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Biomedical subjects

M Remacle

Publications and source records attributed to M Remacle.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Carotid artery obstruction caused by vagal paraganglioma].

A 72 year-old-man presented with right hemiparesis and global aphasia related to a large infarct in the left middle cerebral artery territory. A left carotid angiography revealed internal carotid artery occlusion and vascular blush just below the base of the skull. The blush was supplied by branches from the external carotid artery. Cervical CT-scan showed a large tumor centered by the left internal carotid artery. At cervical surgery, the internal carotid artery was compressed and infiltrated by the tumoral process: a benign paraganglioma. The site below the base of the skull and the connection between tumor and vagal nerve suggested a vagal paraganglioma. To our knowledge, this is the first case of cerebral infarction and internal carotid artery occlusion revealing a vagal paraganglioma.

Aged↗
PubMed1992

[The value of flow cytometry in the prognosis and treatment of head-and-neck cancers. Preliminary studies].

There is no reliable method to determine the malignancy degree of a tumour. Histology is not accurate. TNM classification is very interesting for planning surgical technique but gives little information about cancer aggressiveness. Flow-cytometry is a new technique to measure nuclear DNA quantity with great reproducibility and sensitivity. A normal cell is diploid (2N chromosome) and a tumoral one aneuploid. DNA quantitation is possible on fresh as well as on histological samples stored in formaldehyde or paraffin. Aneuploidy reflects the cancer aggressiveness. Aneuploidy is also correlated with TNM classification. Aneuploid tumors could require a more "aggressive" treatment regardless their size.

DNA, Neoplasm↗
PubMed1992

[Exudative laryngeal diseases of Reinke's space].

Exudative laryngopathies are represented by the nodule, the polyp and the Reinke's oedema. Their origin is found in exudative processes located in the Reinke's space. Evolution towards one or another lesion depends on the etiological factor (vocal abuse, tobacco, alcohol, acute vocal fold trauma) and can happen according three modalities: oedema, fibrosis and angiectasies development. Apparition of fibrosis inside the lesion or too important haemorrhage require microsurgical treatment in addition to the medical treatment and the speech therapy.

Humans↗
PubMed1992

Carcinoma of the larynx. Surgery: general aspects.

A necessary and adequate selection of operations capable of meeting all the indications involved by partial surgery, is required. We suggest such a selection inspired on that of 1983. Partial laryngectomies for glottic carcinoma: CO2-laser endoscopic cordectomy, fronto-lateral partial laryngectomy (LEROUX-ROBERT), hemiglottectomy (GUERRIER), anterior partial laryngectomy with epiglottoplasty (TUCKER), subtotal laryngectomy with cricohyoidoepiglottopexy (MAJER-PIQUET). Partial laryngectomies for supraglottic carcinoma: horizontal supraglottic laryngectomy (anterior approach), CO2-laser endoscopic epiglottectomy, lateral supraglottic pharyngo-laryngectomy (ALONSO), subtotal laryngectomy with cricohyoidopexy (LABAYLE). Total laryngectomy As from the early eighties onwards, the great progress in vocal rehabilitation following laryngectomy has certainly been the development of phonatory prosthesis.

Humans↗
PubMed1991

Tissue integration of the collagen-hydroxylapatite implant: histological examination in canine bone and surrounding tissues.

Using the dog as an animal model, we have tested an implant material composed of purified fibrillar collagen (PFC) and particulate hydroxylapatite (HA) in the mandible and in surrounding tissues. Bone and tissue samples were taken at 2, 4 and 6 months for histological study. After 2 months, the PFC was replaced by fibro-connective host tissues. After 4 months, some small areas of ossification were observed around the HA particles. After 6 months, the fibro-connective tissue was replaced by neo-formed bone in the mandible. PFC was found to increase the interfaces between the HA particles and the host tissues, permitting HA integration into the bone. The PFC/HA implant was also molded when moistened by blood or saline solution and then became mis-sharpen by local pressures exerted. These findings show that the implant should preferably be reserved for the restoration of bones not subjected to significant forces or local stresses.

Animals↗
PubMed1991

Immune response after collagen injection for laryngeal rehabilitation: development of an enzyme-linked immunosorbent assay.

The appearance of circulating antibodies directed against bovine collagen has been observed in dermatology after collagen injections with or without clinical reactions. Knowing the serologically positive patients among the clinically negatives ones is important if a second collagen injection should be planned. In these cases, skin and blood tests have to be carefully checked to confirm reactivity. In connection with this, we have developed an enzyme-linked immunosorbent assay (ELISA) for determining the response to GAX collagen injections. Such injections induce a very low rate of anti-collagen antibodies. However, without having recourse to a positive control permitting statistical analysis of data, no conclusions can be made about significant positivity. In the present investigation of 12 patients following GAX collagen injections into the larynx, 1 was found to be borderline and 1 positive (17%). The positive control was made up with 20 ng/ml anti-type III collagen antibodies, which was purified and tested against type III bovine and human collagen. The present study showed that the systematic detection of antinuclear or anti-DNA antibodies after GAX collagen injection is not useful. However, the anti-collagen positivity of two control samples from 3 patients already positive for antinuclear antibodies demonstrates that bovine collagen injections are contraindicated in auto-immune disease.

Adolescent↗
PubMed1991

Further morphologic studies on collagen injected into canine vocal folds.

