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J Richaud

Publications and source records attributed to J Richaud.

At least 19 recordsLinked to original sources
PubMed2003

[Primary dural lymphoma: a report of two cases with review of the literature].

Primary lymphoma arising in dura is exceedingly rare. We report the clinicopathologic findings of two patients with primary B-cell lymphoma of dura. Both were female, 38 and 45 years old. Prior to biopsy they were felt to have meningioma on preoperative magnetic resonance imagery. Histologically, tumors were classified as MALT-type lymphoma. Literature describe only 14 reports of similar entity. Primary lymphomas arising in dura appear to have a more favourable clinical course compared to PCNSL and may require a less aggressive treatment.

Adult↗
PubMed2000

Suprasellar seeding of a benign choroid plexus papilloma of the fourth ventricle with local recurrence.

A suprasellar location of a benign choroid plexus papilloma is reported. Local recurrence within the fourth ventricle was also present, 8 years after apparently complete removal. Imaging and histological findings were similar to those of the initial lesion. At surgery, the suprasellar lesion had no connection with the ventricular system. Seeding of choroid plexus papillomas is discussed, and the pertinent literature reviewed.

Female↗
PubMed1998

Recurrent intracranial neurenteric cysts.

Neurenteric cysts are cystic lesions lined by a columnar epithelium of endodermal derivation. They are rarely located in the central nervous system. We describe the case history of two recurrent neurenteric cysts located within the posterior fossa: one in the 4th ventricle and the second in the cerebellopontine angle. The literature is reviewed and the follow-up and recurrence of such cysts are discussed.

Adult↗
PubMed1994

Kidney mobility during respiration.

Radiotherapy treatment planning needs optimum definition of the target volume in its relative position to normal tissue. The motion of the kidneys during respiration has not been well quantified. They move in a tilted coronal and sagittal plane. Using fast MRI while patients held their breath we quantified the movements of the kidneys. Fourteen patients volunteered for the study. Nine MRI images of the kidneys for one volunteer were done: three in the axial plane (all in deep inspiration) and six in the coronal plane (three in deep inspiration, three in deep expiration). The maximal vertical motion of the superior pole from its end-expiratory to its end-inspiratory position is 39 mm (43 mm for the inferior pole). In deep inspiration or deep expiration the positions of the right and left kidneys appear reproducible. The mean deviation of kidney movement is less than 4 mm in all three dimensions (range, 0-6.9). For tumors close to the kidney, we advocate respiration gated radiation therapy so as to minimize the movement of this very radiosensitive structure.

Adult↗
PubMed1994

[Brain metastasis of a cutaneous neuroendocrine carcinoma. Apropos of a case].

The authors report the case of a 69-year-old woman with a brain metastasis from a cutaneous neuroendocrine carcinoma. The initial lesion was situated on the leg. No other secondary lesion was found. The cutaneous neuroendocrine carcinoma was initially considered to be a locally malignant tumor. In fact, it is frequently complicated by metastases. However, brain secondaries remain rare.

Aged↗
PubMed1993

5-Fluorouracil combined with the [6S]-stereoisomer of folinic acid in high doses for treatment of patients with advanced colorectal carcinoma. A phase I-II study of two consecutive regimens.

BACKGROUND: Potentiation of the antitumor activity of 5-fluorouracil (5-FU) by folinic acid has been demonstrated in patients with colorectal adenocarcinoma. Modulation is due to the interaction of thymidylate synthase (TS), fluorodeoxyuridylate (FdUMP), and methylene tetrahydrofolate (5,10-CH2-FH4), which leads to the formation of a stable ternary complex with concomitant enzyme inactivation. Folinic acid consists of a mixture of equal parts of two stereoisomers differing in chirality at the C6 carbon of the pteridine ring. Only the levorotatory [6S]-folinic acid is transformed into active folate cofactors. However, the [6R]-stereoisomer is not inert; it was shown to interfere with the [6S] form at the cellular level. The possibility of a deleterious effect of the unnatural stereoisomer on the modulation of 5-FU led us to carry out 2 consecutive phase I-II studies of 5-FU combined with the [6S]-stereoisomer of folinic acid given in high doses for treatment of patients with advanced colorectal carcinoma. PATIENTS AND METHODS: Treatment comprised 5-FU by i.v. infusion for 2 hours (the initial dose was 350 mg/m2/d; it was incremented by 25 mg/m2/d until a maximal dose of 550 mg/m2/d) and [6S]-folinic acid (100 mg/m2/d by rapid i.v. injection in Regimen 1, and 100 mg/m2 by rapid i.v. injection followed by a 2-hour infusion of 250 mg/m2 in Regimen 2) for 5 days, every 21 days. Twenty-five pts and 27 pts were assessed in Regimen 1 and in Regimen 2, respectively. They had had no prior chemotherapy. The median follow-up time was 9 months and 15.5 months for patients treated with Regimen 1 and Regimen 2, respectively. For pts treated with Regimen 1, the response rate was 52% (CR, 12%; PR, 40%). The median time to disease progression was 9.2 months. The probability of survival at 12 months was 73%. For pts treated with Regimen 2, the response rate was 37% (CR, 7%; PR, 30%). The median time to disease progression was 8.9 months. The probability of survival at 12 months was 67%. Improvement in quality of life was achieved in most patients who had symptoms due to the tumor before the start of treatment. The dose-limiting toxic effects (WHO grades > or = 3) were diarrhea, dermatitis, and mucositis. One single episode of grade 4 diarrhea occurred. After injection according to the schema in Regimen 1, [6S]-folinic acid was rapidly cleared from plasma (mean t 1/2 alpha and t 1/2 beta of 7.2 and 126 minutes, respectively). The mean concentration of the [6S]-stereoisomer two hours after injection was 5.8 mmol/L. After a rapid i.v. injection of 100 mg/m2 followed by a 2-hour infusion of 250 mg/m2, the mean concentration of [6S]-folinic acid two hours after the injection was 57.5 mmol/L. Pharmacokinetic data suggests saturation of the metabolic conversion of [6S]-folinic acid when large doses are administered. CONCLUSION: The [6S]-form of folinic acid potentiates the antitumor effect of 5-FU given concomitantly. However, increase of the daily dose of the folate did not result in a therapeutic improvement. The present results justify a more complete exploration of the pure active stereoisomer as a modulator of the fluoropyrimidines.

