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Biomedical subjects

F Bacourt

Publications and source records attributed to F Bacourt.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Evaluation of vascular surgery with digital subtraction angiography. A study of 127 patients].

We have performed digital subtraction angiography (DSA) on 127 patients treated by vascular surgery. This technique was easily and safely performed in outpatients, without any complication. Our experience indicates that DSA is accurate for post operative evaluation in 96% of cases. In digestive arterial surgery, some examinations (3.3%) are insufficient. Distal run off is usually well seen, everywhere, except in kidneys. There is a good correlation between angiographic results and clinical status. However, significant abnormalities were discovered in 5% of cases without any clinical signs. Digital intravenous angiography is a safe and mildly invasive procedure for postoperative evaluation of vascular surgery.

Angiography↗
PubMed1984

[Parathyroid adenoma disclosed by a massive subcapsular hemorrhage].

In the case reported here a parathyroid gland adenoma was revealed by the sudden occurrence of a large subcapsular haematoma compressing cervical structures and causing recurrent nerve paralysis; spontaneously regressive hypercalcaemia was present. The place of these haemorrhages among other manifestations of a hitherto silent parathyroid gland adenoma is discussed, together with the diagnostic value of thyroid gland scintigraphy and cervical ultrasonography. In view of their potentially somber prognosis, emergency surgery is mandatory in such cases.

Adenoma↗
PubMed1984

Pulmonary metastases in differentiated thyroid carcinoma. Study of 58 cases with implications for the primary tumor treatment.

Fifty-eight cases of pulmonary metastases (PM) from 831 cases of differentiated thyroid carcinoma (DTC) were studied. PM were found in about 10% of follicular and 5% of papillary tumors. 131I uptake was found in 55% of the cases, irrespective of histology. Twenty-one patients were treated by 131I only and 12 were cured. Micronodular metastases, 92% papillary, with 86% positive 131I uptake and 77% 8-year survival rate, are the most favorable forms. In others the influence of PM size/age, uptake, delay of appearance, presence of cervical or mediastinal lymph nodes is discussed. Occurrence of late PM according to treatment of the primary tumor was 1.3% thyroidectomy + 131I; 3% thyroidectomy; 5% partial thyroidectomy + 131I; 11% partial thyroidectomy only. Thus prevention in DTC of severe PM (28% 8-year survival rate) can best be achieved by complete thyroidectomy + 131I ablation dose.

Adult↗
PubMed1983

[Paradoxical embolism through a patent foramen ovale. 4 cases].

Four cases of paradoxical embolism through a patent foramen ovale associated with massive pulmonary embolism are reported. In two cases, patency of the foramen ovale was demonstrated by a new technique: cross-sectional contrast echocardiography potentiated by coughing. The conventional surgical treatment included arterial embolectomy followed by insertion of a caval filter. Embolism recurred on three occasions under mechanical ventilation prior to insertion of the filter. A new sequence of investigations to facilitate detection of paradoxical embolism in patients with unexplained arterial embolism is suggested: (1) blood gas measurements, which reveal associated pulmonary embolism; (2) cough-potentiated cross-sectional contrast echocardiography, which demonstrates a patent foramen ovale and excludes emboligenic cardiopathies; (3) phlebography and pulmonary angiography which complete the diagnosis. To reduce the risk of recurrent embolism, it is recommended to begin treatment by blocking the vena cava without mechanical ventilation. This can be done by inserting a filter through the jugular vein under local anaesthesia. Arterial embolism can then be treated at lesser risk under mechanical ventilation.

Echocardiography↗
PubMed1983

[Coarctation of the abdominal aorta: diagnosis, pathogenesis, medical or surgical treatment. 7 cases].

