PubMed Health⌕ Search

Biomedical subjects

P Sauvage

Publications and source records attributed to P Sauvage.

At least 19 recordsLinked to original sources
PubMed1997

[Endoscopic aspects of posterior urethral valve].

Most congenital posterior urethral valves arise from the urethral crest, just below the veru montanum. Urethral diaphragms have been well identified but the concept of valves running from the vern to the bladder neck is questionable. Despite advances in non-invasive investigations, the accurate identification of urethral valves can be achieved only by endoscopy. Such an exploration is required to define the mechanism of urethral obstruction and therefore to provide an appropriate endoscopic treatment. The age, the clinical condition of the child and the size of his penis and meatus might sometimes delay urethral endoscopy for some months in order to avoid secondary urethral stenosis.

Child↗
PubMed1996

Diversion of salivary flow to treat drooling in patients with cerebral palsy.

The authors performed six sialodochoplasties between 1991 and 1994 to treat drooling in six children who suffered from cerebral palsy. There were three boys and three girls, aged 13 to 22 years (mean, 16 years). All patients underwent parotid duct rerouting. The first four patients (group I) also underwent associated excision of submandibular ducts, and the last two patients (group II) benefited from rerouting of the submandibular ducts. In group I, results were considered good in two cases, fair in one case, and poor in one case. A fistula of the new Stenon duct appeared in one patient, which required excision and ligation followed by progressive involution of the parotid gland. Both group II patients had excellent and rapid results. The requirements leading to surgical decision are determined. The importance of physiotherapy is emphasized. Surgical techniques are described and discussed, as are objective criteria for the assessment of surgical results, namely salivary radioisotopic scanning.

Adolescent↗
PubMed1996

Free to total prostate-specific antigen (PSA) ratio improves the discrimination between prostate cancer and benign prostatic hyperplasia (BPH) in the diagnostic gray zone of 1.8 to 10 ng/mL total PSA.

OBJECTIVES: Improved discrimination between prostate cancer (PC) and benign prostatic hyperplasia (BPH) is clearly needed. Our aim in this study was to evaluate whether the free to total prostate-specific antigen (PSA) ratio would be useful in the gray zone of 1.8-10 ng/mL total PSA range. METHODS: In a consecutive series of 435 clinic patients referred for prostate evaluation, 308 had a total PSA < 10 ng/mL (92 had PC and 216 BPH). Free and total PSA were measured, and the free to total PSA ratio calculated. RESULTS: Total PSA values were significantly different between the two groups. For the 200 patients with a total PSA < 6 ng/mL, no significant difference in total PSA values were seen (P = 0.411), whereas free to total PSA ratios remained statistically different (P < 0.001). Receiver operating characteristic (ROC) curve analysis comparing the performances of total PSA over the ratio of free to total PSA showed a clear advantage for the ratio at all sensitivity levels. CONCLUSIONS: These data demonstrate that in a significant number (n = 308) of prostatic patients in the diagnostic gray zone of 1.8-10 ng/mL total PSA, the routine use of free to total PSA might be advantageous in discriminating between cancer and benign hyperplasia. This advantage remained for total PSA < 4 ng/mL. Further study is warranted to confirm these findings in an unselected population.

Aged↗
PubMed1996

[Common mesentery: clinical and therapeutic aspects in children. Apropos of 58 cases].

Fifty-eight children with isolated malrotation of the midgut were treated in our service between 1970 and 1993. They presented with acute bilious vomiting in 75% of cases. The remaining 25% consulted for various digestive symptoms. Diagnoses were established by an upper gastrointestinal radiographic study. Prognoses were good whenever an emergency operation was performed.

Barium Sulfate↗
PubMed1996

Free to total prostate-specific antigen (PSA) ratio is superior to total-PSA in differentiating benign prostate hypertrophy from prostate cancer.

