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C Guedon

Publications and source records attributed to C Guedon.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Cancer of the tongue in women. A propos of 40 cases].

Forty women, average age of 54, have been treated in first intention or after the failure of a previous treatment, for a squamous cell carcinoma of the tongue. Eighteen (45%) had no risk factors and 9 were under forty years of age. The oral tongue was the most frequent localisation in the group of patient without risk factors. Nineteen local failures were observed. Actuarial three-years survival was 36%. We believe that the poor prognosis of female tongue squamous carcinoma requires aggressive treatment with combined surgery and brachytherapy on the primary lesion and prophylactic neck dissection even in patients without palpable cervical nodes.

Actuarial Analysis↗
PubMed1994

[Use of myoplasty after acute mediastinitis occurring after heart surgery. Apropos of 167 cases].

Infected median sternotomy often requires open wound management. A large thoracic defect usually results in subsequent exposure of heart, great vessels, aorto-coronary bypass grafting or vascular prosthesis. After thorough wound debridement, coverage with muscle transposition was carried out in a series of 167 cases observed over a period of 10 years. Transposition of both pectoralis major muscles on internal pedicles was performed in 75 cases. In 27 of these cases, internal mammary grafting did not preclude their use. Since 1986, intrathoracic transposition of the trapezius muscle has been our treatment of choice in 25 cases, most frequently combined with a double pectoralis major transposition. Rectus abdomini muscle flap was seldom used alone whereas latissimus dorsi was mainly used as a salvage flap. Muscle transposition provided effective heart and great vessel protection after acute hemorrhage in 18 cases. This series confirms that mortality and mean hospital stay have decreased dramatically since the routine use of muscle transposition.

Acute Disease↗
PubMed1992

Advanced carcinoma of the tongue: total glossectomy without total laryngectomy. Review of 80 cases.

Opinions are divided over the validity of total glossectomy without associated total laryngectomy for advanced carcinoma of the tongue. This retrospective study evaluates the oncologic and functional results obtained in 80 patients who underwent total glossectomy as a primary procedure or as salvage surgery. Satisfactory swallowing ability was obtained in 41 patients, and speech was understandable in 49 patients. The survival rate at 1 year was 65%, with early recurrence of the disease, which was especially frequent in patients with prior radiotherapy, being the major cause of death. The study confirms the poor prognosis of cases with mandibular involvement, and the fact that partial laryngectomy, when required, impairs functional results. In the light of the authors' experience, total glossectomy without total laryngectomy should only be undertaken in motivated and well-supported patients able to accomplish the difficult rehabilitation process.

Adult↗
PubMed1992

[Current role of reconstructive surgery in the treatment of acute mediastinitis after cardiac surgery].

Infected median sternotomy often requires wide debridement. A large thoracic defect usually results with subsequent exposition of heart, great vessels, aortocoronary bypass grafting, vascular prosthesis. Coverage with muscles transplantation was the standard procedure carried out in this series of 150 cases observed between 1983 and 1991. Details of technique are presented as well as a review of our reconstructive options. Rewarding results were observed even in the most challenging circumstances, suggesting that pursuing this aggressive approach was warranted.

Acute Disease↗
PubMed1990

Effect of chemotherapy on resting energy expenditure in patients with non-Hodgkin's lymphoma. Results of a sequential study.

This study compared the resting energy expenditure (REE) modifications observed during successive intensive identical chemotherapy courses in non-Hodgkin's lymphoma patients to assess indirectly the metabolic changes induced by the cytotoxic effect of drugs on the tumor. With this therapeutic regimen, reduction of tumor mass is mostly achieved during the first course of chemotherapy. The study included 10 non-Hodgkin's lymphoma adult patients receiving three intensive 5-day courses of Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), cyclophosphamide, vindesine, and bleomycin. Resting energy expenditure was evaluated by indirect calorimetry during each course, first within the first 2 days before chemotherapy and then on days 2, 3 and 5. Initial REE (day 0) on entry into the study (21.8 +/- 1.2 kcal/kg.d-1) represented 99 +/- 6.7% of theoretical REE. Resting energy expenditure on day 0 was lower during course 2 and 3 (19.1 +/- 0.7 and 18.4 +/- 1.8 kcal/kg/d) than during course 1 (21.8 +/- 1.2 kcal/kg/d). The REE profile was different among the 3 courses: course 1 induced a significant REE decrease on days 3 and 5 (P less than 0.01); during course 2, REE remained stable and was lower than during course 1; during course 3, REE increased on days 2, 3, and 5 (P less than 0.05). Energy balance was positive during the three courses and nutritional status remained stable. The REE decrease observed during course 1 may be regarded as the metabolic effect of chemotherapy on the tumor metabolism.

Adult↗
PubMed1990

[Conservative transmandibular lateral pharyngectomy in cancer of the lateral oropharyngeal wall].

