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Polineni D, Lindwall J, Muther E, Durkin K, Ahrabi-Nejad C, Ruvalcaba E, Nelson E, White M, Bord E, Goodman A, Riekert K, Duncan C. P342 Development of a pilot trial of a novel tele-coaching intervention to improve treatment adherence in cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30671-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Frapin L, Clouet J, Chédeville C, Moraru C, Samarut E, Henry N, André M, Bord E, Halgand B, Lesoeur J, Fusellier M, Guicheux J, Le Visage C. Controlled release of biological factors for endogenous progenitor cell migration and intervertebral disc extracellular matrix remodelling. Biomaterials 2020; 253:120107. [PMID: 32450408 DOI: 10.1016/j.biomaterials.2020.120107] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/20/2020] [Accepted: 05/06/2020] [Indexed: 02/06/2023]
Abstract
The recent description of resident stem/progenitor cells in degenerated intervertebral discs (IVDs) supports the notion that their regenerative capacities could be harnessed to stimulate endogenous repair of the nucleus pulposus (NP). In this study, we developed a delivery system based on pullulan microbeads (PMBs) for sequential release of the chemokine CCL-5 to recruit these disc stem/progenitor cells to the NP tissue, followed by the release of the growth factors TGF-β1 and GDF-5 to induce the synthesis of a collagen type II- and aggrecan-rich extracellular matrix (ECM). Bioactivity of released CCL5 on human adipose-derived stem cells (hASCs), selected to mimic disc stem/progenitors, was demonstrated using a Transwell® chemotaxis assay. The regenerative effects of loaded PMBs were investigated in ex vivo spontaneously degenerated ovine IVDs. Fluorescent hASCs were seeded on the top cartilaginous endplates (CEPs); the degenerated NPs were injected with PMBs loaded with CCL5, TGF-β1, and GDF-5; and the IVDs were then cultured for 3, 7, and 28 days to allow for cell migration and disc regeneration. The PMBs exhibited sustained release of biological factors for 21 days. Ex vivo migration of seeded hASCs from the CEP toward the NP was demonstrated, with the cells migrating a significantly greater distance when loaded PMBs were injected (5.8 ± 1.3 mm vs. 3.5 ± 1.8 mm with no injection of PMBs). In ovine IVDs, the overall NP cellularity, the collagen type II and the aggrecan staining intensities, and the Tie2+ progenitor cell density in the NP were increased at day 28 compared to the control groups. Considered together, PMBs loaded with CCL5/TGF-β1/GDF-5 constitute an innovative and promising strategy for controlled release of growth factors to promote cell recruitment and extracellular matrix remodelling.
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Affiliation(s)
- Leslie Frapin
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France
| | - Johann Clouet
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, Pharmacie Centrale, PHU 11, Nantes, F-44093, France; Université de Nantes, UFR Sciences Biologiques et Pharmaceutiques, Nantes, F-44035, France
| | - Claire Chédeville
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France
| | - Constantin Moraru
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, Service de Neurotraumatologie, PHU4 OTONN, Nantes, F-44093, France
| | - Edouard Samarut
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, Service de Neurotraumatologie, PHU4 OTONN, Nantes, F-44093, France
| | - Nina Henry
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France
| | - Manon André
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; SC3M -"Electron Microscopy, Microcharacterization, and Functional Morphohistology Imaging" Core Facility, Structure Fédérative de Recherche François Bonamy, INSERM - UMS016, CNRS 3556, CHU Nantes, Université de Nantes, Nantes, Nantes, F-04402, France
| | - Eric Bord
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, Service de Neurotraumatologie, PHU4 OTONN, Nantes, F-44093, France
| | - Boris Halgand
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, PHU4 OTONN, Nantes, F-44093, France
| | - Julie Lesoeur
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; SC3M -"Electron Microscopy, Microcharacterization, and Functional Morphohistology Imaging" Core Facility, Structure Fédérative de Recherche François Bonamy, INSERM - UMS016, CNRS 3556, CHU Nantes, Université de Nantes, Nantes, Nantes, F-04402, France
| | - Marion Fusellier
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; Department of Diagnostic Imaging, CRIP, National Veterinary School (ONIRIS), Nantes, F-44307, France
| | - Jérôme Guicheux
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; SC3M -"Electron Microscopy, Microcharacterization, and Functional Morphohistology Imaging" Core Facility, Structure Fédérative de Recherche François Bonamy, INSERM - UMS016, CNRS 3556, CHU Nantes, Université de Nantes, Nantes, Nantes, F-04402, France; CHU Nantes, PHU4 OTONN, Nantes, F-44093, France.
| | - Catherine Le Visage
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France.
