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Biomedical subjects

A Zaouche

Publications and source records attributed to A Zaouche.

At least 19 recordsLinked to original sources
PubMed2005

[Extragastrointestinal stromal tumors: a report of 4 cases].

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors that arise from the wall of the gastrointestinal tract expressing CD117 and/or the CD34. Similar tumors were described in the soft tissue of the abdomen and are so-called extragastrointestinal stromal tumors (EGIST). We report 4 new cases of EGIST. The tumors occurred in 2 women and 2 men, who ranged in age from 42 to 71 years. Three tumors arose from the soft tissue of the abdominal cavity, and the remainder arose from the retroperitoneum. They ranged in size from 10 to 27 cm. Three cases were composed purely of short fusiform cells tumors, the last case showed an epithelioid pattern. All the tumors expressed CD117. One patient presented with local recurrence and metastasis, one was lost to the follow-up and two patients were doing well. Immunohistochemistry is useful in distinguishing EGIST from other mesenchymal tumors. Intra-abdominal aggressive fibromatosis may express actin and CD117 but catenin is also positive, leiomyosarcoma expresses the actin and/or desmin but CD117 is usually negative, retroperitoneal dedifferentiated liposarcoma is CD117 negative and PS100 positive, inflammatory myofibroblastic tumor is negative for CD117 and CD34. The solitary fibrous tumor expresses CD34 and is negative to CD117. Some tumors expressing CD117 such desmoplastic round cell tumor should not be confused with EGIST. On the occasion of these four observations, we will discuss the clinical aspects and the main differential diagnoses of this tumor.

Abdominal Neoplasms↗
PubMed2001

Management of liver hydatid cysts with a large biliocystic fistula: multicenter retrospective study. Tunisian Surgical Association.

The large biliocystic fistula (> 5 mm) encountered with hydatic cyst of the liver produces clinical manifestations only when it allows the hydatic cyst content to pass into the common bile duct. Various therapeutic problems occur. The aim of this study was to evaluate the results of the therapeutic methods used by 14 Tunisian centers to treat this specific aspect of the hydatic cyst of the liver associated with a large biliocystic fistula. This study concerned a period of 5 years between January 1988 and December 1992, and it included 244 cases associated with hydatic content in the common bile duct (158 cases) and with cholelithiasis and choledocholithiasis (2 cases); 127 patients underwent an emergency operation (52%). The surgical procedures performed consisted in radical procedures (24 cases, 9.8%) and conservative procedures (220 cases, 90.2%). The latter included 52 cases of internal transfistulary drainage, 140 unroofing procedures associated in 20 cases with the fistula, in 93 cases with suture of the fistula, and in 27 cases with direct fistulization. In the 28 remaining cases, through the choledoctomy evacuation of the parasite was performed. The common bile duct was approached in 180 cases (73.7%). The postoperative course was uneventful in 57% of the cases and complicated in 38.5% others. The mortality rate was 4.5%. In conclusion, the presence (or not) of hydatic material in the common bile duct did not seem to be a determinant of the surgical procedure choice and did not influence the results. The only difficulty with treatment was the large biliocystic fistula itself. The internal transfistulary drainage on one part, and the unroofing procedure associated with suturing healthy fistula tissue and to omentoplasty or capitonnage of the remaining cavity on the other part, were easily performed and constituted efficient methods. Radical methods constituted operations that had excellent results, but they were feasible in only 10% of the cases.

Adolescent↗
PubMed2001

Oroesophageal motor disorders in Pierre Robin syndrome.

BACKGROUND: Feeding disorders are one of the main clinical features in PRS, which combines a posterior U-shaped cleft palate, retrognathia, and glossoptosis. The aim of this study was to evaluate the oral and esophageal motor function of children with PRS without additional neurologic symptoms. METHODS: All children hospitalized with Pierre Robin syndrome either isolated (n = 27) or associated with Stickler syndrome (n = 8) were included. Clinical evaluation of their oroesophageal disorders and systematic esophageal manometry were performed. RESULTS: Feeding disorders were always present, but type of disorder varied from one child to another. Esophageal disorders were frequent and seemed to be resistant to classic gastroesophageal reflux treatment. Eighty-six percent of the children required nasogastric tube feeding for a mean duration of 8.6 months. Esophageal manometric abnormalities were noted in 50% of the children: lower esophageal sphincter hypertonia, failure of lower esophageal sphincter relaxation at deglutition, and esophageal dyskinesia. These clinical and manometric disorders showed a trend to spontaneous regression after 12 months. CONCLUSION: In the current Pierre Robin syndrome series, clinical and manometric anomalies of oroesophageal motility were always present. The authors identified an unusual manometric pattern that has also been described in situations of neurovegetative instability. It could reflect dysregulation of the control of the central pattern generators of swallowing in the brain stem.

Cleft Palate↗
PubMed2001

Early feeding resistance: a possible consequence of neonatal oro-oesophageal dyskinesia.

UNLABELLED: Paediatricians frequently find early feeding disorders in neonates and infants that result in poor weight gain and which sometimes have no clear organic basis. For many years, we have observed infants with unexplained poor feeding skills and excessive regurgitation, and since 1992 we have prospectively performed oesophageal manometry in infants hospitalized for retarded growth and "unexplained" feeding disorders. From the group of infants hospitalized for growth failure in the General Paediatric Unit of Necker-Enfants Malades Hospital from 1992 to 1997, we identified 16 children (3%) with abnormal feeding behaviour who had an abnormal oesophageal manometry. The manometric data of these children were compared with those of a group of 16 age-matched children who underwent oesophageal manometry for other reasons, and served as controls. The affected children had precocious feeding skills disorders: prolonged bottle-feeding (75%), bottle refusal (75%), unexplained crying (63%) and excessive regurgitation (94%). Half of them had mild anatomical facial consequences of their poor foetal sucking, and mild pharyngolaryngeal hypotonia, which could not be considered as malformations. Apart from these disorders, their clinical status was normal. At inclusion, their oesophageal manometry was abnormal, showing in 70% of cases specific anomalies: lower oesophageal sphincter hypertonia and/or partial failure to relax, and giant waves of oesophagus body. Their course was good and their feeding difficulties decreased around the end of the first year, with the acquisition of normal voluntary mastication. CONCLUSION: We suggest that the early feeding resistance of this group of children could be related to an organic and transient neonatal oro-oesophageal dyskinesia.

