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Biomedical subjects

G Delepine

Publications and source records attributed to G Delepine.

52 records · Page 3Linked to original sources
PubMed1986

[Magnetic resonance imaging of tumors of the knee using surface coils].

Fourteen patients presenting with a primary bone tumour of the knee have been assessed, in parallel with other imaging techniques, by examination using MRI with surface coils. The first examinations were made before any biopsy was made or chemotherapy given so as not to impair the interpretation of the images and to provide guidance as to the correct site for biopsy. Two sequences were made - a longitudinal sequence made with echo-spin, echo-time = 30 ms, repetition-time = 500 ms, with four impulses and a transverse sequence made with echo-spin, echo-time = 40 ms, repetition-time = 1300 ms with two impulses (+/- multi-echo). Thanks to the excellent spatial resolution using a surface aerial, we have been able to determine not only the intramedullary extent of the tumour and its relationship with healthy muscles and vessels but also, in a much more precise way than previously, evidence of extension to the skin, to the epiphysis, to the articular cartilage and to the synovium, thus allowing an objective assessment to be made of the possibility of a closed block-excision of the joint. A second MRI examination with cranial coil was made pre-operatively at the end of adjuvant chemotherapy to determine the precise progress of the tumour, and in particular, to discover the localisation of the tumour in the femoral and tibial shafts, the investigation being aided by systemic scintigraphy.

Bone Neoplasms↗
PubMed1986

[Massive allografts cold-preserved and radiation-sterilized].

Thirty massive bone allografts measuring between 7 and 30 centimeters and banked after freezing at -30 degrees centigrade and sterilization by Beta irradiation (2.5 to 3.5 megarads) were implanted. Ninety eight grafts were for reconstructions after a tumour resection and two were used for the treatment of femoral non-union and for reconstruction after removal of a prosthesis. In fifteen instances the only goal was to restore bone stability--six arthrodeses, seven replacements of diaphyseal or metaphyseal section and two iliac bone lesions. In fifteen other cases the aim was to preserve mobility (10 knees, 2 hips and 3 shoulders). Among these cases, a prosthesis was added in 9 knees and 2 hips and the graft was used alone in three shoulders and one knee. The average follow-up is too short to assess the incidence of recurrence, but it is long enough to note that there has been no case of post-operative infection. The authors considered that this is thanks to the use of sterilization by irradiation. Bone union was seen in 26 out of 30 cases at the diaphyseal--graft junction and in eight cases out of nine at the epiphyseal--graft junction. Three cases are pure diaphyseal replacements, did not unite. Two recurrent fractures of the graft at the third and fourth month united later. Scintigraphy showed that revascularization may take place after three months, thanks to the peripheral muscle which reattach to the graft spontaneously. This could be demonstrated by biopsy made during a second surgical procedure. A search for anti-HLA anti-bodies in the serum was positive on three occasions.

Adolescent↗
PubMed1986

[Appearance of the normal knee by MRI using a surface antenna].

NMR imaging of the knee using a surface aerial provides remarkable anatomical detail of this joint without the need for invasive procedures or stressful positioning. Results of the use of this technique on seven normal knees confirmed the precise anatomical details provided, with direct visualization of the femorotibial interline and particularly of the cruciate ligaments, menisci and cartilages. This method allows a new diagnostic approach to the knee, especially for traumatic or tumoral lesions, and greater efficacy of treatment.

Adult↗
PubMed1986

[NMR examination of soft tissue tumors].

Preliminary findings on NMR imaging of 30 soft tissue tumors demonstrated the indispensable value of this examination (particularly when a surface antenna is used) for preoperative investigation and diagnosis of tumoral recurrence when compared with other radiologic techniques. The possible potential of NMR imaging for characterization of tissues, apart from lipoma or liposarcoma, cannot be evaluated at the present time.

Abdominal Neoplasms↗
PubMed1985

[Resection in the treatment of osteosarcoma of the limbs. Is amputation still indicated?].

