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Biomedical subjects

J Philippon

Publications and source records attributed to J Philippon.

At least 55 records · Page 3Linked to original sources
PubMed1990

Intracranial meningiomas in elderly patients. Postoperative morbidity and mortality. Factors predictive of outcome.

We studied retrospectively a series of 96 patients (36 men, 60 women), older than 65 years of age (mean age: 70 +/- 4 years, range 65-82), operated upon for an intracranial meningioma from October 1978 to December 1988. Fifty-two patients (54%) were under 70, 32 between 71 and 75 and 12 over 75 (46%). The tumours were diagnosed for all the patients by CT scan. Thirty-four (35%) were located over the convexity, 24 (25%) in the falx/parasagittal region, 38 (40%) in the base, tentorium and posterior fossa. Neurological and physical conditions were assessed preoperatively and at the closing date in June 1989. Operative mortality was 16% (15/96). Patients were divided into two groups: poor outcome, defined by the death or a post-operative Karnofsky index less than or equal to 70 (n = 36), and good outcome defined by a Karnofsky index of 80 or more (n = 60). The two groups did not differ regarding age, sex ratio, tumour size and peritumoural oedema. The only predictors of poor outcome were poor preoperative general health condition (stage III of the American Society of Anesthesiology classification), (p less than 0.01), poor preoperative neurological condition (Karnofsky's index) (p less than 0.001), and location of the tumour on the base or in posterior fossa (p = 0.02).

Aged↗
PubMed1990

Assessment of chromosome 22 anomalies in neurinomas by combined karyotype and RFLP analyses.

We report the cytogenetic study of 28 neurinomas; sixteen of them were also analysed using 11 polymorphic DNA markers for the loss of alleles of chromosome 22. Partial or total loss of chromosome 22 was found in nine cases. The results of the two approaches appear homogeneous, however, three tumors that yielded only cells with normal karyotypes demonstrated loss of constitutional heterozygosities. One of the tumors, which displayed an isodicentric or isopseudodicentric 22, was obtained in a patient with von Recklinghausen neurofibromatosis. It appears that loss of chromosome 22 is a characteristic of neurinomas whatever their context of occurrence.

Alleles↗
PubMed1990

Treatment of malignant gliomas with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy: a phase II study.

Forty patients with malignant supratentorial gliomas were treated with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy. The median duration of survival was 12 months; it differed according to the histological subtype (over 30 months for patients with anaplastic astrocytomas or anaplastic oligodendroglioma and 10.5 months for glioblastoma; P = 0.0025). Serious complications of monocular blindness and leukoencephalopathy were observed in four patients (10%).

Adolescent↗
PubMed1990

[Ependymoma of the intradural filum terminale in adults. 20 cases].

Twenty cases of ependymomas of the intradural filum terminale in adults have been reviewed. Their pathology was quite uniform, of a myxopapillary type, similar to the low grade ependymoma described by Kernohan, which represent about 23% of the tumours of cauda equina. Mean age of the patients was 35.7 years. Mean time between the first symptom and the diagnosis was 46 months. Clinical symptoms were often non specific, with low back pain and radiculalgias. At the time of operation, clinical signs were essentially motor deficits usually moderate (11 cases), sphincter disturbances (10 cases), and sensory loss (9 cases). In 3 patients with rapid worsening, an intratumoral haemorrhage was found. In 2 other cases, intracranial hypertension was the main symptom: in the first, it was related to hydrocephalus probably caused by spinal subarachnoid haemorrhage; in the second, there was no ventricular dilatation. In this series, neuroradiological examinations had consisted mainly in myelographies. C.T. scan has been performed in 3 patients; in only one case it has allowed to visualize a presacral extension. One patient had preoperative M.R.I.: the association of an expansive lesion with upper cyst in conus medullaris and presence of blood in the sacral area permitted the diagnosis of ependymoma of the filum terminalis. The average size of the tumours was 8 cm. Total removal has been possible in 15 cases (and in 2 of the 5 giant tumours), subtotal removal in 2 cases, and partial removal in 3 cases. In 4 patients where existed an intraspinal cord extension above the conus, it has been resected completely, except for one case with recurrence. Patients with a total removal had a good functional recovery (13/15). No recurrence has been observed in this group. In conclusion, with M.R.I., one may hope an earlier diagnosis, condition of radical surgery. So, radiotherapy which is not without risk, could be avoided.

Adolescent↗
PubMed1990

[The prognosis of medulloblastoma in adults].

We studied retrospectively the series of 24 patients (17 men, 7 women), median age 25.5 years (range: 16-57), operated upon for a cerebellar medulloblastoma from March 1979 to June 1988. The tumors were diagnosed for all the patients by C.T. scan and by M.R. imaging for the six last patients. Seven tumors (29.2%) were located in the fourth ventricle, 2 in the vermis (8.3%), 9 in the cerebellar hemisphere (37.5%), 5 in the vermis and cerebellar hemisphere (20.8%). One patient had a diffuse infiltration of the cerebellum. All patients have been operated on (complete removal: 15 patients (62.5%), subtotal removal: 8 patients (33.3%), biopsy: 1 patient). Operative mortality was 8.3% (2/24). One patient died at two months from septicemia. The twenty-one surviving patients received radiotherapy. Twelve patients received both radiotherapy and chemotherapy. Six patients (25%) died during the follow up at 17, 22, 24, 60, 84 and 85 months. One patient is lost to follow up at 45 months and 13 patients are living at the closing date (June 1989). For the total group (n = 24) the probability of survival at 5 years was 64.8% (C.I. 95%: 42.8%-86.8%). Among the 21 patients who received radiotherapy alone or radiotherapy and chemotherapy the probability of survival at 5 years was 74.4% (C.I. 95%: 52.2%-96.7%). We studied the following predictors of poor outcome: age, sex, prognosis subgroups as defined by Chang et Coll., extension of tumor removal, adjunction of chemotherapy, histology. None of these factors was statistically related to the survival duration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Lumboperitoneal shunt and normal pressure hydrocephalus in elderly subjects].

