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Biomedical subjects

A Gaillard

Publications and source records attributed to A Gaillard.

At least 37 records · Page 2Linked to original sources
PubMed1990

Cervical epidural anaesthesia for carotid artery surgery.

A series of 394 patients (251 men, 143 women; mean age 70.0 +/- 8.4 yr) selected for carotid artery surgery (CAS) performed under cervical epidural anaesthesia (CEA) was analysed retrospectively. Carotid endarterectomy was performed in 326 patients and saphenous vein bypass in 68. The cervical epidural administration of 15 ml 0.5 per cent bupivacaine or 0.37-0.40 per cent bupivacaine plus fentanyl (50-100 micrograms) resulted in an effective sensory blockade from C2 to T4-T8. Patients were maintained awake during the surgical procedure in comfortable condition. Serious complications included dural puncture in two patients, epidural venipuncture in six patients and respiratory muscle paralysis in three patients. Hypotension (10.9 per cent) and bradycardia (2.8 per cent) were the most frequent side-effects of CEA. Transient neurological events were noticed in 84 patients during the surgical procedure. A definite neurological deficit occurred postoperatively in 12 patients. Three patients suffered postoperative myocardial infarction. The mortality rate was 2.3 per cent (nine patients). Carotid artery surgery may be performed under CEA but haemodynamic variables should be monitored closely and managed closely during the procedure.

Aged↗
PubMed1990

[Prognostic and therapeutic aspects of lympho-epithelial lesions of the parotid. Apropos of 8 cases].

The so-called benign lympho-epithelial lesion (BLEL) of the parotid is a rare condition. Its diagnosis is based on histology. For a long time there have been problems with its classification and prognosis: classification since certain cases may be classified as Sjögren's syndrome or as a precursor of the latter, prognosis there may be recurrence, contralateral involvement or progression to non-hodgkin's lymphoma. The authors discuss these factors in 8 cases and propose total parotidectomy with facial nerve preservation as the treatment of choice.

Adult↗
PubMed1990

[Intractable pain of the bucco-pharyngeal region due to tics and "abnormal" habits].

The bucco-pharyngeal region is a predominant site for functional, non lesional pain syndromes associated with "abnormal" habits (often tics), which are themselves due to an anxiety related psychological disorders. These extremely common syndromes, often in the form of a self-perpetuating "vicious circle", include two types of pain: mucosal pain and fatigue myalgia. Psychotherapy is generally the appropriate treatment.

Deglutition Disorders↗
PubMed1989

[Cervical epidural anesthesia in carotid artery surgery].

A series of 394 patients who underwent surgery of the carotid artery under cervical extradural anaesthesia is presented. With this technique the patient remains conscious throughout the operation, which facilitates neurological monitoring. Due to failure or complication, extradural anaesthesia was abandoned and replaced by general anaesthesia in 1.5 per cent of the cases. The mortality rate in this series was 2.3 per cent; in 2 out of 3 cases death was of neurological origin; 21 per cent of the patients had peroperative neurological accidents which, in 9 out of 10 cases, were due to a low cerebral blood flow rate during clamping. Thirty-five intra-arterial shunts (8.9 per cent) were installed, and none of these accidents was permanent. Twenty-five patients (6.3 per cent) had postoperative deficit which did not regress in 12 cases (3 per cent). The risk of peroperative neurological accident was significantly increased in patients with bilateral lesions of the vertebral arteries (x 3.5) or with occlusion of the contralateral carotid artery (x 4.5). Surgery of the carotid artery in conscious patients reveals a high incidence of ischaemic neurological events the reversibility of which is ensured by appropriate therapeutic procedures (arterial shunt, increase of brain perfusion pressure). Patients at risk of neurological accidents may benefit from cervical extradural anaesthesia.

Aged↗
PubMed1989

[Families in France and Sweden: the search for new models].

"Examination of the evolution of family models in France and Sweden reveals many similar trends: increase in the divorce rate, fall in marriage and fertility rates, decrease in the size of the average family, increase in the number of single parent families, diversity of rearranged households, etc. However, the authors stress the extent to which the historical and ideological context of this evolution is different in the two countries. Whereas new conjugal models are diffused rapidly in Sweden without provoking reactions of rejection, a certain ideology in France recommends an ideal of conjugal stability and demands a policy openly favouring an increased birth rate. The Swedes find contraception and abortion natural whereas they are still the subject of impassioned debates in France. The attitude to children is very different in the two countries. However, in both cases, although the evolution of family ties still has an experimental aspect it seems sufficiently radical to make it necessary to rethink the nature of social ties in general." (SUMMARY IN ENG)

Abortion, Induced↗
PubMed1989

[The use of free forearm flaps in oropharyngeal neoplastic surgery. Our experience with 52 cases].

The authors report their experience in the management of a series of 52 patients treated in Nantes for repair of loss of substance in the bucco-pharyngeal cavity, using a free antebrachial flap. Its fundamental value is to provide a very fine, supple cutaneous sheet of large surface area, which is particularly adapted to bucco-pharyngeal cancer surgery by limiting as much as possible the anatomical and functional sequelae and thereby allowing much larger resections to be carried out. After a review of the anatomy, a study of the indications, precautions and results obtained in this series is presented.

