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Biomedical subjects

N Gros

Publications and source records attributed to N Gros.

At least 19 recordsLinked to original sources
PubMed2001

[Correlation between Gleason score of prostatic biopsies and the one of the radical prostatectomy specimen].

UNLABELLED: The Gleason score obtained on prostatic biopsies is an essential element in the treatment decision for localized prostate cancer. The objective of this study was to evaluate the correlation between the biopsy Gleason score and the definitive Gleason score and to propose a classification into 3 groups in order to improve this correlation. MATERIAL AND METHODS: One hundred radical prostatectomies were performed between 1995 and 1998. Eighty four of these patients underwent 6 biopsies. The Gleason score of the biopsies and operative specimens were compared. The concordance between the biopsy Gleason score and the operative specimen Gleason score was initially analysed score by score. The concordance was then established according to three groups, well differentiated tumours (score 2-4), moderately differentiated tumours (score 5-7), poorly differentiated tumours (score 8-10). RESULTS: The concordance between the biopsy Gleason score and the operative specimen Gleason score was perfect in only 37% of cases. A 1-point difference of the score was observed in 35.7% of cases and a 2-point or greater difference was observed in 27.3% of cases. By classifying patients into 3 groups, the concordance increased from 37% to 72.6%. CONCLUSION: The classification of patients into three distinct groups (well, moderately and poorly differentiated tumours) increases the concordance between the biopsy Gleason score and the definitive Gleason score. However, the limitations of the biopsy Gleason score must be kept in mind, particularly in the case of low-grade tumours.

Biopsy, Needle↗
PubMed2000

[Primitive neuroectodermal tumor of the kidney manifested as a spontaneous hematoma].

Ultrasound and CT in a young man, admitted for violent left flank pain, revelead a large heterogeneous left renal mass, with hypodense collection along the psoas. The diagnosis was spontaneous renal hematoma. A check CT 3 weeks later found a large tumor of the inferior pole. After radical nephrectomy, histopathology diagnosed a primitive neuroectodermal tumor. The patient died one year later despite neoadjuvant chemotherapy. This article reports the clinical, radiological and histopathological aspect of a primitive neuroectodermal tumor of the kidney, compared with the other cases in literature.

Adult↗
PubMed1997

Enhanced rehabilitation of gait after stroke: a case report of a therapeutic approach using multichannel functional electrical stimulation.

The beneficial effects of using multichannel functional electrical stimulation (MFES) for gait rehabilitation in nonambulatory hemiplegic patients have already been shown. The methodology of application and the results presented were pooled for the whole group of participants, which blurs the exact picture of each particular subject and many vital details are not presented. The purpose of this article is to focus on a single subject from the study and to present all the details of the treatment. The presented subject participated six weeks in the study, first three weeks in MFES therapy and second three weeks in conventional therapy. The effects of each therapy were evaluated by the following measures: temporal-distance parameters of gait, ground reaction forces, goniograms in hip knee and ankle, and assessment of the physical status of the patient according to the Fugl-Meyer evaluation scale. An analysis of the measured parameters showed improved performance of the patient during MFES therapy and stagnation or even slight recession during conventional therapy. The patient achieved independent gait during the three weeks of MFES therapy. At 30 months after the beginning of therapy, the patient was still able to ambulate independently without any significant changes in his gait pattern. The accomplishment was mainly attributed to the avoidance of pathological gait pattern development by using MFES assisted gait training and to the high motivation of the patient to walk and exercise during therapy as well as after he was released to go home.

Activities of Daily Living↗
PubMed1995

Posttraumatic colonic polyps with skin heterotopia. Report of a case.

A case of posttraumatic colonic polyps with skin heterotopia is reported. A 35-year-old man was the victim of a grenade explosion, which caused evisceration and partial amputation of the right colon. Twenty-five months after the accident, hypochromic anemia developed because of three polyps in the ascending colon. Histology documented the presence of sebaceous glands and keratinized epithelium, suggesting a graft of skin fragments on the colonic mucosa. Such a skin heterotopia has never been reported.

Adult↗
PubMed1995

The rehabilitation of gait in patients with hemiplegia: a comparison between conventional therapy and multichannel functional electrical stimulation therapy.

