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Biomedical subjects

M Veyrac

Publications and source records attributed to M Veyrac.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Extracorporeal lithotripsy in gallbladder calculi. Results of a single-center experience of 31 patients].

The authors studied thirty one cases (18 women, 13 men) of extracorporeal shock-waves lithotripsy on symptomatic gallbladder stones realized with piezoelectric generators. There were one to six stones per patient with individual stone size from 8 to 40 mm; among them 16% were calcified. Any anesthesia was necessary. Shock-wave frequency was 1.25 and 2.5 Hz. The average number of shock waves administered was 4,600 per treatment. Fragmentation occurred in 67% after first treatment and in 74% after second treatment. Gallstones disappeared in 9.5% and 19.5% of patients after 6 weeks and 4 months respectively. There was no modification after four treatments in 22.5% of patients. Minor side effects were noted: back pain (29%) probably because of uncomfortable position during treatment; increased thickness of gallbladder wall (26%); biliary pain (22%). Two episodes of biliary tract obstruction by stone fragments (one mild pancreatitis, one jaundice with liver enzymes elevation) disappeared spontaneously. These results were comparable with those of other groups using the same shock waves lithotripter.

Adult↗
PubMed1990

pH monitoring for 24 hours of gastroesophageal reflux and gastric function after intrathoracic gastroplasty after esophagectomy.

Gastroesophageal reflux is the main complaint after intrathoracic gastroplasty for carcinoma of the esophagus. Eighteen patients who underwent intrathoracic gastroplasty were studied by 24 hour pH monitoring. Two groups of patients were separately evaluated according to the surgical procedure performed--group 1, nine patients with tubulized stomach and gastroesophageal anastomosis at the apex of the thorax, and group 2, nine patients without tubulized stomach and with low gastroesophageal anastomosis. Gastroesophageal reflux and gastric function were analyzed. Gastroesophageal reflux was clinically present in 36 per cent of patients. During the 24 hour pH monitoring period, the percentage of time that the esophageal electrode showed a pH value of less than 4 was shorter for group 1 than for group 2 (13.3 +/- 11.3 versus 32.7 +/- 21.7), indicating less gastroesophageal reflux. Gastric secretion was also studied with 24 hour pH monitoring. Gastric secretion was reduced after gastroplasty, compared with a control group. Gastric secretion was identical between groups 1 and 2. Tubulization did not impair gastric secretion. Findings from this study show that good functional results can be achieved after intrathoracic gastroplasty if the anastomosis is performed on the neck or at the apex of the thorax. This technique can reduce gastroesophageal reflux without an antireflux procedure.

Adult↗
PubMed1989

Inhibitory effect of the C-terminal octapeptide of oxyntomodulin on pentagastrin-stimulated gastric acid secretion in man.

The effect of the C-terminal octapeptide of human oxyntomodulin (KA-8) on pentagastrin-stimulated gastric acid secretion was studied versus placebo in eight human volunteers after an overnight fast, using a double-blind randomized protocol. KA-8 (7.5 nmol/kg body weight) was bolus-injected at a plateau stimulation obtained with pentagastrin (3 micrograms/kg/h). KA-8 significantly decreased the volume secreted by 36% (p less than 0.025) and the acid output by 32% (p less than 0.025) 20 min after injection. The areas under the curve were significantly reduced for volume and acid output during the 1st h after peptide injection.

Adult↗
PubMed1989

[Anteroposterior rectopexy for disorders of rectal stasis: clinical and radiologic results. Value of digital subtraction rectography. Apropos of 30 cases].

We report the results of 30 antero-posterior rectopexies (APR) for rectal kinetic disorders with descending perineum syndrome. All patients were investigated by digital subtraction defecography and ano-rectal manometry. The associated surgical procedures were: sphincterotomy (n = 13) for outlet obstruction demonstrated by anal manometry or balloon expulsion test: hypertonic sphincter (n = 7), narrow fibrous sphincter (n = 6); 10 cases of prolapsectomy with extended anterior mucosectomy to reduce anterior rectal prolapse; 2 sigmoidectomy for dolichosigmoid. Best results (mean follow-up: 12 months, 3-26) were observed for ano-rectal or pelvic pain and rectal bleeding, which were cured in more than 80% of cases. Faecal incontinence (n = 5) was cured in all cases. Although normalisation of bowel movements and easier defecation were observed in 78% of cases, improvement in the dyschezic syndrome was differently perceived by the patients. Postoperative investigation demonstrated the probable cause of surgical failures (23%): impairment of rectal sensitivity (n = 2), anismus (n = 3), motor constipation (n = 4), with dolichosigmoid (n = 3). Severe perineal deficiency was also noted in 4 cases. Solitary ulcer (n = 6), anterior proctitis (n = 8), were cured within 2 months. Postoperative defecography showed correction of rectal intussusception without impairment of anterior rectal motility during defecation. These results confirm the efficacy of ARP for treatment of rectal intussusception or anterior rectocele. This functional rectopexy avoids the rectal "sling effect" of standard rectopexy which usually increases rectal dysfunction. Nevertheless, ARP alone seems to be insufficient when the associated functional or organic disorders implicated in rectal dysfunction are not also corrected, essentially outlet obstruction and dolichosigmoid.

