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Biomedical subjects

C Meyer

Publications and source records attributed to C Meyer.

At least 631 records · Page 35Linked to original sources
PubMedDate not supplied

[The remaining indications for open surgery in common bile duct lithiasis].

Once with the continuous development of mini-invasive procedures, the open surgery indications in the treatment of CBD stones are decreasing. Between January 1986 and December 1987, 514 patients with average age 60 years old (18-94) were treated for suspected or confirmed CBDS. Three distinctive periods were studied function of how the conventional surgery were either exclusive (group I), either together with the beginning era of laparoscopy (group II), or together with institutionalised laparoscopy (group III). Group I had 110 cases, group II--207 cases and group III--197 cases. The conventional surgery were 100% performed in group I, 26% (52 cases) performed in group II, 14% (28 cases) performed in group III. If the laparotomy was the only therapeutical option in patients with CBDS from group I, the therapeutical procedures become more various after 1990. It was done endoscopic sphincterotomy in 59% (124 cases) in group II and in 64% (126 cases) in group III. The laparoscopic extraction of CBDS was 12% (cases) in group II and 19% (37 cases) in group III. The overall mortality in conventional surgery was 1.5% with 1.8% in group I and 0% in group II and III. The complications rate was 13% with 8% in group II and 21% in group III. The postoperative hospitalisation time average was 16 days for laparotomy of the 3 groups. The conventional surgery is main indicated when laparoscopic surgery for CBDS extractions or endoscopic sphincterotomy is contraindicated or failed; also it is useful in some complicated forms of CBDS.

Adolescent↗
PubMedDate not supplied

Class II restorations with a polyacid-modified composite resin in primary molars placed in a dental practice: results of a two-year clinical evaluation.

This study evaluated the two-year success rate of a hybrid composite material (TPH-Spectrum; Dentsply DeTrey, Konstanz, Germany) and a polyacid-modified composite resin (Compoglass, Vivadent, Schaan, Liechtenstein) in Class II restorations placed in primary molars in a dental practice. In each of 52 children, at least two primary molars were restored. Ninety-six primary molars were filled with TPH-Spectrum using the total-etching technique, and 94 with Compoglass without acid etching prior to application of the bonding adhesive. At baseline, one and two years, the restorations were assessed according to the Ryge criteria. Forty-seven children with a total of 132 fillings (68 TPH-Spectrum, 64 Compoglass) were evaluated after two years. The cumulative success rate after 24 months amounted to 89.2% for the Compoglass and 89.7% for the TPH-Spectrum restorations. No significant differences were observed between the two materials with respect to color matching, cavosurface discoloration, anatomic form, margin integrity and caries assessment. This investigation suggests that for a period of two years, the hybrid composite TPH-Spectrum and the polyacid-modified composite resin Compoglass, are suitable materials for restoration of primary molars.

Acid Etching, Dental↗
PubMedDate not supplied

Morbidity of laparoscopic fundoplication for gastroesophageal reflux: a retrospective study about 1470 patients.

BACKGROUND/AIMS: The aim of this retrospective study was to report and quantify the immediate and 3-year complications after laparoscopic anti-reflux surgery in order to understand the mechanism. METHODOLOGY: From 1992 to 1996, 1470 laparoscopic fundoplications were performed for symptomatic gastroesophageal reflux disease. Preoperative checkup included upper gastrointestinal tract endoscopy in 1437 patients (97.7%), esophageal manometry in 934 patients (63.5%), and 24-hour pHmetry in 799 patients (54.3%). Three procedures were performed: Nissen (n = 655), Nissen-Rossetti (n = 423), and Toupet (n = 392). The results were estimated at 1 and 3 months; thereafter they were evaluated at 3 years. Patients unable to return to the hospital center were contacted by telephone. RESULTS: Mean length of hospital stay was 4.6 days (range: 2-48 days). The preoperative complication rate was 2.1% (n = 31). The postoperative morbidity and mortality rates were 2.9% (43 patients) and 0.07% (1 patient), respectively. Conversion rate to laparotomy was 6.5% (96 patients). At 3 months, 87 patients (5.9%) had invalid dysphagia but there was no difference between the 3 procedures. Twelve patients have been reoperated (0.8%). At 3 years, 78 patients (5.6%) presented a clinical recurrence. The rate of dysphagia was 0.35%, and 38 patients were reoperated. CONCLUSIONS: Laparoscopic fundoplication is safe and effective with a low morbidity and mortality rate if junior surgeons commenced this procedure under the direct supervision of an experienced surgeon. Despite the advantage of this technique, we believe that indications for surgical management remain unchanged in the laparoscopic era.

Adolescent↗
PubMedDate not supplied

[The surgical therapy of liver trauma].

