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B Dupas

Publications and source records attributed to B Dupas.

81 records · Page 5Linked to original sources
PubMed1980

[Sterno-costo-clavicular hyperostosis (author's transl)].

The authors report two cases of sterno costo clavicular hyperostosis. Six cases have been described in previous reports by Köhler (five cases) and CAMUS (one case). This disease begins with sterno costo clavicular pain that develops with exacerbations over several years. Biologically, there is a no specific inflammatory syndrome. Radiologically, clavicles sternum and first ribs are enlarged and increased in density. There is also an ossification of the sterno clavicular and sterno costal junctions. Phlebography sometimes show subclavian veins occlusion. Histological finding is hyperostosis without osteoclast inclusions. The main differential diagnosis is the Paget's disease.

Adult↗
PubMedDate not supplied

Delineation of liver necrosis using double contrast-enhanced MRI.

The purpose of this study was to demonstrate the potential usefulness of the combination of gadolinium and dysprosium to enhance the different between normal and necrotic liver tissue. Small regions of acute necrosis were induced by injecting 200-300 microliters of 95% alcohol into the liver of 26 rats. MRI was performed 24 hours after necrosis induction, before and immediately after injection of one or both contrast agents. Using a mixed T1/T2-weighted sequence, the signal intensity of (SI) of the normal liver was reduced by 70%, whereas the necrotic regions had more than a 50% increase in SI after double contrast. The region that was enhanced corresponded largely with the region of necrosis as observed postmortem. The lesion size, when identified, was largely underestimated using either of the agents along, albeit using the common pulse sequences. The double contrast effect of simultaneous administration of gadolinium and dysprosium allows accurate delineation of liver necrosis.

Animals↗
PubMedDate not supplied

Pancreaticoduodenectomy for metastatic ampullary and pancreatic tumors.

BACKGROUND/AIMS: To report the clinical presentation, diagnosis and results of aggressive surgical management in patients with metastatic ampullary and pancreatic tumors. METHODOLOGY: Twelve patients underwent pancreaticoduodenectomy for ampullary or pancreatic metastases from January 1, 1987, to June 30, 1998, in 2 institutions. The primary cancer was renal cell carcinoma (n = 5), melanoma (n = 2), venous leiomyosarcoma (n = 1), carcinoid tumor (n = 1), colon carcinoma (n = 1), breast carcinoma (n = 1) and small-cell lung carcinoma (n = 1). The mean interval between primary treatment and metachronous pancreatic metastasis was 88 months. In 3 cases, pancreatic metastases were synchronous with the primary tumor. The main symptoms were jaundice (n = 8) and upper gastrointestinal tract bleeding (n = 2). The principal investigations were computed tomography scan (n = 9), arteriography (n = 7), duodenoscopy (n = 6) and fine-needle aspiration (n = 4). A correct preoperative diagnosis was made for 8 patients. RESULTS: In all cases, the pancreatic tumor was resected with intention to cure or provide useful palliation, using pancreaticoduodenectomy for isolated tumors (n = 11) or total pancreatectomy for multiple lesions (n = 1). Three out of 12 patents had positive lymph nodes, and the resection margin was free of disease in all cases. There was no postoperative mortality. Survival after pancreaticoduodenectomy averaged 26 months. Overall survival of patients undergoing pancreaticoduodenectomy was 35% at 2 years and 17% at 5 years. One patient is still alive more than 10 years after pancreaticoduodenectomy. CONCLUSIONS: Pancreaticoduodenectomy can be performed safely, representing a suitable option for resection in patients with symptomatic or late isolated pancreatic metastases in the absence of widely metastatic disease. The best indications are solitary metastases from renal cell carcinoma, sarcoma and neuroendocrine tumors. However, there is no evidence of survival benefit after pancreaticoduodenectomy for synchronous tumors or metachronous tumors from melanoma or colon carcinoma.

Adult↗
PubMedDate not supplied

Experimental venous thrombosis: what animal model?

A new experimental venous thrombosis model is described and its role relative to other models is defined. Previous models are not satisfactory for all types of investigation. Opposite, present model based on the three classic thrombogenic factors is suitable for venous scintigraphy and evaluation of different forms of therapy for venous thrombosis of the limbs. So this model permits research on diagnosis and therapy of thromboembolic disease.

Animals↗
PubMedDate not supplied

[Problems posed by secondary peritoneal carcinosis of digestive origin].

Secondary peritoneal carcinoma occurs in cases of malignant bowel disease after the initial curative operation or rarely after palliative surgery. The main problems are frequent overshoot in the diagnosis and correct management. Based on our experience with 101 patients with secondary peritoneal carcinoma treated over the last 10 years, we determined the therapeutic possibilities. In 23% of the cases no surgery was possible and in only 4% underwent a second palliative operation. Survival was basically dependent on the initial malignant disease. More aggressive therapeutic methods are currently under study.

Adult↗
PubMedDate not supplied

[Textiloma. Apropos of 25 cases and review of the literature].

It is exceptional to "forget" a compress in a operative wound, but the consequence are important. We report 25 cases of textilomes operated over a period of 18 years. There were 18 cases involving visceral surgery and 7 involving bone surgery. Sixty percent of the patients were women and 82% were adults. Emergency surgery was required in 70% of the bone operations and in only 33% of the visceral indications. Twelve percent of the cases were discovered fortuitously and 40% led to pain or occlusion, 24% leading to a digestive tract fistula and 24% to an inflammatory tumour formation. Standard X-rays and echography were sufficient for diagnosis in the abdominal cases. CT scan or MRI may be useful. Ablation of the abdominal foreign body was the followed by complications in two-thirds of the cases with a mortality of 25%. No deaths were observed in the other localizations but the functional result was impaired. We reviewed the literature reporting 117 such cases.

Adult↗
PubMedDate not supplied

[Ruptured hepatocarcinoma. Report of 20 cases and review of the literature].

Hepatocellular carcinomas may rupture in rare cases (5 to 15%) creating a serious short-term and mid-term situation. Over a period of 10 years, 20 patients (19 males, 1 female, mean age 68 years, range 38-82) were treated for ruptured hepatocellular carcinoma involving a cirrhotic (ethylic) liver in 12 cases, haemochromatosis in 2 and a normal liver in 6. Twelve patients underwent emergency surgery for acute haemoperitonium operation was delayed until after exploratory investigations (CT scan and arteriography +/- embolization) for pain in the right hypochondria associated with partitioned effusion and anaemia. The diagnosis of cancer had been known in 5 patients and rupture was the first manifestation in 15 others. Emergency procedures, 7 excisions, 3 sutures, were performed but 2 patients died during vascular clamping. Four deaths occurred within 8 days due to liver failure. There were no postoperative deaths after programmed procedures, 6 excisions, 1 ligature. One patient underwent embolization peroperatively and died 6 days later due to digestive haemorrhage and liver failure. Lesions were localized in the left liver (9), right liver (6) and in both with multiple nodules (5). Among the 13 survivors, 7 died within a delay of 2 to 30 months, 1 due to recurrent rupture (5%). Six patients are still living with a follow-up of 3 to 36 months (including 2 hepatocellular carcinomas on a healthy liver and 1 with haemochromatosis). A review of the literature confirms the severity of such events whatever the initial management. Acute rupture of hepatocellular carcinoma usually requires emergency procedures with a high risk of mortality (50%). Fissuration authorizes explorations and possibly peroperative embolization with better immediate results.

Adult↗