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Biomedical subjects

J Pialat

Publications and source records attributed to J Pialat.

52 records · Page 3Linked to original sources

Revascularization of the spinal cord by micro-anastomoses in dogs.

The severity of ischemic lesions in the spinal cord justifies attempts at its surgical revascularization. The experiments consisted of: (1) creating devascularization of the conus medullaris by ligation of all the lumbo-sacral collaterals of the aorta, and (2) revascularizing the lumbo-sacral rachidian circulation by performing an end-to-side anastomosis between the caudal mesenteric artery and the 5th left lumbar artery (from which in the dog the Adamkiewicz artery generally arises). After two-months, the patency rate of the 20 cases was 85%. Such a procedure of revascularization could be useful in man in cases of interruption of the arterial supply of the spinal cord.

Angiography↗

[Alpers' infantile cerebral poliodystrophy. A case with abnormal hepatic pyruvate carboxylase].

The authors describe an anatomical familial case of progressive infantile cerebral poliodystrophy (Alpers disease), in which the study of enzyme kinetics of hepatic pyruvate carboxylase revealed an abnormal graph reflecting a loss of activity of the enzyme with low concentrations of substrate, This is a new feature in the literature on Alpers disease, and possibly indicates one of the pathogenic mechanisms responsible in this disorder which remains mysterious, although its pathology has been clearly described.

Ataxia↗

Experimental bypass for sagittal sinus repair. Preliminary report.

Bypasses of the sagittal sinus, 2.5 mm in diameter, were carried out in 25 dogs with venous (13 cases) and arterial (12 cases) autogenous grafts, by classical microtechniques. Animals were sacrificed 10 to 75 days after the operation, average 40 days. The patency rate was 54% in the venous autograft group; in all cases, thrombosis occurred early and was due to technical factors. The immediate postoperative patency rate was 100% in the arterial graft group, but this type of graft showed a tendency to progressive occlusion because of extensive fibrosis of the arterial wall; thus the patency rate was 75% at the time of autopsy. This preliminary work demonstrates the technical feasibility of bypass procedure which could be used for sagittal sinus repair.

Animals↗

[Neuropathology of trichopoliodystrophy (Menkes' disease). Anatomoclinical observation].

The authors describe an anatomo-clinical case of trichopoliodystrophy in many ways similar to cases already published. The original features of the case are as follows: the ultrastructure of the duodenal mucosa is normal; the endoplasmatic reticulum of the putaminal neurons contains many-layered lamellar structures probably composed of protein; type II fibres predominate in the striated skeletal muscle suggesting abnormal neuromuscular maturation.

Blindness↗

[Severe traumatic coma from diffuse brain lesions (neuropathological aspects) (author's transl)].

From a review of recent literature, and pathological study of more than 100 personal cases, the authors describe the most interesting of these "diffuse" lesions; they only recall the most common types of lesions (contusions, vascular lesions, edema and its consequences - especially on brain stem); but a more detailed description is given of less known lesions of corpus callosum, brain stem and white matter, which have a more complex pathogeny (direct physical injury, anoxia-ischaemia, edema), and which they consider to be factors which worsen or protract the coma. "Biochemical" lesions (basic myelinic protein, liberated "false" neurotransmitters) are also discussed.

Brain↗

[Extemporaneous histopathological examination in neurosurgery. Report on 500 cases].

The authors review 500 extemporaneous histopathological examinations done in a neurosurgical unit over a 16-month period. The following four questions are asked by the neurosurgeon: is there a tumor? is it a primary or secondary one? what variety is it? what is its degree of malignancy? The percentage of errors was respectively: 2 per cent, 2.2 per cent, 8.8 per cent and 7.4 per cent, or roughly, a percentage two times lower than in a series from the same laboratory done before the use of the low-temperature microtome. It especially seems that the tumoral variety is often determined accurately in meningiomas, neurinomas, medulloblastomas and craniopharyngiomas. In gliomas the variety is often more difficult to accurately affirm, and especially the "grade" of malignancy. The authors analyse the problems raised by the different types of tumors.

Brain Neoplasms↗

Development of an intracerebral glioma model in whole body irradiated hairless rats.

