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Biomedical subjects

D Fohanno

Publications and source records attributed to D Fohanno.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Severe multiple injuries. Strategy and results. Experience at the Hôpital de la Pitié in 1988 and 1989].

In our series of 97 patients with multiple in juries observed in 2 consecutive years (1988-1989), we have selected only the most severe injuries, of which the patients died within 48 hours, and those that required a long stay in the intensive care department. On admission, we recorded 49 cases of stage II or more severe coma, and 67% of patients under respiratory assistance with an instable hemodynamic state. Out of the 44 deaths recorded, 30 subjects were comatose from the beginning. The justifies the confrontation of 3 specialist teams in 2/3 of cases. The specific recruitment of the hospital and the selection of the most severe cases of these "people under a death sentence" for the study shows a heavy toll of mortality (45,4%), including 60% on the first day. The main cause of death is head injuries (81%). The multivisceral and infectious consequences of long-lasting, heavy intensive care and pulmonary or myocardial contusions account fort secondary deaths in 25% of the patients who had survived. Emergent neurosurgical operations are exceptional, but a neurosurgeon's opinion is always essential. Orthopedic surgical issues are not specific, but the frequency of spinal lesions must be emphasized (27,2%). In this series, 85% of the patients with multiple trauma presented with a lesion of the locomotive apparatus and underwent emergent surgery in every second case in satisfactory conditions. Severe thoracic and maxillofacial lesions requiring surgery are rare. Abdominal lesions are more frequent (17%) and must be dealt with in priority, but they rarely cause death. On the contrary, lesions to the major blood vessels and retroperitoneal compound lesions have a very poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗
PubMed1990

Treatment of malignant gliomas with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy: a phase II study.

Forty patients with malignant supratentorial gliomas were treated with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy. The median duration of survival was 12 months; it differed according to the histological subtype (over 30 months for patients with anaplastic astrocytomas or anaplastic oligodendroglioma and 10.5 months for glioblastoma; P = 0.0025). Serious complications of monocular blindness and leukoencephalopathy were observed in four patients (10%).

Adolescent↗
PubMed1984

[Progesterone receptors in normal human leptomeninges in adults].

Cytosolic and/or nuclear 3H-R 5020 binding sites were detected in 6/6 samples of normal leptomeninges obtained at the time of operation in human adults. The levels of binding sites were higher in leptomeninges samples (range of values: 140-1780 fmol/gT) than in the corresponding intracranial tumors (one meningioma, two neurinomas, one metastasis) in 3 out of the 4 cases that were simultaneously studied. The 3H-R 5020 binding systems were characterized in 2 groups, A and B, of pooled samples representing respectively 4 and 17 samples of normal leptomeninges. The study of A (cytosolic and nuclear binding sites) and B (cytosolic binding sites) groups showed that binding systems had a limited capacity and a high affinity (Kd were respectively 2 X 10(-9) and 5.3 10(-10) M) as previously noted for the progestin receptor in human meningioma. Biochemical data and ultrastructural pictures obtained in the present study as well as in previous works, allow to consider the presence of the progestin receptor in normal leptomeninges.

Adult↗
PubMed1982

[Simplified technic for stereotaxic biopsy of hemispheric tumors].

Stereotaxic biopsy of cerebral tumors has been considerably facilitated by the use of CT scanner. A new method is described using the CT section in the horizontal or oblique plan of biopsy. When this has been determined, it is possible to define a trajectory, calculated by the CT scan computer, with external landmarks marked on the skin. This method is possible with any kind of CT apparatus; the surgical biopsy is performed in the operating room with a simple stereotaxic frame square-shaped and fixed in the plan of the CT section. The biopsy needle may be oriented in an antero-posterior or medio-lateral direction. This method has been used in 33 patients, leading to as precise histological diagnosis in 30 cases. No complications have been noted, except for transient neurological deterioration in two cases, due to local edema. Hemorrhage have not been observed. The topographical precision of the method was verified by the injection of lcc of air followed by a post-biopsy CT scan. This technique seems particularly valuable for the diagnosis of deep or wide spread hemispheric tumors, non indicated for open surgery.

Biopsy, Needle↗
PubMed1980

[Practical method for the preoperative spatial localisation of small intracranial neoplasms from scanner data (author's transl)].

When only transverse axial slices of a CT examination already performed are available, the localisation in space of small intracranial space occupying lesions is easy only if a lateral view is available at the same time. In terms of three dimensional localisation, it is possible to rely on the coordinates of transverse axial sections only if the examination has been carried out under stereotaxic conditions. In all other cases, uncertainty concerning the site of the plane of reference of the examination would be too great. The method suggested may be used to identify the site of the plane of reference of a computed tomography examination on a lateral skull X-ray with a margin of error of +/- 2 degrees. It uses the lateral skull X-ray of the patient examined by computed tomography, the transverse axial slices of the examination and a pre-established template. Once the plane of reference is identified, the lesion may be rapidly reconstructed using two other templates. The method has the advantage of being applicable to examinations already carried out and thus does not prolong the duration of investigations.

Brain Neoplasms↗
PubMed1980

[Recurrency of intracranial tumors operated. Diagnosis (author's transl)].

The records of 123 patients who had previously be operated upon for intra-cranial tumors are studied to find symptoms of recurrency. 82 of these patients underwent a second operation. The value of CT Scan, cinegammagraphy and angiography are compared. CT Scan yields the best results to detect recurrency and its place. Using both CT Scan and cinegammagraphy increases reliability for difficult cases, mainly in the cases of multiple lesions. Angiography is no longer used to detect recurrencies but only just before operation.

Angiography↗
PubMed1979

[Compressive extradural lipomatosis as an unusual complication of corticosteroid therapy: one case (author's transl)].

In a 43 year old man we reported a spinal cord compression by extradural lipomatosis associated with long term corticosteroid therapy for periarteritis nodosa. Decompressive surgery at the 16th month of corticosteroid treatment resulted in regression of symptoms and signs. Corticosteroid therapy was felt to be responsible for this neurological complication, which is unknown in periarteritis nodosa, but has been seen in association with intraspinal lipomas.

Adult↗
PubMed1979

Prolactin-secreting pituitary adenoma in a man with gigantism: a case report.

A prolactin-secreting pituitary adenoma was removed trans-sphenoidally from a 37 years old man with gigantism (218 cm). Serum levels of prolactin (PRL) were elevated pre-operatively and decreased after administration of L-Dopa with no increase after TRH as is usually observed in PRL-secreting adenomas. Growth hormone (GH) and somatomedin serum levels were normal with no modification of GH after insulin hypoglycemia, oral glucose loading or L-Dopa. Morphological examination of the tumour demonstrated the presence of lactotrophs by light and electron microscopy and by immunofluorescense staining. No somatotrophs were found. In this unique case, the relationship between a PRL-secreting adenoma and gigantism is discussed.

Adenoma↗
PubMed1977

[Treatment of chronic pain syndromes by transcutaneous stimulation. Preliminary results. A propos of 40 cases].

The study of the effect of transcutanous stimulations shows that 40% of the patients suffering of chronic pain can be relieved or greatly improved by this technic. The best results are obtained with peripheral nerves lesions. On the contrary no results are observed with malignancies or facial pain. This way of stimulation is easy to develop and does not imply any danger for the patient. It can be used as a test prior to percutanous stimulation or implantation of a direct stimulation, or can, by itself be an effective treatment.

Electric Stimulation Therapy↗