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Biomedical subjects

G Beauchamp

Publications and source records attributed to G Beauchamp.

At least 55 records · Page 3Linked to original sources
PubMed1991

Clinical spectrum of bronchogenic cysts of the mediastinum and lung in the adult.

Bronchogenic cysts are closed sacs considered to be the result of an abnormal budding of the respiratory system. They are lined by ciliated epithelium and have focal areas of hyaline cartilage, smooth muscle, and bronchial glands within their walls. They are seldom seen in the adult, and most are thought to be asymptomatic and free of complications. During a 20-year period, 86 patients underwent resection of a bronchogenic cyst of the mediastinum (66 patients) and lung (20 patients). There were 47 women and 39 men whose ages ranged from 16 to 69 years. Seventy-two percent of patients (67% with mediastinal cysts and 90% with cysts of the lung) were symptomatic at the time of operation, and the majority had two or more symptoms. Despite extensive investigations, which in some cases included computed tomographic scanning (n = 12) and angiography (n = 22), a positive diagnosis was never made preoperatively even if it was suspected in 57% of patients. In nearly all patients, the operative approach was that of a posterolateral thoracotomy. All but two mediastinal bronchogenic cysts could be locally excised, but all bronchogenic cysts of the lung required pulmonary resection (lobectomy, 13; limited resection, 6; pneumonectomy, 1). Major operative difficulties were encountered in 35 patients, all of whom were symptomatic preoperatively. Thirty-three patients had a complicated cyst; the complications consisted of fistulization (n = 16), ulcerations of the cyst wall (n = 13), hemorrhage (n = 2), infection without fistulization (n = 1), and secondary bronchial atresia (n = 1). Overall, 82% of patients had a bronchogenic cyst that was either symptomatic or complicated or both.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Surgical treatment of achalasia in a general hospital.

The authors report their experience with 43 patients treated for achalasia of the esophagus in a general hospital between 1971 and 1986. Patients were divided into two groups according to the type of surgery performed: group 1--29 patients treated by Heller myotomy, performed by nine general surgeons between 1971 and 1983; and group 2--14 patients treated by transthoracic Heller myotomy with the addition of a Belsey Mark-IV fundoplication. Dysphagia was reduced postoperatively in 82.6% of patients in group 1 and 92.8% of patients in group 2. Three patients in group 1 and one patient in group 2 had persistent dysphagia. Ten patients in group 1 had symptoms of gastroesophageal reflux (5 of them required a second antireflux procedure). In group 2, one patient had symptoms of gastroesophageal reflux, but was treated successfully medically. There was no difference in the degree of relief of dysphagia between the abdominal and thoracic approach, or in whether the operation was performed by a general surgeon without specific experience in the treatment of achalasia. The addition of a fundoplication to a Heller myotomy appeared to lessen the problem of postoperative gastroesophageal reflux. Since the Heller myotomy is technically difficult and may lead to obstruction of the poorly emptying esophagus the authors recommend that it be used selectively and only by the experienced esophageal surgeon.

Adolescent↗
PubMed1991

Bronchial carcinoids: long-term prognostic factors.

Between 1962 and 1987 bronchial carcinoids were diagnosed in 41 patients (21 men, 20 women) at l'Hôpital du Sacré-Coeur and the Centre hospitalier Maisonneuve-Rosemont. The patients ranged in age from 19 to 73 years (mean 47 years). Fourteen of the 19 asymptomatic carcinoids were discovered on routine chest radiography. Twenty-two symptomatic patients presented with either pneumonia or hemoptysis. Tumours involved the right and left lungs equally. Thirty tumours were located centrally and 11 peripherally. Sensitivity of endoscopic biopsy specimens was 66%. No complications occurred during biopsy. Cytologic examination of sputum, lavage, brushing and transthoracic biopsy specimens was of no value in establishing the diagnosis. Thirty-seven patients underwent surgical resection: lobectomies (26, 3 with bronchoplasties), pneumonectomies (7), segmentectomies (2) and wedge resections (2). One patient (3%) died, and there was one major complication (3%) related to surgery. The mean follow-up was 8 years. The probability of survival was 97% +/- 3 at 5 years and 92% +/- 6 at 10 years. None of the 19 patients treated for a peripheral tumour died, but two patients who had centrally located tumours that exhibited transbronchial invasion and lymph-node metastasis died. No prognostic information could be gained from tumour size or type. A statistical association was found between transbronchial invasion and lymph-node metastasis. Bronchial carcinoids are low-grade malignant tumours. Resection should be conservative, but lymph-node involvement requires a more radical approach.

