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Biomedical subjects

F Berthoumieu

Publications and source records attributed to F Berthoumieu.

At least 19 recordsLinked to original sources
PubMed1989

[Natural history of bronchiolo-alveolar cancer. Apropos of 38 cases].

Thirty-eight cases of bronchioloalveolar carcinoma were selected on anatomico-pathological criteria and analysed both radioclinically and histologically. At histology, this type of carcinoma is characterized chiefly by the growth of malignant cells along the alveolar walls. Cytology, which determines the nature of these cells (pneumocyte II or Clara cell), is not specific but remains important as regards phylogenesis. The course of bronchioloalveolar carcinoma gives a better understanding of its mode of propagation. Actuarial curves show that all patients with a diffuse carcinoma die very rapidly, whereas the survival rate of those who have localized lesions is 60% at 5 years. Moreover, the time required for dissemination to take place is long in assessable cases. This means that the condition should be diagnosed at an early stage on the presence of crepitant rales, on their air bronchogram at CT and on transparietal needle biopsy under CT. The chances are that early excision will result in cure.

Actuarial Analysis↗
PubMed1981

[Transluminal angioplasty of the coronary vessels. Preliminary results].

Transluminal coronary angioplasty is a new therapeutic procedure perfected by Gruntzig in 1977 consisting of compressing atheromatous plaques and dilating the arterial lumen with an inflatable balloon-tipped catheter of fixed external diameter. This catheter is introduced into the coronary artery through a preformed catheter guide under radioscopic control. The authors describe their experience of 36 attempts at coronary angioplasty performed over a one year period. The stenosis was catheterised in 30 cases and a good immediate result was obtained in 28 patients (77%). The percentage narrowing was reduced from an average of 79 +/- 8% to 26 +/- 12% (p less than 0.001) and the trans stenotic gradient from 40 +/- 11 mm Hg to 4 +/- 8 mm Hg (p less than 0.001). No serious complications were observed during these procedures. The 8 other patients underwent aorto-coronary bypass surgery as an emergency (2 cases) or otherwise (5 cases). 26 patients with good immediate results are asymptomatic at medium term follow-up, 1 has improved from functional Class IV to II, and I has recurrent Class IV effort angina. 15 patients have been followed up after six months. 14 remain asymptomatic with negative maximal exercise stress testing; 1 has angina. 14/15 stenoses remain dilated, 1 stenosis has progressed (60%). 2 patients developed a new stenosis, 1 of whom underwent another angioplasty procedure (functional Class III). In the 13 remaining patient, clinical improvement was confirmed by exercise stress testing. With strict selection of patients and a prudent operative technique this method seems to be an attractive intermediate therapeutic procedure (over 60% good results at medium term) between medical and surgical management of patients with severe angina and a tight monotruncular stenosis.

Adult↗
PubMed1981

[Rupture of the heart in the acute phase of myocardial infarction operated on successfully].

This case of rupture of the left ventricular wall in the acute stage of myocardial infarction, presenting clinically as cardiac tamponnade with no electrical signs of transmural infarction, is reported. After cardiac catheterisation and angiography which confirmed the adiastole, the worsening of the patient's condition necessitated pericardial aspiration which showed the presence of a haemopericardium. This led to surgical exploration and to the repair of a cardiac rupture under cardiopulmonary bypass. The authors recall the incidence of cardiac rupture during myocardial infarction, its poor prognosis, the difficulty of preoperative diagnosis, the anatomical features of the infarct which are theoretically favourable for surgical repair and the rarity of survival after surgery which relies essentially on the availability of medicosurgical facilities for very early surgical intervention.

Acute Disease↗
PubMed1980

[Floating thrombus of the left ventricle after recent myocardial infarction, treated by surgery].

The case of a 55 year old man admitted with an uncomplicated anteroseptal myocardial infarction is reported. At the third week this young patient underwent complete assessment. On coronary angiography severe double vessel disease was demonstrated and ventriculography showed a "floating" pediculated thrombus attached to the akinetic anterior wall. The ejection fraction was calculated at 40%. Subacute ischaemia of the right lower limb developed in the hours following catheterisation. In the face of all these findings surgery was proposed; ablation of the "fresh" thrombus was associated with a ventricular resection and an aorto-coronary bypass graft on the left marginal branch, together with disobliteration of the distal ilio-femoral artery of the right leg. The following points are emphasised with respect to this report: - the rarity of such cases in the litterature despite the high incidence of mural thrombi after infarction; - the value of diagnosing this complication by systematic investigation of patients under 60 years of age in full socio-professional activity; - the indications of rational surgery comprising ablation of the thrombus and any necessary prophylactic coronary revascularisation.

Coronary Angiography↗
PubMed1979

[Secondary tamponade following cardiac surgery with reference to 3 cases].

Secondary tamponnade after cardiac surgery occurs after a variable period, generally between the 15th day and the 5th post-operative week. Although this is a rare complication, it occurred three times in a consecutive series of 225 patients (1.3 p. 100). Based on this short experience as compared to the number of cases already published, the authors discuss their opinions on: -- the factors of inflammation and post-operative anticoagulation which predispose to this complication; -- the progress in diagnosis brought about by echocardiography; -- the minimal suggested management of pericardocentesis completed or not by surgical drainage; -- the possibilities of prevention based on prolonged follow-up of patients who present post-operative "pericardial problems". In this way it may be possible to eliminate a not negligeable cause of secondary mortality after cardiac surgery.

Aged↗
PubMed1979

[Dystrophic hyperlucent lung (author's transl)].

Emphysematous bullae isolated on a healthy lung and primitive progressive dystrophic emphysema all belong to the dystrophic hyperlucent lung and are surgical cases. Having recalled the excellent prognosis of isolated bullae, the authors analyzed the surgical indications in the progressive dystrophic emphysema concerning 66 observations of which 52 cases were operated. They showed that surgery provided many improvements and that making a pleural adhesion during the intervention limited the bullous evolution of the disease. Results plead in favour of early interventions and wider indications.

Adult↗
PubMed1977

[Posttraumatic real and false Mendelson's syndromes].

Six observations of post-traumatic acute respiratory insufficiency of alveolar origin are reported briefly. Three of them have been attributed to a Mendelson's syndrome. This authors showed that diagnosing these lung diseases by acid inhalation is particularly difficult in casualties. It is a diagnosis by elimination which no certainty can prop. These post-traumatic Mendelson's syndrome are serious and difficult to prevent. In the three cases reported two accidents occurred during or immediately after an intubation. The systematic use of an efficient anti-acid could be recommended in all serious casualities.

Abdominal Injuries↗