[Intracranial hypertension. Physiopathology, diagnosis, emergency treatment].
Explore the source record for details and available documents.
Emergencies↗
Biomedical subjects
G Guy
Publications and source records attributed to G Guy.
Invasive character of an intradural spinal meningioma in early childhood.
The authors report the case of a 2-year-old baby girl with an intradural meningotheliomatous meningioma of the cauda equina which recurred three times. Despite four operative procedures and localized radiotherapy, the lesion kept on growing to reach the retroperitoneal space. Extensive laminectomy and associated radiotherapy were probably responsible for a spinal dislocation which had to be operated on. The child was left paraplegic with major bladder dysfunction after all procedures. This is the first reported case of well-documented "malignant" evolution of a spinal meningioma.
Female↗
Focal midbrain tumors in children.
Explore the source record for details and available documents.
Brain Neoplasms↗
Anomalies of the A1 segment.
Explore the source record for details and available documents.
Cerebral Arteries↗
[Metastases in the cauda equina in visceral cancers. Apropos of 2 cases].
Two new cases of cauda equina metastases from visceral cancers are reported. This diagnosis is only infrequently considered in patients with intra-dural lesions visualized by magnetic resonance imaging or saccoradiculography. The diagnosis is especially difficult in patients with no known primary cancer. Diagnosis rests on surgery during which only a biopsy is performed. Treatment is symptomatic and focuses on relieving pain. Prognosis is bleak.
Adenocarcinoma↗
[Are calcium channel blockers really useful in cerebral aneurysm surgery?].
Two retrospective series of early operated cerebral arterial aneurysms are compared. One series involves 74 patients treated from 1983 to 1987 by vascular volume expansion only. The other series involves 75 patients treated from 1987 to 1990 by vascular volume expansion associated by calcium antagonists (nimodipine or nicardipine). The conclusion is that in our experience, calcium antagonists do not improve the outcome (mortality, cognition findings and return to work) obtained by vascular volume expansion alone. Moreover they put forward that there is no difference between the patients treated by nimodipine and those treated by nicardipine.
Calcium Channel Blockers↗
Recurrent intrinsic brain stem epidermoid cyst.
The authors report the case of a 14-month-old baby boy with an epidermoid cyst located entirely within the pons and medulla, without an exophytic component. The lesion was examined by computed tomography and magnetic resonance imaging. The child was operated upon three times after two recurrences of the lesion. A suboccipital, subtonsillar approach was used for the first and second procedures and a transtemporal approach for the last one. Excision was thought to be complete the first time, since a solid tumor was found and removed in a large cyst. The cyst wall was not identified. No tumor was found during the second procedure despite recurrence of the cyst, which was drained without an attempt to remove the cyst wall. Finally the cyst recurred with a large tumor in the cyst wall which was again totally removed. Consistent with the high mortality of brain stem epidermoid cysts in the literature, the child eventually died. The therapeutic problems, surgical options, and consequences are discussed.
Brain Stem↗
Contribution of immunohistochemistry, electron microscopy, and cell culture to the characterization of nonfunctioning pituitary adenomas: a study of 40 cases.
We studied 40 endocrinologically inactive pituitary adenomas by immunohistochemistry, electron microscopy, and cell culture in order to determine the incidence of gonadotropic adenomas and to classify nonfunctioning adenomas. Immunohistochemical studies using a large panel of monoclonal and polyclonal antibodies identified the following nonfunctioning adenomas: 20 gonadotropic adenomas, four silent corticotropic adenomas, one plurihormonal adenoma, and 15 nonsecreting adenomas. Among nonsecreting adenomas, ultrastructural study of 13 cases identified seven null cell adenomas and six oncocytomas. Silent corticotropic adenomas were classified into subtypes I, II, and III according to Kovacs and Horvath. Most often, gonadotropic adenomas displayed a varying number of oncocytic cells, characteristic secretory granules, and a prominent Golgi apparatus. Postembedding immunoelectron microscopy was performed on eight gonadotropic or nonsecreting adenomas, but this technique did not provide any additional information. Six gonadotropic adenomas and 10 so-called nonsecreting adenomas were studied in primary cell cultures. The six gonadotropic adenomas and seven of the 10 nonsecreting adenomas released gonadotropins in the culture medium. The use of in vitro results as a supplementary diagnostic criterion allowed classification of the 40 nonfunctioning adenomas as follows: 27 gonadotropic adenomas, four silent corticotropic adenomas, one plurihormonal adenoma, and eight nonsecreting adenomas. These results demonstrate a high proportion of gonadotropic adenomas among nonfunctioning adenomas (67.5%) and the usefulness of several techniques in characterizing this type of pituitary adenoma.
