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Biomedical subjects

G Etienne

Publications and source records attributed to G Etienne.

At least 19 recordsLinked to original sources
PubMed1991

Thoracic outlet syndrome caused by tumor of the first rib.

We report a new case of thoracic outlet syndrome caused by a tumor of the first rib and review 11 other reports found in the literature. A 25-year-old man was admitted with thoracic outlet syndrome in the C8-T1 nerve roots. The first rib was removed through a supraclavicular approach with excision of the medial clavicle. All symptoms disappeared. On histologic examination fibrous dysplasia was found in the rib. Tumors of the first rib are uncommon and are rarely responsible for thoracic outlet syndrome. When the tumor is very large, as in our case, we recommend a supraclavicular approach associated with excision of the medial clavicle. During the liberation of the brachial plexus, great care should be exercised to avoid nerve injuries. Because malignancy of the tumor cannot be eliminated with certainty before or during the operation, wide excision of the entire rib is recommended.

Adult↗
PubMed1991

A screening method to identify antibiotics of the aminoglycoside family.

A simple and selective screening method was developed for detecting new aminoglycoside (AMG) antibiotics from actinomycetes strains propagated on solid culture media. The first phase of the screening program is designed to isolate AMG-type activities using: 1) two Serratia marcescens strains, one susceptible and one resistant to AMGs, 2) the high tolerance of AMGs to heat in acidic solutions and 3) the specific resistance of a streptothricin producing strain of Streptomyces lavendulae to streptothricin antibiotics. The second phase of the screening program identifies already known AMG antibiotics through the characteristic spectrum of action which each AMG shows toward a group of bacterial strains synthesizing various AMG-inactivating enzymes.

Actinomyces↗
PubMed1991

[Early prognostic factors of the surgery of aneurysms of the abdominal aorta with renal artery clamping].

The aneurysms of the abdominal aorta requiring suprarenal clamping are rare. Suprarenal clamping was required for only 43 of 544 aneurysms operated electively from 1981 to 1989. Twenty-five patients had a juxtarenal aneurysm, without any normal aortic segment under the renal arteries, and suprarenal clamping was therefore necessary while the upper anastomosis was being established (group I). Eighteen patients had an aneurysm enclosing the root of at least one renal artery (group II). Several prognostic factors have been assessed: patient's age, presence of preoperative renal insufficiency, of arterial hypertension or of coronary insufficiency, and revascularization method. Five patients died. Four of them belonged to group II and were over 75 years old. All presented with a preoperative renal insufficiency. Two of these deaths were caused by mesenteric infarction. Four cases of regressive postoperative renal insufficiency were observed in patients for whom renal clamping had lasted longer than 45 minutes. This study allowed outlining three prognostic factors: the patient's age, preoperative renal insufficiency, a period of renal ischemia exceeding 40 minutes. On the other hand, the severity of hypertension had no predictive value. Coronary insufficiency requires a strict hemodynamic surveillance, but is not a contraindication for revascularization.

Age Factors↗
PubMed1991

[Sub-crural bypasses via saphenous vein in situ. Predictive factors of early occlusion].

Twenty-six early occlusions were encountered in a series of 155 infrainguinal saphenous vein bypasses for arterial disease. By univariate and logistic regression analysis, two predictive factors were found to be strongly associated with early occlusion: vein fibrosis (F) and uncorrected intraoperative arteriographic anomaly (A). Regression coefficients were 0.775 +/- 0.343 for F and 1.125 +/- 0.352 for A. The probability (p) of early occlusion of bypass is: [formula; see text] (Exp = Exponent) The vein diameter, the quality of run-off, the site of anastomosis and the length of the bypass were not predictive of early occlusion. We conclude that 1) the presence of fibrous ipsilateral saphenous vein should prompt using the contralateral vein, and 2) routine intraoperative arteriograms of the entire length of the bypass should be obtained: any anomaly visible on the intraoperative films should be corrected immediately, even if it seems minute or if bypass flow seems otherwise adequate.

Adult↗
PubMed1990

[Role of surgery in the treatment of diffuse hyperthyroidisms].

A prospective study was set up to help in the choice of treatment for diffuse hyperthyroidism: antithyroid drugs, radioactive iodine or surgery? Over a 20-year period 477 patients with diffuse hyperthyroidism were operated upon and followed up every year. Early complications were uncommon; permanent functional sequelae, usually not troublesome, were observed in only 1.8 percent of the cases. The endocrine status obtained remained stable beyond 2 years in 98 percent of the patients. Ten years after surgery, failure or relapse were recorded in 3 percent of the cases, hypothyroidism in 27 percent and euthyroidism in 78 percent. These results appear to be better than those of the other methods reported in the literature. Antithyroid drugs expose to relapse in 50 percent of the cases. With radioactive iodine, the cumulative incidence of hypothyroidism is 3.6 percent per year and 100 percent in 30 years. The recent preference for non-surgical therapeutic methods does not seem to be soundly founded. Except when diffuse hyperthyroidism occurs in adolescents or in elderly or high surgical risk adults, surgery performed by a well-trained multidisciplinary team deserves to be considered.

Adolescent↗
PubMed1990

A screening method for antifungal substances using Saccharomyces cerevisiae strains resistant to polyene macrolides.

