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H Baumel

Publications and source records attributed to H Baumel.

At least 19 recordsLinked to original sources
PubMed1992

[Cyclosporin A metabolism and induction of cytochrome P-450 in orthoptic hepatic transplantation in rats].

The aim of our study were 1) to establish that cyclosporin (CsA) metabolism was correlated with the rate of cytochrome P4503A (cyt.) in Wistar rats induced with dexamethasone (Dex.), 2) to demonstrate that the induction of cyt. with Dex. in liver "rat donor" was transmissible to "recipient rat" after liver transplantation. Sixty rats were divided in 5 groups. In group T, a single dose of CsA (10 mg/kg) was administered intravenously in 10 rats; in group D, 10 rats were treated with Dex (300 mg/kg daily for 4 days) and then received CsA as above; in group BN 5 rats were treated with beta-naphthoflavone. Thirty five rats underwent a liver transplantation either from "non induced donors" (group G, n = 11) or from "induced donors with Dex." (group GD, n = 24) followed by CsA injection the next day. For each rat, CsA plasma levels were determined by radioimmunoassay in 6 samples. Liver microsomes cyt. from samples of the liver of donor rats (group G and GD) or after sacrifice (group T, D, BN) were quantitated by immunoblot analysis and estimated from densitometric analysis of the blot. Mean maximal plasma concentration (Cmax) were 2,822 +/- 997 ng/ml in group T, 1,447 +/- -458 ng/ml in group D, 2,685 +/- 1,383 ng/ml in group G, 1,337 +/- 713 ng/ml in group GD and 3,094 +/- 685 ng/ml in group BN. Considering the Cmax and the ASC (area under curve), there was a significant difference between all groups and separately between groups T and D, G and GD.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Medical behaviors and cancer of the exocrine pancreas].

A French national enquiry examined 4,530 cases of cancer of the exocrine pancreas treated from 1982 to 1989. Ultrasonography was performed in 98% of cases. Other radiological or biological investigations varied from one department to another (P < 0.001). Of 769 patients seen in Gastroenterology departments, 47% (range: 0 to 72%) were operated on. Of 3,761 patients undergoing operation, surgical techniques differed significantly from one department to another (P < 0.001). Resections were performed in 21% (range: 2 to 45%) of cases. Causes of unresectability, choice of biliary bypass, indications for gastrojejunostomy, and use of splanchnicectomy varied from one surgical department to another (P < 0.01). Wide variance in therapeutic policies may be explained by differences in local indications or surgical expertise, giving support to the need for a consensus conference to discern the indications of the available therapeutic alternatives for cancer of the exocrine pancreas.

Biliopancreatic Diversion↗
PubMed1992

[Celioscopic cholecystectomy in simple and complicated cholelithiasis. Apropos of 392 cases].

In a study including 392 patients we compared two groups of patients according to the indication for laparoscopic cholecystectomy: group I: 293 patients treated for simple cholelithiasis (n = 291) or gallbladder polyps (n = 2). Group II: 99 patients operated for complicated cholelithiasis. For each patient, 14 pre, intra and postoperative parameters were analysed and compared. Mean operative time was 80 minutes. Primary and secondary laparotomies were necessary in 5.8% and 1.3% of cases respectively. Biliary injury was the most frequent complication (1.3%). Mean hospital stay was 4.5 days. In terms of mean age, operative time, intraoperative incidents and complications, and primary laparotomy. There was a significant difference between the two groups (p less than 0.001). There were 4 secondary laparotomies in group II and one in group I. These results suggests that laparoscopic cholecystectomy is a safe technique with a low mortality rate (0.25%). The comparative study proves that this technique, first indicated for simple cholelithiasis, is also applicable to the majority of complicated cholelithiasis.

Acute Disease↗
PubMed1991

[EC-cell pancreatic endocrine carcinoma responsible for chronic diarrhea].

Ec cell or carcinoid enterochromaffinomas are very rare among the endocrine tumors, and more specifically orthocrine tumors, of the pancreas. We report one case of primary malignant carcinoid tumor of the pancreas, with no apparent metastasis, discovered during exploration for chronic diarrhea associated with hypercalcemia, disorders of carbohydrate metabolism and a serotonin secretion. The treatment consisted in a left splenopancreatectomy associated with a left adrenectomy. The clinical and biological signs immediately disappeared and, after a time lapse of almost five years, the general condition of this patient is quite satisfactory.

