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Biomedical subjects

M Deysine

Publications and source records attributed to M Deysine.

At least 19 recordsLinked to original sources
PubMed1992

Hernia repair with expanded polytetrafluoroethylene.

Prostheses of expanded polytetrafluoroethylene (e-PTFE) were used to repair 89 abdominal wall defects in which primary closure would produce undue tension on tissue. Over a 52-month period (median follow-up: 24 months), we observed three wound infections, one in a clean wound, and four hernia recurrences. No other complications were noted. Twenty-one e-PTFE grafts were placed directly over intraperitoneal viscera without clinical evidence of adhesions leading to intestinal obstruction. In grafts inspected postoperatively, no apparent evidence of fatigue or fragmentation was observed. Histologic findings concurred with experimental data obtained during animal trials revealing the creation of a new mesothelial lining. These results encourage the use of e-PTFE prostheses for the repair of abdominal wall hernias, particularly when the parietal peritoneum is absent.

Follow-Up Studies↗
PubMed1991

Inguinal herniorrhaphy. Reduced morbidity by service standardization.

To ascertain if service specialization and procedure standardization would improve the complication rate of inguinal herniorrhaphy, the results of all inguinal herniorrhaphies performed during a 3-year period by board-certified general surgeons who also performed a variety of other procedures common to the field of general surgery, assisted by general surgical residents (group B, 390 patients), were compared in the same institution with the results of inguinal herniorrhaphy when performed during 3 years under protocol by a Hernia Service directed by a senior faculty member assisted by junior surgical residents (group C, 442 patients). Group B patients had essentially no follow-up until they reappeared for care at the Hernia Service, whereas patients in group C achieved an 82% 7-year follow-up. The infection and recurrence rates of group C patients (0.45% and 0.9%, respectively) were significantly better than those of group B patients (5.9% and 4.6%, respectively). These results suggest that in our institution, the concentration of patients with hernias in a hernia service, manned by a specialized surgeon, produced better short- and long-term results than those obtained by general surgeons not dedicated to the field of hernia repair. Further studies will be necessary to confirm these findings.

Follow-Up Studies↗
PubMed1987

Herniorrhaphy in the elderly. Benefits of a clinic for the treatment of external abdominal wall hernias.

Elective abdominal herniorrhaphy carries morbidity and mortality rates of 26 percent and 1.5 percent, respectively, in patients over 65 years of age. These figures climb to 55 percent and 15 percent during emergent surgery. Our purpose was to investigate if standardization of treatment could improve such results. Our program stressed centralization of care in a hernia clinic; early operation of patients at risk of incarceration; optimization of underlying systemic disorders by consultative services; operation under local anesthesia; preoperative, operative, and postoperative protocol; and continuity of care by senior personnel. Over a 4 year period, we have performed 241 abdominal herniorrhaphies in patients over 65 years of age (median age 71.5 years old) who exhibited an 84 percent incidence of significant preoperative systemic disorders. Since the inception of our program, our rate of emergent operation has decreased significantly from 7 percent to 2 percent (chi-square less than or equal to 0.05). Our rate of systemic complications after elective operation was 1.2 percent and 0 after emergent operation. These data are statistically better than those reported in the literature (chi-square less than or equal to 0.05). These results suggest that the creation of a hernia clinic significantly improves the care of herniated patients.

Age Factors↗
PubMed1984

The management of recurrent inguinal hernias by muscle transposition--a preliminary communication.

Recurrent inguinal hernias occur almost exclusively in adult men. The rarity of both direct and recurrent hernias in women is due, among other factors, to the muscularity of an inguinal canal that has not been partially replaced by fibrous tissue to allow the passage of a large spermatic cord. Throughout the body, contractile dynamic muscular tissue resists strains and stresses better than do fascia and ligaments. With regard to the abdominal wall, herniation through this muscular corset is a rare event and herniations nearly always occur through areas in which fibrous tissue has replaced muscle. When the tissues of a recurrent hernia or the type of hernia preclude a satisfactory repair, transposition of a thigh muscle, preferably the gracilis, will provide a dynamic repair that is superior to the introduction of foreign material with all its disadvantages or to the other approaches when local conditions are unsatisfactory. Clinical experience with seven procedures in six patients is presented as a preliminary report.

Aged↗
PubMed1983

Chronic haematogenous osteomyelitis; studies on an experimental model.

The progression of acute haematogenous osteomyelitis into a chronic infection was investigated in a group of ten dogs in which the infection was produced by injection of micropaque barium mixed with Staphylococcus aureus or Salmonella Group C-2 into the tibial nutrient artery. Antibiotics were not used. Twenty four months later the infected limb of the surviving animals exhibited clinical, histological, radiological and microbiological changes which closely resembled those found in chronic haematogenous osteomyelitis (CHO) in humans. We observed spontaneous fractures, skin fistulae, bone sequestration and active bone remodelling. The original infecting bacteria were often replaced by different microorganisms because of skin fistulae or haematogenous contamination. Although the initial mortality was high the surviving animals showed signs of local and systemic symbiosis with the infecting bacteria. In two animals the previously infected and remodelled bone failed to show histological evidence of infection. This model may be useful in the study of a variety of factors affecting the natural history of CHO, particularly those encompassing the immunological response of the host.

Animals↗
PubMed1980

Effects of cortisone on decrease of serum albumin secondary to experimental infections.

The observation that severe clinical bacterial infections are associated with decreases in total serum albumin levels was confirmed in experiments involving dogs and rats. In rodents, the injection of methylprednisolone sodium succinate after the onst of the infection significantly reduced the decrease in the serum albumin values. However, this protective or corrective effect did not occur if the steroid was given prior to the infection. The effect of cortisone may be due to its capacity to stimulate albumin synthesis by the parenchyma of the liver.

Animals↗
PubMed1980

Albumin shifts across the extracellular space secondary to experimental infections.

The pathway across tissue spaces of intravenously injected 125I albumin was studied in five dogs before and after the injection of Escherichia coli endotoxin by the use of perforated plastic capsules placed in the subcutaneous tissue. The already negative extracellular space pressure became less so after the endotoxin injection, when albumin was detected shifting from the intravascular space into the extracellular space compartment and then into the intralymphatic space. The injection of endotoxin produced a marked increase in the thoracic duct lymph flow, while, at the same time, erythrocytes entered the lymphatic stream. Results of this study suggest that experimental canine endotoxemia is associated with an increased passage of albumin into the extravascular compartment and explains, in part, the fall in serum levels of this protein during clinical and experimental sepsis.

Animals↗
PubMed1977

Stress gastric bleeding. Prevention of experimental lesions by intravenous hyperalimentation.

Rats, weighing 125-150 gm., were restrained under a tight wire screen for one hour at 20degrees C and another hour at 4degrees C of ambient temperature. Animals receiving no infusions, or those receiving an intravenous solution of normal saline, developed 16 +/- 3 S.D. bleeding areas in their gastric mucosa. In contrast, in animals exposed to the same degree of stress who received intravenous hyperalimentation, the number of gastric stress bleeding areas counted was 4 +/- 2 S.D. These results demonstrate that the delivery of calories and protein in the form if intravenous hyperalimentation can significantly reduce the incidence of gastric stress bleeding in an experimental model (P less than .001).

Animals↗