Polyneuropathy in Dupuytren's disease. (An electroneurographic study).
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Adult↗
Biomedical subjects
C Vasilescu
Publications and source records attributed to C Vasilescu.
Neuromyotonia in alcoholic patients with gastrectomy.
Four patients with severe muscle cramps were reported. In two of them the electrical signs of neuromyotonia were demonstrated. All the patients had undergone gastrectomy and all were immoderate consumers of alcohol. The neuromuscular disorder was reversible in all the patients.
Adult↗
Hereditary motor and sensory neuropathy. Clinical, genetic and electrodiagnostic studies.
Motor conduction velocity (MCV) alone cannot separate all the cases with types I and II of hereditary motor and sensory neuropathy (HMSN). However, sensory conduction velocity (SCV) in sural nerve distinctly separated types I and II of HMSN (8). As in most of our patients with HMSN sural nerve was unexcitable, we introduced SCV estimation in the distal segments of median and ulnar nerves. So, we studied 124 patients from families with typical and uncomplicated cases of Charcot-Marie-Tooth disease (CMTD): 68 patients had the "hypertrophic" form (type I) and 56 cases the "neuronal" form (type II). In this series, 16 patients had median MCV from 35 to 45 m/s, but SCV in the median and ulnar nerves separated 7 cases with type I and 9 patients with type II of HMSN. In conclusion, the type I and II of HMSN were delimited in most of the studied cases by MCV values in the median nerve. Nevertheless, in cases difficult to be classified either into type I or II of HMSN, i.e. patients with MCV from 35 to 45 m/s, only SCV measurements in distal median and ulnar nerves segments can distinctly separate type I (a slowing over 40% from control values), indicating that this type is underlain by a process of segmental demyelination (SD), which also was confirmed by sural nerve biopsy data. In our cases with HMSN type II MCV was either normal or slightly slowed. By contrast SCV was significantly slowed (a slowing of up to 30%). In addition, we have also a few cases of complicated HMSN forms (rare variants), associated with: 1. Isaacs' syndrome; 2. "denervation-reinnervation" muscle hypertrophy; and 3. Marinesco-Sjögren syndrome. 1. In 3 patients, the clinical features of "neuronal" form of CMTD were associated with fasciculation, cramps, impaired muscular relaxation, and percussion myotonia with respective electromyographic (EMG) accompaniments, which were responsive to valproic acid therapy. 2. On the other hand 3 patients developed in addition to the Isaacs' syndrome a significant "denervation-reinnervation" muscle hypertrophy, confirmed by both morphometric data on muscle biopsy and computed tomography. In these patients there was an increased proportion of type I and a decreased one either of type IIB or of type IIA fibres, without myotonic or dystrophic features.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Chronic sensorimotor polyneuropathy associated with cerebello-extrapyramidal manifestations in a patient with tomaculous neuropathy.
Clinical, electrophysiological and morphological (sural nerve and gastrocnemius muscle biopsies) data of a 57-year-old man with a chronic sensorimotor polyneuropathy of Charcot-Marie-Tooth type associated with a progressive cerebello-extrapyramidal syndrome are reported. Patient's family data were negative. Nerve structural and ultrastructural examinations revealed the morphological picture of a tomaculous neuropathy. The association of different clinical syndromes and the specificity of the tomaculous neuropathy are discussed.
Basal Ganglia Diseases↗
[Mechanical digestive system suturing devices].
Between 1994 (December)-1996 (May) 150 patients have been operated on using one or many stapling devices. The staplers disposable to us were the "Linear Cutter" or GIA (Gastrointestinal Anastomosis), "Linear Stapler" (TA) and "Intraluminal Circular Stapler" or EEA (end-to-end anastomosis) types, produced by ETHICON (Johnson and Johnson Ltd. Company). The principles operations performed were various digestive resections, intervisceralis anastomosis and interventions of reconstructions (in oesophagus surgery, ileal pouch etc.). The advantages of staplers applications are: a) the reduction of the time of operation, of the anesthesia, of the blood loss; b) a soft manipulation of the tissues; c) a smaller inflammatory reaction and the prevention of intraoperative septic contamination and d) a better and faster take back of the functionality of the anastomosis. There were only 4 intraoperative haemorrhages easy controllable. Postoperative complications: a) 3 haemorrhages medically treated; b) immediate leakage 1 patient after colorectoanastomosis, treated by Hartman colostomy; precocious, 7 patients and after 4-6 month, 2 patients. Corrective iterative interventions were necessary only in 5 patients. The operative mortality-1 patient, the cause of death being a bronhopneumonia after a radical oesophagectomy with oesophagoplasty (oesophageal cancer). There was not postoperative mortality depending of stapling application. We don't observed late postoperative complications like stenosis of various anastomosis, quoted in the literature, because the time of following of our 150 patients is too short (maximum 18 months). The conclusions are that the stapling devices are a real surgical progress with the conditions of a correct indication and adequate tactics and operative technique. The economical effort is justified and entirely compensated by the major benefits obtained for the patients.
Anastomosis, Surgical↗
[Anterior resection of the rectum via laparoscopy].
Of the newer laparoscopic procedures for colorectal cancers the abdominoperineal resection of the rectum was previously communicated in this journal. The laparoscopic anterior resection is a more technically demanding operation. We report the case of 63 years old women with a rectal cancer at 9 cm from the anus. The procedure was realised under general anaesthesia, with a urinary catheter in place. An blunt obturator was introduced into the uterine cavity and used to manipulate the uterus during the procedure. After establishing of the pneumoperitoneum, a 30 degrees telescope was introduced through the umbilical port (10 mm). The 30 degrees telescope allows visualization of the splenic flexure and rectal side wall. The main steps of the procedure were the exploration of the abdominal cavity, mobilization of the descendent colon and sigmoid, exposure of the left ureter, division of the left sided peritoneal leaf and division of the inferior mesenteric vessels. The anterior dissection of the rectum was facilitated by manipulation of the uterus. The rectum was then mobilized with the "abdominalization of the tumor". A 5 cm left paramedian vertical incision was performed; through this incision a stapler was introduced and the rectum was transected 5 cm under the tumor. The rectum with the tumor, the sigmoid and mesosigmoid were exteriorized through the incision; the sigmoid was divided with a linear stapler cutter 20 cm above the tumor and the specimen was removed extracorporeally. The anvil of a circular stapler was secured in the left colon and returned in the abdominal cavity. The body of the stapler was inserted into the rectal stump through the anus and connected intracorporeally to the anvil. The postoperative evolution was simple; flatus and feces were passed at 48 hours. The patient was discharged to home after 6 days, 13 months after operation she has no morbidity.
Adenocarcinoma↗
Motor and sensory conduction velocity in patients with Charcot-Marie-Tooth disease exposed to carbon disulphide.
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Adolescent↗