Search PubMed⌕ Search

Biomedical subjects

M Menard

Publications and source records attributed to M Menard.

At least 37 records · Page 2Linked to original sources
PubMed1995

Madreporic coral for cranial base reconstruction. 8 years experience.

The authors, since 1985, have used 587 Madreporic Coral grafts as bone substitute in a total of 183 patients, among them in 80 cases for repair of cranial base bone defects. They report their long-term results. Partial resorption to about 40% of the initial volume occurred in almost all cases within 8 to 10 months, with complete resorption after about one year. 20% of the coral blocks moved spontaneously or split into pieces, but could easily be withdrawn rhinoscopically through the nostrils. No CSF leakage was noticed afterwards. The local infection rate was only 4%, always close to the basal coral graft. This is lower than the infection rate after using autologous bone harvested from the inner table of the bone flap (20%). Infections were cured by removal of the coral graft. Despite the mentioned draw backs, Madreporic Coral graft implants can be recommended as bone substitute in cranial base surgery: 1. The material simplifies the surgical procedure; 2. Harvesting of autologous bone is no longer necessary; 3. Transmission of infections like AIDS, Hepatitis C or Creutzfeld-Jacob-disease can be avoided with certainty.

Biocompatible Materials↗
PubMed1994

Ethmoid sinus carcinomas: results and prognosis after neoadjuvant chemotherapy and combined surgery--a 10-year experience.

From June 1982 to June 1992, 144 ethmoido-sphenoido-orbital tumors have been referred to the neurosurgical department of Ste Anne Hospital. One hundred five of them were malignant lesions, among which 83 were included into our therapeutic protocol (1) neo-adjuvant chemotherapy (CDDP + 5-FU), (2) combined surgical procedure (subfrontal and transfacial), (3) postoperative radiotherapy. Fifty nine percent of the patients had no response to chemotherapy; 19% had a partial response (reduction of the tumoral volume > 50% and < 100%), 22% had a complete response. One patient had an immediate and transient postoperative rhinorrhea responsible for meningitis (acinetobacter) that was cured after a 3-day treatment. Four patients had postoperative meningitis without any cerebrospinal fluid leakage; they were also cured. Five patients had a local suppuration that was treated by subcutaneous drainage (n = 1) or the removal of the cranial basis graft (n = 4). Oncologic results are presented for only adenocarcinomas (n = 63) because they represent the only population of this series large enough to assure significant statistical figures. The global actuarial survival rate was 53% at 3 years and 42.5% at 5 years. The 5-year actuarial survival rate was 80% for T1 tumors, 60% for T2, 40% for T3, and 25% for T4. Patients with an intracranial extension had a 3-year survival rate of 19%; none survived after 4-year follow-up. Neo-adjuvant chemotherapy seemed to influence the survival: 100% survival rate at 5 and 10 years for the complete responders. We discuss the opportunity of intraorbital exenteration, the indications, and the limits of combined surgery. We emphasize the importance of neo-adjuvant chemotherapy and of combined surgical procedures, even when the patients are complete responders to chemotherapy: complete responders who had only a transfacial approach have a 5-year actuarial survival rate of 80% (instead of 100% when a combined procedure was performed). Those who were not operated primarily recurred within 3 years and then had to be operated. We propose to follow such a combined surgery for all large ethmoidal cancers (T3 and T4) and for small tumors (T1 and T2) developed superiorly and posteriorly. Anterior T1 and T2 tumors should be operated through a single transfacial route.

Actuarial Analysis↗
PubMed1994

[Computerized evaluation of acoustic parameters of voice and speech after partial supracricoid laryngectomy with cricohyoidoepiglottopexy].

