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Biomedical subjects

R Claude

Publications and source records attributed to R Claude.

At least 19 recordsLinked to original sources
PubMed2000

[Acute pancreatitis: recent advances in understanding its pathophysiology].

This article reviews the recent changes in the understanding of acute pancreatitis pathophysiology emphasizing results deriving from the more detailed comprehension of the local and systemic aspects of the inflammatory process. The authors briefly discuss those theories that have been influencing the basic philosophies of treatment efforts. The role of premature digestive enzyme activation as the principal determinant of the pathoetiology and mortality of this disease has been questioned lately, and the inflammatory explosion has been placed into the center of attention. Simultaneously with the enzyme activation, the pancreatitogenic noxious event rapidly induces the formation of oxygen derived free radicals, activation of the transcription factor NF kappa-B, with consequent citokine production, cellular adhesion molecule upregulation and leukocyte hyperstimulation. Numerous other mediator cascades are activated in parallel, the uncontrolled surge of proinflammatory stimuli, and activity of the effector cells lead to multiple organ failure in severe cases. A genetically determined catastrophe management program is set forth in the acinar cell with pancreatitis associated protein expression and activation of the apoptosis machinery. Therapeutic approaches based on these recent findings are briefly touched upon.

Acute Disease↗
PubMed1996

[A case of adrenal gland metastasis of a cutaneous melanoma treated by excision with 3-year survival].

Case report of a 38-year-old man who, 14 months after resection of a malignant melanoma from the right shoulder in September 1990, presented with a tumour of the right adrenal gland. Resection confirmed metastatic melanoma. Chemotherapy was administered for 3 months. The patient was followed until his death in March 1995, i.e. three years after resection of the secondary adrenal tumour.

Adrenal Gland Neoplasms↗
PubMed1992

[Current role of cryosurgery in benign prostatic hypertrophy compared to recent minimally invasive methods].

The authors review results of 20 years of cryosurgery for benign prostatic hypertrophy based on 992 cases treated by this method. In particular, they compare the 500 more recent cases of cryocauterisation with the new minimally invasive techniques proposed:balloon dilatation, prostatic stent, thermotherapy, hyperthermia, medical treatment with a 5-alpha-reductase. A study of the cost of these treatments with similar performances places cryosurgery in a good position. It covers the largest range of therapeutic indications with the fewest contraindications in high-risk patients. Good long-term objective results were observed. In their current state of application, thermotherapy and hyperthermia are essentially palliative modalities.

5-alpha Reductase Inhibitors↗
PubMed1991

["Clam" enteroplasty in the treatment of unstable or low compliance bladders].

The treatment of urinary incontinence due to unstable bladder remains difficult. In the case of failure of medical or physiotherapeutic treatments, clam enterocystoplasty represents a major and important therapeutic possibility. The operation consists of frontal section of the bladder to form a bivalve followed by interposition, between the two valves, of a detubed ileal graft in order to increase the functional vesical capacity and to interrupt the transmission of detrusor contraction waves from one valve to the other. 10 patients (7 men and 3 women) suffering from urinary incontinence due to neurogenic unstable bladder (4 cases: 3 meningoceles, 1 operated cauda equina neuroma) or to another cause (6 cases, including one sequela of radiotherapy for prostatic cancer and 5 cases of apparently primary urinary incontinence) underwent enterocystoplasty combined, in the case of neurogenic incontinence (2 cases simultaneously and 2 cases previously), with the insertion of an AMS 800 sphincter. No major complication was observed. 9 patients are continent and 1 had to be reoperated to undergo an augmentation enterocystoplasty (failure of the initial operation due to radiation changes of the bladder), 3 retain a post-voiding residual of about 200 ml but not requiring self catheterisation due to the absence of any repercussions on the upper urinary tract. Lastly, urodynamic studies demonstrated a spectacular increase in compliance and functional capacity of the bladder together with a reduction of the amplitude of intravesical pressure peaks.

Adolescent↗
PubMed1990

[Alithiasic cholecystitis and viral hepatitis B disclosing periarteritis nodosa].

