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Biomedical subjects

P Devos

Publications and source records attributed to P Devos.

At least 73 records · Page 4Linked to original sources

Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents.

In order to evaluate the diagnostic contribution of brain SPECT imaging with 99mTc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploration of cerebral infarction, with detection in, respectively, 89.5% and 87.5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia.

Brain↗

Discectomies of the lower cervical spine using interbody biopolymer (B.O.P.) implants. Advantages in the treatment of complicated cervical arthrosis. A review of 150 cases.

The authors report their experience with 150 cases of discectomies performed with interbody grafts using a copolymer (Biocompatible Orthopedic Polymer or BOP). Made of N-Vinylpyrrolidone-Methylmethacrylate monomers, polyamide fibres and calcium gluconate. BOP is a biocompatible, biodegradable, osteoconductive matrix, easy to use and quite safe. These properties are quite well appreciated for cervical interbody grafting. After discectomy, stabilization of the spine is immediate, and fusion slowly occurs around and through the biopolymer within one year. The biomaterial avoids morbidity inherent in the harvesting of an autograft, as well as any limitations resulting from the use of allografts.

Adult↗

Effects of the new calcium entry blocker isradipine (PN 200-110) in essential hypertension.

In this double-blind cross-over study 16 patients with mild-to-moderate hypertension were treated with placebo and the dihydropyridine derivative, isradipine 5-10 mg twice daily. In the supine position isradipine reduced systolic (-18 mm Hg; p less than 0.002) and diastolic (-15 mm Hg; p less than 0.001) pressures, while heart rate was not changed; in the standing position, systolic (-15 mm Hg; p less than 0.002) and diastolic (-14 mm Hg; p less than 0.001) pressures decreased, whereas heart rate increased (+6 bpm; p less than 0.05). Body weight and lower leg volumes remained unaltered, suggesting that isradipine did not cause fluid retention. On IS plasma angiotensin I (+40 pg/ml), angiotensin II (+ 14 pg/ml), and aldosterone (+4.1 ng/dl) rose. The intracellular Na+ and K+ concentrations and the transmembrane cation transport activities (Na+-K+ pump, Na+-K+ cotransport, Na+-Li+ countertransport), measured ex vivo in the erythrocytes of eight male patients, were not significantly influenced by isradipine. Hot flushes and facial erythema occurred more frequently (p less than 0.05) on isradipine than on placebo. In conclusion, the new calcium entry blocker isradipine at a dose of 5-10 mg twice daily lowers blood pressure and is well tolerated in most patients with essential hypertension.

Blood Pressure↗

[Surgical indications for hydronephrosis discovered antenatally].

The authors report series of 82 hydronephrosis (in 70 infants), detected antenatally by ultrasound. The cases were classified in 3 groups according to the severity of pelviureteric junction obstruction. Only the more severe cases are operated at once. In the remaining cases the observation help to decide the indications. In this series 35 renal units among 82 have been operated at date. The 47 remaining are annually followed up by ultrasound.

Female↗

[Direct osteosynthesis of fractures of the odontoid process using a biodegradable implant (B.O.P.)].

The authors describe a new technique for treatment fractures of the dens. An anterior approach (technique of Boehler) is used. It provides for one-stage fusion and no additional disturbance of C1-C2 rotation. Under AP and lateral guidance the body of C2 is drilled medially, and so are the site of fracture. Then comes the gradual impaction of a conical implant of biocompatible resorbable implant [*], tip cephalad. The biopolymer is used for grafting purposes in all type of fractures of the odontoid process, which permits the latter to be fused without using screws or any other metal implant.

Adult↗

[Percutaneous surgery of the dorsolumbar disks].

The authors report a new technique for percutaneous surgery of thoraco-lumbar discs. It allows nucleotomy or intersomatic grafting. This extra-articular posterolateral approach is performed under fluoroscopic monitoring by using a Kirschner's wire and some specific co-axial tubes. Scanographic polar coordinates are most suitable for valuable locating of thoracic discs and performing of technique. Indications and limits of the method are discussed with preliminary results obtained with the first 19 cases.

Adult↗

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↗