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Biomedical subjects

J A Gruwez

Publications and source records attributed to J A Gruwez.

At least 19 recordsLinked to original sources
PubMed1992

Stenosis of the small bowel after blunt abdominal trauma.

At the Catholic University of Louvain, between 1950 and 1990, two patients were treated for blunt abdominal trauma resulting in stenosis of the small bowel. One patient underwent partial resection of the small bowel 6 weeks after the trauma was sustained. The other was admitted for surgery 26 years after a blunt abdominal trauma. Surprisingly, the stenosis of the small bowel was accompanied by a ureteral obstruction due to fibrosis and terminal hydronephrosis.

Abdominal Injuries↗
PubMed1991

[Anal-perineal lesions in Crohn's disease].

Radical surgery preserving the sphincter was performed in 190 patients with anal Crohn's disease and achieved good results in 163 cases. 28 patients had a restorative sphincteroplasty. Anal Crohn's disease should be treated according to the same surgical criteria than the other localizations of the disease.

Anus Diseases↗
PubMed1991

Lymphedema of the leg associated with rheumatoid arthritis.

A 14-year-old boy with a two year history of seronegative rheumatoid arthritis developed left leg lymphedema and subsequently a severe episode of lymphangitis. The diagnosis of "rheumatoid lymphedema" was confirmed by lymphscintigraphy and conventional lymphography. Treatment consisted of bedrest and antibiotic drugs. When the signs of inflammation had subsided, therapy with corticosteroids was started with improvement of both joint pain and leg swelling. Whereas lymphedema associated with rheumatoid arthritis has been described in the upper limb of adults, to our knowledge this is the first report of the coexistent condition in the lower leg of a child.

Adolescent↗
PubMed1990

Potency and selectivity of the aromatase inhibitor R 76,713. A study in human ovarian, adipose stromal, testicular and adrenal cells.

The effects of R 76,713 on steroidogenesis were studied in primary cultures of four different human cell types, i.e. ovarian granulosa cells, adipose stromal cells, testicular cells and adrenal cells. In human granulosa cells aromatization of [1 beta, 2 beta-3H]androstenedione (as measured by the release of tritiated water) showed a Km (Michaelis constant) of 78 nM. R 76,713 competitively inhibited aromatization with a Ki (dissociation constant of the enzyme-inhibitor complex) of 1.6 nM. In human adipose stromal cells aromatization was measured by following the conversion of androstenedione to estrone and 17 beta-estradiol. In this system a Km for aromatization of androstenedione of 10.8 nM was found. R 76,713 again showed competitive kinetics with a Ki-value of 0.14 nM. In human testicular cells the synthesis of the androgens testosterone, androstenedione and dehydroepiandrosterone was only inhibited by drug concentrations exceeding 10(-6) M. At 10(-5) M of R 76,713, steroid concentrations were lowered to 56, 64 and 81% of the control for testosterone, androstenedione and dehydroepiandrosterone respectively. Concomitantly, a slight increase in the levels of pregnenolone (138% of the control) and progesterone (133% of the control) was seen. In human adrenal cells the synthesis of cortisol and aldosterone was slightly affected by R 76,713 also at concentrations exceeding 10(-6) M. At 10(-5) M of R 76,713 the concentrations of cortisol and aldosterone were lowered to respectively 59 and 51% of the control. At the same drug concentration the precursors 11-deoxycortisol and 11-deoxycorticosterone rose to 189 and 147% of the control. These results show that in primary cultures of human cells, R 76,713 is a very potent aromatase inhibitor with a selectivity of at least 1000-fold compared to other steps in steroidogenesis.

Adipose Tissue↗
PubMed1989

Sutureless large bowel anastomosis: European experience with the biofragmentable anastomosis ring.

Sutureless colonic anastomosis using a biofragmentable anastomosis ring (BAR) has been evaluated in a prospective randomized comparison with sutures and staples for elective colorectal surgery. One hundred and one patients underwent BAR anastomosis, 85 a sutured anastomosis, and 16 a stapled anastomosis. There were two anastomotic leaks in the patients undergoing BAR anastomosis, seven in patients having a sutured anastomosis, and one in a patient who had a stapled anastomosis. Wound infection occurred in ten BAR patients, ten sutured patients and no stapled patient. There was no statistically significant difference in these or in other postoperative complications between the groups. The BAR was easy to use and is a safe alternative to sutures and staples for large bowel anastomosis.

Adolescent↗
PubMed1989

Pertrochanteric fractures in elderly patients. Treatment with a long-stem/long-neck endoprosthesis.

The long-stem, long-neck endoprosthesis is used in the treatment of pertrochanteric hip fractures in the elderly. Between 1978 and 1984, 157 patients 70 years of age and over were treated at our clinic for fresh unstable pertrochanteric hip fractures. Fifty-five patients had internal fixation. Because of the high incidence of mechanical complications, the long spherostem endoprosthesis became the treatment of choice between 1980 and 1984. Thus, 102 patients were treated with this type of arthroplasty. They were compared with the 55 patients treated with osteosynthesis, and we concluded that: (1) in comparison with osteosynthesis, the procedure of endoprosthetic replacement is no more extensive and the mortality is no higher; (2) the incidence of mechanical complications is significantly lower in the endoprosthesis group; (3) even if the dynamic hip screw is now the treatment of choice for pertrochanteric fractures, the long spherostem endoprosthesis is still indicated in arthrotic hip fractures or in the case of reintervention after implant failure.

Aged↗
PubMed1989

Rupture of the diaphragm caused by blunt trauma. Review of 54 successive cases.

