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J Philippon

Publications and source records attributed to J Philippon.

At least 19 recordsLinked to original sources
PubMed1992

Allelic loss on chromosome 22 correlates with histopathological predictors of recurrence of meningiomas.

Meningiomas are common tumors of the nervous system. Although usually benign, they may exhibit variable degrees of aggressiveness. Their probability of recurrence after subtotal resection has been correlated with several histological parameters. Independently, a loss of chromosome 22, as evidenced either by cytogenetics or by somatic loss of alleles, has been observed in about half of the cases studied. In 34 meningiomas we have examined the relationship between loss of chromosome 22 alleles and 6 histological predictors of recurrence. Significant correlations were found for 3 of these, i.e. prominent nucleoli (p less than 0.002), microscope count of mitoses (p less than 0.05) and nuclear pleomorphism (p less than 0.02). Correlation with the other 3, i.e. sheeting of cells, vascularity and micronecrosis, did not reach significance. Total tumor score, defined by the sum of the individual scores for these 6 parameters, was strongly correlated to allelic loss (p less than 0.0001). Thus, the loss of chromosome 22 alleles, which possibly contribute to the inactivation of tumor-suppressor gene(s), might be a potent genetic marker of the aggressiveness of meningiomas.

Aneuploidy↗
PubMed1992

Increase in omega 3 (peripheral-type benzodiazepine) binding site densities in different types of human brain tumours. A quantitative autoradiography study.

The density of omega 3 (peripheral type benzodiazepine) binding sites, a marker of reactive and tumoural cells, has been measured in different types of human brain tumours; omega 3 sites were quantified autoradiographically in sections from biopsy or autopsy specimens labelled with the specific radioligand 3H-PK 11195. Compared to normal brain parenchyma, up to 12-fold increase in omega 3 site densities were found in apparently viable areas of high grade astrocytoma and glioblastoma specimens, whereas more limited increases (2 to 3-fold) in this marker were observed in areas of necrosis. Low grade gliomas (astrocytomas) and meningiomas exhibited only moderate increases (2 to 3-fold) in this autoradiographic marker. Metastases of lung or kidney origin were characterized by greatly elevated (up to 20-fold) omega 3 site densities as compared to normal brain parenchyma. In every case, there was a good spatial correspondence between the histopathological limits of the tumour and the anatomical location of the increase in omega 3 site densities. These results suggest that omega 3 site densities in human brain tumours reflect their proliferative activity and point to a possible future usefulness of positron or gamma-ray emitting omega 3 site ligands for the clinical investigation and detection of human brain proliferative diseases.

Astrocytoma↗
PubMed1991

Value of electroencephalogram in prediction and diagnosis of vasospasm after intracranial aneurysm rupture.

The Electroencephalogram (EEG) of 151 patients whose ruptured aneurysm was confirmed by CT scan and angiography was recorded on the first day (D1) and the fifth day (D5). On D1, EEG had a prognostic value: among 46 patients with normal EEG, 72% presented neither further electrical ischaemic features nor delayed angiographic vasospasm; on the other hand, when bilateral bursts of slow waves, "axial bursts" or slow delta waves were recorded (78 cases), 97% exhibited EEG signs of ischaemia and angiographic vasospasm a few days later. These data were clearly related to the importance of the haemorrhage, specially when thick clots in the subarachnoid cisterns were found on the CT scan. On D5, EEG had a diagnostic value: focal or asymetrical bilateral delta waves occurring at that date seemed to correspond to ischaemia; among 107 patients with these electrical features, an angiographic vasospasm appeared in 96% of cases, and the importance of electrical abnormalities could be related to the degree of arterial narrowing. We conclude that EEG data are very useful in prediction as well in recognition of post-subarachnoid haemorrhage ischaemia due to vasospasm and are sufficiently precise to postpone control angiography and operation, when delayed surgery is programmed.

Adolescent↗
PubMed1990

[Vascular accidents of the cerebellum].

Vascular accidents of the cerebellum include heamorrhages and infarctions. These two pathologies share the same clinical symptoms and the same potential severity due to the sudden creation of an expansive cerebellar process (haematoma or infarct). Owing to acute compression of the brain stem and of CSF channels in the posterior fossa, and to the resulting supratentorial obstructive hydrocephalus, cerebellar vascular accidents are acute neurosurgical emergencies. Although the diagnosis and prognosis of the lesions have been transformed by computerized tomography of the brain, they remain extremely serious. This underlines the need for early detection, especially since, unlike vascular accidents of the brain, their functional sequelae after treatment are moderate.

Cerebellum↗
PubMed1990

Intracranial meningiomas in elderly patients. Postoperative morbidity and mortality. Factors predictive of outcome.

We studied retrospectively a series of 96 patients (36 men, 60 women), older than 65 years of age (mean age: 70 +/- 4 years, range 65-82), operated upon for an intracranial meningioma from October 1978 to December 1988. Fifty-two patients (54%) were under 70, 32 between 71 and 75 and 12 over 75 (46%). The tumours were diagnosed for all the patients by CT scan. Thirty-four (35%) were located over the convexity, 24 (25%) in the falx/parasagittal region, 38 (40%) in the base, tentorium and posterior fossa. Neurological and physical conditions were assessed preoperatively and at the closing date in June 1989. Operative mortality was 16% (15/96). Patients were divided into two groups: poor outcome, defined by the death or a post-operative Karnofsky index less than or equal to 70 (n = 36), and good outcome defined by a Karnofsky index of 80 or more (n = 60). The two groups did not differ regarding age, sex ratio, tumour size and peritumoural oedema. The only predictors of poor outcome were poor preoperative general health condition (stage III of the American Society of Anesthesiology classification), (p less than 0.01), poor preoperative neurological condition (Karnofsky's index) (p less than 0.001), and location of the tumour on the base or in posterior fossa (p = 0.02).