Adenocarcinoma↗
PubMed1992

Fluorouracil combined with the pure (6S)-stereoisomer of folinic acid in high doses for treatment of patients with advanced colorectal carcinoma: a phase I-II study.

BACKGROUND: Potentiation of the antitumor activity of fluorouracil (5-FU) by folinic acid has been demonstrated in patients with colorectal adenocarcinoma. Modulation is due to the interaction of thymidylate synthase, fluorodeoxyuridine monophosphate, and methylene tetrahydrofolate, which leads to the formation of a stable ternary complex with concomitant enzyme inactivation. Folinic acid consists of a mixture of equal parts of two stereoisomers differing in chirality at the C-6 carbon of the pteridine ring. Only the levorotatory (6S)-stereoisomer of folinic acid is transformed into active folate cofactors. However, the (6R)-stereoisomer of folinic acid is not inert; it was shown to interfere with the (6S) form at the cellular level. PURPOSE: The possibility of a deleterious effect of the unnatural stereoisomer on the modulation of 5-FU led us to carry out a phase I-II study of 5-FU combined with the (6S)-stereoisomer of folinic acid given in high doses for treatment of patients with advanced colorectal carcinoma. We also determined the plasma pharmacokinetics of folates after intravenous (IV) injection of (6S)-folinic acid at the dose used in this study. METHODS: Treatment consisted of 5-FU (350-550 mg/m2 per day by IV infusion for 2 hours) and (6S)-folinic acid (100 mg/m2 per day by IV bolus injection) given for 5 consecutive days; the treatment was repeated every 21 days. Twenty-five patients with advanced colorectal carcinoma, who had had no prior chemotherapy, were evaluated for antitumor activity. The quantity of folates in plasma was measured using a microbiological assay. RESULTS: The median follow-up time was 9 months (range, 3.5-15.2 months). The response rate was 52% (complete response, 12%; partial response, 40%). The median time to disease progression for responding patients was 9.2 months (range, 5.9-15+ months). The estimated probability of survival at 12 months was 73%. Palliative improvement in quality of life was achieved in most patients who had symptoms due to the tumor before the start of treatment. The dose-limiting toxic effects were grade 3 diarrhea, dermatitis, and oral mucositis. Grade 4 toxicity did not occur. Myeloid toxicity was minor. After IV injection, (6S)-folinic acid was rapidly cleared from plasma (mean half-lives: alpha = 7.2 minutes and beta = 126 minutes). The mean concentration of the unchanged compound 2 hours after injection was 5.8 mumol/L. CONCLUSION: The (6S)-form of folinic acid potentiates the antitumor effect of 5-FU given concomitantly. IMPLICATION: Our results justify a more complete exploration of the pure active stereoisomer as a modulator of the fluoropyrimidines.

Adult↗
PubMed1991

[Analysis of the results of surgery and nucleolysis using papain in 1085 cases of lumbar disk hernias].

1,085 patients have been treated for intervertebral disc herniation with lombo-sciatica: in 751 cases surgical discectomy without laminectomy has been performed with or without microscope; 334 underwent papain nucleolysis. The two clinical groups were separated on clinical and radiographic backgrounds: nucleolysis was performed in patients with no motor disturbance, no stenosis of the lumbar canal, no displaced fragment; the other patients received surgical treatment. The results were evaluated according to MacNab's criteria with a follow-up of 12 to 84 months (mean 17.2 months). The results after surgical treatment were excellent in 53.8% and good in 36.8% of the cases. For papain treatment they were excellent in 32.7% and good in 38.8% of the cases. Papain nucleolysis therefore appears to be an efficient method for the treatment of intervertebral disc herniations associated with lombo-sciatica but, overall, gives poorer results than surgery in spite of a strict selection procedure. In this study, complications due to papain nucleolysis were restricted to chemical spondylodiscitis (5 cases) and to 2 benign allergic syndromes. Statistical analysis of all the cases and multifactorial correlation research pointed out the importance of "workmen's compensation" as prognostic factor. Since this study, 90% of the patients presenting with disc herniation associated with lombo-sciatica recalcitrant to medical treatment undergo surgical discectomy; papain nucleolysis is reserved for sub-ligamentary and non-displaced forms without stenosis of the lumbar canal and represent 10% of our current population.

