17 results on '"Philippe Otten"'
Search Results
2. Spektrum der Wirbelsäulenchirurgie in der Schweiz
- Author
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Hans-Heinrich Trouillier, Philippe Otten, Gianluca Maestretti, Paul F. Heini, Emin Aghayev, Lorin Michael Benneker, Fabrice Külling, and Dezsö Jeszenszky
- Abstract
Das internationale «Spine Tango»-Wirbelsaulenregister wurde 2002 gegrundet, um das therapeutische Bemuhen auf nationaler und internationaler Ebene vergleichen und sich in Richtung Harmonisierung und Standardisierung der Therapien bewegen zu konnen.
- Published
- 2019
3. Spectre de la chirurgie rachidienne en Suisse
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Fabrice Külling, Dezsö Jeszenszky, Philippe Otten, Lorin Michael Benneker, Gianluca Maestretti, Emin Aghayev, Paul F. Heini, and Hans-Heinrich Trouillier
- Abstract
Le registre international du rachis «Spine Tango» a ete lance en 2002 afin de pouvoir comparer les efforts therapeutiques au niveau national et international et de tendre vers une harmonisation et une standardisation des traitements.
- Published
- 2019
4. Giant Extra-Axial Cavernous Angioma of the Falx: Case Report
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Caroline Passaplan, Alexandre Simonin, Sara Sancho, Philippe Otten, and Angelo Rusconi
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Hemangioma ,Angioma ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Parenchyma ,medicine ,Meningeal Neoplasms ,Humans ,business.industry ,Port-wine stain ,Anatomy ,Middle Aged ,medicine.disease ,Falx cerebri ,medicine.anatomical_structure ,Hemangioma, Cavernous ,Anterior cranial fossa ,030220 oncology & carcinogenesis ,Cavernous sinus ,Surgery ,Female ,Neurology (clinical) ,Dura Mater ,medicine.symptom ,business ,Meningioma ,030217 neurology & neurosurgery - Abstract
BACKGROUND AND IMPORTANCE Cavernous angiomas or cavernomas are vascular malformations usually located in the brain parenchyma. However, they rarely present as extra-axial lesions, attached to the dura, and may mimic meningiomas. Most reported cases concern the cavernous sinus region and other locations are very uncommon. CLINICAL PRESENTATION A 61-yr-old female known for long-standing mental illness presented with progressive gait instability. Imaging studies revealed an extra-axial lesion in relation to the anterior part of the falx cerebri. An interhemispheric approach was used to remove the lesion. Pathological analysis revealed features compatible with an extra-axial cavernoma: structureless vascular channels lacking smooth muscle and elastic lamellae, without intervening brain parenchyma. CONCLUSION Cavernous angiomas or cavernomas can present as extra-axial lesions. Although progressive growth can be observed, they should not be considered as tumoral lesions, because there is no cellular duplication. Unlike other locations, resection of anterior cranial fossa extra-axial cavernomas seems to be facilitated by minimal bleeding.
- Published
- 2017
5. Pott's puffy tumor presenting as a frontal swelling under a Swiss army helmet
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Veronique Erard, Victor Colin, Edouard Stauffer, Alexandre Simonin, Philippe Otten, Caroline Passaplan, Angelo Rusconi, and Gianluca Maestretti
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Male ,medicine.medical_specialty ,Subperiosteal abscess ,Pott Puffy Tumor ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Frontal Sinusitis ,Clinical history ,Streptococcal Infections ,medicine ,Humans ,Pott's puffy tumor ,business.industry ,030206 dentistry ,General Medicine ,medicine.disease ,Dermatology ,Abscess ,Anti-Bacterial Agents ,030211 gastroenterology & hepatology ,Surgery ,Head Protective Devices ,Neurology (clinical) ,Presentation (obstetrics) ,business ,Chronic frontal sinusitis - Abstract
In this report, we describe an uncommon presentation of a Pott's puffy tumor, which is defined as a subperiosteal abscess related to a chronic frontal sinusitis. This condition has become rare in our part of the world because of the widespread use of antibiotics. Clinical history, investigations, and management are presented.
