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Biomedical subjects

P Sava

Publications and source records attributed to P Sava.

At least 19 recordsLinked to original sources

[Treatment of splenic injuries. Retrospective study of 101 cases].

101 patients with splenic trauma were treated during the period 1978 to 1988. They included 76 men and 25 women aged between 16 and 85 years, with a mean age of 38 years 6 months. Exclusively splenic lesions were present in 33 cases (32.67%) and bony or visceral lesions were also present in 68 cases (67.33%). 61 cases (60.39%) suffered from multiple trauma. 97 patients underwent laparotomy, 86 (85.1%) subsequently underwent total splenectomy and 11 (10.8%) conservative surgical treatment (10 partial splenectomies and 1 splenorrhaphy). Four patients did not undergo surgery and were kept under surveillance in a surgical ward for 3 weeks. The majority of partial splenectomies were carried out after 1985 though the first was performed in 1981. There was no operative mortality and post-operative mortality was 9.9% (10 deaths). The overall mean duration of hospitalisation was 20.2 days: 15.6 days for patients who underwent partial splenectomy, 19.6 days for patients who underwent total splenectomy and 21 days for cases involving simple surveillance. Operative complications occurred in 28 patients who underwent laparotomy. Complications did not occur in the 4 patients who received simple surveillance. The most frequent complications were sepsis, pneumonia, thrombo-embolic complications and four patients required reoperation for hemoperitoneum. Conservative surgical treatment is increasingly being used in splenic trauma. The criteria for avoidance of surgical intervention remain difficult to define at the present time.

Accidents

[Cancer of the extrahepatic biliary tracts and abnormality of the biliopancreatic junction].

This retrospective study was undertaken to evaluate the incidence of an abnormal pancreaticobiliary ductal union (long common duct) in biliary tract carcinoma. Of 86 patients presenting with such a cancer, 67 had a pre- or intra-operative radiologic examination. An abnormal pancreaticobiliary ductal union was found in only one 60 year old woman having stones associated with invasive gallbladder carcinoma. Operative cholangiogram revealed an early and marked Wirsung opacification with a 1.5 cm long common duct. This low incidence in our study contrasts deeply with Japanese data and raises several questions about the correct evaluation of pancreaticobiliary ductal union, the true consequences of such an anomaly and possible interracial variations in incidence.

Biliary Tract Neoplasms

[Surgical treatment of postoperative eventration with a prosthetic grid. 62 cases].

The treatment of post-operative eventration with major loss of parietal substance often justifies the use of prosthetic material. 62 post-operative patients from a series of 345 benefited from such a procedure. In the majority of cases they were patients who had undergone multiple surgery and also one or many attempts to cure the eventration (55%). The eventrations were of large volume and complex and one or more operative risk factors were present (81%). A Mersilene grid, implanted retromuscularly in all but one case, was the prosthetic material used in 96% of cases. Operative mortality in this series was zero, but unfortunately post-operative hematomas occurred in 27% of cases and one half of these became infected. Recurrent eventration (11%) was seen in all but one case where post-operative infection occurred. In five out of six cases under these circumstances this became apparent during the first post-operative year. The authors stress the fundamental importance of peri-operative care during such interventions; the quality of post-operative results depends, to a large extent, on this care and on the respect of the peroperative technical principles defined by the authors.

Adult

[Platelet antioxidant enzyme activities in arteriopathy].

Some publications have pointed out that oxygen free radicals can induce injury of vessel wall and increase platelet aggregation and clotting, which can suppose a dependent relationship with arteriosclerotic process. We therefore studied the hypothesis of a possible abnormal platelet antioxidant enzymatic equipment in arteriopathic patients. A control group of 20 healthy subjects and an other one of 40 non diabetic patients with peripheral arterial disease were investigated, and the following tests were performed: measure of transcutaneous oxygen tension (PTCO2), determination of activity of platelet superoxide dismutase (SOD), glutathione-peroxidase (G-Px) and catalase (CAT). A significant decrease of SOD and G-Px is observed in platelets of arteriopathic patients. This decrease seems to be correlated with the severity of ischemia. The pathological reduction of platelet antioxidant equipment can be one factor enhancing thrombotic complications in chronic arterial disease.

Arteritis

[Relationship between intestinal motility and absorption. Electromyographic study in the dog. (author's transl)].

The effects of different food components on intestinal motility were studied by means of an electromyographic technique. The electrical activity of the small intestine in the fasted state consists of a cyclic recurring phenomenon - the myoelectric complex - which is inhibited by feeding. The duration of inhibition of the myoelectric complex was shown to depend on the nature of the food components (glucose, peptides or lipids) as well as on the caloric load. In the opposite, the intensity of the intestinal motility was seen to depend only on the nature of the food components, and not on the caloric load. Thus, the duration of inhibition of themyoelectric complex can be considered as a consistent and objective parameter, which reflects the duration of the fed state.

