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Biomedical subjects

R Richer

Publications and source records attributed to R Richer.

14 recordsLinked to original sources

[Ocular burns caused by latex from manchineel trees].

OBJECTIVE OF THE STUDY: The objective of this study is to enter on an inventory and to appreciate the severity of the ocular burn caused by the latex of manchineel tree and to propose a therapeutic attitude. MATERIAL AND METHOD: We report on the results of a prospective study included 11 patients examined in the Department of Ophthalmology (Centre Hospitalier Universitaire de Fort-de-France) between November 1992 and November 1993. All of them presented with ocular burn due to a contact with the latex of the manchineel tree. RESULTS: The study included 11 patients, 8 adults and 3 children, the mean age was 22.9 years (range 4-40). All of them had hyperhemia and conjunctival erosions of various intensity. Ten patients had corneal lesions: superficial punctate keratitis in 5 cases and corneal ulcers in 5 cases. Three cases of corneal ulcerations were associated with an inflammatory reaction of the anterior segment. Both eyes were affected in 4 cases (37%), and only the right one in the other cases (63%). Seven patients had cutaneous lesions (63%), of whom 4 periocular burns of superficial second degree. Full recovery was obtained within 15 days for all the patients. CONCLUSION: Ocular lavage is the first treatment, as for all chemical burns. Local antibiotherapy is used systematically to prevent superinfection. With a proper treatment, a complete recovery with no sequelae is obtained.

Adolescent

[Interstitial keratitis and Cogan syndrome].

Cogan's syndrome consists of non syphilitic interstitial keratitis associated with vestibuloauditory dysfunction. This syndrome is rare and very few cases have been reported since Cogan's first characterization in 1945. We present the case of a 24-year-oldman with a history of recurrent access of arthralgia and glomerulonephritis. Bilateral corneal disease consists of peripheral whitish patchy opacities in deep stroma. The patient also shows bilateral severe deafness, fever, meningeal and tetrapyramidal syndrome. Ocular involvement responds well to corticosteroids therapy but hearing loss is severe and often irreversible.

Adult

Pharmacokinetics and clinical study of cefotetan in bile: prophylactic use in biliary tract surgery.

The excretion of cefotetan, a 7 alpha-methoxy-cephalosporin, was studied in 27 patients undergoing biliary surgery. Pharmacokinetic parameters were determined after a single intravenous bolus dose of 1 g (10 patients) or 2 g (17 patients). Rapidly excreted in bile, cefotetan concentrations were considerably higher in bile [range: 92-2,594 mg.l-1 (1 g); 35-4,610 mg.l-1 (2 g)] than in plasma despite the presence of gall stones. Bile bactericidal activities against Staphylococcus aureus (MIC 8 mg.l-1) and Bacteroides fragilis (MIC 2 mg.l-1) correlated well with gall bladder cefotetan levels [r = 0.888 (1 g); r = 0.971 (2 g)]. No cefotetan was detected in the bile of 3 patients with nonfunctioning gall bladders. One other patient with very low activity and these three aside, the inhibitory quotients (cefotetan concentration/MIC) were > 4 for both doses against both bacteria.

Adult

Adjuvant post-operative radiotherapy in rectal cancer: results from the ANZ Bowel Cancer Trial (Protocol 8202).

In July 1982 the Gastrointestinal Section of The Clinical Oncological Society of Australia began a multicentre randomized trial to assess the value of post-operative pelvic radiotherapy in the local control of stage B and C carcinoma of the rectum. Patients who had undergone a potentially curative resection were randomized either to no further treatment (NO RT) or to pelvic radiotherapy (RT), 45 Gy in 25 fractions (plus a perineal boost of 5 Gy in 2 fractions after abdomino-perineal resection). The trial was prematurely terminated in December 1985 owing to slow accrual after 70 patients had been randomized: 36 patients to RT and 34 patients to NO RT. Two patients in each group were found to be ineligible after randomization and, for a variety of reasons, thirteen patients who were randomized to RT did not receive that treatment. The incidence of post-operative complications were comparable in both groups, indicating that radiotherapy produced no additional problems. Radiotherapy-related morbidity comprised mainly diarrhoea (grade 1 = 2/21; grade 2 = 5/21; grade 3 = 0/21; grade 4 = 1/21). There were no deaths due to radiotherapy and only one patient, with grade 4 diarrhoea, failed to complete the prescribed course of radiotherapy. After an average follow-up period of 52 months there were 15 local recurrences, 8 in the RT group and 7 in the NO RT group, giving an actuarial 2 year local recurrence rate of 16%. There was no difference in the time to local recurrence, either by randomization group (p = 0.50) or by actual treatment received (p = 0.91).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma

Morphologic heterogeneity of cell populations isolated by density gradient centrifugation from serous fluids of ovarian tumors.

The cells of tumor fluid from patients with malignant and benign serous ovarian neoplasms were fractionated using Ficoll-Uropoline density gradient centrifugation. Density distribution and morphologic characteristics of cell fractions were analyzed. It was found that serous ovarian adenocarcinomas contained three to four types of morphologically malignant cells focused in low density layers. Borderline ovarian neoplasms showed the presence of one subpopulation of cells with some features of malignancy and cells with some atypical but non-malignant features. The fluids of serous cysts contained mainly normal epithelial cells representing different stages of morphological maturity and were focused in denser layers. The results allowed us to catalogue ovarian tumor cell subpopulations present in each density fraction of individual patients and confirmed that ovarian tumors could be diagnosed by morphologic identification of cells from tumor fluids.

Adult

[Phenoperidine and operative common bile duct pressure (author's transl)].

The pressure variations registered in the common bile duct, after injection of phenoperidine (0,033 mg/kg) during sixteen anaesthesias performed for cholecystectomy, showed no significant modifications. In one case a spasm of the common bile duct was observed before analgesic administration which induced no change in the biliary pressure, an inhalation of amyl nitrite made it possible to affirm the functional character of the anomaly. The analgesic anaesthesia using phenoperidine, method chosen for high-risk patients, is compatible with bile duct surgery without risk of bringing about unnecessary surgical procedures.

Adult

[Enteral feeding with reinjection in the terminal gut (author's transl)].

About one case, we describe our technology. The main avantage of the method is to reduce strongly septic complications resulting from intravenous feeding. It can be used as soon as the gastrointestinal tract is functional without any risk and it is the most effective means of providing nutrition for an extended period.

Aged

[Therapy of chronic autonomous pancreatitis. Results in 147 cases (author's transl)].

The authors summarize their own personal experience acquired in the Department of Pr. Mercadier, concerning chronic pancreatitis. They attempt to define the factors influencing the choice of surgical technic, whilst emphasizing the grave nature of this condition, the long term prognosis of which remains severe in 50 per cent of cases.

Chronic Disease