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Biomedical subjects

J M Richard

Publications and source records attributed to J M Richard.

At least 55 records · Page 3Linked to original sources
PubMed1985

Reirradiation of head and neck cancers. Presentation of 35 cases treated at the Gustave Roussy Institute.

Thirty-five patients with head and neck carcinoma who were treated with a second course of radiotherapy for relapse or second malignancy at the Gustave Roussy Institute between 1973 and 1981 were studied. Immediate tolerance for total doses greater than 80 Gy was good but 37% of patients suffered from delayed necrosis or bleeding. Thirty-seven per cent of lesions were locally controlled at 3 months and 97% of patients showed a subjective improvement to reirradiation. Local control was obtained in 53% of patients aged between 40 and 60 as compared to 19% in other age groups, and was obtained in 55% of patients who were irradiated a second time with a dose greater than 60 Gy as compared to 8% for doses less than 60 Gy. Complications following treatment are related to failure to achieve local control and area of second treatment fields greater than 70 cm2. Survival was worse for those patients having an interval less than 12 months between the two courses of irradiation and those in whom local control was not achieved.

Adult↗
PubMed1985

[Secondary reconstruction of the buccal floor by total skin graft after noninterruptive pelvimandibulectomy].

A technique of secondary reconstruction of the buccal floor after non-interruptive pelvimandibulectomy by thin-split skin graft enables insertion of a dental prosthesis to assist functional recovery. Results of 21 grafts of this type performed at the Institut Gustave Roussy, Villejuif, France are analyzed, this operative procedure enabling 14 of these patients to start taking solid food again.

Humans↗
PubMed1984

[Chemotherapy of carcinoma of the respiratory and digestive tracts with vindesine sulfate. Phase II clinical trial].

Results of a phase II clinical trial of vindesine sulfate in differentiated carcinoma of the upper respiratory and digestive tracts demonstrated good efficacy, with 6 objective responses in the 14 patients with interpretable reports several toxic reactions were observed, three patients developing polyneuritis of the upper and lower limbs after doses of 33 to 40 mg of DVA. Hematologic toxicity was moderate and regressive.

Aged↗
PubMed1983

The value of combining radiotherapy with surgery in the treatment of hypopharyngeal and laryngeal cancers.

Two-hundred and six cases of hypopharyngeal and laryngeal squamous cell carcinoma treated at the Institut Gustave-Roussy were retrospectively analyzed. All of them were treated by surgery and they were divided into three therapeutic groups following the adjuvant radiotherapy: (A) Postoperative radiotherapy at doses equal to or greater than 4500 rad; (B) Postoperative radiotherapy at doses less than 4500 rad; and (C) Preoperative irradiation at doses less than 4500 rad. Group A included a greater proportion of patients with hypopharyngeal cancer and patients with advanced tumors (T3, T4; N1b, N2, N3). However, the local and regional control rate in this group is significantly higher than those of the other groups in spite of the poor prognostic factors. The survival rate is comparable in all the three groups, with distant metastases more frequently found in group A. The results showing a significant improvement in lymph node control with postoperative radiotherapy, this adjuvant therapy is used systematically in this center in patients being operated on for hypopharyngeal and laryngeal cancer with incomplete histologically defined resection and/or with lymph nodes histologically involved.

Carcinoma, Squamous Cell↗
PubMed1983

Intermittent exotropia. Surgical results in different age groups.

The surgical results of 111 consecutive patients with intermittent exotropia treated via bilateral rectus muscle recession and having at least 2 years of follow-up are reviewed. These data are analyzed from a standpoint of three age groups at the time of surgery: younger than 3 years (41 patients), 3 years to younger than 6 years (42 patients), and 6 years to younger than 17 years (28 patients). The initial surgical results for all ages were as follows: 56% satisfactory, 38% undercorrected, and 6% overcorrected. After appropriate management (which was almost always surgical) in those patients initially either undercorrected or overcorrected, a satisfactory result was obtained in 95% of all patients comprising this series.

Adolescent↗
PubMed1983

[Tumor regression following local chemotherapy in carcinomas of the upper respiratory and digestive tracts. The viewpoint of the pathologist].

Few pathologists have given much thought to the problem of post-chemotherapeutic tumoral regression of upper respiratory and digestive tract carcinoma. In other oncological fields (pediatry: nephroblastoma, embryonic sarcoma, osteosarcoma; gynecology: mammary tumors...) pre- and post-chemotherapy tissue studies have led to histological grading of prognostic value (particularly well known is that of Rosen et al). Numerous specimens were examined following operations for cancer, including pelvimandibulectomy, buccopharyngectomy, facial resection... Possible tumoral changes were evaluated using a conventional scale of regression based on 6 histologic degrees, and findings were of prognostic significance when compared with the initial biopsy results. This evaluation scale may require modification in the near future since recently introduced chemotherapy, particularly cisplatinum, appears to have a more potent and more specific effect on histologie features.