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Gluais M, Clouet J, Fusellier M, Decante C, Moraru C, Dutilleul M, Veziers J, Lesoeur J, Dumas D, Abadie J, Hamel A, Bord E, Chew SY, Guicheux J, Le Visage C. In vitro and in vivo evaluation of an electrospun-aligned microfibrous implant for Annulus fibrosus repair. Biomaterials 2019; 205:81-93. [PMID: 30909111 DOI: 10.1016/j.biomaterials.2019.03.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/21/2019] [Accepted: 03/11/2019] [Indexed: 12/29/2022]
Abstract
Annulus fibrosus (AF) impairment is associated with reherniation, discogenic pain, and disc degeneration after surgical partial discectomy. Due to a limited intrinsic healing capacity, defects in the AF persist over time and it is hence necessary to adopt an appropriate strategy to close and repair the damaged AF. In this study, a cell-free biodegradable scaffold made of polycaprolactone (PCL), electrospun, aligned microfibers exhibited high levels of cell colonization, alignment, and AF-like extracellular matrix deposition when evaluated in an explant culture model. The biomimetic multilayer fibrous scaffold was then assessed in an ovine model of AF impairment. After 4 weeks, no dislocation of the implants was detected, and only one sample out of six showed a partial delamination. Histological and immunohistochemical analyses revealed integration of the implant with the surrounding tissue as well as homogeneously aligned collagen fiber organization within each lamella compared to the disorganized and scarcer fibrous tissue in a randomly organized control fibrous scaffold. In conclusion, this biomimetic electrospun implant exhibited promising properties in terms of AF defect closure, with AF-like neotissue formation that fully integrated with the surrounding ovine tissue.
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Affiliation(s)
- Maude Gluais
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France
| | - Johann Clouet
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, Pharmacie Centrale, PHU 11, Nantes, F-44093, France; Université de Nantes, UFR Sciences Biologiques et Pharmaceutiques, Nantes, F-44035, France
| | - Marion Fusellier
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Department of Diagnostic Imaging, CRIP, ONIRIS, College of Veterinary Medicine, Food Science and Engineering, Nantes, F-44307, France
| | - Cyrille Decante
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; CHU Nantes, Service de Chirurgie Infantile, PHU5, Nantes, F-44093, France
| | - Constantin Moraru
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; CHU Nantes, Service de Neurotraumatologie, PHU4 OTONN, Nantes, F-44093, France
| | - Maeva Dutilleul
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; INSERM, UMS 016, CNRS 3556, Structure Fédérative de Recherche François Bonamy, SC3M Facility, CHU Nantes, Université de Nantes, Nantes, F-44042, France
| | - Joëlle Veziers
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; INSERM, UMS 016, CNRS 3556, Structure Fédérative de Recherche François Bonamy, SC3M Facility, CHU Nantes, Université de Nantes, Nantes, F-44042, France; CHU Nantes, PHU4 OTONN, Nantes, F-44093, France
| | - Julie Lesoeur
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; INSERM, UMS 016, CNRS 3556, Structure Fédérative de Recherche François Bonamy, SC3M Facility, CHU Nantes, Université de Nantes, Nantes, F-44042, France
| | - Dominique Dumas
- Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), UMR 7365 CNRS - Université de Lorraine, Vandœuvre-lès-Nancy, F54505, France; UMS2008 IBSLor - CNRS-UL-INSERM Plateforme d'Imagerie et de Biophysique Cellulaire PTIBC-IBISA, Vandœuvre-lès-Nancy, F54505, France
| | - Jérôme Abadie
- Animal Cancers as Models for Research in Comparative Oncology (AMaROC), ONIRIS, College of Veterinary Medicine, Food Science and Engineering, Nantes, F-44307, France
| | - Antoine Hamel
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; CHU Nantes, Service de Chirurgie Infantile, PHU5, Nantes, F-44093, France
| | - Eric Bord
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; CHU Nantes, Service de Neurotraumatologie, PHU4 OTONN, Nantes, F-44093, France
| | - Sing Yian Chew
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 637459, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 308232, Singapore
| | - Jérôme Guicheux
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France; CHU Nantes, PHU4 OTONN, Nantes, F-44093, France
| | - Catherine Le Visage
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, F-44042, France; Université de Nantes, UFR Odontologie, Nantes, F-44042, France.
