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J J Roux

Publications and source records attributed to J J Roux.

At least 19 recordsLinked to original sources

Below-knee bypass using fresh arterial allografts for limb salvage: early results.

The purpose of this study was to evaluate early results of below-knee bypass using fresh arterial allografts as arterial substitutes for limb salvage. From April 1991 to September 1993, we performed 28 below-knee bypass procedures using fresh arterial allografts in patients without a suitable autologous vein. Allografts were obtained by multiorgan harvesting from brain-dead subjects and preserved at 4 degrees C. Histologic examination of grafts was carried out. Secondary patency at 2 years calculated using the Kaplan-Meier method was 64% (confidence interval [CI] 45%-79%). No signs of graft deterioration or rejection were noted. These preliminary results are encouraging but long-term assessment is needed before expanding the range of application.

Aged↗

[Primary bone leiomyosarcoma. Anatomo-clinical case with immunohistochemistry study and review of the literature].

We describe a primary leiomyosarcoma arising in the proximal part of the right tibia of a 38-year-old man. The diagnosis was confirmed by immunohistochemistry (positivity of tumor cells for alpha smooth muscle actin, HHF 35, desmin and vimentin). To the best of our knowledge, this is the 49th documented case of primary leiomyosarcoma of bone outside the facial skeleton. This exceptional tumor arises more commonly in adults (mean age: 53 years) and in the long bones of lower limbs, near the knee. The most frequent symptom is pain with or without swelling or fracture. Radiological findings invariably consist of a non specific osteolytic lesion. Although their histological appearance does not differ from that of extraosseous leiomyosarcomas, their diagnosis is difficult and often requires immunohistochemical and/or ultrastructural study. From a practical point of view, the diagnosis of primary leiomyosarcoma of bone also requires an intensive review of the case history and of previous pathology. This is necessary in order to eliminate an extraosseous primary site (mainly in uterus, gastrointestinal tract and soft tissues). As well as clinicopathological features, modes of treatment and results are also reviewed.

Adult↗

[Primary synovial sarcoma of the mediastinum. A case report with immunohistochemistry, ultrastructural and cytogenetic study].

A biphasic synovial sarcoma occurring in the anterior and inferior mediastinum in a 19-year-old woman is reported. A biopsy showed a mesenchymal proliferation and the tumor was first misdiagnosed as a hemangiopericytoma. Inefficacy of chemotherapy led to a tumorectomy. Histologic and immunohistochemical studies on multiple samples showed a biphasic tumor. Ultrastructural study confirmed the presence of epithelial elements and cytogenetic analysis disclosed a translocation t(X;18) (p11;q11), leading to a diagnosis of synovial sarcoma. Synovial sarcoma of the mediastinum is very rare and to our knowledge has not been previously studied with the help of cytogenetics. Given the biphasic pattern of the tumor and its mediastinal location, it can be confused with mesothelioma. This stresses the interest of chromosome analysis in the study of tumors histologically difficult to classify.

Adult↗

Carcinoid tumour complicating inflammatory bowel disease. A study of two cases with review of the literature.

Two cases of carcinoid tumour complicating inflammatory bowel disease (IBD) are presented. Both tumours were located in the appendiceal tip. The first case occurred in a man with Crohn's disease (CD), and the second one in a woman suffering from ulcerative colitis (UC). Histochemical and immunohistochemical studies were not allowed on case 1 because the tumour was not still present on serial sections of the appendix. On case 2, tumour cells were not reactive with Grimelius and Masson-Fontana stainings, but were strongly stained with anti-keratin and anti-chromogranin monoclonal antibodies (MAb), and faintly expressed neuron specific enolase (NSE), and Leu-7. Both cases occurred in inflammatory or damaged mucosa which exhibited Paneth cell metaplasia and hyperplasia and areas indefinite for dysplasia. Along with these lesions, hyperplasia of enteroendocrine cells was pointed out in the neighbouring appendiceal and colonic mucosa by means of anti-chromogranin MAb. These data suggest that the association of carcinoid tumour with IBD, albeit rare, is not coincidental and is the result of hyperplastic and dysplastic troubles that may involve enteroendocrine cells as well as such other derivatives of digestive stem cells as columnar cells, goblet cells and Paneth cells.

