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Biomedical subjects

D Brasnu

Publications and source records attributed to D Brasnu.

At least 217 records · Page 12Linked to original sources
PubMed1986

[Epitheliomas of the piriform sinus. Therapeutic orientation. Apropos of 642 patients].

On the basis of 642 patients treated and followed up since 1961 at Laennec Hospital, the authors compare the results of radiotherapy, of surgery and of surgery with subsequent radiotherapy. Surgery followed by radiotherapy gives the best 3 and 5 year survival rates and the lowest local and lymph node recurrence rates. The introduction since 1970 of induction chemotherapy shows an improvement in local prognosis and 5 year survival. There has been a more marked improvement since the introduction of cisplatinum and the use of continuous infusions of cisplatinum and of fluoro-5-uracil with or without bleomycin.

Adult↗
PubMed1986

[Laryngeal lesions after prolonged intubation. Anatomo-pathologic study].

Laryngeal lesions produced during prolonged intubation were studied in 11 larynxes from consecutive patients dying during intensive care. A constant finding was ulceration of the vocal process, combined in 7 cases with inter- or pre-arytenoidal subglottic ulcerations. Histology failed to reveal signs of lesions of the cricoarytenoid joint or chondritis of the posterior arch of the cricoid cartilage.

Adult↗
PubMed1985

[Induction chemotherapy of cancers of the upper respiratory and digestive tract. Analysis of tumor response in 176 patients].

Tumoral responses to 3 courses of induction chemotherapy were investigated in 176 patients with squamous cell carcinomas of the head and neck previously untreated. The number of responses increased with the number of courses. Thus, out of 79 patients with a more than 50% response after the 3 courses, almost one third had no response after the first course, and 98.8% had a less than 50% response after the second course. In consequence, it may be stated that a 3rd and perhaps a 4th course is justified in patients who responded after 2 courses. There seems to be a poor correlation in responders between clinical and histological results: 68.5% of patients with complete response still had a tumour on the excised tissue. No correlation was found between the influence of T in the TNM clinical classification and that of squamous cell differentiation on the one hand and the macroscopic character of the tumour during response on the other hand.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Induction chemotherapy in cancer of the upper respiratory and digestive tract. Preliminary results of the protocol combining cisplatin, 5-fluorouracil and bleomycin (CFB)].

Prognosis in cancer of the upper respiratory-digestive tract (URDT) is dominated by the importance of local and regional spread, of second localizations or metastases and of any underlying clinical condition. Stable results are obtained using local and regional treatment (surgery and/or chemotherapy) alone, and the use of chemotherapy has been evaluated since 1965, neo-adjuvant cancer chemotherapy being adapted in 1970 for cancer of URDT. From november 1982 to december 1983, 184 patients with epidermoid cancer of URDT were treated by combined therapy with Cisplatin, 5 Fluoro-uracil, Bleomycin as a continuous infusion. Results are presented of the different tumoral responses as a function of localization and stage, excluding any glandular responses.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Approaches to the infra-spleno-temporal fossa and the lateral wall of the nasopharynx].

The authors suggest replacement of the term "infra-temporal fossa" (indicating in the international anatomical nomenclature the pterygo-maxillary fossa) by the term "infra-spheno-temporal fossa" which would seem anatomically more appropriat. In the context of an operation performed in this region for a recurrence of a nasopharyngeal angiofibroma, a review and anatomical study of the different approaches has been undertaken and a classification established. The antero-inferior approach via the cervico-trans-oral route would seem to be of particular interest, offering good exposure of the anatomical features of the region and avoiding the parotid bed ans dissection of the facial nerve.

Adolescent↗
PubMed1984

[Effects of the CO2 laser on mandibular bone. Preliminary study].

A study of the effects of the CO2 laser on bone was undertaken using human mandibles obtained from cadavers. Different series of shots were used, varying the power and duration of the shots, as well as the latent period between two impacts with intermittent shooting. For a given impact duration, the depth of penetration increased in proportion to power up to 25 watts. Beyond, penetration was less deep but more extensive. For a given intensity, the duration of the shot did not result in any variation in penetration. These findings and their possible clinical implications are discussed.

Aged↗
PubMed1984

[Laryngeal immobility after intubation].

Based on findings in 14 cases of post-intubation laryngeal immobility simulating a paralysis, it is demonstrated that a mechanical cause bringing into play the arytenoids exists in every case. The origin may be from a synechia between the vocal cords, crico-arytenoid ankylosis, inter-arytenoid and plate of the cricoid fibrosis, or a combination of these lesions. Conclusive evidence of the type of lesion involved is rarely apparent from clinical or paraclinical examinations, an exact diagnosis requiring a median thyrotomy. This emphasizes the need for pathologic investigation of the arytenoidectomy surgical specimens. These findings suggest that neurogenic theories concerning the etiopathogenicity of post-intubation laryngeal immobility be revised.

Adult↗
PubMed1984

[Undifferentiated carcinoma and lymphoma of the thyroid gland. Apropos of a series of 38 cases].