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Terrier LM, Bauchet L, Rigau V, Amelot A, Zouaoui S, Filipiak I, Caille A, Almairac F, Aubriot-Lorton MH, Bergemer-Fouquet AM, Bord E, Cornu P, Czorny A, Dam Hieu P, Debono B, Delisle MB, Emery E, Farah W, Gauchotte G, Godfraind C, Guyotat J, Irthum B, Janot K, Le Reste PJ, Liguoro D, Loiseau H, Lot G, Lubrano V, Mandonnet E, Menei P, Metellus P, Milin S, Muckenstrum B, Roche PH, Rousseau A, Uro-Coste E, Vital A, Voirin J, Wager M, Zanello M, François P, Velut S, Varlet P, Figarella-Branger D, Pallud J, Zemmoura I. Natural course and prognosis of anaplastic gangliogliomas: a multicenter retrospective study of 43 cases from the French Brain Tumor Database. Neuro Oncol 2018; 19:678-688. [PMID: 28453747 DOI: 10.1093/neuonc/now186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022] Open
Abstract
Background Anaplastic gangliogliomas (GGGs) are rare tumors whose natural history is poorly documented. We aimed to define their clinical and imaging features and to identify prognostic factors. Methods Consecutive cases of anaplastic GGGs in adults prospectively entered into the French Brain Tumor Database between March 2004 and April 2014 were screened. After diagnosis was confirmed by pathological review, clinical, imaging, therapeutic, and outcome data were collected retrospectively. Results Forty-three patients with anaplastic GGG (median age, 49.4 y) from 18 centers were included. Presenting symptoms were neurological deficit (37.2%), epileptic seizure (37.2%), or increased intracranial pressure (25.6%). Typical imaging findings were unifocal location (94.7%), contrast enhancement (88.1%), central necrosis (43.2%), and mass effect (47.6%). Therapeutic strategy included surgical resection (95.3%), adjuvant radiochemotherapy (48.8%), or radiotherapy alone (27.9%). Median progression-free survival (PFS) and overall survival (OS) were 8.0 and 24.7 months, respectively. Three- and 5-year tumor recurrence rates were 69% and 100%, respectively. The 5-year survival rate was 24.9%. Considering unadjusted significant prognostic factors, tumor midline crossing and frontal location were associated with shorter OS. Temporal and parietal locations were associated with longer and shorter PFS, respectively. None of these factors remained statistically significant in multivariate analysis. Conclusions We report a large series providing clinical, imaging, therapeutic, and prognostic features of adult patients treated for an intracerebral anaplastic GGG. Our results show that pathological diagnosis is difficult, that survivals are only slightly better than for glioblastomas, and that complete surgical resection followed with adjuvant chemoradiotherapy offers longer survival.
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Affiliation(s)
- Louis-Marie Terrier
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
| | - Luc Bauchet
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.,French Brain Tumor DataBase, ICM, Montpellier, France
| | - Valérie Rigau
- French Brain Tumor DataBase, ICM, Montpellier, France.,Department of Neuropathology and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France
| | - Aymeric Amelot
- Department of Neurosurgery, Hôpital La Pitié Salpétrière, APHP, Paris, France
| | - Sonia Zouaoui
- Department of Neurosurgery and INSERM U1051, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France.,French Brain Tumor DataBase, ICM, Montpellier, France
| | - Isabelle Filipiak
- Plateforme CIRE, UMR-PRC, 37380 Nouzilly, Centre INRA Val de Loire, France
| | - Agnès Caille
- Université François-Rabelais de Tours, Tours, France.,Inserm, CIC 1415, CHRU de Tours, Tours, France.,Service de Neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France
| | - Fabien Almairac
- Department of Neurosurgery, Hôpital Pasteur, University Hospital Center, 06000, Nice, France
| | - Marie-Hélène Aubriot-Lorton
- Department of Pathology, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France
| | | | - Eric Bord
- Department of Neurosurgery and Neurotraumatology, Nantes University Hospital, Nantes, France
| | - Philippe Cornu
- Department of Neurosurgery, Hôpital La Pitié Salpétrière, APHP, Paris, France
| | - Alain Czorny
- Service de Neurochirurgie, CHU Jean-Minjoz, 3 boulevard Alexander-Fleming, Besançon cedex, France
| | - Phong Dam Hieu
- Department of Neurosurgery, CHU de la Cavale Blanche, Brest, France
| | - Bertrand Debono
- Department of Neurosurgery, Cèdres Hospital, Toulouse, France
| | - Marie-Bernadette Delisle
- Laboratoire Universitaire d'Anatomie Patholgique, Neuropathologie humaine et expérimentale, CHU Rangueil, Toulouse, France
| | - Evelyne Emery
- Department of Neurosurgery, University Hospital of Caen, Caen, France
| | - Walid Farah
- Service de Neurochirurgie, Hôpital François Mitterand, CHU de Dijon, 14 rue Paul Gaffarel, 21000 Dijon, France
| | - Guillaume Gauchotte
- Department of Pathology, CHU Nancy and INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | | | - Jacques Guyotat
- Department of Neurosurgery, Neurological Hospital, Lyon, France
| | - Bernard Irthum
- Service de neurochirurgie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - Kevin Janot
- Service de Neuroradiologie, CHRU de Tours, Tours, France
| | - Pierre-Jean Le Reste
- Department of Neurosurgery, University Hospital Pontchaillou, 2, Rue Henri Le Guilloux, 35000, Rennes, France
| | - Dominique Liguoro
- Service de neurochirurgie A, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - Hugues Loiseau
