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Biomedical subjects

R Mercier

Publications and source records attributed to R Mercier.

At least 19 recordsLinked to original sources
PubMed1989

[Retroperitoneal perforation of duodenal ulcer responsible for abscess].

The authors report a case of retroperitoneal perforation of a duodenal ulcer. This is a rare condition which is exceptionally responsible for abscess formation. If often has a poor prognosis. In the present case, the abscess was infrahepatic. The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture. Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity. The ulcer was cured by medical treatment. This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity.

Abscess↗
PubMed1986

[Injuries of the thoracic duct during neck surgery].

Although rarely published, operative injuries to thoracic duct in neck are by no means exceptional, and can occur during all types of surgery to lower cervical and supraclavicular regions. A case is reported and used as a basis for an analysis of diagnostic means and therapeutic possibilities of injuries detected during operation or those developing manifestations at a later stage. In the case reported, long-term medical treatment resulted in arrest of lymphorrhea within 37 days.

Adult↗
PubMed1985

[Mediastinoscopy in the evaluation of the operability of bronchial cancer].

Mediastinoscopy is an invasive technique used to explore the anterior and upper mediastinum. The axial mediastinum and its lymph nodes are explored through the cervical approach, and the pulmonary vessels and anterior mediastinal lymph nodes through the parasternal approach. Bronchial carcinomas which extend to the mediastinum, either via the lymphatic system or by contiguity, are of extremely severe prognosis. The advent of mediastinoscopy has considerably reduced the number of exploratory thoracotomies and therefore the operative mortality rate, while increasing the resectability rate to 95%. It has also narrowed the indications for surgery without decreasing the number of curative resections. In the hands of experienced operators, the technique has a low morbidity rate. CT examination is not as accurate as mediastinoscopy to evaluate the mediastinal extension of bronchial carcinomas, but it can help to lay down the indications for the invasive technique, thereby limiting its use to selected cases.

Aged↗
PubMed1984

Prophylactic use of cefotaxime in colonic and rectal surgery.

Two hundred and seventeen patients, undergoing abdominal colonic and rectal surgery, received after randomization, the following regimen: group A (74 patients): cefotaxime 1 g intravenous at the induction of anaesthesia, the beginning of the resection, 4 and 8 h later; group B (72 patients): cefotaxime in the same regimen associated with ornidazole or metronidazole 0.5 g intravenous at the induction of anaesthesia and 0.5 g intravenous with the last injection of cefotaxime; group C (71 patients):cefotaxime following the same regimen as groups A and B and metronidazole orally 0.5 tds 3 days before surgery. All wounds were assessed daily, until discharge from hospital. Severe sepsis included: septicaemia, peritonitis, intra-abdominal abscess and extra-abdominal infections with death. Non-severe sepsis included all others. All the patients having a history of allergy to beta-lactam antibiotics and those with pre-operative infection were excluded. Mean age of the population was: 64.5 years. Seventy-seven patients had rectal cancer and 82 patients cancer of the colon; Twenty-five patients had inflammatory bowel disease, and in 33 others disease such as polyposis was present. Risk factors of post-operative infection were present in 115 cases (A, 36 patients; B, 37 patients; C, 42 patients). All three groups were very well matched for age, sex, type of intervention and diagnosis. Non-infectious complications appeared in 56 patients. Sepsis developed in 76 patients (A, 27 patients; B, 27 patients; C, 22 patients, no significant difference). Severe sepsis occurred in 14 patients (A, 6 patients; B, 4 patients; C, 4 patients, no significant difference) and in 62 patients non severe sepsis (A, 21 patients; B, 23 patients; C, 18 patients, no significant difference). Post-operative peritonitis was not seen. This study suggests that cefotaxime alone 4 g peri-operatively is useful in prophylaxis during rectal and colonic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Cystic abdomino-mediastinal lymphangioma. Apropos of a case. Review of the literature].