The authors have treated 30 cases of limb sarcoma by conservative surgery since 1980. During this period only one limb had to be amputated. The follow-up period is short and this is a preliminary report. The early results of cases treated by resection followed by radiotherapy and chemotherapy appear to be encouraging. Up to date, only one recurrence has occurred which has been treated by another local resection with no further recurrence 18 months later. 10 patients have had metastasis: 6 died--3 metastasis were resected with success and the patients are still alive. It is concluded that amputation is rarely, indicated, provided there is adequate initial information about the extent of the tumour and continuing post-operative co-operation between Surgeon and Physician.

Adolescent↗
PubMed1984

[Sterno-chondro-costal joint arthritis in heroin addicts. Value of computed x-ray tomography. 4 cases].

Four cases of sterno-articular arthritis in young heroin addicts are reported. The diagnosis, much facilitated by the knowledge of drug addiction, is confirmed by biopsy which excludes a tumour, usually malignant in that region. Computerized tomography is essential to explore for retrosternal extension. In the absence of extension cure can be obtained by medical treatment, thus avoiding resection of the sternum and rib with subsequent plastic surgery.

Adult↗
PubMedDate not supplied

Pharmacokinetic modelling of ifosfamide administered by continuous infusion on 5 days at the dose of 6 g/m2.

BACKGROUND: We aimed to create a model for Ifosfamide (IFX) pharmacokinetics for drug monitoring in order to improve protocol dose intensity. MATERIAL AND METHODS: We studied ifosfamide pharmacokinetics in 12 patients aged 8-19 years. Sixteen courses were modelled (6 g/m2, on 5 days). The auto-induction of ifosfamide was taken into account in the model. Ifosfamide measurement was performed on serum samples by gas chromatography with thermo-ionic detection. Two pharmacokinetic models were compared. The following parameters were estimated: volume of distribution (Vd), clearance at the beginning of the induction (CLi), clearance extrapolated to infinity (CLf), clearance at the end of infusion (CL120), a rate constant (Kc) indicating the clearance variation with time and the lag time (Lag) indicating the time elapsed between the start of infusion and the start of induction. The Wilcoxon test was used to investigate possible differences between models. We tested the hypothesis that Boddy's model is an acceptable simplification of Levy's model. RESULTS: Four of six parameters were significantly different between the two models (p = 0.05). The best curve fitting was obtained using the Levy's model which provided the following estimates, Cli = 2.46 +/- 0.94 L.h-1.m-2, CLf = 5.22 +/- 1.02 L.h-1.m-2, Kc = 0.024 +/- 0.014 h-1, Vd = 18.84 +/- 5.04 L and Lag = 4.86 +/- 6.61 h. The most important difference is found for the distribution volume. CONCLUSION: Levy's model is more accurate and takes into account the integration of clearance.

Adolescent↗
PubMedDate not supplied

[Blood pressures in children and adolescents. An epidemiological study on 6 391 school children in a French circumscription (author's tranls)].

Distribution characteristics of blood pressure (BP) by age and sex were studied in a school population of 6 391 children aged 6-18 years. BP distributions were according to a Gaussian curve tending towards the higher values. Mean BP increased with age according to linear curve. Systolic BP (SBP) was higher in boys from 14 and diastolic BP (DBP) after 16. An over all prevalence of 3,1 % systolic and 2,2 % diastolic hypertension (BP greater than or equal to 2 DS) was detected. Subjects with hypertension must be annually examined ; only those with BP greater than or equal to 3 DS must be completely investigated for etiological purpose. SBP and DBP were strongly connected. Scales give opportunity to BP follow-up during growth and promise a better understanding of early hypertension.

Adolescent↗
PubMedDate not supplied

Dose escalation with pharmacokinetics monitoring in methotrexate chemotherapy of osteosarcoma.

This paper evaluates the influence of pharmacokinetics monitoring of HDMTX in the treatment of localized operable previously untreated high grade osteosarcoma. 44 patients (group 1) received a T10 protocol with dose adapted only to age. 27 other patients (group 2) had a pharmacokinetics monitored dose adaptation of MTX. The pharmacokinetics monitoring leads to higher dosage, higher area under the concentration/time curve and permits higher toxicity to be avoided. The higher dose intensity of MTX gave higher histologic response rate (66% compared to 45%) and higher 5 year disease free survival (92% compare to 76%). HDMTX treatment of osteosarcoma should be dose adapted to indivi-dual pharmacokinetics.

Adolescent↗