Strains of Saccharomyces cerevisiae FL200 capable of growing on a solid medium containing a mixture of polyene macrolide antibiotics (nystatin, 40 micrograms/ml, amphotericin B, 40 micrograms/ml, pimaricin, 150 micrograms/ml and RP9971 antibiotic, 10 micrograms/ml) have been isolated after successive selection steps. The mutant strains, PR13 and PRC24, are 10 to 100 times more resistant than the polyene macrolide antibiotics. When 4% Tween 80 is added to the medium, resistance to these antifungal drugs is further increased. In addition, strain PRC24, derived from strain PR13, is resistant to a non-polyene macrolide antifungal antibiotic, cycloheximide. In contrast, PR13 and PRC24 are both highly susceptible to a large range of compounds, including non-polyenic antifungal, antitumor and antibacterial agents. These particular characteristics make these strains useful for the rapid detection of antifungal compounds of the polyene macrolide and cycloheximide types, as well as for the recognition of antimitotic substances.

Anti-Bacterial Agents↗
PubMed1990

[Postoperative vascular infections. A pathognomonic x-ray computed tomographic sign].

The potential gravity of post-operative vascular infection makes early diagnosis essential. We report a case where this diagnosis was made on CT findings alone, in the absence of any other signs of infection. Rapid intervention led to complete cure. Beyond the immediate post-operative period, the presence of gas on the CT scan is rare but pathognomonic in the absence of a cutaneous fistula. The presence of this sign is therefore sufficient to indicate that reintervention is mandatory.

Aged↗
PubMed1990

[Surgical treatment of associated bronchial, upper respiratory and digestive tract cancers].

Between 1980 and 1987, 63 lung cancers associated with upper aero-digestive tract carcinomas were operated on 50% of the primary malignancies of the upper aero-digestive system were laryngeal. These tumors developed synchronously in 13% and metachronously in 87%. The operative mortality rate was 3%. The five years survival rate was 30%. Our results were found identical to those observed in a single lung cancer series. Coin lesion of the lung should be therefore considered as a second primary cancer. Thus, the best treatment is surgical resection. When the option exist, the lung cancer should be treated before the upper airway cancer to avoid the impact of previous irradiation and/or surgical treatment of the upper airway cancer upon the post-thoracotomy management.

Adult↗
PubMed1990

[Esophago-bronchial fistula in adults].

The authors report five cases of benign oesophago-bronchial fistula in adults. These chronic bronchitic patients presented with recurrent episodes of secondary lung infections (or even haemoptysis). Questioning of the patients revealed a history of coughing when swallowing liquids in three cases. Two women concealed this symptom, which was only revealed retrospectively. The fistula was detected by upper GI series in three cases and by oesophageal fibroscopy in one case. In the remaining case, it was discovered at operating for severe haemoptysis. In four of the five cases, the fistula was situated on the right and was of post-tuberculous origin. In one case of post-traumatic fistula, it involved the left main bronchus. All of the patients were operated: a resection-suture of the fistula was performed via the oesophageal approach and, via the bronchial approach, simple suture of the fistula was possible in two cases, while resection of the destroyed pulmonary parenchyma was necessary in three cases (one right lower lobectomy, two bilobectomies). Demonstration of the oesophago-bronchial fistula, definition of its site and assessment of the condition of the pulmonary parenchyma are essential steps to be performed prior to surgery.

Adult↗
PubMed1990

[Natural and corrected history of obliterative radiation arteritis. Apropos of 14 case reports].

Analysis of a series of 14 cases of obliterative radiation arteriopathy was carried out in order to study the clinical features, symptomatology and the results of appropriate therapy. This demonstrated that the diagnosis is often missed due to the time interval since radiation and that on the contrary the diagnosis should only be considered in precise circumstances in terms of the delay and localisation superimposed on the irradiated zone with respect of other non-irradiated zones. Diagnosis requires double investigation both in terms of the arterial disease and associated post-radiation lesions and also in terms of the malignant disease, its progression and treatment. Arterial surgery is fraught with difficulty due to sclerosis and other specific problems: skin closure problems, and in the case of a prosthesis, anastomotic breakdown and superinfection. These dangers should not be underestimated even if in the series presented there were no serious postoperative complications. The indication for surgery should therefore be carefully considered: best avoided in asymptomatic forms, dilatation for short lesions and revascularisation for widespread and symptomatic lesions, while choosing the most appropriate revascularisation procedure. Radiation arteritis should be better understood by radiotherapists who should pay attention to preventive measures and advise systematic screening after three years.

Adult↗
PubMed1989

[Treatment of hydrothorax in patients with cirrhosis using a peritoneo-jugular shunt].

Two cirrhotic patients with massive hydrothorax associated with ascites resistant to medical management were treated by insertion of peritoneovenous shunt. In each case the hydrothorax resolved within 2 to 4 months after shunt insertion. This treatment was still successful 10 to 26 months after surgery. The peritoneovenous shunt is an alternative to medical therapy for large effusions. Its effectiveness in resolving them supports the idea that diaphragmatic defects are involved in their formation.

Adult↗
PubMed1989

[Bronchial cancer associated with upper respiratory and digestive tract cancers].

The authors report a series of 63 cases, all operated, of bronchial cancer associated with upper airway cancer. The laryngeal portion of the upper airways was the site of cancer in 50% of cases. The two cancers occurred synchronously in 13% and at different times in 87% of cases. Operative mortality was 3%. Post-operative complications were dominated by bronchopulmonary congestion. Long-term survival was similar to that in series of operated bronchial cancer alone and was 70% at one year and 30% at five years. These results should lead to all isolated pulmonary lesions being considered as second primary cancers with early surgical resection being proposed.

Adult↗