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Biomedical subjects

F Lacaine

Publications and source records attributed to F Lacaine.

At least 109 records · Page 6Linked to original sources
PubMed1980

[Superficial cancer of the stomach. 16 cases].

The improvement in the end-results of surgical treatment of gastric carcinoma can be ascribed for the most part to a better knowledge and an increased incidence of mucosal or submucosal types of carcinoma in the patients treated. Of a group of 100 gastric carcinoma, 16 had a superficial carcinoma. Only 11 patients presented at hospital within 12 months of the onset of symptoms. The commonest radiological and macroscopic appearance was a "muco erosival" aspect (10 cases). All patients had a gastric resection without operative mortality. The five-year survival rate (actuarial) was over 80 per cent. To not miss such superficial carcinoma a gastroscopy must be perform not only in all abnormalities of a barium meal, but also in all patients with normal barium meal and upper digestive symptoms.

Adult↗
PubMed1980

[Carcinoma of the stomach. Factors relating to survival (author's transl)].

Records were reviewed for 100 consecutive patients who were operated for adenocarcinoma of the stomach. In 72 cases the carcinomas have been resected. Operative mortality has been 25% in the non resected cases and 8.9% after resection. For the 100 patients the five years cumulative survival rate was 28.9%, and 45.2% after resection. In resected cases survival was related to the size of the tumor, depth of penetration, differentiation on the tumor, and lymph nodes invasion (Log Rank test).-20

Adenocarcinoma↗
PubMed1980

Preoperative evaluation of the risk of common bile duct stones.

The patient with gallstones has an unknown risk of also having choledocholithiasis. To establish this risk preoperatively, several tests were studied in 167 patients, 37 of whom had common duct stones at exploration. With no previous or current jaundice, as well as normal alkaline phosphatase levels and a duct size of less than 12 mm, there was less than a 5% risk of choledocholithiasis; elevated bilirubin and/or alkaline phosphatase levels indicated intermediate risks (33% to 66%); and a duct size of 12 mm or greater, with any combination of other factors, indicated a 90% to 100% risk of choledocholithiasis. The surgeon should be aware of these probabilities in evaluating conditions of patients with cholelithiasis.

Alkaline Phosphatase↗
PubMed1980

[Computed tomography investigation of hepatic carcinomas (author's transl)].

Computed tomography examinations, using a second generation Acta 200 FS apparatus, were conducted on 28 occasions in 25 patients with hepatic carcinoma. Before injection, the tumor is usually of low density, to a small degree in many cases, and is heterogeneous and has indefinite limits. The sensitivity of the method is 96 p. cent. A precise study of the localization of the tumor was possible in only 11 cases, and a definite diagnosis was made in 64 p. cent. The method was only moderately effective in assessing the degree of regional extension. When compared with other methods for the investigation of the liver (scintigraphy, ultrasonography, arteriography), computed tomography shows no superiority over ultrasonography which should be employed for the initial examination.

Adult↗
PubMed1978

[Evaluation of the effectiveness of a diagnostic examination: from data to medical decision (author's transl)].

It is desirable to assess the value of special investigations by objective criteria. Conditional probabilities are suitable for this purpose. Sensitivity and specificity indicate the prevalence of a sign in a disease. Predictive values estimate the probability of a disease when a sign is present and the probability of absence of disease when the sign is absent. Comparison between the informational value of a sign or examination with concepts of cost or of risk to the patient is then possible. This made be used as a basis for determining a strategy for special investigations in the establishment of a diagnosis.

Bayes Theorem↗
PubMed1978

[Per-operative cholangiography in cholelithiasis: diagnostic value (author's transl)].

This study was aimed at determining the predictive value of pre-operative signs in comparison with those of per-operative cholangiography in the diagnosis of an obstruction in the common bile duct during cholecystectomy for lithiasis. 154 cases were studied. The predictive value of pre-operative signs suggestive of obstruction was 0.46 and that of per-operative cholangiography 0.81. The predictive value of signs suggestive of the absence of obstruction was 0.90 and 1 for per-operative cholangiography. Per-operative cholangiography should thus be performed whenever possible during cholecystectomy for lithiasis.