Adenoma↗
Treatment of atopic eczema with traditional Chinese medicinal plants.
Explore the source record for details and available documents.
Adolescent↗
Cavernomas of the spinal cord: report of two patients.
Two operated cases of spinal cord cavernomas are presented. Since spinal angiography is usually normal and myelography not specific, the contribution of magnetic resonance imaging to the diagnosis is emphasized. Surgical considerations of treatment are discussed.
Adult↗
[Intracerebral grafts in Parkinson's disease].
Although the beginnings of neural transplantation can be traced back to the last century, this technique was not fully developed until the 1970's. Following an experimental stage, considered insufficient by some authors, the first neural grafts on humans were performed in Parkinsonians in 1982. One must, in fact, distinguish between two types of operation, each with its own ethical and scientific problems. The first operation is human embryonic neural transplants the effects of which are related to a real reinnervation of the striatum. The other operation consists of autografts of adrenal medulla, which still have hypothetical modes of action. The first results obtained in man with both types of operation are rather disappointing. Even though neuronal grafting is unquestionably a technique of the future, much caution must be exerted since intracerebral grafting in Parkinson's disease remains at the experimental stage.
Adrenal Medulla↗
Further investigations on protein requirement of genetically lean and fat chickens.
1. Genetically lean (LL) or fat (FL) chickens were fed from 28 to 42 d of age on one of 6 diets with different protein contents (from 73 to 208 g/kg). In order to keep a constant amino acid balance the experimental diets were made by diluting a well-balanced protein-rich diet with a protein-free diet. 2. Dietary protein influenced the growth rate of both genotypes similarly. However, maximum weight gain was reached in LL at a lower protein intake than in FL. 3. Regression between total protein gain (body protein + feather protein) or body protein gain and protein intake exhibited significantly different slopes, that of LL being superior to that of FL. 4. At a given protein intake, feather protein gain was also superior in LL to FL. Moreover feather protein, as a percentage of total protein gain, was superior in LL to FL. When the dietary protein fell below 126 g/kg, feather protein represented a higher proportion of total protein gain. 5. Multiple linear regressions of protein intake (as the dependent variable), and body weight and protein gain or weight gain (as the independent variables) suggest that the maintenance requirement for protein is similar in both lines but that the protein efficiency for growth is significantly superior in LL. 6. In a second experiment both genotypes were offered either a single high protein diet (232 g/kg) or a single medium protein diet (186 g/kg) or had free-choice between a high (269 g/kg) and a low protein (145 g/kg) diet. In free-choice feeding, FL chickens selected an overall dietary protein content which was significantly lower (179 v. 200 g/kg) to that of LL. In both genotypes, free-choice feeding led to fatter and less efficient chickens than predicted by the linear regression between adiposity or food conversion and protein content.
Amino Acids↗
[Calcificated necrotic inflammatory granuloma after intradiscal injection of triamcinolone hexacetonide].
Recently, it has been demonstrated that symptomatic epidural calcifications represent a complication of intradiscal injection of triamcinolone hexacetonide (Hexatrione). Out of our three cases, pathological examination showed lesions of necrosis with granulomatous inflammatory reaction and bone metaplasia. Necrosis seems to be the primary cause of calcifications so we propose to call the lesion inflammatory and necrotic granuloma. The incidence of these granulomas is unknown. They are unpredictable and appear with a mean range of a year following the intradiscal injection. The treatment is surgery if they become symptomatic.
Anti-Inflammatory Agents↗
[Complications and biological risks of neuronal grafts].
