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Biomedical subjects

J P Chodkiewicz

Publications and source records attributed to J P Chodkiewicz.

At least 55 records · Page 3Linked to original sources
PubMed1985

Intracranial haemostasis with a neurosurgical CO2-laser unit.

The authors have been using CO2-laser radiation routinely for more than 2 years. After having recalled the basic thermal properties of this beam, they present their experience. The goal of this work is to point out the particular benefit of CO2-laser cautery to perform tumoral haemostasis. The technical data of this CO2-laser haemostasis are detailed for 3 main indications: In cases of a precise origin of the haemorrhage, the coagulation of small intratumoural vessel necessitates a low output power: 2-4 watts in continued emission; 10-15 watts in the pulsed mode. The beam must be defocussed so as to be as large as the aimed vessel. A micro-manipulatotor is necessary for deeply located tumours. Basal meningiomas, neurinomas, giant adenomas are the best indications. If a diffuse bleeding is encountered in the operative cavity the output must be a little higher: 3-8 watts in continuous mode or 15-30 watts in the pulsed mode; first the cavity is swept with a defocussed CO2-laser ray; then the few larger vessels which have not been cauterized are coagulated one by one either by laser or by bipolar coagulation. The insertion zone of a meningioma can be efficiently coagulated by CO2-laser: a 150-200 watts output in the pulsed mode is necessary if the attachment is dural, a 300-400 watts pulsed output in the case of bony infiltration.

Adolescent↗
PubMed1985

[Electro-clinical semiology of subintrant temporal lobe seizures].

The authors recorded 10 to 67 TLS (mean 29) in 10 patients (5 M, 5 F; 9 to 41 years, mean 23) during 'acute' (4-6 hours) stereo-EEG exploration. At the onset of seizures, we observed: subjective manifestations (often epigastric), autonomic symptoms, and oro-alimentary 'automatisms'. Affective, unpleasant, manifestations occurred in only 2 patients. The discharges may only affect the Ammon's horn, but they never involve only the amygdala. There is a strong relationship between the duration of the discharge, the number of cerebral structures (temporal and, later, extratemporal) involved in the discharge, and the clinical symptomatology. Somatomotor lateralized manifestations, and gestural 'automatisms' only occur when the discharges spread to extratemporal cerebral structures. The secondary generalizations are very rare and are also linked to a large extratemporal spread of the discharge.

Adolescent↗
PubMed1985

Cryptic vascular malformations diagnosed by stereotactic biopsies--a preliminary study.

A series of 14 cryptic vascular malformations (CVM) deeply situated or localized in functional cortical areas were diagnosed by serial stereotactic biopsies. No history was suggestive of hemorrhage, despite a substantial hematoma being evacuated during biopsy procedures in 4 patients. Retrospectively, CVM without hematoma were found to have certain characteristics that should raise the suspicion as to the correct diagnosis. At the time of discharge from the hospital, only 1 patient had mild aggravation of a preexisting motor deficit, which further improved. Serial stereotactic biopsies provided the required histological diagnosis with relatively low risk.

Adolescent↗
PubMed1985

Correlation between stereo-EEG, CT-scan and stereotactic biopsy data in epileptic patients with low-grade gliomas.

Stereo-EEG activity, which was recorded precisely from the same location as stereotactic biopsies, was studied on 11 patients with low-grade glioma and severe partial epilepsy. The volume of the lesions varied from 6 to 72 cm3 (mean 23 cm3). A very depressed activity was recorded in all the 25 specimens of solid tumor and in more than half of infiltrated white matter. The background activity was still conserved in all 'normal' fragments, while it is never found in solid tumor; sometimes it could be found in the infiltrating tumors of white or gray matter. High voltage theta and delta activity was recorded in neither 'normal' nor solid tumors. We emphasize the importance of considering the stage of evolution when we evaluate the significance of the stereo-EEG activity.

Adolescent↗
PubMed1985

[Mucoceles of the sphenoid sinus and their ophthalmological manifestations].

The authors describe two cases of sphenoïd sinus mucoceles, the first with a chiasmatic syndrome and the second with an oculomotor paralysis, and compare these cases with those described in the litterature. This rare benign tumor is revealed by ophthalmological complications which result from compression of adjacent structures. The main clinical findings are pain, decrease in visual acuity, proptosis, and diplopia. Plain X rays and pluridirectional tomographies are usually sufficient to make the diagnosis but CT scan is the procedure of choice for defining the extent of the lesion and thus assuring an appropriate surgical approach. The CT scan findings have been reviewed. Early and correct diagnosis is important to prevent permanent visual loss by optic nerve atrophy.

Adult↗
PubMed1985

[Stereotaxic treatment of expanding cysts in craniopharyngiomas by endocavitary beta-irradiation (Re-186; Au-198; Y-90)].

