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Biomedical subjects

F X Roux

Publications and source records attributed to F X Roux.

At least 19 recordsLinked to original sources
PubMed1994

[Multiple cavernoma of delayed appearance].

The authors report on a right fronto-singular cavernous angioma which appeared, in a 46 year-old woman, four years after the excision of a right rolandic localization. Diagnosis suggested on radiological findings was confirmed by histological examination. After a review of the literature the authors discuss possible mechanisms of such delayed appearance of intra-cerebral cavernous angiomas. They suggest the possibility of infraradiologic stage corresponding to a micro-malformation characterized by abnormal capillaries, which has not been yet histologically modified by hemorrhages, thrombosis, fibrosis, gliosis and calcifications.

Brain Neoplasms↗
PubMed1992

Characterization of the 5-hydroxytryptamine receptor modulating the release of 5-[3H]hydroxytryptamine in slices of the human neocortex.

In the rat brain, the presynaptic 5-hydroxytryptamine (5-HT) autoreceptors located on 5-HT terminals correspond to the 5-HT1B subtype. The presence of a 5-HT receptor probably located on 5-HT nerve endings and modulating transmitter release in the human neocortex has been reported, but its detailed pharmacological characterization is not yet available. On the other hand, receptor binding and autoradiographic results indicate that the 5-HT1B receptor subtype is not present in the human brain. We, therefore, studied the modulation of the electrically evoked release of [3H]5-HT by various 5-HT receptor agonists and antagonists in preloaded slices of human neocortex obtained from 18 patients undergoing neurosurgery. The nonselective 5-HT1A/1B/1D receptor agonist 5-carboxamidotryptamine produced a potent inhibition (70% at 0.03 microM) of the electrically evoked release of [3H]5-HT which was blocked by 5-HT receptor antagonists with the following relative order of potency: methiothepin greater than metergoline = methysergide greater than propranolol. The selective 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin at 0.1 microM did not modify the electrically evoked release of [3H]5-HT. The 5-HT1A/1B receptor agonist RU 24969 was 10 times more potent at inhibiting [3H]5-HT overflow in the rat frontal cortex than in the human neocortex. The potent 5-HT1B receptor antagonist cyanopinodolol did not modify the 5-carboxamidotryptamine-induced inhibition of the electrically evoked release of [3H]5-HT in slices of the human neocortex, but produced by itself a small inhibition of [3H]5-HT overflow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Meningeal sarcoidosis, pseudo-meningioma, and pachymeningitis of the convexity.

Two cases of meningeal sarcoidosis with unusual and misleading presentations are reported. In the first case, CT scan, angiographic, and MRI findings were indistinguishable from those of meningioma. CSF pleiocytosis may help in diagnosing sarcoid pseudo-meningioma. The second patient had transient focal deficits and pachymeningitis of the convexity. The transient deficits were probably of epileptic origin based on their response to antiepileptic treatment. The diagnosis of neurosarcoidosis was made only after meningeal biopsy, despite thorough investigations.

Adult↗
PubMed1992

[YAG laser in neurosurgery].

The authors try to answer to some practical questions concerning Yag Lasers in neurosurgery. The aim of this work is to determine the main data useful for the choice of a YAG-Laser. Are considered: the wavelengths which can be bought on the international market (1.06 microns or 1.32 microns for instance), the peripherics at disposal, the tissular effects due to the different lasers, the surgical applications and indications. The Laser unit which will be chosen should be a compromise between the different advantages and inconveniences of a particular laser, its tissular effects, its price. The multi-wavelengths units appear to be, at the present time, interesting compromises (such as 1.32 + 1.06 microns, CO2 + 1.06 microns).

Humans↗
PubMed1992

[Combined CO2 and Nd-YAG laser in neurosurgical practice. A 1st experience apropos of 40 intracranial procedures].