- Published
- 2017
6. Misdiagnosed atypical Lemierre's Syndrome: what a neurosurgeon has to know
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Riccardo, Ciarpaglini and Philippe, Otten
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Male ,Fusobacterium Infections ,Humans ,Pharyngitis ,Thrombosis ,Jugular Veins - Published
- 2016
7. Treatment of Discogenic Low Back Pain by Total Disc Arthroplasty using the Prodisc Prosthesis: Analysis of a Prospective Cohort Study with Five- Year Clinical Follow-Up
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Mathias Jacobi, Titus Bihl, Federico Balague, Philippe Otten, Peter Wahl, Gianluca Maestretti, and Nikolaus Reischl
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Leg pain ,Total Disc Arthroplasty ,Prosthesis ,Low back pain ,Surgery ,Patient satisfaction ,Lumbar ,medicine ,Physical therapy ,medicine.symptom ,Range of motion ,Prospective cohort study ,business - Abstract
Few studies are available for the long-term outcome of disc arthroplasty using the Prodisc prostheses. We evaluated if total disc arthroplasty using the Prodisc prosthesis could be a reliable treatment for disabling low-back pain, and if long lasting improvement in quality-of-life could be achieved. We hypothesized that analysis of a prospective cohort study with a mean 5-year follow-up, clinical control, done by rheumatologists not involved in treatment would provide data that was not influenced by surgeon bias. Thirty-nine patients undergoing disc replacement between May 2002 and July 2004 were the study population. Fifty-two levels from L2 to S1, of which 28 were single-level, 9 were double-level and two were three levels, were treated. Independent clinical evaluation by uninvolved rheumatologists was done preoperatively at 1, 2 and 5 years after surgery. The Visual Analogue Score (VAS) for leg and lumbar pain intensity, Oswestry Low Back Pain Disability Index (ODI), Short Form-36 (SF-36), patient satisfaction, and the return to work rate were assessed. Analysis revealed a significant amelioration of the VAS for back and leg pain, as well as for the ODI and the SF-36. Since this is a motion preservation device study it is important to include range of motion ROM analysis at the follow-up times. These data suggest that total disc arthroplasty using the prodisc prosthesis is a good treatment option for disabling discogenic low back pain. The improvement achieved after 1 year could be conserved at 2- and 5-year follow
- Published
- 2011
8. Primary cranial vault lymphoma with brain infiltration: case report and review of the literature
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Philippe Otten and Riccardo Ciarpaglini
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Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Skull Neoplasms ,Meningioma ,Lesion ,Rare Diseases ,Cranial vault ,medicine ,Humans ,Neoplasm Invasiveness ,Subdural space ,Aged ,Brain Neoplasms ,business.industry ,General Medicine ,medicine.disease ,Combined Modality Therapy ,Cranioplasty ,Lymphoma ,medicine.anatomical_structure ,Scalp ,Female ,Surgery ,Lymphoma, Large B-Cell, Diffuse ,Neurology (clinical) ,medicine.symptom ,business ,Infiltration (medical) - Abstract
Primary cranial vault lymphomas (PCVL) are extremely rare tumours. An extensive review of the literature shows that only 26 previous PCVL were reported while only four presented with cortex infiltration. We present a singular case of a 74-year-old woman with a voluminous painful mass lesion of the right temporal scalp. Preoperative neuroradiological assessment showed a lesion involving the scalp, the cranial vault and the subdural space; underneath, a cerebral oedema suggested brain infiltration. The absence of any neurological signs despite brain infiltration makes this case exceptional. The preoperative diagnostic hypothesis was infiltrating meningioma, and a surgical excision was scheduled. A radical removal of the lesion was obtained, but the histopathological result was unexpectedly large B-cell non-Hodgkin lymphoma. Further investigations failed to identify pathology elsewhere confirming the diagnosis of PCVL. Postoperative radio and chemotherapy were administered. The patient is free from signs of disease recurrence at a 2-year follow-up. Radiological features are debated with the aim to stress the possible differential diagnosis, and prognostic factors are discussed. Even if an accepted therapeutic algorithm is far from being defined for these extremely rare tumours, we suggest that radical surgical removal associated with radio and chemotherapy could be the best choice in these particular cases.