Seven cases of coarctation of the abdominal aorta are reported. The diagnosis, suggested by the presence of arterial hypertension associated with nonperception of the arterial pulse in the lower limbs and/or systolic murmur in the abdomen, is supported by non-invasive investigations, such as Döppler flowmetry of lower limb arteries and ultrasonography of the abdominal aorta. Arteriography, however, is mandatory because of frequently associated lesions of other arteries, notably renal and/or intestinal arteries. The type and location of these lesions are of prime importance to therapeutic decision. According to the results of the present study, surgery may not be required in all cases and may be replaced, in some very specific circumstances, by medical treatment. There is still disagreement concerning the congenital or acquired origin of this type of aortic coarctation and the mechanism of hypertension. The various theories put forward are discussed.

Adolescent↗
PubMed1983

[Angioma of the thyroid gland. Apropos of a case].

The discovery of one angioma of the thyroid among 1000 thyroidectomy specimens examined confirmed the extremely rare nature of this lesion. These angiomas, localized to the thyroid gland, are observed in adults and could result from an intrathyroidal mesenchymatous inclusion. They should be distinguished from childhood forms which occur within the framework of an almost always fatal multiple viscera angiomatous disease. Diagnosis is difficult before operation, while the prognosis is excellent after partial thyroid excision.

Female↗
PubMed1981

[Location of an insulinoma by transhepatic phlebography with staged insulin assays (author's transl)].

Insulinoma was easily diagnosed in a 73-year-old woman who had organic hypoglycaemia associated with hyperinsulinism, but the tumour could not be located by echotomography and computerized tomography. The state of the patient's arteries precluded arteriography. Pancreatic phlebography was carried out by the portal transhepatic route and blood was collected at different levels for plasma insulin assays. A very high gradient at the pancreatic isthmus indicated the site of the tumour, which was found on surgery to be precisely there and could be enucleated. This technique cannot be used systematically to locate insulinomas, but it is unquestionably helpful when the tumour cannot be located by other methods or when these are contra-indicated.

Adenoma, Islet Cell↗
PubMed1981

[Clamping of the thoracic aorta in a hypertensive patient with coronary disease. An indication of sodium nitroprusside (author's transl)].

In patients with cardiac failure, coronary disease or arterial hypertension, clamping of the aorta results in increased filling pressure of the left ventricle which may produce or increase subendocardial ischaemia with consequent aggravation of the ventricular insufficiency. And the higher the clamping the greater the risk. This vicious circle can be broken by sodium nitroprusside, which has potent and reversible vasodilator properties. The drug is indicated whenever the left ventricular filling pressure rises above 5 mmHg. These considerations are illustrated by the descriptions of a case where sodium nitroprusside ensured blood circulation in the lower limbs and intra-abdominal organs after clamping of the aorta above the coeliac artery in a high risk cardiac patient.

Aorta, Thoracic↗
PubMed1981

[Distal mesenteric arteritis: a rare complication of D. methylsergide treatment (author's transl)].

A patient developed typical abdominal angina due to mesenteric arteritis secondary to D. methylsergide (Desernil) treatment. Multiple regular distal stenoses were revealed by arteriography, but these had completely disappeared 5 months after discontinuing treatment. Histology demonstrated fibrosis of the three tunicae with hyperelastosis. Six analogous cases due to D. methylsergide or ergotamine tartrate have been reported in the published literature, rapid regression occurring in all of them after interruption of treatment.

Arteritis↗
PubMed1980

[Thyroid metastases from renal tumours: 3 cases (author's transl)].

Metastatic tumours from clear cell renal cancer were found in 3 out of 4 000 thyroidectomy specimens. These tumours appeared on scintigrams as low density nodules, one to three in number, and were accompanied in one case by signs of hyperthyroidism. They were treated by partial excision 4, 5 and 7 years after nephrectomy. One patient relapsed, was re-operated upon 2 years later and is still alive after one year. The other two patients showed no sign of relapse after 2 and 4 years respectively. When the renal history is unknown it is difficult histologically to differentiate these tumours from clear cell epitheliomas of the thyroid gland.

Adenocarcinoma↗