Twenty-seven patients with undifferentiated carcinoma and eleven with lymphoma of the thyroid are reviewed. Histologic sections of all tumors were re-examined critically. Most tumors were extensive forms spreading beyond the thyroid. Complete macroscopic excision was performed in 18 cases, incomplete excision in 12 patients. Surgery was not carried out in 8 patients, while radiotherapy was given to 27 cases. Local changes decide the prognosis whatever the findings on histology. Undifferentiated carcinomas have a poor local prognosis even after apparently satisfactory macroscopic excision. Effective local control was obtained in all cases of lymphoma treated by surgery and radiotherapy combined.

Adult↗
PubMed1984

[Cancer of the mobile tongue. Therapeutic development and results].

The authors analyse the results of treatment of 84 squamous cell carcinomas of the mobile portion of the tongue treated between 1961 and 1982. 64% of the patients treated were Stage I or II. The local recurrence rate was 13% at 5 years (6/43) for T1, T2. Recurrences were more frequent after interstitial radium therapy (17% at 5 years: 5/28) than after partial glossectomy performed at the outset (6.6% : 1.15). The treatment of stage NO remains controversial. The frequency of lymph node recurrences remains proportional to lymph node involvement by histology (NO, N-: no recurrences; NO, N+: 18.1%: 6/33) but seemed to be independent of the initial treatment of the regional nodes: no treatment, neck dissection with or without subsequent external radiotherapy. It is important to emphasize that lymph node recurrences contralateral to the tumour always occurred in the presence of initial homolateral lymphadenopathy with capsular rupture. Other oncological failures were frequent (35% : 20/56) at 5 years, grouping together visceral metastases (14.3% : 8/56) and second primary cancers in the upper respiratory/digestive tract (21.4% : 12/56).

Adult↗
PubMed1984

[Classification of laryngotracheal stenoses in the adult].

A new classification for laryngotracheal stenoses in adults is proposed, based on 145 cases treated between 1965 and 1980. Three factors were analyzed when establishing this classification: the extent of laryngeal and tracheal cartilage involvement, laryngeal mobility, and the complexity of the lesions as a function of whether they were systematized or not. This new approach enables a more functional therapy for these stenosis to be instituted.

Adult↗
PubMed1984

[Etiology of laryngotracheal stenoses in the adult].

Laryngotracheal stenosis in 145 adults was the direct result of laryngeal lesions in 27 cases and of iatrogenic etiology in 118. External injury was at the origin of most of the direct cases, the resulting complex anatomical lesions being treated with difficulty and having a very poor prognosis. Lesions of an indirect origin were principally sequelae from intensive care, their analysis and treatment being more easily systematized.

Adult↗
PubMed1984

[Use of the CO2 laser in the emergency treatment of dyspnea in laryngeal cancer].

Occlusion of the larynx of neoplastic origin was treated by CO2 laser in seven patients between Marc 1982 and April 1983. Temporary tracheotomy was avoided in all 7 cases but treatment had to be repeated in two patients. Specific anesthetic techniques necessary when using the laser in hypercapneic patients are described, and the advantages, limitations and complications of this therapy are discussed.

Carcinoma, Squamous Cell↗
PubMed1983

[Comparative study of 2 chemotherapy induction protocols. Cisplatinum-methotrexate-bleomycin and oncovin-methotrexate-bleomycin].

A prospective randomized study was conducted in 77 patients with stages III and IV epidermoid carcinomas of the buccal cavity, oropharynx, and pharyngolaryngeal regions to compare effects of two induction chemotherapy regimens: cisplatinum, methotrexate, bleomycin, and oncovin, methotrexate, bleomycin. Tumoral response and complications were analyzed as a function of the regimen, the tumoral site, and the stage. Chemotherapy including cisplatinum provided a tumoral response in 58.8 p.cent of stage III pharyngolaryngeal epitheliomas as against 38.4 p.cent with oncovin, methotrexate, bleomycin, but with a higher frequency of complications.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Value of computed tomography in tumors of the pharyngolarynx].

A study was conducted of 27 case-reports to assess the value of computed tomography for investigation of pharyngolaryngeal cancer spread. Analysis was by comparison of clinical, endoscopic, conventional radiologic, computed tomography, and definitive operative specimen histologic findings. Certain laryngeal structures were studied more particularly: the anterior commissure, the pre-epiglottic spaces, the subglottic region, and the thyroid cartilage. Findings demonstrated that the CT Scan is of no value for the study of the anterior commissure and the pre-epiglottic spaces, but is of major interest for detection of subclinical lesions of the subglottic region and thyroid cartilage.

Carcinoma, Squamous Cell↗
PubMed1983

[Criteria for choice of an anesthetic technic for laryngeal laser microsurgery using the laser in adults].

Laryngeal microsurgery by means of the laser involves anesthetic constraints regarding mainly the mode of ventilation during operation. The principal techniques and different anesthetic protocols are discussed. The two main criteria for the choice of method appear to be the permeability of the laryngeal passage and the patient's general condition and history. The two principal methods proposed are high frequency jet ventilation and ventilation controlled by a protected intubation tube.

Adult↗