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Biomedical subjects

G Fromont

Publications and source records attributed to G Fromont.

31 records · Page 2Linked to original sources
PubMed1995

[Results of the celioscopic modification of Hill's operation (HMC). Apropos of an experience of 50 cases].

The objective of this study was to evaluate the clinical, endoscopic and manometric results of modified Hill's operation performed by laparoscopy. Between may 1991 and december 1992, 50 symptomatic patients (27 males and 23 females, mean age: 47 +/- 15.3 years, mean weight: 74.5 +/- 12.6 kg) were operated by laparoscopic modified Hill's operation. Gastro-oesophageal endoscopy and oesophageal manometry (25 cases) were performed preoperatively and postoperatively. The patients were interviewed by an independent observer with a mean follow-up of 8 +/- 4.9 months after the operation. Preoperatively, the mucosal cardia was situated 36 cm from the dental arch (range: 30-43), 29 patients presented with ulcerated oesophagitis refractory to treatment (58%), while the mean resting pressure of the lower oesophageal sphincter was 7.24 +/- 4.93 mmHg. After introduction of the laparoscope and insertion of the various trocars, the operation consisted of dissecting the hiatal orifice, posterior myorrhaphy of the diaphragmatic crura, suture of the right border of the oesophagus to the diaphragmatic crura and closure of the angle of His. This antireflux device was completed by an anterior hemivalve, fixed to the left and right crura. Postoperatively, the mucosal cardia was situated 39.8 cm from the dental arch (range: 35-45) and only one case of oesophagitis persisted (3.4%). The mean resting pressure of the lower oesophageal sphincter was significantly increased to 18.5 +/- 6.86 mmHg (p < 0.001). The mean duration of anaesthesia and the mean operating time were 116 +/- 45 min and 92 +/- 40 min, respectively. The mean hospital stay was 6 +/- 2.3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Elevated levels of interleukin-1 beta (IL-1 beta) and IL-6 in serum and increased production of IL-1 beta mRNA in lymph nodes of patients with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome.

To evaluate a possible implication of cytokines in the pathogenesis of polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome, we studied five consecutive patients with this condition, of which four had sclerotic bone lesions and four had multicentric Castleman's disease. Interleukin-1 beta (IL-1 beta) and IL-6 serum levels were determined in these patients (13 serum samples) and in patients with multiple myeloma (5) and Waldenström's macroglobulinemia (5). In situ hybridization of the relevant mRNAs was performed on lymph node specimens of two patients with POEMS syndrome who had Castleman's disease. Elevated serum levels of IL-1 beta (13/13 samples), and IL-6 (7/13 samples) were found in patients with POEMS syndrome. In the other patients, serum IL-1 beta was undetectable or slightly increased and IL-6 was elevated in a single patient with Waldenström's macroglobulinemia. Abundant IL-1 beta mRNA-producing cells were present in interfollicular spaces in the two tested patients, while IL-6 mRNA-producing cells were rare. We conclude that IL-1 beta and IL-6 serum levels may be chronically elevated in patients with POEMS syndrome, and that lymph node may be one site of IL-1 beta overproduction. These results are in keeping with the hypothesis that cytokines mediate systemic manifestations of POEMS syndrome.

Adult↗
PubMed1994

Cytokine expression in the muscle of HIV-infected patients: evidence for interleukin-1 alpha accumulation in mitochondria of AZT fibers.

To evaluate the possible role of cytokines in human immunodeficiency virus (HIV)-associated muscular disorders, we performed immunocytochemistry for interleukin-1 alpha, -1 beta, and -6 and tumor necrosis factor-alpha on frozen muscle biopsy specimens from HIV-infected patients with various myopathies (HIV polymyositis in 5, HIV-wasting syndrome in 5, zidovudine myopathy in 10) and from seronegative individuals (normal muscle in 2, mitochondrial cytopathies in 10). The HIV-infected patients showed positive reactivities in vessels (interleukin-1) and in inflammatory cells (mainly interleukin-1 and tumor necrosis factor-alpha), including perivascular hemosiderin-laden macrophages in 5 patients. In zidovudine myopathy, a majority of AZT fibers (i.e., ragged-red fibers with marked myofibrillar changes) showed mild to marked expression of interleukin-1. Expression of interleukin-1 in the other mitochondrial myopathies was much weaker. Interleukin-1 beta messenger RNA was demonstrated in muscle fibers by in situ hybridization, implying that interleukin-1 was produced in muscle cells. Immunoelectron microscopy showed that interleukin-1 alpha was mainly bound to mitochondrial membranes in AZT fibers. Proinflammatory and destructive effects of the studied cytokines might be responsible for several myopathological changes observed in HIV-infected patients, including inflammation and hemosiderin deposits in muscle tissue, and prominent myofibrillar breakdown in AZT fibers.

