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Biomedical subjects

B Tomeno

Publications and source records attributed to B Tomeno.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Ewing's sarcoma of bone in adults: an anatomic-clinical study of 30 cases].

The records of 30 adult patients with Ewing's sarcoma (ES) of bone treated between 1980 and 1990 at the Institut Curie were studied retrospectively; the diagnosis was reevaluated by histological and immunohistochemical analysis, using HNK and anti-neuron specific enolase (NSE) antibodies. The immunohistological analysis disclosed a significant staining of neoplastic cells in only few of our cases and is therefore of limited interest in the diagnosis of ES. Three groups of patients have been considered according to their clinical presentation: axial, peripheric and initial metastatic disease. The global prognosis is poor: the survival rate is 70% after a follow-up period of one year, and 23% after three years. The evolution was severe for patients with pelvic localization and/or initial metastatic disease. In contrast, five of six patients who are currently free of disease after a mean follow-up period of 42 months presented initial peripheric lesion. Four of these six patients were treated by a combination of surgical, chemical and radiation therapies.

Adolescent↗
PubMed1991

Femoral infarction following intraarterial chemotherapy for osteosarcoma of the leg: a possible pitfall in magnetic resonance imaging.

Bone infarction of the distal femur is reported in two patients with osteosarcoma of the leg (1 tibia, 1 fibula) treated by preoperative chemotherapy including intraarterial chemotherapy (IAC) by Cis-platinum. Both patients were examined by magnetic resonance imaging before chemotherapy and again prior to limb salvage surgery. The location of these lesions in the distal femur must suggest bone infarction especially if the tumor has decreased in size under treatment.

Adult↗
PubMed1991

Monobloc resection of the upper extremity of the leg for bone tumor with distal vascular reconstruction.

A patient with juxtacortical osteosarcoma of the upper extremity of the left tibia which encased the popliteal neurovascular bundle was treated by monobloc resection of the superior extremity of the tibia and the tibial nerve. The knee joint was replaced by a Guepar prosthetic knee. Arterial and venous continuity was reestablished by a double bypass using the contralateral greater saphenous vein. One year later the patient had good lower limb function and was free of local or general disease. This observation confirms that preservation of lower limb function is possible using reconstruction techniques of bone, nerves, and vessels in sarcoma of the musculoskeletal system.

Adult↗
PubMed1991

Histological patterns of bone and articular tissues after orthopaedic reconstructive surgery (artificial joint implants).

Revision surgery after failures of joint replacements leads to histological studies on joint and bone tissues close to the implanted material. Aspectic loosening is the main complication. The surgical pathologist has to identify wear debris (metal, polyethylene, polymethylmethacrylate, chiefly) which promotes a histiocytic granuloma. Some surgical procedures such as cup or resurfacing arthroplasties create a new articular surface and a bone remodeling or necrosis. Cemented joint prostheses show various membrane structures between bone and the cement mantle while there is an association of bone resorption and formation. Non-cemented, porous-coated joint prostheses induce little bone ingrowth, even in satisfactory clinical results. Mechanical factors are predominant in massive limb prostheses. For silicone elastomer implants or artificial ligaments, wear of material promotes many tissular reactions. Often used bone grafts show little creeping substitution process in case of homografts, even well-incorporated on X-rays. More retrieval specimen studies are necessary to delineate precise topographical histological lesions, including non-loosened joint implants.

Bone and Bones↗
PubMed1991

[Tumor prognostic factors in chondrosarcoma of the locomotor system. Apropos of 180 cases].

One hundred and seventy-eight patients suffering from 180 chondrosarcomas have been treated by the orthopaedic department of Cochin Hospital. Actuarial survival in these patients was 67 per cent after five years, 62 per cent after 10 years and 59 per cent after 15 years. The two main bases for survival prognosis were: --the histoprognostic grade in O'Neal and Ackerman's classification (survival after 5 years: 83 per cent for grade 1, 75 per cent for grade 2, and 15 per cent for grade 3); --the quality of the surgical resection (survival after 5 years: 78 per cent in cases of carcinological resection, and 52 per cent in cases of incorrect resection). Keeping the limb did not reduce the chances of a cure. Patients treated recently have a better prognosis than those treated before 1970: this improvement was mostly because carcinological treatment was used more often. The same prognostic factors govern local recurrences.