- Université de Bordeaux - Service de Neurochirurgie B, hôpital Pellegrin Tripode, Bordeaux, France
| | - Guillaume Lot
- Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France
| | - Vincent Lubrano
- Service de neurochirurgie, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA, Toulouse, France
| | | | - Philippe Menei
- Département de neurochirurgie, CHU d'Angers, 4, rue Larrey, 49940 Angers cedex 9, France
| | - Philippe Metellus
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - Serge Milin
- Department of Pathology, CHU de Poitiers, Hôpital la Milétrie, Poitiers, France
| | | | - Pierre-Hugues Roche
- Service de Neurochirurgie, Hôpital Nord, APHM, University Hospital of Marseille Aix-Marseille Univ, Marseille, France
| | - Audrey Rousseau
- Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalo-universitaire d'Angers, 4 rue Larrey, Angers Cedex, France
| | - Emmanuelle Uro-Coste
- CHU Toulouse, Hôpital de Rangueil, Service d'Anatomie et Cytologie Pathologique, Toulouse, France
| | - Anne Vital
- Bordeaux Institute of Neuroscience, CNRS UMR 5227, F-33076, Bordeaux, France
| | - Jimmy Voirin
- Department of Neurosurgery, Strasbourg-Colmar Hospital, France
| | - Michel Wager
- Department of Neurosurgery, Imaging Laboratory, University Hospital Poitiers, 2 Rue de La Miletrie, Poitiers Cedex, France
| | - Marc Zanello
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neurosurgery, Sainte-Anne Hospital, Paris, France
| | | | - Stéphane Velut
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
| | - Pascale Varlet
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neuropathology, Sainte-Anne Hospital, Paris, France
| | | | - Johan Pallud
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Neurosurgery, Sainte-Anne Hospital, Paris, France
| | - Ilyess Zemmoura
- CHRU de Tours, Service de Neurochirurgie, Tours, France.,Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France
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Amelot A, Cristini J, Moles A, Salaud C, Hamel O, Bord E, Buffenoir K. Non neurologic burst thoracolumbar fractures fixation: Case-control study. Injury 2017; 48:2150-2156. [PMID: 28807432 DOI: 10.1016/j.injury.2017.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/02/2017] [Indexed: 02/02/2023]
Abstract
STUDY DESIGN Burst fractures not associated with any neurological deficits are frequent but not therapeutic agreement on their management is available to date. This case-control study was conducted to try to help guide therapeutic decision in the treatment of such fractures. MATERIALS AND METHODS This case-control study includes consecutive retrospective evaluation of 25 case-patients treated by posterior short-segment fixation associated with kyphoplasty (SFK) in the treatment of A3 thoracolumbar unstable fractures, as compared to a control-group composed of 82 patients treated by long-segment (LF) pedicle screws. RESULTS SFK patients bled significantly less than the LF patients (p=0.04). Assessment of deformation progression, vertebral height restoration and reduction of the regional kyphotic angle in the SFK and LF groups revealed no statistically significant superiority of one approach on another. In contrast, the height of endplates was significantly increased in the SFK group (p=0.006). The patients' pain levels were significantly improved in the SFK group (p=0.002). However, patients from the SFK group stood earlier postoperatively (1.7 vs 3.7days, p=0.001). CONCLUSION We believe that SFK in vertebral fractures is as efficient as LF for bone consolidation and spine stabilization. In addition, SFK patients may use fewer analgesics.
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Affiliation(s)
- Aymeric Amelot
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
| | - Joseph Cristini
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
| | - Alexis Moles
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
| | - Celine Salaud
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
| | - Olivier Hamel
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
| | - Eric Bord
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
| | - Kevin Buffenoir
- Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France
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Amelot A, Moles A, Cristini J, Salaud C, Touzeau C, Hamel O, Bord E, Buffenoir K. Predictors of survival in patients with surgical spine multiple myeloma metastases. Surg Oncol 2016; 25:178-83. [DOI: 10.1016/j.suronc.2016.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 12/14/2022]
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Maillard N, Buffenoir-Billet K, Hamel O, Lefranc B, Sellal O, Surer N, Bord E, Grimandi G, Clouet J. A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method. Int J Surg 2015; 15:68-73. [DOI: 10.1016/j.ijsu.2014.12.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/06/2014] [Accepted: 12/28/2014] [Indexed: 11/28/2022]
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Terreaux L, Loubersac T, Hamel O, Bord E, Robert R, Buffenoir K. Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients. J Neurosurg Spine 2015; 22:246-52. [PMID: 25555053 DOI: 10.3171/2014.11.spine131013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid. Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery. After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability. This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.