BACKGROUND: Serum prostate-specific antigen (PSA) exists in different molecular forms, and their respective concentration has been proposed as a useful tool to improve discrimination between benign prostatic hypertrophy (BPH) and prostate cancer (PC). METHODS: The relevance of the free to total PSA ratio was prospectively studied in a selected urology clinic population of 420 patients. Total serum PSA ranged from 2.1 to 30 ng/ml; 154 had PC and 266 had BPH. RESULTS: Receiver operating characteristic (ROC) curves were constructed for the total population (total-PSA range from 2.1 to 30 ng/ml) and for the diagnostic gray zone of 2.1-10 ng/ml. For the two groups, the free to total PSA ratio had a higher specificity than total-PSA for all sensitivity levels. Cut-off values were found to, vary with prostate weight. CONCLUSIONS: Although free to total PSA ratio demonstrated better performances than total-PSA, its use in screening appears problematic, due to the low prevalence of prostate cancer.

Aged↗
PubMed1996

[Small bowel obstruction and laparoscopic treatment in children].

From 1992 to 1996, 15 children with an acute small bowel obstruction were treated by laparoscopy. There were 10 boys and 5 girls between 6 to 15 years. They had been formerly operated in the neonatal period (4 cases), for appendectomy (9 cases), or ureteronephrectomy for Wilm's tumor (1 case), and caudal pancreatectomy after a traumatism (1 case). Thirteen times it was the first obstruction and twice the second or more (but never treated by surgery). Conversion in laparotomy was necessary in 4 cases. There were no operative complication. We noted a quick recovery (12 hours), an early discharge (3.5 days), and a good postoperative comfort. Laparoscopic viscerolysis for acute small bowel obstructions seems to be a good treatment in children.

Adolescent↗
PubMed1995

Accessory diaphragm--review of 31 cases in the literature.

The authors report a case history of a male newborn at term, presenting with an accessory diaphragm in the right hemithorax, and an associated lung hypoplasia, revealed by a transient respiratory distress. The review of 31 cases published in the literature confirm the rare occurrence of this malformation. The diagnostic difficulties are discussed. The advantages of both MRI and CT scanning are compared. Pulmonary, vascular, or diaphragmatic abnormalities were due either to the isolated diagnosis or to its possible associated malformations. Operative management is often considered in view of the progressive respiratory complications. Excision of the accessory diaphragm does not necessarily solve the problem of a coexisting lung hypoplasia.

Adult↗
PubMed1995

Mediastinal stabilization by an expansion prosthesis in postoperative congenital diaphragmatic hernia with severe pulmonary hypoplasia.

The authors illustrate a case of right neonatal congenital diaphragmatic hernia (CDH) of Bochdalek with major pulmonary hypoplasia and postoperative massive mediastinal displacement to the right, leading to tracheal compression and recurrent respiratory distress at every attempt to wean the infant from the ventilator. Mediastinal stabilization was obtained by placing an expansion prosthesis (of the cutaneous type) in the right hemithorax, to prevent mediastinal obstruction of the main airways. This procedure may prove to be an original and efficient solution for the critical postoperative respiratory obstruction due to severe pulmonary hypoplasia and mediastinal mass effect in the newborn with CDH. However, this may not prevent progressive scoliosis, a serious problem frequently seen in the absence of one lung.

Airway Obstruction↗
PubMed1995

[Gastroschisis. Management. 50 cases].

OBJECTIVE: Demonstrate the need for a multidisciplinary antenatal approach to laparoschisis. MATERIAL AND METHODS: A retrospective series of 50 children who underwent surgery for laparoschisis between 1975 and 1994 in the Infant Surgery Department of the Strasbourg University Hospitals. Postoperative outcomes were evaluated as a function of the stage of laparoschisis and surgical technique. Follow-up was also examined. RESULTS: Depending on the periods evaluated, ultrasound diagnosis varied from 16 to 92% and was made at 21 weeks gestation on the average. Lesions observed were atresia of the bowel (10%), complete intestinal involution (2%), and perivisceritis (88%). Complete parietal closure was achieved after bowel emptying in 58% of the newborns. Postoperative mortality, usually in vere severe forms, fell from 46% to 15% over the 20-years study period. CONCLUSION: Antenatal echography can confirm the diagnosis of laparoschisis. It can be used to define risk factors (size, bowel dilatation(s), mesenteric blood flow) allowing planned extraction in an Infantile Surgery Unit. This multidisciplinary attitude should help to improve overall outcome.

