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Biomedical subjects

J G Brun

Publications and source records attributed to J G Brun.

At least 37 records · Page 2Linked to original sources
PubMed1992

Calprotectin in patients with rheumatoid arthritis: relation to clinical and laboratory variables of disease activity.

Calprotectin (L1) is a major granulocyte and monocyte protein which is released during activation of these cells. The plasma level of L1 is thought to reflect disease activity in rheumatoid arthritis (RA). In our cross sectional study of 70 patients with RA, L1 had significant correlations with erythrocyte sedimentation rate (r = 0.50), C-reactive protein (r = 0.58), orosomucoid (r = 0.62), platelet count (r = 0.42), leukocyte count (r = 0.33) and IgM rheumatoid factor (r = 0.32); and with the following clinical variables: number of swollen joints (r = 0.24), grip strength (r = -0.22), PIP joint circumferences (r = 0.33) and a combined global assessment score (r = 0.24). L1 was higher in seropositive (median 14,861 micrograms/l) than seronegative patients (median 10,487 micrograms/l) (p less than 0.03).

Adolescent↗
PubMed1989

[Low back pain and instability of the pelvic ring].

Low back pain is a major cause of disability, and a large percentage of patients with low back pain have no identifiable pathology. In this review of the literature low back pain is considered from the point of view of dysfunction of the pelvic joints. The reliability of the commonly used tests, signs and procedures are considered. Inflammatory causes such as ankylosing spondylitis are well documented to cause low back pain, but mechanical factors apart from intervertebral disc protrusion are largely speculative.

Back Pain↗
PubMed1986

[An original method of making a purse for circular mechanical anastomoses].

A simple and reliable procedure applicable to all segments of the digestive tract, except the oesophagus, is described. A series of superficial U-shaped stitches is inserted along the upper edge of a Kocher's forceps that clamps the entire width of the intestine. The intestine is then cut with a scalpel along the lower edge of the forceps, i.e. on the side opposite to the sutures. After the forceps is released, a purse about 2 mm distant from the intestinal opening is obtained. When the purse is tightened the mucosa, crushed by clamping, does not protrude and therefore does not interfere with the mechanical anastomosis.

Humans↗
PubMed1986

[Fibrovascular polyp of the esophagus].

A case of large intraluminal tumour located in the cervical portion of the oesophagus and removed by thoracotomy is presented. Detailed histological study was necessary, since hypervascularization and hypercellularity made it difficult to diagnose a fibrovascular polyp and to establish its histopathological prognosis. The patient has now been followed up for 7 years and remains cured. Intraluminal tumours are reviewed. Whether fibrovascular polyps should be removed surgically or endoscopically depends on their site and on their size.

Esophageal Neoplasms↗
PubMed1984

[Parathyroid adenoma disclosed by a massive subcapsular hemorrhage].

In the case reported here a parathyroid gland adenoma was revealed by the sudden occurrence of a large subcapsular haematoma compressing cervical structures and causing recurrent nerve paralysis; spontaneously regressive hypercalcaemia was present. The place of these haemorrhages among other manifestations of a hitherto silent parathyroid gland adenoma is discussed, together with the diagnostic value of thyroid gland scintigraphy and cervical ultrasonography. In view of their potentially somber prognosis, emergency surgery is mandatory in such cases.

Adenoma↗
PubMed1984

[Colectomy by combined resection-anastomosis using linear mechanical sutures].

In the technique described, anastomosis is started with a GIA mechanical stapler then completed with a TA stapler followed by resection of the segment involved. We prefer this technique to other mechanical procedures (triangulation, circular anastomosis) in all colectomies which do not require lower colorectal anastomosis. It is simple, economical and solves problems of incongruence. Finally--and this is the most important point in surgery of the colon--it considerably shortens the septic operative stages.

Colectomy↗
PubMed1984

Blunt thorax oesophageal stripping: an emergency procedure for caustic ingestion.

We report our experience with an original procedure which we have applied to the management of acute necrotic caustic burns of the upper gastro-intestinal tract. Blunt thorax oesophageal stripping is performed through a cervicotomy and a laparotomy, thus avoiding a wide pleural exposure and the frequent and often fatal respiratory complications of a thoracotomy. The stripping method permitted survival of 13 of 17 patients and is thus considered to be a safer and more successful technique than open thoracic oesophagectomy.

Adult↗
PubMed1983

[Multiple lesions in primary hyperparathyroidism. Nosologic approach].

