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Biomedical subjects

P Icard

Publications and source records attributed to P Icard.

At least 19 recordsLinked to original sources
PubMed1992

Primary lung cancer in young patients: a study of 82 surgically treated patients.

The aim of this study was to evaluate the prognosis for surgically treated young patients with primary lung cancer, a prognosis generally considered to be very poor. Eighty-two patients less than 40 years of age were operated on at Marie-Lannelongue Hospital between 1982 and 1990. There were 72 male and 10 female patients. Ten patients (12%) had never smoked, whereas 48 patients (59%) had smoked for more than 20 pack-years. The lung cancer was asymptomatic in 27 patients (33%) and symptomatic in the others. Adenocarcinoma was found in 42% of the patients, epidermoid carcinoma in 28%, mixed cell carcinoma in 16%, small cell carcinoma in 8.5%, and undifferentiated large cell carcinoma in 6%. Among the 69 resected tumors, 22 were stage I, ten were stage II, 32 were stage IIIa, and five were stage IIIb. The resection was considered complete and curative in 56 patients (68%) and noncurative in 26 (32%) either because of an incomplete resection (12 in stage IIIa; 1 in stage IIIb) or because of an exploratory thoracotomy only (13). The overall actuarial 5-year survival rate was 41%, and the actuarial 5-year survival for patients who had a complete resection was 56%. The actuarial 5-year survival rates were as follows: patients in stage I, 70%; stage II, 54%; stage IIIa, 28%; stage IIIb, 0%; and patients having exploratory thoracotomy only, 18%. These survival rates are similar to those of patients older than 40 years with similar stages of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Cancer surgery on a single residual lung.

A series of nine patients with single lungs operated on for lung cancer is reported. This represents 10% of all the synchronous and metachronous lung cancers operated during the same period. There were three early postoperative deaths and a further three patients died subsequently at 15, 20 and 24 months, respectively, after operation; the remaining three are alive 6, 12 and 29 months, respectively, following their surgery. The analysis of the results of this small series indicates that wedge and segmental resection, when feasible, may be undertaken in patients with a single lung with reasonable life expectancy. The fact that lobectomy is not tolerated in such patients emphasizes the importance of early diagnosis when minimal local excision can be undertaken.

Cause of Death↗
PubMed1992

Adrenocortical carcinoma in surgically treated patients: a retrospective study on 156 cases by the French Association of Endocrine Surgery.

BACKGROUND: Because of the rarity of adrenocortical carcinoma, survival rates and prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors in all patients treated during a 12-year period by its members. METHODS: One hundred fifty-six patients (95 women, 61 men) with a mean age of 47 years were included. Functional symptoms were found in 52% of patients, and hormonal studies revealed secreting tumors in 62% of cases. Ninety-four percent of the patients underwent resection of the adrenal tumor, and 20% of them had extensive resection because of invasive cancers. Complete resection was achieved in 127 patients (81%) and incomplete resection in 29 patients. Mean tumor weight was 714 gm (range, 12 to 4750 gm), and the mean diameter was 12 cm (range, 3 to 30 cm). The results of the tumor staging were stage I, eight patients (5%); stage II (local disease), 75 patients (48%); stage III (locoregional disease), 39 patients (25%); and stage IV (metastases), 34 patients (22%). RESULTS: The 5-year actuarial survival rates were 34% overall, 42% in curative group, 53% in local cancer group, 24% in regional disease group, and 27% in the reoperated group. One-year actuarial survival rate of the palliative group was 9% (median survival, 6 months). Multivariate analysis showed that better prognosis occurred in patients younger than 35 years of age (p = 0.01) and in patients with androgen-secreting tumors, precursor-secreting tumors, or nonsecreting tumors (p = 0.003). Mitotane improved the survival rate only in patients with metastases who received it after operation (vs non-mitotane-treated patients [p < 0.05]). CONCLUSIONS: In this study age, extent of disease, aspect of the surgical resection, and type of hormonal secretion influenced survival.

Adrenal Cortex Neoplasms↗
PubMed1992

[Adrenal gland pheochromocytomas. Apropos of 35 operated patients].