- Published
- 2012
9. Sacroiliac joint syndrome 10 years after lumbar arthroplasty: the importance of spinopelvic alignment
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Emanuel Gautier, Philippe Otten, Gianluca Maestretti, Riccardo Ciarpaglini, Vo Quoc Duy, and Patrick Sutter
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musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Sacrum ,medicine.medical_treatment ,Young Adult ,Lumbar ,Sacroiliac joint dysfunction ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Arthroplasty, Replacement ,Pelvic Bones ,Postural Balance ,Orthodontics ,Sacroiliac joint ,Lumbar Vertebrae ,business.industry ,Sagittal balance ,Sacroiliac Joint ,Bone Malalignment ,Middle Aged ,Arthroplasty ,Sagittal plane ,Surgery ,medicine.anatomical_structure ,Female ,Neurosurgery ,medicine.symptom ,Joint Diseases ,business ,Lumbar lordosis - Abstract
Sagittal balance is an independent predictor of outcomes in spinal care and several authors focused their attention on the lumbar lordosis restoration as the key point to prevent secondary sacroiliac joint dysfunction (SIJD) after fusion. On the other hand, lumbar disc arthroplasty allows preservation of motion avoiding increased stress on the spinopelvic junction and preventing iatrogenic sagittal imbalance.We analyze the incidence of a secondary SIJD and the spinopelvic alignment on a series of 31 consecutive lumbar disc prosthesis with a 10-year follow-up.Sagittal balance assessment showed no significant variation of preoperative spinopelvic parameters. Four patients (12 %) presented a symptomatic SIJD. Only two of them required a percutaneous SIJ fixation. Both of them presented a fused L5-S1 prosthesis.The low rate of SIJD 10 years after lumbar arthroplasty might be explained by the preservation of the spinopelvic balance.
- Published
- 2014
10. Occipitalisation of Atlas with Sudden Onset
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Patrick Sutter, Gianluca Maestretti, Riccardo Ciarpaglini, and Philippe Otten
- Subjects
education.field_of_study ,Skull ,medicine.anatomical_structure ,business.industry ,Atlas (anatomy) ,Population ,Medicine ,Anatomy ,Synostosis ,business ,medicine.disease ,education ,Sudden onset - Abstract
Occipitalisation of Atlas with Sudden Onset Occipitalization or assimilation of the atlas, atlanto-occipital fusion and occipito-cervical synostosis are synonyms and indicate a fusion of C1 to the base of the skull. This condition was initially described by Rokitansky in 1844 and was demonstrated radiologically by Schuller in 1911. Atlo-occipital fusion can be complete or partial, unilateral or bilateral and bony or fibrous. Its incidence is reported from 0.14 to 3.63% according to different authors in the whole population, with equal repartition in both sexes and it is considered the most common anomaly of the cranio-cervical junction.
- Published
- 2014
11. Non-union after a two-level anterior cervical decompression and fusion with Surgibone™
- Author
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Philippe Otten, Anne-Marie Kurt, and Pascal Seite
- Subjects
medicine.medical_specialty ,Osteosynthesis ,business.industry ,General Medicine ,Spondylolysis ,medicine.disease ,Non union ,Degenerative disc disease ,Surgery ,Bovine bone ,Neurology ,Physiology (medical) ,Cervical decompression ,medicine ,Neurology (clinical) ,Cervical fusion ,business ,Histological examination - Abstract
Numerous alternative implants have been proposed for cervical fusion, including bovine bone. We report a case of a two level cervical interbody fusion for degenerative disc disease using bovine dowels of Unilab Surgibonetrade mark. We describe the clinical evolution and histological examination after failure of the procedure due to non-union of the Surgibone implants. Alternative grafting substitutes are discussed with respect to their immunological, cytotoxic and osteoinductive aspects. Based on a literature review we conclude that allografts have a significantly better cytological biocompatibility than Surgibonetrade mark and allow a higher fusion rate. The ideal graft remains autologous bone.
