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Biomedical subjects

F Saegesser

Publications and source records attributed to F Saegesser.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Medullary cancer of the thyroid gland].

Thirty-one cases of medullary carcinoma of the thyroid have been studied over the past fifteen years at the University Hospital of the Canton of Vaud, Switzerland (CHUV). Twenty cases were of sporadic nature and eleven presented as part of the familial MEN II syndrome (multiple endocrine neoplasia), one of which showed the classical features of the rare MEN IIb type. It is important to distinguish between the familial and sporadic cases, because membership of the former group implies the investigation of associated endocrinopathies (pheochromocytoma, hyperparathyreoidism) and study of the family tree as the syndrome is autosomal dominant. Medullary carcinoma of the thyroid is a constant feature of the MEN II syndrome and is the cause of premature death in these patients. The familial type should be suspected if the carcinoma appears early in life, is located in the superior pole of the thyroid or is bilateral or multicentric, if the histology shows hyperplasia of the C cells and, of course, if there is a history of surgery for pheochromocytoma or hyperparathyroidism. Although total thyroidecomy is the rule for these familial cases, its role is debatable in sporadic medullary carcinoma of the thyroid. Postoperative follow-up of these patients is based on serum calcitonin determination, as this is an extremely sensitive marker. The ten year survival rate is 50%, with the worst prognosis in MEN IIb type.

Adenoma↗
PubMed1983

[Treatment and prognosis of colo-rectal cancer. Study of 1357 cases].

This retrospective report deals with 1357 cases of colorectal cancer operated on in the last 26 years. It covers the main epidemiologic data, tumour locations, surgical approaches, follow-up and prognosis according to the extent of the cancer. The results are given for the entire period and then by fractions thereof, and it is thus possible to appreciate how the treatment and prognosis of colorectal cancer have evolved. Though a high proportion of advanced cancer has been observed throughout the period studied, progress has been made in early diagnosis in particular: an increasing number of patients (13.5%) are nowadays operated on for tumours in situ or Dukes A.

Adenocarcinoma↗
PubMed1982

[A rare variety of polyendocrine neoplasms: the MEN IIb and MEN III syndrome].

The MEN IIb syndrome is a rare form of multiple endocrine neoplasia, clearly defined more than 15 years ago, since which time more than 100 cases have been identified. It has a characteristic phenotype appearance which is unique and should permit more frequent diagnosis. The patient who is the subject of this study had passed through several different hospital departments without his very characteristic appearance being recognized or a diagnosis established. The marfanoid aspect of such patient is however very obvious, with kyphosis, skeletal asymmetry and funnel chest. The facial appearance of blunt features and thick lips is even more specific. The tongue and digestive mucosa are covered with small polypoid lesions which are submucosal ganglioneuromas. The visible presence of fine hyperplastic nerve fibres on the cornea is pathognomonic. This syndrome occurs sporadically but is generally transmitted genetically in an autosomal dominant manner. A medullary thyroid carcinoma, followed or preceded by pheochromocytoma (often bilateral), is associated with these dysmorphic signs. The tumours are themselves preceded by C-cell hyperplasia or adrenal medullary hyperplasia. The ganglioneuromas which predominate in the digestive tract exist from birth. The accompanying symptoms may, initially, be mistaken for inflammatory bowel disease. The prognosis is poor, since it relates to the evolution of the medullary thyroid carcinoma which is particularly malignant and presents at an early age. We have been following the course of this unusual disease of the APUD system in a young man, now aged 26 years, for over 2 years.

Adrenal Gland Neoplasms↗
PubMed1982

[Multifocal pulmonary bilharzioma due to Schistosoma mansoni].

A case of mixed schistosomiasis in an African female immigrant from Cameroon is reported. Schistosoma mansoni was found in a symptomatic double abscess of the lower lobe of the left lung (1981). S. haematobium was present in the stool and the rectal mucosa but the patient had no symptoms. In Africa the patient had been treated for urinary and intestinal bilharziosis with niridazole in 1979, at which time she did not present pulmonary symptoms. After her arrival to Switzerland (1980) she complained of thoracic pain and bloody purulent sputum. A solitary pulmonary infiltration in the left lower lobe and eosinophilia were noted. Tuberculosis was suspected and, despite negative bacillary findings, trial treatment with tuberculostatics was started. As a smaller infiltration appeared beside the first, left lower lobectomy was performed followed by niridazole treatment. The exceptional diagnosis of pulmonary bilharzioma should be considered in patients with a solitary pulmonary infiltration who come from an area endemic for bilharziosis or who show clinical or laboratory signs of a present or past bilharzial infection.

Adult↗
PubMed1982

[Urethral complications of severe fractures of the pelvis. (author's transl)].

Between 1975 and 1979, 282 fractures of the pelvis were treated in Centre Hospitalier Universitaire Vaudois' sixty-eight of these patients sustained severe fractures, with two or more rupture of the pelvic ring. Twenty-eight patients presented with hematuria (microscopic or macroscopic) and five others with urethral bleeding. Urethral bleeding is even more serious; in the present study, it was always associated with urethral rupture. These cases are discussed; mechanism, diagnosis and treatment of these injuries are described.

Adult↗
PubMed1981

[Study of 58 intrathoracic complications in 166 accidental or iatrogenic esophageal injuries].

In 58 patients among 166 cases of esophageal trauma who developed an intrathoracic complication, the cases are studied of 26 esophageal instrumental perforations, 10 vomiting or effort ruptures, 14 ingestions of foreign bodies (observed in a surgical unit), 5 corrosions by acids or alkalis and 3 esophageal injuries after closed chest trauma. Some complications occurred or were recognized after a delay of 1 to 16 days. In 22 cases treated after the second day, 9 patients survived and in 18 cases treated after 4 days, 6 patients nevertheless survived. The outcome is difficult to assess initially but hope must be entertained even in the most severe cases. The discussion focuses on symptoms and signs, modes of clinical presentation and the different types of fistulas (4 intramural, 31 esophago-mediastinal, 15 esophago-pleural, 5 esophago-tracheal, 1 esophago-aortic, 1 esophago-pericardial). Treatment varies with the delay in diagnosis and is often complex. In cases requiring reoperation the mortality is very high.

Accidents↗
PubMed1981

[Gardner syndrome. Genetic aspects of 7 cases in 3 families].

Gardner's syndrome, a hereditary affection of the bastoderm layers, is rarely recognized though it is seen in 8-16% of cases of colorectal polyposis. Seven cases (4 female and 3 male) of Gardner's syndrome in 3 families are presented. Six of the patients belonged to 2 families, several members of which suffered from familial polyposis; the seventh case was an isolated case of Gardner's syndrome without a family history of polyposis. Because of the high risk of malignancy in the presence of polyps, the treatment of Gardner's syndrome is identical to that of familial polyposis. Four patients underwent total colectomy and 2 simple polypectomy. One refused all treatment or monitoring. From these patients, one of the polyps excised from the rectum was found to be undergoing malignant transformation. The extracolic symptoms of this condition precede polyposis within the gut; they attract attention and thus permit early diagnosis.

Adult↗