The different therapeutic patterns of liver trauma are presented; they should be chosen on the basis of both clinical assessment, particularly looking for hemodynamic impairment and associated bowel lesions, and CT scan data. Surgical abstention should be considered for a great number of blunt liver trauma; open or severe blunt trauma should be preferably treated by elective hemostasis and biliostasis, with only rare use of hepatic resection "à la demande", on partially sectioned or devitalized tissues. Cavo-suprahepatic wounds remain the most important technical problem and continue to worse the prognosis in liver trauma.

Embolization, Therapeutic↗
PubMedDate not supplied

Antitumor activity of 5'-deoxy-5-fluorouridine in human digestive organ cancer xenografts and pyrimidine nucleoside phosphorylase activity in normal and neoplastic tissues from human digestive organs.

5'-Deoxy-5-fluorouridine (5'-DFUR) is believed to be metabolized to 5-fluorouracil (5-FU) by pyrimidine nucleoside phosphorylase (PyNPase). PyNPase activity is reported to be higher in neoplastic tissues than in normal tissues, and this has been proposed as an explanation for the selective cytotoxicity of 5'-DFUR against tumors. In the present study, PyNPase activity was measured in 95 neoplastic and normal specimens from human digestive organ tissues. In specimens from the esophagus, stomach, intestine and pancreas, PyNPase activity was higher in neoplastic tissues than in normal tissues. However, PyNPase activity in non-malignant liver tissues, especially cirrhotic liver tissues, was much higher than in the normal tissues of the other digestive organs. PyNPase activity in non-malignant liver tissues was a high as in primary liver tumors, and PyNPase activity in metastatic liver tumors was lower than in primary tumors and non-malignant cirrhotic tissues. The in vivo antitumor activities of oral 5'-DFUR and intravenous 5-FU were also assessed in 6 human digestive organ cancer xenograft lines transplanted subcutaneously in nude mice, and the relationship between the in vivo antitumor effects of 5'-DFUR and PyNPase activity in the tumors was assessed. However, there was no statistically significant correlation between them. Although the in vivo antitumor effect of intravenous 5-FU correlated significantly with the in vitro sensitivity of the tumors to 5-FU (assessed by DNA synthesis inhibition assay), the in vivo effects of 5'-DFUR did not correlate with the in vitro sensitivity to 5-FU. It is suggested that: (a) the liver may be the major site for metabolizing 5'-DFUR to 5-FU, and (b) measuring PyNPase activity in the tumor may not be a useful indicator for chemotherapy with 5'-DFUR.

Adenocarcinoma↗
PubMedDate not supplied

[Anorectal malignant melanomas. Apropos of 2 new cases].

Clinical and therapeutic characteristics of anorectal melanoma have been studied about 2 new cases. The initial symptoms were often misdiagnosed with hemorrhoids disease. This cancer carries a bad prognosis but the best treatment seems to be abdominoperineal resection (APR) when the thickness of the melanoma is under 3 mm. Over this limit, APR alone will not cure this disease. Curative treatment will probably involve a combined therapy with local and systemic therapies.

Anus Neoplasms↗
PubMedDate not supplied

[The giant ulcer of the stomach. Notes concerning 30 cases (author's transl)].

The giant stomach ulcer can be defined as a crater measuring more than 30 mm in diameter. This variety of stomach ulcer represents 10-15% of the whole range of gastric ulcers, but they are not quite different from the nosologic point of view. It appears effectively that no etiopathogenic clinical or evolving particular factors can distinguish this kind of ulcer from the niches of normal size. To be taken into consideration is the risk of transforming into cancer which is multiplied by 3 or 5 times when compared with normal stomach ulcers, whence the importance of the endoscopy with many biopsies. In spite of the endoscopy the percentage of error is 5%, this is the reason for which, when in doubt, the more or less extensive gastric resection of the total gastrectomy is required with even more necessity then in normal cases of ulcers.

Adult↗
PubMedDate not supplied

[The place of surgery and its influence on recurrence in the evolution of Crohn's disease].

This retrospective study analyses the results of 37 patients suffering from Crohn's disease and submitted to surgery. 49 operations were carried on with a follow up ranging from 24 to 276 months. Lesions were mainly located in the ileo-colic segment (24 cases) the rectum (8 cases), the colon (9 cases) and the anus or rectum (10 cases). The operative mortality was about 8% and long term results show an overall recurrence rate of 66.6%, the average follow up being 88 months. Nutritional complications associated with a constant increase of the recurrence rate should lead to avoid reiterated resections. A conservative therapy under medical surveillance is then indicated and in case of surgical management, parsimonious resections are required but the anastomosis should not involve pathological tissues. The surgical management of Crohn's disease being a temporary and sometimes mangling solution should only be required in case of medical treatment failure or while facing evolution complications.

Adult↗