Acidosis↗
PubMed1991

[Heterotopic hepatic transplantation. Apropos of a case treated in the terminal stage of decompensated alcoholic cirrhosis].

Heterotopic liver transplantation is an exceptional indication for acute or chronic liver disease. The authors report a case of auxiliary liver transplantation performed for end-stage alcoholic cirrhosis. The patient was contra-indicated for orthotopic transplantation because of poor general and nutritional status. The HLT was indicated because of intractable ascites, liver insufficiency and chronic encephalopathy. The operation was performed according to the technique described by Fortner. Liver function tests returned to normal within 3 days and the only postoperative complication were gastro-intestinal bleeding due to CMV viral infection. Liver function was assessed by HIDA scintigram which showed blood intake by the graft and atrophy of the native liver. The patient was discharged after 3 months. The follow-up is 17 months. At the 15th month control, liver CT showed multiple hypodense nodules biopsied and corresponding to metastasis from a probable pancreatic carcinoma. ERCP and morphologic explorations did not show the primary tumor. The authors discuss the indications of HLT, the rules of successful performance of HLT and the problem of the graft involvement by metastases.

Hemodynamics↗
PubMed1991

[A prospective and comparative study of 262 laparoscopic cholecystectomies].

A prospective, comparative study is made of 262 patients (195 males, 67 females) subjected to laparoscopic cholecystectomy. Two groups were considered: simple cholelithiasis (SC) (187 cases), and complicated cholelithiasis (CC) (75 cases: 63 acute cholecystitis, 8 hydrocholecystitis, 4 pancreatitis). Mean age was 51 among the SC cases, and 57 in the CC patients. Mean operating time was 67 and 96 minutes for the SC and groups, respectively. Preoperative complications were more frequent in the CC group (51.4%) than in the SC patients (24%)--immediate laparotomies being performed in 2 and 25% of the SC and CC patients, respectively. Mortality was zero, with similar morbidity in both groups. Mean hospitalization time was 4.9 and 3.4 days for the CC and SC groups, respectively.

Age Factors↗
PubMed1991

[Treatment of exocrine pancreas tumors].

A review of the literature over the last five years reveals that the results of treatment of pancreatic carcinoma have barely improved over the last thirty years, except in terms of the operative mortality which has markedly improved over the last decade. Pancreatectomy still constitutes the only, although slight, chance of cure. It must be reserved to the rare macroscopically curable cases, i.e. small tumours of the head of the pancreas, apparently confined to the pancreas. Palliative treatments should preferably be surgical. Endoscopic biliary drainage should only be performed in inoperable cases. Adjuvant radiotherapy and chemotherapy must be integrated into curative and palliative strategies. These various therapeutic modalities can only be evaluated by means of prospective studies and controlled trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Colo-rectal anastomosis. Early postoperative course].

A retrospective study of immediate postoperative events was carried out in 138 cases of colorectal anastomosis. The overall operative mortality rate was 7.2 percent. The proportion of clinical fistulae was 9.4 percent, and fistulae were responsible for death in 0.7 percent of the cases. Based on these results, a statistical analysis of the various factors that could have influenced the solidity of anastomoses (antibiotic prophylaxis, nature of the disease, level and technique of the anastomosis) was conducted. No significant difference was found between these factors, except for antibiotic prophylaxis which reduced the number of disjunctions.

Adult↗
PubMed1990

Intrahepatic bile duct cystadenocarcinoma: case report and imaging diagnosis.

The authors report the 30th case in the literature of cystadenocarcinoma of the liver and the second case arising in the caudate lobe. This case illustrates the 2 main questions raised by this tumor: the importance of differentiating benign and malignant cystadenoma and bile duct cyst on sonographic and scanographic aspects and the surgical management of these tumors of the liver, especially in this malignant centrohepatic case.

Bile Duct Neoplasms↗
PubMed1990

[Ileal pouch in the treatment of ulcerative rectocolitis and familial polyposis. Analysis of morbidity in a series of 30 cases].

Between 1984 and 1989, 30 patients underwent total coloproctectomy with J ileal pouch and ileo-anal anastomosis. They corresponded to 29 cases of ulcerative colitis and one case of familial polyposis. The authors report their own experience and the related morbidity and functional results. There were 23% fistulae, 6.6% pouchitis, 10% stenoses, 8.7% pelvic abscesses, 10% bowel obstructions, 6.6% fistulae after ileostomy closure. Only one pouch had to be removed for severe pouchitis. Functional results were partly related to post-operative complications: 50% of patients had normal continence, 57% at least 6 stools per day, 81% had one stool per night, 15% had soiling. Morbidity is discussed for the various types of complications.

