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Biomedical subjects

J Guérin

Publications and source records attributed to J Guérin.

At least 55 records · Page 3Linked to original sources
PubMed1989

Anatomical basis of the extended subtemporal approach to the cerebellopontine angle: its value and limitations.

The cerebellopontine angle is an anatomic region situated deeply at the anterolateral aspect of the brainstem, access to which is complicated by the presence of neurovascular bundles. The functional importance of these cranial n. (trigeminal, facial, vestibulo = cochlear, glossopharyngeal, vagus and accessory) calls for the use of special surgical routes of access in certain cases. In particular, tumors situated between the vestibulocochlear-facial bundle behind and the trigeminal n. in front are difficult to reach by the suboccipital and subtemporal transmeatal routes. The endeavor to preserve hearing in particular situations, where the side opposite the tumor is no longer functional, justifies the use of a subtemporal transmeatal route extended by opening the tentorium cerebelli. This anatomic and experimental surgical study deals with the possibilities of this route of approach.

Cerebellar Neoplasms↗
PubMed1989

[ORL aspect of meningioma of the cerebellopontine angle].

Through 14 recent cases, the authors review the main clinical syndromes leading to the diagnosis of petrous and brain-stem meningiomas. The cochleovestibular syndrome, the most frequent amongst them, recalls the symptomatology of an acoustic neuroma. The jugular foramen syndrome is similar to that seen in jugulo-tympanic paragangliomas. The middle ear tumor syndrome is specific to primary or secondary intrapetrous tumors. The positive diagnosis of meningiomas belongs to the field of CAT scares and mainly of NMR, which define morphological characters, none of them being specific: oval shape, the closed angle sign, intratumor calcification, hyperdensity, osseous changes on the posterior aspect of the petrous bone NMR permits a very precise localization and definition of the tumor which is necessary among the per-op studies. This decreases the occurrence of once frequent surgical surprises.

Cerebellar Neoplasms↗
PubMed1989

[Nephronophthisis, tapeto-retinal degeneration, encephalopathy and vermian agenesis: a new association. Apropos of 3 familial cases].

We observed a combination of nephronophthisis, tapetoretinal degeneration, vermian agenesis and encephalopathy in three first cousins. Juvenile nephronophthisis, the main inherited renal disease of childhood, is occasionally associated with a genetically linked disease involving the eyes and/or bone and/or liver and/or nervous system. We have assembled approximately one hundred cases of complex nephronophthisis. We discuss the various associations, among which the Senior syndrome (nephronophthisis + tapetoretinal degeneration) is the most frequent. The familial combination seen in our patients has apparently not been previously reported and seems to represent a new expression of the disease.

Brain Diseases↗
PubMed1988

[Intrathecal analgesia. Apropos of 50 cases].

Fifty patients with intractable pain, mainly of neoplastic origin, were treated by morphine through unidose drug delivery system. Criteria of selection of the patients and technical procedures are reported. Most common side effects are nausea and dysuria but can be effectively prevented. The most severe complications are leakage of cerebro spinal fluid with or without meningitis. The success rate at 20 days is 80% as well in pelvic pain as in subdiaphragmatic extra cephalic pain.

Adult↗
PubMed1988

[Early prediction of the magnitude of seasonal variations in testicular diameter and percentage of abnormal spermatozoa in Ile-de-France rams. 1. Animals born in February].

The aim of this study, conducted in spring born animals, was to analyse if within a group of males of the same age, there is any relationship between the testis diameters (TD) or between the percentages of morphologically abnormal spermatozoa (AS) recorded in the same animal at two periods of its life (be it at two different spring periods or at two stages of its age: ram lamb and adult). Eighteen Ile-de-France ram lambs born in February 1980 and issued from five adult rams whose seasonal variations in TD and AS had been followed for two consecutive years were used in this study. Semen was collected (artificial vagina, 1 ej/male/wk) from October 1980 until December 1983 (slaughter of the animals) every semester during "Periods" (n = 7). Within a same year, the first semester (February to June) was called "Spring", the second (August to December) "Autumn". AS (150 cells/smear) were controlled on each ejaculate and the same week maximum TD of both testes was measured using a calliper. Correlations were calculated for TD and AS between individual values (simple correlations) or between groups of individual values (multiple or canonic correlations) at different periods. These values were chosen as follows: TD: 4th and 5th control for the first period (P1, ram lamb); the three lowest values recorded in April (P2, P4, P6); the three mean highest values recorded in Autumn (P3, P5, P7). AS: the first five measurements in P1; the four highest percentages obtained in March-April in P2, P4, P6 (correlations were not calculated in autumn since AS were very few). 1 a: On the whole, TD increased with the age of the animal until 24-27 months and passed alternatively by minimal (February to April) and maximal (September) values each year. Testis growth due to the effect of photoperiodism started every year in the first days of June. 1 b: Except alterations of semen quality in August 1983 (due to high local temperatures), AS were always higher in Spring than in Autumn, maximal values being reached in February (P4) or in March-April (P2 and P6). Their seasonal variations were thus opposed to those of TD (r = -0,671 between weekly means of AS and TD of the whole group of animals from P2 to P6). II-TD: Individual TD of ram lambs were significantly correlated with those recorded in the same adult animal (P1-P2, P1-P6, but P1-P4 NS) especially in autumn (P1-P3, P1-P5, P1-P7.

Animals↗
PubMed1987

Neuropsychologic impairment in adults with brain tumors.

