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Biomedical subjects

J M David

Publications and source records attributed to J M David.

At least 55 records · Page 3Linked to original sources
PubMed1991

Combined postoperative radiotherapy and weekly cisplatin infusion for locally advanced squamous cell carcinoma of the head and neck: preliminary report of a randomized trial.

A prospective clinical trial was designed to evaluate efficacy, toxicity, and patient compliance of concomitant postoperative radiotherapy and Cisplatin infusion in patients with Stage III or IV S.C.C. of the head and neck and histological evidence of extra-capsular spread of tumor in lymph node metastase(s). Cisplatin 50 mg IV with forced hydration was given or not every week (i.e., 7 to 9 cycles) concurrently with radiotherapy. Between 1984 and 1988, 83 patients were randomized: 44 were treated by irradiation without chemotherapy (RT group) and 39 by the combined modality (CM group). There was no significant difference between the two groups in terms of patient characteristics, primary sites, tumor differentiation, T.N. stages, or postoperative prognostic factors. All patients completed the planned radiotherapy. There were seven severe toxicities (greater than grade 3) in the RT group. In the CM group, 30 severe toxicities occurred in 16/39 (41%) patients but none was life-threatening. Seven of 39 (18%) patients received less than two-thirds of the scheduled Cisplatin courses because of intolerance, mainly nausea and vomiting. Preliminary results show a better disease-free survival for the CM group (65% at 24 months) than for the RT group (41% at 24 months). This significant difference is largely due to increased loco-regional control in the CM group (79% vs 59%), the actuarial distant metastasis rates in patients controlled above the clavicles not being statistically different in the two groups.

Carcinoma, Squamous Cell↗
PubMed1989

[Lingual necrosis after radiotherapy. Radiation arteritis?].

Describing a case of tongue necrosis five years after Radiotherapy for a T3N0M0 carcinoma of the tonsil, the authors discuss the principal causes of these necrosis and insist on the potentialisation of the effects of radiotherapy on latent arterial disease.

Arteriosclerosis↗
PubMed1989

[Postoperative external irradiation of epidermoid epitheliomas of the larynx and hypopharynx. Analysis of tumor control factors in and outside of the neck].

The authors present a retrospective analysis of 138 patients with squamous cell carcinoma of the hypopharynx and larynx treated with post-operative irradiation. Overall tumoral control rate within the treated areas was 73.9%, uncorrected actuarial survival rates at 3 years and at 5 years were respectively 49.4 and 37.6%. The clinical status (TNM-UICC, 4th edition, 1987) seems to be the main determinant for the prognosis in terms of cervical tumoral control. Patients with N0-N1 nodal stage presented 14/88 (15.9%) cervical failures, while patients staged as N2-N3 presented 22/50 (44%) tumoral recurrences within the treated areas (P less than 0.001). Pyriform sinus tumors were found to present cervical relapses in 13/32 cases (40.6%). This recurrence rate was significantly higher than cervical failure risk in other tumoral sites (P less than 0.05). Cervical relapse (P less than 0.0001), N2-N3 nodal stage and pyriform sinus localization (P less than 0.05) were all found to increase metastasis rate. On the other hand, our results show that the use of post-operative irradiation reduces the prognostic influence of the primary tumor volume; in the same manner, the use of modulated post-operative external irradiation permits the control of microscopically positive surgical margins. In conclusion, the initial staging alone is sufficient to safely evaluate the risk of cervical relapse or metastatic spread; the use of these clinical parameters for selecting patients who could benefit from adjunctive chemotherapy is discussed.

Adult↗
PubMed1988

Hyperbaric effects on sensorimotor reactivity studied with acoustic startle in the rat.

In three experiments, startle responses to brief intense tone-bursts (30 msec, 110 dB, 6000 Hz) and single pulse (0.1 msec) stimulation of the cochlear nucleus and the nucleus reticularis pontis caudalis are studied under high pressures of heliox (from 0 bar to 50 bars) in the rat. For each rat (N = 12), mean amplitude and latency changes in startle responses (nuchal electromyography and whole-body accelerometry) are compared at normobaric pressure and during compression, at a speed of 100 bar/H. The results indicate that high pressures decrease (50% of control size) tone evoked startle by acting on the peripheral auditory organ, probably through middle and/or inner ear barotrauma. The large increases in electrically-elicited startle (250% of control size) from the cochlear and reticular nuclei, under hyperbaric conditions, suggest that high pressures affect sensorimotor reactivity by excitatory action on synaptic transmission in the relays of the acoustic startle reflex arc at the lower brainstem and spinal levels. Startle latencies remain unaffected by the heliox high pressures studied here.

