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Biomedical subjects

A Hamy

Publications and source records attributed to A Hamy.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Mycotic aneurysm in acute bacterial mitral valve endocarditis. Apropos of a case].

A 24 year old man presented with acute endocarditis of the mitral valve. Rupture of a mycotic cerebral aneurysm on the 20th day was successfully treated by interventional catheterisation. Several days later, he underwent mitral valvuloplasty under good conditions. The postoperative period was uncomplicated but emergency surgery was required for a mycotic aneurysm of the superior mesenteric artery. The patient was discharged from hospital without severe neurological sequellae and with a continent mitral valve.

Adult↗
PubMed1998

[Extension of an acinar cell pancreatic carcinoma with cystic changes invading the Wirsung canal].

We report a case of acinar cell carcinoma of the pancreas with misleading cystic changes. A 32-year-old woman presented with symptoms suggesting acute pancreatitis on chronic pancreatitis. The abdominal computed tomography and the endoscopic retrograde pancreatography demonstrated hypertrophy of the pancreatic head associated with global dilatation of main pancreatic duct and secondary canals and a 5 cm communicating cyst. A intraductal papillary-mucinous tumor was suggested. Microscopic findings showed a poorly differentiated adenocarcinoma. Six months later, a liver metastasis was detected. The microscopic appearance was different, suggesting acinar cell carcinoma, confirmed by immunohistochemistry. Only two other cases of acinar cell carcinoma with cystic component have been reported in the literature.

Adult↗
PubMed1997

Percutaneous cholecystostomy for acute cholecystitis in critically ill patients.

BACKGROUND: Cholecystectomy remains the best treatment for acute cholecystitis but may cause high morbidity or mortality in critically ill or elderly patients. METHODS: We report a retrospective study of ultrasonography-guided percutaneous cholecystostomy (USGPC) performed between 1988 and 1994 in 41 patients (mean age, 77.8 years; range, 42-95 years) as an alternative to surgery. RESULTS: Five patients (12.2%) died in the hospital, four (9.8%) subsequently underwent operation without complications, six (15%) had a recurrence of cholecystitis between 3 and 24 months after withdrawal of drainage, and 26 patients are cured without recurrence after a mean follow-up of 33 months (range, 3-67 months). CONCLUSIONS: USGPC appears to be the treatment of choice for high-risk patients, especially those with postoperative cholecystitis, severe acute calculous pancreatitis, or total parenteral nutrition.

Acute Disease↗
PubMed1997

Percutaneous self-expandable metallic stents and malignant biliary strictures.

Thirty-five patients with malignant obstructive jaundice received palliative treatment using percutaneous self-expandable metallic stents. Cholangiocarcinoma was the most frequent cause of the biliary obstruction. In more than 50% of cases, the stricture was located in the hilum. Adequate biliary drainage was achieved in 97% of cases. Median survival was 182 days, and 11% of patients died within 30 days. Early complications occurred in 31% of patients, and 25% of patients showed recurrent jaundice after an average of 180 days. Percutaneous self-expandable metallic stents are an efficient means of palliatively treating malignant biliary strictures, particularly high biliary obstructions.

Aged↗
PubMed1997

[Management of differentiated thyroid cancer of nodular type].

Mortality and recurrence rate in nodular forms of differentiated thyroid cancer are 10 and 15%, raising the question of whether initial treatment was adequate. Recurrence and mortality appear to be higher after lobectomy than after total thyroidectomy. This could result from the development of dedifferentiated relapse or metastasis from residual areas. Metastatic node invasion is frequent (60 to 80%) but does not lead to a high recurrence rate. Prognosis is poor however due to frequent association with visceral metastases. Management should take into account the relative degree of malignancy of this cancer and the risk of morbidity for long surgical procedures. Lobectomy can be acceptable if no criteria of gravity is observed, but total thyroidectomy remains the treatment of choice. In patients with criteria of gravity, needle biopsy guides possible node dissection. Dissection of the recurrent chain misses 20% of the metastatic nodes, while dissection of the supraclavian and middle jugular recurrent chains only misses 7.8%. Radioactive iodine and hormone therapy are also indicated in patients with signs of gravity.

Adenocarcinoma, Follicular↗
PubMed1997

[Tumoral rupture in the intrahepatic biliary tracts: a rare manifestation of hepatocellular carcinoma].

We report one case of unrecognized primary liver tumor revealed by intra biliary system migration of free floating debris and hemobilia. A 64-year-old man presented an isolated jaundice. Ultrasound, computed tomography and percutaneous transhepatic cholangiography are suggestive a cholangiocarcinoma. Operative intervention demonstrated hepatocellular emboli to common bile duct causing obstruction.

Bile Ducts, Intrahepatic↗
PubMed1997

[Uni- and multivariate analysis of predictive survival factors in hepatocellular carcinoma. A study of a series of 122 patients].

The files of 122 patients hospitalized for hepatocellular carcinoma (HCC) were reviewed retrospectively to study survival as a function of treatment and different peri-therapeutic factors. Cirrhosis was certain or probable in 69 cases. Laparotomy was performed 77 times (13 exploratory, 64 excisions). Chemoembolization with Adriamycine was performed 18 times. Median survival was 11.6 months. The factors influencing survival in monovariate analysis were the Child-Pugh stage (p < 0.0001), the Okuda stage (p < 0.0001), ascites (p < 0.001), a post-operative complication (p < 0.0001), gamma-glutamyltransferase level (p < 0.0037), tumor site (p < 0.004), albuminemia (p < 0.008), alkaline phosphatase concentration (p < 0.0087), number of tumors (p < 0.01), portal thrombosis (p < 0.01) and alpha-foetoprotein level (p < 0.01). In multivariate study, the Okuda stage (p < 0.001), age (p < 0.001) and portal thrombosis (p < 0.037) remained significant. The Okuda 1 group was also considered in multivariate study, in which case only patient age and the possibility of therapeutic excision were significant factors. In our opinion, the Okuda classification, which is easy to establish, should be adopted for pretherapeutic evaluation of patients with hepatocellular carcinoma.

