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Biomedical subjects

D Castaing

Publications and source records attributed to D Castaing.

At least 73 records · Page 4Linked to original sources
PubMed1986

Utility of operative ultrasound in the surgical management of liver tumors.

In this study the utility of operative ultrasound in the surgical management of 98 consecutive patients with liver and gastrointestinal tumors was assessed. All patients had preoperative work-up including ultrasound study of the liver as well as selective hepatic arteriography (50 patients) and computerized tomography of the liver (45 patients). At surgery, inspection and palpation of the liver as well as operative ultrasound examination were performed in all cases. Fifty-six patients were known to have liver tumors before operation, while 42 patients had their liver examined as part of the treatment of a primary gastrointestinal malignancy. A total of 126 liver tumors were found in 58 patients, all of whom were confirmed histologically. Eighteen nodules unsuspected before operation were found at surgery--nine by inspection and palpation of the liver, and nine others that were nonpalpable were found by operative ultrasound only. Eighteen lesions that were missed by all diagnostic modalities were found as secondary lesions on pathologic examination of the resected specimens. In addition to diagnostic applications, operative ultrasound was useful in localizing nodules and permitting guided biopsies deep in the hepatic parenchyma. In eight cases, segmental resections were performed with operative ultrasound to localize the plane of section and to catheterize the intrahepatic portal vein branch afferent to the tumor in order to perform balloon catheter occlusion of the vessel for control of bleeding. Operative ultrasound was found to be important in the surgical management of 19 of 98 patients (19%).

Aged↗
PubMed1986

Effect of portacaval anastomosis on rat lipoproteins.

The distribution of cholesterol (C), triglycerides (TG), phospholipids (PL) and protein in the different lipoproteins was studied in male Wistar rats under 2 conditions: control and 2 months after portacaval anastomosis (PCA). PCA decreased the levels of cholesterol and the other components in chylomicrons (-90%), very low density lipoproteins (-65 to -78%), LDL2 (1.040 less than d less than 1.063 g/ml; -51 to -61%) and HDL (1.063 less than d less than 1.21 g/ml), whereas no change was observed in LDL1 (1.006 less than d less than 1.040 g/ml). Apoprotein C contents were decreased in all lipoproteins. The relative proportions of C, TG, PL and proteins in lipoproteins were essentially unchanged by the shunt, suggesting a reduced number of lipoprotein particles in plasma after PCA. It was concluded that PCA reduced the levels of all lipoproteins secreted by liver and/or the intestine without modifying those of intraplasmatic origin (LDL1).

Animals↗
PubMed1985

Intraoperative ultrasonographic study of the liver. Methods and anatomic results.

In this study, we have reported our experience with the use of intraoperative ultrasonography in the field of liver surgery. Using the method, the intrahepatic segmental pedicles can be precisely located and thus, segmentectomies can be performed in an anatomic way. The technique allows the most economic parenchymal resection in cirrhotic patients which may be important for prevention of postoperative liver insufficiency.

Bile Ducts, Intrahepatic↗
PubMed1985

[Behavior of urinary magnesium in comparison with urinary calcium and oxaluria in rats subjected to portacaval anastomosis].

Rats with a portacaval anastomosis are known to be susceptible to develop uric acid stones. The present studies were undertaken to investigate urinary Mg, Ca and oxalate excretion in such rats. We found that their Mg excretion was doubled, Ca excretion tripled, and oxaluria somewhat decreased. The Ca crystallization attributed to the increased Ca2+ in the urine is, therefore, somewhat held in check by the increased presence of Mg in the urine and by decreased oxalates.

Animals↗
PubMed1985

[Value of peroperative ultrasonography in the surgery of hepatic metastases].

16 patients with hepatic metastases and 35 patients with a cancer of the gastrointestinal tract with no apparent metastases on the pre-operative survey were studied prospectively in order to compare the effectiveness of intra-operative ultrasonography and other morphological examinations in the detection of tumour. In this study, the topographical precision of the various morphological examinations was also assessed. This precision is fundamental for modern surgery for hepatic metastases, as it allows limited anatomical resections which are associated with a decreased operative risk, while maintaining the same long term results as wide resections.

