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J Dubousset

Publications and source records attributed to J Dubousset.

At least 19 recordsLinked to original sources
PubMed1992

Does malignant small round cell tumor of the thoracopulmonary region (Askin tumor) constitute a clinicopathologic entity? An analysis of 30 cases with immunohistochemical and electron-microscopic support treated at the Institute Gustave Roussy.

The morphology and clinical outcome of 30 patients with malignant small round cell tumors located in the thoracopulmonary region (Askin tumor) are reported. Histologically, all tumors had similar patterns, with small round-to-oval cells and a lobulated stroma. Immunohistochemical analysis always resulted in positive staining for one or several neural markers. No significant differences were found compared with the immunomarkers in 26 typical Ewing's sarcomas located outside the thoracic wall. In three specimens, electron microscopy confirmed the presence of membrane-bound neurosecretory granules. It was confirmed that there is a remarkable similarity among all malignant small round cell tumors, including Askin tumor and Ewing's sarcoma. Overall survival was poor with a 2-year rate of 38% and a 6-year rate of 14%.

Adolescent↗
PubMed1992

Characterization of bone forming cells in posttraumatic myositis ossificans by lectins.

Lectins were used to characterize bone forming cells in posttraumatic myositis ossificans. The lectins applied were as follows: Arachis hypogaea (PNA): specific for beta-D-galactose (1,3)N-acetyl-D-galactosamine (Gal-1,3 GalNac), Canavalia ensiformis (Con A): specific for alpha-D-glucose (D-Glc) and alpha-D-mannose (D-Man) and Wheat germ (WGA): specific for N-acetyl(1,4)D-glucosamine (Glc-NaC) and neuraminic acid. The development of myositis ossificans was characterized by the appearance of a WGA binding cell population. The lectin-binding sites appeared as a cluster in the supranuclear cytoplasm, corresponding to the Golgi-complex. However, the WGA lectin-binding sites disappeared in the mature form of myositis ossificans. We assume that these lectin binding cells may be the bone marrow derived precursors of myofibroblast-like cells which are responsible for bone formation within the damaged muscle.

Adolescent↗
PubMed1992

No benefit of ifosfamide in Ewing's sarcoma: a nonrandomized study of the French Society of Pediatric Oncology.

PURPOSE: To undertake a new protocol with the goals of improving the chemotherapeutic treatment of pediatric Ewing's sarcoma by introducing ifosfamide, and to widen the indications for surgical resection of Ewing's tumor to obtain better local control and to reduce radiation doses. PATIENTS AND METHODS: The French Society of Pediatric Oncology initiated its first cooperative Ewing's sarcoma study in 1978, using a four-drug regimen (cyclophosphamide, dactinomycin, Adriamycin [doxorubicin; Farmitalia Carlo Erba, Rueil-Malmaison, France], and vincristine). Ninety-five patients were included, and, at 5 years, the disease-free survival reached a plateau of 51%. After encouraging responses of recurrent soft tissue or bone sarcomas to ifosfamide, a second study began in 1984 using a new chemotherapy regimen in which cyclophosphamide was replaced by ifosfamide. Sixty-five patients were treated. RESULTS: By February 1992, the median follow-up was 5.8 years. The estimated 5-year disease-free survival was 52%. We observed unexpected cardiac toxicity. Three patients experienced acute cardiac failure that was lethal in two cases. The acute toxicity of ifosfamide prompted us to stop the protocol. Retrospectively, the lack of efficacy reinforced our decision. CONCLUSION: We conclude that ifosfamide did not improve the outcome of the patients despite the fact that these two treatment regimens were not randomized.

Bone Neoplasms↗
PubMed1992

[Coxa vara in children. Apropos of 28 cases].

