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F Demard

Publications and source records attributed to F Demard.

At least 91 records · Page 5Linked to original sources
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↗
PubMed1987

Characterization of a new surface epitope specific for human epithelial cells defined by a monoclonal antibody and application to tumor diagnosis.

In an attempt to characterize the antigens attached to cells of a line established from a human squamous cell carcinoma of the tongue (CAL 27), BALB/c mice were immunized with whole CAL 27 cells; hybridomas were then produced using spleen cells of the animals and cells of an NS1 syngeneic myeloma. A hybridoma secreting a monoclonal antibody was obtained (CALAM 27); CALAM 27 was directed against an epitope attached to the CAL 27 cells. CALAM 27, IgG2a, reacted with a membrane antigen specific to all epithelial cells. After immunoprecipitation, this antigen corresponded to two bands (Mr 22,000 and 54,000). Reactivity disappeared when the tissue was embedded in paraffin but was conserved after fixation with acetone or methanol. This antigen was conserved for both benign and malignant epithelial cell pathologies. The action of CALAM 27 was tested on 80 samples of pleural effusions, ascites, and cerebrospinal fluid samples; after conventional cytological examinations, CALAM 27 failed to recognize either reactive mesothelial cells or meningothelial cells. In addition, the cell structure recognized by CALAM 27 is not found on certain lymphoid tissue cells. CALAM 27 also failed to react with small cell carcinoma of the lung. Its strictly epithelial specificity therefore permits its use for the diagnosis of micrometastases of carcinoma in ascites and cerebrospinal fluid, in pleural effusions, and in bone marrow. CALAM 27 may also prove useful in confirming diagnosis of pathologies suspected to be of epithelial origin.

Animals↗
PubMed1987

[Value of ultrasonic diagnosis in the study of metastatic cervical adenopathies. Clinical and anatomo-pathological correlation apropos of 266 lymph node excisions].

Preoperative ultrasound exploration of the cervical node regions was performed for 207 patients; US findings were compared with data obtained by physical examination and histopathologic analysis. Ultrasonography offers multiple advantages: detection of subclinical lymph nodes, accurate measurement of node volume, facilitating classification, evaluation of vascular relations, and particularly diagnosis of internal jugular vein thrombosis. Despite the limitations of ultrasonography, the rapidity and noninvasiveness of this technique make it the procedure of choice for the initial workup of patients with a cervicofacial epithelioma.

Evaluation Studies as Topic↗
PubMed1987

[Induction chemotherapy with cisplatin-5 fluorouracil. Current results in cervicofacial carcinology].

150 patients were treated at the Centre Antoine-Lacassagne by CDDP-5 FU induction chemotherapy. Amongst the 134 cases suitable for evaluation, there were 86.6% of greater than 50% responses including 45.5% complete responses (CR). These clinical findings led to changes in post-chemotherapy protocol, mutilating surgical procedures such as total laryngectomy being replaced in complete responders by radiotherapy only. These changes did not lead to any alteration in the survival of the patients. The degree of tumour control at 1 and 2 years was 91.4% and 81.4% for complete responses, 74.6% and 60.6% for partial responses (PR) with survival rates of 1 and 2 years 94% and 78.3% for CR and 77% and 55.1% for PR. The possibility of conservative treatment with a high level of reliability would alone appear to be justification for the use of induction chemotherapy in cervico-facial oncology.

Actuarial Analysis↗
PubMed1987

[Histological aspects and prognostic significance of the regional immune reaction in carcinomas of the upper respiratory and digestive tracts].

A prospective study of histopathologic data from 195 cervical evidements performed in the Centre Antoine-Lacassagne between 1979 and 1983 evaluated the prognostic value of morphologic criteria reflecting the regional immunity reaction of lymph nodes. Results failed to demonstrate any statistically significant correlation between the various groups, particularly with respect to localization, tumor extension and degree of histologic differentiation. These data are in line with other immunologic criteria, particularly measurement of lymphocyte subpopulations.

Digestive System Neoplasms↗
PubMed1987

[Cardiotoxicity of 5-fluorouracil. Spasm or direct myocardial toxicity?].

