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Biomedical subjects

P Devos

Publications and source records attributed to P Devos.

At least 37 records · Page 2Linked to original sources

Operative treatment of thoraco-lumbar metastases, using methylmetacrylate and Kempf's rods for vertebral replacement and stabilization. Report of 15 cases.

The authors report their experience in the treatment of 15 cases in thoracolumbar metastases with spinal cord compression. A decompressive laminectomy was routinely performed and followed by a transversoarthropediculectomy. Most part of the neoplastic tissue was removed from the epidural space, vertebral body and retroperitoneal or retro-pleural areas. Complete decompression of the nervous elements was always achieved. Stabilization was obtained by replacement of the neoplastic vertebral body with a methylmetacrylate prothesis and eventually by Kempf's compression instrumentation. The surgical treatment was completed in a single stage operation, by a classical posterolateral approach. Orthopaedic, neurologic and oncologic advantages of this treatment are discussed.

Female

Chondroma of the cervical spine. Case report.

The authors report a case of cervical chondroma presenting with a syndrome of spinal cord compression in a 76-year-old woman. Total surgical removal of the lesion was followed by partial neurological recovery. Chondromas of the vertebral column are rarely reported in the literature.

Aged

[Treatment of foraminal disk hernia by conservative hemi-transverso-arthro-pediculotomy].

The authors report a new approach of the intervertebral foramen using a conservative hemi-transverso-arthro-pediculotomy. It allows to remove one half of the posterior neural arch and to follow the nervous bundle from its origin to the extra-foraminal space. Removal of the foraminal disc herniation is easy and safe. The monobloc is replaced to prevent any instability.

Adult

[Evaluation of the amnesia caused by restricted thalamic infarcts--6 cases].

The amnesic syndrome is analysed in 6 infarctions restricted to the thalamic area. Bilateral lesions were linked to more definite deficits; the anterograde forgetting was unequivocal at the initial stage and affected both verbal and visual memory. In unilateral lesions, deficits were far more discrete and there was no evidence enough for assuming a strict hemispheric specialisation, left for verbal memory, and right for visual memory. These cases and others from the literature suggested that amnesia is more important and pure in infarctions of the anterior part of the thalamus.

Adult

[Balint syndrome as a result of a biparietal infarct. Neuropsychological analysis].

A case of Balint syndrome with bilateral parietal infarction is presented. Analysis shows the tight intrication of visual inattention and psychic gaze palsy. The deficit of visuo-manual adjustment is characterized by a fixed divergence between the target and the point where the patient places his hand, either in ballistic movements (classical optic ataxia), either in pursuit movements; for this reason, a simple disconnexion should not explain the classic optic ataxia. The discretion of aphasia allows the individualization of an anterograde and partially retrograde amnesia.

Agnosia

Increased levels of osteocalcin (serum bone Gla-protein) in rheumatoid arthritis.

Serum osteocalcin was measured by radio-immunoassay in 56 patients with rheumatoid arthritis (RA), and in 50 controls. Mean serum osteocalcin levels were significantly higher in patients with RA. There was a positive correlation between osteocalcin and fasting mucopolysaccharide/creatinine ratio in both sexes, and between osteocalcin and fasting hydroxyproline/creatinine ratio in women. Serum alkaline phosphatase activity, a less specific marker for bone formation, was also increased in RA, and there was a positive correlation with osteocalcin in both sexes. These data suggest that overall bone turnover is increased in RA and that serum osteocalcin may provide additional information for the evaluation of bone metabolism in this disease.

Adult

Diffuse pulmonary uptake of 99mTc bone-imaging agents: case report and survey.

