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Biomedical subjects

J Brunon

Publications and source records attributed to J Brunon.

At least 73 records · Page 4Linked to original sources
PubMed1978

[Traumatic atlanto-axial dislocation. (About two cases with late clinical manifestations) (author's transl)].

Two cases of atlanto axial dislocation with late neurological manifestations are reported and the very few cases of the literature are reviewed. The clinical signs are non specific. Excellent lateral tomography must demonstrate the abnormal space between atlas and axis. Surgical treatment includes bone fusion after reduction of the dislocation by cautious skull-traction. The results are excellent if the operation is performed before the onset of severe neurological deficits.

Adult↗
PubMed1975

[Posterior osteosynthesis in the treatment of spinal cord tumors].

Prognosis of cancerous tumors of the spine depends above all on their neurological consequences. The authors have wondered whether osteosynthesis of the spine -- in addition to decompressive surgery -- can improve patient's survival and fonctional results. 23 patients, 20 with a metastatic tumor and 3 with a plasmocytoma were treated in this way. All of them had neurological deficits, 4 had isolated radicular symptoms, 1 a cauda equina syndrome and 18 a spinal cord compression (7 of which were complete). 20 of these patients suffered intractable pain of the spine. All the patients underwent decompressive surgical removal of tumor through laminectomy, associated with a bilateral posterior metallic osteosynthesis. The type of osteosynthesis consisted of two metallic plates placed along each articular column and screwed into the articular processes and the vertebral body through the pedicles of the adjacent normal vertebrae. Cobaltotherapy was added in 14 cases, hormonotherapy in one case and radioactive 131 1 in one another patient. Selective spinal angiography, performed in one case of thoracolumbar tumor was found useful in the location and avoidance of Adamkiedwicz's artery. With regard to the complication, there were two operative wound infections requiring reoperation. Our series -- in comparaison with others -- prove the effectiveness of the combined procedure. Patients without complete spinal deficit had a 20 months survival average. Patients with complete deficit had the same survival as in comparative group. But all the 20 patients suffering pain in the spine were substantially relieved. Such a combined procedure is indicated in cases of tumors involving the vertebrae, whether or not the epidural space is invaded especially when there are riskes of unstable fracture and only partial neurological deficits. The technique may be extended even to complete paraplegia because of its worth while antalgic effects. Thus this method -- by consolidating the spine -- relieving pain and consequently allowing kinesitherapy to be resumed earlier is able to improve the functionnal status and increase survival of the patients.

Adult↗
PubMedDate not supplied

[Is cerebral tomoscintigraphy with 99mTc-MIBI useful in the diagnosis of local recurrence in patients with malignant gliomas?].

PURPOSE: 99mTc-MIBI, an alternative radiopharmaceutical for myocardial perfusion study has been proposed for use as a tumor imaging agent, including breast cancer, lung cancer, lymphomas, melanomas, and brain tumors. After routine radiation therapy, deteriorating clinical status or treatment failure may be due to either radiation changes or recurrent tumor. CT and MRI offer imperfect discrimination of tumor viability and radionecrosis. MATERIALS AND METHODS: Thirty-five malignant glioma patients with clinical deterioration were studied retrospectively. Tomoscintigraphy was performed 15 minutes after intravenous injection of 1110 Mbq 99mTc-MIBI. The images were obtained from a dual headed gamma camera using fan beam collimator. Transverse, coronal and sagittal views were reconstructed. RESULTS: A dramatic MIBI uptake was found in 31 patients. This uptake was correlated to tumor recurrence proven by histological fragments and/or the rapid, fatal evolution of these patients. Death occurred after the brain SPECT had been performed for those cases showing MIBI uptake, an average 5.48 months later. No MIBI uptake was found for these four remaining patients: their evolution can be currently considered to be a disease-free time. CONCLUSIONS: According to our results, the sensibility and specificity of 99mTcMIBI brain SPECT seems to be high. Moreover, this investigation is more accurate for discriminating tumor recurrence from radionecrosis than a CT scan or MRI.

Adult↗
PubMedDate not supplied

[Sensitivity to etoposide of human malignant glioma cell lines. Mechanisms of action].