Animals

[Study on the effects of bromopride on intestinal peristalsis (author's transl)].

The effect of 4-amino-5-bromo-N-[2-(diethylamino)-ethyl]-2-methoxy benzamide (bromopride, Viaben) on the intestinal motility was studied in dogs. Highly sensitive transducers were implanted on the intestinal serosa, allowing to measure both electrical and mechanical impulses at the same point from the small intestine. These studies were performed in 5 dogs to which bromopride was administered in i.v. or i.m. doses of 10, 20 and 30 mg. The results of the studies were as follows: 1. Bromopride causes an increase in both the number and amplitude of the spikes; at the same time there is a significant increase in the number and amplitude of the intestinal contractions. 2. The average duration of the cycle of the myoelectric complex does not change. This indicates that bromopride has no effect on the normal cycle of motoric activity in the intestine. 3. Bromopride seems more effective in the fasted state than in the post-prandial phase. 4. The effect of i.v. infection is greater than that of i.m. injection and begins earlier.

Action Potentials

Specific effects of different food components on intestinal motility. Electromyographic study in dogs.

Interdigestive intestinal myoelectric activity is characterized by repetitive aborally migrating complexes which are inhibited by feeding. The aim of the present work was to study the effects of different food components on the duration of inhibition of the myoelectric complex and on the number of spike potentials during this period. 4 dogs were prepared for chronic recordings with electrodes implanted on the jejunum and an alimentary cannula placed into the duodenum. Glucose, peptides and lipids were given into the cannula at doses of 7.5 and 15 kcal/kg. The results indicated that the inhibition of the myoelectric complex was longer for lipids than for glucose and even longer than for peptides. When the caloric load was increased, the duration of inhibition was also increased. As concerns the spike potentials, their number was increased after administration of glucose and of peptides, whereas it was decreased after lipids. Lastly, the increase of the caloric load did not change the number of spike potentials significantly. These results indicated that the duration of inhibition of the myoelectric complex depended on both the nature and the caloric load of the food components, whereas the number of spike potentials was determined only by the composition of food.

Action Potentials

[Operative trauma of the common bile duct. Report of eight cases (author's transl)].

The authors report eight cases of operative trauma to the common bile duct; seven patients were sent up for reoperation often during the late stages following an attempt at immediate or secondary repair. Emphasis was placed on the interest of extensive resection of the stenosis and wide and high opening of the common bile duct for construction of the bilio-jejunal anastomosis, and furthermore the late risk of onset of portal hypertension requiring portacaval anastomosis, finally the possible degradation of the good initial results requiring difficult reoperations.

Adult

[Intestinal motility after intraduodenal and intrajejunal feeding].

Post-prandial intestinal motility, analysed through two electromyographic parameters, duration of inhibition of myoelectric complex (DIMC) and percentage of spike potentials (PSP), was studied after ingestion of glucids, proteins and lipids. Post-prandial intestinal motility depends on both chemical nature and caloric load of nutriments: DICM depends on those two factors but PSP only depends on nature of nutriments. Post-prandial intestinal motility also depends on route of administration of nutriments. Intra-jejunal administration versus intra-duodenal administration increases DIMC observed for glucids and proteins, diminishes DIMC observed for lipids and diminishes PSP observed for glucids and proteins. These results indicate a specificity of intestinal post-prandial motility with characteristics of nutriments. Intestinal digestion and absorption of nutriments, just as hormonal secretion in response to intestinal passage of nutriments could explain such a specificity.

Action Potentials

[Medullary carcinomas of the thyroid. General review apropos of 3 further cases].

The authors report of three cases of medullary carcinoma of the thyroid and, from a review of the literature, study the definition, frequency, embryological and etiological characteristics of this disease. The physiology of thyrocalcitonin, the concept of the APUD system the secretion of active substances by the tumour cells are considered. The macroscopic and microscopic characteristics and its mode of spread are described. The two main clinical forms, the sporadic form and the familial form are described together with the other endocrine involvements. Among the factors in positive diagnosis, accent is placed on per-operative histological examination and on biological tests of familial detection. Among the forms of treatment the essential place of surgery explains partly the relatively favourable course and prognosis of the malignant disease.

Adult

[Study of intestinal motility. Contribution of electromyography].

The longitudinal and circular deformations of the intestinal wall have been studied simultaneously with the intestinal electrical activity. Tracings were obtained for several weeks by means of a compact device which was implanted on the jejunum in 6 dogs and 4 rabbits. The results showed that the transverse movements of the intestine corresponded to the muscular activity of the circular layer. The longitudinal movements were observed permanently in the rabbit. In the dog they could correspond to a contraction or a relaxation movement. In the two cases, no electrical activity was related to the longitudinal mechanical activity of the intestine.

Animals