- Published
- 1998
12. Five-year results of lumbar disc prostheses in the SWISSspine registry
- Author
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Oliver N. Hausmann, François Porchet, Stefan Schären, Emin Aghayev, Christoph Röder, Friedrich Sgier, Christian B. Bärlocher, Thomas M Markwalder, Philippe Otten, Martin Baur, Paul F. Heini, Gianluca Maestretti, Michal Neukamp, and Christian Etter
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Total Disc Replacement ,Joint Prosthesis ,610 Medicine & health ,Intervertebral Disc Degeneration ,Kaplan-Meier Estimate ,Young Adult ,Lumbar ,Postoperative Complications ,Quality of life ,Survivorship curve ,Outcome Assessment, Health Care ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Registries ,Range of Motion, Articular ,Adverse effect ,Intervertebral Disc ,Aged ,Pain Measurement ,Lumbar Vertebrae ,business.industry ,Ossification ,Postoperative complication ,Middle Aged ,Surgery ,Treatment Outcome ,Quality of Life ,Female ,Neurosurgery ,medicine.symptom ,Range of motion ,business ,Low Back Pain ,Follow-Up Studies - Abstract
PURPOSE The Swiss Federal Office of Public Health demanded a nationwide HTA registry for lumbar total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISS spine registry is to generate evidence about the safety and efficiency of lumbar TDA. METHODS Two hundred forty-eight cases treated between 3-2005 and 6-2006, who were eligible for the 5-year follow-up were included in the study. Follow-up rates for 3-6 months, 1, 2 and 5 years were 85.9, 77.0, 44.0 and 51.2 %, respectively. Outcome measures were back and leg pain, medication consumption, quality of life, intraoperative and postoperative complication and revision rates. Additionally, segmental mobility, ossification, adjacent and distant segment degeneration were analysed at the 5-year follow-up. RESULTS There was a significant, clinically relevant and lasting reduction of back (preop/postop 73/29 VAS points) and leg pain (preop/postop VAS 55/22) and a consequently decreased analgesics consumption and quality of life improvement (preop/postop 0.30/0.76 EQ-5D score points) until 5 years after surgery. The rates for intraoperative and early postoperative complications were 4.4 and 3.2 %, respectively. The overall complication rate during five postoperative years was 23.4 %, and the adjacent segment degeneration rate was 10.7 %. In 4.4 % of patients, a revision surgery was performed. Cumulative survivorship probability for a revision/re-intervention-free 5-year postoperative course was 90.4 %. At the 5-year follow-up, the average range of motion of the mobile segments (86.8 %) was 9.7°. In 43.9 % of patients, osteophytes at least potentially affecting the range of motion were seen. CONCLUSIONS Lumbar TDA appeared as efficient in long-term pain alleviation, consequent reduction of pain medication consumption and improvement of quality of life. The procedure also appeared sufficiently safe, but surgeons have to be aware of a list of potential adverse events. The outcome is stable over the 5-year postoperative period. The vast majority of treated segments remained mobile after 5 years, although almost half of patients showed osteophytes.
- Published
- 2013
13. Retroperitoneal bleeding after L4–L5 diskectomy in a patient with crossed-fused renal ectopia: Treatment by selective embolization
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Philippe Otten, P Fransen, Dominique Didier, and Haleem G. Khan
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Postoperative Hemorrhage ,Kidney ,Radiography, Interventional ,Iliac Artery ,Renal Artery ,medicine.artery ,medicine ,Humans ,Retroperitoneal space ,Radiology, Nuclear Medicine and imaging ,Retroperitoneal Space ,Embolization ,Retroperitoneal hemorrhage ,Renal artery ,Diskectomy ,Lumbar Vertebrae ,Renal ectopia ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,medicine.disease ,Aneurysm ,Embolization, Therapeutic ,Surgery ,Intervertebral disk ,medicine.anatomical_structure ,Infarction ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Intervertebral Disc Displacement - Abstract
We present a complication of L4-L5 disk surgery and its treatment by interventional radiology which has not previously been reported. An accessory inferior polar artery of a crossed-fused renal ectopia was injured and the bleeding was successfully managed by selective embolization.
