PubMed Health⌕ Search

Biomedical subjects

J C Pignat

Publications and source records attributed to J C Pignat.

At least 19 recordsLinked to original sources
PubMed2006

[The application of metal stent in the treatment of adult non neoplastic tracheal stenosis].

OBJECTIVE: To assess the feasibility and the curative effect of the metal stent inserted in non neoplastic tracheal stenosis. METHOD: In this study, 7 patients were treated with endotracheal metal ultraflex stent for non neoplastic tracheal stenosis, who had a contraindication or refuse to the surgery operation. There are six cases, their length of tracheal stenosis more than 4 cm. The other one, tracheal stenosis located at the tracheal fistula after total laryngectomy. Non-silica gel membrane metal stent were used in four cases, silica gel membrane metal stent were used in three cases. RESULT: These stents were well tolerated and produced immediate symptomatic and functional improvement. Granulation tissue without obstruction of the airway was observed in 6 patients; only one patient had a local recurrence that needed a re-tracheotomy. One patient had to pull out the stent after 10 months of operation. The reason is local discomfort. CONCLUSION: Metal stent has a good curative effect in the treatment of non neoplastic tracheal stenosis, especially for the nonresectable patient, and it is easy to operate. However, the results are not sufficient to assess the efficacy and tolerance of the device in the medium and the long term.

Adult↗
PubMed2005

[Rhinocerebral mucormycosis].

INTRODUCTION: Mucormycosis is a rare and acute fungal infection which is frequently lethal. The rhinocerebral form is usually seen in diabetics, but other localizations may occur in severely immunocompromised subjects. OBSERVATION: We report the case of a sphenoidal sinusitis associated with a probable cavernous sinus thrombosis and carotid artery thrombosis with middle cerebral artery territory infarction. Diagnosis was made on histological examination following sphenoidotomy. Early medical and surgical treatment led to a good outcome. CONCLUSION: The diagnosis of rhinocerebral mucormycosis should be considered in the clinical setting of necrotic sinusitis and acute neurologic deficit in diabetic patients. Early diagnosis and treatment are crucial factors leading to a good outcome.

Aged↗
PubMed2005

[Treatments of hereditary hemorrhagic telangiectasia of the nasal mucosa].

UNLABELLED: Hereditary Hemorrhagic Telangiectasia is a systemic autosomal dominant disorder involving blood vessels. The most common symptom is recurrent epistaxis. The treatments of these epistaxis are numerous but such treatments are often symptomatic and their effects are often not sustained. Some of these treatments may be complicated by visceral vascular malformations. The aim of this study is to propose a treatment plan for these patients with hierarchical organisation of therapeutic options taking into account of their previous therapy. METHOD: H. Plauchu organized in Paris, december 2002 a meeting with any medical specialists of this disease. They have analysed variety of therapies that have been proposed for epistaxis control in Hereditary Haemorrhagic Télangiectasia. RESULTS: Most common use packing of nasal fossa and then hyperselective embolization of the internal maxillary and facial arteries for severe epistaxis. For chronic epistaxis, best treatment use sclerotics products (Ethibloc) and laser. After discussion, primary embolization could be useful to reduce vascularization of nasal fossa. CONCLUSION: Treatment of epistaxis in Hereditary Haemorrhagic Telangiectasia could increase in few years. Use of an index card of for epistaxis in the disease of Rendu-Osler could help to find treatment of choice.

Acute Disease↗
PubMed2005

[Endobronchial lipomas and their treatment: one case report].