The authors present their experience concerning the use of Combolaser (Lasermatic, Finland), in neurosurgery. This laser-unit combines two wavelengths (CO2 and 1.06 Nd-YAG) which are emitted simultaneously and coaxially. During the last 12 months, 40 patients harbouring an intracranial tumor were operated upon with such a combolaser unit: 8 infra-tentorial, 32 supra-tentorial, 17 were meningiomas. The mean output power used during the procedures was 3-5 w for both CO2 and Nd-YAG beams. The authors discuss the advantages and inconveniences of such a laser; and they compare it with the other laser-units they have been using for the last 10 years: CO2-Laser, 1.06 Nd-YAG and 1.32 Nd-YAG laser. The main inconvenience of this unit is linked to the utilization of the articulated arm which conducts the CO2 laser beam. This drawback should be avoided or limited by the use of a fiber microguide, which will conduct both CO2 and Nd-YAG beams simultaneously. The principal contribution of a combined-laser unit is the quality of the haemostasis associated to a very good vaporization and cutting effect. When both wavelengths are synchronized, the combined laser beams penetrate into the nervous parenchyma more deeply than the only CO2 laser beam would with the same parameters. The vaporization effect is identical to that obtained with the isolated CO2 laser; the quality of haemostasis is limited to the effects of the Nd-YAG laser. Another advantage must be emphasized: the possibility of utilizing separately the CO2 laser and the 1.06 Nd-YAG.

Adolescent↗
PubMed1992

[Stereotaxic laser interstitial thermotherapy. A new alternative in the therapeutic management of some brain tumors].

Laser Interstitial Thermo Therapy (ITT) is a new procedure which has been performed only a few times in our department as well as in foreign services. The aim of an ITT is to increase the temperature of a tumoral target which has been perfectly determined stereotactically. In the center of the target, i-e at the extremity of the laser fibre, temperature reaches 80 degrees 90 degrees C and creates a coagulation necrosis. At the periphery of the target, temperature must be 41 degrees-43 degrees C so as to create a selective lesion of the pathological tissue due to proteinic and enzymatic denaturation. The authors present their experience based on 8 patients who underwent an ITT between June 1990 and October 1991. A stereotactic determination of the tumor is first performed; then two routes are determined for the laser-fibre (Nd-YAG 1.06 microns, fiber diameter: 400 mu) and for the thermic electrode. The ITT itself is performed a few days later (P = 3-5w, time: 800-1200 seconds). Laser heat effects are monitored with MRI controls (H5, H24, D8 then monthly). The authors insist on the importance of a long follow-up so as to be sure of the complete inocuity of such a treatment. It is the only way to broaden and develop laser-ITT procedures as therapeutic alternatives for certain deep-seated intracerebral tumors.

Brain Neoplasms↗
PubMed1992

[Use of Nd-YAG laser in intracranial endoscopy. An initial experience in stereotaxy].

The authors report on four cases of intra-ventricular lesions surgically treated by endoscopic laser-therapy in stereotactic conditions. Two colloid cysts of the third ventricle, one arachnoidal cyst responsible for with an intracranial hypertension and an intraventricular meningioma were treated with such a procedure. The laser beam was used as a surgical knife on cystic lesions and to vaporize the meningioma. The laser coupled with an endoscope add to the comfort given by direct visualization the precision of surgical instrument the effects of which are perfectly controllable in areas where surgical traumatism must be avoided as much as possible.

Arachnoid Cysts↗
PubMed1992

[A rare case of intramedullary epidermoid cyst diagnosed by MRI].

Intramedullary epidermoid cysts are rare entities. A case recently seen on MRI led us to review the literature on the subject. A 9 year old boy developed in a four month-time a spastic paraparesis with a T7-T8 sensitive level. The MRI showed a widening of the spinal cord at the T6 level with an area of decreased signal on T1 weighted images, and a homogeneous round shaped area of increased signal on T2 weighted images. The authors discuss the contribution of MRI to the diagnosis of this lesion. The number of cases of intramedullar epidermoid cysts, like dermoid cysts, diagnosed with this neuroradiological method, is still very limited and the literature only mentions isolated cases.

