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Biomedical subjects

F Paris

Publications and source records attributed to F Paris.

At least 55 records · Page 3Linked to original sources

[Reoperations after esophagomyotomy in esophageal motility disorders].

Out of 96 patients with the diagnosis of primary esophageal motor disorders and treated by esophagomyotomy, a group of 9 patients is reported in whom reoperation was necessary because of persistence or worsening of the previous symptoms (8 patients) or persistent reflux esophagitis (one patient). Clinical and laboratory examinations together with the operative findings allowed classification of these patients: incomplete myotomy proximally (4 patients) or distally (one patient), fibrotic scar at the site of previous myotomy (2 patients), persistence of intact muscle fibers (one patient) and reflux esophagitis for lack of an antireflux intervention during myotomy. Treatment consisted of completing myotomy proximally or distally, resection of the fibrous tissue and an antireflux operation when indicated. Clinical results were excellent in 6 patients (66.6%), fair in 2 patients (22.2%) and bad in one case (11.1%). Fair or bad results were seen in patients with total absence of motor response to deglutition. After operation there was disappearance of vigorous contractions in the esophagus, as shown by manometry and recovery of esophageal peristalsis in another patient. We conclude that in order to improve the results of the surgical treatment of motor esophageal disorders it is essential to correctly classify the type of disorder present by means of manometry and to add a partial funduplication to ensure absence of reflux without dysphagia.

Adolescent↗

Surgical treatment of lung carcinoma involving the chest wall.

From 1969 to 1986, 97 patients with chest wall invasion by lung carcinoma (excluding superior sulcus tumours) underwent surgical resection in two hospitals, La Paz (Madrid) and La Fé (Valencia). The same surgical policy was used in both thoracic surgical units: extrapleural pulmonary resection when tumour involved only the parietal pleura (N = 36), and en bloc chest wall resection when the carcinoma extended into the ribs and intercostal muscles (N = 61). The tumour histology was classified according the WHO criteria. Lobectomy or bilobectomy was carried out in 72%, pneumonectomy in 18% and segmentectomy or wedge resection in 10% of the patients. The perioperative mortality was higher in the en bloc resection group 9/61 (15%) versus 2/36 (6%) for extrapleural dissection. The node staging was NO in 58/97 (60%), N1 in 16/97 (16%) and N2 in 23/97 (24%). The probability of survival was calculated by the Kaplan-Meier method collecting data from the perioperative survivors only. The overall 5-year survival was 23% with no significant differences between the en bloc resection and the extrapleural lung resection groups. The most important predictor of survival was the node stage. The 5-year survival for N1 and N2 were 8% and 6%, respectively. These percentages increased to 34% when N0 patients were considered. Other predictors of survival were not significant. The authors conclude that either extrapleural or en bloc chest wall resection are both valid procedures which may be used depending on the depth of local invasion.

Adenocarcinoma↗

Testosterone immunoreactivity in the seminiferous epithelium of rat testis: effect of treatment with ethane dimethanesulfonate.

Androgens drive spermatogenesis by processes that are largely unknown. Direct effects on germ cells and indirect effects mediated via testicular somatic elements are currently under consideration, and specific localization of androgens in seminiferous tubules may provide information as regards this. Adult male rats were injected with ethane dimethanesulfonate (EDS; 75 mg/kg body weight) or vehicle. Testes were fixed and paraffin-embedded for localization of testosterone immunoreactivity 1 and 2 weeks after treatment, using the unlabeled antibody (PAP) technique. Plasma testosterone dropped from a pre-treatment level of 2.3 ng/ml to below 0.2 ng/ml 3 days after EDS injection and remained at low levels until the end of observation, accompanied by a progressive decrease in testicular weight. In the seminiferous tubules of vehicle-injected males, testosterone immunoreactivity was found in nuclei of spermatocytes and spermatids and in nuclei and the cytoplasm of Sertoli cells, and showed typical variations according to the stage of spermatogenesis. One week after EDS treatment, immunoreactivity had disappeared from the seminiferous epithelium. Two weeks after treatment, staining of germ cells was detected in two out of four males. The disappearance and reappearance of immunoreactivity coincided with the time course of EDS effects on rat Leydig cells, and we conclude that it corresponds to androgen specifically localized in fixed, paraffin-embedded tissue. Because staining of germ cell nuclei varied with the stage of spermatogenesis, the technique may detect a physiologically relevant androgen fraction; its location suggests that androgens may also directly affect certain germ cell stages.

Animals↗

Endobronchial hamartoma. Report of 7 cases.

Seven cases of endobronchial hamartoma are presented. Preoperative fiberoptic bronchoscopic biopsy provided the histologic diagnosis in two cases, but was inconclusive in the others. The tumor was removed by endoscopic resection (2 cases), local resection via a bronchotomy (1), lobectomy (2) or pneumonectomy (1). These six patients are alive and well 2-5 years postoperatively. The seventh patient refused treatment.

Adult↗

[Is the ultrasonic dissector an advance? Apropos of 70 hepatectomies].

