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Biomedical subjects

F Lacaine

Publications and source records attributed to F Lacaine.

At least 73 records · Page 4Linked to original sources
PubMed1988

Bilioportal fistula as a complication of choledochoduodenostomy.

A bilioportal fistula is rare. We report the case of a patient who had a bilioportal fistula 6 years after a choledochoduodenostomy. Percutaneous transhepatic opacification showed the bilioportal fistula to be associated with a thrombosed portal vein and a cavernous formation. Treatment consisted of separate percutaneous drainage of the portal and biliary tracts. Closure of the fistula was obtained by progressive proximal intrahepatic portal thrombosis. Our case contrasts with the four other cases of bilioportal fistula published in the literature in that (1) there was an absence of biliary lithiasis and (2) we did not use surgical treatment. The most likely explanation for our case of bilioportal fistula is an infectious complication related to the choledochoduodenostomy.

Bile Duct Diseases↗
PubMed1987

[Peroperative radiotherapy in cancer of the pancreas].

Intra-operative irradiation has been devised as a method to safely deliver higher radiation doses to the tumors while minimizing the dose to the surrounding normal tissues. Among 12 patients treated by intraoperative radiotherapy in our institution, 7 had a pancreatic carcinoma (unresected in 6 patients, and partially resected in 1). Anesthetized patients were transferred with the incision temporarily closed from the fourth floor operating theatre to the basement accelerator suite. A single dose of 15 to 20 Gy with 20 MeV electrons was delivered. Five of these patients with carcinoma of the head of the pancreas then had a biliary and a digestive bypass. After surgery, all patients received an additional 40 Gy and chemotherapy with 5-fluorouracil. There was neither post-operative mortality nor morbidity. Three patients with pre-operative pain had no pain following treatment. Five patients died after 5 to 10 months and two patients are alive with a follow-up of 4 and 9 months respectively. Because of the short follow-up and small number of patients, no conclusions concerning survival can be drawn. Nevertheless, in other experiences good palliative results have generally been obtained. Significant differences in survival time were noted in a japanese experience of unresected cases. In 16 patients with resected carcinoma a 41% survival rate at 2 years has been observed in 1 North American study. These results suggest that intra-operative irradiation is worth further trials.

Aged↗
PubMed1987

Human basophil degranulation test in liver hydatidosis.

Upon exposure to a specific antigen, granulation of basophils bearing IgE disappears. The aim of this study was to assess the human basophil degranulation (HBD) test with hydatic antigen in 100 patients. Seventy patients were clinically suspected of having liver hydatidosis (LH) (group I). Eight patients had asymptomatic hepatic calcifications. Twenty-two patients had previous surgery for LH (group III). In group I the percentage of HBD was significantly higher in patients with LH (23 of 70) than in patients with other hepatobiliary diseases (P less than 0.001). In group II all patients had negative HBD tests. In group III the test became negative within 8-12 months after radical surgery in four patients, and remained positive in the other 18. These results suggest that the HBD test is useful for the diagnosis of LH. In asymptomatic patients with hepatic calcified cyst, a negative HBD test suggests a dead parasite. In previously operated patients, a positive test suggests persistence of antigen.

Animals↗
PubMed1987

[Nutritional status of patients with digestive system cancer: preoperative prognostic significance].

We have attempted to establish a prognostic nutritional index prospectively in 633 patients with digestive carcinoma making it possible to predict tumor resectability and occurrence of postoperative complications. The following factors were studied prior to surgery: age, sex, weight loss index, triceps skinfold thickness, midarm circumference, lymphocyte count, plasma albumin, transferrin and prealbumin levels, delayed hypersensitivity as investigated by 8 skin tests. The prognostic nutritional index was calculated using Mullen's formula. Unidimensional and multidimensional studies (linear discriminant and logistic discriminant analyses with partial correlations) were used for the statistical analysis. Mortality was 6,7 p. 100 while 16,2 p. 100 of patients presented a postoperative complication. The following variables showed a significant correlation with the resectability of the tumour: weight loss (p less than 0.0001), triceps skinfold thickness (p less than 0.01), midarm circumference (p less than 0.01), total lymphocyte count (p less than 0.01), plasma transferrin (p less than 0.01), delayed hypersensitivity (p less than 0.05). In the occurrence of postoperative complications there was a statistically significant value only to weight loss (p less than 0.001) and delayed hypersensitivity (p less than 0.05). Logistic discriminant analysis gave a linear model predicting tumor resectability in 78 p. 100 of patients and postoperative complications in 86 p. 100 of patients in which weight loss and delayed hypersensitivity were statistically significant. No prognostic value of Mullen's index was found. This study shows that assessment of the preoperative nutritional status of patients with gastrointestinal cancer makes it possible to predict tumor resectability and postoperative complications.

Age Factors↗
PubMed1986

[Biliary cysts of the liver].

Biliary cysts of the liver do not communicate with the biliary tract. Eight of the 10 patients operated on were asymptomatic. The cysts were 3 to 30 cm in diameter. In 1 patient, ultrasonically guided drainage of the cyst was followed by recurrence of the lesion and pain. In another patient, a cholangiocarcinoma was discovered in the wall of the cyst. After resection of the protruding part of the cyst the pathological disorders subsided in all patients who were followed up for 6 months to 16 years.