The authors present conservative transmandibular lateral pharyngectomy (CTLP) as a substitute for BPTM operations in cancers of the tonsillar region. The mandible is sectioned along the symphyses and the oropharynx is widely exposed through an incision of the pelvilingual sulcus. The authors propose a primary operability criterion that allows to salvage the mandibular angle, which is usually sacrificed. This can be assessed peroperatively by testing the possibility to cleave and spread inwardly the pharyngomandibular region following detachment of the pterygoid muscles. The functional and cosmetic benefits of this method are obvious and should commend its more frequent utilization.

Bone Plates↗
PubMed1990

[Mouth and pharyngeal hyperalgesic syndromes in AIDS].

In a series of 12 patients suffering from an HIV infection, including 9 with confirmed AIDS, who complained about pharyngeal pain in a fixed site, having a progressive intensity and not relieved by antalgics and the specific treatments that were prescribed empirically, and for whom etiological investigation yielded negative results, Thalidomide proved to be the only effective means of healing the exulcerated, nail-mark lesions or the ulcerated, budding, neoplastic-like lesions, and of completely suppressing pain.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Jejunal motility during cyclic total parenteral nutrition in patients with Crohn's disease.

Our aim was to study the jejunal motility (a) in seven patients receiving longterm (median: 24 days) cyclic total parenteral nutrition (CTPN) for an acute exacerbation of Crohn's disease involving the ileum and/or the colon without any sign of occlusion and (b) in six healthy volunteers undergoing the same parenteral nutrition for one day after an overnight fast. Continuous recordings, lasting 20 hours, were carried out in patients after correction of their nutritional status and significant improvement of the Crohn's disease activity index. In five of the seven patients, we recorded seven to 14 phase III episodes (PIII) (median: 10), both more frequent and slower during the nocturnal part of the recording time as compared with diurnal. Seven to 18 PIIIs (median: 12) were found in controls. The overall duration of the motor activity was not different between these five patients and controls. In the remaining two patients, no PIII episode was recorded and 79% and 57% respectively of the whole recording time consisted of irregular motor activity. Our work therefore, shows that: (a) PIIIs remain and have a circadian variation in their periodicity and propagation velocity, in most of our patients undergoing longterm CTPN (b) CTPN does not determine a longer duration of motor rest of the small bowel in patients than in controls submitted for a short period of time to the same parenteral intake.

Adult↗
PubMed1989

[Anatomical basis of the transposition of the serratus anterior muscle. Study of 40 dissections].

In order to explore the possibility of serratus anterior muscle (SAM) flap transposition in head-neck and thoracic surgery, we performed an anatomical study including 40 dissections of the muscle's vascular pedicle, the subscapular-thoracodorsal axis, which is a branch of the axillary artery (A. subscapularis A. thoracodorsalis). The SAM is characterized by: its location: extending from the anterior and lateral aspect of the thorax to the medial border of the scapula; its easy surgical access; its constant and reliable vascularization by the thoracodorsal artery, a branch of the subscapular artery; its long arc of rotation allowing the utilization of the SAM flap in head and neck and mediastinal surgery without microvascular anastomoses; its versatility in comparison with other perithoracic muscles. These considerations prompted us to use the SAM in head and neck reconstructive surgery, chest wall surgery, chest wall reconstruction following resection for tumor; breast reconstruction; intrathoracic and mediastinal surgery, reinforcement of high-risk tracheobronchial sutures or anastomoses; management of bronchopleural fistulas and empyema spaces; repair of tracheo esophageal fistulas and tracheal or esophageal defects.

Arteries↗
PubMed1988

Effects of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man.

The effects of intravenous and intraduodenal fat on jejunal motility were studied in nine normal volunteers. Using a nitrogen hydraulic infusion system, recording was performed continuously during 4 hr of fasting and 5 hr of 100 ml/hr infusion of fat (Intralipid 10%) given either intraduodenally (group ID) or intravenously (group IV) and 9 hr after the end of fat administration successively. The two experiments were performed at seven-day intervals in random order. In six of the nine subjects, a third experiment, in which 20 g of cholestyramine was given by mouth during intraduodenal fat infusion (group ID + C), was carried out. Venous blood samples were drawn for measurement of serum triglyceride levels and radioimmunoassay of plasma cholecystokinin. Intraduodenal fat, alone or plus cholestyramine, induced a significant reduction in incidence of phase III of the migrating motor complex. Intravenous fat reduced the incidence of phase III. However, this reduction was significant only during the last 3 hr of fat infusion, corresponding to the highest serum triglyceride concentration. In the three groups, fat infusion induced a significant increase in duration of phase II, leading to a postprandial-like pattern. Plasma cholecystokinin increased significantly in the three groups during fat administration, with a significant positive correlation between serum triglyceride concentration and plasma cholecystokinin in the group IV. The data suggest that, in addition to its known inhibitory effects on activity fronts when acting luminally, fat given intravenously may inhibit phase III activity. The effects in both instances may be mediated in part by cholecystokinin.