- Published
- 1996
14. Late infections after dynamic stabilization of the lumbar spine with Dynesys
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Philippe Otten, Jon A. Lutz, and Gianluca Maestretti
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musculoskeletal diseases ,Adjacent segment ,Adult ,Male ,Reoperation ,medicine.medical_specialty ,Bone Screws ,Postoperative Complications ,medicine ,Back pain ,Humans ,Orthopedics and Sports Medicine ,Aged ,Retrospective Studies ,High rate ,Lumbar Vertebrae ,business.industry ,Propionibacterium ,Retrospective cohort study ,Middle Aged ,equipment and supplies ,Surgery ,Prosthesis Failure ,Screw loosening ,Lumbar spine ,Female ,Original Article ,Implant ,Neurosurgery ,medicine.symptom ,business ,Actinomycetales Infections - Abstract
Dynamic stabilization of the spine was developed as an alternative to rigid fusion in chronic back pain to reduce the risk of adjacent segment degeneration. Dynamic neutralization system (Dynesys, Zimmer CH) is one of the most popular systems available, but some midterm studies show revision rates as high as 30 %. Some late infectious complications in our patients prompted us to review them systematically. Propionibacterium recently has been shown to cause subtle infections of prosthetic material. Here, we report on a consecutive series of 50 Dynesys implants. In a median follow-up of 51 months (range 0–91), we identified 12 infectious and 11 non-infectious complications necessitating reoperation or removal of the implant in 17 patients. Material infections occurred after a median of 52 months (2–77) and were due to Propionibacterium alone (n = 4) or in combination (n = 3) in seven out of 11 patients. Clinical presentation combines new or increasing pain associated with signs of screw loosening on conventional X-rays; however, as many as 73.5 % of patients present some degree of screw loosening without being at all symptomatic of infection. The high rate of late infections with low-grade germs and the frequency of screw loosening signs made us suspect a lack of integration at the bone-screw interface. Surgeons should be suspicious if the patient presents a combination of new or increasing pain and signs of screw loosening, and aggressive revision is recommended in these cases.
- Published
- 2011
15. Indications and experience with balloon kyphoplasty in trauma
- Author
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Jorrit-Jan Verlaan, Stipe Krajinovic, F. Cumhur Oner, Wouter J.A. Dhert, Philippe Otten, and Gianluca Maestretti
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Traumatic fracture ,medicine.medical_specialty ,business.industry ,technology, industry, and agriculture ,medicine.disease ,Balloon ,Surgery ,Burst fracture ,Vertebral height ,Injectable bone ,Medicine ,Pedicle screw ,business ,Cement leakage - Abstract
The safety and treatment possibilities of balloon kyphoplasty have rapidly led to the use of this technique in traumatic vertebral fractures. Initially balloon kyphoplasty was used in osteoporotic patients who sustained a fall and a subsequent traumatic fracture; however, the general rules of balloon kyphoplasty also apply in trauma cases and the guidelines shown above remain valid. Although we now have a safe and effective method of restoring vertebral height and reducing the fracture, the injectable bone substance is still an issue, especially in trauma. In general there is consensus that polymethylmethacrylate (PMMA) is safer in the elderly, as it is not resorbed or remodeled, but in young patients consensus has not yet been found on whether the use of PMMA in traumatic fracture is safe. During the past five years resorbable calcium phosphate cements (CPC) have therefore gained in popularity. In this chapter we summarize knowledge of the use of balloon kyphoplasty with resorbable CPC in traumatic fractures in young patients.
- Published
- 2008
16. Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures
- Author
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Philippe Otten, Claus Cremer, Roland Peter Jakob, and Gianluca Maestretti
- Subjects
Adult ,Calcium Phosphates ,Male ,medicine.medical_specialty ,Adolescent ,Visual analogue scale ,Reviewer's Comment ,Radiography ,Kyphosis ,Balloon ,Catheterization ,Fractures, Compression ,Deformity ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Prospective Studies ,Prospective cohort study ,business.industry ,Bone Cements ,Middle Aged ,medicine.disease ,Bone cement ,Surgery ,Treatment Outcome ,Spinal Fractures ,Female ,Neurosurgery ,medicine.symptom ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Prospective consecutive series cases study to investigate the clinical and radiological results of standalone balloon kyphoplasty and cement augmentation with calcium phosphate in traumatic fractures. Independent observer evaluation of radiological and computer tomography results, visual analogue scale (VAS), Roland-Morris score and complications with acute traumatic compression fractures type A, treated with a standalone balloon kyphoplasty and cement augmentation with calcium