Nineteen supracricoid porticol laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) speakers and 19 normal adult laryngeal (NAL) male speakers took part in this prospective study. Computed analysis of the voice and speech parameters was performed using the Computed Speech Lab from Kay Elemectrics. Parameters recorded for voice analysis were the average fundamental frequency, the fundamental frequency standard deviation, the jitter, the shimmer, the noise to harmonic ratio and the degree of voiceless. Parameters recorded for speech analysis were the maximum phonation time of the /a/ vowel, the phrase grouping and number of words read per minute. Speech and voice parameters statistically differed among NAL and SCPL with CHEP speakers. Among SCPL with CHEP speakers, none of the following factors (age, cricopharyngeal myotomy, piriform sinus tension, associated ipsilateral neck dissection, speech rehabilitation therapy) were statistically related to the frequential and durational variables. Jitter of SCPL with CHEP speakers was reduced as time elapsed from CHEP completion increased (p = .002). Maximum phonation time was reduced if one arytenoid cartilage was resected (p = 0.025).

Adult↗
PubMed1994

[Inverted nasosinusal papilloma and lateronasal rhinotomy].

The authors report about 18 cases of inverting papillomas treated between 1972 and 1992. (17 men and 1 woman). The minimum follow-up was of 30 months. The mean age was 55 years with ages ranging from 26 to 85 years. The most frequent symptom encountered was unilateral nasal obstruction. A synchronous carcinoma occurred in 2 patients. Treatment was always surgical: lateral rhinotomy and total ethmoidectomy. A local recurrence occurred in 1 on 16 benign inverting papillomas (6.2%). No local recurrence occurred in malignant inverting papillomas treated by surgery and followed by postoperative radiation. A metachronous malignant papilloma never occurred. Because of the high risk of recurrence and malignant transformation and after analyzing the literature, the authors recommend a lateral rhinotomy and total ethmoidectomy with as limited after effects as possible.

Adult↗
PubMed1994

[Malignant transformation of inverted papilloma of the nasal sinuses.. Apropos of a series of 7 cases].

Seven cases of malignant inverting papillomas are presented (6 men and 1 woman) with ages ranging from 31 to 72 years (mean age: 58 years); the minimum follow up was 37 months. The diagnosis was based on the histopathologic analysis of biopsy in five patients. In two patients the diagnosis was confirmed by the pathological analysis of the specimen. Treatment was always surgical: lateral rhinotomy and total ethmoidectomy. Neoadjuvant chemotherapy was given to four patients. Post operative radiation therapy was delivered in five patients. Five patients on seven died: local recurrence and systemic metastases: 3; systemic metastases: 1; second primary: 1. Reports from the literature are discussed. The authors emphasize the treatment modalities based on complete tumor removal through lateral rhinotomy.

Adult↗
PubMed1993

[Classification of dysphonia. Vocal dysfunction].

A review of functional dysphonia is presented, pointing out the frequent association with organic dysphonia as a releasing or an aggravating factor. Each pathology is described with its psychopathological and histological features, its clinical and psychophysiological symptoms and its treatment, most of the time based on voice therapy.

Cysts↗
PubMed1992

Prolonged bleeding time of Chediak-Higashi cats corrected by platelet transfusion.

Cats with the Chediak-Higashi syndrome (CHS) have a platelet storage pool deficiency (SPD). Ten CHS cats were transfused with a concentrate of 51Cr-labeled platelets prepared from normal donor cats. One hour after transfusion, the donor platelet count in CHS recipient cats was 40,000-60,000/microliters. Bleeding time before transfusion was 9.1 +/- 3.0 min. When donor platelet count in CHS cats was 50,000/microliters, bleeding time was 1.7 +/- 0.2 min. Bleeding time of normal cats was 1.4 +/- 0.3 min. Bleeding time increased to 3.3 +/- 0.2 min and to 5.3 +/- 0.2 min when the platelet count was 30,000/microliters, and 15,000/microliters, respectively. The close inverse relationship between bleeding time and number of donor platelets in CHS cats (r = -0.92), suggests that prolonged bleeding time is due to a platelet abnormality, that platelet transfusion can effectively correct prolonged bleeding time in an animal model of platelet SPD and that CHS cats may be an appropriate animal model to evaluate hemostatic capabilities of transfused platelets.

