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Biomedical subjects

M Laskar

Publications and source records attributed to M Laskar.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Trapped popliteal arteries. Incidence, epidemiology, therapeutic considerations].

The trapped popliteal artery syndrome is an extrinsic dynamic compression of the vascular structures in the popliteal fossa by the surrounding fibromuscular structures. The condition mainly affects the popliteal artery resulting in atypical intermittent claudication because it often occurs in young and active patients. The arterial lesions are initially purely extrinsic and dynamic; sometimes they progress to thrombosis, embolism or aneurysm due to jet lesions. The diagnosis is obtained by radiology in the uncomplicated forms by showing compression or complete occlusion of the artery during contraction of the gastrocnemius and quadriceps muscles. Doppler studies of the posterior tibial artery may also demonstrate the condition during these manoeuvres. The epidemiological study was performed in 199 medical students and 80 athletes. A positional abolition of the posterior tibial artery was demonstrated in 39 students (19%) and 12 athletes (15%). The entrapment was commoner in females (24%) than males (13%). It was observed more frequently in dancers, cyclists and basket ball players: 12 control digitised intravenous angiographies were performed; the diagnosis was confirmed in 11 cases. Several anatomical anomalies of the popliteal fossa may give rise to this condition. The commonest is a deviation of the artery within the internal head of the gastronemius muscle; compression by the soleus or fibro muscular bands arising from the semi-tendinous or semi-membranous have been described. The treatment is surgical in very symptomatic or complicated cases; uncrossing the artery associated with venous grafting in cases of thrombosis are the procedures of choice.

Constriction, Pathologic↗
PubMed1985

[Iatrogenic internal mammary arteriovenous fistula. Apropos of 2 cases].

Two fairly similar cases of internal mammary arterio-venous fistula were observed in two patients involved in serious road accidents, following which a catheter was inserted into the subclavian vein for the purposes of resuscitation. The clinical diagnosis was made in both cases on routine examination, which revealed a continuous right subclavian bruit with extensive radiation three years after the accident. There were no functional implications. Further investigations revealed a fistula located between the internal mammary artery and the right brachiocephalic venous trunk and demonstrated the haemodynamic consequences: normal intra-cardiac pressures, but a pulmonary blood flow which was twice that of the systemic blood flow. Both cases were treated by means of surgical cure via thoracotomy, which confirmed the nature of the arterio-venous fistula and which defined the relations with the phrenic nerve, which is the most exposed element. The results of this operation were excellent in both cases.

Adult↗
PubMed1984

[Hemasite: a means of vascular access for chronic hemodialysis].

Hemasite is a prosthetic device made of titanium and destined to be inserted in an arterialized circuit, thus constituting an elegant and comfortable means of performing chronic haemodialysis. It would be wrong to reject it because its price is still high, but it should not be used as first-choice device. Three patients in our centre have been equipped with hemasite for periods of 18, 5 and 2 months respectively.

Arm↗
PubMed1984

[Comparison of 14 methods for analysing left ventricle segmental kinetics by cineangiography].

Fourteen methods of analysing left ventricular wall motion on 30 degrees right anterior oblique left ventricular cineangiography were compared in 70 cases using a HP 9845 B computer. The methods included the superposition of the centres of gravity, perpendicular to the long axis, Leighton's Rickard 's, Ingels ' and others to determine the influence of the use of different anatomical points of reference on the results. A score was given for each programme in comparison with three groups of normal angiography, anterior infarction and inferior infarction limited to a single zone with no lesion on the opposite coronary artery. The score was the ratio of radial shortening of normal wall motion to that of the infarcted wall. The fourteen methods were divided into 4 groups according to the type of infarct studied (anterior or inferior) and according to the use of either percentage radial shortening or the ratio of the surfaces described by these radii and the systolic and diastolic contours. The results underlined the importance of the anatomical references : aortic orifice and apex for centering systolic and diastolic contours. The methods which did not take these factors into account or which did not correct for them in diastole and systole gave poor results. The centre of gravity of the systolic contour was also an unreliable reference point. The three methods which gave the best results, independent of the site of infarction or the method of calculation (ratio of the radii or surfaces) were all based on the long axis from the aortic orifice to the apex.(ABSTRACT TRUNCATED AT 250 WORDS)

Cineangiography↗
PubMed1984

[Chronology of vascular access in hemodialysis. Apropos of 244 accesses in 150 hemodialysis patients].

Out of an experience of 244 vascular access in 150 patients the authors try do find the best chronology of the angioaccess procedures. 68% of the patients see their need in vascular access definitely resolved by the first classical forearm internal arterio-venous fistula and everything must be done in the dialysis population to avoid the failure of the fistula. This would lead to internal shunt procedures using graft materials of which we know the limited potency, leading to periodic operations. Emergency situations are approached by use of the femoral vein catheterization for hemodialysis. Only the impossibility of femoral or jugular catheterization would lead to the use of the external A.V. Shunt which would be placed on the leg to preserve the vessels of the arms. For some patients the repeated failure of the successive A.V. fistula and shunts have drived us towards either peritoneal dialysis or "hemasite" vascular access system.

Acute Kidney Injury↗
PubMed1984

[Septicemia on endocavitary sounds for cardiac stimulation].