Child↗
PubMed1991

[Combined approach to malignant tumors of the ethmoid and other paranasal sinuses. Principles and results].

The authors present their experience concerning combined transfacial and neurosurgical procedures in the treatment of carcinomas of the ethmoid sinuses. 109 ethmoid-spheno-orbital tumors were treated at our department from 1982 to 1990: 85 were located into the ethmoidal and/or sphenoidal sinuses; 78 of these were malignant. Among the 65 ethmoidal carcinomas which were operated through a combined route, 48 underwent an induction chemotherapy and 19 a post-operative radiotherapy. The surgical technique is detailed, mostly the intra-cranial approach and the reconstruction of the cranial basis. Clinical results, and particularly the actuarial survival rates are discussed. The 5-year actuarial survival rate is 40% for all first hand ethmoidal adenocarcinomas. The figure reaches 52% for the patients without intra-cranial extension. At last, the 5-year actuarial survival rate is 100% for patients having a complete clinical response to induction chemotherapy.

Actuarial Analysis↗
PubMed1991

[Terson's syndrome and intraocular complications in meningeal hemorrhages (26 cases)].

The Terson syndrome was described in the early 1900's as the association of an intra-vitreous humor bleeding and a subarachnoidal hemorrhage (SAH). The high jeopardy of blindness of such a syndrome emphasizes the importance of evaluating as soon as possible the presence of blood in the posterior chamber of patients presenting with a SAH. 250 patients admitted in the Neurosurgical Department of Ste Anne Hospital with a SAH were evaluated between January 1984 and February 1990. 26 had an intra-ocular hemorrhage (10.5%). In those cases the mortality rate was not increased (15.4%) but the morbidity rate was higher (42%). Concerning the intra-ocular bleeding, 4 patients underwent a vitrectomy (2 had a complementary photocoagulation). Only one patient had a visual sequela (partial decrease of visual acuity). These data emphasize the visual risk which has to be considered; a specific treatment (vitrectomy and/or photocoagulation) must be performed as quickly as possible so as to save the vision. In some particular instances, the ophthalmological treatment might even be necessary before the intracranial procedure itself.

Adolescent↗
PubMed1991

[Intra-orbital hydatid cyst. An uncommon site of hydatidosis. Discussion apropos of a recent case].

The authors present an observation of intraorbital hydatid cyst. They review the literature and discuss the main data of such a rare lesion. Hydatid cyst should be systematically evoked in any case of tumoral exophthalmia developed in a young patient, particularly if he comes from an endemic country. The pre-operative diagnosis relies on the confrontation between clinical and echographical data, and C.T.-scan imaging. The only treatment is surgery. A puncture performed at the beginning of the surgical procedure will confirm the diagnosis. In fact, it should be indicated for every intra-orbital neoplasm observed in a country of endemicity, mostly when the preoperative diagnosis is difficult, that is when no C.T.-scan or echography are at disposal. The infectious prognosis is excellent; but the functional one depends on the precocity of surgery and remains reserved in most cases.

Echinococcosis↗
PubMed1991

[Esthesioneuroblastomas. Could a preoperative chemotherapy improve their prognosis?].

The prognosis of malignant tumours of the olfactory epithelium of the nasal vault stays very poor. In the literature, the 5-year actuarial survival rate ranges between 50% and 65%; the 5-year recovery rate is 15% due to the high frequency of locoregional reoccurrences (60%) and metastasis (35-40%). Up to now chemotherapy was suggested as palliative treatment; but as Esthesioneuroblastomas (ETNB) appear to be sensitive to several chemotherapeutic agents (such as CDDP and 5-FU), we have decided to administer, from now on, to all patients harbouring an ETNB, an inductive chemotherapy whatever the staging and eventual diffusion of the tumour. The present paper presents our recent experience, dealing with such lesions: since 1984, 60 tumours of the ethmoid were treated in our department among which 7 ETNB (11.5%). We discuss our results concerning ETNB.