Animals↗
PubMed1992

Synthesis and antibacterial activity of some novel 6-methyl- and 6-propenyl-substituted carbapenems.

The synthesis and antibacterial activity of a number of 6-methyl- and 6-propenyl-substituted carbapenems is described. The 6-(hydroxymethyl)- and 6-(aminomethyl)carbapenems possessed more potent antibacterial activity in vitro than their respective 6-(1'(R)-hydroxyethyl) or 6-(1'(R)-aminoethyl) counterparts. However, because of reduced stability, the 6-(aminomethyl)carbapenem was found to be inactive in vivo. All 6-hydroxypropenyl or 6-aminopropenyl derivatives that were prepared were less active than their respective 6-heteroethyl-substituted analogues.

Animals↗
PubMed1992

The synthesis, antibacterial, and beta-lactamase inhibitory activity of a novel asparenomycin analog.

An analog, 6-(2'-hydroxyethylidene)-4 beta-methyl-1-azabicyclo[3.2.0]hept-2-ene-2- carboxylate (11), of the carbapenem beta-lactamase inhibitor, asparenomycin A, was synthesized. It possessed a spectrum of antibacterial activity that was comparable to that of asparenomycin A but was less effective as a beta-lactamase inhibitor. With ampicillin, it only exhibited a moderate level of synergy against a variety of beta-lactamase-producing organisms. Although the presence of a 4 beta-methyl group in the analog brought about a significant increase in chemical stability relative to that of asparenomycin A, it did not result in an increase in stability to kidney dehydropeptidase enzyme.

Ampicillin↗
PubMed1992

[Stage T1 malignant tumors of the arythenoid. Analysis of a series of 26 cases].

26 malignant tumours of the arytenoid classified as T1 according to the UICC 1987, were treated in the ENT and Cervico-Facial Surgery wards to Hospital Laennec between 1961 and 1990. The natural history of these lesions, locoregional efficiency of the different treatments used, the part played by chemotherapy, survival, causes of death and therapeutic modalities used as a last measure, have been analysed. The frequency of tumours with neuroendocrine has been emphasized. Such a diagnosis should be questioned when the initial biopsy does not diagnose a well differentiated epidermoid carcinoma. The use of argyrophil colouring in order to find neurosecretive granules helps in carrying out the diagnosis. The treatment of tumours, classed T1 N0 M0, of the arytenoid, is based on partial, laryngeal surgery associated with a preventive, jugulo-carotidian-ipsilateral ganglionary intervention.

Actuarial Analysis↗
PubMed1992

[Deglutition and partial supracricoid laryngectomies].

The indications of partial supracricoid laryngectomy have become more numerous since the first descriptions made by Majer, Labayle and Piquet. The study of the published functional results emphasizes that false passages during deglutition are the main postoperative problem. This technical note is aimed at drawing attention to the various points to be respected intra- and postoperatively to allow swallowing in as physiological a manner as possible.

Cricoid Cartilage↗
PubMed1991

Relationship between performance on lumbar dynamometry and Waddell score in a population with low-back pain.

A prospective, blinded cohort study was performed to investigate the relationship between biomechanical variables measured during lumbar dynamometry and several psychological tests and measures of nonorganic pain behavior. Eighty-five men, aged 18-60 years, who had had low-back pain for longer than 5 weeks participated in the study. Nonorganic pain behavior was measured with the Waddell score, and lumbar function was measured with the Isostation B-200 Lumbar Dynamometer. Two brief psychological tests, the Coopersmith Self-Esteem inventory and an analog self-rating of wellness, were also administered. Relationships between biomechanical variables and psychological tests were calculated with the t-test, the Pearson r correlation, analysis of variance, and multiple step-wise logistic regression. Patients who exhibited excessive illness behavior (Waddell Scores 3-5) performed significantly worse (P less than .01) on almost all biomechanical variables. The Coopersmith Self-Esteem Score and "feelings" score had a slightly weaker but still significant correlation with motor performance. The results suggest that poor performance on biomechanical testing in this population may be a form of abnormal illness behavior and thus may not accurately reflect organic alterations of neuromusculoskeletal function.