BACKGROUND AND PURPOSE: Gait rehabilitation in patients with severe hemiplegia requires substantial effort. Preliminary studies indicate potential beneficial effects of using multichannel functional electrical stimulation (MFES) for gait rehabilitation in these patients. In this study, a new method of gait rehabilitation for nonambulatory patients with hemiplegia by means of MFES added to conventional therapy was introduced. The results of the method's application were evaluated by comparing it with conventional therapeutic methods. SUBJECTS: The proposed rehabilitation method was tested on a group of 20 patients with severe hemiplegia secondary to cerebrovascular accident. Subjects were randomly assigned to one of two groups. One group received 3 weeks of MFES followed by 3 weeks of conventional therapy. The other group received 3 weeks of conventional therapy followed by 3 weeks of MFES. METHODS: The effects of each therapeutic method were evaluated by measurements of temporal-distance variables and ground reaction forces and by assessment of each subject's physical status according to the Fugl-Meyer evaluation scale. RESULTS: There was improved performance of the subjects during MFES combined with conventional therapy as compared with conventional therapy alone. CONCLUSION AND DISCUSSION: The superiority of the MFES method as compared with conventional therapy was mainly attributed to the enhanced motor learning accomplished by application of MFES. These results, however, are preliminary, and further research is needed.

Adult↗
PubMed1994

[Latex and pollinosis].

Through the multidetection test for specific IgE to pneumoallergens (Aero-Matrix Plus, Abbott) our attention has been drawn to polysensitization to pollens. Amongst these pollen tests, plantain seems to be frequently associated with sensitization to latex. The aim of this work at first, is therefore to verify the reality of the frequency of the association between latex and plantain sensitization. However, the conclusions are difficult, since there are no patients who are only sensitive to plantain as sensitivity to this allergen is always found in a pollen polysensitization. at least associated with grass pollens; at most associated with a number of other pollens. The double profile (perhaps plantain + / grass pollen +, or perhaps plantain + / grass pollen + / other pollens +) is determinant in prediction of sensitivity to latex, which is found essentially in the group plantain + / grass pollen + / other pollens +. This study has also shown that amongst the population who have specific IgE to latex (IgEs) (sensitized or allergic): the patients who have a clinical history of allergy to latex have no profile of pollen polysensitization; the non-allergic but sensitive patients (IgE positive, but no clinical signs on contact with latex) show an extreme pollen polysensitization. This poses a problem of different antigenic determinants or perhaps two different pathways to sensitization to latex.

Allergens↗
PubMed1992

Application of a programmable dual-channel adaptive electrical stimulation system for the control and analysis of gait.

A dual-channel electrical stimulation system with a stimulator and a programmer/stride analyzer was designed for clinical rehabilitation of gait and for subsequent daily use as an orthotic aid. The stimulator, with controls to adjust amplitude only (50 mA), adapts chosen stimulation sequences to the walking rate of a patient. Pulse duration (50-500 microseconds), frequency (5-120 Hz), shape (symmetrical biphasic, monophasic), stimulation sequences (16 stride segments) and their cycle (2-12 sec), and right/left foot-switch choices are selected for each patient and programmed into a separate unit. The programming unit also statistically processes the foot-switch data collected by the stimulator. The device was evaluated with regard to the programmable parameters, effectiveness during gait, and feasibility in clinical use. It was applied to 11 stroke patients and 10 brain injury patients during gait, stimulating 22 combinations of peroneal nerve and hamstring, quadriceps, triceps brachii, and gluteus maximus muscles. Forces on both feet, equinovarus, knee extension and hyperextension, elbow flexion, and hip extension were corrected. Selection of the stimulation sequences, their adaptation, range of pulse duration, and valid statistics were verified. Improved forces and joint angles were recorded together with significant changes in the stride time, length, and velocity by the stimulation.

Adult↗
PubMed1991

Immunohistochemical study of thyroid peroxidase in normal, hyperplastic, and neoplastic human thyroid tissues.