Forty six patients who had normal pressure hydrocephalus (NPH) and who presented 2 or more of the 5 following preoperative signs: dementia with gait disturbances and urinary incontinence, gait disturbance as first sign, known etiology, positive lumbar puncture withdrawal test, presence of periventricular hypodensity on CT and absence of visible cerebral sulci, were treated by lumboperitoneal shunt. Postoperative results were evaluated at 1 month, 6 months and 1 year with 60.6 p. 100 of good results. Complications of LP shunts (26 p. 100) were mild and did not compromise the outcome. We emphasize the necessity of clinical selecting criteria before surgery and the value of LP shunt in the treatment of NPH.

Aged↗
PubMed1988

Treatment of syringomyelia by syringo-peritoneal shunt.

Syringomyelic cavitation of various origins (excluding tumour) has been treated by syringo-peritoneal shunting (SPS) in 10 patients. The main clinical and radiological symptoms are reviewed and postoperative results evaluated; among the symptoms, pain is the most likely to improve after surgery. But the global outcome in the majority of cases remains unchanged, some patients showing neurological deterioration. Although MRI is of fundamental importance in diagnosis, the significance of the postoperative appearances on MRI has still to be elucidated. Other studies are certainly necessary to define the exact place of SPS in the treatment of syringomyelia.

Adult↗
PubMed1988

[EGF receptors (epidermal growth factor) and steroid receptors in human meningioma].

Epidermal growth factor receptor (EGF-R) were assayed by 125I-EGF binding in 28 surgical samples of human meningiomas. High affinity EGF-R were found in 26/28 tumors (92 p. 100) at concentrations ranging from 20 to 410 femtomoles per mg of membrane protein (fmol/mg prot. mb.). In 18/26 cases (64 p. 100), the EGF-R concentration was between 95 and 230 fmol/mg prot. mb. No relationship was found between the EGF-R level and the site or histopathology of the tumor. The only noticeable observations were the low levels of EGF-R in the 3 anaplasic meningiomas as compared to the whole population and the undetectable level of EGF-R in the angiomatous tumors. In addition, no correlation was found between EGF-R levels and the hormonal status of the patients, nor between EGF-R levels and the intratumoral concentration of progesterone receptors assayed simultaneously. The biological relevance of EGF-R in meningioma is discussed in this context.

Adult↗
PubMed1988

[Intraventricular neurocysticercosis. Apropos of 3 cases].

Cysticercosis cerebri is a rare neurological diagnosis in France. It is classically divided into four types: intraparenchymal, basilar cisternal, ventricular and diffuse. Three cases of intraventricular cysticercosis are reported. All patients had symptoms of increased intracranial pressure due to hydrocephalus and the authors emphasize the necessity of investigating for possible neurocysticercosis patients from endemics areas who presented such a clinical picture. They emphasize the interest of the E.L.I.S.A. test in order to detect anticysticercosis antibodies in blood and C.S.F. and the interest of Magnetic Resonance Imaging in order to visualise the cysts. Praziquantel do not affect intraventricular cysts and the surgical treatment is necessary to remove the cysts because the presence of an intraventricular parasite indicates an important risk of acute hydrocephalus and secondary of ependymitis source of irreversible neurological damages.

Adult↗
PubMed1986

Steroid receptor status difference in recurrent intracranial meningioma and breast cancer in the same patient.

The authors report a case of multiple recurrent intracranial meningioma associated with breast cancer in a menopausal woman. High affinity estrogen (ER) and progestin receptors (PR) were assayed independently in the meningioma and the tumor. ER were found to be very low in the meningioma and high in the breast tumor. On the contrary PR were found to be high in the meningioma and could be not detected in the breast tumor. This unique case suggests that meningioma and breast cancer are not under the same type of hormonal influence.

Adenocarcinoma, Mucinous↗
PubMed1986

Prevention of vasospasm in subarachnoid haemorrhage. A controlled study with nimodipine.

A prospective randomized double blind study was conducted in 70 patients suffering from subarachnoid haemorrhage, due to aneurysm rupture, to determine if the use of nimodipine reduces the severity of ischaemic deficits secondary to vasospasm. At the end of the study, two patients had severe deficit or died in the treated group, while 10 had a bad outcome in the placebo group. Angiographic vasospasm was not significantly different in its frequency or its severity between the two groups. However, the association of extensive and diffuse vasospasm was less frequent in the nimodipine group. This study confirms the effectiveness of Nimodipine in reducing the occurrence of neurological deficit due to vasospasm, even if this action is not observed in all cases.

Adolescent↗