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Biomedical subjects

J M Fuentes

Publications and source records attributed to J M Fuentes.

At least 73 records · Page 4Linked to original sources
PubMed1980

[A case of intra- and extracranial development of a craniofacial teratoma. Excision during the neonatal period through a mixed cranio-facial approach (author's transl)].

A newborn infant was found to have a laterocervical swelling invading the floor of the mouth. Exploration of the mass revealed that there was invasion of the left side of the soft palate and, more particularly, a prominence in the temporal fossa causing an obvious cranio-facial asymmetry. Radiological and neuroradiological investigations demonstrated the presence of a tumor destroying the greater wing of the sphenoid, invading the left side of the temporal fossa, extending into the pterygomaxillary fossa up to the soft palate, and finally appearing exteriorly in the sub-maxillary region. Excision was carried out in the neonatal period because of the poor tolerance from the neurological point of view. A wide cranio-facial approach was first employed, enabling resection of the point of the temporal lobe, clogging of the cranial base, and excision as one piece of the complete palatocervical extension of the tumor. Follow-up one year later showed that the child possessed excellent neurological development and there was no sign of recurrence of the mass. A review of the published literature showed the extremely rare nature of this type of localization of cervicofacial teratomas (5 other cases have been reported). The surgical procedures and the problems encountered are discussed as well as the indications for excision, based on results obtained in this case and those previously reported. The etiology and anatomy are also reviewed in order to establish their true significance in the case of congenital cranio-facial tumors.

Brain Neoplasms↗
PubMed1980

[Contrast medium turnover in discography (author's transl)].

Discography seems to have lost some interest for diagnosis in froomt of the new methods of myelo and radiculography with Metrizamide. But it remains still usefull before operation in some cases of lumbo-sciatic and cervico brachial pains. Beside the already known morphological disturbances of the disks it appeared very important to follow up the turnover of the contrast medium in the vertebral interspace. The turnover study of the contrast was performed by successives X ray views taken 12 hours, 24 hours and 48 hours after discography and also in some cases by the analysis of the half-life curve of a radioactive isotope (Technetium) injected jointly with the contrast in the disk. In the normal lumbar disk the contrast medium remains still visible after a delay of 24 hours, while it disappears completely at this time in cases of discopathy. This fact was also confirmed by isotope turnover. In cervical disk this information remains valuable but with a little shorter delay. This radiological sign remains trusty for the great majority of operated discopathies.

Contrast Media↗
PubMed1979

[Monitoring of intracranial pression in acute neurotrauma by extra-dural screw (author's transl)].

These data emphasize the interest of the study, in acute traumatic comatose, of the brain-stem reflexes and level of coma (Plum, Posner, Perez-Dominguez, Barge, Espagno) and the monitoring of the intracranial pression (ICP) by extra-dural screw (Vries, de Rougemont, J. Brunon). It is possible to describe: 1)The bilateral hemispherical contusions: with cortico-subcortical level and bilateral decorticate comatose. The normal brain-stem reflexes (N.B.S.R.) are presents. The monitoring of ICP allows to separate the reversible bilateral hemispherical contusions (ICP can present unstable recording during 3 days with pressure-waves--B waves--or to be stable (between 10--15 mm Hg)), from the severe bilateral contusions with rostro-caudal evolution and "plateau-waves". 2) The brain-stem contusions: the clinical level is often a mesencephalic level with decerebrate rigidity and N.B.S.R. +/- (Automatic Eye Movements). In severe injury the ICP is increased and unstable with A waves. In reversible brain-stem contusions the ICP is often stable and low with arteriography and ventriculography insignificant. 3) The associated contusions: In general, the head injuries of this group are alternatively decorticate or on decerebrate rigidity ("ambiguous reaction"). In the severe associated contusions the ICP shows A waves. In reversible contusions ICP is stable with normal supratentorial angiogramm and ventriculography.

Brain Injuries↗
PubMed1978

[Enlarged operations for atypical lombo-sciatic pain from disk origin (author's transl)].

In certain forms of atypical sciatic pain the surgical treatment of the affection cannot be accomplished exclusively upon the disk. This study was done on 120 patients operated upon during a two year period. The major technics used had an action upon the articular processes and facets with or without removal of the disk. In 60 cases a desensibilisation of the region was equally done. The principal reason of the surgical treatment remains still to permit the decompression of the sick root. In certain circumstances a more important surgical treatment is required: laminectomy is performed in cases of stenosis or in other cases an inter body fusion by posterior approach (60 patients). The term atypical lombo-sciatic pain is applied essentially when there exists discordancy in the clinical and neuroradiological examination. Surgical cure is applied when the medical treatment has failed. The best results have been obtained in atypical sciatic pain when facet rhizolysis has been associated with root decompression. However great care was taken to prevent the act from being destructive.

