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Biomedical subjects

G Etienne

Publications and source records attributed to G Etienne.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Technique and results of cryo-stripping in the treatment of varicose veins of the lower limbs].

UNLABELLED: Stripping of varicose veins, a reference method, causes postoperative pain and sometimes dysesthesia due to saphenous nerve damage. Ankle wound healing is sometimes painful and often unaesthetic. Invaginated stripping eliminates some of the drawbacks, but keeps the lower wound and must be left in the case of recurrent saphenous rupture. Those two techniques do not allow total saphenous resection in the case of infected ulcers. Cryosurgery can be used regardless of the state of the ankle skin. It allows a complete invaginated stripping without ankle wound. METHODS: Over a 9-year period, 6157 limbs (3255 patients) underwent cryosurgery for varicose veins. The indication in 88% of cases was based on functional or aesthetic reasons and in 7% of the cases, hypodermitis, in 3% ulcerations and in 2% superficial venous thrombosis. RESULTS: Postoperatively, a single case of sural phlebitis was observed. Frequency and intensity of pain and hematomas are decreased. Thanks to this technique, the lower incision can be avoided thus giving better aesthetic results. CONCLUSION: Cryosurgery for varicose veins can be used in any circumstances. It has a similar efficacy to the stripping technique. Aesthetic and functional results are better. It is an important improvement especially in case of ulceration.

Cryosurgery↗
PubMed1996

[Non-deployment of branches of a vena cava filter. Elements of prevention].

Non-deployment of an L.G.M. percutaneous vena cava filter is rare. The aim of this paper is to report a new case of this complication. A second filter was inserted between the non-deployed filter and the renal veins to prevent proximal migration of the transvenous interruption device to the pulmonary artery or the right side of the heart, and to guarantee an effective prophylaxis of further pulmonary embolization. Two years later, the vena cava was still patent. The best way to avoid this accident is a perfect insertion technique: after a preoperative cavography to check diameter and patency of the vena cava, the filter must be deployed by retracting the introducer sheath while maintaining the position of the inner canula, and not pushing the filter out of the introducer sheath. A second filter must always be available in the operating room in case of incomplete opening of the filter. The use of vena cava filter is not devoid of risks. Restricted indications are therefore recommended.

Aged↗
PubMed1995

[Cryo-stripping: an advance in the treatment of varicose veins. 3811 operated limbs].

OBJECTIVES: Stripping varicose veins can cause invalidating durable dysaesthesia in 25% of the cases due to saphenous vein damage. Postoperative varicosis is also frequently encountered. Cicatrization may be inaesthetic at the ankle and the operation may even be impossible due to infected ulcerations. Alternative methods are therefore needed. Cryosurgery using a freezing probe can be used to remove the entire saphenous vein via the inguinal incision alone. METHODS: Over a 6 year period, 2,009 patients (3,811 members) underwent cryosurgery for varicose veins. The indication in 88% of the cases was based on functional or aesthetic reasons and in 7% hypodermitis, in 3% ulcerations resistant to medical treatment and in 2% superficial venous thrombosis. RESULTS: Postoperatively, a single case of sural phlebitis was observed (0.02%). Dysaesthesia occurred in the saphenous nerve territory in 2% of the cases and resolved in a few months. Functional signs present preoperatively had disappeared within one month of surgery in 98%. The aesthetic result was excellent since there is no scar tissue on the limb excepting the inguinal incision and since postoperative varicosis was rare (0.1%). All varicose ulcerations had healed in less than 3 months of surgery and no case of deep vein failure was observed. CONCLUSION: Cryosurgery for varicose veins is as effective as the stripping procedure and avoids certain complications. The aesthetic result and functional results are better. Cryosurgery is an important progress in the treatment of varicose veins of the lower limbs, especially in case of ulcerations.

Adolescent↗
PubMed1995

[Varicose liposclerosis amd ulcers: importance of cryo-stripping].

Varicose veins stripping is often a difficult procedure when lipodermatosclerosis or ulcers are present, because malleolar incision is impossible. On the contrary, cryo-stripping is performed by a single incision of the groin or the popliteal fossa. A cryroprobe is inserted into the vein lumen, after ligating and interrupting the sapheno-femoral or popliteal junction. The lower saphenous extremity is frozen. The vein is broken and returned inside-out by removing the cryo-probe upwards. Upon 3,811 legs operated on from 1988 to 1994, there were 265 liposclerosis and 114 ulcers. Deep venous insufficiency was associated 43 times. In less than three months, all but six ulcers were healed. These six patients suffered from post phlebitic syndrome. Cryo-stripping is an efficient method in the treatment of unhealing infected ulcers or severe venous lipodermatosclerosis.

Adult↗
PubMed1995

[Pulmonary plasmacytoma. Apropos of a case. Review of the literature].

A 65 old man had a solitary primary pulmonary plasmacytoma. Serum immunoelectrophoresis revealed an immunoglobulin G Lambda M-protein. Screening for multiple myeloma with bone marrow biopsy and skeletal survey were negative. The patient underwent left lower lobectomy associated with resection of mediastinal lymph nodes. Immunoperoxydase staining of the mass revealed a monoclonal plasma cell population producing IgG, Lambda chains. No adjuvant chemotherapy or radiation therapy was performed. In few weeks, the paraprotein durably disappeared. Four years later, the patient is well and has no evidence of recurrence or myelomatosis. Authors emphasize the rarity of this tumor. The best treatment of pulmonary plasmacytoma is discussed.

Aged↗
PubMed1994

Carotido-brachial artery bypass for radiation induced injury of the subclavian artery. The value of a lateral mid-arm approach.

Symptomatic subclavian artery damage, following radiation for breast or head and neck cancer, is very rare. We report three new cases in which arterial insufficiency of the upper limb developed respectively 3, 36, and 27 years after irradiation for breast cancer in two cases and tumor of the clavicle in one case. Patients were treated by saphenous vein by-pass using a new extra-anatomic route from the carotid to the brachial artery. They were two main differences from the classical carotido-brachial by-pass. The brachial artery was approached by a lateral mid-arm incision between the biceps and the humeral bone, and the grafts were tunnelled, subcutaneously, laterally on the medial head of the deltoid muscle avoiding the hump of the clavicle, and then between the biceps and the humeral bone. The postoperative courses were uneventful with good healing of the wounds. All grafts remained long-term patent and no compression was detected by ultrasound and arteriogram. This new technique of extra-anatomic carotido-brachial by-pass is a safe and efficient alternative to treat radiation induced injury of the subclavian artery.

Adult↗
PubMed1993

CL307-24, a new antibiotic complex from Saccharopolyspora aurantiaca sp. nov. II. Physico-chemical and biological properties.

CL307-24I, the main component of the CL307-24 complex produced by Saccharopolyspora aurantiaca sp. nov., was found to be a potent inhibitor of yeast mitochondrial ATPase. CL307-24I displayed a high degree of activity towards some coryneform bacteria and also has been shown to possess an insecticidal activity. Its biological and physico-chemical properties clearly distinguish it from previously known ATPase inhibitors.

Adenosine Triphosphatases↗
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↗