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Affiliation(s)
- Luc Terreaux
- Department of Neurosurgery and Neurotraumatology, Nantes University Hospital; and
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9
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Abstract
Symptomatic vertebral hemangiomas during pregnancy are rare, as only 27 cases have been reported in the literature since 1948. However, symptomatic vertebral hemangiomas can be responsible for spinal cord compression, in which case they constitute a medical emergency, which raises management difficulties in the context of pregnancy. Pregnancy is a known factor responsible for deterioration of these vascular tumors. In this paper, the authors report 2 clinical cases of symptomatic vertebral hemangiomas during pregnancy, including 1 case of spontaneous fracture that has never been previously reported in the literature. The authors then present a brief review of the literature to discuss emergency management of this condition. The first case was a 28-year-old woman at 35 weeks of gestation, who presented with paraparesis. Spinal cord MRI demonstrated a vertebral hemangioma invading the body and posterior arch of T-3 with posterior epidural extension. Laminectomy and vertebroplasty were performed after cesarean section, allowing neurological recovery. The second case involved a 35-year-old woman who presented with spontaneous fracture of T-7 at 36 weeks of gestation, revealing a vertebral hemangioma with no neurological deficit, but it was responsible for pain and local instability. Treatment consisted of postpartum posterior interbody fusion. With a clinical and radiological follow-up of 2 years, no complications and no modification of the hemangiomas were observed. A review of the literature reveals discordant management of these rare cases, which is why the treatment course must be decided by a multidisciplinary team as a function of fetal gestational age and maternal neurological features.
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Affiliation(s)
- Alexis Moles
- Department of Neurosurgery and Neurotraumatology
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10
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Barrios L, Clément R, Visseaux G, Bord E, Le Gall F, Rodat O. A case of atypical chronic subdural hematoma: a spontaneous rupture of dural lymphoma nodule. J Forensic Leg Med 2013; 22:145-7. [PMID: 24485439 DOI: 10.1016/j.jflm.2013.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 10/08/2013] [Accepted: 12/07/2013] [Indexed: 11/30/2022]
Abstract
In forensic medicine, a chronic subdural hematoma (SDH) usually results from trauma, sometimes minimal for elderly people. The case reported here is a forensic medical description of an atypical chronic subdural hematoma. A woman aged of 40-year-old died following a coma. The autopsy and histological analyses revealed the hemorrhagic disintegration of a lymphoid nodule, a metastasis from generalized lymphoma. The combination of chronic symptomatic SDH and a tumor of the dura mater have been described, but are very rare. The possibility of trauma, even minimal, has never been excluded in these cases. In fact, the clinical picture of these patients suggested a significant movement of the brain within the cranial cavity due to the physiological decrease in brain volume. In the reported case, this particular process was excluded since the spontaneous hemorrhagic effusion produced by the meningeal lymphoid nodule was the cause of the chronic SDH. This pathophysiological explanation was possible because the entire brain and meninges were removed for histological analysis. Trauma, even minimal trauma, is not always involved in the formation of a chronic SDH.
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Affiliation(s)
- Lucia Barrios
- Laboratory of Forensic Medicine, Faculty of Medicine, 1 rue Gaston Veil, 44035 Nantes cedex, France
| | - Renaud Clément
- Laboratory of Forensic Medicine, Faculty of Medicine, 1 rue Gaston Veil, 44035 Nantes cedex, France.
| | - Guillaume Visseaux
- Laboratory of Forensic Medicine, Faculty of Medicine, 1 rue Gaston Veil, 44035 Nantes cedex, France
| | - Eric Bord
- Unit of Neurosurgery, CHU of Nantes, 1 place alexis Ricordeau, 44093 Nantes cedex 1, France
| | - Francois Le Gall
- Laboratory of Histopathology, Faculty of Medicine, 2 Avenue du Professeur Léon Bernard, 35043 Rennes cedex, France
| | - Olivier Rodat
- Laboratory of Forensic Medicine, Faculty of Medicine, 1 rue Gaston Veil, 44035 Nantes cedex, France
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11
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Durand N, Espitalier F, Ferron C, Cassagnau E, Bord E, Langlois EM, Malard O. Ethmoid Adenocarcinoma: Systematic Associated Skull Base Resection Improves Disease-Free Survival. Otolaryngol Head Neck Surg 2013. [DOI: 10.1177/0194599813496044a355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Ethmoid adenocarcinoma is an occupational tumor affecting woodworkers with prognosis correlated to the local control of the disease. Since 1998, we have developed a technique of skull base resection with reconstruction by exclusive transfacial approach. This method allows a resection of the cribriform plate and dura mater associated with the removal of the tumor with simplified postoperative features compared with mixed approach. Methods: We performed a retrospective analysis of 89 patients presenting with ethmoid adenocarcinoma from 1998 to 2010 (144 months). All patients treated with surgical removal and postoperative adjuvant radiotherapy were included. Postoperative features and oncologic outcomes were analyzed. Results: 89 patients were treated by surgical removal of the ethmoid tumor associated or not with skull base resection by a transfacial approach. The median age was 67.6 years, and 91% were occupational woodworkers. Among these 89 patients, 71 benefited from skull base resection by transfacial approach. Disease free survival was significantly better in the skull base removal group ( P = 0.009) and decreased for T4 stages ( P = 0.008). Overall survival was not influenced by the surgical technique. This method provided less morbidity than mixed approach and good results of 5-years specific survival (85 %). Conclusions: Prognosis of ethmoid adenocarcinomas is related to local control. In our experience the transfacial approach for systematic skull base resection associated with tumor removal and reconstruction is safe, efficient, and improves local control with a low morbidity, allowing a curative treatment for a larger number of patients.