The authors report on a case of cardiotoxicity observed during a protocol including a 5-day continuous infusion of 5-fluorouracil; anginal manifestations recurred during a second treatment course. Coronary angiography, thallium scintigraphy and methergine test were all normal. An attempt to prevent the recurrence of such manifestations using a calcium inhibitor and nitroderivatives was unsuccessful. In connection with this case, six other with anginal manifestation and four sudden deaths under the same protocol, a review of the relevant literature is included in the discussion on the factors that may favor cardiotoxicity and the different etiopathogenic hypothesis. The generally accepted hypothesis is a coronary spasm but a direct cardiotoxicity of 5-FU cannot be. The only therapeutic possibility appears to be the definitive halt of 5-FU after the onset of such manifestations.

Aged↗
PubMed1986

Clinical pharmacokinetic study of 5-FU in continuous 5-day infusions for head and neck cancer.

Twenty-nine previously untreated patients with head and neck carcinoma received a total of 63 cycles of an initial chemotherapy protocol combining cis-platinum (100 mg/m2 on day 1) and continuous 5-day infusion of 5-FU (1000 mg/m2/24 h) from day 2 to day 6. This protocol was repeated on day 16 and day 31. Two daily blood samples obtained from all patients every day during 5-FU administration were analyzed by HPLC to determine the 5-FU concentrations. In the majority of cases a constant elevation was observed in total 5-FU cycle exposure (C X T) from cycle to cycle. A close relationship was demonstrated between elevated 5-FU C X T values (over 30 000 ng h ml-1) and the frequency of cycles in which signs of toxicity (myelosuppression, mucositis, diarrhea) were observed. By contrast, no obvious association was noted between response to treatment and systemic 5-FU exposure.

Adult↗
PubMed1986

Altered pharmacokinetics and clinical consequences of low dose methotrexate plus cisplatin in the treatment of advanced head and neck cancer.

Thirty-two patients with head and neck carcinoma received a multidrug chemotherapy protocol including low dose methotrexate (LDMTX) (30 mg/m2) and cisplatin as their initial treatment. A sensitive immunoenzymatic technique was used for systematic MTX blood monitoring (0-56 hr) in all patients. The MTX-related side effects observed in 15 patients (47%) were significantly associated with an increase in systemic drug exposure occurring early during drug infusion. The average end-of-infusion concentration varied from 8 X 10(-7) M for nontoxic patients to 1.45 and 3.12 10(-6) M for moderately and severely toxic patients respectively. The area under the curve (AUC) (0-56 hr) was also directly related to the increase in side-effects. Total body clearance was reduced in an inverse manner. Volumes of distribution and terminal elimination half-lives were not related to the presence or intensity of MTX side-effects. Based on these data, the institution of folinic acid rescue adapted to the MTX blood concentration, a measure previously not suggested for LDMTX, completely prevented severe toxicity in a subsequent series of 26 patients without modification of the response rate.

Aged↗
PubMed1986

Induction chemotherapy with cis-platinum and 5-fluorouracil for squamous cell carcinoma of the head and neck.

One hundred and eight patients with squamous cell carcinoma of the upper aerodigestive tract (UADT) (T3, T4, NO-N3; 17% stage II, 54% stage III, 27% stage IV) were given three courses of chemotherapy before any local treatment. The regimen consisted of cis-platinum 100 mg m-2 on day 1 and 5-fluorouracil 1000 mg m-2 on days 2-6; drugs were administered by continuous infusion. The toxicity of this protocol was acceptable, as 82% of the patients were able to receive the initially scheduled drug dose. The overall response rate of 86.5% included a 35% rate of complete lesion regression. The effect of this regimen on primary tumours was especially remarkable--87.5% responses, including 47.5% complete responses. Results for lymph node metastases were not as good--66% responses, including 33% complete responses. The best results were obtained for tumours of the oropharynx and hypopharynx; oral cavity lesions were the most refractory. For those patients who were subsequently operated on, histological examination of the surgical specimen either confirmed sterilization or demonstrated the persistence of small disease foci. After local treatment, which consisted of radiotherapy alone for 69% of patients, the lesion control rate was 80%. At 18 months follow-up, the survival rate for patients who achieved a complete response with chemotherapy was significantly better than that for patients with a response of less than 50%.

Adult↗
PubMed1986

Tongue and tonsil cancer: staging with US.