Abdominal Muscles↗
PubMed1994

[Video-assisted thoracic surgery of hydatid cysts of the lung in children].

10 children between 3 and 9 years old, have been operated on for an echinococcosis cyst of the lung, by a thoracoscopic procedure. It was a vomited cyst in 6 cases, a pyopneumocyst in 1 case, and a jung noncomplicated and univesicular cyst in 3 cases. The surgical procedure is described. We brought into being the operative conditions such it is nowadays an excellent alternative to the classical thoracotomy.

Albendazole↗
PubMed1993

Genetic variation in transforming growth factor alpha: possible association of BamHI polymorphism with bilateral sporadic cleft lip and palate.

Non-syndromic cleft lip with or without cleft palate (CL/P) is one of the most common birth defects affecting 1/1000 Caucasians. Genetic factors are thought to contribute to the development of this disorder. A significant association between two restriction fragment length polymorphisms, the TGF alpha TaqI 2.7-kb allele and the TGF alpha BamHI 40-kb allele, at the transforming growth factor alpha (TGF alpha) locus and the occurrence of clefting has previously been reported. A total of 98 Caucasian patients of Alsacian ancestry was recruited from our registry of congenital malformations. These patients had isolated CL/P but no other anomalies. In addition 57 patients with cleft palate, but without cleft lip, were studied. A control group comprised 99 unrelated healthy Caucasians of the same Alsacian ancestry. TaqI and BamHI identify two-allele polymorphisms. The TGFA Taq and BamHI alleles showed no significant association with the presence of clefting, the only exception being that the BamHI 10.0-kb allele was significantly more frequent in patients with bilateral CL/P.

Child↗
PubMed1993

Transverse mucosal preputial flap for repair of severe hypospadias and isolated chordee without hypospadias: a 350-case experience.

Three hundred patients with hypospadias and 50 patients with isolated chordee without hypospadias were operated on and followed by the same surgeon. A very low postoperative urethrocutaneous fistula rate (4.8%) was related to complete cutaneous coverage of the neourethra. The incidence of stenosis, noted in 8% of the cases, has progressively decreased with improvement of technical details and with growing experience. A total of 75% of the patients were corrected with a single operative procedure. Good disponibility of penile skin rendered a second intervention always easy.

Adolescent↗
PubMed1993

[Multiple autoimmune syndrome].

Report a case of multiple auto-immune syndrome with auto-immune thyroiditis, Sjögren's syndrome, primary biliary cirrhosis. Moreover the patient suffered from neuropsychiatric symptoms and anti-cardiolipid antibodies were significantly elevated.

Aged↗
PubMed1993

Post-traumatic pancreatic pseudocyst: non-operative conservative management--report on 3 cases.

The authors report on 3 cases of post-traumatic pancreatic pseudocysts in children. Complete healing occurred with non-operative conservative treatment and total parenteral nutrition. Daily follow-up with clinical evaluation, abdominal ultrasound and lab exams are detailed under definite criteria of selection and follow-up. This mode of treatment might be considered as an alternative to exploratory laparotomy and external drainage.

Amylases↗
PubMed1993

[Retroperitoneal teratomas in the perinatal period. Review of the literature concerning a neonatal, immature, aggressive teratoma].

A neonate with an immature, poorly demarcated retroperitoneal teratoma invading the aorta-vena cava space died immediately after surgery. Among 34 cases of retroperitoneal teratoma discovered during the first postnatal month, including one renal case and ours, eight can be considered malignant on the basis of histology in two cases and clinical course in six. Five of these tumors exhibited a significant immature component. In neonates, the proportion of malignant teratomas is greater for retroperitoneal tumors than for other sites: sacrum and coccyx, heart, neck, mediastinum, and abdomen. Evaluation of chemotherapy in teratomas with significant immature components is difficult because few of the patients of this small sample received such treatment. As in other sites, regardless of the degree of maturity, exeresis must be as complete as possible.

Antineoplastic Combined Chemotherapy Protocols↗