An immunohistochemical study using two monoclonal antibodies (MoAb 30 and MoAb 47) against thyroid peroxidase (TPO) was performed on surgical specimens of human thyroid carcinoma (n = 65), adenoma (n = 70) and Graves' disease (n = 10). Normal adjacent thyroid tissue was used as positive control. Monoclonal antibody 30 reacted significantly with all adenoma and most carcinoma, whereas MoAb 47 reacted with 66 adenoma but only two carcinoma. Of the four adenomas that did not react with MoAb 47, three were of the fetal type. Both carcinoma reacting with MoAb 47 were of the well-differentiated follicular type. These findings further confirm the hypothesis that thyroid carcinoma is associated with changes in the quantity and antigenic properties of TPO. Although the alterations in antigenic behavior revealed by MoAb 47 are not 100% specific, they may allow more accurate diagnosis of malignancy in thyroid tumors.

Adenocarcinoma↗
PubMed1990

Dietary vitamin A, beta carotene and risk of epidermoid lung cancer in south-western France.

This hospital-based case-control study was designed to investigate the association of low dietary vitamin A and beta carotene consumption with epidermoid lung cancer. Cases were patients with histologically confirmed epidermoid lung cancer diagnosed in six selected hospitals of southwestern France in 1983-84. Controls were selected from patients admitted to the same hospitals during the same period with diagnoses other than cancer. Cases and controls were matched for sex, age, place of residence, occupation, professional exposure to carcinogens, tobacco and alcohol consumption. A total of 106 cases of epidermoid lung cancer and 212 controls were interviewed on their typical weekly intake of 80 food items rich in preformed vitamin A and beta carotene. Index measures of the vitamin A and beta carotene daily intakes were computed for each individual patient and expressed in retinol equivalent (RE). A statistically significant odds ratio (OR) was found for preformed vitamin A (OR = 4.3; 95% CI: 2.5-7.3) with the threshold of 1,000 RE. A similar result was found for beta carotene with the same threshold (OR = 4.1; 95% CI: 2.3-7.4). Using the conditional logistic regression, consumption of preformed vitamin A and consumption of beta carotene were significantly and independently associated with epidermoid lung cancer. While confirming the protective role of beta carotene against epidermoid lung cancer, this study also shows that preformed vitamin A might have a distinct and important protective effect.

Carcinoma, Squamous Cell↗
PubMed1990

Predominance of sialomucin secretion in malignant and premalignant pancreatic lesions.

Sialomucin and sulphomucin-secreting cells were studied in the normal and pathologic human pancreas with the high iron diamine-alcian blue technique which allows differentiation between the two types of mucin. In six normal autopsy pancreata, only sulphomucin was found. In benign lesions of either calcifying chronic pancreatitis (seven cases) or obstructed chronic pancreatitis (six cases), sulphomucins were widely predominant. In contrast, malignant lesions (pancreatic adenocarcinoma [12 cases], cystadenocarcinoma [two cases]) or premalignant lesions (mucinous cystadenoma [one case], ductectatic mucinous cystadenoma [four cases], villous adenoma of the main pancreatic duct [two cases]) showed a predominant sialomucin secretion, except for three poorly differentiated pancreatic carcinomas that did not show mucin staining. The sialomucin positivity was not observed at distance from the malignant lesions. In one case of benign enteroid cyst, sulphomucins predominated. These findings indicate a preponderance of sialomucin secretion in malignant or premalignant pancreatic lesions.

Chronic Disease↗
PubMed1989

An exceptional 18-year follow-up after cardiac transplantation. How can malignancies occur during immunosuppressive therapy?

The present report considers the autopsic study of an homograft recipient who had been living for 18.5 years after a cardiac transplantation. The patient was treated by immunosuppressive therapy associating azathioprine and steroids. During the exceptionally long follow-up, two skin carcinomas and a lung carcinoma occurred successively. In addition, the autopsy allowed observation of a kidney adenocarcinoma associated to a polycystic disease, and a liver regenerative nodular hyperplasia containing several areas of severe dysplasia. These findings, when compared with those usually observed in immunodeficient patients, suggested the possibility that long-term immunosuppressive therapy may give rise to malignancies other than those arising after a short therapy.

Adenocarcinoma, Papillary↗
PubMed1989

Restoration of gait during two to three weeks of therapy with multichannel electrical stimulation.