PURPOSE: Starting from a clinical observation of an endobronchial lipoma and in the light of worldwide literature, the aim of this case report is to specify the epidemiology, the key points of the diagnosis and the advantage of endoscopy both in the diagnosis and the treatment of these rare benign bronchopulmonary tumours. CLINICAL CASE: Recent pneumopathy in the right superior lobe bronchial area in a 73 year old female, symptomatic with cought. Biopsy exeresis gave the histological diagnosis. DISCUSSION AND CONCLUSION: The clinical symptoms due to bronchial obstruction associated with the conventional radiological and computed tomography signs orientate the diagnosis definitively obtained through the anatomopathological study. This histological study is carried out from biopsies performed either during a bronchial fibroscopy or during a tracheobronchoscopy. By confronting the benign macroscopic aspect and the data from the extemporaneous anatomopathological study of the lesion, endoscopy provides an early-stage diagnosis and makes it possible to perform a concomitant and conservative treatment before the stage of irreversible broncho-pulmonary complications. It also avoids the risks and sequelae of classical surgery by thoracotomy.

Aged↗
PubMed2004

[Interest of thyroïdectomy in the management of thyroglossal duct cysts].

PURPOSE OF STUDY: To discuss the authors' experience with thyroglossal duct (TD) carcinoma and expose the interest of the thyroidectomy in the management of this entity. PATIENTS AND METHODS: A retrospective review of all patients with the diagnosis of TD operated on from 1985 to 2002 was performed. RESULTS: Four cases of papillary TD carcinoma were identified. Two patients were treated by a Sistrunk procedure associated with total thyroidectomy. One patient needed a thyroidectomy fifteen years after the initial management of the papillary thyroglossal duct carcinoma. The last patient had a medical treatment, with no evidence of complication after eleven years of follow up. CONCLUSION: A microscopic focus of papillary carcinoma, without cyst wall invasion, can be managed by a Sistrunk procedure, with the need for long-term follow up. Treatment of all other thyroglossal duct papillary carcinomas should include thyroidectomy followed by radioactive iodine treatment.

Adult↗
PubMed1999

Occurrence of monosialosyl pentahexaosylceramide GalNAc-GM1 as specific tumor-associated ganglioside of human head and neck squamous cell carcinomas.

In a recent study of the ganglioside profiles of human head and neck squamous cell carcinomas versus normal tissue, one unidentified GX ganglioside was found exclusively in tumor extracts, migrating between GM1 and GD3 by thin-layer chromatography. To determine the chemical structure of this ganglioside which accounted for 3-8% of the total gangliosides, the lipid samples were pooled and separated by high-pressure liquid chromatography to obtain individual ganglioside species purified to homogeneity. The tumor-associated GX ganglioside was analyzed by gas-liquid chromatography, mass spectrometry and immunostaining on thin-layer plates with mouse monoclonal antibodies after enzymatic cleavage. The data allowed the identification of GX ganglioside as GalNAc-GM1 that has been reported as a very minor brain ganglioside in humans. Thus, GalNAc-GM1 is a specific tumor-associated ganglioside in human head and neck squamous cell carcinomas that could be potentially valuable for clinicians.

Carcinoma, Squamous Cell↗
PubMed1999

[Reconstructive subtotal laryngectomy: a personal technique in a series of 100 patients operated on between 1990 and 1997].

Described by Majer and Rieder, modified by Piquet, subtotal laryngectomy with cricohyoidoepiglottopexy (CHEP) allowed to treat intralaryngeal carcinoma with preservation of speech and swallowing. Some modifications were proposed to the procedure to simplify it and to improve functional results. Most important one is the one proposed by Guerrier. In the refined procedure we describe, we didn't do any -pexy to conserved as near as possible from normality morphology and physiology of pharyngolaryngeal unit. Dynamics is preserved by keeping jointly the laryngotracheal tract. In addition, we avoid doing a tracheotomy. We present the functional outcome of 100 patients treated between 1990 and 1997: oral feeding was initiated at the 6th day postoperative, delay to achieve proper swallowing was 11.5 days and median hospitalization duration was 18 days (14 days for non tracheotomized group). The comfort of patients without tracheotomy was greatly increased with a low risk of pneumonia. Such a procedure could be applied every time a laryngeal reconstruction had to be done (partial laryngectomy, laryngeal trauma).