Infantile coxa-vara is an infrequent lesion and two etiologic factors have been recognised: mechanical and genetic. As in Blount's disease, the same populations (black and scandinavian people) are usually affected. Twenty eight patients with 42 infantile coxa vara were reviewed. The diagnosis was often late. The radiographs showed the decrease of the neck-shaft angle and the signs of cervical dystrophy. The aggravation of the coxa vara is usual and pseudarthrosis or osteo-arthritis can be observed. Thirty six femoral valgus sub-trochanteric osteotomies were done. The results were best when the surgery was done before the age of 9 years. When the surgery was done later, an epiphysiodesis of the greater trochanter was associated to the femoral osteotomy if the epiphyseal cartilage was fused. Langenskiold's osteotomy was used only when the neck-shaft angle was lower than 80 degrees. The results were evaluated according to the neck shaft angle and the morphology of the femoral head: 22 very good and good, 11 fair and 3 bad results were noted.

Adolescent↗
PubMed1991

[Large resection of the sacroiliac joint. Technique, reconstruction, anatomical and functional results].

The surgical treatment of tumors close to the sacro-iliac joint is made uneasy due to the thinness of the posterior skin cover and the proximity of anterior vascular and nerve elements. A complete, pre-operative appreciation of the extent of the lesion is necessary. 12 patients were operated on and reviewed after a 34 months average follow-up. Complications were frequent, particularly on the cutaneous and neurological standpoint. The surgical technique varied according to a greater extension of the lesion toward the iliac or sacral bone. Extension to the acetabulum was particularly distressing. The functional results depended on extent of muscular resection nerve resections, volume of resected bone. However the surgical treatment is the only one possible in some tumors non-sensible to conservative treatments.

Adolescent↗
PubMed1991

Management of osteogenic sarcoma in children and adolescents.

The management of osteogenic sarcoma in children has made a fantastic step on the survival rate, but there still remains unexpected late metastatic recurrence even in initially good responders to chemotherapy and lower survival rate in the bad responder group. Therefore, the research on etiology and on the understanding and rating of oncologic power of the tumoral cells as well as other kinds of treatment (vaccine, immunotherapy, and other types of chemotherapy) must be increased. The initial function after replacement is good and is often excellent but increasing deterioration is noticed during each follow-up evaluation. A considerable effort is still to be done for bone and joint replacement. Biocompatible material with mechanical strength and resistance to wear will be used for a long time because of the young age of the patients. There must be better use and understanding of the allograft revascularization, as well as a better biologic connection between the bone host and replacement device. This will probably be used in the future with less cement and more of a modular system. The final prognosis will remain for a long time in the perfect cooperation between the various members of the teams (oncologist, surgeon, imager, pathologist, and research team) who treat the patients.

Adolescent↗
PubMed1991

Application technique of Cotrel-Dubousset instrumentation for scoliosis deformities.

Used in over 600 cases, the posterior Cotrel-Dubousset spinal instrumentation device has become the device of choice. This technique allows the most effective correction for all kinds of spinal deformities. It requires lengthy preoperative planning and is a technically demanding surgical procedure; however, because of its versatility it can be adapted to most spinal deformities. The Cotrel- Dubousset technique is a rigid system of immobilization, and, because it does not require any postoperative immobilization, patients are able to resume their normal lives and activities very quickly.

Adolescent↗
PubMed1990

[Cotrel-Dubousset instrumentation in idiopathic scoliosis. Angular results in 70 cases].

The authors have reviewed 70 cases of idiopathic scoliosis operated on following the Cotrel-Dubousset technique between 1984 and 1987. The patients aged 15.2 years in average, presented with a double major curve still in progress at the thoracic or thoraco-lumbar level. The mean pre operative angle was 49 degrees, reducible to 34 degrees on bending. The goals of the method have been reached: in the three dimensional space the correction was selective with an angular gain of 65 per cent in the frontal plane, 34 per cent in the antero posterior plane and 56 per cent in the horizontal plane the technique allowed the suppression of any post operative immobilization, an early weight bearing with resume of social activities.

Adolescent↗
PubMed1990

[CD instrumentation in pelvic tilt].