Adult↗
PubMed1988

Anatomic basis of serratus anterior muscle flap transposition.

In order to explore the possibility of serratus anterior muscle (SAM) flap transposition in head, neck and thoracic surgery, we performed an anatomic study including 40 dissections of the muscle's vascular pedicle, the subscapular-thoracodorsal axis, which is a branch of the axillary artery. The SAM is characterized by its location: extending from the anterior and lateral aspect of the thorax to the medial border of the scapula; its easy surgical access; its constant and reliable vascularization by the thoracodorsal artery, a branch of the subscapular artery; its long arc of rotation allowing utilization of the SAM flap in head and neck and mediastinal surgery without microvascular anastomoses; its versatility in comparison with other perithoracic muscles. These considerations prompted us to use the SAM in head and neck reconstructive surgery; chest wall surgery, including chest wall reconstruction following resection for tumor and breast reconstruction; intrathoracic and mediastinal surgery, including reinforcement of high-risk tracheobronchial sutures or anastomoses, management of bronchopleural fistulas and empyema spaces, and repair of tracheo-esophageal fistulas and tracheal or esophageal defects.

Back↗
PubMed1988

Rupture of the right ventricular free wall. An unusual complication of mediastinitis after cardiac surgery.

Of 2171 patients who underwent open heart surgery between 1981 and 1986, 41 (1.8%) developed postoperative mediastinitis and were treated by closed irrigation drainage or open chest therapy. Six patients, (mean age 59 years) developed rupture of the right ventricular free wall. The primary procedures were: resection of akinetic fibrous plaque (2), mitral valve replacement (1), coronary bypass grafting (1), removal of a left atrial myxoma (1) and repair of post-infarction rupture of the left ventricle (1). In 2 patients, rupture occurred in the operating theatre during revision of the irrigation drainage. Both patients died after repair. In 4 patients, rupture occurred during coughing. One died before surgery. In the 3 other cases, the defects were repaired either by direct suture (2 patients) or with a pericardial patch (1 patient) with the aid of normothermic extracorporeal circulation. Three days later, a muscular flap (pectoral or dorso-lumbar) was mobilized to protect the mediastinal viscera. All 3 patients are alive and well. When bleeding occurs during treatment of mediastinitis, an immediate exploration with extracorporeal circulation to close the defect should be considered.

Aged↗
PubMed1988

[Methods of enteral nutrition].

The technique used for enteral nutrition has recently been improved by the development of certain new procedures: percutaneous endoscopic gastrostomy, a small-caliber catheter, use of a single container for a 24 hour period, ambulatory enteral nutrition in the hospital, and a wide range in the preparation and composition of nutritive mixtures. This paper reviews the different techniques used and evaluates the cost of enteral nutrition in the hospital.

Costs and Cost Analysis↗
PubMed1988

[Buccopharyngeal Kaposi's sarcoma in AIDS. Apropos of 51 cases].

The authors present a series of 51 cases of buccopharyngeal Kaposi's sarcoma observed in patients with AIDS. The diagnosis of Kaposi's sarcoma is generally obvious due to its appearance, its constantly violaceous colour and its site, especially palatine and velar. When Kaposi's sarcoma is the first manifestation of the disease, it appears to be associated with a relatively favourable pejorative connotation when the nevertheless extremely modest median survival of these patients is compared with that of patients who initially presented with an opportunistic infection not associated with Kaposi's sarcoma. Buccopharyngeal Kaposi's sarcoma is usually only an epiphenomenon. It is rare that the local course requires any tumour reduction treatment. When such treatment is required, radiotherapy with 35 Gys is currently considered to be the best solution.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[The effect of ranitidine on gastric pH measured by continuous monitoring over 24 hours in healthy subjects. Comparison of 2 methods of administration: 150 mg morning and night, vs 300 mg in a single dose at night].

The gastric pH of 8 healthy subjects was determined, in a continuous fashion, during three different 24 hour periods corresponding to the 3 following treatments: Placebo, ranitidine 150 mg twice per day, and ranitidine 300 mg in the evening. During each period, the feeding conditions were normal and standardized. The results are expressed in terms of the number of hours under a threshold pH value. In comparison with the placebo, ranitidine, regardless of its mode of administration, results in a significant decrease of the mean number of hours under pH 1.5, 2 and 3 during 24 hours; no significant difference was demonstrated between the two modes of administration in 24 hours. During the 12 night-hours, a single dose of 300 mg of ranitidine was more effective to ranitidine taken in 2 doses for pH thresholds of 2 and 3, while during the 12 day-hours, no difference was demonstrated for pH thresholds of 1.5, 2 and 3. The analysis of the mean pH graphs in relation to time, suggests that a single 300 mg dose is more effective than the same dose divided into 2 doses during the day. These results tally with the variations of ranitidine plasma levels in 24 hours. These results justify, from a pharmacological standpoint, the prescription of a single dose of ranitidine, in the evening.

Adult↗