HIV Infections↗
PubMed1994

[MRI in cancer of the prostate with T1-weighted sequences using fat suppression and injection of gadolinium].

The assessment of tumor extension in 20 patients with cancers of the prostate at a clinical stage A or B included MRI with a body coil before prostatectomy. Transverse and coronal T1-weighted sections with injections of gadopentate dimeglumine (gadolinium) and fat suppression were systematically taken to assess the vascularity of the various regions of the prostate and of the cancer, as well as the merits of such sequences for the assessment of extension. The normal, poorly vascularized peripheral area is only slightly enhanced by injection, while the transition area, which is most often hyperplastic in the age group studied, enhances heterogeneously with contrast. All cancers enhance after injection. In the assessment of extension, the major merit of gadolinium is that it allows exploration both of the vesiculodeferential junction on coronal sections and of the structure of the seminal vesicles. Thus a normal junction allows ruling out macroscopic invasion of the vesicles. In addition, gadolinium allows correcting false positive MRI findings when the areolar structure of the vesicles is preserved. Gadolinium does not provide additional evidence of extension through the capsule in comparison with T2-weighted sequences. On a whole, in our series, MRI with a body coil, associated T2-weighted sequences and T1-weighted sequences after gadolinium injection and fat suppression, has 58% sensitivity and 100% specificity for the diagnosis of stage C cancers.

Aged↗
PubMed1993

[Laparoscopic repair of inguinal hernia by subperitoneal prosthesis implantation (Stoppa operation)].

The authors present their technique of inguinal hernia treatment by the putting of a very tall (15 x 10 cm) polypropylene prosthesis in its place in subperitoneal by laparoscopic access. From May 1, 1991 until January 31, 1992, 110 inguinal hernias (64 right and 46 left hernias) were operated on 93 patients. The first results are analysed: there was in particular no recurrence with an average of 4.3 months set-back. It should be observed that about 40% of the patients were operated under epidural analgesia.

Adult↗
PubMed1992

Cutaneous lymphadenoma with focal mucinosis.

Cutaneous lymphadenoma of the eyebrow occurred in a 72-year-old man. The nodular tumor was well circumscribed but non encapsulated and invaded the reticular dermis and superficial hypodermis without any connection with the epidermis. Tumor cells had a basal-like appearance and were arranged in small lobules and islands with peripheral palisading and areas of central keratinization. They were often dissociated by an extracellular mucinous material. The stroma was fibroblastic and contained a marked lymphoid infiltrate that surrounded and penetrated the neoplastic lobules. Occasional germ-like hair follicle structures were noted. The immunohistochemical pattern was similar to that of hair follicles, and the leucocytic component was predominantly composed of T-lymphocytes and Langerhans cells, which were specially numerous within the neoplastic lobules. We believe that the tumor, in the present case, has morphologic features consistent with epithelial and stromal attributes observed in hair follicles.

Aged↗
PubMed1992

[What may be expected from endorectal echography and magnetic resonance imaging in the evaluation of local extension of cancer of the prostate?].

Thirty patients presenting with a clinical stage A or B cancer underwent TRUS and MRI with a body coil prior to radical prostatectomy. Imaging and pathology were correlated to assess the limits of TRUS and MRI in pre-operative staging of prostatic carcinoma. Results showed that TRUS and MRI had a sensitivity of 42 and 66% and a specificity of 89 and 94% respectively, for the diagnosis of macroscopic capsular effraction. Seminal vesicle invasion was diagnosed by TRUS with a sensitivity of 16% and a specificity of 81%. With MRI, the sensitivity and the specificity were 85 and 94% if only gross infiltration was considered. Sensitivity dropped to 45% if microscopic invasion was included. We conclude that: 1) postero-lateral venous plexus are more easily delineated by MRI, permitting a more accurate diagnosis of capsular penetration. 2) Seminal vesicle invasion cannot be diagnosed by TRUS as the echo-structure of the cancer and the caudal junction of the seminal vesicles and vas deferent are similar. 3) A normal caudal junction on TRUS or a normal bilateral hypersignal of the seminal vesicles on MRI are associated with seminal vesicle invasion in less than 5% of cases. 4) A normal caudal junction on TRUS eliminates false positive cases of MRI related to non tumoral hyposignals of the seminal vesicles.

