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Biomedical subjects

J P Constans

Publications and source records attributed to J P Constans.

At least 37 records · Page 2Linked to original sources
PubMed1983

Spinal metastases with neurological manifestations. Review of 600 cases.

The authors have studied 600 cases of spinal metastasis causing a neurological syndrome. The most significant statistical data are reviewed. The cases are examined according to clinical characteristics, type of primary tumor, site of lesion, and survival. Each of these factors influenced the choice and results of treatment. As a general rule, combined treatment (surgery and radiotherapy) was used. Preliminary surgery was performed as an emergency, designed to halt progression of the neurological syndrome and to prevent its more serious manifestations. The technique and usefulness of surgery are discussed for different situations and the short-term results of treatment are related to the various factors involved.

Adolescent↗
PubMed1983

[The intercapital metatarsal space. Anatomical and pathological aspects].

The metatarsal intercapital space is located in the forefoot, between two metatarsal heads and above the transverse inter-metatarsal ligament. The 2nd space is the narrowest, the 1st is the widest and the 3rd is the most mobile. It contains a connective tissue bursa which facilitates the sliding of the metatarsal heads. The existence of this bursa was confirmed in two cases of rheumatoid arthritis (at operation). As the bursa hypertrophies, it gradually extends beyond its normal site towards the dorsal or plantar region of the foot. The metatarsal intercapital space, like the metatarso-phalangeal joint, warrants thorough clinical investigation.

Arthritis, Rheumatoid↗
PubMed1982

[Meningeal carcinomatosis in adults (author's transl)].

Twenty cases of carcinomatous meningitis in adults, treated in the Gustave Roussy Institute between 1970 and 1980, are reviewed. In fourteen cases meningitis was secondary to breast cancer. Initial inflammation was present in 90% of the mammary tumors. Clinical features as well as biochemical and cytological findings in cerebrospinal fluid are described. The various therapeutic regimens using radiotherapy and intrathecal chemotherapy are analyzed in terms of survival and compared with other published studies. The most significant point is the necessity for early diagnosis which improves survival. However, prognosis for this metastatic disease is always very poor.

Adenocarcinoma↗
PubMed1982

[Manifestations of cerebral metastases: diagnostic and therapeutic importance of research on their primary sites in 120 cases].

Among 120 cases of cerebral metastases, 62 primary sites were found. The diagnosis of the primary site was confirmed: --after the first investigations in 48 cases (in 90% of cases by anamnestic inquiry, clinical examination or chest X ray); --by the evolution of the disease in 5 cases; --by autopsy in 9 cases. The most frequent primary sites were lung (45%), digestive tract (17.7%), melanoma (8%) and ovary (6.5%). Among the identified cases, 25 received treatment for their primary cancer, but only 4 had a surgical resection. There was no significant difference in mean survival between the 2 groups (defined as primary site known or unknown); over all mean survival was 8 months. The early discovery of cerebral metastases suggests the advanced state of the disease. Therefore, investigations which cause the patient to suffer do not seem justified merely for research purposes.

Brain Neoplasms↗
PubMed1981

Surgical features of cranial metastases.

This study comprises 14 patients with metastatic involvement of the cranium treated between 1957 and 1979. Anatomical and radiological aspects and the clinical manifestations of these metastatic lesions are analyzed. These lesions are not a definite clinical entity, and they have specific therapeutic problems. Treatment consisted of surgical excision and radiotherapy. The surgical results are presented and discussed.

Adolescent↗
PubMed1981

[Recurrences of malignant astrocytomas (III-IV) and glioblastomas. Therapeutic approach (author's transl)].

The therapeutic problems raised by recurrences are different from those which apply to the initial malignant glioma. Firstly, the histological diagnosis is known (by excision or biopsy) and secondly the clinical period which has elapsed before the recurrence represents a factor in the assessment of progression and/or malignancy. The management of treatment must take into account various parameters of an anatomical and clinical nature, but although those relating the various forms of treatment used already. Although the methods used are the same: surgery, radiotherapy, chemotherapy, the strategy will differ according to indications of final recourse or reoperation will be discussed after initial surgery followed by radiotherapy, irradiation in those cases in which radiotherapy has not already been used and chemotherapy, Corticosteroids are also widely employed. Whilst such palliative treatment has the merit of ensuring prolongation of survival, the principal aims must be concerned with the quality and conditions of this survival.