Adult↗
PubMed1991

[Combined approach to malignant tumors of the ethmoid and other paranasal sinuses. Principles and results].

The authors present their experience concerning combined transfacial and neurosurgical procedures in the treatment of carcinomas of the ethmoid sinuses. 109 ethmoid-spheno-orbital tumors were treated at our department from 1982 to 1990: 85 were located into the ethmoidal and/or sphenoidal sinuses; 78 of these were malignant. Among the 65 ethmoidal carcinomas which were operated through a combined route, 48 underwent an induction chemotherapy and 19 a post-operative radiotherapy. The surgical technique is detailed, mostly the intra-cranial approach and the reconstruction of the cranial basis. Clinical results, and particularly the actuarial survival rates are discussed. The 5-year actuarial survival rate is 40% for all first hand ethmoidal adenocarcinomas. The figure reaches 52% for the patients without intra-cranial extension. At last, the 5-year actuarial survival rate is 100% for patients having a complete clinical response to induction chemotherapy.

Actuarial Analysis↗
PubMed1991

[Esthesioneuroblastomas. Could a preoperative chemotherapy improve their prognosis?].

The prognosis of malignant tumours of the olfactory epithelium of the nasal vault stays very poor. In the literature, the 5-year actuarial survival rate ranges between 50% and 65%; the 5-year recovery rate is 15% due to the high frequency of locoregional reoccurrences (60%) and metastasis (35-40%). Up to now chemotherapy was suggested as palliative treatment; but as Esthesioneuroblastomas (ETNB) appear to be sensitive to several chemotherapeutic agents (such as CDDP and 5-FU), we have decided to administer, from now on, to all patients harbouring an ETNB, an inductive chemotherapy whatever the staging and eventual diffusion of the tumour. The present paper presents our recent experience, dealing with such lesions: since 1984, 60 tumours of the ethmoid were treated in our department among which 7 ETNB (11.5%). We discuss our results concerning ETNB.

Adult↗
PubMed1991

[Extension to the infratemporal fossa of malignant tumors of the face].

The authors report about the experience of the N&T department of Laënnec Hospital with tumors of the upper facial structures invading the infratemporal fossa. This invasion is currently diagnosed preoperatively owing to the progress made in imaging. The involvement of the posterior wall of the sinus is the first CT sign. 45 tumors extended into the ITF, including 35 maxillary tumors. For the latter, the frequency of invasion of the ITF was of 38% for all histological types, and of 26% for epidermoid carcinomas. Trismus, the most characteristic sign, was present in 45% only of the tumors studied. Facial pain also was frequent. The prognosis of these tumors is extremely poor, as the survival rate was of 17% at 3 years, with a mean survival of 10 months. The failures of treatment were essentially local. The surgical treatment proposed associates scooping out the ITF to maxillary resection.

Carcinoma, Squamous Cell↗
PubMed1990

Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma.

The partial horizontal supracricoid laryngectomy with cricohyoidoepiglottopexy consists of resection of the whole thyroid cartilage and paraglottic space. The cricoid cartilage, the hyoid bone, most of the epiglottis, and at least one arytenoid cartilage are conserved. Thirty-six patients with squamous cell carcinoma of the glottis who underwent this procedure from 1974 through 1986 are presented. All 36 recovered physiologic deglutition and phonation. None required a permanent tracheotomy. The 3-year actuarial survival rate was 86.5%. The local recurrence rate was 5.5%. The indications for the procedure are carcinomas of the glottis that 1) spread beyond the confines of the membranous portion of the true vocal cord or 2) present with limitation of true vocal cord mobility. The procedure is presented as a useful alternative to radiotherapy, partial vertical laryngectomy, and total laryngectomy in select cases of glottic carcinoma.

Adult↗