phosphate (Calcibon); follow-up time at a mean of 30 months (24-37 months). From August 2002 to August 2003, consecutive patients with traumatic compression fractures (Magerl type A) without neurological deficit underwent standalone kyphoplasty with Calcibon. We report here the pre-, post-operative and the follow-up results, applying the VAS (0-10) for pain rating, the Roland-Morris (0-24) disability score, CT-scan examination, detailed radiographic evaluation of vertebral body (VB) deformity and segmental kyphosis measurement. The pre-operative X-ray measurements, VAS and the 7 days Roland-Morris scores are compared with the post-operative and the 30 months follow-up findings. Twenty-eight patients with 33 treated fracture levels were included in this study. The mean initial vertebral deformity (VB kyphosis) was 17 degrees, corrected to a post-operative of 6 degrees. We noted a loss of correction at the follow-up in comparison to the post-operative standing X-ray at 24 h of 3 degrees vertebral deformity and 3 degrees segmental kyphosis. The VAS score demonstrates a decrease over time from a mean of 8.7-3.1 at 7 days and to 0.8 at the last follow-up. The Roland-Morris disability score demonstrates a similar improvement. We noticed no major complications related to the procedure. The mean cement resorption after 1 year was 20.3% (0.3-35.3%) and is related to the individual biological resorption process and is not predictable. All patients with vertebral fractures as sole medical problem were discharged within 48 h. All active patients returned to the same work within 3 months with the same working ability as before the accident. Standalone balloon kyphoplasty is a potential alternative mini-invasive technique to reduce the fractures. However, due to the intrinsic characteristic of calcium phosphate cement (Calcibon) we recommend the application of this biological cement for standalone reduction and stabilisation only in fractures type A1 and A3.1 in young patient. In case of higher destruction levels of the VB, we propose the utilisation of Calcibon associated with posterior instrumentation. Having regard to the pointed out indications, our preliminary results demonstrate a new possibility to treat this kind of fractures, allowing a rapid handling of pain, early discharge and return to normal activities.
- Published
- 2004
17. Clinical trial substantiates the predictive value of O-6-methylguanine-DNA methyltransferase promoter methylation in glioblastoma patients treated with temozolomide
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Sandrine Ostermann, Pierre-Yves Dietrich, Annie Claire Diserens, Roger Stupp, Monika E. Hegi, Nicolas de Tribolet, Guy van Melle, Sophie Godard, Philippe Otten, and Luca Regli
- Subjects
Adult ,Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,Methyltransferase ,Time Factors ,DNA repair ,Dacarbazine ,Biopsy ,Biology ,O(6)-Methylguanine-DNA Methyltransferase ,Predictive Value of Tests ,medicine ,Temozolomide ,Humans ,Epigenetics ,Promoter Regions, Genetic ,neoplasms ,Antineoplastic Agents, Alkylating ,Aged ,Proportional Hazards Models ,Brain Neoplasms ,O-6-methylguanine-DNA methyltransferase ,Methylation ,DNA Methylation ,Middle Aged ,Combined Modality Therapy ,Survival Analysis ,digestive system diseases ,Oncology ,DNA methylation ,Multivariate Analysis ,Cancer research ,Female ,Glioblastoma ,medicine.drug - Abstract
Purpose: In the setting of a prospective clinical trial, we determined the predictive value of the methylation status of the O-6-methylguanine-DNA methyltransferase (MGMT) promoter for outcome in glioblastoma patients treated with the alkylating agent temozolomide. Expression of this excision repair enzyme has been associated with resistance to alkylating chemotherapy. Experimental Design: The methylation status of MGMT in the tumor biopsies was evaluated in 38 patients undergoing resection for newly diagnosed glioblastoma and enrolled in a Phase II trial testing concomitant and adjuvant temozolomide and radiation. The epigenetic silencing of the MGMT gene was determined using methylation-specific PCR. Results: Inactivation of the MGMT gene by promoter methylation was associated with longer survival (P = 0.0051; Log-rank test). At 18 months, survival was 62% (16 of 26) for patients testing positive for a methylated MGMT promoter but reached only 8% (1 of 12) in absence of methylation (P = 0.002; Fisher’s exact test). In the presence of other clinically relevant factors, methylation of the MGMT promoter remains the only significant predictor (P = 0.017; Cox regression). Conclusions: This prospective clinical trial identifies MGMT-methylation status as an independent predictor for glioblastoma patients treated with a methylating agent. The association of the epigenetic inactivation of the DNA repair gene MGMT with better outcome in this homogenous cohort may have important implications for the design of future trials and supports efforts to deplete MGMT by O-6-benzylguanine, a noncytotoxic substrate of this enzyme.
- Published
- 2004
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