Humans↗
PubMed1985

[Increase in urinary uric acid in the rat following portacaval shunt. The action of clofibrate].

Two successive experiments on rats confirm that a portocaval shunt leads to a substantial increase in uricosuria, which does not climax in the first week postoperatively. Clofibrate, an inductive liver enzyme, significantly reduces the uricosuria, but only after a certain timelag. Uricosuria, the degree of which varies with individual rats, leads to crystallization of uric acid, mainly in the form of ammonium urate, but polyuria secondary to portocaval shunt tends to inhibit the crystallization. A reduced water intake one day out of two facilitates the crystallization after a portocaval shunt.

Animals↗
PubMed1985

Cholesterol metabolism in lean and obese Zucker rats: effects of portacaval anastomosis.

The effects of portacaval anastomosis (PCA) on cholesterol biodynamics of male adult (fa/fa) Zucker rats and their lean littermates were studied with an isotopic equilibrium method. Animals were fed with a sucrose-rich semi-purified diet. Obese rats were hypercholesterolemic (2.03 +/- 0.14 vs 1.06 +/- 0.7 mg/ml), had a cholesterol-enriched liver (135.3 +/- 14.5 vs 40.0 +/- 2.6 mg/liver) and accumulated cholesterol in body pools. However no difference in the rates of cholesterol absorption, synthesis, fecal elimination or transformation into bile acids distinguished obese from lean Zucker rats. In both lean and obese rats, PCA decreased cholesterolemia by about 28 per cent and liver weight by 40 per cent while the total cholesterol content of the liver was not affected. Input of synthesized cholesterol (internal secretion) was strikingly decreased by the shunt (from 13.2 +/- 0.6 and 12.6 +/- 0.7 mg/day/rat before PCA, to 8.9 +/- 0.8 and 8.6 +/- 1.0 mg/day/rat after PCA) in lean and obese rats respectively. A similar decrease was observed in the cholesterol transformation into bile acids. Since the activity of the gut for cholesterol synthesis, as shown by the fecal external secretion (cholesterol synthesized by the gut and directly eliminated in the gut and feces) was probably not modified, the reduction of internal secretion induced by PCA resulted from decreased hepatic cholesterogenesis. It is suggested that this decrease may be one of the factors involved in the lowering effect of PCA on plasma cholesterol level.

Animals↗
PubMed1985

[Surgical treatment of hepatic metastases].

355 patients with hepatic metastases were followed between 1970 and 1984 at the Hôpital Paul Brousse. 132 cases were of colonic origin: 32 were treated by means of hepatic resection (including 5 metastasectomies), 7 by intra-hepatic anastomosis and 5 by devascularisation. The other 88 patients did not receive any surgical treatment. In 148 of the other 233 patients, the metastases were of non colonic gastro-intestinal or rectal origin and in the remaining 75 cases the metastases were derived from another site. 12 patients were treated by hepatic resection, 6 by devascularisation, 2 by intra-hepatic anastomosis and 2 by intubation of the bile ducts. One patient (0.5 per cent) died during the post-operative period following these operations. The long term survival was 73 per cent at 1 year and 29 per cent at 3 years. In conclusion, some patients are definitely cured by hepatic resection, although these patients cannot be predicted. For this reason, the surgeon's role consists of trying to decrease as much as possible the operative risk and to propose this type of treatment to all patients in which it may be beneficial.

Colonic Neoplasms↗
PubMed1984

[Brain-death unit and renal transplantation. Evaluation of 5 years' experience].

From 1977 to 1982, 170 potential organ donors were referred to "a brain-death unit". A vast majority of these patients were provided by intensive care units of district general hospitals from Ile-de-France. This fact confirms the dispersion of potential organ donors and the usefulness of an organ-procurement structure based in an University Hospital. Its effectiveness is demonstrated by an harvesting rate of 58%, largely over the already published reports in case of absence of such a center. It is concluded that the adoption of this system by other hospitals would significantly increase the number of cadaver kidney grafts available for transplantation whereas actually the number of kidney grafts remains dramatically low in France.

Adolescent↗