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Lucas O, Hamel O, Blanchais A, Lesoeur J, Abadie J, Fellah BH, Fusellier M, Gauthier O, Bord E, Grimandi G, Vinatier C, Guicheux J, Clouet J. Laser-treated Nucleus pulposus as an innovative model of intervertebral disc degeneration. Exp Biol Med (Maywood) 2013; 237:1359-67. [PMID: 23239447 DOI: 10.1258/ebm.2012.012049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study describes an innovative experimentally induced model of intervertebral disc degeneration. This innovative approach is based on the induction of extracellular matrix disorders in the intervertebral disc (IVD) using a diode laser. For this study, 15 one-year-old and five 30-month-old New Zealand White rabbits were used. Two procedures were tested to trigger IVD degeneration: needle aspiration (reference technique) and a laser approach. The IVD degeneration process was assessed 20, 40, 60, 90 and 120 days after surgery by X-ray radiography (IVD height), magnetic resonance imaging (MRI) (T2 intensity of IVD signal) and histological analysis using modified Boos' scoring. Our data indicate that a marked IVD degeneration was found compared with sham-operated animals regardless of the procedure tested. A significant decrease in disc height on X-ray radiographs was first demonstrated. In addition, MRI disc signals were significantly reduced in both groups. Finally, a statistically significant increase in Boos' scoring was found in both laser and aspiration-induced IVD degeneration. Interestingly, IVD degeneration induced by laser treatment was more progressive compared with aspiration. Moreover, the histological results indicated that laser-induced disc degeneration was quite similar to that obtained during the natural aging process as observed in 30-month-old rabbits. Our study describes the consistency of this innovative experimentally-induced animal model of IVD degeneration. The radiological, MRI and histological data confirm its relevance. The histological examination indicates that IVD degeneration induced by laser treatment is comparable to the degenerative process observed during the onset of spontaneous IVD degeneration. This model could be a useful tool to help us validate biomaterial-assisted, cell-based, regenerative medicine strategies for the prevention and treatment of IVD degeneration.
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Affiliation(s)
- Olivier Lucas
- INSERM (Institut National de la Santé et de la Recherche Médicale) UMRS791, LIOAD, Group STEP 'Skeletal Tissue Engineering and Physiopathology', School of Dental Surgery, Nantes, France
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Bord E, Farrell Z, Heur W, Keslin W, Laughlin R, Leedom H, LeMense A, Lucre S, Marable C, Mielke S, Olk S, Orozco C, Rosio C, Schubert J, Smith S, Wade G, Weeden M, Sampe D, Frank DW. Feel the Burn, then Feel the Death. ExoU as a Phospholipase. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.lb180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- E. Bord
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - W. Heur
- Brown Deer HIgh SchoolBrown DeerWI
| | | | | | | | | | - S. Lucre
- Brown Deer HIgh SchoolBrown DeerWI
| | | | | | - S. Olk
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - C. Rosio
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - S. Smith
- Brown Deer HIgh SchoolBrown DeerWI
| | - G. Wade
- Brown Deer HIgh SchoolBrown DeerWI
| | | | - D. Sampe
- Brown Deer HIgh SchoolBrown DeerWI
| | - D. W. Frank
- Microbiology and Molecular GeneticsMedical College of WisconsinMilwaukeeWI
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Espitalier F, Michel G, Mourrain-Langlois E, Lebouvier T, Bord E, Ferron C, Malard O. Leptomeningeal carcinomatosis from ethmoid sinus adenocarcinoma. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 131:49-51. [PMID: 23273418 DOI: 10.1016/j.anorl.2012.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 06/06/2012] [Accepted: 07/09/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Adenocarcinoma of the ethmoid is an aggressive tumor, with potential extension to surrounding structures. Leptomeningeal extension is a rarely reported entity. CASE REPORT A carpenter, aged 55, developed multifocal cranial nerve-related symptoms 1 week after resection of adenocarcinoma of the ethmoid, evolving towards deteriorated general health status and death 10 weeks later. Brain MRI showed diffuse contrast enhancement of the cranial nerves, and repeated cerebrospinal fluid (CSF) examination found increased protein concentration associated with decreased glucose concentration, without malignant cells. The diagnosis of carcinomatous meningitis was based on the association of clinical, CSF and brain MRI data. DISCUSSION/CONCLUSION Leptomeningeal dissemination of adenocarcinoma of the ethmoid is rare; diagnosis is guided by clinical signs. MRI reveals neurological spread, but the presence of malignant cells in the CSF is sufficient for diagnosis. Due to poor prognosis, the only currently available treatments are palliative.