Multichannel electrical stimulation was applied in 20 patients with hemiplegia secondary to stroke or head injury using a six-channel microprocessor stimulator-stride analyzer to restore independent gait and to reestablish a normal gait pattern in a two- to three-week therapy period. The therapy was followed up at every session by a stride analyzer incorporated into the stimulator. At the beginning and at the end of the therapy period, each subject's gait was measured with a ground reaction measuring system. Statistical results and observations are presented for the group of 20 subjects, and a detailed description of the results is given for one subject who is representative of the whole group. According to the measured gait characteristics, gait improved significantly in all subjects during the therapy period, resulting in a partly or completely independent gait. The subjects' posture and endurance also improved, and they spontaneously learned how to use a crutch. The measurements and visual assessment of the subjects' progress indicate that the described treatment protocol offers good prospects for faster and more efficient gait rehabilitation in severely impaired patients. To determine the efficacy of gait therapy with multichannel electrical stimulation, a comparative study of conventional therapeutic methods and the method described in this article should be conducted.

Adolescent↗
PubMed1989

FES and spasticity.

A model of hemiplegic spasticity based on electromyographical and biomechanical parameters measured during passive muscle stretching is presented. Two components of spasticity can be distinguished--phasic and tonic. This classification depends on the pattern of stretch reflex activity which can be either phasic or tonic as well as on the muscle stretch/tension characteristic. Stretch reflex, as a control loop, is in phasic spasticity characterized by increased sensitivity to velocity of stretching. In tonic spasticity, sensitivity to length of stretching is increased. After the injury, phasic spasticity appears first and invokes monosynaptic reflex pathways. The intensity of tonic spasticity increases with the duration of disability and hence causes changes in muscle fiber biomechanical properties. The model mentioned above has been used to evaluate the effects of FES on spasticity. Hemiplegic patients with implanted peroneal nerve stimulator for gait correction were followed up for one year starting a week before implantation. Long-term use of FES resulted in decrease of tonic spasticity in both ankle joint antagonistic muscle groups. In stimulated tibialis anterior muscle, the phasic type of spasticity increased. To obtain the correlation between changes in spasticity and functional abilities of patients, the maximal voluntary isometric contraction of both muscle groups was also measured. An improvement in voluntary strength was also observed. This can be taken as additional evidence that tonic spasticity is of greater physiological and clinical significance than phasic spasticity. It may be concluded that use of FES can decrease tonic spasticity and, if applied early after the injury, can prevent the appearance of tonic spasticity.

Adult↗
PubMed1989

[Giant leiomyoma of the inferior vena cava].

The authors report an uncommon case of giant leiomyoma of the inferior vena cava with intracardiac extension and arising from the external iliac vena. This case report illustrates the diagnostical problems usually encountered with this type of tumour. Indeed, despite ultrasound and transverse CT scan, the diagnosis was only assessed by histopathological analysis following a successful surgical removal of the leiomyoma. Only 7 cases of leiomyoma of the inferior vena cava are already reported in the literature. Relationship with intravenous leiomyomatosis of the uterus is also discussed.

Aged↗
PubMed1988

Chronic electrical stimulation for the modification of spasticity in hemiplegic patients.

The effects of long-term electrical stimulation on reflex hyperactivity and voluntary muscle control were studied. Eight hemiplegic patients with implanted peroneal stimulator were included. After six months of functional electrical stimulation (FES) there was a decrease of tonic activity in both tibialis anterior and triceps surae muscles. The phasic stretch reflex activity in the stimulated tibialis anterior muscle increased. The resulting resistance during passive movements decreased due to diminution of tonic activity. The absence of tonic activity also resulted in improvement of voluntary control, particularly in the tibialis anterior muscle.

Adult↗
PubMed1988

Electrical stimulation for control of paralysis and therapy of abnormal movements.

After a short review of the functional aspects of electrical stimulation in rehabilitating paralysed patients, the article describes its effects on spasticity. Three different studies are briefly described. In the first one paraplegic patients' knee extensors and flexors were stimulated with four channel stimulator. In the second one two channel stimulation was applied to the ankle joint flexors and extensors in hemiplegic patients, while in the third, the effects of spinal cord stimulation were studied in multiple sclerosis patients. Although the parameters and sites of stimulation were different in each study, the effects were similar. In approximately 50% of paraplegic and hemiplegic patients stimulation caused decrease of reflex activity which lasted more than half an hour. In M.S. patients measurements were performed only in intervals of day and therefore short term effects were not documented. Two days after interruption of continuous spinal cord stimulation the reflex activity significantly increased in the majority of patients. In addition to this increase the volitional force decreased considerably.

Electric Stimulation Therapy↗