Two cases of septicaemia on endocavitary cardiac pacemaker probes lead the authors to discuss the aetiological and therapeutic aspects of this type of infection. In both cases, the pacemaker had been in situ for a long time and had been replaced on several occasions, there was infection in the site of implantation and an attempt at removal of all of the pacemaker material failed, leaving a probe incarcerated in the right ventricle by one of its extremities with the other extremity floating free. The endocarditis associated with this septicaemia can, theoretically, be due to two mechanisms: metastatic implantation of infection form a distant site which must be detected or infection developing in contact with the pacemaker and propagated along the probe. The treatment of this type of septicaemia consists of appropriate antibiotics, which are only rarely sufficient to sterilize the infection. In most cases, all of the pacemaker material must be removed, which is easily achieved in the majority of cases. After cleansing of the site, the pacemaker has been successfully replaced. Sometimes, the probe is buried in the myocardium: surgical removal by cardiotomy, with or without extracorporeal circulation, seems to be preferable to the techniques of continuous traction which carry certain risks (tricuspid and myocardial lesions). Persistent floating probes must be removed surgically.

Aged↗
PubMed1983

[Intra-atrial implantation of the mitral valve].

Infectious lesions of the mitral ring sometimes cause so much damage that insertion of the prosthesis in its normal place is impossible. In such cases, artificial valves with a dacron flange can be implanted into the left atrium, just above the mitral ring, and sutured to the atrial wall. These valves are generally used in first or second reoperations for recurrent desinsertion, but they have proved so reliable that their use can be extended to primary mitral valve replacement in cases where extreme calcification of the mitral ring throws considerable doubt on the success of conventional techniques.

Bioprosthesis↗
PubMed1983

[Latent adrenal cortical tumor. Plea for a better designation of adrenal cortical tumor. Apropos of 3 cases].

The authors isolate the characteristics of "nonhormonal" adrenocortical carcinomas from three clinical reports and a review of the literature. The absence of any clinical endocrine syndrome at the outset, and the tardy appearance of the tumoral syndrome explain the latency of these tumors. The investigations aim at circumscribing the tumor itself and any extensions - especially invasion of the vena cava, which is a determining point in the choice of therapy. Management is mainly surgical even though, in some cases, the operation can do no more than confirm the diagnosis. The prognosis seems to be greatly improved by medical treatment, especially with OP'DDD.

Adrenal Cortex Neoplasms↗
PubMed1981

[Post-traumatic rupture of the pericardium with cardiac luxation associated with-myocardial infarction, and a rupture of the aortic isthmus (author's transl)].

A case of rupture of the pericardium with cardiac luxation is reported. Violent trauma is necessary to produce such lesions, and this explains the frequency of rapid death before the pericardium rupture is recognised. A definite diagnosis is only possible during operation in one out of two cases that survive. This lesion should be suspected in all cases of chest injury, and complementary examinations, particularly radiological and electrocardiographic, should be requested. Treatment is surgical.

Accidents, Traffic↗
PubMedDate not supplied

[Acute ischemia of an arm manifesting Buerger's disease. Predisposing role of anorexia nervosa].

Peripheral vasomotor disorders, notably acrocyanosis, are frequent in anorexia nervosa, but ischaemic accidents are unknown. We report the case of a 32-year-old woman with a 10-year history of anorexia nervosa, who developed acute ischaemia in one of her upper limbs. In this particular case several aetiological factors may be considered: Buerger's disease, of course, as the patient smoked and had an abnormal arteriography, but also hypercholesterolaemia, thrombocytosis and disorders of platelet aggregation.

Acute Disease↗
PubMedDate not supplied

[Acute dissection of the infrarenal aorta and horseshoe kidney. Apropos of a case and review of the literature].

We report about one case of acute dissection of the infrarenal abdominal aorta associated with a horseshoe kidney. A few points in the history of this 47-year-old patient deserve being underscored: the absence of an "etiological" factor of aortic dissection, the presence of five renal arteries, illustrating the complex vascularity of a horseshoe kidney, the specific surgical problems arising from both a lesion of the aortic junction and a horseshoe kidney. On the basis of the literature, we underline the incidence of dissection of the infrarenal aorta (1 to 3%), that of horseshoe kidney (0.15%) and that of pathology of the aortic junction in patients with a horseshoe kidney, which seems to be accidental.

Aortic Dissection↗
PubMedDate not supplied

[Surgical treatment of pulmonary metastases].

Between 1977 and 1986, 23 patients with pulmonary metastases were operated upon in a thoracic and cardiovascular surgery department, totalling 26 thoracotomies. The time elapsed between treatment of the primary tumour and that of the metastasis (single or multiple) ranged from 11 to 89 months. The metastases were discovered on follow-up x-ray films of the chest in 15 cases. All patients underwent preoperative lung function assessment, pulmonary radiotomography or thoracic computerized tomography and bronchial fibroscopy. Surgery consisted of tumorectomy (12 cases), lobectomy (5 cases), pneumonectomy (3 cases), segmentectomy (1 case) and tumorectomy combined with lobectomy (1 case). In 2 patients only exploratory thoracotomy could be performed. The operative mortality was nil. The mean survival counted from the date of the last thoracotomy was 17 months (range 1 to 51 months). The mean absolute survival was 24 months (range 13 to 51 months). The actuarial survival rate was 60 percent at 1 year, 47 percent at 2 years and 26 percent at 3 years. Terminal respiratory failure was the main cause of death. Surgery within a multidisclinary approach of lung cancer must therefore spare as much lunch parenchyma as possible to preserve the patient's future.

Adult↗