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Biomedical subjects

F Becker

Publications and source records attributed to F Becker.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Ischemic vascular complications following thrombopenia induced by heparin. Diagnostic and therapeutic problems].

The authors report 21 cases of heparin-induced thrombocytopenia with ischemic vascular complications. The clinical presentations were peripheral arterial ischemia (16 cases), hemiplegia (1 case) and deep vein thrombosis (4 cases). The vascular surgeon confronted by these complications in an emergency situation should recognise the difficulties of clinical diagnosis (atypical forms) and biological investigations (problems of tests of platelet aggregation). Arterial occlusions are usually accessible to disobliteration with a Fogarty catheter without peroperative heparinisation. Delayed diagnosis explains the seriousness of these complications; in our series of 21 patients, there were 2 deaths, 1 paraplegia, 4 amputations due to arterial problems, 4 severe post-deep vein thrombosis conditions, two of which followed trans-metatarsal amputation. The diagnosis of heparin-induced thrombocytopenia implies immediate withdrawal of heparin therapy. A relay with a low molecular weight heparin is not without risk and should only be undertaken after a negative platelet aggregation test (with the low molecular weight heparin). These tests are rarely practicable in emergency situations and a relay using oral anti-vitamin K antagonists with a rapid onset of action is probably the safest option.

Adult↗
PubMed1990

Specific therapeutic attempts in experimental and clinical type-I diabetes.

The morphological basis of type-I diabetes is the destruction of the islets of Langerhans by an inflammatory process. Immunosuppressive and immunomodulatory mechanisms can prevent diabetes in NOD-mice and BB-rats when given before onset of the disease. In man at the time of diagnosis of diabetes insulitis has progressed already to a loss of more than 80% of the Beta-cells. Several immunosuppressive drugs and immunobiological regimen may influence the course of the disease only in the sense of a temporary remission. Cyclosporine-A was the most effective drug, but can not be recommended for general use at present time because of side effects on the kidney at least when given in higher doses. Whether minimizing the effective dose will be equally effective remains open. Other drugs as ciamexone which seems to be safer have to be taken into account for further studies. Suppression of insulitis most probably will be more successful when the treatment starts at an earlier phase i.e. before onset of the disease. The criteria at what time this may be justified have to be elaborated.

Animals↗
PubMed1990

[Pelvic arteriovenous fistula after ligation of the spermatic cord].

The authors report the case of a 40 year old man undergoing left orchiectomy for Leydig cell tumour. Eight months later, the patient presented with a thrill in the left femoral triangle which angiography revealed to be due to a voluminous pelvic arteriovenous fistula arising at the expense of the left hypogastric artery, especially the arteries supplying the external genitalia. Surgical repair of the arteriovenous fistula was performed without prior embolisation. This haemorrhagic surgery was facilitated by the use of a blood recovery apparatus. The immediate postoperative course was uneventful and follow-up angiography one year later showed perfect stability of the result. This case offers an occasion to recall the risks of fistula during massive ligation of arteriovenous pedicles even in the case of small pedicles which should be treated with the same preventive approach as for the renal or splenic pedicle, i.e. separate ligation of the arterial and the venous element.

Adult↗
PubMed1990

[Dense middle cerebral artery: etiologic significance and prognosis].

Five cases of infarction in the territory of the middle cerebral artery (MCA) are reported. The main feature common to these 5 cases was the presence at CT without contrast injection, in the first 24 hours, of a spontaneous hyperdensity of the ipsilateral MCA. In one case, angiography demonstrated that this hyperdensity was associated with occlusion. In 2 other cases, doppler examination showed occlusion of the internal carotid artery. The transient character of these radiological findings is underlined. In the acute phase of an infarction, hyperdensity of the MCA at an early CT scan without contrast injection suggests an occlusive mechanism and massive infarction with poor clinical outcome.

Acute Disease↗
PubMed1989

[Results of local radiotherapy and modified total-brain irradiation in astrocytoma].

A retrospective evaluation was made on the results of primary or postoperative radiotherapy in 162 patients with grade I to IV astrocytomas. The greatest part of the overall group was built by 113 patients suffering from glioblastoma multiforme. For the survival analysis, the prognostic importance of the following factors was investigated: sex, age, surgery, radicality of surgery, grading according to Kernohan, tumorous lesions in central structures, and target volume of radiotherapy. The prognosis is first of all dependent on the operability, the grading, and the age of the patient. The survival of patients with malignant gliomas is not influenced by the radicality of the operation and the extension of the target volume to the whole brain (total-brain irradiation and boost). Thus in the treatment of malignant astrocytomas, the less extensive surgical and radiotherapeutical intervention seems an adequate method to manage this disease.

Adolescent↗
PubMed1989

[Value of measuring transcutaneous oxygen pressure in arterial disease of the legs].

The authors specify the methods used for measuring teh transcutaneous oxygen pressure (TcPO2), then present the four main advantages of the TcPO2. 1. Although the decision to amputate remains controlled by the clinical evaluation, TcPO2 is useful when one has to choose to preserve or not the heel support or the knee joint, when hesitating on the indication of amputation or the nature of the pain of a stump. Two measurements are crucial: a value of TcPO2 in a decubitus position greater than 30 mmHg at the amputation level seems to guarantee a primary healing, while under 10 mmHg, failure is the rule. 2. Correlations between the Fontaine classification and TcPO2 measured on the fore-foot in decubitus position, show that, at stages I and II, the TcPO2 is not significantly decreased in comparison with the control group (54 +/- 12 mmHg at stage I, 49 +/- 11 mmHg at stage II) and that at stages III and IV, TcPO2 is significantly much lower than at stages I and II and the value of 10 mmHg seems a remarkable threshold defining severe ischemias (12 +/- 15 mmHg at stage III, 3 +/- 5 mmHg at stage IV). 3. A prospective study of 66 arterial disease of the lower extremities cases, at stages II and IV, validated by a TcPO2 measured at the fore-foot in decubitus position less than 10 mmHg, and which could all benefit from reconstructive arterial surgery, is presented.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