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Affiliation(s)
- F Espitalier
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - G Michel
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - E Mourrain-Langlois
- Service de Radiologie, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - T Lebouvier
- Service de Neurologie, Hôpital Nord-Laënnec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 01, France
| | - E Bord
- Service de Neurotraumatologie, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - C Ferron
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - O Malard
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
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15
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Buffenoir-Billet K, Hamel O, Bord E, Robert R. Kyphoplastie dans le traitement du tassement ostéoporotique : indications, bénéfices et risques. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Buffenoir-Billet K, Hamel O, Bord E, Robert R. Apport de la chirurgie mini-invasive dans le traitement des pathologies axiales traumatiques. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Buffenoir-Billet K, Hamel O, Bord E, Robert R. Kyphoplasty in the treatment of osteoporotic settlement: Indications, benefits and risks. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Buffenoir-Billet K, Hamel O, Bord E, Robert R. Contribution of minimally invasive surgery in the management of traumatic axial pathologies. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Clouet J, Grimandi G, Pot-Vaucel M, Masson M, Fellah HB, Guigand L, Cherel Y, Bord E, Rannou F, Weiss P, Guicheux J, Vinatier C. Identification of phenotypic discriminating markers for intervertebral disc cells and articular chondrocytes. Rheumatology (Oxford) 2009; 48:1447-50. [PMID: 19748963 DOI: 10.1093/rheumatology/kep262] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The present study was conducted to improve our knowledge of intervertebral disc (IVD) cell biology by comparing the phenotype of nucleus pulposus (NP) and annulus fibrosus (AF) cells with that of articular chondrocytes (ACs). METHODS Rabbit cells from NP and AF were isolated and their phenotype was compared with that of AC by real-time PCR analysis of type I (COL1A1), II (COL2A1) and V (COL5A1) collagens, aggrecan transcript (AGC1), matrix Gla protein (MGP) and Htra serine peptidase 1 (Htra1). RESULTS Transcript analysis indicated that despite certain similarities, IVD cells exhibit distinct COL2A1/COL1A1 and COL2A1/AGC1 ratios as compared with AC. The expression pattern of COL5A1, MGP and Htra1 makes it possible to define a phenotypic signature for NP and AF cells. CONCLUSIONS Our study shows that NP and AF cells exhibit a clearly distinguishable phenotype from that of AC. Type V collagen, MGP and HtrA1 could greatly help to discriminate among NP, AF and AC cells.
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Affiliation(s)
- Johann Clouet
- INSERM U791, Osteoarticular and Dental Tissue Engineering, University of Nantes, 1-Place Alexis Ricordeau, 44042, Nantes Cedex 1, France
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Khalfallah M, Faure A, Hamel O, Cantarovich D, Doe K, Raoul S, Bord E, Robert R. [Dialysis-associated spondyloarthropathy. Case report and literature review]. Neurochirurgie 2006; 51:165-72. [PMID: 16389902 DOI: 10.1016/s0028-3770(05)83472-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hemodialysis has considerably prolonged the life of patients suffering from terminal renal failure. However, long-term hemodialysis leads to new bone complications and spinal disorders such as destructive spondyloarthropathy (DSA). At the present time DSA is reported in 8% to 18% of the dialysed patients. Diagnosis is based on severe narrowing of the intervertebral disk, erosions and geodes of the adjacent vertebral plates simulating infectious spondylitis. Lesions progressively involve posterior joints and may lead to severe destruction of the spine. The pathogenesis of this syndrome is still unknown. Several factors have been implicated, including microcrystal deposition, amyloidosis, inflammatory and foreign body reactions and suggest that the pathogenesis of erosive spondyloarthropathies of hemodialysed patients is multifactorial. Spinal instability inducing myelopathy and radiculopathy were observed in 8% of the cases. Treatment must be accorded to the natural disease course and to the quality of the bone. We report the case of a chronic dialysed patient with destructive spondyloarthropathy involving the cervical and thoracic spine. Pathogenesis, radiological datas and therapeutic approach are discussed.
