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Biomedical subjects

F Demard

Publications and source records attributed to F Demard.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Use of the conjunctival approach in orbital-palpebral plastic surgery].

The conjunctival route has several indications in palpebral surgery and traumatology. After a brief anatomical summary, the authors review the principles of the technique and differentiate between the preseptal and retroseptal dissection planes. This technique has two indications: in subcutaneous lipectomy for isolated palpebral lipoptosis and in surgery involving the orbital bones, for example in osteotomies or relatively undisplaced fractures of the orbital floor. The conjunctival route has numerous advantages and enlarges the surgical arsenal of the specialist by providing another approach to the orbito-palpebral structures.

Conjunctiva↗
PubMed1990

[Gardner's syndrome. Review of the literature. Report of a familial form].

Through a family form study and a literature review, the authors define the symptoms of the Gardner's disease and the checkup to be carried out. Sometimes, the surgical treatment, proposed in an aesthetical purpose, is difficult to carry out due to the tumor location and consistency. Incomplete forms are likely to be more frequent but the risk of colic degeneration remains the same as for the usual form. Examination and multi-departmental care are required.

Adolescent↗
PubMed1989

Salivary passage of 5-fluorouracil during continuous infusion.

Plasmatic and salivary concentrations of 5-FU were investigated in ten patients given 5-day continuous infusions of 5-fluorouracil (5-FU) (1 g/m2/day). Measurable concentrations of salivary 5-FU were scattered ranging from 6 to 100 ng/ml. Between individual 5-FU concentrations in saliva and plasma the coefficient of correlation was low. The theoretically predicted ratios of 5-FU concentrations in saliva over those in plasma, calculated as a function of salivary pH, did not correlate with the observed ratios, the majority of which ranged between 0.1 and 0.5. Noteworthy, 8 of 10 patients exhibited a more or less pronounced increase in 5-FU salivary excretion during 5-day continuous i.v. infusions.

Aged↗
PubMed1989

The labelling index: a prognostic factor in head and neck carcinoma.

The thymidine labelling index (LI), representing the percentage of cells in the DNA-synthesis phase, was measured in vitro prior to therapy in 87 patients with squamous cell carcinoma of the head and neck, who were treated between 1977 and 1982. The LI was not related to patient age, site of the tumour, clinical stage or histological grade. Overall survival was 44.5%. Univariate analysis demonstrated that survival was affected by the following factors: (1) age: patients older than 55 had a better outcome (p = 0.03); (2) site of the tumour (p = 0.005): laryngeal tumours had the best survival; (3) clinical stage (p = 0.05). Histological grade did not influence the survival (p = 0.41). Patients having a tumour LI higher than 15.5% (mean + 1 S.D.) had a significantly lower survival than patients with lower tumour LI (p = 0.008). A multivariate analysis using the Cox model showed that clinical stage and LI kept their prognostic impact with regard to survival. Finally, survival after relapse was lower in patients with a high tumour LI. These results demonstrate that a high tumour proliferation rate is an additional factor influencing the disease outcome in head and neck carcinoma. Patients with bad prognosis defined by this parameter could be offered a more energetic treatment.

Adult↗
PubMed1989

5-FU therapeutic monitoring with dose adjustment leads to an improved therapeutic index in head and neck cancer.

This 4 year study reports on a pharmacokinetic study for the widely used regimen of cis-platin plus continuous 5-day 5-FU as first-line chemotherapy of head and neck cancer, and the benefit of such data for real-time therapy management. Pharmacokinetic analysis of 177 cycles for 77 patients from a group of 89 patients (group 1; 228 cycles) revealed that both the time-concentration product (AUC) for the entire cycle and the half-cycle AUC (AUC0-3 days) were predictive of cycle toxicity. Real-time analysis of individual AUC0-3 days was used to decide whether to reduce the dose during the second half of the cycle for a total of 249 cycles (81 patients; group 2). The dose in the second half of the course was reduced in 40% of the group 2 courses. There was a statistical difference in complete response rates between group 1 (31%) and group 2 (47%), (0.02 less than P less than 0.05) and a statistically significant reduction was observed in the incidence of toxic cycles (greater than grade 2, group 1 = 20% versus group 2 = 12.4%; 0.02 less than P less than 0.05). Pharmacokinetic follow-up of these patients has proved to be an objective means to improve therapeutic index significantly.

Adult↗
PubMed1989

[Intra-arterial chemotherapy of ORL cancer. Value of an implantable infusion system and scintigraphic monitoring].

The technical difficulties and complications related to arterial catheterisation have inhibited the development of regional chemotherapy in ENT oncology despite the numerous theoretical advantages associated with this method. We report our recent experience with a completely implantable infusion system; 12 systems were inserted, 11 unilateral and 1 bilateral. Treatment was carried out in 8 patients and the perfect biocompatibility of the material was confirmed. Good distribution of the infusion to the tumor zone and lack of cerebral diffusion were confirmed before treatment using an infusion of free Technetium.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Paraganglioma of the head and neck. Familial forms].

The clinical, epidemiological and genetic aspects of familial paragangliomas of the head and neck are discussed in relation to 6 recent cases from two families which accounted for 2 and 4 patients respectively. Tumors of the carotid body are the most frequent. Bilaterality and association with other paragangliomas are suggestive of a hereditary disorder and should lead to investigation of the family. The establishment of a family tree will define those subjects at risk in whom systemic screening should be performed. The recent advances obtained using new imaging techniques in the diagnosis, evaluation of extension and treatment should enable treatment to be instituted at an earlier stage and thus reduce functional sequelae.