Adult↗
PubMed1998

Analysis of glycosphingolipids of human head and neck carcinomas with comparison to normal tissue.

Glycosphingolipids of head and neck carcinomas from six tumor-bearing patients were analyzed and compared to those of normal tissue from similar areas. The total glycosphingolipid content and the lipid-bound sialic acid were much higher in carcinomas than in normal tissue. Major neutral glycolipids were glucosylceramide, lactosylceramide, trihexosylceramide and paragloboside. Sulfatides were seen only in extracts from normal tissue which also showed a rather simple ganglioside pattern with #GM3 and GD3 as major species, whereas tumors showed additional species such as GM2 and GD2, along with a strong increase in LM1, GM1, GD1a and GT1b.

Biomarkers, Tumor↗
PubMed1998

Self-expanding metal stents for the management of bronchial stenosis and bronchomalacia after lung transplantation.

BACKGROUND: Airway stenosis or malacia after lung transplantation, usually as a result of anastomotic ischemia, remains a major problem. METHODS: The authors report their experience with the Gianturco expandable stent for the management of 23 bronchial stenoses in 18 patients following lung transplantation. Stent placement occurred an average of 5.6 months after transplantation. RESULTS: Stents were well tolerated and produced immediate symptomatic and functional improvement. The mean follow-up after implantation was 21 months (range, 4 to 48 mo). The authors removed five stents by endoscopy and replaced them, and removed one stent entirely. Laser resection was used to control granulomas or partial fibrosis stenosis that occurred in four stents (14.3%) after an average of 4 months. One stent broke but was still in place and effective 32 months later. One patient died of hemorrhage 4 months after stenting. CONCLUSION: Although it can still be improved, this expandable metal stent is suitable for the treatment of posttransplantation proximal bronchial stenosis.

Adult↗
PubMed1997

Salvage brachytherapy of posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area.

PURPOSE: Brachytherapy performed in patients with posterior pharyngeal wall carcinoma in a previously irradiated area is evaluated in terms of local control, survival, and complications. METHODS AND MATERIALS: Between January 1982 and July 1993, 14 patients were treated with interstitial low dose rate brachytherapy alone for posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area (local recurrences in five cases and second tumors in nine cases). Tumor size ranged from 1 to 4 cm. No patient had a macroscopic nodal involvement or metastase at the time of diagnosis. Median dose delivered was 55 Gy (39 to 60 Gy). RESULTS: Thirteen patients were assessed for local control. Twelve of them achieved complete macroscopic response within 2 months after brachytherapy. Local relapse occurred in five patients, from 5 to 29 months after brachytherapy. One patient developed distant metastatis without loco-regional relapse. Disease free survival was 69, 59, and 37% at 1, 2, and 5 years, respectively; overall survival was 78, 50, and 21% at 1, 2, and 5 years, respectively. Three patients were still alive without recurrence (8, 8, and 10 years after treatment). We did not observe any severe acute or delayed toxicity. CONCLUSION: Based on these results, interstitial brachytherapy should be considered as a potentially curative treatment for selected patients with posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area. There are no reports in the literature on this subject.

Aged↗
PubMed1996

Improvement of quality of life by treatment with cetirizine in patients with perennial allergic rhinitis as determined by a French version of the SF-36 questionnaire.

