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Biomedical subjects

A Leguerrier

Publications and source records attributed to A Leguerrier.

105 records · Page 6Linked to original sources
PubMed1977

[Study of anastomoses between the left renal vein and the internal vertebral plexus].

Anastomosis between the left renal vein and the rachidian plexus exists in about 80% of the cases (16 cases out of 20); they are important in 25% of the cases (5 cases) ; their origin is constant ; their ending has a high frequency for the rachidian plexus of the intervertebral foramen L1-L2. These anastomoses are of great importance : as they are the only renal circulation's safety device in seven of our cases : their hypertrophy in some pathological cases can explain some neurological clinical pictures of compression, reversible after the ligature of the hypertrophic anastomotic veins.

Collateral Circulation↗
PubMed1977

[Vascularization of the transverse colon].

Results of 21 injections of the transverse colon with coloured latex. The superior and inferior mesenteric arteries are separately injected. Dissections allowed the study of the topography and width of the colic transverse vessels. Collateral circulation is also described. A middle colic artery is present in 85% of the cases. The length of transverse colon vascularized by each arterial system is related with accuracy to the number of arcades issued from each system. The superior mesenteric artery prevails in the blood supply of the transverse colon (70% of its length).

Colon↗
PubMed1977

[Leiomyomas of the esophagus. Report of 20 cases (author's transl)].

The authors report 20 cases of leiomyoma of the esophagus operated on between 1964 and 1976. The diagnosis depended on the existence of dysphagia without loss of weight, the integrity of the mucosa on endoscopy and the findings of the esophagogram, suggested the true origin of the mediastinal image. Surgical operation usually permits simple enucleation of the leiomyoma. Postoperative mortality was nil. The late postoperative period was uneventful. There was no relapse of the histologically benign leiomyoma.

Adult↗
PubMed1977

[Surgery of 19 bilateral simultaneous pulmonary metastases].

19 patients with bilateral simultaneous pulmonary metastases were operated on between 1954 and april 1976 at the Marie-Lannelongue surgical centre. Sarcomas were twice as common as carcinomas. In 10 cases the thoracotomy was only unilateral, either because thoracotomy was not attempted on the other side owing to the diffuse nature of the lesions (8 cases) or because prior chemotherapy had permitted complete reduction of the metastases on the opposite side (2 cases). This thoracotomy remained exploratory in 47 p. cent of cases, radical removal of all the tumour nodules was possible in 53 p. cent of cases (10 patients). Peripheral resections of the lesions were the rule. But in 4 cases, lobectomy was carried out on one side. 7 of the 9 bilateral operations were performed during the same stage. There were no operative deaths. The late results are encouraging considering the number of sarcomas in which the prognosis is usually poor. Bilateral lesions are thus not an absolute contra-indication, provided one remains within reasonable anatomical and functional limits, in the fields of well-conducted anti-cancer strategy.

Adolescent↗
PubMed1976

[Does the phrenico-gastric ligament exist?].

On thirty cadaveric dissections, we studied the so-called "phreno-gastric" ligament. In fact, it appears that there is an adhesion between the fundus and the posterior wall in only 60 % of the cases. This adhesion is always very loose, easily cleaved and in no case is there a real fibrous suspensory ligament. Moreover, in 40 % of the cases, the posterior surface of the fundus is entirely covered by peritoneum and is free in the bursa omentalis. In that case, the posterior surface of the stomach is connected with the diaphragm by a very short meso extending on the right to the meso esophagus and on the left to the gastrosplenic ligament.

Humans↗
PubMed1976

[Anatomic variation of the aortic coronary openings (apropos of 80 dissections)].