Adolescent↗
PubMed1990

[Giant-cell tumor of the lower end of the radius treated by resection-arthrodesis. Report of 9 cases].

Nine benign giant cell tumors of the lower end of the radius, resulting in arthrodesis of the wrist mostly because of failed curettage-filling treatment, have enabled the authors to describe a resection-arthrodesis technique which allows continued mobility in the medio-carpal joint in some cases. Because this reconstruction is fragile immediately after operation, it must be protected by a plaster cast or better still by an external fixation. The systematic resection of the distal end of the ulna enables subnormal pronosupination to be maintained.

Adult↗
PubMed1990

[Subchondral cysts (capsulo-synovial inclusions). Apropos of 25 cases].

Twenty three patients with 25 subchondral bone cysts have been treated by the authors. Clinical and radiological appearances of these rare lesions, were typical enough to allow, in most cases, the diagnosis. The lesions appeared as well limited subchondral defects adjacent to normal joint. The treatment was based on curettage followed or not by cancellous bone graft. The pathogenesis of this lesion is still unknown. Many hypothesis are discussed.

Adolescent↗
PubMed1990

Bone allografts sterilised by irradiation. Biological properties, procurement and results of 150 massive allografts.

Massive bone allografts from cadavers have been sterilised by gamma-radiation from radioactive cobalt at a dose of 25,000 gray (Gy). The biological effects of radiation are discussed. Human cortical bone showed an acceptable 20% decrease in strength on bending tests after 27,000 Gy irradiation, but higher doses are more damaging and should be avoided. The procurement protocol used at the Cochin Hospital is described, and the importance of dosimetry and record-keeping emphasised. The clinical results of 150 massive bone allografts are reported. The infection rate was low. The evolution of the graft in each type of reconstruction is analysed and appears to be comparable to nonirradiated allografts. Very few complications occurred after composite reconstructions in the lower limb. Pelvic reconstructions had the highest complication rate, but most were not related to the use of the allograft.

Bone Transplantation↗
PubMed1989

[Benign chondroblastoma. A review of 30 cases].

Thirty cases of chondroblastoma treated (between 1950 and 1986) at the Cochin-St-Vincent de Paul group of hospitals in Paris were reviewed. The most frequent sites (63 per cent) were the proximal epiphyses of the femur, humerus and tibia. The male predominance is clear (63 per cent) and the lesion was generally discovered in the second decade of life (66 per cent). Three cases of intra-articular invasion were noted, of which one involved a meniscus. The treatment was surgical in every case (two cases had adjuvant radiotherapy besides, because of an initial erroneous diagnosis of malignancy). Five recurrences were noted, of which only one involved the soft tissues. Curettage with bone grafting has to be preferred to simple biopsy curettage which leads to 33 per cent of recurrences as against 6 per cent. Histological association with areas of aneurysmal cysts is not a factor predisposing to recurrence. No progression to malignancy was noted. Apart from infection following a joint replacement, no other complications, resulting from surgical treatment were noted.

Adolescent↗
PubMed1987

[Diaphyseal resection and reconstruction in cases of tumors involving the long bones of the extremities. Apropos of 23 cases].

An analysis has been made of the records of 23 cases of resection-reconstruction of the shafts of long bones for a variety of tumours of bone. Four were in the humerus, four in the forearm bones, five in the femur and ten in the tibia. The reconstructed bone was stabilised by an intramedullary nail in thirteen cases and by a plate or blade-plate in five cases. In five cases, the grafts were simply held by screws. The bone was reconstructed by an autograft in thirteen cases and by allograft in ten cases, four of which were combined with an autograft. Resections in the upper limb gave rise to few complications. Conversely, reconstructions in the lower limbs, particularly of the tibia, were associated with a significant number of complications because of infection and delayed union. The best fixation, when it was technically possible, was an intramedullary nail surrounded by autografts. Allografts, and the vascularised fibular graft, were very liable to secondary fatigue fracture. A combination of autograft and allograft needs to be considered if a sufficient quantity of autograft is not available.

Bone Neoplasms↗