Adult↗
PubMed1989

[Sacro-rectopexy by a posterior intersphincteric approach with anteroposterior perineoplasty and mucosal resection. Therapeutic proposal in descending peritoneum syndrome. Apropos of 23 cases].

We report the results of a procedure aimed at correcting the disorders of rectal and perineal tone responsible for the descending perineum syndrome (DPS). The procedure, carried out by the perineal approach, combines a posterior intersphincteric sacro-rectopexy, an anterior perineoplasty via a pre-anal levator myorraphie, a posterior perineoplasty using a post anal repair technique and a mucosal resection aimed at freeing the anal canal. 22 F and 1 M, mean age 68 years, with DPS were operated on. Digitised rectography demonstrated pathological perineal descent (greater than 3 cm) in all cases and posterior rectal angulation at rest of more than 25 degrees (normal less than 10 degrees) confirming an important deterioration in perineal tone. Results after a mean follow up of 12 months (6 to 30 months) were excellent, with objective improvement in rectal bleeding, pain, mucosal prolapse and anal incontinence. In spite of an almost constant return to normal in the number of stools and their facility of evacuation improvement in the dyschesic syndrome (78% of patients) was subjectively variable. Improvement was judged to be very good in 34%, good in 33%, fair in 11%. Healing of mucosal lesions: solitary ulcer (n = 2), rectal inflammation (n = 2), ulcerated mucosal prolapse (n = 3) occurred in all cases within 1 month. Post operative rectography demonstrated a significant decrease in posterior rectal angulation and ano-coccygeal distance confirming the efficacy of the anatomical correction. No serious complications, in particular, infections, were noted under appropriate prophylactic antibiotic cover (Piperacillin) continued up to D5.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

[A cause of terminal constipation: hypertonia of the striated pelvic muscle. Value of complementary studies].

The aim of this study was to define an other cause of idiopathic constipation with a mathematic automatic classification Fifty patients were studied by colonic transit time, anorectal manometry and defecography. Three classical causes were found: 12 patients had hypertonic upper anal pressure; 8 patients had abnormal rectonanal inhibitory reflex and 12 patients had anatomic conditions reducing stool frequencies Automatic mathematic classification coming from optimised bowls technic has led to the characterization of a new cause. Eight young women (mean age 33 years) with hypertonic striated pelvic muscles on straining were identified. Three items were significantly different: defect of sphincteric relaxation without high sphincteric pressure; closure or non opening anorectal angle, hypertonic levator ani on straining. There was a significant high frequency (p less than 0.05) of urinary disorders in this new group. All abnormalities occurred during defecation. This group can be studied with other methods: balloon expulsion, anal electromyography. Clinical identity with urinary pathology may be explained by common neurologic disorders of pelvic striated muscle innervation.

Adult↗
PubMed1987

[Idiopathic constipation in children. Value of treatment by biofeedback].

Anorectal manometry was used in the training by biofeedback of children with idiopathic constipation. Fourteen children 7 to 12 years old with outlet obstruction due to sphincteric disorders were submitted to a biofeedback session. There was a good improvement in 10 of the 12 children who accepted this treatment. This result is in agreement with the data published in literature. This complementary treatment appears useful when it is well accepted by the parents and the child and when the manometric signal is well understood by the child who must be also able to apply the technique at home.

Anal Canal↗
PubMed1987

[Gastro-esophageal reflux, personality study by the Minnesota Multiphasic Personality Inventory (MMPI)].