Adult↗
PubMed1990

Tricyclic antidepressants inhibit voltage-dependent calcium channels and Na(+)-Ca2+ exchange in rat brain cortex synaptosomes.

We have used a resting (5 mM K+) or depolarizing (60 mM K+) choline-based medium, and a nondepolarizing sodium-based or choline-based medium, to characterize the inhibitory potential of tricyclic antidepressants against the voltage-dependent calcium channels or the Na(+)-Ca2+ exchange process, respectively, in synaptosomes from rat brain cortex. Imipramine, desipramine, amitriptyline, and clomipramine inhibited net K(+)-induced 45Ca uptake with similar IC50 values (26-31 microM), and this uptake was also inhibited by diltiazem with an IC50 of 36 microM; these results indicate an inhibition of voltage-dependent calcium channels by tricyclic antidepressants. The net uptake of 45Ca induced by Na(+)-Ca2+ exchange was also inhibited by the four tricyclic antidepressants tested, but not by diltiazem; imipramine (IC50 = 94 microM) was a more potent inhibitor of this process than desipramine (IC50 = 151 microM), and the IC50 values of amitriptyline (107 microM) and clomipramine (97 microM) were similar to that of imipramine. Some degree (approximately 25%) of brain calcium channel blockade could be present at the steady-state concentrations of tricyclic antidepressants expected to occur therapeutic use of these compounds to treat depression or panic disorder.

Animals↗
PubMed1990

Endoscopic Nd:YAG laser therapy of malignant esophageal obstruction on an outpatient basis.

Between May 1985 and December 1988, 41 patients were treated palliatively with endoscopic neodymium:yttrium-aluminum-garnet laser therapy for obstruction of the esophagus by malignant disease. All were considered incurable, because they presented with distant metastases, severe systemic disease, extensive local disease or recurrent disease. Thirty-nine percent were managed as outpatients; the remainder required admission to hospital. Sixty-three percent of the outpatients had adenocarcinoma, and 31% had squamous cell carcinoma; over 90% of the tumours were less than 8 cm long, and 63% were in the distal one-third of the esophagus or the cardia. Forty-four percent of the inpatients had adenocarcinoma, and 44% had squamous cell carcinoma; in this group, over 90% of the tumours were less than 8 cm long, and 56% were in the distal one-third of the esophagus or the cardia. The mean number of sessions and laser energy administered were 2.6 and 4949 J for outpatients and 2.7 and 4974 J for inpatients. Palliation of dysphagia was good to excellent in all outpatients but was not as good for the inpatient group, in which one major complication occurred. The mean length of survival for outpatients and inpatients was 6.3 months (range from 1 to 16 months) and 3.9 months (range from 1 to 18 months) respectively.

Adult↗
PubMed1989

Canine tooth size variability in primates.

I present an analysis of canine tooth size variability in male and female primates. The coefficient of variation (CV = SD X 100/mean) as an index of canine size variability proved to be dependent on mean canine size in males and, to a lower extent, in females. Therefore, variability tends to increase with increasing values of mean canine size. Using residuals from the regression of log SD on log mean canine size in male and female primates, I analysed the contribution of diet, habitat and mating system to canine size variability. Habitat and mating system are known to influence to a certain extent the degree of sexual dimorphism in canine size. Given the well-known relationship between sexual dimorphism and phenotypic variability, it was suggested that these factors might influence variability in canine size. Everything else being equal, males of polygynous species are characterized by more variable canine sizes than males of monogamous species. Habitat and diet did not contribute to the level of variability observed in either males or females. It is proposed that a high level of variability in canine size may be related to the likelihood that enlarged canines evolved as a result of male-male competition for mates in polygynous species.

Animals↗
PubMed1987

Comparison of technetium-99m sulfur colloid and technetium-99m albumin colloid labeled solid meals for gastric emptying studies.

A Tc-99m albumin colloid (Tc-AC) kit has been introduced as an alternative to Tc-99m sulfur colloid (Tc-SC) for liver-spleen imaging. Since there is no need for boiling, the use of Tc-AC reduces preparation time and manipulation. Tc-SC is one of the most commonly used radiopharmaceuticals for the labeling of solid-phase markers in gastric emptying studies. In vitro studies were performed to evaluate the labeling efficiency and stability in hydrochloric acid and in human gastric juice of intracellularly labeled chicken liver and scrambled eggs labeled with Tc-SC and Tc-AC. Gastric emptying studies also were performed on 20 healthy volunteers with both Tc-SC and Tc-AC labeled scrambled egg sandwiches. There was no significant difference between Tc-SC and Tc-AC in the labeling efficiency of chicken liver (98% +/- 1% for Tc-SC, 96% +/- 2% for Tc-AC) and scrambled eggs (92% +/- 2% for Tc-SC, 91% +/- 3% for Tc-AC). However, both Tc-SC and Tc-AC labeled scrambled eggs showed a lower stability than chicken liver, particularly in human gastric juice. Gastric emptying curves from both meals in 20 normal subjects were also similar, with a mean half-emptying time of 85 +/- 13 minutes and 87 +/- 16 minutes for the meals containing Tc-SC and Tc-AC respectively. Tc-AC is a reliable alternative to Tc-SC as a radiotracer for solid-phase gastric emptying studies.