Surgical exploration identified 40 patients with several enlarged parathyroid glands (two to five) out of a retrospective series of 500 cases of primary hyperthyroidism. Complete clinicopathological correlations were available in 27 cases (19 women and 8 men). Seven patients had a history of Wermer's syndrome (type I, MEN). Final diagnosis was as follows: double adenomas, 11 cases; primary hyperplasia, 16 cases. In two cases, there was a clear-cell hyperplasia, 16 cases. In two cases, there was a clear-cell hyperplasia with massive involvement of four parathyroid glands. The fourteen other cases presented with predominantly chief-cell hyper plasia; the involvement of the parathyroid glands was frequently asymmetrical, mainly or exclusively confined to two enlarged glands in 9 cases. The authors conclude that when a patient presents with two enlarged parathyroid glands, two diagnoses are possible--double adenoma or asymmetrical hyperplasia. Since anatomical study of the two enlarged glands is not always sufficient for accurate classification of the lesions, it is advisable to make a histological examination of a third.

Adenoma↗
PubMed1983

[Total gastrectomy. Primary esophagojejunal anastomosis, the organ in place, using linear mechanical suture staplers].

In "mechanical" surgery, continuity of the digestive tract may be re-established with either circular (E.E.A. - I.L.S.) or linear stapled anastomosis (G.I.A. - T.A.). For oesophago-jejunal anastomosis, the authors prefer the second method which provides wider anastomosis without the risk of stenosis attached to circular sutures. The stomach is kept for traction, thus facilitating the procedure, which can be performed through the abdominal incision.

Esophagus↗
PubMed1983

Urolithiasis in children. Presenting signs, etiology, bacteriology and localisation.

Based on a personal series of 310 observations, the authors have studied the presenting signs, the etiology, the urinary bacteriology and the localization of the stone in children with urolithiasis. Urinary tract infection is the presenting sign in 55% of the cases, hematuria in 23% and abdominal pain in 20%. Urinary malformation is associated in 26% of cases, whatever the age at diagnosis. The urinary bacteria found in 55% of cases is Proteus. Localization was in the kidney in 228 cases, in the ureter in 71 cases, the bladder in 45 cases and in the urethra in 5 cases.

Adolescent↗
PubMed1982

[Caustic digestive stenosis involving the hypopharynx. Esophagopharyngoplasty using a right ileocolic graft].

The authors describe an oesophago-laryngoplastic technique using a retrosternal ileocolic graft and involving anterior pharyngotomy above the hyoid bone. The technique was applied to five cases of major destructive lesions of the hypopharynx with fibrotic stenosis, due to severe burns of the upper digestive tract by ingestion of caustic substances. Continuity between the oral cavity and the digestive tract was re-established in all cases.

Adult↗
PubMed1982

[The reversed stomach technique of oesophagoplasty (author's transl)].

A technique of oesophagoplasty using the whole stomach is described and discussed. In this technique, the duodenum is divided and the stomach is turned-up, passed through a retrosternal tunnel and anastomosed with the cervical oesophagus. Continuity of the intra-abdominal digestive tract is restored by anastomosing the gastric fundus with the duodenum. The new technique, successfully used by the authors in 10 patients, is applicable to oesophageal carcinomas as a palliative measure or as the first stage of secondary oesophagectomy; and to oesophageal stenosis consecutive to caustic burns.

Duodenum↗
PubMed1982

[Massive retroperitoneal hematoma caused by rupture of the kidney, secondary to cortical abscess].

A massive retroperitoneal hemorrhage found to be due to a renal abscess in a previously healthy kidney was treated successfully by nephrectomy. This type of lesion occurs fairly infrequently, but it is quite exceptional to observe presenting signs as in the case reported, and recovery is not mentioned in the published literature. Therapy for renal abscess involves either urgent nephrectomy in cases of associated hemorrhagic or septic shock, or medical treatment under close supervision in the absence of major signs of severity, which may, however, develop at any moment making surgery inevitable.

Abscess↗
PubMed1982

[Esophagopharyngoplasty by transplantation of a right ileocolic graft in the treatment of sequelae of esophageal and hypopharyngeal caustic stenosis].

Esophagopharyngoplasty was employed to treat 7 cases of severe stenosis from scarring due to caustic burns. Emphasis is placed on the advantages of retrosternally applied right ileocolic transplants using the supraphyoidal anterior pharyngeal approach. Results were considered as satisfactory in 4 cases, exclusively oral alimentation being possible, though bougierage, sometimes repeated, was necessary. The 3 unsuccessful cases were due to loss of oropharyngeal muscle peristaltism in one case, progression of scar retraction in the second patient, and the psychological behavior and lack of essential active cooperation in the third case.

Adult↗