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Biomedical subjects

C Smadja

Publications and source records attributed to C Smadja.

98 records · Page 6Linked to original sources
PubMed1979

[Unusual sequelae of a cranial injury].

A 13 year old child who had an apparently mild head injury presented with psychiatric sequelae. The main feature was a variable level of consciousness. The only explanation for the symptoms lay within the family environment. A hysterical converion symptom was possible but the start of a psychosis could not be excluded.

Adolescent↗
PubMedDate not supplied

Surgical treatment of small hepatocellular carcinomas in cirrhosis.

Over the last five years a policy of systematic screening for small hepatocellular carcinomas (HCC) in patients at risk has led to an increasing number of resections in patients with cirrhosis. Remarkable progress in the surgery of HCC in cirrhosis has been accomplished through: (a) a better understanding of the surgical anatomy of the liver, (b) the definition of new types of liver resection aimed at reducing the amount of parenchyma removed while still being oncologically satisfactory, (c) the reduction of intraoperative blood loss by various techniques of clamping afferent and efferent vessels, (d) the systematic use of intraoperative ultrasonography, and (e) the prevention of postoperative variceal bleeding and the formation of ascites. Results of resection of small HCC in cirrhosis have been quite impressive in Japanese series, with a low operative mortality and above 50% three-year survivals. Results in the West have been somewhat less good. Differences in the pathology of these tumours and particularly in the rate of encapsulation could account for these differences. Clearly, surgical resection has become an established treatment for small HCC in cirrhosis. More information is needed on the results of surgery in operated patients and this should be compared with the natural history of small HCC in cirrhosis in order to better define the patients who will most benefit from these operations and which tests performed at which intervals, are most reliable in screening patients at risk.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Management of colorectal cancer in patients with cirrhosis and a LeVeen shunt.

Two cirrhotic patients with a LeVeen shunt presented with a large bowel cancer. In one patient, the shunt was removed and the venous catheter was ligated prior to the performance of a colon resection. The postoperative course was uneventful. A new valve was inserted and connected to the venous catheter two months later. The second patient had a carcinoma of the rectum. In order to prevent ascites and to ease the colorectal resection he had preliminary construction of a portacaval shunt. Six weeks later, he underwent an anterior resection of the rectum. The postoperative course was uneventful except for a self limiting episode of febrile subacute intestinal obstruction. These two cases demonstrate that it is possible to resect colorectal cancer in patients with cirrhosis, ascites and a peritoneovenous shunt provided measures are taken to avoid specific complications due to the presence of the shunt, ascites or portal hypertension.

Aged↗
PubMedDate not supplied

[Histochemical changes of the intestinal mucus in benign and malignant lesions of the colon and rectum].

The purpose of this work was to assess the presence of an abnormal production of sialomucins in different pathological conditions using high iron diamine-Alcian-blue staining. Sixty patients with a colorectal tumor and 95 subjects with either a normal colonic mucosa or suffering from non-malignant colorectal disease were studied. An increased production of sialomucins was searched in the first group on the mucosa of the tumor, on the transitional mucosa and on the surgical resection margins respectively and in the second group, on the colonic mucosa. A retrospective study was also performed on 48 patients who underwent curative resection for colorectal tumor. Twenty-four of those patients subsequently developed local tumor recurrence whereas the 24 other patients remained free of recurrence. The prospective study showed the presence of a constantly increased production of sialomucins in the neoplastic mucosa. These abnormalities were found in: 85 p. 100 of cases in the transitional mucosa, in 42 p. 100 and 25 p. 100 of the proximal and distal resection margins respectively, and in 73 p. 100 of patients with dysplasia. The retrospective study showed that 83 p. 100 of patients suffering from local recurrent tumors had an increased production of sialomucins whereas only 8 p. 100 of patients free of local recurrence presented such an abnormal production. This study confirms the presence of an increased production of sialomucins in various pathological colorectal conditions. It suggests that it is possible to individualize a high risk group of patients who might justify a closer follow-up with appropriate therapy.

Adenocarcinoma↗
PubMedDate not supplied

[Acute necrotic pancreatitis: toward restriction of surgical indications].

Fifty-two patients operated for acute necrotising pancreatitis are reported. All severely-ill patients, operated early in order to perform a necrosectomy, died subsequently. Patients without severe illness were operated either for a complication of their pancreatic necrosis or electively for biliary lithiasis. The postoperative mortality was 29 p. 100 and 0 p. 100 respectively. Pancreatic necrosectomies were associated with a high morbidity whether performed for complications (64 p. 100) or during elective biliary surgery (33 p. 100). From this study, it appears that there is no indication for early necrosectomy in the severe forms of acute necrotising pancreatitis. However, pancreatic abscess remains a formal indication for drainage. It seems also justified to perform elective surgery without necrosectomy for biliary lithiasis complicated by acute necrotising pancreatitis.

Acute Disease↗