A series of 80 heart dissections, compared with a survey of the literature shows that:--both coronary ostia are usually in the right anterior and in the left posterior position, in the commissural plane, at the level of the corresponding sinus of Valsalva (the left one being often superior in size to the right one).--anatomic variations of the coronary ostia (especially variations of the left coronary ostium) may be summed up into 3 patterns: Variations in number : sometimes, there is only one aortic coronary ostium, usually owing to a left coronary artery originating from the pulmonary artery; a common aortic ostium for a single coronary artery is not frequent. Multiple ostia are the most common variations : an accessory artery may arise from a separate ostium (often the "third coronary artery" from the right aortic sinus; sometimes the anterior descending and the circumflex arteries may originate from separated orifices). Variations in origin remain few, affecting most often the left ostium. Variations in size reflect the corresponding coronary plexus preponderance.

Coronary Vessel Anomalies↗
PubMed1976

[Anatomic variations of the common trunk of the left coronary artery (apropos of 80 dissections)].

An anatomic study of the main left coronary artery is reported : important anatomic variations may occur:--sometimes, the main left coronary artery is missing (1 % of the cases),--its origin may be unusual (from the pulmonary artery),--its average length is 11 mm; but, it may be longer (35 mm) and sometimes very short (less than 8 mm in 15 per cent of the cases) : this last aspect has to be taken in account by the surgeon during aortic valve surgery if a coronary perfusion has been decided.--At last, its division into two branches (anterior descending and left circumflex) is the most usual (65 or 70 per cent of the cases). A third branch of division may exist (diagonal or lateral branch) in about 20 to 30 per cent of the cases. The left coronary artery may also divide into four (or even five) branches in 5 to 10 per cent of the cases.

Coronary Vessel Anomalies↗
PubMedDate not supplied

Transfusion therapy and HLA antibody response in patients undergoing open heart surgery.

HLA antibody formation was studied in 212 patients undergoing open-heart surgery on cardiopulmonary bypass in relation to the following variables: sex, obstetric history, transfusion history, quantity and nature of blood products transfused, type of oxygenator used, duration of bypass, and time of assay. Postoperative alloimmunization was seen in 33.6 percent of males and 64.3 percent of females. Previous pregnancy seemed to favor the development of antibody. No statistically significant correlation was noted between alloimmunization and the amount of blood products transfused. The best time for assay was day eight following surgery.

Adult↗
PubMedDate not supplied

[Bronchial tumor and paraneoplastic syndrome of antiduresis: a new case of Schwartz-Bartter's syndrome (author's transl)].

The autors reports about a new case of Schwartz-Bartter's syndrome. Its first clinical manifestations are primarily the neuro-psychiatric disorder and the arterial hypertension. These manifestations were attributed to an inappropriate secretion of antidiuretic hormon, in relation with a bronchial neoplasm (oat-cell carcinoma). The tumor was removed surgically; shortly after the operation the biological disorders disappeared completely. But they reappeared 5 months later, indicating recurrence (local and metastatic). This recurrence started to present clinical manifestation, 2 months later. After a brief historical approach, the authors suggested the aetiology, the diagnosis circumstances and the biological criteria of Schwartz-Bartter's syndrome. Then later, the precised the main principles of its management.

Bronchial Neoplasms↗
PubMedDate not supplied

[Surgery for bronchogenic carcinoma in patients over seventy years old (author's transl)].

125 patients aged over 70 years underwent operation for bronchogenic carcinoma at the Centre Chirurgical Marie Lannelongue for a period extending from 1963 to 1976. There were 123 male and 2 female patients. 112 had a squamous cell carcinoma. A total of 32 patients had a pneumonectomy performed, 86 a partial resection (lobectomy or bilobectomy) and 7 an exploratory thoracotomy. Post operative death was definitely higher (15,6%) in the pneumonectomy group than in the lobectomy one (2,6%). The main cause of post-operative death (62%) was pulmonary embolism. Post-operative complications were mainly related to cardiac arrhythmias. Overall survival rate after 5 years was 25,2%, slightly higher in the lobectomy group (25,9%) than in the pneumonectomy group (22,2%), higher in the differentiated squamous cell carcinoma group (31,1%) than in the undifferentiated (6,3%). The quality of life was reasonably satisfactory in most of the patients considering their age. Surgery for bronchogenic carcinoma in patients over 70 years old is recommended specially with limited resection is possible.

