Biomedical subjects

H Viard

Publications and source records attributed to H Viard.

At least 37 records · Page 2Linked to original sources

PubMed1991

[Practical role of ultrasonography and clinical examination for the diagnosis of acute appendicitis. Prospective study].

The aim of this 100-patient prospective study was to compare three types of investigations in the diagnosis of acute appendicitis: initial clinical examination, initial appendicular ultrasound examination, and final results of repeated clinical examinations carried out within the first 48 hours. Final results included initial evaluation, obvious clinical results and definitive results from patients under 48 hour observation for uncertain diagnosis. Clinical initial or appendicular ultrasound examinations were poorly contributive to diagnosis (overall accuracy: 76 percent). On the contrary, repeated clinical examinations yielded a 100 percent sensitivity, a 94 percent specificity, a 94 percent positive predictive value, a 97 percent negative predictive value and a 97 p. 100 overall accuracy. No morbidity was noted in observing patients for 48 hours. Unwarranted appendectomies were carried out in 3 percent of cases. Ultrasonography of the appendix seems useful for the differential diagnosis of acute appendicitis.

Acute Disease↗

PubMed1991

[Prevention of postoperative wound dehiscence. Comparative study of polyglactin 910 mesh and total reinforced extraperitoneal sutures].

Postoperative wound dehiscence is a serious complication. Various surgical procedures have been proposed to prevent it but only few studies have compared their effectiveness. The authors report a retrospective study on 292 high risk patients operated between 1980 and 1988. These patients were divided in two groups according to the methods of abdominal wall support: 226 patients (group I) with total reinforced extraperitoneal sutures and 66 (group II) with a polyglactin 910 mesh. Preoperative risk factors, surgical pathology and the incisions performed were similar in the two groups. Only two parameters were different: the number of previous operations and emergency surgery which were more frequent in group II (p less than 0.05). Fourteen patients in group I developed postoperative wound dehiscence and none in group II (p = 0.02). Nine of these patients were reoperated with a mortality of 28.5%. The frequency of the other complications was similar in the two groups. Polyglactin 910 mesh was more effective than total reinforced extraperitoneal sutures in the prevention of post operative wound dehiscence justifying its use in high risk patients.

Aged↗

PubMed1991

[Cavernous hemangioma of the liver associated with angiosarcoma: malignant transformation?].

Angiosarcoma of the liver is a rare tumor. Its treatment is usually regarded as unsuccessful and its prognosis extremely poor. The authors report the case of a solitary and encapsulated hepatic tumor characterized by the association of a cavernous hemangioma surrounded by an angiosarcoma. The hypothesis of an eventual malignant transformation of cavernous hemangiomas of the liver is raised.

Adult↗

PubMed1990

[Factors influencing survival after resection of cancer of the cardia. Comparison of total esophagogastrectomy and upper pole esophagogastrectomy].

Total oesophagogastrectomy (TOG) is the best surgical technique for carcinoma of the cardia. However, oesophagogastric anastomosis is easier in upper pole oesophagogastrectomy (UPOG). This is a retrospective study excluding post-operative deaths and palliative surgery. We studied the factors affecting the survival and then compared TOG (n = 15) and UPOG (n = 26) in carcinomas of the cardia. Bad prognosis was related to several factors: poorly differentiated adenocarcinomas, tumor size, lymph node involvement and residual tumor at the resection margins. The survival rate of resected carcinomas of the cardia was 22 +/- 13%. No difference was noted between extended and limited resections. 5-year survival after UPOG was 20 + 18% and after TOG 11% (0-30) (p = 0.21). In stage 1B, 5-year survival after UPOG 11% and TOG was 50% (19-81) and 33% (0-82) (p = 0.54). In stages II and III A, 3-year survival after UPOG and TOG was 7% (0-20) and 0% (p = 0.16). For a given tumor size, 5-year survival is the same whatever the technique.

Adenocarcinoma↗

PubMed1990

[Pulmonary metastasis with left intra-atrial extension of liposarcoma. Apropos of a case].

The direct extension of a neoplastic thrombus of the pulmonary veins into the left atrium is extremely rare. The authors report the case of a pulmonary metastasis from a liposarcoma of the thigh extending into the pulmonary veins and prolapsing into the left atrium. The patient was successfully treated by tumorectomy under cardiopulmonary bypass then by left upper lobectomy.

Adult↗

PubMed1990

[Post-traumatic retroligamentary pneumatocele. Apropos of a case].

A case-report of a 17 year-old man admitted for thoracic trauma associated with a vertical air and fluid collection located behind the pulmonary ligament raises the question of the exact nature of retroligamentary pulmonary pneumatoceles. They may be intraparenchymatous pneumatoceles or simple loculated pneumothorax but whatever the actual lesion, exact recognition of this radiological image avoids drainage and operation. This lesion resolves spontaneously within several weeks.

Adolescent↗

PubMed1989

[Dumbbell neurogenic tumors. 5 cases (4 thoracic, 1 lumbar)].

Benign in more than 90% cases, dumbbell neurogenic tumors are rare. It was 3 thoracic schwannome and 1 thoracic ganglioneuroma and 1 lumbar schwannoma are reported. In 2 cases complete removal was performed by thoracotomy, in another case thoracic removal was incomplete with leateag of spinal fluid, laminectomy was necessary 3 months later and in a third case laminectomy was performed first because of paraplagia and thoracotomy one month later. In lumbar case a two ways procedure in 3 weetes space permitted complete removal, a monoparesia and sphincters troubles, regressive spontaneously in 5 months, complicated first performed laminectomy. Schwannome and benign neurofibroma are the most frequent tumors. Latero vertebral situation in chest radio or in abdominal ultrasonography must induce neurogenic tumors diagnosis. Myelography or tomodensitometry confirms intraspinal extension when osseous signs are present on vertebral radiographies. In thoracic localization a one stage combined resection gives the lowest morbidity. In lumbo-sacral localization tumoral large size requires a combined approach, which can be performed in a single stage. Recklinghausen's association in neurofibroma (4 to 16%) exposes to malign evolution risk (12 to 13%).

Adult↗

PubMed1989