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Biomedical subjects

R Fastrez

Publications and source records attributed to R Fastrez.

16 recordsLinked to original sources
PubMed2001

[Surgical strategy in rectosigmoidal cancer].

Colorectal cancer is frequent and diagnosed earlier thanks to the screening and to the progresses in the preoperative assessment. The precocity of the surgical resection takes advantage from the complete resection of vascular and nodes involvement. The rectal localisation of the cancer requires to take the reconstruction into account. If preoperative radiotherapy is helpful in T4 and T3 N2 and locally advanced tumour, the surgeon should consider the four approaches of rectal cancer: the anterior resection (Dixon-Wangensteen) (DW) with total mesorectal excision (TME), the colo-anal anastomosis with a J pouch, the abdomino-perineal approach (Miles procedure) requiring a definitive left colostomy, and in some rare cases the transanal local resection.

Colectomy↗
PubMed1993

Nuclear DNA content, proliferation index, and nuclear size determination in normal and cirrhotic liver, and in benign and malignant primary and metastatic hepatic tumors.

The distribution values of ploidy, of the proliferation index, of the percentages of diploid cells/case, of nuclear size, and DNA histogram type are described in a series of 92 liver samples from 87 patients. The 92 samples include normal (31 cases) and cirrhotic (14 cases) tissues, benign tumors (7 cases), well-differentiated hepatocellular carcinomas (HCCs, 13 cases), moderately and poorly differentiated HCCs (8 cases), and colorectal glandular metastatic tissues (19 cases). The samples are from either fine-needle aspiration biopsy (FNAB) or histologic imprint smears (HIS). Nuclear assessments were computed on Feulgen-stained nuclei by means of a cell image processor. The results show that the mean DNA index value, the mean nuclear area (NA) value, and the mean percentages of diploid cells per sample are significantly different in the three benign groups under study (normal and cirrhotic tissues and benign tumors) as compared with the mean parameter values from the three neoplastic liver groups (well-differentiated and poorly differentiated HCCs and colorectal metastases). None of these three parameters, however, makes it possible to discriminate clearly between these six histopathologic groups at the individual case level. The mean proliferation index values were significantly lower in the normal tissues and the benign tumors than in the four other histopathologic groups. Recognizing six DNA histogram types, ie, diploid, hyperdiploid, triploid, hypertriploid, tetraploid, and polymorphic, we observed that all the benign samples (the normal and cirrhotic tissues and the benign tumors) exhibited a diploid and/or tetraploid DNA histogram pattern, whereas the neoplastic samples exhibited the six DNA histogram patterns. The combination of the five computerized parameters into a cytologic score (CS) ranging from 5 to 15 permits clear-cut discrimination between nonneoplastic and neoplastic liver cases. The specificity and sensitivity, and the positive and negative predictive values relating to this score were as high as 100%, 95%, 100%, and 96%, respectively.

Biopsy, Needle↗
PubMed1993

Heterogeneity of DNA ploidy, proliferation index and nuclear size in human colorectal carcinomas.

Measurements of DNA ploidy, proliferation index and nuclear area were performed on 210 samples taken from 15 human colorectal tissues. The tissues were divided into four groups labeled G1, G2, G3 and C. For each of the 15 tissues 9 samples were taken from the so-called unaffected--i.e., marginal--mucosa (G1-G3 groups) and 5 from the tumor (C group). The 9 samples from the unaffected mucosa of each tumor were obtained at a distance of 10 cm (3 samples/tissue, G1 group), 5 cm (3 samples/tissue, G2 group) and 1 cm (3 samples/tissue, G3 group) from the tumor. Computerized cell image analysis was carried out on Feulgen-stained cell suspensions obtained from paraffin-embedded, formalin-fixed tissues. The results revealed that four to five analyses are necessary to detect minor aneuploid cell nuclei populations in human colorectal tumors. A definite homogeneous diploid pattern was found in the G1-G3 samples. In contrast, proliferative activity varied widely between the normal and tumor samples, with such variations observed at both the sample-to-sample and tissue-to-tissue level. The nuclear area also varied markedly across the samples from a given tissue--i.e., both marginal and tumoral and across the tissues themselves. Finally, we observed that the diploid tumors, the nuclear sizes of which varied as widely as those of the aneuploid tumors, possessed a higher proportion of highly proliferating samples than did the aneuploid.

