for grade 2, and 15 per cent for grade 3); --the quality of the surgical resection (survival after 5 years: 78 per cent in cases of carcinological resection, and 52 per cent in cases of incorrect resection). Keeping the limb did not reduce the chances of a cure. Patients treated recently have a better prognosis than those treated before 1970: this improvement was mostly because carcinological treatment was used more often. The same prognostic factors govern local recurrences.

Adolescent↗
PubMed1979

Clear-cell chondrosarcoma: a report of five cases including ultrastructural study.

Five cases of clear-cell variant of chondrosarcoma (Unni et al.) are reported. The tumors occurred in the epiphyseal region of long bones; three in the femoral head. Roentgenographically, the lesion was usually a well-defined and benign appearing one, either purely lytic (3 cases) or with central radiodensity (2 cases). Histologically, all five cases had areas of conventional chondrosarcoma; however, the greater portion of the tumor was made up of sheets of clear-cells intermixed with nonneoplastic bone trabeculae but devoid of chondroid matrix. Electron microscopic studies showed that these clear-cells possess cytoplasmic microvilli, abundant glycogen particles and prominent golgi complexes, like normal or tumorous chondroid cells usually have. In our experience, the best treatment seemed to be en bloc resection with joint replacement; indeed, despite the fact that they are true chondrosarcomas, these tumors usually have a very slow rate of growth.

Adolescent↗
PubMed1979

[Bone metastasis simulating a chondrosarcoma (author's transl)].

The authors report three cases of bone tumours, two in the scapula and one in the pelvis, which simulated chondrosarcoma on radiological examination. After biopsy it was concluded that they were metastases secondary to carcinoma of the bladder in one case and of unknown origin in the other two.

Adenocarcinoma↗
PubMed1979

[Pantalar arthrodesis. A follow up study of 45 operations (author's Transl)].

The authors have studied the long term results of 45 Pantalar arthrodesis realised either in one stage, or in two stages. Technical details are given for obtaining a good positioning during the surgical procedure. It was found that post operative complications were more frequent than after more limited operations. The long term results were satisfactory, provided a good positioning. Residual equinus deformities were better tolerated than deformities in pronation or supination. It was noted no consequences on neighboring joints.

Adolescent↗
PubMed1979

[Phalangeal osteoid osteoma (13 cases)].

Thirteen cases of osteoid osteoma of the phalanxes are reported: 10 fingers and 3 toes. Any phalanx may be affected, with no preference for a particular site, in the young adult. Segmentary tumefaction of the soft parts near the lesion is a more consistent sign than pain, which is often quite minimal. Radiographies demonstrate the increase in the size of the phalanx, whose matrix is condensed. All radiographic techniques must be used to determine the exact location of the nidus, that is always very small (1 to 2 mm), and whose total removal is the only guarantee of cure.

Adolescent↗