Carcinoma↗
PubMed1982

Administration of iduronate sulfatase by plasma exchange to patients with the Hunter syndrome: a clinical study.

The Hunter syndrome (MPS II) is the only mucopolysaccharidosis in which there is appreciable activity of the deficient enzyme in normal plasma. We performed enzyme-replacement treatment by plasma exchange in five Hunter syndrome children. Carefully monitoring the cardiovascular status, we administered monthly single plasma volume exchanges for a 3 to 8 mo period. The results indicate a substantial gain of enzyme activity, persisting with a t50% = 19 +/- 5 hr. The maximal level and persistence of increased enzyme activity did not change after repeated exchanges, suggesting that immune responses were not elicited. Despite this, no demonstrable clinical benefit was apparent when the study group was compared with an age-matched control group of Hunter syndrome patients.

Adolescent↗
PubMed1980

[The treatment by radiotherapy only of carcinomas of the margin of the larynx. Experience of the Institut Gustave-Roussy. 161 cases (author's transl)].

From 1955 to 1970, 161 squamous cell carcinomas of the épilarynx were treated at Institut Gustave-Roussy by radiation therapy alone. Most part of the patients were referred to radiotherapy for local extensions (21 cases), or medically poor conditions (73) forbiding surgery. Only 50 cases were really suitable to radiation therapy. Results are poor. 30% at 3 years, 15% at 5 years. Analysis of different groups (indications, size, of the tumor, nodes, mobility), gives a better appreciation of the possibility of radiation therapy. The results are in agreement with literature. Application of combination of surgery and radiotherapy permitted by improvement of anesthesia is probably better in same cases, but many of the patients with epilarynx are in so poor conditions, that besides patient suitable to radiation therapy (bulky tumors, type of epiglottis with normal mobility) many of the patients are in too poor conditions to receive surgery.

Aged↗
PubMed1979

Labelling index of human squamous cell carcinomas. Comparison of in vivo and in vitro labelling methods.

In vivo and in vitro labelling has been compared in sixteen human solid squamous cell carcinomas (ENT). The median in vivo/in vitro LI ratio was 1-2, but for two-thirds of the patients it was only 1-1, suggesting a slight LI underestimation in vitro. Two factors can possibly explain the divergences: heterogeneity from one biopsy to another in the same tumour, and lower mean grain count in the deep cell layers of the in vitro labelled tumour samples. Therefore, the fact we did not find a good agreement between in vivo and in vitro data for one-third of the tumours points out that one must be cautious in considering in vitro LI as a valid result for a given patient. However, even if the in vitro LI leads to a certain underestimate, it can provide useful data.

Autoradiography↗
PubMed1978

A comparison of penetrating keratoplasty and lamellar keratoplasty in the surgical management of keratoconus.

A retrospective study of patients who underwent keratoplasty for keratoconus was done in 100 consecutive cases, of which 50 were penetrating keratoplasty procedures, and 50 were lamellar keratoplasty procedures. Each case was done by the same surgeon in both series. Criteria for patient selection were essentially the same. Postoperative care differed primarily in the time before suture removal, being an average of ten months in the penetrating keratoplasty group and three months in the lamellar keratoplasty group. Of those patients who underwent penetrating keratoplasty, the mean best-corrected visual acuity was 6/6 (20/20-) and the average corneal astigmatism was + 5.00 diopters. Of those patients who received lamellar keratoplasty, the mean best-corrected visual acuity was 6/9 (20/30-), and the average corneal astigmatism was +3.25 diopters. The most frequent complications of both techniques were wound separations that responded well to resuturing.

Adolescent↗
PubMed1977

Results of a randomized clinical trial of preoperative irradiation versus postoperative in treatment of tumors of the hypopharynx.

Preoperative radiotherapy vs postoperative radiotherapy in the management of patients with primary tumors of the hypopharynx was evaluated by a prospective, randomized clinical trial. A statistically significant difference (p less than 1%) existed in favor of postoperative radiotherapy relative to survival rates, complications, and quality of survival. The postoperative radiotherapy group showed a 56% 5-year survival rate compared to 20% in the preoperative radiotherapy group. An analysis of the results is discussed.

Clinical Trials as Topic↗