The authors report the results of 17 intracystic injection of colloidal 186 rhenium, 2 colloidal 198 gold, and 1 colloidal 90 yttrium for endocavitary treatment of 18 cystic craniopharyngiomas (16 pts during a period ranging from January 1975 till July 1982. Follow-up studies ranging from 12 to 72 months (m: 36 m) revealed that all craniopharyngiomas cysts were effectively treated with cessation of fluid formation, progressive shrinkage of the formerly expansive cysts, and finally cyst obliteration in 75% of the cases. No early or late side-effects were observed during the entire observation period. Late reexpansion of one craniopharyngioma cyst, observed at 11 months, was successfully treated by a second injection. Leakage of colloid isotope into the CSF spaces during the "test" or "therapeutic" injections occurred in 18% of the global number of injections, however no clinical complications were observed. On the basis of a clinical dosimetric study a 30 000 rads wall-dose, not exceeding 40 000 rads is actually considered as the safer dose for endocavitary treatment of craniopharyngioma.

Adolescent↗
PubMed1985

[Neurosurgery with a CO2 laser. Evaluation of 61 operations].

The authors present the results of their over two years experience with CO2 Laser neurosurgical unit. They explicit the indications and the technical data followed during intra-cranial (N = 44), intra-spinal (N = 12) and intra-orbital (N = 5) procedures. Meningiomas, neurinomas and adenomas are the best indications for tumoral CO2 Laser neurosurgery. In other respects sterilization and cranialization of aeric sinuses are simplified by the use of CO2 Laser: it assures vaporization of the mucosa and carbonization of the walls more easily than an electric coagulator. At last the use of CO2 Laser for dissection and removal of intra-orbital tumors is quite demonstrative. Thus owing to its physical and thermical qualities CO2 Laser is often a very useful, sometimes irreplaceable, apparatus: provided that its indications are precise and rigorous.

Adolescent↗
PubMed1984

[Value and limitations of the use of CO2 laser in neurosurgery. Reflexions from a French experience].

The authors have been using routinely since February 1983 a french 80W. CO2 Laser unit. They discuss the advantages and limits of this technic in the light of the first 26 intracranial and intraspinal operations carried on with it. The main and wellknown qualities of CO2 Laser are: the easiness of the hemostasis of the tumor and of the surgical cavity; and the absence of traction on the same tissue. The coupling of CO2 Laser with the operating microscope appeared very useful and made safer deep tumor excision, particularly that of the posterior fossa such as neurinomas and meningiomas. It was also quite efficient for intra-orbital tumors. The maniability of the hand piece was increased by the use of oblique mirror (45 degrees and 60 degrees) fixed at its extremity. The incision of skin, subcutaneous and muscular layers was not simplified by CO2 Laser; indeed this apparatus increased the operatory duration and was responsible of a healing time extension.

Adolescent↗
PubMed1983

Brain regional pharmacokinetics of 11C-labeled diphenylhydantoin: positron emission tomography in humans.

We used positron emission tomography to study the regional cerebral pharmacokinetics of 11C-labeled diphenylhydantoin (11C-DPH), which was given intravenously to 10 patients (8 intractable partial epileptics and 2 nonepileptics). In the nonaffected hemisphere, 11C-DPH concentration in gray matter reached equilibrium with blood within 20 minutes but was still rising at 60 minutes in white matter, where equilibrium was too slow to be detected owing to the fast physical decay of 11C. Brain-blood concentration ratios at 50 minutes were 1.37 and 1.06 in gray and white matter, respectively, similar but less variable than steady-state DPH ratios reported in human brain surgical samples. There was no indication that normal brain regions of medically resistant epileptics bind DPH less effectively than in nonepileptic patients. Brain and blood 11C-DPH concentrations were well correlated, confirming that the latter gives a reliable estimate of the former in unaffected brain regions.

Adolescent↗
PubMed1982

[Craniopharyngioma in adults].

Initial signs of a craniopharyngioma in a 58 years old woman were a decrease in visual acuity and suppression of the pupillary light reflex. Perimetric signs were: left: central scotoma with an inferior temporal defect of the peripheral field; right: superior temporal field defect. The CT scan showed an intrasellar tumor, extending into the suprasellar region, isodensity of the tumor being the main finding. The radiological diagnosis was adenoma, but all the perimetric defects disappeared spontaneously, and the post-operative diagnosis was craniopharyngioma. Variations of the visual field defect are one of the most typical signs of craniopharyngioma, and absence of calcification, with isodensity of the tumor on the CT scan may lead to a mistaken.

Craniopharyngioma↗
PubMed1980

[Intracranial tumors in mental patients (author's transl)].

One hundred and fifty patients admitted consecutively to the same neurosurgical service in Paris were reviewed retrospectively. There is no definite difference between intracranial tumors in mental patients and those encountered in a normal population in terms of: frequency, anatomic localisation and histological distribution. All the patients had been referred previously to psychiatric hospitals for: confusional states, disturbed behaviour or pseudo-depression in 60% of the cases. Neurological localizing signs were present in 83% of the cases; EEG was abnormal in 96% of the patients recorded during their stay in psychiatric wards. Diagnosis of brain tumors in mental patients appears feasible if not always simple; it is based upon elementary neurological examination and routine investigations. In a near future, isotopic scan and CT scan should become a great help to reduce excessive diagnostic delays in order to improve the prognosis which remains poor.

Brain Neoplasms↗