Adenomatous Polyposis Coli↗
PubMed1989

Small carcinomas of the pancreas with associated chronic pancreatitis: two case reports.

Two cases of pancreatitis associated with papillary atypical hyperplastic lesions and micro-invasive cancers are reported. They are interesting from an etiopathogenic and diagnostic point of view by again illustrating the problem of transmission between hyperplastic lesions and cancer, together with the difficulties encountered in asserting the certainty of diagnosis. In each observation the association of pancreatic lesions, of all stages of hyperplasia, and of cancer can be observed. This suggests that transmission occurs between those different lesions. In such cases diagnosis of benignity or malignancy is always difficult to assert. No clinical, biological, morphological or even cytological criterion allows one to make a ruling. For this reason excision is recommended by the authors whenever the etiology of pancreatitis remains obscure and especially in the presence of important dystrophic lesions.

Adenocarcinoma↗
PubMed1989

[Prognostic factors of surgically-treated cancers of the right colon. Multifactorial analysis of a series of 50 curative excisions].

Between 1970 and 1986, 502 colorectal cancers were operated in our department. In 82 cases, it was located on the right, including 50 patients who underwent curative right hemicolectomy. Overall, at 5 years, 23 patients are alive with no recurrence (46%), 17 died from their cancer (34%) and 10 patients died of intercurrent causes (20%). Among the 13 prognostic factors analyzed, only the pathologic stage of the tumor (extend of dissemination to the abdominal wall and lymph nodes) and preoperative fever had a statistically significant effect on 5 year survival (p = 0.001 for fever and p = 0.01 for Duke's stage). The multifactor analysis clearly delineates a group with a poor prognosis (group with lymph node involvement and fever) in which the median of survival was 30 months.

Aged↗
PubMed1988

[Pancreatic insulinoma. Peroperative topographical diagnosis].

Difficult problems may arise and place the surgeon in an uncomfortable position in cases where neither pre-operative investigations nor palpation of the pancreas have enabled pancreatic insulinomas to be localized. However, 3 examinations performed during the operation should help solve these problems, as shown by the case presented here. These examinations are insulin assays in the peripancreatic venous blood, blood glucose measurements under constant rate glucose infusion, and intra-operative ultrasonography. Pre-operative radioimmunological assays of insulin have been used for about 10 years, but owing to technical advances and shortening of the incubation time these assays can now be performed during surgery and, above all, with immediate results. Blood glucose measurements are good pointers, and this method has long been used in this type of surgery. Intra-operative ultrasonography has recently been introduced; it is very effective in diagnosing endocrine tumours of the pancreas, since the images it provides are quite characteristic. These 3 examinations combined should be used to localize pancreatic insulinomas; they may replace most of the pre-operative examinations that are still carried out.

Adenoma, Islet Cell↗
PubMed1988

[A case of peritonitis due to perforation of the small intestines of tubercular etiology. Review of the literature].

The perforation into free peritoneum is a singular complication of the intestinal tuberculosis. Regarding a recent observation of this complication revealing small intestinal tuberculosis, we have tried to make the point on this exceptional form of small intestinal tuberculosis. By means of prolonged enteric nutrition and antitubercular treatment, the patient will be cured of this disease without any after-effects as we mentioned it in our observation. Very fearsome in the past (44 deaths out of 104 published cases), perforation into free peritoneum nowadays has a better prognosis.

Humans↗
PubMed1988

[A Technic of re-using a thrombosed hepatic artery in hepatic intra-arterial chemotherapy].

Nowadays the palliative treatment of hepatic metastasis very often uses the hepatic arterial chemotherapy in subcutaneous injection cavity. Unfortunately in about ten per cent of the cases, the thrombosis of hepatic artery limits the lasting quality of use of the catheters which last about twelve months (more or less four). As mentioned in our observation, if the patient "answers" the chemotherapy, we propose reusing this thrombosized artery by means of an original technical artifice. In this observation, in fact, we grafted a small segment of submesenteric vein on the hepatic disobstructed artery. We think that this artifice could also be used in case of anatomic variations of the hepatic artery like trifurcation.

Aged↗