Adult↗
PubMed1978

[Anesthetic evidence of pheochromocytoma].

The authors report the clinical case of a patients who underwent four anaesthetic inductions during a period of 3 months. Two were associated with severe acute hypertension making the intended operation impossible at that time. Thorough investigations led to a diagnosis of phaeochromocytoma. Reviewing the protocol of the four anaesthetic inductions, the authors discuss the mechanism of provocation of paroxysmal hypertension which was seen on two occasions.

Adrenal Gland Neoplasms↗
PubMed1978

[Fractures and dislocations of the lumbar vertebrae (author's transl)].

The authors report 6 cases of fracture and dislocation of the lower lumbar vertebrae (L3, L4, L5) and note that they were usually lesions following violent trauma usually in hyperflexion. The following were treated 1 dislocation L3-L4, 2 dislocations L4-L5, 2 comminuted fractures of L4, 1 fracture of L5, and included in all cases intersomatic arthrodesis at one (five cases) level or two levels (one case) and one posterior internal fixation with Kempf's material. The simplicity of the follow up and the stability of the fixation, permit us to propose the method for all unstable lesions of the lower lumbar vertebrae.

Adolescent↗
PubMed1977

[Recent fractures of the dorso-lumbar spine. Reduction by the double shroud technique (author's transl)].

The use of posterior osteosynthesis in traumatic pathology of the dorso-lumbar spine, entails some throught about the time maintenance of the quality of the reduction and the solidity of equipment. The observation of the advantages and inconveniences of different methods has led us to the double shroud technique. The simultaneous use of Harrington's and Roy Camille's materials gives an excellent reduction from all points of view. Moreover the double shroud technique improves the stability of posterior osteosynthesis.

Fractures, Bone↗
PubMed1977

[Inseparable prognostic value of spinothalamic and corticospinal functions in severe spinal cord injuries].

In severe spinal cord trauma with initial complete paraplegia or tetraplegia, even the smallest recovery of sensibility to pain or motor function has an obvious prognostical value as it results from the study of 112 spinal injuries. For the motor aspect it is well known from experimental work and in man that even a small part of a single pyramidal tract in the spinal cord can take in charge the bilateral motricity of the limbs. It remains exceptional in severe spinal cord injury that recovery of motricity is not followed by a return of pain sens. In the lateral funiculus of the cord the sensitive and pyramidal tracts belongs to a same anastomotic vascular area between the central and peripherical circulatory streams. In physiological conditions this intermediate circulatory stream is poorly functional. But in severe spinal cord trauma with reduction of central blood flow the adjacent spinothalamic and corticospinal tracts survive in couple on the basis of the same anastomotic vascular area: from this results the prognostical unity that belongs to pain sens and motricity.

Adult↗
PubMed1976

Embolization of cerebral angiomas by catheterization of cortical arteries.

A method of combined direct embolization of submillimetric cortical arteries, after preoperative arteriography, is described and 3 cases of cerebral angiomas presented with striking symptomatic improvement after embolization. Postoperative angiography in one case showed considerable diminution in the size of the angioma.

Adult↗
PubMed1975

[Prognostic elements at early stapes of severe spinal cord injuries (value of pain sensitivity].

The prognosis in serious spinal cord injury remains difficult. The neurologist has a large number of elements at his disposal, but their reliability is uncertain. Clinical information, experimental work and recent data on medullar vascularization makes it possible to isolate diagramatically in the spinal cord a medium layer which contains the pyramidal and spino-thalamic tracts. The neighbourhood of these two fasciculi confers them a similar vulnerability to severe injury. Thus when an injured tetraplegic or paraplegic patient recovers his sensitivity to pain, he finally must recover his motor function and on the contrary, the recovery of motility is impossible without a return of pain sens. Clinical observation is in consequence of major importance as it shows that the recovery of sensitivity to pain, in the case of a patient with a serious spinal cord injury, is an argument for a favourable prognosis, whereas the recovery of an isolated tact perception does not in itself makes it possible to hope for eventual recovery of motor power.

Adult↗