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Biomedical subjects

G Nisand

Publications and source records attributed to G Nisand.

10 recordsLinked to original sources
PubMed1996

Comparison of resection, liver transplantation and transcatheter oily chemoembolization in the treatment of hepatocellular carcinoma.

BACKGROUND/AIMS: Resection and liver transplantation are currently considered as the most useful treatments for hepatocellular carcinoma. However, transcatheter oily chemoembolization may be favourably compared with these two surgical treatments in patients with anatomically operable tumors. METHODS: Between 1985 and 1991, 122 patients with an Okuda stage I tumor were hospitalized in two French hospitals. Among these patients, 33 remained untreated, 42 were treated by transcatheter oily chemoembolization, 30 by resection and 17 by liver transplantation. The four groups were closely comparable except for age, the patients in the two surgical groups being significantly younger. Moreover, the frequency of pTNM II tumor was significantly higher in the resection group. RESULTS: The 5-year probability of survival was close to 45% in each of the three treated groups and was significantly higher than in the untreated group (0% at 4 years, p < 0.0001). The probability of cancer recurrence and/or metastatic dissemination was lower after transcatheter oily chemoembolization than after surgery. CONCLUSION: Thus, transcatheter oily chemoembolization seems comparable at 5 years with resection or transplantation for the treatment of resectable hepatocellular carcinoma.

Aged↗
PubMed1995

Prospective study on fetal weight estimation using limb circumferences obtained by three-dimensional ultrasound.

The aim of this prospective study was to evaluate the usefulness of fetal weight estimation in a prospective study, based on formulae derived from a previous retrospective study, using forward stepwise multiple regression analysis. Three-dimensional ultrasound was used to make reproducible measurement of limb circumferences, which formed the basis of our models. A total of 213 women with singleton pregnancies were scanned in the week prior to delivery and the following variables were measured: biparietal diameter, head circumference, transverse abdominal diameter, abdominal circumference, femur length, thigh circumference and arm circumference. The whole population was divided into three subgroups according to the abdominal circumference (< 10th centile, 10-90th centile, and > 90th centile). We demonstrated the need for only two models for accurate fetal weight estimation, one for the small-for-dates fetuses and a second for the others. The most accurate results were obtained for the macrosomic fetuses with a standard deviation of 8.8%. Our data confirm the usefulness of measurement of fetal thigh circumference for the the small-for-dates-fetuses and arm circumference for the other groups. We concluded that the use of three-dimensional ultrasound could facilitate the accurate prediction of fetal weight.

Adolescent↗
PubMed1995

Effect of pantothenic acid and ascorbic acid supplementation on human skin wound healing process. A double-blind, prospective and randomized trial.

This study aimed at testing human skin wound healing improvement by a 21-day supplementation of 1.0 g ascorbic acid (AA) and 0.2 g pantothenic acid (PA). 49 patients undergoing surgery for tattoos, by the successive resections procedure, entered a double-blind, prospective and randomized study. Tests performed on both skin and scars determined: hydroxyproline concentrations, number of fibroblasts, trace element contents and mechanical properties. In the 18 supplemented patients, it was shown that in skin (day 8) Fe increased (p < 0.05) and Mn decreased (p < 0.05); in scars (day 21), Cu (p = 0.07) and Mn (p < 0.01) decreased, and Mg (p < 0.05) increased; the mechanical properties of scars in group A were significantly correlated to their contents in Fe, Cu and Zn, whereas no correlation was shown in group B. In blood, AA increased after surgery with supplementation, whereas it decreased in controls. Although no major improvement of the would healing process could be documented in this study, our results suggest that the benefit of AA and PA supplementation could be due to the variations of the trace elements, as they are correlated to mechanical properties of the scars.

Adolescent↗
PubMed1995

[Does the choice of mammoplasty pedicle influence the shape of reduced the reduced-sized breast?].

Thirty seven patients with breast hypertrophy were restrospectively reviewed with a mean follow-up of 2 years. Reduction mammoplasty was performed with 3 different pedicles (superior, inferior and both) involving a glandular resection of a least 500 g on each side in all cases. The results were evaluated according to both objective and subjective criteria. The choice of pedicle had a considerable influence on the results. The vertical limb usually increased with time (months), although its intraoperative length was 5 cm. The increasing length of the vertical limb varies according to the type of pedicle chosen. The mean length increase was 1.52 cm; 4.18 cm; 4.15 cm for superior, inferior, and both pedicles respectively. The different increase was statistically significant (p < 0.001) when the technic involving a superior pedicle was compared to a technic involving an inferior pedicle. No statistically significant difference was observed between technics using the inferior and both pedicles. A superior pedicle technic entails the lowest increase of the vertical limb length which in turns leads to better long-term cosmetic results.