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Affiliation(s)
- M Khalfallah
- Servie de Neurochirurgie, Centre Hospitalier de la Côte-Basque, 64109 Bayonne
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Abstract
The investigation of patients suffering from perineal pain when sitting led us to perform an anatomical study of the pudendal nerve. We dissected 50 cadavers and found areas of conflict for the nerve fibers. The nerve trunk can become entrapped at the level of the ischiatic spine, in the Alcock's canal and when it crosses the falciform process. Considering the clinical and neurophysiological data, this type of chronic pain may arise from compression of the nerve between the sacro-tuberal and the sacro-spinal ligaments, and/or in the fascia of the internal obturator muscle. Much like treatment of entrapment of the median nerve in the wrist, we decided to treat chronic perineal pain by nerve blocks, and later by surgery. We describe here the clinical symptoms, the neurophysiological data, and the technique of the nerve blocks. For patients with persistent pain, we propose a posterior surgical approach which has provided successful pain relief in two third of patients.
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Affiliation(s)
- R Robert
- Service de Neurotraumatologie, Hôtel-Dieu, CHU, 44035 Nantes Cedex 01.
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Robert R, Raoul S, Hamel O, Doe K, Lanoiselée JM, Berthelot JM, Caillon F, Bord E. [Chronic lower back pain: a new therapeutic approach]. Neurochirurgie 2004; 50:117-22. [PMID: 15213641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Lower back pain is a common complaint of patients seen in our consultations. Despite progress, surgical procedures are still often unsuccessful in relieving pain. Blocks performed in the epidural spaces or more often in the articular facets have provided poor relief of chronic lower back pain. The pain has vegetative components. Considering anatomic findings, we describe the innervation of the peridiscal tIssues which suffer during degenarative conditions. We analyze the course of the autogenic nerves mediating lumbar pain, and select the site of the blocks necessary to obtain optimal selective pain relief. A well-defined block at the level of the communicating rami is described.
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Affiliation(s)
- R Robert
- Service de Neurotraumatologie, Hôtel-Dieu, CHU, Nantes.
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Abstract
✓ The authors describe a case of arachnoiditis ossificans (AO) of the cauda equina. The lesion is a rare pathological entity usually confined to the thoracic and high lumbar regions that can cause progressive spinal cord and cauda equina compression, inducing severe neurological deterioration. The authors analyze the clinical symptoms, radiological features, histological data, and treatment options relating to this case and 13 others described in the literature; additionally, they consider the possible mechanisms responsible for ossification of the leptomeninges. Although clustered arachnoidal cells are usually implicated in its pathogenesis, an environment induced by arachnoiditis and disturbed cerebrospinal fluid flow appears to be a more important factor. A therapeutic strategy is proposed for AO for which no effective treatment currently exists.
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Affiliation(s)
- Alexis Faure
- Department of Neurotraumatology, University Hospital (Hôtel-Dieu), Nantes, France.
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Faure A, Monteiro R, Hamel O, Raoul S, Szapiro J, Alcheikh M, Bord E, Robert R. Inverted-hook occipital clamp system in occipitocervical fixation. Technical note. J Neurosurg 2002; 97:135-41. [PMID: 12120638 DOI: 10.3171/spi.2002.97.1.0135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe an occipitocervical fixation procedure in which they use inverted occipital hooks inserted through a burr hole drilled in the squamous part of the occipital bone. Fifteen patients with unstable lesions of the occipitocervical junction underwent occipitocervical internal fixation. The mean follow-up period was 21 months (range 2-63 months). No implant failed, and postoperative immobilization was not required. The placement of a posterior occipitocervical graft (for which fusion is uncertain) can be avoided in certain conditions.
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Affiliation(s)
- Alexis Faure
- Department of Neurotraumatology, University Hospital (Hôtel-Dieu), Nantes, France.
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Faure A, Bord E, Monteiro da Silva R, Diaz Saldaña A, Robert R. Occipitocervical fixation with a single occipital clamp using inverted hooks. Eur Spine J 1998; 7:80-3. [PMID: 9580455 PMCID: PMC3615371 DOI: 10.1007/s005860050034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A simple occipitocervical osteosynthesis technique using cervical CCD (compact Cotrel-Dubousset) material is described in a clinical case. The originality of this technique consists in the occipital fastening used, involving the simultaneous insertion of two hooks into a single burr-hole. This greatly facilitated the positioning of the osteosynthesis rods, reduced surgical time, and provided immediate stability. These criteria are of considerable importance since this difficult surgical procedure is often performed in patients in a frail condition.
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Affiliation(s)
- A Faure
- Department of Neurotraumatology, Centre Hospitalier Universitaire, Hôtel-Dieu, Nantes, France
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Cales P, Voigt JJ, Suduca JM, Bord E, Vinel JP, Pascal JP. [Cholestatic hepatitis caused by carbimazole]. Presse Med 1987; 16:1005. [PMID: 2955303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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