A further case of cystic lymphangioma is reported, characteristic features being the multiple abdominal and thoracic localizations of the lesions. Apart form splenic sites, it is rare to detect lesions in the mesogastric and mediastinal regions, particularly as propagation of abdominal lymphangioma towards the mediastinum is an exceptional occurrence. A literature review provides data on the various regions in which cysts have been reported in the body, and the diagnostic problems they raise.

Abdominal Neoplasms↗
PubMed1983

[Explosion of intestinal gas during surgery].

Two cases of colonic gas explosion during surgery are reported. The treatment of the lesions required a partial colectomy in one case and a total colectomy in the other case. The different factors involved in such accidents are discussed. Three factors are necessary to trigger off an explosion of intestinal gases: the presence of combustible gases (hydrogen, methane), the presence of combustive gases (oxygen, nitrous oxide) and an initiating heat source (endoscopic or surgical electrocautery). The mannitol used for bowel cleansing undergoes partial colonic bacterial fermentation increasing the intraluminal concentration of hydrogen. During anaesthesia the oxygen-nitrous oxide mixture increases the intestinal concentration of these two major combustive gases. Electrocautery provides the spark triggering the explosion. The use of mannitol for colonic preparation should be questioned; the use of electrocautery to open the colon is advised against.

Aged↗
PubMed1981

Codon catalog usage is a genome strategy modulated for gene expressivity.

The nucleic acid sequence bank now contains 161 mRNAs, 43 new genes are added. One sequence, that of B. mori fibroin, is dropped due to uncertainty on the starting point for translation. Frequencies of all codons are given for each gene added and for each genome type in the total bank. A new series of correspondence analyses on codon use is presented, substantiating the genome hypothesis. Internal regulation of mRNA expression by different third base choices between quartet and duet codons is proposed for bacterial genes.

Amino Acid Sequence↗
PubMed1980

Codon catalog usage and the genome hypothesis.

Frequencies for each of the 61 amino acid codons have been determined in every published mRNA sequence of 50 or more codons. The frequencies are shown for each kind of genome and for each individual gene. A surprising consistency of choices exists among genes of the same or similar genomes. Thus each genome, or kind of genome, appears to possess a "system" for choosing between codons. Frameshift genes, however, have widely different choice strategies from normal genes. Our work indicates that the main factors distinguishing between mRNA sequences relate to choices among degenerate bases. These systematic third base choices can therefore be used to establish a new kind of genetic distance, which reflects differences in coding strategy. The choice patterns we find seem compatible with the idea that the genome and not the individual gene is the unit of selection. Each gene in a genome tends to conform to its species' usage of the codon catalog; this is our genome hypothesis.

Animals↗
PubMed1978

[Instrumental technics of exploration of the mediastinum].

Several techniques can be used for the diagnosing of diseases pertaining to the mediastinum. The diagnosis can be made in 78% of cases by mediastinoscopy. When the lesion is situated beyond the reach of mediastinoscopy, needle biopsy and pleuroscopy can be used either alone or associated to mediastinoscopy. The histological diagnosis can be made in almost all cases. But a few precautions are necessary because this technique carries a certain risk for vessels. Therefore preoperative angiography of the superior vena cava or arteriography of the branches of the aortic arch should be performed to help for the diagnosis and ensure its safety.

Biopsy, Needle↗
PubMed1978

[Role of surgery in the treatment of deep venous thrombosis of the lower limbs and prevention of pulmonary embolism].

Besides anticoagulants and thrombolytic drugs, surgery should be included among the therapeutical means to prevent deep phlebitis of the lower limbs. Early phlebography, thoroughly innocuous, is necessary to any coherent therapy. The prevention of pulmonary embolism which can be done by a ligature of the inferior vena cava or by the fitting of an umbrella-shaped filtre, is performed most of the time with a clamp of Adams and de Weese. Its reliability is satisfactory as the percentage of embolic recurrences does not exceed 5%. Early venous thrombectomy prevents in 60 to 80% of cases the post-phlebitic incidents; but its indication must be reserved to young patients.

Humans↗