Adult↗
PubMed1994

[Survival in acute myocardial infarction in a group of 369 patients consecutively admitted between 1988 and 1992. Analysis of risk factors and medical procedure].

A retrospective analysis without exclusion of 369 consecutive cases of myocardial infarction admitted between January 1988 and March 1992 studied the risk factors, previous medical history and treatment in this period during which medical practice seemed to be standardised with acknowledged benefits of thrombolysis, beta-blockade and aspirin therapy. The population observed is divided in three age groups (< 65, > 65 < 75 and > 75). A Cox model multivariate analysis for age, sex, diabetes, hypertension, hypercholesterolaemia, tobacco smoking, previous infarction, coronary artery disease and cardiac failure underlined the risk related to age which was 3.2 for patients 65-75 years of age and 4 for patients over 75 years of age. The risk was high in women (1.4), diabetes (1.5) and previous infarction (1.7). The excess mortality of the elderly age groups could also have been related to medical management as the most effective treatments were less commonly used. Thrombolysis was used in 44% of patients under 65 years of age but in only 9.7% of patients over 75 years; betablockers were prescribed in 77.6% of the younger but only in 27.4% of the older patients. The same tendency was observed in the administration of aspirin, with 81.6% receiving this drug in the younger patients compared to only 61% in older patients. Differences in survival at 6 months according to age (93.6%, 74% and 54.9%) show that there is a clearly defined therapeutic objective over 65 years of age with a large field of action and a probability of significant improvement in mortality and morbidity.

Adrenergic beta-Antagonists↗
PubMed1993

Measurement of limb circumferences with three-dimensional ultrasound for fetal weight estimation.

A large number of formulae have been published for fetal weight estimation. This study examines the possibility of using three-dimensional ultrasound to measure the limb circumference. This technology provides us with the opportunity to visualize two simultaneous, orthogonal planes, allowing the exact determination of the transverse plane at the mid-point of the limb. A total of 157 patients were scanned in the week prior to delivery. The following variables were measured in 154 fetuses: biparietal diameter, head circumference, transverse abdominal diameter, abdominal circumference, femur length, thigh circumference and arm circumference. The whole population was split into three subgroups according to the abdominal circumference centile (< 10th centile, 10-90th centile, and > 90th centile), because this single variable has the strongest correlation with neonatal weight (R = 0.901). With forward stepwise multiple regression analysis, four models were elaborated, one for the whole population and one for each subgroup. The small-for-dates fetuses need a targeted formula including only two variables, thigh circumference and femur length. Our data suggest that the thigh circumference measurement improves the estimation for growth-retarded fetuses and that the arm circumference improves the weight prediction for the others. The measurement of the two variables, made possible with three-dimensional ultrasound, has improved our results in fetal weight estimation.

Journal Article↗
PubMedDate not supplied

Can the wound healing process be improved by vitamin supplementation? Experimental study on humans.

UNLABELLED: The improvement of the wound healing process in humans by vitamin supplements is still controversial because of the lack of a clearly demonstrated correlation with the mechanical properties of scars. OBJECTIVE: The aim of this work was to study the effects of high doses of ascorbic acid (AA) and pantothenic acid (PA) on the wound healing process of human skin. METHOD: Two groups of patients undergoing surgery for tattoo removal by the successive resection procedure received AA (1 or 3 g/day) and PA (0.2 or 0.9 g/day). More than 80 mechanical, biological and histological parameters were investigated in both preoperated skin and the scars. RESULTS: The breaking energy of scars was higher in group 2, and energy and treatment were directly correlated (p = 0.006). Mg and Mn significantly rose in group 2 whereas Fe decreased in a dose-dependent manner. Intragroup comparison showed patient and treatment effects for Mg, a time.treatment effect for Cu and a treatment effect for Fe. CONCLUSION: The degree and rapidity of variations rather than the variations of the absolute values themselves of fibroblasts, hydroxyproline, Fe, Cu and Mg are significantly related to the enhancement of the mechanical properties of scars. From this study, it may be assumed that in order to obtain 'better', more solid and resistant scars, the decrease of Fe must be quick and acute in order to avoid the harmful effects of toxic radicals; the increase of Cu, Mg and Mn must be early and high in order to have more stable and solid collagen.

Ascorbic Acid↗