The authors report the case of a patient with acute alithiasic cholecystitis associated with viral B hepatitis revealing periarteritis nodosa. Histopathological results showed signs of focal arteritis in the gallbladder and liver. Because of the negativity of the viral DNA in serum and the lack of histopathological necrosis in hepatic specimen, the patient was treated by steroid therapy only with a rapid regression of signs of vasculitis and the disappearance of the hepatitis markers.

Adult↗
PubMed1990

[Ambulatory urologic surgery].

Since November 1st, 1988, an outpatient clinic has been set up in our department of Urology. Patients come to the clinic on the morning of the procedure and leave in the evening after a few hours of monitoring. Eligibility for outpatient surgery is determined using strict social, surgical and medical criteria. A visit with the anesthesiologist is scheduled one week before the operation. On the day of the procedure, the patient arrives at 7 a.m., is shaved, prepared and operated on by a senior surgeon before impatient operations begin. Postoperative monitoring is carried out as usual and around 6 p.m. the surgeon and the anesthesiologist decide whether the patient can be discharged. Most patients are interviewed by telephone within one week of the procedure. From November 1988 through December 1989, 172 adults were admitted to the outpatient clinic for endoscopic surgery (85 cases), open surgery (42 cases) or other procedures including diagnostic investigations, instillations, and removal or replacement of stents (44 cases). Twenty-three patients were discharged only on the day following the procedure. One patient was readmitted for clotting in the bladder. These preliminary results show that, as compared to inpatient surgery, outpatient surgery is cost-saving, easier to cope with psychologically and less apt to be followed by nosocomial infection, without greater risk to the patient provided inclusion criteria are stringently applied.

Adolescent↗
PubMed1989

[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↗
PubMed1987

Value of sonographically guided fine needle aspiration biopsy in evaluating the liver with sonographic abnormalities.

This retrospective study was undertaken to evaluate the diagnostic usefulness of 97 sonographically guided fine needle aspiration biopsy cytologies in 92 patients with one or more hepatic lesions suspicious of malignancy. Results of the fine needle aspiration biopsy were then compared with the definitive results obtained by histologic examination, or with the subsequent course of the patient. A final diagnosis of malignancy was established in 65 cases, of which fine needle aspiration biopsy cytology revealed a concordant diagnosis in 54 cases. The diagnostic sensitivity of this technique was 83% for malignant lesions with 93% specificity. Of the 54 cases with malignant cytology, it was possible to distinguish between a primary or secondary lesion in 31 cases (57%). Benign lesions were aspirated in 32 cases, of which 30 cases concorded with the final diagnosis. This study confirms the usefulness of sonographically guided fine needle aspiration biopsy cytology in diagnosing malignant hepatic tumors.

Adult↗
PubMed1985

[Hemolymphangioma of the pancreas].

The authors report a case of hemo-lymphangioma from the body and the tail of the pancreas. Through a review of the literature, the histological, histogenetical and clinical features of this disease are recalled and the diagnostic and therapeutic modalities are considered. These are benign tumors and their treatment must be surgical and radical. Two operative attitudes are possible: the tumoral enucleation and the partial pancreatectomies.

Adult↗
PubMed1982

[Oesophagitis during mechanical ventilation].

Twenty-one patients whose condition required mechanical ventilation with nasogastric intubation were investigated for oesophagitis before the 3rd day and on the 15th day of treatment, including endoscopy and biopsy. Lesions of oesophagitis were detected in 14 cases during the initial examination and in 19 cases on the second endoscopy. The course of the lesions varied from one patient to another and appeared to be unrelated to the course of the primary disease. Oesophagitis in these patients is probably due to frequent episodes of gastro-oesophageal reflux encouraged by cough, impaired consciousness and the presence of a tube. Reflux may also be the cause of inapparent and recurrent lung aspiration.

Adult↗
PubMed1981

[Compensating presbyopia: a new physiological progressive lens (author's transl)].

After discussing the functional disadvantages arising after correction of presbyopia with uni--or multifocal lenses, the authors describe the optical and physiological advantages of a lens with progressively increasing power. The principal qualities of these physiologically progressive lenses are studies, and the results of a preliminary survey concerning their use are analysed. The indications for, and adaptation and tolerance of these lenses are outlined.

Aged↗