Aged↗
PubMed1986

Empyema due to Salmonella dublin.

An alcoholic patient presented with a thoracic empyema secondary to a pancreatic abscess with Salmonella dublin. The absence of an adjacent pulmonary parenchymal infection suggested a transdiaphragmatic passage of organisms.

Abscess↗
PubMed1985

Azathioprine. An alternative treatment for recurrent idiopathic retroperitoneal fibrosis.

Ureteral obstruction resulting from idiopathic retroperitoneal fibrosis (IRF) generally requires a surgical approach sometimes associated with the administration of a corticosteroid. Corticosteroids alone have also been used successfully for recurrences of IRF after the surgical procedure; however, their success is not uniform. We treated a patient with IRF and ureteral obstruction who showed a dramatic recurrence soon after treatment with prednisone was discontinued. Azathioprine was then considered as an alternative treatment. A six-week course of azathioprine (150 mg/day) resolved all the biologic signs of inflammation, normalized renal function, and greatly improved ureteral obstruction. We discuss the choice of immunosuppressive drugs in the management of the disease and propose azathioprine treatment for the recurrent forms.

Azathioprine↗
PubMed1983

[Venous thrombosis caused by central catheters. Phlebographic study of 41 cases].

Forty-one central catheters placed in 37 patients were subjected to a twofold phlebographic study - classic angiography of the main veins, and injection of a radio-opaque fluid while withdrawing the catheter under fluoroscopy. Although data from the literature shows a high incidence of venous thrombosis due to central catheters, we only found 3 positive results in our series of 37 patients (8%). A fibrin sheath develops along the entire length of the catheter, and, in cases of thrombosis, the point at which the catheter penetrates the central venous system is always involved.

Adult↗
PubMed1976

[Prophylaxis of postoperative deep vein thromboses by means of weak doses of subcutaneous heparin (author's transl)].

The authors intend to control with the marked fibrinogen test, the real frequency of postoperative deep vein thromboses (DVT) and the eventual prophylactic effect of subcutaneous heparin in weak doses. Heparin was administered 2 hours before the operation and every 8 hours during 6 days thereafter, each time at the dose of 5,000 U subcutaneously. Ninety-nine patients undergoing major surgery were randomized into two groups of 55 control operated patients and 44 operated patients treated with heparin. The radioactive fibrinogen test was used in 27 patients of the control group and in 23 of the treated group. In the control group of 55, 7 DVT were clinically recognized : the isotopic test was positive in 17 patients. In the treated group of 44 no DVT was clinically diagnosed : 6 DVT were recognized by the marked fibrinogen test. There were no noticeable hemorrhagic complications in the treated group. Low dose of subcutaneous heparin is an efficient and safe prophylactic method in postoperative thromboembolic accidents.

Aged↗
PubMedDate not supplied

[Initial results of a study on morphonuclear parameters at the level of benign and primary neoplastic hepatic tissue].

This study characterises morphonuclear parameters from normal, cirrhotic, tumoral benign and malignant liver specimens obtained by computerized morphonuclear images analyses. The material is obtained by cytological aspirations or by imprint smears from liver biopsy. The monoparametric analysis differentiates a benign and a malignant cellular populations. In the malignant populations, two types are individualised: the well differentiated and the pleiomorphic hepatocarcinoma. The treatment of the data by canonical projections onto the factorial plan and by discriminant analysis allowed the selection of homogeneous cell populations belonging to each of the pathological groups described above.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[94 inguinal hernias treated by interposition of a prosthesis using medial and preperitoneal approach].

Having chosen the utilization of a Teflon prosthesis, interposed in preperitoneal position by medial incision, in a series of 58 patients presenting 94 hernias, the authors wish to express a preference to this method for reoccurring and bilateral hernias. They underline the simplicity of the technique, its reduced morbidity, and they focus on the infrequency of reoccurrence in 47 patients reseen 6 months to 4 1/2 years in follow up. The authors have not observed a difference in the local results, recent and long term, after intervention using this technique under general or local-regional anesthesia. But they do appreciate however, a low percentage of general complications encountered in the group operated without general anesthesia, which thus permits an enlarged spectrum of indications for patients at risk. Previous operations by low midline incisions (prostatectomy, etc...) do not constitute a contra-indication.

Adult↗