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Biomedical subjects

J M Molkhou

Publications and source records attributed to J M Molkhou.

11 recordsLinked to original sources
PubMed1989

[Detection of hepatic metastasis of digestive cancers. Value of enzyme assays and ultrasonography].

Alkaline phosphatase (AP), gamma-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) and aspartate aminotransferase (AsT) assays, as well as ultrasonography are the easiest and least expensive examinations to perform in the diagnosis of hepatic metastases. The 273 patients included in this series had cancer of the digestive tract. The diagnosis of presence or absence of liver metastases was made at surgery and was positive in 38 patients (14 per cent). A receiver operating characteristic (ROC) curve was drawn after computing the sensitivity (Se) and specificity (Sp) of each laboratory determination while the threshold indicating that the value was normal was incremented. The examinations were then compared in terms of Se, Sp, positive predictive value and negative predictive value. The threshold was determined on the ROC curve where less false-positive and more true-positive results were shown. According to predictive values, laboratory determinations could be classified in decreasing order of usefulness as: AP, LDH, GGT and AsT. Ultrasonography had a positive predictive value of 68 per cent a negative predictive value of 95 per cent, both figures being higher than those of any laboratory examination. These results suggest that ultrasonography has a higher diagnostic value than any of the enzyme assays in the detection of hepatic metastases. Moreover, ultrasonography provides morphological information which, in case of liver resection, may be useful to the surgeon.

Alkaline Phosphatase↗
PubMed1989

Povidone-iodine enema as a preoperative bowel preparation for colorectal surgery. A bacteriologic study.

To evaluate the effects of povidone-iodine (PI) enema on the bacterial flora of colorectal mucosa, the authors studied 113 patients who were candidates for colorectal surgery. The study of the rectum included 72 patients. Total bacterial concentrations after a PI enema (N = 44) were significantly lower than after a simple water enema (N = 12, P less than 0.001), or than after a water enema associated with intravenous metronidazole (N = 16, P less than 0.01). The study of the colon included 41 patients. Total bacterial concentrations did not differ after a PI enema (N = 24) than after a water enema (N = 11); both groups were associated with intravenous metronidazole. In contrast, both preparations significantly reduced bacterial concentrations when compared with oral administration of polyethyleneglycol (N = 6, P less than 0.01). Similar results were observed in rectal and colonic studies, when analysis was restricted to the anaerobic flora. PI is an antiseptic that, when administered alone in an enema or in association with metronidazole, significantly reduces bacterial concentrations in the mucosa of the colon and rectum. It may be proposed as a simple preoperative preparation for colorectal surgery.

Bacteria, Aerobic↗
PubMed1989

[Rectal angiodysplasia].

We report 6 cases of rectal angiodysplasia. 2 patients were treated successfully laser coagulation.

Adult↗
PubMed1988

[Budd-Chiari syndrome with thrombosis of the inferior vena cava. Treatment by mesenterico-innominate shunt].

We report two cases of patients, 12 and 28 years old, suffering from a Budd-Chiari syndrome with a thrombosed inferior vena cava, who were treated by a shunt interposed between the superior mesenteric vein and the left innominate vein. The aim of this shunt was to avoid pericardiotomy in these patients with peroperative ascites, in order to reduce the risk of pericarditis after surgery. A reinforced polytetrafluoroethylene prosthesis (Gore-Tex) was used, associated with an interposition jugular vein graft in the 12-year old child, alone in the other case. The left innominate vein was isolated through a midline sternotomy, and the prosthesis was placed in a retrosternal position. Operation and postoperative course were uneventful. All signs of ascites disappeared. The patients were free of symptoms, 8 and 4 months after surgery respectively. Shunt patency was documented by angiography and magnetic nuclear resonance.

Adult↗
PubMed1987

Treatment of rectal prolapse by Delorme's operation.

Rectopexy in the sacral hollow or to the promontory with synthetic material is the most efficient method of reducing and fixing a complete rectal prolapse. However, this distressing condition occurs frequently in elderly patients, often with high operative risk. In these some surgeons have advocated a perineal approach. Eighteen female patients (mean age 74 years) with complete rectal prolapse have been treated by a modified Delorme's procedure which involves a mucosal stripping of the prolapse and longitudinal plication of the muscular wall of the rectum. There was no postoperative mortality or morbidity. After a mean follow-up of 18 months, two complete recurrences occurred. These were treated by the same technique with a good result at 3 years. One other patient presented a partial and intermittent recurrence. Incontinence has improved in four patients and was not made worse in the others. Our results and those previously published show that this procedure is safe in elderly high risk patients considered too unfit for transabdominal surgery.

Aged↗