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Biomedical subjects

J Brotchi

Publications and source records attributed to J Brotchi.

At least 181 records · Page 10Linked to original sources

Action of phenytoin, ethosuximide and of the carbidopa-L-dopa association in semi-chronic cobalt-induced epilepsy in the rat.

A semi-chronic model of cobalt-induced experimental epilepsy in the rat was used to investigate the action of two classic anticonvulsant drugs, phenytoin and ethosuximide. Single injections of ethosuximide lead to an inhibition of the epileptic discharges. We failed to demonstrate an inhibitory effect of phenytoin after preventive administration. The carbidopa-L-dopa association was investigated owing to the inhibitory effects of dopamine and its presence in the cortex. We showed that a dose of 100 mg/kg of L-dopa combined with 25 mg/kg of carbidopa is necessary and sufficient to produce an almost complete inhibition of the discharges.

Animals↗

Surgical treatment of subdural effusions in infants.

We puropose a simplified method for external drainage of subdural effusions in infants, not calling for a second operation to remove the catheters. This method allows the daily control of evacuated fluid, guarantees smooth and uninterrupted drainage, and permits analysis of the subdural collection. This operation which we would like to call external controlled drainage, does not call for parenteral feeding, but demands paediatric and neurosurgical collaboration. The method has no pretensions other than being simple, easy, and safe.

Drainage↗

[Correlation between epileptogenic nature of a lesional focus and presence of "activated astrocytes". Human and animal investigation (author's transl)].

Histoenzymologic analysis of human and animal epileptogenic foci has shown enzymatic changes in certain reactive astrocytes. Histochemical examination of these astrocytes in animals has led to clear differentiation between the classic, perilesional reactive astrocyte, constituting a medium for cicatrical glioses and the reactive astrocyte present in experimental epileptogenic foci. We have called the latter the "activated astrocyte". Analysis of 154 human cerebral tumours revealed activated astrocytes in the cortex of all patients with epileptic antecedents. No epileptic attacks were observed in patients where the cortex was invaded by the tumour but no activated astrocytes were present. Analysis of ten cases of non tumoral focal epilepsy confirmed the presence of activated astrocytes in the focus in all cases where the scar was resected surgically. The production of epileptogenic foci in animals shows the close relation between activated astrocytes and the epileptogenic focus. It even seems that the enzymatic changes in the astrocytes precedes the first electrical signs. The authors arguse against the hypothesis that the activated astrocytes are the result of attacks. Until the morphological criteria of the epilectic neuron have been defined the activated astrocyte constitutes the only morphological evidence of the epileptogenic focus.

Animals↗

[Unrecognized aneurysms of the circle of Willis].

The authors present, among 200 intracranial arterial aneurysms, 13 cases where the angiographic diagnosis of the aneurysm had been difficult. Among them, there were ten mistakes through default, and four mistakes through excess. Angiographic studies were done early, about the third day following subarachnoidal hemorrhage, so that conscious patients may have rapid surgery. The main diagnosis defaults were observed in aneurysms of the anterior communicating artery (cases 1, 2, 3, 4, 6), where the flexurae and arterial anomalies explain the diagnostic mistakes; double anterior cerebral artery, median anterior cerebral artery of Lazorthes, early origin of the frontopolar artery or of the callosomarginal artery. The aneurysms of the posterior wall of the carotid bifurcation, were hidden by this artery in the A.P. view and by the middle cerebral artery in the profile view (cases 5 and 7). Oblique views are necessary for the two localizations of these aneurysms. The middle cerebral aneurysms (case 8) may be hidden by a bony superposition. The Ziedses des Plantes subtraction method obviates this diagnostic default. Aneurysms of the peripheral branches of cerebral arteries (case 9) are filled later and slightly. Aneurysms of an artery less than 3 mm wide (posterior communicating artery, lenticular artery) are difficult to discriminate from their enlarged infundibulum (case 10). The small size of the aneurysm is not the only explanation of the difficult diagnosis. Indeed, few aneurysms are not evidenced by the first angiography, done at an early stage, even if any spasms exist. Only repeated angiographies could show the aneurysm particularly in young people. We repeat the angiography 15 to 20 days after the first one, and even some months later. In two young patients, angiographic studies were repeated a few times in three years and were normal; but after four years in one case and five years in the other, a new subarachnoidal hemorrhage occurred, and only then was the aneurysm shown by a new angiography (cases 4 and 5). In our series, the angiographic spasm could not afford an explanation for the diagnostic default. This, soon after the subarachnoidal hemorrhage, might be explained by the hemostatic clot which compresses or plugs the aneurysm. Further, the clot's lysis occurs, and the aneurysm can be evident. A double conlcusion must be drawn: --first, the angiography must be repeated if the image is dubious; the angiographic technique must be perfect and varied (oblique view, subtraction method, enlargement technique). Mistakes through excess, leading to useless operations, are as dangerous as mistakes through default; --secondly, great care should be exerted when reading and interpreting the X-ray films in the post-operative period in order to evaluate the surgical results, as well as in the preoperative period.