Astrocytoma↗
PubMed1980

[Intracranial tumors in mental patients (author's transl)].

One hundred and fifty patients admitted consecutively to the same neurosurgical service in Paris were reviewed retrospectively. There is no definite difference between intracranial tumors in mental patients and those encountered in a normal population in terms of: frequency, anatomic localisation and histological distribution. All the patients had been referred previously to psychiatric hospitals for: confusional states, disturbed behaviour or pseudo-depression in 60% of the cases. Neurological localizing signs were present in 83% of the cases; EEG was abnormal in 96% of the patients recorded during their stay in psychiatric wards. Diagnosis of brain tumors in mental patients appears feasible if not always simple; it is based upon elementary neurological examination and routine investigations. In a near future, isotopic scan and CT scan should become a great help to reduce excessive diagnostic delays in order to improve the prognosis which remains poor.

Brain Neoplasms↗
PubMed1977

[Concentrated irradiation of malignant astrocytoma and glioblastoma].

Since 1965, 118 glioblastoma and 18 malignant astrocytomas of the adult have been treated by concentrated irradiation after a more or less complete surgical excision of the tumor. Three types of irradiation have been used; at present 3 600 rads whole brain irradiation are delivered in 2 series of 1 800 rads over 3 days 20 to 30 spaced a part. All patients receive ACTH and the tolerance has been excellent. The results of this rapid palliative therapy are quite comparable to those of more classical irradiation. Because of the very short survival of these patients, it would appear advantageous to treat them in as short a time interval as possible.

Astrocytoma↗
PubMed1976

[Results of concentrated irridiation in glioblastomas, astrocytomas and brain tumours of the adult (author's transl)].

Concentrated irradiation (two series of 1,800 rads in 2 sessions and 3 days) separated by a rest period of 3 to 4 weeks has been used to treat 214 adult patients with brain tumors between 1965 and 1972. These included 108 glioblastomas, 18 astrocytomas and 88 brain metastases from different origins. Early side effects are moderate or inexistent provided synthetic ACTH or corticoid steroids have been given several days before irradiation. Survival is related, at least, in the first 2 groups of primary tumor to local failure. For brain metastases, death could be related to others reasons. In spite of the fact that comparison is made with a previous series of 121 cases it seems that this type of irradiation gives the same survival rates. Moreover it has specific advantages as reducing duration of hospitalization and the number of treatment sessions.

Adult↗
PubMed1975

[Trial of experimental induction of cerebral metastasis in the rabbit carrying a VX2 tumor].

Numerous factors remain unknown as far as the mechanism of induction of cerebral metastases is concerned. Where as of cancer give metastases more readily than others, especially cerebral metastases, the neoplastic embolus can be either eliminated or remain in place in a state of quiescence. What is the role played by the blood brain barrier from a pathophysiological point of view? Is there a mechanism which prevents central nervous system metastases? What is the importance of individual variation? We attempted to induce cerebral metastases in VX2 carcinoma carrying rabbits to look for an approach to these problems and to create an experimental model of cerebral metastase. The VX2 carcinoma is easily transplantable and its biological characteristics are well known. The VX2 tumor is implanted in the thigh of the rabbits and is used in the experimentation starting two weeks following the take of the graft; the tumor is surgically resected and a solution containing approximatively 50,000 tumor cells for 0,1 ml is prepared. This solution is inoculated via the carotid artery to the same rabbit or to another rabbit of the same breed either or intrathecal way into the brain. Death occurred 6 to 20 days later and was followed by a complete pathological survey. The results were the following: --The inoculation via the carotid artery, even with very highly concentrated solution was never followed by any recognizable brain metastasis. --The inoculation intrathecaly produced only extraparenchymatous metastases where as the direct intracerebral inoculation was followed by the occurence of intracerebral metastases.

Animals↗