A prospective study on the value of ultrasound (US) for the staging of 70 cases of cancer of the tongue and tonsil was performed. A real-time, high-frequency transducer was used, and the examination was often coupled with endobuccal palpation. US did not visualize the tumor in nine of 42 cases of tongue cancer (seven stage T1 and two anterior stage T2 tumors); US accurately defined tumor size in 33 cases. The degree of in-depth extension and the location with respect to the median line (only four false results) were evaluated correctly. With regard to 28 tonsil cancers, US depicted extension from the tonsillar fossa to the tongue in all cases but one (13 of 14 cases). US is valuable for the detection of cervical lymph nodes associated with both tongue and tonsil tumors and is a safe and helpful technique for the follow-up of medium-size lesions. The major limitations of US include the nonvisualization of superficial lesions, reduced accuracy for evaluation of the extension of large tumors, and analysis of posterior pharyngeal extension.

Humans↗
PubMed1986

[Poncet-Spiegler cylindroma. Apropos of a recent case].

The authors describe a new case of multiple cutaneous cylindromas (Poncet-Spiegler cylindroma), and discuss the clinical and histopathological characteristics of this rare affection. Treatment is exclusively surgical, with plastic surgery being required for advanced cases. In the case presented, a free flap from the forearm was used to cover the area of extensive loss of cutaneous matter in the parotid region.

Carcinoma, Adenoid Cystic↗
PubMed1985

[High-definition real-time ultrasonic echography of tumors of the thyroid gland. Apropos of 379 surgically treated cases].

The authors present the results of a review of 379 cases of benign and malignant thyroid tumors examined by high frequency (7 MHz) ultrasound prior to surgery. Features of the 37 cases of cancer are described. Hyperechogenicity was almost always correlated with benign lesions (only 1 cancer out of 71 hyperechoic nodules). For 313 of the 342 cases of benign tumors a good correlation was found between sonograms and intraoperative examination of the two thyroid lobes. In the case of clinically evident polyadenomatous goiters, ultrasound is a highly accurate means of determining whether any zones of healthy tissue remain (sensitivity 104/110 cases, i. e. 93.7%). When a contralateral lobe is normal on sonograms, intraoperative examination only rarely reveals lesions (12/159 cases, including 2 false positives for surgical investigation). Due to the excellent concordance between ultrasound and intraoperative exploration, and the difficulties involved in anterior dissection, the results of sonograms can be used to decide on the surgical approach. Direct intraoperative surgical exploration of the lobe opposite a thyroid lesion appears unnecessary if the sonogram is normal (cases of non suspected occult thyroid cancer). Since intraoperative exploration can give false negatives, intraoperative ultrasound can be used in the rare cases where 1 or 2 deep micronodules have been detected by pre-surgery sonograms in the lobe contralateral to the main lesion.

Adenocarcinoma↗
PubMed1985

[Intra-arterial chemotherapy of ORL tumors. 10 years' experience in the Antoine-Lacassagne Center].

One hundred and two patients with malpighian epithelioma of ORL origin were treated with intra-arterial chemotherapy (IAC) as initial therapy, followed by either surgery, radiotherapy or a combination of the two. Regression in tumor size of more than 50% was noted in 46% of cases, the introduction of cisplatin into the multiple system chemotherapy providing a response in 71% of the 42 patients treated in this way. A response to induction IAC is a factor of good prognosis as shown by the improvement in level of local and regional extensions and the probability rate of survival in responders. Technical and methodologic progress has made IAC a simple and effective procedure, and its place in the treatment of epitheliomas of head and neck should be established more precisely.

Adult↗
PubMed1984

Ear, nose, and throat cancer: ultrasound diagnosis of metastasis to cervical lymph nodes.

We present the results of a study on the value of ultrasound in the detection of metastasis to the cervical lymph nodes in connection with cancer of the ear, nose, and throat. Comparison of clinical, ultrasound, and histological findings for 100 patients who underwent surgery revealed that clinical examination had a sensitivity of 78% versus 92.6% for ultrasound. All 18 cases of thrombosis of the internal jugular vein were detected by ultrasound. Clinical staging of the disease was modified in 28 of these patients based on ultrasound findings, including three false positive findings. Ultrasonographic follow-up at three months for a second group of 110 patients who did not undergo neck dissection provided prognostic information, since lesion stability or progression was correlated with death in less than one year in 41 of 43 patients. Ultrasound is of primary value in providing information of an anatomic nature, including the detection of subclinical lymph nodes, volumetric evaluation, and determination of vascular connections, particularly detection of internal jugular venous thrombosis. Furthermore, for patients whose necks have been thickened as a result of radiotherapy, ultrasound allows assessment of local status.

Antineoplastic Agents↗