Our realistic definition of pelvic obliquity is: any fixed malalignment existing between the spinal and pelvic structure in the frontal, sagittal and horizontal plane. The pelvic unit--with rare exceptions--must be considered one unique vertebra, an intercalary bone between the trunk and lower limbs. Like a structural vertebra in a scoliotic spine, the pelvic unit can be distorted in structure. The etiologies of pelvic obliquity can be divided into three major levels: below, inside and above the pelvis. Preoperative surgical planning must consider the position of the pelvis in the three dimensions. The technical options of pelvic fixation are described: alar staples, sacral screws, the cannulated iliosacral screw and finally the Galveston technique. The surgical technique is described. The results are presented in about 80 cases of CD instrumentation with pelvic fixation. For preoperative hyperlordosis a mean correction of 40 degree was achieved and for preoperative hyperkyphosis a mean correction of 66 degree.

Adolescent↗
PubMed1990

[Resection of the knee reconstructed with a massive prosthesis. Results after a 5 to 9 years follow-up].

Since ten years, with the progress of the adjuvant chemotherapy we treated conservatively 170 osteosarcomas. We try to review the functional and mechanical results of the knee prosthesis with 5 years of follow-up or more. There were 64 resections, 51 of the lower femur and 13 of the upper tibia. The early postoperative complications are few (less than 2%). The functional results are satisfying with 90% of excellent and good results. We observed 3 local recurrences (2 femur, 1 tibia). The survey is really increased by the adjuvant chemotherapy with a rate of 70% at 5 years. However for us the problem is the evolution of our reconstitution prosthesis. 3 kinds of mechanical failures occurred: a wear of the hinge, a fracture of the stem and a loosening of the massive component. The Guepar hinge was finally a good solution when it was metallic, but all the hinges with metal plastic. Articulation needed reinterventions because of quick wearing. For the tibial reconstitution prosthesis we did not observed any problem but for the femoral massive prosthesis, the failures were more frequent, perhaps because the mechanical situation is different. We observed 4 fractures of the stem, 5 loosening of femoral stem (bipolar loosening in one case). In all except one, the reintervention gave a good result. Finally, the result seems to be encouraging, the progress of the implant (Titanium stem, modular prosthesis, semi-constrained knee) may again decrease the rate of mechanical failures.

Adolescent↗
PubMed1989

[CD-instrumentation in the treatment of spinal deformities].

The development of CD-instrumentation aimed at corset-free postoperative patient management. Special attention was paid to a three-dimensional correction of spine deformities. Basic principles and implants are presented. After the description of the technique of implant fixation the surgical technique is presented with regard to the treatment of flexible thoracic lordo-scoliosis, rigid thoracic and thoraco-lumbar scoliosis. Finally, the basic principles in the treatment of kyphoses are discussed. The case material includes 150 patients who underwent surgery between 1983 and 1986.

Follow-Up Studies↗
PubMed1988

[Experience with protocol T10 in the pediatric service at the Gustave-Roussy Institute].

Between April and September 1986, 60 patients with osteosarcoma have been treated according to the T10 protocol in the Pediatrics Department of the Gustave Roussy Institute in Villejuif, France. Limb sparing could be achieved in 49 patients and amputation was necessary in 11. The necrosis of the primary tumor was total or subtotal in 33 cases and incomplete in the 27 others. With a median follow-up of 28 months, the actuarial survival is 85% at 48 months and the actuarial disease-free survival is 58%; the disease-free survival of "good responders" is 75% and 32% for "bad responders".

Adolescent↗
PubMed1988

[Autotransfusion using Cell Saver III. Experience with 90 cases of surgery of the spine in childhood and adolescence].

Intra-operative transfusion was used with Cell Saver Haemonetics III in 90 children undergoing spinal surgery for scoliosis. This technic keeps pace with controlled bleeding by collecting and processing shed blood and reinfusing washed packed red cells. During high blood loss procedures this device allowed to save up 51% of shed red cells. Our study of the intra-operative bleeding and its replacement was assessed with calculation using an individual regression line for each patient. Statistical analysis was performed by using multivariate correlation and "step wise analysis".

Adolescent↗