Over the past 5 years, we have encountered 6 cases of diffuse pulmonary uptake of 99m-Tc bone-scanning agents (incidence, 0.04%). To assess the significance of this phenomenon, we reviewed all of the cases reported since 1974 (Including our series, a total of 32 cases). Three groups can be discerned, the first consisting of 24 patients without radiological calcifications in the lungs and with hypercalcemia of different origins (mostly hyperparathyroidism). Of the eight autopsies performed in this group, seven revealed extensive calcifications in alveolar walls and lung vessels; the other autopsy showed no calcification at all and only bronchopneumonic lesions. The second group consists of 6 patients in chronic dialysis. The last group consists of 2 patients having diffuse pulmonary alveolar microlithiasis with extensive radiologic calcifications. The mechanism of lung uptake of 99m-Tc bone-imaging agents is probably the same as that of bone uptake (chemisorption on hydroxyapatite crystals), although other uptake mechanisms have also been discussed. Bone scintigraphy can be useful in the detection of early pulmonary calcifications, which have been associated with impaired pulmonary function and, due to their size, are generally not detected by X-ray.

Adenoma

Single photon emission computerized tomography of the skull.

The diagnostic contribution of single photon emission tomography for detection of bone lesions of the skull was explored in 125 cases and compared with planar imaging. Twenty-one localizations (16% of the total group) were only visualized by scintitomography, these were predominantly lesions of the base of the skull and facial bones. Scintitomography gave a false negative result in only one lesion out of 49 visible on skull radiographs. Together with the revelation of unsuspected bone abnormalities, SPECT generally provides a better visualization of the skull lesions and their extent than does planar imaging. In cases where disease of the facial bones and the base of the skull is suspected, scintitomography is an indispensable adjunct to planar scintigraphy.

Bone Neoplasms

[Brain stem infarction, systemic lupus erythematosus and circulating lupus anticoagulant].

A 30 year old man admitted with a brain stem infarct presented with intellectual deterioration. A diagnosis of systemic lupus erythematosus (S.L.E.) was based on the presence of five A.R.A. criteria :photosensitivity, arthralgia, leukopenia and thrombopenia, false positive syphilitic serology, antinuclear factors on immunofluorescence. A lupus type circulating anticoagulant (L.C.A.) was no longer detected after corticotherapy. This appears to be a case of the "hematologic" form of S.L.E. in which the presence of L.C.A. predisposes towards thrombosis, not only of veins--which is typical--but also of arteries. These may be isolated and reveal the underlying disease as in the present case. The L.C.A. is an antibody possessing antiphospholipid specificity which explains the anticoagulant action in vitro and the thrombogenic effect in vivo. Some authors consider this to be sufficient justification for administration of anticoagulants and/or antiplatelet agents, but corticotherapy may be effective.

Adult

"Pseudotumoral" cystic cerebellar infarction with slow evolution.

A 63-year-old female patient presented with cerebellovestibular symptoms and posterior headaches. The onset of the symptoms was sudden, and the neurological condition slowly worsened over a 5-month period. It was found that she suffered from a cystic infarction of the cerebellar lobe, with subsequent hydrocephalus. This case and two others discovered in the literature argue for the recognition of a slowly evolving, cystic form of cerebellar infarction that calls for a direct surgical approach.

Cerebellar Diseases

[Ocular and head movements in infarctions of the thalamic region].

Oculomotor disorders in 22 infarctions in the thalamic region are recorded. Clinical examination and electro-oculography (17 cases) showed that paramedian thalamo-subthalamic lesions were responsible for clear deficits: upgaze paralysis and in some cases downgaze paralysis, partial paresis of the oculomotor nerve, deficits of lateral eye movements, myosis, paralysis of head flexion combined with downgaze paralysis. Postero-median choroid artery infarction was associated with upgaze paresis, slight deficit of lateral eye movements and myosis. Postero-lateral choroid artery infarction resulted in a partial visual field defect and in some cases, a contralateral hypometria; myosis was slight and inconstant. Infarctions of the internal capsule (anterior choroid artery, deep branches of the middle cerebral artery) were associated with a deficit of contralateral saccades. Ocular pursuit, when possible, was often saccadic, whatever the site of the infarction. This prevailed with gaze towards the lesion side.

Adult