Adult↗

Selective coronary arteriography by percutaneous transaxillary approach.

Coronary angiography by the percutaneous femoral approach is widely used. This technique is potentially dangerous or impossible in patients with advanced arterial disease of the lower limbs, whether or not surgically treated. In these cases, percutaneous left or right axillary approach is an alternative to brachial approach. In this article, we report our multicenter experience involving 120 patients. The left axillary artery was used in 94 cases (78%) and the right in 26 cases (22%). We used performed coronary catheters usually associated with the femoral approach. The left axillary artery was used preferentially since this avoids catheterization of the innominated trunk and allows easier catheterization of the coronary ostia and aortic ends of aorto-coronary bypass grafts. The routine use of a sheath (arterial introducer) avoided arterial compression during catheterization, prevented hemorrhagic suffusion when the catheters were exchanged, and reduced the risk of thrombosis or laceration of the axillary artery. There were no failures in the catheterization of the axillary artery and no complication was observed during or after the procedure. Axillary percutaneous technique appears to have the following advantages over the brachial arteriotomy: 1) Investigation time is equivalent to the time needed for the femoral percutaneous approach. 2) There is the possibility of lateral and simultaneous bi-plane angiograms. 3) Arterial puncture is preferable to arteriotomy. The axillary approach could also be used for percutaneous transluminal coronary angioplasty.

Adult↗

[Left ventricular function in chronic obstructive pulmonary disease after decompensation (author's transl)].

13 patients with chronic obstructive pulmonary disease (COPD) were studied for left ventricular function immediately after acute decompensation. Parameters of right and left ventricular function were measured. Mean pulmonary wedge pressure (Paw) was elevated (11.9 mm Hg) but there was no correlation between Paw and left ventricular end-diastolic pressure (LVEDP). The indices of left ventricular contractility were in the normal range. In 4 patients, LVEDP was too high. A correlation was established between RVEDP and LVEDP. Left ventricular compliance, as studied by the index of Diamond and Forrester, was abnormal. Two conclusions are discussed: (1) in COPD, Paw cannot indicate left ventricular dysfunction; (2) alteration of left ventricular compliance is possibly related to an elevation of RVEDP.

Aged↗

[Use of dopamine in sequelae of extracorporeal circulation. Apropos of 50 patients].

Dopamine was used after open heart surgery in a group of 50 patients. The therapeutic indications were: diffuse coronary insufficiency in 27 cases, myocardial infarction in 12 cases and early septicaemic shock in 6 cases. In the other 5 cases, dopamine was prescribed for short lasting circulatory insufficiency. The dosage varied between 3-15 gammas/kg/min. The variations of different parameters were studied over 12 hours. Improvement of cardiac efficiency was an early feature (less than 3 h) and was observed for all dosages (above 3 gammas/kg/min). It was accompanied by a marked diuresis. The chromotropic effects were non-existent at these dosages. At medium-term dopamine was effective in 40 patients (80 p. 100). Dopamine is effective in over 3 out of 4 cases after cardiopulmonary bypass. Its effect is immediate, and is observed in dosages less than 10 gammas/kg/min.

Adult↗

[Application of echocardiography to the diagnosis of tricuspid valve diseases. Apropos of 103 cases].

In a series of 103 consecutive surgical patients, the normal and pathological echocardiographic appearances of the tricuspid valve were analysed and compared with the anatomical findings. It was possible to define the nature of the lesions by echocardiography, which was superior to angiography in this field. The right ventricular index (right ventricular dimension body surface area) correlated well with the mean pulmonary artery pressure (r = 0.75; p less than 0.001). The index may be useful in the long term follow-up of post-operative patients.

Adolescent↗