Adult↗
PubMed1987

[Palliative treatment of cancer of the esophagus using an endoluminal prosthesis].

Between 1973 and 1984, 27 patients with a cancer of the esophagus or the cardia and suffering dysphagia underwent palliation with an endoluminal prosthesis. Intubation under esophagoscopy or through a gastrotomy, or both, allowed the placement of 23 Celestin tubes and 4 Mousseau-Barbin prostheses. The early postoperative death rate was 11%. The overall morbidity was 37%. It included such complications as tube displacement (18.5% of patients), tracheal compression by the tube (7.4%), obstruction of the prosthesis (11%), esophageal fistula (7.4%), aspiration (7.4%) and wound infection (7.4%). The ability to swallow was acceptable in 24 patients.

Adult↗
PubMed1986

Comparative evaluation of technetium-99m glucoheptonate and gallium-67 citrate thoracic imaging in detection of mediastinal and hilar involvement in primary lung cancer.

Fifty-two patients with proven primary lung cancer who were referred for mediastinoscopy were prospectively studied with Tc-99m glucoheptonate and Ga-67 citrate thoracic scintigraphy. Primary lung tumors concentrated Ga-67 in 92% of cases, compared to 88% for Tc-99m glucoheptonate. Mediastinoscopy confirmed the presence of mediastinal metastases in 23 patients. The sensitivity of Tc-99m glucoheptonate and Ga-67 scans for mediastinal involvement detection is respectively 52% and 83%, for a specificity of 100% (Tc-99m glucoheptonate) and 88% (Ga-67). Twenty-nine patients underwent thoracotomy after a negative mediastinoscopy. Hilar metastatic involvement was present in eight patients. The sensitivity and the specificity for detection of hilar involvement were respectively 63% and 95% for Tc-99m glucoheptonate and 88% and 78% for Ga-67. Although more specific than Ga-67 scan, Tc-99m glucoheptonate thoracic imaging cannot be recommended in the staging of lung cancer because of its low sensitivity in the detection of intrathoracic metastatic spread of primary lung carcinoma.

Adenocarcinoma↗
PubMed1986

Nuclear medicine and esophageal surgery.

The principal radionuclide procedures involved in the evaluation of esophageal disorders that are amenable to surgery are illustrated and briefly described. The role of the radionuclide esophagogram (RE) in the diagnosis and management of achalasia, oculopharyngeal muscular dystrophy and its complications, tracheoesophageal fistulae, pharyngeal and esophageal diverticulae, gastric transposition, and fundoplication is discussed. Detection of columnar-lined esophagus by Tc-99m pertechnetate imaging and of esophageal carcinoma by Ga-67 citrate and Tc-99m glucoheptonate studies also is presented.

Barrett Esophagus↗
PubMed1986

Extramedullary plasmacytoma associated with angiofollicular lymph node hyperplasia.

We report a case of hyaline-vascular type of angiofollicular lymph node hyperplasia involving the left pulmonary lymph nodes and lung. It clinically presented as an obstruction of the left lower lobe main bronchus secondary to the development of an extramedullary plasmacytoma in the lesion. An immunoperoxidase stain revealed a monoclonal IgG-lambda pattern of the tumor, contrasting with the polyclonal plasma cell population of the angiofollicular lymph node hyperplasia. This case demonstrates the neoplastic potential of angiofollicular lymph node hyperplasia.

Antibodies, Monoclonal↗
PubMed1986

[Physiopathology and surgical correction of gastroesophageal reflux: review of the issues].

The authors review the pathophysiology of gastroesophageal reflux, pointing out the predominant role of the lower esophageal sphincter in antireflux mechanisms. The diagnosis of gastroesophageal reflux must be based on the results of detailed examination and other tests of which endoscopy and esophageal pH monitoring are the most important. The authors describe how to manage operation for gastroesophageal reflux so as to prevent complications. Although the Hill, Belsey and Nissen operations, referred to as valvuloplasties, have proved their effectiveness in curing gastroesophageal reflux, a review of the literature shows that better results are achieved by Nissen total fundoplication.

Esophagogastric Junction↗