Neuropsychologic studies were performed in 49 adult patients with primary intracranial tumors following surgery and radiation therapy. In the absence of computed tomography (CT) scan evidence of tumor recurrence or neurologic disorders, patients' intellectual functioning was tested once (49 patients), twice (18 patients), or three times (5 patients) by the Wechsler Intelligence Scale (WAIS) between 1.5 and 110 months after the beginning of irradiation. Full scale IQ (FSIQ) and deterioration coefficient (DC) were evaluated. Time elapsed from treatment to initial evaluation (vertical study) determined three statistically different patient groups. During the first 4 months, DC and FSIQ did not differ from a normal population. From 5 to 30 months, there appeared a significant probability of intellectual deterioration (p = 0.01), whereas median FSIQ remained at a normal level. Beyond 30 months, deterioration disappeared in terms of DC, but median FSIQ fell (p = 0.01). Second and third evaluations (horizontal study) confirmed the initial evaluation. Nevertheless, later recovery from FSIQ impairment was seen in 4 of 5 patients who were less than 30 years old and in 2 patients between 30 and 50 years of age who returned to work early after treatment. We believe that early neuropsychologic testing to detect early psychologic impairment is needed in all adult patients treated for brain tumors, especially in younger patients. Psychologic assistance and an early return to work may be beneficial.

Adolescent↗
PubMed1985

[Spontaneous subarachnoid hemorrhage. Plea for a standard evaluation system].

There is no univocal grading of subarachnoid hemorrhage by ruptured intra-cranial aneurysms. Three systems are commonly used: Botterell's, Hunt's and Hess's, Nischioka's. Besides, many surgical teams use modified or derived systems. It is this very difficult to compare series of patients whose grading has not been made, using the same criteria. The authors propose to make a unique system of grading with new criteria of clinical evaluation.

Humans↗
PubMed1985

[Extended spinal decompression using an anterior approach in the treatment of myelopathies caused by cervical arthrosis].

Forty-five patients suffering from severe myelopathy due to cervical spondylosis with stenosis of the spinal canal were treated by anterior decompression extending over three levels or more. In eight instances, the decompression was the only surgical procedure: in 37 instances, there was associated bone graft. No severe complications were noted. The clinical results were assessed, using the Nurick scale. The average follow-up was four years. No patient was made worse. Twelve were completely relieved, 21 were improved and 12 were unchanged. The authors conclude that this technique is worthwhile. Grafting should be done only in cases where there is post-operative instability. After a review of the literature, the authors conclude that anterior resection of the vertebral bodies is more reliable than extensive laminectomy.

Adult↗
PubMed1983

[Effects of synthetic ACTH on plasma cortisol and aldosterone in neurosurgery].

Cerebral oedema, present or potential, is a predominant medical complication of neurosurgery. Its physiopathology and treatment can be in part linked to adrenal activity (aldosterone and sodium balance; cortisol and hormone treatments). In 25 non-comatose patients presenting with a tumoral or vascular neurosurgical condition, plasma cortisol and aldosterone levels were measured by radioimmunoassay, always at the same time (07 h), before any investigations or treatment were carried out, the patient being at rest. Cortisol levels were increased in more than half the patients (n = 14; 44.11 +/- 3.4 micrograms X 100 ml-1; p less than 0.001); aldosterone levels were high in one third of the patients (n = 8; 304.29 +/- 57 micrograms X ml-1; p less than 0.001). 17 of these patients were studied according to the protocol of the synthetic ACTH test during the first four days of their receiving 1 mg X 24 h-1 synthetic ACTH. The expected therapeutic effect on cortisol was not obtained in all cases, and the stimulation of aldosterone release was important and prolonged.

Adrenocorticotropic Hormone↗
PubMed1983

[Electrocardiographic anomalies in subarachnoid hemorrhage].

An electrocardiographic study was undertaken in 100 patients with subarachnoid haemorrhage to try and establish a relationship between the clinical state of the patient and the ECG abnormalities. Cerebral angiography was performed in 95 cases showing 1 or more aneurysms in 68 cases and an angioma in 6 cases. Twenty one patients had no cerebrovascular abnormality. Routine ECGs were recorded on admission and were abnormal (Lipman and Massie's criteria) in 80 p. 100 of cases. The commonest changes were T-wave inversion (34 cases), bradycardia (32 cases), abnormal U-waves (28 cases) and prolongation of the Q-T interval (21 cases). Only 2 patients had giant T waves of normal polarity. Intraventricular conduction defects were more common (12 cases) than atrioventricular block (3 cases). Ten patients had sinus tachycardia and ventricular extrasystoles were observed in 5 cases. The patients were divided into two groups according to severity of their clinical state: Group A (52 patients) without changes in the level of consciousness, and Group B (48 patients) with disturbed levels of consciousness. The incidence of bradycardia and T-wave inversion in the two groups was compared by the Chi-squared test. Bradycardia was commoner than T-wave inversion in Group A (52 p. 100 and 19 p. 100 respectively). This finding was the contrary to what was observed in Group B where 10 p. 100 of patients had bradycardia (p less than 0,0005) and 50 p. 100 had T-wave inversion (p less than 0,005). The ECG changes were of prognostic value. The survival rate in patients with T-wave inversions was 85,7 p. 100 (p less than 0,001). The presence and site of the cerebrovascular abnormalities were not related to the ECG changes and no correlations were found between electrolyte changes and the ECG appearances.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