Adult↗
PubMed1986

Treatment of local recurrence after primary restorative resection or Hartmann's operation for carcinoma of the colon and the rectum.

Between 1970 and 1985, 20 patients underwent laparotomy for local recurrence following a restorative resection or Hartmann's operation for carcinoma of the colon and rectum. Histological confirmation was made in 18 cases and in 2, recurrence not confirmed at surgery became apparent during subsequent follow-up. Of the 16 patients in whom the site of local recurrence could be defined, there was involvement of the previous anastomosis in 13. At laparotomy 7 patients had disseminated disease and in 5 patients without dissemination, local disease was unresectable. Ten recurrences were amenable to resection. Of these 8 patients had a curative operation with a median survival of 26 months and a 5-year actuarial survival rate of 50%. In 10 patients no resection was performed. Median survival in this group was 5 months but 1 patient is still alive at 10 years after radiotherapy. The results emphasise the importance of follow-up given the high salvage rate in patients in whom a curative resection was possible.

Adult↗
PubMed1986

High ornithine decarboxylase activity and polyamine levels in human colorectal neoplasia.

Polyamines are required for cell proliferation, and ornithine decarboxylase (ODC) is the first and probably rate-limiting enzyme in their synthesis. Tissue containing colonic or rectal adenocarcinomas (N = 34) or polyps (N = 6) and noninvolved paired colonic mucosa were obtained from fresh surgical specimens. ODC activity was elevated (mean: 320%) in both the cancer and polyps. In noninvolved colonic mucosa of tumor-bearing specimens, ODC activity was 165% that of colonic mucosa of non-neoplastic disease. Concentrations of polyamines in neoplasms were 121-214% increased, as compared with normal mucosa; those of spermidine and spermine varied inversely with the histological grade of the tumor. High levels of ODC activity and of polyamines were features of neoplasia, but not of malignancy alone. These characteristics of colonic neoplasia suggest its susceptibility to control by inhibition of ODC.

Adenocarcinoma↗
PubMed1986

[Choledochoduodenal anastomoses in biliary lithiasis].

In choledocholithiasis, after opening the common bile duct, we used to perform choledochoduodenostomy in old patients. The aim of this study was to evaluate our results in 77 patients. The mean age of the patients was 75 years. Twenty-two patients were operated for angiocholitis, 19 had jaundice, and 36 had gallstones without angiocholitis or jaundice. There was two hospital deaths (2.6 p. cent). All the patients but two could be traced. The mean follow-up was 6.7 years. Two patients had had transients episodes of angiocholitis. Twenty-five patients have dead. Expected mortality in french population corresponding in age and sex was 29 deaths. Our results suggest that choledochoduodenostomy is a safe and effective procedure in the management of calculous biliary tract disease for old patients.

Aged↗
PubMed1985

Choledochoduodenostomy for calculous biliary tract disease.

After the opening of the common bile duct, several controversial procedures may be used. In choledocholithiasis, our preference is to perform choledochoduodenostomy in older patients. We report the results in 77 consecutive patients with a mean age of 75 years. There were two hospital deaths (2.6%). Follow-up ranged from six months to 15 years, with an average of 6.7 years. Fifty patients are alive and well. Twenty-five patients have died. Only two patients were unavailable for follow-up. Expected mortality in the French population corresponding in age and sex was 29 deaths and the overall survival is not different, including the two postoperative deaths. Delicate technique allows anastomoses to ducts of any size, with no difference in long-term survival compared with a French population similar in age and sex.

Aged↗
PubMed1985

Chemoprevention and chemotherapy by inhibition of ornithine decarboxylase activity and polyamine synthesis: colonic, pancreatic, mammary, and renal carcinomas.

Specific, irreversible, inhibition of ODC activity with DFMO and resultant low levels of intracellular polyamines markedly suppress the induction of experimental colonic and mammary cancers and hold promise for augmenting the multidrug chemotherapy of established colonic, pancreatic, renal and mammary cancers without increasing systemic toxicity.

Animals↗
PubMed1985

Prognostic factors in survival after portasystemic shunts. Multivariate analysis.

Multivariate analyses correlated short-term survival and long-term survival with clinical data from 141 patients with portasystemic shunts for bleeding esophageal varices over the 8 years from 1974 through 1981. By logistic regression analysis, the elements with independent prognostic significance for operative death were an emergency operation, serum albumin and bilirubin levels, age, and sex. A cutpoint probability value of 0.75 marked the single level above which 84% of patients could be expected to survive, but below which 77% are likely to die. By a Cox regression model, elements with independent prognostic significance were identical. Male sex (p = 0.02) and prolonged partial thromboplastin time (p = 0.04) indicated a poor prognosis after an emergency operation; after an elective operation only the serum albumin level was prognostic (p = 0.02). Normal blood clotting is the major determinant of survival after an emergency shunt, and the serum albumin level chiefly determines survival after elective portasystemic decompression.

Adult↗