Prognostic factors and role of adjuvant therapies in the management of parasagittal meningiomas

Background: The goal of the present study was to retrospectively analyze our series of parasagittal meningiomas, treated by either single or combined therapies (surgery and/or SRS and FSRT), in order to determine the factors that influence patient outcome. Methods: Between January 1999 and May 2007, 37 parasagittal meningiomas were treated in our center. We compared the outcome of the parasagittal meningiomas in relation to the treatment and adjuvant treatment given, their location along the SSS, their volume, their histological and resection grade as well as the patient's sex and age to understand which factors influenced their natural history. Findings: Median follow-up was 6.7 years (2.4-12 years). Tumor grades and Simpson resection grade were distributed evenly along the SSS. The actuarial overall tumor control rate was 65.9%. Regression analysis showed, that the tumor histological grade and the Simpson resection grade were two significant factors in determining the tumor control (p<0.002 and p<0.008). Location along the SSS showed a lower control rate in the posterior third (p<0.002). Sex, age and tumor volume, however, were not significant factors. Moreover, and unexpectedly, the In our series, the proportion of adjuvant treatment was much higher than in former described series (39% vs 7%) but with similar control rate and lower morbidity and mortality. Conclusions: In our series, histological grade and Simpson grade are independent factors for recurrence and tumor control. Interestingly, location in the posterior third of the SSS seems to be another independent factor for recurrence. In order to avoid major morbidities related to surgery we advocate earlier use of adjuvant therapies for higher histological grade tumors and for tumors located at the posterior portion of the SSS, but definitive conclusions might warrant a larger series.

Geomorphological heritage, conservation and promotion in high-alpine protected areas

In recent decades, recognition of both cultural and natural heritage has grown in the Alps. This tendency illustrates a collective identity building (local, national, alpine), but it also highlights, in the current context of global change, a renewed reflection of man's relationship with the environment. Thus, a fundamental and scientific intrinsic value (as a part of wilderness) tends to be recognized in the natural heritage as a whole. However, geoheritage (and geodiversity) is still often perceived as a secondary natural component, compared with bioheritage (and biodiversity). In this context, we study the geomorphological heritage (landforms and the processes that shape them) of Les Contamines-Montjoie Natural Reserve. Indeed, despite the high geomorphological richness (especially glacial) of the reserve, which covers more than 4000 ha of the Mont-Blanc Massif, local recognition of this heritage is still limited. In order to recognize and protect it, and starting with a scientific study, this research identifies the main local richness and assesses the geotourist and educational potentials. Finally, several tools to educate and promote geoheritage (educational paths and website) are proposed.

[Illustrations des Oeuvres.] / Pierre de Ronsard, aut. du texte

Comprend : [Fig. p. de titre :] Porto omnia mea mecum. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. Préface de Marc Antoine de Muret :] Mureti Effigies. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.1, Ronsard]. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.407, de Charles IX]. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.471, de :] Henri III, roi de France et de Pologne. [Cote : microfilm R 1138]

[Illustrations de Pantagruel, roy des Dipsodes, restitué à son naturel, avec des faictz et prouesses espoventables composez par feu M.Alcofribas, abstracteur de quinte essence.] / François Rabelais, aut. du texte

Comprend : [Fig. au Prologue de l'auteur, f.2]. [Cote : microfilm R 9849] ; [Fig. au chap. II, f.10 :] De la nativité du très redoubté Pantagruel. [Cote : microfilm R 9849] ; [Fig. au chap. V, f.18 :] Des faictz du noble Pantagruel en son jeune âge. [Cote : microfilm R 9849] ; [Fig. au chap. IX, f.35 intitulé :] Comment Pantagruel trouva Panurge lequel il ayma toute sa vie. [représentant Panurge et sa Dame de Paris]. [Cote : microfilm R 9849] ; [Fig. au chap. XI en reg. f.45 :] Comment les seigneurs de Baisecul et Bume vesne plaidoient devant Pantagruel sans advocatz.. [Cote : microfilm R 9849] ; [Fig. au chap. XII, f.48 :] Comment le seigneur de Bume vesne plaidoie davant Pantagruel. [Cote : microfilm R 9849] ; [Fig au chap. XIII, f.52 :] Comment Pantagruel donna sentence sus le différent des deux seigneurs. [Cote : microfilm R 9849] ; [Fig au chap. XXI, f.86 :] Comment Panurge feut amoureux d'une hauste dame de Paris. [Cote : microfilm R 9849] ; [Fig au chap. XXV, f.101 :] Comment Pantagruel et ses compaignons estoient fachez de manger de la chair salée, et comme Carpalim alla chasser pour avoir de la venaison. [Cote : microfilm R 9849]

[Illustrations de La vie inestimable du grand Gargantua, père de Pantagruel, jadis composée par l'abstracteur de quinte essence. Livre plein de pantagruelisme. / [non identifié] ; François Rabelais, aut. du texte

Comprend : [Bandeau et lettrine au Prologue de l'auteur p.2 : le maître et son disciple] [Cote : microfilm R 18678] ; [Bandeau au chap. I en reg. p.6 :] De la généalogie et antiquité de Gargantua. [L'auteur rédigeant les chroniques pantagruelines.] [Cote : microfilm R 18678]

[Illustrations du Quart livre des faictz et dictz héroïques du noble Pantagruel.] / François Rabelais, aut. du texte

Comprend : [Livre IV. Fig. au Prologue : François Rabelais rédigeant les aventures de Pantagruel.] [Cote : microfilm R 28836] ; [Livre IV. Chap. Ier. Fig. au titre :] Comment Pantagruel monta sur mer pour visiter l'Oracle de la divine bouteille [Cote : microfilm R 28836] ; [Livre IV. Chap. II. Fig. au titre :] Comment Pantagruel rencontra un navire de voyageurs retournans du pays Lanternois. [Cote : microfilm R 28836] ; [Livre IV. Chap. III. Fig. au titre :] Comment Panurge feit noyer en mer les moutons et le marchant qui les conduisoit [Cote : microfilm R 28836] ; [Livre IV. Chap. IV. Fig. au titre :] Comment Pantagruel arriva en l'Isle Eunasin, et des estranges alliances du pays. [Cote : microfilm R 28836] ; [Livre IV. Chap. V. Fig. au titre :] Comment Pantagruel descendit en l'Isle de Chely, en laquelle regnoit Panigon [Cote : microfilm R 28836] ; [Livre IV. Chap. VI. Fig. au titre :] Comment nous passasmes Procuration et de l'estrange maniere de vivre entre les Chicquanoux. [Cote : microfilm R 28836] ; [Livre IV. Chap. VII. Fig. au titre :] Comment Pantagruel passa les Isles de Tohu et Bohu et de l'estrange mort de Bringuenaril les avaleurs de moulins à vent [Cote : microfilm R 28836] ; [Livre IV. Chap. IX. Fig. au titre :] Quelles contenances eurent Panurge et frere Jean durant la tempeste [Cote : microfilm R 28836]