Thirty-five patients (20 female and 15 male, mean age = 47 years) operated on for an adrenal pheochromocytoma were reviewed. Catecholamine excessive production was symptomatic in 33 patients (94%). Urinary excretion of vanyl-mandelic acid, catecholamines and metanephrine was abnormal in 84%, 75% and 90% of cases, respectively. Tumor was presumed benign (no metastasis) in 31 cases. Sensitivity of CT scan (n = 35) and magnetic resonance imaging (n = 13) was 100%. Meta-iodo-benzylguanidine scan (n = 19) always recognized the main tumor, but did not visualize 1 second tumor in 1 patient and 1 metastasis in 1 other patient. An anterior intraperitoneal approach was performed in all cases. Operative mortality rate was 5.7%. In the last 15 patients, systematic preoperative treatment by prazosine did not lead to fall in rates of peroperative arrythmia and hemodynamic disorders. Twenty-two of 25 (88%) hypertensive patients remained normotensive without medication postoperatively. The risk of undiagnosed pheochromocytoma and problems in resection of large right-sided tumors are discussed.

Adolescent↗
PubMed1991

[Excision under local anesthesia of parathyroid adenomas. Criteria of selection and control of effectiveness. 35 cases].

Primary hyperparathyroidism caused by an adenoma that has been identified and localized by ultrasonography can be treated through a limited approach route, under local anaesthesia, provided the effect of excision is controlled by a perioperative assay of urinary cAMP or, preferably, of plasma parathormone level, and provided the contra-indications of this method are respected. Thirty-three out of 35 patients have been successfully operated upon by this method. In case of failure confirmed by laboratory tests, local anaesthesia was only a prelude to cervicotomy under general anaesthesia.

Adenoma↗
PubMed1991

[Resumption of function of the liver graft. Controlled comparative study of UW solution and SLF Cochin].

Nowadays the UW solution is usually used in liver transplantation for graft preservation. The importance of each of its components has not been fully resolved. The omission of some of the components does not result in poor hepatic function. The aim of this controlled study was to assess the early graft function (ALAT, factor V and total bilirubin at days 1, 2, 3 and 6) after use of the UW solution and SLF Cochin. SLF Cochin is a modified UW solution without hydroxyethyl starch, adenosine, penicillin, dexamethazone and allopurinol. No significant difference was observed in the early graft function between the two solutions for a cold ischemia time below 15 hours. Considering the qualities of the SLF Cochin and its three fold lower cost, it is concluded that the use of the SLF Cochin solution is justified for liver transplantation in which foreseeable cold ischemia time is less than 15 hours.

Adolescent↗
PubMed1990

False aneurysm infected by Aspergillus fumigatus: an unusual complication of aortofemoral bypass graft.

Two cases of Aspergillus fumigatus infection of aortobifemoral prosthetic grafts are reported. Both patients were treated successfully by excision of the infected prosthetic material, axillofemoral extra-anatomic bypass, and prolonged medical treatment. The patients received amphotericin B, 5-flucytosine and itraconazole until negative aspergillus serology was obtained (at 9 and 18 months, respectively). Later, repeat disobliteration procedures for thrombosis of the axillofemoral bypass were required. No recurrent aspergillus infection was found.

Amphotericin B↗
PubMed1990

Coelioscopic cholecystectomy. Preliminary report of 36 cases.

Intra-abdominal endoscopy, routinely used for gynecologic operations can be extended safely for cholecystectomy in uncomplicated cholelithiasis. Thirty-six patients underwent coelioscopic cholecystectomy with few and only benign complications. The main advantages are cosmetic preservation, reduction of postoperative pain, shortening of hospital stay, and early recovery of a normal activity.

Abdominal Pain↗
PubMed1990

Comparison of rat liver preservation with Eurocollins and a modified University of Wisconsin solution: transplantation and isolation of hepatocytes for culture.

The efficiency of Eurocollins or modified University of Wisconsin (UW) solution (MUW) in preserving rat livers was compared. After cold storage with one of the solutions, the livers were transplanted or perfused by collagenase for isolation of hepatocytes. Five of the 6 rats receiving a graft preserved with MUW versus none of the 6 rat receiving a graft preserved with Eurocollins solution survived 24 h or more. A significantly greater number of hepatocytes were isolated from livers preserved with MUW than from livers preserved with Eurocollins solution. This suggests a better reperfusion of MUW-preserved livers by collagenase resulting from less endothelial injury. LDH release by cultured hepatocytes, ketone body production and stimulation by glucagon were not significantly different between the two groups. These results confirm the superiority of MUW solution over Eurocollins in preserving liver grafts. They suggest that the advantage of MUW solution results from better protection of vascular endothelium rather than of hepatocytes.

Adenosine↗