Aged↗
PubMedDate not supplied

[Surgical treatment of constrictive pericarditis and life-threatening pericardic effusions (author's transl)].

Total excision of both pericardic sac and epicardium is the basic surgical procedure for chronic constrictive pericarditis. Approach being through a vertical sternotomy. In case of either cardiac injury or poor haemodynamic of either cardiac injury or poor haemodynamic conditions, it is sometimes indicated to get help from an extracorporal circulation with femoro-femoral shunt. Surgery for acute pericarditis may vary according to local and general conditions. As soon as a pericardic effusion, whether or not infected, has occurred, drainage by means of an infraxiphoid incision seems to be a safe method. Where pericardic effusions relapse or densify to a constrictive pericarditis, pericardectomy is to be considered. Total pericardectomy is therefore regarded as the best procedure to prevent further disease.

Cardiac Tamponade↗
PubMedDate not supplied

[Heart transplantation. Clinical study and results apropos of a consecutive series of 100 first grafts].

OBJECTIVES: Global results of entire series of heart transplantations are essential to better evaluate survival rates. We therefore report the results of our first 100 transplantations. METHODS: Orthotopic heart transplantation was performed in 82 men and 18 women (age 50.5 +/- 11.4; range 9-65). Sixteen were over 60. Primitive cardiomyopathies (n = 51) and coronary artery disease (n = 44) were the most frequent underlying diseases. Secondary morbidity was evaluated according to the international classification on the basis of pathological examination of endomyocardial biopsies. RESULTS: Immediate post-operative survival rate was 89 percent: there was 1 peroperative death, 7 deaths due to persistent pulmonary hypertension and 4 due to irreversible left ventricular failure. Eight deaths occurred during the 2nd and 3rd postoperative months for an overall early survival rate of 81 percent. After a mean follow-up of 2.4 years (maximum 6.16 yr), the actuarial survival rate at 5 years was 58 percent. Among the 470 biopsies performed, rejection was classified weak or null in 326, moderate in 125 and severe in 19. Pulmonary artery resistance, immunosuppression and, later, the risk of coronary artery disease and intrinsic graft changes were the three major problems encountered in this series. CONCLUSIONS: Despite its limits, heart transplantation remains an effective therapeutic option, particularly for young patients in good general health.

Adolescent↗
PubMedDate not supplied

[Mediastinitis after cardiac surgery. A 10-year evaluation (1985-1995)].

UNLABELLED: From June 1985 to May 1995, 9,814 patients were operated for a cardiac procedure with cardiopulmonary by-pass. Mean age was 61,3 years. The most frequent procedure was coronary surgery (45%), followed by valvular surgery (34%) then combined surgery (11%) and other surgery (4%). 66 cases of mediastinitis were observed: 38 from June 1985 to May 1990 (first group), 28 from June 1990 to May 1995 (second group). The changes between the two groups was antibiotic prophylaxis using Cefuroxime in the first group and Cefamandole in the second and also an impairment of general status of the patients in the second group. Staphylococcus remains the most frequent organism in both groups and for Gram negative bacteria was less frequent in the second group. Several risks factors mediastinitis were identified (males, emergency, diabetes mellitus, obesity, redo, patient of first group, duration of Cardiopulmonary by pass for 100 minutes, mechanical ventilation greater than 48 hours) and the most important factor was the need for mechanical ventilation for more than 48 hours. The mortality rate was 39.4% (26 patients). Identified risk factors of mortality were age over 65 years, females, poor constitution, and cardio/thoracic ratio > 0.55. CONCLUSION: Mediastinitis after cardiac surgery remains a serious complication. In this series we observed a decrease of mediastinitis rates, especially in the second group (p < 0.001). In high risk patients, specific preoperative methods of patient care may be able to prevent such complications. When mediastinitis appears, and when debridement is necessary, a cover procedure seems necessary in elderly or poor constitution patients.

Adolescent↗