From 1970 to 1987, 54 patients were treated for rupture of the diaphragm as a result of blunt trauma, mostly due to road accidents. In more than 75% of the cases, other severe post-traumatic lesions were noted in association with the rupture. There were 46 lesions in the left hemidiaphragm. An early diagnosis was made 34 times (i.e., within 24 h after the accident). This is why it is so important to interpret plain X-ray films of the thorax and abdomen correctly, perhaps after inserting a nasogastric tube. In general, exploration by laparotomy is preferred. Thoracolaparotomy is only used in cases of thoracic or thoracoabdominal injuries associated with important lesions in the lungs or mediastinal organs or in the case of longstanding ruptures accompanied by herniation of different organs. The total mortality was 20%. Death was due to hypovolemia, serious brain injuries, or multiple organ failure (MOF) due to sepsis.

Adolescent↗
PubMed1989

Current concepts of inhalation injury in burn victims.

Twenty patients with bronchoscopic diagnosis of inhalation injury were reviewed. The history of a burn in a closed space was present in 90% of the patients in our study and evidence of orofacial burns in 100%. In four of these patients serum concentrations of human placental alkaline phosphatate (hPLAP) were determined. This protein can be detected in serum with hPLAP specific monoclonal antibody and increased serum levels of hPLAP are found when there is damage of pneumocyt I cells.

Adolescent↗
PubMed1978

Experience with lymphangioma.

Lymphangioma is a rare and benign tumor, mostly encountered in childhood. Our experience extends to 21 patients, all of which were operated upon. Early radical excision in moderate forms or cervical locations and delayed excision or combined management in complex cervical forms are the more preferable way of treatment.

Abdominal Neoplasms↗
PubMedDate not supplied

Pharyngo-oesophageal diverticulum (Zenker's). Clinical, therapeutic and morphological aspects.

In a series of 100 surgically treated patients, Zenker's diverticulum (ZD) appeared mostly as a typical geriatric disorder (50% over 70 years) in which not only oesophageal symptoms but also pulmonary symptoms (37%) may lead to a life-threatening situation. In 60% of the patients, associated upper gastrointestinal pathology was observed, most frequently being gastro-oesophageal reflux (30 patients). In 30% of the manometric studies of the oesophageal body and lower oesophageal sphincter, clear pathological patterns were observed. Morphological examinations, enzymohistochemistry, immunohistochemistry showed clear pathological changes not only at the level of the cricopharyngeal muscle but also at the level of the striated muscles of the cervical oesophagus. These clinical, manometric and morphological changes suggest that ZD is one expression of a more complex neurogenic disorder. They also justify the extramucosal myotomy of the cricopharyngeal wall and the striated muscle wall of the cervical oesophagus as well, as the cardinal step of operation. This myotomy was combined with a diverticulopexy resulting in no post-operative mortality and a minimum of morbidity. The mean longterm follow-up in this series is 4 years, showing excellent and very good results in 96% of the patients for the oesophageal symptoms and in 92% for the full spectrum of oesophageal and pulmonary symptomatology. With this single step operation, no recurrence has been seen seen as opposed to the endoscopic procedure.

Adult↗
PubMedDate not supplied

The Belsey Mark IV antireflux procedure: indications and long-term results.

UNLABELLED: From 1977 to 1990, a Belsey Mark IV antireflux procedure was performed in 177 patients. The primary indication was gastro-oesophageal reflux (GOR) resistant to medical treatment in all but 5 patients presenting themselves with a complicated para-oesophageal hernia. Ninety-eight patients (53.5%) had some form of additional pathology or complication: grade III oesophagitis: 26, grade IV: 6, Barrett's oesophagus: 38, reintervention: 14, concomitant duodenal ulcer requiring highly selective vagotomy: 14, bleeding: 23, small benign tumours: 2. There was one postoperative and one late mortality. At one year an objective evaluation was made in all patients operated on since this interval (N = 147), consisting in endoscopy: 121, Barium-swallow: 113, 24 hour oesophageal pH-monitoring: 81, manometry: 69. A recurrence was documented in 11 patients (7.4%). The mean follow-up of these 147 patients is 4.4 years with a range from 1 to 13 years. Over the entire follow-up period 17 patients (11.5%) had symptoms suggestive of recurrent reflux. Subjective and objective recurrence rate was 13%. Undesired gastrointestinal side effect were seen in 13 patients (8.8%), whereas post-thoracotomy pain was equally noticed in 13 patients (8.8%). The final score combining recurrence rate and side effects showed excellent to very good results in 77.5% of the patients, good results in 7.5% and bad results in 15%. CONCLUSION: Candidates for surgical treatment of GOR often present themselves with a variety of reflux related complications or additional pathology. Long term follow-up shows good reflux control in 87% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Omphalocele: mode of management. A case report and review of literature.

Management of "giant" omphaloceles has always been a challenge to pediatric surgeons. The primary goal is to minimize the mortality and morbidity by creating an optimum protection of the exposed viscera. The ideal approach of this congenital defect has not yet been found. Over the years, a number of authors have introduced new and modified techniques to solve the problem. Some results are encouraging. Selection of management method should always be based on complete evaluation of the individual characteristics of each case.

Eosine Yellowish-(YS)↗
PubMedDate not supplied

Hip fractures in the elderly. Mortality, functional results and social readaptation.

Six-hundred and fourteen aged over 70 and presenting hip fractures have been studied prospectively. The results were compared with the literature. The overall mortality rate within three months was 24%. This mortality was significantly influenced by the general health condition of the patient at the time of the injury, his living conditions and the possibility of walking again after the operation (p less than 0.001). For 38% of the survivors, the fracture means a considerable loss of functional independence. The adjacent impairment was in close relationship with patient's age and fracture-type (p less than 0.05). Sixty per cent of the patients were able to return home. In predicting the probability of returning home, the functional status before injury and the possibility of walking at the moment of discharge were particularly important (p less than 0.001).

Aged↗