BACKGROUND AND AIM: Perennial allergic rhinitis impairs social life, but it is not known whether quality of life may be improved when patients are treated with an H1-blocker. A randomized, double-blind, placebo-controlled study was carried out with cetirizine to assess the effect of this drug on quality of life. METHODS: Two hundred seventy-four patients with perennial allergic rhinitis were tested. Quality of life was measured by using the Medical Outcome Study Short-Form Health Survey (SF-36) questionnaire. After a 2-week run-in period, cetirizine, 10 mg once daily, (136 patients) or placebo (138 patients) was given for the next 6 weeks. The SF-36 questionnaire was administered after the run-in period (at the start of treatment) and after 1 and 6 weeks of treatment. Symptom-medication scores were measured daily during the study. RESULTS: After the run-in period (baseline), there were no significant differences between the cetirizine and placebo groups in terms of symptoms or quality-of-life scores. After 6 weeks of treatment, percentage of days without rhinitis or with only mild rhinitis symptoms was significantly greater in the cetirizine group in comparison with the placebo group (p < 0.0001, Mann-Whitney U test). All of the nine quality-of-life dimensions were significantly improved (from p = 0.01 to p < 0.0001, Mann-Whitney U test) after 1 and 6 weeks of cetirizine treatment compared with placebo. There was no improvement in the placebo group. CONCLUSIONS: This study is the first to demonstrate that an H1-blocker, cetirizine, can improve quality of life for patients with perennial allergic rhinitis.

Adolescent↗
PubMed1994

[Contribution of chemotherapy in the treatment of cancer of the cavum (UCNT): apropos of 47 cases].

The authors present, from a 47 patients retrospective study, the place of BAC chemotherapy in the treatment of undifferenciated nasopharyngeal carcinoma. Twenty three patients treated with exclusive radiation therapy are compared with 24 patients treated with three courses of BAC chemotherapy prior to and after radiation therapy. The procedure using associated chemotherapy permits to increase the 5 years survival rate up to 20% more and to obtain a 100% primary response of the tumor. This encouraging results should be confirmed by a prospective randomized study about a great number of patients.

Adult↗
PubMed1990

[Extensive fibromatosis of the neck muscles].

Extensive fibromatosis, also called desmoid tumor, is a histologically benign tumor, which is nonetheless serious due to its recurrent character and to its potential for infiltration of neighboring tissues. Extensive surgery is the only effective means of treatment, radiation therapy being used only as a complement. The authors describe an elective location of the lesion in the sheaths of the scalenus muscles. This development is usually observed in young women, as is the case in the observation reported here.

Adult↗
PubMed1989

[A new marker in oncology. Assay of gangliosides bound to sialic acid].

Gangliosides are released from cells proliferating in serum and can be assayed by a LASA method. The authors report the assay method for sialic acid bound exclusively to glycosphingolipids (GASA method). They study the reliability and discuss the preliminary factors concerning this upper respiratory tract squamous cell marker.

Biomarkers, Tumor↗
PubMed1989

[Cervicofacial non-Hodgkin's malignant lymphoma. Classification, prognosis and treatment apropos of 65 cases].

The approach to non hodgkins malignant lymphomas (NHML) has changed in recent years, notably because of advances in pathological evaluation due to histo-immuno-labelling leading to a more accurate classification. Such pathology being relatively common in the cervical facial region, with a figure of 10 to 25%, this report concerns the personal experience of the authors based upon 65 cases treated in the department between 1975 and 1985.

Adolescent↗
PubMed1989

[Diffuse spontaneous cervical cellulitis caused by anaerobic bacteria].

Nine cases of diffusal cervical cellulitis due to anaerobes were analysed. Some of them had right away extensions (to the inferior mediastinum or to the face). From these cases, the authors argue their treatment protocol. Surgery was performed immediately after diagnosis, and associated with intensive management. The excision of the necrotic tissue and the aperture of all cervical spaces (particularly the floor to the buccal cavity and the prevertebral space) were made. The source of infection was looked for (most often this being the teeth) and treated at the same time. Bacteriologic aero and anaerobic prelevements were done. A thoracic or facial surgery, being necessary because of persistency or appearance of extension, was performed secondary, after the patient was better prepared with a hyperoxygenation and a triple antibiotic therapy. Life prognosis improved with this treatment protocol. The gravity of the conditions presented by our patients depended more on the presence of an underlying disease (diabetes, immunosuppression, age...) or the delay of the diagnosis than on the cellulitis extension.

Adult↗