Aged↗
PubMed1996

[Subacute paraneoplastic cerebellar degeneration with anti-neuronal antibodies and gynecological cancers. A case report of a bilateral ovarian cancer where the classic "anti-YO" antibody is associated with another antineuronal antibody].

Subacute paraneoplastic cerebellar degeneration (SPCD) is a cerebellar syndrome associated with an identifiable or occult carcinoma without direct involvement of the nervous system by the cancer. This subacute syndrome is due to an extensive Purkinje cell destruction by anti-Purkinje cells autoantibodies. Some of them are specific for example "anti-YO" antibodies in gynecologic cancer situations. We report the case of a 50-year-old woman who presented an ovarien carcinoma revealed by a SPCD associated to an anti-Purkinje cell autoantibody "anti-YO" and to another unidentified autoantibody. Despite the treatment of the carcinoma, the invaliding SPCD did not regress. The diagnosis of SPCD requires identification and early treatment of the carcinoma, giving the patient the best chances for cure and avoiding major neurologic effects.

Antibodies, Antinuclear↗
PubMed1996

[Oncocytic tumors of the thyroid. Diagnostic and therapeutic problems. Report of 17 cases and review of the literature].

Histopathologic and clinical follow-up data of 17 patients observed 3-104 months (mean: 38 months) after operation for oncocytic tumors of the thyroid gland are presented. Mean patient age was 50 +/- 15 years. Benign and malignant lesions were respectively 13 and 4. Frozen sections were positive for benign and malignant lesions in respectively 7 and 2 cases. Total thyroidectomy was performed in all cases of malignant lesions and in 7 cases of benign lesion, the latter in order to treat high volume adenomas or associated controlateral lesions. No tumor relapse was observed during the follow-up period (data about 16 patients). A review of the literature indicates that thyroid oncocytic adenoma diagnosis can be trusted and that this tumor is not especially prone to a malignant course with the mode of treatment applied. Thus total thyroidectomy should be recommended for: 1) malignant tumors. 2) and for selected benign adenomas depending on the tumor volume or on associated lesions.

Adenocarcinoma↗
PubMed1996

[Pure 46XY gonadal dysgenesis].

46 XY pure gonad dysgenesia, also known as Swyer syndrome, is a disorder of sexual differentiation. The patients are phenotypic females with a 46 XY karyotype and hypoplastic gonads without germ cells. They present most often with primary amenorrhea. The study of this abnormality in testicular differentiation contributed to the identification of the gene SRY, testis determining factor. To date, 20% of 46 XY pure gonad dysgenesia are explained by a mutation or a deletion in SRY. In 80%, SRY is apparently normal. The risk of gonadal neoplasia is high, dictating early prophylactic removal of these dysgenetic gonads. Gonadoblastoma and dysgerminoma are the most frequently reported malignancies. Because of the possible inheritance of XY gonad dysgenesia all family members should undergo a thorough screening.

Adolescent↗
PubMed1995

[Resection of hepatic metastases from non colorectal cancers. Our experience apropos of 20 cases].

The authors analyse their experience of 20 hepatic resections of metastatic malignant lesion to the liver from non-colorectal primary neoplasms: tubal or ovarian adenocarcinoma (3 cases), digestive adenocarcinoma (6 cases), sarcoma (3 cases) and endocrine malignancies (8 cases). Then, they discuss the justification of such aggressive approach, the type of hepatic resection that has to be done and the date of the procedure according to the characteristics of the secondary neoplasm (synchronous or metachronous). The histological type of the primary malignancy is an important factor in this debate.

Adult↗
PubMed1995

[Pyelo-ureteral dilatation revealing appendiceal abscess. Apropos of 2 cases].

The pyelo-ureteral dilatation revealing a appendiceal abscess is a uncommon situation. Its physio-pathological mechanism is not clear. The authors present two cases of which the diagnosis was not immediately made. The appendiceal abscess treatment is usually enough to make disappear the ureteral dilatation and the after effects stenosis are exceptional.

Abscess↗
PubMed1995

[Left single-lobe Caroli disease discovered during intraoperative cholecystography ... or how a routine cholecystectomy can lead to left hepatectomy].

The authors report a case of single-lobe Caroli's disease discovered at the radiologic exploration during a laparoscopic cholecystectomy leading to a left hepatic lobectomy 2.5 months later. Localized dilatation of the intrahepatic bile-ducts are infrequent. They may be associated with others pathological conditions such as cystic dilatation of the extrahepatic bile-ducts, congenital hepatic fibrosis of the liver or renal pathology. Hepatic resection is the logical treatment of such localized lesions, but it may have an excessive risk in case of association with a congenital hepatic fibrosis of the liver. The authors insist about the necessity of radiographic exploration during every biliary surgical approach, even with laparoscopic technic.

Caroli Disease↗
PubMed1994

[Our surgical experience in the resection of benign hepatic tumors. Apropos of 31 cases].

The authors report their experience about 31 patients (30 women and 1 man, mean age 45,7 years) opered for a benign hepatic tumor between 1984 and 1993. There were 12 focal nodular hyperplasia, 9 simple hepatic cysts, 8 hemangioma and 1 hepatic adenoma. All but one (a cyst) tumors were completely resected. The reasons of indications for surgery (which is contraversial) are then discussed, most of them being based on doubts concerning correct identification of the tumor (despite a modern assessment by imaging) or symptoms or risks of the tumor.

Adenoma↗