Esophageal Motility Disorders↗
PubMed2000

Effects of oral Saccharomyces boulardii on bacterial overgrowth, translocation, and intestinal adaptation after small-bowel resection in rats.

BACKGROUND: Small-bowel resection in animals results in alterations of the morphology and functional adaptation in the remaining intestine. The aim of our study was to study the effect of Saccharomyces boulardii versus placebo in rats after 50% small-bowel resection. METHODS: Sixty-three rats were assigned to one of three groups: small-bowel resection (n = 31), transected surgery controls (n = 16), or non-surgical controls (n = 16). Of the 31 rats with small-bowel resection, 15 were given S. boulardii (140 mg/dl), and 16 were given placebo. Intestinal markers measured included bacterial overgrowth (BO) on days 4 and 8 and translocation into mesenteric lymph nodes, liver, and spleen. Markers of small-bowel adaptation included histomorphology of the mucosa, protein content, and various brush-border enzymes (sucrase, glucoamylase, n-aminopeptidase). RESULTS: In the jejunal mucosal samples on day 8, S. boulardii-treated rats showed a significant increase in protein content (58.3 +/- 12 mg/10 cm) compared with placebo-treated rats (29.2 +/- 1.8) or non-surgery controls (18.3 +/- 1.2; P < 0.001). S. boulardii-treated rats also had significantly higher levels of all three brush-border enzymes. A significant increase of enzyme-specific activities was observed in the ileum of S. boulardii resected rats compared with the placebo resected group on day 4, and no significant differences were seen in the remnant ileum except an increase in protein content in S. boulardii-treated rats on day 8. Histomorphometric studies showed no differences in ileal villus height or translocation frequencies by day 8 in S. boulardii or placebo resected rats. CONCLUSIONS: These data indicate that, after resection, S. boulardii does not modify bacterial overgrowth or translocation frequency but does significantly enhance the functional adaptation of the remaining intestinal segments.

Adaptation, Physiological↗
PubMed2000

[Abdominal actinomycosis. Report of three cases and review of the literature].

Actinomyces are Gram positive, anaerobic, filamentous bacteria, saprophytes of the oral cavity and intestinal tract of humans. They rarely cause chronic suppurative infections. Abdominal abscess can masquerade as a malignant process and lead to a surgical intervention with resection. We report three patients with abdominal actinomycosis; the first affected the liver with a favorable outcome on medical treatment, the second of abdomino-pelvic localisation was related to an intra-uterine device and the last affecting the transverse colon simulated a malignant process and required an hemicolectomy. These observations illustrates the difficulties of the diagnosis of this rare and unrecognized disease.

Abdominal Abscess↗
PubMed1999

[Colonic tuberculosis: an exceptional cause of a massive surgical hemorrhage apropos of a case and review of the literature].

Colonic tuberculosis rarely causes massive bleeding, as a matter of fact less than twenty cases have been reported in medical literature. Resorting to surgery in this context is even more exceptional. We have not found any case operated on in the literature we have consulted. Endoscopy together with histological study of biopsies is the best exam for the diagnosis of this disease. We report the case of a 37 year old male, coronarian, carrying a caecal lesion evocative of tuberculosis at the endoscopic exam, who had an emergency right hemicolectomy for massive bleeding caused by caecal tuberculosis. The surgical indication was dictated by the abundance and the persistence of the bleeding. The post-operative course was uneventful.

Adult↗
PubMed1999

[Neuroendocrine carcinoma in Barrett's esophagus. Report of a case].

The neuroendocrine tumours of the oesophagus are exceptional. They are a spectrum of heterogeneous tumours often not clearly defined in the literature. We report a case of moderately differentiated neuroendocrine tumour of the oesophagus arising from Barrett's mucosa in 51-year-old man treated surgically and who was free of disease 28 months after excision. We discuss about this case, the classification, the histogenesis and therapeutic approaches of these tumours.

Barrett Esophagus↗
PubMed1999

[Colon cancer. Study of 153 cases and comparison with a series of 140 historic cases].

The authors study the epidemiological, diagnostic and therapeutic features of 153 consecutive cases of colon cancers collected between 1985 and 1998. They compare the results with those of a previous study performed in the same hospital service (140 cases between 1966 and 1984). It is a series of 79 men and 74 women (sex ratio = 1.07). The mean age was 56.6 +/- 14 years old with 13.7% of the patients who were less than 40 years old. The operability and the resectability were respectively 98.7% and 83.7% with a global operative mortality of 7.9%. According to the Dukes classification, they were 2 A stages, 73 B stages, 32 C stages and 45 D stages. Starting from 1993, 53% of the C stages an 48% of the B stages had an adjuvant chemotherapy. The comparison between our present results and those of our previous series does not show any modification in what regards the mean age, the cancer frequency in young people, the complicated forms proportion and time needed for the diagnosis by comparison to the beginning of symptomatology. The colic cancer prognostic improvement is attained through an earlier diagnosis, making it possible to reduce the developed forms and the complicated forms proportion, the consequence of which is the operative mortality decrease and the log-range survival increase.

Adult↗