The aim of this retrospective study was to determinate whether the ultrasonic dissector (U.S.D.) is a major advance over existing methods in hepatic surgery. Between 1983 and 1989, we performed 70 hepatectomies "réglées". Twenty seven patients were operated because of benign lesions and 43 patients because of malignant tumours. Transparenchymal approach using "Kellyclasy" or digitoclasy with control of the hilar vessels was carried out 39 times. U.S.D. was used 31 times. No mortality was observed during operating time or post-operative period. The postoperative morbidity was not attributable to the use of the U.S.D. On the whole, U.S.D. has modified neither the amounts of blood loss nor the duration of hilar clamping. However the use of U.S.D. presents 3 advantages: it allows sometimes to perform hepatectomy without pedicular clamping, it makes easy the transparenchymal approach of the large vascular and biliary structures, and it is useful in hydatic cyst surgery. Although the U.S.D. is not indispensable to carry out hepatectomy, it improves intraparenchymal control of vessels and biliary ducts, making therefore hepatic resection easier.

Constriction↗

[Hepatic undifferentiated (or embryonal) sarcoma. Diagnostic and therapeutic problems apropos of botryoid rhabdomyosarcoma].

Primary undifferentiated sarcomas (also called embryonal sarcomas or malignant mesenchymomas) are an exceptional form of cancer of the liver, occurring preferentially in children or adolescents. They can exhibit poor differentiation, embryonal rhabdomyosarcoma being the most frequent. To date, therapeutic success has been reported only rarely. The authors describe the case of a 16 year old boy with primary hepatic sarcoma showing a rhabdomyoblastic differentiation, who is in complete remission two years after total surgical resection and polychemotherapy.

Adolescent↗

Use of a new and rapid milk progesterone assay to monitor reproductive activity in the cow.

A new and rapid enzyme-amplified immunoassay (AELIA) has been developed for the measurement of progesterone in milk. The AELIA system is a non-isotopic method that gives results within 35 minutes. Milk progesterone concentrations measured in 10 cows sampled daily at various stages of the reproductive cycle were very similar to those recorded by a validated radioimmunoassay. The results show that the speed and sensitivity of the AELIA system would make it possible to diagnose pregnancy rapidly at about 24 days after insemination, to predict the onset of behavioural oestrus from decreasing progesterone values during the third week after a preceding oestrus, and to obtain a daily record of milk progesterone levels in animals treated for infertility of ovarian origin.

Animals↗

Motor activity of esophageal substitute (stomach, jejunal, and colon segments).

Manometric studies were performed to evaluate motor activity of several types of esophageal substitutes: total stomach (5 patients), isoperistaltic gastric tube (5 patients), jejunal Roux-en-Y loops (4 patients), and isoperistaltic left colon (15 patients). Motor behavior of substitutes was assessed following dry swallows and following several stimuli: intraluminar injection of 30 ml of water or 0.1N hydrochloric acid and swallowing pills. Following dry swallows, there was no response with either stomach or isoperistaltic gastric tube, jejunum showed a variable response, and a response was infrequent in patients with colon transplants. After dry swallows, transmission of the pressure wave through the anastomosis was not observed in any patient. Total stomach and isoperistaltic gastric tube did not respond to any stimulus. Jejunum responded with progressive waves after water and solid stimuli, and had a hyperkinetic response after acid injection. Colon had a constant (80 to 90%) and homogeneous response with progressive waves after all stimuli. After wet swallows, there was transmission through the anastomosis in 2 patients with colon transplants. Our data indicate that stomach and isoperistaltic gastric tubes do not contribute actively to the onward transmission of food in the digestive tract. Jejunum may contribute actively in digestive transit, but its responses are variable. Having steady and homogeneous responses, colon segments take an active part in transit.

Adolescent↗

Motor activity after colon replacement of esophagus. Manometric evaluation.

Motor activity of the colon transplant for esophageal reconstruction is a point of controversy. In this paper we present manometric studies carried out in 15 patients subjected to isoperistaltic colon interposition. Manometric studies were carried out with two polyvinyl water-filled catheters inserted through pressure transducers. Basal colonic activity and motor activity following several stimuli and "dry swallows" were registered. The type of waves after stimuli were classified as (1) synchronous, (2) sequential or progressive, and (3) segmental. Details of the basal colonic waves and colon contractions after stimuli are given: i.e., rate, duration, amplitude, interval from the stimulus, and percentage of motor activity. The data reported here indicate the good motor response of the isoperistaltic colon to intraluminal injection of water or 0. 1 N hydrochloric acid and to chachet swallowing. Only two free-symptoms patients did not have motor activity. One of them was submitted to manometric studies too soon after the operation. We conclude that the presence of sequential waves in the interposed segment likely can help to propel the contents of the colon into the stomach and to clear gastric juice if reflux from the stomach should occur.

Adolescent↗

[Results of surgery in bullous emphysema (author's transl)].

The authors report a series of 20 patients with single (8) or multiple (12) bullae. In most cases, exeresis of these bullae favorably affected functional signs. Standard spirometry (FEV1, VC) was improved significantly in long-term studies.

Humans↗

Melanotic spinothoracic schwannoma.

A dumb-bell mediastinal melanotic schwannoma is described, and the rarity of this type of tumour emphasised. The tumour was resected by simultaneous laminectomy and posterior thoracotomy. The patient is well four years after operation. The pathology of the tumour is described and the origin of melanotic cells is discussed.

Female↗