Adult↗

Characterization of nuclear size, ploidy, DNA histogram type and proliferation index in 79 nerve sheath tumors.

The distribution values of ploidy, of the DNA histogram type, of the proliferation index and of the nuclear area are described in a series of 79 nerve sheath tumors including 7 traumatic neuromas, 55 primary and 9 recurrent benign schwannomas, 5 benign neurofibromas and 3 malignant tumors. The nuclear parameters were computed on Feulgen-stained nuclei (from archival formalin-fixed paraffin-embedded materials) by means of digital cell image analysis. The results show that 20-30% of benign nerve sheath tumors exhibit an abnormal nuclear DNA content (DNA index > 1.30). Such a feature was observed in the four groups of benign tumors, i.e. primary and recurrent schwannomas, neurofibromas and even traumatic neuromas. Aneuploid tumors exhibited triploid, hypertriploid or polymorphic DNA histogram types. The three malignant tumors under study were aneuploid. Lastly, the nuclear area and proliferation index measurements did not allow any clear distinction to be made between the four groups of benign tumors on the one hand, and between the benign and malignant tumors on the other.

Adult↗

[Primary and secondary glioblastoma. Distinction by glutamate dehydrogenase activity].

The study by bistochemical method of some dehydrogenases in 74 glioblastoma multiforma permits to distinguish several metabolic groups. But if particular attention is payed to the activity of glutamate dehydrogenase, it is noted to be observed only in the small, dedifferentiated cells when the survival postoperative time was more than twelve months. As it is known that an operated glioblastoma does not survive more than one year, except if it is a secondary glioblastoma, it is concluded that the existence of this enzyme in those little cells permits to distinguish secondary from primitive glioblastoma.

Astrocytoma↗

[ACTH therapy and peritumoral oedema (author's transl)].

Out of the various drugs which may be used in the treatment of intracramial hypertension we have tested long-acting Synacthen (Synacthen-dépot) in patients with inoperable cerebral tumours. The results were favourable, especially in the case of long-term treatment, since the delayed action of the drug allows flexible application while ensuring significant comfort for the patient.

Adrenocorticotropic Hormone↗

Epidermal growth factor receptors in human tumors of the central nervous system.

Epidermal growth factor receptors (EGF-R) have been measured in human tumors of the Central Nervous System (CNS) by 125I EGF ligand binding. High affinity receptors (Ka congruent to 1 x 10(9) M-1) were detected in nearly all individual specimens of meningiomas and tumors of glial origin (astrocytomas, glioblastomas). The phosphotyrosine kinase activity associated with the EGF-R was evaluated by measuring the incorporation of gamma 32P-ATP, after immunoprecipitation of the receptor with the monoclonal antibody EGFRI. A good relationship was observed between the EGF-binding capacity and the autophosphorylation of the receptor, indicating that in most cases functional molecules of EGF-R were expressed on the tumor membranes. In the group of meningiomas, no relationship could be established between the EGF-R level and the histopathology of the tumors. Astrocytomas exemplify a progression of malignancy, from benign (low grade astrocytomas) towards an increased malignant phenotype (glioblastomas). In this group, our observations indicate a positive relationship between the EGF-R level and phosphokinase activity and the degree of malignancy.

Brain Neoplasms↗