Adult↗
PubMed1989

[Malignant non-Hodgkin's lymphoma of the bony cavity of the face. Apropos of 17 cases].

Malignant non Hodgkin lymphomas (NHL) are fairly frequent, but involvement of the bony cavities of the face is less common than invasion of the cervical lymph nodes and the lymphoid components of Waldeyer's ring. In connection with a series of 17 personal observations, the authors discuss the main features of NHL and review the diagnostic problems and therapeutic alternatives. Two histologic-clinical entities can be defined: orbital NHL: generally stage I, with a low or intermediate histoprognostic grade and a good prognosis; naso-sinusal NHL: often locally advanced, these lesions are often associated with other visceral disease sites; the prognosis for these intermediate or high histo-prognostic grade lesions is much more somber.

Adolescent↗
PubMed1989

[Induction chemotherapy with Cis DDP-5FU in cancers of the upper respiratory and digestive tract after 70 years of age].

Sixty one aged patients with advanced squamous cell carcinoma of the upper aerodigestive tract were given a chemotherapy Cis DDP-5 FU before any local treatment. The objective response rate was 77% which included 46% of complete response. Toxic manifestations were more severe than those observed in the general population with the same protocol (nine deaths during the course of the treatment). A few appropriate measures may contribute for the improvement of the therapeutic index: consideration of nutritional and cardiac status, reduction of doses according to age, pharmacokinetic monitoring of 5 FU. An acceptable level of toxicity will be necessary in the design of future, intensive induction trials. The possibility of conservative treatment with a high level of reliability would justify the use of induction chemotherapy in the aged subjects.

Aged↗
PubMed1988

Orosomucoid:prealbumin ratio--a marker of the host-tumor relationship in head and neck cancer.

The OPR was studied in 203 patients with squamous cell carcinoma of the head and neck at the time of diagnosis, before any specific treatment. The mean initial OPR value was significantly higher in cancer patients than in 63 healthy controls: 5.29 +/- 3.09 vs. 2.63 +/- 1.07; P less than 0.001. There was no significant difference by anatomic site, but the OPR was significantly lower in stage I-II disease than in stage III-IV: 5.10 +/- 3.85 vs. 3.23 +/- 1.99, P less than 0.001. An initial OPR under or over 6 seems to be an important prognostic factor: at 2 years, 51% of patients with an OPR less than 6 were alive vs. only 24.5% of those with an OPR greater than 6, P less than 0.001. The difference was also noted in patients with stage III-IV disease (mean survival: 16 months vs. 7 months, P less than 0.001) and in 89 of the patients who received chemotherapy (mean survival 16 months vs. 6 months, P less than 0.001) whatever the response to chemotherapy. The OPR index, which explores nutritional and acute phase reactant proteins, seems to reflect the host-tumor relationship. Its initial value is strongly related to prognosis at 2 years.

Adult↗
PubMed1988

Two new human tumor cell lines derived from squamous cell carcinomas of the tongue: establishment, characterization and response to cytotoxic treatment.

Two new permanent cell lines derived from squamous cell carcinomas of the tongue, CAL 27 and CAL 33, have been established in culture. Both cell lines were isolated in standard culture media without epidermal growth factor or fibroblast feeder layer to avoid obtaining clones of more differentiated cells. Analysis of the morphology, ultrastructure, karyotype and immunohistochemical properties of these two cell lines demonstrated that they are both well characterized, uncontaminated by HeLa cells, and do in fact correspond to transformed epithelial cells that have conserved certain characteristics of the original Malpighian epithelium. CAL 27 and CAL 33 have relatively long doubling times (35 and 43 h respectively). Their response to 14 drugs used for cancer chemotherapy was evaluated by a short term assay based on tritiated thymidine incorporation after exposure to the drugs. CAL 27 was more resistant than CAL 33 in all cases but one. Although cytogenetic examination revealed both lines to be malignant, neither CAL 27 nor CAL 33 produced colonies in soft agar; both lines were tumorigenic after inoculation into nude mice. This study clearly demonstrates the diversity of cancers of a given histologic form, in agreement with the diversity noted previously in vivo. Isolated without the use of any selection criteria, these cell lines constitute appropriate models for the study of human tumors.

Aged↗
PubMed1988

[Fractures of the floor of the orbit. A critical study of methods of repair].

Based on a personal series of 160 cases of surgically treated closed orbital floor fractures, the authors discuss the various reconstruction procedures and their respective indications. Emphasis is placed on surgical access and osteoplasty techniques. In this series, both cutaneous upper eyelid (127 patients) and transconjunctival approaches (33 cases) were used. Access through the upper eyelid gave the fewest complications; transconjunctival surgery was reserved for pure "blow-out" fractures. Several materials were tested for osteoplasty: conventional techniques included Silastic sheets (112 cases), corticospongiosal bone grafts (16 cases), and lyophilized dura mater (9 cases); new techniques included use of resorbable thermoplastic sheets (23 cases). Choice of a material depends on the size of the defect to be filled. Thin Silastic sheets are the ideal solution for small defects. Bone grafts are reserved for extensive losses of substance.

Adult↗