Gastro-esophageal reflux (GER) is often associated with other functional digestive manifestations. The subjectivity of these manifestations permits an in-depth study of the personality of these patients as compared to a regional reference population with the use of the Minnesota multiphasic personality inventory. In these patients suspected to have a gastro-esophageal reflux, the means to the scales are modified except for that of the psychopathy scale, which is reassuring considering its severity. However, no personality profile may be exteriorized. The difference between patients with GER certified or not by pH measurement rests on the predominance of neurotic scales in the group presenting a gastro-esophageal reflux certified by pH measurement. This results appears to be due to the disease itself rather than to the conditions of performance of the MMPI during pH measurement. Only a pre- and post-therapeutic study will enable to confirm these data.

Adult↗
PubMed1986

[Systemic scleroderma. Contribution of esophageal manometry].

Oesophageal motor function was studied by oesophageal manometry in 48 patients with progressive systemic sclerosis: 25 with proximal scleroderma and 23 with diffuse scleroderma. Oesophageal lesions were noted in 70% (74% in diffuse scleroderma; 64% in proximal scleroderma). Classical manometric signs of scleroderma were found in only 31% of patients. Peristaltic modifications might begin at the junction of the two muscular coats, since a four centimeter long aperistaltic suspended area was noted in that region in 20% of patients, especially in the proximal scleroderma group. Oesophageal motility and low lower oesophageal sphincter pressure account for the gastro-oesophageal reflux and may compromise respiratory function, as suggested by the high frequency of concurrent oesophageal and respiratory dysfunction in diffuse scleroderma. Systematic prevention of gastro-oesophageal reflux should perhaps be advocated as soon as abnormalities in oesophageal motility are diagnosed.

Adolescent↗
PubMed1986

[Esophageal scintigraphy and pH measurement in asthmatic adults suspected of having gastroesophageal reflux].

Fifty-five adults with asthma were explored by gastroesophageal scintigraphy (GES) and pH monitoring (3 postprandial hours, 12 nocturnal hours). For their asthma, all patients received theophylline twice a day. Associated digestive symptomatology led to investigations for gastroesophageal reflux (GER). Twelve hours pH monitoring, the reference method, was validated in 13 normal volunteers. During 12 hr pH monitoring, 4 criteria were studied: number of GER, percentage of time at pH 4, number of GER longer than 5 min and longest GER. Acid reflux occurred in 69 p. 100 of cases. Three hours postprandial pH monitoring and GES showed a GER in 40 and 47.5 p. 100 of cases (p greater than 0.05). GES revealed pulmonary aspiration in almost a quarter of asthmatic adults. Detection of a 30 p. cent increment of nocturnal GER by long pH monitoring could explain that results may differ with various techniques. Pulmonary aspiration was more frequent after longer and deeper GER. The mean duration of GER was more than 9 min but it was not significantly different from GER without pulmonary aspiration. GES may be helpful after 12 h pH monitoring because it can prove pulmonary aspiration. Its association with long and intense GER at 12 h pH monitoring suggests definitive surgical treatment of GER in asthmatic patients.

Adolescent↗
PubMed1984

Kinetics of [99mTc]heparin, venous scintigraphy with [99mTc]fibrinogen and beta-thromboglobulin assay in the diagnosis of deep-vein thrombosis.

The information provided by three examinations: [99mTc]heparin kinetics (KH), venous scintigraphy with [99mTc]fibrinogen (VSF) and plasmatic assay of beta-thromboglobulin (beta TG), are studied on 23 patients separated into two groups on the basis of phlebographic results. VSF which could provide to a certain extent the same kind of information as phlebography, proves to have insufficient sensitivity. KH has high specificity but low sensitivity, while beta TG performance is the opposite. The authors discuss the mechanisms responsible for these discordant results. They observe that in cases where the KH and beta TG correspond, the diagnostic value is very satisfactory, so that a double positive can replace phlebography in cases where the latter is contra-indicated or difficult to perform.

Beta-Globulins↗
PubMed1984

[Bacterial endocarditis of a mitral valve prolapse. Apropos of 2 cases].

We report on two observations of bacterial endocarditis complicating mitral valve prolapse. A review of the literature finds that endocarditis has complicated about 4 p. 100 of the cases of mitral valve prolapse that have been followed-up for 4 to 9 years. In one out of 4 such cases, a diagnostic delay has been held responsible for severe complications: arterial embolism, and cardiac failure with or without rupture of the chordae tendinae. Echocardiography, especially bidimensional, might lessen the diagnostic delay. Our analysis of the available reports indicates that young men with a late systolic murmur seem to be particularly prone do endocarditis, so that in this subgroup of patients antibiotic prophylaxis should be systematically prescribed when aggressive manipulations are considered.

Adult↗