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Biomedical subjects

G Gagna

Publications and source records attributed to G Gagna.

At least 19 recordsLinked to original sources

[A case of ureteral stenosis and ureterorectal fistula secondary to sigmoid diverticulitis].

The paper reports a case of ureteral [correction of urethral] stenosis with ureterorectal [correction of urethro-rectal] fistula due to diverticulitis of the sigmoid [correction of sigma] which resolved following reconstruction of the urinary tract by ureterocystostomy [correction of urethrocystotomy] using a modified version of Boari's technique, with satisfactory renal functional recovery. On the basis of an analysis of the literature, the authors comment on ureteral [correction of urethral] stenosis and its etiological diagnosis.

Constriction, Pathologic

[Constipation: drug or surgical treatment?].

Constipation is a very frequent symptom. It affects 7-10% of people. Otherwise a severe constipation exists which is rare, but extremely serious with evacuations every 15 days to 2 months. We expose the classification of constipation in its types: colonic, rectal and anal. We analyse the diagnostic trial which has to be started with a careful anamnesis and well directed physical examination. Laboratory tests and instrumental investigations will be essential means to define exactly the type of constipation and its pathogenetic mechanism. We go deep into physical involvement of constipation and into the problem of constipation in the elderly: except for particular groups (women suffering from colonic hypokinetic constipation) the age of patient is usually old. Medical treatment is described especially regarding the type of constipation. At last we review the surgical techniques proposed for every form of constipation, with exposure and interpretation of their results.

Age Factors

The surgical treatment of post-traumatic vertebral deformities.

The authors report their experience in the treatment of malunited fractures of the spine. After eliminating reducible lesions, the methods of treatment used for fixed irreducible lesions are described. In the cervical spine, the approach is anterior, and includes corporectomy to decompress the medullary canal. It is often impossible to restore cervical lordosis but this is not essential. In the dorsal, dorsolumbar and lumbar spines, experience has demonstrated the inadequacy of isolated anterior and posterior surgical approaches, so a combined approach is proposed aimed at achieving good results, both neurological and mechanical. Reconstruction of the vertebral body is carried out by anterior grafting using bank bone from femoral heads, while fixation is achieved posteriorly by the use of Roy-Camille plates. Indications are carefully considered, taking into account that progression is always a possibility in patients with no neurological deficit. The results are analysed in 14 cervical lesions and 10 dorsolumbar lesions. This operative treatment frequently produced stabilisation as well as the regression of pyramidal signs, but recovery of medullary lesions was never observed. The relief of pain, however, was a constant finding.

Fractures, Bone

[Chronic external instability of the ankle. Surgical treatment by a periosteum ligamentoplasty].

The authors have used an original technique of repair for lateral instability of the ankle. The method utilises the fibro-periosteal covering of the lateral malleolus as a strip which is inserted either into the talus only, or into the talus and the calcaneum in cases with severe talar tilt. The advantages of this technique are to preserve the peroneus brevis tendon and to leave sub-talar joint mobility unimpaired. Twenty-three patients have been operated on and reviewed with an average follow-up of 27 months. The results were encouraging.

Ankle Joint

Transverse fracture of the upper sacrum. Suicidal jumper's fracture.

Thirteen patients with transverse fractures of the upper sacrum were studied to determine fracture anatomy, clinical presentation, and therapeutic approaches. The injury results from falls from a height and is usually associated with suicidal attempts by jumping. The position of the lumbar spine in lordosis or kyphosis at the time of impact determines which of three types of morbid anatomy will result. Because of associated polytrauma, fracture of the upper sacrum is often not recognized in the acute stage, and awareness of the possibility of such injury, especially in the presence of perineal neurologic deficit should result in securing good quality radiographic study, including tomograms. Surgical treatment is often required.

Adult

[Primary lymphoma of the breast].

Analysis of 5 cases of primary breast lymphoma highlights the marked rarity of the lesion and the extreme difficulty of pre-operative diagnosis. It is also shown that the disease generally runs a rapid course and that prognosis is usually unfavourable. The most effective treatment appears to be a combination of surgery and radiation therapy, while chemotherapy--although widely used--still requires further confirmation.

Aged