Adult↗
PubMed1987

[Lateral cysts and fistulae of the neck. Apropos 70 cases].

Anomalies of branchial origin, amygdaloid cysts and fistulae of 1st, 2nd and 3rd slits are not rare cervical affections. Their histology is characteristic: cylindrical epithelium for fistulae and malpighian epithelium with lymphoid masses for cysts. Excision must be completed by an approach route that is sufficiently wide to avoid recurrence and vascular-neural lesions of the neck.

Adolescent↗
PubMed1985

[Use of barbiturates in posttraumatic comas at the mesencephalic level. Apropos of 38 cases].

Thirty-eight patients with brain injury and mesencephalic coma, or a Glasgow score of less than 5, were treated routinely with Thiopental administered by electric syringe for a mean duration of 4 days. Follow up review criteria were based on clinical computed tomography and electroencephalographic data, as well as results of monitoring of intracranial pressure and assay of blood barbiturate levels. Global results indicated a mortality of 55.3% and reintegration of 34.2% of the patients. Results as a function of the different parameters of surveillance are discussed.

Adult↗
PubMed1985

[Actinomycosis. What describes the pathological events referred to by this term?].

The disease named "actinomycosis" hadn't found its final position in infections pathology. Many terms were successively created to describe in a better way similar entities: actinomycosis, pseudo-actinomycosis, actinobacteriosis, corynebacteriosis, ramibacteriosis... is just a part of the terminology. After the analysis of the classical conception of the "actinomycosis" and, also, the latest data, the author came to the conclusion that the facts are just a clinical manifestation, related to the germ, of the large syndrome of the Infections of the soft tissues.

Actinomyces↗
PubMed1985

[Study of the pharyngomandibular region].

Expressions used up to the present time to designate the region situated between the vertical ramus of the mandible and the lateral wall of the pharynx (Pterygomaxillary region of Rouvière) are unsatisfactory. In describing the limits of this region and its contents, the authors justify the use of the expression "pharyngomandibular region" and divide the region into two levels, one upper, or rhinopharyngomandibular and one lower or oropharyngomandibular.

Humans↗
PubMed1985

[Angiolymphoid hyperplasia with eosinophilia or Kimura's disease].

A rare affection of unknown etiology that is benign but frequently recurrent, Kimura's disease involves infiltration of the dermis and hypodermis usually of the face. Documented data exists describing clinical findings and results of histopathology that are analogous but are grouped under other names: angiolymphoid hyperplasia with eosinophilia, pyogenic pseudogranuloma, atypical pyogenic granuloma. A case followed up for 13 years is reported.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed1983

[The place of condylectomy in the treatment of hypercondylosis].

Condylectomy is an indication of choice for unilateral hypercondylia, whatever the age of the patient, and should be conducted as early as possible and associated with intermaxillary elastic traction. Complementary one- or two-stage operations for mandibular correction are necessary in severe advanced cases. Complementary maxillary osteotomies are very rarely required.

Adult↗
PubMed1983

[Conservation of the mandible by osteotomy-osteosynthesis in "trans-mandibular" oropharyngectomy. 34 case reports].

Trans-mandibular oropharyngectomy was performed in 34 patients, as initial treatment in 20 cases and following tumoral recurrence after radiotherapy in the other 14 cases. Results indicate that mandibular conservation is possible when bone is not affected by the neoplastic process and when an oropharyngoplasty ensures perfect covering of the mandible. The site of choice for osteotomy-osteosynthesis appears to be the parasymphysial region, as this provides a very satisfactory route of approach, the mental nerve and innervation of the lip are respected, it is situated outside of the irradiation field (before or after surgery), and there are no dental articulation complications.

Humans↗
PubMed1983

[Ligation of the external carotid in the parotid space. Its surgical significance].

The classical procedure of external carotid artery ligature in the carotid sulcus presents certain difficulties: The subdiagastric lymph nodes and branches of farabeuf's venous trunk must be avoided, and major nerves and vessels, including the hypoglossal nerve, internal carotid artery, and internal jugular vein, identified and protected. An approach to the external carotid artery at its entry into the parotid space, as employed in parotidectomy, avoids such problems due to major anatomical elements. This technique appears to be simpler, less restrictive, and more rapidly accomplished than the classical method of ligature, when its objective, the most frequent one, is arrest or prevent ion of hemorrhage in the region supplies by the internal maxillary artery.

Carotid Artery, External↗
PubMed1983

[Treatment of florid oral papillomatosis. Apropos of 10 cases].

Florid oral papillomatosis is a well defined, not exceptionally observed clinical entity of unknown pathogenesis. The exuberant lesions are characterized by their benign appearance on histology, but this is usually associated with a marked capacity for progression and recurrence and a tendency for epitheliomatous degeneration. Based on a review of cases in the published literature and a series of ten patients treated personally, it would appear that radiation therapy should be formally excluded, and that the treatment of choice is by wide excision associated, whenever possible, with reconstructive surgery.

Aged↗