AIMS: To study the in vivo radiosensitivity of malignant gliomas, an animal glioma model was developed using the implantation of glioma cell lines into the brain of the Hairless rat (a mutant from the Sprague-Dawley strain, characterised by its complete absence of hair). METHODS: 10(6) malignant cells were suspended in 10 microliters phosphate buffered saline (PBS) and injected at a 4 microns depth into the left frontal lobe of an anaesthetised animal through a small craniotomy hole without opening the dura mater. The glioma cell line C6 (obtained from a chemically-induced rat glioblastoma) was introduced into 11 animals, and the human glioblastoma line G5 into 12 animals. RESULTS: The tumour take was checked using histological criteria. It was poor: 0% for the G5 line and only 27.3% for the C6 line. To improve the tumour growth rate, rats were subjected to a single dose (3.5 Gray) total body irradiation, 24 hours prior to injection, causing a marked immunosuppression. 84.6% of the rats grafted with the C6 line then produced tumours. Similar results (75% tumour take) were obtained using a stereotactic inoculation of the tumour cells. CONCLUSIONS: Thanks to the contribution of whole body irradiation, an animal intracerebral glioma model was establish, which can be used for clinical and biological studies.

Animals↗

[Pan-spinal ependymoma. Apropos of 2 cases with complete exeresis].

Authors performed in two patients a macroscopically complete exeresis of a panspinal ependymoma. The first case concerns a 27 years old woman, submitted to surgery in 1971, soon after a delivery, who exhibited a tumor in all points identical to the one described by G. Horrax an D. Henderson (1939). The second case concerns a male subject submitted to surgery in May 1973 because of a lesion extending from C2 to L2 and corresponding to a dorsal fleshy ependymoma, surrounded by two voluminous pseudosyringomyelic cysts, with respectively cervical and dorsal-lumbar localization. Such cases rare, with sometimes difficult clinical and roentgenologic diagnosis, raise before all problems of surgical tactics. We are dealing here with benign ependymomas, few favourable to roentgentherapy. Their management is surgical, i.e. complete exeresis. The few common extent of some of these tumors to the totality of the spinal cord does not modify in any manner such a principle. The same may be said of some etiologic circumstances, such as pregnancy, that often enough constitute a postponing of diagnosis and mangement detrimental for the patient. Only, the march of the surgical procedure may be object of discussion. The here reported experience lets appear that, when necessary, complete exeresis may be performed in one session under the same conditions and with the same spinal risks than for a less extensive analogous tumor. At long term the problem of spasticity of lower extremities has to be considered. However, in spite of extensive laminectomy, no major deformity of the vertebral column is to be noted.

Adult↗

[Experimental intracranial venous microsurgery. Bypass of the sagittal sinus for arterial or venous repair and preoperative measurement of the cerebral impedance in the dog].

By-passes of the sagittal sinus-which is 2,5 mm in diameter-were carried out with autogenous arterial or venous grafts, in 34 dogs, using the classical microtechniques (operative microscope, micro-instruments, micro-sutures...). Controls were done both 1 degree by angiography (direct sinography was the only convenient procedure to visualize the sinus and the by-pass) during survival, and 2 degrees by anatomical and histological examination after sacrifying the animals, on an average the 40th post-operative day (from the 10th to the 75th day). The early patency rate (within the first post-operative month) was 76 p. 100. All cases of early thromboses, which affected especially venous autografts, were related to technical insufficiencies. The late patency rate (after a one month follow-up) was only 64 p. 100, because of the secondary occlusion of some arterial autografts. All these late thromboses were related to an extensive fibrosis of the arterial wall.

Animals↗

[Amyloid neuropathy. Ultrastructural study of 2 new cases].

Two familial and sporadic cases of amyloid neuropathy are reported. Nerve biopsies ultrastructural studies permit to involve endothelial and Schwann cells basement membranes into formation of amyloid. This classical notion was worth being recalled and specified. The purpose of amyloid formation is searched in a toxico-metabolic processus possibly in relation with observed demyelinating mechanism. The Schwann cell is at the cross of the cause and of its effect.

Adult↗

[Hepatic lesions caused by vinyl chloride monomer in humans. Study of eight clinicopathological cases (author's transl)].

Six hepatic angiosarcomas, one hepatoma and one hepatic "fibrosis" with portal hypertension in patients chronically exposed to vinyl chloride monomer (VCM) are reported. The industrial methods of synthesis and current knowledge concerning the carcinogenic role of VCM are reviewed. Histogenetic and pathogenetic concepts of "fibrosis" and angiosarcomas of liver are exposed.

Adult↗