Acoustic Stimulation↗
PubMed1988

Involvement of serotonin in the enhancement of the rat spinal excitability by high pressures.

Using an electrical stimulation of the reticulospinal tract at the level of the medial longitudinal fasciculus, the effects, and the neurochemical mechanisms of these effects, of a progressive increase in helium-oxygen pressures, up to 50 bar, on the spinal cord excitability in the chronic rat are investigated. In control animals, high pressure exposure over 30 bar was found to increase markedly the electromyogram response evoked in nuchal muscles. This startlelike response was monosynaptically induced by stimulation of the reticulospinal tract. Conversly, no hyperbaric alteration in spinal excitability has been observed in animals pretreated with the classical 5-HT antagonist drug metergoline. These results emphasize the importance of spinal cord as a potential target for mediating hyperbaric effects on sensorimotor behaviors (i.e., motor disturbances of the HPNS). Moreover, our work suggests that serotonin could be implicated in hyperbaric spinal cord hyperexcitability.

Animals↗
PubMed1985

[Second-look laparotomy or the search for curable stage III FIGO ovarian epitheliomas. Apropos of a series of 35 cases].

The authors report their experience in 35 cases of second-look laparotomy performed on 35 patients in the Claudius Regaud Centre. The actuarial survival rate at 3 years of patients who had undergone this surgery has been shown to be 41% as against 13% for all Stage III and IV cases randomly taken in this same period (194 cases). Indications for a second-look laparotomy are generally reserved for patients who have responded to chemotherapy after a mean of 6 treatments unless there in an obvious indication to go in. The reasons for this procedure include the idea of assessing completely the state of affairs and if necessary carrying out a large excision operation, knowing full well that the results will depend mainly on the quality of the first treatment given. Survival after second-look laparotomy depends on the mass of neoplastic tissue that is left behind, its size and its position in the peritoneal cavity or in the lumbo-aortic lymph nodes. This makes it possible to define that privileged group of patients that have a good prognosis. These patients who can be cured are those who have no disease in the peritoneal cavity or in the lymph glands. The combination of different ways of treating residual disease in the peritoneum or behind the peritoneum are derived from decisions made following second-look laparotomy. There is no place for radiotherapy of the abdomen and pelvis when there is residual lymph gland disease.

Actuarial Analysis↗
PubMed1984

[Pectoralis major myocutaneous flap in cervicofacial oncology. Apropos of 61 cases].

Personal experience with the use of musculocutaneous flaps from pectoralis major confirmed classical documented data. These flaps are reliable in use, they allow wide tumoral excision to be performed, and are therefore perfectly adapted for cervicofacial cancer surgery; however, carcinologic results have to be weighed against the operative procedures necessary.

Adult↗
PubMed1983

[Suppurative thyroiditis and epithelioma of the piriform sinus].

The authors report a case of suppurative thyroiditis revealing cancer of the piriform sinus. The course ran two distinct phases. Initially, symptoms resolved under methylprednisolone and ampicillin given with a diagnosis of acute thyroiditis. After corticosteroids were discontinued, a tumefaction in the thyroid area recurred, with clinical features indicating centesis that removed 30 cc of pus ORL examination connected this suppurative thyroiditis to an epithelioma of a piriform sinus.

Aged↗
PubMed1983

[Toxicity and dangers of volatile nitrites sold in sex shops].

The authors report a case of methemoglobinemia following a suicidal attempts with a popper containing isobutyl nitrite. The toxic effects of this substances, either by ingestion or inhalation, are described as well as risks of use in "everyday life". Regulations, still incomplete has been suggested in USA. In France, preventive measures should be taken.

Adult↗
PubMed1982

[Modelling of spatial evolution and dynamics of a population of healthy then rabies infected foxes].

The authors describe the main feature of a computer model which helps to simulate the evolution of a rabies epi-enzootic in foxes. They show first the goals and interests of the study, then the originality of used methodology. Their results deal successively with dynamic evolution of a healthy population of foxes, then with this same population infected with rabies and, at last, spatial and temporal evolution of the enzootics. Simulated results are discussed by comparison with those observed in the field.

Animals↗