Aged↗
PubMed1992

[Thoracoscopic middle lobe resection].

The authors report a case of middle lobectomy by a thoracoscopic procedure. A forty-year old patient had carcinoma of the middle lobe (6 cm diameter). The use of staplers and ligatures by this way allows the control of the different vessels and bronchus. The indications of that technique must be evaluated in the future.

Adenocarcinoma↗
PubMed1991

[What may be expected from endorectal ultrasonography and magnetic resonance imaging in the assessment of local extension of cancer of the prostate?].

30 patients presenting with a clinical stage A or B cancer underwent TRUS and MRI with a body coil prior to radical prostatectomy. Imaging and pathology were correlated to assess the limits of TRUS and MRI in pre-operative staging of prostatic carcinoma. Results showed that TRUS and MRI had a sensitivity of 42 and 66% and a specificity of 89 and 94% respectively, for the diagnosis of macroscopic capsular effraction. Seminal vesicle invasion was diagnosed by TRUS with a sensitivity of 16% and a specificity of 81%. With MRI, the sensitivity and the specificity were 85 and 94% if only gross infiltration was considered. Sensitivity dropped to 45% if microscopic invasion was included. We conclude that: (1) postero-lateral venous plexus are more easily delineated by MRI, permitting a more accurate diagnosis of capsular penetration. (2) Seminal vesicle invasion cannot be diagnosed by TRUS as the echostructure of the cancer and the caudal junction of the seminal vesicles and vas deferens are similar. (3) A normal caudal junction on TRUS or a normal bilateral hypersignal of the seminal vesicles on MRI are associated with seminal vesicle invasion in less than 5% of cases. (4) A normal caudal junction on TRUS eliminates false positive cases of MRI related to non tumoral hyposignals of the seminal vesicles.

Aged↗
PubMed1984

[Evoked potentials and structured and colored stimuli].

After a historical account and a brief description of the techniques of signal analysis used in their laboratory (visual evoked potentials (VEPs) with statistical calculations, Fast Fourier Transform, correlation function), the authors present the experiments they undertook concerning colored stimulations. These experiments were carried out in 3 steps: colored stimulations on a cathode-ray screen, with constant luminance, concerning 8 healthy volunteers (72 VEPs analyzed); colored stimulations on a 'structured' screen (pattern reversal), concerning 31 healthy volunteers (186 VEPs analyzed); colored and pattern stimulations on a new cathode-ray stimulator built in the 'Centre National des Arts et Métiers' enabling both preceding types of stimulations with increased reliability and offering new possibilities of stimulation (variation of contrast, luminance or chromaticity precisely controlled) with various patterns in the background. The results evidence two different groups of electrophysiological responses, distinctly related to the presence or absence of a morphological structure in the stimulation. As well as this, a significant increase in latencies is observed with blue stimulations.

Adult↗
PubMedDate not supplied

[Inguinal hernia in adults. Subperitoneal prosthesis under celioscopic control (370 operated sides in 320 patients with 411 hernias)].

The authors present their technique of groin hernias repair by putting of a very tall (15 X 15 cm for unilateral hernias, or 30 X 15 cm for bilateral hernias). Polypropylene prosthesis in subperitoneal space by laparoscopic access. From may 1991 to june 1993, 320 patients were operated on 370 sides (50 bilateral hernias) with a total of 411 hernias. The first results are analysed: there was in particular no conversion and infection. Recurrences were studied only on the patients operated since at least one year: There were 1 recurrence (0.6%) on 163 sides operated in 141 patients with a mean average follow up of 17 months. There were 2 occlusions (on 370 sides operated), by incarcerated small bowel in the preperitoneal space after partial failed of the peritoneal suture. The first patient was reoperated on at the fifteenth postoperative day (chronic occlusion) by laparotomy. The second patient was reoperated on at the fifth postoperative day by laparoscopy which permit to reduce the small bowel in the abdominal cavity and closing the peritoneum with a new suture. It should be observed that 74 patients (23%) were operated on epidural anesthesia.

Adult↗