AIM OF THE STUDY: Etoposide, a Topoisomerase II inhibitor agent, is currently being explored as a therapeutic agent for brain tumors. The aim of this experimental study was to compare the in vitro etoposide sensitivity of human glioma cells vs human squamous cell carcinoma (SCC) cells. MATERIAL AND METHODS: Twelve human cell lines (six malignant glioma cell lines and six head and neck SCC cell lines) were used for this comparative study. A standard colony formation assay was used to assess cell survival. Since Topoisomerase II is the critical target for etoposide, it was of interest to determine Topoisomerase II activity and etoposide induced inhibition of Topoisomerase II activity for the glioma cells vs the SCC cells. RESULTS: Except for etoposide-induced inhibition of Topoisomerase II activity, no difference was found for etoposide sensitivity and Topoisomerase II activity between the both type of cells. CONCLUSION: These results suggested that the Topoisomerase II reactive agents may prove to be clinically a useful drug for patients presenting with malignant gliomas.

Antineoplastic Agents, Phytogenic↗
PubMedDate not supplied

[Spino-thalamic cordotomy in cancerous pain. Results of a series of 124 patients operated on by the direct posterior approach].

The authors -- about a series of 124 cancerous patients treated during the 12 last years with open spino-thalamic cordotomy for intractable pain -- have tried to evaluate effectiveness of the operation with regard to its levels in relation to the site of pain. Patients suffering median or bilateral perineo-pelvic pain, isolated or associated with algias in one or both legs (group I: 50%) underwent a bilateral C8-C6 cordotomy in one stage. Patients with the same perineo-pelvic cancers but suffering only unilateral pain (group II : 31,8%) and patients with painful cancers in the leg (group III : 3,2%), were operated on with a C7 controlateral cordotomy. Patients suffering widespread unilateral pain in the chest, isolated or associated with algias in the arm, for instance from lung or breast cancers (group IV : 15%) underwent a controlateral C2 cordotomy. There was 3,2% mortality and one paraplegia. A useful early effect(i.e. complete or partial relief) was obtained : in 85% cases (60% and 25%) for the 1st group, in only 51% (36% and 15%) for the 2nd, and in 87% (56% and 31%) for the 4th. Relief was complete in each of the 4 cases of the 3rd group. In the 2nd group 39% of patients were completely relieved of their initial unilateral pain, but complained of an early post-operative pain on the other side. This secondary pain was supposed existing prior to the operation, but masked because of its lesser intensity. The useful results at the time of death, after a 6 month mean survival (from 1 month to 4 years), were 63,75% in the 1st group, 33% in the 2nd, 100% in the 3rd and 72% in the 4th. The high rate of poor results with unilateral cervical cordotomy in the perineo-pelvic cancers with apparently unilateral pain, led us since then to systematically perform for them a bilateral cordotomy. Thus, our general management for pain of malignant origin is now as follows: C8-C6 bilateral cordotomy for all the perineo-pelvic cancers whatever uni- or bilateral the site of pain may be; C7 controlateral cordotomy for the painful cancers of the leg; and C2 controlateral cordotomy for hemithoracic and/or arm pain, when related to very extended lung or breast cancers. We prefer complete posterior rhizotomy for limited cancers of the thoracic wall, and selective posterior rhizotomy through the scope, from -- the brachial plexus roots down to T4 -- for pain as from the PANCOAST-TOBIAS syndromes, or in case of painful involvements of the upper limb roots. For cervico-facial cancers we generally use combined sections of the sensory cranial nerves in the posterior fossa and of the cervical posterior roots.

Cordotomy↗
PubMedDate not supplied

Development of an intracerebral glioma model in whole body irradiated hairless rats.

AIMS: To study the in vivo radiosensitivity of malignant gliomas, an animal glioma model was developed using the implantation of glioma cell lines into the brain of the Hairless rat (a mutant from the Sprague-Dawley strain, characterised by its complete absence of hair). METHODS: 10(6) malignant cells were suspended in 10 microliters phosphate buffered saline (PBS) and injected at a 4 microns depth into the left frontal lobe of an anaesthetised animal through a small craniotomy hole without opening the dura mater. The glioma cell line C6 (obtained from a chemically-induced rat glioblastoma) was introduced into 11 animals, and the human glioblastoma line G5 into 12 animals. RESULTS: The tumour take was checked using histological criteria. It was poor: 0% for the G5 line and only 27.3% for the C6 line. To improve the tumour growth rate, rats were subjected to a single dose (3.5 Gray) total body irradiation, 24 hours prior to injection, causing a marked immunosuppression. 84.6% of the rats grafted with the C6 line then produced tumours. Similar results (75% tumour take) were obtained using a stereotactic inoculation of the tumour cells. CONCLUSIONS: Thanks to the contribution of whole body irradiation, an animal intracerebral glioma model was establish, which can be used for clinical and biological studies.

Animals↗