Adult↗
PubMed1990

1.32 microns Nd:YAG laser during neurosurgical procedures experience with about 70 patients operated on with the MC 2100 unit.

The authors present their clinical experience with 1.32 microns Nd-YAG Laser. After a series of experimental studies which demonstrated the adaptability of such a wavelength to central nervous surgery, they used such a Laser during current neurosurgical procedures. The MC 2100 unit combines two wavelengths 1.32 microns and 1.06 microns, and two emission modes: continuous wave (c.w.) and pulsed. This Laser has been used during 70 procedures: 54 supra-tentorial, 8 infra-tentorial, 5 intra-spinal, 3 intra-orbital, 600 microns and 400 microns fibers were preferred in most cases, either with a telescopic light handpiece or- less often--with a focussing handpiece. The quality of vaporization--close to that of CO2 Laser- and of haemostasis-close to that of 1.06 microns Nd-YAG Laser-makes this 1.32 microns wavelength very suitable for neurosurgery. The manoeuverability due to the optic fibers is most interesting. Furthermore, such a Laser should have in the near future large applications in stereotactic and/or endoscopic neurosurgery.

Brain Neoplasms↗
PubMed1990

Effects of 1.32-micron Nd-YAG laser on brain thermal and histological experimental data.

Considering that the 1.32-microns Nd-YAG laser should have physicothermal properties close to those of the CO2 laser, a series of experiments were conducted on rat cortex (N = 51). Three laser wavelengths were compared: CO2 laser (10.6 microns), 1.06-microns Nd-YAG, and 1.32-microns Nd-YAG lasers. For each shot, temperature measurements were recorded with an infrared thermographic videocamera. The digitized signals were figured as thermal profiles and temperature developments. Ninety-five shots were correctly studied and analyzed: CO2, N = 29; 1.06-microns Nd-YAG, N = 20; 1.32-microns Nd-YAG, N = 46. The histological lesions produced by these three lasers were compared on animals killed 24 hours (N = 20), 8 days (N = 20), and 30 days (N = 5) after the laser impacts. For equivalent densities of energy, the depth of cortical necrosis was comparable for the CO2 laser (200-250 microns) and the 1.32-microns Nd-YAG laser (210-260 microns) whatever the date of death; the 1.06-microns Nd-YAG laser shots were responsible for much more important damage (400-550 microns). Because of its important absorption in water and nervous tissue, the authors consider the 1.32-microns Nd-YAG laser most suitable for neurosurgery, particularly because it is conducted through optic fibers, and therefore is easy to handle during neurosurgical procedures.

Animals↗
PubMed1990

[The use of coral in bone surgery. Results following 4 years of utilization].

The authors have used Porites coral as a bone substitute in more than 200 patients since 1985, initially for reconstruction after craniotomy or removal of graft from the iliac crest. Encouraging results have prompted wider use. No complications have occurred. The biological properties of coral are described. It is easily available and appears to be a promising bone substitute.

Calcium Carbonate↗
PubMed1989

Adenocarcinoma of the ethmoid sinuses. Results of a new protocol based on inductive chemotherapy combined with surgery. Four years experience.

New therapeutic modalities for Ethmoidal Adenocarcinomas are presented. Thirty three patients harbouring such a tumour have been treated during the last four years. Twenty three were included in the following protocol:--the first step consisted in inductive chemotherapy based on a four-day course of continuous cisplatine (CDDP) and 5-fluoro-uracyl (5-FU infusion)--the second step was the tumour removal, which was performed through a combined transfacial and subfrontal approach. A contralateral ethmoidectomy was always performed. The integrity of the sphenoidal sinus was systematically checked. The cranial base was reconstructed with madreporic coral grafts; then a large extra-dural pediculated galea flap was placed onto the anterior base to line the sub-frontal dura. The authors discuss the results of this series of rare tumours.

Adenocarcinoma↗