Cholangiography↗
PubMedDate not supplied

Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: a multivariate analysis.

The aim of this study was to evaluate the independent influence of clinical and pathological variables on survival of patients with gastric carcinoma using the Cox regression proportional hazard model. Of 156 patients operated on for gastric carcinoma, 46 (29.5%) underwent palliative operation, 24 (15.5%) had a palliative resection, and 86 (55%) had a curative resection. The overall 5-year survival rate was 25 +/- 4%. After curative resection, the 5-year survival rate was 44 +/- 6%. Univariate analysis applied to these patients showed that poor survival was related (p less than 0.01) to: age (over 80 years), absence of epigastric pain, vomiting and dysphagia, total gastrectomy, tumor size (more than 4 cm), lymph node involvement (LNI), invasion through the muscularis propria, absence of intestinal metaplasia near the tumor, and linitis plastica. In multivariate analysis, lymph node involvement was found to be the only independent prognostic factor. The 5-year survival rate was 75.5 +/- 8% without LNI, 28 +/- 10% with proximal LNI, and 7 +/- 6% with distal LNI. Our results suggest that classification into 3 LNI groups is the best staging system for curative resection in gastric carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Survival after a first episode of spontaneous bacterial peritonitis. Prognosis of potential candidates for orthotopic liver transplantation.

To determine the potential role of orthotopic liver transplantation (OLT) in cirrhotic patients surviving a first episode of spontaneous bacterial peritonitis (SBP), medical records of 79 patients presenting with a first episode of SBP were reviewed. Of these patients, 37 were selected as potential candidates for OLT using the following criteria: absence of hepatocellular carcinoma; no severe organ failure other than the liver; age < or = 66 years; and survival after SBP > 60 days. Survival time was calculated from the day of SBP diagnosis. Prognostic value of clinical, biological and bacteriological data recorded at the time of SBP was determined using univariate and multivariate analysis (Cox's regression model). Survival rate of the potential candidates for OLT at 3 months, 1 year and 2 years was 94, 46 and 30% respectively. Serum creatinine value (P = 0.001) and Pugh score (P = 0.005) were independently correlated with death. The 1 year survival rate was 80% for the 11 patients with a Pugh score < 10, and 26% for the 26 patients with a Pugh score > or = 10. Our results suggest that after SBP, OLT should be considered in patients with severe liver disease. Survival of patients with a moderate liver disease (i.e. Pugh score < 10) might be relatively high.

Aged↗
PubMedDate not supplied

[The predictive criteria of lithiasis of the main biliary tract associated with gallbladder lithiasis].

Before the laparoscopic era, detection of CBD stones in patients with lithiasis of the gallbladder has been made, preferably, by intraoperative cholangiography. Development of laparoscopy gives the necessity of a preoperative detection of CBD stones, especially when a previous endoscopic treatment is preferred. Tenon's multifactorial score, in the Author's opinion, is able to detect patients "at risk" for CBD stones. This score includes the following parameters: age, CBD diameter, size of gallstones, colic pain and cholecystitis. The chance of CBD stones was 2% for a score lower than 3.5 and 81% for a score greater than 5.9. In this way, patients with high probability of CBD stones can be submitted to a preoperative ERCP or to a intraoperative cholangiography, according to the choices of the surgeon.

Cholangiography↗
PubMedDate not supplied

[Technic of partial splenectomy with linear stapler instrument (TA 90, U.S., Surgical Corps].

Seven patients have been treated by partial splenectomy, performed with TA 90 linear stapler instrument (U.S. Surgical Corp). Three patients had non parasitic cyst of the spleen, two had malignant disease and two were operated for traumatic injuries. The section and the hemostasis of the spleen was performed with the linear stapler instrument. No patient required blood unit transfusion. Postoperative course was uneventful. Partial splenectomy with the TA 90 stapler, which does not supply the complications of total splenectomy, is an easy and safe procedure. It should be more often indicated.

Colonic Neoplasms↗