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Biomedical subjects

J Lagarrigue

Publications and source records attributed to J Lagarrigue.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Materials for osteo-dural reconstruction in the cranium. An update].

Materials available for repair of a bony or dural defect at the cranial level are reviewed with particular attention stressed on their qualities and drawbacks for neurosurgical purposes. These materials include autologous or heterologous bone graft and biologically stable or biodegradable implants. No material can demonstrate ideal qualities of biocompatibility and biofunctionality. It should be either perfectly stable biologically and inert or perfectly biodegradable allowing simultaneous new bone reconstruction; moreover, it should be sterilizable, disposable, easy to handle and of low cost. Autologous grafts (iliac bone, split bone flap, pericranium...) have the best features but irradiated heterologous bone can be used instead; the latter needs a particular organization (bone graft bank) to fill the strict conditions of safety, especially regarding the risks of virus transmission. Implants have more recently been developed (acrylic, coral, B.O.P., ceramic, collagen-vicryl...) and present some drawbacks: generally high cost and not well established or insufficient biological properties. The experience of French neurosurgeons is reported from a questionnaire (102 answers) on the most frequently used materials. Autologous bone grafts, and acrylic as bone substitutes and pericranium for dural repair are preferentially used. Some materials, including coral, B.O.P. and collagen-vicryl, have a decreasing utilisation because of poor results especially with regards to bone incorporation and water tightness. Particular techniques (acrylic + teflon, acrylic with pre-op external casting and even non-repair of bone defects) are proposed by some neurosurgeons. New materials still under experimentation are finally presented (lyophilized bovine pericardium, collagen IV, polylactic acid).

Biocompatible Materials↗
PubMed1985

[Chemonucleolysis in the treatment of surgical sciatica].

Enzymatic dissolution of nucleus pulposus by percutaneous injection of a papain preparation is now used frequently to treat lumbosacral disc hernias responsible for resistant sciatica. Mechanisms of action and techniques are reviewed, and the importance of applying strict criteria for indications for use emphasized. The method should be reserved for nerve root sciatica resistant to medical treatment or physiotherapy, and it constitutes the last stage of conservative treatment. Exclusion criteria are mainly "excluded" disc lesions, major dysfunction or associated spinal vertebral canal stenosis. The optimal indication is represented by the subacute disc hernia in the young. This alternative to open surgery in no way compromises the results in case of failure. Results obtained in a personal series of 150 cases are analyzed comparatively with those reported in the literature.

Adolescent↗
PubMed1980

[Traumatic injury affecting the extracranial portion of internal carotid artery (17 case reports) (author's transl)].

The authors analyse the detailed clinical course in an homogenous review of 17 cases reports of traumatic injury affecting the extracranial portion of internal carotid artery. Only cases in which there were neither cervical perforating wound nor atheromatous predisposing lesion were considered. As in cases reported in the literature, the young age of these patients, with prevalence in the second decade and in men, was attributable to the etiology. Circumstances in which diagnosis was established induce to discern two unequal groups, according as there was either a coma or immediate focal signs, or a delayed symptomatology : it occured most frequently after a free interval shorter than 48 hours, and reaching in the extrema (one instance) 40 days. Brachiofacial hemiparesis was the most frequent clinical picture. Doppler investigation was able to detect, with a rather satisfying reliability, anomalies in the carotid flow before angiography ; angiogram showed lesions nearly always facing first or second cervical vertebra and bilateral lesions in four instances. Injuries consisted in dissecting aneurysm with stenosis aspect much more often than in thrombosis. In a third of cases distal ischemic lesions below dissecting aneurysm were noted. Prognosis in these cases is very poor since eight patients in our series died without any possibility of expectation according to clinical or angiographical data. Medical therapeutics were disappointing, and this induced to consider an extension in preventive realization of extra-intracranial by pass, each time diagnosis is established and patient is lucid. Etiopathogenical aspect is the originaler part of this study, since we could precisely approach incriminated mechanisms in a methodic analysis of impacts and their results. In our review cranial or facial shock was constantly noted, always frontal and often mild. In II cases association to a frontal and upper thoracic traumatism was found ; safety belt may have been responsible in part, in the mechanism of fixation of upper thoracic orifice, in most cases where this thoracic impact seemed to be missing. Thwarted stretching of carotid artery seems to be the necessary condition for occurring of an intimal tear. Other mechanisms like direct cervical shock may certainly be found, but we did not observe any instance in this review.

Adult↗
PubMed1979

[Percutaneous thermocoagulation of sacral roots (author's transl)].

Following spinal cord lesions, signs of spasticity may be observed on bladder with decreased capacity and urinary leaks. We have attempted to associate the inocuity of anesthetic blocks and the selective precision of microsurgical rhizotomies by percutaneous thermocoagulation of sacral roots. Bilateral 53 root coagulation, under Rx control, vesical pressure monitoring and stimulation tests, is ususally efficient. Authors report the technic and the results of this simple method about the first nine cases with more than one year of follow up.

Adolescent↗
PubMed1978

[The measurement of sensory conduction in the median nerve and its diagnostic value in the carpal canal syndrome (author's transl)].

The authors studied the rate of sensory conduction of the median nerve in three groups of subjects: a group including subjects of different ages in order to determine the variations in conduction and the evoked response as a function of age; a group of patients with the carpal canal syndrome; a group treated by median nerve infiltration in the carpal canal. It was confirmed that there is a slowing of the rate of sensory conduction and spreading of the evoked response in the elderly subjects. The electromyographic data in the carpal canal syndrome is defined, as well as the difficulty of diagnosis which sometimes necessitates specific measurement of the conduction rate between the carpal canal limits.

Adolescent↗