Adolescent↗
PubMed1990

New technique for posterior intra-articular arthrodesis using a single-block graft in cases of atlantoaxial instability. Case report of unstable atlantoaxial rotatory luxation in a 10-year-old girl.

A new method of posterior C1-2 arthrodesis, derived from the W.V. Cone and G. Bertrand, technique (Montreal, 1970) is described with two modifications: (1) the exact measurements of the ideal graft are determined preoperatively, using CT and a sterilized pasteboard horseshoe-shaped model; (2) in the sitting position, single occipital block graft was cut out microsurgically, using the preoperative model. After decortication of the graft, posterior arches of C1 and 2, and microsurgical excision of the cartilage of the C1-2 lateral joints, the graft was imbedded into the entire C1-2 space, fixed, and tightened using a braid of "nylacap" yarn. A case report of rotatory luxation and associated atlantoaxial instability in a 10-year-old girl illustrates the excellent functional results of this technique.

Atlanto-Axial Joint↗
PubMed1990

[Recalibration via a postero-lateral approach in recent traumatic stenosis of the dorsal and lumbar spine. Modalities and results apropos of 31 cases].

The authors present 31 cases of spinal trauma affecting thoraco lumbar level with severe spinal canal stenosis secondary to compressive trauma of the anterior disco-corpereal region. Associated neurological disorders were of varying severity. 23 cases were investigated by computed tomography. In all cases, the surgical procedure involved rectification of spinal deformities, with initially a unilateral postero-lateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of free disc fragments. The stabilization was usually achieved by complementary bilateral plates using Roy-Camille or Privat material in 22 cases, associated with postero-lateral arthrodesis by grafting with reconstruction of the articulo-pedicular structure in 19 cases. Emergency operation was done in 14 cases; in 5 cases operation was done on the 2nd or 3rd day and in 11 cases after the 3rd day. The functional spinal result was excellent, and recalibration was verified by tomography in all cases. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis, and a consequently neurological improvement was always obtained, even for the most serious of lesions except those at the thoracis level superior to T10. The application of this postero-lateral approach for severe spinal trauma seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods. We do not share the opinion that delay in decompression does not influence the neurological prognosis and emergency operation is advisable.

Adolescent↗
PubMed1989

[Desmoid tumors of the mesentery in Gardner's syndrome. Value of x-ray computed tomography].

3 cases of desmoid tumours of the mesentery occurring as part of Gardner's syndrome are reported. In 2 cases, CAT scanning was carried out. We underline the value of this examination compared to other imaging methods. It allows the establishment of a diagnosis, investigation for complications, the operability to be assessed and is useful for monitoring patients. Its major value is in avoiding an unnecessary laparotomy, a factor certain to produce recurrence, in certain patients. Other alternative therapy may then be proposed.

Adult↗
PubMed1988

Spinal meningeal malformations in children (without meningoceles or meningomyeloceles).

Multiple meningeal malformations are described: anterior or lateral meningoceles, extradural meningeal cysts, and intradural arachnoid cysts. All diverticulae appear to be extensions of the subarachnoid space, producing symptoms early or later. It is impossible to unify all these lesions because they cause multiple pathological conditions, depending upon the anatomical form or level, other systemic malformations, spinal abnormalities, or associated familial diseases. Surgical treatment requires complete evaluation of each anatomical aspect before procedure.

Adult↗
PubMed1988

Chemonucleolysis for herniated cervical disc.

The authors treated 38 cases with cervical disc prolapse and discoradicular pain by percutaneous chemonucleolysis. Material and procedure are described and the results of 31 cases with a follow-up between 3 and 52 months analysed. The global results were excellent. In detail the results are analysed according to symptomatology, aetiology, findings of discography and the dose of enzyme used.

Adult↗
PubMed1988

[The double approach in recent cervical injury. Indications apropos of 15 cases and a review of the literature].

The authors presented 15 cases of recent spinal cervical injuries treated with double approach procedure. Neurological disorders were variable but instability was severe in all cases. In 11 cases with severe neurological disorders the anterior procedure was made immediately, in 4 cases secondary with one or two sequences. In all cases was made discectomy and arthrodesis or removal vertebral body and arthrodesis associated with a posterior stabilization using generally bilateral plates of Roy-Camille. The functional spinal results were excellent with immediate or early mobilisation. In 4 cases with incomplete quadriplegia was observed favorable recovery. In 9 cases with complete quadriplegia two excellent recovery are obtained.

Adult↗