Biomedical subjects
Publications and source records attributed to F Lemoine.
By morphometric analysis of fatty liver, we propose to value volume density of fat vacuoles and liver hypertrophy. By this method we appreciate liver cell modification in malnutrition.
Three cases of metastatic malignant thymoma are reported. In all three cases the tumour was invasive and excision was only partial or impossible. Histologically, these tumours were of epithelial origin with a variable lymphocytic component. Metastases were initially present in one case and in the other two developed within the first year. Partial remission was obtained with different drug combinations in only one case, and it was of short duration. The authors emphasize the increased frequency and poor prognosis of these tumours and the need for multiple chemotherapy and loco-regional treatment in the management of invasive thymomas.
Moderate alcohol consumption is associated with lower cardiovascular mortality. The effect of moderate alcohol intake during 5 weeks on lipoproteins, especially on the high density lipoprotein (HDL) cholesterol total (of which the levels are inversely predictive of coronary heart disease) and apoproteins A, A1 and B, was studied in 7 normal men. HDL cholesterol total appreciated by the heparin manganese precipitation method and phosphotungstate magnesium method increased (p less than 0.01) during alcohol consumption. The composition of HDL was modified by alcohol consumption: increase of the esterified/total cholesterol ratio (p less than 0.05) and phospholipids (p less than 0.05) without significant modification of triglycerides. Low density lipoprotein and very low density lipoprotein did not vary significantly. Apoprotein A1 increased during alcohol consumption (p less than 0.05) with a transitory increase of apoprotein A. There was no significant modification of apoprotein B.
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The authors propose a computer card for registering the main information required in the management of ovarian cancers. The data include a detailed description of the lesions noted at operation, the surgical procedure, and postoperative lesions. They concern both the initial laparotomy and any second-look operations.
The effects of the converting enzyme inhibitor captopril (Lopril) were studied in a 53 year old woman with acute exacerbation of scleroderma. In addition to her chronic symptoms of Raynaud's syndrome, the patient presented with severe hypertension, cardiac failure and oligoanuria. Right heart catheterisation with a Swan-Ganz catheter confirmed the systemic hypertension with cardiac failure, and also demonstrated precapillary pulmonary hypertension with raised pulmonary arterial resistance. The organic renal failure was an indication for renal biopsy which showed segmental and focal fibrinoid necrosis with microthrombosis and chronic ischemic changes. Due to raised plasma renin activity, treatment with captopril was instituted, leading to a rapid normalisation of systemic and pulmonary hypertension, the regression of cardiac failure and a transient improvement in the Raynaud's syndrome. The renal failure did not improve and the patient had to undergo chronic hemodialysis. These spectacular initial results should be interpreted in the context of the poor prognosis of acute exacerbations of scleroderma despite the encouraging data published recently after well-controlled antihypertensive therapy.
Thirteen variables were evaluated for their significance in predicting the survival of 148 patients in a retrospective study with clinical Stage I cutaneous malignant melanoma. The variables studied were histological type, tumor thickness, level of invasion, mitotic activity, pigmentation type, existence of ulceration, presence of lymphocytic infiltration, cell type, sex and age of the patient, site of melanoma, and wide local excision preceded or not by contact radiotherapy and associated or not with lymphadenectomy. When these variables were individualized, only seven were significantly related to survival: histological type; tumor thickness; level of invasion; mitotic activity; pigmentation type; existence of ulceration; and sex of the patient. Multivariate analysis based on Breslow's version of the Cox proportional-hazards model was performed on a group of 110 patients. This analysis demonstrated that 5 of the original 13 variables (i.e., mitotic activity, tumor thickness, sex, lymphadenectomy, and site of primary melanoma) could be used to develop a prognostic model. A Gompertz distribution which provided for an appropriate smoothing of the Breslow model estimates was used to derive a simple prognostic index and to predict the survival of individual patients. Fifty-four patients in a prospective study were subsequently evaluated with the Gompertz model in order to test the prognostic accuracy of the model for the five variables.
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A retrospective study of severity symptoms in a series of 102 patients operated upon for acute haemorrhagic pancreatitis showed that the risk of death was much significantly higher when shock (p less than 0,00001) and renal failure (p less than 0,0001) were present. The association, during the post-operative period, of shock and renal failure with one of the following symptoms: digestive haemorrhage, psychic disorders, pulmonary oedema, post-operative peritonitis and evisceration invariably proved fatal. It is suggested that controlled therapeutic trials should be carried out in patients presenting with these complications.
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These sixty five cases of abdomino-trans anal excision account for approximately one third of 210 operations performed for carcinoma of the rectum. In the context of curative surgery, indications for preservation of the sphincter must be strict in order to permit satisfactory excision inferior to the tumour and to avoid the risk of local recurrence. Post-operative care and early complications involve the segment of colon which must be brought down. Gangrene of the exteriorised colon did not, in general, compromise the definitive result, at the price of an early colostomy which could always be closed later. Long term results are encouraging: 22 patients out of 26 who underwent non-palliative surgery are alive, without recurrence, after 5 years. The functional result can be assessed only after 6 months adaptation. One patient in two considers himself to be normal. The other half are forced to used enemas, and one in four must wear a protective dressing.
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