Following an experimental stage, considered insufficient by some authors, the first neural grafts on humans were done on Parkinson patients in 1982. Since then, hundreds of patients, mostly with Parkinson disease, have been subjected to grafts. Recently patients suffering from other neurodegenerative diseases or pain of carcinomatous origin have also been grafted. The first results obtained in humans are modest and vary depending on the research groups and methods employed. It must be distinguished between two types of surgery which raise different ethical and scientific problems. First, embryonic neural transplants, in which the effects could be related to a possible actual reinnervation of the striatum. Second, autografts of adrenal medulla, the mechanisms of action of which are still hypothetical. The relative ease of graft technique and their success with the media should not minimize complications and risks. There are three types of known or possible complications: 1 - the complications related to the surgery, 2 - the non-specific complications of the graft itself, that are secondary to the host reaction to transplantation, 3 - the specific graft complications related to relationship established between the grafted cells and the host. In the adrenal medulla autograft, the surgery complications are responsible for an important morbidity and mortality. The immunological and infectious (viral) risks are the most worrying in the embryonic transplants. Even though neuronal grafting can be a technique of the future, great caution is necessary, since intracerebral grafting in Parkinson's disease still is in the experimental field.
Adrenal Medulla↗
[Value of the neuropsychological evaluation in cerebral arterial aneurysms surgically treated].
Early examination (3 months) of 81 patients, operated on for ruptured cerebral aneurysms, by neurosurgeons and neuropsychologists show significant differences between them both; the neuropsychological evaluation has the best predictive value as far as the outcome is concerned especially regarding the return to their initial job (69% after a year in this series). The outcome also depends on the age, the preoperative grade, and the professional qualification. The aneurysm location and the date of the operation are not so important. Early neuropsychological evaluation enable us to start a rehabilitation program for socio professional reinsertion and to improve the quality of life.
Adolescent↗
Topographic anatomy of the lumbar lateral vertebral groove. Anatomical basis of the surgical approach to extra foraminal herniated disc.
The study of numerous dissections, sections and X-rays of the lumbar spine has enabled us to clarify the connections of the lumbar spinal nerves at their emergence from the intervertebral foramen and in the lateral vertebral groove. This work naturally leads to the study of the extra foraminal herniated disc by an extra isthmian approach or to percutaneous surgery of thoracolumbar discs.
Humans↗
Metabolism of very low density lipoproteins in genetically lean or fat lines of chicken.
Metabolism of very low density lipoproteins (VLDL) has been compared in fat (FL) and lean (LL) lines of chicken. When refed after fasting, plasma triglyceride concentration reached a significantly higher plateau in FL, although their feed consumption was lower than in LL. Newly synthesized VLDL were studied using anti-lipoprotein lipase antibodies. VLDL triglyceride (TG) concentrations were increased by antibody injection and reached a higher concentration in FL plasma than in LL. Newly synthesized VLDL exhibited a similar lipid composition. Fatty acid profiles were also similar when birds ingested a very low fat diet. Comparison of in vitro affinity of lipoprotein lipase and VLDL from both genotypes did not reveal any difference in Km and Vmax. [14C]labelled VLDL from fat or lean donors were prepared and were injected into chickens from both genotypes. Fractional rate constants did not differ between lines. However, as plasma VLDL-TG pools were very different, plasma turnover was higher in FL than in LL. About 3-fold more VLDL-TG were incorporated in abdominal fat of FL than in LL. Difference in fattening between both genotypes seem to be due to both increased VLDL secretion and VLDL removal from plasma without difference in VLDL characteristics.
Adipose Tissue↗
A rare embryologic variation: carotid-anterior cerebral artery anastomosis or infraoptic course of the anterior cerebral artery.
Carotid-anterior cerebral artery anastomosis constitutes an anomaly of the anterior part of the arterial circle of the brain. The anterior cerebral a. arises a few millimeters above the emergence of the internal carotid from the cavernous sinus, at the usual level of origin of the ophthalmic a. It travels medially, beneath the optic n., and then describes a curve with a superolateral concavity to arrive at the anterior part of the optic chiasma, where it anastomoses with the anterior communicating a. This asymptomatic variant of course is often associated with other cerebral vascular anomalies, especially arterial aneurysms. On the basis of 2 new cases discovered by chance, together with a review of the literature, various hypotheses capable of explaining the embryologic origin of these anomalies are discussed.
Adult↗