We compared the morphologic fate of three types of soluble bovine collagen injected into vocal folds of dogs: 1) Zyderm collagen implant containing 35 mg/mL of collagen (ZCI I), 2) Zyderm collagen implant containing 65 mg/mL of collagen (ZCI II), and 3) GAX collagen containing 35 mg/mL of collagen minimally cross-linked with 0.0075% glutaraldehyde. Light and electron microscopy showed good host tolerance and a long-term persistence of the three types of collagen at the site of injection. The collagen implants were progressively colonized by fibroblasts and capillaries accompanied by host collagen deposition. No inflammatory process or foreign body reaction occurred, in contrast to the typical host reaction to injected Teflon. The colonization of GAX collagen was slower than for ZCI I and ZCI II. No other significant difference was evident among the three types of injectable collagen. All three appear to be very suitable materials for laryngeal implants; moreover, they seem to best meet accepted requirements for a good implant: they are easy to inject, they are well tolerated, and they persist for a long time. We prefer GAX collagen for clinical use because of its lower reactivity and higher stability, and because overinjection is not necessary (GAX shrinks less than ZCI I and ZCI II).

Animals↗
PubMed1991

[Permanent tracheotomy in respiratory insufficiency].

Assisted ventilation at home for breathing insufficiencies requires long-term tracheotomy. Standard tracheotomy is frequently complicated by granuloma and tracheostomy stenosis. We have designed a permanent opening technique that we report on 9 patients. The technique prevents, as far as possible, granuloma and stenosis formation and provides a sufficiently large opening to reduce irritation during tracheotomy tube change. Surgery must be done under general anesthesia. High-dose long-term corticosteroid treatment can induce skin breakdown.

Adolescent↗
PubMed1991

GAX-collagen in the human vocal fold.

A report is presented of the first histological study of GAX-collagen injected into the human vocal cord. The study concerns a specimen from an arytenoidectomy performed 28 months after injection. As it had already been the case in the animal, the excellent integration of GAX-collagen with the host-tissues has been noted, as well as the stability of the result more than 2 years later. It also appeared that colonization of GAX-collagen by the host cells is less rapid than for the ZCI. While inflammatory reaction is weak in the region of the GAX-collagen, there is to be seen some atrophy and fibrosis of the muscular fibres around the deposit, probably due to compression during injection.

Collagen↗
PubMed1991

[Tumors of the submaxillary gland].

The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from three Departments over ten years. The tumors of the submaxillary gland are malignant in as many as 50% of all cases! When the lesion is benign, pleiomorphic adenoma is the most frequent possibility. The authors emphasize the necessity of early and complete surgical treatment, requiring at least total submaxillectomy in case of benign tumor. Cervical mode dissection will be considered if the tumor is malignant.

Adenoma, Pleomorphic↗
PubMed1991

[Objective study of the voice quality following partial laryngectomy].

The high resolution frequency analyzer is used for the study of the vocal quality after partial laryngectomy. The post-operative plot after speech therapy is of good quality when respecting one vocal fold. On the contrary, the heard vocal sound does not correspond to the harmonics of the fundamental frequency but to intense noise from irregular vibrations of the residual laryngeal mucosa (ventricular folds, arytenoids). High resolution frequency analysis contributes to the follow-up of the partial laryngectomy.

Glossectomy↗
PubMed1990

Correction of glottic insufficiency by collagen injection.

Thirty-nine patients were treated with GAX collagen for vocal fold augmentation. The objective results were evaluated by measurement of the maximum phonation time, the phonatory quotient, vocal frequency analysis, and laryngostroboscopy. These results are as good as those with Zyderm Collagen II (ZCI). Avoidance of useless overcorrection, better resistance to collagenase, and less induced hypersensitivity differentiate GAX from ZCI.

Adolescent↗
PubMed1990

The use of injectable collagen to correct velopharyngeal insufficiency.

The use of Gax collagen is proposed for correcting velopharyngeal insufficiency with posterior pharyngeal wall augmentation. The indications for this procedure are velopharyngeal insufficiency that remains after surgery and treatment by a speech pathologist. The procedure is also valuable after velum paralysis. Collagen (2.5-5cc) is injected through a device designed for vocal-fold and laryngeal rehabilitation. Several injection points are necessary to raise a good Passavant's ridge. The muscular activity of the posterior pharyngeal wall models the collagen pad for the first 3 weeks; afterwards, the collagen shape remains unchanged due to its integration in the host tissues. At this time, five patients have been injected with Gax collagen and have improved. The oldest case dates from 28 months ago; the most recent dates from 8 months ago. There were no adverse reactions, and the results remain stable at the present time.

Adolescent↗
PubMed1990

[Hydroxyapatite/collagen. Experimental study of its application in facial surgery and report of a case].

A new implant made of purified fibrillar collagen (P.F.C.) and hydroxylapatite particles (HA) (Maxill-HAPR) is tested in canine mandibulae and surrounding tissues so that its integration and its bone-induction capacity can be histologically studied. A clinical case is also reported. The goal of this combined implant is to improve the interface of the HA particles with the host-tissues through the P.F.C. This study shows that P.F.C. is replaced after two months by host fibro-conjunctive tissues. Between 3 and 4 months, ossification areas are observed. After 6 months, the host conjunctive tissue is replaced by bone surrounding the HA particles. P.F.C.-HA implants can be made for replacement or restoration of facial bones not submitted to important forces like the frontal or malar bones.

Animals↗