Aged↗
PubMed1990

Assessment of chromosome 22 anomalies in neurinomas by combined karyotype and RFLP analyses.

We report the cytogenetic study of 28 neurinomas; sixteen of them were also analysed using 11 polymorphic DNA markers for the loss of alleles of chromosome 22. Partial or total loss of chromosome 22 was found in nine cases. The results of the two approaches appear homogeneous, however, three tumors that yielded only cells with normal karyotypes demonstrated loss of constitutional heterozygosities. One of the tumors, which displayed an isodicentric or isopseudodicentric 22, was obtained in a patient with von Recklinghausen neurofibromatosis. It appears that loss of chromosome 22 is a characteristic of neurinomas whatever their context of occurrence.

Alleles↗
PubMed1990

Treatment of malignant gliomas with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy: a phase II study.

Forty patients with malignant supratentorial gliomas were treated with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy. The median duration of survival was 12 months; it differed according to the histological subtype (over 30 months for patients with anaplastic astrocytomas or anaplastic oligodendroglioma and 10.5 months for glioblastoma; P = 0.0025). Serious complications of monocular blindness and leukoencephalopathy were observed in four patients (10%).

Adolescent↗
PubMed1990

[Ependymoma of the intradural filum terminale in adults. 20 cases].

Twenty cases of ependymomas of the intradural filum terminale in adults have been reviewed. Their pathology was quite uniform, of a myxopapillary type, similar to the low grade ependymoma described by Kernohan, which represent about 23% of the tumours of cauda equina. Mean age of the patients was 35.7 years. Mean time between the first symptom and the diagnosis was 46 months. Clinical symptoms were often non specific, with low back pain and radiculalgias. At the time of operation, clinical signs were essentially motor deficits usually moderate (11 cases), sphincter disturbances (10 cases), and sensory loss (9 cases). In 3 patients with rapid worsening, an intratumoral haemorrhage was found. In 2 other cases, intracranial hypertension was the main symptom: in the first, it was related to hydrocephalus probably caused by spinal subarachnoid haemorrhage; in the second, there was no ventricular dilatation. In this series, neuroradiological examinations had consisted mainly in myelographies. C.T. scan has been performed in 3 patients; in only one case it has allowed to visualize a presacral extension. One patient had preoperative M.R.I.: the association of an expansive lesion with upper cyst in conus medullaris and presence of blood in the sacral area permitted the diagnosis of ependymoma of the filum terminalis. The average size of the tumours was 8 cm. Total removal has been possible in 15 cases (and in 2 of the 5 giant tumours), subtotal removal in 2 cases, and partial removal in 3 cases. In 4 patients where existed an intraspinal cord extension above the conus, it has been resected completely, except for one case with recurrence. Patients with a total removal had a good functional recovery (13/15). No recurrence has been observed in this group. In conclusion, with M.R.I., one may hope an earlier diagnosis, condition of radical surgery. So, radiotherapy which is not without risk, could be avoided.

Adolescent↗
PubMed1990

[The prognosis of medulloblastoma in adults].

We studied retrospectively the series of 24 patients (17 men, 7 women), median age 25.5 years (range: 16-57), operated upon for a cerebellar medulloblastoma from March 1979 to June 1988. The tumors were diagnosed for all the patients by C.T. scan and by M.R. imaging for the six last patients. Seven tumors (29.2%) were located in the fourth ventricle, 2 in the vermis (8.3%), 9 in the cerebellar hemisphere (37.5%), 5 in the vermis and cerebellar hemisphere (20.8%). One patient had a diffuse infiltration of the cerebellum. All patients have been operated on (complete removal: 15 patients (62.5%), subtotal removal: 8 patients (33.3%), biopsy: 1 patient). Operative mortality was 8.3% (2/24). One patient died at two months from septicemia. The twenty-one surviving patients received radiotherapy. Twelve patients received both radiotherapy and chemotherapy. Six patients (25%) died during the follow up at 17, 22, 24, 60, 84 and 85 months. One patient is lost to follow up at 45 months and 13 patients are living at the closing date (June 1989). For the total group (n = 24) the probability of survival at 5 years was 64.8% (C.I. 95%: 42.8%-86.8%). Among the 21 patients who received radiotherapy alone or radiotherapy and chemotherapy the probability of survival at 5 years was 74.4% (C.I. 95%: 52.2%-96.7%). We studied the following predictors of poor outcome: age, sex, prognosis subgroups as defined by Chang et Coll., extension of tumor removal, adjunction of chemotherapy, histology. None of these factors was statistically related to the survival duration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

Prolactin-secreting pituitary adenoma in a man with gigantism: a case report.

A prolactin-secreting pituitary adenoma was removed trans-sphenoidally from a 37 years old man with gigantism (218 cm). Serum levels of prolactin (PRL) were elevated pre-operatively and decreased after administration of L-Dopa with no increase after TRH as is usually observed in PRL-secreting adenomas. Growth hormone (GH) and somatomedin serum levels were normal with no modification of GH after insulin hypoglycemia, oral glucose loading or L-Dopa. Morphological examination of the tumour demonstrated the presence of lactotrophs by light and electron microscopy and by immunofluorescense staining. No somatotrophs were found. In this unique case, the relationship between a PRL-secreting adenoma and gigantism is discussed.

Adenoma↗
PubMed1979

[Preoperative diagnosis of posterior fossa tumors (author's transl)].

The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.

Adult↗